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To reassess the value of neuroimaging of the emergency patient presenting with seizure as a screening procedure for providing information that will change acute management, and to reassess clinical and historical features associated with an abnormal neuroimaging study in these patients.
To assess the efficacy and tolerability of adjunctive levetiracetam in patients with uncontrolled generalized
tonic-clonic (GTC) seizures associated with idiopathic generalized epilepsies
(IGE).
The purpose of this review was to summarize studies reporting on the psychometric properties of measures commonly utilized in spinal cord injury (SCI) pain research to better inform clinicians and researchers on the selection of appropriate pain-related instruments.
Journal of the New Zealand Medical Association, 26-October-2007, Vol 120 No 1264
A significant proportion of stroke survivors suffer from persistent and significant fatigue which is linked to reduced independence and case fatality. Despite its high prevalence and detrimental effects, studies of post-stroke fatigue
(PSF) interventions are scarce. Only one randomised controlled trial of post-stroke fatigue treatment (i.e.
fluoxetine) was identified, and though improving post-stroke emotional incontinence and depression in patients with fatigue this did not improve PSF itself. Despite there being no literature on its efficacy, patient and family
education/counselling has been identified as an important rehabilitation intervention for the management of stroke-related fatigue, which has been found effective in other patient groups (i.e. cancer, multiple sclerosis, and those with traumatic brain injury). Factors contributing to the lack of evidence for PSF management are identified and it is concluded that there is a need to better differentiate those most likely to suffer
PSF, to validate existing assessments of fatigue, and to evaluate the efficacy of fatigue management and treatment strategies in stroke survivors.
Clinical Neurology and Neurosurgery, Volume 109, Issue 10, Pages 902-904
Colloid cysts are rare intracerebral lesions that are predominantly located in the third ventricle. Extraventricular colloid cysts have only rarely been reported but so far there are no reports of a colloid cyst residing in the olfactory groove. A 74-year-old patient underwent a brain computed tomography scan for a mild head trauma that incidentally revealed a space-occupying lesion near the olfactory groove. Brain magnetic resonance imaging that ensued demonstrated a hyperintense lesion in T1, T2, and FLAIR sequences, without evidence of surrounding brain edema.
Clinical Neurology and Neurosurgery, Volume 109, Issue 10, Pages 918-921
A normal component of the flora of the oropharynx, Neisseria sicca was first isolated in 1906 and has since been reported as a rare cause of various human infections including
endocarditis, pneumonia, sinusitis, sepsis, and urethritis. We report the case of a 44-year-old African-American female with a history of hypertension who presented with complaints of right frontal headache, nausea, photophobia, and vomiting.
Clinical Neurology and Neurosurgery, Volume 109, Issue 10, Pages 914-917
A case of an acute life-threatening presentation of hemiconvulsion' hemiplegia' epilepsy
(HHE) syndrome requiring an urgent decompressive hemicraniectomy is described. A 9 month-old baby had a status epilepticus following a sustained fever, leading to a comatose state and a right pupillary dilatation associated with a left
hemiplegia. The MRI showed a swelling right hemisphere with marked temporal
herniation. The baby underwent a decompressive right hemicraniectomy with temporal cortical biopsies. The post-operative course was
favourable.
American Journal of Neuroradiology 28:1736-1742, October 2007
This study was undertaken to analyze the outcomes and treatment-related complications of the
polyglycolic/polylactic acid (PGLA)-coated Matrix platinum coils in the treatment of intracranial aneurysms and compare these results with those derived from the same single-institutional experience with use of uncoated, bare platinum coils.
American Journal of Neuroradiology 28:1668-1673, October 2007
The purpose of this work was to test the feasibility of using high angular resolution diffusion imaging
(HARDI)-based multitensor tractography to depict motor pathways in patients with brain tumors.
American Journal of Neuroradiology 28:1706-1709, October 2007
Although the prevalence of pineal cysts in autopsy series has been reported as being between 25% and 40%, MR studies have documented their frequency to range between 1.5% and 10.8%. The purpose of this high-resolution brain MR imaging study at 1.9T was to determine the prevalence of pineal cysts in healthy adults.
American Journal of Neuroradiology 28:1690-1692, October 2007
3D digital subtraction angiography (DSA) allows clinicians to review intracranial aneurysms and other vascular lesions. We report 2 basilar aneurysms that were imaged by both 3D DSA and
DynaCT. These 2 techniques produced very different aneurysm appearances. Anterior portions of the aneurysms were invisible on 3D DSA but were revealed by
DynaCT. These aneurysms appeared to have been flattened by image artifacts in 3D
DSA. Pulsation and gravity are 2 possible causes of aneurysm underestimation.
Cochrane Database of Systematic Reviews 2007 Issue 4
Secondary ischaemia is a frequent cause of poor outcome in patients with aneurysmal subarachnoid haemorrhage
(SAH). Besides vasospasm, platelet aggregation seems to play a role in the pathogenesis of secondary
ischaemia. Experimental studies have suggested that antiplatelet agents can prevent secondary
ischaemia.
Journal of the Medical Association of Thailand Vol90 No.10 2010 9653
To study the prevalence of depression and anxiety in Thai epileptic patients at Songklanagarind Hospital, a tertiary care center in the South of Thailand.
Material and Method: One hundred and twenty six patients were included in the present study. A HADS questionnaire and demographics data were used for data collection in the present cross-sectional study.
Neuroblastoma (NB) is the most common extracranial solid tumour of childhood. Several genomic imbalances correlate to prognosis in NB, with structural rearrangements, including gene amplification, in a near-diploid setting typically signifying high-risk tumours and numerical changes in a near-triploid setting signifying low-risk
tumours. Little is known about the temporal sequence in which these imbalances occur during the carcinogenic process.
Medical Hypotheses, Volume 69, Issue 6, Pages 1234-1237
Spinal cord repair is a problem that has long puzzled neuroscientists. The failure of the spinal cord to regenerate and undergo reconstruction after spinal cord injury (SCI) can be attributed to secondary axonal demyelination and neuronal death followed by cyst formation and infarction as well as to the nature of the injury environment, which promotes glial scar formation.
Progress in management of critically ill neurological patients has led to improved survival rates. However, severe residual neurological impairment, such as persistent coma, occurs in some survivors. This raises concerns about whether it is ethically appropriate to apply aggressive care routinely, which is also associated with burdensome long-term management costs.
Chronic pain is one of the more disturbing sequelae of spinal cord injury, often interfering with the basic activities, effective rehabilitation, and quality of life of the patient. Pain in the cord-injured patient is often recalcitrant to treatment. This dilemma is amplified by the limited availability of effective pharmacological and nonpharmacological treatment options.
Diffusion magnetic resonance (MR) imaging is evolving into a potent tool in the examination of the central nervous system. Although it is often used for the detection of acute ischemia, evaluation of directionality in a diffusion measurement can be useful in white matter, which demonstrates strong diffusion anisotropy.
Archives of Physical Medicine and Rehabilitation, Volume 88, Issue 10, Pages 1249-1255
To determine if the presence of specialized rehabilitation units (SRUs) within Veterans Affairs medical centers
(VAMC) influences access to rehabilitation services.
Cochrane Database of Systematic Reviews 2007 Issue 4
To determine if repetitive task training after stroke improves global, upper or lower limb function, and if treatment effects are dependent on the amount, type or timing of practice.
Australasian Radiology, Volume 51, Number 6, December 2007 , pp. 532-537(6)
The aim of the study was to validate a multimodality cranial computed tomography
(CCT) protocol for patients with acute stroke in the United Arab Emirates as a basic imaging procedure for a stroke unit. Therefore, a comparative study was conducted between two groups: retrospective, historical group 1 with early unenhanced CCT and prospective group 2 undergoing a multimodality CCT protocol.
Medical Hypotheses, Volume 69, Issue 6, Pages 1284-1289
Temporal lobe epilepsy (TLE) is the most common cause of intractable adult epilepsy. It is proposed that different kinds of epilepsy be classified into one of two categories, which correspond to the two basic kinds of neurons in the brain, that is, as diseases of oscillators or as diseases of resonators. Oscillator (or
pacemacker) neurons are endowed with intrinsic conductances that permit periodic spontaneous generation of action potentials; in contrast, resonators are neurons which process information coming from sensory stimuli or from other neurons.
The incidence of heterotopic ossification (HO) among patients with traumatic brain injury
(TBI) varies in the literature from 11 to 73.3%. The aim of this study was to determine the incidence of HO among patients with very severe TBI treated in a new established intensive rehabilitation Brain Injury Unit and to list some of the risk-predicting features.
Medical Hypotheses, Volume 69, Issue 6, Pages 1179-1182
Critically ill patients are at high risk of developing serious neurological dysfunctions including delirium and long-term neurocognitive impairment. Here a novel mechanism is proposed for this highly deleterious condition. A growing body of evidence has shown that critical illness and its treatment can lead to de novo cerebral atrophy including white and grey matter abnormalities, delirium, and neurocognitive decline.
Child's Nervous System, Volume 23, Number 8, August 2007 , pp. 867-871(5)
Antibiotic-impregnated shunt (AIS) systems have been designed to prevent the colonization of shunt components by skin flora that occurs at surgery. Although such systems may decrease the incidence of early shunt infections (those occurring within 6 months of shunt placement), it is unclear if such exposure to prolonged antibiotics leads to an increased incidence or virulence of late shunt infections (those occurring later than 6 months after shunt placement).
Archives of Physical Medicine and Rehabilitation, Volume 88, Issue 10, Pages 1241-1248
To determine the effect of hippotherapy on spasticity and on mental well-being of persons with spinal cord injury (SCI), and to compare it with the effects of other interventions.
American Journal of Neuroradiology 28:1693-1699, October 2007
The purpose of this study was to determine whether qualitative and quantitative measures obtained with pulsed arterial spin-labeling (PASL) and apparent diffusion coefficients (ADC) improve glioma grading compared with conventional MR images.
An automated procedure for the detection, quantification, localization and statistical mapping of white matter hyperintensities (WMH) on T2-weighted magnetic resonance (MR) images is presented and validated based on the results of a between-centre reproducibility study.
Little information is available on long-term headache following head injury. We compared the prevalence of headache in a cohort with previous hospitalization for head injury and matched controls.
Evulsion of the globe as a result of trauma is a rarity; to the best of our knowledge, only four "evulsions of the globe" have been described. We present the case of a 35-year-old Hispanic woman with traumatic evulsion of the right eye and subarachnoid haemorrhage. The management of brain injury was the priority over preservation of globe structures. We briefly describe the tomographic features of this uncommon situation and the proposed "evulsion" mechanism.
The purposes of this study were to describe stroke mortality in urban and rural populations in China and to monitor the transition using the best available surveillance data during the past 2 decades.
European Journal of Neurology, Volume 14, Number 10, October 2007 , pp. 1186-1188(3)
The presentation and treatment of a patient with extra-temporal non-lesional partial epilepsy is discussed herein. His clinical semiology was consistent with supplementary motor area seizures; however, MR imaging did not demonstrate a lesion.
European Journal of Neurology, Volume 14, Number 11, November 2007 , pp. 1296-1298(3)
The association of spontaneous intracranial hypotension (SIH) with cerebral venous thrombosis (CVT) is rare. We are reporting two new cases. In one case, CVT is extensive concerning three sinuses and bilateral parietal cortical veins and, in the other case, only a cortical vein is involved. Both the patients presented had no thrombosis risk factors. There is certainly a link between these two pathologies. SIH should be considered as a risk factor of CVT. Modification of symptoms of SIH leading to CVT must be known to start early treatment.
Neuroserpin, primarily localized to CNS neurons, inhibits the adverse effects of tissue-type plasminogen activator (tPA) on the neurovascular unit and has neuroprotective effects in animal models of ischemic stroke. We sought to evaluate the association of neuroserpin polymorphisms with risk for ischemic stroke among young women.
With rapid advances in functional imaging methods, human studies that feature functional neuroimaging techniques are increasing exponentially and have opened a vast arena of new possibilities for understanding brain function and improving the care of patients with cognitive disorders in the clinical setting.
Circulation October 22, 2007, doi: 10.1161/CIRCULATIONAHA.107.699785
Determining whether the distribution of stroke subtypes differs between ethnic groups is important in understanding the mechanisms of the increased stroke incidence in black patients.
PEO patients with this mutation can further develop parkinsonism or premature ovarian failure. Mouse and yeast models with this mutation show enhanced amounts of oxidative lesions and increased mtDNA damage.
Occupational and Environmental Medicine 2007;64:673-680
To investigate associations of Parkinson’s disease (PD) and parkinsonian syndromes with polymorphic genes that influence metabolism of either foreign chemical substances or dopamine and to seek evidence of gene-environment interaction effects that modify risk.
Journal of Manipulative and Physiological Therapeutics, Volume 30, Issue 7, Pages 536-538
Conservative treatment of lumbar radiculopathy includes bed rest, oral medications, physical therapy, spinal manipulation, mobilization, and epidural steroid injections. Intracranial subdural hematoma after accidental dural puncture is a rare and life-threatening complication of epidural steroid injections. In this report, we present a case of subacute intracranial subdural hematoma that developed after epidural steroid injection.
To evaluate cerebrospinal fluid (CSF) markers for neuronal degeneration and demyelination in idiopathic normal pressure hydrocephalus (INPH), subcortical arteriosclerotic encephalopathy (SAE), and neurologically healthy subjects.
European Journal of Neurology, Volume 14, Number 11, November 2007 , pp. 1201-1209(9)
Angiotensin receptor blockers (ARB's) are an important class of antihypertensive agents and appear to have a role in the prevention and management of ischaemic stroke. We present a discussion of the data on ARB's in this important condition.
The therapeutic armamentarium for vascular risk factors in industrialized countries improved over the past decades. We therefore studied vascular mortality trends in France between 1979 and 2001, and explored how these trends are related to stroke or nonstroke vascular mortality changes.
P-selectin (PSEL) and its ligand, P-selectin glycoprotein ligand-1 (PSGL-1), play key roles in both the inflammatory response and the atherosclerotic process, but there are conflicting results regarding the affect of PSEL and PSGL-1 gene variation on risk for cardiovascular and cerebrovascular disease. We tested the association of four PSEL and two PSGL-1 polymorphisms with incident coronary heart disease (CHD) and ischemic stroke among 13,875 participants in the prospective Atherosclerosis Risk in Communities (ARIC) study. We also tested common haplotypes in the PSEL and PSGL-1 genes to assess associations with incident CHD and ischemic stroke.
A large cohort of subjects with mild cognitive impairment (MCI) was categorized into tertiles based on hippocampal atrophy rates, as a proxy for Alzheimer-type pathology. We compared baseline clinical, neuropsychological, and MRI measures to characterize these MCI subgroups.
Clinical Nuclear Medicine. 32(11):886-888, November 2007
A 59-year-old man, with a history of several years of parkinsonism and multiple vascular risk factors, presented to our unit to undergo I-123-Ioflupane (I-123-FP-CIT) and cerebral perfusion SPECT studies. Parkinson disease usually shows abnormal uptake in the striatum, which progresses from putamen to caudate and matches contralaterally the clinically more affected side. On the other hand, several reports have shown that normal I-123-FP-CIT images is the common pattern in vascular parkinsonism.
Bupropion hydrochloride is currently available in three formulations: immediate-release, sustained-release, and extended-release (ER). Several published reports exist concerning bupropion's history of inducing seizures in both the immediate- and sustained-release formulations.
Journal of Internal Medicine, Volume 262, Number 5, November 2007 , pp. 555-561(7)
Cholesteryl ester transfer protein (CETP) plays a key role in the metabolism of high-density lipoprotein (HDL), a strong, inverse, independent risk factor for cardiovascular disease.
American Journal of Neuroradiology 28:1652-1658, October 2007
MR imaging features of metronidazole-induced encephalopathy (MIE) have not been fully established. This study was undertaken to determine the topographic distributions and diffusion-weighted imaging (DWI) findings of MIE.
American Journal of Neuroradiology 28:1755-1761, October 2007
The purpose of this study was to analyze angiographic and clinical results before and after additional endovascular therapy in patients with previously coiled but reopened cerebral aneurysms and to identify possible risk factors for retreatment of an aneurysm.
Child's Nervous System, Volume 23, Number 8, August 2007 , pp. 891-895(5)
Vestibular schwannomas (VS) in young patients are rare. They are regarded to have different biological characteristics. Our objective is to analyze a series of such patients, with respect to their clinical presentation, treatment, and outcome and to compare the results to a matched series of adult patients.
Medical Hypotheses, Volume 69, Issue 5, Pages 1064-1069
Hepatic encephalopathy (HE) is a common neuropsychiatric complication of liver disease affecting about 20–30% patients with cirrhosis. HE may only affect quality of life (e.g. impairments in attention; coordination; driving ability), but in some patients this progresses to coma and death; defining mortality in those with acute liver failure. HE is thought to occur through accumulation of ammonia as a by-product of protein metabolism.
American Journal of Neuroradiology 28:1710-1714, October 2007
Currently, more reliable parameters to predict the risk of aneurysmal rupture are needed. Intra-aneurysmal pressure gradients and flow maps could provide additional information regarding the risk of rupture. Our hypothesis was that phase contrast with vastly undersampled isotropic projection reconstruction (PC-VIPR), a novel 3D MR imaging sequence, could accurately assess intra-aneurysmal pressure gradients in a canine aneurysmal model when compared with invasive measurements.
Brain tumors are the second most common pediatric malignancy. The literature suggests that one of the most common subtypes of malignant childhood brain tumor, medulloblastoma, has some seasonal variation in incidence by month of birth.
Studies that accurately identify myocardial infarction (MI) and stroke within populations would provide valuable epidemiological information as well as data on vascular disease prevention.
Epilepsy Research Volume 77, Issue 1, Pages 70-74 (October 2007)
In this study, we investigate permutation entropy as a tool to predict the absence seizures of genetic absence epilepsy rats from Strasbourg
(GAERS) by using EEG recordings. The results show that permutation entropy can track the dynamical changes of EEG data, so as to describe transient dynamics prior to the absence seizures.
Epilepsy Research Volume 77, Issue 1, Pages 65-69 (October 2007)
The occurrence of unwanted afterdischarges (ADs) impedes cortical stimulation for mapping purposes. We investigated the safety of several stimulation paradigms.
Epilepsy research Volume 77, Issue 1, Pages 62-64 (October 2007)
Stertorous breathing may occur after epileptic convulsions, but does not typically occur after psychogenic non-epileptic convulsions. During an 18-month audit at a tertiary referral centre in the United Kingdom, we analysed 75 convulsions arising in 45 patients and found that nursing and ancillary staff can be easily trained to reliably identify the presence or absence of stertorous breathing after a convulsion.
Epilepsy Research Volume 77, Issue 1, Pages 36-43 (October 2007)
Eslicarbazepine acetate (ESL, BIA 2-093) is a novel antiepileptic drug endowed with an anticonvulsant potency similar to that of
carbamazepine, and shares with carbamazepine and oxcarbazepine the capability to inhibit voltage-gated sodium channels. ESL is efficacious against maximal electroshock seizure-induced seizures, protects against
picrotoxin-induced seizures in mice and rats, and prevents development of kindling in rats. In vivo, latrunculin A microperfusion in the rat hippocampus induces acute epileptic seizures and long-term biochemical changes leading to decreased picrotoxin seizure threshold and spontaneous seizures.
Epilepsy Research Volume 77, Issue 1, Pages 17-21 (October 2007)
To evaluate if a standard awake EEG recording in the morning is superior to afternoon awake EEG session in detecting generalized epileptiform discharges
(GEDs) in patients with juvenile myoclonic epilepsy (JME).
Epilepsy Research Volume 77, Issue 1, Pages 11-16 (October 2007)
Temporal lobe resection for epilepsy involves a risk of damaging the anterior part of the optic radiation, Meyer's loop, causing a contralateral upper quadrant visual field defect. This study aims to assess the intersubject variability in the course of Meyer's loop in vivo by diffusion tensor imaging and
tractography.
Epilepsy Research Volume 77, Issue 1, Pages 1-10 (October 2007)
Occipital lobe epilepsy is uncommon in epilepsy surgery series and often difficult to assess due to rapid seizure propagation, misleading seizure semiology and confounding interictal epileptiform activity. Ictal recordings with surface electrodes may not define properly the seizure onset zone in surgical evaluation for intractable occipital epilepsy. Specially in dysplastic lesions, the extension of the epileptogenic zone is not well defined by neuroimaging techniques, therefore, implantation of intracranial electrodes is often indicated. In this study we present our experience with individually tailored resections of occipital lobe epileptic foci guided by monitoring with subdural electrodes.
The Epilepsy Genetics (EPIGEN) Consortium was established to undertake genetic mapping analyses with augmented statistical power to detect variants that influence the development and treatment of common forms of epilepsy.
Patients with transient ischaemic attack (TIA) or minor stroke are at high immediate risk of stroke. The optimum early treatment options for these patients are not known.
Diagnosis and treatment of cerebral and retinal transient ischaemic attacks
(TIAs) are often delayed by the lack of immediate access to a dedicated TIA clinic. We evaluated the effects of rapid assessment of patients with TIA on clinical decision making, length of hospital stay, and subsequent stroke rates.
While in residency, both my husband (a physical medicine and rehabilitation resident) and I were able to experience an international elective which has enhanced our clinical training and perspective. This elective was organized with resources from the international health program at our institution as well as World Medical Mission
(WMM)/Samaritan’s Purse, a nonprofit organization that places physicians in areas of need around the world.
European Journal of Neurology, Volume 14, Number 10, October 2007 , pp. 1091-1097(7)
The C242T polymorphism of p22phox, a component of NAD(P)H oxidase, may have an impact on cardiovascular diseases; however, the association between this polymorphism and brain infarction is not fully understood.
International Journal of Clinical Practice, Volume 61, Number 11, November 2007 , pp. 1819-1823(5)
Ischaemic stroke (IS) is a complex disease that involves genetic and environmental factors. The role of factor XI
(FXI) in arterial thrombosis is unclear.
Journal of Pediatric Psychology 2007 32(9):1040-1049
Risk-adapted treatment approaches employed within contemporary medulloblastoma treatment protocols aim to reduce the neurotoxicity directed at the central nervous system. Despite these important steps to reduce radiation dose exposure, an overwhelming majority of medulloblastoma survivors continue to experience academic failure and significant learning delays.
To prospectively evaluate changes in brain perfusion computed tomographic (CT) parameters after revascularization of unilateral symptomatic carotid artery stenosis and to determine whether pretreatment perfusion CT parameters can be used to predict changes in cerebral hemodynamics after treatment.
COX-2 expression was evalueted in intracranial meningiomas, relating this molecule to grade, vasculature, VEGF and brain edema. Fifty-six tumors were evaluated for COX-2 and VEGF expression and for microvessel density. In 34/56 cases, the edema was evaluated by CT scan. COX-2 was detected in 46/56 meningiomas (82.14%), and it resulted as being related to histologic grade (t-test: p = 0.006) and to edema (t-test: p = 0.002). No statistical association between COX-2 and VEGF or MVD was found. In conclusion, COX-2 seems to be related to the more aggressive meningiomas and, somehow, to the development of
meningioma-associated brain edema.
An automated procedure for the detection, quantification, localization and statistical mapping of white matter hyperintensities
(WMH) on T2-weighted magnetic resonance (MR) images is presented and validated based on the results of a between-centre reproducibility study.
Rapid eye movement (REM) sleep behavior disorder (RBD) is frequently found in Parkinson’s disease (PD). PD has been classified in different subtypes and it is unknown if RBD occurs more often in one particular subtype.
Hippocampal sclerosis (HS) is the most common cause of refractory temporal lobe epilepsy.
Histopathologically, HS is characterized by neuron loss and gliosis. HS can be identified on MRI by signal increase on T2-weighted images and volume loss on T1-weighted volume images.
American Journal of Neuroradiology 28:1769-1770, October 2007
We report a case of immediate reproducible and reflexive response of asystole upon stimulation of Onyx injection during embolization of a tentorial dural arteriovenous fistula in a 53-year-old man. Upon recognition of the reflexive relationship between Onyx injection and increased vagal tone, the patient was given anticholinergic in an effort to block cholinergic hyperactivity. After atropine was given, no further dysrhythmias occurred.
Focal cortical dyplasia (FCD) is a frequent cause of medication-resistant focal epilepsy. Patients with FCD may benefit from epilepsy surgery. However, it is difficult to intraoperatively define lesion boundaries. In this case report we present a novel tool to identify FCD
intraoperatively. A patient with frontal lobe epilepsy underwent resection of a left frontomesial
FCD.
Recently completed trials suggest the addition of nitrosourea-based chemotherapy to radiotherapy increases the progression-free but not overall survival of grade II and III
gliomas. Temozolomide has proven benefit in grade II/III gliomas progressive following standard therapy and when added to radiation for
glioblastoma. Newly launched and planned phase III trials will explore whether the addition of temozolomide to radiotherapy improves overall survival in grade II/III as well as the prognostic and predictive value of 1p/19q analyses and MGMT promotor methylation status. Additionally, they will measure cognition and quality of life to determine if improvements in time to progression translate into better functional status and patient satisfaction.
Epilepsy surgery has been proved to be efficacious, safe and cost-effective in developing countries. However, the success of epilepsy surgery depends on selecting suitable candidates based on the available resources and technologies. Some of the challenges to provide appropriate surgical treatment for epilepsy patients in developing countries include providing human and technological resources and developing realistic presurgical protocols.
Journal of Clinical Oncology, Vol 25, No 30 (October 20), 2007: pp. 4722-4729
The prognosis for patients with recurrent glioblastoma multiforme is poor, with a median survival of 3 to 6 months. We performed a phase II trial of
bevacizumab, a monoclonal antibody to vascular endothelial growth factor, in combination with
irinotecan.
Intracranial arterial stenosis increases flow velocities on the upslope of the Spencer's curve of cerebral
hemodynamics. However, the velocity can decrease with long and severely narrowed vessels. We assessed the frequency and accuracy for detection of focal and diffuse intracranial stenoses using novel diagnostic criteria that take into account increased resistance to flow with widespread lesions.
International Clinical Psychopharmacology. 22(6):330-337, November 2007
To review signs and symptoms of valproate-induced hyperammonaemic encephalopathy without hepatotoxicity in the psychiatric setting, explore its mechanisms, and give recommendations for prevention and treatment.
International Journal of Clinical Practice, Volume 61, Number 10, October 2007 , pp. 1749-1755(7)
The primary role of a trial's data monitoring committee (DMC) is to ensure the safety of enrolled patients. In stroke trials, safety is monitored typically by comparing death and stroke-specific events between treatment groups.
Poor chemosensitivity and the development of chemoresistance remain major obstacles to successful chemotherapy of malignant
gliomas. GRP78 is a key regulator of the unfolded protein response (UPR). As a Ca2+-binding molecular chaperone in the endoplasmic reticulum (ER), GRP78 maintains ER homeostasis, suppresses stress-induced apoptosis, and controls UPR signaling.
Medical Hypotheses, Volume 69, Issue 5, Pages 1021-1028
The development of amyotrophic lateral sclerosis (ALS) in the relatively common psychiatric disorder schizophrenia is very rare. This observation has been made by us and a number of other neuromuscular specialists at large ALS centers. We propose that the use of neuroleptics and some antidepressants, which are chronically prescribed to schizophrenics and which have neuroprotective properties and some of which promote
neurogenesis, may confer protection against this deadly neurodegenerative disease
ALS. Such an observation may have important implications towards the therapy and understanding the pathophysiology of this deadly neurodegenerative disease.
A 25-year-old man presented with complaints of nonpleuritic, substernal chest pain,
dyspnea, and decreasing exercise tolerance. His vital signs were normal, with the exception of an oxygen saturation level of 93% while breathing room air. During his assessment, he developed transient left facial droop, left arm and leg weakness, and an ataxic gait, which lasted 15 min then resolved spontaneously.
Patients experiencing acute elevations of ammonia present to the ICU with encephalopathy, which may progress quickly to cerebral
herniation. Patient survival requires immediate treatment of intracerebral hypertension and the reduction of ammonia levels. When hyperammonemia is not thought to be the result of liver failure, treatment for an occult disorder of metabolism must begin prior to the confirmation of an etiology. This article reviews ammonia metabolism, the effects of ammonia on the brain, the causes of
hyperammonemia, and the diagnosis of inborn errors of metabolism in adult patients.
Epilepsia Volume 48 Issue 10 Page 1979-1983, October 2007
We describe a young woman with progressive cognitive and neurological deficits during a parietal lobe status epilepticus (SE). Ictal
FDG-PET showed left parietal lobe hypermetabolism and frontal lobe hypometabolism with concomitant EEG slowing. Cognitive and neurological deficits fully reversed more than 1 year after seizure remission, and were associated with normalization of
FDG-PET and EEG.
American Journal of Neuroradiology 28:1778-1782, October 2007
Thromboembolic events are the most common complications of elective coil embolization of cerebral aneurysms. Administration of oral clopidogrel and/or aspirin could lower the thromboembolic complication rate.
Cochrane Database of Systematic Reviews 2007 Issue 4
Approximately 30% of epilepsy patients remain refractory to drug treatment and continue to experience seizures whilst taking one or more antiepileptic drugs. There are a number of non-pharmacological interventions available to refractory patients which may be used in conjunction with or as an alternative to antiepileptic medication. In view of the fact that seizures in intellectually disabled people are often complex and refractory to pharmacological interventions it is evident that good quality randomised controlled trials
(RCTs) assessing the efficacy of alternatives or adjuncts to pharmacological interventions are needed in this population.
Several reports suggest that higher levels of serum uric acid are associated with a lower risk of Parkinson disease (PD). None of these studies, however, evaluated the potential association between gout, a condition characterized by
hyperuricemia, and the risk of PD.
European Journal of Neurology, Volume 14, Number 10, October 2007 , pp. 1118-1123(6)
Because of existing controversy about use of mannitol in intracerebral hemorrhage
(ICH) this open exploratory trial with blinded outcome assessment of single mannitol bolus in ICH was undertaken. CT proven primary supratentorial ICH patients having midline shift of >=3 mm were randomized into 20% mannitol (1.5 g/kg) and control groups. Clinical evaluation included Glasgow coma scale (GCS) score, Canadian Neurological scale (CNS) score, pupils, breathing, extensor posturing and contra-lateral pyramidal signs.
Although most mild traumatic brain injury (mTBI) patients suffer any of several post-concussion symptoms suggestive of thalamic involvement, they rarely present with any
MRI-visible pathology. The aim here, therefore, is to characterize their thalamic metabolite levels with proton MR spectroscopy (1H-MRS) compared with healthy controls.
Relatively little research has documented functional recovery following traumatic brain injury using neuroimaging techniques. This study aimed to examine the effects of moderate-to-severe brain injury on brain functioning over time.
Word deafness refers to an inability to understand spoken words despite intact hearing. In a cognitive approach, word deafness could be explained by a deficiency at the lower perceptive level of the auditory process. The impairment of the auditory analysis system would explain a disorder of identification of speech sounds. Only few studies addressed rehabilitation of central auditory processing and have described therapy focused on phoneme discrimination.
To determine the incidence of autonomic arousal vs. Dysautonomia following traumatic brain injury
(TBI) in an Intensive Care Unit (ICU) setting and to prospectively evaluate these groups against injury severity and outcome variables.
Dysarthria with severe articulatory impairment is a common and debilitating sequelae following severe traumatic brain injury
(TBI). Eectropalatography (EPG) is an instrumental treatment technique allowing visual feedback of tongue to palate movement during real time articulation. The present study investigated the effectiveness of EPG in treating the articulatory component of dysarthria
post-TBI.
To determine the mood profile and sleep functioning of a patient with left anterior temporal region damage characterized by post-operative symptoms of mania.
Journal of the American Geriatrics Society, Volume 55, Number 10, October 2007 , pp. 1571-1577(7)
To investigate the prognostic effect of poststroke urinary incontinence (UI) on 1-year outcome in relation to measurements of attention and mental processing speed.
Journal of Clinical Oncology, Vol 25, No 30 (October 20), 2007: pp. 4714-4721
Evaluation of treatment effects in malignant brain tumors is challenging because of the lack of reliable response predictors of tumor response. This study examines the predictive value of positron emission tomography (PET) using [18F] fluorothymidine (FLT), an imaging biomarker of cell proliferation, in patients with recurrent malignant gliomas treated with bevacizumab in combination with
irinotecan.
Clinical Cancer Research 13, 6001-6009, October 15, 2007
Neuroblastoma is a childhood cancer that exhibits either a favorable or an unfavorable phenotype. Favorable neuroblastoma genes (EPHB6, EFNB2, EFNB3, NTRK1, and CD44) are genes whose high-level expression predicts favorable neuroblastoma disease outcome. Accordingly, the forced expression of these genes or their reactivation by gene silencing inhibitors in unfavorable neuroblastoma cells results in suppression of tumor growth and metastases. This study was undertaken to design an experimental strategy to identify additional favorable neuroblastoma genes.
European Journal of Neurology, Volume 14, Number 10, October 2007 , pp. 1098-1101(4)
Data concerning genetic factors that may influence the risk of primary intracerebral hemorrhage
(PICH) are scarce. One previous study, indicated that the carriers of the (-323)Ins allele of the coagulation factor VII
(FVII) have an increased risk of PICH. Another recent study, tested the effect of apolipoprotein E.
American Journal of Neuroradiology 28:1796-1802, October 2007
Children with congenital hemiparesis have greater asymmetry in diffusion parameters of the pyramidal tracts compared with control subjects. We hypothesized that the asymmetry correlates with the severity of hemiparesis and that diffusion metrics would be abnormal in the affected tracts and normal in the unaffected tracts.
To explore the use of boron neutron capture therapy (BNCT) for patients with glioblastoma multiforme
(GBM), recurring after surgery and conventional radiotherapy (photon radiotherapy).
Electroencephalographic source localization (ESL) by noninvasive means is an area of renewed interest in clinical
epileptology. This has been driven by innovations in the computer-assisted modeling of dipolar and distributed sources for the investigation of focal epilepsy; a process fueled by the ever-increasing computational power available to researchers for the analysis of scalp EEG recordings.
Screening of therapeutics relies on representative cancer models. The representation of human glioblastoma by in vitro cell culture models is questionable. We obtained genomic profiles by array comparative genomic hybridization of both short- and long-term primary cell and spheroid cultures, derived from seven glioblastomas and one anaplastic
oligodendroglioma.
JNCI Journal of the National Cancer Institute 2007 99(20):1544-1550
Glioma is a rapidly progressive disease, and little is known about its etiology. Atopic diseases are on the rise in western populations, with increasing interest on their long-term health consequences. An inverse association between atopy and the risk of glioma has been observed. We carried out a meta-analysis of studies examining the association between atopic disease and risk of glioma and
meningioma.
Otology & Neurotology. 28(7):934-938, October 2007
To calculate cerebrospinal fluid (CSF) leak rates for translabyrinthine (TL), middle cranial fossa
(MCF), and retrosigmoid/suboccipital (SO) craniotomies performed for removal of vestibular schwannoma (VS) and analyze whether packing the eustachian tube (ET) in TL VS resections impacts CSF rhinorrhea rates.
Diabetologia 2859-2865 Volume 49, Number 12 / December, 2006
Risk estimates for stroke in patients with diabetes vary. We sought to obtain reliable risk estimates for stroke and the association with diabetes, comorbidity and lifestyle in a large cohort of type 2 diabetic patients in the UK.
The flavivirus West Nile virus (WNV) is an emerging pathogen that causes life-threatening encephalitis in susceptible individuals. We investigated the role of the proinflammatory cytokine macrophage migration inhibitory factor
(MIF), which is an upstream mediator of innate immunity, in WNV
immunopathogenesis. We found that patients suffering from acute WNV infection presented with increased MIF levels in plasma and in cerebrospinal fluid. MIF expression also was induced in
WNV-infected mice.
Pediatric Emergency Care. 23(10):735-737, October 2007
Tears of the lingual and labial frena have been associated with accidental and nonaccidental injury. Three cases of infants are presented who were evaluated in the hospital with frena tears which were not recognized as manifestations of abuse, discharged home, and subsequently returned with manifestations of severe abusive head injury.
The aim of our study was to evaluate the safety and efficacy of intra-arterial (IA) thrombolysis using recombinant tissue plasminogen activator
(rt-PA) in patients with acute stroke due to occlusion in the anterior or posterior circulation.
American Journal of Neuroradiology 28:1789-1795, October 2007
The early postnatal period is perhaps the most dynamic phase of white matter development. We hypothesized that the early postnatal development of the corpus callosum and corticospinal tracts could be studied in unsedated healthy neonates by using novel approaches to diffusion tensor imaging (DTI) and quantitative
tractography.
[18F]-Fluoro-d-deoxyglucose positron emission tomography (FDG-PET) is an expensive, invasive, and not widely available technique used in the presurgical evaluation of temporal lobe epilepsy. We assessed its added value to the decision-making process in relation to other commonly used tests.
American Journal of Neuroradiology 28:1628-1632, October 2007
Within the past 2 decades, the number of CT examinations performed has increased almost 10-fold. This is in large part due to advances in
multidetector-row CT technology, which now allows faster image acquisition and improved isotropic imaging. The increased use, along with multidetector technique, has led to a significantly increased radiation dose to the patient from CT studies.
To investigate the hypothesis that some patients with epilepsy are generally prone to develop psychiatric adverse events
(PAEs) during antiepileptic drug (AED) therapy irrespective of the mechanism of action of the drugs.
Topiramate (TPM) is a new generation antiepileptic drug approved for the treatment of partial onset or primary generalized
tonic-clonic seizures, and migraine prophylaxis.
Nursing Inquiry, Volume 14, Number 3, September 2007 , pp. 243-254(12)
The sudden and unexpected impact of stroke may have a stressful affect on close relatives. To illuminate the essential meaning in the lived experience of a middle-aged close relative of a person who has suffered a stroke, narrative interviews were conducted with 10 close relatives of people who had suffered their first stroke where both parties were aged over 18 and under 65. A phenomenological-hermeneutic interpretation of the narratives was then conducted.
5' adenosine monophosphate-dependent protein kinase (AMPK) acts as a metabolic sensor. AMPK is elevated under ischemic conditions, but the role of AMPK in ischemic brain remains controversial. In this study, we examined the effects of AMPK inhibition using both pharmacological and genetic approaches in an in vivo stroke model.
American Journal of Neuroradiology 28:1803-1805, October 2007
Lymphomatoid granulomatosis (LA) is a rare angiocentric lymphoreticular proliferative disease that primarily involves the lungs but may also involve extrapulmonary sites including the central nervous system, skin, and kidneys. It is rare for this condition to affect children, and presentation as a cerebellar mass is unusual. In this report, we describe a 10-year-old girl with biopsy-proved cerebellar LA.
Child's Nervous System, Volume 23, Number 8, August 2007 , pp. 913-916(4)
The authors present the case of a 5-year-old girl with traumatic hydrocephalus secondary to a retroclival haematoma associated with
atlanto-occipital dislocation (AOD) after a motor vehicle accident. Clinical history and neuroimaging of the patient are described.
The estimated prevalence of mental health disorders in those with epilepsy in the general population varies owing to differences in study methods and heterogeneity of epilepsy syndromes. We assessed the population-based prevalence of various psychiatric conditions associated with epilepsy using a large Canadian national population health survey.
American Journal of Neuroradiology 28:1752-1754, October 2007
Four patients underwent angioplasty and stenting of medically refractory symptomatic intracranial atherosclerosis with the new Wingspan stent system. In all 4 patients, CT angiography
(CTA) showed an abnormality within the stented segment that was suggestive of nonocclusive
in-stent thrombus. However, subsequent conventional angiography findings were typical for
in-stent restenosis. The CTA imaging features of in-stent restenosis are important to recognize, and the misinterpretation of
in-stent restenosis as in-stent thrombus may result in inappropriate management.
American Journal of Neuroradiology 28:1679-1682, October 2007
Our aim was to determine the patterns of error of radiology residents in the detection of intracranial hemorrhage on head CT examinations while on call. Follow-up studies were reviewed to determine if there was any adverse effect on patient outcome as a result of these preliminary interpretations.
Child's Nervous System, Volume 23, Number 8, August 2007 , pp. 881-886(6)
To assess the incidence of vascular malformations in children presenting with non-traumatic intra-cerebral haemorrhage and outline the need for radiological investigations.
This multicenter, double-blind, double-dummy, randomized, inpatient trial evaluated the safety, tolerability, and pharmacokinetics of intravenous lacosamide as replacement for oral lacosamide in patients with partial-onset seizures.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1260-1262
Ataxic hemiparesis (AH) is a well recognised lacunar syndrome involving homolateral ataxia with accompanying corticospinal tract impairment. Most previous studies of lesion location in AH did not use diffusion weighted MRI
(DW MRI). The purpose of this study was to use DW MRI to evaluate the radiological correlation in patients presenting with AH.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1226-1230
Refractory temporal lobe epilepsy (TLE) is often associated with hippocampal sclerosis (HS). Patients with major depression (MD) may also show structural abnormalities in the limbic system. Co-occurrence of TLE with HS and MD is not uncommon. We have investigated the clinical and morphological characteristics of TLE patients in relation to MD.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1202-1208
While patients with amyotrophic lateral sclerosis (ALS) may complain of fatigue, the underlying mechanisms appear complex, with dysfunction of central and peripheral nervous systems independently reported as contributing factors. The aim of the present study was to further delineate the mechanisms underlying increased fatigability in ALS by measuring activity dependent changes in axonal excitability following a maximum voluntary contraction
(MVC).
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1213-1217
Brain arteriovenous malformations (BAVMs) are thought to be sporadic developmental vascular lesions, but familial occurrence has been described. We compared the characteristics of patients with familial BAVMs with those of patients with sporadic
BAVMs.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1239-1247
The aims of this study were to develop models of personality change after traumatic brain injury
(TBI) based on information provided by the TBI survivor and a significant other (SO), and to compare the models generated from the two different sources of information.
Human eyes are a powerful social cue that may automatically attract the attention of an observer. Here we tested whether looking toward open human eyes, as often arises in standard clinical "confrontation" tests, may affect contralesional errors in a group of right brain-damaged patients showing visual extinction.
To better delineate the clinical spectrum and the natural history of COL4A1 mutations, a newly defined genetic cause of small vessel disease including the brain and retina.
The objectives were to: quantify dynamic canal pinch diameter (CPD) narrowing during simulated bilateral facet dislocation of a cervical functional spinal unit model with muscle force replication, determine if peak dynamic CPD narrowing exceeded that observed post-trauma, and evaluate dynamic cord compression.
Mental practice as an additional cognitive therapy is getting increased attention in stroke rehabilitation. A systematic review shows some evidence that several techniques in which movements are rehearsed mentally might be effective but not enough to be certain. This trial investigates whether mental practice can contribute to a quicker and/or better recovery of stroke in two Dutch nursing homes.
Interruption of flow through of cerebral blood vessels results in acute ischemic stroke. Subsequent breakdown of the blood brain barrier increases cerebral injury by the development of vasogenic edema and secondary hemorrhage known as hemorrhagic transformation (HT). Diabetes is a risk factor for stroke as well as poor outcome of stroke. The current study tested the hypothesis that diabetes-induced changes in the cerebral vasculature increase the risk of HT and augment ischemic injury.
To evaluate the clinical utility of an infection control program in a patient cohort at high risk for
methicillin-resistant Staphylococcus aureus (MRSA) infection and to identify risk factors interfering with successful decolonization of
MRSA.
Medical Hypotheses, Volume 69, Issue 5, Pages 1046-1053
An analysis is carried out of a set of psychic phenomena appearing always in the same way: an experience suddenly invades the consciousness, unfolding automatically and with great intensity. This psychic automatism, of which the patient is a passive observer, is accompanied by an overwhelming feeling of strangeness.
Abstract
A patient with chronic aphasia underwent functional imaging during a language comprehension task using magnetoencephalography (MEG) before and after constraint induced language therapy
(CILT). In the pre- and immediate post-treatment (TX) scans MEG activity sources were observed within right hemisphere only, and were located in areas homotopic to left hemisphere language areas.
Clinically silent brain lesions detected with magnetic resonance imaging (MRI) are associated with increased risk for stroke, while stroke risk is controversial in familial hypercholesterolemia
(FH).
Southern Medical Journal. 100(10):1051-1053, October 2007
Most cases of West Nile encephalitis virus (WNV) infection are asymptomatic. In cases where WNV is symptomatic, patients usually experience high fever of sudden onset,
myalgia, headache, and gastrointestinal symptoms, accompanied by a macular erythematous rash in a quarter to half of cases. More severe infections manifest as a poliomyelitis. Immunocompromise and immune senescence confer an increased risk of severe central nervous system (CNS) infection.
British Journal of Neurosurgery, Volume 21, Issue 5 October 2007 , pages 524 - 527
Metastasis of meningiomas due to iatrogenic implantation of tumour cells is extremely rare and only four cases have been reported to date. In this study, we report a 45-year-old female patient who presented with meningioma metastasis at the pin site of head holder applied in the original operation.
Cochrane Database of Systematic Reviews 2007 Issue 3
The primary objective of this review is to determine the effectiveness of preconception counselling aimed at: reducing adverse pregnancy outcome in both mother and child; increasing the knowledge of women with epilepsy; increasing intention to plan pregnancy.
Wernicke described the clinical features of three patients, including two alcoholics, suffering from confusion, ataxia and ophthalmoplegia in whom pathologically he found
'polioencephalitis haemorrhagica superioris'.
Journal of Trauma-Injury Infection & Critical Care. 63(4):841-848, October 2007
Prior surveys of acute medical management of severe traumatic brain injury (TBI) indicate that care is fragmented and inconsistent, although Guidelines for the management of severe traumatic brain injury (guidelines) were distributed and endorsed by the American Association of Neurologic Surgeons. We conducted a survey of US trauma centers to evaluate guideline adherence, to examine predictors of adherence, and to compare our results with similar surveys conducted in 1991 and 2000.
American Journal of Neuroradiology 28:1683-1689, October 2007
Noninvasive grading of gliomas remains a challenge despite its important role in the prognosis and management of patients with intracranial
neoplasms. In this study, we evaluated the ability of cerebral blood flow
(CBF)-guided voxel-by-voxel analysis of multivoxel proton MR spectroscopic imaging (1H-MRSI) to differentiate low-grade from high-grade
gliomas.
Current Medical Research and Opinion, Volume 23, Number 10, October 2007 , pp. 2461-2465(5)
Pharmacokinetic interactions can make necessary anti-epileptic medication (AED) changes hazardous for children with epilepsy. We report the utility of a dosing algorithm designed to maintain stable trough lamotrigine
(LTG) concentrations during conversion from valproate (VPA) to LTG monotherapy in adolescents aged 16-20 years.
Three-dimensional (3-D) visualization of multimodality neuroimaging data provides a powerful technique for viewing the relationship between structure and function. A number of applications are available that include some aspect of 3-D visualization, including both free and commercial products.
Clinical Pharmacology & Therapeutics September 2007
Patients with amyotrophic lateral sclerosis (ALS) who are treated with the antiglutamatergic drug riluzole receive a fixed-dose regimen of 50 mg
b.i.d. The drug has been shown to increase tracheostomy-free survival by 3-6 months.
Journal of Computer Assisted Tomography. 31(5):666-670, September/October 2007
To assess the brain metabolites in the hippocampus of patients with mild cognitive impairment (MCI) using proton magnetic resonance spectroscopy at 0.5 T.
Pediatric Radiology 0301-0449 Volume 37, Number 10 / October, 2007
Giant cavernous malformations are rare. There are 17 cases reported in the literature, eight of them in children. Although cavernous malformations have typical imaging findings, the diagnosis of giant cavernous malformation can be challenging because of its large size and varied appearance. It can be more challenging when imaging reveals multilobular involvement and a focal infiltrative pattern mimicking malignancy. We report a case of a giant cavernous malformation with multilobular involvement and a focal infiltrative pattern.
Angiotensin-converting enzyme (ACE) polymorphism may play a role in stroke and silent brain infarction
(SBI) susceptibility, but the results among the populations studied to date have not been consistent. Thus, we investigated the association between ACE genotypes and ischemic stroke and SBI in Korean patients.
Polyglot speakers who become aphasics are not necessarily affected to the same extent in each language. In some cases there is a mixing of the different languages or a switching between languages and in very rare cases the switch is to the language seldom if ever used in everyday live.
Susceptibility-weighted imaging (SWI) is a novel magnetic resonance (MR) technique that exploits the magnetic susceptibility differences of various tissues, such as blood, iron and calcification. This pictorial review covers many clinical conditions illustrating its usefulness.
Epilepsia Volume 48 Issue 10 Page 1990-1994, October 2007
The influence of antiepileptic drugs (AEDs) and/or common polymorphisms (677C - T, 1298A - C) of the methylene-tetrahydrofolate-reductase
(MTHFR) gene on the recurrence time of hyper-total-homocysteinemia (tHcy > 13 μmol/L) was investigated in 59
hyper-homocysteinemic patients (34M/25F, 20–49 years).
American Journal of Neuroradiology 28:1819-1823, October 2007
As the standard of care for the evaluation of the cervical spine shifts from plain radiographs to multidetector row CT
(MDCT), a re-examination of the normal anatomic relationships of the occipitovertebral articulations is needed. We aimed to define the normal anatomic relationships of craniocervical articulations on MDCT and address any discrepancies with currently accepted ranges of normal on plain radiographs.
European Journal of Neurology, Volume 14, Number 10, October 2007 , pp. 1154-1161(8)
Epilepsies are amongst the most frequent chronic neurological conditions. Patients suffer from spontaneously recurring seizures because of sudden extensive electrical gray matter discharges. Although the current drug therapy allows many patients at least some degree of a satisfying course of the disease, a substantial number of patients remain without adequate seizure control.
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