In this observational study from an area with a high rate of endemic tuberculosis (TB), prophylactic treatment of TB was appropriate in those treated with high doses of prednisone and evidence of prior TB infection.
Cholinesterase inhibitors are one of the few drug classes approved by the Food and Drug Administration for the treatment of patients with Alzheimer’s disease. This study shows a long-term benefit in slowing the decline of cognition, as measured by the Mini-Mental State Exam, but it is unclear if there is any benefit in quality of life.
Nearly 25% of patients with chronic inflammatory demyelinating polyneuropathy (CIDP) have a poor response to intravenous immunoglobulin treatment. Variations in the PRF1 and FCGR2B genes in CIDP patients offer insights into the heterogenous treatment response.
Idiopathic intracranial hypertension is an important cause of intractable headaches and may cause permanent loss of vision as a result of chronic papilledema. Weight loss is an effective treatment, and this randomized study demonstrated superior outcomes for both weight loss and reduced intracranial pressure from bariatric surgery compared to community weight-loss programs.
Chronic inflammatory demyelinating polyradiculoneuropathy is commonly misdiagnosed. It is important to adhere to established diagnostic criteria and to regularly re-evaluate all patients given this diagnosis.
Chronic subdural hematoma is a common cause of serious neurological morbidity and mortality in the elderly population. Atorvastatin has both an anti-inflammatory effect and the ability to mobilize endothelial progenitor cells, which assist in vascular repair. The investigators proposed that adding a low dose of dexamethasone to atorvastatin treatment might enhance the anti-inflammatory benefits without causing the side effects associated with high doses of corticosteroids.
Primary intracerebral hemorrhage is a major cause of severe neurological disability and carries a high rate of death. Tranexamic acid was tested in a study of 2,325 patients with intracerebral hemorrhage within eight hours of symptom onset, but did not significantly improve neurological outcome.
Basilar artery occlusion is a dangerous clinical syndrome of large artery occlusion that carries a high morbidity and mortality with severe disability in survivors. In multiple trials, alteplase has shown minimal benefit in achieving reperfusion in patients with large artery occlusion, including the basilar artery. Tenecteplase is a modified variant of alteplase that has greater specificity in binding to fibrin, a longer half-life, and can be administered in a single bolus.