Diagnosis is difficult. No specific clinical feature, no blood or imaging study that can confirm the diagnosis. No established consensus on making the diagnosis. Common features Headache Encephalopathy cognitive changes seizure Tests MRI head abnormal 93% CSF abnormal 74% CTA or MRA: multiple stenotic lesion in multiple or a...

Apoaequorin is a protein that was originally discovered in the jellyfish species Aequorea victoria. When apoaequorin binds with calcium, a blue light is produced. This compound is being marketed as Prevagen as a supplement to improve memory. There has been some concern over false advertising claims being made by...

Multiple sclerosis (MS) is the most common demyelinating disease of the central nervous system. Symptoms are highly variable. A very brief summary is is follow. Types Clinically isolated syndrome Relapsing remitting MS Secondary progressive MS Primary progressive MS Features suggestive of MS Relapses and remissions Onset age 15-50 years...

HIV associated neurocognitive disorder HANDS Asymptomatic neurocognitive impairment Mild neurocognitive disorder HIV associated dementia Risk factors low CD4 count, high plasma viral levels older age duration of infection head injury Imaging MRI patch white matter changes CSF: elevated CSF protein, hiv levels Evaluate for other causes Especially those with...

ICH Bleed after given TPA Get CBC, PT, aPTT, fibrogen level Type and match Cryoprecipitate 10 units over 30 minutes Tranexamic acide 1 gram over 10 minutes or Aminocaproic acid 4 gram over 1 hour...

Daily new cases by state Daily new cases over the past 14 days States: number of new cases still rising everyday: South Carolina, South Dakota Most states are about the same or start dropping Infected per 1 million population by state In the next few months The virus is...

Patients with neurological problems frequently have to apply for social security disability and were turned down. It will be helpful for physicians to have some basic understanding of how disability is determined, so that the necessary information is documented on the medical record. Links to SSA Social security disability...

Bleeding into the space outside the brain under the dura. Acute SDH – caused by tear of bridging veins, rarely from small cortical arterial bleed Chronic SDH: form a hydroma Acute on chronic SDH: from rebleed Risk factors Older age alcohol abuse previous traumatic brain injury more often in...

This review will discuss the nontraumatic subarachnoid hemorrhage, which consisted of about 3% of all acute stroke. Cause: Cerebral aneurysm For discussion of unruptured aneurysm, click here. Clinical Sudden onset severe headache Neck stiffness May occur during activity or rest Hunt & Hess Scale Grade 1 – Asymptomatic, or...

Anticoagulation recommended for atrial fibrillation, atrial flutter MI with mural thrombus Mechanical cardiac valve PFO with evidence of deep vein thrombosis Hypercoagulable state, warfarin is indicated for Antiphospholipid syndrome Inherited thrombophilia Anticoagulation can be considered Dilated cardiomyopathy, EF < 35% Restrictive cardiomyopathy Acute STEMI without mural thrombus but with...