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Optical coherence tomography-guided flow diversion for aneurysmal treatment
A 28-year-old man presenting with right third nerve palsy was diagnosed with a giant unruptured aneurysm supplied by the right posterior communicating and cerebral arteries (figure 1, A and B). The aneurysm was treated with flow-diverting stent-assisted coiling. Two months later, he presented with new-onset left-sided weakness, and MRI showed increased edema in the thalamus (figure 1C) and increased aneurysm size and no filling. There was no evidence of stent malapposition with high-resolution cone-beam (VASO) CT (figure 2). Angiography and optical coherence tomography (OCT) imaging demonstrated no stent endothelialization...
Source: Neurology Clinical Practice - August 9, 2020 Category: Neurology Authors: Pasarikovski, C. R., da Costa, L., Pereira, V. M., Ramjist, J., Dobashi, Y., Yang, V. X. D. Tags: Stroke in young adults, CT, MRI, Subarachnoid hemorrhage Case Source Type: research

Association between recent cannabinoid use and acute ischemic stroke
Conclusion This is one of the few studies analyzing the association of recent cannabis use and AIS using admission urine toxicology test independent of polysubstance use. Although our study has limitations, we did not find an independent association between recent cannabis use and the incidence of AIS. Further studies using urine toxicology tests with larger sample size and including dosage of cannabis exposure should be conducted.
Source: Neurology Clinical Practice - August 9, 2020 Category: Neurology Authors: San Luis, C. V., O'Hana S. Nobleza, C., Shekhar, S., Sugg, R., Villareal, D. J., Mehta, T., Gangadhara, S. Tags: All Cerebrovascular disease/Stroke, Other toxicology Research Source Type: research

Looking ahead: The risk of neurologic complications due to COVID-19
The rapid spread of Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 has become a public health emergency of international concern. The outbreak was characterized as a pandemic by the World Health Organization (WHO) in March 2020. The most characteristic symptom of patients with COVID-19 is respiratory distress. Some patients may also show neurologic signs and symptoms ranging from headache, nausea, vomiting, and confusion to anosmia, ageusia, encephalitis, and stroke. Coronaviruses are known pathogens with neuroinvasive potential. There is increasing evidence that coronavirus i...
Source: Neurology Clinical Practice - August 9, 2020 Category: Neurology Authors: Perez, C. A. Tags: Viral infections, All global neurology, Public health, COVID-19 Commentary Source Type: research

Can and should neurologists screen their patients for depression? Yes, and...
The boundary between neurology and psychiatry is often an artificial one. Sharing an organ system, neurologists refer to diseases of the brain and nervous system, whereas psychiatrists diagnose and treat disorders of the mind. The distinction is one more of perspective than the actual state of our respective patients. The elegant approach of neuroanatomical localization does not neatly accommodate mood and thought disorders, whereas focal neurologic diseases are considered outside the spectrum of psychiatric disease. However, the prevalence of psychiatric disease in the neurologic population is considerable. Patients suffe...
Source: Neurology Clinical Practice - June 7, 2020 Category: Neurology Authors: Ney, J. P., Satya-Murti, S. Tags: Cost effectiveness/economic, Diagnostic test assessment, All Clinical Neurology, Depression, All epidemiology Editorial Source Type: research

Validity of the Patient Health Questionnaire-9 in neurologic populations
Conclusions Despite theoretical concerns about its validity, the PHQ-9 performed well at its standard cut-point of 10. Consistent with the literature, being able to use a validated, brief tool that is available publicly should improve case finding of depression in neurologic populations. When considering clinical practicality along with the findings of this analyzed, this study confirmed that the PHQ-9 is valid in a general outpatient neurologic population.
Source: Neurology Clinical Practice - June 7, 2020 Category: Neurology Authors: Williams, K. G., Sanderson, M., Jette, N., Patten, S. B. Tags: Cost effectiveness/economic, Diagnostic test assessment, All Clinical Neurology, Depression, All epidemiology Research Source Type: research

Treatment and outcome of childhood cerebral sinovenous thrombosis
Conclusions Within the IPSS registry, children with risk factors of trauma or intracranial surgery were less likely to receive anticoagulation for CSVT. Anticoagulation was associated with a lower odds of severe neurologic impairment or death at hospital discharge, but this finding is limited and needs further confirmation in randomized, controlled, prospective studies.
Source: Neurology Clinical Practice - June 7, 2020 Category: Neurology Authors: Felling, R. J., Hassanein, S. M. A., Armstrong, J., Aversa, L., Billinghurst, L., Goldenberg, N. A., Lee, J. E., Maxwell, E. C., Noetzel, M. J., Lo, W., on behalf of the International Pediatric Stroke Study Group Tags: Childhood stroke, Hematologic, Pediatric stroke; see Cerebrovascular Disease/ Childhood stroke, Intracerebral hemorrhage, Cerebral venous thrombosis Research Source Type: research

Risk of stroke after emergency department visits for neurologic complaints
Conclusions Among patients discharged from the ED without a diagnosis of TIA or stroke, the occurrence of a head CT and/or specific neurologic symptoms established a clinically meaningful risk gradient for subsequent stroke.
Source: Neurology Clinical Practice - April 5, 2020 Category: Neurology Authors: Rosenman, M. B., Oh, E., Richards, C. T., Mendelson, S., Lee, J., Holl, J. L., Naidech, A. M., Prabhakaran, S. Tags: CT, All Cerebrovascular disease/Stroke Research Source Type: research

Cerebral venous thrombosis: Associations between disease severity and cardiac markers
Conclusions In this single-center cohort study, markers of CVT severity were associated with increased odds of cTn elevation; further investigation is needed to elucidate causality and significance.
Source: Neurology Clinical Practice - April 5, 2020 Category: Neurology Authors: Johansen, M. C., Gottesman, R. F., Urrutia, V. C. Tags: Other cerebrovascular disease/ Stroke, All Clinical Neurology, All Cerebrovascular disease/Stroke, Cerebral venous thrombosis Research Source Type: research

Apraxia of speech involves lesions of dorsal arcuate fasciculus and insula in patients with aphasia
Conclusions Results are consistent with previous findings identifying lesions of the insula and AF in patients with AOS, damage to both of which may create dysfluency in patients with aphasia.
Source: Neurology Clinical Practice - April 5, 2020 Category: Neurology Authors: Chenausky, K., Paquette, S., Norton, A., Schlaug, G. Tags: MRI, All Cerebrovascular disease/Stroke, Aphasia, Apraxia Research Source Type: research

Serial vessel wall MR imaging of pediatric tuberculous vasculitis
Vessel wall MR imaging may be helpful in diagnosing and monitoring the treatment of vasculitic complications from CNS infections.
Source: Neurology Clinical Practice - December 8, 2019 Category: Neurology Authors: Song, J. W., Lehman, L., Rivkin, M., Gorman, M. P., Yang, E. Tags: Childhood stroke, MRI, Meningitis, Pediatric stroke; see Cerebrovascular Disease/ Childhood stroke Case Source Type: research

Zoster vasculopathy surveillance using intracranial vessel wall imaging
Vessel wall imaging can be useful for diagnosis and assessment of intracranial zoster vasculopathy activity, even in the setting of remote cutaneous zoster infection.
Source: Neurology Clinical Practice - December 8, 2019 Category: Neurology Authors: English, S. W., Carabenciov, I. D., Lehman, V. T., Petty, G. W., Scharf, E. L. Tags: MRI, Viral infections, All Cerebrovascular disease/Stroke Case Source Type: research

Mumps encephalitis with bilateral hippocampal lesions preceding parotitis
Bilateral hippocampal lesions can be a feature in both infectious and autoimmune limbic encephalitis. Although rare, mumps meningoencephalitis should be considered in the differential diagnosis of bilateral hippocampal lesions, especially in the presence of symptoms suggestive of systemic and/or CNS infection.
Source: Neurology Clinical Practice - December 8, 2019 Category: Neurology Authors: Chee, Y. C., Ong, B. H. Tags: MRI, Encephalitis, All Clinical Neurology, All Cerebrovascular disease/Stroke, EEG; see Epilepsy/Seizures Case Source Type: research

The utility of histopathologic characteristics of thrombi in large vessel occlusions
Consider reviewing the histopathology of retrieved thrombi from patients treated with mechanical thrombectomy. Histopathologic features of thrombi have the potential to provide a large array of information in the identification of stroke mechanism and subsequent treatment.
Source: Neurology Clinical Practice - December 8, 2019 Category: Neurology Authors: Ridha, M., Malek, A., Arkun, K., Leung, L. Y. Tags: All Cerebrovascular disease/Stroke, Embolism Case Source Type: research

Optical coherence tomography as an adjunct during carotid artery stenting for carotid web
Consider optical coherence tomography as an adjunct to visualize the membrane of a carotid web, the extent of the web, and aid in placement of a carotid stent.
Source: Neurology Clinical Practice - December 8, 2019 Category: Neurology Authors: Pasarikovski, C. R., Ramjist, J., da Costa, L., Yang, V. X. D. Tags: Stroke in young adults, Stroke prevention, Embolism, Infarction Case Source Type: research

Disappearance of long-term right-sided essential tremor after stroke in the left corona radiata
Diffusion tensor tractography may help precisely identify the potential target brain area for ET therapy.
Source: Neurology Clinical Practice - December 8, 2019 Category: Neurology Authors: Xi, C., Li, S., Liu, Y., Mei, B. Tags: Tremor, Motor Control, Motor cortex, Basal ganglia, Infarction Case Source Type: research

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