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Neurocritical Care 1541-6933 (Print) 10.1007/s12028-008-9132-5
Cerebral vasoconstriction syndromes such as vasospasm after subarachnoid hemorrhage
(SAH) and trauma, or Call-Fleming syndrome are difficult to treat, and can lead to substantial disability and death.
Dantrolene, a ryanodine receptor antagonist, inhibits intracellular calcium release from the
sarco-endoplasmic reticulum.
Neurocritical Care 1541-6933 (Print) 10.1007/s12028-008-9124-5
Small improvements in clinical outcomes after intracerebral hemorrhage (ICH) can have a substantial impact on overall health care costs, yet little data exists on the costs associated with the most commonly studied clinical outcomes in this type of stroke.
Pediatric Anesthesia Published Online: 30 Jul 2008
Children with seizure disorders unresponsive to medical management may undergo surgical disconnection of a cerebral hemisphere, or hemispherectomy, in order to reduce or eliminate seizures.
American Journal of Neuroradiology 29:1335-1339, August 2008
Large arachnoid granulations (AG) within the dorsal superior sagittal sinus (SSS) have been incompletely characterized and can be confused with pathology. This report reviews the characteristics of these anatomic structures to establish common imaging features that allow differentiation from pathology.
American Journal of Neuroradiology 29:1329-1334, August 2008
Visual field defects sometimes occur after temporal resection surgery. Our purpose was to evaluate the correlation between visual field defects caused by temporal lobe resection and the degree of resection of the Meyer loop, as assessed by diffusion tensor tractography.
American Journal of Neuroradiology 29:1317-1323, August 2008
The occurrence of brain parenchymal signal-intensity changes within the drainage territory of developmental venous anomalies (DVAs) in the absence of cavernous malformations (CMs) has been incompletely assessed.
American Journal of Neuroradiology 29:1302-1307, August 2008
Anoxic brain injury is a devastating result of prolonged hypoxia. The goal of this study was to use arterial spin-labeling (ASL) to characterize the perfusion patterns encountered after anoxic injury to the brain.
Academic Emergency Medicine Published Online: 11 Aug 2008
To be useful in development of clinical decision rules, clinical variables must demonstrate acceptable agreement when assessed by different observers. The objective was to determine the interobserver agreement in the assessment of historical and physical examination findings of children undergoing emergency department (ED) evaluation for blunt head trauma.
Most pregnant women with epilepsy require antiepileptic drug (AED) therapy. Present guidelines recommend optimizing treatment prior to conception, choosing the most effective AED for seizure type and syndrome, using monotherapy and lowest effective dose, and supplementing with folate.
Journal of Neurosurgery: Pediatrics August 2008 Volume 2, Number 2
Glossopharyngeal (that is, cranial nerve IX) schwannomas are extremely rare nerve sheath tumors that frequently mimic the more common vestibular schwannoma in their clinical as well as radiographic presentation.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:1079-1081
The goal of this study was to evaluate the utility of the stroke thrombolytic predictive instrument (s-TPI) in predicting clinical outcome in patients with acute ischaemic stroke treated with intravenous tissue plasminogen activator (t-PA).
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:997-1001
Previous studies that have assessed whether the presence of depressive symptoms predisposes to stroke in the general elderly population have been contradictory.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:1082-1083
A 30-year-old male was admitted to hospital with a 1-week history of personality changes, confusion, agitation and recurrent generalised tonic-clonic seizures. His past medical history was unremarkable, except for the presence of generalised fatigue and sore throat a few days before symptom onset.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:1085
Amyotrophic lateral sclerosis (ALS) is an adult onset neurodegenerative disease characterised by progressive loss of motor neurons. Approximately 5% of cases of ALS are familial, with the remaining being sporadic.
Some theories of lexical access in production locate the effect of lexical frequency at the retrieval of a word's phonological characteristics, as opposed to the prior retrieval of a holistic representation of the word from its meaning.
It is well established that patients with semantic memory impairment show a relative sparing of general superordinate information as compared with more detailed item-specific information.
The aim of this retrospective study was to review the medical complications of patients with traumatic brain injury (TBI) who were followed in 2000-2006.
Recent efforts have been aimed at developing a panel of protein biomarkers for the diagnosis/prognosis of the neurological damage associated with acute brain injury.
The renin-angiotensin system (RAS) is a major regulatory system of cardiovascular and renal function. Many new aspects of this system have been revealed in recent years, leading to new therapeutic approaches.
Intracerebral hemorrhage (ICH) is the most serious complication of oral anticoagulant therapy (OAT), with mortality in excess of 50%. Major risk factors are advanced patient age, elevated systolic blood pressure, intensity of anticoagulation, and previous cerebral ischemia.
The modern treatment of spontaneous intracranial hemorrhages requires a multidisciplinary approach including neurosurgery, interventional neuroredicology, vascular neurology and radiosurgery to determine the best management strategy.
Intracerebral hemorrhage (ICH) accounts for between 10% to 30% of first-ever strokes; outcomes are significantly worse than with ischemic stroke with a 30-day mortality rate up to 50%, furthermore, half of the deaths occur in the acute phase.
Intracerebral haemorrhage may both be a presenting manifestation in unrecognised brain tumour or - more frequently - take place in the disease course of known/suspected brain tumour due to diagnostic/therapeutic procedures, including biopsy, locoregional treatments and anti-angiogenic therapies.
A pictorial review was performed (with added acquisition technique optimization guidelines) on CT and MR imaging of intracranial meningeal involvement from infectious or inflammatory origin, on the inherent main differential diagnoses, and on the topography of contiguous extension of lesions.
Primary intracerebral hemorrhage is the least treatable form of stroke and is associated with high mortality rates. In the thrombolytic era, the attention has bee driven on the first hours of onset, when the hematoma is still growing.
The rate of strokes among amphetamine and cocaine abusers is increasing. The exact mechanism remains unclear. Many factors could be involved including vasospasm, cerebral vasculitis, enhanced platelet aggregation, cardioembolism, and hypertensive surges.
Journal of Neuro-Oncology 0167-594X (Print) 10.1007/s11060-008-9663-9
We performed a new phase II trial enrolling patients with newly diagnosed high-grade glioma (HGG) to test the efficacy of a weekly alternating temozolomide (TMZ) schedule after surgery and concomitant chemoradiotherapy.
American Journal of Epidemiology 2008 168(4):366-373
The etiology of primary brain tumors is largely unknown. Since a peak of incidence occurs during childhood, factors operating very early in life might play a key role.
European Radiology 0938-7994 (Print) 10.1007/s00330-008-1127-2
The aim of this study was to assess whether the addition of a black blood (BB) sequence to standard three-dimensional time-of-flight (3D-TOF) imaging yields improved quantitative assessment of intracranial aneurysms.
European Radiology 0938-7994 (Print) 10.1007/s00330-008-1119-2
Interpretation of brain images from older patients requires knowledge of changes that occur with healthy ageing. We constructed and tested a reference template for older subjects.
We conducted a systematic review and meta-analysis of mechanical thrombectomy in the treatment of ischemic stroke and assessed factors for technical and clinical success and survival.
The significance of Lewy bodies detected at autopsy in the brains of clinically normal individuals is uncertain but may represent preclinical Parkinson disease (PD).
Substance use disorders, traumatic brain injury (TBI), and posttraumatic stress disorder (PTSD) are common in military and civilian populations, and often occur together.
The Centers for Disease Control and Prevention estimates that approximately 1.4 million US individuals sustain traumatic brain injuries (TBIs) per year. Previous reports suggest an association between TBI and chronic pain syndromes (eg, headache) thought to be more common in patients with mild TBI and in those who have sustained brain injury from violent rather than unintentional trauma.
Phytotherapy Research Published Online: 11 Aug 2008
A large body of experimental evidence supports a role for oxidative stress as a mediator of nerve cell death in Parkinson's disease (PD). Phytoestrogens such as genistein have been reported to prevent neuronal degeneration caused by increased oxidative burden, therefore, this study examined whether genistein administration at a high dose would attenuate behavioral and structural abnormalities in an experimental model of PD in rat.
Journal of Neurosurgery: Pediatrics August 2008 Volume 2, Number 2
Currently, no diagnostic or treatment standards exist for extracranial carotid artery dissection (CAD) in children after trauma. The purpose of this study was to review and describe the characteristics, diagnosis, and treatment of this rather uncommon sequelae of pediatric trauma.
European Journal of Plastic Surgery 0930-343X (Print) 10.1007/s00238-008-0276-5
Sincipital encephaloceles presenting in adulthood are misdiagnosed until they present with persistent cerebrospinal fluid (CSF) rhinorrhea or, in extreme cases, meningeal infection.
Haplotypes of the fibrinogen gamma and alpha (FGG and FGA) genes are associated with the structure of the fibrin network and may therefore influence the risk of stroke.
The two objectives of this study were (1) to replicate the previous finding that a single nucleotide polymorphism (SNP) in the ANKK1 gene (SNP rs1800497 formerly known as the DRD2 TAQ1 A allele) is associated with measures of learning and response latency after traumatic brain injury (TBI) and (2) to further characterize the genetic basis of the effect by testing the strength of association and degree of linkage disequilibrium between the cognitive outcome measures and a selected ensemble of 31 polymorphisms from three adjacent genes in the region of rs1800497.
European Journal of Nuclear Medicine and Molecular Imaging 1619-7070 (Print) 10.1007/s00259-008-0886-y
The aim of the present study was to determine whether preoperative cerebrovascular reactivity (CVR) to acetazolamide measured by quantitative brain perfusion single-photon emission computed tomography (SPECT) predicts development of cerebral ischemic lesions on postoperative diffusion-weighted magnetic resonance imaging (DWI) that are caused by microemboli during carotid endarterectomy (CEA).
The combination of healthy lifestyle factors is associated with lower risk of coronary heart disease, diabetes, and total cardiovascular disease. Little is known about the impact of multiple lifestyle factors on the risk of stroke.
Journal of Trauma-Injury Infection & Critical Care. 65(2):380-386, August 2008
Using decompressive craniectomy as part of the treatment regimen for severe traumatic brain injury (STBI) has become more common at our Level I trauma center. This study was designed to examine this practice with particular attention to long-term functional outcome.
Adiponectin and its receptors, AdipoR1 and AdipoR2, constitute integral components of energy homeostatic mechanism in peripheral tissues. Recent studies have implicated adiponectin in central neural networks regulating food intake and energy expenditure.
This research concerns the measurement of self-monitoring in people who were diagnosed with traumatic brain injury (TBI), learning disability (LD) and emotional disorder (ED). Two measures of self-monitoring were evaluated: (1) the correlation between participants' self-predicted and observed standardized sub-test scores (R) on 17 WAIS-III 1 sub-tests and (2) the average difference between the participants' predicted and observed sub-tests scores (B). It was then determined if these measures could discriminate the three diagnostic groups.
This study reports on a pilot study using a temporal discounting paradigm and a standardized impulsivity questionnaire to examine decision-making in a group of brain injured patients and age matched controls.
The aim of the present study was to investigate the event-based prospective memory (EBPM) and time-based prospective memory (TBPM) in patients with lesion in prefrontal cortex (PFC) and test the hypothesis that the prefrontal cortex is involved in the prospective memory (PM) network.
To report the use of physical interventions (PI) used to manage aggressive behaviour in a neurobehavioural unit and any injuries that were sustained to patients and staff during its implementation.
To compare the sensitivity to simple and complex visual stimuli of children who have sustained a mild traumatic brain injury (mTBI) to that of matched non-injured children and to determine the evolution of visuo-perceptual performance over time.
To investigate the effectiveness of occupational therapy (OT) with adults demonstrating agitation and post-traumatic amnesia (PTA) following brain injury.
The experiment determined first whether visible markers of brain injury shape judgements of severity of injury and time since injury; and secondly whether these two judgements predict attributions for undesirable actions performed by an adolescent with brain-injury.
The arrival of an action potential at a synapse triggers neurotransmitter release with a limited probability, pr. Although pr is a fundamental parameter in defining synaptic efficacy, it is not uniform across all synapses, and the mechanisms by which a given synapse sets its basal release probability are unknown.
International Journal of Cancer Published Online: 7 Aug 2008
Meningiomas are the second most common type of brain and CNS tumors by histology. Surgery and radiotherapy are main treatment options, but meningiomas may be impossible to adequately resect or may regrow after surgery.
Although anxiety and depression in populations with epilepsy have been studied, no research on fear of childbirth in women with epilepsy have been conducted. The purposes of this study were to examine whether a significant difference occurred in fear of childbirth between pregnant women with epilepsy and pregnant healthy controls and to evaluate the most common fears.
International Journal of Clinical Practice Published Online: 31 Oct 2007
Dialysis patients have a higher incidence of cerebrovascular events compared with the general population. However, the value of C-reactive protein (CRP) in predicting stroke in chronic haemodialysis patients is unknown. The aim of this study was to determine the association between serum CRP levels and ischaemic stoke in chronic haemodialysis patients.
Blood First Edition Paper, prepublished online August 1, 2008; DOI 10.1182/blood-2008-04-144758
In ischemic stroke treatment options are limited. Therapeutic thrombolysis is restricted to the first few hours after stroke, and the utility of current platelet aggregation inhibitors including GPIIb/IIIa receptor antagonists, and anticoagulants is counterbalanced by the risk of intracerebral bleeding complications.
Tick-borne encephalitis (TBE) is a potentially debilitating disease caused by the TBE virus. Natural foci of TBE were localized in the Lublin region (Poland). We observed the growing tendency of the incidence of TBE in the Lublin region at the beginning of the 1990s. Farmers and forestry workers were most often infected due to the occupational risk.
Takotsubo cardiomyopathy, which is characterized by transient left ventricular apical ballooning, is a known complication of subarachnoid hemorrhage. The aim of this study was to identify the clinical characteristics of acute ischemic stroke patients who experienced development of takotsubo cardiomyopath
Progressive multifocal leukoencephalopathy (PML) is a fatal demyelinating disease of the white matter affecting immunocompromised patients that results from the cytolytic destruction of glial cells by the human neurotropic JC virus (JCV).
Falls pose an important problem to neurologists caring for patients with cerebellar disorders. Normal human gait is characterized by prominent up-and-down linear head movements (vertical translations).
The modified Rankin scale (mRS) is the most commonly used outcome measure in stroke trials. However, substantial interobserver variability in mRS scoring has been reported.
Dysphagia is a common problem after stroke associated with significant morbidity and mortality. Except for patients with brain stem strokes, particularly lateral medullary strokes, it is difficult to predict which cases are likely to develop swallowing dysfunction based on their neuroimaging.
In this study, linked, anonymous data from The National Hospital Discharge Register and the Swedish Prescribed Drug Register were used for studying to what extent recommended drugs for secondary prevention after stroke and TIA were purchased by patients in the region of Stockholm, Sweden (2 million inhabitants).
Increasing attention has been paid to associations between cognitive dysfunction and brain microbleeds (MBs). Because all previous studies have investigated patients with neurological disorders, we examined subjects without neurological disorder in order to clarify pathogenic relationships.
Governmental actions affect our lives and the lives of our fellow citizens in a variety of ways. This is certainly true for both the conduct of biomedical research and the provision of medical care.
We examined patient demographic and hospital characteristics and clinical predictors of delay time from hospital arrival until CT among 20 374 patients enrolled in the North Carolina Collaborative Stroke Registry (January 2005 to April 2008).
Microemboli generated during dissection of the carotid arteries in patients undergoing carotid endarterectomy result in postoperative cerebral ischemic events. The purpose of this study was to determine whether these events correlate with middle cerebral artery blood flow velocity.
Previous multicenter carotid endarterectomy (CEA) studies had screening criteria for patient comorbidities and very few blacks. We assessed the hypothesis that CEA results from two urban hospitals would approximate those of the previous multicenter trials.
Some patients diagnosed with transient ischemic attack (TIA) in the emergency department may actually have alternative diagnoses such as seizure, migraine, or other nonvascular spells.
Activation of NMDA subtypes of glutamate receptors is implicated in cell damage induced by ischemia as well as for the establishment of ischemic tolerance after ischemic preconditioning in animal models.
Prospective data on the association between cardiorespiratory fitness (CRF) and stroke are largely limited to studies in men or do not separately examine risks for fatal and nonfatal stroke. This study examined the association between CRF and fatal and nonfatal stroke in a large cohort of asymptomatic women and men.
The purpose of this study was to prospectively investigate the contribution of the ipsilateral external carotid artery (ECA) to cerebral perfusion in patients with internal carotid artery occlusion.
Evolution of intracranial aneurysmal disease is known to be related to hemodynamic forces acting on the vessel wall. Low wall shear stress (WSS) has been reported to have a negative effect on endothelial cells normal physiology and may be an important contributor to local remodeling of the arterial wall and to aneurysm growth and rupture.
Journal of Neuro-Oncology 0167-594X (Print) 10.1007/s11060-008-9659-5
Medulloblastoma (MB) is the most common brain malignancy in children. Whole neural axis irradiation is the treatment of choice, but it often results in long-term neurocognitive and developmental impairment.
Journal of Neurosurgery: Pediatrics August 2008 Volume 2, Number 2
Infantile or capillary hemangioma is the most common vascular tumor of childhood. The tumors most frequently affect the head and neck area, but rare cases of intracranial lesions have been reported.
The ubiquitin-proteasome system (UPS) and autophagy-lysosome pathway (ALP) are the two most important mechanisms that normally repair or remove abnormal proteins.
Following hypoxia-ischaemia (HI), an early biomarker of insult severity is desirable to target neuroprotective therapies to patients most likely to benefit; currently there are no biomarkers within the
"atent phase" period before the establishment of secondary energy failure.
The pulvinar is an important structure for visual attention function. Spatial and temporal attention was examined in three patients with varying pulvinar lesions. Spatial and temporal deficits were dissociable.
In two patients with total acquired cortical colour blindness and in six control subjects we studied the binocular pupillary response to a variety of sharply defined coloured and grey displays that either had the same mean luminance as the background (isoluminant) or were of greater mean luminance.
In the human brain, the morphology of cortical gyri and sulci is complex and variable among individuals, and it may reflect pathological functioning with specific abnormalities observed in certain developmental and neuropsychiatric disorders.
The identity and functional potential of dopamine neurons derived in vitro from embryonic stem cells are critical for the development of a stem cell-based replacement therapy for Parkinson's disease.
Recessive Charcot-Marie-Tooth disease type-4J (CMT4J) and its animal model, the pale tremor mouse (plt), are caused by mutations of the FIG4 gene encoding a PI(3,5)P2 5-phosphatase.
Electrocorticographic (ECoG) spectral patterns obtained during language tasks from 12 epilepsy patients (age: 12-44 years) were analysed in order to identify and characterize cortical language areas.
Depression represents one of the most common comorbidities in patients with epilepsy. However, the mechanisms of depression in epilepsy patients are poorly understood.
Journal of Medical Imaging and Radiation Oncology Volume 52 Issue 3, Pages 201 - 207
Acute ischaemic stroke is among the leading causes of death and disability in developed societies. I.v. and intra-arterial thrombolysis, and mechanical thrombectomy carried out within the appropriate time window can result in superior clinical outcomes compared with traditional therapy consisting of anticoagulation and/or aspirin.
Stem Cells Vol. 26 No. 7 July 2008, pp. 1673 -1682
Systemically injected neural precursor cells (NPCs) were unexpectedly shown to reach the cerebral parenchyma and induce recovery in various diffuse brain pathologies, including animal models of multiple sclerosis.
Ictal and postictal language dysfunction is common and strongly predictive of language laterality in monolingual patients. For bilingual patients, selective dysfunction has been reported for a single language with focal cerebral lesions, electrical brain stimulation, and intracarotid sodium amytal.
There are concerns that generic and brand antiepileptic drugs (AEDs) may not be therapeutically equivalent. This study investigated how generic AED substitution may have negative consequences.
Ten-year follow-up results from the Parkinson's Disease Research Group of the United Kingdom trial demonstrated that there were no long-term advantages to initiating treatment with bromocriptine compared with l-dopa in early Parkinson disease (PD).
Fatigue is a common complaint in Parkinson disease (PD). We investigated fatigue in a cohort of previously untreated patients with early PD enrolled in the Earlier vs Later Levodopa (ELLDOPA) clinical trial.
The paraoxonase gene cluster on chromosome 7 comprising the PON1-3 genes is an attractive candidate for association in amyotrophic lateral sclerosis
(ALS) given the role of paraoxonase genes during the response to oxidative stress and their contribution to the enzymatic break down of nerve toxins.
The significance of Lewy bodies detected at autopsy in the brains of clinically normal individuals is uncertain but may represent preclinical Parkinson disease (PD).
To compare carbon 11–labeled Pittsburgh Compound B ([11C]PiB) positron emission tomography (PET) findings in patients with and without Alzheimer disease lesions in frontal cortical biopsy specimens.
Gait difficulties, tremors, and coordination difficulties are common features of Cockayne syndrome that are consequences of leukodystrophy, cerebellar atrophy, and demyelinating neuropathy, but no pharmacotherapy for these disabling symptoms is available.
We conducted a systematic review and meta-analysis of mechanical thrombectomy in the treatment of ischemic stroke and assessed factors for technical and clinical success and survival.
A 56-year-old man was admitted to the hospital with a 2-week history of general
myalgia, fever, and cough. A complete blood cell count on admission showed the following: white blood cell count,
1720/µL (to convert to value x 109/L, multiply by 106); hemoglobin level, 6.7
g/dL (to convert to grams per liter, multiply by 10.0); and platelet count, 24 x
103/µL (to convert to value x 109/L, multiply by .001).
A 66-year-old man fell from a height of 2 meters while at work. He was quickly attended to by an on-site physician who diagnosed cardiorespiratory arrest. The patient received ventilatory support using a laryngeal mask. He recovered cardiac activity and arterial pressure after epinephrine was administered.
A 47-year-old man presented with sudden onset of dysarthria and left-sided weakness while practicing golf on a driving range. His medical history was unremarkable.
When asked to review The Thalamus, I immediately agreed, wanting to update and increase my knowledge of this mysterious nucleus at the center of the nervous system.
This book presents a thorough and up-to-date compilation by experts in the field of the incredibly complex facets of central nervous system (CNS) regeneration research focused on mammalian models and mechanisms.
Management of Stroke: A Practical Guide for the Prevention, Evaluation, and Treatment of Acute Stroke is a clinically based pocketbook intended to assist physicians and other health care providers in their daily management of stroke patients.
Journal of
Neuro-Oncology 0167-594X (Print) 10.1007/s11060-008-9669-3
Low-grade gliomas (LGG) are increasingly being diagnosed in older patients (>60 years). The rising incidence is incompletely understood but demands an analysis of the natural history and prognostic factors to determine if there are differences compared to younger populations.
Journal of Neurosurgery: Pediatrics August 2008 Volume 2, Number 2
Achondroplasia has a known association with foramen magnum stenosis that can result in cervicomedullary compression, which is most often due to a hypertrophied posterior occipital rim and an undersized transverse diameter.
Pediatric Blood & Cancer Published Online: 22 Jul 2008
Neuroblastoma is the most common extracranial pediatric solid cancer. Lung metastasis is rarely detected in children with newly diagnosed neuroblastoma. We aimed to describe the incidence, clinical characteristics, and outcome of patients with lung metastasis at initial diagnosis using a large international database
Geriatrics & Aging Volume 11, Number 6, July 2008, Pages 351-356
Differentiating between Parkinson's disease dementia (PDD) and dementia with Lewy bodies
(DLB) is a difficult issue for many clinicians. To date, these diseases share most of their clinical,
neuropathological, and management features.
Transient isolated lesions of the splenium with restricted diffusion are rare in the pediatric population. We report two such cases with influenza-associated encephalitis/encephalopathy (IAEE).
PEDIATRICS Vol. 122 No. 2 August 2008, pp. e426-e437
Abnormalities in cognitive function and brain structure have been reported in acutely ill adolescents with anorexia nervosa, but whether these abnormalities persist or are reversible in the context of weight restoration remains unclear.
To identify factors that determine disease severity and clinical phenotype of the most common spinocerebellar ataxias (SCAs), we studied 526 patients with SCA1, SCA2, SCA3. or SCA6.
Journal of Neurosurgery August 2008 Volume 109, Number 2
Treatment options for patients with brain metastasis include tumor resection, whole-brain radiation therapy, and radiosurgery. A single treatment is not useful in cases of multiple tumors, of which at least 1 is a cystic tumor.
Journal of Neurosurgery August 2008 Volume 109, Number 2
The anterior condylar confluence (ACC) is located on the external orifice of the canal of the hypoglossal nerve and provides multiple connections with the dural venous sinuses of the posterior fossa, internal jugular vein, and the vertebral venous plexus.
Mutations of the neuronal nicotinic acetylcholine (nACh) receptor identified in patients with autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) lead to increased sensitivity to ACh. As activation of presynaptic nicotinic receptors augments the release of dopamine in the striatum and the prefrontal regions, we tested the hypothesis that that the {alpha}4-Ser248Phe mutation affects dopaminergic transmission.
loss-of-function causes recessive, early-onset parkinsonism. In Tunisia there is a high rate of consanguineous marriage but PINK1 carrier frequency and disease prevalence have yet to be assessed.
White matter hyperintensities (WMH) are commonly seen on neuroimaging scans, but their underlying histopathologic substrate is unclear. The aim of this work was to establish the pathologic correlates of WMH in unselected elderly cases using two study designs.
Conflicting perspectives about the diagnosis and prognosis of the persistent vegetative state (PVS) as well as end-of-life (EOL) decision-making were disseminated in the Terri Schiavo case. This study examined print media coverage of these features of the case.
Neurosurgical Focus August 2008 Volume 25, Number 2
The authors describe a technique for minimally invasive anterior vertebroplasty for treating metastatic disease of the C-2 vertebra and discuss its application in 2 cases. After a 2-cm lateral neck incision is made, blunt dissection is performed toward the anterior inferior endplate of the C-2 vertebra.
The prevalence of neurodegenerative diseases such as Parkinson's disease (PD) increases with age. In an aging population, an understanding of the management of late complications of PD is becoming ever more important.
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 194-195 (15 September 2008)
Topiramate has been shown to be highly effective for preventive treatment of migraine and its use has been significantly increased in the last few years. However, around 10% of migraineurs develop a worsening of their symptoms while on topiramate.
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 191-193 (15 September 2008)
Bilateral internal carotid artery (ICA) agenesis is an extremely rare congenital anomaly. The most common type of collateral circulation is developed through the circle of Willis via the basilar and posterior communicating arteries.
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 183-185 (15 September 2008)
A 70-year-old man with right hemiparesis (NIHSS score 15) was admitted to our hospital 1 h after onset. Diffusion-weighted imaging (DWI) revealed a hyperintense lesion in the left corona radiata and magnetic resonance angiography (MRA) revealed occlusion of the left middle cerebral artery (MCA).
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 171-173 (15 September 2008)
Paraneoplastic cerebellar degeneration (PCD) is a rare immune mediated phenomenon often associated with cancer of the ovarian. Hitherto, tumor dissection is the mainstay in therapy while immunomodulatory treatment regimes often fail.
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 158-163 (15 September 2008)
Depression is a frequently observed neuropsychiatric phenomenon in Parkinson's disease (PD) and it has been lately considered as a manifestation of such disease.
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 151-157 (15 September 2008)
Penetrating injuries may infrequently cause pseudoaneurysms, lacerations and arteriovenous fistulas involving the subclavian artery. These injuries present with life-threatening bleedings, associated regional injuries and critical limb ischemia and although surgery has been considered the treatment of choice, subclavian injuries pose a real surgical challenge.
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 143-150 (15 September 2008)
MRI helps in detecting the etiology of epilepsy, which may assist in better management. However its role in emergency situations like status epilepticus (SE) is still not clear. We analyzed the MRI findings in various subtypes of SE and tried to find out if etiological diagnosis improves by doing MRI over and above that provided by clinical evaluation, CT scan and CSF and other laboratory data.
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 136-142 (15 September 2008)
Symptomatic intracranial hemorrhages are typically clinically catastrophic and occur more frequently with tissue plasminogen activator (t-PA) therapy compared to without t-PA therapy. However, it has been unclear whether asymptomatic intracranial hemorrhage has clinical implications.
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 132-135 (15 September 2008)
Stroke is one of the most complex diseases with several subtypes, arising from numerous gene-gene and gene-environmental interactions. The aim of our study was to investigate whether the insertion/deletion polymorphism in Angiotensin-converting enzyme gene is associated with ischemic stroke in a South Indian population.
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 129-131 (15 September 2008)
It is well known that upper respiratory infections or vaccinations are etiologic factors in the majority of acute disseminated encephalomyelitis (ADEM) cases. However, it is less well known that aseptic meningitis may be an initial manifestation of ADEM.
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 123-128 (15 September 2008)
Evaluation of therapeutic agents for Friedreich Ataxia (FA) has been limited by a lack of adequate markers of disease progression. We assessed the capacity of health related quality of life (HRQOL) questionnaires to reflect disease status in FA.
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 115-122 (15 September 2008)
As infections occur more frequently in developing countries, we carried out this prospective case-control study, to establish the association, if any, between C. pneumoniae antibodies and ischemic stroke particularly in relation to its subtypes.
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 99-105 (15 September 2008)
Recent studies have shown the beneficial effect of infliximab in ocular manifestation of Behçet's disease. The current studies examined the efficacy of infliximab in progressive neuro-Behcet's syndrome (NB) refractory to methotrexate (MTX).
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 83-86 (15 September 2008)
DVT was detected a total of 21 patients (40.4%) after two weeks. Patients with DVT tended to be older, and had significantly more severe disturbance of consciousness (p=0.020) and paralysis (p=0.035) on admission than those without DVT.
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 77-82 (15 September 2008)
Atypical antipsychotics (AA) are generally associated with weight gain. We determined body mass index (BMI) change in Parkinson's disease (PD) before and after taking AA and compared against PD controls and Alzheimer's disease (AD) patients on AA.
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 71-76 (15 September 2008)
We report two cases presenting focal neurological deficits with high intensity lesions in fluid attenuated inversion recovery (FLAIR) images on brain magnetic resonance imaging (MRI), which almost completely improved by corticosteroid therapy.
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 60-70 (15 September 2008)
Amyotrophic Lateral Sclerosis is a progressive disease causing degeneration of upper and lower motor neurons with an average survival of 2 to 3 years. We retrospectively analyzed 1153 patients of classical sporadic ALS seen over 30 years for the clinical manifestations and survival pattern.
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 48-59 (15 September 2008)
Earlier studies have reported that hippocampal atrophy can to some extent predict which patients with mild cognitive impairment (MCI) will subsequently convert to dementia, and that converters have an enhanced rate of hippocampal volume loss.
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 43-47 (15 September 2008)
Hyperhomocysteinemia (hyper-Hcy) is a known risk factor for venous thrombosis, but few studies document the risk in puerperal cerebral venous thrombosis (CVT). Nutritional folate and vitamin B12 deficiency can cause hyper-Hcy and pregnancy may contribute to this deficiency.
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 20-33 (15 September 2008)
Mitochondrial disorders, in particular respiratory chain diseases (RCDs), present either as single organ problem or as multi-system disease. One of the most frequently affected organs in RCDs, in addition to the skeletal muscle, is the central nervous system (CNS).
Journal of the Neurological Sciences Volume 272, Issue 1, Pages 1-7 (15 September 2008)
Patients with a history of ischemic stroke or transient ischemic attack (TIA) are at risk for recurrent ischemic events in the same or different vascular bed. Due to the central role of platelets in the spectrum of ischemic events in all vascular beds, antiplatelet therapy is a critical component of treatment. Of all antiplatelet therapies approved for the secondary prevention of stroke, aspirin is the most well-established and is recommended for all patients with a history of cerebrovascular disease.
International Journal of Speech-Language Pathology, Volume 10, Issue 5 2008 , pages 305 - 313
Speech-language pathology outcomes following stroke are poorly understood, and potential predictors of these, such as age and therapy input have not been well documented. For 12 months, the Australian Therapy Outcome Measures (AusTOMs) for Speech Pathology scales were used to rate swallowing and language outcomes for patients (n = 63) receiving rehabilitation post stroke.
Several studies have suggested that the specific stroke subtype may influence the presence of leukoaraiosis in patients with ischemic stroke. We investigated the association between stroke subtype and leukoaraiosis in Korean patients with ischemic stroke by MRI.
The foramen spinosum is an easily identifiable landmark in microsurgery of the middle cranial fossa, and knowledge of the variations in its relationship to the surrounding neurovascular structures is important when operating in this area.
In 1996, Civit et al. (Neurosurgery, 38:955–961, 1996) reported a series of eight patients whose aneurysms were clipped after previous embolization with coils. This paper highlighted the safety of this surgery in second line, with a low complication rate and a favorable outcome.
Journal of Neurosurgery: Pediatrics August 2008 Volume 2, Number 2
Implantation of cerebrospinal fluid (CSF) shunting devices is associated with a 5-15% risk of infection as cited in contemporary pediatric neurosurgical literature. Shunt infections typically require complete removal of the device and prolonged antibiotic treatment followed by shunt replacement.
PEDIATRICS Vol. 122 No. 2 August 2008, pp. e376-e382
The 22q13.3 deletion syndrome (Online Mendelian Inheritance in Man No. 606232) is a neurodevelopmental disorder that includes hypotonia, severely impaired development of speech and language, autistic-like behavior, and minor dysmorphic features.
Pediatric Transplantation, Volume 12, Number 5, August 2008 , pp. 527-530(4)
Children undergoing kidney transplantation are at increased risk for symptomatic seizures with a previously reported incidence of approximately 20%. Little data exist to help predict which children may be at risk.
Journal of Neurosurgery August 2008 Volume 109, Number 2
The aim of this study was to correlate proton MR (1H-MR) spectroscopy data with histopathological and surgical findings of proliferation and hemorrhage in pituitary macroadenomas.
Journal of Neurosurgery August 2008 Volume 109, Number 2
Endothelial proliferation has been recognized as a marker of high-grade or aggressive glioma. Bevacizumab is a humanized immunoglobulin G1 monoclonal antibody to vascular endothelial growth factor that has been shown to have activity in malignant gliomas when combined with irinotecan.
PEDIATRICS Vol. 122 No. 2 August 2008, pp. e330-e333
We evaluated the efficacy and long-term outcome of the ketogenic diet in patients with intractable childhood epilepsy as a result of focal malformation of cortical development.
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2007-1403
Cabergoline, a dopamine receptor-2 agonist, used to treat prolactinomas was associated with increased risk of cardiac valve disease in Parkinson's disease.
Caffeine use is negatively associated with the risk of developing Parkinson disease (PD) and is protective in animal models of PD, but the relationship between caffeine intake and rate of progression of PD is unknown. We assessed this relationship using data from 2 recent clinical trials of PD.
Spinal Cord advance online publication 5 August 2008; doi: 10.1038/sc.2008.94
The purpose of this study was to report the functional ability of children with spinal cord injury (SCI) as recorded on motor items of the functional independence measure (FIM) and to examine the factors associated with FIM motor admission and post-discharge gain scores.
Spinal Cord advance online publication 5 August 2008; doi: 10.1038/sc.2008.101
To assess the utility of ultrasonography for detecting deep tissue injury or incipient pressure ulcers and to determine the patterns of development of pressure ulcers in subjects with chronic spinal-cord injury (SCI).
Journal of Neurosurgery: Pediatrics August 2008 Volume 2, Number 2
Dialysis disequilibrium syndrome is a rare neurological manifestation of intermittent hemodialysis. Urea removal occurs more slowly across the blood-brain barrier than from the plasma, generating an osmotic gradient that promotes water movement into the brain and cerebral edema.
Journal of Neuro-Oncology 0167-594X (Print) 10.1007/s11060-008-9662-x
Valproic acid (VPA) inhibits histone deacetylase and has been reported to induce apoptosis in glioma. We report 44 heavily pretreated pediatric patients with high-grade glioma or diffuse intrinsic pontine glioma who received VPA as oral continues maintenance treatment with individual dose adaptation.
Journal of Neuro-Oncology 0167-594X (Print) 10.1007/s11060-008-9660-z
Carmustine (BCNU)-impregnated biodegradable polymer wafers have been shown to prolong survival in patients with recurrent malignant glioma. Interferon alfa-2b (IFN{alpha}2b) has demonstrated antitumor activity against a number of cancers, but its use in glioma has been limited.
European Journal of Nuclear Medicine and Molecular Imaging 1619-7070 (Print) 10.1007/s00259-008-0872-4
Thirty-six de novo PD patients underwent 123I-FP-CIT SPECT and MRI scan. SPECT data were reconstructed with filtered back projection (FBP), with an iterative algorithm (ordered subset expected maximization, OSEM) and with a method previously developed in our institution, called least-squares (LS) method.
Venous thromboembolism (VTE) is an important complication of neurosurgery. Current guidelines recommend pharmacologic prophylaxis in this setting with either unfractionated heparin or low-molecular-weight heparin (LMWH). We conducted a systematic review asking, "Among patients undergoing neurosurgical procedures, how safe and effective is the prophylactic use of heparin and mechanical devices?"
Patients with renal cell carcinoma brain metastases (RCCBM) are frequently excluded from trials and to the authors' knowledge no guidelines currently exist regarding central nervous system (CNS) surveillance or treatment. The objective of the current study was to assist in the creation of treatment guidelines.
Journal of Neurosurgery: Pediatrics August 2008 Volume 2, Number 2
The authors describe the previously unreported occurrence of thoracolumbar subdural hematoma (SDH) resulting from nonaccidental trauma and emphasize the need for a complete and thorough neurological, physical, and radiological examination in all cases of suspected nonaccidental trauma.
The extrastriate cortex is a visual processing structure beyond the striate cortex. This region contains cells that differ in selectivity for different features of stimuli such as color, motion and stereopsis.
American Journal of Surgical Pathology. 32(8):1220-1227, August 2008
Evaluation of O6-methylguanine-DNA methyltransferase (MGMT) expression is important for antiglioma therapy as many clinical trials have demonstrated that promoter hypermethylation and low level expression of MGMT are associated with an enhanced response to alkylating agents.
Journal of Neural Transmission 0300-9564 (Print) 10.1007/s00702-008-0074-z
Yemenite Jews in Israel are a distinctive ethnic division of the Jewish
diaspora. Clinical findings, disease course and genetic tests for the LRRK2 6055G > A (G2019S) mutation were compared between Ashkenazi and Yemenite Israeli patients with
Parkinson's disease (PD).
Journal of Neurosurgery August 2008 Volume 109, Number 2
The authors of this preliminary study investigated the outcome and feasibility of intraoperative microelectrode recording (MER) in patients with Parkinson disease (PD) undergoing deep brain stimulation of the subthalamic nucleus (STN) after anesthetic inhalation.
Journal of Neurosurgery August 2008 Volume 109, Number 2
The "syndrome of the trephined" is an uncommon and poorly understood disorder of delayed neurological deficit following
craniectomy. From the authors' extensive experience with decompressive hemicraniectomy for traumatic brain injury
(TBI), they have encountered a number of patients who developed delayed motor deficits, also called "motor trephine syndrome," and reversal of the weakness following cranioplasty repair.
Journal of Neurosurgery August 2008 Volume 109, Number 2
The goal of this study was to examine the sensitivity and specificity in preoperative localization of hand motor cortex by imaging regional event-related desynchronization (ERD) of brainwaves in the {beta} frequency band (15-25 Hz) involved in self-paced movement.
Journal of Neurosurgery August 2008 Volume 109, Number 2
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a clinically effective neurosurgical treatment for Parkinson disease. Tissue reaction to chronic DBS therapy and the definitive location of active stimulation contacts are best studied on a postmortem basis in patients who have undergone DBS.
Journal of Neurosurgery August 2008 Volume 109, Number 2
Carney complex is a rare autosomal-dominant familial tumor syndrome that involves the triad of myxoma, mucocutaneous pigmentation, and endocrine overactivity.
Journal of Neurosurgery August 2008 Volume 109, Number 2
It has been shown that craniotomy may lead to a decrease in lung volumes and arterial blood gas tensions as well as a change in the respiratory pattern. The purpose of this study was to determine the incidence of postoperative pulmonary complications (PPCs) and the mortality rate in patients who have undergone elective craniotomy and to evaluate the associations between preoperative and postoperative variables and PPCs in this population.
Journal of Neurosurgery August 2008 Volume 109, Number 2
Because of high recanalization rates associated with wide-necked intracranial aneurysms treated with bare platinum coils, hydrogel coils (HydroCoil, MicroVention, Inc.) have been developed. Hydrogel coils undergo progressive expansion once exposed to the physiological environment of blood and increase overall aneurysm filling.
Journal of Neurosurgery August 2008 Volume 109, Number 2
The annual rate of rupture of intracranial aneurysms is often assumed to be constant, but it is unknown whether this assumption is true. Recent case reports have suggested that aneurysms grow fast in a short period of time.
Journal of Neurosurgery August 2008 Volume 109, Number 2
Skull base approaches play a fundamental role in modern neurosurgery by reducing surgical morbidity. Increasing experience has allowed surgeons to perform minimally invasive approaches without straying from the premises of skull base surgery.
Journal of Neurosurgery August 2008 Volume 109, Number 2
The use of dural grafts is frequently unavoidable when tension-free dural closure cannot be achieved following neurosurgical procedures or trauma. Biodegradable collagen matrices serve as a scaffold for the regrowth of natural tissue and require no suturing.
Journal of Neurosurgery August 2008 Volume 109, Number 2
The subarachnoid space around the optic nerve in the orbit can be visualized using T2-weighted MR imaging with the fat-saturation pulse sequence. The optic nerve sheath (ONS) diameter can be estimated by measuring the outer diameter of the subarachnoid space.
Journal of Neurosurgery August 2008 Volume 109, Number 2
Transvenous embolization (TVE) for the treatment of a cavernous sinus (CS) dural arteriovenous fistula (DAVF) occasionally causes cranial nerve palsy (CNP). Overpacking of coils is considered to result in CNP. The purpose of this study was to analyze the association of TVE-induced CNP with the volume and location of coils activated in the CS.
Journal of Neurosurgery August 2008 Volume 109, Number 2
In this paper the authors analyzed the clinical and neuroimaging outcomes of patients with cerebral arteriovenous malformations (AVMs) after Gamma Knife surgery (GKS), focusing on the analysis of the radiation injury rate depending on the AVM volume.
Journal of Neurosurgery August 2008 Volume 109, Number 2
In territorial stroke vasogenic edema formation leads to elevated intracranial pressure (ICP) and can cause herniation and death. Brain swelling further impairs collateral blood flow to the ischemic penumbra and causes mechanical damage to adjacent brain structures. In the present study the authors sought to quantify the impact of this space-occupying effect on ischemic lesion formation.
Journal of Neurosurgery August 2008 Volume 109, Number 2
Delayed cerebral ischemia is a major cause of morbidity and death following aneurysmal subarachnoid hemorrhage and requires timely intervention for a successful outcome to be achieved. In this study the investigators compared the commonly used Fisher scale with 2 newer radiographic scales for the prediction of vasospasm, delayed infarction, and poor outcome.
Brain edema after cardiac surgery is unusual and often asymptomatic. We encountered a 34-year-old man who had postoperative left flaccid hemiplegia and anosognosia after undergoing composite root replacement and closure of a patent foramen ovale.
PEDIATRICS Vol. 122 No. 2 August 2008, pp. 375-382
Erythropoietin has been shown to be protective against hypoxic-ischemic and inflammatory injuries in cell culture, animal models of brain injury, and clinical trials of adult humans.
Journal of Neuropathology & Experimental Neurology. 67(8):819-827, August 2008
Immune reconstitution inflammatory syndrome represents a spectrum of clinicopathologic entities encountered in human immunodeficiency virus-infected patients who have received highly active anti-retroviral therapy.
A major mechanism of resistance to methylating agents, including temozolomide, is the DNA repair protein O6-alkylguanine-DNA alkyltransferase (AGT). Preclinical data indicates that defective DNA mismatch repair (MMR) results in tolerance to temozolomide regardless of AGT activity.
Using a model of embolic stroke, the present study tested the hypothesis that blockage of endothelin-1 with S-0139, a specific endothelin type A receptor (ETA) antagonist, enhances the neuroprotective effect of recombinant tissue plasminogen activator (rtPA) by suppressing molecules that mediate thrombosis and blood brain barrier (BBB) disruption induced by ischemia and rtPA.
It is often thought that elderly patients in particular would benefit from endovascular aneurysm treatment. The aim of this analysis was therefore to compare the efficacy and safety of endovascular coiling (EVT) with neurosurgical clipping (NST) in the subgroup of elderly SAH patients in the International Subarachnoid Aneurysm Trial (ISAT).
Vascular prevention trials mostly count "yes/no" (binary) outcome events, eg, stroke/no stroke. Analysis of ordered categorical vascular events (eg, fatal stroke/nonfatal stroke/no stroke) is clinically relevant and could be more powerful statistically. Although this is not a novel idea in the statistical community, ordinal outcomes have not been applied to stroke prevention trials in the past.
The Journal of Headache and Pain 1129-2369 (Print) 1129-2369 (Print)
The 5-hydroxytryptamine (5-HT) has been implicated in migraine pathophysiology for the past 50 years. A low central 5-HT disposition associated with an increase in 5-HT release during attack is the most convincing change of 5-HT metabolism implicated in migraine.
The Journal of Headache and Pain 1129-2369 (Print) 10.1007/s10194-008-0057-3
Headache is a common symptom after cerebral angiography, although it has seldom been studied. We aimed to evaluate the frequency of headache at 24 h and 6 months after angiography and to describe its characteristics.
A 77-year-old man presented with a 1-year history of upper limb rest tremor, rigidity, and bradykinesia. He reported focal dystonia affecting the right thumb over the preceding 7 years, resulting in a constant "thumbs up" gesture reminiscent of the fictional television character Arthur Fonzarelli.1 Subsequent levodopa therapy reduced his bradykinesia and rigidity, but did not ameliorate the dystonia (see the video)
Mental retardation is one of the most prevalent neurologic disorders globally. Surveys in high-income countries show 3 to 5 per 1,000 with severe intellectual disability, i.e., IQ below 55. Estimates from developing countries, however, have found prevalence rates from 5 to as much as 22 per 1,000.
Anti-GQ1b antibody has been found in Miller Fisher syndrome (MFS), Guillain-Barr syndrome
(GBS) with ophthalmoplegia, Bickerstaff brainstem encephalitis
(BBE), and acute ophthalmoplegia without ataxia (AO).
To assess the prognostic implications of both the absolute spike frequency over the affected temporal lobe and the relative spike distribution between the two temporal lobes (i.e., uni- vs bitemporal spike distribution) for postoperative seizure control in a series of consecutive patients with medically refractory mesial temporal lobe epilepsy (MTLE) and MRI evidence of unilateral hippocampal atrophy (HA).
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