collection
https://read.qxmd.com/read/31662037/guidelines-for-the-early-management-of-patients-with-acute-ischemic-stroke-2019-update-to-the-2018-guidelines-for-the-early-management-of-acute-ischemic-stroke-a-guideline-for-healthcare-professionals-from-the-american-heart-association-american-stroke-association
#1
JOURNAL ARTICLE
William J Powers, Alejandro A Rabinstein, Teri Ackerson, Opeolu M Adeoye, Nicholas C Bambakidis, Kyra Becker, José Biller, Michael Brown, Bart M Demaerschalk, Brian Hoh, Edward C Jauch, Chelsea S Kidwell, Thabele M Leslie-Mazwi, Bruce Ovbiagele, Phillip A Scott, Kevin N Sheth, Andrew M Southerland, Deborah V Summers, David L Tirschwell
Background and Purpose- The purpose of these guidelines is to provide an up-to-date comprehensive set of recommendations in a single document for clinicians caring for adult patients with acute arterial ischemic stroke. The intended audiences are prehospital care providers, physicians, allied health professionals, and hospital administrators. These guidelines supersede the 2013 Acute Ischemic Stroke (AIS) Guidelines and are an update of the 2018 AIS Guidelines. Methods- Members of the writing group were appointed by the American Heart Association (AHA) Stroke Council's Scientific Statements Oversight Committee, representing various areas of medical expertise...
October 30, 2019: Stroke; a Journal of Cerebral Circulation
https://read.qxmd.com/read/31543134/clinical-policy-critical-issues-in-the-evaluation-and-management-of-adult-patients-presenting-to-the-emergency-department-with-acute-headache
#2
JOURNAL ARTICLE
Steven A Godwin, David S Cherkas, Peter D Panagos, Richard D Shih, Richard Byyny, Stephen J Wolf
This clinical policy from the American College of Emergency Physicians addressed key issues in the evaluation and management of adult patients presenting to the emergency department with acute headache. A writing subcommittee conducted a systematic review of the literature to derive evidence-based recommendations to answer the following clinical questions: (1) In the adult emergency department patient presenting with acute headache, are there risk-stratification strategies that reliably identify the need for emergent neuroimaging? (2) In the adult emergency department patient treated for acute primary headache, are nonopioids preferred to opioid medications? (3) In the adult emergency department patient presenting with acute headache, does a normal noncontrast head computed tomography scan performed within 6 hours of headache onset preclude the need for further diagnostic workup for subarachnoid hemorrhage? (4) In the adult emergency department patient who is still considered to be at risk for subarachnoid hemorrhage after a negative noncontrast head computed tomography, is computed tomography angiography of the head as effective as lumbar puncture to safely rule out subarachnoid hemorrhage? Evidence was graded and recommendations were made based on the strength of the available data...
October 2019: Annals of Emergency Medicine
https://read.qxmd.com/read/31383632/essential-tremor-diagnosis-and-management
#3
REVIEW
Vicki Shanker
Essential tremor is one of the most common movement disorders in adults and can affect both children and adults. An updated consensus statement in 2018 redefined essential tremor as an isolated action tremor present in bilateral upper extremities for at least three years. Tremor may also be present in other locations, commonly the neck or the vocal cords. Patients with additional neurologic symptoms are now categorized as "essential tremor plus." Additional clinical features associated with the condition include but are not limited to cognitive impairment, psychiatric disorders, and hearing loss...
August 5, 2019: BMJ: British Medical Journal
https://read.qxmd.com/read/29250761/medical-treatment-guidelines-for-acute-migraine-attacks
#4
JOURNAL ARTICLE
Yung-Chu Hsu, Kao-Chang Lin, Treatment Guideline Subcommittee Of Taiwan Headache Society Taiwan Headache Society
In 2015, the American Headache Society (AHS) amended the treatment guideline of acute migraine based on evidence-based medicine (EBM) that all triptans in any form of preparations, acetaminophen, and non-steroid anti-inflammation drugs-NSAID (aspirin, diclofenac, ibuprofen, naproxen), sumatriptan/naproxen, combined acetaminophen/aspirin/caffeine are considered effective (Level A). Previously effective drugs as prochlorperazine, and dihydroergotamine-DHE (excluded inhaled form) were downrated to probable effective (Level B)...
June 15, 2017: Acta Neurologica Taiwanica
https://read.qxmd.com/read/28063597/living-near-major-roads-and-the-incidence-of-dementia-parkinson-s-disease-and-multiple-sclerosis-a-population-based-cohort-study
#5
JOURNAL ARTICLE
Hong Chen, Jeffrey C Kwong, Ray Copes, Karen Tu, Paul J Villeneuve, Aaron van Donkelaar, Perry Hystad, Randall V Martin, Brian J Murray, Barry Jessiman, Andrew S Wilton, Alexander Kopp, Richard T Burnett
BACKGROUND: Emerging evidence suggests that living near major roads might adversely affect cognition. However, little is known about its relationship with the incidence of dementia, Parkinson's disease, and multiple sclerosis. We aimed to investigate the association between residential proximity to major roadways and the incidence of these three neurological diseases in Ontario, Canada. METHODS: In this population-based cohort study, we assembled two population-based cohorts including all adults aged 20-50 years (about 4·4 million; multiple sclerosis cohort) and all adults aged 55-85 years (about 2·2 million; dementia or Parkinson's disease cohort) who resided in Ontario, Canada on April 1, 2001...
February 18, 2017: Lancet
https://read.qxmd.com/read/28327340/epileptic-activity-in-alzheimer-s-disease-causes-and-clinical-relevance
#6
REVIEW
Keith A Vossel, Maria C Tartaglia, Haakon B Nygaard, Adam Z Zeman, Bruce L Miller
Epileptic activity is frequently associated with Alzheimer's disease; this association has therapeutic implications, because epileptic activity can occur at early disease stages and might contribute to pathogenesis. In clinical practice, seizures in patients with Alzheimer's disease can easily go unrecognised because they usually present as non-motor seizures, and can overlap with other symptoms of the disease. In patients with Alzheimer's disease, seizures can hasten cognitive decline, highlighting the clinical relevance of early recognition and treatment...
April 2017: Lancet Neurology
https://read.qxmd.com/read/27582897/poststroke-epilepsy-update-and-future-directions
#7
REVIEW
Johan Zelano
Stroke is among the most common causes of epilepsy after middle age. Patients with poststroke epilepsy (PSE) differ in several respects from patients with other forms of structural-metabolic epilepsy; not least in age, age-related sensitivity to side effects of antiepileptic drugs (AEDs), and specific drug-drug interaction issues related to secondary-stroke prophylaxis. Encouragingly, there has lately been remarkable activity in the study of PSE. Three developments in PSE research deserve particular focus. First, large prospective trials have established the incidence and risk factors of PSE in the setting of modern stroke care...
September 2016: Therapeutic Advances in Neurological Disorders
https://read.qxmd.com/read/27672165/the-terrorist-inside-my-husband-s-brain
#8
EDITORIAL
Susan Schneider Williams
No abstract text is available yet for this article.
September 27, 2016: Neurology
https://read.qxmd.com/read/26250687/neurodegeneration-alzheimer-s-and-parkinson-s-diseases-the-prion-concept-in-relation-to-assembled-a%C3%AE-tau-and-%C3%AE-synuclein
#9
REVIEW
Michel Goedert
The pathological assembly of Aβ, tau, and α-synuclein is at the heart of Alzheimer's and Parkinson's diseases. Extracellular deposits of Aβ and intraneuronal tau inclusions define Alzheimer's disease, whereas intracellular inclusions of α-synuclein make up the Lewy pathology of Parkinson's disease. Most cases of disease are sporadic, but some are inherited in a dominant manner. Mutations frequently occur in the genes encoding Aβ, tau, and α-synuclein. Overexpression of these mutant proteins can give rise to disease-associated phenotypes...
August 7, 2015: Science
https://read.qxmd.com/read/27352245/too-good-to-treat-ischemic-stroke-patients-with-small-computed-tomography-perfusion-lesions-may-not-benefit-from-thrombolysis
#10
JOURNAL ARTICLE
Andrew Bivard, Min Lou, Christopher R Levi, Venkatesh Krishnamurthy, Xin Cheng, Richard I Aviv, Patrick McElduff, Longting Lin, Tim Kleinig, Billy O'Brien, Kenneth Butcher, Zhang Jingfen, Jim Jannes, Qiang Dong, Mark W Parsons
OBJECTIVE: Although commonly used in clinical practice, there remains much uncertainty about whether perfusion computed tomography (CTP) should be used to select stroke patients for acute reperfusion therapy. In this study, we tested the hypothesis that a small acute perfusion lesion predicts good clinical outcome regardless of thrombolysis administration. METHODS: We used a prospectively collected cohort of acute ischemic stroke patients being assessed for treatment with IV-alteplase, who had CTP before a treatment decision...
August 2016: Annals of Neurology
https://read.qxmd.com/read/27239312/neurocritical-care-update
#11
REVIEW
Yasuhiro Kuroda
This update comprises six important topics under neurocritical care that require reevaluation. For post-cardiac arrest brain injury, the evaluation of the injury and its corresponding therapy, including temperature modulation, is required. Analgosedation for target temperature management is an essential strategy to prevent shivering and minimizes endogenous stress induced by catecholamine surges. For severe traumatic brain injury, the diverse effects of therapeutic hypothermia depend on the complicated pathophysiology of the condition...
2016: Journal of Intensive Care
https://read.qxmd.com/read/27083888/vestibular-migraine-the-most-frequent-entity-of-episodic-vertigo
#12
REVIEW
Marianne Dieterich, Mark Obermann, Nese Celebisoy
Vestibular migraine (VM) is the most common cause of episodic vertigo in adults as well as in children. The diagnostic criteria of the consensus document of the International Bárány Society for Neuro-Otology and the International Headache Society (2012) combine the typical signs and symptoms of migraine with the vestibular symptoms lasting 5 min to 72 h and exclusion criteria. Although VM accounts for 7% of patients seen in dizziness clinics and 9% of patients seen in headache clinics it is still underdiagnosed...
April 2016: Journal of Neurology
https://read.qxmd.com/read/26839703/evidence-based-treatments-for-adults-with-migraine
#13
REVIEW
Rubesh Gooriah, Randa Nimeri, Fayyaz Ahmed
Migraine, a significantly disabling condition, is treated with acute and preventive medications. However, some individuals are refractory to standard treatments. Although there is a host of alternative management options available, these are not always backed by strong evidence. In fact, most of the drugs used in migraine were initially designed for other purposes. Whilst effective, the benefits from these medications are modest, reflecting the need for newer and migraine-specific therapeutic agents. In recent years, we have witnessed the emergence of novel treatments, of which noninvasive neuromodulation appears to be the most attractive given its ease of use and excellent tolerability profile...
2015: Pain Research and Treatment
https://read.qxmd.com/read/26984607/acute-vestibular-syndrome-a-critical-review-and-diagnostic-algorithm-concerning-the-clinical-differentiation-of-peripheral-versus-central-aetiologies-in-the-emergency-department
#14
REVIEW
J Venhovens, J Meulstee, W I M Verhagen
Almost 20 % of cerebral ischaemic strokes occur in the posterior circulation. Estimates are that 20 % of these patients present with isolated vertigo. In approximately one-sixth to one-third of these patients, this symptom is wrongly diagnosed to be peripheral vestibular in origin. As a result, these missed stroke patients are withheld from therapeutic and secondary prophylactic treatment, which may result in unnecessary morbidity and mortality. We therefore propose a diagnostic algorithm concerning the clinical differentiation of acute vestibular syndrome (AVS) patients based on a critical review of the available literature...
November 2016: Journal of Neurology
https://read.qxmd.com/read/26886360/recent-advances-in-status-epilepticus
#15
REVIEW
Eugen Trinka, Francesco Brigo, Simon Shorvon
PURPOSE OF REVIEW: This review discusses advances in the understanding of the mechanisms of status epilepticus and its current treatment approaches. Many of these have been topics at the 5th London-Innsbruck Colloquium on status epilepticus 2015. RECENT FINDINGS: A new definition and classification of status epilepticus was proposed, which is expected to improve treatment and stimulate research. A better understanding of the failure of seizure suppressing mechanisms and the initiation of self-sustaining seizures begins to translate into the clinical arena...
April 2016: Current Opinion in Neurology
https://read.qxmd.com/read/26886206/clinical-features-pathogenesis-and-treatment-of-myasthenia-gravis-a-supplement-to-the-guidelines-of-the-german-neurological-society
#16
REVIEW
Nico Melzer, Tobias Ruck, Peter Fuhr, Ralf Gold, Reinhard Hohlfeld, Alexander Marx, Arthur Melms, Björn Tackenberg, Berthold Schalke, Christiane Schneider-Gold, Fritz Zimprich, Sven G Meuth, Heinz Wiendl
Myasthenia gravis (MG) is an autoimmune antibody-mediated disorder of neuromuscular synaptic transmission. The clinical hallmark of MG consists of fluctuating fatigability and weakness affecting ocular, bulbar and (proximal) limb skeletal muscle groups. MG may either occur as an autoimmune disease with distinct immunogenetic characteristics or as a paraneoplastic syndrome associated with tumors of the thymus. Impairment of central thymic and peripheral self-tolerance mechanisms in both cases is thought to favor an autoimmune CD4(+) T cell-mediated B cell activation and synthesis of pathogenic high-affinity autoantibodies of either the IgG1 and 3 or IgG4 subclass...
August 2016: Journal of Neurology
https://read.qxmd.com/read/25857657/bell-s-palsy-aetiology-clinical-features-and-multidisciplinary-care
#17
REVIEW
Timothy J Eviston, Glen R Croxson, Peter G E Kennedy, Tessa Hadlock, Arun V Krishnan
Bell's palsy is a common cranial neuropathy causing acute unilateral lower motor neuron facial paralysis. Immune, infective and ischaemic mechanisms are all potential contributors to the development of Bell's palsy, but the precise cause remains unclear. Advancements in the understanding of intra-axonal signal molecules and the molecular mechanisms underpinning Wallerian degeneration may further delineate its pathogenesis along with in vitro studies of virus-axon interactions. Recently published guidelines for the acute treatment of Bell's palsy advocate for steroid monotherapy, although controversy exists over whether combined corticosteroids and antivirals may possibly have a beneficial role in select cases of severe Bell's palsy...
December 2015: Journal of Neurology, Neurosurgery, and Psychiatry
https://read.qxmd.com/read/24745706/atrophic-changes-in-the-trigeminal-nerves-of-patients-with-trigeminal-neuralgia-due-to-neurovascular-compression-and-their-association-with-the-severity-of-compression-and-clinical-outcomes
#18
JOURNAL ARTICLE
Paulo Roberto Lacerda Leal, Charlotte Barbier, Marc Hermier, Miguel Angelo Souza, Gerardo Cristino-Filho, Marc Sindou
OBJECT: The aim of this study was to prospectively evaluate atrophic changes in trigeminal nerves (TGNs) using measurements of volume (V) and cross-sectional area (CSA) from high-resolution 3-T MR images obtained in patients with unilateral trigeminal neuralgia (TN), and to correlate these data with patient and neurovascular compression (NVC) characteristics and with clinical outcomes. METHODS: Anatomical TGN parameters (V and CSA) were obtained in 50 patients (30 women and 20 men; mean age 56...
June 2014: Journal of Neurosurgery
https://read.qxmd.com/read/23685183/trigeminal-nerve-anatomy-in-neuropathic-and-non-neuropathic-orofacial-pain-patients
#19
JOURNAL ARTICLE
Sophie L Wilcox, Sylvia M Gustin, Elizabeth N Eykman, Gordon Fowler, Christopher C Peck, Greg M Murray, Luke A Henderson
UNLABELLED: Trigeminal neuralgia, painful trigeminal neuropathy, and painful temporomandibular disorders (TMDs) are chronic orofacial pain conditions that are thought to have fundamentally different etiologies. Trigeminal neuralgia and neuropathy are thought to arise from damage to or pressure on the trigeminal nerve, whereas TMD results primarily from peripheral nociceptor activation. This study sought to assess the volume and microstructure of the trigeminal nerve in these 3 conditions...
August 2013: Journal of Pain
https://read.qxmd.com/read/26826207/a-new-type-of-cervical-vertigo-head-motion-induced-spells-in-acute-neck-pain
#20
JOURNAL ARTICLE
Thomas Brandt, Doreen Huppert
No abstract text is available yet for this article.
March 8, 2016: Neurology
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