Articles related to CEREBRAL CONCERNS
Clinical Challenge: Headache With Transient Drooling
Navigate the complex world of diagnosing Chiari malformation in this insightful review of a clinical case. To understand Chiari malformation, let’s explore a clinical case. A mid-30s patient with a migraine history came to the ED with a sudden posterior headache. Accompanied by transient total body numbness, loss of coordination, and an inability to swallow with drooling, these symptoms started abruptly after violent sneezing. Although neurological symptoms faded after 20 seconds, the headache persisted. Regarding vital signs and physical examination, everything was normal. The patient had a head CT ordered. Interpreting the clinical picture and CT images with care is crucial in these cases. Even though a sudden onset headache could signify a ruptured berry aneurysm, no blood was detected on the CT cuts, minimizing that concern. Remember, an LP is seldom recommended if the CT is performed within 6 hours and hemoglobin exceeds 10 g/dL. However, the clinical presentation in this case, characterized by headache and drooling, didn’t match a typical migraine. Be mindful that many patients might loosely use the term “migraine” for any severe headache. The CT cut revealed a brainstem compressed by the cerebellum, indicative of a Chiari malformation type 1. Chiari malformation, characterized by an […]
Emergency Medicine May 24th 2023
Time for Brain Medicine
Delve into the fascinating world of an integrated approach to brain medicine that amalgamates neurology and psychiatry, ushering a new era in patient care. Our understanding of the brain is constantly expanding. This unprecedented knowledge blurs the boundaries between neurology and psychiatry. However, an issue arises: current clinical training maintains a dichotomy stemming from 19th-century practices. This divergence is creating a shift. Neurologists, traditionally untrained in psychiatric management, find themselves treating more psychiatric patients. Likewise, new neuroscience-based precision treatments and diagnostic biomarkers demand skills beyond the psychiatric training purview. This status quo poses a significant challenge to training future doctors. We need to focus on establishing competence in whole-brain aspects and fostering subspecialized expertise. Additionally, implementing feasible and practical programs is paramount. In response, this article proposes a novel 4-year residency program. The first two years concentrate on common and urgent neurology and psychiatry aspects, followed by two years of elective subspecialty tracks. This concept mirrors internal medicine residencies and fellowships, without necessitating changes to existing departmental structures. The article further introduces ‘brain medicine’ as a fitting term for this unified practice. The name emphasizes a holistic focus on all brain aspects. Conventionally, the division between neurology and psychiatry relates […]
Neurology May 23rd 2023
Study Links Nutrients, Brain Structure, Cognition in Healthy Aging
Adding to the evidence that good nutrition supports healthy aging, this study shows that blood levels of certain saturated fatty acids, along with omega-6, -7 and -9 fatty acids, correlated with improved memory as well as larger frontal, temporal, parietal lobes.
Endocrinology, Diabetes, Metabolism May 9th 2023
Intravenous Thrombolysis in Patients with Ischemic Stroke and Recent Ingestion of Direct Oral Anticoagulants
The risk of symptomatic intracranial hemorrhage was lower among the 832 patients receiving direct oral anticoagulant treatment in this cohort study involving 33,207 patients with ischemic stroke who received intravenous thrombolysis at 64 centers in Europe, Asia, Australia, and New Zealand when compared to controls who received no anticoagulation. This outcome held true across subgroups and various selection methodologies.
Cardiology January 18th 2023
Autopsies Show COVID-19 in the Brain
This meticulous study shows that SARS-CoV-2 infection is systemic and involves many organ systems, including the brain. But are the findings relevant to today’s public? None of the patients had been vaccinated and all were older with significant comorbidities.
Internal Medicine January 4th 2023