Neurologic clinics
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Headache and rhinosinusitis are 2 of the most common conditions seen in clinical practice. In general, chronic and disabling headaches, especially if migraine features are present, are not due to sinus abnormalities. ⋯ Although most cases of sinusitis are fairly easy to diagnose, sphenoid sinusitis may be overlooked, and can present with progressive or thunderclap headache in adults. Contact-point headache should be considered in patients with focal headaches and a contact point on the lateral nasal wall.
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Transcranial MRI-guided focused ultrasound (TcMRgFUS) is an old idea but a new technology that may change the entire clinical field of the neurosciences. TcMRgFUS has no cumulative effect, and it is applicable for repeatable treatments, controlled by real-time dosimetry, and capable of immediate tissue destruction. ⋯ It is potentially more precise than proton beam therapy and definitely more cost effective. Neuro-oncology may be the most promising area of future TcMRgFUS applications.
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This article focuses on advancements in neuroimaging techniques, compares the advantages of each of the modalities in the evaluation of mild traumatic brain injury, and discusses their contribution to our understanding of the pathophysiology as it relates to prognosis. Advanced neuroimaging techniques discussed include anatomic/structural imaging techniques, such as diffusion tensor imaging and susceptibility-weighted imaging, and functional imaging techniques, such as functional magnetic resonance imaging, perfusion-weighted imaging, magnetic resonance spectroscopy, and positron emission tomography.
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Critically ill neurologic patients are common in the hospital practice of neurology and are often in extreme states requiring accurate and specific information. Imaging, especially using advanced imaging techniques, can provide an important means of garnering this information. This article focuses on the clinical utilization of selective imaging methods that are commonly used in critically ill neurologic patients to render diagnoses, to monitor effects of treatment, or have contributed to a better understanding of pathophysiology in the intensive care unit.
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Friedreich ataxia is the most common autosomal recessive ataxia. It is a progressive neurodegenerative disorder, typically with onset before 20 years of age. ⋯ There are no disease-modifying medications to either slow or halt the progression of the disease, but research investigating therapies to increase endogenous frataxin production and decrease the downstream consequences of disrupted iron homeostasis is ongoing. Clinical trials of promising medications are underway, and the treatment era of Friedreich ataxia is beginning.