@article{Manorenj_2025h,

title = {Anticoagulant initiation after cardioembolic stroke: practical timing and options},

author = {Sandhya Manorenj and S. Sravan Kumar and Chillapuram Shashanka},

url = {https://www.ijcmph.com/index.php/ijcmph/article/view/14185/8653},

doi = {10.18203/2394-6040.ijcmph20252872},

issn = {2394-6032},

year  = {2025},

date = {2025-08-30},

urldate = {2025-08-30},

journal = {International Journal of Community Medicine and Public Health},

volume = {12},

issue = {9},

pages = {4186-4195},

abstract = {Cardioembolic Stroke (CES) is a leading cause of Acute Ischemic Stroke (AIS) and is linked to worse outcomes. There is a notably increased risk of “hemorrhagic transformation” (HT) in CES cases, where anticoagulant therapy is essential for patients with atrial fibrillation (AF) to prevent future strokes. Additionally, larger infarcts are associated with a higher risk of HT, effectively doubling the mortality risk. Currently, there are no clear guidelines connecting infarct size to “anticoagulation” decisions or management of HT cases. This review specifically focuses on the timing of “anticoagulation” initiation in patients with AF. Out of 380 articles evaluated, 50 relevant studies were included in this review. Generally, existing guidelines recommend starting “anticoagulation” between 4 to 14 days after anAIS. The review seeks to summarize current research on early versus late “anticoagulation” initiation in AF patients who experience AIS, providing clinicians with practical insights on optimal timing and the selection of effective and safe anticoagulants.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2025g,

title = {Hot water epilepsy: a case report with EEG findings and clinical insights},

author = {Sandhya Manorenj and Eluka Mounika Reddy},

url = {https://sciencevolks.com/neurology/pdf/SVOA-NE-06-017.pdf},

doi = {10.58624/SVOANE.2025.06.017},

issn = {2753-9180},

year  = {2025},

date = {2025-06-25},

urldate = {2025-06-25},

journal = {SVOA Neurology},

volume = {6},

issue = {3},

pages = {86-90},

abstract = {Hot water epilepsy (HWE) is a rare form of reflex epilepsy triggered by exposure to hot water, typically during baths, and can be difficult to diagnose due to normal electroencephalogram (EEG) results. This case outlines a 30-year-old woman who experienced recurrent seizures over five years while bathing in hot water. Despite her history of generalized epilepsy, her initial EEG and MRI results were unremarkable. A subsequent sleep-deprived video EEG detected ictal discharges originating from the frontal lobes, confirming epilepsy. The patient was advised to continue her anti-seizure medication and to avoid hot baths. The discussion emphasizes the challenges in identifying the anatomical substrate of HWE, as most cases typically involve the temporal or parietal regions. This case contributes to a deeper understanding of HWE by identifying frontal lobe discharges as a potential correlate and highlights the vital role of EEG in guiding treatment adjustments.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kumar_2025b,

title = {A case of bilateral spiller syndrome},

author = {S. Sravan Kumar and Sandhya Manorenj and Chillapuram Shashanka},

url = {https://journals.lww.com/neur/fulltext/9900/a_case_of_bilateral_spiller_syndrome.108.aspx},

doi = {10.4103/neurol-india.Neurol-India-D-24-00780},

issn = {0028-3886},

year  = {2025},

date = {2025-06-18},

urldate = {2025-06-18},

journal = {Neurology India},

abstract = {No abstract available},

note = {Online ahead of print},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kumar_2025,

title = {A deadly duo: viper bite-induced coagulation disorder and multiple territory ischemic stroke},

author = {S. Sravan Kumar and Sandhya Manorenj},

url = {https://journals.lww.com/annalsofian/citation/9900/a_deadly_duo__viper_bite_induced_coagulation.436.aspx},

doi = {10.4103/aian.aian_1015_24},

issn = {0972-2327},

year  = {2025},

date = {2025-06-11},

urldate = {2025-06-11},

journal = {Annals of Indian Academy of Neurology},

abstract = {No abstract available},

note = {Online ahead of print},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2025f,

title = {Isolated starfield pattern and the type 1 cerebral fat microembolism: a radiological perspective},

author = {Sandhya Manorenj and S. Sravan Kumar and Sravan Kumar Marupaka and Farah Naaz},

url = {https://journals.lww.com/annalsofian/fulltext/2025/05000/isolated_starfield_pattern_and_the_type_1_cerebral.19.aspx},

doi = {10.4103/aian.aian_1042_24},

issn = {0972-2327},

year  = {2025},

date = {2025-06-09},

urldate = {2025-06-09},

journal = {Annals of Indian Academy of Neurology},

volume = {28},

number = {40485206},

issue = {3},

pages = {435-436},

abstract = {No abstract available},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2025e,

title = {Teaching video neuroImage: palmo-facial reflex a variant of the palmomental reflex},

author = {Sandhya Manorenj and S. Sravan Kumar and Chillapuram Shashanka and Eluka Mounika Reddy},

url = {https://www.neurology.org/doi/full/10.1212/WNL.0000000000213731},

doi = {10.1212/WNL.0000000000213731},

issn = {0028-3878},

year  = {2025},

date = {2025-05-22},

urldate = {2025-05-22},

journal = {Neurology},

volume = {104},

issue = {12},

pages = {e213731},

abstract = {No abstract available},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2025c,

title = {Cytotoxic edema of bilateral semicentrum ovale in uremic encephalopathy: a rare radiological entity},

author = {Sandhya Manorenj and S. Sravan Kumar and Chillapuram Shashanka},

url = {https://sciencevolks.com/neurology/pdf/SVOA-NE-06-009.pdf},

doi = {10.58624/SVOANE.2025.06.009},

issn = {2753-9180},

year  = {2025},

date = {2025-03-21},

urldate = {2025-03-21},

journal = {SVOA Neurology},

volume = {6},

issue = {2},

pages = {47-49},

abstract = {Uremic encephalopathy can mimic clinically and radiologically like a stroke. The presence of cytotoxic edema in bilateral semicentrum ovale without involvement of basal ganglion is uncommon in uremic encephalopathy in a diabetic patient. Here we demonstrate the rare white matter radiological subtype of uremic encephalopathy in a 48-year-old woman with chronic kidney disease.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2025d,

title = {Acute migraine: an overview},

author = {Sandhya Manorenj},

url = {https://www.ijcmph.com/index.php/ijcmph/article/view/13681/8304},

doi = {10.18203/2394-6040.ijcmph20250952},

issn = {2394-6032},

year  = {2025},

date = {2025-03-19},

urldate = {2025-03-19},

journal = {International Journal of Community Medicine and Public Health},

volume = {12},

issue = {4},

pages = {1952-1964},

abstract = {Migraine is a primary headache disorder that affects people of all ages. It is the second most common type of headache disorder after tension headache. Migraine headache usually begins in adolescence, peak in the third decade of life, and becomes less frequent and less severe in later decades. Migraine affects women three times more often than men. Migraine can be very debilitating and can significantly impair an individual's ability to perform daily activities. Creating a clinical review on acute migraine and its management, using a pragmatic approach based on recent advances. The author reviewed the available literature on migraine and identified relevant articles through a literature search in the PubMed database to create this review. Migraine diagnosis is based on clinical examination and medical history, and imaging is usually not required. There are two main types of pharmacological treatment for migraine: abortive treatment to stop acute attacks and prophylactic treatment or preventive medication to reduce the frequency and severity of attacks. The treatment of migraine is constantly improving with new target-specific treatments, neuromodulation devices, and non-oral formulations of established medicines. This comprehensive review focuses on recent guidelines, newer approved drugs, and emerging therapies for managing acute migraine. },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2025i,

title = {I-Beam sign in progressive supranuclear palsy},

author = {Sandhya Manorenj and Chillapuram Shashanka},

url = {https://journals.lww.com/neur/fulltext/2025/03000/i_beam_sign_in_progressive_supranuclear_palsy.20.aspx},

doi = {10.4103/neurol-india.neurol-india-d-24-00101},

issn = {0028-3886},

year  = {2025},

date = {2025-03-01},

urldate = {2025-03-01},

journal = {Neurology India},

volume = {73},

number = {pmid40176225},

issue = {2},

pages = {330-331},

abstract = {Background: Postural instability occurs in both progressive supranuclear palsy (PSP) and idiopathic Parkinson’s disease (IPD). Objective: Testing for postural instability using a pull test helps to differentiate IPD from PSP based on the presence of an I-beam sign in the latter. Methods and Materials: Here, we demonstrate the I-beam sign in a 65-year-old lady who presented with initial marked postural instability. Results: In PSP, postural instability occurs early. Here, we found that in patients with PSP on the backward pull test, they fall without taking a single step, like a building falls without an I-beam. This sign is called I-beam sign. In patients with IPD, this sign is absent as they take one or a few steps before falling. Clinical examination showed mild restriction of upward gaze, and there was radiological evidence of midbrain atrophy. The present case was diagnosed as PSP with a postural instability variant. Conclusion: The presence of the I-beam sign in patients with Parkinsonism suggests PSP.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2025,

title = {Diaphragmatic myoclonus effectively treated with lacosamide: a very rare phenomenon of belly dancer syndrome},

author = {Sandhya Manorenj and Bushra Naaz and Manju Madhavan},

url = {https://journals.lww.com/neur/fulltext/2025/01000/diaphragmatic_myoclonus_effectively_treated_with.26.aspx},

doi = {10.4103/neurol-india.Neurol-India-D-23-00458},

issn = {0028-3886},

year  = {2025},

date = {2025-02-07},

urldate = {2025-02-07},

journal = {Neurology India},

volume = {73},

issue = {1},

pages = {149-151},

abstract = {Diaphragmatic myoclonus, also called diaphragmatic flutter, has characteristic abdominal movements resembling those of a belly dancer; hence, it is also called belly dancer syndrome (BDS). BDS is characterized by high-frequency involuntary diaphragmatic contractions. BDS can occur due to a lesion anywhere in the pathway for diaphragmatic control, from the motor cortex to the neural supply to the diaphragm. Here we report a 21-year-old girl who presented with acute-onset abdominal movements of 5 days duration. Clinical examination showed abdominal jerky movements with preserved awareness. Electroencephalograms (EEG) showed polyspike wave discharges consistent with cortical myoclonus. These abdominal myoclonic jerks disappeared dramatically on treatment with lacosamide, a third-generation antiepileptic drug. There are few case reports of BDS in the literature with a cortical myoclonus origin instead of the widely described segmental myoclonus form. The case also highlights the efficacy of lacosamide in treating diaphragmatic myoclonus jerk in young adults.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2025b,

title = {Acquired hepatocerebral degeneration and accumulation of manganese},

author = {Sandhya Manorenj and Sravan Kumar Marupaka},

url = {https://journals.lww.com/annalsofian/fulltext/2025/01000/acquired_hepatocerebral_degeneration_and.17.aspx},

doi = {10.4103/aian.aian_633_24},

issn = {0972-2327},

year  = {2025},

date = {2025-01-02},

urldate = {2025-01-02},

journal = {Annals of Indian Academy of Neurology},

volume = {28},

issue = {1},

pages = {107-109},

abstract = {A 43-year-old man with chronic liver disease (CLD) due to alcoholism and hepatitis B virus (HBV) infection presented at the emergency department after experiencing a generalized tonic–clonic seizure and altered consciousness. He had been diagnosed with adult-onset epilepsy 3 years ago and was taking medication for seizure, which he had missed 2 days before. In addition, he was being treated with entecavir for the HBV infection.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2024g,

title = {Efficacy and safety of tenecteplase versus alteplase in acute ischemic stroke: evidence from a South Indian cohort},

author = {Sandhya Manorenj and Maryam and Iqra Jahan and Syeda Noor Fatima and Yumna Fatima and Mir Wajahath Ali},

url = {https://rjn.com.ro/articles/2024.4/RJN_2024_4_Art-13.pdf},

doi = {10.37897/RJN.2024.4.13},

issn = {1843-8148},

year  = {2024},

date = {2024-12-26},

urldate = {2024-12-26},

journal = {Romanian Journal of Neurology},

volume = {23},

issue = {4},

pages = {403-409},

abstract = {Background. Acute ischemic stroke (AIS) requires efficient thrombolytic therapy to re-establish vascular permeability and mitigate tissue damage. Alteplase and tenecteplase are prominent tissue plasminogen activators (tPAs) employed in this clinical scenario. This study compares these two agents, focusing on their efficacy, safety profiles, time parameters, and rates of re-hospitalization.

Objectives. To compare the efficacy and safety of tenecteplase versus alteplase for treating acute ischemic stroke in South Indian patients: a prospective study.

Methods. At a single center, we conducted a prospective, observational, non-interventional study of patients receiving thrombolytics alteplase or tenecteplase from November 2023 to July 2024, which included patients within a 4.5-hour window of symptom onset. The principal outcome of this study is to evaluate early neurological improvement using the clinical assessment scales – the National Institutes of Health Stroke Scale (NIHSS) at baseline and 24 hours, and the Modified Rankin Scale (mRS) at admission and 3 months. The secondary outcomes include the door-to-needle time (DTN) and assessing the need for re-hospitalization. Data was scrutinized using a t-test and median interquartile range (IQR).

Results. The study enrolled 64 patients, 32 treated with alteplase and 32 with tenecteplase. Statistical significance was found for the efficacy of the drugs (NIHSS post-treatment p = 0.01 and mRS p = 0.002). The DTN and re-hospitalization were found to be non-significant.

Conclusion. Both alteplase and tenecteplase efficiently manage AIS, with tenecteplase demonstrating advantages in early neurological improvement, ease of administration, and cost-effectiveness.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Shaik_2024d,

title = {A pseudo guillain barre syndrome (GBS) presentation of sjogren’s syndrome},

author = {Reshma Sultana Shaik and Sandhya Manorenj},

url = {https://journals.lww.com/neur/fulltext/2024/11000/a_pseudo_guillain_barre_syndrome__gbs_.29.aspx},

doi = {10.4103/ni.ni_4_23},

issn = {0028-3886},

year  = {2024},

date = {2024-12-17},

urldate = {2024-12-17},

journal = {Neurology India},

volume = {72},

issue = {6},

pages = {1283-1284},

abstract = {NA},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Mohiuddin_2024,

title = {Vasculopathy and posterior circulation stroke after measles in two children},

author = {Mohammed Fahad Mohiuddin and Sandhya Manorenj and Shalini Akunuri and Ahlaam Arif},

url = {https://journals.lww.com/neur/fulltext/9900/vasculopathy_and_posterior_circulation_stroke.5.aspx},

doi = {10.4103/neurol-india.neurol-india-d-24-00502},

issn = {1998-4022},

year  = {2024},

date = {2024-11-29},

urldate = {2024-11-01},

journal = {Neurology India},

publisher = {Medknow},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2024e,

title = {Awake bruxism in a patient with advanced alzheimer’s disease: an epiphenomenon of anxiety or marker of advanced disease},

author = {Sandhya Manorenj},

url = {https://journals.lww.com/neur/fulltext/2024/09000/awake_bruxism_in_a_patient_with_advanced.35.aspx},

doi = {10.4103/neurol-india.Neurol-India-D-23-00401},

issn = {0028-3886},

year  = {2024},

date = {2024-10-31},

urldate = {2024-10-31},

journal = {Neurology India},

volume = {72},

number = {pmid39428794},

issue = {5},

pages = {1103-1104},

abstract = {NA},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2024f,

title = {Unilateral asymptomatic multiple cerebral microbleeds: a very rare radiological entity},

author = {Sandhya Manorenj and S. Sravan Kumar and Chillapuram Shashanka and Sravan Kumar Marupaka},

url = {https://journals.lww.com/annalsofian/fulltext/2024/27050/unilateral_asymptomatic_multiple_cerebral.18.aspx},

doi = {10.4103/aian.aian_383_24},

issn = {0972-2327},

year  = {2024},

date = {2024-09-06},

urldate = {2024-09-06},

journal = {Annals of Indian Academy of Neurology},

volume = {27},

number = {pmid39240195},

issue = {5},

pages = {573-575},

abstract = {NA},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2024d,

title = {Basal cistern sparing pattern of subarachnoid hemorrhage: an imaging clue for SAH beyond aneurysm},

author = {Sandhya Manorenj},

url = {https://journals.lww.com/neur/fulltext/2024/07000/basal_cistern_sparing_pattern_of_subarachnoid.40.aspx},

doi = {10.4103/neurol-india.Neurol-India-D-23-00705},

issn = {0028-3886},

year  = {2024},

date = {2024-08-31},

urldate = {2024-08-31},

journal = {Neurology India},

volume = {72},

number = {pmid39216057},

issue = {4},

pages = {892-893},

abstract = {NA},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Shaik_2024b,

title = {Acute necrotizing encephalopathy of childhood (ANEC) in a patient with dengue and leptospirosis},

author = {Reshma Sultana Shaik and Sandhya Manorenj and Sravan Kumar Marupaka},

url = {https://journals.lww.com/neur/fulltext/2024/03000/acute_necrotizing_encephalopathy_of_childhood.43.aspx},

doi = {10.4103/ni.ni_984_21},

issn = {0028-3886},

year  = {2024},

date = {2024-04-30},

urldate = {2024-04-30},

journal = {Neurology India},

volume = {72},

number = {pmid38691496},

issue = {2},

pages = {433-434},

abstract = {None},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Shaik_2024c,

title = {Cervicomedullary compression in achondroplasia: a feared complication and an unforeseen risk factor of posterior circulation stroke},

author = {Reshma Sultana Shaik and Sandhya Manorenj and Sravan Kumar Marupaka},

url = {https://journals.lww.com/neur/fulltext/2024/03000/cervicomedullary_compression_in_achondroplasia__a.31.aspx},

doi = {10.4103/ni.ni_537_21},

issn = {0028-3886},

year  = {2024},

date = {2024-04-30},

urldate = {2024-04-30},

journal = {Neurology India},

volume = {72},

number = {pmid38691484},

issue = {2},

pages = {399-402},

abstract = {Achondroplasia is an autosomal dominant disorder with defect in the ossification of the cartilage of long bones. Many bony abnormalities constitute its clinical features, with craniovertebral junction (CVJ) anomalies being one of most common issues which need to be addressed at the earliest. CVJ anomalies in individuals may cause neurovascular compression, which may warrant an early surgery to prevent catastrophic complications. Posterior circulation strokes secondary to CVJ anomalies are well known. We hereby present an unusual case of posterior circulation stroke in an achondroplastic dwarf who presented to our tertiary care centre. Prospective case study. The present case adds to the existing literature about one of the preventable causes of fatal posterior circulation strokes in the young. A high index of suspicion for neurovascular compression at the foramen magnum and early initiation of treatment in achondroplastic young individuals may have gratifying results.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}