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FLAIR vascular hyperintensity resolution in a TIA patient: Clinical-radiologic correlation
An 83-year-old woman presented with acute aphasia. Brain MRI, performed 3 hours after symptom onset, showed isolated fluid-attenuated inversion recovery vascular hyperintensities (FVH) in the left middle cerebral artery, including dot-like and serpentine hyperintensities (figure). Immediately after this first MRI (i.e., 3 hours and 15 minutes after symptom onset), aphasia resolved. A second MRI performed 15 minutes later showed FVH disappearance.
Source: Neurology - June 2, 2014 Category: Neurology Authors: Taieb, G., Renard, D., Macri, F. Tags: MRI, All Cerebrovascular disease/Stroke NEUROIMAGES Source Type: research

Robert E. Lee's Last Stand: His Dying Words and the Stroke That Killed Him. (P1.294)
CONCLUSIONS: Lee suffered chronic angina and congestive heart failure, with a probable myocardial infarction during the war. His death stemmed from an acute, possibly cardioembolic stroke manifesting as expressive aphasia, and subsequent respiratory complications. Given his aphasia, Lee’s famous last words are questionable.Disclosure: Dr. Southerland has received personal compensation in an editorial capacity for Neurology Podcast.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Southerland, A. Tags: History of Neurology Source Type: research

Inter-Individual Variability in Motor and Language Recovery during the Acute Stroke Period (P1.136)
CONCLUSIONS: Motor and language recovery for individuals during the acute stroke period was unpredictable, based on initial impairment. Our findings demonstrate the feasibility of measuring the trajectory of acute stroke recovery.Disclosure: Dr. Lazar has nothing to disclose. Dr. Dunn has nothing to disclose. Dr. Schweber has nothing to disclose. Dr. Manson has nothing to disclose. Dr. Lendaris has nothing to disclose. Dr. Marshall has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Lazar, R., Dunn, L., Schweber, A., Manson, D., Lendaris, A., Marshall, R. Tags: Cerebrovascular Disease and Interventional Neurology: Rehabilitation and Recovery Source Type: research

Video Tracking of Cancellation Is Sensitive to Acute Brain Impairment and Disability (P3.226)
CONCLUSIONS: Video tracking of search on cancellation offers a simple, inexpensive, non-intrusive method to assess executive control in a wide variety of brain-impaired patients and appears to tap cognitive functions important to functional recovery.Study Supported by: UAB Department of Physical Medicine and Rehabilitation Resident Scholarly Project ProgramDisclosure: Dr. Mullins has nothing to disclose. Dr. Mark has nothing to disclose. Dr. Woods has nothing to disclose. Dr. Banasiewicz has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Mullins, L., Mark, V., Woods, A., Banasiewicz, M. Tags: Aging, Dementia, and Cognitive and Behavioral Neurology: Executive Function Source Type: research

Predictors of Recovery of Chronic Aphasia (P6.228)
Conclusions: Chronic aphasia recovery is positively influenced by higher education, smaller lesions, younger age, and current antidepressant use (independently of one another).*Study supported by: NIH R01 DC05375Disclosure: Dr. Suneja has nothing to disclose. Dr. Gonzalez-Fernandez has nothing to disclose. Dr. Hillis has received research support from Allon Pharmaceutical.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Suneja, A., Gonzalez-Fernandez, M., Hillis, A. Tags: Aging, Dementia, and Cognitive and Behavioral Neurology: Language 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

Brain Herniation Due To Mitochondrial Encephalomyopathy, Lactic Acidosis, Stroke Like Events (MELAS) With 3256 Mutation Responsive To Decompressive Craniotomy (P6.257)
CONCLUSIONS:In our MELAS case, decompessive craniotomy is life saving for brain herniation due to SLE. Headache refractory to narcotics and increased lactic acid level are early warning signs of acute SLE since MRI can be normal. Steriod might be indicated for acute treatment of cortical edema.Disclosure: Dr. Cui has nothing to disclose. Dr. Schwendimann has received research support from Lundbeck.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Cui, C., Schwendimann, R. Tags: Cerebrovascular Disease and Interventional Neurology: Case Reports Source Type: research

Intracranial Dural Arteriovenous Fistula Presenting with Recurrent Transient Fluent Aphasia (P2.097)
Conclusion: This case illustrates that a vascular malformation can present with recurrent transient focal deficits. A well-defined hypodensity with increased vascularity is an uncommon early finding in acute ischemic stroke. In the setting of recurrent neurological deficits, these findings should prompt a thorough neurovascular evaluation.Disclosure: Dr. Nourbakhsh has nothing to disclose. Dr. Rojas -Martinez has nothing to disclose. Dr. Banerjee has nothing to disclose. Dr. Novakovic has nothing to disclose. Dr. Warnack has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Nourbakhsh, B., Rojas -Martinez, J., Banerjee, C., Novakovic, R., Warnack, W. Tags: Cerebrovascular Disease and Interventional Neurology: Acquired and Congenital Vascular Malformations Source Type: research

Synthetic Cannabis and Acute Ischemic Stroke (P6.259)
CONCLUSIONS:These cases introduce a previously unreported association between synthetic cannabis use and ischemic stroke in young adults. Our two cases had risk factors for ischemic stroke but were otherwise young and healthy and the onset of their deficits occurred within hours after first-time exposure to synthetic cannabis. Synthetic cannabis use is an important consideration in the investigation of stroke in young adults.Disclosure: Dr. Bernson-Leung has nothing to disclose. Dr. Leung has nothing to disclose. Dr. Kumar has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Bernson-Leung, M., Leung, L., Kumar, S. Tags: Cerebrovascular Disease and Interventional Neurology: Case Reports Source Type: research

Recurrent Stroke-like Events Preceding the X-linked Charcot-Marie-Tooth Disease Diagnosis (P6.011)
CONCLUSIONS:The transient encephalopathic syndrome with focal paresis, dysarthria, and ataxia is an under recognized early presentation of CMT1X and it continues to be clinically challenging due to its rarity. Thus, this case emphasizes the need for awareness among practitioners to consider CMT1X in the differential diagnosis of acute encephalopathy with symmetric cerebral white matter signal alterations with restricted diffusion to avoid unnecessary work-up and the associated costs.Study Supported by: noneDisclosure: Dr. Kimbason has nothing to disclose. Dr. Anilkumar has nothing to disclose. Dr. Bronov has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Kimbason, T., Anilkumar, A., Bronov, O. Tags: Child Neurology V Source Type: research

The Feeling That 'I Can Say It in My Head' Predicts Word-by-Word Success in Subsequent Aphasia Treatment. (P2.118)
CONCLUSIONS: In one individual, self-reported internal naming predicted success and rate of learning on a word-by-word basis during speech therapy for anomia. This suggests that claims of inner speech may be more reliable than previously appreciated, and may also be clinically relevant. These self-reports could improve accuracy of prognosis, or potentially be used to guide treatment on a word-by-word basis.Disclosure: Dr. Hayward has nothing to disclose. Dr. Sullivan has nothing to disclose. Dr. Snider has nothing to disclose. Dr. Lacey has nothing to disclose. Dr. Friedman has nothing to disclose. Dr. Turkeltaub has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Hayward, W., Sullivan, K., Snider, S., Lacey, E., Friedman, R., Turkeltaub, P. Tags: Cerebrovascular Disease and Interventional Neurology: Behavioral, Cognitive, and Miscellaneous Source Type: research

Stroke Mortality And Its Predictors In Nigeria: Results Of A Hospital-Based Study (P2.120)
Conclusion: The 30-day case fatality rate among our stroke patients is high while the independent predictors of this outcome are severity of stroke on admission and presence of complications. Continuing health education of the public on stroke recognition and the need for early hospital presentation is necessary while optimal management of cases in a stroke care unit is advocated in order to improve outcome.Disclosure: Dr. Wahab has nothing to disclose. Dr. Sanya has nothing to disclose. Dr. Ademiluyi has nothing to disclose. Dr. Abiodun has nothing to disclose. Dr. Alaofin has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Wahab, K., Sanya, E., Ademiluyi, B., Abiodun, B., Alaofin, W. Tags: Cerebrovascular Disease and Interventional Neurology: Behavioral, Cognitive, and Miscellaneous Source Type: research

Episodic Aphasia After Subdural Hemorrhage Due to Cortical Spreading Depression: A Case Report (P2.124)
CONCLUSION:CSD can be difficult to detect due to its brief and focal pathology. EEG should be done to exclude seizure and MRI/MRA to exclude stroke. CSD should be considered with a focal deficit with brief episodes when all other tests are negative. Better knowledge of the pathophysiolgy of CSD and its possible manifestations may facilitate a better way to diagnose as well as treatment to prevent CSD from causing permanent damage.Disclosure: Dr. Grayson has nothing to disclose. Dr. Shah has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Forteza has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Grayson, J., Shah, N., Patel, S., Forteza, A. Tags: Cerebrovascular Disease and Interventional Neurology: Behavioral, Cognitive, and Miscellaneous Source Type: research

Intracerebral Hemorrhage Associated with Oral Phenylephrine Use (P5.138)
CONCLUSION: It is scientifically plausible that Phe may cause strokes given that it is consistent with the pharmacological properties and adverse event profiles of similar amphetamine-like sympathomimetics. As RCVS has been well-described in association with over the counter sympathomimetics, these lines of evidence support a likely, although not definitive, causal relationship between Phe and ICH.Disclosure: Dr. Tark has nothing to disclose. Dr. Messe has received personal compensation for activities with GlaxoSmithKline, Inc. Dr. Messe has received research support from WL Gore, and GlaxoSmithKline, Inc. Dr. Balucani has...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Tark, B., Messe, S., Balucani, C., Levine, S. Tags: Cerebrovascular Disease and Interventional Neurology: Intracerebral Hemorrhage and Other Hemorrhages Source Type: research

Nonverbal Oral Apraxia in Primary Progressive Aphasia and Apraxia of Speech (P2.166)
CONCLUSIONS:We have shown that AOS, NVOA and IMA are at least partially distinct among patients with PPA and PPAOS. NVOA might be more common in patients with AOS due to the proximity of the region we identified by VBM to the premotor area, which has been implicated in AOS. The association of IMA and NVOA among patients without AOS could represent disruption of a module shared by nonverbal oral movements and limb movements.Study Supported by: NIH grant R01-DC010367Disclosure: Dr. Botha has nothing to disclose. Dr. Duffy has nothing to disclose. Dr. Strand has nothing to disclose. Dr. Whitwell has nothing to disclose. Dr. J...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Botha, H., Duffy, J., Strand, E., Whitwell, J., Josephs, K. Tags: Aging, Dementia, and Cognitive and Behavioral Neurology: General Cognition Source Type: research

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