Giulia Ruocco’s research while affiliated with Sapienza University of Rome and other places

Citation: Nuti, F.; Ruocco, G.; Pasculli, P.; Ciardi, M.R.; Fabbrini, G.; Bologna, M. Caudate Head Ischemic Stroke with Concurrent Tubercular Meningoencephalitis: A Case Report. Reports 2025, 8, 55. https://doi. Abstract: Background and Clinical Significance: The pathogenesis of ischemic lesions in tubercular meningoencephalitis remains unclear, as do the best therapeutic strategies during the acute phase and for secondary prevention. Case Presentation: We report on an atypical case of tubercular meningoencephalitis with a concomitant ischemic stroke. The infectious origin of the ischemic lesion was hypothesized due to a discrepancy between clinical and radiological findings. The patient underwent neuroimaging, blood tests, and a lumbar puncture to diagnose tubercular meningoencephalitis. She subsequently started on antitubercular therapy. Despite the initiation of treatment, her neurological condition worsened. A computed tomography revealed hydrocephalus, leading to the placement of an external ventricular shunt. This intervention resulted in a reduction in ventricular size and an overall improvement in her clinical condition. To reduce the risk of death, secondary prophylaxis with cardioaspirin was added to her treatment regimen. Conclusions: This report highlights the diagnostic and therapeutic challenges encountered in managing patients with tubercular meningitis presenting with concomitant ischemic stroke. By elucidating the complexities of this clinical scenario, we emphasize the importance of early recognition, comprehensive evaluation, and multidisciplinary management to optimize patient outcomes.

Patients with cervical dystonia (CD) often show an improvement in dystonic posture after sensory trick (ST), though the mechanisms underlying ST remain unclear. In this study, we aimed to investigate the effects of ST on cortical activity in patients with CD and to explore the contribution of motor and sensory components to ST mechanisms. To this purpose, we studied 15 CD patients with clinically effective ST, 17 without ST, and 14 healthy controls (HCs) who mimicked the ST. We used electroencephalographic (EEG) recordings and electromyography (EMG) data from bilateral sternocleidomastoid (SCM) muscles. We compared ST-related EEG spectral changes from sensorimotor and posterior parietal areas and EMG power changes between groups. To better understand the contribution of motor and sensory components to ST, we tested EEG and EMG correlates of three different conditions mimicking ST, the first without skin touch ("no touch" condition), the second without voluntary movements ("passive" condition), and finally without arm movements ("examiner touch" condition). Results showed ST-related alpha desynchronization in the sensorimotor cortex and theta desynchronization in the sensorimotor and posterior parietal cortex. Both spectral changes were more significant during maneuver execution in CD patients with ST than in CD patients without ST and HCs who mimicked the ST. Differently, the "no touch", "passive", or "examiner touch" conditions did not show significant differences in EEG or EMG changes determined by ST execution/mimicking between CD patients with or without ST. A higher desynchronization within alpha and theta bands in the sensorimotor and posterior parietal areas correlated with a more significant activity decrease in the contralateral SCM muscle, Findings from this study suggest that ST-related changes in the activity of sensorimotor and posterior parietal areas may restore dystonic posture and that both motor and sensory components contribute to the ST effect.