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Sample records for posttherapeutic cerebral radionecrosis

  1. Posttherapeutic cerebral radionecrosis: a complication of head and neck tumor therapy

    SciTech Connect

    Araoz, C.; Weems, A.M.

    1981-12-01

    Patients with treated head and neck cancer may have focal neurologic symptoms and personality changes due to delayed cerebral radionecrosis. A history of past treatment should direct the physician to consider these lesions in the differential diagnosis. Craniotomy is the management recommended. Histopathologic changes include fibrotic response of the meninges with pleomorphic and vacuolated fibroblasts, capillary hyperplasia, reactive astrocytes, and fibrosis of the blood vessels. Amyloid is deposited in the arteriolar walls and extracellular space. Ischemic, autoimmune, or vascular mechanisms, and glial alterations have all been considered in the pathogensis of delayed cerebral radionecrosis. Some researchers have concluded that chemotherapeutic agents, such as methotrexate, may contribute to its production.

  2. Multifocal brain radionecrosis masquerading as tumor dissemination

    SciTech Connect

    Safdari, H.; Boluix, B.; Gros, C.

    1984-01-01

    The authors report on an autopsy-proven case of multifocal widespread radionecrosis involving both cerebral hemispheres and masquerading as tumor dissemination on a CT scan done 13 months after complete resection of an oligodendroglioma followed by radiation therapy. This case demonstrates that radiation damage may be present in a CT scan as a multifocal, disseminated lesion. Since the survival of brain-tumor patients who have undergone radiation therapy is prolonged by aggressive therapy, the incidence and variability of radiation-induced complications in such cases is likely to increase. For similar reasons, the radionecrosis in such cases should be taken into consideration. A short review of the CT scan findings and diagnostic and therapeutic considerations in a case of widespread radionecrosis is presented. The need for appropriate diagnosis and subsequent life-saving management is emphasized.

  3. Hyperbaric oxygen therapy for laryngeal radionecrosis

    SciTech Connect

    Ferguson, B.J.; Hudson, W.R.; Farmer, J.C. Jr.

    1987-01-01

    Radionecrosis of the larynx is a debilitating disease associated with pain, dysphagia, respiratory obstruction, and, in some cases, the need for laryngectomy. Persistent poor wound healing can lead to death. A series of eight patients with advanced (grades III and IV, Chandler classification) radionecrosis of the larynx treated with adjunctive hyperbaric oxygen therapy is presented. Signs and symptoms of radionecrosis were dramatically ameliorated in seven of eight patients, while one patient, despite subjective improvement, eventually required laryngectomy. There were no deaths. These results are compared to previous series on radionecrosis of the larynx in which hyperbaric oxygen was not used. This series indicates that hyperbaric oxygen therapy is a useful and effective adjunctive treatment modality in the management of laryngeal radionecrosis.

  4. Change of paradigm in thoracic radionecrosis management.

    PubMed

    Dast, S; Assaf, N; Dessena, L; Almousawi, H; Herlin, C; Berna, P; Sinna, R

    2016-06-01

    Classically, muscular or omental flaps are the gold standard in the management of thoracic defects following radionecrosis debridement. Their vascular supply and antibacterial property was supposed to enhance healing compared with cutaneous flaps. The evolution of reconstructive surgery allowed us to challenge this dogma. Therefore, we present five consecutive cases of thoracic radionecrosis reconstructed with cutaneous perforator flaps. In four patients, we performed a free deep inferior epigastric perforator (DIEP) flap and one patient had a thoracodorsal perforator (TDAP) flap. Median time healing was 22.6 days with satisfactory cutaneous covering and good aesthetic results. There were no flap necrosis, no donor site complications. We believe that perforator flaps are a new alternative, reliable and elegant option that questions the dogma of muscular flaps in the management of thoracic radionecrosis. PMID:26831037

  5. Stereotactic radiosurgery for brain metastases: analysis of outcome and risk of brain radionecrosis

    PubMed Central

    2011-01-01

    Purpose to investigate the factors affecting survival and toxicity in patients treated with stereotactic radiosurgery (SRS), with special attention to volumes of brain receiving a specific dose (V10 - V16 Gy) as predictors for brain radionecrosis. Patients and Methods Two hundred six consecutive patients with 310 cerebral metastases less than 3.5 cm were treated with SRS as primary treatment and followed prospectively at University of Rome La Sapienza Sant'Andrea Hospital. Overall survival, brain control, and local control were estimated using the Kaplan-Meier method calculated from the time of SRS. Univariate and multivariate analysis using a Cox proportional hazards regression model were performed to determine the predictive value of prognostic factors for treatment outcome and SRS-related complications. Results Median overall survival and brain control were 14.1 months and 10 months, respectively. The 1-year and 2-year survival rates were 58% and 24%, and respective brain control were 43% and 22%. Sixteen patients recurred locally after SRS, with 1-year and 2-year local control rates of 92% and 84%, respectively. On multivariate analysis, stable extracranial disease and KPS >70 were associated with the most significant survival benefit. Neurological complications were recorded in 27 (13%) patients. Severe neurological complications (RTOG Grade 3 and 4) occurred in 5.8% of patients. Brain radionecrosis occurred in 24% of treated lesions, being symptomatic in 10% and asymptomatic in 14%. On multivariate analysis, V10 through V16 Gy were independent risk factors for radionecrosis, with V10 Gy and V12 Gy being the most predictive (p = 0.0001). For V10 Gy >12.6 cm3 and V12 Gy >10.9 cm3 the risk of radionecrosis was 47%. Conclusions SRS alone represents a feasible option as initial treatment for patients with brain metastases, however a significant subset of patients may develop neurological complications. Lesions with V12 Gy >8.5 cm3 carries a risk of radionecrosis

  6. Histopathological study of radionecrosis in laryngeal carcinoma

    SciTech Connect

    Keene, M.; Harwood, A.R.; Bryce, D.P.; van Nostrand, A.W.

    1982-02-01

    With modern radiotherapy techniques, clinical radionecrosis is uncommon following eradication of primary squamous cell carcinoma from the larynx. Histologic sections from 265 specimens, prepared by the technique of whole organ subserial step-sectioning were studied to determine the incidence and location of chondronecrosis and/or osteomyelitis in both irradiated and non-irradiated cases. Chondronecrosis occurred in only 1 of 41 early (pT1 - pT2) tumors but in 143 advanced tumors (pT - pT4) treated with radical radiotherapy and containing residual carcinoma, 27% had evidence of significant necrosis, compared with 24% of those not irradiated. Age, sex, tumor grade and previous laryngeal surgery did not appear to be significant factors in the development of necrosis in irradiated patients. The arytenoid cartilage was most frequently involved when chondronecrosis occurred in association with radiotherapy. Six total laryngectomy specimens (3%) were received from patients with symptoms of chondronecrosis and in whom no residual tumor was present. We conclude that although the incidence of clinical perichondritis is low, histologic chondronecrosis and/or osteomyelitis occurred in 26% of all the larynges studied. Radiotherapy appears to be a significant causative factor only in advanced supraglottic tumors.

  7. Management of radionecrosis of the vulva and distal vagina

    SciTech Connect

    Roberts, W.S.; Hoffman, M.S.; LaPolla, J.P.; Ruas, E.; Fiorica, J.V.; Cavanagh, D. )

    1991-05-01

    Twelve patients were seen between January 1983 and June 1989 with the clinical diagnosis of radionecrosis of the vulva or distal vagina. Seven patients received radiation for vulvar cancer, three for distal vaginal cancer, and two for recurrent endometrial cancer. No patient healed spontaneously and the mean delay in surgical therapy was 8.5 months. The radionecrotic site was treated with local therapy, radical local excision (with or without colostomy), or exenteration. The operative defect was closed primarily in three patients and covered with local flaps or myocutaneous flaps in seven patients. The two patients with local care still have radionecrotic ulcers. One of three patients who were closed primarily continues to have an ulcer. All other patients have healed satisfactorily except one who died after two attempts to correct the problem. Radionecrosis of the vulva and distal vagina should generally be treated surgically.

  8. Radionecrosis 30 years after breast cancer.

    PubMed

    Huq, Fuad; Pai, Ms Deepa; Potdar, Nandkishore

    2015-04-01

    This report describes the case of a 70-year-old woman presenting to outpatient with a several-week history of a painful mass in her right breast, 30 years after her treatment for primary breast cancer. At first, this was suspected to have been a recurrence of her malignancy; however, repeated biopsies ultimately proved this to be negative. Her injury was actually a case of radiotherapy-induced necrosis (radionecrosis) and was subsequently treated with surgical debridement. PMID:25972654

  9. Long-term risk of radionecrosis and imaging changes after stereotactic radiosurgery for brain metastases.

    PubMed

    Kohutek, Zachary A; Yamada, Yoshiya; Chan, Timothy A; Brennan, Cameron W; Tabar, Viviane; Gutin, Philip H; Yang, T Jonathan; Rosenblum, Marc K; Ballangrud, Åse; Young, Robert J; Zhang, Zhigang; Beal, Kathryn

    2015-10-01

    Radionecrosis is a well-characterized effect of stereotactic radiosurgery (SRS) and is occasionally associated with serious neurologic sequelae. Here, we investigated the incidence of and clinical variables associated with the development of radionecrosis and related radiographic changes after SRS for brain metastases in a cohort of patients with long-term follow up. 271 brain metastases treated with single-fraction linear accelerator-based SRS were analyzed. Radionecrosis was diagnosed either pathologically or radiographically. Univariate and multivariate Cox regression was performed to determine the association between radionecrosis and clinical factors available prior to treatment planning. After median follow up of 17.2 months, radionecrosis was observed in 70 (25.8%) lesions, including 47 (17.3%) symptomatic cases. 22 of 70 cases (31.4%) were diagnosed pathologically and 48 (68.6%) were diagnosed radiographically. The actuarial incidence of radionecrosis was 5.2% at 6 months, 17.2% at 12 months and 34.0% at 24 months. On univariate analysis, radionecrosis was associated with maximum tumor diameter (HR 3.55, p < 0.001), prior whole brain radiotherapy (HR 2.21, p = 0.004), prescription dose (HR 0.56, p = 0.02) and histology other than non-small cell lung, breast or melanoma (HR 1.85, p = 0.04). On multivariate analysis, only maximum tumor diameter (HR 3.10, p < 0.001) was associated with radionecrosis risk. This data demonstrates that with close imaging follow-up, radionecrosis after single-fraction SRS for brain metastases is not uncommon. Maximum tumor diameter on pre-treatment MR imaging can provide a reliable estimate of radionecrosis risk prior to treatment planning, with the greatest risk among tumors measuring >1 cm. PMID:26307446

  10. The Effectiveness of Bevacizumab in Radionecrosis After Radiosurgery of a Single Brain Metastasis

    PubMed Central

    Ursino, Stefano; Pasqualetti, Francesco; Pesaresi, Ilaria; Desideri, Ilaria; Cosottini, Mirco; Laliscia, Concetta; Paiar, Fabiola; Fabrini, Maria Grazia

    2015-01-01

    Radionecrosis (RN) of brain tissue is a serious late complication of brain irradiation and historically has been treated with corticos-teroid therapy and alternatively surgical decompression. Recently, bevacizumab has been suggested for treatment of cerebral radiation necrosis. We present a case of a 73-years-old women affected by a primary non-small cell lung cancer with a single brain metastasis treated with radiosurgery. Two years after radiosurgery the patient referred neurological symptoms and a brain magnetic resonance confirmed the presence of RN. The patient refused surgical decompression so underwent at the treatment with bevacizumab 7.5 mg/kg/2 weeks for a total of 4 cycles. After two months of treatment the patient reported strumental and clinical improvement. Ten months after bevacizumab discontinuation the patient experienced a recurrence of RN with evident clinical manifestation and confirmed by radiological imaging. A new treatment with bevacizumab was not performed due to the systemic progression disease and the worsening of clinical status. Despite limited to only one clinical case, our study suggests the efficacy of bevacizumab to treat RN. Future studies are needed to confirm its mechanism and to properly define the optimal scheduling, dosage and duration of therapy. PMID:26788278

  11. Radionecrosis of normal tissue: studies on mouse tails.

    PubMed

    Hendry, J H

    1978-01-01

    Studies on the radionecrosis of mouse tails demonstrate the following modifications to the dose necessary for necrosis in 50 per cent of tails (the ND50): (a) There is very little reduction in ND50 values for irradiated lengths of tail from 2 cm to almost the whole tail, but there is a sharp increase in dose for lengths less than 1.5 cm. (b) The ND50 is high for unanesthetized mice irradiated in air, due to tissue hypoxia. (c) The hypoxia can be reduced by varying amounts by applying heat to the tail, or by flowing oxygen over the tail surface, or by anesthetizing the animal. (d) The ingress of oxygen through the surface can be reduced by placing a clamp round the proximal tail. These features are discussed with reference to the state and possible position of the target cells, and to the use of this assay technique in comparative studies. PMID:304849

  12. Low Incidence of Radionecrosis in Children Treated with Conventional Radiation Therapy and Intrathecal Radioimmunotherapy

    PubMed Central

    Kramer, Kim; Pandit-Taskar, Neeta; Zanzonico, Pat; Wolden, Suzanne L.; Humm, John L.; DeSelm, Carl; Souweidane, Mark M.; Lewis, Jason S.; Cheung, Nai-Kong. V.

    2015-01-01

    Radionecrosis is a potentially devastating complication of external beam radiotherapy (XRT). Intraventricular compartmental radioimmunotherapy (cRIT) using 131I-3F8 or 131I-8H9 can eradicate malignant cells in the CSF. The incidence of radionecrosis using cRIT 131I based intraventricular radioiimunotherapy, when used alone or in combination with conventional craniospinal CSI-XRT is unknown. We retrospectively analyzed the incidence of radionecrosis in 2 cohorts of pediatric patients treated with both CSI-XRT and cRIT at MSKCC since 2003: patients with metastatic CNS neuroblastoma (NB) and medulloblastoma (MB). 94 patients received both CSI-XRT and cRIT, 2 received cRIT alone, median follow up 41.5 months (6.5–124.8 months). Mean CSI-XRT dose was 28 Gy (boost to the primary tumor site up to 54 Gy) in the MB cohort, and CSI XRT dose 18–21 Gy (boost to 30 Gy for focal parenchymal mass) in the NB cohort. For MB patients, 20% had focal re-irradiation for a second or more subsequent relapse, mean repeat-XRT dose was 27.5 Gy; 7 patients with NB had additional focal XRT. Median CSF cRIT dose was 18.6 Gy in the MB cohort and 32.1 in the NB cohort. One asymptomatic patient underwent resection of 0.6-cm hemorrhagic periventricular white-matter lesion confirmed to be necrosis and granulation tissue, 2.5 years after XRT. The risk of radionecrosis in children treated with XRT and cRIT appears minimal (~1%). No neurologic deficits secondary to radionecrosis have been observed in long-term survivors treated with both modalities, including patients who underwent re-XRT. Administration of cRIT may safely proceed in patients treated with conventional radiotherapy without appearing to increase the risk of radionecrosis. PMID:25944385

  13. Low incidence of radionecrosis in children treated with conventional radiation therapy and intrathecal radioimmunotherapy.

    PubMed

    Kramer, Kim; Pandit-Taskar, Neeta; Zanzonico, Pat; Wolden, Suzanne L; Humm, John L; DeSelm, Carl; Souweidane, Mark M; Lewis, Jason S; Cheung, Nai-Kong V

    2015-06-01

    Radionecrosis is a potentially devastating complication of external beam radiotherapy (XRT). Intraventricular compartmental radioimmunotherapy (cRIT) using (131)I-3F8 or (131)I-8H9 can eradicate malignant cells in the CSF. The incidence of radionecrosis using cRIT (131)I based intraventricular radioimmunotherapy, when used alone or in combination with conventional craniospinal CSI-XRT is unknown. We retrospectively analyzed the incidence of radionecrosis in two cohorts of pediatric patients treated with both CSI-XRT and cRIT at MSKCC since 2003: patients with metastatic CNS neuroblastoma (NB) and medulloblastoma (MB). 94 patients received both CSI-XRT and cRIT, two received cRIT alone, median follow up 41.5 months (6.5-124.8 months). Mean CSI-XRT dose was 28 Gy (boost to the primary tumor site up to 54 Gy) in the MB cohort, and CSI XRT dose 18-21 Gy (boost to 30 Gy for focal parenchymal mass) in the NB cohort. For MB patients, 20 % had focal re-irradiation for a second or more subsequent relapse, mean repeat-XRT dose was 27.5 Gy; seven patients with NB had additional focal XRT. Median CSF cRIT dose was 18.6 Gy in the MB cohort and 32.1 in the NB cohort. One asymptomatic patient underwent resection of 0.6-cm hemorrhagic periventricular white-matter lesion confirmed to be necrosis and granulation tissue, 2.5 years after XRT. The risk of radionecrosis in children treated with XRT and cRIT appears minimal (~1 %). No neurologic deficits secondary to radionecrosis have been observed in long-term survivors treated with both modalities, including patients who underwent re-XRT. Administration of cRIT may safely proceed in patients treated with conventional radiotherapy without appearing to increase the risk of radionecrosis. PMID:25944385

  14. Extremity Radioactive Iodine Uptake on Post-therapeutic Whole Body Scan in Patients with Differentiated Thyroid Cancer

    PubMed Central

    Wakabayashi, Hiroshi; Taki, Junichi; Inaki, Anri; Toratani, Ayane; Kayano, Daiki; Kinuya, Seigo

    2015-01-01

    Objective(s): We investigated a frequency of lower extremity uptake on the radioactive iodine (RAI) whole body scan (WBS) after RAI treatment in patients with differentiated thyroid cancer, in order to retrospectively examine whether or not the frequency was pathological. Methods: This retrospective study included 170 patients with thyroid cancer, undergoing RAI treatment. Overall, 99(58%) and 71(42%) patients received single and multiple RAI treatments, respectively. Post-therapeutic WBS was acquired after 3 days of RAI administration. For patients with multiple RAI treatments, the WBS of their last RAI treatment was evaluated. Lower extremity uptake on post-therapeutic WBS was classified into 3 categories: bilateral femoral uptake (type A), bilateral femoral and tibia uptake (type B), and uptake in bilateral upper and lower extremities (type C). Then, the patients with RAI uptake in the lower extremities on WBS were analyzed with clinical parameters. Results: Overall, 99 patients (58%) had the extremity uptake on their posttherapeutic RAI WBS. As the results indicated, 42, 53, and 4 patients had type A, type B, and type C uptakes, respectively. Lower extremity uptake was significantly associated with younger age, not only in subjects with multiple RAI treatments but also in all the patients (P<0.05). Accumulation in patients with multiple RAI treatments was more frequent than patients with single RAI treatment (P<0.05). Lower extremity uptake was not associated with counts of the white blood cell count, hemoglobin level, platelet count, estimated glomerular filtration rate, effective half-time of RAI, serum TSH level, and anti-Tg concentration. Conclusion: About half of the patients had lower extremity uptake on the posttherapeutic RAI WBS, especially younger patients and those with multiple courses of RAI treatment. Bilateral lower extremity’s RAI uptake on the posttherapeutic WBS should be considered as physiological RAI distribution in bone marrow.

  15. Amino Acid PET – An Imaging Option to Identify Treatment Response, Posttherapeutic Effects, and Tumor Recurrence?

    PubMed Central

    Galldiks, Norbert; Langen, Karl-Josef

    2016-01-01

    Routine diagnostics and treatment monitoring in patients with primary and secondary brain tumors is usually based on contrast-enhanced standard MRI. However, the capacity of standard MRI to differentiate neoplastic tissue from non-specific posttreatment effects may be limited particularly after therapeutic interventions such as radio- and/or chemotherapy or newer treatment options, e.g., immune therapy. Metabolic imaging using PET may provide relevant additional information on tumor metabolism, which allows a more accurate diagnosis especially in clinically equivocal situations, particularly when radiolabeled amino acids are used. Amino acid PET allows a sensitive monitoring of a response to various treatment options, the early detection of tumor recurrence, and an improved differentiation of tumor recurrence from posttherapeutic effects. In the past, this method had only limited availability due to the use of PET tracers with a short half-life, e.g., C-11. In recent years, however, novel amino acid PET tracers labeled with positron emitters with a longer half-life (F-18) have been developed and clinically validated, which allow a more efficient and cost-effective application. These developments and the well-documented diagnostic performance of PET using radiolabeled amino acids suggest that its application continues to spread and that this technique may be available as a routine diagnostic tool for several indications in the field of neuro-oncology. PMID:27516754

  16. [Post-therapeutic lymphedema of the arm--possibilities and limits of diagnosis and therapy].

    PubMed

    Döller, W

    1999-01-01

    The post-therapeutical secondary arm lymphedema is the most frequent complication after a curatively treated cancer of mamma. For the diagnosis and therapy the knowledge of physiology and pathophysiology of lymphedema and of specific anatomy are necessary. The diagnosis facilities are essentially limited to a basic diagnosis (anamnesis, inspection, palpation, sonography, functional-diagnosis). Specific apparative diagnostics like lab, sonography, CT, MRI and PTE have to be applied especially at an early stage of the secondary arm lymphedema for the differential diagnosis between the secondary malign and secondary benign arm lymphedema. Specific apparative examinations like lymphscintigraphy and lymphography are limited and solely indicated for special questions. As a therapy possibility of the secondary arm-lymph edema, a conservative therapy, that is, the complex two-stage-decongestive physiotherapy (CDP) is recommended as first choice. Surgical therapies such as autologous lympho-lymphostatic anastomoses and lymphovenous anastomoses are only recommended in selected individual cases. The secondary malignant arm lymphedema must be primarily treated oncologically; lymphological therapy measures have to be postponed. Diagnosis and therapy are limited through lymphological incompetence and insufficient patient compliance. In this respect the provision of financial resources through National Health policy ist regarded as utterly important. PMID:10378339

  17. Tumour recurrence vs radionecrosis: an indication for multitrajectory serial stereotactic biopsies.

    PubMed

    Zamorano, L; Katanick, D; Dujovny, M; Yakar, D; Malik, G; Ausman, J I

    1989-01-01

    External RT has been proved to be an important adjuvant to surgery in the treatment of malignant glioma. It has also been demonstrated, that its effect on survival is dose-dependent, although accompanied by a higher morbidity. Intents to localize the field of high dose RT to the tumour area have been performed with the aim to spare damage of the normal brain tissue. Between August 1983 to December 1987, 40 patients with malignant astrocytoma (16 GM, 24 AA) underwent high dose localized hyperfractionated external RT after surgical resection. Patients received 57.6 Gy to the tumour and oedema area associated with a boost localized to the tumour of 7.4, 14.4 or 24 Gy. In the follow-up, 16 patients died with evidence of increase in size of lesion diagnosed by CT/MRI. Since July 1987, 12 patients with recurrence or increase on size of CT/MRI lesion have undergone multitrajectory serial stereotactic biopsies. From the biopsies 8 patients were histologically diagnosed was compatible with radionecrosis. From the 4 recurrences, 2 patients were treated with 125I implants and 1 with new resection. Patients with radionecrosis were treated with corticoides and diuretics, obtaining partial or complete remission of symptoms and decrease in size of CT lesion. Undoubtly, Multiplanar/3D multitrajectory serial stereotactic biopsies play a major role in the follow-up of these patients, and accurate diagnosis need to be established for further treatment therapy. The question remains if these localized boost should be replaced by 3D Multiplanar stereotactic interstitial radiotherapy boost after surgery and conventional radiotherapy. PMID:2549769

  18. Detection of Post-Therapeutic Effects in Breast Carcinoma Using Hard X-Ray Index of Refraction Computed Tomography – A Feasibility Study

    PubMed Central

    Mittone, Alberto; Gasilov, Sergey; Brun, Emmanuel; Bravin, Alberto; Mayr, Doris; Auweter, Sigrid D.; Hellerhoff, Karin; Reiser, Maximilian; Coan, Paola

    2016-01-01

    Objectives Neoadjuvant chemotherapy is the state-of-the-art treatment in advanced breast cancer. A correct visualization of the post-therapeutic tumor size is of high prognostic relevance. X-ray phase-contrast computed tomography (PC-CT) has been shown to provide improved soft-tissue contrast at a resolution formerly restricted to histopathology, at low doses. This study aimed at assessing ex-vivo the potential use of PC-CT for visualizing the effects of neoadjuvant chemotherapy on breast carcinoma. Materials and Methods The analysis was performed on two ex-vivo formalin-fixed mastectomy samples containing an invasive carcinoma removed from two patients treated with neoadjuvant chemotherapy. Images were matched with corresponding histological slices. The visibility of typical post-therapeutic tissue changes was assessed and compared to results obtained with conventional clinical imaging modalities. Results PC-CT depicted the different tissue types with an excellent correlation to histopathology. Post-therapeutic tissue changes were correctly visualized and the residual tumor mass could be detected. PC-CT outperformed clinical imaging modalities in the detection of chemotherapy-induced tissue alterations including post-therapeutic tumor size. Conclusions PC-CT might become a unique diagnostic tool in the prediction of tumor response to neoadjuvant chemotherapy. PC-CT might be used to assist during histopathological diagnosis, offering a high-resolution and high-contrast virtual histological tool for the accurate delineation of tumor boundaries. PMID:27362638

  19. [Contribution of 3D CISS MRI for pre- and post-therapeutic monitoring of obstructive hydrocephalus].

    PubMed

    Doll, A; Christmann, D; Kehrli, P; Abu Eid, M; Gillis, C; Bogorin, A; Thiebaut, A; Dietemann, J L

    2000-12-01

    This report describes the use of the recent three-dimensional Fourier transform constructing imaging in the steady state (CISS) MR sequence in the management of obstructive hydrocephalus. It is a gradient-echo imaging technique with high resolution which remains sensitive to flow. It enables locating the obstruction and determining the upstream impact. It provides anatomical information about third ventricle (V3) morphology and relationships useful before ventriculostomy. Twenty patients with obstructive hydrocephalus at the level of cerebral aqueduct or posterior V3 underwent sagittal 3DFT-CISS acquisition, supplemented by frontal, axial and coronal reformations in the cerebral aqueduct axis. 9 patients were examined after ventriculostomy with the same protocol. CISS-3DFT allows good visualization of the cerebral aqueduct and diagnosis of the underlying cause of obstruction (malformation, tumor), sometimes better than classical sequences. In case of complete obstruction, the flow-related signal void is usually absent in the cerebral aqueduct or V3. The position of V3 floor and its relationship with the tip of basilar artery are well analyzed. The dilatation of the anterior V3 recesses is a better sign of activity of hydrocephalus - and then of therapeutical indication - than classical transependymal resorption signs which are not always present in chronic longstanding adult hydrocephalus. Of the 9 ventriculostomy patients seven had linear flow-related signal void through V3 floor, from anterior V3 to basal cisterns on the postoperative MR study. This flow void confirms patent ventriculostomy. PMID:11223612

  20. Cerebral Palsy

    MedlinePlus

    ... How Can I Help a Friend Who Cuts? Cerebral Palsy KidsHealth > For Teens > Cerebral Palsy Print A A ... do just what everyone else does. What Is Cerebral Palsy? Cerebral palsy (CP) is a disorder of the ...

  1. Revisiting the Posttherapeutic Cure Criterion in Chagas Disease: Time for New Methods, More Questions, Doubts, and Polemics or Time to Change Old Concepts?

    PubMed Central

    de Lana, Marta; Martins-Filho, Olindo Assis

    2015-01-01

    One of the most relevant issues beyond the effectiveness of etiological treatment of Chagas disease is the lack of consensual/feasible tools to identify and certify the definitive parasitological cure. Several methods of distinct natures (parasitological, serological, and molecular) have been continuously proposed and novel perspectives are currently under investigation. Although the simultaneous use of distinct tests may offer better contributions and advances, it also leads to controversies of interpretation, with lack of mutual consent of cure criterion amongst researchers and physicians. In fact, when distinct host compartments (blood/tissues) are evaluated and explored, novel questions may arise due to the nature and sensitivity limit of each test. This short analytical review intends to present a chronological and critical overview and discuss the state-of-the-art distinct devices available for posttherapeutic cure assessment in Chagas disease, their contributions, meanings, and interpretation, aiming to point out the major gaps and propose novel insight for future perspectives of posttherapeutic management of Chagas disease patients. PMID:26583124

  2. Cerebral Hypoxia

    MedlinePlus

    ... Enhancing Diversity Find People About NINDS NINDS Cerebral Hypoxia Information Page Synonym(s): Hypoxia, Anoxia Table of Contents ( ... Trials Organizations Publicaciones en Español What is Cerebral Hypoxia? Cerebral hypoxia refers to a condition in which ...

  3. LINE-1 Methylation Status Correlates Significantly to Post-Therapeutic Recurrence in Stage III Colon Cancer Patients Receiving FOLFOX-4 Adjuvant Chemotherapy

    PubMed Central

    Fan, Yun-Ching; Chang, Wei-Chiao; Lu, Chien-Yu; Wu, I-Chen; Hsu, Wen-Hung; Huang, Ching-Wen; Wang, Jaw-Yuan

    2015-01-01

    Background Methylation levels of long interspersed nucleotide elements (LINE-1) are representative of genome-wide methylation status and crucial in maintaining genomic stability and expression. Their prognostic impact on colon cancer patients receiving adjuvant chemotherapy has not been well established. We evaluated the association between LINE-1 methylation status and clinicopathologic features and postoperative oncological outcomes in stage III colon cancer patients. Materials and Methods 129 UICC stage III colon cancer patients who had received radical resection and FOLFOX adjuvant chemotherapy were enrolled. Global methylation was estimated by analyzing tumor LINE-1 methylation status using bisulfite-polymerase chain reaction (PCR) and pyrosequencing assay. Demographics, clinicopathological data, and postoperative outcomes were recorded by trained abstractors. Outcome measurements included postoperative recurrence and disease-free survival. Univariate, multivariate, and survival analyses were conducted to identify prognostic factors of oncological outcomes. Results The LINE-1 methylation of all 129 patients was measured on a 0–100 scale (mean 63.3; median 63.7, standard deviation 7.1), LINE-1 hypomethylation was more common in patients aged 65 years and above (61.7%±7.6% vs. 64.6±6.4, p=0.019) and those with post-therapeutic recurrence (61.7±7.4 vs 64.3±6.7, p=0.041). Considering risk adjustment, LINE-1 hypomethylation was found to be an independent risk factor of post-therapeutic recurrence (Adjusted OR=14.1, p=0.012). Kaplan-Meier analysis indicated that patients in the low methylation group had shorter period of disease free survival (p=0.01). In a stratified analysis that included 48 patients with post-therapeutic recurrence, it was found that those who experienced shorter period of disease free survival (≦6 months) appeared to have lower LINE-1 methylation levels than patients who reported of recurrence after 6 months (56.68±15.75 vs. 63.55±7

  4. Cerebral Palsy

    MedlinePlus

    ... Got Homework? Here's Help White House Lunch Recipes Cerebral Palsy KidsHealth > For Kids > Cerebral Palsy Print A A ... the things that kids do every day. What's CP? Some kids with CP use wheelchairs and others ...

  5. Cerebral Palsy

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    ... Loss > Birth defects & other health conditions > Cerebral palsy Cerebral palsy E-mail to a friend Please fill in ... movement problems a child has. What is spastic CP? Spastic means tight or stiff muscles, or muscles ...

  6. Cerebral Palsy

    MedlinePlus

    Cerebral palsy is a group of disorders that affect a person's ability to move and to maintain balance ... do not get worse over time. People with cerebral palsy may have difficulty walking. They may also have ...

  7. Cerebral palsy

    MedlinePlus

    Cerebral palsy is a group of disorders that can involve brain and nervous system functions, such as movement, ... and thinking. There are several different types of cerebral palsy, including spastic, dyskinetic, ataxic, hypotonic, and mixed.

  8. Cerebral Palsy

    MedlinePlus

    ... Awards Enhancing Diversity Find People About NINDS NINDS Cerebral Palsy Information Page Clinical Trials Trial of Erythropoietin Neuroprotection ... en Español Additional resources from MedlinePlus What is Cerebral Palsy? The term cerebral palsy refers to a group ...

  9. Cerebral Aneurysms

    MedlinePlus

    ... Enhancing Diversity Find People About NINDS NINDS Cerebral Aneurysms Information Page Synonym(s): Aneurysm, Brain Aneurysm Condensed from ... Español Additional resources from MedlinePlus What is Cerebral Aneurysms? A cerebral aneurysm is a weak or thin ...

  10. Fluoroscopy-induced radionecrosis.

    PubMed

    Tchanque-Fossuo, Catherine N; Kamangar, Faranak; Ho, Baran; Chang, Shurong; Dahle, Sara E; Schulman, Joshua M; Isseroff, R Rivkah

    2016-01-01

    Complications from radiation exposure during fluoroscopic guidance of cardiac catheterization may occur. With repeated procedures, the risk for cutaneous injuries increases. Herein, we describe a 59-year-old man with extensive coronary artery disease, who had undergone multiple revascularization procedures and developed a non-healing ulcer on his left inferior scapula. The patient's medical history, physical exam findings, and histopathology gave clues to a case of radiation-induced dermatitis and necrosis. PMID:27617939

  11. Cerebral palsy.

    PubMed

    Wimalasundera, Neil; Stevenson, Valerie L

    2016-06-01

    Cerebral palsy has always been known as a disorder of movement and posture resulting from a non-progressive injury to the developing brain; however, more recent definitions allow clinicians to appreciate more than just the movement disorder. Accurate classification of cerebral palsy into distribution, motor type and functional level has advanced research. It also facilitates appropriate targeting of interventions to functional level and more accurate prognosis prediction. The prevalence of cerebral palsy remains fairly static at 2-3 per 1000 live births but there have been some changes in trends for specific causal groups. Interventions for cerebral palsy have historically been medical and physically focused, often with limited evidence to support their efficacy. The use of more appropriate outcome measures encompassing quality of life and participation is helping to deliver treatments which are more meaningful for people with cerebral palsy and their carers. PMID:26837375

  12. Cerebral palsy.

    PubMed

    Graham, H Kerr; Rosenbaum, Peter; Paneth, Nigel; Dan, Bernard; Lin, Jean-Pierre; Damiano, Diane L; Becher, Jules G; Gaebler-Spira, Deborah; Colver, Allan; Reddihough, Dinah S; Crompton, Kylie E; Lieber, Richard L

    2016-01-01

    Cerebral palsy is the most common cause of childhood-onset, lifelong physical disability in most countries, affecting about 1 in 500 neonates with an estimated prevalence of 17 million people worldwide. Cerebral palsy is not a disease entity in the traditional sense but a clinical description of children who share features of a non-progressive brain injury or lesion acquired during the antenatal, perinatal or early postnatal period. The clinical manifestations of cerebral palsy vary greatly in the type of movement disorder, the degree of functional ability and limitation and the affected parts of the body. There is currently no cure, but progress is being made in both the prevention and the amelioration of the brain injury. For example, administration of magnesium sulfate during premature labour and cooling of high-risk infants can reduce the rate and severity of cerebral palsy. Although the disorder affects individuals throughout their lifetime, most cerebral palsy research efforts and management strategies currently focus on the needs of children. Clinical management of children with cerebral palsy is directed towards maximizing function and participation in activities and minimizing the effects of the factors that can make the condition worse, such as epilepsy, feeding challenges, hip dislocation and scoliosis. These management strategies include enhancing neurological function during early development; managing medical co-morbidities, weakness and hypertonia; using rehabilitation technologies to enhance motor function; and preventing secondary musculoskeletal problems. Meeting the needs of people with cerebral palsy in resource-poor settings is particularly challenging. PMID:27188686

  13. Cerebral Palsy

    MedlinePlus

    ... Español (Spanish) Recommend on Facebook Tweet Share Compartir Cerebral palsy (CP) is a group of disorders that affect a ... ability to move and maintain balance and posture. CP is the most common motor disability in childhood. ...

  14. Cerebral Arteriosclerosis

    MedlinePlus

    ... Cerebral arteriosclerosis is the result of thickening and hardening of the walls of the arteries in the ... cause an ischemic stroke. When the thickening and hardening is uneven, arterial walls can develop bulges (called ...

  15. Cerebral angiography

    MedlinePlus

    ... Cerebral angiography is done in the hospital or radiology center. You lie on an x-ray table. ... be done in preparation for medical treatment (interventional radiology procedures) by way of certain blood vessels. What ...

  16. Cerebral Palsy (For Parents)

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy Cerebral Palsy KidsHealth > For Parents > Cerebral Palsy Print A A ... kids who are living with the condition. About Cerebral Palsy Cerebral palsy is one of the most common ...

  17. Cerebral palsy - resources

    MedlinePlus

    Resources - cerebral palsy ... The following organizations are good resources for information on cerebral palsy : National Institute of Neurological Disorders and Stroke -- www.ninds.nih.gov/disorders/cerebral_palsy/cerebral_palsy. ...

  18. Innovations in diagnosis and post-therapeutic monitoring of Chagas disease: Simultaneous flow cytometric detection of IgG1 antibodies anti-live amastigote, anti-live trypomastigote, and anti-fixed epimastigote forms of Trypanosoma cruzi.

    PubMed

    Alessio, Glaucia Diniz; Côrtes, Denise Fonseca; Machado de Assis, Girley Francisco; Júnior, Policarpo Ademar Sales; Ferro, Eloisa Amália Vieira; Antonelli, Lis Ribeiro do Valle; Teixeira-Carvalho, Andréa; Martins-Filho, Olindo Assis; de Lana, Marta

    2014-11-01

    This study developed a remarkable methodological innovation (FC-ATE) which enables simultaneous detection of antibodies specific to the three evolutive forms of Trypanosoma cruzi: live amastigote (AMA), live trypomastigote (TRYPO), and fixed epimastigote (EPI) using a differential fluorescence staining as low (AMA), intermediate (TRYPO), and high (EPI). An outstanding performance (100%) was observed in the discrimination of the chagasic (CH) and non-chagasic (NCH) patients. In the applicability of FC-ATE in the diagnosis of Chagas disease, 100% of the CH samples presented positivity in the percentage of positive fluorescent parasites (PPFP) for all the three forms of T. cruzi. Moreover, 94% of the samples of NCH presented negative values of PPFP with AMA and TRYPO, and 88% with EPI. Samples from the NCH group with false-positive results were those belonging to the leishmaniasis patients. Considering the applicability of this technique in post-therapeutic monitoring of Chagas disease, 100% of non-treated (NT) and treated non-cured (TNC) samples were positive with the three T. cruzi evolutive forms, while a percentage of 100% from samples of the treated cured (TC) patients were negative with AMA, 93% with TRYPO and 96% with EPI. The comparison between FC-ATE and two other flow cytometric tests using the same samples of patients NT, TNC and TC showed that the three techniques presented different reactivities, although categorical correlation between the methodologies was observed. Taken together, the results obtained with the novel FC-ATE method have shown an outstanding performance in the diagnosis and post-therapeutic monitoring of Chagas disease. PMID:25064148

  19. Employees with Cerebral Palsy

    MedlinePlus

    ... Resources Home | Accommodation and Compliance Series: Employees with Cerebral Palsy (CP) By Eddie Whidden, MA Preface Introduction Information About ... SOAR) at http://AskJAN.org/soar. Information about Cerebral Palsy (CP) What is CP? Cerebral palsy is a ...

  20. Cerebral Aneurysms Fact Sheet

    MedlinePlus

    ... Awards Enhancing Diversity Find People About NINDS Cerebral Aneurysms Fact Sheet See a list of all NINDS ... I get more information? What is a cerebral aneurysm? A cerebral aneurysm (also known as an intracranial ...

  1. Cerebral malaria.

    PubMed

    Postels, Douglas G; Birbeck, Gretchen L

    2013-01-01

    Malaria, the most significant parasitic disease of man, kills approximately one million people per year. Half of these deaths occur in those with cerebral malaria (CM). The World Health Organization (WHO) defines CM as an otherwise unexplained coma in a patient with malarial parasitemia. Worldwide, CM occurs primarily in African children and Asian adults, with the vast majority (greater than 90%) of cases occurring in children 5 years old or younger in sub-Saharan Africa. The pathophysiology of the disease is complex and involves infected erythrocyte sequestration, cerebral inflammation, and breakdown of the blood-brain barrier. A recently characterized malarial retinopathy is visual evidence of Plasmodium falciparum's pathophysiological processes occurring in the affected patient. Treatment consists of supportive care and antimalarial administration. Thus far, adjuvant therapies have not been shown to improve mortality rates or neurological outcomes in children with CM. For those who survive CM, residual neurological abnormalities are common. Epilepsy, cognitive impairment, behavioral disorders, and gross neurological deficits which include motor, sensory, and language impairments are frequent sequelae. Primary prevention strategies, including bed nets, vaccine development, and chemoprophylaxis, are in varied states of development and implementation. Continuing efforts to find successful primary prevention options and strategies to decrease neurological sequelae are needed. PMID:23829902

  2. [Cerebral palsy].

    PubMed

    Malagón Valdez, Jorge

    2007-01-01

    The term cerebral palsy (CP), is used for a great number of clinical neurological syndromes. The syndromes are characterized by having a common cause, motor defects. It is important, because they can cause a brain damage by presenting motor defects and some associated deficiencies, such as mental deficiency, epilepsy, language and visual defects and pseudobulbar paralysis, with the non-evolving fact. Some authors prefer using terms such as "non-evolving encephalopathies". In the treatment the utility of prevention programs of early stimulation and special rehabilitation methods, and treatment of associated deficiencies such as epilepsy, mental deficiency, language, audition and visual problems, and the attention deficit improve the prognosis in an important way. The prognosis depends on the severity of the disease and the associated manifestations. PMID:18422084

  3. United Cerebral Palsy

    MedlinePlus

    ... of UCP blog for the latest updates. United Cerebral Palsy UCP educates, advocates and provides support services to ... Partners Merz Logo Sprint Relay Copyright © 2015 United Cerebral Palsy 1825 K Street NW Suite 600 Washington, DC ...

  4. Cerebral amyloid angiopathy

    MedlinePlus

    Cerebral amyloid angiopathy is a neurological condition in which proteins called amyloid build up on the walls of the arteries ... The cause of cerebral amyloid angiopathy is unknown. Sometimes, it ... Persons with this condition have deposits of amyloid protein ...

  5. Cerebral Contusions and Lacerations

    MedlinePlus

    ... Stretch Additional Content Medical News Cerebral Contusions and Lacerations By James E. Wilberger, MD, Derrick A. Dupre, ... a direct, strong blow to the head. Cerebral lacerations are tears in brain tissue, caused by a ...

  6. Aging and Cerebral Palsy.

    ERIC Educational Resources Information Center

    Networker, 1993

    1993-01-01

    This special edition of "The Networker" contains several articles focusing on aging and cerebral palsy (CP). "Aging and Cerebral Palsy: Pathways to Successful Aging" (Jenny C. Overeynder) reports on the National Invitational Colloquium on Aging and Cerebral Palsy held in April 1993. "Observations from an Observer" (Kathleen K. Barrett) describes…

  7. [Etiology of cerebral palsy].

    PubMed

    Jaisle, F

    1996-01-01

    The "perinatal asphyxia" is regarded to be one of the causes of cerebral palsy, though in the very most of the children with cerebral palsy there is found no hypoxia during labour. It should be mentioned, that the definition of "perinatal" and "asphyxia" neither are unic nor concret. And also there is no correlation between nonreassuring fetal heart rate patterns and acidosis in fetal blood with the incidence of cerebral palsy. Numerous studies in pregnant animals failed in proving an acute intrapartal hypoxia to be the origin of the cerebral palsy. Myers (1975) describes four patterns of anatomic brain damage after different injuries. Only his so called oligo-acidotic hypoxia, which is protracted and lasts over a longer time is leading to brain injury, which can be regarded in analogy to the injury of children with cerebral palsy. Summarising the update publications about the causes of cerebral palsy and the studies in pregnant animals there is no evidence that hypoxia during labour may be the cause of cerebral palsy. There is a great probability of a pre(and post-)natal origin of brain injury (for instance a periventricular leucomalacia found after birth) which leads to cerebral palsy. Short after labour signs of a so called "asphyxia" may occur in addition to this preexisting injury and misrepresent the cause of cerebral palsy. Finally the prepartal injury may cause both: Cerebral palsy and hypoxia. PMID:9035826

  8. Hemiparesis post cerebral malaria

    PubMed Central

    Taiaa, Oumkaltoum; Amil, Touriya; Darbi, Abdelatif

    2015-01-01

    Cerebral malaria is one of the most serious complications in the Plasmodium falciparum infection. In endemic areas, the cerebral malaria interested mainly children. The occurrence in adults is very rare and most interested adult traveling in tropical zones. This case report describes a motor deficit post cerebral malaria in a young adult traveling in malaria endemic area. This complication has been reported especially in children and seems very rare in adults. PMID:25995798

  9. Cerebral Asymmetries and Reading Acquisition

    ERIC Educational Resources Information Center

    Pirozzolo, Francis J.

    1978-01-01

    Reviewed are historical developments regarding the concepts of cerebral localization, and analyzed are implications of current research on the role of the cerebral hemispheres in reading disorders. (CL)

  10. Cerebral Palsy (CP) Quiz

    MedlinePlus

    ... Submit Button Past Emails CDC Features Pop Quiz: Cerebral Palsy Language: English Español (Spanish) Recommend on Facebook Tweet ... Sandy is the parent of a child with cerebral palsy and the Board President of Gio’s Garden , a ...

  11. Cerebral amyloid angiopathy

    MedlinePlus

    ... Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice . 6th ed. Philadelphia, PA: Elsevier ... al. Course of cerebral amyloid angiopathy-related inflammation. Neurology. 2007;68:1411-1416. PMID: 17452586 www.ncbi. ...

  12. Rehabilitation in cerebral palsy.

    PubMed Central

    Molnar, G. E.

    1991-01-01

    Cerebral palsy is the most frequent physical disability of childhood onset. Over the past four decades, prevalence has remained remarkably constant at 2 to 3 per 1,000 live births in industrialized countries. In this article I concentrate on the rehabilitation and outcome of patients with cerebral palsy. The epidemiologic, pathogenetic, and diagnostic aspects are highlighted briefly as they pertain to the planning and implementation of the rehabilitation process. PMID:1866952

  13. Nanomedicine in cerebral palsy

    PubMed Central

    Balakrishnan, Bindu; Nance, Elizabeth; Johnston, Michael V; Kannan, Rangaramanujam; Kannan, Sujatha

    2013-01-01

    Cerebral palsy is a chronic childhood disorder that can have diverse etiologies. Injury to the developing brain that occurs either in utero or soon after birth can result in the motor, sensory, and cognitive deficits seen in cerebral palsy. Although the etiologies for cerebral palsy are variable, neuroinflammation plays a key role in the pathophysiology of the brain injury irrespective of the etiology. Currently, there is no effective cure for cerebral palsy. Nanomedicine offers a new frontier in the development of therapies for prevention and treatment of brain injury resulting in cerebral palsy. Nanomaterials such as dendrimers provide opportunities for the targeted delivery of multiple drugs that can mitigate several pathways involved in injury and can be delivered specifically to the cells that are responsible for neuroinflammation and injury. These materials also offer the opportunity to deliver agents that would promote repair and regeneration in the brain, resulting not only in attenuation of injury, but also enabling normal growth. In this review, the current advances in nanotechnology for treatment of brain injury are discussed with specific relevance to cerebral palsy. Future directions that would facilitate clinical translation in neonates and children are also addressed. PMID:24204146

  14. Vasospasm in Cerebral Inflammation

    PubMed Central

    Eisenhut, Michael

    2014-01-01

    All forms of cerebral inflammation as found in bacterial meningitis, cerebral malaria, brain injury, and subarachnoid haemorrhage have been associated with vasospasm of cerebral arteries and arterioles. Vasospasm has been associated with permanent neurological deficits and death in subarachnoid haemorrhage and bacterial meningitis. Increased levels of interleukin-1 may be involved in vasospasm through calcium dependent and independent activation of the myosin light chain kinase and release of the vasoconstrictor endothelin-1. Another key factor in the pathogenesis of cerebral arterial vasospasm may be the reduced bioavailability of the vasodilator nitric oxide. Therapeutic trials in vasospasm related to inflammation in subarachnoid haemorrhage in humans showed a reduction of vasospasm through calcium antagonists, endothelin receptor antagonists, statins, and plasminogen activators. Combination of therapeutic modalities addressing calcium dependent and independent vasospasm, the underlying inflammation, and depletion of nitric oxide simultaneously merit further study in all conditions with cerebral inflammation in double blind randomised placebo controlled trials. Auxiliary treatment with these agents may be able to reduce ischemic brain injury associated with neurological deficits and increased mortality. PMID:25610703

  15. Cerebral venous sinus thrombosis

    PubMed Central

    Allroggen, H.; Abbott, R.

    2000-01-01

    Cerebral venous sinus thrombosis is a challenging condition because of its variability of clinical symptoms and signs. It is very often unrecognised at initial presentation. All age groups can be affected. Large sinuses such as the superior sagittal sinus are most frequently involved. Extensive collateral circulation within the cerebral venous system allows for a significant degree of compensation in the early stages of thrombus formation. Systemic inflammatory diseases and inherited as well as acquired coagulation disorders are frequent causes, although in up to 30% of cases no underlying cause can be identified. The oral contraceptive pill appears to be an important additional risk factor. The spectrum of clinical presentations ranges from headache with papilloedema to focal deficit, seizures and coma. Magnetic resonance imaging with venography is the investigation of choice; computed tomography alone will miss a significant number of cases. It has now been conclusively shown that intravenous heparin is the first-line treatment for cerebral venous sinus thrombosis because of its efficacy, safety and feasability. Local thrombolysis may be indicated in cases of deterioration, despite adequate heparinisation. This should be followed by oral anticoagulation for 3-6 months. The prognosis of cerebral venous sinus thrombosis is generally favourable. A high index of clinical suspicion is needed to diagnose this uncommon condition so that appropriate treatment can be initiated.


Keywords: cerebral venous sinus thrombosis PMID:10622773

  16. Neuroprotection after cerebral ischemia

    PubMed Central

    Namura, Shobu; Ooboshi, Hiroaki; Liu, Jialing; Yenari, Midori A.

    2013-01-01

    Cerebral ischemia, a focal or global insufficiency of blood flow to the brain, can arise through multiple mechanisms, including thrombosis and arterial hemorrhage. Ischemia is a major driver of stroke, one of the leading causes of morbidity and mortality worldwide. While the general etiology of cerebral ischemia and stroke has been known for some time, the conditions have only recently been considered treatable. This report describes current research in this field seeking to fully understand the pathomechanisms underlying stroke; to characterize the brain’s intrinsic injury, survival, and repair mechanisms; to identify putative drug targets as well as cell-based therapies; and to optimize the delivery of therapeutic agents to the damaged cerebral tissue. PMID:23488559

  17. Cerebral Folate Deficiency

    ERIC Educational Resources Information Center

    Gordon, Neil

    2009-01-01

    Cerebral folate deficiency (CFD) is associated with low levels of 5-methyltetrahydrofolate in the cerebrospinal fluid (CSF) with normal folate levels in the plasma and red blood cells. The onset of symptoms caused by the deficiency of folates in the brain is at around 4 to 6 months of age. This is followed by delayed development, with deceleration…

  18. Cerebral Palsy Litigation

    PubMed Central

    Sartwelle, Thomas P.

    2015-01-01

    The cardinal driver of cerebral palsy litigation is electronic fetal monitoring, which has continued unabated for 40 years. Electronic fetal monitoring, however, is based on 19th-century childbirth myths, a virtually nonexistent scientific foundation, and has a false positive rate exceeding 99%. It has not affected the incidence of cerebral palsy. Electronic fetal monitoring has, however, increased the cesarian section rate, with the expected increase in mortality and morbidity risks to mothers and babies alike. This article explains why electronic fetal monitoring remains endorsed as efficacious in the worlds’ labor rooms and courtrooms despite being such a feeble medical modality. It also reviews the reasons professional organizations have failed to condemn the use of electronic fetal monitoring in courtrooms. The failures of tort reform, special cerebral palsy courts, and damage limits to stem the escalating litigation are discussed. Finally, the authors propose using a currently available evidence rule—the Daubert doctrine that excludes “junk science” from the courtroom—as the beginning of the end to cerebral palsy litigation and electronic fetal monitoring’s 40-year masquerade as science. PMID:25183322

  19. Cerebral White Matter

    PubMed Central

    Schmahmann, Jeremy D.; Smith, Eric E.; Eichler, Florian S.; Filley, Christopher M.

    2013-01-01

    Lesions of the cerebral white matter (WM) result in focal neurobehavioral syndromes, neuropsychiatric phenomena, and dementia. The cerebral WM contains fiber pathways that convey axons linking cerebral cortical areas with each other and with subcortical structures, facilitating the distributed neural circuits that subserve sensorimotor function, intellect, and emotion. Recent neuroanatomical investigations reveal that these neural circuits are topographically linked by five groupings of fiber tracts emanating from every neocortical area: (1) cortico-cortical association fibers; (2) corticostriatal fibers; (3) commissural fibers; and cortico-subcortical pathways to (4) thalamus and (5) pontocerebellar system, brain stem, and/or spinal cord. Lesions of association fibers prevent communication between cortical areas engaged in different domains of behavior. Lesions of subcortical structures or projection/striatal fibers disrupt the contribution of subcortical nodes to behavior. Disconnection syndromes thus result from lesions of the cerebral cortex, subcortical structures, and WM tracts that link the nodes that make up the distributed circuits. The nature and the severity of the clinical manifestations of WM lesions are determined, in large part, by the location of the pathology: discrete neurological and neuropsychiatric symptoms result from focal WM lesions, whereas cognitive impairment across multiple domains—WM dementia—occurs in the setting of diffuse WM disease. We present a detailed review of the conditions affecting WM that produce these neurobehavioral syndromes, and consider the pathophysiology, clinical effects, and broad significance of the effects of aging and vascular compromise on cerebral WM, in an attempt to help further the understanding, diagnosis, and treatment of these disorders. PMID:18990132

  20. Noninvasive measurement of cerebral oxygen saturation and cerebral phronetal function

    NASA Astrophysics Data System (ADS)

    Li, Shengli; Zhang, Aiyu; Xu, Min; Jin, Taiyi

    1998-08-01

    Using the Near-Infrared Spectroscopy (NIRS), the noninvasive measurement of cerebral oxygen concentration can be achieved in vivo based on the Lambert-Beer Law. In this paper, we discuss the possibility of studying higher brain functions through combining cerebral oxygen saturation and cerebral function measurement. Event-related experiments are introduced to measure the cerebral phronetal function. Time domain curves show sight differences among these experiment results. However, with the aid of DFT, experiment data of all five human volunteers show the frequency near 20 Hz or 40 Hz is evoked depending on the difficulty of the mental tasks. The results demonstrate the feasibility of cerebral functions study by means of cerebral oxygen saturation measurement analyzed in the frequency domain.

  1. Genetics of Cerebral Vasospasm

    PubMed Central

    Ladner, Travis R.; Zuckerman, Scott L.; Mocco, J

    2013-01-01

    Cerebral vasospasm (CV) is a major source of morbidity and mortality in aneurysmal subarachnoid hemorrhage (aSAH). It is thought that an inflammatory cascade initiated by extravasated blood products precipitates CV, disrupting vascular smooth muscle cell function of major cerebral arteries, leading to vasoconstriction. Mechanisms of CV and modes of therapy are an active area of research. Understanding the genetic basis of CV holds promise for the recognition and treatment for this devastating neurovascular event. In our review, we summarize the most recent research involving key areas within the genetics and vasospasm discussion: (1) Prognostic role of genetics—risk stratification based on gene sequencing, biomarkers, and polymorphisms; (2) Signaling pathways—pinpointing key inflammatory molecules responsible for downstream cellular signaling and altering these mediators to provide therapeutic benefit; and (3) Gene therapy and gene delivery—using viral vectors or novel protein delivery methods to overexpress protective genes in the vasospasm cascade. PMID:23691311

  2. Phenylpropanolamine and cerebral hemorrhage

    SciTech Connect

    McDowell, J.R.; LeBlanc, H.J.

    1985-05-01

    Computerized tomography, carotid angiograms, and arteriography were used to diagnose several cases of cerebral hemorrhage following the use of phenylpropanolamine. The angiographic picture in one of the three cases was similar to that previously described in association with amphetamine abuse and pseudoephedrine overdose, both substances being chemically and pharmacologically similar to phenylpropanolamine. The study suggests that the arterial change responsible for symptoms may be due to spasm rather than arteriopathy. 14 references, 5 figures.

  3. Cerebral dysgenesis. An overview.

    PubMed

    Schaefer, G B; Sheth, R D; Bodensteiner, J B

    1994-11-01

    A significant portion of patients with neurodevelopmental abnormalities (mental retardation, learning disabilities, and so forth) have no definable cause for these problems. Mounting evidence suggests a substantial number of these idiopathic conditions have subtle abnormalities of brain development (cerebral dysgenesis) as the inherent pathophysiologic event. In this article the authors summarize normal and abnormal brain development, the diagnostic approach to idiopathic neurodevelopmental anomalies, and the new molecular genetic insights into the underlying causes of brain malformations. PMID:7845342

  4. What provides cerebral reserve?

    PubMed

    Staff, Roger T; Murray, Alison D; Deary, Ian J; Whalley, Lawrence J

    2004-05-01

    The cerebral reserve hypothesis is a heuristic concept used to explain apparent protection from the onset of cerebral disease and/or cognitive decline in old age. A significant obstacle when investigating the reserve hypothesis is the absence of baseline data with which to compare current cognitive status. We tested the influence of three hypothesized proxies of reserve (education, head size and occupational attainment [OCC]) in 92 volunteers born in 1921, whose cognitive function was measured at age 11 and 79 years, and who underwent brain MRI. The association between each proxy and old age cognitive function was tested, adjusting for variance contributed by childhood mental ability and detrimental age-related pathological changes measured using MRI. The results showed that education and OCC, but not total intracranial volume (TICV), contribute to cerebral reserve and help retain cognitive function in old age. Education was found to contribute between 5 and 6% of the variance found in old age memory function but was found to have no significant association with reasoning abilities. OCC was found to contribute around 5% of the variance found in old age memory function and between 6 and 8% of the variance found in old age reasoning abilities. We conclude that the intellectual challenges experienced during life, such as education and occupation, accumulate reserve and allow cognitive function to be maintained in old age. PMID:15047587

  5. [Insomnia and cerebral hypoperfusion].

    PubMed

    Káposzta, Zoltán; Rácz, Klára

    2007-11-18

    Insomnia is defined as difficulty with the initiation, maintenance, duration, or quality of sleep that results in the impairment of daytime functioning, despite adequate opportunity and circumstances for sleep. In most countries approximately every third inhabitant has insomnia. Insomnia can be classified as primary and secondary. The pathogenesis of primary insomnia is unknown, but available evidence suggests a state of hyperarousal. Insomnia secondary to other causes is more common than primary insomnia. Cerebral hypoperfusion can be the cause of insomnia in some cases. In such patients the cerebral blood flow should be improved using parenteral vascular therapy. If insomnia persists despite treatment, then therapy for primary insomnia should be instituted using benzodiazepine-receptor agonists such as Zolpidem, Zopiclone, or Zaleplon. In those cases Midazolam cannot be used for the treatment of insomnia due to its marked negative effect on cerebral blood flow. In Hungary there is a need to organize multidisciplinary Insomnia Clinics because insomnia is more than a disease, it is a public health problem in this century. PMID:17988972

  6. Cerebral oxygenation and hyperthermia

    PubMed Central

    Bain, Anthony R.; Morrison, Shawnda A.; Ainslie, Philip N.

    2014-01-01

    Hyperthermia is associated with marked reductions in cerebral blood flow (CBF). Increased distribution of cardiac output to the periphery, increases in alveolar ventilation and resultant hypocapnia each contribute to the fall in CBF during passive hyperthermia; however, their relative contribution remains a point of contention, and probably depends on the experimental condition (e.g., posture and degree of hyperthermia). The hyperthermia-induced hyperventilatory response reduces arterial CO2 pressure (PaCO2) causing cerebral vasoconstriction and subsequent reductions in flow. During supine passive hyperthermia, the majority of recent data indicate that reductions in PaCO2 may be the primary, if not sole, culprit for reduced CBF. On the other hand, during more dynamic conditions (e.g., hemorrhage or orthostatic challenges), an inability to appropriately decrease peripheral vascular conductance presents a condition whereby adequate cerebral perfusion pressure may be compromised secondary to reductions in systemic blood pressure. Although studies have reported maintenance of pre-frontal cortex oxygenation (assessed by near-infrared spectroscopy) during exercise and severe heat stress, the influence of cutaneous blood flow is known to contaminate this measure. This review discusses the governing mechanisms associated with changes in CBF and oxygenation during moderate to severe (i.e., 1.0°C to 2.0°C increase in body core temperature) levels of hyperthermia. Future research directions are provided. PMID:24624095

  7. What You Should Know about Cerebral Aneurysms

    MedlinePlus

    ... About Stroke What You Should Know About Cerebral Aneurysms Updated:Jun 13,2014 About Cerebral Aneurysms Diagnosis ... to view an animation What is a cerebral aneurysm? An aneurysm is a weak area in a ...

  8. Molecular pathophysiology of cerebral edema.

    PubMed

    Stokum, Jesse A; Gerzanich, Volodymyr; Simard, J Marc

    2016-03-01

    Advancements in molecular biology have led to a greater understanding of the individual proteins responsible for generating cerebral edema. In large part, the study of cerebral edema is the study of maladaptive ion transport. Following acute CNS injury, cells of the neurovascular unit, particularly brain endothelial cells and astrocytes, undergo a program of pre- and post-transcriptional changes in the activity of ion channels and transporters. These changes can result in maladaptive ion transport and the generation of abnormal osmotic forces that, ultimately, manifest as cerebral edema. This review discusses past models and current knowledge regarding the molecular and cellular pathophysiology of cerebral edema. PMID:26661240

  9. Molecular pathophysiology of cerebral edema

    PubMed Central

    Gerzanich, Volodymyr; Simard, J Marc

    2015-01-01

    Advancements in molecular biology have led to a greater understanding of the individual proteins responsible for generating cerebral edema. In large part, the study of cerebral edema is the study of maladaptive ion transport. Following acute CNS injury, cells of the neurovascular unit, particularly brain endothelial cells and astrocytes, undergo a program of pre- and post-transcriptional changes in the activity of ion channels and transporters. These changes can result in maladaptive ion transport and the generation of abnormal osmotic forces that, ultimately, manifest as cerebral edema. This review discusses past models and current knowledge regarding the molecular and cellular pathophysiology of cerebral edema. PMID:26661240

  10. Oligodendrogenesis after cerebral ischemia

    PubMed Central

    Zhang, Ruilan; Chopp, Michael; Zhang, Zheng Gang

    2013-01-01

    Neural stem cells in the subventricular zone (SVZ) of the lateral ventricle of adult rodent brain generate oligodendrocyte progenitor cells (OPCs) that disperse throughout the corpus callosum and striatum where some of OPCs differentiate into mature oligodendrocytes. Studies in animal models of stroke demonstrate that cerebral ischemia induces oligodendrogenesis during brain repair processes. This article will review evidence of stroke-induced proliferation and differentiation of OPCs that are either resident in white matter or are derived from SVZ neural progenitor cells and of therapies that amplify endogenous oligodendrogenesis in ischemic brain. PMID:24194700

  11. Hemodynamics of Cerebral Aneurysms

    PubMed Central

    Sforza, Daniel M.; Putman, Christopher M.; Cebral, Juan Raul

    2009-01-01

    The initiation and progression of cerebral aneurysms are degenerative processes of the arterial wall driven by a complex interaction of biological and hemodynamic factors. Endothelial cells on the artery wall respond physiologically to blood-flow patterns. In normal conditions, these responses are associated with nonpathological tissue remodeling and adaptation. The combination of abnormal blood patterns and genetics predisposition could lead to the pathological formation of aneurysms. Here, we review recent progress on the basic mechanisms of aneurysm formation and evolution, with a focus on the role of hemodynamic patterns. PMID:19784385

  12. Therapeutic interventions in cerebral palsy.

    PubMed

    Patel, Dilip R

    2005-11-01

    Various therapeutic interventions have been used in the management of children with cerebral palsy. Traditional physiotherapy and occupational therapy are widely used interventions and have been shown to be of benefit in the treatment of cerebral palsy. Evidence in support of the effectiveness of the neurodevelopmental treatment is equivocal at best. There is evidence to support the use and effectiveness of neuromuscular electrical stimulation in children with cerebral palsy. The effectiveness of many other interventions used in the treatment of cerebral palsy has not been clearly established based on well-controlled trials. These include: sensory integration, body-weight support treadmill training, conductive education, constraint-induced therapy, hyperbaric oxygen therapy, and the Vojta method. This article provides an overview of salient aspects of popular interventions used in the management of children with cerebral palsy. PMID:16391455

  13. Cerebral pathology post heart transplantation.

    PubMed

    Peteghem, S Van; Pauw, M De

    2015-04-01

    Cerebral pathology is frequently encountered post heart transplantation with a cumulative incidence of about 80% after 15 years. A broad spectrum of disease entities is reported, from minor abnormalities to life-threatening diseases. Although cerebral infections and malignancies are rare in this patient population, they have a high mortality rate. Since 1991, 171 orthotopic heart transplantations were performed at the Ghent University Hospital with a 10-year survival rate of 75%. Severe cerebral complications occurred in 10 patients, with epilepsy in 2 patients, cerebrovascular accidents in 4 patients, cerebral infections in 3 patients and a cerebral malignancy in 1 patient, resulting in a fatal outcome in 7 patients. We present four of these cases. PMID:25292206

  14. Cerebral cartography and connectomics

    PubMed Central

    Sporns, Olaf

    2015-01-01

    Cerebral cartography and connectomics pursue similar goals in attempting to create maps that can inform our understanding of the structural and functional organization of the cortex. Connectome maps explicitly aim at representing the brain as a complex network, a collection of nodes and their interconnecting edges. This article reflects on some of the challenges that currently arise in the intersection of cerebral cartography and connectomics. Principal challenges concern the temporal dynamics of functional brain connectivity, the definition of areal parcellations and their hierarchical organization into large-scale networks, the extension of whole-brain connectivity to cellular-scale networks, and the mapping of structure/function relations in empirical recordings and computational models. Successfully addressing these challenges will require extensions of methods and tools from network science to the mapping and analysis of human brain connectivity data. The emerging view that the brain is more than a collection of areas, but is fundamentally operating as a complex networked system, will continue to drive the creation of ever more detailed and multi-modal network maps as tools for on-going exploration and discovery in human connectomics. PMID:25823870

  15. Cerebral sinus venous thrombosis

    PubMed Central

    Alvis-Miranda, Hernando Raphael; Milena Castellar-Leones, Sandra; Alcala-Cerra, Gabriel; Rafael Moscote-Salazar, Luis

    2013-01-01

    Cerebral sinus venous thrombosis (CSVT) is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT) and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment. PMID:24347950

  16. Cerebral sinus venous thrombosis.

    PubMed

    Alvis-Miranda, Hernando Raphael; Milena Castellar-Leones, Sandra; Alcala-Cerra, Gabriel; Rafael Moscote-Salazar, Luis

    2013-10-01

    Cerebral sinus venous thrombosis (CSVT) is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT) and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment. PMID:24347950

  17. [Noradrenaline and cerebral aging].

    PubMed

    Jouvet, M; Albarede, J L; Lubin, S; Meyrignac, C

    1991-01-01

    The central functions of norepinephrine (NE) are a recent discovery: regulation of alertness and of the wakefulness-sleep cycle, maintenance of attention, memory and learning, cerebral plasticity and neuro-protection. The anatomical, histological, biochemical and physiological properties of the central noradrenergic system: extreme capacity for ramification and arborization; slow conduction, non-myelinized axons with extrasynaptic varicosities producing and releasing NE; frequency of co-transmission phenomena, and; neuromodulation with fiber effect responsible for improvement in the signal over background noise ratio and selection of significant stimuli form a true interface between the outside world and the central nervous system, notably for the neocortex in the context of the cognitive treatment of information. This central noradrenergic system is involved in the neurophysiology and the clinical features of cerebral aging (ideation-motor and cognitive function slowing down, loss of behavioral adjustment), neuro-degenerative disorders (SDAT, Parkinson's disease), certain aspects of depression and less obvious conditions (head injuries, sequelae of cerebrovascular accidents, sub-cortical dementia). The recent development of medications improving alertness (adrafinil, modafinil) with a pure central action and specifically noradrenergic, may contribute to an improvement in these multifactorial disorders. PMID:1864252

  18. Cerebral blood flow velocity in two patients with neonatal cerebral infarction.

    PubMed

    Nishimaki, S; Seki, K; Yokota, S

    2001-04-01

    Cerebral blood flow velocity was measured in the middle cerebral artery of two patients who exhibited unilateral neonatal cerebral infarction during the neonatal period. Doppler studies demonstrated increases in cerebral blood flow velocity but decreases in the resistance index on the affected side of the middle cerebral artery in the neonate who developed hemiplegia with cystic encephalomalacia, although the neonate with normal neurologic outcome exhibited symmetric cerebral blood flow velocity and resistance index. The asymmetry in cerebral blood flow velocity measurements of both middle cerebral arteries may be useful to evaluate the severity of brain damage and predict the neurodevelopmental prognosis of unilateral neonatal cerebral infarction. PMID:11377112

  19. Cerebral venous angiomas

    SciTech Connect

    Olson, E.; Gilmor, R.L.; Richmond, B.

    1984-04-01

    Several unusual cases of cerebral venous angiomas as well as some characteristic cases are reported. The characteristic angiographic feature is that of a collection of dilated medullary veins draining into a single large draining vein, which appears first in the early venous phase and persists into the late venous phase of the arteriogram. Computed tomography (CT) was abnormal in 12/13 cases. The draining vein was the most common abnormality identified on CT. Coronal and sagittal reconstruction may be helpful in demonstrating the draining vein. A case of large twin venous angiomas, a case of hemorrhage from a venous angioma, and a case of a venous angioma with an incidentally associated glioblastoma are presented.

  20. Cerebral Laterality and Verbal Processes

    ERIC Educational Resources Information Center

    Sherman, Jay L.; And Others

    1976-01-01

    Research suggests that we process information by way of two distinct and functionally separate coding systems. Their location, somewhat dependent on cerebral laterality, varies in right- and left-handed persons. Tests this dual coding model. (Editor/RK)

  1. Cognitive Deficits and Cerebral Asymmetry.

    ERIC Educational Resources Information Center

    Bakker, Dirk J.

    1982-01-01

    Research concerning cerebral asymmetry and its effect on scholastic achievement, reading disabilities, learning disabilities, and linguistic competence is reviewed in an exploration of brain hemisphere-specific etiologies of dyslexia. (CJ)

  2. [Plasma osmolarity and cerebral volume].

    PubMed

    Boulard, G

    2001-02-01

    Under normal physiological conditions, the osmolarity of extracellular fluids (ECFs) and natremia are controlled by two regulatory mechanisms modulating the water balance and sodium outflow from information collected by the osmoreceptors and baroreceptors, respectively. As well, under normal physiological conditions, water and electrolytes of brain ECFs are secreted by the endothelial cells of brain capillaries. Furthermore, isotonicity is present on both sides of the blood-brain barrier. In the event of systemic osmolarity disorders, water transport subject to osmosis laws occurs at the level of the blood-brain barrier. In the case of plasmatic hyperosmolarity cerebral dehydration is observed, while cerebral edema occurs in the contrary case. However, plasmatic osmolarity disorders have less effect on the cerebral volume when their introduction is slow. Experimentation in acute conditions shows that measured variations of the cerebral water content are lower than calculated variations, thus suggesting the existence of an adaptive mechanism, that is, the cerebral osmoregulation which limits the variation of the volume of brain cells by modulating their osmoactive molecule content. These osmoactive molecules are, on the one hand, the electrolytes, which are early and rapidly mobilized, and, on the other hand, the organic osmoles (amino acids, etc.), whose secretion is slower and delayed. This phenomenon should be taken into account in the treatment of osmolarity disorders. Thus, the related-risk of treatment for natremia disorders is therapeutic reversal of the osmotic gradient at the level of the blood-brain barrier. This reversal, which corresponds to a second osmotic stress, requires the implementation of a new procedure of cerebral osmoregulation in the opposite direction of the preceding one. As successive osmotic stresses decrease the effectiveness of brain osmoregulation, the risk for cerebral dehydration and pontine myelinolysis increases when the treatment

  3. Hydrostatic determinants of cerebral perfusion

    SciTech Connect

    Wagner, E.M.; Traystman, R.J.

    1986-05-01

    We examined the cerebral blood flow response to alterations in perfusion pressure mediated through decreases in mean arterial pressure, increases in cerebrospinal fluid (CSF) pressure, and increases in jugular venous (JV) pressure in 42 pentobarbital anesthetized dogs. Each of these three pressures was independently controlled. Cerebral perfusion pressure was defined as mean arterial pressure minus JV or CSF pressure, depending on which was greater. Mean hemispheric blood flow was measured with the radiolabeled microsphere technique. Despite 30-mm Hg reductions in mean arterial pressure or increases in CSF or JV pressure, CBF did not change as long as the perfusion pressure remained greater than approximately 60 mm Hg. However, whenever perfusion pressure was reduced to an average of 48 mm Hg, cerebral blood flow decreased 27% to 33%. These results demonstrate the capacity of the cerebral vascular bed to respond similarly to changes in the perfusion pressure gradient obtained by decreasing mean arterial pressure, increasing JV pressure or increasing CSF pressure, and thereby support the above definition of cerebral perfusion pressure.

  4. Cerebral oximetry and cardiac arrest.

    PubMed

    Skhirtladze-Dworschak, Keso; Dworschak, Martin

    2013-12-01

    Cerebral oximetry is a Food and Drug Administration-approved technology that allows monitoring of brain oxygen saturation in accessible superficial brain cortex regions, which are amongst the most vulnerable in regard to ischemic or hypoxic injury. Since most oxygen in the area of interest is located in the venous compartment, the determined regional brain oxygen saturation approximately reflects the local balance between oxygen delivery and oxygen consumption. Major systemic alterations in blood oxygen content and oxygen delivery will be accompanied by corresponding changes in regional brain saturation. This systematic review, which is based on a Medline search, focuses on the characteristic changes in regional cerebral oxygen saturation that occur, when global oxygen supply to the brain ceases. It further highlights the potential application of cerebral oximetry in the management of cardiac arrest victims, the predictability of clinical outcome after global cerebral ischemia, and it also indicates possible potentials for the management of cerebral reperfusion after having instituted return of spontaneous circulation. PMID:23782549

  5. Cerebral palsy and aging

    PubMed Central

    Haak, Peterson; Lenski, Madeleine; Hidecker, Mary Jo Cooley; Li, Min; Paneth, Nigel

    2014-01-01

    Cerebral palsy (CP), the most common major disabling motor disorder of childhood, is frequently thought of as a condition that affects only children. Deaths in children with CP, never common, have in recent years become very rare, unless the child is very severely and multiply disabled. Thus, virtually all children assigned the diagnosis of CP will survive into adulthood. Attention to the adult with CP has been sparse, and the evolution of the motor disorder as the individual moves through adolescence, young adulthood, middle age, and old age is not well understood. Nor do we know what happens to other functional domains, such as communication and eating behavior, in adults with CP. Although the brain injury that initially causes CP by definition does not progressively worsen through the lifetime, the effects of CP manifest differently throughout the life span. The aging process must inevitably interact with the motor disorder, but we lack systematic, large-scale follow-up studies of children with CP into adulthood and through adulthood with thorough assessments performed over time. In this paper we summarize what is known of the epidemiology of CP throughout the life span, beginning with mortality and life expectancy, then survey what is known of functioning, ability, and quality of life of adults with CP. We conclude by describing a framework for future research on CP and aging that is built around the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) and suggest specific tools and approaches for conducting that research in a sound manner. PMID:19740206

  6. Cerebritis: an unusual complication of Klebsiella pneumoniae.

    PubMed

    Majumdar, Mainak; Simes, David C; Prabha, Ramesh D

    2009-01-01

    Cerebritis is part of a continuum of brain infection and is difficult to diagnose. Cerebritis caused by Klebsiella in immunocompetent adults without predisposing factors such as neurosurgery or penetrating brain injury has not been reported before. We report a case of Klebsiella cerebritis in an adult patient with a proven extracranial focus of infection. We suggest considering cerebritis as a differential diagnosis for altered level of consciousness in patients of severe sepsis, even if an extracranial source of infection is proven. PMID:19881180

  7. Cerebritis: An unusual complication of Klebsiella pneumoniae

    PubMed Central

    Majumdar, Mainak; Simes1, David C.; Prabha1, Ramesh D.

    2009-01-01

    Cerebritis is part of a continuum of brain infection and is difficult to diagnose. Cerebritis caused by Klebsiella in immunocompetent adults without predisposing factors such as neurosurgery or penetrating brain injury has not been reported before. We report a case of Klebsiella cerebritis in an adult patient with a proven extracranial focus of infection. We suggest considering cerebritis as a differential diagnosis for altered level of consciousness in patients of severe sepsis, even if an extracranial source of infection is proven. PMID:19881180

  8. Multiple infected cerebral hydatid cysts.

    PubMed

    Gana, R; Skhissi, M; Maaqili, R; Bellakhdar, F

    2008-05-01

    We report an unusual patient with multiple infected cerebral hydatid cysts. A 20-year-old man presented with a 2-month history of headache and progressive left-sided hempiparesis. A cerebral CT scan showed a large and heterogeneous parieto-occipital lesion. During surgery an infected hydatid cyst was discovered with multiple daughter vesicles. Post-operatively the patient was treated with albendazol, cefotaxime and metronidazole. The clinical course was good with total recovery of the hemiparesis. A follow-up CT scan showed persistence of some small deep-seated cysts. Multiple infected cerebral hydatid cyst is uncommon and can be confused with other cystic brain lesions. The aim of surgery is to remove the cyst unruptured and this should be followed by antihelminthic and antibiotic treatment in order to avoid recurrences. PMID:18342511

  9. Oculoauriculovertebral spectrum and cerebral anomalies.

    PubMed Central

    Schrander-Stumpel, C T; de Die-Smulders, C E; Hennekam, R C; Fryns, J P; Bouckaert, P X; Brouwer, O F; da Costa, J J; Lommen, E J; Maaswinkel-Mooy, P D

    1992-01-01

    We report on three Dutch children with a clinical diagnosis of oculoauriculovertebral spectrum (OAVS) and hydrocephalus. The clinical features are compared to 15 published cases of OAVS and hydrocephalus. Several other cerebral abnormalities were present in the whole group. About half of the cases had cleft lip/palate, anophthalmia/microphthalmia, or a cardiac defect. Mental retardation was found in five of the surviving 11 patients and early death occurred in one-third. We compared the cases with OAVS and hydrocephalus with published reports of OAVS and other cerebral anomalies and found no significant clinical differences. However, the clinical characteristics were clearly more severely expressed than generally found in patients with OAVS. Children with OAVS and more severe clinical features, especially anophthalmia/microphthalmia and cleft lip/palate, seem to be at an increased risk for cerebral malformations and for mental retardation. Images PMID:1583660

  10. Behaviour Problems Amongst Children With Cerebral Palsy.

    ERIC Educational Resources Information Center

    Oswin, Maureen

    Based on 6 years of work with cerebral palsied children, the thesis considers types and causes of cerebral palsy, the life pattern of the child with cerebral palsy from early years to adolescence, and the effect of the handicapped child on his parents and family. Literature on behavior disorders is reviewed, and kinds of behavior problems are…

  11. Neuroevolutional Approach to Cerebral Palsy and Speech.

    ERIC Educational Resources Information Center

    Mysak, Edward D.

    Intended for cerebral palsy specialists, the book emphasizes the contribution that a neuroevolutional approach to therapy can make to habilitation goals of the child with cerebral palsy and applies the basic principles of the Bobath approach to therapy. The first section discusses cerebral palsy as a reflection of disturbed neuro-ontogenisis and…

  12. Cerebral vasculitis associated with cocaine abuse

    SciTech Connect

    Kaye, B.R.; Fainstat, M.

    1987-10-16

    A case of cerebral vasculitis in a previously healthy 22-year-old man with a history of cocaine abuse is described. Cerebral angiograms showed evidence of vasculitis. A search for possible causes other than cocaine produced no results. The authors include cocaine with methamphetamines, heroin, and ephedrine as illicit drugs that can cause cerebral vasculitis.

  13. Cerebral Palsy: A Dental Update

    PubMed Central

    Sehrawat, Nidhi; Bansal, Kalpana; Chopra, Radhika

    2014-01-01

    ABSTRACT Special and medically compromised patients present a unique population that challenges the dentist’s skill and knowledge. Providing oral care to people with cerebral palsy (CP) requires adaptation of the skills we use everyday. In fact, most people with mild or moderate forms of CP can be treated successfully in the general practice setting. This article is to review various dental considerations and management of a CP patient. How to cite this article: Sehrawat N, Marwaha M, Bansal K, Chopra R. Cerebral Palsy: A Dental Update. Int J Clin Pediatr Dent 2014;7(2):109-118. PMID:25356010

  14. Inflammation, Cerebral Vasospasm, and Evolving Theories of Delayed Cerebral Ischemia

    PubMed Central

    Carr, Kevin R.; Zuckerman, Scott L.; Mocco, J

    2013-01-01

    Cerebral vasospasm (CVS) is a potentially lethal complication of aneurysmal subarachnoid hemorrhage (aSAH). Recently, the symptomatic presentation of CVS has been termed delayed cerebral ischemia (DCI), occurring as early as 3-4 days after the sentinel bleed. For the past 5-6 decades, scientific research has promulgated the theory that cerebral vasospasm plays a primary role in the pathology of DCI and subsequently delayed ischemic neurological decline (DIND). Approximately 70% of patients develop CVS after aSAH with 50% long-term morbidity rates. The exact etiology of CVS is unknown; however, a well-described theory involves an antecedent inflammatory cascade with alterations of intracellular calcium dynamics and nitric oxide fluxes, though the intricacies of this inflammatory theory are currently unknown. Consequently, there have been few advances in the clinical treatment of this patient cohort, and morbidity remains high. Identification of intermediaries in the inflammatory cascade can provide insight into newer clinical interventions in the prevention and management of cerebral vasospasm and will hopefully prevent neurological decline. In this review, we discuss current theories implicating the inflammatory cascade in the development of CVS and potential treatment targets. PMID:24058736

  15. Radiosurgery for cerebral cavernomas.

    PubMed

    Nagy, G; Kemeny, A A

    2015-09-01

    The role of stereotactic radiosurgery (SRS) in the management of cerebral cavernomas (CCMs) remains controversial. However, during the last decade the increasing knowledge on natural history and numerous publications from SRS centers using modern treatment protocols has been changing the initial resistance of the neurosurgical community. Unfortunately, the quality of publications on CCM SRS remains heterogeneous. Controversies arise from the lack of control groups, the different definition of hemorrhage, heterogeneous patient populations, and poor definition of treatment protocols. The key for proper interpretation of results is the understanding of the natural history of CCMs, which is varied both according to anatomical location and the presence or absence of previous hemorrhage. Hemispheric lesions appear to be more benign with lower annual bleed rate and risk of persisting disability, whereas those found in the thalamus, basal ganglia and brainstem typically have higher rebleed risk resulting in higher cumulative morbidity following subsequent hemorrhages. However, we are still unable at presentation to predict the future behavior of an individual lesion. In the present paper we critically review and analyze the modern SRS literature on CCMs. The expanding number of available data with current treatment protocols strongly supports the initial intuition that SRS is an effective treatment alternative for deep-seated CCMs with multiple hemorrhages reducing pretreatment annual rebleed rates from 32% pre-treatment to 1.5% within 2 years after treatment (N.=197). Moreover, it appears to stabilize lesions with no more than one bleed, and it is also effective for CCMs causing therapy resistant epilepsy especially if applied within 3 years after presentation. In modern SRS series the rate of persisting adverse radiation effects is low, resulting only in mild morbidity even in deep-seated lesions (4.16%, N.=376), and morbidity caused by post-treatment hemorrhages is also

  16. Cerebral ischemia during surgery: an overview

    PubMed Central

    Zhou, Zhi-Bin; Meng, Lingzhong; Gelb, Adrian W; Lee, Roger; Huang, Wen-Qi

    2016-01-01

    Abstract Cerebral ischemia is the pathophysiological condition in which the oxygenated cerebral blood flow is less than what is needed to meet cerebral metabolic demand. It is one of the most debilitating complications in the perioperative period and has serious clinical sequelae. The monitoring and prevention of intraoperative cerebral ischemia are crucial because an anesthetized patient in the operating room cannot be neurologically assessed. In this paper, we provide an overview of the definition, etiology, risk factors, and prevention of cerebral ischemia during surgery.

  17. Caffeine induced changes in cerebral circulation

    SciTech Connect

    Mathew, R.J.; Wilson, W.H.

    1985-09-01

    While the caffeine induced cerebral vasoconstriction is well documented, the effects of oral ingestion of the drug in a dose range comparable to the quantities in which it is usually consumed and the intensity and duration of the associated reduction in cerebral circulation are unknown. Cerebral blood flow was measured via the TTXenon inhalation technique before and thirty and ninety minutes after the oral administration of 250 mg of caffeine or a placebo, under double-blind conditions. Caffeine ingestion was found to be associated with significant reductions in cerebral perfusion thirty and ninety minutes later. The placebo group showed no differences between the three sets of cerebral blood flow values.

  18. [Cerebral ischemia in young adults].

    PubMed

    Berlit, P; Endemann, B; Vetter, P

    1991-08-01

    An overview is given over etiology and prognosis of cerebral ischemias until the age of 40. In a time period of 19 years, 168 patients were diagnosed with cerebral ischemia until the age of 40 (91 females, 77 males). The most frequent etiology is premature atherosclerosis in patients with vascular risk factors (up to 50%). Cardiogenic embolism is responsible for 1 to 34% of the cases: cardiac valve diseases and endocarditis being the most frequent sources. In 2 to 19% a vasculitis is diagnosed. While infectious arteritis is especially frequent in countries of the third world, immunovasculitides are common in Europe and the USA. Noninflammatory vasculopathies include spontaneous or traumatic dissection, fibromuscular dysplasia and vascular malformations. A migrainous stroke is especially frequent in female smokers with intake of oral contraceptives. During pregnancy both sinus thrombosis and arterial ischemia occur. Hematologic causes for ischemia are polycythemia, thrombocytosis and genetic diseases (sickle cell anemia, AT3-deficiency). Cerebral ischemia may occur in connection with the ingestion of ergot-derivates. The prognosis of cerebral ischemia in young adults is better than in older stroke-patients. PMID:1937340

  19. Innervation of the cerebral vasculature.

    PubMed

    Duckles, S P

    1983-01-01

    With the development of specific antibodies to vasoactive peptides and application of immunohistochemistry and radioimmunoassay methods, knowledge of vascular innervation has grown rapidly. In the cerebral circulation, four possible neurotransmitters are present: norepinephrine, acetylcholine, vasoactive intestinal peptide (VIP), and substance P. There is a dense adrenergic innervation of cerebral arteries, but contractile responses to nerve stimulation or circulating catecholamines are relatively small both in vitro and in vivo. Recent studies using radioligand binding techniques indicate a lack of specific 3H-prazosin binding in cerebral arteries, in contrast to other vascular beds. Thus a lack of alpha1-adrenergic receptors in cerebral arteries may account for weak responsiveness to sympathetic stimulation. Both VIP and acetylcholine may be vasodilator neurotransmitters, but blockade of cholinergic responses does not alter neurogenic vasodilation. The lack of specific VIP antagonists hampers efforts to explore this system more fully. Substance P-containing nerves are affected by capsaicin, supporting the hypothesis that these are primary sensory afferents, perhaps mediating pain. Future work in this area may focus on defining the pathways of these nerves and exploring the role of co-transmitters and possible interactions between nerves. With this basic information, experiments can be designed to elucidate more clearly the functional roles these nerves play. PMID:6210001

  20. Neuropathology of Acquired Cerebral Trauma.

    ERIC Educational Resources Information Center

    Bigler, Erin D.

    1987-01-01

    To help educators understand the cognitive and behavioral sequelae of cerebral injury, the neuropathology of traumatic brain injury and the main neuropathological features resulting from trauma-related brain damage are reviewed. A glossary with definitions of 37 neurological terms is appended. (Author/DB)

  1. Investigating cerebral oedema using poroelasticity.

    PubMed

    Vardakis, John C; Chou, Dean; Tully, Brett J; Hung, Chang C; Lee, Tsong H; Tsui, Po-Hsiang; Ventikos, Yiannis

    2016-01-01

    Cerebral oedema can be classified as the tangible swelling produced by expansion of the interstitial fluid volume. Hydrocephalus can be succinctly described as the abnormal accumulation of cerebrospinal fluid (CSF) within the brain which ultimately leads to oedema within specific sites of parenchymal tissue. Using hydrocephalus as a test bed, one is able to account for the necessary mechanisms involved in the interaction between oedema formation and cerebral fluid production, transport and drainage. The current state of knowledge about integrative cerebral dynamics and transport phenomena indicates that poroelastic theory may provide a suitable framework to better understand various diseases. In this work, Multiple-Network Poroelastic Theory (MPET) is used to develop a novel spatio-temporal model of fluid regulation and tissue displacement within the various scales of the cerebral environment. The model is applied through two formats, a one-dimensional finite difference - Computational Fluid Dynamics (CFD) coupling framework, as well as a two-dimensional Finite Element Method (FEM) formulation. These are used to investigate the role of endoscopic fourth ventriculostomy in alleviating oedema formation due to fourth ventricle outlet obstruction (1D coupled model) in addition to observing the capability of the FEM template in capturing important characteristics allied to oedema formation, like for instance in the periventricular region (2D model). PMID:26749338

  2. Cerebral autoregulation with changes in arterial and cerebral venous pressure

    SciTech Connect

    McPherson, R.W.; Traystman, R.J.

    1986-03-01

    The effect of cerebral venous pressure (Pcv) elevation on cerebral autoregulation has been incompletely studied. The authors compared the effect of decreased cerebral perfusion pressure (CPP) by elevated Pcv and decreased arterial pressure (Pa) on cerebral blood flow (CBF) in a canine modified bypass model. CPP of 80, 70, 60, 50, 40 and 30 mmHg were produced by decreasing Pa with intracranial pressure (ICP) and Pcv maintained at 0 mmHg (group 1, n = 5), or by elevating Pcv as Pa was maintained at 80 mmHg (group 2, n = 5. CBF was measured using radiolabeled microspheres, and CMRO/sub 2/ = CBF times arterial-sagittal sinus O/sub 2/ content difference. Cerebrovascular resistance (CVR) = CPP/CBF. In group 1 CBF (ml/100 gm/min) was unchanged from control (36 +/- 4) as CPP was decreased from 80 to 40 mmHg. As CPP was decreased to 30 mmHg, CBF decreased to 28 +/- 1. CVR (mmHg/ml/min/100 gm) was 2.3 +/- 0.3 and progressively decreased to 1.0 +/- 0.1 at CPP of 30 mmHg. In group 2 CBF was 34 +/- 3 and was unchanged as CPP decreased to 50 mmHg. At CPP of 40 and 30 mmHg CBF decreased to 25 +/- 3 and 22 +/- 2 respectively. Control CRV was 2.4 +/- 0.2 and progressively decreased to 1.4 +/- 0.1 as CPP decreased to 30 mmHg. CMRO/sub 2/ was unchanged from control in both groups. Thus, CBF is maintained to low CPP regardless of whether vascular transmural pressure was decreased (decrease Pa) or increased (increased Pcv) demonstrating that the myogenic mechanism of autoregulation may be unimportant in normoxic dogs.

  3. What's new in cerebral palsy.

    PubMed

    JONES, M H

    1953-11-01

    Among new researches bearing on cerebral palsy are the growth of brain cells in tissue cultures for experimentation; the use of polysaccharides to prevent the formation of a glial barrier to nerve growth after injury; observation of changes in reactions of neurons at various stages of development; the finding of hypernatremia and hyperchloremia in lesions of the frontal lobe and the thalamus; stimulation of cerebral blood flow by injection of sodium bicarbonate and retardation with ammonium chloride; and studies of serial sections of brains of palsied children who died. Study of development in the early months of life has made possible the detection of significant abnormalities in behavior early in life. Loss of hearing may be tested in very young children by measuring minute variations in electrical resistance of the skin upon auditory stimulation of the sympathetic nervous system. Conditions which have been described as having been confused with cerebral palsy are dislocation of a cervical vertebra, hereditary spastic paraplegia, transverse myelopathy, injury to the spinal cord or cauda equina by anomalous growths of the spine, and also encephalitis and meningitis. Sedation has proved a valuable adjunct to electroencephalographic study of cerebral palsy. Better criteria for abnormality in the young child should be determined and the application of them more clearly standardized. Simple exercises are useful for early training of palsied children to stimulate development. "Crossed laterality"-the dominant eye being contralateral to the preferred hand-has been counteracted by special training with great success in eliminating emotional and behavior problems and accelerating development.Recent studies indicate that only 50 per cent of cerebral palsy patients have normal or better intelligence. Subluxation of the hip joint, a common deformity associated with cerebral palsy, can sometimes be corrected by operation if detected at an early stage. Radical ablation of

  4. CEREBRAL PALSY. PRENTICE-HALL FOUNDATIONS OF SPEECH PATHOLOGY SERIES.

    ERIC Educational Resources Information Center

    CHANCE, BURTON, JR.; MCDONALD, EUGENE T.

    THIS INTRODUCTORY TEXT ON CEREBRAL PALSY IS DIVIDED INTO TWO SECTIONS. THE FIRST SECTION OF THE BOOK CONTAINS INFORMATION ABOUT UNDERSTANDING THE MEANING OF CEREBRAL PALSY, PROGRAMS FOR THOSE WITH CEREBRAL PALSY, THE NEUROLOGICAL BASES, ETIOLOGY, AND DIAGNOSIS, AND THE CLASSIFICATION OF CEREBRAL PALSY. PROBLEMS OFTEN ASSOCIATED WITH CEREBRAL PALSY…

  5. [Cerebral syndromes in premature children].

    PubMed

    Edel'shteĭn, E A; Bandarenko, E S

    1983-01-01

    Cerebral disturbances observed in premature infants are analyzed. These disturbances are a consequence of developmental slowdown and are associated with the pathological immaturity of the brain structures. On condition an active pathogenetic therapy is given these disturbances may gradually regress. On the basis of long-term observations of 600 prematurely born infants the authors describe the following clinical syndromes: muscular hypotonicity lasting up to 4-5 months and followed with a rise of the tone; the syndrome of "paretic hands" observed during the first two months of life; a hypertensive-hydrocephalic syndrome combined with a rise of the neuro-reflectory excitability; the syndrome of psychomotor development retardation followed at an age of over 1.5 to 2 years by complete recovery or minimal cerebral insufficiency with belated development of motor speech and neurosis-like reactions. PMID:6880498

  6. Imaging of cerebral venous thrombosis.

    PubMed

    Bonneville, F

    2014-12-01

    Cerebral venous thrombosis (CVT) is a potentially life-threatening emergency. The wide ranging of clinical symptoms makes the use of imaging in "slices" even more important for diagnosis. Both CT and MRI are used to diagnose the occlusion of a venous sinus, but MRI is superior to CT for detecting a clot in the cortical or deep veins. CT can show the hyperintense clot spontaneously and CT angiography the intraluminal defect. MRI also detects this thrombus, whose signal varies over time: in the acute phase, it is hypointense in T2*, whilst T1 and T2 can appear falsely reassuring; in the subacute phase, it is hyperintense on all sequences (T1, T2, FLAIR, T2*, diffusion). MRI easily shows the ischemic damage, even hemorrhagic, in the cerebral parenchyma in cases of CVT. Finally, imaging may reveal pathology at the origin of the CVT, such as a fracture of the skull, infection, tumor, dural fistula, or intracranial hypotension. PMID:25465119

  7. Animal models of cerebral ischemia

    NASA Astrophysics Data System (ADS)

    Khodanovich, M. Yu.; Kisel, A. A.

    2015-11-01

    Cerebral ischemia remains one of the most frequent causes of death and disability worldwide. Animal models are necessary to understand complex molecular mechanisms of brain damage as well as for the development of new therapies for stroke. This review considers a certain range of animal models of cerebral ischemia, including several types of focal and global ischemia. Since animal models vary in specificity for the human disease which they reproduce, the complexity of surgery, infarct size, reliability of reproduction for statistical analysis, and adequate models need to be chosen according to the aim of a study. The reproduction of a particular animal model needs to be evaluated using appropriate tools, including the behavioral assessment of injury and non-invasive and post-mortem control of brain damage. These problems also have been summarized in the review.

  8. [Cerebral artery thrombosis in pregnancy].

    PubMed

    Charco Roca, L M; Ortiz Sanchez, V E; Hernandez Gutierrez-Manchon, O; Quesada Villar, J; Bonmatí García, L; Rubio Postigo, G

    2015-11-01

    A 28 year old woman, ASA I, who, in the final stages of her pregnancy presented with signs of neural deficit that consisted of distortion of the oral commissure, dysphagia, dysarthria, and weakness on the left side of the body. She was diagnosed with thrombosis in a segment of the right middle cerebral artery which led to an ischemic area in the right frontal lobe. Termination of pregnancy and conservative treatment was decided, with good resolution of the symptoms. PMID:25698610

  9. Bilateral posterior cerebral artery infarction.

    PubMed

    Ryan, Davinia; Murphy, Sinead M; Hennessey, Michael J

    2010-01-01

    We report the case of a 70-year-old man who presented with short-term memory impairment and a homonymous left inferior quadrantanopia secondary to simultaneous bilateral posterior cerebral artery (PCA) territory infarction. As in more than a quarter of cases of PCA infarction, no aetiological cause was identified. Unlike the transient nature of symptoms in some cases following unilateral infarction, his deficits persisted on 2-month follow-up. PMID:22798298

  10. [Pathogenesis of infantile cerebral palsy].

    PubMed

    Semenova, K A

    1980-01-01

    Some causes of the pathological activity of postural reflexes and other motor disturbances underlying the clinical picture of infantile cerebral paralysis are considered. It is shown that disturbed metabolism of corticosteroids observed in that disease, as well as impaired functional activity of T lymphocytes promote the development of both inflammatory and neuroimmune processes in the brain, mainly in large hemispheres--and this may be one of the causes of the pathological postural activity. PMID:6969015

  11. Incidental Cerebral Microbleeds and Cerebral Blood Flow in Elderly Individuals

    PubMed Central

    Gregg, Nicholas M.; Kim, Albert E.; Gurol, M. Edip; Lopez, Oscar L.; Aizenstein, Howard J.; Price, Julie C.; Mathis, Chester A.; James, Jeffrey A.; Snitz, Beth E.; Cohen, Ann D.; Kamboh, M. Ilyas; Minhas, Davneet; Weissfeld, Lisa A.; Tamburo, Erica L.; Klunk, William E.

    2016-01-01

    IMPORTANCE Cerebral microbleeds (CMBs) are collections of blood breakdown products that are a common incidental finding in magnetic resonance imaging of elderly individuals. Cerebral microbleeds are associated with cognitive deficits, but the mechanism is unclear. Studies show that individuals with CMBs related to symptomatic cerebral amyloid angiopathy have abnormal vascular reactivity and cerebral blood flow (CBF), but, to our knowledge, abnormalities in cerebral blood flow have not been reported for healthy individuals with incidental CMBs. OBJECTIVE To evaluate the association of incidental CMBs with resting-state CBF, cerebral metabolism, cerebrovascular disease, β-amyloid (Aβ), and cognition. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study of 55 cognitively normal individuals with a mean (SD) age of 86.8 (2.7) years was conducted from May 1, 2010, to May 1, 2013, in an academic medical center in Pittsburgh; data analysis was performed between June 10, 2013, and April 9, 2015. INTERVENTIONS 3-Tesla magnetic resonance imaging was performed with susceptibility-weighted imaging or gradient-recalled echo to assess CMBs, arterial spin labeling for CBF, and T1- and T2-weighted imaging for atrophy, white matter hyperintensities, and infarcts. Positron emission tomography was conducted with fluorodeoxyglucose to measure cerebral metabolism and Pittsburgh compound B for fibrillar Aβ. Neuropsychological evaluation, including the Clinical Dementia Rating scale, was performed. MAIN OUTCOMES AND MEASURES Magnetic resonance images were rated for the presence and location of CMBs. Lobar CMBs were subclassified as cortical or subcortical. Measurements of CBF, metabolism, and Aβ were compared with the presence and number of CMBs with voxelwise and region-of-interest analyses. RESULTS The presence of cortical CMBs was associated with significantly reduced CBF in multiple regions on voxelwise and region-of-interest analyses (percentage difference in global CBF,

  12. Photoacoustic imaging of cerebral hypoperfusion during acupuncture

    PubMed Central

    Chen, B. Z.; Yang, J. G.; Wu, D.; Zeng, D. W.; Yi, Y.; Yang, N.; Jiang, H. B.

    2015-01-01

    Using acupuncture to treat cerebral hypoperfusion is a hot topic. However, there is a lack of effective tools to clarify the therapeutic effect of acupuncture on cerebral hypoperfusion. Here, we show in a mouse model of cerebral hypoperfusion that photoacoustic tomography (PAT) can noninvasively image cerebral vasculature and track total hemoglobin (HbT) concentration changes in cerebral hypoperfusion with acupuncture stimulation on the YangLingQuan (GB34) point. We measured the changes of HbT concentration and found that the HbT concentration in hypoperfusion regions was clearly lower than that in the control regions when the acupuncture was absent; however, it was significantly increased when the acupuncture was implemented on the GB34 point. We also observed the increase of vessel size and the generation of new vessels in cerebral hypoperfusion during acupuncture. Laser speckle imaging (LSI) was employed to validate some of the PAT findings. PMID:26417495

  13. Cerebral ischaemia: A neuroradiological study

    SciTech Connect

    Bories, J.

    1985-01-01

    After a brief clinical and pathophysiological approach, the papers presented in this book are devoted to CT and angiography. Concerning CT, a particular study has been made of cerebral arterial territories on cuts parallel to the orbito-meatal line: these are very important in making the differential diagnosis from some tumors. Also concerning CT, a paper has been devoted to cerebral ''lacunae.'' The term ''lacuna'' as far as CT imaging is concerned, should be reserved only for those hypodense areas corresponding to small cavities containing fluid, which are sequelae of infarcts in the territory of penetrating arteries. Before this sequellar state come all the evolutive states of a small deep infarct. The angiographic study specifies the indications of angiography in the study of cerebral ischemia, and the techniques to be used. It shows the main etiologic aspects. Because of the important place of vascular surgery today, it seemed necessary to show also the main post operative angiographic aspects. After CT and angiography, some pages are reserved to more modern techniques. Finally, some pages are devoted to certain particular associations and etiologies: childhood, cardiopathies, migraine, oral contraception and end with venous infarction.

  14. Bone age in cerebral palsy

    PubMed Central

    Miranda, Eduardo Régis de Alencar Bona; Palmieri, Maurício D'arc; de Assumpção, Rodrigo Montezuma César; Yamada, Helder Henzo; Rancan, Daniela Regina; Fucs, Patrícia Maria de Moraes Barros

    2013-01-01

    Objective To compare the chronological age and bone age among cerebral palsy patients in the outpatient clinic and its correlation with the type of neurological involvement, gender and functional status. Methods 401 patients with spastic cerebral palsy, and ages ranging from three months to 20 years old, submitted to radiological examination for bone age and analyzed by two independent observers according Greulich & Pyle. Results In the topographic distribution, there was a significant delay (p<0.005) in tetraparetic (17.7 months), hemiparetic (10.1 months), and diparetic patients (7.9 months). In the hemiparetic group, the mean bone age in the affected side was 96.88 months and the uncompromised side was 101.13 months (p<0.005). Regarding functional status, the ambulatory group showed a delay of 18.73 months in bone age (p<0.005). Comparing bone age between genders, it was observed a greater delay in males (13.59 months) than in females (9.63 months), but not statistically significant (p = 0.54). Conclusion There is a delay in bone age compared to chronological age influenced by the topography of spasticity, functional level and gender in patients with cerebral palsy. Level of Evidence IV, Case Series. PMID:24453693

  15. Cerebral Palsy. Fact Sheet = La Paralisis Cerebral. Hojas Informativas Sobre Discapacidades.

    ERIC Educational Resources Information Center

    National Information Center for Children and Youth with Disabilities, Washington, DC.

    This fact sheet on cerebral palsy is written in both English and Spanish. First, it provides a definition of cerebral palsy and considers various causes (e.g., an insufficient amount of oxygen reaching the fetal or newborn brain). The fact sheet then offers incidence figures and explains characteristics of the three main types of cerebral palsy:…

  16. Parasympathetic tonic dilatory influences on cerebral vessels.

    PubMed

    Boysen, Nicholas C; Dragon, Deidre Nitschke; Talman, William T

    2009-05-11

    Parasympathetic nerves from the pterygopalatine ganglia may participate in development of cluster headaches, in vascular responses to hypertension and in modulation of damage due to stroke. Stimulation of the nerves elicits cerebral vasodilatation, but it is not known if the nerves tonically influence cerebrovascular tone. We hypothesized that parasympathetics provide a tonic vasodilator influence and tested that hypothesis by measuring cerebral blood flow in anesthetized rats before and after removal of a pterygopalatine ganglion. Ganglion removal led to reduced cerebral blood flow without changing blood pressure. Thus, parasympathetic nerves provide tonic vasodilatory input to cerebral blood vessels. PMID:19195933

  17. Blood flow distribution in cerebral arteries

    PubMed Central

    Zarrinkoob, Laleh; Ambarki, Khalid; Wåhlin, Anders; Birgander, Richard; Eklund, Anders; Malm, Jan

    2015-01-01

    High-resolution phase–contrast magnetic resonance imaging can now assess flow in proximal and distal cerebral arteries. The aim of this study was to describe how total cerebral blood flow (tCBF) is distributed into the vascular tree with regard to age, sex and anatomic variations. Forty-nine healthy young (mean 25 years) and 45 elderly (mean 71 years) individuals were included. Blood flow rate (BFR) in 21 intra- and extracerebral arteries was measured. Total cerebral blood flow was defined as BFR in the internal carotid plus vertebral arteries and mean cerebral perfusion as tCBF/brain volume. Carotid/vertebral distribution was 72%/28% and was not related to age, sex, or brain volume. Total cerebral blood flow (717±123 mL/min) was distributed to each side as follows: middle cerebral artery (MCA), 21% distal MCA, 6% anterior cerebral artery (ACA), 12%, distal ACA, 4% ophthalmic artery, 2% posterior cerebral artery (PCA), 8% and 20% to basilar artery. Deviating distributions were observed in subjects with ‘fetal' PCA. Blood flow rate in cerebral arteries decreased with increasing age (P<0.05) but not in extracerebral arteries. Mean cerebral perfusion was higher in women (women: 61±8; men: 55±6 mL/min/100 mL, P<0.001). The study describes a new method to outline the flow profile of the cerebral vascular tree, including reference values, and should be used for grading the collateral flow system. PMID:25564234

  18. Hemodynamic Intervention of Cerebral Aneurysms

    NASA Astrophysics Data System (ADS)

    Meng, Hui

    2005-11-01

    Cerebral aneurysm is a pathological vascular response to hemodynamic stimuli. Endovascular treatment of cerebral aneurysms essentially alters the blood flow to stop them from continued growth and eventual rupture. Compared to surgical clipping, endovascular methods are minimally invasive and hence rapidly gaining popularity. However, they are not always effective with risks of aneurysm regrowth and various complications. We aim at developing a Virtual Intervention (VI) platform that allows: patient-specific flow calculation and risk prediction as well as recommendation of tailored intervention based on quantitative analysis. This is a lofty goal requiring advancement in three areas of research: (1). Advancement of image-based CFD; (2) Understanding the biological/pathological responses of tissue to hemodynamic factors in the context of cerebral aneurysms; and (3) Capability of designing and testing patient-specific endovascular devices. We have established CFD methodologies based on anatomical geometry obtained from 3D angiographic or CT images. To study the effect of hemodynamics on aneurysm development, we have created a canine model of a vascular bifurcation anastomosis to provide the hemodynamic environment similar to those in CA. Vascular remodeling was studied using histology and compared against the flow fields obtained from CFD. It was found that an intimal pad, similar to those frequently seen clinically, developed at the flow impingement site, bordering with an area of `groove' characteristic of an early stage of aneurysm, where the micro environment exhibits an elevated wall shear stresses. To further address the molecular mechanisms of the flow-mediated aneurysm pathology, we are also developing in vitro cell culture systems to complement the in vivo study. Our current effort in endovascular device development focuses on novel stents that alters the aneurysmal flow to promote thrombotic occlusion as well as favorable remodeling. Realization of an

  19. Variations in Writing Posture and Cerebral Organization

    ERIC Educational Resources Information Center

    Levy, Jerre; Reid, Marylou

    1976-01-01

    Investigated the relationship between hand writing posture and cerebral dominance of 48 left handed writers and 25 right handed writers. Determined that cerebral dominance is related to handedness and to whether or not the writing hand posture is normal or inverted. (SL)

  20. Restenosis After Balloon Angioplasty for Cerebral Vasospasm

    SciTech Connect

    Sedat, J. Chau, Y.; Popolo, M.; Gindre, S.; Rami, L.; Orban, J. C.

    2009-03-15

    Transluminal balloon dilatation for symptomatic vasospasm after subarachnoid hemorrhage is effective, and clinical studies have shown that it achieves long-lasting dilatation of spastic cerebral arteries. Delayed arterial renarrowing has not been reported. Here we report the case of a 58-year-old woman who presented asymptomatic and permanent restenosis after angioplasty for cerebral vasospasm.

  1. Mobility Experiences of Adolescents with Cerebral Palsy

    ERIC Educational Resources Information Center

    Palisano, Robert J.; Shimmell, Lorie J.; Stewart, Debra; Lawless, John J.; Rosenbaum, Peter L.; Russell, Dianne J.

    2009-01-01

    The purpose of this study was to describe how youth with cerebral palsy experience mobility in their daily lives using a phenomenological approach. The participants were 10 youth with cerebral palsy, 17 to 20 years of age, selected using purposeful sampling with maximum variation strategies. A total of 14 interviews were completed. Transcripts…

  2. Basal ganglia germinoma with progressive cerebral hemiatrophy.

    PubMed

    Liu, E; Robertson, R L; du Plessis, A; Pomeroy, S L

    1999-04-01

    The authors describe a 7-year-old Chinese-American female with a germinoma of the basal ganglia who presented with progressive hemiparesis and cerebral hemiatrophy. The additional finding of markedly elevated antiphospholipid antibodies suggests the possibility of an autoimmune pathogenesis for the progressive cerebral atrophy, as well as the later development of cognitive decline, tics, and obsessive-compulsive behaviors. PMID:10328283

  3. New Hope for Children with Cerebral Palsy.

    ERIC Educational Resources Information Center

    Obringer, S. John

    This paper explains the use of a unique experimental therapy for students with a type of cerebral palsy specifically called Botox. Botulinum Toxin Type A has been tried on a sizable number of students with cerebral palsy in clinical settings to reduce spastic and dystonic movements. By injecting Botox into overly tight heel cords, a normal or near…

  4. Genetics Home Reference: cerebral cavernous malformation

    MedlinePlus

    ... R, Awad IA, Ginsberg MH. Cerebral cavernous malformations proteins inhibit Rho kinase to stabilize vascular integrity. J Exp Med. 2010 Apr 12;207(4):881-96. doi: 10.1084/jem.20091258. Epub 2010 Mar 22. Citation on ... CCM1 and CCM2 protein interactions in cell signaling: implications for cerebral cavernous ...

  5. UNDERSTANDING CEREBRAL PALSY, A HANDBOOK FOR PARENTS.

    ERIC Educational Resources Information Center

    HATTON, DANIEL A.

    THIS MANUAL, WRITTEN BY A PSYCHOLOGIST, PROVIDES BASIC INFORMATION ABOUT THE NATURE OF CEREBRAL PALSY AND DISCUSSES FEELINGS AND REACTIONS OF PARENTS OF CEREBRAL PALSIED CHILDREN. INFORMATION ABOUT THE BRAIN AND BRAIN DAMAGE IN RELATION TO MOTOR AND EMOTIONAL FUNCTION, PERCEPTION AND INTELLIGENCE IS PRESENTED. PART TWO GIVES INSIGHT INTO PROBLEMS…

  6. Rhinomaxillary mucormycosis with cerebral extension

    PubMed Central

    Goel, Shikha; Palaskar, Sangeeta; Shetty, Vishwa Parkash; Bhushan, Anju

    2009-01-01

    Mucormycosis is a rare opportunistic infection caused by fungus belonging to the order Mucorales. A case of a controlled diabetic male with rhino maxillary mucormycosis, with cerebral extension, is described. The patient presented with hemifacial swelling, a nasal twang in his voice, fever, ocular signs, gross tissue destruction, and was sluggish. Early recognition of mucormycosis is necessary to limit the spread of infection, which can lead to high morbidity and mortality. Therefore, health practitioners should be familiar with the signs and symptoms of the disease. PMID:21886991

  7. Apraxia in deep cerebral lesions.

    PubMed Central

    Agostoni, E; Coletti, A; Orlando, G; Tredici, G

    1983-01-01

    In a series of 50 patients with cerebrovascular lesions (demonstrated with CT scan), seven patients had lesions located in the basal ganglia and/or thalamus. All these seven patients were apractic. Ideomotor apraxia was present in all patients; five also had constructional apraxia, and one had bucco-facial apraxia. None of the patients had utilisation apraxia. These observations indicated that apraxia is not only a "high cerebral (cortical) function", but may depend also on the integrity of subcortical circuits and structures. PMID:6619888

  8. Phase dynamics in cerebral autoregulation.

    PubMed

    Latka, Miroslaw; Turalska, Malgorzata; Glaubic-Latka, Marta; Kolodziej, Waldemar; Latka, Dariusz; West, Bruce J

    2005-11-01

    Complex continuous wavelet transforms are used to study the dynamics of instantaneous phase difference delta phi between the fluctuations of arterial blood pressure (ABP) and cerebral blood flow velocity (CBFV) in a middle cerebral artery. For healthy individuals, this phase difference changes slowly over time and has an almost uniform distribution for the very low-frequency (0.02-0.07 Hz) part of the spectrum. We quantify phase dynamics with the help of the synchronization index gamma = (sin delta phi)2 + (cos delta phi)2 that may vary between 0 (uniform distribution of phase differences, so the time series are statistically independent of one another) and 1 (phase locking of ABP and CBFV, so the former drives the latter). For healthy individuals, the group-averaged index gamma has two distinct peaks, one at 0.11 Hz [gamma = 0.59 +/- 0.09] and another at 0.33 Hz (gamma = 0.55 +/- 0.17). In the very low-frequency range (0.02-0.07 Hz), phase difference variability is an inherent property of an intact autoregulation system. Consequently, the average value of the synchronization parameter in this part of the spectrum is equal to 0.13 +/- 0.03. The phase difference variability sheds new light on the nature of cerebral hemodynamics, which so far has been predominantly characterized with the help of the high-pass filter model. In this intrinsically stationary approach, based on the transfer function formalism, the efficient autoregulation is associated with the positive phase shift between oscillations of CBFV and ABP. However, the method is applicable only in the part of the spectrum (0.1-0.3 Hz) where the coherence of these signals is high. We point out that synchrony analysis through the use of wavelet transforms is more general and allows us to study nonstationary aspects of cerebral hemodynamics in the very low-frequency range where the physiological significance of autoregulation is most strongly pronounced. PMID:16024579

  9. Chronic ketosis and cerebral metabolism.

    PubMed

    DeVivo, D C; Leckie, M P; Ferrendelli, J S; McDougal, D B

    1978-04-01

    The effects of chronic ketosis on cerebral metabolism were determined in adult rats maintained on a high-fat diet for approximately three weeks and compared to a control group of animals. The fat-fed rats had statistically significantly lower blood glucose concentrations and higher blood beta-hydroxybutyrate and acetoacetate concentrations; higher brain concentrations of bound glucose, glucose 6-phosphate, pyruvate, lactate, beta-hydroxybutyrate, citrate, alpha-ketoglutarate, alanine, and adenosine triphosphate (ATP); lower brain concentrations of fructose 1,6-diphosphate, aspartate, adenosine diphosphate (ADP), creatine, cyclic nucleotides, succinyl coenzyme A (CoA), acid-insoluble CoA, and total CoA; and similar brain concentrations of glucose, malate, calculated oxaloacetate, glutamate, glutamine, adenosine monophosphate, phosphocreatine, reduced CoA, acetyl CoA, sodium, potassium, chloride, and water content. The metabolite data in the chronically ketotic rats demonstrate an increase in the cerebral energy reserve and energy charge. These data also suggest negative modification of the enzymes phosphofructokinase, pyruvic dehydrogenase, and alpha-ketoglutaric dehydrogenase; positive modification of glycogen synthase; and possible augmentation of the hexose transport system. There was no demonstrable difference in brain pH, water content, or electrolytes in the two groups of animals. We speculate that the increased brain ATP/ADP ratio is central to most, if not all, the observed metabolic perturbations and may account for the increased neuronal stability that accompanies chronic ketosis. PMID:666275

  10. Cerebral lateralization in simultaneous interpretation.

    PubMed

    Fabbro, F; Gran, L; Basso, G; Bava, A

    1990-07-01

    Cerebral asymmetries for L1 (Italian), L2 (English), and L3 (French, German, Spanish, or Russian) were studied, by using a verbal-manual interference paradigm, in a group of Italian right-handed polyglot female students at the Scuola Superiore di Lingue Moderne per Interpreti e Traduttori (SSLM-School for Interpreters and Translators) of the University of Trieste and in a control group of right-handed monolingual female students at the Medical School of the University of Trieste. In an automatic speech production task no significant cerebral lateralization was found for the mother tongue (L1) either in the interpreting students or in the control group; the interpreting students were not significantly lateralized for the third language (L3), while weak left hemispheric lateralization was shown for L2. A significantly higher degree of verbal-manual interference was found for L1 than for L2 and L3. A significantly higher disruption rate occurred in the meaning-based mode of simultaneous interpretation (from L2 into L1 and vice versa) than in the word-for-word mode (from L2 into L1 and vice versa). No significant overall or hemispheric differences were found during simultaneous interpretation from L1 into L2 or from L2 into L1. PMID:2207622

  11. The transcriptome of cerebral ischemia

    PubMed Central

    VanGilder, Reyna L.; Huber, Jason D.; Rosen, Charles L.; Barr, Taura L.

    2015-01-01

    The molecular causality and response to stroke is complex. Yet, much of the literature examining the molecular response to stroke has focused on targeted pathways that have been well-characterized. Consequently, our understanding of stroke pathophysiology has made little progress by way of clinical therapeutics since tissue plasminogen activator was approved for treatment nearly a decade ago. The lack of clinical translation is in part due to neuron-focused studies, preclinical models of cerebral ischemia and the paradoxical nature of neuro-inflammation. With the evolution of the Stroke Therapy Academic Industry Roundtable criteria streamlining research efforts and broad availability of genomic technologies, the ability to decipher the molecular fingerprint of ischemic stroke is on the horizon. This review highlights preclinical microarray findings of the ischemic brain, discusses the transcriptome of cerebral preconditioning and emphasizes the importance of further characterizing the role of the neurovascular unit and peripheral white blood cells in mediating stroke damage and repair within the penumbra. PMID:22381515

  12. Cerebral Syndromes of Diabetes Mellitus

    PubMed Central

    Shavelle, Henry S.

    1969-01-01

    Three labile diabetic patients had recurring episodes of altered sensorium. Each had severe cerebrovascular disease with superimposed metabolic derangements, including ketoacidosis, hyperglycemia without ketosis, mild uremia, and possibly cerebral edema. Two of the patients were examined postmortem. Severe leptomeningeal scarring, basal ganglial calcification and destruction of small intracerebral vessels without evidence of large vessel atherosclerosis were found unexpectedly in one patient, a rare occurrence in this country although recently reported from Europe. The other patient had large vessel atherosclerosis only. The clinical expression of the vascular disease was modified by concurrent abnormalities and reflected the sum total of the complexities which coexisted. The pathophysiology of the unconscious state necessarily depends on the inciting factors. Ketoacidotic coma is associated with depressed cerebral oxygen consumption. Spinal fluid pH is usually maintained during ketosis but is sometimes lowered inadvertently during bicarbonate therapy, with resultant coma. Other variables influencing the clinical expression, with or without ketosis, would include, among others, blood viscosity alterations, rapid decrements in blood sugar, and existing degrees of lactic acidosis. The increasing life-span of the juvenile diabetics, favorably influenced by improved management and recently by hemodialysis, may uncover vascular complications heretofore rarely seen and create additional diagnostic and therapeutic enigmas. ImagesFigure 1.Figure 2.Figure 3. PMID:5798497

  13. [Cerebral vasospasm after subarachnoid hemorrhage].

    PubMed

    Milojević, T M; Baljozović, B V; Rakić, M Lj; Nestorović, B D; Dostanić, M M; Milaković, B D; Kojić, Z Z; Repac, N R; Cvrkota, I S

    2008-01-01

    Cerebral vasospasm causes permanent neurolological deficit or death occurance in 13% of clinical cases. Peak frequency is from 8-10th day after SAH. The purpose of this study is factor analysis that may have influence on vasospasm development , as well as predictor determination. The study is prospective and analysis 192 patients treated in Institute of Neurosurgery, Clinical Centre of Serbia, Belgrade. The majority of patients were admitted in hospital in first four days after SAH, and 184 had GCS over 7. Univariate methods of factor analysis were used, and for significance of predictors influence testing multivariante regression analysis was used. Vasospasm occurred in 22,40% of all cases. No relationships have been found between sex, age, previous hypertension, timing of surgery, appearance of hydrocephalus and intracerebral hematoma, hypertermia or mean arterial blood pressure, with occurrence of cerebral vasospasm. Factors with significantly associated with the occurance of vasospasm were: hearth disease, hypernatriemia, Hct, clinical grade on admission as well as preoperative clinical grade and Fisher CT scan grade. In the first four days after SAH, Fisher scan grade, preoperative clinical grade and Hct, appeared as predictors. After four days, clinical grade on admission and hypernatiemia, showed as poredictors. PMID:18792575

  14. Septic cerebral venous sinus thrombosis.

    PubMed

    Khatri, Ismail A; Wasay, Mohammad

    2016-03-15

    Septic cerebral venous sinus thrombosis, once a common and deadly disease, has fortunately become rare now. Not only that the incidence has fallen significantly after the antibiotic era, the morbidity and mortality has also decreased substantially. Cavernous sinus thrombosis is by far the commonest form of septic cerebral venous sinus thrombosis. Due to its rare occurrence, a lot of current generation clinicians have not encountered the entity in person. Despite all the advances in diagnostic modalities, a high index of clinical suspicion remains the mainstay in prompt diagnosis and management of this potentially lethal condition. Keeping this in view, the authors have reviewed the subject including the old literature and have summarized the current approach to diagnosis and management. Septic cavernous thrombosis is a fulminant disease with dramatic presentation in most cases comprised of fever, periorbital pain and swelling, associated with systemic symptoms and signs. The preceding infection is usually in the central face or paranasal sinuses. The disease rapidly spreads to contralateral side and if remains undiagnosed and untreated can result in severe complications or even death. Prompt diagnosis using radiological imaging in suspected patient, early use of broad spectrum antibiotics, and judicial use of anticoagulation may save the life and prevent disability. Surgery is used only to treat the nidus of infection. PMID:26944152

  15. Lifetime costs of cerebral palsy.

    PubMed

    Kruse, Marie; Michelsen, Susan Ishøy; Flachs, Esben Meulengracht; Brønnum-Hansen, Henrik; Madsen, Mette; Uldall, Peter

    2009-08-01

    This study quantified the lifetime costs of cerebral palsy (CP) in a register-based setting. It was the first study outside the US to assess the lifetime costs of CP. The lifetime costs attributable to CP were divided into three categories: health care costs, productivity costs, and social costs. The population analysed was retrieved from the Danish Cerebral Palsy Register, which covers the eastern part of the country and has registered about half of the Danish population of individuals with CP since 1950. For this study we analysed 2367 individuals with CP, who were born in 1930 to 2000 and were alive in 2000. The prevalence of CP in eastern Denmark was approximately 1.7 per 1000. Information on productivity and the use of health care was retrieved from registers. The lifetime cost of CP was about 860,000 euro for men and about 800,000 euro for women. The largest component was social care costs, particularly during childhood. A sensitivity analysis found that alterations in social care costs had a small effect, whereas lowering the discount rate from 5 to 3 per cent markedly increased total lifetime costs. Discounting decreases the value of costs in the future compared with the present. The high social care costs and productivity costs associated with CP point to a potential gain from labour market interventions that benefit individuals with CP. PMID:19416329

  16. [Negative symptoms and cerebral imaging].

    PubMed

    Kaladjian, A; Belzeaux, R; Adida, M; Azorin, J-M

    2015-12-01

    A number of neuroanatomical and neurofonctional abnormalities have been evidenced by cerebral imaging studies in patients suffering from schizophrenia. Nevertheless, those specifically associated with the negative symptoms of this disease are still insufficiently known. This work is a review of selected studies that have assessed the brain correlates of negative symptoms in schizophrenia. Approaches using structural imaging have highlighted reduction of gray matter density or cortical thickness associated with negative symptoms, which is rather sparsely distributed within the frontal and temporal regions, localized nevertheless more particularly in the frontal medial and orbitofrontal areas, as well as the amygdalo-hippocampic complex. These deficits are concurrent with a loss of integrity of the principal paths of white matter tracts between frontal and limbic regions. On the other hand, neurofonctional abnormalities associated with negative symptoms involve especially the frontal areas and limbic striatum. A disturbed functioning within the fronto-striatal loops, related to a striatal dopaminergic deficit, may represent a potential explanatory hypothesis of the negative symptoms of schizophrenia, as suggested by studies using Positron Emission Tomography on this topic or neuroimaging studies on the effects of antipsychotics. A better identification of the cerebral abnormalities associated with the negative dimension of schizophrenia, with regard to the lateralization of these abnormalities or to their changes during the course of the disease, could offer new therapeutic modalities for the treatment of this dimension which, until now, remains few responsive to conventional pharmacological treatments. PMID:26776387

  17. Caring for Children with Cerebral Palsy: A Team Approach.

    ERIC Educational Resources Information Center

    Dormans, John P., Ed.; Pellegrino, Louis, Ed.

    Twenty-one papers on caring for children with cerebral palsy are organized into four sections, including: (1) cerebral palsy and the interdisciplinary team approach; (2) management of impairments related to cerebral palsy; (3) preventing disability by optimizing function of the child with cerebral palsy; and (4) preventing handicap by creating…

  18. Cerebral tissue oxygenation impairment during experimental cerebral malaria

    PubMed Central

    Cabrales, Pedro; Martins, Yuri C; Ong, Peng Kai; Zanini, Graziela M; Frangos, John A; Carvalho, Leonardo JM

    2013-01-01

    Ischemia and hypoxia have been implicated in cerebral malaria (CM) pathogenesis, although direct measurements of hypoxia have not been conducted. C57BL/6 mice infected with Plasmodium berghei ANKA (PbA) develop a neurological syndrome known as experimental cerebral malaria (ECM), whereas BALB/c mice are resistant to ECM. In this study, intravital microscopy methods were used to quantify hemodynamic changes, vascular/tissue oxygen (O2) tension (PO2), and perivascular pH in vivo in ECM and non-ECM models, employing a closed cranial window model. ECM mice on day 6 of infection showed marked decreases in pial blood flow, vascular (arteriolar, venular), and perivascular PO2, perivascular pH, and systemic hemoglobin levels. Changes were more dramatic in mice with late-stage ECM compared with mice with early-stage ECM. These changes led to drastic decreases in O2 delivery to the brain tissue. In addition, ECM animals required a greater PO2 gradient to extract the same amount of O2 compared with non-infected animals, as the pial tissues extract O2 from the steepest portion of the blood O2 equilibrium curve. ECM animals also showed increased leukocyte adherence in postcapillary venules, and the intensity of adhesion was inversely correlated with blood flow and O2 extraction. PbA-infected BALB/c mice displayed no neurological signs on day 6 and while they did show changes similar to those observed in C57BL/6 mice (decreased pial blood flow, vascular/tissue PO2, perivascular pH, hemoglobin levels), non-ECM animals preserved superior perfusion and oxygenation compared with ECM animals at similar anemia and parasitemia levels, resulting in better O2 delivery and O2 extraction by the brain tissue. In conclusion, direct quantitative assessment of pial hemodynamics and oxygenation in vivo revealed that ECM is associated with severe progressive brain tissue hypoxia and acidosis. PMID:24128424

  19. Cerebral Hypoperfusion Precedes Nausea During Centrifugation

    NASA Technical Reports Server (NTRS)

    Serrador, Jorge M.; Schlegel, Todd T.; Black, F. Owen; Wood, Scott J.

    2004-01-01

    Nausea and motion sickness are important operational concerns for aviators and astronauts. Understanding underlying mechanisms associated with motion sickness may lead to new treatments. The goal of this work was to determine if cerebral blood flow changes precede the development of nausea in motion sick susceptible subjects. Cerebral flow velocity in the middle cerebral artery (transcranial Doppler), blood pressure (Finapres) and end-tidal CO2 were measured while subjects were rotated on a centrifuge (250 degrees/sec). Following 5 min of rotation, subjects were translated 0.504 m off-center, creating a +lGx centripetal acceleration in the nasal-occipital plane. Ten subjects completed the protocol without symptoms while 5 developed nausea (4 while 6ff-center and 1 while rotating on-center). Prior to nausea, subjects had significant increases in blood pressure (+13plus or minus 3 mmHg, P less than 0.05) and cerebrovascular resistance (+46 plus or minus 17%, P less than 0.05) and decreases in cerebral flow velocity both in the second (-13 plus or minus 4%) and last minute (-22 plus or minus 5%) before symptoms (P less than 0.05). In comparison, controls demonstrated no change in blood pressure or cerebrovascular resistance in the last minute of off-center rotation and only a 7 plus or minus 2% decrease in cerebral flow velocity. All subjects had significant hypocapnia (-3.8 plus or minus 0.4 mmHg, P less than 0.05), however this hypocapnia could not fully explain the cerebral hypoperfusion associated with the development of nausea. These data indicate that reductions in cerebral blood flow precede the development of nausea. Further work is necessary to determine what role cerebral hypoperfusion plays in motion sickness and whether cerebral hypoperfusion can be used to predict the development of nausea in susceptible individuals.

  20. Cerebral Lactate Metabolism After Traumatic Brain Injury.

    PubMed

    Patet, Camille; Suys, Tamarah; Carteron, Laurent; Oddo, Mauro

    2016-04-01

    Cerebral energy dysfunction has emerged as an important determinant of prognosis following traumatic brain injury (TBI). A number of studies using cerebral microdialysis, positron emission tomography, and jugular bulb oximetry to explore cerebral metabolism in patients with TBI have demonstrated a critical decrease in the availability of the main energy substrate of brain cells (i.e., glucose). Energy dysfunction induces adaptations of cerebral metabolism that include the utilization of alternative energy resources that the brain constitutively has, such as lactate. Two decades of experimental and human investigations have convincingly shown that lactate stands as a major actor of cerebral metabolism. Glutamate-induced activation of glycolysis stimulates lactate production from glucose in astrocytes, with subsequent lactate transfer to neurons (astrocyte-neuron lactate shuttle). Lactate is not only used as an extra energy substrate but also acts as a signaling molecule and regulator of systemic and brain glucose use in the cerebral circulation. In animal models of brain injury (e.g., TBI, stroke), supplementation with exogenous lactate exerts significant neuroprotection. Here, we summarize the main clinical studies showing the pivotal role of lactate and cerebral lactate metabolism after TBI. We also review pilot interventional studies that examined exogenous lactate supplementation in patients with TBI and found hypertonic lactate infusions had several beneficial properties on the injured brain, including decrease of brain edema, improvement of neuroenergetics via a "cerebral glucose-sparing effect," and increase of cerebral blood flow. Hypertonic lactate represents a promising area of therapeutic investigation; however, larger studies are needed to further examine mechanisms of action and impact on outcome. PMID:26898683

  1. Cerebral blood flow in the newborn infant.

    PubMed Central

    Pryds, O.; Edwards, A. D.

    1996-01-01

    Studies of CBF have provided some insight into cerebrovascular physiology and pharmacology. However, the precise relation between CBF and cerebral damage remains elusive, and there is no definition of a threshold CBF below which ischaemic brain damage always occurs. Measurement of CBF thus does not currently provide a secure guide in the clinical management of sick infants. Further work, particularly using techniques like magnetic resonance imaging and NIRS, which provide data in addition to CBF measurements, may yet disclose strategies which manipulate CBF to reduce cerebral ischaemia. While cerebral injury remains a substantial problem in neonatal intensive care, such research is urgently needed. Images Figure 3 PMID:8653440

  2. The evolution of cerebral revascularization surgery.

    PubMed

    Hayden, Melanie G; Lee, Marco; Guzman, Raphael; Steinberg, Gary K

    2009-05-01

    Among the relatively few surgeons to be awarded the Nobel Prize was Alexis Carrel, a French surgeon and pioneer in revascularization surgery at the turn of the 20th century. The authors trace the humble beginnings of cerebral revascularization surgery through to the major developments that helped shape the modern practice of cerebral bypass surgery. They discuss the cornerstone studies in the development of this technique, including the Extracranial/Intracranial Bypass Study initiated in 1977. Recent innovations, including modern techniques to monitor cerebral blood flow, microanastomosis techniques, and ongoing trials that play an important role in the evolution of this field are also evaluated. PMID:19408995

  3. Cerebral Palsy Gait, Clinical Importance

    PubMed Central

    TUGUI, Raluca Dana; ANTONESCU, Dinu

    2013-01-01

    ABSTRACT Cerebral palsy refers to a lesion on an immature brain, that determines permanent neurological disorders. Knowing the exact cause of the disease does not alter the treatment management. The etiology is 2-2.5/1000 births and the rate is constant in the last 40-50 years because advances in medical technologies have permitted the survival of smaller and premature new born children. Gait analysis has four directions: kinematics (represents body movements analysis without calculating the forces), kinetics (represents body moments and forces), energy consumption (measured by oximetry), and neuromuscular activity (measured by EMG). Gait analysis can observe specific deviations in a patient, allowing us to be more accurate in motor diagnoses and treatment solutions: surgery intervention, botulinum toxin injection, use of orthosis, physical kinetic therapy, oral medications, baclofen pump. PMID:24790675

  4. Malignant cerebral swelling following cranioplasty.

    PubMed

    Honeybul, S; Damodaran, O; Lind, C R P; Lee, G

    2016-07-01

    Over the past few years there have been a number of case reports and small cohort studies that have described so called "malignant" cerebral swelling following an uneventful cranioplasty procedure. The pathophysiology remains to be established however it has been suggested that it may be related to a combination of failure of autoregulation and the use of closed vacuum suction drainage. The current study presents three further patients who had had a decompressive hemicraniectomy for ischaemic stroke. If decompressive craniectomy is utilised in the management of neurological emergencies, close attention and wider reporting of this type of complication is required not only to focus attention on possible management strategies, but also to determine which patients are at most risk of this devastating complication. PMID:27189792

  5. Cerebral astroblastoma: A radiopathological diagnosis.

    PubMed

    Singh, Deepak Kumar; Singh, Neha; Singh, Ragini; Husain, Nuzhat

    2014-01-01

    Astroblastoma is a rare glial neoplasm whose histogenesis has been clarified recently. It primarily occurs in children and young adults. We are reporting a case of 12-year-old girl child who presented with features of raised intracranial tension and generalized tonic-clonic seizures. Brain magnetic resonance imaging revealed a large well-circumscribed, cystic lesion without perifocal edema, and enhancing mural nodule in right parietal region. A radiological differential diagnosis of pilocytic astrocytoma and cerebral astroblastoma was made. A complete excision was done and histologically the lesion turned out to be an astroblastoma. We review the histology, immunohistochemistry, and imaging features of astroblastoma and survey the current literature, treatment strategies, and prognostic aspects for the management of this rare neoplasm. PMID:24891904

  6. Rodent models of cerebral ischemia

    SciTech Connect

    Ginsberg, M.D.; Busto, R. )

    1989-12-01

    The use of physiologically regulated, reproducible animal models is crucial to the study of ischemic brain injury--both the mechanisms governing its occurrence and potential therapeutic strategies. Several laboratory rodent species (notably rats and gerbils), which are readily available at relatively low cost, are highly suitable for the investigation of cerebral ischemia and have been widely employed for this purpose. We critically examine and summarize several rodent models of transient global ischemia, resulting in selective neuronal injury within vulnerable brain regions, and focal ischemia, typically giving rise to localized brain infarction. We explore the utility of individual models and emphasize the necessity for meticulous experimental control of those variables that modulate the severity of ischemic brain injury.169 references.

  7. Cerebral Amyloid Angiopathy: Emerging Concepts

    PubMed Central

    2015-01-01

    Cerebral amyloid angiopathy (CAA) involves cerebrovascular amyloid deposition and is classified into several types according to the amyloid protein involved. Of these, sporadic amyloid β-protein (Aβ)-type CAA is most commonly found in older individuals and in patients with Alzheimer's disease (AD). Cerebrovascular Aβ deposits accompany functional and pathological changes in cerebral blood vessels (CAA-associated vasculopathies). CAA-associated vasculopathies lead to development of hemorrhagic lesions [lobar intracerebral macrohemorrhage, cortical microhemorrhage, and cortical superficial siderosis (cSS)/focal convexity subarachnoid hemorrhage (SAH)], ischemic lesions (cortical infarction and ischemic changes of the white matter), and encephalopathies that include subacute leukoencephalopathy caused by CAA-associated inflammation/angiitis. Thus, CAA is related to dementia, stroke, and encephalopathies. Recent advances in diagnostic procedures, particularly neuroimaging, have enabled us to establish a clinical diagnosis of CAA without brain biopsies. Sensitive magnetic resonance imaging (MRI) methods, such as gradient-echo T2* imaging and susceptibility-weighted imaging, are useful for detecting cortical microhemorrhages and cSS. Amyloid imaging with amyloid-binding positron emission tomography (PET) ligands, such as Pittsburgh Compound B, can detect CAA, although they cannot discriminate vascular from parenchymal amyloid deposits. In addition, cerebrospinal fluid markers may be useful, including levels of Aβ40 for CAA and anti-Aβ antibody for CAA-related inflammation. Moreover, cSS is closely associated with transient focal neurological episodes (TFNE). CAA-related inflammation/angiitis shares pathophysiology with amyloid-related imaging abnormalities (ARIA) induced by Aβ immunotherapies in AD patients. This article reviews CAA and CAA-related disorders with respect to their epidemiology, pathology, pathophysiology, clinical features, biomarkers, diagnosis

  8. Cerebral vascular findings in PAPA syndrome: cerebral arterial vasculopathy or vasculitis and a posterior cerebral artery dissecting aneurysm.

    PubMed

    Khatibi, Kasra; Heit, Jeremy J; Telischak, Nicholas A; Elbers, Jorina M; Do, Huy M

    2016-08-01

    A young patient with PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome developed an unusual cerebral arterial vasculopathy/vasculitis (CAV) that resulted in subarachnoid hemorrhage from a ruptured dissecting posterior cerebral artery (PCA) aneurysm. This aneurysm was successfully treated by endovascular coil sacrifice of the affected segment of the PCA. The patient made an excellent recovery with no significant residual neurologic deficit. PMID:26122324

  9. Progressive intracranial hypertension and cerebral hypoperfusion in a fatal case of cerebral aspergilloma

    PubMed Central

    Toksvang, Linea Natalie; Plovsing, Ronni R; Berg, Ronan M G

    2014-01-01

    Summary We report a case of cerebral aspergilloma in a 25-year-old immunoincompetent man admitted to a general intensive care unit. Monitoring of intracranial pressure was instigated and revealed hour-long epochs of severe intracranial hypertension, despite a normal opening pressure, with decreases in cerebral perfusion pressure. We documented that this was associated with cerebral hypoperfusion by transcranial Doppler ultrasound. The present case illustrates that severe intracranial hypertension may evolve despite a normal opening pressure; it furthermore shows that continuous monitoring of intracranial pressure may be used to predict changes in cerebral haemodynamics in critically ill patients with neuroinfection. PMID:24907204

  10. Cerebral blood flow: Physiologic and clinical aspects

    SciTech Connect

    Wood, J.H.

    1987-01-01

    This book contains 46 chapters divided among nine sections. The section titles are: Historical Perspectives; Cerebrovascular Anatomy; Cerebrovascular Physiology; Methods of Clinical Measurement; Experimental Methods; Imaging of Cerebral Circulation; Cerebrovascular Pathophysiology; Cerebrovascular Pharmacology; and Surgical and Interventional Augmentation.

  11. Genetics Home Reference: hereditary cerebral amyloid angiopathy

    MedlinePlus

    ... recurrent seizures (epilepsy). People with the Flemish and Italian types of hereditary cerebral amyloid angiopathy are prone ... amyloid angiopathy . APP gene mutations cause the Dutch, Italian, Arctic, Iowa, Flemish, and Piedmont types of this ...

  12. Transcranial cerebral oximetry in random normal subjects

    NASA Astrophysics Data System (ADS)

    Misra, Mukesh; Stark, Jennifer; Dujovny, Manuel; Alp, M. Serdar; Widman, Ronald; Ausman, James I.

    1997-08-01

    Near infrared optical spectroscopy is becoming a useful method for monitoring regional cerebral oxygenation status. The method is simple, reliable and noninvasive and the information which it provides is clinically significant in managing a growing number of neurological ailments. Use of this technique has been described previously by numerous authors. In the present study, regional cerebral oxygen saturation was measured at rest in 94 subjects randomly elected from a diverse population of individuals. This sample consisted of 38 males and 65 females, with the age ranging from 18 - 70. There were 68 light-skinned individuals and 35 with darker skin comprising various ethnic and cultural backgrounds. Mean regional cerebral hemoglobin oxygen saturation was recorded as 67.14 plus or minus 8.84%. The association of the mean regional cerebral hemoglobin oxygen saturation in various group of individuals in relationship of their age, race, sex and skin color is examined.

  13. Cerebral Sinovenous Thrombosis in Neonates and Children.

    PubMed

    Chung, Melissa G

    2016-03-01

    Investigators from Erasmus University Hospital in Belgium and Gustave-Dron Hospital and Roger-Salengro Hospital in France studied the clinical and neuroradiologic characteristics of cerebral sinovenous thrombosis (CSVT) in neonates and children. PMID:27396366

  14. Cerebral aneurysms: Formation, progression and developmental chronology

    PubMed Central

    Etminan, Nima; Buchholz, Bruce A.; Dreier, Rita; Bruckner, Peter; Torner, James C.; Steiger, Hans-Jakob; Hänggi, Daniel; Macdonald, R. Loch

    2015-01-01

    The prevalence of unruptured intracranial aneurysms (UAIs) in the general population is up to 3%. Existing epidemiological data suggests that only a small fraction of UIAs progress towards rupture over the lifetime of an individual, but the surrogates for subsequent rupture and the natural history of UIAs are discussed very controversially at present. In case of rupture of an UIA, the case-fatality is up to 50%, which therefore continues to stimulate interest in the pathogenesis of cerebral aneurysm formation and progression. Actual data on the chronological development of cerebral aneurysm has been especially difficult to obtain and, until recently, the existing knowledge in this respect is mainly derived from animal or mathematical models or short-term observational studies. Here, we highlight the current data on cerebral aneurysm formation and progression as well as a novel approach to investigate the developmental chronology of cerebral aneurysms. PMID:24323717

  15. Reversible cerebral vasoconstriction syndrome: a comprehensive update.

    PubMed

    Mehdi, Ali; Hajj-Ali, Rula A

    2014-09-01

    Reversible cerebral vasoconstriction syndrome (RCVS) is a clinico-radiological syndrome characterized by recurrent thunderclap headache, with or without neurologic symptoms, and reversible vasoconstriction of cerebral arteries. RCVS affects patients in various racial and ethnic groups and in all age groups, although most commonly in the fourth decade of life. Many conditions and exposures have been linked to RCVS, including vasoactive drugs and the peripartum period. Disturbance of the cerebral vascular tone is thought to contribute to the disease's pathophysiology. RCVS generally follows a monophasic course. Associated strokes and cerebral hemorrhages are not uncommon. In this review we will attempt to provide a comprehensive overview of RCVS, with emphasis on the controversies in the field and the newest findings in the reported literature. PMID:25138149

  16. Cerebral intraventricular echinococcosis in an adult

    PubMed Central

    Pandey, Sharad; Pandey, Deepa; Shende, Neeraj; Sahu, Anurag; Sharma, Vivek

    2015-01-01

    Background: Echinococcosis in humans occurs as a result of infection by the larval stages of taeniid cestodes of the genus echinococcus. Intracranial hydatid cysts usually develop at an intraparenchymal site. Hydatid cyst within the cerebral ventricle is quite unusual. Methods: We reviewed the literature on adult intraventricular hydatid cyst and found case reports mainly in children with an only handful of cases in adults. We reported a rare case of cerebral intraventricular (left lateral ventricle) hydatid cyst in a 21-year-old adult female. Results: Although cerebral hydatid cysts are most commonly seen in children and young adults cerebral intraventricular hydatid cyst are comparatively rarer in adults. Conclusion: The possibility of infection with Echinococcus granulosus should be included in the differential diagnosis of raised intracranial hypertension in patients from endemic areas. PMID:26392915

  17. Wearable wireless cerebral oximeter (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Zhang, Xin; Jiang, Tianzi

    2016-03-01

    Cerebral oximeters measure continuous cerebral oxygen saturation using near-infrared spectroscopy (NIRS) technology noninvasively. It has been involved into operating room setting to monitor oxygenation within patient's brain when surgeons are concerned that a patient's levels might drop. Recently, cerebral oxygen saturation has also been related with chronic cerebral vascular insufficiency (CCVI). Patients with CCVI would be benefited if there would be a wearable system to measure their cerebral oxygen saturation in need. However, there has yet to be a wearable wireless cerebral oximeter to measure the saturation in 24 hours. So we proposed to develop the wearable wireless cerebral oximeter. The mechanism of the system follows the NIRS technology. Emitted light at wavelengths of 740nm and 860nm are sent from the light source penetrating the skull and cerebrum, and the light detector(s) receives the light not absorbed during the light pathway through the skull and cerebrum. The amount of oxygen absorbed within the brain is the difference between the amount of light sent out and received by the probe, which can be used to calculate the percentage of oxygen saturation. In the system, it has one source and four detectors. The source, located in the middle of forehead, can emit two near infrared light, 740nm and 860nm. Two detectors are arranged in one side in 2 centimeters and 3 centimeters from the source. Their measurements are used to calculate the saturation in the cerebral cortex. The system has included the rechargeable lithium battery and Bluetooth smart wireless micro-computer unit.

  18. Cerebral Microcirculation during Experimental Normovolaemic Anemia

    PubMed Central

    Bellapart, Judith; Cuthbertson, Kylie; Dunster, Kimble; Diab, Sara; Platts, David G.; Raffel, O. Christopher; Gabrielian, Levon; Barnett, Adrian; Paratz, Jenifer; Boots, Rob; Fraser, John F.

    2016-01-01

    Anemia is accepted among critically ill patients as an alternative to elective blood transfusion. This practice has been extrapolated to head injury patients with only one study comparing the effects of mild anemia on neurological outcome. There are no studies quantifying microcirculation during anemia. Experimental studies suggest that anemia leads to cerebral hypoxia and increased rates of infarction, but the lack of clinical equipoise, when testing the cerebral effects of transfusion among critically injured patients, supports the need of experimental studies. The aim of this study was to quantify cerebral microcirculation and the potential presence of axonal damage in an experimental model exposed to normovolaemic anemia, with the intention of describing possible limitations within management practices in critically ill patients. Under non-recovered anesthesia, six Merino sheep were instrumented using an intracardiac transeptal catheter to inject coded microspheres into the left atrium to ensure systemic and non-chaotic distribution. Cytometric analyses quantified cerebral microcirculation at specific regions of the brain. Amyloid precursor protein staining was used as an indicator of axonal damage. Animals were exposed to normovolaemic anemia by blood extractions from the indwelling arterial catheter with simultaneous fluid replacement through a venous central catheter. Simultaneous data recording from cerebral tissue oxygenation, intracranial pressure, and cardiac output was monitored. A regression model was used to examine the effects of anemia on microcirculation with a mixed model to control for repeated measures. Homogeneous and normal cerebral microcirculation with no evidence of axonal damage was present in all cerebral regions, with no temporal variability, concluding that acute normovolaemic anemia does not result in short-term effects on cerebral microcirculation in the ovine brain. PMID:26869986

  19. Cerebral perturbations during exercise in hypoxia.

    PubMed

    Verges, Samuel; Rupp, Thomas; Jubeau, Marc; Wuyam, Bernard; Esteve, François; Levy, Patrick; Perrey, Stéphane; Millet, Guillaume Y

    2012-04-15

    Reduction of aerobic exercise performance observed under hypoxic conditions is mainly attributed to altered muscle metabolism due to impaired O(2) delivery. It has been recently proposed that hypoxia-induced cerebral perturbations may also contribute to exercise performance limitation. A significant reduction in cerebral oxygenation during whole body exercise has been reported in hypoxia compared with normoxia, while changes in cerebral perfusion may depend on the brain region, the level of arterial oxygenation and hyperventilation induced alterations in arterial CO(2). With the use of transcranial magnetic stimulation, inconsistent changes in cortical excitability have been reported in hypoxia, whereas a greater impairment in maximal voluntary activation following a fatiguing exercise has been suggested when arterial O(2) content is reduced. Electromyographic recordings during exercise showed an accelerated rise in central motor drive in hypoxia, probably to compensate for greater muscle contractile fatigue. This accelerated development of muscle fatigue in moderate hypoxia may be responsible for increased inhibitory afferent signals to the central nervous system leading to impaired central drive. In severe hypoxia (arterial O(2) saturation <70-75%), cerebral hypoxia per se may become an important contributor to impaired performance and reduced motor drive during prolonged exercise. This review examines the effects of acute and chronic reduction in arterial O(2) (and CO(2)) on cerebral blood flow and cerebral oxygenation, neuronal function, and central drive to the muscles. Direct and indirect influences of arterial deoxygenation on central command are separated. Methodological concerns as well as future research avenues are also considered. PMID:22319046

  20. [Platelets, atherothrombosis, antiplatelet drugs and cerebral ischemia].

    PubMed

    Bousser, Marie-Germaine

    2013-02-01

    Platelets play a much more important role in myocardial ischemia than in cerebral ischemia, because atherothrombosis - the underlying cause of the vast majority of myocardial infarcts - is responsible for only 25-30% of cerebral infarcts. Aspirin is the only effective antiplatelet drug for primary prevention of ischemic events, especially those affecting the heart. For secondary prevention of cerebral infarction, clopidogrel and the combination of aspirin with extended-release dipyridamole are both marginally better than aspirin alone, but aspirin remains the gold standard worldwide because of its remarkable cost/benefit/tolerability ratio. The clopidogrel-aspirin combination is to be avoided because of the risk of hemorrhage, particularly in the brain and gastrointestinal tract. Revascularization strategies and the choice of antiplatelet drugs for the acute phase of myocardial and cerebral ischemia are very different, consisting of endovascular treatment and aggressive platelet inhibition for coronary infarcts, versus intravenous thrombolysis and / or aspirin for cerebral infarcts. None of the new antiplatelet drugs used in acute coronary syndromes has so far been studied in acute cerebral ischemia. PMID:24919368

  1. Correlation of CT cerebral vascular territories with function. 3. Middle cerebral artery

    SciTech Connect

    Berman, S.A.; Hayman, L.A.; Hinck, V.C.

    1984-05-01

    Schematic displays are presented of the cerebral territories supplied by branches of the middle cerebral artery as they would appear on axial and coronal computed tomographic (CT) scan sections. Companion diagrams of regional cortical function and a discussion of the fiber tracts are provided to simplify correlation of clinical deficits with coronal and axial CT abnormalities.

  2. Multifractality of cerebral blood flow

    NASA Astrophysics Data System (ADS)

    West, Bruce J.; Latka, Miroslaw; Glaubic-Latka, Marta; Latka, Dariusz

    2003-02-01

    Scale invariance, the property relating time series across multiple scales, has provided a new perspective of physiological phenomena and their underlying control systems. The traditional “signal plus noise” paradigm of the engineer was first replaced with a model in which biological time series have a fractal structure in time (Fractal Physiology, Oxford University Press, Oxford, 1994). This new paradigm was subsequently shown to be overly restrictive when certain physiological signals were found to be characterized by more than one scaling parameter and therefore to belong to a class of more complex processes known as multifractals (Fractals, Plenum Press, New York, 1988). Here we demonstrate that in addition to heart rate (Nature 399 (1999) 461) and human gait (Phys. Rev. E, submitted for publication), the nonlinear control system for cerebral blood flow (CBF) (Phys. Rev. Lett., submitted for publication; Phys. Rev. E 59 (1999) 3492) is multifractal. We also find that this multifractality is greatly reduced for subjects with “serious” migraine and we present a simple model for the underlying control process to describe this effect.

  3. The hip in cerebral palsy.

    PubMed

    Bleck, E E

    1980-01-01

    Orthopedic surgery can alleviate the hip flexion, adduction, and medial rotation deformities of the hip and improve the function and appearance of gait. To accomplish this, however, careful examination and prudence in the operative procedure to avoid overdoing and overcorrecting are important. Orthopedic surgery can prevent subluxation and dislocation of the hip before the age of seven years, and consequently repetitive radiographic examinations of the hip in children who have spastic paralysis of the hip musculature should be a routine procedure. Subluxation and dislocation of the hip, when established, can be successfully treated with orthopedic surgical procedures. Physicians must keep in mind that the spastic paralysis of cerebral palsy originates in the brain, and therefore the spasticity cannot be eliminated. The best that can be done is to weaken or remove some muscles as deforming forces and to achieve compromises for continued function. The goal should be optimal independence for the child and adolescent during development, and freedom from pain with deteriorating function due to degenerative arthritis in the adult. PMID:7360505

  4. Cerebral thrombosis and myeloproliferative neoplasms.

    PubMed

    Artoni, Andrea; Bucciarelli, Paolo; Martinelli, Ida

    2014-11-01

    Myeloproliferative neoplasms (MPN) are acquired clonal disorders characterized by the proliferation of bone marrow myeloid cells. Different somatic mutations have been recently associated with MPN, the most common being JAK-2 V617F. Among MPN, polycythemia vera and essential thrombocythemia are particularly associated with an increased risk to develop thrombotic complications, either arterial or venous. Cerebrovascular events (stroke and transient ischemic attacks) are prevalent, accounting for approximately two-thirds of all events. Also cerebral vein thrombosis can complicate MPN and can be the first manifestation of the disease. Risk factors for thrombosis in patients with MPN are related or unrelated to the disease. Among the former there are cellular risk factors, such as increased white blood cell counts, vascular cell activation, endothelial dysfunction, and plasmatic risk factors, such as increased plasma viscosity, reduced levels of protein S, increased thrombin generation. The latter include increased age and previous thrombotic events. In addition, common cardiovascular risk factors (smoking, hypertension, diabetes, dyslipidemia, obesity) contribute to the pathogenesis of arterial events, whereas circumstantial risk factors (particularly oral contraceptive use and pregnancy/puerperium) to that of venous events. Primary prevention of arterial thrombosis with antiplatelet therapy is warranted in the majority of patients with MPN, whereas primary prevention of venous thrombosis is limited to anticoagulant prophylaxis during high-risk situations. Secondary prevention includes long-term antiplatelet therapy for arterial and short- or long-term anticoagulant therapy for venous thrombosis, depending on the risk factors present at the first event. PMID:25217248

  5. Bone Density in Cerebral Palsy

    PubMed Central

    Houlihan, Christine Murray; Stevenson, Richard D.

    2010-01-01

    Osteoporosis is a skeletal disorder characterized by compromised bone strength predisposing a person to an increased risk of fracture.1 Osteoporosis remains a major health problem worldwide, costing an estimated $13.8 billion in health care each year in the United States. Despite advances in treating osteoporosis in the elderly, no cure exists. Osteoporosis has its roots in childhood. Accrual of bone mass occurs throughout childhood and early adulthood, and peak bone mass is a key determinant of the lifetime risk of osteoporosis. Because the foundation for skeletal health is established so early in life, osteoporosis prevention begins by optimizing gains in bone mineral throughout childhood and adolescence.2,3 Osteoporosis evaluation and prevention is relevant to children with cerebral palsy (CP). CP is the most prevalent childhood condition associated with osteoporosis. Bone density is significantly decreased, and children with CP often sustain painful fractures with minimal trauma that impair their function and quality of life. Preventing or improving osteoporosis and maximizing bone accrual during critical stages of growth will minimize the future lifelong risks of fractures in children with CP. This article addresses the anatomy and structure of bone and bone metabolism, the clinical assessment of bone mass, the causes of osteoporosis and its evaluation and treatment in children with CP. PMID:19643349

  6. Cerebral concussion: a historical perspective.

    PubMed

    Maroon, Joseph C; Mathyssek, Christina; Bost, Jeffrey

    2014-01-01

    No topic in sports has gathered more attention and publicity than the diagnosis, management, and long-term effects of cerebral concussion. The relevant history of concussion starts in 1905 when President Theodore Roosevelt drew attention to the football 'death harvest'. Soon after, rules started to change to reduce the amount and severity of head injuries in football. Up until 1980, the primary focus regarding concussions was to diagnose a potentially fatal intracranial hemorrhage. While aware of long-term consequences of concussions, the perception at the time was that virtually all concussions would 'clear' with time and rest. Concussion management guidelines gave way to objective neuropsychological testing in the early 1990s with the development of the ImPACT™ (Immediate Post-Concussion Assessment and Cognitive Testing) neurocognitive test. Led by organized football, in 1994 the National Football League (NFL) formed the Mild Traumatic Brain Injury Committee which began to investigate the cause of concussions, evaluate equipment (particularly helmets), and recommend methods for prevention. In 2005, the first case of chronic traumatic encephalopathy was described in a deceased football player, raising concerns about the long-term consequences of head injuries and concussions. Major advancements in contact sports and the military are underway to reduce the incidence of concussions and subconcussive blows to the head. PMID:24923388

  7. Motor mapping in cerebral palsy.

    PubMed

    Wittenberg, George F

    2009-10-01

    The measurement of motor deficits in individuals with cerebral palsy (CP) has been largely based on clinical criteria. Yet functional imaging and non-invasive stimulation methods provide a means to measure directly abnormalities of the motor system. The size and location of muscles and movement representations can be determined with transcranial magnetic stimulation (TMS) and functional magnetics resonance imaging. Thus the homunculus can be individually mapped in children with CP. Because size of representation within the homunculus relates to quality of motor control, measurement of the distance between body parts provides a metric that may be useful in classifying deficits. Bilateral motor control in one hemisphere, while normal in neonates, persists variably in CP, providing another physiological metric. In this study, we used TMS to measure hand and ankle representations in a convenience sample of children with spastic CP. Overlapping thumb and ankle maps were found in children with both hemiplegia and diplegia, and these maps may be from either side of the body. While more participants are required to make conclusions about disability and compression/bilaterality of the homunculus, it appears as if TMS-derived metrics relate to motor abnormalities. These abnormal motor maps also are a therapeutic target, as stimulation methods are being developed as adjuncts to physical means of rehabilitation. PMID:19740221

  8. Arterial tree asymmetry reduces cerebral pulsatility.

    PubMed

    Vrselja, Zvonimir; Brkic, Hrvoje; Curic, Goran

    2015-11-01

    With each heartbeat, pressure wave (PW) propagates from aorta toward periphery. In cerebral circulation, at the level of circle of Willis (CW), four arteries and four PWs converge. Since the interference is an elemental property of the wave, PWs interfere at the level of CW. We hypothesize that the asymmetry of brain-supplying arteries (that join to form CW) creates phase difference between the four PWs that interfere at the level of CW and reduce downstream cerebral pulsatility. To best of our knowledge, the data about the sequence of PWs' arrival into the cerebral circulation is lacking. Evident imperfect bilateral symmetry of the vessels results with different path length of brain-supplying arteries, hence, PWs should arrive into the head at different times. The probabilistic calculation shows that asynchronous arrival is more probable than synchronous. The importance of PWs for the cerebral circulation is highlighted by the observation that barotrauma protection mechanisms are more influenced by the crest of PW (pulse pressure) than by the mean arterial pressure. In addition, an increased arterial pulsatility is associated with several brain pathologies. We created simple computational models of four converging arteries and found that asynchronous arrival of the PWs results with lower maximum pressure, slower rate of pressure amplification and lower downstream pulsatility. In analogy, the asynchronous arrival of the pressure waves into the cerebral circulation should decrease blood flow pulsatility and lower transmission of kinetic energy on arterial wall. We conclude that asynchronous arrival of PWs into the cerebral circulation influences cerebral hemodynamics and represents a physiological necessity. PMID:26277658

  9. Cerebral Air Embolism from Angioinvasive Cavitary Aspergillosis

    PubMed Central

    Lin, Chen; Barrio, George A.; Hurwitz, Lynne M.; Kranz, Peter G.

    2014-01-01

    Background. Nontraumatic cerebral air embolism cases are rare. We report a case of an air embolism resulting in cerebral infarction related to angioinvasive cavitary aspergillosis. To our knowledge, there have been no previous reports associating these two conditions together. Case Presentation. A 32-year-old female was admitted for treatment of acute lymphoblastic leukemia (ALL). Her hospital course was complicated by pulmonary aspergillosis. On hospital day 55, she acutely developed severe global aphasia with right hemiplegia. A CT and CT-angiogram of her head and neck were obtained demonstrating intravascular air emboli within the left middle cerebral artery (MCA) branches. She was emergently taken for hyperbaric oxygen therapy (HBOT). Evaluation for origin of the air embolus revealed an air focus along the left lower pulmonary vein. Over the course of 48 hours, her symptoms significantly improved. Conclusion. This unique case details an immunocompromised patient with pulmonary aspergillosis cavitary lesions that invaded into a pulmonary vein and caused a cerebral air embolism. With cerebral air embolisms, the acute treatment option differs from the typical ischemic stroke pathway and the provider should consider emergent HBOT. This case highlights the importance of considering atypical causes of acute ischemic stroke. PMID:25197589

  10. Radionuclide cerebral perfusion imaging: Normal pattern

    SciTech Connect

    Goldsmith, S.J.; Stritzke, P.; Losonczy, M.; Vallabhajosula, S.; Holan, V.; DaCosta, M.; Muzinic, M.

    1991-12-31

    Regional cerebral perfusion imaging using a new class of {sup 99m}Tc and {sup 123}I labeled compounds which traverse the blood brain barrier and SPECT imaging technology provides an opportunity to assess this physiologic phenomenon during normal cerebral function and as a manifestation of disease in the central nervous system disease. These applications pose a challenge to the nuclear medicine physician for several reasons: (a) the complex and somewhat unfamiliar functional anatomy, (b) the marked regional differences in regional cerebral perfusion at rest, (c) the lack of understanding of the effect of variations in ambient conditions on regional cerebral perfusion. The difficulties in interpretation are augmented by the display itself. There is frequently no difficulty in differentiating between gray and white matter. However, the frequently used {open_quotes}hot body{close_quotes} color maps, introduce a good deal of contrast, producing displays with apparent interruption in regional cortical perfusion whereas black and white displays provide minimal contrast in the regional cortical activity. The authors sought to define how much variation in regional cerebral perfusion is {open_quotes}allowed{close_quotes} under controlled conditions, to establish a basis to interpret if changes in the environment, psychological interventions, or disease states are accompanied by a measurable change. 2 figs., 1 tab.

  11. Cerebral Vascular Injury in Traumatic Brain Injury.

    PubMed

    Kenney, Kimbra; Amyot, Franck; Haber, Margalit; Pronger, Angela; Bogoslovsky, Tanya; Moore, Carol; Diaz-Arrastia, Ramon

    2016-01-01

    Traumatic cerebral vascular injury (TCVI) is a very frequent, if not universal, feature after traumatic brain injury (TBI). It is likely responsible, at least in part, for functional deficits and TBI-related chronic disability. Because there are multiple pharmacologic and non-pharmacologic therapies that promote vascular health, TCVI is an attractive target for therapeutic intervention after TBI. The cerebral microvasculature is a component of the neurovascular unit (NVU) coupling neuronal metabolism with local cerebral blood flow. The NVU participates in the pathogenesis of TBI, either directly from physical trauma or as part of the cascade of secondary injury that occurs after TBI. Pathologically, there is extensive cerebral microvascular injury in humans and experimental animal, identified with either conventional light microscopy or ultrastructural examination. It is seen in acute and chronic TBI, and even described in chronic traumatic encephalopathy (CTE). Non-invasive, physiologic measures of cerebral microvascular function show dysfunction after TBI in humans and experimental animal models of TBI. These include imaging sequences (MRI-ASL), Transcranial Doppler (TCD), and Near InfraRed Spectroscopy (NIRS). Understanding the pathophysiology of TCVI, a relatively under-studied component of TBI, has promise for the development of novel therapies for TBI. PMID:26048614

  12. Mechanisms of Astrocyte-Mediated Cerebral Edema

    PubMed Central

    Stokum, Jesse A.; Kurland, David B.; Gerzanich, Volodymyr; Simard, J. Marc

    2014-01-01

    Cerebral edema formation stems from disruption of blood brain barrier (BBB) integrity and occurs after injury to the CNS. Due to the restrictive skull, relatively small increases in brain volume can translate into impaired tissue perfusion and brain herniation. In excess, cerebral edema can be gravely harmful. Astrocytes are key participants in cerebral edema by virtue of their relationship with the cerebral vasculature, their unique compliment of solute and water transport proteins, and their general role in brain volume homeostasis. Following the discovery of aquaporins, passive conduits of water flow, aquaporin 4 (AQP4) was identified as the predominant astrocyte water channel. Normally, AQP4 is highly enriched at perivascular endfeet, the outermost layer of the BBB, whereas after injury, AQP4 expression disseminates to the entire astrocytic plasmalemma, a phenomenon termed dysregulation. Arguably, the most important role of AQP4 is to rapidly neutralize osmotic gradients generated by ionic transporters. In pathological conditions, AQP4 is believed to be intimately involved in the formation and clearance of cerebral edema. In this review, we discuss aquaporin function and localization in the BBB during health and injury, and we examine post-injury ionic events that modulate AQP4- dependent edema formation. PMID:24996934

  13. Effects of cerebral ischemia on neuronal hemoglobin

    PubMed Central

    He, Yangdong; Hua, Ya; Liu, Wenquan; Hu, Haitao; Keep, Richard F.; Xi, Guohua

    2009-01-01

    Summary The present study examined whether or not neuronal hemoglobin (Hb) is present in rats. It then examined whether cerebral ischemia or ischemic preconditioning (IPC) affects neuronal Hb levels in vivo and in vitro. In vivo, male Sprague-Dawley rats were subjected to either 15 minutes of transient middle cerebral artery occlusion with 24 hours of reperfusion, an IPC stimulus, or 24 hours of permanent middle cerebral artery occlusion (pMCAO), or IPC followed three days later by 24 hours of pMCAO. In vitro, primary cultured neurons were exposed to 2 hours of oxygen-glucose deprivation with 22 hours of reoxygenation. Results showed that Hb is widely expressed in rat cerebral neurons but not astrocytes. Hb expression was significantly upregulated in the ipsilateral caudate and the cortical core of the middle cerebral artery territory after IPC. Hb levels also increased in more penumbral cortex and the contralateral hemisphere 24 hours after pMCAO, but expression in the ipsilateral caudate and cortical core area were decreased. Ischemic preconditioning modified pMCAO-induced brain Hb changes. Neuronal Hb levels in vitro were increased by 2 hours of oxygen-glucose deprivation and 22 hours of reoxygenation. These results indicate that Hb is synthesized in neurons and can be upregulated by ischemia. PMID:19066615

  14. Management of laryngeal radionecrosis: Animal and clinical experience

    SciTech Connect

    Oppenheimer, R.W.; Krespi, Y.P.; Einhorn, R.K.

    1989-05-01

    Radiation necrosis of the laryngeal cartilages is an uncommon complication of radiotherapy for laryngeal carcinoma. It is a devastating process for which there is no one acceptable treatment. Medical management offers only temporary, symptomatic relief, which further necessitates surgical treatment. Surgical management may start with a tracheotomy; however, it often ends with a total laryngectomy. Physiologically, the necrotic cartilages are the source of the problem. It is a general surgical principle that nonviable tissue must be excised to promote healing. Therefore, if the affected laryngeal cartilages were removed, the larynx should heal. Total or near total removal of the thyroid and cricoid cartilages with preservation of the endolaryngeal soft tissues has not been reported in the literature. Theoretically, if the entire cartilaginous framework is removed, there would be no structural support for the airway. We have found using animal models, that submucosal resection of the laryngeal cartilages, leaving the perichondrium and endolaryngeal soft tissues intact can result in a competent airway. Animal and clinical experience will be presented.

  15. Hypothermia reduces cerebral metabolic rate and cerebral blood flow in newborn pigs

    SciTech Connect

    Busija, D.W.; Leffler, C.W. )

    1987-10-01

    The authors examined effects of hypothermia on cerebral metabolic rate and cerebral blood flow in anesthetized, newborn pigs (1-4 days old). Cerebral blood flow (CBF) was determined with 15-{mu}m radioactive microspheres. Regional CBF ranged from 44 to 66 ml{center dot}min{sup {minus}1}{center dot}100 g{sup {minus}1}, and cerebral metabolic rate was 1.94 {plus minus} 0.23 ml O{sub 2}{center dot}100 g{sup {minus}1}{center dot}min{sup {minus}1} during normothermia (39{degree}C). Reduction of rectal temperature to 34-35{degree}C decreased CBF and cerebral metabolic rate 40-50%. In another group of piglets, they examined responsiveness of the cerebral circulation to arterial hypercapnia during hypothermia. Although absolute values for normocapnic and hypercapnic CBF were reduced by hypothermia and absolute values for normocapnic and hypercapnic cerebrovascular resistance were increased, the percentage changes from control in these variables during hypercapnia were similar during normothermia and hypothermia. In another group of animals that were maintained normothermic and exposed to two episodes of hypercapnia, there was no attenuation of cerebrovascular dilation during the second episode. They conclude that hypothermia reduces CBF secondarily to a decrease in cerebral metabolic rate and that percent dilator responsiveness to arterial hypercapnia is unaltered when body temperature is reduced.

  16. Multiple medullary venous malformations decreasing cerebral blood flow: Case report

    SciTech Connect

    Tomura, N.; Inugami, A.; Uemura, K.; Hadeishi, H.; Yasui, N. )

    1991-02-01

    A rare case of multiple medullary venous malformations in the right cerebral hemisphere is reported. The literature review yielded only one case of multiple medullary venous malformations. Computed tomography scan showed multiple calcified lesions with linear contrast enhancement representing abnormal dilated vessels and mild atrophic change of the right cerebral hemisphere. Single-photon emission computed tomography using N-isopropyl-p-({sup 123}I) iodoamphetamine demonstrated decreased cerebral blood flow in the right cerebral hemisphere.

  17. Relationship between cerebral sodium-glucose transporter and hyperglycemia in cerebral ischemia.

    PubMed

    Yamazaki, Yui; Harada, Shinichi; Tokuyama, Shogo

    2015-09-14

    Post-ischemic hyperglycemia exacerbates the development of cerebral ischemia. To elucidate this exacerbation mechanism, we focused on sodium-glucose transporter (SGLT) as a mediator that lead hyperglycemia to cerebral ischemia. SGLT transport glucose into the cell, together with sodium ion, using the sodium concentration gradient. We have previously reported that suppression of cerebral SGLT ameliorates cerebral ischemic neuronal damage. However, detail relationship cerebral between SGLT and post-ischemic hyperglycemia remain incompletely defined. Therefore, we examined the involvement of cerebral SGLT on cerebral ischemic neuronal damage with or without hyperglycemic condition. Cell survival rate of primary cultured neurons was assessed by biochemical assay. A mouse model of focal ischemia was generated using a middle cerebral artery occlusion (MCAO). Neuronal damage was assessed with histological and behavioral analyses. Concomitant hydrogen peroxide/glucose treatment exacerbated hydrogen peroxide alone-induced cell death. Although a SGLT family-specific inhibitor, phlorizin had no effect on developed hydrogen peroxide alone-induced cell death, it suppressed cell death induced by concomitant hydrogen peroxide/glucose treatment. α-MG induced a concentration-dependent and significant decrease in neuronal survival. PHZ administered on immediately after reperfusion had no effect, but PHZ given at 6h after reperfusion had an effect. Our in vitro study indicates that SGLT is not involved in neuronal cell death in non-hyperglycemic condition. We have already reported that post-ischemic hyperglycemia begins to develop at 6h after MCAO. Therefore, current our in vivo study show post-ischemic hyperglycemic condition may be necessary for the SGLT-mediated exacerbation of cerebral ischemic neuronal damage. PMID:26254165

  18. Cerebral blood flow variations in CNS lupus

    SciTech Connect

    Kushner, M.J.; Tobin, M.; Fazekas, F.; Chawluk, J.; Jamieson, D.; Freundlich, B.; Grenell, S.; Freemen, L.; Reivich, M. )

    1990-01-01

    We studied the patterns of cerebral blood flow (CBF), over time, in patients with systemic lupus erythematosus and varying neurologic manifestations including headache, stroke, psychosis, and encephalopathy. For 20 paired xenon-133 CBF measurements, CBF was normal during CNS remissions, regardless of the symptoms. CBF was significantly depressed during CNS exacerbations. The magnitude of change in CBF varied with the neurologic syndrome. CBF was least affected in patients with nonspecific symptoms such as headache or malaise, whereas patients with encephalopathy or psychosis exhibited the greatest reductions in CBF. In 1 patient with affective psychosis, without clinical or CT evidence of cerebral ischemia, serial SPECT studies showed resolution of multifocal cerebral perfusion defects which paralleled clinical recovery.

  19. Amyloid angiopathy and lobar cerebral haemorrhage.

    PubMed Central

    Ishii, N; Nishihara, Y; Horie, A

    1984-01-01

    Seven cases of lobar cerebral haemorrhage due to amyloid angiopathy were found among 60 necropsy cases of intracerebral haemorrhage. Clinically five patients were demented and two had hypertension. Immediately after the onset of stroke there was a high incidence of headache and vomiting, followed by nuchal rigidity. Amyloid angiopathy was most prominent in the cerebral cortex and the leptomeninges. Senile plaques were noted in all cases. One should suspect that a haemorrhage may be due to amyloid angiopathy, when lobar cerebral haemorrhage occurs in an aged, normotensive patient with or without dementia. Surgical evacuation of the haematoma is inadvisable, because of the diffuse nature of amyloid angiopathy, high recurrence rate and less tendency to cause brain stem compression. Images PMID:6502178

  20. Cerebral palsy: A reconceptualization of the spectrum.

    PubMed

    Shapiro, Bruce K

    2004-08-01

    Approximately 50 years ago, interest in cerebral palsy increased, and the current definitions and classification were developed. The interplay among the dimensions of significant impairment, nonprogressive lesions, and persistence defines a group of children who were of interest to the researchers who developed the definition. Cerebral palsy as a definition does not attend to the broader issues of neurodevelopmental dysfunction. It isolates a portion of the spectrum of motor dysfunction and creates a category whose bounds are defined by a range of motor capability. The classifications of cerebral palsy that require revision are discussed. Some classifications should be discarded. Others should be brought in line with current knowledge and approaches. Still others should be modified to encompass the broader views of function and therapy that reflect the current expectations for persons with disabilities. PMID:15292880

  1. Brain protection therapy in acute cerebral infarction.

    PubMed

    Katsura, Ken-ichiro; Suda, Satoshi; Abe, Arata; Kanamaru, Takuya; Toda, Yusuke; Katayama, Yasuo

    2012-01-01

    Many drugs for cerebral infarction that were shown to be effective in animal experiments have shown negative results in human clinical trials. For this reason, a completely new approach is needed to develop brain protection therapies against cerebral infarction. Brain protection therapies can be categorized into 3 types: 1) lengthening the therapeutic time window for thrombolytic therapy, 2) reducing the side effects of thrombolytic therapy, and 3) brain protection drug therapy for patients with contraindications for thrombolytic therapy (including combination therapy). Here, we show our recent results of brain protection therapy. First, combination therapy with 2 effective drugs was tried, and time-lag administration was performed. Combination therapy was effective and lengthened the therapeutic time window. Next, a completely new approach to improve cerebral ischemic damage, namely, H2 gas inhalation therapy, was tried. This therapy was also effective, even in the ischemic core. PMID:22687352

  2. Assessment of the hand in cerebral palsy

    PubMed Central

    Bhardwaj, Praveen; Sabapathy, S. Raja

    2011-01-01

    Cerebral palsy is the musculoskeletal manifestation of a nonprogressive central nervous system lesion that usually occurs due to a perinatal insult to the brain. Though the cerebral insult is static the musculoskeletal pathology is progressive. Some patients with cerebral palsy whose hands are affected can be made better by surgery. The surgical procedures as such are not very technically demanding but the assessment, decision-making, and selecting the procedures for the given patient make this field challenging. When done well, the results are rewarding not only in terms of improvement in hand function but also in appearance and personal hygiene, which leads to better self-image and permits better acceptance in the society. This article focuses on the clinical examination, patient selection, and decision-making while managing these patients. PMID:22022045

  3. [Cerebral vascular accidents in anticoagulant therapy].

    PubMed

    Woimant, F; Lecoz, P; Rajzbaum, G; Haguenau, M; Pépin, B

    1986-01-01

    Thirty-three patients hospitalized as they presented with cerebral vascular lesions during anticoagulant therapy (25 intracerebral hemorrhages, 7 subdural hematoma, and one ischemia lesion). Frequency of intra-cerebral hemorrhages along with anticoagulant therapy was about 11 p. 100, this of subdural hematoma ranged from 12 to 38 p. 100. Intra-cerebral hemorrhages failed to show any peculiar topography and volume was variable. A predisposing factor thus existed in about 50 p. 100 of cases: high blood pressure or arterial aneurysm. Previous cranial traumatism was only demonstrated in 48 p. 100 patients presenting with a subdural hematoma. Prognosis as for these intracranial hemorrhages might be compared to this of hemorrhagic lesions appearing under other etiologic conditions. Ischemia lesion was secondary to a severe thrombopenia to heparin. PMID:3813286

  4. [Cerebral venous thrombosis during tuberculous meningoencephalitis].

    PubMed

    Guenifi, W; Boukhrissa, H; Gasmi, A; Rais, M; Ouyahia, A; Hachani, A; Diab, N; Mechakra, S; Lacheheb, A

    2016-05-01

    Cerebral venous thrombosis is a rare disease characterized by its clinical polymorphism and multiplicity of risk factors. Infections represent less than 10% of etiologies. Tuberculosis is not a common etiology, only a few observations are published in the literature. Between January 2005 and March 2015, 61 patients were hospitalized for neuro-meningeal tuberculosis. Among them, three young women had presented one or more cerebral venous sinus thromboses. No clinical feature was observed in these patients; vascular localizations were varied: sagittal sinus (2 cases), lateral sinus (2 cases) and transverse sinus (1 case). With anticoagulant and antituberculosis drugs, the outcome was favorable in all cases. During neuro-meningeal tuberculosis, the existence of consciousness disorders or neurological focal signs is not always the translation of encephalitis, hydrocephalus, tuberculoma or ischemic stroke; cerebral venous sinus thrombosis may be the cause and therefore should be sought. PMID:27090100

  5. Neuropsychological Effects of Cerebral Amyloid Angiopathy.

    PubMed

    Schrag, Matthew; Kirshner, Howard

    2016-08-01

    Cerebral amyloid angiopathy is a condition of the cerebral arterioles and to a lesser extent capillaries and veins, wherein beta-amyloid is deposited. In arterioles, this preferentially targets vascular smooth muscle cells and in the later stages undermines the stability of the vessel. This condition is frequently comorbid with Alzheimer's disease and its role in cognitive impairment and dementia is a topic of considerable recent research. This article reviews recent literature which confirms that CAA independently contributes to cognitive impairment by potentiating the neurodegeneration of Alzheimer's disease, by predisposing to microhemorrhagic and microischemic injury to the brain parenchyma, and by interfering with the autoregulation of CNS blood flow. In this review, we discuss the clinical presentation of cerebral amyloid angiopathy, with a focus on the neuropsychological manifestations of this vasculopathy. PMID:27357378

  6. [Clinical relevance of cerebral microbleeds--update].

    PubMed

    Yakushjii, Yusuke; Tanaka, Jun; Hara, Hideo

    2016-04-01

    Cerebral microbleeds (CMBs) on paramagnetic-sensitive magnetic resonance sequences correspond pathologically to clusters of hemosiderin-laden macrophages and have emerged as an important new imaging marker of cerebral small vessel disease (SVD), including intracerebral hemorrhage (ICH). The prevalence of CMBs varies according to the specific disease settings (stroke subtypes and demented disorders) and is highest in ICH patients. The associations of CMBs with aging, hypertension and apolipoprotein E genotype are consistent with the two major underlying pathogenesis of CMBs: hypertensive arteriopathy and cerebral amyloid angiopathy (CAA). The distributional patterns of CMBs might help us understand the predominant SVD pathogenesis of the brain; the strictly lobar type of CMBs often reflects the presence of advanced CAA, while the other types of CMBs, such as "deep or infratentorial CMBs", including the mixed type, are strongly associated with hypertension. PMID:27333747

  7. Child Abuse in a Cerebral-Palsied Population.

    ERIC Educational Resources Information Center

    Diamond, Linda J.; Jaudes, Paula K.

    1983-01-01

    Of 86 cerebral-palsied children (six months-eight years old) in one care center, 17 had been abused. Eight of these children's cerebral palsy was a result of abuse. Findings suggest a high incidence of child abuse among children with cerebral palsy. Journal Availability: See DC 152 470. (Author/CL)

  8. Mental Imagery Abilities in Adolescents with Spastic Diplegic Cerebral Palsy

    ERIC Educational Resources Information Center

    Courbois, Yanick; Coello, Yann; Bouchart, Isabelle

    2004-01-01

    Four visual imagery tasks were presented to three groups of adolescents with or without spastic diplegic cerebral palsy. The first group was composed of six adolescents with cerebral palsy who had associated visual-perceptual deficits (CP-PD), the second group was composed of five adolescents with cerebral palsy and no associated visual-perceptual…

  9. Functional stability of cerebral circulatory system

    NASA Technical Reports Server (NTRS)

    Moskalenko, Y. Y.

    1980-01-01

    The functional stability of the cerebral circulation system seems to be based on the active mechanisms and on those stemming from specific of the biophysical structure of the system under study. This latter parameter has some relevant criteria for its quantitative estimation. The data obtained suggest that the essential part of the mechanism for active responses of cerebral vessels which maintains the functional stability of this portion of the vascular system, consists of a neurogenic component involving central nervous structures localized, for instance, in the medulla oblongata.

  10. Cerebral Blood Flow Autoregulation and Dysautoregulation.

    PubMed

    Armstead, William M

    2016-09-01

    This article provides a review of cerebral autoregulation, particularly as it relates to the clinician scientist experienced in neuroscience in anesthesia and critical care. Topics covered are biological mechanisms; methods used for assessment of autoregulation; effects of anesthetics; role in control of cerebral hemodynamics in health and disease; and emerging areas, such as role of age and sex in contribution to dysautoregulation. Emphasis is placed on bidirectional translational research wherein the clinical informs the study design of basic science studies, which, in turn, informs the clinical to result in development of improved therapies for treatment of central nervous system conditions. PMID:27521192

  11. Role of Embolization for Cerebral Arteriovenous Malformations

    PubMed Central

    Ellis, Jason A.; Lavine, Sean D.

    2014-01-01

    Cerebral arteriovenous malformations (AVMs) are complex high-flow lesions that can result in devastating neurological injury when they hemorrhage. Embolization is a critical component in the management of many patients with cerebral AVMs. Embolization may be used as an independent curative therapy or more commonly in an adjuvant fashion prior to either micro- or radiosurgery. Although the treatment-related morbidity and mortality for AVMs—including that due to microsurgery, embolization, and radiosurgery—can be substantial, its natural history offers little solace. Fortunately, care by a multidisciplinary team experienced in the comprehensive management of AVMs can offer excellent results in most cases. PMID:25624978

  12. Electrical Cerebral Stimulation Modifies Inhibitory Systems

    NASA Astrophysics Data System (ADS)

    Cuéllar-Herrera, M.; Rocha, L.

    2003-09-01

    Electrical stimulation of the nervous tissue has been proposed as a method to treat some neurological disorders, such as epilepsy. Epileptic seizures result from excessive, synchronous, abnormal firing patterns of neurons that are located predominantly in the cerebral cortex. Many people with epilepsy continue presenting seizures even though they are under regimens of antiepileptic medications. An alternative therapy for treatment resistant epilepsy is cerebral electrical stimulation. The present study is focused to review the effects of different types of electrical stimulation and specifically changes in amino acids.

  13. Progenitor genealogy in the developing cerebral cortex.

    PubMed

    Laguesse, Sophie; Peyre, Elise; Nguyen, Laurent

    2015-01-01

    The mammalian cerebral cortex is characterized by a complex histological organization that reflects the spatio-temporal stratifications of related stem and neural progenitor cells, which are responsible for the generation of distinct glial and neuronal subtypes during development. Some work has been done to shed light on the existing filiations between these progenitors as well as their respective contribution to cortical neurogenesis. The aim of the present review is to summarize the current views of progenitor hierarchy and relationship in the developing cortex and to further discuss future research directions that would help us to understand the molecular and cellular regulating mechanisms involved in cerebral corticogenesis. PMID:25141969

  14. Cerebral malaria in the United Kingdom.

    PubMed Central

    Janota, I; Doshi, B

    1979-01-01

    Four fatal cases of cerebral Plasmodium falciparum malaria in English travellers returning from Africa have been seen in the last 13 years. The haemorrhages, accumulations of microglia, and destruction of cerebral white matter around small veins as a result of blockage of cortical capillaries by parasitised red blood corpuscles resemble the effect of fat embolism. Microglia in the lesions is demonstrated by special neuropathological techniques. Attention is drawn to the need for a prompt recognition of malaria since appropriate treatment can be successful. Images Fig. 1 Fig. 2 PMID:389955

  15. Evidence for Cerebral Hemodynamic Measurement-based Therapy in Symptomatic Major Cerebral Artery Disease

    PubMed Central

    YAMAUCHI, Hiroshi

    In patients with atherosclerotic internal carotid artery or middle cerebral artery occlusive disease, chronic reduction in cerebral perfusion pressure (chronic hemodynamic compromise) increases the risk of ischemic stroke and can be detected by directly measuring hemodynamic parameters. However, strategies for selecting treatments based on hemodynamic measurements have not been clearly established. Bypass surgery has been proven to improve hemodynamic compromise. However, the benefit of bypass surgery for reducing the stroke risk in patients with hemodynamic compromise is controversial. The results of the two randomized controlled trials were inconsistent. Hypertension is a major risk factor for stroke, and antihypertensive therapy provides general benefit to patients with symptomatic atherosclerotic major cerebral artery disease. However, the benefit of strict control of blood pressure for reducing the stroke risk in patients with hemodynamic compromise is a matter of debate. The results of the two observational studies were different. We must establish strategies for selecting treatments based on hemodynamic measurements in atherosclerotic major cerebral artery disease. PMID:26041631

  16. Cerebral blood flow in humans following resuscitation from cardiac arrest

    SciTech Connect

    Cohan, S.L.; Mun, S.K.; Petite, J.; Correia, J.; Tavelra Da Silva, A.T.; Waldhorn, R.E.

    1989-06-01

    Cerebral blood flow was measured by xenon-133 washout in 13 patients 6-46 hours after being resuscitated from cardiac arrest. Patients regaining consciousness had relatively normal cerebral blood flow before regaining consciousness, but all patients who died without regaining consciousness had increased cerebral blood flow that appeared within 24 hours after resuscitation (except in one patient in whom the first measurement was delayed until 28 hours after resuscitation, by which time cerebral blood flow was increased). The cause of the delayed-onset increase in cerebral blood flow is not known, but the increase may have adverse effects on brain function and may indicate the onset of irreversible brain damage.

  17. Cognitive Styles of Students With Cerebral Palsy.

    ERIC Educational Resources Information Center

    Junkala, John; Talbot, Michael L.

    1982-01-01

    Because the Matching Familiar Figures Test has a heavy visual perceptual loading, its usefulness for measuring cognitive style was examined with cerebral palsied students, frequently characterized by ocular anomalies and visual perceptual deficits. The students' cognitive styles were qualitatively similar to nonhandicapped. Extraocular movements…

  18. Measuring Cerebral Dominance: Implications for Education.

    ERIC Educational Resources Information Center

    Yachimowicz, David J.; And Others

    The psychometric properties of a paper-and-pencil instrument for assessing individual differences in cerebral dominance are explored. The instrument, Your Style of Learning and Thinking (SOLAT), contains 50 multiple-choice questions. The study subjects consisted of three groups: 235 undergraduate and graduate students, 124 undergraduate and…

  19. Narrative Ability in Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Holck, Pernille; Sandberg, Annika Dahlgren; Nettelbladt, Ulrika

    2011-01-01

    In a previous study a group of children with cerebral palsy (CP) were found to have considerable difficulties with narratives, performing several standard deviations below the criteria for the Information score of the Bus Story Test (BST). To examine in depth the performance of children with CP and a control group with typically developing (TD)…

  20. Gait Stability in Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Bruijn, Sjoerd M.; Millard, Matthew; van Gestel, Leen; Meyns, Pieter; Jonkers, Ilse; Desloovere, Kaat

    2013-01-01

    Children with unilateral Cerebral Palsy (CP) have several gait impairments, amongst which impaired gait stability may be one. We tested whether a newly developed stability measure (the foot placement estimator, FPE) which does not require long data series, can be used to asses gait stability in typically developing (TD) children as well as…

  1. Cerebral palsy in two national cohort studies.

    PubMed

    Emond, A; Golding, J; Peckham, C

    1989-06-01

    The prevalence of cerebral palsy in the 1958 British Perinatal Mortality Survey and the 1970 British Births Survey remained constant at 2.5/1000 births (40 and 41 cases, respectively). The prevalence at 10 years was higher in the 1970 cohort in which all children with cerebral palsy survived, whereas 22% of the cases in the 1958 cohort died during the first 10 years of life. A case-control study matched three controls for social class, maternal age, parity and marital state, and a further three controls for the infant's sex, gestation, and birth weight. Comparison of cases and controls showed no consistent differences in social and environmental factors, history of pregnancy, labour, or delivery. Important differences were found in the incidence of respiratory and neurological symptoms in the neonatal period. These prospective data derived form two whole populations of births support the hypothesis that most cases of cerebral palsy are not associated with adverse obstetric factors, and confirm that neonatal neurological symptoms are associated with subsequent cerebral palsy. PMID:2774617

  2. Cerebral Palsy: Exceptional Child Bibliography Series.

    ERIC Educational Resources Information Center

    Council for Exceptional Children, Reston, VA. Information Center on Exceptional Children.

    Eighty-one references selected from Exceptional Child Education Abstracts are included in the annotated bibliography on cerebral palsy, one in a series of over 50 similar listings dealing with handicapped and gifted children. For each listing, bibliographic and availability information, indexing and retrieval descriptors, and an abstract are…

  3. Cerebral Vasospasm Pharmacological Treatment: An Update

    PubMed Central

    Siasios, Ioannis; Kapsalaki, Eftychia Z.; Fountas, Kostas N.

    2013-01-01

    Aneurysmal subarachnoid hemorrhage- (aSAH-) associated vasospasm constitutes a clinicopathological entity, in which reversible vasculopathy, impaired autoregulatory function, and hypovolemia take place, and lead to the reduction of cerebral perfusion and finally ischemia. Cerebral vasospasm begins most often on the third day after the ictal event and reaches the maximum on the 5th–7th postictal days. Several therapeutic modalities have been employed for preventing or reversing cerebral vasospasm. Triple “H” therapy, balloon and chemical angioplasty with superselective intra-arterial injection of vasodilators, administration of substances like magnesium sulfate, statins, fasudil hydrochloride, erythropoietin, endothelin-1 antagonists, nitric oxide progenitors, and sildenafil, are some of the therapeutic protocols, which are currently employed for managing patients with aSAH. Intense pathophysiological mechanism research has led to the identification of various mediators of cerebral vasospasm, such as endothelium-derived, vascular smooth muscle-derived, proinflammatory mediators, cytokines and adhesion molecules, stress-induced gene activation, and platelet-derived growth factors. Oral, intravenous, or intra-arterial administration of antagonists of these mediators has been suggested for treating patients suffering a-SAH vasospam. In our current study, we attempt to summate all the available pharmacological treatment modalities for managing vasospasm. PMID:23431440

  4. Complementary and Alternative Therapies for Cerebral Palsy

    ERIC Educational Resources Information Center

    Liptak, Gregory S.

    2005-01-01

    The optimal practice of medicine includes integrating individual clinical expertise with the best available clinical evidence from systematic research. This article reviews nine treatment modalities used for children who have cerebral palsy (CP), including hyperbaric oxygen, the Adeli Suit, patterning, electrical stimulation, conductive education,…

  5. Junk DNA Used in Cerebral Cortical Evolution.

    PubMed

    Pratt, Thomas; Price, David J

    2016-06-15

    In this issue of Neuron, Rani et al. (2016) address important questions about the mechanisms of cerebral cortical evolution. They describe how a primate-specific long non-coding RNA titrates the levels of a microRNA that regulates an ancient signaling pathway controlling neuronal numbers. PMID:27311076

  6. Civilisations of the Left Cerebral Hemisphere?

    ERIC Educational Resources Information Center

    Racle, Gabriel L.

    Research conducted by Tadanobu Tsunoda on auditory and visual sensation, designed to test and understand the functions of the cerebral hemispheres, is discussed. Tsunoda discovered that the Japanese responses to sounds by the left and the right sides of the brain are very different from the responses obtained from people from other countries. His…

  7. Pretend Play of Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Pfeifer, Luzia Iara; Pacciulio, Amanda Mota; dos Santos, Camila Abrao; dos Santos, Jair Licio; Stagnitti, Karen Ellen

    2011-01-01

    Background and Purpose: Evaluate self-initiated pretend play of children with cerebral palsy. Method: Twenty preschool children participated in the study. Pretend play ability was measured by using the child-initiated pretend play assessment culturally adapted to Brazil. Results: There were significant negative correlations between the children's…

  8. The cerebral venous system and hypoxia.

    PubMed

    Wilson, Mark H; Imray, Christopher H E

    2016-01-15

    Most hypobaric hypoxia studies have focused on oxygen delivery and therefore cerebral blood inflow. Few have studied venous outflow. However, the volume of blood entering and leaving the skull (∼700 ml/min) is considerably greater than cerebrospinal fluid production (0.35 ml/min) or edema formation rates and slight imbalances of in- and outflow have considerable effects on intracranial pressure. This dynamic phenomenon is not necessarily appreciated in the currently taught static "Monro-Kellie" doctrine, which forms the basis of the "Tight-Fit" hypothesis thought to underlie high altitude headache, acute mountain sickness, and high altitude cerebral edema. Investigating both sides of the cerebral circulation was an integral part of the 2007 Xtreme Everest Expedition. The results of the relevant studies performed as part of and subsequent to this expedition are reviewed here. The evidence from recent studies suggests a relative venous outflow insufficiency is an early step in the pathogenesis of high altitude headache. Translation of knowledge gained from high altitude studies is important. Many patients in a critical care environment develop hypoxemia akin to that of high altitude exposure. An inability to drain the hypoxemic induced increase in cerebral blood flow could be an underappreciated regulatory mechanism of intracranial pressure. PMID:26294747

  9. Cerebral Lateralization and Its Effect on Drawing.

    ERIC Educational Resources Information Center

    Thomas, Yvonne A.; Thomas, Stephen B.

    1983-01-01

    Discusses the importance of both sides of the brain for the development of drawing skills but notes that the left brain can inhibit the action of the right brain. Provides a discussion of cerebral lateralization and child development. Suggests five drawing exercises to help develop hemispheric cooperation. (SB)

  10. Progress in Drug Treatment of Cerebral Edema.

    PubMed

    Deng, Y Y; Shen, F C; Xie, D; Han, Q P; Fang, M; Chen, C B; Zeng, H K

    2016-01-01

    Cerebral edema causes intracranial hypertension (ICH) which leads to severe outcome of patients in the clinical setting. Effective anti-edema therapy may significantly decrease the mortality in a variety of neurological conditions. At present drug treatment is a cornerstone in the management of cerebral edema. Osmotherapy has been the mainstay of pharmacologic therapy. Mannitol and hypertonic saline (HS) are the most commonly used osmotic agents. The relative safety and efficacy of HS and mannitol in the treatment of cerebral edema and reduction of enhanced ICP have been demonstrated in the past decades. Apart from its osmotic force, HS exerts anti-edema effects partly through inhibition of Na(+)-K(+)-2Cl(-) Cotransporter-1 (NKCC1) and aquaporin 4 (AQP4) expression in astrocytes. Melatonin may also reduce brain edema and exert neuroprotective effect on several central nervous system diseases through inhibition of inflammatory response. The inhibitors of Na/H exchanger, NKCC and AQP4 may attenuate brain edema formation through inhibition of excessive transportation of ion and water from blood into the cerebral tissue. In this review we survey some of the most recent findings in the drug treatment of brain edema focusing on the use of osmotherapy, melatonin and inhibitors of ion cotransporters and water channels. A better understanding of the molecular mechanism of these agents would help to improve in the clinical management of patients with brain edema. PMID:26948324

  11. Localized cerebritis following an esthetic rhinoplasty.

    PubMed

    Lewin, M L; Argamaso, R V; Friedman, S

    1979-11-01

    We report a case of Wernicke's sensory aphasia, caused by a localized cerebritis of the left temporal lobe. The condition developed in the second week after an esthetic rhinoplasty. There was an associated small abscess in the right inner canthal area. PMID:92036

  12. [Pyruvate dehydrogenase deficiency and cerebral malformations].

    PubMed

    Eirís, J; Alvarez-Moreno, A; Briones, P; Alonso-Alonso, C; Castro-Gago, M

    1996-10-01

    Pyruvate dehydrogenase (PDH) deficiency is a major cause of primary lactic acidosis and severe global developmental delay. A deficiency of PDH E1 alpha, a subunit of the PDH complex is a prominent cause of congenital lactic acidosis. The E1 alpha cDNA and corresponding genomic DNA have been located in the short arm of the X-chromosome (Xp22-1). A isolated 'cerebral' lactic acidosis with cerebral dysgenesis is a recognized pattern of presentation of PDH deficiency. Here, we report clinical features, magnetic resonance, and biochemical studies of two females aged 6 months (case 1) and 26 months (case 2). Both had severe development delay, minor dysmorphic features, microcephaly, severe hypoplasia of the corpus callosum, cerebral atrophy, ventricular dilatation and increase in serum lactate levels without systemic acidosis. Urinary organic acid profile was compatible with PDH deficiency. Increased CSF lactate and pyruvate levels and reduced total PDH and PDH E1 activities in muscle and fibroblasts were observed in case 1. Otherwise, decreased total PDH activity in muscle but not in fibroblasts was seen in case 2. The PDH E1á gene was sequenced in the case 1 and a deletion in exon 7 was demonstrated. Dysmorphism with severe cerebral malformations in female patients merits a metabolic evaluation, including determination of lactate and pyruvate levels in CSF. PMID:8983728

  13. Cerebral Palsy--A Continuing Battle.

    ERIC Educational Resources Information Center

    Gullerud, Ruth A.

    1979-01-01

    A review of the changes in the treatment of and attitudes toward cerebral palsy in the last 30 years is presented. The author stresses the need for early diagnosis and evaluation, day care (especially respite care), counseling, transportation, special living arrangements, and integration of this population. (PHR)

  14. CEREBRAL PALSY, ITS INDIVIDUAL AND COMMUNITY PROBLEMS.

    ERIC Educational Resources Information Center

    CRUICKSHANK, WILLIAM M.; AND OTHERS

    IN THIS REVISED EDITION, ILLUSTRATED WITH 98 FIGURES AND TABLES, SOME ORIGINAL CHAPTERS HAVE BEEN EXPANDED, AND NEW CHAPTERS HAVE BEEN ADDED. CONTRIBUTING AUTHORS ARE LISTED, AND INCLUDE EDUCATORS, CLINICAL WORKERS, AND ADMINISTRATORS IN THE FIELD OF CEREBRAL PALSY. REFERENCES AND NOTES CONCLUDE EACH CHAPTER, AND SEVERAL CHAPTERS HAVE SECTIONS ON…

  15. MATHEMATICAL MODELS OF CEREBRAL HEMODYNAMICS FOR DETECTION OF VASOSPASM IN MAJOR CEREBRAL ARTERIES

    PubMed Central

    Cattivelli, Federico S.; Sayed, Ali H.; Hu, Xiao; Lee, Darrin; Vespa, Paul

    2007-01-01

    SUMMARY Cerebral vasospasm is a typical complication occurring after Subarachnoid Hemorrhage, which may lead to delayed cerebral ischemia and death. The standard method to detect vasospasm is angiography, which is an invasive procedure. Monitoring of vasospasm is typically performed by measuring Cerebral Blood Flow Velocity (CBFV) in the major cerebral arteries and calculating the Lindegaard Index. State estimation techniques rely on mathematical models to estimate arterial radii based on available measurements. Mathematical models of cerebral hemodynamics have been proposed by Ursino and Di Giammarco in 1991, and vasospasm was modeled by Lodi and Ursino in 1999. We propose two new models. Model 1 is a more general version of Ursino’s 1991 model that includes the effects of vasospasm, and Model 2 is a simplified version of Model 1. We use Model 1 to generate Intracranial Pressure (ICP) and CBFV signals for different vasospasm conditions, where CBFV is measured at the middle cerebral artery (MCA). Then we use Model 2 to estimate the states of Model 1, from which we readily obtain estimates of the arterial radii. Simulations show that Model 2 is capable of providing good estimates for the radius of the MCA, allowing the detection of the vasospasm. PMID:19388290

  16. Mathematical Modelling of Cerebral Blood Circulation and Cerebral Autoregulation: Towards Preventing Intracranial Hemorrhages in Preterm Newborns

    PubMed Central

    Botkin, Nikolai; Alves-Pinto, Ana

    2014-01-01

    Impaired cerebral autoregulation leads to fluctuations in cerebral blood flow, which can be especially dangerous for immature brain of preterm newborns. In this paper, two mathematical models of cerebral autoregulation are discussed. The first one is an enhancement of a vascular model proposed by Piechnik et al. We extend this model by adding a polynomial dependence of the vascular radius on the arterial blood pressure and adjusting the polynomial coefficients to experimental data to gain the autoregulation behavior. Moreover, the inclusion of a Preisach hysteresis operator, simulating a hysteretic dependence of the cerebral blood flow on the arterial pressure, is tested. The second model couples the blood vessel system model by Piechnik et al. with an ordinary differential equation model of cerebral autoregulation by Ursino and Lodi. An optimal control setting is proposed for a simplified variant of this coupled model. The objective of the control is the maintenance of the autoregulatory function for a wider range of the arterial pressure. The control can be interpreted as the effect of a medicament changing the cerebral blood flow by, for example, dilation of blood vessels. Advanced numerical methods developed by the authors are applied for the numerical treatment of the control problem. PMID:25126111

  17. The clinical characteristics and treatment of cerebral AVM in pregnancy

    PubMed Central

    Lv, Xianli; Liu, Peng

    2015-01-01

    Cerebral arteriovenous malformation (AVM) in pregnancy is a complex situation and there is no agreement on its hemorrhage risk and treatment. Although studies on bleeding risk of cerebral AVMs in pregnancy are very few, and they provide different results, pregnancy will increase the hemorrhagic risk of AVM and ruptured cerebral AVM in pregnancy should be actively treated. After intracranial hemorrhage, cerebral angiography should be performed for pregnant women shielded correctly. Cerebral angiography could clearly demonstrate the characteristics of cerebral AVM. Results from the literature show that the radiation dose of endovascular and stereotactic radiotherapy for cerebral AVM in pregnancy was below the safety value and was safe. For an unruptured AVM in pregnancy, if there are no bleeding factors, e.g. no coexisting aneurysm, smooth venous drainage, no venous ectasia, or high risk of treatment, then it should be observed conservatively. PMID:26246089

  18. Cerebral hemodynamics during graded Valsalva maneuvers

    PubMed Central

    Perry, Blake G.; Cotter, James D.; Mejuto, Gaizka; Mündel, Toby; Lucas, Samuel J. E.

    2014-01-01

    The Valsalva maneuver (VM) produces large and abrupt changes in mean arterial pressure (MAP) that challenge cerebral blood flow and oxygenation. We examined the effect of VM intensity on middle cerebral artery blood velocity (MCAv) and cortical oxygenation responses during (phases I–III) and following (phase IV) a VM. Healthy participants (n = 20 mean ± SD: 27 ± 7 years) completed 30 and 90% of their maximal VM mouth pressure for 10 s (order randomized) whilst standing. Beat-to-beat MCAv, cerebral oxygenation (NIRS) and MAP across the different phases of the VM are reported as the difference from standing baseline. There were significant interaction (phase * intensity) effects for MCAv, total oxygenation index (TOI) and MAP (all P < 0.01). MCAv decreased during phases II and III (P < 0.01), with the greatest decrease during phase III (−5 ± 8 and −19 ± 15 cm·s−1 for 30 and 90% VM, respectively). This pattern was also evident in TOI (phase III: −1 ± 1 and −5 ± 4%, both P < 0.05). Phase IV increased MCAv (22 ± 15 and 34 ± 23 cm·s−1), MAP (15 ± 14 and 24 ± 17 mm Hg) and TOI (5 ± 6 and 7 ± 5%) relative to baseline (all P < 0.05). Cerebral autoregulation, indexed, as the %MCAv/%MAP ratio, showed a phase effect only (P < 0.001), with the least regulation during phase IV (2.4 ± 3.0 and 3.2 ± 2.9). These data illustrate that an intense VM profoundly affects cerebral hemodynamics, with a reactive hyperemia occurring during phase IV following modest ischemia during phases II and III. PMID:25309449

  19. Advanced cerebral monitoring in neurocritical care.

    PubMed

    Barazangi, Nobl; Hemphill, J Claude

    2008-01-01

    New cerebral monitoring techniques allow direct measurement of brain oxygenation and metabolism. Investigation using these new tools has provided additional insight into the understanding of the pathophysiology of acute brain injury and suggested new ways to guide management of secondary brain injury. Studies of focal brain tissue oxygen monitoring have suggested ischemic thresholds in focal regions of brain injury and demonstrated the interrelationship between brain tissue oxygen tension (P bt O 2 ) and other cerebral physiologic and metabolic parameters. Jugular venous oxygen saturation (SjVO 2 ) monitoring may evaluate global brain oxygen delivery and consumption, providing thresholds for detecting brain hypoperfusion and hyperperfusion. Furthermore, critically low values of P bt O 2 and SjVO 2 have also been predictive of mortality and worsened functional outcome, especially after head trauma. Cerebral microdialysis measures the concentrations of extracellular metabolites which may be relevant to cerebral metabolism or ischemia in focal areas of injury. Cerebral blood flow may be measured in the neurointensive care unit using continuous methods such as thermal diffusion and laser Doppler flowmetry. Initial studies have also attempted to correlate findings from advanced neuromonitoring with neuroimaging using dynamic perfusion computed tomography, positron emission tomography, and Xenon computed tomography. Additionally, new methods of data acquisition, storage, and analysis are being developed to address the increasing burden of patient data from neuromonitoring. Advanced informatics techniques such as hierarchical data clustering, generalized linear models, and heat map dendrograms are now being applied to multivariable patient data in order to better develop physiologic patient profiles to improve diagnosis and treatment. PMID:19127034

  20. Hemodynamic and metabolic effects of cerebral revascularization.

    PubMed

    Leblanc, R; Tyler, J L; Mohr, G; Meyer, E; Diksic, M; Yamamoto, L; Taylor, L; Gauthier, S; Hakim, A

    1987-04-01

    Pre- and postoperative positron emission tomography (PET) was performed in six patients undergoing extracranial to intracranial bypass procedures for the treatment of symptomatic extracranial carotid occlusion. The six patients were all men, aged 52 to 68 years. Their symptoms included transient ischemic attacks (five cases), amaurosis fugax (two cases), and completed stroke with good recovery (one case). Positron emission tomography was performed within 4 weeks prior to surgery and between 3 to 6 months postoperatively, using oxygen-15-labeled CO, O2, and CO2 and fluorine-18-labeled fluorodeoxyglucose. Cerebral blood flow (CBF), cerebral blood volume (CBV), cerebral metabolic rates for oxygen and glucose (CMRO2 and CMRGlu), and the oxygen extraction fraction (OEF) were measured in both hemispheres. Preoperatively, compared to five elderly control subjects, patients had increased CBV, a decreased CBF/CBV ratio, and decreased CMRO2, indicating reduced cerebral perfusion pressure and depressed oxygen metabolism. The CBF was decreased in only one patient who had bilateral carotid occlusions; the OEF, CMRGlu, and CMRO2/CMRGlu and CMRGlu/CBF ratios were not significantly different from control measurements. All bypasses were patent and all patients were asymptomatic following surgery. Postoperative PET revealed decreased CBV and an increased CBF/CBV ratio, indicating improved hemodynamic function and oxygen hypometabolism. This was associated with increased CMRO2 in two patients in whom the postoperative OEF was also increased. The CMRGlu and CMRGlu/CBF ratio were increased in five patients. Changes in CBF and the CMRO2/CMRGlu ratio were variable. One patient with preoperative progressive mental deterioration, documented by serial neuropsychological testing and decreasing CBF and CMRO2, had improved postoperative CBF and CMRO2 concomitant with improved neuropsychological functioning. It is concluded that symptomatic carotid occlusion is associated with altered

  1. Noninvasive optoacoustic monitoring of cerebral venous blood oxygenation in newborns

    NASA Astrophysics Data System (ADS)

    Petrov, Irene Y.; Wynne, Karon E.; Petrov, Yuriy; Esenaliev, Rinat O.; Richardson, C. Joan; Prough, Donald S.

    2012-02-01

    Cerebral ischemia after birth and during labor is a major cause of death and severe complications such as cerebral palsy. In the USA alone, cerebral palsy results in permanent disability of 10,000 newborns per year and approximately 500,000 of the total population. Currently, no technology is capable of direct monitoring of cerebral oxygenation in newborns. This study proposes the use of an optoacoustic technique for noninvasive cerebral ischemia monitoring by probing the superior sagittal sinus (SSS), a large central cerebral vein. We developed and built a multi-wavelength, near-infrared optoacoustic system suitable for noninvasive monitoring of cerebral ischemia in newborns with normal weight (NBW), low birth-weight (LBW, 1500 - 2499 g) and very low birth-weight (VLBW, < 1500 g). The system was capable of detecting SSS signals through the open anterior and posterior fontanelles as well as through the skull. We tested the system in NBW, LBW, and VLBW newborns (weight range: from 675 g to 3,000 g) admitted to the neonatal intensive care unit. We performed single and continuous measurements of the SSS blood oxygenation. The data acquisition, processing and analysis software developed by our group provided real-time, absolute SSS blood oxygenation measurements. The SSS blood oxygenation ranged from 60% to 80%. Optoacoustic monitoring of the SSS blood oxygenation provides valuable information because adequate cerebral oxygenation would suggest that no therapy was necessary; conversely, evidence of cerebral ischemia would prompt therapy to increase cerebral blood flow.

  2. Effects of rapamycin on cerebral oxygen supply and consumption during reperfusion after cerebral ischemia.

    PubMed

    Chi, O Z; Barsoum, S; Vega-Cotto, N M; Jacinto, E; Liu, X; Mellender, S J; Weiss, H R

    2016-03-01

    Activation of the mammalian target of rapamycin (mTOR) leads to cell growth and survival. We tested the hypothesis that inhibition of mTOR would increase infarct size and decrease microregional O2 supply/consumption balance after cerebral ischemia-reperfusion. This was tested in isoflurane-anesthetized rats with middle cerebral artery blockade for 1h and reperfusion for 2h with and without rapamycin (20mg/kg once daily for two days prior to ischemia). Regional cerebral blood flow was determined using a C(14)-iodoantipyrine autoradiographic technique. Regional small-vessel arterial and venous oxygen saturations were determined microspectrophotometrically. The control ischemic-reperfused cortex had a similar blood flow and O2 consumption to the contralateral cortex. However, microregional O2 supply/consumption balance was significantly reduced in the ischemic-reperfused cortex. Rapamycin significantly increased cerebral O2 consumption and further reduced O2 supply/consumption balance in the reperfused area. This was associated with an increased cortical infarct size (13.5±0.8% control vs. 21.5±0.9% rapamycin). We also found that ischemia-reperfusion increased AKT and S6K1 phosphorylation, while rapamycin decreased this phosphorylation in both the control and ischemic-reperfused cortex. This suggests that mTOR is important for not only cell survival, but also for the control of oxygen balance after cerebral ischemia-reperfusion. PMID:26742793

  3. Cerebral oxygen metabolism and blood flow in human cerebral ischemic infarction

    SciTech Connect

    Lenzi, G.L.; Frackowiak, R.S.; Jones, T.

    1982-09-01

    Fifteen patients with acute cerebral hemispheric infarcts have been studied with positron emission tomography and the /sup 15/O steady-state inhalation technique. Thirteen follow-up studies were also performed. The values of cerebral oxygen metabolism (CMRO/sub 2/), cerebral blood flow (CBF), and oxygen extraction ration (OER) have been calculated for the infarcted regions, their borders, the symmetrical regions in contralateral cerebral hemispheres, and the cerebellar hemispheres. This study demonstrates that in the completed stroke there are thresholds for regional CMRO/sub 2/ and regional CBF below which the general clinical outcome of the patients is usually poor. The ischaemic lesions invariably produce an uncoupling between the greatly decreased metabolic demand and the less affected blood supply, with very frequent instances of relative hyperperfusion. Remote effects of the hemispheric infarcts have been demonstrated, such as crossed cerebellar diaschisis and contralateral transhemispheric depression. The level of consciousness correlates with oxygen uptake and blood flow both in the posterior fossa and in the contralateral cerebral hemispheres. The follow-up studies of individual patients underline the high variability of metabolism-to-flow balance during the acute phase of the illness, and stress the need for more studies focused on repeated assessments of homogeneous patient populations.

  4. Local cerebral blood flow and partition coefficients measured in cerebral astrocytomas of different grades of malignancy

    SciTech Connect

    Tachibana, H.; Meyer, J.S.; Rose, J.E.; Kandula, P.

    1984-02-01

    Local cerebral blood flow and local partition coefficients were measured in patients with different grades of malignant cerebral astrocytomas (n . 5) who inhaled 35% stable xenon during computed tomography scanning. Results were compared with those in age-matched normal subjects (n . 5. Mean values for local cerebral blood flow in the gray matter in patients with astrocytomas were decreased throughout the tumor mass and surrounding brain that was apparently free of tumor. Patients with highly malignant glioblastoma multiforme (astrocytoma grade IV; n . 2) showed more variable values for local cerebral blood flow and local partition coefficients compared to those with astrocytomas of lower grades (grades I-II; n . 3). Local partition coefficients in gray matter invaded by grade IV astrocytoma were significantly higher than those in gray matter invaded by grade I-III astrocytomas. Local cerebral blood flow and local partition coefficients in the brain tissue surrounding grade IV astrocytomas were reduced to a greater extent than those in more benign tumors.

  5. Risk factors for cerebral hemorrhage and cerebral infarction in a Japanese rural community.

    PubMed

    Tanaka, H; Ueda, Y; Hayashi, M; Date, C; Baba, T; Yamashita, H; Shoji, H; Tanaka, Y; Owada, K; Detels, R

    1982-01-01

    A ten-year follow-up study of stroke among residents 40 years and older in a rural community located on Shikoku Island, Japan, was completed in 1977. The response rate for the initial examinations was 85% of 920 males and 90% of 1,012 females. Seven hundred and seventy-two males and 901 females who were initially free of stroke were followed from July 1967 through June 1977. The incidence of all strokes was 10.47 per thousand person-years for males and 6.41 per thousand person-years for females. The statistically significant risk factors for stroke were age, male sex, elevated blood pressure, ECG abnormalities, and funduscopic abnormalities. Elevated blood pressure was the strongest risk factor and mean arterial pressure was the best predictive measure. Twice as high a proportion of strokes were subclassified as cerebral hemorrhage (26%) in this study as have been reported in comparable studies in the United States (12-15%). An inverse relationship between serum cholesterol levels and cerebral hemorrhage incidence, but not cerebral infarct, was observed. High alcohol intake was a risk factor for cerebral hemorrhage but not for cerebral infarct. No relationship between stroke and weight was observed despite the relationship of stroke to blood pressure and of weight to blood pressure. PMID:7064181

  6. EFFECTS OF RAPAMYCIN ON CEREBRAL OXYGEN SUPPLY AND CONSUMPTION DURING REPERFUSION AFTER CEREBRAL ISCHEMIA

    PubMed Central

    CHI, O. Z.; BARSOUM, S.; VEGA-COTTO, N. M.; JACINTO, E.; LIU, X.; MELLENDER, S. J.; WEISS, H. R.

    2016-01-01

    Abstract—Activation of the mammalian target of rapamycin (mTOR) leads to cell growth and survival. We tested the hypothesis that inhibition of mTOR would increase infarct size and decrease microregional O2 supply/consumption balance after cerebral ischemia–reperfusion. This was tested in isoflurane-anesthetized rats with middle cerebral artery blockade for 1 h and reperfusion for 2 h with and without rapamycin (20 mg/kg once daily for two days prior to ischemia). Regional cerebral blood flow was determined using a C14-iodoantipyrine autoradiographic technique. Regional small-vessel arterial and venous oxygen saturations were determined microspectrophotometrically. The control ischemic-reperfused cortex had a similar blood flow and O2 consumption to the contralateral cortex. However, microregional O2 supply/consumption balance was significantly reduced in the ischemic-reperfused cortex. Rapamycin significantly increased cerebral O2 consumption and further reduced O2 supply/consumption balance in the reperfused area. This was associated with an increased cortical infarct size (13.5 ± 0.8% control vs. 21.5 ± 0.9% rapamycin). We also found that ischemia–reperfusion increased AKT and S6K1 phosphorylation, while rapamycin decreased this phosphorylation in both the control and ischemic-reperfused cortex. This suggests that mTOR is important for not only cell survival, but also for the control of oxygen balance after cerebral ischemia–reperfusion. PMID:26742793

  7. Cerebral Whipple's disease. Diagnosis by brain biopsy.

    PubMed

    Johnson, L; Diamond, I

    1980-10-01

    Whipple's disease, a multisystem chronic granulomatous disease treatable by antibiotics, usually presents clinically with gastrointestinal or joint symptoms. Usually, the diagnosis is substantiated by small intestinal biopsy. This shows diastase-resistant periodic-acid-Schiff-(PAS)-positive inclusions in the cytoplasm of macrophages within the lamina propria. By electron microscopy, this PAS-positive material consists of 1.5 X 0.2-mum bacilli and fine fibrillar material within macrophage phagolysosomes. Rarely, Whipple's disease presents clinically as a primary neurologic disease without gastrointestinal symptoms. Because untreated cerebral Whipple's disease usually progresses rapidly to death, it is imperative to establish the diagnosis promptly. This report describes a case of cerebral Whipple's disease without gastrointestinal symptoms that was diagnosed early by light-and electron-microscopic study of brain biopsy material. PMID:6158859

  8. Clinical management of infectious cerebral vasculitides.

    PubMed

    Carod Artal, Francisco Javier

    2016-01-01

    A wide range of infections (virus, bacteria, parasite and fungi) may cause cerebral vasculitides. Headache, seizures, encephalopathy and stroke are common forms of presentation. Infection and inflammation of intracranial vessels may cause pathological vascular remodelling, vascular occlusion and ischemia. Vasculitis in chronic meningitis may cause ischemic infarctions, and is associated with poor outcome. Appropriate neuroimaging (CT-angiography, MR-angiography, conventional 4-vessel angiography) and laboratory testing (specific antibodies in blood and CSF, CSF culture and microscopy) and even brain biopsy are needed to quickly establish the aetiology. Enhancement of contrast, wall thickening and lumen narrowing are radiological signs pointing to an infectious vasculitis origin. Although corticosteroids and prophylactic antiplatelet therapy have been used in infectious cerebral vasculitis, there are no randomized clinical trials that have evaluated their efficacy and safety. Stable mycotic aneurysms can be treated with specific antimicrobial therapy. Endovascular therapy and intracranial surgery are reserved for ruptured aneurysms or enlarging unruptured aneurysms. PMID:26689107

  9. MicroRNAs tune cerebral cortical neurogenesis

    PubMed Central

    Volvert, M-L; Rogister, F; Moonen, G; Malgrange, B; Nguyen, L

    2012-01-01

    MicroRNAs (miRNAs) are non-coding RNAs that promote post-transcriptional silencing of genes involved in a wide range of developmental and pathological processes. It is estimated that most protein-coding genes harbor miRNA recognition sequences in their 3′ untranslated region and are thus putative targets. While functions of miRNAs have been extensively characterized in various tissues, their multiple contributions to cerebral cortical development are just beginning to be unveiled. This review aims to outline the evidence collected to date demonstrating a role for miRNAs in cerebral corticogenesis with a particular emphasis on pathways that control the birth and maturation of functional excitatory projection neurons. PMID:22858543

  10. Assessment of cerebral perfusion in childhood strokes

    SciTech Connect

    Gates, G.F.; Fishman, L.S.; Segall, H.D.

    1982-11-01

    Thirty-three children who had strokes were studied by dynamic and static scintigraphy, 29 by CT scanning, and 10 by cerebral angiography. The accuracy of dynamic scintigraphy in stroke detection during the first week of clinical symptoms was 94% while CT scanning was 60% accurate and static scintigraphy 11% accurate. During the second week the accuracy of CT scanning increased to 100%, but static scintigraphy improved to only 50%. Fifty percent of scintiangiograms performed during the first week showed either luxuriant perfusion or flip-flop patterns. In some patients these two flow patterns changed to that of cerebral hemispheric ischemia after going through a phase during which perfusion appeared to be equal in the two hemispheres. Dynamic scintigraphy is believed to be the test of choice for stroke detection in children during the first week.

  11. Pediatric neuroradiology: Cerebral and cranial diseases

    SciTech Connect

    Diebler, C.; Dulac, O.

    1987-01-01

    In this book, a neuroradiologist and a neuropediatrician have combined forces to provide the widest possible knowledge in investigating cranial and cerebral disorders in infancy and childhood. Based on more than 20,000 pediatric CT examinations, with a follow-up time often exceeding ten years, the book aims to bridge interdisciplinary gaps and help radiologists, pediatricians and neurosurgeons solve the various problems of pediatric neuroradiology that frequently confront them. For each disease, the etiology, clinical manifestation, pathological lesions and radiological presentations are discussed, supported by extensive illustrations. Malformative, vascular, traumatic, tumoral, infectious and metabolic diseases are reviewed. Miscellaneous conditions presenting particular symptoms or syndromes are also studied, such as hydrocephalus and neurological complications of leukemia. Contents: Cerebral and cranial malformations; neurocutaneous syndromes; inherited metabolic diseases; infectious diseases - vascular disorders; intracranial tumors; cranial trauma - miscellaneous and subject index.

  12. Cerebral blood flow in normal pressure hydrocephalus

    SciTech Connect

    Mamo, H.L.; Meric, P.C.; Ponsin, J.C.; Rey, A.C.; Luft, A.G.; Seylaz, J.A.

    1987-11-01

    A xenon-133 method was used to measure cerebral blood flow (CBF) before and after cerebrospinal fluid (CSF) removal in patients with normal pressure hydrocephalus (NPH). Preliminary results suggested that shunting should be performed on patients whose CBF increased after CSF removal. There was a significant increase in CBF in patients with NPH, which was confirmed by the favorable outcome of 88% of patients shunted. The majority of patients with senile and presenile dementia showed a decrease or no change in CBF after CSF removal. It is suggested that although changes in CBF and clinical symptoms of NPH may have the same cause, i.e., changes in the cerebral intraparenchymal pressure, there is no simple direct relation between these two events. The mechanism underlying the loss of autoregulation observed in NPH is also discussed.

  13. Minor congenital anomalies and ataxic cerebral palsy.

    PubMed Central

    Miller, G

    1989-01-01

    The incidence of minor congenital anomalies was examined in 36 patients with ataxic cerebral palsy, in unaffected family members, and in 100 unrelated control subjects. None of the control subjects or family members had more than four anomalies, and 25 of 36 (69%) of the patients had more than four. The distribution of anomalies differed considerably, with 60% of the index cases having seven or more, and 94% of the controls having three or less. The number occurring in the patients was significantly more than in their relatives. Of the 25 patients with more than four anomalies, 16 (64%) had undergone potentially adverse perinatal or early postnatal events. Thus minor congenital anomalies were considerably more frequent in those with ataxic cerebral palsy than in related or unrelated control subjects. These anomalies may be markers of early prenatal factors that contributed to the adverse outcome either directly or by predisposing to perinatal difficulties. PMID:2751330

  14. The Age of Human Cerebral Cortex Neurons

    SciTech Connect

    Bhardwaj, R D; Curtis, M A; Spalding, K L; Buchholz, B A; Fink, D; Bjork-Eriksson, T; Nordborg, C; Gage, F H; Druid, H; Eriksson, P S; Frisen, J

    2006-04-06

    The traditional static view of the adult mammalian brain has been challenged by the realization of continuous generation of neurons from stem cells. Based mainly on studies in experimental animals, adult neurogenesis may contribute to recovery after brain insults and decreased neurogenesis has been implicated in the pathogenesis of neurological and psychiatric diseases in man. The extent of neurogenesis in the adult human brain has, however, been difficult to establish. We have taken advantage of the integration of {sup 14}C, generated by nuclear bomb tests during the Cold War, in DNA to establish the age of neurons in the major areas of the human cerebral cortex. Together with the analysis of the cortex from patients who received BrdU, which integrates in the DNA of dividing cells, our results demonstrate that whereas non-neuronal cells turn over, neurons in the human cerebral cortex are not generated postnatally at detectable levels, but are as old as the individual.

  15. Human cerebral response to animal affective vocalizations

    PubMed Central

    Belin, Pascal; Fecteau, Shirley; Charest, Ian; Nicastro, Nicholas; Hauser, Marc D; Armony, Jorge L

    2007-01-01

    It is presently unknown whether our response to affective vocalizations is specific to those generated by humans or more universal, triggered by emotionally matched vocalizations generated by other species. Here, we used functional magnetic resonance imaging in normal participants to measure cerebral activity during auditory stimulation with affectively valenced animal vocalizations, some familiar (cats) and others not (rhesus monkeys). Positively versus negatively valenced vocalizations from cats and monkeys elicited different cerebral responses despite the participants' inability to differentiate the valence of these animal vocalizations by overt behavioural responses. Moreover, the comparison with human non-speech affective vocalizations revealed a common response to the valence in orbitofrontal cortex, a key component on the limbic system. These findings suggest that the neural mechanisms involved in processing human affective vocalizations may be recruited by heterospecific affective vocalizations at an unconscious level, supporting claims of shared emotional systems across species. PMID:18077254

  16. Magnetic resonance imaging of experimental cerebral oedema.

    PubMed Central

    Barnes, D; McDonald, W I; Tofts, P S; Johnson, G; Landon, D N

    1986-01-01

    Triethyl tin(TET)-induced cerebral oedema has been studied in cats by magnetic resonance imaging (MRI), and the findings correlated with the histology and fine structure of the cerebrum following perfusion-fixation. MRI is a sensitive technique for detecting cerebral oedema, and the distribution and severity of the changes correlate closely with the morphological abnormalities. The relaxation times, T1 and T2 increase progressively as the oedema develops, and the proportional increase in T2 is approximately twice that in T1. Analysis of the magnetisation decay curves reveals slowly-relaxing and rapidly-relaxing components which probably correspond to oedema fluid and intracellular water respectively. The image appearances taken in conjunction with relaxation data provide a basis for determining the nature of the oedema in vivo. Images PMID:3806109

  17. Intraoperative cerebral blood flow imaging of rodents

    NASA Astrophysics Data System (ADS)

    Li, Hangdao; Li, Yao; Yuan, Lu; Wu, Caihong; Lu, Hongyang; Tong, Shanbao

    2014-09-01

    Intraoperative monitoring of cerebral blood flow (CBF) is of interest to neuroscience researchers, which offers the assessment of hemodynamic responses throughout the process of neurosurgery and provides an early biomarker for surgical guidance. However, intraoperative CBF imaging has been challenging due to animal's motion and position change during the surgery. In this paper, we presented a design of an operation bench integrated with laser speckle contrast imager which enables monitoring of the CBF intraoperatively. With a specially designed stereotaxic frame and imager, we were able to monitor the CBF changes in both hemispheres during the rodent surgery. The rotatable design of the operation plate and implementation of online image registration allow the technician to move the animal without disturbing the CBF imaging during surgery. The performance of the system was tested by middle cerebral artery occlusion model of rats.

  18. High-altitude cerebral oedema mimicking stroke.

    PubMed

    Yanamandra, Uday; Gupta, Amul; Patyal, Sagarika; Varma, Prem Prakash

    2014-01-01

    High-altitude cerebral oedema (HACO) is the most fatal high-altitude illness seen by rural physicians practising in high-altitude areas. HACO presents clinically with cerebellar ataxia, features of raised intracranial pressure (ICP) and coma. Early identification is important as delay in diagnosis can be fatal. We present two cases of HACO presenting with focal deficits mimicking stroke. The first patient presented with left-sided hemiplegia associated with the rapid deterioration in the sensorium. Neuroimaging revealed features suggestive of vasogenic oedema. The second patient presented with monoplegia of the lower limb. Neuroimaging revealed perfusion deficit in anterior cerebral artery territory. Both patients were managed with dexamethasone and they improved dramatically. Clinical picture and neuroimaging closely resembled acute ischaemic stroke in both cases. Thrombolysis in these patients would have been disastrous. Recent travel to high altitude, young age, absence of atherosclerotic risk factors and features of raised ICP concomitantly directed the diagnosis to HACO. PMID:24671373

  19. Scheie syndrome diagnosed after cerebral infarction.

    PubMed

    Fujii, Daiki; Manabe, Yasuhiro; Tanaka, Tomotaka; Kono, Syoichiro; Sakai, Yasuko; Narai, Hisashi; Omori, Nobuhiko; Furujyo, Mahoko; Abe, Koji

    2012-05-01

    We report a 41-year-old woman with Scheie syndrome diagnosed after cerebral infarction. She presented with acute onset dysarthria and right upper limb weakness. The neurologic findings revealed dysarthria, right central facial paralysis, mild right hemiparesis, and mild sensory impairment in the right arm and leg. Diffusion-weighted magnetic resonance imaging (MRI) showed subtle high signal lesions in the left corona radiata and posterior limb of the internal capsule. The diagnosis was made by a coarse facial appearance, claw hands, pigmentary degeneration of the bilateral retinas, and a deficiency of the enzymatic activity of lysosomal α-L-iduronidase. The patient was successfully treated with intravenous recombinant tissue plasminogen activator (rtPA) followed by enzyme replacement therapy. The prognosis of this disease would improve with enzyme replacement therapy. It is necessary to be aware of cerebral infarction in patients with Scheie syndrome. PMID:21167740

  20. [Cerebral fat embolism after closed leg injury].

    PubMed

    Wiel, E; Fleyfel, M; Onimus, J; Godefroy, O; Leclerc, X; Adnet, P

    1997-01-01

    A 21-year-old man sustained a closed fracture of the leg from an industrial accident, without associated head trauma. The orthopaedic treatment consisted of immediate immobilization by setting leg in plaster. Two hours after admission, the Glasgow coma scale score was 10. Four hours after admission he developed a coma (Glasgow coma scale score = 7) with repetitive seizures. No lesion was visible on cerebral CT scan. Chest X-ray was unremarkable. Petechiae on the anterior chest wall and abdomen with bilateral mydriasis occurred. Thrombocytopenia with prothrombine time increase were observed. Magnetic resonance imaging, 27 hours after admission, showed high-intensity areas on T2 weighted views due to fat embolism. Retinal haemorrhages were observed. The bronchoalveolar lavage showing fat staining of tracheal aspirates confirmed the diagnosis of fat embolism. This case report emphasizes the possibility of predominant neurologic manifestations of a fat embolism and the diagnostic help of cerebral magnetic resonance imaging. PMID:9750647

  1. Alzheimer's silent partner: cerebral amyloid angiopathy.

    PubMed

    Cupino, Tanya L; Zabel, Matthew K

    2014-06-01

    Alzheimer's disease (AD) is the most common form of dementia, which completely lacks a viable, long-term therapeutic intervention. This is partly due to an incomplete understanding of AD etiology and the possible confounding factors associated with its genotypic and phenotypic heterogeneity. Cerebral amyloid angiopathy (CAA) is a common, yet frequently overlooked, pathology associated with AD. CAA manifests with deposition amyloid-beta (Aβ) within the smooth muscle layer of cerebral arteries and arterioles. The role of Aβ in AD and CAA pathophysiology has long been controversial. Although it has demonstrated toxicity at super-physiological levels in vitro, Aβ load does not necessarily correlate with cognitive demise in humans. In this review, we describe the contributions of CAA to AD pathophysiology and important pathomechanisms that may lead to vascular fragility and hemorrhages. Additionally, we discuss the effect of Aβ on smooth muscle cell phenotype and viability, especially in terms of the complement cascade. PMID:24323728

  2. Cerebral Autoregulation Real-Time Monitoring

    PubMed Central

    Tsalach, Adi; Ratner, Eliahu; Lokshin, Stas; Silman, Zmira; Breskin, Ilan; Budin, Nahum; Kamar, Moshe

    2016-01-01

    Cerebral autoregulation is a mechanism which maintains constant cerebral blood flow (CBF) despite changes in mean arterial pressure (MAP). Assessing whether this mechanism is intact or impaired and determining its boundaries is important in many clinical settings, where primary or secondary injuries to the brain may occur. Herein we describe the development of a new ultrasound tagged near infra red light monitor which tracks CBF trends, in parallel, it continuously measures blood pressure and correlates them to produce a real time autoregulation index. Its performance is validated in both in-vitro experiment and a pre-clinical case study. Results suggest that using such a tool, autoregulation boundaries as well as its impairment or functioning can be identified and assessed. It may therefore assist in individualized MAP management to ensure adequate organ perfusion and reduce the risk of postoperative complications, and might play an important role in patient care. PMID:27571474

  3. Glibenclamide in Cerebral Ischemia and Stroke

    PubMed Central

    Simard, J. Marc; Sheth, Kevin N.; Kimberly, W. Taylor; Stern, Barney J.; del Zoppo, Gregory J.; Jacobson, Sven; Gerzanich, Volodymyr

    2013-01-01

    The sulfonylurea receptor 1 (Sur1)–transient receptor potential 4 (Trpm4) channel is an important molecular element in focal cerebral ischemia. The channel is upregulated in all cells of the neurovascular unit following ischemia, and is linked to microvascular dysfunction that manifests as edema formation and secondary hemorrhage, which cause brain swelling. Activation of the channel is a major molecular mechanism of cytotoxic edema and “accidental necrotic cell death.” Blockade of Sur1 using glibenclamide has been studied in different types of rat models of stroke: (i) in conventional non-lethal models (thromboembolic, 1–2 h temporary, or permanent middle cerebral artery occlusion), glibenclamide reduces brain swelling and infarct volume and improves neurological function; (ii) in lethal models of malignant cerebral edema, glibenclamide reduces edema, brain swelling, and mortality; (iii) in models with rtPA, glibenclamide reduces swelling, hemorrhagic transformation, and death. Retrospective studies of diabetic patients who present with stroke have shown that those whose diabetes is managed with a sulfonylurea drug and who are maintained on the sulfonylurea drug during hospitalization for stroke have better outcomes at discharge and are less likely to suffer hemorrhagic transformation. Here, we provide a comprehensive review of the basic science, preclinical experiments, and retrospective clinical studies on glibenclamide in focal cerebral ischemia and stroke. We also compare the preclinical work in stroke models to the updated recommendations of the Stroke Therapy Academic Industry Roundtable (STAIR). The findings reviewed here provide a strong foundation for a translational research program to study glibenclamide in patients with ischemic stroke. PMID:24132564

  4. Cerebral SPECT imaging: Impact on clinical management

    SciTech Connect

    Bloom, M.; Jacobs, S.; Pozniakof, T.

    1994-05-01

    Although cerebral SPECT has been reported to be of value in a variety of neurologic disorders, there is limited data available on the value of SPECT relative to clinical management decisions. The purpose of this study was to determine the effect of cerebral SPECT imaging on patient management. A total of 94 consecutive patients referred for clinical evaluation with brain SPECT were included in this study. Patients were assigned to one of nine groups depending on the clinical indication for the study. These groups included transient ischemia (16), stroke (20), dementia (18), seizures (5), hemorrhage (13), head trauma (6), arteriovenous malformations (6), encephalopathy (6) and a miscellaneous (4) group. All patients were injected with 99mTc HMPAO in doses ranging from 15 mCi to 22 mCi (555 MBq to 814 MBq) and scanned on a triple headed SPECT gamma camera. Two weeks after completion of the study, a standardized interview was conducted between the nuclear and referring physicians to determine if the SPECT findings contributed to an alteration in patient management. Overall, patient management was significantly altered in 47% of the cases referred. The greatest impact on patient management occurred in the group evaluated for transient ischemia, where a total of 13/16 (81%) of patients had their clinical management altered as a result of the cerebral SPECT findings. Clinical management was altered in 61% of patients referred for evaluation of dementia, 67% of patients evaluated for arteriovenous malformations, and 50% of patients with head trauma. In the remainder of the patients, alteration in clinical management ranged from 17% to 50% of patients. This study demonstrates the clinical utility of cerebral SPECT imaging since in a significant number of cases clinical management was altered as a result of the examination. Long term follow up will be necessary to determine patient outcome.

  5. Cerebral blood flow at high altitude.

    PubMed

    Ainslie, Philip N; Subudhi, Andrew W

    2014-06-01

    This brief review traces the last 50 years of research related to cerebral blood flow (CBF) in humans exposed to high altitude. The increase in CBF within the first 12 hours at high altitude and its return to near sea level values after 3-5 days of acclimatization was first documented with use of the Kety-Schmidt technique in 1964. The degree of change in CBF at high altitude is influenced by many variables, including arterial oxygen and carbon dioxide tensions, oxygen content, cerebral spinal fluid pH, and hematocrit, but can be collectively summarized in terms of the relative strengths of four key integrated reflexes: 1) hypoxic cerebral vasodilatation; 2) hypocapnic cerebral vasoconstriction; 3) hypoxic ventilatory response; and 4) hypercapnic ventilatory response. Understanding the mechanisms underlying these reflexes and their interactions with one another is critical to advance our understanding of global and regional CBF regulation. Whether high altitude populations exhibit cerebrovascular adaptations to chronic levels of hypoxia or if changes in CBF are related to the development of acute mountain sickness are currently unknown; yet overall, the integrated CBF response to high altitude appears to be sufficient to meet the brain's large and consistent demand for oxygen. This short review is organized as follows: An historical overview of the earliest CBF measurements collected at high altitude introduces a summary of reported CBF changes at altitude over the last 50 years in both lowlanders and high-altitude natives. The most tenable candidate mechanism(s) regulating CBF at altitude are summarized with a focus on available data in humans, and a role for these mechanisms in the pathophysiology of AMS is considered. Finally, suggestions for future directions are provided. PMID:24971767

  6. Cerebral metastases from epithelial ovarian carcinoma treated with carboplatin.

    PubMed

    Cooper, K G; Kitchener, H C; Parkin, D E

    1994-11-01

    We describe three women with cerebral metastases who presented following treatment for ovarian cancer. In all three cases the primary tumor underwent complete remission following cytoreductive surgery and adjuvant platinum-based combination chemotherapy. Cerebral metastases occurred at 18, 19, and 25 months following initial diagnosis of ovarian carcinoma. These cerebral lesions were treated with carboplatin 400 mg/m2 as a single agent. In one case total resolution of a single cerebral metastasis was achieved. In the other two women a significant reduction in tumor mass occurred and one of these responded to repeat treatment on two occasions. Survival times from diagnosis of the cerebral lesions were 11, 16, and 25 months. The treatment afforded rapid subjective and objective relief, significantly improved survival times, and was associated with good quality of life. Carboplatin should be considered for the treatment of cerebral metastases for ovarian cancer. PMID:7959302

  7. Is longer sevoflurane preconditioning neuroprotective in permanent focal cerebral ischemia?

    PubMed

    Qiu, Caiwei; Sheng, Bo; Wang, Shurong; Liu, Jin

    2013-08-15

    Sevoflurane preconditioning has neuroprotective effects in the cerebral ischemia/reperfusion model. However, its influence on permanent cerebral ischemia remains unclear. In the present study, the rats were exposed to sevoflurane for 15, 30, 60, and 120 minutes, followed by induction of permanent cerebral ischemia. Results demonstrated that 30- and 60-minute sevoflurane preconditioning significantly reduced the infarct volume at 24 hours after cerebral ischemia, and 60-minute lurane preconditioning additionally reduced the number of TUNEL- and caspase-3-positive cells in the ischemic penumbra. However, 120-minute sevoflurane preconditioning did not show evident neuroprotective effects. Moreover, 60-minute sevoflurane preconditioning significantly attenuated neurological deficits and infarct volume in rats at 4 days after cerebral ischemia. These findings indicated that 60-minute sevoflurane preconditioning can induce the best neuroprotective effects in rats with permanent cerebral ischemia through the inhibition of apoptosis. PMID:25206521

  8. Cocaine Constrictor Mechanisms of the Cerebral Vasculature.

    PubMed

    Rapoport, Robert M; Yoon, SeongHun; Zuccarello, Mario

    2016-05-01

    Cocaine constriction of the cerebral vasculature is thought to contribute to the ischemia associated with cocaine use. However, the mechanisms whereby cocaine elicits relevant vasoconstriction remain elusive. Indeed, proposed intra- and intercellular mechanisms based on over 3 decades of ex vivo vascular studies are, for the most part, of questionable relevancy due to the generally low contractile efficacy of cocaine combined with the use of nonresistance-type vessels. Furthermore, the significance attached to mechanisms derived from in vivo animal studies may be limited by the inability to demonstrate cocaine-induced decreased cerebral blood flow, as observed in (awake) humans. Despite these apparent limitations, we surmise that the vasoconstriction relevant to cocaine-induced ischemia is elicited by inhibition of dilator and activation of constrictor pathways because of cocaine action on the neurovascular unit (neuron, astrocyte, and vessel) and on vessels outside the unit. Furthermore, previous cocaine exposure, that is, conditions present in human subjects, downregulates and sensitizes these dilator and constrictor pathways, respectively, thereby enhancing constriction to acute cocaine. Identification of specific intra- and intercellular mechanisms requires investigations in the isolated microvasculature and the neurovascular unit from species chronically exposed to cocaine and in which cocaine decreases cerebral blood flow. PMID:26771152

  9. Visual function and perinatal focal cerebral infarction.

    PubMed Central

    Mercuri, E; Atkinson, J; Braddick, O; Anker, S; Nokes, L; Cowan, F; Rutherford, M; Pennock, J; Dubowitz, L

    1996-01-01

    AIMS: To evaluate the visual function of infants with perinatal cerebral infarction in whom the site and size of the lesion has been determined using magnetic resonance imaging (MRI). METHODS: Twelve infants with cerebral infarction on MRI were studied with a battery of tests specifically designed to evaluate visual function in infancy. This included tests: for visual attention (fixation shifts); of cerebral asymmetry (optokinetic nystagmus, visual fields); for assessment of acuity (forced choice preferential looking); and neurophysiological measures of vision (phase reversal and orientation reversal visual evoked potential). RESULTS: A considerable incidence of abnormalities on at least one of the tests for visual function used was observed. The presence or severity of visual abnormalities could not always be predicted by the site and extent of the lesion seen on imaging. CONCLUSIONS: Early focal lesions affecting the visual pathway can, to some extent, be compensated for by the immature developing brain. These data suggest that all the infants presenting with focal lesions need to be investigated with a detailed assessment of various aspects of vision. Images PMID:8949687

  10. Cerebral Ischemic Preconditioning: the Road So Far….

    PubMed

    Thushara Vijayakumar, N; Sangwan, Amit; Sharma, Bhargy; Majid, Arshad; Rajanikant, G K

    2016-05-01

    Cerebral preconditioning constitutes the brain's adaptation to lethal ischemia when first exposed to mild doses of a subtoxic stressor. The phenomenon of preconditioning has been largely studied in the heart, and data from in vivo and in vitro models from past 2-3 decades have provided sufficient evidence that similar machinery exists in the brain as well. Since preconditioning results in a transient protective phenotype labeled as ischemic tolerance, it can open many doors in the medical warfare against stroke, a debilitating cerebrovascular disorder that kills or cripples thousands of people worldwide every year. Preconditioning can be induced by a variety of stimuli from hypoxia to pharmacological anesthetics, and each, in turn, induces tolerance by activating a multitude of proteins, enzymes, receptors, transcription factors, and other biomolecules eventually leading to genomic reprogramming. The intracellular signaling pathways and molecular cascades behind preconditioning are extensively being investigated, and several first-rate papers have come out in the last few years centered on the topic of cerebral ischemic tolerance. However, translating the experimental knowledge into the clinical scaffold still evades practicality and faces several challenges. Of the various preconditioning strategies, remote ischemic preconditioning and pharmacological preconditioning appears to be more clinically relevant for the management of ischemic stroke. In this review, we discuss current developments in the field of cerebral preconditioning and then examine the potential of various preconditioning agents to confer neuroprotection in the brain. PMID:26081149

  11. Brain endothelial dysfunction in cerebral adrenoleukodystrophy.

    PubMed

    Musolino, Patricia L; Gong, Yi; Snyder, Juliet M T; Jimenez, Sandra; Lok, Josephine; Lo, Eng H; Moser, Ann B; Grabowski, Eric F; Frosch, Matthew P; Eichler, Florian S

    2015-11-01

    See Aubourg (doi:10.1093/awv271) for a scientific commentary on this article.X-linked adrenoleukodystrophy is caused by mutations in the ABCD1 gene leading to accumulation of very long chain fatty acids. Its most severe neurological manifestation is cerebral adrenoleukodystrophy. Here we demonstrate that progressive inflammatory demyelination in cerebral adrenoleukodystrophy coincides with blood-brain barrier dysfunction, increased MMP9 expression, and changes in endothelial tight junction proteins as well as adhesion molecules. ABCD1, but not its closest homologue ABCD2, is highly expressed in human brain microvascular endothelial cells, far exceeding its expression in the systemic vasculature. Silencing of ABCD1 in human brain microvascular endothelial cells causes accumulation of very long chain fatty acids, but much later than the immediate upregulation of adhesion molecules and decrease in tight junction proteins. This results in greater adhesion and transmigration of monocytes across the endothelium. PCR-array screening of human brain microvascular endothelial cells after ABCD1 silencing revealed downregulation of both mRNA and protein levels of the transcription factor c-MYC (encoded by MYC). Interestingly, MYC silencing mimicked the effects of ABCD1 silencing on CLDN5 and ICAM1 without decreasing the levels of ABCD1 protein itself. Together, these data demonstrate that ABCD1 deficiency induces significant alterations in brain endothelium via c-MYC and may thereby contribute to the increased trafficking of leucocytes across the blood-brain barrier as seen in cerebral adrenouleukodystrophy. PMID:26377633

  12. Focal embolic cerebral ischemia in the rat

    PubMed Central

    Zhang, Li; Zhang, Rui Lan; Jiang, Quan; Ding, Guangliang; Chopp, Michael; Zhang, Zheng Gang

    2015-01-01

    Animal models of focal cerebral ischemia are well accepted for investigating the pathogenesis and potential treatment strategies for human stroke. Occlusion of the middle cerebral artery (MCA) with an endovascular filament is a widely used model to induce focal cerebral ischemia. However, this model is not amenable to thrombolytic therapies. As thrombolysis with recombinant tissue plasminogen activator (rtPA) is a standard of care within 4.5 hours of human stroke onset, suitable animal models that mimic cellular and molecular mechanisms of thrombosis and thrombolysis of stroke are required. By occluding the MCA with a fibrin-rich allogeneic clot, we have developed an embolic model of MCA occlusion in the rat, which recapitulates the key components of thrombotic development and of thrombolytic therapy of rtPA observed from human ischemic stroke. The surgical procedures of our model can be typically completed within approximately 30 min and are highly adaptable to other strains of rats as well as mice for both genders. Thus, this model provides a powerful tool for translational stroke research. PMID:25741989

  13. Traditional Chinese herbal medicine and cerebral ischemia.

    PubMed

    Chen, Yuh-Fung

    2012-01-01

    Stroke is an important cause of mortality and morbidity worldwide but effective therapeutic strategy for the prevention of brain injury in patients with cerebral ischemia is lacking. Although tissue plasminogen activator (t-PA) has been used to treat stroke patients, this therapeutic strategy is confronted with ill side effects and is limited to patients within 3 hours of a stroke. Stroke-mediated cell death is a complex interplay of aberrant events involving excitotoxicity, acidosis, inflammation, oxidative stress, peri-infarct depolarization, and apoptosis. Due to the complexity of the events and the disappointing results from single agent trials, the combination of thrombolytic therapy and effective neural protection therapy may be an alternative strategy for patients with cerebral ischemia. Traditional Chinese herbal medicine has been described in ancient medicine systems as a treatment for various ailments associated with stroke. Recently, there have been reports of its benefits in treating stroke. This review will focus on various traditional Chinese herbal medicines and their neuroprotective effects on cerebral ischemia. PMID:22201915

  14. Opiates and cerebral functional activity in rats

    SciTech Connect

    Trusk, T.C.

    1986-01-01

    Cerebral activity was measured using the free-fatty acid (1-/sup 14/C) octanoate as a fast functional tracer in conscious, unrestrained rats 5 minutes after intravenous injection of heroin, cocaine or saline vehicle. Regional changes of octanoate labeling density in the autoradiograms relative to saline-injected animals were used to determine the functional activity effects of each drug. Heroin and cocaine each produced a distinctive pattern of activity increases and suppression throughout the rat brain. Similar regional changes induced by both drugs were found in limbic brain regions implicated in drug reinforcement. Labeled octanoate autoradiography was used to measure the cerebral functional response to a tone that had previously been paired to heroin injections. Rats were trained in groups of three consisting of one heroin self-administration animal, and two animals receiving yoked infusion of heroin or saline. A tone was paired with each infusion during training. Behavioral experiments in similarly trained rats demonstrated that these training conditions impart secondary reinforcing properties to the tone in animals previously self-administering heroin, while the tone remains behaviorally neutral in yoked-infusion rats. Cerebral functional activity was measured during presentation of the tone without drug infusion. Octanoate labeling density changed in fifteen brain areas in response to the tone previously paired to heroin without response contingency. Labeling density was significantly modified in sixteen regions as a result of previously pairing the tone to response-contingent heroin infusions.

  15. Update on cerebral uptake of blood ammonia.

    PubMed

    Sørensen, Michael

    2013-06-01

    Ammonia is believed to play a key role in the development of hepatic encephalopathy (HE) with increased formation of glutamine playing a central role. It has been debated whether blood ammonia enters the brain by passive diffusion and/or active transport by ion-transporters and that changes in blood pH could affect the blood-to-brain transfer of ammonia. It has also been proposed that the permeability-surface area product for ammonia across the blood-brain barrier (PSBBB) should be increased in cirrhosis and HE. In the present paper it is argued that changes in blood pH does not alter PSBBB for ammonia and the question of passive diffusion versus active transport of ammonia remains unresolved. Furthermore, recent studies do not find evidence for increased PSBBB for ammonia in cirrhosis. The main determent for cerebral uptake of blood ammonia (i.e. flux) is the arterial blood ammonia concentration. This means that the only way to protect the brain from hyperammonemia is by lowering blood ammonia, inhibit cerebral uptake of ammonia, or by manipulating cerebral ammonia metabolism so that less glutamine is produced. PMID:23479402

  16. An Unruptured Cerebral Aneurysm at the Origin of the Duplicated Middle Cerebral Artery

    PubMed Central

    Kim, Jin Seong; Park, Hyun; Han, Jong-Woo

    2015-01-01

    A variety of cerebral vascular anomalies are widely applied, however anomalies of the middle cerebral artery (MCA) are relatively infrequent. The duplicated MCA (DMCA) is a MCA anomaly. Aneurysm arising from the origin of the DMCA is rare. Cerebral angiography in a 61-year-old female demonstrated a small (about 3 mm) saccular aneurysm located at the origin of the DMCA in the anterior direction. Considering the unusual location, the lesion was treated, regardless of the size. Aneurysmal characteristics of a broad neck and small size limited the endovascular approach, necessitating open surgery. Her postoperative course was uneventful and postoperative angiography showed complete obliteration of the aneurysm. The patient was discharged without neurologic deficit. PMID:26523256

  17. Immunologic Cerebral Vasculitis and Extrapulmonary Tuberculosis: An Uncommon Association.

    PubMed

    Wang, Yiyi; Li, Qian; Zhen, Xiaohan; Liu, Yuan; Wu, Qi

    2015-09-01

    Infection can cause cerebral vasculitis not only by direct invasion of the vessel wall, but by immune complex deposition, or through secondary cryoglobulineamia. There are also two types of cerebral vasculitis associated with tuberculosis (TB). In TB treatment, cerebral vasculitis caused by immunologic injury received little attention than vasculitis due to direct invasion of TB infection. We report a case in a young woman who presented with fever, generalized lymphadenopathy, stroke-like events, movement disorder and coma, which was found to be active, lymph node TB with immunologic cerebral vacuities without tuberculosis meningitis. PMID:26500938

  18. Patterns of human local cerebral glucose metabolism during epileptic seizures

    SciTech Connect

    Engel, J. Jr.; Kuhl, D.E.; Phelps, M.E.

    1982-10-01

    Ictal patterns of local cerebral metabolic rate have been studied in epileptic patients by positron computed tomography with /sup 18/F-labeled 2-fluoro-2-deoxy-D-glucose. Partial seizures were associated with activation of anatomic structures unique to each patient studied. Ictal increases and decreases in local cerebral metabolism were observed. Scans performed during generalized convulsions induced by electroshock demonstrated a diffuse ictal increase and postictal decrease in cerebral metabolism. Petit mal absences were associated with a diffuse increase in cerebral metabolic rate. The ictal fluorodeoxyglucose patterns obtained from patients do not resemble autoradiographic patterns obtained from common experimental animal models of epilepsy.

  19. Immunologic Cerebral Vasculitis and Extrapulmonary Tuberculosis: An Uncommon Association

    PubMed Central

    Wang, Yiyi; Li, Qian; Zhen, Xiaohan; Liu, Yuan

    2015-01-01

    Infection can cause cerebral vasculitis not only by direct invasion of the vessel wall, but by immune complex deposition, or through secondary cryoglobulineamia. There are also two types of cerebral vasculitis associated with tuberculosis (TB). In TB treatment, cerebral vasculitis caused by immunologic injury received little attention than vasculitis due to direct invasion of TB infection. We report a case in a young woman who presented with fever, generalized lymphadenopathy, stroke-like events, movement disorder and coma, which was found to be active, lymph node TB with immunologic cerebral vacuities without tuberculosis meningitis. PMID:26500938

  20. The accessible cerebral vascular proteome in a mouse model of cerebral β-amyloidosis.

    PubMed

    Roesli, Christoph; Fugmann, Tim; Borgia, Beatrice; Schliemann, Christoph; Neri, Dario; Jucker, Mathias

    2011-04-01

    Assessing protein changes in the cerebral vasculature of brain disorders may increase our understanding of disease pathogenesis and facilitate diagnostic and therapeutic intervention. By combining perfusion of mice with a charged reactive biotin derivative and subsequent quantification of the biotinylated proteins, the proteome accessible from the vasculature in an APPPS1 transgenic mouse model of cerebral β-amyloidosis was identified and compared to that in non-transgenic control mice. Our results provide proof-of-concept of this technology for the identification of new targets for antibody-based therapy or pharmacodelivery, and for neuroimaging in neurodegenerative diseases. PMID:21262399

  1. Trigeminal neuralgia increases cerebral blood flow in a focal cerebral ischemic model in rats

    PubMed Central

    Wang, Wei; Zhao, Weiliang; Liu, Zhenxiu; Xia, Jianhua; Wu, Jingru; Shi, Xueyin

    2015-01-01

    Objective: To investigate the influences of trigeminal neuropathic pain on the cerebral blood flow in a ET-1 focal cerebral ischemia model. Methods: Male Sprague-Dawley (SD) rats (220-260 g) were randomly divided into a model group (trigeminal neuralgia, TN group) and a sham operation group (sham group). The TN group received bilateral infraorbital nerve chronic constriction surgery, and the sham group only underwent exposure of the infraorbital nerve. The mechanical pain threshold of the rats was continuously monitored for 30 days post surgery. On postoperative day 30, the animals were anesthetized, and 3 μL (120 pM/μL) ET-1 was injected into the surroundings of the middle cerebral artery (MCA) to establish a cerebral focal ischemia-reperfusion injury model in rats. The changes in cerebral blood flow of these two groups were monitored 30 min after the injection of ET-1. Results: The mechanic pain threshold values between rats in the two groups were not significantly different (P>0.05). The threshold value in the TN group on postoperative day 9 significantly decreased compared with that before surgery (P<0.01). Between postoperative days 9 and 30, the pain threshold values in the TN group were significantly lower than those in the sham group (P<0.01). From postoperative day 10, the mean arterial pressure in the TN group significantly increased compared with that before surgery (P<0.05), and the blood pressure (BP) in the TN group was higher than that in the sham group between postoperative days 10 and 30 (P<0.05). After 75 min of ET-1 microinjection, the cerebral blood flow in the rat frontal cortex exhibited reperfusion, and the cerebral blood flow in the TN group was significantly higher than that in the sham group (P<0.05). In addition, the content of calcitonin gene-related peptide (CGRP) in the blood of rats in the TN group was significantly higher than that in the sham group (P<0.05). Conclusions: Trigeminal neuropathic pain may increase the mean arterial

  2. Outcome of cerebral arteriovenous malformations after linear accelerator reirradiation

    PubMed Central

    Moraes, Paulo L.; Dias, Rodrigo S.; Weltman, Eduardo; Giordani, Adelmo J.; Benabou, Salomon; Segreto, Helena R. C.; Segreto, Roberto A.

    2015-01-01

    Background: The aim of this study was to evaluate the clinical outcome of patients undergoing single-dose reirradiation using the Linear Accelerator (LINAC) for brain arteriovenous malformations (AVM). Methods: A retrospective study of 37 patients with brain AVM undergoing LINAC reirradiation between April 2003 and November 2011 was carried out. Patient characteristics, for example, gender, age, use of medications, and comorbidities; disease characteristics, for example, Spetzler–Martin grading system, location, volume, modified Pollock–Flickinger score; and treatment characteristics, for example, embolization, prescription dose, radiation dose–volume curves, and conformity index were analyzed. During the follow-up period, imaging studies were performed to evaluate changes after treatment and AVM cure. Complications, such as edema, rupture of the blood–brain barrier, and radionecrosis were classified as symptomatic and asymptomatic. Results: Twenty-seven patients underwent angiogram after reirradiation and the percentage of angiographic occlusion was 55.5%. In three patients without obliteration, AVM shrinkage made it possible to perform surgical resection with a 2/3 cure rate. A reduction in AVM nidus volume greater than 50% after the first procedure was shown to be the most important predictor of obliteration. Another factor associated with AVM cure was a prescription dose higher than 15.5 Gy in the first radiosurgery. Two patients had permanent neurologic deficits. Factors correlated with complications were the prescription dose and maximum dose in the first procedure. Conclusion: This study suggests that single-dose reirradiation is safe and feasible in partially occluded AVM. Reirradiation may not benefit candidates whose prescribed dose was lower than 15.5 Gy in the first procedure and initial AVM nidus volume did not decrease by more than 50% before reirradiation. PMID:26110078

  3. Induced hypertension for the treatment of cerebral ischemia after subarachnoid hemorrhage. Direct effect on cerebral blood flow

    SciTech Connect

    Muizelaar, J.P.; Becker, D.P.

    1986-04-01

    The best treatment for symptomatic cerebral ischemia from presumed vasospasm after aneurysmal subarachnoid hemorrhage remains a matter of controversy. A direct effect of any treatment modality on regional cerebral blood flow has never been documented. In a series of 43 patients operated on for ruptured anterior circulation aneurysms, five patients (11.6%) developed clinical signs of cerebral ischemia postoperatively. In four of those patients, the diagnosis of vasospasm was made with measurements of cerebral blood flow (133Xe inhalation or intravenous injection, 10-16 detectors, cerebral blood flow infinity). Treatment with induced arterial hypertension with phenylephrine was instituted. Hemodilution was instituted in one patient; the other three patients already had hematocrits in the range of 33. Within 1 hour, the cerebral blood flow measurement was repeated to document the effect of treatment. The average pretreatment hemispherical blood flow on the operated side was 18.8 mL/100 g per minute, on the contralateral side 21.0 mL/100 g per minute. With treatment these flows increased to 30.8 and 35.8 mL/100 g per minute, respectively. There was also an immediate and obvious positive clinical effect in all patients. The role of measurement of cerebral blood flow in the clinical management of vasospasm is discussed. We stress the theoretical and practical advances of measurements of cerebral blood flow over cerebral angiography, especially in comatose patients.

  4. Effects of ischemic stroke on dynamics of cerebral autoregulation

    NASA Astrophysics Data System (ADS)

    Chen, Zhi; Ivanov, Plamen Ch; Hu, Kun; Stanley, Eugene; Novak, Vera

    2004-03-01

    Cerebral vasoregulation involves several complex mechanisms adapting blood flow to fluctuations of systemic blood pressure (BP). Autonomic BP and metabolic vasoregulation are impaired after stroke and cerebral blood flow depends on systemic BP. To probe the mechanisms of cerebral autoregulation we study levels of nonlinear synchronization between cerebral blood flow velocity (BFV) and peripheral BP. We quantify the instantaneous phase of each signal employing analytic signal approach and Hilbert transform. As a marker of synchronization, we introduce a measure of cross-correlation between the instantaneous phase increments of the BFV and BP signals at different time lags. We have studied 12 subjects with minor chronic ischemic stroke and 11 matched normotensive controls (age<65years). BFV and BP of these subjects are continuously recorded during supine baseline, head-up tilt, hyperventilation and CO2 rebreathing. For control subjects we find significant synchronization between cerebral BFV and peripheral BP only for short time lags of up to 5-6 seconds, suggesting a rapid return to a steady cerebral blood flow after initial blood pressure perturbations. In contrast, for stroke subjects BFV/BP we find enhanced synchronization over longer time lags of up to 20 seconds, suggesting entrainment of cerebral blood flow velocity by slow vasomotor rhythms. These findings suggest that cerebral vasoregulation is impaired and cerebral blood flow follows the fluctuations of systemic BP in a synchronous manner. Our analysis shows that cerebral autoregulation is impaired in 10 out of the 12 stroke subjects, which is typically difficult to diagnose with conventional methods. Thus, our novel synchronization approach offers a new tool sensitive for evaluation of changes in the dynamics of cerebral autoregulation under stroke.

  5. Neuroprotective effects of systemic cerebral endothelial cell transplantation in a rat model of cerebral ischemia

    PubMed Central

    Moon, Jong-Hyun; Na, Joo-Young; Lee, Min-Cheol; Choi, Kang-Ho; Lee, Jeong-Kil; Min, Jung-Joon; Kim, Kyung-Tae; Park, Jong-Tae; Park, Man-Seok; Kim, Hyung-Seok

    2016-01-01

    Human cerebral microvascular endothelial cell line (hCMEC)/D3 cells, which are from a stable clonal cell line of human immortalized cerebral endothelial cells, were intra-arterially transplanted through the common carotid artery in a rat model of photochemical-induced cerebral ischemia. Their therapeutic effects on infarct size, blood-brain barrier (BBB) breakdown, and outcome were examined. The hCMEC/D3 cells were genetically modified with the firefly luciferase gene for in vivo imaging post-transplantation. Transplanted hCMEC/D3 cells were identified in the infarcted brain by bioluminescence imaging at 1 day after transplantation. Compared with the control group, the hCMEC/D3-transplanted group showed reduced infarct size on day 3, reduced Evans blue dye leakage on day 1 indicating decreased BBB breakdown, and early recovery from Rotarod test neurological deficits. The hCMEC/D3-transplanted group also showed decreased levels of matrix metalloproteinase (MMP)-9, which were inversely correlated with TIMP-1 levels on post-transplantation days 1 and 3. The expression of tumor necrosis factor-α and interleukin-1β were markedly diminished in the hCMEC/D3-transplanted group compared with controls. The systemically transplanted cells selectively migrated and integrated into the ischemically lesioned area, which accelerated neurological recovery. This new cerebral endothelial cell-based therapy may hold promise for clinical trials in patients with ischemic stroke. PMID:27347342

  6. Neuroprotective effects of systemic cerebral endothelial cell transplantation in a rat model of cerebral ischemia.

    PubMed

    Moon, Jong-Hyun; Na, Joo-Young; Lee, Min-Cheol; Choi, Kang-Ho; Lee, Jeong-Kil; Min, Jung-Joon; Kim, Kyung-Tae; Park, Jong-Tae; Park, Man-Seok; Kim, Hyung-Seok

    2016-01-01

    Human cerebral microvascular endothelial cell line (hCMEC)/D3 cells, which are from a stable clonal cell line of human immortalized cerebral endothelial cells, were intra-arterially transplanted through the common carotid artery in a rat model of photochemical-induced cerebral ischemia. Their therapeutic effects on infarct size, blood-brain barrier (BBB) breakdown, and outcome were examined. The hCMEC/D3 cells were genetically modified with the firefly luciferase gene for in vivo imaging post-transplantation. Transplanted hCMEC/D3 cells were identified in the infarcted brain by bioluminescence imaging at 1 day after transplantation. Compared with the control group, the hCMEC/D3-transplanted group showed reduced infarct size on day 3, reduced Evans blue dye leakage on day 1 indicating decreased BBB breakdown, and early recovery from Rotarod test neurological deficits. The hCMEC/D3-transplanted group also showed decreased levels of matrix metalloproteinase (MMP)-9, which were inversely correlated with TIMP-1 levels on post-transplantation days 1 and 3. The expression of tumor necrosis factor-α and interleukin-1β were markedly diminished in the hCMEC/D3-transplanted group compared with controls. The systemically transplanted cells selectively migrated and integrated into the ischemically lesioned area, which accelerated neurological recovery. This new cerebral endothelial cell-based therapy may hold promise for clinical trials in patients with ischemic stroke. PMID:27347342

  7. Stent-assisted coil embolization for anterior cerebral artery dissection presented with cerebral infarction

    PubMed Central

    Iwasaki, Mitsuhiro; Hattori, Itaro; Sasaki, Makoto; Ishimori, Hisatsugu; Nemoto, Akihiro; Hikita, Chiyoe; Sato, Junko; Fukuta, Shinya; Morimoto, Masafumi

    2015-01-01

    Background: Compared to those found in the vertebrobasilar system, intracranial dissection in the anterior circulation is relatively rare, especially in the anterior cerebral artery (ACA). Moreover, only several cases of ACA dissection that underwent endovascular treatment have been reported. Here we present a rare case of gradually developing ACA dissecting aneurysm causing cerebral infarction, successfully treated by stent-assisted coil embolization. Case Description: A 36-year-old man was admitted with sudden right hemiparesis. Diffusion-weighted magnetic resonance (MR) imaging showed cerebral infarction in the left ACA territory, and MR angiography showed segmental stenosis at the A2 portion of the left ACA. Three-dimensional digital subtraction angiogram showed segmental dilatation and stenosis at the left A2 portion. We diagnosed ACA dissection causing acute cerebral infarction and treated the patient conservatively. Five months after the onset, the dissecting artery at the left A2 portion formed a gradually dilating aneurysm, suggesting increased risk for aneurysmal rupture. We attempted endovascular treatment entailing coil embolization of an aneurysm while preserving the left A2 with stent assistance. The patient remained neurologically stable 6 months after the procedure. Conclusions: Although there are few reported cases of ACA dissection where endovascular treatment was attempted, we consider stent-assisted embolization for gradually developing ACA dissecting aneurysm as an alternative method to prevent bleeding and recurrent infarction. PMID:26677416

  8. The role of cerebral oxygenation and regional cerebral blood flow on tolerance to central hypovolemia.

    PubMed

    Kay, Victoria L; Rickards, Caroline A

    2016-02-15

    Tolerance to central hypovolemia is highly variable, and accumulating evidence suggests that protection of anterior cerebral blood flow (CBF) is not an underlying mechanism. We hypothesized that individuals with high tolerance to central hypovolemia would exhibit protection of cerebral oxygenation (ScO2), and prolonged preservation of CBF in the posterior vs. anterior cerebral circulation. Eighteen subjects (7 male/11 female) completed a presyncope-limited lower body negative pressure (LBNP) protocol (3 mmHg/min onset rate). ScO2 (via near-infrared spectroscopy), middle cerebral artery velocity (MCAv), posterior cerebral artery velocity (PCAv) (both via transcranial Doppler ultrasound), and arterial pressure (via finger photoplethysmography) were measured continuously. Subjects who completed ≥70 mmHg LBNP were classified as high tolerant (HT; n = 7) and low tolerant (LT; n = 11) if they completed ≤60 mmHg LBNP. The minimum difference in LBNP tolerance between groups was 193 s (LT = 1,243 ± 185 s vs. HT = 1,996 ± 212 s; P < 0.001; Cohen's d = 3.8). Despite similar reductions in mean MCAv in both groups, ScO2 decreased in LT subjects from -15 mmHg LBNP (P = 0.002; Cohen's d=1.8), but was maintained at baseline values until -75 mmHg LBNP in HT subjects (P < 0.001; Cohen's d = 2.2); ScO2 was lower at -30 and -45 mmHg LBNP in LT subjects (P ≤ 0.02; Cohen's d ≥ 1.1). Similarly, mean PCAv decreased below baseline from -30 mmHg LBNP in LT subjects (P = 0.004; Cohen's d = 1.0), but remained unchanged from baseline in HT subjects until -75 mmHg (P = 0.006; Cohen's d = 2.0); PCAv was lower at -30 and -45 mmHg LBNP in LT subjects (P ≤ 0.01; Cohen's d ≥ 0.94). Individuals with higher tolerance to central hypovolemia exhibit prolonged preservation of CBF in the posterior cerebral circulation and sustained cerebral tissue oxygenation, both associated with a delay in the onset of presyncope. PMID:26676249

  9. Cerebral oximetry improves detection of sickle cell patients at risk for nocturnal cerebral hypoxia.

    PubMed

    Raj, Ashok B; O'brien, Louise M; Bertolone, Salvatore J; Gozal, David; Edmonds, Harvey L

    2006-11-01

    We previously used cerebral oximetry to identify low cerebral venous oxygen saturation in waking children with sickle cell disease (SCD). Because arterial oxyhemoglobin desaturation is common during sleep in SCD patients, this study compared both waking and sleeping systemic arterial and cerebral venous oxygenation dynamics in children with and without SCD. Seventeen African-American (AA) children with homozygous SCD [8 (4-15) years; 29% male; normal transcranial Doppler velocities] were compared with a control cohort (CON) comprised of six healthy AA children [9 (4-16) years, 33% male]. Standard all-night polysomnographic recordings were performed, including measurement of arterial oxygen saturation by pulse oximetry (SpO(2)). Regional cerebral oxygen saturation (rSO(2)) was measured non-invasively with cerebral oximetry. Intra-cohort comparisons examined the influence of sleep on SpO(2) and rSO(2) in the subjects. Inter-cohort comparisons of SpO(2), rSO(2,) and the rSO(2)/SpO(2) ratio assessed the impact of SCD on systemic and cerebral oxygenation during wakefulness and sleep. Cohort differences in SpO(2) were not statistically significant in either wakefulness or sleep. However, only in the SCD cohort was the magnitude of SpO(2) change statistically significant (P = 0.002). In contrast, both waking and sleep rSO(2) cohort median values did differ significantly [awake: CON 76 (67-86) vs. SCD 62 (58-71), P = 0.01; sleep: CON 65 (60-77) vs. SCD 55 (48-61), P = 0.01)]. The waking rSO(2)/SpO(2) ratio was also significantly lower in the SCD group [CON 0.78 (0.68-0.88) vs. SCD of 0.66 (0.61-0.72); P = 0.015]. During sleep, the ratio was also significantly lower in the SCD group [CON 0.71 (0.66-0.81) vs. SCD 0.59 (0.52-0.65); P = 0.011]. Our findings suggest that SCD patients may be at increased risk of cerebral hypoxia during both wakefulness and sleep. PMID:16998929

  10. A new rodent model of cerebral hyperperfusion

    PubMed Central

    Jia, Bin; Zhao, Lei; Xiao, Wei; Cai, Bing; Wang, Tian-Long; Li, Dong-Guo

    2015-01-01

    Background: Most studies of hyperperfusion and hyperperfusion syndrome after carotid endarterectomy or carotid stenting are based on clinical observation or meta-analyses in patients, whereas there is little corresponding fundamental research since proper animal model that can reproduce phenotype stably is not available. Therefore, we developed a rat model in which the pathophysiologic process of hyperperfusion can be mimicked. Methods: Global ischemia was induced by occluding bilateral common carotid arteries (BCAO) for 2 weeks. After that, the ligature was loosened to allow reperfusion. Phenylephrine was administered at concentrations of 10, 20, 30, 40, 50, 80, and 120 μg/mL for rapidly elevating blood pressure. Relative cerebral blood flow in relation to mean arterial pressure (MAP) was measured with Laser Doppler techniques. Sham animals underwent the same surgical operation but without artery-occlusion and received the same concentrations of phenylephrine. Results: Mild hypertension rapidly increased cerebral blood flow. Phenylephrine at different concentrations produced different effects on blood pressure. Hyperperfusion can be induced by phenylephrine at around 30 μg/mL, whereas phenylephrine at 80 μg/ml or higher induced arrhythmia and further cardiac dysfunction thus failed to induce hyperperfusion. Conclusions: Our data suggest that 30-50 μg/mL phenylephrine mildly elevated MAP and cerebral blood flow to the level exceeding 100% of baseline. This hyperperfusion model possesses several advantages including high phenotype reproducibility, low experimental failure rate and low animal mortality rate. It can be applied to study carotid stenosis or ischemia/reperfusion injury in rats. PMID:26770334

  11. Quality of Arithmetic Education for Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Jenks, Kathleen M.; de Moor, Jan; van Lieshout, Ernest C. D. M.; Withagen, Floortje

    2010-01-01

    The aim of this exploratory study was to investigate the quality of arithmetic education for children with cerebral palsy. The use of individual educational plans, amount of arithmetic instruction time, arithmetic instructional grouping, and type of arithmetic teaching method were explored in three groups: children with cerebral palsy (CP) in…

  12. Cerebral Lipiodol Embolism after Lymphatic Embolization for Plastic Bronchitis.

    PubMed

    Kirschen, Matthew P; Dori, Yoav; Itkin, Maxim; Licht, Daniel J; Ichord, Rebecca; Vossough, Arastoo

    2016-09-01

    An adolescent with plastic bronchitis due to congenital heart disease had altered mental status after an interventional lymphatic procedure in which lipiodol contrast was used. Neuroimaging revealed cerebral lipiodol embolization due to direct shunting between lymphatic channels and pulmonary veins. Cerebral lipiodol embolization is a potential neurologic morbidity associated with interventional lymphatic procedures. PMID:27297208

  13. Cerebral Lipiodol Embolism after Lymphatic Embolization for Plastic Bronchitis

    PubMed Central

    Kirschen, Matthew P.; Dori, Yoav; Itkin, Maxim; Licht, Daniel J.; Ichord, Rebecca; Vossough, Arastoo

    2016-01-01

    An adolescent with plastic bronchitis due to congenital heart disease had altered mental status after an interventional lymphatic procedure in which lipiodol contrast was used. Neuroimaging revealed cerebral lipiodol embolization due to direct shunting between lymphatic channels and pulmonary veins. Cerebral lipiodol embolization is a potential neurologic morbidity associated with interventional lymphatic procedures. PMID:27297208

  14. PET Quantification of Cerebral Oxygen Metabolism in Small Animals

    PubMed Central

    Temma, Takashi; Koshino, Kazuhiro; Moriguchi, Tetsuaki; Enmi, Jun-ichiro; Iida, Hidehiro

    2014-01-01

    Understanding cerebral oxygen metabolism is of great importance in both clinical diagnosis and animal experiments because oxygen is a fundamental source of brain energy and supports brain functional activities. Since small animals such as rats are widely used to study various diseases including cerebral ischemia, cerebrovascular diseases, and neurodegenerative diseases, the development of a noninvasive in vivo measurement method of cerebral oxygen metabolic parameters such as oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO2) as well as cerebral blood flow (CBF) and cerebral blood volume (CBV) has been a priority. Although positron emission tomography (PET) with 15O labeled gas tracers has been recognized as a powerful way to evaluate cerebral oxygen metabolism in humans, this method could not be applied to rats due to technical problems and there were no reports of PET measurement of cerebral oxygen metabolism in rats until an 15O-O2 injection method was developed a decade ago. Herein, we introduce an intravenous administration method using two types of injectable 15O-O2 and an 15O-O2 gas inhalation method through an airway placed in the trachea, which enables oxygen metabolism measurements in rats. PMID:25202714

  15. Cerebral air embolism after pleural streptokinase instillation.

    PubMed

    Janisch, Thorsten; Siekmann, Ullrich; Kopp, Rüdger

    2013-12-01

    Iatrogenic pulmonary barotrauma and cerebral arterial gas embolism (CAGE) may complicate a variety of medical procedures, such as certain types of surgery, drug administration through thoracic drainage, pneumoperitoneum, cystoscopy, bronchoscopy, etc. Hyperbaric oxygen treatment following the guidelines for CAGE in diving is the treatment of choice. Pleural streptokinase instillation is a common treatment for parapneumonic pleural effusion and may lead to CAGE. We present such a complication in a 79-year-old woman with a left-sided empyema. Neurological recovery was reasonable, but a left hemiparesis persisted. Prompt treatment of CAGE is necessary to avoid permanent injury and severe disability. PMID:24510333

  16. Regional cerebral blood flow in schizophrenia

    SciTech Connect

    Mathew, R.J.; Duncan, G.C.; Weinman, M.L.; Barr, D.L.

    1982-10-01

    Regional cerebral blood flow (rCBF) was measured via xenon133 inhalation technique in 23 patients with schizophrenia and 18 age- and sex-matched controls. The mean blood flow to both hemispheres was found to be lower for the patients. The patients and their controls did not differ on interhemispheric differences in blood flow. There were no differences in rCBF between medicated and unmedicated, subchronic and chronic, and paranoid and nonparanoid patients. Hallucinations were associated with reduced blood flow to several postcentral regions.

  17. Hypocapnia and cerebral hypoperfusion in orthostatic intolerance

    NASA Technical Reports Server (NTRS)

    Novak, V.; Spies, J. M.; Novak, P.; McPhee, B. R.; Rummans, T. A.; Low, P. A.

    1998-01-01

    BACKGROUND AND PURPOSE: Orthostatic and other stresses trigger tachycardia associated with symptoms of tremulousness, shortness of breath, dizziness, blurred vision, and, often, syncope. It has been suggested that paradoxical cerebral vasoconstriction during head-up tilt might be present in patients with orthostatic intolerance. We chose to study middle cerebral artery (MCA) blood flow velocity (BFV) and cerebral vasoregulation during tilt in patients with orthostatic intolerance (OI). METHODS: Beat-to-beat BFV from the MCA, heart rate, CO2, blood pressure (BP), and respiration were measured in 30 patients with OI (25 women and 5 men; age range, 21 to 44 years; mean age, 31.3+/-1.2 years) and 17 control subjects (13 women and 4 men; age range, 20 to 41 years; mean age, 30+/-1.6 years); ages were not statistically different. These indices were monitored during supine rest and head-up tilt (HUT). We compared spontaneous breathing and hyperventilation and evaluated the effect of CO2 rebreathing in these 2 positions. RESULTS: The OI group had higher supine heart rates (P<0.001) and cardiac outputs (P<0.01) than the control group. In response to HUT, OI patients underwent a greater heart rate increment (P<0.001) and greater reductions in pulse pressure (P<0.01) and CO2 (P<0.001), but total systemic resistance failed to show an increment. Among the cerebrovascular indices, all BFVs (systolic, diastolic, and mean) decreased significantly more, and cerebrovascular resistance (CVR) was increased in OI patients (P<0.01) compared with control subjects. In both groups, hyperventilation induced mild tachycardia (P<0.001), a significant reduction of BFV, and a significant increase of CVR associated with a fall in CO2. Hyperventilation during HUT reproduced hypocapnia, BFV reduction, and tachycardia and worsened symptoms of OI; these symptoms and indices were improved within 2 minutes of CO2 rebreathing. The relationships between CO2 and BFV and heart rate were well described by

  18. Cerebral venous thrombosis revealing an ulcerative colitis

    PubMed Central

    Taous, Abdellah; Berri, Maha Aït; Lamsiah, Taoufik; Zainoun, Brahim; Ziadi, Tarik; Rouimi, Abdelhadi

    2016-01-01

    Cerebral venous thrombosis (CVT) has been reported as an uncommon and devastating complication of ulcerative colitis (UC), with an annual incidence varying between 0,5 to 6,7%. It is suspected to be a consequence of the hypercoagulable state occurring during disease relapse. We report a case of 22-year-old female patient presenting with CVT revealing an UC. Our case raises the awareness among health professionals about the inflammatory bowel diseases (IBD) as a rare etiology of CVT, and signifies the importance of considering antithrombotic prophylaxis in all hospitalised IBD patients, especially those with active disease. PMID:27279947

  19. Cerebral venous thrombosis in ulcerative colitis

    PubMed Central

    Menon, Bindu; Goyal, Rajeev; Nihal, Lalit; Reddy, Rajasekhar

    2013-01-01

    Ulcerative colitis has been reported to show hyper coagulation leading to peripheral and rarely central thrombosis. A 35-year-old female was admitted with chief complaints of increased frequency of bloody diarrhea, abdominal pain, and weight loss for 2 months. The patient was diagnosed to have ulcerative colitis after sigmoidoscopy and biopsy and she was started on treatment. Two days later, the patient developed headache and seizures. Magnetic resonance imaging of brain showed cerebral venous thrombosis with venous infarcts. A high index of clinical suspicion is needed to diagnose this uncommon condition so that appropriate treatment can be initiated. PMID:23546367

  20. [Cerebral Aspergillus abscess in immunocompetent patient].

    PubMed

    Pianetti Filho, Geraldo; Pedroso, Enio Roberto Pietra; Giannetti, Alexandre Varela; Darwich, Rogério

    2005-12-01

    We report an unusual case of brain aspergillosis with multiple recurrent abscess in a 40 year-old immunocompetent woman, with good therapeutical outcome. The patient presented a subarachnoid hemorrhage caused by a ruptured pericallosal artery aneurysm and was submitted to a craniotomy for aneurysm surgery. Five months later, she developed multiple Aspergillus cerebral abscess. Two craniotomies and amphotericin B became necessary during treatment. Fourteen years later, she is asymptomatic. Treatment of brain aspergillosis abscess implied the combination of both surgical and drug therapy with amphotericin B. PMID:16400435

  1. Hypopigmentation, anomalous cerebral dominance and seasonality.

    PubMed

    London, W P

    1993-12-01

    This paper proposes a prenatal seasonal hypopigmentation influence associated with anomalous cerebral dominance that occurs during the winter or early spring. A possible mechanism would be seasonal changes in sex hormone levels that affect the activation and inactivation of DNA by reversible methylation. The proposed prenatal seasonal hypopigmentation effect might be relevant to dyslexia, Prader-Willi syndrome, breast cancer, Alzheimer's and Parkinson's disease. Putative chromosomal loci associated with the proposed seasonal mechanism would be 15q11-13 (dyslexia and Prader-Willi syndrome), 21q region (breast cancer and Alzheimer's disease) and 19p region (pigmentation gene). PMID:8183125

  2. Increase in cerebral palsy in normal birthweight babies.

    PubMed Central

    Jarvis, S N; Holloway, J S; Hey, E N

    1985-01-01

    A register has been compiled of the 421 children with congenital cerebral palsy born between 1960 and 1975 from a defined geographical area of North East England (population 770 000). There was a fall in the rate of cerebral palsy among very low birthweight babies between 1964 and 1975 and also in the small group with dyskinetic cerebral palsy. The rate rose, however, among babies weighing more than 2.5 kg at birth in the second half of the study, in parallel with changes in perinatal mortality. The net effect is that the overall congenital cerebral palsy rate (mean 1.64 per 1000 livebirths) showed a gradual rise between 1968 and 1975. This conclusion is reinforced by evidence of a rise in incidence among the subgroup of patients with severe cerebral palsy (as defined by an interval measurement of handicap) during the same period. PMID:2936310

  3. Inflammatory response and neuronal necrosis in rats with cerebral ischemia

    PubMed Central

    Wu, Lingfeng; Zhang, Kunnan; Hu, Guozhu; Yan, Haiyu; Xie, Chen; Wu, Xiaomu

    2014-01-01

    In the middle cerebral artery occlusion model of ischemic injury, inflammation primarily occurs in the infarct and peripheral zones. In the ischemic zone, neurons undergo necrosis and apoptosis, and a large number of reactive microglia are present. In the present study, we investigated the pathological changes in a rat model of middle cerebral artery occlusion. Neuronal necrosis appeared 12 hours after middle cerebral artery occlusion, and the peak of neuronal apoptosis appeared 4 to 6 days after middle cerebral artery occlusion. Inflammatory cytokines and microglia play a role in damage and repair after middle cerebral artery occlusion. Serum intercellular cell adhesion molecule-1 levels were positively correlated with the permeability of the blood-brain barrier. These findings indicate that intercellular cell adhesion molecule-1 may be involved in blood-brain barrier injury, microglial activation, and neuronal apoptosis. Inhibiting blood-brain barrier leakage may alleviate neuronal injury following ischemia. PMID:25422636

  4. Sleep in children with cerebral palsy: a review.

    PubMed

    Simard-Tremblay, Elisabeth; Constantin, Evelyn; Gruber, Reut; Brouillette, Robert T; Shevell, Michael

    2011-10-01

    Children with neurodevelopmental disabilities, such as cerebral palsy, are considered to be a population at risk for the occurrence of sleep problems. Moreover, recent studies on children with cerebral palsy seem to indicate that this population is at higher risk for sleep disorders. The importance of the recognition and treatment of sleep problems in children with cerebral palsy cannot be overemphasized. It is well known that the consequences of sleep disorders in children are broad and affect both the child and family. This review article explores the types and possible risk factors associated with the development of sleep problems in children with cerebral palsy and the impact of this disorder on the child and family. In addition, a brief summary of current diagnostic and treatment modalities is provided. Finally, the characteristics, diagnostic techniques, and management of sleep-related breathing disorders in children with cerebral palsy are discussed. PMID:21670393

  5. Retinal vascular changes are a marker for cerebral vascular diseases

    PubMed Central

    Moss, Heather E.

    2016-01-01

    The retinal circulation is a potential marker of cerebral vascular disease because it shares origin and drainage with the intracranial circulation and because it can be directly visualized using ophthalmoscopy. Cross sectional and cohort studies have demonstrated associations between chronic retinal and cerebral vascular disease, acute retinal and cerebral vascular disease and chronic retinal vascular disease and acute cerebral vascular disease. In particular, certain qualitative features of retinopathy, retinal artery occlusion and increased retinal vein caliber are associated with concurrent and future cerebrovascular events. These associations persist after accounting for confounding variables known to be disease-causing in both circulations, which supports the potential use of retinal vasculature findings to stratify individuals with regards to cerebral vascular disease risk. PMID:26008809

  6. Cerebral Palsy: General Information. Fact Sheet Number 2 = La Paralisis Cerebral: Informacion General. Fact Sheet Number 18.

    ERIC Educational Resources Information Center

    Interstate Research Associates, McLean, VA.

    This fact sheet on cerebral palsy is offered in both English and Spanish. First, it provides a definition and considers various causes (e.g., an insufficient amount of oxygen reaching the fetal or newborn brain). The fact sheet then offers incidence figures and explains characteristics of the three main types of cerebral palsy: spastic, athetoid,…

  7. Cerebral Toxocariasis: Silent Progression to Neurodegenerative Disorders?

    PubMed Central

    Holland, Celia V.; Loxton, Karen; Barghouth, Ursula

    2015-01-01

    SUMMARY Toxocara canis and T. cati are highly prevalent nematode infections of the intestines of dogs and cats. In paratenic hosts, larvae do not mature in the intestine but instead migrate through the somatic tissues and organs of the body. The presence of these migrating larvae can contribute to pathology. Toxocara larvae can invade the brains of humans, and while case descriptions of cerebral toxocariasis are historically rare, improved diagnosis and greater awareness have contributed to increased detection. Despite this, cerebral or neurological toxocariasis (NT) remains a poorly understood phenomenon. Furthermore, our understanding of cognitive deficits due to toxocariasis in human populations remains particularly deficient. Recent data describe an enhanced expression of biomarkers associated with brain injury, such as GFAP, AβPP, transforming growth factor β1 (TGF-β1), NF-L, S100B, tTG, and p-tau, in mice receiving even low doses of Toxocara ova. Finally, this review outlines a hypothesis to explore the relationship between the presence of T. canis larvae in the brain and the progression of Alzheimer's disease (AD) due to enhanced AD-associated neurodegenerative biomarker expression. PMID:26062575

  8. Photodynamic therapy of recurrent cerebral glioma

    NASA Astrophysics Data System (ADS)

    Zhu, Shu-Gan; Wu, Si-En; Chen, Zong-Qian; Sun, Wei

    1993-03-01

    Photodynamic therapy (PDT) was performed on 11 cases of recurrent cerebral glioma, including 3 cases of recurrent glioblastoma, 7 of recurrent anaplastic astrocytoma, and 1 recurrent ependymoma. Hematoporphyrin derivative (HPD) was administered intravenously at a dose of 4 - 7 mg/kg 5 - 24 hours before the operation. All patients underwent a craniotomy with a nearly radical excision of the tumor following which the tumor bed was irradiated with 630 nm laser light emitting either an argon pumped dye laser or frequency double YAG pumped dye laser for 30 to 80 minutes with a total dose of 50 J/cm2 (n equals 1), 100 J/cm2 (n equals 2), 200 J/cm2 (n equals 7), and 300 J/cm2 (n equals 1). The temperature was kept below 37 degree(s)C by irrigation. Two patients underwent postoperative radiotherapy. There was no evidence of increased cerebral edema, and no other toxicity by the therapy. All patients were discharged from the hospital within 15 days after surgery. We conclude that PDT using 4 - 7 mg/kg of HPD and 630 nm light with a dose of up to 300 J/cm2 can be used as an adjuvant therapy with no additional complications. Adjuvant PDT in the treatment of recurrent glioma is better than simple surgery.

  9. Growth hormone deficiency and cerebral palsy

    PubMed Central

    Devesa, Jesús; Casteleiro, Nerea; Rodicio, Cristina; López, Natalia; Reimunde, Pedro

    2010-01-01

    Cerebral palsy (CP) is a catastrophic acquired disease, occurring during development of the fetal or infant brain. It mainly affects the motor control centres of the developing brain, but can also affect cognitive functions, and is usually accompanied by a cohort of symptoms including lack of communication, epilepsy, and alterations in behavior. Most children with cerebral palsy exhibit a short stature, progressively declining from birth to puberty. We tested here whether this lack of normal growth might be due to an impaired or deficient growth hormone (GH) secretion. Our study sample comprised 46 CP children, of which 28 were male and 18 were female, aged between 3 and 11 years. Data obtained show that 70% of these children lack normal GH secretion. We conclude that GH replacement therapy should be implemented early for CP children, not only to allow them to achieve a normal height, but also because of the known neurotrophic effects of the hormone, perhaps allowing for the correction of some of the common disabilities experienced by CP children. PMID:20856687

  10. Cerebral aneurysms following radiotherapy for medulloblastoma

    SciTech Connect

    Benson, P.J.; Sung, J.H.

    1989-04-01

    Three patients, two males and one female aged 21, 14, and 31 years, respectively, developed cerebral saccular aneurysms several years after undergoing radiotherapy for cerebellar medulloblastoma at 2, 5, and 14 years of age, respectively. Following surgery, all three received combined cobalt-60 irradiation and intrathecal colloidal radioactive gold (/sup 198/Au) therapy, and died from rupture of the aneurysm 19, 9, and 17 years after the radiotherapy, respectively. Autopsy examination revealed no recurrence of the medulloblastoma, but widespread radiation-induced vasculopathy was found at the base of the brain and in the spinal cord, and saccular aneurysms arose from the posterior cerebral arteries at the basal cistern or choroidal fissure. The aneurysms differed from the ordinary saccular aneurysms of congenital type in their location and histological features. Their locations corresponded to the areas where intrathecally administered colloidal /sup 198/Au is likely to pool, and they originated directly from a segment of the artery rather than from a branching site as in congenital saccular aneurysms. It is, therefore, concluded that the aneurysms in these three patients were most likely radiation-induced.

  11. Birthweight specific trends in cerebral palsy.

    PubMed Central

    Pharoah, P O; Cooke, T; Cooke, R W; Rosenbloom, L

    1990-01-01

    A register of infants with cerebral palsy born to mothers resident in the Mersey region from 1967-84 has been maintained using various sources of information. A total of 1056 patients are registered of whom 331 (31%) have hemiplegia or mixed hemiplegia, 236 (22%) have diplegias or mixed diplegia, and 369 (35%) have quadriplegia or mixed quadriplegia. The remainder have dyskinetic or dystonic forms except for seven, who are unclassified. There has been no significant change in the prevalence of cerebral palsy among infants of normal birth weight (greater than 2500 g). Among low birthweight infants (less than or equal to 2500 g) there has been a significant increase in prevalence of all the main clinical types. This increase started later among the very low birthweight infants (less than or equal to 1500 g) than among those weighing 1501-2500 g. These changes in prevalence could be the result of either improved survival of prenatally impaired infants because of improvements in medical care, or a reflection of failure to maintain optimal conditions at or around the time of birth. PMID:2378516

  12. [Stereotactically targeted radiotherapy of cerebral arteriovenous malformations].

    PubMed

    Kimmig, B; Engenhart, R; Wowra, B; Höver, K H; Marin-Grez, M; Sturm, V

    1989-09-01

    A report is given about radiotherapy in 41 patients suffering from cerebral vessel anomalies. A modified linear accelerator was used in a moving field technique with multiple pendulum planes to apply single doses between 8 and 28 Gy by means of stereotaxis into the angiographically determined target volume. The medium follow-up is 23 months. The latency of radiogenic effects is between one and two years. Radiological controls with an interval of more than 18 months after therapy are available in 17 out of 41 patients. Angiographic investigation showed complete obliterations of pathological vessels in six out of these patients and partial obliterations in six patients; five patients remained unchanged. There were no acute complications. Seven patients presented neurological deficiencies with a latency of 6 to 12 months, however, in all cases but one they regressed completely. Even taking into consideration the small number of patients and the short time of observation, a comparison with the results of other radiotherapeutical proceedings allows to draw the conclusion that the presented technique of stereotaxic convergent-beam irradiation represents a relatively simple, reliable and, in case of precise indication, efficient method for the therapy of cerebral arteriovenous malformations. PMID:2678547

  13. The evolution and genetics of cerebral asymmetry

    PubMed Central

    Corballis, Michael C.

    2008-01-01

    Handedness and cerebral asymmetry are commonly assumed to be uniquely human, and even defining characteristics of our species. This is increasingly refuted by the evidence of behavioural asymmetries in non-human species. Although complex manual skill and language are indeed unique to our species and are represented asymmetrically in the brain, some non-human asymmetries appear to be precursors, and others are shared between humans and non-humans. In all behavioural and cerebral asymmetries so far investigated, a minority of individuals reverse or negate the dominant asymmetry, suggesting that such asymmetries are best understood in the context of the overriding bilateral symmetry of the brain and body, and a trade-off between the relative advantages and disadvantages of symmetry and asymmetry. Genetic models of handedness, for example, typically postulate a gene with two alleles, one disposing towards right-handedness and the other imposing no directional influence. There is as yet no convincing evidence as to the location of this putative gene, suggesting that several genes may be involved, or that the gene may be monomorphic with variations due to environmental or epigenetic influences. Nevertheless, it is suggested that, in behavioural, neurological and evolutionary terms, it may be more profitable to examine the degree rather than the direction of asymmetry. PMID:19064358

  14. Evaluation of the child with cerebral palsy.

    PubMed

    Russman, Barry S; Ashwal, Stephen

    2004-03-01

    Cerebral palsy (CP) is a common problem, occurring in about 2 to 2.5 per 1000 live births. The diagnosis of CP is based upon a history of abnormal motor development that is not progressive coupled with an examination (e.g. hypertonicity, increased reflexes, clonus) "placing" the lesion in the brain. In order to establish that a brain abnormality exists in children with CP that may, in turn, suggest an etiology and prognosis, neuroimaging is recommended with magnetic resonance imaging preferred to computed tomography. Metabolic and genetic studies should be obtained if there are atypical features in the history or on the examination. Detection of a brain malformation in a child with CP might suggest an underlying genetic or metabolic etiology. As cerebral infarction is high in children with hemiplegic CP, diagnostic testing for coagulation disorders should be considered. However, there is insufficient evidence at present to be precise as to what studies should be ordered. An electroencephalogram is not recommended unless there are features suggestive of epilepsy or a specific epileptic syndrome. As children with CP may have associated deficits of mental retardation, ophthalmologic and hearing impairments, speech and language disorders and oral-motor dysfunction, screening for these conditions should be part of the initial assessment. PMID:15132253

  15. [Cerebral manifestations of thromboangiitis obliterans. Case report].

    PubMed

    Aszalos, Csongor; Dongó, Eleni; Farkas, Zsuzsanna; Kollár, Attila; Magyar, Péter; Várallyay, György; Bereczki, Dániel; Vastagh, Ildikó

    2016-07-01

    Thromboangiits obliterans (Buerger's disease) is a non-atherosclerotic, segmental inflammatory and obliterative disease affecting small and medium sized arteries and veins. The etiology is still unknown, but it is in close relationship with tobacco use. Symptoms begin under the age of 45 years and the undulating course is typical. Patients usually present with acute and chronic ischemic or infectious acral lesions. Diagnosis is usually based on clinical and angiographic criteria and it is important to exclude autoimmune disease, thrombophilia, diabetes, and proximal embolic sources. Even though Buerger's disease most commonly involves the arteries of the extremities, the pathologic findings sometimes affect the cerebral, coronary and internal thoracic, renal and mesenteric arteries as well. The authors present the history of a patient with known Buerger's disease and acute ischemic stroke. Brain imaging detected acute and chronic ischemic lesions caused by middle cerebral non-atherosclerotic arteriopathy on the symptomatic side. Other etiology was excluded by detailed investigations. Orv. Hetil., 2016, 157(30), 1207-1211. PMID:27452071

  16. Clipping techniques in cerebral aneurysm surgery.

    PubMed

    Acciarri, Nicola; Toniato, Giovanni; Raabe, Andreas; Lanzino, Giuseppe

    2016-03-01

    The history of cerebral aneurysm surgery owes a great tribute to the tenacity of pioneering neurosurgeons who designed and developed the clips used to close the aneurysms neck. However, until the beginning of the past century, surgery of complex and challenging aneurysms was impossible due to the lack of surgical microscope and commercially available sophisticated clips. The modern era of the spring clips began in the second half of last century. Until then, only malleable metal clips and other non-metallic materials were available for intracranial aneurysms. Indeed, the earliest clips were hazardous and difficult to handle. Several neurosurgeons put their effort in developing new clip models, based on their personal experience in the treatment of cerebral aneurysms. Finally, the introduction of the surgical microscope, together with the availability of more sophisticated clips, has allowed the treatment of complex and challenging aneurysms. However, today none of the new instruments or tools for surgical therapy of aneurysms could be used safely and effectively without keeping in mind the lessons on innovative surgical techniques provided by great neurovascular surgeons. Thanks to their legacy, we can now treat many types of aneurysms that had always been considered inoperable. In this article, we review the basic principles of surgical clipping and illustrate some more advanced techniques to be used for complex aneurysms. PMID:26657306

  17. Unusual Presentation of Cerebral Cavernous Malformation.

    PubMed

    Kim, Won-Hyung; Lim, Dong-Jun; Choi, Jong-Il; Ha, Sung-Kon; Kim, Sang-Dae; Kim, Se-Hoon

    2015-09-01

    Cerebral cavernous malformations (CMs) are vascular malformations of the central nervous system, which can be detected in the absence of any clinical symptoms. Nodules and cysts with mixed signal intensity and a peripheral hemosiderin rim are considered brain magnetic resonance imaging (MRI) findings typical of CMs. A 48-year-old man was admitted to our hospital because of abnormal MRI findings without significant neurological symptoms. A cyst with an internal fluid-fluid level was found in the left basal ganglia on the initial brain MRI. We decided to observe the natural course of the asymptomatic lesion with serial MRI follow-up. On MRI at the 5-month follow-up, the cystic mass was enlarged and showed findings consistent with those of cystic CM. Surgical resection was performed and the pathological diagnosis was CM. Our experience suggests that the initial presentation of a CM can be a pure cyst and neurosurgeons should consider the likelihood of CMs in cases of cystic cerebral lesions with intracystic hemorrhage. PMID:26523262

  18. Unusual Presentation of Cerebral Cavernous Malformation

    PubMed Central

    Kim, Won-Hyung; Choi, Jong-Il; Ha, Sung-Kon; Kim, Sang-Dae; Kim, Se-Hoon

    2015-01-01

    Cerebral cavernous malformations (CMs) are vascular malformations of the central nervous system, which can be detected in the absence of any clinical symptoms. Nodules and cysts with mixed signal intensity and a peripheral hemosiderin rim are considered brain magnetic resonance imaging (MRI) findings typical of CMs. A 48-year-old man was admitted to our hospital because of abnormal MRI findings without significant neurological symptoms. A cyst with an internal fluid-fluid level was found in the left basal ganglia on the initial brain MRI. We decided to observe the natural course of the asymptomatic lesion with serial MRI follow-up. On MRI at the 5-month follow-up, the cystic mass was enlarged and showed findings consistent with those of cystic CM. Surgical resection was performed and the pathological diagnosis was CM. Our experience suggests that the initial presentation of a CM can be a pure cyst and neurosurgeons should consider the likelihood of CMs in cases of cystic cerebral lesions with intracystic hemorrhage. PMID:26523262

  19. Pediatric granulomatous cerebral amebiasis: a delayed diagnosis.

    PubMed

    Galarza, Marcelo; Cuccia, Vicente; Sosa, Fidel P; Monges, Jorge A

    2002-02-01

    We present four cases of cerebral amebae infection treated at our neurosurgical department. Patient 1 was a 12-year-old male with skin lesions of 2 years' progression involving the midface. He received a corticosteroid course, and, after that, he presented a right body hemiparesis. Patient 2 was a 5-year-old male, with a past surgical history of fibula fracture and osteomyelitis of 1-year evolution, associated with lesions of the surrounding skin that presented with partial seizures. Patient 3 was a 3-year-old female who presented with a stroke-like episode and with partial seizures. Patient 4 was a 6-year-old male who had ulcerative lesions in the face of 1-year evolution. After a corticosteroid course, he presented with right-body hemiparesis. All patients were human immunodeficiency virus-negative and died 1 month or less after surgery because of progressive evolution of the disease. Histopathology revealed granulomatous amebic encephalitis. All patients revealed infection from Balamuthia mandrillaris (Leptomyxiidae). Treatment consisting of pentamidine, clarithromycin, fluconazole, and 5-fluorocytosine was ineffective. Although extremely uncommon, granulomatous amebic encephalitis should be considered in the differential diagnosis of cerebral lesions while nonspecific, associated granulomatous skin lesions support the diagnosis of amebiasis. PMID:11897483

  20. Cerebral blood volume changes during brain activation

    PubMed Central

    Krieger, Steffen Norbert; Streicher, Markus Nikolar; Trampel, Robert; Turner, Robert

    2012-01-01

    Cerebral blood volume (CBV) changes significantly with brain activation, whether measured using positron emission tomography, functional magnetic resonance imaging (fMRI), or optical microscopy. If cerebral vessels are considered to be impermeable, the contents of the skull incompressible, and the skull itself inextensible, task- and hypercapnia-related changes of CBV could produce intolerable changes of intracranial pressure. Because it is becoming clear that CBV may be useful as a well-localized marker of neural activity changes, a resolution of this apparent paradox is needed. We have explored the idea that much of the change in CBV is facilitated by exchange of water between capillaries and surrounding tissue. To this end, we developed a novel hemodynamic boundary-value model and found approximate solutions using a numerical algorithm. We also constructed a macroscopic experimental model of a single capillary to provide biophysical insight. Both experiment and theory model capillary membranes as elastic and permeable. For a realistic change of input pressure, a relative pipe volume change of 21±5% was observed when using the experimental setup, compared with the value of approximately 17±1% when this quantity was calculated from the mathematical model. Volume, axial flow, and pressure changes are in the expected range. PMID:22569192

  1. Cerebral oxygenation and cerebral oxygen extraction in the preterm infant: the impact of respiratory distress syndrome.

    PubMed

    Lemmers, Petra M A; Toet, Mona; van Schelven, Leonard J; van Bel, Frank

    2006-08-01

    Haemodynamic factors play an important role in the etiology of cerebral lesions in preterm infants. Respiratory distress syndrome (RDS), a common problem in preterms, is strongly related with low and fluctuating arterial blood pressure. This study investigated the relation between mean arterial blood pressure (MABP), fractional cerebral oxygen saturation (ScO2) and fractional (cerebral) tissue oxygen extraction (FTOE), a measure of oxygen utilisation of the brain, during the first 72 h of life. Thirty-eight infants (gestational age < 32 week) were included, 18 with and 20 without RDS. Arterial oxygen saturation (SaO2), MABP and near infrared spectroscopy-determined ScO2 were continuously measured. FTOE was calculated as a ratio: (SaO2-ScO2)/SaO2. Gestational age and birth weight did not differ between groups, but assisted ventilation and use of inotropic drugs were more common in RDS infants (P<0.01). MABP was lower in RDS patients (P<0.05 from 12 up to 36 h after birth), but increased in both groups over time. ScO2 and FTOE were not different between groups over time, but in RDS infants ScO2 and FTOE had substantial larger variance (P<0.05 at all time points except at 36-48 h for ScO2 and P<0.05 at 12-18, 18-24, 36-48 and 48-60 h for FTOE). During the first 72 h of life, RDS infants showed more periods of positive correlation between MABP and ScO2 (P<0.05 at 18-24, 24-36 36-48 48-60 h) and negative correlation between MABP and FTOE (P<0.05 at 18-24, 36-48 h). Although we found that the patterns of cerebral oxygenation and extraction in RDS infants were not different as compared to infants without RDS, we suggest that the frequent periods with possible lack of cerebral autoregulation in RDS infants may make these infants more vulnerable to cerebral damage. PMID:16506004

  2. Perioperative management of patients with lung carcinoma and cerebral metastases

    PubMed Central

    Gheorghita, Eva; Pruna, Viorel Mihai; Neagoe, Luminita; Bucur, Cristina; Cristescu, Catioara; Gorgan, Mircea Radu

    2010-01-01

    ABSTRACT Objective: The present study proposes to present the importance of perioperative therapeutic management in survival prolongation and the quality of life for patients that have undergone surgery for cerebral metastases secondary to pulmonary tumors. Method: During 2001-2009, 40 patients with ages between 43-74 years have been diagnosed in our clinic with pulmonary tumor and cerebral metastases. The patients presented single cerebral lesion (excepting one patient with 2 cerebral metastases) and pulmonary tumor. Intracranial pressure (ICP) was high in all cases. All patients have undergone operation with general anesthesia. Results:For all patients the reduction of ICP and keeping an optimal CPP (cerebral perfusion pressure) was pursued. In 38 cases, general anesthesia was performed with Sevoflurane and opioids (fentanyl, remifentanyl, sufentanyl) and in 2 cases the TIVA (total intravenous anesthesia) technique was used with propofol and remifentanyl. 14 of the patients required intraoperative depletive treatment through administering mannitol 20%. 37 patients (92%) have been discharged with improved neurological condition without showing signs of intracranial hypertension, convulsive seizures and with partially or totally remitted hemiparesis and one patient had worse postoperative neurological status. Conclusion:Pulmonary tumor with cerebral metastases represent an important cause for death rate. To solve secondary cerebral lesions, the perioperative management must include assesment and choosing an anesthesia technique with a proper intraoperative management. PMID:21977115

  3. Acute Chagas Disease Induces Cerebral Microvasculopathy in Mice

    PubMed Central

    Nisimura, Lindice Mitie; Estato, Vanessa; de Souza, Elen Mello; Reis, Patricia A.; Lessa, Marcos Adriano; Castro-Faria-Neto, Hugo Caire; Pereira, Mirian Claudia de Souza; Tibiriçá, Eduardo; Garzoni, Luciana Ribeiro

    2014-01-01

    Cardiomyopathy is the main clinical form of Chagas disease (CD); however, cerebral manifestations, such as meningoencephalitis, ischemic stroke and cognitive impairment, can also occur. The aim of the present study was to investigate functional microvascular alterations and oxidative stress in the brain of mice in acute CD. Acute CD was induced in Swiss Webster mice (SWM) with the Y strain of Trypanosoma cruzi (T. cruzi). Cerebral functional capillary density (the number of spontaneously perfused capillaries), leukocyte rolling and adhesion and the microvascular endothelial-dependent response were analyzed over a period of fifteen days using intravital video-microscopy. We also evaluated cerebral oxidative stress with the thiobarbituric acid reactive species TBARS method. Compared with the non-infected group, acute CD significantly induced cerebral functional microvascular alterations, including (i) functional capillary rarefaction, (ii) increased leukocyte rolling and adhesion, (iii) the formation of microvascular platelet-leukocyte aggregates, and (iv) alteration of the endothelial response to acetylcholine. Moreover, cerebral oxidative stress increased in infected animals. We concluded that acute CD in mice induced cerebral microvasculopathy, characterized by a reduced incidence of perfused capillaries, a high number of microvascular platelet-leukocyte aggregates, a marked increase in leukocyte-endothelium interactions and brain arteriolar endothelial dysfunction associated with oxidative stress. These results suggest the involvement of cerebral microcirculation alterations in the neurological manifestations of CD. PMID:25010691

  4. An Evidence-Based Review of Related Metabolites and Metabolic Network Research on Cerebral Ischemia

    PubMed Central

    Liu, Mengting; Tang, Liying; Liu, Xin; Fang, Jing; Zhan, Hao; Wu, Hongwei; Yang, Hongjun

    2016-01-01

    In recent years, metabolomics analyses have been widely applied to cerebral ischemia research. This paper introduces the latest proceedings of metabolomics research on cerebral ischemia. The main techniques, models, animals, and biomarkers of cerebral ischemia will be discussed. With analysis help from the MBRole website and the KEGG database, the altered metabolites in rat cerebral ischemia were used for metabolic pathway enrichment analyses. Our results identify the main metabolic pathways that are related to cerebral ischemia and further construct a metabolic network. These results will provide useful information for elucidating the pathogenesis of cerebral ischemia, as well as the discovery of cerebral ischemia biomarkers. PMID:27274780

  5. Cerebral aneurysms: relations between geometry, hemodynamics and aneurysm location in the cerebral vasculature

    NASA Astrophysics Data System (ADS)

    Passerini, Tiziano; Veneziani, Alessandro; Sangalli, Laura; Secchi, Piercesare; Vantini, Simone

    2010-11-01

    In cerebral blood circulation, the interplay of arterial geometrical features and flow dynamics is thought to play a significant role in the development of aneurysms. In the framework of the Aneurisk project, patient-specific morphology reconstructions were conducted with the open-source software VMTK (www.vmtk.org) on a set of computational angiography images provided by Ospedale Niguarda (Milano, Italy). Computational fluid dynamics (CFD) simulations were performed with a software based on the library LifeV (www.lifev.org). The joint statistical analysis of geometries and simulations highlights the possible association of certain spatial patterns of radius, curvature and shear load along the Internal Carotid Artery (ICA) with the presence, position and previous event of rupture of an aneurysm in the entire cerebral vasculature. Moreover, some possible landmarks are identified to be monitored for the assessment of a Potential Rupture Risk Index.

  6. Regional cerebral blood flow during comprehension and speech (in cerebrally healthy subjects)

    SciTech Connect

    Lechevalier, B.; Petit, M.C.; Eustache, F.; Lambert, J.; Chapon, F.; Viader, F. )

    1989-07-01

    Regional cerebral blood flow (rCBF) was measured by the xenon-133 inhalation method in 10 cerebrally healthy subjects at rest and during linguistic activation tests. These consisted of a comprehension test (binaural listening to a narrative text) and a speech test (making sentences from a list of words presented orally at 30-s intervals). The comprehension task induced a moderate increase in the mean right CBF and in both inferior parietal areas, whereas the speech test resulted in a diffuse increase in the mean CBF of both hemispheres, predominating regionally in both inferior parietal, left operculary, and right upper motor and premotor areas. It is proposed that the activation pattern induced by linguistic stimulation depends on not only specific factors, such as syntactic and semantic aspects of language, but also the contents of the material proposed and the attention required by the test situation.

  7. Immunocompetent young man with cerebral abscess and cortical venous infarction mimicking cerebritis caused by Gemella morbillorum.

    PubMed

    Milnik, Annette; Gazis, Angelos; Tammer, Ina; Bartels, Claudius

    2013-01-01

    Gemella morbillorum is an anaerobic gram-positive diplococcus and in most cases a harmless commensal, which occasionally causes infections in the central nervous system. We report on an immunocompetent young man with focal neurological symptoms and cephalgia caused by a cerebral abscess. Although successful treatment was done with neurosurgical intervention and antibiotic therapy, he suffered from a venous infarction 5 weeks after first diagnosis, which mimicked cerebritis as an early stage of relapsing abscess. Imaging and investigation of cerebrospinal fluid was necessary for sufficient differential diagnosis and antibiotic therapy could be stopped after altogether 8 weeks of treatment. In summary, G morbillorum causes not only biphasic infections, but also can be accompanied by infarction in the central nervous system despite sufficient antibiotic therapy. PMID:23355562

  8. Regulation of the cerebral circulation: bedside assessment and clinical implications.

    PubMed

    Donnelly, Joseph; Budohoski, Karol P; Smielewski, Peter; Czosnyka, Marek

    2016-01-01

    Regulation of the cerebral circulation relies on the complex interplay between cardiovascular, respiratory, and neural physiology. In health, these physiologic systems act to maintain an adequate cerebral blood flow (CBF) through modulation of hydrodynamic parameters; the resistance of cerebral vessels, and the arterial, intracranial, and venous pressures. In critical illness, however, one or more of these parameters can be compromised, raising the possibility of disturbed CBF regulation and its pathophysiologic sequelae. Rigorous assessment of the cerebral circulation requires not only measuring CBF and its hydrodynamic determinants but also assessing the stability of CBF in response to changes in arterial pressure (cerebral autoregulation), the reactivity of CBF to a vasodilator (carbon dioxide reactivity, for example), and the dynamic regulation of arterial pressure (baroreceptor sensitivity). Ideally, cerebral circulation monitors in critical care should be continuous, physically robust, allow for both regional and global CBF assessment, and be conducive to application at the bedside. Regulation of the cerebral circulation is impaired not only in primary neurologic conditions that affect the vasculature such as subarachnoid haemorrhage and stroke, but also in conditions that affect the regulation of intracranial pressure (such as traumatic brain injury and hydrocephalus) or arterial blood pressure (sepsis or cardiac dysfunction). Importantly, this impairment is often associated with poor patient outcome. At present, assessment of the cerebral circulation is primarily used as a research tool to elucidate pathophysiology or prognosis. However, when combined with other physiologic signals and online analytical techniques, cerebral circulation monitoring has the appealing potential to not only prognosticate patients, but also direct critical care management. PMID:27145751

  9. Modelling the effects of cerebral microvasculature morphology on oxygen transport

    PubMed Central

    Park, Chang Sub; Payne, Stephen J.

    2016-01-01

    The cerebral microvasculature plays a vital role in adequately supplying blood to the brain. Determining the health of the cerebral microvasculature is important during pathological conditions, such as stroke and dementia. Recent studies have shown the complex relationship between cerebral metabolic rate and transit time distribution, the transit times of all the possible pathways available dependent on network topology. In this paper, we extend a recently developed technique to solve for residue function, the amount of tracer left in the vasculature at any time, and transit time distribution in an existing model of the cerebral microvasculature to calculate cerebral metabolism. We present the mathematical theory needed to solve for oxygen concentration followed by results of the simulations. It is found that oxygen extraction fraction, the fraction of oxygen removed from the blood in the capillary network by the tissue, and cerebral metabolic rate are dependent on both mean and heterogeneity of the transit time distribution. For changes in cerebral blood flow, a positive correlation can be observed between mean transit time and oxygen extraction fraction, and a negative correlation between mean transit time and metabolic rate of oxygen. A negative correlation can also be observed between transit time heterogeneity and the metabolic rate of oxygen for a constant cerebral blood flow. A sensitivity analysis on the mean and heterogeneity of the transit time distribution was able to quantify their respective contributions to oxygen extraction fraction and metabolic rate of oxygen. Mean transit time has a greater contribution than the heterogeneity for oxygen extraction fraction. This is found to be opposite for metabolic rate of oxygen. These results provide information on the role of the cerebral microvasculature and its effects on flow and metabolism. They thus open up the possibility of obtaining additional valuable clinical information for diagnosing and treating

  10. Impaired fasting glucose is associated with increased regional cerebral amyloid.

    PubMed

    Morris, Jill K; Vidoni, Eric D; Wilkins, Heather M; Archer, Ashley E; Burns, Nicole C; Karcher, Rainer T; Graves, Rasinio S; Swerdlow, Russell H; Thyfault, John P; Burns, Jeffrey M

    2016-08-01

    The Alzheimer's disease risk gene apolipoprotein E epsilon 4 (APOE ε4) is associated with increased cerebral amyloid. Although impaired glucose metabolism is linked to Alzheimer's disease risk, the relationship between impaired glycemia and cerebral amyloid is unclear. To investigate the independent effects of APOE ε4 and impaired glycemia on cerebral amyloid, we stratified nondemented subjects (n = 73) into 4 groups: normal glucose, APOE ε4 noncarrier (control [CNT]; n = 31), normal glucose, APOE ε4 carrier (E4 only; n = 14) impaired glycemia, APOE ε4 noncarrier (IG only; n = 18), and impaired glycemia, APOE ε4 carrier (IG+E4; n = 10). Cerebral amyloid differed both globally (p = 0.023) and regionally; precuneus (p = 0.007), posterior cingulate (PCC; p = 0.020), superior parietal cortex (SPC; p = 0.029), anterior cingulate (p = 0.027), and frontal cortex (p = 0.018). Post hoc analyses revealed that E4 only subjects had increased cerebral amyloid versus CNT globally and regionally in the precuneus, PCC, SPC, anterior cingulate, and frontal cortex. In IG only subjects, increased cerebral amyloid compared with CNT was restricted to precuneus, PCC, and SPC. IG+E4 subjects exhibited higher cerebral amyloid only in the precuneus relative to CNT. These results indicate that impaired glycemia and APOE ε4 genotype are independent risk factors for regional cerebral amyloid deposition. However, APOE ε4 and impaired glycemia did not have an additive effect on cerebral amyloid. PMID:27318141

  11. Early CT findings of acute cerebral infarction in the middle cerebral artery territory.

    PubMed

    Ying, K S; Pang, K K; Huang, J K; Lin, J C

    1992-04-01

    For an early and definitive diagnosis of acute cerebral infarction by computed tomography (CT), we retrospectively analyzed the initial CT findings of 14 patients with proven acute middle cerebral artery (MCA) infarction within 4 hours after stroke onset. The following results were obtained: (a) abnormal CT findings could be recognized quite early in 13 patients (92.9%), (b) the most common and earliest finding was loss of defination of the gray-white interface at the lateral margins of the insula. This sign was recognized in 12 patients (85.7%) and could be detected as early as 1 hour after stroke onset, (c) the next common finding was narrowing or blurring of the Sylvian fissure in 10 patients (71.4%) and could be detected 1.5 hours after stroke onset, (d) an obscured outline or partial disappearance of the lentiform nucleus was recognized in 7 patients (50%) and could be detected 1.5 hours after stroke onset, (e) effacement of the cerebral sulci was found in 6 patients (42.9%) and could be detected 2.5 hours after stroke onset, (f) increased density in MCA or its major branches was not seen in our patients. PMID:1318145

  12. Gene expression profiling in the human middle cerebral artery after cerebral ischemia.

    PubMed

    Vikman, P; Edvinsson, L

    2006-12-01

    We have investigated the gene expression in human middle cerebral artery (MCA) after ischemia. Ischemic stroke affects the perfusion in the affected area and experimental cerebral ischemia results in upregulation of vasopressor receptors in the MCA leading to the ischemic area. We obtained human MCA samples distributing to the ischemic area, 7-10 days post-stroke. The gene expression was examined with real-time polymerase chain reaction (PCR) and microarray, proteins were studied with immunohistochemistry. We investigated genes previously shown to be upregulated in animal models of cerebral ischemia (e.g. ET(A), ET(B), AT1, AT2, and 5-HT(2A/1B/1D)). Their mRNA expression was increased compared with controls, consistent with findings in experimental stroke. Immunohistochemistry showed upregulation of the receptors localized on the smooth muscle cells. The gene expression was profiled with microarray and seven genes chosen for further investigation with real-time PCR; ELK3, LY64, Metallothionin IG, POU3F4, Actin alpha2, RhoA and smoothelin. Six of these were regulated the same way when confirming array expression with real-time PCR. Gene expression studies in the human MCA leading to the ischemic region is similar to that seen after MCA occlusion in rats. We found new genes that support the dynamic changes that occur in the MCA distributing to the ischemic region. PMID:17116215

  13. Autoregulation of cerebral blood circulation under orthostatic tests

    NASA Technical Reports Server (NTRS)

    Gayevyy, M. D.; Maltsev, V. G.; Pogorelyy, V. E.

    1980-01-01

    Autoregulation of cerebral blood flow (ACBF) under orthostatic tests (OT) was estimated in acute experiments on rabbits and cats under local anesthesia according to changes of perfusion pressure (PP) in carotid arteries, cerebral blood flow, pressure in the venous system of the brain, and resistance of cerebral vessels. The OT were conducted by turning a special table with the animal fastened to it from a horizontal to a vertical (head up or head down) position at 40 to 80 deg. In most experiments ACBF correlated with the changes of PP. Different variations of ACBF and its possible mechanisms are discussed.

  14. Rho kinase as a target for cerebral vascular disorders

    PubMed Central

    Bond, Lisa M; Sellers, James R; McKerracher, Lisa

    2015-01-01

    The development of novel pharmaceutical treatments for disorders of the cerebral vasculature is a serious unmet medical need. These vascular disorders are typified by a disruption in the delicate Rho signaling equilibrium within the blood vessel wall. In particular, Rho kinase overactivation in the smooth muscle and endothelial layers of the vessel wall results in cytoskeletal modifications that lead to reduced vascular integrity and abnormal vascular growth. Rho kinase is thus a promising target for the treatment of cerebral vascular disorders. Indeed, preclinical studies indicate that Rho kinase inhibition may reduce the formation/growth/rupture of both intracranial aneurysms and cerebral cavernous malformations. PMID:26062400

  15. Cerebral blood flow and autoregulation during hypothermic cardiopulmonary bypass

    SciTech Connect

    Johnsson, P.; Messeter, K.; Ryding, E.; Nordstroem, L.S.; Stahl, E.

    1987-04-01

    Mean hemispheric cerebral blood flow (CBF) was studied following intravenous or intraarterial administration of xenon-133, in 10 men admitted for coronary artery bypass grafting. Repeated CBF measurements were performed to evaluate autoregulation before, during, and after cardiopulmonary bypass (CPB). During CPB mean CBF remained unchanged compared with the pre-CPB level, without evidence of cerebral hyperemia or impairment of autoregulation. A marked increase in CBF occurred after CPB and was followed by a time-dependent reduction toward the pre-CPB level. The data support the alpha-stat regulation theory but cannot explain the cerebral vasodilation observed after CPB.

  16. Nocardia cerebral abscess: New concepts in diagnosis, management, and prognosis.

    PubMed Central

    Byrne, E; Brophy, B P; Perrett, L V

    1979-01-01

    Three cases of multiple cerebral nocardial abscess are presented. All were cured by a combination of chemotherapy and surgery, a unique experience. Early detection, appropriate chemotherapy, absence of underlying immune malfunction, and surgically remediable disease are good prognostic indices in cerebral nocardiosis. If other adverse prognostic factors are absent, however, multiple abscess formation does not preclude the possibility of cure. Accurate localisation of nocardia cerebral abscesses by computerised axial tomography is a great help in management if multiple lesions are present. Images PMID:501368

  17. Effects of CDP-choline on neurologic deficits and cerebral glucose metabolism in a rat model of cerebral ischemia

    SciTech Connect

    Kakihana, M.; Fukuda, N.; Suno, M.; Nagaoka, A.

    1988-02-01

    The effects of cytidine 5'-diphosphocholine (CDP-choline) on neurologic deficits and cerebral glucose metabolism were studied in a rat model of transient cerebral ischemia. Cerebral ischemia was induced by occluding both common carotid arteries for 20 or 30 minutes 24 hours after the vertebral arteries were permanently occluded by electrocautery. CDP-choline was administered intraperitoneally twice daily for 4 days after reestablishing carotid blood flow. CDP-choline at two dosages (50 and 250 mg/kg) shortened the time required for recovery of spontaneous motor activity in a dose-related manner; recovery time was measured early after reperfusion. Neurologic signs were observed for 10 days. High-dose CDP-choline improved neurologic signs in the rats within 20-30 minutes of ischemia. When cerebral glucose metabolism was assessed on Day 4, increases in the levels of glucose and pyruvate were accompanied by decreases in the synthesis of labeled acetylcholine from uniformly labeled (/sup 14/C)glucose measured in the cerebral cortex of rats with 30 minutes of ischemia. High-dose CDP-choline also attenuated changes in these variables. CDP-(1,2-/sup 14/C)choline injected intravenously 10 minutes after reperfusion was used for membrane lipid biosynthesis. These results indicate that CDP-choline has beneficial effects on brain dysfunction induced by cerebral ischemia, which may be due in part to the restorative effects of CDP-choline on disturbed cerebral glucose metabolism, probably by stimulating phospholipid biosynthesis.

  18. Hyponatremia—What Is Cerebral Salt Wasting?

    PubMed Central

    Momi, Jasminder; Tang, Christopher M; Abcar, Antoine C; Kujubu, Dean A; Sim, John J

    2010-01-01

    Background: Hyponatremia is a common electrolyte imbalance in hospitalized patients. It is associated with significant morbidity and mortality, especially if the underlying cause is incorrectly diagnosed and not treated appropriately. Often, the hospitalist is faced with a clinical dilemma when a patient presents with hyponatremia of an unclear etiology and with uncertain volume status. Syndrome of inappropriate antidiuretic hormone (SIADH) is frequently diagnosed in this clinical setting, but cerebral salt wasting (CSW) is an important diagnosis to consider. Objective: We wanted to describe the diagnosis, treatment, and history of CSW to provide clinicians with a better understanding of the differential diagnosis for hyponatremia. Conclusion: CSW is a process of extracellular volume depletion due to a tubular defect in sodium transport. Two postulated mechanisms for CSW are the excess secretion of natriuretic peptides and the loss of sympathetic stimulation to the kidney. Making the distinction between CSW and SIADH is important because the treatment for the two conditions is very different. PMID:20740122

  19. Chronic Fenfluramine Administration: Some Cerebral Effects

    PubMed Central

    Lewis, S. A.; Oswald, Ian; Dunleavy, D. L. F.

    1971-01-01

    Human cerebral function was monitored electrophysiologically during sleep over a period of months before, during, and after the intake of fenfluramine, 40-120 mg/day. Effects included dose-related reduction of paradoxical sleep, increase of intra-sleep restlessness, and changes in E.E.G. slow-wave sleep. It is hypothesized that weight loss may be associated with increase of the last. Grinding of teeth (bruxism) also was noted. Long-term studies make it possible to demonstrate changing central effects with time, including tolerance phenomena. Withdrawal abnormalities are related to the time taken for the drug to be eliminated—in the present case reaching a maximum four days after withdrawal. PMID:4326288

  20. [Pasteurella multocida meningitis with cerebral abscesses].

    PubMed

    Nguefack, S; Moifo, B; Chiabi, A; Mah, E; Bogne, J-B; Fossi, M; Fru, F; Mbonda, E; Djientcheu, V-P

    2014-03-01

    Pasteurella multocida is classically responsible for local soft tissue infections secondary to dog bites or cat scratches. It can be responsible for meningitis in infants and elderly persons. We report the case history of a 5-year-old male child admitted to our pediatric unit for meningitis. Cerebrospinal fluid analysis revealed an infection with P. multocida. The suspected mode of contamination was either from the saliva of a pet dog or through an unnoticed skull fracture sustained after an accident 1 year prior to the occurrence of meningitis. In spite of the neurologic complication (cerebral abscess), the progression was favorable after drainage of the abscess, 5 weeks of parenteral treatment, and 3 weeks of oral antibiotic therapy. Meningitis due to Pasteurella sp. is rare and can lead to neurologic complications. The notion of bites or scratches can be absent and the mode of contamination is sometimes difficult to unveil. PMID:24457110

  1. Spindle Bursts in Neonatal Rat Cerebral Cortex

    PubMed Central

    Yang, Jenq-Wei; Reyes-Puerta, Vicente; Kilb, Werner; Luhmann, Heiko J.

    2016-01-01

    Spontaneous and sensory evoked spindle bursts represent a functional hallmark of the developing cerebral cortex in vitro and in vivo. They have been observed in various neocortical areas of numerous species, including newborn rodents and preterm human infants. Spindle bursts are generated in complex neocortical-subcortical circuits involving in many cases the participation of motor brain regions. Together with early gamma oscillations, spindle bursts synchronize the activity of a local neuronal network organized in a cortical column. Disturbances in spindle burst activity during corticogenesis may contribute to disorders in cortical architecture and in the activity-dependent control of programmed cell death. In this review we discuss (i) the functional properties of spindle bursts, (ii) the mechanisms underlying their generation, (iii) the synchronous patterns and cortical networks associated with spindle bursts, and (iv) the physiological and pathophysiological role of spindle bursts during early cortical development. PMID:27034844

  2. Cerebral palsy: the whys and hows.

    PubMed

    Fairhurst, Charlie

    2012-08-01

    The descriptive term of cerebral palsy encompasses the largest group of childhood movement disorders. Severity and pattern of clinical involvement varies widely dependent on the area of the central nervous system compromised. A multidisciplinary team approach is vital for all the aspects of management to improve function and minimise disability. From a medical viewpoint, there are two pronged approaches. First a focus on developmental and clinical comorbidities such as communication, behaviour, epilepsy, feeding problems, gastro-oesophageal reflux and infections; and second on specifics of muscle tone, motor control and posture. With regards to the latter, there is an increasing number of available treatments including oral antispasticity and antidystonic medications, injectable botulinum toxin, multilevel orthopaedic and neurosurgical options and a variety of complementary and alternative therapies. PMID:22868578

  3. Gender differences in regional cerebral blood flow

    SciTech Connect

    Gur, R.E.; Gur, R.C. )

    1990-01-01

    Gender differences have been noted in neurobehavioral studies. The 133xenon inhalation method for measuring regional cerebral blood flow (rCBF) can contribute to the understanding of the neural basis of gender differences in brain function. Few studies have examined gender differences in rCBF. In studies of normal subjects, women have higher rates of CBF than men, and this is related to age. Usually by the sixth decade men and women have similar flow rates. Fewer studies on rCBF in schizophrenia have examined sex differences. The pattern of higher flows for females maintains, but its correlates with gender differences in clinical as well as other parameters of brain function remain to be examined.

  4. Cerebral cavernous malformation proteins at a glance.

    PubMed

    Draheim, Kyle M; Fisher, Oriana S; Boggon, Titus J; Calderwood, David A

    2014-02-15

    Loss-of-function mutations in genes encoding KRIT1 (also known as CCM1), CCM2 (also known as OSM and malcavernin) or PDCD10 (also known as CCM3) cause cerebral cavernous malformations (CCMs). These abnormalities are characterized by dilated leaky blood vessels, especially in the neurovasculature, that result in increased risk of stroke, focal neurological defects and seizures. The three CCM proteins can exist in a trimeric complex, and each of these essential multi-domain adaptor proteins also interacts with a range of signaling, cytoskeletal and adaptor proteins, presumably accounting for their roles in a range of basic cellular processes including cell adhesion, migration, polarity and apoptosis. In this Cell Science at a Glance article and the accompanying poster, we provide an overview of current models of CCM protein function focusing on how known protein-protein interactions might contribute to cellular phenotypes and highlighting gaps in our current understanding. PMID:24481819

  5. [An epileptic syndrome in infantile cerebral palsy].

    PubMed

    Sumerkina, M L

    1997-01-01

    The results of examination of 102 patients with infantile cerebral paralysis (ICP) with epileptic syndrome (ES) at the age from 3 months to 14 years are presented. Epileptic fits predominated in patients with hemiparetic form of ICP (40.8%) and spastic diplegia (32.4%). ES manifestations were observed in ICP during the first 3 years of life (more than 80% of cases). The peculiarities of ES clinical course were revealed. There were determined the main types of seizures in patients with ICP which depended on age of their manifestation, as well as their further transformation and prognosis. Computer tomographic and EEG-correlations were established in different forms of ICP. They permitted to revealed pathogenetic mechanisms of ES development in patients with ICP and to determine therapeutic policy and prognosis of the disease. PMID:9163254

  6. Complementary and alternative therapies for cerebral palsy.

    PubMed

    Liptak, Gregory S

    2005-01-01

    The optimal practice of medicine includes integrating individual clinical expertise with the best available clinical evidence from systematic research. This article reviews nine treatment modalities used for children who have cerebral palsy (CP), including hyperbaric oxygen, the Adeli Suit, patterning, electrical stimulation, conductive education, equine-assisted therapy, craniosacral therapy, Feldenkrais therapy, and acupuncture. Unfortunately, these modalities have different degrees of published evidence to support or refute their effectiveness. Uncontrolled and controlled trials of hippotherapy have shown beneficial effects on body structures and functioning. Studies of acupuncture are promising, but more studies are required before specific recommendations can be made. Most studies of patterning have been negative and its use cannot be recommended. However, for the other interventions, such as hyperbaric oxygen, more evidence is required before recommendations can be made. The individual with CP and his or her family have a right to full disclosure of all possible treatment options and whatever knowledge currently is available regarding these therapies. PMID:15977320

  7. Reciprocal organization of the cerebral hemispheres

    PubMed Central

    McGilchrist, Iain

    2010-01-01

    The cerebral hemispheres are anatomically and neurophysiologically asymmetrical. The evolutionary basis for these differences remains uncertain. There are, however, highly consistent differences between the hemispheres, evident in reptiles, birds, and mammals, as well as in humans, in the nature of the attention each applies to the environment. This permits the simultaneous application of precisely focused, but narrow, attention, needed for grasping food or prey, with broad, open, and uncommitted attention, needed to watch out for predators and to interpret the intentions of conspecifics. These different modes of attention can account for a very wide range of repeated observations relating to hemisphere specialization, and suggest that hemisphere differences lie not in discrete functional domains as such, but distinct modes of functioning within any one domain. These modes of attention are mutually incompatible, and their application depends on inhibitory transmission in the corpus callosum. There is also an asymmetry of interaction between the hemispheres at the phenomenological level. PMID:21319495

  8. Laser Speckle Imaging of Cerebral Blood Flow

    NASA Astrophysics Data System (ADS)

    Luo, Qingming; Jiang, Chao; Li, Pengcheng; Cheng, Haiying; Wang, Zhen; Wang, Zheng; Tuchin, Valery V.

    Monitoring the spatio-temporal characteristics of cerebral blood flow (CBF) is crucial for studying the normal and pathophysiologic conditions of brain metabolism. By illuminating the cortex with laser light and imaging the resulting speckle pattern, relative CBF images with tens of microns spatial and millisecond temporal resolution can be obtained. In this chapter, a laser speckle imaging (LSI) method for monitoring dynamic, high-resolution CBF is introduced. To improve the spatial resolution of current LSI, a modified LSI method is proposed. To accelerate the speed of data processing, three LSI data processing frameworks based on graphics processing unit (GPU), digital signal processor (DSP), and field-programmable gate array (FPGA) are also presented. Applications for detecting the changes in local CBF induced by sensory stimulation and thermal stimulation, the influence of a chemical agent on CBF, and the influence of acute hyperglycemia following cortical spreading depression on CBF are given.

  9. Spindle Bursts in Neonatal Rat Cerebral Cortex.

    PubMed

    Yang, Jenq-Wei; Reyes-Puerta, Vicente; Kilb, Werner; Luhmann, Heiko J

    2016-01-01

    Spontaneous and sensory evoked spindle bursts represent a functional hallmark of the developing cerebral cortex in vitro and in vivo. They have been observed in various neocortical areas of numerous species, including newborn rodents and preterm human infants. Spindle bursts are generated in complex neocortical-subcortical circuits involving in many cases the participation of motor brain regions. Together with early gamma oscillations, spindle bursts synchronize the activity of a local neuronal network organized in a cortical column. Disturbances in spindle burst activity during corticogenesis may contribute to disorders in cortical architecture and in the activity-dependent control of programmed cell death. In this review we discuss (i) the functional properties of spindle bursts, (ii) the mechanisms underlying their generation, (iii) the synchronous patterns and cortical networks associated with spindle bursts, and (iv) the physiological and pathophysiological role of spindle bursts during early cortical development. PMID:27034844

  10. Early GABAergic circuitry in the cerebral cortex.

    PubMed

    Luhmann, Heiko J; Kirischuk, Sergei; Sinning, Anne; Kilb, Werner

    2014-06-01

    In the cerebral cortex GABAergic signaling plays an important role in regulating early developmental processes, for example, neurogenesis, migration and differentiation. Transient cell populations, namely Cajal-Retzius in the marginal zone and thalamic input receiving subplate neurons, are integrated as active elements in transitory GABAergic circuits. Although immature pyramidal neurons receive GABAergic synaptic inputs already at fetal stages, they are integrated into functional GABAergic circuits only several days later. In consequence, GABAergic synaptic transmission has only a minor influence on spontaneous network activity during early corticogenesis. Concurrent with the gradual developmental shift of GABA action from excitatory to inhibitory and the maturation of cortical synaptic connections, GABA becomes more important in synchronizing neuronal network activity. PMID:24434608

  11. Infrared laser hemotherapy in cerebral ischemia modeling

    NASA Astrophysics Data System (ADS)

    Musienko, Julia I.; Nechipurenko, Natalia I.

    2003-10-01

    Use of intravenous laser irradiation of blood (ILIB) is considered to be the most effective method of laser therapy and its application is expedient pathogenetically in the ischemic disturbances. The aim of this study is to investigate ILIB influence with infrared laser (IL) with 860 nm wavelength on hemostasis, acid-base status (ABS) of blood in normal rabbits and after modeling of local ischemia of brain (LIB). Experimental cerebral ischemia is characterized by development of hypercoagulation syndrom and metabolic acidosis. ILIB with infrared radiation of 2.0 mW power provokes hypocoagulation in intact animals. Application of ILIB in rabbits after LIB contributes for hemostasis and acid-base status normalizing compared to operated animals. IL radiation with 8,5 mW power results in marked hemostatic activation in all animals. Therefore, beneficial effect of low power laser radiation (LPLR) manifests in narrow power diapason in experimental brain ischemia.

  12. Electrophysiological measures of acute cerebral ischaemia

    NASA Astrophysics Data System (ADS)

    Ferree, T. C.; Hwa, R. C.

    2005-09-01

    A method of EEG analysis is described which provides new insights into EEG pathology in cerebral ischaemia. The method is based on a variant of detrended fluctuation analysis (DFA), which reduces short (10 s) segments of spontaneous EEG time series to two dimensionless scaling exponents. The spatial variability of each exponent is expressed in terms of its statistical moments across EEG channels. Linear discriminant analysis combines the moments into concise indices, which distinguish normal and stroke groups remarkably well. On average over the scalp, stroke patients have larger fluctuations on the longest time scales. This is consistent with the notion of EEG slowing, but extends that notion to a wider range of time scales. The higher moments show that stroke patients have markedly reduced variability over the scalp. This contradicts the notion of a purely focal EEG scalp topography and argues instead for a highly distributed effect. In these indices, subacute patients appear further from normal than acute patients.

  13. [Neurourological signs of chronic cerebral vascular diseases].

    PubMed

    Shvarts, P G; Dutov, V V; Kadykov, A S; Shvedkov, V V; Popov, S V; Plotnikov, A N

    2013-01-01

    Disorders of urination, along with motor and cognitive disorders, are characteristic of different forms of chronic cerebral vascular diseases (CCVD). Irritation symptoms are more frequent in subcortical arteriosclerotic encephalopathy (SAE) and multi infarct hypertonic encephalopathy (MIHE). Overactive urine bladder syndrome (OUBS) caused by neurogenic detrusive hyperactivity manifests itself in frequent urination, nocturia and imperative enuresis and thus decreases quality of life and results in disability of patents with CCVD. At the same time, the character of symptoms points indirectly to the localization of lacunar infarction or the extent of severity of leukoareosis. It is the most frequent form of disorders of urination in the first years of disease that significantly aggravates its course and needs timed diagnosis and pharmacological treatment. Competitive antagonists of muscarinic receptors M2, M3 subtypes are the most effective drugs for treatment of OUBS comorbid to CCVD. PMID:23994932

  14. Lupus cerebritis after visiting a tanning salon.

    PubMed

    Geara, Abdallah S; Torbey, Estelle; El-imad, Badiaa

    2009-01-01

    A 53-year-old female was admitted to the intensive care unit for lupus cerebritis; she had a 15-year history of stable lupus. Over the prior 1 to 2 months, the patient visited a tanning salon and this triggered the exacerbation of lupus. Her initial symptoms were cutaneous in the form of an erythematous rash. Within 2 weeks she started to have headaches and was admitted for seizure and psychosis. Ultraviolet A exposure in the tanning salon is known to exacerbate lupus by modulation of the immune system at the level of the skin. It has also been found that ultraviolet light can lead to the formation of antinuclear antibodies. This case illustrates the need to emphasize the danger of the tanning salon to patients with systemic lupus erythematous; the risk is not only cutaneous, it can also be systemic. PMID:20001946

  15. Localization of cerebral activity during simple singing.

    PubMed

    Perry, D W; Zatorre, R J; Petrides, M; Alivisatos, B; Meyer, E; Evans, A C

    1999-11-01

    Cerebral blood flow (CBF) was measured with PET during rudimentary singing of a single pitch and vowel, contrasted to passive listening to complex tones. CBF increases in cortical areas related to motor control were seen in the supplementary motor area, anterior cingulate cortex, precentral gyri, anterior insula (and the adjacent inner face of the precentral operculum) and cerebellum, replicating most previously seen during speech. Increases in auditory cortex were seen within right Heschl's gyrus, and in the posterior superior temporal plane (and the immediately overlying parietal cortex). Since cortex near right Heschl's has been linked to complex pitch perception, its asymmetric activation here may be related to analyzing the fundamental frequency of one's own voice for feedback-guided modulation. PMID:10599861

  16. Localization of cerebral activity during simple singing.

    PubMed

    Perry, D W; Zatorre, R J; Petrides, M; Alivisatos, B; Meyer, E; Evans, A C

    1999-12-16

    Cerebral blood flow (CBF) was measured with PET during rudimentary singing of a single pitch and vowel, contrasted to passive listening to complex tones. CBF increases in cortical areas related to motor control were seen in the supplementary motor area, anterior cingulate cortex, precentral gyri, anterior insula (and the adjacent inner face of the precentral operculum) and cerebellum, replicating most previously seen during speech. Increases in auditory cortex were seen within right Heschl's gyrus, and in the posterior superior temporal plane (and the immediately overlying parietal cortex). Since cortex near right Heschl's has been linked to complex pitch perception, its asymmetric activation here may be related to analyzing the fundamental frequency of one's own voice for feedback-guided modulation. PMID:10716244

  17. Patterning the cerebral cortex: traveling with morphogens.

    PubMed

    Borello, Ugo; Pierani, Alessandra

    2010-08-01

    The neocortex represents the brain structure that has been subjected to a major expansion in its relative size during the course of mammalian evolution. An exquisite coordination of appropriate growth of competent territories along multiple axes and their spatial patterning is required for regionalization of the cortical primordium and the formation of functional areas. The achievement of such a highly complex architecture relies on a precise orchestration of the proliferation of progenitors, onset of neurogenesis, spatio-temporal generation of distinct cell types and control of their migration. We will review recent work on alternative molecular mechanisms that, via the migration of signaling cells/structures, participate in coordinating growth and spatial patterning in the developing cerebral cortex. By integrating temporal and spatial parameters as well as absolute levels of signaling this novel strategy might represent a general mechanism for long-range patterning in large structures, in addition to the passive diffusion of morphogens. PMID:20542680

  18. [Ataxic cerebral palsy and brain imaging].

    PubMed

    Imamura, S; Tachi, N; Tsuzuki, A; Sasaki, K; Hirano, S; Tanabe, C; Sakuma, K

    1992-09-01

    Five cases diagnosed as having ataxic cerebral palsy were presented with their brain imaging. Case 1, a 3-year-old-girl had been floppy since 7 months of age and began ataxic walk with spastic legs from 18 months of age. MRI revealed generalized atrophy of cerebellum (especially in anterior superior part) and slight atrophy of pons. Her mother also had ataxia with spastic legs of early onset. She and her mother were thought to have an early-onset inherited non-progressive cerebellar ataxia syndrome. Case 2, a 8-year-old-girl had ataxic walk since 17 months of age. MRI revealed cerebellar atrophy especially in anterior superior part. Case 3, a 10-year-old boy was floppy since 4 months of age and suspected as ataxic at 4 years of age. He could walk only with cruches. He had dwarfism and cataracts since 4 years of age. CT and MRI revealed generalized spino-ponto-cerebellar atrophy. Final diagnosis was Marinesco-Sjörgren syndrome. Case 4, a 10-year-old girl had opisthotonus and floppiness since 4 months of age. She could walk only with cruches. CT and MRI revealed generalized spino-ponto-cerebellar atrophy. Case 5, a 8-year-old boy showed head nodding and nystagmus since 4 months of age. He started ataxic gait at 8 years of age. He could vocalize only single sound for speech. MRI revealed cranium bifida and agenesis of anterior medullar velum. Ataxic cerebral palsy is the term often used to describe very different conditions, the clinical picture starts as hypotonia and changes into the ataxic symptoms in a few years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1389327

  19. Cerebral cortex structure in prodromal Huntington disease.

    PubMed

    Nopoulos, Peggy C; Aylward, Elizabeth H; Ross, Christopher A; Johnson, Hans J; Magnotta, Vincent A; Juhl, Andrew R; Pierson, Ronald K; Mills, James; Langbehn, Douglas R; Paulsen, Jane S

    2010-12-01

    Neuroimaging studies of subjects who are gene-expanded for Huntington Disease, but not yet diagnosed (termed prodromal HD), report that the cortex is "spared," despite the decrement in striatal and cerebral white-matter volume. Measurement of whole-cortex volume can mask more subtle, but potentially clinically relevant regional changes in volume, thinning, or surface area. The current study addressed this limitation by evaluating cortical morphology of 523 prodromal HD subjects. Participants included 693 individuals enrolled in the PREDICT-HD protocol. Of these participants, 523 carried the HD gene mutation (prodromal HD group); the remaining 170 were non gene-expanded and served as the comparison group. Based on age and CAG repeat length, gene-expanded subjects were categorized as "Far from onset," "Midway to onset," "Near onset," and "already diagnosed." MRI scans were processed using FreeSurfer. Cortical volume, thickness, and surface area were not significantly different between the Far from onset group and controls. However, beginning in the Midway to onset group, the cortex showed significant volume decrement, affecting most the posterior and superior cerebral regions. This pattern progressed when evaluating the groups further into the disease process. Areas that remained mostly unaffected included ventral and medial regions of the frontal and temporal cortex. Morphologic changes were mostly in thinning as surface area did not substantially change in most regions. Early in the course of HD, the cortex shows changes that are manifest as cortical thinning and are most robust in the posterior and superior regions of the cerebrum. PMID:20688164

  20. Cerebral Cortex Structure in Prodromal Huntington Disease

    PubMed Central

    Nopoulos, Peggy C.; Aylward, Elizabeth H.; Ross, Christopher A.; Johnson, Hans J.; Magnotta, Vincent A.; Juhl, Andrew R.; Pierson, Ronald K.; Mills, James; Langbehn, Douglas R.; Paulsen, Jane S.

    2010-01-01

    Neuroimaging studies of subjects who are gene-expanded for Huntington Disease, but not yet diagnosed (termed prodromal HD), report that the cortex is “spared,” despite the decrement in striatal and cerebral white-matter volume. Measurement of whole-cortex volume can mask more subtle, but potentially clinically relevant regional changes in volume, thinning, or surface area. The current study addressed this limitation by evaluating cortical morphology of 523 prodromal HD subjects. Participants included 693 individuals enrolled in the PREDICT-HD protocol. Of these participants, 523 carried the HD gene mutation (prodromal HD group); the remaining 170 were non gene-expanded and served as the comparison group. Based on age and CAG repeat length, gene-expanded subjects were categorized as “Far from onset,” “Midway to onset,” “Near onset,” and “already diagnosed.” MRI scans were processed using FreeSurfer. Cortical volume, thickness, and surface area were not significantly different between the Far from onset group and controls. However, beginning in the Midway to onset group, the cortex showed significant volume decrement, affecting most the posterior and superior cerebral regions. This pattern progressed when evaluating the groups further into the disease process. Areas that remained mostly unaffected included ventral and medial regions of the frontal and temporal cortex. Morphologic changes were mostly in thinning as surface area did not substantially change in most regions. Early in the course of HD, the cortex shows changes that are manifest as cortical thinning and are most robust in the posterior and superior regions of the cerebrum. PMID:20688164

  1. Time evolution and hemodynamics of cerebral aneurysms

    NASA Astrophysics Data System (ADS)

    Sforza, Daniel M.; Putman, Christopher; Tateshima, Satoshi; Viñuela, Fernando; Cebral, Juan

    2011-03-01

    Cerebral aneurysm rupture is a leading cause of hemorrhagic strokes. Because they are being more frequently diagnosed before rupture and the prognosis of subarachnoid hemorrhage is poor, clinicians are often required to judge which aneurysms are prone to progression and rupture. Unfortunately, the processes of aneurysm initiation, growth and rupture are not well understood. Multiple factors associated to these processes have been identified. Our goal is to investigate two of them, arterial hemodynamics (using computational fluid dynamics) and the peri-aneurysmal environment, by studying a group of growing cerebral aneurysms that are followed longitudinally in time. Six patients with unruptured untreated brain aneurysms which exhibited growth during the observation period were selected for the study. Vascular models of each aneurysm at each observation time were constructed from the corresponding computed tomography angiography (CTA) images. Subsequently, models were aligned, and geometrical differences quantified. Blood flow was modeled with the 3D unsteady incompressible Navier-Stokes equation for a Newtonian fluid, and wall shear stress distribution and flow patterns were calculated and visualized. Analysis of the simulations and changes in geometry revealed asymmetric growth patterns and suggests that areas subject to vigorous flows, i.e. relative high wall shear stress and concentrated streamlines patterns; correspond to regions of aneurysm growth. Furthermore, in some cases the geometrical evolution of aneurysms is clearly affected by contacts with bone structures and calcifications in the wall, and as a consequence the hemodynamics is greatly modified. Thus, in these cases the peri-aneurysmal environment must be considered when analyzing aneurysm evolution.

  2. Binding of radiolabeled misonidazole in cerebral infarction

    SciTech Connect

    Rasey, J.S.; Hoffman, J.; Spence, A.M.; Krohn, K.A.

    1985-05-01

    The metabolic trapping of the radiolabeled nitroimidazole, misonidazole, in viable hypoxic tissue may form the basis for the nuclear imaging of ischemia in cerebral infarction. Misonidazole congeners could be labeled with /sup 75/Br, /sup 18/F, or /sup 11/C and detected with PET. Infarction was induced in male Mongolian gerbils by ligation of the right common carotid artery. Severity of the lesions was determined by scoring neurological symptoms with a stroke index, in which scores >10, out of a possible 25, indicate presence of a severe infarct. Gerbils with scores ranging from 0 (asymptomatic) to 13 as well as control (unligated) animals received 3 injections (50 ..mu..Moles/kg) of /sup 3/H-misonidazole in 2 hours and % injected dose/g (% I.D./g) was determined 2 hours after the final injection. Uptake into whole brain of control animals averaged 0.137 +- 0.0168 % I.D./g. The cerebral hemispheres of ligated gerbils were divided into 7, 2 mm-thick coronal sections which were then bisected. In the right half of slide number3 (midparietal region) the % I.D./g increased with increasing stroke index. For animals with a stroke index = 0, uptake was 0.159 % I.D./g, and right/left R/L ratio was 1.07. For 2 animals with a score = 13, uptake in the same region ws 0.752 and 0.717 and I.D./g with R/L ratios of 3.29 and 2.3l, respectively. Animals with intermediate scores had moderately elevated uptake. The authors conclude that the uptake of /sup 3/H-misonidazole in the right hemisphere positively correlates with the severity of infarction. Studies are underway to determine whether the regions of highest uptake correlate with histological evidence of infarction and reduced oxygen availability.

  3. Glycogen: the forgotten cerebral energy store.

    PubMed

    Gruetter, Rolf

    2003-10-15

    The brain contains a significant amount of glycogen that is an order of magnitude smaller than that in muscle, but several-fold higher than the cerebral glucose content. Although the precise role of brain glycogen to date is unknown, it seems affected by focal activation, neurotransmitters, and overall electrical activity and hormones. Based on its relatively low concentration, the role of brain glycogen as a significant energy store has been discounted. This work reviews recent experimental evidence that brain glycogen is an important reserve of glucose equivalents: (1) glial glycogen can provide the majority of the glucose supply deficit during hypoglycemia for more than 100 min, consistent with the proposal that glial lactate is a fuel for neurons; (2) glycogen concentrations may be as high as 10 micromol/g, substantially higher than was thought previously; (3) glucose cycling in and out of glycogen amounts to approximately 1% of the cerebral metabolic rate of glucose (CMRglc) in human and rat brain, amounting to an effective stability of glycogen in the resting awake brain during euglycemia and hyperglycemia, (4) brain glycogen metabolism/concentrations are insulin/glucose sensitive; and (5) after a single episode of hypoglycemia, brain glycogen levels rebound to levels that exceed the pre-hypoglycemic concentrations (supercompensation). This experimental evidence supports the proposal that brain glycogen may be involved in the development of diabetes complications, specifically impaired glucose sensing (hypoglycemia unawareness) observed clinically in some diabetes patients under insulin treatment. It is proposed further that brain glycogen becomes important in any metabolic state where supply transiently cannot meet demand, such conditions that could occur during prolonged focal activation, sleep deprivation, seizures, and mild hypoxia. PMID:14515346

  4. Progressive cerebral vascular degeneration with mitochondrial encephalopathy.

    PubMed

    Longo, Nicola; Schrijver, Iris; Vogel, Hannes; Pique, Lynn M; Cowan, Tina M; Pasquali, Marzia; Steinberg, Gary K; Hedlund, Gary L; Ernst, Sharon L; Gallagher, Renata C; Enns, Gregory M

    2008-02-01

    MELAS (mitochondrial encephalopathy with lactic acidosis and stroke-like episodes) is a maternally inherited disorder characterized by recurrent cerebral infarctions that do not conform to discreet vascular territories. Here we report on a patient who presented at 7 years of age with loss of consciousness and severe metabolic acidosis following vomiting and dehydration. She developed progressive sensorineural hearing loss, myopathy, ptosis, short stature, and mild developmental delays after normal early development. Biochemical testing identified metabolites characteristic of medium-chain acyl-CoA dehydrogenase (MCAD) deficiency (hexanoylglycine and suberylglycine), but also severe lactic acidemia (10-25 mM) and, in urine, excess of lactic acid, intermediates of the citric cycle, and marked ketonuria, suggesting mitochondrial dysfunction. She progressed rapidly to develop temporary cortical blindness. Brain imaging indicated generalized atrophy, more marked on the left side, in addition to white matter alterations consistent with a mitochondrial disorder. Magnetic resonance angiography indicated occlusion of the left cerebral artery with development of collateral circulation (Moyamoya syndrome). This process worsened over time to involve the other side of the brain. A muscle biopsy indicated the presence of numerous ragged red fibers. Molecular testing confirmed compound heterozygosity for the common mutation in the MCAD gene (985A>G) and a second pathogenic mutation (233T>C). MtDNA testing indicated that the muscle was almost homoplasmic for the 3243A>T mutation in tRNALeu, with a lower mutant load (about 50% heteroplasmy) in blood and skin fibroblasts. These results indicate that mitochondrial disorders may be associated with severe vascular disease resulting in Moyamoya syndrome. The contribution of the concomitant MCAD deficiency to the development of the phenotype in this case is unclear. PMID:18203188

  5. Cerebral atrophy and subdural haemorrhage after cerebellar and cerebral infarcts in an 8-month-old child after having been stung by a scorpion

    PubMed Central

    Sığırcı, Ahmet; Öztürk, Mehmet; Yakıncı, Cengiz

    2014-01-01

    A scorpion sting causing cerebellar and cerebral infarctions with corpus callosum involvement and bilateral cerebral atrophy with subdural haemorrhage in an 8-month-old girl, has not been previously described to the best of our knowledge. PMID:24962491

  6. Cerebral specialization. [greater performance efficiency for certain mental abilities or processes by one cerebral hemisphere over another

    NASA Technical Reports Server (NTRS)

    Morris, Robin D.; Hopkins, William D.; Rumbaugh, Duane M.

    1991-01-01

    The concept of greater performance efficiency for certain mental abilities or processes in one cerebral hemisphere rather than the other is referred to as 'cerebral lateralization'. The experimental paradigm for lateralization research involves the study of patients with one damaged hemisphere, which prevents their performance of a certain task or function; this approach, however, presents many difficulties in extrapolating to brain function in normal patients. Attention is presently given to gender differences in lateralization, cerebral asymmetries in other species, and the evolutionary bases of hemispheric specialization.

  7. Seizure in Pregnancy Following Cerebral Venous Sinus Thrombosis

    PubMed Central

    Farzi, Farnoush; Abdollahzadeh, Mehrsima; Faraji, Roya; Chavoushi, Tahereh

    2015-01-01

    Introduction: Seizure involves less than 1% of pregnancies; however it is associated with increased maternal and fetal complications. Cerebral venous sinus thrombosis is a rare, but potentially life-threatening cause of seizure during pregnancy, presenting primarily as seizure in 12% - 31.9% of cases. Pregnancy and puerperium are known as the risk factors of cerebral venous sinus thrombosis. Case Presentation: Here is presented a case of seizure after delivery by cesarean section in an otherwise healthy woman. The final diagnosis was cerebral venous sinus thrombosis probably due to hypercoagulable state in pregnancy. Conclusions: If seizure occurs during the peripartum period, along with providing complete cardiovascular and respiratory support, advanced diagnostic measures are needed and cerebral venous sinus thrombosis should be considered as a possible diagnosis. PMID:26161329

  8. Experimental Models of Microvascular Immunopathology: The Example of Cerebral Malaria

    PubMed Central

    El-Assaad, Fatima; Combes, Valery; Grau, Georges ER

    2015-01-01

    Human cerebral malaria is a severe and often lethal complication of Plasmodium falciparum infection. Complex host and parasite interactions should the precise mechanisms involved in the onset of this neuropathology. Adhesion of parasitised red blood cells and host cells to endothelial cells lead to profound endothelial alterations that trigger immunopathological changes, varying degrees of brain oedema and can compromise cerebral blood flow, cause cranial nerve dysfunction and hypoxia. Study of the cerebral pathology in human patients is limited to clinical and genetic field studies in endemic areas, thus cerebral malaria (CM) research relies heavily on experimental models. The availability of malaria models allows study from the inoculation of Plasmodium to the onset of disease and permit invasive experiments. Here, we discuss some aspects of our current understanding of CM, the experimental models available and some important recent findings extrapolated from these models. PMID:26430675

  9. Prognostic Impact of Cerebral Small Vessel Disease on Stroke Outcome

    PubMed Central

    Kim, Beom Joon

    2015-01-01

    Cerebral small vessel disease (SVD), which includes white matter hyperintensities (WMHs), silent brain infarction (SBI), and cerebral microbleeds (CMBs), develops in a conjunction of cumulated injuries to cerebral microvascular beds, increased permeability of blood-brain barriers, and chronic oligemia. SVD is easily detected by routine neuroimaging modalities such as brain computed tomography or magnetic resonance imaging. Research has revealed that the presence of SVD markers may increase the risk of future vascular events as well as deteriorate functional recovery and neurocognitive trajectories after stroke, and such an association could also be applied to hemorrhagic stroke survivors. Currently, the specific mechanistic processes leading to the development and manifestation of SVD risk factors are unknown, and further studies with novel methodological tools are warranted. In this review, recent studies regarding the prognostic impact of WMHs, SBI, and CMBs on stroke survivors and briefly summarize the pathophysiological concepts underlying the manifestation of cerebral SVD. PMID:26060797

  10. Erythropoietin and cerebral vascular protection: role of nitric oxide.

    PubMed

    Santhanam, Anantha Vijay R; Katusic, Zvonimir S

    2006-11-01

    Cerebral vasospasm after subarachnoid hemorrhage (SAH) is a major clinical problem causing cerebral ischemia and infarction. The pathogenesis of vasospasm is related to a number of pathological processes including endothelial damage and alterations in vasomotor function leading to narrowing of arterial diameter and a subsequent decrease in cerebral blood flow. Discovery of the tissue protective effects of erythropoietin (EPO) stimulated the search for therapeutic application of EPO for the prevention and treatment of cerebrovascular disease. Recent studies have identified the role of EPO in vascular protection mediated by the preservation of endothelial cell integrity and stimulation of angiogenesis. In this review, we discuss the EPO-induced activation of endothelial nitric oxide (NO) synthase and its contribution to the prevention of cerebral vasospasm. PMID:17049112

  11. Cerebral large vessel vasculitis in systemic lupus erythematosus.

    PubMed

    Böckle, B C; Jara, D; Aichhorn, K; Junker, D; Berger, T; Ratzinger, G; Sepp, N T

    2014-11-01

    Neuropsychiatric systemic lupus erythematosus (NPSLE) is defined by involvement of the central nervous system in systemic lupus erythematosus (SLE), with a wide range of both neurological and psychiatric manifestations. Although its aetiopathogenesis is not fully elucidated, NPSLE seems to be a consequence of cerebral vascular pathology including thromboembolism, small-vessel vasculopathy and, in rare cases, true vasculitis. Cerebral vasculitis is rare, and cerebral large-vessel vasculitis in SLE is even more unusual. We report the case of a female patient with the diagnosis of SLE. She presented with stroke-like symptoms, headache and vertigo, and palpable purpura on her legs. Further investigations revealed that she suffered from both vasculitis of the cerebral large vessels and coexisting cutaneous small-vessel vasculitis. PMID:24969082

  12. Variants in CUL4B are Associated with Cerebral Malformations

    PubMed Central

    Vulto-van Silfhout, Anneke T.; Nakagawa, Tadashi; Bahi-Buisson, Nadia; Haas, Stefan A.; Hu, Hao; Bienek, Melanie; Vissers, Lisenka E.L.M.; Gilissen, Christian; Tzschach, Andreas; Busche, Andreas; Müsebeck, Jörg; Rump, Patrick; Mathijssen, Inge B.; Avela, Kristiina; Somer, Mirja; Doagu, Fatma; Philips, Anju K.; Rauch, Anita; Baumer, Alessandra; Voesenek, Krysta; Poirier, Karine; Vigneron, Jacqueline; Amram, Daniel; Odent, Sylvie; Nawara, Magdalena; Obersztyn, Ewa; Lenart, Jacek; Charzewska, Agnieszka; Lebrun, Nicolas; Fischer, Ute; Nillesen, Willy M.; Yntema, Helger G.; Järvelä, Irma; Ropers, Hans-Hilger; de Vries, Bert B.A.; Brunner, Han G.; van Bokhoven, Hans; Raymond, F. Lucy; Willemsen, Michèl A.A.P.; Chelly, Jamel; Xiong, Yue; Barkovich, A. James; Kalscheuer, Vera M.; Kleefstra, Tjitske; de Brouwer, Arjan P.M.

    2015-01-01

    Variants in cullin 4B (CUL4B) are a known cause of syndromic X-linked intellectual disability. Here, we describe an additional 25 patients from 11 families with variants in CUL4B. We identified nine different novel variants in these families and confirmed the pathogenicity of all nontruncating variants. Neuroimaging data, available for 15 patients, showed the presence of cerebral malformations in ten patients. The cerebral anomalies comprised malformations of cortical development (MCD), ventriculomegaly, and diminished white matter volume. The phenotypic heterogeneity of the cerebral malformations might result from the involvement of CUL-4B in various cellular pathways essential for normal brain development. Accordingly, we show that CUL-4B interacts with WDR62, a protein in which variants were previously identified in patients with microcephaly and a wide range of MCD. This interaction might contribute to the development of cerebral malformations in patients with variants in CUL4B. PMID:25385192

  13. Cerebral air embolism caused by a bronchogenic cyst.

    PubMed

    Jung, Simon; Wiest, Roland; Frigerio, Susanna; Mattle, Heinrich P; Hess, Christian W

    2010-06-01

    An unusual case is presented of a tourist who developed fatal cerebral air embolism, pneumomediastinum and pneumopericardium while ascending from low altitude to Europe's highest railway station. Presumably the air embolism originated from rupture of the unsuspected bronchogenic cyst as a result of pressure changes during the ascent. Cerebral air embolism has been observed during surgery, in scuba diving accidents, submarine escapes and less frequently during exposure to very high altitude. People with known bronchogenic cysts should be informed about the risk of cerebral air embolism and surgical removal should be considered. Cerebral air embolism is a rare cause of coma and stroke in all activities with rapid air pressure changes, including alpine tourism, as our unfortunate tourist illustrates. PMID:20498190

  14. Primary Cerebral Alveolar Echinococcosis: Mycology to the Rescue

    PubMed Central

    Goehringer, François; Umhang, Gérald; Gauchotte, Guillaume; Hénard, Sandrine; Boué, Franck; May, Thierry; Machouart, Marie

    2014-01-01

    A case of primary cerebral alveolar echinococcosis with a favorable outcome is reported. A universal fungal PCR enabled this diagnosis, while the initial serological analysis remained noncontributive. PMID:24478516

  15. [The structural typology of the human cerebral cranium].

    PubMed

    Zaĭchenko, A A

    1997-01-01

    819 skulls (250 of them were represented as frontal sections) obtained from men and women of different age were examined in order to study the variability of human cerebral cranium biomechanical stability to external mechanical influences and to work out its morphological constructional typology. Methods were based considering cerebral cranium as a coat, approximating to half of the rotation ellipsoid in shape. The following craniotypes are the extreme types of cerebral cranium construction stability, a) morphologically-stable one, where strength is provided both by great bone thickness and small curvature radiuses, 6) structurally-stable, in which strength is provided by great bone thickness, B) configurationally stable in which strength is provided by curvature small radiuses, r) morphologically unstable with small bone thickness and great curvature radiuses. Phylo-ontogenetic dynamics of human cerebral cranium construction stability was followed up. PMID:9244538

  16. Ependymal lined paraventricular cerebral cysts; a report of three cases

    PubMed Central

    Bouch, D. C.; Mitchell, I.; Maloney, A. F. J.

    1973-01-01

    Three cases are reported, each with a benign ependymal-lined cyst which produced clinical signs and symptoms simulating cerebrovascular disease or cerebral neoplasm. The pathological features are described and their histogenesis discussed. Images PMID:4731330

  17. CEREBRAL CYSTICERCOSIS BY TAENIA CRASSICEPS IN A DOMESTIC CAT

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Carnivorous domestic mammals occasionally become atypical intermediate hosts of taeniid tapeworms. In cases of intermittent relapsing neurological disease in cats, cerebral cysticercosis e. g., by Taenia crassiceps may be considered. Significantly this case represents the first record of neurocystic...

  18. Speech Performance, Dysphagia and Oral Reflexes in Cerebral Palsy.

    ERIC Educational Resources Information Center

    Love, Russell J.; And Others

    1980-01-01

    The adequacy of biting, sucking, swallowing, and chewing as well as the presence or absence of nine infantile oral reflexes were assessed in 60 cerebral palsied individuals (ages 3 to 23). (Author/PHR)

  19. Effect of a new vasodilator (flunarizine) on the cerebral circulation.

    PubMed

    Toyoda, M; Takagi, S; Seki, T; Takeoka, T; Goto, F

    1975-07-01

    In order to clarify the effects of flunarizine, a newly-synthesized derivative of piperazine on cerebral circulation and metabolism, cerebrocortical oxygen tension, carbon dioxide tension and cerebrocortical blood flow were continuously recorded, along with a simultaneous monitoring of arterial blood pressure in 11 cats. Maximal changes in cerebrocortical oxygen tension induced by intravenous administration of flunarizine (0.6-1.0 mg/kg) were compared with those of papaverine hydrochloride (1 mg/kg). Flunarizine caused increases in cerebrocortical oxygen tension as well as cerebrocortical blood flow and a decrease in cerebrocortical carbon dioxide tension despite a fall in blood pressure, indicating an increase of cerebral blood flow presumably due to cerebral vasodilatation. Since the increase of cerebrocortical oxygen tension induced by flunarizine was comparable to that induced by papaverine, it was concluded that flunarizine appears to be a potent vasodilator of cerebral vessels. PMID:1159451

  20. Spatio-temporal analysis of the cerebral spontaneous oscillation

    NASA Astrophysics Data System (ADS)

    Choi, Jee H.; Wolf, Martin; Toronov, Vladislav Y.; Michalos, Antonios; Gratton, Enrico

    2004-05-01

    Cerebral vasomotion was studied on the human brain in vivo by use of multi-optode frequency domain near-infrared spectroscopy (NIRS). Vasomotion is a spontaneous oscillation with a frequency of 0.1 Hz in the arterial flow. We investigated (1) the fluctuations of cerebral hemodynamics on the dynamical characteristics of cerebral vasomotion and (2) the dynamical coupling between vasomotion in the skin and brain. We found that (1) vasomotion is temporal coherent at least for about 3 min; (2) vasomotion observed from NIRS is low-dimensional chaotic with its fractal dimension of about 4.5; (3) vasomotion is spatially coherent with coherence length of about 1 - 2 cm but cerebral vasomotion is dynamically independent from vasomotion in the skin.

  1. Noninvasive method of estimating human newborn regional cerebral blood flow

    SciTech Connect

    Younkin, D.P.; Reivich, M.; Jaggi, J.; Obrist, W.; Delivoria-Papadopoulos, M.

    1982-12-01

    A noninvasive method of estimating regional cerebral blood flow (rCBF) in premature and full-term babies has been developed. Based on a modification of the /sup 133/Xe inhalation rCBF technique, this method uses eight extracranial NaI scintillation detectors and an i.v. bolus injection of /sup 133/Xe (approximately 0.5 mCi/kg). Arterial xenon concentration was estimated with an external chest detector. Cerebral blood flow was measured in 15 healthy, neurologically normal premature infants. Using Obrist's method of two-compartment analysis, normal values were calculated for flow in both compartments, relative weight and fractional flow in the first compartment (gray matter), initial slope of gray matter blood flow, mean cerebral blood flow, and initial slope index of mean cerebral blood flow. The application of this technique to newborns, its relative advantages, and its potential uses are discussed.

  2. Regional cerebral blood flow changes associated with ethanol intoxication

    SciTech Connect

    Mathew, R.J.; Wilson, W.H.

    1986-11-01

    Regional cerebral blood flow (CBF) was measured via the 133Xenon inhalation technique in 26 healthy volunteers before and 60 minutes after the oral administration of ethyl alcohol or placebo on a double-blind basis. The cerebral blood flow values, corrected for test-retest differences in carbon dioxide showed a significant bilateral increase after ethanol administration. Blood levels of ethanol, estimated with a breath analyser, did not correlate with the CBF changes.

  3. Differential diagnosis of cerebral hemispheric pathology: multimodal approach.

    PubMed

    Moritani, T; Smoker, W R K; Lee, H K; Sato, Y

    2011-06-01

    This article gives a comprehensive review and illustrations of the imaging features of various pathological conditions and clinical syndromes associated with cerebral hemispheric involvement. The various conditions are described and defined to provide a basis for the differential diagnostics. The hypotheses relating to the pathology of the various syndromes are discussed with special emphasis on excitotoxic mechanisms for explaining the subsequent cerebral hemiatrophy. PMID:21528369

  4. Clinical Features of Liver Cancer with Cerebral Hemorrhage

    PubMed Central

    Lu, Qiuhong; Chen, Li; Zeng, Jinsheng; Huang, Gelun; Qin, Chao; Cheng, Daobin; Yu, Lixia; Liang, Zhijian

    2016-01-01

    Background Cerebral hemorrhage is common in patients with cancer, but the clinical features and pathogenesis of liver cancer patients with cerebral hemorrhage are not well known. Material/Methods Liver cancer patients who developed cerebral hemorrhage were recruited from the First Affiliated Hospital of Guangxi Medical University between January 2003 and December 2014. We retrospectively analyzed clinical presentations, results of laboratory tests, and imaging examinations. The clinical features and pathogenesis were summarized. Results Among 11133 patients with liver cancer, 9 patients (0.08%), including 3 females and 6 males met the inclusion criteria. The age range was 48–73 years and the average age was 61.67±8.97 years. Five patients did not have traditional hemorrhage risk factors and 4s had the risk factors; however, all had developed hepatocellular carcinoma, and 3 had developed metastasis. All 9 patients showed elevated tumor markers: an increased AFP level was detected in 6 patients, coagulation dysfunctions in 8 patients, and abnormal liver functions in 6 patients. Five patients had developed cerebral hemorrhagic lesions in the lobes of their brains, while hemorrhagic lesions in the basal ganglia occurred in 3 patients and in the brainstem in only 1 patient. Four patients had clear consciousness, while 5 patients were in coma and showed poor prognosis. Conclusions Patients who have liver cancer complicated with cerebral hemorrhage usually lack traditional risk factors of cerebral hemorrhage. The site of cerebral hemorrhage is often detected in the lobes of the brain. Coagulation dysfunctions might be the main pathogenesis of liver cancer complicated with cerebral hemorrhage. PMID:27209058

  5. Clinical Features of Liver Cancer with Cerebral Hemorrhage.

    PubMed

    Lu, Qiuhong; Chen, Li; Zeng, Jinsheng; Huang, Gelun; Qin, Chao; Cheng, Daobin; Yu, Lixia; Liang, Zhijian

    2016-01-01

    BACKGROUND Cerebral hemorrhage is common in patients with cancer, but the clinical features and pathogenesis of liver cancer patients with cerebral hemorrhage are not well known. MATERIAL AND METHODS Liver cancer patients who developed cerebral hemorrhage were recruited from the First Affiliated Hospital of Guangxi Medical University between January 2003 and December 2014. We retrospectively analyzed clinical presentations, results of laboratory tests, and imaging examinations. The clinical features and pathogenesis were summarized. RESULTS Among 11133 patients with liver cancer, 9 patients (0.08%), including 3 females and 6 males met the inclusion criteria. The age range was 48-73 years and the average age was 61.67±8.97 years. Five patients did not have traditional hemorrhage risk factors and 4s had the risk factors; however, all had developed hepatocellular carcinoma, and 3 had developed metastasis. All 9 patients showed elevated tumor markers: an increased AFP level was detected in 6 patients, coagulation dysfunctions in 8 patients, and abnormal liver functions in 6 patients. Five patients had developed cerebral hemorrhagic lesions in the lobes of their brains, while hemorrhagic lesions in the basal ganglia occurred in 3 patients and in the brainstem in only 1 patient. Four patients had clear consciousness, while 5 patients were in coma and showed poor prognosis. CONCLUSIONS Patients who have liver cancer complicated with cerebral hemorrhage usually lack traditional risk factors of cerebral hemorrhage. The site of cerebral hemorrhage is often detected in the lobes of the brain. Coagulation dysfunctions might be the main pathogenesis of liver cancer complicated with cerebral hemorrhage. PMID:27209058

  6. [Comprehensive therapy of cerebral and cerebrovascular decompensation (author's transl)].

    PubMed

    Hofmann, G

    1980-06-01

    Many psychiatric syndroms in older age are based on cerebral and cerebrovascular decompensation. Diagnosis of metabolic dysfunction or vascular dysregulation--leading to cerebral decompensation--and their therapy is of greater importance than immediate therapy of psychiatric syndroms. We use Strophantin therapy, hemodilation, stabilization of blood pressure, antidiabetics combined with mild sedation by low dose neuroleptics. After achieving metabolic and cerebrovascular equilibrium we start more or less specific psychiatric syndrom therapy like antidepressants. PMID:6109459

  7. Cerebral vasoreactivity during hypercapnia is reset by augmented sympathetic influence.

    PubMed

    Zhang, Peizhen; Huang, Guoyuan; Shi, Xiangrong

    2011-02-01

    Sympathetic nerve activity influences cerebral blood flow, but it is unknown whether augmented sympathetic nerve activity resets cerebral vasoreactivity to hypercapnia. This study tested the hypothesis that cerebral vasodilation during hypercapnia is restrained by lower-body negative pressure (LBNP)-stimulated sympathoexcitation. Cerebral hemodynamic responses were assessed in nine healthy volunteers [age 25 yr (SD 3)] during rebreathing-induced increases in partial pressure of end-tidal CO(2) (Pet(CO(2))) at rest and during LBNP. Cerebral hemodynamic responses were determined by changes in flow velocity of middle cerebral artery (MCAV) using transcranial Doppler sonography and in regional cerebral tissue oxygenation (ScO(2)) using near-infrared spectroscopy. Pet(CO(2)) values during rebreathing were similarly increased from 41.9 to 56.5 mmHg at rest and from 40.7 to 56.0 mmHg during LBNP of -15 Torr. However, the rates of increases in MCAV and in ScO(2) per unit increase in Pet(CO(2)) (i.e., the slopes of MCAV/Pet(CO(2)) and ScO(2)/Pet(CO(2))) were significantly (P ≤0.05) decreased from 2.62 ± 0.16 cm·s(-1)·mmHg(-1) and 0.89 ± 0.10%/mmHg at rest to 1.68 ± 0.18 cm·s(-1)·mmHg(-1) and 0.63 ± 0.07%/mmHg during LBNP. In conclusion, the sensitivity of cerebral vasoreactivity to hypercapnia, in terms of the rate of increases in MCAV and in ScO(2), is diminished by LBNP-stimulated sympathoexcitation. PMID:21071587

  8. Anterior cerebral artery territory infarctions presenting with ascending tetraparesis.

    PubMed

    Okamoto, Kensho; Hamada, Eri; Okuda, Bungo

    2004-01-01

    We describe a patient with ascending tetraparesis following stroke. The patient presented initially with spastic paraparesis which acutely evolved to tetraparesis with abulia. Magnetic resonance imaging revealed acute infarctions in the bilateral medial frontal regions but not in the brainstem or spinal cord. Multiple infarctions in the anterior cerebral artery territory appeared to originate from artery to artery embolism. The present case provides distinct clinical features of anterior cerebral artery syndrome which mimic myelopathy or brainstem lesions. PMID:17903956

  9. Management of Spasticity in Children with Cerebral Palsy

    PubMed Central

    Shamsoddini, Alireza; Amirsalari, Susan; Hollisaz, Mohammad-Taghi; Rahimnia, Alireza; Khatibi-Aghda, Amideddin

    2014-01-01

    Cerebral palsy is the most common cause of spasticity and physical disability in children and spasticity is one of the commonest problems in those with neurological disease. The management of spasticity in children with cerebral palsy requires a multidisciplinary effort and should be started as early as possible. There are a number of treatments available for the management of spasticity. This article reviews the variety of options available for the clinical management of spasticity. PMID:25755853

  10. Hemodilution increases cerebral blood flow in acute ischemic stroke

    SciTech Connect

    Vorstrup, S.; Andersen, A.; Juhler, M.; Brun, B.; Boysen, G.

    1989-07-01

    We measured cerebral blood flow in 10 consecutive, but selected, patients with acute ischemic stroke (less than 48 hours after onset) before and after hemodilution. Cerebral blood flow was measured by xenon-133 inhalation and emission tomography, and only patients with focal hypoperfusion in clinically relevant areas were included. Hemodilution was done according to the hematocrit level: for a hematocrit greater than or equal to 42%, 500 ml whole blood was drawn and replaced by the same volume of dextran 40; for a hematocrit between 37% and 42%, only 250 ml whole blood was drawn and replaced by 500 cc of dextran 40. Mean hematocrit was reduced by 16%, from 46 +/- 5% (SD) to 39 +/- 5% (SD) (p less than 0.001). Cerebral blood flow increased in both hemispheres by an average of 20.9% (p less than 0.001). Regional cerebral blood flow increased in the ischemic areas in all cases, on an average of 21.4 +/- 12.0% (SD) (p less than 0.001). In three patients, a significant redistribution of flow in favor of the hypoperfused areas was observed, and in six patients, the fractional cerebral blood flow increase in the hypoperfused areas was of the same magnitude as in the remainder of the brain. In the last patient, cerebral blood flow increased relatively less in the ischemic areas. Our findings show that cerebral blood flow increases in the ischemic areas after hemodilution therapy in stroke patients. The marked regional cerebral blood flow increase seen in some patients could imply an improved oxygen delivery to the ischemic tissue.

  11. Stability and Harmony of Gait in Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Iosa, Marco; Marro, Tiziana; Paolucci, Stefano; Morelli, Daniela

    2012-01-01

    The aim of this study was to quantitatively assess the stability and harmony of gait in children with cerebral palsy. Seventeen children with spastic hemiplegia due to cerebral palsy (5.0 [plus or minus] 2.3 years old) who were able to walk autonomously and seventeen age-matched children with typical development (5.7 [plus or minus] 2.5 years old,…

  12. Probabilistic atlas based labeling of the cerebral vessel tree

    NASA Astrophysics Data System (ADS)

    Van de Giessen, Martijn; Janssen, Jasper P.; Brouwer, Patrick A.; Reiber, Johan H. C.; Lelieveldt, Boudewijn P. F.; Dijkstra, Jouke

    2015-03-01

    Preoperative imaging of the cerebral vessel tree is essential for planning therapy on intracranial stenoses and aneurysms. Usually, a magnetic resonance angiography (MRA) or computed tomography angiography (CTA) is acquired from which the cerebral vessel tree is segmented. Accurate analysis is helped by the labeling of the cerebral vessels, but labeling is non-trivial due to anatomical topological variability and missing branches due to acquisition issues. In recent literature, labeling the cerebral vasculature around the Circle of Willis has mainly been approached as a graph-based problem. The most successful method, however, requires the definition of all possible permutations of missing vessels, which limits application to subsets of the tree and ignores spatial information about the vessel locations. This research aims to perform labeling using probabilistic atlases that model spatial vessel and label likelihoods. A cerebral vessel tree is aligned to a probabilistic atlas and subsequently each vessel is labeled by computing the maximum label likelihood per segment from label-specific atlases. The proposed method was validated on 25 segmented cerebral vessel trees. Labeling accuracies were close to 100% for large vessels, but dropped to 50-60% for small vessels that were only present in less than 50% of the set. With this work we showed that using solely spatial information of the vessel labels, vessel segments from stable vessels (>50% presence) were reliably classified. This spatial information will form the basis for a future labeling strategy with a very loose topological model.

  13. Ten year clinical experience with stroke and cerebral vasculitis.

    PubMed

    Kempster, Peter A; McLean, Catriona A; Phan, Thanh G

    2016-05-01

    Angiitis of the central nervous system (CNS) is difficult to diagnose but potentially fatal. When stroke occurs in a younger individual or is associated with multiple infarcts on imaging, clinicians must decide how far to pursue a possible diagnosis of vasculitis. The aim of this study is to establish the prevalence of primary and secondary cerebral angiitis among patients presenting with stroke. Hospital attendances over a 10year period were surveyed by searching for diagnostic codes and key words specific for cerebral vasculitis/angiitis. Case notes were reviewed by the authors using two sets of criteria for angiitis of the CNS. Thirty-two patients were initially considered likely to have cerebral angiitis by treating physicians. Thirteen had been admitted to hospital with stroke. During this period, there were 7475 admissions for ischaemic and haemorrhagic stroke. Six patients had a final diagnosis of vasculitic stroke but only one had definite CNS angiitis with a first presentation as ischaemic stroke (0.02%). Most patients who did have cerebral vasculitis developed multifocal or subacute neurological deficits, or already had an immunological disorder known to be associated with secondary CNS angiitis. Of 19 patients given an alternative final diagnosis, the most common were atherosclerotic/embolic cerebrovascular disease (n=9) and reversible cerebral vasoconstriction syndrome (n=7). Stroke is rarely the first manifestation of cerebral vasculitis. Our findings suggest that routine screening for angiitis in stroke patients may not be warranted. PMID:26778046

  14. Association of PECAM1/CD31 polymorphisms with cerebral malaria

    PubMed Central

    Ohashi, Jun; Naka, Izumi; Hananantachai, Hathairad; Patarapotikul, Jintana

    2016-01-01

    Platelet/endothelial cell adhesion molecule-1 (PECAM1/CD31), a receptor recognized by P. falciparum-infected red blood cells (iRBCs), on the vascular endothelium has been implicated in mediating cytoadherence in patients with P. falciparum malaria. To examine associations of PECAM1 polymorphisms with cerebral malaria, 11 tag single nucleotide polymorphisms (SNPs) of PECAM1 were analysed for 312 Thai patients with P. falciparum malaria (109 with cerebral malaria and 203 with mild malaria). The rs1122800-C allele was significantly associated with protection from cerebral malaria (P = 0.017), and the rs9912957-A significantly increased the risk for cerebral malaria (P = 0.0065) in malaria patients. Fine-scale mapping using genotyped and imputed SNPs and linkage disequilibrium (LD) analysis revealed that rs1122800 and rs9912957 were located in two distinct LD blocks and were independently associated with cerebral malaria. The rs1122800-C allele was significantly associated with lower expression level of PECAM1 in EBV-transformed lymphoblastoid cell lines (P = 0.045). The present results suggest that PECAM1-mediated cytoadherence of iRBCs to brain endothelium plays a crucial role in the pathogenesis of cerebral malaria. PMID:27335627

  15. Autonomic neural control of dynamic cerebral autoregulation in humans

    NASA Technical Reports Server (NTRS)

    Zhang, Rong; Zuckerman, Julie H.; Iwasaki, Kenichi; Wilson, Thad E.; Crandall, Craig G.; Levine, Benjamin D.

    2002-01-01

    BACKGROUND: The purpose of the present study was to determine the role of autonomic neural control of dynamic cerebral autoregulation in humans. METHODS AND RESULTS: We measured arterial pressure and cerebral blood flow (CBF) velocity in 12 healthy subjects (aged 29+/-6 years) before and after ganglion blockade with trimethaphan. CBF velocity was measured in the middle cerebral artery using transcranial Doppler. The magnitude of spontaneous changes in mean blood pressure and CBF velocity were quantified by spectral analysis. The transfer function gain, phase, and coherence between these variables were estimated to quantify dynamic cerebral autoregulation. After ganglion blockade, systolic and pulse pressure decreased significantly by 13% and 26%, respectively. CBF velocity decreased by 6% (P<0.05). In the very low frequency range (0.02 to 0.07 Hz), mean blood pressure variability decreased significantly (by 82%), while CBF velocity variability persisted. Thus, transfer function gain increased by 81%. In addition, the phase lead of CBF velocity to arterial pressure diminished. These changes in transfer function gain and phase persisted despite restoration of arterial pressure by infusion of phenylephrine and normalization of mean blood pressure variability by oscillatory lower body negative pressure. CONCLUSIONS: These data suggest that dynamic cerebral autoregulation is altered by ganglion blockade. We speculate that autonomic neural control of the cerebral circulation is tonically active and likely plays a significant role in the regulation of beat-to-beat CBF in humans.

  16. Cerebral Venous Air Embolism Secondary to Mesenteric Infarction

    PubMed Central

    Tamura, Aileen; Matsuda, Brent; Leo, Qi Jie Nicholas; Sung, Hiro

    2016-01-01

    Cerebral air embolism is a rare, yet potentially fatal condition. We present a case of retrograde cerebral venous air emboli arising from the hepatic portal venous system, secondary to a mesenteric infarction. A 69-year-old man with a history of gastrointestinal amyloidosis presented with fever and lethargy. Computed tomography of the brain detected multiple foci of air in the right frontal, fronto-parietal, and left lateral frontal sulci consistent with cerebral venous air emboli. Computed tomography of the abdomen and pelvis revealed moderate thickening and dilatation of the small bowel with diffuse scattered intestinal pneumatosis suggestive of mesenteric infarction with resultant extensive intrahepatic portal venous air. The patient was deemed a poor candidate for surgical intervention and died as a result of septic shock. We believe the cerebral venous air emboli was a result of retrograde flow of air arising from the hepatic venous air ascending via the inferior and superior vena cava to the cerebral venous system. To our knowledge, there have been no reported cases of retrograde cerebral venous air embolism arising from hepatic portal venous system secondary to mesenteric infarction. The clinical significance and prognosis in this setting requires further investigation. PMID:27239392

  17. Human cerebral malaria and Plasmodium falciparum genotypes in Malawi

    PubMed Central

    2012-01-01

    Background Cerebral malaria, a severe form of Plasmodium falciparum infection, is an important cause of mortality in sub-Saharan African children. A Taqman 24 Single Nucleotide Polymorphisms (SNP) molecular barcode assay was developed for use in laboratory parasites which estimates genotype number and identifies the predominant genotype. Methods The 24 SNP assay was used to determine predominant genotypes in blood and tissues from autopsy and clinical patients with cerebral malaria. Results Single genotypes were shared between the peripheral blood, the brain, and other tissues of cerebral malaria patients, while malaria-infected patients who died of non-malarial causes had mixed genetic signatures in tissues examined. Children with retinopathy-positive cerebral malaria had significantly less complex infections than those without retinopathy (OR = 3.7, 95% CI [1.51-9.10]).The complexity of infections significantly decreased over the malaria season in retinopathy-positive patients compared to retinopathy-negative patients. Conclusions Cerebral malaria patients harbour a single or small set of predominant parasites; patients with incidental parasitaemia sustain infections involving diverse genotypes. Limited diversity in the peripheral blood of cerebral malaria patients and correlation with tissues supports peripheral blood samples as appropriate for genome-wide association studies of parasite determinants of pathogenicity. PMID:22314206

  18. Neuroprotective effects of rutaecarpine on cerebral ischemia reperfusion injury

    PubMed Central

    Yan, Chunlin; Zhang, Ji; Wang, Shu; Xue, Guiping; Hou, Yong

    2013-01-01

    Rutaecarpine, an active component of the traditional Chinese medicine Tetradium ruticarpum, has been shown to improve myocardial ischemia reperfusion injury. Because both cardiovascular and cerebrovascular diseases are forms of ischemic vascular disease, they are closely related. We hypothesized that rutaecarpine also has neuroprotective effects on cerebral ischemia reperfusion injury. A cerebral ischemia reperfusion model was established after 84, 252 and 504 μg/kg carpine were given to mice via intraperitoneal injection, daily for 7 days. Results of the step through test, 2,3,5-triphenyl tetrazolium chloride dyeing and oxidative stress indicators showed that rutaecarpine could improve learning and memory ability, neurological symptoms and reduce infarction volume and cerebral water content in mice with cerebral ischemia reperfusion injury. Rutaecarpine could significantly decrease the malondialdehyde content and increase the activities of superoxide dismutase and glutathione peroxidase in mouse brain. Therefore, rutaecarpine could improve neurological function following injury induced by cerebral ischemia reperfusion, and the mechanism of this improvement may be associated with oxidative stress. These results verify that rutaecarpine has neuroprotective effects on cerebral ischemia reperfusion in mice. PMID:25206511

  19. Sleep slow-wave activity regulates cerebral glycolytic metabolism.

    PubMed

    Wisor, Jonathan P; Rempe, Michael J; Schmidt, Michelle A; Moore, Michele E; Clegern, William C

    2013-08-01

    Non-rapid eye movement sleep (NREMS) onset is characterized by a reduction in cerebral metabolism and an increase in slow waves, 1-4-Hz oscillations between relatively depolarized and hyperpolarized states in the cerebral cortex. The metabolic consequences of slow-wave activity (SWA) at the cellular level remain uncertain. We sought to determine whether SWA modulates the rate of glycolysis within the cerebral cortex. The real-time measurement of lactate concentration in the mouse cerebral cortex demonstrates that it increases during enforced wakefulness. In spontaneous sleep/wake cycles, lactate concentration builds during wakefulness and rapid eye movement sleep and declines during NREMS. The rate at which lactate concentration declines during NREMS is proportional to the magnitude of electroencephalographic (EEG) activity at frequencies of <10 Hz. The induction of 1-Hz oscillations, but not 10-Hz oscillations, in the electroencephalogram by optogenetic stimulation of cortical pyramidal cells during wakefulness triggers a decline in lactate concentration. We conclude that cerebral SWA promotes a decline in the rate of glycolysis in the cerebral cortex. These results demonstrate a cellular energetic function for sleep SWA, which may contribute to its restorative effects on brain function. PMID:22767634

  20. Evaluation of postural stability in children with hemiplegic cerebral palsy

    PubMed Central

    Kenis-Coskun, Ozge; Giray, Esra; Eren, Beyhan; Ozkok, Ozlem; Karadag-Saygi, Evrim

    2016-01-01

    [Purpose] Postural stability is the ability of to maintain the position of the body within the support area. This function is affected in cerebral palsy. The aim of the present study was to compare static and dynamic postural stability between children with hemiplegic cerebral palsy and healthy controls. [Subjects and Methods] Thirty-seven children between the ages of 5 and 14 diagnosed with hemiplegic cerebral palsy (19 right, 18 left) and 23 healthy gender- and age-matched controls were included in the study. Postural stability was evaluated in both of the groups using a Neurocom Balance. Sway velocity was measured both with the eyes open and closed. Sit to stand and turning abilities were also assessed. [Results] The sway velocities with the eyes open and closed were significantly different between the groups. The weight transfer time in the Sit to Stand test was also significantly slower in children with cerebral palsy. Children with cerebral palsy also showed slower turning times and greater sway velocities during the Step and Quick Turn test on a force plate compared with their healthy counterparts. [Conclusion] Both static and dynamic postural stability parameters are affected in hemiplegic cerebral palsy. Further research is needed to define rehabilitation interventions to improve these parameters in patients. PMID:27313338

  1. Enhanced global mathematical model for studying cerebral venous blood flow.

    PubMed

    Müller, Lucas O; Toro, Eleuterio F

    2014-10-17

    Here we extend the global, closed-loop, mathematical model for the cardiovascular system in Müller and Toro (2014) to account for fundamental mechanisms affecting cerebral venous haemodynamics: the interaction between intracranial pressure and cerebral vasculature and the Starling-resistor like behaviour of intracranial veins. Computational results are compared with flow measurements obtained from Magnetic Resonance Imaging (MRI), showing overall satisfactory agreement. The role played by each model component in shaping cerebral venous flow waveforms is investigated. Our results are discussed in light of current physiological concepts and model-driven considerations, indicating that the Starling-resistor like behaviour of intracranial veins at the point where they join dural sinuses is the leading mechanism. Moreover, we present preliminary results on the impact of neck vein strictures on cerebral venous hemodynamics. These results show that such anomalies cause a pressure increment in intracranial cerebral veins, even if the shielding effect of the Starling-resistor like behaviour of cerebral veins is taken into account. PMID:25169660

  2. A case of cerebral embolism due to cardiac myxoma presenting with multiple cerebral microaneurysms detected on first MRI scans.

    PubMed

    Sato, Takahiro; Saji, Naoki; Kobayashi, Kazuto; Shibazaki, Kensaku; Kimura, Kazumi

    2016-03-01

    A 64-year-old man developed right arm weakness and dysarthria, and was admitted to our hospital. Diffusion-weighted magnetic resonance imaging of the brain showed a high intensity area in the frontal lobe. T2*-weighted images showed multiple spotty low intensity lesions in bilateral cerebral hemispheres, mimicking cerebral microbleeds. Cerebral angiography showed multiple aneurysms in the anterior, middle, posterior cerebral arteries and cerebellar arteries. Transthoracic echocardiography revealed a floating structure in the left atrial chamber, indicating cardiac myxoma. We diagnosed cardioembolic ischemic stroke due to left atrial myxoma. Cardiac surgery for excision of a left atrial myxoma was performed on the 3rd hospital day. Multiple aneurysms should be taken into account for differential diagnosis in patients with cardiac myxoma and with atypical spotty low intensity on T2*-weighted images. PMID:26797485

  3. Sequential assessment of regional cerebral blood flow, regional cerebral blood volume, and blood-brain barrier in focal cerebral ischemia: a case report

    SciTech Connect

    Di Piero, V.; Perani, D.; Savi, A.; Gerundini, P.; Lenzi, G.L.; Fazio, F.

    1986-06-01

    Regional CBF (rCBF) and regional cerebral blood volume (rCBV) were evaluated by N,N,N'-trimethyl-N'-(2)-hydroxy-3-methyl-5-(123I)iodobenzyl-1, 3-propanediamine-2 HCl- and /sup 99m/TC-labeled red blood cells, respectively, and single-photon emission computerized tomography (SPECT) in a patient with focal cerebral ischemia. Sequential transmission computerized tomography (TCT) and SPECT functional data were compared with clinical findings to monitor the pathophysiological events occurring in stroke. A lack of correlation between rCBF-rCBV distributions and blood-brain barrier (BBB) breakdown was found in the acute phase. In the face of more prolonged alteration of BBB, as seen by TCT enhancement, a rapid evolution of transient phenomena such as luxury perfusion was shown by SPECT studies. Follow-up of the patient demonstrated a correlation between the neurological recovery and a parallel relative improvement of the cerebral perfusion.

  4. Cerebral blood flow velocity underestimates cerebral blood flow during modest hypercapnia and hypocapnia.

    PubMed

    Coverdale, Nicole S; Gati, Joseph S; Opalevych, Oksana; Perrotta, Amanda; Shoemaker, J Kevin

    2014-11-15

    To establish the accuracy of transcranial Doppler ultrasound (TCD) measures of middle cerebral artery (MCA) cerebral blood flow velocity (CBFV) as a surrogate of cerebral blood flow (CBF) during hypercapnia (HC) and hypocapnia (HO), we examined whether the cross-sectional area (CSA) of the MCA changed during HC or HO and whether TCD-based estimates of CBFV were equivalent to estimates from phase contrast (PC) magnetic resonance imaging. MCA CSA was measured from 3T magnetic resonance images during baseline, HO (hyperventilation at 30 breaths/min), and HC (6% carbon dioxide). PC and TCD measures of CBFV were measured during these protocols on separate days. CSA and TCD CBFV were used to calculate CBF. During HC, CSA increased from 5.6 ± 0.8 to 6.5 ± 1.0 mm(2) (P < 0.001, n = 13), while end-tidal carbon dioxide partial pressure (PETCO2) increased from 37 ± 3 to 46 ± 5 Torr (P < 0.001). During HO, CSA decreased from 5.8 ± 0.9 to 5.3 ± 0.9 mm(2) (P < 0.001, n = 15), while PetCO2 decreased from 36 ± 4 to 23 ± 3 Torr (P < 0.001). CBFVs during baseline, HO, and HC were compared between PC and TCD, and the intraclass correlation coefficient was 0.83 (P < 0.001). The relative increase from baseline was 18 ± 8% greater (P < 0.001) for CBF than TCD CBFV during HC, and the relative decrease of CBF during HO was 7 ± 4% greater than the change in TCD CBFV (P < 0.001). These findings challenge the assumption that the CSA of the MCA does not change over modest changes in PETCO2. PMID:25012027

  5. Cerebral Venous Thrombosis in Paroxysmal Nocturnal Hemoglobinuria

    PubMed Central

    Meppiel, Elodie; Crassard, Isabelle; de Latour, Régis Peffault; de Guibert, Sophie; Terriou, Louis; Chabriat, Hugues; Socié, Gérard; Bousser, Marie-Germaine

    2015-01-01

    Abstract Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired disorder of hematopoietic stem cells characterized by hemolytic anemia, marrow failure, and a high incidence of life-threatening venous thrombosis. Cerebral venous system is the second most frequent location of thrombosis after hepatic veins. However, data about PNH-related cerebral venous thrombosis (CVT) are very scarce because of the rarity of both the disorders. We report a French study about PNH patients with CVT. Patients were recruited retrospectively, from the Société Française d’Hématologie (SFH) registry of 465 patients with PNH; the Lariboisière registry of 399 patients with CVT; and a direct contact with 26 French Hematology Units. We review cases reported since 1938 in the English and French language literature. We then compared patients of our series with cases from the literature, with non-PNH-related CVT cases from Lariboisière registry, and with PNH patients without CVT from SFH registry. Fifteen patients were included between 1990 and 2012. Most patients were women (12/15) and half of them presented associated hormonal venous thrombosis risk factors. Three patients had concomitant hepatic vein thrombosis. CVT was the first manifestation of PNH in 4 patients. No major difference in CVT characteristics was found compared with non-PNH-related CVT cases, except for a younger age at diagnosis in PNH patients (P < 0.001). All patients were treated with anticoagulation therapy. One death occurred in acute stage. All surviving patients were independent 1 year after. Median survival time was 9 years. Recurrent thrombosis rate was 50% at 6 years, occurring in patients that did not have bone marrow transplantation or eculizumab therapy. Cases of death were mainly related to hepatic vein thrombosis. Prognosis of CVT was good in our series. However, these patients have a poor long-term prognosis due to PNH disease by itself. PNH treatment should be proposed as soon as possible to

  6. Cerebral Hemodynamics and Vascular Reactivity in Mild and Severe Ischemic Rodent Middle Cerebral Artery Occlusion Stroke Models

    PubMed Central

    Sim, Jeongeun; Jo, Areum; Kang, Bok-Man; Lee, Sohee; Bang, Oh Young; Heo, Chaejeong; Jhon, Gil-Ja; Lee, Youngmi

    2016-01-01

    Ischemia can cause decreased cerebral neurovascular coupling, leading to a failure in the autoregulation of cerebral blood flow. This study aims to investigate the effect of varying degrees of ischemia on cerebral hemodynamic reactivity using in vivo real-time optical imaging. We utilized direct cortical stimulation to elicit hyper-excitable neuronal activation, which leads to induced hemodynamic changes in both the normal and middle cerebral artery occlusion (MCAO) ischemic stroke groups. Hemodynamic measurements from optical imaging accurately predict the severity of occlusion in mild and severe MCAO animals. There is neither an increase in cerebral blood volume nor in vessel reactivity in the ipsilateral hemisphere (I.H) of animals with severe MCAO. The pial artery in the contralateral hemisphere (C.H) of the severe MCAO group reacted more slowly than both hemispheres in the normal and mild MCAO groups. In addition, the arterial reactivity of the I.H in the mild MCAO animals was faster than the normal animals. Furthermore, artery reactivity is tightly correlated with histological and behavioral results in the MCAO ischemic group. Thus, in vivo optical imaging may offer a simple and useful tool to assess the degree of ischemia and to understand how cerebral hemodynamics and vascular reactivity are affected by ischemia. PMID:27358581

  7. Dietary cholesterol protects against alcohol-induced cerebral artery constriction

    PubMed Central

    Bukiya, Anna; Dopico, Alex; Leffler, Charles; Fedinec, Alexander

    2014-01-01

    Background Binge drinking represents the major form of excessive alcohol (EtOH) consumption in the US. Episodic (such as binge) drinking results in blood alcohol levels (BAL) of 18–80 mM, and leads to alcohol-induced cerebral artery constriction (AICAC). AICAC was shown to arise from EtOH-induced inhibition of large-conductance, calcium/voltage-gated potassium (BK) channels in the vascular smooth muscle. Factors that modulate BK channel-mediated AICAC remain largely unknown. Methods Male Sprague-Dawley rats were placed on high-cholesterol (2% of cholesterol) diet for 18–23 weeks. Their littermates were placed on control iso-caloric diet. AICAC was evaluated both in vivo and in vitro, by means of pial arteriole diameter monitoring through a closed cranial window and diameter measurements of isolated, pressurized cerebral arteries. Cholesterol level in the cerebral artery tissue was manipulated by methyl-β-cyclodextrin to reverse dietary-induced accumulation of cholesterol. BK channel surface presence on the plasma membrane of cerebral artery myocytes was evaluated by immunofluorescence staining. BK channel function in pressurized cerebral artery was assessed using selective BK channel blocker paxilline. Results Within 5 minutes of 50 mM EtOH injection into carotid artery in vivo, arteriole diameter decreased by 20% in control group. Pial arteriole constriction was significantly reduced in rats on high-cholesterol diet, resulting in only 10% reduction of diameter. BAL in both groups, however, remained the same. Significant reduction of AICAC in group on high-cholesterol diet compared to control was also observed after middle cerebral artery dissection and in vitro pressurization at 60 mmHg, this reduction remaining after endothelium removal. Cholesterol level in de-endothelialized cerebral arteries was significantly increased in rats on high-cholesterol diet. Removal of excessive cholesterol content restored AICAC to the level, observed in cerebral arteries of

  8. Hypertension and Cerebral Hemorrhage: A Malpractice Controversy

    PubMed Central

    Franklin, Stanley S.; Hunt, Marshall T.; Vogt, Thomas; Walsh, Gregory; Paglia, Donald E.

    1980-01-01

    The plaintiff alleged that failure of the attending physician to manage her husband's hypertension properly resulted in his death from intracerebral hemorrhage. Four lines of evidence supported the defendant: (1) In 1970 to 1971 there was uncertainty in the medical community whether mild hypertension should be treated with drugs; this uncertainty still existed at the time of the trial. (2) Severe hypertension and advanced age are the two most important predisposing factors leading to intracerebral hemorrhage; the deceased patient had neither. (3) Hemorrhage into the cerebral cortex and underlying white matter is not typical of hypertensive intracerebral bleeding; more likely, rupture of an arteriovenous malformation occurred. (4) A diagnosis of hypertensive intracerebral hemorrhage is not one of exclusion but requires objective evidence of vascular change in the brain, heart and kidney; these changes were not found in the deceased patient. In conclusion, an expert witness should testify objectively rather than be the advocate of a lawyer's theory of liability. ImagesFig. 6.Fig. 7.Fig. 9.Fig. 10. PMID:7233893

  9. Comparative aspects of cerebral cortical development

    PubMed Central

    Molnár, Zoltán; Métin, Christine; Stoykova, Anastassia; Tarabykin, Victor; Price, David J.; Francis, Fiona; Meyer, Gundela; Dehay, Colette; Kennedy, Henry

    2006-01-01

    This review intends to provide examples how comparative and genetic analyses both contribute to our understanding of the rules for cortical development and evolution. Genetic studies helped to understand evolutionary rules of telencephalic organization in vertebrates. The control of the establishment of conserved telencephalic subdivisions and the formation of boundaries between these subdivisions has been examined and revealed the very specific alterations at the striatocortical junction. Comparative studies and genetic analyses both demonstrated the differential origin and migratory pattern of the two basic neuron types of the cerebral cortex. GABAergic interneurons are mostly generated in the subpallium and a common mechanisms govern their migration to the dorsal cortex in both mammals and sauropsids. The pyramidal neurons are generated within the cortical germinal zone and migrate radially. The earliest generated cell layers comprising preplate cells. Reelin positive Cajal-Retzius cells are a general feature of all vertebrates studied so far, however, there is a considerable amplification of the reelin signaling, which might have contributed to the establishment of the basic mammalian pattern of cortical development. Based on numerous recent observations we shall present an argument that specialization of the mitotic compartments might constitute a major drive behind the evolution of the mammalian cortex. Comparative developmental studies revealed distinct features in the early compartments of the developing macaque brain drawing our attention to the limitations of some of the current model systems for understanding human developmental abnormalities of the cortex. Comparative and genetic aspects of cortical development both reveal the workings of evolution. PMID:16519657

  10. Gait stability in children with cerebral palsy

    PubMed Central

    Bruijn, Sjoerd M.; Millard, Matthew; van Gestel, Leen; Meyns, Pieter; Jonkers, Ilse; Desloovere, Kaat

    2013-01-01

    Children with unilateral Cerebral Palsy (CP) have several gait impairments, amongst which impaired gait stability may be one. We tested whether a newly developed stability measure (the foot placement estimator, FPE) which does not require long data series, can be used to asses gait stability in typically developing (TD) children as well as children with CP. In doing so, we tested the FPE’s sensitivity to the assumptions needed to calculate this measure, as well as the ability of the FPE to detect differences in stability between children with CP and TD children, and differences in walking speed. Participants were asked to walk at two different speeds, while gait kinematics were recorded. From these data, the FPE, as well as the error that violations of assumptions of the FPE could have caused were calculated. The results showed that children with CP walked with marked instabilities in anterior-posterior and mediolateral directions. Furthermore, errors caused by violations of assumptions in calculation of FPE were only small (~1.5 cm), while effects of walking speed (~20 cm per m/s increase in walking speed) and group (~5cm) were much larger. These results suggest that the FPE may be used to quantify gait stability in TD children and children with CP. PMID:23500163

  11. Fatal Hemorrhage in Cerebral Proliferative Angiopathy

    PubMed Central

    Maekawa, H.; Tanaka, M.; Hadeishi, H.

    2012-01-01

    Summary Cerebral proliferative angiopathy (CPA) is a rare vascular abnormality with several angiomorphological features that are distinct from brain arteriovenous malformations (AVMs). The natural history of CPAs indicates a lower risk for hemorrhage compared to brain AVMs. A 62-year-old woman presented with gait instability and dysarthria. MRI and angiography revealed a diffuse vascular network involving the tectum and cerebellar vermis with intermingled brain parenchyma. This lesion had no dominant feeder, high-flow arteriovenous shunt, flow-related aneurysm or highly dilated veins on angiogram. These findings were consistent with a diagnosis of CPA. During follow-up, she developed progressive gait instability and eye movement abnormalities, but no remarkable change was detected on the repeated MRI and angiography. Nine years later, she died of mesencephalic hemorrhage originating from the CPA. To the best of our knowledge, this is the first description of a patient with CPA who died as a result of the initial hemorrhage. It is important to recognize that a part of CPAs is aggressive and can be more vulnerable to critical hemorrhage. PMID:22958770

  12. Potential of immunosuppressive agents in cerebral ischaemia

    PubMed Central

    Gupta, Yogendra Kumar; Chauhan, Anjali

    2011-01-01

    Ischaemic stroke is a disorder involving multiple mechanisms of injury progression including activation of glutamate receptors, release of proinflammatory cytokines, nitric oxide (NO), free oxygen radicals and proteases. Presently, recombinant tissue plasminogen activator (rtPA) is the only drug approved for the management of acute ischaemic stroke. This drug, however, is associated with limitations like narrow therapeutic window and increased risk of intracranial haemorrhage. A large number of therapeutic agents have been tested including N-methly-D-aspartate (NMDA) receptor antagonist, calcium channel blockers and antioxidants for management of stroke, but none has provided significant neuroprotection in clinical trials. Therefore, searching for other potentially effective drugs for ischaemic stroke management becomes important. Immunosuppressive agents with their wide array of mechanisms have potential as neuroprotectants. Corticosteroids, immunophilin ligands, mycophenolate mofetil and minocycline have shown protective effect on neurons by their direct actions or attenuating toxic effects of mediators of inflammation. This review focuses on the current status of corticosteroids, cyclosporine A, FK506, rapamycin, mycophenolate mofetil and minocycline in the experimental models of cerebral ischaemia. PMID:21321416

  13. Correlation of cerebral cortical morphology with behavior

    SciTech Connect

    Norton, S.

    1989-03-01

    Association between functional damage and damage to the central nervous system from toxic agents can be used to determine the value of behavioral tests as predictors of damage to the nervous system. Variability in data from behavioral tests may be caused, in part, by varying levels of structural differences in the nervous system. Stepwise multiple regression is one method for analyzing the relationship between variability in data resulting from linkage between functional and morphological or other parameters of the structure of the nervous system. As an example, the predictive value of four behavioral tests is assessed in detecting thinning of the cerebral cortex following gestational exposure of rats to ionizing radiation. In this analysis, there were seven independent variables for predicting cortical thickness. The sequence of number of times each variable was used in prediction, from most frequent to least frequent, was: angle of stride greater than negative geotaxis greater than continuous corridor greater than body weight greater than width of stride greater than length of stride greater than reflex suspension. The data support the concept that there are varying degrees of predictive associations between these functional and cortical parameters.

  14. Multiple sphingolipid abnormalities following cerebral microendothelial hypoxia

    PubMed Central

    Testai, Fernando D.; Kilkus, John P.; Berdyshev, Evgeny; Gorshkova, Irina; Natarajan, Viswanathan; Dawson, Glyn

    2015-01-01

    Hypoxia has been previously shown to inhibit the dihydroceramide (DHC) desaturase, leading to the accumulation of DHC. In this study, we used metabolic labeling with [3H]-palmitate, HPLC/MS/MS analysis, and specific inhibitors to show numerous sphingolipid changes after oxygen deprivation in cerebral microendothelial cells. The increased DHC, particularly long-chain forms, was observed in both whole cells and detergent-resistant membranes. This was reversed by reoxygenation and blocked by the de novo sphingolipid synthesis inhibitor myriocin, but not by the neutral sphingomyelinase inhibitor GW-4869. Furthermore, oxygen deprivation of microendothelial cells increased levels of dihydro-sphingosine (DH-Sph), DH-sphingosine1-phosphate (DH-S1P), DH-sphingomyelin (DH-SM), DH-glucosylceramide (DH-GlcCer), and S1P levels. In vitro assays revealed no changes in the activity of sphingomyelinases or sphingomyelin synthase, but resulted in reduced S1P lyase activity and 40% increase in glucosylceramide synthase (GCS) activity, which was reversed by reoxygenation. Inhibition of the de novo sphingolipid pathway (myriocin) or GCS (EtPoD4) induced endothelial barrier dysfunction and increased caspase 3-mediated cell death in response to hypoxia. Our findings suggest that hypoxia induces synthesis of S1P and multiple dihydrosphingolipids, including DHC, DH-SM, DH-GlcCer, DH-Sph and DH-S1P, which may be involved in ameliorating the effects of stroke. PMID:25060904

  15. Physical Factors Effecting Cerebral Aneurysm Pathophysiology

    PubMed Central

    Sadasivan, Chander; Fiorella, David J.; Woo, Henry H.; Lieber, Baruch B.

    2013-01-01

    Many factors that are either blood-, wall-, or hemodynamics-borne have been associated with the initiation, growth, and rupture of intracranial aneurysms. The distribution of cerebral aneurysms around the bifurcations of the circle of Willis has provided the impetus for numerous studies trying to link hemodynamic factors (flow impingement, pressure, and/or wall shear stress) to aneurysm pathophysiology. The focus of this review is to provide a broad overview of such hemodynamic associations as well as the subsumed aspects of vascular anatomy and wall structure. Hemodynamic factors seem to be correlated to the distribution of aneurysms on the intracranial arterial tree and complex, slow flow patterns seem to be associated with aneurysm growth and rupture. However, both the prevalence of aneurysms in the general population and the incidence of ruptures in the aneurysm population are extremely low. This suggests that hemodynamic factors and purely mechanical explanations by themselves may serve as necessary, but never as necessary and sufficient conditions of this disease’s causation. The ultimate cause is not yet known, but it is likely an additive or multiplicative effect of a handful of biochemical and biomechanical factors. PMID:23549899

  16. Cerebral microbleed segmentation from susceptibility weighted images

    NASA Astrophysics Data System (ADS)

    Roy, Snehashis; Jog, Amod; Magrath, Elizabeth; Butman, John A.; Pham, Dzung L.

    2015-03-01

    Cerebral microbleeds (CMB) are a common marker of traumatic brain injury. Accurate detection and quantification of the CMBs are important for better understanding the progression and prognosis of the injury. Previous microbleed detection methods have suffered from a high rate of false positives, which is time consuming to manually correct. In this paper, we propose a fully automatic, example-based method to segment CMBs from susceptibility-weighted (SWI) scans, where examples from an already segmented template SWI image are used to detect CMBs in a new image. First, multiple radial symmetry transforms (RST) are performed on the template SWI to detect small ellipsoidal structures, which serve as potential microbleed candidates. Then 3D patches from the SWI and its RSTs are combined to form a feature vector at each voxel of the image. A random forest regression is trained using the feature vectors, where the dependent variable is the binary segmentation voxel of the template. Once the regression is learnt, it is applied to a new SWI scan, whose feature vectors contain patches from SWI and its RSTs. Experiments on 26 subjects with mild to severe brain injury show a CMB detection sensitivity of 85:7%, specificity 99:5%, and a false positive to true positive ratio of 1:73, which is competitive with published methods while providing a significant reduction in computation time.

  17. The human cerebral cortex flattens during adolescence.

    PubMed

    Alemán-Gómez, Yasser; Janssen, Joost; Schnack, Hugo; Balaban, Evan; Pina-Camacho, Laura; Alfaro-Almagro, Fidel; Castro-Fornieles, Josefina; Otero, Soraya; Baeza, Immaculada; Moreno, Dolores; Bargalló, Nuria; Parellada, Mara; Arango, Celso; Desco, Manuel

    2013-09-18

    The human cerebral cortex appears to shrink during adolescence. To delineate the dynamic morphological changes involved in this process, 52 healthy male and female adolescents (11-17 years old) were neuroimaged twice using magnetic resonance imaging, approximately 2 years apart. Using a novel morphometric analysis procedure combining the FreeSurfer and BrainVisa image software suites, we quantified global and lobar change in cortical thickness, outer surface area, the gyrification index, the average Euclidean distance between opposing sides of the white matter surface (gyral white matter thickness), the convex ("exposed") part of the outer cortical surface (hull surface area), sulcal length, depth, and width. We found that the cortical surface flattens during adolescence. Flattening was strongest in the frontal and occipital cortices, in which significant sulcal widening and decreased sulcal depth co-occurred. Globally, sulcal widening was associated with cortical thinning and, for the frontal cortex, with loss of surface area. For the other cortical lobes, thinning was related to gyral white matter expansion. The overall flattening of the macrostructural three-dimensional architecture of the human cortex during adolescence thus involves changes in gray matter and effects of the maturation of white matter. PMID:24048830

  18. Immune mechanisms in cerebral ischemic tolerance

    PubMed Central

    Garcia-Bonilla, Lidia; Benakis, Corinne; Moore, Jamie; Iadecola, Costantino; Anrather, Josef

    2014-01-01

    Stressor-induced tolerance is a central mechanism in the response of bacteria, plants, and animals to potentially harmful environmental challenges. This response is characterized by immediate changes in cellular metabolism and by the delayed transcriptional activation or inhibition of genetic programs that are not generally stressor specific (cross-tolerance). These programs are aimed at countering the deleterious effects of the stressor. While induction of this response (preconditioning) can be established at the cellular level, activation of systemic networks is essential for the protection to occur throughout the organs of the body. This is best signified by the phenomenon of remote ischemic preconditioning, whereby application of ischemic stress to one tissue or organ induces ischemic tolerance (IT) in remote organs through humoral, cellular and neural signaling. The immune system is an essential component in cerebral IT acting simultaneously both as mediator and target. This dichotomy is based on the fact that activation of inflammatory pathways is necessary to establish IT and that IT can be, in part, attributed to a subdued immune activation after index ischemia. Here we describe the components of the immune system required for induction of IT and review the mechanisms by which a reprogrammed immune response contributes to the neuroprotection observed after preconditioning. Learning how local and systemic immune factors participate in endogenous neuroprotection could lead to the development of new stroke therapies. PMID:24624056

  19. Rehabilitation outcomes of children with cerebral palsy.

    PubMed

    Yalcinkaya, Ebru Yilmaz; Caglar, Nil Sayıner; Tugcu, Betul; Tonbaklar, Aysegul

    2014-02-01

    [Purpose] To evaluate the results of Bobath-based rehabilitation performed at a pediatric cerebral palsy (CP) inpatient clinic. [Subjects and Methods] The study subjects were 28 children with CP who were inpatients at a pediatric service. Inclusion criteria were: being an inpatient of our hospital aged 2-12 with a diagnosis of CP; having one permanent primary caregiver; and the caregiver having no medical or psychotic problems. All of the patients received Bobath treatment for 1 hour per day, 5 days a week. The locomotor system, neurologic and orthopedic examination, Gross Motor Function Measure (GMFM) of the patients, and Short Form-36 (SF-36) of permanent caregivers were evaluated at the time of admission to hospital, discharge from hospital, and at 1 and 3 months after discharge. [Results] Post-admission scores of GMFM at discharge, and 1 and 3 months later showed significant increase. Social function and emotional role subscores of SF-36 had increased significantly at discharge. [Conclusion] Bobath treatment is promising and randomized controlled further studies are needed for rehabilitation technics. PMID:24648650

  20. Complications of cerebral vein and sinus thrombosis.

    PubMed

    Ferro, José M; Canhâo, P

    2008-01-01

    Thrombosis of the dural sinus and encephalic veins (CVT) is an infrequent condition accounting for less than 1% of all strokes. Several recent prospective series, in particular the large International Study on Cerebral Vein and Dural Sinus Thrombosis cohort, definitely have shown a more benign prognosis compared with that of arterial strokes: CVT has an acute case fatality of less than 5%, and almost 80% of patients recover without sequelae. However, patients surviving the acute phase of CVT are at risk of a number of complications such as recurrence of any thrombotic events in about 7%, recurrence of CVT in about 2-12%, seizures in 5 to 32%, visual loss due to optic atrophy in percentages that range from less than 1 to 5%, presence of dural fistula (there are no data available about exact frequency) and neuropsychological and neuropsychiatric sequelae characterized by aphasia, abulia and depression. However, there is only little information on the long-term neuropsychological outcome. Studies investigating professional status, cognitive performance, depressive symptoms and quality of life evidenced depression and anxiety in 2/3 of CVT patients despite an apparent good recovery in 87% of these patients. Thus, patients should be encouraged to return to previous occupations and hobbies and reassured about the very low risk of recurrence. PMID:18004061

  1. Ophthalmologic identification of cerebral malaria in adults

    PubMed Central

    Pedrosa, Catarina Areias; Santos, Cristina; Coutinho, Inês; Lisboa, Maria; Teixeira, Susana; Silva, Filomena; Pires, Graça; Prieto, Isabel

    2015-01-01

    Objective: To report the clinical presentation of malarial retinopathy in an adult, emphasizing the importance of this diagnosis for the clinical suspicion and prognosis of cerebral malaria. Methods: A 39-year-old caucasian man presented with hemolytic anemia, thrombocytopenia, acidemia and acute renal failure, developing severe encephalopathy. The diagnosis of Plasmodium falciparum malaria was done and after systemic stabilization, the patient noticed a central scotoma in the left eye. Ophthalmological examination revealed retinal features of malarial retinopathy. Results: At one-month follow-up, the patient had improved his systemic condition and the left eye scotoma had disappeared. Visual acuity was 20/20 in both eyes and on examination almost all lesions had regressed. Conclusion: Malarial retinopathy is a diagnostic factor and a prognosis indicator of severe P. falciparum infection, usually with brain involvement. The knowledge of the ophthalmological features associated with severe malaria, which is more frequent in children but can also occur in adults, becomes imperative in order to reduce the risk of neurologic sequelae and associated mortality.

  2. Multiple molecular penumbras after focal cerebral ischemia.

    PubMed

    Sharp, F R; Lu, A; Tang, Y; Millhorn, D E

    2000-07-01

    Though the ischemic penumbra has been classically described on the basis of blood flow and physiologic parameters, a variety of ischemic penumbras can be described in molecular terms. Apoptosis-related genes induced after focal ischemia may contribute to cell death in the core and the selective cell death adjacent to an infarct. The HSP70 heat shock protein is induced in glia at the edges of an infarct and in neurons often at some distance from the infarct. HSP70 proteins are induced in cells in response to denatured proteins that occur as a result of temporary energy failure. Hypoxia-inducible factor (HIF) is also induced after focal ischemia in regions that can extend beyond the HSP70 induction. The region of HIF induction is proposed to represent the areas of decreased cerebral blood flow and decreased oxygen delivery. Immediate early genes are induced in cortex, hippocampus, thalamus, and other brain regions. These distant changes in gene expression occur because of ischemia-induced spreading depression or depolarization and could contribute to plastic changes in brain after stroke. PMID:10908035

  3. Rehabilitation Outcomes of Children with Cerebral Palsy

    PubMed Central

    Yalcinkaya, Ebru Yilmaz; Caglar, Nil Sayıner; Tugcu, Betul; Tonbaklar, Aysegul

    2014-01-01

    [Purpose] To evaluate the results of Bobath-based rehabilitation performed at a pediatric cerebral palsy (CP) inpatient clinic. [Subjects and Methods] The study subjects were 28 children with CP who were inpatients at a pediatric service. Inclusion criteria were: being an inpatient of our hospital aged 2–12 with a diagnosis of CP; having one permanent primary caregiver; and the caregiver having no medical or psychotic problems. All of the patients received Bobath treatment for 1 hour per day, 5 days a week. The locomotor system, neurologic and orthopedic examination, Gross Motor Function Measure (GMFM) of the patients, and Short Form-36 (SF-36) of permanent caregivers were evaluated at the time of admission to hospital, discharge from hospital, and at 1 and 3 months after discharge. [Results] Post-admission scores of GMFM at discharge, and 1 and 3 months later showed significant increase. Social function and emotional role subscores of SF-36 had increased significantly at discharge. [Conclusion] Bobath treatment is promising and randomized controlled further studies are needed for rehabilitation technics. PMID:24648650

  4. Cerebral blood flow tomography with xenon-133

    SciTech Connect

    Lassen, N.A.

    1985-10-01

    Cerebral blood flow (CBF) can be measured tomographically by inhalation of Xenon-/sup 133/. The calculation is based on taking a sequence of tomograms during the wash-in and wash-out phase of the tracer. Due to the dynamic nature of the process, a highly sensitive and fast moving single photon emission computed tomograph (SPECT) is required. Two brain-dedicated SPECT systems designed for this purpose are mentioned, and the method is described with special reference to the limitations inherent in the soft energy of the 133Xe primary photons. CBF tomography can be used for a multitude of clinical and investigative purposes. This article discusses in particular its use for the selection of patients with carotid occlusion for extracranial/intracranial bypass surgery, for detection of severe arterial spasm after aneurysm bleeding, and for detection of low flow areas during severe migraine attacks. The use of other tracers for CBF tomography using SPECT is summarized with emphasis on the /sup 99m/Tc chelates that freely pass the intact blood-brain barrier. The highly sensitive brain-dedicated SPECT systems described are a prerequisite for achieving high resolution tomograms with such tracers.

  5. Is Vasomotion in Cerebral Arteries Impaired in Alzheimer's Disease?

    PubMed

    Di Marco, Luigi Yuri; Farkas, Eszter; Martin, Chris; Venneri, Annalena; Frangi, Alejandro F

    2015-01-01

    A substantial body of evidence supports the hypothesis of a vascular component in the pathogenesis of Alzheimer's disease (AD). Cerebral hypoperfusion and blood-brain barrier dysfunction have been indicated as key elements of this pathway. Cerebral amyloid angiopathy (CAA) is a cerebrovascular disorder, frequent in AD, characterized by the accumulation of amyloid-β (Aβ) peptide in cerebral blood vessel walls. CAA is associated with loss of vascular integrity, resulting in impaired regulation of cerebral circulation, and increased susceptibility to cerebral ischemia, microhemorrhages, and white matter damage. Vasomotion- the spontaneous rhythmic modulation of arterial diameter, typically observed in arteries/arterioles in various vascular beds including the brain- is thought to participate in tissue perfusion and oxygen delivery regulation. Vasomotion is impaired in adverse conditions such as hypoperfusion and hypoxia. The perivascular and glymphatic pathways of Aβ clearance are thought to be driven by the systolic pulse. Vasomotion produces diameter changes of comparable amplitude, however at lower rates, and could contribute to these mechanisms of Aβ clearance. In spite of potential clinical interest, studies addressing cerebral vasomotion in the context of AD/CAA are limited. This study reviews the current literature on vasomotion, and hypothesizes potential paths implicating impaired cerebral vasomotion in AD/CAA. Aβ and oxidative stress cause vascular tone dysregulation through direct effects on vascular cells, and indirect effects mediated by impaired neurovascular coupling. Vascular tone dysregulation is further aggravated by cholinergic deficit and results in depressed cerebrovascular reactivity and (possibly) impaired vasomotion, aggravating regional hypoperfusion and promoting further Aβ and oxidative stress accumulation. PMID:25720414

  6. [Large distal anterior cerebral artery aneurysm associated with azygos anterior cerebral artery: case report].

    PubMed

    Suzuki, Y; Kawamata, T; Matsumoto, H; Kunii, N; Matsumoto, K

    1998-10-01

    A 51-year-old woman presented with a distal anterior cerebral artery aneurysm (DACAA) manifesting as severe headache and monoparesis of the left lower limb. Computed tomography revealed subarachnoid hemorrhage in the interhemispheric fissure, bilateral sylvian fissures, and basal cistern, and a hematoma in the supracallosal region. Angiography showed a large aneurysm (23 x 18 mm) located on the distal end of the azygos anterior cerebral artery (azygos ACA) at the supracallosal portion. T2-weighted magnetic resonance imaging demonstrated the hematoma as a mixed intensity mass, compressing the corpus callosum downward, and the aneurysm as a flow void anterior to the hematoma. Unilateral frontoparietal parasagittal craniotomy was performed with a horse-shoe shaped incision. The aneurysm was clipped via the interhemispheric approach, and the hematoma was aspirated. Postoperative angiography showed disappearance of the aneurysm and intact azygos ACA. The patient was discharged with mild monoparesis, paresthesia of the left lower limb and diagnostic dyspraxia. DACAA almost always arises at or near the genu of the corpus callosum and is often associated with vascular anomaly. In the literature, 22 of 26 cases of large and giant DACAA were located at or near the genu, but only 3 cases, including ours, in the supracallosal area. 11 cases were associated with azygos ACA. Therefore, hemodynamic stress caused by vascular anomaly may be involved in the formation of large or giant DACAA in contrast with cases of normal DACAA. PMID:9789300

  7. Clinical Neuropathological Analysis of 10 Cases of Cerebral Amyloid Angiopathy-Related Cerebral Lobar Hemorrhage

    PubMed Central

    Su, Dong-Feng; Chen, Hui-Sheng; Fang, Qu

    2015-01-01

    Objective The clinical and pathological characteristics of 10 cases of cerebral amyloid angiopathy (CAA)-related cerebral lobar hemorrhage (CLH) that was diagnosed at autopsy were investigated to facilitate the diagnosis of this condition. Methods The clinical characteristics of 10 cases of CAA-related CLH were retrospectively reviewed, and a neuropathological examination was performed on autopsy samples. Results The 10 cases included two with a single lobar hemorrhage and eight with multifocal lobar hemorrhages. In all of the cases, the hemorrhage bled into the subarachnoid space. Pathological examinations of the 10 cases revealed microaneurysms in two, double barrel-like changes in four, multifocal arteriolar clusters in five, obliterative onion skin-like intimal changes in four, fibrinoid necrosis of the vessels in seven, neurofibrillary tangles in eight, and senile plaques in five cases. Conclusion CAA-related CLHs were located primarily in the parietal, temporal, and occipital lobes. These hemorrhages normally consisted of multiple repeated CLHs that frequently bled into the subarachnoid space. CAA-associated microvascular lesions may be the pathological factor underlying CLH. PMID:26279810

  8. Evaluating CT Perfusion Deficits in Global Cerebral Edema after Aneurysmal Subarachnoid Hemorrhage

    PubMed Central

    Baradaran, H.; Fodera, V.; Mir, D.; Kesavobhotla, K.; Ivanidze, J.; Ozbek, U.; Gupta, A.; Claassen, J.; Sanelli, P.C.

    2015-01-01

    BACKGROUND AND PURPOSE Global cerebral edema is an independent predictor of mortality and poor outcomes after aneurysmal SAH. Global cerebral edema, a complex disease process, is thought to be associated with an altered cerebral autoregulatory response. We studied the association between cerebral hemodynamics and early global cerebral edema by using CTP. MATERIALS AND METHODS We retrospectively studied consecutive patients with aneurysmal SAH with admission CTP performed at days 0–3. Two neuroradiologists classified global cerebral edema and hydrocephalus on NCCT performed concurrently with CTP. Global cerebral edema was defined as diffuse effacement of the sulci and/or basal cisterns or diffuse disruption of the cerebral gray-white matter junction. CTP was postprocessed into CBF and MTT maps by using a standardized method. Quantitative analysis of CTP was performed by using standard protocol with ROI sampling of the cerebral cortex. The Fisher exact test, Mann-Whitney test, and independent-samples t test were used to determine statistical associations. RESULTS Of the 45 patients included, 42% (19/45) had global cerebral edema and 58% (26/45) did not. Patient groups with and without global cerebral edema were well-matched for demographic and clinical data. Patients with global cerebral edema were more likely to have qualitative global CTP deficits than those without global cerebral edema (P = .001) with an OR = 13.3 (95% CI, 2.09–138.63). Patients with global cerebral edema also had a very strong trend toward statistical significance, with reduced quantitative CBF compared with patients without global cerebral edema (P = .064). CONCLUSIONS Global perfusion deficits are significantly associated with global cerebral edema in the early phase after aneurysmal SAH, supporting the theory that hemodynamic disturbances occur in global cerebral edema. PMID:25977478

  9. Cerebral Hyperperfusion after Revascularization Inhibits Development of Cerebral Ischemic Lesions Due to Artery-to-Artery Emboli during Carotid Exposure in Endarterectomy for Patients with Preoperative Cerebral Hemodynamic Insufficiency: Revisiting the “Impaired Clearance of Emboli” Concept

    PubMed Central

    Fujimoto, Kentaro; Matsumoto, Yoshiyasu; Oikawa, Kohki; Nomura, Jun-ichi; Shimada, Yasuyoshi; Fujiwara, Shunrou; Terasaki, Kazunori; Kobayashi, Masakazu; Yoshida, Kenji; Ogasawara, Kuniaki

    2016-01-01

    The purpose of the present study was to determine whether cerebral hyperperfusion after revascularization inhibits development of cerebral ischemic lesions due to artery-to-artery emboli during exposure of the carotid arteries in carotid endarterectomy (CEA). In patients undergoing CEA for internal carotid artery stenosis (≥70%), cerebral blood flow (CBF) was measured using single-photon emission computed tomography (SPECT) before and immediately after CEA. Microembolic signals (MES) were identified using transcranial Doppler during carotid exposure. Diffusion-weighted magnetic resonance imaging (DWI) was performed within 24 h after surgery. Of 32 patients with a combination of reduced cerebrovascular reactivity to acetazolamide on preoperative brain perfusion SPECT and MES during carotid exposure, 14 (44%) showed cerebral hyperperfusion (defined as postoperative CBF increase ≥100% compared with preoperative values), and 16 (50%) developed DWI-characterized postoperative cerebral ischemic lesions. Postoperative cerebral hyperperfusion was significantly associated with the absence of DWI-characterized postoperative cerebral ischemic lesions (95% confidence interval, 0.001–0.179; p = 0.0009). These data suggest that cerebral hyperperfusion after revascularization inhibits development of cerebral ischemic lesions due to artery-to-artery emboli during carotid exposure in CEA, supporting the “impaired clearance of emboli” concept. Blood pressure elevation following carotid declamping would be effective when embolism not accompanied by cerebral hyperperfusion occurs during CEA. PMID:27527146

  10. Focal cerebral ischaemia in the rat: 2. Regional cerebral blood flow determined by (14C)iodoantipyrine autoradiography following middle cerebral artery occlusion

    SciTech Connect

    Tamura, A.; Graham, D.I.; McCulloch, J.; Teasdale, G.M.

    1981-01-01

    Local cerebral blood flow has been measured by quantitative autoradiography, employing (14C)iodoantipyrine as tracer, in rats killed half an hour after occlusion of the middle cerebral artery. The results were compared with pattern of local cerebral blood flow (CBF) in sham-operated rats and with neuropathological findings. In every animal there was a profound reduction (to 13% of control levels)in blood flow in the neocortex previously by the occluded artery. The level of blood flow in the areas in which ischaemic brain damage occurred was 0.24 +/- 0.03 ml g-1 min-1 (mean +/- SEM). this level of CBF is considerably greater than that reported following a similar surgical procedure in cats and primates. Moderate reductions in blood flow were also seen outside the territory of the occluded artery and in parts of the opposite hemisphere. Absolute increases in blood flow (hyperaemia) were seen only in the substantia nigra and globus pallidus ipsilateral to the occlusion. It is of the middle cerebral artery are reflections of alterations in neuronal function and metabolic activity secondary to the ischaemic lesion.

  11. Abnormal cerebral vasodilation in aneurysmal subarachnoid hemorrhage: use of serial 133Xe cerebral blood flow measurement plus acetazolamide to assess cerebral vasospasm.

    PubMed

    Tran Dinh, Y R; Lot, G; Benrabah, R; Baroudy, O; Cophignon, J; Seylaz, J

    1993-10-01

    A patient with cerebral vasospasm following subarachnoid hemorrhage (SAH) was investigated by serial measurement of cerebral blood flow (CBF) using the xenon-133 emission tomography method. The CBF was measured before and after acetazolamide injection. On Day 2 after SAH, there was early local hyperperfusion in the middle cerebral artery (MCA) territory, ipsilateral to the left posterior communicating artery aneurysm. The regional CBF of this arterial territory decreased slightly after acetazolamide injection, probably because of vasoplegia and the "steal" phenomenon, and thus surgery was delayed. A right hemiplegia with aphasia and disturbed consciousness occurred 4 days later (on Day 6 after SAH) due to arterial vasospasm, despite treatment with a calcium-channel blocker. The initial hyperemia of the left MCA territory was followed by ischemia. The vasodilation induced by acetazolamide administration was significantly subnormal until Day 13, at which time CBF and vasoreactivity amplitude returned to normal and the patient's clinical condition improved. Surgery on Day 14 and outcome were without complication. It is concluded that serial CBF measurements plus acetazolamide injection are useful for monitoring the development of cerebral vasospasm to determine the most appropriate time for aneurysm surgery. PMID:8410215

  12. Cerebral versus systemic hemodynamics during graded orthostatic stress in humans

    NASA Technical Reports Server (NTRS)

    Levine, B. D.; Giller, C. A.; Lane, L. D.; Buckey, J. C.; Blomqvist, C. G.

    1994-01-01

    BACKGROUND: Orthostatic syncope is usually attributed to cerebral hypoperfusion secondary to systemic hemodynamic collapse. Recent research in patients with neurocardiogenic syncope has suggested that cerebral vasoconstriction may occur during orthostatic hypotension, compromising cerebral autoregulation and possibly contributing to the loss of consciousness. However, the regulation of cerebral blood flow (CBF) in such patients may be quite different from that of healthy individuals, particularly when assessed during the rapidly changing hemodynamic conditions associated with neurocardiogenic syncope. To be able to interpret the pathophysiological significance of these observations, a clear understanding of the normal responses of the cerebral circulation to orthostatic stress must be obtained, particularly in the context of the known changes in systemic and regional distributions of blood flow and vascular resistance during orthostasis. Therefore, the specific aim of this study was to examine the changes that occur in the cerebral circulation during graded reductions in central blood volume in the absence of systemic hypotension in healthy humans. We hypothesized that cerebral vasoconstriction would occur and CBF would decrease due to activation of the sympathetic nervous system. We further hypothesized, however, that the magnitude of this change would be small compared with changes in systemic or skeletal muscle vascular resistance in healthy subjects with intact autoregulation and would be unlikely to cause syncope without concomitant hypotension. METHODS AND RESULTS: To test this hypothesis, we studied 13 healthy men (age, 27 +/- 7 years) during progressive lower body negative pressure (LBNP). We measured systemic flow (Qc is cardiac output; C2H2 rebreathing), regional forearm flow (FBF; venous occlusion plethysmography), and blood pressure (BP; Finapres) and calculated systemic (SVR) and forearm (FVR) vascular resistances. Changes in brain blood flow were

  13. Familial risk of cerebral palsy: population based cohort study

    PubMed Central

    Wilcox, Allen J; Lie, Rolv T; Moster, Dag

    2014-01-01

    Objective To investigate risks of recurrence of cerebral palsy in family members with various degrees of relatedness to elucidate patterns of hereditability. Design Population based cohort study. Setting Data from the Medical Birth Registry of Norway, linked to the Norwegian social insurance scheme to identify cases of cerebral palsy and to databases of Statistics Norway to identify relatives. Participants 2 036 741 Norwegians born during 1967-2002, 3649 of whom had a diagnosis of cerebral palsy; 22 558 pairs of twins, 1 851 144 pairs of first degree relatives, 1 699 856 pairs of second degree relatives, and 5 165 968 pairs of third degree relatives were identified. Main outcome measure Cerebral palsy. Results If one twin had cerebral palsy, the relative risk of recurrence of cerebral palsy was 15.6 (95% confidence interval 9.8 to 25) in the other twin. In families with an affected singleton child, risk was increased 9.2 (6.4 to 13)-fold in a subsequent full sibling and 3.0 (1.1 to 8.6)-fold in a half sibling. Affected parents were also at increased risk of having an affected child (6.5 (1.6 to 26)-fold). No evidence was found of differential transmission through mothers or fathers, although the study had limited power to detect such differences. For people with an affected first cousin, only weak evidence existed for an increased risk (1.5 (0.9 to 2.7)-fold). Risks in siblings or cousins were independent of sex of the index case. After exclusion of preterm births (an important risk factor for cerebral palsy), familial risks remained and were often stronger. Conclusions People born into families in which someone already has cerebral palsy are themselves at elevated risk, depending on their degree of relatedness. Elevated risk may extend even to third degree relatives (first cousins). The patterns of risk suggest multifactorial inheritance, in which multiple genes interact with each other and with environmental factors. These data offer additional

  14. How to Perfuse: Concepts of Cerebral Protection during Arch Replacement

    PubMed Central

    Habertheuer, Andreas; Wiedemann, Dominik; Kocher, Alfred; Laufer, Guenther; Vallabhajosyula, Prashanth

    2015-01-01

    Arch surgery remains undoubtedly among the most technically and strategically challenging endeavors in cardiovascular surgery. Surgical interventions of thoracic aneurysms involving the aortic arch require complete circulatory arrest in deep hypothermia (DHCA) or elaborate cerebral perfusion strategies with varying degrees of hypothermia to achieve satisfactory protection of the brain from ischemic insults, that is, unilateral/bilateral antegrade cerebral perfusion (ACP) and retrograde cerebral perfusion (RCP). Despite sophisticated and increasingly individualized surgical approaches for complex aortic pathologies, there remains a lack of consensus regarding the optimal method of cerebral protection and circulatory management during the time of arch exclusion. Many recent studies argue in favor of ACP with various degrees of hypothermic arrest during arch reconstruction and its advantages have been widely demonstrated. In fact ACP with more moderate degrees of hypothermia represents a paradigm shift in the cardiac surgery community and is widely adopted as an emergent strategy; however, many centers continue to report good results using other perfusion strategies. Amidst this important discussion we review currently available surgical strategies of cerebral protection management and compare the results of recent European multicenter and single-center data. PMID:26713319

  15. Cerebral metabolic adaptation and ketone metabolism after brain injury

    PubMed Central

    Prins, Mayumi L

    2010-01-01

    The developing central nervous system has the capacity to metabolize ketone bodies. It was once accepted that on weaning, the ‘post-weaned/adult’ brain was limited solely to glucose metabolism. However, increasing evidence from conditions of inadequate glucose availability or increased energy demands has shown that the adult brain is not static in its fuel options. The objective of this review is to summarize the body of literature specifically regarding cerebral ketone metabolism at different ages, under conditions of starvation and after various pathologic conditions. The evidence presented supports the following findings: (1) there is an inverse relationship between age and the brain’s capacity for ketone metabolism that continues well after weaning; (2) neuroprotective potentials of ketone administration have been shown for neurodegenerative conditions, epilepsy, hypoxia/ischemia, and traumatic brain injury; and (3) there is an age-related therapeutic potential for ketone as an alternative substrate. The concept of cerebral metabolic adaptation under various physiologic and pathologic conditions is not new, but it has taken the contribution of numerous studies over many years to break the previously accepted dogma of cerebral metabolism. Our emerging understanding of cerebral metabolism is far more complex than could have been imagined. It is clear that in addition to glucose, other substrates must be considered along with fuel interactions, metabolic challenges, and cerebral maturation. PMID:17684514

  16. mRNA redistribution during permanent focal cerebral ischemia.

    PubMed

    Lewis, Monique K; Jamison, Jill T; Dunbar, Joseph C; DeGracia, Donald J

    2013-12-01

    Translation arrest occurs in neurons following focal cerebral ischemia and is irreversible in penumbral neurons destined to die. Following global cerebral ischemia, mRNA is sequestered away from 40S ribosomal subunits as mRNA granules, precluding translation. Here, we investigated mRNA granule formation using fluorescence in situ histochemistry out to 8 h permanent focal cerebral ischemia using middle cerebral artery occlusion in Long Evans rats with and without diabetes. Neuronal mRNA granules colocalized with PABP, HuR, and NeuN, but not 40S or 60S ribosomal subunits, or organelle markers. The volume of brain with mRNA granule-containing neurons decreased exponentially with ischemia duration, and was zero after 8 h permanent focal cerebral ischemia or any duration of ischemia in diabetic rats. These results show that neuronal mRNA granule response has a limited range of insult intensity over which it is expressed. Identifying the limits of effective neuronal stress response to ischemia will be important for developing effective stroke therapies. PMID:24323415

  17. Cerebral blood flow measured by NMR indicator dilution in cats

    SciTech Connect

    Ewing, J.R.; Branch, C.A.; Helpern, J.A.; Smith, M.B.; Butt, S.M.; Welch, K.M.

    1989-02-01

    We developed techniques to assess the utility of a nuclear magnetic resonance (NMR) indicator for cerebral blood flow studies in cats, using Freon-22 for the first candidate. A PIN-diode-switched NMR experiment allowed the acquisition of an arterial as well as a cerebral fluorine-19 signal proportional to concentration vs. time in a 1.89 T magnet. Mean +/- SD blood:brain partition coefficients for Freon-22 were estimated at 0.93 +/- 0.08 for gray matter and 0.77 +/- 0.12 for white matter. Using maximum-likelihood curve fitting, estimates of mean +/- SD resting cerebral blood flow were 50 +/- 19 ml/100 g-min for gray matter and 5.0 +/- 2.0 ml/100 g-min for white matter. Hypercapnia produced the expected increases in gray and white matter blood flow. The physiologic effects of Freon-22, including an increase in cerebral blood flow itself with administration of 40% by volume, may limit its use as an indicator. Nevertheless, the NMR techniques described demonstrate the feasibility of fluorine-19-labeled compounds as cerebral blood flow indicators and the promise for their use in humans.

  18. [Visual disturbances following right cerebral lesion: a case report].

    PubMed

    Sato, M; Yasui, N; Suzuki, A; Kobayashi, T

    1984-07-01

    A 49-year-old right handed male, who showed three types of visual disturbance, e. g. hemianopsia, obscuration phenomena and unilateral visuospatial agnosia at different times, was reported. At first, he had hemiparesis, hemisensory disturbance and homonymous hemianopsia on the left side because of multiple stenoses of posterior branches of the right middle cerebral artery. His motor and visual field disturbances improved for several days after onset, but there appeared transient obscuration phenomena on the left visual field. CT scan revealed an abnormal low density area in the right temporo-parietal region. At about 4.5 years after the first attack, he again had hemiparesis and homonymous hemianopsia on the left side. Cerebral angiography showed an occlusion of the right middle cerebral artery. Since his paresis was progressive, STA-MCA anastomoses was performed. Hemiparesis was improved, but homonymous hemianopsia remained. Moreover, at about one year after the second attack, left visuospatial agnosia participated in his hemianopsia. Cerebral angiography showed an additional occlusion in the crural segment of the right posterior cerebral artery. CT scan showed a lesion in the right basal ganglia and temporo-parietal lobe. In most cases, unilateral visuospatial agnosia occurs with hemianopsia. But, in this case, these symptoms occurred at different times. This may indicate the differentiation between unilateral visuospatial agnosia and hemianopsia. PMID:6487433

  19. Role of phorbol esters in regional cerebral blood flow regulation

    SciTech Connect

    Hanley, D.F.; Uhl, G.R.; Miyabe, M.; Traystman, R.J.

    1986-03-05

    Phorbol esters are known to activate protein kinase C, an intracellular enzyme capable of phosphorylating membrane associated receptors. By using phorbol-12-13-dibutyrate (PDBU), they investigated the presence and function of protein kinase C on canine cerebral vessels. In vitro tissue autoradiographic studies performed on 8 ..mu.. sections of canine cerebral vessels with H/sup 3/-PDBU revealed a 3 to 1 ratio of specific to nonspecific binding. Competitive displacement was demonstrated for 3 physiologically active phorbol esters but could not be demonstrated for 3 physiologically inactive phorbol derivatives. The effect of PDBU on regional cerebral blood flow (rCBF) was then studied in vivo using radiolabelled microspheres in 6 dogs. Measurements were made during control ventriculocisternal CSF infusions and 5,10,15,20 and 25 minutes after infusion of .1 nM/min PDBU. For grey matter regions in contact with the perfusate, caudate nucleus, cortical watershed and cerebellum, blood flow increased from 33 +/- 6 to 45 +/- 7, 20 +/- 2 to 27 +/- 2, and 31 +/- 2 to 42 +/- 5 ml/min/100 gm, respectively. rCBF was unchanged for brainstem, temporal lobe or white matter regions. They conclude (1) PDBU has high affinity binding to canine cerebral vascular smooth muscle, and (2) PDBU produces an increase in rCBF when delivered intraventricularly. These data suggest a possible role for protein kinase C in the regulation of cerebral blood flow.

  20. Cerebral infarction in a 24-year-old pilot.

    PubMed

    Ohashi, Koichiro; Nakanishi, Kuniaki; Miyajima, Daijiro; Fukushima, Koji; Shirotani, Toshiki; Kuwamura, Keiichi; Tong, Andrew

    2003-10-01

    Ischemic stroke is a rare event in young adults. We report on a 24-yr-old pilot with cerebral infarction of undetermined etiology, temporally associated with chain smoking. The patient exhibited dysphasia, stupor (confused consciousness), and right facial-nerve palsy. Computed-tomography revealed a low-density area in the left insular cortex. Cerebroangiography showed severe stenosis in a branch of the left middle cerebral artery. After admission, the patient made a rapid and uneventful recovery within 72 h. MRI showed an area of hyperintensity on T2-weighted images 2 mo after the attack. Based on the hyperintense area on FLAIR (fluid attenuated inversion recovery sequence) images obtained in MRI performed 10 mo after the attack, we diagnosed a cerebral infarction. In the Japan Air Self-Defense Force, cerebral infarction is an aeromedically disqualifying condition. However, in the evaluation 2 mo after the attack, differentiation from reversible ischemic neurological deficit was difficult. We discuss the criteria used for diagnosis and the risk factors for cerebral infarction in young adults, as well as the aeromedical disposition of young pilots. PMID:14556575

  1. Optoacoustic monitoring of cerebral venous blood oxygenation through extracerebral blood

    PubMed Central

    Petrov, I. Y.; Petrov, Y.; Prough, D. S.; Deyo, D. J.; Cicenaite, I.; Esenaliev, R. O.

    2011-01-01

    There is strong clinical evidence that controlling cerebral venous oxygenation (oxyhemoglobin saturation) is critically important for patients with severe traumatic brain injury as well as for patients undergoing cardiac surgery. However, the only available method for cerebral venous blood oxygenation monitoring is invasive and requires catheterization of the internal jugular vein. We designed and built a novel optoacoustic monitor of cerebral venous oxygenation as measured in the superior sagittal sinus (SSS), the large midline cerebral vein. To the best of our knowledge, optical monitoring of cerebral venous blood oxygenation through overlying extracerebral blood is reported for the first time in this paper. The system was capable of detecting SSS signals in vivo at 700, 800, and 1064 nm through the thick (5–6 mm) sheep skull containing the circulating blood. The high (submillimeter) in-depth resolution of the system provided identification of the SSS peaks in the optoacoustic signals. The SSS peak amplitude closely followed the actual SSS blood oxygenation measured invasively using catheterization, blood sampling, and “gold standard” CO-Oximetry. Our data indicate the system may provide accurate measurement of the SSS blood oxygenation in patients with extracerebral blood over the SSS. PMID:22254173

  2. Impaired cerebrovascular hemodynamics are associated with cerebral white matter damage

    PubMed Central

    Purkayastha, Sushmita; Fadar, Otite; Mehregan, Aujan; Salat, David H; Moscufo, Nicola; Meier, Dominik S; Guttmann, Charles RG; Fisher, Naomi DL; Lipsitz, Lewis A; Sorond, Farzaneh A

    2014-01-01

    White matter hyperintensities (WMH) in elderly individuals with vascular diseases are presumed to be due to ischemic small vessel diseases; however, their etiology is unknown. We examined the cross-sectional relationship between cerebrovascular hemodynamics and white matter structural integrity in elderly individuals with vascular risk factors. White matter hyperintensity volumes, fractional anisotropy (FA), and mean diffusivity (MD) were obtained from MRI in 48 subjects (75±7years). Pulsatility index (PI) and dynamic cerebral autoregulation (dCA) was assessed using transcranial Doppler ultrasound of the middle cerebral artery. Dynamic cerebral autoregulation was calculated from transfer function analysis (phase and gain) of spontaneous blood pressure and flow velocity oscillations in the low (LF, 0.03 to 0.15 Hz) and high (HF, 0.16 to 0.5 Hz) frequency ranges. Higher PI was associated with greater WMH (P<0.005). Higher phase across all frequency ranges was associated with greater FA and lower MD (P<0.005). Lower gain was associated with higher FA in the LF range (P=0.001). These relationships between phase and FA were significant in the territories limited to the middle cerebral artery as well as across the entire brain. Our results show a strong relationship between impaired cerebrovascular hemodynamics (PI and dCA) and loss of cerebral white matter structural integrity (WMH and DTI metrics) in elderly individuals. PMID:24129749

  3. The Role of Information Systems to Manage Cerebral Palsy

    PubMed Central

    AJAMI, Sima; MAGHSOUDLORAD, Ali Akbar

    2016-01-01

    Objective In healthcare system, it is necessary to have exact and accurate information in order to address health care needs and requirements of society members as well as expectations of policy makers, planners and decision makers. The aim of this narrative review article was to explain the role of information systems in cerebral palsy management and identify the advantages and barriers to the development of cerebral palsy registry system. Data were collected using databases such as of Science Direct, PubMed, Proquest, Springer, and SID (Scientific Information Database). Overall, 65 sources were selected. One of the biggest challenges for children with physical and motor disabilities in rehabilitation center is access to a system, which provides a comprehensive data set reflecting all information on a patient’s care. Thus, data and information management in children with physical and motor disability such as cerebral palsy facilitates access to data and cerebral palsy data comparison as well as the monitoring incidence rate of cerebral palsy, enhancing health care quality; however, there are always numerous barriers to establish the system. One of the ways to overcome these problems is the establishment of a standard framework of minimum data sets and exact definition of its data components. Reliable standards in the use of applications as well as user-friendly software will ensure patients’ data extraction and registration. PMID:27247578

  4. Dynamic touch is affected in children with cerebral palsy.

    PubMed

    Ocarino, Juliana M; Fonseca, Sergio T; Silva, Paula L P; Gonçalves, Gabriela G P; Souza, Thales R; Mancini, Marisa C

    2014-02-01

    Children with developmental disorders such as cerebral palsy have limited opportunities for effortful interactions with objects and tools. The goal of the study was to investigate whether children with cerebral palsy have deficits in their ability to perceive object length by dynamic touch when compared to typically developing children. Fourteen children with typical development and 12 children with cerebral palsy were asked to report the length of hand-held rods after wielding them out of sight. Multilevel regression models indicated that I1 (maximum principal moment of inertia) was a significant predictor of perceived length - LP (p<.0001). The effect of I1 on LP was significantly different among children (p=.001) and the presence of cerebral palsy (group factor) partially explained such variance (p=.002). In addition, accuracy and reliability of the length judgments made by children with cerebral palsy were significantly lower than the typically developing children (p<.05). Theoretical and clinical implications of these results were identified and discussed. PMID:24054355

  5. Effects of Steroid Hormones on Sex Differences in Cerebral Perfusion

    PubMed Central

    Ghisleni, Carmen; Bollmann, Steffen; Biason-Lauber, Anna; Poil, Simon-Shlomo; Brandeis, Daniel; Martin, Ernst; Michels, Lars; Hersberger, Martin; Suckling, John

    2015-01-01

    Sex differences in the brain appear to play an important role in the prevalence and progression of various neuropsychiatric disorders, but to date little is known about the cerebral mechanisms underlying these differences. One widely reported finding is that women demonstrate higher cerebral perfusion than men, but the underlying cause of this difference in perfusion is not known. This study investigated the putative role of steroid hormones such as oestradiol, testosterone, and dehydroepiandrosterone sulphate (DHEAS) as underlying factors influencing cerebral perfusion. We acquired arterial spin labelling perfusion images of 36 healthy adult subjects (16 men, 20 women). Analyses on average whole brain perfusion levels included a multiple regression analysis to test for the relative impact of each hormone on the global perfusion. Additionally, voxel-based analyses were performed to investigate the sex difference in regional perfusion as well as the correlations between local perfusion and serum oestradiol, testosterone, and DHEAS concentrations. Our results replicated the known sex difference in perfusion, with women showing significantly higher global and regional perfusion. For the global perfusion, DHEAS was the only significant predictor amongst the steroid hormones, showing a strong negative correlation with cerebral perfusion. The voxel-based analyses revealed modest sex-dependent correlations between local perfusion and testosterone, in addition to a strong modulatory effect of DHEAS in cortical, subcortical, and cerebellar regions. We conclude that DHEAS in particular may play an important role as an underlying factor driving the difference in cerebral perfusion between men and women. PMID:26356576

  6. Cerebral perfusion reserve indexes determined by fluoromethane positron emission scanning

    SciTech Connect

    Levine, R.L.; Sunderland, J.J.; Lagreze, H.L.; Nickles, R.J.; Rowe, B.R.; Turski, P.A.

    1988-01-01

    An index of cerebral perfusion reserve (RES%), defined as the percent change of regional cerebral blood flow over baseline per mm Hg of end-tidal CO/sub 2/ tension, was determined for each middle cerebral artery (MCA) territory in patients with unilateral carotid distribution transient ischemic attacks or minor cerebrovascular accidents and was compared with that of age-matched, neurologically normal volunteers. Vasodilator responses to induced hypercapnia were tested during inhalation of 5% CO/sub 2/ in 95% O/sub 2/ while regional cerebral blood flow was measured by fluoromethane inhalation positron emission tomography. Mean RES% for 24 normal MCA territories was 5.2 +/- 0.8%. Mean RES% for 15 patient nonischemic MCA territories was 3.8 +/- 1.3% and for 15 ischemic MCA territories was 2.8 +/- 1.9% (both p less than 0.001). Individual RES% values and symmetry ratios between ischemic and nonischemic regions were also determined and compared with angiographic data. Areas of diminished, asymmetric, or paradoxical (two patients) CO/sub 2/ reactivity appear to correspond to areas of compensatory vasodilation. We found this technique to be a safe and reproducible method for defining and recording localized areas of cerebral tissue at apparent risk for hemodynamically related damage.

  7. The Role of Information Systems to Manage Cerebral Palsy.

    PubMed

    Ajami, Sima; Maghsoudlorad, Ali Akbar

    2016-01-01

    Objective In healthcare system, it is necessary to have exact and accurate information in order to address health care needs and requirements of society members as well as expectations of policy makers, planners and decision makers. The aim of this narrative review article was to explain the role of information systems in cerebral palsy management and identify the advantages and barriers to the development of cerebral palsy registry system. Data were collected using databases such as of Science Direct, PubMed, Proquest, Springer, and SID (Scientific Information Database). Overall, 65 sources were selected. One of the biggest challenges for children with physical and motor disabilities in rehabilitation center is access to a system, which provides a comprehensive data set reflecting all information on a patient's care. Thus, data and information management in children with physical and motor disability such as cerebral palsy facilitates access to data and cerebral palsy data comparison as well as the monitoring incidence rate of cerebral palsy, enhancing health care quality; however, there are always numerous barriers to establish the system. One of the ways to overcome these problems is the establishment of a standard framework of minimum data sets and exact definition of its data components. Reliable standards in the use of applications as well as user-friendly software will ensure patients' data extraction and registration. PMID:27247578

  8. Noninvasive cerebral perfusion imaging in high-risk neonates.

    PubMed

    Goff, Donna A; Buckley, Erin M; Durduran, Turgut; Wang, Jiongjong; Licht, Daniel J

    2010-02-01

    Advances in medical and surgical care of the high-risk neonate have led to increased survival. A significant number of these neonates suffer from neurodevelopmental delays and failure in school. The focus of clinical research has shifted to understanding events contributing to neurological morbidity in these patients. Assessing changes in cerebral oxygenation and regulation of cerebral blood flow (CBF) is important in evaluating the status of the central nervous system. Traditional CBF imaging methods fail for both ethical and logistical reasons. Optical near infrared spectroscopy (NIRS) is increasingly being used for bedside monitoring of cerebral oxygenation and blood volume in both very low birth weight infants and neonates with congenital heart disease. Although trends in CBF may be inferred from changes in cerebral oxygenation and/or blood volume, NIRS does not allow a direct measure of CBF in these populations. Two relatively new modalities, arterial spin-labeled perfusion magnetic resonance imaging and optical diffuse correlation spectroscopy, provide direct, noninvasive measures of cerebral perfusion suitable for the high-risk neonates. Herein we discuss the instrumentation, applications, and limitations of these noninvasive imaging techniques for measuring and/or monitoring CBF. PMID:20109972

  9. Whole body vibration and cerebral palsy: a systematic review

    PubMed Central

    Duquette, Sean A.; Guiliano, Anthony M.; Starmer, David J.

    2015-01-01

    Purpose: The goal of this review is to evaluate the effects of whole body vibration on outcomes in patients with cerebral palsy. The findings in this review may help clinicians make evidence informed decisions on the use of whole body vibration for cerebral palsy. Methods: A systematic search was conducted on April 29, 2014.The following search terms were used to search of several databases: (whole body vibration OR whole-body vibration OR whole body-vibration OR WBV) AND (cerebral palsy). Articles that met the inclusion criteria were assessed using the Scottish intercollegiate guidelines network (SIGN) rating system to assess the methodology and bias of the articles for randomized control trials. Results: The search produced 25 articles, of which 12 duplicates were identified and removed. Another seven articles were not considered since they did not fit the inclusion criteria, leaving a total of five studies for review. Four of the articles analyzed the effects of WBV in children while the other study focused on adults with cerebral palsy. There was one low quality article, four acceptable quality articles and one high quality article when assessed using the SIGN criteria. Conclusions: It appears that whole body vibration has the potential to provide symptomatic relief for patients with cerebral palsy. Whole body vibration may improve spasticity, muscle strength and coordination. There is a lack of research to conclusively determine whether it does alter bone mineral density. PMID:26500358

  10. Urinary kallidinogenase for the treatment of cerebral arterial stenosis

    PubMed Central

    Zhao, Liandong; Zhao, Ying; Wan, Qi; Zhang, Haijun

    2015-01-01

    Aim Urinary kallidinogenase (UK) has shown promise in improving cerebral perfusion. This study aimed to examine how UK affects cognitive status and serum levels of amyloid betas (Aβs) 1-40 and 1-42 in patients with cerebral arterial stenosis. Methods Ninety patients with cerebral arterial stenosis were enrolled, of whom 45 patients received UK + conventional treatment (UK group), and 45 patients received conventional treatment alone as control group. Cognitive status and Aβ1-40 and Aβ1-42 serum levels were determined before treatment and at 4 weeks and 8 weeks after treatment. Results At 4 weeks after treatment, cognitive status in patients treated with UK clearly improved accompanied by Aβ1-40 serum levels decreasing while there was no change of Aβ1-42. Cognitive status in patients receiving UK continued to improve, Aβ1-40 serum levels declined further as well as Aβ1-42 serum levels began to decrease dramatically at 8 weeks after treatment. Conclusion UK could improve cognitive status and decrease both Aβ1-40 and Aβ1-42 serum levels to prevent ischemic cerebral injury, which represents a good option for patients with cerebral arterial stenosis. PMID:26508834

  11. Excess Pre-Pregnancy Weight May Slightly Raise Baby's Cerebral Palsy Risk

    MedlinePlus

    ... Excess Pre-Pregnancy Weight May Slightly Raise Baby's Cerebral Palsy Risk But, study found overall odds remain quite ... slight increased risk of having a baby with cerebral palsy, a new study suggests. After reviewing data from ...

  12. Cerebral Palsy Among Asian Ethnic Subgroups

    PubMed Central

    Lang, Tess C.; Fuentes-Afflick, Elena; Gilbert, William M.; Newman, Thomas B.; Xing, Guibo

    2012-01-01

    OBJECTIVE: Asians have a reduced risk for cerebral palsy (CP) compared with whites. We examined whether individual Asian subgroups have a reduced risk of CP and whether differences in sociodemographic factors explain disparities in CP prevalence. METHODS: In a retrospective cohort of 629 542 Asian and 2 109 550 white births in California from 1991 to 2001, we identified all children who qualified for services from the California Department of Health Services on the basis of CP. Asians were categorized as East Asian (Chinese, Japanese, Koreans), Filipino, Indian, Pacific Islander (Guamanians, Hawaiians, and Pacific Islanders), Samoan, or Southeast Asian (Cambodian, Laotian, Thai, Vietnamese). RESULTS: Overall, CP prevalence was lower in Asians than whites (1.09 vs 1.36 per 1000; relative risk = 0.80, 95% confidence interval [CI] = 0.74–0.87) and ranged from 0.61/1000 in Thai children to 2.08/1000 in Samoan children. Several Asian subgroups had low risk profiles with respect to maternal age, educational attainment, and birth weight. However, after we adjusted for maternal age and education, infant gender, and birth weight, the adjusted risk of CP remained lower in East Asians (odds ratio [OR] = 0.75, 95% CI = 0.65–0.87), Filipinos (OR = 0.87, 95% CI = 0.75–0.99), Indians (OR = 0.59, 95% CI = 0.44–0.80), Pacific Islanders (OR = 0.62, 95% CI = 0.40–0.97), and Southeast Asians (OR = 0.68, 95% CI = 0.57–0.82) compared with whites. CONCLUSIONS: Most Asian national origin subgroups have a lower rate of CP than whites, and this disparity is unexplained. Additional studies that focus on the cause of ethnic disparities in CP may provide new insights into pathogenesis and prevention. PMID:22430449

  13. Cerebral Critical Closing Pressure During Infusion Tests.

    PubMed

    Varsos, Georgios V; Czosnyka, Marek; Smielewski, Peter; Garnett, Matthew R; Liu, Xiuyun; Adams, Hadie; Pickard, John D; Czosnyka, Zofia

    2016-01-01

    We studied possible correlations between cerebral hemodynamic indices based on critical closing pressure (CrCP) and cerebrospinal fluid (CSF) compensatory dynamics, as assessed during lumbar infusion tests. Our data consisted of 34 patients with normal-pressure hydrocephalus who undertook an infusion test, in conjunction with simultaneous transcranial Doppler ultrasonography (TCD) monitoring of blood flow velocity (FV). CrCP was calculated from the monitored signals of ICP, arterial blood pressure (ABP), and FV, whereas vascular wall tension (WT) was estimated as CrCP - ICP. The closing margin (CM) expresses the difference between ABP and CrCP. ICP increased during infusion from 6.67 ± 4.61 to 24.98 ± 10.49 mmHg (mean ± SD; p < 0.001), resulting in CrCP rising by 22.93 % (p < 0.001), with WT decreasing by 11.33 % (p = 0.005) owing to vasodilatation. CM showed a tendency to decrease, albeit not significantly (p = 0.070), because of rising ABP (9.12 %; p = 0.005), and was significantly different from zero for the whole duration of the tests (52.78 ± 22.82 mmHg; p < 0.001). CM at baseline correlated inversely with brain elasticity (R = -0.358; p = 0.038). Neither CrCP nor WT correlated with CSF compensatory parameters. Overall, CrCP increases and WT decreases during infusion tests, whereas CM at baseline pressure may act as a characterizing indicator of the cerebrospinal compensatory reserve. PMID:27165909

  14. S-nitrosoglutathione prevents experimental cerebral malaria

    PubMed Central

    Zanini, Graziela M.; Martins, Yuri C.; Cabrales, Pedro; Frangos, John A.; Carvalho, Leonardo J. M.

    2012-01-01

    Administration of the exogenous nitric oxide (NO) donor dipropylenetriamine-NONOate (DPTA-NO) to mice during Plasmodium berghei ANKA (PbA) infection largely prevents development of experimental cerebral malaria (ECM). However, a high dose (1mg/mouse twice a day) is necessary and causes potent side effects such as marked hypotension. In the present study we evaluated whether an alternative, physiologically relevant NO donor, S-nitrosoglutathione (GSNO), was able to prevent ECM at lower doses with minimal side effects. Prophylactic treatment with high (3.5mg), intermediate (0.35mg) or low (0.035mg) doses of GSNO decreased incidence of ECM in PbA-infected mice, decreasing also edema, leukocyte accumulation and hemorrhage incidence in the brain. The high dose inhibited parasite growth and also induced transient hypotension. Low and intermediate doses had no or only mild effects on parasitemia, blood pressure, and heart rate compared to saline-treated mice. PbA infection decreased brain total and reduced (GSH) glutathione levels. Brain levels of oxidized (GSSG) glutathione and the GSH/GSSG ratio were positively correlated with temperature and motor behavior. Low and intermediate doses of GSNO failed to restore the depleted brain total glutathione and GSH levels, suggesting that ECM prevention by GSNO was probably related to other effects such as inhibition of inflammation and vascular protection. These results indicate that ECM is associated with depletion of the brain glutathione pool and that GSNO is able to prevent ECM development in a wide range of doses, decreasing brain inflammation and inducing milder cardiovascular side effects. PMID:22391863

  15. Increased Cerebral Water Content in Hemodialysis Patients

    PubMed Central

    Costa, Ana Sofia; Gras, Vincent; Tiffin-Richards, Frances; Mirzazade, Shahram; Holschbach, Bernhard; Frank, Rolf Dario; Vassiliadou, Athina; Krüger, Thilo; Eitner, Frank; Gross, Theresa; Schulz, Jörg Bernhard; Floege, Jürgen; Shah, Nadim Jon

    2015-01-01

    Little information is available on the impact of hemodialysis on cerebral water homeostasis and its distribution in chronic kidney disease. We used a neuropsychological test battery, structural magnetic resonance imaging (MRI) and a novel technique for quantitative measurement of localized water content using 3T MRI to investigate ten hemodialysis patients (HD) on a dialysis-free day and after hemodialysis (2.4±2.2 hours), and a matched healthy control group with the same time interval. Neuropsychological testing revealed mainly attentional and executive cognitive dysfunction in HD. Voxel-based-morphometry showed only marginal alterations in the right inferior medial temporal lobe white matter in HD compared to controls. Marked increases in global brain water content were found in the white matter, specifically in parietal areas, in HD patients compared to controls. Although the global water content in the gray matter did not differ between the two groups, regional increases of brain water content in particular in parieto-temporal gray matter areas were observed in HD patients. No relevant brain hydration changes were revealed before and after hemodialysis. Whereas longer duration of dialysis vintage was associated with increased water content in parieto-temporal-occipital regions, lower intradialytic weight changes were negatively correlated with brain water content in these areas in HD patients. Worse cognitive performance on an attention task correlated with increased hydration in frontal white matter. In conclusion, long-term HD is associated with altered brain tissue water homeostasis mainly in parietal white matter regions, whereas the attentional domain in the cognitive dysfunction profile in HD could be linked to increased frontal white matter water content. PMID:25826269

  16. Mapping of cerebral oxidative metabolism with MRI

    PubMed Central

    Mellon, Eric A.; Beesam, R. Shashank; Elliott, Mark A.; Reddy, Ravinder

    2010-01-01

    Using a T1ρ MRI based indirect detection method, we demonstrate the detection of cerebral oxidative metabolism and its modulation by administration of the mitochondrial uncoupling agent 2,4-dinitrophenol (DNP) in a large animal model with minimum utilization of gas. The study was performed by inhalation in swine during imaging on clinical MRI scanners. Metabolic changes in swine were determined by two methods. First, in a series of animals, increased metabolism caused by DNP injection was measured by exhaled gas analysis. The average whole-body metabolic increase in seven swine was 11.9%+/-2.5% per mg/kg, stable over three hours. Secondly, hemispheric brain measurements of oxygen consumption stimulated by DNP injection were made in five swine using T1ρ MRI following administration of gas. Metabolism was calculated from the change in the T1ρ weighted MRI signal due to H217O generated from inhalation before and after doubling of metabolism by DNP. These results were confirmed by direct oxygen-17 MR spectroscopy, a gold standard for in vivo H217O measurement. Overall, this work underscores the ability of indirect oxygen-17 imaging to detect oxygen metabolism in an animal model with a lung capacity comparable to the human with minimal utilization of expensive gas. Given the demonstrated high efficiency in use of and the proven feasibility of performing such measurements on standard clinical MRI scanners, this work enables the adaption of this technique for human studies dealing with a broad array of metabolic derangements. PMID:20547874

  17. Regional cerebral blood flow in childhood headache

    SciTech Connect

    Roach, E.S.; Stump, D.A.

    1989-06-01

    Regional cerebral blood flow (rCBF) was measured in 16 cranial regions in 23 children and adolescents with frequent headaches using the non-invasive Xenon-133 inhalation technique. Blood flow response to 5% carbon dioxide (CO2) was also determined in 21 patients, while response to 50% oxygen was measured in the two patients with hemoglobinopathy. Included were 10 patients with a clinical diagnosis of migraine, 4 with musculoskeletal headaches, and 3 with features of both types. Also studied were 2 patients with primary thrombocythemia, 2 patients with hemoglobinopathy and headaches, 1 patient with polycythemia, and 1 with headaches following trauma. With two exceptions, rCBF determinations were done during an asymptomatic period. Baseline rCBF values tended to be higher in these young patients than in young adults done in our laboratory. Localized reduction in the expected blood flow surge after CO2 inhalation, most often noted posteriorly, was seen in 8 of the 13 vascular headaches, but in none of the musculoskeletal headache group. Both patients with primary thrombocythemia had normal baseline flow values and altered responsiveness to CO2 similar to that seen in migraineurs; thus, the frequently reported headache and transient neurologic signs with primary thrombocythemia are probably not due to microvascular obstruction as previously suggested. These data support the concept of pediatric migraine as a disorder of vasomotor function and also add to our knowledge of normal rCBF values in younger patients. Demonstration of altered vasomotor reactivity to CO2 could prove helpful in children whose headache is atypical.

  18. Treating cerebral palsy with aculaser therapy

    NASA Astrophysics Data System (ADS)

    Anwar, Shahzad; Nazir Khan, Malik M.; Nadeem Khan, Malik M.; Qazi, Faiza M.; Awan, Abid H.; Dar, Irfan

    2008-03-01

    A single, open and non comparative study was conducted at Anwar Shah Trust for C.P. & Paralysis in collaboration with the Departments of Neurology and Neurosurgery, Children Hospital Lahore, Pakistan to evaluate the effects of ACULASER THERAPY in childern suffering from Cerebral Palsy (C.P.) and associated Neurological Disorders like epilepsy, cortical blindness, spasticity, hemiplegia, paraplegia, diplegia, quadriplegia, monoplegia, sensory-neural deafness and speech disorders. In all 250 childern were treated and the data was gathered during a period of 3 years from December 2003 till December 2006. These children were further classified according to the type of C.P. (spastic, athetoid, mixed) they suffered from and associated Neurological Disorders. This article shows results in C.P. childern who were treated with ACULASER THERAPY for minimum 6 weeks and more or had minimum of 15 treatment sessions and more. This article also shows that those childern who were given a break in the treatment for 1 month to 1 year did not show any reversal of the signs and symptoms. Analysis of the data showed that out of 171 children with Spasticity and Stiffness 147 showed marked improvement showing 87% success rate, out of 126 children with Epileptic fits, there was a significant reduction in the intensity, frequency and duration of Epileptic fits in 91 children showing 72% success rate, out of 48 children with Cortical Blindness 30 children showed improvement accounting for 63% efficacy rate, out of 105 children with Hearing Difficulties, 63 showed marked improvement accounting for 60% improvement rate, out of 190 children with Speech Disorders 122 showed improvement reflecting 64% improvement rate, out of 96 children with Hemiplegia 71 showed improvement in movement, tone and power accounting for 74% improvement rate, out of 76 children with Quadriplegia 52 showed improvement in gross and fine motor functions showing 69% success rate and out of 58 children with Paraplegia of

  19. Hand Functioning in Children with Cerebral Palsy

    PubMed Central

    Arnould, Carlyne; Bleyenheuft, Yannick; Thonnard, Jean-Louis

    2014-01-01

    Brain lesions may disturb hand functioning in children with cerebral palsy (CP), making it difficult or even impossible for them to perform several manual activities. Most conventional treatments for hand dysfunction in CP assume that reducing the hand dysfunctions will improve the capacity to manage activities (i.e., manual ability, MA). The aim of this study was to investigate the directional relationships (direct and indirect pathways) through which hand skills influence MA in children with CP. A total of 136 children with CP (mean age: 10 years; range: 6–16 years; 35 quadriplegics, 24 diplegics, 77 hemiplegics) were assessed. Six hand skills were measured on both hands: touch-pressure detection (Semmes–Weinstein esthesiometer), stereognosis (Manual Form Perception Test), proprioception (passive mobilization of the metacarpophalangeal joints), grip strength (GS) (Jamar dynamometer), gross manual dexterity (GMD) (Box and Block Test), and fine finger dexterity (Purdue Pegboard Test). MA was measured with the ABILHAND-Kids questionnaire. Correlation coefficients were used to determine the linear associations between observed variables. A path analysis of structural equation modeling was applied to test different models of causal relationships among the observed variables. Purely sensory impairments did seem not to play a significant role in the capacity to perform manual activities. According to path analysis, GMD in both hands and stereognosis in the dominant hand were directly related to MA, whereas GS was indirectly related to MA through its relationship with GMD. However, one-third of the variance in MA measures could not be explained by hand skills. It can be concluded that MA is not simply the integration of hand skills in daily activities and should be treated per se, supporting activity-based interventions. PMID:24782821

  20. Radiosurgery for brain metastases and cerebral edema.

    PubMed

    Gazit, Inbal; Har-Nof, Sagi; Cohen, Zvi R; Zibly, Zion; Nissim, Uzi; Spiegelmann, Roberto

    2015-03-01

    The objective of this study was to assess reduction in cerebral edema following linear accelerator radiosurgery (LINAC) as first line therapy for brain metastasis. We reviewed the medical records of all patients who underwent LINAC radiosurgery for brain metastasis at our institution during 2010-2012, and who had not previously undergone either surgery or whole brain radiotherapy. Data were analyzed for 55 brain metastases from 46 patients (24 males), mean age 59.9 years. During the 2 months following LINAC radiosurgery, the mean steroid dose decreased from 4.8 to 2.6 mg/day, the mean metastasis volume decreased from 3.79±4.12 cc to 2.8±4.48 cc (p=0.001), and the mean edema volume decreased from 16.91±30.15 cc to 12.85±24.47 cc (p=0.23). The 17 patients with reductions of more than 50% in brain edema volume had single metastases. Edema volume in the nine patients with two brain metastases remained stable in five patients (volume change <10%, 0-2 cc) and increased in four patients (by >10%, 2-14 cc). In a subanalysis of eight metastases with baseline edema volume greater than 40 cc, edema volume decreased from 77.27±37.21 cc to 24.84±35.6 cc (p=0.034). Reductions in brain edema were greater in metastases for which non-small-cell lung carcinoma and breast cancers were the primary diseases. Overall, symptoms improved in most patients. No patients who were without symptoms or who had no signs of increased intracranial pressure at baseline developed signs of intracranial pressure following LINAC radiosurgery. In this series, LINAC stereotactic radiosurgery for metastatic brain lesions resulted in early reduction in brain edema volume in single metastasis patients and those with large edema volumes, and reduced the need for steroids. PMID:25533053

  1. Isolation and Cannulation of Cerebral Parenchymal Arterioles.

    PubMed

    Pires, Paulo W; Dabertrand, Fabrice; Earley, Scott

    2016-01-01

    Intracerebral parenchymal arterioles (PAs), which include parenchymal arterioles, penetrating arterioles and pre-capillary arterioles, are high resistance blood vessels branching out from pial arteries and arterioles and diving into the brain parenchyma. Individual PA perfuse a discrete cylindrical territory of the parenchyma and the neurons contained within. These arterioles are a central player in the regulation of cerebral blood flow both globally (cerebrovascular autoregulation) and locally (functional hyperemia). PAs are part of the neurovascular unit, a structure that matches regional blood flow to metabolic activity within the brain and also includes neurons, interneurons, and astrocytes. Perfusion through PAs is directly linked to the activity of neurons in that particular territory and increases in neuronal metabolism lead to an augmentation in local perfusion caused by dilation of the feed PA. Regulation of PAs differs from that of better-characterized pial arteries. Pressure-induced vasoconstriction is greater in PAs and vasodilatory mechanisms vary. In addition, PAs do not receive extrinsic innervation from perivascular nerves - innervation is intrinsic and indirect in nature through contact with astrocytic endfeet. Thus, data regarding contractile regulation accumulated by studies using pial arteries does not directly translate to understanding PA function. Further, it remains undetermined how pathological states, such as hypertension and diabetes, affect PA structure and reactivity. This knowledge gap is in part a consequence of the technical difficulties pertaining to PA isolation and cannulation. In this manuscript we present a protocol for isolation and cannulation of rodent PAs. Further, we show examples of experiments that can be performed with these arterioles, including agonist-induced constriction and myogenic reactivity. Although the focus of this manuscript is on PA cannulation and pressure myography, isolated PAs can also be used for

  2. Repeat radiosurgery for cerebral arteriovenous malformations.

    PubMed

    Awad, Ahmed J; Walcott, Brian P; Stapleton, Christopher J; Ding, Dale; Lee, Cheng-Chia; Loeffler, Jay S

    2015-06-01

    We perform a systematic review of repeat radiosurgery for cerebral arteriovenous malformations (AVM) with an emphasis on lesion obliteration rates and complications. Radiosurgery is an accepted treatment modality for AVM located in eloquent cortex or deep brain structures. For residual or persistent lesions, repeat radiosurgery can be considered if sufficient time has passed to allow for a full appreciation of treatment effects, usually at least 3years. A systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. References for this review were identified by searches of MEDLINE, Web of Science and Google Scholar databases. A total of 14 studies comprising 733 patients met the review criteria and were included. For series that reported target dose at both first and repeat treatments, the weighted means were 19.42Gy and 19.06Gy, respectively. The mean and median obliteration rate for the repeat radiosurgery treatments were 61% (95% confidence interval 51.9-71.7%) and 61.5%, respectively. The median follow up following radiosurgery ranged from 19.5 to 80months. Time to complete obliteration after the repeat treatment ranged from 21 to 40.8months. The most common complications of repeat radiosurgery for AVM included hemorrhage (7.6%) and radiation-induced changes (7.4%). Repeat radiosurgery can be used to treat incompletely obliterated AVM with an obliteration rate of 61%. Complications are related to treatment effect latency (hemorrhage risk) as well as radiation-induced changes. Repeat radiosurgery can be performed at 3 years following the initial treatment, allowing for full realization of effects from the initial treatment prior to commencing therapy. PMID:25913746

  3. Monitoring cerebral oxygenation in a pediatric patient undergoing surgery for vascular ring.

    PubMed

    Joshi, Reena K; Motta, Pablo; Horibe, Mayumi; Mossad, Emad

    2006-02-01

    Regional cerebral oxygenation can be monitored using near-infrared spectroscopy (NIRS). Inadequacy of collateral cerebral circulation and regional cerebral ischemia during cardiac and vascular surgery may be detected by the use of NIRS monitoring. We report a 2-year-old child who underwent surgical repair of vascular ring and subclavian reimplantation, where use of NIRS helped in early detection and timely intervention to prevent prolonged cerebral ischemia. PMID:16430416

  4. Effects of cerebral ischemia on human neurovascular coupling, CO2 reactivity, and dynamic cerebral autoregulation.

    PubMed

    Salinet, Angela S M; Robinson, Thompson G; Panerai, Ronney B

    2015-01-15

    Cerebral blood flow (CBF) regulation can be impaired in acute ischemic stroke but the combined effects of dynamic cerebral autoregulation (CA), CO2 cerebrovascular reactivity (CVR), and neurovascular coupling (NVC), obtained from simultaneous measurements, have not been described. CBF velocity in the middle cerebral artery (MCA) (CBFv, transcranial Doppler), blood pressure (BP, Finometer), and end-tidal Pco2 (PetCO2 , infrared capnography) were recorded during a 1-min passive movement of the arm in 27 healthy controls [mean age (SD) 61.4 (6.0) yr] and 27 acute stroke patients [age 63 (11.7) yr]. A multivariate autoregressive-moving average model was used to separate the contributions of BP, arterial Pco2 (PaCO2 ), and the neural activation to the CBFv responses. CBFv step responses for the BP, CO2, and stimulus inputs were also obtained. The contribution of the stimulus to the CBFv response was highly significant for the difference between the affected side [area under the curve (AUC) 104.5 (4.5)%] and controls [AUC 106.9 (4.3)%; P = 0.008]. CBFv step responses to CO2 [affected hemisphere 0.39 (0.7), unaffected 0.55 (0.8), controls 1.39 (0.9)%/mmHg; P = 0.01, affected vs. controls; P = 0.025, unaffected vs. controls] and motor stimulus inputs [affected hemisphere 0.20 (0.1), unaffected 0.22 (0.2), controls 0.37 (0.2) arbitrary units; P = 0.009, affected vs. controls; P = 0.02, unaffected vs. controls] were reduced in the stroke group compared with controls. The CBFv step responses to the BP input at baseline and during the paradigm were not different between groups (P = 0.07), but PetCO2 was lower in the stroke group (P < 0.05). These results provide new insights into the interaction of CA, CVR, and NVC in both health and disease states. PMID:25593216

  5. Cerebral sinovenous thrombosis associated with isopropanol ingestion in an infant.

    PubMed

    Nwosu, Michelle E; Golomb, Meredith R

    2009-03-01

    This report describes a 5-week-old female infant who presented with accidental ingestion of rubbing alcohol (which contains about 70% isopropanol), and was subsequently diagnosed with cerebral sinovenous thrombosis. Isopropanol is a clear, volatile 3-carbon alcohol found in varying concentrations in many solvents. Mislabeled rubbing alcohol was mixed with this patient's formula. After ingesting it, she presented with a 1-day history of uncontrolled fussiness and an episode of deviation of the eyes to the right for 30 minutes, followed by rhythmic movements of the arms and legs for 20 minutes. Cerebral imaging demonstrated sinovenous thrombosis. To our knowledge, there have been no reports describing cerebral sinovenous thrombosis as a complication of isopropanol ingestion. The possible association of isopropanol ingestion and sinovenous thrombosis is discussed. PMID:19258296

  6. Cerebral phaeohyphomycosis: A rare case from central India

    PubMed Central

    Nandedkar, Shirish; Bajpai, Trupti; Bhatambare, Ganesh S.; Sakhi, Pramod

    2015-01-01

    Cerebral phaeohyphomycosis is a rare and frequently fatal disease, often caused by hematogenous spread of pathogens that are inoculated in the skin of the extremities following minor trauma, and its mortality rate is much high despite aggressive treatment. A rare case of 25-year-old immuno-competent man with cerebral abscess has been described. The etiological agent was microbiologically proved to be a dematiaceous fungi Cladophilaophora bantiana, which is primarily a neurotropic fungus causing deep-seated intra-cranial infections. Treatment was individualized by surgical intervention and appropriate anti-fungal therapy. Thus, it has been described as a successfully managed case of cerebral phaeohyphomycosis known to be associated with a high degree of morbidity and mortality. PMID:25972951

  7. Cerebral phaeohyphomycosis: A rare case from central India.

    PubMed

    Nandedkar, Shirish; Bajpai, Trupti; Bhatambare, Ganesh S; Sakhi, Pramod

    2015-01-01

    Cerebral phaeohyphomycosis is a rare and frequently fatal disease, often caused by hematogenous spread of pathogens that are inoculated in the skin of the extremities following minor trauma, and its mortality rate is much high despite aggressive treatment. A rare case of 25-year-old immuno-competent man with cerebral abscess has been described. The etiological agent was microbiologically proved to be a dematiaceous fungi Cladophilaophora bantiana, which is primarily a neurotropic fungus causing deep-seated intra-cranial infections. Treatment was individualized by surgical intervention and appropriate anti-fungal therapy. Thus, it has been described as a successfully managed case of cerebral phaeohyphomycosis known to be associated with a high degree of morbidity and mortality. PMID:25972951

  8. [Sporadic Cerebral Amyloid Angiopathy: An Overview with Clinical Cases].

    PubMed

    Schöberl, F; Eren, O E; Wollenweber, F A; Kraus, T; Kellert, L

    2016-09-01

    Sporadic cerebral amyloid angiopathy (CAA) is a cerebral small vessel disease in the elderly. Neuropathologically, it is characterized by deposition of amyloid-ß (Aß) in the wall of small to medium-sized arteries, capillaries and venules of the cerebral cortex and leptomeninges. Over the last years it was recognized as an important cause of spontaneous intracerebral hemorrhage and cognitive deficits in the elderly. The clinical and radiological manifestations are diverse ranging from acute onset focal neurological deficits due to intracerebral lobar hemorrhage to subacute progressive cognitive impairment due to Aß-mediated inflammation confluent subcortical edema. The wide clinico-radiological spectrum of CAA is a major challenge for the neurologist and stroke physician. This review provides a structured and detailed look at recent developments in CAA, and is illustrated with case studies. PMID:27607067

  9. Cerebral amyloid angiopathy-related inflammation: an emerging disease.

    PubMed

    Savoiardo, M; Erbetta, A; Di Francesco, J C; Brioschi, M; Silani, V; Falini, A; Storchi, G; Brighina, L; Ferrarese, C; Ticozzi, N; Messina, S; Girotti, F

    2011-05-15

    Three elderly patients with, respectively: mild cognitive impairment, severe and progressive neurologic involvement, and focal neurologic deficit, were observed. MRI showed multiple areas of white matter edema, at times partially involving the cortex, in the first two patients, and a single area in the third. Treatment with steroids determined the disappearance of the lesions and clinical amelioration. The key to the diagnosis of cerebral amyloid angiopathy-related inflammation (CAA-ri) was the demonstration, with appropriate MRI sequences, of microbleeds consistent with cerebral amyloid angiopathy (CAA). This diagnosis was supported by genetic analysis of APOE with demonstration of ε4/ε4 genotype, found in about 80% of CAA patients who develop inflammatory changes. In the appropriate clinical setting, MRI demonstration of microbleeds supported by results of genetic analysis of APOE may strongly support the diagnosis of CAA-ri thus avoiding cerebral biopsy. PMID:24059616

  10. Cerebral venous thrombosis after ventriculoperitoneal shunting: a case report.

    PubMed

    Matsubara, Teppei; Ayuzawa, Satoshi; Aoki, Tsukasa; Ikeda, Go; Shiigai, Masanari; Matsumura, Akira

    2014-01-01

    Ventriculoperitoneal shunting (VPS) is a simple procedure, but there are several potential complications. We describe the first reported case of cerebral venous thrombosis (CVT) after VPS. A 69-year-old man suffering from normal pressure hydrocephalus underwent left VPS. Two months later he developed CVT and cerebral venous hemorrhage in the left frontal lobe. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed the thrombus formation just adjacent to the shunt tube. One possible cause is compression of the cortical vein after brain shift and/or tension of the cortical vein due to intracranial hypotension. A protein C deficiency was also detected. Surgeons should be aware that cerebral venous thrombosis can occur after VPS. PMID:24257484

  11. Cerebral Venous Thrombosis after Ventriculoperitoneal Shunting: A Case Report

    PubMed Central

    MATSUBARA, Teppei; AYUZAWA, Satoshi; AOKI, Tsukasa; IKEDA, Go; SHIIGAI, Masanari; MATSUMURA, Akira

    2014-01-01

    Ventriculoperitoneal shunting (VPS) is a simple procedure, but there are several potential complications. We describe the first reported case of cerebral venous thrombosis (CVT) after VPS. A 69-year-old man suffering from normal pressure hydrocephalus underwent left VPS. Two months later he developed CVT and cerebral venous hemorrhage in the left frontal lobe. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed the thrombus formation just adjacent to the shunt tube. One possible cause is compression of the cortical vein after brain shift and/or tension of the cortical vein due to intracranial hypotension (IH). A protein C deficiency was also detected. Surgeons should be aware that cerebral venous thrombosis can occur after VPS. PMID:24257484

  12. Reversible cerebral vasoconstriction syndrome: rare or underrecognized in children?

    PubMed

    Probert, Rebecca; Saunders, Dawn E; Ganesan, Vijeya

    2013-04-01

    Reversible cerebral vasoconstriction syndrome (RCVS) is a clinicoradiological diagnosis comprising 'thunderclap' headaches and reversible segmental vasoconstriction of cerebral arteries, occasionally complicated by ischaemic or haemorrhagic stroke. We report a case of RCVS in a 13-year-old male with severe thunderclap headaches and no focal neurological signs. Brain imaging showed multiple posterior circulation infarcts; cerebral computed tomography, magnetic resonance imaging, and catheter angiography showed multifocal irregularity and narrowing, but in different arterial segments. Laboratory studies did not support a diagnosis of vasculitis. Symptoms resolved over 3 weeks; magnetic resonance angiography 3 months later was normal and remained so after 2 years. We highlight the typical clinical features of RCVS in this case and suggest that the diagnosis should be considered in children with thunderclap headaches or stroke syndromes where headache is a prominent feature, especially if cerebrovascular imaging studies appear to be evolving or discrepant. PMID:23066702

  13. Involuntary masturbation and hemiballismus after bilateral anterior cerebral artery infarction.

    PubMed

    Bejot, Yannick; Caillier, Marie; Osseby, Guy-Victor; Didi, Roy; Ben Salem, Douraied; Moreau, Thibault; Giroud, Maurice

    2008-02-01

    Ischemia of the areas supplied by the anterior cerebral artery is relatively uncommon. In addition, combined hemiballismus and masturbation have rarely been reported in patients with cerebrovascular disease. We describe herein a 62-year-old right-handed man simultaneously exhibiting right side hemiballismus and involuntary masturbation with the left hand after bilateral infarction of the anterior cerebral artery territory. Right side hemiballismus was related to the disruption of afferent fibers from the left frontal lobe to the left subthalamic nucleus. Involuntary masturbation using the left hand was exclusively linked to a callosal type of alien hand syndrome secondary to infarction of the right side of the anterior corpus callosum. After 2 weeks, these abnormal behaviours were completely extinguished. This report stresses the wide diversity of clinical manifestations observed after infarction of the anterior cerebral artery territory. PMID:17961914

  14. Cerebral perfusion imaging with iodine 123-labeled amines

    SciTech Connect

    Holman, B.L.; Hill, T.C.; Polak, J.F.; Lee, R.G.; Royal, H.D.; O'Leary, D.H.

    1984-10-01

    Two amines, N-isopropyl p-iodoamphetamine and N,N,N'-trimethyl-N'-(2-hydroxyl-3-methyl-5-iodobenzyl)-1,3-prop anediamine, have been labeled with iodine 123. The brain uptake of these radioactive tracers is proportional to cerebral blood flow. These tracers are retained in the brain for a sufficiently long time so that imaging can be performed with standard, readily available instrumentation. Transaxial tomography with amines is useful in acute cerebral infarction, in which the x-ray computed tomographic scan may be normal for several days after onset of symptoms while the uptake of radioisotope-labeled amines will be altered immediately after the onset of the stroke. It is also useful in examining patients with cerebral vascular disease and in the preoperative examination of patients with partial epilepsy.

  15. Contrast-enhanced imaging of cerebral vasculature with laser speckle

    NASA Astrophysics Data System (ADS)

    Murari, K.; Li, N.; Rege, A.; Jia, X.; All, A.; Thakor, N.

    2007-08-01

    High-resolution cerebral vasculature imaging has applications ranging from intraoperative procedures to basic neuroscience research. Laser speckle, with spatial contrast processing, has recently been used to map cerebral blood flow. We present an application of the technique using temporal contrast processing to image cerebral vascular structures with a field of view a few millimeters across and approximately 20 μm resolution through a thinned skull. We validate the images using fluorescent imaging and demonstrate a factor of 2-4 enhancement in contrast-to-noise ratios over reflectance imaging using white or spectrally filtered green light. The contrast enhancement enables the perception of approximately 10%-30% more vascular structures without the introduction of any contrast agent.

  16. The cerebral effects of ascent to high altitudes.

    PubMed

    Wilson, Mark H; Newman, Stanton; Imray, Chris H

    2009-02-01

    Cellular hypoxia is the common final pathway of brain injury that occurs not just after asphyxia, but also when cerebral perfusion is impaired directly (eg, embolic stroke) or indirectly (eg, raised intracranial pressure after head injury). We Review recent advances in the understanding of neurological clinical syndromes that occur on exposure to high altitudes, including high altitude headache (HAH), acute mountain sickness (AMS), and high altitude cerebral oedema (HACE), and the genetics, molecular mechanisms, and physiology that underpin them. We also present the vasogenic and cytotoxic bases for HACE and explore venous hypertension as a possible contributory factor. Although the factors that control susceptibility to HACE are poorly understood, the effects of exposure to altitude (and thus hypobaric hypoxia) might provide a reproducible model for the study of cerebral cellular hypoxia in healthy individuals. The effects of hypobaric hypoxia might also provide new insights into the understanding of hypoxia in the clinical setting. PMID:19161909

  17. Hippocampal neurogenesis in the new model of global cerebral ischemia

    NASA Astrophysics Data System (ADS)

    Kisel, A. A.; Chernysheva, G. A.; Smol'yakova, V. I.; Savchenko, R. R.; Plotnikov, M. B.; Khodanovich, M. Yu.

    2015-11-01

    The study aimed to evaluate the changes of hippocampal neurogenesis in a new model of global transient cerebral ischemia which was performed by the occlusion of the three main vessels (tr. brachiocephalicus, a. subclavia sinistra, and a. carotis communis sinistra) branching from the aortic arch and supplying the brain. Global transitory cerebral ischemia was modeled on male rats (weight = 250-300 g) under chloral hydrate with artificial lung ventilation. Animals after the same surgical operation without vessel occlusion served as sham-operated controls. The number of DCX-positive (doublecortin, the marker of immature neurons) cells in dentate gyrus (DG) and CA1-CA3 fields of hippocampus was counted at the 31st day after ischemia modeling. It was revealed that global cerebral ischemia decreased neurogenesis in dentate gyrus in comparison with the sham-operated group (P<0.05) while neurogenesis in CA1-CA3 fields was increased as compared to the control (P<0.05).

  18. Biomechanical bases of rehabilitation of children with cerebral palsy

    NASA Astrophysics Data System (ADS)

    Davlet'yarova, K. V.; Korshunov, S. D.; Kapilevich, L. V.

    2015-11-01

    Biomechanical analysis and the study results of children's with cerebral palsy (CP) muscles bioelectrical activity while walking on a flat surface are represented. Increased flexion in the hip and shoulder joints and extension in the elbow joint in children with cerebral palsy were observed, with the movement of the lower limbs had less smooth character in comparison with the control group. Herewith, the oscillation amplitude was significantly increased, and the frequency in the m. gastrocnemius and m. lateralis was decreased. It was shown, that the dynamic stereotype of walking in children with cerebral palsy was characterized by excessive involvement of m. gastrocnemius and m.latissimus dorsi in locomotion. Thus, resulting biomechanical and bioelectrical parameters of walking should be considered in the rehabilitation programs development.

  19. Pharmacologic interventions for reducing spasticity in cerebral palsy.

    PubMed

    Patel, Dilip R; Soyode, Olufemi

    2005-10-01

    Motor function abnormalities are a key feature of cerebral palsy. Spasticity is one of the main motor abnormalities seen in children with cerebral palsy. Spasticity is a velocity dependent increased resistance to movement. While in some children, spasticity may adversely impact the motor abilities, in others, it may help maintain posture and ability to ambulate. Thus, treatment to reduce spasticity requires careful consideration of various factors. Non-pharmacologic interventions used to reduce spasticity include physiotherapy, occupational therapy, use of adaptive equipment, various orthopedic surgical procedures and neurosurgical procedures. Pharmacologic interventions used for reducing spasticity in children with cerebral palsy reviewed in this article include oral administration of baclofen, diazepam, dantrolene and tizanidine, intrathecal baclofen, and local injections of botulinum toxin, phenol, and alcohol. PMID:16272661

  20. A prognostic classification of cerebral cysticercosis: therapeutic implications.

    PubMed Central

    Estañol, B; Corona, T; Abad, P

    1986-01-01

    Cerebral cysticercosis is a parasitic infestation with a highly variable prognosis and diverse clinical manifestations. Over the period of two years 51 patients were studied prospectively with this infestation, paying particular attention to the duration and severity of the illness, clinical course, CT findings and therapeutic modalities. Patients with parenchymal cysts or calcification without hydrocephalus had a benign disorder presenting commonly with seizures. This type of infestation usually is long-standing, almost never requires surgical treatment, responds to praziquantel therapy and has a good prognosis. In contrast, patients who present with hydrocephalus, large supratentorial cysts, multiple granulomata with cerebral oedema or with vasculitis and cerebral infarction, have an aggressive, acute or subacute illness, presenting with raised intracranial pressure, gait disturbances, mental changes, seizures, cranial nerve palsies, hemisphere syndromes, chronic meningitis and stroke. This malignant form usually requires surgical therapy, does not respond to praziquantel and may produce a fatal outcome or serious sequelae. PMID:3783174

  1. Cerebral coherence between communicators marks the emergence of meaning.

    PubMed

    Stolk, Arjen; Noordzij, Matthijs L; Verhagen, Lennart; Volman, Inge; Schoffelen, Jan-Mathijs; Oostenveld, Robert; Hagoort, Peter; Toni, Ivan

    2014-12-23

    How can we understand each other during communicative interactions? An influential suggestion holds that communicators are primed by each other's behaviors, with associative mechanisms automatically coordinating the production of communicative signals and the comprehension of their meanings. An alternative suggestion posits that mutual understanding requires shared conceptualizations of a signal's use, i.e., "conceptual pacts" that are abstracted away from specific experiences. Both accounts predict coherent neural dynamics across communicators, aligned either to the occurrence of a signal or to the dynamics of conceptual pacts. Using coherence spectral-density analysis of cerebral activity simultaneously measured in pairs of communicators, this study shows that establishing mutual understanding of novel signals synchronizes cerebral dynamics across communicators' right temporal lobes. This interpersonal cerebral coherence occurred only within pairs with a shared communicative history, and at temporal scales independent from signals' occurrences. These findings favor the notion that meaning emerges from shared conceptualizations of a signal's use. PMID:25489093

  2. Cerebral blood flow asymmetries in headache-free migraineurs

    SciTech Connect

    Levine, S.R.; Welch, K.M.; Ewing, J.R.; Joseph, R.; D'Andrea, G.

    1987-11-01

    Regional cerebral blood flow (rCBF) asymmetries were studied in controls and patients with common and classic/complicated migraine using /sup 133/Xe inhalation with 8 homologously situated external collimators over each cerebral hemisphere. Migraine patients as a group more frequently had posterior rCBF asymmetries than controls (p less than 0.03). Although there were no differences in the number of anterior rCBF asymmetries, migraine patients had 2 or more asymmetric probe pairs more often than controls (p less than 0.02). The posterior rCBF asymmetries, consistent with the site of activation of many migraine attacks, may be related to more labile control of the cerebral circulation.

  3. Expression of Estrogen Receptor α in the Mouse Cerebral Cortex

    PubMed Central

    Dietrich, Alicia K.; Humphreys, Gwendolyn I.; Nardulli, Ann M.

    2015-01-01

    Although estrogen receptor alpha (ERα) and 17β-estradiol play critical roles in protecting the cerebral cortex from ischemia-induced damage, there has been some controversy about the expression of ERα in this region of the brain. We have examined ERα mRNA and protein levels in the cerebral cortices of female mice at postnatal days 5 and 17 and at 4, 13, and 18 months of age. We found that although ERα transcript levels declined from postnatal day 5 through 18 months of age, ERα protein levels remained stable. Importantly, expression of the E2-regulated progesterone receptor gene was sustained in younger and in older females suggesting that age-related changes in estrogen responsiveness in the cerebral cortex are not due to the absence of ERα protein. PMID:25700604

  4. Cerebral venous sinus thrombosis as presenting feature of ulcerative colitis.

    PubMed

    Ennaifer, R; Moussa, A; Mouelhi, L; Salem, M; Bouzaidi, S; Debbeche, R; Trabelsi, S; Najjar, T

    2009-01-01

    Thrombosis is a well recognized complication of inflammatory bowel disease that occurs in 1.3 to 6.4% of patients, however, cerebral vascular involvement is unusual. We present the case of a 16-year-old female in whom cerebral venous thrombosis was the presenting symptom of an active ulcerative pancolitis. Thrombophilia screen (plasma levels of proteins C and S, antithrombin, antibeta2-glycoprotein, lupus anticoagulant and anticardiolipin antibodies, activated protein C resistance, homocystein level antinuclear antibodies) was negative. The patient was successfully treated with anticoagulant therapy, phenobarbital and sulfasalazine. Cerebral venous thrombosis is an exceptional presenting feature of ulcerative colitis. Disease activity may play a major role in the occurrence of thrombosis. PMID:19902870

  5. Cardiovascular autonomic functions & cerebral autoregulation in patients with orthostatic hypotension

    PubMed Central

    Khandelwal, Ekta; Jaryal, Ashok Kumar; Deepak, K.K.

    2011-01-01

    Background & objectives: Patients of orthostatic hypotension may or may not have symptoms of the cerebral hypoperfusion despite fall in the blood pressure. The present study was done to quantify autonomic functions and cerebral autoregulation in patients of orthostatic hypotension with or without symptoms. Methods: The study was conducted in 15 patients of orthostatic hypotension and 15 age, sex matched control subjects. The sympathetic reactivity was measured by diastolic blood pressure response to handgrip test (ΔDBP in HGT) and cold pressor test (ΔDBP in CPT). The parasympathetic reactivity was measured by E:I ratio during deep breathing test (DBT) and Valsalva ratio (VR) during Valsalva maneuver. The cerebral autoregulation was computed from the changes in the cerebral blood flow, cerebrovascular conductance and blood pressure measured during different time points during head-up tilt (HUT). Results: The sympathetic reactivity was lower in patients as compared to controls [ΔDBP in HGT: 10 (4 - 16) vs 18 (12 - 22) mmHg, P<0.01; ΔDBP in CPT : 10 (4-12) vs 16 (10-20) mmHg, P<0.01]. The parasympathetic reactivity was also lower in patients as compared to controls. The sympathetic and parasympathetic reactivity was comparable in the symptomatic and asymptomatic patients. The maximum fall in blood pressure during HUT was comparable between symptomatic and asymptomatic patients (29.14 ± 10.94 vs 29.50 ± 6.39 mmHg), however, the percentage fall in the cerebral blood flow was significantly higher in the symptomatic (P<0.05) compared to asymptomatics. Interpretation & conclusions: Patients with orthostatic hypotension had deficits in sympathetic and parasympathetic control of cardiovascular system. Cerebral autoregulation was present in asymptomatic patients (increase in cerebrovascular conductance) during HUT while it was lost in symptomatic patients. PMID:22089608

  6. Effectiveness of sugammadex for cerebral ischemia/reperfusion injury.

    PubMed

    Ozbilgin, Sule; Yılmaz, Osman; Ergur, Bekir Ugur; Hancı, Volkan; Ozbal, Seda; Yurtlu, Serhan; Gunenc, Sakize Ferim; Kuvaki, Bahar; Kucuk, Burcu Ataseven; Sisman, Ali Rıza

    2016-06-01

    Cerebral ischemia may cause permanent brain damage and behavioral dysfunction. The efficacy and mechanisms of pharmacological treatments administered immediately after cerebral damage are not fully known. Sugammadex is a licensed medication. As other cyclodextrins have not passed the necessary phase tests, trade preparations are not available, whereas sugammadex is frequently used in clinical anesthetic practice. Previous studies have not clearly described the effects of the cyclodextrin family on cerebral ischemia/reperfusion (I/R) damage. The aim of this study was to determine whether sugammadex had a neuroprotective effect against transient global cerebral ischemia. Animals were assigned to control, sham-operated, S 16 and S 100 groups. Transient global cerebral ischemia was induced by 10-minute occlusion of the bilateral common carotid artery, followed by 24-hour reperfusion. At the end of the experiment, neurological behavior scoring was performed on the rats, followed by evaluation of histomorphological and biochemical measurements. Sugammadex 16 mg/kg and 100 mg/kg improved neurological outcome, which was associated with reductions in both histological and neurological scores. The hippocampus TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) and caspase results in the S 16 and S 100 treatment groups were significantly lower than those of the I/R group. Neurological scores in the treated groups were significantly higher than those of the I/R group. The study showed that treatment with 16 mg/kg and 100 mg/kg sugammadex had a neuroprotective effect in a transient global cerebral I/R rat model. However, 100 mg/kg sugammadex was more neuroprotective in rats. PMID:27377841

  7. Radioactive microsphere study of cerebral blood flow under acceleration. Technical report

    SciTech Connect

    Greenlees, K.J.; Yoder, J.E.; Toth, D.M.; Oloff, C.M.; Karl, A.

    1980-11-01

    A study using radioactive microspheres for the investigation of cerebral blood flow during acceleration is described. Details of a technique for the blunt dissection of cerebral tissues are included. Results of flow studies at 3 and 5 G sub z acceleration stress indicate there is no selective regional preservation of cerebral tissue. (Author)

  8. Cerebral Dysfunctions Related to Perinatal Organic Damage: Clinical-Neuropathologic Correlations.

    ERIC Educational Resources Information Center

    Towbin, Abraham

    1978-01-01

    Recent neuropathology studies identify hypoxia as the main cause of perinatal cerebral damage. Cerebral lesions present at birth, with transition to chronic scar lesions, are correlated to mental retardation, cerebral palsy, epilepsy, and minimal brain dysfunction. Gestation age and severity of hypoxic exposure essentially determine the cerebral…

  9. Post-therapeutic surveillance strategies in head and neck squamous cell carcinoma.

    PubMed

    Digonnet, Antoine; Hamoir, Marc; Andry, Guy; Haigentz, Missak; Takes, Robert P; Silver, Carl E; Hartl, Dana M; Strojan, Primož; Rinaldo, Alessandra; de Bree, Remco; Dietz, Andreas; Grégoire, Vincent; Paleri, Vinidh; Langendijk, Johannes A; Vander Poorten, Vincent; Hinni, Michael L; Rodrigo, Juan P; Suárez, Carlos; Mendenhall, William M; Werner, Jochen A; Genden, Eric M; Ferlito, Alfio

    2013-05-01

    The management of head and neck squamous cell carcinomas does not end with the completion of ablative therapy. The oncologic objectives of post-treatment follow-up are to detect recurrences and second primary tumors; beyond that, follow-up should evaluate acute and chronic treatment-related side effects, guide the rehabilitation process, alleviate functional loss, manage pain, restore nutritional status and assess psychosocial factors. In this structured review, we address the questions of timing and the tools required to achieve a complete and coherent routine surveillance. Several guidelines and consensus statements recommend clinical examination as the cornerstone of follow-up which should be performed for at least 5 years, although there are no data in favor of any one particular follow-up program, and only low-level evidence suggests an improvement in oncologic outcomes by close follow-up. Baseline imaging (computed tomography and magnetic resonance imaging) should be obtained within 2-6 months after definitive therapy if used for treatment response evaluation. Metabolic response, if indicated, should be assessed preferably after 3 months in patients who undergo curative-intent therapy with (chemo)-radiotherapy. Chest computed tomography is more sensitive than plain radiography, if used in follow-up, but the benefit and cost-effectiveness of routine chest computed tomography has not been demonstrated. There are no current data supporting modifications specific to the surveillance plan of patients with human papillomavirus-associated disease. PMID:22972497

  10. [Ovarian cancer. Pretherapeutic evaluation and post-therapeutic follow-up].

    PubMed

    Wolff, J P; Masselot, J

    1982-01-01

    The number, the variety and the complexity of investigations for diagnosis and follow-up of ovarian carcinoma are related to the diversity of possible involvement and the insufficiency of the reliability of each of the applied methods. Cytologic examination, sonography and CT scanning are of first line importance, as well as the different roentgenologic methods. However, none allows dispensing surgical exploration and pathological examination. Moreover, as one speaks of therapeutic strategy, diagnostic strategy lead by a homogeneous and well coordinated team, is worthy of mention as well, for it is the only guarantee for efficiency and valuable results. PMID:6181837

  11. Posttherapeutic Cure Criteria in Chagas' Disease: Conventional Serology followed by Supplementary Serological, Parasitological, and Molecular Tests

    PubMed Central

    Silva, A. R.; Do Bem, V. A. L.; Bahia, M. T.; Martins-Filho, O. A.; Dias, J. C. P.; Albajar-Viñas, P.; Torres, R. M.; Lana, M.

    2012-01-01

    We performed a critical study of conventional serology, followed by supplementary serological, parasitological, and molecular tests, to assess the response to etiologic treatment of Chagas' disease. A group of 94 Chagas' disease patients treated with benznidazole at least 10 years earlier were evaluated from the laboratory and clinical points of view. When conventional serology (enzyme-linked immunosorbent assay [ELISA], indirect immunofluorescence [IIF], and indirect hemagglutination [IHA]) and classic criteria (consistent results with any two of the three tests) or more rigorous criteria (consistent results from the three tests) were used, 10.6% and 8.5% of patients were considered treated and cured (TC) by classic and rigorous criteria, respectively. Patients were then evaluated using supplementary (recombinant ELISA and Trypanosoma cruzi excreted-secreted antigen blotting [TESA-blot]), parasitological (hemoculture), and molecular (PCR) tests. The results of recombinant ELISA were similar to those with the rigorous criterion (three consistent test results). The TESA-blot group showed a higher percentage (21.3%) of negative results than the groups defined by either cure criterion. Hemoculture and PCR gave negative results for all treated and cured (TC) patients, regardless of the criterion used. Recombinant ELISA and TESA-blot tests showed negative results for 70% and 87.5% of the patients categorized as TC by the classic and three-test criteria, respectively. For patients with discordant conventional serology, the supplementary serological and molecular tests were the decisive factor in determining therapeutic failure. Clinical evaluation showed that 62.5% of TC patients presented with the indeterminate form of the disease. Additionally, treated patients with negative TESA-blot results should be reevaluated later with all methodologies used here to verify whether TESA-blot is a reliable way to determine early parasitological cure of Chagas' disease. PMID:22739694

  12. Comprehensive cognitive and cerebral hemodynamic evaluation after cranioplasty

    PubMed Central

    Coelho, Fernanda; Oliveira, Arthur Maynart; Paiva, Wellingson Silva; Freire, Fabio Rios; Calado, Vanessa Tome; Amorim, Robson Luis; Neville, Iuri Santana; de Andrade, Almir Ferreira; Bor-Seng-Shu, Edson; Anghinah, Renato; Teixeira, Manoel Jacobsen

    2014-01-01

    Decompressive craniectomy is an established procedure to lower intracranial pressure and can save patients’ lives. However, this procedure is associated with delayed cognitive decline and cerebral hemodynamics complications. Studies show the benefits of cranioplasty beyond cosmetic aspects, including brain protection, and functional and cerebrovascular aspects, but a detailed description of the concrete changes following this procedure are lacking. In this paper, the authors report a patient with trephine syndrome who underwent cranioplasty; comprehensive cognitive and cerebral hemodynamic evaluations were performed prior to and following the cranioplasty. The discussion was based on a critical literature review. PMID:24833902

  13. Fractal dimension of cerebral surfaces using magnetic resonance images

    SciTech Connect

    Majumdar, S.; Prasad, R.R.

    1988-11-01

    The calculation of the fractal dimension of the surface bounded by the grey matter in the normal human brain using axial, sagittal, and coronal cross-sectional magnetic resonance (MR) images is presented. The fractal dimension in this case is a measure of the convolutedness of this cerebral surface. It is proposed that the fractal dimension, a feature that may be extracted from MR images, may potentially be used for image analysis, quantitative tissue characterization, and as a feature to monitor and identify cerebral abnormalities and developmental changes.

  14. Cerebral glucose utilization is reduced in second test session.

    PubMed

    Stapleton, J M; Morgan, M J; Liu, X; Yung, B C; Phillips, R L; Wong, D F; Shaya, E K; Dannals, R F; London, E D

    1997-06-01

    Cerebral glucose utilization was higher during the first positron emission tomography (PET) session than during the second session, as assayed using the PET [18F]fluorodeoxyglucose method in male human volunteers. This difference was due largely to data from subjects with low-trait anxiety, since subjects with high anxiety showed similar metabolism in both PET sessions. High-anxiety subjects showed greater right/ left ratios of cerebral metabolism than low-anxiety subjects, particularly during the second PET session. These findings suggest that the level of anxiety may be an important variable to consider in PET studies using multiple sessions. PMID:9236727

  15. Stent Application for the Treatment of Cerebral Aneurysms

    PubMed Central

    Kim, Dong Joon; Kim, Dong Ik

    2011-01-01

    Rapid and striking development in both the techniques and devices make it possible to treat most of cerebral aneurysms endovascularly. Stent has become one of the most important tools in treating difficult aneurysms not feasible for simple coiling. The physical features, the dimensions, and the functional characteristics of the stents show considerable differences. There are also several strategies and tips to treat difficult aneurysms by using stent and coiling. Nevertheless, they require much experience in clinical practice as well as knowledge of the stents to treat cerebral aneurysms safely and effectively. In this report, a brief review of properties of the currently available stents and strategies of their application is presented. PMID:22125751

  16. Effect of certain cerebral hemispheric diseases on dreaming.

    PubMed

    Epstein, A W

    1979-02-01

    Dreaming may be altered by cerebral hemispheric disease. A woman who sustained a probable left posterior cerebral artery thrombosis, with right homonymous hemianopsia and alexia, had virtual cessation of dreaming for at least 9 months. Four individuals with temporal lobe epilepsy experienced recurrent painful (frightening) dreams, which in two patients showed features identical to seizures. Sleep recordings showed abnormalities in all four, including rhythmic temporal epileptiform activity during REM sleep. Lesions in parieto-occipital loci may interfere with production of the visual imagery required for dreaming (negative symptom in the Jacksonian sense) while epileptic activity in temporal loci may produce painful repetitive dream imagery (positive symptom). PMID:217457

  17. Modelling cerebral blood oxygenation using Monte Carlo XYZ-PA

    NASA Astrophysics Data System (ADS)

    Zam, Azhar; Jacques, Steven L.; Alexandrov, Sergey; Li, Youzhi; Leahy, Martin J.

    2013-02-01

    Continuous monitoring of cerebral blood oxygenation is critically important for the management of many lifethreatening conditions. Non-invasive monitoring of cerebral blood oxygenation with a photoacoustic technique offers advantages over current invasive and non-invasive methods. We introduce a Monte Carlo XYZ-PA to model the energy deposition in 3D and the time-resolved pressures and velocity potential based on the energy absorbed by the biological tissue. This paper outlines the benefits of using Monte Carlo XYZ-PA for optimization of photoacoustic measurement and imaging. To the best of our knowledge this is the first fully integrated tool for photoacoustic modelling.

  18. Impact of COPD exacerbation on cerebral blood flow.

    PubMed

    Yildiz, Sema; Kaya, Ihsan; Cece, Hasan; Gencer, Mehmet; Ziylan, Zeki; Yalcin, Funda; Turksoy, Ozlem

    2012-01-01

    We aimed to investigate the impact of chronic obstructive pulmonary disease (COPD) exacerbation on cerebral blood flow (CBF). In 21 COPD patients - in both exacerbation and stable phases -Doppler ultrasonographies of internal carotid artery (ICA) and vertebral artery (VA) were performed. There were significant differences in total, anterior and posterior CBF, ICA and VA flow volumes in exacerbated COPD compared to stable COPD. Total CBF was correlated with cross-sectional areas of left and right ICA, whereas independent predictor of total CBF was cross-sectional area of right ICA. Increased CBF might indicate cerebral autoregulation-mediated vasodilatation to overcome COPD exacerbation induced hypoxia. PMID:22542376

  19. Inflammation and human cerebral aneurysms: current and future treatment prospects

    PubMed Central

    Hudson, Joseph S; Hoyne, Danielle S; Hasan, David M

    2013-01-01

    The formation of cerebral aneurysms and their rupture propensity is of immediate clinical importance. Current management includes observation with expectant management, microsurgical clipping and/or endovascular coiling. The surgical options are invasive and are not without increased risk despite the technological advances. Recent human and animal studies have shown that inflammation plays a critical role in aneurysm formation and progression to rupture. Modulating this inflammatory process may prove to be clinically significant. This review will discuss cerebral aneurysm pathogenesis with a focus on current and future research of potential use of pharmaceutical agents that attenuate inflammation in the aneurysm wall leading to decreased risk of aneurysm rupture. PMID:24376373

  20. Local production of astrocytes in the cerebral cortex.

    PubMed

    Ge, W-P; Jia, J-M

    2016-05-26

    Astrocytes are the largest glial population in the mammalian brain. Astrocytes in the cerebral cortex are reportedly generated from four sources, namely radial glia, progenitors in the subventricular zone (SVZ progenitors), locally proliferating glia, and NG2 glia; it remains an open question, however, as to what extent these four cell types contribute to the substantial increase in astrocytes that occurs postnatally in the cerebral cortex. Here we summarize all possible sources of astrocytes and discuss their roles in this postnatal increase. In particular, we focus on astrocytes derived from local proliferation within the cortex. PMID:26343293

  1. Reversible Cerebral Vasoconstriction Syndrome: A Report on Three Cases.

    PubMed

    Roongpiboonsopit, Duangnapa; Kongbunkiat, Kannikar; Phanthumchinda, Kammant

    2016-01-01

    Reversible cerebral vasoconstriction syndrome (RCVS), a recently recognized syndrome, is defined as an intermittent segmental vasospasm of cerebral arteries accompanied by thunderclap headache. The major complications of RCVS include ischemic or hemorrhagic stroke, which may cause morbidity and mortality. It is important to detect RCVS in clinical practice because misdiagnosis may lead to inappropriate treatment. In Thailand, there are only two reported cases of RCVS, which may reflect an underdiagnosis of this syndrome. To raise awareness of RCVS, we reported a case series of three RCVS cases. Two of the presented cases had interesting precipitating factors, and two cases had an unusual delayed clinical course. PMID:27455831

  2. Comprehensive Overview of Contemporary Management Strategies for Cerebral Aneurysms.

    PubMed

    Manhas, Amitoz; Nimjee, Shahid M; Agrawal, Abhishek; Zhang, Jonathan; Diaz, Orlando; Zomorodi, Ali R; Smith, Tony; Powers, Ciarán J; Sauvageau, Eric; Klucznik, Richard P; Ferrell, Andrew; Golshani, Kiarash; Stieg, Philip E; Britz, Gavin W

    2015-10-01

    Aneurysmal subarachnoid hemorrhage (SAH) remains an important health issue in the United States. Despite recent improvements in the diagnosis and treatment of cerebral aneurysms, the mortality rate following aneurysm rupture. In those patients who survive, up to 50% are left severely disabled. The goal of preventing the hemorrhage or re-hemorrhage can only be achieved by successfully excluding the aneurysm from the circulation. This article is a comprehensive review by contemporary vascular neurosurgeons and interventional neuroradiolgists on the modern management of cerebral aneurysms. PMID:26072457

  3. Subarachnoid hemorrhage as the initial presentation of cerebral venous thrombosis.

    PubMed

    Kato, Yuji; Takeda, Hidetaka; Furuya, Daisuke; Nagoya, Harumitsu; Deguchi, Ichiro; Fukuoka, Takuya; Tanahashi, Norio

    2010-01-01

    Cerebral venous thrombosis presenting as subarachnoid hemorrhage (SAH) is very rare. We present a woman with thrombosis of the superior sagittal, straight, transverse and sigmoid sinuses who presented with SAH in the right temporal sulcus and bilateral cerebellar sulci. Brain perfusion CT demonstrated a delay of the mean transit time and high cerebral blood volume around the right posterior temporal lobe and cerebellum. These findings were compatible with venous congestion and they suggest the possibility that extension of the dural sinus thrombosis into the superficial veins caused localized venous hypertension with dilatation of the thin, fragile-walled cortical veins which eventually ruptured into the subarachnoid space. PMID:20190485

  4. Rhino-orbito-cerebral mucormycosis in patients with diabetic ketoacidosis.

    PubMed

    Gen, Ramazan; Horasan, Elif Şahin; Vaysoğlu, Yusuf; Arpaci, Rabia Bozdoğan; Ersöz, Gülden; Özcan, Cengiz

    2013-03-01

    Mucormycosis is a life-threatening fungal infection that occurs in immunocompromised patients. The most common predisposing risk factor for mucormycosis is diabetes mellitus. Rhino-orbito-cerebral mucormycosis is the most common form in diabetic patients and is characterized by paranasal sinusitis, ophthalmoplegia with blindness, and unilateral proptosis with cellulitis, facial pain with swelling, headache, fever, rhinitis, granular or purulent nasal discharge, nasal ulceration, epistaxis, hemiplegia or stroke, and decreased mental function. Diabetic ketoacidosis is the most common and serious acute complication of diabetic patients. We herein report 2 cases of fatal rhino-orbito-cerebral mucormycosis in a patient with diabetic ketoacidosis. PMID:23524816

  5. Sporadic Cerebral Amyloid Angiopathy: Pathophysiology, Neuroimaging Features, and Clinical Implications.

    PubMed

    Boulouis, Gregoire; Charidimou, Andreas; Greenberg, Steven M

    2016-06-01

    Sporadic cerebral amyloid angiopathy is a small vessel disorder defined pathologically by progressive amyloid deposition in the walls of cortical and leptomeningeal vessels resulting from disruption of a complex balance between production, circulation, and clearance of amyloid-β peptide (Aβ) in the brain. Cerebral amyloid angiopathy is a major cause of lobar symptomatic intracerebral hemorrhage, transient focal neurologic episodes, and a key contributor to vascular cognitive impairment. The mechanisms and consequences of amyloid-β deposition at the pathological level and its neuroimaging manifestations, clinical consequences, and implications for patient care are addressed in this review. PMID:27214698

  6. General technical considerations for the endovascular management of cerebral aneurysms.

    PubMed

    Eboli, Paula; Ryan, Robert W; Alexander, Michael J

    2014-07-01

    Cerebral aneurysms pose a threat to patients because of their risk of rupture causing subarachnoid hemorrhage, and the goal of treatment is the exclusion of the aneurysm from the circulation to prevent bleeding (in the case of unruptured aneurysms) or rebleeding. This article analyzes the general technical factors associated with the endovascular treatment of cerebral aneurysms. It discusses issues with transarterial access; imaging of aneurysm size, morphology, and regional anatomy to determine the endovascular plan; the techniques for the major endovascular aneurysm devices; and periprocedural management issues to reduce potential treatment-related complications. PMID:24994079

  7. Sporadic cerebral amyloid angiopathy: An important cause of cerebral hemorrhage in the elderly.

    PubMed

    Bano, Shahina; Yadav, Sachchida Nand; Garga, Umesh Chandra; Chaudhary, Vikas

    2011-01-01

    Cerebral amyloid angiopathy (CAA) is an important cause of primary intracerebral hemorrhage (PICH) in the elderly. Although there are no pathognomic clinical features of CAA-related PICH, the association of white matter changes with lobar, recurrent, or multiple simultaneous hemorrhages in older patients should raise the suspicion of its diagnosis. A definitive diagnosis of CAA requires pathologic examination of the affected tissue. However, with modern imaging techniques, it is possible to diagnose the "probable CAA" in patients presenting with PICH. Gradient-echo magnetic resonance imaging is a very sensitive, noninvasive technique for identifying microhemorrhages in life. The diagnosis of CAA is important because of the likely implication it has on future management targeted to reduce risk of future bleeding. PMID:21716867

  8. Fetal thrombotic vasculopathy in the placenta: cerebral thrombi and infarcts, coagulopathies, and cerebral palsy.

    PubMed

    Kraus, F T; Acheen, V I

    1999-07-01

    Thrombi in the fetal circulation of the placenta cause a pattern of clustered fibrotic villi called fetal thrombotic vasculopathy (FTV), which has been associated with serious injuries to neonates, especially brain injuries. Correlation of FTV with visceral thrombi in autopsy specimens might lead to a more accurate estimate of the prevalence of somatic thrombi as a significant and underrecognized cause of prenatal injury or perinatal death, and show the potential validity of placental FTV as an indicator of thrombotic lesions in the fetus and newborns who survive. Clinicopathologic correlation was used to perform a 3-year retrospective autopsy review. We identified 16 cases (19%) among 84 perinatal autopsy specimens in which placental FTV was associated with stillbirth, intrapartum, or neonatal death. Two liveborn neonates survived 2.5 hours, and one for 24 hours; there was one intrapartum death, and the rest were stillborn. Clinical evidence of severe central nervous system (CNS) injury to two of the liveborn infants was evident at birth. Twelve stillborns died from 12 to 48 hours before delivery. Placental FTV had features of organization that clearly antedated the fetal death. Autopsy findings confirmed somatic thrombi in six cases (37.5%) of the 16 with FTV, including cerebral thrombi or infarcts (three cases), renal thromboemboli (three cases), and pulmonary thromboemboli (two cases). One mother had history of deep vein thrombosis, and four of eight tested had abnormal coagulation test results. Placental FTV indicates a significant probability of thrombi in the fetus and represents an important, possibly underrecognized cause of perinatal mortality and neonatal injury. Parental coagulopathy as a significant factor in prenatal injury and death deserves more comprehensive study. The placenta remains an undervalued and underutilized surgical specimen in the evaluation of perinatal injury, especially cerebral palsy. PMID:10414494

  9. Cerebral aspergillosis in a diabetic patient leading to cerebral artery occlusion and ischemic stroke: a case report and literature review.

    PubMed

    Li, Wentao; Shafi, Neelofer; Periakaruppan, Ramayee; Valyi-Nagy, Tibor; Groth, John; Testai, Fernando D

    2015-01-01

    Cerebral aspergillosis is a rare and highly fatal hematogenous infection most commonly found in immune compromised patients. From the onset of neurologic symptoms, the median reported rate of survival is between 5 and 9 days. Compounded with increased hemorrhagic risks and the lack of specificity in both clinical presentation and traditional imaging, a fast and noninvasive method of definitive diagnosis is necessary if there is to be any hope for positive outcomes. We describe the case of a 50-year-old female diabetic with a history of otitis media, an uncharacterized inflammatory nasopharyngeal process, and prior ischemic strokes who presented with a new cerebral infarction in the setting of an angioinvasive fungal infection of the large cerebral arteries. We also present a literature review of aspergillosis detection and treatment in hopes that future cases will be diagnosed in a timely manner and more patients may be saved. PMID:25444026

  10. Activation of cerebral sodium-glucose transporter type 1 function mediated by post-ischemic hyperglycemia exacerbates the development of cerebral ischemia.

    PubMed

    Yamazaki, Y; Ogihara, S; Harada, S; Tokuyama, S

    2015-12-01

    The regulation of post-ischemic hyperglycemia plays an important role in suppressing neuronal damage in therapeutic strategies for cerebral ischemia. We previously reported that the cerebral sodium-glucose transporter (SGLT) was involved in the post-ischemic hyperglycemia-induced exacerbation of cerebral ischemic neuronal damage. Cortical SGLT-1, one of the cerebral SGLT isoforms, is dramatically increased by focal cerebral ischemia. In this study, we focused on the involvement of cerebral SGLT-1 in the development of cerebral ischemic neuronal damage. It was previously reported that activation of 5'-adenosine monophosphate-activated protein kinase (AMPK) increases SGLT-1 expression. Moreover, ischemic stress-induced activation of AMPK exacerbates cerebral ischemic neuronal damage. Therefore, we directly confirmed the relationship between cerebral SGLT-1 and cerebral AMPK activation using in vitro primary culture of mouse cortical neurons. An in vivo mouse model of focal cerebral ischemia was generated using a middle cerebral artery occlusion (MCAO). The development of infarct volume and behavioral abnormalities on day 3 after MCAO were ameliorated in cerebral SGLT-1 knock down mice. Cortical and striatal SGLT-1 expression levels were significantly increased at 12h after MCAO. Immunofluorescence revealed that SGLT-1 and the neuronal nuclear antigen (NeuN) were co-localized in the cortex and striatum of MCAO mice. In the in vitro study, primary cortical neurons were cultured for five days before each treatment with reagents. Concomitant treatment with hydrogen peroxide and glucose induced the elevation of SGLT-1 and phosphorylated AMPK/AMPK ratio, and this elevation was suppressed by compound C, an AMPK inhibitor in primary cortical neurons. Moreover, compound C suppressed neuronal cell death induced by concomitant hydrogen peroxide/glucose treatment in primary cortical neurons. Therefore, we concluded that enhanced cerebral SGLT-1 function mediated by post

  11. Tumor necrosis factor-α inhibition attenuates middle cerebral artery remodeling but increases cerebral ischemic damage in hypertensive rats

    PubMed Central

    Girgla, Saavia S.; Moreno, Guillermo; McClain, Jonathon L.; Dorrance, Anne M.

    2014-01-01

    Hypertension causes vascular inflammation evidenced by an increase in perivascular macrophages and proinflammatory cytokines in the arterial wall. Perivascular macrophage depletion reduced tumor necrosis factor (TNF)-α expression in cerebral arteries of hypertensive rats and attenuated inward remodeling, suggesting that TNF-α might play a role in the remodeling process. We hypothesized that TNF-α inhibition would improve middle cerebral artery (MCA) structure and reduce damage after cerebral ischemia in hypertensive rats. Six-week-old male stroke-prone spontaneously hypertensive rats (SHRSP) were treated with the TNF-α inhibitor etanercept (ETN; 1.25 mg·kg−1·day−1 ip daily) or PBS (equivolume) for 6 wk. The myogenic tone generation, postischemic dilation, and passive structure of MCAs were assessed by pressure myography. Cerebral ischemia was induced by MCA occlusion (MCAO). Myogenic tone was unchanged, but MCAs from SHRSP + ETN had larger passive lumen diameter and reduced wall thickness and wall-to-lumen ratio. Cerebral infarct size was increased in SHRSP + ETN after transient MCAO, despite an improvement in dilation of nonischemic MCA. The increase in infarct size was linked to a reduction in the number of microglia in the infarct core and upregulation of markers of classical macrophage/microglia polarization. There was no difference in infarct size after permanent MCAO or when untreated SHRSP subjected to transient MCAO were given ETN at reperfusion. Our data suggests that TNF-α inhibition attenuates hypertensive MCA remodeling but exacerbates cerebral damage following ischemia/reperfusion injury likely due to inhibition of the innate immune response of the brain. PMID:25015967

  12. Spaceflight-induced alterations in cerebral artery vasoconstrictor, mechanical, and structural properties: implications for elevated cerebral perfusion and intracranial pressure.

    PubMed

    Taylor, Curtis R; Hanna, Mina; Behnke, Bradley J; Stabley, John N; McCullough, Danielle J; Davis, Robert T; Ghosh, Payal; Papadopoulos, Anthony; Muller-Delp, Judy M; Delp, Michael D

    2013-06-01

    Evidence indicates that cerebral blood flow is both increased and diminished in astronauts on return to Earth. Data from ground-based animal models simulating the effects of microgravity have shown that decrements in cerebral perfusion are associated with enhanced vasoconstriction and structural remodeling of cerebral arteries. Based on these results, the purpose of this study was to test the hypothesis that 13 d of spaceflight [Space Transportation System (STS)-135 shuttle mission] enhances myogenic vasoconstriction, increases medial wall thickness, and elicits no change in the mechanical properties of mouse cerebral arteries. Basilar and posterior communicating arteries (PCAs) were isolated from 9-wk-old female C57BL/6 mice for in vitro vascular and mechanical testing. Contrary to that hypothesized, myogenic vasoconstrictor responses were lower and vascular distensibility greater in arteries from spaceflight group (SF) mice (n=7) relative to ground-based control group (GC) mice (n=12). Basilar artery maximal diameter was greater in SF mice (SF: 236±9 μm and GC: 215±5 μm) with no difference in medial wall thickness (SF: 12.4±1.6 μm; GC: 12.2±1.2 μm). Stiffness of the PCA, as characterized via nanoindentation, was lower in SF mice (SF: 3.4±0.3 N/m; GC: 5.4±0.8 N/m). Collectively, spaceflight-induced reductions in myogenic vasoconstriction and stiffness and increases in maximal diameter of cerebral arteries signify that elevations in brain blood flow may occur during spaceflight. Such changes in cerebral vascular control of perfusion could contribute to increases in intracranial pressure and an associated impairment of visual acuity in astronauts during spaceflight. PMID:23457215

  13. Spaceflight-induced alterations in cerebral artery vasoconstrictor, mechanical, and structural properties: implications for elevated cerebral perfusion and intracranial pressure

    PubMed Central

    Taylor, Curtis R.; Hanna, Mina; Behnke, Bradley J.; Stabley, John N.; McCullough, Danielle J.; Davis, Robert T.; Ghosh, Payal; Papadopoulos, Anthony; Muller-Delp, Judy M.; Delp, Michael D.

    2013-01-01

    Evidence indicates that cerebral blood flow is both increased and diminished in astronauts on return to Earth. Data from ground-based animal models simulating the effects of microgravity have shown that decrements in cerebral perfusion are associated with enhanced vasoconstriction and structural remodeling of cerebral arteries. Based on these results, the purpose of this study was to test the hypothesis that 13 d of spaceflight [Space Transportation System (STS)-135 shuttle mission] enhances myogenic vasoconstriction, increases medial wall thickness, and elicits no change in the mechanical properties of mouse cerebral arteries. Basilar and posterior communicating arteries (PCAs) were isolated from 9-wk-old female C57BL/6 mice for in vitro vascular and mechanical testing. Contrary to that hypothesized, myogenic vasoconstrictor responses were lower and vascular distensibility greater in arteries from spaceflight group (SF) mice (n=7) relative to ground-based control group (GC) mice (n=12). Basilar artery maximal diameter was greater in SF mice (SF: 236±9 μm and GC: 215±5 μm) with no difference in medial wall thickness (SF: 12.4±1.6 μm; GC: 12.2±1.2 μm). Stiffness of the PCA, as characterized via nanoindentation, was lower in SF mice (SF: 3.4±0.3 N/m; GC: 5.4±0.8 N/m). Collectively, spaceflight-induced reductions in myogenic vasoconstriction and stiffness and increases in maximal diameter of cerebral arteries signify that elevations in brain blood flow may occur during spaceflight. Such changes in cerebral vascular control of perfusion could contribute to increases in intracranial pressure and an associated impairment of visual acuity in astronauts during spaceflight.—Taylor, C. R., Hanna, M., Behnke, B. J., Stabley, J. N., McCullough, D. J., Davis III, R. T., Ghosh, P., Papadopoulos, A., Muller-Delp, J. M., Delp, M. D. Spaceflight-induced alterations in cerebral artery vasoconstrictor, mechanical, and structural properties: implications for elevated

  14. Ligustrazine monomer against cerebral ischemia/reperfusion injury.

    PubMed

    Gao, Hai-Jun; Liu, Peng-Fei; Li, Pei-Wen; Huang, Zhuo-Yan; Yu, Feng-Bo; Lei, Ting; Chen, Yong; Cheng, Ye; Mu, Qing-Chun; Huang, Hai-Yan

    2015-05-01

    Ligustrazine (2,3,5,6-tetramethylpyrazine) is a major active ingredient of the Szechwan lovage rhizome and is extensively used in treatment of ischemic cerebrovascular disease. The mechanism of action of ligustrazine use against ischemic cerebrovascular diseases remains unclear at present. This study summarizes its protective effect, the optimum time window of administration, and the most effective mode of administration for clinical treatment of cerebral ischemia/reperfusion injury. We examine the effects of ligustrazine on suppressing excitatory amino acid release, promoting migration, differentiation and proliferation of endogenous neural stem cells. We also looked at its effects on angiogenesis and how it inhibits thrombosis, the inflammatory response, and apoptosis after cerebral ischemia. We consider that ligustrazine gives noticeable protection from cerebral ischemia/reperfusion injury. The time window of ligustrazine administration is limited. The protective effect and time window of a series of derivative monomers of ligustrazine such as 2-[(1,1-dimethylethyl)oxidoimino]methyl]-3,5,6-trimethylpyrazine, CXC137 and CXC195 after cerebral ischemia were better than ligustrazine. PMID:26109963

  15. Rating Scales for Dystonia in Cerebral Palsy: Reliability and Validity

    ERIC Educational Resources Information Center

    Monbaliu, E.; Ortibus, E.; Roelens, F.; Desloovere, K.; Deklerck, J.; Prinzie, P.; De Cock, P.; Feys, H.

    2010-01-01

    Aim: This study investigated the reliability and validity of the Barry-Albright Dystonia Scale (BADS), the Burke-Fahn-Marsden Movement Scale (BFMMS), and the Unified Dystonia Rating Scale (UDRS) in patients with bilateral dystonic cerebral palsy (CP). Method: Three raters independently scored videotapes of 10 patients (five males, five females;…

  16. Cerebral Laterality Effects in the Dual Processing of Prose.

    ERIC Educational Resources Information Center

    Dean, Raymond S.

    1984-01-01

    The degree to which concreteness of prose material presented in an auditory fashion would interact with learners' lateral preference under different right hemispheric presentation conditions was investigated with 96 adults. Subjects recalled a greater number of ideas when the passage was concrete. Abstractness interacted with cerebral dominance.…

  17. The Relationships Between Cerebral Dominance and Different Mental Abilities.

    ERIC Educational Resources Information Center

    Reynolds, Carl; Bartek, Elmer

    Using a sample of 77 10th grade boys, the researchers studied the relationships between the mental abilities measured by the Differential Aptitude Tests and cerebral dominance (CD: the extent to which one hemisphere of the brain dominates the other for control of behavior). The surprise finding was that CD was negatively related to spatial…

  18. Cerebral Dominance and Childhood Learning Disorders: Theoretical Perspectives.

    ERIC Educational Resources Information Center

    Dean, Raymond S.

    1981-01-01

    An examination of Orton's early hypothesis of inconsistent cerebral dominance for linguistically disabled children in light of some 50 years of research is provided. Although a hypothesis based on data from nonintrusive measures of functional asymmetry with learning impaired children is postulated, caution in this area is suggested. (Author/AL)

  19. Neurobehavioral and Life-Quality Changes after Cerebral Revascularization.

    ERIC Educational Resources Information Center

    Baird, Anne Dull; And Others

    1988-01-01

    Studied neuropsychological and life-quality changes six months after carotid endarterectomy, superficial temporal artery to middle cerebral artery bypass, multiple revascularization, and vertebrobasilar revascularization procedures. Compared changes with those in patients with recent severe spinal complaints and in patients for whom…

  20. Gender Characteristics of Cerebral Hemodynamics during Complex Cognitive Functioning

    ERIC Educational Resources Information Center

    Misteli, Maria; Duschek, Stefan; Richter, Andre; Grimm, Simone; Rezk, Markus; Kraehenmann, Rainer; Boeker, Heinz; Seifritz, Erich; Schuepbach, Daniel

    2011-01-01

    Functional Transcranial Doppler sonography (fTCD) has been applied to assess peak mean cerebral blood flow velocity (MFV) with a high temporal resolution during cognitive activation. Yet, little attention has been devoted to gender-related alterations of MFV, including spectral analysis. In healthy subjects, fTCD was used to investigate a series…