Compromised cerebrovascular reactivity related to presence of white matter hyperintensities in cryptogenic stroke with right-to-left shunts.

Objective: This study investigates cerebrovascular reactivity (CVR) changes in cryptogenic stroke (CS) patients with right-to-left shunts (RLS) and evaluates the relationship between CVR and white matter hyperintensities (WMHs).

Methods: The breath-holding index (BHI), representing CVR, was measured from the middle cerebral artery (MCA) using the breath-holding method. WMHs were defined as clearly hyperintense areas on 3T magnetic resonance imaging (MRI), assessed separately as periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH).

Efficacy, tolerability and safety of add-on third-generation antiseizure medications in treating focal seizures worldwide: a network meta-analysis of randomised, placebo-controlled trials.

Background: Adjunctive newer antiseizure medications (ASMs) are being used in patients with treatment-resistant focal-onset seizures (FOS). An updated network meta-analysis (NMA) was necessary to compile evidence in this critical area.

Methods: We systematically searched PubMed, Embase, Cochrane Library, Web of Science, and Scopus from their inception until 17 January 2024, evaluating the efficacy, tolerability, and safety of rufinamide (RUF), brivaracetam (BRV), cenobamate (CNB), eslicarbazepine (ESL), lacosamide (LCM), retigabine (RTG), and perampanel (PER) as adjunctive treatments for FOS.

A case presentation with tranverse testicular ectopia.

Transverse testicular ectopia (TTE) is a rare congenital anomaly, in which both gonads migrate toward the same hemiscrotum with increased risk of testicular malignancy and associated with various abnormalities. Proper knowledge and imaging techniques are essential in diagnosis. Ultrasonography(USG) offer an easy, safe, and convenient alternative in assessment of TTE.