Neurology
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Women Have a Higher Risk for Rupture of Intracranial Aneurysms than Men, Not Explained by Aneurysm Characteristics
It has been noted by clinicians that women have a higher risk of rupture of intracranial aneurysms than men, but in epidemiological studies this was not found to be an independent risk factor. These investigators undertook a review of several large, prospective studies and performed a meta-analysis to assess the characteristics that might be different between men and women to explain these observations.
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Men Are More Likely to Have High-Risk and Dangerous Carotid Artery Plaques than Women
Investigators in the Netherlands investigated the differences between atherosclerotic plaque burden and plaque morphology between men and women who had recent ischemic stroke symptoms and less than 70% ipsilateral carotid artery stenosis.
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Hypertensive Disorders of Pregnancy Are Associated with an Increased Risk of Ischemic and Hemorrhagic Stroke
It has been established that women who have hypertension during pregnancy from any cause, compared to those without a history of hypertension, have an increased risk for subsequent stroke. Investigators in this study from Taiwan looked at the differences between the four major types of hypertensive disorders and the relative risks of subsequent stroke in women.
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Women Who Experienced Miscarriage or Stillbirth Early in Life Have an Increased Risk of Stroke in Later Life
There have been limited studies looking at the effect of miscarriage and stillbirth, which could have an effect on endothelial function and chronic systemic inflammation, conditions that play a role in the long-term risk of stroke. These investigators performed a comprehensive literature search and meta-analysis that reviewed the records of women who experienced complications around pregnancy to determine the subsequent risk of stroke.
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Post-Surgical Seizure Outcomes in MRI-Positive Focal Cortical Dysplasia
This comprehensive meta-analysis of the surgical outcomes for drug-resistant epilepsy caused by focal cortical dysplasia demonstrated an excellent result with post-surgical freedom from seizures in 70% of patients followed for more than 24 months.
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Pyridoxine (B6) Toxicity in Chronic Idiopathic Axonal Polyneuropathy
In a careful prospective collection of features of chronic idiopathic axonal neuropathy, with retrospective ascertainment of vitamin B6 levels in the blood, the investigators reported there was no significant correlation between the severity of neuropathy symptoms and plasma B6 levels.
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Cerebral Amyloid Angiopathy and Transient Neurological Events: Can Intracerebral Hemorrhage Risk Be Predicted?
In this retrospective review and meta-analysis of reported cases of cerebral amyloid angiopathy (CAA), the investigators suggested that the risk of intracerebral hemorrhage can be quantified by the type of symptoms the patient presents with, but there remain many questions around the accuracy of diagnosis of CAA without pathological verification.
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How Fast Can You Recognize This Rhythm?
How might the reader interpret the two-lead rhythm strip shown in the figure? Is there AV block? If so, is this complete (i.e., third-degree) AV block?
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Daridorexant Tablets (Quviviq)
Daridorexant can be prescribed to adult patients with insomnia characterized by difficulty with sleep onset and/or sleep maintenance.
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Delaying Antibiotics in Patients with Suspected Infection Increases Risk of Septic Shock
A retrospective cohort study revealed delaying the first dose of antibiotics in patients suspected of presenting with an infection in the ED led to a higher risk of progressing to septic shock and in-hospital mortality. Every hour antibiotics were delayed raised the risk of septic shock by 4%.