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Elevated ventricular CSF lactate within the first week after aneurysmal subarachnoid hemorrhage is associated with poor outcome (P5.068)
Conclusions:Elevated CSF lactate drawn within the first week of hospitalization following aSAH correlates with outcome. Larger prospective studies are needed to test the validity of this data for predicting outcome and for understanding the pathophysiologic mechanisms.Study Supported by: No funding was received for this study.Disclosure: Dr. Renfrow has nothing to disclose. Dr. Wilson has nothing to disclose. Dr. Arnel has nothing to disclose. Dr. Wolfe has nothing to disclose. Dr. Datar has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Renfrow, J., Wilson, T., Arnel, M., Wolfe, S., Datar, S. Tags: Neurocritical Care: Subarachnoid Hemorrhage Source Type: research

Trends and Characteristics of Tuberculous Meningitis in the United States, 1993-2013 (S30.007)
Conclusions:Over the past two decades, the incidence and mortality of TBM in the US have steadily declined, but neurological complications are increasing.Study Supported by:This work was supported by the National Institute of Neurological Disorders [grant numbers K23NS082367, R01NS097443-01 to H.K.] and the Michael Goldberg Stroke Research Fund to [H.K.].Disclosure: Dr. Merkler has nothing to disclose. Dr. Chatterjee has nothing to disclose. Dr. Gialdini has nothing to disclose. Dr. Reynolds has nothing to disclose. Dr. Morris has nothing to disclose. Dr. Murthy has nothing to disclose. Dr. Thakur has received personal com...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Merkler, A., Chatterjee, A., Gialdini, G., Reynolds, A., Morris, N., Murthy, S., Thakur, K., Kamel, H. Tags: Infectious Disease: HIV, Syphilis, Borrelia, TB, Cysticercosis, and Other Infections Source Type: research

A Rare Case of Central Nervous System Tuberculosis Presenting as Transient Splenial Lesion: Case Report and Literature Review (P1.320)
Conclusions:Based on literature review, the transient splenial lesion of corpus callosum has never been reported in patients with CNS tuberculosis. The mechanisms underlying transient splenial lesions may due to intramyelinic edema and inflammatory cell infiltration. This hypothesis supported by the MR spectroscopy findings in our patient. Since early diagnosis and treatment can reduce mortality and morbidity, patients with isolated splenial lesion warrant diagnostic tests for CNS tuberculosis.Study Supported by:The authors report no disclosures relevant to the manuscript.Disclosure: Dr. Wu has nothing to disclose. Dr. Che...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Wu, J.-W., Chen, S. Tags: Autoimmunity with Infection, Syphilis, Lyme, Tuberculosis, and other Bacteria Source Type: research

Teaching NeuroImages: Posterior reversible encephalopathy syndrome resulting in hydrocephalus
A woman with prior lung transplantation presented with headaches, seizure, and obtundation. Head MRI (figure) revealed obstructive hydrocephalus and hyperintensity on T2-weighted imaging in the bilateral thalami and brainstem. Management included antiepileptic medications, ventriculostomy placement, and cessation of tacrolimus for concern of atypical posterior reversible encephalopathy syndrome (PRES). Infectious and paraneoplastic etiologies were ruled out. An autoimmune process was unlikely due to immunosuppression. There was rapid clinical improvement with repeat MRI revealing resolution of hydrocephalus and T2 changes....
Source: Neurology - June 5, 2016 Category: Neurology Authors: Paolini, S., Jadhav, A. P. Tags: Hydrocephalus, Secondary headache disorders, Other cerebrovascular disease/ Stroke RESIDENT AND FELLOW SECTION Source Type: research

Is normal pressure hydrocephalus becoming less idiopathic?
Normal pressure hydrocephalus (NPH) has posed a challenge to neurologists for 5 decades.1 Difficulties in understanding its pathophysiology have hindered efforts to diagnose it and to develop a better approach to selecting patients for shunt surgery.
Source: Neurology - February 15, 2016 Category: Neurology Authors: Graff-Radford, N. R. Tags: All Cerebrovascular disease/Stroke, All Cognitive Disorders/Dementia, All epidemiology EDITORIALS Source Type: research

Vascular factors in suspected normal pressure hydrocephalus: A population-based study
Conclusions: Hypertension, WMLs, and DM were related to clinical and imaging features of iNPH, suggesting that vascular mechanisms are involved in the pathophysiology. These findings might have implications for understanding disease mechanisms in iNPH and possibly prevention.
Source: Neurology - February 15, 2016 Category: Neurology Authors: Jaraj, D., Agerskov, S., Rabiei, K., Marlow, T., Jensen, C., Guo, X., Kern, S., Wikkelso, C., Skoog, I. Tags: All Cerebrovascular disease/Stroke, All Cognitive Disorders/Dementia, All epidemiology ARTICLE Source Type: research

Pineal Apoplexy With Cerebral Infarction (P1.033)
CONCLUSIONS:Although it appears that the infarcts were caused by the apoplexy due to their temporal progression, we conclude that pineal apoplexy was unlikely to cause the patient’s stroke and that the potential culprit of both events was a proximal source such as a cardiac or aortic thromboembolism.Disclosure: Dr. Truong has nothing to disclose. Dr. Young has nothing to disclose. Dr. Naderi has nothing to disclose. Dr. Brizuela has nothing to disclose. Dr. Handwerker has nothing to disclose. Dr. Al-Khoury has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Truong, A., Young, M., Naderi, N., Brizuela, A., Handwerker, J., Al-Khoury, L. Tags: Cerebrovascular Disease and Interventional Neurology: Case Reports Source Type: research

Warfarin and Antiplatelet Medication Use Are Independently Associated with Poor Functional Outcomes Following Spontaneous Intracerebral Hemorrhage (P3.096)
Conclusion: Warfarin use is associated with a higher incidence of hydrocephalus, IVH and hematoma expansion, but lesser relative edema volume. While both warfarin and antiplatelet use are independently associated with worse functional outcomes, only warfarin use correlates with higher mortality.Disclosure: Dr. Murthy has nothing to disclose. Dr. Moradiya has nothing to disclose. Dr. Dawson has nothing to disclose. Dr. Lees has received personal compensation for activities with Stryker. Dr. Lees has received research support from various companies and funding bodies. Dr. Hanley has received research support from the FDA, Ca...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Murthy, S., Moradiya, Y., Dawson, J., Lees, K., Hanley, D., Ziai, W. Tags: Cerebrovascular Disease and Interventional Neurology: Intracerebral Hemorrhage Source Type: research

Predictors of Poor Outcome in Bacterial Meningitis: Retrospective Analysis of Nationwide Inpatient Sample (P5.046)
CONCLUSIONS: In this retrospective study, every decade increase in age, teaching hospital status and development of complications like hydrocephalus, ischemic stroke, seizures, intracranial abscess and respiratory failure were predictors of poor outcome. Every calendar year increase was a negative predictor of poor outcome. Study Supported by:Disclosure: Dr. Dharaiya has nothing to disclose. Dr. Modi has nothing to disclose. Dr. Maraka has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Dharaiya, D., Modi, S., Maraka, S. Tags: Neuroepidemiology: Headache, Global Health, and Infectious Disease Source Type: research

Mortality Predictors in Bacterial Meningitis Patients who developed Hydrocephalus (P5.050)
CONCLUSIONS: In this retrospective analysis, we found that every decade increase in age, ischemic stroke, respiratory failure and requirement of ventriculostomy were significant predictors of mortality in patients of bacterial meningitis who developed hydrocephalus. Study Supported by:Disclosure: Dr. Irshad has nothing to disclose. Dr. Modi has nothing to disclose. Dr. Naqvi has nothing to disclose. Dr. Dharaiya has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Irshad, K., Modi, S., Naqvi, I., Dharaiya, D. Tags: Neuroepidemiology: Headache, Global Health, and Infectious Disease Source Type: research

Subarachnoid Hemorrhage as the Initial Neurologic Manifestation in Thrombotic Thrombocytopenic Purpura (P6.014)
Conclusion: Upon review of the literature, ischemic infarction and intracerebral hemorrhage are uncommon complications of TTP. Our case demonstrates a unique case of subarachnoid hemorrhage as the initial neurological manifestation of TTP.Disclosure: Dr. Wei has nothing to disclose. Dr. Ramesh has nothing to disclose. Dr. Farmakidis has nothing to disclose. Dr. Nalleballe has nothing to disclose. Dr. JADEJA has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Wei, J., Ramesh, A., Farmakidis, C., Nalleballe, K., Jadeja, N. Tags: Cerebrovascular Disease and Interventional Neurology II ePosters Source Type: research

Teaching NeuroImages: Cortical blindness following acute obstructive hydrocephalus by a colloid cyst
A 46-year-old woman was admitted for acute headache, postseizure confusion, and visual loss. Urgent head CT scan showed obstructive hydrocephalus due to a colloid cyst (figure 1). External ventricular drains inserted emergently demonstrated CSF under pressure, above 40 mm H2O. MRI confirmed the suspected diagnosis of a colloid cyst and highlighted bilateral occipital lobe infarcts (figure 2). CT angiography showed no thrombosis of the posterior cerebral arteries (PCAs). After neurosurgical excision of the colloid cyst, the patient remained blind. The presumed mechanism of infarction was acute compression of the PCAs agains...
Source: Neurology - February 9, 2015 Category: Neurology Authors: Champeaux, C., Grivas, A. Tags: Hydrocephalus, Stroke in young adults, MRI, Clinical neurology examination, Visual loss RESIDENT AND FELLOW SECTION Source Type: research

Stroke and nonstroke brain attacks in children
Conclusions: Brain attack etiologies differ from adults, with stroke being the fourth most common diagnosis. These findings will inform development of ED clinical pathways for pediatric brain attacks.
Source: Neurology - April 21, 2014 Category: Neurology Authors: Mackay, M. T., Chua, Z. K., Lee, M., Yock-Corrales, A., Churilov, L., Monagle, P., Donnan, G. A., Babl, F. E. Tags: Childhood stroke, All Cerebrovascular disease/Stroke, All Pediatric, Prevalence studies ARTICLE Source Type: research

Predictive Factors of Central Nervous Infection: Prospective Evaluation of 124 Cases with Suspicion of Meningitis. (P2.303)
Discussion and conclusions: The presence of meningeal signs, hypoglucorraquia and low PH in CSF are the most suggestive findings of meningitis, when compared to fever, mental status changes or other variables. Initial CSF image should include the application of constrast when possible.Disclosure: Dr. Trevino has nothing to disclose. Dr. Gonzalez Duarte has nothing to disclose. Dr. Avila-Funes has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Trevino, I., Gonzalez Duarte, M. A., Avila-Funes, A. Tags: CNS Infectious Disease: Miscellaneous Source Type: research

Arteriovenous fistula after ventriculostomy in aneurysmal subarachnoid hemorrhage
A 66-year-old woman was found unresponsive after complaining of severe headache several days prior. She was comatose upon initial evaluation and a cranial CT revealed diffuse subarachnoid hemorrhage. A right posterior communicating artery aneurysm (figure, A, arrow) was successfully treated with endovascular embolization. Conventional angiography performed 7 days following ventriculostomy placement for hydrocephalus demonstrated interval development of a traumatic arteriovenous fistula (AVF) filling by the middle meningeal artery (figure, C, D, arrow). The AVF was treated with intra-arterial embolization. Ventriculostomy-a...
Source: Neurology - June 3, 2013 Category: Neurology Authors: Meisel, K., Yee, A., Stout, C., Kim, W., Cooke, D., Halbach, V. Tags: All Cerebrovascular disease/Stroke, Arteriovenous malformation, Subarachnoid hemorrhage NEUROIMAGES Source Type: research

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