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Siegler JE, Galetta S. Editors' note: Meta-analysis of magnetic resonance spectroscopy in the diagnosis of hepatic encephalopathy. Neurology 2020. [DOI: 10.1212/wnl.0000000000011039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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202
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Lewis A, Galetta S. Editors' note: MT in anticoagulated patients: Direct oral anticoagulants versus vitamin K antagonists. Neurology 2020. [DOI: 10.1212/wnl.0000000000010971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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203
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Lewis A, Galetta S. Editors' note: Undetermined stroke genesis and hidden cardiomyopathies determined by cardiac magnetic resonance. Neurology 2020. [DOI: 10.1212/wnl.0000000000010974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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204
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Ganesh A, Galetta S. Editors' note: Questionnaire-based diagnosis of benign paroxysmal positional vertigo. Neurology 2020. [DOI: 10.1212/wnl.0000000000010934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Siegler JE, Galetta S. Editors' note: Thrombolysis for acute ischemic stroke in the unwitnessed or extended therapeutic time window. Neurology 2020. [DOI: 10.1212/wnl.0000000000010870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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206
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Siegler JE, Galetta S. Editors' note: Cerebrospinal fluid dynamics disorders: Relationship to Alzheimer biomarkers and cognition. Neurology 2020. [DOI: 10.1212/wnl.0000000000010873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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207
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Lewis A, Galetta S. Editors' note: Telemedicine in neurology: Telemedicine Work Group of the American Academy of Neurology update. Neurology 2020. [DOI: 10.1212/wnl.0000000000010837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Ganesh A, Galetta S. Editors' note: Beware of deep water after subthalamic deep brain stimulation. Neurology 2020. [DOI: 10.1212/wnl.0000000000010795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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209
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Siegler JE, Galetta S. Editors' note: Migraine progression in subgroups of migraine based on comorbidities: Results of the CaMEO Study. Neurology 2020. [DOI: 10.1212/wnl.0000000000010718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Siegler JE, Galetta S. Editors' note: Readmission to a different hospital following acute stroke is associated with worse outcomes. Neurology 2020. [DOI: 10.1212/wnl.0000000000010711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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211
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Lewis A, Galetta S. Editors' note: Racial/ethnic disparities in the risk of intracerebral hemorrhage recurrence. Neurology 2020. [DOI: 10.1212/wnl.0000000000010667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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212
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Lewis A, Galetta S. Editors' note: Blood NfL: A biomarker for disease severity and progression in Parkinson disease. Neurology 2020. [DOI: 10.1212/wnl.0000000000010663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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213
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Ganesh A, Galetta S. Editors' note: Longitudinal optic neuritis-unrelated visual evoked potential changes in NMO spectrum disorders. Neurology 2020. [DOI: 10.1212/wnl.0000000000010626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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214
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Ganesh A, Galetta S. Editors' note: Motor speech patterns in Huntington disease. Neurology 2020. [DOI: 10.1212/wnl.0000000000010624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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215
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Siegler JE, Galetta S. Editors' note: The dimension of preventable stroke in a large representative patient cohort. Neurology 2020. [DOI: 10.1212/wnl.0000000000010589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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216
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Lewis A, Galetta S. Editors' note: Prospective validation of the PML risk biomarker l-selectin and influence of natalizumab extended intervals. Neurology 2020. [DOI: 10.1212/wnl.0000000000010510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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217
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Lewis A, Galetta S. Editors' note: Outcomes of patients with stroke treated with thrombolysis according to prestroke Rankin Scale scores. Neurology 2020. [DOI: 10.1212/wnl.0000000000010514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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218
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Ganesh A, Galetta S. Editors' note: Optimizing in-hospital triage for large vessel occlusion using a novel clinical scale (GAI 2AA). Neurology 2020. [DOI: 10.1212/wnl.0000000000010441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Siegler JE, Galetta S. Editors' note: Miller Fisher syndrome and polyneuritis cranialis in COVID-19. Neurology 2020; 95:408. [DOI: 10.1212/wnl.0000000000010401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Siegler JE, Galetta S. Editors' note: COVID-19 presenting with ophthalmoparesis from cranial nerve palsy. Neurology 2020; 95:410. [DOI: 10.1212/wnl.0000000000010407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Usmani S, Balcer L, Galetta S, Minen M. Feasibility of Smartphone-Delivered Progressive Muscle Relaxation in Persistent Post-Traumatic Headache Patients. J Neurotrauma 2020; 38:94-101. [PMID: 32484070 DOI: 10.1089/neu.2019.6601] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Persistent post-traumatic headache (PPTH) is often the most common injury after mild traumatic brain injury (mTBI), reported by 47-95% of patients. Progressive muscle relaxation (PMR) has level A evidence in preventing migraine and tension headaches. However, research on this behavioral therapy for PPTH, let alone smartphone delivered, is limited. We performed a single-arm study of prospective patients calling our Concussion Center between June 2017 and July 2018. Inclusion criteria were that subjects had to meet International Classification of Headache Disorders, 3rd Edition criteria for PPTH secondary to mTBI, have four or more headache days a month, be age 18-85 years and 3-12 months post-injury, own a smartphone, and not tried headache behavioral therapy within the year. We recorded baseline headache and neuropsychiatric data. Using the RELAXaHEAD smartphone application, which has a headache diary and PMR audio files, participants were instructed to record headache symptoms and practice 20 min of PMR daily. There were three monthly follow-up assessments. There were 49 subjects enrolled. Basic demographics were: 33 (67%) female with mean age 40.1 ± 14.6 [20, 75] years. Of the 49 subjects, 15 (31%) had pre-existing headaches. In 11 (22%) subjects, mTBI was sports related. Subjects reported 17.7 ± 9.3 [4, 31] headache days in the month before enrollment, and 49 (100%) experienced over three concussion symptoms. Participants inputted data in the RELAXaHEAD app on average 18.3 ± 12.0 days [0, 31] the first month. Number of participants who did PMR over four times per week was 12 (24.5%) the first month, 9 (22.5%) the second month, and 6 (15%) the third month. After 3 months, 17 (42.5 %) participants continued doing PMR. Participants cited time constraints, forgetfulness, application glitches, and repetitiveness as obstacles to practicing PMR. It is feasible to get PPTH subjects to practice behavioral therapy through low-cost smartphone-based PMR two times weekly. Future work will assess efficacy and examine how to optimize barriers to PMR.
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Lewis A, Galetta S. Editors' note: Miller Fisher syndrome and polyneuritis cranialis in COVID-19. Neurology 2020; 95:368. [DOI: 10.1212/wnl.0000000000010288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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223
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Ganesh A, Galetta S. Editors' note: Neurologic complications of coronavirus infections. Neurology 2020; 95:321. [DOI: 10.1212/wnl.0000000000010221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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224
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Siegler JE, Galetta S. Editors' note: Intrathecal IgM production is a strong risk factor for early conversion to multiple sclerosis. Neurology 2020. [DOI: 10.1212/wnl.0000000000010126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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225
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Siegler JE, Galetta S. Editors' note: An observational study on quality of life and preferences to sustain life in locked-in state. Neurology 2020. [DOI: 10.1212/wnl.0000000000010119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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226
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Huang H, Eichelberger H, Chan M, Valdes E, Kister I, Krupp L, Weinberg H, Galetta S, Frontera J, Zhou T, Kahn DE, Lord A, Lewis A. Pearls & Oy-sters: Leukoencephalopathy in critically ill patients with COVID-19. Neurology 2020; 95:753-757. [PMID: 32788252 DOI: 10.1212/wnl.0000000000010636] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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227
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Agarwal S, Jain R, Dogra S, Krieger P, Lewis A, Nguyen V, Melmed K, Galetta S. Cerebral Microbleeds and Leukoencephalopathy in Critically Ill Patients With COVID-19. Stroke 2020; 51:2649-2655. [PMID: 32755456 PMCID: PMC7434006 DOI: 10.1161/strokeaha.120.030940] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Supplemental Digital Content is available in the text. Background and Purpose: We conducted this study to investigate the prevalence and distribution of cerebral microbleeds and leukoencephalopathy in hospitalized patients with coronavirus disease 2019 (COVID-19) and correlate with clinical, laboratory, and functional outcomes. Methods: We performed a retrospective chart review of 4131 COVID-19 positive adult patients who were admitted to 3 tertiary care hospitals of an academic medical center at the epicenter of the COVID-19 pandemic in New York City from March 1, 2020, to May 10, 2020, to identify patients who had magnetic resonance imaging (MRI) of the brain. We evaluated the MRIs in detail, and identified a subset of patients with leukoencephalopathy and/or cerebral microbleeds. We compared clinical, laboratory, and functional outcomes for these patients to patients who had a brain MRI that did not show these findings. Results: Of 115 patients who had an MRI of the brain performed, 35 (30.4%) patients had leukoencephalopathy and/or cerebral microbleeds. Patients with leukoencephalopathy and/or cerebral microbleeds had neuroimaging performed later during the hospitalization course (27 versus 10.6 days; P<0.001), were clinically sicker at the time of brain MRI (median GCS 6 versus 14; P<0.001), and had higher peak D-dimer levels (8018±6677 versus 3183±3482; P<0.001), lower nadir platelet count (116.9±62.2 versus 158.3±76.2; P=0.03), higher peak international normalized ratio (2.2 versus 1.57; P<0.001) values when compared with patients who had a brain MRI that did not show these findings. They required longer ventilator support (34.6 versus 9.1 days; P<0.001) and were more likely to have moderate and severe acute respiratory distress syndrome score (88.6% versus 23.8%, P<0.001). These patients had longer hospitalizations (42.1 versus 20.9 days; P<0.001), overall worse functional status on discharge (mRS 5 versus 4; P=0.001), and higher mortality (20% versus 9%; P=0.144). Conclusions: The presence of leukoencephalopathy and/or cerebral microbleeds is associated with a critical illness, increased mortality, and worse functional outcome in patients with COVID-19.
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Lewis A, Galetta S. Editors' note: Disruption of the ascending arousal network in acute traumatic disorders of consciousness. Neurology 2020. [DOI: 10.1212/wnl.0000000000010098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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229
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Lewis A, Galetta S. Editors' note: Degree of serotonin reuptake inhibition of antidepressants and ischemic risk: A cohort study. Neurology 2020. [DOI: 10.1212/wnl.0000000000010064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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230
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Villoslada P, Sanchez-Dalmau B, Galetta S. Optical coherence tomography: A useful tool for identifying subclinical optic neuropathy in diagnosing multiple sclerosis. Neurology 2020; 95:239-240. [PMID: 32723803 DOI: 10.1212/wnl.0000000000009840] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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231
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Lewis A, Galetta S. Editors' note: Reducing birth defects in women with epilepsy: Research leading to results. Neurology 2020. [DOI: 10.1212/wnl.0000000000009958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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232
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Ganesh A, Galetta S. Editors' note: Muscle-targeted nutritional support for rehabilitation in patients with parkinsonian syndrome. Neurology 2020. [DOI: 10.1212/wnl.0000000000009898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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233
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Ganesh A, Galetta S. Editors' note: Discrepancy in redetermination of SMN2 copy numbers in children with SMA. Neurology 2020. [DOI: 10.1212/wnl.0000000000009905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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234
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Siegler JE, Galetta S. Editors' note: Low-density lipoprotein cholesterol and risk of intracerebral hemorrhage: A prospective study. Neurology 2020. [DOI: 10.1212/wnl.0000000000009796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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235
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Lewis A, Galetta S. Editors' note: Understanding and addressing gender equity for women in neurology. Neurology 2020. [DOI: 10.1212/wnl.0000000000009743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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236
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Ganesh A, Galetta S. Editors' note: Acute elevation of serum inflammatory markers predicts symptom recovery after concussion. Neurology 2020. [DOI: 10.1212/wnl.0000000000009661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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237
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Ganesh A, Galetta S. Editors' note: Sporadic late-onset nemaline myopathy: Clinical spectrum, survival, and treatment outcomes. Neurology 2020. [DOI: 10.1212/wnl.0000000000009655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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238
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Siegler JE, Galetta S. Editors' note: Epidemiology of NMOSD in Sweden from 1987 to 2013: A nationwide population-based study. Neurology 2020. [DOI: 10.1212/wnl.0000000000009598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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239
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Siegler JE, Galetta S. Editors' note: Low hemoglobin and hematoma expansion after intracerebral hemorrhage. Neurology 2020. [DOI: 10.1212/wnl.0000000000009604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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240
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Lewis A, Galetta S. Editors' note: The two lives of neurologist Helmut J. Bauer (1914–2008): Renowned MS specialist and National Socialist. Neurology 2020. [DOI: 10.1212/wnl.0000000000009536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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241
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Ganesh A, Galetta S. Editors' note: RCVS2 score and diagnostic approach for reversible cerebral vasoconstriction syndrome. Neurology 2020. [DOI: 10.1212/wnl.0000000000009499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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242
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Ganesh A, Galetta S. Editors' note: Peripheral synucleinopathy in a DJ1 patient with Parkinson disease, cataracts, and hearing loss. Neurology 2020. [DOI: 10.1212/wnl.0000000000009488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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243
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Dogra S, Jain R, Cao M, Bilaloglu S, Zagzag D, Hochman S, Lewis A, Melmed K, Hochman K, Horwitz L, Galetta S, Berger J. Hemorrhagic stroke and anticoagulation in COVID-19. J Stroke Cerebrovasc Dis 2020; 29:104984. [PMID: 32689588 PMCID: PMC7245254 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104984] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/15/2020] [Indexed: 02/07/2023] Open
Abstract
Background and Purpose Patients with the Coronavirus Disease of 2019 (COVID-19) are at increased risk for thrombotic events and mortality. Various anticoagulation regimens are now being considered for these patients. Anticoagulation is known to increase the risk for adverse bleeding events, of which intracranial hemorrhage (ICH) is one of the most feared. We present a retrospective study of 33 patients positive for COVID-19 with neuroimaging-documented ICH and examine anticoagulation use in this population. Methods Patients over the age of 18 with confirmed COVID-19 and radiographic evidence of ICH were included in this study. Evidence of hemorrhage was confirmed and categorized by a fellowship trained neuroradiologist. Electronic health records were analyzed for patient information including demographic data, medical history, hospital course, laboratory values, and medications. Results We identified 33 COVID-19 positive patients with ICH, mean age 61.6 years (range 37–83 years), 21.2% of whom were female. Parenchymal hemorrhages with mass effect and herniation occurred in 5 (15.2%) patients, with a 100% mortality rate. Of the remaining 28 patients with ICH, 7 (25%) had punctate hemorrhages, 17 (60.7%) had small- moderate size hemorrhages, and 4 (14.3%) had a large single site of hemorrhage without evidence of herniation. Almost all patients received either therapeutic dose anticoagulation (in 22 [66.7%] patients) or prophylactic dose (in 3 [9.1] patients) prior to ICH discovery. Conclusions Anticoagulation therapy may be considered in patients with COVID-19 though the risk of ICH should be taken into account when developing a treatment regimen.
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Jain R, Young M, Dogra S, Kennedy H, Nguyen V, Jones S, Bilaloglu S, Hochman K, Raz E, Galetta S, Horwtiz L. COVID-19 related neuroimaging findings: A signal of thromboembolic complications and a strong prognostic marker of poor patient outcome. J Neurol Sci 2020; 414:116923. [PMID: 32447193 PMCID: PMC7236667 DOI: 10.1016/j.jns.2020.116923] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 01/09/2023]
Abstract
Objective To investigate the incidence and spectrum of neuroimaging findings and their prognostic role in hospitalized COVID-19 patients in New York City. Methods This is a retrospective cohort study of 3218 COVID-19 confirmed patients admitted to a major healthcare system (three hospitals) in New York City between March 1, 2020 and April 13, 2020. Clinical data were extracted from electronic medical records, and particularly data of all neurological symptoms were extracted from the imaging reports. Four neuroradiologists evaluated all neuroimaging studies for acute neuroimaging findings related to COVID-19. Results 14.1% of admitted COVID-19 patients had neuroimaging and this accounted for only 5.5% of the total imaging studies. Acute stroke was the most common finding on neuro-imaging, seen in 92.5% of patients with positive neuro-imaging studies, and present in 1.1% of hospitalized COVID-19 patients. Patients with acute large ischemic and hemorrhagic stroke had much higher mortality risk adjusted for age, BMI and hypertension compared to those COVID-19 patients without neuroimaging. (Odds Ratio 6.02 by LR; Hazard Ratio 2.28 by CRR). Conclusions Our study demonstrates acute stroke is the most common neuroimaging finding among hospitalized COVID-19 patients. Detection of an acute stroke is a strong prognostic marker of poor outcome. Our study also highlights the fact there is limited use of neuroimaging in these patients due to multiple logistical constraints.
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Siegler JE, Galetta S. Editors' note: Use of β2-adrenoreceptor agonist and antagonist drugs and risk of Parkinson disease. Neurology 2020. [DOI: 10.1212/wnl.0000000000009450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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246
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Siegler JE, Galetta S. Editors' note: Lower carotid revascularization rates after stroke in racial/ethnic minority-serving US hospitals. Neurology 2020. [DOI: 10.1212/wnl.0000000000009445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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247
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Lewis A, Galetta S. Editors' note: Carotid plaques and detection of atrial fibrillation in embolic stroke of undetermined source. Neurology 2020. [DOI: 10.1212/wnl.0000000000009426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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248
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Siegler JE, Galetta S. Editors' note: MRI predicts intracranial hemorrhage in patients who receive long-term oral anticoagulation. Neurology 2020. [DOI: 10.1212/wnl.0000000000009385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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249
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Siegler JE, Galetta S. Editors' note: Early hemodynamic predictors of good outcome and reperfusion injury after endovascular treatment. Neurology 2020. [DOI: 10.1212/wnl.0000000000009381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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250
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Lewis A, Galetta S. Editors' note: Characteristics of graduating US allopathic medical students pursuing a career in neurology. Neurology 2020. [DOI: 10.1212/wnl.0000000000009327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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