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A Diagnostic Approach to Stroke in Young Adults
Opinion statementOptimal diagnosis and management of stroke in young adults benefit from a multidisciplinary team, including a vascular neurology specialist. In addition to the “standard” vascular risk factors including smoking, hypertension, diabetes, and hyperlipidemia, one needs to consider alternative etiologies including substance abuse, carotid/vertebral artery dissections, and rare genetic conditions among others. Once a young patient is determined to have had a stroke, the next question a clinician should ask iswhy did this patient have a stroke? A “heart to head” diagnostic approach is recommended. A thoro...
Source: Current Treatment Options in Cardiovascular Medicine - September 25, 2017 Category: Cardiology Source Type: research

After Moyamoya surgery, a back-to-normal birthday for Carolyn
Before Moyamoya surgery Carolyn Milks turns 8 on August 21. It’s a big celebration. Carolyn and her family aren’t just celebrating her birthday — they’re celebrating Carolyn’s return to normal. For most of the summer, things like swimming, riding her bicycle and horsing around with her sisters and cousins had been out of the question for Carolyn. But on August 11, Dr. Ed Smith, co-director of the Boston Children’s Hospital Cerebrovascular Surgery and Interventions Center, gave Carolyn the green light. She could go back to being a kid. “This is what kids really want. They just want to ...
Source: Thrive, Children's Hospital Boston - August 18, 2016 Category: Pediatrics Authors: Joyce Choi Tags: Our Patients’ Stories Boston Children's at Waltham Cerebrovascular Surgery and Interventions Center Dr. Ed Smith moyamoya Source Type: news

Myriad Manifestations of a Global Infectious Disease (I7-5A)
CONCLUSIONS: This case exhibits the myriad manifestations of tuberculosis in one patient; including meningitis, vasculitis, and tuberculomas. It also highlights that insular stroke in the non-dominant hemisphere could affect the cardiovascular-autonomic system.Disclosure: Dr. Prabhu has nothing to disclose. Dr. Raghupathi has nothing to disclose. Dr. Dissin has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Prabhu, A., Raghupathi, R., Dissin, J. Tags: The Global Burden of Neurological Infections: Epidemiology, Treatment, and Prevention Poster Presentations Source Type: research

Stroke in Children with Human Immunodeficiency Virus in Botswana: A Report of Six Cases (P4.303)
CONCLUSIONS: The risk of stroke appears to be increased in children with HIV, though further controlled studies are necessary to further investigate this. Etiologies for stroke in children with HIV includes HIV vasculopathy, HIV cardiomyopathy, and opportunistic infections. Evaluation should include head imaging with vascular imaging, MRI with MRA if possible, and CT. The utility of lumbar puncture and hypercoaguability workup in this population needs to be investigated further. Given the difficulties of monitoring anticoagulation in this setting, low dose aspirin is a reasonable first line treatment.Disclosure: Dr. Khuran...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Khurana, E., Bearden, D. Tags: NeuroAIDS Source Type: research

The Rhino Without It's Sugar (P2.324)
We present a case of a non-diabetic patient with stroke like symptoms that was determined to be due to mucormycosis invading the sphenoid sinus.A 64 year old female was admitted for slurred speech and right-sided weakness. She was brought to the ER after being found unresponsive. Family members stated she had been experiencing difficulty speaking, and mild right facial weakness. She has been complaining of headaches for the past seven months and 15 pound weight loss. On admission, temperature was 98.4°F, BP 122/77, PR 78, and RR 18. Exam was significant for right-sided facial asymmetry/droop, expressive aphasia, and sl...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Kahlon, J., Gahley, H., Sonpal, N., Graham, R. Tags: Fungi, Parasites, and Other Pathogens Source Type: research

Reversible leukoencephalopathy as a presentation of cerebral amyloid angiopathy
A 73 year old man with a past medical history of hypertension, osteoathritis and asthma presented to the local district general hospital with recurrent episodes of spontaneously resolving encephalopathy. The initial presentation was characterised by acute confusion and visual hallucinations followed by a generalised tonic–clonic seizure. On examination his blood pressure was 215/115 mmHg. Neurological examination did not reveal any lateralising signs but the patient was found to be encephalopathic with a Montreal Cognitive Assessment (MOCA) score of 9/30. Routine blood tests were unremarkable. A CT brain scan showed ...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Lilleker, J., Vassallo, J., Punter, M. Tags: Genetics, Immunology (including allergy), Epilepsy and seizures, Stroke, Hypertension, Drugs: psychiatry, Radiology, Surgical diagnostic tests Association of British Neurologists (ABN) joint meeting with the Royal College of Physicians (RCP), London, 23 Source Type: research

Staring you in the face! sturge-weber syndrome is a spectrum disorder and late presentation is possible
A 52 year old man with a four year history of migraine with aura presented to hospital with a severe right sided headache and prolonged episode of left sided sensory and motor disturbance. Examination revealed left homonymous hemianopia, sensory inattention and hemiparesis (3/5). Reflexes were symmetrical and plantars downing. He had a facial port wine stain in a V1 distribution on the right. Unenhanced CT scan was normal. Migrainous infarction was the working diagnosis and he was commenced on aspirin. Two days later he experienced intermittent episodes of left face and arm twitching consistent with focal motor seizures, t...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Cosgrove, J., Hassan, A. Tags: Genetics, Drugs: CNS (not psychiatric), Epilepsy and seizures, Headache (including migraine), Pain (neurology), Stroke, Radiology, Radiology (diagnostics) Association of British Neurologists (ABN) joint meeting with the Royal College of Physicians (RCP) Source Type: research