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https://www.readbyqxmd.com/read/29665155/defining-mechanisms-of-neural-plasticity-after-brainstem-ischemia-in-rats
#1
Jens Minnerup, Jan-Kolja Strecker, Lydia Wachsmuth, Maike Hoppen, Antje Schmidt, Dirk M Hermann, Heinz Wiendl, Sven Meuth, Cornelius Faber, Kai Diederich, Wolf Rüdiger Schäbitz
OBJECTIVE: Neurological recovery after stroke mainly depends on the location of the lesion. A substantial portion of strokes affects the brainstem. However, patterns of neural plasticity following brainstem ischemia are almost unknown. METHODS: Here, we established a rat brainstem ischemia model that resembles key features of the human disease and investigated mechanisms of neural plasticity including neurogenesis and axonal sprouting as well as secondary neurodegeneration...
April 17, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29660221/brainstem-leukoaraiosis-independently-predicts-poor-outcome-after-ischemic-stroke
#2
Eva Giralt-Steinhauer, Santiago Medrano, Carolina Soriano-Tárraga, Marina Mola-Caminal, Raquel Rasal, Elisa Cuadrado-Godia, Ana Rodríguez-Campello, Angel Ois, J Capellades, Jordi Jimenez-Conde, Jaume Roquer
BACKGROUND: Increased supratentorial white matter hyperintensities volume (S-WMHV) has been reported as a predictor of worse outcome in acute ischemic stroke (AIS) patients. However, few studies focus on less common locations such as brainstem-white matter hyperintensities (B-WMH), and their relationship with S-WMHV. This study aimed to examine whether B-WMH affects clinical outcome after AIS or transient ischemic attack (TIA). METHODS: Based on MRI evidence, B-WMH was evaluated in 313 prospectively identified patients with AIS/TIA and registered as absent or present...
April 16, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29626028/lesson-of-the-month-2-a-rare-presentation-of-stroke-diagnosis-made-on-magnetic-resonance-imaging
#3
Danielle Berenson, Luke Nuttall, Eluzai Hakim, Khaled Abdel-Aziz
Bilateral thalamic infarcts are uncommon posterior circulation strokes. The artery of Percheron (AOP) is a rare anatomical variant involving a singular arterial supply to both thalami and occlusion leads to bilateral thalamic infarction.We report the case of a 71-year-old man who presented with decreased consciousness (fluctuating Glasgow Coma Scale score of 5-7). He had a background of atrial fibrillation and was anticoagulated with dabigatran, a novel oral anticoagulant. Computed tomography (CT) scan showed a mildly reduced attenuation in the region of the left thamalus...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29608513/clinical-predictors-of-survival-and-functional-outcome-of-stroke-patients-admitted-to-critical-care
#4
Mariëlle K van Valburg, M Sesmu Arbous, Milena Georgieva, David A Brealey, Mervyn Singer, Bart F Geerts
OBJECTIVES: To determine the predictive value of commonly used clinical variables upon ICU admission for long-term all-cause mortality and functional outcome of adult stroke patients admitted to the ICU. DESIGN: Retrospective observational cohort study. SETTING: General and neurosurgical ICUs of the University College London Hospitals in North Central London. PATIENTS: All adult ICU patients with a clinical diagnosis of acute stroke admitted between February 2010 and May 2012...
March 30, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29607917/-cadasil-with-cysteine-sparing-notch3-mutation-manifesting-as-dissociated-progression-between-cognitive-impairment-and-brain-image-findings-in-3-years-a-case-report
#5
Keisuke Tachiyama, Yuji Shiga, Yutaka Shimoe, Ikuko Mizuta, Toshiki Mizuno, Masaru Kuriyama
A 55-year-old man with no history of stroke or migraine presented to the clinic with cognitive impairment and depression that had been experiencing for two years. Neurological examination showed bilateral pyramidal signs, and impairments in cognition and attention. Brain MRI revealed multiple lacunar lesions and microbleeds in the deep cerebral white matter, subcortical regions, and brainstem, as well as diffuse white matter hyperintensities without anterior temporal pole involvement. Cerebral single-photon emission computed tomography (SPECT) revealed bilateral hypoperfusion in the basal ganglia...
March 31, 2018: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/29593921/unilateral-asterixis-in-arm-and-leg-caused-by-internal-capsula-stroke
#6
Katharina Feil, Marion Huber, Nicolina Goldschagg, Lars Kellert
We report an unusual clinical manifestation of ischemic stroke with acute right-sided asterixis affecting the arm as well as the leg due to a lesion in the left posterior limb of the internal capsula. After treatment with intravenous thrombolysis the patient made a good recovery. Notably, in this case unilateral asterixis affected the arm as well as the leg, resulting in postural and gait instability. In addition, damage in the basal ganglia-thalamo-cortical network, as in our patient, has to be distinguished from other supratentorial causes of acute asterixis like thalamic or frontal lobe lesions linked to the cerebello-brainstem-thalamo-frontal lobe circuits...
2018: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29560323/usefulness-of-early-videofluoroscopic-swallowing-study-in-acute-stroke-patients-with-dysphagia
#7
Sang Beom Kim, Sook Joung Lee, Kyeong Woo Lee, Jong Hwa Lee, Dong Won Kim
Objective: To demonstrate the usefulness of early videofluoroscopic swallowing study (VFSS) and to investigate change patterns in dietary methods in stroke patients with dysphagia. Methods: The VFSS was performed within 7 days of stroke onset in neurologically stable patients. The patients were divided into three groups according to type of brain lesion: cortical lesion (CL), subcortical lesion (SCL), and brainstem/cerebellar lesion (BCL). Based on the VFSS results, this study investigated change patterns in feeding method and discrepancies in the aspiration risk predicted by the Water Swallowing Test (WST) and the VFSS...
February 2018: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29559783/association-between-etiology-and-lesion-site-in-ischemic-brainstem-infarcts-a-retrospective-observational-study
#8
Gozde Baran, Tugce Ozdemir Gultekin, Oguz Baran, Cigdem Deniz, Salim Katar, Gulsen Babacan Yildiz, Talip Asil
Background and purpose: To assess the anatomical distribution of the ischemic strokes of the brainstem, the effect of anatomical distribution on clinical features and prognosis, and the association between etiology and anatomical involvement. Methods: A retrospective search of the patient database of our institution was performed for a total of 227 patients who were admitted to the Department of Neurology, Medical Faculty of Bezmialem Vakif University between January 2012 and September 2014...
2018: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29549469/why-acute-unilateral-vestibular-midbrain-lesions-rarely-manifest-with-rotational-vertigo-a-clinical-and-modelling-approach-to-head-direction-cell-function
#9
Marianne Dieterich, Stefan Glasauer, Thomas Brandt
A retrospective clinical study focused on the frequency of rotational vertigo in 63 patients with acute unilateral midbrain strokes involving the vestibular and ocular motor systems. In contrast to unilateral pontomedullary brainstem lesions, rotational vertigo in midbrain lesions occurred with a low frequency (14%) and transient (< 1 day) course. Swaying vertigo or unspecific dizziness (22%) and postural imbalance (31%) were more frequent. Midbrain strokes with transient rotational vertigo manifested with lesions chiefly in the caudal midbrain tegmentum, while manifestations with swaying, unspecific, or no vertigo chiefly occurred in rostral mesencephalic or meso-diencephalic lesions...
March 16, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29543142/use-of-computed-tomography-perfusion-for-acute-stroke-in-routine-clinical-practice-complex-scenarios-mimics-and-artifacts
#10
Carlos Garcia-Esperon, Andrew Bivard, Christopher Levi, Mark Parsons
Background Computed tomography perfusion is becoming widely accepted and used in acute stroke treatment. Computed tomography perfusion provides pathophysiological information needed in the acute decision making. Moreover, computed tomography perfusion shows excellent correlation with diffusion-weighted imaging and perfusion-weighted sequences to evaluate core and penumbra volumes. Multimodal computed tomography perfusion has practical advantages over magnetic resonance imaging, including availability, accessibility, and speed...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29540323/cell-based-therapy-enhances-activation-of-ventral-premotor-cortex-to-improve-recovery-following-primary-motor-cortex-injury
#11
Mary E Orczykowski, Kevin R Arndt, Lauren E Palitz, Brian C Kramer, Monica A Pessina, Adrian L Oblak, Seth P Finklestein, Farzad Mortazavi, Douglas L Rosene, Tara L Moore
Stroke results in enduring damage to the brain which is accompanied by innate neurorestorative processes, such as reorganization of surviving circuits. Nevertheless, patients are often left with permanent residual impairments. Cell based therapy is an emerging therapeutic that may function to enhance the innate neurorestorative capacity of the brain. We previously evaluated human umbilical tissue-derived cells (hUTC) in our non-human primate model of cortical injury limited to the hand area of primary motor cortex...
March 11, 2018: Experimental Neurology
https://www.readbyqxmd.com/read/29527159/muscle-synergies-control-during-hand-reaching-tasks-in-multiple-directions-post-stroke
#12
Sharon Israely, Gerry Leisman, Chay C Machluf, Eli Carmeli
Purpose: A muscle synergies model was suggested to represent a simplifying motor control mechanism by the brainstem and spinal cord. The aim of the study was to investigate the feasibility of such control mechanisms in the rehabilitation of post-stroke individuals during the execution of hand-reaching movements in multiple directions, compared to non-stroke individuals. Methods: Twelve non-stroke and 13 post-stroke individuals participated in the study. Muscle synergies were extracted from EMG data that was recorded during hand reaching tasks, using the NMF algorithm...
2018: Frontiers in Computational Neuroscience
https://www.readbyqxmd.com/read/29506874/mt-nd5-mutation-exhibits-highly-variable-neurological-manifestations-at-low-mutant-load
#13
Yi Shiau Ng, Nichola Z Lax, Paul Maddison, Charlotte L Alston, Emma L Blakely, Philippa D Hepplewhite, Gillian Riordan, Surita Meldau, Patrick F Chinnery, Germaine Pierre, Efstathia Chronopoulou, Ailian Du, Imelda Hughes, Andrew A Morris, Smaragda Kamakari, Georgia Chrousos, Richard J Rodenburg, Christiaan G J Saris, Catherine Feeney, Steven A Hardy, Takafumi Sakakibara, Akira Sudo, Yasushi Okazaki, Kei Murayama, Helen Mundy, Michael G Hanna, Akira Ohtake, Andrew M Schaefer, Mike P Champion, Doug M Turnbull, Robert W Taylor, Robert D S Pitceathly, Robert McFarland, Gráinne S Gorman
Mutations in the m.13094T>C MT-ND5 gene have been previously described in three cases of Leigh Syndrome (LS). In this retrospective, international cohort study we identified 20 clinically affected individuals (13 families) and four asymptomatic carriers. Ten patients were deceased at the time of analysis (median age of death was 10years (range: 5·4months-37years, IQR=17·9years). Nine patients manifested with LS, one with mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS), and one with Leber hereditary optic neuropathy...
February 24, 2018: EBioMedicine
https://www.readbyqxmd.com/read/29492135/intractable-yawning-as-a-predominant-symptom-of-temporal-lobe-ganglioglioma-case-report-and-review-of-literature
#14
Raja K Kutty, Jacob Paul Alapatt, Aparna Govindan
Yawning, a physiologic reflex exhibited by vertebrates, is seldom noticed as a symptom of a disease. Not too often is a patient aware of it as a symptom, unless it is of such a distressing nature to seek attention. In this situation, to distinguish between normal and abnormal behavior would pose a diagnostic dilemma for the attending physician. Intractable yawning has been a presenting symptom of many pathologic states such as stroke, epilepsy, and migraine. Literature is sparse regarding intractable yawning caused by tumors of the brain...
January 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29460203/time-is-cerebellum
#15
EDITORIAL
Hiroshi Mitoma, Mario Manto, Christiane S Hampe
The cerebellum characteristically has the capacity to compensate for and restore lost functions. These compensatory/restorative properties are explained by an abundant synaptic plasticity and the convergence of multimodal central and peripheral signals. In addition, extra-cerebellar structures contribute also to the recovery after a cerebellar injury. Clinically, some patients show remarkable improvement of severe ataxic symptoms associated with trauma, stroke, metabolism, or immune-mediated cerebellar ataxia (IMCA, e...
February 19, 2018: Cerebellum
https://www.readbyqxmd.com/read/29457651/progressive-recruitment-of-contralesional-cortico-reticulospinal-pathways-drives-motor-impairment-post-stroke
#16
Jacob G McPherson, Albert Chen, Michael D Ellis, Jun Yao, C J Heckman, Julius P A Dewald
KEY POINTS: Activation of the shoulder abductor muscles in the arm opposite a unilateral brain injury causes involuntary increases in elbow, wrist and finger flexion in the same arm, a phenomenon referred to as the flexion synergy. It has been proposed that flexion synergy expression is related to reduced output from ipsilesional motor cortex and corticospinal pathways. In this human subjects study, we provide evidence that the magnitude of flexion synergy expression is instead related to a progressive, task-dependent recruitment of contralesional cortex...
February 19, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29333567/predictors-for-intracranial-hemorrhage-following-intravenous-thrombolysis-in-posterior-circulation-stroke
#17
Tomáš Dorňák, Michal Král, Zuzana Sedláčková, Daniel Šaňák, Eva Čecháková, Petra Divišová, Jana Zapletalová, Petr Kaňovský
Intravenous thrombolysis (IVT) is a standard treatment for anterior (ACS) and posterior circulation stroke (PCS). However, due to the low occurrence of PCS and of intracranial hemorrhage (ICH) in PCS, the knowledge about ICH predictors following IVT in PCS is sparse. Our aim was to identify predictors for ICH following IVT in PCS. The set consisted of 1281 consecutive ischemic stroke (IS) patients treated with IVT, out of which 158 (103 males; mean age 65.6 ± 12.3 years) had PCS. Collected data include baseline characteristics, common stroke risk factors, pre-medication, stroke severity, admission blood glucose level, blood pressure and treatment with intravenous antihypertensive therapy before and during IVT, occlusion of arteries, recanalization rate, time to treatment, and clinical outcome at day 90...
January 15, 2018: Translational Stroke Research
https://www.readbyqxmd.com/read/29281159/non-alcoholic-fatty-liver-disease-is-associated-with-stroke-severity-and-progression-of-brainstem-infarctions
#18
H Li, B Hu, L Wei, L Zhou, L Zhang, Y Lin, B Qin, Y Dai, Z Lu
BACKGROUND AND PURPOSE: Non-alcoholic fatty liver disease (NAFLD) is closely correlated to visceral obesity, dyslipidaemia, insulin resistance and type 2 diabetes mellitus. We sought to assess the association between a specific stroke subgroup, brainstem infarctions (BSIs) and NAFLD. Furthermore, we evaluated whether NAFLD is an independent risk factor in patients with BSIs. METHODS: Non-alcoholic fatty liver disease was assessed in 306 patients with radiologically confirmed BSIs via liver ultrasound...
March 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29274051/stroke-and-craniectomy
#19
Eelco F M Wijdicks
Neurosurgical involvement in the care of major stroke complications has yielded striking results in the subtentorial region but equivocal outcomes in the supratentorial compartment. Most neurosurgeons want to see some degree of deterioration before proceeding; thus, timing will be debated. Viewpoints have changed over the years regarding surgical or medical intervention, but in many patients the procedure has not produced a definitive change in outcome other than preventing death from terminal brainstem shift...
December 22, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29249993/unexpected-improvement-of-hand-motor-function-with-a-left-temporoparietal-low-frequency-repetitive-transcranial-magnetic-stimulation-regime-suppressing-auditory-hallucinations-in-a-brainstem-chronic-stroke-patient
#20
Fanny Thomas, Noomane Bouaziz, Julià L Amengual, Palmyre Schenin-King Andrianisaina, Christian Gaudeau-Bosma, Virginie Moulier, Antoni Valero-Cabré, Dominique Januel
We here report paradoxical hand function recovery in a 61-year-old male tetra-paretic chronic patient following a stroke of the brainstem (with highly degraded right and abolished left-hand finger flexion/extension disabling him to manipulate objects) who experienced insidious auditory hallucinations (AHs) 4 years after such event. Symptomatic treatment for AHs was provided with periodical double sessions of low-frequency repetitive transcranial magnetic stimulation (rTMS) (daily 1 Hz, 2 × 1,200 pulses interleaved by 1 h interval) delivered to the left temporoparietal junction across two periods of 5 and 3 weeks, respectively...
2017: Frontiers in Psychiatry
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