NEURO

A 35-year-old African American female with history of gastric bypass surgery and iron deficiency anemia had a positive nasopharyngeal swab for SARS-CoV-2 PCR in April 2020 in the setting of anosmia and ageusia. Per her sister's report, she did not have confusion, dyspnea, or cough. She did not receive any treatment for COVID-19. Bloodwork in May 2020 demonstrated positive serum SARS-CoV-2 antibodies. from Journal of the Neurological Sciences https://ift.tt/2ZKKIVp

We read with interest the review by El-Abassi et al. published on this journal, which clearly illustrates the complexity of the Stiff person syndrome (SPS) [1]. The authors included respiratory failure as one possible major complication of this syndrome. Specifically, they reported the occurrence of unpredictable life-threatening apneic episodes, possibly caused by spasms of diaphragm, thoracic paraspinal and intercostal muscles, which impede chest expansion. Respiratory impairment is not an isolated sign of disease and it usually appears a few months after the diagnosis. from Journal of the Neurological Sciences https://ift.tt/3cdo0KW

Introduction: Age of onset modifiers are of considerable importance in Alzheimer's and related dementias. Arboleta-Valesquez et al., reporting on a single PSEN1 subject, suggested that homozygosity for the Christchurch variant of APOE could represent such a modifier.Methods: We studied APOE Christchurch and Kloth-VS genotypes of five dementia age of onset outliers who carried their families' pathogenic variant, but were asymptomatic at ages beyond the families' average age of onset.Results: Four age of onset outliers with PSEN1/2 and MAPT mutations did not carry the Christchurch variant and a fifth individual was also determined to not be homozygous for this variant. from Journal of the Neurological Sciences https://ift.tt/2HcumyH

As the number of patients with left ventricular assist device (LVAD) implantation has been increasing, treatment of LVAD-related ischemic stroke is becoming a critical issue. We sought to clarify the features of mechanical thrombectomy in LVAD-related stroke with large vessel occlusion. from Journal of the Neurological Sciences https://ift.tt/3iFO0AZ

The extant literature confirms that an array of polymorphic genes related to- neurotransmitters and second messengers govern the net release of dopamine in the Nucleus Accumbens (NAc) in the mesolimbic region of the brain. They are linked predominantly to motivation, anti-stress, incentive salience (wanting), and wellbeing. Notably, in 2000 the Nobel Prize was awarded to Carlsson, Greengard, and Kandel for their work on the molecular and cellular function of dopaminergic activity at neurons. This historical psychopharmacological work involved neurotransmission of serotonin, endorphins, glutamate, and dopamine, and the seminal work of Blum, Gold, Volkow, Nestler, and others related to neurotransmitter function and related behaviors. from Journal of the Neurological Sciences https://ift.tt/32umf8L

Endovascular treatment of acute ischemic stroke (AIS) and mechanical thrombectomy (MT) is proven as a safe and effective novel treatment for emergent large vessel occlusion in the anterior cerebral circulation. However, there are still many unanswered questions on peri and post-procedural management including blood pressure (BP) control. The current guidelines recommend maintaining BP <180/105 mmHg in the first 24 h after MT. However, recent studies suggest that maintaining BP levels at lower levels in the first 24 h after successful revascularization have been associated with favorable functional outcome, reduced mortality rate, and hemorrhagic complications. from Journal of the Neurological Sciences https://ift.tt/35xzeby

An association between spontaneous hyperventilation, delayed cerebral ischemia, and poor clinical outcomes has been reported in subarachnoid hemorrhage. We evaluated the relationship between early pCO2 changes, ischemic lesions and outcomes in patients with intracerebral hemorrhage (ICH). from Journal of the Neurological Sciences https://ift.tt/2Fqeo3f

Post-stroke epilepsy (PSE) is associated with poorer quality of life, higher mortality, and greater health expenditures. We are unaware of any published reports on the frequency of and factors associated with PSE in Africa. from Journal of the Neurological Sciences https://ift.tt/2Zr1AAo

Frailty is a geriatric state of reduced functional reserve and vulnerability that represent a major public health problem because of its relationship with systemic diseases, increased risk for hospitalization, institutionalization, and all-cause mortality [1]. On the other hand, the SARS-CoV-2 pandemic has affected almost 27 million people worldwide [2]. Therefore, it is likely that many individuals with frailty get exposed to this novel virus. Some reports argued that frail individuals may develop more severe COVID-19 disease [3,4]. from Journal of the Neurological Sciences https://ift.tt/32f4zh8

Objective: To determine the impact of infarct site combinations on prognosis of small subcortical infarction (SSI) by classifying the infarcted perforator area in relation to the anatomical structures that surround and/or involve the corticospinal tract.Methods: Consecutive patients with SSI ≤24 h from onset to initial magnetic resonance imaging (MRI) and ≤ 14 days from onset to second MRI were included. Infarct sites were defined as follows: caudate head, lentiform (L), corona radiata (CR), posterior limb and genu of the internal capsule (IC), thalamus, and brainstem with or without involvement of the corticospinal tract. from Journal of the Neurological Sciences https://ift.tt/3lXAZEK

White matter hyperintensities (WMHs) in the cholinergic pathways are associated with cognitive impairment in Parkinson's disease (PD). This study aimed to investigate the role of WMHs within the cholinergic pathways in cognitive performance following bilateral subthalamic nucleus deep brain stimulation (STN DBS) in patients with PD. from Journal of the Neurological Sciences https://ift.tt/3i3rjGr

The novel coronavirus SARS-CoV-2 is known to cause hypoxemia and acute respiratory distress syndrome (ARDS) in a significant portion of those with severe disease. Survivors of critical illness and ARDS often experience neurocognitive impairment but, to date, there is scant literature correlating radiographic hypoxic brain injury to hypoxemia related to ARDS. In this case series, we describe three cases of hypoxic brain injury seen on magnetic resonance imaging (MRI) in patients with hypoxemia secondary to COVID-19-related ARDS. from Journal of the Neurological Sciences https://ift.tt/3jOof1p

Stroke is a major public health issue in many low- and middle-income countries (LMICs). Despite the emergence of new effective interventions for acute stroke care, uptake remains slow and largely inaccessible to patients in LMICs, where health systems response has been inadequate. In this paper, we propose a policy framework to optimise access to acute stroke care in LMICs. We draw on evidence from relevant primary studies, such as availability of evidence-based acute stroke care interventions, barriers to uptake of interventions for stroke care and insights on stroke mortality and morbidity burden in LMICs. from Journal of the Neurological Sciences https://ift.tt/2ETD9Ve

To describe the spectrum of COVID-19 neurology in Singapore. from Journal of the Neurological Sciences https://ift.tt/2QNDDP8

Background:The detection and diagnosis of Parkinson's disease (PD) is of paramount importance for optimal treatment and for participation in disease-modifying trials. The present study assesses the diagnostic accuracy of the Baylor Functional Assessment Scale (BFAS), a self-administered screening instrument, designed to distinguish between patients with PD, other disorders (OD), and healthy controls (HC).Methods: Using the BFAS, we screened a total of 265 individuals including patients diagnosed at the Baylor College of Medicine Parkinson's Disease Center and Movement Disorders Clinic (PDCMDC) with PD (N = 63) and with OD (N = 47), and HC (N = 155) participants recruited from the PDCMDC and community health fairs. from Journal of the Neurological Sciences https://ift.tt/3hSUxaW

Strokes in the young and middle-aged are associated with a disproportionately large economic and social impact in addition to their clinical effects. Standard Modifiable Cardiovascular Risk Factors (SMuRFs; hypercholesterolaemia, hypertension, diabetes mellitus and smoking) are key drivers of cardiovascular disease including strokes, however recent temporal trends in the younger stroke population have not been well characterised. We aimed to evaluate recent trends of SMuRFs in a cohort of younger patients with ischaemic stroke. from Journal of the Neurological Sciences https://ift.tt/2ESPAk6

Imaging modalities such as dynamic computed tomography (CT) studies of the brain have aided in clinical management of stroke patients through identification of tissue at risk and tissue infarcted. Such a capability provides the opportunity to intervene in stroke patients previously deemed unfit for thrombectomy, [1] while allowing software engineers to develop modeling tools stratifying the risk and benefit of intervention [2]. One unexpected consequence of these advances is the ability to recognize the neurophysiologic changes associated with stroke mimics such as seizure. from Journal of the Neurological Sciences https://ift.tt/3gPIREJ

neuroborreliosis-related CNS vasculitis is believed to be a manifestation of Lyme disease [1,2]. We here report the case of a patient, diagnosed with neuroborreliosis and a fusiform cerebral aneurysm. We made use of 7 Tesla magnetic resonance imaging (MRI), in order to better visualize the aneurysm and discriminate between a congenital and an infectious malformation. The ultra-high resolution imaging permitted the representation of the vessel wall and showed accumulation of contrast medium, which, along with localization and form of the malformation, reinforced the suspicion of an infectious cause of the aneurysm. from Journal of the Neurological Sciences https://ift.tt/2YWn9ca

we have read with great interest the article “Myasthenic Crisis in COVID-19 “by Delly et al. [1], which described the case of a patient with myasthenic crisis simultaneous with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The authors claimed that, given the possible infection-induced exacerbations of myasthenia gravis (MG) [2] and the shared cytokine hyperactivation state of coronavirus disease 19 (COVID-19) and MG crisis [2], COVID-19 might have precipitated the MG course. from Journal of the Neurological Sciences https://ift.tt/3gTh3iG

Recently, during the pandemic infection of the novel SARS-CoV-2, some cases of Guillan-Barré Syndrome (GBS) have been reported.The aim of this work is to report the natural history of patients with GBS, both COVID and not-COVID related, hospitalized in Liguria region, during lock down period, in order to assess clinical features of both groups and possible managements pitfalls due to pandemic emergency.Fifteen GBS patients were admitted to the Hospitals of Liguria, from February 15th to May 3rd 2020, six with SARS-CoV-2 infection and nine without infection. from Journal of the Neurological Sciences https://ift.tt/3hOeccj