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The role of hippocampal pathology in post-stroke cognitive impairment
Background Cognitive impairment is common following cerebrovascular disease. Recently it has been associated with hippocampal ultra-structural damage in stroke survivors. We aim to study the long-term cognitive profile of patients after ischaemic stroke and characterise the cognitive behaviours associated with any dynamic changes in the structure, function and metabolism of the hippocampi, using multimodal MRI at 3Tesla. Methods We are conducting a dual-centre study to investigate the predictive value of diagnostic MRI and resting-state fMRI based on observing natural history of cognitive function following stroke (at bas...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Hosseini, A. A., Ispoglou, S., Hayton, T., Evans, R., Wilson, M., Sawlani, V., Rotshtein, P., Auer, D. P. Tags: Stroke, Memory disorders (psychiatry), Radiology, Radiology (diagnostics) ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Is the outpatient management of acute minor stroke feasible and safe?
Paul et al1 have assessed the clinical outcomes, early hospital admission rates and hospital care costs in clinic referred and hospital referred minor stroke patients in a prospective population based study. They did not find significant differences in the 30 day admission rate in clinic patients compared with the 30 day readmission rate after discharge in hospital treated patients (16/237 vs 9/150). The 30 day recurrent stroke risk in patients with minor ischaemic stroke was also similar in those discharged from clinic compared with hospital patients (3.8% vs 5.3%; p=0.61). The recurrent stroke risk remained similar in pa...
Source: Journal of Neurology, Neurosurgery and Psychiatry - February 15, 2013 Category: Neurosurgery Authors: Csiba, L. Tags: Epilepsy and seizures, Stroke, Hypertension Editorial commentaries Source Type: research

Predicting delirium after a stroke
Clinicians treating patients with stroke will be familiar with delirium: a syndrome characterised by the rapid onset of disorganised thought, inattention and altered level of consciousness, with a characteristically fluctuant course. Limited data suggest that up to a quarter of patients with stroke admitted to hospital are affected at some point.1 In addition to being distressing for patients and carers, delirium doubles the risk of death and dependency.2 If diagnosed correctly, delirium can be treated by searching for precipitating factors such as infection, altering predisposing factors such as medication and taking step...
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 5, 2014 Category: Neurosurgery Authors: Makin, S. D. J., Wardlaw, J. Tags: Open access, Stroke, Delirium, Memory disorders (psychiatry), Disability Editorial commentaries Source Type: research

Strokes happen round the clock, but why is stroke care worse on weekends and overnight?
Walk into a typical acute hospital on a weekend or overnight, and it feels like a very different place than on a weekday. Most laboratories, theatres and diagnostics run reduced services, the corridors are quiet, and you are more likely to see a doctor or nurse rushing to an emergency than walking the wards on consults or rounds. Strokes however do not happen only when the hospital is best prepared, with 6 in 10 strokes occurring overnight or on weekends. This discontinuity between the provision of healthcare across the working week and the presentation of stroke has raised concerns that patients admitted on weekends and o...
Source: Journal of Neurology, Neurosurgery and Psychiatry - January 14, 2016 Category: Neurosurgery Authors: Rudd, A. G., Bray, B. Tags: Stroke Editorial commentaries Source Type: research

Whatsapp--an innovative solution for the stroke care
A 54-year-old man with a suspected stroke was admitted to a small clinical facility about 288 kilometres away from the tertiary stroke care centre with the thrombolysis facility. When the staff at the hospital contacted us, we requested them to send the CT brain images via Whatsapp on iPhone5. Whatsapp is a communication software which runs on various mobile platforms. The image quality was excellent and was read off and a diagnosis of a left MCA territory lacunar stroke was made. The initial management was discussed over phone and was initiated at the peripheral clinical facility. Subsequently, the patient was transferred...
Source: Journal of Neurology, Neurosurgery and Psychiatry - September 9, 2014 Category: Neurosurgery Authors: Dey, K. Tags: Abstracts Source Type: research

The use of smartphone applications in patients attending tia clinic
Ten major risk factors account for 90% of the population attributable stroke risk. Smartphone applications may be used for education and self-managing risk factors. We aimed to explore use and attitudes towards smartphones in a TIA clinic. Methods From September 2015 consecutive patients attending University College Hospitals, London TIA clinic completed a questionnaire, relating to, stroke risk factors and use of smartphones. A likert scale (strongly disagree=1, strongly agree=10) evaluated attitudes towards Smartphone applications in stroke education and management. Results 118 patients completed the questionnaire. Mean...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Clayton, L., Dados, A., Simister, R., Gill, S., Chandratheva, A. Tags: Stroke, Hypertension ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

050 Feasibility of an automated assessment to measure cognition and mood in the acute stroke setting
Discussion Screening was adapted due to Covid pandemic and utilising remote consent and participa- tion allowed the project to continue.
Source: Journal of Neurology, Neurosurgery and Psychiatry - August 12, 2022 Category: Neurosurgery Authors: Bell, S., Harkness, K., Roman, M., Gardner, J., Richards, E., Howe, J., Sikaonga, M., Mirheidari, B., Christensen, H., Blackburn, D. Tags: Poster presentations Source Type: research

Reversible leukoencephalopathy as a presentation of cerebral amyloid angiopathy
A 73 year old man with a past medical history of hypertension, osteoathritis and asthma presented to the local district general hospital with recurrent episodes of spontaneously resolving encephalopathy. The initial presentation was characterised by acute confusion and visual hallucinations followed by a generalised tonic–clonic seizure. On examination his blood pressure was 215/115 mmHg. Neurological examination did not reveal any lateralising signs but the patient was found to be encephalopathic with a Montreal Cognitive Assessment (MOCA) score of 9/30. Routine blood tests were unremarkable. A CT brain scan showed ...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Lilleker, J., Vassallo, J., Punter, M. Tags: Genetics, Immunology (including allergy), Epilepsy and seizures, Stroke, Hypertension, Drugs: psychiatry, Radiology, Surgical diagnostic tests Association of British Neurologists (ABN) joint meeting with the Royal College of Physicians (RCP), London, 23 Source Type: research

Staring you in the face! sturge-weber syndrome is a spectrum disorder and late presentation is possible
A 52 year old man with a four year history of migraine with aura presented to hospital with a severe right sided headache and prolonged episode of left sided sensory and motor disturbance. Examination revealed left homonymous hemianopia, sensory inattention and hemiparesis (3/5). Reflexes were symmetrical and plantars downing. He had a facial port wine stain in a V1 distribution on the right. Unenhanced CT scan was normal. Migrainous infarction was the working diagnosis and he was commenced on aspirin. Two days later he experienced intermittent episodes of left face and arm twitching consistent with focal motor seizures, t...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Cosgrove, J., Hassan, A. Tags: Genetics, Drugs: CNS (not psychiatric), Epilepsy and seizures, Headache (including migraine), Pain (neurology), Stroke, Radiology, Radiology (diagnostics) Association of British Neurologists (ABN) joint meeting with the Royal College of Physicians (RCP) Source Type: research

Spatial neglect
Giuseppe Vallar, MD, specialty in Neurology, Italian, was born in Milan. Department of Psychology, University of Milano-Bicocca, & IRCCS Italian Auxological Institute, Milan, Italy. Email: giuseppe.vallar@unimib.it Giuseppe Vallar since 1999, Professor of Psychobiology and Physiological Psychology and, since 2009, the Director of the Specialty School in Neuropsychology, of the Department of Psychology of the University of Milan-Bicocca-Milan, Italy. Since 2005 Giuseppe Vallar is the Head of the Neuropsychological Laboratory, of the Italian Auxological Institute, Saint Luca Hospital, Milan, Italy. Previously, Giuseppe V...
Source: Journal of Neurology, Neurosurgery and Psychiatry - August 13, 2015 Category: Neurosurgery Tags: Stroke PRESENTATION ABSTRACTS - DAY 2 Source Type: research

TEARS: a longitudinal investigation of the prevalence, psychological associations and trajectory of poststroke emotionalism
This study aimed to assess the prevalence and course of PSE over the first year poststroke, and its psychological associations. Methods Consenting stroke survivors who were physically and cognitively able to participate were assessed within 2 weeks, 6 and 12 months of stroke to determine PSE point prevalence using a diagnostic, semistructured PSE interview (Testing Emotionalism After Recent Stroke-Diagnostic Interview). At the same assessments, neuropsychological and disability status were determined using Hospital Anxiety and Depression Scale, Abbreviated Mental Test, National Institute of Health Stroke Scale, Barthel In...
Source: Journal of Neurology, Neurosurgery and Psychiatry - July 14, 2022 Category: Neurosurgery Authors: Broomfield, N. M., West, R., Barber, M., Quinn, T. J., Gillespie, D., Walters, M., House, A. Tags: Editor's choice Neuropsychiatry Source Type: research

266 A drowsy patient: beyond the familiar territory
A 72-year-old man was brought to the hospital after he was found unresponsive at home by his wife who reported that he has been sleepy in the last few days. He has a background of hypertension, myocardial infarct, and osteoarthritis. His medications include anti-hypertensive and morphine sulphate. On examination, he was drowsy with GCS fluctuating between 9–11 but maintaining his airways. He was moving all four limbs; pupils were small and unequal but reactive to light. Planter reflexes were downgoing. Opioid toxicity was suspected and treated with naloxone without any response. The CT head scan showed no acute patho...
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 27, 2022 Category: Neurosurgery Authors: Oo, A., Khine, N. Tags: Poster Presentations Source Type: research

Unilateral isolated hypoglossal nerve palsy associated with internal carotid artery dissection
A 54-year-old healthy man was admitted to our hospital with acute dysarthria and mild impairment in swallowing and tongue movements, which he had noticed 2 days before. He was not taking any drugs, and his medical history was unremarkable except for mild hypertension (145/95 mm Hg). He denied prior trauma, fever, facial pain, headache or any other symptoms. Physical examination showed mild dysarthria and left-sided tongue deviation when the patient poked his tongue out, which was consistent with left hypoglossal nerve palsy (figure 1A). Other cranial nerves were preserved. Carotid murmurs were not heard, and...
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 7, 2013 Category: Neurosurgery Authors: Riancho, J., Infante, J., Mateo, J. I., Berciano, J., Agea, L. Tags: Brain stem / cerebellum, Cranial nerves, Drugs: CNS (not psychiatric), Headache (including migraine), Neuroimaging, Neurological injury, Pain (neurology), Stroke, Trauma CNS / PNS, Hypertension, Ophthalmology, Radiology, Radiology (diagnostics), Trauma, I Source Type: research

Anti glutamic acid decarboxylase antibody mediated encephalopathy while on etanercept in a patient with multiple autoimmune diseases
A 39 year old lady presented with an altered mental state and unsteadiness of gait. She had a history of juvenile idiopathic arthritis, autoimmune thyroiditis and alopecia, protein S deficiency with vena cava thrombosis, previous excision of ovarian mass and vasculitic rash. There was a previous history of ovarian mass and her immunomodulatory therapy for arthritis over the previous year was Etanercept. She used recreational cannabis but denied any other illicit drug usage. Her affect was variable and at times inappropriate with frequent laughter. She would spit regularly. There was anxiety and a prevailing sensation of do...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: MacDougall, N., Waddell, B., O'Riordan, J. I. Tags: Immunology (including allergy), Brain stem / cerebellum, Drugs: CNS (not psychiatric), Epilepsy and seizures, Infection (neurology), Stroke, Drugs misuse (including addiction), Connective tissue disease, Musculoskeletal syndromes Association of British Source Type: research

Think outside the box, collapse the box, and take a sharp knife to it!
A 74 year–old woman presented in December 2011 with left sided cerebellar symptoms. She was initially diagnosed as having a posterior circulation infarction and discharged from hospital on appropriate medication. However, over the following month she continued to deteriorate, developing increasing unsteadiness, falls, nausea and vomiting. Following a second admission in January 2012 she had a single seizure and developed focal left sided myoclonus affecting mainly the upper limb. Over the following month the myoclonus spread to affect all four limbs, although it remained more prominent on the left side. There was evi...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Dobson, R., McMillan, A., Kung, K., Thom, M., Davis, A., Simister, R., Giovannoni, G., Gnanapavan, S. Tags: Immunology (including allergy), HIV/AIDS, Tropical medicine (infectious diseases), Brain stem / cerebellum, Epilepsy and seizures, Infection (neurology), Multiple sclerosis, Stroke, Ophthalmology, Radiology, Surgical diagnostic tests Association of Brit Source Type: research

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