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Source: Neurologic Clinics

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Total 72 results found since Jan 2013.

Cerebellar Hemorrhage
This article summarizes the current multidisciplinary approach to cerebellar hemorrhage, and addresses the controversies regarding its optimal management.
Source: Neurologic Clinics - September 14, 2014 Category: Neurology Authors: Sudhir Datar, Alejandro A. Rabinstein Source Type: research

Preface
This issue of Neurologic Clinics is devoted to cerebrovascular disease. Over the past four decades, the field of cerebrovascular diseases has progressed from recommendations based on experience and opinion to guidelines based on data from multiple, well-executed, randomized clinical trials. Nevertheless, there remain areas of uncertainty and controversy for which current data available from clinical trials have failed to produce consensus within the community of stroke practitioners. For this issue, thirteen of these areas were selected, and experts in each area were asked to provide up-to-date articles defining the proble...
Source: Neurologic Clinics - March 19, 2015 Category: Neurology Authors: William J. Powers Source Type: research

Cerebrovascular Diseases: Controversies and Challenges
This issue of Neurologic Clinics is devoted to cerebrovascular disease. Over the past four decades, the field of cerebrovascular diseases has progressed from recommendations based on experience and opinion to guidelines based on data from multiple, well-executed, randomized clinical trials. Nevertheless, there remain areas of uncertainty and controversy for which current data available from clinical trials have failed to produce consensus within the community of stroke practitioners. For this issue, thirteen of these areas were selected, and experts in each area were asked to provide up-to-date articles defining the proble...
Source: Neurologic Clinics - March 19, 2015 Category: Neurology Authors: William J. Powers Tags: Preface Source Type: research

Management of Asymptomatic Carotid Stenosis
With modern intensive medical therapy, the risk of ipsilateral stroke in patients with asymptomatic carotid stenosis (ACS) is below the risk of either carotid stenting or endarterectomy. Routine intervention for ACS is therefore not justified; approximately 90% of patients with ACS would be better off with intensive medical therapy. The few who could benefit can be identified by transcranial Doppler embolus detection or features of vulnerable plaque that can be imaged by 3-dimensional ultrasound, MRI or positron emission tomography/computed tomography; some of these methods are still in development.
Source: Neurologic Clinics - April 22, 2015 Category: Neurology Authors: J. David Spence Source Type: research

TiTrATE
This article proposes a new paradigm based on symptom timing, triggers, and targeted bedside eye examinations (TiTrATE). Patients fall into 1 of 4 major syndrome categories, each with its own differential diagnosis and set of targeted examination techniques that help make a specific diagnosis. Following an evidence-based approach could help reduce the frequency of misdiagnosis of serious causes of dizziness. In the spirit of the flipped classroom, the editors of this Neurologic Clinics issue on emergency neuro-otology have assembled a collection of unknown cases to be accessed electronically in multimedia format. By design...
Source: Neurologic Clinics - July 29, 2015 Category: Neurology Authors: David E. Newman-Toker, Jonathan A. Edlow Source Type: research

Misdiagnosing Dizzy Patients
This article highlights 5 pitfalls in the diagnosis of common vestibular disorders: (1) overreliance on dizziness symptom type to drive diagnostic inquiry; (2) underuse and misuse of timing and triggers to categorize patients; (3) underuse, misuse, and misconceptions linked to hallmark eye examination findings; (4) overweighting age, vascular risk factors, and neuroexamination to screen for stroke; and (5) overuse and overreliance on head computed tomography to rule out neurologic causes. This article discusses the evidence base describing each pitfall’s frequency and likely causes, and potential alternative strategies t...
Source: Neurologic Clinics - July 29, 2015 Category: Neurology Authors: Kevin A. Kerber, David E. Newman-Toker Source Type: research

Medical and Nonstroke Neurologic Causes of Acute, Continuous Vestibular Symptoms
Most patients with the acute vestibular syndrome (AVS) have vestibular neuritis or stroke or, in the setting of trauma, a posttraumatic vestibular cause. Some medical and nonstroke causes of the AVS must also be considered. Multiple sclerosis is the most common diagnosis in this group. Other less common causes include cerebellar masses, inflammation and infection, mal de debarquement, various toxins, Wernicke disease, celiac-related dizziness, and bilateral vestibulopathy. Finally, there may be unmasking of prior posterior circulation events by various physiologic alterations such as alterations of temperature, blood press...
Source: Neurologic Clinics - July 29, 2015 Category: Neurology Authors: Jonathan A. Edlow, David E. Newman-Toker Source Type: research

Case Studies in Neurocritical Care
This article presents 5 cases that illustrate just some of the conditions encountered in the daily practice of neurocritical care and exemplify some of the common diagnostic, therapeutic, and prognostic challenges facing the neurointensivist. Life-threatening medical complications after severe acute ischemic stroke, seizures and extreme agitation from autoimmune encephalitis, refractory seizures after subdural hemorrhage, neurologic and systemic complications related to aneurysmal subarachnoid hemorrhage, and status epilepticus after cardiac arrest are discussed in this article.
Source: Neurologic Clinics - June 2, 2016 Category: Neurology Authors: Amra Sakusic, Alejandro A. Rabinstein Source Type: research

Neurological Fallacies Leading to Malpractice
This article provides a case studies approach exposing the fallacies and highlighting proper management of these common neurologic presentations.
Source: Neurologic Clinics - July 19, 2016 Category: Neurology Authors: James C. Johnston, Knut Wester, Thomas P. Sartwelle Source Type: research

Neurology of Pregnancy
The anatomic and physiologic changes that occur during pregnancy are unique. A neurologist needs to be aware of normal pregnancy-induced physiologic changes in the cardiovascular, renal, hematologic, and autoimmune systems, and the local anatomic changes, which include alteration of body habitus and pelvic ligaments. These changes are clearly advantageous, but in certain circumstances may predispose to pathology. In addition, pregnancy effects treatment of chronic neurologic conditions as regards medication safety and metabolism. This case-oriented review discusses the important aspects of pregnancy physiology and an appro...
Source: Neurologic Clinics - July 19, 2016 Category: Neurology Authors: Mary Angela O’Neal Source Type: research

Case Studies in Neurocritical Care
This article presents 5 cases that illustrate just some of the conditions encountered in the daily practice of neurocritical care and exemplify some of the common diagnostic, therapeutic, and prognostic challenges facing the neurointensivist. Life-threatening medical complications after severe acute ischemic stroke, seizures and extreme agitation from autoimmune encephalitis, refractory seizures after subdural hemorrhage, neurologic and systemic complications related to aneurysmal subarachnoid hemorrhage, and status epilepticus after cardiac arrest are discussed in this article.
Source: Neurologic Clinics - June 2, 2016 Category: Neurology Authors: Amra Sakusic, Alejandro A. Rabinstein Source Type: research

Neurological Fallacies Leading to Malpractice
This article provides a case studies approach exposing the fallacies and highlighting proper management of these common neurologic presentations.
Source: Neurologic Clinics - July 31, 2016 Category: Neurology Authors: James C. Johnston, Knut Wester, Thomas P. Sartwelle Source Type: research

Neurology of Pregnancy
The anatomic and physiologic changes that occur during pregnancy are unique. A neurologist needs to be aware of normal pregnancy-induced physiologic changes in the cardiovascular, renal, hematologic, and autoimmune systems, and the local anatomic changes, which include alteration of body habitus and pelvic ligaments. These changes are clearly advantageous, but in certain circumstances may predispose to pathology. In addition, pregnancy effects treatment of chronic neurologic conditions as regards medication safety and metabolism. This case-oriented review discusses the important aspects of pregnancy physiology and an appro...
Source: Neurologic Clinics - July 31, 2016 Category: Neurology Authors: Mary Angela O ’Neal Source Type: research

Homonymous Hemianopia and Vision Restoration Therapy
Homonymous hemianopia from stroke causes visual disability. Although some patients experience spontaneous improvement, others have limited to no change and may be left with a severe disability. Current rehabilitation strategies are compensatory and cannot restore function. Animal studies suggest that central nervous system plasticity could allow for redirection of lost visual function into undamaged areas of cortex. A commercial therapy system was developed, from which claims of visual field expansion were disputed by independent researchers. The treatment remains controversial with seemingly contradictory data being gener...
Source: Neurologic Clinics - November 23, 2016 Category: Neurology Authors: Alexander Frolov, Jeanne Feuerstein, Prem S. Subramanian Source Type: research

Nosocomial Infections in the Neurointensive Care Unit
This article reviews the concept of brain injury –induced immune modulation, and summarizes available data and knowledge on nosocomial meningitis and ventriculitis, and systemic infectious complications in patients with traumatic brain injury, ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and status epilepticus.
Source: Neurologic Clinics - August 9, 2017 Category: Neurology Authors: Katharina Maria Busl Source Type: research