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Source: Journal of Neurology, Neurosurgery and Psychiatry

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Total 415 results found since Jan 2013.

202 Frequency of inter-specialty consensus decisions and adherence to advice following a weekly neurovascular multidisciplinary meeting
Conclusions High-frequency inter-specialty consensus regarding management/adherence to proposed treatment supports a collaborative, multidisciplinary model-of-care in patients with extracranial arterial stenosis. Service development should shorten intervals between symptoms-MDT discussion-intervention to optimise secondary prevention.
Source: Journal of Neurology, Neurosurgery and Psychiatry - August 12, 2022 Category: Neurosurgery Authors: Offiah, C., Tierney, S., Egan, B., Collins, D., Ryan, D., McCarthy, A., Smith, D., Boyle, E., Delaney, H., McCabe, D., on behalf of the TUH/AMNCH NV MDT Team Tags: Poster presentations Source Type: research

Does pre-existing cognitive impairment no-dementia influence the outcome of patients treated by intravenous thrombolysis for cerebral ischaemia?
Approximately 10% of patients with a first-ever stroke and 30% with a recurrent stroke have pre-existing dementia,1 and many others have cognitive impairment no-dementia (CIND). A recent trial and an updated meta-analysis showed that rt-PA is also beneficial after 80 years of age. Cognitive impairment being frequent in elderly subjects, more patients eligible for rt-PA will have prestroke cognitive impairment. They often have an underlying brain pathology associated with an increased bleeding risk: brain microbleeds and leukoaraiosis are frequent and usually associated with cerebral amyloid angiopathy in Alzheimer's d...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 13, 2013 Category: Neurosurgery Authors: Murao, K., Bodenant, M., Cordonnier, C., Bombois, S., Henon, H., Pasquier, F., Bordet, R., Leys, D. Tags: PostScript Source Type: research

When you hear hooves think percheron horses not zebras
We present two patients with decreased level of consciousness as a result of a stroke. Patient 1: a 73 year old male who presented with a sudden collapse. His GCS was 6 on arrival without any history of seizure. It was unclear whether a cardiac or respiratory arrest caused his collapse. Neurological examination revealed sluggish pupils with miosis on the left and loss of the oculo-cephalic reflex. He could move his limbs spontaneously, with localisation to painful stimuli. Patient 2: a 49 year old female Who presented acutely with drowsiness but no localising signs. She improved slightly by day 4, and referred to Neurology...
Source: Journal of Neurology, Neurosurgery and Psychiatry - September 9, 2014 Category: Neurosurgery Authors: Dharia, S., Sittampalam, M., Shah, A., Jones, J., Nor, A. M., Edwards, S. Tags: Abstracts Source Type: research

Immunocompetent pml--an immunological scotoma?
We describe two cases of progressive multifocal leucoencephalopathy (PML) presenting as stroke in the immunocompetent. A 73-year-old man with a background of treated prostate carcinoma presented in October 2013 with a right hemiplegia; a diagnosis of lacunar infarction was made following CT. However, he progressed with increasing pyramidal weakness, ataxia, dysphasia and dysarthria. MRI in December revealed confluent T2 and FLAIR hyperintense white matter change with normal DWI. Extensive infective, vasculitic and malignancy screen were unremarkable; PCR in serum and CSF demonstrated JC virus DNA. Unfortunately the patient...
Source: Journal of Neurology, Neurosurgery and Psychiatry - September 9, 2014 Category: Neurosurgery Authors: Cooper, R., Doshi, A., Harris, P., Sivagnanasundaram, J., Wells, G., Barritt, A., Aram, J., Giovannoni, G., Gnanapavan, S., Dobson, R. Tags: Abstracts Source Type: research

The many faces of melas
We report the case of a 76-year-old man (the second oldest diagnosed case to the authors' knowledge) whose case exemplifies the complexity of diagnosing and managing these patients including the complications of the disease.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: AlMasri, O., Massey, T., Mukhopadhyay, D., Walters, R. J. Tags: Genetics, Epilepsy and seizures, Headache (including migraine), Infection (neurology), Muscle disease, Neuromuscular disease, Musculoskeletal syndromes Thur 21, Parallel session 5: Therapeutics Source Type: research

Effects of vascular comorbidity in parkinson's disease
Vascular disease and risk factors are common in Parkinson's disease (PD) and may influence phenotype. Statin therapy may thus be indicated. 1759 recently diagnosed PD cases from a multicentre prospective study underwent a Montreal Cognitive Assessment and the Unified PD Rating Scale part 3 (UPDRS 3). History of vascular events, risk factors and statin usage was recorded. QRISK2 quantified cardiovascular risk. Mean age was 67.5 (SD 9.3), disease duration 1.3 (SD 0.9) years, 65.2% male. 4.7% had prior stroke/TIA, 12.5% cardiac disease, 30.4% hypertension, 27.3% high cholesterol, 20.7% obesity, 7.2% diabetes and 4.6% smokers....
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Swallow, D. M. A., Malek, N., Grosset, K. A., Lawton, M. A., Bajaj, N. P., Barker, R. A., Ben-Shlomo, Y., Burn, D. J., Morris, H. R., Williams, N., Wood, N. W., Grosset, D. G., on behalf of the PRoBaND collaborators Tags: Drugs: CNS (not psychiatric), Parkinson's disease, Hypertension, Memory disorders (psychiatry) ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Tolosa-hunt syndrome associated severe internal carotid artery stenosis resulting in cerebral infarcts
Conclusions TSH is a rare cause of ICA stenosis but has not been reported to result in ischaemic strokes. The presumed mechanism of stenosis is due to non-specific periarteritic granuloma and is generally responsive to steroid therapy. The mechanism for stroke in this patient is presumably haemodynamic and this case illustrates that THS should be recognised as a potentially reversible cause for stroke in the appropriate clinical context.
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 8, 2017 Category: Neurosurgery Authors: Triplett, J. D., Chemmanam, T. Tags: Abstracts Source Type: research

Neurological complication related to atrial myxomas
Conclusions This case highlights both the recognised neurologic complications of atrial myxoma in a single patient and presents the characteristic angiographic findings. The diagnosis of cerebral aneurysms can be delayed up to five years1. Evaluation should therefore be considered following a histologic diagnosis of atrial myxoma.
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 8, 2017 Category: Neurosurgery Authors: Baird-Gunning, J., Lalloo, S., Lueck, C. J., Das, C. Tags: Abstracts Source Type: research

262 Limb-shaking linked to haemodynamic cerebrovascular disease
We present a case of a 61-year-old patient who developed transient but persistent right upper limb shaking and syncope on turning to the left. He suffered a recent NSTEMI causing severe left ventricular dysfunction and associated anaemia. His ictal EEG was unremarkable. CT angiography and doppler ultrasound revealed severe left internal carotid artery stenosis. This suggested an underlying low-flow TIA and symptoms resolved with blood pressure optimisation and blood transfusions. Cerebrovascular events typically present with acute negative symptoms including loss of power, sensation, vision or speech. Alternatively, focal ...
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 27, 2022 Category: Neurosurgery Authors: Cleaver, J., Pope, L., Mayo, T., Gbadamoshi, L. Tags: Poster Presentations Source Type: research

266 A drowsy patient: beyond the familiar territory
A 72-year-old man was brought to the hospital after he was found unresponsive at home by his wife who reported that he has been sleepy in the last few days. He has a background of hypertension, myocardial infarct, and osteoarthritis. His medications include anti-hypertensive and morphine sulphate. On examination, he was drowsy with GCS fluctuating between 9–11 but maintaining his airways. He was moving all four limbs; pupils were small and unequal but reactive to light. Planter reflexes were downgoing. Opioid toxicity was suspected and treated with naloxone without any response. The CT head scan showed no acute patho...
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 27, 2022 Category: Neurosurgery Authors: Oo, A., Khine, N. Tags: Poster Presentations Source Type: research

106 Critical ischaemia without infarction presenting as progressive hemichorea: a case study and literature review
A 69 year old lady with COPD presented with a 3-week history of progressive worsening involuntary movements of her right limbs, beginning in her right hand, and spreading to involve her right leg after 1 week. Three days prior to admission, she had an episode of dysarthria and orolingual numbness lasting five minutes. On examination, she was hypertensive (200/105mmHg), and had marked right hemiballismus/hemichorea, with subtle orolingual chorea. Her neurological and cognitive examination was otherwise normal. The hemichorea worsened with commencement of antihypertensive therapy. It seemed likely that our patient’s pr...
Source: Journal of Neurology, Neurosurgery and Psychiatry - August 12, 2022 Category: Neurosurgery Authors: Wrigley, S., Killeen, R., ORiordan, S. Tags: Poster presentations Source Type: research

Parallel Session 3: Acute/Vascular/Trauma| Wed 18 May, 1445 - 1600|4 Circulating Interleukin-6 predicts carotid study
Conclusions Plasma IL-6 predicts carotid plaque severity, vulnerability, and progression. The 2.0 pg/mL cut-off could help select individuals that would benefit from anti-IL-6 drugs for stroke prevention.
Source: Journal of Neurology, Neurosurgery and Psychiatry - August 12, 2022 Category: Neurosurgery Authors: Kamtchum-Tatuene, J., Saba, L., Heldner, M., Poorthuis, M. H., Borst, G. d., Rundek, T., Kakkos, S., Chaturvedi, S., Topakian, R., et al Tags: Parallel Session 3: Acute/Vascular/Trauma Wed 18 May, 1445 - 1600 3 Source Type: research

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

205 Relationship between thrombin generation and micro-embolic signals in moderate-severe asymptomatic and symptomatic carotid stenosis patients
Discussion Thrombin generation decreases over time and following revascularisation in TIA/stroke patients with moderate-severe symptomatic carotid stenosis, including those who are MES-ve. These data improve our understanding of haemostatic/thrombotic biomarker profiles in patients with carotid stenosis.
Source: Journal of Neurology, Neurosurgery and Psychiatry - August 12, 2022 Category: Neurosurgery Authors: Subramanian, A., Murphy, S., Smith, D., Tierney, S., Egan, B., Rushe, H., OSullivan, J., ODonnell, J., Hamilton, G., McCabe, D. Tags: Poster presentations Source Type: research

022 Preliminary results from a consultant-led acute neurology service based in the emergency department
Conclusions Acute Neurology input in the ED had major impacts on working diagnoses, hospital admis- sions, urgent outpatient referrals, and emergency investigations.
Source: Journal of Neurology, Neurosurgery and Psychiatry - August 12, 2022 Category: Neurosurgery Authors: Alim-Marvasti, A., See, I., Kandasamy, R., Hutchinson, J., Lane, C., Baruah, T., Balaratnam, M., Chandratheva, A., Simister, R., Haider, S. Tags: Poster presentations Source Type: research