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Disconnection syndromes

Michelle C Nguyen, Latifah Sage Silski, Musab Alebrahim, Sylvester Black, Elmahdi Elkhammas, Ken Washburn, Ashraf El-Hinnawi
OBJECTIVES: Large spontaneous splenorenal shunts can result in portal vein steal syndrome and is a risk factor for portal vein thrombosis after orthotopic liver transplant. Disconnection of these shunts by left renal vein ligation has been suggested as a potential technique for improving portal venous flow and mitigating risk of portal vein thrombus, thus improving graft perfusion. We present a series of 6 patients who underwent left renal vein ligation for spontaneous splenorenal shunts and their outcomes...
November 28, 2018: Experimental and Clinical Transplantation
T L Poon, C Ht Lui, I Chan, D Yw Siu
Epilepsy is defined as drug-resistant after failure of two adequate trials of appropriately chosen and administered antiepileptic drugs. Approximately 30% of patients with epilepsy have drug-resistant epilepsy. Reasons for treatment failure include failure to recognise epilepsy syndrome, poor drug compliance, and lifestyle factors. Patients with drug-resistant epilepsy should be encouraged to have early referral to a tertiary epilepsy centre for presurgical evaluation. Comprehensive neurophysiology, structural neuroimaging, neuropsychological, and psychiatric assessments are regarded as essential for determining suitability for epilepsy surgery...
November 27, 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Kaylan M Brady, Jonathan A Blau, Spencer J Serras, Jeremy T Neuman, Richard Sidlow
Multilevel cervical disconnection syndrome (MCDS) is a rare malformation of the cervical spine previously documented in two toddlers. We present a case of a newborn first thought to have hypoxic-ischemic encephalopathy who was subsequently diagnosed with MCDS. The possibility of in utero presentation of the syndrome in this patient and the categorization of this syndrome in the spectrum of basilar skull/upper cervical malformation syndromes is discussed.
2018: Case Reports in Neurological Medicine
Joseph R Hoyt, Kate E Langwig, J Paul White, Heather M Kaarakka, Jennifer A Redell, Allen Kurta, John E DePue, William H Scullon, Katy L Parise, Jeffrey T Foster, Winifred F Frick, A Marm Kilpatrick
Understanding host interactions that lead to pathogen transmission is fundamental to the prediction and control of epidemics1-5 . Although the majority of transmissions often occurs within social groups6-9 , the contribution of connections that bridge groups and species to pathogen dynamics is poorly understood10-12 . These cryptic connections-which are often indirect or infrequent-provide transmission routes between otherwise disconnected individuals and may have a key role in large-scale outbreaks that span multiple populations or species...
November 19, 2018: Nature
Paula Salgado, Ricardo Taipa, Joana Domingos, Daniel Dias, Manuel Melo Pires, Marina Magalhães
Background: Chorea may occur as a manifestation of an acute stroke. Patients with vascular-related chorea typically present with an acute or subacute onset of hemichorea, contralateral to the lesion. Methods and Findings: In this clinico-pathological case, we report a 90-year-old female who presented, at age 81, with a transient episode of generalized chorea. Over the years, the patient continued to have intermittent episodes of generalized chorea or hemichorea, followed by a progressive dementia syndrome with gait and sphincter disturbance...
November 2017: Movement Disorders Clinical Practice
Łukasz Przepiórka, Przemysław Kunert, Paulina Juszyńska, Michał Zawadzki, Bogdan Ciszek, Mariusz Głowacki, Andrzej Marchel
Spinal dural arteriovenous fistula (SDAVF) is the most common vascular malformation of the spine in adults. However, the coincidence of tethered cord syndrome, lipoma, and SDAVF on the sacral level is exceptionally rare. We describe two patients, probably the fifth and sixth ever reported. The first was a 33 year-old female who underwent surgical cord de-tethering. Surprisingly, a sacral SDAVF was discovered intraoperatively, despite negative digital subtraction angiography (DSA). The second patient was a 30 year-old male with similar pathologies...
2018: Frontiers in Neurology
Qing Ye, Feng Bai
Vascular cognitive impairment (VCI) describes all forms of cognitive impairment caused by any type of cerebrovascular disease. Early identification of VCI is quite difficult due to the lack of both sensitive and specific biomarkers. Extensive damage to the white matter tracts, which connect the cortical and subcortical regions, has been shown in subcortical VCI (SVCI), the most common subtype of VCI that is caused by small vessel disease. Two specific MRI sequences, including diffusion tensor imaging (DTI) and functional MRI (fMRI), have emerged as useful tools for identifying subtle white matter changes and the intrinsic connectivity between distinct cortical regions...
September 2018: Stroke and Vascular Neurology
Michele Veldsman, Amy Brodtmann
Modern clinical neuroscience was built on observations of how localized damage caused specific functional, cognitive and behavioral deficits. Stroke neurology was a cornerstone of understanding this functional specialization in the brain. But most lesion-symptom mapping provides little prognostic value above clinical observations. Stroke topography remains a poor indicator of long-term outcome, and with stroke a major risk factor for dementia, there is strong incentive to find markers of predictive value. There is now growing recognition that the damage caused by stroke does not occur in isolation but is embedded within a complex, highly interconnected, organized and dynamic system: the connectome...
October 5, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Raquel Jimenez Fernandez, Inmaculada Corral Liria, Rocio Rodriguez Vázquez, Susana Cabrera Fernandez, Marta Elena Losa Iglesias, Ricardo Becerro de Bengoa Vallejo
In 1994, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) included "culture-bound syndromes" in its classification of psychiatric disorders and associated them with disease processes that manifest in behavioural or thought disorders that develop within a given cultural context. This study examines the definitions, explanatory models, signs and symptoms, and healthcare-seeking behaviours common to Fang culture-bound syndromes (i.e., kong, eluma, witchcraft, mibili, mikug, and nsamadalu)...
2018: PloS One
Juan M Aguilar, Fernando Rodríguez-Serrano, Andrea Ferreiro-Marzal, María Esteban-Molina, Antonio Gabucio, Enrique García, Lorenzo Boni, José M Garrido
Left superior vena cava draining into the left atrium in the absence of coronary sinus is an anomaly that can appear in heterotaxy syndrome and unroofed coronary sinus syndrome. Regardless of the origin of these syndromes, biventricular repair can be done through rerouting by intracardiac procedures or through disconnection-reconnection of the left superior vena cava to the right atrium or right superior vena cava by extracardiac procedures. Different techniques can be used for this purpose, each of which has its own advantages and limitations...
September 1, 2018: Archives of Cardiovascular Diseases
Hidenobu Shozawa, Akinori Futamura, Yu Saito, Motoyasu Honma, Mitsuru Kawamura, Michael W Miller, Kenjiro Ono
Diagonistic apraxia is a corpus callosal disconnection syndrome. Callosal lesions in Neuromyelitis optica spectrum disorder (NMOSD) have been reported, but callosal disconnection syndrome are rare. A 48-year-old woman was treated for fever and a cough before hospitalization. Her fever abated immediately, but she had balance problems in walking and standing. She also had slurred speech. On neurological examination, she had diagonistic apraxia. Her left hand moved in an uncoordinated way when she moved her right hand: changing her clothes for example or using a knife and fork...
2018: Frontiers in Neurology
David L Penn, Kyle C Wu, Kayla R Presswood, Coleman P Riordan, R Michael Scott, Edward R Smith
Children with arteriovenous malformations (AVMs) are at cumulative, life-long risk of debilitating and fatal intracranial hemorrhage, especially with syndromes such as hereditary hemorrhagic telangiectasia. Cerebral angiography is the gold standard for diagnosis and allows simultaneous adjunctive embolization limiting radiation and contrast exposure and intraoperative blood loss, important in pediatric patients with low blood volume. Microsurgical resection of low-grade AVMs offers cure with minimal morbidity...
August 7, 2018: Operative Neurosurgery (Hagerstown, Md.)
Lauren Nicholas, Rebecca Fischbein, Lynn Falletta, Kristin Baughman
Objective: The aim of this study was to assess patient experiences when reporting symptoms of twin-twin transfusion syndrome (TTTS) to their health-care providers. Methodology: The study utilized an online, retrospective survey of women, over the age of 18, who were living in the United States at the time of their pregnancy and had completed a TTTS pregnancy. Results: Three hundred sixty-seven cases were included for analysis. Nearly half of the respondents (45...
June 2018: Journal of Patient Experience
V Zimmer
No abstract text is available yet for this article.
October 2018: Journal of Gastroenterology and Hepatology
Eamonn M M Quigley, John Horn, Michele Kissous-Hunt, Robert A Crozier, Lucinda A Harris
INTRODUCTION: The BURDEN IBS-C study was conducted to better understand the experiences, attitudes, and unmet needs of sufferers of irritable bowel syndrome with constipation (IBS-C) in comparison to the perceptions and challenges of healthcare providers (HCPs) who treat IBS-C patients. METHODS: This was an author-developed, online questionnaire using KnowledgePanel® to survey individuals with IBS-C (N = 1311). HCPs participated in a complementary online questionnaire and were recruited separately (N = 331)...
July 2018: Advances in Therapy
Xinxin Ma, Wen Su, Haibo Chen
RATIONALE: Reversible splenial lesion syndrome (RESLES) is a reversible condition with an excellent prognosis in most patients. The clinical features include altered states of consciousness, delirium, headache, and seizures, but no callosal disconnection syndromes have been described in RESLES. PATIENT CONCERNS: We presented a 57-year-old patient with alien hand syndrome, autotopagnosia, gait disorders, and left ideomotor apraxia after blood transfusion. The brain magnetic resonance imaging (MRI) showed a few regions with high signal intensity in the genu, body, and splenium of the right corpus callosum on diffusion weighted images...
June 2018: Medicine (Baltimore)
Christopher J DiMaio
PURPOSE OF REVIEW: Acute pancreatitis can result in a number of localized complications such as pancreatic pseudocysts, walled-off pancreatic necrosis (WON), and disconnected pancreatic duct syndrome (DPDS). The management of these conditions has evolved over the past three decades such that minimally invasive endoscopic drainage and debridement methods are now the favored, first-line approach. This article will review the latest developments and controversies regarding the endoscopic management of these conditions...
September 2018: Current Opinion in Gastroenterology
Shu-Ling Wang, Sheng-Bing Zhao, Tian Xia, Zhao-Shen Li, Yu Bai
No abstract text is available yet for this article.
July 2018: Endoscopy
Marialuisa Cavelti, Stephanie Winkelbeiner, Andrea Federspiel, Sebastian Walther, Katharina Stegmayer, Stéphanie Giezendanner, Karin Laimböck, Thomas Dierks, Werner Strik, Helge Horn, Philipp Homan
This study examined the hypothesis that a fronto-temporal disconnection in the language network underpins formal thought disorder (FTD) in schizophrenia. Forty-nine patients with a schizophrenia spectrum disorder (27 with mild FTD, 22 with severe FTD) and 26 healthy controls (HC) were included. Overall psychopathology and FTD were assessed by the Positive and Negative Syndrome Scale and the Thought, Language, and Communication scale, respectively. White matter (WM) microstructure was analysed using Tract-Based Spatial Statistics...
September 30, 2018: Psychiatry research. Neuroimaging
Anthony F DiMarco
Diaphragm pacing (DP) is a useful and cost-effective alternative to mechanical ventilation in patients with ventilator-dependent spinal cord injury and central hypoventilation syndrome. Patients with SCI should be carefully screened to assess the integrity of their phrenic nerves. In eligible patients, DP improves mobility, speech, olfaction, and quality of life. The stigma of being attached to a mechanical device and risk of ventilator disconnection are eliminated. There is also some evidence that DP results in a reduction in the rate of respiratory tract infections...
June 2018: Clinics in Chest Medicine
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