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Objective: With advances in magnetic resonance imaging (MRI) technology, nonspecific white matter lesions (NSWMH) are often incidentally detected on T2-weighted images. The origin of these lesions is unknown. In younger individuals, these findings may prompt consideration of multiple sclerosis (MS) as a possible diagnosis. In the presence of these lesions, the misinterpretation of radiological diagnostic criteria can lead to the overdiagnosis of MS. This study aims to address the management of patients with NSWMH. Method: This retrospective study involved patients referred to our MS outpatient clinic, suspected of having MS following the detection of T2-hyperintense lesions, who were subsequently diagnosed with NSWMH between 2017 and 2021. We collected data on patients' medical complaints, neurological examinations, brain MRI findings, and results from additional investigations from our hospital's data system. Results: The study included 70 patients (87.1% female), with an average age of 40.87±8.13 years (range, 19 to 55 years). The average follow-up period was 22.1±16.5 months. MRI analysis showed the number and location of lesions to be subcortical (12.06±14.01), cortical/juxtacortical (1.2±2.2), periventricular (0.91±1.42), in the corpus callosum (0.38±0.23), and in the posterior fossa (0.05±0.07). Lesions were bilaterally located in 63% of cases. Only two patients developed new lesions, as observed in the first follow-up MRI, with no further changes in subsequent MRIs during the long-term follow-up. Conclusion: Neurologists need to distinguish between NSWMH and MS lesions. Ultimately, MRI serves as a supportive diagnostic tool, with clinical findings taking precedence over all other diagnostic methods. [ABSTRACT FROM AUTHOR]

The article presents a study which investigates the onset of progressive disease course of multiple sclerosis (MS) in relation to the patient's age. The study assessed population-based and clinical-based MS cohort as well as age-of-progression-onset (t-test) and time to Expanded Disability Status Scale of 6 (EDSS6). The study found that onset of progression is more dependent on age than the presence or duration of a relapsing disease course in MS.

Background & Objective: The presence of multiple acute infarcts in stroke patients indicates cardioembolism in etiology. However, it has also been proposed that 3-territory sign (TTS) with infarction in three different vascular teritories is a radiological marker for cancer. In this study, we aimed to examine TTS in stroke patients with cancer comorbidity as compared to control. Methods: Among the patients who were hospitalized with the diagnosis of acute stroke between 2017-2022, 68 patients with a history of cancer were included in this study. Age, sex, medication, vascular risk factors (RF), cancer type, Bamford and TOAST classification, National Institute of Health Stroke Score (NIHSS), modified Rankin Score (mRS) and TTS as imaging findings were recorded. As the control group (CG), 47 stroke patients matched for age, sex, medication and RF were included. Results: The most common cancer types were gastrointestinal system, breast and lung, respectively. There was a significant difference between the two groups in terms of Bamford classification and NIHSS. 64.7% of the CaG had infarction in 1 territory, 13.2% in 2 and 13.2% in 3 territories. While 83% of CG had infarction in 1 territory, 14.9% in 2 territories, there were no participants with infarction in 3 territories (p=0.02). After exclusion of the patients with cardioembolic etiology, 14% of CaG had TTS, while no patient had TTS in CG (p=0.047). Conclusion: Our study supports the finding of TTS in cancer-related stroke, even after excluding cardioembolic etiologies. [ABSTRACT FROM AUTHOR]

Background: It is unclear if all patients with relapsing-remitting multiple sclerosis (RRMS) ultimately develop progressive MS. Onset of progressive disease course seems to be age- rather than disease duration-dependent. Some forms of progressive MS (e.g. primary progressive MS (PPMS)) are uncommon in population-based studies. Ascertainment of patients with PPMS from clinic-based populations can facilitate a powerful comparison of age at progression onset between secondary progressive MS (SPMS) and PPMS but may introduce unclear biases., Objective: Our aim is to confirm that onset of progressive disease course is more relevant to the patient's age than the presence or duration of a pre-progression relapsing disease course in MS., Methods: We studied a population-based MS cohort (n=210, RRMS n=109, progressive MS n=101) and a clinic-based progressive MS cohort (n=754). Progressive course was classified as primary (PPMS; n=322), single attack (SAPMS; n=112) and secondary progressive (SPMS; n=421). We studied demographics (chi(2) or t-test), age-of-progression-onset (t-test) and time to Expanded Disability Status Scale of 6 (EDSS6) (Kaplan-Meier analyses)., Results: Sex ratio (p=0.58), age at progression onset (p=0.37) and time to EDSS6 (p=0.16) did not differ between the cohorts. Progression had developed before age 75 in 99% of patients with known progressive disease course; 38% with RRMS did not develop progression by age 75. Age at progression onset did not differ between SPMS (44.9±9.6), SAPMS (45.5±9.6) and PPMS (45.7±10.8). In either cohort, only 2% of patients had reached EDSS6 before onset of progression., Conclusions: Patients with RRMS do not inevitably develop a progressive disease course. Onset of progression is more dependent on age than the presence or duration of a pre-progression symptomatic disease course. Moderate disability is sustained predominantly after the onset of a progressive disease course in MS.