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Specialty: Neurology
Source: Neurology Clinical Practice

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Total 200 results found since Jan 2013.

Amyloid spells
A 66-year-old woman presented with a history of recurrent, transient neurologic symptoms including limb shaking, focal paresthesias, focal weakness, dysphasia, and unresponsiveness. The episodes showed no preference for time of day, lasted less than 6 minutes, and occurred less than monthly in small clusters, increasing in frequency slowly over 2 years. She lived independently, denied cognitive or other complaints, and had no history of smoking, hypertension, hyperlipidemia, coronary atherosclerosis or diabetes mellitus, or family history of stroke. Clinical examination was unremarkable. Cognition was grossly intact but no...
Source: Neurology Clinical Practice - April 7, 2019 Category: Neurology Authors: Cooperman, S. S., Shah, A. K., Rajamani, K. Tags: Intracerebral hemorrhage Case Source Type: research

Mirror therapy for improving motor functions in patients with leprosy with grade 2 disabilities
Conclusion Mirror therapy is a safe and cost-effective approach in the treatment of paretic limbs of patients with leprosy. Classification of evidence This study provides Class IV evidence that mirror therapy improves muscle strength in patients with leprosy associated with paresis.
Source: Neurology Clinical Practice - April 7, 2019 Category: Neurology Authors: Singh, M., Pawar, M. Tags: Bacterial infections, All Clinical Neurology, Clinical trials Observational study (Cohort, Case control), Class IV Research Source Type: research

Three Territory Sign: An MRI marker of malignancy-related ischemic stroke (Trousseau syndrome)
Conclusion The TTS is a highly specific marker and 6 times more frequently observed in malignancy-related ischemic stroke than atrial fibrillation-related ischemic stroke. Evaluation for underlying malignancy in patients with the TTS is reasonable in patients with undetermined etiology.
Source: Neurology Clinical Practice - April 7, 2019 Category: Neurology Authors: Nouh, A. M., Staff, I., Finelli, P. F. Tags: MRI, DWI, All Cerebrovascular disease/Stroke, All Oncology Research Source Type: research

Poor glycemic control and posterior circulation ischemic stroke
Conclusions Poor glycemic control may be associated with an increased risk of thrombotic infarction that occurs preferentially in the posterior circulation of the brain.
Source: Neurology Clinical Practice - April 7, 2019 Category: Neurology Authors: Kuroda, J., Matsuo, R., Yamaguchi, Y., Sato, N., Kamouchi, M., Hata, J., Wakisaka, Y., Ago, T., Kitazono, T., on behalf of the Fukuoka Stroke Registry Investigators Tags: Infarction Research Source Type: research

Role of CYP2C19 alleles in the management of recurrent ischemic stroke
Purpose of review CYP2C19 is the primary enzyme involved in the activation of clopidogrel, an antiplatelet agent used for secondary stroke prevention. An individual's CYP2C19 alleles are used to understand their CYP2C19-clopidogrel metabolizer phenotype. Single nucleotide polymorphisms of the CYP2C19 gene result in altered metabolism of this prodrug. Recent findings Three ischemic stroke cases were treated with clopidogrel. Despite confirming adequate drug exposure, medication adherence, and ruling out drug-drug interactions, all had recurrent ischemic stroke. Each case had a CYP2C19 *2/*17 genotype, categorizing them as ...
Source: Neurology Clinical Practice - April 7, 2019 Category: Neurology Authors: Lyerly, M. J., Bartlett, K., Albright, K. C. Tags: All Cerebrovascular disease/Stroke, Infarction, All Genetics Review Source Type: research

Torsional internuclear ophthalmoplegia in acute ischemic stroke
A 45-year-old man with no medical history woke up with acute binocular diplopia. Clinical examination revealed disturbances in eye movements (video 1). MRI showed a recent infarction in the left posteromedial mesencephalon (figures 1 and 2). Lesions of this type can result in inactivation of the interstitial nucleus of Cajal which causes an ipsilateral torsional quick phase nystagmus,1 as well as inactivation of the left medial longitudinal fascicle, which causes a left-sided internuclear ophthalmoplegia.2 Within 24 hours, symptoms had resolved completely.
Source: Neurology Clinical Practice - April 7, 2019 Category: Neurology Authors: Vynckier, J., Lemmens, R. Tags: Stroke in young adults, DWI, Clinical neurology examination, All Cerebrovascular disease/Stroke Case Source Type: research

Reader response: Traumatic and spontaneous intracranial hemorrhage in patients with atrial fibrillation on warfarin
We read with interest the study by Lehtola et al.1 Anticoagulation (AC) in atrial fibrillation (AF) reduces the risk of ischemic stroke, but at the cost of increasing the risk of hemorrhagic stroke.
Source: Neurology Clinical Practice - February 12, 2019 Category: Neurology Authors: Vilanilam, G. K., Gopal, N., Agarwal, A., Badi, M. K. Tags: The Nerve! Readers Speak Source Type: research

Hemorrhagic stroke complicated by cerebral venous sinus thrombosis with idarucizumab
Idarucizumab can lead to acute thrombosis in a patient with an underlying procoagulant state.
Source: Neurology Clinical Practice - February 12, 2019 Category: Neurology Authors: Phua, C. S., Bonura, A., Choong, H. Tags: MRI, Gastrointestinal, Hematologic, Intracerebral hemorrhage, Cerebral venous thrombosis Case Source Type: research

Door in door out and transportation times in 2 telestroke networks
Conclusion In the included telestroke networks, the sDTG time is longer when CTA is conducted at spoke site prior to transportation to TSC. New strategies are urgently needed to decrease sDTG when CTA is done prior to transfer to TSC.
Source: Neurology Clinical Practice - February 12, 2019 Category: Neurology Authors: Al Kasab, S., Almallouhi, E., Harvey, J., Turner, N., Debenham, E., Caudill, J., Holmstedt, C. A., Switzer, J. A. Tags: Other cerebrovascular disease/ Stroke, All Cerebrovascular disease/Stroke Research Source Type: research

Cytomegalovirus encephalitis radiographically mimicking lateral medullary stroke
Cytomegalovirus encephalitis may demonstrate unique MRI characteristics that allow for earlier diagnosis and treatment.
Source: Neurology Clinical Practice - December 10, 2018 Category: Neurology Authors: Li, D., van Gaal, S. Tags: MRI, Encephalitis, Viral infections, HIV, All Cerebrovascular disease/Stroke Case Source Type: research

Treatment of a hot carotid: More fuel is needed to clarify the best treatments
The majority of patients presenting with a stroke or TIA receive imaging for carotid stenosis. Treatment of symptomatic carotid stenosis is familiar to most neurologists since high-profile clinical trials have been conducted in the past. The most well-known in North America is the North American Symptomatic Carotid Endarterectomy Trial (NASCET).1 NASCET and additional analysis by Rothwell et al.2 led to the recommendation that if the patient is an otherwise suitable candidate for carotid endarterectomy (CEA), then performing the operation within 2 weeks of the last symptomatic event is desirable.
Source: Neurology Clinical Practice - December 10, 2018 Category: Neurology Authors: Chaturvedi, S. Tags: CT, Stroke prevention, Ultrasound, All Cerebrovascular disease/Stroke, Practice Current Editorial Source Type: research

Experience of a neurology service during the 2016 Olympic and Paralympic Games
Conclusions As expected, many athletes with sports-related injuries were evaluated, but cases of diverse acute neurologic pathologies were observed among nonathlete members of the OF and PF. Olympic Games are large, logistically complex events involving thousands of people. Our observations suggest that a comprehensive and detailed plan for neurologic emergencies should be considered for future games.
Source: Neurology Clinical Practice - December 10, 2018 Category: Neurology Authors: da Silva, I. R. F., Gouvea, L., Bruno Nogueira, C., Cravo, V., Liberato, B. B. Tags: Medical care, All Cerebrovascular disease/Stroke, Brain trauma, Critical care Research Source Type: research

Stroke in young adults: Five new things
Purpose of review The incidence of stroke in young adults is increasing, mainly driven by an increasing incidence of ischemic stroke in this population. We provide new information that has been recently presented regarding the risk factor prevalence, some specific etiologic causes, and management strategies in ischemic stroke in this population. Recent findings Recent studies indicate a rapid increase in traditional risk factors in young adults. New information regarding the management of patent foramen ovale in cryptogenic stroke and cervical artery dissection is available. Summary Stroke in young adults is a rapidly gr...
Source: Neurology Clinical Practice - December 10, 2018 Category: Neurology Authors: Bhatt, N., Malik, A. M., Chaturvedi, S. Tags: Stroke in young adults, Stroke prevention, All Cerebrovascular disease/Stroke, Carotid artery dissection Review Source Type: research

The COAST stroke advance directive: A novel approach to preserving patient autonomy
This article discusses some of the challenges of preserving patient autonomy in patients presenting with acute stroke and the advent of a stroke advance directive (Coordinating Options for Acute Stroke Therapy [COAST]) aimed to overcome these obstacles.
Source: Neurology Clinical Practice - December 10, 2018 Category: Neurology Authors: McGehrin, K., Spokoyny, I., Meyer, B. C., Agrawal, K. Tags: All Cerebrovascular disease/Stroke, All Ethics in Neurology/Legal issues, Palliative care Commentary Source Type: research

Practice Current: How do you manage patients with a "hot carotid"?
Patients presenting with acutely symptomatic carotid stenosis (a "hot carotid") are known to be at a high up-front risk of recurrent strokes. Uncertainties remain regarding the appropriate management of such patients in the acute period, particularly with respect to anti-thrombotic treatment as they await revascularisation with carotid endarterectomy (CEA) or angioplasty/stenting (CAS). Decision-making is further complicated when intraluminal thrombi are encountered on vessel imaging. Given these uncertainties, and the paucity of high-quality data in the literature, we sought expert opinion from around the globe on how to ...
Source: Neurology Clinical Practice - December 10, 2018 Category: Neurology Authors: Ganesh, A., Wong, J. H., Menon, B. K., Bartolini, L. Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Practice Current Commentary Source Type: research