IMPORTANCE Persistent localized pruritus is a rare manifestation of central nervous system tumors. Delayed diagnosis can lead to devastating complications. OBSERVATIONS We report an otherwise healthy 19-month-old girl who presented with signs of localized intractable pruritus of 6 months' duration on the left side of the neck, shoulder, and arm, resistant to systemic antihistamines and topica...

The neurologic examination (neuroexamination) is one of the most powerful tools available to nurses and physicians caring for patients with neurologic or neurosurgical illness. Assessing cranial nerve function is one of the most vital components of the neuroexamination. The pupillary light reflex helps to evaluate the status of the second and third cranial nerves and is one of the most well-kno...

Myopathies are a heterogeneous group of disorders that can be challenging to diagnose. This review provides a diagnostic approach based predominantly on the clinical history and neurologic examination. Laboratory testing that can be used to confirm the suspected diagnosis based on this pattern recognition approach is also discussed. Careful consideration of the distribution of muscle weakness a...

Objective. To identify the role of thrombolytic therapy in acute embolic stroke due to infective endocarditis. Design. Case report. Setting. University hospital. Patient. A 70-year-old male presented with acute onset aphasia and hemiparesis due to infective endocarditis. His head computerized tomographic scan revealed left parietal sulcal effacement. He was given intravenous tissue plasminogen ...

Headaches are common during childhood and become more common and increase in frequency during adolescence. The rational, cost-effective evaluation of children with headache begins with a careful history. The first step is to identify the temporal pattern of the headache--acute, acute-recurrent, chronic-progressive, chronic-nonprogressive, or mixed. The next step is a physical and neurologic exa...

SECTION 1 A 69-year-old man was admitted to our hospital with left upper quadrant pain, splenomegaly, acute renal failure, hyperuricemia, thrombocytopenia (platelet count 32,000/mm), and leukocytosis (leukocyte count 88,000/mm). His medical history was significant for prior diagnosis of myelodysplastic syndrome (MDS) by bone marrow biopsy at an outside institution treated with the hypomethylati...

Background: The neurological examination is considered to be complex and contributes to the phenomenon of "neurophobia". It is traditionally taught in small groups by residents ("traditional concept"), making the learning success partially dependent on the resident's level of clinical training, didactic education and personal motivation. Aim of this study was to examine the effects of a newly d...

Coronary artery bypass surgery (CABG) without cardiopulmonary bypass (CPB) may potentially reduce the number of microembolic signals (MES) associated with aortic manipulation or generated by the pump circuit, resulting in a better neurologic outcome after surgery. Our aim was to compare the frequency of MES and neurologic complications in CABG with and without CPB. Twenty patients eligible to r...

PURPOSE To describe the MR findings in eight girls and women with incontinentia pigmenti, from two families. Four had skin lesions and neurologic disease, and four had only skin lesions. METHODS Eight patients had physical examination, family history, electroencephalogram and MR examination of the brain. MR was repeated in the two cases with more severe changes several years after the first s...

OBJECTIVE We tested the hypothesis that surveillance neuroimaging and neurologic examinations identified changes requiring emergent surgical interventions in patients with intracerebral hemorrhage (ICH). METHODS Patients with primary ICH were enrolled into a prospective registry between December 2006 and July 2012. Patients were managed in a neuroscience intensive care unit with a protocol th...