Abstract:
PURPOSE OF REVIEW:Stroke thrombolysis is in the process of moving from academic centers into community-based standard therapy in experienced centers. Recently published data on patient selection, imaging and other technical or organizational advances are reviewed in order to improve the safety and efficacy of stroke thrombolysis and identify areas in which more study is needed. RECENT FINDINGS:During the past year, several open series were published on the application of thrombolysis in community-based settings, which have mostly reproduced the outcome described in randomized, placebo-controlled recombinant tissue plasminogen activator cohorts. New information has been produced to identify the clinical parameters that are associated with good and adverse outcomes after stroke thrombolysis. Elevated blood glucose decreases the likelihood of a good outcome and increases that of cerebral hemorrhagic change, but the effect of early glucose reduction needs to be investigated. Non-contrast computed tomography still prevails as the standard imaging method in patient selection, but computed tomography angiography can be added within a reasonable time to furnish vascular diagnosis. Perfusion-weighted imaging is used to quantify the fraction of brain tissue salvaged by intravenous thrombolysis, and may be used in the future to select patients with still viable penumbral brain tissue, even beyond a 3-h time-window, if efficacy can be proved. SUMMARY:Thrombolysis with recombinant tissue plasminogen activator is well tolerated and effective within 3 h of symptoms, and new trials will determine if extension of this time-window or new target populations for thrombolysis, such as children with stroke, can be substantiated. An unfinished task remains in the education of health personnel; imperatives stemming from pathophysiology need to penetrate attitudes on acute stroke at all levels before acute therapies such as thrombolysis can have an impact on stroke outcome in general.
journal_name
Curr Opin Neuroljournal_title
Current opinion in neurologyauthors
Lindsberg PJ,Kaste Mdoi
10.1097/01.wco.0000053584.70044.65subject
Has Abstractpub_date
2003-02-01 00:00:00pages
73-80issue
1eissn
1350-7540issn
1473-6551journal_volume
16pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:This review summarizes the recent studies assessing patients with psychogenic nonepileptic seizures and developments in treatment. RECENT FINDINGS:The misdiagnosis of nonepileptic seizure is costly to patients, the healthcare system, and to society. Patients with nonepileptic seizures are prescribed ...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e3282f7008f
更新日期:2008-04-01 00:00:00
abstract:PURPOSE OF REVIEW:To describe the most important issues a clinician must consider whenever selecting and administering antiepileptic drugs (AEDs). There is no available algorithm that identifies how to individualize selection of AEDs. Proper selection and administration can make an enormous difference in both effective...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000532
更新日期:2018-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Medulloblastoma is no more a unique disease. Clinical and biologic classification used so far are challenged by molecular classification(s). Following the consensus article that described four molecular groups of medulloblastoma in 2012, several articles in 2017 provided more relevant classifications ...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000626
更新日期:2018-12-01 00:00:00
abstract:PURPOSE OF REVIEW:This review describe the role and advancements of MRI in the diagnosis and monitoring of progressive multifocal leukoencephalopathy (PML) in multiple sclerosis patients treated with natalizumab. RECENT FINDINGS:MRI is the most sensitive paraclinical tool in the detection of PML lesions in natalizumab...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000099
更新日期:2014-06-01 00:00:00
abstract:PURPOSE OF REVIEW:With the aging of the population, treatment of painful neuropathies is becoming more and more important for neurological practice. This short review highlights recent findings and current problems. RECENT FINDINGS:In addition to tricyclic antidepressants and gabapentin, the reliability of which is es...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e328285dfd6
更新日期:2007-10-01 00:00:00
abstract:PURPOSE OF REVIEW:To describe the path of technological developments that have led to the actual application of MRI-guided focused ultrasound in multiple neurological disorders and to update the more recent technical advances in the field. An insight into the latest clinical achievements in movement disorders will be p...
journal_title:Current opinion in neurology
pub_type: 杂志文章
doi:10.1097/WCO.0000000000000840
更新日期:2020-08-01 00:00:00
abstract:PURPOSE OF REVIEW:To summarize the currently known side effects of the approved therapies of multiple sclerosis and to suggest monitoring procedures. RECENT FINDINGS:The progress in the treatment of multiple sclerosis with new very effective therapies is accompanied by a number of side effects. Some of these have alre...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000824
更新日期:2020-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Recent terminations of clinical trials of myostatin inhibitors in muscular dystrophy have raised questions about the predictiveness of mouse models for this therapeutic strategy. RECENT FINDINGS:A variety of myostatin inhibitors have been developed for preclinical and clinical studies. These inhibito...
journal_title:Current opinion in neurology
pub_type: 杂志文章
doi:10.1097/WCO.0000000000000853
更新日期:2020-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Treatment response of brain tumours is typically evaluated with gadolinium-enhanced MRI using the Macdonald criteria. These criteria depend on changes in the area of enhancement. However, gadolinium enhancement of brain tumours primarily reflects impairment of the blood-brain barrier. RECENT FINDINGS...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e328332363e
更新日期:2009-12-01 00:00:00
abstract:PURPOSE OF REVIEW:To give an overview of recent data on the use of skin biopsy as a diagnostic tool in neuropathies. RECENT FINDINGS:The sensitivity and specificity of skin biopsy in detecting small fiber neuropathy is supported by new data. In many patients with small fiber neuropathy, a treatable disorder can be ide...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e328309000c
更新日期:2008-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The last two decades have witnessed a growing concern over the treatment of epilepsy in women of childbearing age, with an increased risk of major congenital malformations and possible cognitive difficulties associated with certain antiepileptic drugs. The aim here is to review the literature regardin...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e3283292401
更新日期:2009-04-01 00:00:00
abstract::This paper reviews current knowledge about epileptogenesis in the developing brain. Animal studies indicate that the maturational balance of excitatory and inhibitory neurotransmitter systems should result in an increased susceptibility to seizures. However, the reason for specific age-locked syndromes and the high ra...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-199804000-00006
更新日期:1998-04-01 00:00:00
abstract:PURPOSE OF REVIEW:To summarize the application of advanced MRI sequences such as magnetic resonance spectroscopy, diffusion tensor imaging and functional MRI for the evaluation of patients with altered consciousness. RECENT FINDINGS:Magnetic resonance spectroscopy, volumetry and diffusion tensor imaging have shown pro...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e3282f169ec
更新日期:2007-12-01 00:00:00
abstract::Slowly, advances are being made in the understanding and treatment of primary childhood brain tumors. The addition of chemotherapy has resulted in better survival for children with medulloblastoma. For other tumor types, therapeutic advances have been slower. High-dose chemotherapy is increasingly being employed to tr...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-199712000-00005
更新日期:1997-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Cerebral amyloid angiopathy (CAA) is diagnosed primarily as a cause of lobar intracerebral hemorrhages (ICH) in elderly patients. With improving MRI techniques, however, the role of CAA in causing other symptoms has become clear. Recognizing the full clinical spectrum of CAA is important for diagnosis...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000510
更新日期:2018-02-01 00:00:00
abstract::This paper reviews clinical reports of various movement disorders (dystonia, chorea, ballism and parkinsonism) caused by well defined lesions of the putamen, globus pallidus, substantia nigra, thalamus and subthalamus. The role of basal ganglia in motor control is also emphasized. ...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:
更新日期:1995-08-01 00:00:00
abstract:PURPOSE OF REVIEW:This review provides an update on our knowledge regarding prevention and management of medication overuse headache (MOH). RECENT FINDINGS:The prevalence of MOH is 1-2% in the general population worldwide, and because of the tremendous socio-economic cost, it is likely to be the most costly neurologic...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e328352c431
更新日期:2012-06-01 00:00:00
abstract:PURPOSE OF REVIEW:This article will review the recent experience with West Nile virus encephalitis and myelitis. RECENT FINDINGS:In the summer of 2003, the majority of cases of West Nile virus infection in the United States were reported from the western states. The transmission of West Nile virus through blood transf...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-200406000-00016
更新日期:2004-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Patients with asymptomatic carotid stenosis are at increased vascular risk but optimal treatment is controversial. We reviewed the current evidence for medical and surgical intervention in these patients. RECENT FINDINGS:Optimal medical treatment is the most important aspect of management of patients...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e328012da60
更新日期:2007-02-01 00:00:00
abstract:PURPOSE OF REVIEW:This review focuses on recent advances in the diagnostic approaches and the underlying pathophysiological mechanisms of Charcot-Marie-Tooth (CMT) disease. We also discuss the emerging therapies for this hereditary neuropathy. RECENT FINDINGS:To date, numerous genes are implicated in CMT, and new gene...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e328364c04b
更新日期:2013-10-01 00:00:00
abstract:PURPOSE OF REVIEW:This review draws together the most recent findings in ALS biomarker research from biochemical, imaging and neurophysiology techniques. RECENT FINDINGS:The potential of circulating RNA is highlighted, including new retrieval techniques. With ongoing genetic clinical trials, the need for pharmacodynam...
journal_title:Current opinion in neurology
pub_type: 杂志文章
doi:10.1097/WCO.0000000000000854
更新日期:2020-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The diagnosis of dementia rests on an improved knowledge and a better detection of early impairments, to which functional imaging can certainly contribute. RECENT FINDINGS:Progress has been observed at different levels. First, the understanding of different dementias has benefited from explorations o...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-200208000-00006
更新日期:2002-08-01 00:00:00
abstract:PURPOSE OF REVIEW:The concept of epilepsy and seizure disorders caused by autoantibodies to specific neuronal membrane proteins has developed significantly during the past few years. RECENT FINDINGS:Antibodies to cell-surface membrane proteins such as voltage-gated potassium channels or N-methyl-D-aspartate receptors,...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e32833735fe
更新日期:2010-04-01 00:00:00
abstract:PURPOSE OF REVIEW:This review discusses current data on nosological boundaries related to diagnosis, pathophysiology and therapeutic strategies in chronic tension-type headache (CTTH). RECENT FINDINGS:Diagnostic criteria of CTTH should be adapted to improve its sensitivity against migraine. It seems that mechanical pa...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e32832973ce
更新日期:2009-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Research on multiple sclerosis (MS) pathogenesis and therapy is to a large extent driven by results obtained in experimental autoimmune encephalomyelitis (EAE). This approach provided deep insights into the mechanism of brain inflammation and immune mediated tissue injury and, thus, most of our curren...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000685
更新日期:2019-06-01 00:00:00
abstract:PURPOSE OF REVIEW:The computational power of the brain arises from the complex interactions between neurons. One straightforward method to quantify the strength of neuronal interactions is by measuring correlation and coherence. Efforts to measure correlation have been advancing rapidly of late, spurred by the developm...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000512
更新日期:2018-02-01 00:00:00
abstract::Nuclear magnetic resonance methods as a whole have contributed as much to the study and treatment of epilepsy as to any branch of medicine. The pace of the progress in this field increases as recently developed nuclear magnetic resonance techniques mature into practical tools for epilepsy research and management. Rece...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-199704000-00005
更新日期:1997-04-01 00:00:00
abstract:PURPOSE OF REVIEW:The trigeminal autonomic reflex is a physiological reflex with an important protective function which also plays a role in pathophysiological conditions, such as primary headache. It is not understood whether the autonomic symptoms in trigeminal autonomic cephalalgias and migraine are the consequence ...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000691
更新日期:2019-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Precise localization of the epileptogenic zone is imperative for the success of resective surgery of drug-resistant epileptic patients. To decrease the number of surgical failures, clinical research has been focusing on finding new biomarkers. For the past decades, high-frequency oscillations (HFOs, 8...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000663
更新日期:2019-04-01 00:00:00
abstract:PURPOSE OF REVIEW:The funduscopic examination can be a technically difficult, and often omitted, portion of the neurologic examination, despite its great potential to influence patient care. RECENT FINDINGS:Medical practitioners are often first taught to examine the ocular fundus using a direct ophthalmoscope, however...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000637
更新日期:2019-02-01 00:00:00