Neuronland History

Neuronland Blogspot History

Purpose

- Self‑repository of articles

- Concepts and lessons learned throughout my life

Authors

Jamir Pitton Rissardo

Ana Leticia Fornari Caprara

Remarkable milestones

🏅Jan 3, 2020

>1st post

https://neuronland.blogspot.com/2020/01/number-1-article-type-case-report.html

🏅Jan 30, 2026

> 1,000,000 views

🏅Apr 12, 2026 → free Google indexation 

233. Accepted

232. Accepted

231. Accepted

230. Accepted

Rowan Research Day - 2026

Rowan Research Day - 2026

Reference list

Irritability and Related Behavioral Adverse Events Associated With Levetiracetam: A Meta‑Analysis and Meta‑Regression of Randomized Trials

Wearable and Technology‑Assisted Gait and Balance Interventions in Parkinson’s Disease: A Systematic Review and Meta‑Analysis

Trends and Disparities in Mortality Involving Epilepsy and Aspiration Pneumonia Among Older Adults in the United States, 1999–2020

Cerebrospinal Fluid and Serum Manganese Levels in Parkinson’s Disease: A Method‑Stratified Meta‑analysis

Efficacy and Safety of Levetiracetam for Essential Tremor: A Systematic Review and Meta‑Analysis

Prevalence and Clinical Correlates of Restless Legs Syndrome in Neuromyelitis Optica Spectrum Disorder: A Systematic Review and Meta‑analysis

Effects of Subthalamic Nucleus Deep Brain Stimulation on Depressive Symptoms in Patients with Parkinson’s Disease: A Meta‑Analysis

Efficacy and Safety of Droxidopa for Neurogenic Orthostatic Hypotension: A Systematic Review and Meta‑analysis

Focal Status Epilepticus in a Patient with Responsive Neurostimulation: A Rare Complication and Management Insights

Post-concussion syndrome

Post-concussion syndrome

Definition

mTBI ✚ persistent sx ✚ fx impact ✚ exclusion

mTBI

•Head trauma with ± brief loss of consciousness (<30 min)

•± post‑traumatic amnesia (<24 h)

•± confusion/disorientation

•GCS 13–15

•No structural brain injury explaining symptoms

Persistent sx

•One or more post‑concussive sx

•Persisting beyond expected recovery

>4 weeks (children/adolescents)

>3 months (adults)

Sx domains

-Somatic: headache, dizziness, fatigue, photophobia/phonophobia

-Cognitive: attention deficit, memory impairment, slowed processing, executive dysfunction

-Emotional/Behavioral: irritability, anxiety, depression, emotional lability

-Sleep: insomnia, hypersomnia, fragmented sleep

Cannabis use disorder

Cannabis use disorder (CUD)

Note

-DSM-V criteria for CUD

-RCVS

Cannabis withdrawal syndrome

>not life-threatening, but can last 2 wks

Treatment

-Psychosocial tx (CBT) 

-OFF-label

>Acetylcysteine (NAC 1200 mg BID)

>Gabapentin

>Mirtazapine

>Dronabinol/nabiximols

Increase Alertness

Increase Alertness

Situations

-Stroke (mainly thalamic)

-PD/ MS

-Consciousness disorder (TBI)

-Narcolepsy/ OSA residual sleepiness

Medications

Base on safety

In-hospital

1st: caffeine, amantadine

2nd: methylphenidate

3rd: levodopa

Outpatient: 

-modafinil/ armodafinil, bupropion, atomoxetine

-dextroamphetamine, lisdexamfetamine

Unclear:

-solriamfetol, pitolisant

Safety pearls

-Avoid late‑day dosing → insomnia, agitation

-Monitor BP/HR with methylphenidate, amphetamines, solriamfetol

-Renal adjust amantadine

-Modafinil induces CYP3A4 → ↓ OCP effectiveness

-Start low and titrate weekly

Neuroimaging Acquisition (CTA HN & CTV & DE)

Neuroimaging Acquisition

CTA H&N and CTV and DE

CTA H&N

Note

-1 CTA radiation is equal to 13 mo

Patient preparation

-Large‑bore peripheral IV (usually 18–20 G)

-Preferred site: antecubital vein (2/2 resistance)

Contrast parameters

-Volume: 50–100 mL

-Injection rate: 3–6 mL/s

-Saline flush: 20–40 mL

Timing the scan

Bolus tracking

-A small ROI is placed over a target artery (e.g., aortic arch, carotid)

-The scanner automatically triggers acquisition when attenuation reaches a preset threshold (e.g., 100–150 HU)(our hospital 130); or can manually press ☢️

Graph pressure vs timing

-Maximum pressure: 300 psi (standard)

*peak injection pressure

1, contrast injection; 2, finish of contrast injection

Time between injection to imaging

-Arterial phase 20-22s
-Venous phase 45s

*dependent of cardiac output

CTV acquisition

-Separate imaging

-If more than 3 minutes of last CTA H&N, wait 4h

-Acquisition window 40–60s

Dual Energy (DECT)

-Usual CTH is 120 Kvp

>DE is low (80–90) and high (140–150) energy acquisition

*Low→ iodine; High→ blood 

-Creates 2 maps→ iodine (IOM) & non-iodine (VNC-Virtual non-contrast)

-CT scans w/ DE

>Siemens SOMATOM Force / Drive→ 2 tubes

>Philips Spectral CT→ dual-layer

>GE Revolution→ rapid switch