European neurology
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Chronic hydrocephalus is a common complication that can occur after aneurysmal subarachnoid haemorrhage (SAH). The purpose of this study was to investigate clinical risk factors that could predict the occurrence of shunt-dependent chronic hydrocephalus after aneurysmal SAH. ⋯ Chronic hydrocephalus after aneurysmal SAH has a multifactorial aetiology. Understanding the risk factors that predict the occurrence of chronic hydrocephalus may help neurosurgeons to expedite permanent cerebrospinal fluid diversion, which could decrease both the cost and length of hospital stay and prevent further complications.
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Elevated intracranial pressure (ICP) as a result of intracerebral hemorrhage (ICH) and perihematomal edema often leads to tissue shift, which can be identified in cross-sectional imaging and presents a known predictor of functional outcome. Pulsatility indices (PIs) of the intracranial arteries as measured by transcranial Doppler sonography (TCD) may serve as surrogate parameters for ICP. This study aims to investigate whether PI correlates with ICP and midline shift and serves as a reliable predictor of functional outcome in patients with ICH. ⋯ Early PI monitoring by TCD correlated with ICP and may be used to predict the outcome after 6 months.
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We aimed to investigate the clinical courses and common nystagmus of isolated vertigo patients with vertebrobasilar stroke. ⋯ In the early stage of vertebrobasilar stroke, an accurate diagnosis was difficult in the Emergency Department even though a radiologic study was performed, but various VNG abnormalities and delayed neurologic signs could help to diagnose whether the origin is central or not.
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We propose an analog restless legs syndrome (RLS) rating scale (ARLS) to assess RLS severity. ARLS has three components: overall perceived severity of symptoms, the severity of urge to move and the degree to which symptoms improve with movement, each scored from 0 to 100. ARLS is relatively convenient, easy to administer in clinics and can be rapidly assessed. ⋯ For both low and high IRLS scores, the urge to move measured with ARLS saturated, suggesting a non-linear, multifactorial relationship between the perception of RLS severity and the urge to move. In conclusion, individual components of the ARLS correlated well with total IRLS score. We emphasize that the ARLS is a simple RLS rating tool that can be used in clinical settings.
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The impact of poststroke seizures on the neurological deficits related to ischemic stroke is not well known. It has been reported that following poststroke epilepsy, transient or long-lasting worsening of the poststroke sequelae may develop, but the underlying mechanism of deficit worsening has not been systematically studied by magnetic resonance diffusion-weighted imaging (MRI-DWI). ⋯ Poststroke seizures may affect poststroke sequelae transiently, which we see more often, but some seizure types may prolong the duration of deficits. Multiple DWI changes and LLW following recurrent and longer poststroke seizures were strongly associated, and this may be due to the effect of seizures causing additional metabolical changes.