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Review on the Diagnosis and Treatment of Reversible Cerebral Vasoconstriction Syndrome in Children and Adolescents
Semin Neurol DOI: 10.1055/s-0040-1702942Reversible cerebral vasoconstriction syndrome (RCVS) is a clinical–radiologic diagnosis that affects children and adolescents, but it is much more frequently reported in adults. Clinically, patients present with severe and commonly recurrent thunderclap headaches. Typical precipitating triggers include vasoactive substances, serotonergic agents, and the postpartum period. There may be associated neurologic complications at presentation or in the weeks following, such as convexity subarachnoid hemorrhage, stroke, cerebral edema, cervical artery dissection (CeAD), and seizures. Angio...
Source: Seminars in Neurology - February 19, 2020 Category: Neurology Authors: Qubty, William Irwin, Samantha Lee Fox, Christine K. Tags: Review Article Source Type: research

Guidelines for the Acute Treatment of Cerebral Edema in Neurocritical Care Patients
ConclusionThe available evidence suggests hyperosmolar therapy may be helpful in reducing ICP elevations or cerebral edema in patients with SAH, TBI, AIS, ICH, and HE, although neurological outcomes do not appear to be affected. Corticosteroids appear to be helpful in reducing cerebral edema in patients with bacterial meningitis, but not ICH. Differences in therapeutic response and safety may exist between HTS and mannitol. The use of these agents in these critical clinical situations merits close monitoring for adverse effects. There is a dire need for high-quality research to better inform clinicians of the best options ...
Source: Neurocritical Care - May 14, 2020 Category: Neurology Source Type: research

Understanding the neurotropic characteristics of SARS-CoV-2: from neurological manifestations of COVID-19 to potential neurotropic mechanisms
AbstractCoronavirus disease 2019 (COVID-19), a disease caused by the novel betacoronavirus (SARS-CoV-2), has become a global pandemic threat. The potential involvement of COVID-19 in central nervous system (CNS) has attracted considerable attention due to neurological manifestations presented throughout the disease process. In addition, SARS-CoV-2 is structurally similar to SARS-CoV, and both bind to the angiotensin-converting enzyme 2 (ACE2) receptor to enter human cells. Thus, cells expressing ACE2, such as neurons and glial cells may act as targets and are thus vulnerable to SARS-CoV-2 infection. Here, we have reviewed ...
Source: Journal of Neurology - May 25, 2020 Category: Neurology Source Type: research

Predictors of deep-vein thrombosis in subarachnoid hemorrhage: a retrospective analysis
ConclusionElevated d-dimer level at the time of hospitalization, motor deficit, and the presence of an intraparenchymal hemorrhage are independent risk factors for deep-vein thrombosis. Patients with DVT also had a significantly longer hospital stay. Even though further studies are needed, patients with elevated d-dimer at hospitalization and intraparenchymal cerebral hemorrhage may benefit from a more aggressive screening strategy for deep-vein thrombosis.
Source: Acta Neurochirurgica - August 13, 2020 Category: Neurosurgery Source Type: research

Neurologic Emergencies at the Extremes of Age
The diagnosis and management of neurologic conditions are more complex at the extremes of age than in the average adult. In the pediatric population, neurologic emergencies are somewhat rare and some may require emergent consultation. In older adults, geriatric physiologic changes with increased comorbidities leads to atypical presentations and worsened outcomes. The unique considerations regarding emergency department presentation and management of stroke and altered mental status in both age groups is discussed, in addition to seizures and intracranial hemorrhage in pediatrics, and Parkinson's disease and meningitis in t...
Source: Emergency Medicine Clinics of North America - November 18, 2020 Category: Emergency Medicine Authors: Danya Khoujah, Megan J. Cobb Source Type: research

Neurologic Emergencies at the Extremes of Age.
Abstract The diagnosis and management of neurologic conditions are more complex at the extremes of age than in the average adult. In the pediatric population, neurologic emergencies are somewhat rare and some may require emergent consultation. In older adults, geriatric physiologic changes with increased comorbidities leads to atypical presentations and worsened outcomes. The unique considerations regarding emergency department presentation and management of stroke and altered mental status in both age groups is discussed, in addition to seizures and intracranial hemorrhage in pediatrics, and Parkinson's disease a...
Source: The Medical Clinics of North America - November 23, 2020 Category: General Medicine Authors: Khoujah D, Cobb MJ Tags: Emerg Med Clin North Am Source Type: research

Neurology: Images in Clinical Medicine
Editor: V. Dimov, M.D., Cleveland ClinicHypoglossal Nerve Palsy during Meningococcal Meningitis. NEJM, 10/2014.Absent Superficial Abdominal Reflex due to thoracic spinal cord neuromyelitis. NEJM, 05/2014.Kayser-Fleischer Rings in Wilson ' s Disease. NEJM, 03/2012.Perilymph Fistula Test leads to nystagmus. NEJM, 01/2012.A stray bullet in the brain - with no deficit of power, cognition, sense of touch, or speech. Lancet, 01/2012.Blindness after Fat Injections. NEJM, 12/2011.Internal-Carotid-Artery Dissection and Cranial-Nerve Palsies. NEJM, 12/2011.A Head Shot. NEJM, 12/2011.Multiple Intracranial Tuberculomas. NEJM, 10/2011....
Source: Clinical Cases and Images - August 22, 2009 Category: General Medicine Tags: Images Neurology Source Type: news

Infectious Diseases: Images in Clinical Medicine
Editor: V. Dimov, M.D., Cleveland ClinicHypoglossal Nerve Palsy during Meningococcal Meningitis. NEJM, 10/2014.Herpes Zoster Involving the S1 Dermatome. NEJM, 05/2014.Tinea Faciei. NEJM, 05/2014.Disseminated Cryptococcosis in a CLL patient. 05/2014.Scrofuloderma due to Mycobacterium tuberculosis. NEJM, 06/2012.Leonine Facies in Lepromatous Leprosy. NEJM, 04/2012.Intestinal Infestation with Ancylostoma ceylanicum. NEJM, 03/2012.Kerion celsi form of tinea capitis caused by a T-cell hypersensitivity reaction. NEJM, 03/2012.Eye can see a nest of worms! Thelazia callipaeda. Lancet, 03/2012.Madura Foot. NEJM, 01/2012.Paragonimia...
Source: Clinical Cases and Images - August 22, 2009 Category: General Medicine Tags: Images Infectious Diseases Source Type: news

Severe chickenpox disease and seroprevalence in Sweden – implications for general vaccination
Chickenpox is the clinical manifestation of primary infection with varicella zoster virus (VZV) and a mild disease in the vast majority of cases. However, complications occur, primarily bacterial infections of vesicles, sometimes with deeper infection and sepsis, as well as neurological complications; e.g. encephalitis, meningitis, or classically acute cerebellitis with ataxia. Rare complications such as pneumonitis, hepatitis and haemorrhagic complications may occur (Gershon et al., 2018). There is even an increased risk of stroke in the time period 6 months after a chickenpox episode (Thomas et al., 2014).
Source: International Journal of Infectious Diseases - August 8, 2021 Category: Infectious Diseases Authors: K Widgren, L Persson Berg, A M örner, L Lindquist, A Tegnell, J Giesecke, M Studahl Source Type: research

Treatment strategies for giant pituitary adenomas in the era of endoscopic transsphenoidal surgery: a multicenter series
CONCLUSIONS: ETS as a primary treatment modality to relieve mass effect in GPAs and extent of resection are dependent on GPA morphology. The pattern of residual pituitary adenoma guides further treatment strategies, including early transcranial reoperation, delayed endoscopic transsphenoidal/transcranial reoperation, and adjuvant radiosurgery.PMID:34388714 | DOI:10.3171/2021.1.JNS203982
Source: Journal of Neurosurgery - August 13, 2021 Category: Neurosurgery Authors: Alexander Micko Matthew S Agam Andrew Brunswick Ben A Strickland Martin J Rutkowski John D Carmichael Mark S Shiroishi Gabriel Zada Engelbert Knosp Stefan Wolfsberger Source Type: research

Clinical presentation and assessment of older patients presenting with headache to emergency departments: A multicentre observational study
CONCLUSION: Older patients with headache had different clinical features to the younger cohort and were more likely to have a serious secondary cause of headache than younger adults. There should be a low threshold for investigation in older patients attending ED with non-traumatic headache.PMID:34570422 | DOI:10.1111/ajag.12999
Source: Australasian Journal on Ageing - September 27, 2021 Category: Geriatrics Authors: Sierra Beck Frances B Kinnear Anne Maree Kelly Kevin H Chu Win Sen Kuan Gerben Keijzers Richard Body Mehmet A Karamercan Sharon Klim Tissa Wijeratne Sinan Kamona Colin A Graham Tom Roberts Daniel Horner Said Laribi HEAD Study Group Source Type: research

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