CSF inflammatory response after intraventricular hemorrhage
Conclusions:
Aseptic CSF inflammation after IVH is primarily dependent on the volume of initial bleed. Thrombolysis intensifies the inflammatory response, with no apparent detrimental effect on clinical outcome.
Clinicaltrials.gov identifier:
NCT00784134. (Source: Neurology)
Source: Neurology - October 9, 2017 Category: Neurology Authors: Fam, M. D., Zeineddine, H. A., Eliyas, J. K., Stadnik, A., Jesselson, M., McBee, N., Lane, K., Cao, Y., Wu, M., Zhang, L., Thompson, R. E., John, S., Ziai, W., Hanley, D. F., Awad, I. A., On behalf of the CLEAR III Trial Investigators Tags: Clinical trials Observational study (Cohort, Case control), Intracerebral hemorrhage ARTICLE Source Type: research
Relevance of supraventricular runs detected after cerebral ischemia
Conclusions:
Patients with cerebral ischemia and SV runs had more recurrent strokes and numerically more novel AF during follow-up and could benefit from further prolonged ECG monitoring. pAF detected after stroke is not a temporal phenomenon. (Source: Neurology)
Source: Neurology - October 9, 2017 Category: Neurology Authors: Weber-Krüger, M., Lutz, C., Zapf, A., Stahrenberg, R., Seegers, J., Witzenhausen, J., Wasser, K., Hasenfuss, G., Gröschel, K., Wachter, R. Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Clinical trials Observational study (Cohort, Case control), Cardiac ARTICLE Source Type: research
Franz Gerstenbrand, Dr med (1924-2017)
Franz Gerstenbrand was born on September 6, 1924, in Hof, North Moravia. He attended elementary and high school in Nikolsburg in Südmähren. In 1942, he was in the German armed forces, and after the Second World War he studied medicine at the University of Vienna, earning a doctorate in 1950. Under Hans Hoff, the head of the Department of Neurology of the University Hospital Vienna, he finished his specialization in neurology and psychiatry. At that time, his special interests were neurotrauma, prolonged coma after severe brain damage, spinal cord injury, and the early diagnosis of brain damage in child neur...
Source: Neurology - October 9, 2017 Category: Neurology Authors: Golaszewski, S. Tags: IN MEMORIAM Source Type: research
Striving to improve the quality of stroke care in the USA
Compelling evidence indicates that the organization and delivery of stroke care makes a difference in the chances of patients surviving, their level of disability, and the chances of further strokes. Most evidence-based interventions do not require expensive high-technology medicine but rather need well-organized basic care delivered by people with expertise in stroke. Yet there are many places in the world, including parts of the United States, where high-quality care cannot be guaranteed, resulting in higher than necessary levels of mortality and morbidity. (Source: Neurology)
Source: Neurology - October 9, 2017 Category: Neurology Authors: Rudd, A., Bray, B. Tags: EDITORIALS Source Type: research
HIV-related cognitive decline despite viral suppression and complex confounds in American women
In this issue of Neurology®, the Women's Interagency HIV Study (WIHS)1 presents a longitudinal analysis of its American cohort. The cohort is unique because it is large and representative of contemporary women with or at risk of HIV infection the United States. The cohort is ethnically diverse, composed of a substantial number who are economically disadvantaged, and includes participants with mental health issues, including alcohol/drug use (most women report past use of alcohol and recreational drugs, and between 7% and 18% are current users). There were few differences between the women who completed and those who di...
Source: Neurology - October 9, 2017 Category: Neurology Authors: Cysique, L. A., Becker, J. T. Tags: EDITORIALS Source Type: research
Preventing multiple sclerosis: To (take) vitamin D or not to (take) vitamin D?
Over 2 million persons worldwide have multiple sclerosis (MS),1 and the burden of the disease for affected individuals and society is substantial. A recent study estimated that by 2031, 133,635 Canadians would be living with MS, and that the direct costs of their care would reach a staggering $2 billion annually.2 Therefore, identifying modifiable risk factors for MS remains vitally important. Researchers still seek to firmly demonstrate a causal role for vitamin D, a biologically plausible etiologic factor which is modifiable. Vitamin D receptors are ubiquitous, being expressed on immune cells and in the CNS; immune respo...
Source: Neurology - October 9, 2017 Category: Neurology Authors: Marrie, R. A., Beck, C. A. Tags: Multiple sclerosis, Case control studies, Risk factors in epidemiology EDITORIALS Source Type: research
Some light in the shadows of atrial fibrillation and stroke: To look or not to look
In ischemic stroke, the diagnostic workup determines the best preventive strategy. However, cryptogenic stroke accounts for about 20%–40% of all strokes.1 For these patients, the best preventive treatment remains unknown, and most guidelines recommend risk factor modification and antiplatelet therapy. Given the substantial recurrence rate for cryptogenic stroke, this is not a comfortable situation: just try to tell your stroke patients, "After all these tests, I do not have any clue why you had a stroke"; and about the treatment, "Just take an aspirin and cross fingers you do not have another one." (Source: Neurology)
Source: Neurology - October 9, 2017 Category: Neurology Authors: Ustrell, X., Tagawa, M. Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Cardiac, Embolism EDITORIALS Source Type: research
Spotlight on the October 10 issue
(Source: Neurology)
Source: Neurology - October 9, 2017 Category: Neurology Authors: Gross, R. A. Tags: IN FOCUS Source Type: research
Teaching NeuroImages: Spinocerebellar ataxia type 3 presenting with a cock-walk gait phenotype
A 22-year-old woman presented with a 4-year history of progressive gait disturbance and slurred speech. Examination disclosed ataxia, nystagmus, pyramidal signs, bradykinesia, and feet dystonia with a cock-walk gait pattern (video at Neurology.org). There was no weakness of ankle dorsiflexion or plantar flexion. Family history was remarkable for ataxia. MRI showed mild pontocerebellar atrophy (figure). Genetic testing confirmed spinocerebellar ataxia type 3 (SCA3; 34/77 alleles). There were poor responses to levodopa, anticholinergic drugs, and botulinum toxin. (Source: Neurology)
Source: Neurology - October 9, 2017 Category: Neurology Authors: Rocha, E., Vale, T. C., Kok, F., Pedroso, J. L., Barsottini, O. G. Tags: Gait disorders/ataxia, Botulinum toxin, Basal ganglia RESIDENT AND FELLOW SECTION Source Type: research
Teaching NeuroImages: Giant cell arteritis presenting with acute ischemic strokes due to diffuse intracranial stenoses
A 72-year-old woman with unremarkable medical history was admitted with acute ischemic strokes (AIS) in multiple arterial distributions in anterior and posterior circulation (figure 1A and supplemental data at Neurology.org). Elevated erythrocyte sedimentation rate (98 mm/h) prompted the evaluation of superficial temporal arteries (STA) with duplex sonography (halo sign; figure 1B) and contrast angiography (right STA [figure 2A] and multiple intracranial arterial stenoses [figure 2, A–D]). STA biopsy confirmed the diagnosis of giant cell arteritis (GCA; figure 1, C and D). (Source: Neurology)
Source: Neurology - October 9, 2017 Category: Neurology Authors: Kargiotis, O., Safouris, A., Petrou, V. N., Magoufis, G., Stamboulis, E., Tsivgoulis, G. Tags: MRI, Ultrasound, Vasculitis, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research
Teaching NeuroImages: Interferon-induced psoriasis flare in a multiple sclerosis case remits with dimethyl fumarate
A 26-year-old woman with a history of psoriasis diagnosed with relapsing-remitting multiple sclerosis (Expanded Disability Status Scale score 1) received SC interferon β-1a as first-line treatment. Interferon was discontinued 4 months later, following a dramatic psoriasis flare with plaques in upper and lower extremities (figure, A–C) and manifestation of Koebner phenomenon along abdominal injection sites (figure, C). Switch to oral dimethyl fumarate (DMF) resulted in complete remission within 14 months (figure, D–F), and the patient remained relapse-free for the last 3 years under DMF treatment. Our case ...
Source: Neurology - October 9, 2017 Category: Neurology Authors: Tsivgoulis, G., Papadimitropoulos, G. N., Katsanos, A. H., Zompola, C., Safouris, A., Kargiotis, O., Voumvourakis, K. Tags: Autoimmune diseases, Multiple sclerosis RESIDENT AND FELLOW SECTION Source Type: research
Clinical Reasoning: A 55-year-old man with rapidly progressive dementia and parkinsonism
A 55-year-old right-handed man presented with a history of rapidly progressive apathy and behavior changes, speech loss, bladder and bowel incontinence, and gait loss in the previous month. He had been diagnosed with depression 7 months before and tried to commit suicide with carbon monoxide poisoning 2 months before, needing treatment in a hyperbaric chamber, with a good recovery. He had no history of other comorbidities and an unremarkable family history. At the first neurologic evaluation at our department, he presented with marked apathy and mutism, pseudobulbar affect, marked frontal release signs, generalized rigidit...
Source: Neurology - October 9, 2017 Category: Neurology Authors: Tabuas-Pereira, M., Santana, I., Santo, G. C. Tags: Parkinson's disease/Parkinsonism, Executive function, All Cognitive Disorders/Dementia, Assessment of cognitive disorders/dementia RESIDENT AND FELLOW SECTION Source Type: research
Author response: Prolonged sleep duration as a marker of early neurodegeneration predicting incident dementia
We thank Dr. Munakomi for the letter regarding our recent article on prolonged sleep duration as a potential marker of early-onset neurodegeneration and subsequent dementia.1 We agree it is important to unpack the associations between sleep and Alzheimer disease (AD). The fascinating study by Xie et al.2 demonstrated that the rate of β-amyloid clearance is increased during sleep. However, the role of REM sleep or sleep hygiene in the neurodegenerative process is unclear. In the experiments of Xie et al.,2 sleep was characterized by an increased prevalence of delta wave activity, typical of deep sleep as compared with ...
Source: Neurology - October 2, 2017 Category: Neurology Authors: Pase, M. P., Westwood, A. J., Beiser, A., Jain, N., DeCarli, C., Himali, J. J., Auerbach, S. H., Seshadri, S. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
Letter re: Prolonged sleep duration as a marker of early neurodegeneration predicting incident dementia
I read with interest the article by Westwood et al.,1 which implicated prolonged sleep duration as a potential marker of early-onset neurodegeneration and subsequent dementia. There is possibly a pivotal role of fragmented, and thereby disturbed, sleep hygiene in patients with obstructive sleep apnea. These patients spend minimal time of their sleep in the REM phase, which is crucial for clearance of metabolic waste, especially β-amyloid plagues, through the paravascular pathways in the brain.2 This is accountable for early neurodegenerative processes. Further studies monitoring total time spent in each phase of sleep...
Source: Neurology - October 2, 2017 Category: Neurology Authors: Munakomi, S. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
Author response: Prolonged sleep duration as a marker of early neurodegeneration predicting incident dementia
We thank Liguori et al. for the interest in our article, which demonstrated an association between long sleep duration and incident dementia.1 We did not examine the underlying mechanisms; these require investigation. (Source: Neurology)
Source: Neurology - October 2, 2017 Category: Neurology Authors: Pase, M. P., Seshadri, S. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
