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INTRODUCTION: Balo's Concentric Sclerosis (BCS) is a rare demyelinating disease sometimes considered a variant of multiple sclerosis. It is characterized by an acute or subacute neurological symptoms with characteristic MRI "onion-like" white matter lesions. BCS has a wide range of presentations but is mostly self-limiting. Steroids are indicated in patients with aggressive disease. CASE PRESENTATION: We report 2 cases of BCS with monophasic course of stroke-like symptoms and single periventricular concentric lamella with onion-like appearance on MRI without inflammatory reaction in the CSF. They were treated with corticosteroids achieving clinical improvement and without neurological deficit or relapse over the following years. CLINICAL DISCUSSION: A number of cases of BCS are described in the literature that show marked recovery with early diagnosis and treatment with steroids. CONCLUSION: BCS appears to have a good prognosis when treated early in its diagnosis with steroids.
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BACKGROUND AND PURPOSE: A delay in recognizing early warning signs (WS) and risk factors (RF) of ischemic stroke causes a delay in treatment. We evaluated knowledge of RF and WS and the impact of an educational program by medical students. METHODS: We first surveyed individuals to determine knowledge of WS and RF. Then, after a 6-month education program, knowledge was reassessed. The questionnaire included sociodemographic and comorbidity data. A χ(2) and Mann-Whitney U test, as well as a multivariate logistic regression analysis to determine variables associated with knowledge, were used. RESULTS: We performed 329 baseline and 355 posteducation surveys. Initially, 57.1% mentioned at least 1 RF; this later increased to 65.9%. Mentions of obesity, dyslipidemias, hypertension, and diabetes mellitus increased significantly. With regard to WS, 37.6% mentioned at least 1, which increased to 48.1% who mentioned weakness in 1 limb, in half the body, severe headache, and altered vision. Educational level (OR, 2.53; 95% CI, 1.42-4.53; P=0.001), employment (OR, 1.72; 95% CI, 1.08-2.74; P=0.021), a family history of brain infarction (OR, 2.35; 95% CI, 1.35-4.11; P=0.02), obesity (OR, 1.63; 95% CI, 1.026-2.6; P=0.038), and having received information in the last 6 months (OR, 2.7; 95% CI, 1.51-4.83; P=0.001) were associated with a better understanding of RF and WS. CONCLUSIONS: The educational program was cost-effective and had a positive impact on knowledge of RF and WS of ischemic stroke. More education programs are required to improve knowledge of ischemic stroke.