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Journal of the Medical Association of Thailand Vol91 No.3 394 7352
Stroke patients who live in different areas might have different adjustments for their impairment and disability after stroke attack. These factors should be evaluated in Thai patients.
To measure the prevalence of computed tomography (CT)-detected cerebral lesions in a population-based sample of elderly persons living in
Gateborg, Sweden.
Current Opinion in Critical Care. 14(2):129-134, April 2008
The review provides key points and recent advances regarding the treatments of intracranial hypertension as a consequence of traumatic brain injury. The review is based on the pathophysiology of brain edema and draws on the current literature as well as clinical bedside experience.
To estimate the incidence and mortality associated with first unprovoked seizure or newly diagnosed epilepsy in a low-income, predominantly Hispanic community in Northern Manhattan, New York City.
American Journal of Neuroradiology 29:501-505, March 2008
arkinson disease (PD) is characterized by basal ganglia abnormalities. However, there are neurodegenerative changes in PD that extend beyond the basal ganglia and that are not sufficiently evaluated with standard MR imaging. The aim of this study was to characterize whole-brain gray matter (GM) and white matter (WM) changes in PD by using diffusion tensor imaging (DTI).
American Journal of Neuroradiology 29:603-607, March 200
Cortical visual loss is a rare complication of cerebral angiography without a definitive pathophysiology. Given the rapid increase in endovascular procedures used to treat cerebral aneurysms, we explored the prevalence of this complication and whether we could add to the understanding of this disorder.
Drug-induced liver injury associated with antiepileptic drugs (AED) is well recognized. The frequency of the most common AED is rare but the consequences can be very serious leading to death or liver transplantation due to acute liver failure induced by these drugs.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:448-450
alpha-Methylacyl-CoA racemase (AMACR) deficiency is a rare disorder of fatty acid metabolism which has recently been described in three adult cases. We have identified a further patient with clinical features of a relapsing encephalopathy, seizures and cognitive decline over a 40 year period. Biochemical studies revealed grossly elevated plasma pristanic acid levels, and a deficiency of AMACR in skin fibroblasts.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:471-473
Several lines of evidence indicate a role for inflammatory processes in the development of cerebral aneurysms. Recently, polymorphisms in the promoter region of the interleukin 6 (IL6) gene were shown to be associated with intracranial aneurysmal disease.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:451-453
Transcranial direct current stimulation (tDCS) has been proposed as an adjuvant technique to improve functional recovery after ischaemic stroke. This study evaluated the effect of tDCS over the left frontotemporal areas in eight chronic non-fluent post-stroke aphasic patients.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:464-466
Unilateral neglect is a challenging disorder that pervades a range of behaviours following stroke and hampers recovery. Although a preponderance of clinical studies measure performance on a range of bedside assessments, including line bisection and cancellation tasks, there have been calls for studies to embrace more relevant functional measures.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:368-376
Parkinson's disease (PD) is a progressive neurological disorder characterised by a large number of motor and non-motor features that can impact on function to a variable degree. This review describes the clinical characteristics of PD with emphasis on those features that differentiate the disease from other parkinsonian disorders.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:443-447
We report on fixation instabilities in a patient diagnosed with Parkinson's disease (PD). This patient underwent deep brain stimulation (DBS) surgery bilaterally in the vicinity of the subthalamic nuclei
(STN).
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:397-400
Models are used to adjust for case mix and to stratify treatment allocation in clinical trials and can, if accurate enough, be used to aid decision-making in individual patients. We aimed to validate, in patients assessed within 6 hours of onset, a previously described six simple variable (SSV) model that was developed in stroke patients who were assessed sub-acutely.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:387-391
To examine the occurrence and clinical and demographic correlates of REM sleep behaviour disorder
(RBD) in patients with Parkinson's disease (PD) in a community-based cohort over 8 years.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:421-425
Myasthenia gravis (MG) is a rare neurological disorder, which can be life threatening. Although death is a rare outcome, evidence does not exist as to whether neurological care leads to any better outcome than care by other specialties.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:392-396
Primary late-onset focal dystonias may spread over time to adjacent body regions, but differences in the risk of spread over time among the various focal forms and the influence of age at dystonia onset on the risk of spread are not well established.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:401-406
Motor dysfunction in the contralateral hand has been well characterised after stroke. The ipsilateral hand has received less attention, yet may provide valuable insights into the structure of the motor system and the nature of the recovery process. By tracking motor function of both hands beginning in the acute stroke period in patients with cortical versus subcortical lesions, we sought to understand the functional anatomy of the ipsilateral deficit.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:426-430
To investigate the effect of carrying the apolipoprotein epsilon 4 (APOE-4) allele on global functional outcome, on activity limitations and participation restrictions, and on community integration at 3, 6, 12, 18, 24 and 36 months after traumatic brain injury.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:488
As the medical school curricula change towards a more "problem-orientated" approach and the time available for each speciality keeps shrinking, this textbook will come in handy. It contains an initial discussion of the essentials of history-taking, examination and diagnostic techniques. The authors then move on to discuss different symptoms and their possible causes.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:487-488
"The soul in the brain: the cerebral basis of language, art, and belief" represents a major project from neuropsychiatrist Michael Trimble. An original and distinguished academic who has focused his research on the behavioural and psychiatric correlates of epilepsy, Dr Trimble has attempted to describe the neurological substrates that make us uniquely human.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:483-484
Polymicrogyria is a malformation of cortical organisation morphologically marked by an irregular brain surface with multiple excessively folded small gyri. Cortical thickness is reduced but appears increased in some areas as a result of the fusion of small gyri.1 On magnetic resonance imaging (MRI) polymicrogyria is delineated by an abnormal gyral pattern, increased cortical thickness and irregularity of the cortical-white matter junction.
Journal of Neurology, Neurosurgery, and Psychiatry 2008;79:480-481
A previously healthy 28-year-old Caucasian woman experienced a syncope and was referred to our emergency department. On admission, the patient was neurologically normal and alert. Electrocardiogram (ECG) was normal. Peripheral blood count and blood chemistry, including C-reactive protein and cardiac troponin T, were within normal limits. The patient revealed no history of drug or alcohol abuse.
TRPV1 is a sensory transduction channel that mediates thermal nociception and some aspects of pathological pain. In this issue of Neuron, Gibson et al. report that TRPV1 also plays important roles in hippocampal synaptic plasticity, presenting a potential challenge for TRPV1-targeted therapeutics for the treatment of pain.
The aim of this prospective, population-based study is to present the incidence of hospital-treated traumatic brain injury (TBI) in Oslo, Norway, and to describe the severity of brain injuries and outcome of the patients' acute medical care.
Plasmatic B-type-natriuretic peptide (NT-PBNP) and C-reactive protein (CRP) have been reportedly elevated in stroke patients; however their clinical significance remains uncertain. The purpose of this work is to investigate whether elevation of these proteins at baseline predicts CT-evidence of brain edema.
It is well known that most odorants stimulate both the olfactory system and the trigeminal system. However, the overlap between the brain processes involved in each of these sensorial perceptions is still poorly documented. This study aims to compare fMRI brain activations while smelling two odorants of a similar perceived intensity and pleasantness: phenyl ethyl alcohol (a pure olfactory stimulus) and iso-amyl-acetate (a bimodal olfactory-trigeminal stimulus) in a homogeneous sample of 15 healthy, right-handed female subjects.
To determine the involvement of cerebral metabolism in 2 siblings with mitochondrial neurogastrointestinal encephalomyopathy syndrome
(MNGIE)–like disease with multiple mitochondrial DNA
(mtDNA) deletions.
Motor neuron diseases (amyotrophic lateral sclerosis [ALS] and spinal muscular atrophy [SMA]) have been rarely associated with mitochondrial respiratory chain defects.
A high intake of magnesium, calcium, and potassium and a low intake of sodium have been hypothesized to reduce the risk of stroke. However, prospective data relating intake of these minerals to risk of stroke are inconsistent.
Journal of Clinical Oncology, Vol 26, No 8 (March 10), 2008: pp. 1338-1345
The prognostic role of extent of resection (EOR) of low-grade gliomas (LGGs) is a major controversy. We designed a retrospective study to assess the influence of EOR on long-term outcomes of LGGs.
Journal of Pediatric Orthopaedics. 28(2):234-238, March 2008
Friedreich's ataxia is a genetically transmitted, progressive spinocerebellar degenerative disease characterized by ataxia. The purpose of this study is to evaluate the demographics, progression, nonoperative, and operative treatment of spinal deformities in patients with Friedreich's ataxia at 2 tertiary pediatric orthopaedic hospitals.
Southern Medical Journal. 101(3):324-326, March 2008
The case of a 38-year-old man with a history of chronic migraine is reported. Despite a 3 week history of changes in his migraine pattern, a normal neurologic examination led to conservative treatment. He later presented with worsening headaches and imbalance; tendon reflexes were increased on the right side, and brain computed tomography and magnetic resonance imaging revealed a massive subacute subdural hematoma over the left hemisphere, developing on the grounds of bilateral temporal agenesis.
Current Opinion in Critical Care. 14(2):142-148, April 2008
Although theoretical advantages to early intubation include airway protection, improved oxygenation, and control of ventilation, recent clinical data document an association between early intubation and mortality. This likely reflects some degree of selection bias when considering intubation without the use of neuromuscular blocking agents. Paramedic use of these drugs, however, has also been associated with higher mortality.
Southern Medical Journal. 101(3):268-272, March 2008
Despite the availability of guidelines for the treatment of status epilepticus (SE), there may be variability in the initial stabilization, evaluation, and pharmacologic treatment of infants and children with SE. To improve the treatment of such patients, documentation of these problems is needed.
Acute confusion (AC) is a frequent reason for hospital admission in elderly patients. Although in majority of cases the cause is a systemic disorder (e.g., dehydration or septicaemia), patients are frequently subjected to cerebral imaging. This study was undertaken to find clinical predictors of normal cerebral computed tomography (CCT) or magnetic resonance imaging (MRI) scans in AC.
The role of the antihypertensive therapy in preventing cognitive disorders in elderly persons without a history of stroke is a matter of debate. This review focuses on the pathogenesis of the cognitive disorders in elderly hypertensives and on the risk factors of their occurrence.
Pallidal deep brain stimulation (DBS) of globus pallidus internus (Gpi) has emerged as an effective treatment for dystonia. The experience is however limited concerning focal dystonias and to date only a few cases of pallidal DBS in the treatment of Meige syndrome have been published.
The presurgical evaluation of children with intractable epilepsy includes evaluation by an experienced clinician, MRI, video EEG, and functional imaging techniques to localize seizure onset. However, the contributions of each investigation to surgical decision making has not been systematically assessed.
The use of volumetric MRI as a biomarker for assessing transitions to dementia presumes that more rapid brain loss marks the clinical transition from benign aging to mild cognitive impairment (MCI). The trajectory of this volume loss relative to the timing of the clinical transition to dementia has not been established.
A narrative, at its simplest, is a story. Doctors listen to and tell stories every day. At morning report, on rounds, at case conferences, while taking a patient’s history in clinic and when signing out in the evenings, stories are told, revised, and retold. These narratives are the foundations of clinical practice and the currency of patient-physician and physician-physician relationships.
Typically, the apraxic deficit of patients with left hemisphere damage is more pronounced for complex, i.e., sequential actions, than for simple ones. This impaired action sequencing can be attributed to a faulty selection of movements, a deficit of shifting motor attention, or, alternatively, disturbed processing of action-related temporal information.
Low-density lipoprotein cholesterol (LDL) is the primary lipid target for vascular risk reduction in stroke patients, but emerging data suggest that other lipid indices may better predict vascular hazard. We evaluated the relationship between several measures of the classically obtained serum lipid panel and the occurrence of large artery atherosclerotic stroke.
To quantify, in adults with chronic spinal cord injury (SCI): (1) presence of metabolic syndrome versus the general North American population (GP) and (2) 10-year coronary heart disease (CHD) risk using Framingham risk scoring (FRS).
Arch Neurol. 2008;65(5) There is some uncertainty whether prior use of antiplatelet (AP) drugs increases the risk of symptomatic intracerebral hemorrhage (SICH) and influences functional outcome in patients with ischemic stroke treated with intravenous thrombolysis.
Malformations of cortical development (MCDs) are a major source of handicap. Much progress in understanding the genetic causes has been made recently. The number of affected children in whom a molecularly confirmed diagnosis can be made is unclear.
Whole-genome association analyses have begun to yield confirmed findings for genetic risk variants for complex disease. As the first reports of its application to neurological disease are described, we review this progress, explain the principles of the analysis, and discuss what the future is likely to be in this exciting area.
Mutations that cause autosomal recessive primary microcephaly (MCPH), including MCPH1 through MCPH6, have provided insight into the normal programming that directs brain growth and defines ultimate brain size. The common denominator in these mutations is that they all manifest within neural stem and progenitor cells, decreasing their numbers at various stages of neurogenesis.
Journal of Neurosurgery March 2008 Volume 8, Number 3
The authors describe a rare case of Brown-Sequard syndrome as a result of indirect, concussive trauma to the spinal cord from a gunshot wound (GSW) and present the magnetic resonance (MR) imaging evidence obtained in this interesting case.
123I-Iomazenil brain SPECT has been used for the detection of epileptogenic foci, especially when surgical intervention is considered. Although epileptogenic foci exhibit a decrease in 123I-iomazenil accumulation, normal cerebral cortices often exhibit similar findings because of thin cortical ribbons, gray matter atrophy, or pathologic brain structures.
We performed a pilot project to assess the need for and feasibility of a church-based stroke risk reduction intervention in a predominantly Mexican American community.
The prognosis of acute basilar artery occlusion (BAO) is poor if early recanalization is not achieved. Recanalization strategies include intravenous thrombolysis (IVT) and intra-arterial thrombolysis, as well as endovascular mechanical thrombectomy (EMT). The combination of IVT with consecutive on-demand EMT may allow for early treatment initiation with high recanalization rates but has never been systematically tested in patients with BAO.
Intraprocedural rupture (IPR) is a well known complication of intracranial aneurysm treatment. Risks and predictors of IPR and its impact on outcome have not been clearly established.
For selected stroke patients, intra-arterial thrombolysis (IAT) has been shown to be an effective treatment option. However, knowledge of safety and efficacy of IAT in patients with acute stroke as a complication of arterial catheter interventions is limited.
The possible cause of chronic hydrocephalus after subarachnoid hemorrhage (SAH) has been reported to be meningeal fibrosis. We examined whether the induction of tenascin-C (TN-C), an extracellular matrix glycoprotein known to promote tissue fibrosis, was associated with chronic hydrocephalus after SAH.
Tissue factor (TF) is a transmembrane protein that acts as a receptor for activated coagulation factor VII (FVIIa), initiating the coagulation cascade. Recent studies demonstrate that expression of tumor-derived TF also mediates intracellular signaling relevant to tumor growth and apoptosis. Our present study investigates the possible mechanism by which the interaction between TF and FVIIa regulates chemotherapy resistance in neuroblastoma cell lines.
Journal of Neurosurgery Pediatrics March 2008 Volume 1, Number 3
Extracranial carotid artery (CA) aneurysms are rare in the pediatric population and are usually the result of connective tissue disorders, traumatic dissection, or infection. The authors present the case of a large calcified internal carotid artery pseudoaneurysm of obscure origins presenting with embolic stroke in a child.
Journal of Neurosurgery Pediatrics March 2008 Volume 1, Number 3
The authors present a case of scalp and facial edema following craniofacial reconstruction for metopic craniosynostosis in which recombinant human bone morphogenetic protein–2 (rhBMP-2) was used to treat cranial defects related to the frontoorbital reconstruction.
Men, but not women, with unrecognized myocardial infarction (MI) have an increased risk of cardiac events and stroke compared with those without MI or with recognized MI. We investigated whether unrecognized MI is also a risk factor for dementia and cerebral small vessel disease (white matter lesions and brain infarction) in 2 population-based cohort studies.
Limited information is available on the role of the metabolic syndrome (MetS) to predict stroke. We investigated the relationship of the MetS and its single components, defined by 6 different criteria, with stroke in a prospective population-based study.
Studies on adult stroke patients have demonstrated functional changes in cortical excitability, metabolic rate, or blood flow after motor therapy, measures that can fluctuate rapidly over time.
Focal stroke is associated with cell death, abnormal synaptic activity, and neurologic impairments. Given that many of these neuropathologic processes can be attributed to events that occur shortly after injury, it is necessary to understand how stroke affects the structure of neurons in surviving peri-infarct regions, particularly at the level of the dendritic spines, which transmit normal and potentially abnormal and injurious synaptic signaling. Recently, we described ischemia-induced changes in the structure of layer 1 dendritic tufts of transgenic mice expressing YFP in layer 5 cortical neurons.
We studied the natural course of white matter hyperintensities (WMH) and lacunes, the main MRI representatives of small vessel disease, over time and evaluated possible predictors for their development.
The molecular pathways involved in the progression of intracranial large artery atherosclerosis (ILA) are largely unknown. Our objective was to prospectively study the relationship between circulating levels of inflammatory markers and fibrinolysis inhibitors, and the risk of progression of symptomatic ILA.
Genetic variation in the EPHX2 gene region has been reported to influence susceptibility to ischemic stroke in blacks. We assessed the role of this gene region in white Europeans and performed analyses with regard to stroke subtypes.
The recent finding that genetic variants in 5-lipoxygenase activating protein and leukotriene A4 hydrolase may confer an increased risk of ischemic stroke has implicated the leukotriene family as potential mediators of cardiovascular disease. Using a case control replication methodology, all members of the leukotriene synthesis pathway and their receptors were examined for genetic variants, which may act as risk factors for all ischemic stroke and stroke subtypes.
In animal models of stroke, functional improvement has been obtained after stem cell transplantation. Successful therapy depends largely on achieving a robust and targeted cell engraftment, with intraarterial (IA) injection being a potentially attractive route of administration.
Smoking and increased levels of blood pressure (BP) substantially increase the risk of cardiovascular diseases (CVD). If these 2 risk factors have a synergistic impact on cardiovascular events, lowering BP and quitting smoking will contribute more to reducing CVD than would be expected from ignoring their interaction.
This meta-analysis systematically reviewed randomized controlled trials comparing aspirin plus dipyridamole with aspirin alone in patients with stroke and TIA to determine the efficacy of these agents in preventing recurrent cerebral and systemic vascular events.
Atherothrombotic diseases, including stroke and myocardial infarction, share a common pathogenesis. Chromosomal regions have been linked to atherothrombotic diseases in family studies, and association studies have identified candidate gene polymorphisms that affect the risk of stroke and/or myocardial infarction. Using data from the Family Blood Pressure Program, we tested for chromosomal regions linked to the composite phenotype of stroke or myocardial infarction in a large set of hypertensive families.
Current Opinion in Critical Care. 14(2):135-141, April 2008
Emerging data suggest that biomarkers of brain injury have potential utility as diagnostic, prognostic, and therapeutic adjuncts in the setting of traumatic and ischemic brain injury. Two approaches are being used, namely, assessing markers of structural damage and quantifying mediators of the cellular, biochemical, or molecular cascades in secondary injury or repair. Novel proteomic, multiplex, and lipidomic methods are also being applied.
The effects of alternative antiplatelet agents such as clopidogrel and dipyridamole have been studied in clinical trials and heavily marketed. Because public data on their usage are limited, we examined trends in their prescription after stroke and transient ischemic attack to assess the impact of marketing and trial results.
MRI-based quantification of gray and white matter volume is common in studies involving elderly patient populations. The aim of the present study was to describe the effects of not accounting for subcortical white matter hyperintensities (WMH) on tissue volumes in Alzheimer Disease patients with varying degrees of WMH (mild: n=19, moderate: n=22, severe: n=18).
Metabolic syndrome (MetS) is a recognized risk factor for stroke, but it is unclear whether MetS is also related to subclinical ischemic lesions. We examined the association of MetS with the prevalence of silent brain infarction, periventricular hyperintensity, and subcortical white matter lesions in healthy adults.
The benefit of intravenous thrombolysis in tandem internal carotid artery (ICA)/middle cerebral artery (MCA) occlusion remains unclear. We studied clinical and imaging outcome of intravenous thrombolysis in MRI-selected patients with tandem ICA/MCA occlusion as compared to isolated MCA occlusion.
Evaluation of posterior circulation with single-gate transcranial Doppler (TCD) is technically challenging and yields lower accuracy parameters in comparison to anterior circulation vessels. Transcranial power motion-mode Doppler (PMD-TCD), in addition to spectral information, simultaneously displays in real-time flow signal intensity and direction over 6 cm of intracranial space. We aimed to evaluate the diagnostic accuracy of PMD-TCD against angiography in detection of acute posterior circulation stenoocclusive disease.
Neurology India Year : 2008 Volume : 56 Issue : 1 Page : 103-104
A 13-year-old boy presented with history of recurrent episodes of right focal seizures since first year of life. The neurological examination was within normal limits. Routine laboratory and hematological workup was also normal. The seizures were well controlled on anti-epileptic medication.
Journal of Neurosurgery Pediatrics March 2008 Volume 1, Number 3
Cerebellar mutism syndrome (CMS) is a unique postoperative syndrome typically arising 1 to 2 days after resection of a midline posterior fossa tumor; it consists of diminished speech progressing to mutism, emotional lability, hypotonia, and ataxia. Most descriptions have been limited to small institutional series using a retrospective chart review methodology.
Although preparation of voluntary movement has been extensively studied, very few human neuroimaging studies have examined preparation of an intentional reaction to a motor perturbation.
We aimed to investigate differences in fractional anisotropy (FA) between primary lateral sclerosis (PLS) and amyotrophic lateral sclerosis (ALS) and the relationship between FA and disease progression using tract-based spatial statistics (TBSS).
Lesion studies on nonhuman primates utilizing recognition memory tests have shown that the orbitofrontal cortex is critical for the encoding of novel information, and anatomical studies have shown that the orbitofrontal cortex forms part of a mnemonic circuit that connects limbic medial temporal areas with higher-order lateral frontal cortical regions.
Journal of Neurosurgery March 2008 Volume 108, Number 3
Standard extracranial-intracranial (EC-IC) arterial bypass surgery represents a well-recognized procedure in which the aim is to augment distal cerebral circulation. The creation of the bypass requires temporary occlusion of the recipient vessel. Thus, there exists controversy about the risk of standard EC-IC arterial bypass surgery causing ischemic complications due to temporary vessel occlusion.
Journal of Neurosurgery March 2008 Volume 108, Number 3
Resection strategies for the treatment of temporal lobe epilepsy (TLE) are a matter of discussion, and little information is available. The aim of this study was to compare seizure outcomes at the 5-year follow-up in patients with medically refractory unilateral mesial TLE (MTLE) due to hippocampal sclerosis (HS) who were treated using a cortical amygdalohippocampectomy (CorAH) or a selective AH (SelAH).
Journal of Neurosurgery March 2008 Volume 108, Number 3
Primary temporal bone malignancy is a rare form of tumor for which the therapeutic strategy remains controversial. In this study, the authors reviewed their experience with radical temporal bone resection (TBR) of such lesions and analyzed the long-term results to provide treatment recommendations.
Journal of Neurosurgery March 2008 Volume 108, Number 3
The aim of this study was to assess the long-term results of intracranial aneurysms treated with Guglielmi detachable coils (GDCs) with the aid of contrast-enhanced magnetic resonance (MR) angiography.
Journal of Neurosurgery March 2008 Volume 108, Number 3
Experience with intraarterial abciximab for the treatment of thromboembolism during endovascular coil embolization is limited. The authors report the outcome of intraarterial abciximab use, with an emphasis on fatal hemorrhagic complications.
Journal of Neurosurgery March 2008 Volume 108, Number 3
The gap junction is important in the propagation of dilation/constriction signals along vessels for coordinated behavior in control of vascular tone. The authors hypothesized that gap junctions might play a role in cerebral vasospasm following subarachnoid hemorrhage (SAH).
Journal of Neurosurgery March 2008 Volume 108, Number 3
The purpose of this study was to determine whether cocaine use is a significant prognostic factor for outcome measures such as Hunt and Hess grade and Glasgow Outcome Scale (GOS) score among patients presenting with ruptured intracranial aneurysms (IAs).
Journal of Neurosurgery March 2008 Volume 108, Number 3
Because oral calcium channel blockers appear to reduce the severity of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH), interest in their application intraarterially has emerged for cases in which noninvasive means of alleviating vasospasm are unsuccessful. Studies to date have been limited to the administration of low intraarterial doses because of concerns about hemodynamic stability and changes in intracranial pressure. These doses, although effective in cases of milder vasospasm, were inadequate in severe cases.
Journal of Neurosurgery March 2008 Volume 108, Number 3
The treatment of complex cerebrovascular or skull base pathological conditions necessitates a microsurgical blood flow preservation or augmentative revascularization procedure as either an adjunctive safety measure or a definitive treatment. The brain is susceptible to ischemia, and procedure-related risks can be minimized by the reduction of occlusion time or the use of a nonocclusive technique. The authors therefore analyzed the feasibility of an automatic device (C-Port xA, Cardica) designed for constructing an end-to-side anastomosis with or without flow interruption for a middle cerebral artery (MCA) bypass in a human cadaveric model and in an in vivo craniotomy simulation model.
Journal of Neurosurgery March 2008 Volume 108, Number 3
The authors present the case of a patient with a direct carotid artery–cavernous sinus fistula caused by head trauma in whom a self-expanding covered stent was successfully used to obliterate the fistula. However, at the 9-month follow-up an angiogram revealed a complex caroticocavernous fistula that was completely obliterated with Onyx 18
transarterially.
Blood blister-like aneurysms (BBAs) are among the most hazardous cerebrovascular aneurysms to treat; microsurgical treatment of these small, wide-necked, and exceptionally fragile aneurysms place patients at significant risk of morbidity or mortality.
Journal of Pediatric Psychology 2008 33(3):242-247
To examine objective and subjective reports of sleep disturbance in school-aged children who had sustained mild traumatic brain injury (TBI) at least 6 months prior to the study.
Hashimoto encephalopathy (HE) is a serious but treatable condition that is probably underdiagnosed. We summarize and review all published cases to delineate the disease and to alert paediatricians so that they recognize the disease in children.
The study aimed to compare the cost-effectiveness of concomitant and adjuvant temozolomide (TMZ) for the treatment of newly diagnosed glioblastoma multiforme versus initial radiotherapy alone from a public health care perspective.
Previous functional neuroimaging studies on executive function suggested multiple functionally aberrant cortical regions in patients with Huntington's disease (HD). However, little is known about the neural mechanisms of working memory (WM) function in this patient population.
Journal of Neurosurgery Pediatrics March 2008 Volume 1, Number 3
Dysembryoplastic neuroepithelial tumors (DNTs) are commonly associated with medically resistant epilepsy that usually starts in childhood. Presurgical workup and surgical strategies remain controversial. The authors present a study of long-term seizure outcome after noninvasive presurgical investigations and different surgical strategies were used in a series of pediatric patients.
Journal of Neurosurgery Pediatrics March 2008 Volume 1, Number 3
Medulloblastoma is the most common malignant neuroepithelial tumor found in children. Several reports have described efforts to identify the prognostic significance of various patterns of pathological and immunohistochemical features in medulloblastoma, but the published data appear to be controversial. The authors therefore attempted to demonstrate these prognostic factors convincingly in a retrospective study performed in patients with medulloblastoma.
Clinical Cancer Research 14, 1571-1580, March 1, 2008
We have examined the spread and antitumor efficacy of an oncolytic herpes simplex virus-1-based vector (G207) in glioblastoma biopsy spheroids in vitro and in vivo after local delivery to corresponding intracranial xenografts. Spheroids from three patients were infected with increasing doses of G207 and transgene expression was quantified.
Current Opinion in Critical Care. 14(2):156-162, April 2008
The review outlines recent clinical and experimental studies regarding the effects of red blood-cell transfusion on clinical outcome in neurocritical patients, including patients with subarachnoid hemorrhage, acute ischemic stroke and traumatic brain injury. Optimal hemoglobin transfusion trigger and the role of other transfusion indicators for neurocritical patients are discussed.
Current Opinion in Critical Care. 14(2):163-166, April 2008
Hypoadrenalism occurs in approximately 25% of patients soon after traumatic brain injury. Neurosurgeons or critical care physicians should be prepared to diagnose and treat this and other related hormonal deficiencies.
Journal of Clinical Neuromuscular Disease. 9(2):318-325, December 2007
The issue of quality of life is important for the patient with amyotrophic lateral sclerosis (ALS) and his or her family. Although initial thoughts frequently are that quality of life will be poor, there are strong data to support a relatively good quality of life despite the inexorable decline in strength and loss of function with disease progression.
Seizure exacerbation in catamenial epilepsy (CE) is associated with the decrease in progesterone secretion and increase in estradiol secretion during the premenstrual period.
Oral lacerations and urinary incontinence have long been considered useful clinical features for the diagnosis of epileptic seizures; however, both are also reported in patients with psychogenic nonepileptic seizures (PNES).
American Journal of Epidemiology 2008 167(5):553-560
Data from Asian populations on dietary and lifestyle factors associated with Parkinson's disease are sparse. In 1993-2005, the authors examined these factors in relation to Parkinson's disease in the Singapore Chinese Health Study, a prospective cohort of 63,257 Chinese men and women.
Journal of Neurosurgery March 2008 Volume 108, Number 3
The current body of sports-related concussion literature is hampered by a lack of research conducted in high school athletes. Accordingly, the authors sought to examine the neuropsychological deficits and recovery patterns after concussive injuries in this population.
Contrast-enhanced magnetic resonance angiography (CE-MRA) is less prone to flow-related signal intensity loss than three-dimensional time-of-flight (3D TOF) MRA and may therefore be more sensitive for detection of residual patency in platinum coil-treated intracranial aneurysms.
To determine the sensitivity of positron emission tomography with[11]C-labeled dihydrotetrabenazine (DTBZ) to the nigrostriatal changes associated with early, untreated Parkinson's disease (PD), and to determine the correlation between any regionally reduced DTBZ binding and the major motor features of PD.
Journal of Neurosurgery Pediatrics March 2008 Volume 1, Number 3
The authors report on a rare case of pilomyxoid astrocytoma in a patient presenting with fatal hemorrhage. This 5-year-old boy presented to the outpatient clinic with headache and vomiting.
Journal of Neurosurgery Pediatrics March 2008 Volume 1, Number 3
Complicated shunt infections are defined for the purpose of this protocol as multiple compartment hydrocephalus, multiple organism shunt infection, severe peritonitis, or infections in other sites of the body. The initial treatment protocol for these patients was 3 weeks of intravenous antibiotic therapy and 2 weeks of twice daily intraventricular/intrashunt antibiotic therapy. Cerebrospinal fluid (CSF) cultures were monitored during therapy and obtained again 48 hours after completion. The shunt was completely replaced. Additionally, follow-up cultures were obtained in all patients 3-6 months after therapy was completed.
Hypoxic/ischemic (HI) brain injury affects 1 to 6 per 1000 live human births, with a mortality of 15% to 20%. A quarter of survivors have permanent disabilities. Hypothermia is the only intervention that improves outcome; however, further improvements might be obtained by combining hypothermia with additional treatments.
This review will focus on the emerging principles of neural repair after stroke, and on the overlap between cellular mechanisms of neural repair in stroke and clinical principles of recovery and rehabilitation.
Epidemiologic studies have demonstrated that hypertension increases the risk of stroke, and clinical trials have shown that antihypertensive therapy reduces this risk. Incident stroke was significantly decreased by treatment in the Systolic Hypertension in Elderly Program (SHEP) Trial, but the reduction in fatal events was not statistically significant.
In 1998, 2947 patients in metropolitan Phoenix were hospitalized for acute cerebral infarction. Only 2 of the 26 regional hospitals satisfied criteria for primary stroke center (PSC) designation. Fewer than 1% of patients with ischemic stroke received tissue plasminogen activator for thrombolysis. We sought to develop and evaluate the effectiveness of a metropolitan prehospital emergency medical system for effectively identifying and transporting patients with acute stroke to a matrix of predesignated PSCs and increasing to 20% the proportion of all such patients receiving tissue plasminogen activator.
To prospectively compare the agreement between digital subtraction angiography (DSA) and time-resolved magnetic resonance (MR) angiography with sensitivity encoding (SENSE) in combination with keyhole acquisition and contrast material-enhanced robust-timing angiography (CENTRA) k-space sampling techniques for the characterization of intracranial arteriovenous malformations (AVMs).
Variations in technical performance in surgery are known to exist but are poorly understood. Gaining an appreciation of these differences may have implications for technical skills training, assessment, and selection. Investigators attempting to correlate technical skill with visuospatial or perceptual tests have failed to identify surrogate markers of surgical aptitude. Evidence from unrelated fields suggests that studying brain function may advance our understanding of disparate technical performance in surgery.
Lacunar stroke is associated with endothelial dysfunction and histologically with intrinsic cerebral microvascular disease of unknown cause. Endothelial dysfunction could impair blood-brain barrier integrity. We assessed background blood-brain barrier leakage in patients with lacunar ischemic stroke compared with cortical stroke controls
From the studied variables in subarachnoid hemorrhage (SAH) risk, hypertension is probably the most controvertible one. The aim of this study was to determine whether confirmed hypertension, prospectively diagnosed with strict criteria, is an independent risk factor for aneurysmal SAH.
Complete ophthalmoplegia, the combination of bilateral ptosis with loss of all extraocular movements, is rarely a consequence of ischemic stroke. We describe 3 patients who had complete ophthalmoplegia as a manifestation of bilateral paramedian midbrain-thalamic infarction, and we discuss possible pathophysiologic mechanisms.
Studies have suggested that mood status is associated with an increased risk of stroke, though mostly based on measures of depression defined by symptoms alone rather than diagnostic criteria representative of clinically important distress and impairment. We investigated this association based upon a large population-based prospective cohort study.
Bevacizumab, a humanized monoclonal antibody against vascular endothelial growth factor, may have activity in recurrent malignant gliomas. At recurrence some patients appear to develop nonenhancing infiltrating disease rather than enhancing tumor.
Thirty-six patients with unsatisfactory treatment of neurogenic bowel dysfunctions (NBD) were enrolled from Spinal Units and Rehabilitation Centers in Italy.
A retrospective study of patients with motor complete spinal cord lesion and somatosensory preservation (American Spinal Injury Association (ASIA) impairment scale B).
Previous studies have reported conflicting results regarding the plasma concentrations of testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in tetraplegia.
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