Rapid versus gradual external ventricular drain (EVD) weaning methods have been widely debated, aiming to establish a standard clinical practice. The techniques used in each approach offer their own set of benefits and associated risks. Many published works continue to deliberate and dispute each other on the topic, as many believe gradual weaning is preferable due to its perceived potential to decrease ventriculoperitoneal shunt (VPS) dependency. In contrast, rapid weaning is known to have benefits such as a reduction in ventriculostomy-associated infections. Additionally, both weaning method ..read more

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Background: Moyamoya disease (MMD) is a rare cerebrovascular disease radiologically characterized by slowly progressive bilateral occlusion of the distal portion of the internal carotid artery and compensating intracranial and extracranial collaterals. Herein, we report a rare case of medullary infarction in a patient with MMD. Case Report: We present the case of a 54-year-old male with hypertension, hyperlipidemia, and unstable angina with a sudden onset of dysarthria and ataxia. Diffusion-weighted and T2-weighted images of magnetic resonance imaging showed a high-signal intensity lesion on t ..read more

Background: Acute ischemic stroke is a disease with multiple etiologies. Therefore, identifying the mechanism of acute ischemic stroke is fundamental to its treatment and secondary prevention. The Trial of Org 10172 in Acute Stroke Treatment classification is currently the most widely used system, but it often has a limitations of classifying unknown causes and inadequate inter-rater reliability. Therefore, we attempted to develop a three-dimensional (3D)-convolutional neural network (CNN)-based algorithm for stroke lesion segmentation and subtype classification using only the diffusion and ap ..read more

Refractory status epilepticus (RSE) is defined as the persistence of either clinical or electrographic seizures despite the administration of appropriate doses of an initial benzodiazepine and suitable second-line antiepileptic drugs (AEDs). The Neurocritical Care Society and the American Epilepsy Society have proposed a treatment paradigm for the management of convulsive status epilepticus (CSE). The third-line therapy in refractory CSE may involve general anesthesia using intravenous midazolam, propofol, or other agents, while recent evidence supports the use of ketamine to manage RSE in bot ..read more

Background: Bacterial meningitis is a life-threatening disease associated with high morbidity and mortality. Subarachnoid hemorrhage (SAH) can accompany bacterial meningitis in adult patients in ..read more

Background: Optimal anticoagulation therapy reduces the risk of ischemic stroke in patients with nonvalvular atrial fibrillation (AF). Therefore, we aimed to evaluate the effects of prior anticoagulation therapy with vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs) on ischemic stroke outcomes in patients with nonvalvular AF. Methods: We enrolled 487 patients with ischemic stroke and nonvalvular AF between January 2013 and August 2020. The infarct volume was semi-automatically evaluated using diffusion-weighted magnetic resonance imaging. Patients were categorized into no ant ..read more

Background: We present the case of a patient who was administered dabigatran and showed an extremely elevated prothrombin time-international normalized ratio (PT-INR). Case report: A 79-year-old man was referred due to PT-INR 12.6. The patient was taking 110 mg of dabigatran twice daily in capsule form. On admission, blood urea nitrogen level was 23 mg/dL, creatinine was 1.51 mg/dL, and the estimated glomerular filtration rate was 44.8 mL/min/1.73 m2. Coagulation tests revealed PT 96.8 seconds, PT-INR 12.46, and activated partial thromboplastin time 125.5 seconds. Dabigatran was discontinued ..read more

Background: Cerebral malaria, caused by Plasmodium falciparum, can lead to severe neurological complications. This phenomenon is observed more frequently in children than in adults. As cerebral malaria is rare and has no specific symptoms or neurological findings, diagnosing the condition is difficult. Case report: We report a case of a 61-year-old man who returned from the Democratic Republic of Congo with fever, fatigue, and confusion. Amidst various laboratory tests conducted to find the cause of his neurological symptoms, a peripheral blood smear confirmed P. falciparum infection (initial ..read more