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Phentermine associated recurrent intracerebral hemorrhage
Awareness of obesity as a risk factor for cardiovascular events has increased in recent years. Many medications have been developed to suppress appetite to achieve weight loss. Phentermine is one of many medications that often used for weight loss. However, the sympathomimetic effect of phentermine can result in palpitations, hypertension, and tachycardia [1]. Neurological complications include irritability, ischemic stroke, posterior reversible encephalopathy syndrome (PRES) and hemorrhagic stroke [2 –6].
Source: Journal of the Neurological Sciences - August 22, 2018 Category: Neurology Authors: Stephanie McNeill, Eyad Almallouhi, Forrest J. Lowe, Tanya N. Turan Tags: Letter to the Editor Source Type: research

In a stroke cohort with incident hypertension; are more women than men likely to be excluded from recombinant tissue-type Plasminogen Activator (rtPA)?
The treatment outcomes in the use of rt-PA have been reported. Some studies reported worse outcome in women than men, while others presented opposing data. Using data from a hospital-based stroke registry, we investigated evidence of gender difference and determined exclusion criteria in a stroke population with incidence of hypertension.
Source: Journal of the Neurological Sciences - February 7, 2018 Category: Neurology Authors: Jordan Gainey, Leanne Brechtel, Sarah Konklin, Lee Madeline, Lowther Ervin, Brice Blum, Thomas I. Nathaniel Source Type: research

Comparative effects of low-dose versus standard-dose alteplase in ischemic patients with prior stroke and/or diabetes mellitus: The ENCHANTED trial
History of prior stroke (PS) and diabetes mellitus (DM) are considered relative contraindications to the use of intravenous alteplase in patients with acute ischemic stroke (AIS). We aimed to assess whether a history of PS and DM modified the comparative effects of low- versus standard-dose alteplase in patients who participated in the alteplase-dose arm of the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED).
Source: Journal of the Neurological Sciences - January 11, 2018 Category: Neurology Authors: Guofang Chen, Xia Wang, Thompson G. Robinson, Richard I. Lindley, Shengkui Zhou, Lei Ping, Weiwei Liu, Leijing Liu, John Chalmers, Craig S. Anderson, for the ENCHANTED Investigators Source Type: research

Feasibility study of a targeted self-management intervention for reducing stroke risk factors in a high-risk population in Uganda
Stroke remains a global concern due to increasing lifespan, patterns of industrialization, adoption of harmful western diets, and an increasing prevalence of risk factors such as hypertension, obesity, and diabetes. We investigated an adopted novel self-management intervention, TargetEd mAnageMent Intervention (TEAM) to reduce modifiable stroke risk factors in Uganda.
Source: Journal of the Neurological Sciences - January 4, 2018 Category: Neurology Authors: Mark Kaddumukasa, Jane Nakibuuka, Levicatus Mugenyi, Olivia Namusoke, Bryan Kabaala, Carol Blixen, Elly Katabira, Anthony Furlan, Martha Sajatovic, Doreen Birungi Source Type: research

Management of blood pressure in acute stroke: Comparison of current prescribing patterns with AHA/ASA guidelines in a Sub-Saharan African referral hospital
High blood pressure (HBP) is common at acute phase of stroke. It may reflect untreated or uncontrolled hypertension before stroke, or it may relate to stress response. The present study was designed to compare current American Stroke Association (ASA) guidelines with actual prescribing patterns for management of HBP at the acute phase of stroke, in a tertiary care Hospital in Douala, Cameroon.
Source: Journal of the Neurological Sciences - October 5, 2017 Category: Neurology Authors: C. Kuate-Tegueu, J.J. Dongmo-Tajeuna, J. Doumbe, Y. Mapoure-Njankouo, G. Noubissi, V.D.P. Djientcheu Source Type: research

Delayed leukoencephalopathy after recanalized cardioembolic stroke: Two case reports
A 66-year-old man with a history of hypertension, dyslipidemia, diabetes mellitus, and myocardial infarction was admitted to our hospital due to sudden somnolence, global aphasia, right spatial neglect, and right hemiparesis. Diffusion weighted images (DWI) revealed no hyperintense lesions (Fig. 1A, B). Magnetic resonance angiography (MRA) demonstrated an occlusion of the left middle cerebral artery (MCA). The patient was treated with intravenous tissue plasminogen activator and endovascular therapy using the Penumbra ™ 3MAX and 5MAX ACE catheters, leading to successful recanalization of the MCA 287min after symptom onse...
Source: Journal of the Neurological Sciences - May 25, 2017 Category: Neurology Authors: Takaomi Singu, Yuichiro Inatomi, Toshiro Yonehara, Yukio Ando Tags: Letter to the Editor Source Type: research

Hemichorea-hemiballismus in the setting of posterolateral putaminal lesion and treatment with topiramate
A-60year old female with medical history of hypertension, diabetes mellitus (with good glycemic control) and hyperlipidemia suffered from right sided involuntary movements of upper and lower extremities progressing over the past 4years (Video 1). She had had an ischemic stroke characterized with right sided weakness 8years ago. Motor examinations revealed 4+/5 motor weakness solely in the right triceps muscle and her walking was antalgic due to gonarthrosis. Cranial MRI showed chronic ischemic lesion in the left thalamic and posterior putamen (Fig.
Source: Journal of the Neurological Sciences - February 13, 2017 Category: Neurology Authors: Halil Onder Tags: Letter to the Editor Source Type: research

Circulating autoantibodies against the NR2 peptide of the NMDA receptor are associated with subclinical brain damage in hypertensive patients with other pre-existing conditions for vascular risk
Arterial hypertension (HT) and other vascular pre-existing conditions (PEC) generate asymptomatic brain damage which increases the occurrence of stroke and cognitive decline. The aim of this work was to explore if serum antibodies against the NR2 subunit of the NMDA receptor (NR2Ab) could predict subclinical brain damage (SBD) in hypertensive patients with PEC. Forty seven neurologically asymptomatic hypertensive subjects were classified according to the number of PEC (retinopathy, overweight/obesity, diabetes mellitus and dyslipidemia).
Source: Journal of the Neurological Sciences - February 13, 2017 Category: Neurology Authors: S. Gonz ález-García, A. González-Quevedo, Z. Hernandez-Diaz, L. Alvarez Camino, M. Peña-Sanchez, A. Cordero-Eiriz, M. Brown, J.A. Gaya, M. Betancourt-Losa, I. Fernandez-Almirall, M.C. Menendez-Sainz, R. Fernandez-Carriera Source Type: research

Administration of a pictorial questionnaire to screen for stroke among patients with hypertension or diabetes in rural Ghana
Stroke prevention is an important public health goal in low-and-middle income countries (LMIC) due to its high mortality and morbidity in these settings. Epidemiological data from high-income countries have demonstrated a potent predictive association between self-reported stroke symptoms and risks of future strokes, incident cognitive impairment and all-cause mortality.
Source: Journal of the Neurological Sciences - January 6, 2017 Category: Neurology Authors: Fred S. Sarfo, Rexford Adu Gyamfi, Sheila Adamu, Osei Sarfo-Kantanka, Mayowa Owolabi, Bruce Ovbiagele Source Type: research

What a downer: The dark side of cannabis
It has been known for decades that cigarette smoking is associated with an increased risk of stroke. In 1988, the Framingham Heart Study cohort showed that even after age and hypertension were taken into account, smoking was significantly related to stroke [1]. This risk increased with greater number of cigarettes smoked, and conversely, after two years of cessation, decreased significantly, and by five years reached the level of nonsmokers.
Source: Journal of the Neurological Sciences - March 10, 2016 Category: Neurology Authors: David Z. Rose Source Type: research

The impacts of premorbid hypertension treatment on functional outcomes of ischemic stroke
This study aimed to evaluate the impacts of premorbid hypertension treatment on the functional outcomes in patients with acute ischemic stroke and hypertension.
Source: Journal of the Neurological Sciences - February 10, 2016 Category: Neurology Authors: Qinqin Cao, Shuyu Zhou, Biyang Cai, Qing Wang, Jun Zhang, Ruifeng Shi, Keting Liu, Xinfeng Liu, Gelin Xu Source Type: research

Unusual case of cerebral small vessel disease with a heterozygous nonsense mutation in
Cerebral small vessel disease (CSVD) is a heterogeneous group of disorders with a predisposition for lacunar infarcts and white matter lesions. It is one of the main causes of ischemic stroke and cognitive impairment among the elderly. Several monogenic conditions cause the rare inherited forms of CSVD, which are distinguishable from many others associated with common cerebrovascular risk factors such as hypertension or diabetes mellitus on the basis of family history, onset in early adulthood, or syndromic presentation [1].
Source: Journal of the Neurological Sciences - January 20, 2016 Category: Neurology Authors: Toru Tateoka, Hideaki Onda, Kengo Hirota, Hidetoshi Kasuya, Toyoaki Shinohara, Hiroyuki Kinouchi, Hiroyuki Akagawa Source Type: research

Extraction of tumor embolus following perioperative stroke
We would like to highlight the case of a 69-year old man who was found to have a rare cause of perioperative stroke. The patient was diagnosed with primary adenocarcinoma of the lung, with no evidence of metastases on staging PET CT. His only past medical history was of hypertension. He underwent resection of the left upper lobe tumour. During the six-hour operation, hypotension or hypoxia were not encountered but supraventricular tachycardia was noted both intra- and post-operatively. In the recovery ward, he was noted to have new left-sided limb weakness.
Source: Journal of the Neurological Sciences - March 27, 2015 Category: Neurology Authors: Stella E. Hughes, Stephen J. Hunt Tags: Letter to the Editor Source Type: research

Extraction of tumour embolus following perioperative stroke
We would like to highlight the case of a 69-year old man who was found to have a rare cause of perioperative stroke. The patient was diagnosed with primary adenocarcinoma of the lung, with no evidence of metastases on staging PET CT. His only past medical history was of hypertension. He underwent resection of the left upper lobe tumour. During the six-hour operation, hypotension or hypoxia was not encountered but supraventricular tachycardia was noted both intra- and post-operatively. In the recovery ward, he was noted to have new left-sided limb weakness.
Source: Journal of the Neurological Sciences - March 27, 2015 Category: Neurology Authors: Stella E. Hughes, Annemarie Hunter, Jamie Campbell, Aidan Brady, Brian Herron, Graham Smyth, Ian Rennie, Stephen J. Hunt Tags: Letter to the editor Source Type: research

Blood–retina-barrier disruption accompanying blood–brain-barrier dysfunction in posterior reversible encephalopathy syndrome
Blood-brain-barrier dysfunction is well known to accompany hypertensive posterior reversible encephalopathy syndrome (PRES) and is considered as the culprit of vasogenic edema and cerebral hemorrhage observed as part of this syndrome. An 84-year-old female was admitted with a diagnosis of PRES in the setting of malignant hypertension. The clinical course was further complicated by ischemic stroke and seizures. Contrast enhanced fluid attenuated inversion recovery (FLAIR) studies revealed diffuse enhancement within the subarachnoid space extending to regions without evidence of cytotoxic or vasogenic edema.
Source: Journal of the Neurological Sciences - August 29, 2014 Category: Neurology Authors: Esra Ozkan, Rahsan Gocmen, Mehmet Akif Topcuoglu, Ethem Murat Arsava Source Type: research

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