Background: Previous studies on pathophysiology suggest a role of inflammation in atherothrombotic stroke and intracardiac thrombosis in cardioembolic stroke. We explored the magnitude of D-dimer, fibrinogen and C-reactive protein (CRP) as biomarkers in acute ischemic cerebral stroke and their relation to ischemic stroke subtypes and their impact on stroke outcome after 30 days.

Background: Migraine is a prevalent disease with much economic burden and relatively inadequate available treatment. Calcitonin gene-related peptide (CGRP) is the most abundant neuropeptide in the trigeminal nerve and it may be involved in the pathogenesis of migraine. The aim of the study was to determine the plasma level of CGRP in patients with primary headache, and if it could be a potential biomarker for migraine. Methods: The study involved four groups with 20 patients in each one: chronic migraine, episodic migraine, cluster headache and tension type headache subjects, as well as healthy volunteers of matched age and sex as controls. Their venous blood was drawn, plasma was separated, and CGRP was analyzed with commercially available ELISA kit. Results: Plasma CGRP levels were significantly increased in chronic migraine (165.0 ± 17.9 ng/L, range 131.8-194.6) as compared with control group (70.5 ± 8.36 ng/L, range 51.7-83.65), patients with episodic migraine (94.1 ± 17.83 ng/L, range 69.6-121.9), and patients with cluster headache and tension type headache (87.2 ± 13.8 ng/L, range 62.8-110.8). Plasma CGRP levels in chronic migraine were significantly higher in patients with aura (191.32 ± 5.09, range 185.45-194.60) than without aura (160.30 ± 14.93, range 131.80-186.0), and in episodic migraine were significantly higher in patients with aura (109.88 ± 7.54, range 100.70-116.30) than without aura (90.16 ± 17.56, range 69.60-121.90). Conclusion: The plasma CGRP levels were elevated in patients with chronic migraine and may be considered a potential biomarker for it. This opens the door for a therapeutic role of it for migraine.

Background: Some studies showed that copeptin, a hypothalamic hormone derived from the precursor of vasopressin, may be useful in the prediction of outcome of ischemic cerebral stroke. The aim of this work was to search if there is any correlation between serum copeptin, in the first day of ischemic stroke, and its clinical severity, radiological findings and also its predictive value of functional outcome in these patients.

Background Post-stroke cognitive and physical disabilities are common sequelae; however, it seems that the second ischemic stroke carries a higher proportional risk more than expected. In this study, we aimed to study second stroke sequelae over first-ever one with regard to cognition and physical competence. This study was conducted on two groups; the first composed of 40 patients with acute first lifetime ischemic stroke, and the second group composed of 40 acute second lifetime ischemic stroke. The study was done at menoufiya university hospitals from August 2017 to August 2018. Modified Rankin Scale (MRS), National Institute of Health Stroke Scale (NIHSS), and MINI-Cog Score, were performed at onset, 2 weeks and 3 months later. In addition, routine lab and neuro-imaging were also done. Results Size of infarction is larger in 2nd group (p < 0.001), MRS, and NIHSS are significantly higher in 2nd group. Also, there are significant differences between baseline, 2 weeks, and 3 months follow-up in MRS and NIHSS. Mini-Cog scale showed significant difference between the two groups in favor of better cognition in the 1st group. Atrial fibrillation (AF), p = 0.012 was a significant risk factor in the 1st group while smoking, p = 0.017 was the significant risk factor in the 2nd group. Large size stroke was found as independent risk factor in the 2nd group (p < 0.001). Conclusions There are significant cognitive and physical disabilities in the second recurrent ischemic stroke as compared to the first-ever one, and the second stroke tend to be more dangerous and carry more disability.

Background: Dyskinesia is one of the major complications of longterm dopaminergic treatment of Parkinson's disease (PD), and deep brain stimulation may be the only satisfactory treatment for it. This study aims to search if there is any therapeutic effect of repetitive transcranial magnetic stimulation (rTMS) for levodopa-induced dyskinesia (LID) in PD patients.Methods: This study was conducted in Mansoura International Specialized Hospital in 43 complicated idiopathic PD patients. The patients with LID were divided into two groups matched in age, sex, duration and stage of the disease. Dyskinesia was detected by the Unified PD Rating Scale section IV. The patients of the study group (20 patients) received active rTMS, 5 Hz was applied bilaterally over the motor hand and leg areas of the cortex, in 20 trains, and each train is formed of 100 pulses, with 20-s inter-train interval. Ten sessions were administered once per day for 10 successive days for each patient. The patients of the control group (20 patients) received sham rTMS.Results: After rTMS, there was significant improvement in LID in the study group (P < 0.001), while there was no improvement in the control one (P = 0.585). As regards to the LID clinical presentations, there was no significant difference between the two groups according to dyskinesia duration (P = 0.246), disability (P = 0.425) and early morning dystonia (P = 0.059), while there was significant improvement of painful dyskinesia in the study group (P = 0.046). Conclusions:The rTMS may have an additional therapeutic benefit for LID. Further studies may put the best rTMS parameters to establish more prominent and longer-lasting clinical effects.