Cysteine-Altering NOTCH3 Variants Are Associated with an Increased Risk of Autoimmune Diseases.

Autoimmune conditions have been reported among patients with cysteine-altering variants and CADASIL. This study aimed to investigate the occurrence of autoimmune illnesses and markers of inflammation in such populations. Cases were identified who had a cysteine-altering variant from the Geisinger MyCode Community Health Initiative (MyCode).

Implementation and Follow-up Experience of an e-Consult Program in a Rural Neurology Setting.

Objective: The demand for neurology services at Geisinger exceeds the current clinical capacity. Therefore, we implemented and assessed the utility of Ask-a-Doc (AAD), which is an electronic medical record-based interface developed at Geisinger to facilitate communication between primary care physicians (PCPs) and specialists.

Methods: AAD was used at the end of 2015 in our department.

Adherence to anticoagulant guideline for atrial fibrillation: A large care gap among stroke patients in a rural population.

Objective: This study aimed to investigate the prevalence and factors associated with oral anticoagulant undertreatment of atrial fibrillation (AF) among a cohort of rural patients with stroke outcomes and examine how undertreatment may influence a patient's one-year survival after stroke.

Methods: This retrospective cohort study examined ischemic stroke patients with pre-stroke AF diagnosis from September 2003 to May 2019 and divided them into proper treatment and undertreatment group. Analysis included chi-square test, variance analysis, Kruskal-Wallis test, logistic regression, Kaplan-Meier estimator, and Cox proportional-hazards model.

Cognitive Sequelae of Central-Variant Posterior Reversible Encephalopathy Syndrome (PRES).

Introduction: Although the posterior reversible encephalopathy syndrome (PRES) is often associated with headache and visual changes, central-variant PRES can be difficult to clinically diagnose in a patient with alteration of consciousness. Central-variant PRES has been previously described in the literature affecting subcortical white matter and the brainstem. .

Atypical Variant of Guillain Barre Syndrome in a Patient with COVID-19.

Objective: A rare variant Miller Fisher Syndrome overlap with Guillain Barre Syndrome is described in an adult patient with SARS-COV-2 infection.

Case Presentation: The clinical course of a 45-year-old immunosuppressed man is summarized as a patient who developed ataxia, ophthalmoplegia, and areflexia after upper respiratory infection symptoms began. A nasopharyngeal swab was positive for COVID-19 polymerase chain reaction.

Serotonin Syndrome Presenting as a Posterior Reversible Encephalopathy Syndrome.

Posterior reversible encephalopathy syndrome (PRES) is a neurological syndrome characterized by an altered level of consciousness, headaches, seizure, and visual changes. PRES has several different etiologies, including malignant hypertension, eclampsia, and certain medications. Here, we describe a 41-year-old woman who presented with altered mental status.

Lateral Medullary Ischemic Infarct Caused by Posterior Inferior Cerebellar Artery Aneurysm.

Posterior inferior cerebellar artery (PICA) aneurysms are rare. The most common complication of intracranial aneurysms is rupture causing subarachnoid hemorrhage. Ischemic infarct, although more common in giant thrombosed aneurysms, is a very rare manifestation of small intracranial aneurysms.

Recurrent Intracerebral Hemorrhage after Exercise in a Young Patient Presenting with Sporadic Cerebral Amyloid Angiopathy in a Young Patient.

Cerebral Amyloid Angiopathy (CAA) is one of the significant causes of lobar intracerebral hemorrhage (ICH) mainly among elderly people. Sporadic cases of CAA have been linked to genetic polymorphisms with an increased risk of disease, an earlier presentation, and an accelerated pathology [1]. Here, we present a patient with no significant risk factors who had a recurrent intracerebral hemorrhage secondary to CAA probably induced by exercise.

The association of adult vaccination with the risk of cerebrovascular ischemia: A systematic review and meta-analysis.

There is mounting evidence supporting infection as an independent risk factor for ischemic stroke (IS), while preliminary data indicate that vaccination may prevent IS. We performed a systematic review and meta-analysis of available randomized clinical trials (RCTs) or prospective observational cohorts reporting associations of influenza vaccination (IV) and/or pneumococcal vaccination (PV) with IS. We identified a total of 12 studies (543,311 patients; 47.

The effect of alcohol and red wine consumption on clinical and MRI outcomes in multiple sclerosis.

Background: Alcohol and in particular red wine have both immunomodulatory and neuroprotective properties, and may exert an effect on the disease course of multiple sclerosis (MS).

Objective: To assess the association between alcohol and red wine consumption and MS course.

Methods: MS patients enrolled in the Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women's Hospital (CLIMB) who completed a self-administered questionnaire about their past year drinking habits at a single time point were included in the study.

Factors associated with recovery from acute optic neuritis in patients with multiple sclerosis.

Objective: To identify clinical and demographic features associated with the severity and recovery from acute optic neuritis (AON) episodes in patients with multiple sclerosis (MS).

Methods: Adult (n = 253) and pediatric (n = 38) patients whose first symptom was AON were identified from our MS database. Severity measured by loss of visual acuity (mild attack ≤20/40, moderate attack 20/50-20/190, and severe attack ≥20/200) and recovery in visual acuity at 1 year after the attack (complete recovery ≤20/20, fair recovery 20/40, and poor recovery ≥20/50) were recorded.