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Neurohospitalist

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https://www.readbyqxmd.com/read/28042373/ominous-etiology-of-blurry-vision
#1
Joseph Zachariah, Parul Nijhawan, Sunil Manjila
No abstract text is available yet for this article.
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28042372/rasmussen-encephalitis
#2
G Abbas Kharal, Sashank Prasad
No abstract text is available yet for this article.
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28042371/wernicke-like-encephalopathy-associated-with-ifosfamide
#3
John Kent Lin, Daniel S Chow, Leslie Sheu, Bhavya Rehani
No abstract text is available yet for this article.
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28042370/review-of-critical-illness-myopathy-and-neuropathy
#4
Starane Shepherd, Ayush Batra, David P Lerner
Critical illness myopathy (CIM) and neuropathy are underdiagnosed conditions within the intensive care setting and contribute to prolonged mechanical ventilation and ventilator wean failure and ultimately lead to significant morbidity and mortality. These conditions are often further subdivided into CIM, critical illness polyneuropathy (CIP), or the combination-critical illness polyneuromyopathy (CIPNM). In this review, we discuss the epidemiology and pathophysiology of CIM, CIP, and CIPNM, along with diagnostic considerations such as detailed clinical examination, electrophysiological studies, and histopathological review of muscle biopsy specimens...
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28042369/oral-baclofen-withdrawal-resulting-in-progressive-weakness-and-sedation-requiring-intensive-care-admission
#5
Bret D Alvis, Christopher M Sobey
Baclofen is a common medication used as a muscle relaxant and antispasmodic. Baclofen-withdrawal syndrome has many symptoms such as sedation, somnolence, and weakness but can include psychological symptoms. We present a 62-year-old female whose oral baclofen was not continued at a skilled nursing facility after discharge following inpatient surgery that led to the development of altered mental status and respiratory insufficiency necessitating intensive care unit admission. Abrupt cessation of baclofen, no matter the mode of administration to the patient, can lead to baclofen-withdrawal syndrome...
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28042368/neurological-prognostication-of-cardiac-arrest-in-an-era-of-extracorporeal-membrane-oxygenation
#6
Supreet K Sahai, Tamara Majic, Jignesh Patel, Michael Nurok, Asma M Moheet, Axel J Rosengart, Shouri Lahiri
A neuron-specific enolase level greater than 33 ng/mL at days 1 to 3 or status myoclonus within 1 day are traditional indicators of poor neurological prognosis in survivors of cardiac arrest. We report the case of a 70-year-old man who received extracorporeal membrane oxygenation following cardiac arrest. Despite having both an elevated neuron-specific enolase concentration of 68 ng/mL and status myoclonus, he made an excellent neurological recovery. The value of traditional markers of poor prognosis such as elevated neuron-specific enolase or status myoclonus has not been systematically validated in patients treated with extracorporeal membrane oxygenation or therapeutic hypothermia...
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28042367/the-upside-of-bias-a-case-of-chronic-meningitis-due-to-sporothrix-schenckii-in-an-immunocompetent-host
#7
Christine Hessler, Carol A Kauffman, Felicia C Chow
Chronic meningitis of unknown etiology is a vexing illness for patients and clinicians. Identification of the correct pathogen can be challenging and time consuming, leading to delays in appropriate treatment. Although Sporothrix schenckii is a recognized and treatable cause of chronic meningitis, neurologists and infectious diseases physicians may not regularly evaluate for Sporothrix infection. We describe an immunocompetent patient with chronic meningitis who partially responded to empiric fluconazole. Prompted by a recent culture-confirmed case of meningeal sporotrichosis, we tested for S schenckii antibodies from the cerebrospinal fluid, which were positive...
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28042366/posterior-reversible-encephalopathy-syndrome-local-experience-from-saudi-arabia
#8
Hussein Algahtani, Abdulhadi Algahtani, Ahmad Aldarmahi, Mohammed Hmoud, Yousef Marzuk, Bader Shirah
OBJECTIVES: Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome characterized by headache, altered mental status, seizures, or loss of vision. In this study, we report the largest series of PRES coming from Saudi Arabia and explore the etiology, clinical presentation, and outcome. We also report new imaging findings associated with this condition. METHODS: We performed a retrospective study of all cases of PRES admitted to King Abdulaziz Medical City, Jeddah, Saudi Arabia, between the years 2005 and 2015...
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28042365/variations-in-strategies-to-prevent-ventriculostomy-related-infections-a-practice-survey
#9
Ariane Lewis, Barry M Czeisler, Aaron S Lord
BACKGROUND AND PURPOSE: The ideal strategy to prevent infections in patients with external ventricular drains (EVDs) is unclear. METHODS: We conducted a cross-sectional survey of members of the Neurocritical Care Society on infection prevention practices for patients with EVDs between April and July 2015. RESULTS: The survey was completed by 52 individuals (5% response rate). Catheter selection, use of prolonged prophylactic systemic antibiotics (PPSAs), cerebrospinal fluid (CSF) collection policies, location of EVD placement, and performance of routine EVD exchanges varied...
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28042364/predictors-of-acute-kidney-injury-in-neurocritical-care-patients-receiving-continuous-hypertonic-saline
#10
Michael J Erdman, Heidi Riha, Lauren Bode, Jason J Chang, G Morgan Jones
BACKGROUND AND PURPOSE: Continuous intravenous 3% hypertonic saline (HTS) infusions are commonly used for the management of cerebral edema following severe neurologic injuries. Despite widespread use, data regarding the incidence and predictors of nephrotoxicity are lacking. The purpose of this study was to describe the incidence and identify predictors of acute kidney injury (AKI) in neurocritical care patients administered continuous infusion HTS. METHODS: This was an institutional review board-approved, multicenter, retrospective cohort study of patients receiving HTS infusions at 2 academic medical centers...
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28042363/adding-salt-to-the-wounds-perceived-risk-of-hypertonic-saline-for-cerebral-edema
#11
EDITORIAL
David Z Rose, David A Decker, Karen P Wilson, Juan Ramos-Canseco
No abstract text is available yet for this article.
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28042362/zika-virus-infection-some-facts
#12
Viroj Wiwanitkit
No abstract text is available yet for this article.
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/27695602/a-case-study-in-the-history-of-neurology
#13
Gregory S Day, David F Tang-Wai, Michel C F Shamy
We review the case of a young man who developed a constellation of symptoms and signs-bizarre behavior, seizures, abnormal movements, and autonomic instability-that evaded diagnosis at the time of presentation. We use this case to explore the way medical knowledge changes over time. Despite the dramatic advances in our understanding of neurological diseases in recent decades, physicians tend to approach diseases and diagnoses as if they were immutable. Our case reinforces how the diagnosis and treatment of disease are determined by an ever-changing historical context driven by the rapid expansion of medical knowledge...
October 2016: Neurohospitalist
https://www.readbyqxmd.com/read/27695601/a-27-year-old-man-with-right-sided-hemiparesis-and-dysarthria
#14
Anita Tipirneni, Sebastian Koch, Jose G Romano, Amer M Malik
No abstract text is available yet for this article.
October 2016: Neurohospitalist
https://www.readbyqxmd.com/read/27695600/human-african-trypanosomiasis-encephalitis-in-the-united-states-serial-magnetic-resonance-imaging
#15
Mary Carter Denny, Leon L Lai, Robert Laureno
It is important to recognize the signs and symptoms of human African trypanosomiasis (HAT) in order to facilitate early diagnosis and treatment. A 36-year-old man developed encephalitis caused by HAT. This encephalitis can appear many years after well-tolerated systemic infection. The neurologic manifestations developed 7 years after he had emigrated from Cameroon to the United States. We demonstrate the magnetic resonance imaging before, during, and after his treatment with intravenous eflornithine. Clinical signs and symptoms of HAT can be nonspecific and precede abnormalities on magnetic resonance imaging...
October 2016: Neurohospitalist
https://www.readbyqxmd.com/read/27695599/cefepime-associated-sirpids-in-a-patient-with-normal-renal-function
#16
Emily Johnson, Yousef Hannawi, Nirma Carballido Martinez, Eva K Ritzl
Cefepime has been associated with encephalopathy and with nonconvulsive seizure activity, primarily in patients with renal impairment. Here, we report a case of cefepime-associated encephalopathy in a patient with normal renal function with stimulus-induced rhythmic activity seen on electroencephalogram, which resolved on discontinuation of cefepime. We bring this to the attention of the neurohospitalist community, as cefepime is widely used in the hospital setting, and cefepime-related neurotoxicity may go overlooked, especially in patients with normal renal function...
October 2016: Neurohospitalist
https://www.readbyqxmd.com/read/27695598/electrographic-correlates-of-plateau-waves-in-patients-with-leptomeningeal-metastases
#17
C A Gold, N Odom, S Srinivasan, L Schaff, A Haggiagi, Yazmín Odia
We describe video electroencephalography (video-EEG) correlates of transient neurological attacks due to plateau waves-paroxysmal elevations in intracranial pressure-in patients with leptomeningeal metastases. We identified 3 patients with leptomeningeal metastases, intracranial hypertension, and transient neurological attacks captured on video-EEG without evidence of seizures or epileptiform activity. We identified all clinical events on video and reviewed the corresponding EEG data for evidence of abnormalities...
October 2016: Neurohospitalist
https://www.readbyqxmd.com/read/27695597/continuous-qualitative-electroencephalography-as-a-noninvasive-neuromonitor
#18
Zachary D Threlkeld, Mohan Kottapally, Aimee Aysenne, Nerissa Ko
Intracranial pressure (ICP) monitoring frequently guides key decisions in the management of diseases causing intracranial hypertension. Although typically measured by invasive means, contraindications may leave the clinician with little recourse for dynamic ICP evaluation-particularly when the patient's mental status is compromised. We describe here a healthy 18-year-old woman who subacutely progressed to coma due to diffuse cerebral venous sinus thrombosis. Heparinization precluded the use of invasive ICP monitoring, and electroencephalography (EEG) was used novelly as a surrogate ICP monitor...
October 2016: Neurohospitalist
https://www.readbyqxmd.com/read/27695596/ziprasidone-as-a-potential-abortive-therapy-for-status-migrainosus
#19
Eric C Landsness, Leo H Wang, Robert C Bucelli
Migraine headache is among the most prevalent neurologic disorders. Status migrainosus often leads to hospitalization, and multiple medications are sometimes required for symptomatic relief. In 2008, neurologists at our institution started using the atypical antipsychotic ziprasidone as an abortive medication for status migrainosus. The Clinical Investigation Data Exploration Repository was used to search for patients admitted to the Barnes-Jewish Hospital inpatient neurology service with diagnoses of "headache" or "migraine...
October 2016: Neurohospitalist
https://www.readbyqxmd.com/read/27695595/international-classification-of-diseases-ninth-revision-icd-9-diagnosis-codes-can-identify-cerebral-venous-thrombosis-in-hospitalized-adults
#20
Ava L Liberman, Hooman Kamel, Michael T Mullen, Steven R Messé
BACKGROUND: Cerebral venous thrombosis (CVT) is a relatively rare and understudied disease. We sought to determine the accuracy of International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes to identify CVT. METHODS: Retrospective chart review using the electronic medical record (EMR) to identify all patients discharged with CVT following admission or emergency department visit from May 1, 2010 to May 1, 2015 at our center. RESULTS: We identified 111 patients with an ICD-9 discharge diagnosis code of 325...
October 2016: Neurohospitalist
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