Bilateral loss of taste from a unilateral thalamic infarct.

Loss of sense of taste (hypogeusia) involving a part of the tongue can follow acute stroke. We describe a woman with a small right thalamic acute infarct causing bilateral (mainly left-sided) hypogeusia. Her problem remains sufficiently severe to cause distress and nutritional deficit. The anatomical distribution of her problem-cheiro-oral syndrome with concurrent hypogeusia-suggested involvement of adjacent relevant thalamic fibres. We address key considerations in examining taste in research and in practice and discuss issues to address in people with hypogeusia, including swallow deficits, psychological elements of the poststroke condition and nutrition. Dietetic management should include optimising taste stimuli and nutritional support. Introducing more detailed taste assessments into standard practice would likely improve stroke unit care.

Impact of COVID-19 on Stroke Caseload in a Major Hyperacute Stroke Unit.

Northwick Park Hospital in London, United Kingdom (UK) is one of the busiest stroke units in the country and is located in one of the areas most heavily affected by the COVID-19 pandemic in the first half of 2020. Admissions to the stroke unit and changes during the peak of COVID-19 were reviewed. Compared with the previous year, mean 96 patients were admitted with suspected stroke during April and May 2020 compared with mean 116 per month in non-COVID periods, ratio 0.82, P = 0.01. This reduction involved both strokes and mimics and was unlikely to have occurred by chance. Numbers of patients thrombolysed and of patients referred for thrombectomy decreased dramatically during this time. Mechanisms by which the COVID-19 pandemic and the March lockdown may have affected admissions to the unit are discussed. Reduced admissions to the stroke unit allowed it to contribute its resources to the care of patients with COVID-19 during the peak of admissions.