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Capecitabine-induced acute toxic leukoencephalopathy.
Abstract A 45-year-old woman was treated by Capecitabine (Xeloda(®)) during 6days for breast cancer with metastatic bone lesions when she presented with nausea, headaches, muscle cramps, dysarthria and swallowing disorders. A stroke was first suspected. Brain CT was normal. MRI showed bilateral and symmetric high signal intensities of deep white matter, corpus callosum and corticospinal tracts on diffusion-weighted imaging and T2 fluid-attenuated inversion recovery (FLAIR) sequence, similar to 5-FU acute leukoencephalopathy. An acute toxic leukoencephalopathy was diagnosed prompting to discontinue capecitabine, w...
Source: Neurotoxicology - May 6, 2017 Category: Neurology Authors: Obadia M, Leclercq D, Wasserman J, Galanaud D, Dormont D, Sahli-Amor M, Psimaras D, Pyatigorskaya N, Law-Ye B Tags: Neurotoxicology Source Type: research

Primary Angiitis of the Central Nervous System Clinical Sciences
Conclusions—Adult primary angiitis of the central nervous system is a heterogenous disease, with multiterritorial, distal, and bilateral acute stroke being the most common pattern of parenchymal lesions found on magnetic resonance imaging. Our findings suggest a higher than previously thought prevalence of hemorrhagic transformation and other hemorrhagic manifestations.
Source: Stroke - April 24, 2017 Category: Neurology Authors: Gregoire Boulouis, Hubert de Boysson, Mathieu Zuber, Loic Guillevin, Eric Meary, Vincent Costalat, Christian Pagnoux, Olivier Naggara Tags: Imaging, Magnetic Resonance Imaging (MRI), Cerebrovascular Disease/Stroke, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Stroke like migraine attacks after radiation therapy (SMART) syndrome a case series of three patients (P6.179)
Conclusions:Our patients represent the first case series of SMART syndrome in a single institution. Our cases share similarities to the prior reports in the literature and highlights the clinical and MRI triad of acute onset headaches, neurological deficits and MRI findings of transient contrast enhancement of the cortex with white matter sparing in a previous radiation field.Disclosure: Dr. rauf has nothing to disclose. Dr. Boulter has nothing to disclose. Dr. Imitola has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Rauf, Y., Boulter, D., Imitola, J. Tags: Neurologic Complications of Cancer Source Type: research

Giant-Cell Arteritis Presenting as Isolated Bilateral CN-VI Palsies: A Rare Case Report of a 65 Year Male. (P2.378)
Conclusions:GCA is the most prevalent systemic vasculitis in the elderly. It can present with a wide variety of symptoms ranging from fatigue, headache, visual loss, and even stroke. However as noted in this case, isolated CN-VI palsy can be a very rare, early manifestation of GCA. As GCA responds well to corticosteroid therapy, prompt diagnosis and treatment is critical to prevent and/or limit neurologic sequelae. As highlighted by this case, in the event of recurrent incidents and absence of other diagnosis; GCA should be considered even if headache is absent.Disclosure: Dr. Lunagariya has nothing to disclose. Dr. Patel ...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Lunagariya, A., Patel, U., Kotadiya, F., Wilson, C. Tags: CNS Inflammatory Diseases and Differential Diagnosis II Source Type: research

Pituitary apoplexy causing bilateral anterior cerebral infarction (P3.283)
Conclusions:Pituitary apoplexy occurs when a pituitary tumor, typically macroadenoma, hemorrhages or infarcts resulting in a rapid expansion of the hypophysis and compression of adjacent structures, including the internal carotid arteries (ICA)which can result in cerebral ischemia. Proposed mechanisms of cerebral infarction to date include both direct compression or vasospasm of the ICA. Vasospasm as a cause is proposed to be from either extravasation of blood into the subarachnoid space or release of vasoactive substances by the tumor itself. This matter is still debated in the literature. Emergent recognition and imaging...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Vargas, A., Testai, F. Tags: Cerebrovascular Disease Case Reports II Source Type: research

Neurological Diseases Cost The U.S. $800 Billion Each Year
Over 100 million Americans ― close to a third of the total population ― suffer from neurological diseases such as Alzheimer’s, multiple sclerosis, migraines, epilepsy and spinal cord injury.  These conditions put an enormous financial strain on the health care system, totaling nearly $800 billion in annual costs, according to a new report published in the journal Annals of Neurology. To put that into perspective, the figure exceeds the U.S. military budget by over $100 billion.  That number reflects the total cost of the nine most common neurological diseases, but the total costs related to th...
Source: Healthy Living - The Huffington Post - March 30, 2017 Category: Consumer Health News Source Type: news

A case of acute subdural hematoma due to bleeding from metastatic chondrosarcoma of the skull.
CONCLUSION: In the event of subdural invasion of a metastatic lesion, intratumoral hemorrhage may induce acute SDH, as in the present case. Similar to our case, most previous reports of intracranial chondrosarcoma hemorrhage have had an unclear etiology. Despite the rarity of this event, a patient with a history of malignancy presenting with nontraumatic acute SDH should be examined for the intratumoral hemorrhage of skull metastasis in the differential diagnosis. PMID: 28303203 [PubMed - in process]
Source: Surgical Neurology International - March 19, 2017 Category: Neurosurgery Tags: Surg Neurol Int Source Type: research

A Case of Posterior Reversible Encephalopathy Syndrome Induced by Cisplatin/Pemetrexed Chemotherapy for Lung Cancer
This report presents the case of a 60-year-old woman who was diagnosed with stage IV lung adenocarcinoma with asymptomatic brain metastases and commenced chemotherapy with cisplatin/pemetrexed (CDDP/Pem). She experienced tonic-clonic convulsions on day 9 of the first cycle, which were accompanied by increased blood pressure (173/69 mm Hg) and headache. Therefore, brain MRI was performed to check for stroke or progression of brain metastatic foci. T2-weighted, FLAIR, and ADC map images showed high-intensity areas in the subcortical region of the bilateral parieto-occipital lobes, leading to a diagnosis of posterior reversib...
Source: Case Reports in Oncology - March 9, 2017 Category: Cancer & Oncology Source Type: research

Seizure syndrome as a first manifestation of solitary tumor-like mass lesion of PACNS: Two case reports
Rationale: Primary angiitis of the central nervous system (PACNS) is an inflammatory disease involving cerebrovascular and parenchymal, and solitary tumor-like mass lesion of PACNS (TLML-PACNS) is frequently misdiagnosed as neoplastic or other inflammatory diseases. However, seizure syndrome as a first manifestation of TLML-PACNS has rarely reported before. Patient concerns: Here, we report 2 cases of seizure syndrome, which was the first sign that presented prior to the diagnosis of TLML-PACNS by brain biopsy. Diagnoses: A mass lesion in the white and gray matters was detected by magnetic resonance imaging. The patholog...
Source: Medicine - March 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Ntox-11. recurrent episodes of stroke-like migraine attacks after radiation therapy (smart) syndrome in adults
We report two cases of multiply-recurrent SMART syndrome, one autopsy-documented. Case 1 is a 46 year old woman with an atypical meningioma treated with resection and radiation who presented sixteen months after completion of radiation with sudden onset hemiparesis and dysarthria. Brain MRI showed the typical gyriform enhancement seen in SMART syndrome. No other attributable disorders were found on extensive workup, and both symptoms and radiographic abnormalities resolved over several weeks without further therapies. Six months later she again presented with identical symptoms and MRI findings. Incomplete resolution ...
Source: Neuro-Oncology - November 6, 2016 Category: Cancer & Oncology Authors: Mohler, A., Kleinschmidt-DeMasters, B. K., Damek, D. Tags: NEUROTOXICITY OF THERAPY Source Type: research

Neuroimmune Crosstalk in CNS Disorders: The Histamine Connection.
Abstract The neuroimmune system represents a dense network of biochemical signals associated with neurotransmitters, neuropeptides, neurohormones, cytokines, chemokines, and growth factors synthesized in neurons, glial cells and immune cells, to maintain systemic homeostasis. Endogenous and/or exogenous, noxious stimuli in any tissue are captured by sensor cells to inform the brain; likewise, signals originating at the central nervous system (CNS) level are transmitted to peripheral immune effectors which react to central stimuli. This multidirectional information system makes it possible for the CNS to respond to...
Source: Epilepsy Curr - November 1, 2016 Category: Neurology Authors: Cacabelos R, Torrellas C, Fernández-Novoa L, Aliev G Tags: Curr Pharm Des Source Type: research

Unusual case of recurrent SMART (stroke-like migraine attacks after radiation therapy) syndrome
Ramnath Santosh Ramanathan, Gayathri Sreedher, Konark Malhotra, Zain Guduru, Deeksha Agarwal, Mary Flaherty, Timothy Leichliter, Sandeep RanaAnnals of Indian Academy of Neurology 2016 19(3):399-401Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare delayed complication of cerebral radiation therapy. A 53-year-old female initially presented with headache, confusion and left homonymous hemianopia. Her medical history was notable for cerebellar hemangioblastoma, which was treated with radiation in 1987. Her initial brain MRI (magnetic resonance imaging) revealed cortical enhancement in the right te...
Source: Annals of Indian Academy of Neurology - July 24, 2016 Category: Neurology Authors: Ramnath Santosh Ramanathan Gayathri Sreedher Konark Malhotra Zain Guduru Deeksha Agarwal Mary Flaherty Timothy Leichliter Sandeep Rana Source Type: research

Pre-Mixing tPA: Moving Past Gestalt (P2.303)
Conclusions: While pre-mixing tPA does not incur financial risk as drug manufacturers replace unused vials without cost, stroke centers remain wary of wasting the drug. We believe succinct criteria can reduce avoidable tPA waste, allowing health care providers to remain fiscally responsible while ensuring AIS patients are treated as fast as possible.Disclosure: Dr. McCarthy has nothing to disclose. Dr. Caputo has nothing to disclose. Dr. Whaley has received personal compensation for activities with Clinical Data Management/Neurobase and Genentech. Dr. Fanale has received personal compensation for activities with Genentech,...
Source: Neurology - April 3, 2016 Category: Neurology Authors: McCarthy, K., Caputo, L., Whaley, M., Fanale, C., Bar-Or, D. Tags: Acute Therapy: IV t-PA Source Type: research

Status Epilepticus in Patients with SMART (P5.012)
CONCLUSIONS We describe three patients with SMART presenting with SE. Our cases raise the concern that SMART is not necessarily a migraine phenomenon but can be a form of focal SE associated with stroke-like symptoms. In patients with radiographic suspicion of SMART we suggest a low threshold for vEEG monitoring and aggressive anti-epileptic management.Disclosure: Dr. Fan has nothing to disclose. Dr. Gabriel has nothing to disclose. Dr. Gerard has nothing to disclose. Dr. Schuele has received personal compensation for activities with Sunovion and Eisai as a speaker.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Fan, P., Gabriel, H., Gerard, E., Schuele, S. Tags: Neuromuscular Disease and Epilepsy ePoster Session Source Type: research

Better than Aspirin for Your Heart
If you’ve been diagnosed with heart disease, the chances are you’ve been told to take low-dose aspirin every day as a preventative measure against heart attack and stroke. It’s most commonly prescribed for patients with congestive heart failure. This is the inability of your heart to pump as much blood as your body needs. And this is a big worry to me, because there is very little evidence that aspirin helps. In fact, regular use of aspirin — even baby aspirin — can do you more harm than good. Common Aspirin Beliefs The idea is that aspirin thins the blood, making it easier to pump.  It is also s...
Source: Al Sears, MD Natural Remedies - April 1, 2016 Category: Complementary Medicine Authors: Al Sears Tags: Heart Health Source Type: news

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