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200 Covid-19 and acute ischaemic strokes in CADASIL: a systematic review of the literature
Conclusions This systematic review describes the pattern of COVID-19 associated AIS in CADASIL. Such multiple infarcts, primarily affecting the internal borderzones, have been described in patients with Covid-19 without CADASIL. We discuss possible pathophysiological mechanisms, which may be extrapolated to patients with cerebral small vessel disease, including endothelial injury causing microvascular thrombosis and hypoperfusion due to cerebral blood flow dysautoregulation.
Source: Journal of Neurology, Neurosurgery and Psychiatry - August 12, 2022 Category: Neurosurgery Authors: Noui, Y., Williams, O., Chan, N., Chandra, J., Sztriha, L. Tags: Poster presentations Source Type: research

Stroke outcome of early antiplatelet in post-thrombolysis haemorrhagic infarction
Conclusions Antiplatelet therapy can be safely used between 24 and 48 hours when HI occurs after IVT, and such therapy is associated with reduced risk of END and improved neurological outcome in patients who had an AIS.
Source: Journal of Neurology, Neurosurgery and Psychiatry - July 14, 2022 Category: Neurosurgery Authors: Zhong, W., Yan, S., Chen, Z., Luo, Z., Chen, Y., Zhang, X., Wu, C., Tang, W., Zhang, X., Wang, Y., Gu, Q., Xu, D., Chen, H., Lou, M., on behalf of the CASE-II Study Group Tags: Cerebrovascular disease Source Type: research

IVIg-exposure and thromboembolic event risk: findings from the UK Biobank
Background Arterial and venous thromboembolic events (TEEs) have been associated with intravenous Ig use, but the risk has been poorly quantified. We aimed to calculate the risk of TEEs associated with exposure to intravenous Ig. Methods We included participants from UK Biobank recruited over 3 years, data extracted September 2020. The study endpoints were incidence of myocardial infarction, other acute ischaemic heart disease, stroke, pulmonary embolism and other venous embolism and thrombosis. Predictors included known TEE risk factors: age, sex, hypertension, smoking status, type 2 diabetes mellitus, hypercholesterolae...
Source: Journal of Neurology, Neurosurgery and Psychiatry - July 14, 2022 Category: Neurosurgery Authors: Kapoor, M., Hunt, I., Spillane, J., Bonnett, L. J., Hutton, E. J., McFadyen, J., Westwood, J.-P., Lunn, M. P., Carr, A. S., Reilly, M. M. Tags: Neuromuscular Source Type: research

103 High rates of venous and arterial thrombotic events in POEMS patients
Conclusion Arterial and venous thromboses are more common in POEMS syndrome than previously reported and appear associated with disease pathology and activity. We propose a management strategy for appropriate thromboprophylaxis in POEMS patients throughout the course of disease. stephen.keddie@nhs.net
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 27, 2022 Category: Neurosurgery Authors: Keddie, S., Sayar, Z., Weatherill, A., Sive, J., Thomas, M., DSa, S., Lunn, M. Tags: Poster Presentations Source Type: research

Radiology ruse: dural venous sinus cyst masquerading as venous sinus thrombosis presenting with headache and stroke
Conclusions Radiological differentiation between venous sinus thrombosis and dural venous sinus cyst is clinically important to avoid unnecessary anticoagulation and associated risks. Final management included propranolol for migraine prophylaxis; aspirin for acute migraine; aspirin for stroke prevention; vascular risk factor management; and cessation of triptans.
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 8, 2017 Category: Neurosurgery Authors: McAulay-Powell, C., Murton, A., Tsai, W.-C., Jones, D., Froelich, J. Tags: Abstracts Source Type: research

Posterior circulation cerebrovascular syndromes: diagnosis and management
One in five strokes affects the posterior circulation. Diagnosing posterior circulation stroke can be challenging, as the vascular anatomy can be variable, and because presenting symptoms are often non-specific and fluctuating. Nevertheless, making the correct diagnosis is important, as these strokes have a high chance of recurrence, can be life threatening, and can lead to equally life-threatening complications. Investigation and management largely follow those for stroke in general, although some specific differences exist. These include the preferred use of MRI for diagnosing posterior fossa lesions, the management of b...
Source: Journal of Neurology, Neurosurgery and Psychiatry - December 14, 2016 Category: Neurosurgery Authors: Schulz, U. G., Fischer, U. Tags: Stroke Cerebrovascular disease Source Type: research

Recurrent cerebral venous sinus thrombosis secondary to eltrombopag for itp
Conclusion Extensive chronic cerebral venous sinus thrombosis likely caused by abnormally structured platelets may result when Eltrombopag increases their number.
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Mallick, S., Janarthen, V., Warner, G. Tags: Cranial nerves, Headache (including migraine), Pain (neurology), Stroke, Ophthalmology ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

The clinical management of cerebral venous sinus thrombosis. a uk survey
Conclusion Overall respondents were confident in the use of heparin for the treatment of CVST. Respondents used LMWH predominantly, in keeping with EFNS guidance, yet in contrast to a previous European survey.1
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Lavin, T., Punter, M., Holland, M. Tags: Stroke ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Neck vessel dissection following whiplash-type neck injury
Arterial dissection is a recognised complication of neck manipulation and trauma. In a systematic audit of 148 complex medicolegal whiplash cases 131 had only neck pain, 8 had radiculopathic symptoms, and 9 had symptoms and signs suggesting an arterial dissection of a neck vessel with presumed secondary thromboembolism. Their ages ranged from 28–55. Three had hemipareses supported by scan abnormalities, and one had a probable posterior fossa stroke. Five cases had prolonged symptoms without imaging abnormalities. This series cannot be considered representative of whiplash cases as a whole. The dissection is necessari...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Peatfield, R., Jenkins, H. Tags: Pain (neurology), Stroke, Trauma, Injury ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Service provision for cerebral venous sinus thrombosis. a uk survey
Conclusion Provision of care for patients with CVST is mainly through specialist services and is evenly split between acute stroke and neurology. Most cases are cared for by a neurologist or stroke physician, but just over half would see a specialist within 24 hours of admission.
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Lavin, T., Punter, M., Holland, M. Tags: Stroke ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Time to recanalisation in patients with cerebral venous thrombosis under anticoagulation therapy
Conclusions We found that recanalisation occurs over time, until month 11. Complete recanalisation may influence functional outcome.
Source: Journal of Neurology, Neurosurgery and Psychiatry - February 14, 2016 Category: Neurosurgery Authors: Arauz, A., Vargas-Gonzalez, J.-C., Arguelles-Morales, N., Barboza, M. A., Calleja, J., Martinez-Jurado, E., Ruiz-Franco, A., Quiroz-Compean, A., Merino, J. G. Tags: Stroke, Radiology, Radiology (diagnostics) Cerebrovascular disease Source Type: research

Acute appearance of a carotid pseudoaneurysm during coughing
An adolescent with Behçet's disease presented after an episode of violent coughing with the sudden appearance of a pulsatile mass on his neck (figure 1A). Since childhood, he had been treated with a coumarin derivative (international normalised ratio at admission: 3.2) after cavernous sinus thrombosis and detection of heterozygous mutations in the prothrombin and homocysteine genes. Neurological examination was unremarkable except for mild hoarseness. Imaging revealed a pseudoaneurysm with common carotid artery dissection (figure 1B, C). Two stents were placed. On follow-up, there was no detectable aneurysm. Beh&cce...
Source: Journal of Neurology, Neurosurgery and Psychiatry - December 17, 2014 Category: Neurosurgery Authors: Enamorado, J. E., Witsch, J., Aviles, A. H., Perez, R. H. Tags: Genetics, Neurological injury, Stroke, Trauma CNS / PNS, Ophthalmology, Radiology, Adult intensive care, Vascularitis, Radiology (diagnostics), Ear, nose and throat/otolaryngology, Trauma, Injury Neurological pictures Source Type: research

Anti glutamic acid decarboxylase antibody mediated encephalopathy while on etanercept in a patient with multiple autoimmune diseases
A 39 year old lady presented with an altered mental state and unsteadiness of gait. She had a history of juvenile idiopathic arthritis, autoimmune thyroiditis and alopecia, protein S deficiency with vena cava thrombosis, previous excision of ovarian mass and vasculitic rash. There was a previous history of ovarian mass and her immunomodulatory therapy for arthritis over the previous year was Etanercept. She used recreational cannabis but denied any other illicit drug usage. Her affect was variable and at times inappropriate with frequent laughter. She would spit regularly. There was anxiety and a prevailing sensation of do...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: MacDougall, N., Waddell, B., O'Riordan, J. I. Tags: Immunology (including allergy), Brain stem / cerebellum, Drugs: CNS (not psychiatric), Epilepsy and seizures, Infection (neurology), Stroke, Drugs misuse (including addiction), Connective tissue disease, Musculoskeletal syndromes Association of British Source Type: research

Successful outcome after traumatic rupture and secondary thrombosis of the superior sagittal sinus
A 15-year-old adolescent was admitted to the emergency department after a car accident because of severe traumatic brain injury. Upon arrival, he was sedated and intubated because of a Glasgow Coma Scale score below 8. He had isocoria with reactive pupils. An occipital puncture wound (diameter 2 cm) was profusely bleeding. His blood pressure was 85/45 mm Hg. Laboratory values identified a haemoglobin level of 4.6 mmol/l. A CT scan of the brain demonstrated a comminuted-depressed fracture of the parietal bone in the midline with a rupture of the superior sagittal sinus (SSS) and secondary thrombosis (fig...
Source: Journal of Neurology, Neurosurgery and Psychiatry - September 2, 2013 Category: Neurosurgery Authors: Oudeman, E. A., De Witt Hamer, P. C. Tags: Coma and raised intracranial pressure, Neuroimaging, Neurological injury, Stroke, Trauma CNS / PNS, Hypertension, Radiology, Drugs: musculoskeletal and joint diseases, Radiology (diagnostics), Trauma, Injury Neurological pictures Source Type: research

Why, for once, is the UK leading the way in implementing evidence?
One of the major factors influencing the quality of healthcare is the responsiveness of clinicians to new evidence and their willingness to implement findings into routine clinical practice in a timely way.1 The factors that affect the efficiency of getting evidence into practice are complex; a good example of this is illustrated in the paper by Ankolekar et al.2 The Clots in Legs or sTockings after Stroke (CLOTS) 1 trial definitively showed that compression stockings after stroke did not prevent venous thromboembolism. The trial was well conducted and adequately powered for the primary outcome, so there was little room fo...
Source: Journal of Neurology, Neurosurgery and Psychiatry - February 15, 2013 Category: Neurosurgery Authors: Fraser, A., Rudd, A. Tags: Drugs: CNS (not psychiatric), Stroke, Radiology Editorial commentaries Source Type: research

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