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The relationship between elevated lipoprotein (a) levels[Lp(a)] and stroke is controversial. We systematically reviewed the literature to determine whether
Lp(a) is a risk factor for stroke.
Pediatric and Developmental Pathology Volume 10, Issue 3 (May-June 2007) Article: pp. 208-223
Sudden unexplained death in childhood (SUDC) is the sudden death of a child older than 1 year of age that remains unexplained after review of the clinical history, circumstances of death, and autopsy with appropriate ancillary testing. We report here 5 cases of SUDC in toddlers that we believe define a new entity associated with hippocampal anomalies at autopsy.
There are no prospective randomized studies assessing the clinical relevance of routine cardiovascular investigations in stroke patients. The objective of this study was to evaluate the utilization, relevance, and economics of cardiovascular investigations in an ambulatory stroke clinic.
Collateral circulation influences cerebral infarction occurrence and size. Statins may improve ischemic stroke outcomes. We evaluated the relationship between prestroke statin use and pretreatment angiographic collateral grade among acute ischemic stroke patients presenting with occlusion of a major cerebral artery. After adjusting for covariates, the
statin-treated group had significantly higher collateral scores than
non-statin users, suggesting an association between statin use and better collateralization during acute stroke.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:529-531;
The clinical features associated with West Nile virus (WNV) infections are described based on data collected from history forms submitted with samples during a province-wide WNV testing
programme.
To explore sick leave, disability pension and health-care-seeking behaviour among people 30-65 years of age prior to their stroke in 2001 in the county of Sweden.
To study longitudinal changes in psychological coping strategies, social support, life orientation and health-related quality of life in the late period after traumatic brain injury
(TBI).
This paper describes the approach used by the Victorian Acquired Brain Injury
(ABI) specialist team of CRS Australia (formerly Commonwealth Rehabilitation Service) to facilitate participation in the workforce for its clients. The approach and results achieved are compared and contrasted with other models nationally and internationally.
Archives of Clinical Neuropsychology Volume 22, Issue 4, May 2007, Pages 465-474
We aimed to determine the severity and pattern of cognitive dysfunction in patients with basal ganglia (BG) hemorrhage within the first 6 months after stroke and to identify its clinical correlates.
American Journal of Neuroradiology 28:1078-1084, June-July 2007
Glioblastoma multiforme (GBM) and single brain metastasis (MET) are the 2 most common malignant brain tumors that can appear similar on anatomic imaging but require vastly different treatment strategy. The purpose of our study was to determine whether the peak height and the percentage of signal intensity recovery derived from dynamic susceptibility-weighted contrast-enhanced (DSC) perfusion MR imaging could differentiate GBM and MET.
Since the clinical observations published by Janz in 1957, the presence of personality irregularities in patients with juvenile myoclonic epilepsy
(JME) has been described repeatedly, but never quantified using standardized assessments. The aim of the present study was to investigate whether juveniles with a short history of JME exhibit psychopathological symptoms and/or personality irregularities.
Assessing if an early therapeutic response to an antiepileptic drug (AED) is of prognostic value for long-term outcome is of considerable clinical interest. To that end, we evaluated the likelihood that a patient who becomes seizure-free after 6 months of treatment with a single AED would lose that response at 12 months, or vice versa.
Journal of the International Neuropsychological Society (2007), 13: 561-570 Cambridge University Press
Previous research suggests that reduced self-awareness is common following traumatic brain injury
(TBI). However, few studies have examined the magnitude of this problem in a sample representative of hospitalized individuals. In this longitudinal study, individuals with complicated mild to severe TBIs and their significant others (SO) were evaluated at 1 and 12 months postinjury on the Sickness Impact Profile.
Journal of the International Neuropsychological Society (2007), 13: 710-715 Cambridge University Press
Recency discrimination has been conceptualized as an executive ability by some investigators and as an aspect of episodic memory by others. We compared the performance of 261 neurologically healthy adults on a recency discrimination task
(RDT) with their performance on measures of executive functioning and explicit memory.
Journal of the International Neuropsychological Society (2007), 13: 582-594 Cambridge University Press
Twenty-three chronic nonfluent aphasia patients with moderate or severe word-finding impairments and 11 with profound word-finding impairments received two novel picture-naming treatments. The intention treatment initiated picture-naming trials with a complex left-hand movement and was designed to enhance right frontal participation during word retrieval.
Journal of the International Neuropsychological Society (2007), 13: 664-671 Cambridge University Press
Reliable neuropsychological markers of right temporal integrity have proven elusive. Specifically it is unclear whether figural and spatial aspects of visual memory are differentially affected by right temporal lobe epilepsy
(TLE) and subsequent resection. To investigate this we used the modified Rey Complex Figure
(RCF) scoring system devised by Brier et al. (1996) to obtain separate indices of figural and spatial memory in TLE surgery candidates.
Journal of the International Neuropsychological Society (2007), 13: 642-652 Cambridge University Press
The study investigated the nature of the effects of maternal epilepsy on cognitive performance of the offspring. One hundred fifty-four children of mothers with epilepsy aged 5 to 11 years (study group), along with 130 control children, comparable with respect to IQ, socio-economic status, age, and gender underwent a neuropsychological assessment using subtests from the
NEPSY: A Developmental Neuropsychological Assessment, tapping
attentional, auditory-verbal, visuomotor, fine motor, and memory abilities.
Journal of the International Neuropsychological Society (2007), 13: 726-728 Cambridge University Press
Many researchers have explored the development of emotional and psychiatric disorders following stroke. Few individuals, however, have dedicated years of clinical research to the topic or have the depth of knowledge required to critically evaluate the existent large body of literature.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:760-763
Adult normal pressure hydrocephalus (NPH) is one of the few potentially treatable causes of dementia. Some morphological and functional abnormalities attributed to hydrocephalus improve following treatment.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:694-698
Trunk performance is an important predictor of functional outcome after stroke. However, the percentage of explained variance varies considerably between studies. This may be explained by the stroke population examined, the different scales used to assess trunk performance and the time points used to measure outcome. The aim of this multicentre study was to examine the predictive validity of the Trunk Impairment Scale
(TIS) and its subscales when predicting the Barthel Index score at 6 months after stroke.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:690-693
To analyse the risk for symptomatic intracranial haemorrhage (sICH), morbidity and mortality after thrombolytic therapy in octogenarians focusing, in particular, on whether patients selected using magnetic resonance imaging
(MRI) had a better risk:benefit ratio.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:716-721
To clarify the clinical usefulness of preoperative fibre-tracking in affected pyramidal tracts for intraoperative monitoring during the removal of brain tumours from patients with motor weakness.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:770-771
We report a presentation of relapsing and remitting isolated intracranial neurosarcoidosis in a female patient who presented with episodic severe headache and behavioural disturbance initially misdiagnosed as psychosis. Eventually, several episodes were accompanied by visual disturbance secondary to
papilloedema, ultimately leading to a diagnosis of neurosarcoidosis on meningeal biopsy.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:729-731
Magnesium therapy probably reduces the frequency of delayed cerebral ischaemia (DCI) in subarachnoid haemorrhage
(SAH) but uncertainty remains about the optimal serum magnesium concentration. We assessed the relationship between serum magnesium concentrations achieved with magnesium sulphate therapy 64
mmol/day and the occurrence of DCI and poor outcome in patients with
SAH.
The results from this study highlight ways that the disabilities community within the USA can begin to further promote the numbers and qualities of its leaders. Twenty-one grassroots and statewide leaders of the disabilities movement in one state described how they became a leader and identified ways that the disabilities movement can more effectively promote leadership within its ranks. Overall, our informants highlighted the need for the disabilities movement to re-examine its current definitions of and approaches to leadership development. They described the need for a more collective, versus individualistic, approach to leadership within the disabilities movement and the adoption of a more integrated, action learning approach to leadership development. Implications for the disabilities movement are discussed.
Published reports of nail gun injuries to the face are uncommon. We describe an unusual delayed presentation with injury through the infratemporal fossa and a literature review.
Epileptic Disorders. Volume 9, Number 2, 174-8, June 2007
Vasovagal syncope can be confused with epileptic seizure. In this situation, eye compression may be performed during EEG. We present a video-EEG of a patient in whom eye compression produced a typical syncope.
Neuroradiology Volume 49, Number 4 / April, 2007 289-298
Statistical parametric mapping (SPM) and statistical probabilistic anatomical mapping (SPAM) were applied to
basal/acetazolamide Tc-99m ECD brain perfusion SPECT images in patients with middle cerebral artery (MCA) stenosis to assess the efficacy of endovascular stenting of the MCA.
Pediatric Neurology Volume 36, Issue 6, June 2007, Pages 366-372
A retrospective multicenter study was conducted, designed to evaluate the efficacy and safety of midazolam for the treatment of status
epilepticus. The subjects were 358 inpatients who received intravenous midazolam therapy for status
epilepticus. The mean age was 48.6 ± 46.5 months.
Although the atypical antipsychotic medications appear to be safe in patients with epilepsy, few studies have specifically addressed the use of risperidone in children with seizures. The objective of this study was to evaluate behavior improvement and seizure outcome in children with epilepsy and behavioral disorders (self-injurious, aggressive, or destructive behavior) after introduction of
risperidone.
Few randomized, controlled trials evaluating antiepileptic drug (AED) efficacy and tolerability have focused solely on patients with juvenile myoclonic epilepsy
(JME). We conducted a pilot, randomized controlled trial comparing topiramate (N = 19) and valproate (N = 9) in adolescents/adults with JME to evaluate clinical response when these broad-spectrum agents are titrated to optimal effect.
Energy drinks contain a mixture of compounds, of which caffeine, guarana, and herbal supplements such as ginkgo and ginseng are major components. Survey of popular literature reveals anecdotal observations of adverse events associated with consumption of energy drinks.
Vaccine Volume 25, Issue 27, 28 June 2007, Pages 5097-5101
In order to evaluate the long-term immunity 2 and 3 years after booster vaccination against tick-borne encephalitis
(TBE) following time intervals 3 years and longer since last TBE immunization, 195 (mean age 50.5 ± 15.1 years) and 240 subjects (mean age 47.0 ± 15.4 years), respectively, who had received a single booster dose in a preceding study, returned for a serological follow-up.
Pediatric Neurology Volume 36, Issue 6, June 2007, Pages 387-392
Occipital lobe epilepsy in children can present as an idiopathic form (i.e., childhood epilepsy with occipital paroxysms) or as a symptomatic form. Forty-three children (18 boys, 25 girls) were divided into the idiopathic group or symptomatic group, according to the classification for epileptic seizures of the International League Against Epilepsy.
Three men with epilepsy (age range, 38–62) who exhibited brief episodes of violent behavior during the postictal period are described. Disease duration ranged from 27 to 44 years. Patients had both complex partial seizures and secondarily generalized
tonic-clonic seizures, which were refractory to antiepileptic drugs.
Journal of Trauma-Injury Infection & Critical Care. 62(6):1452-1456, June 2007
Mild head injury (MHI) implies a risk for traumatic brain injury and even a small risk for development of an intracranial
hematoma. Head computed tomography (CT) is recommended for early detection of such pathologic findings. The present multicenter study was performed to investigate whether determination of protein S100B in serum could contribute to the selection of patients for CT scanning.
There is fairly general agreement that the melody and the rhythm are the independent components of the perception of music. In the theory of music, the melody and harmony determine to which tonality the music belongs.
Pain Practice, Volume 7, Number 2, June 2007 , pp. 135-142(8)
Spinal cord stimulation (SCS) is used in the treatment of chronic pain, ischemia because of obstructive arterial disease, and anginal pain. Recently, a number of studies have described the effects of the high cervical
SCS, including increased cerebral blood flow, although the underlying mechanisms are unknown.
We compared parametric maps, measured values and value distributions of cerebral blood volume
(CBV) derived from (1) first pass T1 weighted dynamic contrast-enhanced
(DCE) data (T1-CBV) using the recently described leakage profile model and (2) conventional T2* weighted DCE data
(T2*-CBV) using a conventional curve fitting technique, in nine patients with intraaxial
tumours.
This study prospectively examined whether continued add-on treatment with oxcarbazepine
(OXC) is associated with quantitative improvement in mood and anxiety symptoms in adult patients with partial epilepsy. Depressive symptoms and anxiety were assessed by clinical interview using the Hamilton Depression Rating Scale
(HDRS), the Cornell Dysthymia Rating Scale (CDRS), the Beck Depression Inventory
(BDI), and the Hamilton Anxiety Rating Scale (HARS).
Journal of Neurotrauma May 2007, Vol. 24, No. 5 : 790 -797
Presence of the apolipoprotein E (APOE) 4 allele has been associated with increased incidence and faster progression of neurodegenerative diseases, poorer recovery from neurologic insult, and decreased cognitive function in the well-elderly. The specific association between APOE genotype and recovery from severe traumatic brain injury
(TBI) is conflicting with many groups finding the APOE 4 allele to be associated with poorer outcome while others have found no association.
Neurocritical Care April 2007, Volume 6, Issue 2, pps. 117-120
Infective endocarditis can lead to serious neurological complications including ischemic stroke and intracranial hemorrhage. Treatment with intravenous thrombolysis within 3 h of symptom onset has become the standard of care in acute ischemic stroke, but the safety and efficacy of this intervention in patients with infective endocarditis is unknown.
To describe and illustrate three distinct surgical approaches that permit exposure and resection of
extradural, intradural, and transdural lesions involving the hypoglossal canal.
Lack of human leukocyte antigens and costimulatory molecules have been suggested as mechanisms by which human malignant gliomas avoid immune recognition and elimination.
To examine the structural abnormalities in the amygdala in stroke patients and see what contribution the amygdala may make to psychopathology and cognitive dysfunction related to stroke, because the amygdala has important roles in the processing of emotions, cognitive function, and psychiatric disorders.
Journal of Stroke and Cerebrovascular Diseases Volume 16, Issue 3, May-June 2007, Pages 119-121
South Asians are the largest ethnic group in the world, yet there are no data on metabolic syndrome
(MetS) among ethnic South Asian patients with ischemic stroke. Ethnic differences in the prevalence of MetS are known to exist.
Over the past decade, much has been learned about the cellular and molecular mechanisms underlying hypoxic-ischemic (H-I) injury in the preterm human brain. The pathogenesis of H-I brain injury is now understood to be multifactorial and quite complex, depending on
(i) the severity, intensity and timing of asphyxia, (ii) selective ischemic vulnerability, (iii) the degree of maturity of the brain, and (iv) the characteristics of the ensuing
reoxygenation/reperfusion phase. Each of these factors has differential effects on the distinct cell populations in the brain, with certain specific cell types being particularly vulnerable in the developing brain.
Intravenous tissue plasminogen activator (tPA) is an economically worthwhile but underused treatment option for acute ischemic stroke. We sought to identify the extent of tPA use in Canadian medical centers and the potential savings associated with increased use nationally and by province.
Journal of Clinical Neuroscience Volume 14, Issue 5, May 2007, Pages 494-497
Aneurysms are seen rarely at the P2–P3 junction of the posterior cerebral artery
(PCA). P2-P3 junction aneurysm surgery is challenging. Here, a successful clipping of a large P2-P3 junction aneurysm via a subtemporal approach is reported.
Epileptic Disorders. Volume 9, Number 2, 158-63, June 2007
To determine the electromagnetic sources of localized epileptic activities using magnetoencephalography (MEG) in three adult patients with epilepsy suggestive of
Lennox-Gastaut syndrome (LGS).MethodsMEG and simultaneous electroencephalography (EEG) were recorded from three adult patients using a 204-channel, whole-head MEG system. Equivalent current dipoles
(ECDs) were calculated for epileptic spikes on MEG according to the single dipole model.
Data on post-stroke depression in aphasia are scarce. Methods: Eighty-nine acute stroke patients with aphasia of all types were followed for 6 months to investigate if depression can be reliably diagnosed (DSM-IV criteria) and validly assessed by the verbal Montgomery-Ã…sberg Depression Rating Scale
(MADRS) and a global technique (Clinical Global Impressions Rating Scale for Severity).
Epileptic Disorders. Volume 9, Number 2, 164-9, June 2007
Periodic lateralized epileptiform discharges (PLEDs) are a rare phenomenon in electroencephalography, occurring in acute structural brain lesions. In general, PLEDs appear transiently in acute lesions, but a few reports have described persistent PLEDs in chronic lesions.
Cardiovascular risk factors are suboptimally treated in diabetes, possibly because of the impression that there is a long delay between diagnosis and the development of macrovascular complications such as stroke. We determined the incidence of stroke in people newly treated for type 2 diabetes.
We reviewed the clinical, radiological, surgical, and histopathological features of patients with meningiomas to identify factors that can predict tumor recurrence after "microscopic total removal," to improve preoperative surgical planning, and to help determine the need for close radiological observation at shorter intervals or the need for radiotherapy as an adjuvant treatment in the early postoperative period.
Journal of Neurotrauma May 2007, Vol. 24, No. 5 : 753 -765
Traumatic brain injury (TBI) is the most common cause of death and disability in young people. The functional outcome in patients with TBI cannot be explained by focal pathology alone, and diffuse axonal injury (DAI) is considered a major contributor to the neurocognitive deficits experienced by this group.
Neurocritical Care April 2007, Volume 6, Issue 2, pps. 82-89
Aim of this randomized prospective clinical trial is to compare two methods of antipyretics and evaluate their efficacy in controlling fever during the acute phase of brain damage.
The mechanism of stroke in patients with atherosclerotic occlusive disease and hemodynamic failure may be primarily hemodynamic or a combination of hemodynamic and embolic factors. The purpose of this study was to investigate the clinical and imaging features of stroke in these patients.
This study defines significant thrombolysis associated intracranial hemorrhage
(ICH) by identifying an objective threshold volume that predicts clinical deterioration attributable to
ICH.
Numerous effective strategies for the secondary prevention of cardiovascular events in high-risk patients have now been established. We sought to calculate the cumulative benefit of combining multiple strategies for preventing recurrent events in patients with a history of ischemic stroke or transient ischemic attack.
Despite many studies investigating the association between the ischemic changes and cognitive impairment in subcortical vascular dementia
(SVaD), few studies correlated cognitive impairment with microbleeds
(MBs) frequently seen in SVaD.
Cancer Immunology, Immunotherapy, Volume 56, Number 5, May 2007 , pp. 615-625(11)
Glioblastoma is the most common and highly malignant brain tumor. It is also one among the most therapy-resistant human
neoplasias. Patients die within a year of diagnosis despite the use of available treatment strategies such as surgery, radiotherapy, and chemotherapy. Thus, there is a critical need to find a novel therapeutic strategy for treating this disease.
Epileptic Disorders. Volume 9, Number 2, 145-8, June 2007
A child had the characteristic clinical and EEG pattern of migrating partial seizures in infancy with left temporal lobe atrophy, hippocampal sclerosis and
cortical-subcortical blurring. Seizures were drug-resistant, with recurring episodes of status
epilepticus. The child developed microcephaly with arrest of psychomotor development. Focal brain lesions, in the context of migrating partial seizures, have not been previously reported.
Of late, obstructive sleep apnea (OSA) has been suggested to be a risk factor for atherosclerotic artery disease. In the present study, we analyzed the prevalence of atherosclerosis in stroke patients with and without
OSA.
Neuroradiology Volume 49, Number 4 / April, 2007 299-305
Neuroimaging in seizures associated with nonketotic hyperglycemia (NKH) is considered normal. We report magnetic resonance imaging
(MRI) abnormalities in four patients with NKH and seizures.
Motivation has an important influence on neuropsychological test performances. This study examined effort on the Word Memory Test
(WMT) in groups with differing external incentives.
Many clinicians allow blood pressure to run high in patients with intracranial stenosis to protect against
hypoperfusion. We sought to determine whether higher blood pressure decreases the risk of stroke in these patients.
Archives of Clinical Neuropsychology Volume 22, Issue 4, May 2007, Pages 519-531
This study examined prevalence of depression and anxiety as well as the relationships of age, gender, hemisphere of lesion, functional independence, and cognitive functioning (i.e., memory, attention/impulsivity, cognitive speed) to depression and anxiety at 3 months post stroke in 73 individuals.
Neuroradiology Volume 49, Number 4 / April, 2007 343-349
We report imaging and clinical characteristics of patients with aneurysms that repeatedly reopened over time and were coiled three times or more during a follow-up period of 2-11 years.
Epileptic Disorders. Volume 9, Number 2, 170-3, June 2007
Syncope and epileptic seizures share some common clinical characteristics that may complicate the diagnostic process. In clinical practice, syncope is frequently misdiagnosed as an epileptic seizure and consequently treated with antiepileptic drugs. In this study, we identified 57 patients with syncope (diagnosis based on accepted criteria) who had come to our unit with a previous diagnosis of definite epilepsy in 30 cases (syncope misdiagnosed as epileptic seizures,
SMS), or suspected epilepsy in the remaining 27 cases (unrecognized syncope, US).
Transcranial Doppler ultrasound (TCD) and magnetic resonance angiography (MRA) can identify intracranial atherosclerosis but have not been rigorously validated against the gold standard, catheter angiography. The WASID trial
(Warfarin Aspirin Symptomatic Intracranial Disease) required performance of angiography to verify the presence of intracranial
stenosis, allowing for prospective evaluation of TCD and MRA.
Collateral circulation influences cerebral infarction occurrence and size. Statins may improve ischemic stroke outcomes. We evaluated the relationship between prestroke statin use and pretreatment angiographic collateral grade among acute ischemic stroke patients presenting with occlusion of a major cerebral artery. After adjusting for covariates, the
statin-treated group had significantly higher collateral scores than non–statin users, suggesting an association between statin use and better collateralization during acute stroke.
There are no randomized trials comparing intra-arterial (IA) therapy with best medical treatment for acute ischemic stroke. To assess potential benefit from this therapeutic approach, we performed a systematic review of published IA series.
In this in vivo study, we investigated the influence of different load situations on humeral cartilage thickness in individuals with paraplegia and quadriplegia.
Intravenous thrombolysis with recombinant tissue plasminogen activator is the standard of care for the treatment of acute ischemic stroke within 3 hours after stroke onset. Randomized clinical studies have demonstrated that intravenous thrombolysis improves functional outcomes but is not lifesaving.
Friedreich ataxia (FA) is a progressive, multisystem degenerative disorder in which oxidative stress is believed to have a role. Recent clinical studies indicate that the antioxidant
idebenone, administered at 5 mg/kg per day, reduces the cardiac hypertrophy that occurs in FA, but improvement in neurologic measures is unclear. Some studies suggest that higher doses of idebenone may be more effective, but pharmacology and toxicology at higher doses have not been investigated in human beings.
Epileptic Disorders. Volume 9, Number 1, 90-3, March 2007
Ictal crying is a rare type of epileptic seizure associated with hypothalamic hamartoma and with other lesions such as
tumours, vascular malformations, hippocampal sclerosis, or cerebral infarction. We describe the case of an infant with
gelastic, dacrystic and other types of seizures associated with a giant hypothalamic
hamartoma, and present a video sequence of dacrystic seizures.
Epileptic Disorders. Volume 9, Number 1, 77-81, March 2007
The cortical control of the autonomic system may account for the clinical phenomenon of ictal asystole which, in turn, has been speculated to be a potential mechanism for sudden unexpected death in epilepsy
(SUDEP). We report an 18-year-old patient with frontal lobe epilepsy who had intracranial electrode placement showing bifrontal seizure-onset.
Journal of Head Trauma Rehabilitation. 22(3):192-197, May/June 2007
Mild traumatic brain injury (mTBI) without frank neurological disturbance has been linked to persistent physical, cognitive, and affective disturbances in some cases. The cognitive sequelae of this syndrome represent the most frequently studied symptoms, yet the legacy of such injuries on communicative functions remains largely undetermined.
Tracheostomy has been employed to release the airway obstruction at the glottic level and to prevent sudden death in patients with multiple system atrophy
(MSA). However, sudden death is possible even after tracheostomy. Nocturnal polysomnography showed that the
apnea-hypopnea index became higher after tracheostomy, and all tracheostomized patients had frequent central sleep apneas.
Journal of Pediatric Surgery Volume 42, Issue 3, March 2007, Pages 482-488
In previous studies, incubation of doxorubicin-resistant neuroblastoma SK-N-SH
(Dox-R) cells with epidermal growth factor (EGF) decreased extracellular signal-regulated kinase activation. Because extracellular signal-regulated kinase activation is associated with cell proliferation, we hypothesized that EGF could induce apoptosis and decrease the rate of cell growth in these cells.
There are only limited data regarding pituitary functions in the acute phase of traumatic brain injury
(TBI) and previous studies have been conducted in only small cohorts of subjects. Therefore we have investigated the pituitary functions in the early acute phase, within 24 hours of trauma, in 104 patients with
TBI. Additionally, the relationships between basal pituitary hormones, severity of the trauma and mortality due to trauma were also investigated.
Using a correlational design, this study verifies the relationships between personal characteristics of individuals with TBI and their spouses and their level of psychological and marital adjustment.
Neurocritical Care April 2007, Volume 6, Issue 2, pps. 104-112
Introduction Raised intracranial pressure (ICP) has been consistently associated with poor neurological outcome. Our purpose was to systematically review the literature to estimate the association between ICP values and patterns and short- and long-term vital and neurological outcome.
American Journal of Neuroradiology 28:938-939, May 2007
In adult patients with acquired immunodeficiency syndrome (AIDS), cerebral arteritis usually takes the form of arterial wall thickening,
stenosis, and occlusion, leading to cerebral ischemia and infarction. Aneurysms and intracranial hemorrhage are much less commonly associated with cerebral
vasculitis. For reasons not entirely clear, this form is seen more often in pediatric patients infected with human immunodeficiency virus.
To determine whether elevated urine erythrocyte (red blood cell) and leukocyte (white blood cell) counts, reflecting concomitant renal and cerebral emboli of cardiac origin, would be useful in discriminating cardioembolic (CE) from non-CE stroke in acute ischemic stroke.
The identification and analysis of pedigrees with rare congenital oculomotility syndromes has led to the definition of the congenital cranial dysinnervation disorders. These disorders appear to result from mutations in genes that are essential to the normal development and/or connectivity of cranial
motoneurons. This review highlights the clinical features and genetic etiology of 3 congenital cranial dysinnervation disorders: the human homeobox A1 (HOXA1) syndromes, in which early motoneuron development is disrupted; horizontal gaze palsy with progressive scoliosis, in which there is aberrant axonal targeting onto abducens
motoneurons; and congenital fibrosis of the extraocular muscles type 1, in which there is aberrant axonal targeting onto the extraocular muscles.
A randomized trial was completed to assess the feasibility of a 2-year education rehabilitation program for students with sickle cell disease and memory deficits. Eleven students were assigned to tutoring with or without memory training for 2 years. Eighty-two percent completed the program. Evidence of improvement in memory and academic achievement existed. Educational rehabilitation is a feasible strategy, but further investigation is needed to assess the benefit in a multi center trial.
Journal of Pediatric Hematology/Oncology. 29(6):420-422, June 2007
Acute colonic pseudo-obstruction is characterized by dilatation of the large bowel without mechanical obstruction. Although the first step of the treatment is conservative management, mechanical decompression should be performed when symptoms persist.
Anaesthesia, Volume 62, Number 6, June 2007 , pp. 555-560(6)
Pain after craniotomy remains a significant problem. The effect of morphine and tramadol patient-controlled analgesia
(PCA) on arterial carbon dioxide tension is unknown in patients having such surgery. Sixty craniotomy patients were randomly allocated to receive morphine
PCA, tramadol PCA or codeine phosphate 60 mg intramuscularly. Baseline values of pain score (0-10), sedation and arterial carbon dioxide tension were recorded at the time of first analgesic administration and at 30min, 1, 4, 8, 12, 18 and 24h.
Clinical Journal of Pain. 23(5):383-391, June 2007
To examine chronic pain prevalence in a spinal cord injury (SCI) population, and to determine the influence of psychologic factors on SCI pain and impact of SCI pain on quality of life.
This article provides an overview of the latest knowledge and understanding of childhood febrile seizures. This review also discusses childhood febrile seizure occurrence, health services utilization and treatment costs. Parental reactions associated with its occurrence and how healthcare providers can assist parents with dealing effectively with this potentially frightening and anxiety-producing event are also discussed.
Recent reports have shown promising short- to medium-term results in patients with refractory idiopathic intracranial hypertension
(IIH) treated using the stereotactic ventriculoperitoneal shunting
(SVPS) technique. However, the long-term clinical efficacy of this technique remains questionable. This report provides the long-term results of SVPS in treating refractory IIH patients.
Surgical treatment may be required for large petroclival meningiomas; however, surgery for these lesions is a major undertaking, and modern surgical approaches are still associated with considerable morbidity and recurrence rates.
Placement of a lumboperitoneal (LP) shunt is a method for treating communicating hydrocephalus. These shunts can be placed with or without valves. We sought to review the complications associated with the use of LP shunts with the increasing use of horizontal-vertical
(HV) valve systems.
Epileptic Disorders. Volume 9, Number 2, 127-33, June 2007
We investigated the clinical features and surgical outcome of 17 patients with refractory epilepsy secondary to CNS infection who were referred to a tertiary center for presurgical evaluation. Six patients had a history of meningitis and 11 patients had a history of encephalitis. Median age at infection was three years (40 days-40 years).
Epileptic Disorders. Volume 9, Number 2, 111-26, June 2007
The cognitive outcome of the surgical removal of an epileptic focus depends on the assessment of the localisation and functional capacity of language and memory areas which need to be spared by the neurosurgeon. Traditionally, presurgical evaluation of epileptic patients has been achieved by means of the intracarotid amobarbital test assisted by neuropsychological measures. However, the advent of neuroimaging techniques has provided new ways of assessing these functions by means of non-invasive or minimally invasive methods, such as anatomical and functional magnetic resonance imaging, positron emission tomography, single-photon emission computed tomography, transcranial magnetic stimulation, functional transcranial Doppler monitoring, magnetoencephalography and near infrared spectroscopy.
Epileptic Disorders. Volume 9, Number 2, 134-9, June 2007
We report a patient diagnosed as having subacute encephalopathy with frequent seizures in alcoholics
(SESA syndrome), in which recurrent, non-convulsive seizures of frontal origin contributed significantly to the alteration of the mental state. Our case suggests that the occurrence of episodes of complex partial status epilepticus
(CPSE) may contribute greatly to the origin and pathophysiology of the confusional state in this rare, epileptic entity.
American Journal of Clinical Oncology. 30(3):310-314, June 2007
This study was undertaken to evaluate the outcome of patients undergoing stereotactic radiosurgery (SRS) as primary or salvage treatment of brain metastases arising from breast cancer.
To assess the clinical and radiological long-term outcome after aneurysmal subarachnoid hemorrhage
(SAH) in a defined referral area regarding recurrent SAH and de novo aneurysm formation.
Present the rationale for adaptive behavior rating and introduce the Adaptive Behaviour and Community Competency Scale
(ABCCS), a comprehensive and detailed measure of adaptive behaviour, for use with persons with traumatic brain injury
(TBI) in the post-acute period.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:501-507
Conventional MRI can provide critical information for care of patients with traumatic brain injury
(TBI), but MRI abnormalities rarely correlate to clinical severity and outcome. Previous magnetic resonance spectroscopy studies have reported clinically relevant brain metabolic changes in patients with
TBI. However, these changes were often assessed a few to several days after the trauma, with a consequent variation of the metabolic pattern due to temporal changes.
Although relevant information exists regarding the chance of obliterating arteriovenous malformations (AVMs) using
radiosurgery, the overall chance of cure after gamma knife radiosurgery is usually only extrapolated from a portion of all monitored patients.
Stroke is a leading cause of hospital admission among the elderly. Although studies have examined subsequent vascular outcomes, limited data are available regarding the full burden of hospital readmission after stroke. We sought to determine the rates of hospital readmissions and mortality and the reasons for readmission over a 5-year period after stroke.
Surgery for intractable temporal lobe epilepsy usually controls seizures and improves health-related quality of life
(HRQOL), but some patients experience continued seizures, memory decline, or both. The relative impact of these unfavorable outcomes on HRQOL has not been described.
A randomized trial was completed to assess the feasibility of a 2-year education rehabilitation program for students with sickle cell disease and memory deficits. Eleven students were assigned to tutoring with or without memory training for 2 years. Eighty-two percent completed the program.
Neuroblastoma patients show heterogeneous clinical courses ranging from life-threatening progression to spontaneous regression. Recently, gene expression profiles of neuroblastoma tumours were associated with clinically different phenotypes. However, such data is still rare for important patient subgroups, such as patients with MYCN non-amplified advanced stage disease.
Cochrane for Clinicians June 1, 2007 Vol. 76 No. 10
Compared with usual care, how effective is occupational therapy focused specifically on activities of daily living
(ADL) in improving ADL, morbidity, and mortality in patients who recently have had a stroke?
Journal of Clinical Oncology, Vol 25, No 16 (June 1), 2007: pp. 2288-2294
The clinical significance of epidermal growth factor receptor variant III
(EGFRvIII) expression in glioblastoma multiforme (GBM) and its relationship with other key molecular markers are not clear. We sought to evaluate the clinical significance of GBM subtypes as defined by EGFRvIII status.
European Journal of Neurology, Volume 14, Number 6, June 2007, pp. 683-685(3)
Wegener granulomatosis is a systemic vasculitis that mainly affects the upper and lower respiratory tract and the kidneys. The presence of an ischemic stroke in this disease is very rare. A 40-year-old man, smoker with cavitated lesions in both lungs, and inflammation in the nasal mucosa and vocal cords developed an ischemic stroke in the left middle cerebral artery, with the etiological study showing non-bacterial
endocarditis.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:485-49
The mismatch between perfusion and diffusion lesions on magnetic resonance perfusion-weighted imaging
(PWI)/diffusion-weighted imaging (DWI) may help identify patients for
thrombolysis. Evidence underlying this hypothesis was assessed.
Seizure Volume 16, Issue 4, June 2007, Pages 371-376
The mechanisms underlying the hemiconvulsion-hemiplegia-epilepsy syndrome (HHE) remain unclear. The current proposed pathogenic mechanism is a neuronal injury induced by venous thrombosis and/or hypoxia. Previous abnormalities of the brain were suggested as underlying mechanism.
Annales Françaises d’Anesthésie et de Réanimation Volume 26, Issue 5, May 2007, Pages 445-451
Traumatic brain injury occurs abruptly, involves multiple specialized teams, solicits the health care system in its emergency dimension and engages the well being of the patient and his relatives for a life time period. Clinicians are faced with issues of uppermost importance: medical issues such as predicting long term neurological outcome of the comatose patient, ethical issues because of the influence of intensive care on the long term survival of patients in vegetative and minimally conscious state, legal issues as the consequence of the current law which has set a new concept of proportionality of care, social issues as the result of the very high cost of these pathologies.
To map the disease-causing locus in a large Belgian family with occipitotemporal lobe epilepsy associated with migraine with visual aura and to describe the clinical,
electrophysiologic, and imaging characteristics.
Pediatric Surgery International Volume 23, Number 6 / June, 2007 571-574
The concentration of metabolites of neurohormones in cerebrospinal fluid (CSF) is an index of turnover of substances in brain parenchyma. The raised intracranial pressure in hydrocephalic children may cause alteration in the metabolism of
neurohormones. Serotonin and its metabolite 5-HIAA have been studied extensively in CSF of patients with neuropsychiatric diseases.
The rehabilitation of the traumatic brain injury (TBI) patient is especially challenging in non-western populations as the phenotypic indicators as well as the neurobehavioral assessments for the survivors of brain injury are limited.
Clinical Endocrinology, Volume 66, Number 6, June 2007, pp. 833-837(5)
Patients who have sustained aneurysmal subarachnoid haemorrhage (SAH) often suffer persistent impairments in their quality of life
(QoL) and psychological disturbances despite a good neurological outcome.
Most perinatal arterial stroke (PAS) studies that investigated infant characteristics have excluded preterm infants from the study population. We sought to analyze the imaging findings and antenatal and perinatal risk factors in preterm infants with PAS.
Changes in patterns of regional cerebral blood flow (rCBF) were assessed over a period of 6 years in 14 treated hypertensive participants
(HTNs) and 14 age-matched healthy older participants (healthy controls
[HCs]) in the Baltimore Longitudinal Study of Aging.
We used transcranial Doppler to screen 3,057 patients who had at least one vascular risk factor of hypertension, diabetes, or hyperlipidemia and found 385 (12.6%) had middle cerebral artery
stenosis. Elderly, hypertension, diabetes, and hyperlipidemia were associated factors.
Surgery for intractable temporal lobe epilepsy usually controls seizures and improves health-related quality of life
(HRQOL), but some patients experience continued seizures, memory decline, or both. The relative impact of these unfavorable outcomes on HRQOL has not been described.
To assess the clinical and radiological long-term outcome after aneurysmal subarachnoid hemorrhage
(SAH) in a defined referral area regarding recurrent SAH and de novo aneurysm formation.
Neurosurgery. 60(6):1050-1058, June 2007
Sports medicine clinicians commonly use multiple tests when evaluating patients with concussion. The specific tests vary but often include symptom inventories,
posturography, and neurocognitive examinations. The sensitivity of these tests to concussion is vital in reducing the risk for additional injury by prematurely returning an athlete to play.
Surgical treatment may be required for large petroclival meningiomas; however, surgery for these lesions is a major undertaking, and modern surgical approaches are still associated with considerable morbidity and recurrence rates.
To evaluate patients' clinical outcome, survival, and performance status, at the long-term follow-up evaluation after aggressive microsurgical resection of petroclivaTl
meningiomas.
Although relevant information exists regarding the chance of obliterating arteriovenous malformations (AVMs) using
radiosurgery, the overall chance of cure after gamma knife radiosurgery is usually only extrapolated from a portion of all monitored patients. This chance and the risks involved in
radiosurgery, including repeat treatment when necessary in a defined population of treated patients, were analyzed in our study.
A large number of traditional Chinese patent medicine (TCPM) are widely used for ischemic stroke in China. The aim of this study was to systematically review the existing clinical evidence on TCPM for ischemic stroke.
The Food and Drug Administration has established requirements for protecting the public health by assuring the safety and effectiveness of a variety of medical products including drugs, devices, and biological products, and for promoting public health by expediting the approval of treatments that are safe and effective.
To assess the incidence of late post-traumatic epilepsy (PTE) in patients with very severe traumatic brain injury
(TBI) who either received or did not receive anti-epileptic prophylactic treatment.
Impaired cerebral vascular reserve (CVR) in patients with symptomatic internal carotid artery (ICA) occlusion is regarded as a possible indication for performing extra-/intracranial (EC/IC) bypass surgery. As perfusion MR imaging
(MRI) can demonstrate cerebral haemodynamics at capillary level, our hypothesis was that perfusion MRI could be used in these patients for the evaluation of CVR following acetazolamide challenge in a similar way to single photon emission CT
(SPECT) and might provide additional information.
Few pediatric reports of thrombolysis exist. We sought to determine national rates of thrombolysis among pediatric ischemic stroke patients using a national database.
To characterize different forms of intracranial artery dissections (IADs), and to test the assumption that IADs are frequently associated with subarachnoid hemorrhage
(SAH) and poor outcome, and that anticoagulant therapy is contraindicated in these patients.
The NeuroThera Effectiveness and Safety Trial-1 (NEST-1) study evaluated the safety and preliminary effectiveness of the NeuroThera Laser System in the ability to improve 90-day outcomes in ischemic stroke patients treated within 24 hours from stroke onset. The NeuroThera Laser System therapeutic approach involves use of infrared laser technology and has shown significant and sustained beneficial effects in animal models of ischemic stroke.
The aim of this statement is to present current and comprehensive recommendations for the diagnosis and treatment of acute spontaneous intracerebral hemorrhage.
West Nile virus (WNV) infection can cause severe meningitis and encephalitis in humans. Apoptosis was recently shown to contribute to the pathogenesis of WNV encephalitis. Here, we used
WNV-infected glioma cells to study WNV-replication and WNV-induced apoptosis in human brain-derived cells.
Journal of Clinical Oncology, Vol 25, No 16 (June 1), 2007: pp. 2306-2312
There is no accepted standard of care for the chemotherapy treatment of metastatic brain tumors, which has been generally limited to lipophilic
alkylators, which may not have efficacy against the tumor that metastasized to the brain. More than 50% of chemotherapy agents are natural product drugs, which are rarely used in the treatment of metastatic brain tumors because they are thought to not cross the blood-brain barrier (BBB).
We report a case of Hashimoto's encephalopathy with detailed neuropsychological testing before, during and after steroid treatment, allowing a more precise characterization of the deficits and their response to treatment. It highlights that behavioral and psychotic symptoms remit before cognitive deficits and suggests that the latter may be more appropriate for guiding the duration of steroid treatment.
To compare high-field, high-resolution, susceptibility-weighted magnetic resonance imaging (3 Tesla [T]
HR-SW-MRI) and standard (1.5 Tesla [T]) MRI for the detection of cerebral
cavernomas. To evaluate the ability of 3 T HR-SW-MRI to visualize intralesional structures compared with standard (1.5 T)
MRI, in correlation with histopathologic findings.
Depression is common after stroke. Reported frequencies vary widely between studies because of differences in patient selection, time from stroke to assessment, evaluation methods and diagnostic criteria. Poststroke depression is related to increased mortality and poorer rehabilitation outcome.
Stroke is a major healthcare issue worldwide with an incidence comparable to coronary events, highlighting the importance of understanding risk factors for stroke and subsequent mortality.
Abnormalities in neurocognitive function are common after surgery for aneurysmal subarachnoid hemorrhage, even among patients with good functional outcomes. The time course of neurocognitive recovery, along with the long-term effects of mild intraoperative hypothermia and aneurysm location, is unknown.
Journal of Palliative Medicine Apr 2007, Vol. 10, No. 2 : 367 -374
The primary objective of this study was to assess whether there was an improvement in quality of life for patients with brain metastases as measured 1 and 2 months after a course of whole-brain radiotherapy. The secondary objective was to assess the level of agreement between patient and proxy quality of life scores.
Journal of Clinical Neuroscience Volume 14, Issue 5, May 2007, Pages 429-434
Early identification of mood disorder post-stroke (MDPS) or its determinants could improve stroke outcomes. However, the natural history, prevalence and determinants of MDPS within the first weeks post-stroke require further investigation.
The distribution of 3-month modified Rankin scale (mRS) scores has been used as an outcome measure in acute stroke trials. We hypothesized that hospitalization and institutional care home stays within the first 90 days after stroke should be closely related to 90-day
mRS, that each higher mRS category will reflect incremental cost, and that resource use may be less clearly l
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