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Tranexamic Acid in Patients with Intracerebral Hemorrhage Does Not Improve Outcomes

Primary intracerebral hemorrhage is a major cause of severe neurological disability and carries a high rate of death. Tranexamic acid was tested in a study of 2,325 patients with intracerebral hemorrhage within eight hours of symptom onset, but did not significantly improve neurological outcome.

Tenecteplase vs. Alteplase for Thrombolysis in Basilar Artery Occlusion

Basilar artery occlusion is a dangerous clinical syndrome of large artery occlusion that carries a high morbidity and mortality with severe disability in survivors. In multiple trials, alteplase has shown minimal benefit in achieving reperfusion in patients with large artery occlusion, including the basilar artery. Tenecteplase is a modified variant of alteplase that has greater specificity in binding to fibrin, a longer half-life, and can be administered in a single bolus.

Brain Cancer and Brain Injury Drive Systemic Immunosuppression

Glioblastoma-associated immunosuppression is a significant factor associated with poor survival in this disease. Accumulating evidence suggests that mouse models of glioblastoma and other brain cancers induce systemic immunosuppression through dysregulation of a newly recognized brain-thymus axis and that targeting this pathway may promote more effective immune surveillance of these tumors.

Polyradiculoneuropathy from Immune Checkpoint Inhibitors

Immune checkpoint inhibitors have become an important part of the armamentarium for the medical treatment of cancers such as melanoma and lung carcinomas. A number of immune-mediated neurological complications have been identified during the use of these agents, including polyradiculoneuropathy.

Cognitive Deficits in Patients Recovering from COVID-19

Hospitalized COVID-19 patients with cognitive complaints demonstrate reduced attention and executive dysfunction on formal cognitive testing consistent with the same frequency and pattern of cognitive changes associated with critical illness.

Phospho-Tau217 Blood Biomarker May Help to Diagnose Early Alzheimer’s Disease

Serum phospho-tau217, a biomarker of tau protein that can be detected in the blood, is increased in preclinical Alzheimer’s disease and may have clinical utility for the early detection of brain pathology.

Stem Cell Transplantation for MS Treatment

In this small study of the effect of mesenchymal stem cell treatment, both intravenous and intrathecal, in patients with progressive multiple sclerosis, the treatment was shown to be safe, and there was a trend showing some benefit in slowing disease progression, compared to the sham group. A larger randomized controlled trial is needed to confirm these early findings.

Spontaneous Intracranial Hypotension Syndrome

A systematic review of spontaneous intracranial hypotension demonstrates heterogeneity in clinical and radiographic presentations. Diagnostic studies, such as brain imaging and lumbar puncture, may be unrevealing, and the clinician may have to rely on symptom patterns alone to make a diagnosis.

Efficacy and Safety of Cannabidiol in Treatment of Focal Seizures Associated with Tuberous Sclerosis Complex

Cannabidiol used as an add-on therapy for intractable focal seizures in patients with tuberous sclerosis complex was efficacious. Cannabidiol also had an acceptable adverse event profile, but frequently induced transient elevation of liver enzymes.

Gluten/Celiac Disease Neuropathy

Gluten neuropathy should be suspected in any patient who presents with a neuropathy and has a history of gastrointestinal disease. The diagnosis is made using blood serology plus intestinal mucosal biopsy.