Articles in Neurology (10)

The Canadian CT Head Rule is a highly sensitive clinical decision instrument used to identify adult patients with minor head trauma who require an emergent non-contrast head computed tomography scan to rule out neurologically significant intracranial injuries. The gold-standard diagnostic investigation is a non-contrast head computed tomography scan, and the first-line protocol involves risk stratification via high-risk and medium-risk criteria followed by immediate neuroimaging or safe discharge without imaging when all criteria are absent.

The Glasgow Coma Scale (GCS) and the Full Outline of UnResponsiveness (FOUR) score are validated neurological assessment instruments designed to quantify levels of consciousness in acute brain injury; the gold-standard diagnostic approach relies on serial clinical evaluation coupled with urgent neuroimaging, while first-line management mandates emergent airway protection and physiological stabilization.

The Modified Rankin Scale (mRS) is a clinician-reported 7-level global disability and functional outcome score used predominantly in stroke clinical trials and neurovascular practice, assessed via structured clinical interview or historical documentation.

The Hunt and Hess scale and the modified Fisher scale are essential clinical grading instruments used to stratify patient status and predict delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage, guiding neurosurgical intervention and intensive care management.

The ABCD2 score is a validated clinical prediction tool utilized to estimate the short-term risk of stroke following a transient ischaemic attack, identifying patients who require urgent secondary prevention workup. The gold-standard diagnostic modality for assessing acute cerebral ischemia is magnetic resonance imaging with diffusion-weighted imaging, while first-line management involves immediate antiplatelet therapy and rapid vascular evaluation.

The NIH Stroke Scale (NIHSS) is a validated 15-item standardized neurological examination tool used to objectively quantify acute ischemic and hemorrhagic stroke impairment. The gold-standard diagnostic assessment involves immediate non-contrast brain computed tomography (NCCT) combined with a rapid structured clinical neurological examination, while the first-line therapeutic protocol centers on rapid stroke severity stratification to determine eligibility for intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT).

Wernicke encephalopathy is an acute, life-threatening neuropsychiatric syndrome caused by thiamine (vitamin B1) deficiency, classically presenting with confusion, ocular dysfunction, and ataxia. Diagnosis is primarily clinical supported by characteristic MRI findings showing symmetric hyperintensities in the mammillary bodies, thalami, and periaqueductal gray matter, requiring immediate high-dose intravenous thiamine replacement before any glucose administration.

Wallenberg syndrome, or lateral medullary syndrome, is a classic brainstem stroke syndrome caused by ischemia in the territory of the posterior inferior cerebellar artery (PICA) or vertebral artery, characterized by ipsilateral Horner syndrome, facial sensory loss, and cerebellar ataxia alongside contralateral trunk and limb thermoanesthesia. Diagnosis is confirmed via diffusion-weighted MRI and vascular imaging, while first-line management relies on acute stroke protocols, strict NPO protocols with swallow evaluations, and secondary stroke prevention.

Myasthenia gravis is a chronic autoimmune neuromuscular disorder mediated by autoantibodies against postsynaptic acetylcholine receptors or muscle-specific kinase, leading to fluctuating skeletal muscle weakness. Myasthenic crisis represents a life-threatening acute exacerbation complicated by respiratory muscle failure necessitating emergency intubation and ventilatory support.

Guillain-Barré syndrome (GBS) is an acute, immune-mediated polyradiculoneuropathy typically presenting with rapidly progressive, ascending, symmetrical weakness and areflexia, often following an infection. Diagnosis relies on clinical features supported by cerebrospinal fluid (CSF) analysis showing albuminocytologic dissociation. First-line UK management involves supportive care, monitoring for respiratory failure, and consideration of immunomodulatory therapies like plasma exchange or intravenous immunoglobulin (IVIg).