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Paroxysmal sympathetic hyperactivity: A common consequence of traumatic brain injury.

Auton Neurosci

January 2025

Department of Medicine, Jinnah Sindh Medical University, Rafiqi H J Shaheed Road, Karachi, Pakistan. Electronic address:

Paroxysmal Sympathetic Hyperactivity (PSH) is a challenging and often underrecognized syndrome, commonly arising after a traumatic brain injury (TBI). Characterized by episodic bursts of heightened sympathetic activity, PSH presents with a distinct constellation of symptoms including hypertension, tachycardia, hyperthermia, and diaphoresis. While the exact pathophysiology remains elusive, current evidence suggests that the syndrome results from an imbalance between excitatory and inhibitory neuronal pathways within the central nervous system, leading to dysregulated autonomic responses.

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Introduction: The efficacy and safety of statins for secondary prevention in patients who have experienced a cardioembolic stroke are not well-defined. However, previous observational data reported hyperlipidemia as a risk factor for both ischemic and bleeding complications in patients with AF and previous stroke. Based on these premises, we conducted a sub-analysis of the RAF and RAF-NOAC studies to evaluate the efficacy and safety of statins in secondary prevention in patients with acute ischemic stroke and AF.

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The relationship between left atrial enlargement (LAE) and primary cryptogenic stroke (PCS) remains a mystery. LAE has been proposed to be an independent risk factor of PCS, recurrent ischemic strokes, paroxysmal atrial fibrillation, and thromboembolism. Our study evaluates the prevalence of LAE among patients with PCS in the absence of atrial fibrillation, unlike previous studies that included atrial fibrillation, in order to isolate LAE as a risk factor.

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Background: A scarcity of data exists concerning atrial fibrillation (AF) during the perioperative stage of non-cardiothoracic surgery, particularly orthopedic surgery. In addition, given the frequency and significant impact of AF in the perioperative period, therefore our aim was to identify prognosis and predictors of elderly hip fracture patients with perioperative AF.

Methods: An examination of hip fracture patients at the Third Hospital of Hebei Medical University, who had been hospitalized from January 2018 to October 2020 in succession, was conducted retrospectively.

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Objective: To evaluate the plasma levels of the otoconial proteins, otoconin-90 and otolin-1, in individuals diagnosed with vestibular neuritis (VN) and determine the feasibility of using these proteins as biomarkers for VN.

Methods: In this preliminary study, 30 patients diagnosed with VN and 70 healthy individuals were recruited and followed to confirm whether they had benign paroxysmal positional vertigo (BPPV) during the following time. The recorded data included measurements of height, weight, and history of diabetes mellitus or hypertension.

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