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246 results

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  • Left-Sided Neurological Symptoms and Negative Diffusion-Weighted MRI in Suspected Minor Stroke Patients

  • Umberto Pensato, Nishita Singh, Raed A. Joundi, Koji Tanaka, Andrew M. William Penn, Kristine Votova, Maximilian Bibok, Robert Balshaw, Andrew M. Demchuk, Michael D. Hill, Shelagh B. Coutts
  • Journal:
    Canadian Journal of Neurological Sciences , First View
    Published online by Cambridge University Press:
    27 June 2025, pp. 1-6
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  • Background:

    Historically, it has been proposed that functional neurological symptoms occur more frequently on the left side of the body due to a distinct body representation and emotional processing of the right hemisphere, yet objective imaging data to support this are lacking. We aimed to investigate whether patients with acute left-sided symptoms (right hemisphere) suspected of having a minor stroke are more likely to show negative diffusion-weighted imaging (DWI) compared to those with right-sided symptoms.

    Methods:

    Data are from the SpecTRA (Spectrometry for Transient Ischemic Attack Rapid Assessment) multicenter prospective cohort study conducted between 2013 and 2017. Patients with mild persistent unilateral hemiparesis and/or hemisensory symptoms (National Institute of Health Stroke Scale ≤ 3) and available DWI were included. The primary outcome was the proportion of patients with a negative DWI.

    Results:

    Of 1731 patients, 584 (30.8%) were included. Of these, 310 (53.1%) patients presented with left-sided symptoms and 274 (46.9%) with right-sided symptoms. Overall, 214 (36.6%) patients had a negative DWI, 126 (58.9%) with left-sided symptoms and 88 (41.1%) with right-sided symptoms: risk ratio (RR) 1.27 (95% CI = 1.02–1.57). Left-sided hemiparesis was associated with negative DWI (RR 1.42 [95% CI = 1.08–1.87]), while left-sided hemisensory symptoms were not (RR 1.11 [95% CI = 0.87–1.41]). There was no effect modification by age or sex on this association (Pinteraction 0.787 and 0.057, respectively).

    Conclusions:

    Unilateral left-sided neurological symptoms were more frequently associated with negative DWI compared to right-sided symptoms in suspected minor stroke patients. This observation is exploratory, as the final diagnosis in DWI-negative cases was not established.

The Art of Child and Adolescent Psychiatry
  • Jonathan Williams, Peter Hill
  • Published online:
    05 June 2025
    Print publication:
    24 April 2025
  • The Art of Child and Adolescent Psychiatry is an engaging and authoritative account of the essential skills required to practice child and adolescent psychiatry for all those working in children's mental health, from trainees to experienced professionals in paediatrics, psychiatry, psychology, and psychotherapy. The practical tasks of meeting the child and family, planning treatments, and working with colleagues are all covered, building on existing texts that mainly focus on diagnostic criteria, protocols, and laws. This book respects the evidence base, while also pointing out its limitations, and suggests ways in which to deal with these. Psychiatry is placed within broader frameworks including strategy, learning, management, philosophy, ethics, and interpersonal relations. With over 200 educational vignettes of the authors' vast experience in the field, the book is also highly illustrated. The Art of Child and Adolescent Psychiatry is an indispensable guide to thoughtful practice in children's mental health.

  • Introduction

  • Jonathan Williams, Barnet CAMHS, Peter Hill, St George's Hospital Medical School, University of London
  • Book:
    The Art of Child and Adolescent Psychiatry
    Published online:
    05 June 2025
    Print publication:
    24 April 2025, pp 1-4
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Page 1 of 13