Neurology/Neurosurgery General
RSSArticles
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Increased Treatment Opportunities for Trigeminal Autonomic Cephalalgias
Trigeminal autonomic cephalalgias (TACs) include cluster headache, paroxysmal hemicrania, hemicrania continua, short-lasting unilateral neuralgiform headache with conjunctival injection and tearing, and short-lasting unilateral neuralgiform headache with cranial autonomic symptoms. They are female-predominant primary headache disorders that coexist with migraines and mood disorders. Indomethacin is underused in those TACs that are specifically indomethacin responsive. Noninvasive vagus nerve stimulation for TACs is well-tolerated and more effective for prevention than as an acute treatment.
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Plasma Exchange for Relapses in MOGAD
In this multicenter, international study of a cohort of patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), the authors examined the effectiveness of plasma exchange for acute relapses and reported favorable disability outcomes but found that advanced age and delayed initiation of the treatment reduced its benefit.
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Potential Benefit of Glyburide in Moderate-Volume Acute Ischemic Stroke
An exploratory analysis of the CHARM trial suggests intravenous glyburide may improve outcomes in large hemispheric stroke patients with infarct volumes < 125 mL, particularly alongside thrombectomy, reducing edema, mortality, and the need for decompressive surgery, and highlighting a potential neuroprotective role.
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Repeated Head Impacts Are Associated with Tau Astrogliopathy
This study demonstrates that both traumatic brain injury and participation in contact sports are independently associated with increased tau astrogliopathy, particularly thorn-shaped astrocytes, even when cases of chronic traumatic encephalopathy neuropathologic change are excluded.
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Intracranial EEG Activity and Consciousness in Frontal Lobe Seizures
Frontal seizures were classified as focal preserved consciousness (FPC), focal impaired consciousness (FIC), or focal to bilateral tonic-clonic (FBTC). Intracranial electroencephalogram (icEEG) recording was analyzed in those seizures. FPC seizures showed significant icEEG power increases in the seizure-onset region across frequency ranges, with smaller increases in other regions. FIC seizures demonstrated a significant increase in icEEG power not only within the seizure-onset zone but also across distal cortical regions. Widespread power increases also were noted in FBTC seizures. In addition, the power increase in FBTC is much greater compared to FIC seizures.
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Increased Treatment Opportunities for Trigeminal Autonomic Cephalalgias
Trigeminal autonomic cephalalgias (TACs) include cluster headache, paroxysmal hemicrania, hemicrania continua, short-lasting unilateral neuralgiform headache with conjunctival injection and tearing, and short-lasting unilateral neuralgiform headache with cranial autonomic symptoms. They are female-predominant primary headache disorders that coexist with migraines and mood disorders. Indomethacin is underused in those TACs that are specifically indomethacin responsive. Noninvasive vagus nerve stimulation for TACs is well-tolerated and more effective for prevention than as an acute treatment.
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Treatment Window for Lowering Blood Pressure in Acute ICH
Effective treatment for acute intracerebral hemorrhage (ICH) has remained elusive, with inconclusive results from surgical evacuations, as well as blood pressure management. The investigators performed a pooled analysis of four INTERACT trials that studied the effect of aggressive blood pressure lowering in patients with acute ICH. Ultra-early treatment (< 3 hours from onset) may be beneficial, but most patients are not so quickly diagnosed or treated.
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The Walk ’n Watch Trial: Stroke Recovery Through High-Intensity Walking
An intensive real-life walking protocol, started as soon as possible after acute stroke, resulted in improved overall walking endurance, mobility, balance, and quality of life.
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Clinical and Genetic Reassessment of Patients with Presumed Hereditary Polyneuropathy
This is an observational, cross-sectional study of patients seen at a specialized neuromuscular center with a clinical diagnosis of hereditary polyneuropathy, without a previously identified genetic diagnosis. The goal of this study was to assess the combination of clinical reassessment with updated genetic testing, including whole genome sequencing. Reassessment improved the diagnostic clarification rate in these patients.
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Treatment Window for Lowering Blood Pressure in Acute ICH
Effective treatment for acute intracerebral hemorrhage (ICH) has remained elusive, with inconclusive results from surgical evacuations, as well as blood pressure management. The investigators performed a pooled analysis of four INTERACT trials that studied the effect of aggressive blood pressure lowering in patients with acute ICH. Ultra-early treatment (< 3 hours from onset) may be beneficial, but most patients are not so quickly diagnosed or treated.