Category Archives: Neurology

Hypothermia not helpful in bacterial meningitis

This randomized trial found induced hypothermia was associated with higher mortality in patients with bacterial meningitis (compared to standard care) (abstract).

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MRI useful for new onset seizures

This cohort of patients with new onset seizures found epileptogenic foci in 28% of patients with true seizures (abstract).

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Delirium common and affects long-term cognition

In this cohort of ICU patients, 3/4 developed ICU delirium; at 3 months 40% had cognition scores 1.5 SD below the mean, and 25% were 2 SD below the mean. By 12 months, ~1/3 had scores similar to mild traumatic … Continue reading

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GO-FAR score predicts risk of bad outcome after in-hospital cardiac arrest

This large derivation and validation cohort of >50,000 in-hospital arrest patients found a 13-variable model was able to identify ~25% of patients whose outcomes were highly unlikely to be good (survival to discharge with good neurologic function); this can be … Continue reading

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Thrombolytics and stroke; the faster the better

This large prospective cohort found thrombolytics given within 90 minutes of stroke symptom onset had 1.5 times the odds of a 3-month Rankin score of 0 or 1, compared to longer times (abstract).

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Predicting delirium at admission

In this derivation and validation cohort, 4 factors independently predicted the risk of developing delirium: age>80, unable to spell “WORLD” backwards, disoriented to place, and higher nurse-rated illness severity. Rates of delirium for scores 0-4 were 2%, 4%, 14%, 20% … Continue reading

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Clopidogrel + ASA for minor stroke or TIA

In this large multicenter trial, patients with minor stroke or TIA were randomized to clopidogrel+ASA or ASA alone; 90-day stroke occurred in 8% vs 12% respectively, and rates of hemorrhage or hemorrhagic stroke were the same (abstract).

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Guidelines for peri-procedural use of antithrombotics in ischemic cerebrovascular disease

These guidelines provide an evidence based for the use of periprocedural antithrombotics in patients with cerebrovascular disease. They recommend continuing ASA-warfarin for dental procedures, and most other minor procedures. There is little evidence to support the use of procedural bridging … Continue reading

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Thrombolytics in stroke; the faster the better

A large analysis from a stroke registry found better outcomes with earlier thrombolytics for acute ischemic stroke; every 15 minutes earlier was associated with an odds ratio of 0.96 for in-hospital death or intracranial hemorrhage, and an odds ratio of … Continue reading

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Intensive BP lowering in ICH

This large trial of patients with acute intracranial hemorrhage randomized them to usual BP care (target SBP <180) or intensive BP care (target SBP <140). Outcomes did not differ between the groups (death or major disability at 90 days), and … Continue reading

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