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Safety and efficacy of incobotulinumtoxinA doses up to 800 U in limb spasticity: The TOWER study
Conclusion: Escalating incobotulinumtoxinA doses (400 U up to 800 U) did not compromise safety or tolerability, enabled treatment in a greater number of muscles/spasticity patterns, and was associated with increased treatment efficacy, improved muscle tone, and goal attainment. ClinicalTrials.gov identifier: NCT01603459. Classification of evidence: This study provides Class IV evidence that, for patients with limb spasticity, escalating incobotulinumtoxinA doses (400 U up to 800 U) increases treatment efficacy without compromising safety or tolerability.
Source: Neurology - April 3, 2017 Category: Neurology Authors: Wissel, J., Bensmail, D., Ferreira, J. J., Molteni, F., Satkunam, L., Moraleda, S., Rekand, T., McGuire, J., Scheschonka, A., Flatau-Baque, B., Simon, O., Rochford, E. T. J., Dressler, D., Simpson, D. M., On behalf of the TOWER study investigators Tags: Botulinum toxin, All Cerebrovascular disease/Stroke, All Rehabilitation, Patient safety ARTICLE Source Type: research

A common cold is no stroke of luck: Risk for cerebral ischemia in children
Chronic and acute (minor) infections or inflammatory conditions are associated with an increased risk for cerebral ischemic stroke in adults.1–3 Stroke etiology is different in children, is probably multifactorial, and may be elusive. Minor infections are common in children and lead to similar systemic and especially prothrombotic changes as in adults. Because conventional vascular risk factors are less prevalent in children, inflammatory conditions may be more relevant contributors to stroke risk in children. However, data on the association of inflammation and pediatric stroke are scarce. In this issue of Neurology...
Source: Neurology - September 1, 2014 Category: Neurology Authors: Marquardt, L. Tags: Childhood stroke, All Infections, Pediatric stroke; see Cerebrovascular Disease/ Childhood stroke EDITORIALS Source Type: research

Intracerebral Hemorrhage Associated with Oral Phenylephrine Use: A Case Report and Review of the Literature
Conclusions: It is scientifically plausible that phenylephrine may cause strokes, consistent with the pharmacologic properties and adverse event profiles of similar amphetamine-like sympathomimetics. As RCVS has been well described in association with over-the-counter sympathomimetics, a likely, although not definitive, causal relationship between phenylephrine and ICH is proposed.
Source: Journal of Stroke and Cerebrovascular Diseases - August 25, 2014 Category: Neurology Authors: Brian E. Tark, Steven R. Messe, Clotilde Balucani, Steven R. Levine Tags: Original Articles Source Type: research

Intracerebral Hemorrhage Associated with Oral Phenylephrine Use (P5.138)
CONCLUSION: It is scientifically plausible that Phe may cause strokes given that it is consistent with the pharmacological properties and adverse event profiles of similar amphetamine-like sympathomimetics. As RCVS has been well-described in association with over the counter sympathomimetics, these lines of evidence support a likely, although not definitive, causal relationship between Phe and ICH.Disclosure: Dr. Tark has nothing to disclose. Dr. Messe has received personal compensation for activities with GlaxoSmithKline, Inc. Dr. Messe has received research support from WL Gore, and GlaxoSmithKline, Inc. Dr. Balucani has...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Tark, B., Messe, S., Balucani, C., Levine, S. Tags: Cerebrovascular Disease and Interventional Neurology: Intracerebral Hemorrhage and Other Hemorrhages Source Type: research

Evaluation of Misdiagnosed Cases of Subarachnoid Hemorrhage and Causal Factors for Misdiagnosis
Conclusions: Type 1 cases were mild, and diagnosis required detailed medical history analyses. Type 2 cases were severe and were diagnosed based on electrocardiographic and echocardiographic changes characteristic of SAH. Symptoms of type 3 cases included vomiting, and diagnosis required recognition of meningeal irritation syndrome and detailed medical history analyses.
Source: Journal of Stroke and Cerebrovascular Diseases - March 15, 2013 Category: Neurology Authors: Tetsuhisa Yamada, Yoshihiro Natori Tags: Original Articles Source Type: research

Zoster Sine Herpete, Vertebral Artery Stenosis, and Ischemic Stroke
We report an immunocompetent man with common cold symptoms and conjunctivitis, followed by an acute onset of bulbar weakness and hemihypesthesia without preceding skin rash. Acute medullary infarction and left vertebral artery stenosis were detected. VZV infection was finally identified. Zoster sine herpetic interferes with accurate diagnosis of infectious stroke, and vertebral artery involvement is unusual in ischemic stroke in this situation. An unexplained course of ischemic stroke event should be suspected in patients with VZV cerebrovasculopathy, especially in those without conventional stroke risk factors and those...
Source: Journal of Stroke and Cerebrovascular Diseases - September 12, 2012 Category: Neurology Authors: Wei-Hsi Chen, Chi Chui, Hsin-Ling Yin Tags: Case Reports Source Type: research