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testai, fernando

Peter W MacIntosh, Amy Y Lin, Jin Suh Kim, Fernando D Testai, Heather E Moss
A 60-year-old woman with history of multiple myeloma was in remission after stem cell transplant 6 years prior. She was undergoing work-up for headaches that were thought to be secondary to a right mastoiditis seen on magnetic resonance imaging (MRI). On routine eye exam, papilloedema was noted. A lumbar puncture was performed, with elevated opening pressure with normal constituents. She was an atypical age for idiopathic intracranial hypertension, and her mastoiditis raised concern for secondary cerebral venous sinus thrombosis...
October 2017: Neuro-ophthalmology
Amelia K Boehme, Mary E Comeau, Carl D Langefeld, Aaron Lord, Charles J Moomaw, Jennifer Osborne, Michael L James, Sharyl Martini, Fernando D Testai, Daniel Woo, Mitchell S V Elkind
Objective: Systemic inflammatory response syndrome (SIRS) may be related to poor outcomes after intracerebral hemorrhage (ICH). Methods: The Ethnic/Racial Variations of Intracerebral Hemorrhage study is an observational study of ICH in whites, blacks, and Hispanics throughout the United Sates. SIRS was defined by standard criteria as 2 or more of the following on admission: (1) body temperature <36°C or >38°C, (2) heart rate >90 beats per minute, (3) respiratory rate >20 breaths per minute, or (4) white blood cell count <4,000/mm3 or >12,000/mm3 ...
March 2018: Neurology® Neuroimmunology & Neuroinflammation
Joseph R Geraghty, Fernando D Testai
PURPOSE OF REVIEW: Delayed cerebral ischemia (DCI) is common after subarachnoid hemorrhage (SAH) and represents a significant cause of poor functional outcome. DCI was mainly thought to be caused by cerebral vasospasm; however, recent clinical trials have been unable to confirm this hypothesis. Studies in humans and animal models have since supported the notion of a multifactorial pathophysiology of DCI. This review summarizes some of the main mechanisms under investigation including cerebral vascular dysregulation, microthrombosis, cortical spreading depolarizations, and neuroinflammation...
October 23, 2017: Current Atherosclerosis Reports
Alessandro Biffi, Joji B Kuramatsu, Audrey Leasure, Hooman Kamel, Christina Kourkoulis, Kristin Schwab, Alison M Ayres, Jordan Elm, M Edip Gurol, Steven M Greenberg, Anand Viswanathan, Christopher D Anderson, Stefan Schwab, Jonathan Rosand, Fernando D Testai, Daniel Woo, Hagen B Huttner, Kevin N Sheth
OBJECTIVE: Oral anticoagulation treatment (OAT) resumption is a therapeutic dilemma in intracerebral hemorrhage (ICH) care, particularly for lobar hemorrhages related to amyloid angiopathy. We sought to determine whether OAT resumption after ICH is associated with long-term outcome, accounting for ICH location (ie, lobar vs nonlobar). METHODS: We meta-analyzed individual patient data from: (1) the multicenter RETRACE study (n = 542), (2) a U.S.-based single-center ICH study (n = 261), and (3) the Ethnic/Racial Variations of Intracerebral Hemorrhage study (n = 209)...
November 2017: Annals of Neurology
Philip B Gorelick, Karen L Furie, Costantino Iadecola, Eric E Smith, Salina P Waddy, Donald M Lloyd-Jones, Hee-Joon Bae, Mary Ann Bauman, Martin Dichgans, Pamela W Duncan, Meighan Girgus, Virginia J Howard, Ronald M Lazar, Sudha Seshadri, Fernando D Testai, Stephen van Gaal, Kristine Yaffe, Hank Wasiak, Charlotte Zerna
Cognitive function is an important component of aging and predicts quality of life, functional independence, and risk of institutionalization. Advances in our understanding of the role of cardiovascular risks have shown them to be closely associated with cognitive impairment and dementia. Because many cardiovascular risks are modifiable, it may be possible to maintain brain health and to prevent dementia in later life. The purpose of this American Heart Association (AHA)/American Stroke Association presidential advisory is to provide an initial definition of optimal brain health in adults and guidance on how to maintain brain health...
October 2017: Stroke; a Journal of Cerebral Circulation
Martha L Cruz, Shama Farooq, Fernando D Testai
PURPOSE OF REVIEW: Hematologic diseases are blood disorders which can affect different organs, including the central and peripheral nervous systems. Some of them are associated with increased risk of permanent disability and death. This review highlights a selected group of primary and acquired hematologic disorders that can present as neurologic or neurosurgical emergencies. RECENT FINDINGS: There is an increasing recognition of the broad neurologic presentations of hematologic disorders...
March 2017: Current Neurology and Neuroscience Reports
Fernando D Testai
No abstract text is available yet for this article.
April 2017: Lancet Neurology
Wentao Li, Haoliang Xu, Fernando D Testai
Fingolimod (FTY720) is an orally bio-available immunomodulatory drug currently approved by the FDA for the treatment of multiple sclerosis. Currently, there is a significant interest in the potential benefits of FTY720 on stroke outcomes. FTY720 and the sphingolipid signaling pathway it modulates has a ubiquitous presence in the central nervous system and both rodent models and pilot clinical trials seem to indicate that the drug may improve overall functional recovery in different stroke subtypes. Although the precise mechanisms behind these beneficial effects are yet unclear, there is evidence that FTY720 has a role in regulating cerebrovascular responses, blood-brain barrier permeability, and cell survival in the event of cerebrovascular insult...
2016: Frontiers in Neurology
Sebastian Koch, Mitchell S V Elkind, Fernando D Testai, W Mark Brown, Sharyl Martini, Kevin N Sheth, Ji Y Chong, Jennifer Osborne, Charles J Moomaw, Carl D Langefeld, Ralph L Sacco, Daniel Woo
OBJECTIVE: To assess race-ethnic differences in acute blood pressure (BP) following intracerebral hemorrhage (ICH) and the contribution to disparities in ICH outcome. METHODS: BPs in the field (emergency medical services [EMS]), emergency department (ED), and at 24 hours were compared and adjusted for group differences between non-Hispanic black (black), non-Hispanic white (white), and Hispanic participants in the Ethnic Racial Variations of Intracerebral Hemorrhage case-control study...
August 23, 2016: Neurology
Daniel Woo, Andrew J Kruger, Padmini Sekar, Mary Haverbusch, Jennifer Osborne, Charles J Moomaw, Sharyl Martini, Shahla M Hosseini, Simona Ferioli, Bradford B Worrall, Mitchell S V Elkind, Gene Sung, Michael L James, Fernando D Testai, Carl D Langefeld, Joseph P Broderick, Sebastian Koch, Matthew L Flaherty
OBJECTIVE: We tested the hypothesis that intraventricular hemorrhage (IVH) is associated with incontinence and gait disturbance among survivors of intracerebral hemorrhage (ICH) at 3-month follow-ups. METHODS: The Genetic and Environmental Risk Factors for Hemorrhagic Stroke study was used as the discovery set. The Ethnic/Racial Variations of Intracerebral Hemorrhage study served as a replication set. Both studies performed prospective hot-pursuit recruitment of ICH cases with 3-month follow-up...
March 8, 2016: Neurology
Benjarat Changyaleket, Haoliang Xu, Francesco Vetri, Tibor Valyi-Nagy, Chanannait Paisansathan, Zhao Zhong Chong, Dale A Pelligrino, Fernando D Testai
S100B is an astrocyte-derived protein that can act through the receptor for advanced glycation endproducts (RAGE) to mediate either "trophic" or "toxic" responses. Its levels increase in many neurological conditions with associated microvascular dysregulation, such as subarachnoid hemorrhage (SAH) and traumatic brain injury. The role of S100B in the pathogenesis of microvasculopathy has not been addressed. This study was designed to examine whether S100B alters pial arteriolar vasodilating function. Rats were randomized to receive (1) artificial cerebrospinal fluid (aCSF), (2) exogenous S100B, and (3) exogenous S100B+the decoy soluble RAGE (sRAGE)...
March 1, 2016: Brain Research
Ali Kord Valeshabad, Justin Wanek, Faisal Mukarram, Ruth Zelkha, Fernando D Testai, Mahnaz Shahidi
Since the internal carotid artery supplies blood to both the eye and the brain, ocular microvascular hemodynamics can be altered due to ischemic stroke. The purpose of the current study was to establish the feasibility of conjunctival microcirculation imaging for detection of inter-ocular differences in microvascular hemodynamics in subjects with unilateral ischemic stroke. Conjunctival microcirculation imaging was performed in both eyes of 15 healthy control subjects and 12 subjects following unilateral ischemic stroke...
July 2015: Microvascular Research
Anne I Boullerne, Demetrios Skias, Elizabeth M Hartman, Fernando D Testai, Sergey Kalinin, Paul E Polak, Douglas L Feinstein
We identified a family in which five siblings were diagnosed with multiple sclerosis (MS) or clinically isolated syndrome. Several women in the maternal lineage have comorbidities typically associated with Peutz Jeghers Syndrome, a rare autosomal-dominant disease caused by mutations in the serine-threonine-kinase 11 (STK11) gene, which encodes liver kinase B1. Sequence analysis of DNA from one sibling identified a single-nucleotide polymorphism (SNP) within STK11 intron 5. This SNP (dbSNP ID: rs9282860) was identified by TaqMan polymerase chain reaction (PCR) assays in DNA samples available from two other siblings...
January 2015: ASN Neuro
Haoliang Xu, Fernando D Testai, Tibor Valyi-Nagy, Mani N Pavuluri, Fengguo Zhai, Danop Nanegrungsunk, Chanannait Paisansathan, Dale A Pelligrino
Our previous findings indicated that in rats subjected to subarachnoid hemorrhage (SAH), suppression of post-SAH neuroinflammation via vascular adhesion protein-1 (VAP-1) blockade provides significant neuroprotection. We and others have reported that neuroinflammation contributes to cerebral microvascular impairment. Thus, in the present study, we tested the hypotheses that: (1) treatment with LJP-1586, a selective VAP-1 blocker, prevents SAH-associated pial arteriolar dilating dysfunction; and (2) the vasculoprotective effect of LJP-1586 arises from inhibiting SAH-elicited neutrophil recruitment...
April 7, 2015: Brain Research
Hao-Liang Xu, Dale A Pelligrino, Chanannait Paisansathan, Fernando D Testai
BACKGROUND: Subarachnoid hemorrhage (SAH) is a neurological emergency with limited pharmacological treatment options. Inflammation is increasingly recognized as a key pathogenic contributor to brain injury in this condition. In the present study, we examined the neuroprotective effects of the immunomodulatory agent, fingolimod, in rats subjected to SAH. METHODS: We utilized an endovascular rat perforation model of SAH. Animals were divided into four groups: (1) sham-vehicle; (2) sham-fingolimod; (3) SAH-vehicle; and (4) SAH-fingolimod...
2015: Journal of Neuroinflammation
Fernando D Testai, Hao-Liang Xu, John Kilkus, Vidyani Suryadevara, Irina Gorshkova, Evgeny Berdyshev, Dale A Pelligrino, Glyn Dawson
We previously described how ceramide (Cer), a mediator of cell death, increases in the cerebrospinal fluid (CSF) of subarachnoid hemorrhage (SAH) patients. This study investigates the alterations of biochemical pathways involved in Cer homeostasis in SAH. Cer, dihydroceramide (DHC), sphingosine-1-phosphate (S1P), and the activities of acid sphingomyelinase (ASMase), neutral sphingomyelinase (NSMase), sphingomyelinase synthase (SMS), S1P-lyase, and glucosylceramide synthase (GCS) were determined in the CSF of SAH subjects and in brain homogenate of SAH rats...
May 2015: Journal of Neuroscience Research
Wentao Li, Neelofer Shafi, Ramayee Periakaruppan, Tibor Valyi-Nagy, John Groth, Fernando D Testai
Cerebral aspergillosis is a rare and highly fatal hematogenous infection most commonly found in immune compromised patients. From the onset of neurologic symptoms, the median reported rate of survival is between 5 and 9 days. Compounded with increased hemorrhagic risks and the lack of specificity in both clinical presentation and traditional imaging, a fast and noninvasive method of definitive diagnosis is necessary if there is to be any hope for positive outcomes. We describe the case of a 50-year-old female diabetic with a history of otitis media, an uncharacterized inflammatory nasopharyngeal process, and prior ischemic strokes who presented with a new cerebral infarction in the setting of an angioinvasive fungal infection of the large cerebral arteries...
January 2015: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Venkatesh Aiyagari, Dilip K Pandey, Fernando D Testai, Rebbeca A Grysiewicz, Alexander Tsiskaridze, Claudio Sacks, Yomi Ogun, Olubunmi A Ogunrin, Basim M Uthman, Patrice Lindsay, Philip B Gorelick
Stroke is a global health problem. However, very little is known about stroke care in low- to middle-income countries. Obtaining country-specific information could enable us to develop targeted programs to improve stroke care. We surveyed neurologists from 12 countries (Chile, Georgia, Nigeria, Qatar, India, Lithuania, Kazakhstan, Indonesia, Denmark, Brazil, Belgium, and Bangladesh) using a web-based survey tool. Data were analyzed both for individual countries and by income classification (low income, lower middle income, upper middle income, and high income)...
February 2015: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Hao-Liang Xu, Maggie Garcia, Fernando Testai, Francesco Vetri, Alexandra Barabanova, Dale A Pelligrino, Chanannait Paisansathan
Aneurysmal subarachnoid hemorrhage (SAH) is a potentially devastating clinical problem. Despite advances in the diagnosis and treatment of SAH, outcome remains unfavorable. An increased inflammatory state, one that is characterized by enhanced leukocyte trafficking has been reported to contribute to neuronal injury in association with multiple brain insults, including hemorrhagic and ischemic stroke. This study was designed to investigate, in rats, the neuropathologic consequences of heightened leukocyte trafficking following SAH, induced via endovascular perforation of the anterior cerebral artery...
October 24, 2014: Brain Research
Matthew K Tobin, Jacqueline A Bonds, Richard D Minshall, Dale A Pelligrino, Fernando D Testai, Orly Lazarov
This review covers the pathogenesis of ischemic stroke and future directions regarding therapeutic options after injury. Ischemic stroke is a devastating disease process affecting millions of people worldwide every year. The mechanisms underlying the pathophysiology of stroke are not fully understood but there is increasing evidence demonstrating the contribution of inflammation to the drastic changes after cerebral ischemia. This inflammation not only immediately affects the infarcted tissue but also causes long-term damage in the ischemic penumbra...
October 2014: Journal of Cerebral Blood Flow and Metabolism
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