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Precise Localization of Focused Ultrasound Thalamotomy Determines Clinical Benefit
Lesioning of the posterior portion of the VIM thalamus is most efficacious. Lesions extending beyond this portion can lead to adverse side effects in those with essential tremor treated with MRI-guided focused ultrasound.
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Miller Fisher Syndrome: Atypical Features
Other than the classic triad of neurological signs that define Miller Fisher syndrome, it also is common to see delayed facial palsy, loss of taste, and weakness of pharyngeal and cervical muscles.
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Treatment of Acute Migraine With Ginger
Ginger extract has a long anecdotal history as a treatment for migraine headaches in traditional Chinese medicine. This well-designed study provides evidence that adding ginger to a standard nonsteroidal anti-inflammatory medication improves outcomes of migraine treatment by all measured parameters.
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Proceedings From the International Stroke Conference, Honolulu, February 2019
The following reviews of studies presented at the 2019 International Stroke Conference were written after my personal attendance at the presentations, followed by review of the simultaneous publications in The New England Journal of Medicine and The Lancet. All comments and opinions are solely those of this editor. — Matthew E. Fink, MD
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Thinking Outside of the ‘Alpha-Synuclein Box’: A Critical Role of Tau in Lewy Body Disorders
Neocortical tau pathology was associated with worse antemortem cognition in this large study of Parkinson’s disease dementia and dementia with Lewy bodies. Regional brain variations correlated with specific cognitive domains.
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Predicting the Risk of Mild Cognitive Impairment Using Imaging Biomarkers
In this population-based study, researchers used imaging biomarkers of amyloid and neuronal injury to estimate an absolute risk of mild cognitive impairment in the elderly.
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Amyloid-ß Pathology Induced by Contaminated Cadaver-Derived Growth Hormone
Cadaveric pituitary-derived growth hormone that previously was known to transmit Creutzfeldt-Jakob disease (CJD) also contains ß-amyloid. Growth hormone vials from cases associated with amyloid plaques in CJD patients cause amyloid plaque formation and cerebral amyloid angiopathy when injected intracranially into mice.
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Rituximab for CIDP Associated With Systemic Immune Disorders
Rituximab has been used “off label” for the treatment of primary chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with variable reports of success. These authors reported a high rate of response in patients who developed CIDP in the setting of other systemic immune-mediated disorders.
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Continuous EEG Monitoring in Critically Ill Patients Is Associated With Reduced Hospital Mortality
In this retrospective cross-sectional study involving more than 7 million critically ill adult patients from the National Inpatient Sample database, researchers showed that the use of continuous electroencephalography is associated with lower in-hospital mortality.
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Clinical Outcomes After Oral Anticoagulant-Associated Intracerebral Hematoma
In this meta-analysis of multiple observational studies, clinical outcomes after oral anticoagulant-associated intracerebral hematoma were similar for those associated with vitamin K antagonists or the new class of direct oral anticoagulants.