Use of Tenecteplase in Acute Ischemic Stroke in the Time of SARS-CoV-2.

Tenecteplase (TNK) is a fibrinolytic drug that is administrated in a single bolus, recommended in eligible patients with acute ischemic stroke prior to mechanical thrombectomy. This study explores its usefulness in adverse situations, such as the SARS-CoV-2 pandemic. We conducted a retrospective study involving consecutive patients with suspected acute ischemic stroke treated either with intravenous fibrinolysis with alteplase during 2019 or with TNK (.

Hereditary cerebral small vessel disease: Assessment of a HTRA1 variant using protein stability predictors and 3D modelling.

Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) is an autosomal recessive vascular disorder caused by biallellic variants in HTRA1. Recently, it has been reported that several heterozygous mutations in HTRA1 are responsible for a milder late-onset cerebral small vessel disease (CSVD) with an autosomal dominant pattern of inheritance. The majority of them are missense that affects the Htr1A protease activity due to a dominant-negative effect caused by defective trimerization or monomer activation.

Presence of Extra-Criteria Antiphospholipid Antibodies Is an Independent Risk Factor for Ischemic Stroke.

Ischemic stroke is the most common and severe arterial thrombotic event in Antiphospholipid syndrome (APS). APS is an autoimmune disease characterized by the presence of thrombosis and antiphospholipid antibodies (aPL), which provide a pro-coagulant state. The aPL included in the classification criteria are lupus anticoagulant, anti-cardiolipin (aCL) and anti-β2-glycoprotein-I antibodies (aB2GPI) of IgG and IgM isotypes.

[From in-person didactic sessions to videoconferencing during the COVID-19 pandemic: satisfaction survey among participants].

Introduction And Aim: COVID-19 pandemic has disturbed many hospital activities, including medical education. We describe the switch from in-person didactic sessions to videoconferencing in a Neurology department. We analyse the opinions and satisfaction of participants.

Pure alexia: two cases and a new neuroanatomical classification.

Pure alexia without visual or language accompanying deficits (isolated pure alexia), represents an infrequent finding in clinical practice. It has been linked to lesions involving the splenium of the callosal corpus in classical descriptions; however, it has also been reported after occipito-temporal cortex damage in the absence of white matter implication. In this regard, a functional region called the visual word form area has been recently related to the posterior aspect of the occipitotemporal gyrus.

Symptomatic Atherosclerotic Disease and Decreased Risk of Cancer-Specific Mortality: A Prospective, Population-Based Study (NEDICES).

The few studies that have assessed the association between symptomatic atherosclerotic disease and risk of cancer have had conflicting results. In addition, these studies ascertained participants either from treatment settings (ie, service-based studies) or by using a records linkage system (ie, medical records of patients evaluated at clinics or hospitals) and, therefore, were prone to selection bias. Our purpose was to estimate the risk of cancer mortality in a large population-based sample of elderly people, comparing participants with symptomatic atherosclerotic disease (atherosclerotic stroke and coronary disease) to their counterparts without symptomatic atherosclerotic disease (ie, controls) in the same population.

Higher glutamate to glutamine ratios in occipital regions in women with migraine during the interictal state.

Background: Glutamate (Glu) and glutamine (Gln) are strongly compartmentalized (in neurons for Glu and in astrocytes for Gln). The visual cortex is the brain region with a higher neuron/astrocyte ratio (the highest neuronal density and the relatively lowest density of astrocytes). Elevations in extracellular Glu or potassium above certain thresholds are likely candidates to be the final common steps in the multiple distinct processes that can lead to cortical spreading depression.

Cognitive and behavioral profile in females with epilepsy with PDCH19 mutation: two novel mutations and review of the literature.

Mutation in the protocadherin 19 (PCDH19) gene is an increasingly recognized cause of epilepsy in females. This disorder is frequently associated with mental retardation and psychiatric features. We describe two unrelated females with novel PCDH19 missense mutations.

Infiltrative cervical lesions causing symptomatic occipital neuralgia.

Background: Occipital neuralgia is a well-recognized cause of posterior head and neck pain that may associate mild sensory changes in the cutaneous distribution of the occipital nerves, lacking a recognizable local structural aetiology in most cases. Atypical clinical features or an abnormal neurological examination are alerts for a potential underlying cause of pain, although cases of clinically typical occipital neuralgia as isolated manifestation of lesions of the cervical spinal cord, cervical roots, or occipital nerves have been increasingly reported.

Case Reports: We describe two cases (one with typical and another one with atypical clinical features) of occipital neuralgia secondary to paravertebral pyomyositis and vertebral relapse of multiple myeloma in patients with relevant medical history that aroused the possibility of an underlying structural lesion.

Cerebrovascular disease incidence in central Spain (NEDICES): a population-based prospective study.

Background: Stroke is one of the most disabling and burdensome health conditions worldwide, but no prospective population-based study has been conducted in Spain. Our aim was to assess age- and gender incidence rates of cerebrovascular disease, including stroke and transient ischemic attack, in three populations in central Spain using data from the NEDICES (Neurological Diseases in Central Spain), a population-based survey of elderly participants.

Methods: Individuals were evaluated at baseline (1994-1995) and at follow-up (a median of 3.

Akinetic mutism induced by tacrolimus.

Akinetic mutism is an uncommon clinical syndrome characterized by the inability to produce voluntary movements or speech without loss of awareness. Cerebrovascular diseases are the most frequent etiology. It has been reported in cyclosporine-related neurotoxicity, but it is exceptional as the presenting form of tacrolimus intoxication.

[Meralgia paraesthetica: a report on a series of 140 cases].

Introduction: Meralgia paraesthetica is a pathology that is frequently seen in visits to extra-hospital neurology services. Nevertheless, the diagnosis, treatment and prognosis of this condition remain somewhat unclear.

Patients And Methods: A retrospective study was conducted involving 140 patients.

[Continuing medical education in neurology: a necessary challenge].

Introduction: The knowledge and skills acquired in the neurology specialty during post-graduate studies must be developed later as a specialist. Exponential growth of the scientific knowledge and its practical application make lifelong learning essential for optimal development of our professional activity.

Revision: The most relevant aspects of the learning and continued development of the neurologist have been reviewed.

[Nocturnal sleep-related eating disorder that responds to topiramate].

Introduction: Nocturnal sleep-related eating disorder is a non-REM sleep parasomnia that is associated to other sleep disorders, especially sleepwalking. It becomes chronic, is not remitting and consists in episodes of compulsive eating during the night, which are then partially or completely forgotten by the patient. This condition must be differentiated from night-eating syndrome, which is far more common and is linked to endocrinological and psychiatric disorders, as well as to other disorders involving eating behaviour during sleeping hours.

[Sensory ganglionopathy as a manifestation of celiac disease].

Introduction: The neurological manifestations of celiac disease (CD) may be caused by the disease itself, by associated autoimmune diseases or by complications from the tumours that may develop in the long term. We report a case of sensory ganglionopathy associated to CD.

Case Report: A 59-year-old female with chronic diarrhoea and loss of weight, who visited because of a clinical picture of gait disorders that progressed to the point where she was barely able to walk.