European neurology
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The perception of the vertical is frequently shifted to the contralesional side in patients with hemispheric lesions, and this is amplified by spatial neglect. However, we do not know the specific influence of hemianopia and space of perception on this phenomenon. Here, we analyzed the respective influences of spatial neglect, hemianopia and hemispace on the subjective vertical in patients with right hemispheric stroke. ⋯ Patients showed a counter-clockwise deviation, and this was exaggerated by both neglect and hemianopia. In patients with neglect, the error was greater in the left hemispace. In conclusion, neglect and hemianopia had additive effects on the contralesional bias of the subjective vertical.
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It is important to recognize acutely evolving ischemic stroke attributable to reactivation of varicella zoster virus vasculopathy since antiviral agents are effective. ⋯ Chronic neuralgic pain in a dermatomal distribution of an evolving central nervous system vasculopathy is an important clue to its recognition.
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Unilateral facial weakness is common. Transcranial magnetic stimulation (TMS) allows identification of a conduction failure at the level of the canalicular portion of the facial nerve and may help to confirm the diagnosis. ⋯ These data shed light on the TMS-based diagnosis of peripheral facial palsy, an ability to localize the site of lesion within the Fallopian channel regardless of the underlying pathology.
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Intracranial aneurysms with daughter blebs appear to have a higher risk of rupture. Whether hemodynamic factors are involved in this phenomenon is not clear. ⋯ These observations indicate that low WSS and high OSI in the daughter blebs might be involved in increasing the risk of rupture. The localized striking force caused by inflow jets may contribute to the development of daughter blebs. However, a precise role of hemodynamics in predicting the future rupture of daughter blebs needs further study.
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The safety of intravenous (IV) thrombolysis when administered between 4.5 and 6 h after acute ischemic stroke with alteplase has not been established. ⋯ IV thrombolysis in patients who fulfill the NINDS study criteria may still be considered up to 6 h after ischemic stroke.