Aquaporin-4 protein antibody-associated optic neuritis related to neuroendocrine tumor after receiving an inactive COVID-19 vaccine

Neuromyelitis optica (NMO), also known as Devic’s disease, is a rare, autoimmune, and recurrent demyelinating disorder that primarily affects the spinal cord and optic nerve. We report a case with recurrent optic neuritis caused by the paraneoplastic NMO spectrum disorder in the setting of a gastric neuroendocrine tumor 2 weeks after receiving an inactive COVID?19 vaccine.

The Totaled Health Risks in Vascular Events (THRIVE) Score Predicts Ischemic Stroke Outcomes.

Objective: Assessment of the outcome after an ischemic stroke is important both to serve as a baseline for the evaluation of therapeutic measures and for rehabilitation and health planning. Our aim was to compare the Total Health Risks in Vascular Events (THRIVE) score with outcome scores and infarct volumes. Methods: We retrospectively reviewed our stroke registry for the period 12/2012–12/2013 and identified patients diagnosed with ischemic stroke. We included patients who had undergone Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI) within 24 hours of their stroke. One of the investigators reviewed all the DW-MRI images to verify infarct volumes. The periphery of the lesion area in each section was drawn by hand, and the surface area of the section was automatically calculated in mm2 by PACS (Picture Archiving and Communication System software), which was installed on the computer. The areas were summed, and the result was multiplied by the section thickness to calculate infarct volumes. The THRIVE scores were calculated. Infarct volumes and clinical outcomes, as measured by Modified Rankin Scale (mRS) and Barthel Index (BI), were compared to initial THRIVE score subgroups of 0–2 and ≥3. Results: We included 153 (65 female, 88 male) patients in the study. The mean age was 68.30±12.07 years. The median infarct volume was 4.10 cm3 (Interquartile range (IQR):19.180). An increasing THRIVE score was independently associated with an increasing likelihood of poor outcome (mRS≥3: odds ratio, 2.140; 95% confidence interval, 1.068–4.290; BI<60: odds ratio, 0.335; 95% confidence interval, 0.149–0.751). There was no significant difference in infarct volumes between the THRIVE score subgroups of 0–2 and ≥3 (P=0.43). Discussion: The THRIVE score is simple to use and predicts long-term neurological outcomes in ischemic stroke patients.