Neurologist
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Control of hypertension is a well-established goal of primary prevention of stroke, but management of blood pressure in patients with a previous stroke or in the setting of acute stroke is complicated by the effect blood pressure changes may have on cerebral perfusion. ⋯ Current data support the use of blood pressure reduction in the secondary prevention of stroke in patients with cerebrovascular disease. In the setting of acute stroke, however, data are limited and blood pressure management must be tailored to the specific clinical situation.
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Review Case Reports
Neuralgic amyotrophy, diagnosed with magnetic resonance neurography in acute stage: a case report and review of the literature.
We present a case of neuralgic amyotrophy (NA) diagnosed with magnetic resonance neurography (MRN) in the acute stage. ⋯ MRN should be the preferred imaging modality for the diagnosis of acute NA. This might not only help early diagnosis and guide treatment but also prevent unnecessary testing.
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Neuromyelitis optica (NMO) is an uncommon CNS demyelinating syndrome often mistaken for severe multiple sclerosis (MS). Several clinical, laboratory, and neuroimaging characteristics may accurately distinguish NMO from MS early in the disease course. ⋯ NMO can be reliably differentiated from MS at an early stage using validated diagnostic criteria. The spectrum of NMO is wider than previously appreciated. Accurate, early diagnosis is critical to facilitate initiation of immunosuppressive therapy for attack prevention.
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Cerebral edema is a potentially devastating complication of various acute neurologic disorders. Its successful treatment may save lives and preserve neurologic function. ⋯ The therapy for brain edema remains largely empirical. More research aimed at enhancing our understanding of the pathophysiology of cerebral edema is needed to identify new and more effective forms of treatment.
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Cerebral venous thrombosis (CVT) is less frequent than arterial thrombosis, presents in an atypical fashion, and is an uncommon cause of stroke. Although the functional outcome from CVT is better than arterial strokes, the outcome of CVT remains unpredictable and may lead to sequelae or even death if not recognized and treated early. ⋯ Further clinical trials are needed to address optimal treatment of this infrequent but potentially serious condition.