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Source: Neurology
Condition: Migraine

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Total 247 results found since Jan 2013.

Examining the Spectrum of Reversibles: RCVS and PRES at Mayo Clinic Arizona (S53.007)
Conclusions:This large series of patients with clinical and radiographic features of PRES identified the presence of RCVS in over 24% of patients; a finding that is of critical importance in understanding the pathogenesis of these disorders, their diagnosis, and their management.Disclosure: Dr. Steenerson has nothing to disclose. Dr. Pena has nothing to disclose. Dr. Starling has received personal compensation for activities with Amgen and eNeura as a consultant. Dr. Goodman has nothing to disclose. Dr. Temkit has nothing to disclose. Dr. O'Carroll has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Steenerson, K., Pena, A., Starling, A., Goodman, B., Temkit, H., OCarroll, C. Tags: General Neurology: Mechanisms and Diagnosis in Overlapping Medical and Neurological Diseases Source Type: research

Emergent MRI during a Stroke Alert. Single center experience. (P6.299)
Conclusions:Clinical presentation and head CT provide sufficient information for decision making about provision of IV tPA. Emergent MRI increases door-to-needle time and may only be used in rare cases when history is not available. Presence of headache, absence of atrial fibrillation and low NIHSS score may help differentiating stroke mimics from AIS.Disclosure: Dr. Kapoor has nothing to disclose. Dr. Iser has nothing to disclose. Dr. Thompson has nothing to disclose. Dr. Haxton has nothing to disclose. Dr. Sidorov has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Kapoor, N., Iser, C., Thompson, D., Haxton, M. E., Sidorov, E. Tags: Cardiovascular Issues in Ischemic Stroke Source Type: research

Neurological involvement in Chikangunya Virus infection (S40.007)
Conclusions:Chikangunya fever is frequently associated with neurological symptoms, especially alteration in sensorium, neutrophilia and hyponatremia in more than two-thirds of the patients, sepsis and hepatorenal dysfunction in almost one third of the patients, CSF lymphocytosis with raised proteins and topographically involves temporal and frontal lobes predominantly.Disclosure: Dr. Anand has nothing to disclose. Dr. Kasundra has nothing to disclose. Dr. Prasad has nothing to disclose. Dr. Handa has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Anand, R., Kasundra, G., Prasad, A., Handa, R. Tags: Infectious Disease: The Neurology of Zika, Chikungunya, and Acute Flaccid Myelitis Source Type: research

Cervical artery dissection in patients >=60 years: Often painless, few mechanical triggers
Conclusion: In our study population of patients diagnosed with CeAD, 1 in 14 was aged ≥60 years. In these patients, pain and mechanical triggers might be missing, rendering the diagnosis more challenging and increasing the risk of missed CeAD diagnosis in older patients.
Source: Neurology - April 3, 2017 Category: Neurology Authors: Traenka, C., Dougoud, D., Simonetti, B. G., Metso, T. M., Debette, S., Pezzini, A., Kloss, M., Grond-Ginsbach, C., Majersik, J. J., Worrall, B. B., Leys, D., Baumgartner, R., Caso, V., Bejot, Y., Compter, A., Reiner, P., Thijs, V., Southerland, A. M., Ber Tags: Stroke in young adults, All Cerebrovascular disease/Stroke, Carotid artery dissection ARTICLE Source Type: research

Letter re: Neuroimaging overuse is more common in Medicare compared with the VA
We strongly encourage Drs. Burke and Callaghan to reread our comment, since it has nothing to do with the number of lawsuits filed, but the number of patients harmed (and claims made and settled before a suit is filed) due to substandard care by the intransigent adherence to outdated guidelines. The recommendation by Burke et al.1 to limit neuroimaging based on these flawed guidelines is contrary to an acceptable standard of care. There is no reason to fear incidental findings on neuroimaging since these often warrant further evaluation (e.g., stroke), continued monitoring (e.g., aneurysm), or treatment (e.g., arachnoid cy...
Source: Neurology - February 5, 2017 Category: Neurology Authors: Johnston, J. C., Sartwelle, T. P. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research

Clinical Reasoning: Sudden-onset pulsatile headache in a previously healthy young man
A previously healthy 41-year-old man presented to the local hospital with a sudden-onset right-sided pulsatile headache, accompanied by vertigo, unstable gait, nausea, and vomiting. On admission, he additionally presented with left central facial paralysis, left-sided hemiparesis, and NIH Stroke Scale score of 2. The patient denied history of hypertension, diabetes, or any other high-risk factors for cerebral vascular diseases (CVD). Diffusion-weighted imaging (DWI) revealed multiple acute focal infarctions in the right frontoparietal lobe consistent with decreased blood supply through the right carotid artery (figure e-1A1 at Neurology.org).
Source: Neurology - January 15, 2017 Category: Neurology Authors: Qin, C., Pan, C., Tian, D.-S. Tags: Stroke in young adults, Carotid artery dissection RESIDENT AND FELLOW SECTION Source Type: research

Avoidance of steroids in the reversible cerebral vasoconstriction syndrome
Reversible cerebral vasoconstriction syndrome (RCVS), characterized by multifocal constrictions of cerebral arteries resolving spontaneously within 3 months, most commonly presents with unusual, severe, mostly thunderclap headaches (severe pain peaking in less than 1 minute).1,2 Seizures and focal neurologic deficits related to cortical subarachnoid hemorrhage, intracerebral hemorrhage, ischemic stroke, or posterior reversible encephalopathy syndrome may occur.3–5 Treatment relies on rest; withdrawal of any vasoactive drugs; avoidance of triggering factors; administration of nimodipine, given by analogy to aneurysmal...
Source: Neurology - January 15, 2017 Category: Neurology Authors: Mawet, J. Tags: All Headache, Stroke in young adults, All Imaging, Vasculitis, All Cerebrovascular disease/Stroke EDITORIALS Source Type: research

Glucocorticoid-associated worsening in reversible cerebral vasoconstriction syndrome
Conclusion: Patients with RCVS at risk for worsening can be identified on basis of baseline features. Iatrogenic factors such as glucocorticoid exposure may contribute to worsening.
Source: Neurology - January 15, 2017 Category: Neurology Authors: Singhal, A. B., Topcuoglu, M. A. Tags: All Headache, Stroke in young adults, All Imaging, Vasculitis, All Cerebrovascular disease/Stroke ARTICLE Source Type: research

Abnormal neurovascular coupling during status epilepticus migrainosus in Sturge-Weber syndrome
Sturge-Weber syndrome is a rare, sporadic, neurocutaneous disorder classically characterized by a facial nevus in the trigeminal distribution (port wine stain), leptomeningeal angiomatosis, and glaucoma, although intracranial changes can be present without cutaneous involvement.1 Seizures occur in up to 75% of individuals, are often associated with headache, and stroke-like episodes causing prolonged neurologic deficits are also described.1,2
Source: Neurology - January 8, 2017 Category: Neurology Authors: Sethi, M., Kowalczyk, M. A., Dalic, L. J., Archer, J. S., Jackson, G. D. Tags: Migraine, Status epilepticus, Functional neuroimaging, PET in epilepsy, SPECT in epilepsy CLINICAL/SCIENTIFIC NOTES Source Type: research

Ten-year results of pallidal stimulation for cricopharyngeal dystonia with spasmodic dysphonia
Sturge-Weber syndrome is a rare, sporadic, neurocutaneous disorder classically characterized by a facial nevus in the trigeminal distribution (port wine stain), leptomeningeal angiomatosis, and glaucoma, although intracranial changes can be present without cutaneous involvement.1 Seizures occur in up to 75% of individuals, are often associated with headache, and stroke-like episodes causing prolonged neurologic deficits are also described.1,2
Source: Neurology - January 8, 2017 Category: Neurology Authors: Horisawa, S., Ochiai, T., Goto, S., Nakajima, T., Kawamata, T., Taira, T. Tags: Dystonia, Surgery/Stimulation CLINICAL/SCIENTIFIC NOTES Source Type: research

Teaching NeuroImages: Intracranial vertebral dissection in a 15-year-old boy with sickle cell disease
A 15-year-old boy with sickle cell disease became unresponsive after sudden-onset headache. There was no antecedent trauma. A head CT scan demonstrated subarachnoid hemorrhage at the medulla (figure). Magnetic resonance angiography of the head and neck identified the patient's known bilateral internal carotid artery stenosis (a moyamoya-like arteriopathy associated with stroke in sickle cell disease) and a new right vertebral artery dissection, which was confirmed on conventional angiography (figure). Prior MRI performed as part of routine cerebral monitoring did not reveal any preexisting abnormality of the vertebral artery.
Source: Neurology - December 11, 2016 Category: Neurology Authors: Siegler, J. E., Banwell, B., Ichord, R. N. Tags: Pediatric stroke; see Cerebrovascular Disease/ Childhood stroke RESIDENT AND FELLOW SECTION Source Type: research

Cardioembolism as the unsuspected missing link between migraine and ischemic stroke
First identified in 1975, the relationship between migraine and stroke has received considerable attention.1 Forty years later, solid evidence indicates that those with migraine have a 1.5-fold to 2.5-fold increased risk of stroke.2–4 However, the strength of this relationship varies based on the subtypes of migraine (with vs without aura) and stroke (hemorrhagic vs ischemic). While the majority of data support an increased risk of ischemic stroke in those with migraine, the association between migraine without aura and ischemic stroke seems weaker and more controversial, possibly due to methodologic heterogeneity across studies.2,3
Source: Neurology - December 11, 2016 Category: Neurology Authors: Sposato, L. A., Peterlin, B. L. Tags: Migraine, All Cerebrovascular disease/Stroke, Cardiac, Embolism, Risk factors in epidemiology EDITORIALS Source Type: research

Ischemic stroke subtypes and migraine with visual aura in the ARIC study
Conclusion: In participants with migraine with visual aura in late middle age, increased risk of cardioembolic stroke was observed. Migraine with visual aura was linked to increased stroke risk, while migraine without visual aura was not, over the period of 20 years. These results are specific to older migraineurs.
Source: Neurology - December 11, 2016 Category: Neurology Authors: Androulakis, X. M., Kodumuri, N., Giamberardino, L. D., Rosamond, W. D., Gottesman, R. F., Yim, E., Sen, S. Tags: Migraine, All Cerebrovascular disease/Stroke ARTICLE Source Type: research

Teaching NeuroImages: Multicompartmental intracranial hemorrhage in a pediatric patient
A previously healthy 9-year-old girl presented with sudden-onset headache followed by confusion. In the emergency department, she was hypertensive, bradycardic, and no longer responsive to any stimuli. An emergent head CT scan demonstrated a left frontal intraparenchymal hematoma with intraventricular and subarachnoid extension as well as subfalcine herniation (figure). She underwent decompressive hemicraniectomy, and digital subtraction angiography confirmed a 7-mm left middle cerebral artery aneurysm (figure).
Source: Neurology - December 4, 2016 Category: Neurology Authors: Siegler, J. E., Ichord, R. N. Tags: Childhood stroke, Intracerebral hemorrhage, Subarachnoid hemorrhage RESIDENT AND FELLOW SECTION Source Type: research

Three-dimensional modeling of Eagle syndrome
A 63-year-old man presented with transient episodes of left-hand weakness and right-eye vision loss following a lengthy airplane trip. The patient had reported right neck pain after sleeping awkwardly on the flight. Carotid dissection, paradoxical embolism, atherosclerotic occlusion, and thrombotic occlusion were considered possible etiologies of the associated carotid occlusion. Following a period of anticoagulation, a subsequent CT angiography (figure 1, A–C) revealed findings consistent with the styloid-carotid artery, or Eagle, syndrome.1 A 3-dimensional model was subsequently created (figure 2, A and B) utilizin...
Source: Neurology - November 20, 2016 Category: Neurology Authors: Shah, K., Miller, D. J. Tags: All Headache, All Clinical Neurology, All Cerebrovascular disease/Stroke, All Education NEUROIMAGES Source Type: research