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Emergency neurology

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https://www.readbyqxmd.com/read/29922528/reversible-cerebral-vasoconstriction-disorder-in-a-patient-with-a-chief-complaint-of-headache
#1
Simran Buttar, Anuja Trivedi, Dimitrios Papanagnou
As emergency medicine physicians, we have formulated an approach to managing patients with a chief complaint of headache that starts with considering the story the patient relays in the context of a wide differential. Here we will describe a case that presented to our emergency department in hopes to broaden your differential. Reversible cerebral vasoconstriction syndrome (RCVS), well described in the neurology literature, is characterized by severe headaches that may or may not be accompanied by neurological symptoms and is definitively diagnosed by diffuse constriction of cerebral arteries on cerebral angiogram...
April 16, 2018: Curēus
https://www.readbyqxmd.com/read/29922527/failure-of-the-condyle-c1-interval-method-to-diagnose-atlanto-occipital-dislocation-in-the-presence-of-an-associated-atlanto-axial-dislocation-a-case-report
#2
Mohamed Abouelleil, Daanish Siddique, Nader S Dahdaleh
Atlanto-occipital dislocation (AOD) is a craniocervical injury that has serious neurological consequences and is often fatal. High-speed blunt trauma, such as motor vehicle accidents, that extend and put traction on the head can cause this injury. The current recommendation for diagnosis is to measure the condyle-C1 interval (CCI) using a computed tomography (CT) scan in the coronal plane and more recently in the sagittal plane. We report the case of a patient who suffered a motor vehicle accident and had concomitant AOD and atlanto-axial dislocation...
April 16, 2018: Curēus
https://www.readbyqxmd.com/read/29921359/aviation-fuel-exposure-resulting-in-otitis-externa-with-vertigo
#3
Robert J Long, Reese A Charles
BACKGROUND: Otitis externa secondary to irritant or chemical exposure is well documented; however, specifically secondary to jet fuel exposure and its associated toxicology is not. Over 2 million military and civilian personnel per year are occupationally exposed to aviation fuels. CASE REPORT: An aircraft maintainer presented with noninfectious acute otitis externa secondary to external ear canal exposure to JP-5 jet fuel. Proper exposure guidelines were followed, but it was not realized that the external ear canal was involved...
July 1, 2018: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/29915915/post-embolization-neurological-syndrome-after-embolization-for-intracranial-and-skull-base-tumors-transient-exacerbation-of-neurological-symptoms-with-inflammatory-responses
#4
Yujiro Tanaka, Takao Hashimoto, Daisuke Watanabe, Hirofumi Okada, Daichi Kato, Shigeru Aoyagi, Jiro Akimoto, Michihiro Kohno
PURPOSE: Pre-operative embolization is an effective treatment strategy for hypervascular intracranial and skull base tumors. However, neurological complications resulting from tumor swelling, cranial nerve ischemia, or hemorrhage can occur after embolization. The purpose of this study was to examine the relationship between neurological complications following pre-operative embolization and minor adverse events including fever, headache, or increasing inflammation, which are common after embolization for abdominal tumors (i...
June 18, 2018: Neuroradiology
https://www.readbyqxmd.com/read/29915815/modeling-the-blood-brain-barrier-beyond-the-endothelial-cells
#5
Benjamin D Gastfriend, Sean P Palecek, Eric V Shusta
The blood-brain barrier (BBB) regulates the transport of ions, nutrients, and metabolites to help maintain proper brain function. This restrictive interface formed by brain microvascular endothelial cells excludes the majority of small and large molecule drugs from entering the brain, and blood-brain barrier dysfunction is a signature of many neurological diseases. Thus, in vitro models of the BBB based on brain endothelial cells have been developed to facilitate screening drugs for BBB permeability. However, while brain endothelial cells form the main interface, they work in concert with other brain-resident cells such as neural progenitor cells, pericytes, astrocytes, and neurons to form the neurovascular unit (NVU)...
March 2018: Current Opinion in Biomedical Engineering
https://www.readbyqxmd.com/read/29915095/prospective-countywide-surveillance-and-autopsy-characterization-of-sudden-cardiac-death-post-scd-study
#6
Zian H Tseng, Jeffrey E Olgin, Eric Vittinghoff, Philip C Ursell, Anthony S Kim, Karl Sporer, Clement Yeh, Benjamin Colburn, Nina M Clark, Rana Khan, Amy P Hart, Ellen Moffatt
BACKGROUND: Studies of out-of-hospital cardiac arrest and sudden cardiac death (SCD) use emergency medical services records, death certificates, or definitions that infer cause of death; thus, the true incidence of SCD is unknown. Over 90% of SCDs occur out-of-hospital; nonforensic autopsies are rarely performed, and therefore causes of death are presumed. We conducted a medical examiner-based investigation to determine the precise incidence and autopsy-defined causes of all SCDs in an entire metropolitan area...
June 19, 2018: Circulation
https://www.readbyqxmd.com/read/29914773/transcranial-direct-current-stimulation-a-glimmer-of-hope-for-multiple-sclerosis-fatigue
#7
Samar S Ayache, Moussa A Chalah
Multiple sclerosis (MS) is a neurological disease of the central nervous system characterized by inflammation, demyelination and neurodegeneration. Throughout the disease process, patients may complain of a panel of sensory, motor, cognitive and behavioral symptoms. Fatigue is a debilitating manifestation of central nervous system diseases with physical, cognitive and psychosocial dimensions. In MS, fatigue could be very frequent concerning up to 90% of patients and may have a drastic impact on their quality of life...
June 15, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29913815/distribution-of-concussion-related-symptoms-after-whiplash-injury-in-risk-strata
#8
Helge Kasch, Troels S Jensen
Background/aims The presence and severity of concussion related symptoms after acute whiplash injury are debatable. In this study we examine the distribution and development of the burden of concussion related symptoms in whiplash patients. Methods Consecutively 141 acute whiplash patients and 40 ankle injured controls were recruited from emergency units and were examined after 1 week, 1, 3, 6, 12 months obtaining neck/head VAS score, number-of-non-painful complaints, epidemiological, social, psychological data and neurological examination, active neck mobility, and furthermore muscle tenderness and pain response, strength and duration of neck muscles...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913017/safety-and-tolerability-of-multiple-ascending-doses-of-prx002-rg7935-an-anti-%C3%AE-synuclein-monoclonal-antibody-in-patients-with-parkinson-disease-a-randomized-clinical-trial
#9
Joseph Jankovic, Ira Goodman, Beth Safirstein, Tonya K Marmon, Dale B Schenk, Martin Koller, Wagner Zago, Daniel K Ness, Sue G Griffith, Michael Grundman, Jay Soto, Susanne Ostrowitzki, Frank G Boess, Meret Martin-Facklam, Joseph F Quinn, Stuart H Isaacson, Omid Omidvar, Aaron Ellenbogen, Gene G Kinney
Importance: Aggregated α-synuclein is believed to be central to the pathogenesis of Parkinson disease (PD). PRX002/RG7935 (PRX002) is a humanized monoclonal antibody designed to target aggregated forms of α-synuclein, thereby inhibiting neuron-to-neuron transfer of presumed pathogenic forms of α-synuclein, potentially resulting in neuronal protection and slowing disease progression. Objective: To evaluate the safety and tolerability of multiple intravenous infusions of PRX002 in patients with idiopathic PD...
June 18, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29908672/changing-the-neurology-policy-landscape-in-the-united-states-misconceptions-and-facts-about-epilepsy
#10
David C Grabowski, Jesse Fishman, Imane Wild, Bruce Lavin
Epilepsy has a relatively high prevalence, and diagnosis and treatment are often challenging. Seizure freedom without significant side effects is the ultimate goal for both physicians and patients, but not always achievable. In those cases, the treatment goals of patients and providers may differ. In the United States, many clinicians continue to prescribe older AEDs, even though newer AEDs have a more desirable safety and tolerability profile, fewer drug-drug interactions, and are associated with lower epilepsy-related hospital visits...
May 26, 2018: Health Policy
https://www.readbyqxmd.com/read/29908647/emergency-department-use-of-neuroimaging-in-children-and-adolescents-presenting-with-headache
#11
Meghan R Cain, Dimitrios Arkilo, Amy M Linabery, Anupam B Kharbanda
OBJECTIVES: To evaluate emergency department use and outcomes of neuroimaging for headache in a free-standing children's hospital system. STUDY DESIGN: We prospectively enrolled children aged 6-18 years who presented to the emergency department with a chief complaint of headache from September 2015 to September 2016. Standardized data collection was performed in real time, including telephone follow-up as needed, and imaging outcome was determined through a chart review...
June 14, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29907475/radiotherapy-for-langerhans-cell-histiocytosis-with-paraplegia-a-rare-oncologic-emergency-case-report-in-infancy-and-literature-review
#12
Kentaro Nakashima, Yuhki Koga, Yasunari Sakai, Hidetoshi Takada, Katsumi Harimaya, Saiji Ohga, Tomoaki Taguchi, Yoshinao Oda, Hiroshi Honda, Shouichi Ohga
BACKGROUND: Langerhans cell histiocytosis (LCH) is a clonal disease with focal or disseminated lesions that may compress the surrounding tissues, including the spinal cord. Because few reports have described the spinal symptoms as the first manifestation of pediatric LCH, the long-term neurological outcomes remain unclear. CASE REPORT AND LITERATURE REVIEW: We report a 21-month-old boy who presented with sudden-onset paraplegia. Imaging analyses revealed that osteolytic lesions and epidural tumors compressing the spinal cord at the T7-9 vertebrae...
June 12, 2018: Brain & Development
https://www.readbyqxmd.com/read/29907171/-carbon-monoxide-poisoning-treatment-and-orientation
#13
Thibaut Le Corfec, Olga Maurin, Stéphane Foucher, Kilian Bertho, Hugues Lefort
Colourless and odourless, each year carbon monoxide is responsible for several thousand cases of poisoning. Often collective, their symptoms are non specific and can result in serious neurological sequelae or even death, if they are not detected in time. The (pre-) hospital emergency nurse plays an important role in the management of these patients, in terms of assessment, treatment and monitoring as well as the organisation of the admittance of victims, categorisation and medical triage. As part of a team, the nurse ensures that the patient enters an adapted, regulated pathway, with the most serious cases being directed towards a hospital equipped with a hyperbaric medicine facility...
June 2018: Revue de L'infirmière
https://www.readbyqxmd.com/read/29904793/-tips-for-taking-the-medical-history-in-patients-with-syncope
#14
REVIEW
Carsten W Israel
Transient loss of consciousness represents one of the most frequent reasons for patients to present in the emergency room. Already at the very beginning, the diagnostic work-up is faced with fundamental questions: (1) Was it really a loss of consciousness? (2) Which department (neurology, cardiology, or others) should check the patient? (3) Is an in-hospital diagnostic work-up required? These questions can be answered from a meticulous patient history which needs to be adjusted to the individual case but also has to systematically go through a list of questions...
June 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29903440/ultrasound-and-ct-of-the-posterior-fossa-in-neonates
#15
Elizabeth Snyder, Misun Hwang, Bruno P Soares, Aylin Tekes
Ultrasound, CT and MRI may all be used in the evaluation of the posterior fossa in neonates depending on the clinical scenario. Ultrasonography is particularly valuable for the evaluation of the neonatal brain because of the lack of ionizing radiation and the ability to perform exams at the bedside and, importantly, advancements in ultrasound technology now allow for diagnostic-quality imaging. While CT is still the initial imaging modality of choice in most neurologic emergencies, in the neonate, ultrasound is the first line in nontraumatic emergencies...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29901457/cystic-intestinal-pneumatosis-of-the-small-gut-etiopathogenesis-and-review-of-literature
#16
Luca Napolitano, Mathew Waku, Gustavo Maggi, Franco Ciarelli
Cystic intestinal pneumatosis (CIP) is the presence of gas bubbles inside the wall of the intestine. In literature it has been reported to be associated with a variety of clinical conditions such as: superior mesenteric ischemia, intestinal perforation, bowel necrosis, infections which can cause mucosal alterations and therefore increasing its permeability, necrotizing enterocolitis in babies, trauma, intestinal obstruction, autoimmune and pulmonary pathologies. Its presence is usually documented by radiological techniques such as abdominal X-ray, CT scan and endoscopy and are usually characterized by the typical pattern of gas bubbles in the wall of the intestine...
March 19, 2018: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29900784/review-psychopathologies-in-captive-nonhuman-primates-and-approaches-to-diagnosis-and-treatment
#17
Maya S Kummrow, Martin Brüne
  Despite the growing knowledge and literature on primate medicine, assessment and treatment of behavioral abnormalities in nonhuman primates (NHPs) is an underdeveloped field. There is ample evidence for similarity between humans and great apes, including basic neurologic physiology and emotional processes, and no substantial argument exists against a concept of continuity for abnormal conditions in NHPs that emerge in response to adverse experiences, akin to human psychopathology. NHPs have served as models for human psychopathologies for many decades, but the acquired knowledge has only hesitantly been applied to primates themselves...
June 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29900090/leptomeningeal-metastases-in-hormone-refractory-prostate-cancer
#18
Jessica Y Ng, Justin Y Ng
Leptomeningeal metastases from the prostate are extremely rare, with few cases described in the medical literature (antemortem prevalence of less than 0.03%). Prostatic leptomeningeal metastases harbour a poor prognosis with a median survival after diagnosis of 15.7 weeks. We present the case of an 82-year-old male with a history of hormone-refractory prostate cancer who presented to the emergency department with neurological symptoms.
April 12, 2018: Curēus
https://www.readbyqxmd.com/read/29898143/predictors-of-outcomes-after-correction-of-acute-type-a-aortic-dissection-under-moderate-hypothermic-circulatory-arrest-and-antegrade-cerebral-perfusion
#19
George Samanidis, Charalampos Katselis, Constantinos Contrafouris, Georgios Georgiopoulos, Ioannis Kriaras, Theofani Antoniou, Konstantinos Perreas
INTRODUCTION: Hypothermic circulatory arrest is widely used for correction of acute type A aortic dissection pathology. We present our experience of 45 consecutive patients operated in our unit with bilateral antegrade cerebral perfusion and moderate hypothermic circulatory arrest. METHODS: Between January 2011 and April 2015, 45 consecutive patients were admitted for acute type A aortic dissection and operated emergently under moderate hypothermic circulatory arrest and bilateral antegrade cerebral perfusion...
March 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29898036/role-of-non-coding-rnas-in-non-aging-related-neurological-disorders
#20
A S Vieira, D B Dogini, I Lopes-Cendes
Protein coding sequences represent only 2% of the human genome. Recent advances have demonstrated that a significant portion of the genome is actively transcribed as non-coding RNA molecules. These non-coding RNAs are emerging as key players in the regulation of biological processes, and act as "fine-tuners" of gene expression. Neurological disorders are caused by a wide range of genetic mutations, epigenetic and environmental factors, and the exact pathophysiology of many of these conditions is still unknown...
June 11, 2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
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