neurological emergencies
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Author(s):  
Kelly L. Sloane ◽  
Julie J. Miller ◽  
Amanda Piquet ◽  
Brian L. Edlow ◽  
Eric S. Rosenthal ◽  
...  

Author(s):  
Tatsuya Yoshihara ◽  
Masayoshi Zaitsu ◽  
Kazuya Ito ◽  
Ryuzo Hanada ◽  
Eunhee Chung ◽  
...  

The concentration of cerebrospinal fluid total protein (CSF-TP) is important for the diagnosis of neurological emergencies. Recently, some Western studies have shown that the current upper reference limit of CSF-TP is quite low for older patients. However, little is reported about the concentration of CSF-TP in the older Asian population. In this study, we retrospectively analyzed the CSF-TP concentrations in healthy older Japanese volunteers. CSF samples in 69 healthy Japanese volunteers (age range: 55–73 years) were collected by lumbar puncture, and the data of CSF were retrospectively analyzed. The mean (standard deviation) CSF-TP was 41.7 (12.3) mg/dL. The older group (≥65 years old) had higher CSF-TP concentration than the younger group (55–64 years old). The 2.5th percentile and 97.5th percentile of CSF-TP were estimated as 22.5 and 73.2 mg/dL, respectively, which were higher than the current reference range in Japan (10–40 mg/dL). Conclusions: The reference interval of CSF-TP in the older population should be reconsidered for the precise diagnosis of neurological emergencies.


2021 ◽  
Author(s):  
Mario Mastrangelo ◽  
Valentina Baglioni

AbstractNeurological emergencies account for about one-third of the highest severity codes attributed in emergency pediatric departments. About 75% of children with acute neurological symptoms presents with seizures, headache, or other paroxysmal events. Life-threatening conditions involve a minor proportion of patients (e.g., less than 15% of children with headache and less than 5% of children with febrile seizures). This review highlights updated insights about clinical features, diagnostic workup, and therapeutic management of pediatric neurological emergencies. Particularly, details will be provided about the most recent insights about headache, febrile seizures, status epilepticus, altered levels of consciousness, acute motor impairment, acute movement disorders, and functional disorders, as well as the role of diagnostic tools (e.g., neuroimaging, lumbar puncture, and electroencephalography), in the emergency setting. Moreover, the impact of the current novel coronavirus disease2019 (COVID-19) pandemic on the evaluation of pediatric neurologic emergencies will also be analyzed.


2021 ◽  
Vol 39 (2) ◽  
pp. 649-670
Author(s):  
Elizabeth Macri ◽  
Diana Greene-Chandos

2021 ◽  
Vol 32 ◽  
pp. 80-85
Author(s):  
Giacomo Garone ◽  
Valentina Ferro ◽  
Marta Barbato ◽  
Nicola Vanacore ◽  
Laura Papini ◽  
...  

2021 ◽  
Author(s):  
Anil Ramineni ◽  
Erik A. Roberts ◽  
Molly Vora ◽  
Sohail K. Mahboobi ◽  
Ala Nozari

Author(s):  
Nikita Dhar ◽  
Govind Madhaw ◽  
Mritunjai Kumar ◽  
Niraj Kumar ◽  
Ashutosh Tiwari ◽  
...  

Abstract Objective This study assesses the impact of coronavirus disease 2019 (COVID-19) on the pattern of neurological emergencies reaching a tertiary care center. Materials and Methods This is a retrospective and single center study involving 295 patients with neurological emergencies mainly including acute stroke, status epilepticus (SE), and tubercular meningitis visiting emergency department (ED) from January 1 to April 30, 2020 and divided into pre- and during lockdown, the latter starting from March 25 onward. The primary outcome was number of neurological emergencies visiting ED per week in both periods. Secondary outcomes included disease severity at admission, need for mechanical ventilation (MV), delay in hospitalization, in-hospital mortality, and reasons for poor compliance to ongoing treatment multivariate binary logistic regression was used to find independent predictors of in-hospital mortality which included variables with p <0.1 on univariate analysis. Structural break in the time series analysis was done by using Chow test. Results There was 53.8% reduction in number of neurological emergencies visiting ED during lockdown (22.1 visits vs. 10.2 visits per week, p = 0.001), significantly affecting rural population (p = 0.004). Presenting patients had comparatively severe illness with increased requirement of MV (p < 0.001) and significant delay in hospitalization during lockdown (p < 0.001). Poor compliance to ongoing therapy increased from 34.4% in pre-lockdown to 64.7% patients during lockdown (p < 0.001), mostly due to nonavailability of drugs (p < 0.001). Overall, 35 deaths were recorded, with 20 (8.2%) in pre-lockdown and 15 (29.4%) during lockdown (p = 0.001). Lockdown, nonavailability of local health care, delay in hospitalization, severity at admission, and need for MV emerged as independent predictors of poor outcome in stroke and delay in hospitalization in SE. Conclusion COVID-19 pandemic and associated lockdown resulted in marked decline in non-COVID neurological emergencies reporting to ED, with more severe presentations and significant delay from onset of symptoms to hospitalization.


2021 ◽  
pp. 23-39
Author(s):  
Christian Ventura ◽  
Edward Denton ◽  
Emily Van Court

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