Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
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Various neurological manifestations have been reported in the literature associated with COVID-19, which in the current study are classified into Central Nervous System (CNS) related manifestations including headache, dizziness, impaired consciousness, acute cerebrovascular disease, epilepsy, and Peripheral Nervous System (PNS) related manifestations such as hyposmia/anosmia, hypogeusia/ageusia, muscle pain, and Guillain-Barre syndrome. ⋯ During the current context of COVID-19 pandemic, physicians should be aware of wide spectrum of neurological COVID-19 sign and symptoms for early diagnosis and isolation of patients. In this regard, COVID-19 has been associated with many neurological manifestations such as confusion, anosmia, and ageusia. Also, various evidences support the possible CNS roles in the COVID-19 pathophysiology. In this regard, further investigation of CNS involvement of SARS-COV-2 is suggested.
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Meta Analysis
The accuracy of aneurysm size in predicting rebleeding after subarachnoid hemorrhage: a meta-analysis.
Aneurysmal subarachnoid hemorrhage (SAH) is a severe cerebrovascular disease. Rebleeding is an independent predictor of unfavorable outcome after aneurysmal SAH. However, the accuracy of aneurysm size for predicting rebleeding after aneurysmal SAH is still unclear. Hence, we conducted this meta-analysis to evaluate the predictive accuracy of large aneurysm for rebleeding after SAH. ⋯ The specificity of large aneurysm for predicting rebleeding after SAH is relatively high. However, its overall accuracy for predicting aneurysm rebleeding is not very satisfying. A comprehensive model should be developed to improve the accuracy of rebleeding prediction after SAH.
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Respiratory failure is the most worrisome problem of COVID-19. Patients may develop severe pneumonia requiring invasive mechanical ventilation and a significant proportion of them dies. It has been suggested that brainstem might play a role in severe respiratory failure of COVID-19 patients. ⋯ Our clinical evaluation was consistent with an involvement of the brainstem and especially of respiratory centre thus possibly explaining the weaning failure in patients that were awake and had recovered from lung involvement. Our data, though limited, indicate that brainstem involvement may play a role in respiratory failure and perhaps in the high death rate of COVID-19 patients. Moreover, the weaning failure from mechanical ventilation due to central respiratory drive depression might underlie the unusual long stay in ICU reported for COVID-19 patients.