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Transdermal opioid patch in treatment of paroxysmal autonomic instability with dystonia with multiple cerebral insults: A case report
Rationale: Paroxysmal autonomic instability with dystonia (PAID) is an underdiagnosed syndrome that describes a collection of symptoms following diverse cerebral insults, such as traumatic brain injury, hydrocephalus, hemorrhagic stroke, or brain anoxia. It is manifested by systemic high blood pressure, hyperthermia, tachycardia, tachypnea, diaphoresis, intermittent agitation, and certain forms of dystonia. Patient concerns: A semi-comatose 46-year-old man was transferred from the regional rehabilitation hospital with various complaints involving fluctuating vital signs, including uncontrolled hyperthermia, hypertensi...
Source: Medicine - October 2, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Is Aberrant Reno-Renal Reflex Control of Blood Pressure a Contributor to Chronic Intermittent Hypoxia-Induced Hypertension?
This study demonstrated unaltered vascular conductance in response to lumbar sympathetic stimulation in CIH-exposed rats. Aortic compliance was increased and estimated blood volume was unchanged in CIH-exposed rats. Increased blood pressure was related to an increase in cardiac output, which was confirmed by echocardiography (Lucking et al., 2014). It is suggested therefore that hypertension in the CIH model can be evoked by over-excitation of the cardiac arm of sympathetic nervous system (SNS), even before mechanisms of enhanced peripheral vasoconstriction and endothelial dysfunction are initiated (Naghshin et al., 2009)....
Source: Frontiers in Physiology - April 23, 2019 Category: Physiology 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

Hepatic Ketogenesis Induced by Middle Cerebral Artery Occlusion in Mice Stroke
ConclusionsWe conclude that brain ischemia induces the formation of β‐hydroxybutyrate (ketogenesis) in the liver and the consumption of β‐hydroxybutyrate in the brain. This effect seems to be mediated by β‐adrenergic receptors.
Source: JAHA:Journal of the American Heart Association - April 5, 2017 Category: Cardiology Authors: Koch, K., Berressem, D., Konietzka, J., Thinnes, A., Eckert, G. P., Klein, J. Tags: Ischemia, Metabolism, Cerebrovascular Disease/Stroke, Ischemic Stroke Original Research Source Type: research

Hypersomnia and Reduction in Essential Tremor after Bilateral Subthalamic Ischemic Stroke (P4.285)
Conclusions:Prevalence of hypersomnia among stroke patients ranges from 1.1 to 27[percnt].A reduction in the activity of arousal systems underlies most forms of post stroke hypersomnia.Multiple changes like reduction in the amount of NREM sleep, sleep time, sleep spindles, REM sleep ( in occipital strokes ) were also described depending on the location of the stroke. Thalamic and brainstem strokes can present with pathological EEG patterns like alpha coma.Along with bilateral thalamic strokes, strokes in thalamo-mesencephalic regions, upper pons and medial pontomedullary lesions can cause marked hypersomnia. Cortical and s...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Pesala, S., Nalleballe, K., Bollu, P. Tags: Parasomnias and Hypersomnias Source Type: research

Activation of hepatic inflammatory pathways by catecholamines is associated with hepatic insulin resistance in male ischemic stroke rats.
Abstract Patients who experience acute ischemic stroke may develop hyperglycemia, even in the absence of diabetes. In the current study we determined the effects of acute stroke on hepatic insulin signaling, tumor necrosis factor α (TNF-α) expression, endoplasmic reticulum (ER) stress, the activities of c-Jun N-terminal kinase (JNK), inhibitor κB kinase β (IKK-β), and nuclear factor-κB (NF-κB) pathways. Rats with cerebral ischemia developed higher blood glucose, and insulin levels, and insulin resistance index, as well as hepatic gluconeogenic enzyme expression compared to the sham-treated group. The hepati...
Source: Endocrinology - January 17, 2014 Category: Endocrinology Authors: Wang YY, Lin SY, Chuang YH, Sheu WH, Tung KC, Chen CJ Tags: Endocrinology Source Type: research

Managing migraine and other headache syndromes in those over 50
Abstract: Migraine in an older person may appear with sensory or motor phenomena (“late-life migraine accompaniments”), so that it may be confused with transient ischemic attack or stroke. An older patient may have cervicogenic headache in addition to migraine. Medication overuse headache is just as much of a problem in older patients as it is in younger ones. Abdominal migraine without headache can be seen in older adults as a migraine equivalent, just as it can occur in children. The most effective drugs for migraine prophylaxis in young people (divalproex, topiramate, metoprolol and propranolol) are similarly effect...
Source: Maturitas - May 1, 2013 Category: Primary Care Authors: Brett Dees, Rhonda Coleman-Jackson, Linda A. Hershey Tags: Reviews Source Type: research