关键词： SARS-CoV-2   COVID-19   Neurology   Neurosurgery   Brain  

摘要： Coronavirus disease 2019 (COVID-19) is a devastating respiratory illness that has dramatically changed the medical landscape around the world. In parallel with a rise in the number of cases globally, the COVID-19 literature has rapidly expanded with experts around the world disseminating knowledge and collaborating on best practices. To date, the literature has predominantly consisted of case reports, case series, and systemic protocols for dealing with this deadly disease from a plethora of specialties with larger observational and randomized studies only now starting to emerge. This scoping review of MEDLINE, EMBASE, SCOPUS, and the Cochrane Library aims to evaluate and summarize the current status of the COVID-19 literature at it applies to neurology and neurosurgery. Neurological symptomatology, neurological risk factors for poor prognosis, pathophysiology for neuroinvasion, and actions taken by neurological or neurosurgical services to manage the current COVID-19 crisis are reviewed.

关键词： family history of diabetes mellitus   neurological disorders   obesity   offspring  

摘要： AimThe aim of the present study was to determine whether being born to non-diabetic mother with a family history of diabetes mellitus (DM) is associated with higher rates of long-term neurological hospitalisations of the offspring. MethodsA retrospective analysis of all live births and paediatric hospitalisations at Soroka University Medical Center between 1991 and 2014 was performed. Family history of DM was collected from prepartum women using anamnesis. During the study period, 208 728 deliveries met the inclusion criteria, and of them 8.2% (n = 17 040) were of non-diabetic mothers with family history of DM. Rates of neurological hospitalisation with or without family history were analysed. ResultsOffspring born to non-diabetic mothers with family history of DM had higher rates of neurological hospitalisations. The cumulative incidence of long-term neurological hospitalisations was higher as compared with those without family history of DM (log-rank test P = .007). Neurological hospitalisations was higher by 13% in the study group, after controlling for confounders such as maternal age, maternal obesity, hypertensive disorders, birth weight and caesarean delivery. (adjusted odds ratio 1.13, 95% confidence interval 1.04-1.23). ConclusionBeing born to a non-diabetic mother with a family history of DM is independently associated with higher long-term neurological hospitalisations of the offspring.

关键词： Brain donation   Neurodegeneration   Neurological disorders   Patient survey  

摘要： Brain donations are imperative for research;understanding possible barriers to entry is required to improve brain donation rates. While a few surveys have studied attitudes towards brain banking in patients with neurodegenerative disorders, none have surveyed patients with chronic neurological disorders but without neurodegeneration. This cross-sectional study was conducted on 187 participants, with both neurodegenerative (n = 122) and non-neurodegenerative disorders (n = 65), to compare their attitudes and preferences towards brain donation. Encouragingly, patients with non-neurodegenerative disorders were just as likely to consider brain donation as those with neurodegenerative diseases. Approximately half of each group were willing to consider brain donation, and majority of participants across both groups would not be offended if asked to participate in brain donation (71%). Across both groups, altruistic reasons such as desire to advance medical knowledge and benefit to other patients were the main motivating factors for brain donation, while perceived stress for family members, fears of body disfigurement and religious reasons were the main reasons against brain donation. Of note, nearly two-thirds of all participants were agreeable to allow their family to decide on their behalf. Overall, participants with non-neurodegenerative disorders appeared equally likely to consider brain donation as participants with neurodegenerative disorders. This is an important finding as they represent a significant population seen in specialist neurology clinics who may be overlooked in brain donor recruitment and awareness efforts. Healthcare professionals involved in brain banking should consider actively approaching these potential donors and involving their family members in these discussions.

关键词： Influenza-associated encephalopathy   Influenza B   Influenza neurological complications  

摘要： Background Neurological complications associated with influenza (NCI) are rare events in adults with seasonal influenza. Information about the characteristics of neurological complications and the burden of disease has been limited to case reports, mainly during the pandemic 2009. Influenza-associated encephalopathy/encephalitis (IAE) is one of the most severe and frequently reported NCI, mostly caused by influenza A. Isolated case reports exist about NCI caused by influenza *** The aim of this single center retrospective study is the better understanding of the frequency and the characteristics of NCI in adults in season 2017-2018, depending on the influenza subtype A or *** design We reviewed 874 adult patients with laboratory confirmed influenza admitted to the Christian Doppler University Hospital Salzburg, Austria from December 2017 until March 2018 looking for *** 37 (4 %) of the 874 patients with confirmed influenza had NCI. 4 (11 %) had influenza A and 33 (89 %) had influenza B. IAE was the most frequent complication diagnosed in 24 (65 %) patients, of whom all but one had influenza B and 3 (13 %) had neurological residuals. Moreover 6 (16 %) had isolated epileptic seizures, 2 (5 %) had acute inflammatory demyelinating polyneuropathy (AIDP), and 5 (14 %) were classified as having infection-associated *** We report an incidence of 4 % for NCI and a high frequency of IAE caused by subtype B. Therefore, we recommend considering both influenza A and B as an etiologic factor of encephalopathy and other neurological disease in adults.

关键词： MRI   hyperpolarization   neurology   neuro-oncology   metabolism  

摘要： Cerebral metabolism is tightly regulated and fundamental for healthy neurological function. There is increasing evidence that alterations in this metabolism may be a precursor and early biomarker of later stage disease processes. Proton magnetic resonance spectroscopy (H-1-MRS) is a powerful tool to non-invasively assess tissue metabolites and has many applications for studying the normal and diseased brain. However, the technique has limitations including low spatial and temporal resolution, difficulties in discriminating overlapping peaks, and challenges in assessing metabolic flux rather than steady-state concentrations. Hyperpolarized carbon-13 magnetic resonance imaging is an emerging clinical technique that may overcome some of these spatial and temporal limitations, providing novel insights into neurometabolism in both health and in pathological processes such as glioma, stroke and multiple sclerosis. This review will explore the growing body of pre-clinical data that demonstrates a potential role for the technique in assessing metabolism in the central nervous system. There are now a number of clinical studies being undertaken in this area and this review will present the emerging clinical data as well as the potential future applications of hyperpolarized C-13 magnetic resonance imaging in the brain, in both clinical and pre-clinical studies.

关键词： Carbon monoxide poisoning   delayed neurologic syndrome   delayed neurologic sequelae   hyperbaric oxygen therapy  

摘要： Severe carbon monoxide (CO) poisoning causes fulminant deaths in common environment as well as neurological sequelae to survivors. Prevention of delayed neurological syndrome (DNS) after exposure to CO, the most important sequela, is based up to date on hyperbaric oxygen administration. Nevertheless, its use remains controversial due to the lack of evidence regarding its efficacy. The aim of this review is to report therapies under investigation for preventing or improving DNS, some of them with promising results in humans.

关键词： Long-term neurological status   Cerebral performance category   Neurological status   Functional outcome   Out of hospital cardiac arrest  

摘要： Introduction: Neurological status following out-of-hospital cardiac arrest is commonly assessed using measures such as the Cerebral Performance Category (CPC) at hospital discharge. However, it remains unclear if these measures accurately reflect long-term neurological status after discharge. The objective of this systematic review was to determine the association between post-arrest neurological outcome scores at hospital discharge and long-term (>6 months) neurological outcome scores. Methods: Comprehensive database searches of Medline, Embase, and the Cochrane library databases from inception to August 2019 were conducted and reference lists were hand-searched. Randomized controlled trials (RCT) and prospective observational studies were included. Results: After screening 7844 titles and abstracts independently and in duplicate, we included 7 studies with a total of 602 patients from 6 prospective observational studies and 1 RCT. Four studies reported long-term follow-up at 6 months post-arrest and three studies reported follow-up at 1 year. In the studies with 6-month follow-up, 368 patients (82.7%) had favorable short-term neurological scores (CPC 1-2) at discharge or 30 days post-arrest, and 352 patients (79.1%) had favorable scores at 6 months post-arrest. In the studies with 1-year follow-up, 101 patients (64.3%) had favorable neurological scores at discharge or 30 days post-arrest, and 91 patients (59.5%) patients had favorable neurological scores at 1 year. Conclusions: Long-term neurological outcome scores following OHCA were consistent with short-term outcome at hospital discharge or 30 days post-arrest. All included studies measured neurological outcome using CPC, further studies are needed using other standards to better elucidate patient-centered long-term neurological outcome.

关键词： Stroke   Calycosin   Brain-derived neurotrophic factor   Microglia   Neuronal death  

摘要： Both brain-derived neurotrophic factor (BDNF) and microglia activation are involved in the pathogenesis of ischemic stroke. Herein, we attempt to ascertain whether Calycosin, an isoflavonoid, protects against ischemic stroke by modulating the endogenous production of BDNF and/or the microglia activation. This study was a prospective, randomized, blinded and placebo-controlled preclinical experiment. Sprague-Dawley adult rats, subjected to transient focal cerebral ischemia by middle cerebral artery occlusion (MCAO), were treated randomly with 0 (corn oil and/or saline as placebo), 30 mg/kg of Calycosin and/or 1 mg/kg of a tropomyosin-related kinase B (TrkB) receptor antagonist (ANA12) at 1 h after reperfusion and once daily for a total of 7 consecutive days. BDNF and its functional receptor, full-length TrkB (TrkB-FL) levels, the percentage of hypertrophic microglia, tumor necrosis factor-alpha (TNF-alpha)-containing microglia, and degenerative and apoptotic neurons in ischemic brain regions were determined 7 days after cerebral ischemia. A battery of functional sensorimotor test was performed over 7 days. Post-stroke Calycosin therapy increased the cerebral expression of BDNF/TrkB, ameliorated the neurological injury and switched the microglia from the activated amoeboid state to the resting ramified state in ischemic stroke rats. However, the beneficial effects of BDNF/ TrkB-mediated Calycosin could be reversed by ANA12. Our data indicate that BDNF/TrkB-mediated Calycosin ameliorates rat ischemic stroke injury by switching the microglia from the activated amoeboid state to the resting ramified state. Graphical abstract