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Naderafshar Fereydonyan, Sadra Rohani, Morteza Taheri, Mohammad Rohani
No abstract text is available yet for this article.
January 2019: Neurohospitalist
Lauren Gluck, Matthew Robbins, Benjamin Galen
No abstract text is available yet for this article.
January 2019: Neurohospitalist
Arushi Gahlot Saini, Vivek Gupta, Pratibha Singhi
No abstract text is available yet for this article.
January 2019: Neurohospitalist
Chitra Sivasankar, Kyle White, Maranatha Ayodele
No abstract text is available yet for this article.
January 2019: Neurohospitalist
Amy Li, Tresa McGranahan, Elaine Su, Lucas Kipp, Carl A Gold
The occurrence of amyotrophic lateral sclerosis (ALS) and neuromyelitis optica (NMO) in a single patient is exceedingly rare. We report a case of a 54-year-old woman of East Asian descent with a prior diagnosis of ALS who developed an episode of unexplained hiccups and nausea and vomiting consistent with area postrema syndrome 3 months prior to the onset of acute transverse myelitis. Magnetic resonance imaging revealed abnormal T2 hyperintensity and gadolinium enhancement at the cervicomedullary junction with extension to C3...
January 2019: Neurohospitalist
Michael A Pizzi, David Alejos, Tasneem F Hasan, Paldeep S Atwal, Suparna R Krishnaiengar, William D Freeman
Ornithine transcarbamylase (OTC) deficiency is an X-linked recessive disorder that usually presents in the neonatal period. Late-onset presentation of OTC can cause mild to severe symptoms. We describe laboratory and clinical findings of late-onset presentations of OTC deficiency. We conducted a literature search using search terms "ornithine transcarbamylase deficiency," "late onset presentation," and "hyperammonemia" from January 1, 1987, to December 31, 2016, was performed. Only papers published in English were included...
January 2019: Neurohospitalist
Harish Varma Tandra, Pritam Singha Roy, Rahul Sharma, Vikas Bhatia, Arushi Gahlot Saini
Subacute sclerosing panencephalitis is a devastating neurodegenerative disorder characterized by cognitive and memory deterioration, personality changes, behavior abnormalities, and a steady motor decline. Extrapyramidal manifestations are commonly seen in the advanced stage of the disease. We discuss a 10-year-old boy with subacute sclerosing panencephalitis presenting with generalized choreoathetosis, myoclonus, and cognitive decline. He had not been immunized for measles. His elder sister had a viral exanthematous illness 4 years ago...
January 2019: Neurohospitalist
Nirav Bhatt, Erika T Marulanda-Londoño, Kunakorn Atchaneeyasakul, Amer M Malik, Negar Asdaghi, Nida Akram, Daniel D'Amour, Kathy Hesse, Tony Zhang, Ralph L Sacco, Jose G Romano
The therapeutic window for acute ischemic stroke with intravenous recombinant tissue plasminogen activator (IV rt-PA) is brief and crucial. The American Heart Association/American Stroke Association Target: Stroke Best Practice Strategies (TSBPS) aim to improve intravenous thrombolysis door-to-needle (DTN) time. We assessed the efficacy of implementation of selected TSBPS to reduce DTN time in a large tertiary care hospital. A multidisciplinary DTN committee assessed causes of delayed DTN time and implemented focused TSBPS in our urban academic medical center...
January 2019: Neurohospitalist
Ciera L Patzke, Michael J Armahizer, Neeraj Badjatia, Melissa Motta
Background and Purpose: Current literature reports that half of critically ill patients are continued on broad-spectrum antibiotics beyond 72 hours despite no confirmed infection. The purpose of this retrospective study was to identify the incidence of and risk factors for prolonged empiric antimicrobial therapy (PEAT) in adult neurocritical care (NCC) patients treated for pneumonia, hypothesizing that NCC patients will have a higher incidence of PEAT. Methods: This is a retrospective chart review of adult NCC patients treated for pneumonia...
January 2019: Neurohospitalist
Ava L Liberman, Daniel Pinto, Sara K Rostanski, Daniel L Labovitz, Andrew M Naidech, Shyam Prabhakaran
Introduction: There is practice variability in the treatment of patients with minor ischemic stroke with thrombolysis. We sought to determine which clinical factors physicians prioritize in thrombolysis decision-making for minor stroke using adaptive conjoint analysis. Methods: We conducted our conjoint analysis using the Potentially All Pairwise RanKings of all possible Alternatives methodology via the 1000Minds platform to design an online preference survey and circulated it to US physicians involved in stroke care...
January 2019: Neurohospitalist
Sara K Rostanski, Benjamin R Kummer, Eliza C Miller, Randolph S Marshall, Olajide Williams, Joshua Z Willey
Background and Purpose: Use of emergency medical services (EMS) is associated with decreased door-to-needle time in acute ischemic stroke (AIS). Whether patient language affects EMS utilization and prenotification in AIS has been understudied. We sought to characterize EMS use and prenotification by patient language among intravenous tissue plasminogen activator (IV-tPA) tissue plasminogen (IV-tPA) treated patients at a single center with a large Spanish-speaking patient population. Methods: We performed a retrospective analysis of all patients who received IV-tPA in our emergency department between July 2011 and June 2016...
January 2019: Neurohospitalist
Paul Johnson, Basavaraj Ghodke, Sandeep Khot
No abstract text is available yet for this article.
October 2018: Neurohospitalist
William Allingham, Vinodh Devakumar, Amit Herwadkar, Martin Punter
No abstract text is available yet for this article.
October 2018: Neurohospitalist
Asher J Albertson, Alexander R Dietz, John R Younce, Arun S Varadhachary
Here we report the challenging case of a 41-year-old man with HIV complicated by AIDS and a history of prior neurologic injury from progressive multifocal leukoencephalopathy who presented with headache, fevers, lower extremity weakness, hyperreflexic upper extremities, and diminished lower extremity reflexes. We review the clinical decision-making and differential diagnosis for this presentation as the physical examination evolved and diagnostic testing changed over time.
October 2018: Neurohospitalist
Jonathan J D Baird-Gunning, Dinushi Weerasinghe, Matthew Silsby, Yash Gawarikar, Matteo S Carlino, Jessica L Smith, Steve Vucic
Immunotherapy is a treatment strategy that has demonstrated survival benefit for metastatic melanoma. Ipilimumab and nivolumab are examples of immunotherapy, in which monoclonal antibodies antagonize cytotoxic T-lymphocyte-associated protein 4 and programmed death-ligand 1 receptors, respectively, resulting in upregulation of the host immune response to cancer cells. There is increasing recognition of immune-mediated adverse events associated with immune therapies in patients with cancer. We present a case report of a patient who developed Miller Fisher syndrome associated with these therapies for metastatic melanoma along with a discussion of its management...
October 2018: Neurohospitalist
Aristeidis H Katsanos, Chrissa Sioka, Maria Chondrogiorgi, Athanasios Papadopoulos, Andreas Fotopoulos, Athanassios P Kyritsis, Vasileios Ragos
Even though different imaging modalities are available in sole or in combination for the optimal detection of bone metastases, whole-body bone scintigraphy (BS) in a single session seems to be advantageous. We present an 80-year-old male with unilateral left hypoglossal nerve palsy (HNP) and no other focal deficits on neurological examination. Initial brain computed tomography (CT) scan revealed no pathological findings, while the subsequent cranial CT and magnetic resonance imaging (MRI) scans uncovered only mild nonspecific sclerotic lesions in left occipital condyle...
October 2018: Neurohospitalist
Michael W Ruff, Anthony Fine, Jay Mandrekar, Cindy Sweeney, Lyell K Jones, James P Klaas
Background: Activity aprons are commercially available products used to occupy patients with dementia at home or in long-term care facilities. We hypothesized that inpatient use of activity aprons could potentially reduce or eliminate behaviors that result in self-harm, increased nursing supervision, and restraint use in an inpatient hospital setting. Methods: A single-center prospective randomized controlled pilot study was performed from July 2015 to November 2016 comparing activity apron plus standard care versus standard care alone...
October 2018: Neurohospitalist
Mariano Marrodan, Catalina Bensi, Lucas Alessandro, Alejandro D Muggeri, Mauricio F Farez
Background and Purpose: Although incidence rates vary, infectious, autoimmune, and neoplastic diseases can all cause chronic and subacute meningitis (CSM). We report a Latin-American, single center, CSM case series, analyzing the main clinical characteristics as well as ancillary diagnostic methods differentiating neoplastic from non-neoplastic etiologies. Methods: Retrospective review of CSM cases from a single center in Buenos Aires, Argentina. Results: Seventy patients with CSM diagnosis were identified, 49 with neoplastic and 21 with non-neoplastic meningitis...
October 2018: Neurohospitalist
Abhinaba Chatterjee, Monica Chen, Gino Gialdini, Michael E Reznik, Santosh Murthy, Hooman Kamel, Alexander E Merkler
Background: Real-world data on long-term trends in the use of tracheostomy after stroke are limited. Methods: Patients who underwent tracheostomy for acute ischemic stroke (AIS), intracerebral hemorrhage (ICH), or subarachnoid hemorrhage (SAH) were identified from the 1994 through 2013 releases of the National Inpatient Sample using previously validated International Classification of Diseases, Ninth Revision, Clinical Modification codes. Survey weights were used to report nationally representative estimates...
October 2018: Neurohospitalist
Jerina Nogueira, Pedro Abreu, Patrícia Guilherme, Ana Catarina Félix, Fátima Ferreira, Hipólito Nzwalo, Ana Marreiros
Background: The long-term prognosis of spontaneous intracerebral hemorrhage (SICH) is poor. Frequent emergency department (ED) visits can signal increased risk of hospitalization and death. There are no studies describing the risk of frequent ED visits after SICH. Methods: Retrospective cohort study of a community representative consecutive SICH survivors (2009-2015) from southern Portugal. Logistic regression analysis was performed to identify sociodemographic and clinical factors associated with frequent ED visits (≥4 visits) within the first year after hospital discharge...
October 2018: Neurohospitalist
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