Hilmar Krapf

In a prospective clinical investigation of 20 patients with primary Sjögren's syndrome (SS), neurological complications, not attributable to other diseases were detected in 14 patients (= 70%). Dysfunction of the peripheral nervous system (PNS) was nearly twice as frequent as central nervous system (CNS) complications. PNS involvement was dominated by symmetric sensory neuropathies, carpal tunnel syndromes, cranial nerve palsies (above all trigeminal sensory neuropathy) and pupillary dysfunction. CNS impairment was represented by cortical atrophy (n = 4), hemiparesis (n = 1) and aseptic meningitis (n = 1). Though CNS complications were rare, psychometric testing revealed diminished cognitive capacity in 14 patients. In addition to the characteristic sicca syndrome patients suffered from musculoskeletal pain and recurring abnormal sensation which frequently lead to the misdiagnosis of functional disorders. Additionally the frequent occurrence of psychiatric symptoms such as nervosity and depression support the impression of a psychosomatic pattern with no organic basis.

Hemiparesis

Depression

Aseptic meningitis

Peripheral Nervous System

10.1111/j.1600-0404.1994.tb01629.x

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Stentgestützte Angioplastie von Karotisstenosen

Clinical Neuroradiology (2002)

Hilmar Krapf Ulrike Ernemann Andreas Kastrup Helge Topka Martin Skalej

10.1007/s00062-002-2324-z

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Subarachnoid Hemorrhage due to Septic Embolic Infarction in Infective Endocarditis

Cerebrovascular Diseases (1999)

Hilmar Krapf Martin Skalej Karsten Voigt

During antibiotic therapy, a 56-year-old man with a Streptococcus bovis endocarditis developed an infarction of the right middle cerebral artery (MCA). Thirty hours after stroke onset, cranial computed tomography controls demonstrated a secondary subarachnoid hemorrhage, marked in the cistern of the right MCA. The latent period, cerebrospinal fluid analysis, angiographic and pathologic findings favor the assumption of a pyogenic arterial wall necrosis of the MCA due to a septic embolus. This pathomechanism of intracranial hemorrhage in infective endocarditis should be distinguished from a rupture of a mycotic aneurysm.

Infective Endocarditis

Embolus

Streptococcus bovis

Mycotic aneurysm

Stroke

10.1159/000015952

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