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Specialty: Neurology
Source: Neurology Clinical Practice

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Total 200 results found since Jan 2013.

A severe, relapsing case of myelin oligodendrocyte glycoprotein IgG-associated CNS inflammation
A 55-year-old man presented in October 2004 with general unease, vomiting, and gait disturbance. Initially diagnosed with an inner ear infection, the patient's symptoms did not improve and he was evaluated further. MRI revealed a cerebellar lesion, which led to the suspicion of a posterior circulation stroke, and he was started on antiplatelet drugs. However, an angiogram suggested no vascular pathology. In March 2011, he had another episode of ataxia and MRI showed a right brainstem lesion. Cryptogenic stroke was reconsidered. In March 2013, the patient developed paraparesis with urinary and bowel symptoms. MRI revealed m...
Source: Neurology Clinical Practice - February 12, 2018 Category: Neurology Authors: Saviour, M., Hamid, S., Moore, P., Mutch, K., Bhojak, M., Duddy, M., Jacob, A. Tags: All Demyelinating disease (CNS), Devic's syndrome, Optic neuritis; see Neuro-ophthalmology/Optic Nerve, Transverse myelitis Case Source Type: research

Neurologic attack and dynamic perfusion abnormality in neuronal intranuclear inclusion disease
Neuronal intranuclear inclusion disease (NIID) is a neurodegenerative disease characterized by eosinophilic hyaline intranuclear inclusions in cells in the central, peripheral, and autonomic nervous system and visceral organs. Although clinical diagnosis was difficult until recently, an increasing number of adult cases of leukoencephalopathy have been diagnosed antemortem with NIID based on the characteristic hyperintensity in the corticomedullary junction on diffusion-weighted imaging (DWI) and confirmatory skin biopsy.1 While adult-onset NIID is characterized by slowly progressive dementia, it may also present with acute...
Source: Neurology Clinical Practice - December 11, 2017 Category: Neurology Authors: Fujita, K., Osaki, Y., Miyamoto, R., Shimatani, Y., Abe, T., Sumikura, H., Murayama, S., Izumi, Y., Kaji, R. Tags: MRI, SPECT, DWI, All Cognitive Disorders/Dementia Case Source Type: research

The upgoing thumb sign: An interobserver/intraobserver reliability study
Conclusions: The upgoing thumb sign is a subtle upper limb neurologic finding, with a high level of interobserver and intraobserver reliability. The test is easy to perform and can be interpreted accurately.
Source: Neurology Clinical Practice - December 11, 2017 Category: Neurology Authors: Abootalebi, S., Azarpazhooh, M. R., Sposato, L., Hachinski, V. Tags: Research Source Type: research

Transgender venous thrombosis
A 53-year-old male-to-female transgender patient on cross-sex hormone replacement therapy (CSHT), estradiol 8 mg daily, presented to the emergency department (ED) with acute-onset headache and left visual field disturbances after a recent mechanical fall with head trauma. The medical history was notable for hyperlipidemia. There was no personal or family history of clotting disorders and no history of tobacco use.
Source: Neurology Clinical Practice - December 11, 2017 Category: Neurology Authors: Opaskar, A., Scharf, E. L., Chilungu, M. W., Kelly, A. G. Tags: All Cerebrovascular disease/Stroke, Cerebral venous thrombosis Case Source Type: research

Thrombolysis of a stroke patient with history of rtPA-associated angioedema
We report such a case where a patient with previous rtPA-related orolingual angioedema was successfully treated with IV rtPA without adverse reactions.
Source: Neurology Clinical Practice - December 11, 2017 Category: Neurology Authors: De Los Rios La Rosa, F., Starosciak, A. K., Wolf, B. Tags: All Cerebrovascular disease/Stroke, Patient safety Case Source Type: research

Brain and spinal cord infarcts secondary to an atrial-esophageal fistula
We report a patient whose spinal cord inflammation on pathology is suggestive of septic emboli.
Source: Neurology Clinical Practice - October 16, 2017 Category: Neurology Authors: Renati, S., Yang, C., Walsh, M., Trejo-Lopez, J., Khanna, A. Tags: All Cerebrovascular disease/Stroke, Spinal cord infarction, Cardiac Case Source Type: research

Cerebral microemboli detection for monitoring structural cardiac disease
This report demonstrates the presence of a major valvular thrombus not visualized on echocardiography, but detected by TCD microemboli detection.
Source: Neurology Clinical Practice - October 16, 2017 Category: Neurology Authors: Shafie, M., Song, S., Nezhad, M., Lamberti, J., Cocalis, M., Cavallaro, M., Rinsky, B., Lyden, P. Tags: Stroke prevention, Cardiac, Embolism, Infarction Case Source Type: research

Nivolumab-induced posterior reversible encephalopathy syndrome
A 47-year-old woman with metastatic, poorly differentiated lung cancer with neuroendocrine features was brought to the hospital after 4 days of nausea, vomiting, disorientation, and 1 generalized tonic clonic seizure. On examination, her blood pressure was 148/95 mm Hg, heart rate 95 bpm, and temperature 36.4°C. She was encephalopathic and had cortical blindness. She had no history of seizures or visual impairment. MRI brain without contrast showed changes consistent with posterior reversible encephalopathy syndrome (PRES; figure, A). She had been on nivolumab, of which she had received 2 doses; the last dose was 24 da...
Source: Neurology Clinical Practice - October 16, 2017 Category: Neurology Authors: Hussein, H. M., Dornfeld, B., Schneider, D. J. Tags: MRI, Other cerebrovascular disease/ Stroke, All Clinical Neurology, Chemotherapy-tumor Case Source Type: research

Pure lemniscal sensory stroke
A 67-year-old hypertensive woman was seen in consultation after the sudden onset of left leg numbness. Neurologic assessment disclosed reduced perception of the left lower limb (under the knee) to light touch as well as to vibratory and proprioceptive stimuli.
Source: Neurology Clinical Practice - August 14, 2017 Category: Neurology Authors: Carota, A., Knoepfli, A.-S., Bogousslavsky, J. Tags: Other cerebrovascular disease/ Stroke, All Clinical Neurology, Clinical neurology examination, Central pain, Infarction Case Source Type: research

Heath care utilization, access, and advocacy
Neurologic diseases rarely occur in isolation. Clinical practitioners need to consider possible comorbidities and their effect on disease management when treating their patients. Lukmanji et al. (p. 344) review online tools for patients with neurologic diseases and depression and advocate for the development of high-quality, evidence-based online tools. Xu et al. (p. 324) use ENCHANTED trial data to examine early seizures after thrombolysis for acute ischemic stroke. Campiglio et al. (p. 296) use retrospective data to evaluate the utility of 48 hours of observation and a follow-up head CT in patients with mi...
Source: Neurology Clinical Practice - August 14, 2017 Category: Neurology Tags: From the Editor ' s Desk Source Type: research

Frequency, determinants, and effects of early seizures after thrombolysis for acute ischemic stroke: The ENCHANTED trial
Conclusions: In thrombolysis-treated patients with acute ischemic stroke, seizures are uncommon, occur early, and predict poor recovery. Clinicaltrials.gov identifier: NCT01422616.
Source: Neurology Clinical Practice - August 14, 2017 Category: Neurology Authors: Xu, Y., Hackett, M. L., Chalmers, J., Lindley, R. I., Wang, X., Li, Q., Robinson, T., Arima, H., Lavados, P. M., Anderson, C. S., For the ENCHANTED Study Group Tags: Quality of life, All Cerebrovascular disease/Stroke, Prevalence studies, Infarction, All Epilepsy/Seizures Research Source Type: research

The emerging partnership between palliative care and stroke
Stroke care displays 2 truisms. First, a severe stroke is a common event often close to one's death. It unleashes a series of intense conversations among clinicians, patients, and families, rife with uncertainty, about health states with varying degrees of acceptability and what makes life worth living.1 Second, enormous variations in clinical practice remain prevalent, including end-of-life care practices. This end-of-life practice variation has been called a hidden curriculum, providing medical students with insights into how the location of their residency training helps shape the type of physicians they will become.2 I...
Source: Neurology Clinical Practice - June 12, 2017 Category: Neurology Authors: Holloway, R. G., Bernat, J. L. Tags: Editorial Source Type: research

Early transition to comfort measures only in acute stroke patients: Analysis from the Get With The Guidelines-Stroke registry
Conclusions: Early CMO was utilized in about 5% of stroke patients, being more common in ICH and SAH than IS. Early CMO use varies widely between hospitals and is influenced by patient and hospital characteristics.
Source: Neurology Clinical Practice - June 12, 2017 Category: Neurology Authors: Prabhakaran, S., Cox, M., Lytle, B., Schulte, P. J., Xian, Y., Zahuranec, D., Smith, E. E., Reeves, M., Fonarow, G. C., Schwamm, L. H. Tags: All Cerebrovascular disease/Stroke, Palliative care Research Source Type: research

Cerebrovascular fibromuscular dysplasia: The MGH cohort and literature review
Conclusions: Cerebrovascular FMD may present with myriad symptoms. Our data support that patients with FMD with symptomatic disease have a low rate of recurrent symptoms or disease progression and can be managed conservatively with stroke risk modification, antiplatelet agents, surveillance imaging, and counseling.
Source: Neurology Clinical Practice - June 12, 2017 Category: Neurology Authors: Harriott, A. M., Zimmerman, E., Singhal, A. B., Jaff, M. R., Lindsay, M. E., Rordorf, G. A. Tags: All Cerebrovascular disease/Stroke, Carotid artery dissection, Infarction Research Source Type: research

A resident boot camp for reducing door-to-needle times at academic medical centers
Conclusions: DTN times were reduced after the implementation of a stroke boot camp and were driven primarily by efficient resident stroke code management. Educational programs should be developed for health care providers involved in acute stroke patient care to improve rapid access to IV tPA at academic institutions.
Source: Neurology Clinical Practice - June 12, 2017 Category: Neurology Authors: Ruff, I. M., Liberman, A. L., Caprio, F. Z., Maas, M. B., Mendelson, S. J., Sorond, F. A., Bergman, D., Bernstein, R. A., Curran, Y., Prabhakaran, S. Tags: All Cerebrovascular disease/Stroke, All Education, Methods of education, Infarction Review Source Type: research