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Telestroke Consultation Increases Rate of Thrombolysis and Reduces Mortality

Real-time video conferencing between the patient, a remotely located stroke specialist, and the bedside healthcare provider in a hospital emergency department is referred to as “telestroke.” However, there are little data comparing its benefit with in-person evaluation and treatment for hospitals that do not have in-hospital stroke specialists 24 hours per day, seven days per week.

Intensive Lowering of Blood Pressure Does Not Affect the Progression of Small Vessel Disease

Small vessel disease of the brain accounts for 20% to 25% of all ischemic strokes and is a common cause of vascular cognitive impairments. The major risk factor for small vessel disease is hypertension. Targeting a systolic blood pressure of 120 mmHg to 125 mmHg has been recommended, but this has not been confirmed as effective in preventing stroke or long-term cognitive impairment in these patients.

Pregnancy-Associated Stroke Is Increasing in Frequency

Stroke during pregnancy or the puerperium is a rare event but accounts for a considerable part of maternal morbidity and mortality. The incidence has been increasing in all countries, particularly in wealthy industrialized countries, where pregnancy is being delayed considerably and other cardiovascular risk factors have taken on greater importance.

Autologous Hematopoietic Stem Cell Transplantation in Multiple Sclerosis

This retrospective study of autologous hematopoietic stem cell transplantation in patients with active relapsing remitting multiple sclerosis or progressive multiple sclerosis showed efficacy in relapse rate reduction and on magnetic resonance imaging and disability outcomes during a median post-transplant follow-up of about two years. There were risks, including death, associated with the treatment.

Diagnostic Utility of CSF Alpha-Synuclein

This observational study investigated whether the cerebrospinal fluid (CSF) α-synuclein (α-syn) real-time quaking-induced conversion (RT-QuIC) assay, applied to 289 CSF samples, accurately identified patients with mild cognitive impairment (MCI) caused by probable Lewy body (LB) disease. RT-QuIC identified patients with MCI-LB against cognitively unimpaired controls with 95% sensitivity, 97% specificity, and 96% accuracy and showed 98% specificity in neuropathologic controls, indicating that CSF α-syn RT-QuIC is a robust biomarker for prodromal dementia with Lewy bodies.

Surgical Approaches to Decompression in Degenerative Lumbar Spondylolisthesis

A multicenter, randomized, noninferiority trial of people with symptomatic lumbar stenosis and single-level spondylolisthesis who were refractory to conservative treatment found no significant difference between outcomes in those who underwent decompression surgery with instrumented fusion vs. decompression surgery without fusion.

Treatment of Seizures After Spontaneous Intracerebral Hemorrhage

The reported incidence of post-stroke seizures varies and appears to have a higher incidence following hemorrhagic stroke. Post-stroke seizures have been associated with a greater length of hospitalization, increased mortality, and complications. This study compared four seizure prophylaxis strategies to determine the greatest net benefit for patients with spontaneous intracerebral hemorrhage. There was a better outcome with short-term antiepileptic medication use compared to long-term use.

Cortical Lesions Correlate with Disability in Patients with Multiple Sclerosis

In a long-term, 30-year follow-up study of a cohort of patients with multiple sclerosis who presented with clinically isolated syndrome, the investigators found that, among the variables assessed, the presence of cortical lesions had the highest association with long-term physical and cognitive disability.

Proteomics: A New Method to Understand the Influence of Genetic Variation on Disease Pathogenesis

The combination of genome-wide association studies with the analysis of messenger ribonucleic acid and unique proteins in the brain, cerebrospinal fluid, and plasma can shed new light on our understanding of the genetic risks for the development of various neurological diseases.

What Is Focal CIDP?

Chronic inflammatory demyelinating polyneuropathy (CIDP) usually is diagnosed in patients who have a generalized disorder. However, there are focal syndromes that have been observed and diagnosed under different names that meet many of the clinical and electrodiagnostic criteria of CIDP and may be referred to as “focal” CIDP.