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Granulomatous Diseases of the Central Nervous System
AbstractPurpose of ReviewTo discuss the pathophysiology, key clinical features, necessary diagnostic evaluation, and current treatment regimens for granulomatous diseases of the central nervous system.Recent findingsThe diagnosis and management of granulomatous disease of the central nervous system has been revolutionized by advances in diagnostic imaging. Nevertheless, tissue and/or cerebrospinal fluid (CSF) sampling remains necessary to establish the diagnosis in most cases. Establishing a specific diagnosis is critical because treatment selection needs to focus on the granulomatous process centering on either an...
Source: Current Neurology and Neuroscience Reports - February 9, 2022 Category: Neuroscience Source Type: research

Post-traumatic Headache: Pharmacologic Management and Targeting CGRP Signaling
AbstractPurpose of ReviewPost-traumatic headache is a common sequela of injury to the head and/or neck. Here, we review the current approach to pharmacologic management of post-traumatic headache and explore the therapeutic promise of targeting calcitonin gene –related peptide signaling to address unmet treatment needs.Recent FindingsThe scarcity of data from controlled trials has left clinicians to rely on mainly expert opinion for the pharmacologic management of post-traumatic headache. The current view is that a phenotype-guided approach should be used, in which patients are treated according to the primary headache p...
Source: Current Neurology and Neuroscience Reports - February 9, 2022 Category: Neuroscience Source Type: research

Central and Peripheral Nervous System Complications of Vasculitis Syndromes From Pathology to Bedside: Part 1 —Central Nervous System
AbstractPurpose of ReviewThe aim of this review is to provide a comprehensive update on the clinical assessment, diagnosis, complications, and treatment of primary central nervous system vasculitis (PCNSV).Recent FindingsThe developments in neuroimaging, molecular testing, and cerebral biopsy have enhanced clinical assessment and decision making, providing novel insights to prevent misdiagnosis increasing diagnostic certainty. Advances in imaging techniques visualizing the wall of intracranial vessels have improved the possibility to distinguish inflammatory from non-inflammatory vascular lesions. Large recent studies have...
Source: Current Neurology and Neuroscience Reports - February 9, 2022 Category: Neuroscience Source Type: research

Mobile Stroke Units: Current Evidence and Impact
AbstractPurpose of ReviewSeveral approaches have been developed to optimize prehospital systems for acute stroke given poor access and significant delays to timely treatment. Specially equipped ambulances that directly initiate treatment, known as Mobile Stroke Units (MSUs), have rapidly proliferated across the world. This review provides a comprehensive summary on the efficacy of MSUs in acute stroke, its various applications beyond thrombolysis, as well as the establishment, optimal setting and cost-effectiveness of incorporating an MSU into healthcare systems.Recent FindingsMSUs speed stroke treatment into the first “...
Source: Current Neurology and Neuroscience Reports - February 7, 2022 Category: Neuroscience Source Type: research

Advances in Immunotherapies for Gliomas
This article summarizes the current clinical trials underway by evaluating the leading immunotherapy paradigms, the encountered barriers, and the future directions needed to overcome such tumor evasion.Recent FindingsA limited number of phase III trials have been completed for checkpoint inhibitor, vaccine, as well as gene therapies, and have been unable to show improvement in survival outcomes. Nevertheless, these trials have also shown these strategies to be safe and promising with further adaptations. Further large-scale studies for chimeric antigen receptors T cell therapies and viral therapies are anticipated.SummaryM...
Source: Current Neurology and Neuroscience Reports - February 2, 2022 Category: Neuroscience Source Type: research

Moving Forward from the COVID-19 Pandemic: Needed Changes in Movement Disorders Care and Research
AbstractPurpose of ReviewThe COVID-19 pandemic has dramatically affected the health and well-being of individuals with movement disorders. This manuscript reviews these effects, discusses pandemic-related changes in clinical care and research, and suggests improvements to care and research models.Recent FindingsDuring the on-going COVID-19 pandemic, individuals with movement disorders have experienced worsening of symptoms, likely due to decreased access to care, loss of social connection, and decreased physical activity. Through telemedicine, care has moved out of the clinic and into the home. Clinical research has also b...
Source: Current Neurology and Neuroscience Reports - February 2, 2022 Category: Neuroscience Source Type: research

Tourette Syndrome Treatment Updates: a Review and Discussion of the Current and Upcoming Literature
This study aims to examine the treatments currently available for Tourette syndrome (TS) and to discuss evolving therapies, spanning behavioral, pharmacologic, complementary and alternative medicine, and neuromodulation approaches.Recent FindingsBehavioral therapies have undergone several modifications to improve accessibility, including transitioning to a virtual format which is particularly important in the current pandemic. There are several recent or ongoing pharmacologic studies that have shown promise including the selective D1 receptor antagonist ecopipam and various cannabinoid compounds. Adaptive DBS may enable th...
Source: Current Neurology and Neuroscience Reports - February 2, 2022 Category: Neuroscience Source Type: research

Endovascular Treatment of Acute Stroke
AbstractPurpose of ReviewIn the USA, around 30% of 795,000 strokes per year are due to proximal large-vessel occlusion, and these are a major cause of death and disability. We review the most recent advances regarding treatment of ischemic stroke amenable to mechanical thrombectomy.Recent FindingsIn the last four years, clinical trial evidence has expanded the time window for successful endovascular treatment to 24 h. Current research is aimed at expanding patient selection to mild strokes, large ischemic cores and occlusions of smaller, more distal blood vessels. Further, we have developed understanding of how to manage...
Source: Current Neurology and Neuroscience Reports - January 31, 2022 Category: Neuroscience Source Type: research