| 04/29/2006
12:12 PM
Racial and Geographic Differences in Awareness Treatment and Control of Hypertension
Stroke. 2006;37:1171
Stroke mortality is higher in the "Stroke Belt" and among blacks in the United States. Because hypertension is the leading risk factor for stroke, hypertension management (raising awareness, increasing treatment, and improving control) may reduce these disparities.
04/29/2006
12:11 PM
Lifetime Cost of Ischemic Stroke in Germany Results and National Projections From a Population Based Stroke Registry
Stroke. 2006;37:1179
The number of stroke patients and the healthcare costs of strokes are expected to rise. The objective of this study was to determine the direct costs of first ischemic stroke and to estimate the expected increase in costs in Germany.
04/29/2006
12:10 PM
Not All Patients With Atrial Fibrillation Associated Ischemic Stroke Can Be Started on Anticoagulant Therapy
Stroke. 2006;37:1217
Ischemic stroke patients in atrial fibrillation (AF) have a 10% to 20% risk of recurrent stroke. Warfarin reduces this risk by two thirds. However, warfarin is underutilized in this patient group. We performed a prospective study to determine the reasons why warfarin is not started in these patients.
04/29/2006
12:09 PM
Poststroke C Reactive Protein Is a Powerful Prognostic Tool Among Candidates for Thrombolysis
Stroke. 2006;37:1205
After acute stroke, an increased level of C-reactive protein (CRP) measured at discharge predicts unfavorable outcome. We sought to investigate whether CRP measured before tissue plasminogen activator (tPA) treatments may add prognostic information to guide stroke thrombolysis.
04/29/2006
12:08 PM
Multiple Mechanisms Underlying the Neuroprotective Effects of Antiepileptic Drugs Against In Vitro Ischemia
Stroke. 2006;37:1319
The possible neuroprotective effects of classic and new antiepileptic drugs on the electrophysiological changes induced by in vitro ischemia on striatal neurons were investigated. In particular, the aim of the study was to correlate the putative neuroprotective effects with the action of these drugs on fast sodium (Na+) and high-voltage–activated
(HVA) calcium (Ca2+) currents.
04/29/2006
12:07 PM
How Critical Is Fibrous Cap Thickness to Carotid Plaque Stability
Stroke. 2006;37:1195
Acute cerebral ischemic events are associated with rupture of vulnerable carotid atheroma and subsequent thrombosis. Factors such as luminal stenosis and fibrous cap thickness have been thought to be important risk factors for plaque rupture. We used a flow–structure interaction model to simulate the interaction between blood flow and atheromatous plaque to evaluate the effect of the degree of luminal stenosis and fibrous cap thickness on plaque vulnerability.
04/29/2006
11:43 AM
Increasing Rates of Dementia at Time of Declining Mortality From Stroke
Stroke. 2006;37:1155
Stroke is associated with increased risk of dementia. There has been a decline in mortality from stroke among persons 65 and over in recent decades in the US. It is not clear, however, how this process has affected incidence of various dementias.
04/29/2006
11:42 AM
Weir Mitchells observations on sensory localization and their influence on Jacksonian neurology
NEUROLOGY 2006;66:1241-1244
To examine Weir Mitchell's clinical observations on sensory localization, to determine whether they influenced Jacksonian neurology, and to elucidate the private relationship between the two men.
04/29/2006
11:41 AM
Endogenous Expression of C Reactive Protein Is Increased in Active Ulcerated Noncomplicated Human Carotid Artery Plaques
Stroke. 2006;37:1200
There is growing evidence suggesting that C-reactive protein (CRP) is an effecter molecule able to induce and promote atherothrombosis. The presence of CRP in atherosclerotic plaques may reflect local production or infiltration from circulating CRP increased in general inflammatory responses. Our aim was to analyze the presence of CRP in human advanced carotid artery plaques with differential anatomo-pathological characteristics and to assess local expression of CRP and other proinflammatory genes in these lesions.
04/29/2006
11:40 AM
Alcohol Intake Carotid Plaque and Cognition
Stroke. 2006;37:1160
Moderate alcohol intake has been associated with better cognitive performance, implicating vascular and neurodegenerative processes. Few studies to clarify the importance of vascular disease have included direct measures of atherosclerosis or minority populations at higher risk of vascular disease and dementia.
04/29/2006
11:39 AM
Clinical Outcome After First and Recurrent Hemorrhage in Patients With Untreated Brain Arteriovenous Malformation
Stroke. 2006;37:1243
The morbidity from spontaneous hemorrhage of untreated brain arteriovenous malformations (AVM) is not well described.
04/29/2006
11:38 AM
Dose Escalation of Desmoteplase for Acute Ischemic Stroke DEDAS
Stroke. 2006;37:1227
Desmoteplase is a novel plasminogen activator with favorable features in vitro compared with available agents. This study evaluated safety and efficacy of intravenous (IV) desmoteplase in patients with perfusion/diffusion mismatch on MRI 3 to 9 hours after onset of acute ischemic stroke.
04/28/2006
10:18 AM
VA REINFORCES STATESIDE REHAB UNITS FOR IRAQ BLAST INJURIES
Neurology Today. 6(8):18,24, April 18, 2006
04/28/2006
10:17 AM
CAUSE OF THE REFRACTORY EPILEPSY A RING CHROMOSOME 20 MUTATION
Neurology Today. 6(8):11, April 18, 2006
04/28/2006
10:16 AM
POST STROKE MANAGEMENT FOR AFRICAN AMERICANS LEAVES ROOM FOR IMPROVEMENT
Neurology Today. 6(8):16-17, April 18, 2006
04/28/2006
10:16 AM
NEUROPROTECTIVE AGENT EFFECTIVE IN ISCHEMIC STROKE IN CLINICAL TRIALS
Neurology Today. 6(8):5-7, April 18, 2006
04/28/2006
10:15 AM
WHAT IS CAUSING REFRACTORY EPILEPSY
Neurology Today. 6(8):4, April 18, 2006
04/28/2006
10:15 AM
NEARLY HALF OF STROKE SURVIVORS READMITTED WITHIN ONE YEAR AFTER DISCHARGE
Neurology Today. 6(8):4-5, April 18, 2006
04/28/2006
10:10 AM
Might calcium disorders cause or contribute to myoclonic seizures in epileptics
Medical Hypotheses Volume 66, Issue 5 , 2006, Pages 969-974
Although epilepsy is not rare, many epileptic conditions are considered to be idiopathic and the related seizures of unknown origin. It does appear that different types of seizures are caused by differing mechanisms. This paper discusses scattered case reports involving problems with calcium metabolism and the thyroid, and/or the parathyroid glands concurrent with seizures that support the position that calcium control mechanisms may have been involved in causing seizures in those patients.
04/28/2006
10:10 AM
Hematoma growth is a determinant of mortality and poor outcome after intracerebral hemorrhage
NEUROLOGY 2006;66:1175-1181
Although volume of intracerebral hemorrhage (ICH) is a predictor of mortality, it is unknown whether subsequent hematoma growth further increases the risk of death or poor functional outcome.
04/28/2006
10:09 AM
Long term mortality after intracerebral hemorrhage
NEUROLOGY 2006;66:1182-1186
To characterize long-term mortality following intracerebral hemorrhage (ICH) in two large population-based cohorts assembled more than a decade apart.
04/28/2006
10:08 AM
Normalizing motor related brain activity
NEUROLOGY 2006;66:1192-1199
To test whether therapeutic unilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) in patients with Parkinson disease (PD) leads to normalization in the pattern of brain activation during movement execution and control of movement extent.
04/28/2006
10:06 AM
Prospective study of symptomatic atherothrombotic intracranial stenoses
NEUROLOGY 2006;66:1187-1191
Symptomatic intracranial atherothrombotic stenoses (ICAS) are associated with high rates of cerebrovascular ischemic events.
04/27/2006
07:46 AM
Brain and behaviour in children with 22q11 2 deletion syndrome a volumetric and voxel based morphometry MRI study
Brain 2006 129(5):1218-1228
In people with velo-cardio-facial syndrome [or 22q11.2 deletion syndrome (22qDS)], a single interstitial deletion of chromosome 22q11.2 causes a wide spectrum of cognitive deficits ranging from global learning difficulties to specific cognitive deficits. People with 22qDS are also at high risk of developing attention-deficit/hyperactivity disorder and autism spectrum disorders in childhood, and schizophrenia in adolescence or adult life.
04/27/2006
07:45 AM
Evaluation of HCN2 abnormalities as a cause of juvenile audiogenic seizures in Black Swiss mice
Brain Research Volume 1083, Issue 1 , 14 April 2006, Pages 14-20
Epilepsy is an often-debilitating disease with many etiologies. Genetic predisposition is common for many of the generalized epilepsy syndromes, and mutations in genes encoding neuronal ion channels are causative in many cases.
04/27/2006
07:43 AM
Intranasal midazolam therapy for pediatric status epilepticus
The American Journal of Emergency Medicine Volume 24, Issue 3 , May 2006, Pages 343-346
Prolonged seizure activity in a child is a frightening experience for families as well as care providers. Because duration of seizure activity impacts morbidity and mortality, effective methods for seizure control should be instituted as soon as possible, preferably at home. Unfortunately, parenteral methods of medication delivery are not available to most caregivers and rectal diazepam, the most commonly used home therapy, is expensive and often ineffective. This brief review article examines recent research suggesting that there is a better way to treat pediatric seizures in situations where no intravenous access is immediately available. Intranasal midazolam, which delivers antiepileptic medication directly to the blood and cerebrospinal fluid via the nasal mucosa, is safe, inexpensive, easy to learn by parents and paramedics, and provides better seizure control than rectal diazepam.
04/27/2006
07:42 AM
Superficial siderosis
NEUROLOGY 2006;66:1144-1152
Superficial siderosis (SS) of the CNS is caused by repeated slow hemorrhage into the subarachnoid space with resultant hemosiderin deposition in the subpial layers of the brain and spinal cord. Despite extensive investigations, the cause of bleeding is frequently undetermined.
04/27/2006
07:40 AM
Multiple Cerebral Microbleeds in Hyperacute Ischemic Stroke Impact on Prevalence and Severity of Early Hemorrhagic Transformation After Thrombolytic Treatment
AJR 2006; 186:1443-1449
The purpose of our study was to assess whether cerebral microbleeds are related to early hemorrhagic transformation after thrombolytic therapy for hyperacute ischemic stroke.
04/27/2006
07:39 AM
Antiplatelets ACE inhibitors and statins combination reduces stroke severity and tissue at risk
NEUROLOGY 2006;66:1153-1158
Antiplatelets (APL), angiotensin-converting enzyme (ACE) inhibitors (ACEI), and statins (STAT) are commonly used for stroke prevention. The authors examined whether combination therapy with these agents has additive protective effects in reducing ischemic stroke severity.
04/27/2006
07:39 AM
MR diffusion weighted imaging and outcome prediction after ischemic stroke
NEUROLOGY 2006;66:1159-1163
MR diffusion-weighted imaging (DWI) shows acute ischemic lesions early after stroke so it might improve outcome prediction and reduce sample sizes in stroke treatment trials. Previous studies of DWI and outcome produced conflicting results.
04/27/2006
07:37 AM
Precordial Doppler Probe Placement for Optimal Detection of Venous Air Embolism During Craniotomy
Anesth Analg 2006;102:1543-1547
Verification of appropriate precordial Doppler probe position over the anterior chest wall is crucial for early detection of venous air embolism.
04/27/2006
07:36 AM
Statin treatment and adherence to national cholesterol guidelines after ischemic stroke
NEUROLOGY 2006;66:1164-1170
National cholesterol guidelines have defined high vascular risk individuals as those who could potentially benefit most from statin therapy. The authors aimed to determine the rate of statin use, its predictors, and the achievement of national guideline target lipid goals among ischemic stroke survivors.
04/27/2006
07:35 AM
Proteinuria and Risk for Stroke and Coronary Heart Disease During 27 Years of Follow up
Arch Intern Med. 2006;166:884-889
Urinary protein excretion has been linked to coronary heart disease (CHD); the relationship to stroke is less clear. We assessed whether urine dipstick screening for protein predicted stroke and CHD in the Honolulu Heart Program cohort.
04/26/2006
07:21 AM
Neurotoxicity of methylenedioxyamphetamines MDMA ecstasy in humans how strong is the evidence for persistent brain damage
Addiction, Volume 101, Number 3, March 2006, pp. 348-361(14)
The popular dance drug ecstasy (3,4-methylenedioxymethamphetamine: MDMA and some analogues) causes selective and persistent neurotoxic damage of central serotonergic neurones in laboratory animals. Serotonin plays a role in numerous functional systems in the central nervous system (CNS). Consequently, various abnormalities including psychiatric, vegetative, neuroendocrine and cognitive disorders could be expected in humans following MDMA-induced neurotoxic brain damage.
04/26/2006
07:20 AM
Brain transplantation of human neural stem cells transduced with tyrosine hydroxylase and GTP cyclohydrolase 1 provides functional improvement in animal models of Parkinson disease
Neuropathology, Volume 26, Number 2, April 2006, pp. 129-140(12)
Parkinson disease is a neurodegenerative disease characterized by loss of midbrain dopaminergic neurons resulting in movement disorder. Neural stem cells (NSC) of the CNS have recently aroused a great deal of interest, not only because of their importance in basic research of neural development, but also for their therapeutic potential in neurological disorders.
04/26/2006
07:19 AM
Dexmedetomidine as Rescue Drug During Awake Craniotomy for Cortical Motor Mapping and Tumor Resection
Anesth Analg 2006;102:1556-1558
Dexmedetomidine, approved for providing sedation in the critical care environment, is also used during awake craniotomies to facilitate procedures such as cortical mapping. Herein, we describe the use of dexmedetomidine as a rescue drug during awake craniotomy avoiding conversion to general anesthesia, thus allowing completion of cortical mapping.
04/26/2006
07:18 AM
Thunderclap Stroke Embolic Cerebellar Infarcts Presenting as Thunderclap Headache
Headache: The Journal of Head and Face Pain, Volume 46, Number 3, March 2006, pp. 520-522(3)
Thunderclap headache is known to be a presenting feature of subarachnoid hemorrhage, unruptured intracranial aneurysm, cerebral venous thrombosis, cervical artery dissection, spontaneous intracranial hypotension, pituitary apoplexy, retroclival hematoma, and hypertensive reversible posterior leukoencephalopathy.
04/26/2006
07:17 AM
Hypoglycemic encephalopathy with extensive lesions in the cerebral white matter
Neuropathology, Volume 26, Number 2, April 2006, pp. 147-152(6)
Here we report an autopsy case of hypoglycemic encephalopathy with prolonged coma. Laboratory data obtained when the patient lapsed into a coma showed that she had a low level of serum glucose (27?mg/dL). Although the level of glucose returned to within the normal range rapidly after glucose infusion, the patient remained in a coma for 22?months. It was presumed that the state of hypoglycemia persisted for about 4?h. There was no evidence of hypotension or hypoxia. Magnetic resonance imaging was performed 3?h after glucose administration; diffusion-weighted images revealed hyperintensity in the cerebral white matter and in the boundary zone between the middle and posterior cerebral arteries. Post-mortem examination revealed superficial laminar necrosis throughout the cerebral cortex.
04/26/2006
07:15 AM
Neuroenteric cyst of the craniocervical junction
Australasian Radiology, Volume 50, Number 1, February 2006, pp. 59-62(4)
A neuroenteric cyst is a rare cause of an intradural, extramedullary mass. We report the MRI findings in a case of a neuroenteric cyst of the craniovertebral junction without associated abnormalities.
04/26/2006
07:14 AM
A Case of Sotos Syndrome with Subduroperitoneal Shunt
Pediatric Neurosurgery 2006;42:174-179
The authors present a case of Sotos syndrome with increasing severity of subdural hygroma from the age of 5 months, which was managed with a subduroperitoneal shunt at 10 months of age. The patient had been followed up until 30 months of age with continuing improvement of symptoms.
04/25/2006
08:10 AM
Deficits in feature-based control of attention in a patient with a right fronto temporal lesion
Cognitive Neuropsychology Volume 23, Number 03 / May 2006
Three experiments examined feature-based top-down control of search in a patient with right frontal-temporal lobe brain damage (YW), in comparison with normal control participants. In Experiment 1, YW showed normal search functions for single-feature targets. However, he showed abnormal search functions relative to normal control participants when a singleton distractor irrelevant to the target-defining feature was presented. YW showed longer RTs when a target was presented in the contralesional visual field and a singleton distractor was in the ipsilesional visual field (Experiment 1), or when both were presented in the contralesional visual field (Experiment 2). These results suggest that YW's difficulty is due to a failure of selectivity for targets based on top-down control of target-defining features. Experiment 3 compared singleton detection tasks and feature detection tasks. YW showed no deficits on the singleton detection tasks, where no knowledge of target-defining features was required. However, on the feature detection tasks, YW showed long RTs when targets were presented in the contralesional visual field where knowledge of target-defining features was required. We concluded that YW's difficulty in visual search with singleton distractors was due to deficits in feature-based control. We discuss the role of fronto-temporal regions in feature-based control of attention.
04/25/2006
07:13 AM
CURRENT CONTROVERSIES IN THE MANAGEMENT OF PATIENTS WITH SEVERE TRAUMATIC BRAIN INJURY
ANZ Journal of Surgery, Volume 76, Number 3, March 2006, pp. 163-174(12)
Traumatic brain injury is a major cause of mortality and morbidity, particularly among young men. The efficacy and safety of most of the interventions used in the management of patients with traumatic brain injury remain unproven. Examples include the `cerebral perfusion pressure-targeted' and `volume-targeted' management strategies for optimizing cerebrovascular haemodynamics and specific interventions, such as hyperventilation, osmotherapy, cerebrospinal fluid drainage, barbiturates, decompressive craniectomy, therapeutic hypothermia, normobaric hyperoxia and hyperbaric oxygen therapy.
04/25/2006
07:24 AM
Endoscopic Nasal and Anterior Craniotomy Resection for Malignant Nasoethmoid Tumors Involving the Anterior Skull Base
Skull Base 2006; 16: 015-018
The traditional approach to sinonasal tumors involving the skull base has been the anterior craniofacial resection. The first report by Ketcham et al (American Journal of Surgery, 1963;106:698-703) documented their experience with 17 anterior craniofacial resections for malignant tumors of the sinonasal tract. Later experience with this technique at several centers has resulted in the publication of many refinements of technique and further reduction in the morbidity and mortality associated with this procedure. In our hands, endoscopic techniques have allowed us to approach the intranasal aspect of skull base lesions without external incisions and yet still achieve an en bloc resection. The type of lesions suitable for this approach and the associated technical issues are discussed in this article.
04/25/2006
07:22 AM
Endonasal Endoscopic Duraplasty Our Experience
Skull Base 2006; 16: 019-024
Endoscopic repair of cerebrospinal fluid (CSF) leaks is a recognized technique. We consider our experience and evaluate the outcomes in patients who underwent endoscopic repair of CSF leaks.
04/25/2006
07:22 AM
Esthesioneuroblastoma Endonasal Endoscopic Treatment
Skull Base 2006; 16: 025-030
To illustrate endoscopic techniques used in the treatment of esthesioneuroblastoma and to advocate this method of management followed by radiation therapy in selected cases.
04/25/2006
07:19 AM
Seizure as a Manifestation of Intracranial Hypotension in a Shunted Patient
Pediatric Neurosurgery 2006;42:165-167
The authors describe a child with a ventriculo-peritoneal shunt in place for 5 years who presented with 'postural' seizures (seizures on sitting upright, which resolved on recumbency). On shunt tap, the cerebrospinal fluid was obtained freely, but required gentle aspiration with a syringe in the recumbent position, suggesting very low intracranial pressure. Contrast magnetic resonance imaging showed pachymeningeal enhancement and enlargement of the pituitary gland diagnostic of intracranial hypotension along with well-decompressed ventricles. At the time of revision of the shunt, no evidence of malfunction was found and the valve was changed to one with a higher opening pressure. Following this, she became asymptomatic and seizure free. This case illustrates the fact that following shunting, intracranial hypotension may also predispose to seizures, and should be kept in mind while managing these patients.
04/25/2006
07:17 AM
Functional connectivity of the fusiform gyrus during a face matching task in subjects with mild cognitive impairment
Brain 2006 129(5):1113-1124
Cognitive function requires a high level of functional interaction between regions of a network supporting cognition. Assuming that brain activation changes denote an advanced state of disease progression, changes in functional connectivity may precede changes in brain activation. The objective of this study was to investigate changes in functional connectivity of the right middle fusiform gyrus (FG) in subjects with mild cognitive impairment (MCI) during performance of a face-matching task.
04/25/2006
07:16 AM
Higher Serum Triglyceride Level in Patients with Acute Ischemic Stroke Is Associated with Lower Infarct Volume on CT Brain Scans
European Neurology 2006;55:89-92
We investigated the relationship between serum triglyceride level and acute ischemic stroke severity using infarct volume on CT brain scans as a marker. A total of 121 consecutive acute ischemic stroke patients (53 males and 68 females, age 47-93 years) with anterior circulation (75%), posterior circulation (9%) or lacunar infarcts (16%) were examined. All patients were admitted within 24 h of the symptom onset, and CT scans were taken over the subsequent 24-72 h. With adjustment for the infarct type, age, sex, timing of CT imaging (24-36, >36-48 or >48-72 h since admission), atrial fibrillation, hypertension, fasting cholesterol and glucose levels, a higher (1.70 mmol/l) fasting serum triglyceride level (within 24 h after admission) was associated with a lower infarct volume (p = 0.014). In line with a recent report on milder clinical symptoms in acute ischemic stroke patients with higher triglycerides, the results suggest an independent association between serum triglyceride level and stroke severity.
04/25/2006
07:15 AM
Primary Intracerebral Hemorrhage During Asleep Period
American Journal of Hypertension
Volume 19, Issue 4 , April 2006, Pages 403-406
The onset of intracerebral hemorrhage (ICH) has a circadian variation, with a lower risk during the asleep period. It is unclear, however, whether ICH during the asleep period differs from that during the awake period in pathophysiologic nature. The purpose of this study is to elucidate the incidences and clinical features of ICH during the asleep period.
04/25/2006
07:12 AM
Absence and myoclonic status epilepticus precipitated by antiepileptic drugs in idiopathic generalized epilepsy
Brain 2006 129(5):1281-1292
Aggravation of idiopathic generalized epilepsy (IGE) syndromes by inappropriate antiepileptic drugs (AEDs) is increasingly recognized as a serious and common problem. Precipitation of status epilepticus (SE) by inappropriate medication has rarely been reported. We retrospectively studied all adult patients with IGE taking at least one potentially aggravating AED, who developed video-EEG documented SE over 8 years, and whose long-term outcome was favourable after adjustment of medication.
04/24/2006
07:46 AM
CSF Shunt Failure with Stable Normal Ventricular Size
Pediatric Neurosurgery 2006;42:151-155
The purpose of this study was to review the clinical features of a group of patients in whom ventricular enlargement was not a manifestation of prolonged CSF shunt obstruction.
04/24/2006
07:44 AM
Laparoscopy Guided Insertion of Peritoneal Catheters in Ventriculoperitoneal Shunt Procedures: Analysis of 39 Children
Pediatric Neurosurgery 2006;42:156-158
Ventriculoperitoneal shunting is the mainstay in the treatment of hydrocephalus in childhood. Repeated shunt revision and previous laparotomy may complicate the implantation of the distal catheter. We describe our experience with laparoscopic insertion of peritoneal catheters in 21 male and 18 female children with an age range from 3 months to 18 years, operated between 2002 and 2004. Fourteen patients (36%) had laparotomy due to previous shunt operations and 5 patients (13%) due to other reasons.
04/24/2006
07:41 AM
Subtle cognitive deficits after cerebellar infarcts
European Journal of Neurology, Volume 13, Number 2, February 2006, pp. 161-170(10)
The role of the cerebellum in cognitive functions has been under debate. We investigated the neuropsychological functioning of patients with cerebellar lesions (infarcts) and evaluated the significance of laterality in cognitive symptoms. Twenty-six patients with exclusive cerebellar lesions as verified by clinical and neuroradiological findings underwent a neuropsychological assessment at the acute stage and at 3?months.
04/24/2006
07:40 AM
Danger of Flumazenil Use in Pediatric Status Epilepticus
Pediatric Emergency Care. 22(3):168-169, March 2006
Benzodiazepines are an important class of drugs in the management of acute pediatric seizure disorders such as status epilepticus. They are used both in the community and in the hospital; however, one of their major side effects is respiratory depression. If ventilation is needed for benzodiazepine-induced respiratory depression during seizure management, pressures to facilitate extubation may lead to the use of the specific reversal agent for this class of drugs, flumazenil. Three cases of seizure recurrence after flumazenil use in this context are reported, and the pharmacology is discussed. Irrespective of pressure to extubate such children, physicians must be alert to the potential risk of flumazenil in the clinical scenario.
04/24/2006
07:33 AM
Is there any correlation between severity of epilepsy and cognitive abilities in patients with temporal lobe epilepsy
European Journal of Neurology, Volume 13, Number 2, February 2006, pp. 130-134(5)
Frequent refractory seizures may cause cognitive deterioration when they present at an early age, especially in infants. The findings of previous studies designed to examine the impact of repetitive seizures on cognition in adolescents and adults, however, have shown wide variation.
04/24/2006
07:32 AM
Juvenile myoclonic epilepsy non classic electroencephalographical presentation in adult patients
European Journal of Neurology, Volume 13, Number 2, February 2006, pp. 171-175(5)
Although diagnosis of juvenile myoclonic epilepsy (JME), a common form of idiopathic generalized epilepsy, is based on clinical and electroencephalogram (EEG) criteria, at times clinical symptoms may be misleading, like the occurrence of asymmetric myoclonic jerks. Thus EEG assumes an important role in these cases, it can fail to show the classical polyspike and slow wave (PSW) discharges of JME, specially in a routine evaluation in older patients.
04/24/2006
07:31 AM
A case series of young stroke in Rome
pean Journal of Neurology, Volume 13, Number 2, February 2006, pp. 146-152(7)
In this hospital case series study we enrolled 394 consecutive ischemic stroke patients aged 14–47?years, all of whom were submitted to a diagnostic protocol. We evaluated the incidence of cerebral ischemia in young adults, as well as the risk factors and the etiopathogenesis of this pathology.
04/24/2006
07:29 AM
Cerebral vasomotor reactivity of bilateral severe carotid stenosis is stroke unavoidable
European Journal of Neurology, Volume 13, Number 2, February 2006, pp. 183-186(4)
We evaluated the cerebral hemodynamic features of severe bilateral carotid stenosis by assessing and comparing cerebral vasomotor reactivity (VMR) in the middle cerebral (MCA) and vertebral arteries (VA) by transcranial Doppler and the Diamox (1?g acetazolamide i.v.) test. VMR was evaluated by recording the percentage differences in peak systolic blood flow velocity in each MCA and VA at baseline and by the Diamox test.
04/24/2006
07:28 AM
Enterobacter sakazakii in the mouths of stroke patients and its association with aspiration
European Journal of Internal Medicine Volume 17, Issue 3 , May 2006, Pages 185-188
Previous studies by our group have identified a high prevalence of Gram-negative bacilli in the mouths of stroke patients. Eradication of such organisms by selective decontamination of the digestive tract (SDD) has not previously been studied. Enterobacter sakazakii is a rarely found organism that has previously been identified as a cause of neonatal meningitis and sepsis but that has rarely been reported as a pathogen in older people. The purpose of this study was to look specifically for E. sakazakii in the mouths of stroke patients and to correlate its isolation with response to SDD gel and the presence of clinical complications such as pneumonia.
04/24/2006
07:26 AM
Subtle cognitive deficits after cerebellar infarcts
ropean Journal of Neurology, Volume 13, Number 2, February 2006, pp. 161-170(10)
The role of the cerebellum in cognitive functions has been under debate. We investigated the neuropsychological functioning of patients with cerebellar lesions (infarcts) and evaluated the significance of laterality in cognitive symptoms.
04/20/2006
03:36 PM
Health Care Utilization and Needs After Pediatric Traumatic Brain Injury
PEDIATRICS Vol. 117 No. 4 April 2006, pp. e663-e674
Children with moderate to severe traumatic brain injury (TBI) show early neurobehavioral deficits that can persist several years after injury. Despite the negative impact that TBI can have on a child's physical, cognitive, and psychosocial well-being, only 1 study to date has documented the receipt of health care services after acute care and the needs of children after TBI. The purpose of this study was to document the health care use and needs of children after a TBI and to identify factors that are associated with unmet or unrecognized health care needs during the first year after injury.
04/20/2006
03:35 PM
Postprocedural Monitoring of Cerebral Aneurysms
Acta Radiologica, Volume 47, Number 3, April 2006, pp. 320-327(8)
The treatment of intracranial aneurysms has been revolutionized since the introduction of electrolytically detachable platinum coils in 1991. Since this basic innovation, many refinements of the embolic materials and techniques have emerged. Today, in Europe, half of all aneurysms are treated endoarterially and this share is growing. The reassuring results of the International Subarachnoid Aneurysm Trial (ISAT) have changed the treatment strategy from neurosurgical clipping to embolization. However, the role of these alternative modes of treatment varies between institutions and countries.
04/20/2006
03:34 PM
Serum albumin level and nosocomial pneumonia in stroke patients
European Journal of Neurology, Volume 13, Number 3, March 2006, pp. 299-301(3)
Hypoalbuminemia is associated with increased risk of infections. The aim of this study was to determine if serum albumin level is an independent predictor of nosocomial pneumonia in stroke patients.
04/20/2006
03:40 PM
Second Order Peer Review of the Medical Literature for Clinical Practitioners
JAMA. 2006;295:1801-1808
To create a second order of clinical peer review for journal articles to determine which articles are most relevant for specific clinical disciplines.
04/20/2006
10:36 AM
Neuroprotective Effects of Selective Group II mGluR Activation in Brain Trauma and Traumatic Neuronal Injury
Journal of Neurotrauma Feb 2006, Vol. 23, No. 2: 117-127
The effects of group II mGluR activation by selective agonist (–)-2-oxa-4-aminobicyclo[3.1. 0]hexane-4,6-dicarboxylate (LY379268) were examined in a mouse model of controlled cortical impact
(CCI)–induced brain injury and in primary neuronal/glial and neuronal cultures subjected to mechanical trauma.
04/20/2006
07:56 AM
Essential Role of the Hippocampal Formation in Rapid Learning of Higher Order Sequential Associations
The Journal of Neuroscience, April 12, 2006, 26(15):4111-4117
Evidence from studies of amnesia and functional imaging in humans suggest that the medial temporal lobe is involved in the learning of higher-order sequences during acquisition of serial reaction time (SRT) tasks. However, these studies have not clarified whether the hippocampal formation specifically is essential to this type of learning. Here, we developed a rodent model of the SRT task to examine the specific roles of the hippocampal formation in learning first- and second-order conditional sequences.
04/20/2006
07:55 AM
Seizures Accelerate Functional Integration of Adult Generated Granule Cells
The Journal of Neuroscience, April 12, 2006, 26(15):4095-4103
In humans and experimental animals, structural and functional changes in neural circuits can accompany the development of epilepsy. In the dentate gyrus, seizures enhance adult neurogenesis, but it is unclear to what extent newborn granule cells participate in seizure-induced synaptic reorganization.
04/20/2006
07:53 AM
Spectroscopic evidence of hippocampal abnormalities in neocortical epilepsy
European Journal of Neurology, Volume 13, Number 3, March 2006, pp. 256-260(5)
Lesional neocortical epilepsy (NE) can be associated with hippocampal sclerosis or hippocampal spectroscopic abnormalities without atrophy (dual pathology). In this study, magnetic resonance spectroscopic imaging (MRSI) was used to determine the frequency of hippocampal damage/dysfunction in NE with and without structural lesion.
04/20/2006
07:52 AM
Blood Pressure Reduction in the Primary and Secondary Prevention of Stroke
Current Vascular Pharmacology, Volume 4, Number 2, April 2006, pp. 155-160(6)
Control of hypertension is well established for the primary prevention of stroke. Prior studies, on the other hand, conflict over whether hypertension remains a risk factor for recurrent stroke and if blood pressure reduction is associated with better outcomes in this subset of patients. We review current evidence regarding the role of BP lowering for primary and secondary prevention of stroke. Current evidence amassed from both primary and secondary prevention trials demonstrate that BP reduction is a crucial common element in overall reduction of stroke risk.
04/20/2006
07:51 AM
Eligibility of stroke units in Poland for administration of intravenous thrombolysis
European Journal of Neurology, Volume 13, Number 3, March 2006, pp. 220-224(5)
Systemic thrombolysis treatment was approved in Poland in 2003 and should be performed in specialist stroke units (SU). We performed a survey to determine stroke service preparedness for thrombolysis treatment in Poland.
04/20/2006
07:50 AM
Diagnosing refractory epilepsy response to sequential treatment schedules
European Journal of Neurology, Volume 13, Number 3, March 2006, pp. 277-282(6)
Diagnosing refractory epilepsy would facilitate referral for specialist pharmacological review and early consideration of epilepsy surgery. An outcomes study was undertaken in an unselected cohort of newly diagnosed patients to determine the number of antiepileptic drug (AED) regimens needed to be failed before the epilepsy could be designated as pharmacoresistant.
04/20/2006
07:47 AM
Early admission to stroke unit influences clinical outcome
European Journal of Neurology, Volume 13, Number 3, March 2006, pp. 250-255(6)
An improvement in patient arrival time to stroke unit (SU) is recommended, since earlier stroke management seems to improve `per se' functional outcome. The objective of this study was to determine if early admission influences the outcome, reduces disability and mortality at discharge and three months later independent of tlirombolytic treatment.
04/20/2006
07:46 AM
Emergency department delays in acute stroke analysis of time between ED arrival and imaging
European Journal of Neurology, Volume 13, Number 3, March 2006, pp. 225-232(8)
We determined the factors leading to emergency department (ED) delays in patients with acute stroke. Data were collected prospectively in four Berlin inner-city hospitals by ED documentation, medical records, imaging files and patient interviews. An extended Cox proportional hazards model was fitted to the data. Analyses were performed in 558 patients with confirmed diagnosis of stroke. Median time from admission at ED to beginning of computed tomography/magnetic resonance imaging (CT/MRI) was 108?min. In a subgroup of patients potentially eligible for thrombolysis with a pre-hospital delay <120?min and a National Institutes of Health Stroke Scale (NIHSS) >4 (n?=?74), the median interval to imaging was 68?min. Multivariable analysis revealed that a more severe initial NIHSS, a pre-hospital delay <3?h, admission at two specific hospitals, admission at weekends, and private health insurance were significantly associated with reduced delays. In stroke patients, the time interval between ED admission and imaging depends both on factors that emerge from clinical needs and on factors independent of clinical necessities. Considering the urgency of therapeutic measures in acute stroke, there is necessity and room for both improvement of in-hospital management and of medical and non-medical factors influencing pre-hospital delays.
04/20/2006
07:42 AM
Migraine and stroke why do we talk about it
European Journal of Neurology, Volume 13, Number 3, March 2006, pp. 215-219(5)
Data from observational studies suggest that migraine may be a risk factor for stroke. Furthermore, a significant association between migraine and ischemic stroke (IS) has been demonstrated in population and case–control studies. The risk of IS appears to be higher for migraine with aura than for migraine without aura. The pathogenesis is not known but several studies report some common biochemical mechanisms in the two diseases. Meta-analysis also demonstrates that subjects with migraine are at higher risk of showing white matter abnormalities on magnetic resonance images than are those without migraine.
04/20/2006
07:40 AM
Plasma total homocysteine levels are associated with advanced leukoaraiosis but not with asymptomatic microbleeds on T2 weighted MRI in patients with stroke
European Journal of Neurology, Volume 13, Number 3, March 2006, pp. 261-265(5)
Both leukoaraiosis and asymptomatic microbleeds are associated with small-artery diseases. Although an association between hyperhomocysteinemia and leukoaraiosis has been reported, no studies have evaluated the association between total homocysteine
(tHcy) level and presence of microbleeds in stroke patients. We evaluated the association between tHcy level and leukoaraiosis or microbleeds in stroke patients. In 102 patients with stroke (69.5?±?10.3?years old, 54 men and 48 women), microbleeds on T2*-weighted MR images were counted, leukoaraiosis on T2-weighted images was graded and fasting plasma tHcy concentrations were measured. Plasma tHcy level was significantly higher in patients with advanced leukoaraiosis than in those without advanced leukoaraiosis (13.9?±?4.6?µmol/l vs. 10.2?±?3.4?µmol/l, P?
04/20/2006
07:39 AM
Primary intramedullary primitive neuroectodermal tumor PNET case report and review of the literature
European Journal of Neurology, Volume 13, Number 3, March 2006, pp. 240-243(4)
Spinal primitive neuroectodermal tumors (PNET) are very rare tumors, and intramedullary localization is even less common. Indeed, amongst the 23 cases of the spinal PNET described in the literature, only eight cases had an intramedullary localization. Following the WHO 2000 classification, PNETs have been considered embryonal tumors composed of undifferentiated neuroepithelial cells with a capacity of differentiation into different cellular lines, such as astrocytic, ependymal, melanotic and muscular. They have been considered to arise from a neoplastic transformation of primitive neuroepithelial cells, thereby making their presence possible in any part of the central nervous system. The optimal treatment for these malignant tumors is not yet clear, although, over the years, radiotherapy has been considered the best treatment for spinal PNETs. The described case is that of a 38-year-old man with a primary intra-extramedullary PNET, treated by laminectomy, open biopsy and chemotherapy. The patient, 18?months after the onset of his symptomatology, died without cerebral tumor involvement.
04/20/2006
07:58 AM
Knowledge of Grocery Shopping Skills as a Mediator of Cognition and Performance
Psychiatr Serv 57:573-575, April 2006
Cognitive impairments in serious mental illness are associated with poorer community outcomes; yet the mechanisms through which cognition limits functioning are unknown. This study examined knowledge of grocery shopping skills as a mediator of cognition and performance of grocery shopping skills.
04/18/2006
12:30 PM
Osteogenic Effects of Traumatic Brain Injury on Experimental Fracture Healing
The Journal of Bone and Joint Surgery (American). 2006;88:738-743
Heterotopic bone formation has been observed in patients with traumatic brain injury; however, an association between such an injury and enhanced fracture-healing remains unclear. To test the hypothesis that traumatic brain injury causes a systemic response that enhances fracture-healing, we established a reproducible model of traumatic brain injury in association with a standard closed fracture and measured the osteogenic response with an in vitro cell assay and assessed bone-healing with biomechanical testing.
04/19/2006
09:47 AM
Intraoperative wake up test in neonatal neurosurgery
Paediatric Anaesthesia, Volume 16, Number 4, April 2006, pp. 451-453(3)
Intraoperative wake-up test (WPT) still remains the gold standard to monitor anterior spinal cord function during spinal surgery. However, the test requires patient cooperation and hence difficult to perform in very young children or mentally challenged. In this report, we describe a WPT in a newborn during surgical repair of a large myelomeningocele. We relied on mivacurium for intubation and the relaxant effect was allowed to wear-off to permit the use of intraoperative nerve stimulator. We used desflurane and propofol infusion for rapid titration of the anesthetic depth and BIS monitor to `gauge' the `wakefulness' of the child during the WPT. We employed lidocaine infusion to improve tolerance to the tracheal tube and to bestow beneficial effect on intracranial pressure during surgery and the WPT. The results of the WPT were judged to be satisfactory after confirming flexion and extension of the lower extremities at the hip and knee level, correlating it with the BIS values, and comparing it with the preoperative status. Frequently associated prematurity, higher possibility of remaining intubated in the immediate postoperative period and any new onset neurologic deficit not becoming apparent until after extubation makes intraoperative neuromonitoring relevant in this age group. Our methodology of management has permitted us to perform a delicate test safely and will allow us to repeat the WPT if needed during neonatal neurosurgery.
04/19/2006
09:47 AM
Stroke and treatment with nasal CPAP
European Journal of Neurology, Volume 13, Number 2, February 2006, pp. 198-200(3)
Stroke patients present a high prevalence of obstructive sleep apnea (OSA) and those with OSA have a higher mortality after 1?year and poorer functional outcome compared with others. The aim of this study was to prospectively evaluate the acceptance of nasal continuous positive airway pressure (CPAP) by recent stroke patients with OSA. Recruitment of non-comatose stroke patients with sufficient consciousness for diagnostic evaluation of OSA was performed and they were treated at home with nasal CPAP after hospital calibration and training on the usage of CPAP. Initial evaluation and regular follow-up of the home trial of auto-CPAP was carried out for a duration of 8?weeks. Of 50 initially recruited patients, 32 (100%) responded to the minimum cognitive criteria but seven patients (22%) only used nasal CPAP for 8?weeks. Subject dropout was related to difficulties with CPAP usage as perceived by patient and family members, facial weakness, motor impairment and increase difficulties and discomfort with usage of full-face mask. The majority of OSA stroke patients rejected CPAP treatment. Better education and support of patients and families, and special training sessions in rehabilitation services, will be needed to improve compliance.
04/19/2006
09:28 AM
Incidence Rates of Hospitalization Related to Traumatic Brain Injury 12 States 2002
JAMA. 2006;295:1764-1765
Traumatic brain injury (TBI) is a major cause of death and disability in the United States. Each year, among the estimated 1.4 million persons who sustain a TBI, an estimated 80,000-90,000 experience the onset of long-term disability.1-2 Since the early 1990s, CDC has supported state-level, population-based surveillance of TBI associated with hospitalization or death. For 2002, 12 states* conducted TBI surveillance according to established CDC guidelines1; the 2002 multistate data were finalized in December 2005 and are the most recent available. This report presents the results of TBI surveillance for 2002, which indicated that an estimated 74,517 persons (79.0 per 100,000 population) were hospitalized with TBI-related diagnoses in the 12 reporting states; unintentional falls, motor vehicle traffic (MVT) incidents, and assaults were the leading contributors to TBI-related hospitalizations. The findings underscore the need for states to continue to monitor TBI incidence and to implement effective injury-prevention programs.
04/18/2006
08:12 AM
Differentiating Among Prefrontal Substrates in Psychopathy Neuropsychological Test Findings
Neuropsychology. 2006 Mar Vol 20(2) 153-165
Frontal lobe and consequent executive dysfunction have long been related to psychopathy. More recently, there have been suggestions that specific regions of frontal cortex, rather than all of frontal cortex, may be implicated in psychopathy.
04/18/2006
08:00 AM
Loss of Emotional Experience After Traumatic Brain Injury Findings With the Startle Probe Procedure.
Neuropsychology. 2006 Mar Vol 20(2) 224-231
The authors used affective modulation of the eyeblink startle response to examine the impact of traumatic brain injury (TBI) on emotional reactions to pictures. Participants were 13 individuals with severe TBI and 24 controls. Participants were presented with pictures that differed in affective valence (e.g., mutilated bodies, erotic couples, and household objects) while the eyeblink startle response to an acoustic probe was measured. Startle amplitude was used to assess valence of emotional response, and startle latency was used to index interest in the pictures.
04/18/2006
07:58 AM
Risk of stroke and hormone replacement therapy a prospective cohort study
Maturitas Volume 54, Issue 1 , 20 April 2006, Pages 11-18
The purpose of this study was to examine the risk of first-ever stroke in relation to use of hormone replacement therapy (HRT) among middle-aged and older Swedish women.
04/18/2006
07:57 AM
The Role of Functional Neuroimaging in Pediatric Brain Injury
PEDIATRICS Vol. 117 No. 4 April 2006, pp. 1372-1381
The aim of this article is to review empirical studies published in the last 10 years that used various functional neuroimaging techniques to assess pediatric patients with brain injury. Overall, these studies have demonstrated the ability of functional neuroimaging to offer unique information concerning the diagnosis, clinical outcome, and recovery mechanisms after pediatric brain injury. Future research using functional neuroimaging is recommended to better understand the functional reorganization and neurodevelopmental consequences resulting from brain injury. Such research might allow clinicians to design tailored early-intervention and rehabilitation programs to maximize the recovery process for pediatric patients. Limitations and advantages associated with the use of functional neuroimaging in pediatric populations are discussed.
04/18/2006
07:51 AM
Mild cognitive impairment
The Lancet Volume 367, Issue 9518 , 15 April 2006-21 April 2006, Pages 1262-1270
Mild cognitive impairment is a syndrome defined as cognitive decline greater than expected for an individual's age and education level but that does not interfere notably with activities of daily life. Prevalence in population-based epidemiological studies ranges from 3% to 19% in adults older than 65 years. Some people with mild cognitive impairment seem to remain stable or return to normal over time, but more than half progress to dementia within 5 years. Mild cognitive impairment can thus be regarded as a risk state for dementia, and its identification could lead to secondary prevention by controlling risk factors such as systolic hypertension. The amnestic subtype of mild cognitive impairment has a high risk of progression to Alzheimer's disease, and it could constitute a prodromal stage of this disorder. Other definitions and subtypes of mild cognitive impairment need to be studied as potential prodromes of Alzheimer's disease and other types of dementia.
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