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Journal of Head Trauma Rehabilitation. Brain Injury versus TBI. 23(3):158-163, May/June 2008
To identify and characterize injury variables and outcomes in persons with traumatic brain injury (TBI) 55 years and older admitted to a tertiary rehabilitation unit.
Journal of Head Trauma Rehabilitation. Brain Injury versus TBI. 23(3):149-157, May/June 2008
To compare patterns of cognitive functioning in older adults with traumatic brain injury (TBI), Alzheimer's disease (AD), and no neurological disorder (ND).
Journal of Head Trauma Rehabilitation. Brain Injury versus TBI. 23(3):139-148, May/June 2008
Cognitive impairments are common sequelae of traumatic brain injury (TBI) and are often associated with the natural process of aging. Few studies have examined the effect of both age and TBI on cognitive functioning.
Journal of Head Trauma Rehabilitation. Brain Injury versus TBI. 23(3):164-167, May/June 2008
Falls are the leading cause of traumatic brain injury (TBI) among older adults aged 75 and older. Despite this burden, many older adults, their caregivers, and professionals are not aware of the importance of TBI as an outcome of falls among older adults.
International Journal of Rehabilitation Research. 31(2):111-117, June 2008
As there is no single, accepted definition of health-related quality of life (HRQOL), it is assumed to be a broad, multidimensional construct referring to those aspects of people's lives that reasonably relate to their health. Although many scales are used to assess HRQOL, the operationalization of this construct within each tool is unclear.
International Journal of Rehabilitation Research. 31(2):177-180, June 2008
The aim of this study was to investigate the effect of ideomotor apraxia on activities of daily living and to determine if the presence of apraxia interferes with rehabilitation.
Epilepsy Research Volume 80, Issue 1, Pages 93-97 (July 2008)
Rasmussen encephalitis (RE) is a rare form of severe unihemispheric epilepsy established to be an autoimmune disease. Here we demonstrate the presence of autoantibodies against Munc18-1 in 20% of patients collective with biopsy-proven RE. Intriguingly, brain biopsy specimens of these patients showed a striking perivascular accentuated infiltration of B-lymphocytes and plasma cells, suggesting a subgroup of RE patients harboring Munc18-1 antibodies and concomitant B- and plasma cell infiltration.
Epilepsy Research Volume 80, Issue 1, Pages 91-92 (July 2008)
A 64-year-old patient with symptomatic epilepsy developed thrombocytopenia during treatment with levetiracetam (LEV). As no other medical reason could be evaluated, a medication side effect was postulated. The only new drugs were valproic acid (since 3 weeks) and levetiracetam (since 3 days). After valproic acid medication was ended, thrombocytopenia did not improve and even worsened further. Finally levetiracetam administration was ended and trombocytopenia resolved rapidly and completely within few days.
Epilepsy Research Volume 80, Issue 1, Pages 83-89 (July 2008)
Our aim is to use the high field MR scanner (3T) to verify whether diffusion tensor imaging (DTI) could help in locating the epileptogenic zone in patients with MRI-negative refractory partial epilepsy.
Epilepsy Research Volume 80, Issue 1, Pages 67-76 (July 2008)
Functional magnetic resonance imaging (fMRI) is being used increasingly for language dominance assessment in the presurgical work-up of patients with pharmacoresistant epilepsy. However, the interpretation of bilateral fMRI-activation patterns is difficult.
Epilepsy Research Volume 80, Issue 1, Pages 57-66 (July 2008)
Many children with epilepsy do not satisfactorily respond to conventional pharmacological therapy, but to the ketogenic diet, a high-fat, low-carbohydrate diet. This diet increases the concentrations of ketone bodies and polyunsaturated fatty acids (PUFAs) in cerebrospinal fluid (CSF) and plasma. However, its anticonvulsant mechanism is not known.
Epilepsy Research Volume 80, Issue 1, Pages 47-56 (July 2008)
Epilepsy is a major public health problem affecting nearly 50 million people world wide. Treatment with anti-epileptic drugs (AEDs) is generally chronic if not life long and may be associated with significant metabolic effects including decreased bone mass and increased fractures.
Epilepsy Research Volume 80, Issue 1, Pages 42-46 (July 2008)
The C3435T polymorphism in the gene coding for P-glycoprotein (ABCB1) has been correlated with drug resistance in patients with epilepsy. However, replication studies have revealed conflicting results and the reason for this is not clear.
Epilepsy Research Volume 80, Issue 1, Pages 23-29 (July 2008)
Indication of gamma-knife surgery (GKS) in temporal lobe epilepsy (TLE) remains a matter of debate. Either positive or negative results have been reported in studies with a maximum follow-up of 24 months. No long-term data have been published yet.
Epilepsy Research Volume 80, Issue 1, Pages 18-22 (July 2008)
Glucose transporter 1 (GLUT1) deficiency syndrome is caused by a deficit in glucose transport to the brain during the pre- and postnatal periods. Here, we report two cases of GLUT1 deficiency syndrome diagnosed on the basis of clinical features, reduced GLUT1 activities, and mutations in the GLUT1 gene. Patient 1 had a novel heterozygous 1bp insertion in exon 7 that resulted in a shift of the reading frame and the introduction of a premature stop codon at amino acid position 380.
Epilepsy Research Volume 80, Issue 1, Pages 9-17 (July 2008)
To describe a familial epileptic condition combining a peculiar electro-clinical pattern with developmental language dysfunction in a large Italian kindred.
Epilepsy Research Volume 80, Issue 1, Pages 1-8 (July 2008)
Mutations in the LGI1 gene are linked to autosomal dominant lateral temporal epilepsy
(ADTLE) in about half of the families tested, suggesting that ADLTE is genetically heterogeneous. Recently, the Lgi1 protein has been found associated with different protein complexes and two distinct molecular mechanisms possibly underlying ADLTE have been hypothesized: the one recognizes Lgi1 as a novel subunit of the presynaptic Kv1 potassium channel implicated in the regulation of channel inactivation, the other suggests that Lgi1 acts as a ligand that selectively binds to the postsynaptic receptor ADAM22, thereby regulating the glutamate–AMPA neurotransmission.
Journal of the Neurological Sciences Volume 270, Issue 1, Pages 189-193 (15 July 2008)
We herein report a 12-year-old girl with a basal ganglia germinoma who presented with right-sided hemiparesis after a minor head trauma. Magnetic resonance (MR) imaging revealed a minimally enhanced lesion involving the left putamen, thalamus, and corona radiata.
Journal of the Neurological Sciences Volume 270, Issue 1, Pages 172-183 (15 July 2008)
Brain edema is one of the most frequent and serious complications of intracerebral hemorrhage (ICH), but how the ICH cause brain edema is unknown. Our studies were designed to investigate the regulation and distribution of protease nexin-1 (PN-1), thrombin and aquaporin-4 (AQP-4) in brain edema after ICH in rat and human brain in vivo.
Journal of the Neurological Sciences Volume 270, Issue 1, Pages 141-147 (15 July 2008)
Post-stroke hyperglycemia (HG) is associated with poor physical recovery, in particular in patients with cortical stroke. We tested whether HG is also associated with cognitive impairment after ischemic stroke.
Journal of the Neurological Sciences Volume 270, Issue 1, Pages 127-132 (15 July 2008)
In this study we investigated the factors associated with pre-hospital delay to treat acute ischemic stroke and transient attack with intravenous recombinant tissue-plasminogen activator (rt-PA) in Japan. In 625 patients, we investigated the pathways and times of their arrival to our hospital, and the significant and independent factors in the patients' clinical backgrounds associated with delayed arrival (>2 h after notice). In total, 287 patients arrived at our hospital directly via EMS, 113 came by themselves, and 225 transferred from other institutes.
Journal of the Neurological Sciences Volume 270, Issue 1, Pages 107-113 (15 July 2008)
Many patients with Parkinson's disease (PD) suffer from non-motor symptoms like sleep disturbances, excessive daytime sleepiness and fatigue. The aim of our research was to explore whether fatigue is related to sleepiness and sleep problems, depression and functional status, controlled for age, gender and disease duration.
Journal of the Neurological Sciences Volume 270, Issue 1, Pages 82-87 (15 July 2008)
The role of blood lipids and lipoprotein-related variables in the prediction of ischemic stroke is less clear than that for coronary heart disease. Apolipoprotein B (Apo B), which reflects the concentration of potentially atherogenic lipoprotein particles, and apolipoprotein AI (Apo A-I), which reflects the corresponding concentration of the anti-atherogenic HDL, represent additional lipoprotein-related variables that may indicate vascular risk.
Journal of the Neurological Sciences Volume 270, Issue 1, Pages 70-76 (15 July 2008)
Multiple sclerosis is an inflammatory disease of the central nervous system (CNS) which includes a neurodegenerative component. Brain derived neurotrophic factor
(BDNF) is a neuroprotective agent which might be useful in preventing neurodegeneration but its application has been limited because the blood brain barrier restricts its access to the CNS.
Journal of the Neurological Sciences Volume 270, Issue 1, Pages 67-69 (15 July 2008)
At present, the evaluation of Parkinson's Disease (PD) relies mainly on Unified Parkinson's Disease Rating Scale (UPDRS). Other objective measures have been proposed, including functional studies, timed tests and ambulatory activity monitors (AAM). We carried out a prospective study to analyze the utility and correlation of the AAM: ActiTrac® with UPDRS scores and timed tests in patients with PD.
Journal of the Neurological Sciences Volume 270, Issue 1, Pages 60-66 (15 July 2008)
Multivariate models have not been widely used to predict the outcome of acute stroke patients admitted to the intensive care unit (ICU). The purpose of this study was to determine potential measures observed in the first 12 h post-stroke that predict early mortality and functional outcomes in ICU-admitted stroke patients.
Journal of the Neurological Sciences Volume 270, Issue 1, Pages 48-52 (15 July 2008)
Intravenous administration of tissue plasminogen activator (t-PA) can improve clinical outcomes in patients with acute ischemic stroke. The most important complication of t-PA therapy is intracerebral hemorrhage (ICH). The aim of this study was to use serial MRI studies to identify independent predictors of symptomatic and asymptomatic ICH after t-PA therapy.
European Journal of Cardiovascular Prevention & Rehabilitation. 15(3):329-335, June 2008
Stroke survivors are at high risk of recurrent strokes and other vascular events. Smoking is an established risk factor for stroke, with cessation recommended for secondary prevention. Little is known about patterns of smoking cessation after stroke.
The Journal of Pathology Published Online: 26 Mar 2008
Glioma stem cells (GSCs), or stem cell-like glioma cells, isolated from malignant glioma cell lines, were capable of producing vascular endothelial growth factor (VEGF). However, the exact role of such tumour cells in angiogenesis remains unknown.
NeuroRehabilitation Volume 23, Number 3 / 2008 263-265
Subthalamic (STN) deep brain stimulation (DBS) is an effective treatment for advanced Parkinson's disease. We present a patient with significant gait problems due to Parkinson's disease (PD) who underwent STN DBS. Gait worsened after surgery despite significant improvement in parkinsonian signs, due to underlying spasticity previously overshadowed by his parkinsonian motor symptoms.
NeuroRehabilitation Volume 23, Number 3 / 2008 273-281
Recent findings suggest that compromised patient effort occurs in nonlitigious settings, but the nature and base rate of suboptimal effort in these settings remains poorly understood. In the treatment-seeking, acquired brain injury, outpatient rehabilitation sample included in this investigation, 21.8% of the patients scored below recommended cutting scores for suboptimal effort on the Test of Memory Malingering (TOMM). Disability status was the only variable explored in this study to be associated with suboptimal effort.
NeuroRehabilitation Volume 23, Number 3 / 2008 239-244
Constraint-induced movement therapy (CIMT) has been demonstrated to be effective in improving hemiparetic upper extremity function in stroke patients, but few studies have been performed to assess orthosis modification. We investigated the effect of the newly designed small orthosis named modified opposition restriction orthosis (MORO) in chronic hemiparetic patients with stroke.
NeuroRehabilitation Volume 23, Number 3 / 2008 207-216
This pilot study aimed to investigate the effects of vocal exercises and singing on intelligibility and speech naturalness for subjects with acquired dysarthria following traumatic brain injury or stroke.
International Journal of Hematology 0925-5710 (Print) 10.1007/s12185-008-0099-y
Nocardial brain abscess is a rare but severe complication in patients with malignancy. Nocardia exalbida was isolated in Japan and characterized within the genus Nocardia.
Henoch-Schonlein purpura is a small vessel vasculitis that affects mainly the skin, joints, gastrointestinal tract and kidneys. The central nervous system is also occasionally involved, although the majority of patients experience only mild symptoms such as headaches and behavioural changes.
Intracranial capillary hemangiomas are very rare, though several spinal capillary hemangiomas have recently been reported. We report here a case of intracranial capillary hemangioma with multiple cysts and review the current literature of similar cases.
American Journal of Neuroradiology 29:1095-1097, June-July 2008
We report the first use of Onyx in the embolization of spinal tumors in 2 cases of aggressive vertebral hemangioma. In both cases, Onyx embolization provided effective preoperative tumor devascularization after the initial prolonged particulate embolization with Embospheres made little overall impact. Onyx enables a more rapid and visible embolization than particles and is less technically demanding than traditional liquid embolic agents, such as n-butyl cyanoacrylate.
American Journal of Neuroradiology 29:1147-1152, June-July 2008
Atypical and malignant meningiomas are uncommon tumors with aggressive behavior and higher mortality, morbidity, and recurrence compared with benign tumors.
Journal of Clinical Oncology, 10.1200/JCO.2007.15.2363
Assessment of radiologic response (RR) for brain tumors utilizes the Macdonald criteria 8 to 10 weeks from the start of treatment. Diffusion magnetic resonance imaging (MRI) using a functional diffusion map (fDM) may provide an earlier measure to predict patient survival.
Data on the association between air pollution and cerebrovascular disease in the United States are limited. The objective of this study was to investigate the association between short-term exposure to ambient air pollution and risk for ischemic cerebrovascular events in a US community.
Journal of Hypertension. 26(7):1282-1289, July 2008
To compare the effects of angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors on the risk of myocardial infarction, stroke, cardiovascular mortality and total mortality.
Neuroblastoma is a malignant condition of the developing sympathetic nervous system that most commonly affects young children and is often lethal. Its cause is not known.
Three papers recently published in Nature Medicine provide the most detailed analyses of fetal midbrain grafts in patients with Parkinson's disease. Some of the results are surprising and suggest a new wave of questions aimed at both the value of cell therapy and the nature of the disease itself.
The Chinese-German Journal of Clinical Oncology Volume 7, Number 4 / April, 2008 245-247
To evaluate the therapeutic efficacy of low-grade glioma (WHO grades I-II) patients treated with gamma knife radiosurgery and study on the efficacy evaluation method and radiobiological effect.
CyberPsychology & Behavior. June 1, 2008, 11(3): 329-339
Stroke and traumatic brain injury affect an increasing number of people, many of whom retain permanent damage in cognitive functions. Conventionally, cognitive function has been assessed by a paper-based neuropsychological evaluation.
Clinical Nuclear Medicine. 33(6):441-442, June 2008
Imaging protein metabolism by means of radiolabeled amino acids is an established method in the diagnosis of brain tumors. I-123 iodo-l-phenylalanine is a novel iodinated amino acid currently used for brain tumor imaging with single photon emission computed tomography.
This study applied decision tree analysis to evaluate the sensitivity, specificity, and cost-effectiveness of clinical algorithms that incorporate 18F-FDG PET.
Journal of Neuropathology & Experimental Neurology. 67(6):565-577, June 2008
Schimke immuno-osseous dysplasia (OMIM 242900) is an uncommon autosomal-recessive multisystem disease caused by mutations in SMARCAL1 (swi/snf-related, matrix-associated, actin-dependent regulator of chromatin, subfamily a-like 1), a gene encoding a putative chromatin remodeling protein.
Journal of Neuropathology & Experimental Neurology. 67(6):590-599, June 2008
Neuronal injury and loss are recognized features of neuroinflammatory disorders, including acute and chronic encephalitides and multiple sclerosis; destruction of astrocytes has been demonstrated in cases of Rasmussen encephalitis.
Journal of Neuropathology & Experimental Neurology. 67(6):600-611, June 2008
Various types of neuronal damage have been reported in acquired immunodeficiency syndrome (AIDS) dementia. We previously demonstrated that inflammation and cortical damage occur independently according to viral tropism in a simian immunodeficiency virus (SIV)-infected macaque model of AIDS dementia. To elucidate the pathogenesis of cortical degeneration, we examined the frontal cortex of SIV-infected macaques and found apoptosis and decreased expression of the excitatory amino acid transporter 2 in astrocytes and diffuse activation of microglia in association with limited neuronal damage. Some activated microglia also expressed excitatory amino acid transporter 2 but not proinflammatory cytokines.
We report here on the experience with continuous jejunal levodopa infusion in 13 German parkinsonian patients who have motor and nonmotor complications despite individually optimized oral treatment. The tolerability, efficacy, and the need for dose adjustment of levodopa infusion were followed-up prospectively. Thereby, we describe clinically relevant details for how to successfully initiate and handle this new treatment strategy.
A matter of debate is the impact of levodopa (LD) application in patients with Parkinson disease (PD) on altered force development and coordination, which are also influenced by the strength of muscles used.
American Journal of Neuroradiology 29:1071-1075, June-July 2008
CT angiography (CTA) has been used for the evaluation of intracranial aneurysms and recently has been applied to assess postoperative aneurysms treated with titanium-alloy clips.
American Journal of Neuroradiology 29:1061-1066, June-July 2008
Because intravenous (IV) recombinant tissue plasminogen activator (rtPA) does not always lead to a good outcome in a considerable proportion of patients, combined IV rtPA and rescue endovascular therapy (ET) have been performed in several recent studies.
American Journal of Neuroradiology 29:1053-1060, June-July 2008
The efficacy of intra-arterial administration of nimodipine (IAN) in patients with severe vasospasm after aneurysmal subarachnoid hemorrhage (SAH) remains unproved.
PEDIATRICS Vol. 121 No. 6 June 2008, pp. e1599-e1603
The objective of this study was to determine the relationship between the frequency and total volume of intravascular volume administration and the development of intracranial hemorrhage during venoarterial extracorporeal membrane oxygenation.
American Journal of Neuroradiology 29:1144-1146, June-July 2008
It is possible that identification of eye deviation may sensitize a scan reader to early brain hypodensity associated with an arterial occlusive process.
American Journal of Neuroradiology 29:1118-1123, June-July 2008
In spite of the advent of thrombolytic therapy, CT-perfusion imaging is currently not fully used for clinical decision-making and not included in published clinical guidelines for management of ischemic stroke.
The Paul Coverdell National Acute Stroke Registry (PCNASR) is a U.S. based registry designed to monitor and improve the quality of acute stroke care delivered by hospitals. The registry monitors care through specific performance measures, the accuracy of which depends in part on the reliability of the individual data elements used to construct them.
Social Ties and Cognitive Recovery after Stroke: Does Social Integration Promote Cognitive Resilience?
Little is known about the possible effects of social resources on stroke survivors' level and change in cognitive outcomes. Understanding this association may help us identify strategies to improve stroke recovery and help elucidate the etiology of dementia.
There is strong evidence for the existence of a socioeconomic gradient in stroke incidence and mortality, but there seem to be contradictory findings concerning an association between socioeconomic status and case fatality after stroke. Moreover, there is still a lack of studies that include men and women as well as people over 75 years.
Journal of Neural Transmission 0300-9564 (Print) 10.1007/s00702-008-0070-3
Despite the vast number of studies on Parkinson's disease (PD), its effective diagnosis and treatment remains unsatisfactory. Hence, the relentless search for an optimal cure continues.
Diabetes is associated with an increased risk of incident stroke and both early and late recurrent stroke after transient ischaemic attack. Some small studies have suggested that atherosclerotic plaques from diabetics have a higher prevalence of unstable features than plaques from non-diabetics but results have been inconsistent.
Low socioeconomic status is associated with increased incidence of stroke. This study investigated stroke incidence, recurrence, and case-fatality after stroke among middle-aged Swedish men and women and whether this association differs by gender or stroke subtype.
Right to left shunt is involved in conditions in which postural changes may be pathogenically relevant. The aim of this work was to assess the frequency of posturally dependent right to left shunt.
The role of abnormal angiogenesis in the formation and progression of cerebral arteriovenous malformations (AVMs) is unclear. Previous studies have demonstrated increased local expression of vascular endothelial growth factor (VEGF) in AVM tissue and increased circulating levels of VEGF in AVM patients.
Stroke mortality appears to be declining more rapidly in the UK than in many other Western countries. To understand this apparent decline better, we studied trends in mortality in the UK using more detailed data than are routinely available.
Stroke MRI protocols provide useful information about underlying vessel pathologies in the anterior circulation by means of intracranial time-of-flight angiography.
MRI is useful for detecting early ischemic lesions before administration of tissue plasminogen activator in patients with hyperacute ischemic stroke. However, it is unclear whether early ischemic change seen on diffusion-weighted imaging (DWI) can be used to predict patient outcomes.
Large artery intracranial occlusive disease (LAICOD) is a common and important stroke subtype. In this commentary, we review key epidemiological aspects of LAICOD.
PEDIATRICS Vol. 121 No. 6 June 2008, pp. e1686-e1695
Children with traumatic brain injuries often show impaired executive function (the ability to carry out goal-directed behavior). The Behavior Rating Inventory of Executive Function, a caregiver-report questionnaire, measures executive function in everyday activities.
Because there is no biologic marker offering precise information about stroke etiology, many patients receive a diagnosis of undetermined stroke even after all available diagnostic tests are done, precluding correct treatment.
Data monitoring trends in stroke risk among different ethnic groups are lacking. Thus, we investigated trends in stroke incidence and modifiable stroke risk factors over a 10-year time period between different ethnic groups.
Early hemorrhagic transformation (HT) is a complication of ischemic stroke but its effect on patient outcome is unclear. The aims of this study were to assess: (1) the rate of early HT in patients admitted for ischemic stroke, (2) the correlation between early HT and functional outcome at 3 months, and (3) the risk factors for early HT.
Spiny neurons in the neostriatum are highly vulnerable to ischemia. Despite an enormous body of research suggesting that dopamine is involved in ischemia-induced neuronal loss in the striatum, it remains unclear how dopamine interacts with the glutamatergic excitotoxicity that is widely accepted as a major cause of ischemic cell death.
European directives and legislation in some countries forbid inclusion of subjects incapable of consent in research if recruitment of patients capable of consent will yield similar results. We compared brain lesion volumes in stroke patients deemed to have capacity to consent with those defined as incapacitated.
Future Oncology, Volume 4, Number 3, June 2008 , pp. 433-442(10)
Despite maximal therapy, malignant gliomas have a very poor prognosis. Patients with glioma express significant immune defects, including CD4 lymphopenia, increased fractions of regulatory T cells in peripheral blood and shifts in cytokine profiles from Th1 to Th2
European Journal of Pediatrics 0340-6199 (Print) 10.1007/s00431-008-0755-5
To study the hypothesis that a delay in the diagnosis of paediatric brain tumours results in decreased survival outcome probability, we compared the prediagnostic period of 315 brain tumour patients (median age 6.7 years, range, 0 to 16 years) with progression-free and overall survival.
Intracranial extracerebral neuroglial choristoma is a very rare entity. A cleft palate or a nasopharyngeal teratoma has been described as accompanying choristoma, but there are no observations of both anomalies being simultaneously present and combined.
Congenital glioblastoma multiforme is a rare primary brain tumor that has a unique biology distinct from pediatric and adult variants. In this report, we present a case of congenital glioblastoma with complicated management course.
On the basis of the previously proposed hierarchic organisation of the central nervous system (CNS) and of its syntropic behaviour, a view of neurodegenerative diseases focusing on the assemblage of abnormal multimeric proteins (pathologic protein mosaics (PMs)) is proposed.
American Journal of Clinical Oncology. 31(3):250-254, June 2008
Brain metastases (BM) are a significant complication of metastatic breast cancer (MBC). The high incidence of BM in HER2 overexpressing MBC is now well recognized, however, the optimal management of such patients is not yet clearly defined. We aimed to analyze factors affecting survival after diagnosis of BM in patients treated in our center.
This study was designed to evaluate the therapeutic effect of stereotactic radiosurgery (SRS) in patients aged >75 years who presented with brain metastasis.
Following the concept of interhemispheric competition, downregulation of the contralesional primary motor cortex (M1) may improve the dexterity of the affected hand after stroke.
Migraine and epilepsy are comorbid episodic disorders that have common pathophysiologic mechanisms. Migraine attacks, like epileptic seizures, may be triggered by excessive neocortical cellular excitability; in migraine, however, the hyperexcitability is believed to transition to cortical spreading depression rather than to the hypersynchronous activity that characterizes seizures.
A 56-year-old woman presented with a 1-year history of nonprogressive gait disturbance. On examination she had marked parkinsonian features limited to the right side.
A healthy 28 year-old man developed acute pharyngitis and fever. Three days later he experienced a prolonged generalized tonic-clonic seizure that required admission into the intensive care unit. Neurological examination findings were unremarkable.
A 71-year-old woman presented with headache and depression with suicidal ideation. Her medical history was unremarkable except for mild arterial hypertension.
In the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) study, atorvastatin 80 mg/day reduced the risk of stroke in patients with recent stroke or TIA. Post hoc analysis found this overall benefit included an increase in the numbers of treated patients having hemorrhagic stroke (n = 55 for active treatment vs n = 33 for placebo).
The NIH Stroke Scale (NIHSS) may not appropriately assess the spectrum of posterior circulation (PC)-related neurologic deficits. We determined the cutoff baseline NIHSS score that predicts independent daily life activity during the chronic stage in anterior circulation (AC) vs PC ischemic strokes.
Identify and describe the body of literature pertaining to non-pharmacological management of orthostatic hypotension (OH) during the early rehabilitation of persons with a spinal cord injury (SCI).
To determine the potential impact of rehabilitation care on associated symptoms and functional improvements of paraplegic patients with metastatic spinal cord compression.
We aimed to correlate the spinal cord changes as depicted by magnetic resonance imaging (MRI) with the neurological deficit and motor recovery of patients with acute cervical spinal cord injury (SCI).
Journal of Neurosurgery Pediatrics June 2008 Volume 1, Number 6
Lymphangiomas are benign collections of blind-ended lymphatic and vascular channels. Lesions typically occur in the soft tissues of the head and neck, although any region of the body can be affected. Involvement of the spine is very rare. A complete resection is generally curative. On rare occasions, these tumors are complicated by infection or hemorrhage.
of Neurosurgery Pediatrics Journal June 2008 Volume 1, Number 6
The authors describe the case of a patient with an intracranial capillary hemangioma, and they review the recent literature on intracranial capillary hemangiomas with special attention to their differential diagnosis and management.
European Radiology 0938-7994 (Print) 10.1007/s00330-008-1046-2
This study aimed to broaden the diagnostic possibilities of low-field MRI systems (i) by examining the feasibility of functional MRI of human brain activation at 1 T, and (ii) by assessing its reliability in comparison with acquisitions at 3 T.
The aims of our study were to elucidate the differences in the distribution of acute middle cerebral artery (MCA) infarctions involving the striatocapsular region and to compare those following embolic striatocapsular infarctions with those originating from MCA disease (MCAD).
Serious cardiac arrhythmias have been described in approximately 5% of patients after subarachnoid hemorrhage (SAH). The aim of this study was to identify the frequency, risk factors and clinical impact of cardiac arrhythmia after SAH.
American Journal of Hematology Published Online: 13 Feb 2008
Polymorphism in human platelet antigen (HPA)-1 and HPA-3 (GPIIb/IIIa), HPA-2 (GPIb/IX), HPA-4 (GPIIIa), and HPA-5 (GPIa/IIa) was investigated in 329 stroke patients and 444 matched control subjects. HPA genotyping was done by PCR-SSP method.
PEDIATRICS Vol. 121 No. 6 June 2008, pp. 1174-1180
The goal was to examine the case flow of child physical abuse prosecutions through the judicial system and to examine determinants of charges and sentencing decisions.
PEDIATRICS Vol. 121 No. 6 June 2008, pp. 1146-1154
Our goals were to compare (1) single-channel amplitude-integrated electroencephalography alone, (2) 2-channel amplitude-integrated electroencephalography alone, and (3) amplitude-integrated electroencephalography plus 2-channel electroencephalography with simultaneous continuous conventional electroencephalography for seizure detection in term infants to check the accuracy of limited channels and compare the different modalities of bedside electroencephalography monitoring.
A systematic review of studies that focused on the executive functions of problem solving, planning, organising and multitasking by adults with traumatic brain injury (TBI) was performed through 2004. Qualitative and quantitative methods were used to evaluate the 15 studies that met inclusion criteria. Demographic variables, design and intervention features, and impairment and activity/participation outcomes (ICF) (World Health Organization, 2001) were documented.
Pediatric Blood & Cancer Published Online: 3 Apr 2008
We aimed to determine the long-term natural history of low-grade astrocytomas (LGA) in children, with respect to pathology, and to evaluate influence of treatment on survival.
Pediatric Blood & Cancer Published Online: 17 Apr 2008
Combined cisplatin chemotherapy and cranial irradiation for treatment of medulloblastoma in children can cause significant ototoxicity and impair cognitive function and quality of life. We have previously demonstrated the conformal technique of intensity-modulated radiation therapy (IMRT) to reduce ototoxicity, however, it has been suggested that IMRT may increase risk of cognitive deficits compared to conventional radiation therapy (CRT). This study compared the impact of the two treatments on measures of neurocognitive functioning.
Cerebrovascular complications (CVCs) have remained a major therapeutic and prognostic challenge associated with infective endocarditis, and definite risk factors have not been fully elucidated. This prospective study was designed to the evaluate the total incidence of CVC associated with infective endocarditis and major risk factors.
We sought to quantify perfusion changes associated to acute spontaneous intracerebral hemorrhage (SICH) by means of computed tomography perfusion (CTP) imaging.
Journal of Neurosurgery June 2008 Volume 108, Number 6
Symptomatic local inflammation, aseptic meningitis, and hydrocephalus are reported in a group of patients treated with second generation/modified platinum coils. The purpose of this study was to define the frequency and determinants of magnetic resonance (MR) imaging findings of aneurysm wall enhancement, perianeurysmal edema, and hydrocephalus in a cohort of coil-embolized intradural cerebral aneurysms treated with bare platinum or modified platinum coils (Matrix or HydroCoils).
Journal of Neurosurgery June 2008 Volume 108, Number 6
Considerable confusion exists in the literature regarding the classification of cerebrovascular malformations and their clinical significance. One example is provided by the atypical developmental venous anomaly (DVA) with arteriovenous shunt, because it remains controversial whether these lesions should be classified as DVAs or as atypical cases of other subtypes of cerebrovascular malformations.
Journal of Neurosurgery June 2008 Volume 108, Number 6
The use of intracranial stents in stent-assisted coil embolization is now a current neurosurgical practice worldwide. The clinical utility of these stents in the sole stenting (SS) technique, however, has not been thoroughly described, and the published reports of this experience are scarce.
Journal of Neurosurgery June 2008 Volume 108, Number 6
The authors of recent publications have suggested that a combination of cisternal irrigation and head-shaking therapy might reduce cerebral vasospasm after subarachnoid hemorrhage (SAH) and therefore improve outcome.
Journal of Neurosurgery June 2008 Volume 108, Number 6
The goal of this study was to prospectively compare the effectiveness of 16-slice computed tomography (CT) angiography with that of conventional digital subtraction (DS) angiography and the surgical findings used to detect and characterize intracranial aneurysms.
Journal of Neurosurgery June 2008 Volume 108, Number 6
Approximately 20% of patients with an intracranial saccular aneurysm report a family history of intracranial aneurysm (IA) or subarachnoid hemorrhage. A better understanding of predictors of aneurysm detection in familial IA may allow more targeted aneurysm screening strategies.
Journal of Neurosurgery June 2008 Volume 108, Number 6
The most appropriate treatment for cerebral aneurysms, both ruptured and unruptured, is currently under debate, and updated guidelines have yet to be defined. The authors attempted to identify trends in therapy for cerebral aneurysms in the US as well as outcomes.
Journal of Neurosurgery June 2008 Volume 108, Number 6
Posterior fossa arteriovenous malformations (AVMs) are relatively uncommon and often difficult to treat. The authors present their experience with multimodality treatment of 76 posterior fossa AVMs, with an emphasis on Spetzler-Martin Grades III-V AVMs.
Journal of Neurosurgery June 2008 Volume 108, Number 6
The introduction of the Neuroform microstent has facilitated the embolization of complex cerebral aneurysms, which were previously not amenable to endovascular therapy.
Journal of Neurosurgery June 2008 Volume 108, Number 6
The well-known predictors for increased early deaths after spontaneous intracerebral hemorrhage (ICH) include the clinical and radiological severity of bleeding as well as being on a warfarin regimen at the onset of stroke. Ischemic heart disease and atrial fibrillation may also increase early deaths. In the present study the authors aimed to elucidate the role of the last 2 factors.
Journal of Neurosurgery June 2008 Volume 108, Number 6
The best approach to the management of vestibular schwannoma (VS) remains controversial. The aim of this study is to analyze the initial and follow-up costs of resection and stereotactic radiosurgery for patients with VS.
Journal of Neurosurgery June 2008 Volume 108, Number 6
Endovascular therapy for dural carotid cavernous fistulas (CCFs) is generally accepted to be safe and effective. The authors report a rare complication of hemorrhage and subsequent venous infarcts of the pons and cerebellum after transvenous embolization.
Journal of Neurosurgery June 2008 Volume 108, Number 6
The authors describe a novel device for the endovascular treatment of intracranial aneurysms, the endovascular clip system (eCLIPs). Descriptions of the device and its delivery system as well as the results of flow model tests and the treatment of experimental aneurysms are provided.
Pediatric Infectious Disease Journal. 27(6):558-559, June 2008
Nontyphoidal Salmonella (NTS) encephalopathy is characterized by rapidly progressive brain dysfunction that develops after NTS enteritis. The mechanism of central nervous system involvement remains unclear.
Clinical Cancer Research 14, 3386-3394, June 1, 2008
We previously showed that overexpression of epidermal growth factor receptor (EGFR) is associated with malignant grade in childhood glioma. The objective of this study was to determine whether protein expression of EGFR or platelet-derived growth factor receptor (PDGFR) and their active signaling pathways are related to malignant histology, progression of disease, and worse survival.
Clinical Cancer Research 14, 3248-3253, June 1, 2008
MDM2 is a key negative regulator of p53 activity, and a single nucleotide polymorphism (SNP309, T>G change; rs 2279744) in its promoter increases the affinity for the transcription factor SP1, enhancing MDM2 expression. We carried out a pilot study to investigate the effect of this polymorphism on development and behavior of neuroblastoma, an extracranial pediatric tumor with unfrequent genetic inactivation of p53.
Clinical Cancer Research 14, 3299-3305, June 1, 2008
The focal adhesion kinase (FAK) is a nonreceptor protein tyrosine kinase important in signaling between cells and their extracellular matrix. Studies have shown that FAK expression is up-regulated in several human tumors and is related to tumor progression.
Clinical Cancer Research 14, 3416-3426, June 1, 2008
Inhibition of the protein kinase mammalian target of rapamycin (mTOR) is being evaluated for treatment of a variety of malignancies. However, the effects of mTOR inhibitors are cytostatic and standard size criteria do not reliably identify responding tumors.
To determine whether long-term heavy cannabis use is associated with gross anatomical abnormalities in 2 cannabinoid receptor-rich regions of the brain, the hippocampus and the amygdala.
Journal of Neurosurgery June 2008 Volume 108, Number 6
To the authors' knowledge, only 1 case of communicating hydrocephalus after endovascular coiling of unruptured brain aneurysms has been reported previously. Here, they report on 2 such cases of delayed communicating hydrocephalus after treatment with hydrogel-coated coils and offer the first histopathological evidence of foreign material, presumably related to the coils, as the cause of hydrocephalus.
Journal of Neurosurgery June 2008 Volume 108, Number 6
Procedure-related rupture during endovascular therapy of intracranial aneurysms is associated with a mortality rate of more than one third. Previously ruptured aneurysms are a known risk factor for procedure-related rupture. The objective of this study was to evaluate whether very small, ruptured aneurysms are associated with more frequent intraprocedural ruptures.
Inpatient magnetic resonance imaging for evaluation of new-onset afebrile seizures can extend hospital stay, can add cost, and may not affect acute management. The study was to assess cost and impact on acute management of inpatient brain magnetic resonance imagings performed as part of new-onset seizure evaluation.
Despite recent advances in neuroimaging, differentiation between cerebral abscesses and necrotic tumors with ring-type contrast enhancement can be puzzling at times. The introduction of advanced imaging techniques, such as diffusion-weighted imaging, has contributed to the identification of cerebral abscesses.
Treatments for brain abscesses have typically involved invasive craniotomies followed by debridement. These methods often require large incisions with vast exposure and may be associated with high morbidity rates.
Brain abscesses have been one of the most challenging lesions, both for surgeons and internists. From the beginning of the computed tomography (CT) era, the diagnosis and treatment of these entities have become easier and less invasive.
Postoperative infection after cranial surgery is a serious complication that requires immediate recognition and treatment. In certain cases such as postoperative meningitis, the patient can be treated with antibiotics only. In cases that involve a bone flap infection, subdural empyema, or cerebral abscess, however, reoperation is often needed.
Brain abscesses occur infrequently but continue to be problematic for the pediatric neurosurgical community. The incidence of brain abscesses in children has not changed much, although individual reports may show an increase or decrease in the number of reported cases depending on the patient population studied.
Halo orthoses are commonly used in the management of a variety of cervical spinal pathological conditions. Although placement of the cranial pins was initially believed to be safe with minimal complications, minor complications related to the cranial pins have the potential to create a setting for formation of cerebral abscesses. The risk of death due to cerebral abscesses has declined in the modern antibiotic era, but cerebral abscesses are associated with long-standing neurological morbidity that should not be considered negligible.
Recent advances in neuroimaging have resulted in a marked decrease in morbidity and death due to brain abscesses. The advent of computed tomography-guided stereotaxy has reduced morbidity in patients with deep-seated abscesses.
Brain abscesses are well-known lesions that have been reported from the beginning of the Hippocratic era. They continue, however, to be characterized by problematic and fatal features, even though there have been enormous developments in treatment and diagnostic technologies-especially in the areas of computed tomography (CT), surgery, anesthesia, bacterial isolation techniques, and new antibiotics.
Intracranial abscesses located deep in the cerebral parenchyma and in eloquent regions are often difficult to manage surgically. The authors have attempted to analyze the efficacy of stereotactic aspiration in the management of these abscesses.
Hydatid cysts are rare, but most often they occur in the liver and lungs. Cerebral manifestation is very rare, and surgery is the main treatment. The goal of surgery is to remove the cysts in toto without rupture. The aim of this study was to investigate the surgical technique of removing cerebral hydatid cysts and to show the possible pitfalls of surgery.
n this study the authors' goal was to present the clinical and imaging results of the combined surgical and medical treatment of intracranial abscesses.
The brain tends to be immune to inflammation and abscess formation, despite chronically and recurrently infected neighboring structures, and not uncommon pyemias and septicemias. Experimental inoculation of the brain tissue with microbes confirms this clinical experience.
Although it is uncommon, pediatric brain abscess remains a serious, life-threatening neurological problem. Those with congenital heart disease, an ongoing infection, or an immunocompromised state are particularly at risk. The symptoms on presentation may include those associated with a space-occupying lesion in the brain, and neuroimaging has made the diagnosis of brain abscess more reliable.
The 4th Annual Mid-Hudson Brain Injury Rehabilitation Conference will be held again this year in Kingston, NY, presented by Northeast Center for Special Care.
Clinicians and support persons working with this population are invited to attend this highly-rated conference with cutting-edge educational sessions to increase knowledge and skills in this highly specialized area.
Brain abscess is a rare but very dangerous neurosurgical lesion. Prompt diagnosis and emergency surgical evacuation are the hallmarks of therapy. Brain abscess following ischemic and hemorrhagic stroke is a rare entity. These cases are often preceded by episodes of bacteremia, sepsis, and local infection.
Journal of Neurosurgery Pediatrics June 2008 Volume 1, Number 6
Spontaneous ventriculocisternostomy, the spontaneous communication between the ventricular system and the subarachnoid space, is rare. The authors report a case of an infant with obstructive hydrocephalus who developed a spontaneous third ventriculocisternostomy.
Journal of Neurosurgery Pediatrics June 2008 Volume 1, Number 6
In this study, the authors investigated whether preoperative ventricular volume can be used to predict the need for permanent treatment of hydrocephalus in children with posterior fossa medulloblastomas.
Journal of Neurosurgery Pediatrics June 2008 Volume 1, Number 6
Cysts occupying the third ventricle are rare lesions and may appear as an unusual cause of obstructive hydrocephalus. Various types of lesions occur in this location, and they generally have an arachnoidal, endodermal, or neuroepithelial origin.
Journal of Neurosurgery Pediatrics June 2008 Volume 1, Number 6
Important risk factors for shunt infections (such as age, comorbidity, cause of hydrocephalus, operating time, and duration of external cerebrospinal fluid drainage prior to shunt placement) did not differ between the study and control groups.
Concepts in Magnetic Resonance Part A Volume 32A Issue 3, Pages 219 - 237
Noninvasive assessment of spinal cord integrity following injury is critical for precise diagnosis, prognosis, and surgical intervention strategies. Diffusion weighted imaging and diffusion tensor imaging are more sensitive to the underlying spinal cord microstructure than traditional imaging techniques.
A sensitive clinical sign of a vestibular tone imbalance in the roll plane is the ocular tilt reaction (OTR), a combination of skew deviation, ocular torsion and head and perceptual tilts such as tilts of the subjective visual vertical (SVV). Of these OTR components tilts of SVV are the most frequent.
In 15 patients with primary dystonia (six cervical and nine generalized dystonias) who were treated with bilateral chronic pallidal stimulation, we investigated the sensorimotor modulation of the oscillatory local field potentials (LFPs) recorded from the pallidal electrodes.
This article reconsiders the events that took place at the 1868 meeting of the British Association for the Advancement of Science (BA) in Norwich. Paul Broca and John Hughlings Jackson were invited to speak on the new and controversial subject of aphasia.
Deep brain stimulation (DBS) of the bilateral subthalamic nucleus (STN) in Parkinson's disease is thought to produce adverse events such as emotional disorders, and in a recent study, we found fear recognition to be impaired as a result.
The pedunculopontine nucleus (PPN) is a promising new target for deep brain stimulation (DBS) in parkinsonian patients with gait disturbance and postural instability refractory to other treatment modalities. This region of the brain is unfamiliar territory to most functional neurosurgeons.
Failed storage capacity, leading to pulsatile delivery of dopamine (DA) in the striatum, is used to explain the emergence of ‘wearing off’ and dyskinaesia in Parkinson's disease.
Patterns of responses in the cerebral cortex can vary, and are influenced by pre-existing cortical function, but it is not known how rapidly these variations can occur in humans.
Temporal lobe epilepsy remains amongst the most common and drug refractory of neurological disorders. Gene therapy may provide a realistic therapeutic approach alternative to surgery for intractable focal epilepsies.
Familial amyotrophic lateral sclerosis (FALS) is an inherited neurodegenerative disorder of the motor neurons. While 10-15% of cases are caused by mutations in the copper/zinc superoxide-dismutase-1 (SOD-1) gene, the dying-forward hypothesis, in which corticomotoneurons induce anterograde excitotoxic motoneuron degeneration, has been proposed as a potential mechanism.
Following spinal cord injury (SCI), prolonged muscle spasms are readily triggered by brief sensory stimuli. Animal and indirect human studies have shown that a substantial portion of the depolarization of motoneurons during a muscle spasm comes from the activation of persistent inward currents (PICs).
The full extent of the brain's ability to compensate for damage or changed experience is yet to be established. One question particularly important for evaluating and understanding rehabilitation following brain damage is whether recovery involves new and aberrant neural connections or whether any change in function is due to the functional recruitment of existing pathways, or both.
British Journal of Anaesthesia, doi:10.1093/bja/aen149
Although vasospasm usually occurs in the presence of normal coronary arteries, its clinical course is indistinguishable from coronary ischaemia, and actual myocardial damage frequently occurs, as demonstrated by ECG changes and troponin rises seen in such cases. Spasm can be promptly and effectively treated if recognized early, and treatment with nitrate therapy is often sufficient to abolish spasm.
PEDIATRICS Vol. 121 No. 6 June 2008, pp. 1281-1286
Febrile seizures are the most common seizure disorder in childhood, affecting 2% to 5% of children between the ages of 6 and 60 months. Simple febrile seizures are defined as brief (<15-minute) generalized seizures that occur once during a 24-hour period in a febrile child who does not have an intracranial infection, metabolic disturbance, or history of afebrile seizures.
Hypothermia therapy improves survival and the neurologic outcome in animal models of traumatic brain injury. However, the effect of hypothermia therapy on the neurologic outcome and mortality among children who have severe traumatic brain injury is unknown.
British Journal of Neurosurgery, Volume 22, Issue 3 June 2008 , pages 339 - 349
The objective of this study was to review the results of randomized Phase III controlled trials (RCTs) that involve initial treatments of malignant glioma and determine changes in median survival times (MST) over the last 40 years. An electronic database search identified RCTs for patients undergoing initial treatment for supratentorial high-grade malignant glioma.
British Journal of Neurosurgery, Volume 22, Issue 3 June 2008 , pages 360 - 367
Day-case biopsy and craniotomy for brain tumours have been reported as safe and feasible options for selected patients. The incidence and timing of complications after such procedures has also been characterized in recent publications. However, more widespread adoption of day-case cranial neurosurgery has not taken place.
British Journal of Neurosurgery, Volume 22, Issue 3 June 2008 , pages 415 - 422
It has been suggested that potential risk of hemiballismus after subthalamotomy makes DBS preferable to ablation for IPD treatment; however, cost and the need for regular electrode control have also been observed as disadvantages to stimulation. The objective was to compare efficacy and safety of different surgical approaches to STN, in a prospective randomized pilot study. Sixteen consecutive IPD patients randomized to receive either: bilateral STN-DBS, bilateral subthalamotomy or unilateral subthalamotomy plus contralateral STN-DBS implantation, and followed for 12 months after surgery.
itish Journal of Neurosurgery, Volume 22, Issue 3 June 2008 , pages 452 - 455
The surgical management of recurrent glioblastoma multiforme is controversial. Recent publications suggest that re-operation provides 3-5 months median survival, without significant increases in morbidity or martality.
Doyal and Gough's theory of human need highlighted that personal autonomy is a universal need and human right, essential for well-being. In applying their theory to older disabled people in the UK the author suggests that their 'minimally autonomous' threshold would exclude some older people in long-term care who still have a fundamental need for autonomy or, alternatively, extant autonomy. The disability movement has highlighted that independent living is fundamental to achieving self-determination for disabled people and debate on equality and caregiving emphasises the autonomy of carers. However, there is a lack of recognition in both academic research and government policy of autonomy as a need and right of older disabled people.
Through examining the case of people with epilepsy (which, as we demonstrate, has an ambiguous status in relation to both popular and academic conceptions of disability) we explore the fluid, negotiable and contingent nature of identity and, in particular, the identification as 'disabled'.
First published on May 12, 2008
Journal of Child Neurology 2008, doi:10.1177/0883073808315416
In children, clinical recognition of stroke and determination of its exact etiology are extremely difficult. The authors described a case of cryptogenic stroke in a 14-year-old-boy with asymptomatic atrial septal defect and hypercoagulable state. Paradoxical embolism was hypothesized as the responsible etiopathological mechanism. It is crucial to increase clinician awareness of stroke in children.
Glioblastoma is the most common and severe primary brain tumor in adults. Its aggressive and infiltrative nature renders the current therapeutics of surgical resection, radiation, and chemotherapy relatively ineffective. Accordingly, recent research has focused on the elucidation of various signal transduction pathways in glioblastoma, particularly aberrant activation.
Severe myocardial dysfunction after blunt head injury is a rare but potentially lethal complication. We describe remarkable myocardial recovery after severe hemodynamic deterioration in a young man with brain injury, due to extracorporeal membrane oxygenation support. Because of the severity of brain damage, the patient succumbed after diagnosis of brain death. Postmortem histopathological examination of the heart showed severe myocardial necrosis.
Inflammatory stenoses of cerebral arteries cause stroke in patients with florid vasculitis. However, diagnosis is often difficult even with digital subtraction angiography (DSA) and biopsy.
Dysphagia is an important complication of acute stroke with a reported incidence of up to 76%. The purpose of this investigation was to develop and to evaluate an endoscopic scoring system which has the potential to guide dysphagia management in acute stroke patients.
Common genetic variants that increase the risk for Parkinson's disease may differentiate patient subgroups and influence future individualized therapeutic strategies. Herein we show evidence for leucine-rich repeat kinase 2 (LRRK2) c.4883G>C (R1628P) as a risk factor in ethnic Chinese populations.
Typically, aortic dissection has to be considered in patients with acute thoracic or abdominal pain and accompanying cardiovascular symptoms. Due to these clinical symptoms, neurologists have not been involved in the routine emergency management of aortic dissection.
The aim of this study was to confirm the nature and number of genes contributing to stroke risk and qualify the genetic risk of each susceptibility gene in the Han Chinese population.
Patients with major cerebral artery steno-occlusion and the formation of the moyamoya-like vessels associated with some other disorders have been distinguished from moyamoya disease and classified as moyamoya syndrome
Although antiplatelets are known to be effective for secondary prevention of cerebral infarction, the number needed to treat is rather large and the effects in stroke patients with complications such as hypertension or diabetes are inadequately defined.
Reversible cerebral vasoconstriction syndromes (RCVS) are characterized by thunderclap headaches and reversible cerebral vasoconstrictions. No systematic studies on cerebral hemodynamics have been published.
Spreading depolarizations occur in human ischemic stroke with high incidence Published Online: 21 May 2008
Cortical spreading depression (CSD) and periinfarct depolarization (PID) have been shown in various experimental models of stroke to cause secondary neuronal damage and infarct expansion. For decades it has been questioned whether CSD or PID occur in human ischemic stroke. Here, we describe CSD and PID in patients with malignant middle cerebral artery infarction detected by subdural electrocorticography (ECoG).
The onset of neurological signs in experimental autoimmune encephalomyelitis is tightly associated with infiltration and reactivation of T cells in the central nervous system. The anatomic localization of the initial T cell-antigen-presenting cell (APC) interactions leading to reactivation of T cells in the central nervous system is, however, still unclear. We hypothesized that activated CD4+ T cells gain direct access to the subarachnoid space and become reactivated on encounter with cognate antigen in this compartment.
This study was designed to determine the histopathological characteristics of cardiac and vascular lesions responsible for various subtypes of ischemic stroke.
To gain information on the predictive and prognostic value of magnetic source imaging (MSI), 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (18FDG-PET), and ictal single-photon emission computed tomography (SPECT) as compared with intracranial electroencephalography (ICEEG) localization in epilepsy surgery.
Data on the association between air pollution and cerebrovascular disease in the United States are limited. The objective of this study was to investigate the association between short-term exposure to ambient air pollution and risk for ischemic cerebrovascular events in a US community.
Journal of Neural Transmission 0300-9564 (Print) 10.1007/s00702-008-0061-4
The aim of this study was to assess the effect of dopaminergic treatment on emotional memory in patients with Parkinson’s disease (PD). We tested memory for emotional and neutral visual stimuli in ten non-demented PD patients on and off dopaminergic medication.
Traditional risk factors associated with adult arterial ischemic stroke (AIS; ie, hypertension, hyperlipidemia, diabetes, smoking, and atherosclerosis) are relatively rare in children. Childhood AIS is instead associated with a variety of conditions including cerebral arteriopathies, congenital heart disease, infection, head and neck trauma, sickle cell anemia, and prothrombotic abnormalities.
Acute bacterial parotitis (ABP) is a relatively uncommon condition that tends to occur in debilitated older patients. We report a case of an older woman that presented with an acute intracerebral hemorrhage who developed ABP. This morbidity led to endotracheal intubation, mechanical ventilation, tracheostomy and gastrostomy, all of which were not initially needed. We discuss the proposed physiopathology and etiopathogenesis of ABP in adults.
Molecular Carcinogenesis Published Online: 19 Feb 2008
Resveratrol (3,4,5-trihydroxystilbene) is a polyphenol synthesized by a wide variety of plant species in response to injury, UV irradiation and fungal attack. Many studies have revealed a variety of resveratrol intracellular targets whose modulation gives rise to overlapping responses leading to growth arrest and death.
High-grade astrocytomas are among the most intractable types of cancers and are often fatal. Previous studies have suggested that high-grade astrocytomas may adopt the self-renewal and migration properties of neural stem cells (NSCs) to proliferate and spread by expressing the stem cell-specific genes.
Our aim was to assess prevalence rates of cerebrovascular disease (CVD; stroke and transient ischemic attacks) according to age and gender in three populations in central Spain using data from the Neurological Disorders in Central Spain (NEDICES) study, a population-based survey of elderly participants.
Journal of Neurosurgery Pediatrics June 2008 Volume 1, Number 6
The aim of this study was to determine whether the presence of intracranial pathophysiology on computed tomography (CT) scans obtained within 24 hours of mild traumatic brain injury (MTBI) in children adversely affects neuropsychological outcome during the 1st year postinjury.
Ganglioglioma is an uncommon neoplasm of the central nervous system, most frequently seen in the temporal lobe, and usually associated with medically refractory epilepsy in children and young adults. Few reports have considered ganglioglioma-associated epileptogenicity arising in the temporal lobe. The purpose of our study was to define the imaging features of ganglioglioma in the temporal lobe and their relation to the seizure foci revealed by electrocorticograms.
To ascertain the prevalence of epilepsy and understand the differences in the comorbidities of non-epileptic and epileptic patients with learning disabilities. A simple comparative survey was undertaken between the two main groups of patients: non-epileptic and epileptic.
The Journal of Infectious Diseases 2008;197:1695-1700
Simian immunodeficiency virus-infected macaques may develop encephalitis, a feature more commonly observed in macaques with rapid progressive disease than in those with conventional disease. In this report, an analysis of 2 conventional progressors with encephalitis is described.
This randomized pilot trial investigated whether primary chemotherapy was feasible in terms of efficacy, survival, toxicity profile, and quality of life compared with whole-brain radiotherapy (WBRT) given first in chemotherapy-naive patients nonsmall cell lung cancer (NSCLC) with synchronous brain metastasis when neurologic symptoms or signs are absent or controlled by supportive care.
Ependymomas account for 2% of all intracranial tumors in adults. Supratentorial ependymomas are less common than their infratentorial counterparts. To the authors' knowledge to date, the predictive values of surgery, histology, and patient-related prognostic factors for these tumors remain unresolved. The authors report a series of adult patients with supratentorial ependymomas to characterize the roles of surgery and histology in tumor control.
The incidence of brain metastases (BM) from colorectal cancer (CRC) is increasing, and the management of this previously rare complication at a single institution is reported.
The British Journal of Psychiatry (2008) 192: 464-469
Previous work has identified elevated prevalence rates for psychiatric disorders in individuals with medically refractory focal epilepsy, particularly temporal lobe epilepsy. Many studies were undertaken before the advent of video electroencephalogram monitoring (VEM) and magnetic resonance imaging (MRI).
Current salvage therapy for recurrent high-risk neuroblastoma is rarely curative. Assessment of the effectiveness of new, primarily cytostatic agents requires the redefinition of study endpoints to reflect disease stabilization rather than tumor response or regression. The intervals of disease control in the patients in the current study with recurrent neuroblastoma were characterized to provide comparison criteria for exploratory studies of new agents.
The safety and efficacy of istradefylline, a selective adenosine A2A receptor antagonist, was evaluated in a 12-week, double-blind study in levodopa-treated Parkinson disease (PD) subjects with motor complications.
To develop a basic pain data set (International Spinal Cord Injury Basic Pain Data Set, ISCIPDS:B) within the framework of the International spinal cord injury (SCI) data sets that would facilitate consistent collection and reporting of pain in the SCI population.
Wheelchair sports have become popular in Germany. This is important because of the difficulty experienced by wheelchair-dependent people in maintaining cardiovascular health and fitness by daily activities.
Exercise has beneficial effects on muscle and motor function after spinal cord injury (SCI). Little is known regarding effects of prolonged intense exercise (IE) in humans with chronic SCI.
British Journal of Neurosurgery, Volume 22, Issue 3 June 2008 , pages 402 - 408
The transformation from low grade to aggressive astrocytoma is well known. However, the development of a completely different tumour such as a primitive neuroectodermal tumour (PNET) within a low grade astrocytoma (LGA) is rare.
British Journal of Neurosurgery, Volume 22, Issue 3 June 2008 , pages 452 - 455
The surgical management of recurrent glioblastoma multiforme is controversial. Recent publications suggest that re-operation provides 3-5 months median survival, without significant increases in morbidity or martality.
British Journal of Neurosurgery, Volume 22, Issue 3 June 2008 , pages 339 - 349
The objective of this study was to review the results of randomized Phase III controlled trials (RCTs) that involve initial treatments of malignant glioma and determine changes in median survival times (MST) over the last 40 years. An electronic database search identified RCTs for patients undergoing initial treatment for supratentorial high-grade malignant glioma.
British Journal of Neurosurgery, Volume 22, Issue 3 June 2008 , pages 415 - 422
It has been suggested that potential risk of hemiballismus after subthalamotomy makes DBS preferable to ablation for IPD treatment; however, cost and the need for regular electrode control have also been observed as disadvantages to stimulation. The objective was to compare efficacy and safety of different surgical approaches to STN, in a prospective randomized pilot study.
British Journal of Neurosurgery, Volume 22, Issue 3 June 2008 , pages 433 - 435
We report the case of an adolescent with a thoracic spine astrocytoma whose initial presentation was communicating hydrocephalus. We speculate that the mechanism may be reduced meningeal compliance due to meningeal spread of the tumour. Craniospinal MR imaging should be considered as part of the routine work up for patients presenting with unexplained hydrocephalus, elevated CSF protein and/or long tract symptoms/signs.
British Journal of Neurosurgery, Volume 22, Issue 3 June 2008 , pages 360 - 367
Day-case biopsy and craniotomy for brain tumours have been reported as safe and feasible options for selected patients. The incidence and timing of complications after such procedures has also been characterized in recent publications. However, more widespread adoption of day-case cranial neurosurgery has not taken place.
British Journal of Neurosurgery, Volume 22, Issue 3 June 2008 , pages 368 - 372
Increased numbers of asymptomatic intracranial lesions are being identified because of recent advances in imaging technology. Understanding of the natural history of these diseases, together with length bias is highly important in refining treatment strategy. Two sample models of hypothetical healthy cohorts were constructed, in which diseases showed either dual-type or multiple-type heterogeneity. Relative preclinical interval (PCI) of asymptomatic lesions including length-biased sampling was calculated, confirming that relative PCI increased according to heterogeneity of the disease.
British Journal of Neurosurgery, Volume 22, Issue 3 June 2008 , pages 389 - 397
Non-invasive measurement of cerebral hydrodynamic parameters may be of great use in the study and treatment of conditions involving abnormal intracranial pressure (ICP). ICP can be assessed indirectly in humans by calculation of intracranial volume changes and elastance using MRI. These two hydrodynamic parameters are derived from mathematical analysis of the relationships between blood flow to and from the brain, CSF flow and heart rate.
The majority of optic pathway tumors associated with Neurofibromatosis type-1 (NF-1) are benign, slow-growing lesions: however, rapidly growing tumors, which cause proptosis and visual loss, can sometimes occur.
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