A5039806230- Intracerebral and Subarachnoid Hemorrhage Research
- Glioma Diagnosis and Treatment
- Brain Metastases and Treatment
- Bipolar Disorder and Treatment
- Functional Brain Connectivity Studies
- Cancer Genomics and Diagnostics
- Emergency and Acute Care Studies
- Autoimmune Neurological Disorders and Treatments
- CNS Lymphoma Diagnosis and Treatment
- Peripheral Neuropathies and Disorders
- Palliative Care and End-of-Life Issues
- Vestibular and auditory disorders
- Health, Medicine and Society
- Multiple Sclerosis Research Studies
- Cerebral Venous Sinus Thrombosis
- Healthcare Decision-Making and Restraints
- Intensive Care Unit Cognitive Disorders
- Neurology and Historical Studies
- Hospital Admissions and Outcomes
- Balance, Gait, and Falls Prevention
- Genomics and Phylogenetic Studies
- Neurological Complications and Syndromes
- Cardiovascular Syncope and Autonomic Disorders
- Bacteriophages and microbial interactions
- Advanced Neuroimaging Techniques and Applications
University of California, San Francisco
2015-2024
University of Nevada, Reno
2024
Renown Health
2024
University of Pennsylvania
2023
University of California San Francisco Medical Center
2015-2022
Universitetshospitalernes Center for Sundhedsfaglig Forskning
2022
Purdue University West Lafayette
2016
University of California System
2013
California Pacific Medical Center
2012
Cornell University
2012
Identifying infectious causes of subacute or chronic meningitis can be challenging. Enhanced, unbiased diagnostic approaches are needed.To present a case series patients with diagnostically challenging using metagenomic next-generation sequencing (mNGS) cerebrospinal fluid (CSF) supported by statistical framework generated from mNGS control samples the environment and who were noninfectious.In this series, data obtained CSF 94 noninfectious neuroinflammatory disorders 24 water reagent used...
Behavioral studies suggest that emotional reactivity in depressed persons predicts subsequent symptom reduction. Using functional magnetic resonance imaging a prospective study, we show greater amygdala activation to facial expressions among patients reduction 8 months later, controlling for initial depression severity and medication status. Functional may thus be used as method identify neural markers at risk poor outcome.
A patient in California, USA, with rare and usually fatal Balamuthia mandrillaris granulomatous amebic encephalitis survived after receiving treatment a regimen that included the repurposed drug nitroxoline. Nitroxoline, which is quinolone typically used to treat urinary tract infections, was identified screen for drugs amebicidal activity against Balamuthia.
Convergent evidence implicates white matter abnormalities in bipolar disorder. The cingulum is an important candidate structure for study disorder as it provides substantial connections within the corticolimbic neural system that subserves emotional regulation involved disorder.To test hypothesis associated with abnormal integrity cingulum.Fractional anisotropy anterior and posterior was compared between 42 participants healthy using diffusion tensor imaging.Fractional significantly...
Background and Purpose— Dizziness can herald a cerebrovascular event. The ABCD 2 score predicts the risk of stroke after transient ischemic attack partly by distinguishing from mimics. We evaluated whether this would also identify events among emergency department patients with dizziness. Methods— retrospectively identified consecutive adults presenting to university primary symptom dizziness, vertigo, or imbalance. Two neurologists independently reviewed medical records determine was caused...
Acute disseminated encephalomyelitis (ADEM) is one characteristic manifestation of myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD). A previously healthy man presented with retro-orbital headache and urinary retention 14 days after Tdap vaccination. Brain spine MRI suggested a CNS demyelinating process. Despite treatment IV steroids, he deteriorated, manifesting hemiparesis later impaired consciousness, requiring intubation. repeat brain demonstrated new bilateral...
<h3>Importance</h3> Cerebrospinal fluid (CSF) cytologic testing and flow cytometry are insensitive for diagnosing neoplasms of the central nervous system (CNS). Such clinical phenotypes can mimic infectious autoimmune causes meningoencephalitis. <h3>Objective</h3> To ascertain whether CSF metagenomic next-generation sequencing (mNGS) identify aneuploidy, a hallmark malignant neoplasms, in difficult-to-diagnose cases CNS neoplasm. <h3>Design, Setting, Participants</h3> Two case-control...
Objective Co‐occurring anti‐tripartite motif‐containing protein 9 and 67 autoantibodies (TRIM9/67‐IgG) have been reported in only a very few cases of paraneoplastic cerebellar syndrome. The value these biomarkers the most sensitive methods TRIM9/67‐IgG detection are not known. Methods We performed retrospective, multicenter study to evaluate cerebrospinal fluid serum candidate by tissue‐based immunofluorescence, peptide phage display immunoprecipitation sequencing, overexpression cell‐based...
Objectives To report an autoimmune paraneoplastic encephalitis characterized by immunoglobulin G (IgG) antibody targeting synaptic protein calmodulin kinase‐like vesicle‐associated (CAMKV). Methods Serum and cerebrospinal fluid (CSF) samples harboring unclassified antibodies on murine brain‐based indirect immunofluorescence assay (IFA) were screened human microarray. In 5 patients with identical cerebral IFA staining, CAMKV was identified as top‐ranking candidate antigen. Western blots,...
Dizziness is a frequent reason for neuroimaging and neurological consultation, but little known about the utility of either practice. We sought to characterize patterns yield consultation dizziness in emergency department (ED).We retrospectively identified consecutive adults presenting an academic ED from 2007 2009, with primary complaint dizziness, vertigo, or imbalance. Neurologists reviewed medical records determine clinical characteristics, whether study (head computed tomography [CT]...
To examine national 30-day readmission rates for patients hospitalized with neurologic disorders.Using the University HealthSystem Consortium (UHC) database, we identified 554,399 index admissions from October 2011 through January 2015. We collected information regarding age, race, insurance payer, Medicare severity diagnosis-related group, and of illness. examined by diagnosis performed multivariable logistic regression to determine predictors readmission.The unplanned rate was 11.0%. Rates...
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Epstein-Barr virus (EBV) encephalitis has been infrequently described in immunocompromised patients. Here, we report a unique case of biopsy-proven EBV renal transplant recipient presenting with altered mental status, prominent visual disturbances, and hemorrhagic, ring-enhancing mass lesions on magnetic resonance imaging. The patient was successfully treated prolonged course antivirals. This illustrates the difficulty interpretation cerebrospinal fluid polymerase chain reaction assay, given...
Background and Purpose: Medicine hospitalist programs have effectively incorporated hospitalist-run discharge clinics into clinical practice to help bridge the vulnerable transition periods after hospital discharge. A neurohospitalist clinic would similarly allow continuity with inpatient provider while addressing challenges in coordination of neurologic care. We anticipated that this afford a greater total number patients be seen at shorter interval. Methods: The posthospital who were...
Abstract After severe neurocognitive decline developed in an otherwise healthy 63-year-old man, brain magnetic resonance imaging showed eosinophilic meningoencephalitis and enhancing lesions. The patient tested positive for antibodies to Baylisascaris spp. roundworms, was treated with albendazole dexamethasone, improvement after 3 months. Baylisascariasis should be considered all patients meningitis.
Abstract Background Eosinophilic meningitis is uncommon and often attributed to infectious causes. Case presentation We describe a case of 72-year-old man who presented with subacute onset eosinophilic meningitis, vasculitis, intracranial hypertension progressive severe neurologic symptoms. Brain MRI demonstrated multifocal strokes co-localized right temporo-parieto-occipital vasogenic edema, cortical superficial siderosis, diffuse leptomeningeal enhancement. He ultimately underwent brain...
Abstract Importance Identifying infectious causes of subacute and chronic meningitis can be challenging. Enhanced, unbiased diagnostic approaches are needed. Objective To present a case series patients with diagnostically challenging in whom metagenomic next-generation sequencing (mNGS) cerebrospinal fluid (CSF), supported by statistical framework generated from mNGS non-infectious environmental controls, identified pathogen. Design Case series. Using data the CSF 94 neuroinflammatory cases...
At laboratory and clinical levels, therapeutic hypothermia has been shown to improve neurologic outcomes mortality following cardiac arrest. We reviewed each arrest in our community-based Veterans Affairs Medical Center over a three-year period. The majority of cases were in-hospital arrests associated with initial pulseless electrical activity or asystole. Of total 100 patients suffering 118 arrests, 29 involved comatose survivors, eight completing cooling. Cerebral performance category...