Amado Jimenez-Ruiz

• MD
• Professor (Assistant) at Hospital Civil de Guadalajara

Background and objectives: Multiple sclerosis (MS) is a CNS disease causing significant disability, mainly in young and middle-aged individuals. Despite extensive global research, Mexico lacks comprehensive epidemiologic data on MS, complicating effective health care planning and intervention. This study analyzes the epidemiology of MS in Mexico u...

[This corrects the article DOI: 10.1371/journal.pone.0247433.].

A 17-year-old male presented with a 20-day history of vomiting, abdominal pain, weight loss, headache and fever progressing to dysarthria, somnolence, urinary incontinence, slurred speech, weakness, and inability to walk. Neurological examination revealed diminished visual acuity and diplopia. A head computed tomography (CT) showed acute hydrocepha...

Vascular cognitive impairment (VCI) is the second most common cause of cognitive impairment after Alzheimer's disease. The VCI spectrum involves a decline in cognition attributable to vascular pathologies (e.g., large infarcts or hemorrhages, microinfarcts, microbleeds, lacunar infarcts, white matter hyperintensities, and perivascular space dilatio...

Background: The leading cause of spontaneous intracerebral hemorrhage (ICH) is hypertensive arteriolopathy. In addition to age and hypertension history, patients usually present other comorbidities that potentially increase morbimortality. Ancillary studies other than non-contrast computerized tomography (NCCT) may help clarify the diagnosis and i...

Background and objectives: Stroke mortality is more common in low-income and middle-income nations such as Mexico. Prognosis data typically rely on short-term hospital follow-ups, revealing high mortality rates due to systemic complications and early recurrence. We aim to explore stroke's long-term impact by examining all-cause and cause-specific...

In 1974, Sir Graham Teasdale and Bryan Jennett wrote the “Assessment of coma and impaired consciousness, A practical scale,” which has become one of the most influential papers in the history of traumatic brain injury, with more than 10,000 citations as of January 2024. Today, it is one of the most widely used tools in emergency departments, provid...

Objective: Focal status epilepticus requires timely diagnosis and treatment. Stroke is a common cause of epileptic seizures, but stroke-induced epilepsia partialis continua (SIEPC) is a rare type of focal status epilepticus with unknown management and prognosis. The aim of the study was to present a single-center case series of patients admitted to...

Pseudotumoral posterior fossa infarction is a potentially life-threatening condition due to elevated intracranial pressure. In this context, cortical atrophy may be beneficial by redistributing pressure, reducing complications, and potentially minimizing the need for surgical intervention.

Migraine and stroke are highly prevalent diseases with a high impact on quality of life, with multiple epidemiological, pathophysiological, clinical, and prognostic areas of overlap. Migraine is a risk factor for stroke. This risk is explained by common risk factors, migraine-specific mechanisms, and non-migraine-specific mechanisms that have a rel...

Cognitive impairment involves complex interactions between multiple pathways and mechanisms, one of which being cardiac disorders. Atrial cardiopathy (AC) is a structural and functional disorder of the left atrium that may be a substrate for other cardiac disorders such as atrial fibrillation (AF) and heart failure (HF). The association between AF...

Background and Purpose: Recent evidence suggests that patients with atrial fibrillation (AF) detected after stroke ( AFDAS ) may have a lower prevalence of cardiovascular comorbidities and lower risk of stroke recurrence than AF known before stroke ( KAF ). We performed a systematic search and meta-analysis to compare the characteristics of AFDAS a...

Objectives The antiphospholipid syndrome (APS) is an autoimmune disease associated with thrombotic and non-thrombotic neurologic manifestations. APS is classified as primary (PAPS) or secondary (SAPS) when it co-exists with another autoimmune disease. We aim to describe the spectrum of acute cerebrovascular disease among patients with APS, their di...

Background: Intracerebral hemorrhage (ICH) is associated with an ominous outcome influenced by the time to hospital presentation. Objective: This study aims to identify the factors that influence an early hospital arrival after ICH and the relationship with outcome. Methods: In this multicenter registry, patients with confirmed ICH on CT scan...

Background: Preliminary evidence suggests that patients with atrial fibrillation (AF) detected after stroke (AFDAS) may have a lower prevalence of cardiovascular comorbidities and lower risk of stroke recurrence than AF known before stroke (KAF). Objective: We performed a systematic search and meta-analysis to compare the characteristics of AFDA...

A 66-year-old woman with a history of untreated hypocalcemia presented to the emergency room (ER) with a three-week history of progressive right-sided hyperkinetic, quick, violent, unpredictable movements affecting proximal and distal muscles with partial voluntary control, consistent with hemiballismus. Initial blood workup was relevant for low se...

ANTECEDENTES: El síndrome lacunar disartria-mano torpe fue descrito por Charles Miller-Fisher en 1967. Actualmente se han descrito diversos mecanismos fisiopatológicos responsables, como el infarto aterotrombótico o el infarto embólico; sin embargo, la hipótesis lacunar descrita originalmente por Miller-Fisher sigue siendo el mecanismo etiológico p...

Background: The coronavirus disease 2019 (COVID-19) pandemic dramatically increased the number of patients requiring treatment in an intensive care unit or invasive mechanical ventilation worldwide. Delirium is a well-known neuropsychiatric complication of patients with acute respiratory diseases, representing the most frequent clinical expression...

Introduction The underlying pathophysiology of atrial fibrillation (AF) detected after stroke (AFDAS) is relatively unknown. Preliminary evidence suggests AFDAS has a lower prevalence of cardiovascular comorbidities and higher incidence of insular cortex involvement than AF known to exist before stroke occurrence (KAF). This favours a neurogenic AF...

Backgorund Right atrial thrombi are rarely found straddling a patent foramen ovale (PFO). A thrombus straddling a PFO (TSPFO), also known as impending paradoxical embolism, is a medical emergency associated with up to 11.5% risk of death within 24 h of being diagnosed. We hypothesized that acute myocardial infarction (MI) and ischemic stroke (IS) d...

El Dr. Vladimir Hachinski es uno de los contribuyentes más importantes de la neurología y la neurología vascular a nivel mundial. Ha dedicado su vida a estudiar distintas áreas entre las cuales destacan la enfermedad cerebro-vascular, el deterioro cognitivo y el control cardiaco a nivel cerebral. El presente texto pretende difundir una pizca de la...

Background: Thrombi identified on echocardiography at the time of straddling a patent foramen ovale (PFO) constitute a medical emergency with an associated imminent risk of death. Ischemic stroke (IS) and myocardial infarction (MI) occurring in patients with a thrombus straddling a PFO (TSPFO) may be associated with increased risk of in-hospital de...

Background The coronavirus disease 2019 (COVID-19) is a systemic entity that frequently implies neurologic features at presentation and complications during the disease course. We aimed to describe the characteristics and predictors for developing in-hospital neurologic manifestations in a large cohort of hospitalized patients with COVID-19 in Mexi...

Introduction: Osmotic demyelination syndrome (ODS) is a non-inflammatory process of the central nervous system caused by extracellular osmotic changes, which leads to oligodendrocyte apoptosis and disruption of myelin sheaths, usually affecting patients with underlying systemic conditions that impose susceptibility to osmotic stress. Description of...

Strokes are the paradigmatic example of the sudden impairment of the cerebral regulation of cardiac autonomic regulation. Although several aspects of dysautonomic cardiovascular regulation post stroke remain unanswered, there has been a wealth of research in this area in the last decade. In this article, we present a state-of-the-art review on the...

Background: Wallenberg syndrome (WS) is a classic neurologic disorder secondary to vascular pathology of the vertebrobasilar circulation. Methods: Consecutive patients > 18 years with WS and isolated lateral medullary infarction syndrome were included from two Mexican hospitals. Risk factors, initial signs, symptoms, radiological findings, and acu...

Introduction It is unknown which comorbidities and stroke characteristics are associated with elevated cardiac troponin (cTn) levels after stroke. The main objective of this systematic review and meta-analysis is to assess the association of elevated cTn with preexisting cardiovascular comorbidities (eg, coronary artery disease, heart failure and s...

We studied the relationship between intrapulmonary shunting detected by Transcranial Doppler, disease severity, and in-hospital outcome in COVID-19 patients not undergoing IMV (non- IMV). In this study we demonstrate that intrapulmonary shunting may occur in mild to moderate COVID-19, and that pulmonary vascular pathology may not play a key role u...

The bilateral anterior opercular or Foix-Chavany-Marie syndrome (FCMS) is a rare type of cortico-subcortical suprabulbar palsy involving the lower cranial nerves. FCMS is a rare diagnosis that clinicians should keep in mind in patients presenting with bilateral facio-pharyngo-glosso-masticatory paralysis and automatic-voluntary dissociation. The...

Background: Information regarding the clinical presentation and outcome of Guillain-Barré Syndrome (GBS) in adults from Latin America is limited. Objective: To identify clinical characteristics and short-term outcome predictors in adult Mexican patients with GBS. Patients and methods: We included adult patients with clinical and electrophysiol...

This study aimed at examining the approval rate of the medical students’ regarding active euthanasia, passive euthanasia, and physician-assisted-suicide over the last ten years. To do so, the arguments and variables affecting students’ choices were examined and a systematic review was conducted, using PubMed and Web of Science databases, including...

Background: Thrombi identified on echocardiography at the time of straddling a patent foramen ovale (PFO) constitute a medical emergency with an associated imminent risk of death. Ischemic stroke (IS) and myocardial infarction (MI) occurring in patients with a thrombus straddling a PFO (TSPFO) may be associated with increased risk of in-hospital de...

Background: Hyperglycemia at admission has been recognized as an independent predictor of poor outcome after aneurysmal subarachnoid hemorrhage (aSAH); however, it remains poorly characterized in multivariate models depicting representative population samples. Objective: The objective of the study was to identify if admission blood glucose can ind...

Las enfermedades cardiovasculares y cerebrovasculares ocupan los primeros lugares de morbimortalidad en México y el mundo. El sistema nervioso y el sistema cardiovascular comparten una red intrínseca de mecanismos fisiológicos y patológicos que competen al neurólogo y al cardiólogo.

Background: The prompt recognition of an acute neurovascular syndrome by the patient or a bystander witnessing the event can directly influence outcome. We aimed to study the predictive value of the medical history and clinical features recognized by the patients’ bystanders to preclassify acute stroke syndromes in prehospital settings. Methods: W...

A previously healthy 22-year-old woman with a history with a healthy pregnancy presented 12 weeks after an uneventful delivery with progressive dyspnea and edema. Initial blood workup was relevant for an elevated B-type natriuretic peptide in 1641 pg/mL (reference: 0-100).

Background: Myasthenia gravis (MG) is a post-synaptic autoimmune disease of the neuromuscular junction, whose cardinal manifestations are weakness and fatigue. Objective: The objective of the study was to report a cohort of patients with a diagnosis of MG in a West Mexican hospital and compare the clinical profile, diagnostic, and therapeutic appr...

Background: Symptomatic palatal tremor (SPT) is an uncommon hyperkinetic movement disorder caused by the interruption of the dentato-rubro-olivary pathway due to a lesion in the brainstem or cerebellum. Methods: We describe a cohort of consecutive patients with SPT who were assessed by a single neurologist in a tertiary reference center. Results:...

Background: The recognition of stroke symptoms by patients or bystanders directly affects the outcomes of patients with acute cerebrovascular disease. Objective: The objective of the study was to assess the predictive value of the medical his- tory and clinical features recognized by the patients’ bystanders to classify neurovascular syndromes in...

Primary central nervous system lymphoma is a rare and aggressive form of extranodal non‐Hodgkin lymphoma, and its occurrence in pharmacologically immunosuppressed patients has increased over the years. Currently, mycophenolate mofetil (MMF) is one of the recommended treatment options for the induction and maintenance of lupus nephritis. The evidenc...

Objectives: To investigate the hypothesis that strokes occurring in patients with COVID-19 have distinctive features, we investigated stroke risk, clinical phenotypes, and outcomes in this population. Methods: We performed a systematic search resulting in 10 studies reporting stroke frequency among COVID-19 patients, which were pooled with one u...

Introducción. La enfermedad de Creutzfeldt-Jakob esporádica (ECJe) es una encefalopatía priónica que conlleva a cambios neurodegenerativos del sistema nervioso central de rápida progresión con pérdida neuronal y gliosis extensa. Clínicamente produce demencia rápidamente progresiva, ataxia, y mioclonias, así como datos de afectación motora, síntomas...

The COVID-19 pandemic, which started in China, has spread rapidly to affect the entire world in a matter of months. Main manifestations of the disease include a febrile syndrome accompanied by respiratory symptoms; however, cases of systemic involvement are increasingly being reported, including cardiac and central nervous system compromise. In the...

The COVID-19 pandemic, which started in China, has spread rapidly to affect the entire world in a matter of months. Main manifestations of the disease include a febrile syndrome accompanied by respiratory symptoms; however, cases of systemic involvement are increasingly being reported, including cardiac and central nervous system compromise. In the...

La pandemia de COVID-19, que comenzó en China, se ha expandido rápidamente para afectar a todo el mundo en cuestión de meses. Las manifestaciones principales incluyen un síndrome febril acompañado de síntomas respiratorios; sin embargo, cada vez se reportan más casos de afección sistémica, incluyendo la cardiaca y del sistema nervioso central. En l...

A 70-year-old woman with a history of chronic obstructive pulmonary disease, hypertension, and heart failure was transferred to our hospital after an episode of witnessed out-of-hospital cardiac arrest, for which she received 20 minutes of cardiopulmonary resuscitation. At admission, she was comatose, requiring intubation. Neurological examination...

El cáncer testicular representa el 8.3% de todas las neoplasias en hombres mexicanos. Este tipo de tumores son más frecuentes en varones de edad reproductiva entre los 15 y 35 años, y el 95% de estos se originan de células germinales. Presentamos el caso de un varón de 26 años con antecedente de tumor testicular germinal no seminomatoso estadio clí...

Meningiomas are the most common benign intracranial tumors accounting for up to 30% of non-glial tumors of the central nervous system (CNS); on neuroimaging studies, they usually appear as a lobular, extra-axial mass with well-circumscribed margins mostly located in the parasagittal aspect of the cerebral convexity. On magnetic resonance imaging (M...

A 28‐year‐old male with a history of systemic lupus erythematosus (SLE) and negative antiphospholipid syndrome (APS) serology presented with a 3‐day history of severe headache; neurological examination was unremarkable. Magnetic resonance imaging (MRI) of the brain showed bilateral frontal lobe hyperintensities in the T2‐weighted sequence with bloo...

“The Other Side of the Coin”: Hemorrhagic Stroke in Congenital Hypofibrinogenemia - Volume 46 Issue 5 - Amado Jimenez-Ruiz, Alejandro Gutierrez-Castillo, Jose Luis Ruiz-Sandoval

Septo-optic dysplasia plus is a rare congenital syndrome characterized by the classic triad of optic nerve hypoplasia, hypothalamic-hypophyseal dysfunction, and midline abnormalities, with associated malformations of cortical development. Clinical manifestations include optic nerve disease, epilepsy, intellectual delay, and endocrine dysfunction. W...

Intracerebral hemorrhage is the most devastating complication in patients taking oral warfarin. Despite theoretic reversibility with fresh frozen plasma, vitamin K and prothrombin complex concentrate, it remains an entity with high mortality. Fluid-fluid level, also known as blood-fluid level, sedimentation level, or hematocrit effect, seen on nonc...

Monoballism secondary to a mixed hyperglycemic crisis is a rare initial symptom of new-onset diabetes, which commonly affects the elderly and Asian women having inadequate glycemic control. In hyperglycemic states, the elevated serum glucose levels raise the viscosity of the blood reducing cerebral perfusion, decreasing gamma-aminobutyric acid leve...

Introduction Postural tachycardia Syndrome (POTS) is a form of chronic orthostatic intolerance where the hallmark physiological trait is an excessive increase in heart rate upon standing. POTS is a final common pathway for a number of overlapping conditions, including lower body autonomic neuropathy, elevated sympathetic tone, mast cell activation,...

Introduction: Symmetric, bilateral basal ganglia calcification is rare finding that sometimes occurs asymptomatically. Its prevalence increases with age, and the most affected site is the globus pallidus. Report of cases: A series of seven cases with clinical and imaging diagnosis of basal ganglia calcification, recorded during the 2012 to 2016...

ANTECEDENTES: los síndromes neurológicos paraneoplásicos son trastornos asociados con neoplasias, casi siempre por autoanticuerpos producidos por el propio tumor, que causan autoinmunidad cruzada con antígenos en el sistema nervioso central. Hace poco se describió una nueva enfermedad neuropsiquiátrica en mujeres jóvenes con teratoma ovárico, que p...

Patients with malignant brain astrocytomas are at high risk for developing hyperglycemia secondary to frequent corticosteroid administration. Several clinical studies have shown that hyperglycemia is associated with poor outcome in multiple disease states. Furthermore, hyperglycemia augments in vitro astrocytoma growth, whereas hypoglycemia attenua...