Neurologic manifestations in 1760 COVID-19 patients admitted to Papa Giovanni XXIII Hospital, Bergamo, Italy.

Objectives: Evidences from either small series or spontaneous reporting are accumulating that SARS-CoV-2 involves the Nervous Systems. The aim of this study is to provide an extensive overview on the major neurological complications in a large cohort of COVID-19 patients.

Methods: Retrospective, observational analysis on all COVID-19 patients admitted from February 23rd to April 30th, 2020 to ASST Papa Giovanni XXIII, Bergamo, Italy for whom a neurological consultation/neurophysiological assessment/neuroradiologic investigation was requested.

Incidence of orolingual angioedema after intravenous thrombolysis for stroke.

Introduction: Orolingual angioedema (OA) is a known adverse effect of intravenous (i.v.) alteplase.

Migraine improves after ischemic stroke.

Objective: To assess if migraine frequency spontaneously changes after stroke.

Background: Patent foramen ovale (PFO) closure has been reported to decrease migraine attacks. Because many closures are carried out after an ischemic stroke, it is possible that migraine spontaneously improves after stroke.

Common carotid artery duplex for the bubble test to detect right-to-left shunt.

We prospectively compared the bubble test with agitated saline for right-to-left shunt using transcranial Doppler (TCD) of the right middle cerebral artery and second harmonic imaging duplex of the right common carotid artery (CCA) in 100 consecutive patients. Microembolic signals (MES) were counted offline. MES were classified into 6 classes: absent (class 0), 1-10 MES (class 1), 11-20 MES (class 2), 21-30 MES (class 3), 31-50 MES (class 4) and >50 MES or "curtain effect" (class 5).

Plasma homocysteine and severe white matter disease.

The objective of this study was to assess if high total plasma homocysteine (tHcy) levels are a risk factor for severe leukoaraiosis (LA). This case-control study was done in a primary care neurology ward and included 178 consecutive patients. Patients with severe LA at CT scan were compared with patients without any LA regarding age, cerebrovascular risk factors, tHcy, vitamin B12, folate, creatinine levels and dementia.

Spontaneous dissection of carotid and coronary arteries.

The authors report a case of spontaneous dissection of both carotid arteries, followed by spontaneous dissection of the left anterior descending coronary artery after a few days. No major abnormalities of collagen production were found. This case may be underlain by a dysplasia of common precursors of the carotid and coronary walls.

Experience with a questionnaire administered by emergency medical service for pre-hospital identification of patients with acute stroke.

We prospectively verified whether an ad-hoc questionnaire administered by phone supports pre-hospital suspicion of stroke in order to reduce the time before care is given. From June 1996 to May 1997, physicians of the Emergency Medical Service in the area of Bergamo, Italy asked all people calling for a patient with symptoms and signs suggesting a cerebral vascular injury to immediately answer some questions on common symptoms and signs of stroke. The medical records of the patients hospitalized at Ospedali Riuniti of Bergamo were reviewed at the end of the study by a single neurologist, skilled in stroke management and blinded to the questionnaires.

Large demyelinating brain lesion mimicking a herniating tumor.

We describe the case of a large brain lesion whose computed tomography appearance and clinical evolution mimicked a herniating tumor. The patient progressed to coma within 6 days of hospitalization despite high-dose steroid treatment. Emergency excision of the lesion was carried out.

Length of hospitalization of patients with transient ischemic attacks.

Objective: To investigate factors that influence length of stay (LOS) in patients hospitalized for transient ischemic attacks (TIAs). This may help to reduce unnecessary days of hospitalization.

Design: Retrospective study.

Doppler microembolic signals predict ischemic recurrences in symptomatic carotid stenosis.

Objective: To assess if Doppler microembolic signals (MES) associated with > or = 60% symptomatic extracranial carotid stenosis may predict ischemic recurrences before endarterectomy or angioplasty.

Methods: All patients with > or = 60% carotid stenosis with symptoms in the preceding 2 months were prospectively considered. MES were identified using current criteria.

Carotid stents are not a source of microemboli late after deployment.

Objectives: To evaluate the presence of microembolic signals (MES) in the middle cerebral artery distal to a stented carotid artery late after stent deployment. MES may be a signal of thrombus formation at the stent level.

Patients And Methods: Two patient groups were studied with transcranial Doppler at different intervals after deployment of Palmaz stents or Wallstents for stenosis of the internal or common carotid artery.

Malignancy and sensory neuropathy of unexplained cause: a prospective study of 51 patients.

Objective: To investigate the frequency of cancer developing in patients with peripheral sensory neuropathy of unexplained cause.

Design: Prospective study.

Setting: A neurologic unit in a general hospital.

Cerebral venous thrombosis in young adults. Experience in a stroke unit, 1988-1994.

We report a series of nine patients younger than 45 years with angiographically-documented cerebral venous thrombosis, consecutively referred to our Stroke Unit from 1988 to 1994. Two of them were men and seven were women. Eight patients initially complained of headache, often associated with other symptoms of increased intracranial pressure.

Dementia after first stroke.

Background And Purpose: Cognitive deficits may significantly worsen the quality of life after stroke. Our aim was to determine the frequency of dementia in a consecutive series of previously nondemented patients between the ages of 40 and 79 years at 3 months after a first ischemic stroke.

Methods: All patients admitted to our department during an 18-month period who met the above criteria were visited and tested and underwent a CT scan 3 months after their stroke.

Intra-arterial thrombolysis in acute ischaemic stroke: experience with a superselective catheter embedded in the clot.

Objectives: To report experience of intra-arterial thrombolysis for acute stroke, performed with a microcatheter navigated into the intracranial circulation to impale the clot.

Methods: Patients were selected on the following criteria: (1) clinical examination suggesting a large vessel occlusion in stroke patients between 18 and 75 years; (2) no radiographic signs of large actual ischaemia on CT at admission; (3) angiographically documented occlusion of the middle cerebral artery (MCA) stem or of the basilar artery (BA), without occlusion of the ipsilateral extracranial internal carotid artery or of both the vertebral arteries; (4) end of the entire procedure within six hours of stroke. 12 patients with acute stroke were recruited, eight of whom had occlusion of the MCA stem and four of the BA.

Acute rhabdomyolysis associated with acute cocaine intoxication. A case report.

We report a case of acute rhabdomyolysis associated with acute intravenous cocaine intoxication in an asymptomatic HIV-positive young man and discuss the possible pathogenetic mechanisms. Recent cocaine use must be considered among the causes of acute rhabdomyolysis without obvious precipitating factors in our country too. The characteristically uncollaborative attitude of habitual drug users may make differential diagnosis very difficult to establish.