Neurology
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Radiosurgery vs. Watch-and-Wait Approach for Newly Diagnosed Vestibular Schwannoma
Vestibular schwannoma is the most common tumor of the cerebellopontine angle. There is controversy regarding the management of these benign tumors with up-front radiosurgery vs. observation, especially for those that are small- to medium-sized with minimal symptoms. Recent evidence suggests that up-front radiosurgery may reduce tumor volume at four-year follow-up.
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Nitrous Oxide-Induced Neuropathy
Nitrous oxide-induced neuropathy presents with a rapidly progressive sensorimotor neuropathy that may mimic Guillain-Barré syndrome. The pattern of clinical weakness and progression, as well as electrophysiological features, can help to rapidly distinguish the two disorders.
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Comparison of the Efficacy of Rituximab vs. Ocrelizumab in the Treatment of Relapsing Multiple Sclerosis
Rituximab is an anti-CD20 chimeric monoclonal antibody used off-label to treat multiple sclerosis (MS). Ocrelizumab is a humanized monoclonal anti-CD20 monoclonal antibody that is Food and Drug Administration-approved for the treatment of MS. In this observational cohort study, the authors were not able to demonstrate noninferiority of rituximab compared to ocrelizumab because of a significantly lower relapse rate in the ocrelizumab-treated group.
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Statins Might Lower Risk of Recurrent Stroke
Patients in Denmark who suffered an intracerebral hemorrhage and were taking cholesterol-lowering medication were less likely to experience another stroke.
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Ethics Consults Focus on the Criteria Used to Determine Death
Some families simply need more time to process strong emotional reactions and grief. Establishing trust can help resolve these cases. Particularly in critical care, it is important from the moment that clinicians meet a family to start to build a good therapeutic relationship with them.
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Higher Mortality Rates Among ICU Patients with Alzheimer’s Disease
Consider early and timely palliative care services instead of the ICU. Early exposure to palliative care may improve both survivability and quality of life, and may lower the risk of hospital-acquired infections.
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Treating Psychotic Symptoms Among Alzheimer’s Disease Patients
In a meta-analysis of several large treatment trials of patients with Alzheimer’s disease, Parkinson’s disease, and dementia with Lewy bodies, cholinesterase inhibitors demonstrated a small but statistically significant benefit in alleviating psychotic symptoms.
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Lawsuits Allege Delays, Failure to Treat with Mechanical Thrombectomy
Malpractice claims involving intravenous thrombolytic therapy to treat acute ischemic stroke patients are more likely to allege failure to treat than to allege complications related to therapy. A group of researchers wanted to know if the same was true regarding mechanical thrombectomy.
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Tarlov Cysts of the Lumbosacral Spine
Tarlov cysts (root sleeve cysts) are common incidental findings on magnetic resonance imaging of the lumbosacral spine. However, they rarely are correlated with electrophysiological findings or clinical symptoms. Undertake extreme care and caution before recommending surgical intervention for these common imaging abnormalities.
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Cumulative Number of Head Strikes Contributes to the Development of Chronic Traumatic Encephalopathy
Researchers recently evaluated the connection between head impact and chronic traumatic encephalopathy (CTE) in male athletes. They found the total number and severity of head impacts throughout life better predicted CTE than the number of symptomatic concussions.