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De novo status epilepticus with isolated aphasia
Conclusions Magnetic resonance imaging findings were only subtle, and EEG was without clear ictal pattern, so the diagnosis of aphasic status remains with some uncertainty. However, status epilepticus can mimic stroke symptoms and has to be considered in patients with aphasia even when no previous stroke or structural lesions are detectable and EEG shows no epileptic discharges. Epileptic origin is favored when CT or MR imaging reveal no hypoperfusion. In this case, MRI was superior to CT in detecting hyperperfusion. This article is part of a Special Issue entitled “Status Epilepticus”.
Source: Epilepsy and Behavior - June 12, 2015 Category: Neurology Source Type: research

De novo status epilepticus with isolated aphasia.
CONCLUSIONS: Magnetic resonance imaging findings were only subtle, and EEG was without clear ictal pattern, so the diagnosis of aphasic status remains with some uncertainty. However, status epilepticus can mimic stroke symptoms and has to be considered in patients with aphasia even when no previous stroke or structural lesions are detectable and EEG shows no epileptic discharges. Epileptic origin is favored when CT or MR imaging reveal no hypoperfusion. In this case, MRI was superior to CT in detecting hyperperfusion. This article is part of a Special Issue entitled "Status Epilepticus". PMID: 26044094 [PubMed - as supplied by publisher]
Source: Epilepsy and Behaviour - June 1, 2015 Category: Neurology Authors: Flügel D, Kim OC, Felbecker A, Tettenborn B Tags: Epilepsy Behav Source Type: research

CT within 6 hours of headache onset to rule out subarachnoid hemorrhage in nonacademic hospitals
Conclusions: Our results support a change of practice wherein a lumbar puncture can be withheld in patients with a head CT scan performed <6 hours after headache onset and reported negative for the presence of SAH by a staff radiologist in the described nonacademic setting.
Source: Neurology - May 11, 2015 Category: Neurology Authors: Blok, K. M., Rinkel, G. J. E., Majoie, C. B. L. M., Hendrikse, J., Braaksma, M., Tijssen, C. C., Wong, Y. Y., Hofmeijer, J., Extercatte, J., Kerklaan, B., Schreuder, T. H. C. M. L., ten Holter, S., Verheul, F., Harlaar, L., Pruissen, D. M. O., Kwa, V. I. Tags: All Headache, Diagnostic test assessment, CT, Subarachnoid hemorrhage ARTICLE Source Type: research

Left Ventricular Noncompaction With Normal Heart Function: A Rare Cause of Cardioembolic Stroke in a Young Adult (P1.026)
CONCLUSIONS: LV noncompaction, even in the absence of coexisting vascular risk factors, should be considered as a rare cause of stroke in the young. Thrombi may form in the meshwork of the noncompacted LV endocardium and embolize to the cerebral arteries. In this population, familial cardiac screening and oral anticoagulation may be warranted.Disclosure: Dr. Hainline has nothing to disclose. Dr. Antoniello has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Hainline, C., Antoniello, D. Tags: Cerebrovascular Disease and Interventional Neurology: Case Reports Source Type: research

Myriad Manifestations of a Global Infectious Disease (I7-5A)
CONCLUSIONS: This case exhibits the myriad manifestations of tuberculosis in one patient; including meningitis, vasculitis, and tuberculomas. It also highlights that insular stroke in the non-dominant hemisphere could affect the cardiovascular-autonomic system.Disclosure: Dr. Prabhu has nothing to disclose. Dr. Raghupathi has nothing to disclose. Dr. Dissin has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Prabhu, A., Raghupathi, R., Dissin, J. Tags: The Global Burden of Neurological Infections: Epidemiology, Treatment, and Prevention Poster Presentations Source Type: research

Spinal Cord Infarction as the Initial Presentation of Systemic Lupus Erythematosus (P2.077)
CONCLUSIONS:Aggressive therapy with high dose corticosteroids and intravenous cyclophosphamide followed by oral therapy may be a successful therapeutic approach to spinal cord infarcts secondary to systemic lupus erythematosus. Study Supported by: N/ADisclosure: Dr. Michael has nothing to disclose. Dr. Hayat has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Michael, A., Hayat, G. Tags: Neurological Consequences of Autoimmune Disease Source Type: research

A comprehensive simulation curriculum for neurology residents - preparing for future challenges in neurology (P4.188)
CONCLUSIONS: Our study demonstrates that integrating simulation in classical neurology didactics not only improves the knowledge base but improves competency and execution of high-risk time sensitive decisions in an emergency setting.Disclosure: Dr. Sabharwal has nothing to disclose. Dr. Saba has nothing to disclose. Dr. Szyld has nothing to disclose. Dr. Czeisler has nothing to disclose. Dr. Ishida has nothing to disclose. Dr. Lord has nothing to disclose. Dr. Rucker has nothing to disclose. Dr Balcer received personal compensation from Biogen Idec and consulting for Biogen Idec, Vaccinex and Genzyme. She is on a clinical...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Sabharwal, P., Saba, S., Szyld, D., Czeisler, B., Ishida, K., Lord, A., Rucker, J., Balcer, L., Sander, H., Galetta, S. Tags: Research Methodology and Education Source Type: research

Basilar Artery Territory Stroke Secondary to Invasive Fungal Sphenoid Sinusitis: A Case Report and Review of the Literature
We present a case of a 38-year-old man with invasive mucormycosis that led to a basilar artery territory stroke. Rhinocerebral mucormycosis is an unusual cause of stroke. Case Report: A 38-year-old man with a past medical history of diabetes mellitus presented with altered mental status. A lumbar puncture revealed eosinophilic pleocytosis with a mildly elevated total protein and borderline low glucose level. CT revealed a left medullary and cerebellar infarct confirmed by MRI. MRI also displayed a diffuse marrow signal abnormality in the clivus with contiguous sinus disease. Endoscopic sinus surgery confirmed that the fung...
Source: Case Reports in Neurology - March 6, 2015 Category: Neurology Source Type: research

Dural puncture: an overlooked cause of cerebral venous thrombosis
Abstract Cerebral venous thrombosis (CVT) accounts for 0.5–1 % of all strokes. Although dural puncture is proposed as one of the rare risk factors, this association has only been mentioned in anecdotal reports. Headache, i.e., usually the first and the most frequent clinical symptom on admission, is often attributed to the dural puncture itself. We investigated the frequency of CVT following a recent dural puncture in our stroke database, together with the other risk factors. The computerized medical records of patients (n = 10,740) registered in our tertiary-care neurology clinic stroke database were review...
Source: Acta Neurologica Belgica - March 1, 2015 Category: Neurology Source Type: research

Effect of Intrathecal Baclofen Bolus Injection on Ankle Muscle Activation During Gait in Patients With Acquired Brain Injury
Conclusions. ITB bolus injection alters the activation of MG and TA during gait. However, the changes in muscle activation are not closely related to the changes in gait speed or resting muscle hypertonia. The analysis of ankle muscle activation during gait better characterizes the response to ITB bolus injection than gait kinematics.
Source: Neurorehabilitation and Neural Repair - December 24, 2014 Category: Neurology Authors: Chow, J. W., Yablon, S. A., Stokic, D. S. Tags: Clinical Research Articles Source Type: research

MRI spot sign
A 47-year-old woman presented with fever and acute right subdural hematoma. Her neurologic examination was normal, but she experienced persistent severe headache and repeat CT showed increasing mass effect. Lumbar puncture was deferred for risk of herniation. MRI was performed to evaluate for septations, abnormal enhancement, or other atypical features that would suggest an alternative diagnosis such as subdural empyema. An area of active contrast extravasation was seen on MRI (figure) and corresponded, at surgical evacuation, to a small bleeding artery that was ablated with bipolar cautery. Despite extensive evaluation, n...
Source: Nature Clinical Practice - December 8, 2014 Category: Neurology Authors: Cutsforth-Gregory, J. K., Black, D. F., Hoffman, E. M., Datar, S. V., Wijdicks, E. F. Tags: MRI, All Cerebrovascular disease/Stroke, Critical care Cases Source Type: research

Clinical Reasoning: A 28-year-old man with progressive gait disturbance and encephalopathy
A 28-year-old man with sickle cell disease presented with 7 months of difficulty walking. Initial examination 3 months prior to admission to our hospital was thought to be consistent with a polyneuropathy. He was areflexic, was unable to stand on toes or heels with decreased sensation on the left foot to light touch and vibration, had difficulty with heel to shin, and was unable to perform tandem gait. Laboratory tests revealed anemia (hemoglobin 7.2 g/dL) and elevated creatinine (1.49 g/dL). HIV, antinuclear antibodies, antineutrophil cytoplasmic antibodies, hepatitis serologies, rapid plasma reagin, thyroid-stimulating h...
Source: Neurology - December 8, 2014 Category: Neurology Authors: Massaro, A. M., Pruitt, A. Tags: Stroke in young adults, MRI, Gait disorders/ataxia, All Oncology RESIDENT AND FELLOW SECTION Source Type: research

miRNA Expression Profiles in Cerebrospinal Fluid and Blood of Patients with Acute Ischemic Stroke
Abstract The aims of the study were (1) to determine whether miRNAs (microRNAs) can be detected in the cerebrospinal fluid (CSF) and blood of patients with ischemic stroke and (2) to compare these miRNA profiles with corresponding profiles from other neurological patients to address whether the miRNA profiles of CSF or blood have potential usefulness as diagnostic biomarkers of ischemic stroke. CSF from patients with acute ischemic stroke (n = 10) and patients with other neurological diseases (n = 10) was collected by lumbar puncture. Blood samples were taken immediately after. Expression profiles in the ...
Source: Translational Stroke Research - October 30, 2014 Category: Neurology Source Type: research

Clinical management guidelines for subarachnoid haemorrhage. Diagnosis and treatment
Conclusions SAH is a severe and complex disease which must be managed in specialised centres by professionals with ample experience in relevant diagnostic and therapeutic processes.
Source: Neurologia - October 12, 2014 Category: Neurology Source Type: research

The Rhino Without It's Sugar (P2.324)
We present a case of a non-diabetic patient with stroke like symptoms that was determined to be due to mucormycosis invading the sphenoid sinus.A 64 year old female was admitted for slurred speech and right-sided weakness. She was brought to the ER after being found unresponsive. Family members stated she had been experiencing difficulty speaking, and mild right facial weakness. She has been complaining of headaches for the past seven months and 15 pound weight loss. On admission, temperature was 98.4°F, BP 122/77, PR 78, and RR 18. Exam was significant for right-sided facial asymmetry/droop, expressive aphasia, and sl...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Kahlon, J., Gahley, H., Sonpal, N., Graham, R. Tags: Fungi, Parasites, and Other Pathogens Source Type: research

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