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Growth Hormone & IGF Research Volume 16, Supplement 1 , July 2006, Pages 25-29
Acute brain injury has many causes, but the most common is trauma. There are 1.5–2.0 million traumatic brain injuries
(TBI) in the United States yearly, with an associated cost exceeding $10 billion. TBI is the most common cause of death and disability in young adults less than 35 years of age. The consequences of TBI can be severe, including disability in motor function, speech, cognition, and psychosocial and emotional skills. Recently, clinical studies have documented the occurrence of pituitary dysfunction after TBI and another cause of acute brain injury, subarachnoid hemorrhage
(SAH).
The purpose of this study is to analyze the effect of a modified intraoperative anticoagulation strategy including acetylsalicylic acid (ASA) on complication rates during endovascular coil embolization.
Early thrombolytic therapy with intravenous recombinant tissue plasminogen activator (rtPA) improves clinical outcome in acute ischemic stroke (AIS), but impaired endogenous fibrinolysis, thrombin generation, and vascular injury may hamper the efficacy of thrombolysis. We investigated in an exploratory, post hoc analysis the relationship between hemostatic markers and clinical outcomes among patients included in the National Institute of Neurological Disorders and Stroke (NINDS) rtPA Stroke Study.
Determine feasibility and safety of intravenous (IV) versus combined (IV-IA [intra-arterial]) thrombolysis guided by transcranial color-coded duplex sonography (TCCD).
Based on previous studies comparing different recombinant tissue plasminogen activator (rt-PA) doses, we performed a clinical trial with 0.6 mg/kg, which is lower than the internationally approved dosage of 0.9 mg/kg, aiming to assess the efficacy and safety of alteplase in acute ischemic stroke for the Japanese.
Systemic thrombolysis is the only therapy proven to be effective for ischemic stroke. Telemedicine may help to extend its use. However, concerns remain whether management and safety of tissue plasminogen activator (tPA) administration after telemedical consultation are equivalent in less experienced hospitals compared with tPA administration in academic stroke centers.
Recovery of motor function after subcortical stroke appears to be related to the integrity of descending connections from the ipsilesional cortical motor system, a view supported by the observation of greater than normal movement-related activation in ipsilesional motor regions in chronic subcortical stroke patients.
In this study we compared risk factors, clinical features, and stroke recurrence in a large series of patients with large subcortical, cortical, or small deep infarcts.
Research on the pathophysiology and treatment of brain damage with special focus on thermal vascular responses is the subject of this minireview. Interruption of cerebral blood supply by vascular obstruction, temporary cardiac arrest or hyperthermia causes a sudden attack of vascular stroke or heatstroke with serious consequences. It may not induce immediate cell death, but can precipitate a complex biochemical cascade leading to a delayed neuronal loss.
Increased evidence suggests that poor respiratory function increases risk of ischemic damage to the brain. Longitudinal studies on respiratory function and cerebral small-vessel disease are lacking. We examined midlife and late-life respiratory function in relation to small-vessel disease on computed tomography (CT) in women followed for 26 years.
Cardiac abnormalities occur commonly after subarachnoid hemorrhage (SAH) and may be caused by excessive release of catecholamines from the myocardial sympathetic nerves. We hypothesized that adrenoceptor polymorphisms resulting in greater catecholamine sensitivity would be associated with an increased risk of cardiac injury.
Carotid intima-media thickness (IMT) reflects generalized atherosclerosis and is predictive of future vascular events. Evidence exists that carotid IMT is heritable, and genetic studies can provide clues in the pathogenesis of atherosclerosis.
Hypertension promotes carotid intima-media thickening. We reviewed the randomized controlled trials that evaluated the effects of an antihypertensive drug versus placebo or another antihypertensive agent of a different class on carotid intima-media thickness.
A 6-point scoring system (ABCD) was described recently for stratifying risk after transient ischemic attack (TIA). This score incorporates age (A), blood pressure (B), clinical features (C), and duration (D) of TIA. A score <4 reportedly indicates minimal short-term stroke risk. We evaluated this scoring system in an independent population.
C-reactive protein (CRP) has emerged as an important predictor of cardiovascular disease, but there are few prospective data on its association with risk of ischemic stroke in patients at high risk.
To evaluate the patient-perceived impact of resective epilepsy surgery, a key outcome to consider in evaluating such a highly invasive, elective procedure.
Data on behavioral changes after thalamic lesion are sparse and largely based on isolated reports of patients with thalamic strokes. However, recent findings suggest that behavioral patterns can be delineated on the basis of the four main arterial thalamic territories. The anterior pattern consists mainly of perseverations and superimposition of unrelated information, apathy, and amnesia. After paramedian infarct, the most frequent features are disinhibition syndromes, with personality changes, loss of self-activation, amnesia, and, in the case of extensive lesions, thalamic "dementia"; this pattern may often be difficult to distinguish from primary psychiatric disorders, especially when neurologic dysfunction is lacking. After inferolateral lesion, executive dysfunction may develop but is often overlooked, although it may occasionally lead to severe long-term disability. After posterior lesion, whereas cognitive dysfunction with neglect and aphasia are well known, no specific behavioral syndrome has been reported. In the future, perfusion CT, functional MRI, and tractography using diffusion imaging in stroke patients may provide a better understanding of the role of the corticothalamic relationship in behavioral changes associated with thalamic stroke.
The mechanism of transient global amnesia (TGA) is not clear. Attempting to support the hypothesis that retrograde venous hypertension causing cerebral venous ischemia plays a role in the pathogenesis of TGA, the authors used cranial three-dimensional time-of-flight (TOF) MR angiography (MRA) to detect a possible intracranial retrograde venous flow in TGA patients.
The authors previously reported a low initial emergency department (ED) blood pressure (BP) to be associated with a significantly increased risk of death at 90 days. In this article, they examine the impact of acute BP variability following onset of ischemic stroke.
Hypoxic brain injury can be a devastating complication of anesthesia. Fortunately, it has become increasingly rare. Here we report a case of suspected intraoperative hypoxic brain injury treated with moderate hypothermia. Anesthesiologists should be aware of the option of using this therapy and how to employ it in the setting of suspected hypoxic brain injury.
Geriatrics and Gerontology International, Volume 6, Number 2, June 2006, pp. 87-93(7)
Many studies have reported that carotid parameters measured by ultrasonography are predictors for cerebral infarction. The aim of this study was to investigate by a cross-sectional study whether those carotid parameters are markers for atherothrombotic infarction (AI) and lacunar infarction (LI) in elderly people having cardiovascular risk factors.
The Journal of Neuroscience, June 21, 2006, 26(25):6851-6862
Transient global ischemia is a neuronal insult that induces delayed cell death. A hallmark event in the early post-ischemic period is enhanced permeability of mitochondrial membranes. The precise mechanisms by which mitochondrial function is disrupted are, as yet, unclear.
Labetalol is an effective antihypertensive medication frequently used to treat systemic hypertension in acute care settings, including the management of hypertension associated with a subarachnoid hemorrhage. We present a case of profound hypotension, refractory to inotropic and vasopressor therapy following an iv infusion of labetalol.
To prospectively assess abnormalities in brain activation patterns during encoding and retrieval in subjects with mild cognitive impairment by using 4-T functional magnetic resonance (MR) imaging.
To investigate the anatomic substrates underlying the beneficial effect of prism adaptation in five patients with persistent left neglect following right stroke.
To study the frequency, clinical course, and functional outcome of perforator stroke (PS) resulting from elective stenting of symptomatic intracranial stenosis.
The authors previously reported a low initial emergency department (ED) blood pressure (BP) to be associated with a significantly increased risk of death at 90 days. In this article, they examine the impact of acute BP variability following onset of ischemic stroke.
Neurobiology of Disease Volume 22, Issue 3 , June 2006, Pages 523-537
Neonatal hypoxia–ischemia (H–I) is a common cause of perinatal morbidity and mortality leading to prominent activation of caspase-3 in the brain. Previous studies have shown that acute inhibition of caspase-3 can protect against neonatal H–I in rats. In this study, we investigated brain injury following neonatal H–I in mice deficient in caspase-3. Wild-type, caspase-3+/- and caspase-3-/- mice underwent unilateral carotid ligation at postnatal day (P) 7, followed by 45 min of exposure to 8% oxygen.
To evaluate the patient-perceived impact of resective epilepsy surgery, a key outcome to consider in evaluating such a highly invasive, elective procedure.
To assess short- and long-term seizure freedom, the authors reviewed 371 patients who underwent anterior temporal lobectomy to treat pharmacoresistant epilepsy. The mean follow-up duration was 5.5 years (range 1 to 14.1 years). Fifty-three percent of patients were seizure free at 10 years. The authors identified multiple predictors of recurrence. Results of EEG performed 6 months postoperatively correlated with occurrence and severity of seizure recurrence, in addition to breakthrough seizures with discontinuation of antiepileptic drugs.
Disability & Society Volume 21, Number 4 / June 2006 299 - 313
Government policy frameworks on the support of disabled people can often be difficult to ‘read’, as they contain contradictory elements that simultaneously support and confront social processes that create inequalities and oppression. Valuing People (VP), the UK government’s policy framework for learning disability (intellectual disability), provides such a context for work that enhances learning-disabled people’s inclusion in community and society, and to reverse some of the systemic disadvantage they have experienced. However, as an uneasy amalgam of the progressive and the
neoliberal, the romantic and the practical, it has been difficult to evaluate in order to use its opportunities and minimise its dangers. This article attempts to decode VP in terms of ideologies in human services, and the current New Labour policy mix. Its emphases on Person Centred Planning, Direct Payments and employment will be analysed to try to establish what VP means, and to suggest more adequate priorities. This analysis might also be relevant to other sectors where there is a similar problem of decoding their particular policy context.
Disability & Society Volume 21, Number 4 / June 2006 359 - 374
A problem for disabled people, particularly individuals dependent on the use of a wheelchair, is housing that is not easily usable due to physical barriers. A proposed solution by government is the adoption of lifetime homes (LTH) standards that are likely to become mandatory for all newly constructed dwellings in the private sector in England by 2008. It is, therefore, an appropriate time to take stock of LTH standards, and to evaluate to what extent they are able to address the problems for disabled people caused by physically inaccessible housing. In doing so, the article provides a critique of LTH standards, and suggests that while they are, in some respects, a positive development, they are not, in and of themselves, a panacea in relation to rectifying the shortfall of accessible dwellings.
Journal of Head Trauma Rehabilitation. Focus on Clinical Research and Practice, Part 2. 21(3):272-278, May/June 2006
To determine whether diffusion tensor imaging (DTI) can detect diffuse axonal injury, and to evaluate the association of DTI findings with motor function in patients with traumatic brain injury.
Journal of Head Trauma Rehabilitation. Focus on Clinical Research and Practice, Part 2. 21(3):260-271, May/June 2006
To determine characteristics of patients with complicated mild traumatic brain injury (CMTBI) on the inpatient rehabilitation unit and to accentuate limits of current classification systems for patients with mild TBI.
Journal of Head Trauma Rehabilitation. Focus on Clinical Research and Practice, Part 2. 21(3):226-235, May/June 2006
To examine the relation between impaired awareness of deficits (IAD) and treatment adherence and to verify previous findings regarding the types of disabilities that people with traumatic brain injury (TBI) tend to underestimate.
Journal of Head Trauma Rehabilitation. Focus on Clinical Research and Practice, Part 2. 21(3):199-212, May/June 2006
To document the frequency of insomnia (according to DSM-IV and ICSD criteria), to describe its sociodemographic and clinical characteristics, and to identify potential predictors of insomnia in persons with traumatic brain injury (TBI).
Archives of Physical Medicine and Rehabilitation Volume 87, Issue 6 , June 2006, Pages 806-813
To determine the effects of increasingly demanding environments related to simultaneous visual tasks and physical obstructions on the locomotor ability of people with traumatic brain injury (TBI).
Journal of Pediatric Surgery Volume 41, Issue 6 , June 2006, Pages 1177-1179
Surgically created portosystemic shunts can alleviate the symptoms of bleeding from gastric and esophageal varices and improve the hematologic consequences of hypersplenism in patients with portal hypertension. However, the diversion of mesenteric venous blood away from the liver can result in encephalopathy. In this report, we describe a case in which encephalopathy caused by a proximal splenorenal shunt was reversed by the restoration of portal flow to the liver by a mesenteric-to-left portal vein bypass operation.
Archives of Physical Medicine and Rehabilitation Volume 87, Issue 6 , June 2006, Pages 799-805
To compare errorless learning with trial-and-error (T&E) learning of declarative facts in children with memory disorders secondary to traumatic brain injury (TBI).
To determine the scale of acute neurosurgery for severe traumatic brain injury (TBI) in childhood, and whether surgical evacuation for haematoma is achieved within four hours of presentation to an emergency department.
Previous studies have proposed correlation between variants of the cerebral arterial circle (also known as circle of Willis) and some cerebrovascular diseases. Differences in the incidence of these diseases in different populations have also been investigated. The study of variations in the anatomy of the cerebral arterial circle may partially explain differences in the incidence of some of the cerebrovascular diseases in different ethnic or racial groups. While many studies have investigated the variations in the anatomy of each segment of the cerebral arterial circle, few have addressed the variants of the cerebral arterial circle as a whole. Similarly, the frequency of occurrence of such variants in different ethnic or racial groups has not been compared.
Epileptic Disorders. Volume 8, Number 1, 11-23, March 2006
Benign childhood epilepsy with centrotemporal spikes (BECTS) is regarded as a benign form of epilepsy because of its usually favorable outcome, in terms of seizures. Eighteen children with BECTS were studied in terms of neuropsychological and learning abilities: intellectual quotient, oral language (phonological production, naming skills, verbal fluency and syntactic comprehension), drawing and visuo-spatial skills, visual and selective attention, verbal and visuo-spatial memory, reading, numeracy and spelling. The mean IQ of the population was within the normal range, but individual results were heterogeneous. Verbal functions and memory were normal. In contrast, drawing and visuo-spatial skills, attention and visuo-spatial memory were significantly weak compared to the normal range for age. Reading, numeracy and/or spelling ability were significantly delayed by one academic year or more in ten of the children. In conclusion, despite its benign outcome in terms of epilepsy, BECTS can be accompanied by specific cognitive disorders and low academic achievement.
Epileptic Disorders. Volume 8, Number 1, 24-31, March 2006
Although the seizure prognosis is mostly favorable in idiopathic partial epilepsies, there is some empirical evidence showing that subtle neuropsychological impairments, with a consequent risk of academic underachievement, are not rare. We investigated neuropsychological functioning including attention, memory, visuomotor ability, and executive functioning with a closer look at the associated mathematical ability in patients with idiopathic partial epilepsies.
Epileptic Disorders. Volume 8, Number 1, 37-44, March 2006
In add-on studies of partial-onset seizures, the placebo response, defined as a 50% decrease from baseline in seizure frequency, ranges from 0-19%. Reasons for this significant difference between placebo groups in different trials are not given in the literature. This exploratory analysis was undertaken to compare the baseline characteristics of placebo responders and nonresponders, in an attempt to identify common features.
Epileptic Disorders. Volume 8, Number 1, 45-52, March 2006
Paroxysmal motor phenomena and arousals during sleep are frequent. The differential diagnoses between benign hypnic transient events, epileptic and non-epileptic seizures represent a common clinical problem. Video-EEG monitoring during sleep, recording several episodes in the same patient, is essential in order to characterize these phenomena. It offers the possibility to compare electro-clinical data, to demonstrate the eventual stereotyped pattern of motor phenomena and their progression in time, and to study EEG-polygraphic correlates.
Epileptic Disorders. Volume 8, Number 1, 65-9, March 2006
Yawning has been rarely described in association with seizures and not previously documented by video-EEG. We present a 48-year-old woman with a long history of non-dominant for speech hemisphere seizures and post-ictal yawning. Yawning was irresistible, forceful and often repetitive. We reviewed the few similar epileptic cases described in the literature and discussed the possible mechanisms. [Published with video sequences].
Epileptic Disorders. Volume 8, Number 1, 73-6, March 2006
We report a case of frontal lobe epilepsy due to focal cortical dysplasia that included three independent unusual features. The patient, a 45-year-old, right-handed woman, had her first seizure at age 29, well into adulthood. Seizures had been easily controlled with medication for 15 years, then without provocation they became medically intractable during a single, identifiable day. Resection of the dysplastic tissue in the posterior dorsolateral right frontal cortex rendered the patient seizure-free, but produced a significant, non-fluent, Broca type, crossed aphasia. In addition, the seizure semiology was striking and remarkable, a common finding in frontal lobe epilepsy. [Published with video sequences].
Epileptic Disorders. Volume 8, Number 1, 61-4, March 2006
Generalized 1Hz, burst-and-slow-wave complexes were observed in a comatosed patient with acute disseminated encephalomyelitis
(ADEM) when she showed extremely intractable, generalized convulsions and fragmented myoclonus in the whole body. Two types of short-latency SEPs were obtained separately during the burst and slow phase of the EEG (SEP-burst and SEP-slow, respectively), which showed a two fold greater amplitude of N20 in the former than in the latter. This suggests enhanced responsiveness to the peripheral stimuli during the burst phase as compared with the slow phase. CSF and serum were positive for autoantibodies to NMDA receptors. The “burst and slow complexes” reported here are considered to be an atypical EEG pattern of a generalized epileptic phenomenon.
Epileptic Disorders. Volume 8, Number 1, 53-6, March 2006
We report on a 4-year 8-month-old boy with Panayiotopoulos syndrome who showed atypical evolution with newly developed absence seizures and EEG exacerbation induced by carbamazepine. Soon after the introduction of carbamazepine, EEGs began to worsen, and finally absence seizures and myoclonic seizures appeared. Immediately after we discontinued carbamazepine, the seizures disappeared and the EEG improved. Carbamazepine may induce unusual electroclinical features, electrophysiologically explained by bilateral synchrony. This case provides more evidence of the close links between Panayiotopoulos syndrome and benign childhood epilepsy with centrotemporal spikes.
Epileptic Disorders. Volume 8, Number 1, 3-10, March 2006
Literary texts are an important part of the cultural history of many fields of medicine. Accounts of epilepsy are frequent, and descriptions of seizure semiology are often included with varying detail. This review looks at these, and considers the authors’ background knowledge of epilepsy.The first group of writers suffered seizures themselves. Some of them provide remarkable and novel insights into the subjective symptoms and experiences in and around seizures.A second group draws from their own observations of seizures in others who may have been close relatives or fortuitous strangers.
Journal of Hypertension. 24(7):1413-1417, July 2006
A poor outcome after stroke is associated independently with high blood pressure during the acute phase; however, relationships with other haemodynamic measures [heart rate (HR), pulse pressure (PP), rate-pressure product (RPP)] remain less clear.
Archives of Physical Medicine and Rehabilitation Volume 87, Issue 6 , June 2006, Pages 853-859
To determine the effect of previous treatments of functional electric stimulation (FES) and transcutaneous electric stimulation (TENS) on improving gait speed in subjects poststroke.
spasticity following stroke is common, but clinical measurement is difficult and inaccurate. The most common measure is the modified Ashworth scale (MAS) which grades resistance to passive movement (RPM), but its validity is unclear.
The American Journal of Cardiology Volume 97, Issue 12 , 15 June 2006, Pages 1776-1777
Death from pulmonary embolism (PE) in patients with ischemic stroke was determined from the United States Census Bureau’s Compressed Mortality File, which is based on all death certificates throughout the United States. Among patients with ischemic stroke who died over a 19-year study period, PE was the listed cause of death in 11,101 of 2,000,963 individuals (0.55%).
Journal of Neurology, Neurosurgery, and Psychiatry 2006;77:850-855
Non-missile traumatic brain injury (nmTBI) without macroscopically detectable lesions often results in cognitive impairments that negatively affect daily life.
Journal of Neurology, Neurosurgery, and Psychiatry 2006;77:834-840
The memory deficits in patients with temporal lobe epilepsy (TLE) are associated with epileptogenic lesions of the temporal lobes, especially hippocampal sclerosis. Memory deficits have been extensively studied in TLE, but the presence of pre-existing temporal lobe abnormality has confounded studies on the relationship between memory dysfunction and seizure activity. Idiopathic generalised epilepsy (IGE) is characterised by primary generalised seizures and is found to occur in the absence of any macroscopic brain abnormalities. IGE is therefore ideal for investigations on the effects of seizure activity on memory and cognition.
Journal of Neurology, Neurosurgery, and Psychiatry 2006;77:826-829
The benefit of intravenous tissue plasminogen activator (tPA) given within 3 h of acute ischaemic stroke to patients over 80 years of age is uncertain.
The two human cerebral hemispheres are continuously interacting, through excitatory and inhibitory influences and one critical structure subserving this interhemispheric balance is the corpus callosum. Interhemispheric neurophysiological abnormalities and intrahemispheric behavioral impairments have been reported in individuals lacking the corpus callosum. The aim of this study was to examine intrahemispheric neurophysiological function in primary motor cortex devoid of callosal projections.
Seizure Volume 15, Issue 5 , July 2006, Pages 340-343
Postoperative fever is a usual source of concern among caregivers and patients’ family given that it may reflect a wide range of complications. The objective of this paper was to outline the expected postoperative temperature variation after
hemispherectomies, and to establish factors that affect this curve. From 1987 to 2003, 30 patients were hemispherectomized in our institution. Among them, 24 patients without clinical diagnosis of infection were selected for this study.
Seizure Volume 15, Issue 5 , July 2006, Pages 292-298
We enrolled 36 patients (median age 7.75) with new diagnosis of partial epilepsy in an open prospective study. All type of epilepsy were included: 25 patients were affected by idiopathic epilepsy, eight by symptomatic epilepsy and three by cryptogenic epilepsy. Patients were then scheduled to come back for controls at 3 months (T1), 12 months (T2) and 24 months (T3) after the beginning of OXC-monotherapy (T0). At each control we evaluated patients through their seizure diary, a questionnaire on side effects, their level of 10-monohydroxy (MHD) metabolite and laboratory analysis.
Seizure Volume 15, Issue 5 , July 2006, Pages 313-319
Studies on accidents at work in people with epilepsy are scarce and the evidence that epilepsy carries an increased risk of accidents at work is mostly anecdotal. The present survey is a multicentre prospective cohort study of everyday life risks recently conducted in eight European countries (Estonia, Germany, Italy, the Netherlands, Portugal, Russia, Slovenia and United Kingdom) comparing referral children and adults with epilepsy to age- and sex-matched non-epileptic controls. In this context, every accident occurring during work over a 1–3 year follow-up was prospectively reported by patients and controls.
Seizure Volume 15, Issue 5 , July 2006, Pages 307-312
Guidelines have been published recently on when an electroencephalogram (EEG) should be undertaken and the expected waiting time for a routine EEG, but have not included recommendations on how an EEG should be undertaken or who should undertake and report EEGs. The purpose of this survey was to obtain background information on the composition and practice of EEG departments throughout Great Britain that might form the basis for additional recommendations and guidelines.
Seizure Volume 15, Issue 5 , July 2006, Pages 350-354
Antibodies against the glutamate receptor type 3—(GluR3) have been found in association with Rasmussen's encephalitis (RE) but were also detected in patients with non-inflammatory focal epilepsies. We report the case of an 18-year-old patient with treatment refractory left mesial temporal lobe epilepsy accompanied by high levels of GluR3 antibodies. Different from experiences in patients with RE immunomodulatory therapy by use of intravenous gammaglobulines neither altered GluR3 serum levels nor had any effect on seizure frequency in our patient. Interestingly, GluR3 serum levels remained positive after successful surgical intervention leading to patient's seizure freedom.
Seizure Volume 15, Issue 5 , July 2006, Pages 348-349
Glenohumeral instability following seizures is usually of the posterior type. Rarely patients can have anterior dislocation of the shoulder following an epileptic seizure.
This guideline provides an overview of the evidence on various established and potential stroke risk factors and provides recommendations for the reduction of stroke risk.
Seizure Volume 15, Issue 5 , July 2006, Pages 320-327
This study investigated whether air travel is associated with an increase in seizures for individuals with epilepsy. Thirty-seven participants monitored their seizure frequency for one week prior to flying and for one week after flying.
Journal of Clinical Oncology, Vol 24, No 18 (June 20), 2006: pp. 2779-2785
To examine whether stroke risk is elevated in American breast cancer patients treated with modern techniques, as well as whether supraclavicular radiation therapy (RT) is associated with increased risk.
American Journal of Neuroradiology 27:1211-1216, June-July 2006
Intracranial neurenteric (NE) cysts are rare congenital lesions that may be mistaken for other, more common non-neoplastic cysts as well as cystic neoplasms. We delineate the imaging spectrum, pathologic findings, and differential diagnosis of NE cysts.
American Journal of Neuroradiology 27:1258-1271, June-July 2006
Diffusion tensor imaging (DTI) and white matter tractography (WMT) are promising techniques for estimating the course, extent, and connectivity patterns of the white matter (WM) structures in the human brain. In this study, DTI and WMT were used to evaluate WM tract reorganization after the surgical resection of brain tumors and vascular malformations.
Cerebral microdialysis is a well-established laboratory tool that is increasingly used as a bedside monitor to provide on-line analysis of brain tissue biochemistry during neurointensive care. This review describes the principles of cerebral microdialysis and the rationale for its use in the clinical setting, including discussion of the most commonly used microdialysis biomarkers of acute brain injury. Potential clinical applications are reviewed and future research applications identified. Microdialysis has the potential to become an established part of mainstream multi-modality monitoring during the management of acute brain injury but at present should be considered a research tool for use in specialist centres.
American Journal of Neuroradiology 27:1245-1251, June-July 2006
Cerebral atrophy following herpes simplex encephalitis has formerly been described. We aimed to quantify atrophy after encephalitis of various causes. Additional objectives were to define which initial or long-term clinical factors correlate with volume loss and to search for any correlate in global clinical outcome measures.
American Journal of Neuroradiology 27:1177-1182, June-July 2006
The MERCI (Mechanical Embolus Removal in Cerebral Ischemia) trial reported efficacy of the Merci Retriever for opening intracranial vessels in patients ineligible for intravenous (IV) tissue plasminogen activator (tPA). Patients who receive IV tPA but do not recanalize may also benefit from thrombectomy, but the revascularization efficacy and safety of this strategy has not been reported.
American Journal of Neuroradiology 27:1338-1345, June-July 2006
To assess by diffusion-weighted MR imaging (DWI) the efficacy of cerebral protection devices in avoiding embolization and new ischemic lesions in patients with severe internal carotid artery (ICA) stenosis undergoing carotid artery stent placement (CAS).
Post-stroke depression affects the outcome of stroke rehabilitation and is observed in approximately 30% of all stroke patients. We investigated whether the addition of light treatment to medical antidepressants influences the course of depression as measured by the Hamilton Depression Scale.
American Journal of Neuroradiology 27:1357-1361, June-July 2006
Recent studies have focused on mechanical thrombectomy as a means to reduce the time required for revascularization and increase the revascularization rate in acute stroke. To date no systematic evaluation has been made of the different mechanical devices in this novel and fast-developing field of endovascular interventions. To facilitate such evaluations, we developed a specific in vivo model for mechanical thrombectomy that allows visualization of dislocation or fragmentation of the thrombus during angiographic manipulation.
American Journal of Neuroradiology 27:1362-1369, June-July 2006
Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps provide information at MR imaging that may reflect cell attenuation and integrity. We hypothesized that cerebellar tumors in children can be differentiated by their ADC values.
American Journal of Neuroradiology 27:1275-1282, June-July 2006
Reorganization of brain function may result in preservation of motor function in patients with brain tumors. The goal of the present study was to investigate whether function of the primary motor area (M1) was restored and whether motor function improved after brain tumor resection.
The central melanocortin system plays a key role in the regulation of energy homeostasis. Neurons containing the peptide precursor proopiomelanocortin (POMC) are found at two sites in the brain, the arcuate nucleus of the hypothalamus (ARC) and the caudal region of the nucleus of the solitary tract (NTS). ARC POMC neurons, which also express cocaine- and amphetamine-regulated transcript (CART), are known to mediate part of the response to factors regulating energy homeostasis, such as leptin and ghrelin.
The Journal of Neuroscience, June 14, 2006, 26(24):6627-6636
Recent studies have revealed that the adult mammalian brain has the capacity to regenerate some neurons after various insults. However, the precise mechanism of insult-induced neurogenesis has not been demonstrated. In the normal brain, GFAP-expressing cells in the subventricular zone (SVZ) of the lateral ventricles include a neurogenic cell population that gives rise to olfactory bulb neurons only. Herein, we report evidence that, after a stroke, these cells are capable of producing new neurons outside the olfactory bulbs. SVZ GFAP-expressing cells labeled by a cell-type-specific viral infection method were found to generate neuroblasts that migrated toward the injured striatum after middle cerebral artery occlusion.
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