MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Clinical Neurology and Neurosurgery' source. Sun, 21 Mar 2010 17:25:04 +0100 http://www.medworm.com/index.php?rid=3322036&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003187%2Fabstract%3Frss%3Dyes We present a case of a 69-year-old male with a hemangiopericytoma in the left perisylvian region which was subcortically located. This is an uncommon location. We discuss the case and review the literature. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3322036 Tue, 02 Mar 2010 17:56:25 +0100 3322036 http://www.medworm.com/index.php?rid=3322035&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003151%2Fabstract%3Frss%3Dyes We report the observation of a female patient with severe cognitive presentation at the onset of MS, with dramatically demented evolution, and show MRI examination results. We discuss the published reports of primary cognitive types of MS. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3322035 Tue, 02 Mar 2010 17:56:25 +0100 3322035 http://www.medworm.com/index.php?rid=3322034&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003114%2Fabstract%3Frss%3Dyes Abstract: The authors discuss a rare case of hemorrhage in a filum terminale ependymoma presenting with acute paraparesis and transient hydrocephalic dementia in association with long-term phenprocoumon anticoagulation.The CT scan of the brain revealed the presence of blood in both occipital horns and communicating hydrocephalus. The symptoms gradually resolved after tumor removal and there was no need for shunting.This is a complex clinical presentation of a spinal cord tumor associated hemorrhage, which further illustrates the possibility of retrograde passage of blood from the lumbosacral region to the ventricles. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3322034 Tue, 02 Mar 2010 17:56:25 +0100 3322034 http://www.medworm.com/index.php?rid=3322033&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003084%2Fabstract%3Frss%3Dyes We report on a 55-year-old male that was admitted due to altered mental status. He had recent sinus drainage and polypectomy, craniotomy with drainage of brain abscess, and ventriculo-peritoneal shunt placement. On admission, imaging studies showed no evidence of shunt dysfunction but did reveal extensive white matter decreased attenuation. Microscopic examination of the first 10 daily cerebrospinal fluid (CSF) cultures revealed yeast. Flucytosine and liposomal amphotericin B were started and externalization of shunt was performed on day 3. On day 8, CSF culture from admission grew C. parapsilosis; fluconazole was added. On day 10, daily CSF still showed yeast and cultures consistently grew C. parapsilosis. Shunt was removed and bilateral ventriculostomy drains were inserted. CSF after pro... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3322033 Tue, 02 Mar 2010 17:56:25 +0100 3322033 http://www.medworm.com/index.php?rid=3322032&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002996%2Fabstract%3Frss%3Dyes Abstract: Genetic transmissible spongiform encephalopathies (TSEs) account for approximately 10–15% of overall human prion diseases worldwide, but genotype–phenotype correlations remain incomplete. Here we report the case of an 80-year-old man who developed rapidly progressive behavioral abnormalities and myoclonus following a stroke. Repeated electroencephalography (EEG) revealed a general slowing of the basic activity, as well as several episodes of triphasic waves, with neither periodic activity nor recorded seizure. 14.3.3 protein was detected in cerebral cerebrospinal fluid, and direct sequencing of the PRNP gene showed an E196K mutation associated with homozygosity for methionine at codon 129. The patient was diagnosed with probable genetic prion disease with a Creutzfeldt-Jakob ... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3322032 Tue, 02 Mar 2010 17:56:25 +0100 3322032 http://www.medworm.com/index.php?rid=3322031&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003205%2Fabstract%3Frss%3Dyes Conclusion: Low field iMRI is a helpful tool in modern neurosurgery and facilitates brain tumor resection to a maximum safe extent. Its use translates into a better prognosis for these patients with devastating tumors. Future studies covering the use of iMRI will need to be conducted in a prospective, randomized fashion to prove the true benefit of iMRI in glioma surgery. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3322031 Tue, 02 Mar 2010 17:56:25 +0100 3322031 http://www.medworm.com/index.php?rid=3322030&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003163%2Fabstract%3Frss%3Dyes Abstract: Objectives: To describe clinical, radiological findings, and outcome in a multiethnic population of stroke survivors with basilar artery occlusive disease (BAOC).Methods: Forty patients with infarcts in the basilar artery (BA) territory, alive 30 days after the ictus, participated in the study. BA stenosis (>50%) or occlusion was shown by magnetic resonance or digital subtraction angiography in all patients. Demographical, clinical and radiological characteristics were described. Modified Rankin Scale (MRS) scores at 30 days and 6 months after the ischemic event were evaluated. Association between demographical, clinical, radiological features and outcome were analyzed with Chi-square and Fisher's exact tests. MRS scores at 30 days and 6 months were compared with the Wilcoxon tes... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3322030 Tue, 02 Mar 2010 17:56:25 +0100 3322030 http://www.medworm.com/index.php?rid=3322029&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS030384670900314X%2Fabstract%3Frss%3Dyes Conclusions: This study showed that action slowing of MS patient is mainly related to (1) attentional deficit resulting in inability to maintain high level of rapid actions, and (2) subtle motor slowing even in patients without motor deficit on clinical examination, whereas (3) divided attention and decisional process are preserved. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3322029 Tue, 02 Mar 2010 17:56:25 +0100 3322029 http://www.medworm.com/index.php?rid=3322028&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003138%2Fabstract%3Frss%3Dyes Abstract: Objective: To evaluate the contribution of DWI and DTI to the differential diagnosis of cerebral ring enhancing lesions by describing DWI and ADC (apparent diffusion coefficient) findings and measuring the two DTI parameters mean diffusivity (MD) and fractional anisotropy (FA).Materials and methods: A total of 17 patients presenting with 26 rim enhancing cysts were investigated with DWI and DTI. Parameter maps of the DTI metrics MD and FA were calculated and quantified using regions of interest (ROIs).Results: Five patients suffered from abscesses with a total of 10 cysts, 9 from glioblastomas with 10 cysts, and 3 from metastases with 6 cysts. All abscess cavities showed hyperintense DWI signal intensity compared to normal appearing white matter (NAWM), low ADC, low MD and high F... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3322028 Tue, 02 Mar 2010 17:56:24 +0100 3322028 http://www.medworm.com/index.php?rid=3322027&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003126%2Fabstract%3Frss%3Dyes Conclusions: These results, although based on a small sample, suggest that STN DBS, in addition to the effect to the mobility, might also favorably regulate sweat in idiopathic PD. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3322027 Tue, 02 Mar 2010 17:56:24 +0100 3322027 http://www.medworm.com/index.php?rid=3322026&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003096%2Fabstract%3Frss%3Dyes Conclusion: Isolated degeneration of the posterior column is a rare condition with a clinically benign course without progression involving other systems and characteristic electrophysiologic findings (isolated loss of cortical tibial-SEP with normal lumbar leads). Pes cavus deformity seems to be an unusual but typical clinical feature. The etiology is most likely a sporadic degenerative disease of the cord. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3322026 Tue, 02 Mar 2010 17:56:24 +0100 3322026 http://www.medworm.com/index.php?rid=3322025&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003072%2Fabstract%3Frss%3Dyes Conclusion: High-resolution 3D-sequences like trueFISP increase the detection rate of pineal cysts to levels reported in autoptic series while decreasing the diagnostic uncertainty. Atypically configurated pineal cysts are frequently detected as an incidental finding. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3322025 Tue, 02 Mar 2010 17:56:24 +0100 3322025 http://www.medworm.com/index.php?rid=3322024&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003060%2Fabstract%3Frss%3Dyes Conclusion: This first study on the epidemiological and clinical features of Moyamoya disease in mainland China indicated an increasing incidence of Moyamoya disease with bimodal incidence distribution appearing more frequently in adults. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3322024 Tue, 02 Mar 2010 17:56:24 +0100 3322024 http://www.medworm.com/index.php?rid=3322023&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003059%2Fabstract%3Frss%3Dyes Abstract: In this case-control study, ELISA and Western blot with whole bacterial protein lysate were performed on serum and cerebrospinal fluid (CSF) of 15 controls and 15 patients. According to Griffin subtypes, 10 of our patients were in acute inflammatory demyelinating polyradiculoneuropathy (AIDP) group, 3 in acute motor axonal neuropathy (AMAN) group, and 2 in acute motor sensory axonal neuropathy (AMSAN) subtype. 86.6% of patients were positive for Helicobacter pylori (H. pylori) IgG. Serum anti-H. pylori IgG of patients and controls were significantly different. CSF anti-H. pylori IgG was significantly higher in patients than controls. In patients, the titer of anti-H. pylori IgG in serum was significantly higher than CSF, which may indicate extra-neural antibody synthesis. CSF IgG... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3322023 Tue, 02 Mar 2010 17:56:24 +0100 3322023 http://www.medworm.com/index.php?rid=3322022&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003102%2Fabstract%3Frss%3Dyes Conclusion: A variety of neurological complications were noted in military tuberculosis patients, tuberculous meningitis and cerebral tuberculomas being the most frequent complications. However, a majority of patients improved following antituberculous treatment. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3322022 Tue, 02 Mar 2010 17:56:21 +0100 3322022 http://www.medworm.com/index.php?rid=3322021&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003011%2Fabstract%3Frss%3Dyes Abstract: Objective: Many patients with brain metastases due to SCLC have a poor survival prognosis. The most common treatment is whole-brain radiotherapy (WBRT). This retrospective study compares short-course WBRT with 5×4Gy in 1 week to standard WBRT with 10×3Gy in 2 weeks.Methods: Forty-four SCLC patients receiving WBRT with 5×4Gy were compared to 102 patients receiving 10×3Gy for survival (OS) and local (intracerebral) control (LC). Seven further potential prognostic factors were investigated: age, gender, Karnofsky Performance Score (KPS), number of brain metastases, extracerebral metastases, interval from tumor diagnosis to WBRT, RPA (Recursive Partitioning Analysis) class.Results: After 5×4Gy, 12-month OS was 15%, versus 22% after 10×3Gy (p=0.69). On multivariate analysis, imp... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3322021 Tue, 02 Mar 2010 17:56:20 +0100 3322021 http://www.medworm.com/index.php?rid=3322020&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003448%2Fabstract%3Frss%3Dyes Abstract: The primary treatment of meningiomas is surgery which can be curative if the tumor is completely removed. For parasagittal, lateral sphenoid wing and olfactory groove meningiomas, gross-total resection should be the goal. Tuberculum and diaphragma sella meningiomas can be resected through the subfrontal or the pterional approaches. In meningiomas of the sphenoid wing with osseous involvement or involvement of the cavernous sinus subtotal resection can be achieved via several surgical approaches. Similarly, subtotal resection rather than gross-total resection of meningiomas of the petroclival, parasellar, and posterior fossa regions can preserve neurological function. Prior to surgery, embolization may reduce intraoperative bleeding and prevent postoperative complications. Stereot... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3322020 Tue, 02 Mar 2010 17:56:20 +0100 3322020 http://www.medworm.com/index.php?rid=3322019&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846710000478%2Fabstract%3Frss%3Dyes (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3322019 Tue, 02 Mar 2010 17:56:20 +0100 3322019 http://www.medworm.com/index.php?rid=3193482&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002777%2Fabstract%3Frss%3Dyes Concerning our paper “Mutations in the NKX2-5 gene in patients with stroke and patent foramen ovale” that has been recently published in Clinical Neurology and Neurosurgery, [2009 September;111(7)574–8], we want to shed light on some aspects of the nomenclature of the mutations employed. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193482 Thu, 21 Jan 2010 16:36:26 +0100 3193482 http://www.medworm.com/index.php?rid=3193481&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS030384670900300X%2Fabstract%3Frss%3Dyes Abstract: Involvement of the nervous system is not uncommon in patients with multiple myeloma, with polyneuropathy and myelopathy predominating. Intracranial involvement producing neurological symptoms, however, is distinctly uncommon. Massive intraparenchymal hemorrhage from a previously unrecognized intracranial plasmacytoma is exceedingly rare. The authors report the case of a 57-year-old male who presented with sudden onset of severe headache, rapid onset of right-sided weakness and deterioration in level of consciousness while at work. Two years earlier the patient had completed treatment for multiple myeloma and was considered to be in remission, with a recent bone marrow biopsy that was negative, and complete normalization of serum protein electrophoresis. Imaging studies revealed a... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193481 Thu, 21 Jan 2010 16:36:25 +0100 3193481 http://www.medworm.com/index.php?rid=3193480&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002960%2Fabstract%3Frss%3Dyes We reported one case with venous hypertension presenting with severe neurological symptoms. The case had quick clinical recovery after correction of venous hypertension by endovascular angioplasty and stent placement in occluded lateral sinuses. Accordingly, we propose this method can be an ideal treatment option either in single or staged therapy of venous hypertension related to DAVFs and VST. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193480 Thu, 21 Jan 2010 16:36:25 +0100 3193480 http://www.medworm.com/index.php?rid=3193479&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002935%2Fabstract%3Frss%3Dyes Abstract: A 52-year-old man suffered sudden anterograde and retrograde amnesia without any focal neurological deficit. Assessment using Wechsler Memory Scale-Revised test revealed significant memory impairment with a marked decline of delayed recall and preserved attention and concentration. Wechsler Adult Intelligent Scale-Third Edition indicated poor intelligent quotients. MRI revealed a small infarction at the anterior column of the left fornix. His memory loss persisted for more than 3 months with only slight improvement. This rare case indicates that isolated damage to the anterior column of the unilateral fornix is sufficient to cause significant memory disturbance, and that cerebral infarction should be considered in the differential diagnosis of a patient presenting with amnesia as... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193479 Thu, 21 Jan 2010 16:36:25 +0100 3193479 http://www.medworm.com/index.php?rid=3193478&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002698%2Fabstract%3Frss%3Dyes We report two patients with severe cardiac manifestations at the time of the initial presentation of polymyositis. Both cases are unusual in that they presented with predominant cardiac disturbances, associated with muscle weakness. One patient had a typical clinical syndrome of congestive heart failure, and the second mimicked an acute myocardial infarction in which coronary angiography was normal. From our cases, we can emphasize that aside from characteristic symmetrical proximal muscle weakness, the clinical features of polymyositis may also include cardiac complications. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193478 Thu, 21 Jan 2010 16:36:25 +0100 3193478 http://www.medworm.com/index.php?rid=3193477&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002686%2Fabstract%3Frss%3Dyes We report two children who had cryptococcal meningitis and associated increased intracranial pressure, and were treated with an Ommaya reservoir. Both patients experienced rapid reversal of symptoms. At the time of discharge both patients had recovered and have remained asymptomatic. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193477 Thu, 21 Jan 2010 16:36:25 +0100 3193477 http://www.medworm.com/index.php?rid=3193476&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002674%2Fabstract%3Frss%3Dyes We describe a 34-year-old PML patient with incomplete Heerfordt syndrome, a rare type of sarcoidosis, who had not received any immunosuppressants, including steroids, at the onset and who was clinically and radiologically responsive to the antiviral drug cidofovir. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193476 Thu, 21 Jan 2010 16:36:25 +0100 3193476 http://www.medworm.com/index.php?rid=3193475&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002637%2Fabstract%3Frss%3Dyes Abstract: Myoclonus–dystonia (M–D) is characterized by early onset myoclonus and dystonia. It is thought to be subcortical in origin. Response to oral medications may be incomplete, such that deep brain stimulation (DBS) surgery to the globus pallidum interna (GPi) or ventral intermediate thalamic nucleus (VIM) may be considered. The optimal site is not known. The physiology and surgical response for a 63-year-old woman who underwent GPi DBS for M–D with onset at age 2 and related to a mutation in the epsilon-sarcoglycan gene (SGCE) is described. She showed excellent clinical and neurophysiological improvement of both myoclonus and dystonia, suggesting that modulation by DBS is effective even after long disease duration and only partial response to oral medications. (Source: Clinical... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193475 Thu, 21 Jan 2010 16:36:25 +0100 3193475 http://www.medworm.com/index.php?rid=3193474&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003047%2Fabstract%3Frss%3Dyes Conclusion: The results of the present series support the usefulness of the neurovascular coverage and retraction with collagen films and cigarettes, respectively. It seems to be a good alternative to surgical cotton patties and other materials owing to its hemostatic, protection, retraction, and dissection capacity. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193474 Thu, 21 Jan 2010 16:36:25 +0100 3193474 http://www.medworm.com/index.php?rid=3193473&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003035%2Fabstract%3Frss%3Dyes Conclusions: DBS of the unilateral right nucleus accumbens showed encouraging results in patients with treatment-resistant OCD. Five out of ten patients reached at least a partial response after the first year. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193473 Thu, 21 Jan 2010 16:36:25 +0100 3193473 http://www.medworm.com/index.php?rid=3193472&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003023%2Fabstract%3Frss%3Dyes Conclusions: The pattern of normal VEP and abnormal MEP, SEP, ABR is a clinically useful electrophysiological feature for the diagnosis. BST techniques are helpful to detect, functionally, intracranial corticospinal tract involvement, probably demyelination, in pure AMN patients. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193472 Thu, 21 Jan 2010 16:36:24 +0100 3193472 http://www.medworm.com/index.php?rid=3193471&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002972%2Fabstract%3Frss%3Dyes Conclusions: Our study suggests that cognitive functioning (in particular on sustained attention and aspects of executive function) must be considered in a comprehensive account of the factors contributing to successful coping in MS patients. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193471 Thu, 21 Jan 2010 16:36:24 +0100 3193471 http://www.medworm.com/index.php?rid=3193470&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002959%2Fabstract%3Frss%3Dyes Abstract: Objective: This is a descriptive study of patients who underwent invasive video-EEG monitoring (IVEM) at Ghent University Hospital. The aim of the study is to identify predictive factors for outcome of IVEM and resective surgery (RS). These factors may optimize the patient flow following the non-invasive presurgical evaluation towards IVEM and RS or other treatments.Patients and methods: Over the past 16 years, 68/710 refractory epilepsy patients included in the presurgical evaluation protocol (M/F 41/27, mean age 33 years) underwent IVEM at Ghent University Hospital. Patient features and follow-up data were collected from the patients’ medical files and the electronic patient database at the neurology and neurosurgery department. Predictive factors for IVEM outcome were identi... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193470 Thu, 21 Jan 2010 16:36:24 +0100 3193470 http://www.medworm.com/index.php?rid=3193469&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002753%2Fabstract%3Frss%3Dyes Conclusion: After accurate presurgical evaluation using invasive recordings and functional brain mapping, epileptogenic cortical resection can give excellent results and few deficits in patients with perirolandic epilepsy. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193469 Thu, 21 Jan 2010 16:36:24 +0100 3193469 http://www.medworm.com/index.php?rid=3193468&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002662%2Fabstract%3Frss%3Dyes Conclusion: MLE has minimal long term clinical effect except for possibly allowing for lower DBS settings. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193468 Thu, 21 Jan 2010 16:36:24 +0100 3193468 http://www.medworm.com/index.php?rid=3193467&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002765%2Fabstract%3Frss%3Dyes Conclusion: Our study confirms that diagnosis of ALS is still a common clinical problem and shows the need of sensitive and specific diagnostic tests. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193467 Thu, 21 Jan 2010 16:36:24 +0100 3193467 http://www.medworm.com/index.php?rid=3193466&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002388%2Fabstract%3Frss%3Dyes In this study, our purpose was to examine whether HbA1c was independently associated with various types of cerebral vascular lesions in stroke patients.Methods: A consecutive series of acute ischemic stroke patients were included for this analysis from October, 2002, to March, 2006. HbA1c was examined on admission, and MR imaging was performed for analysis of large artery diseases (LADs) and small artery diseases (SADs). Symptomatic or asymptomatic LAD was diagnosed by MR angiography, and SAD was classified as leukoaraiosis, microbleeds, or old lacunar infarctions.Results: A total of 639 stroke patients were analyzed (diabetics, n=247; non-diabetics, n=392). There was no relationship between the level of HbA1c and any type of cerebrovascular lesion in the non-diabetic patients. In contrast... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193466 Thu, 21 Jan 2010 16:36:24 +0100 3193466 http://www.medworm.com/index.php?rid=3193465&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002984%2Fabstract%3Frss%3Dyes In this report, we review the clinical, radiographic, and histological findings of supratentorial neurenteric cysts. We discuss the differential diagnoses and surgical considerations in the management of these intriguing lesions. We also provide an extensive review of normal human embryogenesis and discuss putative mechanisms of embryopathogenesis of supratentorial neurenteric cysts. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193465 Thu, 21 Jan 2010 16:36:24 +0100 3193465 http://www.medworm.com/index.php?rid=3193464&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846710000193%2Fabstract%3Frss%3Dyes (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3193464 Thu, 21 Jan 2010 16:36:22 +0100 3193464 http://www.medworm.com/index.php?rid=3092505&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002364%2Fabstract%3Frss%3Dyes Abstract: Establishing the mechanism of ischemia in patients with cerebrovascular ischemia is important in determining prognosis as well as the therapeutic approach. Recurrent transient ischemic attacks in a patient with accessory middle cerebral artery described by Gao et al. pose important questions. The underlying mechanisms responsible for cerebral ischemia remain unclear. I propose some of the possible methods to elucidate the pathogenic mechanisms for optimization of treatment and secondary prevention. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092505 Wed, 16 Dec 2009 16:10:22 +0100 3092505 http://www.medworm.com/index.php?rid=3092504&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002741%2Fabstract%3Frss%3Dyes We report on a patient who presented with complete ophthalmoplegia as a first symptom of fatal invasive aspergillosis.Case report: We present the clinical course of an immunocompromised 68-year-old man with unclear painless loss of vision, ptosis and ophthalmoplegia of the right eye lasting for 10 days which was referred from an ophthalmological outpatient clinic. He had a history of kidney transplantation after renal failure, diabetes mellitus II, and coronary heart disease. He was on immunsuppressive therapy with tacrolimus, mycophenolate and prednisolone since renal transplantation. The initial cranial magnetic resonance imaging (MRI) was unremarkable. The additional thin section computed tomography (CT) of the paranasal sinuses was suspicious for bone erosion of the superior wall of th... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092504 Wed, 16 Dec 2009 16:10:21 +0100 3092504 http://www.medworm.com/index.php?rid=3092503&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002625%2Fabstract%3Frss%3Dyes We describe a unique case of SS in a 67-year-old man with an 8-year history of episodic encephalopathy associated with headache and vomiting. The patient also had a history of progressive dementia, ataxia, and myelopathy. A diagnosis of superficial siderosis was made after magnetic resonance gradient-echo images showed diffuse hemosiderin staining over the cerebellum and cerebral convexities. No intracerebral source of hemorrhage was identified. The patient therefore underwent gadolinium-enhanced spinal MRI which suggested a possible vascular malformation. A therapeutic laminectomy subsequently confirmed an arteriovenous fistula which was resected. In SS, there are often long delays between symptom onset and definitive diagnosis. Early identification is facilitated by magnetic resonance im... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092503 Wed, 16 Dec 2009 16:10:21 +0100 3092503 http://www.medworm.com/index.php?rid=3092502&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002571%2Fabstract%3Frss%3Dyes We describe a patient with an unusual form of focal task-specific orofacial dystonia, manifested by asynchronous twitching of the right and left lower hemiface upon closure of the mouth and pursing of the lips. Injection of BTX produced complete resolution of task-specific dystonia for 4.5 months. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092502 Wed, 16 Dec 2009 16:10:21 +0100 3092502 http://www.medworm.com/index.php?rid=3092501&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS030384670900256X%2Fabstract%3Frss%3Dyes We describe a case of unilateral Moyamoya syndrome in a patient with well-controlled HIV infection. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092501 Wed, 16 Dec 2009 16:10:21 +0100 3092501 http://www.medworm.com/index.php?rid=3092500&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002418%2Fabstract%3Frss%3Dyes We describe here two cases of sexsomnia that took place in adult women whose personal history was remarkable for traumatic sexual psychological stress during childhood. In addition, the first patient had a medical history of alcoholism during adolescence and current sleepwalking. In the second patient, drug consumption was reported during adolescence, and psychiatric assessment found a major depressive disorder. Neurological examination was normal for both patients. The sexual behaviour was reported by the bed partner because of total amnesia of the event by the patients. Events included moaning, vocalizations with dirty talk, masturbation, sexual assault, and sexual intercourse. The behaviour was harmful for the bed partner in the second case. For both patients, electroencephalogram and b... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092500 Wed, 16 Dec 2009 16:10:21 +0100 3092500 http://www.medworm.com/index.php?rid=3092499&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002406%2Fabstract%3Frss%3Dyes We report two patients with isolated trochlear nerve palsy due to circumscribed dorsal midbrain strokes, one from infarction and the other from hemorrhage, which are located in the region of the trochlear nucleus or adjacent fascicle. Focal brain stem stroke should be considered as a rare cause of trochlear palsy even though there are no associated neurological deficits. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092499 Wed, 16 Dec 2009 16:10:21 +0100 3092499 http://www.medworm.com/index.php?rid=3092498&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002376%2Fabstract%3Frss%3Dyes Abstract: Granulocyte colony stimulating factor (GCSF) may boost physiological stem cell repair system in patients with cerebral lesions. Atypical parkinsonisms (PSP, CBD, MSA) are characterized by rapidly progressive course without significant benefit from current therapies.We treated 11 patients with atypical parkinsonism (MSA n=4, PSP n=5, CBD n=2) with GCSF (5mcg/kg s.c. daily for 6 days/month) for 3 months.We assessed CBC, CD34+ cells, routine biochemical and coagulation tests, UPDRS motor scores and safety.We did not observe significant adverse events during and following GCSF treatment. One patient withdrew informed consent. Three patients complained about bone pain that improved following steroid treatment. Four patients perceived a subjective benefit after treatment was completed.... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092498 Wed, 16 Dec 2009 16:10:21 +0100 3092498 http://www.medworm.com/index.php?rid=3092497&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002352%2Fabstract%3Frss%3Dyes We report two cases of superficial siderosis (SS) of the central nervous system (CNS), which is caused by chronic haemorrhaging into the subarachnoid space with haemosiderin deposition in the superficial portion of the CNS. Patient 1 had fluid collection in the spinal canal, which was reported as the source of the chronic bleeding. Patient 2 was bleeding from thickened dura at the level of the sacral vertebrae. Both of the patients had xanthochromic cerebrospinal fluid. We surgically repaired the sources of bleeding. Subsequently the cerebrospinal fluid (CSF) cleared and their symptoms were not aggravated for about 1 year. We measured several CSF markers of SS before and after surgery. Total tau protein (CSF-t-tau), phosphorylated tau protein (CSF-p-tau), iron (CSF-iron) and ferritin (CSF-... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092497 Wed, 16 Dec 2009 16:10:20 +0100 3092497 http://www.medworm.com/index.php?rid=3092496&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002303%2Fabstract%3Frss%3Dyes Abstract: Multiple system atrophy (MSA) and multiple sclerosis (MS) are progressive neurological disorders with overlapping clinical signs and symptoms. However, due to the course of the disease and the age of onset both disorders are rarely differential diagnosis for each other. We here report the remarkable association of the two diseases in one patient. As MSA dominated the clinical presentation, diagnosis and therapy of MS were delayed. We discuss the clinical symptoms in our patient and highlight the features that allow to differentiate both diseases. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092496 Wed, 16 Dec 2009 16:10:20 +0100 3092496 http://www.medworm.com/index.php?rid=3092495&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002716%2Fabstract%3Frss%3Dyes Conclusions: Despite implementation of a quality-improvement program neuroradiologists frequently identified major discrepancies and recommended additional investigations in this DGH neuroimaging service. Future research should identify interventions which are more effective in improving neuroimaging reports in DGHs. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092495 Wed, 16 Dec 2009 16:10:20 +0100 3092495 http://www.medworm.com/index.php?rid=3092494&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002704%2Fabstract%3Frss%3Dyes Conclusions: CT-MR fusion images helped to reprogram stimulation parameters with ease and confidence in a time-saving manner and resulted in further clinical improvement. This method could complement the conventional method of adjusting stimulation parameters after bilateral STN-DBS. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092494 Wed, 16 Dec 2009 16:10:20 +0100 3092494 http://www.medworm.com/index.php?rid=3092493&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002650%2Fabstract%3Frss%3Dyes Conclusion: Our data indicate that recurrent craniofacial meningiomas can usually be managed by using a lateral cranial base approach. Whereas it would be expected that a radical resection may prevent further recurrence with an acceptable quality of life, a long-term follow-up would be required for confirming the benefit of this treatment strategy. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092493 Wed, 16 Dec 2009 16:10:20 +0100 3092493 http://www.medworm.com/index.php?rid=3092492&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002649%2Fabstract%3Frss%3Dyes Conclusion: The present surgical strategy based on preoperative BTO provides a reliable tool to achieve acceptable clinical and hemodynamic outcomes in patients with complex ICA aneurysms to be treated by parent artery occlusion. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092492 Wed, 16 Dec 2009 16:10:20 +0100 3092492 http://www.medworm.com/index.php?rid=3092491&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002583%2Fabstract%3Frss%3Dyes Conclusion: This suggests that modafinil may be useful, particularly when MS fatigue is associated with sleepiness. The relationship between fatigue and excessive daytime sleepiness is poorly understood and needs to be better defined before appropriate measures of the most clinically relevant outcomes can be selected for clinical trials. Outcome measures used in previous clinical trials have not properly evaluated the effects of modafinil. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092491 Wed, 16 Dec 2009 16:10:20 +0100 3092491 http://www.medworm.com/index.php?rid=3092490&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002558%2Fabstract%3Frss%3Dyes Conclusion: Despite all the advances in imaging techniques and therapeutic methods, central nervous system hydatidosis remains difficult to cure and patient outcomes are not satisfactory especially in case of spinal involvement due to the high incidence of recurrence. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092490 Wed, 16 Dec 2009 16:10:20 +0100 3092490 http://www.medworm.com/index.php?rid=3092489&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS030384670900239X%2Fabstract%3Frss%3Dyes Conclusions: The endoscopic procedures carried a high success rate in the management of intra-ventricular lesions, and were especially valuable in patients harboring chemo and/or radiosensitive deep seated tumors. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092489 Wed, 16 Dec 2009 16:10:19 +0100 3092489 http://www.medworm.com/index.php?rid=3092488&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002340%2Fabstract%3Frss%3Dyes Abstract: Objective: Hydrocephalus due to neurocysticercosis usually shows poor prognosis and shunt failure is a common complication. Neuroendoscopy has been suggested as treatment, but the indications remain unclear.Methods: A cohort of patients with clinical/radiological diagnosis of hydrocephalus due to NCC, treated between January 2002 and September 2006, were the subjects of the study. We excluded patients with tumors or those in whom diagnosis was not confirmed (histology/positive ELISA in CSF). Neuroendoscopy was offered as the first line of treatment. Shunt failure rate and Karnofsky index at 12 months were assessed.Results: Eighty-six patients (47 male) with a median age of 38 (9–79) were included in the study. Of them, 36.1% had a shunt before endoscopy and 97.7% had a Karnofsk... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092488 Wed, 16 Dec 2009 16:10:19 +0100 3092488 http://www.medworm.com/index.php?rid=3092487&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS030384670900273X%2Fabstract%3Frss%3Dyes Abstract: There is increasing evidence suggesting that epilepsy and its treatment can affect bone mineralization and calcium metabolism. Many studies have shown a significant reduction in bone mineral density in patients treated with classic (phenobarbital, carbamazepine, valproate, etc.) and with new (oxcarbazepine, gabapentin) antiepileptic drugs. In spite of data about the possible effects of the antiepileptic drugs on calcium metabolism, the mechanisms of this important side effect remain to be defined. The abnormalities of calcium metabolism were thought to result from the cytochrome P450 enzyme-inducing properties of some antiepileptic drugs and the resultant reduction in vitamin D levels, but the effect of many medications (e.g., valproate) cannot be readily explained by vitamin D m... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092487 Wed, 16 Dec 2009 16:10:19 +0100 3092487 http://www.medworm.com/index.php?rid=3092486&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709003333%2Fabstract%3Frss%3Dyes (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=3092486 Wed, 16 Dec 2009 16:10:17 +0100 3092486 http://www.medworm.com/index.php?rid=2958673&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002066%2Fabstract%3Frss%3Dyes Abstract: The pyramidal signs in the lower extremity can be divided into three groups: (1) Babinski's group characterised by dorsoflexion of the great toe, (2) pyramidal signs marked by plantar flexion of the toes (e.g. Rossolimo's sign), and (3) synkinetic movements such as Strümpell's phenomenon. Puusepp's sign described by the Estonian neurologist and neurosurgeon Ludvig Puusepp belongs to none of these three groups. Its eliciting does not differ from that of Babinski's sign. The response, however, is different and consists of a tonic slow abduction of the little toe. We showed its relevance on the basis of clinical examination of six patients: four females aged 29, 50, 43 and 57 years and two males aged 42 and 49 years. The diagnoses were as follows: a new relapse of multiple sclerosi... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958673 Wed, 04 Nov 2009 16:46:57 +0100 2958673 http://www.medworm.com/index.php?rid=2958672&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001905%2Fabstract%3Frss%3Dyes We report a 13-year-old-girl, who was referred for progressive gait difficulty that had begun 20 days before with in addition paresthesiae in the feet. Clinical examination revealed a spastic paraparesis, with bilateral Babinski sign, a global and sensory loss at T9–T10 level, and percussion of the spinal processes of D6 elicited pain. MRI of the spine revealed a cystic lesion involving the T4 and T5 vertebras on the left, with one process extending into the extradural space compressing the spinal cord () and many further other cystic lesions in the liver (stage III). Chest X-ray showed posterior and left mediastinal opacity with calcifications. Ultrasound of the abdomen confirmed the polycystic images in the liver. The indirect immunofluorescent antibody test for hydatid disease was neg... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958672 Wed, 04 Nov 2009 16:46:56 +0100 2958672 http://www.medworm.com/index.php?rid=2958671&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002273%2Fabstract%3Frss%3Dyes Abstract: The pathogenesis and genetics of moyamoya disease (MMD) remain a mystery. Here we report a case of female Caucasian adult twins with similar presentations of bilateral MMD that were treated with different surgical modalities. One twin was treated with a bypass and remains event free (defined as either transient ischemic event or stroke) at her 4-year follow-up. The second twin underwent angioplasty to treat a left middle cerebral artery stenosis as well as the placement of a Wingspan stent to treat a right supraclinoid ICA stenosis on separate occasions. The left middle cerebral artery angioplasty thrombosed due to the discontinuation of clopidogrel resulting in recurrent symptoms, principally aphasia, and the Wingspan stent underwent angioplasty for in-stent stenosis. Despite th... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958671 Wed, 04 Nov 2009 16:46:56 +0100 2958671 http://www.medworm.com/index.php?rid=2958670&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002261%2Fabstract%3Frss%3Dyes In this study, we present two cases of primary intracranial leiomyomas in middle-aged men. Magnetic resonance images (MRI) showed lesions with homogeneous low signals on T1-, T2-, diffusion-weighted, and FLAIR sequences. Tumors were totally removed and there was no evidence of recurrence in the follow-up study. Pathological analysis with immunohistochemistry revealed that tumors had characteristics of benign smooth muscles. A review of relevant literature has been conducted. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958670 Wed, 04 Nov 2009 16:46:56 +0100 2958670 http://www.medworm.com/index.php?rid=2958669&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS030384670900211X%2Fabstract%3Frss%3Dyes We report a case of MPA with multiple bilateral non-hemorrhagic cerebral infarctions in a 66-year-old woman who was undergoing steroid pulse therapy. The diagnosis of MPA was based on the presence of painful mononeuritis multiplex, pulmonary fibrosis, and increased myeloperoxidase activity and on the biopsy of the sural nerve. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958669 Wed, 04 Nov 2009 16:46:56 +0100 2958669 http://www.medworm.com/index.php?rid=2958668&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002108%2Fabstract%3Frss%3Dyes Abstract: A case of pseudohypoxic brain swelling, a newly defined entity, is described. The patient experienced generalized seizures and did not awake initially after a seemingly uneventful elective craniotomy for clipping of an unruptured anterior communicating artery aneurysm. Neuroimaging findings demonstrated diffuse brain swelling, especially in the bilateral basal ganglia and thalami. The rarity of this postoperative complication is addressed and the pathogenesis discussed. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958668 Wed, 04 Nov 2009 16:46:56 +0100 2958668 http://www.medworm.com/index.php?rid=2958667&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002091%2Fabstract%3Frss%3Dyes This report raises the fact that a patient with RMD may present with multiple complex rhythmic movements disrupting sleep, which emphasizes that better understanding of the clinical features of complex rhythmic movements during sleep in primary care settings is essential for early clinical diagnosis and optimal management. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958667 Wed, 04 Nov 2009 16:46:56 +0100 2958667 http://www.medworm.com/index.php?rid=2958666&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS030384670900208X%2Fabstract%3Frss%3Dyes We report on two cases of frontal epidural hematoma revealed by an exophthalmia after a minor head trauma. On reporting our cases we aim to increase the awareness of this association each time a head or facial trauma is associated with exophthalmia. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958666 Wed, 04 Nov 2009 16:46:56 +0100 2958666 http://www.medworm.com/index.php?rid=2958665&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002054%2Fabstract%3Frss%3Dyes We report a 48-year-old patient with neuro-Behcet's disease who presented with the combination of severe memory impairment and frontal/executive dysfunction. The clinical feature mimicked that of diencephalic amnesic syndrome. The MRI and SPECT findings supported the notion that the thalamus and related subcortical–frontal connection was responsible for this patient's problem. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958665 Wed, 04 Nov 2009 16:46:56 +0100 2958665 http://www.medworm.com/index.php?rid=2958664&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002042%2Fabstract%3Frss%3Dyes Abstract: Neglect is the failure to report, respond, or orient to novel or meaningful stimuli presented to the side opposite a brain lesion. Here we describe the case of a 73-year-old woman who experienced a writing deficit in the right-sided component of Kanji letters (morphograms) of the Japanese language. Magnetic resonance imaging of the brain showed an infarction in the left middle temporal and occipital gyrus. The patient wrote recognizable, well-formed but paragraphic Kanji letters in both spontaneous and dictated writing. Most letters are composed of two elements: “hen” (left) and “tsukuri” (right). Neographism in tsukuri was her most frequent error. When she was instructed to answer orally hen and tsukuri, she made more mistakes related to tsukuri than to hen. Unilateral s... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958664 Wed, 04 Nov 2009 16:46:56 +0100 2958664 http://www.medworm.com/index.php?rid=2958663&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001875%2Fabstract%3Frss%3Dyes Conclusion: To the best of our knowledge, this is the first report of ziprasidone-related OGC in an adult patient. Physicians must be aware of its occurrence in order to improve care of patients treated with these agents. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958663 Wed, 04 Nov 2009 16:46:56 +0100 2958663 http://www.medworm.com/index.php?rid=2958662&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS030384670900184X%2Fabstract%3Frss%3Dyes Abstract: Objective of the present study was to evaluate the possible pathophysiology and clinical characteristics of dystonia in patients with the 18p deletion syndrome by describing a new case and reviewing the literature. Dystonia in patients with the 18p deletion syndrome seems to present heterogeneously with a variable age of onset and distribution of symptoms. It may be accompanied with white matter lesions on the MRI. Deletion of 2 known dystonia loci on chromosome 18p, DYT7 and DYT15, or the deletion of another dystonia gene just above the centromere of chromosome 18p may be the cause of dystonia in patients with the 18p deletion syndrome. However, dystonia may also be secondary to structural brain changes often seen in patients with the 18p deletion syndrome. (Source: Clinical Neu... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958662 Wed, 04 Nov 2009 16:46:56 +0100 2958662 http://www.medworm.com/index.php?rid=2958661&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001772%2Fabstract%3Frss%3Dyes Abstract: Behçet's disease is a multisystem inflammatory disorder that presents with a classic triad of recurrent oral and genital ulcerations and uveitis with hypopyon. The initial symptom of Behçet's disease is neurological in only 3% of cases. Although Neuro-Behçet's Syndrome commonly presents with focal neurological symptoms, it is possible that psychiatric symptoms could be the first manifestation of the disease. To our knowledge, this is the first case report of Neuro-Behçet's Syndrome that presents with an acute psychotic attack. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958661 Wed, 04 Nov 2009 16:46:56 +0100 2958661 http://www.medworm.com/index.php?rid=2958660&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001735%2Fabstract%3Frss%3Dyes We report a case of acute-onset dropped head syndrome in a 65-year-old patient in whom the diagnosis of amyotrophic lateral sclerosis (ALS) was initially proposed based on electromyographic signs of neck and shoulder muscle denervation. There were no signs of pyramidal involvement and the clinical and electromyographic signs of motor denervation never evolved beyond the neck and shoulder girdle muscles after a 6-year follow-up period, which argued against ALS. Other causes of dropped head syndrome were carefully ruled out based on clinical findings, electrodiagnostic studies and blood investigations. The restriction of muscle denervation to a few cervical myotomes, the presence of C3–C4 spondylotic changes without associated root or spinal cord compression, and the absence of an alternat... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958660 Wed, 04 Nov 2009 16:46:55 +0100 2958660 http://www.medworm.com/index.php?rid=2958659&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001760%2Fabstract%3Frss%3Dyes Abstract: The management of a ruptured pseudoaneurysm of intracranial vertebral artery (VA), which is the sole supplier to an isolated vertebrobasilar system, is challenging. The authors report on such a case in a 49-year-old man who suffered a grade III subarachnoid hemorrhage (SAH) caused by a dissecting fusiform pseudoaneurysm of the left VA. The right VA terminated in the posterior inferior cerebellar artery and posterior communicating arteries were absent. The patient developed symptoms consistent with vasospasm on day 9 after SAH, which was treated by intra-arterial vasolytic therapy, followed by stent placement and “in-stent” balloon angioplasty. Angiography 2 weeks later showed near-complete resolution of the pseudoaneurysm. At discharge, the patient's modified Rankin score was... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958659 Wed, 04 Nov 2009 16:46:55 +0100 2958659 http://www.medworm.com/index.php?rid=2958658&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001759%2Fabstract%3Frss%3Dyes Conclusion: Clinical and neuroradiological findings and the possible sensitivity to neuroleptics indicate dopaminergic impairment. Our case suggests that chronic toluene abuse causes presynaptic dopaminergic depletion. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958658 Wed, 04 Nov 2009 16:46:55 +0100 2958658 http://www.medworm.com/index.php?rid=2958657&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001747%2Fabstract%3Frss%3Dyes We report a case of stroke attributable to spontaneous calcific emboli from the aortic arch in which migration of the emboli was observed along the middle cerebral artery following iv tPA. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958657 Wed, 04 Nov 2009 16:46:55 +0100 2958657 http://www.medworm.com/index.php?rid=2958656&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001504%2Fabstract%3Frss%3Dyes Conclusion: Fractionated stereotactic radiosurgery is a feasible, safe, and effective modality for the treatment of ICSM and should be carefully considered in the management of this difficult to treat condition. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958656 Wed, 04 Nov 2009 16:46:55 +0100 2958656 http://www.medworm.com/index.php?rid=2958655&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002339%2Fabstract%3Frss%3Dyes Conclusion: Frontal lobe atrophy in ischemic stroke patients may be associated with small vessel disease. The association between WMLs and FLA was predominant over atrophy of the parietal and temporal lobes, which suggests that the frontal lobe may be vulnerable to subcortical ischemic changes. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958655 Wed, 04 Nov 2009 16:46:55 +0100 2958655 http://www.medworm.com/index.php?rid=2958654&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002327%2Fabstract%3Frss%3Dyes Abstract: Objective: Inflammatory endothelial activation mediated by intercellular adhesion molecule-1 (ICAM-1) plays a role in the pathogenesis of large- and small-vessel disease. We explored the association between soluble ICAM-1 (sICAM-1) and white matter lesion (WML) as a manifestation of cerebral small-vessel disease.Methods: One hundred and seventy-five elderly individuals aged ≥ 60 without neurological deficits were studied. Subcortical deep white matter hyperintensity (SDWMH) and periventricular hyperintensity (PVH) were rated separately. Lesions in each category were then divided into three groups (grade 0-I, grade II, grade III) according to the Fazekas scale.Results: Plasma sICAM-1 levels were positively associated with grades of WML (for SDWMH: 297.4±135.6ng/mL in grade 0-I,... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958654 Wed, 04 Nov 2009 16:46:55 +0100 2958654 http://www.medworm.com/index.php?rid=2958653&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002315%2Fabstract%3Frss%3Dyes Conclusion: ICG angiography can provide real-time information and guide revision in the same surgical procedure for the management of intracranial aneurysms. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958653 Wed, 04 Nov 2009 16:46:55 +0100 2958653 http://www.medworm.com/index.php?rid=2958652&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002285%2Fabstract%3Frss%3Dyes Conclusion: Stereotactic brain biopsy is a safe and reliable way to obtain a histological diagnosis. Based on our recent clinical experiences, the data suggests that more attention should be paid to liver cirrhotic patients, since the chance on hemorrhage is significantly larger. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958652 Wed, 04 Nov 2009 16:46:55 +0100 2958652 http://www.medworm.com/index.php?rid=2958651&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002297%2Fabstract%3Frss%3Dyes Conclusion: We suggest that a widespread brain involvement is present in patients with MSA-C and the decreased rCBF in the pons may support the differential diagnosis between MSA-C and LCCA. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958651 Wed, 04 Nov 2009 16:46:54 +0100 2958651 http://www.medworm.com/index.php?rid=2958650&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS030384670900225X%2Fabstract%3Frss%3Dyes Conclusion: The presence of CMB is an independent predictor of first-ever symptomatic cerebrovascular diseases. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958650 Wed, 04 Nov 2009 16:46:54 +0100 2958650 http://www.medworm.com/index.php?rid=2958649&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002212%2Fabstract%3Frss%3Dyes Conclusion: Adjacent-level ossification in cervical spine injuries may appear very early in the postoperative period and it can have a different course than in the degenerative disc disease population, at least in some patients. The first cephalad level adjacent to a fusion appears to be at greater risk. However, even when ALOD is evident radiographically, it very rarely produces any symptoms. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958649 Wed, 04 Nov 2009 16:46:54 +0100 2958649 http://www.medworm.com/index.php?rid=2958648&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002200%2Fabstract%3Frss%3Dyes Conclusion: PD is a moderately prevalent disease in Jordan. The clinical characteristics of PD patients are similar to those reported in other countries. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958648 Wed, 04 Nov 2009 16:46:54 +0100 2958648 http://www.medworm.com/index.php?rid=2958647&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002121%2Fabstract%3Frss%3Dyes Conclusion: Initial evidence suggests that 99mTc-TF could provide a non-invasive indicator of glioma proliferative activity. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958647 Wed, 04 Nov 2009 16:46:54 +0100 2958647 http://www.medworm.com/index.php?rid=2958646&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002078%2Fabstract%3Frss%3Dyes Conclusions: Treatment of vascular malformations is required in case of progression of symptoms. In cases of visual deterioration, we generally favour early treatment. The least invasive surgical approach, tailored to the individual patient, should be chosen. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958646 Wed, 04 Nov 2009 16:46:54 +0100 2958646 http://www.medworm.com/index.php?rid=2958645&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001917%2Fabstract%3Frss%3Dyes Conclusions: The pathological changes affect not only the central nerve fibers of the TNR, but also some of the peripheral axons, their myelin sheath and Schwann cells. These are signs of the retrograde ultrastructural and biochemical alterations, which could participate in the pathophysiological mechanism underlying the trigeminal neuralgia. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958645 Wed, 04 Nov 2009 16:46:54 +0100 2958645 http://www.medworm.com/index.php?rid=2958644&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001887%2Fabstract%3Frss%3Dyes We report here, for the first time, the case of a 41-year-old man with both Machado-Joseph disease (MJD)/spinocerebellar ataxia type 3 (SCA3) and myotonic dystrophy type 1. The patient noted dysarthria at 14 years of age and unsteady gait at 30 years of age. Similar sized expansions of the CAG trinucleotide repeats in one allele of the ataxin-3 (ATXN3) gene were found in both the patient and his father, although in the other allele the length of the CAG repeats was shorter in the father compared with the patient. In the dystrophia myotonica protein kinase (DMPK) gene the CTG repeats were much more expanded in the patient compared with his father. Thus it is possible that, in the farther, the short CAG repeat in the non-expanded ATXN3 allele delayed the onset of cerebellar symptoms, and/or ... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958644 Wed, 04 Nov 2009 16:46:54 +0100 2958644 http://www.medworm.com/index.php?rid=2958643&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS030384670900287X%2Fabstract%3Frss%3Dyes (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2958643 Wed, 04 Nov 2009 16:46:54 +0100 2958643 http://www.medworm.com/index.php?rid=2862216&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001826%2Fabstract%3Frss%3Dyes Mortality rates following acute basilar artery (BA) occlusion range between 50 and 95% . Recanalization of the BA with intra-arterial (IA) thrombolytic therapy has been shown to improve outcomes, particularly in selected patients treated within 24h of symptom onset . A number of features have been associated with poor outcome, including coma, tetraplegia and neuroimaging evidence of brainstem ischemia . We recently treated a patient who made an excellent recovery, despite the presence of all these prognostic features. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2862216 Mon, 05 Oct 2009 18:50:48 +0100 2862216 http://www.medworm.com/index.php?rid=2862215&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS030384670900170X%2Fabstract%3Frss%3Dyes Abstract: Cavernous malformations are vascular lesions which can occur throughout the entire neuraxis. This term is synonymous to cavernous angioma, cavernous haemangioma, and cavernoma. They comprise of closely packed, capillary-like vascular channels, without intervening neural tissue. MR imaging is currently the study of choice for the diagnosis of cavernous malformations as they are considered angiographically occult lesions. Intramedullary location represents only 3–5% of all central nervous system cavernous malformations, with the majority of them being supratentorial. Only 10% of the intramedullary cavernous malformations present in the paediatric population. As the natural history of these lesions is not well known, the debate on the optimal management of them is still ongoing. H... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2862215 Mon, 05 Oct 2009 18:50:48 +0100 2862215 http://www.medworm.com/index.php?rid=2862214&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS030384670900153X%2Fabstract%3Frss%3Dyes Abstract: Huge supratentorial ependymomas are rarely encountered tumors, even in the infant population. A recovery from complete hemiplegia following a tumor resection including the primary motor cortex was observed.A 5-month-old girl presented with a conjugate deviation to the right and a head circumference that had gradually expanded since birth. Magnetic resonance imaging (MRI) demonstrated a well-enhanced huge mass extending into the right hemisphere. A subtotal removal with the primary motor cortex was performed. However, a regrowth of the residual tumor was observed and, thereafter, the patient underwent a subsequent surgical intervention 5 months later. The histological findings demonstrated an ependymoma. Her motor function was dramatically improved after rehabilitation and no tumo... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2862214 Mon, 05 Oct 2009 18:50:48 +0100 2862214 http://www.medworm.com/index.php?rid=2862213&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001528%2Fabstract%3Frss%3Dyes Abstract: Neuroblastomas of the sellar region are exceedingly rare. Only 2 cases have previously been reported. Management of these tumours depends on the tumour's primary site, the patient's age and histopathological features. We are reporting the case of a 43-year-old woman who developed progressive bitemporal hemianopsia and visual loss, accompanied by amenorrhea and hyponatremia. Laboratory findings revealed a slightly elevated prolactin level. Cranial MR-imaging displayed an intrasellar and suprasellar lesion with a maximum diameter of 2.5cm that was suspicious for a pituitary adenoma or tuberculum sellae meningioma. The tumour was approached via a pterional trepanation. Intraoperatively, the tumour was highly vascularized and adhesive to the optic chiasm, the floor of the third ventr... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2862213 Mon, 05 Oct 2009 18:50:48 +0100 2862213 http://www.medworm.com/index.php?rid=2862212&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001498%2Fabstract%3Frss%3Dyes Abstract: Schwann cell tumors arising within the neuraxis and in an intraventricular location are an exceedingly rare tumor entity of the brain. The authors present the first case of a cellular intraventricular schwannoma occurring in the fourth ventricle. The pertinent literature is reviewed.A 71-year-old female was admitted to the hospital with an incidental finding of a ventricular tumor. Computed tomography scanning and magnetic resonance imaging revealed a solitary contrast enhancing exophytic mass lesion within the fourth ventricle. Microsurgical excision via a midline suboccipital craniotomy and tonsillo-nodular approach led to complete tumor removal. Subsequent histopathological examination confirmed the diagnosis of an unsuspected primary intraventricular cellular schwannoma.A uni... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2862212 Mon, 05 Oct 2009 18:50:48 +0100 2862212 http://www.medworm.com/index.php?rid=2862211&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001486%2Fabstract%3Frss%3Dyes We report a patient who presented with sudden onset instability and diplopia. On neurological examination he had asymmetrical asterixis, predominantly in the left hand, and ocular findings consistent with a pretectal syndrome. He was also unable to stand or even sit up unassisted, with a tendency to tilt his body and rotate his trunk axis to the left. Brain MRI showed a hemorrhage in the right thalamo-mesencephalic junction. This region involves important structures for the control of postural stability, motor control, ocular movements and vestibulo-ocular integration, not yet well understood. To our knowledge, this is the first reported case with the simultaneous combination of astasia, prectectal syndrome and asymmetrical asterixis. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2862211 Mon, 05 Oct 2009 18:50:48 +0100 2862211 http://www.medworm.com/index.php?rid=2862210&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001474%2Fabstract%3Frss%3Dyes We describe a 33-year-old man with cyclosporine encephalopathy who showed continuous jerking in the left upper limb due to epilepsia partialis continua. Jerk-locked back averaging (JLA) of magnetoencephalogram disclosed a spike preceding the jerk localized at the hand motor area, whereas JLA of electroencephalogram revealed no premyoclonus spikes. The paired-pulse motor cortical transcranial magnetic stimulation revealed motor cortical hyperexcitability, while the paired-pulse somatosensory evoked potential showed no sensory cortical hyperexcitability. The brain MRI showed a high intensity lesion localized at the hand sensory area. These results suggest that the jerks were produced by discharges at the motor cortex probably disinhibited by the sensory cortical lesion. (Source: Clinical Neu... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2862210 Mon, 05 Oct 2009 18:50:48 +0100 2862210 http://www.medworm.com/index.php?rid=2862209&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001371%2Fabstract%3Frss%3Dyes Conclusion: The present report underscores the anatomical variants of the PICA. Although uncommon, PICA aneurysms do occur and caretakers should be aware of this when treating patients with clinical signs or CT evidence of subarachnoid haemorrhage. Even extracranial PICA aneurysms can be encountered, either through a caudal loop or an early extracranial lateral medullary segment. We stress the use of four vessel angiography or CT angiography with thin cuts to rule out such aneurysms. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2862209 Mon, 05 Oct 2009 18:50:48 +0100 2862209 http://www.medworm.com/index.php?rid=2862208&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001899%2Fabstract%3Frss%3Dyes Abstract: Objective: The Tap Test (TT) is a commonly used method for predicting shunt responsiveness in patients with Normal Pressure Hydrocephalus (NPH). The present study investigates whether measures of upper extremity motor function are useful for assessing response to spinal fluid drainage.Methods: 42 subjects undergoing evaluations for idiopathic NPH (iNPH) participated in this study. A standardized gait evaluation, a neuropsychological battery, and objective tests of upper extremity motor functions were administered. A Neurologist skilled in NPH assessment independently rated patients as TT Responders (n=26) or Non-Responders (n=16) based on clinical impression of change 2–4h after 40–50cm3 drainage of spinal fluid by lumbar puncture (LP). In the subset of subjects who underwent... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2862208 Mon, 05 Oct 2009 18:50:48 +0100 2862208 http://www.medworm.com/index.php?rid=2862207&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001863%2Fabstract%3Frss%3Dyes Conclusion: Adjuvant TMZ chemotherapy provided a clinically relevant benefit of survival, as compared with NUBC. Thus, we suggest that adjuvant TMZ chemotherapy may be effective even for patients who did not receive concomitant chemoradiotherapy for GBM. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2862207 Mon, 05 Oct 2009 18:50:47 +0100 2862207 http://www.medworm.com/index.php?rid=2862206&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001851%2Fabstract%3Frss%3Dyes Conclusions: The low incidence of adverse reactions and low rate of treatment withdrawal observed in this study support the effectiveness and tolerability of RPN in the treatment of Parkinson's disease. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2862206 Mon, 05 Oct 2009 18:50:47 +0100 2862206 http://www.medworm.com/index.php?rid=2862205&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001838%2Fabstract%3Frss%3Dyes Conclusion: Our results suggest that females have a delayed onset of symptoms, possibly related to the gonadotropin profile of our population upon the nigrostriatal dopaminergic system. The effect of low educational level may be related to a delayed diagnosis, rather than a true delay of disease onset. This report suggests an influence of gender on the onset of Parkinson's disease. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2862205 Mon, 05 Oct 2009 18:50:47 +0100 2862205 http://www.medworm.com/index.php?rid=2862204&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001693%2Fabstract%3Frss%3Dyes Abstract: Objective: To investigate the impact of depressive symptoms on health-related quality of life (HR-QOL) in a group of patients with early Parkinson's disease (PD).Methods: A 20-item scale, the Center for Epidemiologic Studies Depression Scale (CESD) and a 36-item questionnaire, the medical outcomes study short form (SF-36) were administered as part of baseline assessment of a clinical trial in PD, enrolling 391 early-stage, l-dopa exposed PD patients in China. We used multiple regression models to examine the relationship of depressive symptoms, measured by the CESD with HR-QOL, as measured by the SF-36. The SF-36 score of the depressed patients was compared with those non-depressed, as well.Results: A total of 146 (37.3%) patients screened positive for depression. Compared with t... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2862204 Mon, 05 Oct 2009 18:50:47 +0100 2862204 http://www.medworm.com/index.php?rid=2862203&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001553%2Fabstract%3Frss%3Dyes Conclusion: There were no sex differences in functional outcome at 90 days after the stroke among patients treated with IV rtPA. This finding might confirm that thrombolytic therapy nullifies usual sex differences in stroke outcome and suggests that women with stroke may benefit more from rtPA treatment. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2862203 Mon, 05 Oct 2009 18:50:47 +0100 2862203 http://www.medworm.com/index.php?rid=2862202&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001516%2Fabstract%3Frss%3Dyes Abstract: There is evidence to support that oxidative stress is increased in Parkinson's disease (PD) and contributes to degeneration of dopaminergic neurons. Uric acid (UA), a natural antioxidant in blood and brain tissue, scavenging superoxide, peroxynitrite and hydroxyl radical, was found reduced in the serum of PD patients. In addition low plasma uric acid (UA) levels have been associated with an increased risk of PD.Objectives: The aim of our study was to investigate serum UA levels in PD patients compared with age-matched healthy controls and their possible relationship with several clinical parameters of PD and pharmaceutical treatment.Patients and methods: We measured serum UA levels in 43 PD patients and 47 healthy volunteers, age and sex-matched. UA levels were correlated with di... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2862202 Mon, 05 Oct 2009 18:50:47 +0100 2862202 http://www.medworm.com/index.php?rid=2862201&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001425%2Fabstract%3Frss%3Dyes Conclusion: CTV aided with MMBE is a robust technique for visualization of the intracranial venous circulation, removing bone effectively. CTV has high interobserver agreement for presence or absence of cerebral venous thrombosis. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2862201 Mon, 05 Oct 2009 18:50:47 +0100 2862201 http://www.medworm.com/index.php?rid=2862200&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002510%2Fabstract%3Frss%3Dyes (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2862200 Mon, 05 Oct 2009 18:50:47 +0100 2862200 http://www.medworm.com/index.php?rid=2737478&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001711%2Fabstract%3Frss%3Dyes Abstract: An 86-year-old, right-handed, hypertensive man suddenly experienced blurring of vision predominating in the left visual field. Neurological examinations were normal, except for left homonymous hemianopsia. Goldmann visual field testing revealed a left congruent incomplete homonymous hemianopsia with macular splitting. Brain MRI, with a T2-weighted image, demonstrated a lesion of high intensity in the right lateral geniculate body (LGB), as well as the posterior part of the caudate nucleus, posterolateral thalamus, and dorsolateral thalamus. MRA revealed severe stenosis at the second segment of right posterior cerebral artery (PCA). SPECT revealed significantly decreased blood perfusion in the striate cortex. To the best of our knowledge, this is the first case of an isolated, con... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2737478 Thu, 27 Aug 2009 13:41:58 +0100 2737478 http://www.medworm.com/index.php?rid=2737477&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001462%2Fabstract%3Frss%3Dyes We present a 67-year-old non-diabetic male who presented with muscle cramps, paresis, atrophy and fasciculations in the left leg, followed by rapidly progressive muscle stiffness and superimposed spasms which subsequently also affected the right leg and the trunk. GAD65 autoantibodies were elevated in serum and CSF, compatible with systemic and intrathecal synthesis of oligoclonal and high-avidity autoantibodies, and GAD65 specific T cells were clonally expanded in the CSF. The patient did not respond to GABAergic and immunomodulatory treatment or plasma exchange, and died from respiratory failure after 18 months. Autopsy revealed unilateral axonal swelling, chromatolysis and vacuolisation of anterior horn cells of the lower spinal cord, accompanied by microglia proliferation and discrete ... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2737477 Thu, 27 Aug 2009 13:41:58 +0100 2737477 http://www.medworm.com/index.php?rid=2737476&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001450%2Fabstract%3Frss%3Dyes Conclusions: Despite ECS is a minimally invasive surgical technique, our results only support its use in selected patients with advanced PD, in whom this therapy may be modestly effective. More experimental studies regarding the neuromodulation of the basal ganglia-cortex loops are required to optimize its clinical application. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2737476 Thu, 27 Aug 2009 13:41:58 +0100 2737476 http://www.medworm.com/index.php?rid=2737475&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001401%2Fabstract%3Frss%3Dyes Abstract: A 62-year-old man had a new onset of severe, orthostatic headache which eventually progressed to a stupor and a coma 3 weeks later. A computed tomography (CT) scan showed bilateral chronic subdural haematoma and magnetic resonance imaging (MRI) of the brain showed the typical findings of spontaneous intracranial hypotension (SIH). After pre-medication with acetazolamide, he was treated with three lumbar autologous epidural blood patches (EBPs) and kept in the Trendelenburg position, with full recovery. The first lumbar autologous EBP was ineffective and the second was only partially effective because of incorrect execution of the procedure as shown by spinal neuroimaging examination post-EBP. A spinal neuroimaging examination post-EBP is therefore to be recommended in order to co... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2737475 Thu, 27 Aug 2009 13:41:55 +0100 2737475 http://www.medworm.com/index.php?rid=2737474&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001358%2Fabstract%3Frss%3Dyes We present a case in which a patient with preexisting left internal carotid artery (ICA) occlusion developed limb-shaking TIAs secondary to severe stenosis of her left external carotid artery (ECA). After angioplasty and stenting of her left ECA, her symptoms resolved. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2737474 Thu, 27 Aug 2009 13:41:54 +0100 2737474 http://www.medworm.com/index.php?rid=2737473&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001139%2Fabstract%3Frss%3Dyes We present herein the clinical, neuroimaging, neuromuscular, and molecular findings of the first French Canadian patient with MNGIE caused by a novel homozygous invariant splicing site (IVS5 +1 G>A) mutation of the TYMP gene. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2737473 Thu, 27 Aug 2009 13:41:54 +0100 2737473 http://www.medworm.com/index.php?rid=2737472&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS030384670900105X%2Fabstract%3Frss%3Dyes Abstract: Pantothenate kinase-associated neurodegeneration (PKAN) is a genetic disease with childhood onset characterized clinically by dystonia, parkinsonism, pyramidal signs, visual failure and mental retardation. Progression is usually relentless culminating in severe disability and death within 15 years of onset. Eye movement abnormalities have been described in patients with PKAN including slowed vertical saccades and saccadic vertical pursuit. We here report a patient with PKAN and supranuclear gaze palsy broadening the phenotypic spectrum of the disease. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2737472 Thu, 27 Aug 2009 13:41:54 +0100 2737472 http://www.medworm.com/index.php?rid=2737471&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001723%2Fabstract%3Frss%3Dyes Conclusion: Our study showed that CSS-associated neuropathy is a treatable disorder and that the first choice therapy is high-dose corticosteroid. In cases where corticosteroids are ineffective or for severe cases, immunosuppressive therapy (cyclophosphamide) with steroids should be considered, and IVIg might be a treatment option. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2737471 Thu, 27 Aug 2009 13:41:53 +0100 2737471 http://www.medworm.com/index.php?rid=2737470&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001541%2Fabstract%3Frss%3Dyes Abstract: Introduction: The use of radiotherapy plus temozolomide administered concomitantly with and after radiotherapy for glioblastoma was recently shown to improve median and 2-year survival in a large international multicenter study. To compare this result in routine clinical practice, an audit of the management and outcome of patients with glioblastoma at our institute was performed.Methods: A total of 79 patients with pathologically confirmed glioblastoma were treated with radiotherapy (daily fractions of 2Gy for a total of 60Gy) combined with temozolomide at a dose of 75mg/m2 per day, followed by 6 cycles of adjuvant temozolomide (150–200mg/m2, 5 consecutive days per month). The primary end point was overall survival (OS). Secondary endpoints included progression-free survival (P... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2737470 Thu, 27 Aug 2009 13:41:53 +0100 2737470 http://www.medworm.com/index.php?rid=2737469&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001449%2Fabstract%3Frss%3Dyes Abstract: The aim of this study was to evaluate the plasma level changes of B-type natriuretic peptide (BNP), biochemical marker of heart failure, and echocardiographic parameters during mitoxantrone treatment in 22 multiple sclerosis (MS) patients (8 males, 14 females, mean age 37.1±6.6). Mitoxantrone (after mean cumulative dose of 58.0±7.0mg/m2) did not alter left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), posterior wall thickness (PWT) and left ventricular end-diastolic volume (LVEDV). However, mean plasma level of BNP raised from 14.53±3.29pg/ml at the baseline to 16.79±3.05pg/ml and 18.83±4.90pg/ml (P (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2737469 Thu, 27 Aug 2009 13:41:53 +0100 2737469 http://www.medworm.com/index.php?rid=2737468&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001437%2Fabstract%3Frss%3Dyes Conclusions: Cerebral revascularization is a safe and effective technique of treatment for selective cases of complex large or giant aneurysms and unclippable fusiform aneurysms in the MCA. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2737468 Thu, 27 Aug 2009 13:41:53 +0100 2737468 http://www.medworm.com/index.php?rid=2737467&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001413%2Fabstract%3Frss%3Dyes Abstract: Introduction: The aim of this study is to analyze the clinical differences between Parkinson's disease patients with major (MD) and minor depression (md) and to see how both affect the quality of life.Material and methods: 118 patients diagnosed with Parkinson's disease. The mean age of onset was 60.4±11.2 years with a mean duration of 8.5±6.2 years. Depression was diagnosed according to DSM-IV-TR criteria. Scores on the Hamilton depression inventory, MMSE, PDQ-39, NPI-10, UPDRS III, and UPDRS IV were recorded.Results: Twenty-one patients (17.8%) met the criteria of major depression (MD) and 33 (28.0%) those of minor depression (md). The scores on the PDQ-39 and NPI-10 of patients with MD were higher than in patients with md, and control group. The MMSE scores were lower in pat... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2737467 Thu, 27 Aug 2009 13:41:53 +0100 2737467 http://www.medworm.com/index.php?rid=2737466&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001395%2Fabstract%3Frss%3Dyes Conclusions: This study emphasizes that knowledge of stroke risk factors and warning signs was moderate at best. Improvements can only result from using a broad range of sustained educational efforts through simple and understandable school education or public media. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2737466 Thu, 27 Aug 2009 13:41:53 +0100 2737466 http://www.medworm.com/index.php?rid=2737465&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001814%2Fabstract%3Frss%3Dyes Conclusions: In MIDs laminar cortical necrosis represents the histopathological and imaging endpoint of a stroke-like lesion. Though laminar cortical necrosis may have a wide pathophysiological background the histological and imaging characteristics do not vary between the different underlying conditions. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2737465 Thu, 27 Aug 2009 13:41:53 +0100 2737465 http://www.medworm.com/index.php?rid=2737464&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001383%2Fabstract%3Frss%3Dyes Conclusions: The coexistence of meningioma and aneurysm seems to be a coincidence. Treatment should primary focus on the cause of presenting symptoms, but in cases with intratumoural aneurysm, the aneurysm should be treated first. Due to the development of microsurgical and endovascular techniques peri-procedural mortality and morbidity has decreased. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2737464 Thu, 27 Aug 2009 13:41:53 +0100 2737464 http://www.medworm.com/index.php?rid=2737463&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709002005%2Fabstract%3Frss%3Dyes (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2737463 Thu, 27 Aug 2009 13:41:53 +0100 2737463 http://www.medworm.com/index.php?rid=2625684&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001310%2Fabstract%3Frss%3Dyes Lambert–Eaton myasthenic syndrome (LEMS) is an autoimmune disease in which autoantibodies against voltage-gated calcium channels (VGCCs) cause muscle weakness, ataxia and autonomic dysfunction . It has been reported that 50–90% of LEMS cases are related to malignancy , and small cell lung cancer (SCLC) is one of the most common and well-known causes . The occurrence of LEMS associated with SCLC is rather common, but a familial case of LEMS associated with SCLC has not yet been reported until now. We hereby present a familial case of SCLC–LEMS. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625684 Wed, 22 Jul 2009 12:24:39 +0100 2625684 http://www.medworm.com/index.php?rid=2625683&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001048%2Fabstract%3Frss%3Dyes We have read with great interest a recent paper published in your journal of a patient suffering from stiff-person syndrome (SPS), type 1 diabetes mellitus (DM), dermatitis herpetiformis (DH) and celiac disease (CD). We want to report a patient with the same clinical presentation, also diagnosed with microcytic anemia with normal iron level and decreased copper level in serum . (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625683 Wed, 22 Jul 2009 12:24:39 +0100 2625683 http://www.medworm.com/index.php?rid=2625682&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001036%2Fabstract%3Frss%3Dyes Stiff-person syndrome (SPS) is a rare neurologic disease with dramatic manifestations. The condition is thought to have an autoimmune etiology. Associated neuropsychiatric symptoms of SPS cause it to be mistaken for hysterical paralysis, a conversion disorder which presents with voluntary motor deficits that suggest a neurological or general medical condition. However, after thorough evaluation, the symptoms are found to be unrelated to a physical cause . (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625682 Wed, 22 Jul 2009 12:24:39 +0100 2625682 http://www.medworm.com/index.php?rid=2625681&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS030384670900081X%2Fabstract%3Frss%3Dyes Recently, a 33-year-old man was referred to our hospital because of rapidly progressive tremor and myoclonic jerks of the head, neck, trunk and all limbs in combination with ataxia. Intermittently spontaneous myoclonic eye movements were observed. The first complaint was trembling of the right hand 2 weeks earlier. His medical history was otherwise unremarkable. Family history was negative for neurological diseases. Neurological examination revealed multifocal myoclonus, most pronounced in axial muscles and increasing with action. Except for myoclonic jerks of the eyes, predominantly in the horizontal plane, there was no cranial nerve involvement. Furthermore, ataxia of four limbs and trunk was observed. There was an inability to walk, stand or sit without assistance. The clinical diagnosi... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625681 Wed, 22 Jul 2009 12:24:38 +0100 2625681 http://www.medworm.com/index.php?rid=2625680&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001152%2Fabstract%3Frss%3Dyes Abstract: Nervous system infections by Cryptococcus neoformans may occur not only in congenital or acquired immunodeficiency syndromes, but also in immunocompetent hosts. Neurological manifestations of C. neoformans infection include meningitis and, less commonly, parenchymal CNS granulomatous disease. This paper provides detailed clinical descriptions of highly unusual neurological manifestations of cryptococcal nervous system infections. Medical records and diagnostic data including magnetic resonance imaging, histopathology, serology, and CSF analysis were reviewed. A conus medullaris abscess was found in a patient infected with the human immunodeficiency virus (HIV). A patient with Hodgkin's disease was diagnosed with cryptococcal meningitis and dermatitis mimicking ophthalmic zoster. ... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625680 Wed, 22 Jul 2009 12:24:38 +0100 2625680 http://www.medworm.com/index.php?rid=2625679&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001140%2Fabstract%3Frss%3Dyes Abstract: The nongerminomatous germ cell tumor occurring in the fourth ventricle is extremely rare. A 9-year-old boy presented with symptoms of obvious headache, projectile vomiting, diplopia and motor weakness. MRI scanning revealed lesions occupying the fourth ventricle, with dual-lateral ventricle expansion after gadolinium administration. Suboccipital craniectomy was performed and the tumor was removed by block resection. Twice intraoperative biopsy specimens revealed fiber vascular tissue and hemangioma. Histological examination revealed that the tumor consisted of loose network structures and Schiller–Duval bodies. Immunohistochemical study showed that the primitive germ cells were positive for placental alkaline phosphatase, alpha-fetoprotein, cytokeratin, vimentin, but negative f... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625679 Wed, 22 Jul 2009 12:24:38 +0100 2625679 http://www.medworm.com/index.php?rid=2625678&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001127%2Fabstract%3Frss%3Dyes We describe a 57-year-old patient who developed symptoms of posterior AHS after an acute infarction in the left (presumably dominant) parietal lobe. A review of the different clinical features of AHS and the underlying mechanisms is also presented. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625678 Wed, 22 Jul 2009 12:24:38 +0100 2625678 http://www.medworm.com/index.php?rid=2625677&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001115%2Fabstract%3Frss%3Dyes We present a patient with a provisional diagnosis of bilateral thalamic neoplasm based on clinical history and an advanced imaging workup including MR spectroscopy. Subsequent biopsy suggested venous congestion, hypoxia, and edema without neoplasia. Routine post-operative CT the following day revealed suggestion of dAVF due to the presence of residual contrast from prior unrelated abdominal CT. Cerebral angiography eventually revealed a Cognard grade IIb dAVF. Trans-arterial Onyx embolization resulted in a dramatic clinical and radiographic improvement. This case highlights an unusual presentation and challenging diagnosis of a dAVF and the importance of pursuing the correct diagnosis. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625677 Wed, 22 Jul 2009 12:24:38 +0100 2625677 http://www.medworm.com/index.php?rid=2625676&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001103%2Fabstract%3Frss%3Dyes We describe three cases of HTLV-I-associated myelopathy (HAM) with abnormal spinal magnetic resonance imaging (MRI) findings. The serum and cerebrospinal fluid (CSF) of all 3 patients tested positive for anti-HTLV-I antibody. Swelling of the spinal cord with high-intensity lesions on T2-weighted images was observed. Corticosteroid treatment in the case of two patients gradually improved the symptoms, decreased the protein and IgG levels as well as the cell count, and reduced the abnormal MRI findings. To confirm the assumption that abnormal spinal MRI findings are reflective of active inflammation, we compared the clinical parameters, namely, the protein content, IgG level, and cell count, in the CSF of patients exhibiting abnormal spinal MRI findings with those in the case of patients wit... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625676 Wed, 22 Jul 2009 12:24:38 +0100 2625676 http://www.medworm.com/index.php?rid=2625675&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001097%2Fabstract%3Frss%3Dyes We present a case of a 50-year-old man who developed an intracranial tumor of the left lateral ventricle at the trigone, for which he underwent total tumor resection followed by gamma knife radiosurgery for recurrence of the tumor. The histological diagnosis was rhabdoid papillary meningioma. Five years after surgery, diffuse craniospinal leptomeningeal metastases developed and subtotal removal of the spinal tumor was performed. The spinal tumor was considered to have metastasized via cerebrospinal fluid (CSF) in view of its histological features that were identical to those of the primary tumor. Immunohistochemistry revealed the unusual cytoplasmic expression of glial fibrillary acidic protein (GFAP) of tumor cells. To our knowledge, this is the first reported case of diffuse craniospinal... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625675 Wed, 22 Jul 2009 12:24:38 +0100 2625675 http://www.medworm.com/index.php?rid=2625674&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001085%2Fabstract%3Frss%3Dyes Abstract: Dysferlinopathy refers to a variety of autosomal recessive, skeletal muscle disorders due to the mutations of dysferlin-encoding gene, DYSF. It encompasses limb-girdle muscular dystrophy type 2B (LGMD2B), Miyoshi myopathy (MM), distal myopathy with anterior tibial onset (DMAT), isolated hyperCKemia, rigid spine syndrome and congenital muscular dystrophy. Herein, we report five Thai patients with distal myopathy due to dysferlinopathy including four MM and one DMAT patients. Muscle biopsy from one MM patient depicted numerous ring fibers which is an atypical finding in dysferlinopathy. Mutation analysis of DYSF revealed novel compound heterozygous mutations of p.Tyr309X and c.236+1G>T in two related MM patients, known homozygous mutations, p.Arg89X and p.Gln176X, in two MM patient... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625674 Wed, 22 Jul 2009 12:24:38 +0100 2625674 http://www.medworm.com/index.php?rid=2625673&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709000845%2Fabstract%3Frss%3Dyes Abstract: Propionibacterium acnes (P. acnes) is emerging as a pathogen in postneurosurgical infections. A case of cranial bone flap infection due to P. acnes successfully treated with daptomycin is presented. This case demonstrates the potential of daptomycin as an option in the treatment of P. acnes. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625673 Wed, 22 Jul 2009 12:24:38 +0100 2625673 http://www.medworm.com/index.php?rid=2625672&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709000808%2Fabstract%3Frss%3Dyes We describe the clinical features of a patient with Gerstmann-Sträussler-Scheinker syndrome with a mutation in the prion protein gene at codon 105 (GSS105) who presented with ataxia. Neurologic examination showed memory disturbance, dysarthria, extrapyramidal signs (bradykinesia and resting tremor) and ataxic gait without spasticity. Although GSS105 has been referred to as “spastic paraparesis-type GSS”, the patient did not show spastic paraparesis or pyramidal signs, even 11 years after the onset of symptoms. Thus, the spectrum of the GSS105 phenotype varies among patients and requires further clinicopathologic elucidation. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625672 Wed, 22 Jul 2009 12:24:38 +0100 2625672 http://www.medworm.com/index.php?rid=2625671&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709000791%2Fabstract%3Frss%3Dyes Abstract: A 24-year-old male underwent awake surgery for a lesion in the left dominant basal temporo-occipital junction.During the intraoperative functional mapping using picture naming, cortical stimulation near the visual word form area led to visual paraphasia. These visual paraphasias were also elicited axonally by subcortical stimulation at the anterior wall of the cavity.We propose to discuss the existence of this “visual object form area”, devoted to the visual recognition of object, and its links with the closely related “visual word form area”. We suggest that its afference, whose stimulation also induced visual paraphasias, may be one part of the U-shaped fibers distributed along the posterior part of the occipito-temporal connection system (inferior longitudinal fascicul... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625671 Wed, 22 Jul 2009 12:24:38 +0100 2625671 http://www.medworm.com/index.php?rid=2625670&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709000742%2Fabstract%3Frss%3Dyes Conclusions: In head injured patients with long bone fractures one should consider cerebral fat embolism. When the classical clinical syndrome is not present, MR imaging is warranted for diagnosis and to exclude other causes of secondary deterioration. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625670 Wed, 22 Jul 2009 12:24:37 +0100 2625670 http://www.medworm.com/index.php?rid=2625669&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709000584%2Fabstract%3Frss%3Dyes Abstract: The aim of this study was to collect, describe and analyze the radiation-induced gliomas in craniopharyngioma patients reported in the literature up to date. Review of the relevant literature was performed. One personal illustrative case was added. Reports of 15 patients, including the presented illustrative case, were evaluated. The average age of the patients at the time of irradiation was 12.5 years. All patients underwent conventional fractionated radiotherapy with mean total radiation dose of 55Gy and an average latency period of 10.8 years. Glioma localization varied with the highest frequency of the temporal lobe involvement. All but one patient had high-grade gliomas on the histological exam. Although exceptionally rare, the radiation-induced gliomas in craniopharyngioma ... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625669 Wed, 22 Jul 2009 12:24:37 +0100 2625669 http://www.medworm.com/index.php?rid=2625668&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709000237%2Fabstract%3Frss%3Dyes We report a patient who presented with transient ischemic attack (TIA) associated with stenosis of the accessory MCA ostium. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625668 Wed, 22 Jul 2009 12:24:37 +0100 2625668 http://www.medworm.com/index.php?rid=2625667&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS030384670900136X%2Fabstract%3Frss%3Dyes Conclusions: Confinement caused by looking after PD patients may disorganize the life of the entire family and have adverse social consequences for unpaid CGs. This could disrupt the established balance within the family, limiting and narrowing the CGs’ life-space. The narrowed life-space of these CGs must be considered and acted upon when offering and planning healthcare. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625667 Wed, 22 Jul 2009 12:24:37 +0100 2625667 http://www.medworm.com/index.php?rid=2625666&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001061%2Fabstract%3Frss%3Dyes Conclusion: In our experience, image-guided neuroendoscopy can improve the accuracy of the endoscopic approach, minimising brain trauma. It can be particularly helpful when performing a brain biopsy in the absence of clear intraventricular landmarks or in the event of adverse visual conditions such as intraventricular bleeding. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625666 Wed, 22 Jul 2009 12:24:37 +0100 2625666 http://www.medworm.com/index.php?rid=2625665&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709000857%2Fabstract%3Frss%3Dyes Conclusion: Despite the fact that the NKX2-5 could account for the persistence of PFO, mutations of this gene in peripheral blood DNA were barely detected in our study. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625665 Wed, 22 Jul 2009 12:24:37 +0100 2625665 http://www.medworm.com/index.php?rid=2625664&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709000833%2Fabstract%3Frss%3Dyes Conclusions: Data support the view about MPV as a determinant of severity/outcome of the acute ischemic stroke. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625664 Wed, 22 Jul 2009 12:24:37 +0100 2625664 http://www.medworm.com/index.php?rid=2625663&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709000535%2Fabstract%3Frss%3Dyes The objective of this study was to determine if the preoperative use of antifungal therapy positively influences clinical outcome in patients with Aspergillus brain abscess.Methods: We studied 25 patients with confirmed diagnosis of cerebral aspergillosis. We compared baseline characteristics and outcomes of patients treated with either amphotericin B or itraconazole either pre-operatively (n=11) or post-operatively (n=14) at a tertiary care hospital in Karachi.Results: Twenty-five patients were included in the study. Cerebral aspergillosis was largely a disease of immune competent people (80%). Baseline clinical characteristics between the two treatment groups were comparable i.e., age (P>0.896), gender (P>0.999), coma at presentation (P>0.999), immunosuppression (P>0.623), number of absc... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625663 Wed, 22 Jul 2009 12:24:37 +0100 2625663 http://www.medworm.com/index.php?rid=2625662&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709001656%2Fabstract%3Frss%3Dyes (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2625662 Wed, 22 Jul 2009 12:24:36 +0100 2625662 http://www.medworm.com/index.php?rid=2457168&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709000286%2Fabstract%3Frss%3Dyes We read with great interest the study by Force et al. regarding the prevalence of atrial septal abnormalities among older patients presenting with cryptogenic ischemic stroke or transient ischemic attack (TIA). Their relationship remains unclear with regards to the recommendations for management and certain important issues need to be addressed. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2457168 Sat, 06 Jun 2009 03:32:21 +0100 2457168 http://www.medworm.com/index.php?rid=2457167&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709000079%2Fabstract%3Frss%3Dyes Dear Sir, Intravenous administration of recombinant tissue plasminogen activator (t-PA) is beneficial for patients with acute ischemic stroke . Because of the potential bleeding complications, there is a list of exclusion criteria which was strictly designed initially. The coexistence of brain tumor is one of the exclusion criteria for t-PA use and there were only few reports regarding t-PA use in non-stroke patients with brain tumor . (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2457167 Sat, 06 Jun 2009 03:32:17 +0100 2457167 http://www.medworm.com/index.php?rid=2457166&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709000560%2Fabstract%3Frss%3Dyes We report on a pediatric patient with refractory status epilepticus treated with a prolonged propofol infusion who developed isolated pathologically confirmed fatty liver without the usually reported extrahepatic manifestations. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2457166 Sat, 06 Jun 2009 03:32:13 +0100 2457166 http://www.medworm.com/index.php?rid=2457165&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709000559%2Fabstract%3Frss%3Dyes We present a case with severe bilateral hippocampal malformations who underwent right temporal lobectomy due to intractable temporal lobe epilepsy. Postoperative examination of the resected hippocampus revealed abnormal shape of the dentate gyrus and an atypical convolution of the CA1 pyramidal cell-subicular layers. After surgery, the patient has been seizure free. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2457165 Sat, 06 Jun 2009 03:32:12 +0100 2457165 http://www.medworm.com/index.php?rid=2457164&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709000547%2Fabstract%3Frss%3Dyes We report a case of HES encephalopathy in a 79-year-old male presenting with a focal neurological deficit and cognitive function disorders. Eosinophil number was >20,000/mm3. Initial DWI revealed multiple high-signal lesions that were clearer than on T2-weighted images. After corticosteroid therapy, symptoms improved and MRI-identified lesions decreased. This is the first report demonstrating DWI findings of HES encephalopathy. We suggest that lesions identified on MRI may be related to a combination of demyelination, inflammation and/or even small-vessel infarction due to local intimal lesions and clotting, secondary to eosinophilic toxicity. Investigation using DWI should therefore be done in patients with HES encephalopathy even if T2-weighted images are normal. (Source: Clinical Neurol... Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2457164 Sat, 06 Jun 2009 03:32:11 +0100 2457164 http://www.medworm.com/index.php?rid=2457163&cid=s_35403_153_f&fid=35403&url=http%3A%2F%2Fwww.clineu-journal.com%2Farticle%2FPIIS0303846709000523%2Fabstract%3Frss%3Dyes We report the successful use of low-dose intraventricular thrombolysis (rt-PA) in two cases of life-threatening intraventricular hemorrhage due to periventricular AVMs as rescue therapy, even prior to source control of the bleeding. Our observations, together with nine comparable published cases, illustrate that this treatment might be useful to clear the intraventricular blood and lower intracranial pressure. It might also improve neurological outcome and mortality in these selected patients.This suggests that hemorrhage from a periventricular AVM, even before surgical resection or endovascular embolization, is not necessarily an absolute contraindication for intraventricular thrombolysis in patients with massive IVH. (Source: Clinical Neurology and Neurosurgery) Clinical Neurology and Neurosurgery journals http://www.medworm.com/rss/comments.php?id=2457163 Sat, 06 Jun 2009 03:32:06 +0100 2457163