Articles

Stopping “transient ischemic attacks” by antiplatelet withdrawal

Transient ischemic attack (TIA) is considered to be an important risk factor for the development of ischemic stroke and requires complete etiopathogenic evaluation and prompt initiation of secondary prevention...

Authors: Lina Palaiodimou, Aikaterini Theodorou, Stefanos Lachanis, George P. Paraskevas, Matilda Papathanasiou, Christina Zompola, Konstantinos I. Voumvourakis and Georgios Tsivgoulis

Closure or medical therapy of patent foramen ovale in cryptogenic stroke: prospective case series

Results of randomized controlled trials (RCT) do not provide definite guidance for secondary prevention after ischemic stroke (IS)/transient ischemic attack (TIA) attributed to patent foramen ovale (PFO). No r...

Authors: Sven Poli, Elisabeth Siebert, Joshua Mbroh, Khouloud Poli, Markus Krumbholz, Annerose Mengel, Simon Greulich, Florian Härtig, Karin A. L. Müller, Wolfgang Bocksch, Meinrad Gawaz, Ulf Ziemann and Christine S. Zuern

Acute ischemic stroke care in Germany – further progress from 2016 to 2019

Stroke Unit Care (SUC), intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) are evidence-based treatment options for acute ischemic stroke (AIS). Using nationwide comprehensive administrative data ...

Authors: Daniel Richter, Ralph Weber, Jens Eyding, Dirk Bartig, Björn Misselwitz, Armin Grau, Werner Hacke and Christos Krogias

Sudden paraparesis due to spinal cord ischemia with initial contrast enhancement of the cauda equina and time-delayed owl-eyes sign on follow-up MR imaging: a case report

We report on a case of a 52-year-old male with sudden paraparesis. The initial MRI showed contrast enhancement of the conus medullaris and the complete cauda equina. Follow-up MRI revealed a spinal ischemia in...

Authors: Benedict Breitling, Frederic Carsten Schmeel, Alexander Radbruch and Oliver Kaut

Consequences of COVID-19 pandemic lockdown on emergency and stroke care in a German tertiary stroke center

COVID-19 pandemic caused a decline in stroke care in several countries. The objective was to describe lockdown stroke care in a tertiary stroke center in Düsseldorf, Germany near Heinsberg, a German hot spot f...

Authors: Robin Jansen, John-Ih Lee, Bernd Turowski, Marius Kaschner, Julian Caspers, Michael Bernhard, Hans-Peter Hartung, Sebastian Jander, Tobias Ruck, Sven G. Meuth and Michael Gliem

Post-COVID-19 encephalomyelitis

Since the outbreak of coronavirus disease 2019 (COVID-19), a growing number of cases of acute transverse myelitis associated with COVID-19 have been reported. Here, we present the case of a patient who develop...

Authors: Ji-Won Kim, Nuran Abdullayev, Janina Neuneier, Gereon R. Fink and Helmar C. Lehmann

Neurological symptoms in COVID-19: a cross-sectional monocentric study of hospitalized patients

The SARS-Coronavirus-2 (SARS-CoV-2) invades the respiratory system, causing acute and sometimes severe pulmonary symptoms, but turned out to also act multisystematically with substantial impact on the brain. A...

Authors: Ummehan Ermis, Marcus Immanuel Rust, Julia Bungenberg, Ana Costa, Michael Dreher, Paul Balfanz, Gernot Marx, Martin Wiesmann, Kathrin Reetz, Simone C. Tauber and Jörg B. Schulz

Insomnia in neurological diseases

Insomnia is defined as difficulties of initiating and maintaining sleep, early awakening and poor subjective sleep quality despite adequate opportunity and circumstances for sleep with impairment of daytime pe...

Authors: Geert Mayer, Svenja Happe, Stefan Evers, Wiebke Hermann, Sabine Jansen, Ulf Kallweit, Maria-Lucia Muntean, Dieter Pöhlau, Dieter Riemann, Michael Saletu, Melanie Schichl, Wolfgang J. Schmitt, Friederike Sixel-Döring and Peter Young

SOP: treatment of delirium

Delirium is a frequent complication in hospitalised patients, often leading to difficulties in patient management and is associated with increased morbidity and mortality. Most patients in intensive care units...

Authors: Juraj Kukolja and Jens Kuhn

Variability of computed tomography angiography coverage of lung parenchyma in acute stroke

Computed tomography angiography (CTA) of the head and neck during acute ischemic stroke (AIS) usually includes visualization of lung apices. The possibility to evaluate for pulmonary changes, e.g. peripheral g...

Authors: Johannes A. R. Pfaff, Bianka Füssel, Marcial E. Harlan, Alexander Hubert and Martin Bendszus

COX2 expression is associated with preoperative tumor volume but not with volumetric tumor growth in vestibular schwannoma

Vestibular schwannomas (VS) are benign slow growing tumors arising from the vestibular nerve. The role of cyclooxygenase 2 (COX2) in tumor development of growth has been addressed in a few studies with contrad...

Authors: Felix Behling, Elisa Suhm, Vanessa Ries, Vítor Moura Gonçalves, Ghazaleh Tabatabai, Marcos Tatagiba and Jens Schittenhelm

Point-of-care testing for emergency assessment of coagulation in patients treated with direct oral anticoagulants including edoxaban

Direct oral anticoagulants (DOAC) including edoxaban are increasingly used for stroke prevention in atrial fibrillation. Despite treatment, annual stroke rate in these patients remains 1–2%. Rapid assessment o...

Authors: Florian Härtig, Ingvild Birschmann, Andreas Peter, Sebastian Hörber, Matthias Ebner, Matthias Sonnleitner, Charlotte Spencer, Paula Bombach, Maria-Ioanna Stefanou, Johannes Tünnerhoff, Annerose Mengel, Joachim Kuhn, Ulf Ziemann and Sven Poli

Effect of NEuroplasticity-Principles-based SEnsory-Rehabilitation (NEPSER) on sensori-motor recovery in stroke: study protocol for a randomized controlled trial

Up to 2/3rd of the stroke subjects may experience impairment in any of the somatosensory modalities such as light touch, proprioception, and stereognosis. The sensory recovery is strongly associated with the l...

Authors: Kamal Narayan Arya, Shanta Pandian, G. G. Agarwal, Neera Chaudhary and Akshay Kumar Joshi

Rationale and design of an interventional study of cross-sectoral, coordinated treatment of stroke patients with patient-orientated outcome measurement (StroCare)

Stroke has a long-term impact on functional status and quality of life in multiple health domains. A well-coordinated managed care program for stroke patients is crucial for ameliorating patients’ health and c...

Authors: David Leander Rimmele, Theresa Schrage, Christian Brettschneider, Alexander Engels, Christian Gerloff, Martin Härter, Michael Rosenkranz, Holger Schmidt, Levente Kriston and Götz Thomalla

Moral distress among residents in neurology: a pilot study

Medical progress, economization of healthcare systems, and scarcity of resources raise fundamental ethical issues. Physicians are exposed to increasing moral conflict situations, which may cause Moral Distress...

Authors: Hanna Hildesheim, Annette Rogge, Christoph Borzikowsky, Victoria Dorothea Witt, Eva Schäffer and Daniela Berg

Glymphatic system, AQP4, and their implications in Alzheimer’s disease

Lacking conventional lymphatic system, the central nervous system requires alternative clearance systems, such as the glymphatic system, which promotes clearance of interstitial solutes. Aquaporin-4 water chan...

Authors: Inês Silva, Jéssica Silva, Rita Ferreira and Diogo Trigo

Off-label intravenous thrombolysis for early recurrent brain embolism associated with aortic arch thrombus

Safety data of intravenous thrombolysis (IVT) in presence of aortic arch thrombus is scant. Furthermore, IVT is debatable in patients with prior recent stroke. We present a 51-year-old woman with recurrent maj...

Authors: Ioanna Koutroulou, Georgios Tsivgoulis, Vasileios Rafailidis, Elissavet Psoma, Konstantinos Kouskouras, Panagiotis Fotiadis, Nikolaos Grigoriadis and Theodoros Karapanayiotides

Neurological research and practice: the first milestone has been reached

Authors: Werner Hacke

SOP: emergency workup in patients with suspected acute bacterial meningitis

Despite antibiotic therapy, adjunctive treatment with dexamethasone, and care on modern intensive care units, bacterial meningitis remains a life-threatening disease with a high mortality and morbidity. One of...

Authors: Susanne Dyckhoff-Shen, Uwe Koedel, Hans-Walter Pfister and Matthias Klein

Probability assessment of intracerebral hemorrhage in prehospital emergency patients

Routing of patients with intracerebral hemorrhage (ICH) and acute ischemic stroke (AIS) to the most appropriate hospital is challenging for emergency medical services particularly when specific treatment optio...

Authors: Frederik Geisler, Medschid Wesirow, Martin Ebinger, Alexander Kunz, Michal Rozanski, Carolin Waldschmidt, Joachim E. Weber, Matthias Wendt, Benjamin Winter and Heinrich J. Audebert

DIagnostic Subdural EEG electrodes And Subdural hEmatoma (DISEASE): a study protocol for a prospective nonrandomized controlled trial

Epileptic seizures are common clinical features in patients with acute subdural hematoma (aSDH); however, diagnostic feasibility and therapeutic monitoring remain limited. Surface electroencephalography (EEG) ...

Authors: Sae-Yeon Won, Thomas M. Freiman, Philipp S. Reif, Daniel Dubinski, Elke Hattingen, Eva Herrmann, Volker Seifert, Felix Rosenow, Adam Strzelczyk and Juergen Konczalla

Prevention of thromboembolism in spinal cord injury -S1 guideline

Traumatic and non-traumatic spinal cord injury bears a high risk for thromboembolism in the first few months after injury. So far, there is no consented guideline regarding diagnostic and prophylactic measures...

Authors: Norbert Weidner, Oliver J. Müller, Viola Hach-Wunderle, Karsten Schwerdtfeger, Rüdiger Krauspe, Rolf Pauschert, Christian Waydhas, Michael Baumberger, Christoph Göggelmann, Gabriela Wittgruber, Renate Wildburger and Oswald Marcus

Immunoglobulins to mitigate paraneoplastic Lambert Eaton Myasthenic Syndrome under checkpoint inhibition in Merkel cell carcinoma

Lambert-Eaton myasthenic syndrome (LEMS) is a rare, autoimmune or paraneoplastic condition characterized by muscle weakness and fatigability. In cancer therapy, immune checkpoint inhibitors (ICI) sensitize the...

Authors: Maike F. Dohrn, Ulrike Schöne, Charlotte Küppers, Deborah Christen, Jörg B. Schulz, Burkhard Gess and Simone Tauber

Comprehensive approaches for diagnosis, monitoring and treatment of chronic inflammatory demyelinating polyneuropathy

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is the most common chronic inflammatory neuropathy. CIDP is diagnosed according to the European Federation of Neurological Societies/Peripheral ...

Authors: Anna Lena Fisse, Jeremias Motte, Thomas Grüter, Melissa Sgodzai, Kalliopi Pitarokoili and Ralf Gold

Diagnosis and therapy of functional tremor a systematic review illustrated by a case report

Diagnosis of functional movement disorders and specifically functional tremor (FT) (representing 50% of them) remains demanding. Additionally, due to heterogeneity of the disorders, structured concepts and gui...

Authors: Michael Bartl, Rebekka Kewitsch, Mark Hallett, Martin Tegenthoff and Walter Paulus

“Neurological manifestations of COVID-19” - guideline of the German society of neurology

Infection with the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) leads to a previously unknown clinical picture, which is known as COVID-19 (COrona VIrus Disease-2019) and was first describe...

Authors: Peter Berlit, Julian Bösel, Georg Gahn, Stefan Isenmann, Sven G. Meuth, Christian H. Nolte, Marc Pawlitzki, Felix Rosenow, Benedikt Schoser, Götz Thomalla and Thomas Hummel

Historic review: select chapters of a history of stroke

There is no shortage of books, chapters and papers on the history of stroke focusing predominantly on the last 150 years and enumerating endless “milestones”. Instead of adding another article to this body of ...

Authors: Axel Karenberg

Sphingosine 1-phosphate levels in cerebrospinal fluid after subarachnoid hemorrhage

Sphingosin-1-phosphate (S1P) plays a crucial role as a signaling molecule in the immune system and the vasculature. Previous studies suggested a role as a vasoconstrictor of cerebral arteries via the S1P3-Rece...

Authors: Anika Männer, Dominique Thomas, Marlies Wagner, Jürgen Konczalla, Helmuth Steinmetz, Robert Brunkhorst and Waltraud Pfeilschifter

Impact of the COVID-19-pandemic on thrombectomy services in Germany

The Coronavirus Disease 2019 (COVID-19) pandemic may have altered emergency workflows established to optimize the outcome of patients with large-vessel occlusion (LVO) stroke.

Authors: Steffen Tiedt, Felix J. Bode, Timo Uphaus, Anna Alegiani, Klaus Gröschel and Gabor C. Petzold

Safety and efficacy of intravenous thrombolysis in stroke patients on prior antiplatelet therapy in the WAKE-UP trial

One quarter to one third of patients eligible for systemic thrombolysis are on antiplatelet therapy at presentation. In this study, we aimed to assess the safety and efficacy of intravenous thrombolysis in str...

Authors: Benedikt M. Frey, Florent Boutitie, Bastian Cheng, Tae-Hee Cho, Martin Ebinger, Matthias Endres, Jochen B. Fiebach, Jens Fiehler, Ian Ford, Ivana Galinovic, Alina Königsberg, Josep Puig, Pascal Roy, Anke Wouters, Tim Magnus, Vincent Thijs…

Comparison of stroke care parameters in acute ischemic stroke patients with and without concurrent Covid-19. A Nationwide analysis

Comparing health care parameters of acute ischemic stroke (AIS) patients with and without concurrent coronavirus disease 2019 (Covid-19, SARS-CoV-2 infection), may be helpful in terms of optimizing clinical an...

Authors: Daniel Richter, Christos Krogias, Jens Eyding, Dirk Bartig, Armin Grau and Ralph Weber

German guidelines on the diagnosis and treatment of neurosyphilis

In view of the importance of neurosyphilis and the difficulties encountered in diagnosing it, the S1 guideline “Neurosyphilis” has been published by the German Society for Neurology (DGN) in accordance with th...

Authors: Matthias Klein, Klemens Angstwurm, Stefan Esser, Kathrin Hahn, Matthias Maschke, Simone Scheithauer, Helmut Schoefer, Matthias Sturzenegger, Brigitte Wildemann and Jörg Weber

Decreased admissions and change in arrival mode in patients with cerebrovascular events during the first surge of the COVID-19 pandemic

Investigating clinical characteristics of patients presenting with cerebrovascular events during the pandemic may provide valuable insight into further understanding the phenomenon of decreased stroke admissio...

Authors: Carolin Hoyer, Lenja Weber, Vesile Sandikci, Anne Ebert, Michael Platten and Kristina Szabo

Collateral damages in the SARS-CoV-2 pandemia– two cases

At present, “severe acute respiratory syndrome new coronavirus” (SARS-CoV-2) affects the whole world and has led to a pandemia with almost 2.000.000 infected patients in the mid of April 2020 (WHO). Thus, heal...

Authors: Christian Urbanek, Jana Kötteritzsch, Wolfgang Zink and Armin J. Grau

A machine learning-based classification approach on Parkinson’s disease diffusion tensor imaging datasets

The presence of motor signs and symptoms in Parkinson’s disease (PD) is the result of a long-lasting prodromal phase with an advancing neurodegenerative process. The identification of PD patients in an early p...

Authors: Jannik Prasuhn, Marcus Heldmann, Thomas F. Münte and Norbert Brüggemann

Printed by Parkinson’s: a neurological art project linking patient stories and biosignals

“Printed by Parkinson’s” is an innovative project with the main aim to raise awareness for the many aspects of Parkinson’s disease and their implication for everyday life. In a cooperation of Innocean Worldwid...

Authors: Lucia K. Feldmann and Andrea A. Kühn

Disease modifying treatment trials in Parkinson’s disease: how to balance expectations and interests of patients, physicians and industry partners?

The advent of therapeutic strategies designed to modify the disease course in Parkinson’s disease has raised great expectations in the currently conducted clinical trials. However, we see ethical challenges in...

Authors: D. Berg, K. Eggert, B. Haslinger, J. Kassubek, B. Mollenhauer, K. Reetz, A. Rogge, E. Schaeffer, L. Tönges and K. E. Zeuner

Outcome measures and treatment effectiveness in late onset myasthenia gravis

Recently different subtypes of myasthenia gravis (MG) have been described. They differ for clinical features and pathogenesis but the prognosis and response to treatment is less clear. The aim of the study was...

Authors: Francesca Pasqualin, Silvia V. Guidoni, Mario Ermani, Elena Pegoraro and Domenico M. Bonifati

Combined subthalamic and nucleus basalis of Meynert deep brain stimulation for Parkinson’s disease with dementia (DEMPARK-DBS): protocol of a randomized, sham-controlled trial

Dementia in Parkinson’s disease (PDD) is a common non-motor symptom of advanced disease, associated with pronounced neocortical cholinergic deficits due to neurodegeneration of the nucleus basalis of Meynert (...

Authors: Christine Daniels, Frank Steigerwald, Philipp Capetian, Cordula Matthies, Uwe Malzahn, Peter U. Heuschmann and Jens Volkmann

Severe pneumonia with formation of a pulmonary cavity associated with long-term rituximab therapy in multiple sclerosis

Nowadays B-cell depletion via anti-CD20 antibodies is commonly applied in the treatment of multiple sclerosis (MS). Yet, not much is known about infection risks associated with long-term B-cell depletion in th...

Authors: Carolin Schwake and Ralf Gold

Dural tear from diagnostic lumbar puncture followed by long-term morbidity: a case report

Lumbar punctures are performed in different medical settings and are a key procedure in the diagnosis of several neurological conditions. Complications are rare and generally self-limiting. There are no report...

Authors: Aleksander Fjeld Haugstvedt, Inger Birgitte Havsteen and Hanne Christensen

Historic review: the foundation-period and the first 15 years of the “Gesellschaft fuer Neuropaediatrie” (GNP) between 1950 and 1990

After the end of Nazi terrorism with many crimes against neuropsychiatric and disabled people, from 1950 on detection and treatment of these diseases in children and adolescents grew continuously: in the 50s a...

Authors: Hans Michael Strassburg

Cross-cultural adaption and validation of the German version of the Mini-BESTest in individuals after stroke: an observational study

Postural control is a very important function in everyday life. However, assessing postural control with commonly used measurement instruments (MIs) is limited due to deficits in their psychometric properties....

Authors: Elena Cramer, Franziska Weber, Gilian Faro, Michael Klein, Dennis Willeke, Thomas Hering and Dörte Zietz

Validation of a German version of the Cerebellar Cognitive Affective/ Schmahmann Syndrome Scale: preliminary version and study protocol

Traditionally, cerebellar disorders including ataxias have been associated with deficits in motor control and motor learning. Since the 1980’s growing evidence has emerged that cerebellar diseases also impede ...

Authors: Andreas Thieme, Sandra Roeske, Jennifer Faber, Patricia Sulzer, Martina Minnerop, Saskia Elben, Heike Jacobi, Kathrin Reetz, Imis Dogan, Miriam Barkhoff, Juergen Konczak, Elke Wondzinski, Mario Siebler, Oliver Mueller, Ulrich Sure, Jeremy D. Schmahmann…

Lack of cerebellar tDCS effects on learning of a complex whole body dynamic balance task in middle-aged (50–65 years) adults

Cerebellar transcranial direct current stimulation (tDCS) is widely considered as a promising non-invasive tool to foster motor performance and learning in health and disease. The results of previous studies, ...

Authors: M. Rauscher, F. Yavari, G. Batsikadze, N. Ludolph, W. Ilg, M. A. Nitsche, D. Timmann and K. M. Steiner

Increased incidence of transient global amnesia during the Covid-19 crisis?

Since the beginning oft he Covid-19 pandemic we have observed an increased incidence of transient global amnesia, possibly related to emotional stress as a trigger factor.

Authors: Ralph Werner, Moritz Keller and Johannes C. Woehrle

Gene specific therapies – the next therapeutic milestone in neurology

Gene selective approaches that either correct a disease mutation or a pathogenic mechanism will fundamentally change the treatment of neurological disorders. Basically, gene specific therapies are designed to ...

Authors: David Brenner, Albert C. Ludolph and Jochen H. Weishaupt

Historic review: a short history of neuropediatrics in Germany between 1850 and 1950

Since the middle of the nineteenth century, there has been increasing knowledge about the diagnosis and therapy of diseases of the central and peripheral nervous system and muscle in children. The leading caus...

Authors: Hans Michael Strassburg

Vojta therapy improves postural control in very early stroke rehabilitation: a randomised controlled pilot trial

It is still unclear, which physiotherapeutic approaches are most effective in stroke recovery. Vojta therapy is a type of physiotherapy that was originally developed for children and adolescents with cerebral ...

Authors: Corina Epple, Barbara Maurer-Burkhard, Mari-Carmen Lichti and Thorsten Steiner

Letter to the editor: risk comorbidities of COVID-19 in Parkinson’s disease patients in Germany

Authors: Daniel Richter, Dirk Bartig, Christos Krogias and Lars Tönges