| 02/28/2006
03:58 PM
The development of a city wide epilepsy register
Seizure Volume 15, Issue 2 , March 2006, Pages 93-97
The provision of care for patients with epilepsy in the UK is fragmented and inadequate. Lack of support in the community, poor communication across the primary–secondary care interface and inaccessibility of specialist services are contributory factors. The inclusion of epilepsy as a quality marker in the new general practitioner (GP) contract provides an opportunity to improve co-ordination of services.
02/28/2006
03:57 PM
Serum ghrelin levels are enhanced in patients with epilepsy
Seizure Volume 15, Issue 2 , March 2006, Pages 106-111
In patients with epilepsy, although many changes in the physiology of hormones in the neuroendocrine system can occur (especially in the sex hormones, for example), the causes of these changes have not been fully elucidated. There are also relations between seizure activity and stages of sleep. Ghrelin is the peptide hormone, which has been shown to affect both endocrine function and sleep. The purpose of this study was to evaluate serum levels of ghrelin in epilepsy patients.
02/28/2006
03:56 PM
Selective posterior cerebral artery amobarbital test in patients with temporal lobe epilepsy for surgical treatment
Seizure Volume 15, Issue 2 , March 2006, Pages 117-124
To evaluate whether the selective posterior cerebral artery amobarbital test (PCAAT) can predict postoperative memory function in patients with temporal lobe epilepsy (TLE) for surgical treatment and its clinical safety.
02/28/2006
03:54 PM
Pregabalin A new antiepileptic drug for refractory epilepsy
Seizure Volume 15, Issue 2 , March 2006, Pages 73-78
Pregabalin is a recently licensed and marketed antiepileptic drug for use as adjunctive treatment of partial epilepsy. It acts at presynaptic calcium channels, modulating neurotransmitter release in the CNS, properties it shares with
gabapentin. Its clinical development over the past decade has included its use in the treatment of neuropathic pain, and generalized anxiety disorder, in addition to epilepsy. Three
multi-centre randomised, double-blind, placebo-controlled trials enrolling patients with refractory partial epilepsy have demonstrated an antiepileptic effect of pregabalin against placebo, as adjunctive therapy, with 31–51% of patients showing a 50% reduction in seizure frequency. Adverse effects were dose related, the commonest being somnolence, dizziness, and ataxia. Weight gain was seen in 14% of patients on the highest dose of 600 mg/day. Around 9000 people have been exposed to pregabalin in its development for all indications. No idiosyncratic reactions have been described to date. Pregabalin may be a useful addition in the treatment of refractory partial epilepsy. As with all new AEDs long-term follow up and post marketing surveillance is required.
02/28/2006
03:53 PM
Safety of Induced Hypertension Therapy in Patients With Acute Ischemic Stroke
Neurocritical Care February 2006, Volume 4, Issue 1, pps. 003-007
The management of blood pressure in acute stroke is controversial. Small pilot studies have suggested that blood pressure augmentation improves short-term neurological function, but the rate of adverse events with induced hypertension (IH) therapy is unknown.
02/28/2006
03:52 PM
Clinical experience with topiramate dosing and serum levels in patients with epilepsy
Seizure Volume 15, Issue 2 , March 2006
To investigate the relevance of serum topiramate (TPM) levels (SL) monitoring in the clinical management of epileptic patients.
02/28/2006
03:50 PM
Prognostic factors for surgery of neocortical temporal lobe epilepsy
Seizure Volume 15, Issue 2 , March 2006
In the current classification of epilepsies two forms of temporal lobe epilepsy (TLE) were included: mesial and lateral (neocortical) TLE. We aimed at identifying prognostic factors for the surgical outcome of lesional neocortical TLE.
02/28/2006
03:49 PM
Silent cerebral infarction in patients with dilated cardiomyopathy Echocardiographic correlates
International Journal of Cardiology Volume 107, Issue 3 , 8 March 2006
Patients with dilated cardiomyopathy (DCM) have an increased risk of thromboembolic events. Incidence of silent cerebral infarction (SCI) has not been investigated in these patients. The aim of this study was to investigate the incidence of SCI in patients with DCM and to determine its associations with echocardiographic parameters.
02/28/2006
03:47 PM
Use of the STRATIFY falls risk assessment in patients recovering from acute stroke
Age and Ageing 2006 35(2):138-143
To investigate the predictive validity and reliability of the STRATIFY falls risk assessment tool as applied to patients recovering from acute stroke.
02/25/2006
08:00 AM
Impact of Intracranial Pressure and Cerebral Perfusion Pressure on Severe Disability and Mortality After Head Injury
Neurocritical Care February 2006, Volume 4, Issue 1, pps. 008-013
To investigate the relationships between intracranial pressure (ICP), cerebral perfusion pressure (CPP), and outcome after traumatic brain injury.
02/25/2006
07:58 AM
Association between Calcification of the Cervical Carotid Artery Bifurcation and White Matter Ischemia
American Journal of Neuroradiology 27:378-383, February 2006
The association of cervical carotid artery bifurcation calcification to future stroke risk is unknown, though coronary artery calcification is a proven indicator of heart disease risk. Severity of white matter change has been correlated with future stroke risk. We sought to use white matter severity grade on CT as a surrogate predictor of relative future stroke risk and thus correlate white matter and future stroke risk with carotid calcification grade.
02/25/2006
07:57 AM
Walking trajectory in neglect patients
Gait & Posture Volume 23, Issue 2 , February 2006, Pages 200-205
A lateral deviation of the walking trajectory is often observed in stroke patients with unilateral spatial neglect. However, existing research appears to be contradictory regarding the direction of this deviation. The aim of the present study was to gain more insight into the walking trajectory of neglect patients. Twelve right hemisphere stroke patients (six neglect, six no neglect), eight left hemisphere stroke patients (none neglect) and 10 healthy control subjects were instructed to walk towards a target while a two-dimensional ultrasonic positioning system recorded their walking trajectory. Patients’ recovery of walking ability was assessed and they were tested for the presence of neglect. Neglect patients showed a larger lateral deviation in their walking trajectory compared to stroke patients without neglect or controls. Neglect patients with good walking ability showed a deviation to the contralesional side. Neglect patients with limited walking ability showed a deviation to the ipsilesional side. Within the neglect group we found no relation between the severity of neglect and lateral deviation. Differences in walking ability may account for the contradictory results between studies regarding the lateral deviation in neglect patients’ walking trajectory. We suggest that when a neglect patient's walking ability is limited, walking towards a target becomes a dual task: heading control and walking. A limited walking ability will cause a higher task priority of walking compared to heading control. This shift in task priority may be causing the change in walking trajectory deviation.
02/25/2006
07:56 AM
Prognostic Significance of Angiographically Confirmed Large Vessel Intracranial Occlusion in Patients Presenting With Acute Brain Ischemia
Neurocritical Care February 2006, Volume 4, Issue 1, pps. 014-017
Independent predictors of outcome for ischemic stroke include age and initial stroke severity. Intracranial large-vessel occlusion would be expected to predict poor outcome. Because large-vessel occlusion and stroke severity are likely correlated, it is unclear if largevessel occlusion independently predicts outcome or is simply a marker for stroke severity.
02/25/2006
07:55 AM
The relationship of asymmetric weight bearing with postural sway and visual reliance in stroke
Gait & Posture Volume 23, Issue 2 , February 2006, Pages 249-255
Due to motor and sensory deficits in individuals with stroke, we proposed that they must compensate for these impairments during standing with greater dependence on vision. In addition, we hypothesized that asymmetric weight-bearing, which occurs following stroke, is related to increased postural sway and those with greater asymmetry will have greater reliance on vision. Twenty-eight individuals with stroke and 28 healthy older adult controls stood quietly with eyes open
(EO) or closed on a force platform while postural sway was quantified by centre of pressure measures and weight-bearing asymmetry was calculated from vertical ground reaction forces. To determine the influence of vision on postural sway, a visual ratio (eyes open/eyes closed (EC)) was calculated for the sway measures. The results demonstrated that individuals with stroke had greater visual dependence for the control of postural sway velocity in the medial–lateral (ML), but not anterior–posterior (AP) direction, compared to controls. Further, we found that greater asymmetry was moderately related to increased medial–lateral sway for the individuals with stroke. Contrary to predictions, those individuals with stroke with mild asymmetry had greater visual dependence than those with more severe asymmetry.
02/25/2006
07:54 AM
Anesthetic Complications of Awake Craniotomies for Epilepsy Surgery
Anesth Analg 2006;102:882-887
Awake craniotomies are often performed for resection of epileptogenic foci close to vital areas of the brain. For awake craniotomies at our institution, propofol is infused during local anesthetic injection and craniotomy, spontaneous ventilation is preserved, and no endotracheal tube or laryngeal mask airway is used. Propofol is discontinued for language, motor, and/or sensory mapping and for electrocorticography. Patients are re-sedated with propofol for resection and closure. We performed a retrospective chart review of 332 propofol-based "asleep-awake-asleep" (AAA) techniques with unsecured airways and 129 general anesthesia with endotracheal intubation craniotomies for epilepsy surgery. We compared the incidence of intraoperative respiratory and hemodynamic complications and incidence of seizures, nausea, brain swelling, patient movement, bleeding, aspiration, air embolism, and death. Airway compromise was uncommon in AAA cases and although incidences of hypertension, hypotension, and tachycardia were statistically increased in AAA versus general anesthesia craniotomy, these were treated appropriately. In only one patient the use of our AAA technique may have contributed to a poor clinical outcome.
02/25/2006
07:53 AM
Remote Cerebellar Hemorrhage
American Journal of Neuroradiology 27:387-390, February 2006
Remote cerebellar hemorrhage (RCH) is a rare but benign, self-limited complication of supratentorial craniotomies that, to the best of our knowledge, has not been described in the imaging literature. RCH can be an unexpected finding on routine postoperative imaging studies and should not be mistaken for more ominous causes of bleeding such as coagulopathy, hemorrhagic infarction, or cortical vein occlusion. Cerebellar hemorrhage in the typical setting can be identified as RCH and does not require more extensive or invasive evaluation.
02/25/2006
07:52 AM
Helmet Use and Risk of Head Injuries in Alpine Skiers and Snowboarders
JAMA. 2006;295:919-924
To determine the effect of wearing a helmet on the risk of head injury among skiers and snowboarders while correcting for other potential risk factors.
02/25/2006
08:01 AM
THE TREATMENT OF PATIENTS AT RISK OF DEVELOPING WERNICKE'S ENCEPHALOPATHY IN THE COMMUNITY
Alcohol and Alcoholism 2006 41(2):159-167
To review the process of identifying alcohol-dependent patients at risk of developing Wernicke's encephalopathy (WE) in the community, and prophylactic treatment options.
02/25/2006
07:50 AM
Multidetector Row CT Angiography of Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage Comparison of Volume Rendered Images and Digital Subtraction Angiography
American Journal of Neuroradiology 27:370-377, February 2006
Cerebral vasospasm remains a major problem in patients recovering after surgical treatment of cerebral aneurysms. The purpose of this study was to evaluate cerebral vasospasm at multidetector-row spiral CT angiography (MDCTA) compared with digital subtraction angiography (DSA) in patients with aneurysmal subarachnoid hemorrhages (SAHs).
02/24/2006
09:42 AM
Panhypopituitarism After Traumatic Head Injury
Neurocritical Care February 2006, Volume 4, Issue 1, pps. 021-024
We describe a case report of panhypopituitarism after traumatic head injury. A previously healthy young man suffered a closed head injury and multiple spinal fractures after a motorcycle accident.
02/24/2006
09:41 AM
Juvenile myoclonic epilepsy in an elderly patient
Age and Ageing 2006 35(2):194-196
Juvenile myoclonic epilepsy constitutes 5–10% of idiopathic generalised epileptic syndromes. The clinical triad of absence seizures, myoclonic jerks and generalised tonic clonic seizures
(GTCS) rarely begin after the second decade of life. We present the case of a 74-year-old lady presenting for the first time with myoclonic jerks and absences. The electro encephalogram revealed generalised polyspike and wave epileptiform activity with photosensitivity. On close questioning, she appeared to have had a single episode of GTCS at the age of 10. She remained asymptomatic for 64 years before the diagnosis was made. Although rare, idiopathic myoclonic epilepsy could remain asymptomatic for decades and can present in the elderly. Proper classification of this epileptic syndrome, even in the elderly, is essential in view of the response to appropriate antiepileptic therapy.
02/24/2006
09:31 AM
Inadvertent Foreign Body Embolization in Diagnostic and Therapeutic Cerebral Angiography
American Journal of Neuroradiology 27:278-282,
Inadvertent foreign body embolization is a rarely diagnosed and neglected complication of cerebral angiography that has not been studied systematically.
02/24/2006
09:30 AM
The Study of Cerebral Hemodynamics in the Hyperacute Stage of Fat Embolism Induced by Triolein Emulsion
American Journal of Neuroradiology 27:398-401
The purpose of this study was to evaluate the cerebral hemodynamic change in the hyperacute stage of cerebral fat embolism induced by triolein emulsion, by using MR perfusion imaging in cat brains.
02/24/2006
09:28 AM
Thromboelastography Detects Inadequate Response to Abciximab Therapy During Stent Assisted Cerebral Aneurysm Coil Embolization Complicated by Stroke
Neurocritical Care February 2006, Volume 4, Issue 1, pps. 032-034
Thromboembolic stroke is the most common severe complication following coil embolization of intracerebral aneurysms, with a 5% incidence of permanent deficits. Despite heparin anticoagulation, rescue therapy with the platelet glycoprotein IIb/IIIa receptor antagonist abciximab may be required. However, we describe a failure of abciximab rescue therapy and discuss the importance of monitoring the variable individual response to abciximab.
02/24/2006
09:26 AM
Stent Supported Angioplasty for Acute Stroke Caused by Carotid Dissection
Neurocritical Care February 2006, Volume 4, Issue 1, pps. 047-053
Carotid dissection is a less common but important cause of acute ischemic stroke, which has specific treatment implications.
02/24/2006
09:25 AM
Improvement in Nocturnal Disordered Breathing After First Ever Ischemic Stroke
Chest. 2006;129:238-245
The aim of this study was to analyze the role of dysphagia as a model of pharyngeal muscle dysfunction in the time course of nocturnal disordered breathing (NDB) in patients who experienced a first-ever ischemic stroke.
02/23/2006
08:58 AM
Analysis of Linear Head Accelerations from Collegiate Football Impacts
Current Sports Medicine Reports 2006, 5:23-28
Sports-related concussions result in 300,000 brain injuries in the United States each year. We conducted a study utilizing an in-helmet system that measures and records linear head accelerations to analyze head impacts in collegiate football. The Head Impact Telemetry (HIT) System is an in-helmet system with six spring-mounted accelerometers and an antenna that transmits data via radio frequency to a sideline receiver and laptop computer system. A total of 11,604 head impacts were recorded from the Virginia Tech football team throughout the 2003 and 2004 football seasons during 22 games and 62 practices from a total of 52 players. Although the incidence of injury data are limited, this study presents an extremely large data set from human head impacts that provides valuable insight into the lower limits of head acceleration that cause mild traumatic brain injuries.
02/23/2006
08:57 AM
Repeat Mild Traumatic Brain Injury How to Adjust Return to Play Guidelines
Current Sports Medicine Reports 2006, 5:15-22
Determining when it is safe for an athlete to return to play (RTP) after concussion is one of the most difficult decisions facing the team physician. There is significant variability in the evaluation and management of mild traumatic brain injury (mTBI). In the past decade, a tremendous amount of sport-specific research has improved our understanding of mTBI. The advent of neuroÂpsychologic (NP) testing batteries designed to assess concussive injury has improved the assessment of cognitive dysfunction that occurs in the absence of structural brain abnormalities. The severity of injury is determined by the nature, burden, and duration of symptoms. Athletes must be asymptomatic and have a normal neurologic and cognitive evaluation prior to RTP. Several factors aid in making the RTP decision, including age, the severity of injury, and history of prior mTBIs. Given the potential complications of mTBI, the RTP decision must be made using a thoughtful, individualized process.
02/23/2006
08:42 AM
The Use Abuse and Future of Neuropsychologic Testing in Mild Traumatic Brain Injury
Current Sports Medicine Reports 2006, 5:9-14
A comparison is made between abbreviated formal neuropsychologic testing programs and computerized neuropsychologic programs such as ImPACT, Headminders, CogSport, and others. Issues of time, cost, need for supervision, liability, and validation are discussed. Specific time and monetary costs per athlete are calculated for each program. The estimated cost is between $22 and $27 per athlete for abbreviated formal testing and between $669 and $677 per athlete for computerized testing. Because of the significant time and monetary costs of neuro-psychologic testing, its lack of validation in deterÂmining recovery, limited validation and utility in diagnosing concussion, and its numerous logistic concerns, its widespread use is probably not justified until appropriate data are published and costs contained. Recommendations for alternative evaluation techniques are suggested.
02/23/2006
08:41 AM
The cognitive profile of posterior cortical atrophy
NEUROLOGY 2006;66:331-338
Posterior cortical atrophy (PCA) is a progressive dementia characterized by prominent disorders of higher visual processing, affecting both dorsal and ventral streams to cause Balint’s syndrome, alexia, and visual
agnosia.
02/23/2006
08:39 AM
Emerging Drug Therapies for Dementia
Geriatrics & Aging Volume 9, Number 2, February 2006
Emerging drug therapies for dementia are increasingly chosen to tackle molecular targets important in Alzheimer’s disease (AD)
pathobiology. Amyloid oligomers, amyloid deposits, and neurofibrillary tangles
(NFTs) are characteristic findings in AD. Hence, drugs that interfere with these proteinaceous aggregates are receiving the most attention: a) alpha, beta, and gamma secretase modulators, b) inhibitors of amyloid beta
(Ab) aggregation, and c) anti-Ab immunologic strategies. Oxidative stress and inflammatory reactions appear part of a loop of neurotoxicity with the proteinacous aggregates. Antioxidants and anti-inflammatory compounds have thus received much attention. Finally, other compounds may work by a variety of other mechanisms.
02/23/2006
08:37 AM
Shotgun Pellet Embolization to the Posterior Cerebral Circulation
American Journal of Neuroradiology 27:261-263
The embolization of missiles to the intracranial circulation is a rare event. We describe here a case of a man shot by a shotgun, presenting with a posterior fossa stroke and occlusion of the superior cerebellar artery by a metallic pellet. To our knowledge, this is the third case of posterior fossa circulation pellet emboli.
02/23/2006
08:35 AM
Outcome of short term antiepileptic treatment in patients with solitary cerebral cysticercus granuloma
Acta Neurologica Scandinavica, Volume 113, Number 3, March 2006
The duration of antiepileptic drug (AED) therapy in cases of solitary cerebral cysticercus granuloma (SCCG) presents a major dilemma and the efficacy of short-term (6?months) vs long-term (2?years) AED therapy has been studied.
02/23/2006
08:32 AM
Evidence for a rapid action of levetiracetam compared to topiramate in refractory partial epilepsy
Seizure Volume 15, Issue 2 , March 2006, Pages 112-116
The objective of this observational study was to compare the efficacy of levetiracetam and topiramate during the first 15 days of add-on treatment in adults with refractory partial epilepsy.
02/23/2006
08:30 AM
Large scale expression study of human mesial temporal lobe epilepsy evidence for dysregulation of the neurotransmission and complement systems in the entorhinal cortex
Brain 2006 129(3):625-641
Human mesial temporal lobe epilepsies (MTLE) are the most frequent form of partial epilepsies and display frequent
pharmacoresistance. The molecular alterations underlying human MTLE remain poorly understood. A two-step transcriptional analysis consisting in cDNA microarray experiments followed by quantitative RT–PCR validations was performed. Because the entorhinal cortex (EC) plays an important role in the pathophysiology of the MTLE and usually discloses no detectable or little cell loss, resected EC and each corresponding lateral temporal neocortex
(LTC) of MTLE patients were used as the source of disease-associated and control
RNAs, respectively.
02/23/2006
08:28 AM
Change in Mobility Activity in the Second Year After Stroke in a Rehabilitation Population Who is at Risk for Decline
Archives of Physical Medicine and Rehabilitation Volume 87, Issue 1 , January 2006, Pages 45-50
To investigate the development of mobility status during the second year after stroke in patients who had had inpatient rehabilitation, and to evaluate risk factors for mobility decline.
02/23/2006
08:26 AM
Stroke after varicose vein foam injection sclerotherapy
Journal of Vascular Surgery Volume 43, Issue 1 , January 2006, Pages 162-164
This report describes an ischemic stroke after foam injection sclerotherapy of varicose veins in a patient with a patent foramen ovale. Foam injection sclerotherapy has created resurgence in the minimally invasive treatment of varicose veins.
02/23/2006
08:25 AM
Histopathologic Evaluation of Aneurysms Treated with Guglielmi Detachable Coils or Matrix Detachable Microcoils
American Journal of Neuroradiology 27:283-288
The purpose of this study was to evaluate the degree of organization and fibrocellular tissue development in aneurysms treated with bare platinum or biologically active microcoils.
02/23/2006
08:24 AM
Brain abscess clinical aspects of 100 patients
International Journal of Infectious Diseases Volume 10, Issue 2 , March 2006, Pages 103-109
To verify if, in the last two decades, there have been any changes in epidemiological, clinical, diagnostic, therapeutic and prognostic aspects of patients with brain abscess.
02/23/2006
08:23 AM
Patient Recognition of and Response to Symptoms of TIA or Stroke
Neuroepidemiology 2006;26:168-175
Campaigns within Australia and internationally have sought to increase awareness of the emergent nature of stroke. For these initiatives to be effective it is important to gather information about delay in seeking treatment and the reasons given for the delay by people with stroke. The purpose of this study was to examine delay in seeking treatment in people with an evolving stroke or TIA and identify clinical, behavioral and demographic factors that contributed to the delay.
02/23/2006
08:15 AM
Lung-protective ventilation in neurosurgical patients
Current Opinion in Critical Care. 12(1):3-7, February 2006
Purpose of review: Concepts of ventilator-induced lung injury have revolutionized our approach to the ventilatory management of patients with acute lung injury and acute respiratory distress syndrome over the past 10 years. The extension of these principles to patients with brain injuries is challenging, as many of them are out of keeping with usual brain-protective management.
02/21/2006
03:22 PM
Aortic Rupture in Mitochondrial Encephalopathy Lactic Acidosis and Stroke-Like Episodes
Arch Neurol. 2006;63:281-283
To describe a patient with the common A3243G/MELAS point mutation who had aortic rupture and whose mother also died of large vessel rupture.
02/21/2006
03:21 PM
Cerebral infarction following thrombolysis for massive pulmonary embolism
Resuscitation Volume 68, Issue 1 , January 2006, Pages 135-137
A 29-year-old male developed a fatal stroke 6 h after successful thrombolysis for massive pulmonary embolism. Autopsy showed thrombus protruding through a patent foramen ovale (PFO). A strand of thrombus extended from the aortic arch into the left common carotid artery. The brain showed extensive infarction of the left fronto-parietal area. Thrombolysis caused initial disintegration of the embolism. It is likely that thrombolysis caused fragments of clot to later break lose and embolise into the cerebral circulation. We discuss the need for risk stratification in patients who present with massive pulmonary embolism and PFO.
02/21/2006
03:18 PM
Prevalence and Rupture Rate of Cerebral Aneurysms Discovered during Intra Arterial Chemotherapy of Brain Tumors
American Journal of Neuroradiology 27:297-299, February 2006
During the administration of intra-arterial (IA) chemotherapy for the treatment of brain tumors (BTs), angiography may demonstrate asymptomatic, incidental cerebral aneurysms. The prevalence and complication rate of incidental aneurysms in patients undergoing IA chemotherapy remains unknown. It remains unclear whether the presence of an aneurysm represents an increased risk or a contraindication to this form of treatment.
02/21/2006
03:17 PM
Silent microbleeds are associated with volume of primary intracerebral hemorrhage
NEUROLOGY 2006;66:430-432
The authors performed a correlative radiologic study on the micro-bleeds and volume of intracerebral hemorrhage in the supratentorial ICH patients. In the patients with lobar or putaminal hemorrhage, the hemorrhage volumes increased more than twofold or threefold in the patients with micro-bleeds. Moreover, the presence of microbleeds was an independent risk factor for large-sized hemorrhage. These data show that microbleeds may be associated with a larger ICH volume.
02/21/2006
03:16 PM
Association of White Matter Hyperintensity Volume With Decreased Cognitive Functioning
Arch Neurol. 2006;63:246-250
To examine the relationship between white matter hyperintensity (WMH) volume on magnetic resonance images and cognitive tests in a large, population-based sample.
02/21/2006
03:15 PM
Proliferative response of distinct hippocampal progenitor cell populations after cortical infarcts in the adult brain
Neurobiology of Disease Volume 21, Issue 2 , February 2006, Pages 324-332
Precursor cells in the adult dentate gyrus are a heterogeneous population. Astrocytic cell types with radial glia-like morphology and low proliferative activity have been distinguished from highly dividing subtypes expressing early neuronal properties. Recent evidence indicates that physiological stimuli predominantly increased proliferation of non-astrocytic cell types whereas radial glia-like precursors remained quiescent. We here analyzed the proliferative response of precursor cell subtypes under pathophysiological conditions in a model of photochemical cortical infarcts. Using transgenic pNestin-GFP mice and single intraperitoneal injections of 5-bromo-2-deoxyuridine 4 h after surgery, immunocytochemical analysis revealed a differential activation of the distinct subpopulations within 72 h after the infarct. The stimulation was most prominent in radial glia-like precursor cells but also non-astrocytic precursors with early neuronal phenotypes were activated. The present study indicates that the proliferative response of precursor cell subpopulations in the subgranular zone might differ under physiological and pathophysiological conditions.
02/21/2006
03:13 PM
Vertebral Artery Compression of the Medulla
Arch Neurol. 2006;63:234-241
To describe a series of patients with vertebral arteries compressing the medulla oblongata.
02/18/2006
11:04 AM
Distinct right frontal lobe activation in language processing following left hemisphere injury
Brain 2006 129(3):754-766
Right hemisphere activation during functional imaging studies of language has frequently been reported following left hemisphere injury. Few studies have anatomically characterized the specific right hemisphere structures engaged. We used functional MRI (fMRI) with verbal fluency tasks in 12 right-handed patients with left temporal lobe epilepsy (LTLE) and 12 right-handed healthy controls to localize language-related activity in the right inferior frontal gyrus (RIFG). During the phonemic task, LTLE patients activated a significantly more posterior region of the right anterior insula/frontal operculum than healthy controls (P = 0.02). Activation of the left inferior frontal gyrus (LIFG) did not differ significantly between the two groups.
02/18/2006
11:02 AM
Fetal hippocampal CA3 cell grafts enriched with FGF 2 and BDNF exhibit robust long term survival and integration and suppress aberrant mossy fiber sprouting in the injured middle aged hippocampus
Neurobiology of Disease Volume 21, Issue 2 , February 2006, Pages 276-290
Cell transplants that successfully replace the lost neurons and facilitate the reconstruction of the disrupted circuitry in the injured aging hippocampus are invaluable for treating acute head injury, stroke and status epilepticus in the elderly. This is because apt graft integration has the potential to prevent the progression of the acute injury into chronic epilepsy in the elderly. However, neural transplants into the injured middle-aged or aged hippocampus exhibit poor cell survival, suggesting that apt graft augmentation strategies are critical for robust integration of grafted cells into the injured aging hippocampus. We examined the efficacy of pre-treatment and grafting of donor fetal CA3 cells with a blend of fibroblast growth factor-2 (FGF-2) and brain-derived neurotrophic factor (BDNF) for lasting survival and integration of grafted cells in the injured middle-aged (12 months old) hippocampus of F344 rats.
02/18/2006
11:01 AM
Tracking the recovery of visuospatial attention deficits in mild traumatic brain injury
Brain 2006 129(3):747-753
The goal of the current investigation was to probe the deficits in the alerting, orienting and executive components of visuospatial attention in individuals who have recently suffered a mild traumatic brain injury (mTBI) and to assess the rate and degree of recovery for each of these components over a month post-injury. A group design was employed to assess and compare the performance of participants (12 males, 8 females; mean age: 21 ± 1.74 years) identified with mTBI relative to control subjects matched for gender, age, height, weight and activity level. Participants performed the attentional network test, designed to isolate the constituents of attention into alerting, orienting and executive components.
02/18/2006
11:00 AM
Cortical spreading depression and peri infarct depolarization in acutely injured human cerebral cortex
Brain 2006 129(3):778-790
Electrocorticographic (ECoG) activity was recorded for up to 129 h from 12 acutely brain-injured human patients using six platinum electrodes placed near foci of damaged cortical tissue. The method probes ECoG activity in the immediate vicinity of the injured cortex and in adjacent supposedly healthy tissue. Six out of twelve patients displayed a total of 73 spontaneous episodes of spreading depression of the ECoG. Of the remaining 6 patients 1 displayed an episode of synchronous depression of ECoG during surgery.
02/18/2006
10:59 AM
Catastrophic Childhood Temporal Lobe Epilepsy
Journal of Neurological Sciences (Turkish) 2005, Volume 22, Number 3, Page(s) 314-318
Focal epilepsy, more frequently of extratemporal type, in children can present with a rapidly progressing course of intractable, severe epilepsy, associated to cognitive regression or stagnation. We present a typical example of such a patient with focal seizures due to a temporal lobe cortical lesion of developmental origin. Brain MRI revealed abnormalities in the right temporal lobe and Video-EEG monitoring revealed episodes clinically characterized by epileptic spasms followed by automotor seizures, with EEG findings suggestive of a right temporal lobe focus. Surgical resection resulted in excellent outcome.
02/18/2006
10:57 AM
Folinic Acid Responsive Seizures Initially Responsive to Pyridoxine
Pediatric Neurology Volume 34, Issue 2 , February 2006, Pages 164-167
This report presents a male who developed clonic seizures on the day he was born. The next day, the diagnosis of pyridoxine-dependent seizures was made. However, contradictory to this diagnosis, seizures reappeared despite treatment with pyridoxine. Seizures ceased after folinic acid was initiated. The clinical and biochemical characteristics of folinic acid–responsive seizures are reviewed. Treatment with folinic acid should be considered in neonatal seizures of unknown origin that do not respond to pyridoxine, or manifest a transient response to pyridoxine.
02/18/2006
10:56 AM
Prevalence and Rupture Rate of Cerebral Aneurysms Discovered during Intra Arterial Chemotherapy of Brain Tumors
During the administration of intra-arterial (IA) chemotherapy for the treatment of brain tumors (BTs), angiography may demonstrate asymptomatic, incidental cerebral aneurysms. The prevalence and complication rate of incidental aneurysms in patients undergoing IA chemotherapy remains unknown. It remains unclear whether the presence of an aneurysm represents an increased risk or a contraindication to this form of treatment.
02/18/2006
10:56 AM
Silent microbleeds are associated with volume of primary intracerebral hemorrhage
NEUROLOGY 2006;66:430-432
The authors performed a correlative radiologic study on the micro-bleeds and volume of intracerebral hemorrhage in the supratentorial ICH patients. In the patients with lobar or putaminal hemorrhage, the hemorrhage volumes increased more than twofold or threefold in the patients with micro-bleeds. Moreover, the presence of microbleeds was an independent risk factor for large-sized hemorrhage. These data show that microbleeds may be associated with a larger ICH volume.
02/18/2006
10:54 AM
Association of White Matter Hyperintensity Volume With Decreased Cognitive Functioning
Arch Neurol. 2006;63:246-250
To examine the relationship between white matter hyperintensity (WMH) volume on magnetic resonance images and cognitive tests in a large, population-based sample.
02/18/2006
10:53 AM
Proliferative response of distinct hippocampal progenitor cell populations after cortical infarcts in the adult brain
Neurobiology of Disease Volume 21, Issue 2 , February 2006, Pages 324-332
Precursor cells in the adult dentate gyrus are a heterogeneous population. Astrocytic cell types with radial glia-like morphology and low proliferative activity have been distinguished from highly dividing subtypes expressing early neuronal properties. Recent evidence indicates that physiological stimuli predominantly increased proliferation of non-astrocytic cell types whereas radial glia-like precursors remained quiescent. We here analyzed the proliferative response of precursor cell subtypes under pathophysiological conditions in a model of photochemical cortical infarcts. Using transgenic pNestin-GFP mice and single intraperitoneal injections of 5-bromo-2-deoxyuridine 4 h after surgery, immunocytochemical analysis revealed a differential activation of the distinct subpopulations within 72 h after the infarct. The stimulation was most prominent in radial glia-like precursor cells but also non-astrocytic precursors with early neuronal phenotypes were activated. The present study indicates that the proliferative response of precursor cell subpopulations in the subgranular zone might differ under physiological and pathophysiological conditions.
02/18/2006
10:52 AM
The Auditory Oddball Paradigm in Patients with Vascular Cognitive Impairment A Prolonged Latency of the N2 Complex
Dementia and Geriatric Cognitive Disorders 2006;21:322-327
The event-related potential (ERP) evoked by the auditory oddball paradigm has been investigated mainly in patients with Alzheimer's disease and in patients with different causes of subcortical dementia. Subcortical ischemic vascular disease (SIVD) seems to be an important cause of vascular cognitive impairment (VCI) frequently not fulfilling the criteria for dementia. Recognition of VCI is needed in order to provide adequate care and therapy. The aim of this study was to investigate the diagnostic value of the different elements of this response (N1, N2 complex and P3 latencies) in a group of elderly patients with VCI caused by SIVD.
02/18/2006
10:50 AM
Multimodal imaging of brain reorganization in motor areas of the contralesional hemisphere of well recovered patients after capsular stroke
Brain 2006 129(3):791-808
Clinical recovery after stroke can be significant and has been attributed to plastic reorganization and recruitment of novel areas previously not engaged in a given task. As equivocal results have been reported in studies using single imaging or electrophysiological methods, here we applied an integrative multimodal approach to a group of well-recovered chronic stroke patients (n = 11; aged 50–81 years) with left capsular lesions.
02/16/2006
01:22 PM
Clinical Determinants of Dementia and Mild Cognitive Impairment following Ischaemic Stroke The Sydney Stroke Study
Dementia and Geriatric Cognitive Disorders 2006;21:275-283
Dementia following stroke is common but its determinants are still incompletely understood. Methods: In the Sydney Stroke Study, we performed detailed neuropsychological and medical-psychiatric assessments on 169 patients aged 50-85 years, 3-6 months after a stroke, and 103 controls with a majority of both groups undergoing MRI brain scans. Stroke subjects were diagnosed as having vascular mild cognitive impairment (VaMCI) or vascular dementia (VaD) or no cognitive impairment by consensus. Demographic, functional, cerebrovascular risk factors and neuroimaging parameters were examined as determinants of dementia using planned logistic regression.
02/16/2006
01:21 PM
Deep brain stimulation for the alleviation of post stroke neuropathic pain
Pain Volume 120, Issues 1-2 , January 2006, Pages 202-206
Our aim was to asses the efficacy of deep brain stimulation in post-stroke neuropathic pain. Since 2000, 15 patients with post-stroke intractable neuropathic pain were treated with deep brain stimulation of the periventricular gray area (PVG), sensory thalamus (Ventroposterolateral nucleus-VPL) or both. Pain was assessed using both a visual analogue scale and the McGill's pain questionnaire. VAS scores show a mean improvement of 48.8% (SD 8.6%). However, there is a wide variation between patients. This study demonstrates that it is an effective treatment in 70% of such patients.
02/16/2006
01:19 PM
Mild Cognitive Impairment Deficits in Cognitive Domains Other than Memory
Dementia and Geriatric Cognitive Disorders 2006;21:284-290
Patients with mild cognitive impairment (MCI) typically present with memory complaints, but may have mild deficits in other cognitive domains. We compared the neuropsychological profiles of a series of consecutive MCI patients (n = 116) with a control group of healthy elderly subjects (n = 63). The presence of a memory deficit on delayed recall was consistent in the MCI sample, as it was an inclusion criterion in the study.
02/16/2006
01:19 PM
The Effect of Etomidate on Intracranial Pressure and Systemic Blood Pressure in Pediatric Patients with Severe Traumatic Brain Injury
Pediatric Emergency Care. 22(2):90-93, February 2006
To evaluate the effects of single-dose etomidate in pediatric patients with intracranial hypertension after severe traumatic brain injury.
02/15/2006
02:01 PM
Early Transient Increase in Complexin I and Complexin II in the Cerebral Cortex following Traumatic Brain Injury Is Attenuated by N Acetylcysteine
Journal of Neurotrauma Jan 2006, Vol. 23, No. 1: 86-96
Alteration of excitatory neurotransmission is a key feature of traumatic brain injury (TBI) in which extracellular glutamate levels rise. Although increased synaptic release of glutamate occurs at the injury site, the precise mechanism is unclear.
02/15/2006
01:59 PM
Comparison of Seven Anesthetic Agents on Outcome after Experimental Traumatic Brain Injury in Adult Male Rats
Journal of Neurotrauma Jan 2006, Vol. 23, No. 1: 97-108
Isoflurane is commonly used in experimental traumatic brain injury (TBI), both before and early after injury, yet it is rarely used clinically. Narcotics and benzodiazepines are frequently used after injury in clinical TBI. We compared seven anesthetic/sedative agents applied after injury in the controlled cortical impact model: diazepam, fentanyl, isoflurane, ketamine, morphine, pentobarbital, and propofol. Our objective was to provide insight into the relative degrees of neuroprotection provided by these agents in a standard model of TBI.
02/15/2006
01:56 PM
Cyclosporin A Disposition following Acute Traumatic Brain Injury
Journal of Neurotrauma Jan 2006, Vol. 23, No. 1: 109-116
Although the precise mechanism of action remains to be defined, Cyclosporin A (CsA) has demonstrated potential for neuroprotection in animal models. Predictive dosing strategies for CsA in acute traumatic brain injured (TBI) patients must account for the influence of the acute phase response on drug disposition.
02/15/2006
01:55 PM
Galantamine for vascular cognitive impairment
The Cochrane Library, Issue 1, 2006
To assess the efficacy of galantamine in the treatment of people with vascular cognitive impairment or vascular dementia or "mixed" dementia.
02/15/2006
01:54 PM
Controversies in the management of aneurysmal subarachnoid hemorrhage
Critical Care Medicine. 34(2):511-524, February 2006
The care of patients with aneurysmal subarachnoid hemorrhage has evolved significantly with the advent of new diagnostic and therapeutic modalities. Although it is believed that these advances have contributed to improved outcomes, considerable uncertainty persists regarding key areas of management.
02/15/2006
10:15 AM
Impaired Naming of Unique Landmarks Is Associated With Left Temporal Polar Damage
Neuropsychology. 2006 Jan Vol 20(1) 1-10
Previous studies have shown that the left temporal polar (TP) region is important for the retrieval of proper names for persons. It has been proposed that the key specialization of left TP is for proper nouns (rather than names for persons, per se), which predicts that left TP should support other categories whose members are denoted by proper names (e.g., landmarks). A lesion study tested the hypothesis that impaired naming of famous unique landmarks would be associated with damage to left TP. A Landmark Recognition and Naming Test was administered to participants with lesions to left TP, right TP, or regions outside TP.
02/15/2006
10:10 AM
Understanding Predictors of Functional Recovery and Outcome 30 Months Following Early Childhood Head Injury
Neuropsychology. 2006 Jan Vol 20(1) 42-57
Much is known about outcome following traumatic brain injury (TBI) in school-age children; however, recovery in early childhood is less well understood. Some argue that such injuries should lead to good outcome, because of the plasticity of the developing brain. Other purport that the young brain is vulnerable, with injury likely to result in a substantial impairment (H. G. Taylor & J. Alden, 1997). The aim of this study was to examine outcomes following TBI during early childhood, to plot recovery over the 30 months postinjury, and to identify predictors of outcome.
02/15/2006
10:08 AM
Functional neuroimaging and presenting psychiatric features in frontotemporal dementia
Journal of Neurology, Neurosurgery, and Psychiatry 2006;77:4-7
To identify presenting psychiatric changes not part of diagnostic criteria of FTD and contrast them with the degree of hemispheric asymmetry and frontal and temporal hypoperfusion on single photon emission computed tomography (SPECT) imaging.
02/15/2006
10:07 AM
Galantamine for Alzheimers disease and mild cognitive impairment
The Cochrane Library, Issue 1, 2006
To assess the clinical effects of galantamine in patients with mild cognitive impairment (MCI), probable or possible Alzheimer's disease (AD), and potential moderators of effect.
02/15/2006
10:05 AM
Acute transient hemorrhagic hypotension does not aggravate structural damage or neurologic motor deficits but delays the long term cognitive recovery following mild to moderate traumatic brain injury
Critical Care Medicine. 34(2):492-501, February 2006
Posttraumatic hypotension is believed to increase morbidity and mortality in traumatically brain-injured patients. Using a clinically relevant model of combined traumatic brain injury with superimposed hemorrhagic hypotension in rats, the present study evaluated whether a reduction in mean arterial blood pressure aggravates regional brain edema formation, regional cell death, and neurologic motor/cognitive deficits associated with traumatic brain injury.
02/15/2006
10:04 AM
Treatment Of Stroke Related Motor Impairment By Yamamoto New Scalp Acupuncture
Medical Acupuncture Volume 17 Number 1
To show the efficacy of YNSA in treating stroke patients with the aid of topometry.
02/15/2006
10:03 AM
High blood pressure in early acute stroke a sign of a poor outcome
Journal of Hypertension. 24(2):381-386, February 2006
To evaluate the prognostic value of admission blood pressure in patients with acute ischemic stroke by determining whether it contributes to clinical outcome and vascular death.
02/15/2006
10:01 AM
Primary Presentations of Syncope in the Older Adult Population
Geriatrics & Aging Volume 9, Number 2, February 2006, Pages 80, 82-86
Syncope is a common presenting complaint in the older adult population. Unfortunately, cognitive issues and the fact that most falls are not witnessed in older adults can make the separation of falling and syncope quite difficult. In fact, about one third of older adults will have amnesia for faints, even if they are cognitively normal. A systemic approach can help separate cardiac from neurocardiovascular causes and avoid future mortality and morbidity.
02/15/2006
10:00 AM
Decreased Frequencies of ABCA1 Polymorphisms R219K and V771M in Hungarian Patients with Cerebrovascular and Cardiovascular Diseases
Cerebrovascular Diseases 2006;21:254-259
Genetic polymorphisms in ABC transporter A1 (ABCA1) may alter the regulation of plasma high-density lipoprotein (HDL), promoting or protecting from vascular diseases.
02/15/2006
09:59 AM
Spasticity and Its Association with Functioning and Health Related Quality of Life 18 Months after Stroke
Cerebrovascular Diseases 2006;21:247-253
There is no consensus concerning the presence of spasticity or the relationship between spasticity and functioning and spasticity and health-related quality of life (HRQL) in the stable phase after stroke. Objective: The aim of the present study was to describe, 18 months after stroke, the frequency of spasticity and its association with functioning and HRQL.
02/15/2006
09:58 AM
Efficacy of Dual Antiplatelet Therapy in Cerebrovascular Disease as Demonstrated by a Decline in Microembolic Signals
Cerebrovascular Diseases 2006;21:242-246
The presence of microembolic signals (MES) may indicate an increased risk of recurrent ischemic events in patients with stroke. The optimal management of such patients is uncertain. We report the effect of clopidogrel in addition to aspirin on the number of MES in a series of patients with ischemic stroke and transient ischemic attack (TIA) due to large-vessel disease.
02/15/2006
09:57 AM
External and Extreme Capsular Stroke Clinical Topographical and Etiological Patterns
Cerebrovascular Diseases 2006;21:217-222
To characterize clinically acute external (EcC) and extreme capsular (ExC) strokes in 9 patients with first-ever acute stroke. Methods: Nine patients with a lesion limited to the EcC-ExC region proven by diffusion-weighted imaging included in our registry, corresponding to 0.3% of 3,600 patients with ischemic stroke, were studied.
02/15/2006
09:56 AM
Effect of Smoking Status on Outcome after Acute Ischemic Stroke
Cerebrovascular Diseases 2006;21:260-265
The status of smoking as a risk factor for the occurrence of stroke is well established. However, there is a paucity of data on the relationship between smoking status and acute stroke outcomes. We evaluated the role of recent smoking as a prognostic factor following acute ischemic stroke.
02/15/2006
09:55 AM
Premorbid antiplatelet use and ischemic stroke outcomes
NEUROLOGY 2006;66:319-323
To evaluate the independent effect of premorbid antiplatelet use on incident ischemic stroke severity and outcome at discharge.
02/15/2006
09:54 AM
Secondary prevention drug prescription in the very elderly after ischemic stroke or TIA
NEUROLOGY 2006;66:313-318
An age bias may exist in the prescription of important secondary-preventive therapies in the elderly.
02/14/2006
08:18 AM
Increased von Willebrand Factor in Acute Stroke Patients With Atrial Fibrillation
Journal of Stroke and Cerebrovascular Diseases Volume 15, Issue 1, Pages 1-7 (January 2006)
Plasma level of von Willebrand factor (vWF) is a useful marker not only for endothelial dysfunction, but also for left atrial thrombogenesis. We measured plasma levels of vWF antigen and other coagulation and fibrinolysis markers in 183 consecutive patients with acute ischemic stroke and compared these data between patients with and without atrial fibrillation (AF). vWF correlated with severity, outcome, and infarct size and were significantly higher in the AF group than in the non-AF group. The positive correlations of vWF with plasmin-a2 plasmin inhibitor complex and soluble fibrin monomer complex, and higher levels of vWF in patients with than without spontaneous echo contrast, indicate thrombogenesis in the left atrium. Plasma levels of vWF may reflect thrombogenesis in patients with AF.
02/14/2006
08:17 AM
Effect of One Shot Intravenous 042 Mega Unit Urokinase Therapy in Patients With Acute Ischemic Stroke
Journal of Stroke and Cerebrovascular Diseases Volume 15, Issue 1, Pages 8-13 (January 2006)
We evaluated the efficacy of intravenous (IV) urokinase (UK) treatment for acute ischemic stroke patients. We treated 45 patients with 0.42 mega units of IV UK and 201 patients with other conventional agents. Clinical severity and outcome were evaluated using National Institutes of Health Stroke Scale
(NIHSS) scores and modified Rankin scale (mRS). We defined clinical improvement as a reduction of NIHSS score of > 4 points between admission and discharge. The rate of improvement, as defined earlier, was significantly higher in the UK group (27/45; 60%) than in the non-UK group (67/201, 33%) (P = .0009; ?2 test). The rate of mRS 0–2 (good outcome) on discharge in the UK group (28/45; 62%) was slightly (but not significantly) higher than that in the non-UK group (99/201; 49%). Baseline characteristics, including risk factors, did not differ between the 2 groups, except for time to treatment and length of hospitalization. We conclude that treatment of acute ischemic stroke patients with 0.42 mega units of IV UK shows better clinical improvement than conventional therapy.
02/14/2006
08:16 AM
Acute Aortic Dissection Presenting as a Neurologic Disorder
Journal of Stroke and Cerebrovascular Diseases Volume 15, Issue 1, Pages 26-29 (January 2006)
We present 3 patients who had dissections of the aorta that resulted in neurologic disorders. One patient had an altered mental state and developed cardiopulmonary arrest. Two patients had acute hemimotor findings. In 1 of these 2 cases, progression to cardiopulmonary arrest occurred. We discuss the possibility of neurologic disorder, especially acute ischemic stroke, caused by aortic dissection with reviewed reports, and emphasize that thrombolytic therapy may not be easily indicated for acute-stage stroke. We also mention the usefulness of noninvasive techniques, such as chest X-ray, transesophageal echocardiography, color coded Doppler echocardiography, and carotid ultrasound, for accurate diagnosis of the aortic dissection with neurologic deficit.
02/14/2006
08:14 AM
Clinical Predictors of Cerebrovascular Occlusion for Patients Presenting With Acute Stroke
Journal of Stroke and Cerebrovascular Diseases Volume 15, Issue 1, Pages 30-33 (January 2006)
We sought to determine clinical predictors of vascular occlusion in patients with stroke. Methods: From November 1994 to December 1999, 88 patients who were thrombolytic candidates and seen within 6 hours of stroke symptom onset had cerebral angiography. The Oxford Community Stroke Project clinical classification system, admission National Institutes of Health Stroke Scale score, and time from symptom onset until angiography were used to predict vascular occlusion. Results: In all, 79% of patients with total anterior circulation infarctions and 73% with partial anterior circulation infarctions had vascular occlusions, whereas only 29% with lacunar infarcts had occlusion. Strokes were more severe in patients with occlusion than in those without occlusion. Time to angiography was also associated with vascular occlusion.
02/14/2006
08:13 AM
Interleukin 6 Is Associated With Cognitive Function The Northern Manhattan Study
Journal of Stroke and Cerebrovascular Diseases Volume 15, Issue 1, Pages 34-38 (January 2006)
Inflammation has been linked to cognitive decline and dementia, but the mechanism for this is not clear, and few studies have included Hispanic and black subjects who may be at increased risk for these disorders. We performed a cross-sectional analysis of the association between inflammatory marker levels and cognition in the stroke-free population-based cohort of the Northern Manhattan Study. Mini Mental State Exam (MMSE) scores were the continuous outcome, and we adjusted for sociodemographic and vascular risk factors as well as subclinical atherosclerosis. Of the inflammatory markers, only interleukin (IL)-6 levels were associated with the MMSE. In univariate analysis, age, hypertension, diabetes, smoking, moderate alcohol use, total homocysteine, carotid intima media thickness, and body mass index were positively associated with IL-6 levels. Hispanic ethnicity, less than a high school education, hypertension, cardiac disease, and total homocysteine were associated with lower MMSE scores. In a multivariate linear regression model, IL-6 was negatively associated with MMSE score adjusting for sociodemographic and vascular risk factors. We conclude that IL-6 levels were negatively associated with performance on the MMSE in this multiethnic cohort. Adjusting for vascular disease and subclinical atherosclerosis did not attenuate the association, suggesting a direct effect on the brain.
02/14/2006
08:08 AM
Left Ventricular Thrombus Discovered on Chest Computed Tomography for Presumed Cryptogenic Stroke
Journal of Stroke and Cerebrovascular Diseases Volume 15, Issue 1, Pages 41-42 (January 2006)
Stroke in the young adult often presents a diagnostic challenge. This report presents a case of a 27-year-old man who developed an abrupt onset of weakness and aphasia. Transesophageal and transthoracic echocardiography were normal. Chest computed tomography (CT) was then performed during the evaluation, and a left ventricular thrombus was seen. The importance of chest CT in the evaluation of selected cases of otherwise “unexplained” stroke in the young adult is presented here.
02/14/2006
08:07 AM
Spontaneous Acute Subdural Hematoma following Contralateral Calcified Chronic Subdural Hematoma Surgery An Unusual Case
Pediatric Neurosurgery 2006;42:122-124
Calcified chronic subdural hematoma (CCSDH) is a well-known disease to many neurosurgeons but only few cases have been reported regarding its surgical complications. We report a spontaneous acute subdural hematoma following contralateral CCSDH surgery in a 16-year-old boy and discuss its possible mechanisms. The first few days of the postoperative period, especially for the cerebral atrophy cases, should be monitored carefully and a control computerized tomography scan should be performed early for possible complications. To our knowledge, spontaneous acute subdural hematoma following contralateral CCSDH surgery has not been reported previously.
02/14/2006
08:04 AM
Stereotactic Radiosurgery as a Salvage Treatment for Recurrent Skull Base Adenoid Cystic Carcinoma
Stereotactic and Functional Neurosurgery 2005;83:202-207
Twelve patients (15 lesions) with recurrent skull base adenoid cystic carcinoma (ACC) were treated by Gamma Knife stereotactic radiosurgery (SRS). The tumor volume ranged from 2 to 103 ml (median 15 ml). Treatment was prescribed at the 40-60% isodose line and ranged from 10 to 18 Gy (median: 13.0 Gy). The median follow-up period was 18 months (range 3-55). Six patients were alive and 6 dead at the end of the follow-up period. Only 1 patient died from local tumor recurrence. Ten among 15 tumors treated by SRS decreased in size until the end of the follow-up period or the patients' death. Three remained unchanged in size. Two tumors initially regressed but then increased in size. In selected patients with recurrent skull base ACC, SRS can be considered as a salvage treatment with good local control.
02/14/2006
08:02 AM
Pulmonary Function, Cognitive Impairment and Brain Atrophy in a Middle Aged Community Sample
Dementia and Geriatric Cognitive Disorders 2006;21:300-308
To determine the relationship of lung function to brain anatomical parameters and cognitive function and to examine the mediating factors for any relationships.
02/14/2006
08:01 AM
Deep Brain Stimulation Inactivity Can Produce Unexpected High Electrode Impedances when Reactivated Leading to a False Conclusion of Wire Fracture
Stereotactic and Functional Neurosurgery 2005;83:187-189
Two months after bilateral DBS surgery in a patient with PD, the stimulator had to be removed temporarily due to an infection. After successful antibiotic treatment, a new stimulator and extension wire were reimplanted 2 months later. Intraoperative testing of the replacement device yielded unusually high electrode impedances and low currents on one lead across all four contacts. Since the results did not change on repeated measurements, a lead fracture was suspected. Visual inspection of the exposed hardware, however, did not reveal any obvious defects. It was then decided to activate the lead for a prolonged time with significant currents. Subsequent impedance measurements yielded normal values and after the patient awoke from anesthesia, good symptom control was again achieved. It is advisable if a lead fracture is suspected under similar circumstances to 'condition' the electrode with high currents. Failure to do so could lead to a false conclusion of a lead fracture and unnecessary stereotactic surgery to replace it.
02/14/2006
07:55 AM
Hyperechoic Plaque An Ultrasound Marker for Osteoporosis in Acute Stroke Patients with Carotid Disease
European Neurology 2006;55:31-36
Osteoporosis is a significant complication of stroke, and hip fracture after a stroke is a frequent problem. Moreover, growing evidence links vascular and bone diseases, in the form of osteoporosis associated with both atherosclerosis and vascular calcification. The aim of our study is to detect bone change in the acute phase of ischemic stroke in patients with carotid disease and to verify the correlation with carotid echogenic plaques.
02/14/2006
07:54 AM
Comparison of Secondary Prevention Care after Myocardial Infarction and Stroke
Cerebrovascular Diseases 2006;21:235-241
Whether secondary prevention of atherosclerosis is performed as frequently after cerebrovascular events (stroke or transient ischemic attack) as after cardiac events (myocardial infarction or angina) is unknown. Methods: We compared the receipt of six secondary preventive care processes among 943 persons with a prior cardiac event to that among 523 persons with a prior cerebrovascular event using a representative sample of the US population.
02/14/2006
07:49 AM
Does Age Predict Outcome in Stroke Rehabilitation A Study of 878 Chinese Subjects
Cerebrovascular Diseases 2006;21:229-234
The predicting value of age on stroke rehabilitation has been controversial. There is a lack of large-scale studies in the Chinese population to examine the effect of age on stroke rehabilitation outcomes. This study examines the predictors of a good outcome after rehabilitation in Chinese stroke patients with special attention to age as a factor.
02/10/2006
10:20 AM
Regional cerebral saturation monitoring with near infrared spectroscopy during selective antegrade cerebral perfusion Diagnostic performance and relationship to postoperative stroke
J Thorac Cardiovasc Surg 2006;131:371-379
To investigate whether regional cerebral tissue oxygen saturation monitoring during hypothermic selective antegrade cerebral perfusion in surgery involving the aortic arch can predict neurologic sequelae and to evaluate the diagnostic performance of near-infrared spectroscopy monitoring in this setting.
02/10/2006
10:19 AM
Therapeutic effects of suburothelial injection of botulinum a toxin for neurogenic detrusor overactivity due to chronic cerebrovascular accident and spinal cord lesions
Urology Volume 67, Issue 2 , February 2006, Pages 232-236
To investigate the therapeutic effects of suburothelial botulinum A toxin for patients with chronic cerebrovascular accident (CVA) and spinal cord lesions. Suburothelial injection of botulinum A toxin can effectively inhibit the occurrence of neurogenic detrusor overactivity.
02/10/2006
10:17 AM
NXY 059 for Acute Ischemic Stroke
New England Journal of Medicine Volume 354:588-600
We conducted a randomized, double-blind, placebo-controlled trial involving 1722 patients with acute ischemic stroke who were randomly assigned to receive a 72-hour infusion of placebo or intravenous NXY-059 within 6 hours after the onset of the stroke. The primary outcome was disability at 90 days, as measured according to scores on the modified Rankin scale for disability (range, 0 to 5, with 0 indicating no residual symptoms and 5 indicating bedbound, requiring constant care).
02/10/2006
10:11 AM
Lamotrigine versus carbamazepine monotherapy for epilepsy
The Cochrane Database of Systematic Reviews 2006,
To review the best evidence comparing carbamazepine and lamotrigine when used as monotherapy in people with partial onset seizures, or generalized onset tonic-clonic seizures with or without other generalized seizure types.
02/10/2006
10:06 AM
Excellent local tumor control regardless of extent of surgical resection after treatment on the Chicago Pilot II protocol for neuroblastoma
Journal of Pediatric Surgery Volume 41, Issue 1 , January 2006, Pages 271-276
Our aim was to investigate the impact of the extent of surgical resection on local recurrence and survival in high-risk patients treated with the Chicago Pilot II protocol.
02/10/2006
10:05 AM
Ischemic Stroke in a Postpartum Patient Understanding the Epidemiology, Pathogenesis and Outcome of Moyamoya Disease
Seminars in Arthritis and Rheumatism olume 35, Issue 4 , February 2006, Pages 250-259
To review the epidemiology, presentation, diagnosis, differential diagnosis, treatment, prognosis, and postpartum maternal outcomes of MMD.
02/10/2006
10:04 AM
Comparison of prednisolone with piroxicam in complex regional pain syndrome following stroke a randomized controlled trial
QJM 2006 99(2):89-95
To compare the effect of prednisolone with that of piroxicam in patients with CRPSI following stroke.
02/10/2006
10:03 AM
Effects of arginine vasopressin during resuscitation from hemorrhagic hypotension after traumatic brain injury
Critical Care Medicine. 34(2):433-438, February 2006
Two series of experiments were designed to evaluate whether early arginine vasopressin improves acute outcome following resuscitation from traumatic brain injury and severe hemorrhagic hypotension.
02/10/2006
10:02 AM
Intraoperative Portable 0 12Tesla MRI in Pediatric Neurosurgery
Pediatric Neurosurgery 2006;42:74-80
Intraoperative MRI (i |
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