bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk of Intracranial Aneurysms in Families With Subarachnoid Hemorrhage
Authors: Alberts Mark J. , Quinones Ana , Graffagnino Carmelo , Friedman Allan , Roses Allen D. 
Published: February 2016

AbstractBackground:Genetic factors may be important in the etiology of subarachnoid hemorrhage (SAH) and intracranial aneurysm (IA) formation. Several studies have reported the familial occurrence of SAH and IA, although in most cases asymptomatic family members were not studied with elective angiography. The examination of data from large sibships could provide important information about the frequency of IA occurrence in at-risk individuals and the mode of inheritance for familial SAH/1A.Methods:We reviewed published case series of sibships with SAH and at least four siblings, in which at least one sibling underwent elective angiography. Data were collected on age-of-onset, clinical events, presence of hypertension, angiographic findings, and outcome. Patients were classified as “affected” if they had a SAH or if an IA was detected by elective angiography, and “unaffected” if they were asymptomatic and had a negative angiogram.Results:Seven case series with 52 individuals (26 men and 26 women) met our inclusion criteria. The sibships ranged from 6 to 13 members. Most of the siblings (32 of 52, 61%) were asymptomatic, 18 (35%) had a SAH, and 2 (4%) had focal symptoms but no SAH. Elective angiography of 34 siblings showed an IA in 11 (32%) and was negative in 23 (68%). The overall rate of affecteds (SAH or IA) was 56%.Conclusions:Based on data from these sibships, angiography of asymptomatic at-risk siblings demonstrated an IA in almost one-third of cases. Familial SAH/IA segregated with a pattern that was consistent with an autosomal dominant trait in this selected series of sibships, although other factors could produce these findings.
Bilateral Temporal Lobe MRI Changes in Uncomplicated Hypoglycemic Coma
Authors: Boeve B.F. , Bell D.G. , Noseworthy J.H. 
Published: February 2016

ABSTRACT:We report bilateral temporal lobe MRI findings in a patient following an episode of prolonged hypoglycemia uncomplicated by coexisting anoxia, hypotension, acidosis, drug intoxication, infection, or status epilepticus. The MRI findings are discussed in relation to the experimental and human data on hypoglycemic neuronal injury.
Writer’s Cramp and Tremor Due to Brain Tumor
Authors: Milanov I. , Georgiev D. 
Published: February 2016

ABSTRACT:Writer’s cramp is frequently associated with hand tremor and with other focal dystonias. Sometimes brain infarction, haemorrhage, arterio-venous malformations or tumors are found to cause symptomatic focal dystonias. A 44-year-old man came to our attention due to writer’s cramp of his right hand and postural 6-8 Hz tremor. About three months after the onset of the disease the tremor and dystonia disappeared, while a right hemiparesis gradually appeared. Cranial computed tomography showed a hypodense nonhomogeneous lesion in the left cerebral hemisphere parietally, that was assumed to represent a cystic tumor. The patient underwent craniotomy and the histological diagnosis revealed an astrocytoma (Grade II-III). In conclusion our findings confirm the common anatomical basis of symptomatic focal dystonia and tremor. Both can appear after disruption of the pathways within and adjacent to the basal ganglia.
Acute and Chronic Toxicity of Antiepileptic Medications: a Selective Review
Authors: Camfield Peter , Camfield Carol 
Published: February 2016

Abstract:Acute and chronic toxicity complicates all antiepileptic medications (AED) and is idiosyncratic. Acute toxicity can be categorized into 1) acute brain dysfunction or 2) acute organ dysfunction when AED’s are started. Despite promisingin vitrolymphocyte testing, anticipation of acute reactions cannot be offered. Furthermore, screening for AED toxicity by routine blood and urine tests in asymptomatic patients is of doubtful value and should be abandoned. Patients should be informed of possible reactions and immediately report early symptoms. Treatment for acute reactions is largely unstudied. It is unclear how to reintroduce AED’s following acute reactions. Often patients are sensitive to drugs with a similar chemical structure. The “desensitization” protocol of Purvis may be of merit. Three major chronic toxicities of AED’s have been noted – soft tissue and gum hypertrophy, progressive ataxia, and peripheral neuropathy. New AED’s require careful post-marketing surveillance since long term toxicity data are not yet available.
The Place of Neuronal Migration Abnormalities in Child Neurology
Authors: Aicardi Jean 
Published: February 2016

Abstract:With the development of modern imaging techniques, disturbances of neuronal migration appear to be a major cause of epilepsy, mental retardation and chronic neurological disability in childhood. Sixty-nine cases are presented, including 46 of diffuse migration abnormalities and 23 of localized dysplasia. Patients with diffuse migration disorders presented with mental retardation, gross motor impairment and severe seizure disorders whereas in those with focal anomalies, epilepsy was the chief complaint. Magnetic resonance imaging, although usually diagnostic of migration disorders often does not allow definition of the pathologic type. Some EEG patterns, such as high amplitude fast rhythms or the theta-delta pattern are highly suggestive. Most cases of abnormal migration are sporadic and probably acquired. Some are due to chromosomal anomalies, especially of chromosome 17p where a gene for lissencephaly has been mapped. Familial cases occur with both recessive and possibly dominant inheritance. Epilepsy due to migration abnormalities is often intractable. Resection of dysplastic cortex may be effective for localized disease and callosotomy has been proposed for diffuse anomalies.
The Influence of Sulindac on Experimental Streptozotocin-Induced Diabetic Neuropathy
Authors: Zochodne Douglas W. , Ho Lam T. 
Published: February 2016

Abstract:We studied the influence of sulindac, a nonsteroidal anti-inflammatory agent on experimental streptozotocin-induced diabetic neuropathy. Untreated diabetic rats were compared with nondiabetic rats, diabetic rats treated with low dose insulin and diabetic rats given sulindac (6.0 mg/kg by gavage 5 of 7 days weekly). Neuropathy was assessed by following serialin vivomotor and sensory caudal conduction, resistance to ischemic conduction failure, andin vitroconduction in sural myelinated and unmyelinated sensory fibers. The impact of low dose insulin and sulindac treatment on the microenvironment of the L4 dorsal root ganglion and sciatic endoneurium was asssessed by measuring local perfusion and oxygen tension after 16 weeks of diabetes. Sulindac normalized conduction velocity in caudal sensory fibers, sural myelinated fibers and sural unmyelinated fibers, and reduced the number of diabetic cataracts. Sulindac also normalized a deficit in dorsal root ganglion blood flow and a reduction in sciatic endoneurial oxygen tension in diabetic rats. Low dose insulin improved neuropathy as well but the pattern of benefits was less robust than that of sulindac. Sulindac may be a candidate for a clinical trial in human diabetic polyneuropathy.
Complications of First Craniotomy for Intra-Axial Brain Tumour
Authors: Cabantog Alberto M. , Bernstein Mark 
Published: February 2016

Abstract:Complications were examined in a single surgeon’s series of 207 consecutive adult patients undergoing first craniotomy for intra-axial brain tumour. The study group consisted of 114 gliomas, 74 metastatic tumours and 19 miscellaneous lesions. There were 25 infratentorial tumours and 182 supratentorial tumours (39 deep and 143 superficial). The total number of patients sustaining complications was 52 for an overall complication rate of 25.1%; the rate was higher for infratentorial tumours (44.0%) than supratentorial tumours (22.8%) regardless of histology (p = 0.012). There were 5 deaths for a mortality rate of 2.4%. Forty-seven patients incurred operative morbidity (22.7%); 7 out of the 47 had multiple complications. Sixteen patients sustained transient worsening due to edema (7.7%) and 6 patients sustained permanent neurological deficit (2.9%). Medical complications were suffered by 17 patients (8.2%). Major complications which significantly altered the quality and/or quantity of survival were suffered by 9 patients overall (4.3%).
Stretch Reflex Latencies in Spastic Hemiparetic Subjects are Prolonged After Transcutaneous Electrical Nerve Stimulation
Authors: Hui-Chan Christina W.Y. , Levin Mindy F. 
Published: February 2016

ABSTRACT:Low-intensity repetitive electrical stimulation such as dorsal column and transcutaneous electrical nerve stimulation (TENS) reportedly decreases spasticity and improves voluntary motor control. However, the mechanisms mediating these effects are unclear. Recent findings suggest that spasticity may be characterized more appropriately by a decrease in the stretch reflex threshold than by an increase in gain. Our objectives were: (1) to examine possible changes in stretch reflex excitability following 45 min of TENS, (2) to map out the time course of possible post-stimulation effects via both latency and magnitude (amplitude or area) measurements, and (3) to determine the role of segmental versus non-segmental mechanisms involved in mediating these changes. The effects of 45 min of segmentally and heterosegmentally applied TENS on lower limb reflexes in ten spastic hemiparetic subjects were contrasted with those resulting from placebo stimulation. We found that both segmentally and heterosegmentally applied TENS caused an immediate increase in soleus H reflex latencies that was evident for up to 60 minutes post-stimulation in over 75% of the subjects. Similar increases for up to 60 and 40 minutes post-stimulation was noted for the stretch reflex latencies in 50% and 67% of the subjects respectively for segmental and heterosegmental stimulation. These results suggested that manipulation of segmental and heterosegmental afférents for 45 min may lead to a decrease of the otherwise augmented stretch reflex excitability accompanying hemiparetic spasticity.
Abducens Palsy Following Shunting for Hydrocephalus
Authors: Espinosa J.A. , Giroux M. , Johnston K. , Kirkham T. , Villemure J.G. 
Published: February 2016

ABSTRACT:Over a period of 12 years, 80 patients underwent ventricular shunting for normal pressure hydrocephalus. Three developed sixth cranial nerve palsy in the first two weeks after surgery. This uncommon complication is usually transitory following the same pattern of abducens palsy after lumbar puncture or spinal anesthesia. Traction on the nerve with local ischemia has been involved as the responsible mechanism in both instances.
Impact of Migraine and Tension-Type Headache on Life-Style, Consulting Behaviour, and Medication Use: A Canadian Population Survey
Authors: Edmeads John , Findlay Helen , Tugwell Peter , Pryse-Phillips William , Nelson R.F. , Murray T.J. 
Published: February 2016

ABSTRACT:A large sample of Canadian adults was surveyed by telephone to determine the prevalence and characterization of headache, and the effects of headache on life-style, consulting behaviours and medication use. We reported prevalence and characterization in a previous issue; here, we detail the effects of headaches on sufferers. Sixteen and one-half percent of adult Canadians experience migraine and 29% tension-type headaches. In over 70% of headache sufferers interpersonal relationships are impaired. Regular activities are limited in 78% of migraine attacks and 38% of tension-type headaches. Despite this, only 64% of migraine and 45% of tension-type headache sufferers had ever sought medical attention, and of these only 32% returned for ongoing care. Fourteen percent of migraine and 8% of tension-type headache sufferers had used emergency departments. Most headache sufferers take medication, primarily over-the-counter varieties. Measures to reach the headache population are needed, as are safe effective treatment options that will encourage them to participate in their medical care.
Progressive Focal Degenerative Disease of the Posterior Associative Cortex
Authors: Attig Ezzedine , Jacquy Jean , Uytdenhoef Patrick , Roland Hervé 
Published: February 2016

ABSTRACT:A 72-year-old man developed a very progressive neuropsychologic deficit 6 years ago, beginning with isolated visual topographic memory disturbances and visuo-constructive apraxia without additional manifestations of dementia. The syndrome worsened thereafter with the emergence of visual agnosia, simultagnosia, psychic paralysis of gaze, auditivo-verbal agnosia, and recently an amnestic syndrome with confabulation and confusion (at the end of 1989). CT scans, which remained unchanged over the years, showed mild, focal atrophic changes revealed by dilatation of the right occipital horn. His angiograms were normal. Two SPECT studies (with HMPAO measurements), performed 6 years from the onset, detected marked hypoperfusion in both parieto-occipital regions, mainly on the right side. Progressive focal degenerative disease without dementia is a relatively new syndrome, especially in cases with progressive aphasia.1 As noted in our patient, progressive disturbances initially localized in the right parieto-occipital region followed by posterior bilobar degeneration (pronounced on the right side) without dementia until late in the course may represent another exceptionally reported characteristic of this new syndrome. It is suggested that this variant of the Mesulam syndrome is more likely explained by progressive atrophy of the Alzheimer type.
The Use of Antiepileptic Drug Levels In Children: A Survey of Canadian Pediatric Neurologists
Authors: Dooley J.M. , Camfield P.R. , Camfield C.S. , Gordon K.E. , Fraser A.D. 
Published: February 2016

ABSTRACT:There are 60 pediatric neurologists in Canada. Replies were received from 56 in response to a survey regarding the use and perceived value of antiepileptic drug (AED) levels. AED levels are frequently ordered and influence clinical care. There were, however, discrepancies among pediatric neurologists regarding the upper and lower limits of the “therapeutic ranges” and the clinical application of levels. We suggest that both the value and use of AED levels needs further study.
Failure to Recognize Status Epilepticus in a Paralysed Patient
Authors: Munn R.I. , Farrell K. 
Published: February 2016

ABSTRACT:Paralysis induced by neuromuscular blocking agents facilitates ventilation of seriously ill patients but may preclude clinical recognition of seizures. We describe the occurrence of severe cognitive impairment in a 14-year-old girl in whom status epilepticus was recognized only when pancuronium was withdrawn after 14 hours of paralysis. This patient emphasizes a potential danger of paralysis from drugs in patients with acute cerebral dysfunction.
Parieto-cerebellar Loop Impairment in Ataxic Hemiparesis: Proposed Pathophysiology Based on an Analysis of Cerebral Blood Flow
Authors: Attig Ezzedine 
Published: February 2016

ABSTRACT:Sixteen stroke patients suffering from ataxic hemiparesis syndrome were studied with regional cerebral blood flow measured by 133-Xenon inhalation technique (12 patients) and by SPECT (HMPAO) (9 patients). The causative lesions (hematoma in 7 and infarct in 9), unilateral in 15 patients and bilateral in 1, were located in the posterior two-thirds of the corona radiata, thalamocapsular and subthalamus regions, or cerebral peduncle. Ataxia of the cerebellar type was unilateral in 15 patients and bilateral in 1 with similar, deep, bilateral causative lesions. Four patients presented some characteristics of proprioceptive ataxia (mixed ataxia). Associated cognitive disturbances were present in 9 patients and absent in 7. Eleven of the 12 subjects studied by 133-Xenon inhalation technique showed limited centro-parietal hypoperfusion, mainly in the inferior parietal lobule, ipsilateral to the causative lesion and bilaterally in the patient with bilateral lesions and ataxia. Ipsilateral hypoperfusion was confirmed in 7/9 patients studied by SPECT, which also demonstrated contralateral cerebellar hypoperfusion in 4 patients. These findings suggest that ataxic hemiparesis syndrome results from functional depression (diaschisis) consequent to the interruption at many levels of an “inferior parietal associative cortex - cerebellar anterior lobe” circuit.
SPECT for Differential Diagnosis of Dementia and Correlation of rCBF with Cognitive Impairment
Authors: Osimani Alicia , Ichise Masanori , Chung Dae-Gyun , Pogue Janice M. , Freedman Morris 
Published: February 2016

Abstract:99mTc-HM-PAO single photon emission computed tomography (SPECT) was used to image 30 patients referred for the assessment of dementia. SPECT images revealed various patterns of regional cerebral perfusion (rCBF) in the subgroups of patients with the clinical diagnoses of Alzheimer's disease (AD, n = 14), Pick's disease (n = 1), and multi-infarct dementia (n = 7). In three patients, SPECT clarified the clinical differential diagnostic possibilities. Using a relative rCBF quantification technique, the relationship between specific cognitive impairments and rCBF in the AD patients was determined. There was a significant correlation between language impairment and left hemisphere hypoperfusion, whereas, apraxia correlated with hypoperfusion in the left parietal region. Thus, HMPAO SPECT is useful as an aid in the differential diagnosis of dementia and the technique of relative rCBF quantification with SPECT may contribute to the understanding of the clinico-anatomical relations of cognitive deficits in dementia.
HIV-1/AIDS Neuropathology in a Canadian Teaching Centre
Authors: Walsh Kimberley , Thompson William , Megyesi Joseph , Wiley Clayton A. , Hammond Robert 
Published: February 2016

AbstractBackground:The nervous system is a major target of HIV-1 infection and site of many complications of AIDS. Most of our knowledge pertaining to the range and frequency of neuropathology in HIV-1/AIDS is from large centres outside Canada in different social and health care settings. The goal of the present study was to describe HIV-1/AIDS-associated neuropathology before and during the era of highly active antiretroviral therapy at a Canadian teaching centre.Methods:The records of the Department of Pathology, London Health Sciences Centre were electronically searched for cases of HIV-1/AIDS that came to postmortem examination since 1985. The clinical records and pathological materials were reviewed.Results:Sixteen autopsies of HIV-1/AIDS were identified. All patients were male. Fourteen contracted HIV-1 through high risk homosexual activity, one through the transfusion of blood products and one through intravenous drug use. Three patients (19%) had pre-mortem evidence of HIV-1 associated dementia. At autopsy, 12 of the 16 cases had neuropathological findings and the most common diagnoses were HIV-1 encephalitis, progressive multifocal leukoencephalopathy, toxoplasmosis, and primary CNS lymphoma.Conclusions:High risk homosexual activity was a more prominent factor in acquiring AIDS in cases coming to postmortem examination compared with previous reports from most larger urban centres outside Canada where injection drug use and high risk heterosexual activity factored prominently. The incidence of HIV-1 associated dementia was similar to that reported previously. This study confirms the heavy burden and wide spectrum of disease experienced by the nervous system in HIV-1/AIDS.
Cortical Relay Time for Long Latency Reflexes in Patients with Definite Multiple Sclerosis
Authors: Tataroglu Cengiz , Genc Ahmet , Idiman Egemen , Cakmur Raif , Idiman Fethi 
Published: February 2016

AbstractBackground:Long latency reflexes (LLR) include afferent sensory, efferent motor and central transcortical pathways. It is supposed that the cortical relay time (CRT) reflects the conduction of central transcortical loop of LLR. Recently, evidence related to the cortical involvement in multiple sclerosis (MS) has been reported in some studies. Our aim was to investigate the CRT alterations in patients with MS.Methods:Upper extremity motor evoked potentials (MEP), somatosensory evoked potentials (SEP) and LLR were tested in 28 patients with MS and control subjects (n=22). The patients with MS were classified according to the clinical form (relapsing-remitting [R-R] and progressive groups). The MS patients with secondary progressive and primary progressive forms were considered as the “progressive” group. CRT for LLR was calculated by subtracting the peak latency of somatosensory evoked potentials (SEP) and that of motor evoked potentials (MEP) by transcranial magnetic stimulation from the onset latency of the second component of LLR (LLR2) (CRT = LLR2 – [MEP latency + N20 latency])Results:Cortical relay time was calculated as 7.4 ± 0.9 ms in control subjects. Cortical relay time was prolonged in patients with MS (11.2 ± 2.9 ms) (p<0.0001). The latencies of LLR, MEP and SEP were also prolonged in patients with MS. Cortical relay time was not correlated with disease severity and clinical form in contrast to other tests.Conclusions:Our findings suggested that CRT can be a valuable electrophysiological tool in patients with MS. Involvement of extracortical neural circuits between sensory and motor cortices or cortical involvement due to MS may cause these findings.
The Aphasia Quotient: The Taxonomic Approach to Measurement of Aphasic Disability
Authors: Kertesz Andrew , Poole Elizabeth 
Published: February 2016

Summary150 aphasiacs and 59 controls were examined with a scorable, comprehensive battery, designed to be used by the clinician and the research worker. The subtests of Fluency, Information, Comprehension, Repetition and Naming were added and compared to a hypothetical normal of 100 obtaining the “aphasia Quotient.” This is a measurement of the severity of language impairment. On the basis of their performance on the subtests, the patients were classified according to taxonomic principles into Global, Motor (Broca’s), Isolation, Sensory (Wernicke’s), Transcortical Motor, Transcortical Sensory, Conduction and Anomic groups (in order of severity). This classification is considered a clinically valid baseline for research, diagnosis and prognosis.
Turkey's experience with neoliberal policies since 1980 in retrospect and prospect
Authors: Şenses Fikret 
Published: February 2016

AbstractThis paper provides a critical assessment of Turkey's economic performance under the neoliberal economic policies which have been instrumental in generating a profound transformation in its socioeconomic structure since 1980. The paper draws special attention to the government's loss of policy autonomy and the democratic deficit at the initial and implementation stages of this transformation. It then evaluates Turkey's economic performance on the basis of indicators with medium and long-term impacts, such as investment, saving, industrialization, unemployment, and income distribution. This assessment shows that the neoliberal model has failed to fulfill its promises, with the Turkish economy failing to achieve performance equal to that under the previous import-substitution strategy or in comparable countries. The paper then identifies the main problem areas confronting the economy: the current account deficit, the labor market, insufficient industrial progress and income distribution, and poverty. To solve these problems, it calls for both a radical rethinking of the neoliberal policy regime and for proactive state intervention to stimulate saving and investment as part of a new development strategy, giving primary importance to industrialization, employment creation, and more equitable income distribution.