Cerebral venous thrombosis (CVT) is a rare type of stroke, with a complex clinical presentation that can make it a diagnostic challenge for the swift initiation of anticoagulation. When a hemorrhagic transformation is added, therapeutic management becomes even more complex. We describe a series of four cases, aged between 23 and 37 years old, with cerebral venous thrombosis. They were admitted to our clinic between 2014 and 2022. All cases presented significant challenges in either diagnostic, therapeutic or etiologic evaluation, at different stages of the disease. Late complications such as epilepsy or depression and other behavioral disorders represent long-term sequelae for the patient. Therefore, through its late complications, CVT is not only an acute disease but a chronic disorder with long-term follow-up requirements. The first case of the series is of a postpartum woman with focal neurological deficit caused by CVT with hemorrhagic transformation that presented multiple thrombotic complications and severe depression. The second case is of a man with extensive cerebral thrombosis who developed bilateral papillary edema under therapeutic anticoagulation treatment. The third case is of a woman with bilateral cavernous sinus thrombosis who later developed depressive disorder and focal seizures. The fourth case is of a pregnant woman in the first trimester presenting with a steep decline in consciousness level secondary to deep cerebral vein thrombosis requiring intensive care and subsequently developing a memory disorder. For a long period of time, due to being underdiagnosed, few things were known about CVT. Nowadays, we have all the tools to diagnose, treat, and follow up cases of CVT.

We present the case of a 54-year-old male, without any significant medical history, who insidiously developed speech disturbances and walking difficulties, accompanied by backward falls. The symptoms progressively worsened over time. The patient was initially diagnosed with Parkinson’s disease; however, he failed to respond to standard therapy with Levodopa. He came to our attention for worsening postural instability and binocular diplopia. A neurological exam was highly suggestive of a Parkinson-plus disease, most likely progressive supranuclear gaze palsy. Brain MRI was performed and revealed moderate midbrain atrophy with the characteristic “hummingbird” and “Mickey mouse” signs. An increased MR parkinsonism index was also noted. Based on all clinical and paraclinical data, a diagnosis of probable progressive supranuclear palsy was established. We review the main imaging features of this disease and their current role in diagnosis.

"This article aims to highlight the burnout burden among neurologists and provide information on some of its causes and consequences. We report an original article that reviews our current understanding of burnout matter in the neurology field. The main search engine through which we performed extensive literature research was PubMed, Scopus, and Google Scholar. The following information was collected: triggers of burnout and factors that perpetuate it, major complaints, values, and goals that dictate how coaching with it. Physician burnout is an umbrella term characterized by symptoms determined by exposure to chronic workplace stressors. Simply put, it encompasses many dimensions: emotional exhaustion, feelings of cynism, detachment (depersonalization), and a sense of ineffectiveness at work (low personal accomplishment). Burnout is common among all medical specialties, but neurology ranks at the top of the list. Several identified factors continue to fuel this problem. Properly addressing them, rethinking practice, and implementing wise, modern strategies can make significant contributions to reducing it. Aside from the chronic harm to the physician, burnout puts at risk the healthcare community at many levels including patients, other professionals, finances, etc. This paper wants to emphasize that burnout in neurology should be regarded as a global crisis. Thus, some strategies are proposed "

No abstract