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Neurologic Clinics

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https://www.readbyqxmd.com/read/28410664/alzheimer-and-the-dementias
#1
EDITORIAL
John M Ringman
No abstract text is available yet for this article.
May 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28410663/frontotemporal-dementia
#2
REVIEW
Nicholas T Olney, Salvatore Spina, Bruce L Miller
Frontotemporal dementia (FTD) is a heterogeneous disorder with distinct clinical phenotypes associated with multiple neuropathologic entities. Presently, the term FTD encompasses clinical disorders that include changes in behavior, language, executive control, and often motor symptoms. The core FTD spectrum disorders include behavioral variant FTD, nonfluent/agrammatic variant primary progressive aphasia, and semantic variant PPA. Related FTD disorders include frontotemporal dementia with motor neuron disease, progressive supranuclear palsy syndrome, and corticobasal syndrome...
May 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28410662/lewy-body-disorders
#3
REVIEW
Douglas Galasko
Dementia syndromes associated with Lewy bodies are subdivided into dementia with Lewy bodies (DLB), an underdiagnosed cause of dementia in the elderly, and Parkinson disease with dementia (PDD), cognitive impairment appearing in people diagnosed with Parkinson disease. Their neuropathologic substrates are the widespread distribution of aggregates of the protein α-synuclein in neurons in cortical brain regions, accompanied by variable Alzheimer pathology. Clinical features of DLB and PDD include distinctive changes in cognition, behavior, movement, sleep, and autonomic function...
May 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28410661/vascular-contributions-to-cognitive-impairment-in-late-life
#4
REVIEW
Helena C Chui, Liliana Ramirez Gomez
Cerebrovascular disease (CVD) is the second leading cause of cognitive impairment in late life. Structural neuroimaging offers the most sensitive and specific biomarkers for hemorrhages and infarcts, but there are significant limitations in its ability to detect microvascular disease, microinfarcts, dynamic changes in the blood-brain barrier, and preclinical cerebrovascular disease. Autopsy studies disclose the common co-occurrence of vascular and neurodegenerative conditions, suggesting that in late life, a multifactorial approach to cognitive impairment may be more appropriate than traditional dichotomous classifications...
May 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28410660/late-onset-alzheimer-disease
#5
REVIEW
Aimee L Pierce, Szofia S Bullain, Claudia H Kawas
The oldest-old represent the fastest growing segment of society, and the risk of developing dementia continues to increase with advancing age into the 9th and 10th decades of life. The most common form of dementia in the oldest-old is Alzheimer disease (AD), although there are often mixed pathologies contributing to dementia in addition to amyloid plaques and neurofibrillary tangles. Diagnosing AD in the oldest-old is challenging due to cognitive and physical changes associated with aging. Treatment remains supportive, with current approved medications able to provide modest symptomatic benefit but unable to slow the progression of disease...
May 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28410659/early-onset-alzheimer-disease
#6
REVIEW
Mario F Mendez
Early-onset Alzheimer disease (EOAD), with onset in individuals younger than 65 years, although overshadowed by the more common late-onset AD (LOAD), differs significantly from LOAD. EOAD comprises approximately 5% of AD and is associated with delays in diagnosis, aggressive course, and age-related psychosocial needs. One source of confusion is that a substantial percentage of EOAD are phenotypic variants that differ from the usual memory-disordered presentation of typical AD. The management of EOAD is similar to that for LOAD, but special emphasis should be placed on targeting the specific cognitive areas involved and more age-appropriate psychosocial support and education...
May 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28410658/the-role-of-neuroimaging-in-the-assessment-of-the-cognitively-impaired-elderly
#7
REVIEW
Sara Kollack-Walker, Collin Y Liu, Adam S Fleisher
This article reviews the current diagnostic tools that are available for structural, functional, and molecular imaging of the brain, summarizing some of the key findings that have been reported in individuals diagnosed with Alzheimer disease, mild cognitive impairment, prodromal AD, or other prevalent dementias. Given recent advances in the development of amyloid PET tracers, current guidelines for the use of amyloid PET imaging in patients with cognitive complaints are reviewed. In addition, data addressing the potential value of amyloid PET imaging in the clinical setting are highlighted...
May 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28410657/assessment-of-the-hispanic-cognitively-impaired-elderly-patient
#8
REVIEW
Liliana Ramirez Gomez, Felipe A Jain, Lina M D'Orazio
Hispanics are the largest minority group in the United States, approximately 7% of the population older than 65. They often encounter challenges related to health care access and quality of care. The prevalence of dementia among Hispanics is higher than that of non-Hispanic whites and they frequently present at a more advanced stage of illness. Cognitive evaluation should take into account sociodemographic information and cultural factors to avoid misdiagnosis and guide management. A provider who has knowledge of Hispanic culture should conduct the neuropsychological assessment, and tests used to measure cognitive functioning should be developed for Hispanics in the United States...
May 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28410656/the-role-of-neuropsychology-in-the-assessment-of-the-cognitively-impaired-elderly
#9
REVIEW
Po H Lu, Grace J Lee
Cognitive abilities decline with age and older adults, as a group, are at increased risk for developing age-related cognitive disorders. Neuropsychological evaluation provides objective quantification of the type and severity of cognitive deficits that can affect the elderly population and elucidates a pattern of scores that provides diagnostic clues regarding etiology. It can also detect mild cognitive impairment that may not be evident on bedside assessment or mental status examination and provides critical information regarding the progression of cognitive changes through serial evaluations...
May 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28410655/tau-spread-apolipoprotein-e-inflammation-and-more-rapidly-evolving-basic-science-in-alzheimer-disease
#10
REVIEW
Bianca Gonzalez, Edsel M Abud, Abigail M Abud, Wayne W Poon, Karen H Gylys
To date, Alzheimer disease drug candidates have produced negative results in human trials, and progress in moving new targets out of the laboratory and into trials has been slow. However, based on 3 decades of previous work, there is reason to hope that amyloid-based and other novel therapies will move at a faster pace toward successful clinical trials. This article highlights selected preclinical research topics that are rapidly advancing in the laboratory.
May 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28410654/update-on-alzheimer-s-and-the-dementias-introduction
#11
John M Ringman
Though the numbers of dementia cases are rising worldwide, there is evidence that incidence rates are decreasing. We now know that the neuropathological changes of Alzheimer's disease (AD) precede overt clinical signs by 15 to 20 years and we have biochemical and imaging markers that enable us to identify them. The genetic complexity of AD suggests it is not a single entity but rather represents a group of related diseases. The amyloid cascade hypothesis has led to the development of putative disease-modifying interventions but these have not yet been demonstrated to be substantively effective and additional approaches are warranted...
May 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/27886898/neuro-ophthalmology-for-neurologists
#12
EDITORIAL
Andrew G Lee
No abstract text is available yet for this article.
February 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/27886897/update-on-the-management-of-central-retinal-artery-occlusion
#13
REVIEW
Michael Dattilo, Valérie Biousse, Nancy J Newman
Central retinal artery occlusion (CRAO) is caused by partial or complete occlusion of the central retinal artery, most commonly by an embolus from the ipsilateral carotid artery, aortic arch, or heart, and is the ocular equivalent of an acute cerebral ischemic event. The risk factors for a CRAO and acute cerebral ischemia are very similar, if not identical. Because no current therapeutic intervention has been shown to improve visual outcomes compared with the natural history of CRAO, management of CRAO should be focused on secondary prevention of vascular events, such as cerebral ischemia, myocardial infarction, and cardiovascular death...
February 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/27886896/venous-sinus-stenting-for-idiopathic-intracranial-hypertension-where-are-we-now
#14
REVIEW
Marc J Dinkin, Athos Patsalides
Idiopathic intracranial hypertension causes headache, papilledema and visual field loss, typically in obese women of childbearing age. Its anatomical underpinnings remain unclear, but a stenosis at the junction of the transverse and sigmoid sinuses has been recognized in the majority of patients through venography. The stenosis may result from intrinsic dural sinus anatomy or extrinsic compression by increased intracranial pressure, but in either case, its stenting has been shown to lead to an improvement in symptoms of intracranial hypertension and papilledema in multiple retrospective, non-controlled studies...
February 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/27886895/update-on-idiopathic-intracranial-hypertension
#15
REVIEW
Michael Wall
Idiopathic intracranial hypertension (IIH) is a disorder of elevated intracranial pressure of unknown cause occurring predominantly in young women of childbearing age. The typical patient symptom profile is the presence of daily headache, pulse synchronous tinnitus, transient visual obscurations, and papilledema with its associated visual loss. Although surgical procedures are performed for those who fail medical therapy, their relative efficacy remains unclear. The main morbidity of IIH is from visual loss...
February 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/27886894/homonymous-hemianopia-and-vision-restoration-therapy
#16
REVIEW
Alexander Frolov, Jeanne Feuerstein, Prem S Subramanian
Homonymous hemianopia from stroke causes visual disability. Although some patients experience spontaneous improvement, others have limited to no change and may be left with a severe disability. Current rehabilitation strategies are compensatory and cannot restore function. Animal studies suggest that central nervous system plasticity could allow for redirection of lost visual function into undamaged areas of cortex. A commercial therapy system was developed, from which claims of visual field expansion were disputed by independent researchers...
February 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/27886893/erectile-dysfunction-agents-and-nonarteritic-anterior-ischemic-optic-neuropathy
#17
REVIEW
Howard D Pomeranz
Phosphodiesterase-5 inhibitors (PDE5I) are used for treatment of erectile dysfunction and pulmonary arterial hypertension and have been implicated as a causative factor for development of nonarteritic anterior ischemic optic neuropathy (NAION). Controversy remains regarding a cause and effect between PDE5I use and NAION because the mechanism by which NAION occurs is still not well understood. Because neuro-ophthalmologists have accepted that there is a potential relationship between ingestion of the PDE5I class of medications and NAION, the neuro-ophthalmologist should inquire about PDE5I use when evaluating a patient with a new diagnosis of NAION, and counsel patients regarding the implication of continued use of PDE5I...
February 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/27886892/optical-coherence-tomography-in-neuro-ophthalmology
#18
REVIEW
Fiona Costello
The afferent visual pathway is a functionally eloquent region of the central nervous system (CNS). Key clinical features of inflammatory, ischemic, and compressive CNS lesions can be appreciated through detailed ophthalmic examination. Optical coherence tomography (OCT) provides a noninvasive means of capturing manifestations of axonal and neuronal loss in the CNS. OCT represents a surrogate marker of structural integrity in the CNS, through which mechanisms of neurodegeneration and repair may be better understood...
February 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/27886891/the-yield-of-diagnostic-imaging-in-patients-with-isolated-horner-syndrome
#19
REVIEW
Johanna D Beebe, Randy H Kardon, Matthew J Thurtell
We sought to determine, with a retrospective chart review, the imaging yield for patients with clinically isolated Horner syndrome. MRI/MRA of the head and neck extending from the supraorbital ridge to T4 with fat suppression and with postcontrast images was obtained. Of 88 patients with isolated Horner syndrome who were imaged, 20% had a causative etiology on imaging. The most common cause of an isolated Horner syndrome was a carotid artery dissection. There was 1 patient with a primary malignancy found to be the causative lesion in this group, and 1 patient with spread of their known metastatic disease...
February 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/27886890/orbital-disease-in-neuro-ophthalmology
#20
REVIEW
Jessica R Chang, Anna M Gruener, Timothy J McCulley
Many abnormalities of the orbit present with neuro-ophthalmic findings, such as impaired ocular motility or alignment, and sensory changes, including optic neuropathy. Comprehensive coverage of all orbital diseases is beyond the scope of this article. This review focuses on diagnosis and management of the most common and the most vision- or life-threatening orbital conditions as well as more recently discovered entities and points of active controversy. These conditions include orbital trauma, vascular disease, inflammatory and infectious diseases, and neoplasms...
February 2017: Neurologic Clinics
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