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We seek to determine whether cellular radiosensitivity in nineteen human colorectal tumor cell lines and three human glioblastoma tumor cell lines segregate into statistically distinct groups and whether such groups correlate with gene expression. We measure clonogenic survival in 22 cell lines that vary in radiosensitivity and in expression of selected genes: ATM, TP53, CDKN1A, 14-3-3b.sigma, Ki-ras and DNA mismatch repair genes.
Journal of Neurosurgery Pediatrics July 2007 Volume 107 Number 1
Childhood radiation exposure increases the lifetime risk of cancer from an estimated 0.07 to 0.35%. Neurological evaluation of patients after cranial vault reconstruction for synostosis repair is often complicated by pain medication, sedation, intubation, swelling, and dressings; therefore computed tomography (CT) scans are routinely ordered by some surgeons on the 1st postoperative day. The object of this study was to evaluate the utility of these scans.
Journal of Neurosurgery: Pediatrics July 2007 Volume 107 Number 1
The objectives of this study were to assess, in a cohort of children with recently treated hydrocephalus, the correlation between scores on the Hydrocephalus Outcome Questionnaire
(HOQ) and the children’s type of schooling and motor functioning, and to assess the overall outcome of the children.
Journal of Neurosurgery: Pediatrics July 2007 Volume 107 Number 1
There is scant literature regarding the long-term outcome in patients with cranial vault
encephaloceles, and what literature there is may underestimate long-term deficits. The goal of this study was to address this lack of information.
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.
Some degree of recanalization is reported in up to one-third of intracranial aneurysms treated with endovascular coiling. A technical development potentially effective in avoiding recanalization is the Matrix Detachable Coil (MDC), which is covered with a biodegradable polymeric material that enhances
intra-aneurysmal clot organization and fibrosis.
Epileptic Disorders. Volume 9, Number 2, 153-7, June 2007
Video telemetry in a 15-year-old boy with moderate learning difficulties revealed episodes of staring and cessation of activity, followed by sudden stiffening of the body for several seconds, abduction of the arms and a brief vocal utterance (“ugh”). Each episode lasts around 30 seconds, 3-4 times/day despite treatment. The EEG showed generalized 3-4Hz spike-wave discharges during the “absence” period followed immediately by a run of fast polyspikes typical of a tonic seizure, terminating in a run of 1-2 Hz sharp-slow wave complexes. Although tonic-absence seizures have been reported rarely, the clinical sequence appears to be reversed in this patient, with the occurrence of 'absence-tonic ' attacks. We present video documentation of such attacks and discuss their
nosology.
The knowledge of the pathophysiology after traumatic head injury is necessary for adequate and patient-oriented treatment. As the primary insult, which represents the direct mechanical damage, cannot be therapeutically influenced, target of the treatment is the limitation of the secondary damage (delayed non-mechanical damage).
To examine the risk of sustaining a traumatic brain injury (TBI) associated with prior psychiatric conditions beyond that of fixed demographic variables.
Priorities in the care of stroke patients are often intuitive. An open and translucent priority-setting procedure would benefit patients, professionals, and decision-makers. Prioritization is an innovative part of the new Swedish national stroke guidelines.
There is little information on how to best measure poststroke fatigue. Our aim was to identify which currently available fatigue scale is most valid, feasible, and reliable in stroke patients.
Although FMTLE is a heterogeneous syndrome, one important subgroup is characterized by a relatively benign course, absence of antecedent febrile seizures, and absence of hippocampal sclerosis. These patients have predominantly simple partial seizures
(SPS) and infrequent complex partial seizures (CPS), and intense and frequent déj vu phenomenon may be the only manifestation of this epilepsy syndrome. No linkage has been described in this form of
FMTLE.
Epileptic Disorders. Volume 9, Number 2, 182-5, June 2007
We report on a patient suffering from symptomatic spinal attacks in the form of a paroxysmal "positive"
(algetic-tonic) Brown-Séquard syndrome. A cervical cord lesion, presumably
inflammatory-demyelinating in origin, was identified as the morphological correlate of these attacks. Their pathogenesis is discussed in the light of similar case reports from the literature. For the first time, this rare type of seizure is published with a video documentation.
Epileptic Disorders. Volume 9, Number 2, 194-236, June 2007
The Sixth Epilepsy Research Foundation workshop, held in Oxford in March 2006, brought together basic scientists, geneticists, epidemiologists, statisticians, pharmacologists and clinicians to consider progress, issues and strategies for harnessing genetics to improve the understanding and treatment of the epilepsies.
Most human phenotypic characteristics are determined by the interplay of environmental factors (whether external, or related to the internal milieu) with the unique genetic attributes of the individual.
European Radiology, Volume 17, Number 5, May 2007 , pp. 1221-1225(5)
The purpose of this study was to assess the feasibility of high spatial resolution, selective arterial phase, 3D contrast-enhanced (CE) MR angiography with first pass bolus, software-trigger, elliptical centric view ordering in the detection of intracranial aneurysms.
Ischaemic/hypoxic insults to the brain during surgery and anaesthesia can result in long-term disability or death. Advances in resuscitation science encourage progress in clinical management of these problems. However, current practice remains largely founded on extrapolation from animal studies and limited clinical investigation.
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.
Journal of Neurosurgical Anesthesiology. 19(3):195-199, July 2007
There are limited data on the effect of dexmedetomidine on epileptiform electroencephalogram (EEG). The aim of this study was to investigate if dexmedetomidine will abolish epileptiform discharges in patients with medically refractory seizure disorders who were candidates for surgery to resect foci of epileptic activity. With approval from the Institutional Review Board and written informed consent, we enrolled 5 patients with medically intractable seizures who were undergoing continuous video/EEG monitoring.
Head injury remains an important cause of death and disability in young adults. This review will discuss the role of structural imaging using computed tomography (CT) and magnetic resonance imaging
(MRI) and physiological imaging using CT perfusion, 131Xe CT, MRI and spectroscopy
(MRS), single photon emission computed tomography, and positron emission tomography (PET) in the assessment, management, and prediction of outcome after head injury.
British Journal of Neurosurgery, Volume 21, Issue 2 April 2007 , pages 210 - 216
Traumatic brain injury (TBI) is the commonest cause of death and disability in young adults living in industrialised countries. Recently, several studies have shown that hypopituitarism is a common complication of head trauma, with a prevalence of at least 25% among patients who were studied months or years following injury. This remarkably high frequency has changed the traditional concept of hypopituitarism being a rare complication of
TBI, and suggests that most cases of posttraumatic hypopituitarism remain undiagnosed and untreated in clinical practice.
To compare deformation-based maps of local anatomical size between subjects with frontotemporal dementia
(FTD) and healthy subjects to identify regions of the brain involved in
FTD.
Whereas neuroblastoma (NB) with MYCN amplification presents a poor prognosis, no single marker allows to reliably predict outcome in tumours without MYCN amplification. We report here an extensive analysis of 147 NB samples at diagnosis, without MYCN amplification, by chromosomal comparative genomic hybridisation
(CGH), providing a comprehensive overview of their genomic imbalances.
Journal of the Medical Association of Thailand Vol90 No. 6.1089
The stroke unit has been established as a standard care for stroke. However, it has not been widely established in developing countries due to the lack of understanding and limited resources.
To explore the relationship between serum testosterone levels, age, length of stay, admission, discharge and changes in functional capacity over time among patients with traumatic brain injury treated in a rehabilitation hospital.
We recently demonstrated that recombinant activated factor VII (rFVIIa) given to patients presenting within 3 h of acute spontaneous intracerebral hemorrhage
(ICH) reduces mortality (18% vs. 29%) and poor outcome (modified Rankin Scale,
mRS, 4-6, 53 vs. 69%). This analysis was performed to determine the impact of rFVIIa on health-related quality of life
(HRQoL) in those patients.
The number of persons reaching the age 80 years and over is increasing in most populations. Literature focusing on hypertensive intracerebral hemorrhage
(ICH) inthis age group is lacking. Therefore, we aimed to analyze the main clinical characteristics of ICH of the advanced old age, in the context of hypertension.
More than ten years after its approval intravenous thrombolysis with rtPA still is the only approved therapy for acute ischemic stroke. In this review we aim to give an up-to-date overview of acute stroke imaging within and outside of approved indications for
thrombolysis.
Sex differences in the management of acute coronary symptoms are well documented. We sought to determine whether sex disparities exist in acute stroke management, particularly with regard to early hospital admission and thrombolytic therapy.
The clinical and radiological aspects of hypoxic brain injury without ischemia are not well characterized. A spectrum of clinical manifestations have been observed in patients that recover from hypoxic brain injury, including a subset that demonstrate persistent motor system disturbances. Early Magnetic Resonance Imaging
(MRI) studies have shown abnormalities in basal ganglia, cerebral and cerebellar cortex.
Glioblastoma multiforme (GBM) is an incurable malignancy with inherent tendency to recur. In this study, we have comparatively analyzed the epigenetic profile of 32 paired tumor samples of relapsed GBM and their corresponding primary neoplasms with special attention to genes involved in the mitochondria-independent apoptotic pathway.
Neurocritical Care April 2007, Volume 6, Issue 2, pps. 158-158
The patient had a myelogram performed in 1970. At that time, myelograms were performed using Pantopaque contrast agent, a mixture of iodinated esters with an oily consistency. Small droplets of the contrast agent would frequently linger in the subarachnoid space and remain visible even decades after injection. Intracranial Pantopaque may be observed on head CT as hyperdense droplets along the subarachnoid space.
Journal of Trauma-Injury Infection & Critical Care. 62(5):1259-1263, May 2007
Recent studies suggest racial disparities in the treatment and outcomes of children with traumatic brain injury
(TBI). This study aims to identify race-based clinical and functional outcome differences among pediatric TBI patients in a national database.
To examine the impact of exercise training on the relation between whole body, regional and intermuscular adipose tissue
(IMAT) and glucose tolerance, insulin action and lipid profile.
Limited evidence was available on the metabolic syndrome and risk of cardiovascular disease in Asia. The purpose of this study is to examine the association of the metabolic syndrome and risk of ischemic cardiovascular disease in Japanese men and women.
Epileptic Disorders. Volume 9, Number 2, 149-52, June 2007
Continuous synchronized video-EEG-polygraphic recordings allow us to better define the electroclinical patterns of epileptic events and to study the semiological features of neonatal seizures. Recently, complex behaviours and motor automatisms in newborns have been reported as being epileptic in nature. However, the debate on physiopathology (cortical or brainstem release phenomena) is ongoing. We present the synchronized video-EEG documentation of epileptic complex motor behaviours in a newborn male. Our case contributes to the discussion regarding the semiological classification of the neonatal seizures.
Journal of Trauma-Injury Infection & Critical Care. 62(6):1330-1338, June 2007
Prehospital intubation has been challenged on the grounds that it predisposes to hyperventilation, which is detrimental after traumatic brain injury
(TBI), and impairs venous return in patients with hypovolemia. We sought to determine the incidence of hyperventilation among a cohort of trauma patients undergoing prehospital intubation and the impact of ventilation on outcome after severe
TBI.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:497-500
To compare the preoperative and postoperative health-related quality of life
(QOL) and psychological state of patients with asymptomatic unruptured intracranial aneurysms
(ICAs) who underwent elective surgery.
Recently, a number of developments in the acute management of stroke have necessitated active involvement of neurocritical care. This review focuses on the immediate care, including intensive care, that may make a difference to the patient outcome.
Sixty-four individuals at least 1 year post-TBI underwent neuroendocrine testing including thyroid, adrenal, gonadal axes and growth hormone
(GH) after glucagon stimulation with assessment of fatigue using the Global Fatigue Index
(GFI) and the Fatigue Severity Scale (FSS).
To characterize the efficacy and safety of antithrombotic agents for stroke prevention in patients who have atrial fibrillation, adding 13 recent randomized trials to a previous meta-analysis.
Australian Journal of Rural Health, Volume 15, Number 3, June 2007 , pp. 172-178(7)
To identify the factors influencing participation and outline the benefits and challenges of providing transitional rehabilitation for people with spinal cord injury (SCI) from rural and regional locations.
To extend current theoretical models predicting life satisfaction post-spinal cord injury (SCI). Our primary model predicting life satisfaction as measured by the Satisfaction with Life Scale
(SWLS) examined demographic characteristics, elements of the International Classification of Functioning and subjective and objective measures of health.
Emerging evidence from numerous laboratories supports the notion that brain tumors arise from cells with stem
cell/neuroglial progenitor cell properties ("cancer stem cells"). Two recent studies suggest that histologically similar tumors from different brain regions are molecularly distinct because they arise from distinct populations of site-restricted progenitor cells. These new findings imply an interaction between the cell of origin, the tumor microenvironment, and specific cancer-causing genetic changes in the evolution of central nervous system tumors.
Traumatic brain injury (TBI) remains a major cause of morbidity and mortality, particularly in young people. Despite encouraging animal studies, human trials assessing the use of pharmacological agents after TBI have all failed to show efficacy. Current management strategies are therefore directed towards providing an optimal physiological environment in order to minimize secondary insults and maximize the body's own regenerative processes.
The purpose of this study was to validate the method of performing fetal brain
volumetry. In particular, our objectives were to assess which imaging plane is most reproducible for the performance of brain volumetry measurements and to ascertain inter- and intraobserver variability in determining brain volume in fetuses referred for ventriculomegaly
(VM).
Prostaglandin E2 plays multiple roles both in the physiology and the physiopathology of human brain, which are not completely understood. We have identified in a subset of human glioblastoma multiforme
(GBM) tumors, the most common form of adult brain cancer, an increased expression of mPGES-1, the enzyme which catalyses the isomerization of PGH2 into PGE2 downstream of cyclooxygenase 2 (COX-2).
Stereotactic and Functional Neurosurgery 2007;85:158-161
The 'precentral knob', a cortical representation of the motor hand function, can be identified and localized consistently using magnetic resonance imaging
(MRI) and functional MRI.
Intraoperatively magnetic resonance (MR)-guided neurosurgical operations have been done since 1996, mostly for brain tumors. Several different concepts for intraoperative MRI procedures using low-, middle-, and high-field MR scanners have been reported from pioneering neurosurgical centers. In this article, we present the different solutions used in these centers from a practical point of view. More thoroughly, we present our own concept and experience of 160 craniotomies since 1999 in an operation theater equipped with a low-field (0.23T) scanner, which can be turned on and off during surgery.
Television advertising has been associated with significant increases in the knowledge of the warning signs of stroke among Ontarians aged 45 and older. However, to date there has been little data on the relationship between knowledge of the warning signs of stroke and behavior.
Outcome after first stroke varies significantly across Europe. This study was designed to compare motor and functional recovery after stroke between four European rehabilitation centers.
There are limited and conflicting data on gender differences in clinical outcomes among patients with symptomatic intracranial arterial
stenosis. This study examined gender differences in patients enrolled in the
Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Study.
MRI negative PET positive temporal lobe epilepsy represents a substantial minority of temporal lobe epilepsy
(TLE). Clinicopathological and qualitative imaging differences from mesial temporal lobe epilepsy are reported. We aimed to compare TLE with hippocampal sclerosis
(HS+ve) and non lesional TLE without HS (HS-ve) on MRI, with respect to quantitative
FDG-PET and MRI measures.
Matrix metalloproteinases (MMPs) are a family of extracellular endopeptidases that degrade the extracellular matrix and other extracellular proteins. Studies in experimental animals demonstrate that MMPs play a number of roles in the detrimental as well as in the beneficial events after spinal cord injury (SCI). In the present correlative investigation, the expression pattern of several MMPs and their inhibitors has been investigated in the human spinal cord.
Glioblastoma multiforme (GBM) is an incurable malignancy with inherent tendency to recur. In this study, we have comparatively analyzed the epigenetic profile of 32 paired tumor samples of relapsed GBM and their corresponding primary neoplasms with special attention to genes involved in the mitochondria-independent apoptotic pathway.
Neurocritical Care April 2007, Volume 6, Issue 2, pps. 158-158
The patient had a myelogram performed in 1970. At that time, myelograms were performed using Pantopaque contrast agent, a mixture of iodinated esters with an oily consistency. Small droplets of the contrast agent would frequently linger in the subarachnoid space and remain visible even decades after injection. Intracranial Pantopaque may be observed on head CT as hyperdense droplets along the subarachnoid space.
Journal of Trauma-Injury Infection & Critical Care. 62(5):1259-1263, May 2007
Recent studies suggest racial disparities in the treatment and outcomes of children with traumatic brain injury
(TBI). This study aims to identify race-based clinical and functional outcome differences among pediatric TBI patients in a national database.
To examine the impact of exercise training on the relation between whole body, regional and intermuscular adipose tissue
(IMAT) and glucose tolerance, insulin action and lipid profile.
Limited evidence was available on the metabolic syndrome and risk of cardiovascular disease in Asia. The purpose of this study is to examine the association of the metabolic syndrome and risk of ischemic cardiovascular disease in Japanese men and women.
Epileptic Disorders. Volume 9, Number 2, 149-52, June 2007
Continuous synchronized video-EEG-polygraphic recordings allow us to better define the electroclinical patterns of epileptic events and to study the semiological features of neonatal seizures. Recently, complex behaviours and motor automatisms in newborns have been reported as being epileptic in nature. However, the debate on physiopathology (cortical or brainstem release phenomena) is ongoing. We present the synchronized video-EEG documentation of epileptic complex motor behaviours in a newborn male. Our case contributes to the discussion regarding the semiological classification of the neonatal seizures.
Journal of Trauma-Injury Infection & Critical Care. 62(6):1330-1338, June 2007
Prehospital intubation has been challenged on the grounds that it predisposes to hyperventilation, which is detrimental after traumatic brain injury
(TBI), and impairs venous return in patients with hypovolemia. We sought to determine the incidence of hyperventilation among a cohort of trauma patients undergoing prehospital intubation and the impact of ventilation on outcome after severe
TBI.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:497-500
To compare the preoperative and postoperative health-related quality of life (QOL) and psychological state of patients with asymptomatic unruptured intracranial aneurysms
(ICAs) who underwent elective surgery.
Recently, a number of developments in the acute management of stroke have necessitated active involvement of neurocritical care. This review focuses on the immediate care, including intensive care, that may make a difference to the patient outcome.
Sixty-four individuals at least 1 year post-TBI underwent neuroendocrine testing including thyroid, adrenal, gonadal axes and growth hormone
(GH) after glucagon stimulation with assessment of fatigue using the Global Fatigue Index
(GFI) and the Fatigue Severity Scale (FSS).
To characterize the efficacy and safety of antithrombotic agents for stroke prevention in patients who have atrial fibrillation, adding 13 recent randomized trials to a previous meta-analysis.
Australian Journal of Rural Health, Volume 15, Number 3, June 2007 , pp. 172-178(7)
To identify the factors influencing participation and outline the benefits and challenges of providing transitional rehabilitation for people with spinal cord injury (SCI) from rural and regional locations.
To extend current theoretical models predicting life satisfaction post-spinal cord injury (SCI). Our primary model predicting life satisfaction as measured by the Satisfaction with Life Scale
(SWLS) examined demographic characteristics, elements of the International Classification of Functioning and subjective and objective measures of health.
Emerging evidence from numerous laboratories supports the notion that brain tumors arise from cells with stem
cell/neuroglial progenitor cell properties ("cancer stem cells"). Two recent studies suggest that histologically similar tumors from different brain regions are molecularly distinct because they arise from distinct populations of site-restricted progenitor cells. These new findings imply an interaction between the cell of origin, the tumor microenvironment, and specific cancer-causing genetic changes in the evolution of central nervous system tumors.
Traumatic brain injury (TBI) remains a major cause of morbidity and mortality, particularly in young people. Despite encouraging animal studies, human trials assessing the use of pharmacological agents after TBI have all failed to show efficacy. Current management strategies are therefore directed towards providing an optimal physiological environment in order to minimize secondary insults and maximize the body's own regenerative processes.
The purpose of this study was to validate the method of performing fetal brain
volumetry. In particular, our objectives were to assess which imaging plane is most reproducible for the performance of brain volumetry measurements and to ascertain inter- and intraobserver variability in determining brain volume in fetuses referred for ventriculomegaly
(VM).
Prostaglandin E2 plays multiple roles both in the physiology and the physiopathology of human brain, which are not completely understood. We have identified in a subset of human glioblastoma multiforme
(GBM) tumors, the most common form of adult brain cancer, an increased expression of mPGES-1, the enzyme which catalyses the isomerization of PGH2 into PGE2 downstream of cyclooxygenase 2 (COX-2).
Stereotactic and Functional Neurosurgery 2007;85:158-161
The 'precentral knob', a cortical representation of the motor hand function, can be identified and localized consistently using magnetic resonance imaging
(MRI) and functional MRI.
Intraoperatively magnetic resonance (MR)-guided neurosurgical operations have been done since 1996, mostly for brain tumors. Several different concepts for intraoperative MRI procedures using low-, middle-, and high-field MR scanners have been reported from pioneering neurosurgical centers. In this article, we present the different solutions used in these centers from a practical point of view. More thoroughly, we present our own concept and experience of 160 craniotomies since 1999 in an operation theater equipped with a low-field (0.23T) scanner, which can be turned on and off during surgery.
Television advertising has been associated with significant increases in the knowledge of the warning signs of stroke among Ontarians aged 45 and older. However, to date there has been little data on the relationship between knowledge of the warning signs of stroke and behavior.
Outcome after first stroke varies significantly across Europe. This study was designed to compare motor and functional recovery after stroke between four European rehabilitation centers.
There are limited and conflicting data on gender differences in clinical outcomes among patients with symptomatic intracranial arterial
stenosis. This study examined gender differences in patients enrolled in the
Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Study.
MRI negative PET positive temporal lobe epilepsy represents a substantial minority of temporal lobe epilepsy
(TLE). Clinicopathological and qualitative imaging differences from mesial temporal lobe epilepsy are reported. We aimed to compare TLE with hippocampal sclerosis
(HS+ve) and non lesional TLE without HS (HS-ve) on MRI, with respect to quantitative
FDG-PET and MRI measures.
Matrix metalloproteinases (MMPs) are a family of extracellular endopeptidases that degrade the extracellular matrix and other extracellular proteins. Studies in experimental animals demonstrate that MMPs play a number of roles in the detrimental as well as in the beneficial events after spinal cord injury (SCI). In the present correlative investigation, the expression pattern of several MMPs and their inhibitors has been investigated in the human spinal cord.
The G protein-coupled formylpeptide receptor (FPR), which mediates leukocyte migration in response to bacterial and host-derived chemotactic peptides, promotes the
chemotaxis, survival, and tumorigenesis of highly malignant human glioblastoma cells. Because glioblastoma cells may also express other receptors for growth signals, such as the epidermal growth factor
(EGF) receptor (EGFR), we investigated the role of EGFR in the signaling cascade of FPR and how two receptors cross-talk to exacerbate tumor growth.
In a genome-wide screen using differential methylation hybridization (DMH), we have identified a CpG island within the 5' region and untranslated first exon of the secretory granule neuroendocrine protein 1 gene (SGNE1/7B2) that showed hypermethylation in medulloblastomas compared to fetal cerebellum. Bisulfite sequencing and combined bisulfite restriction assay were performed to confirm the methylation status of this CpG island in primary medulloblastomas and medulloblastoma cell lines.
International Clinical Psychopharmacology. 22(3):159-166, May 2007
Given the high incidence of poststroke depression, its serious sequelae, and inherent problems with diagnosis, prophylactic use of antidepressants may be a viable management strategy in patients experiencing stroke. The purpose of this study was to assess the prophylactic effects of antidepressants in nondepressed patients with stroke.
Traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide. The modern management of severe TBI has fallen into the domain of a multidisciplinary team led by
neurointensivists, neuroanaesthetists, and neurosurgeons and is based on the avoidance of secondary injury, maintenance of cerebral perfusion pressure
(CPP), and optimization of cerebral oxygenation.
Journal of Trauma-Injury Infection & Critical Care. 62(6):1339-1345, June 2007
Controversy exists as to the role of a routine repeat head computed tomography (CT) for patients with traumatic brain injury and an initially abnormal head CT. The specific aim of this study is to identify patients with head injuries who would benefit from a routine repeat head CT.
Journal of Clinical Oncology, Vol 25, No 18 (June 20), 2007: pp. 2601-2606
Prognostic factor analyses have proven useful in predicting outcome in patients with newly diagnosed malignant
glioma. Similar analyses in patients with recurrent glioma could affect the design and conduct of clinical trials substantially.
Neuroanaesthesia continues to develop and expand. It is a speciality where the knowledge and expertise of the anaesthetist can directly influence patient outcome. Evolution of neurosurgical practice is accompanied by new challenges for the
anaesthetist.
British Journal of Neurosurgery, Volume 21, Issue 1 February 2007 , pages 3 - 6
Recently published data from the International Subarachnoid Aneurysm Trial
(ISAT) shows that for patients enrolled in the trial there is a 7.4% reduction in the incidence of death or dependency at 1 year if they undergo coiling, rather than clipping. Furthermore, extrapolation of longer-term follow-up data for patient mortality appears to suggest that this advantage will be maintained in the longer term.
Medicine & Science in Sports & Exercise. 39(6):903-909, June 2007
The purpose of our study was to investigate the association between prior head injury and the likelihood of being diagnosed with clinical depression among retired professional football players with prior head injury exposure.
British Journal of Neurosurgery, Volume 21, Issue 2 April 2007 , pages 210 - 216
Traumatic brain injury (TBI) is the commonest cause of death and disability in young adults living in industrialised countries. Recently, several studies have shown that hypopituitarism is a common complication of head trauma, with a prevalence of at least 25% among patients who were studied months or years following injury. This remarkably high frequency has changed the traditional concept of hypopituitarism being a rare complication of
TBI, and suggests that most cases of posttraumatic hypopituitarism remain undiagnosed and untreated in clinical practice.
British Journal of Neurosurgery, Volume 21, Issue 3 June 2007 , pages 276 - 280
The aim of this study is to define the indications to endoscopy versus other surgical procedures in the management of suprasellar arachnoid cysts from a personal series and an extensive literature review. Five symptomatic patients (two children and three adults) with suprasellar arachnoid cysts were treated by endoscopic fenestration in our neurosurgical unit. The endoscopic procedure consisted of
ventricle-cyst-cisternostomy in three cases and ventricle-cystostomy in two.
ish Journal of Neurosurgery, Volume 21, Issue 3 June 2007 , pages 272 - 275
The object of this study was to determine the relationship between outcome (assessed by Glasgow Outcome Scale) and recurrence in chronic subdural haematoma
(CSDH). Eighty-two consecutive patients who underwent surgery for CSDH were included in this study.
Sudden visual loss after an uncomplicated craniotomy can be a devastating aftermath. This complication is recognized following prolonged spinal surgeries performed in prone position. The authors report a case where an uncomplicated standard
fronto-temporal craniotomy performed in supine position for a ruptured anterior communicating artery
(AComA) aneurysm resulted in permanent visual loss in the ipsilateral eye. Various
aetio-pathological mechanisms and medico-legal consequences are discussed.
An 80-year-old man with a history of Type 2 diabetes mellitus was hospitalized due to generalized convulsive status
epilepticus. Initially, hyperglycemia and ketoacidosis were diagnosed, but his seizures were refractory to the medical treatment. Additionally, a high level of serum theophylline (29.1
mg/mL) was detected.
Hypertensive intracranial haemorrhages are generally located in defined sites and have a relatively typical pattern of extension. We report an unusual case where there were simultaneous spontaneous thalamic and cerebellar haemorrhages in a patient with known hypertension. Presence of two discrete and unconnected clots is rare in hypertensive bleeds and only isolated cases have been recorded in the literature.
Medical complications significantly contribute to the incidence of morbidity and mortality after aneurysmal subarachnoid hemorrhage
(SAH) and it may be as high as that caused by the direct effects of
SAH, re-bleeding and vasospasm. Pulmonary dysfunction was responsible for 50% of all deaths.
Parry Romberg's syndrome is an uncommon disorder characterized by atrophy of skin and subcutaneous tissue of one side of face. It has neurologic sequel. The commonest of which is epilepsy. Here, we present a 17-year old girl with features of Parry Romberg's disease with intractable epilepsy. Her seizures have stopped with systemic corticosteroids.
New-onset acute symptomatic seizures can be the presenting feature of acute neurological diseases. The etiological spectrum of new-onset acute symptomatic seizures and outcome may be different in developing countries when compared to developed countries.
Neuronavigation provides a patient-specific, three-dimensional (3-D) anatomy for preoperative planning and intraoperative navigation. However, the initial and maintenance costs are quite prohibitive, especially in the Indian scenario.
We present our initial experience with the high field (1.5T) intra-operative magnetic resonance imaging, the operating room set-up, our initial cases, the difficulties we faced and how this tool affected a change in the surgical strategy intra-operatively and finally our results.
Primary meningeal lymphoma is very rare. We would like to report a case with some unusual features. A 65-year-old diabetic and hypertensive man presented to us with dressing difficulty. On examination, he had dressing and constructional apraxia and right parietal skull bossing. MRI showed a right
temporo-parietal en-plaque meningeal lesion that was isointense to the parenchyma on T1WI, enhanced intensely with gadolinium and was hyperintense on T2WI.
Although the risk reduction of recurrent stroke with angiotensin converting enzyme-inhibitors with or without a diuretic has been demonstrated under randomized double blind conditions of the PROGRESS study, it is unclear whether the benefit is reflected in primary care practice and in populations with different demographic and clinical characteristics.
Stroke and myocardial infarction (MI) are both life-threatening diseases of vascular origin with a tendency to recur. In both conditions, risk of recurrence is reduced through similar drug regimens.
A 64-year-old woman was referred to our hospital because of possible viral
meningo-encephalitis. Two weeks prior to admission she developed a gait disturbance followed by a fever and headache. Neurological examination showed a small steppage gait,
bradykinesia, and rigidity without tremor. However, deep tendon reflexes and cognitive function were normal.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:508-511
To identify the proportion of patients in a large idiopathic normal pressure hydrocephalus
(INPH) cohort with large head circumference (HC) who presumably have congenital hydrocephalus that has not become clinically apparent until late in life.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:527-528
The central compensation of vestibular tonus imbalance due to unilateral peripheral vestibular lesions has been repeatedly documented. Little is known, however, about the central compensation of vestibular tonus imbalance due to central lesions. Dorsolateral medullary infarctions
(Wallenberg’s syndrome) typically cause a central vestibular tonus imbalance in the roll plane with deviations of perceived verticality and ipsiversive body
lateropulsion.
Prediction models for ischemic stroke outcome have the potential to contribute prognostic information in the clinical and/or research setting. The importance of diffusion-weighted magnetic resonance imaging
(DWI) in the prediction of clinical outcome, however, is unclear. The purpose of this study was to combine acute clinical data and DWI lesion volume for ischemic stroke patients to determine whether DWI improves the prediction of clinical outcome.
Within clinical trials, stroke patients allocated to receive organized inpatient (stroke unit) care are more likely to survive, return home, and regain independence than those allocated to conventional care. However, there are concerns that the benefits seen in clinical trials may not be replicated in routine practice. We carried out a systematic review of observational studies of stroke unit implementation.
The perfusion-diffusion mismatch (PDM) model has been proposed as a tool to select acute stroke patients who are most likely to benefit from reperfusion therapy. The clinical-diffusion mismatch
(CDM) model is an alternative method that is technically less challenging because it does not require perfusion-weighted imaging. This study is an evaluation of these 2 models in the DEFUSE dataset.
Aberrant splice variants are involved in the initiation and/or progression of glial brain tumors. We therefore set out to identify splice variants that are differentially expressed between histologic subgroups of
gliomas. Splice variants were identified using a novel platform that profiles the expression of virtually all known and predicted exons present in the human genome.
British Journal of Neurosurgery, Volume 21, Issue 3 June 2007 , pages 272 - 275
The object of this study was to determine the relationship between outcome (assessed by Glasgow Outcome Scale) and recurrence in chronic subdural haematoma
(CSDH). Eighty-two consecutive patients who underwent surgery for CSDH were included in this study.
American Journal of Neuroradiology 28:1102-1106, June-July 2007
Voxel size/shape of diffusion tensor imaging (DTI) may directly affect the measurement of fractional anisotropy (FA) in regions where there are crossing fibers. The purpose of this article was to investigate the effect of voxel size/shape on measured FA by using isotropic and nonisotropic
voxels.
Journal of Pharmacy and Pharmacology, Volume 59, Number 5, May 2007 , pp. 645-653(9)
We have investigated the solid dispersion and dissolution profiles of three antiepileptic drugs
(carbamazepine (CBZ), oxcarbazepine (OXC) and rufinamide (RFN)) with different aqueous
solubilities, prepared by the solvent evaporation method. Solid dispersions of the three drugs in hydroxy-propylmethylcellulose
(HPMC), with drug:polymer ratios of 1:4, were prepared and characterized by differential scanning calorimetry (DSC), Fourier transformation infrared
(FTIR) spectroscopy, X-ray diffraction (XRD) and scanning electron microscopy.
British Journal of Neurosurgery, Volume 21, Issue 3 June 2007 , pages 303 - 306
A patient with posttraumatic CSF rhinorrhoea underwent a transcranial anterior skull base repair, with a lumbar drain being inserted at induction of
anaesthesia. Postoperative neurological deterioration occurred due to brain sag. Following treatment, there was significant recovery albeit in a slow and steady fashion. Patients with brain sag as a result of lumbar drain insertion can make a good recovery, despite an initial presentation with signs of severe brainstem compression, which could easily be misinterpreted as having a poor prognosis. Absence of an initial dramatic response to treatment does not necessarily imply poor outcome in the long term.
Although racial differences in hospital outcomes are well known for medical conditions
(eg, cardiovascular disease), it is unknown whether differences exist for patients with traumatic brain injury
(TBI).
Radiation therapy to the head, given to patients who had responded to chemotherapy for advanced small-cell lung cancer, reduced by about two-thirds the risk that patients’ tumors would spread to the brain, thus extending patients’ lives. These findings are likely to change the standard of care for this group of patients.
American Journal of Neuroradiology 28:1172-1175, June-July 2007
Remodeling balloons are used to assist in endovascular coiling of aneurysms. We evaluated our experience with balloon-assisted coiling
(BAC) in an attempt to determine whether this technique increased the rate of thrombus formation or symptomatic thromboembolic complications.
British Journal of Neurosurgery, Volume 21, Issue 3 June 2007 , pages 276 - 280
The aim of this study is to define the indications to endoscopy versus other surgical procedures in the management of suprasellar arachnoid cysts from a personal series and an extensive literature review. Five symptomatic patients (two children and three adults) with suprasellar arachnoid cysts were treated by endoscopic fenestration in our neurosurgical unit.
A case report of spinal cord infarction following endoscopic variceal ligation. To describe an exceedingly rare case of spinal cord infarction following endoscopic variceal
ligation.
To extend current theoretical models predicting life satisfaction post-spinal cord injury (SCI). Our primary model predicting life satisfaction as measured by the Satisfaction with Life Scale
(SWLS) examined demographic characteristics, elements of the International Classification of Functioning and subjective and objective measures of health. A second model was developed to examine factors that are associated with successful community participation as measured by the Reintegration to Normal Living Index
(RNL).
Insulin resistance and diabetes mellitus have been reported in the spinal cord injured (SCI). The group exhibits risk factors, as decreased physical activity, as well as episodes of stimulation of sympathetic nervous system below the level of lesion known to stimulate
lipolysis, which in turn could induce insulin resistance.
Thyroid hormone (TH) plays a key role in mammalian brain development. The developing brain is sensitive to both TH deficiency and excess. Brain development in the absence of TH results in motor skill deficiencies and reduced intellectual development. These functional abnormalities can be attributed to maldevelopment of specific cell types and regions of the brain including the cerebellum. TH functions at the molecular level by regulating gene transcription.
The construct of 'cognitive rehabilitation' has not been defined in a consensual manner and the variations in usage have produced misunderstanding and controversy. At one extreme, it refers to a paradigm of complex, sophisticated, integrated interventions and at the other to a poorly conceptualized and largely ineffectual service modality. A number of articles criticizing cognitive rehabilitation make little effort to differentiate between these usages, thus subjecting very different clinical procedures to the same complaints.
To examine the risk of sustaining a traumatic brain injury (TBI) associated with prior psychiatric conditions beyond that of fixed demographic variables.
This study aimed to identify models that predicted the short-term outcome after traumatic brain injury
(TBI) from the literature and to evaluate their clinical significance.
This study focused on basic attentional impairments among persons with TBI who were behaviourally evaluated as suffering from either apathetic or disinhibition symptoms.
Examining the evidence from contrasting epistemological sources a case is made for the use of music as an assessment medium with patients in low awareness states. Profound brain damage can result in long-term states of altered consciousness such as vegetative and minimally conscious states. Differential diagnosis with this population is immensely complex requiring diverse approaches. Neuroimaging alone is not, as yet, sufficient to establish diagnosis in this population and must be supplemented by repeated behavioural observation methods from a skilled and diverse treatment team, as there are enormous medico-legal and ethical implications. Evidence from research in neuroimaging and the behavioural health sciences indicates that auditory stimulation can reveal residual functioning and elicit optimal behaviours in such patients, particularly when the stimulation has emotional significance.
To explore articulatory kinematic differences between normal and dysarthric speakers post-traumatic brain injury
(TBI) during syllable and sentence productions.
Research on the ecological validity of neuropsychological tests of executive functioning has been limited by disagreement in the number and make-up of the factors underlying the dysexecutive syndrome. The current study sought to determine whether similar components of everyday executive dysfunction are being measured by the Dysexecutive Questionnaire
(DEX) and the Brock Adaptive Functioning Questionnaire (BAFQ).
This event-related potentials study investigated the long-term effects associated with a history of one or multiple concussions on the N2pc and P3 components using a visual search oddball paradigm.
To explore the relationship between serum testosterone levels, age, length of stay, admission, discharge and changes in functional capacity over time among patients with traumatic brain injury treated in a rehabilitation hospital.
The aim of this study was to evaluate an out-patient attention programme based on a short in-patient phase followed by an out-patient interdisciplinary rehabilitation
programme.
To understand some reasons behind the lack of medical rehabilitation resources in developing regions and to propose some actions that can change this problem.
Approximately 25% of patients with traumatic brain injury (TBI) may develop partial or complete
hypopituitarism. The causative mechanisms involved in its development are not clear. To the authors' knowledge, there have been no recent morphologic studies of the pituitary following
TBI.
To investigate the use of a 'reminders' function on a mobile phone as a compensatory memory aid for five individuals with traumatic brain injury
(TBI).
Nigrostriatal hypodopaminergism is the fundamental basis in parkinsonism. It may arise secondarily from a variety of disorders but is rarely mentioned shortly after surgery.
Cerebral atrophy has been recently recognized as a key marker of disease progression in cerebral
autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy
(CADASIL). The contribution of subcortical cerebral lesions in this process remains undetermined. The aim of this study was to investigate the relationships between cerebral volume and different types of subcortical MRI lesions in
CADASIL.
The modified Atkins diet is a dietary therapy for intractable epilepsy that mimics the ketogenic diet, yet does not restrict protein, calories, and fluids. The ideal starting carbohydrate limit is unknown. Twenty children with intractable epilepsy were randomized to either 10 or 20 g of carbohydrates per day for the initial 3 months of the modified Atkins diet, and then crossed over to the opposite amount.
Glioblastoma multiforme (GBM) is the most malignant type of astrocytoma (World Health Organization Grade IV) and the most common, representing 50 percent of brain astrocytomas and 12 percent to 20 percent of primary brain
neoplasms. In adults, glioblastomas are typically primary lesions (60%). Lower-grade gliomas (World Health Organization Grades I, II, and III) tend to progress to GBM within 10 years or less, but most lesions develop de novo and present after only a short clinical course of less than three months. Unfortunately, GBM also has the worst prognosis of all the
astrocytomas.
Severe traumatic brain injury (TBI) is associated with a 30-70% mortality rate. Nevertheless, controversy has been raised concerning the prognostic value of biomarkers following severe
TBI. Therefore, our aim was to determine whether sFas or TNFagr serum levels correlate with primary outcome following isolated severe
TBI.
Patients with Diffuse axonal injury (DAI) frequently exhibit cognitive disorders chronically. Radiologic recognition of DAI can help understand the clinical syndrome and to make treatment decisions. However, CT and conventional MRI are often normal or demonstrate lesions that are poorly related to the cognitive disorders. Recently, diffusion tensor imaging (DTI) fiber tractography has been shown to be useful in detecting various types of white matter damage.
The aim of the present study was to evaluate the association of contractures with an increase or reduction of non-spastic muscle overactivity due to severe cerebral damage.
Knowledge of the extent and distribution of infarcts of the posterior cerebral artery
(PCA) may give insight into the limits of the arterial territory and infarct mechanism. We describe the creation of a digital atlas of PCA infarcts associated with PCA branch and trunk occlusion by magnetic resonance imaging techniques.
Vaccine Volume 25, Issue 27, 28 June 2007, Pages 5041-5045
In July 1999, a single dose of live-attenuated SA 14-14-2 Japanese encephalitis
(JE) vaccine was administered to children living in the Bardiya, Banke and Kailali districts of Nepal. In 2004, the original vaccinated population experienced a fifth seasonal exposure to
JE.
Emergency Radiology, Volume 14, Number 1, May 2007 , pp. 1-12(12)
A wide variety of imaging findings can be seen in the setting of acute head trauma. The purpose of this manuscript is to review the major computed tomography and magnetic resonance imaging findings of various types of traumatic head injuries with the intent of providing the reader with a means to diagnose these lesions quickly and accurately.
Clinical Cancer Research 13, 3637-3641, June 15, 2007
To define the safety and efficacy of carmustine polymer wafers when added to a regimen of surgery and external beam radiotherapy for treatment of a single brain metastasis.
American Journal of Neuroradiology 28:1001-1008, June-July 2007
MRA is emerging as an alternative to conventional catheter based angiography for the assessment of aneurysms after endovascular treatment. Short TE and contrast enhanced MRA techniques can be applied to optimize image quality. We review the available data regarding the application of MR for the assessment of cerebral aneurysms after endovascular therapy.
Journal of Neurosurgery: Pediatrics June 2007 Volume 106 Number 6
The authors evaluated the initial intracranial pressure (ICP) and cerebral perfusion pressure
(CPP) as prognostic factors in severe head injury in children and tried to determine the optimal CPP range.
This study examined if children with cryptogenic epilepsy and complex partial seizures (CPS) have smaller total brain, frontal, and temporal lobe volumes than normal children and how this is related to seizure, cognitive, psychiatric, and demographic variables.
Ischemia-reperfusion is an established paradigm for the induction of neuro-oxidative stress. The present report highlights the limitations associated with the measurement of free radical exchange across the human brain after carotid endarterectomy if reperfusion hemodynamics are not taken into account.
The purpose of the work described in this article was to evaluate the health-related quality of life
(HRQOL) of adolescents with well-controlled epilepsy.
In national guidelines, absolute long-term risk of myocardial infarction (MI) or coronary death determines target low-density lipoprotein levels, but stroke patients are not explicitly addressed. We determined the absolute 5-year risk of cardiovascular outcomes and their predictors after first ischemic stroke in a multiethnic cohort.
Phencyclidine (PCP), ketamine (Special K), and MK-801 are noncompetitive
N-methyl-d-aspartate (NMDA) antagonists that produce acute psychosis in humans. The psychosis produced by these psychomimetic drugs is indistinguishable from schizophrenia and includes both positive and negative symptoms.
Complementary and alternative medicine (CAM) is recognized to be commonly used by patients, yet there have been few studies regarding the scope of CAM use by patients with epilepsy. This study assessed usage and perceptions of CAM by patients with epilepsy in the midwest of the United States.
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