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Although poststroke fatigue (PoSF) is common, pharmacological interventions to improve PoSF have rarely been carried out. The purpose of the present study was to evaluate the therapeutic effect of fluoxetine on PoSF.
Transcranial Doppler ultrasound detection of weak embolic signals is inhibited by intrinsic limitations within the human auditory system. Psychoacoustics effects are likely to be exacerbated in a clinical environment, where automated embolus detection has potential to surpass manual detection.
A simple score derived in the Oxfordshire Community Stroke Project (ABCD score) was able to identify individuals at high early risk of stroke after a transient ischemic attack (TIA) both in a population-based and a hospital-referred clinic cohort. We aimed to further validate the former score in a cohort of hospitalized TIA patients.
Hypertensive intracerebral hemorrhage (ICH) in young people has been the object of only succinct analyses. Therefore, it is unclear whether extrapolation of the information obtained from older patients is also valid for the young. Here we describe young persons with hypertensive ICH and compare them with their older counterparts to determine whether age-related clinical differences exist.
Scandinavian Journal of Medicine & Science in Sports, Volume 16, Number 6, December 2006, pp. 412-416(5)
To investigate whether sports activity is associated with better psychological profiles in patients with spinal cord injury (SCI) and to evaluate the effect of demographic factors on psychological benefits.
American Journal of Neuroradiology 27:2048-2052, November-December 2006
Our aim was to describe an expanded experience with endovascular mechanical embolectomy in a broad group of patients, including those not meeting entry criteria for the MERCI multicenter trials.
Data concerning stroke occurrence and recurrence in China are extremely rare. This study was designed to analyze determinants of stroke recurrence in a cohort of Chinese patients.
American Journal of Neuroradiology 27:2149-2154, November-December 2006
We objectively assessed surface structural changes of the hippocampus in mesial temporal sclerosis (MTS) and assessed the ability of large-deformation high-dimensional mapping (HDM-LD) to demonstrate hippocampal surface symmetry and predict group classification of MTS in right and left MTS groups compared with control subjects.
The Annals of Pharmacotherapy: Vol. 40, No. 12, pp. 2115-2122
Appropriate treatment of post-stroke depression (PSD) is critically important, considering the negative impact of PSD. Data regarding the treatment efficacy of antidepressants in patients with PSD are conflicting, and the time-dependent effects of antidepressant treatment in this population are unknown.
Patients remain at high risk of vascular events after stroke, transient ischaemic attack or carotid endarterectomy. We studied how well this risk is addressed by the effective treatment of modifiable risk factors.
Pediatric Emergency Care. 22(10):737-742, October 2006
Carotid artery dissections (CADs) represent an uncommon clinical condition that should be considered in the differential diagnosis of young individuals presenting with symptoms of stroke. The basic pathological changes in CAD include a disruption in the media or intima of arterial wall, through which the affected vasculature is predisposed to aneurysm or stenosis, and subsequent stroke.
American Journal of Neuroradiology 27:2093-2097, November-December 2006
Epileptic syndromes or neurodevelopmental delay may be associated with congenital anomalies of the shape or the orientation of the hippocampus. Scarce data are available about quantitative hippocampal developmental changes during fetal life, in particular about the progressive rotational changes of the hippocampal infolding angle (HIA), which can be considered a hallmark of hippocampal development.
Mutations in neuronal nicotinic acetylcholine receptors have been demonstrated in autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE). The beneficial effect of nicotine administration was previously reported in one single case. We investigated the influence of the tobacco habits of 22 subjects from two pedigrees with a4 mutations (776ins3 and S248F).
Studies on emotion processing in patients with temporal lobe epilepsy have dealt mainly with the processing of negative emotions. To further understand the neural basis of emotional disorders in temporal lobe epilepsy, we studied patterns of brain activation induced by implicit processing of negative and positive emotions perceived through facial expressions and emotionally salient stimuli in candidates for surgical treatment of intractable epilepsy.
Magnetic Resonance Imaging Volume 24, Issue 8 , October 2006, Pages 979-992
A number of recent studies of human brain activity using blood-oxygen-level-dependent (BOLD) fMRI and EEG have reported the presence of spatiotemporal patterns of correlated activity in the absence of external stimuli.
Journal of Neurotrauma Nov 2006, Vol. 23, No. 11 : 1621 -1631
Patients suffering from complete spinal cord injury (SCI) are the most likely candidates for the application of new interventions for neural repair and regeneration.
Magnetic Resonance Imaging Volume 24, Issue 9 , November 2006, Pages 1271-1279
Monovoxel magnetic resonance spectroscopy (MRS) is a technique extensively used for the study of brain tumors in many imaging centers. However, given the fact that monovoxel spectrum quality depends upon voxel size, region of acquisition and the presence of metal and/or blood residue after surgery can make the comparison of MRS brain tumor spectra more difficult than that of other pathologies.
A 50-year-old man with no relevant medical history (started in 2000) suddenly experienced dysarthria and complained about having lockjaw and a deviation of the right corner of his mouth for a period of 6 hours. Although other symptoms disappeared, his dysarthria persisted.
To analyze the likelihood of recovery and prognostic factors in patients with massive anticoagulation-associated intracerebral hemorrhage treated with surgical evacuation after reversal of anticoagulation.
To determine the incidence, predictors, and timing of nonconvulsive seizures (NCSz) during continuous electroencephalographic monitoring (cEEG) in critically ill children.
Intracerebral hemorrhage (ICH) has been described only sporadically for patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL).
Seizures during thrombolytic therapy for ischemic stroke have not previously been described as a favorable prognostic sign. We report three patients with severe stroke (NIH Stroke Scale [NIHSS] score 15 to 20) who experienced a seizure during tissue plasminogen activator (tPA) infusion.
The Barthel Index (BI) may underestimate disability change because its items have few response options. We examined whether a similar scale with more response options (Functional Independence Measure, FIM) was more responsive (n = 1,396).
The medical records of all children at our hospital with International Classification of Diseases 9th revision (ICD-9) codes 342, 433 to 438, or 767 from May 1999 to May 2004 were reviewed to assess whether they had stroke (any type) or, specifically, arterial ischemic stroke (AIS).
Molecular genetics has transformed the diagnosis and understanding of numerous single gene disorders. This success has rarely been duplicated in common neurologic disorders with complex inheritance.
To study the association of previously unknown high blood pressure (HBP) during the acute phase of stroke (new-onset hypertension) with the inflammatory response and clinical outcome.
Disability & Rehabilitation Volume 28, Number 24 / December 2006 1557 - 1561
To highlight the importance of the spouse in stroke rehabilitation. Stroke not only affects the patients, but also their families, but rehabilitation practice is still primarily focused on the patient only.
Journal of Trauma-Injury Infection & Critical Care. 61(5):1142-1149, November 2006
The purpose of this investigation was to examine speeded performance over time and the impact of a common auditory distraction on performance after a mild traumatic brain injury (MTBI).
Progressive ischaemic damage in animals is associated with spreading mass depolarizations of neurons and astrocytes, detected as spreading negative slow voltage variations. Speculation on whether spreading depolarizations occur in human ischaemic stroke has continued for the past 60 years.
Clinical Journal of Pain. 22(9):784-789, November/December 2006
Children with spina bifida report both chronic and acute pain caused by both their condition and the treatments they undergo regularly. This research provides a description of the impact of this pain on their quality of life.
During the past 15 years, the concept of dysembryoplastic neuroepithelial tumors has continued to evolve. We present an interesting case of dysembryoplastic neuroepithelial tumor that showed rapid growth during a short period of time.
To present a rare case of a primary malignant melanoma of the central nervous system presenting as a cerebellopontine angle (CPA) tumor and to delineate aspects of the clinical presentation and magnetic resonance imaging scan characteristics that may suggest this unusual condition.
To investigate a novel method to enhance radiosensitivity of gliomas via modification of metabolite flux immediately before radiotherapy. Malignant gliomas are highly glycolytic and produce copious amounts of lactic acid, which is effluxed to the tumor microenvironment via lactate transporters.
To determine the effect of the angiogenesis inhibitor Cilengitide (EMD 121974) on glioblastoma growth and associated angiogenesis in the brains of nude mice.
Cerebral cavernous malformations (CCMs) are focal dysmorphic blood vessel anomalies predisposing individuals to hemorrhagic stroke and epilepsy. CCMs are sporadic or inherited as autosomal dominant disease with three known genes.
Temporal lobectomy is a well-established neurosurgical procedure for temporal lobe epilepsy. In this study, we conducted a retrospective review of children with drug-resistant temporal lobe epilepsy to evaluate seizure outcome after temporal lobe surgery.
Stereotactic radiosurgery (SRS) is well established in the treatment of cranial base meningiomas. Fractionated stereotactic radiotherapy (SRT) offers an additional treatment option.
We analyzed a consecutive series of patients operated for a foramen magnum (FM) meningioma located on the ventral aspect of the medulla oblongata via a posterolateral suboccipital retrocondylar approach with regard to long-term surgical outcome.
Since the introduction of endovascular embolization, the optimal treatment of ruptured aneurysms has been debated. Much of this debate has been based on results from large neurovascular centers and may not be applicable to small neurosurgical centers with low annual aneurysm loads.
The outcomes reported in the International Subarachnoid Aneurysm Trial (ISAT), a multicenter, prospective, randomized trial to directly compare surgical clipping with endovascular coiling as treatments for ruptured intracranial aneurysms, have been misinterpreted by many to indicate the superiority of coiling to surgical clipping in all instances.
Impaired transmission in GABAergic circuits is thought to contribute to the pathogenesis of epilepsy. Although it is well established that major reorganization of GABAA receptor subtypes occurs in the hippocampus of patients with medically refractory temporal lobe epilepsy (TLE), it is unclear whether this disorder is also associated with alterations in GABAA receptor subtypes in the neocortex.
Archives of Physical Medicine and Rehabilitation Volume 87, Issue 11 , November 2006, Pages 1509-1515
To evaluate the impact of intrathecal baclofen (ITB) on function and quality of life (QOL) and to obtain efficacy and safety data in poststroke spastic hypertonia.
With the recent increase in the use of antithrombotic therapy, intracerebral hemorrhage (ICH) has been found to be a common complication. We determined whether the use of oral antithrombotic therapy and the patients' preexisting comorbidities were predictive of cerebellar hemorrhage (CH; previously reported to be associated with anticoagulants) as compared to other ICH, and whether antithrombotic therapy affected the clinical severity of CH.
American Journal of Neuroradiology 27:2155-2160, November-December 2006
There is mounting evidence of extratemporal volume changes associated with medically refractory temporal lobe epilepsy (TLE). This MR imaging study aimed to characterize volume changes in subcortical structures and cerebellar hemispheres with respect to lateralization of the seizure focus, onset and duration of epilepsy, and frequency of generalized tonic-clonic seizures (GTCS).
The Journal of Clinical Endocrinology & Metabolism Vol. 91, No. 12 4786-4791
The objective of this study was to investigate, for the first time, the neuronal correlates of thyrotoxicosis-associated psychic symptoms using positron emission tomography (PET).
Smoke inhalation in burn patients is a serious medical problem around the world. Inhalation injury increases mortality in addition to increasing infections, ventilator-days, and hospital stays. There are also large numbers of patients subjected to smoke inhalation without burns from cooking fires, burning crops and forest fires. The injury results in a fall in arterial oxygenation as a result of airway blockade, increased pulmonary transvascular fluid flux and loss of hypoxic pulmonary vasoconstriction.
Primary Care Respiratory Journal Volume 15, Issue 6 , December 2006, Pages 342-345
Mitral valve prolapse (MVP) has been described as a common diagnosis and has been reported in 50% of patients with primary spontaneous pneumothorax (PSP). The purpose of this study was to determine the prevalence of MVP - as diagnosed by 2D-echocardiography criteria - in spontaneous pneumothorax.
Several studies have reported an association between asthma and gastro-oesophageal reflux, but it is unclear which condition develops first. The role of obesity in mediating this association is also unclear. We explored the associations between respiratory symptoms, lung function, and gastro-oesophageal reflux symptoms in a birth cohort of approximately 1000 individuals.
Journal of Neurotrauma Nov 2006, Vol. 23, No. 11 : 1600 -1608
Significant traumatic brain injury (TBI) is nearly always associated with cognitive deficits, but in a highly variable manner. Apolipoprotein E (ApoE) plays a pivotal role in CNS response to injury.
The decision for surgical intervention in hydrocephalic patients presenting with symptoms suggesting raised intracranial pressure (ICP) is challenging because radiographic ventricular size often lacks the specificity to predict abnormal ICP. An early assessment of the potential clinical usefulness of a noninvasive magnetic resonance imaging-based measurement of ICP (MR-ICP) in symptomatic hydrocephalic patients is reported.
Journal of Clinical Oncology, Vol 24, No 34 (December 1), 2006: pp. 5427-5433
There is growing recognition that the primary cause of cognitive deficits in adult patients with primary brain tumors is the tumor itself and more significantly, tumor progression. To assess the cognitive performance of high-grade glioma patients, prospectively collected cognitive performance data were analyzed.
Patients with epilepsy frequently report dissatisfaction with their quality of life (QOL), and there is considerable interest in understanding the factors and mechanisms associated with this perception. To date, investigation has focused on the potential contribution of seizure variables (e.g., seizure control) and psychiatric conditions to QOL, but there has not been an examination of the potential role of comorbid medical conditions.
J Neuropsychiatry Clin Neurosci 18:501-508, November 2006
Controversy exists regarding the rate and risk factors for posttraumatic stress disorder
(PTSD) following traumatic brain injury (TBI). The authors determined the rate and phenomenology of PTSD symptoms in the 6 months after TBI by conducting a prospective cohort study of 124 subjects who completed the PTSD
Checklist' Civilian Version. The cumulative incidence of meeting PTSD symptom criteria at 6 months was 11% and full criteria 5.6%. Prevalence peaked at 1 month (10%).
Journal of Neurotrauma Nov 2006, Vol. 23, No. 11 : 1591 -1599
Lipid peroxidation is caused by reactive oxygen species (ROS) and is involved in traumatic brain injury (TBI). Consequently, a therapeutic strategy for TBI may be to control lipid peroxidation.
To provide a comprehensive review of the treatment trials in the field of spinal cord injury, emphasizing what has been learned about the effectiveness of the agents and strategies tested and the quality of the methodology.
Australasian Radiology, Volume 50, Number 6, December 2006, pp. 583-590(8)
Cavernous haemangiomas of the central nervous system are vascular malformations best imaged by MRI. They may present at any age, but to our knowledge only 39 cases in the first year of life have previously been reported. A familial form has been described and some of the underlying genetic mutations have recently been discovered.
Lp(a) lipoprotein plays an important part in atherothrombogenesis and is considered an independent risk factor for coronary heart disease. However, its role in cerebrovascular disease remains unclear, in particular because of the heterogeneous nature of strokes.
Using previously published data, the purpose of this study was to identify and discriminate between three different forms of inpatient stroke care based on timing and duration of treatment and to compare the results of clinically important outcomes.
Intracerebral hemorrhage (ICH) represents the severest form of stroke, yet examinations of long-term prognosis and associated health care use are rare. This study assessed survival, morbidity and cost of hospital care over 11 years following a first-ever ICH in the UK.
Magnetic resonance imaging-guided high-intensity focused ultrasound (MRIgFUS) is a novel technique that may have the potential for precise image-guided thermocoagulation of intracranial lesions. The system delivers small volumetric sonications from an ultrasound phased array transmitter that focuses energy selectively to destroy the target with verification by magnetic resonance imaging-generated thermal maps.
Despite recent advances in neurosurgical resection techniques, radiation therapy, and chemotherapy, malignant gliomas continue to have a dismal prognosis because relapses are unavoidable.
European Journal of Neurology, Volume 13, Number 12, December 2006, pp. 1352-1358(7)
To investigate the influence of levetiracetame (LEV) treatment on the interhemispheric seizure pattern propagation and postictal recovery of electroencephalography (EEG) background activity.
Ischemia-modified albumin (IMA)is a new biological marker of ischemia. Previous studies have found increased serum IMA levels after myocardial ischemia, but no study has investigated the possibility that stroke modifies IMA blood levels.
Disability & Society Volume 22, Number 1 / January 2007 93 - 107
Blatant forms of prejudice towards disabled people appear to be disappearing in the UK. However, subtle forms of prejudice remain and may be highly damaging to the achievement of the vision of disabled people being ‘respected and included as equal members of
society'. In order to assist placing subtle forms of prejudice within a framework, the term aversive disablism is introduced, developed from aversive racism theory and building on Miller, Parker and Gillinson's definition of
disablism: discriminatory, oppressive or abusive behaviour arising from the belief that disabled people are inferior to
others'.
Timely accessibility to organized inpatient stroke rehabilitation services may become compromised since the demand for rehabilitation services following stroke is rapidly growing with no promise of additional resources. This often leads to prolonged lengths of stays in acute care facilities for individuals surviving a stroke.
European Journal of Neurology, Volume 13, Number 12, December 2006, pp. 1312-1323(12)
The inter-hemispheric symmetry of electroencephalographic (EEG) post-movement beta-event-related synchronization (PMBS) after movements on a drawing board was studied in eight acute stroke subjects with mild hemiparesis and eight normal subjects.
European Journal of Neuroscience, Volume 24, Number 10, November 2006, pp. 2932-2944(13)
This paper investigates whether and to what extent vision with awareness is still possible in the whole visual field after loss of the occipital lobe of one or both cerebral hemispheres or after hemispherectomy in childhood.
Tuberculum sellae meningiomas present a special challenge because of their proximity to arteries of the anterior circulation, anterior visual pathways, and the hypothalamus. The authors report on the clinical outcome after surgical treatment of tuberculum sellae meningiomas in our neurosurgical department.
A systematic approach to the consideration of various factors on outcome demands a comprehensive grading system for patients with intracranial aneurysms.
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