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https://www.readbyqxmd.com/read/28387823/synopsis-of-guidelines-for-the-clinical-management-of-cerebral-cavernous-malformations-consensus-recommendations-based-on-systematic-literature-review-by-the-angioma-alliance-scientific-advisory-board-clinical-experts-panel
#1
Amy Akers, Rustam Al-Shahi Salman, Issam A Awad, Kristen Dahlem, Kelly Flemming, Blaine Hart, Helen Kim, Ignacio Jusue-Torres, Douglas Kondziolka, Cornelia Lee, Leslie Morrison, Daniele Rigamonti, Tania Rebeiz, Elisabeth Tournier-Lasserve, Darrel Waggoner, Kevin Whitehead
BACKGROUND: Despite many publications about cerebral cavernous malformations (CCMs), controversy remains regarding diagnostic and management strategies. OBJECTIVE: To develop guidelines for CCM management. METHODS: The Angioma Alliance ( www.angioma.org ), the patient support group in the United States advocating on behalf of patients and research in CCM, convened a multidisciplinary writing group comprising expert CCM clinicians to help summarize the existing literature related to the clinical care of CCM, focusing on 5 topics: (1) epidemiology and natural history, (2) genetic testing and counseling, (3) diagnostic criteria and radiology standards, (4) neurosurgical considerations, and (5) neurological considerations...
April 7, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28382611/parkinsonism-or-other-movement-disorders-presenting-as-stroke-mimics
#2
Cheng-Yang Hsieh, Chih-Hung Chen, Sheng-Feng Sung, Wen-Juh Hwang
PURPOSE: Patients with parkinsonism or other movement disorders may visit the emergency department due to acute deterioration of neurological status or consciousness disturbance. Under such circumstances, patients may be misdiagnosed as having a hyperacute stroke, i.e. stroke mimic. The purpose of the present study was to explore the clinical features and consequences of patients with parkinsonism or other movement disorders presenting as stroke mimics with activation of a stroke code...
December 15, 2016: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/28338452/differentiation-of-idiopathic-spinal-cord-herniation-from-dorsal-arachnoid-webs-on-mri-and-ct-myelography
#3
Randall Schultz, Andrew Steven, Aaron Wessell, Nancy Fischbein, Charles A Sansur, Dheeraj Gandhi, David Ibrahimi, Prashant Raghavan
OBJECTIVE Dorsal arachnoid webs (DAWs) and spinal cord herniation (SCH) are uncommon abnormalities affecting the thoracic spinal cord that can result in syringomyelia and significant neurological morbidity if left untreated. Differentiating these 2 entities on the basis of clinical presentation and radiological findings remains challenging but is of vital importance in planning a surgical approach. The authors examined the differences between DAWs and idiopathic SCH on MRI and CT myelography to improve diagnostic confidence prior to surgery...
March 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28328563/patients-without-intraoperative-neuromonitoring-ionm-alerts-during-veptr-implantation-did-not-sustain-neurological-injury-during-subsequent-routine-expansions-a-retrospective-multicenter-cohort-study
#4
Jaren LaGreca, Tara Flynn, Patrick J Cahill, Amer Samdani, Michael G Vitale, Ron El-Hawary, John T Smith, Jonathan H Phillips, John M Flynn, Michael Glotzbecker, Sumeet Garg
BACKGROUND: The purpose of this study was to determine the rate of intraoperative neurological monitoring (IONM) alerts and neurological injury during vertical expandable prosthetic titanium rib (VEPTR) treatment and evaluate the utility of IONM during VEPTR expansion procedures in patients who have not previously had neurological injury or IONM alerts. METHODS: After institutional review board approval, VEPTR procedures and IONM records were reviewed at 17 institutions for patients treated with VEPTR from 2005 to 2011...
March 21, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28322240/international-spinal-cord-injury-endocrine-and-metabolic-extended-data-set
#5
W A Bauman, J M Wecht, F Biering-Sørensen
OBJECTIVE: The objective of this study was to develop the International Spinal Cord Injury (SCI) Endocrine and Metabolic Extended Data Set (ISCIEMEDS) within the framework of the International SCI Data Sets that would facilitate consistent collection and reporting of endocrine and metabolic findings in the SCI population. SETTING: This study was conducted in an international setting. METHODS: The ISCIEMEDS was developed by a working group...
March 21, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28214074/subspecialty-training-and-certification-in-geriatric-psychiatry-a-25-year-overview
#6
Dorthea Juul, Christopher C Colenda, Jeffrey M Lyness, Laura B Dunn, Rita Hargrave, Larry R Faulkner
The Institute of Medicine estimated that by 2030, from 10.1 to 14.4 million Americans aged 65 years or older will have mental health or substance use disorders. This article reviews the history and current status of training, certification, and practice in geriatric psychiatry against the backdrop of this "silver tsunami." The American Board of Psychiatry and Neurology (ABPN) administered the first subspecialty examination in geriatric psychiatry in 1991, and through 2015 3,329 certificates were awarded. The Accreditation Council for Graduate Medical Education approved the training requirements in 1993...
January 9, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28207655/internally-randomized-control-trial-of-radiation-exposure-using-ultra-low-radiation-imaging-versus-traditional-c-arm-fluoroscopy-for-patients-undergoing-single-level-minimally-invasive-transforaminal-lumbar-interbody-fusion
#7
Timothy Y Wang, S Harrison Farber, Scott S Perkins, Adam G Back, Sarah A Byrd, Debbie Chi, David Vincent, Isaac O Karikari
STUDY DESIGN: Randomized controlled trial. OBJECTIVE: To compare radiation exposure between ultra-low radiation imaging (ULRI) with image enhancement and standard-dose fluoroscopy for patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). SUMMARY OF BACKGROUND DATA: Although the benefits of MIS are lauded by many, there is a significant amount of radiation exposure to surgeon and operating room personnel...
February 15, 2017: Spine
https://www.readbyqxmd.com/read/28161924/practice-patterns-after-acute-embolic-retinal-artery-occlusion
#8
COMPARATIVE STUDY
Anne S Abel, Sandip Suresh, Haitham M Hussein, Adam F Carpenter, Sandra R Montezuma, Michael S Lee
PURPOSE: To compare stroke evaluations recommended by retina special-ists and neurologists for retinal artery occlusion (RAO). DESIGN: A cross-sectional survey. METHODS: An anonymous survey was emailed to members of the American Academy of Neurology Stroke Section listserv and vitreoretinal specialists registered with the American Academy of Ophthalmology. The survey was divided based on duration of symptoms before encounter: less than 12 hours, 24-48 hours, and more than 1 week...
January 2017: Asia-Pacific Journal of Ophthalmology
https://www.readbyqxmd.com/read/28061779/a-motion-classification-strategy-based-on-semg-eeg-signal-combination-for-upper-limb-amputees
#9
Xiangxin Li, Oluwarotimi Williams Samuel, Xu Zhang, Hui Wang, Peng Fang, Guanglin Li
BACKGROUND: Most of the modern motorized prostheses are controlled with the surface electromyography (sEMG) recorded on the residual muscles of amputated limbs. However, the residual muscles are usually limited, especially after above-elbow amputations, which would not provide enough sEMG for the control of prostheses with multiple degrees of freedom. Signal fusion is a possible approach to solve the problem of insufficient control commands, where some non-EMG signals are combined with sEMG signals to provide sufficient information for motion intension decoding...
January 7, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/28042364/predictors-of-acute-kidney-injury-in-neurocritical-care-patients-receiving-continuous-hypertonic-saline
#10
Michael J Erdman, Heidi Riha, Lauren Bode, Jason J Chang, G Morgan Jones
BACKGROUND AND PURPOSE: Continuous intravenous 3% hypertonic saline (HTS) infusions are commonly used for the management of cerebral edema following severe neurologic injuries. Despite widespread use, data regarding the incidence and predictors of nephrotoxicity are lacking. The purpose of this study was to describe the incidence and identify predictors of acute kidney injury (AKI) in neurocritical care patients administered continuous infusion HTS. METHODS: This was an institutional review board-approved, multicenter, retrospective cohort study of patients receiving HTS infusions at 2 academic medical centers...
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28012642/postoperative-cerebral-and-somatic-near-infrared-spectroscopy-saturations-and-outcome-in-hypoplastic-left-heart-syndrome
#11
George M Hoffman, Nancy S Ghanayem, John P Scott, James S Tweddell, Michael E Mitchell, Kathleen A Mussatto
BACKGROUND: Circulatory vulnerability reflected by low systemic venous oxygen saturation after surgical palliation of hypoplastic left heart syndrome predicts adverse neurologic outcome and reduced survival, and targeting venous saturation may improve outcome. We herein test the hypothesis that near-infrared spectroscopy (NIRS)-derived cerebral and somatic/renal regional saturations can predict survival. METHODS: Patient data, from a prospective Institutional Review Board-approved registry of hemodynamic measures after initial palliation of hypoplastic left heart syndrome, were analyzed with logistic and multivariable mixed regression methods to determine relationships between standard hemodynamic measures, direct and NIRS measures of saturation, and outcome...
December 21, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28001116/features-of-stimulus-specific-seizures-in-dogs-with-reflex-epilepsy-43-cases-2000-2014
#12
Linda Shell, Rachel Scariano, Mark Rishniw
OBJECTIVE To describe the occurrence and management of reflex epilepsy (ie, seizure activity triggered by exposure to specific locations or situations) in dogs. DESIGN Retrospective case series. ANIMALS 43 client-owned dogs. PROCEDURES Discussions by veterinarians participating in the Veterinary Information Network online community for the years 2000 through 2014 were reviewed to identify dogs with a diagnosis of reflex epilepsy and seizure activity in response to stimuli. History, signalment (including age at onset), the specific stimulus or stimuli that provoked seizures, treatments, and any concurrent neurologic diagnoses were recorded...
January 1, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/27968868/timing-and-approaches-in-congenital-cataract-surgery-a-randomised-controlled-trial
#13
Weirong Chen, Erping Long, Jingjing Chen, Zhenzhen Liu, Zhuoling Lin, Qianzhong Cao, Xiaohang Wu, Qiwei Wang, Duoru Lin, Xiaoyan Li, Lixia Luo, Bo Qu, Haotian Lin, Yizhi Liu
BACKGROUND: The optimum timing of surgery and the approach that should be used during congenital cataract surgery are controversial and present challenges for paediatric cataract surgeons in China. The aim of this study was to compare visual prognoses and postoperative adverse effects of paediatric cataract surgery done at different times and using different surgical approaches. METHODS: In this prospective, randomised controlled trial, we recruited Chinese patients aged 3 months or younger who were diagnosed with bilateral diffuse or total cataracts, but who did not have coexisting ocular, systemic or neurological diseases...
October 2016: Lancet
https://www.readbyqxmd.com/read/27913539/prevention-of-central-nervous-system-sequelae-in-sickle-cell-disease-without-evidence-from-randomized-controlled-trials-the-case-for-a-team-based-learning-collaborative
#14
Michael R DeBaun, Allison A King
Since 1998, the National Institutes of Health has funded 5 randomized controlled trials (RCTs) for primary and secondary prevention of strokes in children with sickle cell anemia (SCA). In a systematic fashion, these trials have significantly advanced the care of children with SCA. In the absence of an RCT, clinicians are often compelled to make decisions at the bedside, based on experience, observational studies, and principles of hematology. We will provide an initial example that describes how a team-based, learning collaborative developed a multisite standard care protocol with a low budget (<$10 000 per year) to overcome the intrinsic limitations of advancing the care of neurologic complications in sickle cell disease (SCD)...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27909651/hybrid-decompression-and-fixation-technique-for-the-treatment-of-multisegmental-cervical-spondylotic-myelopathy
#15
Barón Zárate-Kalfopulos, Walter Araos-Silva, Alejandro Reyes-Sánchez, Luis Miguel Rosales-Olivarez, Armando Alpizar-Aguirre, Francisco Lopez Melendez
BACKGROUND: Cervical spondilotic myelopathy (CSM) is defined as the compromise of the spinal cord due to degenerative changes of the cervical spine. It is the most common cause of spinal cord dysfunction in patients over 55 years. An early surgical management it is paramount to achieve better neurological outcome. There is still controversy regarding the appropriate surgical treatment for multisegmental CSM involving three or more levels. The hybrid decompression and fixation technique combines one or two level corpectomy and a single level discectomy in order to obtain optimum decompression and fixation in patients with multilevel cervical myelopathy...
2016: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/27903177/follow-up-results-of-brain-metastasis-patients-undergoing-repeat-gamma-knife-radiosurgery
#16
Takao Koiso, Masaaki Yamamoto, Takuya Kawabe, Shinya Watanabe, Yasunori Sato, Yoshinori Higuchi, Tetsuya Yamamoto, Akira Matsumura, Hidetoshi Kasuya
OBJECTIVE Stereotactic radiosurgery (SRS) without upfront whole-brain radiotherapy (WBRT) has influenced recent treatment recommendations for brain metastasis patients. However, in brain metastasis patients who undergo SRS alone, new brain metastases inevitably appear with relatively high incidences during post-SRS follow-up. However, little is known about the second SRS results. The treatment results of second SRS were retrospectively reviewed, mainly for newly developed or, uncommonly, for recurrent brain metastases in order to reappraise the efficacy of this treatment strategy with a special focus on the maintenance of neurological status and safety...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27861447/diagnostic-accuracy-of-neuromonitoring-for-identification-of-new-neurologic-deficits-in-pediatric-spinal-fusion-surgery
#17
Victor M Neira, Kamyar Ghaffari, Srinivas Bulusu, Paul J Moroz, James G Jarvis, Nicholas Barrowman, William Splinter
BACKGROUND: Intraoperative neuromonitoring (IONM) modalities, transcranial motor-evoked potentials (TcMEPs), and somatosensory-evoked potentials (SSEPs) are accepted methods to identify impending spinal cord injury during spinal fusion surgery. Debate exists over sensitivity and specificity of these modalities. Our purpose was to measure the incidence of new neurologic deficits (NNDs) and estimate sensitivity and specificity of IONM modalities. METHODS: Institutional Ethics Board approval was obtained to review charts of patients younger than 22 years undergoing scoliosis surgery from 2007 to 2014 retrospectively...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27767401/-awake-clipping-of-cerebral-aneurysms-report-of-initial-series
#18
Saleem I Abdulrauf, Peter Vuong, Ritesh Patel, Raghu Sampath, Ahmed M Ashour, Lauren M Germany, Jonathon Lebovitz, Colt Brunson, Yuvraj Nijjar, J Kyle Dryden, Maheen Q Khan, Mihaela G Stefan, Evan Wiley, Ryan T Cleary, Connor Reis, Jodi Walsh, Paula Buchanan
OBJECTIVE Risk of ischemia during aneurysm surgery is significantly related to temporary clipping time and final clipping that might incorporate a perforator. In this study, the authors attempted to assess the potential added benefit to patient outcomes of "awake" neurological testing when compared with standard neurophysiological testing performed under general anesthesia. The procedure is performed after the induction of conscious sedation, and for the neurological testing, the patient is fully awake. METHODS The authors conducted an institutional review board-approved prospective study of clipping unruptured intracranial aneurysms (UIAs) in 30 consecutive adult patients who underwent awake clipping...
October 21, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27751795/the-limits-of-electronic-fetal-heart-rate-monitoring-in-the-prevention-of-neonatal-metabolic-acidemia
#19
Steven L Clark, Emily F Hamilton, Thomas J Garite, Audra Timmins, Philip A Warrick, Samuel Smith
BACKGROUND: Despite intensive efforts directed at initial training in fetal heart rate interpretation, continuing medical education, board certification/recertification, team training, and the development of specific protocols for the management of abnormal fetal heart rate patterns, the goals of consistently preventing hypoxia-induced fetal metabolic acidemia and neurologic injury remain elusive. OBJECTIVE: The purpose of this study was to validate a recently published algorithm for the management of category II fetal heart rate tracings, to examine reasons for the birth of infants with significant metabolic acidemia despite the use of electronic fetal heart rate monitoring, and to examine critically the limits of electronic fetal heart rate monitoring in the prevention of neonatal metabolic acidemia...
October 14, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27729811/prolongation-of-greater-occipital-neural-blockade-with-10-lidocaine-neurolysis-a-case-series-of-a-new-technique
#20
David Daewhan Kim, Nabil Sibai
INTRODUCTION: Greater occipital nerve blocks (GONB) have been used for headache but their benefit may be short. Ready et al performed intrathecal injections on rabbits and reported neurologic/histologic changes that required concentrations of at least 8%. Our study tests the hypothesis that the neurolytic effects of GONB with 10% lidocaine can prolong relief. METHODS: After an approval from Henry Ford Hospital Institutional Review Board, a chart review was performed for patients who had GONB with 10% lidocaine...
2016: Journal of Pain Research
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