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Child's Nervous System, Volume 23, Number 1, January 2007, pp. 39-46(8)
The optimal therapeutic management of children with World Health Organization grade I and II gliomas not accessible to complete resection is poorly defined. Radical surgical resection is the first-line treatment for large hemispheric tumors, whereas interstitial iodine-125 radiosurgery (IRS) might be an attractive treatment concept for selected patients with small (tumor diameter in the range of 4 cm) and circumscribed tumors in any location of the brain.
Journal of Neurosurgical Anesthesiology. 19(1):38-44, January 2007
Patients with refractory seizures may undergo awake craniotomy and cortical resection of the seizure area, using intraoperative functional mapping and electrocorticography
(ECoG). We used dexmedetomidine in 6 patients, transitioning successively from the asleep-awake-asleep method, through a combined
propofol/dexmedetomidine sedative infusion, to dexmedetomidine as the only sedation. Initial experience with the asleep-awake-asleep method in 2 patients was successful with the replacement of
propofol/laryngeal mask anesthesia, 20 to 30 minutes before ECoG testing, by dexmedetomidine infusion, maintained at 0.2 mcg kg-1 h-1 throughout neurocognitive testing.
Child's Nervous System, Volume 23, Number 1, January 2007, pp. 117-121(5)
Leptomeningeal involvement in diffuse intrinsic brain stem gliomas is rarely diagnosed clinically and in majority of the instances diagnosed only on postmortem examination. We report two cases of diffuse pontine glioma diagnosed clinicoradiologically and treated with conventional radiotherapy.
Persistence is the most characteristic attribute of long-term memory (LTM). To understand
LTM, we must understand how memory traces persist over time despite the short-lived nature and rapid turnover of their molecular substrates. It is widely accepted that LTM formation is dependent upon hippocampal de novo protein synthesis and Brain-Derived Neurotrophic Factor
(BDNF) signaling during or early after acquisition.
Neuronal ceroid lipofuscinoses (NCLs) are characterized by epilepsy, visual failure, psychomotor deterioration, and accumulation of autofluorescent
lipopigment. CLN8 mutations result in Northern epilepsy and Turkish variant late infantile
NCL.
There is evidence that remote memory is affected by temporal lobe epilepsy (TLE) and by temporal lobectomy (TL) for the relief of epilepsy. However, remote memory is not routinely assessed when patients with epilepsy undergo neuropsychological testing either pre- or
postsurgery.
The impact of epilepsy on women involves unique issues related to hormone effects on seizure control, seizure and drug effects on reproductive health, birth control options, and bone mineral density. Patient–physician communication on these critical issues may not be adequate.
To analyze medical errors and adverse events occurring in stroke patients and to provide insights into system or stroke-specific processes that can be modified to reduce the likelihood of error and patient harm.
Diabetes is an important risk factor for stroke. We conducted analyses in patients who had entered the PROspective pioglitAzone Clinical Trial In macroVascular Events
(PROactive) with a history of stroke or without stroke.
The majority of genes associated with epilepsy syndromes to date are ion channel genes. Selection bias may have allowed us to establish their role in epilepsy based on a priori knowledge of the significance of these proteins in regulating neuronal excitability.
American Journal of Neuroradiology 28:486-488, March 2007
Morphometry and spectroscopy were performed in 3 patients with fragile X-associated tremor/ataxia syndrome
(FXTAS). The brain stem and cerebellum were atrophic and satisfied criteria for olivopontocerebellar atrophy in 2 patients.
American Journal of Neuroradiology 28:497-500, March 2007
Assessments of completeness of endovascular cerebral aneurysm therapy are commonly reported in the literature. We studied several aneurysm assessment scales with regard to observer variability, which directly affects validity of these scales.
American Journal of Neuroradiology 28:503-507, March 2007
It is essential to measure the skin dose of radiation received by patients during interventional neuroradiologic procedures performed under fluoroscopic guidance, such as embolization of cerebral aneurysms, which is regarded as a high-dose interventional radiology procedure.
American Journal of Neuroradiology 28:508-510, March 2007
The purpose of this study was to assess the incidence of de novo aneurysm formation, the incidence of subarachnoid hemorrhage
(SAH), and the growth of existing untreated aneurysms in 52 patients after therapeutic carotid artery balloon occlusion for carotid aneurysms.
American Journal of Neuroradiology 28:537-542, March 2007
Although the cerebellum has not attracted the same degree of attention as cortical areas and the hippocampus in traumatic brain injury
(TBI) literature, there is limited structural and functional imaging evidence that the cerebellum is also vulnerable to insult.
Neurosurgery. 60(2) Supplement 1:83-88, February 2007
Postcraniotomy subdural empyemas and epidural abscesses are uncommon, potentially lethal, complications of neurosurgery. Patients with these complications may be difficult to manage, and mortality can occur.
Neurosurgery. 60(2) Supplement 1:89-99, February 2007
Convection-enhanced delivery (CED) holds tremendous potential for drug delivery to the brain. However, little is known about the volume of distribution achieved within human brain tissue or how target anatomy and catheter positioning influence drug distribution.
A short cut review was carried out to determine whether measuring C Reactive Protein might help in the diagnosis of intracranial infection in a patient presenting to the Emergency department with an acute headache. 62 papers were found, but none answered the question.
To describe clinical, pathologic, and genetic features of three FTD patients having either a family history of FTD (A.III.1 and B.II.1) or of ALS (C.III.1).
To examine gender differences in rate-corrected QT interval (QTc), an index of ventricular
depolarization/repolarization, in young, trained men and women with lower spinal cord injury (SCI) and able-bodied (AB) controls.
To correlate the two types of early ischemic change on noncontrast CT
(NCCT) (parenchymal hypoattenuation [PH] and isolated focal swelling [IFS]) with concurrent assessment of cerebral perfusion and to compare their rates of progression to infarction.
To determine if repeated dosing with methylphenidate hydrochloride (MPD) (Ritalin; Novartis Pharmaceuticals, East Hanover, NJ), an inhibitor of the dopamine transporter, would augment the effects of oral levodopa in patients with Parkinson disease.
Prestroke statin use may improve ischemic stroke outcomes, yet there is also evidence that statins and extremely low cholesterol levels may increase the risk of intracranial hemorrhage.
To evaluate the relationship between body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) and discharge outcomes among persons hospitalized for ischemic stroke.
To determine the association between sex and functional outcomes after thrombolytic treatment for acute ischemic stroke in the context of a clinical trial.
Stem cell transplants are established therapy for hematologic and solid tumor malignancies. Known neurological complications of stem cell transplantation include CNS infection, seizures, strokes, metabolic encephalopathy, and hemorrhage.
Seventy-nine consecutive patients with symptomatic atherosclerotic stenosis 50% of intracranial vertebrobasilar artery (VBA) were treated by elective
stenting. There were five strokes within 30 days, and three strokes in the VBA territory after 30 days (mean of 812 days).
To examine the clinical meaning of the changes in nitric oxide synthase (NOS) expression and activity after spinal cord injury (SCI) according to the age of the experiment animal.
Many Veteran Health Administration (VHA) enrollees receive health services outside the VHA system. However, limited information is available about poststroke utilization and mortality by veterans who used multiple sources of health care. This study assessed the likelihood of 12-month poststroke rehospitalization and mortality of veterans who used VHA only versus those who used multiple sources of care.
American Journal of Neuroradiology 28:293-298, February 2007
Diffusion tensor magnetic resonance imaging (DTI) of the brain is usually acquired with single-shot echo-planar imaging, which is associated with localized signal loss, geometric distortions, and blurring. Parallel imaging can lessen these artifacts by shortening the length of the echo-train acquisition.
Atypical teratoid/rhabdoid tumor of the central nervous system is a highly malignant neoplasm and that usually arises in the posterior
fossa, survival from this is frequently poor.
Hashimoto's encephalopathy is an unusual condition that is associated with Hashimoto's
thyroiditis. Myoclonus, epileptic seizures, dementia, and disturbances of consciousness are the most common features.
Journal of Pediatric Psychology 2007 32(3):354-369
While a small number of research papers have reported findings on attentional deficits following pediatric traumatic brain injury
(TBI), no study to date has reported findings in this area at 5 years
post-TBI in very young children. This study examined attentional skills in a group of children who had sustained a mild, moderate, or severe TBI between the ages of 2 and 7 years.
Intracerebral hemorrhage represents the most feared complication of treatment with intravenous tissue plasminogen activator. We studied whether perfusion-weighted imaging and diffusion-weighted imaging has the potential to identify patients at risk of severe intracerebral hemorrhage after treatment with intravenous tissue plasminogen activator.
Few data on xenon computed tomography-based quantitative cerebral blood flow
(CBF) in spontaneous intracerebral hemorrhage have been reported. We correlated perihematomal CBF in a retrospective series of 42 subacute spontaneous intracerebral hemorrhage patients undergoing xenon computed tomography with in-hospital discharge status and mortality.
The intensity of the inflammatory response may be related to the volume of acute infarction. Ultra-small superparamagnetic particles of iron oxide
(USPIO) may enable assessment of neuroinflammation. We aimed to assess whether the intensity of the inflammatory response might be related to the subacute ischemic lesion volume.
Few acute stroke patients are treated with alteplase, partly because of significant prehospital delays after symptom onset. The aim of this study was to determine among ambulance-transported stroke patients factors associated with stroke recognition and factors associated with a call for ambulance assistance within 1 hour from symptom onset.
Neurosurgery. 60(2) Supplement 1:19-32, February 2007
Hemispherotomy techniques have been developed to reduce complication rates and achieve the best possible seizure control. We present the results of our pediatric patients who underwent vertical parasagittal hemispherotomy and evaluate the safety and global long-term outcome of this technique.
Paediatric Anaesthesia, Volume 17, Number 4, April 2007, pp. 333-340(8)
This study aimed to test the preliminary psychometric properties of the Multidimensional Assessment Pain Scale (MAPS), a clinical instrument developed for assessing postoperative pain in critically ill preverbal children.
European Journal of Emergency Medicine. 14(2):72-74, April 2007
Intracranial stab wounds are relatively uncommon, as the adult skull usually provides an effective barrier to penetration. We present an interesting case of a penetrating intracranial stab wound with several important teaching points.
To determine whether items of the Frenchay Activities Index (FAI) measure Instrumental Activities of Daily Living
(IADL), as a unidimensional construct, in patients with spinal cord injury (SCI). To examine whether the response categories of the FAI are useful in discerning the various ability levels of
IADL.
Child's Nervous System, Volume 23, Number 3, March 2007, pp. 297-303(7)
The Medtronic PS Medical Strata valve has pressure flow characteristics that are noninvasively adjusted with a magnetic tool. The objective of this study was to examine its efficacy during our initial experience with it in shunt-dependent children.
American Journal of Neuroradiology 28:455-461, March 2007
Vascularity, metabolism, and histologic grade are related in gliomas but the exact determinants of these relationships are not fully defined. We used image coregistration and stereotactic biopsies to regionally compare cerebral blood volume
(CBV) and 11C-methionine (MET) uptake measurements in brain gliomas and to assess their relationship by histopathologic examination.
Routine CT of the brain is traditionally performed with sequential CT. We assessed whether sequential CT can be replaced with thinly collimated multisection spiral CT without loss of image quality.
American Journal of Neuroradiology 28:449-454, March 2007
In this study, intensive video electroencephalogram (EEG) monitoring, high-resolution MR imaging
(MR imaging), proton MR spectroscopy (1H-MR spectroscopy) and single-photon emission CT
(SPECT) were compared in patients with temporal lobe epilepsy (TLE) to evaluate lateralization of affected hemisphere with regard to bilateral affection and postoperative outcome.
American Journal of Neuroradiology 28:462-469, March 2007
The underlying changes in the neuronal connectivity adjacent to brain tumors cannot always be depicted by conventional MR imaging. The hypothesis of this study was that preoperative sensorimotor deficits are associated with impairment in pyramidal fiber bundles. Hence, we investigated the potential of combined quantitative diffusion tensor (DT) fiber tracking and MR spectroscopic imaging
(MRSI) to determine changes in the pyramidal tract adjacent to
gliomas.
The current report details our initial periprocedural experience with Wingspan (Boston Scientific/Target), the first self-expanding stent system designed for the treatment of intracranial atheromatous disease.
Neurosurgery. 60(2) Supplement 1:53-59, February 2007
We describe our surgical posterior transpetrosal technique, particularly the transcrusal variant for lesions involving the upper and middle
clivus, petroclival regions, and lesions that involve both the posterior and middle
fossae.
American Journal of Neuroradiology 28:255-259, February 2007
Recent evidence from neuropsychologic and neuroimaging studies suggests that central nervous system involvement in amyotrophic lateral sclerosis
(ALS) extends beyond motor neurons. Our purpose was to obtain measures of global and regional atrophy in nondemented patients with ALS to assess subtle structural brain changes.
The actions of estradiol in the brain involve the interaction with growth factors, such as insulin-like growth factor-I
(IGF-I). Many cells in the brain coexpress receptors for estradiol (ERs) and
IGF-I (IGF-IR) and both factors interact to regulate neural function. Several studies have shown that there is an interaction of IGF-IR and ERs in
neuroprotection.
Gliomas are tumors of the white matter. They are usually located deep within the skull and extend into the basal ganglia, though some are found near the surface of the brain. Calvarial erosion is known to occur with some superficially located tumors, mostly
oligodendrogliomas.
Does stress damage the brain? Studies of adults with posttraumatic stress disorder have demonstrated smaller hippocampal volumes when compared with the volumes of adults with no posttraumatic stress disorder. Studies of children with posttraumatic stress disorder have not replicated the smaller hippocampal findings in adults, which suggests that smaller hippocampal volume may be caused by neurodevelopmental experiences with stress.
Current Opinion in Critical Care. 13(2):175-179, April 2007
This review gives an integrated view on the current status of decompressive surgery in space-occupying hemispheric brain infarction with a focus on new developments based on the available data of recent clinical trials, also including preliminary data from randomized trials reported at international stroke conferences in 2006.
Current Opinion in Critical Care. 13(2):169-174, April 2007
Controversy still exists about the management of spontaneous intracerebral
haemorrhage. This review summarizes our current knowledge on indications and benefits of surgery for intracerebral
haemorrhage. It further describes the detailed meta-analysis of the surgical results in lobar (superficial) supratentorial intracerebral
haemorrhage, summarizes the limited information on the surgical treatment of cerebellar intracerebral
haemorrhage, and identifies three ongoing trials.
The success of gait rehabilitation after stroke depends on active walking exercises. However, the disabling after-effects of stroke often make such exercises impossible at the onset of therapy. To facilitate treadmill training of paraparetic patients, a robot-driven gait orthosis
(Lokomat) was developed. We investigated the effects of the Lokomat when used with hemiparetic patients.
Neonatal arterial ischemic stroke occurs in 1:4000 births. Many children experience motor deficits but acute predictors of outcome are lacking. Diffusion-weighted MRI changes in descending corticospinal tracts remote from arterial ischemic stroke may represent
pre-Wallerian degeneration. We verify and quantify this signal and correlate it with motor outcome.
We retrospectively analyzed the effects of vagus nerve stimulation (VNS) therapy on utilization of medical services by 138 patients in a large staff-model health maintenance organization.
Child's Nervous System, Volume 23, Number 3, March 2007, pp. 269-281(13)
Rates of neurocognitive risk range from 35-50% of school-aged children with isolated single suture craniosynostosis
(SSC). It has been hypothesized that early surgical intervention to release suture fusion reduces risk for increased intracranial pressure
(ICP) and the corresponding risk to neurodevelopment.
Current Opinion in Critical Care. 13(2):163-168, April 2007
To identify the surgical indications in the treatment of posttraumatic intracranial hematomas and to evaluate the role of external decompression in severe posttraumatic intracranial hypertension.
Archives of Physical Medicine and Rehabilitation Volume 88, Issue 1 , January 2007, Pages 81-87
To investigate the natural stroke patterns of wheelchair users pushing on a level surface, to determine if users adapt their stroke patterns for pushing uphill, and to assess whether there are biomechanic advantages to one or more of the stroke patterns.
The preventive effect of anticoagulation in patients with stroke and atrial fibrillation (AF) is documented only in trials of minor stroke. Although anticoagulation reduced stroke recurrence, those trials did not demonstrate an influence of anticoagulation on survival.
In neuroendocrinology, it is believed that steroid hormones are synthesized in the gonads and/or adrenal glands, and reach the brain via the blood circulation.
Child's Nervous System, Volume 23, Number 3, March 2007, pp. 305-314(10)
Diagnosis of brainstem lesions in children based on magnetic resonance imaging alone is a challenging problem. Magnetic resonance spectroscopy
(MRS) is a noninvasive technique for spatial characterization of biochemical markers in tissues and gives information regarding cell membrane proliferation, neuronal damage, and energy metabolism.
Decompressive hemicraniectomy and duroplasty (DHCD) can improve survival in patients with severe cerebral edema. We present our clinical experience with DHCD for the treatment of refractory elevated intracranial pressure
(ICP) in patients with aneurysmal subarachnoid hemorrhage (aSAH).
To determine the characteristics of patients with stroke/TIA whose admission low-density lipoprotein
(LDL) levels were above goals defined by National Cholesterol Education Program Adult Treatment Panel
(NCEP-ATPIII) guidelines.
Brain Research Reviews Volume 53, Issue 2 , February 2007, Pages 250-259
In the memory domain, a large body of experimental evidence about subsystems of memory has been collected from classic lesion studies and functional brain imaging.
American Journal of Neuroradiology 28:305-306, February 2007
Wolfram syndrome is a rare autosomal recessive disorder featuring diabetes
insipidus, diabetes mellitus, optic atrophy, and deafness; DIDMOAD is a commonly accepted anonym for this disorder. We describe a 35-year-old man with Wolfram syndrome, who had marked atrophy of the brain stem, middle cerebellar peduncle, and cerebellum.
PEDIATRICS Vol. 119 No. 3 March 2007, pp. E768-E772
In an effort to shed light on the mechanism of hemiparetic stroke-like events experienced by patients with congenital disorder of glycosylation type
Ia, we evaluated 3 children with this disorder by brain imaging studies and continuous electroencephalogram monitoring during such events.
A ventricular diverticulum is usually found in patients with long-standing severe obstructive hydrocephalus that may extend into the supracerebellar cistern.
The authors report an unusual case of adamantinomatous craniopharyngioma occurring in isolation in the cerebellopontine angle of a 12-year-old female. The patient presented with a 1-year history of nausea, vomiting, and headache.
Brain Research Reviews Volume 53, Issue 2 , February 2007, Pages 235-249
The spinocerebellar ataxias type 2 (SCA2) and type 3 (SCA3) are progressive, currently untreatable and ultimately fatal ataxic disorders, which belong to the group of neurological disorders known as
CAG-repeat or polyglutamine diseases.
Methohexital and amobarbital have been used as agents for Wada testing in the presurgical evaluation of patients with epilepsy. Previous experience with methohexital as an anesthetic indicates that methohexital may decrease seizure threshold and may trigger seizures.
We sought to examine the prospective annual risk of hemorrhage in patients harboring
Spetzler-Martin grades IV and V arteriovenous malformations (AVMs) before and after initiation of treatment.
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy
(CADASIL) is an inherited systemic microangiopathy with prevalently cerebral manifestations. Among the causes of death, sudden unexpected death seems to occur in a significant number of CADASIL patients.
Referral patterns for on-site psychological services were tracked in a pediatric epilepsy clinic at a university medical center. Results revealed that 84 children treated for seizures were referred to an on-site pediatric psychologist.
The objective of this study was to examine clinical outcomes and recanalization rates in a multicenter cohort of stroke patients receiving intravenous tissue plasminogen activator by site of occlusion localized with bedside transcranial Doppler. Angiographic studies with intraarterial thrombolysis suggest more proximal occlusions carry greater thrombus burden and benefit less from local therapy.
Statins may exert some neuroprotection, because use before stroke onset has been related to better outcome and reduced mortality. The purpose of this study was to evaluate whether patients who receive tissue plasminogen activator have better outcome when statins were taken before stroke.
Am J Physiol Endocrinol Metab 292: E946-E951, 2007
The adult brain relies on glucose for its energy needs and stores it in the form of glycogen, primarily in
astrocytes. Animal and culture studies indicate that brain glycogen may support neuronal function when the glucose supply from the blood is inadequate and/or during neuronal activation.
Current Opinion in Critical Care. 13(2):156-162, April 2007
Purpose of review: The intent of this manuscript is to summarize the pathophysiologic basis for hemodynamic manipulation in subarachnoid hemorrhage and traumatic brain injury, highlight the most recent literature and present expert opinion on indications and use.
PEDIATRICS Vol. 119 No. 3 March 2007, pp. E610-E615
We aimed to describe gender differences in blood flow velocity and autoregulation of the anterior and posterior cerebral circulations in prepubertal children.
American Journal of Neuroradiology 28:243-249, February 2007
The loss of a major sensory input early in life is known to cause alterations in neuronal connectivity and physiology at the cellular level, but effects on gross anatomy are less well understood. The purpose of this study was to compare volumetric structural brain MR imaging scans of deaf versus hearing subjects by using
voxel-based morphometry (VBM). The hypothesis was that the deaf would have relative hypoplasia in the temporal lobe centers involved in hearing and speech.
It is known that most adult patients with epilepsy often have poor knowledge of their disorder, treatment options, and social and vocational consequences, despite the huge amount of information available.
Patients with nonvalvular atrial fibrillation and prior stroke or transient ischemic attack (TIA) are at high risk for recurrent stroke. We investigated whether ximelagatran was noninferior to warfarin in patients with prior stroke or TIA.
The Alberta Stroke Program Early CT Score (ASPECTS) is a validated method of assessing parenchymal ischemic changes, including focal swelling and
hypoattenuation. The hypothesis that these signs result from different pathophysiological processes was tested by comparing CT with diffusion and perfusion- weighted
MRI.
It has been suggested that central periodic breathing during sleep (CPBS) may develop in unilateral supratentorial stroke without cardiopulmonary disease and disturbed consciousness. Not many data existed about such patients.
To examine gender differences in rate-corrected QT interval (QTc), an index of ventricular
depolarization/repolarization, in young, trained men and women with lower spinal cord injury (SCI) and able-bodied (AB) controls.
Determine incidence of ASCI due to suicide attempt from 1970 to 2000. Describe demographics, injuries, mental illness, functional outcomes and nature of subsequent deaths.
Parsons et al. compared early ischemic change on noncontrast CT with concurrent perfusion CT. Focal swelling identified penumbral tissue, and parenchymal
hypodensity, infarct core. However, many acutely hypoperfused regions appeared normal on noncontrast CT, whereas perfusion CT accurately classified these regions as core or penumbral.
We report three patients with reflex toothbrushing-induced epilepsy associated with small circumscribed structural lesions in the primary somatosensory cortex in close proximity to the hand and speech motor areas.
To correlate the two types of early ischemic change on noncontrast CT (NCCT)
(parenchymal hypoattenuation [PH] and isolated focal swelling [IFS]) with concurrent assessment of cerebral perfusion and to compare their rates of progression to infarction.
Prestroke statin use may improve ischemic stroke outcomes, yet there is also evidence that statins and extremely low cholesterol levels may increase the risk of intracranial hemorrhage.
Understanding the areas involved in language functions not only enables investigators to understand neuroanatomical structures, but may be a promising technique in the presurgical evaluation of epilepsy.
Sudden unexpected death in epilepsy (SUDEP) is the commonest cause of seizure-related mortality in people with refractory epilepsy. Of the 6140 patients registered with the Epilepsy Unit at the Western Infirmary in Glasgow between 1982 and 2005, 529 had died, 62 (11.7%) of whom succumbed to
SUDEP.
Epilepsy and behavior have a complex, often intriguing relationship. We report here the interesting case of Mrs. A, who presented with depression and developed seizures and an ictal psychosis precipitated by use of a selective serotonin reuptake inhibitor. She subsequently presented with forced normalization characterized by affective somatoform and hysterical manifestations.
This study explores the possibility that people with epilepsy are commonly and persistently perceived as potentially violent during and between seizures. In 1981 and again in 2006, we assessed responses to a questionnaire that includes vignettes and direct questions about violence in epilepsy.
Little is known about the medical decision-making abilities of older adults with chronic partial epilepsy, although these patients are often faced with medical decisions that impact their health care. Twenty-one older adults with epilepsy and 21 healthy older adults completed the Capacity to Consent to Treatment Instrument
(CCTI) and Dementia Rating Scale II (DRS-II).
Spinal neurenteric cysts are very rare intradural developmental lesions, predominantly localized anterior to the cervical cord and arising from misplaced endodermal cells in the 3rd week of embryonic life.
The American Journal of Surgery Volume 193, Issue 3 , March 2007, Pages 380-384
Traumatic brain injury (TBI) may be a risk factor for venous thromboembolism
(VTE). This study was designed to review the incidence of VTE in critically injured patients with an isolated TBI using a standardized venous duplex color-flow Doppler imaging program and to compare it with the overall and high-risk trauma populations.
Brain Research Volume 1136, Issue 1 , 9 March 2007, Pages 59-76
A 5-min unprotected exposure to a cat produces long-lasting anxiogenic effects on behavior which are NMDA receptor-dependent. Since phosphorylation of CREB is regulated by NMDA receptors and pCREB-like-immunoreactivity
(lir) is increased after predator stress, we examined the effects of CPP (3-(2-carboxypiperazin4-yl)propyl-l-phosphonic acid), a competitive NMDA receptor antagonist, on predator stress-induced changes in pCREB-lir in brain areas implicated in fearful and anxious behavior.
PEDIATRICS Vol. 119 No. 3 March 2007, pp. E554-E561
Postterm delivery is a risk factor for perinatal complications, some of which increase risk for neurologic morbidity. We aimed to examine the association between postterm delivery and risk for epilepsy in childhood.
A large Verbal IQ (VIQ)/Performance IQ (PIQ) discrepancy has been viewed as a sign of lateralized brain dysfunction. The current study was conducted to determine if the presence of a large
VIQ/PIQ discrepancy (15 points) would accurately predict laterality of seizure foci in pediatric patients with epilepsy.
People with epilepsy (PWE), particularly those with more severe seizures, are at risk of premature death. The contribution of deaths unrelated to epilepsy to this risk is likely to be significant. Recent studies indicate that comorbid conditions are similarly increased in
PWE. The reason for these increases in unrelated deaths and comorbid conditions is unclear.
European Journal of Neurology, Volume 14, Number 3, March 2007, pp. 321-326(6)
We investigate sleep and breathing in clinically stable myasthenia gravis (MG) patients and ask weather sleep disordered breathing
(SDB) is causally linked with MG. Nineteen MG patients with a mean disease duration of 9.7years underwent sleep studies in two consecutive nights.
An 11-year-old boy developed catastrophic occipital lobe epilepsy with progressive neurocognitive decline which led to surgical treatment. Pathological examination of the resected epileptic area showed chronic inflammatory changes.
American Journal of Kidney Diseases March 2007 Volume 49 Number 3
The purpose of this study is to assess the predictive value of proteinuria and creatinine clearance
(CrCl) in relation to mortality in patients with spinal cord injury.
Few data exist regarding rates and predictors of recurrence after childhood arterial ischemic stroke. We sought to establish such rates within a large, multiethnic population and determine whether clinical vascular imaging predicts recurrence.
PEDIATRICS Vol. 119 No. 3 March 2007, pp. E616-E623
The purpose of this work was to determine cognitive and adaptive behavioral outcomes of children with traumatic brain injury acquired before age 2 years and to compare outcomes between inflicted versus noninflicted brain injury.
PEDIATRICS Vol. 119 No. 3 March 2007, pp. E760-E763
Cat-scratch disease is a common disease, occurring in an estimated 24000 patients annually in the United States, and is one of the most common causes of chronic lymphadenitis in children. A wide array of neurologic complications occurs as a result of cat-scratch disease.
The Journal of Bone and Joint Surgery (American). 2007;89:571-578
Occipitalization is defined as a congenital fusion of the atlas to the base of the
occiput. We are not aware of any previous studies addressing the morphologic patterns of occipitalization or the implications of occipitalization in children. We present data on what we believe is the largest reported series of children with occipitalization studied with computed tomography and/or magnetic resonance imaging, and we provide a description of their clinical characteristics.
Methotrexate (MTX)-based chemotherapy extends survival in patients with primary brain lymphomas, but it is not clear whether multiagent chemotherapy is superior to MTX alone.
Clinical Cancer Research 13, 1253-1259, February 15, 2007
Recurrent grade III-IV gliomas have a dismal prognosis with minimal improvements in survival seen following currently available salvage therapy. This study was conducted to determine if the combination of a novel antiangiogenic therapy,
bevacizumab, and a cytotoxic agent, irinotecan, is safe and effective for patients with recurrent grade III-IV
glioma.
Calcification has been associated with carotid plaque stability; however, an acceptable in vivo method to define plaques based on this component remains to be developed. The purpose of our study was to compare calcified and noncalcified volumes of carotid artery culprit symptomatic plaques with asymptomatic plaques using multidetector computed tomography.
Cephalalgia, Volume 27, Number 2, February 2007, pp. 133-138(6)
The incidence and clinical relevance of subdural haematoma (SDH) in patients with spontaneous intracranial hypotension
(SIH) remain undetermined. We reviewed 40 consecutive SIH patients (18 female, 22 male) in a tertiary hospital.
Infection after experimental focal ischemia may result from brain-induced
immunodepression, but it is unsettled whether a similar syndrome occurs in human stroke.
Background As critical mediators of local and systemic inflammatory responses, cytokines are produced in the brain following ischaemic stroke. Some have been detected in the circulation of stroke patients, but their role and source is unclear.
Reliable and rapid delineation of arteriovenous malformations enables the application of effective treatments such as stereotactic
radiosurgery. We describe a new method to improve the speed and reliability of visualizing the flow of contrast images with digital subtraction angiography.
Radiosurgery is increasingly used to manage malignant melanoma brain metastases. We reviewed our series of patients who underwent radiosurgery for melanoma brain metastases to assess clinical outcomes and identify prognostic factors for survival and cerebral disease control.
Endovascular coiling has been used increasingly as an alternative to neurosurgical clipping for treating subarachnoid hemorrhage secondary to aneurysm rupture. The aim of the present study was to provide a prospective, longitudinal investigation into cognitive function in patients with aneurysmal subarachnoid hemorrhage treated with either neurosurgical clipping or endovascular coiling.
To evaluate the arteriovenous malformation (AVM) obliteration rate and the clinical outcome after radiosurgery in patients with and without previous
embolization.
It remains unclear whether or not and to what extent stereotactic radiosurgery can reduce the risk of first intracranial hemorrhage from brain arteriovenous malformations.
Approximately 800,000 cervical spines are cleared in emergency departments each year. Errors in diagnosis of cervical spine injury are a potentially huge medicolegal liability, but no established protocol for clearance of the cervical spine is known to reduce errors or delays in diagnosis.
This is the first report of the rupture of a giant aneurysm in a patient who sustained a remote angiographically negative subarachnoid hemorrhage
(SAH).
Astroblastomas are rare glial neoplasms that usually occur in young adults and have a predilection for the cerebral hemispheres. Patients typically present with signs of increased intracranial pressure and seizures. Imaging studies reveal circumscribed, contrast-enhancing tumors that contain both cystic and solid components with variable peritumoral edema.
Secondary brain injury after subarachnoid hemorrhage (SAH) is poorly understood. As a result, there are few treatment options. Consequently, SAH is associated with a high rate of morbidity and mortality. In an effort to combat these problems, the role of apoptosis was examined in the whole brain after
SAH. In particular, the role of p53 and the three major apoptotic cascades were studied, the
caspase-dependent and caspase-independent cascades and the mitochondrial pathway.
The identification of neoplastic tissue within normal brain during biopsy and tumor resection remains a problem in the operative management of
gliomas. A variety of nanoparticles are phagocytized by macrophages in vivo. This feature may allow optical
nanoparticles, such as quantum dots, to colocalize with brain tumors and serve as an optical aid in the surgical resection or biopsy of brain tumors.
This study investigated the effects of a combination therapy of marrow stromal cells
(MSCs) and statins (atorvastatin) after traumatic brain injury in rats.
American Journal of Neuroradiology 28:236-242, February 2007
Neuropsychologic deficits are well-known sequelae of traumatic brain injury. However, the cerebral correlates of these deficits are still unclear. The aim of the present study was to elucidate the regions of cerebral dysfunction correlated with such neuropsychologic deficits after traumatic brain injury.
Child's Nervous System, Volume 23, Number 1, January 2007, pp. 31-37(7)
Pediatric arteriovenous malformations (AVMs) are generally treated with microsurgical resection to achieve complete obliteration. We review our experience treating AVMs in children, particularly those with residual or recurrent lesions.
Few suitable instruments exist for use with people, especially children, with both epilepsy and learning disabilities. One such measure is the Epilepsy and Learning Disabilities Quality of Life scale
(ELDQOL), which has recently undergone revision following feedback from relevant users.
In children, early differentiation among various etiologies of arterial ischemic stroke
(AIS) is important. Cerebral arteriopathy is a frequently identified cause of childhood stroke. Children with arteriopathies require a different therapeutic approach from children with AIS of nonarteriopathic origin. We aimed to investigate the association between temporal features of the onset of neurological symptoms and stroke etiology in children with
AIS.
The purpose of the analysis described here was to assess reproductive endocrine disorders in 148 women with epilepsy
(WWE) by epilepsy type and antiepileptic drug use.
Poststroke depression is a prevalent and disabling disorder, yet evidence regarding the effectiveness of treating poststroke depression is inconclusive. Our objective was to determine the effectiveness of the Activate-Initiate-Monitor care management program for the treatment of poststroke depression.
Children with epilepsy attending a condition-specific overnight camp were evaluated for behavioral changes over 3 consecutive years, using a modification of the Vineland Adaptive Behavioral Scale.
Computerized Medical Imaging and Graphics Volume 31, Issue 2 , March 2007, Pages 81-90
A novel approach for correcting intensity nonuniformity in magnetic resonance imaging
(MRI) is presented. This approach is based on the simultaneous use of spatial and gray-level histogram information.
Individuals with transient ischemic attack and ischemic stroke have a high risk of recurrent stroke and death. While acetylsalicylic acid
(ASA, aspirin) is proven and accepted as standard therapy in these patients, recent trials demonstrate that a combination of ASA and dipyridamole (DP) or clopidogrel may be superior to
ASA. Blocking the renin-angiotensin system with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers may also reduce recurrent stroke.
Purpose one was to characterize the consistency of intra-limb hip/knee (H/K) coordination according to a measure of average coefficient of correspondence (ACC) across strides. Purpose two was to investigate H/K ACC validity and ability to discriminate pre-/post-treatment change in stroke survivors.
Magnetic Resonance Imaging Volume 25, Issue 2 , February 2007, Pages 183-187
Temporal clustering analysis (TCA) and independent component analysis (ICA) are promising data-driven techniques in functional magnetic resonance imaging
(fMRI) experiments to obtain brain activation maps in conditions with unknown temporal information regarding the neuronal activity.
We report the case of a patient with complex partial seizures who developed a nonfluent aphasia when topiramate was added to his therapy. This emergent adverse effect appeared to be reversible, as language performance improved after discontinuation of
topiramate. Interictal SPECT performed when the patient was aphasic revealed a focal perfusion reduction in the left lateral and mesial frontal cortex, which was no longer evident at a follow-up study after language recovery.
This aim of this study was to illuminate quality of life (QOL) of young adults with epilepsy. Subjects (n = 102) answered the Quality of Life Index
(QLI) questionnaire together with an overall open question (n = 95/102) regarding the impact of epilepsy on daily life.
The purpose of this study was to determine whether motivational interviewing, a patient-centered counseling technique, can benefit patients’ mood 3 months after stroke.
European Journal of Neurology, Volume 14, Number 3, March 2007, pp. 276-281(6)
The etiology of peripheral neuropathy (PN) often remains elusive resulting in a lack of objective therapeutic strategies. We conducted a pilot study to evaluate the therapeutic effect of acupuncture on PN as measured by changes in nerve conduction and assessment of subjective symptoms.
To perform preliminary examination of electromyographic (EMG)-activated FES for caregiver-independent and synchronized cough and expiration induction in
tetraplegia.
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