bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Arrest of Mental and Motor Development Associated with Bilateral Hippocampal Anoxic Damage
Authors: Fisher C.M. 
Published: December 2014

Background:Clinical-pathological study of the case of a woman with amentia from birth.Case history:A 45-year-old woman was institutionalized since the age of two and showed no change in 43 years. She did not stand, walk, talk, use her hands or comprehend. She was placed in a chair each day. She lacked control of bladder and bowel. She showed no mental capability.Case pathology:The brain weighed 1250 gm and was normally developed. There were two anoxic-ischemic regions of damage. The hippocampus showed extensive damage bilaterally and the cerebellum showed watershed infarction bilaterally.Conclusion:A perinatal anoxic-ischemic episode is suspected. Hippocampal damage was the only finding that might explain the failure of mental and motor development. If this hypothesis is correct, the function of the human hippocampus is broader than currently accepted.
Sarcomatous Change After Sellar Irradiation in a Growth Hormone-Secreting Pituitary Adenoma
Authors: Prabhu Sujit S. , Aldape Kenneth D. , Gagel Robert F. , Benjamin Robert S. , Trent Jonathan C. , McCutcheon Ian E. 
Published: December 2014

Background:Although the benefits of radiotherapy for pituitary adenomas are well-documented, post-irradiation sarcomas of the sella are rarely seen, with only 20 cases (mainly of fibrosarcoma) reported in the medical literature.Method:We describe a case of post-irradiation sarcoma five years after surgery followed by external-beam irradiation for an extensive and locally invasive growth hormone-secreting tumor. The patient was subsequently given pegvisomant, an antagonist of growth hormone receptor, to control symptoms of growth hormone excess.Results:The patient underwent transsphenoidal resection of the recurrent tumor, followed by adjuvant chemotherapy. This led to significant relief in the patient's symptoms including radiological evidence of tumor shrinkage, but the tumor regrew when, owing to dose-limiting toxicity, chemotherapy was stopped.Conclusion:Post-irradiation sarcomas of the pituitary are well-recognized but rare. They should be suspected in patients following sellar irradiation who show abrupt onset of new symptoms and appropriate radiological findings, and such tumors may respond to cytotoxic chemotherapy.
Distal Mycotic Aneurysm of the AICA Mimicking Intracanalicular Acoustic Neuroma
Authors: DiMaio Salvatore , Mohr Gérard , Dufour Jean-Jacques , Albrecht Steffan 
Published: December 2014

Background:Among cases of cerebellopontine angle lesions, vascular lesions involving the internal auditory canal are extremely rare. We report a distal fusiform mycotic pseudoaneurysm of the anterior inferior cerebellar artery (AICA) that simulated an acoustic neuroma on presentation.Methods:A 60-year-old woman was investigated for recent onset of acute dizziness. Laboratory and radiographic investigations are presented, as well as the surgical management of the patient and pathological examination of the aneurysm.Conclusion:An exceptionally rare case of distal mycotic intracanalicular pseudoaneurysm of the AICA with intraluminal thrombus and fusiform anatomy is described. In our review of the literature (1966-present), only five other intracanalicular AICA-aneurysms were encountered, none of which were infectious in etiology. The possible pathophysiologic mechanisms of distal AICA-aneurysms are discussed along with the currently available literature.
Prevalence of Reported Migraine Headaches in Canadian Adolescents
Authors: Gordon K.E. , Dooley J.M. , Wood E.P. 
Published: December 2014

Objective:To examine self-reported prevalence data for migraine among adolescent Canadians and to explore how reported migraine treatment varies by age.Methods:We analyzed the microdata files of the Canadian National Population Health Survey (1996-1997). Respondents reported whether they had “migraine headaches diagnosed by a health professional”. They also reported whether they received “any treatment or medication for migraine headaches”, with treatments subdivided into drug, diet or “other”.Results:99.9% of 173,216 eligible respondents reported whether they had migraine headaches. Migraine was reported by 2.4% of Canadian youth aged 12-14 years and by 5.0% of 15-19 year-olds compared to 7.2% of adults aged 20 years of age (p< 0.0001, chi-square). Active treatment was used by 51.0% - higher by females (53.1%) than males (44.7%) (p<0.0001 chi-square). Treatment was used by 45.1% of 12-14 year-olds, by 45.7% of 15-19 year-olds and by 51.5% of those 20 years (p=0.0027). The nature of the active treatment choice (drug, diet or other) did not significantly vary within the age groups studied.Conclusion:We present robust estimates of self-report diagnosed migraine prevalence, derived from a large nationally representative population survey. Estimates of the prevalence of active treatment for migraine provide insight into the burden of migraine within this population.
Pallidal Deep Brain Stimulation in Cervical Dystonia: Clinical Outcome in Four Cases
Authors: Eltahawy H.A. , Saint-Cyr J. , Poon Y.Y. , Moro E. , Lang A.E. , Lozano A.M. 
Published: December 2014

Objective:Report on the clinical results following bilateral globus pallidus interna deep brain stimulation in four patients (one female and three males) with severe cervical dystonia, mean age 48 years (range 37-67).Methods:All four patients had failed extensive medical and botulinum toxin treatment. The mean duration of the disease was nine years (range 4-15 years). Patients were assessed pre and postoperatively using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). Preoperatively, the mean TWSTRS total score was 43.2 (range 28-60.5). Posteroventral pallidal deep brain stimulators were inserted using MRI and microelectrode recording guidance. Last follow-up was 15 months for the four patients.Results:Mean reduction in the TWSTRS total scores at last follow- up was 73% (range 61- 85%). Improvement in pain occurred soon after deep brain stimulation surgery. Motor improvement was delayed and prolonged over several months. Frequent adjustment in the stimulation parameters was necessary in the first three months.Conclusion:Bilateral pallidal stimulation is effective in management of selected cases of intractable cervical dystonia.
Electrocardiogram Artifacts Caused by Deep Brain Stimulation
Authors: Constantoyannis Constantine , Heilbron Brett 
Published: December 2014

Background:Deep brain stimulation (DBS) is increasingly used to treat a variety of neurological conditions (e.g. movement disorders and chronic pain). This prospective study was designed to detect electrocardiogram (ECG) artifacts induced by deep brain stimulation and to investigate which factors (patient disease, electrode position within the brain or type of stimulation) produced these artifacts.Methods:Twelve patients (four women, eight men) with deep brain stimulators were enrolled in the study. Patients were selected to represent the common indications for DBS (Parkinson's disease, tremor, dystonia), the common electrode locations (pallidum, thalamus, subthalamic nucleus) and the two types of stimulation (monopolar, bipolar). Patients had one ECG with the DBS turned 'on'and another with the DBS turned 'off'. The ECGs were then randomized and read by a cardiologist blinded to the status of the patient and DBS and artifacts were noted to be either present or absent.Results:The six patients using monopolar stimulation all had artifacts on their electrocardiograms. These artifacts were severe enough to interfere with ECG interpretation. There were no artifacts detected in the six patients using bipolar stimulation. Electrode location and patient disease appeared to have no effect on ECG artifact.Conclusion:Deep brain stimulation can cause ECG artifacts when monopolar settings are used. These artifacts are not present with bipolar settings or when the DBS is turned 'off'. Knowledge of these potential ECG artifacts and how to avoid them is essential to facilitate accurate ECG interpretation.
Collision Frequency in Elite Hockey on North American versus International Size Rinks
Authors: Wennberg Richard 
Published: December 2014

Objective:Body impact or collision is the risk factor underlying all sports-related concussions. This study sought to determine whether collision rates in elite hockey differ between games played on North American size rinks as compared to games played on larger international size ice surfaces.Methods:Videotapes of games from the 2001 and 2002 National Hockey League Stanley Cup finals, World Junior championships and the 2002 Winter Olympics were analyzed, with all collisions counted and separated into various categories (player/player bodycheck, player/player into boards, player/boards, player/ice, head/stick, head/puck). Further subdivisions included collisions involving the head directly or indirectly. Twenty-two games were analyzed, 11 played on the small ice and 11 on the big ice.Results:Significantly more collisions of all types (in all categories and subdivisions within categories) were found to occur on the smaller North American ice surface (P value differences from 0.01 to 0.00001).Conclusion:The results of this study showed significantly fewer collisions of all types in elite hockey games played on the international size ice surface. The comparison groups studied here did differ in some aspects other than ice size and so replication of the findings with even more closely matched groups will be needed before definitive conclusions can be drawn. However, if these findings are replicable, it would suggest that a change to uniform usage of the larger international rinks, with no rule changes or other alterations in the game, could provide direct primary prevention to reduce the number of collisions, and, by extension, concussions, that occur in the sport.
Neurologic Course, Endocrine Dysfunction and Triplet Repeat Size in Spinal Bulbar Muscular Atrophy
Authors: Sinnreich Michael , Sorenson Eric J. , Klein Christopher J. 
Published: December 2014

Objective:To study the role of diabetes, gynecomastia and CAG triplet repeat size as disease modifying factors of neurologic expression in spinal bulbar muscular atrophy (SBMA, Kennedy's disease).Methods:Twenty unrelated SBMApatients with confirmatory genetic testing were reviewed. Patterns of neurologic involvement were assessed (e.g. bulbar, asymmetric, proximal, distal, motor and sensory). Slopes of disease progression were calculated from serial quantified neurologic examinations. Patterns of neurologic involvement and course were correlated to the presence of diabetes, gynecomastia and triplet repeat size.Results:Diabetes or glucose impairment occurred in nine and 11 had gynecomastia. Patterns of neurologic involvement and rates of progression did not correlate with these endocrine diseases or triplet repeat sizes. Correlation was seen between number of CAG repeats and age of onset weakness (r = -0.53, r2 = 29%, p = 0.01).Conclusion:The specific neurotoxic effect of expanded CAGs appears limited to age of onset weakness in SBMA. Although significant, only 29% of the variability in onset age could be accounted for by polyglutamine size suggesting the importance of other unidentified factors. In this series diabetes or glucose impairment was more common than previously reported and, like gynecomastia, did not correlate with size of triplet repeats, severity or patterns of neurologic involvement. Modifying factors other than diabetes, gynecomastia or triplet repeat size are suggested in disease expression.
Exacerbation of Pre-existing Epilepsy by Mild Head Injury: a Five Patient Series
Authors: Tai P.C. , Gross D.W. 
Published: December 2014

Objective:While the risk of developing seizures following a mild head injury has been reported and is thought to be low, the effect of mild head injury on patients with a pre-existing seizure disorder has not been reported. We present a series of cases where a strong temporal relationship between mild head injury and worsening of seizure frequency was observed.Methods:Five cases were identified and reviewed in detail. Information was derived from clinic and hospital charts with attention to the degree of injury, pre- and postinjury seizure patterns and frequency.Results:One patient has primary generalized epilepsy and four have localization related epilepsy. Prior to the head injury, three of the patients were seizure free (range: two to 24 years). The patients suffered from mild head injuries with no or transient loss of consciousness and no focal neurological deficits. In all cases, the patients experienced a worsening of seizure control within days of the injury. In one case, the patient's seizure pattern returned to baseline one year after the accident, while in the remaining four cases, the patients continue to have medically refractory seizures.Conclusion:A close temporal relationship between mild head injury and a worsening of seizure control was observed in five patients with epilepsy. Although further study is required, this observation suggests that a head injury that would be considered benign in the general population can have serious consequences such as recurrence of seizures and medical intractability in patients with epilepsy.
Lymphocytic Hypophysitis with a Long Latent Period Before Development of a Pituitary Mass
Authors: Wong Rene W.G. , Ooi Teik Chye , Benoit Brien , Zackon David , Jansen Gerard , Telner Adam 
Published: December 2014

Background:Lymphocytic hypophysitis is an autoimmune condition that commonly presents in women of childbearing age as hypopituitarism and a sellar mass.Case report:A 66-year-old woman presented with anterior pituitary dysfunction. Computed tomography imaging revealed a small hypodensity that was not felt to be the cause of the pituitary dysfunction. Eight years later, her vision rapidly deteriorated and MRI showed a pituitary mass lesion causing optic chiasm compression. Histological examination of the partially resected gland revealed evidence of lymphocytic hypophysitis.Conclusion:Our patient is an example of the variable presentation and course of lymphocytic hypophysitis. Such a long latent period between the initial presentation of adenohypophysial hypofunction and optic chiasm compression due to an enlarging pituitary mass has not been reported.
Intraparenchymal Supratentorial Neurenteric Cyst
Authors: Kachur Edward , Ang Lee-Cyn , Megyesi Joseph F. 
Published: December 2014

Background:Neurenteric cysts are congenital cysts of the central nervous system that are believed to be of endodermal origin. In this report we present the unique case of a supratentorial neurenteric cyst that is contained entirely within the brain parenchyma.Methods:Apatient presented with an intraparenchymal cystic lesion that was subsequently identified as a neurenteric cyst. This lesion is reviewed in light of the available literature.Case report:A 35-year-old female presented with a one year history of progressive headaches and seizure-like episodes. Her examination revealed no deficits. Magnetic resonance imaging showed a 4 cm x 4 cm x 4 cm cystic lesion within the parenchyma of the right frontal lobe. A right frontal craniotomy and complete excision of the cystic lesion was performed. Pathologic examination confirmed that it was a neurenteric cyst. Postoperatively the patient's symptoms improved.Conclusion:Review of the literature revealed this to be the first case of a surgically excised, pathologically confirmed supratentorial neurenteric cyst, contained entirely within the brain parenchyma.
Predicting Final Disposition after using the Orpington Prognostic Scor
Authors: Wright C.J. , Swinton L.C. , Green T.L. , Hill M.D. 
Published: December 2014

Background:Prediction of outcome after stroke is important for triage decisions, prognostic estimates for family and for appropriate resource utilization. Prognostication must be timely and simply applied. Several scales have shown good prognostic value. In Calgary, the Orpington Prognostic Score (OPS) has been used to predict outcome as an aid to rehabilitation triage. However, the OPS has not been assessed at one week for predictive capability.Methods:Among patients admitted to a sub-acute stroke unit, OPS from the first week were examined to determine if any correlation existed between final disposition after rehabilitation and first week score. The predictive validity of the OPS at one week was compared to National Institute of Health Stroke Scale (NIHSS) score at 24 hours using logistic regression and receiver operator characteristics analysis. The primary outcome was final disposition after discharge from the stroke unit if the patient went directly home, or died, or from the inpatient rehabilitation unit.Results:The first week OPS was highly predictive of final disposition. However, no major advantage in using the first week OPS was observed when compared to 24h NIHSS score. Both scales were equally predictive of final disposition of stroke patients, post rehabilitation.Conclusion:The first week OPS can be used to predict final outcome. The NIHSS at 24h provides the same prognostic information.
Infection Rates in Standard vs. Hydrogel Coated Ventricular Catheters
Authors: Kaufmann Anthony M. , Lye Tara , Redekop Gary , Brevner Angela , Hamilton Mark , Kozey Michelle , Easton David 
Published: December 2014

Background:Infection related to external ventricular drain (EVD) use is a common neurosurgical complication. Modified catheters with a hydrophilic surface may impede bacterial adherence and thereby reduce catheter related cerebrospinal fluid (CSF) infection.Methods:A prospective randomized clinical trial compared the occurrence of CSF infection related to use of either standard silastic or hydrogel coated EVD catheters (Bioglide®, Medtronic). Enrolment was available to all adult neurosurgery patients undergoing placement of a first EVD, at three university centers. The catheters were presoaked in a low concentration of bacitracin solution for 5-10 minutes prior to insertion. Bacterial infection was defined by heavy growth in a single CSF sample or light / medium growth in two consecutive samples. A secondary analysis was also conducted for “probable” CSF infection, including patients started on antibiotics after light / medium growth in a single CSF sample. Statistical analyses included Kaplan-Meier survival curve estimates accompanied by Log Rank and Breslow tests.Results:There were 158 randomized patients available to assess for EVD related infection of CSF. The two study groups had similar clinical characteristics including average duration of EVD use (8±4 days). Definite CSF infection occurred in seven and probable infection in another six (8% total). Infection incidence rose steadily from day 2 (1%) to day 11 (11%). There was no difference of daily occurrence of EVD infection between the two catheter types.Conclusion:Infection remains a common hazard in the use of EVD, and we found no reduction of infection using the hydrogel-coated catheters when presoaked in low concentration bacitracin solution.
A Mathematical Model for Prediction of Drug Molecule Diffusion Across the Blood-Brain Barrier
Authors: Burns Jonathan , Weaver Donald F. , Burns Jonathan , Weaver Donald F. 
Published: December 2014

Background:Predicting the ability of drugs to enter the brain is a longstanding problem in neuropharmacology. The first step in creating a much-needed computational algorithm for predicting whether a drug will enter brain is to devise a rigorous mathematical model.Methods:Employing two experimental measures of blood-brain barrier (BBB) penetrability (brain/plasma ratio and the brain-uptake index) and 14 theoretically derived biophysical predictors, a mathematical model was developed to quantitatively correlate molecular structure with ability to traverse the BBB.Results:This mathematical model employs Stein's hydrogen bonding number and Randic's topological descriptors to correlate structure with ability to cross the BBB. The final model accurately predicts the ability of test molecules to cross the BBB.Conclusion:A mathematical method to predict blood-brain barrier penetrability of drug molecules has been successfully devised. As a result of bioinformatics, chemoinformatics and other informatics-based technologies, the number of small molecules being developed as potential therapeutics is increasing exponentially. A biophysically rigorous method to predict BBB penetrability will be a much-needed tool for the evaluation of these molecules.
The Behavioural Neurology Assessment
Authors: Darvesh S. , Leach L. , Black S. E. , Kaplan E. , Freedman M. 
Published: December 2014

ABSTRACT:Background:We present information regarding the standardization, reliability and clinical validity of two versions of the Behavioural Neurology Assessment (BNA). The BNA-Long Form consists of 24 subtests within separate domains: Attention, Memory, Language, Visuospatial Function, Executive Function, and Praxis. The BNA-Short Form consists of 13 subtests within the domains of Attention, Memory, Naming, Visuospatial Function and Executive Function. In addition to individual domain indices, a Grand Total score was calculated for both BNA versions.Objective:To standardize the administration and scoring and validate the BNA for detection of dementia.Methods:Standardized normative data were obtained on 115 healthy subjects ranging in age from 50 to 95. Test-retest stability was obtained on 19 subjects and clinical validity was investigated by administering the BNA and Mini-Mental Status Examination (MMSE) to 29 patients with dementia and 29 age-matched healthy subjects (controls).Results:Age had a significant effect on all but the Visuospatial and Praxis indices of the BNA-Long Form and an effect on Naming and Grand Total score of the Short-Form. Internal consistency (Cronbach's coefficient a) was .87 and .67 for the Long and Short Forms (.95 and .96 for dementia and control groups combined). Test-retest stability was acceptable. Grand Total indices of both BNA versions showed significant, positive correlations with the MMSE. Both BNA versions had superior sensitivity to dementia relative to the MMSE (.93 versus .79). Specificity was equivalent to the MMSE (.93 versus .97).Conclusions:Positive predictive values of the BNA and MMSE are equivalent but the BNA provides superior negative predictive value.
Ligamentum Flavum Cysts Causing Incapacitating Lumbar Spinal Stenosis
Authors: DiMaio Salvatore , Marmor Eric , Albrecht Stephan , Mohr Gérard 
Published: December 2014

ABSTRACT:Background:Cysts of the ligamentum flavum are rare and unusual causes of spinal compression.Methods:We report our experience of four cases of ligamentum flavum cysts occurring in the lumbar spine and discuss some of the possible etiologies and pathophysiologic mechanisms according to the available literature.Conclusion:This entity is clearly different from the synovial facet-joints or ganglion cysts.