Neurology

Cerebral adrenoleukodystrophy (cALD), the most severe clinical phenotype of X-linked adrenoleukodystrophy (X-ALD), is characterized by rapidly progressive, inflammatory destruction of the cerebral white matter. In adult patients, therapeutic options are limited to hematopoietic stem cell transplantation, which carries substantial treatment-related risks, necessitating careful and individualized c…

There is ongoing clinical equipoise regarding the optimal treatment strategy for symptomatic cerebral cavernous malformations (CCMs). The aim of this study was to estimate the causal effect between CCM intervention (microsurgical resection or stereotactic radiosurgery) and clinical outcomes during long-term follow-up.

Background and ObjectivesAlthough evidence suggests that the neurophysiologic impact of estrogen decline during menopause may contribute to increased risk of Alzheimer disease (AD) in women, the effect of menopausal hormonal therapy (MHT) on AD risk requires further study. We sought to examine the associations between MHT use and neuropathologic, clinical, and imaging/fluid biomarker outcomes. Me…

Patients with temporal lobe epilepsy (TLE) can achieve seizure freedom in the early period after surgery, yet up to half experience seizure recurrence in the following years (i.e., long-term). TLE is associated with disruption of highly connected brain regions (hubs), which may reduce the likelihood of long-term surgical success. We tested whether disruption of physiologic (normative) hubs predic…

Background and ObjectivesCurrent recommended blood pressure (BP) targets during mechanical thrombectomy (MT) rely on a one-size-fits-all approach aiming at preventing hypertension. The efficacy and safety of an individualized BP control during thrombectomy for ischemic stroke has not been well studied. We aimed to evaluate whether an individualized BP control during MT could improve functional ou…

Mechanical thrombectomy (MT) has revolutionized the treatment of acute ischemic stroke because of large vessel occlusion (LVO), but distal and medium vessel occlusions (DMVOs) remain a gray zone. DMVOs account for a substantial proportion of ischemic strokes and can cause long-term disability or death despite often presenting with only mild to moderate symptoms. Their biologic and anatomic divers…

BACKGROUND AND OBJECTIVES: Antibody testing has a pivotal role in the diagnosis of myasthenia gravis (MG). However, there are limited data on the accuracy of the different methods available for acetylcholine receptor (AChR) and muscle-specific kinase (MuSK) autoantibody (Ab) detection in a real-world setting. Our aim was to compare the diagnostic accuracy of in-house live cell-based assay (L-CBA)…

BACKGROUND AND OBJECTIVES: Despite successful recanalization after mechanical thrombectomy for acute ischemic stroke, a substantial proportion of patients experience early neurologic deterioration or infarct progression. Early blood-brain barrier disruption, visualized on post-contrast fluid-attenuated inversion recovery (pcFLAIR) imaging as hyperintense acute reperfusion marker (HARM) or gadolin…

BACKGROUND AND OBJECTIVES: Early dementia risk-stratification is crucial for timely intervention. Brain-predicted age difference (brain-PAD) derived from structural MRI reflects the gap between computer-estimated age and chronological age and has been linked to clinical progression to dementia. We evaluate whether brain-PAD has prognostic value for progression to dementia in subjective cognitive …

Trigeminal neuralgia (TN) is an uncommon disorder, with an annual prevalence of 0.03%-0.3% in North America. It is typically unilateral, most commonly involving the V2 and V3 distributions and may be accompanied by mild autonomic features. We report a 35-year-old woman who developed severe right more than left-sided facial pain in the V1 and V2 divisions (upper and midface), occurring up to 100 t…

A 79-year-old man with metastatic Merkel cell carcinoma undergoing cancer-directed treatment was admitted to the hospital with 1 week of bilateral upper and lower extremity tremor and nearly continuous involuntary facial movements. These abnormal movements of his face, head, and limbs were exacerbated by purposeful movement. Examination revealed dysarthria with tremulous speech, intention tremors…

OBJECTIVES: Acute treatment for myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) includes high-dose IV methylprednisolone (IVMP), with escalation to IV immunoglobulin (IVIG) and/or plasma exchange (PLEX) based on severity or incomplete response. We evaluated whether escalation at first attack influences disease course. METHODS: We conducted a retrospective single-center stu…

BACKGROUND AND OBJECTIVES: Readmission after chronic or subacute subdural hematoma (cSDH/sSDH) hospitalization is common, yet clinical attention and trial design have focused primarily on surgical recurrence. The full spectrum of readmission events, their clinical impact, and the heterogeneity of the affected patient population remain poorly understood. This study seeks to characterize the incide…