Long-term use of rituximab increases T cell count in MS patients.

Rituximab has been used to treat MS patients in Iceland for over a decade. However, long-term effect of rituximab on leukocyte populations has not yet been elucidated. By retrospective analysis of flow cytometric data from 349 patients visiting the neurological ward at The National University Hospital of Iceland from 2012 to 2023 for rituximab treatment, the long-term effect of rituximab and whether the effect was dose dependent (1000mg vs 500mg) was evaluated.

[The hereditary vessel disease CADASIL].

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a hereditary small vessel disease of the brain characterized by progressive white matter lesions, subcortical infarcts, and cognitive decline. This autosomal dominant disorder is caused by mutations in the NOTCH3 gene located on chromosome 19, resulting in the accumulation of granular osmiophilic material within the walls of small arteries and arterioles. Clinically, CADASIL typically manifests in mid-adulthood with recurrent ischemic events, migraine with aura, mood disturbances, and cognitive impairment.

[Transient Global Amnesia in the Reykjavik area].

Background: Transient Global Amnesia (TGA) is a benign syndrome characterized by sudden anterograde memory loss, that resolves spontaneously within 24 hours. TGA appears without other focal neurological symptoms. The aim of this study was to study TGA in the greater Reykjavik-area.

[The incidence of sinus thrombosis in Iceland 2008-202].

Background: Cerebral venous sinus thrombosis (CSVT) is the cause of 0.5%-1% of all strokes. CSVT can cause haemorrhage, cerebral infarction and increased intracranial pressure.

[Syndrome of transient headache and neurologic deficits with cerebrospinal fluid lymphocytosis – two cases and review].

Here we describe two cases of HaNDL (Headache with Neurological Deficits and cerebrospinal fluid Lymphocytosis). A thirty year old man with episodes of headache with lateralizing symptoms and confusion and a 41 year old man with headache, aphasia and right hemiparesis. Symptoms resolved completely in both patients.

[Cerebral arteriovenous malformations - overview].

Unlabelled: Cerebral arteriovenous malformations (AVMs) are uncommon but can cause intracerebral hemorrhage with grave disability or death. AVMs can even cause focal neurological symptoms, seizures and headache. The treatment of AVMs is complex.

[Cerebral ischemia/infarction - diagnosis and treatment].

Four hundred individuals suffer from ischemic stroke every year in Iceland, more than one daily. Cerebral ischemia is an emergency. Around two million brain cells die every minute after an occlusion of a cerebral artery.

[Cerebral ischemia/infarction - epidemiology, causes and symptoms].

Eight of ten strokes are due to cerebral ischemia, two from cerebal hemorrhage. Stroke is the most common cause of disability, the second commonest cause of dementia and the fourth commonest cause of death in the developed world. The incidence of stroke is 150-200/100.

[Spontaneus intracerebral haemhorrhage--review].

Spontaneous intracerebral hemorrhage occurs when a blood vessel within the brain parenchyma ruptures without a near related trauma. It is the second most common form of stroke, accounting for approximately 10% to 15% of new strokes. The 30 day mortality is very high (25-50%).

[Cerebral sinus thrombosis - an uncommon but important differential diagnosis to headache, stroke and seizures. Cases and overview].

Thrombosis of the cerebral veins and sinuses is an unusual but important cause of increased intracranial pressure and stroke, especially in the young and middle aged. Pregnant women, especially during the puerperium, and individuals with thrombophilia are a special risk group. What makes the diagnosis difficult is the vast range of symptoms including: headache, nausea, vomiting, blurry vision, reduction of consciousness, aphasia and motor and sensory disturbances.

[Brain abscess - overview].

Brain abscess is a life threatening illness, demanding rapid diagnosis and treatment. Its development requires seeding of an organism into the brain parenchyma, often in an area of damaged brain tissue or in a region with poor microcirculation. The lesion evolves from a cerebritis stage to capsule formation.

[Restless legs syndrome - a review].

Unlabelled: Restless legs syndrome (RLS) is a common disorder with a prevalence between 10-20% in Iceland. There are two forms of RLS, idiopathic and secondary. Symptom onset of RLS before the age of 45 suggests an idiopathic form with no known underlying cause but inheritance.

[Spontaneous subarachnoid haemorrhage--review].

Spontaneous subarachnoid hemorrhage is a bleeding in to the subarachnoid space without trauma. Aneurysms are the underlying cause in 80% of the cases. Among other causes are: arteriovenous malformations, anticoagulation, vasculitis or brain tumor.

[Cervical artery dissection - review].

In recent years carotid and vertebral artery dissections have been diagnosed more frequently, probably because new imaging techniques are more reliable and they are certainly less invasive. The cause of cervical artery dissections is largely unexplained but probably involves a combination of genetic and environmental factors such as trauma or infection. Most authors recommend intravenous heparin or low molecular weight heparin followed by oral warfarin to maintain INR between 2-3 for 3-6 months.

[Health anxiety - increased knowledge and treatment options].

Patients with hypochondriasis are preoccupied with the fear or belief that they have a serious, undiagnosed disease. This concern derives from misinterpretations of benign physical sensations, and persists despite appropriate reassurance to the contrary. They have, on average, disproportionately high rates of visits to physicians, specialty consultations, laboratory tests, and surgical procedures, as well as high health care costs.

[Conversion disorder - review].

In modern medicine the term "functional symptoms" is usually used to refer to symptoms where an organic cause cannot be found. Studies have shown that up to half of all patients consulting their family physician and approximately one third of all those attending neurology outpatient clinics present with such symptoms. These patients commonly go between doctors, repeatedly undergo unnecessary tests, even surgery, and various drugs are tried with limited success.

[Central and extrapontine myelinolysis following correction of extreme hyponatremia. Case report and review of the literature].

We report a case of a 43-year-old woman who developed osmotic demyelination syndrome following correction of extreme hyponatremia that was considered to be of chronic nature. The serum sodium level was 91 mmol/L on admission to hospital. It was decided to correct the serum sodium slowly with the goal that the rate of correction would be no more than 12 mmol/l per 24 hours.

[Spontaneous intracranial hypotension--a case report and discussion].

Thirty-three year old woman came to the emergency room with 3 days' history of worsening headache which was relieved by lying down. Examination was normal. Magnetic Resonance Imaging (MRI) of the head showed an enhancement of the meninges.