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Source: Neurology
Condition: Headache

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Total 267 results found since Jan 2013.

Teaching NeuroImages: Artery of Percheron thrombosis causing selective downgaze palsy
A 47-year-old man with migraines presented with sudden onset of vertical diplopia, dysarthria, right facial weakness, and downgaze palsy (figure 1). Brain MRI revealed ischemic strokes in the midbrain periaqueductal gray, bilateral thalamic–midbrain junction, and thalamus (figure 2, A–C). Gradient echo and T1 MRI showed hypointensity in the interpeduncular fossa (figure 2, D and E). No flow could be visualized in this structure on CT angiogram or catheter angiogram, demonstrating a thrombosed artery of Percheron (figure 2, F–H). Downgaze palsy, which improved 18 months later, may result from bilateral les...
Source: Neurology - October 16, 2017 Category: Neurology Authors: Sechler, M., Singh, J., El Husseini, N. Tags: MRI, DWI, All Cerebrovascular disease/Stroke, Infarction RESIDENT AND FELLOW SECTION Source Type: research

TIPIC syndrome
A 31-year-old woman presented with left acute cervical pain. Cervical imaging showed a large pericarotid infiltration (figure 1). A diagnosis of transient perivascular inflammation of the carotid artery (TIPIC) syndrome was made. The patient received steroids with full clinical recovery 12 days after onset. The follow-up ultrasound showed striking decrease of the perivascular infiltration, confirming the diagnosis (figure 2).
Source: Neurology - October 9, 2017 Category: Neurology Authors: Lecler, A., Obadia, M., Sadik, J.-C. Tags: Secondary headache disorders, MRI, Ultrasound, Other cerebrovascular disease/ Stroke NEUROIMAGES Source Type: research

Teaching NeuroImages: Typical neuroimaging features in high-altitude cerebral edema
A 61-year-old man presented with thunderclap headache followed by loss of consciousness, 2 days after arriving in Atacama Desert, Andes Mountains, Chile, at 4,000 meters. Examination showed coma. Mechanical ventilation was necessary. He had progressive improvement after transfer to low altitudes. Brain MRI showed diffuse vasogenic edema and microhemorrhages (figure), and high-altitude cerebral edema (HACE) was diagnosed.
Source: Neurology - October 2, 2017 Category: Neurology Authors: Marussi, V. H. R., Pedroso, J. L., Piccolo, A. M., Barsottini, O. G., Moraes, F. M. d., Oliveira, A. S. B., Freitas, L. F., Amaral, L. L. F. d. Tags: MRI, Other cerebrovascular disease/ Stroke, All Clinical Neurology RESIDENT AND FELLOW SECTION Source Type: research

Sickle cell disease and the unmet challenges of neurologic complications
Sometimes an important scientific report is more notable for what it cannot tell us than for what it can. In this issue of Neurology®, Noubiap and colleagues1 provide a comprehensive, well-conducted systematic meta-analysis of the neurologic complications of sickle cell disease (SCD) that incorporates rigorous design and advanced analytic methods to delineate in substantial detail what is known about the prevalence of neurologic injury among people with SCD in Africa—where over half the world's population of people with SCD reside. As one might expect, based upon what is known from more medically developed region...
Source: Neurology - October 2, 2017 Category: Neurology Authors: Birbeck, G. L., Green, R. Tags: EDITORIALS Source Type: research

Neurologic complications of sickle cell disease in Africa: A systematic review and meta-analysis
Conclusions: The burden of neurologic complications of SCD is important in Africa and most likely underestimated. A better evaluation of this burden requires larger prospective studies using standard up-to-date screening methods. Accessibility to diagnostic tools such as neuroimaging, transcranial Doppler, EEG, and neuropsychological evaluation, as well as to preventive and therapeutic interventions and trained health care providers, should be improved in routine clinical practice.
Source: Neurology - October 2, 2017 Category: Neurology Authors: Noubiap, J. J., Mengnjo, M. K., Nicastro, N., Kamtchum-Tatuene, J. Tags: VIEWS & amp;amp; REVIEWS Source Type: research

Procoagulant imbalance in premenopausal women with chronic migraine
Migraine has been associated with an increased risk for stroke, especially in young women.1 Among the pathophysiologic mechanisms linking migraine and stroke, coagulation abnormalities have been regarded as a logical link.2
Source: Neurology - October 2, 2017 Category: Neurology Authors: Ferroni, P., Barbanti, P., Aurilia, C., Egeo, G., Fofi, L., La Farina, F., Valente, M. G., De Marchis, M. L., Spila, A., Palmirotta, R., Della-Morte, D., Guadagni, F. Tags: CLINICAL/SCIENTIFIC NOTES Source Type: research

Teaching NeuroImages: RCVS causing simultaneous convexity subarachnoid hemorrhage and hemimedullary infarction
A 34-year-old previously healthy man presented with thunderclap headache, dysphagia, dysarthria, and oscillopsia. Neurologic examination revealed right-beating nystagmus, dysphagia, hypophonia, right hemianesthesia, and left hemiparesis. Brain imaging showed convexity subarachnoid hemorrhage (figure 1A) and left hemimedullary infarct (figure 1B). Catheter angiography showed tapering of left vertebral artery and diffuse segmental vasoconstriction (figure 2). Routine serum and CSF results were unremarkable. Thorough infectious, immunologic, and coagulopathy workup was negative. Reversible cerebral vasoconstriction syndrome (...
Source: Neurology - September 18, 2017 Category: Neurology Authors: Selvan, P., Levine, S. R. Tags: Stroke in young adults, Other cerebrovascular disease/ Stroke, All Cerebrovascular disease/Stroke, Infarction, Subarachnoid hemorrhage RESIDENT AND FELLOW SECTION Source Type: research

Intra-arterial milrinone may differentiate fulminant RCVS from vasculitis
A 39-year-old woman taking a monoamine oxidase inhibitor presented with a 1-week history of severe non-thunderclap headache and visual field deficits. Brain CT showed infarcts in both parietal lobes, with narrowing of intracranial vessels on CT angiogram (figure 1), suggesting either vasculitis or reversible cerebral vasoconstriction syndrome (RCVS). Despite treatment with both methylprednisolone and nimodipine, she experienced progressive aphasia and right leg weakness. She underwent an urgent cerebral angiogram (figure 2), during which intra-arterial milrinone reversed both the vasoconstriction and its symptoms, thereby ...
Source: Neurology - September 4, 2017 Category: Neurology Authors: Laneuville, M., Ding, J., Shamy, M., Lum, C., Dowlatshahi, D. Tags: All Headache, Other cerebrovascular disease/ Stroke NEUROIMAGES Source Type: research

Clinical Reasoning: Two see or not two see--Is it really double vision?
A 57-year-old right-handed woman presented to the emergency department with complaints of double vision and intractable nausea that began abruptly 2 days earlier. Her visual symptoms were characterized as seeing overlapping or separate horizontally or diagonally displaced objects. She had no history of headaches or stroke. Her cerebrovascular risk factors included hypertension, type II diabetes, coronary artery disease, and cigarette smoking. Her medications included clopidogrel, lisinopril, paroxetine, and oxycodone. Her family history was notable for late-onset ischemic heart disease in her parents with no first-degree r...
Source: Neurology - August 7, 2017 Category: Neurology Authors: Murphy, R. R., Al Sawaf, A., Rose, D. R., Goldstein, L. B., Smith, C. D. Tags: Clinical neurology examination, Diplopia (double vision), Visual fields, Visual processing, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research

Evaluating the safety of {beta}-interferons in MS: A series of nested case-control studies
Conclusions: Among patients with RRMS, IFN-β was associated with a 1.8- and 1.6-fold increase in the risk of stroke and migraine and 1.3-fold increases in depression and hematologic abnormalities.
Source: Neurology - June 12, 2017 Category: Neurology Authors: de Jong, H. J. I., Kingwell, E., Shirani, A., Cohen Tervaert, J. W., Hupperts, R., Zhao, Y., Zhu, F., Evans, C., van der Kop, M. L., Traboulsee, A., Gustafson, P., Petkau, J., Marrie, R. A., Tremlett, H., On behalf of the British Columbia Multiple Scleros Tags: Patient safety, Multiple sclerosis, All epidemiology, Case control studies ARTICLE Source Type: research

Stroke-like migraine attacks in long term survivors of high grade glioma. (P1.174)
Conclusions:Stroke-like migraine attacks are difficult to treat and the pathophysiology is unknown. With more sophisticated imaging techniques, a better understanding of this phenomenon will aid in the treatment and prophylaxis of the syndrome with a goal of improving quality of life for this small but slowly growing population.Disclosure: Dr. New has nothing to disclose. Dr. Mirza has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: New, P., Mirza, H. Tags: Neuro-oncology: Gliomas I Source Type: research

Misdiagnosis of CADASIL: A single Medical Center experience (P1.251)
Conclusions:CADASIL is the most prevalent monogenic cerebral small-vessel arteriopathy. Despite wide availability of genetic testing, misdiagnosis and delay diagnosis are common. We encourage for enhanced awareness of CADASIL among patients with migraines with aura, recurrent TIAs or subcortical ischemic strokes, and mood disorder, in order to provide appropriate multidisciplinary treatment, psychological support and genetic counselingStudy Supported by: n/aDisclosure: Dr. Ortiz-Garcia has nothing to disclose. Dr. Orjuela has nothing to disclose. Dr. Sweis has nothing to disclose. Dr. Biller has received personal compensat...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Ortiz-Garcia, J., Orjuela, K., Sweis, R., Biller, J. Tags: Genetic Stroke Syndromes, Biomarkers, and Translational/Basic Research Source Type: research

A rare cause of stroke in young: PHACE syndrome (P1.253)
Conclusions:Neurocutaneous syndromes are typically diagnosed in childhood and can be a rare cause of stroke in young. Our patient suffered an ischemic stroke secondary to sequelae of undiagnosed PHACE syndrome. Early identification of neurocutaneous syndromes allows for proper surveillance, evaluation, and preventative education for development of complications.Disclosure: Dr. Fitzgerald has nothing to disclose. Dr. Chandra has nothing to disclose. Dr. Dannenbaum has nothing to disclose. Dr. Sharrief has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Fitzgerald, K., Chandra, S., Dannenbaum, M., Sharrief, A. Tags: Genetic Stroke Syndromes, Biomarkers, and Translational/Basic Research Source Type: research

Deficiency of adenosine deaminase 2: a recently described autoinflammatory disease with neurological manifestations (p1.254)
Conclusions:DAD2 involves a spectrum of neurological symptoms and MRI findings. Mutations at amino acids 154–204 of the CECR1 gene are more likely to cause neurological symptoms than mutations elsewhere in CECR1. A better understanding of these neurological manifestations will aid in earlier diagnosis, which can reduce morbidity, mortality, and unnecessary testing.Disclosure: Dr. Noll has nothing to disclose. Dr. Kessler has nothing to disclose. Dr. Gratton has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Noll, A., Kessler, E., Gratton, S. Tags: Genetic Stroke Syndromes, Biomarkers, and Translational/Basic Research Source Type: research

Patient characteristics affecting stroke recognition by emergency medical service providers in Kings County Hospital Center (P1.270)
Conclusions:More than half of actual stroke patients were missed in the field in our study. Our study identifies potential patient characteristics affecting stroke recognition by EMS.Disclosure: Dr. Cuascut Lassus has nothing to disclose. Dr. Law has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Lassus, F. C., Law, S. Tags: Pre-Hospital Stroke, Tele-Stroke, and mHealth Source Type: research