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Sample records for antegrade selective cerebral

  1. Cerebral Metabolic Profiling of Hypothermic Circulatory Arrest with and Without Antegrade Selective Cerebral Perfusion: Evidence from Nontargeted Tissue Metabolomics in a Rabbit Model

    Institute of Scientific and Technical Information of China (English)

    Li-Hua Zou; Jin-Ping Liu; Hao Zhang; Shu-Bin Wu; Bing-Yang Ji

    2016-01-01

    Background:Antegrade selective cerebral perfusion (ASCP) is regarded to perform cerebral protection during the thoracic aorta surgery as an adjunctive technique to deep hypothermic circulatory arrest (DHCA).However,brain metabolism profile after ASCP has not been systematically investigated by metabolomics technology.Methods:To clarify the metabolomics profiling of ASCP,12 New Zealand white rabbits were randomly assigned into 60 min DHCA with (DHCA+ASCP [DA] group,n =6) and without (DHCA [D] group,n =6) ASCP according to the random number table.ASCP was conducted by cannulation on the right subclavian artery and cross-clamping of the innominate artery.Rabbits were sacrificed 60 min after weaning off cardiopulmonary bypass.The metabolic features of the cerebral cortex were analyzed by a nontargeted metabolic profiling strategy based on gas chromatography-mass spectrometry.Variable importance projection values exceeding 1.0 were selected as potentially changed metabolites,and then Student's t-test was applied to test for statistical significance between the two groups.Results:Metabolic profiling of brain was distinctive significantly between the two groups (Q2y =0.88 for partial least squares-DA model).In comparing to group D,62 definable metabolites were varied significantly after ASCP,which were mainly related to amino acid metabolism,carbohydrate metabolism,and lipid metabolism.Kyoto Encyclopedia of Genes and Genomes analysis revealed that metabolic pathways after DHCA with ASCP were mainly involved in the activated glycolytic pathway,subdued anaerobic metabolism,and oxidative stress.In addition,L-kynurenine (P =0.0019),5-methoxyindole-3-acetic acid (P =0.0499),and 5-hydroxyindole-3-acetic acid (P =0.0495) in tryptophan metabolism pathways were decreased,and citrulline (P =0.0158) in urea cycle was increased in group DA comparing to group D.Conclusions:The present study applied metabolomics analysis to identify the cerebral metabolic profiling in rabbits with ASCP

  2. Similar cerebral protective effectiveness of antegrade and retrograde cerebral perfusion during deep hypothermic circulatory arrest in aortic surgery: a meta-analysis of 7023 patients.

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    Guo, Shasha; Sun, Yanhua; Ji, Bingyang; Liu, Jinping; Wang, Guyan; Zheng, Zhe

    2015-04-01

    In aortic arch surgery, deep hypothermic circulatory arrest (DHCA) combined with cerebral perfusion is employed worldwide as a routine practice. Even though antegrade cerebral perfusion (ACP) is more widely used than retrograde cerebral perfusion (RCP), the difference in benefit and risk between ACP and RCP during DHCA is uncertain. The purpose of this meta-analysis is to compare neurologic outcomes and early mortality between ACP and RCP in patients who underwent aortic surgery during DHCA. PubMed, EMBASE, and the Cochrane Library were searched using the key words "antegrade," "retrograde," "cerebral perfusion," "cardiopulmonary bypass," "extracorporeal circulation," and "cardiac surgery" for studies reporting on clinical endpoints including early mortality, stroke, temporary neurologic dysfunction (TND), and permanent neurologic dysfunction (PND) in aortic surgery requiring DHCA with ACP or RCP. Heterogeneity was analyzed with the Cochrane Q statistic and I(2) statistic. Publication bias was tested with Begg's funnel plot and Egger's test. Thirty-four studies were included in this meta-analysis, with 4262 patients undergoing DHCA + ACP and 2761 undergoing DHCA + RCP. The overall pooled relative risk for TND was 0.722 (95% CI = [0.579, 0.900]), and the z-score for overall effect was 2.9 (P = 0.004). There was low heterogeneity (I(2) = 18.7%). The analysis showed that patients undergoing DHCA + ACP had better outcomes than those undergoing DHCA + RCP in terms of TND, while there were no significant differences between groups in terms of PND, stroke, and early mortality. This meta-analysis indicates that DHCA + ACP has an advantage over DHCA + RCP in terms of TND, while the two methods show similar results in terms of PND, early mortality, and stroke.

  3. Understanding Antegrade Colonic Enema (ACE) Surgery

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    ... Enema (ACE) Surgery Understanding Antegrade Colonic Enema (ACE) Surgery Antegrade colonic enema surgery (ACE) or Malone antegrade ... Email Print What is antegrade colonic enema (ACE) surgery? Antegrade colonic enema surgery (ACE) or Malone antegrade ...

  4. Graft selection in cerebral revascularization.

    Science.gov (United States)

    Baaj, Ali A; Agazzi, Siviero; van Loveren, Harry

    2009-05-01

    Cerebral revascularization constitutes an important treatment modality in the management of complex aneurysms, carotid occlusion, tumor, and moyamoya disease. Graft selection is a critical step in the planning of revascularization surgery, and depends on an understanding of graft and regional hemodynamics, accessibility, and patency rates. The goal of this review is to highlight some of these properties.

  5. Microvascular hemodynamics in human hypothermic circulatory arrest and selective antegrade cerebral perfusion

    NARCIS (Netherlands)

    P.W.G. Elbers; A. Ozdemir; R.H. Heijmen; J. Heeren; M. van Iterson; E.P.A. van Dongen; C. Ince

    2010-01-01

    Objective: The behavior of the human microcirculation in the setting of cardiac arrest is largely unknown. Animal experiments have consistently revealed that global hemodynamics do not necessarily reflect microvascular perfusion. In addition, the time it takes for capillary blood flow to stop after

  6. Transbrachial artery approach for selective cerebral angiography

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    Touho, Hajime; Karasawa, Jun; Shishido, Hisashi; Morisako, Toshitaka; Numazawa, Shinichi; Yamada, Keisuke; Nagai, Shigeki; Shibamoto, Kenji (Osaka Neurological Inst., Toyonaka (Japan))

    1990-02-01

    Transaxillary or transbrachial approaches to the cerebral vessels have been reported, but selective angiography of all four vessels has not been possible through one route. In this report, a new technique for selective cerebral angiography with transbrachial approach is described. One hundred and twenty three patients with cerebral infarction, vertebrobasilar insufficiency, intracerebral hemorrhage, epilepsy, or cerebral tumor were examined. Those patients consisted of 85 outpatients and 38 inpatients whose age ranged from 15 years old to 82 years old. The patients were examined via the transbrachial approach (97 cases via the right brachial, 29 cases via the left). Materials included a DSA system (Digital Fluorikon 5000, General Electric Co.), a 4 French tight J-curved Simmons 80-cm catheter, a 19-gauge extra-thin-wall Seldinger needle, and a J/Straight floppy 125-cm guide-wire. Generally, the volume of the contrast agent (300 mgI/ml iopamidol) used in the common carotid artery angiogram was 6 ml, while that used in the vertebral artery angiogram was 4 ml. If catheterization of the vertebral artery or right common carotid artery was unsuccessful, about 8 ml of the contrast agent was injected into the subclavian or branchiocephalic artery. Definitive diagnosis and a decision on proper treatment of the patients can be easily obtained, and the results were clinically satisfactory. Moreover, no complications were encountered in this study. This new technique making a transbrachial approach to the cerebral vessels using the DSA system is introduced here. Neurosurgeons can use this technique easily, and they will find that it provides them with all the information they need about the patient. (author).

  7. Antegrade scrotah sclerotherapy and varicocele

    Institute of Scientific and Technical Information of China (English)

    VincenzoFicarra; AlessandraSarti

    2002-01-01

    Antegrade scrotal sclerotherapy is a simple and easy technique for the treatment of varicocele.The success rate varies between87%and95%,The initlal reflux grade and the number of collateral vessels of the spermatic vein are the most important factors to predict the outcome of the technique.The postoperative complica-tion rate is about7%and the common ones are scrotal hematoma and epididymo-orchitis of slight severity.Testicular athrophy is a rare event(0.6%).This technique offers a considerable cost eduction compared to other therapeutic optione currently available for varicocele.

  8. Antegrade Versus Retrograde Cerebral Perfusion in Relation to Postoperative Complications Following Aortic Arch Surgery for Acute Aortic Dissection Type A%双侧顺行与上腔逆行脑灌注在A型主动脉夹层中应用效果对比的临床研究

    Institute of Scientific and Technical Information of China (English)

    吴智勇; 王志维; 夏军; 张遵严; 陈雪芬; 邓宏平; 徐鹏; 李罗成; 王杰

    2011-01-01

    Objective Antegrade or retrograde cerebral perfusion ( RCP) , is a well - established method of brain protection in aortic arch surgery. In this retrospective study, we compard the two methods of brain perfusion. Methods From Oct 2008 to Jan 2011,63 consecutive patients were urgently operated for acute type A aortic dissection and underwent arch replacement under deep hypothermic circulatory arrest (DHCA). Our patient cohort was divided into those protected with antegrade cerebral perfusion ( ACP) (group A, n = 54) and those protected with RCP (group B, n = 9). Results There was no siguificant difference in operative time, cardiopulmonary bypass - time, myocardial blocking time, cerebral - perfusion time between groups B and A, but the incidence of temporary neurologic dysfunction, the mean extubation time,the mean ICU -stay,the hospital -stay increased. Conclusion The antegrade perfusion was related with significantly lower incidence of temporary neurological complications, earlier extubation, shorter ICU - stay, and hospitalization.%目的 深低温停循环(DHCA)的同时顺行或逆行脑灌注,是一种行之有效的脑保护方法.在这个回顾性研究中,我们比较顺行、逆行两种方法的临床疗效.方法 从2008年10月~2011年1月,63例患者行Stanford A型主动脉夹层手术,均在深低温停循环下行全弓置换.其中选择双侧顺行脑灌注的A组病人54例,B组采用上腔静脉逆灌(RCP)脑保护的病人9例.结果 B组与A组比较在手术时间、体外循环时间、心肌阻断时间、脑灌注时间差异不明显,而B组短暂脑神经功能障碍发生率、拔管时间、ICU滞留时间、住院时间有所增加.结论 顺行脑灌注较上腔逆灌降低短暂脑神经功能障碍发生率从而拔管早,缩短ICU及住院时间.

  9. Understanding Antegrade Colonic Enema (ACE) Surgery

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    ... enema. Lancet. 1990;336:1217-1218. Bruce RG, el-Galley RE, Wells J, et al. Antegrade continence ... for Medical Professionals Site Information & Policies Send Us Feedback Site Map About this Website Copyright, Reprint & Licensing ...

  10. Selective gene expression in focal cerebral ischemia.

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    Jacewicz, M; Kiessling, M; Pulsinelli, W A

    1986-06-01

    Regional patterns of protein synthesis were examined in rat cortex made ischemic by the occlusion of the right common carotid and middle cerebral arteries. At 2 h of ischemia, proteins were pulse labeled with intracortical injections of a mixture of [3H]leucine, [3H]isoleucine, and [3H]proline. Newly synthesized proteins were analyzed by two-dimensional gel fluorography, and the results correlated with local CBF, measured with [14C]iodoantipyrine as tracer. Small blood flow reductions (CBF = 50-80 ml 100 g-1 min-1) were accompanied by a modest inhibition in synthesis of many proteins and a marked increase in one protein (Mr 27,000). With further reduction in blood flow (CBF = 40 ml 100 g-1 min-1), synthesis became limited to a small group of proteins (Mr 27,000, 34,000, 73,000, 79,000, and actin) including two new polypeptides (Mr 55,000 and 70,000). Severe ischemia (CBF = 15-25 ml 100 g-1 min-1) caused the isoelectric modification of several proteins (Mr 44,000, 55,000, and 70,000) and induced synthesis of another protein (Mr 40,000). Two polypeptides (Mr 27,000 and 70,000) dominated residual protein synthesis in severe ischemia. The changes in protein synthesis induced by different grades of ischemia most likely comprise a variation of the so-called "heat shock" or "stress" response found in all eukaryotic cells subjected to adverse conditions. Since heat shock genes are known to confer partial protection against anoxia and a variety of other noxious insults, their induction may be a factor in limiting the extent of ischemic tissue damage.

  11. Single-level selective dorsal rhizotomy for spastic cerebral palsy

    Science.gov (United States)

    Graham, David; Cawker, Stephanie; Paget, Simon; Wimalasundera, Neil

    2016-01-01

    The management of cerebral palsy (CP) is complex and requires a multidisciplinary approach. Selective dorsal rhizotomy (SDR) is a neurosurgical technique that aims to reduce spasticity in the lower limbs. A minimally invasive approach to SDR involves a single level laminectomy at the conus and utilises intraoperative electromyography (EMG). When combined with physiotherapy, SDR is effective in selected children and has minimal complications. This review discusses the epidemiology of CP and the management using SDR within an integrated multidisciplinary centre. Particular attention is given to the single-level laminectomy technique of SDR and its rationale, and the patient workup, recovery and outcomes of SDR. PMID:27757432

  12. Retrograde endovenous laser ablation through saphenopopliteal junctional area for incompetent small saphenous vein; Comparison with antegrade approach

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    Kim, Jun Seok; Park, Sang Woo; Yun, Ik Jin; Hwang, Jae Joon; Lee, Song Am; Chee, Hyun Keun; Hwang, Jin Ho [Konkuk University Hospital, Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2016-06-15

    To evaluate the safety and efficacy of retrograde endovenous laser ablation (EVLA) and to compare it with the conventional antegrade EVLA for incompetent small saphenous vein (SSV). Small saphenous vein was cannulated via two approaches under ultrasound-guidance. One method involved puncturing the SSV cranially at mid-calf (the antegrade group). If the antegrade puncture into the SSV failed twice, the other approach for puncture was selected that involved puncturing the SSV toward the ankle (the retrograde group). Patients were evaluated in terms of technical and clinical success, closure rates of the SSV, and complications including pain, bruising, or paresthesia at all follow-up visits. The 1470 nm endovenous laser was used in all limbs. Technical success was seen in all limbs in both groups (100%). Closure rate in both groups showed about 95%, without significant difference (p = 0.685). Similar linear endovenous energy density was supplied during the EVLA in both groups (p = 0.876). Three frequent complications including bruising, pain, and paresthesia did not show statistical significance between groups (p = 0.465, 0.823, 1.000, respectively). Major complications were absent in both groups. The EVLA for the incompetent SSV using a retrograde approach is safe and effective and should be considered the alternative method if the antegrade access fails due to vasospasm or small SSV diameter.

  13. Selective disruption of the cerebral neocortex in Alzheimer's disease.

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    Rahul S Desikan

    Full Text Available BACKGROUND: Alzheimer's disease (AD and its transitional state mild cognitive impairment (MCI are characterized by amyloid plaque and tau neurofibrillary tangle (NFT deposition within the cerebral neocortex and neuronal loss within the hippocampal formation. However, the precise relationship between pathologic changes in neocortical regions and hippocampal atrophy is largely unknown. METHODOLOGY/PRINCIPAL FINDINGS: In this study, combining structural MRI scans and automated image analysis tools with reduced cerebrospinal fluid (CSF Aβ levels, a surrogate for intra-cranial amyloid plaques and elevated CSF phosphorylated tau (p-tau levels, a surrogate for neocortical NFTs, we examined the relationship between the presence of Alzheimer's pathology, gray matter thickness of select neocortical regions, and hippocampal volume in cognitively normal older participants and individuals with MCI and AD (n = 724. Amongst all 3 groups, only select heteromodal cortical regions significantly correlated with hippocampal volume. Amongst MCI and AD individuals, gray matter thickness of the entorhinal cortex and inferior temporal gyrus significantly predicted longitudinal hippocampal volume loss in both amyloid positive and p-tau positive individuals. Amongst cognitively normal older adults, thinning only within the medial portion of the orbital frontal cortex significantly differentiated amyloid positive from amyloid negative individuals whereas thinning only within the entorhinal cortex significantly discriminated p-tau positive from p-tau negative individuals. CONCLUSIONS/SIGNIFICANCE: Cortical Aβ and tau pathology affects gray matter thinning within select neocortical regions and potentially contributes to downstream hippocampal degeneration. Neocortical Alzheimer's pathology is evident even amongst older asymptomatic individuals suggesting the existence of a preclinical phase of dementia.

  14. Percutaneous antegrade ureteric stent removal using a rigid alligator forceps.

    LENUS (Irish Health Repository)

    Given, M F

    2008-12-01

    To evaluate the safety and efficacy of percutaneous antegrade ureteric stent removal using a rigid alligator forceps. Twenty patients were included in our study. Indications for ureteric stent insertion included stone disease (n = 7), malignancy (n = 8) and transplant anastomotic strictures (n = 5). Stent retrieval was carried out for proximal stent placement\\/migration in seven patients and encrustation in the remaining 13. Twenty-two stents were successfully retrieved in 20 patients. There was one technical failure (5%). There were no major complications. We had four minor complications, which included nephrostomy site pain (n = 2), periprocedural sepsis (n = 1) and a small urinoma (n = 1). All patients settled with conservative management. Percutaneous radiologically guided antegrade ureteric stent removal with an alligator forceps is safe and effective, particularly when initial surgical removal has failed.

  15. New puncture needle (Seldinger technique) for easy antegrade catheterization of the superficial femoral artery

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    Saltzmann, J.; Probst, P.

    1987-02-01

    Mainly for anatomical reasons a guide-wire or a catheter has a tendency to turn into the deep femoral artery during antegrade catheterization of the lower limb. To overcome this problem a curved puncture needle has been designed which allows positioning of the guide-wire in an anterior direction. Antegrade catheterization of the superficial femoral artery was achieved in 25 patients without lengthy manipulations or complications. With this technique the rate of complications at antegrade catheterization will probably be reduced.

  16. Performance of antegrade suture passers according to tendon thickness

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    Myung-Sun Kim

    2015-01-01

    Full Text Available Purpose: To determine the effect of tendon thickness on the needle penetration ability of four different designs of antegrade suture passers. Materials and Methods: Four antegrade suture passers were tested: (a ExpresSew II (Depuy Mitek Inc., Raynham, MA, (b Arthrex Scorpion (Arthrex, Naples, FL, (c Concept (Linvatec Corp, Largo, FL, and (d ElitePass (Smith and Nephew Endoscopy, Andover, MA. Bovine tendons were divided into five thickness groups: 3, 5, 7, 9 and 11 mm. At each tendon thickness, we performed 15 trials with the suture loaded and 15 unloaded per device. Successful needle penetration was recorded, and in case of success, the exit point of the needle was noted in relation to the superior arm of the grasping component. Results: All tested suture passing devices successfully penetrated tendon thicknesses of 3 and 5 mm. With the suture loaded, one device (Concept only successfully penetrated 7 mm group tendons in 3/15 (20% trials. Success rates at 9 mm with the suture loaded were 40% in ExpresSew II, 53% in Arthrex Scorpion, 0% in Concept and 53% in ElitePass. Among successful passages with a loaded suture in the 7 and 9 mm-groups, about 20-50% of passages were oblique, and the needle came out distal to the superior arm of grasping the component. No trial with any device succeeded with 11 mm tendons in the suture loading condition. Conclusion: Using an antegrade suture passer during arthroscopic rotator cuff repair should be carefully considered when the torn end of the tendon is thicker than about 7-9 mm due to potential failure of needle penetration and/or too oblique a suture passage. Level of Evidence: Controlled laboratory study.

  17. Treatment of humeral shaft fractures with antegrade intramedullary locking nail.

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    Tsourvakas, Stefanos; Alexandropoulos, Christos; Papachristos, Ioannis; Tsakoumis, Grigorios; Ameridis, Nikolaos

    2011-12-01

    Antegrade interlocked humeral nailing for stabilization of humeral fractures was introduced many years ago, and studies on this method in the orthopedic literature have shown mixed results. The purpose of this investigation was to document the clinical outcome and complications associated with the use of an antegrade intramedullary nail (T2, Stryker) for the humeral fractures. Between 2005 and 2008, 52 fractures of the humeral shaft were treated operatively with this intramedullary nail in our department. Eight patients were polytraumatized, and four patients had an open fracture. The mean age of patients was 51.7 years. Forty-eight patients had an adequate duration of clinical follow-up (a mean of 18 months) for analysis. Complications were recorded, and the time to union was measured. Shoulder and elbow functions were assessed using the Constant Score and the Morrey Score, respectively. Forty-six fractures healed, with a mean time to clinical union of 10.3 weeks. Two patients developed pseudarthroses. There were four adverse events: two proximal screws backed out, one superficial infection at the insertion point, and one fracture at the distal end of the nail. Ninety-one percentage of patients had an excellent or good shoulder function. Five further operations were necessary: two for treatment of pseudarthroses, two for removal the backed out proximal screws, and one wound debridement for superficial infection. Antegrade humeral nailing is a valid therapeutic option for stabilization of humeral shaft fractures. By strictly adhering to the operation technique, the number and the severity of complications can be reduced. When good fracture alignment and stability are obtained, uneventful bone healing with good functional results is the rule.

  18. Selective estrogen receptor modulators (SERMs) enhance neurogenesis and spine density following focal cerebral ischemia.

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    Khan, Mohammad M; Wakade, Chandramohan; de Sevilla, Liesl; Brann, Darrell W

    2015-02-01

    Selective estrogen receptor modulators (SERMs) have been reported to enhance synaptic plasticity and improve cognitive performance in adult rats. SERMs have also been shown to induce neuroprotection against cerebral ischemia and other CNS insults. In this study, we sought to determine whether acute regulation of neurogenesis and spine remodeling could be a novel mechanism associated with neuroprotection induced by SERMs following cerebral ischemia. Toward this end, ovariectomized adult female rats were either implanted with pellets of 17β-estradiol (estrogen) or tamoxifen, or injected with raloxifene. After one week, cerebral ischemia was induced by the transient middle-cerebral artery occlusion (MCAO) method. Bromodeoxyuridine (BrdU) was injected to label dividing cells in brain. We analyzed neurogenesis and spine density at day-1 and day-5 post MCAO. In agreement with earlier findings, we observed a robust induction of neurogenesis in the ipsilateral subventricular zone (SVZ) of both the intact as well as ovariectomized female rats following MCAO. Interestingly, neurogenesis in the ipsilateral SVZ following ischemia was significantly higher in estrogen and raloxifene-treated animals compared to placebo-treated rats. In contrast, this enhancing effect on neurogenesis was not observed in tamoxifen-treated rats. Finally, both SERMs, as well as estrogen significantly reversed the spine density loss observed in the ischemic cortex at day-5 post ischemia. Taken, together these results reveal a profound structural remodeling potential of SERMs in the brain following cerebral ischemia. This article is part of a Special Issue entitled "Sex steroids and brain disorders".

  19. Cerebral Lateralization of Face-Selective and Body-Selective Visual Areas Depends on Handedness

    NARCIS (Netherlands)

    Willems, R.M.; Peelen, M.V.; Hagoort, P.

    2010-01-01

    The left-hemisphere dominance for language is a core example of the functional specialization of the cerebral hemispheres. The degree of left-hemisphere dominance for language depends on hand preference: Whereas the majority of right-handers show left-hemispheric language lateralization, this number

  20. Cerebral lateralization of face-selective and body-selective visual areas depends on handedness

    NARCIS (Netherlands)

    Willems, R.M.; Peelen, M.V.; Hagoort, P.

    2010-01-01

    The left-hemisphere dominance for language is a core example of the functional specialization of the cerebral hemispheres. The degree of left-hemisphere dominance for language depends on hand preference: Whereas the majority of right-handers show left-hemispheric language lateralization, this number

  1. Steerable antegrade stenting: a new trick of the trade

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    Udo Nagele

    2007-06-01

    Full Text Available INTRODUCTION: Whereas a retrograde attempt to insert an indwelling stent is performed in lithotomy position, usually renal access is gained in a prone position. To overcome the time loss of patient repositioning, a renal puncture can be performed in a modified lithotomy position with torqued truncus and slightly elevated flank. There is a two-fold advantage of this position: transurethral and transrenal access can be obtained using a combined approach. In the present study, this simple technique is used to position a floppy guide wire through a modified needle directly through the renal pelvis into the ureter. MATERIALS AND METHODS: The kidney is punctured in the modified lithotomy position under sonographic control using an initial three-part puncture needle. A floppy tip guide-wire is inserted into the collecting system via the needle after retrieving the stylet. The retracted needle is bent at the tip while the guide-wire is secured in the needle and the collecting system. The use of the floppy tip guide-wire helps to insert the curved needle back into the kidney pelvis, which becomes the precise guidance for the now steerable wire. The desired steerable stent is positioned under radiographic control in a retrograde fashion over the endoscopically harbored tip of the guide-wire. Two patient cohorts (newly described method and conventional method were compared. RESULTS: The presented steering procedure saves 16.5 mean minutes compared to the conventional antegrade stenting and 79.5 Euros compared to the control group. CONCLUSION: The described combined antegrade-retrograde stent placement through a bent three-part puncture needle results in both clinical superiority (OR time, success rate and financial benefits.

  2. Selective accumulation of aluminum in cerebral arteries in Alzheimer's disease (AD).

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    Bhattacharjee, Surjyadipta; Zhao, Yuhai; Hill, James M; Culicchia, Frank; Kruck, Theodore P A; Percy, Maire E; Pogue, Aileen I; Walton, J R; Lukiw, Walter J

    2013-09-01

    Once biologically available aluminum bypasses gastrointestinal and blood-brain barriers, this environmentally-abundant neurotoxin has an exceedingly high affinity for the large pyramidal neurons of the human brain hippocampus. This same anatomical region of the brain is also targeted by the earliest evidence of Alzheimer's disease (AD) neuropathology. The mechanism for the selective targeting and transport of aluminum into the hippocampus of the human brain is not well understood. In an effort to improve our understanding of a pathological aluminum entry system into the brain, this study examined the aluminum content of 8 arteries that supply blood to the hippocampus, including the aorta and several cerebral arteries. In contrast to age-matched controls, in AD patients we found a gradient of increasing aluminum concentration from the aorta to the posterior cerebral artery that supplies blood to the hippocampus. Primary cultures of human brain endothelial cells were found to have an extremely high affinity for aluminum when compared to other types of brain cells. Together, these results suggest for the first time that endothelial cells that line the cerebral vasculature may have biochemical attributes conducive to binding and targeting aluminum to selective anatomical regions of the brain, such as the hippocampus, with potential downstream pro-inflammatory and pathogenic consequences.

  3. Selective dorsal rhizotomy opportunities with foot deformitiesin children with cerebral palsy

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    Владимир Маркович Кенис

    2015-03-01

    Full Text Available Foot deformities are the most common orthopedic condition in children with cerebral palsy. The aim of the study was to evaluate the influence of selective dorsal rhizotomy (SDR on foot deformities in children with cerebral palsy. The results were assessed clinically by measurement of changes in muscle spaticity and foot posture. Percentage of resection of dorsal rootlets was from 40 to 90 % of total thickness. The degree of tone reduction had a tendency to be more pronounced in the more proximal muscles and was minimal in calf muscles. Nevertheless, foot posture improved more significantly. That can be explained by generalimprovement of pathological posture at the level of more proximal joints. Thus, SDR has insignificant direct effect on spastic foot deformity and can not be recommended as a basic method of treatment even in pure spasticity. However, SDR should be considered as a part of multidisciplinary management protocol if foot deformity reflects more complex postural disturbance due to generalized spasticity.

  4. Diagnostic and therapeutical aspects of antegrade uretero-pyelography in percutaneous nephro-pyelostomy in childhood

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    Schneider, K.; Helmig, F.J.; Wisser, J.; Fendel, H.

    1986-12-01

    In a sample of 18 children aging one day to eighteen years 21 percutaneous nephrostomies and 27 antegrade pyelographies were performed using sonography and fluoroscopy. Thirteen patients had both nephrostomy and pyelography and 5 had only pyelography. Three of 13 patients needed bilateral nephrostomies. The results indicate that the combination of percutaneous nephrostomy and antegrade pyelography is helpful in diagnosis and treatment of various obstructive disorders of the urinary tract especially in the newborn period.

  5. [Diagnostic and therapeutic aspects of antegrade ureteropyelography and percutaneous nephropyelostomy in childhood].

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    Schneider, K; Helmig, F J; Wisser, J; Fendel, H

    1986-12-01

    In a sample of 18 children aging one day to eighteen years 21 percutaneous nephrostomies and 27 antegrade pyelographies were performed using sonography and fluoroscopy. Thirteen patients had both nephrostomy and pyelography and 5 had only pyelography. Three of 13 patients needed bilateral nephrostomies. The results indicate that the combination of percutaneous nephrostomy and antegrade pyelography is helpful in diagnosis and treatment of various obstructive disorders of the urinary tract especially in the newborn period.

  6. Cerebral lateralization of face-selective and body-selective visual areas depends on handedness.

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    Willems, Roel M; Peelen, Marius V; Hagoort, Peter

    2010-07-01

    The left-hemisphere dominance for language is a core example of the functional specialization of the cerebral hemispheres. The degree of left-hemisphere dominance for language depends on hand preference: Whereas the majority of right-handers show left-hemispheric language lateralization, this number is reduced in left-handers. Here, we assessed whether handedness analogously has an influence upon lateralization in the visual system. Using functional magnetic resonance imaging, we localized 4 more or less specialized extrastriate areas in left- and right-handers, namely fusiform face area (FFA), extrastriate body area (EBA), fusiform body area (FBA), and human motion area (human middle temporal [hMT]). We found that lateralization of FFA and EBA depends on handedness: These areas were right lateralized in right-handers but not in left-handers. A similar tendency was observed in FBA but not in hMT. We conclude that the relationship between handedness and hemispheric lateralization extends to functionally lateralized parts of visual cortex, indicating a general coupling between cerebral lateralization and handedness. Our findings indicate that hemispheric specialization is not fixed but can vary considerably across individuals even in areas engaged relatively early in the visual system.

  7. The use of a cutting balloon in contemporary reverse controlled antegrade and retrograde subintimal tracking (reverse CART) technique.

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    Nakabayashi, Keisuke; Okada, Hisayuki; Oka, Toshiaki

    2016-07-11

    The key concept of reverse controlled antegrade and retrograde tracking (CART) technique is retrograde puncture with a tapered wire to an antegrade balloon (contemporary reverse CART) or new connections between the antegrade and retrograde subintimal space (classical reverse CART). In our case, a 75-year-old man with severe chronic total occlusion of the right coronary artery, reverse CART with conventional balloons could not be accomplished. Externalization wiring was completed by contemporary reverse CART using a cutting balloon as an antegrade balloon to improve the fenestration force of the retrograde guidewire. Thus, the use of a cutting balloon for contemporary reverse CART might be promising.

  8. Excitatory amino acid changes in the brains of rhesus monkeys following selective cerebral deep hypothermia and blood flow occlusion

    Institute of Scientific and Technical Information of China (English)

    Jun Pu; Xiaoqun Niu; Jizong Zhao

    2013-01-01

    Selective cerebral deep hypothermia and blood flow occlusion can enhance brain tolerance to ischemia and hypoxia and reduce cardiopulmonary complications in monkeys. Excitotoxicity induced by the release of a large amount of excitatory amino acids after cerebral ischemia is the major mechanism underlying ischemic brain injury and nerve cell death. In the present study, we used selective cerebral deep hypothermia and blood flow occlusion to block the bilateral common carotid arteries and/or bilateral vertebral arteries in rhesus monkey, followed by reperfusion using Ringer's solution at 4°C. Microdialysis and transmission electron microscope results showed that selective cerebral deep hypothermia and blood flow occlusion inhibited the release of glutamic acid into the extracellular fluid in the brain frontal lobe and relieved pathological injury in terms of the ultrastructure of brain tissues after severe cerebral ischemia. These findings indicate that cerebral deep hypothermia and blood flow occlusion can inhibit cytotoxic effects and attenuate ischemic/ hypoxic brain injury through decreasing the release of excitatory amino acids, such as glutamic acid.

  9. Retrograde versus Antegrade Approach for the Management of Large Proximal Ureteral Stones

    Science.gov (United States)

    Mykoniatis, Ioannis; Isid, Ayman; Gofrit, Ofer N.; Rosenberg, Shilo; Hidas, Guy; Landau, Ezekiel H.; Pode, Dov; Duvdevani, Mordechai

    2016-01-01

    Objective. To evaluate and compare the efficacy and safety of retrograde versus antegrade ureteroscopic lithotripsy for the treatment of large proximal ureteral stones. Patients and Methods. We retrospectively analyzed the medical records of patients with proximal ureteral stones >15 mm, treated in our institution from January 2011 to January 2016. Intraoperative parameters, postoperative outcomes, and complications were recorded and compared between the two techniques. Results. Our analysis included 57 patients. Thirty-four patients (59.6%) underwent retrograde and 23 patients (40.4%) underwent antegrade ureteroscopy. There was no significant difference in patients' demographics and stone characteristics between the groups. Stone-free rate was significantly higher (p = 0.033) in the antegrade group (100%) compared to retrograde one (82.4%). Fluoroscopy time, procedure duration, and length of hospitalization were significantly (p < 0.001) lower in retrograde approach. On the other hand, the need for postoperative stenting was significantly lower in the antegrade group (p < 0.001). No difference was found between the groups (p = 0.745) regarding postoperative complications. Conclusions. Antegrade ureteroscopy is an efficient and safe option for the management of large proximal ureteral stones. It may achieve high stone-free rates compared to retrograde ureteroscopy with the drawback of longer operative time, fluoroscopy time, and length of hospitalization. PMID:27766263

  10. Disappearance of spasticity after selective dorsal rhizotomy does not prevent muscle shortening in children with cerebral palsy: a case report.

    Science.gov (United States)

    Spijker, Margje; Strijers, Rob L M; van Ouwerkerk, Willem J R; Becher, Jules G

    2009-05-01

    Selective dorsal rhizotomy is an effective treatment for spasticity in children with cerebral palsy who have a spastic motor disorder. It is hypothesized that muscle shortening is related to spasticity; the lack of stretch of a muscle is thought to be the cause of muscle shortening. If this is true, the treatment for spasticity should prevent the occurrence of muscle shortening during growth. We present the case of 1 child with cerebral palsy and spastic diplegia, for whom the treatment with selective dorsal rhizotomy was successful in improving the walking abilities. She did, however, develop muscle shortening during growth. In conclusion, the development of muscle shortening during growth in children with cerebral palsy and spastic paresis cannot be prevented by treatment for the spasticity alone.

  11. Does Loss of Spasticity Matter? A 10-Year Follow-up after Selective Dorsal Rhizotomy in Cerebral Palsy

    Science.gov (United States)

    Tedroff, Kristina; Lowing, Kristina; Jacobson, Dan N. O.; Astrom, Eva

    2011-01-01

    Aim: The aim of this study was to evaluate the long-term effects of selective dorsal rhizotomy (SDR) in children with cerebral palsy (CP). Method: Nineteen children (four females, 15 males; mean age 4y 7mo, SD 1y 7mo) with bilateral spastic CP, were prospectively assessed at baseline and 18 months, 3 years, and 10 years after SDR. Assessments…

  12. Selection of a Model of Cerebral Activity for fMRI Group Data Analysis

    CERN Document Server

    Keller, Merlin; Lavielle, Marc

    2010-01-01

    This thesis is dedicated to the statistical analysis of multi-sub ject fMRI data, with the purpose of identifying bain structures involved in certain cognitive or sensori-motor tasks, in a reproducible way across sub jects. To overcome certain limitations of standard voxel-based testing methods, as implemented in the Statistical Parametric Mapping (SPM) software, we introduce a Bayesian model selection approach to this problem, meaning that the most probable model of cerebral activity given the data is selected from a pre-defined collection of possible models. Based on a parcellation of the brain volume into functionally homogeneous regions, each model corresponds to a partition of the regions into those involved in the task under study and those inactive. This allows to incorporate prior information, and avoids the dependence of the SPM-like approach on an arbitrary threshold, called the cluster- forming threshold, to define active regions. By controlling a Bayesian risk, our approach balances false positive...

  13. Detection of Impaired Cerebral Autoregulation Using Selected Correlation Analysis: A Validation Study

    Science.gov (United States)

    Brawanski, Alexander

    2017-01-01

    Multimodal brain monitoring has been utilized to optimize treatment of patients with critical neurological diseases. However, the amount of data requires an integrative tool set to unmask pathological events in a timely fashion. Recently we have introduced a mathematical model allowing the simulation of pathophysiological conditions such as reduced intracranial compliance and impaired autoregulation. Utilizing a mathematical tool set called selected correlation analysis (sca), correlation patterns, which indicate impaired autoregulation, can be detected in patient data sets (scp). In this study we compared the results of the sca with the pressure reactivity index (PRx), an established marker for impaired autoregulation. Mean PRx values were significantly higher in time segments identified as scp compared to segments showing no selected correlations (nsc). The sca based approach predicted cerebral autoregulation failure with a sensitivity of 78.8% and a specificity of 62.6%. Autoregulation failure, as detected by the results of both analysis methods, was significantly correlated with poor outcome. Sca of brain monitoring data detects impaired autoregulation with high sensitivity and sufficient specificity. Since the sca approach allows the simultaneous detection of both major pathological conditions, disturbed autoregulation and reduced compliance, it may become a useful analysis tool for brain multimodal monitoring data. PMID:28255331

  14. Detection of Impaired Cerebral Autoregulation Using Selected Correlation Analysis: A Validation Study

    Directory of Open Access Journals (Sweden)

    Martin A. Proescholdt

    2017-01-01

    Full Text Available Multimodal brain monitoring has been utilized to optimize treatment of patients with critical neurological diseases. However, the amount of data requires an integrative tool set to unmask pathological events in a timely fashion. Recently we have introduced a mathematical model allowing the simulation of pathophysiological conditions such as reduced intracranial compliance and impaired autoregulation. Utilizing a mathematical tool set called selected correlation analysis (sca, correlation patterns, which indicate impaired autoregulation, can be detected in patient data sets (scp. In this study we compared the results of the sca with the pressure reactivity index (PRx, an established marker for impaired autoregulation. Mean PRx values were significantly higher in time segments identified as scp compared to segments showing no selected correlations (nsc. The sca based approach predicted cerebral autoregulation failure with a sensitivity of 78.8% and a specificity of 62.6%. Autoregulation failure, as detected by the results of both analysis methods, was significantly correlated with poor outcome. Sca of brain monitoring data detects impaired autoregulation with high sensitivity and sufficient specificity. Since the sca approach allows the simultaneous detection of both major pathological conditions, disturbed autoregulation and reduced compliance, it may become a useful analysis tool for brain multimodal monitoring data.

  15. Main effects and interactions of cerebral hemispheres, gender, and age in the calculation of volumes and asymmetries of selected structures of episodic memory

    OpenAIRE

    Ramirez-Carmona, Rocio; Garcia-Lazaro, Haydee Guadalupe; Dominguez-Corrales, Brenda; Aguilar-Castañeda, Erika; Roldan-Valadez, Ernesto

    2017-01-01

    The aim of this study was to clarify the influence of anatomical (cerebral hemisphere) and demographic (age and gender) variables on the gray matter (GM) volumes and volumetric asymmetry indices (VAIs) of selected structures involved in episodic memory.

  16. Effect of a Selective Mas Receptor Agonist in Cerebral Ischemia In Vitro and In Vivo.

    Directory of Open Access Journals (Sweden)

    Seyoung Lee

    Full Text Available Functional modulation of the non-AT1R arm of the renin-angiotensin system, such as via AT2R activation, is known to improve stroke outcome. However, the relevance of the Mas receptor, which along with the AT2R forms the protective arm of the renin-angiotensin system, as a target in stroke is unclear. Here we tested the efficacy of a selective MasR agonist, AVE0991, in in vitro and in vivo models of ischemic stroke. Primary cortical neurons were cultured from E15-17 mouse embryos for 7-9 d, subjected to glucose deprivation for 24 h alone or with test drugs, and percentage cell death was determined using trypan blue exclusion assay. Additionally, adult male mice were subjected to 1 h middle cerebral artery occlusion and were administered either vehicle or AVE0991 (20 mg/kg i.p. at the commencement of 23 h reperfusion. Some animals were also treated with the MasR antagonist, A779 (80 mg/kg i.p. 1 h prior to surgery. Twenty-four h after MCAo, neurological deficits, locomotor activity and motor coordination were assessed in vivo, and infarct and edema volumes estimated from brain sections. Following glucose deprivation, application of AVE0991 (10-8 M to 10-6 M reduced neuronal cell death by ~60% (P<0.05, an effect prevented by the MasR antagonist. By contrast, AVE0991 administration in vivo had no effect on functional or histological outcomes at 24 h following stroke. These findings indicate that the classical MasR agonist, AVE0991, can directly protect neurons from injury following glucose-deprivation. However, this effect does not translate into an improved outcome in vivo when administered systemically following stroke.

  17. Comparison of Ultrasound-Guided and Fluoroscopy-Assisted Antegrade Common Femoral Artery Puncture Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Slattery, Michael M.; Goh, Gerard S.; Power, Sarah; Given, Mark F.; McGrath, Frank P.; Lee, Michael J., E-mail: mlee@rcsi.ie [Beaumont Hospital, Department of Radiology (Ireland)

    2015-06-15

    PurposeTo prospectively compare the procedural time and complication rates of ultrasound-guided and fluoroscopy-assisted antegrade common femoral artery (CFA) puncture techniques.Materials and MethodsHundred consecutive patients, undergoing a vascular procedure for which an antegrade approach was deemed necessary/desirable, were randomly assigned to undergo either ultrasound-guided or fluoroscopy-assisted CFA puncture. Time taken from administration of local anaesthetic to vascular sheath insertion in the superficial femoral artery (SFA), patients’ age, body mass index (BMI), fluoroscopy radiation dose, haemostasis method and immediate complications were recorded. Mean and median values were calculated and statistically analysed with unpaired t tests.ResultsSixty-nine male and 31 female patients underwent antegrade puncture (mean age 66.7 years). The mean BMI was 25.7 for the ultrasound-guided (n = 53) and 25.3 for the fluoroscopy-assisted (n = 47) groups. The mean time taken for the ultrasound-guided puncture was 7 min 46 s and for the fluoroscopy-assisted technique was 9 min 41 s (p = 0.021). Mean fluoroscopy dose area product in the fluoroscopy group was 199 cGy cm{sup 2}. Complications included two groin haematomas in the ultrasound-guided group and two retroperitoneal haematomas and one direct SFA puncture in the fluoroscopy-assisted group.ConclusionUltrasound-guided technique is faster and safer for antegrade CFA puncture when compared to the fluoroscopic-assisted technique alone.

  18. Laparoscopic common bile duct exploration and antegrade biliary stenting: Leaving behind the Kehr tube

    Directory of Open Access Journals (Sweden)

    Darío Martínez-Baena

    2013-03-01

    Full Text Available Introduction: single-stage laparoscopic surgery of cholelithiasis and associated common bile duct stones (CL-CBDS has shown similar results when compared to laparoscopic cholecystectomy combined with ERCP. Classically, choledochorrhaphy has been protected by a T-tube drain to allow external bypass of bile flow. However, its removal is associated with a significant complication rate. Use of antegrade biliary stents avoids T-tube removal associated morbidity. The aim of this study is to compare the results of choledochorrhaphy plus T-tube drainage versus antegrade biliary stenting in our series of laparoscopic common bile duct explorations (LCBDE. Material and methods: between 2004 and 2011, 75 patients underwent a LCBDE. Choledochorrhaphy was performed following Kehr tube placements in 47 cases and transpapillary biliary stenting was conducted in the remaining 28 patients. Results: postoperative hospital stay was shorter in the stent group (5 ± 10.26 days than in the Kehr group (12 ± 10.6 days, with a statistically significant difference. There was a greater trend to grade B complications in the stent group (10.7 vs. 4.3 % and to grade C complications in the Kehr group (6.4 vs. 3.6 %. There were 3 cases of residual common bile duct stones in the Kehr group (6.4 % and none in the stent group. Conclusions: antegrade biliary stenting following laparoscopic common bile duct exploration for CL-CBDS is an effective and safe technique that prevents T-tube related morbidity.

  19. Antegrade bowel intussusception after remote Whipple and Puestow procedures for treatment of pancreas divisum

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    To date, antegrade intussusception involving a Roux-en-Y reconstruction has been reported only once. We report a case of acute bowel obstruction due to an intussusception involving two Roux-en-Y limbs in a 40-year-old woman with a history of chronic pancreatitis due to pancreas divisum. Four years preceding this event, the patient had undergone a Whipple procedure, and three years prior to that, a Puestow operation. The patient was successfully treated with bowel resection and a side-to-side anastomosis between the most distal aspect of the bowel and the most distal Roux-en-Y reconstruction, which preserved both Roux-en-Y reconstructions.

  20. Cirurgia do arco aórtico com perfusão cerebral bilateral pelo isolamento do tronco braquiocefálico e da artéria carótida esquerda Aortic arch surgery with bilateral cerebral perfusion by isolation of brachiocephalic trunk and left carotid artery

    Directory of Open Access Journals (Sweden)

    Valdo José Carreira

    2008-03-01

    Full Text Available OBJETIVO: Estudar os resultados da técnica descrita por Carreira et al. com utilização de perfusão cerebral seletiva bilateral (PCSAB pelo isolamento do tronco braquiocefálico e artéria carótida esquerda. MÉTODOS: Quinze pacientes foram operados consecutivamente entre de junho de 2005 e setembro de 2007. Os dados foram analisados por programa informatizado Epi Info e significância estatística com p0,05. CONCLUSÃO: A técnica de PCSAB é reprodutível e apresenta resultados semelhantes aos da literatura mundial. A excelente evolução neurológica e o fácil controle de sangramentos nas linhas de sutura podem ter contribuído com os resultados obtidos.OBJECTIVE: To evaluate the results of a technique described by Carreira et al. using bilateral antegrade selective cerebral perfusion by isolating the brachiocephalic trunk and the left carotid artery. METHODS: Fifteen patients were operated between June 2005 and September 2007. Data analysis were performed using Epi Info and statistical significance was set at p0.05. CONCLUSION: The technique of bilateral selective cerebral perfusion described by Carreira et al. can be performed by others and presents similar results to the international literature. The excellent neurological outcome and easy bleeding control on surgical sutures lines are the major advantages of this new procedure.

  1. Correlation between the selective control assessment of lower extremity and pediatric balance scale scores in children with spastic cerebral palsy

    Science.gov (United States)

    Lim, Hyoungwon

    2015-01-01

    [Purpose] The purpose of this study was to investigate the correlation between the Selective Control Assessment of Lower Extremity (SCALE) and Pediatric Balance Scales (PBS) in children with spastic cerebral palsy and further to test whether the SCALE is a valid tool to predict the PBS. [Subjects and Methods] A cross-sectional study was conducted to evaluate the SCALE and PBS in 23 children (9 females, 14 males, GMFCS level I–III) with spastic cerebral palsy. [Results] Both the SCALE and PBS scores for children with spastic hemiplegia were significantly higher than those for children with spastic diplegia. The scores for SCALE items were low for distal parts. The PBS items that were difficult for the participants to perform were items 8, 9, 10, and 14 with the highest difficulty experienced for item 8 followed by items 9, 10, and 14. The correlation coefficient (0.797) between the SCALE and PBS scores was statistically significant. The correlations between each SCALE item and the PBS scores were also statistically significant. SCALE items were significantly correlated with two PBS dimensions (standing and postural change). [Conclusion] In SCALE assessment, more severe deficits were observed in the distal parts. Standing and postural changes in the PBS method were difficult for the participants to perform. The two tests, that is, the SCALE and PBS, were highly correlated. Therefore, the SCALE is useful to prediction of PBS outcomes and is also applicable as a prognostic indicator for treatment planning. PMID:26834323

  2. Main effects and interactions of cerebral hemispheres, gender, and age in the calculation of volumes and asymmetries of selected structures of episodic memory.

    Science.gov (United States)

    Ramirez-Carmona, Rocio; Garcia-Lazaro, Haydee Guadalupe; Dominguez-Corrales, Brenda; Aguilar-Castañeda, Erika; Roldan-Valadez, Ernesto

    The aim of this study was to clarify the influence of anatomical (cerebral hemisphere) and demographic (age and gender) variables on the gray matter (GM) volumes and volumetric asymmetry indices (VAIs) of selected structures involved in episodic memory. A cross-sectional study was performed in 47 healthy volunteers. Neuropsychological evaluation revealed similar IQs across the sample. Using SPM-based software, brain segmentation, labeling and volume measurements of the hippocampus, amygdala, middle temporal gyrus and parahippocampal gyrus were performed in each cerebral hemisphere. A two-way between-groups multivariate analysis of covariance (MANCOVA) was applied to GM volumes and VAIs. The main effects of gender and cerebral hemisphere on GM volumes were significant (p gender and cerebral hemisphere. VAI measurements showed a nonsignificant effect of gender, but a significant influence of age (p = .015). The linear model of interactions and main effects explained 33% of the variance influencing the GM volume quantification. While cerebral hemisphere and gender were found to affect the volumes of brain structures involved in episodic memory, the calculation of VAIs was affected only by age. A comprehensive understanding of the main effects and interaction effects of cerebral hemisphere, gender and age on the volumes and asymmetries of structures related to episodic memory might help neurologists, psychiatrists, geriatricians and other neuroscientists in the study of degenerative brain diseases.

  3. Main effects and interactions of cerebral hemispheres, gender, and age in the calculation of volumes and asymmetries of selected structures of episodic memory

    Science.gov (United States)

    Ramirez-Carmona, Rocio; Garcia-Lazaro, Haydee Guadalupe; Dominguez-Corrales, Brenda; Aguilar-Castañeda, Erika; Roldan-Valadez, Ernesto

    2016-01-01

    Summary The aim of this study was to clarify the influence of anatomical (cerebral hemisphere) and demographic (age and gender) variables on the gray matter (GM) volumes and volumetric asymmetry indices (VAIs) of selected structures involved in episodic memory. A cross-sectional study was performed in 47 healthy volunteers. Neuropsychological evaluation revealed similar IQs across the sample. Using SPM-based software, brain segmentation, labeling and volume measurements of the hippocampus, amygdala, middle temporal gyrus and parahippocampal gyrus were performed in each cerebral hemisphere. A two-way between-groups multivariate analysis of covariance (MANCOVA) was applied to GM volumes and VAIs. The main effects of gender and cerebral hemisphere on GM volumes were significant (p < .001), while there was no significant interaction effect between gender and cerebral hemisphere. VAI measurements showed a non-significant effect of gender, but a significant influence of age (p = .015). The linear model of interactions and main effects explained 33% of the variance influencing the GM volume quantification. While cerebral hemisphere and gender were found to affect the volumes of brain structures involved in episodic memory, the calculation of VAIs was affected only by age. A comprehensive understanding of the main effects and interaction effects of cerebral hemisphere, gender and age on the volumes and asymmetries of structures related to episodic memory might help neurologists, psychiatrists, geriatricians and other neuroscientists in the study of degenerative brain diseases. PMID:28072386

  4. Functional Outcome After Antegrade Femoral Nailing : A Comparison of Trochanteric Fossa Versus Tip of Greater Trochanter Entry Point

    NARCIS (Netherlands)

    Moein, Chloe Ansari; ten Duis, Henk-Jan; Oey, Liam; de Kort, Gerard; van der Meulen, Wout; Vermeulen, Karin; van der Werken, Christiaan

    2011-01-01

    Objectives: This study was performed to explore the relationship between entry point-related soft tissue damage in antegrade femoral nailing and the functional outcome in patients with a proximal third femoral shaft fracture. Design: Retrospective clinical trial. Setting: Level I university trauma c

  5. Selective reduction of cerebral cortex GABA neurons in a late gestation model of fetal alcohol spectrum disorder.

    Science.gov (United States)

    Smiley, John F; Saito, Mariko; Bleiwas, Cynthia; Masiello, Kurt; Ardekani, Babak; Guilfoyle, David N; Gerum, Scott; Wilson, Donald A; Vadasz, Csaba

    2015-09-01

    Fetal alcohol spectrum disorders (FASD) are associated with cognitive and behavioral deficits, and decreased volume of the whole brain and cerebral cortex. Rodent models have shown that early postnatal treatments, which mimic ethanol toxicity in the third trimester of human pregnancy, acutely induce widespread apoptotic neuronal degeneration and permanent behavioral deficits. However, the lasting cellular and anatomical effects of early ethanol treatments are still incompletely understood. This study examined changes in neocortex volume, thickness, and cellular organization that persist in adult mice after postnatal day 7 (P7) ethanol treatment. Post mortem brain volumes, measured by both MRI within the skull and by fluid displacement of isolated brains, were reduced 10-13% by ethanol treatment. The cerebral cortex showed a similar reduction (12%) caused mainly by lower surface area (9%). In spite of these large changes, several features of cortical organization showed little evidence of change, including cortical thickness, overall neuron size, and laminar organization. Estimates of total neuron number showed a trend level reduction of about 8%, due mainly to reduced cortical volume but unchanged neuron density. However, counts of calretinin (CR) and parvalbumin (PV) subtypes of GABAergic neurons showed a striking >30% reduction of neuron number. Similar ethanol effects were found in male and female mice, and in C57BL/6By and BALB/cJ mouse strains. Our findings indicate that the cortex has substantial capacity to develop normal cytoarchitectonic organization after early postnatal ethanol toxicity, but there is a selective and persistent reduction of GABA cells that may contribute to the lasting cognitive and behavioral deficits in FASD.

  6. ANTEGRADE INTRAMEDULLARY FIXATION OF HUMERAL SHAFT FRACTURES WITH INTERLOCKING NAIL - AN ANALYSIS OF COMPLICATIONS

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    Arvinder

    2013-11-01

    Full Text Available ABSTRACT : Fractures of the humeral shaft account for 3% of all the fractures . Primary cause of these fractures i s high energy traumas. Goals in managing these fractures are osseous union, minimal deformity and return of maximal extremity function. The union rate of simple fractures of humerus treated conservatively is over 90%. Surgical management of these fractures is preferred in Segmental fractures, Polytrauma patients, Pathological fractures, Open fractures , Failed conservative treatment, Associated progressive neurological deficit , Vascular injury, Morbid obesity. We analysed intraoperative and postoperative com plications in twelve patients with humeral shaft fractures managed with antegrade interlocking nails. There were seven males and five females. Their ages ranged between 20 – 60 years with an average of 32.6 years. There were 11 close and one Gustilo grade I open fractures. There were six comminuted , four transverse, and two oblique fractures. Nine fractures were in middle third one in proximal third and two in distal third. Five patients had associated injuries. We faced difficulty in localizing entry port al in 2 patients . There was difficulty in reduction in 2 patients We had one patient with iatrogenic comminution . Three patients had improper locking screw size. One had nail protrusion proximally , one patient had distraction at the fracture site . There we re two superficial entry portal skin infections and one deep proximal cross screw infection. We had two patients with shoulder and one patient with elbow stiffness. Chronic rotator cuff irritation was present in three patients. We recorded three delayed un ions, one nonunion and one rotatory malunion The results of the present study indicate that antegrade intramedullary interlocked nailing is one of the best method of treatment among the currently available methods.

  7. The Effects of Selective Dorsal Rhizotomy on Balance and Symmetry of Gait in Children with Cerebral Palsy

    Science.gov (United States)

    Rumberg, Franziska; Bakir, Mustafa Sinan; Taylor, William R.; Haberl, Hannes; Sarpong, Akosua; Sharankou, Ilya; Lebek, Susanne; Funk, Julia F.

    2016-01-01

    Aim Cerebral palsy (CP) is associated with dysfunction of the upper motor neuron and results in balance problems and asymmetry during locomotion. Selective dorsal rhizotomy (SDR) is a surgical procedure that results in reduced afferent neuromotor signals from the lower extremities with the aim of improving gait. Its influence on balance and symmetry has not been assessed. The aim of this prospective cohort study was to evaluate the impact of SDR on balance and symmetry during walking. Methods 18 children (10 girls, 8 boys; age 6 years (y) 3 months (m), SD 1y 8m) with bilateral spastic CP and Gross Motor Function Classification System levels I to II underwent gait analysis before and 6 to 12 months after SDR. Results were compared to 11 typically developing children (TDC; 6 girls, 5 boys; age 6y 6m, SD 1y 11m). To analyse balance, sway velocity, radial displacement and frequency were calculated. Symmetry ratios were calculated for balance measures and spatio-temporal parameters during walking. Results Most spatio-temporal parameters of gait, as well as all parameters of balance, improved significantly after SDR. Preoperative values of symmetry did not vary considerably between CP and TDC group and significant postoperative improvement did not occur. Interpretation The reduction of afferent signalling through SDR improves gait by reducing balance problems rather than enhancing movement symmetry. PMID:27043310

  8. Percutaneous Antegrade Varicocele Embolization Via the Testicular Vein in a Patient with Recurrent Varicocele After Surgical Repair

    Energy Technology Data Exchange (ETDEWEB)

    Guevara, Carlos J., E-mail: guevarac@mir.wustl.edu; El-Hilal, Alexander H., E-mail: elhilala@mir.wustl.edu; Darcy, Michael D., E-mail: darcym@mir.wustl.edu [Washington University in St. Louis, Department of Radiology, School of Medicine (United States)

    2015-10-15

    This is a case report of an adolescent male who underwent surgical ligation for a left-sided varicocele that recurred 2 years later. Standard retrograde embolization via the left renal vein was not possible, because there was no connection from the renal vein to the gonadal vein following surgical ligation. The patient was treated via antegrade access of the spermatic vein at the inguinal level with subsequent coil embolization.

  9. The Use of ExoSeal Vascular Closure Device for Direct Antegrade Superficial Femoral Artery Puncture Site Hemostasis

    Energy Technology Data Exchange (ETDEWEB)

    Rimon, Uri, E-mail: rimonu@sheba.health.gov.il; Khaitovich, Boris, E-mail: borislena@012.net.il [Tel-Aviv University, Diagnostic and Interventional Imaging Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Yakubovich, Dmitry, E-mail: Dmitry.Yakubovitch@sheba.health.gov.il [Tel-Aviv University, Vascular Surgery Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Bensaid, Paul, E-mail: paulbensaid@hotmail.com; Golan, Gil, E-mail: gilgolan201@gmail.com [Tel-Aviv University, Diagnostic and Interventional Imaging Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Silverberg, Daniel, E-mail: Daniel.Silverberg@sheba.health.gov.il [Tel-Aviv University, Vascular Surgery Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel)

    2015-06-15

    PurposeThis study was designed to assess the efficacy and safety of the ExoSeal vascular closure device (VCD) to achieve hemostasis in antegrade access of the superficial femoral artery (SFA).MethodsWe retrospectively reviewed the outcome of ExoSeal VCD used for hemostasis in 110 accesses to the SFA in 93 patients between July 2011 and July 2013. All patients had patent proximal SFA based on computer tomography angiography or ultrasound duplex. Arterial calcifications at puncture site were graded using fluoroscopy. The SFA was accessed in an antegrade fashion with ultrasound or fluoroscopic guidance. In all patients, 5–7F vascular sheaths were used. The ExoSeal VCD was applied to achieve hemostasis at the end of the procedure. All patients were clinically examined and had ultrasound duplex exam for any puncture site complications during the 24 h postprocedure.ResultsIn all procedures, the ExoSeal was applied successfully. We did not encounter any device-related technical failure. There were four major complications in four patients (3.6 %): three pseudoaneurysms, which were treated with direct thrombin injection, and one hematoma, which necessitated transfusion of two blood units. All patients with complications were treated with anticoagulation preprocedure or received thrombolytic therapy.ConclusionsThe ExoSeal VCD can be safely used for antegrade puncture of the SFA, with a high procedural success rate (100 %) and a low rate of access site complications (3.6 %)

  10. Association of selected primitive reflex patterns with motor development among Nigerian children with cerebral palsy (a hospital-based study

    Directory of Open Access Journals (Sweden)

    Cozens Bankole Aiyejusunle

    2016-01-01

    Full Text Available Background: The retention of primitive reflexes (PRs is considered to be one of the primary impairments associated with cerebral palsy (CP. However, little is known about the pattern of retention of PRs across the different classes of CP. Objectives: This study was undertaken to evaluate, identify, and describe selected PRs in children diagnosed with CP and to determine their association with motor development. Materials and Methods: This study was a cross-sectional analytical survey conducted in the physiotherapy departments of four conveniently selected public hospitals in Lagos metropolis. Thirty-one children diagnosed with CP aged between 18-84 months were recruited. A PR profile consisting of 15 PRs were evaluated. The World Health Organization (WHO windows of achievement for six key motor milestones were employed to explore their motor development. Results: The placing reflex presented the highest pattern of persistence (12.96% across all the classes of CP. Children with spastic CP had the highest mean sum of retained PRs (6.24 ± 2.36. There was no significant association between the sum of retained PRs and motor development (P > 0.05. In addition, there were characteristic patterns of responses for specific PRs. Conclusion: The pattern of retained PRs varies for the different classes of CP. There is no significant association between the retention of PRs and motor development for children with CP. There is a need for further, in-depth study of these reflexes, individually, to better understand how they influence the motor development of children with CP.

  11. Orbital Ultrasound and S100 Protein Monitoring during Unilateral and Bilateral Antegrade Selective Cerebral Perfusion in Total Aortic Arch Replacement%全主动脉弓替换术中顺行性脑灌注时血流变化观察

    Institute of Scientific and Technical Information of China (English)

    田良鑫; 叶赞凯; 程卫平; 杨九光; 郑军; 孙立忠

    2004-01-01

    目的利用前瞻性随机对照方法比较全主动脉弓替换术中单侧顺行性脑灌注(ASCP)和双侧ASCP时视网膜中央动脉、球后血管血流变化和血S100蛋白浓度变化.方法16例全主动脉弓替换术患者随机分为单侧ASCP和双侧ASCP组,每组各8例.两组均行术前术后颅脑计算机体层摄影(CT).术中采用经眼球超声监测视网膜中央动脉及球后血管血流.术中术后动态测定血S100蛋白浓度.结果两组各有1例出现短暂性神经功能异常.ASCP过程中单侧组右侧视网膜中央动脉可探及血流,左侧视网膜中央动脉不可探及,双侧组两侧视网膜中央动脉均可探及血流.所有患者球后动脉均可探及血流.两组间各阶段血S100蛋白浓度无显著性差异(P>0.05).结论在基底动脉环完整,存在有效侧支循环条件下,单侧灌注操作较为简便,双侧灌注在ASCP期间两侧脑灌注较为均衡,但两种灌注方法对S100蛋白浓度的影响无显著性差异.

  12. Continuous Selective Intra-Arterial Application of Nimodipine in Refractory Cerebral Vasospasm due to Aneurysmal Subarachnoid Hemorrhage

    Directory of Open Access Journals (Sweden)

    Stephanie Ott

    2014-01-01

    Full Text Available Background. Cerebral vasospasm is one of the leading courses for disability in aneurysmal subarachnoid hemorrhage. Effective treatment of vasospasm is therefore one of the main priorities for these patients. We report about a case series of continuous intra-arterial infusion of the calcium channel antagonist nimodipine for 1–5 days on the intensive care unit. Methods. In thirty patients with aneurysmal subarachnoid hemorrhage and refractory vasospasm continuous infusion of nimodipine was started on the neurosurgical intensive care unit. The effect of nimodipine on brain perfusion, cerebral blood flow, brain tissue oxygenation, and blood flow velocity in cerebral arteries was monitored. Results. Based on Hunt & Hess grades on admission, 83% survived in a good clinical condition and 23% recovered without an apparent neurological deficit. Persistent ischemic areas were seen in 100% of patients with GOS 1–3 and in 69% of GOS 4-5 patients. Regional cerebral blood flow and computed tomography perfusion scanning showed adequate correlation with nimodipine application and angiographic vasospasm. Transcranial Doppler turned out to be unreliable with interexaminer variance and failure of detecting vasospasm or missing the improvement. Conclusion. Local continuous intra-arterial nimodipine treatment for refractory cerebral vasospasm after aSAH can be recommended as a low-risk treatment in addition to established endovascular therapies.

  13. Antegrade scrotal sclerotherapy of internal spermatic veins for varicocele treatment: technique, complications, and results

    Directory of Open Access Journals (Sweden)

    Alessandro Crestani

    2016-01-01

    Full Text Available Varicocele repair is mainly indicated in young adult patients with clinical palpable varicocele and abnormal semen parameters. Varicocele treatment is associated with a significant improvement in sperm concentration, motility, morphology, and pregnancy rate. Antegrade scrotal sclerotherapy (ASS represented one of the main alternatives to the traditional inguinal or suprainguinal surgical ligation. This article reviews the use of ASS for varicocele treatment. We provide a brief overview of the history of the procedure and present our methods used in ASS. In addition, we review complication and success of ASS, including our own retrospective data of treating 674 patients over the last 17 years. Herein, we analyzed step by step the ASS technique and described our results with an original modified technique with a long follow-up. Between December 1997 and December 2014, we performed 674 ASS. Mean operative time was 14 min (range 9 to 50 min. No significant intraoperative complications were reported. Within 90 days from the procedure, postoperative complications were recorded in overall 49 (7.2% patients. No major complications were recorded. A persistent/recurrent varicocele was detected in 40 (5.9% cases. In 32/40 (80% cases, patients showed preoperative grade III varicoceles. In patients with a low sperm number before surgery, sperm count improved from 13 × 10 6 to 21 × 10 6 ml−1 (P < 0.001. The median value of the percentage of progressive motile forms at 1 h improved from 25% to 45% (P < 0.001. Percentage of normal forms increased from 17% before surgery to 35% 1 year after the procedure (P < 0.001. In the subgroup of the 168 infertile patients, 52 (31% fathered offspring at a 12-month-minimum follow-up. Therefore, ASS is an effective minimal invasive treatment for varicocele with low recurrence/persistence rate.

  14. Ataque cerebral

    OpenAIRE

    Takeuchi Tan, Yuri; Fundación Valle de Lili

    1998-01-01

    ¿Qué es un ataque cerebral?/¿Qué tipos de ataque cerebral existen?/¿Cuáles son los síntomas de un ataque cerebral?/Factores de riesgo para un ataque cerebral/Tratamiento médico del ataque cerebral/¿por qué es importante acudir temprano cuando se presentan las señales de alarma?/ Manejo preventivo del ataque cerebral isquémico/Tratamiento quirúrgico del ataque cerebral/Enfermedad vascular cerebral hemorrágica/¿Cómo está constituido el grupo de ataque cerebral de la fundación Clínica Valle d...

  15. Obesity: An Independent Risk Factor for Insufficient Hemostasis Using the AngioSeal Vascular Closure Device After Antegrade Puncture

    Energy Technology Data Exchange (ETDEWEB)

    Minko, Peter, E-mail: peterminko@yahoo.com; Katoh, Marcus [University Hospital Saarland, Department of Diagnostic and Interventional Radiology (Germany); Graeber, Stefan [University Hospital Saarland, Institute of Medical Biometry, Epidemiology and Medical Informatics (Germany); Buecker, Arno [University Hospital Saarland, Department of Diagnostic and Interventional Radiology (Germany)

    2012-08-15

    Purpose: This study was designed to investigate the efficacy of the AngioSeal vascular closure device after antegrade puncture of the femoral artery. Methods: In a prospective study, 120 consecutive patients underwent lower limb vascular intervention by an antegrade access to the common femoral artery (CFA). After intervention, a 6F (n = 88) or an 8F (n = 32) AngioSeal vascular closure device was used to achieve hemostasis. The technical success or the cause of failure was documented. In addition, the coagulation status (platelets, INR, prothrombin time, atrial thromboplastin time (PTT)), hypertonus, locoregional habitus of the groin, body mass index (BMI), presence of calcifications, and history of previous surgical interventions of the CFA were evaluated. Results: Hemostasis was achieved in 97 patients (81%). In 12 patients (10%), persistent bleeding of the puncture site required manual compression. In another nine patients (8%) a kink of the sheath obviated the passage of the collagen plug toward the vessel, and in two patients the anchor dislodged out of the vessel, requiring manual compression. There were no significant differences between the groups of successful and unsuccessful sealing regarding the mean platelets (241 vs. 254 * 10{sup 9}/l; P = 0.86), INR (1.06 vs. 1.02; P = 0.52), prothrombin time (90% vs. 90%; P = 0.86), and PTT (30 vs. 31 s; P = 0.82). However, unsuccessful sealing was more likely in obese patients with an increased BMI (26.6 vs. 28.8 kg/m{sup 2}; P = 0.04). Conclusions: Obesity seems to be an independent risk factor for insufficient sealing using the AngioSeal vascular closure device after antegrade puncture of the CFA. In 8% of our patients, hemostasis could not be achieved due to kink of the flexible sheath.

  16. Selective up-regulation of 5-HT(1B/1D) receptors during organ culture of cerebral arteries

    DEFF Research Database (Denmark)

    Hoel, N L; Hansen-Schwartz, J; Edvinsson, L

    2001-01-01

    5-Hydroxytryptamine (5-HT) is thought to be involved in migraine headache and the pathophysiology of cerebrovascular diseases. Previous data show that organ culture induces a phenotypic change in cerebral vessels. Therefore we investigated if these changes also applied for the vasoconstrictive 5-HT...

  17. [Practical experiences with antegrade local chemolysis of struvite/apatite, uric acid and cystine calculi in the kidney].

    Science.gov (United States)

    Weirich, W; Frohneberg, D; Ackermann, D; Alken, P

    1984-03-01

    In 18 patients (20 kidneys) with struvite/apatite-, uric acid- and cystine stones antegrade local chemolysis was performed via percutaneous or operative nephrostomy. Complete stone dissolution was achieved in 11 kidneys, while in six kidneys partial dissolution of stones was performed. In these six cases added instrumental manipulations shortened the time of therapy. In three cases chemolysis was unsuccessful. Average irrigation time was 21 days per renal unit. Only minor complications like dysuria and skin rashes were seen. Due to long time of irrigation we recommend chemolitholysis mainly as an additional form of therapy in case of residual stones after operative or percutaneous nephrolithotomy.

  18. Cerebral Palsy

    Science.gov (United States)

    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 ...

  19. Selective α1-adrenergic blockade disturbs the regional distribution of cerebral blood flow during static handgrip exercise.

    Science.gov (United States)

    Fernandes, Igor A; Mattos, João D; Campos, Monique O; Machado, Alessandro C; Rocha, Marcos P; Rocha, Natalia G; Vianna, Lauro C; Nobrega, Antonio C L

    2016-06-01

    Handgrip-induced increases in blood flow through the contralateral artery that supplies the cortical representation of the arm have been hypothesized as a consequence of neurovascular coupling and a resultant metabolic attenuation of sympathetic cerebral vasoconstriction. In contrast, sympathetic restraint, in theory, inhibits changes in perfusion of the cerebral ipsilateral blood vessels. To confirm whether sympathetic nerve activity modulates cerebral blood flow distribution during static handgrip (SHG) exercise, beat-to-beat contra- and ipsilateral internal carotid artery blood flow (ICA; Doppler) and mean arterial pressure (MAP; Finometer) were simultaneously assessed in nine healthy men (27 ± 5 yr), both at rest and during a 2-min SHG bout (30% maximal voluntary contraction), under two experimental conditions: 1) control and 2) α1-adrenergic receptor blockade. End-tidal carbon dioxide (rebreathing system) was clamped throughout the study. SHG induced increases in MAP (+31.4 ± 10.7 mmHg, P blood flow (+80.9 ± 62.5 ml/min, P 0.05). The reduction in ipsilateral ICA vascular conductance (VC) was greater compared with contralateral ICA (contralateral: -0.8 ± 0.8 vs. ipsilateral: -2.6 ± 1.3 ml·min(-1)·mmHg(-1), P blood flow (contralateral: +58.4 ± 21.5 vs. ipsilateral: +54.3 ± 46.2 ml/min, P > 0.05) and decreases in VC (contralateral: -0.4 ± 0.7 vs. ipsilateral: -0.4 ± 1.0 ml·min(-1)·mmHg(-1), P > 0.05). These findings indicate a role of sympathetic nerve activity in the regulation of cerebral blood flow distribution during SHG.

  20. Surgical outcome of pancreatic cancer using radical antegrade modular pancreatosplenectomy procedure

    Institute of Scientific and Technical Information of China (English)

    Ye Rim Chang; Sung-Sik Han; Sang-Jae Park; Seung Duk Lee; Tae Suk Yoo; Young-Kyu Kim; Tae Hyun Kim

    2012-01-01

    To evaluate the surgical outcomes following radical antegrade modular pancreatosplenectomy (RAMPS)for pancreatic cancer.METHODS:Twenty-four patients underwent RAMPS with curative intent between January 2005 and June 2009 at the National Cancer Center,South Korea.Clinicopathologic data,including age,sex,operative findings,pathologic results,adjuvant therapy,postoperative clinical course and follow-up data were retrospectively collected and analyzed for this study.RESULTS:Twenty-one patients (87.5%) underwent distal pancreatectomy and 3 patients (12.5%) underwent total pancreatectomy using RAMPS.Nine patients (37.5%) underwent combined vessel resection,including 8 superior mesenteric-portal vein resections and 1 celiac axis resection.Two patients (8.3%) underwent combined resection of other organs,including the colon,stomach or duodenum.Negative tangential margins were achieved in 22 patients (91.7%).The mean tumor diameter for all patients was 4.09 ± 2.15 cm.The 2 patients with positive margins had a mean diameter of 7.25 cm.The mean number of retrieved lymph nodes was 20.92 ± 11.24 and the node positivity rate was 70.8%.The median survival of the 24 patients was 18.23 ± 6.02 mo.Patients with negative margins had a median survival of 21.80 ± 5.30 mo and those with positive margins had a median survival of 6.47 mo (P =0.021).Nine patients (37.5%) had postoperative complications,but there were no postoperative mortalities.Pancreatic fistula occurred in 4 patients (16.7%):2 patients had a grade A fistula and 2 had a grade B fistula.On univariate analysis,histologic grade,positive tangential margin,pancreatic fistula and adjuvant therapy were significant prognostic factors for survival.CONCLUSION:RAMPS is a feasible procedure for achieving negative tangential margins in patients with carcinoma of the body and tail of the pancreas.

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

    Directory of Open Access Journals (Sweden)

    Andreas Habertheuer

    2015-01-01

    Full Text Available 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.

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

    Science.gov (United States)

    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

  3. Cerebral malaria Malaria cerebral

    Directory of Open Access Journals (Sweden)

    Silvia Blair Trujillo

    2003-03-01

    Full Text Available Is the most common complication of P. falciparum malaria; nearly 90% of people who have suffered CM can recover without neurological problems. Currently there are four hypotheses that explain pathogenesis of CM: cytoadherence and sequestering of parasitized red blood cells to cerebral capillaries; rosette formation and parasitized red blood cells agglutination; production of cytokines and activation of second messengers and opening of the blood-brain barrier. However the main question remains to be answered; how the host-parasite interaction in the vascular space interferes transiently with cerebral function? Recently, the beta amyloid precursor peptide has been employed as marker of neural injury in CM. It is expected that the beta amyloid precursor peptide will help to understand the pathogenesis of CM in complicated patients of endemic areas of Colombia. La malaria Cerebral (MC es la complicación más frecuente de la malaria por P. falciparum; aproximadamente el 90% de las personas que la han padecido se recuperan completamente sin secuelas neurológicas. Aún no se conoce con claridad su patogénesis pero se han postulado cuatro hipótesis o mecanismos posibles: 1 citoadherencia y secuestro de glóbulos rojos parasitados en la microvasculatura cerebral; 2 formación de rosetas y aglutinación de glóbulos rojos parasitados; 3 producción de citoquinas y activación de segundos mensajeros y, 4 apertura de la barrera hematoencefálica. Sin embargo, queda un interrogante sin resolver aún: ¿qué proceso se lleva a cabo para que el parásito, desde el espacio microvascular, pueda interferir transitoriamente con la función cerebral? Recientemente se ha utilizado el precursor de la proteína b-Amiloide como un marcador de daño neuronal en MC; este precursor será de gran ayuda en futuras investigaciones realizadas en nuestro medio que aporten información para comprender la patogénesis de la MC.

  4. Target ballon-assisted antegrade and retrograde approach for recanalization of thrombosed fem-pop bypass graft using the outbreak catheter

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Jung Won; Chung, Hwan Hoon; Lee, Seung Hwa; Yeom, Suk Keu; Cha, Sang Hoon [Dept. of Radiology, Korea University College of Medicine, Ansan Hospital, Ansan (Korea, Republic of)

    2016-01-15

    The subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) technique is reportedly effective in severe peripheral vascular disease that cannot be treated with standard endovascular techniques including subintimal angioplasty. In this report, we used a target balloon with the Outback catheter to recanalize a thrombosed bypass graft that could not be treated successfully with SAFARI.

  5. Novel approach for independent control of brain hypothermia and systemic normothermia: cerebral selective deep hypothermia for refractory cardiac arrest

    Science.gov (United States)

    Wang, Chih-Hsien; Lin, Yu-Ting; Chou, Heng-Wen; Wang, Yi-Chih; Hwang, Joey-Jen; Gilbert, John R; Chen, Yih-Sharng

    2017-01-01

    A 38-year-old man was found unconscious, alone in the driver's seat of his car. The emergency medical team identified his condition as pulseless ventricular tachycardia. Defibrillation was attempted but failed. Extracorporeal membrane oxygenation (ECMO) was started in the emergency room 52 min after the estimated arrest following the extracorporeal cardiopulmonary resuscitation (ECPR) protocol in our center. The initial prognosis under the standard protocol was ECMO and CSDH circuits demonstrated independent control of cerebral and core temperatures. Nasal temperature was lowered to below 30°C for 12 hours while core was maintained at normothermia. The patient was discharged without significant neurological deficit 32 days after the initial arrest. PMID:28108436

  6. The Use of the 'Preclosure' Technique for Antegrade Aspiration Thrombectomy with Large Catheters in Acute Limb Ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Funke, C., E-mail: claas_funke@hotmail.com; Pfiffner, R. [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology (Switzerland); Husmann, M. [University Hospital Zurich, Clinic of Angiology (Switzerland); Pfammatter, T. [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology (Switzerland)

    2013-04-15

    This study was designed to assess retrospectively short- and mid-term outcomes of the use of a suture-mediated closure device to close the antegrade access in patients undergoing percutaneous aspiration thrombectomy with large catheters for acute leg ischemia. Between November 2005 and February 2010, a suture-mediated active closure system (ProGlide{sup Registered-Sign} 6F, Abbott) was placed before arterial sheath (mean 9 F, range 6-12 F) introduction in 101 patients (74 men, 73 %, mean age 70.1 {+-} 12.6 years standard deviation). Data regarding mortality, complications, and factors contributing to vascular complications at the access site was collected for 6 month after the intervention to detect device-related problems. As a coincidence, 77 patients had follow-up visits for a duplex ultrasound. There were a total of 19 vascular complications (19 %) at the puncture site, all of which were of hemorrhagic nature and none of which consisted of vessel occlusion. Two major outcome complications (2 %) occurred. A retroperitoneal hematoma and a serious inguinal bleeding required additive treatment and did not result in permanent sequelae. Nine cases involved death of which eight were not attributable to the closure and one remained unclear. Successful closure was achieved in 95 patients (94 %); additional manual compression was sufficient in the majority of the remaining patients. Numerous factors contributing to vascular complications were encountered. With acceptable short- and mid-term outcomes, the 'preclose' technique can be a reliable option for the closure of a large antegrade femoral access even for patients at a high risk of vascular complications, such as those undergoing aspiration thrombectomy.

  7. Electromagnetic treatment to old Alzheimer's mice reverses β-amyloid deposition, modifies cerebral blood flow, and provides selected cognitive benefit.

    Directory of Open Access Journals (Sweden)

    Gary W Arendash

    Full Text Available Few studies have investigated physiologic and cognitive effects of "long-term" electromagnetic field (EMF exposure in humans or animals. Our recent studies have provided initial insight into the long-term impact of adulthood EMF exposure (GSM, pulsed/modulated, 918 MHz, 0.25-1.05 W/kg by showing 6+ months of daily EMF treatment protects against or reverses cognitive impairment in Alzheimer's transgenic (Tg mice, while even having cognitive benefit to normal mice. Mechanistically, EMF-induced cognitive benefits involve suppression of brain β-amyloid (Aβ aggregation/deposition in Tg mice and brain mitochondrial enhancement in both Tg and normal mice. The present study extends this work by showing that daily EMF treatment given to very old (21-27 month Tg mice over a 2-month period reverses their very advanced brain Aβ aggregation/deposition. These very old Tg mice and their normal littermates together showed an increase in general memory function in the Y-maze task, although not in more complex tasks. Measurement of both body and brain temperature at intervals during the 2-month EMF treatment, as well as in a separate group of Tg mice during a 12-day treatment period, revealed no appreciable increases in brain temperature (and no/slight increases in body temperature during EMF "ON" periods. Thus, the neuropathologic/cognitive benefits of EMF treatment occur without brain hyperthermia. Finally, regional cerebral blood flow in cerebral cortex was determined to be reduced in both Tg and normal mice after 2 months of EMF treatment, most probably through cerebrovascular constriction induced by freed/disaggregated Aβ (Tg mice and slight body hyperthermia during "ON" periods. These results demonstrate that long-term EMF treatment can provide general cognitive benefit to very old Alzheimer's Tg mice and normal mice, as well as reversal of advanced Aβ neuropathology in Tg mice without brain heating. Results further underscore the potential for EMF

  8. Electromagnetic treatment to old Alzheimer's mice reverses β-amyloid deposition, modifies cerebral blood flow, and provides selected cognitive benefit.

    Science.gov (United States)

    Arendash, Gary W; Mori, Takashi; Dorsey, Maggie; Gonzalez, Rich; Tajiri, Naoki; Borlongan, Cesar

    2012-01-01

    Few studies have investigated physiologic and cognitive effects of "long-term" electromagnetic field (EMF) exposure in humans or animals. Our recent studies have provided initial insight into the long-term impact of adulthood EMF exposure (GSM, pulsed/modulated, 918 MHz, 0.25-1.05 W/kg) by showing 6+ months of daily EMF treatment protects against or reverses cognitive impairment in Alzheimer's transgenic (Tg) mice, while even having cognitive benefit to normal mice. Mechanistically, EMF-induced cognitive benefits involve suppression of brain β-amyloid (Aβ) aggregation/deposition in Tg mice and brain mitochondrial enhancement in both Tg and normal mice. The present study extends this work by showing that daily EMF treatment given to very old (21-27 month) Tg mice over a 2-month period reverses their very advanced brain Aβ aggregation/deposition. These very old Tg mice and their normal littermates together showed an increase in general memory function in the Y-maze task, although not in more complex tasks. Measurement of both body and brain temperature at intervals during the 2-month EMF treatment, as well as in a separate group of Tg mice during a 12-day treatment period, revealed no appreciable increases in brain temperature (and no/slight increases in body temperature) during EMF "ON" periods. Thus, the neuropathologic/cognitive benefits of EMF treatment occur without brain hyperthermia. Finally, regional cerebral blood flow in cerebral cortex was determined to be reduced in both Tg and normal mice after 2 months of EMF treatment, most probably through cerebrovascular constriction induced by freed/disaggregated Aβ (Tg mice) and slight body hyperthermia during "ON" periods. These results demonstrate that long-term EMF treatment can provide general cognitive benefit to very old Alzheimer's Tg mice and normal mice, as well as reversal of advanced Aβ neuropathology in Tg mice without brain heating. Results further underscore the potential for EMF treatment

  9. Percutaneous retrograde crossing of a near-occluded celiac trunk via the superior mesenteric artery as an adjuvant maneuver for antegrade stenting

    Directory of Open Access Journals (Sweden)

    Martin Andreas Geiger

    2016-03-01

    Full Text Available Abstract We describe the case of a 63-year-old woman with chronic mesenteric ischemia, persistent postprandial upper abdominal pain and progressive weight loss. Retrograde recanalization was performed via the superior mesenteric artery in order to achieve the goal of crossing the near-occlusion, showing that retrograde catheterization of the celiac trunk can be a feasible approach in challenging cases in which an antegrade approach fails as a single maneuver.

  10. Vasoespasmo cerebral

    Directory of Open Access Journals (Sweden)

    Antonio A. F. de Salles

    1987-09-01

    Full Text Available Vasoespasmo cerebral ocorre em patologias como enxaqueca, hemorragia subaracnóidea, trauma de crânio, após isquemia e/ou hipoxia. A fisiopatologia do vasoespasmo cerebral nestas patologias não está completamente desvendada. Neste artigo são analisados os fatores neuroquímicos e morfológicos responsáveis pelo controle circulatório cerebral. As alterações circulatórias que seguem a hemorragia subaracnóidea são utilizadas como exemplo. Conclui-se que fatores bioquímicos, fisiológicos e morfológicos são responsáveis pelas manifestações vasculares que ocorrem após a hemorragia subaracnóidea. Alternativas de tratamento do vasoespasmo cerebral são discutidas.

  11. Cerebral Paragonimiasis.

    Science.gov (United States)

    Miyazaki, I

    1975-01-01

    The first case of cerebral paragonimiasis was reported by Otani in Japan in 1887. This was nine years after Kerbert's discovery of the fluke in the lungs of Bengal tigers and seven years after a human pulmonary infection by the fluke was demonstrated by Baelz and Manson. The first case was a 26-year-old man who had been suffering from cough and hemosputum for one year. The patient developed convulsive seizures with subsequent coma and died. The postmortem examination showed cystic lesions in the right frontal and occipital lobes. An adult fluke was found in the occipital lesion and another was seen in a gross specimen of normal brain tissue around the affected occipital lobe. Two years after Otani's discovery, at autopsy a 29-year-old man with a history of Jacksonian seizure was reported as having cerebral paragonimiasis. Some time later, however, it was confirmed that the case was actually cerebral schistosomiasis japonica. Subsequently, cases of cerebral paragonimiasis were reported. However, the majority of these cases were not confirmed histologically. It was pointed out that some of these early cases were probably not Paragonimus infection. After World War II, reviews as well as case reports were published. Recently, investigations have been reported from Korea, with a clinicla study on 62 cases of cerebral paragonimiasis seen at the Neurology Department of the National Medical Center, Seoul, between 1958 and 1964. In 1971 Higashi described a statistical study on 105 cases of cerebral paragonimiasis that had been treated surgically in Japan.

  12. Selecting the appropriate outcome in paediatric physical therapy : How individual treatment goals for children with cerebral palsy are reflected in GMFM-88 and PEDI

    NARCIS (Netherlands)

    Engelen, Vivian; Ketelaar, Marjolijn; Gorter, Jan Willem

    2007-01-01

    Objective: To assess to what extent individual physical therapy treatment goals for children with cerebral palsy are reflected in 2 standardized measures: the GMFM-88 and the PEDI. Subjects: A total of 36 paediatric physical therapists working in primary healthcare with children with cerebral palsy

  13. 选择性脊神经后根切断术治疗痉挛性脑性瘫痪%Effects of selective posterior rhizotomy on spastic cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    周南开; 车善理; 周波; 邓宗锵; 张建蓉; 杨学权

    2003-01-01

    AIM:To investigate the effects of selective posterior rhizotomy (SPR) to spastic cerebral palsy.METHODS:55 patients with spastic cerebral palsy who were treated with SPR between April 1999 and January 2002 were followed up and compared their changes of muscle force, muscle tone, the limb function preoperatively and postoperatively.RESULTS: 51 had selective lumbosacral posterior rhizotomy.In 35 cases who could not walk preoperatively,25 could walk alone.6 cases improved their gait and walk ability and 4 did not significantly.20 cases who walked claudicantly preoperatively,can walk nimbly and firmly.Their step width extended and gait improved apparently.4 cases had selective cervical posterior rhizotomy.They had their spasm of upper limbs relieved, joint function improved,and clawhand disappeared.In this group we didn't find severe complications.CONCLUSION: Selective posterior rhizotomy has curative effect to spastic cerebral palsy and has no severe complications.Its long term effects still need observations.

  14. EUS-Guided Antegrade Transhepatic Placement of a Self-Expandable Metal Stent in Hepatico-Jejunal Anastomosis

    Directory of Open Access Journals (Sweden)

    Everson LA Artifon

    2011-11-01

    Full Text Available Context To demonstrate an EUS-guided biliary drainage in patient with gastrointestinal tract modified surgically. Case report An EUS guided access to the left intra hepatic duct, followed by an antegrade passage of a partially self-expandable metal stent that was removed by using an enteroscope, in one patient with hepatico-jejunal anastomosis. There were no early or delayed complications and the procedure was effective in relieving jaundice until the self-expandable metal stent was removed, 3 months later. A cholangiogram was obtained via enteroscopy, after removal of self-expandable metal stent, and found to be normal. The patient had an uneventful evaluation afterwards. Conclusion The indication of these procedures must be made under a multidisciplinary view while sharing information with the patient or legal guardian. EUS-guided biliary drainage is feasible when performed by professionals with expertise in biliopancreatic endoscopy and advanced echo-endoscopy and should be performed currently under rigorous protocol in educational institutions.

  15. Simulating technetium-99m cerebral perfusion studies with a three-dimensional Hoffman brain phantom. Collimator and filter selection in SPECT neuroimaging

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hee-Joung; Yang, Seoung-Oh; Moon, Dae-Hyuk; Lee, Hee-Kyung [Asan Medical Center, Seoul (Korea, Republic of); Karp, J.S.; Mozley, P.D.; Kung, H.F.; Alavi, A.

    1996-02-01

    The choice of a collimator and the selection of a filter can affect the quality of clinical SPECT images of the brain. The compromises that 4 different collimators make between spatial resolution and sensitivity were studied by imaging a three-dimensional Hoffman brain phantom. The planar data were acquired with each collimator on a three-headed SPECT system and were reconstructed with both a standard Butterworth filter and a Wiener pre-filter. The reconstructed images were then evaluated by specialists in nuclear medicine and were also quantitatively analyzed with specific regions of interest (ROI) in the brain. All observers preferred the Wiener filter reconstructed images regardless of the collimator used to acquire the planar images. With this filter, the ultrahigh-resolution fan-beam collimator was the most subjectively preferable and quantitatively produced the highest contrast ratios. The findings support suggestions that higher resolution collimators are preferable to higher sensitivity collimators, and indicate that fan-beam collimators are preferable to parallel-hole collimators for clinical SPECT studies of cerebral perfusion. The results also suggest that the Wiener filter enhances the quality of SPECT brain images regardless of which collimator is used to acquire the data. (author).

  16. Effect of strength training of ankle plantarflexors on selective voluntary motor control, gait parameters, and gross motor function of children with cerebral palsy.

    Science.gov (United States)

    Jung, Jee Woon; Her, Jin Gang; Ko, Jooyeon

    2013-10-01

    [Purpose] The purpose of this study was to investigate the effect of ankle plantarflexor strength training on selective voluntary motor control, gait parameters, and gross motor function of children with cerebral palsy (CP), focusing on changes in the strength and muscle activity of the ankle plantarflexors. [Methods] Six children aged between 4 and 10 years with CP participated in a 6 week strengthening program. The subjects were evaluated before and after the intervention in terms of ankle plantarflexor strength, muscle activity, gait velocity, cadence, step length, and D (standing) and E (walking, running, and jumping) dimensions of the Gross Motor Function Measure (GMFM). The data were analyzed using the non-parametric Wilcoxon signed-rank test. [Results] The strength of the plantarflexors increased in the majority of subjects. Significant and clinically meaningful post-intervention improvements in subject's gait velocity, cadence, and step length were found. [Conclusion] The controlled ankle plantarflexor strengthening program may lead to improvements in strength and spatiotemporal gait parameters of children with CP.

  17. 选择性腰骶脊神经后根切断术治疗脑性瘫痪儿的下肢痉挛%Management of lower limbs spasm following cerebral palsy using selective posterior rhizotomy

    Institute of Scientific and Technical Information of China (English)

    贺文; 徐梅; 汪枚初; 韩赛平; 杨俊

    2002-01-01

    Objective To investigate therapeutic effect of selective posterior rhizotomy in the treatment of lower limbs spasm following cerebral palsy.Method 106 cases received selective posterior rhizotomy.Postoperational follow up was carried for 6~ 36 months,averagely 18 months.Result All cases showed complete relief in muscular spasm,decreased muscular tension.Ashworth grade (1~ 1.5)was 1.3.Dynamic abnormality in joints were all corrected.Conclusion Selective posterior rhizotomy can effectively relieve lower limbs spasm,reduce muscular tension and correct dynamic joint abnormality.

  18. Cerebral, subcortical, and cerebellar activation evoked by selective stimulation of muscle and cutaneous afferents: an fMRI study.

    Science.gov (United States)

    Wardman, Daniel L; Gandevia, Simon C; Colebatch, James G

    2014-01-01

    Abstract We compared the brain areas that showed significant flow changes induced by selective stimulation of muscle and cutaneous afferents using fMRI BOLD imaging. Afferents arising from the right hand were studied in eight volunteers with electrical stimulation of the digital nerve of the index finger and over the motor point of the FDI muscle. Both methods evoked areas of significant activation cortically, subcortically, and in the cerebellum. Selective muscle afferent stimulation caused significant activation in motor-related areas. It also caused significantly greater activation within the contralateral precentral gyrus, insula, and within the ipsilateral cerebellum as well as greater areas of reduced blood flow when compared to the cutaneous stimuli. We demonstrated separate precentral and postcentral foci of excitation with muscle afferent stimulation. We conclude, contrary to the findings with evoked potentials, that muscle afferents evoke more widespread cortical, subcortical, and cerebellar activation than do cutaneous afferents. This emphasizes the importance, for studies of movement, of matching the kinematic aspects in order to avoid the results being confounded by alterations in muscle afferent activation. The findings are consistent with clinical observations of the movement consequences of sensory loss and may also be the basis for the contribution of disturbed sensorimotor processing to disorders of movement.

  19. Vasoespasmo cerebral

    OpenAIRE

    1987-01-01

    Vasoespasmo cerebral ocorre em patologias como enxaqueca, hemorragia subaracnóidea, trauma de crânio, após isquemia e/ou hipoxia. A fisiopatologia do vasoespasmo cerebral nestas patologias não está completamente desvendada. Neste artigo são analisados os fatores neuroquímicos e morfológicos responsáveis pelo controle circulatório cerebral. As alterações circulatórias que seguem a hemorragia subaracnóidea são utilizadas como exemplo. Conclui-se que fatores bioquímicos, fisiológicos e morfológi...

  20. 选择性脊神经前、后根切断与下肢Ⅱ期矫形联合治疗儿童重型脑性瘫痪%Combination of selective anterior and posterior rhizotomy with orthomorphy stage Ⅱ in treating severe cerebral palsy in children

    Institute of Scientific and Technical Information of China (English)

    彭仲双; 李树民; 尹庆水; 权日; 郑伟雄; 叶为华; 周军

    2002-01-01

    Objective To study the general design and practice instages of the treatment of severe cerebral palsy with the combination of selective anterior and posterior rhizotomy with orthomorphy stage II of the lower extremities. Method To evaluate the disability of the cases, calculate the expectant value and design rehabilitation program in stages before selective anterior and posterior rhizotomy orthomorphy, force line recovering , extremities banlancing, joints stabilization and muscle force rebuilding. Result After treatment in stages the 15 children of cerebral palsy could walk without support. Conclusion It's most important to practice the combination of the operations in order in rehabilitation of children's severe cerebral palsy.

  1. What is the optimal duration of middle-cerebral artery occlusion consistently resulting in isolated cortical selective neuronal loss in the spontaneously hypertensive rat?

    Directory of Open Access Journals (Sweden)

    Sohail eEjaz

    2015-03-01

    Full Text Available Introduction and Objectives: Selective neuronal loss (SNL in the reperfused penumbra may impact clinical recovery and is thus important to investigate. Brief proximal middle cerebral artery occlusion (MCAo results in predominantly striatal SNL, yet cortical damage is more relevant given its behavioral implications and that thrombolytic therapy mainly rescues the cortex. Distal temporary MCAo (tMCAo does target the cortex, but the optimal occlusion duration that results in isolated SNL has not been determined. In the present study we assessed different distal tMCAo durations looking for consistently pure SNL.Methods: Microclip distal tMCAo (md-tMCAo was performed in ~6-month old male spontaneously hypertensive rats (SHRs. We previously reported that 45min md-tMCAo in SHRs results in pan-necrosis in the majority of subjects. Accordingly, three shorter MCAo durations were investigated here in decremental succession, namely 30, 22 and 15mins (n=3, 3 and 7 subjects, respectively. Recanalization was confirmed by MR angiography just prior to brain collection at 28 days and T2-weighted MRI was obtained for characterization of ischemic lesions. NeuN, OX42 and GFAP immunohistochemistry appraised changes in neurons, microglia and astrocytes, respectively. Ischemic lesions were categorized into three main types: 1 pan-necrosis; 2 partial infarction; and 3 SNL. Results: Pan-necrosis or partial infarction was present in all 30min and 22min subjects, but not in the 15min group (p < 0.001, in which isolated cortical SNL was consistently present. MRI revealed characteristic hyperintense abnormalities in all rats with pan-necrosis or partial infarction, but no change in any 15min subject. Conclusions: We found that 15min distal MCAo consistently resulted in pure cortical SNL, whereas durations equal or longer than 22min consistently resulted in infarcts. This model may be of use to study the pathophysiology of cortical SNL and its prevention by appropriate

  2. Induction of spermatogenesis in men with azoospermia or severe oligoteratoasthenospermia after antegrade internal spermatic vein sclerotherapy for the treatment of varicocele

    Institute of Scientific and Technical Information of China (English)

    Vassilis Poulakis; Nikolaos Ferakis; Rachelle de Vries; Ulrich Witzsch; Edward Becht

    2006-01-01

    Aim: To evaluate the treatment outcome of antegrade internal spermatic vein sclerotherapy in men with non-obstructive azoospermia or severe oligoteratoasthenospermia (OTA) as a result of varicocele. Methods: Between September 1995 and January 2004, 47 patients (mean age 33.8 ± 6.3 years) underwent antegrade internal spermatic vein sclerotherapy for the treatment of varicocele with azoospermia (14 patients) or severe OTA (33 patients). Testicular core biopsy was also performed in complete azoospermic patients who provided informed consent. The outcome was assessed in terms of improvement in semen parameters and conception rate. Results: Forty-two (89.4%) of 47patients had bilateral varicocele. Serum follicle stimulating hormone (FSH) did not differ between patients with azoospermia and severe OTA. After the follow-up of 24.8 ± 9.2 months, significant improvement was noted in mean sperm concentration, motility and morphology in 35 patients (74.5%). Comparison between groups during the follow-up revealed significantly higher values of sperm concentration, motility and normal morphology in the severe OTA group. Pregnancy was achieved in 14 cases (29.8%). Testicular histopathology of the azoospermic patients with postoperative induction of spermatogenesis revealed maturation arrest at spermatid stage, Sertoli-cell-only (SCO)with focal spermatogenesis or hypospermatogenesis. None of the patients with pure SCO pattern or maturation arrest at spermatocyte stage achieved spermatogenesis after the treatment. Preoperative serum FSH levels didn't relate to treatment outcome. Conclusion: Antegrade internal spermatic vein sclerotherapy is an easy and effective treatment for symptomatic varicocele. It can significantly reverse testicular dysfunction and improve spermatogenesis in men with severe OTA, as well as induce sperm production in men with azoospermia, improving pregnancy rates in subfertile couples.

  3. CEREBRAL PALSY : ANTENATAL RISK FACTORS

    Directory of Open Access Journals (Sweden)

    Srinivasa Rao

    2015-05-01

    Full Text Available INTRODUCTION: Cerebral palsy (CP is a group of permanent movement disorders that appear in early childhood. Cerebral palsy is caused by abnormal development or damage to the parts of the brain that control movement, balance, and posture. Most often the problems occur during pregnancy; however, they may also occur during childbirth, or shortly after birth. Often the cause is unknown. AIM: To study the different antenatal maternal risk factors associated with cerebral palsy in the study group. MATERIA LS AND METHODS: Retrospective study was done to assess possible associated antenatal risk factors for cerebral palsy. Mothers of 100 cerebral palsy children were selected who are treated in Rani Chandramani Devi Hospital, a Government hospital in Visakhapa tn am, Andhra Pradesh State, India , from 2012 to 2014 and 100 controls, mothers of normal children were studied. Detailed antenatal history was obtained from the mothers of the children in both affected and control group. RESULTS: From the data, we conclude that the association of maternal anaemia with cerebral palsy is 7.3 times higher; association of maternal hypertension with cerebral palsy is 6.6 time higher, association with Pre - eclampsia is 6 times higher; association with Eclampsia is 8.6 times higher ; with antepartum haemorrhage, the association is 8.6 times higher and association of multiple pregnancy with cerebral palsy is 4.8 times higher than with controls. CONCLUSION: From this study of the role of antenatal risk factors, in the occurrence of cer ebral palsy in children it is concluded that the most common risk factor associated with cerebral palsy is the maternal anaemia and the other important risk factors associated being hypertension, pre eclampsia, eclampsia, antepartum haemorrhage and multipl e births.

  4. Retrograde pedal access with a 20-gauge intravenous cannula after failed antegrade recanalization of a tibialis anterior artery in a diabetic patient: a case report

    Directory of Open Access Journals (Sweden)

    Yucel Colkesen

    2015-08-01

    Full Text Available Retrograde tibiopedal approach is being used frequently in below-the-knee vascular interventions. In patients with diabetic foot pathology, complex anatomy often requires a retrograde technique when the distal vascular anatomy and puncture site is suitable. The dorsalis pedis and posterior tibial arteries can be punctured because of their relatively superficial position. We report a retrograde puncturing technique in patients with chronic total occlusions. After failed antegrade recanalization, puncturing and cannulation of a tiny dorsalis pedis artery with a narrow bore [20-gauge (0.8 mm] intravenous cannula is described.

  5. Mobility Experiences of Adolescents with Cerebral Palsy

    Science.gov (United States)

    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…

  6. Antegrade pressure measurement of urinary tract in children with persistent hydronephrosis

    Directory of Open Access Journals (Sweden)

    Patrícia Traballi de Carvalho Pegolo

    2012-08-01

    selectively applied mainly in the presence of functional deficit.

  7. Selective lengthening of the psoas and rectus femoris and preservation of the iliacus for flexion deformity of the hip in cerebral palsy patients.

    Science.gov (United States)

    Matsuo, T; Hara, H; Tada, S

    1987-01-01

    Between 1978 and 1983, 52 Japanese patients with cerebral palsy underwent operative correction of flexion deformity of the hip. The results of lengthening of the psoas, rectus femoris, and proximal hamstrings were satisfactory. The iliacus was left intact. Improvement in gait and activities of daily living was attained. Concentric reduction was obtained in 27 of 33 dislocated or subluxated hips. Sitting and perineal care were facilitated, and pain was alleviated. We conclude that preservation of the iliacus is important.

  8. Balloon-Occluded Antegrade Transvenous Sclerotherapy to Treat Rectal Varices: A Direct Puncture Approach to the Superior Rectal Vein Through the Greater Sciatic Foramen Under CT Fluoroscopy Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Ono, Yasuyuki, E-mail: onoyasy@hirakata.kmu.ac.jp; Kariya, Shuji, E-mail: kariyas@hirakata.kmu.ac.jp; Nakatani, Miyuki, E-mail: nakatanm@hirakata.kmu.ac.jp; Yoshida, Rie, E-mail: yagir@hirakata.kmu.ac.jp; Kono, Yumiko, E-mail: kohnoy@hirakata.kmu.ac.jp; Kan, Naoki, E-mail: kanna@takii.kmu.ac.jp; Ueno, Yutaka, E-mail: uenoyut@hirakata.kmu.ac.jp; Komemushi, Atsushi, E-mail: komemush@takii.kmu.ac.jp; Tanigawa, Noboru, E-mail: tanigano@hirakata.kmu.ac.jp [Kansai Medical University, Department of Radiology (Japan)

    2015-10-15

    Rectal varices occur in 44.5 % of patients with ectopic varices caused by portal hypertension, and 48.6 % of these patients are untreated and followed by observation. However, bleeding occurs in 38 % and shock leading to death in 5 % of such patients. Two patients, an 80-year-old woman undergoing treatment for primary biliary cirrhosis (Child-Pugh class A) and a 63-year-old man with class C hepatic cirrhosis (Child-Pugh class A), in whom balloon-occluded antegrade transvenous sclerotherapy was performed to treat rectal varices are reported. A catheter was inserted by directly puncturing the rectal vein percutaneously through the greater sciatic foramen under computed tomographic fluoroscopy guidance. In both cases, the rectal varices were successfully treated without any significant complications, with no bleeding from rectal varices after embolization.

  9. Feasibility and Safety of Vascular Closure Devices in an Antegrade Approach to Either the Common Femoral Artery or the Superficial Femoral Artery

    Energy Technology Data Exchange (ETDEWEB)

    Gutzeit, Andreas, E-mail: andreas.gutzeit@ksw.ch; Schie, Bram van, E-mail: Bram.vanschie@hotmail.com; Schoch, Eric, E-mail: eric.schoch@ksw.ch [Cantonal Hospital Winterthur, Department of Radiology (Switzerland); Hergan, Klaus, E-mail: k.hergan@salk.at [Paracelsus Medical University Salzburg, Department of Radiology (Austria); Graf, Nicole, E-mail: graf@biostatistics.ch; Binkert, Christoph A., E-mail: christoph.binkert@ksw.ch [Cantonal Hospital Winterthur, Department of Radiology (Switzerland)

    2012-10-15

    Introduction: The purpose of the present study was to analyze complications following antegrade puncture of the common femoral artery (CFA) and the superficial femoral artery (SFA) using vascular closure systems (VCS). Methods: A single-center, retrospective study was performed after obtaining approval from the institutional review board and informed consent from all patients. At our center, the CFA or SFA are used for arterial access. All patients were evaluated clinically on the same day. If there was any suspicion of an access site problem, Duplex ultrasound was performed. Results: Access location was the CFA in 50 patients and the SFA in 130 patients. The sheath size ranged from 4F to 10F. Two patients had to be excluded because of lack of follow-up. Successful hemostasis was achieved in 162 of 178 cases (91 %). The following complications were observed in 16 patients (8.9 %): 4 pseudoaneurysms (2.2 %), 11 hematomas (6.2 %), and 1 vascular occlusion (0.5 %). The two pseudoaneurysms healed spontaneously, in one case an ultrasound-guided thrombin injection was performed, and one aneurysm was compressed manually. No further medical therapy was needed for the hematomas. The one vascular occlusion was treated immediately with angioplasty using a contralateral approach. No significant difference was noted between the CFA and the SFA group with respect to complications (p = 1.000). Conclusions: The use of closure devices for an antegrade approach up to 10F is feasible and safe. No differences in low complication rates were observed between CFA and SFA.

  10. Statins and selective inhibition of Rho kinase protect small conductance calcium-activated potassium channel function (K(Ca2.3 in cerebral arteries.

    Directory of Open Access Journals (Sweden)

    Alister J McNeish

    Full Text Available BACKGROUND: In rat middle cerebral and mesenteric arteries the K(Ca2.3 component of endothelium-dependent hyperpolarization (EDH is lost following stimulation of thromboxane (TP receptors, an effect that may contribute to the endothelial dysfunction associated with cardiovascular disease. In cerebral arteries, K(Ca2.3 loss is associated with NO synthase inhibition, but is restored if TP receptors are blocked. The Rho/Rho kinase pathway is central for TP signalling and statins indirectly inhibit this pathway. The possibility that Rho kinase inhibition and statins sustain K(Ca2.3 hyperpolarization was investigated in rat middle cerebral arteries (MCA. METHODS: MCAs were mounted in a wire myograph. The PAR2 agonist, SLIGRL was used to stimulate EDH responses, assessed by simultaneous measurement of smooth muscle membrane potential and tension. TP expression was assessed with rt-PCR and immunofluorescence. RESULTS: Immunofluorescence detected TP in the endothelial cell layer of MCA. Vasoconstriction to the TP agonist, U46619 was reduced by Rho kinase inhibition. TP receptor stimulation lead to loss of K(Ca2.3 mediated hyperpolarization, an effect that was reversed by Rho kinase inhibitors or simvastatin. K(Ca2.3 activity was lost in L-NAME-treated arteries, but was restored by Rho kinase inhibition or statin treatment. The restorative effect of simvastatin was blocked after incubation with geranylgeranyl-pyrophosphate to circumvent loss of isoprenylation. CONCLUSIONS: Rho/Rho kinase signalling following TP stimulation and L-NAME regulates endothelial cell K(Ca2.3 function. The ability of statins to prevent isoprenylation and perhaps inhibit of Rho restores/protects the input of K(Ca2.3 to EDH in the MCA, and represents a beneficial pleiotropic effect of statin treatment.

  11. 兔经股动脉插管自体血栓大脑中动脉栓塞模型%Establishment of rabbit model of embolic middle cerebral artery occlusion stroke through selective transfemoral internal carotid catheterization

    Institute of Scientific and Technical Information of China (English)

    刘振生; 张新江; 周龙江; 高珊玉; 刘一辉; 王苇; 李澄

    2013-01-01

    Objective To establish rabbit model of embolic middle cerebral artery occlusion stroke with clots through selective transfemoral internal carotid catheterization(ICA), and evaluate the feasibility and stability of the technique. Methods A total of 30 New Zealand white rabbits were enrolled, either gender, with mean age of 14-month old and mean body weight of 4.1 kg, which were divided into control group(n=10) and experimental group(n = 20). Both groups received selective transfemoral ICA and angiography, with 1-5 clots injected in experimental group and only the contrast media injected in control group. Digital subtraction angiography (DSA) was performed to observe cerebral vascular obstruction, the modified Bederson scoring was used to observe neurologic impairment, CT perfusion was performed to observe cerebral blood perfusion, and diffusion weighted imaging (DWI) and 2, 3, 5 -triphenyltetrazolium chloride (TTC) staining were used to observe cerebral infarction. Results Seventeen (85 %) embolic rabbit stroke models in experimental group were successfully established, which manifested occlusion of middle cerebral arteries, neurologic deficits, abnormalities of perfusion, DWI and TTC staining. Three embolic rabbit stroke models were failed, because internal carotid arteries were occluded in 2 rabbits and recanalization occurred in occluded middle cerebral artery in 1 rabbit. No abnormality was observed in control animals. There was obvious difference in CT parameters between 2 groups. Conclusion It is demonstrated that the technique for establishing rabbit models of embolic middle cerebral arteries occlusion stroke with clots through selective transfemoral ICA is simple, micro invasive and reliable. Selection of appropriate clots and familiarity with the anatomy and variation of ICA could obviously improve the stability and reproducibility of focal cerebral ischemia model in rabbits.%目的 经股动脉途径行选择性颈内动脉插管建立兔大脑中动

  12. Employees with Cerebral Palsy

    Science.gov (United States)

    ... problems in the muscles or nerves. Instead, faulty development or damage to motor areas in the brain disrupt the brain's ability to adequately control movement and posture (United Cerebral Palsy, 2010). "Cerebral" refers to the ...

  13. United Cerebral Palsy

    Science.gov (United States)

    ... be sure to follow us on Twitter . 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 ...

  14. 腰骶段选择性脊神经后根切断术对痉挛型脑性瘫痪患者伴随症状的影响%The effects of selective posterior rhizotomy on combined symptoms of patients with spastic cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    王业华; 徐林; 龚维成

    2002-01-01

    Objective To investigate the effects of lumbar sacral selective posterior rhizotomy on spasticity of upper limbs,epilepsy, strabismus, sialorrhea and dysarthria of patients with spastic cerebral palsy.Methods 825 patients with cerebral palsy who had received SPR between 1990 and 1998 were followed up for two years at least.Results Of 328 cases with spasticity of upper limbs,67(20.4% ) had partial amelioration of spasticity of upper limbs.Of 35 cases with epilepsy, 31(88.6% ) had lower frequency of onset or needed to take lower dose drug to control than ever.Of 386 cases with strabismus,132(34.2% ) had improved.Of 73 cases with sialorrhea,49(67.1% ) had improved, 21(28.8% ) had found sialorrhea disappeararnce.Of 456 cases with dysarthria,72(15.8% ) had improved.Conclusion Selective posterior rhizotomy has curative effect on combined symptoms in some of patients with cerebral palsy.

  15. Sirt1 in cerebral ischemia

    Science.gov (United States)

    Koronowski, Kevin B.; Perez-Pinzon, Miguel A.

    2015-01-01

    Cerebral ischemia is among the leading causes of death worldwide. It is characterized by a lack of blood flow to the brain that results in cell death and damage, ultimately causing motor, sensory, and cognitive impairments. Today, clinical treatment of cerebral ischemia, mostly stroke and cardiac arrest, is limited and new neuroprotective therapies are desperately needed. The Sirtuin family of oxidized nicotinamide adenine dinucleotide (NAD+)-dependent deacylases has been shown to govern several processes within the central nervous system as well as to possess neuroprotective properties in a variety of pathological conditions such as Alzheimer’s Disease, Parkinson’s Disease, and Huntington’s Disease, among others. Recently, Sirt1 in particular has been identified as a mediator of cerebral ischemia, with potential as a possible therapeutic target. To gather studies relevant to this topic, we used PubMed and previous reviews to locate, select, and resynthesize the lines of evidence presented here. In this review, we will first describe some functions of Sirt1 in the brain, mainly neurodevelopment, learning and memory, and metabolic regulation. Second, we will discuss the experimental evidence that has implicated Sirt1 as a key protein in the regulation of cerebral ischemia as well as a potential target for the induction of ischemic tolerance. PMID:26819971

  16. Sirt1 in cerebral ischemia

    Directory of Open Access Journals (Sweden)

    Kevin B Koronowski

    2015-01-01

    Full Text Available Cerebral ischemia is among the leading causes of death worldwide. It is characterized by a lack of blood flow to the brain that results in cell death and damage, ultimately causing motor, sensory, and cognitive impairments. Today, clinical treatment of cerebral ischemia, mostly stroke and cardiac arrest, is limited and new neuroprotective therapies are desperately needed. The Sirtuin family of oxidized nicotinamide adenine dinucleotide (NAD +-dependent deacylases has been shown to govern several processes within the central nervous system as well as to possess neuroprotective properties in a variety of pathological conditions such as Alzheimer′s Disease, Parkinson′s Disease, and Huntington′s Disease, among others. Recently, Sirt1 in particular has been identified as a mediator of cerebral ischemia, with potential as a possible therapeutic target. To gather studies relevant to this topic, we used PubMed and previous reviews to locate, select, and resynthesize the lines of evidence presented here. In this review, we will first describe some functions of Sirt1 in the brain, mainly neurodevelopment, learning and memory, and metabolic regulation. Second, we will discuss the experimental evidence that has implicated Sirt1 as a key protein in the regulation of cerebral ischemia as well as a potential target for the induction of ischemic tolerance.

  17. Cerebral microangiopathies; Zerebrale Mikroangiopathien

    Energy Technology Data Exchange (ETDEWEB)

    Linn, Jennifer [Klinikum der Universitaet Muenchen (Germany). Abt. fuer Neuroradiologie

    2011-03-15

    Cerebral microangiopathies are a very heterogenous group of diseases characterized by pathological changes of the small cerebral vessels. They account for 20 - 30 % of all ischemic strokes. Degenerative microangiopathy and sporadic cerebral amyloid angiography represent the typical acquired cerebral microangiopathies, which are found in over 90 % of cases. Besides, a wide variety of rare, hereditary microangiopathy exists, as e.g. CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy), Fabrys disease and MELAS syndrome (Mitochondrial myopathy, Encephalopathy, Lactic Acidosis, and Stroke-like episodes). (orig.)

  18. Effect of cerebral lymphatic block on cerebral morphology and cortical evoked potential in rats

    Institute of Scientific and Technical Information of China (English)

    Zuoli Xia; Baoling Sun; Mingfeng Yang; Dongmei Hu; Tong Zhao; Jingzhong Niu

    2006-01-01

    BACKGROUND: It has been shown that although brain does not contain lining endothelial lymphatic vessel,it has lymphatic drain.Anterior lymphatic vessel in brain tissue plays a key role in introducing brain interstitial fluid to lymphatic system;however,the significance of lymphatic drain and the affect on cerebral edema remains unclear.OBJECTIVE: To investigate the effect of cerebral lymphatic block on cerebral morphology and cortical evoked potential in rats.DESIGN: Randomized controlled animal study.SETTING: Institute of Cerebral Microcirulation of Taishan Medical College and Department of Neurology of Affiliated Hospital.MATERIALS:A total of 63 healthy adult male Wistar rats weighing 300-350 g were selected in this study.Forty-seven rats were used for the morphological observation induced by lymphatic drain and randomly divided into three groups:general observation group(n=12),light microscopic observation group(n=21)and electronic microscopic observation group(n=14).The rats in each group were divided into cerebral lymphatic block subgroup and sham-operation control subgroup.Sixteen rats were divided into cerebral the effect of cerebral lymphatic block on cortical evoked potential,in which the animals were randomly divided into sham-operation group(n=6)and cerebral lymphatic block group(n=10).METHODS:The experiment was carried out in the Institute of Cerebral Microcirculation of Taishan Medical College from January to August 2003.Rats in cerebral lymphatic block group were anesthetized and separated bilateral superficial and deep cervical lymph nodes under sterile condition. Superior and inferior boarders of lymph nodes were ligated the inputting and outputting channels, respectively, and then lymph node was removed so as to establish cerebral lymphatic drain disorder models. Rats in sham-operation control group were not ligated the lymphatic vessel and removed lymph nodes.and other operations were as the same as those in cerebral lymphatic block group

  19. EFFECT OF AUDITORY & VISUAL BIOFEEDBACK WITH ELECTRICAL STIMULATION OF THE TIBIALIS ANTERIOR MUSCLE ON ACTIVE ROM & SELECTIVE MOTOR CONTROL OF ANKLE OF CHILDREN WITH SPASTIC CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    Mayuri Sharma

    2015-06-01

    Full Text Available Background & Objective: Cerebral palsy (CP is the most common cause of movement disability in childhood, with an incidence of 1.5–2.5 per 1000 live born children. It is a non-progressive disorder that covers a number of neurological conditions, resulting in an abnormal development of movement and postural control. It is believed that an inability to maximally activate their muscles contributed to this weakness. Visual and auditory feedback cues have been shown to improve ROM & VMC in patients with movement disorders. The aim of this work was to investigate the efficacy of using biofeedback and neuromuscular electrical stimulation applied on tibialis anterior in children with cerebral palsy. The present work was designed to compare the effect of treatment with or without biofeedback applied to children with diplegic CP. Materials and Method: The 30 children with CP were divided in to 2 groups(experimental & control.The control group received NMES on tibialis anterior for 20 min. a day ,6 days in a week for a period of 6 weeks.the experimental group received NMES +biofeedback +conventional treatment.pre and post treatment evaluation included range of motion ,VMC and GMFM scoring. Results: Results showed that there was main effect for time, f(1,28;0.05=4.37, p<0.046 & a main effect for time, f(1,28;0.05=1.30, p<0.00,however there main effects were qualified by a group × time interaction, f (1,28;0.05=219.37, p<0.00.There was main effect for time, f(1,28;0.05=4.64. p<0.04 & a main effect for group, f(1,28;0.05=485.96, p<0.00,however there main effects were qualified by a group × time interaction, f (1,28;0.05=65.96, p <0.00 in right and left ankle joint. Conclusion: A significant improvement in range of motion, VMC & GMFM in experimental group as compare to control group. The study determined that biofeedback have positive clinical effects on the ROM & VMC of ankle of spastic diplegic.

  20. Strategies for Successful Percutaneous Revascularization of Chronic Total Occlusion of the Femoropopliteal Arteries When the Antegrade Passage of a Guide Wire Fails

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hui Jin; Park, Sang Woo; Chang, So Il; Jeon, Hae Jeong; Park, Jeong Hee [Konkuk University Hospital, Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2012-07-15

    To evaluate the efficacy of various strategies for revascularization of chronic total occlusion of femoropopliteal arteries when the guide wire does not pass in an anterograde direction. Twenty-four patients with totally occluded femoropopliteal arteries (mean occlusion length 13.75 cm; range, 6-22 cm) were treated by using a retrograde approach and two novel catheters. After successful recanalization or reentry, balloon angioplasty followed by stent placement was performed to complete the revascularization. In 16 cases in which to cross the occlusion via intraluminal or subintimal route was failed, we used Frontrunner catheters in five cases and Outback catheters in 11 cases. In eight cases in which to reenter after subintimal passage of the guide wire was failed, we used Outback catheters. Successful recanalization was achieved intraluminally or subintimally in all cases. One perforation occurred during subintimal passage of the guide wire that was controlled by recanalization of another subintimal tract. There were no cases of distal thromboembolism or other complications. A retrograde approach and using the Frontrunner and Outback catheters are safe and effective for successful revascularization of chronic total occlusion of femoropopliteal arteries. In particular, they are useful when the initial antegrade attempts at recanalization have failed.

  1. Antegrade Rush nailing for fractures of humeral shaft- an analysis of 200 cases with an average follow up of 1 year

    Directory of Open Access Journals (Sweden)

    Gadegone W

    2006-01-01

    Full Text Available Background : The incidence of humeral fracture has significantly increased during the recent times due to the rising age of the population and the number of automobile accidents. In order to achieve a stable fixation and early mobilization, numerous surgical implants have been devised. Method : We carried out a prospective analysis of the data of 200 consecutive patients who had closed fractures of the humeral shaft treated with ante-grade closed Rush nails at our institute. Patients with preoperative radial nerve injury were excluded from this study. In 186 patients we achieved close to anatomic reduction of the fracture fragments. In 14 patients we had to resort to limited open reduction. Results : Fracture united in 186 of 188 patient followed up for one year. Complications occurred in 26 patients. We strongly advise a careful surgical technique and modification as per the individual fracture pattern to reduce the complications. Conclusion : Osteosynthesis with multiple Rush nails features the advantages of rotational stability of the head-neck fragment to the diaphysis, an unreamed implantation technique without any special instruments, the speed of execution and minimal economic burden so important for the developing country like ours.

  2. Cerebral Arterial Fenestrations

    Science.gov (United States)

    Cooke, Daniel L; Stout, Charles E; Kim, Warren T; Kansagra, Akash P; Yu, John Paul; Gu, Amy; Jewell, Nicholas P; Hetts, Steven W; Higashida, Randall T; Dowd, Christopher F; Halbach, Van V

    2014-01-01

    Summary Arterial fenestrations are an anatomic variant with indeterminate significance. Given the controversy surrounding fenestrations we sought their prevalence within our practice along with their association with other cerebrovascular anomalies. We retrospectively reviewed 10,927 patients undergoing digital subtraction angiography between 1992 and 2011. Dictated reports were searched for the terms “fenestration” or “fenestrated” with images reviewed for relevance, yielding 228 unique cases. A Medline database search from February 1964 to January 2013 generated 304 citations, 127 cases of which were selected for analysis. Cerebral arterial fenestrations were identified in 228 patients (2.1%). At least one aneurysm was noted in 60.5% of patients, with an aneurysm arising from the fenestration in 19.6% of patients. Aneurysmal subarachnoid hemorrhage or non-aneurysmal subarachnoid hemorrhage were present in 60.1% and 15.8%, respectively. For the subset of patients with an aneurysm arising directly from a fenestration relative to those patients with an aneurysm not immediately associated with a fenestration, the prevalence of aneurysmal subarachnoid hemorrhage was 66.7% vs. 58.6% (p = 0.58). Fenestrations were more often within the posterior circulation (73.2%) than the anterior circulation (24.6%), though there was no difference in the prevalence of aneurysms within these groups (61.1% vs. 60.7%, p = 1.0). Cerebral arterial fenestrations are an anatomic variant more often manifesting at the anterior communicating arterial complex and basilar artery and with no definite pathological relationship with aneurysms. PMID:24976087

  3. Influence of remote ischemic preconditioning on cerebral oxygen metabolism and cerebral blood flow indexes of patients with ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    Hui Lu; Ning-Ning Cui; Bin-Cheng Wang

    2016-01-01

    Objective:To study the influence of remote ischemic preconditioning on cerebral oxygen metabolism and cerebral blood flow indexes of patients with ischemic cerebrovascular disease. Methods:A total of 58 patients with ischemic cerebrovascular disease in our hospital from April 2015 to January 2016 were selected as the study object, and 58 patients were randomly divided into two groups, 29 patients in control group were treated with routine treatment, 29 patients in observation group were treated with remote ischemic preconditioning on the basic treatment of control group, then the cerebral oxygen metabolism and cerebral blood flow indexes of two groups before the treatment and at first, third and sixth month after the treatment were respectively detected and compared.Results:The cerebral oxygen metabolism and cerebral blood flow indexes of two groups before the treatment all showed no significant differences (allP>0.05), while the cerebral oxygen metabolism and cerebral blood flow indexes of observation group at first, third and sixth month after the treatment were all significantly better than those before the treatment, and the results were all significantly better than those of control group at the same time too (allP>0.05).Conclusions: The influence of remote ischemic preconditioning on cerebral oxygen metabolism and cerebral blood flow indexes of patients with ischemic cerebrovascular disease are better, and its application value for the patients with ischemic cerebrovascular disease is higher.

  4. Endothelium-dependent relaxant responses to selective 5-HT(1B/1D) receptor agonists in the isolated middle cerebral artery of the rat

    DEFF Research Database (Denmark)

    Hansen-Schwartz, Jacob; Løvland Hoel, Natalie; Nilsson, Elisabeth;

    2003-01-01

    perfused. Luminally added 5- hydroxytryptamine (5-HT), sumatriptan and rizatriptan induced maximal dilatations of 22 +/- 4, 10 +/- 2 and 13 +/- 5%, respectively, compared to the resting diameter. The relaxant effect of sumatriptan was blocked by the 5- HT(1B/1D) receptor selective antagonist GR 55562 (10...

  5. Assessment of the hand in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Praveen Bhardwaj

    2011-01-01

    Full Text Available 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.

  6. 基底节区脑出血患者急诊的CT表现及手术选择分析%Analysis of CT Findings and Surgical Selection of Emergency Patients with Cerebral Hemorrhage in Basal Ganglia

    Institute of Scientific and Technical Information of China (English)

    刘明蓉; 李立为; 张东友

    2016-01-01

    Objective To explore the CT findings of emergency patients with cerebral hemorrhage in basal ganglia and the reference value of CT in surgical selection of patients.Methods 75 patients with cerebral hemorrhage in the basal ganglia treated in the neurosurgery department of our hospital from August 2011 to August 2014 were treated as the research objects. All patients underwent double-slice spiral CT to make clear CT typing of patients and the prognosis was evaluated with ADL.Results Among the 19 patients undergoing traditional craniotomy, the percentage of grade (Ⅰ+Ⅱ) patients was 84.2%. In 31 cases of patients undergoing small bone window minimally invasive craniotomy, grade (I+II) patients accounted for 80.6%.The difference was not statistically significant (P<0.05). In 50 patients, 41 patients had better prognosis which was grade I or II and CT typing results of the patients mainly were type I, II and Ⅲ of which the number of cases was 1, 7 and 16. The rate of good prognosis was 92.3%. The rate of good prognosis in 24 cases of type IV and type V patients was 70.8%. The difference was statistically significant (P<0.05), which indicated that the lower CT type was, the better prognosis was.Conclusion The application of CT in diagnosis of cerebral hemorrhage in basal ganglia is of significant features and it can provide reference for early diagnosis and surgical selection and can predict prognosis. It is worthy of promotion and application.%目的:探析基底节区脑出血患者急诊CT表现及对手术选择的参考价值。方法选择我院神经外科2011年8月-2014年8月收治75例基底节区脑出血患者为例,均行双层螺旋CT检查,明确患者CT分型并应用ADL量表评估预后。结果19例传统开颅手术患者中,(Ⅰ+Ⅱ)级患者所占百分率为84.2%,31例小骨窗微创开颅患者的(Ⅰ+Ⅱ)级患者所占百分率为80.6%,差异无统计学意义(P<0.05)。50例患者中,共41例患者预后较佳,为Ⅰ

  7. Reversible cerebral vasoconstriction syndrome

    Directory of Open Access Journals (Sweden)

    Saini Monica

    2009-01-01

    Full Text Available Reversible cerebral vasoconstriction syndromes (RCVS are a group of disorders that have in common an acute presentation with headache, reversible vasoconstriction of cerebral arteries, with or without neurological signs and symptoms. In contrast to primary central nervous system vasculitis, they have a relatively benign course. We describe here a patient who was diagnosed with RCVS.

  8. The Malone Antegrade Continence Enema (MACE principle in children: is it important if the conduit is implanted in the left or the right colon?

    Directory of Open Access Journals (Sweden)

    Karine F. Meyer

    2008-03-01

    Full Text Available OBJECTIVE: The aim of the study was to determine which was the optimal side for the conduit to be placed (right or left colon for antegrade continence enema implantation. MATERIALS AND METHODS: Between July 1999 and March 2006, 31 patients underwent the construction of a catheterizable conduit using the Malone principle (MACE In 22 cases the conduit was re-implanted in the right colon and in 9 cases in the left colon. There were 20 male patients and 11 female patients, with a mean age of 10.23 years. The follow-up period varied from 3 from 83 months (average 25 months. Right and left implantation of the conduit in the colon were compared with regards to the presence of complications, volume of the solution utilized, frequency of colonic lavage, time needed for performing the enema, and degree of satisfaction. RESULTS: One patient with the conduit in the right colon, using the appendix, lost the mechanism after two month follow-up. Thirty patients remain clean and are all capable of performing self-catheterization. No statistically significant differences were found between the groups regarding the variables studied: complications (p = 1.000, solution volume (p = 0.996, time required (p = 0.790 and patient's rating (p = 0.670. The lavage frequency required for patients with the conduit in the right colon may be lower. CONCLUSION: The MACE principle was considered effective for treating fecal retention and leaks, independent of the implantation site. The success of this surgery appears to be directly related to the patient's motivation and not to the technique utilized.

  9. Regulatory mechanism of endothelin receptor B in the cerebral arteries after focal cerebral ischemia

    DEFF Research Database (Denmark)

    Grell, Anne-Sofie; Thigarajah, Rushani; Edvinsson, Lars;

    2014-01-01

    drug targets to restore normal cerebral artery contractile function as part of successful neuroprotective therapy. METHODS: We have employed in vitro methods on human and rat cerebral arteries to study the regulatory mechanisms and the efficacy of target selective inhibitor, Mithramycin A (MitA...... arteries. RESULTS: Increased expression of specificity protein (Sp1) was observed in human and rat cerebral arteries after organ culture, strongly correlating with the ETBR upregulation. Similar observations were made in MCAO rats. Treatment with MitA, a Sp1 specific inhibitor, significantly downregulated...... vasoconstriction in focal cerebral ischemia via MEK-ERK signaling, which is also conserved in humans. The results show that MitA can effectively be used to block ETBR mediated vasoconstriction as a supplement to an existing ischemic stroke therapy....

  10. Individualized surgical treatment of cerebral palsy with hip adduction deformity after selective posterior rhizotomy%脑瘫SPR术后遗留髋内收畸形的个体化手术治疗

    Institute of Scientific and Technical Information of China (English)

    王逢贤; 曹旭; 俞兴; 曲弋; 穆晓红; 徐林

    2014-01-01

    Objective To evaluate the surgical options and clinical effects of treatment of spastic cerebral palsy with hip adduction deformity after selective posterior rhizotomy (SPR). Methods From August 2008 to August 2012, 126 patients with hip adduction deformity who had performed SPR for spastic cerebral palsy were treated in Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine. According to the range of muscle contracture and the degree of deformity, different surgical methods were chosen including tenotomy of long adductor muscle, short adductor muscle, gracilis, iliopsoas, as well as transection of anterior branch of obturator nerve etc. Results All cases were followed up with the average time of 22 months (14-38 months). Postoperative hip adduction deformity improved significantly, among them, the angle of hip abduction more than 30° was in 118 cases, while 20° to 30° in 8 cases, with the rate of remission 100% (126/126), and the satisfaction rate 93.6% (118/126). No limb sensory disturbance, hip abduction or external rotation deformity were found after the surgery. Conclusion For cerebral palsy patients with hip adduction deformity after SPR, individualized surgical treatment including muscle tenotomy and transection of anterior branch of obturator nerve could bring into satisfactory clinical efficacy according to different patients' individual situations.%目的:评价痉挛型脑瘫患者腰骶段选择性脊神经后根切断术(SPR)后遗留髋内收畸形的手术方案选择及临床疗效。方法回顾性分析2008年8月至2012年8月北京中医药大学东直门医院收治的126例脑瘫SPR术后遗留髋内收畸形患者的临床资料,根据肌肉挛缩的范围和畸形程度采取不同的手术方式,包括长收肌、短收肌、股薄肌、髂腰肌、闭孔神经前支切断术等。观察患者术后髋外展角度及畸形矫正情况。结果126例患者随访14~38个月(平均22个月)。术后髋内

  11. Effect of heat shock protein 70 on cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Wen Yan; Xiulian Chen; Rui Chen; Shiming Xu; Lijuan Zhang; Hongjuan Wang; Chunyue Huo

    2006-01-01

    OBJECTIVE: To summarize the relationship between heat shock protein 70 (HSP70) and cerebral ischemia.DATA SOURCES: An online search of Medline database was undertaken to identify relevant articles published in English from January 1980 to December 2005 by using the keywords of "heat shock protein 70, ischemia". Meanwhile, Chinese relevant articles published from January 2000 to December 2005 were searched in China National Knowledge Infrastructure (CNKI) database and Chinese Journal of Clinical Rehabilitation with the keywords of "heat shock protein 70, cerebral ischemia" in Chinese.STUDY SELECTION: More than 100 related articles were screened, and 29 references mainly about HSP70and cerebral ischemia were selected, including basic and clinical researches. As to the articles with similar content, those published in the authoritative journals in recent 3 years were preferential.DATA EXTRACTION : A total of 29 articles were collected and classified according to the structure, function and clinical application of HSP70. Among them, 1 article is about the structure of HSP70, 27 about the relationship between HSP70 and cerebral ischemia, and 2 about the clinical application of HSP70.DATA SYNTHESTS: HSP70 is one of the most conservative proteins during biological evolution. Experiments in cerebral ischemia revealed that HSP70 expression was time-dependent, also correlated with the injured site and severity. The cerebral ischemia induced HSP70 gene expression in hippocampus of gerbil had protection to tolerance of fatal ischemic injury for neurons. The increase of HSP70 expression may be one of the endogenous protective mechanisms during cerebral ischemia, and can effectively alleviate cerebral ischemia. Thus HSP70 protein and HSP70 mRNA have been taken as important indexes extensively applied in the basic study of cerebral ischemia by some scholars abroad.CONCLUSTON: HSP70 plays a protective role in cerebral ischemia, and a deeper research into the biological function of

  12. Imaging of cerebral flow dynamics via MR angiography and selective presaturation: Initial experiences. Darstellung zerebraler Flussdynamik mit MR-Angiographie und selektiver Vorsaettigung: Erste Erfahrungen

    Energy Technology Data Exchange (ETDEWEB)

    Wallner, B.; Weidenmaier, W.; Vogel, J.; Bargon, G. (Ulm Univ. (Germany). Abt. fuer Roentgendiagnostik)

    1991-11-01

    MR angiography with selective presaturation was applied in 5 normal volunteers, 22 patients with cerebrovascular disease, 3 patients with arteriovenous malformations (AVM) and one patient with thrombosis of the superior sagittal sinus. The results were compared with Doppler ultrasound and conventional angiography. MR angiography reliably demonstrated the direction of blood flow and the presence or absence of collateral flow on the circle of Willis. Collateral flow via leptomeningeal vessels and the ophthalmic artery could not be demonstrated. In the patient with superior sagittal sinus thrombosis, the absence of flow was well seen. MR angiography was able to demonstrate the major supplying arteries in the patients with AVMs. MR angiography is a valid noninvasive means to demonstrate direction of flow and blood supply of the major intracranial arteries. (orig.).

  13. Unilateral cerebral polymicrogyria with ipsilateral cerebral hemiatrophy

    Energy Technology Data Exchange (ETDEWEB)

    Hayakawa, Katsumi [Department of Radiology, Kyoto City Hospital, 1-2 Higashi-Takada-cho, Mibu, Nakagyo-ku, 604-8845 Kyoto (Japan); Kanda, Toyoko; Yamori, Yuriko [Department of Pediatric Neurology, St. Joseph Hospital for Handicapped Children, 603-8323 Kyoto (Japan)

    2002-10-01

    We evaluated six children in whom MR imaging showed unilateral cerebral polymicrogyria associated with ipsilateral cerebral atrophy and ipsilateral brain stem atrophy. The aim of this study was to clarify whether this disorder based on neuroimaging constitutes a new homogeneous clinical entity. The subjects were six children whose ages at the time of MR imaging ranged from 8 months to 11 years. Their clinical and MR features were analyzed. All of the children were born between 38 and 42 weeks gestation, without any significant perinatal events. Spastic hemiplegia and epilepsy were observed in all of the patients, and mental retardation was observed in four. The MR findings included unilateral cerebral polymicrogyria associated with ipsilateral cerebral hemiatrophy and ipsilateral brain stem atrophy in all patients. The ipsilateral sylvian fissure was hypoplastic in four patients. These patients showed relatively homogeneous clinical and neuroimaging features. Although the additional clinical features varied according to the site and the extent affected by the polymicrogyria, this disorder could constitute a new relatively homogeneous clinical entity. (orig.)

  14. Anestesia e paralisia cerebral

    OpenAIRE

    Március Vinícius M Maranhão

    2005-01-01

    JUSTIFICATIVA E OBJETIVOS: A paralisia cerebral (PC) é uma doença não progressiva decorrente de lesão no sistema nervoso central, levando a um comprometimento motor do paciente. O portador de PC freqüentemente é submetido a procedimentos cirúrgicos devido a doenças usuais e situações particulares decorrentes da paralisia cerebral. Foi objetivo deste artigo revisar aspectos da paralisia cerebral de interesse para o anestesiologista, permitindo um adequado manuseio pré, intra e pós-operatório n...

  15. Selective lumbosacral posterior and anterior rhizotomy for mixed cerebral palsy%选择性腰骶脊神经后根+前根切断术治疗混合型脑瘫

    Institute of Scientific and Technical Information of China (English)

    王逢贤; 徐林; 曹旭; 俞兴; 穆晓红; 吴坤懂

    2012-01-01

    Objectives: To investigate the efficacy of selective posterior rhizotomy(SPR) with selective anterior rhizotomy (SAR) for the treatment of mixed cerebral palsy. Methods: 48 patients with an average age of 8.8 years old(3-22 years) were reviewed retrospectively from January 2004 to January 2010. There were 36 males and 12 females. All cases had mixed cerebral palsy, and all patients presented with spasm compliacted with lower limb athetosis, the muscular tension according to Ashworth spasticity scale was grade 3. Preopera-tive lower limb dysfunction included: walking independently in 36 cases, walking with assistance in 8 cases and standing with assistance in 4 cases. SPR with SAR was applied in all cases. The L5 and SI posterior roots in 38 cases and L4, L5 and SI posterior roots in 10 cases were cut off partly in accordance with the degree of lower limb spasticity by preoperativc physical exam. 30-50 percent of the posterior nerve roots were cut off. The L5 anterior roots in 28 cases and S1 anterior roots in 20 cases were cut off partly in accordance with the degree of athetosis. 30 percent of the anterior nerve roots were cut off. Laminae were maintained as far as possible so as not to violate the stability of spine. Results: Postoperative leg or foot numbness were noted in 2 cases, lower limb weakness in 3 cases, low back pain in 2 cases, lower back weakness in 5 cases, urine dysfunction in 1 case, all these were resolved by the corresponding intervention in six months. The average follow-up was 18 months, 48 cases with muscle tension at 1 week, 6 months, 18 months after operation improved significantly compared with preopeiation, and the spasm relief rate reached 100%. As for the lower limb athctosis: after 1 week, deterioration was noted in 1 case, which was controlled satisfactively after administration of sedative drugs and baclofen; unchanged in 4, and excellent in 43 cases; after 6 months, unchanged in 5 cases and excellent in 43 cases, no case was noted

  16. Demonstration of cerebral vessels by multiplane computed cerebral angiotomography

    Energy Technology Data Exchange (ETDEWEB)

    Asari S.; Satch, T.; Sakurai, M.; Yamamoto, Y. (Matsuyama Shimin Hospital, Matsuyama (Japan)); Sadamoto, K.

    1981-06-01

    1. Cerebral arteries and veins were demonstrated by multiplane computed cerebral angiotomography (combination of axial, modified coronal, half axial (Towne), and semisagittal planes). The vessels which were demonstrated by various planes were as follows: Axial plane: Willis ring, middle cerebral arteries (horizontal and insular portions), anterior cerebral arteries (Horizontal and ascending portions), posterior cerebral arteries, basal vein of Rosenthal, internal cerebral veins (and the subependymal veins which join the ICV), and vein of Galen. Coronal plane: intermal carotid arteries (supraclinoid portion), anterior cerebral arteries (horizontal portion), middle cerebral arteries (horizontal and insular portions), lenticulostriate arteries, basal vein of Rosenthal (and the subependymal veins which join this vessel), internal cerebral veins, and vein of Galen. Half axial plane (Towne projection): basilar artery, vertebral arteries, posterior cerebral arteries, superior cerebellar arteries, middle cerebral arteries (horizontal portion), and anterior cerebral arteries (horizontal and ascending portions). Semisagittal plane: internal carotid artery (supraclinoid portion), posterior communicating artery, posterior carebral artery, superior cerebellar artery, internal cerebral vein, basal vein of Rosenthal, vein of Galen, and straight shinus. 2. A detailed knowledge of normal cerebrovascular structures acquired by computed tomography (CT) is essential in detecting and more precisely localizing lesions such as cerebrovascular disease, neoplasm or abscess, in differentiating these lesions from the normal contrast-enhanced structures, and in understanding the spatial relationship between the mass lesion and the neighboring vessels. In addition, it will be possible to discover such asymptomatic cerebrovascular diseases as non-ruptured aneurysms, arteriovenous malformations, and Moyamoya disease by means of computed cerebral angiotomography.

  17. Cerebral venous sinus thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Renowden, Shelley [Frenchay Hospital, Bristol BS16 1LE (United Kingdom)

    2004-02-01

    A comprehensive synopsis on cerebral venous thrombosis is presented. It emphasizes the various aetiologies, the wide clinical spectrum and the unpredictable outcome. Imaging techniques and pitfalls are reported and the therapeutic options are discussed. (orig.)

  18. Acute ischemic cerebral attack

    OpenAIRE

    Franco-Garcia Samir; Barreiro-Pinto Belis

    2010-01-01

    The decrease of the cerebral blood flow below the threshold of autoregulation led to changes of cerebral ischemia and necrosis that traduce in signs and symtoms of focal neurologic dysfunction called acute cerebrovascular symdrome (ACS) or stroke. Two big groups according to its etiology are included in this category the hemorragic that constitue a 20% and the ischemic a 80% of cases. Great interest has wom the ischemic ACS because of its high social burden, being the third cause of no violen...

  19. Computer-assisted three-dimensional correlation between the femoral neck-shaft angle and the optimal entry point for antegrade nailing.

    Science.gov (United States)

    Anastopoulos, George; Chissas, Dionisios; Dourountakis, Joseph; Ntagiopoulos, Panagiotis G; Magnisalis, Evaggelos; Asimakopoulos, Antonios; Xenakis, Theodore A

    2010-03-01

    Optimal entry point for antegrade femoral intramedullary nailing (IMN) remains controversial in the current medical literature. The definition of an ideal entry point for femoral IMN would implicate a tenseless introduction of the implant into the canal with anatomical alignment of the bone fragments. This study was undertaken in order to investigate possible existing relationships between the true 3D geometric parameters of the femur and the location of the optimum entry point. A sample population of 22 cadaveric femurs was used (mean age=51.09+/-14.82 years). Computed-tomography sections every 0.5mm for the entire length of femurs were produced. These sections were subsequently reconstructed to generate solid computer models of the external anatomy and medullary canal of each femur. Solid models of all femurs were subjected to a series of geometrical manipulations and computations using standard computer-aided-design tools. In the sagittal plane, the optimum entry point always lied a few millimeters behind the femoral neck axis (mean=3.5+/-1.5mm). In the coronal plane the optimum entry point lied at a location dependent on the femoral neck-shaft angle. Linear regression on the data showed that the optimal entry point is clearly correlated to the true 3D femoral neck-shaft angle (R(2)=0.7310) and the projected femoral neck-shaft angle (R(2)=0.6289). Anatomical parameters of the proximal femur, such as the varus-valgus angulation, are key factors in the determination of optimal entry point for nailing. The clinical relevance of the results is that in varus hips (neck-shaft angle shaft angle between 120 degrees and 130 degrees , the optimal entry point lies just medially to the trochanter tip (at the piriformis fossa) and the use of stiff implants is safe. In hips with neck-shaft angle over 130 degrees the anatomical axis of the canal is medially to the base of the neck, in a "restricted area". In these cases the entry point should be located at the insertion of the

  20. Cerebral palsy and congenital malformations

    DEFF Research Database (Denmark)

    Garne, Ester; Dolk, Helen; Krägeloh-Mann, Inge;

    2007-01-01

    AIM: To determine the proportion of children with cerebral palsy (CP) who have cerebral and non-cerebral congenital malformations. METHODS: Data from 11 CP registries contributing to the European Cerebral Palsy Database (SCPE), for children born in the period 1976-1996. The malformations were...... classified as recognized syndromes, chromosomal anomalies, cerebral malformations or non-cerebral malformations. Prevalence of malformations was compared to published data on livebirths from a European database of congenital malformations (EUROCAT). RESULTS: Overall 547 out of 4584 children (11.9%) with CP...... were reported to have a congenital malformation. The majority (8.6% of all children) were diagnosed with a cerebral malformation. The most frequent types of cerebral malformations were microcephaly and hydrocephaly. Non-cerebral malformations were present in 97 CP children and in further 14 CP children...

  1. 选择性脊神经根部分切断术对痉挛性偏侧肢体脑瘫患儿基底节区脑代谢影响%The effect of selective dorsal rhizotomy for the cerebral metabolism at basal ganglia of patients with cerebral palsy-spastic hemiplegia

    Institute of Scientific and Technical Information of China (English)

    段宇; 张发永

    2016-01-01

    目的:研究选择性脊神经后根部分切断术对偏侧肢体痉挛性瘫痪患儿早期缓解下肢痉挛作用,以及利用核磁波谱分析患儿在选择性脊神经后根部分切断术后基底节区的小分子代谢变化,探索该术式的“超节段反应”的机制。方法对12~20岁年龄段偏侧痉挛性肢体瘫患者,在接受选择性脊神经后根部分切断术前后,对髋内收肌、腘绳肌和小腿三头肌行改良的Ashworth评级。行核磁波谱分析,利用双侧基底节区域作为兴趣区。分析该区域手术前后的小分子代谢图谱。结果手术后所有患者下肢肌群肌张力有不同程度降低(P<0.01),其中4例患者称获得了类似“超节段反应”临床表现,3例患儿上肢协调性以及精细活动改善,1例患儿斜视改善。患儿对侧基底节区N-乙酰天门冬氨含量下降(P<0.05),同侧各类物质无明显改变。结论选择性脊神经后根部分切除术能有效降低偏侧肢体痉挛,对侧基底节区N-乙酰天门冬氨减少,可能是出现“超节段反应”的机制之一。%Objective To determine the metabolite profile of patients with cerebral palsy-spastic hemiplegia in the basal ganglia after selective dorsal rhizotomy ( SDR ) for researching the mechanism of the “suprasegemental benefits”. Methods The metabolite profile of patients with cerebral palsy-spastic hemiplegia in the both sides of basal ganglia were determined by proton magnetic resonance spectroscopy and the muscle tone of hip adductors ,hamstrings and ankle plantar flexors in lower limb was assessed by the Ashworth scale before and two weeks after SDR .Results Seventeen patients were recruited in our study .The muscular tones of lower limb significantly were reduced following SDR at early time .N-acetylas-partate ( NAA) at the contralateral basal ganglia decreased .Four patients separately described “suprasegemental benefits”, including

  2. Monitoring of cerebral haemodynamics in newborn infants

    DEFF Research Database (Denmark)

    Liem, K Djien; Greisen, Gorm

    2010-01-01

    The most important cerebrovascular injuries in newborn infants, particularly in preterm infants, are cerebral haemorrhage and ischemic injury. The typical cerebral vascular anatomy and the disturbance of cerebral haemodynamics play important roles in the pathophysiology. The term 'cerebral...

  3. Nanomedicine in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Balakrishnan B

    2013-11-01

    Full Text Available Bindu Balakrishnan,1 Elizabeth Nance,1 Michael V Johnston,2 Rangaramanujam Kannan,3 Sujatha Kannan1 1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University; Baltimore, MD, USA; 2Department of Neurology and Pediatrics, Kennedy Krieger Institute, Baltimore, MD, USA; 3Department of Ophthalmology, Center for Nanomedicine, Johns Hopkins University, Baltimore, MD, USA Abstract: 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. Keywords: dendrimer, cerebral palsy, neuroinflammation, nanoparticle, neonatal brain injury, G4OH-PAMAM

  4. Clinical Neuroimaging of cerebral ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawara, Jyoji [Nakamura Memorial Hospital, Sapporo (Japan)

    1999-06-01

    Notice points in clinical imaging of cerebral ischemia are reviewed. When cerebral blood flow is determined in acute stage of cerebral embolism (cerebral blood flow SPECT), it is important to find area of ischemic core and ischemic penumbra. When large cortex area is assigned to ischemic penumbra, thrombolytic therapy is positively adapted, but cautious correspondence is necessary when ischemic core is recognized. DWI is superior in the detection of area equivalent to ischemic core of early stage, but, in imaging of area equivalent to ischemic penumbra, perfusion image or distribution image of cerebral blood volume (CBV) by MRI need to be combined. Luxury perfusion detected by cerebral blood flow SPECT in the cases of acute cerebral embolism suggests vascular recanalization, but a comparison with CT/MRI and continuous assessment of cerebral circulation dynamics were necessary in order to predict brain tissue disease (metabolic abnormality). In hemodynamic cerebral ischemia, it is important to find stage 2 equivalent to misery perfusion by quantification of cerebral blood flow SPECT. Degree of diaschisis can indicate seriousness of brain dysfunction for lacuna infarct. Because cerebral circulation reserve ability (perfusion pressure) is normal in all areas of the low cerebral blood flow by diaschisis mechanism, their areas are easily distinguished from those of hemodynamic cerebral ischemia. (K.H.)

  5. 无症状性脑梗死合并抑郁选择注意功能的研究%A study of the selective attention function of patients with silent cerebral infarction and depression

    Institute of Scientific and Technical Information of China (English)

    危薇; 汪静秋; 罗华; 徐志彬; 段小东; 何传兵

    2013-01-01

    目的:探讨无症状性脑梗死(silent cerebral infarction, SCI)合并抑郁患者选择注意功能损害的特点,抑郁与选择注意及与认知功能障碍的关系。方法选择SCI患者(SCI组)、无SCI的抑郁症患者(无SCI抑郁组)和正常人(对照组)各82例,采用汉密尔顿抑郁(Hamilton Depression Rating Scale, HAMD)量表、蒙特利尔认知评估(Montreal cognitive assessment, MoCA)和Stroop色词测验(Stroop color-word test, CWT)进行评价,SCI患者再根据HAMD得分分为抑郁组和非抑郁组。结果 SCI组MoCA评分为(23.11±5.41),较对照组(28.70±2.18)降低,其中抑郁组为(20.31±5.44),降低更为明显(均P<0.01)。与对照组相比,SCI组的任务A、B、C和Stroop干扰效应(Stroop in-terference effects, SIE)耗时延长(P<0.01),其中抑郁组为(33.25±14.10)、(42.45±15.18)、(104.68±25.08)、(62.24±21.53)秒;SCI组的任务B、C和SIE错误数增多(P<0.05),抑郁组为(3.59±2.14)、(15.67±7.20)、(12.08±6.46),抑郁组变化最为明显。其MoCA评分与SIE耗时和错误数呈负相关(r=-0.429, r=-0.500,均P<0.01)。梗死灶位置与HAMD评分和SIE错误数有一定关系:两者得分左侧梗死组高于右侧梗死组,皮质梗死组SIE得分高于皮质下梗死组,而HAMD评分相反。结论 SCI合并抑郁的患者选择注意功能有明显损害,且与认知功能水平具有良好的相关性。%Objective To explore the characteristics of selective attention function in patients with silent cerebral in-farction (SCI) and depression, the relationship between depression, selective attention and cognitive dysfunction. Methods Eighty-two patients with SCI and 82 normal subjects were selected and evaluated by using Hamilton Depression Rating Scale (HAMD), Montreal cognitive assessment (MoCA) and Stroop color-word test (CWT). Patients with SCI were further classified into depression subgroup and no-depression subgroup based on the score of HAMD. Results The

  6. Cerebral phaeohyphomycosis by Exophiala dermatitidis

    Directory of Open Access Journals (Sweden)

    S Sood

    2014-01-01

    Full Text Available Cerebral phaeohyphomycosis is a rare and frequently fatal disease. We report a case of cerebral phaeohyphomycosis caused by Exophiala dermatitidis in a young immuno competent male presenting to a tertiary care hospital in Jaipur.

  7. Cerebral phaeohyphomycosis by Exophiala dermatitidis.

    Science.gov (United States)

    Sood, S; Vaid, V K; Sharma, M; Bhartiya, H

    2014-01-01

    Cerebral phaeohyphomycosis is a rare and frequently fatal disease. We report a case of cerebral phaeohyphomycosis caused by Exophiala dermatitidis in a young immuno competent male presenting to a tertiary care hospital in Jaipur.

  8. [Cerebral ischemia and histamine].

    Science.gov (United States)

    Adachi, Naoto

    2002-10-01

    Cerebral ischemia induces excess release of glutamate and an increase in the intracellular Ca2+ concentration, which provoke catastrophic enzymatic processes leading to irreversible neuronal injury. Histamine plays the role of neurotransmitter in the central nervous system, and histaminergic fibers are widely distributed in the brain. In cerebral ischemia, release of histamine from nerve endings has been shown to be enhanced by facilitation of its activity. An inhibition of the histaminergic activity in ischemia aggravates the histologic outcome. In contrast, intracerebroventricular administration of histamine improves the aggravation, whereas blockade of histamine H2 receptors aggravates ischemic injury. Furthermore, H2 blockade enhances ischemic release of glutamate and dopamine. These findings suggest that central histamine provides beneficial effects against ischemic neuronal damage by suppressing release of excitatory neurotransmitters. However, histaminergic H2 action facilitates the permeability of the blood-brain barrier and shows deleterious effects on cerebral edema.

  9. Cerebral hemodynamics in migraine

    DEFF Research Database (Denmark)

    Hachinski, V C; Olesen, Jes; Norris, J W

    1977-01-01

    Clinical and angiographic findings in migraine are briefly reviewed in relation to cerebral hemodynamic changes shown by regional cerebral blood flow (rCBF) studies. Three cases of migraine studied by the intracarotid xenon 133 method during attacks are reported. In classic migraine, with typical...... prodromal symptoms, a decrease in cerebral blood flow has been demonstrated during the aura. Occasionally, this flow decrease persists during the headache phase. In common migraine, where such prodromata are not seen, a flow decrease has not been demonstrated. During the headache phase of both types...... of migraine, rCBF has usually been found to be normal or in the high range of normal values. The high values may represent postischemic hyperemia, but are probably more frequently secondary to arousal caused by pain. Thus, during the headache phase rCBF may be subnormal, normal or high. These findings do...

  10. A combined study of cerebral artery system through super-selective angiography and real-time-colored latex perfusion in rabbits%超选择造影与实时乳胶灌注在兔脑动脉系统研究应用

    Institute of Scientific and Technical Information of China (English)

    张桂运; 陈左权; 凌锋; 海舰; 李玉健; 顾斌贤; 吴春红; 俞丽敏

    2009-01-01

    Objective To study the character of cerebral artery system in rabbits and to found the base for establishing cerebrovascular disease models of rabbits.Methods Microcatheter-technique was used to perform super-selective cerebral angiography in New Zealand rabbits,after which three dimensional vascular reconstructions were adopted.At the end of angiography,the live rabbits,through microcatheter,were real time perfused with colored latex mixed with contrast medium under fluoroscopy for visualization of their cerebrovascular anatomy.Results The arteries above aortic arch and the arterial system in anterior and posterior circulation were clearly visualized.After latex perfusion,the arterial circle of skull base,anterior cerebral arteries,middle cerebral arteries,posterior cerebral arteries and their subpial branches were clearly displayed as well asthe resistance vessels in posterior watershed.Conclusions Super-selective cerebral angiography was helpful to better display the anterior and posterior circulation in rabbits,and the colored latex perfusion could provide more details about the microcirculation especially in the posterior watershed.The outcome of colored latex perfusion could be used as an authentication to angiography.With the combination of super-selective angiography and colored latex perfusion,it was easy to find the morphological changes of cerebral arterial circulation in rabbits.%目的 研究兔脑动脉系统的特点,为建立兔脑血管疾病模型奠定基础.方法 应用微导管技术对新西兰大白兔进行超选择性脑血管造影并进行血管三维重建,造影完毕后在活体上透视下经微导管进行染色乳胶实时灌注.结果 主动脉弓上血管及颅内前后循环系统显影清楚;乳胶灌注后清晰显示颅底动脉环、大脑前动脉、大脑中动脉、大脑后动脉及其皮层分枝,后分水岭区阻力血管显示清楚.结论 超选择性脑血管造影有利于更好地显示兔脑前后动脉系统,

  11. The anesthesia for selective posterior rhizotomy at lumbar and sacral regions on juvenile cerebral palsy patients%小儿脑性瘫痪患者腰骶段选择性后根神经切断术的麻醉处理

    Institute of Scientific and Technical Information of China (English)

    王强; 王增春

    2002-01-01

    Objective To summarize the anesthesia techniques performed in the selective posterior rhizotomy(SPR) at lumbar and sacral regions( L& R) on juvenile cerebral palsy(CP) patients. Method 144 CP patients below 10 years were successfully erformed SPR at L& R under combined intravenous and inhalation anesthesia (CIIA) in prone position with threshold values of each nerve root being measured by means of nerve root electric stimulus (NRES). Result All patients were performed SPR and NRES successfully although blood pressure and heart rate increased significantly while NRES. Conclusion CIIA is safe and effective for juvenile CP patients to be performed SPR at L& R.

  12. Experimental Focal Cerebral Ischemia

    DEFF Research Database (Denmark)

    Christensen, Thomas

    2007-01-01

    of the middle cerebral artery (MCAO) was used as an experimental model of ischemic stroke. MCAO produces an acute lesion consisting of an ischemic core or focus with severely reduced blood flow surrounded by a borderzone or ischemic penumbra with less pronounced blood flow reduction. Cells in the ischemic focus...

  13. Neonatal risk factors for cerebral palsy in very preterm babies: case-control study.

    OpenAIRE

    Murphy, D. J.; Hope, P. L.; Johnson, A.

    1997-01-01

    OBJECTIVE: To identify neonatal risk factors for cerebral palsy among very preterm babies and in particular the associations independent of the coexistence of antenatal and intrapartum factors. DESIGN: Case-control study. SETTING: Oxford health region. SUBJECTS: Singleton babies born between 1984 and 1990 at less than 32 weeks' gestation who survived to discharge from hospital: 59 with cerebral palsy and 234 randomly selected controls without cerebral palsy. MAIN OUTCOME MEASURES: Adverse neo...

  14. 顺行区域性切除腮腺浅叶良性肿瘤可行性分析%Analysis of antegrade partial superficial parotidectomy in treating benign parotid gland tumor 47 cases

    Institute of Scientific and Technical Information of China (English)

    孙永强; 杨雯雯; 梁宪斌

    2011-01-01

    Objective To explore the feasibility of anterograde dissections in superficial parotid-ectomy for benign tumor of the parotid gland. Methods Clinical data of 47 patients who underwent an-tegrade partial superficial parotidectomy of benign superficial parotid gland tumor was analyzed retrospectively from January 1995 to December 2006. Results Of the 47 patients, 8 patients had a temporary facial deficit and not a permanent facial nerve paralysis. Frey syndrome was found in 4 patients. None of them had salivary gland fistula, seroma formation and apparent face deformity. The lesion did not recurred after operation in 6 month to 5 year follow - up study. Conclusions It is quite safe and effective that benign parotid gland tumor is removed by antegrade partial superficial parotidectomy.%目的 探讨腮腺浅叶良性肿瘤顺行区域性切除的可行性.方法 回顾分析了1995年1月至2006年12月间收治的47例经顺行区域性切除的腮腺浅叶良性肿瘤患者的病例资料.结果 47例患者中并发暂时性面瘫的8例,无永久性面瘫;Frey综合症4例;无腮腺瘘及皮下积液;面部无明显畸形;随访6个月~5年无复发.结论 顺行区域性切除在腮腺浅叶良性肿瘤治疗中是一种安全、可靠的方法.

  15. Parálisis cerebral Cerebral palsy

    OpenAIRE

    Jorge Malagon Valdez

    2007-01-01

    El término parálisis cerebral (PC) engloba a un gran número de síndromes neurológicos clínicos, de etiología diversa. Estos síndromes se caracterizan por tener una sintomatología común: los trastornos motores. Algunos autores prefieren manejar términos como "encefalopatía fija", "encefalopatías no evolutivas". Se mencionan la utilidad de programas de intervención temprana y métodos especiales de rehabilitación, así como el manejo de las deficiencias asociadas como la epilepsia, deficiencia me...

  16. The history of cerebral PET scanning

    Science.gov (United States)

    Portnow, Leah H.; Vaillancourt, David E.; Okun, Michael S.

    2013-01-01

    Objective: To review the discoveries underpinning the introduction of cerebral PET scanning and highlight its modern applications. Background: Important discoveries in neurophysiology, brain metabolism, and radiotracer development in the post–World War II period provided the necessary infrastructure for the first cerebral PET scan. Methods: A complete review of the literature was undertaken to search for primary and secondary sources on the history of PET imaging. Searches were performed in PubMed, Google Scholar, and select individual journal Web sites. Written autobiographies were obtained through the Society for Neuroscience Web site at www.sfn.org. A reference book on the history of radiology, Naked to the Bone, was reviewed to corroborate facts and to locate references. The references listed in all the articles and books obtained were reviewed. Results: The neurophysiologic sciences required to build cerebral PET imaging date back to 1878. The last 60 years have produced an evolution of technological advancements in brain metabolism and radiotracer development. These advancements facilitated the development of modern cerebral PET imaging. Several key scientists were involved in critical discoveries and among them were Angelo Mosso, Charles Roy, Charles Sherrington, John Fulton, Seymour Kety, Louis Sokoloff, David E. Kuhl, Gordon L. Brownell, Michael Ter-Pogossian, Michael Phelps, and Edward Hoffman. Conclusions: Neurophysiology, metabolism, and radiotracer development in the postwar era synergized the development of the technology necessary for cerebral PET scanning. Continued use of PET in clinical trials and current developments in PET-CT/MRI hybrids has led to advancement in diagnosis, management, and treatment of neurologic disorders. PMID:23460618

  17. Parálisis cerebral Cerebral palsy

    Directory of Open Access Journals (Sweden)

    Jorge Malagon Valdez

    2007-01-01

    Full Text Available El término parálisis cerebral (PC engloba a un gran número de síndromes neurológicos clínicos, de etiología diversa. Estos síndromes se caracterizan por tener una sintomatología común: los trastornos motores. Algunos autores prefieren manejar términos como "encefalopatía fija", "encefalopatías no evolutivas". Se mencionan la utilidad de programas de intervención temprana y métodos especiales de rehabilitación, así como el manejo de las deficiencias asociadas como la epilepsia, deficiencia mental, trastornos del lenguaje, audición, visión, déficit de la atención que mejoran el pronóstico de manera significativa. El pronóstico también depende de la gravedad del padecimiento y de las manifestaciones asociadas.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 nonevolving 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.

  18. Dilatation of the aneurysmal sac after total arch replacement.

    Science.gov (United States)

    Watanuki, Hirotaka; Ogino, Hitoshi; Matsuda, Hitoshi; Minatoya, Kenji; Sasaki, Hiroaki; Fukuda, Tetsuya; Kitamura, Soichiro

    2008-02-01

    In our institution, total arch replacement for distal arch aneurysms is performed through a median sternotomy with antegrade selective cerebral perfusion. The distal anastomosis to the completely transected descending aorta is made through the aneurysmal sac. We report on three interesting cases presenting late dilatation of the aneurysmal sac due to collateral flow after total arch replacement.

  19. Applications of cerebral SPECT

    Energy Technology Data Exchange (ETDEWEB)

    McArthur, C., E-mail: claire.mcarthur@nhs.net [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom); Jampana, R.; Patterson, J.; Hadley, D. [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom)

    2011-07-15

    Single-photon emission computed tomography (SPECT) can provide three-dimensional functional images of the brain following the injection of one of a series of radiopharmaceuticals that crosses the blood-brain barrier and distributes according to cerebral perfusion, neurotransmitter, or cell density. Applications include differentiating between the dementias, evaluating cerebrovascular disease, preoperative localization of epileptogenic foci, diagnosing movement disorders, and evaluation of intracerebral tumours, while also proving a useful research tool. Unlike positronemission tomography (PET), SPECT imaging is widely available and can be performed in any department that has access to a rotating gamma camera. The purpose of this review is to demonstrate the utility of cerebral SPECT and increase awareness of its role in the investigation of neurological and psychiatric disorders.

  20. Cerebral oxygenation decreases during exercise in humans with beta-adrenergic blockade

    DEFF Research Database (Denmark)

    Seifert, T.; Rasmussen, P.; Secher, Niels H.

    2009-01-01

    AIM: Beta-blockers reduce exercise capacity by attenuated increase in cardiac output, but it remains unknown whether performance also relates to attenuated cerebral oxygenation. METHODS: Acting as their own controls, eight healthy subjects performed a continuous incremental cycle test to exhaustion...... with or without administration of the non-selective beta-blocker propranolol. Changes in cerebral blood flow velocity were measured with transcranial Doppler ultrasound and those in cerebral oxygenation were evaluated using near-infrared spectroscopy and the calculated cerebral mitochondrial oxygen tension...

  1. Phenylpropanolamine and cerebral hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    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.

  2. Cerebral salt wasting syndrome

    Directory of Open Access Journals (Sweden)

    Harshal Dholke

    2016-01-01

    Full Text Available Traumatic brain injury (TBI is on the rise, especially in today′s fast-paced world. TBI requires not only neurosurgical expertise but also neurointensivist involvement for a better outcome. Disturbances of sodium balance are common in patients with brain injury, as the central nervous system plays a major role in sodium regulation. Hyponatraemia, defined as serum sodium <135 meq/L is commonly seen and is especially deleterious as it can contribute to cerebral oedema in these patients. Syndrome of inappropriate antidiuretic hormone secretion (SIADH, is the most well-known cause of hyponatraemia in this subset of patients. Cerebral Salt Wasting Syndrome (CSWS, leading to renal sodium loss is an important cause of hyponatraemia in patients with TBI. Although incompletely studied, decreased renal sympathetic responses and cerebral natriuretic factors play a role in the pathogenesis of CSWS. Maintaining a positive sodium balance and adequate hydration can help in the treatment. It is important to differentiate between SIADH and CSWS when trying to ascertain a case for patients with acute brain injury, as the treatment of the two are diametrically opposite.

  3. Cerebral oxygenation and hyperthermia

    Directory of Open Access Journals (Sweden)

    Anthony Richard Bain

    2014-03-01

    Full Text Available 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.

  4. Cerebral malformations without antenatal diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Girard, Nadine J. [Diagnostic Neuroradiology, Hopital Timone, Marseille (France)

    2010-06-15

    Cerebral malformations are usually described following the different steps in development. Disorders of neurulation (dysraphisms), or diverticulation (holoprosencephalies and posterior fossa cysts), and total commissural agenesis are usually diagnosed in utero. In contrast, disorders of histogenesis (proliferation-differentiation, migration, organization) are usually discovered in infants and children. The principal clinical symptoms that may be a clue to cerebral malformation include congenital hemiparesis, epilepsy and mental or psychomotor retardation. MRI is the imaging method of choice to assess cerebral malformations. (orig.)

  5. Application of intraoperative electrophysiological monitoring in lumbosacral selective posterior rhizotomy for spastic cerebral palsy%选择性腰骶神经后根切断术中肌电监测的应用研究

    Institute of Scientific and Technical Information of China (English)

    徐峰; 曹旭; 赵子义; 张鹏; 许世刚; 徐林

    2009-01-01

    目的 研究在痉挛型脑瘫患者选择性脊神经后根切断术(SPR)中的肌电监测技术与标准.方法 在89例痉挛型脑瘫患者SPR中,采用50 Hz方波电脉冲,分别刺激L3-S1神经后根小束,分别于双侧三角肌、长收肌、股直肌、股二头肌、胫骨前肌和腓肠肌内、外侧头记录自由肌电反应及触发肌电反应,同时观察下肢肌肉痉挛性收缩活动.对肌电反应向对侧、乃至远隔神经支配节段明显扩散的3+级和4+级神经后根小束,及引起下肢或足趾肌肉收缩活动的相对低阈值的神经后根小束进行选择性切断.术后观察下肢肌张力的改善程度,并对下肢感觉、运动及排便功能进行评估.结果 触发肌电反应的出现明显滞后于自由肌电反应,观察自由肌电反应更能及时的判断"异常的"神经小束.89例患儿的372根神经后根被选择性切断,其中324根(83.5%)腰神经后根的出现3+~4+级肌电反应的神经小束被选择性切断;48根(12.9%)神经后根的神经小束根据"相对低阈值"被选择性切断.所有患儿术后下肢肌张力明显降低,未出现明显的下肢感觉、运动及排便功能障碍.结论 SPR中,肌电监测所出现的向对侧和(或)远隔节段扩散的持续的肌肉动作电位反应,是判定"异常"神经后根小束并进行选择性切断的有效并可重复的客观标准.%Objective To evaluate the clinical application of intraoperative electrophysiological monitoring in lumbosacral selective posterior rhizotomy for spastic cerebral palsy. Methods Total 372 dorsal roots of 89 patients underwent selective posterior rhizotomy at a single medical center. The dorsal roots from L3 to S1 were divided into rootlets and stimulated with a 1-second 50 Hz train. Motor responses were recorded by electomyography. Rootlets were assigned according to the extent of abnormal electrophysiological propagation, and grades of 3 + to 4 + were cut. If no electrical response was

  6. Cerebral Autoregulation in Normal Pregnancy and Preeclampsia

    NARCIS (Netherlands)

    van Veen, Teelkien R.; Panerai, Ronney B.; Haeri, Sina; Griffioen, Annemiek C.; Zeeman, Gerda; Belfort, Michael A.

    2013-01-01

    OBJECTIVE: To test the hypothesis that preeclampsia is associated with impaired dynamic cerebral autoregulation. METHODS: In a prospective cohort analysis, cerebral blood flow velocity of the middle cerebral artery (determined by transcranial Doppler), blood pressure (determined by noninvasive arter

  7. Proteção cerebral durante parada circulatória total a 28°C

    Directory of Open Access Journals (Sweden)

    Carlos Luiz FILGUEIRAS

    1997-04-01

    Full Text Available As operações de aneurismas do arco aórtico dependem do tempo de parada circulatória hipotérmica total (PCH. Diversas técnicas têm sido propostas para melhorar a proteção do cérebro e estender o tempo seguro de isquemia (45 minutos em hipotermia profunda. A proteção cerebral durante duas horas de parada circulatória hipotérmica foi estudada em 23 suínos, divididos em quatro grupos. Nos grupos de controle, 8 animais foram submetidos a anestesia (Grupo 1 e a circulação extracorpórea (Grupo 2. Os outros dois grupos foram à PCH associada à perfusão cerebral anterógrada a 28°C (Grupo 3 e a PCH associada a perfusão retrógrada do cérebro a 28°C (Grupo 4. A proteção cerebral foi avaliada pelo estudo histológico e pelo metabolismo celular cerebral estudado pela espectroscopia por ressonância nuclear magnética (RNM. Durante a PCH associada à perfusão cerebral anterógrada a 28°C, o metabolismo cerebral manteve-se normal durante todo o experimento e houve preservação das estruturas cerebrais no estudo histológico. Na PCH com a perfusão cerebral retrógrada a 28°C, o pH intracelular, a fosfocreatina (PCr e o trifosfato de adenosina (ATP diminuíram durante o período de parada circulatória e não retornaram aos seus níveis normais durante a reperfusão, permanecendo o cérebro em grave acidose intracelular. Concluímos que, durante duas horas de PCH, a perfusão anterógrada a 28°C proporcionou uma adequada proteção ao cérebro. A PCH associada à perfusão retrógrada em hipotermia moderada a 28°C não proporcionou proteção cerebral, no estudo metabólico e histológico.Aortic surgical treatment of aneurysms is time dependent on the hypothermic circulatory arrest. Many techniques have been proposed to improve brain protection and increase safe time of ischemia (45 minutes in deep hypothermia. Brain protection during two hours of hypothermic circulatory arrest was studied in twenty-three animals that were

  8. The cerebral perivascular cells.

    Science.gov (United States)

    Angelov, D N; Walther, M; Streppel, M; Guntinas-Lichius, O; Neiss, W F

    1998-01-01

    fluorescent mode this DAB reaction product selectively quenches the fluorescence of all immunopositive cells, i.e. only those neuronophages that do not bind to the primary antibody remain fluorescent. Combining FG-labeling of neuronophages with immunoquenching, a population of small round fluorescent cells was discovered, localized in the immediate vicinity of the motoneurons long after the neuronofugal migration of microglia. As the fluorescence of these cells was not quenched after a triple immunostaining with anti-neuronal-specific enolase, anti-GFAP and OX-42 (quenching all fluorescence from neurons, astroglia, and microglia), they seem to represent a new, immunologically unidentified neuronophage. Following this triple immunostaining, a broad panel of antibodies was tested to stain, quench fluorescence, and thus immunotype these enigmatic phagocytes. Only the monoclonal antibody ED2, the classical marker for perivascular cells, specifically stained the small round neuronophages. Although the perivascular cells are in the vicinity of the basal lamina of the cerebral vasculature, they must not be confused with the pericytes, which are not able to perform phagocytosis. In contrast, the perivascular cells are macrophages-ED2 recognizes an established macrophage membrane antigen. In addition, after neuronal injury a subset of the perivascular cells starts to synthesize MHC class II glycoproteins and IL-1 beta. Hence this population of cells seems to possess the complete machinery required for antigen presentation: They are macrophages, upregulate MHC class II molecules and IL-1 beta, and due to their anatomical location, have access to circulating T lymphocytes. What was still lacking, however, was a direct proof of neuronophagia. Our experiments provided this proof. (ABSTRACT TRUNCATED)

  9. Molecular pathophysiology of cerebral edema.

    Science.gov (United States)

    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.

  10. Effect of the modified nerve-sparing technique in open antegrade radical prostatectomy for 30 patients with prostate cancer%改良的保留神经根治性前列腺癌切除术30例

    Institute of Scientific and Technical Information of China (English)

    朱再生; 付强; 徐礼臻; 罗荣利; 张春霆; 刘全启; 陈良佑

    2015-01-01

    目的 探讨改良的保留神经根治性前列腺癌切除术的临床疗效.方法 30例前列腺癌患者采用改良根治性保留神经的前列腺切除术.改良的关键点:采用注水分离前列腺周围筋膜的方法,将Veil保留神经技术应用于开放手术中(即改良Veil保留神经技术);扩大分区(9区5组)盆腔淋巴结清扫;完整保留膀胱颈;集束捆扎背深静脉复合体;跳针套叠技术行膀胱与尿道的吻合.术后行控尿及勃起功能国际问卷-5(IIEF-5)随访.结果 患者平均年龄62岁,前列腺特异性抗原(PSA)水平平均11.9 ng/ml,手术时间平均150 min(75~240 min),术中出血量平均350 ml(100~1 600 ml),术前IIEF-5评分平均为21分,病理分期pT18例、pT2a 15例、pT2b4例、pT3a 3例.Gleason评分5分2例、6分7例、7分20例、8分1例.手术切缘阳性4例,其中2例为T2期,占T2期的10.5%(2/19),2例为T3期.无围手术期严重并发症.平均随访19个月(6-48个月),术后1个月完全控尿27例(90%),3个月达100%.术后3个月和6个月IIEF-5评分分别为13、19分,分别恢复到术前水平的40%和70%.结论 对选择性的前列腺癌患者,改良的保留神经根治性前列腺切除术较完整保留了前列腺周围所有的筋膜神经,使术后控尿及性功能得到早期、快速恢复,切缘阳性发生率低,疗效可靠.%Objective To evaluate the clinical value of the modified nerve-sparing open antegrade retropubic radical prostatectomy (MNS-ORP).Methods MNS-ORPs were performed in 30 patients with clinically localized prostate cancer.The modified technique included: endopelvic fascia was not incised, the prostate capsule was freed laterally from surrounding fasciae and dorsally;using the method of separating the peripheral fascia of the prostate, the Veil technique was applied to the open operation, that is, the modified Veil perserving nerve technology;pelvic lymph node dissections (9 regions and 5 groups) were extended;bladder neck

  11. Clinical experience of antegrade radical retropublic prostatectomy in 30 patients%耻骨后顺行前列腺癌根治术30例临床体会

    Institute of Scientific and Technical Information of China (English)

    张军晖; 邢念增; 平浩

    2010-01-01

    目的 总结耻骨后顺行前列腺癌根治术的手术经验及疗效.方法 采用耻骨后顺行前列腺癌根治术治疗前列腺癌患者30例.平均年龄64(51~73)岁.T_1 8例、T_2 15例、T_3 7例.手术采用先离断前列腺底部和膀胱颈,游离舣侧精囊及输精管并顺行向下分离直至前列腺尖部,紧贴前列腺尖部切断尿道,将尿道与膀胱颈重新吻合. 结果 30例手术顺利,手术时间平均150(75~240)min,术中出血量平均350(100~1600)ml,无直肠、输尿管等周围脏器损伤,无围手术期严重并发症.术后病理报告均为前列腺腺癌,切缘阳性4例.30例平均随访25(6~48)个月,均存活,排尿通畅,无尿失禁者.术前13例有勃起功能者术后7例(54%)恢复勃起功能. 结论 耻骨后顺行前列腺癌根治术并发症发生率低、出血量少,切缘阳性率低,手术效果良好.%Objective To discuss the experience of antegrade radical retropublic prostatectomy. Methods Thirty cases of prostate cancer were treated by antegrade radical retropublie prostateeto-my. The mean age of patients was 64 years. There were 8 cases of T_1, 15 cases of T_2, and 7 cases of T_3. The surgery included following procedures: Firstly the vesical neck was divided. Then the seminal vesicle and the prostate were freed from above downward. After the urethra was separated from the prostatic apex, the proximal end of urethra was sutured to the new vesical neck. Results All the 30 laparoscopic surgeries were accomplished successfully. The mean operative time was 2.5 hours. The mean blood loss was 350 ml in the operation. No ureteral injury, rectal injury and other severe compli-cation was observed. Histopathologic study showed prostate cancer for all the cases. Four cases had positive surgical margins. All cases were followed up from 6 to 48 months (average 25 months) with-out dysuria and permanent incontinence. No death occurred. Sexual function recovered in 7/13(54%) cases after the operation

  12. Hyperventilation, cerebral perfusion, and syncope

    DEFF Research Database (Denmark)

    Immink, R V; Pott, F C; Secher, N H

    2014-01-01

    dioxide (PaCO2) and oxygen (PaO2) partial pressures so that hypercapnia/hypoxia increases and hypocapnia/hyperoxia reduces global cerebral blood flow. Cerebral hypoperfusion and TLOC have been associated with hypocapnia related to HV. Notwithstanding pronounced cerebrovascular effects of PaCO2...

  13. Resting cerebral blood flow

    Science.gov (United States)

    Ances, B M.; Sisti, D; Vaida, F; Liang, C L.; Leontiev, O; Perthen, J E.; Buxton, R B.; Benson, D; Smith, D M.; Little, S J.; Richman, D D.; Moore, D J.; Ellis, R J.

    2009-01-01

    Objective: HIV enters the brain soon after infection causing neuronal damage and microglial/astrocyte dysfunction leading to neuropsychological impairment. We examined the impact of HIV on resting cerebral blood flow (rCBF) within the lenticular nuclei (LN) and visual cortex (VC). Methods: This cross-sectional study used arterial spin labeling MRI (ASL-MRI) to measure rCBF within 33 HIV+ and 26 HIV− subjects. Nonparametric Wilcoxon rank sum test assessed rCBF differences due to HIV serostatus. Classification and regression tree (CART) analysis determined optimal rCBF cutoffs for differentiating HIV serostatus. The effects of neuropsychological impairment and infection duration on rCBF were evaluated. Results: rCBF within the LN and VC were significantly reduced for HIV+ compared to HIV− subjects. A 2-tiered CART approach using either LN rCBF ≤50.09 mL/100 mL/min or LN rCBF >50.09 mL/100 mL/min but VC rCBF ≤37.05 mL/100 mL/min yielded an 88% (29/33) sensitivity and an 88% (23/26) specificity for differentiating by HIV serostatus. HIV+ subjects, including neuropsychologically unimpaired, had reduced rCBF within the LN (p = 0.02) and VC (p = 0.001) compared to HIV− controls. A temporal progression of brain involvement occurred with LN rCBF significantly reduced for both acute/early (<1 year of seroconversion) and chronic HIV-infected subjects, whereas rCBF in the VC was diminished for only chronic HIV-infected subjects. Conclusion: Resting cerebral blood flow (rCBF) using arterial spin labeling MRI has the potential to be a noninvasive neuroimaging biomarker for assessing HIV in the brain. rCBF reductions that occur soon after seroconversion possibly reflect neuronal or vascular injury among HIV+ individuals not yet expressing neuropsychological impairment. GLOSSARY AEH = acute/early HIV infection; ANOVA = analysis of variance; ASL-MRI = arterial spin labeling MRI; CART = classification and regression tree; CBF = cerebral blood flow; CH = chronic HIV

  14. Sleep disorders in children with cerebral palsy: An integrative review.

    Science.gov (United States)

    Lélis, Ana Luíza P A; Cardoso, Maria Vera L M; Hall, Wendy A

    2016-12-01

    Sleep disorders are more prevalent in children with cerebral palsy. The review aimed to identify and synthesize information about the nature of sleep disorders and their related factors in children with cerebral palsy. We performed an electronic search by using the search terms sleep/child*, and sleep/cerebral palsy in the following databases: Latin American literature on health sciences, SCOPUS, medical publications, cumulative index to nursing and allied health literature, psycinfo, worldcat, web of science, and the Cochrane library. The selection criteria were studies: available in Portuguese, English or Spanish and published between 2004 and 2014, with results addressing sleep disorders in children (ages 0-18 y) with a diagnosis of cerebral palsy. 36,361 abstracts were identified. Of those, 37 papers were selected, and 25 excluded. Twelve papers were incorporated in the study sample: eight quantitative studies, three reviews, and one case study. Eleven types of sleep disorders were identified, such as difficult morning awakening, insomnia, nightmares, difficulties in initiating and maintaining nighttime sleep (night waking), and sleep anxiety. Twenty-one factors were linked to sleep disorders, which we classified as intrinsic factors associated with common comorbidities accompanying cerebral palsy, and extrinsic aspects, specifically environmental and socio-familial variables, and clinical-surgical and pharmacological interventions.

  15. Study on the relationship of cytochrome C expression and cerebral edema in perihematomal brain tissue in patients with hypertensive cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    CAI Heng; LIU Guixiang; XU Chunsheng; LIU Qingxin; XU Xiaobo

    2007-01-01

    Objective To investigate the expression of cytochrome C in perihematomal brain tissue and its relationship with the histopathological change and formation of cerebral edema in patients with hypertensive cerebral hemorrhage. Methods Thirty four patients (23 male, 11 female) of hypertensive cerebral hemorrhage in hospital from Sep. 2001 to Sep. 2002 were selected with a mean age 55.6± 10.2 years (from 35 to 75 years). The mean volume of hemorrhagic blood was 50.4±11.6 ml (from 25 to 85 ml). The perihematomal brain tissue was obtained from the minimally invasive surgery. Histopathological change and expressions of cytochrome C in perihematomal brain tissue was detected by histopathological and immunohistochemical techniques. The volume of perihematomal cerebral edema was determined by computed tomographic scan before operation. The results of staining and the volume of perihematomal cerebral edema were analyzed with double blind fashion. Results Perihematomal cerebral edema were found 12-72h after cerebral hemorrhage. Myelin sheath degeneration, condensation of nucleus and typical apopototic body were observed in perihematomal brain tissue. Expression of cytochrome C in perihematomal brain tissue was observed at 4 h and reached peak around 48-72 h after cerebral hemorrhage. Cytochrome C expressed higher positively in 16 patients and lower positively in 13 patients. Cytochrome C expression was not detected only in 5 patints. There were significant differences in volume of perihematomal cerebral edema with different expression of cytochrome C in perihematomal brain tissue (P<0.01). Conclusions Cytochrome C expression was upregulated in perihematomal brain tissue in patients with hypertensive cerebral hemorrhage. Cytochrome C might involve in the histopathological change and the formation of perihematomal cerebral edema.

  16. Carotid endarterectomy after intravenous thrombolysis for acute cerebral ischaemic attack

    DEFF Research Database (Denmark)

    Rathenborg, Lisbet Knudsen; Jensen, L P; Baekgaard, N;

    2013-01-01

    Intravenous thrombolysis (IVT) has proven effective in the treatment of acute cerebral ischaemic attack in selected cases. In the presence of a carotid artery stenosis, such patients may be candidates for carotid endarterectomy (CEA). Few studies have been made on the safety of CEA performed afte...

  17. Cerebral sinus venous thrombosis

    Directory of Open Access Journals (Sweden)

    Hernando Raphael Alvis-Miranda

    2013-01-01

    Full Text Available 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.

  18. Cerebral imaging in pediatrics

    Energy Technology Data Exchange (ETDEWEB)

    Gordon, I. [London, Great Ormond Street Hospital for Children (United Kingdom)

    1998-06-01

    Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligand which go to specific receptor sites is being introduced in pediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in pediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in pediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in pediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are pediatric physiological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in pediatrics.

  19. Cerebral cartography and connectomics.

    Science.gov (United States)

    Sporns, Olaf

    2015-05-19

    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.

  20. Cerebral sinus venous thrombosis

    Science.gov (United States)

    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

  1. Effect of glutamate on inflammatory responses of intestine and brain after focal cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Lei Xu; Jie Sun; Ran Lu; Qing Ji; Jian-Guo Xu

    2005-01-01

    AIM: To study the modulation of glutamate on post-ischemic intestinal and cerebral inflammatory responses in a ischemic and excitotoxic rat model.METHODS: Adult male rats were subjected to bilateral carotid artery occlusion for 15 min and injection of monosodium glutamate intraperitoneally, to decapitate them at selected time points. Tumor necrosis factor alpha (TNF-α) level and nuclear factor kappa B (NF-κB) activity were determined by enzyme-linked immunosorbant assay (ELISA) and electrophoretic mobility shift assay (EMSA), respectively.Hemodynamic parameters were monitored continuously during the whole process of cerebral ischemia and reperfusion.RESULTS: Monosodium glutamate (MSG) treated rats displayed statistically significant high levels of TNF-α in cerebral and intestinal tissuess within the first 6 h of ischemia. The rats with cerebral ischemia showed a minor decrease of TNF-α production in cerebral and intestinal tissuess. The rats with cerebral ischemia and treated with MSG displayed statistically significant low levels of TNF-α in cerebral and intestinal tissues. These results correlated significantly with NF-κB production calculated at the same intervals. During experiment, the mean blood pressure and heart rates in all groups were stable.CONCLUSION: Glutamate is involved in the mechanism of intestinal and cerebral inflammation responses. The effects of glutamate on cerebral and intestinal inflammatory responses after ischemia are up-regulated at the transcriptional level,through the NF-κB signal transduction pathway.

  2. Cerebrovascular hemodynamics in patients with cerebral arteriosclerosis

    Institute of Scientific and Technical Information of China (English)

    Jianbo Yang; Changcong Cui; Chengbin Wu

    2011-01-01

    The present study observed hemodynamic changes in 26 patients with cerebral arteriosclerosis using a cerebral circulation dynamics detector and transcranial Doppler.In patients with cerebral arteriosclerosis the blood supply and flow rate in the bilateral carotid arteries and the blood flow rate in the anterior cerebral and middle cerebral arteries were similar to normal controls, but the cerebral vascular resistance, critical pressure and pulsatility index were increased, and cerebral arterial elasticity and cerebral blood flow autoregulation were decreased.Compared with the lesioned hemisphere of patients with cerebral infarction, the total blood supply and blood flow rate of patients with cerebral arteriosclerosis were higher.Compared with normal subjects, patients with cerebral arteriosclerosis exhibited cognitive disturbances, mainly in short-term memory, attention, abstract capability, and spatial and executive dysfunction.Results showed that cerebral arteriosclerosis does not directly affect the blood supply of a cerebral hemisphere, but affects cognitive function.The increased cerebral vascular resistance and reduced autoregulation of cerebral blood vessels may be important hemodynamic mechanisms of arteriosclerosis-induced cerebral infarction.

  3. CEREBRAL PALSY AND MUSIC ACHIEVEMENT

    Directory of Open Access Journals (Sweden)

    Miodrag L. STOSHLJEVIKJ

    2008-12-01

    Full Text Available Pupils with cerebral palsy attend elementary education accordind to a regular and special teaching plan and program. Regular school curriculum was reformed in 1992, while special plan and program has not been changed and adapted according to pupil’s needs and capacities. Music is one of the best means of expressing oneself and plays a very important role in the development of every child, the child with cerebral palsy in particular.In order to test the possibility of pupils with cerebral palsy, with and without mental retardation, to apprehend the actual program content, we have conducted research on musical achievement of children with cerebral palsy. During 2007 a research was carried out, on the sample of 27 pupils with cerebral palsy and mild mental retardation who attended classes in the school “Miodrag Matikj”, and a sample of16 students with cerebral palsy without mental retardation who attended the school “Dr. Dragan Hercog” in Belgrade.Results of the research, as well as analysis of music curriculum content, indicated that the capacities of students with cerebral palsy to carry out the curriculum tasks require special approach and methodology. Therefore, we introduced some proposals to overcome the difficulties in fulfilling music curriculum demands of those pupils. We made special emphasis on the use of computer based Assistive technology which facilitates the whole process to a large extent.

  4. Observation of therapeutic efficacy of lumbar selective posterior rhizotomy for cerebral palsy-associated lower limb spasm%腰段选择性脊神经后根切断术治疗脑瘫性下肢痉挛99例疗效观察

    Institute of Scientific and Technical Information of China (English)

    王健; 尹靖宇; 郑炳铃; 徐涛; 陈熙慧

    2012-01-01

    目的 探讨腰段选择性脊神经后根切断术(lumbar selective posterior rhizotomy,L-SPR)治疗脑瘫性下肢痉挛的临床疗效.方法 回顾性分析99例脑瘫性下肢痉挛病人的临床资料,均施行L-SPR手术,通过观察下肢肌张力和Holden步行功能分级的变化评估临床疗效.结果 随访99例,时间3~88个月.术后肌张力及Holden步行功能分级同术前相比,差异具有统计学意义(均P <0.05).术后畸形完全消失26例,症状减轻49例,不变24例.近期并发症为一过性头痛23例,切口愈合不良5例,一过性痉挛加重20例,锥体外系症状加重6例;远期并发症为腰部乏力2例,痉挛复发3例,均治疗后改善.结论 L-SPR手术能有效解除脑瘫性下肢痉挛,改善运动功能.%Objective To explore the clinical efficacy of lumbar selective posterior rhizotomy (L-SPR) for cerebral palsy patients with spasticity of lower limbs. Methods Clinical data of 99 cerebral palsy patients with spasticity of lower limbs were analyzed retrospectively, who were treated by L-SPR. The clinical efficacy was evaluated by observing the changes of muscle tension of low limbs and Holden functional ambulation classification. Results All the patients were followed up for 3 to 88 months, there were significantly differences in muscle tension and Holden functional ambulation classification between before and after surgery (all P < 0.05). Deformity disappeared in 26 patients, alleviation of symptom in 49 and no alleviation in 24. Recent complications such as transient headache occurred in 23 patients, poor incision healing in 5, transient spasm aggravation in 20 and aggravation of extrapyramidal symptoms in 6. Long-term complications such as waist weakness occurred in 2 patients and relapse of spasm in 3. All the symptoms were improved after treatment. Conclusions L-SPR is effective to relieve spasticity of lower limbs and improve motor function in patients with cerebral palsy.

  5. Cerebral toxoplasmosis in AIDS

    Energy Technology Data Exchange (ETDEWEB)

    Christ, F.; Steudel, H.; Klotz, D.

    1986-02-01

    Since 1982 (Hauser and co-workers), literature has reported focal cerebral tissue charges in AIDS patients whose diagnosis was unclear at first but which could be identified finally as florid toxoplasmosis encephalitis by biopsy and autopsy. It was found that the value of otherwise reliable serological tests (KBR, Sabin-Feldmann tests, etc.) is questionable in patients with severely impaired or incompetent immune systems, and, in particular, that a negative or uncharacteristic test result may not preclude any opportunistic infection process. Furthermore, isolation of Toxoplasma gondii or specific antibodies from the cerebrospinal fluid will be successful in exceptional cases only. In patients with AIDS or lymphadenopathy syndrome, the differential diagnosis will have to include - first and foremost - reactivated toxoplasma infection (not newly acquired, as a rule) if central neurological symptoms occur.

  6. Changes of Cerebral

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To explore the strengthening of acupuncture analgesic mechanism on the level of β-endorphin and proopimelanocortin mRNA expression in the arcuate nucleus of hypothalamus in rats following electroacupuncture(EA) combined with melatonin (MEL). Methods: Integrated optical density (IOD) was measured by ABC immuno-histochemical and in situ hybridization technique with computerized image processing. The rat's brain was coronally sectioned after combination of EA and MEL. Results: IOD of β-endorphin-like immunopositive substance in rat's brain was lowered significantly, which was measured after MEL (60 mg/kg) was injected intraperitoneally and followed by EA 30 min later for 30 min, and the IOD of cerebral POMC mRNA positive substance increased significantly 10 hrs later. Conclusion:The mechanism of MEL in enhancing EA analgesic effect might be related with the release and synthesis of β-endorphin

  7. The Role of Information Systems to Manage Cerebral Palsy

    Science.gov (United States)

    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. Anestesia e paralisia cerebral Anestesia y parálisis cerebral Anesthesia and cerebral palsy

    OpenAIRE

    Március Vinícius M Maranhão

    2005-01-01

    JUSTIFICATIVA E OBJETIVOS: A paralisia cerebral (PC) é uma doença não progressiva decorrente de lesão no sistema nervoso central, levando a um comprometimento motor do paciente. O portador de PC freqüentemente é submetido a procedimentos cirúrgicos devido a doenças usuais e situações particulares decorrentes da paralisia cerebral. Foi objetivo deste artigo revisar aspectos da paralisia cerebral de interesse para o anestesiologista, permitindo um adequado manuseio pré, intra e pós-operatório n...

  9. Neuromodulation of cerebral blood flow

    NARCIS (Netherlands)

    ter Laan, Mark

    2014-01-01

    Dit proefschrift behandelt de modulatie van de cerebrale doorbloeding (cerebral blood flow, CBF) door cervicale elektrische stimulatie en de aanname dat het sympathisch zenuwstelsel hierin een specifieke rol speelt. Enkele resultaten met cervicale ruggenmergsstimulatie (spinal cord stimulation, SCS)

  10. Learn More About Cerebral Palsy

    Centers for Disease Control (CDC) Podcasts

    2008-03-30

    This podcast describes the causes, preventions, types, and signs and symptoms of cerebral palsy.  Created: 3/30/2008 by National Center on Birth Defects and Developmental Disabilities.   Date Released: 3/21/2008.

  11. Cerebral Laterality and Verbal Processes

    Science.gov (United States)

    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)

  12. Signal transduction in cerebral arteries after subarachnoid hemorrhage-a phosphoproteomic approach

    DEFF Research Database (Denmark)

    Parker, Benjamin; Larsen, Martin Røssel; Povlsen, Gro Klitgaard

    2013-01-01

    After subarachnoid hemorrhage (SAH), pathologic changes in cerebral arteries contribute to delayed cerebral ischemia and poor outcome. We hypothesize such changes are triggered by early intracellular signals, targeting of which may prevent SAH-induced vasculopathy. We performed an unbiased quanti......-induced signaling components downstream and upstream of ERK1/2.Journal of Cerebral Blood Flow & Metabolism advance online publication, 29 May 2013; doi:10.1038/jcbfm.2013.78....... quantitative analysis of early SAH-induced phosphorylations in cerebral arteries and evaluated identified signaling components as targets for prevention of delayed vasculopathy and ischemia. Labeled phosphopeptides from rat cerebral arteries were quantified by high-resolution tandem mass spectrometry. Selected...

  13. Cerebral candidiasis. Computed tomography appearance

    Energy Technology Data Exchange (ETDEWEB)

    Chaabane, M.; Ladeb, M.F.; Bouhaouala, M.H.; Ben Hammouda, M.; Ataalah, R.; Gannouni, A.; Krifa, H.

    1989-07-01

    A three year old child who had been suffering from oral candidiasis since the age of 1 year presented with osteitis of the clavicle, 2 cerebral frontal abscesses and an occipital abscess which extended across the calvaria and was associated with osteolysis. Histological and microbiological studies following surgery confirmed the diagnosis of candidiasis in this girl who was found to have IgA immunodefinciency. The authors report the computed tomographic appearance of the cerebral lesions and review the literature. (orig.).

  14. Parálisis cerebral :

    OpenAIRE

    Giral Lamenca, Mónica

    2015-01-01

    Se aborda el tema de la parálisis cerebral definiendo qué es, clasificando los tipos de parálisis dependiendo de la afectación y las características principales. Se explican algunos de sus tratamientos, se dan sistemas alternativos y/o aumentativos de comunicación para un alumno con PC (parálisis cerebral).

  15. Therapeutic implications of melatonin in cerebral edema.

    Science.gov (United States)

    Rathnasamy, Gurugirijha; Ling, Eng-Ang; Kaur, Charanjit

    2014-12-01

    Cerebral edema/brain edema refers to the accumulation of fluid in the brain and is one of the fatal conditions that require immediate medical attention. Cerebral edema develops as a consequence of cerebral trauma, cerebral infarction, hemorrhages, abscess, tumor, hypoxia, and other toxic or metabolic factors. Based on the causative factors cerebral edema is differentiated into cytotoxic cerebral edema, vasogenic cerebral edema, osmotic and interstitial cerebral edema. Treatment of cerebral edema depends on timely diagnosis and medical assistance. Pragmatic treatment strategies such as antihypertensive medications, nonsteroidal anti-inflammatory drugs, barbiturates, steroids, glutamate and N-methyl-D-aspartate receptor antagonists and trometamol are used in clinical practice. Although the above mentioned treatment approaches are being used, owing to the complexity of the mechanisms involved in cerebral edema, a single therapeutic strategy which could ameliorate cerebral edema is yet to be identified. However, recent experimental studies have suggested that melatonin, a neurohormone produced by the pineal gland, could be an effective alternative for treating cerebral edema. In animal models of stroke, melatonin was not only shown to reduce cerebral edema but also preserved the blood brain barrier. Melatonin's beneficial effects were attributed to its properties, such as being a potent anti-oxidant, and its ability to cross the blood brain barrier within minutes after its administration. This review summarizes the beneficial effects of melatonin when used for treating cerebral edema.

  16. Cerebral small-resistance artery structure and cerebral blood flow in normotensive subjects and hypertensive patients

    Energy Technology Data Exchange (ETDEWEB)

    De Ciuceis, Carolina; Porteri, Enzo; Rizzoni, Damiano; Boari, Gianluca E.M.; Rosei, Enrico Agabiti [University of Brescia, Clinica Medica, Department of Clinical and Experimental Sciences, Brescia (Italy); Cornali, Claudio; Mardighian, Dikran; Fontanella, Marco M. [University of Brescia, Section of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy); Pinardi, Chiara [Spedali Civili, Medical Physics Unit, Brescia (Italy); University of Brescia, Section of Neuroradiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy); Rodella, Luigi F.; Rezzani, Rita [University of Brescia, Section of Anatomy, Department of Clinical and Experimental Sciences, Brescia (Italy); Gasparotti, Roberto [University of Brescia, Section of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy); University of Brescia, Section of Neuroradiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy)

    2014-12-15

    The aim of this study was to prospectively investigate whether the structure of cerebral small-resistance arteries is related to cerebral perfusion parameters as measured with dynamic susceptibility-weighted contrast magnetic resonance imaging (DSC-MRI) in a selected cohort of hypertensive and normotensive patients. Ten hypertensive and 10 normotensive patients were included in the study. All patients underwent neurosurgical intervention for an intracranial tumor and were investigated with DSC-MRI at 1.5 T. Cerebral small-resistance arteries were dissected from a small portion of morphologically normal cerebral tissue and mounted on an isometric myograph for the measurement of the media-to-lumen (M/L) ratio. A quantitative assessment of cerebral blood flow (CBF) and volume (CBV) was performed with a region-of-interest approach. Correlation coefficients were calculated for normally distributed variables. The institutional review board approved the study, and informed consent was obtained from all patients. Compared with normotensive subjects, hypertensive patients had significantly lower regional CBF (mL/100 g/min) in the cortical grey matter (55.63 ± 1.90 vs 58.37 ± 2.19, p < 0.05), basal ganglia (53.34 ± 4.39 vs 58.22. ± 4.33, p < 0.05), thalami (50.65 ± 3.23 vs 57.56 ± 4.45, p < 0.01), subcortical white matter (19.32 ± 2.54 vs 22.24 ± 1.9, p < 0.05), greater M/L ratio (0.099 ± 0.013 vs 0.085 ± 0.012, p < 0.05), and lower microvessel density (1.66 ± 0.67 vs 2.52 ± 1.28, p < 0.05). A statistically significant negative correlation was observed between M/L ratio of cerebral arteries and CBF in the cortical grey matter (r = -0.516, p < 0.05), basal ganglia (r = -0.521, p < 0.05), thalami (r = -0.527 p < 0.05), and subcortical white matter (r = -0.612, p < 0.01). Our results indicate that microvascular structure might play a role in controlling CBF, with possible clinical consequences. (orig.)

  17. Study on clinical effectiveness of lower limb spasticity of non-cerebral palsy treated by selective posterior rhizotomy%选择性脊神经后根切断术治疗非脑瘫性下肢痉挛性瘫痪的临床疗效

    Institute of Scientific and Technical Information of China (English)

    谭祐光; 陈烈; 彭继红; 黄建凯; 余海浪; 纪科伟; 庹秀均

    2012-01-01

    Objective To study curative effect of selective posterior rhizotomy ( SPR ) in treatment of lower limb spasticity in patients with non - cerebral palsy. Methods Thirty six cases of non - cerebral lower limb spasticity ( 8 cases of cerebrovascular accident; 4 cases of hydroceph-alus; 19 cases of cerebral or spinal trauma and 5 cases with other causes ) were treated with selective posterior rhizotomy ( SPR ) during October 2008 to June 2011. Muscle tonicity and gait analysis were measured before and after operation. Results All cases were followed up for 3-18 ( with mean of 5. 3 ±1.8 ) months. Gait analysis and walking ability were significantly improved after treatment. Reduction of spasticity was obtained in every case, and their muscle tonicity was reduced from 3.5 ±0.2 pre - operation to 1. 5 ±0.5 post - operation, hence their movement had been improved. Conclusion SPR is an effective method for treatment of non - cerebral lower limb spasticity. It can remit the spasticity and muscle tonicity, and then it may improve the gait.%目的 探讨选择性脊神经后根切断术(SPR)对非脑瘫性下肢痉挛性瘫痪的疗效.方法 选择自2008年10月至2011年6月除外脑瘫所致下肢痉挛型瘫痪36例(其中脑血管意外后遗症8例,脑积水4例,脑脊髓损伤后遗症19例,不明原因5例),行选择性脊神经后根切断术.对术前、术后的下肢肌张力,步态分析及肢体功能的变化进行分析.结果 所有患者的均获随诊,时间3~18月,平均5.3±1.8月.术后步态分析及行走能力得到明显改善,差异有统计学意义(P<0.01).所有患者痉挛改善,肌张力评分由术前3.5±0.2分下降至术后1.5±0.5分,差异有统计学意义(P<0.01),肢体功能均有不同程度改善.结论 选择性脊神经后根切断治对非脑瘫性下肢痉挛性瘫痪,可改善痉挛,降低肌张力,改善步态.

  18. Neuroimaging diagnosis for cerebral infarction An 8-year bibliometric analysis

    Institute of Scientific and Technical Information of China (English)

    Yan Du; Xiaoxia Yang; Hong Song; Bo Chen; Lin Li; Yue Pan; Qiong Wu; Jia Li

    2012-01-01

    OBJECTIVE:To identify global research trends in neuroimaging diagnosis for cerebral infarction using a bibliometric analysis of the Web of Science.DATA RETRIEVAL:We performed a bibliometric analysis of data retrieval for neuroimaging diagnosis for cerebral infarction containing the key words "CT,magnetic resonance imaging,MRI,transcranial Doppler,transvaginal color Doppler,digital subtraction angiography,and cerebral infarction" using the Web of Science.SELECTION CRITERIA:Inclusion criteria were:(a) peer-reviewed articles on neuroimaging diagnosis for cerebral infarction which were published and indexed in the Web of Science; (b) original research articles and reviews; and (c) publication between 2004-2011.Exclusion criteria were:(a) articles that required manual searching or telephone access; and (b) corrected papers or book chapters.MAIN OUTCOME MEASURES:(1)Annual publication output; (2) distribution according to country;(3) distribution according to institution; (4) top cited publications; (5) distribution according to journals; and (6) comparison of study results on neuroimaging diagnosis for cerebral infarction.RESULTS:Imaging has become the predominant method used in diagnosing cerebral infarction.The most frequently used clinical imaging methods were digital subtraction angiography,CT,MRI,and transcranial color Doppler examination.Digital subtraction angiography is used as the gold standard.However,it is a costly and time-consuming invasive diagnosis that requires some radiation exposure,and is poorly accepted by patients.As such,it is mostly adopted in interventional therapy in the clinic.CT is now accepted as a rapid,simple,and reliable non-invasive method for use in diagnosis of cerebrovascular disease and preoperative appraisal.Ultrasonic Doppler can be used to reflect the hardness of the vascular wall and the nature of the plaque more clearly than CT and MRI.CONCLUSION:At present,there is no unified standard of classification of cerebral infarction

  19. Cerebral edema associated with acute hepatic failure.

    Directory of Open Access Journals (Sweden)

    Fujiwara,Masachika

    1985-02-01

    Full Text Available The clinicopathological findings of cerebral edema were investigated in patients with acute hepatic failure autopsied at Okayama University Hospital between 1970 and 1980 retrospectively. Nine (64% of 14 hepatic failure cases were found to have cerebral edema during a post-mortem examination of the brain. Clinical features of the patients with cerebral edema were not significantly different from those of the patients without cerebral edema. However, general convulsions were observed more frequently in patients later found to have cerebral edema. Moreover, the length of time from deep coma to death was much shorter in the brain edema cases with cerebral herniation than without herniation.

  20. Monitoring Cerebral Oxygenation in Neonates: An Update

    Science.gov (United States)

    Dix, Laura Marie Louise; van Bel, Frank; Lemmers, Petra Maria Anna

    2017-01-01

    Cerebral oxygenation is not always reflected by systemic arterial oxygenation. Therefore, regional cerebral oxygen saturation (rScO2) monitoring with near-infrared spectroscopy (NIRS) is of added value in neonatal intensive care. rScO2 represents oxygen supply to the brain, while cerebral fractional tissue oxygen extraction, which is the ratio between rScO2 and systemic arterial oxygen saturation, reflects cerebral oxygen utilization. The balance between oxygen supply and utilization provides insight in neonatal cerebral (patho-)physiology. This review highlights the potential and limitations of cerebral oxygenation monitoring with NIRS in the neonatal intensive care unit. PMID:28352624

  1. Cerebral trypanosomiasis and AIDS

    Directory of Open Access Journals (Sweden)

    Antunes Apio Claudio Martins

    2002-01-01

    Full Text Available A 36 year-old black female, complaining of headache of one month's duration presented with nausea, vomiting, somnolence, short memory problems, loss of weight, and no fever history. Smoker, intravenous drugs abuser, promiscuous lifestyle. Physical examination: left homonimous hemianopsia, left hemiparesis, no papilledema, diffuse hyperreflexia, slowness of movements. Brain CT scan: tumor-like lesion in the splenium of the corpus calosum, measuring 3.5 x 1.4 cm, with heterogeneous enhancing pattern, sugesting a primary CNS tumor. Due to the possibility of CNS infection, a lumbar puncture disclosed an opening pressure of 380 mmH(20; 11 white cells (lymphocytes; glucose 18 mg/dl (serum glucose 73 mg/dl; proteins 139 mg/dl; presence of Trypanosoma parasites. Serum Elisa-HIV tests turned out to be positive. Treatment with benznidazole dramatically improved clinical and radiographic picture, but the patient died 6 weeks later because of respiratory failure. T. cruzi infection of the CNS is a rare disease, but we have an increasing number of cases in HIV immunecompromised patients. Diagnosis by direct observation of CSF is uncommon, and most of the cases are diagnosed by pathological examination. It is a highly lethal disease, even when properly diagnosed and treated. This article intends to include cerebral trypanosomiasis in the differential diagnosis of intracranial space-occupying lesions, especially in immunecompromised patients from endemic regions.

  2. Pseudotumoral delayed cerebral radionecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Ciaudo-Lacroix, C.; Lapresle, J. (Centre Hospitalier de Bicetre, 94 - Le Kremlin-Bicetre (France))

    1985-01-01

    A 60 year-old woman with a scalp epithelioma underwent radiotherapy, the dose being 57 Gray. A first epileptic seizure occurred twenty months later. Neurological examination revealed signs of left hemisphere involvement. ..gamma..EG, angiography, CT scans, demonstrated a pseudotumoral avascular process. On account of the localisation, the patient being right-handed, no surgical procedure was performed. In spite of corticotherapy and anticonvulsive treatment, seizures recurred and neurological signs slowly progressed. The patient died, 22 months after the first seizure, of an associated disseminated carcinoma with cachexia. Neuropathological examination showed a massive lesion presenting all the features of delayed radionecrosis in the left hemisphere: situated mainly in the white matter; numerous vascular abnormalities; wide-spread demyelination; disappearance of oligoglial cells. The Authors recall the clinical and anatomical aspects of this condition for which the only successful treatment is surgical removal when location and size of the lesion permit. Finally, the mechanisms which have been proposed to explain this delayed cerebral radionecrosis are discussed.

  3. Study on the relationship between serum interleukins, platelet activation indexes and cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Bo Wu

    2015-01-01

    Objective:To study and investigate the relationship between serum interleukins, platelet activation indexes and cerebral infarction.Methods:58 patients with cerebral infarction in our hospital from March 2013 to September 2014 were selected as observation group; meanwhile, 58 healthy persons at the same period were selected as control group, then the serum interleukins and platelet activation indexes of two groups were detected and compared, then the detection results of observation group with different stages and severity of cerebral infarction were compared too, and the relationship between those blood detection indexes and cerebral infarction were analyzed by the Logistic analysis.Results:The serum interleukins and platelet activation indexes of observation group were obviously higher than those of control group, and the detection levels of observation group with cerebral infarction at early and severe stage were obviously higher than those of patients at other stages and light, moderate, and those blood indexes all had close relationship to the cerebral infarction by the Logistic analysis,P<0.05. Conclusion:The serum interleukins and platelet activation indexes all have close relationship to cerebral infarction, and they can be as the important monitoring indexes of the disease.

  4. Initial Experience and Feasibility of the New Low-Profile Stingray Catheter as Part of the Antegrade Dissection and Re-Entry Revascularization Strategy for Coronary Chronic Total Occlusions.

    Science.gov (United States)

    Maeremans, Joren; Palmers, Pieter-Jan; Dens, Joseph

    2017-01-31

    BACKGROUND During antegrade dissection re-entry (ADR) of chronic total occlusions (CTO), the first-generation Stingray catheter requires the use of large-bore guides (sheathless 7.5 Fr or 8 Fr), which increases the risk for access site-related complications and compromises radial approaches. Smaller guiding sizes necessitate long guidewires (e.g., 300 cm) or guidewire extensions for catheter advancement or removal. However, friction between guides and the Stingray catheter can result in unstable guidewire position or unintentional removal. Furthermore, failure to deliver the catheter at the distal re-entry zone is a common problem. To overcome issues of deliverability and reduce the need for pre-dilatations, with its inherent risk of creating subintimal hematomas, the Stingray low-profile (LP) balloon catheter was developed. CASE REPORT We describe 3 cases of successful application of the novel Stingray LP catheter during ADR. In all cases, 7 Fr guiding catheters were successfully used in combination with the device. The lower profile facilitated a good exchange and delivery of the device, without the need for balloon pre-dilatations in 2 cases. This resulted in a limited subintimal plane, enabling a smooth puncture into the true lumen. One case presented with extreme levels of calcification and tortuosity, resulting in a high degree of friction, despite the lower catheter profile. No in-hospital coronary or access site-related complications occurred. CONCLUSIONS This case report illustrates the feasibility of the Stingray LP catheter for the treatment of CTOs via the ADR technique. The lower profile of the catheter potentially increases the deliverability, safety, and exchangeability of the device.

  5. 双侧痉挛型脑瘫患儿选择性脊神经后根切断术术前及术后步态特征%Preoperative and postoperative gait characteristics analysis on bilateral spastic cerebral palsy children after selective posterior rhizotomy

    Institute of Scientific and Technical Information of China (English)

    于江龙; 买尔阿芭; 木塔力甫·努热合买提; 艾克拜尔·哈力克; 刘亮; 栾新平

    2015-01-01

    目的 评估脑瘫患儿选择性脊神经后根切断术(SPR)术观察其对步态各指标的影响.方法 收集脑瘫患儿12例(男6例,女6例),平均年龄6.2岁,同期正常体检的年龄、性别匹配的12例(男6例,女6例)发育正常的儿童被纳入对照组,平均年龄为6.1岁.对脑瘫患儿行选择性脊神经后根切断术,记录脑瘫患儿术前、术后6个月及正常对照组的步频、起步期时间百分比、迈步期时间百分比、双下肢同时着地时间百分比、步长、步速等步态学指标.结果 与术前比较,大运动功能分级系统分级评分(GMFM)在术后6个月后显著增加,从(89.6±5.4)分上升至(94.3±4.3)分,两组比较差异有统计学意义(P<0.05),修正Ashworth量表痉挛状态评分(MAS)在术后6个月后显著降低,从(1.6±0.4)分降至(0.6±0.5)分,两组比较差异有统计学意义(P<0.05).术前、术后脑瘫患儿及正常对照儿童的步频差异有统计学意义(P<0.01).与正常儿童比较,术前脑瘫患儿的步频、起步期时间百分比、双下肢同时着地时间百分比较高;迈步期时间百分比、步长、步速较低(P<0.05).与术前比较,术后6个月后患儿步频、起步期时间百分比显著降低;步长、迈步期时间百分比显著增加(P<0.05),双下肢同时着地时间百分比、步速在两组间差异无统计学意义(P>0.05).结论 SPR术可以显著改善脑瘫患儿运动能力,步态学分析可以在SPR用于术后评估.%Objective Cerebral palsy (CP) is a progressive brain dysfunction syndrome.The bilateral spasm is the most common clinical symptoms.The selective posterior rhizotomy (SPR) is one of the commonly used operation for reducing spasm in cerebral palsy.This study was aimed to assess preoperative and postoperative gait characteristics in bilateral spastic cerebral palsy children after SPR.Methods Study included 12 cases children with cerebral palsy (6 male and 6 female),the average age was 6.2 years

  6. Middle cerebral artery blood velocity during rowing

    DEFF Research Database (Denmark)

    Secher, Niels Henry; Pott, F; Knudsen, L.;

    1997-01-01

    original,arterial blood pressure,central venous pressure,cerebral blood flow, exercise, transcranial Doppler......original,arterial blood pressure,central venous pressure,cerebral blood flow, exercise, transcranial Doppler...

  7. Cerebral Salt Wasting Syndrome

    Directory of Open Access Journals (Sweden)

    Mehmet Salih Sevdi

    2016-12-01

    Full Text Available A serum sodium (Na value below 135 mEq/L is evaluated as hyponatremia. Hyponatremia is the most common electrolyte abnormality observed in hospitalized patients in particular. Hypovolemic hypoosmolar hyponatremia is the most frequent clinical table. One of the reasons of this is cerebral salt-wasting syndrome (CSWS. CSWS is a rare condition progressing with low plasma osmolality, urine osmolality above 100-150 mOsm/kg and urine- Na concentration above 20 mEq/L. In the blood and urine sample analysis performed upon sudden loss of consciousness on the 15th day of the intensive care unit follow-up of 79-year-old female patients due to falling from stairs, blood biochemistry Na value was 120 mEq/L, plasma osmolality was 250 mOsm/kg, urine Na value was 180 mEq/L, urine osmolality was 1200 mOsm/kg, urine diuresis was >3 mL/kg/hour. The central venous pressure was 2 mmHg. The patient, considered to be diagnosed with CSWS, was treated with 9% NaCl and 3% hypertonic saline solution. Her clinical course was improved on the 18th day. She died on the 81st day secondary to septicemia in the subsequent follow-up. In this article, it was aimed to report a patient with CSWS which progresses with low percentage in intensive care unit patients with head trauma, is frequently confused with inappropriate antidiuretic hormone syndrome and progresses mortally when not diagnosed distinctively well.

  8. Cerebral venous thrombosis in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Huisman, T.A.G.M.; Martin, E.; Willi, U.V. [Dept. of Diagnostic Imaging and Radiology, University Children' s Hospital Zurich (Switzerland); Holzmann, D. [Dept. of Otorhinolaryngology, University Children' s Hospital Zurich, Zurich (Switzerland)

    2001-09-01

    This was a retrospective study to determine different etiologies of cerebral venous thrombosis (CVT) in childhood and to correlate extent and location of thrombosis with the etiology and the age of the child as well as the final outcome. In addition, the radiologic approach is discussed. This was a retrospective analysis of 19 children with CVT. The children were examined by contrast-enhanced dynamic CT. Radiologic findings were correlated with the etiology of CVT. Cerebral venous thrombosis is not as infrequent in children as has been thought. Cerebral venous thrombosis in children can occur due to trauma (n=9), infections (n=7), or coagulation disorders (n=3). Extent and location of thrombosis, as well as complications, final outcome, and therapy, depend on the etiology. Computed tomography remains a valuable primary imaging modality in the diagnosis of CVT in the acutely injured or diseased child. (orig.)

  9. Neuronal autophagy in cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Feng Xu; Jin-Hua Gu; Zheng-Hong Qin

    2012-01-01

    Autophagy has evolved as a conserved process for the bulk degradation and recycling of cytosolic components,such as long-lived proteins and organelles.In neurons,autophagy is important for homeostasis and protein quality control and is maintained at relatively low levels under normal conditions,while it is upregulated in response to pathophysiological conditions,such as cerebral ischemic injury.However,the role of autophagy is more complex.It depends on age or brain maturity,region,severity of insult,and the stage of ischemia.Whether autophagy plays a beneficial or a detrimental role in cerebral ischemia depends on various pathological conditions.In this review,we elucidate the role of neuronal autophagy in cerebral ischemia.

  10. Neuroevolutional Approach to Cerebral Palsy and Speech.

    Science.gov (United States)

    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…

  11. Fenestration of the anterior cerebral artery

    Energy Technology Data Exchange (ETDEWEB)

    Ito, J.; Washiyama, K.; Hong, K.C.; Ibuchi, Y.

    1981-08-01

    Three cases of angiographically demonstrated fenestration of the anterior cerebral artery are reported. Fenestration occurred at the medial half of the horizontal segment of the anterior cerebral artery in all cases. Its embryology and clinical significance are briefly discussed, and the anatomical and radiological literature on fenestration of the anterior cerebral artery is reviewed.

  12. Cerebral toksoplasmose primaert diagnosticeret som tumor

    DEFF Research Database (Denmark)

    Cortsen, M E; Skøt, J; Skriver, E B

    1992-01-01

    Three cases of cerebral toxoplasmosis as the presenting manifestation of AIDS are reported. The initial diagnoses were brain tumors because of the cerebral mass lesions which resembled glioblastoma. In the light of the increasing occurrence of AIDS, attention is drawn to cerebral toxoplasmosis...

  13. Lifetime costs of cerebral palsy

    DEFF Research Database (Denmark)

    Kruse, Marie; Michelsen, Susan Ishøy; Flachs, Esben Meulengracht;

    2009-01-01

    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 analyzed 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 analyzed 2367 individuals with CP, who were born in 1930 to 2000 and were alive...

  14. Features to validate cerebral toxoplasmosis

    Directory of Open Access Journals (Sweden)

    Carolina da Cunha Correia

    2013-06-01

    Full Text Available Introduction Neurotoxoplasmosis (NT sometimes manifests unusual characteristics. Methods We analyzed 85 patients with NT and AIDS according to clinical, cerebrospinal fluid, cranial magnetic resonance, and polymerase chain reaction (PCR characteristics. Results In 8.5%, focal neurological deficits were absent and 16.4% had single cerebral lesions. Increased sensitivity of PCR for Toxoplasma gondii DNA in the central nervous system was associated with pleocytosis and presence of >4 encephalic lesions. Conclusions Patients with NT may present without focal neurological deficit and NT may occur with presence of a single cerebral lesion. Greater numbers of lesions and greater cellularity in cerebrospinal fluid improve the sensitivity of PCR to T gondii.

  15. Contraceptives and cerebral thrombosis: a five-year national case-control study

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind; Kreiner, Svend

    2002-01-01

    Oral contraceptives; Cerebral thrombosis; Thrombotic stroke; Transitory cerebral ischemic attack; Thrombosis......Oral contraceptives; Cerebral thrombosis; Thrombotic stroke; Transitory cerebral ischemic attack; Thrombosis...

  16. Embodying Investigations of Cerebral Palsy

    DEFF Research Database (Denmark)

    Martiny, Kristian Møller Moltke

    The main question of Kristian Martiny’s dissertation is: how do we help persons living with the brain damage, cerebral palsy (CP)? This question is as complex and difficult to answer as any healthcare question. Martiny argues that we need to ‘open up’ how we do ( cognitive ) science in order...

  17. Pathogenesis of cerebral amyloid angiopathy.

    NARCIS (Netherlands)

    Rensink, A.A.M.; Waal, R.M.W. de; Kremer, H.P.H.; Verbeek, M.M.

    2003-01-01

    Cerebral amyloid angiopathy (CAA) is the result of the deposition of an amyloidogenic protein in cortical and leptomeningeal vessels. The most common type of CAA is caused by amyloid beta-protein (Abeta), which is particularly associated with Alzheimer's disease (AD). Excessive Abeta-CAA formation c

  18. MR imaging of cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Saginoya, Toshiyuki [Urasoe General Hospital, Okinawa (Japan); Yamaguchi, Keiichiro; Kuniyoshi, Kazuhide [and others

    1996-06-01

    We evaluated 35 patients with cerebral palsy on the basis of MR imaging findings in the brain. The types of palsy were spastic quadriplegia (n=11), spastic diplegia (n=9), spastic hemiplegia (n=2), double hemiplegia (n=1), athetosis (n=10) and mixed (n=2). Of all patients, 28 (80%) generated abnormal findings. In spastic quadriplegia, although eight cases revealed severe brain damage, two cases showed no abnormal findings in the brain. One of the three had cervical cord compression caused by atlanto-axial subluxation. In spastic diplegia, the findings were divided according to whether the patient was born at term or preterm. If the patient had been born prematurely, the findings showed periventricular leukomalacia and abnormally high intensity in the posterior limbs of the internal capsule on T2-weighted images. MR imaging in spastic hemiplegia revealed cerebral infarction. In the athetoid type, half of all cases showed either no abnormal findings or slight widening of the lateral ventricle. Three cases showed abnormal signals of the basal ganglia. The reason why athetoid-type palsy did not show severe abnormality is unknown. We believe that MR imaging is a useful diagnostic modality to detect damage in the brain in cerebral palsy and plays an important role in the differentiation of cerebral palsy from the spastic palsy disease. (author)

  19. Ocular defects in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Katoch Sabita

    2007-01-01

    Full Text Available There is a high prevalence of ocular defects in children with developmental disabilities. This study evaluated visual disability in a group of 200 cerebral palsy (CP patients and found that 68% of the children had significant visual morbidity. These findings emphasize the need for an early ocular examination in patients with CP.

  20. Cerebral edema in drug addicts

    Directory of Open Access Journals (Sweden)

    Daruši Dragana J.

    2014-01-01

    Full Text Available Background/Aim. The effect of drugs leaves permanent consequences on the brain, organic in type, followed by numerous manifestations, and it significantly affects the development of mental dysfunctions. The clinicians are often given a task to estimate a patient’s personality during treatment or during experts estimate of a drug addict. The aim of this research was to determine the differences, if any, in characteristics of addicts experience and personality traits in drug addicts with or without cerebral edema. Methods. The research was conducted on a sample of 252 male drug addicts, the average age of 23.3 (SD = 4.3 years. Cerebral edema was confirmed on magnetic resonance (MR images of the brain performed during the treatment of the addicts. The participants were tested by the psychologists using Minnesota Multiphasic Personality Inventory (MMPI-201 test, and the data were processed using canonical discriminate analysis within the SPSS program. The dependent variable in the study was cerebral edema. A block of independent variables, designed for the requirements of this study, consisted of two subgroups. The first one consisted of 12 variables describing the relevant characteristics of drug abuse. The second subgroup consisted of 8 psychopathological tendencies in the personality defined by the mentioned test. Results. Cerebral edema was confirmed in 52 (20.63% of the drug addicts. The differences between the groups of drug addicts with and without cerebral edema were determined in the following: the time span of taking drugs (0.301, use of alcohol parallel with drugs (0.466, and treatment for addiction (0.603. In the drug addicts with a cerebral edema, MMPI-201 confirmed the increase in the scales for hypochondria, psychopathic deviations and psychastenia, and the decrease in the scales for schizophrenia and depression. Conclusion. Our study confirmed a possible connection between cerebral edema and personality traits in a number of the

  1. Anestesia e paralisia cerebral Anestesia y parálisis cerebral Anesthesia and cerebral palsy

    Directory of Open Access Journals (Sweden)

    Március Vinícius M Maranhão

    2005-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A paralisia cerebral (PC é uma doença não progressiva decorrente de lesão no sistema nervoso central, levando a um comprometimento motor do paciente. O portador de PC freqüentemente é submetido a procedimentos cirúrgicos devido a doenças usuais e situações particulares decorrentes da paralisia cerebral. Foi objetivo deste artigo revisar aspectos da paralisia cerebral de interesse para o anestesiologista, permitindo um adequado manuseio pré, intra e pós-operatório neste tipo de paciente. CONTEÚDO: O artigo aborda aspectos da paralisia cerebral como etiologia, classificação, fatores de risco, fisiopatologia, quadro clínico, diagnóstico, terapêuticas utilizadas bem como avaliação pré-operatória, medicação pré-anestésica, manuseio intra e pós-operatório, analgesia pós-operatória e dor crônica. CONCLUSÕES: O anestesiologista desempenha um papel importante na diminuição da morbidade e mortalidade anestésico-cirúrgica em pacientes portadores de paralisia cerebral. O conhecimento da fisiopatologia dos diferentes tipos de paralisia cerebral bem como das doenças associadas e suas terapêuticas é imprescindível, pois permite ao anestesiologista antecipar e prevenir complicações intra e pós-operatórias neste tipo de paciente.JUSTIFICATIVA Y OBJETIVOS: La parálisis cerebral (PC es una enfermedad no progresiva consecuente de una lesión en el sistema nervioso central, llevando a un comprometimiento motor del paciente. El portador de PC, frecuentemente es sometido a procedimientos quirúrgicos debido a enfermedades usuales y situaciones particulares consecuentes de la parálisis cerebral. El objetivo de este artículo, fue revisar aspectos de la parálisis cerebral de interés para el anestesista, permitiendo un adecuado manoseo pre, intra y posoperatorio en este tipo de paciente. CONTENIDO: El artículo aborda aspectos de la parálisis cerebral como etiología, clasificación, factores de

  2. Digital subtraction angiography in cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sin Young; Kim, Ji Hun; Suh, Hong Kil; Kim, Hyo Heon; Kwack, Eun Young; Lee, Il Seong [College of Medicine Hallym University, Seoul (Korea, Republic of)

    1995-01-15

    The usefulness and radiographic findings of the angiography in cerebral infarction are well known. We attempted to evaluate the angiographic causes, findings, and the usefulness of DSA in cerebral infarction. The authors reviewed retrospectively DSA images of 51 patients who were diagnosed as having cerebral infarction by brain CT and/or MRI and clinical settings. DSA was performed in all 51 patients, and in 3 patients, conventional angiogram was also done. Both carotid DSA images were obtained in AP, lateral, oblique projections, and one or both vertebral DSA images in AP and lateral. The authors reviewed the patient's charts for symptoms, operative findings and final diagnosis, and analysed DSA findings of cerebral atherosclerosis with focus on 6 major cerebral arteries. Among the 51 patients of cerebral infarction 43 patients (84.3%) had cerebral atherosclerosis, 1 dissecting aneurysm, 1 moyamoya disease and 6 negative in angiogram. DSA findings of cerebral atherosclerosis were multiple narrowing in 42 patients (97.7%), tortuosity in 22 (51.2%), dilatation in 14, occlusion in 12, avascular region in 8, collaterals in 7, ulcer in 6, and delayed washout of contrast media in 3. In cerebral atherosclerosis, internal carotid artery was involved in 37 patients (86.0%), middle cerebral artery in 29 (67.4%) posterior cerebral artery in 28, anterior cerebral artery in 26, vertebral artery in 22, and basilar artery in 15. Intracranial involvement of cerebral atherosclerosis (64.9%) was more common than extracranial involvement (16.2%). In cerebral infarction MRA may be the screening test, but for more precise evaluation of vascular abnormality and its extent, DSA should be considered.

  3. Cerebral ischemia upregulates vascular endothelin ET(B) receptors in rat

    DEFF Research Database (Denmark)

    Stenman, Emelie; Malmsjö, Malin; Uddman, Erik;

    2002-01-01

    BACKGROUND AND PURPOSE: Elevated levels of endothelin-1 (ET-1) have been reported in cerebral ischemia. A role for ET may prove more important if the vascular receptors were changed. We addressed whether there is any change in ET receptor expression in cerebral ischemia. METHODS: The right middle...... receptors in the pathogenesis of a vascular component after cerebral ischemia....... cerebral artery (MCA) was occluded in male Wistar rats for 2 hours with the intraluminal filament method. The basilar artery and both MCAs were removed after 46 hours of recirculation. The contractile responses to ET-1, a combined ET(A) and ET(B) receptor agonist, and sarafotoxin 6c (S6c), a selective ET...

  4. Detection of cerebral hemorrhage in rabbits by time-difference magnetic inductive phase shift spectroscopy.

    Directory of Open Access Journals (Sweden)

    Wencai Pan

    Full Text Available Cerebral hemorrhage, a difficult issue in clinical practice, is often detected and studied with computed tomography (CT, magnetic resonance imaging (MRI, and positron emission tomography (PET. However, these expensive devices are not readily available in economically underdeveloped regions, and hence are unable to provide bedside and emergency on-site monitoring. The magnetic inductive phase shift (MIPS is an emerging technology that may become a new tool to detect cerebral hemorrhage and to serve as an inexpensive partial substitute to medical imaging. In order to study a wider band of cerebral hemorrhage MIPS and to provide more useful information for measuring cerebral hemorrhage, we established a cerebral hemorrhage magnetic induction phase shift spectroscopy (MIPSS detection system. Thirteen rabbits with five cerebral hemorrhage states were studied using a single coil-coil within a 1 MHz-200 MHz frequency range in linear sweep. A feature band (FB with the highest detection sensitivity and the greatest stability was selected for further analysis and processing. In addition, a maximum conductivity cerebrospinal fluid (CSF MRI was performed to verify and interpret the MIPSS result. The average phase shift change induced by a 3 ml injection of autologous blood under FB was -7.7503° ± 1.4204°, which was considerably larger than our previous work. Data analysis with a non-parametric statistical Friedman M test showed that in the FB, MIPSS could distinguish the five states of cerebral hemorrhage in rabbits, with a statistical significance of p<0.05. A B-F distribution profile was designed according to the MIPSS under FB that can provide instantaneous diagnostic information about the cerebral hemorrhage severity from a single set of measurements. The results illustrate that the MIPSS detection method is able to provide a new possibility for real-time monitoring and diagnosis of the severity of cerebral hemorrhage.

  5. 选择性腰骶段脊神经后根部分切断术治疗脑瘫性下肢痉挛的临床观察%Clinical observation of selective posterior rhizotomy for spasticity of lower limbs in patients with cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    桑林; 马延山; 郑重; 周峰; 解飞; 葛留锁; 于炎冰; 张黎

    2012-01-01

    Objective To study the therapeutic efficacy of selective posterior rhizotomy (SPR) for spasticity of lower limbs in patients with cerebral palsy. Methods Clinical data of 406 patients with spasticity of lower limbs due to cerebral palsy were analyzed retrospectively. The SPR and rehabilitation training were performed in all the patients, and the remission of clinical symptoms were evaluated by correlative scales. Results Four hundred and six patients were followed up for mean time of 28.8 months, ranged from 6 to 36 months. During the follow-up period, the spasticity remitted in 378 cases (93.3%) and maintained the preoperative levels in 28 (6.7%), The dystonia remitted in 362 cases (89.2%) and maintained the preoperative levels in 44 (10.8%), the gait function improved in 370 cases (91.3%) and maintained the preoperative levels in 36 (8.7%), and the quality of life improved in 378 cases (93.3%) and not obviously changed in 28 (6.7%). Postoperative complications included sensory disturbance of lower limbs in 54 cases (13.3%), muscle strength reduction in 72 (17.7%), transient urinary retention in 9 (2.2%) and transient temperature elevation in 31 (7.6%). Conclusions SPR is a effective and less invasive surgical method for the treatment of spasticity of limbs in cerebral palsy patients with less complication. The proper choice of cases and postoperative rehabilitation are key points for good results.%目的 探讨选择性腰骶段脊神经后根部分切断术(SPR)治疗脑瘫性下肢痉挛的疗效.方法 回顾性分析406例脑瘫性下肢痉挛病人的临床资料,均行SPR治疗和康复训练.并采用相应量表评估病人临床症状的缓解情况.结果 406例获随访6-36个月,平均28.8个月.随访期间,痉挛状态缓解378例(93.3%),维持术前水平28例(6.7%);肌张力缓解362例(89.2%),维持术前水平44例(10.8%);步态功能改善370例(91.3%),维持术前水平36例(8.7%);生活质量提高378例(93.3%),无明显改善28

  6. 选择性腰骶段脊神经后根切断术治疗脑瘫性下肢痉挛的长期疗效%Treatment of spasticity of lower limbs in cerebral palsy with the selective lumbosacral posterior rhizotomy: an accompanying long-term efficacy

    Institute of Scientific and Technical Information of China (English)

    张哲; 于炎冰; 张黎; 袁越; 赵奎明

    2015-01-01

    目的 探讨选择性腰骶段脊神经后根切断术(SPR)治疗脑瘫性下肢痉挛状态的长期疗效.方法 回顾分析采用SPR治疗的1 455例痉挛型脑瘫下肢痉挛状态患者,对手术后除解除下肢痉挛之外的其他伴随疗效进行长期随访.结果 对1 455例患者进行平均21.8个月(12 ~44个月)的随访.随访期间在统计手术解除下肢痉挛状态疗效(总痉挛缓解率为94.8%,步态功能改善率为85.6%)同时发现患者其他伴随症状的改善:流涎改善率64.5%(300/465),口运动及构音障碍改善率39.1% (135/345),上肢痉挛改善率33.3%(240/720),斜视改善率33.3%(225/675).结论 SPR在治疗脑瘫性下肢痉挛的同时可使33.3% ~64.5%的患者流涎、口运动及构音障碍、上肢痉挛、斜视等伴随症状有不同程度的改善,其具体机制尚待进一步研究.%Objective To investigate the treatment of spasticity of lower limbs in cerebral palsy with the selective lumbosacral posterior rhizotomy (SPR).Methods The clinical data of 1 455 patients with spastic cerebral palsy with lower limbs pasticity treated by SPR were analyzed retrospectively.In addition to relieving the lower limb spasticity after procedure,the long-term follow-up of other accompanying effects were performed.Results All 1 455 patients were followed up for 21.8 (mean,12-44) months.While adding up the efficacy of relieving lower limb spasticity with operation (the total spasm remission rate was 94.8% and the gait function improvement rate was 85.6%) during the follow-up period,the improvement of other concomitant symptoms of patients was observed:the improvement rates of salivation,oral dyskinesia and dysarthria,spasticity of upper limbs,and strabismus were 64.5% (300/465),39.1% (135/345),33.3% (240/720),and 33.3% (225/675),respectively.Conclusions While in the treatment of spasticity of lower limbs in cerebral palsy,SPR improves the concomitant symptoms,such as salivation

  7. Application value of DTI tracing the optic tract and optic radiation for the selection of postoperative radiotherapy plan of cerebral gliomas%DTI技术示踪视束、视辐射在指导脑胶质瘤术后放疗方案选择中的应用价值

    Institute of Scientific and Technical Information of China (English)

    赵超云; 夏新舍; 王明磊; 刘子姗; 高文奇; 马辉; 王晓东; 夏鹤春

    2015-01-01

    Objective:To analyze whether the optic tract and the optic radiation showed by diffusion tensor imaging (DTI) can be used to evaluate the value in the guidance of selecting postoperative radiotherapy plan of cerebral gliomas.Materials and Methods: Thirty patients with conifrmed cerebral gliomas underwent conventional and contrast-enhanced MRI and DTI before postoperative radiotherapy. In order to delineate the radiotherapy target volume, organs at risk, optic tract and optic radiation, tractography data sets was fused with correlation MR and CT anatomy image by importing it to radiotherapy planning system. The radiotherapy plans developed with intensity modulated radiation therapy (IMRT) and three- dimensional conformal radiotherapy (3D-CRT) techniques were compared.Results:Both the IMRT and the 3D-CRT plans were ensured the therapeutic dose to the target volume and conventional organs at risk had been protected. The doses patients suffered by using the IMRT plan were lower than that of the 3D-CRT plan both in affected,unaffected side optic tract and optic radiation (P<0.05).Conclusion:DTI can display the location, shape of the optic tract and optic radiation, and the relationship with postoperative radiotherapy target volume of cerebral gliomas, and formulate protective treatment plan to reduce the radiation dose suffered by the optic tract and optic radiation, thereby reducing the visual dysfunction risk after radiotherapy.%目的:通过扩散张量成像(diffusion tensor imaging,DTI)示踪视束、视辐射,探讨其在指导脑胶质瘤术后放疗方案中的应用价值。材料与方法选取30例脑胶质瘤患者,术后拟行放疗前行常规MRI平扫、增强及DTI扫描。获取视束、视辐射的影像学信息与3D T1解剖图像融合,将融合后的3D T1图像导入放疗计划系统并与定位CT匹配,以此勾画放疗靶区、常规危及器官及视束、视辐射。利用调强放疗(intensity modulated radiation therapy,IMRT)

  8. Reperfusion promotes mitochondrial dysfunction following focal cerebral ischemia in rats.

    Directory of Open Access Journals (Sweden)

    Jun Li

    Full Text Available BACKGROUND AND PURPOSE: Mitochondrial dysfunction has been implicated in the cell death observed after cerebral ischemia, and several mechanisms for this dysfunction have been proposed. Reperfusion after transient cerebral ischemia may cause continued and even more severe damage to the brain. Many lines of evidence have shown that mitochondria suffer severe damage in response to ischemic injury. The purpose of this study was to observe the features of mitochondrial dysfunction in isolated mitochondria during the reperfusion period following focal cerebral ischemia. METHODS: Male Wistar rats were subjected to focal cerebral ischemia. Mitochondria were isolated using Percoll density gradient centrifugation. The isolated mitochondria were fixed for electron microscopic examination; calcium-induced mitochondrial swelling was quantified using spectrophotometry. Cyclophilin D was detected by Western blotting. Fluorescent probes were used to selectively stain mitochondria to measure their membrane potential and to measure reactive oxidative species production using flow cytometric analysis. RESULTS: Signs of damage were observed in the mitochondrial morphology after exposure to reperfusion. The mitochondrial swelling induced by Ca(2+ increased gradually with the increasing calcium concentration, and this tendency was exacerbated as the reperfusion time was extended. Cyclophilin D protein expression peaked after 24 hours of reperfusion. The mitochondrial membrane potential was decreased significantly during the reperfusion period, with the greatest decrease observed after 24 hours of reperfusion. The surge in mitochondrial reactive oxidative species occurred after 2 hours of reperfusion and was maintained at a high level during the reperfusion period. CONCLUSIONS: Reperfusion following focal cerebral ischemia induced significant mitochondrial morphological damage and Ca(2+-induced mitochondrial swelling. The mechanism of this swelling may be mediated by

  9. Clinical significance of the corpus callosum in cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Ja; Kim, Ji Chang [The Catholic University of Korea, Seoul (Korea, Republic of); Kim, Jong Chul [School of Medicine, Chungnam National University, Taejon (Korea, Republic of); And Others

    2000-10-01

    To evaluate, using magnetic resonance (MR) imaging, the clinal significance of the corpus callosum by measuring the size of various portions of the corpus callosum in children with cerebral palsy, and in paired controls. Fifty-two children (30 boys and 22 girls aged between six and 96 (median, 19) months) in whom cerebral palsy was clinically diagnosed underwent MR imaging. There were 23 term patients and 29 preterm, and the control group was selected by age and sex matching. Clinal subtypes of cerebral palsy were classified as hemiplegia (n=14), spastic diplegia (n=22), or spastic quadriplegia (n=16), and according to the severity of motor palsy, the condition was also classified as mild (n=26), moderate (n=13), or severe (n=13). In addition to the length and height of the corpus callosum, the thickness of its genu, body, transitional zone and splenium, as seen on midsagittal T1-weighted MR images, were also measured. Differences in the measured values of the two groups were statistically analysed and differences in the size of the corpus callosum according to the clinical severity and subtypes of cerebral palsy, and gestational age, were also assessed. Except for height, the measured values of the corpus callosum in patients with cerebral palsy were significantly less than those of the control group (p less than 0.05). Its size decreased according to the severity of motor palsy. Compared with term patients, the corpus callosum in preterm patients was considerably smaller (p less than 0.05). There was statistically significant correlation between the severity of motor palsy and the size of the corpus callosum. Quantitative evaluation of the corpus callosum might be a good indicator of neurologic prognosis, and a sensitive marker for assessing the extent of brain injury.

  10. Cerebral aterial spasm. I. Adrenergic mechanism in experimental cerebral vasospasm.

    Directory of Open Access Journals (Sweden)

    Morooka,Hiroshi

    1978-04-01

    Full Text Available This study demonstrates that an adrenergic mechanism plays an important role in producing the delayed cerebral vasospasm which follows subarachnoid hemorrhage. Results were as follows: 1. Experimental subarachnoid hemorrhage (SAH was produced by injection of fresh arterial blood into the cisterna magna in cats. The cerebral vasospasm was shown angiographically to be biphasic in nature: immediate constriction lasting 1 h and marked prolonged spasm occurring between the 3rd and 5th day after SAH. The amount of noradrenaline (NA and dopamine-beta-hydroxylase (DBH activity decreased over a period of 24 h both within the wall of the basilar artery and in the locus ceruleus and then gradually increased, reaching a maximum on the 3rd day after SAH. 2. Topical application of spasmogenic substances (NA and blood produced a marked constriction of the hypersensitive basilar artery on the 3rd day after SAH. 3. 6-Hydroxydopamine (6-OHDA injection into the cisterna magna produced prolonged vasocilatation. The dilated vessel responded with mild transient constriction after the topical application of NA or fresh blood. DBH activity and NA concentration in the vessels, locus ceruleus and medial hypothalamus decreased markedly on the 3rd day after the cisternal injection of 6-OHDA. 4. Various spasmogenic substances (i.e. serotonin, NA, prostaglandins and methemoglobin were measured in a mixture of equal volume of CSF and blood in cats. ONly the serotonin in the mixed fluid produced vasoconstriction. Spasmogenic substances decreased markedly in the mixed fluid incubated for 3 days at 37 degrees C, and none of these substances apart from methemoglobin was present in a concentration sufficient to produce constriction of vessels. 5. These results suggest that early spasm is induced by serotonin around the arteries of the cranial base, and delayed spasm might be caused by hyperreaction of cerebral vessels to spasmogenic substances such as methemoglobin, during the

  11. Influence of rotating magnetic field on cerebral infarction volume, cerebral edema and free radicals metabolism after cerebral ischemia/reperfusion injury in rats

    Institute of Scientific and Technical Information of China (English)

    Xiaohong Liu; Zhiqiang Zhang; Lixin Zhang

    2006-01-01

    BACKGROUND: It has shown that magnetic field can improve blood circulation, decrease blood viscosity, inhibit free radicals, affect Ca2+ flow in nerve cells, control inflammatory and immunological reaction, and accelerate nerve cell regeneration. In addition, protective effect of magnetic field, which acts as an iatrophysics, on ischemic brain tissues has been understood gradually.OBJECTIVE: To investigate the effects of rotating magnetic field (RMF) on volume of cerebral infarction,cerebral edema and metabolism of free radicals in rats after cerebral ischemia/reperfusion injury.DESIGN: Randomized controlled animal study.SETTING: Rehabilitation Center of disabled children, Liaoniang; Department of Rehabilitation, the Second Affiliated Hospital, China Medical University; Department of Rehabilitation Physiotherapy, the First Affiliated Hospital, China Medical University.MATERIALS: A total of 70 healthy Wistar rats aged 18-20 weeks of both genders were selected and randomly divided into 3 groups: sham operation group with 12 rats, control group with 20 rats and treatment group with 38 rats. The treatment group included 4 time points: immediate reperfusion with 6 ones, 6-hour reperfusion with 20 ones, 12-hour reperfusion with 6 ones and 18-hour reperfusion with 6 rats. Main instruments were detailed as follows: magnetic head of rotating magnetic device was 6 cm in diameter; magnetic induction intensity at the surface of magnetic head was 0.25 T in silence; the maximal magnetic induction intensity was 0.09 T at the phase of rotation; the average rotating speed was 2500 r per minute.METHODS: The experiment was carried out in the China Medical University in March 2003. Focal cerebral ischemic animal models were established with modified Longa's method. Operation was the same in the sham operation, but the thread was inserted as 10 mm. Neurologic impairment was assessed with 5-rating method to screen out cases. Those survivals with grade 1 and grade 2 after ischemia for 2

  12. Selection of the methods used in MR angiography with arteriovenous malformation, carotid cavernous fistula, moyamoya disease, and cerebral aneurysms; A comparison of 3-D phase-contrast MRA with 3-D time-of-flight MRA

    Energy Technology Data Exchange (ETDEWEB)

    Ikawa, Fusao; Uozumi, Tohru; Kuwabara, Satoshi (Hiroshima Univ. (Japan). School of Medicine) (and others)

    1993-02-01

    The methods used in MR angiography (MRA) can be roughly divided into two groups: time-of-flight methods (TOF methods) which make use of the influx effect of the flow, and the phase-contrast method of Dumoulin, Souza, and their collaborators (PC method), which utilizes phase differences induced by the flow. In this study, the selection of the MRA method was determined by a comparison of the three-dimensional (3-D) PC and the 3-D TOF method in normal and clinical cases. The tool used was SIGNA Advantage (1.5T) made by GE. The 3-D PC method was applied under a pulse sequence generated by gradient-recalled acquisition in the steady state (GRASS); the pulse sequence used for the 3-D TOF method was spoiled GRASS (SPGR) in a total of 28 cases. The following conclusions were reached: the TOF method should be used when aneurysms, arteriovenous malformations (AVM), and moyamoya disease have been diagnosed, and the PC method should be used when AVM and carotid cavernous fistulae (CCF) are to be evaluated in the flow and when CCFs have been diagnosed. (author).

  13. Chinese semantic processing cerebral areas

    Institute of Scientific and Technical Information of China (English)

    SHAN Baoci; ZHANG Wutian; MA Lin; LI Dejun; CAO Bingli; TANG Yiyuan; WU Yigen; TANG Xiaowei

    2003-01-01

    This study has identified the active cerebral areas of normal Chinese that are associated with Chinese semantic processing using functional brain imaging. According to the traditional cognitive theory, semantic processing is not particularly associated with or affected by input modality. The functional brain imaging experiments were conducted to identify the common active areas of two modalities when subjects perform Chinese semantic tasks through reading and listening respectively. The result has shown that the common active areas include left inferior frontal gyrus (BA 44/45), left posterior inferior temporal gyrus (BA37); the joint area of inferior parietal lobules (BA40) and superior temporal gyrus, the ventral occipital areas and cerebella of both hemispheres. It gives important clue to further discerning the roles of different cerebral areas in Chinese semantic processing.

  14. Cerebral blood-flow tomography

    DEFF Research Database (Denmark)

    Lassen, N A; Henriksen, L; Holm, S;

    1983-01-01

    Tomographic maps of local cerebral blood flow (CBF) were obtained with xenon-133 and with isopropyl-amphetamine-iodine-123 (IMP) in 11 subjects: one normal, two tumor cases, and eight cerebrovascular cases. A highly sensitive four-face, rapidly rotating, single-photon emission tomograph was used......., and with low radiation exposure to patient and personnel. On the other hand, IMP gives an image of slightly higher resolution. It also introduces a new class of iodinated brain-seeking compounds allowing, perhaps, imaging of other functions more important than mere blood flow.......Tomographic maps of local cerebral blood flow (CBF) were obtained with xenon-133 and with isopropyl-amphetamine-iodine-123 (IMP) in 11 subjects: one normal, two tumor cases, and eight cerebrovascular cases. A highly sensitive four-face, rapidly rotating, single-photon emission tomograph was used...

  15. Cerebral calcifications and schizophreniform disorder

    Directory of Open Access Journals (Sweden)

    Leonardo Fernandez Meyer

    2013-01-01

    Full Text Available OBJECTIVES: Discuss pathophysiological aspects of cerebral calcifications (CC and highlight its importance related to the occurrence of neuropsychiatric syndromes. METHOD: Single case report. RESULT: Man 52 years old, 20 years after going through a total thyroidectomy, starts showing behavioral disturbance (psychotic syndrome. He was diagnosed as schizophrenic (paranoid subtype and submitted to outpatient psychiatric treatment. During a psychiatric admission to evaluate his progressive cognitive and motor deterioration, we identified a dementia syndrome and extensive cerebral calcifications, derived from iatrogenic hypoparathyroidism. CONCLUSION: The calcium and phosphorus disturbances, including hypoparathyroidism, are common causes of CC. Its symptoms can imitate psychiatric disorders and produce serious and permanent cognitive sequelae. The exclusion of organicity is mandatory in any psychiatric investigative diagnosis in order to avoid unfavorable outcomes, such as in the present case report.

  16. Animal models of cerebral ischemia

    Science.gov (United States)

    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.

  17. Dynamics of cerebral tissue injury and perfusion after temporary hypoxia-ischemia in the rat - Evidence for region-specific sensitivity and delayed damage

    NARCIS (Netherlands)

    Dijkhuizen, RM; Knollema, S; van der Worp, H. Bart; Ter Horst, GJ; De Wildt, DJ; van der Sprenkel, JWB; Tulleken, KAF; Nicolay, K

    1998-01-01

    Background and Purpose-Selective regional sensitivity and delayed damage in cerebral ischemia provide opportunities for directed and late therapy for stroke. Our aim was to characterize the spatial and temporal profile of ischemia-induced changes in cerebral perfusion and tissue status, with the use

  18. The phosphodiesterase 5 inhibitor sildenafil has no effect on cerebral blood flow or blood velocity, but nevertheless induces headache in healthy subjects

    DEFF Research Database (Denmark)

    Kruuse, Christina; Thomsen, Lars Lykke; Jacobsen, Torsten Bjørn

    2002-01-01

    , and regional cerebral blood flow in the perfusion area of the middle cerebral artery (rCBFmca) was measured using single photon emission computed tomography and xenon inhalation. Radial and temporal artery diameters were studied using high-frequency ultrasound. Blood pressure and heart rate were recorded......Cyclic nucleotides are important hemodynamic regulators in many tissues. Glyceryl trinitrate markedly dilates large cerebral arteries and increases cGMP. Here, the authors study the effect of sildenafil, a selective inhibitor of cGMP-hydrolyzing phosphodiesterase 5 on cerebral hemodynamics...

  19. Cerebral hyperperfusion following carotid endarterectomy

    DEFF Research Database (Denmark)

    Schroeder, T; Sillesen, H; Sørensen, O;

    1987-01-01

    , occurred in the low pressure ratio group, while the hemispheric asymmetry on average was unchanged in the high pressure ratio group. This relative hyperemia was most pronounced 2 to 4 days following reconstruction. The marked hyperemia, absolute as well as relative, in patients with a low ICA/CCA pressure...... ratio suggests a temporary impairment of autoregulation. Special care should be taken to avoid postoperative hypertension in such patients, who typically have preoperative hypoperfusion, to avoid the occurrence of cerebral edema or hemorrhage....

  20. Hydrocephalus in cerebral venous thrombosis.

    Science.gov (United States)

    Zuurbier, Susanna M; van den Berg, René; Troost, Dirk; Majoie, Charles B; Stam, Jan; Coutinho, Jonathan M

    2015-01-01

    Increased intracranial pressure is common in cerebral venous thrombosis (CVT), but hydrocephalus is rarely reported in these patients. We examined the frequency, pathophysiology and associated clinical manifestations of hydrocephalus in patients with CVT admitted to our hospital between 2000 and 2010 (prospectively since July 2006). Hydrocephalus was defined as a bicaudate index larger than the 95th percentile for age, and/or a radial width of the temporal horn of ≥ 5 mm. We excluded patients in whom hydrocephalus was caused by a disease other than CVT or if it was iatrogenic. 20 out of 99 patients with CVT had hydrocephalus. 6 patients with hydrocephalus were excluded from the analysis. Patients with hydrocephalus more often had focal neurological deficits (86 vs. 49%, p = 0.02) and were more frequently comatose (43 vs. 16%, p = 0.06), as compared to patients without hydrocephalus. Deep cerebral venous thrombosis (64 vs. 9%, p hydrocephalus. Intraventricular hemorrhage was present in 1 patient with hydrocephalus, compared to none among patients without hydrocephalus (7 vs. 0%, p = 0.15). Outcome at follow-up was worse in patients with hydrocephalus (mRS 0-1, 36 vs. 68%, p = 0.02; mortality 29 vs. 9%, p = 0.07). Hydrocephalus occurs more frequently in cerebral venous thrombosis than previously believed, especially in patients with deep cerebral venous thrombosis and edema of the basal ganglia. The presence of hydrocephalus is associated with a worse clinical outcome, but a direct causal relation is unlikely. Routine shunting procedures are not advisable.

  1. Cerebral ischaemia: A neuroradiological study

    Energy Technology Data Exchange (ETDEWEB)

    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.

  2. MR findings of cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sang Hum; Chang, Seung Kuk; Cho, Mee Young; Park, Dong Woo; Kim, Jong Deok; Eun, Choong Ki [Pusan Paik Hospital, Pusan (Korea, Republic of)

    1994-11-15

    To evaluate the MR findings of brain damage in cerebral palised patients and to correlate it with gestational age and the time of damage. A retrospective analysis was performed in 40 patients who underwent MR scanning for evaluation of brain lesion in clinically diagnosed cerebral palsy. Authors classified the patients into two groups as premature and full-term and compared MR findings of the two groups. Abnormal MR findings were noted in 28 cases (70%). Five out of 6 patients who had been born prematurely showed isolate periventricular white matter lesions. Twenty-three out of 34 patients who had been born at full-term showed abnormal MR findings. Of these 23 patients, migration anomalies in 7 patients, isolate periventricular white matter lesions in 3 patients, and other combined periventricular subcortical white matter and deep gray matter lesions in 14 patients were seen. At least, 10 patients(43%) of full term group showed abnormal MRI findings reflecting intrauterine brain damage and all 5 patients of premature group showed isolate periventricular white matter lesions suggesting immaturity of brain. MRI is thought to be very useful in the assessment of brain damage for the patients with cerebral palsy by recognizing the location of the lesion and estimating the time of damage.

  3. Cerebral Edema and Cerebral Hemorrhages in Interleukin-10-Deficient Mice Infected with Plasmodium chabaudi

    OpenAIRE

    Sanni, Latifu A; Jarra, William; Li, Ching; Langhorne, Jean

    2004-01-01

    During a Plasmodium chabaudi infection in interleukin-10 (IL-10) knockout mice, there is greater parasite sequestration, more severe cerebral edema, and a high frequency of cerebral hemorrhage compared with infection of C57BL/6 mice. Anti-tumor necrosis factor alpha treatment ameliorated both cerebral edema and hemorrhages, suggesting that proinflammatory responses contributed to cerebral complications in infected IL-10−/− mice.

  4. Cerebral Vasospasm Pharmacological Treatment: An Update

    OpenAIRE

    Ioannis Siasios; 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 vasosp...

  5. Cerebral embolic stroke after disappearing takotsubo cardiomyopathy.

    Science.gov (United States)

    Matsuzono, Kosuke; Ikeda, Yoshio; Deguchi, Shoko; Yamashita, Toru; Kurata, Tomoko; Deguchi, Kentaro; Abe, Koji

    2013-11-01

    Takotsubo cardiomyopathy can induce cerebral embolic stroke because of intracardiac thrombosis, but the timing of cardiogenic embolism relating to takotsubo cardiomyopathy has not been well described. We evaluated a 71-year-old woman with takotsubo cardiomyopathy, who developed cardiogenic cerebral embolism after recovery of cardiac wall motion. Nevertheless, we treated her with anticoagulation therapy. The present clinical observation suggests that attention should be paid to the timing when takotsubo cardiomyopathy resolves against risk of cardiogenic cerebral embolism.

  6. Quantitative Cerebral Blood Flow Measurements Using MRI

    OpenAIRE

    Muir, Eric R; Watts, Lora Talley; Tiwari, Yash Vardhan; Bresnen, Andrew; Timothy Q Duong

    2014-01-01

    Magnetic resonance imaging utilized as a quantitative and noninvasive method to image cerebral blood flow. The two most common techniques used to detect cerebral blood flow are dynamic susceptibility contrast (DSC) perfusion MRI and arterial spin labeling perfusion MRI. Herein we describe the use of these two techniques to measure cerebral blood flow in rodents, including methods, analysis, and important considerations when utilizing these techniques.

  7. Cerebral energy metabolism during induced mitochondrial dysfunction

    DEFF Research Database (Denmark)

    Nielsen, T H; Bindslev, TT; Pedersen, S M

    2013-01-01

    In patients with traumatic brain injury as well as stroke, impaired cerebral oxidative energy metabolism may be an important factor contributing to the ultimate degree of tissue damage. We hypothesize that mitochondrial dysfunction can be diagnosed bedside by comparing the simultaneous changes in...... in brain tissue oxygen tension (PbtO(2)) and cerebral cytoplasmatic redox state. The study describes cerebral energy metabolism during mitochondrial dysfunction induced by sevoflurane in piglets....

  8. Cerebral hemodynamics in aging : the interplay between blood pressure, cerebral perfusion, and dementia

    NARCIS (Netherlands)

    Claassen, J.A.H.R.

    2008-01-01

    Advances in measurement techniques have made it possible to study dynamic changes in brain blood flow. Transcranial Doppler ultrasonography measures changes in cerebral blood flow-velocity in the larger cerebral arteries (e.g. the middle cerebral artery). Near infrared spectroscopy records changes i

  9. Lipopolysaccharide infusion enhances dynamic cerebral autoregulation without affecting cerebral oxygen vasoreactivity in healthy volunteers

    DEFF Research Database (Denmark)

    Berg, Ronan Mg; Plovsing, Ronni R; Evans, Kevin A;

    2013-01-01

    Sepsis may be associated with disturbances in cerebral oxygen transport and cerebral haemodynamic function, thus rendering the brain particularly susceptible to hypoxia. The purpose of this study was to assess the impact of isocapnic hypoxia and hyperoxia on dynamic cerebral autoregulation...... in a human-experimental model of the systemic inflammatory response during the early stages of sepsis....

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

    Science.gov (United States)

    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:…

  11. Middle cerebral artery blood velocity during running

    DEFF Research Database (Denmark)

    Lyngeraa, Tobias; Pedersen, Lars Møller; Mantoni, T;

    2013-01-01

    Running induces characteristic fluctuations in blood pressure (BP) of unknown consequence for organ blood flow. We hypothesized that running-induced BP oscillations are transferred to the cerebral vasculature. In 15 healthy volunteers, transcranial Doppler-determined middle cerebral artery (MCA....... During running, rhythmic oscillations in arterial BP induced by interference between HR and step frequency impact on cerebral blood velocity. For the exercise as a whole, average MCA velocity becomes elevated. These results suggest that running not only induces an increase in regional cerebral blood flow...

  12. Predictive value of crawling ability for prognostication of the functional amelioration of children with cerebral palsy after selective posterior rehizotomy%脑性瘫痪患儿术前爬行能力与选择性脊神经后根切断术后下肢功能改善的相关分析

    Institute of Scientific and Technical Information of China (English)

    易斌; 徐林; 洪毅; 俞兴; 王兵

    2001-01-01

    目的分析术前爬行能力与术后下肢功能特别是独立行走能力的关联。方法以量化功能的方式评估选择性脊神经后根切断术后下肢功能。将爬行功能分为A~D4个等级,同时将下肢功能分别量化,观察各级患儿手术前、后的功能变化,并统计分析术前、后的功能差异。结果术后肌张力明显降低,下肢各项功能显著改善;术前爬行能力良好的患儿术后下肢各项功能与独立行走与爬行能力差的患者有显著性差异。结论术前爬行能力对判断手术预后具有参考价值。%Objective To evaluate the value of crawling ability as predictor of walking postoperatively.Methods To observe the function of lower limbs with quantitative functional measurement,and analyze the relation between walk ability after SPR and preoperative crawling stage. Results Muscle tone was significantly decreased,and the development of function of lower limbs was obviously.The achievement was continuously in 1 year and 2 year follow up group.The ability of crawling was closely related with walk ability after SPR. Conclusion SPR decreases spasticity and increases lower estremity range of motion in children with cerebral palsy and appears to be associated with functional improvements.The ability of crawling is a predictive reference of ability to walk after selective posterior rhizotomy.

  13. Ureteral catheter antegrade lavage combined with the analysis of the effect of ureteroscopic lithotripsy (report of 58 cases)%输尿管导管顺行灌洗配合输尿管镜碎石的效果分析(附58例报告)

    Institute of Scientific and Technical Information of China (English)

    于金刚

    2015-01-01

    Objective To explore the feasibility of implementing the ureteral catheter antegrade lavage in ureteroscopic lithotripsy in. Methods from 2013 May to ureteral calculi in patients with _2014 in May in our hospital 58 cases, given the ureteroscope lithotripsy for ureteral catheter, F4 antegrade lavage combined intraoperative, study its treatment effect. Results in this group, 58 cases were successfully crushed stone, the success rate of operation is 100%, no patients with ureteral perforation or laceration of disease, average operation time ( 32.7+4.6) min, the time of hospitalization ( 3.02+0.88) d. Conclusion the ureteroscopic lithotripsy in patients with ureteral catheter antegrade lavage has good effect, can avoid the movement of calculus, to ensure the successful operation, suitable for clinical popularization.%目的:探讨在输尿管镜碎石中实施输尿管导管顺行灌洗的可行性。方法选取2013年5月_2014年5月来我院治疗的输尿管结石患者共58例,给予输尿管镜碎石术治疗,术中配合F4输尿管导管顺行灌洗,研究其治疗效果。结果本组58例病例均得到成功碎石,手术成功率是100%,未见患者发生输尿管穿孔或撕裂等症,平均手术时间(32.7±4.6)min,住院时间(3.02±0.88)d。结论对输尿管镜碎石术患者结合输尿管导管顺行灌洗有良好效果,可避免结石上移,确保手术成功,适合临床普及使用。

  14. Cerebral salt wasting syndrome in children with acute central nervous system injury.

    Science.gov (United States)

    Jiménez, Raquel; Casado-Flores, Juan; Nieto, Monserrat; García-Teresa, María Angeles

    2006-10-01

    The purpose of this investigation was to describe the causes, clinical pattern, and treatment of cerebral salt wasting syndrome in children with acute central nervous system injury. This retrospective study focused on patientscerebral salt wasting syndrome, over a period of 7 years, in the pediatric intensive care unit of a tertiary care hospital. Selection criteria included evidence of hyponatremia (serum sodium120 mEq/L), and volume depletion. Fourteen patients were identified with cerebral salt wasting syndrome, 12 after a neurosurgical procedure (8 brain tumor, 4 hydrocephalus) and 2 after severe brain trauma. In 11 patients the cerebral salt wasting syndrome was diagnosed during the first 48 hours of admission. Prevalence of cerebral salt wasting syndrome in neurosurgical children was 11.3/1000 surgical procedures. The minimum sodium was 122+/-7 mEq/L, the maximum urine osmolarity 644+/-59 mOsm/kgH2O. The maximum sodium supply was 1 mEq/kg/h (range, 0.1-2.4). The mean duration of cerebral salt wasting syndrome was 6+/-5 days (range 1-9). In conclusion, cerebral salt wasting syndrome can complicate the postoperative course of children with brain injury; it is frequently present after surgery for brain tumors and hydrocephalus and in patients with severe head trauma. Close monitoring of salt and fluid balance is essential to prevent severe neurologic and hemodynamic complications.

  15. 主动脉弓部手术中单侧大脑灌注血流变化与神经系统并发症关系的分析%Analysis of the relationship between the hemodynamic changes during selective cerebral perfusion and postoperative neurological complications in aortic arch surgery

    Institute of Scientific and Technical Information of China (English)

    阳晟; 任长伟; 许尚栋; 孙立忠

    2012-01-01

    Objective: This study tries to monitor the hemodynamic changes of middle cerebral artery ( MCA) by transcranial Doppler sonography (TCD) in aortic arch surgery. Analysis of relationship between the hemodynamic changes during selective cerebral perfusion (SCP) and postoperative neurological complications. Methods: From September 2010 to January 2011, 23 patients with aortic dissection undergoing aortic arch operation were included in this study. Every patient underwent profound hypothermia (DHCA) and selective cerebral perfusion. Hemodynamic signals of bilateral MCA were monitored via TCD during operation. Data at 6 time-points were selected for analysis. All the patients were divided into four groups by the decline in the proportion of non-perfusion side flow( 30% ) , and all the postoperative neurological complications and early death after surgery were recorded in each group. Results: During the full flow of CPB, blood flow velocity of MCA at left and right side was no differences ( P = 0. 565 ) . During SCP, blood flow velocity of MCA at perfusion side (right side) was similar with blood flow velocity before SCP; and blood flow velocity of MCA at non-perfusion side (left side) was significant decreased compare with blood flow veloci-ly before SCP (P 30% groups (50% ) ,no permanent neurological dysfunction (PND) and early death was observed. Conclusion; SCP in aortic arch operation can meet the blood supply to the brain; During SCP, blood flow velocity of MCA at perfusion side (right side) was similar to the blood flow velocity before SCP; blood flow velocity of MCA at non-perfusion side (left side) was significant decreased compare with blood flow velocity before SCP. Less than 30% drop of blood flow velocity of MCA at non-perfusion side (left side) may be safe for the patients.%目的:通过经颅多普勒超声(TCD)监测主动脉弓部手术中大脑中动脉(MCA)的血流,评估选择性脑灌注(SCP)期间血流变化与术后神经系统

  16. The use of selective cerebral perfusion through right axillary artery cannulation in aortic aneurysm surgery%经右侧腋动脉插管选择性单侧脑灌注在主动脉瘤手术中的应用

    Institute of Scientific and Technical Information of China (English)

    姚昊; 王强; 骆璇; 王喆妍; 陈杨

    2011-01-01

    Objective To summarize the experiences of selective cerebral perfusion through right axillary artery cannulation in aortic aneurysm surgery. Methods Methods Retrospectively analyzed 105 cases ( from May 2009 to May 2011 ) of aortic aneurysm surgery with deep hypothermic circulatory arrest ( DHCA ). 78 cases were male and 27 cases were female. The operation procedure included Bentall procedure and semi arch replacement in 6 cases, ascending aorta replacement and semi arch replacement in 5 cases, Bentall procedure and elephant trunk technique in 61 cases, ascending aorta replacement and elephant trunk technique in 33 cases. Combined operations included coronery artery bypass grafting ( 10 cases ), mitral valve replacement or mitral valve repair ( 24 cases ) and tricuspid valve repair ( 11 cases ). Results Average cardiopulmonary bypass time was 81 -374 ( 178. 6 ±41. 5 ) min, average DHCA time was 8 - 36 ( 23.2 ± 10. 1 ) min, average selective cerebral perfusion time was 8 - 46 ( 30. 4 ± 12. 4 ) min, nasopharynx temperature during DHCA was 15. 5 -23. 5 ( 19. 5 ± 1. 7 )℃ , rectal temperature during DHCA was 18.0-25.6 ( 20.6 ± 1. 6 )℃. 89 patients'hearts automaticly reheated and 16 reheated after defibrillation. 5 cases died postoperatively. The complications included mul-tiorgan failure for 3 cases, malignant arrhythmia for 1 case and sudden bleeding for 1 case. Conclusion The use of selective cerebral perfusion through right axillary artery cannulation in aortic aneurysm surgery can get effective brain protection and reduce the postoperative nervous system complications with acceptable results.%目的 总结经右侧腋动脉插管选择性脑灌注(SCP)在主动脉瘤手术中应用的经验.方法 回顾性分析我院2009年5月至2011年5月期间采用深低温停循环(DHCA)SCP的手术方式治疗的105例主动脉瘤患者.男78例,女27例.行Bentall+次全弓置换6例,行升主动脉置换+次全弓置换5例,行Bentall+全弓置换+降主

  17. Statistical parametric mapping of Tc-99m HMPAO SPECT cerebral perfusion in the normal elderly

    Energy Technology Data Exchange (ETDEWEB)

    Turlakow, A.; Scott, A.M.; Berlangieri, S.U.; Sonkila, C.; Wardill, T.D.; Crowley, K.; Abbott, D.; Egan, G.F.; McKay, W.J.; Hughes, A. [Austin and Repatriation Medical Centre, Heidelberg, VIC (Australia). Departments of Nuclear Medicine and Centre for PET Neurology and Clinical Neuropsychology

    1998-06-01

    Full text: The clinical value of Tc-99m HMPAO SPECT cerebral blood flow studies in cognitive and neuropsychiatric disorders has been well described. Currently, interpretation of these studies relies on qualitative or semi- quantitative techniques. The aim of our study is to generate statistical measures of regional cerebral perfusion in the normal elderly using statistical parametric mapping (Friston et al, Wellcome Department of Cognitive Neurology, London, UK) in order to facilitate the objective analysis of cerebral blood flow studies in patient groups. A cohort of 20 healthy, elderly volunteers, aged 68 to 81 years, was prospectively selected on the basis of normal physical examination and neuropsychological testing. Subjects with risk factors, or a history of cognitive impairment were excluded from our study group. All volunteers underwent SPECT cerebral blood flow imaging, 30 minutes following the administration of 370 MBq Tc-99m HMPAO, on a Trionix Triad XLT triple-headed scanner (Trionix Research Laboratory Twinsburg, OH) using high resolution, fan-beam collimators resulting in a system resolution of 10 mm full width at half-maximum (FWHM). The SPECT cerebral blood flow studies were analysed using statistical parametric mapping (SPM) software specifically developed for the routine statistical analysis of functional neuroimaging data. The SPECT images were coregistered with each individual`s T1-weighted MR volume brain scan and spatially normalized to standardised Talairach space. Using SPM, these data were analyzed for differences in interhemispheric regional cerebral blood flow. Significant asymmetry of cerebral perfusion was detected in the pre-central gyrus at the 95th percentile. In conclusion, the interpretation of cerebral blood flow studies in the elderly should take into account the statistically significant asymmetry in interhemispheric pre-central cortical blood flow. In the future, clinical studies will be compared to statistical data sets in age

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

    Science.gov (United States)

    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.

  19. The role of cGMP hydrolysing phosphodiesterases 1 and 5 in cerebral artery dilatation

    DEFF Research Database (Denmark)

    Kruuse, C; Rybalkin, S D; Khurana, T S;

    2001-01-01

    The aim was to investigate the presence and activity of cGMP hydrolysing phosphodiesterases in guinea pig basilar arteries and the effect of selective and non-selective phosphodiesterase inhibitors on cerebral artery dilatation involving the nitric oxide (NO)-guanosine cyclic 3'5-monophosphate (c...... by cGMP-independent mechanisms. Targeting the phosphodiesterases present in cerebral arteries, with selective inhibitors or activators of phosphodiesterase, may be a possible new way of treating cerebrovascular disease.......The aim was to investigate the presence and activity of cGMP hydrolysing phosphodiesterases in guinea pig basilar arteries and the effect of selective and non-selective phosphodiesterase inhibitors on cerebral artery dilatation involving the nitric oxide (NO)-guanosine cyclic 3'5-monophosphate (c......GMP) pathway. Immunoreactivity to phosphodiesterases 1A, 1B and 5, but not phosphodiesterase 1C was found in fractions of homogenised cerebral arteries eluted by high-pressure liquid chromatography (HPLC). Both the phosphodiesterase 1 inhibitor 8-methoxymethyl-1-methyl-3-(2methylpropyl)-xanthine (8-MM...

  20. Effect of labetalol on cerebral blood flow and middle cerebral arterial flow velocity in healthy volunteers

    DEFF Research Database (Denmark)

    Schroeder, T; Schierbeck, Jens; Howardy, P;

    1991-01-01

    in normotensive subjects. Neither does it affect CO2 reactivity. The uniform results obtained with the two methods suggest TCD as a usable alternative to conventional CBF technique in the assessment of cerebral vasoactivity of various drugs in subjects with a normal cerebral circulation.......The effect of labetalol, a combined alpha- and beta-adrenoceptor antagonist, on the cerebral circulation was investigated in 7 normotensive subjects. Cerebral blood flow (CBF) was measured with the intravenous 133Xe method and mean flow velocity (Vmean) in the middle cerebral artery was determined...

  1. Relationship of cerebral arterial stenosis to cognitive and memory disorders

    Institute of Scientific and Technical Information of China (English)

    Jifeng Li; Zhou Wang; Shenggang Sun; Gaomei Cai; Kejin Gu; Yaoqun Li

    2006-01-01

    BACKGROUND: Cerebral arterial stenosis can cause cerebral hypoperfusion, and than result in the decline of cognitive function, whereas the cognitive dysfunction induced by different cerebral arterial stenosis have different manifestations and types.OBJECTIVE: To observe the differences of cognitive and memory dysfunctions in patients with cerebral arterial stenosis of different types.DESIGN: A comparative observation.SETTING: Affiliated Hospital of Jining Medical College.PARTICIPANTS: Forty-two outpatients or inpatients with cerebral arterial stenosis were selected from the Department of Neurology, Affiliated Hospital of Jining Medical College from February 2005 to January 2006,including 25 males and 17 females. There were 18 cases of internal carotid arterial stenosis, 14 cases of vertebrobasilar arterial stenosis and 10 cases of whole cerebral arterial stenosis. The diagnostic standards for cerebral arterial stenosis were identified according to North American Symptomatic Carotid Endarterectomy Trial (NAS CET). Meanwhile, 18 healthy physical examinees were enrolled as the control group, including 10males and 8 females, aged 58-80 years old. All the enrolled subjects were informed and agreed with the detection and evaluation.METHODS: ① The memory function was evaluated using revised Wechsler memory scale for adults, including long-term memory (experience, orientation and counting), short-term memory (visual recognition, picture memory, visual regeneration, association and thigmesthesia) and sensory memory (forward and backward recitation of numbers). The scale scores were turned to memory quotients. The higher the scores, the better the memory function. ② The cognitive function was evaluated using revised Wechsler adult intelligence scale:It consisted of eleven subtests, including six language scales (information, digit span, vocabulary, arithmetics,apprehension, similarity) and five operation scales (picture completion, picture arrangement, block design

  2. Arachidonic Acid and Cerebral Ischemia Risk: A Systematic Review of Observational Studies

    Directory of Open Access Journals (Sweden)

    Mai Sakai

    2014-11-01

    Full Text Available Background: Arachidonic acid (ARA is a precursor of various lipid mediators. ARA metabolites such as thromboxane A2 cause platelet aggregation and vasoconstriction, thus may lead to atherosclerotic disease. It is unclear whether dietary ARA influences the ARA-derived lipid mediator balance and the risk for atherosclerotic diseases, such as cerebral ischemia. Considering the function of ARA in atherosclerosis, it is reasonable to focus on the atherothrombotic type of cerebral ischemia risk. However, no systematic reviews or meta-analyses have been conducted to evaluate the effect of habitual ARA exposure on cerebral ischemia risk. We aimed to systematically evaluate observational studies available on the relationship between ARA exposure and the atherothrombotic type of cerebral ischemia risk in free-living populations. Summary: The PubMed database was searched for articles registered up to June 24, 2014. We designed a PubMed search formula as follows: key words for humans AND brain ischemia AND study designs AND ARA exposure. Thirty-three articles were reviewed against predefined criteria. There were 695 bibliographies assessed from the articles that included both ARA and cerebral ischemia descriptions. Finally, we identified 11 eligible articles and categorized them according to their reporting and methodological quality. We used the Strengthening the Reporting of Observational Studies in Epidemiology Statement (STROBE checklist to score the reporting quality. The methodological quality was qualitatively assessed based on the following aspects: subject selection, ARA exposure assessment, outcome diagnosis, methods for controlling confounders, and statistical analysis. We did not conduct a meta-analysis due to the heterogeneity among the studies. All eligible studies measured blood ARA levels as an indicator of exposure. Our literature search did not identify any articles that evaluated dietary ARA intake and tissue ARA as assessments of

  3. 脑瘫儿童选择性脊神经后根切断术术前爬行能力与术后下肢功能改善的关联分析%Predictive value of crawling ability for prognostication of the functional amelioration of children with cerebral palsy after selective posterior rhizotomy

    Institute of Scientific and Technical Information of China (English)

    易斌; 徐林; 洪毅; 俞兴; 王兵; 郑大滨

    2001-01-01

    Objective: To investigate functional changes of lower extremities after selective posterior rhizotomy, and to evaluate the value of crawling ability as a predictor of walking postoperatively. Method: To observe the function of lower limbs with quantitative functional measurement, and analyze the relation between walk ability after SPR and preoperative crawling stage. Result: (1)Muscle tone was significantly decreased, and the development of function of lower limbs was obvious. (2) The achievement was progressing in 1-year and 2-year follow-up groups. ( 3 ) The ability of crawling was closely related with walk ability after SPR. Conclusion:SPR decreases spasticity and increases lower extremity range of motion in children with cerebral palsy and appears to be associated with functional improvements. The ability of crawling is a predictive reference of ability to walk after selective posterior rhizotomy.%目的:分析术前爬行能力与术后下肢功能,特别是独立行走能力的关系。方法:以量化功能的方式评估选择性脊神经后根切断术(SPR)后下肢功能,将爬行功能分为A-D 4个等级,同时将下肢功能分别量化,观察各级患儿手术前、后的功能变化,并统计分析手术前、后功能差异。结果:脑瘫患者SPR术后肌张力明显降低,下肢各项功能显著改善;术前爬行能力良好的患儿术后下肢各项功能及独立行走与爬行能力差的患者有显著性差异。结论:术前评估爬行能力对判断手术预后具有参考价值。

  4. Simultaneous Endovascular Treatment of Ruptured Cerebral Aneurysms and Vasospasm

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Dae; Han, Moon Hee; Kang, Hyun Seung; Kim, Jeong Eun [Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of); Ahn, Jun Hyoung [Dept. of Neurosurgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang (Korea, Republic of); Jung, Seung Chai [Dept. of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Chang Hun [Dept. of Neurology, Stroke Center, Myongji Hospital, Goyang (Korea, Republic of); Lim, Jeong Wook [Dept. of Neurosurgery, Sun Hospital, Daejeon (Korea, Republic of)

    2015-02-15

    The management of patients with ruptured cerebral aneurysms and severe vasospasm is subject to considerable controversy. We intended to describe herein an endovascular technique for the simultaneous treatment of aneurysms and vasospasm. A series of 11 patients undergoing simultaneous endovascular treatment of ruptured aneurysms and vasospasm were reviewed. After placement of a guiding catheter within the proximal internal carotid artery for coil embolization, an infusion line of nimodipine was wired to one hub, and of a microcatheter was advanced through another hub (to select and deliver detachable coils). Nimodipine was then infused continuously during the coil embolization. This technique was applied to 11 ruptured aneurysms accompanied by vasospasm (anterior communicating artery, 6 patients; internal carotid artery, 2 patients; posterior communicating and middle cerebral arteries, 1 patient each). Aneurysmal occlusion by coils and nimodipine-induced angioplasty were simultaneously achieved, resulting in excellent outcomes for all patients, and there were no procedure-related complications. Eight patients required repeated nimodipine infusions. Our small series of patients suggests that the simultaneous endovascular management of ruptured cerebral aneurysms and vasospasm is a viable approach in patients presenting with subarachnoid hemorrhage and severe vasospasm.

  5. Role of cerebral blood flow in extreme breath holding

    Directory of Open Access Journals (Sweden)

    Bain Anthony R.

    2016-01-01

    Full Text Available The role of cerebral blood flow (CBF on a maximal breath-hold (BH in ultra-elite divers was examined. Divers (n = 7 performed one control BH, and one BH following oral administration of the non-selective cyclooxygenase inhibitor indomethacin (1.2 mg/kg. Arterial blood gases and CBF were measured prior to (baseline, and at BH termination. Compared to control, indomethacin reduced baseline CBF and cerebral delivery of oxygen (CDO2 by about 26% (p < 0.01. Indomethacin reduced maximal BH time from 339 ± 51 to 319 ± 57 seconds (p = 0.04. In both conditions, the CDO2 remained unchanged from baseline to the termination of apnea. At BH termination, arterial oxygen tension was higher following oral administration of indomethacin compared to control (4.05 ± 0.45 vs. 3.44 ± 0.32 kPa. The absolute increase in CBF from baseline to the termination of apnea was lower with indomethacin (p = 0.01. These findings indicate that the impact of CBF on maximal BH time is likely attributable to its influence on cerebral H+ washout, and therefore central chemoreceptive drive to breathe, rather than to CDO2.

  6. Fatal cerebral oedema in adult diabetic ketoacidosis.

    NARCIS (Netherlands)

    Haringhuizen, A.; Tjan, D.H.; Grool, A.; Vugt, R. van; Zante, A.R. van

    2010-01-01

    In this report, a case of adult onset fatal cerebral oedema as a rare complication of diabetic ketoacidosis (DKA) is described and confirmed at post-mortem pathological examination. The pathogenesis of cerebral oedema due to DKA is still unknown. Potential mechanisms include the administration of so

  7. Sumatriptan and cerebral perfusion in healthy volunteers.

    Science.gov (United States)

    Scott, A K; Grimes, S; Ng, K; Critchley, M; Breckenridge, A M; Thomson, C; Pilgrim, A J

    1992-04-01

    1. The effect of sumatriptan on regional cerebral perfusion was studied in healthy volunteers. 2. Intravenous sumatriptan (2 mg) had no detectable effect on regional cerebral perfusion as measured using a SPECT system with 99technetiumm labelled hexemethylpropyleneamineoxime. 3. Sumatriptan had no effect on pulse, blood pressure or ECG indices. 4. All six volunteers experienced minor adverse effects during the intravenous infusion.

  8. Cerebral blood flow response to functional activation

    DEFF Research Database (Denmark)

    Paulson, Olaf B; Hasselbalch, Steen G; Rostrup, Egill

    2010-01-01

    Cerebral blood flow (CBF) and cerebral metabolic rate are normally coupled, that is an increase in metabolic demand will lead to an increase in flow. However, during functional activation, CBF and glucose metabolism remain coupled as they increase in proportion, whereas oxygen metabolism only...

  9. Cerebral emboli and depressive symptoms in dementia.

    NARCIS (Netherlands)

    Purandare, N.; Oude Voshaar, R.C.; Hardicre, J.; Byrne, J.; McCollum, C.N.; Burns, A.

    2006-01-01

    BACKGROUND: The vascular depression hypothesis and our recent findings of increased frequency of spontaneous cerebral emboli in dementia suggest that such emboli may be involved in the causation of depressive symptoms in dementia. AIMS: To evaluate the association between spontaneous cerebral emboli

  10. Multiple cerebral aneurysms of middle cerebral artery. Case report

    Directory of Open Access Journals (Sweden)

    D.A. Nica1, Tatiana Rosca1, A. Dinca2, M. Stroi3, Mirela Renta4, A.V. Ciurea5

    2010-11-01

    Full Text Available Multiple cerebral aneurysms present awide variation in incidence with averages of13% at angiographic studies and 22.7% atautopsy.High blood pressue, cigarette smoking,stress and possible also age and female sexseem to be risk factors for multipleintracranial aneurysms (MIAn in patientsof working age who have suffered asubarachnoid hemorrhage (SAH.Aneurysms were situated on the same sidein one-third of the patients with twoaneurysms and the most common site wasthe middle cerebral artery (MCA. Tomanage these challenging lesionsneurosurgeons must use all availableinnovations and advances, includingdiagnostic, technical and perioperativeadjuncts. The author presents a case ofmiddle age female, with two saccularaneurysms situated on the same side (rightMCA, who was operated in our clinic, 20days after first SAH episode, I grade onHunt/Hess scale. The angio MRI wasperformed before, and control DSangiography after operation. After pterionalapproach, the author used themagnification, microsurgical technics,temporal clip, and two permanent Yasargilcurved clips. A postoperative good recoveryenable the patient go to work and drive onemonth later.

  11. Rhinomaxillary mucormycosis with cerebral extension

    Directory of Open Access Journals (Sweden)

    Goel Shikha

    2009-01-01

    Full Text Available 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.

  12. Cerebral salt wasting syndrome: review.

    Science.gov (United States)

    Cerdà-Esteve, M; Cuadrado-Godia, E; Chillaron, J J; Pont-Sunyer, C; Cucurella, G; Fernández, M; Goday, A; Cano-Pérez, J F; Rodríguez-Campello, A; Roquer, J

    2008-06-01

    Hyponatremia is the most frequent electrolyte disorder in critically neurological patients. Cerebral salt wasting syndrome (CSW) is defined as a renal loss of sodium during intracranial disease leading to hyponatremia and a decrease in extracellular fluid volume. The pathogenesis of this disorder is still not completely understood. Sympathetic responses as well as some natriuretic factors play a role in this syndrome. Distinction between SIADH and CSW might be difficult. The essential point is the volemic state. It is necessary to rule out other intermediate causes. Treatment requires volume replacement and maintenance of a positive salt balance. Mineral corticoids may be useful in complicated cases.

  13. Cerebral oximetry in cardiac anesthesia

    Science.gov (United States)

    Vretzakis, George; Georgopoulou, Stauroula; Stamoulis, Konstantinos; Stamatiou, Georgia; Tsakiridis, Kosmas; Katsikogianis, Nikolaos; Kougioumtzi, Ioanna; Machairiotis, Nikolaos; Tsiouda, Theodora; Mpakas, Andreas; Beleveslis, Thomas; Koletas, Alexander; Siminelakis, Stavros N.; Zarogoulidis, Konstantinos

    2014-01-01

    Cerebral oximetry based on near-infrared spectroscopy (NIRS) is increasingly used during the perioperative period of cardiovascular operations. It is a noninvasive technology that can monitor the regional oxygen saturation of the frontal cortex. Current literature indicates that it can stratify patients preoperatively according their risk. Intraoperatively, it provides continuous information about brain oxygenation and allows the use of brain as sentinel organ indexing overall organ perfusion and injury. This review focuses on the clinical validity and applicability of this monitor for cardiac surgical patients. PMID:24672700

  14. CT findings in patients with cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Konno, K. (Akita Univ. (Japan))

    1982-01-01

    Clinical findings and CT findings in 73 cases of cerebral palsy were studied. The causes of cerebral palsy were presumed to be as follows: abnormal cerebral development (36%), asphyxial delivery (34%), and immature delivery (19%), etc. CT findings were abnormal in 58% of the 73 cases, 83% of the spastic tetraplegia patients and all of the spastic hemiplegia patients showed abnormal CT findings. All the patients with spastic monoplegia presented normal CT findings. In 75% of the spastic hemiplegia cases, the CT abnormalities were due to cerebral parenchymal abnormality such as porencephaly and regional low absorption. In cases of spastic tetraplegia, cerebral parenchymal abnormality was found only in 10%. Cortical atrophy was found only in 15 of the 73 cases, whereas central atrophy was found in 36 cases.

  15. Cerebral hemodynamics: concepts of clinical importance

    Directory of Open Access Journals (Sweden)

    Edson Bor-Seng-Shu

    2012-05-01

    Full Text Available Cerebral hemodynamics and metabolism are frequently impaired in a wide range of neurological diseases, including traumatic brain injury and stroke, with several pathophysiological mechanisms of injury. The resultant uncoupling of cerebral blood flow and metabolism can trigger secondary brain lesions, particularly in early phases, consequently worsening the patient's outcome. Cerebral blood flow regulation is influenced by blood gas content, blood viscosity, body temperature, cardiac output, altitude, cerebrovascular autoregulation, and neurovascular coupling, mediated by chemical agents such as nitric oxide (NO, carbon monoxide (CO, eicosanoid products, oxygen-derived free radicals, endothelins, K+, H+, and adenosine. A better understanding of these factors is valuable for the management of neurocritical care patients. The assessment of both cerebral hemodynamics and metabolism in the acute phase of neurocritical care conditions may contribute to a more effective planning of therapeutic strategies for reducing secondary brain lesions. In this review, the authors have discussed concepts of cerebral hemodynamics, considering aspects of clinical importance.

  16. Digital subtraction angiography of the cerebral vessels by intraarterial injection

    Energy Technology Data Exchange (ETDEWEB)

    Nagata, Izumi; Kikuchi, Haruhiko; Karasawa, Jun; Mitsugi, Toru; Naruo, Yoshito; Takamiya, Makoto (National Cardiovascular Center, Suita, Osaka (Japan))

    1984-10-01

    Three hundred and fifty-seven digital subtraction angiography (DSA) were performed in 184 neurosurgical patients by intraarterial injection. Examinations consisted of 192 carotid angiography, 110 vertebral angiography, 23 aortography, 11 spinal angiography and 21 other angiography. In all examinations, visualization of the vessels was excellent and the complications were never experienced. High contrast sensitivity of DSA resulted in better visualization of tumor stains, phlebogram, and arteries in cerebral arteriovenous malformations with large shunt blood flow than conventional angiography. Selective catheterization into each cerebral arteries was not necessarily demanded for good opacification of the vessels because of high sensitivity. High contrast sensitivity also permitted low concentration of contrast material, small dose of contrast material, and slow injection rate. Low concentration of contrast material reduced pain and heat during injection especially in the external carotid and vertebral angiography. Using slow injection, recoiling of catheter into the aorta was reduced, so that injection from the innominate and subclavian arteries for visualization of origin of the cerebral arteries were always successful. Full study of cerebral arteries by Seldinger's method, if necessary, was easily achieved using DSA even in patient with high age or with severe atherosclerosis. Bolus injection of small dose of contrast material as well as serial imaging was helpful in evaluating hemodynamics in the lesion. Real time display of DSA reduced the time required for angiography and was very convenient for artificial embolization. Besides these advantages, DSA became comparable to conventional angiography in spacial resolution by use of intraarterial injection and could be a preoperative genuine examination as well as a screening method.

  17. Effect of Maixuekang enteric coated tablets on absorption of hematoma and treatment of acute cerebral hemorrhage patients with cerebral edema

    Institute of Scientific and Technical Information of China (English)

    Bing-Ding Lu; Chuan Wang

    2016-01-01

    Objective:To study the clinical efficacy of Maixuekang in treating acute cerebral hemorrhage hematomas and promoting brain hemorrhage.Methods: A total of 192 patients with acute intracerebral hemorrhage treated within 3 hours in our hospital during April 2013 to February 2015 were selected. After admission immediately apply brain CT, blood, coagulation function tests were carried out. They were randomly divided into 2 groups. Both groups had anti-infective, mannitol and other conventional treatment. Observation group were treated with enteric-coated tablets Maixuekang on this basis. Clinical efficacy, various stages of treatment of cerebral hematoma volume, brain edema volume, NIHSS score were compared.Results: Before treatment, difference in edema volume and HIHSS scores were not statistically significant (P>0.05). After14 d and 28 d treatment, edema volume of observation group were significantly smaller than those of control group (P<0.01); NIHSS score of observation group were significantly lower than those of control group (P<0.01); 28 d after treatment total effective rate of observation group was significantly higher than that of the control group (P<0.01).Conclusions:Maixuekang enteric-coated tablets as a thrombin inhibitor, can effectively reduce a series of pathological changes after acute cerebral hemorrhage caused by partial thrombin content, promote absorption of hematoma and neurological recovery. The side effects is small, safe and worthy of promotion.

  18. Aneurysmal re-rupture during selective cerebral angiography

    Energy Technology Data Exchange (ETDEWEB)

    Zaehringer, Markus; Gossmann, Axel; Krueger, Karsten; Trenschel, Gertrud; Landwehr, Peter [Department of Radiology, University of Cologne, Joseph-Stelzmann-Strasse 9, 50924 Cologne (Germany); Wedekind, Christoph [Department of Neurosurgery, University of Cologne, Joseph-Stelzmann-Strasse 9, 50924 Cologne (Germany)

    2002-07-01

    Two cases of aneurysmal re-rupture during intracranial angiography are presented. This event is accompanied by disastrous consequences with regard to the clinical condition of the patient, as is evident from the cases presented as well as from the literature. Acute alterations of intraluminal pressure as well as a time interval of less than 6 h seems to increase the risk of re-bleeding during angiography. The introduction of and the growing experience with CT and MR angiography may in the near future provide sufficient diagnostic information for surgical planning and thus help to overcome the risk of aneurysmal re-rupture during intra-arterial angiography. (orig.)

  19. Cerebral Laterality and Handedness in Aviation: Performance and Selection Implications

    Science.gov (United States)

    1989-01-01

    paper. Pat Sanner provided valuable input regarding the laterality of horses , and Kevin Mason helped In testing various right brain functions. Harold...they were collected strays (253). Other examples of non-random behavioral asymmetry are apparent. Denel and Lawrence reported that horses show a strong...remodelling may have a price, however, as the restructured brain may be predisposed to autism or dyslexia (80). Geschwind et al. reported two cases in

  20. Does Intellectual Disability Affect the Development of Dental Caries in Patients with Cerebral Palsy?

    Science.gov (United States)

    Moreira, Rafaela Nogueira; Alcantara, Carlos Eduardo Pinto; Mota-Veloso, Isabella; Marinho, Sandra Aparecida; Ramos-Jorge, Maria L.; Oliveira-Ferreira, Fernanda

    2012-01-01

    The aim of this study was to evaluate if the severity of intellectual disability is a factor that affects the development of dental cavities in patients with cerebral palsy. This cross-sectional study was conducted on 165 individuals who were selected from a physical rehabilitation center, a special public school and a regular public school. Of…

  1. Predicting Speech Intelligibility with a Multiple Speech Subsystems Approach in Children with Cerebral Palsy

    Science.gov (United States)

    Lee, Jimin; Hustad, Katherine C.; Weismer, Gary

    2014-01-01

    Purpose: Speech acoustic characteristics of children with cerebral palsy (CP) were examined with a multiple speech subsystems approach; speech intelligibility was evaluated using a prediction model in which acoustic measures were selected to represent three speech subsystems. Method: Nine acoustic variables reflecting different subsystems, and…

  2. Cerebral cortex modulation of pain

    Institute of Scientific and Technical Information of China (English)

    Yu-feng XIE; Fu-quan HUO; Jing-shi TANG

    2009-01-01

    Pain is a complex experience encompassing sensory-discriminative, affective-motivational and cognitiv e-emotional com-ponents mediated by different mechanisms. Contrary to the traditional view that the cerebral cortex is not involved in pain perception, an extensive cortical network associated with pain processing has been revealed using multiple methods over the past decades. This network consistently includes, at least, the anterior cingulate cortex, the agranular insular cortex, the primary (SⅠ) and secondary somatosensory (SⅡ) cortices, the ventrolateral orbital cortex and the motor cortex. These corti-cal structures constitute the medial and lateral pain systems, the nucleus submedius-ventrolateral orbital cortex-periaque-ductal gray system and motor cortex system, respectively. Multiple neurotransmitters, including opioid, glutamate, GABA and dopamine, are involved in the modulation of pain by these cortical structures. In addition, glial cells may also be in-volved in cortical modulation of pain and serve as one target for pain management research. This review discusses recent studies of pain modulation by these cerebral cortical structures in animals and human.

  3. Modifying the effects of cerebral palsy: the Gregg Mozgala story.

    Science.gov (United States)

    Chaitow, Leon; Rogoff, Tamar; Mozgala, Gregg; Chmelik, Stefan; Comeaux, Zachary; Hannon, John; Lederman, Eyal; Myers, Tom

    2010-04-01

    In response to a news report of the rehabilitation of a New York-based dancer/actor with cerebral palsy, to the point where a ballet performance was scheduled, it was determined that a report based on the individuals involved would be commissioned. The resulting reports from the choreographer responsible for the rehabilitation exercises, and the dancer, were circulated to an interdisciplinary selection of physical medicine experts, for commentary as to what clinicians might learn from the case, and what mechanisms might be involved.

  4. Preliminary study of novel, timed walking tests for children with spina bifida or cerebral palsy

    Science.gov (United States)

    Kane, Kyra J; Lanovaz, Joel; Bisaro, Derek; Oates, Alison; Musselman, Kristin E

    2016-01-01

    Objective: Walking assessment is an important aspect of rehabilitation practice; yet, clinicians have few psychometrically sound options for evaluating walking in highly ambulatory children. The purpose of this study was to evaluate the validity and reliability of two new measures of walking function—the Obstacles and Curb tests—relative to the 10-Meter Walk test and Timed Up and Go test in children with spina bifida or cerebral palsy. Methods: A total of 16 ambulatory children with spina bifida (n=9) or cerebral palsy (n=7) (9 boys; mean age 7years, 7months; standard deviation 3years, 4months) and 16 age- and gender-matched typically developing children participated. Children completed the walking tests, at both self-selected and fast speeds, twice. To evaluate discriminative validity, scores were compared between typically developing and spina bifida/cerebral palsy groups. Within the spina bifida/cerebral palsy group, inter-test correlations evaluated convergent validity and intraclass correlation coefficients evaluated within-session test–retest reliability. Results: At fast speeds, all tests showed discriminative validity (p<0.006 for typically developing and spina bifida/cerebral palsy comparisons) and convergent validity (rho=0.81–0.90, p⩽0.001, for inter-test correlations). At self-selected speeds, only the Obstacles test discriminated between groups (p=0.001). Moderately strong correlations (rho=0.73–0.78, p⩽0.001) were seen between the 10-Meter Walk test, Curb test, and Timed Up and Go test. Intraclass correlation coefficients ranged from 0.81 to 0.97, with higher test–retest reliability for tests performed at fast speeds rather than self-selected speeds. Conclusion: The Obstacles and Curb tests are promising measures for assessing walking in this population. Performing tests at fast walking speeds may improve their validity and test–retest reliability for children with spina bifida/cerebral palsy. PMID:27493754

  5. Cerebral blood flow tomography with xenon-133

    Energy Technology Data Exchange (ETDEWEB)

    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.

  6. Cerebral palsy: definition, assessment and rehabilitation.

    Science.gov (United States)

    Richards, Carol L; Malouin, Francine

    2013-01-01

    Over the last 25 years the definition and classification of cerebral palsy (CP) have evolved, as well as the approach to rehabilitation. CP is a disorder of the development of movement and posture, causing activity limitations attributed to nonprogressive disturbances of the fetal or infant brain that may also affect sensation, perception, cognition, communication, and behavior. Motor control during reaching, grasping, and walking are disturbed by spasticity, dyskinesia, hyperreflexia, excessive coactivation of antagonist muscles, retained developmental reactions, and secondary musculoskeletal malformations, together with paresis and defective programing. Weakness and hypoextensibility of the muscles are due not only to inadequate recruitment of motor units, but also to changes in mechanical stresses and hormonal factors. Two methods, the General Movements Assessment and the Test of Infant Motor Performance, now permit the early detection of CP, while the development of valid and reliable outcome measures, particularly the Gross Motor Function Measure (GMFM), have made it possible to evaluate change over time and the effects of clinical interventions. The GMFM has further led to the development of predictive curves of motor function while the Gross Motor Classification System and the Manual Ability Classification System provide standardized means to classify the severity of the movement disability. With the emergence of the task-oriented approach, the focus of therapy in rehabilitation has shifted from eliminating deficits to enhancing function across all performance domains by emphasizing fitness, function, participation, and quality of life. There is growing evidence supporting selected interventions and interest for the therapy and social integration of adults with CP.

  7. Establishment of a rhesus monkey model of middle cerebral artery ischemia and reperfusion using a microcatheter embolization method

    Institute of Scientific and Technical Information of China (English)

    Jie Yang; Xiaoqi Huang; Hongxia Li; Li Wang; Jingqiu Cheng; Jian Guo; Hongbo Zheng; Muke Zhou; Li He; Wenying Cao; Li Xiao; Jiachuan Duan; Qiyong Gong

    2010-01-01

    Nonhuman primates are closest to humans in terms of lineage,and middle cerebral artery ischemia/reperfusion responses of nonhuman primates are most similar to ischemic stroke in humans.Therefore,nonhuman primates could be utilized to simulate the process of ischemic stroke in the human.Few studies,however,have reported the use of endovascular technology to establish a rhesus monkey stroke model.In the present study,seven adult,male,rhesus monkeys were selected and,following anesthesia,a microcatheter was inserted into one side of the middle cerebral artery via the femoral artery to block blood flow,thereby resulting in middle cerebral artery occlusion.After 2 hours,the microcatheter was withdrawn to restore the middle cerebral artery blood flow and to establish ischemia/reperfusion.Results from angiography and magnetic resonance angiography confirmed occlusion and reopening of the middle cerebral artery.Magnetic resonance imaging revealed the existence of ischemic brain lesions,and neurological examination showed sustained functional deficits following surgery.The rhesus monkey middle cerebral artery ischemia/reperfusion models established by microcatheter embolization had the advantage of non—craniotomy invasion and reproducibility.The scope and degree of ischemic damage using this model was controllable.Therefore,this nonhuman primate model is an ideal model for cerebral ischemia and reperfusion.

  8. Aerobic training in children with cerebral palsy.

    Science.gov (United States)

    Nsenga, A L; Shephard, R J; Ahmaidi, S; Ahmadi, S

    2013-06-01

    Rehabilitation is a major goal for children with cerebral palsy, although the potential to enhance cardio-respiratory fitness in such individuals remains unclear. This study thus compared current cardio-respiratory status between children with cerebral palsy and able-bodied children, and examined the ability to enhance the cardio-respiratory fitness of children with cerebral palsy by cycle ergometer training. 10 children with cerebral palsy (Gross Motor Function Classification System levels I and II) participated in thrice-weekly 30 min cycle ergometer training sessions for 8 weeks (mean age: 14.2±1.9 yrs). 10 additional subjects with cerebral palsy (mean age: 14.2±1.8 yrs) and 10 able-bodied subjects (mean age: 14.1±2.1 yrs) served as controls, undertaking no training. All subjects undertook a progressive cycle ergometer test of cardio-respiratory fitness at the beginning and end of the 8-week period. Cardio-respiratory parameters [oxygen intake V˙O2), ventilation V ˙ E) and heart rate (HR)] during testing were measured by Cosmed K4 b gas analyzer. The children with cerebral palsy who engaged in aerobic training improved their peak oxygen consumption, heart rate and ventilation significantly (pchildren with cerebral palsy can benefit significantly from cardio-respiratory training, and such training should be included in rehabilitation programs.

  9. Cerebral blood flow in the neonate.

    Science.gov (United States)

    Vutskits, Laszlo

    2014-01-01

    Ensuring adequate oxygenation of the developing brain is the cornerstone of neonatal critical care. Despite decades of clinical research dedicated to this issue of paramount importance, our knowledge and understanding regarding the physiology and pathophysiology of neonatal cerebral blood flow are still rudimentary. This review primarily focuses on currently available human clinical and experimental data on cerebral blood flow and autoregulation in the preterm and term infant. Limitations of systemic blood pressure values as surrogates for monitoring adequate cerebral oxygen delivery are discussed. Particular emphasis is placed on the high interindividual variability in cerebral blood flow values, vasoreactivity, and autoregulatory thresholds making the applications of normative values highly questionable. Technical and ethical difficulties to conduct such trials leave us with a near complete lack of knowledge on how pharmacological and surgical interventions impact on cerebral autoregulation. The ensemble of these works argues for the necessity of highly individualized care by taking advantage of continuous bedside monitoring of cerebral circulation. They also point to the urgent need for further studies addressing the exciting but difficult issue of cerebral blood flow autoregulation in the neonate.

  10. Prenatal Exposure to Perfluoroalkyl Substances and the Risk of Congenital Cerebral Palsy in Children

    DEFF Research Database (Denmark)

    Liew, Zeyan; Ritz, Beate; Bonefeld-Jørgensen, Eva Cecilie;

    2014-01-01

    Perfluoroalkyl substances (PFASs) are persistent pollutants and endocrine disruptors that may affect fetal brain development. We investigated whether prenatal exposure to PFASs increases the risk of congenital cerebral palsy (CP). The source population for this study includes 83,389 liveborn...... singletons and mothers enrolled in the Danish National Birth Cohort during 1996-2002. We identified 156 CP cases by linking the cohort to the Danish National Cerebral Palsy Register, and we randomly selected 550 controls using a case-cohort design. We measured 16 PFASs in maternal plasma collected in early...

  11. Inhibitory and excitatory amino acids in the cerebrospinal fluid of children with two types of cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    Haibin Yuan; Li Wang; Fei Yin; Li Li; Jing Peng

    2008-01-01

    BACKGROUND: Under normal conditions, excitatory amino acids are dynamically balanced with inhibitory amino acids. Excitatory amino acids have been implicated in perinatal brain injury. OBJECTIVE: To investigate differences in the levels of the excitatory amino acids glutamic acid and aspartic acid, and the inhibitory amino acid gamma-aminobutyric acid (GABA) in the cerebrospinal fluid (CSF) of children with spastic cerebral palsy or athetotic cerebral palsy. DESIGN, TIME AND SETTING: Case-control exploratory observation of neurotransmitter in patients. The experiment was performed in the Pediatrics Department of the Second Affiliated Hospital of Changsba Medical College, the Cerebral Palsy Center of Xiangtan Affiliated Hospital of South China University and the Pediatrics Department of Xiangya Hospital, between February 2006 and May 2007. PARTICIPANTS: We selected 27 children with cerebral palsy, including 13 with spastic cerebral palsy and 14 with athetotic cerebral palsy. We selected 10 patients who were not affected by any neurological disease as controls. METHODS: Two mL blood-free CSF was harvested between the third and fourth lumbar vertebrae of each patient after anesthesia, and stored at 70℃. One mL CSF was mixed with 10 mg sulfosalicylic acid and placed in ice-bath for 10 minutes, then centrifuged 2 000 g for 10 minutes. The supernatant was collected for amino acid quantitation. MAIN OUTCOME MEASURES: The concentrations of glutamic acid, aspartic acid and GABA in the CSF were determined by high-performance liquid chromatography and fluorometric method. The correlation of glutamie acid, aspartic acid and GABA levels with muscular tension in children with cerebral palsy was analyzed using linear dependence. RESULTS: The concentration of GABA was significantly lower in both spastic cerebral palsy and athetotic cerebral palsy patients than in the control group (P 0.05). CONCLUSION: Spastic cerebral palsy and athetotic cerebral palsy patients exhibit an

  12. Validation of a cerebral palsy register

    DEFF Research Database (Denmark)

    Topp, Monica Wedell; Langhoff-Roos, J; Uldall, P

    1997-01-01

    OBJECTIVES: To analyse completeness and validity of data in the Cerebral Palsy Register in Denmark, 1979-1982. METHODS: Completeness has been assessed by comparing data from The Danish National Patient Register (DNPR) with the cases included in the Cerebral Palsy Register (CPR). Agreement between......, but gestational age was subject to a systematic error, and urinary infections in pregnancy (kappa = 0.43) and placental abruption (kappa = 0.52) were seriously under-reported in the CPR. CONCLUSIONS: Completeness of the Cerebral Palsy Register in Denmark, 1979-1982, has been assessed to maximal 85%, emphasizing...

  13. Cerebral blood flow and metabolism during sleep

    DEFF Research Database (Denmark)

    Madsen, Peter Lund; Vorstrup, S

    1991-01-01

    investigations seem to identify site-specific changes in regional CBF and CMR during REM sleep. CBF and CMR are reflections of cerebral synaptic activity and the magnitude of reduction in these variables associated with deep sleep indicates that overall cerebral synaptic activity is reduced to approximately one......-half the level associated with wakefulness, while cerebral synaptic activity levels during REM sleep are similar to wakefulness. However, even though the new understanding of CBF and CMR during sleep provides significant and important information of the brain's mode of working during sleep, it does not at its...

  14. The serpentine mitral valve and cerebral embolism

    Directory of Open Access Journals (Sweden)

    Ker James

    2011-02-01

    Full Text Available Abstract Valvular strands, well-delineated filiform masses, attached to cardiac valve edges are associated with cerebral embolism and stroke. Strokes, caused by emboli from valvular strands, tend to occur among younger persons. In this case report a valvular strand, giving a peculiar serpentine appearance to the mitral valve is described. This mitral valvular strand was the only explanation for an episode of cerebral embolism, presenting with a transient right sided hemiparesis. It is proposed that a randomized study involving combined treatment with aspirin and clopidogrel is warranted in young patients with valvular strands, presenting with a first episode of cerebral embolism.

  15. Dihydralazine induces marked cerebral vasodilation in man

    DEFF Research Database (Denmark)

    Schroeder, T; Sillesen, H

    1987-01-01

    Dihydralazine is widely used for acute control of hypertension. In experimental studies it seems to dilate cerebral resistance vessels and increase intracranial pressure. However, the effect on cerebral blood flow (CBF) in man has been little studied. Measurements of CBF were performed with the i...... the period of study, in median 16, 27 and 23% at the three periods of measurements, respectively. The arterial blood pressure remained unchanged, whereas heart rate increased significantly. During CO2 inhalation, CBF increased on average 29%. Thus, the cerebral vasodilation exerted by a small i.v. dose...

  16. Association of apolipoprotein E 4 polymorphism with cerebral infarction in Chinese Han population

    Institute of Scientific and Technical Information of China (English)

    Zhu-qing JIN; Wei-feng JI; Jian-gang ZHANG; Yong-sheng FAN; Jing DING; Mei CHEN; Wei FAN; Guang-ji ZHANG; Bin-hui ZHANG; Suo-jing YU; Yong-sheng ZHANG

    2004-01-01

    AIM: To study the association between APOE polymorphisms and cerebral infarction through a case-control study among the Chinese Han population. METHODS: First-ever cerebral infarction patients (n=226) whose ages ranged from 40 to 60 years old were recruited from Department of Neurology, Zhongshan Hospital, Shanghai, and Zhejiang Chinese Traditional Medicine Hospital, Zhejiang, China. Unrelated healthy controls (n=201) were selected from the general population in the same area with similar age and sex distribution. APOE was amplified by one-stage PCR using the forward primer: 5'-GGC ACG GCT GTC CAA GGA GCT-3' and reverse primer: 5'-GAT GGC GCT GAG GCC GCG CT-3'. The PCR product was digested directly with 5 U of CfoI and separated by a 20 % polyacrylamide (acrylamide: bis-acrylamide=29:1) nondenaturing gel. RESULTS: Both cerebral infarction patient and control groups were in Hardy-Weinberg equilibrium. The allele frequency ofAPOE*2, APOE*3, and APOE*4 was 4.6 %,81.9 %, and 13.5 % respectively in the patients with cerebral infarction; 5.7 %, 87.3 %, and 7.0 % respectively in the healthy control group. Compared with APOE3/3 subjects, APOE4/4 carriers had a 2.1-fold risk of cerebral infarction (odds ratio 2.1, 95 % confidence limits 1.3 to 3.4). The allele frequency of APOE*4 in the cerebral infarction patient group was significantly higher than that in the control group (13.5 % vs 7.0 %; P=0.002).CONCLUSION: APOE 4 is a risk factor for cerebral infarction among the Chinese Han population.

  17. Plasma thrombomodulin changes in acute cerebral infarction or hypertension patients An observation for verification

    Institute of Scientific and Technical Information of China (English)

    Pu Feng; Hui Zhang; Bingyi Yang; Yonggang Zheng; Jinhui Xie; Ying Wang; Jinchuan Li

    2008-01-01

    BACKGROUND: Thrombomodulin concentration greatly increases in plasma when vascular endothelial cells are injured, and it is one of the specific molecular markers for endothelial injury.OBJECTIVE: To analyze the plasma levels of thrombomodulin after cerebral infarction or hypertension, and to compare levels with those from healthy control subjects.DESIGN: A case-controlled observation. SETTING: Yuquan Hospital of Tsinghua University.PARTICIPANTS: Patients with hypertension (n = 37) and acute cerebral infarction (n = 26) were selected from the outpatient and inpatient Department of Neurology, Yuquan Hospital of Tsinghua University from February 2003 to February 2006. The cerebral infarction group consisted of 24 males and 2 females, 36–77 years of age, with a mean age of 62 years. All patients fulfilled the diagnosis criteria for cerebral infarction, according to the diagnostic standards revised by the Second National Academic Meeting for Cerebrovascular Disease, and were confirmed by CT or MRI. The hypertension group consisted of 27 males and 10 females, 36–77 years of age, with a mean age of 56 years. These patients fulfilled the diagnostic criteria for hypertension set by WHO. In addition, 43 healthy physical examinees were selected as the control group, consisting of 23 males and 20 females, 35–67 years of age.Informed consent was obtained from all participants.METHODS: In the cerebral infarction group, thrombomodulin plasma levels were determined by enzyme-linked immunoabsorbent assay at days 1, 3, 7, and 14 after attack. Thrombomodulin plasma levels were determined only once in the hypertension group and the control group. The results from the cerebral infarction group were compared with those from the hypertension group and the control group. MAIN OUTCOME MEASURES: Level of thrombomodulin in plasma.RESULTS: All 63 patients and 43 healthy volunteers were included in the final analysis of results. ① At 7 days after the attack, the plasma levels of

  18. Role of Aquaporin-4 in Cerebral Edema and Stroke

    OpenAIRE

    Zador, Zsolt; Stiver, Shirley; Wang, Vincent; MANLEY, GEOFFREY T.

    2009-01-01

    Cerebral edema plays a central role in the pathophysiology of many diseases of the central nervous system (CNS) including ischemia, trauma, tumors, inflammation, and metabolic disturbances. The formation of cerebral edema results in an increase in tissue water content and brain swelling which, if unchecked, can lead to elevated intracranial pressure (ICP), reduced cerebral blood flow, and ultimately cerebral herniation and death. Despite the clinical significance of cerebral edema, the mechan...

  19. Electrocardiogram changes in acute cerebral infarction patients

    Institute of Scientific and Technical Information of China (English)

    Jing Fang; Weihong Yan

    2006-01-01

    BACKGROUND: Comparison of different stroke locations had been focused in past researches in electrocardiogram (ECG) changes of cerebral stroke patients. Some researches neglected the heart disease in the illness history.OBJECTIVE: To discuss ECG changes in different infarction locations and size of acute cerebral infarction and compare with healthy people.DESIGN: Contrast observation.SETrING: Shanghai Ninth People's Hospital.PARTICIPANTS: A total of 57 patients with cerebral infarction were selected from the Neurological Department of Ninth People's Hospital of Shanghai from March 2003 to September 2005. They were diagnosed according to the criteria revised in the 4th National Cerebral Disease Conference and brain images. Patients who had heart disease were excluded. There were 32 males and 25 females, who were 65-84 years old. Among them, 23 cases were involved in right hemisphere, 34 cases in left one, 23 in base ganglion, 11 in brain stem, 9in frontal lobe and 14 in other parts. According to their infarction size (plus size in every different scan), they were divided into three different groups: large-size group (n = 10) with size larger than 3.5 cm3, medium-sizegroup (n = 13) with size between 1.5-3.5 cm3, and small-size group (n = 34) with size smaller than 1.5 cm3.Another 50 healthy subjects were regarded as control group. There were 29 males and 21 females aged 40-82 years. All these cases knew and agreed of the examination.METHODS: Patients received 12-lead ECG examinations within the first 6-24 hours of onset while control group received it at the same time. The HR, PR, QTc, QRS, T wave and ST changes were compared between the two groups.MAIN OUTCOME MEASURES: The ECG changes and differences in two hemispheres, in different infarction lccations and sizes. RESULTS: All 57 patients and 50 healthy subjects were involved in the final analysis. ① ECG changes in infarction group and control group. There were no differences in HR, QRS time and cases with

  20. Effect of selective lumbosacral posterior rhizotomy combined with constraint-induced movement therapy on limb function and serological indexes in patients with cerebral palsy%选择性脊神经后根切断术配合强制性诱导运动训练对脑性瘫痪患儿肢体功能及血清学指标的影响

    Institute of Scientific and Technical Information of China (English)

    陈章明; 周孙章

    2015-01-01

    Objective To analyze the effect of selective lumbosacral posterior rhizotomy combined with con-straint-induced movement therapy on limb function and serological indexes in patients with cerebral palsy. Methods Sev-enty-six children with cerebral palsy in our hospital were selected as research objects, which were randomly divided in-to control group (conventional treatment) and observation group (selective lumbosacral posterior rhizotomy combined with constraint-induced movement therapy), each with 38 cases. Physical function, serum TORCH antibody levels, se-rum NSE and inflammatory factor levels were compared between the two groups. Results (1) After treatment, the pa-tients' CSI score in the observation group was significantly lower than that in the control group, and GMFM score and walking speed were significantly greater (P<0.05);(2) Patients' CMV-IgM, TOX-IgM, HSV2 IgM, RV IgM levels af-ter treatment in the observation group were significantly lower than those in the control group (P<0.05);(3) After treat-ment, patients' serum NSE, IFN-γlevels in the observation group were significantly lower than those in the control group, while IL-4 level was significantly higher (P<0.05). Conclusion Selective lumbosacral posterior rhizotomy combined with constraint-induced movement therapy could improve limb motor ability of children with cerebral palsy, reduce TORCH antibody levels, and balance secretion of cytokines.%目的:分析腰骶部选择性脊神经后根切断术配合强制性诱导运动训练对脑性瘫痪患儿肢体功能以及血清学指标的影响。方法选择在本院接受住院治疗的脑性瘫痪患儿76例作为研究对象,随机分为接受常规治疗的对照组和接受腰骶部选择性脊神经后根切断术配合强制性诱导运动训练的观察组,每组各38例。比较两组患儿的肢体功能、血清TORCH抗体水平、血清神经元特异性烯醇化酶及炎症因子水平等差异。结果(1)观察组患者接受

  1. Cerebral and non-cerebral coenurosis: on the genotypic and phenotypic diversity of Taenia multiceps.

    Science.gov (United States)

    Christodoulopoulos, Georgios; Dinkel, Anke; Romig, Thomas; Ebi, Dennis; Mackenstedt, Ute; Loos-Frank, Brigitte

    2016-12-01

    We characterised the causative agents of cerebral and non-cerebral coenurosis in livestock by determining the mitochondrial genotypes and morphological phenotypes of 52 Taenia multiceps isolates from a wide geographical range in Europe, Africa, and western Asia. Three studies were conducted: (1) a morphological comparison of the rostellar hooks of cerebral and non-cerebral cysts of sheep and goats, (2) a morphological comparison of adult worms experimentally produced in dogs, and (3) a molecular analysis of three partial mitochondrial genes (nad1, cox1, and 12S rRNA) of the same isolates. No significant morphological or genetic differences were associated with the species of the intermediate host. Adult parasites originating from cerebral and non-cerebral cysts differed morphologically, e.g. the shape of the small hooks and the distribution of the testes in the mature proglottids. The phylogenetic analysis of the mitochondrial haplotypes produced three distinct clusters: one cluster including both cerebral isolates from Greece and non-cerebral isolates from tropical and subtropical countries, and two clusters including cerebral isolates from Greece. The majority of the non-cerebral specimens clustered together but did not form a monophyletic group. No monophyletic groups were observed based on geography, although specimens from the same region tended to cluster. The clustering indicates high intraspecific diversity. The phylogenetic analysis suggests that all variants of T. multiceps can cause cerebral coenurosis in sheep (which may be the ancestral phenotype), and some variants, predominantly from one genetic cluster, acquired the additional capacity to produce non-cerebral forms in goats and more rarely in sheep.

  2. Cerebral physiology and preservation during cardiac arrest Fisiología y preservación cerebral durante el paro cardíaco: vulnerabilidad del cerebro

    Directory of Open Access Journals (Sweden)

    Luis M. Gómez

    1991-03-01

    Full Text Available

    Cerebral physiology during cardiac arrest is discussed with particular Interest on selective neuronal damage. Previous concepts on brain tolerance to hypoxia are analyzed and new information about brain function prognosis after cardiac arrest is presented. Therapeutic alternatives for brain preservation are discussed with emphasis on the lack of effectiveness of barbiturates, the results of research with other drugs and the future role that blockers of excitatory neurotransmission may have as elements of cerebral preservation.

    Se hace una aproximación a la fisiología cerebral durante el paro cardíaco, destacando el concepto de darlo neuronal selectivo. Se presentan elementos que permiten modificar concepciones antiguas sobre la tolerancia del cerebro a la hipoxia severa. Además, se hace un nuevo planteamiento sobre el pronóstico cerebral luego de un paro cardíaco y se esbozan las alternativas terapéuticas utilizadas hasta la fecha para la preservación cerebral. Se hace énfasis en la inefectividad de los barbitúricos, en la investigación sobre la terapia con otras drogas y en el futuro abierto hacia los bloqueadores de los neurotransmisores excitadores, como elementos terapéuticos para la preservación cerebral.

  3. Cerebral astroblastoma: A radiopathological diagnosis

    Directory of Open Access Journals (Sweden)

    Deepak Kumar Singh

    2014-01-01

    Full Text Available 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.

  4. Cerebral malformations in Carpenter syndrome.

    Science.gov (United States)

    Taravath, S; Tonsgard, J H

    1993-01-01

    The inherited forms of craniosynostosis can be divided into 4 groups: isolated craniosynostosis, craniosynostosis with syndactyly, craniosynostosis with polydactyly and syndactyly, and craniosynostosis with other somatic abnormalities. Acrocephalopolysyndactyly or Carpenter syndrome consists of craniosynostosis, short fingers, soft tissue syndactyly, preaxial polydactyly, congenital heart disease, hypogenitalism, obesity, and umbilical hernia. As many as three-fourths of the patients have some degree of intellectual impairment. The etiology of mental retardation in this syndrome has not been explored. A patient is reported with the features of Carpenter syndrome who has profound developmental delay and cerebral malformations demonstrated by magnetic resonance imaging and computed tomography. Because mental retardation is not an invariable feature of this syndrome or other craniosynostosis syndromes, neuroradiologic examination may help in predicting the intellectual outcome in these patients.

  5. The effect of malone's procedure with antegrade irrigation on patients with refractory fecal continence%Malone顺行灌肠在治疗顽固性大便失禁中的应用

    Institute of Scientific and Technical Information of China (English)

    王若义; 丁庆光; 刘倩; 陈维秀; 孙小兵; 李金良; 陈雨历

    2011-01-01

    Objective The Malone antegrade colonic enema (MACE) procedure is a minimally invasive therapy for refractory fecal continence.The aim of this study was to assess curative efficacy for patients undergoing MACE via questionnaire investigation.Methods Totally 32 children patients underwent MACE due to fractory fecal continence between 2000 and 2009.The follow-up period was averagely 3.4 years,and all patients filled in the questionnaire form based on scoring system raised by Li-Zheng and Shell.Surgical methods,applications,complications and clinical curative satisfaction as the main content,were involved in questionnaire for evaluation of curative efficacy of MACE.Results 30 patients of all were followed-up after MACE procedure.The clinical satisfaction was 83.3%,and they could administer the enema by themselves.Regarding to the post-operative complications,no significantly statistical difference was seen in procedures with differential techniques and ostomies.57 percent of patients administered the enema once and 28 percent of patients did twice,aiming to keep anal clearance.4 patients were complicated with the anal or stoma soiling,stoma stenosis,skin inflammation,abdominal distension or pain.Further treatment made improvement.Conclusions MACE procedure is a reliable,minimally invasive surgery with low morbidity for refractory fecal continence.%目的 Malone顺行灌肠(MACE)是一种对机体损伤较小的手术方式,通过问卷调查的形式来评估其在顽固性大便失禁治疗的临床疗效.方法 以2000年1月至2009年12月期间接受MACE治疗的32例患儿为研究对象,临床观察和随访时间平均约3.4年,结合李正和Shell的评价项目内容并根据临床实际情况,设计了一张问卷调查,其内容主要包括手术方式、应用情况、术后并发症和临床满意度等方面,通过该问卷综合评价MACE在治疗顽固性大便失禁中的作用.结果 32例手术患儿中30例获得随访,患儿总体满意率为83

  6. Popliteal artery local technique in superficial femoral artery antegrade subintimal recanalization%腘动脉局域超选技术用于股浅动脉内膜下顺行开通

    Institute of Scientific and Technical Information of China (English)

    裴轶飞; 刘广钦; 包俊敏

    2012-01-01

    Objective To evaluate popliteal artery local technique in superficial femoral artery antegrade subintimal recanalization.Methods From January 2009 to Dec 2011,550 limbs in 476 TASC (Trans-Atlantic Inter-Society Consensus) Ⅱ C/D cases underwent endo-therapy at our department.The success rate、operation time、symptom progress and follow up were analyzed retrospectively.Results In the 550 limbs,62 limbs received popliteal artery local technique directly.There was 9 technical failures.Procedures succeeded in 53 limbs(85.5% ).The average operation time was (69 ±24) min,(1.8 ±0.6) stents were used and the main covered length was ( 33 ± 6) cm.Symptoms of 46 limbs was improved and unchanged in 6,amputation needed to be done in one limb.One year follow up accomplished for 39 limb.The 6 and 12 months patence rate was 87.1% and 69.2%.For 488 limbs using traditional approach 378 achieved anti-grade recanalization,the average operation time was ( 89 ± 30) min,average (2.1 ± 0.6) stents were used and the main covered length is (31 ± 13) cm.Symptom in 300 limbs improved.The half and one year patence rate in 292 limbs was 92.1% and 61.0%.Conclusions The popliteal artery local technique is as effective as with traditional approach and is time saving.%目的 研究腘动脉局域超选法在完成股浅动脉顺向内膜下开通中的作用.方法 2009年1月至2011年12月对467例患者(550条肢体)行腔内治疗,病变均为泛大西洋协作组(Trans-Atlantic Inter-Society Consensus,TASC)定义的ⅡC/D级股腘动脉闭塞.统计其中直接应用腘动脉局域超选技术和传统真腔超选方法的62条肢体,观察其手术成功率、手术时间、症状改善和随访情况.结果 在550条肢体中,62条肢体直接应用了腘动脉局域超选技术,其中9条肢体未能顺向返回真腔操作.53条肢体(85.5%)完成手术,平均手术时间(69 ±24) min,平均支架应用数(1.8±0.6)枚,平均覆盖长度(33 ±6) cm.46条肢体(86.8

  7. Cerebral palsy in preterm infants

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    Demeši-Drljan Čila

    2016-01-01

    Full Text Available Background/Aim. Cerebral palsy (CP is one of the leading causes of neurological impairment in childhood. Preterm birth is a significant risk factor in the occurrence of CP. Clinical outcomes may include impairment of gross motor function and intellectual abilities, visual impairment and epilepsy. The aim of this study was to examine the relationships among gestational age, type of CP, functional ability and associated conditions. Methods. The sample size was 206 children with CP. The data were obtained from medical records and included gestational age at birth, clinical characteristics of CP and associated conditions. Clinical CP type was determined according to Surveillance of Cerebral Palsy in Europe (SCPE and topographically. Gross motor function abilities were evaluated according to the Gross Motor Function Classification System (GMFCS. Results. More than half of the children with CP were born prematurely (54.4%. Statistically significant difference was noted with respect to the distribution of various clinical types of CP in relation to gestational age (p < 0.001. In the group with spastic bilateral CP type, there is a greater proportion of children born preterm. Statistically significant difference was noted in the functional classification based on GMFCS in terms of gestational age (p = 0.049, children born at earlier gestational age are classified at a higher GMFCS level of functional limitation. The greatest percentage of children (70.0% affected by two or more associated conditions was found in the group that had extremely preterm birth, and that number declined with increasing maturity at birth. Epilepsy was more prevalent in children born at greater gestational age, and this difference in distribution was statistically significant (p = 0.032. Conclusion. The application of antenatal and postnatal protection of preterm children should be a significant component of the CP prevention strategy. [Projekat Ministarstva nauke Republike

  8. Actualities on molecular pathogenesis and repairing processes of cerebral damage in perinatal hypoxic-ischemic encephalopathy.

    Science.gov (United States)

    Distefano, Giuseppe; Praticò, Andrea D

    2010-09-16

    Hypoxic-ischemic encephalopathy (HIE) is the most important cause of cerebral damage and long-term neurological sequelae in the perinatal period both in term and preterm infant. Hypoxic-ischemic (H-I) injuries develop in two phases: the ischemic phase, dominated by necrotic processes, and the reperfusion phase, dominated by apoptotic processes extending beyond ischemic areas. Due to selective ischemic vulnerability, cerebral damage affects gray matter in term newborns and white matter in preterm newborns with the typical neuropathological aspects of laminar cortical necrosis in the former and periventricular leukomalacia in the latter. This article summarises the principal physiopathological and biochemical processes leading to necrosis and/or apoptosis of neuronal and glial cells and reports recent insights into some endogenous and exogenous cellular and molecular mechanisms aimed at repairing H-I cerebral damage.

  9. Actualities on molecular pathogenesis and repairing processes of cerebral damage in perinatal hypoxic-ischemic encephalopathy

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    Praticò Andrea D

    2010-09-01

    Full Text Available Abstract Hypoxic-ischemic encephalopathy (HIE is the most important cause of cerebral damage and long-term neurological sequelae in the perinatal period both in term and preterm infant. Hypoxic-ischemic (H-I injuries develop in two phases: the ischemic phase, dominated by necrotic processes, and the reperfusion phase, dominated by apoptotic processes extending beyond ischemic areas. Due to selective ischemic vulnerability, cerebral damage affects gray matter in term newborns and white matter in preterm newborns with the typical neuropathological aspects of laminar cortical necrosis in the former and periventricular leukomalacia in the latter. This article summarises the principal physiopathological and biochemical processes leading to necrosis and/or apoptosis of neuronal and glial cells and reports recent insights into some endogenous and exogenous cellular and molecular mechanisms aimed at repairing H-I cerebral damage.

  10. Immunohistochemical Detection of Apoptosis-Related Proteins in Gerbil Hippocampus Transient Cerebral Ischemia: Neuroprotective Effect of Pitavastatin

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    Toshiki Himeda

    2005-01-01

    Full Text Available Delayed and selective neuronal damage was caused in the CA1 sector of hippocampus following 5 min of transient cerebral ischemia in gerbils. We investigated the immunohistochemical alterations of apoptosis-related proteins such as bcl-2α, bcl-xs/l, bax, cytochrome c, and active caspase 3 and TUNEL staining in the hippocampus at 1 and 5 hr and 1, 2, 5 and 14 days after transient cerebral ischemia in gerbils. We also examined the effect of 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor pitavastatin against the alterations of apoptosis-related proteins and TUNEL staining in the hippocampus after cerebral ischemia. The alterations of apoptosis-related proteins in the hippocampal CA1 sector were more pronounced than the changes of hippocampal CA3 sector and dentate gyrus after cerebral ischemia. The alterations of apoptosis-related proteins in the hippocampal CA1 sector after cerebral ischemia preceded the neuronal damage in this region. Furthermore, the study with TUNEL staining showed that a marked increase of TUNEL-positive nuclei was evident only in the hippocampal CA1 sector 5 days after cerebral ischemia. Our immunohistochemical study also showed that pitavastatin prevented the alterations of apoptosis-related proteins and the increase of TUNEL-positive nuclei in the hippocampal CA1 sector 5 days after cerebral ischemia. The present study indicates that transient cerebral ischemia in gerbils causes the mitochondrial-dependent apoptosis in the hippocampal CA1 sector. Furthermore, our present study demonstrates that pitavastatin can prevent the alterations of apoptosis-related proteins and the increase of TUNEL-positive nuclei in the hippocampal CA1 sector after cerebral ischemia. Thus our study provides novel therapeutic strategies in clinical stroke.

  11. Ipsilateral Cerebral and Contralateral Cerebellar Hyperperfusion in Patients with Unilateral Cerebral Infarction; SPM Analysis

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    Hong, Sun Pyo; Yoon, Joon Kee; Choi, Bong Hoi; Joo, In Soo; Yoon, Seok Nam [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2008-10-15

    Cortical reorganization has an important role in the recovery of stroke. We analyzed the compensatory cerebral and cerebellar perfusion change in patients with unilateral cerebral infarction using statistical parametric mapping (SPM). Fifty seven {sup 99m}Tc-Ethylene Cystein Diethylester (ECD) cerebral perfusion SPECT images of 57 patients (male/female=38/19, mean age=56{+-}17 years) with unilateral cerebral infarction were evaluated retrospectively. Patients were divided into subgroups according to the location (left, right) and the onset (acute, chronic) of infarction. Each subgroup was compared with normal controls (male/female=11/1, mean age =36{+-}10 years) in a voxel-by-voxel manner (two sample t-test, p<0.001) using SPM. All 4 subgroups showed hyperperfusion in the ipsilateral cerebral cortex, but not in the contralateral cerebral cortex. Chronic left and right infarction groups revealed hyperperfusion in the ipsilateral primary sensorimotor cortex, meanwhile, acute subgroups did not. Contralateral cerebellar hyperperfusion was also demonstrated in the chronic left infarction group. Using {sup 99m}Tc-ECD SPECT, we observed ipsilateral cerebral and contralateral cerebeller hyperperfusion in patients with cerebral infarction. However, whether these findings are related to the recovery of cerebral functions should be further evaluated.

  12. Comparison of Cerebral Oxygen Saturation and Cerebral Perfusion Computed Tomography in Cerebral Blood Flow in Patients with Brain Injury.

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    Trofimov, Alexey O; Kalentiev, George; Voennov, Oleg; Grigoryeva, Vera

    2016-01-01

    The purpose of this study was to determine the relationship between cerebral tissue oxygen saturation and cerebral blood volume in patients with traumatic brain injury. Perfusion computed tomography of the brain was performed in 25 patients with traumatic brain injury together with simultaneous SctO2 level measurement using cerebral near-infrared oxymetry. The mean age of the injured persons was 34.5±15.6 years (range 15-65); 14 men, 11 women. The Injury Severity Score (ISS) values were 44.4±9.7 (range 25-81). The Glasgow Coma Score (GCS) mean value before the study was 10.6±2.1 (range 5-13). SctO2 ranged from 51 to 89%, mean 62±8.2%. Cerebral blood volume (CBV) values were 2.1±0.67 ml/100 g (min 1.1; max 4.3 ml/100 g). Cerebral blood flow (CBF) was 31.99±13.6 ml/100 g×min. Mean transit time (MTT) values were 5.7±4.5 s (min 2.8; max 34.3 s). The time to peak (TTP) was 22.2±3.1 s. A statistically significant correlation was found between SctO2 level and cerebral blood volume (CBV) level (R=0.9; pperfusion.

  13. Mannitol and other osmotic diuretics as adjuncts for treating cerebral malaria

    Science.gov (United States)

    Okoromah, Christy AN; Afolabi, Bosede B; Wall, Emma CB

    2014-01-01

    Background Cerebral oedema occurs with cerebral malaria, and some clinicians think osmotic diuretics, such as mannitol or urea, may improve outcomes. Objectives To compare mannitol or urea to placebo or no diuretic for treating children or adults with cerebral malaria. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register (Issue 4, 2010), CENTRAL (The Cochrane Library Issue 12, 2010), MEDLINE (1966 to November 2010), EMBASE (1974 to November 2010), LILACS (1982 to November 2010), and the reference lists of articles. We contacted relevant organizations and researchers. Selection criteria Randomized or quasi-randomized controlled trials comparing mannitol or urea to placebo or no treatment in children and adults with cerebral malaria. Primary outcomes were death, life-threatenining sequelae and major neurological sequelae at six months. Data collection and analysis Two authors applied the inclusion criteria, assessed risk of bias, and extracted data independently. Main results One trial met the inclusion criteria, comparing mannitol 20% to saline placebo in 156 Ugandan children. Allocation was concealed. No difference in mortality, time to regain consciousness, or neurological sequelae were detected. Authors’ conclusions There are insufficient data to know what the effects of osmotic diuretics are in children with cerebral malaria. Larger, multicentre trials are needed. PMID:21491391

  14. Effects of Goal-directed Volume Therapy on the Intracranial Pressure and the Balance of Cerebral Oxygen Consumption and Supply in Selective Neurosurgery%目标导向液体治疗在择期神经外科手术中对颅内压和脑氧供需平衡的影响

    Institute of Scientific and Technical Information of China (English)

    田胜兰; 周游; 冯丹

    2015-01-01

    Objective To investigate the effects of goal‐directed volume therapy (GDVT )on the intracranial pressure(ICP) and the balance of cerebral oxygen consumption and supply in selective neurosurgery. Methods Twenty‐four patients sched‐uled for intracranial tumor resection were randomly divided into 2 groups:conventional fluid management group (group C ,n=12) and GDVT group(group G ,n=12). Patients in group C received introperative fluid transfusion according to classical fluid management strategies while those in group G received GDT according to stroke volume variation (SVV) ,guided by Flotrac‐Vigileo system.Mean arterial pressure(MAP) ,heart rate(HR) ,cardiac index(CI) ,ICP ,SVV and jugular bulb oxygen saturation (SjvO2 )were recorded before the anesthesia induction(T1 ) ,at the moment of intubation(T2 ) ,at the moment of opening the hard meninges(T3),1hafteropeningthehardmeninges(T4),andattheendofthesurgery(T5).Thecerebraloxygenextractionra‐tio(CERO2 )was calculated. The duration of surgery ,crystalloid volume ,colloid volume ,blood transfusion volume ,urinary output and bleeding volume were recorded as well.Results The colloid transfusion volume ,the total fluid transfusion volume and uri‐nary output were significantly increased in group G when compared with those in group C (P0.05).Conclusion Goal‐directed fluid therapy optimizes the cardiac preload without increasing the ICP in selective neurosurgery ,and it also improves the balance of cerebral oxygen con‐sumption and supply.%目的:观察目标导向液体治疗在择期神经外科手术中对颅内压和脑氧供需平衡的影响。方法选择择期全麻下行开颅肿瘤切除术的患者24例,随机分为2组:常规输液组(C组,n=12)和目标导向液体治疗组(G组,n=12)。C组按经典输液方案进行术中液体管理;G组在Flortrac/Vigileo系统监测下,以每搏量变异度(SVV)为导向行液体治疗。分别于麻醉诱导前(T1

  15. Cerebral malaria: gamma-interferon redux

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    Nicholas H Hunt

    2014-08-01

    Full Text Available There are two theories that seek to explain the pathogenesis of cerebral malaria, the mechanical obstruction hypothesis and the immunopathology hypothesis. Evidence consistent with both ideas has accumulated from studies of the human disease and experimental models. Thus some combination of these concepts seems necessary to explain the very complex pattern of changes seen in cerebral malaria. The interactions between malaria parasites, erythrocytes, the cerebral microvascular endothelium, brain parenchymal cells, platelets and microparticles need to be considered. One factor that seems able to knit together much of this complexity is the cytokine interferon-gamma. In this review we consider findings from the clinical disease, in vitro models and the murine counterpart of human cerebral malaria in order to evaluate the roles played by interferon-gamma in the pathogenesis of this often fatal and debilitating condition.

  16. Cerebral cysticercosis in a cat : clinical communication

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    E.V. Schwan

    2002-07-01

    Full Text Available The metacestode of Taenia solium, Cysticercus cellulosae, was recovered from the brain of a cat showing central nervous clinical signs ante mortem. This is the first record of cerebral cysticercosis in a cat in South Africa.

  17. Research progress of cerebral small vessel disease

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    Jun-dong JIA

    2015-03-01

    Full Text Available Cerebral small vessel disease refers to a group of pathological processes with various etiologies that affect small arteries, arterioles, venules, and capillaries of the brain. Recently, the researches of cerebral small vessel disease have got initial progressions, and a definite diagnosis of this disease is comfirmed by biopsy. Given the pathological material is difficult to obtain, clinicians should pay more attention to the imaging features and clinical manifestations. Correct understanding of imaging and clinical manifestations contributes to the early identification of cerebral small vessel disease. Herein, an overview is provided on the present status, common imaging features, pathogenesis, clinical manifestations and treatment of cerebral small vessel disease. DOI: 10.3969/j.issn.1672-6731.2015.02.003

  18. Gamma knife radiosurgery for cerebral arteriovenous malformations.

    Science.gov (United States)

    Kemeny, A A; Radatz, M W R; Rowe, J G; Walton, L; Hampshire, A

    2004-01-01

    Since its introduction, gamma knife radiosurgery has become an important treatment modality for cerebral arteriovenous malformations. This paper is a brief overview of the technique used, of the clinical results achieved and of the experience gained in Sheffield.

  19. Mitochondrial Targeted Antioxidant in Cerebral Ischemia.

    Science.gov (United States)

    Ahmed, Ejaz; Donovan, Tucker; Yujiao, Lu; Zhang, Quanguang

    There has been much evidence suggesting that reactive oxygen species (ROS) generated in mitochondria during cerebral ischemia play a major role in programming the senescence of organism. Antioxidants dealing with mitochondria slow down the appearance and progression of symptoms in cerebral ischemia and increase the life span of organisms. The mechanisms of mitochondrial targeted antioxidants, such as SKQ1, Coenzyme Q10, MitoQ, and Methylene blue, include increasing adenosine triphosphate (ATP) production, decreasing production of ROS and increasing antioxidant defenses, providing benefits in neuroprotection following cerebral ischemia. A number of studies have shown the neuroprotective role of these mitochondrial targeted antioxidants in cerebral ischemia. Here in this short review we have compiled the literature supporting consequences of mitochondrial dysfunction, and the protective role of mitochondrial targeted antioxidants.

  20. Plasma catecholamine concentrations associated with cerebral vasospasm.

    Science.gov (United States)

    Loach, A B; Benedict, C R

    1980-03-01

    Plasma concentrations of adrenaline and noradrenaline were measured sequentially over the immediate post-operative period following clipping of an intracranial aneurysm in 11 patients. Those patients who developed local cerebral vasospasm showed a sustained rise in plasma catecholamines, particularly noradrenaline, whilst those patients who developed generalised cerebral vasospasm showed early peaks of very high concentrations of adrenaline and noradrenaline which preceded radiological evidence of generalized vasospam.

  1. Clinical Practice Guidelines for Cerebral Abscess Treatment

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    Danny Barrueta Reyes

    2009-03-01

    Full Text Available Clinical Practice Guidelines for Cerebral Abscess Treatment. It has been defined as a festering process caused by any germ and placed inside the cerebral parenchyma; this is a diagnostic and therapeutic challenge for surgeons and general doctors since the clinical and radiological manifestations are often imprecise. This document describes its etiological agents, clinical presentation, diagnosis and treatment. It includes assessment guidelines focused on the most important aspects to be accomplished.

  2. Crossed cerebral - cerebellar diaschisis : MRI evaluation.

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    Chakravarty A

    2002-07-01

    Full Text Available MRI, done later in life, in two patients with infantile hemiplegia syndrome showed significant volume loss in the cerebellar hemisphere contralateral to the side of the affected cerebrum. The cerebellar volume loss seemed to correlate with the degree of volume loss in the contralateral cerebral hemisphere. These observations provide morphological evidence of the phenomenon of crossed cerebral-cerebellar diaschisis (CCD. Functional neuroimaging studies in support of the concept of CCD has been critically reviewed.

  3. Cerebral microcirculation during experimental normovolaemic anaemia

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    Judith eBellapart

    2016-02-01

    Full Text Available Anaemia is accepted amongst 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 anaemia on neurological outcome. There are no studies quantifying microcirculation during anaemia. Experimental studies suggest that anaemia leads to cerebral hypoxia and increased rates of infarction, but the lack of clinical equipoise when testing the cerebral effects of transfusion amongst 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 anaemia, with the intention of describing possible limitations within management practices in critically ill patients. Under non-recovered anaesthesia, 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 anaemia 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 anaemia 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 anaemia does not result in short term effects on cerebral microcirculation in the ovine brain.

  4. Wearable wireless cerebral oximeter (Conference Presentation)

    Science.gov (United States)

    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.

  5. Mapping the cerebral subject in contemporary culture

    OpenAIRE

    Ortega,Francisco Javier Guerrero; Vidal, Fernando

    2007-01-01

    The research reported here aims at mapping the “cerebral subject” in contemporary society. The term “cerebral subject” refers to an anthropological figure that embodies the belief that human beings are essentially reducible to their brains. Our focus is on the discourses, images and practices that might globally be designated as “neuroculture.” From public policy to the arts, from the neurosciences to theology, humans are often treated as reducible to their brains. The new discipline of neuro...

  6. Cerebral perfusion SPECT in transient ischemic attack

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    You, D.-L. E-mail: dlyou@mail.kfcc.org.tw; Shieh, F.-Y.; Tzen, K.-Y.; Tsai, M.-F.; Kao, P.-F

    2000-04-01

    Purpose: The purpose of our study is to evaluate the efficacy of cerebral perfusion single photon emission computerized tomography (SPECT) in patients with transient ischemic attack (TIA). Methods: Thirty-seven patients with TIA were collected for study. All patients had transient focal neurological symptoms or signs with complete recovery within 24 h after onset. The patients underwent cerebral perfusion SPECT between 6 h and 11 days after onset, with 10 cases performed within 24 h (group A), nine cases performed between 1 and 3 days (group B), 11 cases performed between 3 and 5 days (group C), and seven cases performed after more than 5 days (group D). A semi-quantitative method was used for analyzing the SPECT data, and the difference ratios between lesion side and contralateral normal side were calculated on each pair of regions of interest. Results: In total, 78.4% (29/37) of patients had reduced perfusion in the cerebral cortical regions or deep nuclei, and the regions with reduced perfusion corresponded with clinical presentations of the patients. The abnormal rate with reduced perfusion was 90.0% in group A, 77.8% in group B, 72.7% in group C and 71.4% in group D. Cross cerebellar diaschisis (CCD) was present in seven patients, and all of the primary cerebral perfusion defects of these patients were located at the territory of left or right middle cerebral artery. Conclusion: Cerebral perfusion SPECT is a potential tool to detect cerebral perfusion defects and CCD in patients with TIA. Although the perfusion defect may persist more than 5 days after onset, we suggest cerebral perfusion SPECT should be performed as soon as possible.

  7. EMBOLIA GASEOSA CEREBRAL SECUNDARIA A BIOPSIA PULMONAR

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    Luís Rafael Moscote Salazar

    2008-01-01

    Full Text Available A 68-year-old male patient, underwent a lung biopsy. During the procedure, the patient had sudden loss of consciousness. A simple brain computed tomography was performed. Brain images showed multiple hypodenses areas in the brain parenchyma and subarachnoid space, making the diagnosis of cerebral gaseous embolism.Our case demonstrates the importance of considering the gaseous cerebral embolism when presented sudden loss of consciousness during invasive procedures such as lung biopsy or introduction of arterial and venous catheters.

  8. Purine Metabolism in Acute Cerebral Ischemia

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    Ye. V. Oreshnikov

    2008-01-01

    Full Text Available Objective: to study the specific features of purine metabolism in clinically significant acute cerebral ischemia. Subjects and materials. Three hundred and fifty patients with the acutest cerebral ischemic stroke were examined. The parameters of gas and electrolyte composition, acid-base balance, the levels of malonic dialdehyde, adenine, guanine, hypox-anthine, xanthine, and uric acid, and the activity of xanthine oxidase were determined in arterial and venous bloods and spinal fluid. Results. In ischemic stroke, hyperuricemia reflects the severity of cerebral metabolic disturbances, hemodynamic instability, hypercoagulation susceptiility, and the extent of neurological deficit. In ischemic stroke, hyperuri-corachia is accompanied by the higher spinal fluid levels of adenine, guanine, hypoxanthine, and xanthine and it is an indirect indicator of respiratory disorders of central genesis, systemic acidosis, hypercoagulation susceptibility, free radical oxidation activation, the intensity of a stressor response to cerebral ischemia, cerebral metabolic disturbances, the depth of reduced consciousness, and the severity of neurological deficit. Conclusion. The high venous blood activity of xanthine oxidase in ischemic stroke is associated with the better neurological parameters in all follow-up periods, the better early functional outcome, and lower mortality rates. Key words: hyperuricemia, stroke, xanthine oxidase, uric acid, cerebral ischemia.

  9. Ocular problems in children with cerebral palsy

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    Esra Ayhan Tuzcu

    2012-09-01

    Full Text Available The aim of this study is to evaluate eye problemsin children with cerebral palsy in our region.Materials and Methods: 90 patients which was diagnosedas cerebral palsy, treated and followed up in PediatricNeurology Department of Mustafa Kemal University,were included to this study. The history was taken, anda physical examination was performed to determine theetiology of the disease and type of SP. All of the patientswere underwent a detailed ophthalmological examinationincluding visual acuity, refractive error, amblyopia, strabismus,nystagmus and fundus examination.Results: Totally 90 patients, 51 male and 39 female,were included to the study. When the etiologic factorswere evaluated, the asphyxia was seen in 33.3% of thepatients. The most common type of cerebral palsy wasspastic quadriplegia at the rate of 43.3%. Eye problemswere detected in 60% of our cases. Of this, 54.4% wererefractive errors, 35.6% were strabismus, and 22.2%were optic nerve pathologies. Amblyopia was found in11.1% of cases. Although strabismus is more common inspastic diplegia type of cerebral palsy, there was no statisticallysignificant differenceConclusions: In conclusion, eye problems are commonin children with cerebral palsy. Therefore, we recommendroutine eye examination in these patients due to be beneficialin reducing the detection and communication difficulties.Key words: Cerebral palsy, refractive error, strabismus,optic atrophy

  10. Severe Cerebral Vasospasm in Patients with Hyperthyroidism

    Science.gov (United States)

    Oh, Hyuk-Jin; Oh, Jae-Sang; Shim, Jai-Joon; Bae, Hack-Gun

    2016-01-01

    Cerebral vasospasm associated with hyperthyroidism has not been reported to cause cerebral infarction. The case reported here is therefore the first of cerebral infarction co-existing with severe vasospasm and hyperthyroidism. A 30-year-old woman was transferred to our hospital in a stuporous state with right hemiparesis. At first, she complained of headache and dizziness. However, she had no neurological deficits or radiological abnormalities. She was diagnosed with hyperthyroidism 2 months ago, but she had discontinued the antithyroid medication herself three days ago. Magnetic resonance imaging and angiography showed cerebral infarction with severe vasospasm. Thus, chemical angioplasty using verapamil was performed two times, and antithyroid medication was administered. Follow-up angiography performed at 6 weeks demonstrated complete recovery of the vasospasm. At the 2-year clinical follow-up, she was alert with mild weakness and cortical blindness. Hyperthyroidism may influence cerebral vascular hemodynamics. Therefore, a sudden increase in the thyroid hormone levels in the clinical setting should be avoided to prevent cerebrovascular accidents. When neurological deterioration is noticed without primary cerebral parenchyma lesions, evaluation of thyroid function may be required before the symptoms occur. PMID:28184350

  11. Severe Cerebral Vasospasm in Patients with Hyperthyroidism.

    Science.gov (United States)

    Oh, Hyuk-Jin; Yoon, Seok-Mann; Oh, Jae-Sang; Shim, Jai-Joon; Bae, Hack-Gun

    2016-12-01

    Cerebral vasospasm associated with hyperthyroidism has not been reported to cause cerebral infarction. The case reported here is therefore the first of cerebral infarction co-existing with severe vasospasm and hyperthyroidism. A 30-year-old woman was transferred to our hospital in a stuporous state with right hemiparesis. At first, she complained of headache and dizziness. However, she had no neurological deficits or radiological abnormalities. She was diagnosed with hyperthyroidism 2 months ago, but she had discontinued the antithyroid medication herself three days ago. Magnetic resonance imaging and angiography showed cerebral infarction with severe vasospasm. Thus, chemical angioplasty using verapamil was performed two times, and antithyroid medication was administered. Follow-up angiography performed at 6 weeks demonstrated complete recovery of the vasospasm. At the 2-year clinical follow-up, she was alert with mild weakness and cortical blindness. Hyperthyroidism may influence cerebral vascular hemodynamics. Therefore, a sudden increase in the thyroid hormone levels in the clinical setting should be avoided to prevent cerebrovascular accidents. When neurological deterioration is noticed without primary cerebral parenchyma lesions, evaluation of thyroid function may be required before the symptoms occur.

  12. Changes in mean cerebral blood flow velocity during cognitive task-induced cerebral fatigue in high performance fighter pilots

    Institute of Scientific and Technical Information of China (English)

    Yongsheng Chen

    2008-01-01

    BACKGROUND: Several studies have demonstrated that sustained cognitive tasks can induce cognitive fatigue and that the mean cerebral blood flow velocity changes in some cerebral regions during cerebral fatigue. OBJECTIVE: To dynamically monitor the changes in mean cerebral blood flow velocity in different brain regions of high performance fighter pilots during mental arithmetic tasks and consecutive performance tasks. DESIGN, TIME AND SETTING: The present neurophysiological trial, based on controlled observation, was performed at the Laboratory of Neurophysiology, Institute of Aviation Medicine, Air Force of China between January 2003 and December 2005. PARTICIPANTS: Forty-five males, high performance fighter pilots, averaging (27.6 ± 2.5) years, were recruited for this study. METHODS: The mean cerebral blood flow velocity in the anterior cerebral artery, middle cerebral artery, and posterior cerebral artery of subjects was dynamically tested using transcranial Doppler during 5- hour mental arithmetic tasks and during 5- hour consecutive performance tasks. The neurobehavioral ability index was analyzed throughout each trial according to the number of correct responses, false responses, and lost responses. Simultaneously, cerebral cognitive fatigue-induced lethargy was assessed by the Stanford Sleepiness Scale. MAIN OUTCOME MEASURES: Changes in mean cerebral blood flow velocity in the anterior cerebral artery, middle cerebral artery, and posterior cerebral artery; neurobehavioral ability index of mental arithmetic and consecutive performance tasks; Stanford Sleepiness Scale scores. RESULTS: During mental arithmetic tasks, the mean cerebral blood flow velocity in the anterior cerebral artery increased during hour 2 and decreased after hour 4. There was no significant change in mean cerebral blood flow velocity in the middle cerebral artery and posterior cerebral artery. During hour 4, cerebral cognitive fatigue was observed and, simultaneously, Stanford Sleepiness

  13. 有限度选择性脊神经后根切断术联合内收肌松解改善下肢痉挛型脑性瘫痪儿童的运动能力%Limited selective posterior rhizotomy combined with adductor tenotomy for the improvement of motor ability of children with spastic lower limbs in cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    王博; 张新; 方秀统

    2005-01-01

    BACKGROUND: Selective posterior rhizotomy has been extensively acknowledged as an effective method of relieving lower limb spasticity in cerebral palsy. However, the postoperative complications such as reduced muscle strength and imbalance of the spine are of concern among surgeons and therapists. The combination of limited selective posterior rhizotomy (LSPR) with adductor tenotomy can decrease these complications without compromising the treatment effects.OBJECTIVE: To investigate the effects of combination therapy of LSPR with adductor tenotomy on lower limb spasticity, gait and movement of the patients.DESIGN: A self-controlled trial and observational follow-up taking children with cerebral palsy as the subjects.SETTING: Orthopedic Department of First Hospital Affiliated to Dalian Medical University.PARTICIPANTS: Thirty children patients with cerebral palsy treated in the Orthopedics Department of the First Affiliated Hospital of Jilin University from January 2001 to December 2002 were recruited in this trial. They presented scissors gait, flexed knee and tiptoeing of different degree. There were 18 cases of brisk tendon reflex and ankle clonus, and 15 cases of positive Babinski' s sign. All the patients had no immobile soft tissue contracture and could either accomplish walking and crouching independently or walk with arms on assistant devices.INTERVENTIONS: The patients received LSPR of L5 and S1 dorsal roots together with bilateral adductor tenotomy. Muscle tone and strength, knee and Achilles tendon reflexes, ankle clonus and pathologic signs were recorded before and after operation. X-ray examination on lumbar spine and pelvic was also taken for detection of deformity. The patients' movements were assessed according to their standing and walking postures, standing and crouching movements before operation and on follow-up. During follow-up all the mentioned indices were recorded by reference to the original case history, hospital reexamination and

  14. Effects of acupoint versus non-acupoint electroacupuncture on cerebral cortical neuronal Bcl-2,Bax and caspase-3 expression in a rat model of focal cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Jun Wang; Junming Fan; Yongshu Dong; Xia Huang; Hongxia Zhang

    2008-01-01

    BACKGROUND: Several studies have demonstrated that electroacupuncture by acupoint selection can inhibit cerebral cortical neuronal apoptosis following cerebral ischemia/reperfusion.OBJECTIVE: To validate the effects of electroacupuncture by acupoint selection on the expression level of cortical neuronal anti-apoptotic Bcl-2 protein and the apoptotic executive protein, caspase-3, in rat models of focal cerebral ischemia/reperfusion.DESIGN, TIME AND SETTING: This randomized grouping, neural cell and molecular biology animal experiment was performed at the Laboratory of Pharmacology of Traditional Chinese Medicine and the Laboratory Animal Center of Henan Institute of Traditional Chinese Medicine between November 2006 and May 2007.MATERIALS: Atotal of 40 healthy male adult Sprague-Dawley rats were randomly and evenly divided into four groups: sham-operated, model, electroacupuncture and non-acupoint control. G6895 electro-acupuncture instruments were purchased from Shanghai Huayi Instrument Factory, China. Caspase-3, Bcl-2 and Bax kits were provided by Wuhan Boster Bioengineering Co., Ltd., China.METHODS: Middle cerebral artery occlusion was induced in the model, electroacupuncture and non-acupoint groups. In the electroacupuncture group, the acupoints Jianyu (LI15), Waiguan (SJ5), Biguan (ST31), and Zusanli (ST36) were given electroacupuncture. In the non-acupoint control group, at each time point (immediately after ischemia and after reperfusion, or 2 hours after reperfusion), electroacupuncture was performed at the midpoints of Tianquan (PC2)-Quze (PC 3) line, Quze (PC 3)-Ximen (PC4) line, Zuwuli (LRlO)-Yinbao (LRg) line, and Xiguan (LR7)-Zhongdu (LR6) line. Electroacupuncture parameters were set with a continuous wave with a frequency of 10 Hz, wave width 0.6 ms, voltage 1.5-3.0 V, and a duration of 10 minutes. The sham-operated and model groups received only animal fixation without electroacupuncture procedure.MAIN OUTCOME MEASURES: Five rats were selected from

  15. Cranio-cerebral gunshot wounds

    Directory of Open Access Journals (Sweden)

    C. Majer1, G. Iacob2

    2010-11-01

    Full Text Available Cranio-cerebral gunshots wounds(CCGW are the most devastating injuriesto the central nervous system, especiallymade by high velocity bullets, the mostdevastating, severe and usually fatal type ofmissile injury to the head.Objective: To investigate and compare,using a retrospective study on five cases theclinical outcomes of CCGW. Predictors ofpoor outcome were: older age, delayedmode of transportation, low admissionCGS score with haemodynamic instability,CT visualization of diffuse brain damage,bihemispheric, multilobar injuries withlateral and midline sagittal planestrajectories made by penetrating highvelocity bullets fired from a very closerange, brain stem and ventricular injurywith intraventricular and/or subarachnoidhemorrhage, mass effect and midline shift,evidence of herniation and/or hematomas,high ICP and/or hypotension, abnormalcoagulation states on admission ordisseminated intravascular coagulation. Lessharmful effects were generated by retainedmissiles, bone fragments with CNSinfection, DAI lesions and neuronaldamages associated to cavitation, seizures.Material and methods: 5 patients (4 maleand 1 female, age ranged 22-65 years, withCCGW, during the period 2004-2009,caused by military conflict and accidentalfiring. After initial resuscitation all patientswere assessed on admission by the GlasgowComa Scale (GCS. After investigations: Xrayskull, brain CT, Angio-CT, cerebralMRI, SPECT; baseline investigations,neurological, haemodynamic andcoagulability status all patients underwentsurgical treatment following emergencyintervention. The survival, mortality andfunctional outcome were evaluated byGlasgow Outcome Scale (GOS score.Results: Referring on five cases weevaluate on a retrospective study the clinicaloutcome, imagistics, microscopic studies onneuronal and axonal damage generated bytemporary cavitation along the cerebralbullet’s track, therapeutics, as the review ofthe literature. Two patients with anadmission CGS 9 and 10

  16. Experience of endovascular treatment of occlusion-stenotic lesions of cerebral arteries

    Directory of Open Access Journals (Sweden)

    Cherednichenko Yu.V.

    2016-03-01

    Full Text Available Objective — to evaluate the efficacy of endovascular techniques in the treatment of occlusion and stenotic lesions of the brachiocephalic and cerebral arteries, to define the ways of complications prevention. Materials and methods. 594 patients with occlusion and stenotic lesions of the brachiocephalic and cerebral arteries were operated by endovascular methods in endovascular center of Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov. 688 endovascular operations were carried out. Most part of the operations are carotid stenting (423 operations. All of these operations were carried out with the usage of different types of antiembolic protection systems: distal, proximal or their combination. Intracranial segments of cerebral arteries were operated in 43 cases. 169 operations of stenting of vertebral arteries in extracranial segments were performed. Subclavian arteries and brachiocephal truncus were operated in 53 cases. Results. Total removal of stenosis was achieved in 588 cases (98.99%. 509 patients (85.69% of cases had improvement in neurological status (on a scale NIHHS, Mrs., MoCA. 77 (12.96% patients had no deterioration of neurological status. Postoperative mortality was 1.01%. Common level of other complications was 4.3 %: cerebral complications - 2.7%. Discussion. The results of the endovascular treatment of occlusion and stenotic lesions of the cerebral arteries show high efficacy and low complication level. The ways of reduction complications level are identified. They are in a differentiated selection of antiembolic protection method, endovascular treatment planning, based on monitoring of changes in the brain hemoperfusion, the emphasis is on the use of the special neurologic deviсes. Conclusions. Endovascular treatment of occlusion and stenotic lesions of the cerebral arteries is effective with a small risk of complications. Risk can be reduced further by the differential choice of antiembolic protection

  17. Influence of selective posterior rhizotomy via different operation-sites on lumbar spine stability in children with spastic cerebral palsy%不同入路选择性脊神经后根切断术对腰椎稳定性的影响

    Institute of Scientific and Technical Information of China (English)

    张毅; 程钢; 刘小林; 李智勇; 曾瑞曦; 严凤娇; 刘虹

    2010-01-01

    Objective To investigate variation of lumbar spine stability in children with spastic cerebral palsy (SCP) after two types selective posterior rhizotomy (SPR) at lumbosacral and conical sites.Methods Forty-five cases of SCP have undergone with lumbosacral SPR and 38 with conical SPR. Posteroanterior, lateral, 40°-double-oblique, and dynamic (hyperextension and hyperflexion) position lumbar Xray films were taken for all of them before and three months to seven years ( 19 months in average) after operation to observe postoperative lumbar deformity, lumbosacral angle, lateral Cobb' s angle, arch-vertex distance, lordotic index, Posner's definition, and other stability indicators pre- and post-operation of the two groups. Results ① There was statistically significant difference in lumbosacral angle, lateral Cobb's angle, arch-vertex distance, lordotic index and Posner's definition at the 1 st to 2nd lumbar vertebrae (L1-L2 ), the 4th to 5th lumbar vertebrae ( L4 - L5 ), and the 5th lumbar to the 1st sacral vertebrae ( L5 - S1 ) among those with lumbosacral SPR before and after operation (P <0. 05). But, only Posner's definition at the 12th thoracic vertebra to the 2nd lumbar vertebra ( T12 - L2 ) varied significantly ( P < 0. 05 ) among those with conical SPR ② Various lumbar deformity was observed in six cases ( 13% ) with lumbosacral SPR, three of them with instable neurological symptoms; while two cases (5%) did so after conical SPR,one with neurological symptoms, with statistical significance ( P < 0. 05). Conclusions Little variation of lumbar spine stability is found among children with spastic cerebral palsy in mid-short term after SPR, while influence of conical SPR is much less on lumbar stability. Their long-term postoperative influence has to be followed-up further.%目的 了解痉挛性脑瘫患者行腰骶部选择性脊神经后根切断术(SPR)与圆锥部SPR术后腰椎稳定性的改变.方法 对行腰骶部SPR治疗的45

  18. Cerebral infarction and cerebral salt wasting syndrome in a patient with tuberculous meningoencephalitis.

    Science.gov (United States)

    Loo, K L; Ramachandran, R; Abdullah, B J; Chow, S K; Goh, E M L; Yeap, S S

    2003-09-01

    A 38-year old female with underlying systemic lupus erythematosus was admitted with tuberculous meningoencephalitis. After an initial good response to anti-tuberculous treatment, she developed cerebral infarction and profound hyponatremia. This was due to cerebral salt wasting syndrome, which has only previously been described in 2 cases. The difficulties in diagnosis and management of this case are discussed.

  19. Cerebral oxygen extraction, oxygen consumption, and regional cerebral blood flow during the aura phase of migraine

    DEFF Research Database (Denmark)

    Friberg, L; Olesen, Jes; Lassen, N A

    1994-01-01

    The aura phase of migraine is associated with focal blood flow changes, but it has been largely unknown whether these changes are correlated to changes in the cerebral metabolism.......The aura phase of migraine is associated with focal blood flow changes, but it has been largely unknown whether these changes are correlated to changes in the cerebral metabolism....

  20. The early markers for later dyskinetic cerebral palsy are different from those for spastic cerebral palsy

    NARCIS (Netherlands)

    Einspieler, C; Cioni, G; Paolicelli, PB; Bos, AF; Dressler, A; Ferrari, F; Roversi, MF; Prechtl, HFR

    2002-01-01

    Qualitative abnormalities of spontaneous motor activity in new-borns and young infants are early predictive markers for later spastic cerebral palsy. Aim of this research was to identify which motor patterns may be specific for later dyskinetic cerebral palsy. In a large, prospectively performed lon

  1. Changes in Cerebral Perfusion around the Time of Delayed Cerebral Ischemia in Subarachnoid Hemorrhage Patients

    NARCIS (Netherlands)

    Dankbaar, J. W.; de Rooij, N. K.; Smit, E. J.; Velthuis, B. K.; Frijns, C. J. M.; Rinkel, G. J. E.; van der Schaaf, I. C.

    2011-01-01

    Background: Because the pathogenesis of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) is unclear, we studied cerebral perfusion at different time points around the occurrence of DCI. Methods: We prospectively enrolled 53 patients admitted to the University Medical Center Utrech

  2. Relationship between vasospasm, cerebral perfusion, and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

    NARCIS (Netherlands)

    Dankbaar, Jan W.; Rijsdijk, Mienke; van der Schaaf, Irene C.; Velthuis, Birgitta K.; Wermer, Marieke J. H.; Rinkel, Gabriel J. E.

    2009-01-01

    Vasospasm after aneurysmal subarachnoid hemorrhage (SAH) is thought to cause ischemia. To evaluate the contribution of vasospasm to delayed cerebral ischemia (DCI), we investigated the effect of vasospasm on cerebral perfusion and the relationship of vasospasm with DCI. We studied 37 consecutive SAH

  3. Alterations in the Cerebral Microvascular Proteome Expression Profile After Transient Global Cerebral Ischemia in Rat

    DEFF Research Database (Denmark)

    Spray, Stine; Johansson, Sara E; Edwards, Alistair V G;

    2016-01-01

    This study aimed at obtaining an in-depth mapping of expressional changes of the cerebral microvasculature after transient global cerebral ischemia (GCI) and the impact on these GCI-induced expressional changes of post-GCI treatment with a mitogen-activated protein kinase kinase (MEK1/2) inhibitor...

  4. Effect of siRNA‑induced inhibition of IL‑6 expression in rat cerebral gliocytes on cerebral edema following traumatic brain injury.

    Science.gov (United States)

    Xu, Bin; Yu, Dong-Ming; Liu, Fu-Sheng

    2014-10-01

    The present study aimed to investigate the effect of RNA interference (RNAi) on the inhibition of interleukin (IL)‑6 expression in rat cerebral gliocytes in vitro and rat cerebral traumatic tissues in vivo, as well as the effect of RNAi on cerebral edema. pSUPER vectors containing IL‑6 small hairpin RNA (pSUPER‑IL‑6 1‑5) were designed, constructed and transfected into C6 rat glioma cells using cationic liposomes. ELISA was used to select the plasmid with the strongest interference effect. A freefall method was used to generate a rat brain injury model and rats were randomly divided into treatment, empty plasmid and control groups (n=14/group). IL‑6 levels, water content and sodium content were determined in the brain tissues at 24 and 72 h post‑injury. pSUPER‑IL‑6 was effectively transfected into C6 cells and was found to inhibit the expression of IL‑6 rather than IL‑8. The pSUPER‑IL‑6 1 vector was most effective in inducing RNAi. In vivo, IL‑6 levels were observed to be lowest in the interference group and there were statistically significant differences in water and sodium content among the experimental groups (Pcerebral gliocytes, and the reduction of the IL‑6 levels was found to reduce post‑traumatic cerebral edema.

  5. Intraoperative dexmedetomidine and postoperative cerebral hyperperfusion syndrome in patients who underwent superficial temporal artery-middle cerebral artery anastomosis for moyamoya disease

    Science.gov (United States)

    Seo, Hyungseok; Ryu, Ho-Geol; Son, Je Do; Kim, Jeong-Soo; Ha, Eun Jin; Kim, Jeong-Eun; Park, Hee-Pyoung

    2016-01-01

    Abstract Dexmedetomidine, a selective α2-agonist, reduces cerebral blood flow and has neuroprotective effects against cerebral ischemia/reperfusion injury in experimental animals. We examined whether intraoperative dexmedetomidine would reduce the incidence of postoperative cerebral hyperperfusion syndrome (CHS) after superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis in patients with moyamoya disease. The electronic medical records of 117 moyamoya patients who underwent STA-MCA anastomosis were reviewed retrospectively. The patients were divided into 2 groups: 48 patients received intraoperative dexmedetomidine (Group D), while 69 patients did not (Group ND). The incidence (primary outcome), onset, and duration of postoperative CHS were noted. The incidence of postoperative CHS was 45.8% and 40.6% in groups D and ND, respectively (P = 0.708). The duration of postoperative CHS was shorter in group D than in group ND (median [Q1–Q3], 5 [3–7] vs 8 [5–10] days, P = 0.021). There was no significant difference in the onset of CHS between group D and group ND (0 [0–2] vs 1 [0–3] days, P = 0.226). In conclusion, intraoperative dexmedetomidine did not reduce the incidence of postoperative CHS, although it reduced the duration of CHS, in patients who had undergone direct revascularization surgery for moyamoya disease. PMID:28033272

  6. Subintimal arterial flossing with antegrade-retrograde intervention technique in the treatment of long-segment occlusion of the lower extremity artery%双向内膜下血管成形术治疗长段下肢动脉闭塞

    Institute of Scientific and Technical Information of China (English)

    杨景明; 张小明; 张学民; 李伟; 李清乐; 蒋京军; 沈晨阳; 张永保

    2014-01-01

    Objective To review the technical details regarding subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) and evaluate its role in long-segment occlusion of the lower extremity artery.Methods Between May 2012 and Oct 2013,25 patients underwent endovascular recanalization with SAFARI technique.There were 22 male patients and 3 female patients,aged between 55 to 85 years (mean:69 ± 9 years).All patients had intermittent claudication,with distance less than 200 meters,in whom 4 patients had rest pain,3 with gangrene of the toes.The post-treatment and pre-treatment ankle-brachial index (ABI) and symptoms were analyzed.Results In this group,all 25 patients were followed up for 3 to 12 months(mean:5.9 months).One patient had re-occlusion of femoral artery stenting after 6 months.After the treatment,the ischemic symptoms were markedly improved or even disappeared.No severe perioperative complications occurred.The ABI recheck results were 0.90 ± 0.15,with significance compared with that before surgery (mean 0.40 ± 0.28,t =5.28,P < 0.05).Conclusions SAFARI can be used as a remedy to antegrade technique when the wire could not pass the conclusive lesion,significantly improving the success rate of interventional treatment.%目的 分析双向内膜下血管成形术(subintimal arterial flossing with antegrade-retrograde intervention,SAFARI)的技术要点,并评估该技术在长段下肢动脉闭塞人群中的应用. 方法 2012年5月至2013年10月应用SAFARI技术对25例长段下肢动脉闭塞患者进行介入治疗,其中男22例,女3例,年龄55~ 85岁,平均(69±9)岁.临床表现所有患者均有间歇性跛行,跛行距离均<200 m,4例有静息痛,合并足趾坏疽3例.比较手术前、后患者症状及踝肱指数的变化.结果 本组共25例患者均获得随访,随访时间3~12个月,平均随访(6±3)个月.1例患者术后6个月出现股浅动脉支架内再闭塞.所有患者术后缺血引起的症状消失或明

  7. Flurbiprofen axetil promotes neuroprotection by activation of cerebral peroxisome proliferator-activated receptor gamma after focal cerebral ischemia in rats

    Institute of Scientific and Technical Information of China (English)

    LIU Jun-le; JIN Jian-wen; PEI Shu-jun; WANG Chen

    2012-01-01

    I/R+FA ((23.52±9.90)%) was significantly smaller than that in group I/R+FA+GW9662 ((33.17±7.15)%).Conclusions FA confers the neuroprotective effect on tMCAO in rats and the selective PPAR-γ antagonist GW9662 attenuates the effect of FA.FA could promote a neuroprotective effect by,or in part,activation of PPAR-γ after focal cerebral ischemia in rats.

  8. Pre- and postoperative changes of regional cortical cerebral blood flow in patients with cerebral arteriovenous malformation

    Institute of Scientific and Technical Information of China (English)

    石广志; 赵继宗; 王硕; 王永刚; 陆铮

    2003-01-01

    Objective To investigate pre- and postoperative changes of regional cerebral cortical blood flow in patients with cerebral arteriovenous malformation. Method Twenty-two adult patients with arteriovenous malformation(AVM) were recruited into this study at Beijing Tiantan Hospital from September 2001 to May 2002. Eight patients had giant cerebral AVM and the other 14 had a small one. Cortical cerebral blood flow (CBF) was measured by laser Doppler flowmetry (LDF) before and after AVM resections. After surgery, the probe of LDF was implanted adjacent to the area of AVM and monitored for 24 hours.Results CBF increased significantly after the resection in all patients regardless of AVM size. In patients with small AVM, CBF returned to the baseline level within 4 hours, but in patients with giant AVM, CBF remained high even after 24 hours.Conclusions Monitoring CBF is helpful to understand pre- and postoperative changes of regional cortical CBF in patients with cerebral AVM.

  9. Fulminant cerebral infarction of anterior and posterior cerebral circulation after ascending type of facial necrotizing fasciitis.

    Science.gov (United States)

    Lee, Jun Ho; Choi, Hui-Chul; Kim, Chulho; Sohn, Jong Hee; Kim, Heung Cheol

    2014-01-01

    Necrotizing fasciitis is a soft tissue infection that is characterized by extensive necrosis of the subcutaneous fat, neurovascular structures, and fascia. Cerebral infarction after facial necrotizing fasciitis has been rarely reported. A 61-year-old woman with diabetes was admitted with painful swelling of her right cheek. One day later, she was stuporous and quadriplegic. A computed tomographic scan of her face revealed right facial infection in the periorbital soft tissue, parotid, buccal muscle, and maxillary sinusitis. A computed tomographic scan of the brain revealed cerebral infarction in the right hemisphere, left frontal area, and both cerebellum. Four days later, she died from cerebral edema and septic shock. Involvement of the cerebral vasculature, such as the carotid or vertebral artery by necrotizing fasciitis, can cause cerebral infarction. Facial necrotizing fasciitis should be treated early with surgical treatment and the appropriate antibiotic therapy.

  10. The effect of herbs on cerebral energy metabolism in cerebral ischemia-reperfusion mice

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Vascular dementia is one of the most familiar types of senile dementia. Over the past few years, the research on the damage of cerebral tissues after ischemia has become a focus. The factors and mechanism of cerebral tissue damage after ischemia are very complex. The handicap of energy metabolism is regarded as the beginning factor which leads to the damage of neurons, but its dynamic changes in ischemic area and its role during the process of neuronal damage are not very clear. There are few civil reports on using 31 P nuclear magnetic resonance instrument to explore the changes of cerebral energy metabolism in intravital animals. After exploring the influence of herbs on cerebral energy metabolism in ischemia-reperfusion mice, we came to the conclusion that herbs can improve the cerebral energy metabolism in ischemia-reperfusion mice.

  11. Cerebral CT of ischaemic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Aulich, A.

    1981-11-25

    The diagnosis of stroke must first be established by clinical examination. CT has proved useful for confirmation of the diagnosis and provides a global intracranial picture of morphological changes in cerebral vascular diseases. A hemorrhage can be recognized with certainty at the first CT examination as the cause of the stroke, but in the detection of a lesion due to ischemia an important role is played by the correct choice of the time of examination, and in some cases also of the check-up with contrast medium. The differential diagnosis between infarct in the acute stage and encephalitis or gliomas of low-grade malignity can be difficult. A decision can often only be made after a series of examinations. Postmalacial conditions are often difficult to differentiate from defects due to other causes, such as hemorrhage, head injury, postoperative states and after encephalitis. A knowledge of the anamnesis and the clinical findings is indispensable for CT evaluation. In assessing the prognosis before vascular surgery on the extracranial brain-supplying vessels the performance of a CT examination should be advised. A warning is given against the use of CT as a screening method.

  12. Clinical presentation of cerebral aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Cianfoni, Alessandro [Neurocentro della Svizzera Italiana, Ospedale Civico di Lugano, via Tesserete, 46, 6900 Lugano (Switzerland); Pravatà, Emanuele, E-mail: emanuele.pravata@gmail.com [Neurocentro della Svizzera Italiana, Ospedale Civico di Lugano, via Tesserete, 46, 6900 Lugano (Switzerland); De Blasi, Roberto [Neurocentro della Svizzera Italiana, Ospedale Civico di Lugano, via Tesserete, 46, 6900 Lugano (Switzerland); Tschuor, Costa Silvia [Dipartimento di Radiologia, Ospedale Civico di Lugano, via Tesserete, 46, 6900 Lugano (Switzerland); Bonaldi, Giuseppe [U.O. Neuroradiologia, Ospedali Riuniti di Bergamo, Largo Barozzi, 1, 24128 Bergamo (Italy)

    2013-10-01

    Presentation of a cerebral aneurysm can be incidental, discovered at imaging obtained for unrelated causes, can occur in the occasion of imaging obtained for symptoms possibly or likely related to the presence of an unruptured aneurysm, or can occur with signs and symptoms at the time of aneurismal rupture. Most unruptured intracranial aneurysms are thought to be asymptomatic, or present with vague or non-specific symptoms like headache or dizziness. Isolated oculomotor nerve palsies, however, may typically indicate the presence of a posterior circulation aneurysm. Ruptured intracranial aneurysms are by far the most common cause of non-traumatic subarachnoid hemorrhage and represent a neurological emergency with potentially devastating consequences. Subarachnoid hemorrhage may be easily suspected in the presence of sudden and severe headache, vomiting, meningism signs, and/or altered mental status. However, failure to recognize milder and more ambiguous clinical pictures may result in a delayed or missed diagnosis. In this paper we will describe the clinical spectrum of unruptured and ruptured intracranial aneurysms by discussing both typical and uncommon clinical features emerging from the literature review. We will additionally provide the reader with descriptions of the underlying pathophysiologic mechanisms, and main diagnostic pitfalls.

  13. Enlarged perivascular spaces and lacunar infarction Cerebral magnetic resonance evaluation

    Institute of Scientific and Technical Information of China (English)

    Weihong Yan; Jing Fang; Cuijuan Zhou

    2008-01-01

    BACKGROUND:Previous studies have demonstrated that enlarged perivascular spaces(EPVS)arg a result of microvaseular disease.To date,there age few reports about the relationship between EPVS and lacunar infarction.OBJECTIVE:To investigate whether EPVS is associated with lacunar infarction on the basis of cerebral magnetic resonance(MR)examination,clinical symptoms and signs,and past medical history of patients.DESIGN,TIME AND SETTING:Case contrast analysis was performed at the Department of Neurology,Shanghai Ninth People's Hospital from January 2007 to January 2008.PARTICIPANTS:Sixty-eight patients with lacunar infarction were admired to the Department of Neurology of Shanghai Ninth People's Hospital,including 37 cases with first-ever infarction,and 31 with infarction recurrence.In addition,53 healthy people were selected as controls.METHODS:All participants underwent past medical history investigation,nervous system examination.and cranial MR.The subjects were assessed using the JMW rating scale to identify the EPVS grade.MAIN OUTCOME MEASURES:EPVS scores of patients and controls;risk factors for cerebral vascular disease in patients with first-ever or recurrence of lacunar infarction.RESULTS:The EPVS grade from lacunar infarction patients was significantly higher than of the control group(P<0.05).The EPVS grade in patients with recurring lacunar infarction was significantly higher than in patients with first-ever infarction(P<0.05).In addition,hypertension incidence in patients with recurring lacunar infarction was significantly higher than in patients wim first-ever infarction (P<0.05).CONCLUSION:Results indicate that EPVS is related to the incidence of lacunar infarction.Earlier screening of EPVS.and the evaluation of EPVS severity,is of great importance to control the risk factors for cerebral vascular disease and to prevent lacunar infarction.

  14. Endothelial Repair in Childhood Arterial Ischaemic Stroke with Cerebral Arteriopathy

    Directory of Open Access Journals (Sweden)

    Despina Eleftheriou

    2015-06-01

    Full Text Available Background: We have previously shown that recurrent arterial ischaemic stroke (AIS in children with cerebral arteriopathy is associated with increased circulating endothelial cells and endothelial microparticles, consistent with ongoing endothelial injury. To date, however, little is known about endothelial repair responses in childhood AIS. We examined the relationship between the number and function of circulating endothelial progenitor cells (EPC, the levels of brain-derived neurotrophic factor (BDNF and AIS recurrence. Methods: Flow cytometry was used to identify peripheral blood mononuclear cells positive for CD34/kinase insert domain-containing receptor (KDR. In a subgroup of patients (5 in each group selected at random, monocytic EPC function was assessed by colony-forming unit (EPC-CFU capacity and incorporation into endothelial cell networks in Matrigel. BDNF was measured using ELISA. Results: Thirty-five children, aged 12 years (range: 5-16.5; 9 males, with AIS and cerebral arteriopathy were studied; 10 had recurrent AIS. CD34+/KDR+ cells were significantly higher in recurrent AIS compared to non-recurrent AIS patients (p = 0.005 and controls (p = 0.0002. EPC-CFU and EPC incorporation into endothelial cell networks were significantly reduced in recurrent compared to non-recurrent AIS patients (p = 0.04 and p = 0.01, respectively. Levels of BDNF were significantly higher in recurrent compared to non-recurrent AIS patients (p = 0.0008 and controls (p = 0.0002. Conclusions: Children with recurrent AIS and cerebral arteriopathy had increased circulating CD34+/KDR+ cells and BDNF consistent with an endothelial repair response. However, EPC function was impaired. Future studies are needed to examine whether suboptimal endothelial repair contributes to childhood AIS recurrence.

  15. Current status of cerebral glioma surgery in China

    Institute of Scientific and Technical Information of China (English)

    WU Jin-song; ZHANG Jie; ZHUANG Dong-xiao; YAO Cheng-jun; QIU Tian-ming; LU Jun-feng; ZHU Feng-ping; MAO Ying; ZHOU Liang-fu

    2011-01-01

    The treatment of gliomas is highly individualized.Surgery for gliomas is essentially for histological diagnosis,to alleviate mass effect,and most importantly,to favor longer survival expectancy.During the past two decades,many surgical techniques and adjuvants have been applied to glioma surgery in China,which lead to a rapid development in the field of cerebral glioma surgery.This article broadly and critically reviewed the existing studies on cerebral glioma surgery and to portrait the current status of glioma surgery in China.A literature search was conducted covering major innovative surgical techniques and adjuvants for glioma surgery in China.The following databases were searched:the Pubmed (January 1995 to date);China Knowledge Resource Integrated Database (January 1995 to date) and VIP Database for Chinese Technical Periodicals (January 1995 to date).A selection criterion was established to exclude duplicates and irrelevant studies.The outcome measures were extracted from included studies.A total of 3307 articles were initially searched.After excluded by abstracts and full texts,69 studies conducted in the mainland of China were included and went through further analysis.The philosophy of surgical strategies for cerebral gliomas in China is undergoing tremendous change.Nowadays Chinese neurosurgeons pay more attention to the postoperative neurofunctional status of the patients.The aim of the glioma surgery is not only the more extensive tumor resection but also the maximal safety of intervention.The well balance of longer overall survival and higher quality of life should be judged with respect to each individual patient.

  16. Diagnosis, treatment, and prevention of cerebral palsy.

    Science.gov (United States)

    O'Shea, Thomas Michael

    2008-12-01

    Cerebral palsy is the most prevalent cause of persisting motor function impairment with a frequency of about 1/500 births. In developed countries, the prevalence rose after introduction of neonatal intensive care, but in the past decade, this trend has reversed. A recent international workshop defined cerebral palsy as "a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain." In a majority of cases, the predominant motor abnormality is spasticity; other forms of cerebral palsy include dyskinetic (dystonia or choreo-athetosis) and ataxic cerebral palsy. In preterm infants, about one-half of the cases have neuroimaging abnormalities, such as echolucency in the periventricular white matter or ventricular enlargement on cranial ultrasound. Among children born at or near term, about two-thirds have neuroimaging abnormalities, including focal infarction, brain malformations, and periventricular leukomalacia. In addition to the motor impairment, individuals with cerebral palsy may have sensory impairments, cognitive impairment, and epilepsy. Ambulation status, intelligence quotient, quality of speech, and hand function together are predictive of employment status. Mortality risk increases incrementally with increasing number of impairments, including intellectual, limb function, hearing, and vision. The care of individuals with cerebral palsy should include the provision of a primary care medical home for care coordination and support; diagnostic evaluations to identify brain abnormalities, severity of neurologic and functional abnormalities, and associated impairments; management of spasticity; and care for associated problems such as nutritional deficiencies, pain, dental care, bowel and bladder continence, and orthopedic complications. Current strategies to decrease the risk of cerebral palsy include interventions to

  17. Whether chronic bronchitis is an independent risk factor for cerebral infarction in the elderly 1:1 case paired study

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: The inflammatory reaction already becomes an important risk factor of causing acute cerebral infarction; however, the correlation between chronic bronchitis and senile cerebral infarction is still unclear.OBJECTIVE: To study whether the chronic bronchitis is the risk factor for senile cerebral infarction.DESIGN: 1:1 pair, case contrast, and risk factor study.SETTINGS: Department of Respiratory Medicine, Third Hospital of Tangshan; Department of Neurology,Affiliated Hospital of North China Coal Medical College.PARTICIPANTS: A total of 147 patients with acute cerebral infarction who were regarded as case group were selected from Department of Neurology, the Third Hospital of Tangshan from January 2004 to December 2006. All patients met the diagnostic criteria of the Fourth National Cerebrovascular Diseases Meeting. There were 87 males and 60 females, and their ages ranged from 65 to 83 years. Based on 1∶1 pair study, another 147 subjects without cerebrovascular disease were regarded as control group. Except the diseases about infection, there were 73 males and 74 females, and their ages ranged from 62 to 81 years. All subjects provided the confirm consent and agreed with the coordinate experiment.METHODS: ① Questionnaire of risk factor of cerebral infarction was designed to measure the following items: chronic bronchitis, hypertension, diabetes mellitus, hyperlipemia, coronary heart disease, primary cerebral infarction/transient ischemic attack and history of smoking. ② Cerebral infarction was regarded as the dependent variance, while chronic bronchitis, hypertension, diabetes mellitus, hyperiipemia, primary cerebral infarction/transient ischemic attack, coronary heart disease and smoking were regarded as the independent variance for multiple regression analysis.MAIN OUTCOME MEASURES: Risk factors of senile cerebral infarction.RESULTS: All 147 patients with acute cerebral infarction and 147 subjects without cerebrovascular diseases were involved in

  18. Cerebral Tissue Oxygenation during Immediate Neonatal Transition and Resuscitation

    Science.gov (United States)

    Pichler, Gerhard; Schmölzer, Georg M.; Urlesberger, Berndt

    2017-01-01

    This article provides a review of cerebral tissue oxygenation during immediate transition after birth in human neonates. Recommended routine monitoring, especially if resuscitation is needed, during this period includes arterial oxygen saturation and heart rate measured by pulse oximetry and electrocardiogram. However, there is increasing interest to monitor in addition with near-infrared spectroscopy (NIRS) the oxygenation of the brain. There is a different pattern of increase between cerebral tissue oxygenation and arterial oxygen saturation during the immediate transition, with cerebral tissue oxygenation reaching a plateau faster than arterial oxygen saturation. Differences can be explained, since cerebral tissue oxygenation is not only affected by arterial oxygen saturation but also by cerebral blood flow, hemoglobin content, and cerebral oxygen consumption. Normal values have already been established for different devices, gestational ages, and modes of delivery in neonates without any medical support. Cerebral hypoxia during immediate transition might cause brain damage. In preterm neonates with cerebral hemorrhage evolving in the first week after birth, the cerebral tissue oxygenation is already lower in the first minutes after birth compared to preterm neonates without cerebral hemorrhage. Using cerebral NIRS in combination with intervention guidelines has been shown to reduce the burden of cerebral hypoxia in preterm neonates. Cerebral tissue oxygenation during immediate transition seems to have an impact on outcome, whereby NIRS monitoring is feasible and has the advantage of continuous, non-invasive recording. The impact of NIRS monitoring and interventions on short- and long-term outcomes still need to be evaluated. PMID:28280719

  19. Health-Related Quality of Life of Nigerian Children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    A E Ogunrinu

    2011-10-01

    Full Text Available Purpose: To assess the impact of cerebral palsy on health-related quality of life (HRQoL of Nigerian children.Method: This is a cross-sectional survey. The study involved 54 children (33 males and 21 females, between 1 and 12 years of age, with cerebral palsy. They were consecutively recruited from two tertiary health institutions in Lagos, Nigeria. The socio-demographic details of the participants were obtained through interviews. Their HRQoL was assessed using the Child Health Questionnaire-Parent Form-28 (CHQ-PF 28. The questionnaire was completed by their parents, guardians or primary care-givers. Severity of motor disability was assessed and classified using the Gross Motor Function Classification System (GMFCS. Data were summarised using descriptive statistics. Chi-square was used to find the association between each of the selected socio-demographic variables and motor disability, and HRQoL.Results: Thirty-eight children (70.3% were between 1 and 6 years of age, and 16 (29.7% were between 7 and 12 years. The participants’ overall scores and scores on each domain of CHQ-PF 28 were very low. Majority (69.5% were in GMFCS classification-level 1, 7 (13.0% were in level 2, 12 (22.2% were in level 3, 14 (25.9% were in level 4, and 16 (29.6% were in level 5. Age had significant effect (CI = 95% on HRQoL of children with cerebral palsy. Severity of disability had negative impact (CI = 95% on HRQoL of children with cerebral palsy. Conclusions: The health-related quality of life of Nigerian children with cerebral palsy is low, and is negatively affected by age and severity of disability. Key words: Quality of life, cerebral palsy, children, Nigeriadoi 10.5463/DCID.v22i2.24

  20. Time-varying modeling of cerebral hemodynamics.

    Science.gov (United States)

    Marmarelis, Vasilis Z; Shin, Dae C; Orme, Melissa; Rong Zhang

    2014-03-01

    The scientific and clinical importance of cerebral hemodynamics has generated considerable interest in their quantitative understanding via computational modeling. In particular, two aspects of cerebral hemodynamics, cerebral flow autoregulation (CFA) and CO2 vasomotor reactivity (CVR), have attracted much attention because they are implicated in many important clinical conditions and pathologies (orthostatic intolerance, syncope, hypertension, stroke, vascular dementia, mild cognitive impairment, Alzheimer's disease, and other neurodegenerative diseases with cerebrovascular components). Both CFA and CVR are dynamic physiological processes by which cerebral blood flow is regulated in response to fluctuations in cerebral perfusion pressure and blood CO2 tension. Several modeling studies to date have analyzed beat-to-beat hemodynamic data in order to advance our quantitative understanding of CFA-CVR dynamics. A confounding factor in these studies is the fact that the dynamics of the CFA-CVR processes appear to vary with time (i.e., changes in cerebrovascular characteristics) due to neural, endocrine, and metabolic effects. This paper seeks to address this issue by tracking the changes in linear time-invariant models obtained from short successive segments of data from ten healthy human subjects. The results suggest that systemic variations exist but have stationary statistics and, therefore, the use of time-invariant modeling yields "time-averaged models" of physiological and clinical utility.

  1. Effects of desflurane on cerebral autoregulation.

    Science.gov (United States)

    Bedforth, N M; Girling, K J; Skinner, H J; Mahajan, R P

    2001-08-01

    The aim of this study was to determine the effects of desflurane, at 1 and 1.5 MAC, on cerebral autoregulation. Data were analysed from eight patients undergoing non-neurosurgical procedure. The blood flow velocity in the middle cerebral artery was measured by transcranial Doppler ultrasound and cerebral autoregulation was assessed by the transient hyperaemic response test. Partial pressure of the end-tidal carbon dioxide (PE'(CO(2))) and mean arterial pressure were measured throughout the study. Anaesthesia was induced with propofol and was maintained with desflurane at end-tidal concentrations of 7.4% (1 MAC) or 10.8% (1.5 MAC). The order of administration of the desflurane concentrations was determined randomly and a period of 15 min was allowed for equilibration at each concentration. The transient hyperaemic response tests were performed before induction of anaesthesia and after equilibration with each concentration of desflurane. An infusion of phenylephrine was used to maintain pre-induction mean arterial pressure and ventilation was adjusted to maintain the pre-induction value of PE'(CO(2)) throughout the study. Two indices derived from the transient hyperaemic response test (the transient hyperaemic response ratio and the strength of autoregulation) were used to assess cerebral autoregulation. Desflurane resulted in a marked and significant impairment in cerebral autoregulation; at concentrations of 1.5 MAC, autoregulation was almost abolished.

  2. Regional Cerebral Perfusion in Progressive Supranuclear Palsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Yong; Lee, Ki Hyeong; Yoon, Byung Woo; Lee, Sang Bok; Jeon, Beom S. [Samsung Medical Center, Seoul (Korea, Republic of); Lee, Kyung Han; Lee, Myung Chul [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1996-03-15

    Progressive supranuclear palsy (PSP) is a Parkinson-plus syndrome characterized clinically by supranuclear ophthalmoplegia, pseudobulbar palsy, axial rigidity, bradykinesia, postural instability and dementia. Presence of dementia and lack of cortical histopathology suggest the derangement of cortical function by pathological changes in subcortical structures in PSP, which is supported by the pattern of behavioral changes and measurement of brain metabolism using positron emission tomography. This study was done to examine whether there are specific changes of regional cerebral perfusion in PSP and whether there is a correlation between severity of motor abnormaility and degree of changes in cerebral perfusion. We measured regional cerebral perfusion indices in 5 cortical and 2 subcortical areas in 6 patients with a clinical diagnosis of PSP and 6 healthy age and sex matched controls using Tc-99m-HMPAO SPECT. Compared with age and sex matched controls, only superior frontal regional perfusion index was significantly decreased in PSP (p<0.05). There was no correlation between the severity of the motor abnormality and any of the regional cerebral perfusion indices (p>0.05). We affirm the previous reports that perfusion in superior frontal cortex is decreased in PSP. Based on our results that there was no correlation between severity of motor abnormality and cerebral perfusion in the superior frontal cortex, nonmotoric symptoms including dementia needs to be looked at whether there is a correlation with the perfusion abnormality in superior frontal cortex

  3. [Ischaemic lesions of cerebral after carotid stenting].

    Science.gov (United States)

    Medvedev, R B; Tanashian, M M; Kuntsevich, G I; Lagoda, O V; Skrylev, S I; Krotenkova, M V; Koshcheev, A Iu; Suslin, A S; Gemdzhian, É G

    2015-01-01

    Carotid angioplasty with stenting is a reliable method of primary and secondary prevention of ischaemic stroke in patients with stenosing lesions of the internal carotid artery. However, carrying out such operations is sometimes associated with risk for the development of intraoperative impairments of cerebral circulation due to arterioarterial embolism in cerebral arteries, as well as vasospasm. Presented herein are the results of following up a total of 64 patients with pronounced atherosclerotic lesions of internal carotid arteries (>70%) - "symptomatic" and "asymptomatic", undergoing carotid stenting. Acute foci of ischaemia in the brain after stenting according to the findings of diffusion-weighted magnetic resonance tomography were revealed in 40% of cases, and in only 6% of patients they manifested themselves by symptoms of acute cerebral circulatory impairment. We revealed a direct correlation between the number, size of infarctions in the brain, and the appearance of neurological symptomatology. Intraoperative monitoring of blood flow in the middle cerebral artery during stenting makes it possible to predict the appearance of acute foci of cerebral ischaemia, to specify the genesis of perioperative stroke, as well as to evaluate clinical significance of vasospasm and material microembolism. The obtained findings should concentrate neurologists' attention on active postoperative follow up of patients subjected to carotid angioplasty with stenting in order to perform adequate personified neuroprotective correction, including preventive one.

  4. Cerebral Air Embolism from Angioinvasive Cavitary Aspergillosis

    Directory of Open Access Journals (Sweden)

    Chen Lin

    2014-01-01

    Full Text Available 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.

  5. Mechanisms of Astrocyte-Mediated Cerebral Edema

    Science.gov (United States)

    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

  6. Moderate hyperventilation during intravenous anesthesia increases net cerebral lactate efflux

    NARCIS (Netherlands)

    F. Grüne (Frank); S. Kazmaier (Stephan); B. Sonntag (Barbara); R.J. Stolker (Robert); A. Weyland (Andreas)

    2014-01-01

    textabstractBACKGROUND:: Hyperventilation is known to decrease cerebral blood flow (CBF) and to impair cerebral metabolism, but the threshold in patients undergoing intravenous anesthesia is unknown. The authors hypothesized that reduced CBF associated with moderate hyperventilation might impair cer

  7. Gastrostomy tube feeding of children with cerebral palsy

    DEFF Research Database (Denmark)

    Dahlseng, Magnus O; Andersen, Guro L; DA Graca Andrada, Maria

    2012-01-01

    To compare the prevalence of gastrostomy tube feeding (GTF) of children with cerebral palsy (CP) in six European countries.......To compare the prevalence of gastrostomy tube feeding (GTF) of children with cerebral palsy (CP) in six European countries....

  8. Cerebral near infrared spectroscopy oximetry in extremely preterm infants

    DEFF Research Database (Denmark)

    Hyttel-Sorensen, Simon; Pellicer, Adelina; Alderliesten, Thomas;

    2015-01-01

    OBJECTIVE: To determine if it is possible to stabilise the cerebral oxygenation of extremely preterm infants monitored by cerebral near infrared spectroscopy (NIRS) oximetry. DESIGN: Phase II randomised, single blinded, parallel clinical trial. SETTING: Eight tertiary neonatal intensive care units...

  9. Endovascular treatment of posterior cerebral artery aneurysms using detachable coils

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Hong Gee [Kangwon National University Hospital, Department of Radiology, Chuncheon, Kangwon-do (Korea); Konkuk University Hospital, Department of Radiology, Seoul (Korea); Kim, Sam Soo; Han, Heon [Kangwon National University Hospital, Department of Radiology, Chuncheon, Kangwon-do (Korea); Kang, Hyun-Seung [Konkuk University Hospital, Department of Neurosurgery, Seoul (Korea); Moon, Won-Jin [Konkuk University Hospital, Department of Radiology, Seoul (Korea); Byun, Hong Sik [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea)

    2008-03-15

    Aneurysms of the posterior cerebral artery (PCA) are rare, and most of the studies reported in the literature in which the endovascular approach was applied were carried out on a limited number of patients with PCA aneurysms. We retrospectively reviewed our cases of PCA aneurysms - at various locations and of differing shapes - that received endovascular treatment and evaluated the treatment outcome. From January 1996 to December 2006, 13 patients (eight females and five males) with 17 PCA aneurysms (nine fusiform and eight saccular) were treated using the endovascular approach. The age of the patients ranged from 20 to 67 years, with a mean age of 44 years. Of the 13 patients, ten presented with intracranial hemorrhage, and one patient, with a large P2 aneurysm, presented with trigeminal neuralgia; the aneurysms were asymptomatic in the remaining two patients. All 13 patients were successfully treated, with only one procedure-related symptomatic complication. Seven patients were treated by occlusion of the aneurysm and parent artery together; five patients, by selective embolization of the aneurysm; one patient, by partial coiling. Although infarctions were found in two patients treated with selective embolization and in three patients treated with parent artery occlusion, only one patient with a ruptured P2 aneurysm treated with parent artery occlusion developed transient amnesia as an ischemic symptom. Posterior cerebral artery aneurysms can be treated safely with either occlusion of the aneurysm together with the PCA or with a selective coil embolization. Infarctions may occur after endovascular treatment, but they are rarely the cause of a disabling symptom. (orig.)

  10. Endovascular and microsurgical treatment of cerebral arteriovenous malformations: Current recommendations

    Science.gov (United States)

    Conger, Andrew; Kulwin, Charles; Lawton, Michael T.; Cohen-Gadol, Aaron A.

    2015-01-01

    Background: Cerebral arteriovenous malformations (AVMs) can be a heterogeneous pathological entity whose management requires a complex decision-making process due to the risks associated with their treatment and natural history. Despite the recently published conclusions of the aborted Randomized Trial of Brain Unruptured AVMs (ARUBA) trial, the authors of this article believe multimodality intervention in general and microsurgical resection in particular continue to play a major role in the management of carefully selected ruptured or unruptured AVMs. Methods: The authors provide an overview of their methodology for endovascular intervention and microsurgical resection and share their technical nuances for successful embolization and microsurgical resection of AVMs with special emphasis on complication avoidance. Results: The authors have achieved successful outcomes in embolization and resection of cerebral AVMs when using their methodology. Conclusions: These lesions are among the most technically difficult pathological entities handled by the cerebrovascular specialist, and an overview of technical concepts to help systematize this challenging and variable endeavor can improve the safety of their treatment. PMID:25883831

  11. The future of human cerebral cartography: a novel approach.

    Science.gov (United States)

    Frackowiak, Richard; Markram, Henry

    2015-05-19

    Cerebral cartography can be understood in a limited, static, neuroanatomical sense. Temporal information from electrical recordings contributes information on regional interactions adding a functional dimension. Selective tagging and imaging of molecules adds biochemical contributions. Cartographic detail can also be correlated with normal or abnormal psychological or behavioural data. Modern cerebral cartography is assimilating all these elements. Cartographers continue to collect ever more precise data in the hope that general principles of organization will emerge. However, even detailed cartographic data cannot generate knowledge without a multi-scale framework making it possible to relate individual observations and discoveries. We propose that, in the next quarter century, advances in cartography will result in progressively more accurate drafts of a data-led, multi-scale model of human brain structure and function. These blueprints will result from analysis of large volumes of neuroscientific and clinical data, by a process of reconstruction, modelling and simulation. This strategy will capitalize on remarkable recent developments in informatics and computer science and on the existence of much existing, addressable data and prior, though fragmented, knowledge. The models will instantiate principles that govern how the brain is organized at different levels and how different spatio-temporal scales relate to each other in an organ-centred context.

  12. Cerebral oscillatory activity during simulated driving using MEG

    Directory of Open Access Journals (Sweden)

    Kotoe eSakihara

    2014-12-01

    Full Text Available We aimed to examine cerebral oscillatory differences associated with psychological processes during simulated car driving. We recorded neuromagnetic signals in 14 healthy volunteers using magnetoencephalography (MEG during simulated driving. MEG data were analyzed using synthetic aperture magnetometry to detect the spatial distribution of cerebral oscillations. Group effects between subjects were analyzed statistically using a nonparametric permutation test. Oscillatory differences were calculated by comparison between passive viewing and active driving. Passive viewing was the baseline, and oscillatory differences during active driving showed an increase or decrease in comparison with a baseline. Power increase in the theta band was detected in the superior frontal gyrus (SFG during active driving. Power decreases in the alpha, beta, and low gamma bands were detected in the right inferior parietal lobe (IPL, left postcentral gyrus (PoCG, middle temporal gyrus (MTG, and posterior cingulate gyrus (PCiG during active driving. Power increase in the theta band in the SFG may play a role in attention. Power decrease in the right IPL may reflect selectively divided attention and visuospatial processing, whereas that in the left PoCG reflects sensorimotor activation related to driving manipulation. Power decreases in the MTG and PCiG may be associated with object recognition.

  13. Cerebral oscillatory activity during simulated driving using MEG.

    Science.gov (United States)

    Sakihara, Kotoe; Hirata, Masayuki; Ebe, Kazutoshi; Kimura, Kenji; Yi Ryu, Seong; Kono, Yoshiyuki; Muto, Nozomi; Yoshioka, Masako; Yoshimine, Toshiki; Yorifuji, Shiro

    2014-01-01

    We aimed to examine cerebral oscillatory differences associated with psychological processes during simulated car driving. We recorded neuromagnetic signals in 14 healthy volunteers using magnetoencephalography (MEG) during simulated driving. MEG data were analyzed using synthetic aperture magnetometry to detect the spatial distribution of cerebral oscillations. Group effects between subjects were analyzed statistically using a non-parametric permutation test. Oscillatory differences were calculated by comparison between "passive viewing" and "active driving." "Passive viewing" was the baseline, and oscillatory differences during "active driving" showed an increase or decrease in comparison with a baseline. Power increase in the theta band was detected in the superior frontal gyrus (SFG) during active driving. Power decreases in the alpha, beta, and low gamma bands were detected in the right inferior parietal lobe (IPL), left postcentral gyrus (PoCG), middle temporal gyrus (MTG), and posterior cingulate gyrus (PCiG) during active driving. Power increase in the theta band in the SFG may play a role in attention. Power decrease in the right IPL may reflect selectively divided attention and visuospatial processing, whereas that in the left PoCG reflects sensorimotor activation related to driving manipulation. Power decreases in the MTG and PCiG may be associated with object recognition.

  14. INFLUENCE OF DIFFERENT NEEDLE-RETAINING DURATION ON CEREBRAL HEMODYNAMICS OF CEREBRAL PARALYSIS CHILDREN

    Institute of Scientific and Technical Information of China (English)

    袁青; 王琴玉; 冯健强; 张壮涛; 陈雪云; 靳瑞

    2004-01-01

    Objective: To investigate the effects of different needle-retaining duration on cerebral hemodynamics in cerebral paralysis (CP) children.Methods: A total of 20 cases of CP children were subjected into this study.Changes of systolic peak value (Vs), blood flow velocity at the end-diastolic phase (Ved), mean velocity (Vm), pulsation index (PI) and resistance index (RI) of the cerebral hemodynamics before and after performing JIN's Three-Needling Therapy with the needles retained for 30 min (group A) and 5 min (group B) were observed by using transcranial Doppler ultrasonography (TCD).Results: After acupuncture, the blood flow in the middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA) was accelerated, and the resistance of blood vessels decreased.The effect of needle-retaining-30 min was better than that of needle-retaining-5 min.Conclusion: In treating cerebral paralysis by using JIN's Three-Needling Therapy, sufficient stimulation provided by needle remaining is an important factor for achieving satisfactory therapeutic effects.

  15. Intrathecal baclofen therapy for spasticity of cerebral origin: cerebral palsy and brain injury.

    Science.gov (United States)

    Nuttin, B; Ivanhoe, C; Albright, L; Dimitrijevic, M; Saltuari, L

    1999-04-01

    Spasticity affects approximately 66% of individuals with cerebral palsy and 14% of the 100,000 individuals who, each year, experience brain injury in the US. This spasticity interferes with motor function and limits range of motion. It may cause pain and impede mobility, transfers, activities of daily living, sitting posture, and sleep. In addition, spasticity can contribute to the formation of pressure sores and joint contractures and make nursing or caregiving difficult. Several treatment options are available for intractable spasticity. For some diagnoses, oral medications are still the treatment of choice, while in other settings injection therapy may be more appropriate. If, however, they are ineffective or cause too many side effects, intrathecal baclofen therapy (ITB) may be a valuable alternative. ITB is effective, nondestructive, titratable, and reversible. In addition, it is associated with fewer CNS-related side effects than oral Lioresal (Novartis Pharma AG, Basel, Switzerland). Intrathecal baclofen therapy may improve range of motion, facilitate movement, reduce the patient's expenditure of energy, facilitate nursing, reduce the risk of developing contractures, and, in some cases, diminish pain resulting from spasticity and/or spasms. It also may improve speech, gait, upper extremity function, and activities of daily living, including communication, eating, dressing, hygiene, and other aspects of self-care. A recent study shows that treatment with intrathecal baclofen reduces the need for corrective orthopedic surgeries. Patient selection should be done in a multidisciplinary spasticity setting, where the expertise for different treatment modalities is available. Patients must be screened for response to the drug prior to implantation of the drug delivery pump. Maintenance doses for intrathecal baclofen range from 22 to 1400 μg/day, with most patients adequately maintained on 90-703 μg/day. Complications, while rare, are most often related to the

  16. Cerebral vascular effects of hypovolemia and dopamine infusions

    DEFF Research Database (Denmark)

    Holst Hahn, Gitte; Heiring, Christian; Pryds, Ole

    2012-01-01

    Despite widespread use, effects of volume boluses and dopamine in hypotensive newborn infants remain controversial. We aimed to elucidate if hypovolemia alone impairs cerebral autoregulation (CA) and if dopamine affects cerebral vasculature.......Despite widespread use, effects of volume boluses and dopamine in hypotensive newborn infants remain controversial. We aimed to elucidate if hypovolemia alone impairs cerebral autoregulation (CA) and if dopamine affects cerebral vasculature....

  17. An Adult Case of Diabetic Ketoacidosis Presenting with Cerebral Edema

    OpenAIRE

    Barış Akıncı; Abdurrahman Çömlekçi; Serkan Yener; Süleyman Men

    2009-01-01

    Cerebral edema is a life-threatening complication of diabetic ketoacidosis (DKA) which may predominantly develop in pediatric cases during the management of DKA.. Symptomatic cerebral edema in children is rarely detected at admission, before initiation of the treatment. Cerebral edema associated with DKA is extremely rare in adults. Here, we report an adult patient with DKA who presented with symptomatic cerebral edema. Turk Jem 2009; 13: 16-8

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

    Science.gov (United States)

    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.

  19. [Does cerebral salt wasting syndrome exist?].

    Science.gov (United States)

    Leblanc, P-E; Cheisson, G; Geeraerts, T; Tazarourte, K; Duranteau, J; Vigué, B

    2007-11-01

    Increased natriuresis is a frequent situation after subarachnoid haemorrhage (SAH). It may be responsible for hyponatremia, which can be dangerous in case of severe hypo-osmolarity or hypovolemia. Inappropriate secretion of antidiuretic hormone or cerebral salt wasting syndrome (CSWS) have been incriminated for hyponatremia after SAH, but it remains difficult to distinguish between both syndromes. There are many explanations for increased natriuresis after SAH, depending on the level of blood pressure, the volemia, and the presence or not of natriuretic peptides. The cerebral insult and the treatments, which are done to fight against elevated intracranial pressure or vasospasm, can modify any of these parameters. So it appears that the word "cerebral" in CSWS is probably not a good term and it would be better to talk about appropriate or non-appropriate natriuretic response. Corticoïds or urea can be useful for controlling hypernatriuresis.

  20. [Chronic cerebral ischemia associated with Raynaud's syndrome].

    Science.gov (United States)

    Putilina, M V

    2015-01-01

    Over the last years, a number of patients with chronic cerebral ischemia has been increased significantly. Compensatory possibilities of the brain and cerebral circulatory system are so great that even serious disturbances of blood circulation could not cause clinical signs of brain dysfunction for a long time. At the same time, long-term ischemia can lead to peripheral local disturbances of microcirculation that is appears to be a first signal of the problems with homeostasis. Therefore, Raynaud's syndrome may be one of the predictors of standard symptoms of chronic cerebral ischemia (CCI). This phenomenon is explicitly considered as a sign of blood circulation impairment while the pathogenetic mechanism of vascular arterial bed instability is completely ignored. Detailed study of clinical correlations of Raynaud's syndrome in CCI would help to develop a common pharmacotherapeutic approach to its treatment.

  1. Renovascular hypertension causes cerebral vascular remodeling

    Institute of Scientific and Technical Information of China (English)

    Yamei Tang; Xiangpen Li; Yi Li; Qingyu Shen; Xiaoming Rong; Ruxun Huang; Ying Peng

    2011-01-01

    Renovascular hypertensive rats (RHRs) were developed using the 2-kidney, 2-clip method. All RHRs at 10 weeks displayed high permeability of the cerebral surface blood vessels. Vascular casts of the RHRs showed that the vascular network was sparse. The arterioles of the RHRs at 10 weeks had smaller lumen diameters, but thicker vessel walls with hyalinosis formation compared with control animals. The endothelial cell membrane appeared damaged, and microthrombus formed. After ischemia, the infarction size was larger in RHRs than in control animals. These results suggest that cerebral arterioles in RHRs underwent structural remodeling. High blood pressure may aggravate the severity of brain injury in cerebral ischemia and affect the recovery of ischemia.

  2. Primary Cerebral Hydatid Cyst: Two Cases Report

    Directory of Open Access Journals (Sweden)

    Farideh Nejat

    2008-04-01

    Full Text Available Objective: Cerebral hydatid disease (CHD is a rare manifestation of echinococcosis but it constitutes a significant fraction of all intracranial mass lesions. In this paper we have reported two children with primary CHD without associated extracranial lesions.Case Presentation: Two cases of isolated cerebral hydatid disease are described. They were 7- and 10-year old children referred with focal neurological deficits and intracranial hypertension. Extensive extracranial investigations were negative. The literature concerning isolated cerebral hydatid disease is reviewed, and possible mechanisms by which the disease can be limited to brain, are discussed.Conclusion: Isolated CHD can occur with different mechanisms. Lack of effective immune system in the brain, the special architecture of brain tissue permitting rapid growth of cyst, patent ductus arteriosus, and patent foramen ovale, have been the proposed factors, but none of them has been proved yet.

  3. [Transcranial electrostimulation in chronic cerebral vascular insufficiency].

    Science.gov (United States)

    Voropaev, A A; Mochalov, A D

    2006-01-01

    The method of transcranial electrostimulation (TCES) has been used for treatment of 68 patients with chronic cerebral vascular insufficiency, stages I and II. A treatment course included 7 daily procedures. The influence of TCES was evaluated clinically, by EEG, transcranial ultrasonic Doppler study and hemodynamic indices in arteries and veins as well as by expression of trait and state anxiety. All the parameters were compared to those of the control group which was treated using conventional methods. TCES resulted in normalization of cerebral vascular reactivity, a decrease of venous circulation disturbances, positive influence on cerebral blood flow and EEG parameters, that corresponded to global improvement of the patients' state, regress of cephalgic syndrome and reduction of trait and state anxiety. The method is simple and safety and can be recommended for wide application including outpatient setting.

  4. Computerized tomographic evaluation of cerebral cysticercosis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bo Young; Lee, Mi Sook; Jeon, Doo Sung; Kim, Hong Soo; Rhee, Hak Song [Precbyterian Medical Center, Chonju (Korea, Republic of)

    1988-08-15

    Cerebral cysticercosis, unfortunately frequent in Korea, is a parastic disease in which man serve as the intermediate host of taenia solium. The larvae have a predilection for the central nervous system and can cause a variety of neurologic symptoms. The authors reviewed 19 cases of surgically proven cerebral cysticercosis and following results were obtained. 1. The most frequent age distribution was 5th and 6th decade and male to female ratio was 14:5. 2. The most frevalent involving site was cerebral parenchyme and following by ventricles. 3. Clinical manifestations were symtom and sign of increased ICP, seizure and focal neurological dificit. 4. It was assumed that computerized tomography was the procedure of choice for the diagnosis of these parasitic brain disease.

  5. An interesting case of cerebral abscess.

    Science.gov (United States)

    Rafiq, Muhammad Khizar

    2009-01-01

    An immigrant from Romania was referred to the neurosurgical unit with a cerebral abscess. On examination she was cyanosed and had clubbing of her fingers. A cardiovascular system examination revealed a systolic murmur heard all over the precordium. However, the diagnosis was not congenital cyanotic heart disease. The patient had a history of frequent nosebleeds and had multiple telangiectases on her body, leading to the diagnosis of hereditary haemorrhagic telangiectasia (HHT). A search was carried out for the presence of arteriovenous malformations in internal organs. Large arteriovenous malformations were found in the lungs, causing her cyanosis due to right-to-left shunting of blood and cerebral abscess due to paradoxical septic embolisation into cerebral circulation.

  6. Neurociências, neurocultura e autoajuda cerebral

    Directory of Open Access Journals (Sweden)

    Francisco Ortega

    Full Text Available Este artigo pretende analisar o fenômeno denominado de neuroascese, ou autoajuda cerebral no contexto do crescente impacto das neurociências e do surgimento da neurocultura e do sujeito cerebral. Para tanto, é importante compreender o âmbito sóciocultural mais amplo no qual a neuroascese se insere e que corresponde ao que vem se chamando de 'cultura somática' ou, mais especificamente, de biossociabilidade. O objetivo do artigo é explorar como uma forma de subjetividade reducionista, o sujeito cerebral, dá lugar à aparição de práticas de si cerebrais, isto é, práticas de como agir sobre o cérebro para maximizar a sua performance, que levam a formação de novas formas de sociabilidade.

  7. Perfusion Pressure Cerebral Infarct (PPCI) trial

    DEFF Research Database (Denmark)

    Vedel, Anne G.; Holmgaard, Frederik; Rasmussen, Lars Simon

    2016-01-01

    to be caused by emboli, but inadequate blood flow caused by other mechanisms may increase ischaemia in the penumbra or cause watershed infarcts. During cardiopulmonary bypass, blood pressure can be below the lower limit of cerebral autoregulation. Although much debated, the constant blood flow provided...... by the cardiopulmonary bypass system is still considered by many as appropriate to avoid cerebral ischaemia despite the low blood pressure. Methods/design: The Perfusion Pressure Cerebral Infarct trial is a single-centre superiority trial with a blinded outcome assessment. The trial is randomising 210 patients...... with coronary vessel and/or valve disease and who are undergoing cardiac surgery with the use of cardiopulmonary bypass. Patients are stratified by age and surgical procedure and are randomised 1:1 to either an increased mean arterial pressure (70–80 mmHg) or ‘usual practice’ (40–50 mmHg) during cardiopulmonary...

  8. THE EFFECT OF ANISODAMINE ON CEREBRAL RESUSCITATION OF RATS IN ACUTE CEREBRAL ISCHEMIA FROM CARDIAC ARREST

    Institute of Scientific and Technical Information of China (English)

    彭新琦; 曹苏谊; 可君

    1995-01-01

    In order to investigate the mechanisms of acute cerebral ischemia,and to look for effective drugs on cerebral resuscitation,we made a model of acute complete global brain ischemia,reperfusion and resuscita-tion on rats according to Garavilla's method.Our results showed that the event of cerebral ischemia and reperfusion injury could result in the in-crease of total brain calcium content,and anisodamine has the same reducing brain calcium contents as dil-tiazem's,while improving neurological outcome and alleviating injury to neurons.

  9. Radiologic manifestations of focal cerebral hyperemia in acute stroke

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Skriver, E B; Herning, M

    1991-01-01

    In 16 acute stroke patients with focal cerebral hyperemia angiography and regional cerebral blood flow (rCBF) were studied 1 to 4 days post stroke. CT was performed twice with and without contrast enhancement 3 +/- 1 days and 16 +/- 4 days post stroke. Angiographic evidence of focal cerebral hype...

  10. Low cerebral blood flow in hypotensive perinatal distress

    DEFF Research Database (Denmark)

    Lou, H C; Lassen, N A; Friis-Hansen, B

    1977-01-01

    was used for the cerebral blood flow measurements. The study confirmed that perinatal distress may be associated with low arterial blood pressure, and it was shown that cerebral blood flow is very low, 20 ml/100 g/min or less, in hypotensive perinatal distress. It is concluded that cerebral ischaemia plays...

  11. Clinical significance of urine ferritin in patients with cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    周慧

    2013-01-01

    Objective To find an indicator in urine to assist diagnosis of cerebral infarction,we investigated the changes of urine ferritin in patients with cerebral infarction.Methods Collected serum from 30 healthy volunteers and 53 patients with cerebral infarction (CI) ,with ratio ofmales to females

  12. MRI findings and differential diagnosis in children with cerebral paragonimiasis

    Directory of Open Access Journals (Sweden)

    Zhen Zeng

    2016-06-01

    Conclusions: The clinical manifestations of cerebral paragonimiasis are nonspecific in children while the MRI findings of cerebral paragonimiasis are characteristic, including irregular hemorrhage, ring-like enhancement and disproportionately large areas of surrounding edema. Brain MRI plays an important role in the diagnosis of cerebral paragonimiasis in children.

  13. Recirculation usually precedes malignant edema in middle cerebral artery infarcts

    DEFF Research Database (Denmark)

    Nielsen, T H; Ståhl, N; Schalén, W;

    2012-01-01

    In patients with large middle cerebral artery (MCA) infarcts, maximum brain swelling leading to cerebral herniation and death usually occurs 2-5 days after onset of stroke. The study aimed at exploring the pattern of compounds related to cerebral energy metabolism in infarcted brain tissue....

  14. Cephalea, Horner's syndrome and cerebral ischemia: pathognomonic triad

    Directory of Open Access Journals (Sweden)

    Fulvio Pomero

    2007-06-01

    Full Text Available Dissection of cerebral vessels represents an important cause of stroke in young patients without cardiovascular risk factors. Clinical feature of this pathology is quite peculiar and is described as combination of cephalea, Horner’s syndrome and cerebral ischemia. Clinical suspicion and fast access to ecocolordoppler are the only ways to save vessels’ patency and to restore cerebral blood flow.

  15. Cerebral microbleeds in a neonatal rat model

    Science.gov (United States)

    Carusillo Theriault, Brianna; Woo, Seung Kyoon; Karimy, Jason K.; Keledjian, Kaspar; Stokum, Jesse A.; Sarkar, Amrita; Coksaygan, Turhan; Ivanova, Svetlana; Gerzanich, Volodymyr

    2017-01-01

    Background In adult humans, cerebral microbleeds play important roles in neurodegenerative diseases but in neonates, the consequences of cerebral microbleeds are unknown. In rats, a single pro-angiogenic stimulus in utero predisposes to cerebral microbleeds after birth at term, a time when late oligodendrocyte progenitors (pre-oligodendrocytes) dominate in the rat brain. We hypothesized that two independent pro-angiogenic stimuli in utero would be associated with a high likelihood of perinatal microbleeds that would be severely damaging to white matter. Methods Pregnant Wistar rats were subjected to intrauterine ischemia (IUI) and low-dose maternal lipopolysaccharide (mLPS) at embryonic day (E) 19. Pups were born vaginally or abdominally at E21-22. Brains were evaluated for angiogenic markers, microhemorrhages, myelination and axonal development. Neurological function was assessed out to 6 weeks. Results mRNA (Vegf, Cd31, Mmp2, Mmp9, Timp1, Timp2) and protein (CD31, MMP2, MMP9) for angiogenic markers, in situ proteolytic activity, and collagen IV immunoreactivity were altered, consistent with an angiogenic response. Vaginally delivered pups exposed to prenatal IUI+mLPS had spontaneous cerebral microbleeds, abnormal neurological function, and dysmorphic, hypomyelinated white matter and axonopathy. Pups exposed to the same pro-angiogenic stimuli in utero but delivered abdominally had minimal cerebral microbleeds, preserved myelination and axonal development, and neurological function similar to naïve controls. Conclusions In rats, pro-angiogenic stimuli in utero can predispose to vascular fragility and lead to cerebral microbleeds. The study of microbleeds in the neonatal rat brain at full gestation may give insights into the consequences of microbleeds in human preterm infants during critical periods of white matter development. PMID:28158198

  16. Normal cerebral FDG uptake during childhood

    Energy Technology Data Exchange (ETDEWEB)

    London, Kevin [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Discipline of Paediatrics and Child Health, Sydney Medical School, Sydney, NSW (Australia); Howman-Giles, Robert [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Disciplines of Imaging and Paediatrics and Child Health, Sydney Medical School, Sydney, NSW (Australia)

    2014-04-15

    Current understanding of cerebral FDG uptake during childhood originates from a small number of studies in patients with neurological abnormalities. Our aim was to describe cerebral FDG uptake in a dataset of FDG PET scans in children more likely to represent a normal population. We reviewed cerebral FDG PET scans in children up to 16 years of age with suspected/proven extracranial malignancies and the following exclusions: central nervous system metastases, previous malignancies, previous chemotherapy or radiotherapy, development of cerebral metastases during therapy, neurological conditions, taking antiepileptic medication or medications likely to interfere with cerebral metabolism, and general anaesthesia within 24 h. White matter, basal ganglia, thalamus and the cerebellar cortex were analysed using regional SUV{sub max}, and the cerebral cortex, basal ganglia, thalamus and cerebellum were analysed using a regional relative uptake analysis in comparison to maximal cortical uptake. Scans from 30 patients (age range 11 months to 16 years, mean age 10 years 5 months) were included. All regions showed increasing SUV{sub max} with age. The parietal, occipital, lateral temporal and medial temporal lobes showed lower rates of increasing FDG uptake causing changing patterns of regional FDG uptake during childhood. The cortical regions showing the most intense uptake in early childhood were the parietal and occipital lobes. At approximately 7 years of age these regions had relatively less uptake than the frontal lobes and at approximately 10 years of age these regions had relatively less uptake than the thalamus. Relative FDG uptake in the brain has not reached an adult pattern by 1 year of age, but continues to change up to 16 years of age. The changing pattern is due to different regional rates of increasing cortical FDG uptake, which is less rapid in the parietal, occipital and temporal lobes than in the frontal lobes. (orig.)

  17. Epidemiology of cerebral palsy in Southern Denmark

    DEFF Research Database (Denmark)

    Frøslev-Friis, Christina; Dunkhase-Heinl, Ulrike; Andersen, Johnny Dohn Holmgren;

    2015-01-01

    INTRODUCTION: The aim of this study was to describe the prevalence, subtypes, severity and neuroimaging findings of cerebral palsy (CP) in a cohort of children born in Southern Denmark. Risk factors were analysed and aetiology considered. METHODS: A population-based cohort study covering 17...... prevention of CP is possible if the numbers of preterm births and multiple pregnancies can be reduced. FUNDING: The Danish Cerebral Palsy Follow-up Programme is supported by the foundation "Ludvig og Sara Elsass Fond". TRIAL REGISTRATION: 2008-58-0034....

  18. Trombosis venosa cerebral recurrente en el embarazo

    OpenAIRE

    Gajino S,Clara; Lamelas P,Melania; Cordeiro V,Gloria; Couceiro N,Emilio; López Ramón y Cajal,Carlos Nicolás

    2014-01-01

    La trombosis venosa cerebral es una enfermedad poco frecuente, pero de pronóstico potencialmente grave. Debido a los cambios hemostáticos durante la gestación, es una patología que puede asociarse al embarazo. Presenta un amplio rango de signos y síntomas. El diagnóstico y tratamiento precoz mejoran el pronóstico. Presentamos el caso de una mujer de 30 años, que en la semana 8 de gestación acude a Urgencias por cefalea intensa y cuya resonancia magnética reveló una trombosis venosa cerebral. ...

  19. Reversible cerebral vasconstriction syndrome: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Sub; Park, Ji Kang; Kim, Seung Hyoung; Jeong, Sun Young [Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of)

    2013-11-15

    We report a 46-year-old woman patient with reversible cerebral vasoconstriction syndrome (RCVS). She presented with severe headache, multiple cerebral infarction, and multifocal severe stenosis in the intracranial arteries on magnetic resonance angiography (MRA). One month after the episode, a small bowel gastrointestinal stromal tumor (GIST) was incidentally detected during the evaluation of severe anemia and GIST was removed. Follow-up MRA was performed 3 months and 1 year after an initial attack of headache, and multifocal severe intracranial arterial stenotic lesions were completely resolved, she did not experience any episode of RCVS during the 2 years.

  20. [Cerebral salt wasting syndrome in bacterial meningitis].

    Science.gov (United States)

    Attout, H; Guez, S; Seriès, C

    2007-10-01

    Subarachnoid hemorrhage is the most common cause of cerebral salt wasting syndrome. There are few reports of this condition in infectious meningitis. We describe a patient with hyponatremia and bacterial meningitis. Hyponatremia rapidly improved after administration of sodium chloride. The purpose of this report is to alert clinicians to the fact that hyponatremic patients with central nervous system disease do not necessarily have a syndrome of inappropriate secretion of antidiuretic hormone (SIADH), but may have cerebral salt wasting syndrome. By contrast with SIADH, the treatment requires saline administration.

  1. Cerebral salt wasting in a postoperative period.

    Science.gov (United States)

    Janus, Dominika; Wojcik, Malgorzata; Dolezal-Oltarzewska, Katarzyna; Kalicka-Kasperczyk, Anna; Poplawska, Karolina; Starzyk, Jerzy B

    2014-01-01

    Cerebral salt wasting syndrome (CSW-cerebral salt wasting) was first described in 1950 by Peters. This syndrome can occur in patients who have sustained damage to the central nervous system (e.g. patients with subarachnoid bleeding, bacterial meningitis or after neurosurgery). Patients present with excessive natriuresis and hyponatremic dehydration. Differentiating this syndrome with the syndrome of inappropriate antidiuretic hormone secretion (SIADH-syndrome of inappropriate antidiuretic hormone secretion), which may occur in the same group of patients, is necessary in order to administer the correct treatment which consists of fluid restriction and sodium replacement in SIADH and fluid and sodium replacement as well as occasional mineralocorticoid therapy in CSW.

  2. Cerebral Fat Embolism: A diagnostic challenge

    Science.gov (United States)

    Gupta, Babita; Kaur, Manpreet; D’souza, Nita; Dey, Chandan Kumar; Shende, Seema; Kumar, Atin; Gamangatti, Shivanand

    2011-01-01

    Fat embolism syndrome (FES) is a rare but a serious clinical catastrophe occurring after traumatic injury to long bones. Cerebral involvement in the absence of pulmonary or dermatological manifestation on initial presentation may delay the diagnosis of cerebral fat embolism (CFE). We discuss a case series of CFE which posed a challenge in diagnosis. The clinical presentations of these patients did not satisfy the commonly used clinical criteria for aiding the diagnosis of FES. Early MRI brain (DWI and T2 weighted sequences) in patients with neurological symptoms after trauma even in the absence of pulmonary and dermatological findings should be the goal. PMID:21957425

  3. Cerebral fat embolism: A diagnostic challenge

    Directory of Open Access Journals (Sweden)

    Babita Gupta

    2011-01-01

    Full Text Available Fat embolism syndrome (FES is a rare but a serious clinical catastrophe occurring after traumatic injury to long bones. Cerebral involvement in the absence of pulmonary or dermatological manifestation on initial presentation may delay the diagnosis of cerebral fat embolism (CFE. We discuss a case series of CFE which posed a challenge in diagnosis. The clinical presentations of these patients did not satisfy the commonly used clinical criteria for aiding the diagnosis of FES. Early MRI brain (DWI and T2 weighted sequences in patients with neurological symptoms after trauma even in the absence of pulmonary and dermatological findings should be the goal.

  4. Progressive cerebral atrophy in neuromyelitis optica.

    Science.gov (United States)

    Warabi, Yoko; Takahashi, Toshiyuki; Isozaki, Eiji

    2015-12-01

    We report two cases of neuromyelitis optica patients with progressive cerebral atrophy. The patients exhibited characteristic clinical features, including elderly onset, secondary progressive tetraparesis and cognitive impairment, abnormally elevated CSF protein and myelin basic protein levels, and extremely highly elevated serum anti-AQP-4 antibody titer. Because neuromyelitis optica pathology cannot switch from an inflammatory phase to the degenerative phase until the terminal phase, neuromyelitis optica rarely appears as a secondary progressive clinical course caused by axonal degeneration. However, severe intrathecal inflammation and massive destruction of neuroglia could cause a secondary progressive clinical course associated with cerebral atrophy in neuromyelitis optica patients.

  5. Electrical Cerebral Stimulation Modifies Inhibitory Systems

    Science.gov (United States)

    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.

  6. Feeding difficulties in children with cerebral palsy.

    Science.gov (United States)

    Andrew, Morag J; Parr, Jeremy R; Sullivan, Peter B

    2012-12-01

    Feeding difficulties are common in children with cerebral palsy and have an effect on growth, nutritional state, general health, social interaction and behaviour and developmental outcomes. Many factors have an effect on feeding ability. Identification of these factors and amelioration of their impact on feeding difficulties is essential to promote adequate growth and nutrition. Appropriate assessment and management is best achieved by a multiprofessional team skilled in the care of children with cerebral palsy and feeding impairments. Feeding difficulties must be considered within the wider context of family and social circumstance.

  7. Pathophysiology of muscle contractures in cerebral palsy.

    Science.gov (United States)

    Mathewson, Margie A; Lieber, Richard L

    2015-02-01

    Patients with cerebral palsy present with a variety of adaptations to muscle structure and function. These pathophysiologic symptoms include functional deficits such as decreased force production and range of motion, in addition to changes in muscle structure such as decreased muscle belly size, increased sarcomere length, and altered extracellular matrix structure and composition. On a cellular level, patients with cerebral palsy have fewer muscle stem cells, termed satellite cells, and altered gene expression. Understanding the nature of these changes may present opportunities for the development of new muscle treatment therapies.

  8. A systematic evaluation of the effect of thumb opponens splints on hand function in children with unilateral spastic cerebral palsy

    NARCIS (Netherlands)

    Ten Berge, S.R.; Boonstra, Antje; Dijkstra, P.U.; Hadders-Algra, M.; Haga, N.; Maathuis, C.G.B.

    2012-01-01

    Objective: To examine the effects of a neoprene thumb opponens splint on hand function during a self-selected activities of daily living task in children with unilateral spastic cerebral palsy with thumb-in-palm position of the affected hand. Design: Systematic evaluation of seven cases using a mult

  9. Intrathecal Baclofen in Children with Spastic Cerebral Palsy: A Double-Blind, Randomized, Placebo-Controlled, Dose-Finding Study

    Science.gov (United States)

    Hoving, Marjanke A.; van Raak, Elisabeth P. M.; Spincemaille, Geert H. J. J.; Palmans, Liesbeth J.; Sleypen, Frans A. M.; Vles, Johan S. H.

    2007-01-01

    Intrathecal baclofen (ITB) therapy can be very effective in the treatment of intractable spasticity, but its effectiveness and safety have not yet been thoroughly studied in children with cerebral palsy (CP). The aims of this double-blind, randomized, placebo-controlled, dose-finding study were to select children eligible for continuous ITB…

  10. Transfer function analysis for the assessment of cerebral autoregulation using spontaneous oscillations in blood pressure and cerebral blood flow

    NARCIS (Netherlands)

    Abeelen, A.S.S. van den; Beek, A.H. van; Slump, C.H.; Panerai, R.B.; Claassen, J.A.H.R.

    2014-01-01

    Cerebral autoregulation (CA) is a key mechanism to protect the brain against excessive fluctuations in blood pressure (BP) and maintain cerebral blood flow. Analyzing the relationship between spontaneous BP and cerebral blood flow velocity (CBFV) using transfer function analysis is a widely used tec

  11. Botulinum toxin type A treatment of cerebral palsy: an integrated approach

    OpenAIRE

    Molenaers, Guy; Desloovere, Kaat; Eyssen, M; De Cat, Josse; Jonkers, Ilse; De Cock, Paul

    1999-01-01

    We have applied a multilevel approach no the management of spasticity associated with cerebral palsy (CP). All of the following factors are important in forming an integrated strategy for botulinum toxin type A (BTX-A) therapy: the timing of injections, patient selection, multilevel BTS-A treatment, optimal dosage and injection technique, follow-up treatment and objective measurements of functional outcome. Data on all these factors are presented here. CP patients had a mean age of 6.5 years ...

  12. Systematic review: hereditary thrombophilia associated to pediatric strokes and cerebral palsy

    OpenAIRE

    Vinicius M. Torres; Vera A. Saddi

    2015-01-01

    OBJECTIVES: This review aimed to organize and consolidate the latest knowledge about mutations and genetic polymorphisms related to hereditary thrombophilia and their potential association with pediatric stroke and cerebral palsy (CP). SOURCES: Scientific articles published from 1993 to 2013, written in Portuguese, English, French, and Spanish, were selected and reviewed. The publications were searched in electronic databases, and also in the collections of local libraries. The terms "heredit...

  13. The changes and significance of serum inflammatory factors and hemodynamics in patients with acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Xiao-Wei Lu

    2016-01-01

    Objective:To investigate the changes of serum inflammatory factors and hemodynamics in patients with acute cerebral infarction and its clinical significance.Methods: A total of 55 cases of acute cerebral infarction (ACI) patients as observation group, and cases of healthy physical examination were selected as the observation group, and 55 healthy persons as control group. ELISA method was used to detect inflammatory cytokines interleukin-6 (IL-6), interleukin-8 (IL-8), C-reactive protein (CRP) and tumor necrosis factor (TNF-α) level, WA-880 heart and brain integrated digital hemodynamic monitor to detect bilateral carotid artery blood flow velocity, blood flow and peripheral resistance.Results:The serum levels of IL-8, CRP, IL-6 and TNF-α were higher in the observation group than in the control group, the difference was statistically significant (P<0.05). The blood flow velocity and blood flow velocity in the observation group were significantly lower than those in the control group. The difference was statistically significant (IL-8). With the increase of infarct size, serum IL-6, CRP,P<0.05 and TNF-α increased significantly (P<0.05).Conclusions:The changes of serum inflammatory factors and hemodynamic indexes can be used to judge the early cerebral infarction and the size of the infarct size of the index, the clinical dynamic monitoring of its changes in patients with acute cerebral infarction and the severity of the prognosis and the prognosis of the important significance of the judgment.

  14. Sensory Feedback Training for Improvement of Finger Perception in Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Tobias Blumenstein

    2015-01-01

    Full Text Available Purpose. To develop and to test a feedback training system for improvement of tactile perception and coordination of fingers in children and youth with cerebral palsy. Methods. The fingers of 7 probands with cerebral palsy of different types and severity were stimulated using small vibration motors integrated in the fingers of a hand glove. The vibration motors were connected through a microcontroller to a computer and to a response 5-button keyboard. By pressing an appropriate keyboard button, the proband must indicate in which finger the vibration was felt. The number of incorrect responses and the reaction time were measured for every finger. The perception and coordination of fingers were estimated before and after two-week training using both clinical tests and the measurements. Results. Proper functioning of the developed system in persons with cerebral palsy was confirmed. The tactile sensation of fingers was improved in five of seven subjects after two weeks of training. There was no clear tendency towards improvement of selective use of fingers. Conclusion. The designed feedback system could be used to train tactile perception of fingers in children and youth with cerebral palsy. An extensive study is required to confirm these findings.

  15. Meta-analysis of the effect of strengthening interventions in individuals with cerebral palsy.

    Science.gov (United States)

    Park, Eun-Young; Kim, Won-Ho

    2014-02-01

    This study aimed to investigate the evidence that strengthening interventions can improve muscle strength and activity in individuals with cerebral palsy. The search focused on studies that employed strength training for children with cerebral palsy for which six electronic databases were used to extract literature published from 2001 to 2012. The key terms used in these searches were combined strength training, strengthening, weight training, weight lifting, resistance, and cerebral palsy. The quality of each study was assessed using the PEDro (Physiotherapy Evidence Database) scale. Thirteen randomized controlled trial studies were selected and divided into categories according to program type, mode, and outcome measures. The overall effect sizes of each study and types of strengthening were large. Strengthening exercise improved muscle strength to a greater degree, when practiced 3 times per week in 40-50 min sessions than in other categories of session length, and greater improvement was observed in younger children than in older. The effect size of the activities and variables related to gait, except for gait endurance, were medium to large. The effect size of individual muscles was large, but the effect sizes for ankle plantar flexor, hip abductor/adductor, and extensor were insignificant. Strengthening interventions are useful for increasing muscle strength in individuals with cerebral palsy, specifically in youth and children, and optimal exercise consisted of 40- to 50-min sessions performed 3 times per week. Although strengthening interventions may improve activities, including gait, more studies that are rigorous are needed to determine the contributions to gross motor function.

  16. Rizatriptan does not change cerebral blood flow velocity during migraine attacks.

    Science.gov (United States)

    Gori, S; Morelli, N; Bellini, G; Bonanni, E; Manca, L; Orlandi, G; Iudice, A; Murri, L

    2005-04-30

    Rizatriptan represents a major advance in the treatment of migraine attack: inhibition of peripheral trigeminal nerve and constriction of intracranial extracerebral blood vessels have been proposed as its main antimigraine mechanisms of action. Although many studies may suggest that rizatriptan causes highly selective vasoconstriction within intracranial extracerebral vessels (i.e., meningeal arteries), no literature data are available to date on possible cerebral hemodynamic changes in humans after treatment with rizatriptan. The aim of this study was to evaluate the effect of rizatriptan on cerebral blood flow velocity performing transcranial Doppler during spontaneous attacks of migraine without aura. Fourteen patients suffering from migraine without aura were monitored to evaluate mean flow velocity changes on both middle cerebral arteries during migraine attack 30 min before and 120 min after oral administration of rizatriptan 10mg. Monitoring was repeated for 30 min during the pain-free period. All patients turned out to be drug responders and no significant mean flow velocity changes were observed between the pain-free period and pre-treatment phase; besides no significant difference in mean flow velocity value have been detected between the periods after the drug administration during the attack versus both pre-treatment period and pain-free phase. These findings indicate that the antimigraine action of rizatriptan is not associated with clear intracranial cerebral hemodynamic changes and may support its cerebrovascular safety.

  17. Cross-Cultural adaptation of an instrument to computer accessibility evaluation for students with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Gerusa Ferreira Lourenço

    2015-03-01

    Full Text Available The specific literature indicates that the successful education of children with cerebral palsy may require the implementation of appropriate assistive technology resources, allowing students to improve their performance and complete everyday tasks more efficiently and independently. To this end, these resources must be selected properly, emphasizing the importance of an appropriate initial assessment of the child and the possibilities of the resources available. The present study aimed to translate and adapt theoretically an American instrument that evaluates computer accessibility for people with cerebral palsy, in order to contextualize it for applicability to Brazilian students with cerebral palsy. The methodology involved the steps of translation and cross-cultural adaptation of this instrument, as well as the construction of a supplementary script for additional use of that instrument in the educational context. Translation procedures, theoretical and technical adaptation of the American instrument and theoretical analysis (content and semantics were carried out with the participation of professional experts of the special education area as adjudicators. The results pointed to the relevance of the proposal of the translated instrument in conjunction with the script built to the reality of professionals involved with the education of children with cerebral palsy, such as occupational therapists and special educators.

  18. ТREATMENT STRATEGY OF FLEXION CONTRACTURE OF THE WRIST JOINT IN CHILDREN WITH CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    Владимир Александрович Новиков

    2014-09-01

    Full Text Available Objectives. The objective of study was to assess the effectiveness of transplantation of m. flexor carpi ulnaris tendon on the place of m. extensor carpi radialis brevis / longus (Green operation to eliminate the deficit of active wrist joint extension in children with cerebral palsy. Materials and methods. The present study is based on a survey of children with cerebral palsy with affected upper limb. The main criterion for selection of patients was the presence of active extension deficit in the wrist joint, both isolated and in combination with other contractures of the upper limb joints. Total 22 patients with spastic forms of cerebral palsy were examined. Results and conclusions. Green operation is a good method of surgical treatment of active extension deficit in the wrist joint in patients with cerebral palsy. In the presence of moderately severe contractures in the wrist joint, serial casting can eliminate them completely. Presence of a fixed pronation contracture of the forearm is a factor that reduces the effectiveness of FCU transplantation. Pronation contracture should be corrected before or during Green surgery. FCU transplantation is effective for children of any age, but its effectiveness is reduced from 12 years old.

  19. Polyunsaturated fatty acids are cerebral vasodilators via the TREK-1 potassium channel.

    Science.gov (United States)

    Blondeau, Nicolas; Pétrault, Olivier; Manta, Stella; Giordanengo, Valérie; Gounon, Pierre; Bordet, Régis; Lazdunski, Michel; Heurteaux, Catherine

    2007-07-20

    Vessel occlusion is the most frequent cause for impairment of local blood flow within the brain resulting in neuronal damage and is a leading cause of disability and death worldwide. Polyunsaturated fatty acids and especially alpha-linolenic acid improve brain resistance against cerebral ischemia. The purpose of the present study was to evaluate the effects of polyunsaturated fatty acids and particularly alpha-linolenic acid on the cerebral blood flow and on the tone of vessels that regulate brain perfusion. alpha-Linolenic acid injections increased cerebral blood flow and induced vasodilation of the basilar artery but not of the carotid artery. The saturated fatty acid palmitic acid did not produce vasodilation. This suggested that the target of the polyunsaturated fatty acids effect was the TREK-1 potassium channel. We demonstrate the presence of this channel in basilar but not in carotid arteries. We show that vasodilations induced by the polyunsaturated fatty acid in the basilar artery as well as the laser-Doppler flow increase are abolished in TREK-1(-/-) mice. Altogether these data indicate that TREK-1 activation elicits a robust dilation that probably accounts for the increase of cerebral blood flow induced by polyunsaturated fatty acids such as alpha-linolenic acid or docosahexanoic acid. They suggest that the selective expression and activation of TREK-1 in brain collaterals could play a significant role in the protective mechanisms of polyunsaturated fatty acids against stroke by providing residual circulation during ischemia.

  20. A simple technique for morphological measurement of cerebral arterial circle variations using public domain software (Osiris).

    Science.gov (United States)

    Ansari, Saeed; Dadmehr, Majid; Eftekhar, Behzad; McConnell, Douglas J; Ganji, Sarah; Azari, Hassan; Kamali-Ardakani, Shahab; Hoh, Brian L; Mocco, J

    2011-12-01

    This article describes a straightforward method to measure the dimensions and identify morphological variations in the cerebral arterial circle using the general-purpose software program Osiris. This user-friendly and portable program displays, manipulates, and analyzes medical digital images, and it has the capability to determine morphometric properties of selected blood vessels (or other anatomical structures) in humans and animals. To ascertain morphometric variations in the cerebral arterial circle, 132 brains of recently deceased fetuses, infants, and adults were dissected. The dissection procedure was first digitized, and then the dimensions were measured with Osiris software. Measurements of each vessel's length and external diameters were used to identify and classify morphological variations in the cerebral arterial circle. The most commonly observed anatomical variations were uni- and bilateral hypoplasia of the posterior communicating artery. This study demonstrates that public domain software can be used to measure and classify cerebral arterial circle vessels. This method could be extended to examine other anatomical regions or to study other animals. Additionally, knowledge of variations within the circle could be applied clinically to enhance diagnostic and treatment specificity.

  1. 根治性顺行模块化胰脾切除术治疗胰体尾癌的临床疗效%Clinical effect of radical antegrade modular pancreatosplenectomy for carcinoma of pancreatic body and tail

    Institute of Scientific and Technical Information of China (English)

    徐冬; 蒋奎荣; 陆子鹏; 郭峰; 陈建敏; 卫积书; 尹杰; 张凯; 吴鹏飞

    2016-01-01

    例、2例,胃排空障碍分别为1例、1例,胸腔积液分别为7例、18例,肺部感染分别为0例、4例,腹腔积液分别为6例、15例,腹腔感染分别为4例、5例,切口感染分别为1例、1例,下肢深静脉血栓分别为0例、2例,MODS分别为0例、1例,再次手术分别为0例、1例,两组上述指标比较,差异均无统计学意义(x2=1.554,1.642,P>0.05).RAMPS组和经典手术组患者术后住院时间分别为15 d(13 d,23 d)、12 d(10 d,16 d),住院费用分别为74 632元(67 041元,92 445元)、64 410元(54 709元,80 842元),两组比较,差异均有统计学意义(Z =3.529,2.675,P<0.05).(3)随访情况:99例患者中,86例获得术后随访,其中RAMPS组18例,经典手术组68例.中位随访时间为18个月(5 ~37个月).RAMPS组患者中位生存时间为19个月,复发转移率为33.3% (6/18);经典手术组患者中位生存时间为14个月,复发转移率为45.6%(31/68);两组上述指标比较,差异均无统计学意义(x2=0.060,0.366,P>0.05).结论 采用RAMPS治疗胰体尾癌安全、可行,与经典胰体尾+脾切除术比较,不增加手术并发症发生率,可能提高 R0切除率.%Objective To explore the safety and feasibility of radical antegrade modular pancreatosplenectomy (RAMPS) for carcinoma of pancreatic body and tail (CPBT).Methods The retrospective cohort study was adopted.The clinical data of 99 patients with CPBT who were admitted to the First Affiliated Hospital of Nanjing Medical University from January 2013 to October 2015 were collected.Among the 99 patients,21 receiving RAMPS were allocated into the RAMPS group and 78 receiving traditional resection of body and tail of pancreas and splenectomy were allocated into the operation group.Observation indexes included (1) surgical situation:operation time,volume of intraoperative blood loss,volume of blood transfusion,combined organ resection,combined vascular resection,status of the resection margin,(2) postoperative situation

  2. Predictors of participation of adolescents with cerebral palsy

    DEFF Research Database (Denmark)

    Dang, Van Mô; Colver, Allan; Dickinson, Heather O

    2014-01-01

    We investigated whether childhood factors that are amenable to intervention (parenting stress, child psychological problems and pain) predicted participation in daily activities and social roles of adolescents with cerebral palsy (CP). We randomly selected 1174 children aged 8-12 years from eight...... measures: parent reported stress (Parenting Stress Index Short Form), their child's psychological difficulties (Strength and Difficulties Questionnaire) and frequency and severity of pain; either child or parent reported the child's participation (LIFE Habits questionnaire). We fitted a structural equation...... model to each of the participation domains, regressing participation in childhood and adolescence on parenting stress, child psychological problems and pain, and regressing adolescent factors on the corresponding childhood factors; models were adjusted for impairment, region, age and gender. Pain...

  3. Cerebral infarction in patient with minimal change nephrotic syndrome.

    Science.gov (United States)

    Babu, A; Boddana, P; Robson, S; Ludeman, L

    2013-01-01

    We report a case of 68-year-old Caucasian man who presented with cerebral infarcts secondary to arterial thrombosis associated with nephrotic syndrome. His initial presentation included edema of legs, left hemiparesis, and right-sided cerebellar signs. Investigations with computed tomography and magnetic resonance imaging of brain showed multiple cerebral infarcts in middle cerebral and posterior cerebral artery territory. Blood and urine investigations also showed impaired renal function, hypercholesterolemia, hypoalbuminaemia, and nephrotic range proteinuria. Renal biopsy showed minimal change disease. Cerebral infarcts were treated with antiplatelet agents and nephrotic syndrome was treated with high dose steroids. Patient responded well to the treatment and is all well till date.

  4. A preliminary study on the selection criteria of drainage and craniotomy for patients with supratentorial cerebral hemorrhage%幕上脑出血患者钻孔引流和开颅手术选择标准的初步探讨

    Institute of Scientific and Technical Information of China (English)

    乔建勇; 王昌盛; 武焕颖; 韩广明; 郭伟伦

    2012-01-01

    共288 例幕上脑出血患者分别接受钻孔引流术(140 例)和血肿清除术(148 例).通过分析术前意识状态分级和出血量与6 个月后患者病残率和病死率间的关系,获得钻孔引流术与神经外科手术之间的分界标准,并探讨幕上脑出血患者的合理手术方式.%The study involved a total of 288 patients with supratentorial cerebral hemorrhage who were surgically treated. Among them 140 patients underwent trepanation and drainage, and the other 148 patients underwent evacuation of hematoma. Through analyzing Glasgow Coma Scale (GCS) and the volume of hemorrhage before operation and after 6 months were related with the patients' disability rate and mortality rate. The delimitation standards of drainage and craniotomy were explored, and the reasonable techniques of supratentorial cerebral hemorrhage were investigated.

  5. Decreased light attenuation in cerebral cortex during cerebral edema detected using optical coherence tomography

    OpenAIRE

    Rodriguez, Carissa L. R.; Szu, Jenny I.; Eberle, Melissa M.; Wang, Yan; Hsu, Mike S.; Binder, Devin K.; Park, B. Hyle

    2014-01-01

    Abstract. Cerebral edema develops in response to a variety of conditions, including traumatic brain injury and stroke, and contributes to the poor prognosis associated with these injuries. This study examines the use of optical coherence tomography (OCT) for detecting cerebral edema in vivo. Three-dimensional imaging of an in vivo water intoxication model in mice was performed using a spectral-domain OCT system centered at 1300 nm. The change in attenuation coefficient was calculated and cere...

  6. Hyperdense lesions in CT of cerebral toxoplasmosis. Lesiones hiperdensas en TC en la toxoplamosis cerebral

    Energy Technology Data Exchange (ETDEWEB)

    Quiones Tapia, D.; Ramos Amador, A.; Monereo Alonso, A.

    1994-01-01

    We report a case of cerebral toxoplasmosis in a patient with stage IV C[sub 1] AIDS who presented hyperdense CT images 13 days after beginning antitoxoplasma treatment. These lesions could be caused by calcifications or blood. The attenuation values lead us to believe that they are calcium. Intracranial calcification in adult cerebral toxoplasmosis is an uncommon finding. Its presence in AIDS patients should not suggest any etiology other than toxoplasmosis. (Author) 16 refs.

  7. 腰骶段选择性脊神经后根切断术治疗脑瘫性下肢痉挛状态的远期疗效分析%Analysis of long-term effect of selective posterior rhizotomy for treatment of spasticity of lower limbs in cerebral palsy patients

    Institute of Scientific and Technical Information of China (English)

    邵旭; 于炎冰; 张黎

    2014-01-01

    ) of lumbosacral region was a well-recognized treatment for spasticity of lower limbs in spastic cerebral palsy (CP).However,there was still no agreement on long-term outcome of SPR.The purpose of this study was to assess the long-term outcome in a large amount of patients by using quantitative,standardized assessment tools.Methods 141 patients who had undergone SPR from Jan.2001 to Dec.2006 were followed-up with integrated clinical data for at least 9 years averagely.The outcomes were assessed at the time points of 1 year,5 years and final trace after operation respectively with quantitative,standardized assessment tools,including Modified Ashworth Scale (MAS),Gross Motor Function Classification System (GMFCS) and performance of Activities of Daily Living Scale(ADL).Combined with the subsequent treatment which was required by those patients,statistical analysis was performed to evaluate the long term effects of SPR.Results MAS scores in hip adductors,knee flexors and ankle plantar flexors were reduced persistently until the final follow-up visit and the differences were statistically significant (P < 0.01).The overall improvement rate of muscle tone during follow-up was 90.7%.The distribution of GMFCS was statistically different compared with preoperative levels(P < 0.01).The overall improvement rate of gross motor function compared with preoperative was 80.1%.ADL scores were statistically different when compared with preoperative group(P <0.01).The overall improvement rate of quality of life was 88.9%.When stratified by the preoperative GMFCS,the ADL Scores of GMFCS Group Ⅱ and Ⅲ continued to increase after SPR.The proportion of patients who received subsequent procedures including selective peripheral neurotomy (SPN),Achilles tendon lengthening,orthopedic surgery and botulinum toxin treatment was 27.7% at final follow-up.The independent-samples T test showed that the necessary subsequent surgical treatments after operation significantly increased

  8. Cerebral vasospasm pharmacological treatment: an update.

    Science.gov (United States)

    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.

  9. Cerebral Vasospasm Pharmacological Treatment: An Update

    Directory of Open Access Journals (Sweden)

    Ioannis Siasios

    2013-01-01

    Full Text Available 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.

  10. Cerebral hemodynamics and functional prognosis in hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Hirai, Osamu; Nishikawa, Michio; Watanabe, Shu; Yamakawa, Hiroyasu; Kinoshita, Yoshimasa; Uno, Akira; Handa, Hajime (Hamamatsu Rosai Hospital, Shizuoka (Japan))

    1989-11-01

    The functional outcome of cerebral hemodynamics in the chronic stage of juvenile hydrocephalus was determined using single photon emission computed tomography (SPECT). Five patients including three with aqueductal stenosis, one with post-meningitic hydrocephalus, and one case with hydrocephalus having developed after repair of a huge occipital encephalocele. Early images of cerebral blood flow (CBF) were obtained 25 minutes after intravenous injection of 123-I-iodoamphetamine (IMP), and late images were scanned 3 hours later. Cerebral blood volume (CBV) was also measured using {sup 99m}Tc in three patients. Twenty cases with adult communicating hydrocephalus were also investigated from the point of view of shunt effectiveness. Although there was no remarkable change in the cerebrovascular bed in the juvenile cases, CBF of the remnant brain parenchyma was good irrespective of the degree of ventricular dilatation. There was a periventricular-related IMP uptake in each case; however, it somehow matched the ventricular span. Functional outcome one to 23 years after the initial shunt operation was good in every case, despite multiple shunt revisions. Redistribution on late images had no bearing on clinical states. In adult cases, 8 patients with effective shunting demonstrated a relatively localized periventricular low perfusion, with preoperative increased cerebrospinal fluid (CSF) pressure. On the contrary, 12 patients with no improvement with or without ventricular-reduced IMP uptake, despite low CSF pressure. The present study indicates that periventricular hemodynamics may play an important role in cerebral function compromised by hydrocephalus. (J.P.N.).

  11. What You Should Know about Cerebral Aneurysms

    Science.gov (United States)

    ... Stroke Rehab Facility Stroke In Children Psychological Issues Pediatric Stroke Resources Personal Stories Together to End Stroke American Stroke Month Stroke Hero F.A.S.T. Quiz 5 Things to Know About Stroke What You Should Know About Cerebral Aneurysms Updated:Nov 14,2016 Click image to view ...

  12. Cerebral Arterial Thrombosis in Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Giovanni Casella

    2013-01-01

    Full Text Available Thrombosis, mainly venous, is a rare and well-recognized extraintestinal manifestation of inflammatory bowel disease (IBD. We describe a 25-year-old Caucasian man affected by ulcerative colitis and sclerosing cholangitis with an episode of right middle cerebral arterial thrombosis resolved by intraarterial thrombolysis. We perform a brief review of the International Literature.

  13. [Cognitive stimulation in children with cerebral palsy].

    Science.gov (United States)

    Muriel, V; Garcia-Molina, A; Aparicio-Lopez, C; Ensenat, A; Roig-Rovira, T

    2014-11-16

    Introduccion. La paralisis cerebral a menudo cursa con deficits cognitivos de atencion, visuopercepcion, funciones ejecutivas y memoria de trabajo. Objetivo. Analizar el efecto de un tratamiento de estimulacion cognitiva sobre las capacidades cognitivas en niños con pa­ralisis cerebral. Pacientes y metodos. Muestra de 15 niños con paralisis cerebral, con una edad media de 8,80 ± 2,51 años, clasificados mediante el Gross Motor Function Classification System (GMFCS) en nivel I (n = 6), nivel II (n = 4), nivel III (n = 2) y nivel V (n = 3). Los deficits cognitivos se evaluaron mediante la escala de inteligencia de Wechsler para niños (WISC-IV) y el Continuous Performance Test (CPT-II). Se administraron los cuestionarios para padres y profesores del Behavior Rating Inventory of Executive Function (BRIEF) y las escalas de evaluacion de Conners (CPRS-48 y CTRS-28). Se realizo un programa de estimulacion cognitiva dos horas semanales durante ocho semanas. Resultados. Se observaron diferencias estadisticamente significativas tras aplicar el tratamiento de estimulacion cognitivo en el indice de razonamiento perceptivo de la WISC-IV. No se obtuvieron diferencias antes y despues del tratamiento en las puntuaciones del Conners y del BRIEF. Tampoco se hallaron diferencias en los resultados de la WISC-IV en funcion del sexo ni en el GMFCS. Conclusion. El rendimiento cognitivo de los niños con paralisis cerebral mejora tras la aplicacion de un programa de rehabilitacion cognitiva.

  14. Epidemiology of cerebral palsy in Southern Denmark

    DEFF Research Database (Denmark)

    Frøslev-Friis, Christina; Dunkhase-Heinl, Ulrike; Andersen, Johnny Dohn Holmgren;

    2015-01-01

    INTRODUCTION: The aim of this study was to describe the prevalence, subtypes, severity and neuroimaging findings of cerebral palsy (CP) in a cohort of children born in Southern Denmark. Risk factors were analysed and aetiology considered. METHODS: A population-based cohort study covering 17,580 l...

  15. Is it cerebral or renal salt wasting?

    Science.gov (United States)

    Maesaka, John K; Imbriano, Louis J; Ali, Nicole M; Ilamathi, Ekambaram

    2009-11-01

    Cerebral salt-wasting (CSW), or renal salt-wasting (RSW), has evolved from a misrepresentation of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) to acceptance as a distinct entity. Challenges still confront us as we attempt to differentiate RSW from SIADH, ascertain the prevalence of RSW, and address reports of RSW occurring without cerebral disease. RSW is redefined as 'extracellular volume depletion due to a renal sodium transport abnormality with or without high urinary sodium concentration, presence of hyponatremia or cerebral disease with normal adrenal and thyroid function.' Our inability to differentiate RSW from SIADH lies in the clinical and laboratory similarities between the two syndromes and the difficulty of accurate assessment of extracellular volume. Radioisotopic determinations of extracellular volume in neurosurgical patients reveal renal that RSW is more common than SIADH. We review the persistence of hypouricemia and increased fractional excretion of urate in RSW as compared to correction of both in SIADH, the appropriateness of ADH secretion in RSW, and the importance of differentiating renal RSW from SIADH because of disparate treatment goals: fluid repletion in RSW and fluid restriction in SIADH. Patients with RSW are being incorrectly treated by fluid restriction, with clinical consequences. We conclude that RSW is common and occurs without cerebral disease, and propose changing CSW to RSW.

  16. SPECT analysis of recent cerebral infarction

    DEFF Research Database (Denmark)

    Raynaud, C; Rancurel, G; Tzourio, N

    1989-01-01

    already differentiated in the subacute period. The central area presented a short phase of luxury perfusion and a longer phase of IMP hyperfixation. The peripheral area showed both a slight regional cerebral blood flow decrease and an early IMP uptake decrease similar to those previously found...

  17. Thyroxine Level of Children with Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    Zhang Jie

    2000-01-01

    Objective:To investigate the thyroxine level of Children with cerebral palsy so as to understand thd changes of their nevous endocrine. Methods:Radioimmunoassay was applied to 57 Children with cerebral palsy and 108 normal children.The serum level of tridothyronine(T3), thyroxine(T4)free tridothyronine(FT3),free thyroxin(FT4),and thyroid stimulating hormone(TSH) were measured for those children in the moming and and in condition without any food Rsults: (1)Chiidren with cerebral palsy all showed low T3 values.The difference of T3 value between CP children and norrmal children was significant (P<0.001). (2)Results from groups with difference ages:the CP toddler′s age group also showed low T4 and FT4 values The difference of T4 and FT4 values between the toddler′s age CP childrengroup and the toddler′s age normal children group tegted was significant (CP<0.01 for T4, P <0. 05 for FT4): Conclusion:The tlyroxine level of children with cerebral palsy showed lower values compared to normal children, especisly, the low T3 values were significant.

  18. Cerebral Palsy: Still A Social Problem

    Directory of Open Access Journals (Sweden)

    Angom Bisharda

    1997-08-01

    Full Text Available Research Problem: What arc the social aspects of cerebral palsy?Objective: To determine the extent and severity of neuromuscular involvement in cases of cerebral palsy and to find out the associated defects among these children.Study Design: Cross sectional study.Setting: Tertiary care hospital, outdoor patients.Participants: Children in the age group of 0 - 12 years.Sample Size: 120 children suffering from cerebral palsy.Study Variables: Social factors, neuromuscular involvement.Statistical Analysis: By proportionsResult: Out of 120 cases, maximum number of cases (66.6% were in the age group of 1- 4 years. 83 cases ( 69.16% were males. Among the various types, spastic type was the commonest (87.5%. Of these spastic cases, 52 (49.52% had quadriplegia. No case of tremor and rigidity was seen. Delayed milestones was the commonest associated disorder, seen in 107 (89.16% cases, followed by speech defect in 58(48.3% cases, visual defect in 34(28.3% cases and convulsions in 24 (20.0% cases. Hearing defect was seen in 5 cases (4.16% only.Conclusion: More concerted efforts arc required to identify children with cerebral palsy and rehabilitate them for the betterment of society.

  19. Regional cerebral blood flow in schizophrenics

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, J.; Ohta, Y.; Nakane, Y.; Mori, H.; Hirota, N.; Yonekura, M.

    1987-01-01

    The present study on schizophrenics dealt with the relationship of regional cerebral blood flow (rCBF) to age, disease duration, and treatment length with chlorpromazine hydrochloride (CPZ). Regional cerebral blood flow in 28 cerebral regions of interest was measured by iv injection of /sup 133/X in 54 schizophrenic patients and 39 healthy volunteers. Neither age nor dosage of CPZ significantly influenced rCBF. All patients, including 11 treated for a short period of time (6 months or less), were characterized by having a decreased rCBF over the whole cerebrum. Thirty-four patients treated for a long period of time (2 years or more) had a varied rCBF distribution in the left hemisphere, with the most predominant feature being the decrease in rCBF in the frontal lobe (i.e., hypofrontality); however, there was no linear correlation between rCBF and disease duration. A decreased rCBE in the right occipital region was seen in patients with paranoid schizophrenia, suggesting that manifestations of symptoms may depend on disturbed regions. These results suggest that cerebral dysfunction in schizophrenic patients may not be restricted to the frontal lobe, but cover the whole cerebrum, and that nonuniform dysfunction in various regions of the cerebrum, including the frontal lobe, may be involved in manifestations of symptoms.

  20. Regional cerebral blood flow in aphasia

    DEFF Research Database (Denmark)

    Soh, K; Larsen, B; Skinhøj, E

    1978-01-01

    Regional cerebral blood flow (rCBF) was studied in 13 aphasic patients with left hemisphere lesions, using the intracarotid xenon 133 injection method and a 254-detector gamma camera system. The rCBF was measured during rest and during various function tests, including a simple speech test...

  1. Eye and head turning indicates cerebral lateralization.

    Science.gov (United States)

    Kinsbourne, M

    1972-05-05

    When solving verbal problems, right-handed people usually turn head and eyes to the right, whereas with numerical and spatial problems, these people look up and left. Left-handed people differ in all these respects. The results suggest that the direction in which people look while thinking reflects the lateralization of the underlying cerebral activity.

  2. Cerebral paragonimiasis--report of five cases.

    Science.gov (United States)

    Toyonaga, S; Kurisaka, M; Mori, K; Suzuki, N

    1992-03-01

    Five cases of cerebral paragonimiasis presenting with hemianopsia, convulsion, and gait disturbance are discussed. The cases were all in the chronic stage. The intradermal paragonimiasis reaction, complement fixation, and Ouchterlony tests were not useful for diagnosis. Computed tomography demonstrated calcifications in all cases in sites consistent with the foci of symptoms. Surgical treatment in two cases failed to improve symptoms.

  3. Parental infertility and cerebral palsy in children

    DEFF Research Database (Denmark)

    Zhu, Jin Liang; Hvidtjørn, Dorte; Basso, Olga

    2010-01-01

    Children born after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) have been reported to have a higher risk of cerebral palsy (CP), perhaps due to the higher frequency of preterm birth, multiple births or vanishing embryo in the pregnancies. However, it has been suggested...

  4. Early identification and intervention in cerebral palsy

    DEFF Research Database (Denmark)

    Herskind, Anna; Greisen, Gorm; Nielsen, Jens Bo

    2015-01-01

    Infants with possible cerebral palsy (CP) are commonly assumed to benefit from early diagnosis and early intervention, but substantial evidence for this is lacking. There is no consensus in the literature on a definition of 'early', but this review focuses on interventions initiated within the fi...

  5. THE PATHOGENESIS OF CEREBRAL GLIOMATOUS CYSTS

    NARCIS (Netherlands)

    LOHLE, PNM; VERHAGEN, ITHJ; TEELKEN, AW; BLAAUW, EH; GO, KG

    1992-01-01

    In this study, the authors have examined the mechanism of the formation of tumor cysts. Cyst fluid samples were obtained during surgery and by percutaneous aspiration from 22 patients with cystic cerebral gliomas. The concentration of protein was measured in the cyst fluid and blood plasma. Analysis

  6. Progress in Drug Treatment of Cerebral Edema.

    Science.gov (United States)

    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.

  7. Measurement of cerebral circulation time in man

    Energy Technology Data Exchange (ETDEWEB)

    Celsis, P.; Chan, M.; Marc-Vergnes, J.P.; Leydet, P.; Viallard, G.; Charlet, J.P.; Danet, B.

    1985-05-01

    A simple, inexpensive method for measuring the cerebral circulation time (CCT) was developed. The CCT was considered to be equal to the time that an intravenously injected bolus of sodium pertechnetate Tc 99m took to go from the subclavian artery to the posterior venous confluence. The dilution curves were externally recorded at these two vessels. Particular attention was given to the curve treatment. The computer programmes were specially conceived in order to detect and, if possible, correct the experimental curve defects. Several reliability criteria were also defined in order to test the validity of each measurement. From a physiological point of view, the CCT is equal to the ratio of the global cerebral blood volume to the global cerebral blood flow. Thus, it can be widely applied in clinical research. For example, in a study of the relationship between CCT and age, sex and light cerebrovascular impairment, the technique was sensitive enough to discriminate between healthy subjects and patients suffering from-transient ischemic attack, or regressive stroke, and to show the action of a drug on the cerebral circulation in such patients.

  8. Time constant of the cerebral arterial bed.

    Science.gov (United States)

    Kasprowicz, Magdalena; Diedler, Jennifer; Reinhard, Matthias; Carrera, Emmanuel; Smielewski, Peter; Budohoski, Karol P; Sorrentino, Enrico; Haubrich, Christina; Kirkpatrick, Peter J; Pickard, John D; Czosnyka, Marek

    2012-01-01

    We have defined a novel cerebral hemodynamic index, a time constant of the cerebral arterial bed (τ), the product of arterial compliance (C(a)) and cerebrovascular resistance (CVR). C(a) and CVR were calculated based on the relationship between pulsatile arterial blood pressure (ABP) and transcranial Doppler cerebral blood flow velocity. This new parameter theoretically estimates how fast the cerebral arterial bed is filled by blood volume after a sudden change in ABP during one cardiac cycle. We have explored this concept in 11 volunteers and in 25 patients with severe stenosis of the internal carotid artery (ICA). An additional group of 15 subjects with non-vascular dementia was studied to assess potential age dependency of τ. The τ was shorter (p = 0.011) in ICA stenosis, both unilateral (τ = 0.18 ± 0.04 s) and bilateral (τ = 0.16 ± 0.03 s), than in controls (τ = 0.22 ± 0.0 s). The τ correlated with the degree of stenosis (R = -0.62, p = 0.001). In controls, τ was independent of age. Further study during cerebrovascular reactivity tests is needed to establish the usefulness of τ for quantitative estimation of haemodynamics in cerebrovascular disease.

  9. Plasticity and function of cerebral lateralization

    NARCIS (Netherlands)

    Lust, J.M.

    2011-01-01

    Lateralization refers to the division of labour between the hemispheres. The studies presented in this thesis addressed the developmental plasticity and function of cerebral lateralization. The access to an unique dataset of prenatal testosterone (pT) levels and the use of fTCD to measure individual

  10. Cerebral hemodynamics in normal and complicated pregnancy

    NARCIS (Netherlands)

    van Veen, Teelkien

    2016-01-01

    During pregnancy, approximately 6-25% of women are diagnosed with some form of hypertension. These disorders are among the leading causes of maternal mortality and severe morbidity. While multiple maternal organs can be affected, cerebral involvement is one of the most feared complications as it can

  11. Cerebral hemodynamic dysfunction in parkinsonian patients

    Directory of Open Access Journals (Sweden)

    Mirjana Vladetić

    2009-02-01

    Full Text Available Aim The purpose of this investigation was to determine the cerebral hemodynamics in patients withparkinsonism and the influence of hemodynamic dysfunction in developing the lacunar infarcts.Methods Fifty patients with the signs of parkinsonism were included in this study. The patients weredevided into two subgroups depending on whether they had vascular parkinsonism (VP (N-22 or idiopathicParkinson disease (N-28. The control group consisted of 30 patients who had ischemic stroke.The conventional transcranial dopler sonography was performed to evaluate the cerebral blood flow.To evaluate the cognitive impairment we performed the mini mental state examination to patients withparkinsonism.Results Patients with vascular parkinsonism have greater cognitive disturbances than patients withParkinson disease. In most of the parkinsonian patients the cerebral blood flow was decreased and themicroangiopathy was present.Conclusion In most patients with parkinsonism, the cerebral blood flow was decreased as a consequenceof microangiopathy. In our opinion, this led to lacunar infarction in VP patients, but can also bea risk factor for developing the same changes in patients with idiopathic Parkinson disease.

  12. Gait Stability in Children with Cerebral Palsy

    Science.gov (United States)

    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…

  13. Magnetic resonance angiography in suspected cerebral vasculitis

    Energy Technology Data Exchange (ETDEWEB)

    Demaerel, Philippe; De Ruyter, Nele; Wilms, Guido [Department of Radiology, Universitair Ziekenhuis, KU Leuven, 3000, Leuven (Belgium); Maes, Frederik [Department of Medical Imaging Computing, Universitair Ziekenhuis, KU Leuven, 3000, Leuven (Belgium); Velghe, Beatrijs [Department of Radiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600, Genk (Belgium)

    2004-06-01

    The purpose of this study was to determine the technical capacity and diagnostic accuracy of 3D time-of-flight magnetic resonance angiography (MRA) in suspected cerebral vasculitis in a retrospective analysis of MRA and digital subtraction angiography (DSA) in 14 young patients with clinical and/or radiological suspicion of cerebral vasculitis. A total of nine arteries were evaluated in each patient. Consensus review of DSA by three observers was the reference standard. The sensitivity for detecting a stenosis varied from 62 to 79% for MRA and from 76 to 94% for DSA, depending on the observer. The specificity for detecting a stenosis varied from 83 to 87% for MRA and from 83 to 97% for DSA. Using the criterion ''more than two stenoses in at least two separate vascular distributions'' to consider the examination as being true positive, the false-positive rates for MRA and DSA were comparable. MRA plays a role as the first angiographical examination in the diagnostic work-up of suspected cerebral vasculitis. When more than two stenoses in at least two separate vascular distributions are depicted on MRA, DSA is not expected to add a significant diagnostic contribution in a patient with suspected cerebral vasculitis. DSA remains necessary when MRA is normal or when less than three stenoses are seen. (orig.)

  14. Clinical practice: swallowing problems in cerebral palsy.

    NARCIS (Netherlands)

    Erasmus, C.E.; Hulst, K. van; Rotteveel, J.J.; Willemsen, M.A.A.P.; Jongerius, P.H.

    2012-01-01

    Cerebral palsy (CP) is the most common physical disability in early childhood. The worldwide prevalence of CP is approximately 2-2.5 per 1,000 live births. It has been clinically defined as a group of motor, cognitive, and perceptive impairments secondary to a non-progressive defect or lesion of the

  15. Cerebral blood flow in acute mountain sickness

    DEFF Research Database (Denmark)

    Jensen, J B; Wright, Anne; Lassen, N A

    1990-01-01

    Changes in cerebral blood flow (CBF) were measured using the radioactive xenon technique and were related to the development of acute mountain sickness (AMS). In 12 subjects, ascending from 150 to 3,475 m, CBF was 24% increased at 24 h [45.1 to 55.9 initial slope index (ISI) units] and 4% increased...

  16. Pretend Play of Children with Cerebral Palsy

    Science.gov (United States)

    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…

  17. Cerebral palsy: the first three years.

    Science.gov (United States)

    Hoffer, M M; Koffman, M

    1980-09-01

    The orthopedic surgeion should be an integral part of a medical team for evaluation and treatment of young children with cerebral palsy. Surgical procedures in this first three years of life are usually limited to the adductor releases about the hip. Stretching and plastic splints about the ankle and knee followed by ankle-foot orthoses are frequently effective in correction of deformity.

  18. Obstruction of cerebral arteries in childhood stroke

    Energy Technology Data Exchange (ETDEWEB)

    Velkey, I.; Lombay, B. (County Teaching Hospital, Miskolc (Hungary). Child Health Center); Panczel, G. (Semmelweis Medical Univ., Budapest (Hungary). Dept. of Psychiatry)

    1992-09-01

    Middle cerebral artery obstruction in children is reviewed by our two cases. Ischemic childhood stroke was caused by moyamoya disease in the first, and by fibromuscular dysplasia in the second patient. In both cases transcranial Doppler sonography and cranial CT were performed, but the final diagnosis was made by angiography. The importance of angiography in childhood stroke is emphasized. (orig.).

  19. The clinical relevance of cerebral microbleeds in patients with cerebral ischemia and atrial fibrillation.

    Science.gov (United States)

    Haji, Shamir; Planchard, Ryan; Zubair, Adeel; Graff-Radford, Jonathan; Rydberg, Charlotte; Brown, Robert D; Flemming, Kelly D

    2016-02-01

    The clinical significance of cerebral microbleeds (CMB) in patients hospitalized with atrial fibrillation (AF) and cerebral ischemia is unclear. We aimed to determine the prevalence of CMB in this population and determine the future risk of intracerebral hemorrhage (ICH) and cerebral infarction (CI). The medical records and brain imaging of patients hospitalized with cerebral ischemia due to AF between 2008 and 2011 were reviewed. Followup was obtained through medical record review, mailed survey, and acquisition of death certificates. Prevalence was calculated from those patients with a hemosiderin-sensitive MRI sequence. Recurrent CI and ICH were calculated using Kaplan-Meier curves censored at 3 years. Among 426 patients hospitalized with cerebral ischemia due to AF, 134 had an MRI with hemosiderin-sensitive sequences. The prevalence of CMB was 27.6%. At 3 years, 90.6% of CMB-negative patients were overall stroke free (ICH and CI) compared to 78.6% CMB-positive patients (p = 0.0591). Only one patient in the CMB-positive group had an ICH distant to the CMB. There was a nonsignificant trend toward higher recurrent CI, recurrent overall stroke rate, and mortality in patients with 5 or more CMB compared to 0-4 CMB. The rate of prospective CI in patients with prior cerebral ischemia due to AF is higher than the rate of ICH in patients with CMB. Further study is warranted to assess larger numbers of patients to determine appropriate antithrombotic use in this high-risk population.

  20. Clinical and pathological study on 10 cases of cerebral lobe hemorrhage related with cerebral amyloid angiopathy

    Directory of Open Access Journals (Sweden)

    Xiao-qi LI

    2015-07-01

    Full Text Available Objective To summarize the clinical data and pathological features of 10 cases of cerebral lobar hemorrhage related with cerebral amyloid angiopathy (CAA diagnosed pathologically, thereby to improve the knowledge and diagnosis of the disease. Methods The clinical data of 10 cases of cerebral lobar hemorrhage related with CAA, collected in the General Hospital of Shenyang Command from 1983 up to now, were retrospectively analyzed, and the clinical and neuropathological features of these cases were summarized. Results Of the 10 patients, 2 suffered from single lobar hemorrhage and 8 multiple lobar hemorrhage, all of them were confirmed pathologically to have ruptured into the subarachnoid space. Pathological examination revealed microaneurysm in 2 cases, "double barrel" change in 4 cases, multiple arteriolar clusters in 5 cases, obliterative onion-liked intima change in 4 cases, and fibrinoid necrosis of vessel wall in 7 cases. In addition, neurofibrillary tangles were found in 8 cases, and senile plaque was observed in 5 cases. Conclusions Cerebral lobar hemorrhage related with CAA is mainly located in the parietal, temporal and occipital lobes, readily breaking into the subarachnoid space, and it is often multiple and recurrent. The CAA associated microvasculopathy was found frequently in the autopsy sample of CAA related cerebral lobar hemorrhage, and it may contribute to the pathogenesis of cerebral hemorrhage. DOI: 10.11855/j.issn.0577-7402.2015.07.04

  1. The protective effect of calcitonin gene-related peptide on gastric mucosa injury after cerebral ischemia reperfusion in rats%大鼠脑缺血再灌注后降钙素基因相关肽对受损胃黏膜的保护作用

    Institute of Scientific and Technical Information of China (English)

    冯国营; 许晓博; 王迁

    2009-01-01

    @@ The purpose of the present study is to investigate the protective effect of calcitonin gene-related pepfide (CGRP) on gastric mucosa injury after focal cerebral ischemia reperfusion and gastric ischemia-reperfusion in rats. Wistar male rats (280-320g) were selected for this experiment. Focal cerebral ischemia and reperfusion rat model was established with left middle cerebral artery occlusion by using thread inserting.

  2. [Cerebral salt wasting syndrome and traumatic vasospasm after head trauma: report of two cases].

    Science.gov (United States)

    Katsuno, Makoto; Kobayashi, Shiro; Yokota, Hiroyuki; Teramoto, Akira

    2009-08-01

    While patients with cerebral salt wasting syndrome and traumatic cerebral arterial spasms have been reported, the underlying pathogenesis of these events remains unclear. We encountered 2 patients with head trauma and cerebral infarction who presented with cerebral salt-wasting syndrome and cerebral arterial spasms. Our findings suggested hypothalamic dysfunction due to venous congestion around the hypothalamus caused cerebral salt wasting syndrome and traumatic cerebral arterial spasms.

  3. Evaluation of radiation risk and work practices during cerebral interventions

    Energy Technology Data Exchange (ETDEWEB)

    Livingstone, Roshan S; Raghuram, L; Korah, Ipeson P; Raj, D Victor [Department of Radiodiagnosis, Christian Medical College, Vellore 632004 (India)

    2003-09-01

    This study was intended to evaluate radiation risk to patients during cerebral interventions and the contribution to this risk from work practices. Thirty nine patients undergoing cerebral interventions in a digital subtraction angiography suite were included in this study. Patients who underwent cerebral interventions were categorised into two groups according to the number of cerebral interventions performed on them, and their effective doses were calculated. The effective dose for patients undergoing a single cerebral intervention (group A) varied from 1.55 to 15.9 mSv and for multiple cerebral interventions (group B) varied from 16.52 to 43.52 mSv. Two patients who underwent multiple cerebral interventions (group B) had alopecia of the irradiated scalp.

  4. Expression of bone morphogenetic protein 7 in the cerebral cortex of rats after ischemic-hypoxic injury

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Some researches demonstrate that exogenous bone morphogenetic protein 7 (BMP-7) can protect ischemic cerebral nerve tissue and promote recovery of motor energy function; however, there is lack of direct evidences of endogenous BMP-7 effect.OBJECTIVE: To observe the expression of endogenous BMP-7 in nerve tissue with ischemic-hypoxic injury and investigate the possible effects on damaged nerve tissue.DESIGN: Observational contrast animal study.SETTING: Department of Anatomy and Histoembryology, Peking University Health Science Center.MATERIALS: The experiment was carried out in the Nerve Researching Laboratory of Anatomy Department, Peking University Health Science Center from October 2006 to March 2007. A total of 25 adult male SD rats weighing 250 - 300 g and several newborn SD rats were selected from Experimental Animal Center, Peking University Health Science Center. Rabbit-anti-BMP-7 polyclonal antibody was provided by Wuhan Boster Company.METHODS: ① Adult rats were randomly divided into ischemia group (n =10), sham operation group (n =10) and normal group (n =5). Right external-internal carotid artery occlusion was used to infarct middle cerebral artery of adult rats in the ischemia group so as to copy focal cerebral infarction models. Line cork was inserted in crotch of internal and external carotid artery of adult rats in the sham operation group, while adult rats in the normal group were not given any treatments. ② Cerebral cortex of newborn rats was separated to obtain cell suspension. Cells which were cultured for 10 days were divided into control group and hypoxia/reoxygenation group. And then, cells in the hypoxia/reoxygenation group were cultured in hypoxic incubator for 4 hours and given reoxygenation for 24 hours.MAIN OUTCOME MEASURES: Immunohistochemical method was used to measure expression of BMP-7 in cerebral cortex at 24 hours after ischemia/reperfusion culture and in primary hypoxic culture.RESULTS: ① At 24 hours after

  5. Cerebral blood flow and metabolism during sleep.

    Science.gov (United States)

    Madsen, P L; Vorstrup, S

    1991-01-01

    A review of the current literature regarding sleep-induced changes in cerebral blood flow (CBF) and cerebral metabolic rate (CMR) is presented. Early investigations have led to the notion that dreamless sleep was characterized by global values of CBF and CMR practically at the level of wakefulness, while rapid eye movement (REM) sleep (dream sleep) was a state characterized by a dramatically increased level of CBF and possibly also of CMR. However, recent investigations firmly contradict this notion. Investigations on CBF and CMR performed during non-REM sleep, taking the effect of different levels of sleep into consideration, show that light sleep (stage II) is characterized by global levels of CBF and CMR only slightly reduced by 3-10% below the level associated with wakefulness, whereas CBF and CMR during deep sleep (stage III-IV) is dramatically reduced by 25-44%. Furthermore, recent data indicate that global levels of CBF and CMR are about the same during REM sleep as in wakefulness. On the regional level, deep sleep seems to be associated with a uniform decrease in regional CBF and CMR. Investigations concerning regional CBF and CMR during REM sleep are few but data from recent investigations seem to identify site-specific changes in regional CBF and CMR during REM sleep. CBF and CMR are reflections of cerebral synaptic activity and the magnitude of reduction in these variables associated with deep sleep indicates that overall cerebral synaptic activity is reduced to approximately one-half the level associated with wakefulness, while cerebral synaptic activity levels during REM sleep are similar to wakefulness. However, even though the new understanding of CBF and CMR during sleep provides significant and important information of the brain's mode of working during sleep, it does not at its current state identify the physiological processes involved in sleep or the physiological role of sleep.

  6. [Raman spectra of monkey cerebral cortex tissue].

    Science.gov (United States)

    Zhu, Ji-chun; Guo, Jian-yu; Cai, Wei-ying; Wang, Zu-geng; Sun, Zhen-rong

    2010-01-01

    Monkey cerebral cortex, an important part in the brain to control action and thought activities, is mainly composed of grey matter and nerve cell. In the present paper, the in situ Raman spectra of the cerebral cortex of the birth, teenage and aged monkeys were achieved for the first time. The results show that the Raman spectra for the different age monkey cerebral cortex exhibit most obvious changes in the regions of 1000-1400 and 2800-3000 cm(-1). With monkey growing up, the relative intensities of the Raman bands at 1313 and 2885 cm(-1) mainly assigned to CH2 chain vibrational mode of lipid become stronger and stronger whereas the relative intensities of the Raman bands at 1338 and 2932 cm(-1) mainly assigned to CH3 chain vibrational mode of protein become weaker and weaker. In addition, the two new Raman bands at 1296 and 2850 cm(-1) are only observed in the aged monkey cerebral cortex, therefore, the two bands can be considered as a character or "marker" to differentiate the caducity degree with monkey growth In order to further explore the changes, the relative intensity ratios of the Raman band at 1313 cm(-1) to that at 1338 cm(-1) and the Raman band at 2885 cm(-1) to that at 2 932 cm(-1), I1313/I1338 and I2885/I2932, which are the lipid-to-protein ratios, are introduced to denote the degree of the lipid content. The results show that the relative intensity ratios increase significantly with monkey growth, namely, the lipid content in the cerebral cortex increases greatly with monkey growth. So, the authors can deduce that the overmuch lipid is an important cause to induce the caducity. Therefore, the results will be a powerful assistance and valuable parameter to study the order of life growth and diagnose diseases.

  7. Advanced cerebral monitoring in neurocritical care

    Directory of Open Access Journals (Sweden)

    Barazangi Nobl

    2008-01-01

    Full Text Available 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.

  8. Involvement of calcitonin gene-related peptide in migraine: regional cerebral blood flow and blood flow velocity in migraine patients

    DEFF Research Database (Denmark)

    Lassen, L.H.; Jacobsen, V.B.; Haderslev, P.A.

    2008-01-01

    g/min) or placebo for 20 min was studied in 12 patients with migraine without aura outside attacks. Xenon-133 inhalation SPECT-determined regional cerebral blood flow (rCBF) and transcranial Doppler (TCD)-determined blood velocity (V-mean) in the middle cerebral artery (MCA), as well as the heart......Calcitonin gene-related peptide (CGRP)-containing nerves are closely associated with cranial blood vessels. CGRP is the most potent vasodilator known in isolated cerebral blood vessels. CGRP can induce migraine attacks, and two selective CGRP receptor antagonists are effective in the treatment...... of migraine attacks. It is therefore important to investigate its mechanism of action in patients with migraine. We here investigate the effects of intravenous human alpha-CGRP (h alpha CGRP) on intracranial hemodynamics. In a double-blind, cross-over study, the effect of intravenous infusion of haCGRP (2 mu...

  9. Cerebral monoamine oxidase A inhibition in tobacco smokers confirmed with PET and [{sup 11}C]Befloxatone

    Energy Technology Data Exchange (ETDEWEB)

    Leroy, C.; Bragulat, V.; Penttila, J.; Artiges, E.; Martinot, J.L.; Trichard, Ch. [INSERM U797, Research Unit ' Neuroimaging and Psychiatry' , Orsay (France); Leroy, C.; Bragulat, V.; Penttila, J.; Artiges, E.; Martinot, J.L.; Trichard, Ch. [CEA, ' Neuroimaging and Psychiatry, U797 Unit, Hospital Department Frederic Joliot and Neurospin (France); Leroy, C.; Bragulat, V.; Penttila, J.; Artiges, E.; Martinot, J.L.; Trichard, Ch. [Paris sud University - Paris Descartes University, UMR U797 (France); Berlin, I. [Service de Pharmacologie, Hopital Pitie-Salpetriere - Universite Paris6 - INSERM U677, Paris (France); Gregoire, M.C.; Bottlaender, M.; Roumenov, D.; Dolle, F.; Bourgeois, S. [CEA, DSV, I2BM, Service Hospitalier Frederic Joliot, Orsay (France); Artiges, E.; Trichard, Ch. [Psychiatry Department, Orsay Hospital, Orsay (France)

    2009-07-01

    The inhibition of cerebral monoamine oxidases (MAOs) by cigarette smoke components could participate to the tobacco addiction. However, the actual extent of this inhibition in vivo in smokers is still poorly known. We investigated cerebral MAO-A availability in 7 tobacco-dependent subjects and 6 healthy nonsmokers, using positron emission tomography (PET) and the MAO-A selective radioligand [{sup 11}C]befloxatone. In comparison to nonsmokers, smokers showed a significant overall reduction of [{sup 11}C]befloxatone binding potential (BP) in cortical areas (average reduction, -60%) and a similar trend in caudate and thalamus (-40%). Our findings confirm a widespread inhibition of cerebral MAO-A in smokers. This mechanism may contribute to tobacco addiction and for a possible mood-modulating effect of tobacco. (authors)

  10. Influence of intranasal and carotid cooling on cerebral temperature balance and oxygenation

    Directory of Open Access Journals (Sweden)

    Lars eNybo

    2014-02-01

    Full Text Available The present study evaluated the influence of intranasal cooling with balloon catheters, increased nasal ventilation, or percutaneous cooling of the carotid arteries on cerebral temperature balance and oxygenation in six healthy male subjects. Aortic arch and internal jugular venous blood temperatures were measured to assess the cerebral heat balance and corresponding paired blood samples were obtained to evaluate cerebral metabolism and oxygenation at rest, following 60 min of intranasal cooling, 5 min of nasal ventilation, and 15 min with carotid cooling. Intranasal cooling induced a parallel drop in jugular venous and arterial blood temperatures by 0.30 ± 0.08 ºC (mean ± SD, whereas nasal ventilation and carotid cooling failed to lower the jugular venous blood temperature. The magnitude of the arterio-venous temperature difference across the brain remained unchanged at - 0.33 ± 0.05 ºC following intranasal and carotid cooling, but increased to - 0.44 ± 0.11 ºC (P< 0.05 following nasal ventilation. Calculated cerebral capillary oxygen tension was 43 ± 3 mmHg at rest and remained unchanged during intranasal and carotid cooling, but decreased to 38 ± 2 mmHg (P< 0.05 following increased nasal ventilation. In conclusion, percutaneous cooling of the carotid arteries and intranasal cooling with balloon catheters are insufficient to influence cerebral oxygenation in normothermic subjects as the cooling rate is only 0.3 ºC per hour and neither intranasal nor carotid cooling is capable of inducing selective brain cooling.

  11. Positron emission tomography in cerebrovascular disease: The relationship between regional cerebral blood flow, blood volume and oxygen metabolism

    Energy Technology Data Exchange (ETDEWEB)

    Herold, S.

    1985-03-01

    Positron emission tomography in cerebrovascular disease has demonstrated the importance of the relationship between regional cerebral blood flow and the cerebral metabolic activity. In acute stroke it has been found that within the first hours after the onset of symptoms cerebral blood flow in the affected area is more depressed than cerebral oxygen utilisation. This relative preservation of oxygen utilisation results from an increase in the oxygen extraction ratio far above its normal value. However, the oxygen extraction fraction subsequently falls in the following days indicating the transition from a situation of possibly reversible ischaemia to irreversible infarction. In patients with carotid occlusive disease an increase in the oxygen extraction ratio has been observed only in very few cases. It has been shown, however, that at an earlier stage the relationship between CBF and CBV (as CBF/CBV-ratio) provides a sensitive measure of diminished perfusion pressure which could be helpful for the selection of patients for EC-IC bypass surgery. In patients with sickle cell anaemia it has been found that oxygen delivery to the brain is maintained by an increase in cerebral blood flow, whereas the oxygen extraction ratio is not increased despite the presence of a low oxygen affinity haemoglobin. Preliminary observations in classical migraine suggest an ischaemic situation during the attack.

  12. Hemodynamic changes in a rat parietal cortex after endothelin-1-induced middle cerebral artery occlusion monitored by optical coherence tomography

    Science.gov (United States)

    Liu, Jian; Ma, Yushu; Dou, Shidan; Wang, Yi; La, Dongsheng; Liu, Jianghong; Ma, Zhenhe

    2016-07-01

    A blockage of the middle cerebral artery (MCA) on the cortical branch will seriously affect the blood supply of the cerebral cortex. Real-time monitoring of MCA hemodynamic parameters is critical for therapy and rehabilitation. Optical coherence tomography (OCT) is a powerful imaging modality that can produce not only structural images but also functional information on the tissue. We use OCT to detect hemodynamic changes after MCA branch occlusion. We injected a selected dose of endothelin-1 (ET-1) at a depth of 1 mm near the MCA and let the blood vessels follow a process first of occlusion and then of slow reperfusion as realistically as possible to simulate local cerebral ischemia. During this period, we used optical microangiography and Doppler OCT to obtain multiple hemodynamic MCA parameters. The change trend of these parameters from before to after ET-1 injection clearly reflects the dynamic regularity of the MCA. These results show the mechanism of the cerebral ischemia-reperfusion process after a transient middle cerebral artery occlusion and confirm that OCT can be used to monitor hemodynamic parameters.

  13. Experimental antegrade enema: effects on water, electrolyte and acid-base balances with different solutions Enema anterógrado experimental: equilíbrio hídrico eletrolítico e ácido-base em coelhos submetidos a enema com diferentes soluções

    Directory of Open Access Journals (Sweden)

    Laura Helman

    2007-10-01

    Full Text Available PURPOSE: To study the effects on the water, electrolyte, and acid-base balances in rabbits submitted to antegrade enema with different solutions through appendicostomy. METHODS: Forty male New Zealand rabbits were submitted to appendicostomy, and distributed in 4 groups, according to the antegrade enema solution: PEG group, polyethylene glycol electrolyte solution (n=10; ISS group, isotonic saline solution (n=10; GS group, glycerin solution (n=10; SPS group, sodium phosphate solution (n=10. After being weighed, arterial blood gas analysis, red blood count, creatinine and electrolytes were measured at 4 times: preoperatively (T1; day 6 postop, before enema (T2; 4h after enema (T3; and 24h after T3 (T4. RESULTS: In PEG group occurred Na retention after 4h, causing alkalemia, sustained for 24h with HCO3 retention. In ISS group occurred isotonic water retention and hyperchloremic acidosis after 4h, which was partially compensated in 24h. GS group showed metabolic acidosis after 4h, compensated in 24h. In SPS group occurred hypernatremic dehydration, metabolic acidosis in 4h, and hypokalemia, hypocalcemia, hypomagnesemia, and metabolic alkalosis with partially compensated dehydration in 24h. CONCLUSIONS: All solutions used in this study caused minor alterations on water, electrolyte or acid-base balances. The most intense ones were caused by hypertonic sodium phosphate solution (SPS and isotonic saline solution (ISS and the least by polyethyleneglycol electrolyte solution (PEG and glycerin solution 12% (GS.OBJETIVO: Estudar os efeitos no equilíbrio hídrico, eletrolítico e ácido-base, do enema anterógrado com diferentes soluções em coelhos através de apendicostomia. MÉTODOS: 40 coelhos Nova Zelândia, machos, submetidos a apendicostomia, distribuídos em quatro grupos segundo a solução de enema: grupo PEG (n = 10 solução de polietilenoglicol com eletrólitos; grupo SF (n = 10 solução fisiológica; grupo SG (n = 10 solução glicerinada

  14. The effect of postural control and balance on femoral anteversion in children with spastic cerebral palsy

    Science.gov (United States)

    Karabicak, Gul Oznur; Balcı, Nilay Comuk; Gulsen, Mustafa; Ozturk, Basar; Cetin, Nuri

    2016-01-01

    [Purpose] The aim of the study was to investigate the relationships between femoral anteversion and functional balance and postural control in children with spastic cerebral palsy. [Subjects and Methods] Twenty children with spastic cerebral palsy (mean age=12.4 ± 4.5) with grosss motor functional classification system levels I, II, and III were recruited for this study. Functional balance was evaluated using the Pediatric Balance Scale, postural control was evaluated using the Trunk Control Measurement Scale, and femoral anteversion was assessed with a handheld goniometer using the great trochanter prominence method. [Results] The results indicated that there was significant correlation between femoral anteversion and Trunk Control Measurement Scale dynamic reaching score. There were no significant correlation between femoral anteversion and the Trunk Control Measurement Scale static sitting balance, Trunk Control Measurement Scale selective movement control, total Trunk Control Measurement Scale and Pediatric Balance Scale results. [Conclusion] Increased femoral anteversion has not correlation with functional balance, static sitting, and selective control of the trunk. Femoral anteversion is related to dynamic reaching activities of the trunk, and this may be the result of excessive internal pelvic rotation. It is important for the health professionals to understand that increased femoral anteversion needs to be corrected because in addition to leading to femoral internal rotation during walking, it also effects dynamic reaching activities of spastic children with cerebral palsy. PMID:27390397

  15. The effects of forward and backward walking according to treadmill inclination in children with cerebral palsy

    Science.gov (United States)

    Kim, Won-hyo; Kim, Won-bok; Yun, Chang-kyo

    2016-01-01

    [Purpose] This study investigated the effects of forward and backward walking using different treadmill incline positions on lower muscle activity in children with cerebral palsy, to provide baseline data for gait training intensity. [Subjects and Methods] Nineteen subjects with cerebral palsy walked forward and backward at a self-selected pace on a treadmill with inclines of 0%, 5%, 10%, and 15%. Activation of the rectus femoris, biceps femoris, tibialisanterior, and lateral gastrocnemius was measured using surface electromyography during the stance phase. [Results] As treadmill incline increased during forward walking, muscle activation of the paralyzed lower limbs did not significantly change. However, as treadmill incline increased during backward walking, rectus femoris activation significantly increased and a significant difference was found between treadmill inclines of 0% and 10%. A comparison of backward and forward walking showed a significant difference in rectus femoris activation at treadmill inclines of 0%, 5%, and 10%. Activation of the tibialis anterior was only significantly higher for backward walking at the 10% gradient. [Conclusion] Backward walking may strengthen the rectus femoris and tibialis anterior in walking training for cerebral palsy. Gradient adjustment of the treadmill can be used to select the intensity of walking training. PMID:27313373

  16. On-line electrochemical measurements of cerebral hypoxanthine of freely moving rats

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    This study demonstrates an on-line method for continuous measurements of cerebral hypoxanthine in the freely moving rats with integration of selective electrochemical biosensing with in vivo microdialysis sampling. The selective electrochemical biosensing is achieved by using xanthine oxidase (XOD) as the specific sensing element and Prussian blue (PB) as the electrocatalyst for the reduction of H2O2 generated from the oxidase-catalyzed reaction. The method is virtually interference-free from the co-existing electroactive species in the brain and exhibits a good stability and reproducibility. Upon integrated with in vivo microdialysis, the on-line method is well suitable for continuous measurements of cerebral hypoxanthine of freely moving rats, which is illustrated by the measurements of the microdi-alysates after the hypoxanthine standard was externally infused into the rat brain. This study essentially offers a facile on-line electrochemical approach to continuous measurements of cerebral hypoxanthine and could find some interesting applications in physiological and pathological investigations associated with hypoxanthine.

  17. On-line electrochemical measurements of cerebral hypoxanthine of freely moving rats

    Institute of Scientific and Technical Information of China (English)

    ZHANG ZiPin; LIN YuQing; MAO LanQun

    2009-01-01

    This study demonstrates an on-line method for continuous measurements of cerebral hypoxanthine in the freely moving rats with integration of selective electrochemical biosensing with in vivo microdialysis sampling. The selective electrochemical biosensing is achieved by using xanthine oxidase (XOD) as the specific sensing element and Prussian blue (PB) as the electrocatalyst for the reduction of H_2O_2 generated from the oxidase-catalyzed reaction. The method is virtually interference-free from the coexisting electroactive species in the brain and exhibits a good stability and reproducibility. Upon integrated with in vivo microdialysis, the on-line method is well suitable for continuous measurements of cerebral hypoxanthine of freely moving rats, which is illustrated by the measurements of the microdialysates after the hypoxanthine standard was externally infused into the rat brain. This study essen-tially offers a facile on-line electrochemical approach to continuous measurements of cerebral hypoxanthine and could find some interesting applications in physiological and pathological investigations associated with hypoxanthine.

  18. Automated criterion-based analysis for Cole parameters assessment from cerebral neonatal electrical bioimpedance spectroscopy measurements.

    Science.gov (United States)

    Seoane, F; Ward, L C; Lindecrantz, Kaj; Lingwood, B E

    2012-08-01

    Hypothermia has been proven as an effective rescue therapy for infants with moderate or severe neonatal hypoxic ischemic encephalopathy. Hypoxia-ischemia alters the electrical impedance characteristics of the brain in neonates; therefore, spectroscopic analysis of the cerebral bioimpedance of the neonate may be useful for the detection of candidate neonates eligible for hypothermia treatment. Currently, in addition to the lack of reference bioimpedance data obtained from healthy neonates, there is no standardized approach established for bioimpedance spectroscopy data analysis. In this work, cerebral bioimpedance measurements (12 h postpartum) in a cross-section of 84 term and near-term healthy neonates were performed at the bedside in the post-natal ward. To characterize the impedance spectra, Cole parameters (R(0), R(∞), f(C) and α) were extracted from the obtained measurements using an analysis process based on a best measurement and highest likelihood selection process. The results obtained in this study complement previously reported work and provide a standardized criterion-based method for data analysis. The availability of electrical bioimpedance spectroscopy reference data and the automatic criterion-based analysis method might support the development of a non-invasive method for prompt selection of neonates eligible for cerebral hypothermic rescue therapy.

  19. The effect of postural control and balance on femoral anteversion in children with spastic cerebral palsy.

    Science.gov (United States)

    Karabicak, Gul Oznur; Balcı, Nilay Comuk; Gulsen, Mustafa; Ozturk, Basar; Cetin, Nuri

    2016-06-01

    [Purpose] The aim of the study was to investigate the relationships between femoral anteversion and functional balance and postural control in children with spastic cerebral palsy. [Subjects and Methods] Twenty children with spastic cerebral palsy (mean age=12.4 ± 4.5) with grosss motor functional classification system levels I, II, and III were recruited for this study. Functional balance was evaluated using the Pediatric Balance Scale, postural control was evaluated using the Trunk Control Measurement Scale, and femoral anteversion was assessed with a handheld goniometer using the great trochanter prominence method. [Results] The results indicated that there was significant correlation between femoral anteversion and Trunk Control Measurement Scale dynamic reaching score. There were no significant correlation between femoral anteversion and the Trunk Control Measurement Scale static sitting balance, Trunk Control Measurement Scale selective movement control, total Trunk Control Measurement Scale and Pediatric Balance Scale results. [Conclusion] Increased femoral anteversion has not correlation with functional balance, static sitting, and selective control of the trunk. Femoral anteversion is related to dynamic reaching activities of the trunk, and this may be the result of excessive internal pelvic rotation. It is important for the health professionals to understand that increased femoral anteversion needs to be corrected because in addition to leading to femoral internal rotation during walking, it also effects dynamic reaching activities of spastic children with cerebral palsy.

  20. Subintimal Arterial Flossing with Antegrade-Retrograde Intervention for Subintimal Recanalization in Treatment of Superficial Femoral Artery Long Segment Occlusion in 16 Patients%双向内膜下血管成形术治疗股浅动脉长段硬化性闭塞疾病16例分析

    Institute of Scientific and Technical Information of China (English)

    徐树彬; 梁志会; 李亮; 刘晶磊; 李佳; 崔进国; 赵红恩; 谢永伟

    2014-01-01

    目的 探讨经双向内膜下血管成形术(subintimal arterial flossing with antegrade retrograde intervention,SAFARI)治疗股浅动脉长段硬化性闭塞疾病的临床效果和应用价值.方法 选择2011年5月—2013年8月收治的经内膜下血管成形术治疗失败的股浅动脉长段硬化性闭塞疾病16例,经SAFARI开通,采用经皮穿刺腔内血管成形术(PTA)联合内支架(stent)置入.结果 全组治疗技术成功率为100%,无严重并发症发生;术后平均随访10(3 ~18)个月,一期通畅率为93.75%(15/16),二期通畅率为100%.踝肱指数由术前的0.25±0.15增加至术后的0.89±0.19(P <0.05).结论 SAFARI是治疗股浅动脉长段硬化性闭塞所致慢性严重肢体缺血的安全有效的方法.

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

    Science.gov (United States)

    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.

  2. Acute Headache at Emergency Department: Reversible Cerebral Vasoconstriction Syndrome Complicated by Subarachnoid Haemorrhage and Cerebral Infarction

    Directory of Open Access Journals (Sweden)

    M. Yger

    2015-01-01

    Full Text Available Introduction. Reversible cerebral vasoconstriction syndrome is becoming widely accepted as a rare cause of both ischemic and haemorrhagic stroke and should be evocated in case of thunderclap headaches associated with stroke. We present the case of a patient with ischemic stroke associated with cortical subarachnoid haemorrhage (cSAH and reversible diffuse arteries narrowing, leading to the diagnosis of reversible vasoconstriction syndrome. Case Report. A 48-year-old woman came to the emergency department because of an unusual thunderclap headache. The computed tomography of the brain completed by CT-angiography was unremarkable. Eleven days later, she was readmitted because of a left hemianopsia. One day after her admission, she developed a sudden left hemiparesis. The brain MRI showed ischemic lesions in the right frontal and occipital lobe and diffuse cSAH. The angiography showed vasoconstriction of the right anterior cerebral artery and stenosis of both middle cerebral arteries. Nimodipine treatment was initiated and vasoconstriction completely regressed on day 16 after the first headache. Conclusion. Our case shows a severe reversible cerebral vasoconstriction syndrome where both haemorrhagic and ischemic complications were present at the same time. The history we reported shows that reversible cerebral vasoconstriction syndrome is still underrecognized, in particular in general emergency departments.

  3. Neural perspectives of cerebral correlates of giftedness.

    Science.gov (United States)

    Chen, A C; Buckley, K C

    1988-07-01

    Giftedness is defined as some special endowment or propensity for creativity, skill, and eminent achievement, found in relatively few individuals among the population. A high order of mental power (IQ), creativity, and motivation (task commitment) appear to be the most universally recognized attributes of the gifted. This report summarizes current knowledge of the cerebral correlates of intelligence and creativity, including physiological measures of EEG, cortical power spectrum, brain evoked potentials, and positron emission tomography. Controversy, debates, contentions, formal hypotheses, and research issues are considered. We are especially interested in the formulation of the deterministic function of EEG-brain dynamics. A CHAOS modeling on hierarchy of cognitive organization and cerebral processing in the gifted is suggested.

  4. Severe cerebral vasospasm after traumatic brain injury.

    Science.gov (United States)

    Fehnel, Corey R; Wendell, Linda C; Potter, N Stevenson; Klinge, Petra; Thompson, Bradford B

    2014-07-01

    Severe traumatic brain injury is associated with both acute and delayed neuro- logical injury. Cerebral vasospasm is commonly associated with delayed neurological decline in aneurysmal subarachnoid hemorrhage patients. However, the role played by vasospasm in traumatic brain injury is less clear. Vasospasm occurs earlier, for a shorter duration, and often without significant neurological consequence among traumatic brain injury patients. Detection and management strategies for vasospasm in aneurysmal subarachnoid hemorrhage are not easily transferrable to traumatic brain injury patients. We present a patient with a severe traumatic brain injury who had dramatic improvement following emergent decompressive hemicraniectomy. Two weeks after initial presentation he suffered a precipitous decline despite intensive surveillance. This case illustrates the distinct challenges of diagnosing cerebral vasospasm in the setting of severe traumatic brain injury.

  5. Esquistossomose mansônica cerebral

    Directory of Open Access Journals (Sweden)

    Andyr Nazareth Andrade

    1989-03-01

    Full Text Available Relata-se um caso de neuroesquistossomose (NE mansônica cerebral forma granulomatosa pseudotumoral de localização no córtex do lobo parietal esquerdo determinando, hemiparesia direita e síndrome de hipertensão intracraniana, diagnosticado por biópsia cirúrgica. Fatores vasculares e imunológicos são considerados na fisiopatogenia da NE. Enfatiza-se a necessidade de melhor se estudar, diagnosticar e divulgar as várias formas de envolvimento do SN na esquistossomose mansônica, que parece ser mais freqüente do que se julga atualmente. O comprometimento cerebral com repercussão clínica nesta doença é raro, sendo a forma pseudotumoral limitada a poucos casos descritos na literatura.

  6. Clinical practice: swallowing problems in cerebral palsy.

    Science.gov (United States)

    Erasmus, Corrie E; van Hulst, Karen; Rotteveel, Jan J; Willemsen, Michel A A P; Jongerius, Peter H

    2012-03-01

    Cerebral palsy (CP) is the most common physical disability in early childhood. The worldwide prevalence of CP is approximately 2-2.5 per 1,000 live births. It has been clinically defined as a group of motor, cognitive, and perceptive impairments secondary to a non-progressive defect or lesion of the developing brain. Children with CP can have swallowing problems with severe drooling as one of the consequences. Malnutrition and recurrent aspiration pneumonia can increase the risk of morbidity and mortality. Early attention should be given to dysphagia and excessive drooling and their substantial contribution to the burden of a child with CP and his/her family. This review displays the important functional and anatomical issues related to swallowing problems in children with CP based on relevant literature and expert opinion. Furthermore, based on our experience, we describe a plan for approach of investigation and treatment of swallowing problems in cerebral palsy.

  7. Pediatric neuroradiology: Cerebral and cranial diseases

    Energy Technology Data Exchange (ETDEWEB)

    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.

  8. Cerebral salt wasting syndrome: a case report.

    Science.gov (United States)

    Hegde, R M

    1999-06-01

    A case of hyponatraemia associated with subarachnoid haemorrhage is presented. The provisional diagnosis of an inappropriate antidiuresis was made and treatment with fluid restriction was instituted. However the patient continued to deteriorate as the diuresis continued and the hyponatraemia worsened, resulting in hypovolaema. The salt wasting syndrome was subsequently diagnosed and saline and fludrocortisone (0.2 mg/day) was initiated, reducing the renal salt loss, increasing the plasma sodium and improving the neurological status of the patient. Cerebral salt wasting syndrome is an important and under-recognised cause of hyponatraemia in neurosurgical patients, particularly in patients with subarachnoid hemorrhage. It is essential to differentiate it from the syndrome of inappropriate antidiuretic hormone secretion to avoid complications of hypovolaemia and reduced cerebral perfusion as illustrated by this case. Brain natriuretic peptide may be responsible for this syndrome although this requires further investigation.

  9. Computed tomography in spastic cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Pedersen, H.; Taudorf, K.; Melchior, J.C.

    1982-09-01

    Eighty-three children with spastic cerebral palsy (CP) were examined with cranial CT. In 56 cases the CT findings were abnormal. The most frequent abnormality was atrophy, present in 44 patients. The frequency of pathologic CT increased with severity of the CP. Patients with CP of postnatal aetiology more often had abnormal CT than patients with other known causes. Pathologic CT findings were seen more often in patients with seizures than in patients without. Infarctions and hemiatrophy were much more frequent in patients with hemiplegia than in patients with other types of spastic CP. A special kind of central atrophy, called isolated atrophy around the cella media, is described. This condition was seen in 20% of cases, most often in hemi- and paraplegic patients. Early infarctions in the border areas between the vascular territories of the internal carotid and the posterior cerebral artery may be the reason for this kind of atrophy.

  10. Locations of cerebral infarctions in tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Hsieh, F.Y.; Chia, L.G. (Section of Neurology, Taichung Veterans General Hospital (Taiwan)); Shen, W.C. (Section of Neuroradiology, Taichung Veterans General Hospital (Taiwan))

    1992-06-01

    The locations of cerebral infarctions were studied in 14 patients with tuberculous meningitis (TBM) and 173 patients with noninflammatory ischemic stroke (IS). In patients with TBM, 75% of infarctions occurred in the 'TB zone' supplied by medial striate and thalamoperforating arteries; only 11% occurred in the 'IS zone' supplied by lateral striate, anterior choroidal and thalamogeniculate arteries. In patients with IS, 29% of infarctions occurred in the IS zone, 29% in the subcortical white matter, and 24% in (or involving) the cerebral cortex. Only 11% occurred in the TB zone. Bilaterally symmetrical infarctions of the TB zone were common with TBM (71%) but rare with IS (5%). (orig.).

  11. The Child with Cerebral Palsy and Anaesthesia

    Directory of Open Access Journals (Sweden)

    A Rudra

    2008-01-01

    Full Text Available Cerebral palsy (CP is the result of an injury to the developing brain during the antenatal, perinatal or postnatal period. Clinical manifestation relate to the areas affected. Patients with CP often present for elective surgical proce-dures to correct various deformities. Anaesthetic concerns of anaesthesia are intraoperative hypothermia , and slow emergence. Suxamethonium does not cause hyperkalaemia in these patients, and a rapid sequence induction may be indicated. Temperature should be monitored and an effort made to keep the patient warm. Cerebral abnormalities may lead to slow awakening; the patient should remain intubated until fully awake and airway reflexes have returned. Pulmonary infection can complicate the postoperative course. Postoperative pain management and the prevention of muscle spasms are important and drugs as baclofen and botulinum toxin are discussed. Epidural analgesia is particu-larly valuable when major orthopaedic procedures are performed.

  12. The Age of Human Cerebral Cortex Neurons

    Energy Technology Data Exchange (ETDEWEB)

    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.

  13. Intraoperative cerebral blood flow imaging of rodents

    Science.gov (United States)

    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.

  14. 经腹直肌外侧切口入路重建钢板辅助后柱顺行拉力螺钉治疗复杂髋臼骨折%Surgical treatment of complex acetabular fractures through the lateral-rectus approach with the pelvic reconstructive plate and antegrade posterior-column lag screw

    Institute of Scientific and Technical Information of China (English)

    张潇; 杨晓东; 夏广; 李涛; 王华; 熊然; 樊仕才

    2015-01-01

    Objective To evaluate the clinical value of the lateral-rectus approach with the pelvic recon-structive plate and antegrade posterior -column lag screw in the treatment of complex acetabular fractures .Meth-ods Between May 2012 and Jan.2014,9 patients with complex acetabular fractures were treated with pelvic recon-structive plate and antegrade posterior-column lag screw through the lateral-rectus approach . There were 6 males and 3 females,aged 27-74 years(mean,39 years).Fractures were caused by traffic accident in 5 cases,by falling in 2 cases,and by heavy crash in 2 cases.According to Letournel classification ,there were 2 cases of transverse frac-ture,4 cases of anterior column with posterior hemi-transverse lesion fracture,and 3 cases of both-column fracture with 1 case of central dislocation of hip joint .The operation time and blood loss were statistically analyzed .The pa-tients were evaluated clinically according to Merle d'Aubigne-Postel scoring system and X ray performance based on the criteria described by Matta .Results The average time of operation was 200 minutes ( 150-255 minutes );the average blood loss was 730ml(300-1250ml);the average follow up was 15.9 months(9-30 months);the clinical results were excellent in 5 patients,good in 2 and fair in 2.The radiological results were anatomical reduction in 5 patients,satisfactory in 3 and fair in 1.All the patients were healed within 3 months and there were no complications such as infection ,avascular necrosis of the femoral head ( ANFH) ,or heterotopic ossification .Conclusion The lat-eral-rectus approach is suitable for some complex acetabular fractures ,with advantages of the adequate exposure of quadrilateral surface and insertion of the posterior column antegrade lag screw .%目的:评价经腹直肌外侧切口入路以前柱重建钢板配合后柱顺行拉力螺钉内固定治疗复杂髋臼骨折的临床疗效。方法回顾性分析自2012年5月~2014年1月本科

  15. Perfusão pulmonar anterógrada "versus" retrógrada na preservação pulmonar para transplante em modelo canino de viabilidade pulmonar pós-morte Antegrade versus retrograde lung perfusion in pulmonary preservation for transplantation in a canine model of post-mortem lung viability

    Directory of Open Access Journals (Sweden)

    Jean Carlo Kohmann

    1999-04-01

    reperfusão (p = 0,01 e ao término do período de avaliação (p = 0,01. Os autores concluem que, neste modelo experimental, a perfusão retrógrada hipotérmica resulta em função superior do enxerto após 3 horas de isquemia normotérmica sob ventilação mecânica.Lung retrieval following cardio-circulatory arrest has been studied experimentally, however severe ischemia/reperfusion injury requires improved methods of graft preservation. Allograft perfusion with crystalloid solution delivered via pulmonary artery (antegrade perfusion remains the standard procedure, however it does not provide adequate washout of the blood retained within the bronchial circulation which may trigger reperfusion injury. This has led the authors to test the impact of antegrade versus retrograde (via left atrium perfusion of lung grafts submitted to 3 hours of warm ischemia after cardio-circulatory arrest in a dog model of left lung allotransplantation. Twelve donor dogs were sacrificed with thiopental sodium and kept under mechanical ventilation at room temperature for 3 hours. They were randomized and the heart-lung blocks harvested after being perfused in a retrograde (group I, n = 6 or antegrade (group II, n = 6 fashion with modified Euro-Collins solution. Twelve recipient animals were submitted to a left lung transplant receiving the grafts from both groups and the assessment was performed during 6 hours. Hemodynamic parameters were similar for animals in both groups. The gas exchange (arterial PaO2 and PaCO2 in recipients of group I (retrograde perfusion was significantly better when compared to recipients of grafts perfused via pulmonary artery. Intracellular ATP did not show difference between the groups, however there was a measurable drop in its values when samples obtained upon extraction were compared to those measured after reperfusion and at the end of the assessment. The authors concluded that retrograde perfusion yields better pulmonary function after 6 hours of reperfusion

  16. Differential microRNA expression in experimental cerebral and noncerebral malaria

    DEFF Research Database (Denmark)

    El-Assaad, Fatima; Hempel, Casper; Combes, Valéry

    2011-01-01

    berghei ANKA (PbA), which causes cerebral malaria (CM), or Plasmodium berghei K173 (PbK), which causes severe malaria but without cerebral complications, termed non-CM. The differential expression profiles of selected miRNAs (let-7i, miR-27a, miR-150, miR-126, miR-210, and miR-155) were analyzed in mouse...... acute malaria. To investigate the involvement of let-7i, miR-27a, and miR-150 in CM-resistant mice, we assessed the expression levels in gamma interferon knockout (IFN-¿(-/-)) mice on a C57BL/6 genetic background. The expression of let-7i, miR-27a, and miR-150 was unchanged in both wild-type (WT...... a regulatory role in the pathogenesis of severe malaria....

  17. TRPM7 in cerebral ischemia and potential target for drug development in stroke

    Institute of Scientific and Technical Information of China (English)

    Christine You-Jin BAE; Hong-shuo Sun

    2011-01-01

    Searching for effective pharmacological agents for stroke treatment has largely been unsuccessful. Despite initial excitement, antagonists for glutamate receptors, the most studied receptor channels in ischemic stroke, have shown insufficient neuroprotective effects in clinical trials. Outside the traditional glutamate-mediated excitotoxicity, recent evidence suggests few non-glutamate mechanisms,which may also cause ionic imbalance and cell death in cerebral ischemia. Transient receptor potential melastatin 7 (TRPM7) is a Ca2+permeable, non-selective cation channel that has recently gained attention as a potential cation influx pathway involved in ischemic events. Compelling new evidence from an in vivo study demonstrated that suppression of TRPM7 channels in adult rat brain in vivo using virally mediated gene silencing approach reduced delayed neuronal cell death and preserved neuronal functions in global cerebral ischemia. In this review, we will discuss the current understanding of the role of TRPM7 channels in physiology and pathophysiology as well as its therapeutic potential in stroke.

  18. Assessment of cerebral blood flow autoregulation (CBF AR) with rheoencephalography (REG): studies in animals

    Science.gov (United States)

    Popovic, Djordje; Bodo, Michael; Pearce, Frederick; van Albert, Stephen; Garcia, Alison; Settle, Tim; Armonda, Rocco

    2013-04-01

    The ability of cerebral vasculature to regulate cerebral blood flow (CBF) in the face of changes in arterial blood pressure (SAP) or intracranial pressure (ICP) is an important guard against secondary ischemia in acute brain injuries, and official guidelines recommend that therapeutic decisions be guided by continuous monitoring of CBF autoregulation (AR). The common method for CBF AR monitoring, which rests on real-time derivation of the correlation coefficient (PRx) between slow oscillations in SAP and ICP is, however, rarely used in clinical practice because it requires invasive ICP measurements. This study investigated whether the correlation coefficient between SAP and the pulsatile component of the non-invasive transcranial bioimpedance signal (rheoencephalography, REG) could be used to assess the state and lower limit of CBF AR. The results from pigs and rhesus macaques affirm the utility of REG; however, additional animal and clinical studies are warranted to assess selectivity of automatic REG-based evaluation of CBF AR.

  19. Hip and Spine in Cerebral Palsy

    OpenAIRE

    Persson-Bunke, Måns

    2015-01-01

    Abstract Background: Children with cerebral palsy (CP) have an increased risk of scoliosis, contractures including windswept hip deformity (WS), and hip dislocation. In 1994, a follow-up program and registry for children and adolescents with CP (CPUP) was initiated in Sweden to allow the early detection and prevention of hip dislocations and other musculoskeletal deformities. Purpose: To analyze the prevalence of scoliosis and WS in children with CP and to study the effect of CPUP. To e...

  20. Cerebral venous sinus thrombosis with autoimmune thyroiditis

    Directory of Open Access Journals (Sweden)

    Sameer Aggarwal

    2013-01-01

    Full Text Available Cerebral Venous Thrombosis ( CVT is a multifactorial condition which is described as idiopathic in 12.5% of patients. Hyperthyroidism has been associated with CVT in many case reports, and increased levels of factor VIII and von Willebrand factor (vWF have been proposed as the possible link in this association, but only few rare case reports have described an association of hypothyroidism with CVT. We report here a case of autoimmune thyroiditis presenting with CVT.

  1. Dietary Practices in Saudi Cerebral Palsy Children

    OpenAIRE

    Al-Hammad, Nouf S.

    2015-01-01

    Objectives: To determine the dietary practices of Saudi cerebral palsy (CP) children. Methods: A self-administered questionnaire was used to collect the following information from parents of CP children: demographics, main source of dietary information, frequency of main meals, foods/drinks used for main meals and in-between-meals. Results: Parents of 157 CP children participated. Parents were divided into three, while children were divided into two age groups. The main sources of dietary inf...

  2. Cerebral hypoxia and ischemia in preterm infants

    Directory of Open Access Journals (Sweden)

    Alberto Ravarino

    2014-06-01

    Full Text Available Premature birth is a major public health issue internationally affecting 13 million babies worldwide. Hypoxia and ischemia is probably the commonest type of acquired brain damage in preterm infants. The clinical manifestations of hypoxic-ischemic injury in survivors of premature birth include a spectrum of cerebral palsy and intellectual disabilities. Until recently, the extensive brain abnormalities in preterm neonates appeared to be related mostly to destructive processes that lead to substantial deletion of neurons, axons, and glia from necrotic lesions in the developing brain. Advances in neonatal care coincide with a growing body of evidence that the preterm gray and white matter frequently sustain less severe insults, where tissue destruction is the minor component. Periventricular leukomalacia (PVL is the major form of white matter injury and consists classically of focal necrotic lesions, with subsequent cyst formation, and a less severe but more diffuse injury to cerebral white mater, with prominent astrogliosis and microgliosis but without overt necrosis. With PVL a concomitant injury occurs to subplate neurons, located in the subcortical white matter. Severe hypoxic-ischemic insults that trigger significant white matter necrosis are accompanied by neuronal degeneration in cerebral gray and white matter. This review aims to illustrate signs of cerebral embryology of the second half of fetal life and correlate hypoxic-ischemic brain injury in the premature infant. This should help us better understand the symptoms early and late and facilitate new therapeutic strategies. Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken

  3. Transcranial laser stimulation improves human cerebral oxygenation

    OpenAIRE

    2016-01-01

    Background and Objective Transcranial laser stimulation of the brain with near‐infrared light is a novel form of non‐invasive photobiomodulation or low‐level laser therapy (LLLT) that has shown therapeutic potential in a variety of neurological and psychological conditions. Understanding of its neurophysiological effects is essential for mechanistic study and treatment evaluation. This study investigated how transcranial laser stimulation influences cerebral hemodynamics and oxygenation in th...

  4. Focal cerebral hyperemia in postconcussive amnesia.

    Science.gov (United States)

    Nariai, T; Suzuki, R; Ohta, Y; Ohno, K; Hirakawa, K

    2001-12-01

    Transient amnesia caused by minor head injury is commonly encountered in daily neurosurgical practice, but the mechanism of such amnesia has not been extensively studied. We measured the regional cerebral blood flow (rCBF) of patients with postconcussive amnesia with Xe/CT CBF to examine whether a focal disturbance of CBF exists. The Xe/CT CBF study was performed in eight patients with closed head injury without organic cerebral lesion while they were suffering from posttraumatic amnesia (concussion group). The time interval between accident and CBF measurement was less than 2 h in three patients, 5-6 h in two, 8-9 h in two, and 18 in one. The results were compared with those of nine normal volunteers and eight other age-matched patients who recovered without any neurological deficit despite the presence of hemorrhagic regions (mild hemorrhage group). The rCBF of the concussion group was significantly elevated in the bilateral mesial temporal cortex in comparison to the normal group. The rCBF in the mild hemorrhage group was lower than that of normal controls in all regions. The analysis of right-left difference in CBF indicated that there was significant asymmetry (right > left) in the frontal and temporal cortex in the concussion group, but not in the normal and mild hemorrhage group. This Xe/CT CBF study in acute stages of cerebral concussion, in which patients were amnestic, detected focal cerebral hyperemia. Such hyperemia in regions closely related to human memory function may be the result of vasoparalysis or the compensatory activation of memory circuits after denervation injury.

  5. CT scan findings in cerebral paragonimiasis

    Energy Technology Data Exchange (ETDEWEB)

    Udaka, Fukashi; Okuda, Bungo; Okada, Masako; Okae, Shunji; Kameyama, Masakuni (Chikamori Hospital, Kochi (Japan))

    1982-12-01

    Computed tomography was performed on 5 patients with chronic cerebral paragonimiasis. CT showed solitary or multiple, amorphous, round, or oval calcifications, and ventricular enlargement in all 5 cases. A large low-density area is also found in 4 of the 5 cases. These CT findings are compatible with previously reported findings of simple X-ray films of the skull, pneumoencephalography, and pathological studies.

  6. Gamma Knife treatment for cerebral arteriovenous malformations.

    Science.gov (United States)

    Kemeny, Andras A; Radatz, Matthias W R; Rowe, Jeremy G; Walton, Lee; Vaughan, Paul

    2007-01-01

    One of the earliest indications for Gamma Knife treatment, radiosurgery for cerebral arteriovenous malformations, has stood the test of time. While initially only the ideal cases (small, compact nidus in a non-eloquent site) were chosen, increasingly larger, more complex AVMs were treated. Combination treatment with embolisation and surgery enables most lesions to be treated with success and remarkably low complication rate. This paper is a brief overview of the experience gained in Sheffield.

  7. Radiologic findings of cerebral septic embolism

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jee Young; Kim, Sang Joon; Kim Tae Hoon; Kim, Seung Chul; Kim, Jae Seung; Pai, Hyun Joo [Dankook Univ., Seoul (Korea, Republic of). Coll. of Medicine; Kim, Dong Ik [Yonsei Univ., Seoul (Korea, Republic of). Coll. of Medicine; Chang, Kee Hyun [Seoul National Univ. (Korea, Republic of). Coll. of Medicine; Choi, Woo Suk [Kyung Hee Univ., Seoul (Korea, Republic of). Coll. of Medicine

    1998-01-01

    To determine the MR and CT findings which differentiate cerebral septic embolism from thrombotic infarction. Cerebral septic embolism was confirmed by blood culture in six patients and autopsy in two. The number, size, distribution, contrast enhancement, and hemorrhage of the lesions, as seen on MR and CT, were retrospectively analyzed, and four patients were followed up for between one week and seven months. In a total of eight patients, infective endocarditis (n=5) and sepsis (n=3) caused cerebral septic embolism. The number, of lesions was 3 {approx} 7 in six patients, over 10 in one, and innumerable in one: these varied in size from punctate to 6 cm and were distributed in various areas of the brain. Gyral infarction was noted in five patients: non-enhancing patchy lesions involving the basal ganglia or white matter were found in five, tiny isolated nodular or ring-enhancing small lesions involving the cortex and white matter in three, peripheral rim-enhancing large lesions in one, and numerous enhancing nodules disseminated in the cortex in one. Hemorrhage had occurred in six. follow-up studies in four patients showed that initial lesions had enlarged in two and regressed in two: new lesions had appeared in two. Multiple lesions of different sizes and various patterns which include gyral infarction, patchy or nodular lesion in the cortex, white mater of basal ganglia, and isolated small ring-like or nodular enhancement or frequent hemorrhage are findings which could be helpful in the radiologic diagnosis of cerebral septic embolism. (author). 8 refs., 5 figs.

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

    Institute of Scientific and Technical Information of China (English)

    Caiwei Qiu; Bo Sheng; Shurong Wang; Jin Liu

    2013-01-01

    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, fol owed by induction of perma-nent 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 additional y reduced the number of TUNEL-and caspase-3-positive cel s 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 in-dicated that 60-minute sevoflurane preconditioning can induce the best neuroprotective effects in rats with permanent cerebral ischemia through the inhibition of apoptosis.

  9. EXPERIMENTAL STUDY OF THE MORPHOLOGY OF CEREBRAL BRIDGING VEIN

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective. To investigate the morphological properties of pig cerebral bridging vein. Methods. The morphology and fibre arrangement of 15 cerebral bridging veins obtained from 7 Danish Yorkshire landrace pigs were observed. Results. There was a narrow region at the junction of the cerebral bridging veins and superior sagittal sinus termed “ outflow cuff segment". The diameter and length of outflow cuff segment were much smaller and the thickness was higher than those of the cerebral bridging veins (P0.05). Conclusions. There were differences in fibre arrangement and morphological properties between the outflow cuff segment and the cerebral bridging vein, just like a resistance valve, the outflow cuff segment may play an important role in stabilizing cerebral venous outflow and regulating intracranial pressure.

  10. Brain endothelial dysfunction in cerebral adrenoleukodystrophy.

    Science.gov (United States)

    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.

  11. Complications of endovascular treatment of cerebral aneurysms.

    Science.gov (United States)

    Orrù, Emanuele; Roccatagliata, Luca; Cester, Giacomo; Causin, Francesco; Castellan, Lucio

    2013-10-01

    The number of neuroendovascular treatments of both ruptured and unruptured aneurysms has increased substantially in the last two decades. Complications of endovascular treatments of cerebral aneurysms are rare but can potentially lead to acute worsening of the neurological status, to new neurological deficits or death. Some of the possible complications, such as vascular access site complications or systemic side effects associated with contrast medium (e.g. contrast medium allergy, contrast induced nephropathy) can also be encountered in diagnostic angiography. The most common complications of endovascular treatment of cerebral aneurysms are related to acute thromboembolic events and perforation of the aneurysm. Overall, the reported rate of thromboembolic complications ranges between 4.7% and 12.5% while the rate of intraprocedural rupture of cerebral aneurysms is about 0.7% in patients with unruptured aneurysms and about 4.1% in patients with previously ruptured aneurysms. Thromboembolic and hemorrhagic complications may occur during different phases of endovascular procedures and are related to different technical, clinical and anatomic reasons. A thorough knowledge of the different aspects of these complications can reduce the risk of their occurrence and minimize their clinical sequelae. A deep understanding of complications and of their management is thus part of the best standard of care.

  12. [Acute benign cerebral angiopathy. 6 cases].

    Science.gov (United States)

    Rousseaux, P; Scherpereel, B; Bernard, M H; Guyot, J F

    1983-10-08

    The 6 cases reported here constitute, with 5 previously published cases, a special nosological entity tentatively called "acute benign cerebral angiopathy" by the authors. These 11 cases have in common certain radiological and clinical features. Arteriography shows segmental, multifocal and assymetrical stenoses involving the cerebral arteries between Willis' circle and the terminal arterioles and looking like "strings of sausages". The lesions disappear within one month and present the radiological characteristics of arteritis of medium caliber vessels. The clinical symptoms are suggestive of meningeal haemorrhage or acute cerebromeningeal oedema, with acute repetitive attacks of severe headache and agitation with obnubilation; epileptic seizures and transient neurological deficit may occur. True meningeal haemorrhage confirmed by lumbar puncture is seen in nearly one half of the cases; it seems to be due to alterations in the blood-brain barrier induced by the angiopathy. Intracerebral haematoma may develop, but the disease is usually benign and regresses spontaneously in a few days. None of the usual causes of cerebral arteritis (intra-cranial infection, collagen disease, allergic or toxic angitis) has been found. Pseudo-arteritis (notably spasm of ruptured arterial aneurysms) has been excluded. No aetiological factor common to the 11 cases reported has been elicited, although 6 of the patients had recently given birth and our 6 patients had benign virus infection before or during the clinical manifestations of the disease. In the authors' opinion, the most rewarding line of research would be the role of short acute attacks of arterial hypertension.

  13. Complications of endovascular treatment of cerebral aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Orrù, Emanuele, E-mail: surgeon.ema@gmail.com [Neuroradiology Department, Padua University Hospital, Via Giustiniani 2, Padua 35128 (Italy); Roccatagliata, Luca, E-mail: lroccatagliata@neurologia.unige.it [Neuroradiology Department, IRCCS San Martino University Hospital and IST, Largo Rosanna Benzi 10, Genoa 16132 (Italy); Department of Health Sciences (DISSAL), University of Genoa (Italy); Cester, Giacomo, E-mail: giacomo.cester@sanita.padova.it [Neuroradiology Department, Padua University Hospital, Via Giustiniani 2, Padua 35128 (Italy); Causin, Francesco, E-mail: francesco.causin@sanita.padova.it [Neuroradiology Department, Padua University Hospital, Via Giustiniani 2, Padua 35128 (Italy); Castellan, Lucio, E-mail: lucio.castellan@hsanmartino.it [Neuroradiology Department, IRCCS San Martino University Hospital and IST, Largo Rosanna Benzi 10, Genoa 16132 (Italy)

    2013-10-01

    The number of neuroendovascular treatments of both ruptured and unruptured aneurysms has increased substantially in the last two decades. Complications of endovascular treatments of cerebral aneurysms are rare but can potentially lead to acute worsening of the neurological status, to new neurological deficits or death. Some of the possible complications, such as vascular access site complications or systemic side effects associated with contrast medium (e.g. contrast medium allergy, contrast induced nephropathy) can also be encountered in diagnostic angiography. The most common complications of endovascular treatment of cerebral aneurysms are related to acute thromboembolic events and perforation of the aneurysm. Overall, the reported rate of thromboembolic complications ranges between 4.7% and 12.5% while the rate of intraprocedural rupture of cerebral aneurysms is about 0.7% in patients with unruptured aneurysms and about 4.1% in patients with previously ruptured aneurysms. Thromboembolic and hemorrhagic complications may occur during different phases of endovascular procedures and are related to different technical, clinical and anatomic reasons. A thorough knowledge of the different aspects of these complications can reduce the risk of their occurrence and minimize their clinical sequelae. A deep understanding of complications and of their management is thus part of the best standard of care.

  14. Computed tomographic findings of cerebral paragonimiasis

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Nak Kwan; Nam, Kyung Jin; Park, Churl Min; Eun, Chung Kie; Lee, Sun Wha [Kyung Hee Unversity Hospital, Seoul (Korea, Republic of)

    1983-03-15

    Paragonimiasis is widely distributed in Far East and Southeast Asia, particularly in Korea. The central nervous system is the most frequent location for paragonimiasis outside the lungs. We analyzed the computed tomographic findings of 17 cases which were diagnosed pathologically and clinically as cerebral paragonimiasis. The results were as follows: 1. The ratio of male to female was 10 : 7 and about 88% of cases were under the age of 40 years. 2. The common locations of cerebral paragonimiasis were the occipital (12 cases) and temporal (11 cases) lobes. 3. Precontrast CT findings of cerebral paragonimiasis were low density with calcifications in 6 cases, low and isodensities in 4 cases, mixed densities in 3 cases, only low density in 2 cases and only calcification in 2 cases. Hydrocephalus (7 cases), mass effect (6 cases), atrophic change (6 cases) and cyst formation (3 cases) were associated. 4. The shape of calcifications in CT scan were soap-bubble or ring in 6 cases, nodular or oval in 6 cases, stipple in 4 cases and amorphous conglomerated in 2 cases. 5. The contrast -enhanced 8 cases were 5 ring or rim like, 2 nodular and 1 irregular enhancements, while 9 cases were not enhanced.

  15. [CT findings in "fresh" cerebral paragonimiasis].

    Science.gov (United States)

    Li, H Z; Xie, F W; Sun, S C

    1992-01-01

    There are few reports on CT findings in "fresh" cerebral paragonimiasis. We have experienced four cases of "fresh" cerebral paragonimiasis examined by CT scan. Three patients were children aged 7, 9, and 14 years, and one was an adult aged 25 years. Three patients were examined by CT scan 2 to 6 months after the onset of high grade fever, convulsion and focal deficit signs, and a patient was examined one month after his progressive visual disturbance. The unique CT findings are multilocular cystic lesions in temporo-occipital or in temporo-parietal lobes with extensive brain edema. Two cases were also associated with "soap-bubble" calcifications. The cysts were more dense than CSF and enhanced by contrast media. The histopathological specimen showed that the eggs of paragonimus were in the abscess cavity, of which the wall was composed with highly vascular gliomesenchymal capsule and numerous cell infiltration. Three patients underwent craniotomy for removal of abscess and decompression. Bitionol were administered and all patients recovered well. We also discussed the differential diagnosis of cerebral parasitic granulomas.

  16. Hemicorea asociada a toxoplasmosis cerebral y SIDA

    Directory of Open Access Journals (Sweden)

    N.S. garretto

    1995-03-01

    Full Text Available Se observan complicaciones neurológicas en 40% de enfermos con SIDA. De estos, en 10% puede ser la manifestation inicial de la enfermedad. En otro 11% pueden aparecer trastornos del movimiento. Comunicamos el primer caso de hemicorea asociada a toxoplasmosis cerebral y SIDA en nuestro pais. Hombre de 26 anos, con diagnostico de SIDA y toxoplasmosis cerebral. Habia comenzado con crisis motoras simples de hemicuerpo izquierdo, con generalization secundaria y luego perdida de fuerza progresiva en dicho hemicuerpo. La RMN de cérebro mostro una lesion frontal derecha y otra temporo-occipital izquierda, con gran edema perilesional y efecto de masa. Las serologias para HIV y toxoplasmosis fueron positivas. Comenzo tratamiento con sulfadiazina y pirimetamina. Al duodecimo dia aparecieron movimientos involuntários dei pie izquierdo, coreicos, que se extendieron mas tarde a todo ese miembro inferior y luego al hemicuerpo. Nueva RMN de cérebro mostro disminucion dei edema y efecto de masa de las lesiones. Sin embargo, se observo una nueva lesion a nivel peduncular derecho. Movimientos involuntarios en pacientes con toxoplasmosis cerebral comenzaron a describirse recientemente solo en pacientes con SIDA. El presente seria el decimotercer caso de la literatura mundial y el primero en nuestro pais de hemicorea asociada a toxoplasmosis y SIDA.

  17. Energy requirements of children with cerebral palsy.

    Science.gov (United States)

    Hogan, S Eileen

    2004-01-01

    Energy requirements of children and adolescents with cerebral palsy appear to be disease-specific and different from the current recommendations for healthy children, varying depending upon functional capacity, degree of mobility, severity of disease, and level of altered metabolism. Feeding problems are prevalent in many of these children, and can result in inadequate energy intake. Wasting of voluntary muscles, a common symptom of cerebral palsy, contributes to reduced resting energy needs; nevertheless, the location of the central nervous system lesion may also influence energy requirements. To guarantee individualized, accurate, and optimal energy recommendations for this population, resting energy expenditure should preferentially be measured by indirect calorimetry. Equations and formulae to predict healthy people's resting energy expenditure are available, but tend to overestimate these children's energy needs. Future studies should address the role of the central nervous system in regulating energy metabolism in this population. When adequately nourished, children and adolescents with cerebral palsy appear more tranquil and require decreased feeding time, which gives caregivers time to develop the child's functional independence and character. Understanding energy requirements of this population will provide caregivers and health professionals with guidelines for providing optimal nutritional status.

  18. Personality factors correlate with regional cerebral perfusion.

    Science.gov (United States)

    O'Gorman, R L; Kumari, V; Williams, S C R; Zelaya, F O; Connor, S E J; Alsop, D C; Gray, J A

    2006-06-01

    There is an increasing body of evidence pointing to a neurobiological basis of personality. The purpose of this study was to investigate the biological bases of the major dimensions of Eysenck's and Cloninger's models of personality using a noninvasive magnetic resonance perfusion imaging technique in 30 young, healthy subjects. An unbiased voxel-based analysis was used to identify regions where the regional perfusion demonstrated significant correlation with any of the personality dimensions. Highly significant positive correlations emerged between extraversion and perfusion in the basal ganglia, thalamus, inferior frontal gyrus and cerebellum and between novelty seeking and perfusion in the cerebellum, cuneus and thalamus. Strong negative correlations emerged between psychoticism and perfusion in the basal ganglia and thalamus and between harm avoidance and perfusion in the cerebellar vermis, cuneus and inferior frontal gyrus. These observations suggest that personality traits are strongly associated with resting cerebral perfusion in a variety of cortical and subcortical regions and provide further evidence for the hypothesized neurobiological basis of personality. These results may also have important implications for functional neuroimaging studies, which typically rely on the modulation of cerebral hemodynamics for detection of task-induced activation since personality effects may influence the intersubject variability for both task-related activity and resting cerebral perfusion. This technique also offers a novel approach for the exploration of the neurobiological correlates of human personality.

  19. Beneficial effect of epinephrine infusion on cerebral and myocardial blood flows during CPR.

    Science.gov (United States)

    Koehler, R C; Michael, J R; Guerci, A D; Chandra, N; Schleien, C L; Dean, J M; Rogers, M C; Weisfeldt, M L; Traystman, R J

    1985-08-01

    It is hypothesized that epinephrine improves the ability to resuscitate the heart through a mechanism thought to be related to the increase in aortic pressure. Our results with epinephrine infusion during CPR are consistent with this hypothesis. Epinephrine selectively increased vascular resistance in noncerebral, noncoronary vascular beds, as indicated by a decrease in microsphere-determined blood flow in these areas. This increased vascular resistance raised aortic pressure during the chest compression phase and the relaxation phase of CPR. Because intracranial and right atrial pressures were only slightly higher with epinephrine, cerebral and myocardial perfusion pressures and blood flows were significantly improved. This beneficial effect (compared to no administration of a vasopressor) was more pronounced as CPR progressed beyond ten minutes. Enhanced cerebral and myocardial perfusion occurred with epinephrine when either the conventional or simultaneous compression and ventilation (SCV) mode of CPR was employed in dogs. Similar selective perfusion was sustained for 50 minutes of SCV-CPR with epinephrine, even when the onset of CPR was delayed five minutes. Regional brain blood flow differed in the delayed-CPR group in that cerebellum, brain stem, and thalamic regions initially had higher blood flows. In an infant animal model of CPR using conventional CPR in piglets, epinephrine also was found to increase cerebral and myocardial blood flows. These results show that administration of epinephrine benefits different age groups of different species with different modes of CPR; that benefits occur even with delayed onset of CPR which is associated with additional anoxia and acidosis; and that epinephrine administration is particularly effective in sustaining cerebral and coronary perfusion during prolonged CPR.

  20. Changes in the permeability of blood brain barrier and endothelial cell damage after cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Ke Liu; Jiansheng Li

    2006-01-01

    OBJECTIVE: To investigate the effect of endothelial cells on the permeability of blood brain barrier (BBB) after brain injury and its effect mechanism.DATA SOURCES: We searched for the articles of permeability of BBB and endothelial cell injury after brain ischemia, which were published between January 1982 and December 2005, with the key words of "cerebral ischemia damage,blood brain barrier ( BBB),permeability,effect of endothelial cell (EC) and its variation mechanism"in English.STUDY SELECTION: The materials were primarily selected. The articles related to the changes in the permeability of BBB and the effect of endothelial cells as well as the change mechanism after cerebral ischemia damage were chosen. Repetitive studies or review articles were excluded.DATA EXTRACTION: Totally 55 related articles were collected, and 35 were excluded due to repetitive or review articles, finally 20 articles were involved.DATA SYNTHESIS: The content or viewpoints of involved literatures were analyzed. Cerebral ischemia had damage for endothelial cells, such as the inflow of a lot of Ca2+, the production of nitrogen monoxide and oxygen free radical, and aggravated destruction of BBB. After acceptors of inflammatory mediators on cerebrovascular endothelial cell membrane, such as histamine, bradykinin , 5-hydroxytryptamine and so on are activated, endothelial cells shrink and the permeability of BBB increases. Its mechanism involves in the inflow of extracellular Ca2+and the release of intracellular Ca2+ in the cells. Glycocalyx molecule on the surface of endothelial cell, having structural polytropy, is the determinative factor of the permeability of BBB. VEGF, intensively increasing the vasopermeability and mainly effecting on postcapillary vein and veinlet, is the strongest known blood vessel permeation reagent. Its chronic overexpression in the brain can lead the destruction of BBB.CONCLUSION: The injury of endothelial cell participants in the pathological mechanism of BBB