Clinical characteristics, Risk factors, and outcomes of Posterior circulation stroke: A retrospective study between younger and older adults in Saudi Arabia.

INTRODUCTION: Posterior circulation stroke (PCS) may be less prevalent than its anterior counterpart but contributes to substantial morbidity and mortality. The aim was to characterize PCS's demographics, clinical presentation, management, and outcomes between younger and older adults in Saudi Arabia. METHODS: This retrospective cohort study was conducted at two tertiary medical centers in Saudi Arabia between March 2016 and December 2020. All patients who presented with symptoms of posterior circulation stroke and had positive brain imaging were included. RESULTS: The study involved 160 posterior circulation stroke patients, stratified into two age groups: 71 patients aged 18-59 years and 89 patients aged 60 years and above. The mean age of the entire cohort was 60.9 years, and 77 % were males. Hypertension was more prevalent in the older age group (88 % vs. 69 %, p=0.005), and smoking was significantly higher among younger patients (38 % vs. 15 %; p=0.0009). Only 22.4 % received thrombolysis and/or thrombectomy. Most strokes involved the posterior cerebral artery (45.6 %). Large artery atherosclerosis was the most common subtype. At discharge, younger patients had higher NIHSS compared to older patients. CONCLUSION: Our investigation of 160 PCS patients in Saudi Arabia uncovers notable trends: a mere 22.4 % received thrombolysis and/or thrombectomy and a significant prevalence of posterior cerebral artery involvement due to large artery atherosclerosis. The study further reveals younger patients disproportionately had severe outcomes. Highlighting the need for improved stroke care and heightened awareness, this research contributes vital data to an underexplored domain, urging further study to optimize care and understand PCS dynamics in Saudi Arabia.

Combined Central and Peripheral Demyelinating Disease With Good Response to B-Cell Depleting Therapy.

Combined central and peripheral demyelination (CCPD) is a rare disorder characterized by demyelinating lesions in both the central and peripheral nervous systems. The following case report is of a 29-year-old man who presented with a three-month history of progressive lower and upper limb weakness associated with facial and arm tremor, as well as urinary hesitancy. Brain and spine magnetic resonance imaging showed multiple demyelinating plaques. Nerve conduction studies revealed evidence of demyelination with severe prolongation of distal motor latencies and reduced conduction velocities. The patient received plasmapheresis and high-dose corticosteroids, which lead to clinical improvement. A rituximab infusion protocol was subsequently started, and the patient received two cycles. There was a significant functional improvement upon the use of rituximab. This study reports a rare neurological disease entity and highlights the necessity for conducting larger studies to optimally demonstrate the efficacy of rituximab in CCPD.

The Average Time Gap Between CA-125 Tumor Marker Elevation and Confirmation of Recurrence in Epithelial Ovarian Cancer Patients at Princess Noorah Oncology Center, Jeddah, Saudi Arabia.

The monitoring of the tumor marker cancer antigen 125 (CA-125) is commonly used as a part of epithelial ovarian cancer monitoring for recurrence. This study seeks to calculate the average time between CA-125 elevation above 35 IU/mL and evidence of recurrence through any currently accepted modality (positive clinical findings, biopsy, imaging, or PET [positron emission tomography] findings) in a patient population in Jeddah, Saudi Arabia. We studied patients who were diagnosed between January 2006 and December 2016, underwent successful primary therapy, and were then followed up at Princess Noorah Oncology Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia. We adopted a cross-sectional chart review study design. We used inclusive (consecutive) sampling. A total of 13 patients were included, of whom 76.9% (10 patients) developed CA-125 elevations above 35 IU/mL prior to the confirmation of recurrence. If all 13 patients are included in the mean average calculation, the mean average time elapsed between CA-125 elevation and confirmation of recurrence was 161.5 days (standard deviation ± 230.6). If only the 10 patients who did exhibit a CA-125 elevation above 35 IU/mL were included, the mean average was 210 days (standard deviation ± 244.2).