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https://www.readbyqxmd.com/read/28918356/what-is-the-price-for-the-duchenne-gait-pattern-in-patients-with-cerebral-palsy
#1
Firooz Salami, Mirjam Niklasch, Britta K Krautwurst, Thomas Dreher, Sebastian I Wolf
Duchenne gait is characterized by trunk lean towards the affected stance limb with the pelvis stable or elevated on the swinging limb side during single limb stance phase. We assessed the relationship between hip abduction moments and trunk kinetics in patients with cerebral palsy showing excessive lateral trunk motion. Data of 18 subjects with bilateral spastic cerebral palsy (CP) and 20 aged matched typically developing subjects (TD) were collected retrospectively. Criteria for patient selection were barefoot walking without aid presenting with excessive lateral trunk motion...
September 7, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28918088/evaluation-of-cerebrovascular-reactivity-in-subjects-with-and-without-obstructive-sleep-apnea
#2
Clodagh M Ryan, Anne Battisti-Charbonney, Olivia Sobczyk, David J Mikulis, James Duffin, Joseph A Fisher, Lashmi Venkatraghavan
BACKGROUND: Both obstructive sleep apnea (OSA) and altered cerebrovascular reactivity (CVR) are associated with increased stroke risk. Nevertheless, the incidence of abnormal CVR in patients with OSA is uncertain due to the high variability in the way CVR is measured both within and between studies. We hypothesized that a standardized CVR with a consistent vasoactive stimulus and cerebral blood flow (CBF) measure would be reduced in patients with severe OSA compared with healthy controls...
September 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28916477/nse-serum-levels-in-extracorporeal-life-support-patients-relevance-for-neurological-outcome
#3
Bernhard Floerchinger, Alois Philipp, Daniele Camboni, Maik Foltan, Dirk Lunz, Matthias Lubnow, York Zausig, Christof Schmid
BACKGROUND: Good neurological outcome is a major determinant after cardiac resuscitation. Extracorporeal life support may rapidly stabilize the patient, but cerebral ischemia remains a frequent complication relevant for further therapy. The aim of this study was to prove the value of NSE to indicate cerebral injury in patients with extracorporeal support after CPR. METHODS: 159 patients with CPR were included. NSE 48h peak levels and trends were tested for usability as predictive marker of brain injury, in-hospital mortality and long-term outcome...
September 12, 2017: Resuscitation
https://www.readbyqxmd.com/read/28915340/metabolic-profile-of-visual-cortex-in-diabetic-rats-measured-with-in-vivo-proton-mrs
#4
Shuang Li, Xinghua Wang, Junjie Yang, Hao Lei, Xuxia Wang, Yi Xiang
The purpose of the present study was to characterize the metabolic profile of the visual cortex in streptozotocin-induced Type 1 diabetic rats by means of in vivo proton MRS. Several metabolite concentration ratios in the visual cortex were calculated. In addition, postmortem histologic analyses for retinal ganglion cell (RGC) loss, optic nerve injury and visual cortex alterations were monitored. The results showed that diabetes induced several changes in visual cortex metabolites, such as reduced N-acetylaspartate, glutamate, γ-aminobutyric acid, taurine and choline-containing compound levels...
September 15, 2017: NMR in Biomedicine
https://www.readbyqxmd.com/read/28911510/long-term-prognostic-value-of-gasping-during-out-of-hospital-cardiac%C3%A2-arrest
#5
Guillaume Debaty, Jose Labarere, Ralph J Frascone, Marvin A Wayne, Robert A Swor, Brian D Mahoney, Robert M Domeier, Michael L Olinger, Brian J O'Neil, Demetris Yannopoulos, Tom P Aufderheide, Keith G Lurie
BACKGROUND: Gasping is a natural reflex that enhances oxygenation and circulation during cardiopulmonary resuscitation (CPR). OBJECTIVES: This study sought to assess the relationship between gasping during out-of-hospital cardiac arrest and 1-year survival with favorable neurological outcomes. METHODS: The authors prospectively collected incidence of gasping on all evaluable subjects in a multicenter, randomized, controlled, National Institutes of Health-funded out-of-hospital cardiac arrest clinical trial from August 2007 to July 2009...
September 19, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28904531/potential-therapeutic-mechanisms-and-tracking-of-transplanted-stem-cells-implications-for-stroke-treatment
#6
REVIEW
Yanhong Zhang, Honghong Yao
Stem cell therapy is a promising potential therapeutic strategy to treat cerebral ischemia in preclinical and clinical trials. Currently proposed treatments for stroke employing stem cells include the replacement of lost neurons and integration into the existing host circuitry, the release of growth factors to support and promote endogenous repair processes, and the secretion of extracellular vesicles containing proteins, noncoding RNA, or DNA to regulate gene expression in recipient cells and achieve immunomodulation...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28904465/spectrum-of-visual-impairment-in-cerebral-venous-thrombosis-importance-of-tailoring-therapies-based-on-pathophysiology
#7
Sanjith Aaron, Anupriya Arthur, A T Prabakhar, Pavitra Mannam, N K Shyamkumar, Sunithi Mani, Vivek Mathew, Jeyanthi Peter, Ajith Sivadasan, Anika Alexander, M Karthik, Rohith Ninan Benjamin, Mathew Alexander
Visual impairment can complicate cerebral venous thrombosis (CVT). Here, we describe the various pathophysiological mechanisms and treatments available. A retrospective chart review of all patients treated for CVT in a large quaternary teaching hospital was done, and cases with visual impairment due to CVT were identified. The various mechanisms causing visual impairment in CVT were (1) raised intracranial pressure (ICP) caused by venous thrombosis without venous infarcts resulting in a benign intracranial hypertension-like presentation of CVT, (2) venous infarcts involving the occipital cortex, (3) raised ICP following the development of a secondary dural arteriovenous (AV) fistula, and (4) arterial occipital infarcts due to posterior cerebral artery compression secondary to herniation in large venous infarcts...
July 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28904458/can-transcranial-color-doppler-spectral-signatures-be-a-novel-biomarker-for-monitoring-cerebrovascular-autoregulation-and-intracranial-pressure-a-speculative-synthesis
#8
Sandhya Mangalore, Kotresh, Rakshith Srinivasa, Alangar Sathyaranjandas Hegde, Rangashetty Srinivasa
BACKGROUND: Trans Cranial Colour Doppler (TCCD) has been extensively used in various neurological and neurosurgical conditions causing severe raise in the intracranial pressure (ICP). MATERIAL AND METHOD: Our study explores the sequential evolution of TCCD flow pattern by correlating with pupillary reactivity, Glasgow coma scale (GCS), and imaging. Our cohort consisted of thirty patients with ten patients in each subgroup admitted to the neuro-Intensive Care Unit (NICU) for various neurological and neurosurgical causes...
July 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28904084/relevance-of-supraventricular-runs-detected-after-cerebral-ischemia
#9
Mark Weber-Krüger, Constanze Lutz, Antonia Zapf, Raoul Stahrenberg, Joachim Seegers, Janin Witzenhausen, Katrin Wasser, Gerd Hasenfuß, Klaus Gröschel, Rolf Wachter
OBJECTIVE: Prolonged ECG monitoring after stroke frequently reveals short paroxysmal atrial fibrillation (pAF) and supraventricular (SV) runs. The minimal duration of atrial fibrillation (AF) required to induce cardioembolism, the relevance of SV runs, and whether short pAF results from cerebral damage itself are currently being debated. We aimed to study the relevance of SV runs and short pAF detected by prolonged Holter ECG after cerebral ischemia during long-term follow-up. METHODS: Analysis is from the prospective Find-AF trial (ISRCTN46104198)...
September 13, 2017: Neurology
https://www.readbyqxmd.com/read/28888275/mean-arterial-pressure-of-65-mm-hg-versus-85-100-mm-hg-in-comatose-survivors-after-cardiac-arrest-rationale-and-study-design-of-the-neuroprotect-post-cardiac-arrest-trial
#10
Koen Ameloot, Cathy De Deyne, Bert Ferdinande, Matthias Dupont, Pieter-Jan Palmers, Thibault Petit, Ward Eertmans, Clara Moonen, Ann Belmans, Robin Lemmens, Joseph Dens, Stefan Janssens
BACKGROUND: Post-cardiac arrest (CA) patients admitted to the intensive care unit (ICU) have a poor prognosis, with estimated survival rates of around 30%-50%. On admission, these patients have a large cerebral penumbra at risk for additional damage in case of suboptimal brain oxygenation during their stay in the ICU. The aim of the Neuroprotect post-CA trial is to investigate whether forcing mean arterial blood pressure (MAP) and mixed venous oxygen saturation (SVO2) in a specific range (MAP 85-100 mm Hg, SVO2 65%-75%) with additional pharmacological support (goal-directed hemodynamic optimization) may better salvage the penumbra, reduce cerebral ischemia, and improve functional outcome when compared with current standard of care (MAP 65 mm Hg)...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28885662/differential-diagnosis-of-alterations-in-arterial-flow-and-tissue-oxygenation-on-venoarterial-extracorporeal-membrane-oxygenation
#11
Anna Hofer, Sylvia Leitner, Michaela Kreuzer, Jens Meier
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) may be life-saving in several clinical situations, but it is also one of the most invasive therapeutic procedures, with significant potential for life-threatening complications. Pulse pressure waves are typically very small or even absent at the onset of ECMO therapy, and will reappear with the improvement of cardiac function. A low pulse pressure may indicate low cardiac output due to heart failure during sustained ECMO support...
September 5, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28884722/-severe-carotid-stenosis-cerebral-autoregulation-in-the-ipsilateral-region
#12
V B Semenyutin, G А Asaturyan, А А Nikiforova, G К Panuntsev, V A Aliev, V B Iblyaminov, A V Savello, А Patzak, K V Laptev, I P Dudanov, О А Pavlov
AIM: To study cerebral autoregulation (CA) in region of the stenotic carotid artery. MATERIAL AND METHODS: The study involved 35 patients with critical stenosis of the carotid arteries, including 24 patients were asymptomatic and 11 patients with symptomatic course. Blood flow velocity in middle cerebral arteries was monitored using Multi Dop X (DWL, Germany) with simultaneous noninvasive systemic blood pressure registration (CNAP, Austria). CA was assessed by calculating the phase shift (PS) between spontaneous oscillations of blood flow velocity and blood pressure within the range of systemic Mayer waves (80-120 mHz)...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28881532/-safety-analysis-of-carotid-endarterectomy-without-shunting-in-carotid-artery-stenosis-patients-with-contralateral-carotid-occlusion
#13
R T Luo, G Y Yu, D Zhang, R Wang, J Z Zhao, Y Zhang
Objective: To investigate the safety of carotid endarterectomy (CEA) without shunting in carotid artery stenosis (CAS) patients with contralateral carotid occlusion (CAO) under the protection of monitoring of cerebral blood oxygen saturation. Methods: A total of 71 patients with CAS was enrolled in our research during 2013 to 2016. They were divided into two groups which were group A: 20 CAS patients with contralateral CAO, and group B: 51 CAS patients without contralateral CAO. All patients were given CEA without shunting during operation...
September 5, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28880397/transcranial-doppler-a-stethoscope-for-the-brain-neurocritical-care-use
#14
REVIEW
Chiara Robba, Danilo Cardim, Mypinder Sekhon, Karol Budohoski, Marek Czosnyka
Transcranial Doppler (TCD) ultrasonography is a noninvasive bedside monitoring technique that can evaluate cerebral blood flow hemodynamics in the intracranial arterial vasculature. TCD allows assessment of linear cerebral blood flow velocity, with a high temporal resolution and is inexpensive, reproducible, and portable. The aim of this review is to provide an overview of the most commonly used TCD derived signals and measurements used commonly in neurocritical care. We describe both basic (flow velocity, pulsatility index) and advanced concepts, including critical closing pressure, wall tension, autoregulation, noninvasive intracranial pressure, brain compliance, and cerebrovascular time constant; we also describe the clinical applications of TCD to highlight their utility in the diagnosis and monitoring of cerebrovascular diseases as the "stethoscope for the brain...
September 7, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28879623/the-risk-factors-associated-with-postoperative-hemorrhage-after-tooth-extraction-a-multi-center-retrospective-study-of-patients-receiving-oral-antithrombotic-therapy
#15
Takumi Hasegawa, Souichi Yanamoto, Akira Tachibana, Yuka Kojima, Yoshito Koyama, Michinori Maeda, Takahide Komori
The purpose of this study was to retrospectively investigate the multivariate relationships between specific risk factors and postoperative hemorrhage after tooth extraction in patients who were prescribed oral antithrombotic therapy. Risk factors for postoperative hemorrhage after tooth extraction were evaluated using univariate and multivariate analyses. Patient characteristics such as age and gender; the presence or absence of known comorbidities such as diabetes mellitus, hypertension, cerebral infarction, and alcohol consumption; and perioperative diarrhea were assessed...
September 6, 2017: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28877357/assessment-of-the-fetal-cerebral-artery-importance-of-doppler-preset-settings
#16
Denis Wibbeke, Kerstin Hammer, Mareike Möllers, Janina Braun, Helen Ann Köster, Maria Karina Falkenberg, Kathrin Oelmeier de Murcia, Matthias Borowski, Walter Klockenbusch, Ralf Schmitz
OBJECTIVES: The Doppler assessment of the middle cerebral artery (MCA) has a central role in the monitoring of high-risk pregnancies. The objective of this study was to investigate the importance of Doppler preset settings for measurement of the peak systolic velocity (PSV) and pulsatility index (PI) of the MCA. METHODS: The PI and PSV of the MCA were determined prospectively in 350 healthy fetuses between 19 and 42 weeks of pregnancy. The first measurement of the MCA (MCA...
September 6, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28875044/decreased-rivaroxaban-levels-in-a-patient-with-cerebral-vein-thrombosis-receiving-phenytoin
#17
Ana F Becerra, Tomas Amuchastegui, Aldo H Tabares
Combined use of antiepileptic drugs and anticoagulants is common. We describe the first case documenting laboratory interaction between rivaroxaban and phenytoin. A 48-year-old woman was admitted to our hospital due to cerebral venous thrombosis, bilateral pulmonary embolism, and deep vein thrombosis. She came from a small town with difficult access to warfarin monitoring. She was receiving phenytoin 100 mg three times daily (t.i.d.) and started enoxaparin 60 mg twice daily (b.i.d.). An abdominal mass was diagnosed and removed by laparoscopy (gastrointestinal stromal tumor)...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28873072/amplitude-integrated-eeg-and-brain-sparing-in-preterm-small-for-gestational-age-infants
#18
Isabel Benavente-Fernández, Simón P Lubián-López, Pamela Zafra-Rodríguez, Almudena Alonso-Ojembarrena, Antonio Segado-Arenas, Alfonso M Lechuga-Sancho
PURPOSE: Preterm small-for-gestational-age (SGA) infants are at risk for a high mortality rate and impaired cognitive development. Only a few studies have focused on amplitude-integrated EEG (aEEG) in preterm SGA infants. They have been shown to have a slower rate of brain maturation, but these findings have not consistently been related to neurodevelopmental outcomes. The aim of our study was to evaluate early aEEG monitoring in SGA compared with adequate-for-gestational-age preterms...
September 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28871418/time-spent-with-impaired-autoregulation-is-linked-with-outcome-in-severe-infant-paediatric-traumatic-brain-injury
#19
Konstantin Hockel, Jennifer Diedler, Felix Neunhoeffer, Ellen Heimberg, Carmen Nagel, Martin U Schuhmann
BACKGROUND: It could be shown in traumatic brain injury (TBI) in adults that the functional status of cerebrovascular autoregulation (AR), determined by the pressure reactivity index (PRx), correlates to and even predicts outcome. We investigated PRx, cerebral perfusion pressure (CPP) and intracranial pressure (ICP) and their correlation to outcome in severe infant and paediatric TBI. METHODS: Seventeen patients (range, 1 day to 14 years) with severe TBI (median GCS at presentation, 4) underwent long-term computerised ICP and mean arterial pressure (MAP) monitoring using dedicated software to determine CPP and PRx and optimal CPP (CPP level where PRx shows best autoregulation) continuously...
September 4, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28869474/cortical-metabolic-and-cognitive-correlates-of-disorientation-in-alzheimer-s-disease
#20
Gali H Weissberger, Rebecca J Melrose, Candace M Fanale, Joseph V Veliz, David L Sultzer
Orientation to time, date, and place is commonly utilized in clinical settings to aid in diagnosis, staging, and monitoring of Alzheimer's disease (AD). This study aimed to identify the cerebral metabolic correlates of orientation in patients with AD, and the degree to which regions associated with orientation overlap with memory-related structures. Eighty-five patients with a diagnosis of probable AD underwent fluorodeoxyglucose positron emission tomography (FDG-PET) and neuropsychological testing. Orientation items from the Dementia Rating Scale and recognition performance from the Consortium to Establish a Registry for AD (CERAD) Word List Learning test were correlated with cerebral glucose metabolism...
September 1, 2017: Journal of Alzheimer's Disease: JAD
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