Feng Li, Yan Zhao, Jing Wang, Jiu Chen, Maoxue Wang, Wenxia Hu, Bing Zhang
OBJECTIVES: The modified body mass index (mBMI) combines the body mass index and serum albumin, accurately reflecting the nutritional status. It remains uncertain whether modified body mass index influences neurological function and clinical prognosis in elderly patients with acute ischemic stroke. METHODS: We divided the cohort into quartiles of mBMI (1 to 4). The primary outcome was analyzed using the percentage of patients with a 90-day modified Rankin scale (mRS) score of 0 to 1...
April 29, 2024: Neurologist
Yan Su, Yonggui Cao, Haoran Zang, Wuzhou Gao, Xuewu Liu, Fuqing Li, Qingming An, Zhicheng Dai
OBJECTIVE: To investigate the early prediction value of transcranial Doppler ultrasound (TCD) combined with serum melatonin level for delayed cerebral ischemia (DCI) caused by subarachnoid hemorrhage (SAH). METHODS: This paper is a prospective study. A total of 120 patients with SAH treated were included. The patients were divided into the DCI group (40 cases) and non-DCI group (80 cases) according to whether DCI occurred 14 days after SAH (DCI usually occurs 4 to 14 d after bleeding)...
April 11, 2024: Neurologist
Yuan Zhu, Minghua Wu, Yawei Zheng, Xintong Wang, Jingyi Xiayang, Tianrui Zhang, Shana Wang, Zhuyuan Fang
OBJECTIVES: Research on the association between stroke severity and day-by-day blood pressure variability (BPV) in acute ischemic stroke (AIS) is rare as the majority focus on the blood pressure (BP) or the short-term BPV. Our study aims to explore the exact roles of daily BPV through the 7-day commencement on stroke severity in AIS. METHODS: The study included 633 patients with AIS, defining AIS as the time from the beginning of symptom up to 7 days with recording BP twice a day as well as calculating the daily BPV, and then matching them to the stroke severity...
March 6, 2024: Neurologist
Lei Yang, Maode Wang
OBJECTIVE: This study aimed to examine the association of the systemic immune-inflammation index (SII) with stroke and mortality rates using data from the National Health and Nutrition Examination Survey (NHANES). METHODS: A cross-sectional study was conducted using the aggregated data from 5 cycles (2009 to 2018) of NHANES. SII was the independent variable, and stroke was the dependent variable. Weighted logistic regression models were employed to analyze their relationship...
February 27, 2024: Neurologist
Pasquale F Finelli
OBJECTIVE: Artificial intelligence has recently become available for widespread use in medicine, including the interpretation of digitized information, big data for tracking disease trends and patterns, and clinical diagnosis. Comparative studies and expert opinion support the validity of imaging and data analysis, yet similar validation is lacking in clinical diagnosis. Artificial intelligence programs are here compared with a diagnostic generator program in clinical neurology. METHODS: Using 4 nonrandomly selected case records from New England Journal of Medicine clinicopathologic conferences from 2017 to 2022, 2 artificial intelligence programs (ChatGPT-4 and GLASS AI) were compared with a neurological diagnostic generator program (NeurologicDx...
May 1, 2024: Neurologist
Nuo Wang, Ling Wang, Minmin Zhang, Benqiang Deng, Tao Wu
OBJECTIVES: Elevation of the systemic immune inflammation (SII) index and system inflammation response index (SIRI) is known to be associated with higher risk of stroke and all-cause death. However, no study has reported their correlation with early neurological deterioration (END) following recombinant tissue-type plasminogen activator (IV-rtPA) in acute ischemic stroke patients. The aim of this study was to explore the correlation of SII and SIRI with the risk of END after IV-rtPA. METHODS: Included in this study were 466 consecutive patients treated with IV-rtPA...
May 1, 2024: Neurologist
James E Eaton, Ipek Oguz, Habeeb Kazimuddin, Francesca Bagnato
INTRODUCTION: We present the case of a gentleman who developed rapidly progressive vision loss, ophthalmo-paresis, and flaccid quadriparesis in the context of severe intracranial hypertension. We reviewed the available cases in the literature to increase awareness of this rare clinical entity.Case Report:A 36-year-old man developed rapidly progressive vision loss, ophthalmo-paresis, and flaccid quadriparesis. He had an extensive workup, only notable for severe intracranial hypertension, >55 cm of H2O...
February 19, 2024: Neurologist
Xin-Lei Mao, Si-Si He, Cai-Dan Lin, Xiang-Dong Huang, Jun Sun
OBJECTIVES: Thrombolysis treatment for patients with mild stroke is controversial. The aim of our study was to investigate the clinical characteristics and influencing factors of early neurological deterioration (END) in this group of patients. METHODS: A retrospective analysis was performed on ischemic stroke patients with intravenous thrombolysis (IVT) in Wenzhou Central Hospital. Subgroup analyses were performed for the mild stroke group and nonmild stroke group, END group, and non-early neurological deterioration group in mild stroke patients, respectively...
January 22, 2024: Neurologist
Haimei Liu, Denglu Liu, Peng Zuo
OBJECTIVES: This study aims to investigate the significance of insulin resistance markers in predicting poor prognosis in acute ischemic stroke (AIS) patients after intravenous thrombolysis and to establish the corresponding nomogram. METHODS: From January 2019 to March 2023, the data of 412 patients with AIS who received intravenous alteplase thrombolytic therapy in the Affiliated Taizhou People's Hospital of Nanjing Medical University were selected. Patients were randomly divided into training groups (70%, 288 cases) and validation groups (30%, 124 cases)...
January 22, 2024: Neurologist
Furkan Saridas, Gizem Mesut, Yasemin Dinc, Emine Rabia Koc, Rifat Ozpar, Bahattin Hakyemez, Omer Faruk Turan
OBJECTIVES: Cerebral venous sinus thrombosis (CVST) is a cerebrovascular disease characterized by thrombosis of the cerebral venous or dural sinuses. Autoimmune diseases (AD) are important causes of CVST. This study aims to reveal the differences between CVST associated with autoimmune diseases compared with other causes (OCs) and Behcet's syndrome (BS) compared with other ADs. METHODS: This is a single-center retrospective study in which the medical records of 187 patients we followed with a diagnosis of CVST between 2008 and 2023 were collected retrospectively...
January 22, 2024: Neurologist
Yan Wang, Ling Chen
OBJECTIVES: Intracerebral hemorrhage (ICH) is a severe neurological disorder with substantial societal implications. Cellular senescence plays a critical role in ICH pathogenesis. This study aims to identify senescence-related biomarkers in ICH for diagnostic and therapeutic purposes. METHODS: Raw data from GSE24265 in Gene Expression Omnibus was downloaded. Senescence-related genes were acquired from CellAge. Differential gene analysis was done between patients with ICH and controls...
January 22, 2024: Neurologist
Antonio Marangi, Francesco Benvenuti, Linda Mazzai, Giulio Riva, Diana Polo, Ilaria Franceschetti, Pierino De Sandre, Mariano Agostino Zanusso, Giovanni Scanelli, Francesco Perini
INTRODUCTION: Ixekizumab is an anti-interleukin-17A (IL-17A) humanized monoclonal antibody approved for the treatment of moderate-to-severe plaque psoriasis, active psoriatic arthritis, and ankylosing spondylitis. Central nervous system inflammatory manifestations are atypical during therapy with IL-17A inhibitors, with only one case of myelitis described to date. CASE REPORT: A 72-year-old man with a medical history of active psoriatic arthritis was admitted to our department owing to the acute onset of left face numbness 1 month after the first ixekizumab administration...
January 22, 2024: Neurologist
Meng Fu, Yani Fan, Shuangmei Yan, Sujie Wang, Sai Zhang, Feifei Chen, Rui Han, Xiaohong He, Ping Gu, Jian Li, Lili Chen
OBJECTIVE: We mainly explore the predictive value of Barthel Index (BI), SPAN-100, and National Institute of Health stroke scale (NIHSS) scores on clinical prognosis and functional outcomes in thrombolytic patients and compare the differences in the predictive values of the above 3 scales so as to provide an effective basis to evaluate the prognosis of thrombolytic patients. METHODS: Data were collected from 212 patients with the first-onset AIS (acute ischemic stroke)...
January 22, 2024: Neurologist
Liang Hao, Mingming Gao, Wei Guo, Zhigang Yao
OBJECTIVE: To study the correlation between risk factors, degree of vascular restenosis, and inflammatory factors after interventional treatment for stroke. METHODS: The clinical data of 96 stroke patients who received interventional therapy in our hospital from April 2020 to June 2021 were selected for retrospective study, and the postoperative follow-up was 1 year. Univariate and multivariate regression were used to analyze identified factors associated with interventional stroke efficacy...
January 22, 2024: Neurologist
Jawad Al-Kassmy, Mohammed Alsalmi, Woojin Kang, Philippe Huot
INTRODUCTION: Restless Legs Syndrome (RLS) is a neurological disorder primarily treated with pregabalin and gabapentin, followed by dopamine agonists later in the process due to the risk of augmenting RLS symptoms. In addition, clinical reports have disclosed varying degrees of success employing other agents in patients unresponsive to traditional agents. Here, we present a patient who had success in the reduction of RLS symptoms with lamotrigine, a broad-spectrum anticonvulsant. Previously, lamotrigine had been used in 2 trials with successful treatment of RLS...
January 22, 2024: Neurologist
Ahmed Koriesh, Michael Liu, Waleed Brinjikji, James Klaas, Deena Nasr, Zafer Keser
OBJECTIVES: Tenecteplase is a fibrin-specific plasminogen activator that has shown promising results in the treatment of acute ischemic stroke. Tenecteplase has been suggested to reduce door-to-needle time and to increase the rate of spontaneous recanalization. In February 2021, Mayo Clinic Health System switched to Tenecteplase as the standard thrombolytic therapy for acute ischemic stroke. METHODS: In this center-based observational cohort study, we present clinical characteristics and outcomes of patients with acute ischemic stroke treated with tenecteplase between February 2021 and May 2022 compared with alteplase treatment between September 2019 and February 2021...
January 1, 2024: Neurologist
Danmei Pan, Jina Gu, Chengjun Zeng, Lin Chen
INTRODUCTION: Glial fibrillary acidic protein (GFAP) astrocytopathy, an autoimmune central nervous system disorder characterized by the development of immunoglobulin G reactive with GFAP, has received growing attention in recent years. It is documented that GFAP-immunoglobulin G and other autoantibodies can be both detected in some patients. However, the coexistence of anti-myelin-oligodendrocyte glycoprotein (MOG) and GFAP antibodies is rarely reported. CASE: A 45-year-old man presented with headache, fever, backache, dysuria, tremble of hands, numbness of lower limbs, without diplopia, decreased vision, or other manifestations of optic neuritis...
December 21, 2023: Neurologist
Beihai Ge, Limei Pan, Huihua Liu
BACKGROUND: The feasibility and clinical outcome predictors of mechanical thrombectomy (MT) for strokes caused by distal arterial occlusion (DAO) remain the subject of debate. METHODS: A retrospective analysis was conducted of patients with consecutive acute ischemic stroke treated using MT. Clinical and procedural-associated factors were studied to compare the efficacy, safety, and short-term and long-term outcomes of MT between the proximal arterial occlusion (PAO) and DAO groups...
November 7, 2023: Neurologist
Waseem Wahood, Kelly D Flemming, Giuseppe Lanzino, Zafer Keser
OBJECTIVE: Most cervical artery dissection (CeAD) cases are spontaneous or due to minor traumas, and preceding viral infections have been suggested to be a triggering event for CeAD in some. Herein, we analyze the prevalence of coronavirus disease 2019 (COVID-19) in hospitalized patients with CeAD using a national database. METHODS: The National Inpatient Sample was queried from April 2020 to December 2020 for patients with a diagnosis of CeAD using International Classification of Diseases, 10th edition-Clinical Modification codes...
November 6, 2023: Neurologist
Kadriye Güleda Keskin, Irem Carus, Isil Kalyoncu Aslan, Eren Gözke
INTRODUCTION: HaNDL syndrome is a transient and rare condition that presents with neurological deficit and headache accompanied by lymphocytosis on cerebrospinal fluid (CSF) analysis. It is usually characterized by spontaneous recovery without neurological sequelae. This is a benign condition, which has not yet been adequately defined and includes many diseases in the differential diagnosis. We indicated 2 different cases that applied with acute neurological findings. CASE REPORT: Two patients who were admitted to our hospital with transient neurological deficits and headaches were evaluated...
November 6, 2023: Neurologist
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