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Lorazepam is currently recommended for sustained sedation of mechanically ventilated intensive care unit (ICU) patients, but this and other benzodiazepine drugs may contribute to acute brain dysfunction,
ie, delirium and coma, associated with prolonged hospital stays, costs, and increased mortality. Dexmedetomidine induces sedation via different central nervous system receptors than the benzodiazepine drugs and may lower the risk of acute brain dysfunction.
Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase
(NOS). An elevation of plasma ADMA levels is associated with cardiovascular disease. ADMA is hydrolyzed by dimethylarginine dimethylaminohydrolases
(DDAHs). The goal of this study was to determine whether overexpression of human DDAH-1 in transgenic (DDAH-1-Tg) mice inhibits the vascular effects of
ADMA.
Hepatic encephalopathy is considered to be mainly caused by increased ammonia metabolism of the brain. If this hypothesis is true, cerebral glucose
utilisation, which is considered to represent brain function, should be closely related to cerebral ammonia metabolism. The aim of the present study was to analyse whether cerebral ammonia and glucose metabolism in cirrhotic patients with early grades of hepatic encephalopathy are as closely related as could be expected from current hypotheses on hepatic encephalopathy.
Journal of Trauma-Injury Infection & Critical Care. 63(6):1271-1278, December 2007
A decade after promulgation of treatment guidelines by the Brain Trauma Foundation
(BTF), few studies exist that examine the application of these guidelines for severe traumatic brain injury
(TBI) patients. These studies have reported both cost savings and reduced mortality.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1213-1217
Brain arteriovenous malformations (BAVMs) are thought to be sporadic developmental vascular lesions, but familial occurrence has been described. We compared the characteristics of patients with familial BAVMs with those of patients with sporadic
BAVMs.
For MR perfusion-diffusion (PWI-DWI) mismatch to become routine in thrombolysis patient selection, rapid and reliable assessment tools are required. We examined interrater variability in
PWI/DWI volume measurements and developed a rapid assessment tool based on the Alberta Stroke Program Early CT Scores (ASPECTS) system.
Whether magnetic resonance imaging (MRI) is informative in febrile seizures (FS) is unknown. We undertook a study to determine the frequency of
MRI-detected brain abnormalities and to evaluate their association with FS type and with specific features of complex FS.
Complex genetic disease is inherently difficult to study due to an imperfect relationship between genotype and phenotype. One important reason for this imperfect relationship is genetic heterogeneity, the occurrence of different genetic factors underlying the same clinical syndrome.
Journal of Nuclear Medicine Vol. 48 No. 12 1981-1986
Gait disturbance in idiopathic normal pressure hydrocephalus (iNPH) is reminiscent of parkinsonism. Our recent PET study showed reduction in postsynaptic D2 receptor binding concomitant with a normality of presynaptic dopamine transporter binding.
Neurocritical Care December 2007, Volume 7, Issue 3, pps. 187-193
Relatively little is known about the epidemiology of generalized convulsive status epilepticus
(GCSE) in acute ischemic and hemorrhagic stroke. We examined the occurrence of GCSE in acute ischemic stroke
(AIS) and intracerebral hemorrhage (ICH) using a large discharge database.
Expert Opinion on Pharmacotherapy, Volume 8, Number 18, December 2007 , pp. 3097-3116(20)
Intracerebral haemorrhage (ICH) is a stroke resulting from spontaneous rupture of an intracranial vessel and is associated with high early mortality and long-term morbidity rates.
There exists limited knowledge regarding the relation between depression and healthcare utilization in stroke patients. The objective of this register-based study was to examine the impact of having preexisting depression at the time of hospital admission for acute stroke on length of hospital stay and discharge destination.
Our aim was to develop a screening test to predict Dravet syndrome before the first birthday based on the clinical characteristics of infants and the SCN1A mutation analysis.
To study the long-term outcome in patients with malignant middle cerebral artery (MCA) infarction treated with decompressive
craniectomy. The outcome is described in terms of survival, impairment, disabilities and life satisfaction.
Temporal lobe epilepsy (TLE) is a multifactorial disease often involving the hippocampus. So far the etiology of the disease has remained elusive. In some pharmacoresistant TLE patients the hippocampus is surgically resected as treatment. To investigate the involvement of the immune system in human
TLE, we performed large-scale gene expression profiling on this human hippocampal tissue.
Journal of Trauma-Injury Infection & Critical Care. 63(6):1263-1270, December 2007
Ethnic disparities have been demonstrated in several diseases, but not in trauma. We hypothesized that access to acute rehabilitation and long-term functional outcomes among traumatic brain injury
(TBI) patients are influenced by patient race and ethnicity.
Headache: The Journal of Head and Face Pain doi:10.1111/j.1526-4610.2007.00992.x
A 25-year-old female patient developed headache and papilledema under sulphasalazine treatment for ulcerative colitis. The patient met the International Headache Society's criteria for idiopathic intracranial hypertension.
Although stroke survivors often display abnormal joint torque patterns, studies of torque-coupling in the lower limb are lacking, despite their potential impact on gait abnormalities.
THE NATIONAL HOSPITAL for Neurology and Neurosurgery, Queen Square, London is one of the oldest clinical neuroscience hospitals in the world. It was formed from the fusion of itself with the Maida Vale Hospital in 1948. More recently, in 1996, it was incorporated into the University College London Hospitals group. It has had many distinguished neurosurgeons on its staff, whose history from Sir Victor Horsley to the present is described with particular reference to the development of the specialty of neurosurgery. The current neurosurgical staff and future developments of neurosurgery at the hospital are also elucidated.
Neurosurgical procedures can result in brain injury by various means, including direct trauma, hemorrhage, retractor stretch, and
electrocautery. This surgically-induced brain injury (SBI) can cause postoperative complications such as brain edema after blood-brain barrier (BBB) disruption. The present study seeks to test a matrix metalloproteinase
(MMP) inhibitor for preventing postoperative brain edema and BBB disruption in an in vivo model of surgically-induced brain injury.
The neuropsychological effects of chronic subthalamic nucleus (STN)-deep brain stimulation (DBS) as a treatment for Parkinson's disease are variable. Whether these side effects result from the target per se or current diffusion into neighboring structures is uncertain. In this study, the relationship between clinical outcomes and coordinates of active contact are analyzed and compared between patients with and without neuropsychological
sequelae.
Our goal was to assess the clinical and angiographic outcomes among patients undergoing treatment for distal anterior cerebral artery aneurysms at the Jefferson Hospital for Neuroscience (1997-2005).
Burn injuries associated with excessive heating of medical metallic devices have been reported, but a definite mechanism for magnetic resonance imaging-induced heating remains unresolved. The aim of this study is to evaluate temperature elevation of metallic wires, aneurysm clips, and clips attached to metallic wires under 3.0-T magnetic resonance imaging
The aims of this study are to assess the surgical outcome of elderly patients aged 80 years or more, to analyze the factors influencing postoperative course, and to propose a grading system to standardize the surgical indication of intracranial meningioma in the elderly.
Although histologically benign, Grade I meningiomas can sometimes behave aggressively. The clinically-aggressive subset of Grade I meningiomas is typically indistinguishable from clinically-benign Grade I meningiomas in vivo. We compared molecular genetic and biochemical findings to clinical, pathological, and immunohistochemical information in a series of clinically-aggressive Grade I meningiomas with a series of clinically-benign meningiomas to identify characteristics that may be used to distinguish between these two groups.
Aneurysms of the extracranially originating posterior inferior cerebellar artery are very rare. An anatomic insight of its possible course and variations is necessary when confronting such extraordinary lesions.
To evaluate diffusion tensor imaging (DTI)-based functional neuronavigation in surgery of cerebral gliomas with pyramidal tract (PT) involvement with respect to both perioperative assessment and follow-up outcome.
Anosmia has an important impact on well-being but is often neglected by physicians. In patients with subarachnoid hemorrhage
(SAH), anosmia has mainly been reported after surgery for aneurysms of the anterior communicating artery. We studied the prevalence, predisposing factors (aneurysm site and type of treatment), impact, and prognosis of anosmia in patients with
SAH.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:103-105
A total of 120 patients with histologically proven focal cortical dysplasias (FCD) were retrospectively analysed for prognostic factors for successful epilepsy surgery. Multivariate data analyses showed that older age at epilepsy surgery, occurrence of secondarily generalised seizures and a multilobar extent of the dysplasia were significant negative predictors.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:79-81
Foreign accent syndrome (FAS) is a rare speech disorder characterised by the emergence of a new accent, perceived by listeners as foreign. FAS has usually been described following focal brain insults, such as stroke.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:82-85
Neuropathological descriptions of the brain in Friedreich's ataxia (FRDA) were obtained before availability of the current molecular genetic tests for this disease.
Voxel-based morphometry (VBM) enables an unbiased whole-brain quantitative analysis of differences in gray matter (GM) and white matter (WM) volume.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:107-108
Corticobasal syndrome (CBS) is characterised by asymmetric apraxia, cortical sensory loss, extrapyramidal features and cognitive decline. Although CBS is classically described as a
taupathy, heterogeneity of its aetiology is increasingly recognised. Clinical presentation of CBS appears to reflect areas of the brain involved and not necessarily the nature of the underlying pathology.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:110
Twenty-seven years have passed since the last edition of this well known and widely respected book was published. In the intervening years, advances in structural and functional imaging have transformed the investigation of disorders of consciousness, and the "science of consciousness" has become a popular-even fashionable-pursuit.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:38-43
The ABCD2 score predicts stroke risk within a few days of transient ischaemic attack (TIA). It is not clear whether the predictive value of the ABCD2 score can be generalised to UK TIA services, where delayed presentation of TIA and minor stroke are common. We investigated prognosis, and the use of the ABCD2 score, in patients attending TIA services in the North West of England with a diagnosis of TIA or minor stroke.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:44-46
Aneurysms have been described in HIV infected patients. These involve predominantly extracranial blood vessels with specific histological and clinical features. Intracranial aneurysms are rare and have been identified mainly in children.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:72-75
Chronic subdural (CSDH) or intracystic haematomas may occur as a complication in patients with arachnoid cysts, even in children and young adults. The aim of this study was to investigate how often an arachnoid cyst is complicated by such
haematomas, as this information may be of importance when considering decompressive cyst surgery.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:30-32
We conducted a prospective, population based study to examine trends in incidence and prevalence of amyotrophic lateral sclerosis
(ALS) in Ireland from 1995 to 2004.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:47-51
To determine the imaging and demographic characteristics of intracranial
haemorrhages, which are subsequently found to be due to an underlying intracranial vascular malformation
(IVM).
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:25-29
Subtle cognitive deficits have been found in a substantial percentage of patients with early stage amyotrophic lateral sclerosis
(ALS). Cognitive function in later stages of the disease remain to be investigated because the neuropsychological tests that are usually employed, such as written or verbal fluency tests, cannot be performed by those patients because of motor or speech impairment, or both.
Survivors of traumatic brain injury (TBI) are at increased risk for development of severe, long-term psychiatric disorders. However, the aetiology of these disorders remains unclear. This article systematically reviews the most current prevalence rates and evidence for causality, in terms of established criteria.
A systematic search was conducted of the literature addressing suicidality after traumatic brain injury
(TBI). Results from population-based studies found that people with TBI have an increased risk of death by suicide (3-4 times greater than for the general population), as well as significantly higher levels of suicide attempts and suicide ideation. Clinical studies have also reported high levels of suicide attempts (18%) and clinically significant suicide ideation (21-22%) in TBI samples.
The prevalence and profile of adults with a history of traumatic brain injury
(TBI) has not been studied in large North American forensic mental health populations. This study investigated how adults with a documented history of TBI differed with the
non-TBI forensic population with respect to demographics, psychiatric diagnoses and history of offences.
This study examined the relationships between the Frontal Systems Behaviour Scale
(FrSBe), neuropsychological tests and community integration outcomes among individuals with a history of
TBI.
To establish pre-morbid alcohol and drug use in persons with TBI, relative to controls, investigate how patterns of substance use change over time following TBI and identify factors associated with heavy post-injury substance use.
This study seeks to extend previous findings by documenting memory performance in a sample of 70 children at 5 years post-injury. It was anticipated that increasing injury severity would be associated with decreased performance on working and complex memory tasks. It was also expected that injury severity would significantly predict memory, but that the time from insult to subsequent testing would be associated with an increased relationship to non-injury factors.
Early diagnosis and treatment of venous thrombosis biocontact="no" are essential in preventing pulmonary embolism (PE) and reducing the risk of recurrence. The objective was to assess the usefulness of the
D-Dimer testing to rule out symptomatic VT in populations of patients receiving heparin in prophylactic doses.
This study presents data from a functional neuroimaging experiment which brings into question whether poor performance on the Word Memory Test
(WMT) can be construed as straightforward evidence for 'poor effort' in the context of cognitive assessment, as asserted in a recent report in this journal.
Journal of Neurological Sciences Volume 264, Issue 1, Pages 34-37 (15 January 2008)
We reviewed the charts of 1618 patients seen at a pediatric neurology practice at a tertiary care center from September 2003 to December 2005 for clinical data and incidental intracranial findings on brain magnetic resonance imaging reports. Incidental findings were divided into two categories: normal or abnormal variants. Clinical and demographic data were assessed for associations with incidental findings.
Journal of Neurological Sciences Volume 264, Issue 1, Pages 50-55 (15 January 2008)
Mounting evidence has suggested that paeonol possesses plenty of pharmacologic actions. Our research is to determine if paeonol can protect cultured rat hippocampal neurons from oxygen-glucose
deprivation(OGD)-induced injury and elucidate the underlying mechanism.
Journal of Neurological Sciences Volume 264, Issue 1, Pages 87-92 (15 January 2008)
Previous myocardial infarction (MI) has been linked with poorer stroke outcome. Whether this depends on a greater stroke severity is still uncertain. The aim of the study was to assess the effect of previous MI on characteristics and outcome of stroke in a large hospital cohort of patients.
Journal of Neurological Sciences Volume 264, Issue 1, Pages 140-144 (15 January 2008)
Conflicting data exist on the role of antiplatelet agents in reducing incident ischemic stroke magnitude, but most prior studies used clinically-assessed neurologic deficit as the index of stroke extent rather than more precise volumetric measurements of infarct size. We assessed the relation of premorbid antiplatelet use to initial diffusion-weighted MRI
(DWI) lesion volumes among acute ischemic stroke patients.
Journal of Neurological Sciences Volume 264, Issue 1, Pages 177-181 (15 January 2008)
A 47-year-old man with Behcet's disease presented with a five day history of right side weakness and
dysarthria. Ten years ago, he was diagnosed as Behcet's disease. Since then, he was treated with low dose steroids.
Amyotrophic lateral sclerosis (ALS) is a progressive degenerative disease of upper and lower motor neurons. Reports of the nature and frequency of sensory nerve involvement in ALS have varied.
Autonomic dysregulation is frequent in acute ischemic stroke. Several studies concluded that imbalance between sympathetic and parasympathetic cardiovascular function predisposes to malignant cardiac arrhythmia. However, there are few data on cardiovascular autonomic function in post-acute stroke patients.
The goal of this work was to evaluate the relationship between neuronal injury/loss in the hippocampus, thalamus, and putamen in temporal lobe epilepsy
(TLE) patients using 1H magnetic resonance spectroscopic imaging.
The establishment of functional neural circuits requires the guidance of axons in response to the actions of secreted and cell-surface molecules such as the
semaphorins.
Cognitive decline is commonly observed in advanced aging even in the absence of disease. Here we explore the possibility that normal aging is accompanied by disruptive alterations in the coordination of large-scale brain systems that support high-level cognition.
Synaptic potentials originating at distal dendritic locations are severely attenuated when they reach the soma and, thus, are poor at driving somatic spikes. Nonetheless, distal inputs convey essential information, suggesting that such inputs may be important for compartmentalized dendritic signaling.
Data on patient outcomes after surgery for spinal cord tumors have been derived from single-institution series. The objective of this study is to report inpatient complications, mortality and outcomes on a national level.
British Journal of Neurosurgery, Volume 21, Issue 6 December 2007 , pages 588 - 592
The histological grading of meningiomas underwent substantial revision and standardization in a WHO review of 2000. Prior to this the histological definition of atypical and malignant meningiomas was less tightly defined.
British Journal of Neurosurgery, Volume 21, Issue 6 December 2007 , pages 576 - 582
Primary malignant brain tumours (anaplastic glioma and glioblastoma) display heterogenous histopathology and diverse genetic abnormalities. These tumours remain incurable with no significant improvement in median survival times in the last 20 years, despite significant technological advances in surgery and radiotherapy, and mechanistic insights into their
aetiology.
British Journal of Neurosurgery, Volume 21, Issue 6 December 2007 , pages 618 - 621
We describe the case of a 74-year-old man with large mixed craniopharyngioma who was successfully treated under the concept of neuroendoscopic palliation. He recovered immediately postoperatively and has done well in the 4 years following surgery.
British Journal of Neurosurgery, Volume 21, Issue 6 December 2007 , pages 616 - 618
Isolated sphenoid sinus infection, although an uncommon entity, can cause severe cranial complications when left untreated. A case of temporal epidural abscess secondary to isolated sphenoid sinusitis in a 13-year-old boy is presented. Early diagnosis and treatment are critical because the disease can progress rapidly.
British Journal of Neurosurgery, Volume 21, Issue 6 December 2007 , pages 550 - 561
Gliomas are a heterogeneous group that account for 86% of primary brain
neoplasms, and include astrocytic and oligodendroglial tumours, as well as a variety of less common histopathological subtypes. Magnetic resonance imaging has become the accepted mode of imaging for the clinical management of these
tumours.
British Journal of Neurosurgery, Volume 21, Issue 6 December 2007 , pages 621 - 623
Abstract
We describe a unique case of prolonged nausea and vomiting following posterior fossa craniotomy for removal of a
meningioma. No apparent neurological or gastrointestinal causes were discovered except for a delayed gastric emptying time. The symptoms gradually resolved along with normalization of the gastric emptying time. Possible pathogenic mechanisms are discussed.
A 57-year-old man with no relevant medical history was initially seen with clumsiness and judgment errors while driving for the past 3 weeks. His neurological examination results revealed cognitive impairment and a left homonymous
hemianopsia.
Vitamin A is necessary for normal embryonic development, but its role in the adult brain is poorly understood. Vitamin A derivatives,
retinoids, are involved in a complex signaling pathway that regulates gene expression and, in the central nervous system, controls neuronal differentiation and neural tube patterning.
"The Schwann cell has been historically underrated and poorly understood." With this sentence from the preface of this book, Patricia
Armati, PhD, professor at the University of Sydney, Australia, underlines the need for a comprehensive book in which the broad spectrum of scientific knowledge about this cell type is gathered and brought to attention.
Experimental stroke studies indicate that oxidative stress is a major contributing factor to ischemic cerebral injury. Oxidative stress is also implicated in activation of matrix metalloproteinases
(MMPs) and blood-brain barrier injury after ischemia-reperfusion. Plasma biomarkers of oxidative stress may have utility as early indicators of efficacy in Phase 2 trials of antioxidant therapies in human stroke.
Emboli and proinflammatory mediators are suspected of generating cerebral edema after coronary surgery. In contrast to cardiopulmonary bypass
(CPB), off-pump coronary artery bypass surgery (OPCAB) reduces microemboli count and proinflammatory mediator release but carries the risk of hemodynamic instability. A microaxial blood pump can augment cardiac output.
Apolipoprotein E genotype (APOE) influences cholesterol levels and ischemic heart disease. Although there is no convincing overall association with ischemic stroke, APOE may influence large artery
(atherothrombotic) stroke, for which carotid intima-media thickness
(CIMT) is an informative intermediate phenotype. We therefore performed a systematic review and meta-analysis of the association between APOE and
CIMT.
PEDIATRICS Vol. 120 No. 6 December 2007, pp. e1502-e1511
Precision grasping critically relies on the integrity of the corticospinal tract as evidenced in congenital hemiplegia by the correlation found between corticospinal dysgenesis and hand-movement deficits. Therefore, corticospinal dysgenesis could be used to anticipate upper-limb deficits in young infants with congenital
hemiplegia.
Journal of Neuro-Ophthalmology. 27(4):292-296, December 2007
A 16-year-old boy who was briefly asystolic and hypotensive after a motor vehicle accident complained of abnormal vision after recovering consciousness. Visual acuity was normal, but visual fields were severely constricted without clear hemianopic features.
Neurocritical Care December 2007, Volume 7, Issue 3, pps. 211-216
Recent reports using thrombelastography have suggested that neurosurgical patients develop a hypercoagulable state in the postoperative period. Since venous thromboembolism is a potentially life threatening complication in these patients, we studied a similar population in our institution.
Clinical & Experimental Immunology, Volume 151, Number 1, January 2008 , pp. 123-129(7)
Deleted in Malignant Brain Tumours 1 (DMBT1) is a secreted scavenger receptor
cysteine-rich protein that binds and aggregates various bacteria and viruses in vitro.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1276-1277
We describe the clinical course, with special attention to the disturbance of eye movements, of a 29-year-old man with chronic ataxic neuropathy with
ophthalmoplegia, IgM paraprotein, cold agglutinins and anti-GD1b disialosyl antibodies
(CANOMAD).
PEDIATRICS Vol. 120 No. 6 December 2007, pp. e1465-e1471
In the immature developing fetal brain, amino acids (such as -aminobutyric acid, and
taurine) and monoamines (serotonin, noradrenaline, and dopamine) act as developmental signals or regulators. In subjects with Down syndrome, dysfunctional brain development is evident from birth as reduction in brain weight, as well as volume reductions in specific brain regions, and an altered number of neurons, dendrites, and dendritic branching is observed. However, mechanisms that underlie the observed dysfunctional brain development in Down syndrome are not clear.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1226-1230
Refractory temporal lobe epilepsy (TLE) is often associated with hippocampal sclerosis (HS). Patients with major depression (MD) may also show structural abnormalities in the limbic system. Co-occurrence of TLE with HS and MD is not uncommon. We have investigated the clinical and morphological characteristics of TLE patients in relation to MD.
Child's Nervous System, Volume 23, Number 10, October 2007 , pp. 1181-1183(3)
Domestic accidents resulting in head injury are not uncommon. They mostly involve falls from high beds, tables or window seals. Rarely, children suffer penetrating skull injuries, often from unlikely objects.
Child's Nervous System, Volume 23, Number 10, October 2007 , pp. 1155-1161(7)
A radiation dose of 40-50 Gy is able to produce a cure rate of more than 90% in intracranial pure
germinoma. However, many attempts have been made to reduce the dose and volume of radiation without compromising the disease control rate because of the toxicity of irradiation. This retrospective study is intended to provide the physician with an appropriate therapeutic strategy.
Recent observational studies suggest that the risk for stroke may be high in the first 90 days after transient ischemic attack (TIA). This finding may, however, not be consistent across existing studies assessing stroke risk after TIA.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1209-1212
X linked spinobulbar muscular atrophy (Kennedy disease (KD)), which is clinically characterised mainly by neuromuscular and endocrine symptoms, has to be considered as a multisystem disorder. Based on clinical evidence of central nervous system involvement, potential KD associated cerebral volume alterations were analysed in vivo.
Although neurology originated in Africa, there is little modern African contribution to the advancement of knowledge in this field. We present the African neurologic service and scientific productivity indices and suggest a development plan.
Neuroblastic tumours are composed of variable proportions of neuroblasts and Schwann cells. Whether both components share a common neoplastic origin is highly debated and discrepant results have been reported about the presence of
tumour-related genetic alterations in Schwann cells.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1191-1198
The 39 item Parkinson's disease questionnaire (PDQ-39) is the most widely used patient reported rating scale in
Parkinson's disease. However, several fundamental measurement assumptions necessary for confident use and interpretation of the eight PDQ-39 scales have not been fully addressed.
Neurocritical Care December 2007, Volume 7, Issue 3, pps. 217-220
A 38-year-old man with severe head trauma complicated by paroxysmal severe intracranial pressure elevation associated with
tachypnea, tachycardia, diaphoresis, and extensor posturing was diagnosed as suffering from paroxysmal autonomic instability with dystonia (PAID). These events were unresponsive to standard medical therapy, which included morphine,
fentanyl, labetalol, lorazepam, metoprolol, and clonidine.
Psychiatry and Clinical Neurosciences, Volume 61, Number 6, December 2007 , pp. 695-697(3)
Anticonvulsants have been used for the treatment of impulsive aggression since the 1980s. A 50-year-old man suffered from irritability and agitation after developing a right ipsilateral frontal lobe infarction as a result of Moyamoya disease; these symptoms caused difficulties with his working and interpersonal relationships.
Child's Nervous System, Volume 23, Number 10, October 2007 , pp. 1195-1198(4)
Surgical revascularization for moyamoya disease prevents cerebral ischemic attacks by improving cerebral blood flow
(CBF). It is undetermined, however, how rapid increase in CBF affects ischemic brain at acute stage, especially in children.
Child's Nervous System, Volume 23, Number 10, October 2007 , pp. 1209-1213(5)
Myxopapillary ependymomas are low grade tumours that are known to recur locally even after complete excision, but metastasis to distant sites is extremely uncommon.
Child's Nervous System, Volume 23, Number 10, October 2007 , pp. 1191-1194(4)
Approximately 10% of patients with neurofibromatosis I (NFI) patients will have central nervous system (CNS) tumors. The most common of these are hypothalamic-optic
gliomas, followed by brainstem and cerebellar pilocytic astrocytomas.
To evaluate the accuracy of multidetector-row CT angiography (CTA) for the diagnosis of large-vessel vasospasm following subarachnoid hemorrhage by comparison to digital subtraction angiography
(DSA).
Fibrinogen is an independent risk factor for acute vascular events, but there is uncertainty as to whether it is causal. One potential causal mechanism is the formation of low permeability fibrin clot in association with raised fibrinogen. We hypothesised that if this effect of fibrinogen were causally related to risk of vascular events, the risk relationship would be affected by the two other factors that affect fibrin clot permeability - age and glycaemic control.
Endothelial progenitor cells (EPCs) migrate from bone marrow to systemic circulation in response to tissue ischemia where they differentiate into mature endothelial cells for angiogenesis in situ. This study tested the hypothesis that the level of circulating EPCs is substantially increased and predictive of prognostic outcomes after acute ischemic stroke (IS).
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1255-1259
Despite corticosteroid treatment, patients with temporal arteritis may continue to lose vision. However, predictors of progressive visual loss are not known.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1260-1262
Ataxic hemiparesis (AH) is a well recognised lacunar syndrome involving homolateral ataxia with accompanying corticospinal tract impairment. Most previous studies of lesion location in AH did not use diffusion weighted MRI
(DW MRI). The purpose of this study was to use DW MRI to evaluate the radiological correlation in patients presenting with AH.
More than 47 million individuals in the United States meet the criteria for the metabolic syndrome. The relation between the metabolic syndrome and stroke risk in multiethnic populations has not been well characterized.
Journal of Emergency Medicine Volume 33, Issue 3, Pages 255-260 (October 2007)
Prehospital delays in the treatment of stroke patients, including identification of stroke as a medical emergency, represent a significant and preventable obstacle to optimal stroke care. Although patient delay in seeking care represents the greatest barrier to expedient care, delays often exist in the identification, transport, and triage of stroke patients.
Transcranial Doppler sonongraphy is a non-invasive, non-ionising, inexpensive, portable and safe technique that uses a pulsed Doppler transducer for assessment of intracerebral blood flow. This article deals with the principles and technique of transcranial Doppler
sonography. It gives a brief overview of its use in evaluation of intracranial steno-occlusive disease, subarachnoid
haemorrhage, and extracranial diseases (including carotid artery disease and subclavian steal syndrome). The role of transcranial Doppler in detection of microembolic signals and evaluation of right to left shunts is also dealt with. Finally, its use in acute stroke is briefly outlined.
Studies have suggested that the medial dorsal nucleus of the thalamus plays a role in the behavioral expression of limbic seizures, but it is unclear whether this region is a key component for the primary seizure circuitry or a path for seizure spread from one region to another. This study was undertaken to determine the potential role of this region in limbic seizure activity.
Child's Nervous System, Volume 23, Number 10, October 2007 , pp. 1097-1102(6)
Major skull defects, especially in the anterior region, can present as a most disturbing deformity. Reconstructive cranioplasty can restore cerebral protection and improve craniofacial aesthetics. Complex and large skull defects in children often present reconstructive difficulties.
No randomized controlled trial has evaluated the efficacy of steroids in acute cerebral venous thrombosis
(CVT). We aimed to analyze the effect of steroids on the outcome of patients in the International Study on Cerebral Veins and Dural Sinus Thrombosis
(ISCVT).
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1278-1280
Non-infectious causes of fever are often considered in critical neurological patients but their true significance has not been formally studied. The aim of this study was to evaluate the incidence, causes and predictors of fever in patients with acute neurological/neurosurgical disease and no documented infection.
Journal of Neurology, Neurosurgery, and Psychiatry 2007
Pathological yawning can be a clinical sign in disorders affecting the brainstem. Here we describe seven patients with pathological yawning caused by acute middle cerebral artery stroke, indicating that pathological yawning also occurs in supratentorial stroke. We hypothesise that excessive yawning is a consequence of lesions in cortical or subcortical areas, which physiologically control diencephalic yawning
centres.
Diabetic Medicine, Volume 24, Number 12, December 2007 , pp. 1361-1368(8)
To report the 6-year incidence of, and risk factors for, cardiovascular disease
(CVD), either coronary disease or stroke, in previously hospitalized African-Americans with Type 1 diabetes mellitus.
There have now been numerous phase III trials of neuroprotection that have failed to live up to the expectations created by preclinical testing in animal models, the most recent of which was the second pivotal trial of the spin trap agent NXY-059. We have reached a stage at which research in this area should stop altogether or radical new approaches adopted. The purpose of this article is to review how we reached this stage and make recommendations for a new approach to neuroprotection research.
European Journal of Cardiovascular Prevention & Rehabilitation. 14(6):793-795, December 2007
Passive smoking is an established risk factor for coronary heart disease (CHD). Epidemiological studies suggest that passive smoking may also be associated with an increased risk of stroke. We estimate the burden of stroke due to passive smoking in Germany.
The clinical features and natural course of paramedian thalamic stroke is poorly known. The aim of this study was to characterize the evolution of neurological, neuropsychological, and sleep-wake deficits after paramedian thalamic stroke.
Recent studies have attributed the increased infection vulnerability of patients with stroke to stroke-induced
immunosuppression. We have therefore explored the immunological changes in patients with ischemic stroke.
The primary purpose of intracranial aneurysm treatment is to prevent rupture. Risk factors for rupture after aneurysm treatment have not been clearly established, and the need to completely occlude aneurysms is debated.
The authors conducted a representative, national survey. Of the 596 (64.4%) eligible family physicians who participated, 15.8% reported having a patient with nonvalvular atrial fibrillation experience an intracranial hemorrhage with anticoagulation and 45.8% had a patient with known nonvalvular atrial fibrillation experience a stroke without anticoagulation.
The diagnosis of primary progressive aphasia (PPA) is made in any patient in whom a language impairment (aphasia), caused by a neurodegenerative disease (progressive), constitutes the most salient aspect of the clinical picture (primary).
Journal of Nuclear Medicine Vol. 48 No. 12 1971-1980
11C-Methionine PET is a well-established technique for evaluating tumor extent for diagnosis and treatment planning in
neurooncology. Image interpretation is typically performed using the ratio of uptake within the tumor to a reference region.
Progressive nonfluent aphasia (PNFA) is a clinical syndrome characterized by motor speech impairment and
agrammatism, with relative sparing of single word comprehension and semantic memory. PNFA has been associated with the characteristic pattern of left anterior insular and posterior frontal atrophy, including the motor and premotor regions and Broca's area.
Polymorphisms in human platelet alloantigen (HPA)-1 and HPA-3 (GPIIb/IIIa), HPA-2
(GPIb/IX), HPA-4 (GPIIIa) and HPA-5 (GPIa/IIa) were investigated in 216 stroke patients and 318 matched control subjects.
Delirium is not only one of the most common complications that older patients develop after admission to hospital but it is also one of the most serious. Although stroke is a known predisposing factor for delirium, few studies have investigated this association and results from existing studies give conflicting results with prevalence estimates ranging from 13 to 48%.
Clinical Cancer Research 13, 7155-7165, December 1, 2007
Glioblastoma multiforme is the most frequent primary brain tumor in adults and represents one of the most lethal malignancies with a median survival of 12-16 months. We have previously shown that an oncolytic measles virus derivative expressing soluble human carcinoembryonic antigen
(MV-CEA) has significant antitumor activity against glioblastoma multiforme cell lines and
xenografts. Radiation therapy (RT) represents one of the mainstays of glioma treatment. Here we tested the hypothesis that the combination of RT with
MV-CEA would have synergistic activity against gliomas.
The aim of this study was to determine the risk of fractures after stroke/transient ischemic attack (TIA) in relatively young patients. Methods: Administrative claims data were identified for patients aged 18 years and older hospitalized for stroke/TIA from 1997 to 2005 using ICD-9 codes.
The pharmacological therapy for essential tremor (ET) is inadequate, and many patients resort to surgical procedures. Zonisamide is an antiepileptic with several potential mechanisms of action.
Anticonvulsant drugs are commonly used to treat and prevent seizures after
neurotrauma. However, many physiological changes occur in the neurotrauma patient, which alter the pharmacokinetics of drugs such as
phenytoin. This raises concerns relating to the dosage and monitoring of phenytoin in these patients compared with its routine use in epileptic patients.
Several anticonvulsant drugs have been found to be neuroprotective in preclinical models of stroke, and such drugs may possibly be given in combination with other stroke treatments such as recombinant tissue plasminogen activator
(rt-PA).
Journal of NeuroEngineering and Rehabilitation 2007, 4:46
The aim of electroencephalogram (EEG) source localization is to find the brain areas responsible for EEG waves of interest. It consists of solving forward and inverse problems. The forward problem is solved by starting from a given electrical source and calculating the potentials at the electrodes. These evaluations are necessary to solve the inverse problem which is defined as finding brain sources which are responsible for the measured potentials at the EEG electrodes.
To evaluate the potential diagnostic value of a novel magnetic resonance image
(MRI) postprocessing technique in subtle forms of subcortical band heterotopia
(SBH). The method was introduced to improve the visualization of blurred gray-white matter junctions associated with focal cortical dysplasia but was found to be applicable also to
SBH.
Severe myoclonic epilepsy in infancy (SMEI) is a rare, but severe disorder with seizures typically resistant to conventional antiepileptic drugs. The objective of the present study was to systematically review the literature on the available treatments for
SMEI.
The microdeletion of chromosome 22q11.2 is the most common human deletion syndrome. It typically presents early in life and is rarely considered in adult patients. As part of the manifestations of this condition, patients can have parathyroid glandular involvement ranging from hypocalcemic hypoparathyroidism to normocalcemia with normal parathryroid hormone levels. The first manifestation of the syndrome might be seizures due to profound
hypocalcemia.
The objectives of the present study were to estimate an annual number of patients with moyamoya disease in Japan and to describe the clinicoepidemiological features of the disease.
Stroke, a major health issue affecting the elderly, limits their participation in society. The aim of this study was to investigate changes in stroke survivors’ handicap levels and to identify their determinants in the subacute phase from 3 months to 1 year.
To evaluate the use of EEG responses to transcranial magnetic stimulation (TMS-EEG responses) as a noninvasive tool for the diagnosis of focal epilepsy.
The purpose of this review is to examine what is known about cognitive and brain aging in elders with chronic epilepsy. We contend that much remains to be learned about the ultimate course of cognition and brain structure in persons with chronic epilepsy and concern appears warranted.
The word 'concussion' has several meanings and applications that are controversial. This paper attempts to trace the historical origins and evolution of the descriptive classifications of concussive head injuries.
A 47-year-old right-handed man presented with acute onset of right face, arm, and leg weakness; word-finding difficulties; and bifrontal headache. His medical history was remarkable for hyperlipidemia and spontaneous dissection of a distal coronary artery a year and a half previously. On examination, he had right lower face weakness, a plegic right arm, and distal greater than proximal right leg weakness. His speech was mildly dysarthric with word-finding difficulty. Comprehension was intact. Cardiac auscultation was normal.
Multiple lines of evidence have suggested that developmental dyslexia may be associated with abnormalities of neuronal migration or axonal connectivity. In patients with periventricular nodular
heterotopia-a rare genetic brain malformation characterized by misplaced nodules of gray matter along the lateral ventricles-a specific and unexpected reading disability is present, despite normal intelligence.
To assess the dose-response of this model for the relationship between the force of injury on the rat thoracic spinal cord and histological and functional outcome measures.
Abstract
The present research aimed to investigate whether social perception deficits commonly experienced in the adult traumatic brain injury
(TBI) population can be successfully remediated through cognitive rehabilitation.
Although obsessive-compulsive disorder has been reported as one of many anxiety-related sequelae of brain injury, few empirical data of its responsiveness to psychological intervention are available. In this study, a single participant changing criterion experimental design was used to evaluate a neurobehavioural intervention for compulsive behaviour of an adult with severe traumatic brain injury.
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