eNeurologicalSciPub Date : 2023-10-16DOI: 10.1016/j.ensci.2023.100482
Nicholas Kulaba , Adrian Kayanja , Denis Serubiri , Mark Kaddu Mukasa , Martin Kaddumukasa , Jane Nakibuuka , Shirley M. Moore , Elly T. Katabira , Martha Sajatovic , Cumara B. O'Carroll , Anthony Muyingo
{"title":"Blood pressure variability and early neurological outcomes in acute and subacute stroke in Southwestern Uganda","authors":"Nicholas Kulaba , Adrian Kayanja , Denis Serubiri , Mark Kaddu Mukasa , Martin Kaddumukasa , Jane Nakibuuka , Shirley M. Moore , Elly T. Katabira , Martha Sajatovic , Cumara B. O'Carroll , Anthony Muyingo","doi":"10.1016/j.ensci.2023.100482","DOIUrl":"https://doi.org/10.1016/j.ensci.2023.100482","url":null,"abstract":"<div><h3>Background</h3><p>Greater blood pressure variability has detrimental effects on clinical outcome after a stroke; its effects are controversial and have not been evaluated in Sub-Saharan Africa (SSA).</p></div><div><h3>Methods</h3><p>We conducted a prospective study of patients with CT head confirmed ischemic and hemorrhagic strokes admitted to a tertiary hospital within 7 days of onset of unilateral neurological deficits. Blood pressure variability indices, standard deviation (SD) and coefficient of variation (CV) of systolic and diastolic blood pressure between day 0 and day 7, were calculated with a subsequent modified Rankin Scale (mRS) score on day 14 post-stroke. Linear regression was performed to determine the exponential coefficients of mortality at 14 days post- stroke.</p></div><div><h3>Results</h3><p>Out of 120 patients, 51.7% were female, 52.5% had ischemic stroke and the overall median age was 65 (IQR 54–80) years. Twenty (16.7%) patients died within a median survival time of 7 days, while 32 (26.7%) died by day 14 post-stroke. Patients with hemorrhagic stroke had an overall SDSBP of 16.44 mmHg while those with ischemic stroke had an overall SDSBP of 14.05 mmHg. In patients with ischemic stroke, SDSBP had adjusted coefficients of 1, <em>p</em> = 0.004 with C·I: 1.01–1.04 and NIHSS had adjusted coefficients of 1, <em>p</em> = 0.019 with C·I: 1.00–1.03 while in patients with hemorrhagic stroke, SDSBP had adjusted coefficients of 1, <em>p</em> = 0.045 with C·I: 1.00–1.04 and NIHSS had adjusted coefficients of 1, <em>p</em> ≤0.001 with C·I: 1.01–1.03.</p></div><div><h3>Conclusion</h3><p>Exponential increase in Blood Pressure Variability (BPV) and stroke severity scale were independently associated with early mortality among all stroke patients in our study. We recommend future studies to evaluate whether controlling BPV among patients with stroke in Sub-Saharan Africa can reduce mortality.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"33 ","pages":"Article 100482"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405650223000400/pdfft?md5=653e8643a2152efb97918351794b24c4&pid=1-s2.0-S2405650223000400-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91728700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adding a chapter to the literature: A rare encounter of unilateral Moyamoya disease with ipsilateral persistent trigeminal artery","authors":"Marilhia Cornejo, Ramit Singla, Savdeep Singh, Cheran Elangovan, Balaji Krishnaiah","doi":"10.1016/j.ensci.2023.100478","DOIUrl":"https://doi.org/10.1016/j.ensci.2023.100478","url":null,"abstract":"<div><h3>Background</h3><p>The coexistence of persistent trigeminal artery (PTA) and Moyamoya disease (MMD) has been reported. If their pathogenesis is related and if PTA is protective or harmful in MMD remains unknown as these are rare cerebrovascular anomalies.</p></div><div><h3>Case presentation</h3><p>A 35-year-old woman with sudden global aphasia whose CT head and CT angiography of head and neck showed a hypodensity in the left posterior middle cerebral artery (MCA), a possible left proximal internal carotid artery occlusion, and a left PTA with hypoplasia of vertebral and basilar arteries. Digital subtraction angiography showed chronic MMD in the left MCA with extensive pial collateralization from anterior cerebral artery (ACA). The patient was initiated on single antiplatelet therapy and later she underwent direct bypass surgical intervention and rehabilitation.</p></div><div><h3>Discussion</h3><p>Our case report brings attention to the infrequent coexistence of ipsilateral MMD and PTA suggesting a potential congenital pathogenesis based on embryologic development and hemodynamics. Also, we propose a protective role of PTA in MMD in case of large anterior vessel occlusion. This case contributes to the scarce literature on the intriguing relationship between MMD and PTA.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"33 ","pages":"Article 100478"},"PeriodicalIF":0.0,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405650223000369/pdfft?md5=c6c172ec9074281aff95bb794007c023&pid=1-s2.0-S2405650223000369-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90017200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
eNeurologicalSciPub Date : 2023-09-26DOI: 10.1016/j.ensci.2023.100477
Th Coulibaly , O.A. Dicko , M. Sangaré , A.S. Sissoko , L. Cissé , G. Landouré , S.O. Djimdé , A. Yalcouyé , T. Coulibaly , M. Karambé , Y.M. Maiga , C.O. Guinto
{"title":"Socio-cultural representation of epilepsy at the teaching hospital of point G, Mali","authors":"Th Coulibaly , O.A. Dicko , M. Sangaré , A.S. Sissoko , L. Cissé , G. Landouré , S.O. Djimdé , A. Yalcouyé , T. Coulibaly , M. Karambé , Y.M. Maiga , C.O. Guinto","doi":"10.1016/j.ensci.2023.100477","DOIUrl":"10.1016/j.ensci.2023.100477","url":null,"abstract":"<div><h3>Background</h3><p>Epilepsy is a significant public health concern with psychosocial impacts, including fear, stigma, and misconceptions. These factors contribute to human rights violations and discrimination. The objective of this study was to describe the sociocultural representation of epilepsy in Mali.</p></div><div><h3>Materials and methods</h3><p>This cross-sectional descriptive study was carried out from April 2015 to November 2016 at the University Hospital of Point G. Patients with epilepsy were identified prospectively, and a questionnaire was administered to each patient and their parents.</p></div><div><h3>Results</h3><p>A total of 104 patients were enrolled with an average age of 35 years, ranging from 15 to 89 years. Males were slightly predominant, accounting for 53.85%, resulting in a sex ratio (M/F) of 1.17. In terms of occupation, workers comprised 68.27% of participants. Patients residing in urban areas represented 61.54%, and the most level of education was secondary (40.38%). The majority of patients (57.69%) and their relatives (69.23%) thought that epilepsy was caused by mystical causes. Stigma was reported by 66.35% of our patients.</p></div><div><h3>Conclusion</h3><p>The sociocultural perception of epilepsy hinders evidence-based diagnosis and management in Africa. This study suggests a need to focus on raising awareness to change these misconceptions.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"33 ","pages":"Article 100477"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/13/b2/main.PMC10541633.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41112009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effects of cancer on stroke recurrence and mortality: A single-center retrospective cohort study","authors":"Kang-Po Lee , Hui-Chi Huang , Jui-Yao Tsai , Li-Chi Hsu","doi":"10.1016/j.ensci.2023.100474","DOIUrl":"10.1016/j.ensci.2023.100474","url":null,"abstract":"<div><h3>Background</h3><p>Whether patients with stroke and cancer have specific characteristics remains controversial. In addition, research regarding the effects of individual cancer types on stroke outcomes remains scarce. This study investigated the mortality and stroke recurrence rates in patients with stroke and concomitant cancer and evaluated outcome predictors.</p></div><div><h3>Methods</h3><p>This study retrospectively enrolled 2610 patients in the Taipei Veterans General Hospital Stroke Registry registered from January 2019 to December 2020. A total of 1868 patients were included after excluding those without acute ischemic stroke or hospitalization. The patients were then categorized into the following diagnostic groups: cancer-associated stroke (CAS), stroke and inactive cancer, and stroke without cancer. The discharge mortality rate, 1-year mortality rate, and 1-year stroke recurrence rate were compared. Multiple clinical characteristics and comorbidities—age, sex, stroke severity, coagulopathy, common vascular risk factors, and acute stroke treatment—were also assessed.</p></div><div><h3>Results</h3><p>A total of 302 (16.2%) patients had concomitant cancer; 39 (2.1%) patients were classified as having CAS and 263 (14.1%) as having stroke with inactive cancer. The baseline characteristics, stroke severity, and type of acute reperfusion therapy were similar among the three groups. However, the stroke recurrence and mortality rates were much higher in the patients with CAS in both short-term and long-term follow-up. The 30-day and 1-year mortality rates for the CAS, inactive cancer, and no cancer groups were 17.9%, 12.5%, and 4.7%, (<em>p</em> < 0.001) and 51.3%, 33.8%, and 12.4%, (<em>p <</em> 0.001) respectively.</p></div><div><h3>Conclusion</h3><p>Patients with stroke and active cancer had similar stroke severity. However, the 1-year mortality and stroke recurrence rates were higher in these patients than in patients with inactive cancer or the control group.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"32 ","pages":"Article 100474"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10374457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10286334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
eNeurologicalSciPub Date : 2023-09-01DOI: 10.1016/j.ensci.2023.100470
M.L. Touré , T.H. Baldé , M.S. Diallo , G. Carlos Othon , N. Camara , S.D. Barry , M.M. Konaté , F. Sakadi , E. Lamah , B. Diallo , M. Diakité , A. Sakho , D. Camara , S. Condé , H. Madandi , V. Millimono , A.K.T. Barry , M.T. Diallo , N. Traoré , F.D. Kassa , A. Cissé
{"title":"Ischemic strokes revealing neurosyphilis: Study of six (6) observations at the neurology Department of the University Hospital of Conakry","authors":"M.L. Touré , T.H. Baldé , M.S. Diallo , G. Carlos Othon , N. Camara , S.D. Barry , M.M. Konaté , F. Sakadi , E. Lamah , B. Diallo , M. Diakité , A. Sakho , D. Camara , S. Condé , H. Madandi , V. Millimono , A.K.T. Barry , M.T. Diallo , N. Traoré , F.D. Kassa , A. Cissé","doi":"10.1016/j.ensci.2023.100470","DOIUrl":"10.1016/j.ensci.2023.100470","url":null,"abstract":"<div><h3>Introduction</h3><p>In sub-Saharan Africa (SSA), stroke is a major public health problem and the etiological aspects are poorly studied and documented because of under-medicalization; the syphilitic etiology is rarely mentioned.</p></div><div><h3>Patients and methods</h3><p>We performed a retrospective study of 472 patients hospitalized for ischemic stroke between 2016 and 2021 in the Neurology Department of the University Hospital of Conakry, confirmed by neuroradiological explorations (brain CT, MRI-Angio) and a biological workup including VDRL-TPHA serological reactions in blood and CSF.</p></div><div><h3>Results</h3><p>Syphilitic etiology was retained for six (6) patients (4 men and 2 women) with a mean age of 43 years (extremes 36 and 49 years). The clinical picture was dominated by carotid syndromes: superficial and deep sylvian syndrome, anterior cerebral artery syndrome and vertebro-basilar syndromes and one case of lacunar syndrome.</p><p>The diagnosis was based on the positivity of serological reactions (VDRL-TPHA) in blood and cerebrospinal fluid (CSF) and the presence of a predominantly lymphocytic hypercellularity and a hyperproteinorachy in the CSF in the absence of any other etiology.</p></div><div><h3>Conclusion</h3><p>These neurological vascular syndromes consecutive to a cerebral treponematous attack are often the result of a still poorly conducted management of primary and secondary syphilis in our country.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"32 ","pages":"Article 100470"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ff/69/main.PMC10466423.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10491400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
eNeurologicalSciPub Date : 2023-09-01DOI: 10.1016/j.ensci.2023.100471
Hanxing Liu , Yumin Liu , Hong Cao , Yanping Liu
{"title":"An adult progressive Langerhans cell histiocytosis with central nervous system involvement for 10 years: A case report","authors":"Hanxing Liu , Yumin Liu , Hong Cao , Yanping Liu","doi":"10.1016/j.ensci.2023.100471","DOIUrl":"10.1016/j.ensci.2023.100471","url":null,"abstract":"<div><h3>Introduction</h3><p>Langerhans cell histiocytosis (LCH) is a rare disease that usually occurs in children <15 years of age. Adult-onset LCH is extremely rare. Previous published guidelines and studies mainly focused on pediatric patients. The rarity and also insufficient knowledge of LCH in adults, especially central neuvous system (CNS) involvement of LCH, often resulted in missed and delayed diagnosis.</p></div><div><h3>Case presentation</h3><p>A 35-year-old woman presented with cognitive impairment, anxietydepression, decreased eyesight, skin rash, hypernatremia, gonadal hormone deficiency and hypothyroidism. She had experienced menstrual disturbance and infertility since 10 years ago. MRI examination showed a mass lesion in the hypothalamic-pituitary region. Sighs of radiologic neurodegeneration were not found on brain MRI scans, however. Biopsy of skin rash confirmed the the diagnosis of multisystem LCH. BRAF V600E mutation was detected in the peripheral blood mononuclear cells. She accepted combination chemotherapy of vindesine and prednisone and accquired partial remission. The patient died of severe pneumonia during the second course of chemotherapy.</p></div><div><h3>Conclusion</h3><p>Given the complicated differential diagnoses of neuroendocrine disorders, it was essential to be aware of CNS involvement of LCH at first, especially in adults. BRAF V600E mutation may participated in disease progression.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"32 ","pages":"Article 100471"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/19/61/main.PMC10331404.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9815502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Secondary headaches - red and green flags and their significance for diagnostics","authors":"Tissa Wijeratne , Chanith Wijeratne , Nadja Korajkic , Stefanie Bird , Carmela Sales , Franz Riederer","doi":"10.1016/j.ensci.2023.100473","DOIUrl":"10.1016/j.ensci.2023.100473","url":null,"abstract":"<div><p>A small percentage of patients suffer from a secondary headache syndrome. It is imperative that clinicians are able to differentiate primary headache syndromes from secondary headache syndromes, as failure to do so significantly worsens morbidity and mortality. Recent advances in our understanding of pathobiological mechanisms offer useful information on these enigmatic disorders. We now understand that the causes of secondary headache syndromes can vary significantly – these may be infectious, inflammatory, vascular, traumatic or structural in origin.</p><p>A well-taken history and targeted physical examination coupled with appropriate investigations can enable these syndromes to be recognized consistently and thus allow their timely and appropriate treatment. Along with their epidemiology, some of their key characteristics shall thus be discussed in this review so as to aid the busy clinician at the bedside. Red flags including sudden onset, high pain intensity, pattern of change of a preexisting headache, focal neurological signs or seizure, systemic signs and precipitation by physical activity can guide the clinician to suspect a secondary headache. Importantly a preexisting headache is not an exclusion of a secondary headache – it might even be a predisposition in certain cases.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"32 ","pages":"Article 100473"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/2a/main.PMC10339125.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9828413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
eNeurologicalSciPub Date : 2023-08-23DOI: 10.1016/j.ensci.2023.100476
Dania Qaryouti , Omar Jibril , Floyd D. Silva , Priyanka Jain , Karthik Gangu , Abu Baker Sheikh
{"title":"Gender parity in high impact neurology journals","authors":"Dania Qaryouti , Omar Jibril , Floyd D. Silva , Priyanka Jain , Karthik Gangu , Abu Baker Sheikh","doi":"10.1016/j.ensci.2023.100476","DOIUrl":"10.1016/j.ensci.2023.100476","url":null,"abstract":"<div><h3>Background</h3><p>Although female representation has been growing among physicians, women continue to be underrepresented in neurology, particularly regarding academic research in authorship and leadership. Analyzing recent trends in high-impact neurology journals highlights the underrepresentation of women and helps explore barriers to female representation in academic neurology.</p></div><div><h3>Methods and results</h3><p>Journal Citation Reports (JCR) for 2021 was used to screen neurology journals for selection. The first 15 journals with the highest impact factors (JIF) were included. 15,404 total articles in neurology were examined for gender distribution of editorial staff and authorship with the highest total citations from January 1st, 2018 to October 31st, 2021. Gender was classified using biographical information from public and personal media sources. Genderize.io was used in cases of ambiguity, predicting gender at probability of ≥95%. Our data demonstrated that these journals only had 13% female editor-in-chiefs and 35% female editorial staff. The data further demonstrated that females accounted for 39% of first authors and 26% for last authors. During the four years examined males continued to account for the vast majority of both first and last authors for publications accepted and journal editorial staff members.</p></div><div><h3>Conclusion</h3><p>Women are significantly under-represented in the field of neurological research in leadership positions as editor-in-chiefs, editorial board members as well as first or senior authors in top neurology medical journals. With continued underrepresentation of women occupying leading publishing roles, parity with men is still a work in progress. Additional work is needed to identify and address barriers to academic advancement for women physicians in academic neurology.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"33 ","pages":"Article 100476"},"PeriodicalIF":0.0,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4f/e2/main.PMC10485593.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10275550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}