X-ray wrist showed an old ulnar styloid fracture. Nerve conduction study of the radial nerve was normal. He was switched from aspirin to clopidogrel and underwent rehabilitation. The cerebral peduncle should not be forgotten when attempting to anatomically localise the site of the lesion when evaluating a patient with a wrist drop.We report the case of long-term follow-up of brain magnetic imaging of cerebral amyloid angiopathy. Cerebral amyloid angiopathy is often considered a major cause of spontaneous intracerebral hemorrhage in the elderly. This case illustrates the markedly progressive clinical and radiological features of the vasculopathic process in 10 years.Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a rare hereditary vasculopathy that primarily affects the brain, caused mostly by missense mutations of the NOTCH3 gene which is located on chromosome 19. Clinically, it manifests as transient ischemic attacks and strokes in individuals under the age of 60 years without vascular risk factors. We report a 46-year-old male with a 9 and 3-month history of progressive unilateral lower limb weakness and dysarthria, respectively. He had a history of diabetes mellitus but no hypertension, hyperlipidemia, or smoking history. Both parents had a stroke at the age of 65 years. Neurological examination was significant for moderate dysarthria and reduced right upper limb dexterity. Magnetic resonance imaging (MRI) of the brain revealed extensive white matter disease, lacunar infarcts, and a few microhemorrhages. Electron microscopy of his skin biopsy showed electron-dense deposits of extracellular osmiophilic granular material adjacent to smooth muscle cells. NOTCH3 gene analysis revealed a heterozygous typical mutation in exon 6.  https://www.selleckchem.com/products/ml385.html  He was commenced on aspirin and atorvastatin. Over time, he became more dysarthric and demented. MRI revealed the progression of the white matter disease and a new right subcortical infarct. His aspirin was switched to clopidogrel, and donepezil was added. CADASIL should be considered among younger stroke patients with vascular risk factors, especially in the presence of widespread white matter disease. Genetic counselling may be needed after the diagnosis is made.Cerebral embolism from a cardiac myxoma is a rare cause of ischaemic stroke. These emboli may later lead to the development of cerebral aneurysms. We report a case of delayed presentation of neurological manifestations in form of multiple intracranial aneurysms many years after treatment of a cardiac myxoma. Our patient, a 55-year-old right-handed female with a background history of hypertension, first presented at the age of 45 years with a sudden onset of right hemiplegia. A CT brain scan detected multiple infarcts in the territory of the left middle cerebral artery. Echocardiography revealed a cardiac myxoma for which she underwent immediate total surgical resection. Nearly 10 years after this diagnosis, she presented again with right-sided weakness and left ptosis. CT scan of the brain revealed bilateral acute superior cerebellar infarcts with interval evolution of previously known left cortical infarcts. MRI/MR angiogram showed multiple aneurysms arising from the bilateral middle, left anterior and left posterior cerebral arteries. She was managed conservatively. The management of multiple aneurysms with cardiac myxomas is highly debatable and dependent on the patient's presentation. This case highlights the importance to follow up on potential late extra-cardiac manifestations of the myxomas despite adequate resection.We report a 66-year-old female patient who presented with acute onset of visual loss with relative afferent pupillary defect, hemineglect, hemihypesthesia, and apraxia. Magnetic resonance imaging of the brain demonstrated different stages of ischemic stroke in different vascular territories, suggesting cardiogenic embolism. Past history was significant for advanced-stage adenocarcinoma of the uterine cervix under chemoradiation treatment. On echocardiogram, vegetation at the aortic valve was observed. With the absence of evidence of infectious endocarditis, diagnosis of nonbacterial thrombotic endocarditis was made, and the patient was treated by long-term anticoagulant. This case is unique in terms of the adenocarcinoma cell type of cervical cancer, which is uncommon and has been rarely reported to be related to nonbacterial thrombotic endocarditis.We report a case of acute middle cerebral territory ischemic infarction caused by left ventricular thrombus (LVT) in a doxorubicin cardiomyopathy patient. A major adverse effect of doxorubicin is cardiotoxicity. In doxorubicin cardiomyopathy, as the ventricular contractility decreases, LVT can occur and lead to systemic embolic events such as stroke.Subarachnoid hemorrhage (SAH) due to a solitary spinal aneurysm is extremely rare. Early diagnosis of spinal SAH is challenging, particularly when the spinal cord has not been compressed. We report a case of a 45-year-old male who presented with sudden onset of abdominal pain, followed by severe headache, vomiting, and generalized seizure. Three days after admission to the hospital, he developed progressive paraparesis. Magnetic resonance imaging (MRI) revealed spinal SAH with hematoma resulting in cord compression at the level of T9. Diagnostic spinal angiography identified a ruptured aneurysm of a radiculomedullary artery. In conclusion, rupture of a spinal aneurysm should be considered a possible cause of SAH in appropriate clinical settings, and clinicians must be aware of the possibility of cord compression.The current understanding is that small intracranial aneurysms ( less then 7 mm) are not at a significant risk for rupture. However, there have been several published series of rupture and subarachnoid hemorrhage from aneurysms less then 5 mm. Three cases of intracranial aneurysms rupturing at less then 3 mm are presented in this paper. Patient age ranged between 38 and 57 years. The aneurysms were located in different parts of the circulation in the brain. This case series highlights that the size criterion alone is not adequate when evaluating patients with unruptured brain aneurysms for observational follow-up or treatment.