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Background Transient global amnesia (TGA) is characterised by a sudden onset of anterograde amnesia lasting up to 24 hours. One major differential for TGA is transient epileptic amnesia (TEA), which typically lasts Methods We compared the clinical features of TGA ascertained in two independent cohort studies in Oxfordshire, UK (Oxford cohort 1977‐1987 vs. Oxford Vascular Study‐ OXVASC 2002‐2018) to determine the time‐trends of clinical features of TGA. Results were validated in another independent contemporary TGA cohort in Italy (Northern Umbria registry‐NU 2002‐2018). We compared the risk factors, clinical features and long‐term prognosis (major cardiovascular events–MaCE, recurrent TGA and seizure/epilepsy) of patients presenting with episodes lasting Results Overall 639 TGA patients were included (114 Oxford cohort, 100 OXVASC, 425 NU). Compared to the original Oxford cohort, there were more cases with TGA lasting Conclusions Short‐duration TGA episodes (

Background and purpose: Magnetization transfer ratio (MTR) technique has identified brain changes in grey and white matter in Parkinsons disease (PD), even in the early phase. However, how these tissue changes differ along the course of the illness is still unclear. This study was aimed at investigating how MTR values change from mild PD (PD1) to patients with advanced PD (PD2). Methods: We measured MTR values by region of interest, in 11 PD1, 11 PD2 and 10 healthy age-matched subjects. Results: Compared with controls, patients with PD1 exhibited a significant MTR reduction in substantia nigra pars compacta, substantia nigra pars reticulata, putamen, periventricular white matter and parietal white matter. In addition to the changes observed in PD1, the PD2 group exhibited a significant MTR reduction in caudate, pons, frontal white matter and lateral thalamus. Conclusion: These results suggest that MTR might reflect morphological changes induced by the disease in distinct brain areas at different stages.

An improvement in patient arrival time to stroke unit (SU) is recommended, since earlier stroke management seems to improve 'per se' functional outcome. The objective of this study was to determine if early admission influences the outcome, reduces disability and mortality at discharge and three months later independent of tlirombolytic treatment. Consecutive acute stroke patients admitted to SU between January 1st 2000 and December 31st 2003 were studied in order to analyze the actual role of acute management independent specific pharmacological treatment, we excluded subjects who underwent rt-PA. 35.8% of 2,041 consecutive stroke patients arrived within 3 hours; 62.4% within 6 hours; 37.6% arrived later. Approximately 80% of the6 hour patients presented a National Institutes of Health Stroke Scale (NIHSS)4 and modified Rankin Scale (mRS) score2 in comparison with 60% of the6 hour patients. In hospital (8.7%) and three-month (7.3%) mortality in3 hour patients were not significantly different from what observed in3 hour patients (6.8% and 6.1% respectively) while functional outcome after three months was better in3 hour patients (NIHSS: 34.6 vs 15.2; mRS: 32.9% vs 16.8%). Old age, history of TIA, cardioembolic etiology, severity of neurological deficit and hemorrhagic stroke type all led to earlier arrival time. Admission within 3 hours 'per se' improves outcome and reduced disability at three months.

We studied the correlation between the potential causes of stroke (TOAST etiological groups) and the involvement of different vascular territories seen on computed tomography (CT) scans in patients with ischemic stroke. Information from consecutive patients with a first-ever stroke have been prospectively coded and entered into a computerized data bank (Perugia Stroke Registry). A population of 1719 patients were evaluated: 1284 patients (74.7%) had ischemic stroke. Large artery disease was the main cause of entire middle cerebral artery (MCA) territory infarcts (40.9%), superficial MCA territory infarcts (35.7%), and watershed infarcts (68.2%). The highest presence of emboligenic heart disease was found in the entire MCA territory infarcts (28.8%) or superficial (29.4%) supratentorial infarcts and in cerebellar infarcts (36.8%). Small artery disease was the most common presumed cause of deep MCA infarcts (75.0%) and posterior cerebral artery (PCA) territory infarcts (52.1%). In conclusion: stroke location could depend on its etiology. Lacunar infarcts are the most prevalent (36.7%), being mostly localized in the deep MCA territory; large artery disease includes more than two-thirds of watershed infarcts; the most prevalent territories involved in cardioembolic stroke are the entire MCA and posterior fossa.

Background and purpose: SCA15 is a recently identified spinocerebellar ataxia with pure cerebellar involvement. Here, we report a novel SCA15 Italian family with atypical clinical features. Methods: Three affected members from a three-generation family segregating an autosomal dominant cerebellar ataxia underwent clinical examination and genetic tests for hereditary ataxia. Results: All affected members present with cognitive impairment and two of them with mild intermittent involuntary movements in association with the clinical hallmarks of SCA15 (gait ataxia, balance impairment, and dysarthria). Genetic tests detected a large deletion spanning ITPR1 and SUMF1 genes in affected members. Conclusion: Our findings help enlarging the clinical spectrum of SCA15.

Background and purpose: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) can be considered a useful model of pure subcortical vascular dementia (SVD) because it occurs in young adults, unlikely to have concomitant age- and Alzheimer’s disease (AD)-related pathology. In patients with CADASIL we evaluated the cerebrospinal fluid (CSF) levels of β-amyloid 1-42 (Aβ42), total tau protein (t-tau) and phosphorylated tau protein (p-tau), which are well-accepted biomarkers of AD. Methods: The CSF Aβ42, t-tau and p-tau levels were determined with Innotest β-amyloid 1-42, Innotest hTAU-Ag and Innotest Phospho-tau 181p sandwich enzyme-linked immunoassay, in 10 CADASIL patients and 17 healthy age-matched subjects. A case–control statistical analysis was carried out. Results: CSF Aβ42 levels were significantly lower in CADASIL patients than in controls, whereas CSF t-tau and p-tau levels did not differ between the two groups. Conclusions: The pattern found in CADASIL patients is similar to that reported in those with sporadic SVD, suggesting that decreased CSF Aβ42 might be related to the subcortical vascular lesions in the white matter.