Marfan Syndrome Presenting as Spontaneous Coronary Artery Dissection and Arteriopathy
Conclusion: Although rare, it is important to consider underlying connective tissue disorders in patients presenting with spontaneous coronary artery dissection and arteriopathy without underlying cardiovascular risk factors. (Source: The Neurologist)
Source: The Neurologist - January 1, 2022 Category: Neurology Tags: Case Report/Case Series Source Type: research

HSV-Encephalitis Resembling Acute Cerebral Infarction in a Patient With Atrial Fibrillation: Beware of Stroke Mimics
Conclusion: HSV-encephalitis might occasionally result in the development of unilateral brain MRI lesions with extensive cytotoxic edema, resembling an acute ischemic stroke. Therefore, HSV-encephalitis must be considered in the differential diagnosis of acute ischemic stroke with atypical presentation. The presence of a significant dissociation between the brain MRI lesion volume and the neurological deficits, as well as certain brain MRI imaging discrepancies might serve as “red flags” to extend the diagnostic workup. (Source: The Neurologist)
Source: The Neurologist - January 1, 2022 Category: Neurology Tags: Case Report/Case Series Source Type: research

Saturday Night Myelopathy: Flexion Myelopathy Related to Drug Intoxication
Conclusions: The clinician should consider the possibility of flexion-related myelopathy particularly in cases of drug intoxication or prolonged unconsciousness. Signal change within cervical musculature may provide additional clues and allow diagnosis in a timely manner. (Source: The Neurologist)
Source: The Neurologist - January 1, 2022 Category: Neurology Tags: Case Report/Case Series Source Type: research

Cause-Specific Mortality as a Sequalae of Perioperative Stroke Following Cardiac and Vascular Surgery
In this study, we aim to establish the risk of cause-specific mortality associated with perioperative stroke following cardiac and vascular procedures at 30 days, 90 days, and 1-year postoperative. It is hoped that this fund of knowledge will enhance perioperative risk stratification and medical management for patients who have suffered a perioperative stroke. Methods: This is a retrospective cohort study evaluating 277,654 cardiac and vascular surgical patients dually documented within the Inpatient Discharge Claims Database and the Pennsylvania Department of Health Death Statistics database. A univariate assessmen...
Source: The Neurologist - January 1, 2022 Category: Neurology Tags: Original Article Source Type: research

Randomized Controlled Trials for Neuromyelitis Optica Spectrum Disorder: A Review of Trial Architecture
Conclusions: Ethical considerations for the use of placebo should change in light of the approval of 3 therapies for seropositive NMOSD. Remaining challenges for clinical trials in NMOSD include the assessment of long-term safety and efficacy, standardization of trial design and endpoints, and head-to-head study designs. (Source: The Neurologist)
Source: The Neurologist - January 1, 2022 Category: Neurology Tags: Review Article Source Type: research

Posturographic Findings in Patients With Psychological Dizziness
Conclusion: Judging from scores in Romberg ratios using foam rubber and foam rubber ratios when eyes were closed, foam posturography might have the potential to differentiate PSY from PVD. (Source: The Neurologist)
Source: The Neurologist - January 1, 2022 Category: Neurology Tags: Original Articles Source Type: research

Simulation-Based Training Improves Fellows’ Competence in Brain Death Discussion and Declaration
Background: Despite well-defined American Academy of Neurology guidelines for death by whole brain criteria (brain death), there is marked variability in national practice, which some have attributed to lack of formal education. Further, communication with surrogates and families about brain death is integral to brain death declaration. As such, we developed a targeted brain death curriculum combining didactics and simulation-based education to improve examination and subsequent communication skills with families. Methods: Multidisciplinary critical care fellows participated in (1) didactic and case-based curric...
Source: The Neurologist - January 1, 2022 Category: Neurology Tags: Original Articles Source Type: research

Study on the Correlation Between Ischemic Leukoaraiosis and Cerebral Large Artery Stenosis Using the Stages of the Preinfarction Period Based on the Result of Computed Tomography Perfusion
Background and Objective: The influence of cerebral large artery stenosis (CLAS) on ischemic leukoaraiosis (LA) remains elusive. Based on the proposed stages of the preinfarction period, this study aimed to adopt the staging system to assess the correlation between ischemic LA and CLAS. Materials and Methods: Patients with unilateral CLAS ≥50% and without cerebral stroke were screened. The severity and distribution of stenosis were evaluated on computed tomography angiography images. The degree of regional cerebral perfusion was rated according to the stages of preinfarction period: 0=normal, 1=stage Ia, 2=st...
Source: The Neurologist - January 1, 2022 Category: Neurology Tags: Original Articles Source Type: research

Subacute Herpes Simplex Type 1 Encephalitis: Case Report With Literature Review: Erratum
No abstract available (Source: The Neurologist)
Source: The Neurologist - November 1, 2021 Category: Neurology Tags: Erratum Source Type: research

Lp-PLA2 Predicts the Risk of Ischemic Stroke: A Prospective Cohort Study in the Chinese Population
No abstract available (Source: The Neurologist)
Source: The Neurologist - November 1, 2021 Category: Neurology Tags: Letter to the Editor Source Type: research

Recurrence of COVID-19 in a Patient With NMO Spectrum Disorder While Treating With Rituximab: A Case Report and Review of the Literature
Conclusions: Our case raises the possibility of persistent virus shedding and reactivation of severe acute respiratory syndrome coronavirus-2 in a patient with NMOSD and rituximab therapy. We aimed to emphasize a precise consideration of management of patients with NMOSD during the COVID-19 pandemic. (Source: The Neurologist)
Source: The Neurologist - November 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

COVID-19 Infection and Recurrent Stroke in Young Patients With Protein S Deficiency: A Case Report
Conclusions: SARS-CoV-2 infection potentializes the prothrombotic effect and vascular inflammation by accentuating protein S deficit. The place of steroids seems justifiable in the presence of symptoms of vasculitis in brain imaging. (Source: The Neurologist)
Source: The Neurologist - November 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Wernicke Encephalopathy From Olfactory Dysfunction After COVID-19 Infection
Conclusions: As this pandemic continues to progress, more long-term neurological sequelae from COVID-19 such as Wernicke encephalopathy can be expected. Strong clinical suspicion for these complications is needed to allow for earlier diagnosis and faster treatment initiation. (Source: The Neurologist)
Source: The Neurologist - November 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

COVID-19 Associated Wake-Up Stroke Treated With DWI/FLAIR Mismatch Guided Intravenous Alteplase: A Case Report
Conclusion: The hyperacute-MRI protocol for wake-up COVID-19 associated strokes might be a safe option. (Source: The Neurologist)
Source: The Neurologist - November 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

COVID-19 Associated With Encephalitis: Case Report and Review of Literature
Conclusion: Neurologists should be involved in the evaluation and management of COVID-19 patients who present with associated neurological problems. (Source: The Neurologist)
Source: The Neurologist - November 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Mechanical Thrombectomy Outcomes in COVID-19 Patients With Acute Ischemic Stroke: A Narrative Review
Conclusions: The effect of COVID-19 on the long-term prognosis of stroke patients after thrombectomy is yet to be determined. The accumulating evidence from current studies indicates a negative impact of COVID-19 on outcomes in acute ischemic stroke patients who receive MT, irrespective of timely, successful angiographic recanalization. This review may help alert clinicians of some of the COVID-19-specific postthrombectomy challenges. (Source: The Neurologist)
Source: The Neurologist - November 1, 2021 Category: Neurology Tags: Review Articles Source Type: research

A Call for a Stroke Referral Network Between Primary Care and Stroke-Ready Hospitals in the Philippines: A Narrative Review
Conclusions: In the era of Universal Health Care in the Philippines, the roles of PCP and specialists must be delineated. Increased access to stroke care through the establishment of networks among PCPs and stroke-ready hospitals (ie, via effective transition of care/teleneurology) must be prioritized especially in resource-constrained settings. (Source: The Neurologist)
Source: The Neurologist - November 1, 2021 Category: Neurology Tags: Review Articles Source Type: research

Neurobrucellosis: Brief Review
Conclusions: Neurobrucellosis affects patients globally and in endemic areas. Neurologists should familiarize themselves with its clinical presentation, diagnosis, and treatment to provide optimal care for their patients. (Source: The Neurologist)
Source: The Neurologist - November 1, 2021 Category: Neurology Tags: Review Articles Source Type: research

Responsiveness of 2 Different Ability Outcome Measures in Guillain-Barré Syndrome
Conclusion: Our findings support the use of GDS in an acute phase of GBS. I-RODS have their role mostly during a longer follow-up period when the majority of patients are ambulant and their other abilities besides walking are also of great importance. (Source: The Neurologist)
Source: The Neurologist - November 1, 2021 Category: Neurology Tags: Original Articles Source Type: research

Neurological Symptoms and Diagnoses in Patients Hospitalized With COVID-19: Relationships With Mortality
Background: Coronavirus disease 2019 (COVID-19) is a disease that affects many organs, especially the lung, and may lead to multiorgan failure. Studies describing neurological dysfunctions involving the central and peripheral nervous systems have emerged. In our study, we aimed to evaluate the neurological signs and symptoms in hospitalized patients with COVID-19. Methods: The data of 290 patients admitted to our center (ward and intensive care unit) who received a diagnosis of COVID-19 were analyzed retrospectively. Patients’ demographic, clinical and laboratory data, and their neurological diseases, symp...
Source: The Neurologist - November 1, 2021 Category: Neurology Tags: Original Articles Source Type: research

Transcranial Direct Current Stimulation and Yoga for Functional Movement Disorders
Conclusion: Our study results suggest that anodal tDCS is not superior to sham tDCS in alleviating subjective symptoms and disability in FMD. However, interpretation of these results is limited due to the small number of stimulation sessions and number of subjects. Future studies using more frequent stimulation sessions are needed to further determine whether anodal tDCS may have a therapeutic effect in this patient group compared with sham tDCS. (Source: The Neurologist)
Source: The Neurologist - November 1, 2021 Category: Neurology Tags: Original Articles Source Type: research

COVID-19 Exposure During Neurology Practice: Results of American Academy of Neurology Survey
Conclusions: The data could enhance our knowledge of the factors that contribute to COVID-19 exposure during neurology practice in United States, and inform education and advocacy efforts to neurology providers, trainees, and patients in this unprecedented pandemic. (Source: The Neurologist)
Source: The Neurologist - November 1, 2021 Category: Neurology Tags: Original Articles Source Type: research

Treatment Options for COVID-19–Related Guillain-Barré Syndrome: A Systematic Review of Literature
Conclusions: Although evidence to support specific treatments is lacking, clinicians should consider the benefits of immunotherapy and plasma exchange in addition to the standard antimicrobial and supportive therapies for patients who meet the diagnostic criteria for acute sensory and motor polyradiculoneuritis. Intravenous immunoglobulin treatment alone is not shown to result in improved outcomes or mortality. More extensive studies aimed at exploring the neurological manifestations and complications of COVID-19 and distinctive treatment options for COVID-19–related GBS are warranted. (Source: The Neurologist)
Source: The Neurologist - September 1, 2021 Category: Neurology Tags: Review Articles Source Type: research

Current Review of Leptomeningeal Amyloidosis Associated With Transthyretin Mutations
Conclusion: Clinicians should be aware of this rare form of familial transthyretin amyloidosis as well as its typical MRI enhancement and high CSF protein. The important role of biopsy, genetic testing and the potential early diagnosis value of contrast MRI were suggested. Early recognition of these characteristics is important to provide misdiagnosis and shorten the time before correct diagnosis. These findings expand the phenotypic spectrum of TTR gene and have implications for the diagnosis, treatment, and systematic study of LA. (Source: The Neurologist)
Source: The Neurologist - September 1, 2021 Category: Neurology Tags: Review Articles Source Type: research

Variants of Avellis Syndrome Due to Medulla Oblongata Infarction: A Case Series
Conclusions: Avellis syndrome may present with additional neurological findings besides its classic definition. Apart from atherosclerotic disease, rare causes should be investigated in detail in small ischemic medullary lesions. (Source: The Neurologist)
Source: The Neurologist - September 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Subacute Herpes Simplex Type 1 Encephalitis: Case Report With Literature Review
Conclusion: There is subacute form of HSVE and should be suspected with any subacute febrile illness with nonspecific cognitive impairment even in the absence of focal neurological symptoms and in cases with rapidly progressive dementia. This form has similar radiologic finding and good response to acyclovir but carry even better prognosis than that the acute HSVE. (Source: The Neurologist)
Source: The Neurologist - September 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

MuSK Myasthenia Gravis Presenting with Bilateral Vocal Cord Abduction Paresis: A Case Report and Literature Review
Conclusion: Dysphonia with hoarse quality secondary to vocal cord abduction paresis is a rare presentation of myasthenia gravis, as opposed to the typical flaccid dysarthria seen in bulbar myasthenia and should raise suspicion for MuSK antibody positivity. MuSK myasthenia gravis cases can be more refractory to treatment with cholinesterase inhibitors and are more likely to cause exacerbations and myasthenia crisis. Therefore, early and accurate diagnosis with appropriate antibody testing is imperative to avoid delays in treatment to prevent potentially life-threatening outcomes. (Source: The Neurologist)
Source: The Neurologist - September 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Cytomegalovirus-Associated Mild Encephalopathy/Encephalitis With Reversible Splenial Lesion
Conclusion: This is the first report an adult patient with CMV-associated MERS. Recognition of this clinical-radiologic syndrome can guide diagnosis and management. (Source: The Neurologist)
Source: The Neurologist - September 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Trigeminal Metastasis of Malignant Melanoma: Clinical, Neuroradiological, and Pathological Features. A Case Report
Conclusions: In patients presenting with atypical facial pain and history of head and neck melanoma a trigeminal spreading should be considered. Magnetic resonance imaging can detect early perineural spread and target biopsy. (Source: The Neurologist)
Source: The Neurologist - September 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

A Multifaceted Approach to Improving Postischemic Stroke Dysphagia Screening at a Community Hospital
Conclusion: We conclude that failure analysis, implementation of quality control measures to address the cause of failures and re-evaluating success rates periodically was effective to address this problem. (Source: The Neurologist)
Source: The Neurologist - September 1, 2021 Category: Neurology Tags: Original Articles Source Type: research

Movement Disorders in Multiple Sclerosis and Other Demyelinating Diseases: A Retrospective Review From a Tertiary Academic Center
Conclusions: MD are common in DD and are frequently overlooked or undertreated. MD in this sample have a 69% therapeutic response to a first trial. Greater awareness of potential therapeutic options is needed to decrease disability. (Source: The Neurologist)
Source: The Neurologist - September 1, 2021 Category: Neurology Tags: Original Articles Source Type: research

Phospholipase A2 and Ischemic Stroke Etiology: Erratum
No abstract available (Source: The Neurologist)
Source: The Neurologist - July 1, 2021 Category: Neurology Tags: Erratum Source Type: research

A Case of Combined Central and Peripheral Demyelination Associated With Antineurofascin 155 Antibodies and Paternal History of Multiple Sclerosis
Conclusion: Our case emphasizes that clinicians need to keep in mind the possibility of a coexisting demyelination in both central and peripheral nervous system, even in patients with a family history of MS. The need for a timely diagnosis is imperative since several drugs used in the management of MS can worsen the patient’s symptoms in CCPD. This is, to our knowledge, the first reported case of a patient with anti-NF 155 positive CCPD and a family history of MS. (Source: The Neurologist)
Source: The Neurologist - July 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Wall-Eyed Bilateral Internuclear Ophthalmoplegia (WEBINO) in a Patient With a Unilateral Midbrain Infarction
Conclusion: Herein, we report a rare case of WEBINO caused by a unilateral midbrain infarction in which the patient experienced edema-related neurological deficits. This case provides evidence that early antiedema therapy may benefit patients with similar presentations. (Source: The Neurologist)
Source: The Neurologist - July 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Parkinsonism-hyperpyrexia Syndrome After Amantadine Withdrawal: Case Report and Review of the Literature
Conclusions: Amantadine is an antiparkinsonian medication scarcely associated with PHS. The few reported cases are further summarized and discussed in this article. This case highlights the importance of early recognition of PHS, which may be caused by changes in other antiparkinson agents such as amantadine, and the need to slowly titrate such agents. (Source: The Neurologist)
Source: The Neurologist - July 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-like Episodes (MELAS) Syndrome: Frequency, Clinical Features, Imaging, Histopathologic, and Molecular Genetic Findings in a Third-level Health Care Center in Mexico
Conclusions: MELAS syndrome represents a common diagnostic challenge for clinicians, often delaying definitive diagnosis. It should be suspected in young patients with stroke of undetermined etiology associated with other systemic and neurological features. (Source: The Neurologist)
Source: The Neurologist - July 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Is Autologous Stem Cell Transplantation a Safe and Effective Alternative to Whole Brain Radiation as Consolidation Therapy in Patients With Primary Central Nervous System Lymphoma?: A Critically Appraised Topic
Conclusions: In young patients with newly diagnosed PCNSL, consolidative therapy with HD-ASCT appears to be associated with less neurocognitive toxicity and may be more effective than WBRT at preventing relapses, however, at the cost of a higher treatment-related mortality. (Source: The Neurologist)
Source: The Neurologist - July 1, 2021 Category: Neurology Tags: Critically Appraised Topics Source Type: research

Vertebral Artery Dissection in a Woman Due to Golf: An Under Recognized Etiology
Conclusion: This patient is the first woman in the literature to suffer from VAD as a result of playing golf. The twisting motion of the head and neck in a golf swing may be a risk factor for dissection and subsequent development of stroke. As a result of increased female participation in golf, we expect to see increased incidence of women presenting with “golfer’s stroke” in coming years. (Source: The Neurologist)
Source: The Neurologist - July 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Fabry Disease Frequency Among Young Cryptogenic Stroke Patients in the City of Edirne, Turkey
Conclusions: This research is just one of a few studies conducted on FD screening studies in Turkish stroke patients. Our results underlined the importance of considering FD during the etiologic evaluation of young cryptogenic stroke patients, as it is a rare but potentially treatable entity. (Source: The Neurologist)
Source: The Neurologist - July 1, 2021 Category: Neurology Tags: Original Article Source Type: research

Hemorrhage Into a Subependymal Giant Cell Astrocytoma in an Adult With Tuberous Sclerosis: Case Report
Conclusions: We present an unusual cause of intracranial hemorrhage in a young adult. Thorough work-up and recognition of an underlying genetic predisposition can curtails diagnostic delay when life-threatening complications occur. (Source: The Neurologist)
Source: The Neurologist - July 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Vasculitis Presenting as Autonomic Failure
Conclusions: This is a unique GPA case presenting with autonomic failure and pituitary dysfunction with conclusive objective findings of autonomic dysfunction. Autonomic dysfunction and other disease manifestations were responsive to immunosuppressive therapy. (Source: The Neurologist)
Source: The Neurologist - July 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Meta-Analysis of Perioperative Stroke and Mortality in CABG Patients With Carotid Stenosis
No abstract available (Source: The Neurologist)
Source: The Neurologist - May 1, 2021 Category: Neurology Tags: Letter to the Editor Source Type: research

Does the Initiation of Fluoxetine Postacute Stroke Result in Improved Functional Recovery?: A Critically Appraised Topic
Conclusion: Among patients with stroke, early initiation of fluoxetine did not result in improved functional recovery. Lower rates of depression were observed in the fluoxetine-treated group; however these patients experienced higher rates of bone fracture. (Source: The Neurologist)
Source: The Neurologist - May 1, 2021 Category: Neurology Tags: Critically Appraised Topics Source Type: research

COVID-19–Associated Ischemic Stroke in a Patient on Therapeutic Anticoagulation
Conclusion: Ischemic stroke in anticoagulated patients with COVID-19 has been previously reported. Such cases emphasize the severity of the coronavirus virus associated hypercoagulable state. A majority of reported cases have occurred in patients continuing their ambulatory therapy. Overall, such cases are likely underreported. There are current trials comparing therapeutic versus prophylactic dose anticoagulation in patients with COVID-19. There are no studies specifically addressing anticoagulation agent failure in these patients. Further research is required this area to determine the optimal therapy for patients wi...
Source: The Neurologist - May 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Aβ-related Angiitis (ABRA)—A Rare Paraneoplastic Cause of Cerebral Vasculitis in a Young Patient: A Pathway From Unspecific Neurological Symptoms to Final Diagnosis
Conclusions: The reported case demonstrates our diagnostic approach and the clinical difficulties in validating a rare cause of encephalopathy in a young patient with nonspecific clinical and neuroradiological findings. Because of the possibility of an effective treatment, it is important to consider ABRA in the differential diagnosis especially when blood tests, analysis of cerebrospinal fluid, and angiography show normal results. Since a paraneoplastic genesis is presumed, a search for an underlying tumor disease should be considered. (Source: The Neurologist)
Source: The Neurologist - May 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Giant Cell Arteritis: When an Inspection Is Essential
Conclusion: When dealing a patient with a typical headache, a prominent artery in the inspection, and a visualization of halo sign in ultrasound examination, this diagnosis must be considered. (Source: The Neurologist)
Source: The Neurologist - May 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Erythropoietin-Associated Posterior Reversible Encephalopathy Syndrome
Conclusion: Recombinant human erythropoietin (RhEPO) may be an underrecognized cause of PRES and should be considered in patients receiving this treatment regardless of the absence or presence of renal impairment. RhEPO-mediated precipitation/exacerbation of hypertension, alterations in cerebral blood flow, and changes in endothelial integrity may underlie this association. MRI signal changes are reversible and typical for that of PRES, and significant improvement of symptoms can be expected. (Source: The Neurologist)
Source: The Neurologist - May 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Nonabducent Cranial Neuropathies in Cerebral Venous Sinus Thrombosis: A Case Report and Literature Review
Conclusion: A systematic review identified 26 patients from 21 articles with nonabducent cranial neuropathies. Seven patients had lower motor neuron facial palsy, 13 patients had hearing loss or vertigo with vestibulocochlear involvement, and 6 patients had other mixed cranial nerve palsies with CVST. They are usually associated with transverse sinus and/or sigmoid sinus thrombosis. They have a good prognosis with improvement and complete resolution of cranial neuropathies in most cases usually in 1 month. (Source: The Neurologist)
Source: The Neurologist - May 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Concurrent Stroke and Myocardial Infarction After Mild COVID-19 Infection
Conclusions: Our experience with these cases suggests that patients with mild symptoms can also present thromboembolic complications once the acute phase of COVID-19 infection has passed. (Source: The Neurologist)
Source: The Neurologist - May 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Froin Syndrome, a Rare Complication of Multiple Myeloma
Conclusion: Leptomeningeal myelomatosis associated with MM can cause blockage of CSF circulation leading to Froin syndrome. Inflammatory or neoplastic conditions should be considered as an underlying etiology. (Source: The Neurologist)
Source: The Neurologist - May 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research