Neurohospitalist最新文献_第7页

Response to "Clarification on MTHFR Variants and Ischemic Stroke Risk". 对“阐明MTHFR变异与缺血性卒中风险”的回应。

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Neurohospitalist Pub Date : 2025-11-07 DOI: 10.1177/19418744251397213

Alexis Robin, Cédric Gollion

引用次数: 0

Atypical Parakinesia Brachialis Oscitans in a Patient With Mild Hemiparesis. 轻度偏瘫患者的不典型伸展臂伴发性寄生虫病。

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Neurohospitalist Pub Date : 2025-11-07 DOI: 10.1177/19418744251398268

Juan Alcalá-Torres

引用次数: 0

Intra-Population Disparities in Alcohol Consumption and Associated Intracerebral Hemorrhage Risk in East India. 东印度人群内酒精消费差异及相关脑出血风险

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Neurohospitalist Pub Date : 2025-11-06 DOI: 10.1177/19418744251396854

Vishal Mehta, Divya Jyoti, Ujjwal Sahay, Rishi Tuhin Guria, Chandra Bhushan Sharma

{"title":"Intra-Population Disparities in Alcohol Consumption and Associated Intracerebral Hemorrhage Risk in East India.","authors":"Vishal Mehta, Divya Jyoti, Ujjwal Sahay, Rishi Tuhin Guria, Chandra Bhushan Sharma","doi":"10.1177/19418744251396854","DOIUrl":"10.1177/19418744251396854","url":null,"abstract":"Background: Heavy alcohol use is associated with an increased risk of Intracerebral Hemorrhage (ICH), but the relationship with lesser amounts of alcohol is uncertain. Tribals in East India have a higher prevalence of alcohol abuse. We assessed the dose-risk relationship between alcohol consumption and ICH and evaluated the intra-population variations of this risk.Methods: In this case-control study, we recruited 510 patients with ICH. Cases were matched 1:1 with ICH-free controls. Alcohol consumption patterns were designated into groups - none, rare, moderate, intermediate, and heavy. The no-alcohol consumption category was used as reference to determine ICH risk.Results: Rare and moderate alcohol consumption conferred a decreased risk of ICH (OR = 0.35, P value <0.001 and OR = 0.58, P value 0.008 respectively). Patients with heavy alcohol use were at a significantly higher risk (OR = 1.65, P value = 0.027). Subgroup analysis revealed similar risk profiles for rare and moderate consumption in both lobar and non-lobar ICH, whereas heavy alcohol conferred an increased risk only for non-lobar ICH. Heavy alcohol consumption was also associated with risk of ICH in tribals (OR = 3.24. P value = 0.04).Conclusion: Rare and moderate alcohol consumption may have a protective effect on ICH risk whereas heavy alcohol use is associated with an increased risk, Further, tribal populations have an increased ICH risk with heavy alcohol use with no decrease in risk with rare or moderate use. This highlights the need for culturally tailored prevention strategies for these communities.","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251396854"},"PeriodicalIF":0.6,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483468","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}

引用次数: 0

Successful Treatment of Cryptogenic NORSE Resistant to Immunosuppression With Intravenous Ganaxolone and Electroconvulsive Therapy. 静脉加那洛酮联合电休克成功治疗免疫抑制耐药的隐源性NORSE。

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Neurohospitalist Pub Date : 2025-11-06 DOI: 10.1177/19418744251395578

Zheng D Lan, Rishi Malhotra, Ali Naqvi, Megan Barra, Henri Vaitkevicius, Ibrahim Migdady

{"title":"Successful Treatment of Cryptogenic NORSE Resistant to Immunosuppression With Intravenous Ganaxolone and Electroconvulsive Therapy.","authors":"Zheng D Lan, Rishi Malhotra, Ali Naqvi, Megan Barra, Henri Vaitkevicius, Ibrahim Migdady","doi":"10.1177/19418744251395578","DOIUrl":"10.1177/19418744251395578","url":null,"abstract":"Introduction: New Onset Refractory Status Epilepticus (NORSE) occurs without an acute structural, toxic, or metabolic cause in individuals without known epilepsy or a related neurological disease. In about 50% of cases, NORSE is attributed to autoimmune or viral encephalitis; in the rest, it remains cryptogenic, posing significant treatment challenges and high risks of mortality and long-term neurological issues. Standard management often involves multiple antiseizure medications, and immunosuppressive therapies used even when an autoimmune cause is unproven. Case Description: We report a 23-year-old woman with cryptogenic NORSE resistant to multiple antiseizure medications, intravenous anesthetics, and immunosuppression, requiring a 5-month barbiturate-induced coma. Attempts to reduce anesthetics triggered recurrent super-refractory status epilepticus. Extensive working up including neuroimaging, cerebrospinal fluid, and autoimmune testing revealed no clear etiology. High-dose steroids, IVIG, plasmapheresis, rituximab, tocilizumab, and anakinra were ineffective. An FDA authorization for emergency single-patient IND (eIND) approval allowed treatment with IV ganaxolone, a GABAA receptor modulator, which was used alongside electroconvulsive therapy. Nine days after initiation of ganaxolone and 13 days after ECT was started, pentobarbital was successfully tapered, and seizures ceased. Consciousness and near-normal language function returned gradually, with residual cognitive deficits. After an 8-month hospitalization, she was discharged to inpatient rehabilitation and subsequently home. At 6 months post-discharge, her Glasgow Outcome Scale-Extended Score was 7.","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251395578"},"PeriodicalIF":0.6,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483449","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}

引用次数: 0

Clarification on MTHFR Variants and Ischemic Stroke Risk. MTHFR变异与缺血性卒中风险的澄清。

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Neurohospitalist Pub Date : 2025-11-05 DOI: 10.1177/19418744251396372

Iyas Daghlas

引用次数: 0

Predicting the Likelihood of Neurosurgical Intervention Prior to Transfer of Spontaneous Intracerebral Hemorrhage (ICH) to Tertiary Care Facilities Using Data From a Retrospective Cohort: The Likelihood of Neurosurgery Score (LoNS). 利用回顾性队列数据预测自发性脑出血（ICH）转移到三级医疗机构之前进行神经外科干预的可能性：神经外科评分（LoNS）的可能性

IF 0.6

Neurohospitalist Pub Date : 2025-10-28 DOI: 10.1177/19418744251393352

Jane Morris, Samantha Barry, Jared Sawyer, Duncan Birkbeck, Wendy Y Craig, Madeleine M Puissant

{"title":"Predicting the Likelihood of Neurosurgical Intervention Prior to Transfer of Spontaneous Intracerebral Hemorrhage (ICH) to Tertiary Care Facilities Using Data From a Retrospective Cohort: The Likelihood of Neurosurgery Score (LoNS).","authors":"Jane Morris, Samantha Barry, Jared Sawyer, Duncan Birkbeck, Wendy Y Craig, Madeleine M Puissant","doi":"10.1177/19418744251393352","DOIUrl":"10.1177/19418744251393352","url":null,"abstract":"Background: Patients with spontaneous intracranial hemorrhage (ICH) who present to non-tertiary care centers are often transferred to a facility with neurosurgical expertise without consideration of the likelihood of surgical intervention. At our Comprehensive Stroke Center (CSC), a minority of patients transferred for neurosurgical evaluation undergo interventions putting a strain on hospital resources. This study aimed to (1) quantify the frequency of neurosurgical intervention in ICH patients transferred to our hospital and, (2) to develop a tool to aid in transfer decisions.Methods: Using an IRB-approved retrospective cohort study design, we identified all spontaneous ICH patients transferred to our CSC between January 1, 2016, and May 31, 2023. All patients were reviewed to ensure a primary diagnosis of non-traumatic supratentorial ICH. Odds ratios were calculated using a logistic regression model to identify factors predictive of neurosurgery which were weighted by strength of association. Internal validation was then performed.Results: Of the 496 participants included in the final dataset, 78 (15.7%) underwent neurosurgical intervention. Age, Glasgow Coma Scale, ICH volume, and intraventricular extension were the greatest predictors of neurosurgery. These factors were used to create the Likelihood of Neurosurgery Score (LoNS), a weighted score used to inform transfer decisions. The score performed well on calibration and discrimination tests.Conclusion: The LoNS is a new tool to identify ICH patients unlikely to be neurosurgical candidates who could be safely managed at the local level rather than urgently transferred to a tertiary care center. Prospective validation is needed.","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251393352"},"PeriodicalIF":0.6,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12568538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410382","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}

引用次数: 0

Progressive Multiple Cranial Neuropathies as a Manifestation of CAR-T Neurotoxicity. 进行性多发性颅神经病变是CAR-T神经毒性的表现。

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Neurohospitalist Pub Date : 2025-10-25 DOI: 10.1177/19418744251393076

Zachary T Lazzari, Avi Singh Gandh, Bhagya Sannananja, Samir R Belagaje, Spencer K Hutto

{"title":"Progressive Multiple Cranial Neuropathies as a Manifestation of CAR-T Neurotoxicity.","authors":"Zachary T Lazzari, Avi Singh Gandh, Bhagya Sannananja, Samir R Belagaje, Spencer K Hutto","doi":"10.1177/19418744251393076","DOIUrl":"10.1177/19418744251393076","url":null,"abstract":"Objective: To describe a case of delayed onset multiple cranial neuropathies as a manifestation of neurotoxicity after chimeric antigen receptor T-cell (CAR-T) therapy for multiple myeloma. While ICANS following CAR-T is a well-reported complication, it classically presents with encephalopathy, seizures, dysphasia, tremors, headache, and cerebral edema. Isolated unilateral facial neuropathies secondary to CAR-T neurotoxicity have been described, but progressive multiple cranial neuropathies have not. Herein, a 75-year-old male presented with left facial nerve palsy 19 days after initiating CAR-T therapy for multiple myeloma. Contrasted brain MRI showed contralateral right facial nerve enhancement, and his left facial palsy was treated with steroids and valacyclovir for 7 days. The facial palsy persisted and progressed to involve bilateral facial nerves and left cranial nerve VI by 31 days post-CAR-T. Specifically, his exam showed impaired abduction of left eye and nearly absent facial movement. Repeat contrasted MRI brain showed mild enhancement of bilateral facial nerves. Extensive serum and CSF testing was unremarkable. Initial treatment with oral steroids for 7 days was ineffective. Concern regarding the impact of steroids on CAR-T efficacy influenced treatment dose and duration. Anakinra was considered but not given. Subsequent treatment with intravenous high dose steroids, followed by a prolonged prednisone taper, led to resolution of CN VI palsy at 2.5 months from onset (2 weeks after completed therapy), and moderate improvement of bilateral facial palsy 5.5 months from onset (3.5 months after completed therapy). CAR-T neurotoxicity can present with progressive multiple cranial neuropathies. The best treatment of these cases is unknown; however, this patient improved in the context of corticosteroids and facial rehabilitation over a prolonged period of follow-up.","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251393076"},"PeriodicalIF":0.6,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12553541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145379262","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}

引用次数: 0

Anemia as a Predictor of Mortality in Indian Patients With Cerebral Venous Thrombosis: A Six-Month Follow-Up Study. 贫血作为印度脑静脉血栓患者死亡率的预测因子：一项为期6个月的随访研究。

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Neurohospitalist Pub Date : 2025-10-25 DOI: 10.1177/19418744251392636

Atlanta Borah, Jayaram Saibaba, Rupendra Nath Saha, Lisna Cherupallikkal, Mohamed Azharudeen, Vaibhav Wadwekar, Vellathussery C Sunitha, Bobby Zachariah, Dharanipragada Krishna Suri Subrahmanyam, Molly Mary Thabah

{"title":"Anemia as a Predictor of Mortality in Indian Patients With Cerebral Venous Thrombosis: A Six-Month Follow-Up Study.","authors":"Atlanta Borah, Jayaram Saibaba, Rupendra Nath Saha, Lisna Cherupallikkal, Mohamed Azharudeen, Vaibhav Wadwekar, Vellathussery C Sunitha, Bobby Zachariah, Dharanipragada Krishna Suri Subrahmanyam, Molly Mary Thabah","doi":"10.1177/19418744251392636","DOIUrl":"10.1177/19418744251392636","url":null,"abstract":"Objectives: Anemia has been associated with cerebral venous thrombosis (CVT) and poor outcomes. There have been no Indian studies in this regard. We studied the frequency and type of anemia, and CVT outcomes at 6 months.Methods: In this ambispective, observational study imaging confirmed CVT patients were enrolled. Anemia was defined by WHO criteria: in men hemoglobin <13 g/dL, non-pregnant women hemoglobin <12 g/dL and pregnant women hemoglobin <11 g/dL. Mortality and poor outcome ie, modified Rankin scale (mRS) score of 3-6 at 6-month were the outcomes. Association between admission anemia and outcome was examined using binary logistic regression after adjusting for potential confounders-namely, age, sex, poor GCS, alcohol, smoking, and involvement of multiple sinuses.Results: Data of 203 CVT patients (94 retrospective and 109 prospective) were analysed. Anemia was present in 96/203 (47%) patients, microcytic anemia being most frequent type (47/96, 49%) based on erythrocyte morphology. Severe anemia comprised 24% (23/96) of the patients with anemia. As per iron studies, 61/96 (64%) anemia patients had iron-deficiency anemia. At 6-month poor outcome was present in 38% vs 23% (P = 0.02), mortality was 34% vs 20% (P = 0.03) in anemic and non-anemic group respectively. After adjustment for confounders anemia was independently associated with increased risk of poor outcome (aOR 4.3; 95% CI 1.3-13.9) and mortality (aOR 5.2; 95% CI 1.4-19.3).Conclusion: At admission, anemia is present in almost half CVT patients and is associated with increased risk of poor outcome and higher mortality.","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251392636"},"PeriodicalIF":0.6,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12553548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145379155","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}

引用次数: 0

Bilateral Vertical Gaze Paralysis With Collier's Sign and Contralesional Pseudo-Abducens Paresis From Unilateral Dorsomedial Thalamic Stroke. 单侧背内侧丘脑卒中所致双侧垂直凝视麻痹伴科利尔氏征和对侧假外展肌麻痹。

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Neurohospitalist Pub Date : 2025-10-22 DOI: 10.1177/19418744251392634

Yaimara Hernandez Silva, Ibrahim Lafi, Fatima Javed, M Daniela Orellana Zambrano, Balaji Krishnaiah

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Catastrophic Multiple Recurrent Cerebral Ischemia in a Patient With Newly Diagnosed Hypereosinophilia. 新诊断嗜酸性粒细胞增多症患者的灾难性多发复发性脑缺血。

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Neurohospitalist Pub Date : 2025-10-21 eCollection Date: 2026-04-01 DOI: 10.1177/19418744251391252

Maria Rosaria Bagnato, Mario Ferrante, Emanuele Saggese, Maria Rita Di Ruzza, Martina Gaia Di Donna

引用次数: 0