Article
Medicine, General & Internal
Yan Li, Natalie van Landeghem, Aydin Demircioglu, Martin Kohrmann, Philipp Dammann, Marvin Darkwah Oppong, Ramazan Jabbarli, Jens Matthias Theysohn, Jens-Christian Altenbernd, Hanna Styczen, Michael Forsting, Isabel Wanke, Benedikt Frank, Cornelius Deuschl
Summary: The study examined predictors of symptomatic intracranial hemorrhage (sICH) in acute ischemic stroke (AIS) patients after thrombectomy, finding that short procedure time and complete reperfusion were significantly associated with reduced sICH risk, while successful reperfusion did not necessarily lower sICH risk. Total ischemic time and intravenous thrombolysis were not predictors of sICH.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Multidisciplinary Sciences
Anna K. Bonkhoff, Markus D. Schirmer, Martin Bretzner, Sungmin Hong, Robert W. Regenhardt, Mikael Brudfors, Kathleen L. Donahue, Marco J. Nardin, Adrian Dalca, Anne-Katrin Giese, Mark R. Etherton, Brandon L. Hancock, Steven J. T. Mocking, Elissa C. McIntosh, John Attia, Oscar R. Benavente, Stephen Bevan, John W. Cole, Amanda Donatti, Christoph J. Griessenauer, Laura Heitsch, Lukas Holmegaard, Katarina Jood, Jordi Jimenez-Conde, Steven J. Kittner, Robin Lemmens, Christopher R. Levi, Caitrin W. McDonough, James F. Meschia, Chia-Ling Phuah, Arndt Rolfs, Stefan Ropele, Jonathan Rosand, Jaume Roquer, Tatjana Rundek, Ralph L. Sacco, Reinhold Schmidt, Pankaj Sharma, Agnieszka Slowik, Martin Soderholm, Alessandro Sousa, Tara M. Stanne, Daniel Strbian, Turgut Tatlisumak, Vincent Thijs, Achala Vagal, Johan Wasselius, Daniel Woo, Ramin Zand, Patrick F. McArdle, Bradford B. Worrall, Christina Jern, Arne G. Lindgren, Jane Maguire, Danilo Bzdok, Ona Wu, Natalia S. Rost
Summary: Acute ischemic stroke affects men and women differently, with women experiencing higher severity than men. Different lesion patterns are linked to stroke severity in men and women, with female patients showing more widespread lesion patterns. Women with higher stroke severity tend to have left hemisphere lesions near the posterior circulation. Sex-specific functional cerebral asymmetries may play a role in future investigations of sex-stratified approaches to managing acute ischemic stroke.
NATURE COMMUNICATIONS
(2021)
Article
Behavioral Sciences
Alain Lekoubou, Paddy Ssentongo, Jonathon Maffie, Kunal Debroy, Michelle Kwon, Clever Nguyen, Matthew Pelton, Benjamin Watt, Justin Ceasar, Nadia Dinunno, Vivek Satyasi, Andre Pascal Kengne, Leonardo Bonilha, Vernon M. Chinchilli
Summary: This study examined the association between cerebral microbleeds (CMBs) and acute symptomatic seizures (ASS). It was found that patients with CMBs were three times more likely to develop seizures compared to those without CMBs. However, this association was influenced by factors such as stroke severity, cortical infarct location, and hemorrhagic transformation. Therefore, further evaluation is needed to assess the long-term risk of seizures associated with CMBs and other markers of small vessel disease.
EPILEPSY & BEHAVIOR
(2023)
Article
Neuroimaging
Kai Qiu, Zhen Yu Jia, Yuezhou Cao, Lin-Bo Zhao, Qingquan Zu, Hai-Bin Shi, Sheng Liu
Summary: This study aimed to investigate the relationship between admission plasma D-dimer levels and symptomatic intracranial hemorrhage (sICH) in patients with acute ischemic stroke (AIS) after thrombectomy. The results showed that elevated admission D-dimer levels were closely associated with the occurrence of sICH and could be used as an independent predictor for sICH.
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2023)
Article
Clinical Neurology
Paul Janvier, Basile Kerleroux, Guillaume Turc, Marco Pasi, Wassim Farhat, Nicolas Bricout, Joseph Benzakoun, Laurence Legrand, Frederic Clarencon, Serge Bracard, Catherine Oppenheim, Gregoire Boulouis, Hilde Henon, Olivier Naggara, Wagih Ben Hassen
Summary: This study aims to determine if early venous filling (EVF) after mechanical thrombectomy is an independent predictor of symptomatic intracranial hemorrhage (sICH) and integrate EVF into a risk score for sICH prediction. The results showed that the presence of EVF, time from onset-to-successful recanalization >270 minutes, low Alberta Stroke Program Early CT Score, and high glucose blood level were independent predictors of sICH and constituted the Time-Alberta Stroke Program Early CT-Glycemia-EVF score. This score demonstrated good performance in predicting sICH after mechanical thrombectomy.
Article
Critical Care Medicine
Madihah Hepburn, Naresh Mullaguri, Pravin George, Stephen Hantus, Vineet Punia, Adarsh Bhimraj, Christopher R. Newey
Summary: Seizures can occur in patients with severe COVID-19 disease, and the mechanism is likely multifactorial, including cortical irritation due to blood-brain barrier breakdown and pro-inflammatory cytokine reactions. Further studies are needed to clarify the risk of seizures and the benefit of monitoring in this population.
NEUROCRITICAL CARE
(2021)
Article
Medicine, General & Internal
Ji Min Lee, Yu Jeong Shin, Shin Byoung-Soo, Hyun Goo Kang
Summary: In this study, three cases were reviewed and found that there was a perfusion delay on the contralateral side of the occlusion or stenosis, similar to the subclavian steal syndrome. The authors proposed two hypotheses to explain this phenomenon, but the study was limited due to the inability to identify events before stroke development, such as volume loss or decreased blood pressure.
Article
Clinical Neurology
Malin Dorvall, Annie Pedersen, Jan P. Dumanski, Martin Soderholm, Arne G. Lindgren, Tara M. Stanne, Christina Jern
Summary: This study found an association between mosaic loss of chromosome Y (LOY) in male patients and poor outcome after ischemic stroke, which remained significant in patients not receiving recanalization therapy. Further studies on LOY and other somatic genetic alterations in larger stroke cohorts are needed.
Article
Engineering, Mechanical
Yangyang Yu, Jiajia Li, Zhixuan Yuan, Yongchen Fan, Ying Wu
Summary: This paper investigates the mechanism of epileptic seizures after ischemic stroke by establishing a coupled network model of neurons and astrocytes. The disruption of ion concentration gradient is found to be an important reason for epileptic seizures after ischemic stroke. Furthermore, factors such as massive glutamate release, excessive receptor activation, and high extracellular potassium concentration also play a role in the propagation of epileptic seizures.
NONLINEAR DYNAMICS
(2022)
Article
Clinical Neurology
Blanca Talavera, Beatriz Gomez-Vicente, Mario Martinez-Galdamez, Elena Lopez-Cancio, Carmen Garcia-Cabo, Mar Castellanos, Alexia Roel, Herbert Tejada-Meza, Javier Marta-Moreno, Cristina Perez-Lazaro, Maria Pilar Navarro-Perez, Yolanda Bravo-Anguiano, Monica Bartulos-Iglesias, Javier Tejada-Garcia, Gabriela Rodrigo-Stevens, Maite Martinez-Zabaleta, Patricia de la Riva, Juan Jose Timiraos-Fernandez, Maria del Mar Freijo, Alain Luna, Juan Manuel Garcia-Sanchez, Maria del Carmen Gil-Alzueta, Enrique Jesus Palacio-Portilla, Yesica Jimenez-Lopez, Luis Lopez-Mesonero, Laura Redondo-Robles, Agustin Mayo-Iscar, Juan F. Arenillas
Summary: Approximately one-quarter of patients with anterior circulation acute ischemic stroke who do not show early neurological improvement within the first 24 hours after complete endovascular reperfusion will achieve long-term functional independence. Male sex, lower initial clinical severity, and use of intravenous thrombolysis before endovascular treatment are predictive factors for this clinical pattern.
Article
Biochemistry & Molecular Biology
Kazuki Hatayama, Sydney Riddick, Fares Awa, Xiaodi Chen, Daniela Virgintino, Barbara S. Stonestreet
Summary: Exposure to hypoxic-ischemic insults in newborns can lead to severe neurological sequelae. This study investigated the changes in the neurovascular unit (NVU) after hypoxic-ischemic injury in neonatal rats. The findings showed increased vascular density, neurovascular remodeling, and changes in pericyte coverage and claudin-5 expression in different brain regions.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Clinical Neurology
Renee A. Shellhaas, Courtney J. Wusthoff, Adam L. Numis, Catherine J. Chu, Shavonne L. Massey, Nicholas S. Abend, Janet S. Soul, Taeun Chang, Monica E. Lemmon, Cameron Thomas, Nancy A. McNamara, Ronnie Guillet, Linda S. Franck, Julie Sturza, Charles E. McCulloch, Hannah C. Glass
Summary: This study found that only 13% of infants with acute symptomatic neonatal seizures developed post-neonatal epilepsy by age 24-months, with a high risk of severe neurodevelopmental impairment and drug-resistant seizures among children with post-neonatal epilepsy. The number of days of EEG-confirmed neonatal seizures was a potentially modifiable epilepsy risk factor, while an EEG at three months was not predictive of epilepsy onset.
Article
Clinical Neurology
Yitong Ling, Yinye Li, Xiaoyu Zhang, Lihua Dong, Jintao Wang
Summary: This study analyzed the clinical features of Trousseau's syndrome with multiple acute ischemic strokes in 15 patients, finding that these patients were typically older males with a history of smoking and (or) drinking, elevated D-dimer, CRP and tumor markers, and lesions in multiple vascular territories. The study suggests that treatment with low molecular heparin may be effective in the short term for these patients.
NEUROLOGICAL SCIENCES
(2022)
Article
Clinical Neurology
Tianqi Xu, Jianhong Yang, Qing Han, Yuefei Wu, Xiang Gao, Yao Xu, Yi Huang, Aiju Wang, Mark W. Parsons, Longting Lin
Summary: This study found that neuroimaging marker NWU can predict symptomatic intracranial hemorrhage after acute ischemic stroke. Additionally, NWU-penumbra may have better predictive performance than NWU-core on sICH after mechanical thrombectomy.
FRONTIERS IN NEUROLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Rui Xue, Wansi Zhong, Ying Zhou, Yaode He, Shenqiang Yan, Zhicai Chen, Jianan Wang, Xiaoxian Gong, Min Lou
Summary: This study aimed to evaluate the outcomes of endovascular treatment (EVT) in patients with minor acute ischemic stroke with anterior circulation large vessel occlusion. The results showed that EVT did not improve functional outcomes in patients with minor acute ischemic stroke caused by large vessel occlusion, but EVT guided by perfusion imaging may be beneficial for these patients.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2022)
Article
Clinical Neurology
Anny Reyes, Erik Kaestner, Emily C. Edmonds, Anna Christina Macari, Zhong Irene Wang, Daniel L. Drane, Vineet Punia, Robyn M. Busch, Bruce P. Hermann, Carrie R. McDonald
Summary: Cognitive disorders are common in older adults with temporal lobe epilepsy, with 60% meeting criteria for Mild Cognitive Impairment. Factors such as early onset and vascular risk contribute to cognitive impairment in these patients, with differences in memory and language deficits compared to aMCI.
Editorial Material
Clinical Neurology
Vineet Punia
Summary: This study found that patients with epilepsy have a higher risk of dementia compared to those without epilepsy, especially for vascular dementia. A history of stroke can modify the increased risk of dementia in epilepsy patients. Patients diagnosed with epilepsy at around age 25 have a similar dementia rate to those diagnosed later in life.
Editorial Material
Clinical Neurology
Vineet Punia
Summary: This study discovered a high prevalence of various seizure cycles in a large cohort, helping to explain the natural variability in seizure timing. The results have the potential to guide the scheduling of diagnostic studies, provide time-varying therapies, and design clinical trials in epilepsy.
Article
Clinical Neurology
Vineet Punia, Ryan Honomichl, Pradeep Chandan, Lisa Ellison, Nicolas Thompson, Adithya Sivaraju, Irene Katzan, Pravin George, Chris Newey, Stephen Hantus
Summary: This study found that about one-third of stroke patients with concerns for acute seizures and who received continuous EEG monitoring continued to use anti-seizure medications beyond the first poststroke clinic visit. Admission to the NICU, the presence of acute symptomatic seizures, and epileptiform abnormalities on cEEG were the main factors associated with long-term ASM use.
ANNALS OF CLINICAL AND TRANSLATIONAL NEUROLOGY
(2021)
Article
Health Care Sciences & Services
Becky Bikat S. Tilahun, Nicolas R. Thompson, Jocelyn F. Bautista, Lauren R. Sankary, Susan Stanton, Vineet Punia
Summary: The study investigates the utility of telepsychology in improving treatment adherence in patients with PNES during the COVID-19 pandemic. Results indicate that telepsychology visits significantly increased attendance and reduced cancellation rates.
TELEMEDICINE AND E-HEALTH
(2022)
Editorial Material
Clinical Neurology
Vineet Punia
Summary: This study compared the risk of mortality and causes of death between individuals with late-onset epilepsy (LOE) and those without epilepsy. The findings revealed that individuals with LOE have a significantly increased risk of death, primarily due to stroke and dementia.
Editorial Material
Clinical Neurology
Vineet Punia
Editorial Material
Clinical Neurology
Vineet Punia
Summary: This study analyzed trends in epilepsy center services from 2012 to 2019 in the United States. The findings showed an increase in the number of epilepsy centers, EMU admissions, epileptologists, and access to specialized testing and services. Surgical case complexity increased while surgical volume remained stable or declined.
Article
Clinical Neurology
Vineet Punia, Lisa Ellison, Jim Bena, Pradeep Chandan, Adithya Sivaraju, Pravin George, Christopher R. Newey, Stephen Hantus
Summary: This study found that continuous EEG monitoring in stroke patients, specifically the presence of epileptiform abnormalities (EAs) on EEG, can predict the development of post-stroke epilepsy (PSE).
ANNALS OF CLINICAL AND TRANSLATIONAL NEUROLOGY
(2022)
Review
Clinical Neurology
Majed Alzahrany, Vineet Punia
Summary: This study provides comprehensive details of extremely late-onset genetic generalized epilepsy (GGE) through a retrospective cohort study and literature review. The study found that a small number of patients aged 50 years and older can develop GGE, and the prognosis is generally good.
Review
Clinical Neurology
Eric Dunn, Faisal Ibrahim, Silvia Neme-Mercante, Dileep Nair, Spencer Morris, Irene Wang, Vineet Punia
Summary: Large scale healthcare data shows that 0.3% of patients develop new-onset epilepsy within 6 months of COVID-19 infection. This study analyzed diagnostic epilepsy monitoring unit (EMU) evaluations to identify and report such cases. Among 62 patients without prior epilepsy who were evaluated in the EMU for new-onset spells after confirmed COVID-19 infection, three patients were diagnosed with focal epilepsy.
EPILEPSY & BEHAVIOR REPORTS
(2023)
Editorial Material
Clinical Neurology
Vineet Punia
Summary: Frailty in older adults with epilepsy was found to be associated with seizure frequency and tolerability of anti-seizure medications (ASMs). The Edmonton Frailty Score (EFS) and Clinical Frailty Scale (CFS) were found to be positively correlated with ASM tolerability, while grip strength was not significantly associated with seizure frequency. Future studies can focus on the role of frailty scores in ASM selection among older adults with epilepsy.
Article
Clinical Neurology
Ifrah Zawar, Balu Krishnan, Michael Mackow, Andreas Alexopoulos, Dileep Nair, Vineet Punia
Summary: The study found that older adults treated with the RNS System achieved seizure outcomes comparable to younger adults with the additional benefit of significant postimplantation medication reduction. Efficacy and safety of brain-responsive neurostimulation in older adults were similar to younger adults, with mild adverse events postoperatively.
Article
Clinical Neurology
Hussam Shaker, Anna Milan, Faisal Alsallom, Christopher Newey, Stephen Hantus, Vineet Punia
Summary: This study examined the long-term electrographic findings and clinical correlates among spontaneous cardiac arrest (SCA) survivors. It found that some patients developed clinical seizures or myoclonus during long-term follow-up, while others had interictal epileptiform discharges without clinical seizures. Neuroimaging abnormalities may be a better indicator of epilepsy development, and half of the patients were taking anti-seizure medications at the last follow-up.