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Modafinil for the Improvement of Patient Outcomes Following Traumatic Brain Injury
Conclusion. Modafinil is a central nervous system stimulant with well-established effectiveness in the treatment of narcolepsy and shift-work sleep disorder. There is conflicting evidence about the benefits of modafinil in the treatment of fatigue and EDS secondary to TBI. One randomized, controlled study states that modafinil does not significantly improve patient wakefulness, while another concludes that modafinil corrects EDS but not fatigue. An observational study provides evidence that modafinil increases alertness in fatigued patients with past medical history of brainstem diencephalic stroke or multiple sclerosis. ...
Source: Innovations in Clinical Neuroscience - April 1, 2018 Category: Neuroscience Authors: ICNS Online Editor Tags: Current Issue Review excessive daytime sleep fatigue head injury modafinil stroke TBI traumatic brain injury Source Type: research

Sociodemographic and Geographic Variation in Awareness of Stroke Signs and Symptoms Among Adults - United States, 2017.
Abstract Stroke is the fifth leading cause of death in the United States (1). In 2017, on average, a stroke-related death occurred every 3 minutes and 35 seconds in the United States, and stroke is a leading cause of long-term disability (1). To prevent mortality or long-term disability, strokes require rapid recognition and early medical intervention (2,3). Common stroke signs and symptoms include sudden numbness or weakness of the face, arm, or leg, especially on one side; sudden confusion or trouble speaking; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, or loss of balance; and a...
Source: MMWR Morb Mortal Wkl... - November 6, 2020 Category: Epidemiology Authors: Jackson SL, Legvold B, Vahratian A, Blackwell DL, Fang J, Gillespie C, Hayes D, Loustalot F Tags: MMWR Morb Mortal Wkly Rep Source Type: research

Neurology Concepts: Young Women and Ischemic Stroke —Evaluation and Management in the Emergency Department
ConclusionUnique challenges exist in the evaluation and diagnosis of ischemic stroke in young women. There are still many opportunities for future research aimed at improving detection and treatment of this population.
Source: Academic Emergency Medicine - October 10, 2017 Category: Emergency Medicine Authors: Bernard P. Chang, Charles Wira, Joseph Miller, Murtaza Akhter, Bradley E. Barth, Joshua Willey, Lauren Nentwich, Tracy Madsen Tags: Original Contribution Source Type: research

Pregnancy-Related Stroke: A Review
Conclusions and Relevance Early recognition and management are integral in decreasing the morbidity and mortality associated with a stroke in pregnancy. Relevance Statement This study was an evidence-based review of stroke in pregnancy and how to diagnose and mange a pregnancy complicated by a stroke. Target Audience Obstetricians and gynecologist, family physicians Learning Objectives After completing this learning activity, the participant should be better able to identify the pregnancy-related risk factors for a stroke; explain the presenting signs and symptoms of a stroke in pregnancy; describe...
Source: Obstetrical and Gynecological Survey - June 1, 2022 Category: OBGYN Tags: CME ARTICLES Source Type: research

Acute Stroke Diagnosis
Am Fam Physician. 2022 Jun 1;105(6):616-624.ABSTRACTStroke accounts for significant morbidity and mortality and is the fifth leading cause of death in the United States, with direct and indirect costs of more than $100 billion annually. Expedient recognition of acute neurologic deficits with appropriate history, physical examination, and glucose testing will help diagnose stroke and rule out mimicking presentations. The National Institutes of Health Stroke Scale should be used to determine stroke severity and to monitor for evolving changes in clinical presentation. Initial neuroimaging is used to differentiate between isc...
Source: American Family Physician - June 15, 2022 Category: Primary Care Authors: Edwin Y Choi Gilberto A Nieves Darrell Edward Jones Source Type: research

Maternal Stroke: A Call for Action.
Abstract Maternal mortality rates have been steadily increasing in the United States, and cardiovascular mortality is the leading cause of death among pregnant and postpartum women. Maternal stroke accounts for a significant burden of cardiovascular mortality. Data suggest that rates of maternal stroke have been increasing in recent years. Advancing maternal age at the time of birth and the increasing prevalence of traditional cardiovascular risk factors, and other risk factors, as well, such as hypertensive disorders of pregnancy, migraine, and infections, may contribute to increased rates of maternal stroke. In ...
Source: Circulation - February 16, 2021 Category: Cardiology Authors: Elgendy IY, Bukhari S, Barakat AF, Pepine CJ, Lindley KJ, Miller EC, American College of Cardiology Cardiovascular Disease in Women Committee Tags: Circulation Source Type: research

Headache Disparities in African Americans: A Narrative Review and Response to the National Institute of Neurological Disorders and Stroke Request for Information on Neurological Disparities in the United States.
CONCLUSIONS: Race-based disparities exist in headache medicine in the US. Research is needed. Research strategies and approaches currently with limited use in neurology and headache medicine may be warranted and appropriate to address race-based headache disparities. Funding is paramount. PMID: 33160641 [PubMed - as supplied by publisher]
Source: Journal of the National Medical Association - November 11, 2020 Category: General Medicine Tags: J Natl Med Assoc Source Type: research

Otitis Media Leads to Brain Abscess Presenting as Stroke
By Mikhail Elfond, DO; Esi Quayson, MD; & Joseph V.M. Kelly, MD, MBA A 65-year-old man presented to the ED via EMS with symptoms of stroke. The paramedics stated his right-sided weakness and speech difficulty started 40 minutes prior to presentation in the ED. En route to the hospital, paramedics observed four episodes of facial twitching.       Vitals signs were significant for a rectal temperature of 100.2°F and a fingerstick blood sugar of 220 mg/dL. History of present illness was significant for a diagnosis of left otitis media treated with Augmentin and Vicodin at an urgent care center ...
Source: The Case Files - January 20, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: research

P-039 Flow diverters for treatment of ICA loop dissections or ICA dissections with associated pseudoaneurysm
ConclusionUse of flow diverters, in some cases in conjunction with (carotid) stents, is an effective treatment option for cervical carotid artery dissections, especially loop dissections with or without associated pseudo aneurysms.Disclosures J. Singh: None. A. Kuhn: None. K. de Macedo Rodrigues: None. F. Massari: None. M. Gounis: 1; C; National Institutes of Health (NIH), the United States – Israel Binational Science Foundation, Anaconda, ApicBio, Axovant, Cerenovus, Cook Medical, Gentuity, Imperative Care, InNeuroCo, Magneto, Mic. 2; C; Cerenovus, Imperative Care, phenox, Medtronic Neurovascular, Route 92 Medical, ...
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Singh, J., Kuhn, A., de Macedo Rodrigues, K., Massari, F., Gounis, M., Puri, A. Tags: Oral poster abstracts Source Type: research

Lifelong cerebrovascular disease burden among CADASIL patients: analysis from a global health research network
DiscussionEarly screening and targeted treatment strategies are warranted to help CADASIL patients with symptom management and risk mitigation.
Source: Frontiers in Neurology - July 14, 2023 Category: Neurology Source Type: research

Decreased CSF Levels of ß-Amyloid in Patients With Cortical Superficial Siderosis
Conclusions: Our results demonstrate that the presence and extent of cSS are associated with reduced CSF ß-amyloid 42 levels. Further studies are needed to investigate the underlying mechanisms of this association. Introduction Cerebral amyloid angiopathy (CAA)—characterized by the deposition of ß-amyloid in the walls of leptomeningeal vessels—is a common cerebral small vessel disease and a major cause of intracerebral hemorrhage in the elderly (1–3). Furthermore, it has become evident that CAA is associated with cognitive impairment (4). Specifically, it has been shown that ...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

Debilitating Headache after an Excited Reaction
​BY GREGORY TAYLOR, DO, & MATTHEW WARPINSKI, DOA 35-year-old man with a history of uncontrolled hypertension and medical noncompliance was brought to the emergency department by EMS complaining of a headache. The family said the patient was watching football and developed an acute headache after he stood up screaming in excitement.His family said he had not taken his blood pressure medication for years. He was afebrile, his blood pressure was 245/129 mm Hg, his respiratory rate was 18 bpm, his heart rate was 68 bpm, and he weighed 340 pounds. The patient was obtunded with a Glasgow Coma Scale score of 4 and was subse...
Source: The Case Files - November 20, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Harnessing the Four Elements for Mental Health
DiscussionAs detailed above, the “elements” in both a classical and a contemporary sense have effects on our mental health and are potentially modifiable aspects that can be harnessed as therapeutic interventions. The most robust interventional evidence currently available shows tentative support for several use of the elements via horticultural and nature-exposure therapy, green exercise/physical activity, sauna and heat therapy, balneotherapy, and breathing exercises. It should be noted that, in many cases, these interventions were not studied in definitive diagnosed psychiatric disorders and thus it is pre...
Source: Frontiers in Psychiatry - April 23, 2019 Category: Psychiatry Source Type: research

Mental and Physical Health Conditions in US Combat Veterans: Results From the National Health and Resilience in Veterans Study.
Conclusions: Compared to noncombat veterans in the United States, combat veterans have elevated rates of PTSD, suicide attempt, stroke, and chronic pain independent of other sociodemographic, military, and mental health factors. Younger combat veterans have elevated rates of PTSD, suicidal ideation, and migraine headaches, while older combat veterans have elevated rates of heart disease and heart attack. These results characterize the population-based burden of mental and physical health conditions in combat veterans. They further underscore the importance of age- and condition-sensitive screening, monitoring, and treatmen...
Source: The Primary Care Companion for CNS Disorders - June 30, 2017 Category: Primary Care Tags: Prim Care Companion CNS Disord Source Type: research

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