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https://www.readbyqxmd.com/read/28737304/investigation-and-diagnostic-formulation-in-patients-admitted-with-transient-loss-of-consciousness
#1
R Briggs, T Coughlan, J Doherty, D R Collins, D O'Neill, S P Kennelly
Several commonly completed tests have low diagnostic yield in the setting of transient loss of consciousness (T-LOC). We estimated the use and cost of inappropriate investigations in patients admitted with T-LOC and assessed if these patients were given a definitive diagnosis for their presentation. We identified 80 consecutive patients admitted with T-LOC to a university teaching hospital. Eighty-eight percent (70/80) had a computerized topography (CT) brain scan and 49% (34/70) of these scans were inappropriate based on standard guidelines...
May 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28733121/paradoxical-embolism-in-a-girl-with-atrial-septal-defect-after-paroxysmal-supraventricular-tachycardia-ablation
#2
Xiang Chen, Zhijun Zhu, Danning Wu
Paradoxical embolism is a kind of important pathogenesis of cardiocerebrovascular diseases. In our case, radiofrequency current catheter ablation was accomplished successfully in a 15-year-old girl who had been experiencing supraventricular tachycardia for 6 months. She presented with abrupt onset of left hemiplegia and loss of consciousness on the first postoperative day. An urgent cerebral computed tomography showed a hyperdense right middle cerebral artery. Transthoracic echocardiogram examination revealed an atrial septal defect (ASD), with the diameter measuring 39 mm...
July 19, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28730259/clinical-manifestations-and-morphological-changes-in-one-case-with-post-stroke-kl%C3%A3-ver-bucy-syndrome
#3
Nicolae Cătălin Hreniuc, Carmen NeamŢu, Mircea Florin Sferdian, Cristina Georgiana Ghib Para, Cris Virgiliu Precup, Ioan Ioiart
We present the case of a 71-year-old right-handed male, admitted to the Department of Neurology, Emergency County Hospital of Arad, Romania, on November 2015, with a rare case of Klüver-Bucy syndrome (KBS), following an ischemic stroke of the right temporal lobe, which was previously diagnosed in December 2014 and was treated accordingly. At the moment of second hospital admission, the patient was found somnolent and confused at home, with traumatic signs of biting of the tongue and urine emission. A couple days after admission, our patient became alert and presented hypersexuality, hypermetamorphosis, increased oral tendency, behavior changes including apathy with loss of anger and fear, and a very increased appetite, transient visual agnosia and right-left disorientation...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28729935/single-trial-eeg-informed-fmri-analysis-of-emotional-decision-problems-in-hot-executive-function
#4
Qian Guo, Tiantong Zhou, Wenjie Li, Li Dong, Suhong Wang, Ling Zou
BACKGROUND: Executive function refers to conscious control in psychological process which relates to thinking and action. Emotional decision is a part of hot executive function and contains emotion and logic elements. As a kind of important social adaptation ability, more and more attention has been paid in recent years. OBJECTIVE: Gambling task can be well performed in the study of emotional decision. As fMRI researches focused on gambling task show not completely consistent brain activation regions, this study adopted EEG-fMRI fusion technology to reveal brain neural activity related with feedback stimuli...
July 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28726543/differences-in-brain-architecture-in-remote-mild-traumatic-brain-injury
#5
Aishwarya Rajesh, Gillian E Cooke, Jim M Monti, Andrew Jahn, Ana M Daugherty, Arthur Kramer
Mild TBI (mTBI) is brain trauma from an external impact with a loss of consciousness less than 30 minutes. MTBI results in several biopsychosocial impairments with pronounced cognitive deficits, thought to resolve within three months of injury. Previous research suggests that these impairments are due to a temporary inability to appropriately allocate neural resources in response to cognitive demands. Our study questioned this assumption and instead hypothesized that mTBI was associated with long-term neural disruptions and compromised brain structure integrity...
July 20, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28725184/sevoflurane-induces-coherent-slow-delta-oscillations-in-rats
#6
Jennifer A Guidera, Norman E Taylor, Justin T Lee, Ksenia Y Vlasov, JunZhu Pei, Emily P Stephen, J Patrick Mayo, Emery N Brown, Ken Solt
Although general anesthetics are routinely administered to surgical patients to induce loss of consciousness, the mechanisms underlying anesthetic-induced unconsciousness are not fully understood. In rats, we characterized changes in the extradural EEG and intracranial local field potentials (LFPs) within the prefrontal cortex (PFC), parietal cortex (PC), and central thalamus (CT) in response to progressively higher doses of the inhaled anesthetic sevoflurane. During induction with a low dose of sevoflurane, beta/low gamma (12-40 Hz) power increased in the frontal EEG and PFC, PC and CT LFPs, and PFC-CT and PFC-PFC LFP beta/low gamma coherence increased...
2017: Frontiers in Neural Circuits
https://www.readbyqxmd.com/read/28724277/suicide-by-fire-extinguisher-powder-ingestion-a-case-report
#7
Hamid Mohammadi Kojidi, Morteza Rahbar Taramsari, Alireza Badsar, Mirsaeed Attarchi
A 51-year-old man committed suicide by swallowing the contents of a fire extinguisher. A few hours after his suicide attempt, he was referred to the medical center for poisoning. At the time of admission, the patient was conscious with stable vital signs. The patient complained of burning lips and mouth, mentioning diarrhea. Initial treatments included gastric lavage with activated charcoal, while paraclinical measures were requested. The patient had undergone hypernatremia (Na: 152 mEq/l) and metabolic alkalosis...
May 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28721930/pharmacoresistant-epileptic-eyelid-twitching-in-a-child-with-a-mutation-in-syngap1
#8
Tetsuya Okazaki, Yoshiaki Saito, Rika Hiraiwa, Shinji Saitoh, Masachika Kai, Kaori Adachi, Yoko Nishimura, Eiji Nanba, Yoshihiro Maegaki
SYNGAP1 gene mutation has been associated with epilepsy which is often drug resistant, with seizure types including eyelid myoclonia. However, detailed descriptions, including ictal video-EEG, have not been reported. We report the case of a 4-year-old boy who developed recurrent epileptic eyelid twitching at 1 year and 5 months of age. Seizures gradually increased in frequency to more than 50 times per day and manifested with upward eye deviation, motion arrest, loss of consciousness, and eyelid twitching lasting for five seconds...
July 19, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28721322/etiology-and-age-distribution-of-syncope-in-a-predominantly-african-american-population
#9
Ahmad Awan, Hasan Iftikhar, Fasil Tiruneh, Shahabuddin Soherwardi, Daniel Larbi
BACKGROUND: Syncope, the sudden transient loss of consciousness due to multiple etiologies, usually has worse outcomes in African Americans compared with other races because of other comorbidities. This study aims to identify a correlation between the etiologies of syncope and age in a predominantly African-American sample population to facilitate future investigations with potentially improved specificity to address this condition. METHODS: We reviewed the medical records of 155 patients who presented with syncope concerns to the emergency department at our university hospital...
June 14, 2017: Curēus
https://www.readbyqxmd.com/read/28720183/g-loc-warning-algorithms-based-on-emg-features-of-the-gastrocnemius-muscle
#10
Sungho Kim, Taehwan Cho, Yongkyun Lee, Hyojin Koo, Booyong Choi, Dongsoo Kim
BACKGROUND: G-induced loss of consciousness (G-LOC) is mainly caused by failure to sustain an oxygenated blood supply to the pilot's brain because of the sudden acceleration in the direction of the +Gz axis, and is considered a critical safety issue. The purpose of this study was to develop G-LOC warning algorithms based on monitoring electromyograms (EMG) of the gastrocnemius muscle on the calf. METHODS: EMG data was retrieved from a total of 67 pilots and pilot trainees of the Korean Air Force during high-G training on a human centrifugal simulator...
August 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28719293/case-report-clinical-features-of-a-case-of-suspected-borrelia-miyamotoi-disease-in-hokkaido-japan
#11
Kimiaki Yamano, Takuya Ito, Kaori Kiyanagi, Hirotaka Yamazaki, Mutsubu Sugawara, Takashige Saito, Norio Ohashi, Aya Zamoto-Niikura, Kozue Sato, Hiroki Kawabata
We herein report a case of suspected Borrelia miyamotoi disease in Hokkaido, Japan. The patient complained of lassitude, arthralgia, and high fever after a tick bite. Furthermore, at the time of consultation, the patient exhibited momentary loss of consciousness and low blood pressure. Laboratory tests revealed elevation of liver enzymes, thrombocytopenia, and increased C-reactive protein. Seroconversion to B. miyamotoi glycerophosphoryl diester phosphodiesterase antigen suggested the patient was infected with a relapsing fever group Borrelia species...
July 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28717428/awareness-toward-stroke-in-a-population-based-sample-of-iranian-adults
#12
Mozaffar Hosseininezhad, Hannan Ebrahimi, Seyed Mohammad Seyedsaadat, Babak Bakhshayesh, Motahareh Asadi, Amir Reza Ghayeghran
Background: Stroke is the leading cause of death and functional disability. While there have been major advances regarding the management of stroke, a significant proportion of people are still unaware of stroke-related symptoms and risk factors. This study was performed to assess the awareness of stroke's warning signs and risk factors among a sample of Iranian population. Methods: A total of 649 participants were randomly selected using systematic randomization from the list of telephone numbers obtained from the telephone directory...
January 5, 2017: Iranian Journal of Neurology
https://www.readbyqxmd.com/read/28717095/encephalopathy-associated-with-influenza-b-in-a-healthy-young-man
#13
Masaki Shimamoto, Satoshi Okada, Takeshi Terashima
A 19-year-old man presented with a fever, convulsions, and loss of consciousness at our hospital. The patient had a Glasgow Coma Scale score of 12. Influenza B virus infection was diagnosed using the rapid test kit, and an eight-fold increase in the serum levels of anti-influenza B virus antibody was confirmed using the complement fixation test. Brain magnetic resonance imaging showed multifocal high-signal lesions, and an electroencephalogram showed diffuse slowing of the background activity, indicating acute encephalopathy...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28713626/recurrent-hemorrhage-in-hemangioblastoma-involving-the-posterior-fossa-case-report
#14
Eric Marvin, Asad S Akhter, Jeroen R Coppens
BACKGROUND: Hemangioblastomas (HGBs) are the most common primary intra-axial posterior fossa tumor in adults. Although spontaneous hemorrhage of these tumors is exceedingly rare, despite their vascular nature, we describe a case of recurrent hemorrhage with associated tonsillar herniation, and demonstrate that a surgical approach can provide a suitable outcome. CASE DESCRIPTION: A 54-year-old female with von Hippel-Lindau (VHL) syndrome presented with acute loss of consciousness and Glasgow Coma Scale (GCS) was 4...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28713592/clinicodemographic-profile-of-children-with-seizures-in-a-tertiary-care-hospital-a-cross-sectional-observational-study
#15
Nagendra Chaudhary, Murli Manohar Gupta, Sandeep Shrestha, Santosh Pathak, Om Prakash Kurmi, B D Bhatia, K N Agarwal
Seizures are one of the common causes for hospital admissions in children with significant mortality and morbidity. This study was conducted to study the prevalence and clinicodemographic profile of children with seizures in a tertiary care hospital of western Nepal. This prospective cross-sectional study conducted over a period of 2 years included all admitted children (2 months-16 years) with seizures. Among 4962 admitted children, seizures were present in 3.4% (n = 168) of children, with male preponderance...
2017: Neurology Research International
https://www.readbyqxmd.com/read/28702333/cough-syncope-induced-by-post-nasal-drip-successfully-managed-by-gabapentin
#16
Hussein Algahtani, Bader Shirah
Syncope is a common complaint in both neurology clinic and emergency department. It is defined as transient loss of consciousness with loss of postural tone, which is usually self-limited and followed by a spontaneous recovery. Our report describes a case of cough syncope resulting from chronic intractable cough caused by post nasal drip. Although his experience was debilitating, we were able to control his symptoms significantly using a small dose of Gabapentin. This dose is much lower when compared with the already established licensed indicated higher doses used for the treatment of neuropathic pain and epilepsy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28701321/pituitary-adenylate-cyclase-activating-polypeptide-pacap-drives-cardiorespiratory-responses-to-heat-stress-in-neonatal-mice
#17
Karlene T Barrett, John Andrew Daubenspeck, Richard J A Wilson
The neuropeptide, pituitary adenylate cyclase-activating polypeptide (PACAP), has emerged as a principal and rate-limiting regulator of physiological stress responses in adult rodents and has been implicated in SIDS (Sudden Infant Death Syndrome). Recent studies show that PACAP plays a role in neonatal cardiorespiratory responses to hypoxia, hypercapnia and hypothermia, but not hyperthermia, which is often associated with SIDS. Here we tested the hypothesis that, consistent with a role in SIDS, PACAP is involved in regulating the neonatal cardiorespiratory responses to severe heat...
July 12, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28699848/impact-of-helmet-use-on-traumatic-brain-injury-from-road-traffic-accidents-in-cambodia
#18
Saksham Gupta, Katherine Klaric, Nang Sam, Vuthy Din, Tina Juschkewitz, Vycheth Iv, Mark G Shrime, Kee B Park
OBJECTIVE: Rapid urbanization and motorization without corresponding increases in helmet usage have made traumatic brain injury due to road traffic accidents a major public health crisis in Cambodia. This analysis was conducted to quantify the impact of helmets on severity of injury, neurosurgical indication, and functional outcomes at discharge for motorcycle operators who required hospitalization for a traumatic brain injury following a road traffic accident in Cambodia. METHODS: The medical records of 491 motorcycle operators who presented to a major tertiary care center in Cambodia with traumatic brain injury were retrospectively analyzed using multivariate logistic regression...
July 12, 2017: Traffic Injury Prevention
https://www.readbyqxmd.com/read/28698086/stroke-burden-in-rwanda-a-multicenter-study-on-stroke-management-and-outcome
#19
Agabe Emmy Nkusi, Severien Muneza, Steven Nshuti, David Hakizimana, Paulin Munyemana, Menelas Nkeshimana, Emmanuel Rudakemwa, Etienne Amendezo
BACKGROUND: Cerebro-vascular accidents (CVA) or Stroke constitute the second leading cause of mortality worldwide. Low and middle income countries bear most of stroke burden worldwide. The main objective of this study is to determine the burden of stroke in Rwanda. METHODS: This was a prospective observational study done in 2 parts; 6 months baseline data collection and outcome assessment sessions at 1 year. RESULTS: 96 patients were enrolled in our series...
July 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28690942/cardiac-arrhythmias-resulting-from-a-peripherally-inserted-central-catheter-two-cases-and-a-review-of-the-literature
#20
Jonathan Gapp, Mridula Krishnan, Felicia Ratnaraj, Robert P Schroell, Douglas Moore
We present two cases of patients being treated for diabetic ketoacidosis in the intensive care unit who experienced cardiac arrhythmia secondary to peripherally inserted central catheters (PICCs). In one instance, the patient became bradycardic and experienced related loss of consciousness, ultimately requiring cardiopulmonary resuscitation. In the second case, the patient experienced an episode of nonsustained ventricular tachycardia. We explore the various types of arrhythmias that have been reported secondary to central venous catheters, as well as factors that place patients at an increased risk for arrhythmia while undergoing PICC insertion...
June 3, 2017: Curēus
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