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Maternal Stroke Associated With Pregnancy
This article summarizes current knowledge of the epidemiology, pathophysiology, prevention, and treatment of cerebrovascular disease in pregnant and postpartum women. RECENT FINDINGS Stroke is a leading cause of maternal morbidity and mortality, and most fatal strokes are preventable. Adaptive physiologic changes of pregnancy, including hemodynamic changes, venous stasis, hypercoagulability, and immunomodulation, contribute to increased maternal stroke risk. The highest-risk time period for maternal stroke is the immediate postpartum period. Migraine and hypertensive disorders of pregnancy, including gestational hyp...
Source: CONTINUUM: Lifelong Learning in Neurology - February 1, 2022 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Headache in Women
PURPOSE OF REVIEW Women are greatly overrepresented among patients seeking treatment for symptoms of headache pain in general and migraine in particular. Understanding the presentation of headache in women in relation to hormonal changes both during the menstrual cycle and throughout the life span is essential for appropriate diagnosis and treatment. RECENT FINDINGS Although perimenstrual migraine attacks are generally without aura, the diagnosis of migraine with aura has been added to the headache classification for menstrual migraine to account for women with the diagnosis of migraine with aura who experience ...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Obstructive Sleep Apnea
PURPOSE OF REVIEW Obstructive sleep apnea (OSA) is often overlooked by clinicians; however, undiagnosed OSA can lead to negative outcomes for patients, including patients with underlying neurologic conditions. Clinicians should be aware of what questions to ask, what diagnostic tests to use, and what treatments to consider in patients with OSA. RECENT FINDINGS OSA influences many neurologic conditions, including stroke, epilepsy, headache, and neuromuscular conditions. Treatment of OSA is effective, especially with patient-tailored options, the correct education, and support. SUMMARY OSA is a serious medical condit...
Source: CONTINUUM: Lifelong Learning in Neurology - August 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Cardiac and Pulmonary Disorders and the Nervous System
This article reviews the neurologic complications encountered with cardiac and pulmonary disorders, specifically focusing on endocarditis, cardiac arrest, heart failure, hypercapnia, hypoxia, and cystic fibrosis. As neurologic dysfunction is one of the most frequent complications of these diseases and may even be the presenting symptom, it is important to be familiar with these complications to foster early recognition and intervention. RECENT FINDINGS Advances have been made in the identification of which patients can safely undergo valvular surgery for treatment of infective endocarditis in the setting of stroke, whic...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

The Migraine Aura
This article discusses the basic mechanisms of migraine aura and its clinical significance based upon evidence from human studies and animal models. RECENT FINDINGS Prospective clinical studies have reinforced the understanding that migraine aura is highly variable from one individual to the next as well as from attack to attack in an individual. While migraine with aura clearly has a higher heritability than migraine without aura, population studies have not identified specific genes that underlie this heritability for typical migraine with aura. Imaging studies reveal hypoperfusion associated with migraine aura, altho...
Source: CONTINUUM: Lifelong Learning in Neurology - August 1, 2018 Category: Neurology Tags: Review Articles Source Type: research

Inherited and Uncommon Causes of Stroke
This article is a practical guide to identifying uncommon causes of stroke and offers guidance for evaluation and management, even when large controlled trials are lacking in these rarer forms of stroke. Recent Findings: Fabry disease causes early-onset stroke, particularly of the vertebrobasilar system; enzyme replacement therapy should be considered in affected patients. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), often misdiagnosed as multiple sclerosis, causes migraines, early-onset lacunar strokes, and dementia. Moyamoya disease can cause either ischemic or he...
Source: CONTINUUM: Lifelong Learning in Neurology - February 1, 2017 Category: Neurology Tags: Review Articles Source Type: research