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https://www.readbyqxmd.com/read/29204018/role-of-biomarkers-in-differentiating-new-onset-seizures-from-psychogenic-nonepileptic-seizures
#1
Mahendra Javali, Purushottam Acharya, Shripal Shah, Rohan Mahale, Pushparaja Shetty, Srinivasa Rangasetty
Introduction: Review of literature revealed very limited studies considering a combination of serum prolactin (PRL) and serum creatine kinase (CK) as markers for differentiating epileptic and psychogenic nonepileptic seizures (PNES). Therefore, in the present study, we analyzed the role of serum PRL and serum CK, individually and in combination. Methodology: This prospective study was conducted in a tertiary care medical teaching hospital over a period of 18 months...
October 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29177494/domain-general-subregions-of-the-medial-prefrontal-cortex-contribute-to-recovery-of-language-after-stroke
#2
Fatemeh Geranmayeh, Tsz Wing Chau, Richard J S Wise, Robert Leech, Adam Hampshire
We hypothesized that the recovery of speech production after left hemisphere stroke not only depends on the integrity of language-specialized brain systems, but also on 'domain-general' brain systems that have much broader functional roles. The presupplementary motor area/dorsal anterior cingulate forms part of the cingular-opercular network, which has a broad role in cognition and learning. Consequently, we have previously suggested that variability in the recovery of speech production after aphasic stroke may relate in part to differences in patients' abilities to engage this domain-general brain region...
July 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29157018/progressive-dna-and-rna-damage-from-oxidation-after-aneurysmal-subarachnoid-hemorrhage-in-humans
#3
A Jorgensen, J M Staalsoe, A H Simonsen, S G Hasselbalch, P Høgh, A Weimann, Poulsen He, N V Olsen
Free radical toxicity is considered a key mechanism in the neuronal damage occurring after aneurysmal subarachnoid hemorrhage (SAH). We measured markers of DNA and RNA damage from oxidation in cerebrospinal fluid from 45 patients with SAH on day 1-14 after ictus and 45 age-matched healthy control subjects. At baseline, both markers were significantly increased in patients compared to controls (p-values < 0.001), and exhibited a progressive further increase (to > 20-fold above control levels) from day 5-14...
November 20, 2017: Free Radical Research
https://www.readbyqxmd.com/read/29119370/vasoconstriction-and-impairment-of-neurovascular-coupling-after-subarachnoid-hemorrhage-a-descriptive-analysis-of-retinal-changes
#4
Catharina Conzen, Walid Albanna, Miriam Weiss, David Kürten, Walthard Vilser, Konstantin Kotliar, Charlotte Zäske, Hans Clusmann, Gerrit Alexander Schubert
Impaired cerebral autoregulation and neurovascular coupling (NVC) contribute to delayed cerebral ischemia after subarachnoid hemorrhage (SAH). Retinal vessel analysis (RVA) allows non-invasive assessment of vessel dimension and NVC hereby demonstrating a predictive value in the context of various neurovascular diseases. Using RVA as a translational approach, we aimed to assess the retinal vessels in patients with SAH. RVA was performed prospectively in 24 patients with acute SAH (group A: day 5-14), in 11 patients 3 months after ictus (group B: day 90 ± 35), and in 35 age-matched healthy controls (group C)...
November 8, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/29107638/herniation-despite-decompressive-hemicraniectomy-in-large-hemispherical-ischemic-strokes
#5
Archana Hinduja, Rohan Samant, Dongxia Feng, Yousef Hannawi
BACKGROUND: Despite decompressive hemicraniectomy (DHC), progressive herniation resulting in death has been reported following middle cerebral artery (MCA) strokes. We aimed to determine the surgical parameters measured on brain computed tomography (CT) scan that are associated with progressive herniation despite DHC in large MCA strokes. METHODS: Retrospective chart review of medical records of patients with malignant hemispheric infarction who underwent DHC for cerebral edema was performed...
October 26, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29101862/elevated-glycated-hemoglobin-level-and-hyperglycemia-after-aneurysmal-subarachnoid-hemorrhage
#6
Kerim Beseoglu, Hans-Jakob Steiger
OBJECTIVES: Elevated blood glucose is frequently detected early after aneurysmal subarachnoid hemorrhage (aSAH) and is considered a risk factor for poor neurological outcome. However it remains unclear whether hyperglycemia is caused by the SAH ictus or reflects a pre-existing hyperglycemic metabolism. In a prospective register we analysed glycated haemoglobin levels (HbA1c) in patients with aSAH and its influence on outcome. PATIENTS AND METHODS: Between July 2012 and July 2014, 87 patients with confirmed aSAH were included (NCT02081820)...
December 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29096165/mri-supersedes-ictal-eeg-when-other-presurgical-data-are-concordant
#7
Yun Jung Hur, Andrew J Kim, Douglas R Nordli
PURPOSE: When ictal EEG is discordant with MRI and other presurgical data, our group has sometimes discounted the ictal findings and proceeded with epilepsy surgical resection based on MRI. We aimed to evaluate the prudence of such practice by comparing the outcome of MRI-lesional epilepsy surgery patients with discordant ictal EEG with those with concordant ictal EEG. METHOD: We retrospectively studied 115 children with epilepsy who underwent surgical resection of an MRI lesion that was corroborated as the epileptogenic focus by other presurgical findings...
October 14, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29061461/a-propensity-score-analysis-of-the-impact-of-dexamethasone-use-on-delayed-cerebral-ischemia-and-poor-functional-outcomes-following-subarachnoid-hemorrhage
#8
Nathaniel Mohney, Craig A Williamson, Edward Rothman, Ron Ball, Kyle M Sheehan, Aditya S Pandey, Jeffrey J Fletcher, Teresa L Jacobs, B Gregory Thompson, Venkatakrishna Rajajee
OBJECT: An inflammatory response occurs following aneurysmal Subarachnoid Hemorrhage (aSAH), and predicts poor outcomes. Glucocorticoids suppress inflammation and promote fluid retention. Dexamethasone is often administered following aSAH for post-operative cerebral edema and refractory headache. Our objective was to examine the impact of Dexamethasone use on functional outcomes and DCI following aSAH. METHODS: Patients with aSAH admitted between 2010-2015 were included, the data-source was a single-center SAH registry...
October 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29054774/prognostic-significance-of-ultraearly-hematoma-growth-in-spontaneous-intracerebral-hemorrhage-patients-receiving-hematoma-evacuation
#9
Zhiyuan Yu, Jun Zheng, Rui Guo, Lu Ma, Mou Li, Xiaoze Wang, Sen Lin, Chao You, Hao Li
OBJECTIVE: To investigate the association between ultraearly hematoma growth (uHG) and clinical outcome in patients with spontaneous intracerebral hemorrhage (sICH) receiving hematoma evacuation. METHODS: Supratentorial sICH patients receiving hematoma evacuation within 24 hours after ictus were enrolled in this study. uHG was defined as baseline hematoma volume/onset-to-computed tomography (CT) time (ml/h). The outcome was assessed using modified Rankin Scale (mRS) score at 3 months...
October 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29027862/effect-of-body-mass-index-on-outcome-after-aneurysmal-subarachnoid-hemorrhage-treated-with-clipping-versus-coiling
#10
Lorenzo Rinaldo, Joshua D Hughes, Alejandro A Rabinstein, Giuseppe Lanzino
OBJECTIVE It has been suggested that increased body mass index (BMI) may confer a protective effect on patients who suffer from aneurysmal subarachnoid hemorrhage (aSAH). Whether the modality of aneurysm occlusion influences the effect of BMI on patient outcomes is not well understood. The authors aimed to compare the effect of BMI on outcomes for patients with aSAH treated with surgical clipping versus endovascular coiling. METHODS The authors retrospectively reviewed the outcomes for patients admitted to their institution for the management of aSAH treated with either clipping or coiling...
October 13, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28992906/renal-amyloidosis-associated-with-kartagener-syndrome-in-a-dog
#11
Bartolo Celona, Chiara Crinò, Carmelo Bruno, Simona Di Pietro, Elisabetta Giudice
A 4-year-old cocker spaniel, male, of 12kg body weight was presented because of the onset of polyuria or polydipsia. From the first months of its life, the dog had exhibited constant serous to mucopurulent nasal discharge, productive cough, sneezing, reverse sneezing, otitis, and recurrent episodes of fever. The respiratory signs had been treated several times with antibiotics, without ever achieving a complete resolution. Clinical examination revealed normal rectal temperature (38.3°C), increased respiratory rate (40breaths/min), a copious mucous nasal discharge and right deviation of the heart apex beat (ictus cordis)...
June 2017: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/28973675/the-subarachnoid-hemorrhage-early-brain-edema-score-predicts-delayed-cerebral-ischemia-and-clinical-outcomes
#12
Sung-Ho Ahn, Jude P Savarraj, Mubashir Pervez, Wesley Jones, Jin Park, Sang-Beom Jeon, Sun U Kwon, Tiffany R Chang, Kiwon Lee, Dong H Kim, Arthur L Day, H Alex Choi
BACKGROUND: Early brain injury (EBI) after subarachnoid hemorrhage (SAH) is an important determinant of clinical outcomes. However, a major hindrance to studies of EBI is the lack of radiographic surrogate marker. OBJECTIVE: To propose a scoring system based on early changes in clinically obtained computed tomography (CT), called the Subarachnoid hemorrhage Early Brain Edema Score (SEBES). METHODS: Patients with spontaneous aneurysmal SAH and a CT within 24 h of ictus were included...
July 7, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28964943/ct-angiography-spot-sign-as-an-indicator-for-ultra-early-stereotactic-aspiration-of-intracerebral-hemorrhage
#13
Yuqian Li, Jiancai Wang, Zhihong Li, Xingye Zhang, Bo Tian, Yanlong Yang, Min Li, Bao Wang, Yi Xia, Tao Ma, Yang Yang, Guodong Gao, Lihong Li
BACKGROUND: Ultra-early surgical clot removal relieves mechanical compression on adjacent normal brain tissue and limits the toxic effects of a hematoma, which might improve the outcomes in patients with intracerebral hemorrhage (ICH); however, hematoma expansion frequently occurs within 20 h after the ictus, and this limits the use of ultra-early surgery. CT-angiography (CTA) spot sign was recently validated as an important predictor of hematoma expansion in ICH patients. METHODS: 59 ICH patients with negative spot sign who received ultra-early stereotactic aspiration (< 6 h after ictus; n = 32 [Ultra-early group]) or routine stereotactic aspiration (≥ 6 h after ictus; n = 27 [Routine group]) were included in retrospective analysis...
September 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28946021/significance-of-satellite-sign-and-spot-sign-in-predicting-hematoma-expansion-in-spontaneous-intracerebral-hemorrhage
#14
Zhiyuan Yu, Jun Zheng, Hasan Ali, Rui Guo, Mou Li, Xiaoze Wang, Lu Ma, Hao Li, Chao You
OBJECTIVES: Hematoma expansion is related to poor outcome in spontaneous intracerebral hemorrhage (ICH). Recently, a non-enhanced computed tomography (CT) based finding, termed the 'satellite sign', was reported to be a novel predictor for poor outcome in spontaneous ICH. However, it is still unclear whether the presence of the satellite sign is related to hematoma expansion. MATERIAL AND METHODS: Initial computed tomography angiography (CTA) was conducted within 6h after ictus...
November 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28867322/recurrent-bleeding-after-perimesencephalic-hemorrhage
#15
Frans Kauw, Birgitta K Velthuis, Ufuk Kizilates, Irene C van der Schaaf, Gabriel J E Rinkel, Mervyn D I Vergouwen
BACKGROUND: Perimesencephalic hemorrhage (PMH) is a type of subarachnoid hemorrhage with excellent long-term outcomes. Only 1 well-documented case of in-hospital rebleeding after PMH is described in the literature, which occurred after initiating antithrombotic treatment because of myocardial ischemia. We describe a patient with PMH without antithrombotic treatment who had 2 episodes of recurrent bleeding on the day of ictus. To validate the radiologic findings, we conducted a case-control study...
September 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28843756/recurrent-perimesencephalic-nonaneurysmal-subarachnoid-hemorrhage-case-report-and-review-of-the-literature
#16
REVIEW
Yuan Hong, Yuanjian Fang, Ting Chen, Jianmin Zhang
BACKGROUND: Perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSAH) is a benign form of subarachnoid hemorrhage (SAH) with a favorable prognosis. The risk of recurrent hemorrhage of this benign entity is extremely low. CASE DESCRIPTION: We describe a rare case of recurrent, spontaneous PNSAH in a 56-year-old man. This hypertensive patient suffered a recurrent episode of PNSAH 1 month after its first ictus, suggesting rebleeding can still occur in the setting of PNSAH; however, the risk is much less than that in aneurysmal SAH...
November 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28814933/inflammatory-biomarkers-and-their-value-in-predicting-survival-and-outcome-among-patients-with-spontaneous-intracerebral-haemorrhage
#17
Senthil Kumar Rajapathy, Zamzuri Idris, Regunath Kandasamy, Albert Wong Sii Hieng, Jafri Malin Abdullah
BACKGROUND: Spontaneous intracerebral haemorrhage (SICH) has emerged as one of the most devastating forms of stroke in recent decades. This disease is noted to carry a 30-day mortality rate of approximately 45%. An increasing number of studies have implicated a complex immune-mediated and inflammation-mediated cascade of responses in the pathophysiology of SICH and the resultant neurologic outcome. Several clinical studies have demonstrated an association between inflammatory markers and outcome in patients with SICH...
May 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/28812108/ultra-early-detection-of-microcirculatory-injury-as-predictor-of-developing-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#18
Philipp Gölitz, Philip Hoelter, Julie Rösch, Karl Roessler, Frauke Knossalla, Arnd Doerfler
PURPOSE: Delayed cerebral ischemia (DCI) still remains a major complication after subarachnoid hemorrhage (SAH). The aim of our study was to evaluate whether flow analysis of admission digital subtraction angiography (DSA) using parametric color coding (PCC), a postprocessing algorithm, allows ultra-early identification of SAH patients at risk for developing subsequent symptomatic vasospasm. METHODS: In this study 52 patients who suffered SAH from aneurysm rupture, were retrospectively enrolled...
August 15, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28755916/emerging-markers-of-early-brain-injury-and-delayed-cerebral-ischemia-in-aneurysmal-subarachnoid-hemorrhage
#19
REVIEW
Fawaz Al-Mufti, Krishna Amuluru, Brendan Smith, Nitesh Damodara, Mohammad El-Ghanem, Inder P Singh, Neha Dangayach, Chirag D Gandhi
BACKGROUND: Delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage is characterized by a highly complex pathophysiology and results in neurologic deterioration after the inciting bleed. Despite its significant consequences, prompt diagnosis can be elusive and treatment is often administered too late. Early brain injury, which occurs within the first 72 hours after ictus, may be an important factor for delayed cerebral ischemia and poor overall outcome. Here, we explore the purported clinical and pathologic manifestations of early brain injury to identify biomarkers that could have prognostic value...
November 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28754235/mechanical-thrombectomy-for-acute-ischemic-stroke-patients-aged-80-years-or-older
#20
Taichiro Imahori, Kazuhiro Tanaka, Atsushi Arai, Ryoji Shiomi, Daigo Fujiwara, Tatsuya Mori, Akiyoshi Yokote, Kazushi Matsushima, Daisaku Matsui, Makoto Kobayashi, Atsushi Fujita, Kohkichi Hosoda, Eiji Kohmura
BACKGROUND: There are limited data about the prognostic factors predicting outcomes after mechanical thrombectomy with stent retrievers for the elderly. Here, we evaluated outcomes in elderly patients in a real-world setting. METHODS: Between April 2015 and January 2017, 80 patients with anterior intracranial acute large vessel occlusion, who had lived independently before ictus, were treated with mechanical thrombectomy using a stent retriever at our institute...
July 25, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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