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Ictal asystole (IA) is a rare event mostly seen in patients with temporal lobe epilepsy
(TLE) and a potential contributor to sudden unexplained death in epilepsy
(SUDEP). Clinical and video-electroencephalographic findings associated with IA have not been described, and may be helpful in screening for high risk patients.
To report a case with bilateral lower extremity complex regional pain syndrome
(CRPS) in a patient with paraplegia occurring following spinal disc herniation surgery, who was treated successfully with pulse radiofrequency
(PRF) lumbar sympatholysis.
HLA-G is overexpressed in different tumors and plays a role in immune escape. Because no information is available on
HLA-G in relation to human neuroblastoma, we have investigated the expression of membrane-bound and secretion of soluble isoforms of
HLA-G in neuroblastoma and functionally characterized their immunosuppressive activities.
Massive subchorionic hematoma is a large maternal blood clot, which separates the chorionic plate from the villous
chorion. It is an uncommon condition associated with poor perinatal prognosis and intrauterine growth retardation.
Child's Nervous System, Volume 23, Number 6, June 2007 , pp. 707-712(6)
Intracranial infectious aneurysms in the pediatric population are rare. Although surgery has been the traditional treatment of ruptured pediatric infectious aneurysms, endovascular coil embolization has become an attractive alternative due to its low rate of morbidity and mortality.
NXY-059 is a free radical-trapping neuroprotectant developed for use in acute ischemic stroke. To facilitate prompt administration of treatment, potentially before
neuroimaging, we investigated the safety of NXY-059 in patients with intracerebral hemorrhage
(ICH).
Hereditary spastic paraplegia (HSP) is a clinically and genetically heterogeneous neurodegenerative disorder characterized by progressive spastic paraparesis of the lower limbs.
Metastases to the central nervous system from different primary cancers are an oncologic challenge as the overall prognosis for these patients is generally poor. The incidence of brain metastases varies with type of primary cancer and is probably increasing due to improved therapies of extracranial metastases prolonging patient's overall survival and thereby time for brain metastases to develop.
To assess the effect of teleradiology upon the need for transfer of head injured victims requiring hospitalisation but referred initially to a rural level 2 trauma centre without neurosurgical capacity.
Current Opinion in Neurology. 20(4):403-409, August 2007
Developments in imaging following traumatic brain injury are outlined. Numerous techniques have evolved over the past several years giving us more information about the injury and prognosis for recovery. Some of these techniques are in clinical use while others are used primarily in research but have the potential to become clinically useful.
Because of the risk of hemorrhage, especially in the brain, thrombolytic therapy with intravenous alteplase is restricted by guidelines, and only a small number of selected patients are being treated. Findings from
metaanalyses, post hoc analyses of the randomized trials, and postlicensing experience suggest that more subjects, who otherwise have a poor predicted outcome without treatment, might benefit from intravenous
alteplase.
Intratumor heterogeneity is of great importance in many clinical aspects of glioma biology, including tumor grading, therapeutic response, and recurrence. Modifications in the genetic features of a specific primary tumor recurring after chemo- and radiotherapy are poorly understood. We report a recurrent glioblastoma case exhibiting loss of heterozygosity
(LOH) on chromosome 10q, while the primary tumor exhibited heterogeneity in the LOH status of 1p, 19q, and 10q. To determine the relationship between such modifications and heterogeneous
chemosensitivity, primary cultured cells heterogeneously showing 1p/19q/10q losses were established from a surgical specimen of oligoastrocytoma and were treated with chemotherapeutic agents.
Pneumonia is a major cause of morbidity and mortality after stroke. We aimed to determine key characteristics that would allow prediction of those patients who are at highest risk for poststroke pneumonia.
Cancer treatment may affect school performance. Scholastic achievements after childhood brain tumors have not been previously reported on the level of actual grades.
Critical Care Medicine. 35(8):1844-1851, August 2007
Hypertensive, hypervolemic, hemodilution therapy (triple-H therapy) is a generally accepted treatment for cerebral vasospasm after subarachnoid hemorrhage. However, the particular role of the three components of triple-H therapy remains controversial. The aim of the study was to investigate the influence of the three arms of triple-H therapy on regional cerebral blood flow and brain tissue oxygenation.
To identify the frequency of and impact on outcome of generalized convulsive status epilepticus
(GCSE) among patients with nontraumatic subarachnoid hemorrhage
(SAH).
Cephalalgia, Volume 27, Number 8, August 2007 , pp. 981-987(7)
The migraine-ischemia relationship is best understood in the context of the pathophysiology of migraine. Potential mechanisms of migrainous infarction (stroke occurring during migraine) include vasospasm,
hypercoagulability, and vascular changes related to cortical spreading depression.
European Journal of Neurology, Volume 14, Number 8, August 2007 , pp. 895-899(5)
Old age groups have different risk profile and stroke features compared to younger groups. Our aim was to examine the risk factor profile and stroke subtype in patients older than 80 years with ischemic stroke.
Facial nerve paresis and hearing loss are common complications after vestibular schwannoma surgery. Experiments with facial nerves of the rat and retrospectively analyzed clinical studies showed a beneficial effect of vasoactive treatment on the preservation of facial and cochlear nerve functions. This prospective and open-label randomized pilot study is the first study of a prophylactic vasoactive treatment in vestibular schwannoma surgery.
Archives of Pathology and Laboratory Medicine: Vol. 131, No. 6, pp. 890-901
To review the current literature and to make recommendations with regard to laboratory testing for various hypercoagulability risk factors for ischemic stroke.
Current Opinion in Neurology. 20(4):390-397, August 2007
Recent studies have provided further evidence that white-matter lesions exert a detrimental effect on cognitive profile. New magnetic-resonance techniques may help in clarifying the meaning and extent of this effect.
Minimal research has evaluated the renal safety of emergent computed tomography angiography
(CTA) procedures, consecutive contrast medium application, and the long-term outcome in acute stroke patients. We investigated the incidence of contrast-induced renal impairment in these populations.
Right-to-left shunt (RLS) due to patent foramen ovale is a well-established risk factor for cryptogenic stroke and is highly prevalent in cases of migraine, cluster headache, and obstructive apnea. It can be diagnosed by gaseous-contrast transcranial Doppler, yet in a small percentage of cases it cannot be done owing to an insufficient temporal window. The aim of the study was to compare transtemporal with transoccipital approaches for gaseous-contrast transcranial Doppler for RLS diagnosis.
Abstract
Augmentative and alternative communication (AAC) holds the potential to enable people with severe oral communication impairments to participate more fully in society. However, despite the development of increasingly sophisticated communication aids, as well as recent UK policy initiatives aimed at improving access to them, some major obstacles stand in the way of the inclusory potential of AAC being realized to any significant degree. Drawing on findings of a research study that explored the experiences of people who use
AAC, this paper looks at the various problems that people encounter in using communication aids. It identifies the lack of consistent, structured support as a key overarching issue.
Mastery of the neurosurgical skill set involves many hours of supervised intraoperative training. Convergence of political, economic, and social forces has limited neurosurgical resident operative exposure. There is need to develop realistic neurosurgical simulations that reproduce the operative experience, unrestricted by time and patient safety constraints.
To detect parameters that may augment the therapeutic strategy in patients with a cerebral arteriovenous malformation (AVM) that is considered equally suitable for treatment by neurosurgery or
radiosurgery, we compared the efficacy and risks of these two methods in a paired series with similar patient and AVM characteristics.
The Sugita classification for sylvian fissure arteriovenous malformations (AVMs) categorizes them into four types based on nidus location in the fissure: pure, lateral, medial, and deep. This classification scheme is simple and appealing, but is rarely applied. We applied the Sugita classification to a consecutive, single-surgeon experience with 28 patients to better characterize the Sugita subtypes.
Leptin is the major adipose hormone that regulates body weight and energy expenditure by activating leptin receptors in the hypothalamus. Leptin receptors are also present in other cell types, and a potent antiapoptotic effect for leptin has recently been reported. We investigated whether leptin was neuroprotective against ischemic brain injury.
Tropical Medicine & International Health, Volume 12, Number 7, July 2007 , pp. 895-901(7)
To evaluate the benefits of the detection of both circulating antibodies (Ab) and antigens (Ag) for the diagnosis of cysticercosis in people with epilepsy. Neurocysticercosis is a cause of neurological diseases world-wide, especially epilepsy. The clinical symptoms of neurocysticercosis are non-specific and diagnosis is often difficult.
To characterize the frequency and pattern of diffusion-weighted imaging (DWI) abnormalities detected as part of brain magnetic resonance imaging
(MRI) and their association with short-term neurologic outcomes in patients successfully resuscitated after cardiopulmonary arrest (CPA).
Human neuroblastoma remains enigmatic because it often shows spontaneous regression and aggressive growth. The prognosis of advanced stage of sporadic neuroblastomas is still poor.
Investigative Radiology. 42(8):558-563, August 2007
The purpose of this study was to compare brain and tumor signal characteristics of T1-weighted turbo spin-echo
(TSE) and gradient recalled echo (GRE) sequence techniques at 3 T compared to TSE at 1.5 T, focusing on the detection of contrast enhancement, in a standardized animal model of a brain
glioma.
Spontaneous intracerebral hemorrhage (ICH) continues to be a major medical and socioeconomic problem. While the surgical procedure failed to show benefits over functional outcome, a less invasive and quicker surgical decompression might improve the outcome. The authors introduced
endoscopy-guided evacuation in managing ICH and reports the benefits over the conventional method.
In the first 3 months after acute ischemic stroke, 2% to 6% of patients die from cardiac causes. This may reflect preexisting cardiac disease, cardiac dysfunction related to the acute neurohumoral and autonomic stress response to stroke, or both. Delineation of a high-risk group could facilitate prevention strategies.
Use of retinoic acid (RA) has become the standard of care in the treatment of high risk neuroblastoma (NB). In vitro, RA induces growth arrest and differentiation, an effect that likely underlies its activity in the clinical setting. An important event in differentiation is the transcriptional downregulation of the MYCN
oncogene, which is frequently activated in aggressive tumors.
Tandem internal carotid and middle cerebral artery occlusion independently predicts poor outcome after intravenous
thrombolysis. Recanalization of internal carotid artery dissection by
stent-assisted angioplasty has recently been proposed when anticoagulation fails to prevent a new ischemic event. We recently reported a case of tandem internal carotid and middle cerebral artery occlusion with dissection of the internal carotid artery successfully treated with endovascular
stent-assisted thrombolysis.
To characterize the physiologic and neuroanatomical features and functional outcome of proximal dominant paresis of the upper extremity
(UE) in poststroke patients.
To evaluate the safety of sensation-dependent bladder emptying in complete spinal cord injury (SCI) patients, based on the preservation of the desire to void.
This paper describes the rationale and methodology for the Study of Health and Activity in People with Spinal Cord Injury (SHAPE SCI). The study aims to (1) describe physical activity levels of people with different injury levels and completeness, (2) examine the relationship between physical activity, risk and/or presence of secondary health complications and risk of chronic disease, and (3) identify determinants of physical activity in the SCI population.
This review article investigated the objective evidence of benefits derived from functional electrical stimulation (FES)-assisted gait for people with spinal cord injury (SCI).
Journal of Cancer Research and Therapeutics Year : 2007 Volume : 3 Issue : 1 Page : 50-52
Radiation induced gliomas are uncommon. Occurrence of glioma following radiotherapy for craniopharyngiomas is extremely uncommon and only eight case reports have been so far published. We present our experience with one similar case of temporal gliomas occurring twelve years following radiotherapy for a sub totally excised
craniopharyngioma.
Current Opinion in Endocrinology, Diabetes & Obesity. 14(4):301-305, August 2007
To highlight how traumatic brain injury as well as subarachnoid hemorrhage and primary brain tumors of the central nervous system can induce hypopituitarism - an underdiagnosed clinical problem. Then, further information of the problem is likely to stimulate appropriate screening programs for patients with brain injuries, at high risk of developing an unrecognized
hypopituitarism.
To prospectively determine whether differences between benign and malignant brain lesions can be depicted with fluorine 18 (18F) fluorocholine positron emission tomography (PET).
Journal of Trauma-Injury Infection & Critical Care. 63(1):75-82, July 2007
The purpose of this study was to investigate whether routine follow-up computed tomography (CT) for patients with head injury, in the absence of clinical indications, alters patient management.
To retrospectively compare sensitivity and specificity of admission nonenhanced computed tomographic (CT) scans with those of CT angiographic source images in detection of early ischemic changes in middle cerebral artery (MCA) stroke and to retrospectively compare admission nonenhanced CT scans with CT angiographic source images in delineation of final infarct extent, with follow-up images as reference.
ANZ Journal of Surgery, Volume 77, Number 8, August 2007 , pp. 686-689(4)
Blunt cerebrovascular injury (BCVI), although uncommon, is associated with substantial morbidity and mortality and remains poorly understood. This study was conducted to determine the pattern and outcome of BCVI at a major trauma centre.
The degradation of extracellular matrix (ECM) is a hallmark of a cerebral aneurysm; however, little is known regarding the molecular mechanism leading to this change. Tissue inhibitor of matrix metalloproteinase
(TIMP) regulates the ECM degradation in vascular walls by inhibiting the activity of matrix metalloproteinases
(MMPs). We investigated the role of TIMPs in the progression of cerebral aneurysms in the present study.
The purpose of this study was to use diffusion-weighted and diffusion tensor imaging to investigate the status of cerebral white matter (WM) at term gestation and the rate of WM maturation throughout the first year of life in healthy infants.
Investigative Radiology. 42(8):564-568, August 2007
To investigate maximum enhancement and visual map quality in cerebral perfusion computed tomography (PCT) with variation of iodine concentration of contrast media (CM).
(1) to determine differences between minorities vs. non-minorities on demographic, injury and rehabilitation characteristics and functional outcomes at admission, discharge and 1-year post-injury and (2) to examine differences in functional outcome at 1-year post-injury among (African-Americans, Hispanics and Whites).
Among patients presenting with a transient ischemic attack (TIA), some clinical features predispose to recurrent TIA, whereas others predispose to subsequent strokes. We assessed the implication of negative diffusion-weighted imaging on a baseline MRI in predicting subsequent TIA.
To examine the perceived information needs of community-dwelling individuals with chronic spinal cord injury (SCI) and to determine factors that influence these needs.
This article (i) reviews existing research on the relationships that exist among spirituality, religion, and health for persons with disabilities; and (ii) compares different theoretical coping models (i.e., spiritual vs.
psychoneuroimmunological).
To empirically test a biopsychoecological model referred to as Health Environmental Integration
(HEI) by showing associations between the perception of unmet need for home accessibility features and the experience of Activities of Daily Living
(ADL) difficulties.
(1) to determine differences between minorities vs. non-minorities on demographic, injury and rehabilitation characteristics and functional outcomes at admission, discharge and 1-year post-injury and (2) to examine differences in functional outcome at 1-year post-injury among (African-Americans, Hispanics and Whites).
To investigate the pattern of hemispheric activation, according to cerebral blood flow changes, as measured by Transcranial Doppler Ultrasonography
(TCD) during language tasks in stroke patients with aphasia.
This study was conducted primarily to be a descriptive study about non-traumatic (NT) spinal cord injury (SCI) patients, in terms of their demographic and neurological features, and to investigate the complications and efficient results of rehabilitation in this group. The second aim of the study was to conduct a comparison between non-traumatic SCI patients and traumatic SCI patients.
Identifying patients at risk of traumatic brain injury (TBI) is important because research suggests prophylactic treatments to reduce risk of long-term
sequelae.
To determine factors that influence the strength of therapeutic alliance for patients with traumatic brain injury
(TBI) attending post-acute brain injury rehabilitation (PABIR) and to examine the association of therapeutic alliance with outcome after
PABIR.
To investigate the relationship of working memory, processing speed and verbal comprehension with FAS performance in individuals who had sustained a traumatic brain injury
(TBI).
Child brain injury can have a lasting, detrimental effect upon socio-emotional
behaviour, but little is known about underlying impairments that cause behavioural disturbance. This study explored the possibility that a proportion of difficulties result from compromise to systems in the brain which function in reading emotion in others from eyes, face expression or vocal tone.
Orthostatic circulatory disorders are a common problem in the mobilization of patients with severe neurological diseases such as paraplegia, the vegetative state or the minimally conscious state. They create difficulties when mobilizing the patient out of bed. Although their incidence has not been clearly established and the severity and length of symptoms differ greatly, a relevant number of the patients in a rehabilitation unit is affected. Rehabilitation specialists should therefore be aware of these disorders and the therapeutic alternatives available.
Journal of Head Trauma Rehabilitation. International Programs and Perspectives on Traumatic Brain Injury Rehabilitation. 22(4):234-238, July/August 2007
Traumatic brain injury (TBI) is the number one cause of mortality and morbidity in young adults in modern Western societies. This article discusses TBI rehabilitation in the Netherlands. Facts and figures on rehabilitation as well as on the epidemiology of TBI and its silent epidemic in the Netherlands are presented. The Dutch healthcare system is described, and strengths and weaknesses of TBI rehabilitation are discussed.
Journal of Head Trauma Rehabilitation. International Programs and Perspectives on Traumatic Brain Injury Rehabilitation. 22(4):229-233, July/August 2007
In Sweden, traumatic brain injury (TBI) is a major cause of disability across all ages, and the need for rehabilitation and long-term follow-up is as important as in many other countries. This article presents the rehabilitation of TBI in Sweden. Strengths and weaknesses of TBI rehabilitation within the Swedish healthcare system are described, together with examples of research and development.
Journal of Head Trauma Rehabilitation. International Programs and Perspectives on Traumatic Brain Injury Rehabilitation. 22(4):239-247, July/August 2007
This article describes the setup of brain injury rehabilitation services in the United Kingdom within the context of the National Health Service. The rehabilitation services are broadly divided into local general rehabilitation services, specialist district rehabilitation services, and complex specialized rehabilitation services.
Journal of Head Trauma Rehabilitation. International Programs and Perspectives on Traumatic Brain Injury Rehabilitation. 22(4):214-220, July/August 2007
Brain injury rehabilitation is based on principles of universal access to healthcare in a publicly funded system and is available to all residents in Canada. However, a variability of resources exists because of the vastness of the country and differences in provincial funding. Rehabilitation is typically provided by an interprofessional team and is client centered, goal directed, evidence based, and aimed at improving quality of life for survivors of brain injury. Work is being done exploring different models of care including community treatment and the use of rehabilitation therapists. Patient education is an ongoing priority. Data collection is considered mandatory in many centers for program evaluation and quality improvement. There is a clear need for coordinated standards of care across the country.
Journal of Head Trauma Rehabilitation. International Programs and Perspectives on Traumatic Brain Injury Rehabilitation. 22(4):248-256, July/August 2007
The aim of this study was to complete a systematic evidence-based review of published cognitive and behavioral treatment studies with pediatric subjects who have a history of an acquired brain injury
(ABI).
Journal of Head Trauma Rehabilitation. International Programs and Perspectives on Traumatic Brain Injury Rehabilitation. 22(4):221-228, July/August 2007
This study describes the establishment of a Danish national strategy for treatment and rehabilitation of acquired brain injury, particularly traumatic brain injury, in 1997. The vision was to create a system of tax-financed continuous treatment, restoration of function, and outpatient rehabilitation.
Journal of Neuro-Oncology, Volume 83, Number 2, June 2007 , pp. 145-152(8)
Regulatory T-cells play an important role in the regulation of the immune response and the mediation of dominant immunologic tolerance. We have previously shown that these cells are elevated in tumors and blood of patients with glioblastoma
multiforme.
Journal of Clinical Oncology, Vol 25, No 21 (July 20), 2007: pp. 3137-3143
A dose-escalation phase I and pharmacokinetic study of the farnesyltransferase inhibitor lonafarnib (SCH66336) was conducted in children with recurrent or progressive CNS tumors. Primary objectives were to estimate the maximum-tolerated dose
(MTD) and to describe the dose-limiting toxicities (DLTs) and pharmacokinetics of
lonafarnib. Farnesylation inhibition of HDJ-2 in peripheral blood was also measured.
To evaluate the sensitivity of 16-detector row computed tomographic (CT) angiography in diagnosis of intracranial aneurysms and to determine whether multidetector CT angiography provides sufficient diagnostic information to guide endovascular treatment, with combined imaging and clinical data as the reference standard.
Pediatric Critical Care Medicine. 8(4):348-356, July 2007
Opinion is divided on the value of repeat head computed tomography for guiding clinical management of pediatric patients with blunt head trauma. This study describes the prevalence of worsening brain injury on repeat computed tomography, predictors of worsening computed tomography findings, and the frequency of neurosurgical intervention after the repeat computed tomography.
Child's Nervous System, Volume 23, Number 6, June 2007 , pp. 659-663(5)
Therapeutic modalities for pineal region tumours are still matter of debate. Endoscopic treatment is a minimally invasive approach. The aim of this study was to assess the quality of life of patients with pineal region tumours who underwent endoscopic procedures.
A clinically relevant number needed to harm for tissue plasminogen activator
(tPA)-related symptomatic intracerebral hemorrhage (SICH) would greatly assist therapeutic decision-making.
Acute stroke is a time-dependent emergency in which patients often arrive outside of the therapeutic treatment windows. To determine the role that healthlines may have in promoting early presentation, this study evaluated patterns of healthline triage of potential stroke patients.
(1) To determine the effects of the level of spinal cord injury (SCI) on skeletal muscle, intramuscular fat
(IMF) cross-sectional areas (CSAs) and relative IMF; (2) to determine the relation, if any, of spasticity to each of these variables after incomplete SCI.
Intramedullary spinal cord metastases (ISCMs) are rare type of central nervous system (CNS) involvement of systemic malignant tumors. Since the advent of new neuroradiological techniques, their detection have become increasingly diagnosed in recent years and, although somewhat controversial, surgical treatment has been considered a valid option.
European Journal of Neurology, Volume 14, Number 7, July 2007 , pp. 757-761(5)
Although previous studies have proved that both stroke wards and mobile stroke teams are considerably better than non-specialized stroke care, an unresolved debate in vascular neurology is whether or not stroke wards provide better outcomes in some specific cases to stroke victims.
To describe the course of five spinal cord injury (SCI) patients who underwent proximal amputation of the inferior extremity, secondary to recurrent, complicated pressure ulcers
(PU) and the clinical impact this intervention had in these patients.
Journal of Trauma-Injury Infection & Critical Care. 63(1):179-186, July 2007
Outcomes of treatment of postinjury complications remain unsatisfactory and research continues into the impact of trauma on innate and acquired immunity. The aim of our study was to describe how head injury affects a child's immunity by measuring the neutrophil function and lymphocytes subsets.
Journal of Paediatrics and Child Health, Volume 43, Numbers 7-8, July/August 2007 , pp. 557-559(3)
There is considerable variation in the use of brain imaging and electrophysiological monitoring of encephalopathic term infants. The aims of this study were
(i) to document the current practice among Australian and New Zealand
neonatologists; and (ii) to identify the factors that influence local practice.
Most observational studies investigating physical activity as a risk factor for stroke have concentrated on the years preceding a stroke event. In the present case control study we compared the reported level of physical activity performed during the week preceding an ischemic stroke with that of community controls. Furthermore we calculated the odds ratio for stroke based on the level of physical activity.
Studies evaluating predictors of tPA-associated symptomatic intracerebral hemorrhage
(SICH) have typically focused on clinical and CT-based variables.
MRI-based variables have generally not been included in predictive models, and little is known about the influence of reperfusion on SICH risk.
We aim to compare demographics and functional outcomes of patients with stroke in a variety of vascular territories who underwent inpatient rehabilitation. Such comparative data are important in functional prognostication, rehabilitation, and healthcare planning, but literature is scarce and isolated.
Journal of Paediatrics and Child Health, Volume 43, Numbers 7-8, July/August 2007 , pp. 571-572(2)
Pyridoxine dependency is a rare autosomal-recessive disorder causing intractable seizures in neonates and infants. Life-long therapy with pyridoxine is required for prevention of seizure recurrence and for an optimum intellectual outcome.
Previous studies have suggested a relationship between stress reaction and elevated levels of
prolactine. The aim of the present study was to investigate if there was a relationship between
s-prolactine and menstrual cycle status following spinal cord injury (SCI).
We report a preclinical study of a new endoluminal device for aneurysm occlusion to test the hypothesis that the device, even without use of intrasaccular coil placement, could occlude saccular aneurysms without causing substantial parent artery compromise or compromise of adjacent, small branch arteries.
The purpose of this study was to describe prognostic factors for outcome in a large series of patients undergoing neurosurgical clipping of aneurysms after subarachnoid hemorrhage
(SAH).
Journal of Neuro-Ophthalmology. 27(2):125-126, June 2007
A 63-year-old man suddenly developed an isolated bilateral internuclear ophthalmoplegia
(INO). High-resolution brain MRI showed signal abnormalities consistent with acute ischemic stroke limited to the
infra-aqueductal region of the midbrain bilaterally. This case offers graphic evidence that stroke can be responsible for an isolated bilateral
INO.
Current Opinion in Clinical Nutrition & Metabolic Care. 10(4):475-479, July 2007
Therapeutic advances remain modest for patients with malignant brain tumours, due in part to inadequate ability of in-vitro models to mimic the consequences of tumour progression in vivo, which include profound
immunosuppression, cytokine dysregulation and microvascular proliferation. This review summarizes recent findings on the wasting consequences of glioma growth, including changes in hepatic metabolism caused by the
tumour.
New England Journal of Medicine Volume 356:2704-2712 June 28, 2007 Number 26
A 51-year-old woman presents with a generalized tonic-clonic seizure. After a brief postictal period, she recovers fully and does not report headache or other neurologic symptoms. She takes no medications and her medical history is unremarkable.
The purpose of this study was to further investigate the feasibility and safety of a combined intravenous and intra-arterial approach to recanalization for ischemic stroke.
This study tested whether NADPH-oxidase activity, expression, and functional effects on vascular tone are influenced by gender in the rat cerebral circulation and whether such differences are estrogen-dependent.
Although intravenous (IV) thrombolysis is the standard treatment for patients with ischemic stroke occurring within 3 hours from symptom onset, a few interventional neuroradiologists have been treating this category of patients by an intra-arterial (IA) route for >25 years. However, evidence is still required to support the clinical feeling that IA treatment, which needs longer time and greater complexity, leads to a better outcome. Therefore, the objective of the present review was to analyze beliefs and myths underlying the selection of patients for IA
thrombolysis.
Accurate and consistent outcome assessment is essential to randomized clinical trials. We aimed to explore observer variation in the assessment of outcome in a recently completed trial of dexanabinol in head injury and to consider steps to reduce such variation.
Malignant meningiomas, similar to glioblastomas, are difficult tumors to control. We tried to control malignant tumors related to meningiomas by boron neutron capture therapy
(BNCT).
Journal of Trauma-Injury Infection & Critical Care. 63(1):172-178, July 2007
Brain injury is the most important independent predictor of mortality and morbidity in pediatric trauma. The Glasgow Coma Score (GCS) is the commonly used clinical instrument to assess brain injury. However, the GCS or one of its components is often not applicable in children under a certain age or cannot be computed reliably because of the patient's condition or the circumstances surrounding resuscitation efforts. This limits its usefulness in statistical models of trauma outcomes, which rely on complete data collection and entry into trauma registries.
Current Opinion in Neurology. 20(4):417-423, August 2007
Simultaneous recording of electroencephalogram and functional MRI is being increasingly applied to the investigation of normal cerebral processes and disorders, particularly epilepsies. We will summarize recent epilepsy-related studies and appraise the clinical and scientific value of
EEG/fMRI.
Endothelial progenitor cells (EPCs) are mobilized from the bone marrow to blood circulation in response to tramatic or inflammatory stimulations. Once released, they actively seek and home to the sites of vascular injury to promote vascular repair.
Thrombolysis is a time-dependent therapy. It is therefore very important how fast stroke patients can reach hospital. The present study was designed to assess which proportion of patients with stroke (from the population of Szczecin, the capital of West Pomerania Province, Poland) reaches hospital within the recommended time from the thrombolytic therapy point of view.
We investigated the presence of autoantibodies againstglutamate receptor (GluR) e2 in serum and cerebrospinal fluid
(CSF) samples from 12 consecutive patients with acute encephalitis/encephalopathy by immunoblotting using recombinant GluR e2 as antigen.
Patent foramen ovale (PFO) has been identified as a potential risk factor for cerebrovascular ischemia. Procoagulant mutations may increase the risk and impact the choice of appropriate therapy for secondary prevention. We evaluated the prevalence of the 2 most common genetic risk factors for
thromboembolism, factor V Leiden (G1691A) and prothrombin G20210A, in young PFO patients who were referred for percutaneous transcatheter closure of their
PFO.
Routine anatomical imaging with CT and MRI does not reliably indicate the true extent or the most malignant areas of gliomas and cannot identify the functionally critical parts of the brain. The aim of the study was to see if the use of MR spectroscopic imaging
(MRSI) along with functional MRI (fMRI) can better define both the target and the critical structures to be avoided to improve radiation delivery in
gliomas.
Child's Nervous System, Volume 23, Number 6, June 2007 , pp. 633-644(12)
The significant technological improvement of endoscopic instrumentation has allowed, in the last 10 years, a widespread diffusion of neuroendoscopic procedures. Nevertheless, severe, sometimes life-threatening, complications may occur during neuroendoscopic surgery, and the incidence and age specificity of complications in children have been underdescribed so far.
Prognosis of status epilepticus (SE) depends on its cause, but there is uncertainty as to whether SE represents an independent outcome predictor for a given etiology. Cerebral anoxia is a relatively homogenous severe encephalopathy. Postanoxic SE is associated to a nearly 100% mortality in this setting; however, it is still unclear whether this is a severity marker of the underlying encephalopathy, or an independent factor influencing outcome.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:864-871
To review the angiographic and clinical outcome of patients with unruptured intracranial
aneurysm(s) (UIA) with regard to complications and successful obliteration by surgical clipping or endovascular coiling.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:872-876
Measurement of the duration of post-traumatic amnesia (PTA) is common practice, serving as an important index of the severity of traumatic brain injury
(TBI) and a predictor of functional outcome. However, controversy exists regarding the nature of PTA; some studies indicate that it is a confusional state with symptoms that extend beyond disorientation and amnesia.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:853-856
Studies of long term outcome after epilepsy surgery for cortical malformations are rare. In this study, we report our experience with surgical treatment and year to year long term outcome for a subgroup of patients with focal cortical dysplasia
(FCD).
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