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Acute and Long-term Management of Symptomatic Internal Carotid Artery Dissection in the Setting of Newly Diagnosed Cerebral Amyloid Angiopathy: To Anticoagulate, or Not to Anticoagulate? (P5.155)
CONCLUSIONS:The incidence of CAA is age dependent, with sporadic cases rarely affecting individuals younger than 65 years old. While it is strongly advised that those with CAA avoid antithrombotic therapy for risk of intracerebral hemorrhage, our case poses a unique threat given his age and symptomatic carotid artery occlusion. There are no such guidelines that address antithrombic therapy in the setting of an acute ischemic stroke secondary to extracranial dissection, concurrent with cerebral microhemorrhages. Our patient was initially started on anticoagulation therapy before being discharged on an antiplatelet regimen w...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Danan, I., Noroozi, J., Marks, S. Tags: Cerebrovascular Disease and Interventional Neurology: Dissection Source Type: research

The cerebellar participation in spontaneous post-stroke aphasia recovery: a longitudinal fMRI study (P5.163)
CONCLUSIONS:Stroke-induced aphasia directly impacts language areas in the left neocortex. Due to its functional and structural connections, the cerebellum appears to be affected by this pathology as well. The left part of the cerebellum participates in compensatory recovery mechanism over time.Disclosure: Dr. Nenert has nothing to disclose. Dr. Allendorfer has nothing to disclose. Dr. Vannest has nothing to disclose. Dr. Holland has nothing to disclose. Dr. Szaflarski has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Nenert, R., Allendorfer, J., Vannest, J., Holland, S., Szaflarski, J. Tags: Cerebrovascular Disease and Interventional Neurology: Recovery and Rehabilitation Source Type: research

White matter integrity predicts language deficits in chronic post-stroke aphasia (P5.166)
Conclusions: The current findings show that secondary white matter damage widely occurs in bilateral hemispheres after left hemisphere stroke. Further, white matter disruption in the left hemisphere relates to certain language deficits even accounting for lesion size and location, suggesting residual white matter connectivity is an important predictor of functional outcomes in chronic post-stroke aphasia.Disclosure: Dr. Xing has nothing to disclose. Dr. Lacey has nothing to disclose. Dr. Jiang has nothing to disclose. Dr. Skipper has nothing to disclose. Dr. Fama has nothing to disclose. Dr. Turkeltaub has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Xing, S., Lacey, E., Jiang, X., Skipper, L., Fama, M., Turkeltaub, P. Tags: Cerebrovascular Disease and Interventional Neurology: Recovery and Rehabilitation Source Type: research

Monitoring Treatment Effects of Transcranial Magnetic and Direct Current Stimulation in Patients with Post-stroke Aphasia: A Meta-Analysis Study (P5.168)
CONCLUSIONS: Both TMS and tDCS appear to be promising modalities for enhancing post-stroke aphasia recovery. However, treatment effects are greatly confounded by study design and/or stroke chronicity. Larger-scale clinical trials are required to further substantiate these claims.Disclosure: Dr. Shah has nothing to disclose. Dr. Gervits has nothing to disclose. Dr. Torres has nothing to disclose. Dr. Purcell has nothing to disclose. Dr. Hamilton has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Shah, P., Gervits, F., Torres, J., Purcell, J., Hamilton, R. Tags: Cerebrovascular Disease and Interventional Neurology: Recovery and Rehabilitation Source Type: research

Short-Term Functional Outcome and its Predictors in a Hospital-Based Cohort of Nigerians with Acute Stroke (P5.171)
CONCLUSIONS: About 1 in 3 stroke patients in this cohort had poor functional outcome. In order to improve functional outcome and reduce the burden of stroke in Nigeria, public health education on early recognition and hospital presentation is needed. In acute stroke management, complications should be prevented while speech and language therapy should be instituted to improve functional outcome.Disclosure: Dr. Wahab has nothing to disclose. Dr. Sanya has nothing to disclose. Dr. Ademiluyi has nothing to disclose. Dr. Bello has nothing to disclose. Dr. Alaofin has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Wahab, K., Sanya, E., Ademiluyi, B., Bello, A., Alaofin, W. Tags: Cerebrovascular Disease and Interventional Neurology: Recovery and Rehabilitation Source Type: research

Memantine Treatment for Post-stroke Aphasia: A Case Control Study (P5.173)
CONCLUSION Memantine treatment showed no statistically significant improvement for patients with post-stroke aphasia based on FIM Scores for Motor and Cognition. Long-term follow-up and larger study groups, however, could provide additional information which may warrant further exploration into the benefits of memantine.Disclosure: Dr. Valles has nothing to disclose. Dr. Kennedy has nothing to disclose. Dr. Elashvili has nothing to disclose. Dr. Dohle has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Valles, J., Kennedy, J., Elashvili, M., Dohle, C. Tags: Neuro-rehabilitation: Stroke Source Type: research

Induction of Functional and Structural Plasticity by Intermittent Theta Burst Stimulation in Post-Stroke Aphasia (P5.177)
CONCLUSIONS: The involvement of left frontal areas in verb generation after iTBS increased. iTBS applied to the affected left hemispheric language areas may facilitate re-organization of cortical language networks and restore inhibition of right frontal areas during language tasks.Disclosure: Dr. Griffis has nothing to disclose. Dr. Nenert has nothing to disclose. Dr. Allendorfer has nothing to disclose. Dr. Szaflarski has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Griffis, J., Nenert, R., Allendorfer, J., Szaflarski, J. Tags: Neuro-rehabilitation: Stroke Source Type: research

Medication Self-Administration after Stroke (P5.181)
Conclusion: Stroke patients performed poorly on the HMS, and though performance improved after medication education, this may be related to spontaneous stroke recovery. MSA problems, assessed by HMS performance, may strongly predict post-acute care needs. Funded by: NJ Brain Injury Commission and Kessler FoundationDisclosure: Dr. Oyawusi has nothing to disclose. Dr. Levy has nothing to disclose. Dr. Gentile has nothing to disclose. Dr. March has nothing to disclose. Dr. Hreha has received personal compensation for activities with Kessler Institute for Rehabilitation. Dr. Pagaoa-Cruz has nothing to disclose. Dr. Masmela has...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Oyawusi, M., Levy, B., Gentile, A., March, G., Hreha, K., Pagaoa-Cruz, G., Masmela, J., Galletta, E., Holman, S., McKenna, C., Zhang, J., Barrett, A. Tags: Neuro-rehabilitation: Stroke Source Type: research

Meta-analysis of risk factors for early and late seizures after acute stroke (P7.024)
CONCLUSIONS: Similar risk factors contribute to ES and LS after acute stroke. However, the effect of ES on LS remains poorly understood. Study Supported by: NoneDisclosure: Dr. Tobochnik has nothing to disclose. Dr. Vijayvargiya has nothing to disclose. Dr. Jacobson has received personal compensation for activities with Sunovion Pharmaceuticals.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Tobochnik, S., Vijayvargiya, N., Jacobson, M. Tags: Epilepsy/Clinical Neurophysiology (EEG): Clinical Epilepsy Source Type: research

"Spicy Strokes": Synthetic Cannabis and Strokes in Young (P7.123)
CONCLUSIONS: Our case is unique that there was an association between the use of synthetic cannabis and presentation of stroke. However, the JWH-018 that was previously implicated in the stroke causation was absent. More extensive research is needed in future to find other metabolites and contaminants of street preparation of ‘spice’ that may potentially cause strokes.Disclosure: Dr. El Kouzi has nothing to disclose. Dr. Siddiqui has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: El Kouzi, A., Siddiqui, F. Tags: Cerebrovascular Disease and Interventional Neurology: Stroke in Young Source Type: research

Primary Angiitis of the Central Nervous System (PACNS) presenting with intracerebral hemorrhage (ICH): three cases associated with chronic use of over-the-counter vasoconstrictive drugs (P7.128)
CONCLUSIONS: While the FDA withdrew phenylpropanolamine due to its association with ICH, other vasoconstrictive agents remain ingredients of nasal decongestants/diet pills. These may induce chronic vasoconstriction leading to secondary inflammation and arterial rupture, culminating in atypical PACNS presentations such as multifocal ICH or ICH with acute infarcts (patients 1,2).Disclosure: Dr. Jha has nothing to disclose. Dr. George has nothing to disclose. Dr. Singhal has received personal compensation for activities as a medicolegal expert witness. Dr. Singhal's spouse holds stock and/or stock options in Biogen Idec.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Jha, R., George, J., Singhal, A. Tags: Cerebrovascular Disease and Interventional Neurology: Stroke in Young Source Type: research

CARES (Changing and Advancing Risk factor control through Educations after Stroke): A Pilot Trial of a Transitions in Care Post-discharge Telephone Intervention for Stroke Patients (S13.006)
OBJECTIVE: The purpose of study is to test the feasibility and effectiveness of a telephonic post-discharge intervention designed to improve access to care, reinforce self-management skills, improve health literacy, and screen for complications in a government-run safety net system. BACKGROUND: In the United States, risk factor control after stroke is poor, particularly among socio-economically disadvantaged populations with poor access to care. The immediate post-discharge period is a vulnerable time for stroke patients, given their risk of recurrent stroke, worsening symptoms, complications, and need for medication titra...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Hudson, L., Corrales, M., Moreno, L., Valle, N., Razmara, A., Dutta, T., Ramirez-Gomez, L., Towfighi, A. Tags: Cerebrovascular Disease and Interventional Neurology: Epidemiology and Risk Factors Source Type: research

Urticarial allergic reaction to alteplase: A case report (P6.243)
CONCLUSIONS: Physicians treating acute ischemic stroke with alteplase should be aware of this uncommon but potentially dangerous complication in the spectrum of anaphylactic reactions.Disclosure: Dr. Papolin has nothing to disclose. Dr. Mendes has nothing to disclose. Dr. Lange has nothing to disclose. Dr. Germiniani has nothing to disclose. Dr. Harger has nothing to disclose. Dr. Zetola has nothing to disclose. Dr. Chamma has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Papolin, L., Mendes, D., Lange, M., Germiniani, F., Harger, R., Zetola, V., Chamma, J. Tags: Cerebrovascular Disease and Interventional Neurology: Thrombolysis Complications Source Type: research

Teaching NeuroImages: Radiation-associated symptomatic carotid artery disease with ipsilateral radiodermatitis
A 68-year-old man with a history of squamous cell carcinoma of the tongue treated with external beam radiation therapy in 2007 presented in 2013 with acute onset expressive aphasia and right lower facial weakness. MRI confirmed an acute infarct in the left frontal cortex. CT angiography revealed occlusion vs critical stenosis of the left internal carotid artery, new from 2007. Examination of the patient's neck revealed ipsilateral radiodermatitis (figure). Therapeutic neck irradiation has been associated with accelerated atheromatous disease, carotid artery stenosis, and increased risk of stroke.1,2 Ipsilateral radiodermat...
Source: Neurology - February 2, 2015 Category: Neurology Authors: Ehrlich, M. E., Gulvezan, T., Southerland, A. M. Tags: All Imaging, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research

Teaching NeuroImages: Macaroni sign
A 35-year-old patient with previously diagnosed and currently untreated Takayasu arteritis presented with motor aphasia. The symptom had started 24 hours before presentation and ceased after another 12 hours. Cranial MRI and magnetic resonance angiography were normal. Plasma concentration of C-reactive protein was elevated (9.1 mg/dL). Duplex ultrasonography showed hypoechoic, homogeneous thickening of the intima–media complex of the left common carotid artery (figure). This finding, also referred to as "macaroni sign," has been reported in Takayasu arteritis.1,2 The patient was transferred to the rheumatologic depar...
Source: Neurology - June 30, 2014 Category: Neurology Authors: Siepmann, T., Bodechtel, U. Tags: Ultrasound, Autoimmune diseases, Vasculitis, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research

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