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Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE; MIM 600513) has been associated with mutations in the genes coding for the alfa-4 (CHRNA4), beta-2 (CHRNB2), and alpha-2 (CHRNA2) subunits of the neuronal nicotinic acetylcholine receptor
(nAChR) and for the corticotropin-releasing hormone (CRH).
Temporal lobe epilepsy patients (n = 48) and healthy controls (n = 69) underwent structured psychiatric interview at baseline and 4 years later to characterize the course of DSM-IV Axis I disorders.
Arterial calcification and osteoporosis often coexist, especially in postmenopausal women. Osteoporosis associates with a substantially increased risk of stroke in elderly women, suggesting that impaired estrogen signaling may link stroke and osteoporosis.
International Journal of Cancer Volume 121, Issue 7 , Pages 1473 - 1480
Meningiomas are mostly benign tumors that originate from the coverings of brain and spinal cord. Typically, they reveal a normal karyotype or monosomy for chromosome 22. Rare clinical progression of meningiomas is associated with a nonrandom pattern of secondary losses of other
autosomes. Deletion of the short arm of one chromosome 1 appears to be a decisive step for anaplastic growth in
meningiomas.
Posterior reversible encephalopathy syndrome (PRES) is classically characterized as symmetric parietooccipital edema but may occur in other distributions with varying imaging appearances. This study determines the incidence of atypical and typical regions of involvement and unusual imaging manifestations.
To determine if the clinical characteristics of nonepileptic seizures (NES) are different in children younger than 13 years age as compared to adolescents.
Prolonged electroencephalographic monitoring has facilitated the detection of nonconvulsive seizures. Compressed displays of EEG frequency spectra (such as compressed spectral array, CSA) can facilitate interpretation of continuous EEG by allowing the reader to observe on a single screen patterns evolving over many minutes or hours.
Subthreshold depression (sD) and cognitive impairment but not demented (CIND) in stroke patients are associated with poorer rehabilitative outcomes. Their diagnosis can easily be operationalized using validated scales.
To assess the value of remifentanil in intraoperative evaluation of spike activity in patients undergoing surgery for mesial temporal lobe epilepsy
(MTLE).
Neuroendocrine dysfunction following traumatic brain injury and aneurysmal subarachnoid hemorrhage may occur with a much higher prevalence than previously suspected. This sequela is a potentially serious but treatable complication of brain injury.
To report an unusual case of spontaneous spinal subdural hematoma and to review relevant literature and discuss the etiology, pathogenesis, clinical features, imaging, and prognosis.
Systemic hypoxia-ischemia at birth may alter the neonatal neutrophil phenotype. In this study, we evaluated alterations in perinatal neutrophil phenotype following systemic hypoxia-ischemia compared with normal controls.
Journal of Neuro-Oncology, Volume 84, Number 3, September 2007 , pp. 233-244(12)
Loss of the PTEN tumor suppressor gene and amplification of the epidermal growth factor receptor
(EGFR), which is common in malignant gliomas, result in activation of the mammalian target of rapamycin
(mTOR).
Journal of Neuro-Oncology, Volume 84, Number 3, September 2007 , pp. 293-296(4)
Seizures are a common complication of metastatic brain tumors (MBT), affecting approximately 27-50% of all patients during the course of their illness. Treatment of tumor-induced seizures is often inadequate with traditional antiepileptic drugs
(AED) due to a variety of factors, including activation of glutamatergic NMDA receptors, alterations of neuronal input pathways, and tumor growth.
Journal of Neuro-Oncology, Volume 84, Number 2, September 2007 , pp. 189-199(11)
This work aims to prospectively record all primary central nervous system tumors
(PCNST), in France, for which histological diagnosis is available. The objectives are to create a national registry and a network to perform epidemiological studies, to implement clinical and basic research protocols, and to harmonize the healthcare of patients affected by
PCNST.
Journal of Neuro-Oncology, Volume 84, Number 2, September 2007 , pp. 119-129(11)
Medulloblastoma (MB) is the most common malignant neuroepithelial tumor of childhood. The DNA topoisomerase II
(Topo II) inhibitor etoposide has been widely used for the treatment of
MBs; however, it remains unknown whether MB cells are more sensitive to etoposide than other malignant neuroepithelial tumor cells.
Journal of Neuro-Oncology, Volume 84, Number 2, September 2007 , pp. 179-183(5)
Radiation-induced high-grade gliomas are a rare but serious late complication of radiotherapy. We report a patient with radiation-induced cerebellar high-grade glioma who had a durable response to
temozolomide.
Journal of Neuro-Oncology, Volume 84, Number 3, September 2007 , pp. 315-323(9)
A total of 140 serum samples were analyzed using the weak cation-exchange (WCX) chips. Among those, 73 were sera from astrocytoma patients, 56 from normal controls, and 11 from other brain tumors. For building a diagnosis model, the samples were randomly split into a training set and a test set with similar distribution of case and control samples. Proteomics profiles were obtained using a PBSII instrument and the data were analyzed with the accompanying software.
Journal of Neuro-Oncology, Volume 84, Number 3, September 2007 , pp. 263-267(5)
Medulloblastomas (MBs) are the most common malignant brain tumors of childhood. Antitumor agents promoting long-term survival with limited toxicities are thus far lacking. Preliminary findings suggest that retinoic acid (RA) derivatives
(retinoids) exert antitumor effects by inhibiting cell proliferation and inducing cell differentiation, apoptosis, and growth arrest, and RAs have been specifically shown to induce apoptosis in some MB cells.
Epilepsia Volume 48 Issue 9 Page 1691-1696, September 2007
To report in detail the electroclinical features of a large family in which we recently identified a missense mutation (M145T) of a well-conserved amino acid in the first transmembrane segment of domain I of the human SCN1A. We showed that the mutation is associated with a loss of SCN1A function.
The paraoxonase (PON) gene can reduce the risk of developing atherosclerosis. We investigated the associations between PON polymorphisms and ischemic stroke. We also investigated the associations between PON polymorphisms and lipid profile in stroke patients.
Intensive Care Medicine Volume 33, Number 9 / September, 2007 1587-1593
To determine whether serum N-terminal pro-B-type natriuretic peptide (N-BNP), a biomarker of myocardial wall stress, is specific to acute heart failure
(HF) in patients hospitalized with stroke.
The use of molecular imaging techniques in the central nervous system (CNS) has a rich history. Most of the important developments in imaging-such as computed tomography, magnetic resonance imaging, single photon emission computed tomography, and positron emission tomography-began with neuropsychiatric applications.
Journal of Neuro-Oncology, Volume 84, Number 3, September 2007 , pp. 297-304(8)
Between surgery and radiotherapy patients with a malignant glioma may encounter a number of psychosocial issues that could invoke an anxious or depressive response. This study explored the frequency, severity and cause of anxiety and depression in patients with presumed malignant brain tumours in the period between their surgery and radiotherapy.
Journal of Neuro-Oncology, Volume 84, Number 3, September 2007 , pp. 271-278(8)
Potential treatment-related neurotoxicity and the indolent course of the disease mainly feed the controversy concerning the optimal timing of surgery and radiotherapy in meningioma patients.
Journal of Neuro-Oncology, Volume 84, Number 2, September 2007 , pp. 201-211(11)
Specific gene mutations, loss of heterozygosity, deletions and/or amplifications of entire chromosomal regions and gene silencing have been described in
gliomas.
Longitudinal cohort analysis of consecutive admissions to a specialized in-patient rehabilitation unit. Selection criteria: patients who were highly dependent on admission
(NPDS 25) and had a length of stay > 125 days. Serial changes in dependency and care costs were measured by the Northwick Park Dependency and Care Needs Assessment
(NPDS/NPCNA), which provides a generic estimation of dependency, care hours and weekly cost of continuing care in the community.
A 33-item questionnaire including background parameters, the Cleveland Constipation Score (CCS), and items from the Neurogenic Bowel Dysfunction score was sent to 468 PD patients. Results were compared to a control group (CG) (n = 45). A CCS of at least 15 was used to define severe constipation.
Underutilization of acute stroke therapy is driven by delay to hospital arrival. We present the primary results of a pilot, randomized, controlled trial to encourage calling 911 for witnessed stroke among middle school children and their parents.
International Journal of Cancer Volume 121, Issue 8 , Pages 1756 - 1763
Most tumors of the central nervous system, especially glioblastoma, are refractory to treatment and invariably lethal. The aim of this study was to assess the ability of different interleukins (IL), IL-2, IL-12 and IL-21, produced by transduced glioma cells to activate an immune response and trigger intracranial tumor rejection.
Minocycline exerts beneficial immune modulatory effects in several noninfectious neurodegenerative disease models; however, its potential to influence the host immune response during central nervous system bacterial infections, such as brain abscess, has not yet been investigated.
Epilepsy and malnutrition are both important public health problems in sub-Saharan Africa. A relationship between epilepsy and malnutrition has been suspected for many years. Our objective was to investigate the association between epilepsy and malnutrition in
Djidja, Benin.
To compare the prevalence of transient periventricular echodensities (TPE), periventricular leukomalacia
(PVL) and haemorrhagic brain lesions (HBL) in singleton intrauterine growth-restricted
(IUGR) infants and in those appropriate for gestational age (AGA).
Epilepsia Volume 48 Issue 9 Page 1739-1749, September 2007
Several studies have reported favorable effects of intravenous immunoglobulins (IVIG) in refractory epilepsy. Evidence substantiating an immunomodulatory action is scarce. In an open-label study, we prospectively investigated the effect of IVIG on clinical, EEG and
serum/CSF immunological parameters in patients with refractory childhood-onset epilepsy.
To determine the localizing value of electroencephalography (EEG) for seizures during sleep versus seizures during wakefulness, we compared scalp EEG for 58 seizures that occurred during sleep with 76 seizures during wake in 28 consecutive patients with temporal lobe epilepsy.
Clinical Journal of Sport Medicine. 17(5):369-374, September 2007
Although research is accumulating on the cognitive sequelae from sports-related concussions in men, little to nothing is known about the prolonged cognitive outcome after a concussion in women. This point is important because recent evidence suggests that female athletes are at greater risk of sustaining a concussion.
The purpose of the present study was to investigate whether mechanical efficiency (ME) relates to wheelchair propulsion capacity and wheelchair performance tasks during and after rehabilitation of people with a spinal cord injury (SCI).
Cephalalgia Volume 27 Issue 10 Page 1128-1135, October 2007
Headache and depression were studied in patients who had undergone operation for acoustic
neuroma. A questionnaire with headache and Beck Depression Inventory scale were sent to 228 patients, of whom 192 (84%) responded. Preoperative headache was reported by 61 (32%) of the respondents (47 migraine and nine tension-type headache) and 122 (64%) respondents had postoperative headache (15 new migraine and four new tension-type headache).
To determine high school football coaches' understanding, management and sources of information of concussion at schools without a certified athletic trainer
(ATC) or without one at practice.
In human genetic studies an effect of the apolipoprotein E gene (APOE) polymorphism on the risk, course and prognosis in chronic and acute nervous system disorders was established.
To determine whether critical flicker frequency (CFF) thresholds are abnormal in individuals with mild traumatic brain injury
(TBI) and, if so, if they are correlated with the degree of reported motion and light sensitivity.
Warfarin prevents stroke in atrial fibrillation (AF); however, concerns regarding international normalized ratio control and hemorrhage limit its use in the elderly. The oral direct thrombin inhibitors
(DTIs) are potential alternatives to warfarin, offering fixed dosing without drug and dietary interactions and the need for international normalized ratio monitoring.
Journal of Head Trauma Rehabilitation. Focus on Clinical Research and Practice. 22(5):278-287, September/October 2007
To investigate the association of psychosocial outcome 10 years following traumatic brain injury
(TBI) with demographic variables, injury severity, current cognitive functioning, emotional state, aggression, alcohol use, and fatigue.
Vagus nerve stimulation (VNS) is thought to have a cumulative effect in time on seizure frequency reduction. There also might be other variables than reduction of seizure frequency in order to determine VNS efficacy.
Data from prospective studies on the associations between B vitamin plasma levels and the risk of stroke are limited. We investigated the individual and combined effects of plasma
folate, vitamin B12, and pyridoxal 5-phophate (PLP) levels on the risk of ischemic stroke and transient ischemic attack (TIA) in a large, prospective German cohort.
JNCI Journal of the National Cancer Institute 2007 99(18):1410-1414
The eradication of brain tumor stem cells is essential for long-term brain tumor remission after treatment. In this study, we examined the therapeutic potential of an oncolytic adenovirus, Delta-24-RGD, targeted to the abnormal
p16INK4/Rb pathway in brain tumor stem cells.
Journal of Head Trauma Rehabilitation. Focus on Clinical Research and Practice. 22(5):296-302, September/October 2007
To examine differences in outcomes at transition age (17-21 years) between individuals who sustained complicated mild-to-severe traumatic brain injury
(TBI) in early or middle childhood and those who were injured in late adolescence.
The purposes of this essay are to illustrate the causes of FLAIR hyperintensity in the subarachnoid space and to outline the mechanisms of the findings.
Double origin of the posterior inferior cerebellar artery (PICA) is a congenital anomaly in which the PICA forms from two separate vessels arising from the vertebral artery. The prevalence of double origin of the PICA on catheter angiography is unknown because only four case reports have been published.
The purposes of this article are to illustrate the variable CT and MRI features of carbon
monoxide induced brain injury and to discuss the underlying pathogenesis.
Epilepsy was a well-recognized disease in pre-Columbian cultures. However, anthropological studies about epilepsy in native cultures living at the present time are scarce. The objective of this paper was to study native perception and myths about epilepsy, their magic-religious healing rites and ceremonies, and the natural treatments that archaic cultures used.
Intensive Care Medicine Volume 33, Number 9 / September, 2007 1580-1586
To collect information on clinical practice and current management strategies in 22 Italian neurosurgical hospitals for patients with aneurysmal subarachnoid hemorrhage.
To assess the incidence of fatigue for persons following a mild traumatic brain injury
(MTBI) and to evaluate the relationship between fatigue and APOE genotype. As fatigue is often found to be influenced by anxiety, depression and sleep disturbance, these factors were also measured.
The progression of carotid stenosis reflects the activity of atherosclerotic disease and may indicate a risk for systemic atherothrombotic complications.
Routine chest radiographs at the time of hospital admission are not recommended for stroke patients in the absence of pulmonary symptoms. The usefulness of the test in patients being evaluated by a stroke team for hyperacute stroke symptoms was assessed.
Cochrane Database of Systematic Reviews 2007 Issue 3
Vaccination is recognized as the only practical measure for preventing Japanese encephalitis. Production shortage, costs, and issues of licensure impair vaccination programmes in many affected countries. Concerns over vaccine effectiveness and safety also have a negative impact on acceptance and uptake.
Internal carotid artery (ICA) agenesis is a rare vascular anomaly that, in combination with occlusion of the contralateral ICA, produces significant strain on the posterior circulation for collateral flow.
The use of herbals and health supplements is not without risk. This case report of a 17-year-old girl who presented with acute dural sinus thrombosis following herbal tonic ingestion illustrates the dangers of unsupervised ingestion of "health supplements."
Antiplatelet effects of angiotensin II receptor blocker have been suggested, but satisfactory results in clinical settings are lacking. We investigated spontaneous platelet aggregation (SPA) and CD62P levels in patients with hypertension and chronic-stage ischemic stroke.
Hyperlipidemia and increased serum lipoprotein (Lp)(a) are independent risk factors for atherosclerosis and its complications. Serum
Lp(a) concentration is not influenced by most lipid-lowering therapies other than niacin.
Echocardiography is often performed in patients with stroke, even when alterative stroke causes are identified. We evaluated the use of echocardiography in patients with transient ischemic attack (TIA) or stroke caused by stenosis of a major intracranial artery.
This study prospectively evaluated long-term outcome 2 years after 6-8 weeks of day hospital rehabilitation
(DHR) for stroke in younger patients. Assessment findings after discharge from DHR and at follow-up 2 years later using 3 instruments-the FIM (originally known as the Functional Independence Measure), SF-36, and EuroQol (now known as EQ-5D)-were compared.
The peripheral inflammatory response, as a proxy for the acute-phase response (a known mechanism for ischemic preconditioning), and non-damage-producing transient ischemia must exist together in humans if this candidate mechanism confers ischemic tolerance.
The administration of an adenosine diphosphate (ADP) receptor antagonist, such as
clopidogrel, is recommended for recurrent stroke patients under aspirin treatment. However, up to 25% of vascular patients have an inadequate response to clopidogrel treatment, which could be associated with increased reinfarction rates.
To investigate whether calendrical information influences the occurrence of spontaneous intracerebral hemorrhage, we statistically compared the incidence of intracerebral hemorrhage for inpatients at Teraoka Memorial Hospital (164 patients), against various calendrical factors such as the day of the week, national holidays, and RokuYo (a recurring six-day series of lucky and unlucky days in the Japanese traditional calendar) over the period from January 1, 2001 to December 31, 2003. On Japanese national holidays the relative risk of intracerebral hemorrhage is significantly higher than on other days, certainly due to much more alcohol consumption on holidays.
Epidemiologic studies suggest sex differences in evaluation of patients presenting with ischemic stroke. Sex differences in stroke evaluation could lead to sex differences in the validity of diagnosing ischemic stroke subtypes. This study assessed sex differences in the Ischemic Stroke Genetics Study
(ISGS).
Volume 262, Issue 1, Pages 165-170 (15 November 2007)
Japanese encephalitis (JE) is a major public health problem in Southeast Asia with around 50,000 cases and 10,000 deaths per year affecting essentially children below 10 years of age.
Volume 262, Issue 1, Pages 89-97 (15 November 2007)
The PDE-5 inhibitors sildenafil (Viagra) vardenafil (Levitra) and tadalafil (Cialis) have been taken by millions of men for erectile dysfunction. Transient visual symptoms are common but there also have been fourteen cases of nonarteritic anterior ischemic optic neuropathy
(NAION) described in patients using these drugs as well as a few other vascular events.
Volume 262, Issue 1, Pages 85-88 (15 November 2007)
The development of stroke registries has allowed the accumulation of a wealth of data on the descriptive epidemiology of stroke and its evolution in space and in time. For instance, there has been an observed decrease of stroke incidence and mortality in Western Countries during the past 20 years.
Volume 262, Issue 1, Pages 60-70 (15 November 2007)
Despite intensive evaluation of acute stroke patients, perhaps only half of the attributable stroke risk is usually identified. In addition to traditional and non-traditional vascular risk factors-including most recently
homocysteine, inflammation, and alterations of coagulation-a number of environmental risk factors for stroke have been identified in the last decade.
We determined whether the primary motor hand area was most frequently located in the precentral gyrus in young patients with intractable focal seizures.
Epilepsy surgery is an established therapy for pharmacoresistant focal epilepsy. This study investigated the contribution of routinely used magnetoencepahlography (MEG) in addition to long term video-EEG-monitoring in presurgical evaluation. The distribution of localization results to anatomical lobes was compared with special focus to MEG spike localization results in cases without or with ambiguous EEG findings.
Epidemiological studies have found the risk for heart disease and stroke are increased in persons with epilepsy. Anti-epileptic drugs
(AEDs) have varying effects on serum lipids and homocysteine-an independent risk factor for coronary disease.
Clinical reports suggest that the elderly are hypersensitive to the neurological effects of domoic acid (DOM). In the present study we assessed DOM-induced seizures in young and aged rats, and seizure attenuation following low-dose DOM pretreatment (i.e. preconditioning).
Serotonin (5-HT) has been shown to exert antiepileptic effects in a variety of generalized convulsive seizure models, particularly the genetically epilepsy-prone rat
(GEPR).
Some enaminones are reported to have in vivo anticonvulsant activity. We asked if methyl 4-(4-bromophenyl)aminocyclohex-3-en-6-methyl-2-oxo-1-oate (E139), one of such enaminones produced in vitro effects that may underlie or explain these in vivo anticonvulsant actions by testing if E139 suppressed in vitro seizures.
The possibility that seizures may be intercorrelated has not been sufficiently investigated. A handful of studies, the majority based on patient seizure diaries, provide disparate results: some claim that seizures are serially correlated and others that they are random events. This study investigates the effect that a seizure may have on the time of occurrence and severity of subsequent ones in subjects undergoing invasive surgical evaluation.
To test the putative serotonin (5-HT)-like effect of zonisamide (ZNS) we employed
xanthine-induced epileptiform activity in the hippocampus slice preparation from guinea pigs.
The present study was conducted to identify the role of nitric oxide (NO) in the anticonvulsant effects of pyridoxine hydrochloride on penicillin-induced epileptiform activity in rats.
Mutations in the LGI1 (leucine-rich, glioma inactivated 1) gene are found in less than a half of the families with autosomal dominant lateral temporal epilepsy
(ADLTE), suggesting that ADLTE is a genetically heterogeneous disorder.
The effects of vigabatrin, which increases GABA concentrations by inhibiting GABA
transaminase, on spike and wave discharges (SWDs) in the electroencephalogram of
WAG/Rij rats were studied.
The objective of this pilot study was to evaluate the ability of a novel method of cluster analysis, 2dTCA, for identifying and characterizing peak fluctuations in fMRI BOLD signals in the temporal lobes and the default-mode network in temporal lobe epilepsy
(TLE) without EEG.
Management of hypothalamic hamartoma with intractable gelastic epilepsy remains controversial. We have used stereotactic thermocoagulation for treatment of hypothalamic hamartoma with intractable gelastic epilepsy since 1997.
The Safety of Keppra as Adjunctive Therapy in Epilepsy (SKATE) study aimed to evaluate the safety and efficacy of levetiracetam
(Keppra, LEV) as add-on therapy for refractory partial seizures in clinical practice.
The objective of this study was to describe epilepsy localization, clinical features and surgery outcome in patients with epilepsy and cerebellar structural abnormalities.
Physicians with epilepsy (physician' patients) are an understudied, unique patient population due to the potential adverse outcomes that seizures or medication side effects might have on patients under their care, as well as their ability to modify treatments without consulting treating physicians.
In their article, "Electrographic seizures and periodic discharges after intracerebral hemorrhage," Dr. Claassen and colleagues discuss several important issues that affect people who have bleeding into the brain (Neurology 2007;69:1356-1365). They used a retrospective review to study problems associated with bleeding within the brain. There are problems with this type of study. However, it is this kind of study that often leads to further research.
Low-grade gliomas (LGGs) represent a vexing clinical problem. Some patients present with readily controllable seizures and will enjoy years of freedom from tumor progression without intervention, whereas others progress rapidly with eventual neurologic decompensation and death. Both radiation and chemotherapy are helpful to many patients, but the optimal timing and sequencing of these therapies remain unknown.
Activating mutations in the human KCNJ11 gene, encoding the pore-forming subunit (Kir6.2) of the ATP-sensitive potassium
(KATP) channel, are one cause of neonatal diabetes mellitus. In a few patients, KCNJ11 mutations cause a triad of developmental delay, epilepsy, and neonatal diabetes
(DEND syndrome).
Although rare, the association of intracranial meningiomas and pituitary adenomas has been reported. Intraventricular meningiomas are unusual, and meningiomas located in the fourth ventricle are even more so.
The prevalence rate of epilepsy in India ranges between 4.15 and 7.03 per 1000 population. In the developing countries, the major problems of epilepsy are lying in the treatment gap and discontinuation of treatment due to various adverse socio-economic factors. The objective of this study was to evaluate the rate of discontinuation of epilepsy treatment and its related socio-economic factors responsible for discontinuation.
Journal of Psychopharmacology, Vol. 21, No. 7, 700-708 (2007)
High levels of impulsivity have adverse effects on performance in cognitive tasks, particularLy in those tasks that require high attention investment. Furthermore, both animal and human research has indicated that reduced brain serotonin (5-HT) function is associated with increases in impulsive behaviour or decreased inhibition ability, but the effects of 5-HT challenge have not yet been investigated in subjects vulnerable to impulsivity.
The aim of the study was to estimate trends in stroke case fatality in a French population-based study over the last 20 years, and to compare trends in men and women.
We introduce a validation framework for the segmentation of brain tumors from magnetic resonance
(MR) images. A novel unsupervised semiautomatic brain tumor segmentation algorithm is also presented.
ST-segment depression and T-wave inversion (ST-T changes) in the electrocardiogram
(ECG) and raised levels of natriuretic peptide have been observed in acute ischemic stroke patients. It is unknown whether any relation between ST-T changes and raised levels of natriuretic peptides in patients with an acute ischemic stroke exists.
Although sleep apnea (SA) is a risk factor for ischemic stroke and an important prognosticator in affected patients, the exact pathophysiological link between SA and stroke remains to be established. We investigated whether levels of C-reactive protein (CRP) and fibrinogen are increased in patients with acute stroke and SA compared with stroke patients without SA.
Acta Anaesthesiologica Scandinavica, Volume 51, Number 9, October 2007 , pp. 1194-1201(8)
In patients with severe head injury, control of physiological variables is important to avoid intracranial hypertension and secondary injury to the brain. The aims of this retrospective study were to evaluate deviations of physiological variables and the incidence of extracranial complications in patients with severe head injury. We also studied if these deviations could be related to outcome.
It has been suggested that subcortical lesions may influence cognitive performances at early stages of cognitive impairment but not in late stages of dementia. We aimed to test whether cognitive decline is associated with subcortical hyperintensities in patients with mild cognitive impairment (MCI).
THE TRADITION OF selfless charity for children in Toronto was established by Elizabeth McMaster, founder of the Hospital for Sick Children, or "Sick Kids," in 1875. The tradition of fortitude and perseverance in trying to cure children who were deemed incurable by others was sealed into the history of the Hospital by early pioneering surgeons, including Drs. Clarence Starr,
A.W. Farmer, and William Gallie. Dr. William Gallie recognized the importance of neurosurgery for the future of the Hospital and encouraged Dr. William Keith to acquire training in pediatric neurosurgery in Chicago and London.
An increasing number of intracranial dural arteriovenous fistulae (DAVFs) are amenable to endovascular treatment. However, a subset of patients with high-risk lesions requires surgical intervention for complete obliteration. We reviewed our experience with the surgical management of high-risk intracranial DAVFs and offer recommendations to minimize complications based on fistula location and type.
Neurofibromatosis Type 1 (NF1) is known to be associated with vascular lesions. Association with an extracranial vertebral artery aneurysm is very rare. We report the case of such an aneurysm mimicking a cervical neurofibroma in NF1.
We have frequently observed the development of postoperative communicating hydrocephalus in patients undergoing decompressive
hemicraniectomy. This condition may persist in some patients after cranioplasty and require permanent cerebrospinal fluid
(CSF) diversion. To confirm an independent correlation between hemicraniectomy and the development of communicating hydrocephalus, and to detail the frequency and potential clinical factors contributing to this complication, we evaluated our series of patients undergoing hemicraniectomy for life-threatening increases in intracranial pressure secondary to ischemic or hemorrhagic stroke.
To evaluate the midterm results of intracranial stent-assisted coil embolization in the treatment of wide-necked cerebral aneurysms and to assess the efficacy of various strategies used in stent deployment.
To evaluate the clinical, endocrinological, and radiological presentation of nine cases of surgically verified intrasellar arachnoid cysts and to discuss the physiopathological mechanisms of formation of these cysts.
The authors describe the clinical and pathological features of the second reported case of an intraneural perineurioma involving a major intracranial nerve and the first case of this entity involving the VIIIth cranial nerve.
Vascular abnormalities associated with neurofibromatosis Type 1 (NF-1) are well known, but arteriovenous fistulae
(AVF) are rare and usually involve vertebral AVF. A case of intercostal AVF associated with NF-1 and manifesting as congestive myelopathy is described.
We hypothesize that subtle neurological signs at baseline could be present in some "good grade" subarachnoid hemorrhage
(SAH) patients and that they would have negative prognostic implications.
The association between smoking and intracranial aneurysms is now well recognized. However, the relationship between tobacco use and outcome after aneurysmal subarachnoid hemorrhage
(SAH) is not as well understood and published results are contradictory. The purpose of this study is to examine the degree to which the amount of tobacco exposure/dose impacts delayed neurological deterioration and overall clinical outcome after aneurysmal
SAH.
The clinical course of atypical and anaplastic meningiomas is heterogeneous. As malignant
gliomas, aggressive meningiomas may arise de novo or transform from a benign tumor. This study aims to compare differences in clinical behavior,
cytogenetics, cytokinetics, receptor status, and outcome between de novo malignant meningiomas and meningiomas that progressed to malignancy.
The release of results of International Subarachnoid Aneurysm Trial in 2003 caused a shift in the paradigm of management of ruptured intracranial aneurysms. The cases selected for microsurgical clipping nowadays are usually those patients with aneurysms that are not suitable for
embolization, and are often complex and difficult.
Traumatic brain injury (TBI) causes extensive loss of cerebral parenchyma; however, no strategy for reconstruction has been clinically effective. Our group and others have used human marrow stromal cells
(hMSCs) to treat rats subjected to TBI and found no significant changes in the lesion volume, although functional outcome was improved significantly.
Radiosurgery for arteriovenous malformations is limited to small lesions and may take 3 years to produce total occlusion. It has recently been shown that coadministration of low-dose lipopolysaccharide (LPS) and soluble tissue factor
(sTF) selectively induces thrombosis in murine tumor models, attributable perhaps to the prothrombotic phenotype of tumor vasculature.
Spontaneous acute subdural hematoma (aSDH) may be caused by aneurysm rupture. Patients can present in very poor clinical condition with anisocoria or even bilaterally dilated pupils, absent brainstem reflexes, and cardiac insufficiency.
A 25-year-old Caucasian woman presented with neuralgic facial pain that responded to pharmacological management. She had no neurological deficit. Magnetic resonance imaging scans revealed a space-occupying lesion in the interpeduncular cistern with no evidence of hemorrhagic event.
Although arachnoid cysts and intracranial aneurysms are very common lesions, their association in the same patient is rare. We present a case of a middle cerebral artery aneurysm ruptured into an arachnoid cyst. We found only six cases with intracystic hemorrhage reported in the literature. The presence of an arachnoid cyst can mislead clinical presentation.
Journal of Head Trauma Rehabilitation. Focus on Clinical Research and Practice. 22(5):278-287, September/October 2007
To investigate the association of psychosocial outcome 10 years following traumatic brain injury
(TBI) with demographic variables, injury severity, current cognitive functioning, emotional state, aggression, alcohol use, and fatigue.
Journal of Head Trauma Rehabilitation. Focus on Clinical Research and Practice. 22(5):296-302, September/October 2007
To examine differences in outcomes at transition age (17-21 years) between individuals who sustained complicated mild-to-severe traumatic brain injury
(TBI) in early or middle childhood and those who were injured in late adolescence.
Journal of Head Trauma Rehabilitation. Focus on Clinical Research and Practice. 22(5):257-266, September/October 2007
To investigate the contribution of activity-related satisfaction and perceived self-efficacy to global life satisfaction after traumatic brain injury
(TBI).
Bilateral synchronous epileptiform discharges registered in patients with partial epilepsies may be generated by different pathophysiological mechanisms. Differentiation between underlying mechanisms is often crucial for correct diagnosis and adequate treatment in clinical
epileptology.
BMC Medical Informatics and Decision Making 2007, 7:27
Numerous methods for classifying brain tumours based on magnetic resonance spectra and imaging have been presented in the last 15 years. Generally, these methods use supervised machine learning to develop a classifier from a database of cases for which the diagnosis is already known.
Pediatrics International, Volume 49, Number 5, October 2007 , pp. 584-588(5)
Little is known about childhood epilepsy in Vietnam, and because the causes of symptomatic epilepsy could be the result of both rapid economic development and traditional Vietnamese lifestyle, the purpose of the present paper was to clarify the nature of childhood epilepsy in Vietnam.
Psychiatric events are thought to be more frequent in people with epileptic seizures than in the general population. However,
inter-ictal psychiatric events attributable to epilepsy remain controversial. The aim of the present study was to evaluate the occurrence of psychiatric events in a population of fairly unselected patients with epilepsy and in the general population, and the correlation between psychiatric complaints and selected demographic and disease characteristics.
Previous research suggests that blood pressure falls acutely after ischemic stroke. We aimed to further characterize this fall with a statistical technique that allows the application of regression techniques to serial blood pressure outcome data.
A 31-year-old intoxicated woman self-enucleated her left eye during an acute psychotic episode. CT revealed avulsion of the intracranial optic nerve, chiasmal edema, and adjacent subarachnoid hemorrhage. Exploration via transconjunctival orbitotomy was performed, and the globe and 4.8 cm of contiguous optic nerve were removed. The patient developed postoperative contralateral visual loss followed by middle cerebral artery vasospasm and bilateral cortical infarcts.
American Journal of Neuroradiology 28:1499-1500, September 2007
MR imaging has found abnormalities compatible with low-grade edema in the brain of patients with cirrhosis that have been related to hepatic encephalopathy. We present 3 patients with hepatic encephalopathy who exhibit supratentorial focal or diffuse white matter lesions compatible with small-vessel brain disease. The volume and number of white matter lesions reduced with the improvement of hepatic encephalopathy, suggesting the participation of the blood-brain barrier in the pathogenesis of brain edema in hepatic encephalopathy.
Journal of Head Trauma Rehabilitation. Focus on Clinical Research and Practice. 22(5):288-295, September/October 2007
To investigate the reliability of the Care and Needs Scale (CANS) for measuring the level and types of support needs of people with traumatic brain injury
(TBI).
European Journal of Clinical Investigation, Volume 37, Number 8, August 2007 , pp. 651-657(7)
Low triiodothyronine (T3) has been associated with increased short-term mortality in intensive care unit patients and long-term mortality in patients with heart disease. The objective of this study was to investigate possible associations of thyroid hormone status with clinical outcome in patients admitted for acute stroke.
We investigated the potential mechanism of infarction involving the territories of both the internal carotid artery (ICA) and the ipsilateral posterior cerebral artery
(PCA).
We removed 12 intraorbital tumors (5 schwannomas, 3 meningiomas, 2 cavernomas, 1 pleomorphic adenoma, and 1
neuroblastoma) using the frontozygomatic approach. No patients died. Postoperatively, 1 patient developed transient
ptosis, and 3 patients had mild enophthalmos. Two patients with a meningioma developed transient worsening of their visual acuity and visual field.
One goal of the study was to test specific hypotheses concerning the interdependence of the stroke survivors' recovery and their caregiving partners' attitudes and health. The other aim was to find an applicable method for investigating causal effects on the rehabilitation of chronically sick persons in longitudinal studies with medium-sized samples.
To assess the concurrent validity of the Human Activity Profile (HAP) with stroke and healthy control individuals, when reported by the subject or a proxy and compared to observed performance, used as gold standard; factors related to discrepancies; as well as to determine variables that could best predict physical activity levels.
To examine the literature describing the cost of outpatient rehabilitation for patients with spinal cord injury (SCI) as well as the effect of funding type on cost and outcome. A SCI rehabilitation planning and funding model is presented that calls for structured assessment of the client's economic environment, with follow through to promote full access to funding for rehabilitation plans.
The aim of this study was to describe the treatment from other people as experienced by people with moderate or severe traumatic brain injury
(TBI) and their close relatives.
Venous thromboembolism (VTE) is a major cause of morbidity and mortality in hospitalized patients and 7% of these cases are due to immobility secondary to a neurological impairment. Many guidelines are available to guide clinicians dealing with medical or surgical patients. However, and with the exception of spinal injuries, no guidelines are available to deal with other neurologically impaired patients at risk of
VTE.
Cochrane Database of Systematic Reviews 2007 Issue 3
Psychological treatments are commonly used in the management of anxiety. Certain types of psychological treatments are well suited to needs of people with traumatic brain injury
(TBI). We have systematically reviewed studies examining the effectiveness of these approaches for
TBI.
The burden of cerebrovascular disease in developing countries is projected to be on the rise. However, data on the current epidemiology of stroke in Africa are sparse.
Steroid hormones act on developing neural circuits that regulate the
hypothalamic-pituitary-gonadal axis and are involved in hormone-sensitive
behaviours. To test the hypothesis that developmental exposure to oestradiol (E2) organises the quantity of adult oestrogen receptors
(ERa and ERB), we used male mice with a targeted mutation of the aromatase enzyme gene
(ArKO) and their wild-type (WT) littermates.
Cancer Investigation, Volume 25, Issue 6 September 2007 , pages 470 - 475
Abstract
Temozolomide is an oral cytotoxic agent that has demonstrated its interest in high grade glioma tumors. This drug can be used either concomitantly with radiotherapy or as chemotherapy. The prognosis of relapsing medulloblastoma is poor and treatment is often difficult, especially after radiotherapy.
Imaging has become a cornerstone of stroke management, translating pathophysiological knowledge to everyday decision-making. Plain computed tomography is widely available and remains the standard for initial assessment: the technique rules out
haemorrhage, visualizes the occluding thrombus and identifies early tissue hypodensity and swelling, which have different implications for
thrombolysis.
Cochrane Database of Systematic Reviews 2007 Issue 3
The development of epilepsy in a person with intellectual disabilities is a common occurrence. In view of the fact that seizures in intellectually disabled people are often complex and refractory to treatment and that antiepileptic medication may have a profound effect upon behaviour in this patient group, it is evident that good quality randomised controlled trials are needed in this population.
Dystonia is a syndrome characterized by prolonged muscle contractions that cause sustained twisting movements and abnormal posturing of body parts. Patients with the severe and generalized forms can benefit from bilateral high-frequency pallidal stimulation.
American Journal of Neuroradiology 28:1573-1578, September 2007
The aim of this retrospective study was to report the incidence, clinical presentation, and midterm clinical and imaging results of endovascular parent vessel occlusion of 11 patients with 13 distal cerebellar artery aneurysms.
American Journal of Neuroradiology 28:1579-1585, September 2007
The management of intracranial pseudoaneurysms is controversial. The purpose of this study was to provide a preliminary evaluation of the clinical efficacy of a Willis covered stent specially designed for the intracranial vasculature in the management of a pseudoaneurysm of the cranial internal carotid artery
(CICA).
Intensive Care Medicine September 11, 2007 0342-4642
We compared brain tissue oxygen tension (PtiO2) measured in peri-focal and in normal-appearing brain parenchyma on computerized tomography (CT) in patients following traumatic brain injury
(TBI).
Journal of Neuro-Oncology, Volume 84, Number 1, August 2007 , pp. 39-40(2)
Dermoid cysts represent a rare group of tumors manifesting predominantly in adulthood. Rupture of these tumors is well described with it being symptomatic more commonly intracranially as compared to central canal rupture of intraspinally located dermoid tumor which not only is uncommon, but also frequently asymptomatic.
The most commonly involved areas in subacute sclerosing panencephalitis (SSPE) are periventricular and subcortical white matter. The basal ganglia, cerebellum, spinal cord and corpus callosum are less commonly involved. Brainstem involvement is rare and usually accompanied by other intracranial lesions.
Hypoxic-ischemic encephalopathy (HIE) is a major cause of neonatal morbidity and mortality. Electroencephalography (EEG) and brain magnetic resonance imaging
(MRI) are frequently performed in these infants, but the prognostic value of the combined use of EEG and MRI needs additional exploration.
Glioblastoma multiforme (GBM) is the most aggressive brain tumor, and patients rarely survive for more than 2 years. Gene therapy may offer new treatment options and improve the prognosis for patients with
GBM. Adenovirus-mediated gene therapy strategies for brain tumors have been limited by inefficient gene transfer due to low expression of the adenovirus serotype 5 (Ad5) receptor.
Clinical Endocrinology, Volume 67, Number 4, October 2007 , pp. 598-606(9)
To assess the prevalence of hypopituitarism following traumatic brain injury (TBI), describe the time-course and assess the association with trauma-related parameters and early post-traumatic hormone alterations.
In a retrospective study, we analyzed MRI scans and neuropathology reports of 42 patients who had undergone resective epilepsy surgery in the parietal and occipital lobe between 1998 and 2003. We evaluated, whether lesions were precisely characterized by MRI and whether lesion characterization allowed to estimate postsurgical seizure outcome.
The Clinical Neuropsychologist, Volume 21, Issue 6 November 2007 , pages 943 - 955
This study provided an examination of the performance characteristics of successful brain injury simulators
(SBIS). Coached (n = 56) and uncoached (n = 35) brain injury simulators received instructions to fake cognitive impairment; controls were asked to do their best.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1164;
This is an introductory textbook of neurological and psychiatric disorders with essential information about the structure and function of the normal brain.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1161-1162
Ocular motor findings in Wernicke' encephalopathy (WE) include gaze evoked nystagmus (GEN), central positional
nystagmus, weakness of abduction, internuclear ophthalmoplegia and horizontal or vertical gaze palsy to total
ophthalmoplegia.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1158-1159
Missense mutations in the genes encoding amyloid precursor protein (APP), presenilin 1 (PSEN1) and presenilin 2 (PSEN2) have been found to cause some forms of autosomal dominant early onset Alzheimer disease (AD).
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1072-1075
Health related quality of life outcomes are increasingly used to measure the effectiveness of stroke interventions. People with severe aphasia after stroke may be unable to self-report on such measures, necessitating the use of proxy respondents.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1083-1087
The renin angiotensin system is involved in the development of hypertension, atherosclerosis and cardiovascular disease. We studied the association between the M235T polymorphism of the angiotensinogen gene
(AGT) and the C573T polymorphism of the angiotensin II type 1 receptor (AT1R) and blood pressure, carotid atherosclerosis and cerebrovascular disease.
Journal of Neurology, Neurosurgery, and Psychiatry 2007;78:1103-1108
Although research has implicated the apolipoprotein E (APOE) epsilon-4 genotype as having a negative effect on neuropsychological outcomes following traumatic brain injury
(TBI), the potentially negative role of the 4 allele on TBI outcomes has recently been challenged. In light of this debate, the present study served to examine the role of APOE genotype on neuropsychological outcomes approximately 1 month following mild to moderate TBI in a military population. Because of the well documented role of the APOE-4 allele in increasing the risk of Alzheimer’s disease, we predicted that persons with the APOE-4 genotype would display relatively greater deficits in cognition than their non-4 counterparts.
Expert Review of Cardiovascular Therapy September 2007, Vol. 5, No. 5, Pages 821-824
Several case-controlled studies have demonstrated an association between patent foramen ovale
(PFO) and cryptogenic stroke. However, the risk of first stroke associated with a PFO in the general population is unknown.
Temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) is the most frequent diagnosis in autopsy and surgical epilepsy series.
TLE-HS usually starts during childhood or adolescence. There have been few studies of adult-onset disease.
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