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Teaching NeuroImages: HIV-associated cerebral vasculopathy with multiple nodular aneurysms
HIV-associated cerebral vasculopathy with multiple aneurysms has been widely reported in children1 and has to be considered in HIV-infected patients with high CSF viral load, but only few cases in adults have been published so far. Nodular and fusiform aneurysms (figure, A–D) are a typical imaging finding2 that may lead to suspicion of an autoimmune etiology by mimicking polyarteritis nodosa. These aneurysms might carry clinical significance with regard to the risk of subarachnoid or intracerebral hemorrhage, or causing infarction through formation of emboli. Highly active antiretroviral therapy leads to remission of...
Source: Neurology - April 3, 2017 Category: Neurology Authors: Seiler, A., You, S.-J., Wagner, M., Klein, J. C. Tags: Stroke in young adults, All Imaging, Vasculitis, HIV, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research

Impact of resident and fellow changeovers on patient outcomes: a nationwide cross-sectional study
ConclusionOur findings provide some reassurance regarding cohort changeover and mortality even if they suggest a loss of efficiency in some cases.
Source: The European Journal of Public Health - May 25, 2017 Category: General Medicine Source Type: research

Treatment course and outcomes after revascularization surgery for moyamoya disease in adults
ConclusionsThis analysis of nationally representative US data suggests that although readmission after RS for MMD is not uncommon, cerebral hemorrhagic events during the 90-day postoperative period are rare.
Source: Journal of Neurology - September 8, 2018 Category: Neurology Source Type: research

New Warning for the Multiple Sclerosis Drug Alemtuzumab
The Food and Drug Administration has added a black box warning for alemtuzumab (Lemtrada) stating that the drug, used in the treatment of relapsing multiple sclerosis, may cause ischemic and hemorrhagic stroke and cervicocephalic arterial dissection, rare but serious adverse effects.Nurses should teach patients prescribed this medication to recognize and seek emergency medical care if they develop any signs or symptoms of stroke.
Source: AJN - February 24, 2019 Category: Nursing Tags: Drug Watch Source Type: research

Spontaneous Subarachnoid Haemorrhage in Neurological Setting in Burkina Faso: Clinical Profile, Causes, and Mortality Risk Factors.
In conclusion, our study showed a poor frequency of spontaneous subarachnoid haemorrhage with high mortality. Hypertension was the most common cause of spontaneous subarachnoid haemorrhage. PMID: 31210989 [PubMed]
Source: Neurology Research International - June 19, 2019 Category: Neurology Tags: Neurol Res Int Source Type: research

Admission to Intensive Care Unit due to non-traumatic coma: etiology and outcome
Conclusion: Intracerebral hemorrhage was the leading cause of NTC, followed by respiratory failure and sepsis. Acute kidney injury was the best predictor of ICU mortality.
Source: European Respiratory Journal - November 20, 2019 Category: Respiratory Medicine Authors: Chrysanthopoulou, E., Karampela, I., Patsilinakou, S., Konstantopoulou, G., Franzeskaki, F., Kontogiorgi, M., Diakaki, C., Theodorakopoulou, M., Tsagkaris, I., Armaganidis, A. Tags: Acute critical care Source Type: research

E-246 Professional board certification for nurses, advanced practice providers, and radiology techs working in neurointerventional labs: the certified neurointerventional clinician™ (CNIC)
ConclusionsAttainment of CNIC™ certification demonstrates expertise in neurointerventional lab competencies that include clinical and neuroimaging diagnosis of stroke, evidence-based management principles for both ischemic and hemorrhagic stroke subtypes, and capabilities to safely support peri-procedural management in the neurointerventional lab.Disclosures A. Doerr: None. B. Fill: None. M. Sabapathypillai: None. C. Ortiz: None. H. Shownkeen: None. A. Alexandrov: None. C. Valasco: None. A. Richardson: None. A. Alexandrov: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Doerr, A., Fill, B., Sabapathypillai, M., Ortiz, C., Shownkeen, H., Alexandrov, A., Valasco, C., Richardson, A., Alexandrov, A. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

Increased Hemoglobin A1c Level Is Associated with Decreased Hematoma Volume in Patients with Spontaneous Intracerebral Hemorrhage (P03.176)
CONCLUSIONS: Our data showed inverse correlation between HbA1c levels and BHV. This contradiction may suggest that acute hyperglycemia in response to acute stress is the effect rather than cause of severe ICH. Further studies to determine if increased HbA1c levels lead to the early activation of clotting factors in ICH patients, or increased HbA1c levels lead to changes in the structure of the vessel wall is warranted.Disclosure: Dr. Mehta has nothing to disclose. Dr. Dass has nothing to disclose. Dr. Moussavi has nothing to disclose. Dr. Sodhi has nothing to disclose. Dr. Nizam has nothing to disclose. Dr. Korya has nothi...
Source: Neurology - February 14, 2013 Category: Neurology Authors: Mehta, S., Dass, P., Moussavi, M., Sodhi, R., Nizam, A., Korya, D., Dababneh, H., Ibrahim, M., Kirmani, J. Tags: P03 Cerebrovascular Disease III Source Type: research

Teaching NeuroImages: Susceptibility-weighted MRI: First clue to DAVF complicating sinovenous thrombosis
A 61-year-old man with factor V Leiden thrombophilia presented with hemorrhage and transverse sinus thrombosis (figure, A). Four years later, he developed worsening aphasia, new hemorrhage, and hemispheric edema (figure, B). Susceptibility-weighted imaging (SWI) showed bright signal in the straight sinus (figure, C). A dural arteriovenous fistula (DAVF) was diagnosed (figure, D). The brain edema improved (figure, E) and SWI sinus hyperintensity resolved after endovascular disconnection of the fistula (figure, F).
Source: Neurology - May 20, 2013 Category: Neurology Authors: Kalra, V. B., Malhotra, A., Matouk, C. C. Tags: MRI, All Cerebrovascular disease/Stroke, Arteriovenous malformation, Cerebral venous thrombosis RESIDENT AND FELLOW SECTION Source Type: research

Teaching NeuroImages: Perfusion imaging of cerebral hyperperfusion syndrome following revascularization
A 69-year-old man developed acute-onset confusion and hypertension with systolic pressures in the 160s 1 day after carotid endarterectomy for right facial droop from left hemispheric lacunar infarcts. CT perfusion (figure, A–D) demonstrated findings consistent with cerebral hyperperfusion syndrome (CHS) following revascularization. CHS is caused by loss of autoregulation, hypertension, and ischemia-reperfusion injury resulting in increased regional blood flow and vascular congestion.1 CHS following revascularization may present as ipsilateral headache, focal seizure, or neurologic deficit. Nonperfusion imaging may sh...
Source: Neurology - July 22, 2013 Category: Neurology Authors: Kalra, V. B., Rao, B., Malhotra, A. Tags: CT, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research

Pulmonary Arteriovenous Malformations and Embolic Complications in Patients With Hereditary Hemorrhagic Telangiectasia.
We describe baseline characteristics of HHT and compare the prevalence of embolic complications in patients with significant PAVM compared to patients without significant PAVM. One hundred and eight consecutive patients were included. Significant PAVM was defined as: contrast echocardiography grade 2 or greater; bilateral PAVM or feeding artery bigger than 3mm; or previous PAVM treatment. Primary composite outcome was defined as: cerebrovascular accident, cerebral abscess or peripheral embolism. 20% of participants had embolic complications, the most frequent one was stroke. Embolic complications were associated with signi...
Source: Archivos de Bronconeumologia - March 11, 2014 Category: Respiratory Medicine Authors: Angriman F, Ferreyro BL, Wainstein EJ, Serra MM Tags: Arch Bronconeumol Source Type: research

Sudden unexpected death in schizophrenia: Autopsy findings in psychiatric inpatients
In conclusion, sudden cardiac death occurs at a 0.8% rate in a psychiatric hospital, well above general population rates. Autopsy findings indicate that sudden death in schizophrenia is caused by structural cardiovascular, respiratory and neurological abnormalities, with most cases due to acute myocardial infarction. Early recognition and treatment of coronary artery disease must become a clinical priority for all adults with schizophrenia.
Source: Schizophrenia Research - April 7, 2014 Category: Psychiatry Authors: Petru Ifteni, Christoph U. Correll, Victoria Burtea, John M. Kane, Peter Manu Tags: Clinical Studies Source Type: research

Teaching NeuroImages: Ocular bruit in carotid-cavernous sinus fistula
A 57-year-old man who had a traffic accident 1 month previously presented with left ocular pain, double vision, and left eye proptosis with ptosis and conjunctival hemorrhage. Fundus showed dilated veins with no hemorrhages or disc edema. Left ocular motility showed complete external ophthalmoplegia (figure 1). There was prominent ocular bruit in his left eye (audio file on the Neurology® Web site at Neurology.org). MRI and magnetic resonance angiography showed a dilated left superior ophthalmic vein and an extravasation into cavernous sinus (figure 2). With chemosis, ophthalmoplegia, and retro-orbital pain, the auscul...
Source: Neurology - August 11, 2014 Category: Neurology Authors: Choi, J.-Y., Baek, S.-H., Jung, J.-M., Kwon, D.-Y., Park, M. H. Tags: All Imaging, Other cerebrovascular disease/ Stroke, Clinical neurology examination, All Neuro-ophthalmology RESIDENT AND FELLOW SECTION Source Type: research

Diagnostic Value of S100B Protein in the Differential Diagnosis of Acute Vertigo in the Emergency Department / El Valor Diagnóstico de la Proteína S100B en el Diagnóstico Diferencial del Vértigo Agudo en el Servicio de Urgencias
ConclusionsTo the best of our knowledge this is the first study assessing the utility of serum S100B levels for diagnosis of acute‐onset vertigo. Serum S100B levels are associated with the presence of central causes of vertigo on cranial MRI. However, serum S100B levels are not sufficiently sensitive to exclude candidates from cranial MRI. Resumen ObjetivosEl vértigo es un motivo de consulta frecuente y es consecuencia de una etiología central o periférica. Debido a que las causas centrales pueden ser de riesgo vital, la determinación de la naturaleza del vértigo es crucial en el servicio de urgencias (SU). Con un ...
Source: Academic Emergency Medicine - August 13, 2014 Category: Emergency Medicine Authors: Aslı Gülfer Kartal, Serkan Yılmaz, Elif Yaka, Murat Pekdemir, Hasan Tahsin Sarısoy, Mustafa Baki Çekmen, Melih Yüksel Tags: Original Contribution Source Type: research

Effects of dexmedetomidine on pulse pressure variation changes induced by hemorrhage followed by volume replacement in isoflurane‐anesthetized dogs
ConclusionsDuring ISO anesthesia, PPV increases in individuals prone to developing hypotension from hypovolemia. Because DEX prevents the increase in PPV associated with hypovolemia, PPV should not be used to guide VR in dogs that have been given DEX.
Source: Journal of Veterinary Emergency and Critical Care - December 3, 2014 Category: Veterinary Research Authors: Miriely S. Diniz, Francisco J. Teixeira‐Neto, Thaísa D. Cândido, Felipe S. Zanuzzo, Lívia R. Teixeira, Adriana V. Klein, Paulo do Nascimento Tags: Original Study Source Type: research

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