Trigeminal neuralgia
The Secondary headaches page has been updated with additional information about the treatment of trigeminal neuralgia, especially neurosurgical techniques of treatment.
Neurology
tPA for lacunar strokes
The Thrombolytic therapy in stroke page has been updated with the removal of lacunar stroke from the list of stroke types unlikely to benefit from tPA following the publication of an IST-3 subgroup analysis.
tPA for stroke between 3-4.5 hours
Some additional information about the role of tPA in patients selected without advanced imaging (e.g. CT perfusion, DWI MRI) between 3-4.5 hours has been added to the Thrombolytic therapy in stroke page following the BMJ article published today that does not support the evidence for the use of tPA for this time window.
EXTEND 1A Stroke trial
The Stroke Management, Thrombolytic therapy in stroke and Investigation of stroke pages have been updated following publication of the EXTEND 1A trial in the NEJM today showing substantial benefit for endovascular intervention following tPA in patients selected by CT perfusion to be likely to have benefit.
Sensitivity of CT for stroke
The Investigation of stroke page has been updated with additional information about the sensitivity of CT in acute ischaemic stroke.
Paediatric meningitis causes
The Paediatric meningitis page has been updated with revised information about the causes of meningitis.
Aortic arch anatomical variants
The Cerebrovascular disease page has been updated with details of the common normal aortic arch variants.
Intra-arterial therapy for large vessel stroke
Details on the role of intra-arterial therapy for stroke has been added to the Stroke management page.
Stroke
The Stroke page has been reorganised and updated.
CSF lactate in meningitis
A short segment on CSF lactate has been added to the Meningitis page.
Spontaneous intracranial hypotension
A new page called Intracranial hypotension has been created, and a new segment about spontaneous intracranial hypotension has been added to it.
Polio
A small page about Polio has been created.
Spina bifida occulta Xray
An Xray demonstrating spina bifida occulta of C2 has been added to the Non traumatic spinal cord disorders page.
Quinolone peripheral neuropathy
A minor addition has been made about Quinolone induced peripheral neuropathy on the Sulphonamides and fluoroquinolones page.
Fourth nerve palsy
Some additional information about 4th Nerve palsy has been added to the Abnormal eye movements page.
Spinal vs vertebral segments
The Spinal cord injury page has been updated with additional information about the difference between vertebral, spinal and radiological levels in spinal cord injury.
Sites of cerebral aneurysms
An image demonstrating the commonest sites for cerebral aneurysms has been added to the Subarachnoid haemorrhage page.
Peripheral reflex levels
An image demonstrating the spinal levels of the peripheral reflexes has been added to the Peripheral nervous system examination page.
Eye movements diagram
A new image demonstrating the action of the extra-ocular muscles in various positions of the eye has been added to the Eye movement screening page.
Extra-ocular muscle movement screening
The Abnormal eye movements page has been updated with additional information about the muscles responsible for eye movements in various positions of the eyes.