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RCVS: by clinicians for clinicians —a narrative review
ConclusionIn general, the outcome of reversible cerebral vasoconstriction syndrome is very good. Vasospasm as well as thunderclap headache attacks can be fully reversible, and  >  90% of patients are functionally independent at discharge.
Source: Journal of Neurology - January 30, 2023 Category: Neurology Source Type: research

Cerebral hemorrhage after thrombolysis in stroke patients with unruptured intracranial aneurysms: a systemic review and meta-analysis
ConclusionsIVT is unlikely to induce hemorrhage of pre-existing unruptured aneurysms in stroke patients. Further randomized control studies are warranted to validate these conclusions.Graphical abstract
Source: Journal of Neurology - December 22, 2022 Category: Neurology Source Type: research

Recurrent intracerebral hemorrhage in patients with cerebral amyloid angiopathy: a propensity-matched case –control study
The objective of our study was to compare the readmission rates for recurrent ICH, SAH, and AIS among patients admitted for ICH with and without CAA.MethodsUsing the National Readmissions Database 2016 –2018 we identified patients admitted for ICH with and without a concomitant diagnosis of CAA. Primary outcome of the study was readmission due to ICH. Secondary outcomes included readmissions due to AIS and SAH. Survival analysis was performed, and Kaplan–Meier curves were created to assess for readmissions.ResultsThe study consisted of 194,290 patients with ICH, 8247 with CAA and 186,043 without CAA as a concomitant di...
Source: Journal of Neurology - January 17, 2022 Category: Neurology Source Type: research

Hospital admissions of acute cerebrovascular diseases during and after the first wave of the COVID-19 pandemic: a state-wide experience from Austria
AbstractWe investigated hospital admission rates for the entire spectrum of acute cerebrovascular diseases and of recanalization treatments for ischaemic stroke (IS) in the Austrian federal state of Styria during and also after the first coronavirus disease 2019 (COVID-19) wave. We retrospectively identified all patients with transient ischaemic attack (TIA), IS and non-traumatic intracranial haemorrhage (ICH; including intracerebral, subdural and subarachnoid bleeding types) admitted to one of the 11 public hospitals in Styria (covering  >  95% of inhospital cerebrovascular events in this region). Information was e...
Source: Journal of Neurology - September 27, 2021 Category: Neurology Source Type: research

Risk of intracranial haemorrhage and ischaemic stroke after convexity subarachnoid haemorrhage in cerebral amyloid angiopathy: international individual patient data pooled analysis
ConclusionsPatients with cSAH associated with probable or possible CAA have high risk of future ICH and recurrent cSAH. Convexity SAH associated with probable (vs possible) CAA is associated with increased risk of ICH, and cSAH but not ischemic stroke. Our data provide precise risk estimates for key vascular events after cSAH associated with CAA which can inform management decisions.
Source: Journal of Neurology - July 17, 2021 Category: Neurology Source Type: research

Cerebrovascular manifestations in hematological diseases: an update
AbstractPatients with hematological diseases often experience cerebrovascular complications including ischemic stroke, intracerebral and subarachnoid hemorrhage, microbleeds, posterior reversible encephalopathy syndrome, and dural sinus and cerebral vein thrombosis (CVT). In this update, we will review recent advances in the management of cerebrovascular diseases in the context of myeloproliferative neoplasms, leukemias, lymphomas, multiple myeloma, POEMS, paroxysmal nocturnal hemoglobinuria (PNH), thrombotic thrombocytopenic purpura (TTP), and sickle-cell disease. In acute ischemic stroke associated with hematological dis...
Source: Journal of Neurology - February 13, 2021 Category: Neurology Source Type: research

Investigation of poststroke epilepsy (INPOSE) study: a multicenter prospective study for prediction of poststroke epilepsy
ConclusionsPoststroke epilepsy occurs in almost 6% of patients within 3  years after stroke onset. Hemorrhagic stroke and subcortical lesion appear to be significantly associated with likelihood of developing epilepsy. Thus, prophylactic administration of antiepileptic drugs could be useful for stroke patients with these two risk factors.
Source: Journal of Neurology - June 18, 2020 Category: Neurology Source Type: research

Understanding the neurotropic characteristics of SARS-CoV-2: from neurological manifestations of COVID-19 to potential neurotropic mechanisms
AbstractCoronavirus disease 2019 (COVID-19), a disease caused by the novel betacoronavirus (SARS-CoV-2), has become a global pandemic threat. The potential involvement of COVID-19 in central nervous system (CNS) has attracted considerable attention due to neurological manifestations presented throughout the disease process. In addition, SARS-CoV-2 is structurally similar to SARS-CoV, and both bind to the angiotensin-converting enzyme 2 (ACE2) receptor to enter human cells. Thus, cells expressing ACE2, such as neurons and glial cells may act as targets and are thus vulnerable to SARS-CoV-2 infection. Here, we have reviewed ...
Source: Journal of Neurology - May 25, 2020 Category: Neurology Source Type: research

The changing face of neurosurgery for the older person
AbstractIncreased life expectancy and illness prevention and treatment have led to a growing population of older patients. These changes in patient population are apparent in neurosurgery; however, relatively little is reported about specific outcomes and prognostication in this group. This review summarises the challenges and management changes occurring in the treatment of three common neurosurgical pathologies; aneurysmal subarachnoid haemorrhage, head injury, and haemorrhagic stroke. A move towards less invasive neurosurgical techniques has implications on the risk –benefit profile of interventions. This creates the ...
Source: Journal of Neurology - April 24, 2020 Category: Neurology Source Type: research

Clinical features distinguish cerebral amyloid angiopathy-associated convexity subarachnoid haemorrhage from suspected TIA
ConclusionSimple clinical features could help distinguish cSAH-associated TFNE from suspected TIA, with relevance for investigation and management, including the use of antithrombotic drugs.
Source: Journal of Neurology - October 2, 2019 Category: Neurology Source Type: research

Cumulative alcohol consumption and stroke risk in men
ConclusionsCumulative alcohol consumption is an independent risk factor of total stroke and IS in men in a community-based cohort. Even light alcohol intake increases the risk of total stroke and IS.
Source: Journal of Neurology - August 8, 2019 Category: Neurology Source Type: research

Specific mechanisms of subarachnoid hemorrhage accompanied by ischemic stroke in essential thrombocythemia: two case reports and a literature review
ConclusionsThe current study describes rare cases of SAH accompanied by ischemic stroke secondary to ET along with a review of the current literature, implying specific mechanisms for cerebral artery disorders associated withJAK2 V617F mutation.
Source: Journal of Neurology - May 1, 2019 Category: Neurology Source Type: research

Treatment course and outcomes after revascularization surgery for moyamoya disease in adults
ConclusionsThis analysis of nationally representative US data suggests that although readmission after RS for MMD is not uncommon, cerebral hemorrhagic events during the 90-day postoperative period are rare.
Source: Journal of Neurology - September 8, 2018 Category: Neurology Source Type: research

Stroke recurrence and mortality in northeastern Greece: the Evros Stroke Registry
AbstractUp to date there is no population-based study from Greece providing long-term data on incidence of both all-cause mortality and stroke recurrence for patients with first ever stroke (FES). Adult patients with FES were registered during a 24-month period (2010 –2012) and followed-up for 12 months. We calculated cumulative incidences of stroke mortality and recurrence. Univariable and multivariable Cox proportional hazards regression analyses were used to identify independent determinants of 1-year mortality and 1-year stroke recurrence. We prospectivel y documented 703 first ever stroke cases (mean age 75 ± ...
Source: Journal of Neurology - August 20, 2018 Category: Neurology Source Type: research

Haemorrhagic stroke related to the use of 4-fluoroamphetamine
We report on two patients who presented with headache and mild hypertension after 4-FA use. Patient A developed one-sided weakness and decreased consciousness after a few hours. A computed tomography scan showed a left-sided intracerebral haemorrhage. Because of life-threatening cerebral herniation, haematoma evacuation was performed. Postoperatively, she suffered from a right-sided hemiparalysis and severe aphasia, requiring clinical rehabilitation. Patient B had a subarachnoid haemorrhage without neurological deficits. In total, 939 4-FA-intoxicated patients were registered. These patients used 4-FA alone (44%) or in com...
Source: Journal of Neurology - May 8, 2018 Category: Neurology Source Type: research

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