Selective aphasia and focal hypoperfusion in a bilingual patient with HaNDL syndrome
The syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL) is a rare disease (1) characterized by a benign, self-limited headache syndrome accompanied by neurological deficits (isolated aphasia can be seen in nearly 22% of these patients (2)). Differe...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-09-01
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| Series: | eNeurologicalSci |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405650220300381 |
| Summary: | The syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL) is a rare disease (1) characterized by a benign, self-limited headache syndrome accompanied by neurological deficits (isolated aphasia can be seen in nearly 22% of these patients (2)). Differential diagnosis between acute ischemic stroke and HaNDL syndrome has to be made in order to decide whether to perform a lumbar puncture or start reperfusion treatment early. CT perfusion have proved to be useful for differential diagnosis (3). We present a case of a HaNDL patient referred to the Emergency Department as a stroke in the context of acute onset of selective aphasia (Spanish) in a bilingual patient (French-Spanish). Urgent CT perfusion during the episode revealed increased mean transit time (MTT) with normal Cerebral Blood Flow (CBF) in posterior language areas. The case provides information on a HaNDL attack and its pathophysiology with hemodynamic changes in the acute period during the episode and the benign condition of the illness. |
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| ISSN: | 2405-6502 |