WorldWideScience

Sample records for cerebral interictal em

  1. SPECT cerebral interictal em pacientes com epilepsia do lobo temporal de difícil controle

    Directory of Open Access Journals (Sweden)

    Maria Emilia Cosenza Andraus

    2002-09-01

    Full Text Available O objetivo desse estudo foi avaliar a utilidade do SPECT cerebral interictal na localização do foco epileptogênico em 23 pacientes do Ambulatório de Epilepsias do Hospital Universitário Clementino Fraga Filho (HUCFF/UFRJ, com epilepsia do lobo temporal (ELT de difícil controle e tomografia computadorizada (TC do crânio normal, estudando a correlação entre SPECT interictal, eletrencefalograma (EEG e, em 11 casos, ressonância magnética (RM do crânio, e comparar os resultados com os de outras seis séries da literatura. Doze (52,2% pacientes apresentaram SPECT anormal. Entre esses, cinco (41,6% dos SPECTs anormais apresentaram alteração unilateral ao SPECT do mesmo lado do EEG (hipoperfusão em 4 e hiperperfusão em 1, três (25% dos SPECTs anormais apresentaram hipoperfusão bilateral ao SPECT e alterações também bilaterais ao EEG e 4 (33,3% dos SPECTs anormais apresentaram hipoperfusão unilateral ao SPECT e EEG bilateral. A análise estatística fundamentou-se na lógica fuzzy. Os índices de correlação entre SPECT X EEG, SPECT X RM e SPECT X EEG X RM foram altamente significativos, com níveis de significância de 0,01, p The objective of this study was to evaluate the utility of interictal brain SPECT in localizing the epileptogenic focus in a population of patients of Epilepsy Clinic of Hospital Universitário Clementino Fraga Filho (HUCFF/UFRJ, with medically refractory temporal lobe epilepsy (TLE and normal computed tomography (CT scans, studying the correlation between SPECT, electroencephalogram (EEG and, in 11 cases, brain magnectic resonance imaging (MRI, and to compare the results to the other six literatura series. Twelve (52.2% patients presented abnormal SPECT. Among these, five (41.6% of abnormal SPECTs presented unilateral SPECT changes at the same side of EEG (hypoperfusion in four and hyperperfusion in one, three (25% of abnormal SPECTs presented bilateral hypoperfusion and bilateral EEG changes too, and four

  2. Interictal brain SPECT in patients with medically refractory temporal lobe epilepsy; SPECT cerebral interictal em pacientes com epilepsia do lobo temporal de dificil controle

    Energy Technology Data Exchange (ETDEWEB)

    Andraus, Maria Emilia Cosenza

    2000-06-01

    The brain single photon emission computed tomography (SPECT) is s functional neuroimaging method that can detect localized changes in cerebral blood flow. The temporal lobe epilepsy (TLE) is the most common epileptic syndrome in adults, and more than 50% are medically refractory. The SPECT can contribute to investigation of epileptogenic focus and is one of the methods of pre-surgical evaluation of these patients. (author)

  3. Interictal "patchy" regional cerebral blood flow patterns in migraine patients. A single photon emission computerized tomographic study

    DEFF Research Database (Denmark)

    Friberg, L; Olesen, J; Iversen, Helle Klingenberg;

    1994-01-01

    In 92 migraine patients and 44 healthy control subjects we recorded regional cerebral blood flow (rCBF) with single photon emission computerized tomography and (133) Xe inhalation or with i.v. (99m) Tc-HMPAO. Migraine patients were studied interictally. A quantitated analysis of right-left asymme......In 92 migraine patients and 44 healthy control subjects we recorded regional cerebral blood flow (rCBF) with single photon emission computerized tomography and (133) Xe inhalation or with i.v. (99m) Tc-HMPAO. Migraine patients were studied interictally. A quantitated analysis of right...... patients having attacks with aura and from 19% of patients without aura attacks was scored as containing abnormal right-left asymmetries by the visual analysis. Images from healthy controls were all scored to be normal. In 37% of the images (all from patients) there was lack of consensus among observers (κ...

  4. Interictal noninvasive measurements of regional cerebral blood flow using technetium-99m hexamethylprophylene amine oxime in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Interictal noninvasive measurements of regional cerebral blood flow (rCBF) using 99mTc-HMPAO SPECT were performed on 43 patients with temporal lobe epilepsy. Mean cerebral blood flow (mCBF) showed significant negative correlation with advancing age and duration of illness and mean cerebellar blood flow (mCblBF) showed weak negative correlation with duration of illness. Patients taking phenytoin had significantly lower mCBF and lower mCblBF than those not taking phenytoin. Patients with both visually detected temporal hypoperfusion on SPECT and hippocampal sclerosis on MRI showed quantitatively lower rCBF in the temporal region and more wide-spread hypoperfusion than patients without the both of image findings. Our results suggest that interictal noninvasive cerebral blood flow measurements using 99mTc-HMPAO may give useful information about not only cerebral blood flow in the epileptic focus and its adjacent area but also the effects of antiepileptic drugs on brain function in temporal lobe epilepsy. (author)

  5. Correlation between regional cerebral blood flow and degree of brain tissue injury of interictal epileptic activity in patients with epilepsy

    International Nuclear Information System (INIS)

    Objective: To explore the correlation between the change of regional cerebral blood flow (rCBF) and brain tissue injury from interictal epileptic activity in patients with epilepsy. Methods: Forty-eight patients with epilepsy and 30 healthy persons were included in the study from which the serum S100β protein levels were determined by double antibody sandwich ELISA method. SPECT rCBF imaging was performed in all patients. The visual and semi-quantitative analyses were used to analyze the epileptic foci. SPSS 11.0 was applied for variance and linear correlation analyses. Results: Serum S-100β in patients with interictal epileptic activity was significantly higher than that in control group ((0.572±0.163) μg/L vs (0.218±0.134) μg/L, t =9.96, P<0.01). According to epilepsy control criteria, 20 cases achieved complete control (CC), 18 cases achieved partial control (PR). However, 10 cases got no improvement,whose serum S-100β protein ((0.809±0.056) μg/L) and the percentage change of rCBF ((0.337±0.060) %) were significantly higher than those of CC ((0.443±0.083) μg/L, (0.035±0.038) %) and those of PC ((0.585±0.108) μg/L, (0.187±0.075)%), F=56. 740, 92. 316, P<0.01. There were high correlation between serum S-100β and the percentage change of rCBF in epilepsy patients (r =0.887, P<0.01). Conclusion: Serum S-100β protein assay combined with rCBF on SPECT imaging can make semi-quantitative diagnosis of epilepsy and help evaluate the brain damage from interictal epileptic activity. (authors)

  6. Ictal but Not Interictal Epileptic Discharges Activate Astrocyte Endfeet and Elicit Cerebral Arteriole Responses

    OpenAIRE

    Gómez-Gonzalo, Marta; Losi, Gabriele; Brondi, Marco; Uva, Laura; Sato, Sebastian Sulis; Curtis, Marco de; Ratto, Gian Michele; Carmignoto, Giorgio

    2011-01-01

    Activation of astrocytes by neuronal signals plays a central role in the control of neuronal activity-dependent blood flow changes in the normal brain. The cellular pathways that mediate neurovascular coupling in the epileptic brain remain, however, poorly defined. In a cortical slice model of epilepsy, we found that the ictal, seizure-like discharge, and only to a minor extent the interictal discharge, evokes both a Ca2+ increase in astrocyte endfeet and a vasomotor response. We also observe...

  7. Cerebral Hemispheric Lateralization Associated with Hippocampal Sclerosis May Affect Interictal Cardiovascular Autonomic Functions in Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    Rokia Ghchime

    2016-01-01

    Full Text Available It is well established that the temporal lobe epilepsy (TLE is linked to the autonomic nervous system dysfunctions. Seizures alter the function of different systems such as the respiratory, cardiovascular, gastrointestinal, and urogenital systems. The aim of this work was to evaluate the possible factors which may be involved in interictal cardiovascular autonomic function in temporal lobe epilepsy with complex partial seizures, and with particular attention to hippocampal sclerosis. The study was conducted in 30 patients with intractable temporal lobe epilepsy (19 with left hippocampal sclerosis, 11 with right hippocampal sclerosis. All subjects underwent four tests of cardiac autonomic function: heart rate changes in response to deep breathing, heart rate, and blood pressure variations throughout resting activity and during hand grip, mental stress, and orthostatic tests. Our results show that the right cerebral hemisphere predominantly modulates sympathetic activity, while the left cerebral hemisphere mainly modulates parasympathetic activity, which mediated tachycardia and excessive bradycardia counterregulation, both of which might be involved as a mechanism of sudden unexpected death in epilepsy patients (SUDEP.

  8. Babesiose cerebral em bovinos: 20 casos

    Directory of Open Access Journals (Sweden)

    Rodrigues Aline

    2005-01-01

    Full Text Available Num estudo retrospectivo de 1.071 necropsias de bovinos, foram encontrados 20 casos de babesiose cerebral confirmados pelo exame de esfregaços do córtex telencefálico. A maioria desses casos ocorreu no verão, em bovinos adultos de raças européias ou suas cruzas. Além dos sinais clínicos neurológicos, observou-se hemoglobinúria, anorexia, febre, taquicardia, taquipnéia e queda na produção de leite. O hemograma realizado em cinco bovinos afetados revelou acentuada anemia regenerativa; em média, 20% dos eritrócitos estavam parasitados por Babesia bovis. Na necropsia de todos os casos, a substância cinzenta dos córtices telencefálico e cerebelar e dos núcleos da base era consistente e caracteristicamente róseo-cereja. Essa coloração devia-se ao seqüestro de eritrócitos nos capilares encefálicos. Nesses eritrócitos, podiam-se observar, tanto em esfregaços do córtex como em preparações histológicas do encéfalo, microorganismos com morfologia compatível com B. bovis. Outros achados de necropsia incluíam hemoglobinúria, rins vermelho-escuros, hepatoesplenomegalia, fígado vermelho-alaranjado, icterícia, hemorragias epicárdicas e endocárdicas e edema e congestão dos linfonodos mesentéricos.

  9. Diagnosis of ictal hyperperfusion using subtraction image of ictal and interictal brain perfusion SPECT

    International Nuclear Information System (INIS)

    A robust algorithm to disclose and display the difference of ictal and interictal perfusion may facilitate the detection of ictal hyperfusion foci. Diagnostic performance of localizing epileptogenic zones with subtracted SPECT images was compared with the visual diagnosis using ictal and interictal SPECT, MR, or PET. Ictal and interictal Tc-99m-HMPAO cerebral perfusion SPECT images of 48 patients(pts) were processed to get parametric subtracted images. Epileptogenic foci of all pts were diagnosed by seizure free state after resection of epileptogenic zones. In subtraction SPECT, we used normalized difference ratio of pixel counts(ictal-interictal)/interictal X 100%) after correcting coordinates of ictal and interictal SPECT in semi-automatized 3-dimensional fashion. We found epileptogenic zones in subtraction SPECT and compared the performance with visual diagnosis of ictal and interictal SPECT, MR and PET using post-surgical diagnosis as gold standard. The concordance of subtraction SPECT and ictal-interictal SPECT was moderately good(kappa=0.49). The sensitivity of ictal-interictal SPECT was 73% and that of subtraction SPECT 58%. Positive predictive value of ictal-interictal SPECT was 76% and that of subtraction SPECT was 64%. There was no statistical difference between sensitivity or positive predictive values of subtraction SPECT and ictal-interictal SPECT, MR or PET. Such was also the case when we divided patients into temporal lobe epilepsy and neocortical epilepsy. We conclude that subtraction SPECT we produced had equivalent diagnostic performance compared with ictal-interictal SPECT in localizing epileptogenic zones. Additional value of these subtraction SPECT in clinical interpretation of ictal and interictal SPECT should be further evaluated

  10. Aspergilose cerebral em paciente imunocompetente Cerebral Aspergillus abscess in immunocompetent patient

    OpenAIRE

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

    2005-01-01

    Descrevemos um caso raro de aspergilose cerebral, como complicação de cirurgia para aneurisma cerebral, em paciente imunocompetente, e com sucesso no tratamento. A paciente, de 40 anos, havia sido submetida a craniotomia para clipagem de aneurisma da artéria pericalosa. Após cinco meses, no sitio cirúrgico, surgiram múltiplos abscessos por Aspergillus sp. Foram necessárias duas craniotomias para a retirada da massa fúngica e uso de anfotericina B. Após 14 anos de acompanhamento, a evolução mo...

  11. A New Computational Model for Neuro-Glio-Vascular Coupling: Astrocyte Activation Can Explain Cerebral Blood Flow Nonlinear Response to Interictal Events

    Science.gov (United States)

    Blanchard, Solenna; Saillet, Sandrine; Ivanov, Anton; Benquet, Pascal; Bénar, Christian-George; Pélégrini-Issac, Mélanie; Benali, Habib; Wendling, Fabrice

    2016-01-01

    Developing a clear understanding of the relationship between cerebral blood flow (CBF) response and neuronal activity is of significant importance because CBF increase is essential to the health of neurons, for instance through oxygen supply. This relationship can be investigated by analyzing multimodal (fMRI, PET, laser Doppler…) recordings. However, the important number of intermediate (non-observable) variables involved in the underlying neurovascular coupling makes the discovery of mechanisms all the more difficult from the sole multimodal data. We present a new computational model developed at the population scale (voxel) with physiologically relevant but simple equations to facilitate the interpretation of regional multimodal recordings. This model links neuronal activity to regional CBF dynamics through neuro-glio-vascular coupling. This coupling involves a population of glial cells called astrocytes via their role in neurotransmitter (glutamate and GABA) recycling and their impact on neighboring vessels. In epilepsy, neuronal networks generate epileptiform discharges, leading to variations in astrocytic and CBF dynamics. In this study, we took advantage of these large variations in neuronal activity magnitude to test the capacity of our model to reproduce experimental data. We compared simulations from our model with isolated epileptiform events, which were obtained in vivo by simultaneous local field potential and laser Doppler recordings in rats after local bicuculline injection. We showed a predominant neuronal contribution for low level discharges and a significant astrocytic contribution for higher level discharges. Besides, neuronal contribution to CBF was linear while astrocytic contribution was nonlinear. Results thus indicate that the relationship between neuronal activity and CBF magnitudes can be nonlinear for isolated events and that this nonlinearity is due to astrocytic activity, highlighting the importance of astrocytes in the

  12. A New Computational Model for Neuro-Glio-Vascular Coupling: Astrocyte Activation Can Explain Cerebral Blood Flow Nonlinear Response to Interictal Events.

    Science.gov (United States)

    Blanchard, Solenna; Saillet, Sandrine; Ivanov, Anton; Benquet, Pascal; Bénar, Christian-George; Pélégrini-Issac, Mélanie; Benali, Habib; Wendling, Fabrice

    2016-01-01

    Developing a clear understanding of the relationship between cerebral blood flow (CBF) response and neuronal activity is of significant importance because CBF increase is essential to the health of neurons, for instance through oxygen supply. This relationship can be investigated by analyzing multimodal (fMRI, PET, laser Doppler…) recordings. However, the important number of intermediate (non-observable) variables involved in the underlying neurovascular coupling makes the discovery of mechanisms all the more difficult from the sole multimodal data. We present a new computational model developed at the population scale (voxel) with physiologically relevant but simple equations to facilitate the interpretation of regional multimodal recordings. This model links neuronal activity to regional CBF dynamics through neuro-glio-vascular coupling. This coupling involves a population of glial cells called astrocytes via their role in neurotransmitter (glutamate and GABA) recycling and their impact on neighboring vessels. In epilepsy, neuronal networks generate epileptiform discharges, leading to variations in astrocytic and CBF dynamics. In this study, we took advantage of these large variations in neuronal activity magnitude to test the capacity of our model to reproduce experimental data. We compared simulations from our model with isolated epileptiform events, which were obtained in vivo by simultaneous local field potential and laser Doppler recordings in rats after local bicuculline injection. We showed a predominant neuronal contribution for low level discharges and a significant astrocytic contribution for higher level discharges. Besides, neuronal contribution to CBF was linear while astrocytic contribution was nonlinear. Results thus indicate that the relationship between neuronal activity and CBF magnitudes can be nonlinear for isolated events and that this nonlinearity is due to astrocytic activity, highlighting the importance of astrocytes in the

  13. A New Computational Model for Neuro-Glio-Vascular Coupling: Astrocyte Activation Can Explain Cerebral Blood Flow Nonlinear Response to Interictal Events.

    Directory of Open Access Journals (Sweden)

    Solenna Blanchard

    Full Text Available Developing a clear understanding of the relationship between cerebral blood flow (CBF response and neuronal activity is of significant importance because CBF increase is essential to the health of neurons, for instance through oxygen supply. This relationship can be investigated by analyzing multimodal (fMRI, PET, laser Doppler… recordings. However, the important number of intermediate (non-observable variables involved in the underlying neurovascular coupling makes the discovery of mechanisms all the more difficult from the sole multimodal data. We present a new computational model developed at the population scale (voxel with physiologically relevant but simple equations to facilitate the interpretation of regional multimodal recordings. This model links neuronal activity to regional CBF dynamics through neuro-glio-vascular coupling. This coupling involves a population of glial cells called astrocytes via their role in neurotransmitter (glutamate and GABA recycling and their impact on neighboring vessels. In epilepsy, neuronal networks generate epileptiform discharges, leading to variations in astrocytic and CBF dynamics. In this study, we took advantage of these large variations in neuronal activity magnitude to test the capacity of our model to reproduce experimental data. We compared simulations from our model with isolated epileptiform events, which were obtained in vivo by simultaneous local field potential and laser Doppler recordings in rats after local bicuculline injection. We showed a predominant neuronal contribution for low level discharges and a significant astrocytic contribution for higher level discharges. Besides, neuronal contribution to CBF was linear while astrocytic contribution was nonlinear. Results thus indicate that the relationship between neuronal activity and CBF magnitudes can be nonlinear for isolated events and that this nonlinearity is due to astrocytic activity, highlighting the importance of astrocytes in

  14. Aspergilose cerebral em paciente imunocompetente Cerebral Aspergillus abscess in immunocompetent patient

    Directory of Open Access Journals (Sweden)

    Geraldo Pianetti Filho

    2005-12-01

    Full Text Available Descrevemos um caso raro de aspergilose cerebral, como complicação de cirurgia para aneurisma cerebral, em paciente imunocompetente, e com sucesso no tratamento. A paciente, de 40 anos, havia sido submetida a craniotomia para clipagem de aneurisma da artéria pericalosa. Após cinco meses, no sitio cirúrgico, surgiram múltiplos abscessos por Aspergillus sp. Foram necessárias duas craniotomias para a retirada da massa fúngica e uso de anfotericina B. Após 14 anos de acompanhamento, a evolução mostra resolução da aspergilose, sem seqüela. O tratamento do abscesso cerebral por Aspergilus exige acompanhamento clínico contínuo, repetidas drenagens cirúrgicas intracranianas e o uso de anfotericina B no tratamento medicamentoso.We report an unusual case of brain aspergillosis with multiple recurrent abscess in a 40 years-old immunocompetent woman, with good therapeutical outcome. The patient presented a subaracnoid hemorhage caused by a ruptured pericalosal artery aneurysm and was submitted to a craniotomy for aneurysm surgery. Five months later, she developed multiple Aspergillus cerebral abscess. Two craniotomies and amphotericin B became necessary during treatment. Fourteen years later, she is asymptomatic. Treatment of brain aspergillosis abscess implied the combination of both surgical and drug therapy with amphotericin B.

  15. Using of the interictal EEGs for epilepsy diagnosing

    Science.gov (United States)

    Panischev, O. Yu; Demin, S. A.; Zinatullin, E. M.

    2015-12-01

    In this work we apply a new method to determine the differences in characteristics of the cortical electroencephalographic (EEG) activity, measured during interictal stage (i.e., period between seizures), between healthy subjects and patients with epilepsy. To analyze the dynamical and spectral properties of bioelectric activity we use power spectra and phase portraits which are introduced on the basis of the Memory Function Formalism (MFF). We discover the significant differences in the types of power spectra of the EEG for healthy subjects and patients. We reveal the cerebral cortex areas for which the EEG activity of considered groups of subjects has a different structure of the phase portraits. The proposed approach can be used as an additional method for diagnosis of epilepsy during interictal stage.

  16. User-Guided Interictal Spike Detection

    OpenAIRE

    El-Gohary, Mahmoud; McNames, James; Elsas, Siegward-M.

    2008-01-01

    In the diagnosis and treatment of epilepsy, long-term monitoring may be required to document and study interictal activities such as interictal spikes. However, visual inspection of the EEG done by an expert is too time consuming and researchers normally resort to automatic detection methods. We describe a new EEG user-guided interictal spike detection algorithm that only requires the user to annotate a few spikes. We use the annotations to build a template that captures the relevant features...

  17. Ictal and interictal phonophobia in migraine—a quantitative controlled study

    Science.gov (United States)

    Ashkenazi, A.; Mushtaq, A.; Yang, I.; Oshinsky, ML.

    2016-01-01

    The aim of the study was to evaluate quantitatively ictal and interictal phonophobia in episodic migraine (EM). We included subjects with EM and age- and gender-matched controls. Sound stimuli were pure tones at frequencies of 1000, 4000 and 8000 Hz. Sound aversion thresholds (SATs) were determined as the minimal sound intensity perceived as unpleasant or painful. Migraineurs were examined both between and during attacks. We compared interictal SATs in migraineurs with those in controls. We also compared ictal and interictal SATs in migraineurs. Sixty migraineurs and 52 controls were included. Interictal mean SAT of migraineurs, averaged for the three frequencies, was significantly lower than that of controls [90.4 (0.8) dB vs. 105.9 (1.1) dB, respectively, P < 0.0001]. In migraineurs, mean ictal SAT, averaged for the three frequencies, was significantly lower than interictal SAT [76.0 (0.9) dB vs. 91.0 (0.8) dB, respectively, P < 0.0001]. Patients with EM exhibit increased sound aversion between attacks that is further augmented during an acute attack. PMID:19735532

  18. Epilepsy in children with cerebral palsy Epilepsia em crianças com paralisia cerebral

    OpenAIRE

    Isac Bruck; Sérgio Antônio Antoniuk; Adriane Spessatto; Ricardo Schmitt de Bem; Romeu Hausberger; Carlos Gustavo Pacheco

    2001-01-01

    OBJECTIVE: To describe the prevalence and characteristics of epilepsy in patients with cerebral palsy in a tertiary center. METHODS: a total of 100 consecutive patients with cerebral palsy were retrospectively studied. Criteria for inclusion were follow-up period for at least 2 years. Types and incidence of epilepsy were correlated with the different forms of cerebral palsy. Other factors associated with epilepsy such as age of first seizure, neonatal seizures and family history of epilepsy w...

  19. Desenvolvimento cerebral em recém-nascidos prematuros Cerebral development in preterm newborn infants

    Directory of Open Access Journals (Sweden)

    Andrea Peterson Zomignani

    2009-06-01

    Full Text Available OBJETIVO:Rever a literatura atual que aborda o crescimento e o desenvolvimento cerebral de crianças prematuras e as alterações cognitivas e motoras que podem decorrer da prematuridade. FONTES DE DADOS: Foram utilizadas as bases de dados Medline e Lilacs, selecionados artigos publicados entre os anos de 2000 e 2007 e livros-texto com conteúdo relevante. SÍNTESE DOS DADOS: A evolução do recém-nascido pré-termo diferencia-se da evolução apresentada pela população a termo. Estudos têm demonstrado que ex-prematuros apresentam alterações anatômicas cerebrais que se associam a prejuízos cognitivos. Várias regiões do sistema nervoso central (substância cinzenta, substância branca, corpo caloso, núcleo caudado, hipocampo e cerebelo têm seus volumes avaliados por neuroimagem e, apesar de resultados controversos, parecem ter desenvolvimento alterado nessa população. Diante disso, espera-se haver repercussão funcional e/ou cognitiva em crianças, adolescentes e adultos nascidos prematuramente. Ex-prematuros avaliados na infância tardia e na adolescência demonstram alterações de quociente de inteligência, memória, capacidade para cálculos e função cognitiva global. Déficits motores, na capacidade de planejamento e de associação, na coordenação motora e na atenção também foram relatados na literatura. CONCLUSÕES: A prematuridade pode levar a alterações anatômicas e estruturais do cérebro devido à interrupção das etapas de desenvolvimento pré-natal. Tais alterações podem causar déficits funcionais, tornando os ex-prematuros sujeitos a problemas cognitivos e motores, assim como suas repercussões nas atividades de vida diária, mesmo na adolescência e idade adulta.OBJECTIVE:To review the current literature about brain growth and development of premature children, as well as the motor and cognitive changes that may result from prematurity. DATA SOURCES: Medline and Lilacs were searched between 2000 and

  20. Effect of Music on Interictal Epileptiform Spikes

    OpenAIRE

    J Gordon Millichap

    2004-01-01

    The effect of listening to Mozart’s Sonata for Two Pianos (K448) on the frequency of interictal epileptiform discharges (IEDs) in the EEGs of four children, ages 5 – 9 years, with benign childhood epilepsy with centrotemporal spikes (BCECTS) was studied in a prospective, randomized, crossover, placebo-controlled trial at the Medical University of South Carolina, Charleston, SC.

  1. Ictal and interictal SPECT imaging of 8 patients with symptomatic partial epilepsy

    International Nuclear Information System (INIS)

    Although epileptic discharges such as spike, spike and wave complex, sharp wave, and sharp and wave complex can be recorded by interictal scalp electroencephalography (EEG) in many patients with epilepsy, recent studies have demonstrated that no epileptic discharges can be recorded by interictal and ictal scalp EEGs in some patients who clinically exhibit epileptic seizures. Accordingly scalp EEG is not always helpful for diagnosing epilepsy or identifying the epileptic foci in the brain in these patients. Recently, studies using single photon emission computed tomography (SPECT) have been performed for patients with epilepsy and evidence that epileptic foci can be identified by changes in the regional cerebral blood flow (rCBF) seen on SPECT scanning have been accumulated. In the present study, therefore, 8 patients with medically intractable partial seizures were simultaneously or independently investigated by the recordings of scalp EEG and SPECT scanning during the interictal and ictal period. N-isopropyl-p[123I]-iodoamphetamine (123I-IMP) was used for SPECT scanning for 7 patients and 99mTc-d,l-hexamethyl-propyleneamineoxime (99mTc-HMPAO) for 1 patient. An increase in rCBF (hyperperfusion) or decrease in rCBF (hypoperfusion) were found in 4 patients by interictal SPECT imaging and in all patients by ictal SPECT imaging although epileptic discharges were observed in 3 patients by interictal scalp EEG and 5 patients by ictal scalp EEG. The findings of the present study indicate that ictal SPECT scanning is more useful for diagnosing epilepsy and identifying the epileptic foci in the brain than ictal scalp EEG. (author)

  2. Desenvolvimento cerebral em recém-nascidos prematuros Cerebral development in preterm newborn infants

    OpenAIRE

    Andrea Peterson Zomignani; Helder José L. Zambelli; Maria Ângela R.G.M. Antonio

    2009-01-01

    OBJETIVO:Rever a literatura atual que aborda o crescimento e o desenvolvimento cerebral de crianças prematuras e as alterações cognitivas e motoras que podem decorrer da prematuridade. FONTES DE DADOS: Foram utilizadas as bases de dados Medline e Lilacs, selecionados artigos publicados entre os anos de 2000 e 2007 e livros-texto com conteúdo relevante. SÍNTESE DOS DADOS: A evolução do recém-nascido pré-termo diferencia-se da evolução apresentada pela população a termo. Estudos têm demonstrado...

  3. Vincamina em pacientes com insuficiencia vascular cerebral Effects of vincamine in patients with cerebrovascular insufficiency

    Directory of Open Access Journals (Sweden)

    Sérgio Pereira Novis

    1975-03-01

    Full Text Available Foram estudados, em 20 casos de pacientes com insuficiência vascular cerebral, os efeitos do tratamento com a vincamina. Os doentes foram previamente submetidos a exames neurológico, eletrencefalográfico, laboratoriais, psicométricos (teste de memória, teste de capacidade intelectiva, teste de atenção concentrada, raciocínio abstrato e de personalidade. Os pacientes foram medicados com vincamina na dose de 40 mg nas 24 horas durante o período aproximado de 150 dias, após o que foram novamente submetidos à análise idêntica. Os resultados obtidos, apresentados em tabelas, revelam que, em razoável percentual, foi a vincamina medicamento útil no controle das manifestações clínicas da insuficiência vascular cerebral, sendo evidenciada melhora nos índices de déficit de memória retrógrada e anterógrada observados nos testes objetivos. Houve também melhora no padrão eletrencefalográfico de alguns pacientes.The effects of the treatment with vincamine in 20 patients with cerebral vascular insufficiency are reported. The patients were previously submitted to the following tests: neurologic examination, electroencephalography, laboratory tests, psychometry (memory, intellective capability, concentrated attention, abstract reasoning and personality tests. Patients were medicated with vincamin in a 40 mg dose within 24 hours during approximately a 150 days period, after which were again submitted to an identical analysis. The results obtained revealed that in a reasonable percentage of the cases vincamin is an useful medication in controlling the clinical manifestations of the cerebral vascular insufficiency, an improvement being demonstrated in the retrograde and anterograde deficit rate observed in objective tests. An improvement was also noticed in the electroencephalograpric pattern of a few patients.

  4. Confiabilidade de escalas de comprometimento neurológico em pacientes com acidente vascular cerebral

    Directory of Open Access Journals (Sweden)

    Caneda Marco Aurélio Gralha de

    2006-01-01

    Full Text Available Escalas de comprometimento neurológico são utilizadas na avaliação de novos tratamentos, no acompanhamento da evolução clínica e em decisões terapêuticas. Estudamos a confiabilidade de três escalas: a Escala de Rankin (ER, o Índice de Barthel (IB e a National Institute of Health Stroke Scale (NIHSS versadas em português, em 51 indivíduos com acidente vascular cerebral, estimando a concordância entre resultados de diferentes examinadores. Utilizamos os coeficientes de concordância Kappa e Coeficiente de Correlação Intraclasse. A ER teve coeficientes moderados, substanciais ou excelentes. No IB estes foram substanciais ou excelentes nos totais e nos itens, assim como quando foi estratificado em agrupamentos prognósticos e funcionais. A NIHSS apresentou coeficientes excelentes nos totais, substanciais nos itens e moderados e excelentes nas estratificações em grupos de pontos e de itens afins. Estes resultados indicam que as versões em português da ER, o IB e a NIHSS apresentam adequada confiabilidade.

  5. Crescimento e antropometria em pacientes com paralisia cerebral hemiplégica Growth and anthropometry in hemiplegic cerebral palsy patients

    Directory of Open Access Journals (Sweden)

    Marise Bueno Zonta

    2009-12-01

    Full Text Available OBJETIVO: Analisar o crescimento linear, o perímetro cefálico e as diferenças antropométricas entre o lado envolvido e o não-envolvido de 24 crianças com paralisia cerebral (PC hemiplégica, comparados à média para a idade. MÉTODOS: Estudo transversal com amostragem consecutiva de crianças com PC, classificadas clinicamente como hemiplegia espástica. As medidas antropométricas incluíram: peso, estatura, perímetro cefálico, comprimento total de membro superior, comprimento da mão, largura da palma da mão, comprimento total do membro inferior, comprimento do pé e a circunferência dos membros (braço, coxa e panturrilha. As diferenças antropométricas entre os dimídios foram calculadas em centímetros e como porcentagem de encurtamento, comparando o lado envolvido com o não-envolvido. Dois referenciais populacionais, tabelas de crescimento e o software ABase®, desenvolvido para sistema PalmOS, foram comparados na classificação das medidas do comprimento da mão e do pé. A análise estatística utilizou o coeficiente de correlação de Spearman para avaliar a associação entre variáveis quantitativas e o teste não-paramétrico de Wilcoxon para comparar as medidas do lado envolvido e não-envolvido. RESULTADOS: As médias de peso, estatura e perímetro cefálico se mostraram dentro dos limites normais para a idade e 21% dos pacientes apresentaram microcefalia. A discrepância entre os dimídios foi evidente em todos os casos, sendo maior na largura e comprimento da mão. Houve correlação da dis observada entre os membros superiores e inferiores no lado envolvido (r=0,48 e a discrepância aumenta com a idade (r=0,44. CONCLUSÕES: O maior comprometimento no crescimento das crianças com paralisia cerebral estudadas ocorreu nos membros envolvidos pela hemiplegia e, em menor proporção, no perímetro cefálico.OBJECTIVE: To analyze the linear growth, the head circumference and the anthropometric differences between

  6. Imaging findings and cerebral perfusion in arterial ischemic stroke due to transient cerebral arteriopathy in children; Achados de imagem e perfusao arterial cerebral em acidente vascular cerebral isquemico devido a arteriopatia transitoria em crianca

    Energy Technology Data Exchange (ETDEWEB)

    Barbosa Junior, Alcino Alves, E-mail: alcinojr@uol.com.br [Departamento de Diagnostico por Imagem, Hospital Israelita Albert Einstein - HIAE, Sao Paulo, SP (Brazil); Ellovitch, Saada Resende de Souza [Neuropediatria, Hospital Israelita Albert Einstein - HIAE, Sao Paulo, SP (Brazil); Pincerato, Rita de Cassia Maciel [Hospital Samaritano, Sao Paulo, SP (Brazil)

    2012-04-15

    We report the case of a 4-year-old female child who developed an arterial ischemic stroke in the left middle cerebral artery territory, due to a proximal stenosis of the supraclinoid internal carotid artery, most probably related to transient cerebral arteriopathy of childhood. Computed tomography scan, magnetic resonance imaging, perfusion magnetic resonance and magnetic resonance angiography are presented, as well as follow-up by magnetic resonance and magnetic resonance angiography exams. Changes in cerebral perfusion and diffusion-perfusion mismatch call attention. As far as we know, this is the first report of magnetic resonance perfusion findings in transient cerebral arteriopathy. (author)

  7. Anormalidades de fluxo sangüíneo cerebral em indivíduos dependentes de cocaína Cerebral blood flow abnormalities in cocaine dependent subjects

    OpenAIRE

    Sergio Nicastri; Buchpiguel, Carlos A.; Andrade, Arthur G.

    2000-01-01

    INTRODUÇÃO: Nos últimos anos, tem havido relatos de anormalidades do fluxo sanguíneo cerebral em indivíduos com o abuso de cocaína, detectadas por meio de tomografia computadorizada por emissão de fóton único (SPECT). Esse padrão anormal de perfusão cerebral tem sido associado a prejuízos cognitivos mas não a alterações observáveis por meio de exames de neuroimagem estrutural. Um problema envolvendo a maioria dos trabalhos publicados sobre esse tema é a inclusão de um grande número de usuário...

  8. Síndrome de personalidade interictal na epilepsia do lobo temporal não-dominante: relato de caso Interictal personality syndrome in temporal lobe epilepsy: case report

    Directory of Open Access Journals (Sweden)

    PAULO C. TREVISOL-BITTENCOURT

    2000-06-01

    Full Text Available A síndrome de personalidade interictal na epilepsia do lobo temporal não-dominante consiste de hipossexualidade, hiperreligiosidade, alteração do humor e hipergrafia. Sua descrição, em 1974, foi seguida de extensa busca por estes sinais em uma vasta população de pacientes epilépticos. No entanto, estes estudos científicos fracassaram em encontrar este síndrome na epilepsia do lobo temporal em geral. Sua existência foi, por conseguinte, posta em dúvida. Apresentamos o caso de um senhor de 35 anos cuja peculiaridade hipergráfica é o desenho de plantas de construção civil em grande quantidade, além de hiperreligiosidade, hipossexualidade e circunstancialidade. É o primeiro relato deste tipo de expressão gráfica associada à epilepsia parcial complexa e esclerose mesial temporal. Dentre os mecanismos fisiopatológicos propostos, o mais coerente é o da hiperconexão temporal. Embora as crises possam ser controladas em grande parte dos casos com tratamento clínico ou cirúrgico, a sintomatologia comportamental é refratária ao tratamento psicoterápico.The syndrome of interictal personality in non-dominant temporal lobe epilepsy consists of hyposexuality, hyperreligiosity, humorlessness and hypergraphia. Its notification, in 1974, was followed by an extensive search for these traits in broad epileptic populations. Nevertheless, these statistical studies failed to match this syndrome in general temporal lobe epileptics, and its existence became then target of doubt. We report the case of a 35 year-old man presenting partial complex epilepsy, whose singularity lies in his sophisticated drawing abilities. The large amount of buildings and houses he paints expresses his hypergraphia. He also presents hyposexuality and hyperreligiosity. MRI shows right mesial temporal sclerosis. Temporal hyperconnection, caused by a basal temporal irritative focus, is the most probable pathophysiological mechanism. Epileptic fits can be controlled

  9. GABAergic inhibition shapes interictal dynamics in awake epileptic mice.

    Science.gov (United States)

    Muldoon, Sarah Feldt; Villette, Vincent; Tressard, Thomas; Malvache, Arnaud; Reichinnek, Susanne; Bartolomei, Fabrice; Cossart, Rosa

    2015-10-01

    Epilepsy is characterized by recurrent seizures and brief, synchronous bursts called interictal spikes that are present in-between seizures and observed as transient events in EEG signals. While GABAergic transmission is known to play an important role in shaping healthy brain activity, the role of inhibition in these pathological epileptic dynamics remains unclear. Examining the microcircuits that participate in interictal spikes is thus an important first step towards addressing this issue, as the function of these transient synchronizations in either promoting or prohibiting seizures is currently under debate. To identify the microcircuits recruited in spontaneous interictal spikes in the absence of any proconvulsive drug or anaesthetic agent, we combine a chronic model of epilepsy with in vivo two-photon calcium imaging and multiunit extracellular recordings to map cellular recruitment within large populations of CA1 neurons in mice free to run on a self-paced treadmill. We show that GABAergic neurons, as opposed to their glutamatergic counterparts, are preferentially recruited during spontaneous interictal activity in the CA1 region of the epileptic mouse hippocampus. Although the specific cellular dynamics of interictal spikes are found to be highly variable, they are consistently associated with the activation of GABAergic neurons, resulting in a perisomatic inhibitory restraint that reduces neuronal spiking in the principal cell layer. Given the role of GABAergic neurons in shaping brain activity during normal cognitive function, their aberrant unbalanced recruitment during these transient events could have important downstream effects with clinical implications. PMID:26280596

  10. Linear interictal pain in Epicrania Fugax: a reply

    OpenAIRE

    Wang, Yu; Pan, Qing-Qing; Lu, Ya-Nan; Tian, Miao-Miao; Wang, Xian-Hong

    2015-01-01

    This is a reply to the comments on our article “Linear headache: a recurrent unilateral head pain circumscribed in a line-shaped area” published in JHP 2014 Jun 26; 15:45. In the comments, the authors raise a question whether the linear headache (LH) we reported be a linear interictal pain in epicranial fugax (EF), based on a case they reported. We think that the LH is not a linear interictal pain in EF based on our observations and considerations.

  11. Variação temporal no desempenho em testes de memória em pacientes com doença vascular cerebral Temporal variation in memory tests performance in cerebral vascular disease patients

    OpenAIRE

    Tania Fernandes Campos; Damião Ernane Souza; Carolina Dutra Gomes Pinheiro; Alexandre Augusto de Lara Menezes

    2007-01-01

    Buscando adequar a avaliação neuropsicológica à organização temporal do organismo humano, avaliou-se o desempenho em testes de memória em 12 pacientes pós Doença Vascular Cerebral e 12 indivíduos controle, de ambos os sexos, com idade de 45 a 65 anos. Foram aplicados dois testes de memória com estímulos visuais (figuras) e dois com estímulos verbais (palavras), em 3 dias consecutivos por semana, às 08:00, 10:00 e 12:00 h na primeira semana e às 14:00 e 16:00 h na seguinte. Os pacientes aprese...

  12. Hipometabolismo cerebral em pacientes com esclerose mesial temporal demonstrado pelo FDG-PET

    Directory of Open Access Journals (Sweden)

    DUARTE PAULO S.

    2000-01-01

    Full Text Available O objetivo deste estudo foi avaliar a extensão do hipometabolismo cerebral em pacientes com esclerose mesial temporal (EMT. MÉTODO: Este estudo retrospectivo incluiu 21 pacientes que apresentavam epilepsia parcial complexa refrataria à terapia e que foram selecionados para cirurgia após análise extensa que incluía: EEG de superfície e estudos de neuroimagem (PET, SPECT e ressonância magnética. Todos os pacientes foram submetidos a intervenção cirúrgica e tiveram confirmação histológica de EMT. Uma análise semi-quantitativa foi realizada, utilizando regiões de interesse (ROIs nas seguintes estruturas: lobos frontais, parietais e occipitais, gânglios da base, tálamos, cerebelo e três diferentes regiões nos lobos temporais, que compreendiam o córtex medial, inferior e lateral. Um índice de assimetria (IA foi calculado, comparando as contagens por pixel nas estruturas homólogas em ambos os hemisférios cerebrais. Os IAs das diferentes estruturas foram então correlacionados. RESULTADOS: Uma correlação significativa foi demonstrada entre os IAs do córtex medial dos lobos temporais e aqueles dos lobos frontais, dos lobos parietais, dos gânglios da base e dos tálamos (r = 0,72, 0,62, 0,47 e 0,47 respectivamente com p < 0,05 . Foi demonstrada correlação altamente significativa dos IAs das 3 regiões do lobo temporal entre si (chegando a 0,86 entre os IAs das regiões mediais do lobo temporal e os IAs das regiões inferiores. CONCLUSÃO: Esses dados indicam que o hipometabolismo se estende além do foco epiléptico no lobo temporal em pacientes com epilepsia parcial complexa relacionada a EMT. O metabolismo na porção medial do lobo temporal é mais correlacionado com o metabolismo no lobo frontal do que com aquele de outras estruturas cerebrais externas aos lobos temporais. Os mecanismos fisiopatológicos envolvidos no hipometabolismo continuam controversos.

  13. Statistical voxel-wise analysis of ictal SPECT reveals pattern of abnormal perfusion in patients with temporal lobe epilepsy Análise estatística baseada em voxel do SPECT ictal revela um padrão de alteração perfusional em pacientes com epilepsia de lobo temporal

    Directory of Open Access Journals (Sweden)

    Bárbara Juarez Amorim

    2005-12-01

    Full Text Available OBJECTIVE: To investigate the pattern of perfusion abnormalities in ictal and interictal brain perfusion SPECT images (BSI from patients with temporal lobe epilepsy (TLE. METHOD: It was acquired interictal and ictal BSI from 24 patients with refractory TLE. BSIs were analyzed by visual inspection and statistical parametric mapping (SPM2. Statistical analysis compared the patients group to a control group of 50 volunteers. The images from patients with left-TLE were left-right flipped. RESULTS: It was not observed significant perfusional differences in interictal scans with SPM. Ictal BSI in SPM analysis revealed hyperperfusion within ipsilateral temporal lobe (epileptogenic focus and also contralateral parieto-occipital region, ipsilateral posterior cingulate gyrus, occipital lobes and ipsilateral basal ganglia. Ictal BSI also showed areas of hypoperfusion. CONCLUSION: In a group analysis of ictal BSI of patients with TLE, voxel-wise analysis detects a network of distant regions of perfusional alteration which may play active role in seizure genesis and propagation.OBJETIVO: Investigar o padrão de anormalidades perfusionais no SPECT de perfusão cerebral (SPC ictal e interictal na epilepsia de lobo temporal (ELT. MÉTODO: Foram realizados SPCs ictal e interictal de 24 pacientes com ELT que foram analisados visualmente e com o statistical parametric mapping (SPM2. A análise estatística comparou o grupo de pacientes versus um grupo controle de 50 voluntários. RESULTADOS: Na análise do SPM não foram observadas diferenças significativas no grupo de SPC interictal. No grupo de SPC ictal o SPM revelou hiperperfusão no lobo temporal ipsilateral (foco epileptogênico e também na região parieto-occipital contralateral, porção posterior do cíngulo ipsilateral, lobos occipitais e núcleos da base ipsilateral. O SPC ictal também mostrou áreas de hipoperfusão. CONCLUSÃO: Em uma análise de grupo do SPC ictal de pacientes com ELT, a an

  14. Quantifying interictal metabolic activity in human temporal lobe epilepsy

    International Nuclear Information System (INIS)

    The majority of patients with complex partial seizures of unilateral temporal lobe origin have interictal temporal hypometabolism on [18F]fluorodeoxyglucose positron emission tomography (FDG PET) studies. Often, this hypometabolism extends to ipsilateral extratemporal sites. The use of accurately quantified metabolic data has been limited by the absence of an equally reliable method of anatomical analysis of PET images. We developed a standardized method for visual placement of anatomically configured regions of interest on FDG PET studies, which is particularly adapted to the widespread, asymmetric, and often severe interictal metabolic alterations of temporal lobe epilepsy. This method was applied by a single investigator, who was blind to the identity of subjects, to 10 normal control and 25 interictal temporal lobe epilepsy studies. All subjects had normal brain anatomical volumes on structural neuroimaging studies. The results demonstrate ipsilateral thalamic and temporal lobe involvement in the interictal hypometabolism of unilateral temporal lobe epilepsy. Ipsilateral frontal, parietal, and basal ganglial metabolism is also reduced, although not as markedly as is temporal and thalamic metabolism

  15. MORPHOLOGICAL CLUSTERING OF INTERICTAL EPILEPTIFORM DISCHARGES IN INTRACRANIAL ELECTROENCEPHALOGRAPHY

    Czech Academy of Sciences Publication Activity Database

    Vlk, Pavel; Janča, R.; Čmejla, R.; Kršek, P.; Marusič, P.; Jiruška, Přemysl

    Praha : Humusoft, 2013. ISBN 978-80-7080-863-4. [Technical Computing Prague /21./. Praha (CZ), 13.11.2013] R&D Projects: GA MZd(CZ) NT14489 Institutional support: RVO:67985823 Keywords : epilepsy * interictal epiletiform discharges * morphological clustering Subject RIV: FH - Neurology

  16. Anormalidades de fluxo sangüíneo cerebral em indivíduos dependentes de cocaína Cerebral blood flow abnormalities in cocaine dependent subjects

    Directory of Open Access Journals (Sweden)

    Sergio Nicastri

    2000-06-01

    Full Text Available INTRODUÇÃO: Nos últimos anos, tem havido relatos de anormalidades do fluxo sanguíneo cerebral em indivíduos com o abuso de cocaína, detectadas por meio de tomografia computadorizada por emissão de fóton único (SPECT. Esse padrão anormal de perfusão cerebral tem sido associado a prejuízos cognitivos mas não a alterações observáveis por meio de exames de neuroimagem estrutural. Um problema envolvendo a maioria dos trabalhos publicados sobre esse tema é a inclusão de um grande número de usuários de heroína nas amostras estudadas. Essa outra droga também parece afetar o padrão de perfusão cerebral, particularmente durante estados de abstinência. MÉTODOS: Quatorze pacientes dependentes de cocaína (nenhum com uso de opióides e 14 voluntários normais (grupo controle foram submetidos a exames de SPECT com dímero de etil-cisteína marcado com tecnécio-99m. A análise dos exames de SPECT foi realizada por meio de análise visual qualitativa das imagens obtidas (procedimento padrão na prática clínica, realizada por um radiologista não informado sobre o diagnóstico dos indivíduos avaliados. RESULTADOS: A análise visual revelou um padrão sugestivo de irregularidades do fluxo sangüíneo cerebral em nove pacientes, mas em apenas dois controles (p = 0,018; teste exato de Fisher bicaudal. CONCLUSÕES: Anormalidades de circulação cerebral podem ter relação com prejuízos cognitivos relatados em populações de dependentes de cocaína. Embora déficits de perfusão cerebral associados ao uso de cocaína possam ser irreversíveis, têm surgido relatos na literatura de tratamentos para essas anormalidades de fluxo sangüíneo. Alterações de fluxo sangüíneo cerebral associadas à dependência de cocaína ocorrem mesmo na ausência de abuso ou dependência de opióides.INTRODUCTION: In the last years, there have been reports of abnormalities in brain blood flow of cocaine abusers, detected by single photon computed

  17. The Correlation between Electroencephalography Amplitude and Interictal Abnormalities: Audit study

    Directory of Open Access Journals (Sweden)

    Sami F. Al-Rawas

    2014-10-01

    Full Text Available Objectives: The aim of this study was to establish the relationship between background amplitude and interictal abnormalities in routine electroencephalography (EEG. Methods: This retrospective audit was conducted between July 2006 and December 2009 at the Department of Clinical Physiology at Sultan Qaboos University Hospital (SQUH in Muscat, Oman. A total of 1,718 electroencephalograms (EEGs were reviewed. All EEGs were from patients who had been referred due to epilepsy, syncope or headaches. EEGs were divided into four groups based on their amplitude: group one ≤20 μV; group two 21–35 μV; group three 36–50 μV, and group four >50 μV. Interictal abnormalities were defined as epileptiform discharges with or without associated slow waves. Abnormalities were identified during periods of resting, hyperventilation and photic stimulation in each group. Results: The mean age ± standard deviation of the patients was 27 ± 12.5 years. Of the 1,718 EEGs, 542 (31.5% were abnormal. Interictal abnormalities increased with amplitude in all four categories and demonstrated a significant association (P <0.05. A total of 56 EEGs (3.3% had amplitudes that were ≤20 μV and none of these showed interictal epileptiform abnormalities. Conclusion: EEG amplitude is an important factor in determining the presence of interictal epileptiform abnormalities in routine EEGs. This should be taken into account when investigating patients for epilepsy. A strong argument is made for considering long-term EEG monitoring in order to identify unexplained seizures which may be secondary to epilepsy. It is recommended that all tertiary institutions provide EEG telemetry services.

  18. Cerebral infarct in children aged zero to fifteen years Infarto cerebral em crianças de zero a quinze anos de idade

    Directory of Open Access Journals (Sweden)

    Thelma Ribeiro Noce

    2004-03-01

    Full Text Available Cerebral infarcts in children present peculiar characteristics either due to their diversity of causes or due to the unknown nature of the causes. The etiologies of cerebral infarct were reviewed in children from zero to 15 years old, attended at a tertiary hospital, in Ribeirão Preto (Brazil, from 1990 to 1997, adopting the modified Trial of ORG 10172 in Acute Stroke Treatment (TOAST criteria of classification; 1 - Atherosclerosis in large arteries; 2 - Cardioembolic; 3 - Occlusion of small vessels; 4 - Other etiologies; 5 - Undetermined cause. Thirty-nine children were included, 18 males and 21 females, aged 2 months to 15 years, mean age 5.67. The largest group, N=22 (56.4%, included children with ''other etiologies'', 7 of them aged under two years. The most common etiology was dehydration and septic shock leading to brain hypoperfusion and watershed infarcts. Nine (23% children had ''Undetermined etiology'', 7 (17,9% cardioembolic subtype and none had atherosclerosis. Laboratory improvement is needed for the large number of patients without a defined cause, and the high proportion of children with dehydration in the group with a determined cause emphasizes the need for preventive health actions among infants and children.Infartos cerebrais em crianças apresentam peculiaridades, como grande variedade de causas e alta freqüência sem etiologia definida. Foram revistos os diagnósticos etiológicos em crianças de zero a 15 anos, atendidas durante o ictus e com imagens cerebrais sugestivas de infarto, entre 1990 e 1997 em hospital terciário de Ribeirão Preto (SP. Adotou-se o critério de classificação modificado do Trial of ORG 10172 in Acute Stroke Treatment (TOAST: 1 - Arterioesclerose de grandes artérias, 2 - Cardioembólico, 3 - Oclusão de pequenos vasos, 4 - Outras etiologias, 5 - Não determinada. Trinta e nove crianças foram incluídas, 18 do sexo masculino e 21 do feminino, com idade variando entre 2 meses e 15 anos e m

  19. Variação temporal no desempenho em testes de memória em pacientes com doença vascular cerebral Temporal variation in memory tests performance in cerebral vascular disease patients

    Directory of Open Access Journals (Sweden)

    Tania Fernandes Campos

    2007-01-01

    Full Text Available Buscando adequar a avaliação neuropsicológica à organização temporal do organismo humano, avaliou-se o desempenho em testes de memória em 12 pacientes pós Doença Vascular Cerebral e 12 indivíduos controle, de ambos os sexos, com idade de 45 a 65 anos. Foram aplicados dois testes de memória com estímulos visuais (figuras e dois com estímulos verbais (palavras, em 3 dias consecutivos por semana, às 08:00, 10:00 e 12:00 h na primeira semana e às 14:00 e 16:00 h na seguinte. Os pacientes apresentaram menor número de acertos do que os indivíduos controle em todos os testes aplicados (pThis study intended to investigate the performance in memory tests in order to adequate the neuropsychological evaluation to the temporal order of the human organism. Twelve cerebral vascular accident patients and 12 controls, of both sexes and 45-65 years old were studied. Two memory tests with visual stimuli (pictures and two with verbal stimuli (words were applied three times a day (08:00, 10:00 and 12:00 h during the first week and twice a day (14:00 and 16:00 h in the second week, during three consecutive days in two consecutive weeks. The patients showed lower scores than control subjects in all applied tests (p<0,05. The greater test sensitivity was at 14:00 h for the free recall test and at 16:00 h for recognition tests. According to these results, it is concluded that neuropsychological evaluations should be conducted preferably in the afternoon, as well for the first evaluation as for the re-evaluations.

  20. Crescimento e antropometria em pacientes com paralisia cerebral hemiplégica Growth and anthropometry in hemiplegic cerebral palsy patients

    OpenAIRE

    Marise Bueno Zonta; Fábio Agert; Muzzolon, Sandra Regina B.; Sérgio Antonio Antoniuk; Neiva Isabel R. Magdalena; Isac Bruck; Lúcia Helena C. dos Santos

    2009-01-01

    OBJETIVO: Analisar o crescimento linear, o perímetro cefálico e as diferenças antropométricas entre o lado envolvido e o não-envolvido de 24 crianças com paralisia cerebral (PC) hemiplégica, comparados à média para a idade. MÉTODOS: Estudo transversal com amostragem consecutiva de crianças com PC, classificadas clinicamente como hemiplegia espástica. As medidas antropométricas incluíram: peso, estatura, perímetro cefálico, comprimento total de membro superior, comprimento da mão, largura da p...

  1. Perfil de pacientes com paralisia cerebral em uso de gastrostomia e efeito nos cuidadores Profile of patients with cerebral palsy using gastrostomy and effects on caregivers

    Directory of Open Access Journals (Sweden)

    Fernanda Pellin Susin

    2012-10-01

    Full Text Available OBJETIVO: caracterizar o perfil de pacientes com paralisia cerebral em uso de gastrostomia e verificar o efeito que tal procedimento ocasiona nos cuidadores. MÉTODO: foi realizado estudo transversal de caráter qualitativo e quantitativo. A pesquisa foi feita com pacientes do Hospital da Criança Santo Antônio - Complexo Hospitalar Santa Casa que tivessem diagnóstico médico de Paralisia Cerebral (PC em uso de gastrostomia. Foi aplicado um questionário aos cuidadores contendo questões quantitativas, qualitativas e dados sobre a caracterização da amostra. RESULTADOS: houve predominância de renda mensal de até dois salários mínimos, e uma configuração familiar caracterizada pelo pai trabalhar e a mãe não atuar no mercado de trabalho. Dentre os motivos para a indicação do procedimento, a dificuldade de deglutição esteve presente entre todos os sujeitos, seguido das pneumonias de repetição e baixo peso. Observa-se um grande número de pacientes que fizeram uso de sonda antes da gastrostomia, com tempo de permanência acima de um mês. Destacam-se os principais benefícios observados com a colocação da gastrostomia: ganho de peso, diminuição dos problemas respiratórios e redução de internações. A partir dos relatos dos cuidadores percebe-se a ocorrência de sentimentos como de medo do desconhecido, resistência e aceitação, dificuldades e benefícios. CONCLUSÃO: observa-se que problemas de alimentação são frequentemente encontrados como indicação para colocação de gastrostomia em crianças com PC. Os cuidadores sentem medo quanto à impossibilidade de alimentar a criança pela via oral. Porém, após a cirurgia, grande parte deles relatou benefícios, como por exemplo, ganho de peso e redução das internações.PURPOSE: outlining the profile of patients with cerebral paralysis using gastrotomy and investigating the effects of such procedure on caretakers. METHOD: it is a cross-sectional study with a

  2. Implementation and evaluation of an interictal spike detector

    Science.gov (United States)

    Horak, Peter C.; Meisenhelter, Stephen; Testorf, Markus E.; Connolly, Andrew C.; Davis, Kathryn A.; Jobst, Barbara C.

    2015-09-01

    The detection of epileptiform activity, such as interictal spikes, in electrical brain recordings has important clinical and research applications. Identification of interictal spikes is often carried out manually by trained neurologists. It is a time-consuming process and can exhibit variability between experts. In this work, we develop and evaluate an automated spike detector. We implement a template-matching approach and improve its accuracy on one set of recordings using a supervised machine-learning algorithm. Evaluation with two independent datasets shows the template-matching detector to perform comparably with experts and the version augmented with a classifier. In one test dataset, variations of the detection threshold partially explain discrepancies between experts. In the other, the detector demonstrates similar behavior to an existing algorithm developed with this dataset.

  3. The interictal dysphoric disorder in patients with epilepsy

    DEFF Research Database (Denmark)

    Amiri, Moshgan; Pilebæk Hansen, Christian

    2015-01-01

    Danish IDDI was only 50%. CONCLUSION: With a prevalence of 19%, IDD appeared to be the commonest neuropsychiatric syndrome. The majority of the patients with IDD also had depressive and/or anxiety disorders. Quality of life, seizure control, and side effects to antiepileptic drugs were affected much more......PURPOSE: To examine adult epilepsy outpatients for the existence of the interictal dysphoric disorder (IDD) using the interictal dysphoric disorder inventory (IDDI), the overlap between IDD, depression, and anxiety, and the reproducibility of IDDI. METHODS: Epilepsy outpatients were assessed with...... the Danish IDDI and self-report inventories for depression and anxiety. Patients with abnormal scores were further assessed with the Mini International Neuropsychiatric Interview (MINI). Patients with IDD were asked to repeat IDDI for evaluating the reproducibility. Quality of life, well-being and...

  4. Ictal-interictal continuum: A proposed treatment algorithm.

    Science.gov (United States)

    Rodríguez, Valia; Rodden, Meghan F; LaRoche, Suzette M

    2016-04-01

    The ictal-interictal continuum (IIC) is characterized by periodic and/or rhythmic EEG patterns that occur with relative high frequency in critically ill patients. Several studies have reported that some patterns seen within the continuum are independently associated with poor outcome. However there is no consensus regarding when to treat them or how aggressive treatment should be. In this review we examine peer-reviewed original scientific articles, guidelines and reviews indexed in PubMed and summarize current knowledge related to the ictal-interictal continuum. A treatment algorithm to guide management of critically ill patients with EEG patterns that fall along the IIC is proposed. The algorithm-based on best current practice in adults-takes into account associated clinical events, risk factors for developing seizures, response to medication trials and biomarkers of neuronal injury. PMID:26971489

  5. Rastreio cognitivo em pacientes com acidente vascular cerebral: um estudo transversal

    Directory of Open Access Journals (Sweden)

    Ana Amália Torres Souza Gandour Dantas

    2014-07-01

    Full Text Available Objetivo O estudo objetivou-se a fazer um rastreio cognitivo nos pacientes com acidente vascular cerebral (AVC, a fim de determinar pontos de corte de acordo com a idade, escolaridade e grau de comprometimento neurológico. Métodos Foi realizado um estudo transversal no qual participaram 109 pacientes ambulatoriais, sendo 61 homens, com média da idade de 59 anos (± 11, média do tempo de escolaridade de 5 anos (± 4 e do tempo de sequela de 16 meses (± 14. Os pacientes foram avaliados por meio do Miniexame do Estado Mental (MEEM e pela National Institute of Health Stroke Scale. Os dados foram analisados pela regressão linear múltipla (stepwise forward. Resultados Verificou-se que as variáveis grau de comprometimento neurológico, idade e escolaridade contribuíram significativamente para o valor global do MEEM e explicaram a variância do estado cognitivo (R2 ajustado = 0,24. Cada aumento do comprometimento neurológico representou diminuição de 0,456 no escore do MEEM. Quanto maior a idade, ocorreu uma diminuição de 0,202 no MEEM, e à medida que diminui o tempo de escolaridade, houve uma diminuição de 0,190 no MEEM. Os pontos de corte variaram de 14 a 22 de acordo com o grau de comprometimento neurológico, idade e escolaridade. Conclusão Os resultados apontaram que, por meio do rastreio positivo de déficit cognitivo, foram encontrados pontos de corte associados ao comprometimento neurológico, necessitando também serem ajustados pela idade e escolaridade, sugerindo que essas associações sejam preferencialmente levadas em consideração na planificação da reabilitação neuropsicológica dos pacientes com AVC.

  6. Interictal conduction slowing in muscle fibers in hypokalemic periodic paralysis.

    Science.gov (United States)

    Troni, W; Doriguzzi, C; Mongini, T

    1983-11-01

    Conduction velocity in muscle fibers of the short head of biceps brachii was reduced between attacks in all the affected members of a family suffering from hypokalemic periodic paralysis. This finding represents a further evidence of a primary alteration of sarcolemmal function in this disease. Interictal conduction slowing in muscle fibers is consistent with the prevailing pathophysiologic hypothesis, which considers an increased membrane permeability to sodium ions as the fundamental defect underlying all forms of familial periodic paralysis. PMID:6685247

  7. Hemorrhage in cerebral metastasis from angiosarcoma of the heart: case report Hemorragia em metástase cerebral de angiossarcoma cardíaco: relato de caso

    Directory of Open Access Journals (Sweden)

    Pasquale Gallo

    2001-09-01

    Full Text Available The purpose of this article is to describe the clinical and pathological features of metastatic angiosarcoma in the central nervous system. Only a few cases of cerebral metastasis from angiosarcoma of the heart have been recorded in the literature; particulary related to intracerebral hemorrhage. A case of secondary cerebral angiosarcoma of the heart in a 33 years old man is presented. The initial symptoms were headache, vomiting, lethargy and aphasia. There was a mass in the left temporal lobe with hemorrhage and edema on the computerized tomography (CT. After 24 hours the neurological status worsened and another CT scan showed rebleeding on the tumor area. He underwent an emergency craniotomy but died two days after. Considering the longer survival of sarcoma patients with new modalities of treatment, the incidence of brain metastasis may increase, demanding a bether preventive and more aggressive approach. Besides, due to the hemorrhagic nature of such lesions, we suggest the imediate surgery to prevent a fast and lethal evolution because rebleeding.O propósito deste artigo é descrever os achados clínicos e patológicos das metástases de angiossarcoma no sistema nervoso central. Apenas poucos casos de metástases cerebrais de angiossarcoma cardíaco foram relatados na literatura, menos ainda relacionados a hemorragia intracerebral. Relatamos o caso de um tumor cerebral secundário a angiossarcoma cardíaco em um paciente masculino de 33 anos. Os sintomas iniciais foram: cefaléia, vômitos, letargia e afasia. A tomografia computadorizada mostrou massa no lobo temporal esquerdo associada a hemorragia e edema. Após 24 horas houve piora do estado neurológico e nova tomografia demonstrou ressangramento no leito tumoral. Foi submetido a uma craniotomia de urgência mas faleceu dois dias após. Considerando a longa sobrevida dos pacientes com sarcoma devido às novas modalidades terapêuticas, poderá aumentar a incidência de met

  8. Função vísuo-espacial em paralisia cerebral e proposta de novo teste com a ajuda de computador

    Directory of Open Access Journals (Sweden)

    Marilisa M. Guerreiro

    1991-09-01

    Full Text Available Os autores apresentam o estudo da função vísuo-espacial em uma criança com paralisia cerebral (PC. Apoiados nas teorias de Luria e Piaget, justificam a existência de tal distúrbio em PC. A criança-propósito deste estudo apresentou elementos teórico-práticos que embasaram esta idéia. Face às limitações dos testes disponíveis, propomos novo teste aplicável tanto em papel quanto em computador. Trata-se de quatro linhas dispostas equidistantemente em diferentes inclinações. A simplicidade do teste permitiu seu uso em computador, o que ampliou e aprofundou a investigação, acrescentando novos elementos ao estudo.

  9. Estimulação psicossocial e plasticidade cerebral em desnutridos Psychosocial stimulation and brain plasticity in malnourished individuals

    Directory of Open Access Journals (Sweden)

    Jailma Santos-Monteiro

    2002-04-01

    Full Text Available RESUMO: É feita uma revisão sobre as estratégias e efeitos da estimulação sensorial e ambiental de indivíduos desnutridos. Reportam os autores evidências provenientes de experimentos com modelos animais e de estudos em seres humanos, mostrando os benefícios da administração da estimulação sensorial ou psicossocial programadas sobre as funções neuro-comportamentais. Mostram ainda a importante participação que a plasticidade cerebral pode ter neste processo. Finalmente enfatizam que as evidências eletrofisiológicas - obtidas pela técnica da depressão alastrante cortial em animais - e as observações em seres humanos indicam que as regiões cerebrais comportam-se diferencialmente nesta recuperação. Daí, sugerem uma abordagem nos cuidados médicos em indivíduos desnutridos levando em conta estas peculiaridades regionais do cérebro.Evidences from studies in animal models and human beings are reviewed, showing the benefits produced by programed sensorial and psychosocial stimulation on neuro-behavioral functions of early malnourished individuals. It is emphasized that brain plasticity might play a fundamental role in this process. It is showed also that recent electrophysiological experiments - by using the cortical spreading depression technique - as well as observational studies in children indicate that brain regions may have a differential participation in the recovering of the brain and behavioral functions damaged by malnutrition. A new health care approach, taking into account that regional differences for treatment of children suffering early malnutrition, is suggested.

  10. Política de treinamento com base em definição de competências a partir do método de dominância cerebral: estudo em usina termelétrica de Manaus

    OpenAIRE

    Gomes, Paulo Cesar Rocha

    2011-01-01

    Mestrado em Recursos Humanos O tema da dissertação versa a política de treinamento com base em definição de competências a partir do método de Dominância Cerebral, desenvolvendo-se o estudo em usina termelétrica no estado do Amazonas. Tem como objectivo principal apontar um modelo de definição de competências baseado no Método da Dominância Cerebral para adequação à política de treinamentos de uma usina termelétrica no estado do Amazonas. Em termos de método optou-se pela pesquisa de...

  11. Avaliação da linguagem após acidente vascular cerebral em adultos no estado de Sergipe

    Directory of Open Access Journals (Sweden)

    João Sigefredo Arruda

    2014-06-01

    Full Text Available Objetivo analisar a ocorrência de distúrbios de linguagem nos indivíduos que sofreram Acidente Vascular Cerebral. Métodos foi avaliada a linguagem de todos os pacientes acometidos por Acidente Vascular Cerebral, atendidos de fevereiro a agosto de 2012, no setor de fisioterapia de centro de referência em educação e saúde do Estado de Sergipe. A avaliação foi baseada no Teste do Rio de Janeiro (2005. A análise dos dados foi realizada por meio de estatística descritiva e probabilística através da distribuição de frequência, cálculos da média, desvio padrão e percentis, do Teste U de Mann-Whitney e Qui-Quadrado. Resultado foram encontrados 31 indivíduos, de ambos os gêneros, com idade variando de 30 a 94 anos. Foi evidenciado que as variáveis: gênero, escolaridade e idade, influenciam no desempenho do teste, verificando-se que o gênero masculino, sujeitos abaixo de 65 anos e os com escolaridade acima de fundamental incompleto pontuam mais. Conclusão maior percentual da amostra apresenta mais alteração na compreensão do que na expressão.

  12. Avaliação clínica e objetiva da deglutição em crianças com paralisia cerebral Clinical and instrumental swallowing evaluation in children with cerebral palsy

    OpenAIRE

    Moisés Andrade dos Santos de Queiroz; Izabella Santos Nogueira de Andrade; Renata Cavalcante Barbosa Haguette; Erik Frota Haguette

    2011-01-01

    OBJETIVO: Investigar as principais manifestações disfágicas na avaliação clínica e objetiva da deglutição em crianças com paralisia cerebral. MÉTODOS: Estudo transversal com amostra de 50 crianças com paralisia cerebral. A coleta de dados consistiu na realização das avaliações clínica fonoaudiológica e videoendoscópica da deglutição para a detecção das principais manifestações disfágicas presentes nas fases preparatória oral, oral e faríngea da deglutição, em diferentes consistências alimenta...

  13. Avaliação da isquemia cerebral focal induzida pela oclusão da artéria cerebral média e a ação neuroprotetora do cetoprofeno em ratos

    OpenAIRE

    DIAS LUIZ ANTONIO ARAUJO; COLLI BENEDICTO OSCAR; COUTINHO NETTO JOAQUIM; LACHAT JOÃO JOSÉ

    2000-01-01

    A isquemia cerebral é fenômeno eventualmente observado durante procedimentos neurocirúrgicos e em patologias clínicas resultando em déficits neurológicos incapacitantes ou mesmo na morte. Por tratar-se de problema grave e de difícil solução, vários estudos têm sido efetuados com o objetivo de elucidar os mecanismos do fenômeno isquêmico no sistema nervoso central (SNC) e abolir ou diminuir seus efeitos através das drogas que protegem os neurônios (neuroprotetoras). Vários neurotransmissores e...

  14. Infarto cerebral em duas crianças infectadas pelo HIV-1 Ischaemic stroke in two children with HIV-1

    Directory of Open Access Journals (Sweden)

    Cristiane Rocha

    2003-12-01

    Full Text Available Os quadros vasculares são incomuns não somente nos pacientes adultos (1% como também nas crianças. Nosso objetivo é alertar para a possibilidade da infecção pelo HIV-1 em crianças com manifestações cerebrovasculares. Das 204 crianças infectadas pelo HIV acompanhadas no Ambulatório de SIDA, descrevemos dois pacientes pré-escolares do gênero masculino, com quadro agudo febril, rebaixamento do nível de consciência, status epilepticus e hemiparesia como primeira manifestação de infecção pelo HIV-1. Nos dois casos evidenciou-se extensa isquemia em território da artéria cerebral média. Um dos pacientes evoluiu com tetraparesia espástica grave, sem contactuar com o meio, epilepsia parcial e óbito 4 anos após o diagnóstico, sem melhora do quadro neurológico. O outro paciente apresentou hemiparesia direita e afasia global, evoluindo com regressão completa do quadro neurológico. A infreqüência desses achados torna importante o seu relato, visando a inclusão da infecção pelo HIV-1 no diagnóstico diferencial das quadros cerebrovasculares na criança.Cerebral ischaemia caused by inflammatory vasculopathies has been described as a complication of human immunodeficiency virus (HIV infection. The goal of our study is to report two cases of pediatric human immunodeficiency virus infection and cerebrovascular manifestations. We describe two pre-school boys, from a group of 204 outpatients, who presented fever, seizures, hemiparesis and impairment of conscience level as a first symptom of HIV-1 infection. The serial imaging studies revealed infarction of middle cerebral artery in both cases. The first one child had a severe spastic tetraparesis and partial epilepsy and died four years later without any improvement despite of the antiretroviral therapy. The second patient had a right hemiparesis and global aphasia totally recovered two years later with antiretroviral and rehabilitation therapies. HIV infection should be included

  15. Fatores associados a perfusão cerebral anormal em dependentes de cocaína

    OpenAIRE

    Silveira Dartiu X da; Fernandes Marcelo; Barbieri Antonio; Labigalini Eliseu; Silveira Evelyn D

    2001-01-01

    OBJETIVO: Avaliar a relação entre o padrão de uso da cocaína e a perfusão cerebral de dependentes da substância. MÉTODOS: Estudou-se uma amostra de 30 dependentes de cocaína por meio de tomografia computadorizada por emissão de fóton único (single photon emission computed tomography - SPECT) com hexametil-propileno-amina-oxima, marcada com tecnécio 99 m (99 m-Tc-HMPAO), e comparou-se o padrão de perfusão cerebral com o padrão de consumo da droga. RESULTADOS: Dos dependentes, 80% apresentaram ...

  16. SWELLING MITOCONDRIAL EM AMOSTRAS TECIDUAIS DE GATOS SUBMETIDOS À OCLUSÃO DA ARTÉRIA CEREBRAL MÉDIA

    Directory of Open Access Journals (Sweden)

    Câmara RLB

    2001-01-01

    Full Text Available A isquemia cerebral tem sido largamente estudada com intuito de se obter medidas terapêuticas eficazes que minimizem seus efeitos, visto que uma grande quantidade de pacientes, clínicos ou cirúrgicos, apresentam conseqüências freqüentemente irreversíveis da mesma. A escolha de um modelo experimental satisfatório a fim de nortear pesquisas com agentes neuroprotetores tem sido a base desses estudos. No presente trabalho foi escolhido o gato como modelo experimental de isquemia e a avaliação foi realizada através do swelling mitocondrial. Os trinta e dois animais utilizados neste experimento, foram divididos em quatro grupos distintos, cada qual com dez animais sendo submetido a um tempo de isquemia, que aumentou progressivamente (15, 30 e 60 minutos, exceto no último grupo com dois animais e que não foi submetido a nenhum procedimento isquemiante. Foram observadas alterações evidentes nas curvas de swelling mitocondrial energizado nos animais submetidos a 60 minutos de isquemia, quando se comparou amostras do lado isquêmico em relação ao controle, isto ficou ainda mais claro quando se adicionou o antibiótico Alameticina durante os ensaios laboratoriais do swelling mitocondrial. Foi possível chegar às seguintes conclusões: o swelling funciona como indicador de diferenciação mitocondrial entre diversos tecidos; a mitocôndria do cérebro, quando exposta ao efeito da Alameticina, apresenta uma sensibilidade diferenciada em relação às dos outros tecidos; a mitocôndria do cérebro submetido a isquemia durante 60 minutos se torna mais sensível à Alameticina; e finalmente, as mitocôndrias do cérebro apresentam uma instalação extremamente rápida da reversão do swelling.

  17. Profilaxia de tromboembolismo venoso em pacientes com lesão cerebral traumática

    Directory of Open Access Journals (Sweden)

    Tanya L. Zakrison

    2012-12-01

    Full Text Available Traumatismo crânio-encefálico (TCE, com hemorragia intracraniana associada (HIC ocorre com frequência em trauma. Pacientes vítimas de trauma também estão em alto risco de desenvolver complicações venosas tromboembólicas (TEV. Heparina de Baixo Peso Molecular (HBPM é utilizada em pacientes de trauma, como profilaxia para reduzir o risco de eventos de TEV. Ainda não está claro, no entanto, se a HBPM é segura para uso em pacientes com trauma com HIC por receio da progressão do hematoma. O Clube de Revista "Telemedicina Baseada em Evidências: Cirurgia do Trauma e Emergência (TBE-CiTE" realizou uma apreciação crítica de três estudos recentes e mais relevantes no tocante ao momento de início da profilaxia, à segurança e ao uso de HBPM em pacientes com trauma e HIC. Especificamente, três estudos foram revisados: i uma revisão crítica da literatura sobre o tema, ii um estudo multicêntrico, estudo de coorte retrospectivo avaliando a segurança de HBPM em pacientes com trauma, e com HIC e iii um estudo piloto randomizado, avaliando a viabilidade e as taxas de eventos de progressão de HIC, servindo como base para futuros ensaios clínicos randomizados (ECR sobre o tema. Alguns resultados são conflitantes, com o maior nível de evidência sendo o ECR piloto demonstrando a segurança para o uso precoce de HBPM no TCE associado com HIC. Grande parte desta pesquisa, porém, foi gerada por um único centro e, consequentemente, carece de validade externa. Além disso, as recomendações clínicas não podem ser geradas com base em estudos-piloto. Diretrizes baseadas em evidências e recomendações não podem ser feitas, neste momento, até a realização de outros estudos sobre este assunto desafiador.

  18. Comparação dos valores do índice bispectral em pacientes com paralisia cerebral em estado de vigília Comparación de los valores del índice bispectral en pacientes con parálisis cerebral en estado de vigilia Comparison of the bispectral index in awake patients with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Verônica Vieira da Costa

    2007-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O EEG-BIS foi criado por meio de estudos em pacientes adultos saudáveis e as primeiras publicações em crianças surgiram a partir de 1998. A paralisia cerebral (PC é secundária à lesão estática do encéfalo em desenvolvimento. A necessidade de realização de exames e procedimentos cirúrgicos para correção de deformidades sob anestesia ou sedação é comum nesses pacientes. Torna-se cada vez mais necessária a monitorização do estado de hipnose do paciente anestesiado e pode-se incluir nesse grupo os pacientes com paralisia cerebral. O objetivo desse estudo foi avaliar a eficiência do EEG-BIS nos pacientes com paralisia cerebral (PC em comparação com os pacientes sem doenças neurológicas (sem PC, em estado de vigília. MÉTODO: Foram avaliados dois grupos de pacientes: um com diagnóstico de paralisia cerebral e outro sem doença do sistema nervoso central (SNC. Na véspera da intervenção cirúrgica, na enfermaria, junto aos pacientes despertos era colocado o monitor de EEG-BIS e solicitado que fechassem os olhos. Os valores que apareciam na tela do monitor, em um intervalo de 10 minutos, eram anotados e registrados em ficha padronizada, sendo calculado um valor médio por paciente. RESULTADOS: Foram avaliados 188 pacientes, de ambos os sexos, com idade média de 10, 07 ± 2,9 (PC e 10,21 ± 3,1 (sem PC anos. O grupo PC apresentou EEG-BIS basal de 95,83 ± 5,142 e o grupo sem PC de 96,56 ± 1,941 sem haver diferença estatística significativa entre eles. CONCLUSÕES: Os sinais de EEG são captados normalmente e os valores de EEG-BIS dos pacientes com PC são semelhantes ao dos pacientes sem PC no estado de vigília.JUSTIFICATIVA Y OBJETIVOS: El EEG-BIS fue creado a través de estudios en pacientes adultos saludables y las primeras publicaciones en niños surgieron a partir de 1998. La parálisis cerebral (PC es secundaria a la lesión estática del encéfalo en desarrollo. La necesidad de

  19. STUDY OF INTERICTAL E.E.G IN EPILEPSY

    Directory of Open Access Journals (Sweden)

    Usha Rani

    2013-04-01

    Full Text Available ABSTRACT: The present study includes hundred consecutive patie nts with a clinical diagnosis of Epilepsy attending the department of Neurology. All these patients were evaluated clinically and data recorded in proforma. Electroencephalogram ( E.E.G was recorded with 16-channel Electroencephalograph and the standards of normality are established. The Aim of this study is to study the pattern of abnormalities in interictal EEG in Epilepsy. The Objectives of this study are 1. To confirm the diagnosis of epilepsy. 2. To s tudy the EEG abnormalities in relation to different types of epilepsy. 3. To know the distributi on of epilepsy in relation to age and sex. 4. To study the effect of antiepileptic drugs on EEG. 5 . To study the effect of hyperventilation on EEG. 6. To study the effect of photic stimulation on EEG. 7. To study the effect of interval between last seizure and EEG recording on EEG abnor malities. Epilepsy is a very common neurological illness accounting for 10% of patients attending the Neurology Outpatient department. It most commonly affects people in the fir st 3 decades of life. Males seem to be slightly more frequently affected. The diagnosis of epilepsy is most often on clinical grounds; EEG is helpful in supporting the diagnosis of epilepsy in difficult situation and classification of the seizures. Single awake interictal recording is helpful only in approximately 40% of the patients. Provocative procedures like hyperventilation and photic stimulation increase the diagnostic yield, particularly primarily generalized epilepsies. Sleep records to be more informative should be recorded in light sleep. Gener alized seizures either primary or secondary seem to be the commonest type. In patients with a cl inical diagnosis of generalized seizures, EEG may demonstrate focal abnormalities revealing t he true nature of the seizure. Partial seizures may not reveal focal onset in the EEG maki ng classification of the seizures interacts (on

  20. Implante auditivo de tronco cerebral: técnica cirúrgica e resultados auditivos precoces em pacientes com neurofibromatose tipo 2 Auditory Brainstem Implant: surgical technique and early audiological results in patients with neurofibromatosis type 2

    OpenAIRE

    Ricardo Ferreira Bento; Rubens Vuono Brito Neto; Robinson Koji Tsuji; Marcos Queiroz Telas Gomes; Maria Valéria Schmidt Goffi-Gomez

    2008-01-01

    O implante auditivo de tronco cerebral foi desenvolvido para restaurar alguma audição útil em pacientes que apresentam ausência de nervo coclear bilateralmente. OBJETIVOS: Discutir a indicação, cirurgia e resultados em quatro pacientes submetidos à cirurgia para colocação de implante auditivo de tronco cerebral. CASUÍSTICA E MÉTODOS: Quatro pacientes com diagnóstico de schwannomas vestibulares bilaterais foram submetidos à cirurgia para colocação de Implante Auditivo de Tronco Cerebral durant...

  1. Ontogenetic development of transition of interictal activity of cortical foci into ictal phases

    Czech Academy of Sciences Publication Activity Database

    Mareš, Pavel

    (2007). [WONOEP /9./. 03.07.2007-06.07.2007, Teluk Nibong, Langkawi ] Institutional research plan: CEZ:AV0Z50110509 Keywords : interictal activity * cortical foci * development Subject RIV: ED - Physiology

  2. Anticorpos antifosfolípides em 66 pacientes com infarto cerebral entre 15 e 40 anos Antiphospholipid antibodies in 66 patients with cerebral infarction between 15 and 40 years old

    Directory of Open Access Journals (Sweden)

    José Ibiapina Siqueira Neto

    1996-12-01

    Full Text Available Os anticorpos antifosfolípides (aFLs constituem grupo heterogêneo de imunoglobulinas que tem sido relacionado com alterações na coagulabilidade. Indivíduos com títulos elevados teriam maior probabilidade de desenvolver tromboses de repetição, tanto arterial como venosa, e por conseguinte infarto cerebral (IC. Os testes para detecção mais utilizados em estudos clínicos são o inibidor lúpico e a anticardiolipina. Têm-se relatado maiores percentuais de positividade nesses testes em pacientes jovens com IC. Neste estudo procuramos investigar a prevalência desses anticorpos em pacientes com IC entre 15 e 40 anos em nosso Serviço. Examinamos 66 pacientes para presença de aFLs e obtivemos 16,65% de resultados positivos. Confirmamos diagnóstico de síndrome do anticorpo antifosfolípide primária em três (4,55% casos. Concluímos que a pesquisa de rotina para aFLs em pacientes jovens com IC está indicada neste grupo de pacientes, mas correlacioná-los com o episódio isquêmico nem sempre é possível.The antiphospholipid antibodies (aPLs are a heterogenous group of immunoglobulins that have been related with alterations in blood coagulability in recent years. Patients with elevated titers of these antibodies have a high probability to develop thrombotic events, including cerebral infarct (CI. The tests currently used to detect these antibodies are the lupus anticoagulant and ELISA for anticardiolipin antibodies which have a larger proportion of positivity among young patients with CI. In our study we tested 66 patients with cerebral infarcts whose ages ranged from 15 to 40 years for the presence of lupus anticoagulant and anticardiolipin antibodies. The results showed that eleven (16.65% patients were positive for aPLs and three (4.55% of them fulfilled the diagnostic criteria for primary antiphospholipid syndrome. These data point out to the importance of investigating aPLs in young patients with CI and its high prevalence in this

  3. SpikeGUI: Software for Rapid Interictal Discharge Annotation via Template Matching and Online Machine Learning

    OpenAIRE

    Jin, Jing; Dauwels, Justin; Cash, Sydney; Westover, M. Brandon

    2014-01-01

    Detection of interictal discharges is a key element of interpreting EEGs during the diagnosis and management of epilepsy. Because interpretation of clinical EEG data is time-intensive and reliant on experts who are in short supply, there is a great need for automated spike detectors. However, attempts to develop general-purpose spike detectors have so far been severely limited by a lack of expert-annotated data. Huge databases of interictal discharges are therefore in great demand for the dev...

  4. SpikeGUI: software for rapid interictal discharge annotation via template matching and online machine learning.

    Science.gov (United States)

    Jing Jin; Dauwels, Justin; Cash, Sydney; Westover, M Brandon

    2014-01-01

    Detection of interictal discharges is a key element of interpreting EEGs during the diagnosis and management of epilepsy. Because interpretation of clinical EEG data is time-intensive and reliant on experts who are in short supply, there is a great need for automated spike detectors. However, attempts to develop general-purpose spike detectors have so far been severely limited by a lack of expert-annotated data. Huge databases of interictal discharges are therefore in great demand for the development of general-purpose detectors. Detailed manual annotation of interictal discharges is time consuming, which severely limits the willingness of experts to participate. To address such problems, a graphical user interface "SpikeGUI" was developed in our work for the purposes of EEG viewing and rapid interictal discharge annotation. "SpikeGUI" substantially speeds up the task of annotating interictal discharges using a custom-built algorithm based on a combination of template matching and online machine learning techniques. While the algorithm is currently tailored to annotation of interictal epileptiform discharges, it can easily be generalized to other waveforms and signal types. PMID:25570976

  5. Complicações respiratórias em pacientes com paralisia cerebral submetidos à anestesia geral Complicaciones respiratorias en pacientes con parálisis cerebral sometidos a la anestesia general Respiratory complications in patients with cerebral palsy undergoing general anesthesia

    OpenAIRE

    Sérgio Silva de Mello; Ronaldo Soares Marques; Renato Ângelo Saraiva

    2007-01-01

    JUSTIFICATIVA E OBJETIVOS: Anestesia em pacientes com paralisia cerebral (PC) pode representar um desafio para o anestesiologista. Este estudo prospectivo teve como objetivo determinar a prevalência e o risco de complicações respiratórias em crianças com PC submetidas à anestesia geral inalatória (AGI) para tomografia computadorizada (TC). MÉTODO: Participaram do estudo pacientes com idades entre 1 e 17 anos, estado físico ASA I a III, submetidos a AGI com sevoflurano e máscara laríngea para ...

  6. DIFFERENCES IN INTERICTAL PERFUSION PATTERNS BETWEEN REFRACTORY AND NON-REFRACTORY TEMPORAL LOBE EPILEPSIES EVALUATED WITH FAIR AT 3.0T

    Institute of Scientific and Technical Information of China (English)

    Hui You; Jing-jing Lu; Lian-kun Ren; Xiao-zhen Li; Feng Feng; Chun-ling Meng; Zheng-yu Jin

    2006-01-01

    Objective To investigate the difference in interictal perfusion patterns between refractory and non-refractory temporal lobe epilepsies evaluated with flow-sensitive alternating inversion recovery (FAIR) magnetic resonance (MR) sequence.Methods Nine patients with refractory temporal lobe epilepsy,21 patients with non-refractory temporal lobe epilepsy,and 13 normal volunteers underwent FAIR MR scanning.The relative cerebral blood flow (rCBF) in bilateral hemispheres and mesial temporal lobes were measured.And we also calculated the asymmetry index (AI) values.Results The AI values of bilateral hemispheres in refractory and non-refractory epilepsy patients were both significantly different from those of volunteers (P=0.012 and 0.029,respectively).There was significant difference in AI values of bilateral mesial temporal lobes between non-refractory epilepsy patients and volunteers (P=0.049),while no significant difference between refractory epilepsy patients and volunteers.Conclusions The hypoperfusion pattern of interictal refractory temporal lobe epilepsy patients is different from that of non-refractory patients.Although the hypoperfusion tends to extend out of temporal lobes in all patients,the refractory epilepsy patients have a preference of bilateral mesial temporal hypoperfusion,which may be valuable for evaluating prognosis.

  7. Estudos genéticos e moleculares em um grande grupo de pacientes com malformações do córtex cerebral Genetics and molecular study in group of patients with malformations of cerebral cortex

    Directory of Open Access Journals (Sweden)

    Fábio Rossi Torres

    2008-09-01

    Full Text Available OBJETIVOS: As malformações do córtex cerebral (MCC são uma causa importante de epilepsia. Nossas metas foram: triagem de mutações em genes associados às MCC (FLN1, LIS1, DCX e EMX2, investigar funcionalmente as mutações e mapear o locus para polimicrogiria perisylviana familiar. MÉTODOS: A triagem de mutações foi realizada por PCR, DHPLC e sequênciamento. Estudo funcional foi realizado por RT-PCR, PCR em tempo real e HUMARA. O estudo de ligação foi realizado por PCR e análise com programas Fragment Profiler® e MLINK®. RESULTADOS: Mutações deletérias foram identificadas em 3/108 pacientes. Uma mutação de splicing (G987C em FLN1 foi identificada em duas pacientes aparentadas com heterotopia nodular periventricular. Mudança no padrão de inativação do cromossomo X é responsável pelas diferenças clínicas entre as pacientes. Uma substituição A1385C (H277P foi identificada em LIS1 em um indivíduo com lissencefalia. Alterações neutras foram identificadas em DCX e EMX2. A análise de ligação identificou um locus em Xq27.2-Xq27.3 para polimicrogiria familiar. CONCLUSÃO: Mosaicismo, mutações em regiões não codificantes, deleções, rearranjos e casos atípicos podem estar contribuindo para a baixa freqüência de mutações identificadas. Esquizencefalia e polimicrogiria parecem não ter base genética relacionada com o gene EMX2. Um novo locus candidato em Xq27.2-Xq27.3 foi identificado para polimicrogiria perisylviana familiar.OBJECTIVES: Malformations of cerebral cortex (MCC are an important cause of epilepsy. Our main goals were: to search for mutations in genes responsible for MCC (FLN1, LIS1, DCX and EMX2, to map the locus for familial perisylvian polymicrogyria and to investigate the molecular mechanisms of the mutations identified. Methods: Mutation screening was performed by PCR, DHPLC and sequencing. HUMARA and Real Time PCR were performed to study the molecular mechanisms of mutations. Linkage analysis

  8. Radiosurgery with a linear accelerator in cerebral arteriovenous malformations Radiocirurgia com acelerador linear em malformações arteriovenosas cerebrais

    Directory of Open Access Journals (Sweden)

    Sérgio Carlos Barros Esteves

    2008-04-01

    variables no statistically significant correlation was observed between occlusion and treatment complications.OBJETIVO: Analisar os resultados obtidos com radiocirurgia e as suas complicações do procedimento, no tratamento das malformações arteriovenosas com acelerador linear. MÉTODOS: Este é um estudo retrospectivo. Entre Outubro de 93 e Dezembro de 96, sessenta e um pacientes com malformações arteriovenosas foram tratados, utilizando um acelerador linear com 6MV de energia. As idades variaram de 6 a 54 anos (média: 28,3 anos, 32 pacientes mulheres e 29 pacientes homens. O sintoma inicial mais freqüente foi cefaléia (45,9%, seguido de déficit neurológico (36,1%. Hemorragia cerebral diagnostica por exame de imagem foi observada em 35 pacientes (57,3%. A maioria das malformações arteriovenosas (67,2% eram graus III e IV de Spetzler. Estenose venosa (21,3% e aneurisma (13,1% foram as mais freqüentes alterações da arquitetura vascular. A dose administrada variou de 12 a 27,5Gy na periferia da lesão. RESULTADOS: Dos vinte e oito pacientes que se submeteram a controle angiográfico conclusivo, 18 tiveram obliteração completa (72% e 7 falharam ao tratamento (ausência de oclusão com mais de três anos de seguimento. Quatro pacientes foram submetidos a uma segunda radiocirurgia, e um paciente deste grupo apresentou obliteração em 18 meses de seguimento. DISCUSSÃO: Vários fatores foram analisados em relação ao grau de oclusão (sexo, idade, volume, localização, Spetzler, fluxo, embolização, total de isocentros, dose prescrita e isodose escolhida e complicações (total de isocentros, localização, volume, dose máxima, dose prescrita e isodose escolhida. As variáveis analisadas não mostraram significância estatística para a obliteração do vaso, bem como para as complicações de tratamento. O maior diâmetro da malformação arteriovenosa, seu volume e a dose administrada não influenciaram no tempo de obliteração. CONCLUSÃO: Radiocirurgia

  9. Frequencies and implications of discordant findings of interictal SPECT and itcal SPECT in patients with intractable epilepsy

    International Nuclear Information System (INIS)

    Interictal SPECT could be used at best as a reference image to ictal SPECT, and cause sometimes confusion if it had given unexplained discordant findings from ictal SPECT. We investigated implications of discordant findings which occurred in 26 among 268 which found their epileptogenic zones using ictal EEG and/or operative outcome. Sensitivity of interictal SPECT was only 36%. Among these 268, 69 patients had no structural lesions on MR, 14 of whom had decreased perfusion on interictal SPECT (8 trues and 6 falses (adjacent or contralateral)). Structural lesion were found in 199 on MR, 103 of whom had decreased perfusion (89 trues and 14 falses). Among 26 having discordant cases, 10 interictal SPECT were proved wrong after operation and/or invasive EEG and the other 16 were on speculation using PET and ictal EEG. Ictal hyperperfusion was observed in 14 patients in these interictal SPECT. Six ictal studies were found postictal accompanied by contralateral propagation or not. Two patients had dual pathology, and the remaining 2 unknown. Interictal SPECT was done on the 2nd day after ictal study(24), the 3rd day (18), the 4th day(16), the 5th day (23). Four among 24 interictal studies (17%) of the 2nd day and the other 4 among 57 of 3rd to 5th day revealed ictal hyperperfusion on interictal SPECT. Six interictal studies (2.7% among 221) acquired on the indifferent day showed also ictal hyperperfusion. We could suggest that the next day is not desirable for interictal SPECT after ictal study, as ictal hyperperfusion on interictal study confounded more than postictal findings of ictal SPECT in the discrete localization than reassuring ictal study

  10. Avaliação clínica e objetiva da deglutição em crianças com paralisia cerebral Clinical and instrumental swallowing evaluation in children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Moisés Andrade dos Santos de Queiroz

    2011-06-01

    Full Text Available OBJETIVO: Investigar as principais manifestações disfágicas na avaliação clínica e objetiva da deglutição em crianças com paralisia cerebral. MÉTODOS: Estudo transversal com amostra de 50 crianças com paralisia cerebral. A coleta de dados consistiu na realização das avaliações clínica fonoaudiológica e videoendoscópica da deglutição para a detecção das principais manifestações disfágicas presentes nas fases preparatória oral, oral e faríngea da deglutição, em diferentes consistências alimentares e tipos de paralisia cerebral. RESULTADOS: Não houve influência significativa da idade e do tipo de paralisia cerebral sobre a maior presença de manifestações disfágicas. As principais manifestações disfágicas na avaliação clínica foram: escape anterior de líquidos (70%; tosse na deglutição de líquidos (60%; diminuição da formação do bolo alimentar sólido (57,9%; presença de resíduos alimentares na cavidade oral após a deglutição de sólidos (47,4%; aumento do trânsito oral de pastosos grossos (47,1% e presença da voz molhada após a deglutição de líquidos (30%. As principais manifestações disfágicas na avaliação objetiva foram: aumento do trânsito faríngeo de pastosos grossos (79%; escape posterior de líquidos (77,5%; presença de resíduos alimentares nas estruturas faríngeas após a deglutição de pastosos grossos (58,8%; penetração laríngea de líquidos (37,5% e aspiração traqueal de líquidos (20%. A sensibilidade laríngea esteve alterada em apenas 16% da amostra. CONCLUSÃO: As avaliações clínica e objetiva da deglutição são complementares e essenciais no diagnóstico das disfagias orofaríngeas em crianças com paralisia cerebral.PURPOSE: To investigate the main manifestations of dysphagia in clinical and instrumental evaluation of swallowing in children with cerebral palsy. METHODS: Cross-sectional study of 50 children with cerebral palsy. The data collection

  11. Tuberculoma cerebral Cerebral tuberculoma

    Directory of Open Access Journals (Sweden)

    ELIZABETH CLARA BARROSO

    2002-01-01

    Full Text Available Relata-se o caso de paciente com crises convulsivas de início recente. A tomografia computadorizada cerebral evidenciou imagem sugestiva de lesão expansiva metastática frontoparietal direita. A investigação de tumor primário ou outra doença foi negativa e o exame histopatológico do tecido cerebral diagnosticou tuberculoma. As convulsões foram controladas com a associação de hidantoína 300mg/dia ao esquema específico, utilizado por 18 meses. A tuberculose do sistema nervoso central representa 5-15% das formas extrapulmonares e é reconhecida como de alta letalidade. Apresentação tumoral como a relatada é rara, particularmente em imunocompetentes. Quando tratada, pode ter bom prognóstico e deve entrar sempre no diagnóstico diferencial de massas cerebrais.It is reported a case of a previously healthy man with seizures of sudden onset. A contrast head computerized tomogram (CT showed a right frontoparietal expanding lesion suggesting to be metastatic. No prior disease was found on investigation. The histologic exam of the brain revealed tuberculoma. The seizures were controlled with Hidantoin 300 mg/day and antituberculosis chemotherapy for 18 months. Central nervous system tuberculosis (5-15% of the extrapulmonary forms is highly lethal. The case reported herein is specially rare in immunocompetent patients. It may have good prognosis and should be considered in the differential diagnosis of brain tumours.

  12. Diagnóstico das condições de saúde bucal em portadores de paralisia cerebral do município de Pelotas, Rio Grande do Sul, Brasil Oral health conditions diagnostic in cerebral palsy individuals of Pelotas, Rio Grande do Sul State, Brazil

    OpenAIRE

    Patrícia Osório Guerreiro; Gilberto de Lima Garcias

    2009-01-01

    Paralisia cerebral (PC) é uma lesão encefálica estática, definida como uma desordem não progressiva dos movimentos e postura. Está comumente associada com epilepsia e anormalidades da fala, audição, visão e retardo mental. Embora os portadores de paralisia cerebral necessitem de cuidados especiais na prevenção de problemas bucais, no contexto da assistência odontológica, as informações da literatura são contraditórias quanto à incidência de doenças bucais em pacientes com paralisia cerebral. ...

  13. Interictal spikes and epileptic seizures: their relationship and underlying rhythmicity.

    Science.gov (United States)

    Karoly, Philippa J; Freestone, Dean R; Boston, Ray; Grayden, David B; Himes, David; Leyde, Kent; Seneviratne, Udaya; Berkovic, Samuel; O'Brien, Terence; Cook, Mark J

    2016-04-01

    We report on a quantitative analysis of electrocorticography data from a study that acquired continuous ambulatory recordings in humans over extended periods of time. The objectives were to examine patterns of seizures and spontaneous interictal spikes, their relationship to each other, and the nature of periodic variation. The recorded data were originally acquired for the purpose of seizure prediction, and were subsequently analysed in further detail. A detection algorithm identified potential seizure activity and a template matched filter was used to locate spikes. Seizure events were confirmed manually and classified as either clinically correlated, electroencephalographically identical but not clinically correlated, or subclinical. We found that spike rate was significantly altered prior to seizure in 9 out of 15 subjects. Increased pre-ictal spike rate was linked to improved predictability; however, spike rate was also shown to decrease before seizure (in 6 out of the 9 subjects). The probability distribution of spikes and seizures were notably similar, i.e. at times of high seizure likelihood the probability of epileptic spiking also increased. Both spikes and seizures showed clear evidence of circadian regulation and, for some subjects, there were also longer term patterns visible over weeks to months. Patterns of spike and seizure occurrence were highly subject-specific. The pre-ictal decrease in spike rate is not consistent with spikes promoting seizures. However, the fact that spikes and seizures demonstrate similar probability distributions suggests they are not wholly independent processes. It is possible spikes actively inhibit seizures, or that a decreased spike rate is a secondary symptom of the brain approaching seizure. If spike rate is modulated by common regulatory factors as seizures then spikes may be useful biomarkers of cortical excitability.media-1vid110.1093/brain/aww019_video_abstractaww019_video_abstract. PMID:26912639

  14. Analysis of generalized interictal discharges using quantitative EEG.

    Science.gov (United States)

    da Silva Braga, Aline Marques; Fujisao, Elaine Keiko; Betting, Luiz Eduardo

    2014-12-01

    Experimental evidence from animal models of the absence seizures suggests a focal source for the initiation of generalized spike-and-wave (GSW) discharges. Furthermore, clinical studies indicate that patients diagnosed with idiopathic generalized epilepsy (IGE) exhibit focal electroencephalographic abnormalities, which involve the thalamo-cortical circuitry. This circuitry is a key network that has been implicated in the initiation of generalized discharges, and may contribute to the pathophysiology of GSW discharges. Quantitative electroencephalogram (qEEG) analysis may be able to detect abnormalities associated with the initiation of GSW discharges. The objective of this study was to determine whether interictal GSW discharges exhibit focal characteristics using qEEG analysis. In this study, 75 EEG recordings from 64 patients were analyzed. All EEG recordings analyzed contained at least one GSW discharge. EEG recordings were obtained by a 22-channel recorder with electrodes positioned according to the international 10-20 system of electrode placement. EEG activity was recorded for 20 min including photic stimulation and hyperventilation. The EEG recordings were visually inspected, and the first unequivocally confirmed generalized spike was marked for each discharge. Three methods of source imaging analysis were applied: dipole source imaging (DSI), classical LORETA analysis recursively applied (CLARA), and equivalent dipole of independent components with cluster analysis. A total of 753 GSW discharges were identified and spatiotemporally analyzed. Source evaluation analysis using all three techniques revealed that the frontal lobe was the principal source of GSW discharges (70%), followed by the parietal and occipital lobes (14%), and the basal ganglia (12%). The main anatomical sources of GSW discharges were the anterior cingulate cortex (36%) and the medial frontal gyrus (23%). Source analysis did not reveal a common focal source of GSW discharges. However

  15. Análise biomecânica da marcha e funcionalidade em crianças com Paralisia Cerebral: efeito da intervenção da fisioterapia com facilitação em tapete rolante

    OpenAIRE

    Araújo, Daniela; Sousa, Filipa

    2015-01-01

    Introdução: As crianças com Paralisia Cerebral evidenciam frequentemente alterações da sua funcionalidade global, evidenciadas nomeadamente na marcha. Diferentes protocolos de facilitação da marcha em tapete rolante têm vindo a ser alvo de estudos no sentido de clarificar a sua eficácia nesta população. Estes sugerem uma evolução positiva dos diferentes aspectos estudados (funcionalidade global, resistência cardiorespiratória, componentes da marcha), contudo utilizam diferentes metodologias e...

  16. Avaliação da isquemia cerebral focal induzida pela oclusão da artéria cerebral média e a ação neuroprotetora do cetoprofeno em ratos

    Directory of Open Access Journals (Sweden)

    DIAS LUIZ ANTONIO ARAUJO

    2000-01-01

    Full Text Available A isquemia cerebral é fenômeno eventualmente observado durante procedimentos neurocirúrgicos e em patologias clínicas resultando em déficits neurológicos incapacitantes ou mesmo na morte. Por tratar-se de problema grave e de difícil solução, vários estudos têm sido efetuados com o objetivo de elucidar os mecanismos do fenômeno isquêmico no sistema nervoso central (SNC e abolir ou diminuir seus efeitos através das drogas que protegem os neurônios (neuroprotetoras. Vários neurotransmissores estão envolvidos na isquemia e entre eles o glutamato destaca-se pela sua maior concentração no SNC. O objetivo deste estudo foi avaliar a isquemia cerebral focal em ratos através da dosagem do glutamato e dos achados morfológicos em uma evolução temporal e demonstrar uma possível ação neuroprotetora do cetoprofeno. Foram utilizados 36 ratos Wistar, subdivididos em 4 grupos: um grupo controle e outro sham; e outros dois em que os animais foram submetidos a isquemia pela oclusão seletiva da artéria cerebral média por um fio obstrutor durante 15, 30 e 45 minutos. Os animais de um destes grupos foram tratados com cetoprofeno 15 minutos antes da isquemia. A isquemia foi avaliada através de estudo histopatológico e da dosagem do glutamato extracelular in vitro. A análise morfológica mostrou não haver diferenças entre os animais normais e do grupo sham. Nos animais submetidos a isquemia, as alterações apareceram aos 30 minutos e acentuaram-se aos 45. Os principais achados foram edema intersticial, desorganização cromatínica, vacuolização e desintegração nuclear. Os animais tratados com cetoprofeno apresentaram alterações semelhantes, porém menos intensas. Reduções nas dosagens in vitro do glutamato extracelular no córtex parietal dos animais submetidos a isquemia iniciaram-se a partir dos 30 minutos e acentuaram-se aos 45 e foram semelhantes nos animais com ou sem tratamento com cetoprofeno, indicando que esta droga

  17. Incapacidade funcional associada à lombalgia em cuidadores de crianças com paralisia cerebral grave Functional disability associated to low-back pain in caregivers of children with severe cerebral palsy

    Directory of Open Access Journals (Sweden)

    Angélica Campos Maia

    2008-12-01

    Full Text Available O objetivo deste estudo foi analisar a contribuição de variáveis físicas, psicossociais e sociodemográficas para a ocorrência de incapacidade funcional associada à dor lombar entre cuidadores de crianças com paralisia cerebral grave. A amostra foi composta de 45 cuidadores com lombalgia crônica. Foram coletados dados sociodemográficos e aplicados instrumentos sobre intensidade da dor, satisfação com a vida e incapacidade funcional. Os dados foram tratados estatisticamente e o nível de significância fixado em pThe aim of this study was to assess the contribution of physical, psychosocial, and sociodemographic variables to disability due to low-back pain among caregivers of children with severe cerebral palsy. The sample was made up of 45 caregivers with chronic back pain. Socio-demographic data, as well as pain, satisfaction with life and functional disability measures were collected. Data were statistically treated and significance level set at p<0.05. Variables showing significant association with disability (p<0.05 were entered in a multiple linear regression model. Mean score for pain was 5.67±2.23; for satisfaction with life, 18.9±6.64; and for disability, 9±5,35. Association between intensity of pain and disability was the only significant one found (r=0.34; p=0.021. Linear regression analysis confirmed that pain intensity is a major disability predictor and explained 11% of the disability (r=0.36, p<0.05. Low-back pain intensity is then a moderate predictor of functional disability, but no interference could be found of socio-demographic features or satisfaction with life in caregivers of children with cerebral palsy.

  18. Depressão, ansiedade e sonolência diurna em cuidadores primários de crianças com paralisia cerebral Depresión, ansiedad y somnolencia diurna en cuidadores primarios de niños con parálisis cerebral Depression, anxiety and daytime sleepiness of primary caregivers of children with cerebral palsy

    OpenAIRE

    Catherine Marx; Erica Masruha Rodrigues; Marcelo Masruha Rodrigues; Luiz Celso P Vilanova

    2011-01-01

    OBJETIVO: Avaliar os níveis de depressão, ansiedade e sonolência diurna excessiva em cuidadores primários de crianças com paralisia cerebral, relacionando-os às condições socioeconômicas do cuidador e às características neurológicas da criança e comparando-os a cuidadores de crianças saudáveis. MÉTODOS: 45 cuidadores de crianças com paralisia cerebral e 50 cuidadores de crianças saudáveis foram aleatoriamente incluídos no estudo e responderam a um questionário semiestruturado. Avaliaram-se os...

  19. O uso da ausculta cervical na inferência de aspiração traqueal em crianças com paralisia cerebral The use of cervical auscultation in tracheal aspiration in children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Ana Maria Furkim

    2009-12-01

    Full Text Available OBJETIVO: comparar a detectabilidade da ausculta cervical na avaliação clínica com a comprovação da aspiração na videofluoroscopia da deglutição em crianças com paralisia cerebral tetraparética espástica com disfagia orofaríngea. MÉTODOS: estudo retrospectivo com análise de 101 prontuários de crianças, na faixa etária de 1 a 12 anos, pertencentes a uma instituição, com diagnóstico de paralisia cerebral tetraparética espástica e que foram encaminhadas e avaliadas por equipe interdisciplinar. Foi realizada anamnese com avaliação clínica da alimentação com ausculta cervical e videofluoroscopia da deglutição. RESULTADOS: os resultados estatísticos mostraram que há relação significante entre a ausculta cervical positiva e a penetração ou aspiração laríngea constatada na videofluoroscopia da deglutição e que a ausculta cervical negativa está mais associada à não penetração/aspiração. CONCLUSÃO: concluiu-se que a ausculta cervical pode ser utilizada para inferência do risco de aspiração e, portanto, como alerta para atuação precoce nessa população, além da vantagem de ser um método não invasivo.PURPOSE: to compare the efficacy of cervical auscultation during the clinical evaluation with the confirmation of aspiration in the videofluoroscopy of deglutition in oropharyngeal dysphagic children with tetraparetic cerebral palsy. METHODS: retrospective study with analysis of 101 notes of children, between 1 and 12-year old, enrolled in one institution, with the diagnosis of cerebral palsy spastic quadriplegia and referred and evaluated by interdisciplinary team. Clinical history, clinical evaluation of feeding with cervical auscultation and videofluoroscopy of deglutition were performed. RESULTS: the statistical results showed significance between positive cervical auscultation and laryngeal penetration or aspiration during the videofluoroscopy of deglutition and a negative cervical auscultation is

  20. Tomografia por emissão de fóton único em epilepsia temporal: estudos intercríticos e críticos com análise visual e semi quantitativa Single photon emission tomography in temporal lobe epilepsy: visual and semi quantitative analysis in interictal and ictal studies

    OpenAIRE

    Elza Márcia T. Yacubian; Lilian Y.I. Yamaga; Rosa Maria F. Valério; Lia A. Fiore; Carmen Lisa Jorge; Buchpiguel, Carlos A.

    1995-01-01

    Vinte e oito estudos intercríticos e 9 críticos/pós críticos de tomografia por emissão de fóton único (SPECT) foram realizados em 27 pacientes com epilepsia do lobo temporal e esclerose mesial temporal. Estudos intercríticos localizaram corretamente a área epileptogênica em 19 (67%) dos pacientes pela análise visual e 16 (61,5%) pela semi quantitativa, com 10,7 e 15,3%, de falsa lateralização respectivamente. Todos os 9 estudos críticos/ pós críticos detectaram o hemisfério epileptogênico e p...

  1. Surto de babesiose cerebral em bovinos no Estado do Rio Grande do Sul Cerebral babesiosis outbreak in bovines in the State of Rio Grande do Sul, Brazil

    Directory of Open Access Journals (Sweden)

    Nadia Aline Bobbi Antoniassi

    2009-06-01

    Full Text Available Descreve-se um surto de mortalidade em bovinos por Babesia bovis em abril de 2007, no Município de Picada Café, Rio Grande do Sul. Em um rebanho com 55 novilhas, 28 (50,9% morreram em cinco dias. A doença iniciou vinte dias após o ingresso dos bovinos na propriedade. Os sinais clínicos incluíam febre, incoordenação, agressividade, anemia, petéquias nas mucosas e morte 1 á 2 dias após. Em 4 animais necropsiados, observaram-se palidez de mucosas, hemorragias múltiplas, esplenomegalia, fígado aumentado e alaranjado, vesícula biliar com parede edemaciada e contendo bile grumosa. Os rins estavam vermelho-escuros e a bexiga continha urina cor de vinho tinto. O encéfalo apresentou cor róseo-cereja externamente e ao corte, mais marcado no córtex telencefálico, cerebelo e corpo estriado, contrastando com a cor branca da substância branca. Na histologia havia nefrose hemoglobinúrica, necrose hepática paracentral, bilestase canalicular, congestão esplênica, além de congestão com grande quantidade de eritrócitos parasitados por estruturas compatíveis com Babesia bovis na região cortical do encéfalo, também observadas em esfregaços teciduais dessas regiões. A morte de 28 bovinos em 5 dias deveu-se, provavelmente, à falta de imunidade contra o parasito. O tratamento foi realizado com dipropionato de imidocarb nos demais animais, havendo recuperação dos bovinos que apresentavam sinais iniciais leves e não ocorrência de novos casos durante um período de dois meses, quando foram enviados para abate.An outbreak of cattle mortality due to Babesia bovis infection in the county of Picada Café, Rio Grande do Sul, southern Brazil, in April 2007 is described. Twenty eight heifers (50.9% died, out of a herd of 55 animals, in five days. The disease occurred approximately 20 days after heifers were transferred to this farm. The clinical signs included fever, anemia, aggressiveness, incoordination, petechiae in the mucous membranes

  2. Spatiotemporal mapping of interictal epileptiform discharges in human absence epilepsy: A MEG study

    NARCIS (Netherlands)

    Rozendaal, Y.J.W.; Luijtelaar, E.L.J.M. van; Ossenblok, P.P.W.

    2016-01-01

    PURPOSE: Although absence epilepsy is considered to be a prototypic type of generalized epilepsy, it is still under debate whether generalized 3 Hz spike-and-wave discharges (SWDs) might have a cortical focal origin. Here it is investigated whether focal interictal epileptiform discharges (IEDs), wh

  3. Intact neurovascular coupling during executive function in migraine without aura: interictal near-infrared spectroscopy study

    DEFF Research Database (Denmark)

    Schytz, H W; Ciftçi, K; Akin, A; Ashina, M; Bolay, H

    2010-01-01

    An altered neurovascular coupling has been proposed in migraine. We aimed to investigate neurovascular coupling during a mental task interictally in patients with migraine without aura (MO) by near-infrared spectroscopy (NIRS). Twelve migraineurs and 12 healthy controls were included. Using NIRS,...

  4. Automatic detection and spatial clustering of interictal discharges in invasive recordings

    Czech Academy of Sciences Publication Activity Database

    Janča, R.; Ježdík, P.; Čmejla, R.; Kršek, P.; Jefferys, J. G. R.; Marusič, P.; Jiruška, Přemysl

    Ottawa: IEEE Instrumentation & Measurement Society IEEE Ottawa Section, 2013, s. 219-223. ISBN 978-1-4673-5195-9. [IEEE International Symposium on Medical Measurements and Applications /8./. Gatineau (CA), 04.05.2013-05.05.2013] Institutional support: RVO:67985823 Keywords : epilepsy * interictal discharges * intracranial electroencephalography * automatic detection * clustering Subject RIV: FH - Neurology

  5. Attention deficit associated with early life interictal spikes in a rat model is improved with ACTH.

    Directory of Open Access Journals (Sweden)

    Amanda E Hernan

    Full Text Available Children with epilepsy often present with pervasive cognitive and behavioral comorbidities including working memory impairments, attention deficit hyperactivity disorder (ADHD and autism spectrum disorder. These non-seizure characteristics are severely detrimental to overall quality of life. Some of these children, particularly those with epilepsies classified as Landau-Kleffner Syndrome or continuous spike and wave during sleep, have infrequent seizure activity but frequent focal epileptiform activity. This frequent epileptiform activity is thought to be detrimental to cognitive development; however, it is also possible that these IIS events initiate pathophysiological pathways in the developing brain that may be independently associated with cognitive deficits. These hypotheses are difficult to address due to the previous lack of an appropriate animal model. To this end, we have recently developed a rat model to test the role of frequent focal epileptiform activity in the prefrontal cortex. Using microinjections of a GABA(A antagonist (bicuculline methiodine delivered multiple times per day from postnatal day (p 21 to p25, we showed that rat pups experiencing frequent, focal, recurrent epileptiform activity in the form of interictal spikes during neurodevelopment have significant long-term deficits in attention and sociability that persist into adulthood. To determine if treatment with ACTH, a drug widely used to treat early-life seizures, altered outcome we administered ACTH once per day subcutaneously during the time of the induced interictal spike activity. We show a modest amelioration of the attention deficit seen in animals with a history of early life interictal spikes with ACTH, in the absence of alteration of interictal spike activity. These results suggest that pharmacological intervention that is not targeted to the interictal spike activity is worthy of future study as it may be beneficial for preventing or ameliorating adverse

  6. Processo de indicação do implante coclear em uma criança com paralisia cerebral: estudo de caso Indication process of cochlear implant for a child with cerebral palsy: a case report

    Directory of Open Access Journals (Sweden)

    Maria Jaquelini Dias dos Santos

    2011-12-01

    Full Text Available A paralisia cerebral (PC é o transtorno motor mais frequente na infância, podendo apresentar outras deficiências associadas, inclusive a deficiência auditiva. Estudos sobre a indicação do implante coclear (IC em crianças com PC e deficiência auditiva são restritos internacionalmente, e no Brasil, inexistentes. Desta maneira, o objetivo do estudo foi descrever o processo de avaliação pré-cirúrgica de uma criança com PC candidata ao IC. O estudo foi realizado com um menino, com 2 anos e 6 meses de idade, com PC e deficiência auditiva bilateral. O protocolo pré-cirúrgico seguiu os procedimentos já utilizados no Hospital de Reabilitação de Anomalias Craniofaciais, compreendendo: avaliações fonoaudiológicas, neurológica, otorrinolaringológica e psicológica, por meio de observações clinicas, questionários, e exames radiológicos. O paciente foi diagnosticado com espectro da neuropatia auditiva de grau profundo bilateral, quadriparesia atetóide de grau moderado, atraso global do desenvolvimento, exceto na função visual, comportamento comunicativo intencional presente, bom contato social, ausência de comprometimentos intelectuais ou outras deficiências associadas ao quadro da PC e família integrada ao tratamento. De acordo com os resultados obtidos, o paciente foi considerado apto para cirurgia de IC, e permanece em acompanhamento sistemático no respectivo programa. Ressalta-se a importância de uma etapa pré-cirúrgica ampla e estruturada para crianças com paralisia cerebral e candidatas ao IC. Por meio de instrumentos de avaliação direcionados aos aspectos globais do desenvolvimento, é possível obter informações específicas que enriquecem as orientações dadas aos pais sobre o prognóstico da criança e possibilitam traçar metas reais de reabilitação auditiva.Cerebral palsy (CP is the most common motor disorder in childhood, and is usually associated with other disabilities, including hearing impairment

  7. Análise eletromiográfica durante sessões de equoterapia em praticantes com paralisia cerebral

    OpenAIRE

    Ana Paula Espindula; Mayara Simões; Iramaia Salomão Alexandre de Assis; Mariane Fernandes; Alex Abadio Ferreira; Patrícia Fonseca Ferraz; Isabella Cardoso Cunha; Mara Lúcia da Fonseca Ferraz; Luciane Aparecida Pascucci Sande de Souza; Vicente de Paula Antunes Teixeira

    2012-01-01

    Introduction. Hippotherapy has emerged as a form of treatment for individuals with Cerebral Palsy (CP). Objective. To verify the effect of the mount type in the muscular activity in patients with CP. Methods. Three practitioners with CP were evaluated by electromyography during four hippotherapy sessions. In each session the mount condition was changed. A descriptive statistical analysis with mean and standard deviation of normalized RMS was performed. Results. The trapezius muscle was always...

  8. Temporal variation in memory tests performance in cerebral vascular disease patients / Variação temporal no desempenho em testes de memória em pacientes com doença vascular cerebral

    OpenAIRE

    Tania Fernandes Campos; Damião Ernane Souza; Carolina Dutra Gomes Pinheiro; Alexandre Augusto de Lara Menezes

    2007-01-01

    This study intended to investigate the performance in memory tests in order to adequate the neuropsychological evaluation to the temporal order of the human organism. Twelve cerebral vascular accident patients and 12 controls, of both sexes and 45-65 years old were studied. Two memory tests with visual stimuli (pictures) and two with verbal stimuli (words) were applied three times a day (08:00, 10:00 and 12:00 h) during the first week and twice a day (14:00 and 16:00 h) in the second week, du...

  9. Cerebral Hypoxia

    Science.gov (United States)

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

  10. Nonlinear analyses of interictal EEG map the brain interdependences in human focal epilepsy

    Science.gov (United States)

    Quyen, Michel Le Van; Martinerie, Jacques; Adam, Claude; Varela, Francisco J.

    1999-03-01

    The degree of interdependence between intracranial electroencephalographic (EEG) channels was investigated in epileptic patients with temporal lobe seizures during interictal (between seizures) periods. With a novel method to characterize nonlinear cross-predictability, that is, the predictability of one channel using another channel as data base, we demonstrated here a possibility to extract information on the spatio-temporal organization of interactions between multichannel recording sites. This method determines whether two channels contain common activity, and often, whether one channel contains activity induced by the activity of the other channel. In particular, the technique and the comparison with surrogate data demonstrated that transient large-scale nonlinear entrainments by the epileptogenic region can be identified, this with or without epileptic activity. Furthermore, these recurrent activities related with the epileptic foci occurred in well-defined spatio-temporal patterns. This suggests that the epileptogenic region can exhibit very subtle influences on other brain regions during an interictal period and raises the possibility that the cross-predictability analysis of interictal data may be used as a significant aid in locating epileptogenic foci.

  11. Interval analysis of interictal EEG: pathology of the alpha rhythm in focal epilepsy

    Science.gov (United States)

    Pyrzowski, Jan; Siemiński, Mariusz; Sarnowska, Anna; Jedrzejczak, Joanna; Nyka, Walenty M.

    2015-11-01

    The contemporary use of interictal scalp electroencephalography (EEG) in the context of focal epilepsy workup relies on the visual identification of interictal epileptiform discharges. The high-specificity performance of this marker comes, however, at a cost of only moderate sensitivity. Zero-crossing interval analysis is an alternative to Fourier analysis for the assessment of the rhythmic component of EEG signals. We applied this method to standard EEG recordings of 78 patients divided into 4 subgroups: temporal lobe epilepsy (TLE), frontal lobe epilepsy (FLE), psychogenic nonepileptic seizures (PNES) and nonepileptic patients with headache. Interval-analysis based markers were capable of effectively discriminating patients with epilepsy from those in control subgroups (AUC~0.8) with diagnostic sensitivity potentially exceeding that of visual analysis. The identified putative epilepsy-specific markers were sensitive to the properties of the alpha rhythm and displayed weak or non-significant dependences on the number of antiepileptic drugs (AEDs) taken by the patients. Significant AED-related effects were concentrated in the theta interval range and an associated marker allowed for identification of patients on AED polytherapy (AUC~0.9). Interval analysis may thus, in perspective, increase the diagnostic yield of interictal scalp EEG. Our findings point to the possible existence of alpha rhythm abnormalities in patients with epilepsy.

  12. Differentiating Interictal and Ictal States in Childhood Absence Epilepsy through Permutation Rényi Entropy

    Directory of Open Access Journals (Sweden)

    Nadia Mammone

    2015-07-01

    Full Text Available Permutation entropy (PE has been widely exploited to measure the complexity of the electroencephalogram (EEG, especially when complexity is linked to diagnostic information embedded in the EEG. Recently, the authors proposed a spatial-temporal analysis of the EEG recordings of absence epilepsy patients based on PE. The goal here is to improve the ability of PE in discriminating interictal states from ictal states in absence seizure EEG. For this purpose, a parametrical definition of permutation entropy is introduced here in the field of epileptic EEG analysis: the permutation Rényi entropy (PEr. PEr has been extensively tested against PE by tuning the involved parameters (order, delay time and alpha. The achieved results demonstrate that PEr outperforms PE, as there is a statistically-significant, wider gap between the PEr levels during the interictal states and PEr levels observed in the ictal states compared to PE. PEr also outperformed PE as the input to a classifier aimed at discriminating interictal from ictal states.

  13. SWELLING MITOCONDRIAL EM AMOSTRAS TECIDUAIS DE GATOS SUBMETIDOS À OCLUSÃO DA ARTÉRIA CEREBRAL MÉDIA

    OpenAIRE

    Câmara RLB; JES Roselino; Colli BO

    2001-01-01

    A isquemia cerebral tem sido largamente estudada com intuito de se obter medidas terapêuticas eficazes que minimizem seus efeitos, visto que uma grande quantidade de pacientes, clínicos ou cirúrgicos, apresentam conseqüências freqüentemente irreversíveis da mesma. A escolha de um modelo experimental satisfatório a fim de nortear pesquisas com agentes neuroprotetores tem sido a base desses estudos. No presente trabalho foi escolhido o gato como modelo experimental de isquemia e a avaliação foi...

  14. ANÁLISE BAROPODOMÉTRICA EM CRIANÇA PORTADORA DE PARALISIA CEREBRAL SUBMETIDA A TRATAMENTO COM A TÉCNICA PEDIASUIT: UM ESTUDO DE CASO

    Directory of Open Access Journals (Sweden)

    Bruna Maria da Silva

    2014-04-01

    Full Text Available O Pediasuit que tem como objetivos o reforço muscular, resistência, flexibilidade, equilíbrio, coordenação e o desenvolvimento motor. Para avaliar a eficácia do tratamento pode-se utilizar o baropodômetro que é uma plataforma que visa detectar alterações posturais na posição estática, disfunções no equilíbrio e estabilidade. Neste sentido, o objetivo deste estudo foi verificar a influência do método Pediasuit na postura e controle motor de crianças com paralisia cerebral por meio da baropodometria. Foi realizado um estudo de caso descritivo, com uma criança do sexo feminino de três anos e com diagnóstico clinico de paralisia cerebral, apoiado pelo diagnóstico funcional, por meio da escala GMFM. O tratamento foi realizado durante quatro semanas, quatro horas por dia, cinco vezes por semana. O teste com o baropodômetro foi realizado três vezes: antes, durante e depois da aplicação do protocolo. Constatou-se, em relação à distribuição de carga plantar máxima, um resultado satisfatório, sendo que no início do tratamento o plano anterior recebia uma carga de 58% e o posterior 42% ao final deste demonstrou uma carga de 49% no plano anterior e 51% no posterior. Conclui-se que houve uma melhora na distribuição de carga plantar nos planos de ante e retro pé, sugerindo dessa forma que o método pode ser considerado eficaz.

  15. O uso de procedimentos de estruturação de rotina em indivíduos com anóxia cerebral: relato de caso Procedures to improve daily activities performance in individuals with cerebral anoxia: case report

    Directory of Open Access Journals (Sweden)

    PAULA A. R. GOUVEIA

    2000-06-01

    Full Text Available OBJETIVO: Apresentar um estudo de caso de reabilitação com procedimentos de estruturação de rotina para realização das atividades de vida diária (AVDs. PACIENTE: Quadro de anóxia cerebral, com déficit de memória verbal e visual, desorientação temporal, abulia e bradipsiquismo. MÉTODO: Estruturação de horários fixos na rotina diária; exposição a um calendário 3 vezes ao dia; caminhadas diárias; monitorização do familiar na execução de tarefas de auto cuidado, fornecendo auxílio mediante comandos verbais curtos e pistas específicas. RESULTADOS: Foram observados aumento da iniciativa, maior autonomia nas AVDs, diminuição do período de latência para qualquer resposta, melhora da atenção, orientação temporal e bradipsiquismo. CONCLUSÕES: Estratégias de controle do comportamento trazem ganhos e limitações para pacientes e familiares. Embora obriguem a adaptação a uma rotina pouco flexível, promovem o aprendizado através da automatização de procedimentos que se valem de mecanismos de memória implícita preservados. Estes recursos podem elevar o grau de autonomia do paciente em casa.OBJECTIVE: To present a rehabilitation case study; procedures to improve the performance on daily activities were used by the caregiver. PATIENT: Cerebral anoxia due to cardiac arrest. He presented memory deficits for both visual and verbal material, temporal disorientation, abulia, psychomotor slowing and bradypsychism. METHODS: daily activities were developed in fixed hours; calendar was presented 3 times a day ; daily walks were performed; self-care activities were performed by the patient with short verbal commands and cues from the caregiver. RESULTS: We observed improvement on initiative and autonomy for daily activities, attention, temporal orientation and bradypsychism. There was also reduction on response time. CONCLUSIONS: Behavioral control strategies result on improvement for patients and their family although limit

  16. Infarto do miocárdio e acidente vascular cerebral associados à alta temperatura e monóxido de carbono em área metropolitana do sudeste do Brasil Miocardic infarcts and cerebral-vascular accidents associated with high temperature and carbon monoxide in an metropolitan area of Southeastern Brazil

    OpenAIRE

    Davi Rumel; Lucia Ferreira Riedel; Maria do Rosario D.O. Latorre; Bruce Bartholow Duncan

    1993-01-01

    Muito se tem publicado e discutido acerca de fatores de risco ligados a estilo de vida e a fatores hereditários em Acidente Vascular Cerebral (AVC) e Infarto do Miocárdio (IM). Porém o estudo da influência de fatores ambientais como poluição por monóxido de carbono e temperatura na determinação nas ocorrências dessas patologias ainda é pouco discutido em nosso meio. Visando preencher esta lacuna, foi verificada a associação existente entre os valores de temperaturas máximas diárias e valores ...

  17. Incapacidade funcional em doentes com acidente vascular cerebral seis meses após a sua ocorrência

    OpenAIRE

    Correia, Ricardo Miguel Lourenço

    2015-01-01

    Enquadramento: O Acidente Vascular Cerebral (AVC) é uma patologia com profundas implicações na funcionalidade das pessoas, com efeitos significativos não só ao nível do funcionamento físico, mas também a nível emocional, familiar, social e económico. Objetivos: Avaliar níveis de funcionalidade nas pessoas com AVC seis meses após a sua ocorrência e analisar a sua relação com as variáveis sócio demográficas, clínicas e funcionalidade familiar. Métodos: Trata-se de um estudo não experiment...

  18. Efeito do congelamento sobre a imunogenicidade da vacina contra a raiva produzida em tecido cerebral de camundongo

    Directory of Open Access Journals (Sweden)

    Albas Avelino

    2001-01-01

    Full Text Available A resposta imune humoral induzida pela vacina contra a raiva produzida em cérebros de camundongos recém-nascidos foi estudada em 23 cães e o teste de soroneutralização em camundongos foi usado para avaliação dos níveis de anticorpos rábicos. Um grupo com 10 animais recebeu vacina conservada de 2 a 8°C e apresentou os seguintes resultados: após 30 dias da vacinação 6 (60% amostras responderam ao teste; após 180 dias 4 (40% e após 360 dias apenas 1 (10%. O outro grupo com 13 cães recebeu vacina previamente congelada e somente 2 (15,4% amostras no dia 30 apresentaram resposta satisfatória; os demais períodos (180 e 360 após a vacinação, não foi encontrado título. A análise estatística dos dados referentes a cada uma das variáveis consideradas no estudo foi efetuada segundo a técnica de análise de variância seguida por Tuckey e indicaram diferenças estatisticamente significativas entre os grupos.

  19. Análise de conceito do resultado de enfermagem Mobilidade em pacientes com acidente vascular cerebral

    Directory of Open Access Journals (Sweden)

    Rafaella Pessoa Moreira

    2014-06-01

    Full Text Available O objetivo foi realizar análise do conceito do resultado de enfermagem Mobilidade em paciente com AVC. Realizou-se revisão integrativa da literatura, por meio de acesso on-line às bases: Scopus, Pubmed, Cinahl, Cochrane e Lilacs, usando-se os descritores: mobility, stroke, nursing e sinonímias nas línguas portuguesa e espanhola. Identificaram-se 1.521 artigos de que, após seleção criteriosa, resultaram 49. Destacam-se artigos publicados no Canadá (26,7%, a partir de 2001 (95,9%, por fisioterapeutas (34,6%, em unidades de reabilitação (61,5%. Atributos identificados para Mobilidade: andar, ficar em pé, sentar, colocar a perna de um lado para outro, virar-se, iniciar e parar a locomoção, subir escadas, função motora, transferência e habilidade motora. Também foi construído caso modelo, caso contrário e identificados antecedentes: controle postural e equilíbrio; e consequentes: realiza tarefas no interior e exterior da casa e deambula sem dificuldade. Os conceitos do resultado Mobilidade encontrados nesta pesquisa precisam ser validados com especialistas na área e na prática clínica.

  20. Tuberculoma cerebral Cerebral tuberculoma

    OpenAIRE

    ELIZABETH CLARA BARROSO; TÂNIA REGINA BRÍGIDO DE OLIVEIRA; ANA MARIA DANTAS DO AMARAL; VALÉRIA GÓES FERREIRA PINHEIRO; ANA LÚCIA DE OLIVEIRA SOUSA

    2002-01-01

    Relata-se o caso de paciente com crises convulsivas de início recente. A tomografia computadorizada cerebral evidenciou imagem sugestiva de lesão expansiva metastática frontoparietal direita. A investigação de tumor primário ou outra doença foi negativa e o exame histopatológico do tecido cerebral diagnosticou tuberculoma. As convulsões foram controladas com a associação de hidantoína 300mg/dia ao esquema específico, utilizado por 18 meses. A tuberculose do sistema nervoso central representa ...

  1. Temporal variation in memory tests performance in cerebral vascular disease patients / Variação temporal no desempenho em testes de memória em pacientes com doença vascular cerebral

    Directory of Open Access Journals (Sweden)

    Tania Fernandes Campos

    2007-01-01

    Full Text Available This study intended to investigate the performance in memory tests in order to adequate the neuropsychological evaluation to the temporal order of the human organism. Twelve cerebral vascular accident patients and 12 controls, of both sexes and 45-65 years old were studied. Two memory tests with visual stimuli (pictures and two with verbal stimuli (words were applied three times a day (08:00, 10:00 and 12:00 h during the first week and twice a day (14:00 and 16:00 h in the second week, during three consecutive days in two consecutive weeks. The patients showed lower scores than control subjects in all applied tests (p<0,05. The greater test sensitivity was at 14:00 h for the free recall test and at 16:00 h for recognition tests. According to these results, it is concluded that neuropsychological evaluations should be conducted preferably in the afternoon, as well for the first evaluation as for the re-evaluations.

  2. Hemorragia intracraniana espontânea em pediatria: relato de paciente hemofílico que sobreviveu devido a cisto cerebral

    Directory of Open Access Journals (Sweden)

    José Colleti Junior

    2015-12-01

    Full Text Available RESUMO Relatamos o caso de um uma criança de 2 anos de idade que sobreviveu após um episódio agudo de hemorragia intracraniana espontânea grave com sinais clínicos e radiológicos de hipertensão intracraniana e herniação transtentorial. O paciente foi para cirurgia de urgência para drenagem do hematoma, sendo inserido um cateter para monitorar a pressão intracraniana. Na análise da tomografia de crânio inicial, antes da drenagem do hematoma, constatou-se um cisto cerebral contralateral ao hematoma que, segundo análise do neurocirurgião e do neuroradiologista, possivelmente evitou um desfecho pior, visto que o cisto serviu de acomodação para o cérebro após a hemorragia maciça. Após investigação, constatou-se tratar de um caso de hemofilia tipo A sem diagnóstico prévio. O paciente foi tratado em terapia intensiva com controle da pressão intracraniana, reposição de fator VIII e obteve alta sem sequelas neurológicas evidentes.

  3. Brain hypoperfusion in adolescents dependent of multiple drugs Hipoperfusão cerebral em adolescentes dependentes de múltiplas drogas

    Directory of Open Access Journals (Sweden)

    Elba Cristina Sá de Camargo Etchebehere

    2010-04-01

    Full Text Available Brain SPECT imaging (BSI with statistical parametric mapping (SPM offers a clear and accurate vision of perfusion changes. OBJECTIVE: To study brain perfusion abnormalities in adolescents' dependent of multiple drugs. METHOD: Sixteen male patients (15.1±2.1 years were submitted to 99mTc-HMPAO BSI with SPM. RESULTS: Cortical hypoperfusion occurred in 7/16 patients (44%. There was a significant inverse correlation between the number of hypoperfused regions and the patient's age (p= -0.6737; p=0.004 and with the age when the drug dependence began (p= -0.5616; p=0.023. There was also a tendency towards an inverse correlation between regions of hypoperfusion and the duration of the drug dependence. CONCLUSION: BSI with SPM can help detect hypoperfusion in adolescents dependent on multiple drugs. The younger the patients, the more regions of hypoperfusion are noted. Probably, the neuronal plasticity has an important role in this phenomenon because the highest neural activity occurs in childhood.SPECT cerebral (SC com statistical parametric mapping (SPM oferece uma visão clara e acurada de alterações perfusionais. OBJETIVO: Avaliar anormalidades perfusionais cerebrais em adolescentes usuários de múltiplas drogas. MÉTODO: Dezesseis pacientes masculinos (15,1±2,1 anos foram submetidos a SC com SPM utilizando-se HMPAO-99mTc. RESULTADOS: Hipoperfusão cortical ocorreu em 7/16 pacientes (44%. Houve uma significativa correlação inversa entre o número de áreas hipoperfundidas e a idade dos pacientes (p= -0,6737; p=0,004 e com a idade quando iniciaram o abuso das drogas (p= -0,5616; p=0,023. Também houve uma tendência para uma correlação inversa entre as áreas de hipoperfusão e a duração do abuso de drogas. CONCLUSÃO: SC com SPM pode auxiliar na detecção de hipoperfusão cortical em adolescentes dependentes de múltiplas drogas. Quanto menor a idade, mais áreas de hipoperfusão são identificadas. Provavelmente a plasticidade neuronal

  4. Depressão, ansiedade e sonolência diurna em cuidadores primários de crianças com paralisia cerebral Depresión, ansiedad y somnolencia diurna en cuidadores primarios de niños con parálisis cerebral Depression, anxiety and daytime sleepiness of primary caregivers of children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Catherine Marx

    2011-12-01

    Full Text Available OBJETIVO: Avaliar os níveis de depressão, ansiedade e sonolência diurna excessiva em cuidadores primários de crianças com paralisia cerebral, relacionando-os às condições socioeconômicas do cuidador e às características neurológicas da criança e comparando-os a cuidadores de crianças saudáveis. MÉTODOS: 45 cuidadores de crianças com paralisia cerebral e 50 cuidadores de crianças saudáveis foram aleatoriamente incluídos no estudo e responderam a um questionário semiestruturado. Avaliaram-se os níveis de depressão, ansiedade e sonolência diurna excessiva por meio das escalas de Beck, ansiedade estado-traço e Epworth, respectivamente. RESULTADOS: A maioria dos entrevistados eram mães com baixo nível socioeconômico. Os que se autoavaliaram como ansiosos e depressivos apresentaram resultados comprobatórios de ansiedade e depressão com as escalas de ansiedade estado-traço e Beck para os cuidadores de crianças com paralisia cerebral. Os níveis de sonolência diurna excessiva estiveram relacionados a elevados níveis de depressão. O comprometimento neurológico das crianças não influenciou os resultados sobre os cuidadores. CONCLUSÕES: Depressão, ansiedade e problemas relacionados ao sono foram comuns em cuidadores de crianças com paralisia cerebral. O nível de funcionalidade neurológica da criança não influenciou os resultados.OBJETIVO: Evaluar los niveles de depresión, ansiedad y somnolencia diurna excesiva en cuidadores primarios de niños con parálisis cerebral relacionándolos a las condiciones socioeconómicas del cuidador y a las características neurológicas del niño y comparándolos a cuidadores de niños sanos. MÉTODOS: Se incluyeron aleatoriamente en el estudio a 45 cuidadores de niños con parálisis cerebral y a 50 cuidadores de niños sanos, y contestaron a un cuestionario semiestructurado. Se evaluaron los niveles de depresión, ansiedad y somnolencia diurna excesiva mediante las escalas de

  5. Fortalecimento muscular em adolescentes com paralisia cerebral: avaliação de dois protocolos em desenho experimental de caso único

    Directory of Open Access Journals (Sweden)

    Sheyla Rossana Cavalcanti Furtado

    2015-03-01

    Full Text Available Objetivos: descrever mudanças na função motora de dois adolescentes com diplegia espástica, sendo um deles participante de um protocolo de fortalecimento muscular isolado (FMI e o outro de protocolo de fortalecimento com tarefas funcionais (FTF. Métodos: desenho experimental de caso único, metodologia que revela a temporalidade do perfil de mudanças ao longo e após a terapia. Este desenho incluiu fases de baseline, de intervenção e de followup com quatro, seis e três semanas, respectivamente. Participantes foram duas adolescentes com displegia espástica submetidas, cada uma, a um protocolo de intervenção: fortalecimento muscular isolado (FMI ou fortalecimento com tarefas funcionais (FTF. Os protocolos de intervenção incluíram exercícios de fortalecimento muscular isolado de extensores de quadril, extensores de joelho e flexores plantares (para a participante do FMI, ou de exercícios funcionais para as mesmas musculaturas (para a participante do FTF. Mensurações três vezes por semana avaliaram força muscular, velocidade de marcha, tempo para subir e descer escadas, tempo para se levantar do chão e tempo no teste Timed Get Up and Go. Os dados foram analisados com Celeration Line, Amplitude de Dois Desvios Padrão e Análise Visual. Resultados: ganhos de força muscular de membros inferiores foram observados nas adolescentes submetidas a ambos os protocolos. Mudanças nas atividades motoras foram observadas em 2 das 4 tarefas testadas em somente uma das adolescentes (p<0,05. Conclusões: a especificidade funcional do protocolo de fortalecimento FTF produziu modestos efeitos no desempenho de atividades motoras de uma das adolescentes com PC, em acréscimo aos ganhos de força muscular produzidos por ambos os protocolos.

  6. Análise eletromiográfica durante sessões de equoterapia em praticantes com paralisia cerebral

    Directory of Open Access Journals (Sweden)

    Ana Paula Espindula

    2012-01-01

    Full Text Available Introduction. Hippotherapy has emerged as a form of treatment for individuals with Cerebral Palsy (CP. Objective. To verify the effect of the mount type in the muscular activity in patients with CP. Methods. Three practitioners with CP were evaluated by electromyography during four hippotherapy sessions. In each session the mount condition was changed. A descriptive statistical analysis with mean and standard deviation of normalized RMS was performed. Results. The trapezius muscle was always active in the positions initial sitting and final sitting, in all mount conditions, except in the saddle without the feet support. At the three moments evaluated during sessions, it was observed in the condition horse with blanket, that muscle activity was also high in trapezius compared to the other muscles. The feet support allowed a more homogeneous activation of the trunk muscles evaluated, when compared to lack of support. Conclusion. To use saddle on foot in the stirrup was the best option for the hippotherapy treatment of the hemiparetic individuals evaluated.

  7. A self-adapting system for the automated detection of inter-ictal epileptiform discharges.

    Directory of Open Access Journals (Sweden)

    Shaun S Lodder

    Full Text Available PURPOSE: Scalp EEG remains the standard clinical procedure for the diagnosis of epilepsy. Manual detection of inter-ictal epileptiform discharges (IEDs is slow and cumbersome, and few automated methods are used to assist in practice. This is mostly due to low sensitivities, high false positive rates, or a lack of trust in the automated method. In this study we aim to find a solution that will make computer assisted detection more efficient than conventional methods, while preserving the detection certainty of a manual search. METHODS: Our solution consists of two phases. First, a detection phase finds all events similar to epileptiform activity by using a large database of template waveforms. Individual template detections are combined to form "IED nominations", each with a corresponding certainty value based on the reliability of their contributing templates. The second phase uses the ten nominations with highest certainty and presents them to the reviewer one by one for confirmation. Confirmations are used to update certainty values of the remaining nominations, and another iteration is performed where ten nominations with the highest certainty are presented. This continues until the reviewer is satisfied with what has been seen. Reviewer feedback is also used to update template accuracies globally and improve future detections. KEY FINDINGS: Using the described method and fifteen evaluation EEGs (241 IEDs, one third of all inter-ictal events were shown after one iteration, half after two iterations, and 74%, 90%, and 95% after 5, 10 and 15 iterations respectively. Reviewing fifteen iterations for the 20-30 min recordings 1 took approximately 5 min. SIGNIFICANCE: The proposed method shows a practical approach for combining automated detection with visual searching for inter-ictal epileptiform activity. Further evaluation is needed to verify its clinical feasibility and measure the added value it presents.

  8. Evaluation of EEG localization methods using realistic simulations of interictal spikes.

    Science.gov (United States)

    Grova, C; Daunizeau, J; Lina, J-M; Bénar, C G; Benali, H; Gotman, J

    2006-02-01

    Performing an accurate localization of sources of interictal spikes from EEG scalp measurements is of particular interest during the presurgical investigation of epilepsy. The purpose of this paper is to study the ability of six distributed source localization methods to recover extended sources of activated cortex. Due to the frequent lack of a gold standard to evaluate source localization methods, our evaluation was performed in a controlled environment using realistic simulations of EEG interictal spikes, involving several anatomical locations with several spatial extents. Simulated data were corrupted by physiological EEG noise. Simulations involving pairs of sources with the same amplitude were also studied. In addition to standard validation criteria (e.g., geodesic distance or mean square error), we proposed an original criterion dedicated to assess detection accuracy, based on receiver operating characteristic (ROC) analysis. Six source localization methods were evaluated: the minimum norm, the minimum norm weighted by multivariate source prelocalization (MSP), cortical LORETA with or without additional minimum norm regularization, and two derivations of the maximum entropy on the mean (MEM) approach. Results showed that LORETA-based and MEM-based methods were able to accurately recover sources of different spatial extents, with the exception of sources in temporo-mesial and fronto-mesial regions. Several spurious sources were generated by those methods, however, whereas methods using the MSP always located very accurately the maximum of activity but not its spatial extent. These findings suggest that one should always take into account the results from different localization methods when analyzing real interictal spikes. PMID:16271483

  9. Comparison study of SPECT, EEG and CT in 50 epileptic patients during interictal seizures

    International Nuclear Information System (INIS)

    The authors present a comparison study of SPECT, EEG and CT in 50 epileptic patients during interictal. SPECT showed an abnormal rate of 76 per cent. The abnormal findings of EEG conformed to SPECT in 45.6% patients. If CT scan shows a focal abnormality, 85% of local abnormal finding may also be found in SPECT. But not all SPECT abnormal findings were epileptic foci. SPECT, EEG and CT can not be replaced by each other. When using the three examinations at the same time we can know much about epileptic focus from anatomy and physiology

  10. Effect of medication withdrawal on the interictal epileptiform EEG discharges in presurgical evaluation

    DEFF Research Database (Denmark)

    Andersen, N.B.; Alving, J.; Beniczky, S.

    2010-01-01

    producing epileptiform discharges, leading to a false localization of the irritative zone. In order to investigate this we reviewed 42 consecutive cases of MW, of 36 patients, during a 3-year period. We compared seizure frequency, seizure-types and the localization of interictal epileptiform discharges...... before and after MW. Seizure frequency was significantly higher after MW. In the whole group we found an increase in seizure propagation: the proportion of the complex partial seizures and secondarily generalised seizures increased, while the proportion of the simple partial seizures decreased following...

  11. Effect of medication withdrawal on the interictal epileptiform EEG discharges in presurgical evaluation

    DEFF Research Database (Denmark)

    Andersen, N.B.; Alving, J.; Beniczky, S.

    2010-01-01

    Medication withdrawal (MW) is an important method of provoking seizures and activating epileptiform EEG activity during the diagnostic work-up of patients evaluated for epilepsy surgery. Previously it was suggested that MW might influence the seizure-type and activate cortical areas otherwise not...... producing epileptiform discharges, leading to a false localization of the irritative zone. In order to investigate this we reviewed 42 consecutive cases of MW, of 36 patients, during a 3-year period. We compared seizure frequency, seizure-types and the localization of interictal epileptiform discharges...

  12. Epileptic patterns of local cerebral metabolism and perfusion in man determined by emission computed tomography of 18FDG and 13NH3

    International Nuclear Information System (INIS)

    Seventeen patients with partial epilepsy had EEG monitoring concurrent with cerebral emission computed tomography (ECT) after 18F-fluorodeoxyglucose (18FDG) and 13N-ammonia were given intravenously as indicators of local cerebral glucose utilization (LCMR/sub glc/) and relative perfusion, respectively. In 12 of 15 patients who had unilateral or focal electrical abnormalities, interictal 18FDG scan patterns clearly showed localized regions of decreased (20% to 50%) LCMR/sub glc/, which correlated anatomically with the eventual EEG localization. These hypometabolic zones appeared normal on x-ray computed tomography in all but three patients and were unchanged on scans repeated on different days. In 5 of 6 patients who underwent temporal lobectomy, the interictal 18FDG scan correctly detected the pathologically confirmed lesion as a hypometabolic zone, and removal of the lesion site resulted in marked clinical improvement. In contrast, the ictal 18FDG scan patterns clearly showed foci of increased (82% to 130%) LCMR/sub glc/, which correlated temporally and anatomically with ictal EEG spike foci and were within the zones of interictal hypometabolism (3 studies in 2 patients). 13NH3 distributions paralleled 18FDG increases and decreases in abnormal zones, but 13NH3 differences were of lesser magnitude. When the relationship of 13NH3 uptake to local blood flow found in dog brain was applied as a correction to the patients' 13NH3 scan data, local alterations in perfusion and glucose utilization were usually matched, both in the interictal and ictal states

  13. 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 ...

  14. Counting the pluses and minuses. The use of normalised subtracted ictal/interictal 99mTc-HMPAO brain scans

    International Nuclear Information System (INIS)

    The localisation of an epileptic focus using 99mTc HMPAO injected during seizures as well as in the interictal state is a technique frequently used pre-operatively to assess the suitability of a patient for surgery. These findings are used in conjunction with clinical assessment, video telemetry, electro-encephalogram (EEG) and magnetic resonance imaging (MRI), sometimes with co-registration with the 99mTc HMPAO SPECT studies. Interpretation of these scans has routinely been performed qualitatively, relying upon the reporting physicians to identify hyperperfusion on the ictal scan and normalisation or hypoperfusion in the same area on the interictal scan. However, differences between the ictal and interictal scans such as dissimilar reconstruction filter and axis of reorientation confound the degree of physician certainty in correctly reporting the ictal/interictal scans. Recently investigators have proposed a potential solution to this problem. In this method, the two scans are matched in order to remove variation due to positioning, then the studies are normalised to the same activity in a standard area, all following reconstruction with identical parameters. Additional quantitative information could be gained by subtracting the interictal from the ictal images and then assigning a zero value to ali negatives in order to identify areas where the ictal study is hyperperfused. Conversely, subtraction of ictal from interictal images would identify areas which are hypoperfused during seizures. The value of this matched, normalised and subtracted ictal / interictal method was assessed at Westmead Hospital''s Nuclear Medicine Department and compared to the routine qualitative assessment of a group of patients with epilepsy. A group of 14 patients (9 men, 5 women) with a mean age of 28.3 years (range 13-58 ) who had undergone ictal and interictal 99mTc -HMPAO SPECT studies at Westmead Hospital were retrospectively studied. All patients had also been assessed with

  15. Cerebral Atrophy

    Science.gov (United States)

    ... Alzheimer’s disease, Pick’s disease, and fronto-temporal dementia cerebral palsy , in which lesions (damaged areas) may impair motor ... lead to cerebral atrophy. NIH Patient Recruitment for Cerebral Atrophy Clinical Trials ... by: Office of Communications and Public Liaison National Institute of Neurological Disorders ...

  16. Interictal Spect with Tc-99m ECD studies in migraine patients. Role of Spect in the diagnosis of migraine with ura in headache-free periods

    International Nuclear Information System (INIS)

    Aim: The migraine is one of the neurological alterations more frequent provoking a discharge morbility and big inconveniences the one that endures it. The presence of brain perfusion abnormalities during the pain-free intervals of migraine even is fueling of controversies being so numerous the supporters of its existence as whom they deny it. This study was aimed at assessing the presence of cerebral perfusion abnormalities also during the interictal phase and the role of SPECT with Tc99 ECD on diagnosis of this migrainous patients. Materials And Methods: We studied 20 patients (16 woman and 4 man) with diagnose of migraine with aura during a periods without headache and 20 apareaded controls for age and sex of this patients.Was realized brain spect with 925 MBq Tc99m-ECD on a two heads rotating gamma camera (Piker Axis) equipped with a fan-beam collimator. The images were reconstructed using a filter Mezt and presented in courts in the three axes and reconstruction in three dimensions and later they were analyzed by two observers. Results: We found 14 of the patients (70%) with images of focal hypoperfusion with clear interhemispheric asymmetry while on control groups only two have this find (10%) being this difference statistically significant. The part of the brain more affected was the occipital one, though also they predominated over the more widespread hipocaptations. Conclusion: The brain Spect is a useful technology to identify the patients with migraine, being able to be used in the periods without pain. The boss of perfusion in the patients is the located hypoperfusion and is significantly different from that of the controls, It can be explained by an impaired regional cerebral vascular autoregulation may exist even during headache-free intervals in patients suffering from migraine. Future studies must be realized to determine if it exists relation between the zone of hypoperfusion and the type of present symptomatology in the aura

  17. Aspectos da proteção cerebral em pacientes submetidos a tromboendarterectomia pulmonar com hipotermia profunda e parada circulatória intermitente

    Directory of Open Access Journals (Sweden)

    HUEB Alexandre C.

    2000-01-01

    Full Text Available INTRODUÇÃO: A tromboendarterectomia pulmonar é utilizada como método bem estabelecido para aliviar a hipertensão pulmonar nos casos de tromboembolismo pulmonar crônico. A dificuldade que se apresenta é conciliar o tempo relativamente exíguo de parada circulatória total (PCT hipotérmica com a completa desobstrução das artérias pulmonares, sob pena de danos neurológicos. CASUÍSTICA E MÉTODOS: No período de março de 1998 a abril de 1999 (13 meses, 8 pacientes, 5 do sexo masculino, 1 de cor negra, com idade variando entre 25 a 56 anos (média 46,2 anos e com diagnóstico angiográfico de tromboembolismo pulmonar, foram submetidos a tromboendarterectomia pulmonar uni ou bilateral por tromboembolismo pulmonar crônico (TEP. Instalado o circuito extracorpóreo e incisada a artéria pulmonar, procede-se à PCT e, aproximadamente a cada 20 minutos de procedimento, intermitentemente, o fluxo da circulação extracorpórea (CEC é restabelecido a 14º C por um período de 15 minutos objetivando-se a reperfusão cerebral e corpórea. Sucessivas paradas circulatórias total são realizadas e tantas quanto forem necessárias até a remoção de todos os trombos da artéria pulmonar. RESULTADOS: Não foram registrados óbitos no transoperatório. Um paciente faleceu no 30º dia de pós-operatório (PO devido a broncopneumonia que evoluiu para sepse. Os 8 pacientes foram submetidos a CEC e PCT hipotérmica, sendo que em 5 (62,5% foram necessárias 4 PCT e em 3 (37,5% apenas 3 PCT, com média de 3,6 PCT. O tempo total de CEC variou de 210 a 255 minutos, com média de 225 minutos. O tempo de PCT hipotérmica variou de 58 a 88 minutos, com média de 76,7 minutos e o período de PCT por paciente variou de 18 a 24 minutos, com média de 20,5 minutos. Em todos os pacientes foram realizadas tomografias de crânio, que não revelaram nenhuma alteração anatômica, assim como o exame físico não revelou déficit motor ou rebaixamento do sens

  18. What is the significance of interictal water diffusion changes in frontal lobe epilepsies?

    Science.gov (United States)

    Guye, M; Ranjeva, J P; Bartolomei, F; Confort-Gouny, S; McGonigal, A; Régis, J; Chauvel, P; Cozzone, P J

    2007-03-01

    The aim of this study was to better understand the significance of interictal changes in water molecule diffusivity defined by diffusion-weighted imaging (DWI) in frontal lobe epilepsy (FLE), as well as to test the accuracy of interictal DWI in the definition of the epileptogenic zone (EZ). DWI was carried out in 14 patients with refractory FLE (9 negative-MRI) as well as in 25 controls. Statistical mapping analysis (SPM2) of diffusivity maps was used to detect, for each subject, significant diffusivity alterations. We then studied the relationships between diffusion and depth recorded electrical abnormalities. Clinical correlates of the extent of diffusivity changes were also tested. We found areas of significantly increased diffusivity (SID) in 13 patients. Eight had SID in the EZ, 9 within the irritative zone (IZ) and 12 outside, mainly in connected areas. We found a correlation between the extent of SID and the duration of epilepsy (p corrected=0.026, R=0.621). In addition, SID was significantly less widespread in negative-MRI patients (p=0.028). However, we found no significant differences concerning either seizure frequency (p=0.302), seizure generalization (p=0.841), history of status (p=0.396), or surgical outcome (p=0.606). We suggest that SID in normal appearing areas is not a specific signature of epileptogenicity in FLE, and is more likely to reflect multifactorial and potentially evolving neuro-glial injuries. PMID:17239624

  19. Acidente vascular cerebral precoce: implicações para adultos em idade produtiva atendidos pelo Sistema Único de Saúde Early cerebrovascular accident: implications in working-age adults assisted by the Brazilian Public Health System

    OpenAIRE

    Ilka Veras Falcão; Eduardo Maia Freese de Carvalho; Kátia Magdala Lima Barreto; Fabio José Delgado Lessa; Valéria Moura Moreira Leite

    2004-01-01

    OBJETIVOS: conhecer as incapacidades e identificar se há diferenças de gênero, em sobreviventes de primeiro episódio de acidente vascular cerebral (AVC), entre 20 e 59 anos de idade, na cidade do Recife e que tenham sido hospitalizados pelo Sistema Único de Saúde. MÉTODOS: entrevista domiciliar com uma amostra de sobreviventes, investigando-se as incapacidades referidas na vida funcional e produtiva deles. RESULTADOS: amostra equilibrada entre os sexos, média de idade de 52 anos, com nível el...

  20. Qualidade de vida em sobreviventes de acidente vascular cerebral: instrumentos de avaliação e seus resultados Quality of life in stroke survivors: assessment instruments and their outcomes

    OpenAIRE

    Juliana Ferreira Mota; Rodrigo Nicolato

    2008-01-01

    OBJETIVOS: Os objetivos deste estudo foram identificar os instrumentos genéricos e específicos utilizados na avaliação da qualidade de vida (QV) e os seus resultados em sobreviventes de acidente vascular cerebral (AVC). MÉTODOS: Realizou-se revisão da literatura dos últimos dez anos, com população acima de 18 anos, nos bancos de dados MedLine e Lilacs, cujas publicações utilizassem instrumentos padronizados e validados no país de origem. Combinaram-se os descritores quality of life, cerebrova...

  1. Detection of Interictal Epileptiform Discharges Using Signal Envelope Distribution Modelling: Application to Epileptic and Non-Epileptic Intracranial Recordings

    Czech Academy of Sciences Publication Activity Database

    Janča, R.; Ježdík, P.; Čmejla, R.; Tomášek, M.; Worrell, G. A.; Stead, M.; Wagenaar, J.; Jefferys, J. G. R.; Kršek, P.; Komárek, V.; Jiruška, Přemysl; Marusič, P.

    2015-01-01

    Roč. 28, č. 1 (2015), s. 172-183. ISSN 0896-0267 Grant ostatní: GA Mzd(CZ) NT11460 Institutional support: RVO:67985823 Keywords : spike detection * interictal epileptiform discharges * intracranial recording * automatic detection * Hilbert transform * principal component analysis Subject RIV: FH - Neurology Impact factor: 3.468, year: 2014

  2. Convulsive status epilepticus duration as determinant for epileptogenesis and interictal discharge generation in the rat limbic system

    Science.gov (United States)

    Bortel, Aleksandra; Lévesque, Maxime; Biagini, Giuseppe; Gotman, Jean; Avoli, Massimo

    2016-01-01

    We analyzed with EEG-video monitoring the epileptic activity recorded during the latent and chronic periods in rats undergoing 30 or 120 min pilocarpine-induced convulsive status epilepticus (SE). Interictal discharges frequency in the entorhinal cortex (EC) of animals exposed to 120 min SE was significantly higher in the chronic than in the latent period. Following seizure appearance, interictal spikes diminished in duration in the CA3 of the 120 min SE group, and occurred at higher rates in the amygdala in all animals. Rats exposed to 120 min SE generated shorter seizures but presented twice as many non-convulsive seizures per day as the 30 min group. Finally, seizures most frequently initiated in CA3 in the 120 min SE group but had similar onset in CA3 and EC in the 30 min group. These findings indicate that convulsive SE duration influences the development of interictal and ictal activity, and that interictal discharges undergo structure-specific changes after seizure appearance. PMID:20682341

  3. Brain tissue aspiration neural tube defect Aspiração de tecido cerebral em casos de defeitos de fechamento do tubo neural

    Directory of Open Access Journals (Sweden)

    Luiz Cesar Peres

    2005-09-01

    Full Text Available The study aimed to find out how frequent is brain tissue aspiration and if brain tissue heterotopia could be found in the lung of human neural tube defect cases. Histological sections of each lobe of both lungs of 22 fetuses and newborn with neural tube defect were immunostained for glial fibrillary acidic protein (GFAP. There were 15 (68.2% females and 7 (31.8% males. Age ranged from 18 to 40 weeks of gestation (mean= 31.8. Ten (45.5% were stillborn, the same newborn, and 2 (9.1% were abortuses. Diagnosis were: craniorrhachischisis (9 cases, 40.9%, anencephaly (8 cases, 36,4%, ruptured occipital encephalocele and rachischisis (2 cases, 9.1% each, and early amniotic band disruption sequence (1 case, 4.5%. Only one case (4.5% exhibited GFAP positive cells inside bronchioles and alveoli admixed to epithelial amniotic squames. No heterotopic tissue was observed in the lung interstitium. We concluded that aspiration of brain tissue from the amniotic fluid in neural tube defect cases may happen but it is infrequent and heterotopia was not observed.O objetivo do estudo foi identificar qual a freqüência de aspiração de tecido cerebral e a existência de heterotopia nos pulmões de casos humanos de defeito de fechamento do tubo neural através da reação imuno-histoquímica para proteína fibrilar glial ácida (GFAP em cortes histológicos de todos os lobos de ambos os pulmões de 22 casos de fetos e neonatos com defeito de fechamento do tubo neural. Havia 15 casos femininos (68,2% e 7 masculinos (31,8%, com idade gestacional variando de 18 a 40 semanas (média= 31,8, sendo natimortos e neomortos 10 (45,5% cada e 2 (9,1% abortos. Os diagnósticos foram: Craniorraquisquise (9 casos, 40,9%, anencefalia (8 casos, 36,4%, encefalocele occipital rota e raquisquise (2 casos, 9,1% e 1 (4,5%caso de seqüência de disruptura amniótica precoce. Somente 1 caso (4,5% apresentou células positivas dentro de bronquíolos e alvéolos em meio a células epiteliais

  4. Análise dos efeitos da utilização da tala seriada em crianças portadoras de paralisia cerebral: uma revisão sistemática da literatura Analysis of the effects of the use of serial casting in children with cerebral palsy: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Natália Coutinho Calcagno

    2006-03-01

    Full Text Available OBJETIVOS: realizar uma revisão sistemática da literatura através da seleção e análise criteriosa de artigos científicos que investigaram os efeitos da tala seriada em crianças com diagnóstico clínico de paralisia cerebral espástica. MÉTODOS: busca sistemática na literatura foi realizada no período de março a agosto de 2004, nas bases de dados eletrônicas Medline, Lilacs e PEDro publicados nas línguas inglês e português, no período de 1980 a 2004. O nível de evidência dos artigos estudados foi qualificado utilizando-se a escala Magee. RESULTADOS: os quatro artigos incluídos nessa revisão preencheram todos os critérios de inclusão e foram classificados como fracos de acordo com a escala Magee (índice de concordância Kappa K=1,0 devido às limitações metodológicas apresentadas. CONCLUSÕES: as evidências utilizadas nessa revisão sistemática não apresentam nível que possa suportar a utilização clínica da tala seriada em crianças com paralisia cerebral. Futuras pesquisas devem ser realizadas em observância à necessidade de maior rigor metodológico dos estudos para a fundamentação da prática baseada em evidência.OBJECTIVES: to perform a systematic literature review through a careful survey of scientific articles investigating serial casting effects in children clinically diagnosed with spastic cerebral palsy. METHODS: systematic literature survey performed during the period of March to August 2004, in Medline, Lilacs and PEDro electronic databases published in English and Portuguese from 1980 to 2004. The evidence level of the articles studied was rated according to the Magee scale. RESULTS: the four articles included in this review met all the inclusion criteria and were rated poor according to the Magee scale (agreement index Kappa K = 1.0 due to the methodological limitations determined. CONCLUSIONS: the evidence used in this systematic review was insufficient to support the use of serial casting in

  5. Avaliação da flexibilidade pelo método do Flexômetro de Wells em crianças com Paralisia Cerebral submetidas a tratamento hidroterapêutico: estudo de casos = Flexibility evaluation by the method of Wells’ Flexometer in children with Cerebral Palsy submitted to hydrotherapy treatment: study of the cases

    OpenAIRE

    Vicente de Paula Antunes Teixeira; Marlene Antônia Reis; Débora Tavares Resende Silva Abate; Ana Paula Espindula; Millena Prata Jammal; Camila Souza de Oliveira Guimarães

    2010-01-01

    Avaliar a flexibilidade da cadeia muscular posterior, utilizando o método proposto por Wells e Dillon, antes e após cada sessão de hidroterapia. Foi verificada a flexibilidade de três crianças com Paralisia Cerebral (PC) diparéticas, com idades entre sete a dez anos. Os valores de flexibilidade foram aferidos, utilizando o Flexômetro de Wells. Houve aumento significativo da flexibilidade da cadeia muscular posterior dos pacientes após cada sessão de hidroterapia, tanto na avaliação em grupo q...

  6. Slow pseudoperiodic lateralized epileptiform discharges in nonconvulsive status epilepticus in a patient with cerebral palsy and a large central meningioma

    Directory of Open Access Journals (Sweden)

    Y.Z. Imam

    2014-01-01

    Full Text Available The presence of cerebral palsy and that of slow growing brain tumors are risk factors for convulsive and nonconvulsive status epilepticus. Nonconvulsive status epilepticus (NCSE needs electroencephalographic (EEG monitoring to be confirmed as it may be clinically subtle. Furthermore, it may present with a variety of ictal EEG morphologies. We report a case of a patient with cerebral palsy and a large central meningioma. Electroencephalogram showed a slow pattern of periodic lateralized epileptiform discharges (PLEDs (a pattern considered as being situated in the ictal–interictal continuum on an alpha background. The patient was treated for NCSE successfully with benzodiazepines followed by up-titration of his antiepileptic drug doses.

  7. Análise das intervenções de terapia ocupacional no desempenho das atividades de vida diária em crianças com paralisia cerebral: uma revisão sistemática da literatura Analysis of occupational therapy interventions in the performance of everyday activities in children with cerebral palsy: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Vanessa Pio Diniz Guerzoni

    2008-03-01

    Full Text Available OBJETIVOS: avaliar, através da seleção e análise criteriosa de artigos, os efeitos das intervenções voltadas para a promoção do desempenho de atividades de vida diária, utilizadas por terapeutas ocupacionais, em crianças com paralisia cerebral. MÉTODOS: a busca na literatura foi realizada nas bases eletrônicas: Ovid, Medline, CINAHL e Lilacs, incluindo artigos publicados entre janeiro de 2001 e maio de 2006, nos idiomas inglês e português, utilizando os seguintes descritores: "terapia ocupacional", "paralisia cerebral" e "criança". Foram selecionados quatro estudos, seguindo critérios de inclusão pré-definidos, avaliados quanto à qualidade metodológica com a escala OTSeeker. RESULTADOS: a análise da qualidade metodológica dos estudos selecionados revelaram pontuações de magnitudes baixa à moderada na escala OTSeeker. Foram encontradas diferenças quanto ao tipo de intervenção utilizada para a promoção das atividades de vida diária, bem como dos desfechos investigados. CONCLUSÕES: a análise crítica dos artigos sugere que o contexto no qual a criança com paralisia cerebral está inserida parece ser um fator importante no seu desempenho funcional. A avaliação sistemática da literatura sobre os efeitos de intervenções de Terapia Ocupacional na promoção de atividades de vida diária em crianças com paralisia cerebral poderá contribuir para uma prática baseada em evidências, entre esses profissionais.OBJECTIVES: to evaluate, by means of a careful search for and analysis of articles, the effects of interventions used by occupational therapists to improve the performance of everyday activities in children with cerebral palsy. METHODS: the search for literature on the subject was conducted using the electronic databases Ovid, Medline, CINAHL and LILACS, and covered articles published between January 2001 and May 2006, in English or Portuguese, using the following keywords: "occupational therapy", "cerebral

  8. Análise da consistência alimentar e tempo de deglutição em crianças com paralisia cerebral tetraplégica espástica Analysis of alimentary consistency and deglutition time in children with spastic quadriplegic cerebral palsy

    Directory of Open Access Journals (Sweden)

    Graziela Pacheco Vivone

    2007-12-01

    Full Text Available OBJETIVO: avaliar a consistência alimentar e o tempo de deglutição em crianças que apresentam Paralisia Cerebral Tetraplégica Espástica. MÉTODOS: foram avaliadas 30 crianças entre 0 e 12 anos, com Paralisia Cerebral do tipo tetraplegia espástica, em acompanhamento fonoaudiológico, sendo utilizado um protocolo de avaliação nos padrões de deglutição. RESULTADOS: os dados coletados mostraram a fase oral ineficiente ou ausente em 27crianças (90% e a fase faríngea com anormalidades ou inadequações em 21 crianças (70%. Mais da metade das crianças avaliadas apresentaram disfunção motora oral (DMO entre moderada e grave. Em relação à consistência do alimento e os tempos de deglutição, as crianças com Função Motora Oral profundamente comprometida levam 14,2 vezes mais tempo para deglutir alimentos líquidos e 6,4 vezes mais para o alimento pastoso. CONCLUSÃO: diante do estudo realizado, é possível concluir que a maior dificuldade da criança que apresenta paralisia cerebral é a fase oral da deglutição e quanto maior a disfunção motora oral, maior o tempo gasto para deglutir os alimentos nas três consistências pesquisadas. As relações entre DMO e tempo de deglutição estão diretamente relacionadas.PURPOSE: to evaluate the alimentary consistency and the deglutition time in children with Cerebral Palsy. METHODS: 30 children between 0 and 12 years, with Cerebral Paralysis of the quadriplegic spastic type been evaluated, that were under speech pathology follow-up. RESULTS: the collected data showed that the verbal phase demonstrated to be inefficient or absent in the majority of the children, as well as in the pharyngeal phase of deglutition. More of the half of the evaluated children have shown between moderate to acute verbal motor dysfunction. In relation to the consistency of food and deglutition times, the children with deeply compromised OMF (Oral Motor Function took more 14.2 times to swallow liquid foods

  9. Regressão da anestesia geral em pacientes com paralisia cerebral: estudo comparativo utilizando o índice bispectral Regresión de la anestesia general en pacientes con parálisis cerebral: estudio comparativo utilizando el índice bispectral Regression of general anesthesia in patients with cerebral palsy: a comparative study using the bispectral index

    Directory of Open Access Journals (Sweden)

    Verônica Vieira da Costa

    2006-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: É descrito que os pacientes com paralisia cerebral (PC são mais sensíveis aos agentes anestésicos que poderia comprometer o despertar da anestesia. O objetivo deste estudo foi avaliar a recuperação de pacientes com PC comparada com pacientes sem doença do SNC. MÉTODO: Participaram do estudo crianças de 5 a 15 anos, divididas em dois grupos: com diagnóstico de paralisia cerebral e sem doença do SNC. Todas foram submetidas à anestesia geral com sevoflurano associado a óxido nitroso e oxigênio a 50%. Além da monitorização habitualmente empregada, foram monitorizadas com o EEG-BIS. Durante o despertar da anestesia, a extubação traqueal e o pós-anestésico imediato, foi avaliada a regressão da anestesia segundo os critérios adotados por Saraiva. Avaliou-se também a velocidade de eliminação dos agentes anestésicos correlacionando-a com os valores de EEG-BIS e comparando os dois grupos de pacientes. A análise estatística foi realizada por meio da análise exploratória de dados e teste estatístico para comparação de médias, considerando como diferença estatística significativa o valor de p menor ou igual a 5%. RESULTADOS: Foram avaliados 56 pacientes, sendo 31 com PC e 25 sem doença do SNC. Os grupos foram homogêneos com relação à idade e ao sexo. O valor do EEG-BIS basal dos pacientes com PC foi menor do que o grupo-controle, com diferença estatística significativa (p = 0,04. Nos cinco primeiros minutos após a interrupção do sevoflurano, o valor do EEG-BIS dos pacientes com PC apresentou elevação mais lenta com relação ao controle. A velocidade de eliminação do agente anestésico foi semelhante nos dois grupos. Aos 15 minutos, 48% dos pacientes do grupo-controle estavam no estágio III de regressão anestésica, versus 29% do grupo com paralisia cerebral. Aos 30 minutos, 72% dos pacientes do grupo-controle estavam aptos para receber alta, no estágio IV de regressão anest

  10. Spatio-Temporal Structuring of Brain Activity - Description of Interictal EEG in Paediatric Frontal Lobe Epilepsy

    CERN Document Server

    Bunk, W; Kluger, G; Springer, S

    2009-01-01

    A method for the quantitative assessment of spatio-temporal structuring of brain activity is presented. This approach is employed in a longitudinal case study of a child with frontal lobe epilepsy (FLE) and tested against an age-matched control group. Several correlation measures that are sensitive to linear and/or non-linear relations in multichannel scalp EEG are combined with an hierarchical cluster algorithm. Beside a quantitative description of the overall degree of synchronization the spatial relations are investigated by means of the cluster characteristics. The chosen information measures not only demonstrate their suitability in the characterization of the ictal and interictal phases but they also follow the course of delayed recovery of the psychiatric symptomatology during successful medication. The results based on this single case study suggest testing this approach for quantitative control of therapy in an extended clinical trial.

  11. Reproducible localization of interictal epileptiform discharges using EEG-triggered fMRI

    International Nuclear Information System (INIS)

    We report preliminary experiences using fMRI triggered by EEG to localize the site of interictal epileptiform activity. EEG was recorded in the scanner and monitored on-line; the recording quality was good enough to allow the clear identification of spikes in the EEG. Snap-shot EPI was performed 2-4 s after an epileptiform discharge ('spike') or after at least 10 s of background activity ('rest') was observed. A pixel-by-pixel t-test was performed between the 'rest' and the 'spike' images to determine areas of significant activation. Significant activation was obtained in a patient with epilepsy. To assess the reliability and reproducibility of the technique, the patient was scanned on four separate occasions with similar areas being activated in all the studies, confirming the validity of the result. (author)

  12. Is Interictal EEG Correlated with the Seizure Type in Idiopathic (Genetic Generalized Epilepsies?

    Directory of Open Access Journals (Sweden)

    Ali Akbar ASADI-POOYA

    2012-06-01

    Full Text Available How to Cite this Article: Asadi-pooya AA, Emami M. Is Interictal EEG Correlated with the Seizure Type in Idiopathic (Genetic Generalized Epilepsies? Iran J Child Neurol 2012;6(2: 25-28. Objective We investigated the correlation between different interictal EEG abnormalities observed in patients with idiopathic (genetic generalized epilepsies (IGEs and their seizure types. Material & Methods In this cross-sectional study, all patients with the diagnosis of IGE, were recruited in the outpatient epilepsy clinic at Shiraz University of Medical Sciences, Iran, from 2008 through 2010. Demographic variables and relevant clinical and EEG variables were summarized descriptively. Statistical analyses were performed using independent samples T-test, Chi square and Fisher's Exact tests to determine potentially significant differences. Results Three-hundred thirty-six patients were diagnosed ashaving IGE. Interictal EEG findings in patients with generalized tonic-clonic seizure (GTCS compared to patients without GTCS were not different. Abnormal EEG findings in patients with myoclonic seizures compared to patients without these were not different either. However, normal EEGs were more frequently observed in patients with history of myoclonic seizures (P = 0.0001. EEG findings in patients with absences compared to patients without absences were not different. Conclusion Interictal EEG cannot differentiate the seizure types and therefore different syndromes of IGEs. Polyspikes, 3-Hz generalized spike-wave (GSW complexes and 3.5 - 6 Hz GSW complexes, alone or in combinations, could be observed in various seizure types and syndromes of IGE. The key element in making the correct diagnosis is a detailed clinical history. References Panayiotopoulos CP. Idiopathic generalized epilepsies. In: Panayiotopoulos CP, editor. The epilepsies: seizures, syndromes and management. Oxford: Bladon Medical Publishing 2005. p. 271-348. Lagerlund TD, Cascino GD, Cicora KM

  13. Emergindo a complexidade do cuidado de enfermagem ao ser em morte encefálica Complejidad emergente del cuidado de enfermería al paciente con muerte cerebral Emerging the complexity of nursing care facing a brain death

    Directory of Open Access Journals (Sweden)

    Aline Lima Pestana

    2012-12-01

    Full Text Available O estudo objetivou desvelar a complexidade do cuidado de enfermagem ao ser em morte encefálica. Utilizaram-se como referenciais teórico e metodológico o pensamento complexo e a Grounded Theory, respectivamente. Os dados foram coletados em um hospital universitário do nordeste brasileiro, de dezembro de 2010 a junho de 2011, por meio de entrevistas não estruturadas. A amostra teórica constituiu-se de 12 enfermeiros, distribuídos em três grupos amostrais. O fenômeno "Desvelando relações e interações múltiplas do ser enfermeiro na complexidade do cuidado ao ser em morte encefálica" foi delimitado por cinco categorias. Neste artigo, foi abordada a categoria "Emergindo a complexidade do cuidado de enfermagem ao ser em morte encefálica". O estudo evidenciou que o cuidado ao ser em morte encefálica é caracterizado por desordem e incertezas, fazendo com que o enfermeiro vivencie sentimentos diversos e ambivalentes. A sua complexidade está em compreender a sua singularidade e dialogicidade.Este estudio objetivó desvelar la complejidad del cuidado en enfermería al paciente con muerte encefálica. Se utilizaron como marcos teórico y metodológico el pensamiento complejo y la Grounded Theory, respectivamente. Los datos fueron recolectados en un hospital universitario en el nordeste de Brasil, entre diciembre de 2010 y junio de 2011, a través de entrevistas no estructuradas. La muestra teórica fue compuesta por 12 enfermeras asignadas en tres grupos. El fenómeno "Revelando las múltiples relaciones e interacciones en ser un enfermero en la complejidad del cuidado del paciente con muerte cerebral" fue delimitada en cinco categorías. En este artículo, se dirigió a la categoría de "Emergiendo la complejidad del cuidado de enfermería al paciente en muerte cerebral". El estudio mostró que el cuidado al ser en muerte cerebral se acompaña de desorden e incertidumbres, haciendo con que la enfermera pueda experimentar diferentes y

  14. Interictal functional connectivity of human epileptic networks assessed by intracerebral EEG and BOLD signal fluctuations.

    Directory of Open Access Journals (Sweden)

    Gaelle Bettus

    Full Text Available In this study, we aimed to demonstrate whether spontaneous fluctuations in the blood oxygen level dependent (BOLD signal derived from resting state functional magnetic resonance imaging (fMRI reflect spontaneous neuronal activity in pathological brain regions as well as in regions spared by epileptiform discharges. This is a crucial issue as coherent fluctuations of fMRI signals between remote brain areas are now widely used to define functional connectivity in physiology and in pathophysiology. We quantified functional connectivity using non-linear measures of cross-correlation between signals obtained from intracerebral EEG (iEEG and resting-state functional MRI (fMRI in 5 patients suffering from intractable temporal lobe epilepsy (TLE. Functional connectivity was quantified with both modalities in areas exhibiting different electrophysiological states (epileptic and non affected regions during the interictal period. Functional connectivity as measured from the iEEG signal was higher in regions affected by electrical epileptiform abnormalities relative to non-affected areas, whereas an opposite pattern was found for functional connectivity measured from the BOLD signal. Significant negative correlations were found between the functional connectivities of iEEG and BOLD signal when considering all pairs of signals (theta, alpha, beta and broadband and when considering pairs of signals in regions spared by epileptiform discharges (in broadband signal. This suggests differential effects of epileptic phenomena on electrophysiological and hemodynamic signals and/or an alteration of the neurovascular coupling secondary to pathological plasticity in TLE even in regions spared by epileptiform discharges. In addition, indices of directionality calculated from both modalities were consistent showing that the epileptogenic regions exert a significant influence onto the non epileptic areas during the interictal period. This study shows that functional

  15. Gap Junctions Contribute to Ictal/Interictal Genesis in Human Hypothalamic Hamartomas

    Directory of Open Access Journals (Sweden)

    Jie Wu

    2016-06-01

    Full Text Available Human hypothalamic hamartoma (HH is a rare subcortical lesion associated with treatment-resistant epilepsy. Cellular mechanisms responsible for epileptogenesis are unknown. We hypothesized that neuronal gap junctions contribute to epileptogenesis through synchronous activity within the neuron networks in HH tissue. We studied surgically resected HH tissue with Western-blot analysis, immunohistochemistry, electron microscopy, biocytin microinjection of recorded HH neurons, and microelectrode patch clamp recordings with and without pharmacological blockade of gap junctions. Normal human hypothalamus tissue was used as a control. Western blots showed increased expression of both connexin-36 (Cx36 and connexin-43 (Cx43 in HH tissue compared with normal human mammillary body tissue. Immunohistochemistry demonstrated that Cx36 and Cx43 are expressed in HH tissue, but Cx36 was mainly expressed within neuron clusters while Cx43 was mainly expressed outside of neuron clusters. Gap-junction profiles were observed between small HH neurons with electron microscopy. Biocytin injection into single recorded small HH neurons showed labeling of adjacent neurons, which was not observed in the presence of a neuronal gap-junction blocker, mefloquine. Microelectrode field recordings from freshly resected HH slices demonstrated spontaneous ictal/interictal-like discharges in most slices. Bath-application of gap-junction blockers significantly reduced ictal/interictal-like discharges in a concentration-dependent manner, while not affecting the action-potential firing of small gamma-aminobutyric acid (GABA neurons observed with whole-cell patch-clamp recordings from the same patient's HH tissue. These results suggest that neuronal gap junctions between small GABAergic HH neurons participate in the genesis of epileptic-like discharges. Blockade of gap junctions may be a new therapeutic strategy for controlling seizure activity in HH patients.

  16. Complicações respiratórias em pacientes com paralisia cerebral submetidos à anestesia geral Complicaciones respiratorias en pacientes con parálisis cerebral sometidos a la anestesia general Respiratory complications in patients with cerebral palsy undergoing general anesthesia

    Directory of Open Access Journals (Sweden)

    Sérgio Silva de Mello

    2007-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Anestesia em pacientes com paralisia cerebral (PC pode representar um desafio para o anestesiologista. Este estudo prospectivo teve como objetivo determinar a prevalência e o risco de complicações respiratórias em crianças com PC submetidas à anestesia geral inalatória (AGI para tomografia computadorizada (TC. MÉTODO: Participaram do estudo pacientes com idades entre 1 e 17 anos, estado físico ASA I a III, submetidos a AGI com sevoflurano e máscara laríngea para TC no período de junho/2002 a junho/2003, divididos em três grupos: PC tetraplégicos (PCT, outros tipos de PC (PCO e paciente sem PC (NPC. Os pais ou responsáveis responderam a um questionário com perguntas sobre o histórico médico dos pacientes, infecção de vias aéreas superiores (IVAS, asma, convulsão, incoordenação orofaríngea, refluxo gastroesofágico, etc. Dados sobre incidência e gravidade das complicações respiratórias foram coletados prospectivamente (tosse, broncoespasmo, laringoespasmo, hipoxemia, aspiração. A amostra foi calculada para uma incidência esperada de 5% no grupo NPC, com uma diferença de 15% entre os grupos (alfa = 0,05 e beta = 0,1, utilizando-se os testes do Qui-quadrado, exato de Fisher e t de Student. RESULTADOS: Compuseram a amostra 290 pacientes divididos nos grupos da seguinte forma: PCT - 100, PCO - 79 e NPC - 111. Não houve diferença na prevalência de complicações respiratórias entre os grupos PCT (4%, PCO (8,9% e NPC (7,3%. Houve associação entre a presença de IVAS e a ocorrência de complicações (risco relativo, 10,71. CONCLUSÕES: Crianças com paralisia cerebral tipo tetraplegia espástica não parecem ter um risco aumentado de complicações respiratórias durante anestesia geral inalatória com sevoflurano e máscara laríngea. O estudo confirma IVAS como fator de risco para a ocorrência dessas complicações.JUSTIFICATIVA Y OBJETIVOS: La anestesia en pacientes con par

  17. Implante auditivo de tronco cerebral: técnica cirúrgica e resultados auditivos precoces em pacientes com neurofibromatose tipo 2 Auditory Brainstem Implant: surgical technique and early audiological results in patients with neurofibromatosis type 2

    Directory of Open Access Journals (Sweden)

    Ricardo Ferreira Bento

    2008-10-01

    Full Text Available O implante auditivo de tronco cerebral foi desenvolvido para restaurar alguma audição útil em pacientes que apresentam ausência de nervo coclear bilateralmente. OBJETIVOS: Discutir a indicação, cirurgia e resultados em quatro pacientes submetidos à cirurgia para colocação de implante auditivo de tronco cerebral. CASUÍSTICA E MÉTODOS: Quatro pacientes com diagnóstico de schwannomas vestibulares bilaterais foram submetidos à cirurgia para colocação de Implante Auditivo de Tronco Cerebral durante o mesmo ato cirúrgico utilizado para a exérese de um dos tumores. Aspectos clínicos e técnicos e as referências anatômicas da cirurgia e os resultados auditivos foram analisados. RESULTADOS: Em todos os casos foram identificados as referências anatômicas ao forame de Luschka. As complicações cirúrgicas se resumiram à fístula liquórica em dois pacientes. Os eletrodos foram bem posicionados e a sensação auditiva foi suficiente para reconhecimento de sons e auxílio à leitura labial. CONCLUSÃO: Os resultados auditivos de nossos pacientes abrem uma perspectiva importante aos pacientes com surdez profunda bilateral sem integridade anatômica das vias auditivas centrais.Auditory Brainstem Implants were developed to partially restore the hearing capabilities of patients without cochlear nerves bilaterally. AIM: this paper aims to discuss the clinical and surgical findings of four ABI patients. MATERIALS AND METHOD: four patients diagnosed with bilateral schwannomas received auditory brainstem implants (ABI and had one of their tumors resected in the same surgical procedure. Clinical aspects, surgical technique, anatomic landmarks, and outcomes were analyzed. RESULTS: the anatomic landmarks were identified in all four patients in relation to the foramina of Luschka. Two patients had CSF leaks. The electrodes were well positioned and hearing sensation was good enough to allow for sound recognition and assist patients perform lip

  18. Cerebral Palsy

    Science.gov (United States)

    ... 1 • 2 • 3 For Teens For Kids For Parents MORE ON THIS TOPIC Cerebral Palsy: Keith's Story Physical Therapy I Have Cerebral Palsy. Can I Babysit? Body Image and Self-Esteem Contact Us Print Resources Send to a friend ...

  19. Inclusão escolar de crianças e adolescentes com paralisia cerebral: esta é uma realidade possível para todas elas em nossos dias? School inclusion of children and adolescents with cerebral palsy: is this possible for all of them in our days?

    Directory of Open Access Journals (Sweden)

    Lúcia Helena C. dos Santos

    2011-09-01

    Full Text Available OBJETIVO: Descrever a distribuição escolar de um grupo de crianças e adolescentes com paralisia cerebral (PC e analisar o impacto da função motora grossa e outros déficits no processo de inclusão. MÉTODOS: Estudo prospectivo de pacientes do Ambulatório de Paralisia Cerebral da Universidade Federal do Paraná, avaliados em 2005. Pais ou cuidador completaram um questionário com dados relativos a: tipo de escola frequentada, dificuldades do aprendizado e necessidade de suporte psicopedagógico e fonoaudiológico. Os dados obtidos incluíram quem era o cuidador primário, seu nível de escolaridade e renda. As variáveis coletadas dos prontuários foram antecedentes perinatais e pós-natais, classificação topográfica da PC e função motora (Sistema de Classificação Motora Grossa - SCFMG, classificação da fala e presença de epilepsia. RESULTADOS: 105 crianças e adolescentes foram incluídos. A média de idade foi 10,8 anos, 61 (58% masculinos. Dentre as 105 crianças, 97 (92% frequentavam a escola, 36 (34% em classe regular, 7 (6,5% em classe especial e 54 (51% em escola especial. Crianças que frequentavam a escolar regular apresentavam predominantemente SCFMG nível I ou II, hemiplegia, epilepsia ausente ou com bom controle e fala normal ou disartria. Aqueles em escola especial eram crianças com SCFMG níveis III, IV e V, diplegia ou tetraplegia, epilepsia refratária e atraso na fala ou sua ausência. CONCLUSÕES: Até o momento, a inclusão de crianças com PC em escolas regulares parece trazer benefícios para aquelas com hemiplegia, nível I ou II do SCMFG, sem epilepsia e com fala normal.OBJECTIVE: To describe the school distribution of a group of children and adolescents with cerebral palsy (CP and to analyze the impact of gross motor function and other deficits in the inclusion process. METHODS: Prospective study of patients from de Outpatient Clinic for Cerebral Palsy of the Federal University of Paraná, Brazil, in

  20. Comparison of diagnostic performance between interictal F-18-FDG PET and ictal Tc-99m-HMPAO SPECT in occipital lobe epilepsy

    International Nuclear Information System (INIS)

    Interictal F-18-fluorodeoxyglucose (FDG) PET and ictal Tc-99m-HMPAO SPECT are found to be useful in localizing epileptogenic zones in neocortical lateral temporal or frontal lobe epilepsy. We investigated whether interictal F-18-FDG PET or ictal Tc-99m-HMPAO SPECT was useful to find epileptogenic zones in occipital lobe epilepsy (OLE). We reviewed patterns of hypometabolism in interictal F-18 FDG PET and of hyperfusion in ictal Tc-99m-HMPAO SPECT in 17 OLE patients (mean age=27±6.8 year, M : F=10:7, injection time =30±17 sec). OLE was diagnosed based on invasive electroencephalography (EEG) study, surgery and post-surgical outcome (Engel class I in all for average 14 months). Epileptogenic zones were correctly localized in 9 (60%) out of 15 patients by interictal F-18-FDG PET. Epiletogenic hemispheres were correctly lateralized in 14 patients (93%) . By ictal Tc-99m-HMPAO SPECT, epileptogenic hemispheres were correctly lateralized in 13 patients (76%), but localization was possible only in 3 patients (18%). Among patients who showed no abnormality with MR imaging and no correct localization with ictal Tc-99m-HMPAO SPECT, interictal F-18-FDG PET was helpful in 2 patients. Ictal Tc-99m-HMPAO SPECT was helpful in lateralization but not in localization in OLE. Interictal F-18-FDG PET was helpful for localization of epileptogenic zones even in patients with ambiguous MR of ictal SPECT findings

  1. Uso de dexmedetomidina em anestesia geral para tratamento cirúrgico de aneurisma cerebral, em paciente gestante, portadora de doença hipertensiva específica da gestação: relato de caso Uso de dexmedetomidina en anestesia general para tratamiento quirúrgico de aneurisma cerebral, en paciente embarazada, portadora de enfermedad hipertensiva específica del embarazo: relato de caso Dexmedetomidine in general anesthesia for surgical treatment of cerebral aneurysm in pregnant patient with specific hypertensive disease of pregnancy: case report

    OpenAIRE

    Kleber Machareth de Souza; Luiz César Anzoategui; Washington Cássio Justino Pedroso; Werner Alfred Gemperli

    2005-01-01

    JUSTIFICATIVA E OBJETIVOS: A incidência de cirurgias não obstétricas em pacientes gestantes é de 0,36% a 2%. No entanto, cirurgias visando o tratamento cirúrgico de aneurisma cerebral em gestantes são extremamente raras. A doença hipertensiva específica da gestação, apresenta prevalência clínica de 10% na população gestante. Trata-se de uma doença de elevada complexidade clínica, acometendo múltiplos órgãos e sistemas. A dexmedetomidina, fármaco agonista alfa2, apresenta importante seletivida...

  2. Cerebral palsy.

    Science.gov (United States)

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

    2016-01-01

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

  3. Disseminated cerebral thrombotic microangiopathy in a patient with adult's Still disease Microangiopatia trombótica cerebral em um paciente com doença de Still do adulto

    OpenAIRE

    Domingues, Renan B.; Ana Maria Casati da Gama; Caser, Eliana B; Carlos Musso; Maria Carmen S. Santos

    2003-01-01

    OBJECTIVE: The aim of this report is to describe a fatal disseminated thrombotic micoangiopathy with renal, pancreatic, and cerebral involvement in a patient with recently diagnosed adult's Still disease (ASD). CASE REPORT: A previously healthy 15 year old girl was admitted to our hospital. According to the clinical and laboratory data the diagnosis of adult's still Disease was established. The treatment was begun and few days after an initial improvement a sudden neurologic deterioration wit...

  4. Diagnóstico das condições de saúde bucal em portadores de paralisia cerebral do município de Pelotas, Rio Grande do Sul, Brasil Oral health conditions diagnostic in cerebral palsy individuals of Pelotas, Rio Grande do Sul State, Brazil

    Directory of Open Access Journals (Sweden)

    Patrícia Osório Guerreiro

    2009-12-01

    Full Text Available Paralisia cerebral (PC é uma lesão encefálica estática, definida como uma desordem não progressiva dos movimentos e postura. Está comumente associada com epilepsia e anormalidades da fala, audição, visão e retardo mental. Embora os portadores de paralisia cerebral necessitem de cuidados especiais na prevenção de problemas bucais, no contexto da assistência odontológica, as informações da literatura são contraditórias quanto à incidência de doenças bucais em pacientes com paralisia cerebral. A fim de determinar as condições de saúde bucal e fatores associados, realizou-se um levantamento epidemiológico em 41 crianças portadoras de paralisia cerebral. As variáveis avaliadas foram: aspectos socioeconômicos, fatores de risco para o desenvolvimento de doenças bucais, acesso a serviços odontológicos, índice de cárie, doença periodontal, presença de má oclusão e fluorose dentária. As crianças examinadas apresentaram índices elevados de alteração gengival e experiência de cárie, principalmente na dentição decídua, e má oclusão severa, fatores que indicam a necessidade de intervenção precoce, seja com programas educativos e preventivos como de assistência curativa. O estudo mostrou que, além da necessidade quantitativa de atendimento, também se faz necessário melhorar a qualidade das consultas desses pacientes.Cerebral Palsy (CP is an encephalic static lesion defined as a non-progressive disorder of movements and posture. It is usually associated with epilepsy, speaking, hearing and sight disorders and also mental retardation. Even though, people who have CP need special care for the prevention of factors linked to oral problems, in the odontological context, the literary information is contradictory when it comes to the incidence of oral diseases on patients who have cerebral palsy. In order to determine the oral health and associated factors conditions, an epidemiological research has been made in

  5. Laterality of pain in migraine distinguished by interictal rates of habituation of electrodermal responses to visual and auditory stimuli.

    OpenAIRE

    Gruzelier, J. H.; Nicolaou, T; Connolly, J. F.; Peatfield, R. C.; Davies, P T; Clifford-Rose, F

    1987-01-01

    Support is provided for a primary neural factor in migraine by studies in autonomic responsiveness to sensory stimuli in relation to the laterality of pain. Migraineurs with consistently lateralised headaches were found in two studies to exhibit extremes of autonomic responsiveness to sensory stimuli during the interictal phase. The direction of responsiveness was predictive of the laterality of pain; left-sided pain was associated with under-responsiveness and fast habituation, right-sided p...

  6. All-in-one interictal presurgical imaging in patients with epilepsy: single-session EEG/PET/(f)MRI

    Energy Technology Data Exchange (ETDEWEB)

    Grouiller, Frederic; Delattre, Benedicte M.A.; Lazeyras, Francois; Ratib, Osman; Vargas, Maria I.; Garibotto, Valentina [Geneva University Hospital, Department of Radiology and Medical Informatics, Geneva 14 (Switzerland); Pittau, Francesca; Spinelli, Laurent; Seeck, Margitta; Vulliemoz, Serge [Geneva University Hospital, EEG and Epilepsy Unit, Department of Neurology, Geneva 14 (Switzerland); Heinzer, Susanne [Philips AG Healthcare, Zuerich (Switzerland); Iannotti, Giannina R. [Geneva University Hospital, Functional Brain Mapping Laboratory, Department of Fundamental Neurosciences, Geneva 14 (Switzerland)

    2015-04-17

    In patients with pharmacoresistant focal epilepsy, resection of the epileptic focus can lead to freedom from seizures or significant improvement in well-selected candidates. Localization of the epileptic focus with multimodal concordance is crucial for a good postoperative outcome. Beyond the detection of epileptogenic lesions on structural MRI and focal hypometabolism on FDG PET, EEG-based Electric Source Imaging (ESI) and simultaneous EEG and functional MRI (EEG-fMRI) are increasingly applied for mapping epileptic activity. We here report presurgical multimodal interictal imaging using a hybrid PET/MR scanner for single-session FDG PET, MRI, EEG-fMRI and ESI. This quadrimodal imaging procedure was performed in a single session in 12 patients using a high-density (256 electrodes) MR-compatible EEG system and a hybrid PET/MR scanner. EEG was used to exclude subclinical seizures during uptake of the PET tracer, to compute ESI on interictal epileptiform discharges and to guide fMRI analysis for mapping haemodynamic changes correlated with interictal epileptiform activity. The whole multimodal recording was performed in less than 2 hours with good patient comfort and data quality. Clinically contributory examinations with at least two modalities were obtained in nine patients and with all modalities in five patients. This single-session quadrimodal imaging procedure provided reliable and contributory interictal clinical data. This procedure avoids multiple scanning sessions and is associated with less radiation exposure than PET-CT. Moreover, it guarantees the same medication level and medical condition for all modalities. The procedure improves workflow and could reduce the duration and cost of presurgical epilepsy evaluations. (orig.)

  7. All-in-one interictal presurgical imaging in patients with epilepsy: single-session EEG/PET/(f)MRI

    International Nuclear Information System (INIS)

    In patients with pharmacoresistant focal epilepsy, resection of the epileptic focus can lead to freedom from seizures or significant improvement in well-selected candidates. Localization of the epileptic focus with multimodal concordance is crucial for a good postoperative outcome. Beyond the detection of epileptogenic lesions on structural MRI and focal hypometabolism on FDG PET, EEG-based Electric Source Imaging (ESI) and simultaneous EEG and functional MRI (EEG-fMRI) are increasingly applied for mapping epileptic activity. We here report presurgical multimodal interictal imaging using a hybrid PET/MR scanner for single-session FDG PET, MRI, EEG-fMRI and ESI. This quadrimodal imaging procedure was performed in a single session in 12 patients using a high-density (256 electrodes) MR-compatible EEG system and a hybrid PET/MR scanner. EEG was used to exclude subclinical seizures during uptake of the PET tracer, to compute ESI on interictal epileptiform discharges and to guide fMRI analysis for mapping haemodynamic changes correlated with interictal epileptiform activity. The whole multimodal recording was performed in less than 2 hours with good patient comfort and data quality. Clinically contributory examinations with at least two modalities were obtained in nine patients and with all modalities in five patients. This single-session quadrimodal imaging procedure provided reliable and contributory interictal clinical data. This procedure avoids multiple scanning sessions and is associated with less radiation exposure than PET-CT. Moreover, it guarantees the same medication level and medical condition for all modalities. The procedure improves workflow and could reduce the duration and cost of presurgical epilepsy evaluations. (orig.)

  8. Local cerebral blood flow and glucose metabolism during seizure in spontaneously epileptic El mice

    International Nuclear Information System (INIS)

    Local cerebral blood flow and glucose metabolism were examined in spontaneously epileptic El mice using autoradiography with 125I-IMP and 14C-DG in the interictal phase and during seizure. El (+) mice that developed generalized tonic-clonic convulsions and El (-) mice that received no stimulation and had no history of epileptic seizures were examined. The seizure non-susceptible, maternal strain ddY mice were used as control. Uptake ratios for IMP and DG in mouse brain were calculated using the autoradiographic density. In the interictal phase, the pattern of local cerebral blood flow of El (+) mice was similar to that of ddY and El (-) mice, and glucose metabolism in the hippocampus was higher in El (+) mice than in El (-) and ddY mice, but flow and metabolism were nearly matched. During seizure, no significant changed blood flow and increased glucose metabolism in the hippocampus, the epileptic focus, and no markedly changed blood flow and depressed glucose metabolism in other brain regions were observed and considered to be flow-metabolism uncoupling. These observations have never been reported in clinical or experimental studies of epilepsy. Seizures did not cause large regional differences in cerebral blood flow. Therefore, only glucose metabolism is useful for detection of the focus of secondary generalized seizures in El mice, and appeared possibly to be related to the pathophysiology of secondary generalized epilepsy in El mice. (author)

  9. Avaliação de um programa de aplicação de toxina botulínica tipo A em crianças do Vale do Jequitinhonha com paralisia cerebral

    Directory of Open Access Journals (Sweden)

    Grazielle Fernandes da Silva

    2013-07-01

    Full Text Available O objetivo do estudo foi avaliar os efeitos de um programa público de aplicação de toxina botulínica tipo A (TBA na espasticidade muscular, amplitude de movimento, qualidade da marcha, independência funcional e qualidade de vida de crianças e adolescentes com paralisia cerebral (PC. Foi realizado um estudo quase experimental que avaliou os efeitos do emprego da TBA, aplicada três vezes, com intervalos de três meses, em 14 crianças com PC. Estas foram avaliadas através da Escala Modificada de Ashworth, Goniometria Manual, Physician Rating Scale, Inventário de Avaliação Pediátrica de Incapacidade (PEDI e Questionário do Cuidador da Criança (QCC. Foi observada redução da espasticidade, aumento da amplitude de movimento, melhora das habilidades funcionais de autocuidado e mobilidade do PEDI e das áreas de cuidado pessoal, conforto e interação/comunicação do QCC. O programa de aplicação de TBA em crianças e adolescentes com PC, realizado em um núcleo de reabilitação público do Vale do Jequitinhonha, foi efetivo para a população beneficiada.

  10. Interplay between interictal spikes and behavioral seizures in young, but not aged pilocarpine-treated epileptic rats.

    Science.gov (United States)

    Bajorat, Rika; Goerss, Doreen; Brenndörfer, Linda; Schwabe, Lars; Köhling, Rüdiger; Kirschstein, Timo

    2016-04-01

    Interictal spike activity is commonly observed in the EEG of patients with epilepsy, but the causal interrelationship between interictal spikes and behavioral seizures is poorly understood. We performed long-term video-EEG monitoring of 16 epileptic rats after pilocarpine-induced status epilepticus and five control animals. To quantify the interplay between periods of spikes and seizures, we calculated the time spent with spikes as well as the time spent with seizures for each animal. Within a given subject, we found a significant correlation between these two measures in 7/11 young epileptic rats (aged pilocarpine-treated animals exhibited significant correlation coefficients between spike periods and seizures (>600days, Paged epileptic rats showed a prominent predominance for either spike periods or seizures, which might explain the absence of significant correlation in this population. We found that there is a significant interplay between interictal periods of spikes and behavioral seizures in young epileptic animals, but this association is absent during aging. PMID:26926072

  11. Quality of life of children with cerebral palsy treated with botulinum toxin: are well-being measures appropriate? Qualidade de vida em crianças com paralisia cerebral tratadas com toxina botulínica: estas avaliações são adequadas?

    Directory of Open Access Journals (Sweden)

    Taísa R. Simões de Assis

    2008-01-01

    Full Text Available AIM: To analyze quality of life (QOL of children with cerebral palsy (CP treated with botulinum toxin type A (BTXA. METHOD: Two QOL evaluation tools, translated into Portuguese, were used: Pediatric Outcomes Data Collection Instrument (PODCI and Child's Caregiver Questionnaire (CCQ. Questionnaires were answered by caregivers on two occasions. Patients were divided into 3 groups: I - patients who had been previously treated with BTXA and who underwent a session of BTXA; II - patients who used BTXA for the first time; III - patients previously treated with BTXA but did not in this interval. RESULTS: Sixty-eight patients were evaluated. In group I (n=26 the functional ability had improvement for all types of CP (p=0.04, and tetraplegic increased interaction/communication (p=0.02. In group II (n=14 positioning improved (p=0.02. Group III (n=28 showed no change in QOL. CONCLUSIONS: PODCI and CCQ are able to capture outcome in children with CP.OBJETIVO: Analisar a qualidade de vida (QV de crianças com paralisia cerebral tratadas com toxina botulínica do tipo A (TBA. MÉTODO: Dois instrumentos de QV, adaptados para a língua portuguesa, foram utilizados: Instrumento para Avaliação de Resultados de Reabilitação em Pediatria (IARRP e Questionário do Cuidador da Criança (CQC, sendo respondidos pelos cuidadores. Os pacientes foram divididos em 3 grupos: I - já haviam utilizado TBA e foram submetidos à aplicação neste intervalo; II - utilizaram TBA pela primeira vez; III - utilizaram TBA previamente, mas não neste intervalo. RESULTADOS: Sessenta e oito pacientes foram avaliados, no grupo I (n=26 houve melhora da capacidade funcional em todos os tipos de PC (p=0.04, e tetraplégicos tiveram ganho também na interação/comunicação (p=0.02. No grupo II (n=14 houve melhora em posicionamento (p=0.02. Não foram observadas mudanças na QV do grupo III (n=28. CONCLUSÃO: IARRP e CQC são capazes de avaliar resultados em crianças com PC.

  12. 3D source localization of interictal spikes in epilepsy patients with MRI lesions

    International Nuclear Information System (INIS)

    The present study aims to accurately localize epileptogenic regions which are responsible for epileptic activities in epilepsy patients by means of a new subspace source localization approach, i.e. first principle vectors (FINE), using scalp EEG recordings. Computer simulations were first performed to assess source localization accuracy of FINE in the clinical electrode set-up. The source localization results from FINE were compared with the results from a classic subspace source localization approach, i.e. MUSIC, and their differences were tested statistically using the paired t-test. Other factors influencing the source localization accuracy were assessed statistically by ANOVA. The interictal epileptiform spike data from three adult epilepsy patients with medically intractable partial epilepsy and well-defined symptomatic MRI lesions were then studied using both FINE and MUSIC. The comparison between the electrical sources estimated by the subspace source localization approaches and MRI lesions was made through the coregistration between the EEG recordings and MRI scans. The accuracy of estimations made by FINE and MUSIC was also evaluated and compared by R2 statistic, which was used to indicate the goodness-of-fit of the estimated sources to the scalp EEG recordings. The three-concentric-spheres head volume conductor model was built for each patient with three spheres of different radii which takes the individual head size and skull thickness into consideration. The results from computer simulations indicate that the improvement of source spatial resolvability and localization accuracy of FINE as compared with MUSIC is significant when simulated sources are closely spaced, deep, or signal-to-noise ratio is low in a clinical electrode set-up. The interictal electrical generators estimated by FINE and MUSIC are in concordance with the patients' structural abnormality, i.e. MRI lesions, in all three patients. The higher R2 values achieved by FINE than MUSIC

  13. 3D source localization of interictal spikes in epilepsy patients with MRI lesions

    Science.gov (United States)

    Ding, Lei; Worrell, Gregory A.; Lagerlund, Terrence D.; He, Bin

    2006-08-01

    The present study aims to accurately localize epileptogenic regions which are responsible for epileptic activities in epilepsy patients by means of a new subspace source localization approach, i.e. first principle vectors (FINE), using scalp EEG recordings. Computer simulations were first performed to assess source localization accuracy of FINE in the clinical electrode set-up. The source localization results from FINE were compared with the results from a classic subspace source localization approach, i.e. MUSIC, and their differences were tested statistically using the paired t-test. Other factors influencing the source localization accuracy were assessed statistically by ANOVA. The interictal epileptiform spike data from three adult epilepsy patients with medically intractable partial epilepsy and well-defined symptomatic MRI lesions were then studied using both FINE and MUSIC. The comparison between the electrical sources estimated by the subspace source localization approaches and MRI lesions was made through the coregistration between the EEG recordings and MRI scans. The accuracy of estimations made by FINE and MUSIC was also evaluated and compared by R2 statistic, which was used to indicate the goodness-of-fit of the estimated sources to the scalp EEG recordings. The three-concentric-spheres head volume conductor model was built for each patient with three spheres of different radii which takes the individual head size and skull thickness into consideration. The results from computer simulations indicate that the improvement of source spatial resolvability and localization accuracy of FINE as compared with MUSIC is significant when simulated sources are closely spaced, deep, or signal-to-noise ratio is low in a clinical electrode set-up. The interictal electrical generators estimated by FINE and MUSIC are in concordance with the patients' structural abnormality, i.e. MRI lesions, in all three patients. The higher R2 values achieved by FINE than MUSIC

  14. Cerebral hypoxia

    Science.gov (United States)

    ... the veins ( deep vein thrombosis ) Lung infections (pneumonia) Malnutrition When to Contact a Medical Professional Cerebral hypoxia ... References Bernat JL. Coma, vegetative state, and brain death. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  15. O uso de técnicas para auxiliar a flexibilidade e equilíbrio em adolescentes portadores de paralisia cerebral: o relato de três casos Use of techniques to increase flexibility and equilibrium in adolescents with cerebral palsy: report of three case studies

    Directory of Open Access Journals (Sweden)

    Katia Carpetieri Ferrarezi

    2000-05-01

    Full Text Available Esta pesquisa teve por objetivo descrever os testes e o tratamento pediátrico de paralisia cerebral espástica em fase de independência motora para a flexibilidade dos membros inferiores e para o desenvolvimento do aumento no tempo de equilíbrio. Foram selecionados, para participar deste estudo, 3 sujeitos com paralisia cerebral em fase de independência motora. Sujeito 1 do sexo masculino, 12 anos, diplégico espástico; sujeito 2 do sexo masculino, 13 anos, hemiplegia direita espástica; sujeito 3 do sexo feminino, 10 anos, hemiplegia espástica esquerda. A metodologia usada para a avaliação foi o teste de “sentar e alcançar”, a goniometria e o teste de equilíbrio. O procedimento é composto em 16 semanas, com sessões individuais de 30 minutos, duas vezes por semana. Para conseguir flexibilidade dos membros inferiores, foi usado o método de facilitação neuromuscular proprioceptiva, e para estímulos proprioceptivos e vestibulares (equilíbrio foram usados saltos no mini-trampolim. O resultado obtido com o tratamento proposto foi um ganho na flexibilidade, medido pelo teste de "sentar e alcançar" de 30% para o sujeito 1, 40% para o sujeito 2 e 40 % para o sujeito 3, e o ganho obtido com o tempo de equilíbrio foi de 160% para o sujeito 1, 100% para o sujeito 2 e 500% para o sujeito 3The aim of this paper is to describe the tests and pediatric treatment of motor-independent spastic cerebral palsy to increase lower-limbs flexibility and equilibrium time. Three subjects were selected for the experiment: a twelve-year-old boy with spastic diplegia, a thirteen-year-old boy with right spastic hemiplegia and a ten-year-old girl with left spastic hemiplegia. The evaluation methodology consisted of sit-and-reach test, goniometry and equilibrium test. The treatment procedure consisted of two weekly individual 30-minute sessions covering a period of 16 weeks. Proprioceptive neuromuscular facilitation method was used to increase lower

  16. A gênese cerebral da imagem corporal: algumas considerações sobre o fenômeno dos membros fantasmas em Ramachandran The cerebral genesis of body image: some considerations about phantom-limbs in Ramachandran

    OpenAIRE

    Sergio Gomes da Silva

    2013-01-01

    Os distúrbios da imagem do corpo, na forma conferida pelo fenômeno dos "membros fantasmas", tomaram grande parte dos estudos do neurologista indiano V. S. Ramachandran. Seu trabalho, por meio de testes psicofísicos e estudos de imagem funcional em pacientes com "membros fantasmas", demonstrou aquilo que ele denominou "plasticidade neural" ou "plasticidade cortical" em cérebros humanos adultos. Este artigo tem por objetivo analisar criticamente a construção da imagem do corpo, da interioridade...

  17. Condições de saúde bucal e acesso ao tratamento odontológico de pacientes com paralisia cerebral atendidos em um centro de referência do Nordeste - Brasil Oral health conditions and access to dental treatment in patients with cerebral palsy treated at a reference center in northeastern Brazil

    Directory of Open Access Journals (Sweden)

    Ana Carolina Oliveira Lemos

    2012-10-01

    Full Text Available OBJETIVO: avaliar a ocorrência de cárie dentária e necessidades de tratamento em crianças com paralisia cerebral atendidas no setor de Odontologia de um centro de referência do Nordeste do Brasil (Associação À Criança Deficiente; Recife-Brasil; e conhecer suas principais dificuldades no acesso ao tratamento odontológico. MÉTODO: a amostra foi composta por livre demanda de 167 pacientes de seis a 12 anos. A experiência de cárie foi avaliada de acordo com os critérios da Organização Mundial de Saúde. RESULTADOS: a grande maioria das crianças (70,7% apresentava paralisia cerebral do tipo espástica. Dos que tiveram dificuldades no acesso ao tratamento (46,1%, a maioria relatou a falta de profissional capacitado (34,1%. A prevalência de cárie foi de 61,1% na dentição decídua e 26,3% na permanente. Aproximadamente 60% dos pesquisados necessitavam de algum tipo de tratamento da cárie. Observou-se que, em comparação com estudos realizados em outras regiões do Brasil, as crianças pesquisadas apresentaram experiência de cárie mais elevada. CONCLUSÃO: verificou-se a necessidade de melhorar a assistência odontológica a esses pacientes, principalmente no interior do estado, de forma quantitativa, qualitativa e integrada com ações multidisciplinares.PURPOSE: to assess the occurrence of dental caries and treatment needs in children with cerebral palsy attended in the Disabled Child Assistance Association - Recife, Pernambuco, Brazil; and the main difficulties regarding dental treatment. METHOD: a spontaneous-demand sample of 167 patients aged six to 12 years was composed. Caries experience was assessed with the criteria of World Health Organization. RESULTS: the majority of children (70.7% had spastic cerebral palsy. About the health services accessibility, 46.1% of caregivers had difficulties and 34.1% reported a lack of trained professionals. Caries prevalence in deciduous dentition was 61.1% and 26.3% in the permanent

  18. Semiquantitative analysis of interictal glucose metabolism between generalized epilepsy and localization related epilepsy

    International Nuclear Information System (INIS)

    Positron emission tomography (PET) with [18F]fluoro-D-deoxyglucose (FDG) has been used to detect seizure foci and evaluate surgical resection with localization related epilepsies. However, few investigations have focused on generalized epilepsy in children. To reveal the pathophysiology of generalized epilepsy, we studied 11 patients with generalized epilepsy except West syndrome, and 11 patients with localization related epilepsy without organic disease. The FDG PET was performed by simultaneous emission and transmission scanning. We placed regions of interest (ROI) on bilateral frontal lobe, parietal lobe, occipital lobe, temporal lobe, basal ganglia, thalamus and cerebellum. Standardized uptake value (SUV) was measured and normalized to SUV of ipsilateral cerebellum. Then, we compared the data of generalized epilepsy to those of localization related epilepsy. FDG PET revealed significant interictal glucose hypometabolism in bilateral basal ganglia in generalized epilepsy compared to that in localization related epilepsy (right side: p=0.0095, left side: p=0.0256, Mann-Whitney test). No other region showed any significant difference (p>0.05) between the two groups. These findings indicate that the basal ganglia is involved in the outbreak of generalized seizures or is affected secondarily by the epileptogenicity itself. (author)

  19. Cerebral Palsy (For Parents)

    Science.gov (United States)

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

  20. A influência do método de musicoterapia de John Bean e da musicoterapia em geral na representação espacial do corpo de pessoas com paralisia cerebral (2004 -2010 The influence of John Bean's music therapy method and of music therapy in general in body spatial representation in people with cerebral palsy (2004-2010

    Directory of Open Access Journals (Sweden)

    Jose M.ª Fernández Batanero

    2010-12-01

    Full Text Available Acreditar no princípio da normalização, pressupõem acreditar que todas as pessoas merecem uma sociedade que atenda aos direitos humanos. Uma sociedade que vá ao encontro das características e das particularidades de cada pessoa, atendendo de modo diferenciado às necessidades dos seus elementos, sejam eles ditos "normais", ou com problemáticas. Assim, este artigo, tendo por base um método de investigação quantitativo/qualitativo, aborda a influência do método de musicoterapia de John Bean e da musicoterapia em geral na representação espacial do corpo de pessoas com paralisia cerebral.Believing in the principle of normalization implies believing that all people deserve a society that defends human rights. A society that respects each person's characteristics and particularities, must respond differently to the needs of its constituents, whether or not they are "normal" or have problems. Thus, this article, based on a quantitative/qualitative research approach, discusses the influence of John Bean's music therapy method and of music therapy in general on the spatial representation of the body in people with cerebral palsy.

  1. Avaliação da flexibilidade pelo método do Flexômetro de Wells em crianças com Paralisia Cerebral submetidas a tratamento hidroterapêutico: estudo de casos = Flexibility evaluation by the method of Wells’ Flexometer in children with Cerebral Palsy submitted to hydrotherapy treatment: study of the cases

    Directory of Open Access Journals (Sweden)

    Vicente De Paula Antunes Teixeira

    2010-07-01

    Full Text Available Avaliar a flexibilidade da cadeia muscular posterior, utilizando o método proposto por Wells e Dillon, antes e após cada sessão de hidroterapia. Foi verificada a flexibilidade de três crianças com Paralisia Cerebral (PC diparéticas, com idades entre sete a dez anos. Os valores de flexibilidade foram aferidos, utilizando o Flexômetro de Wells. Houve aumento significativo da flexibilidade da cadeia muscular posterior dos pacientes após cada sessão de hidroterapia, tanto na avaliação em grupo quanto individual, assim como antes da primeira sessão de hidroterapia quando comparada com a última. O estudo sugere que a hidroterapia promove melhora da flexibilidade em relação à cadeia muscular posterior de crianças com PC diparéticas, pelo relaxamento global e consequente diminuição dotônus muscular, quando associada a exercícios de alongamentos passivos. To evaluate the flexibility of the posterior muscle chain using the method proposed by Wells and Dillon, before and after each hydrotherapy session. The study verified the flexibility of three children with diplegic cerebral palsy (CP, aged 7 to 10. The values of flexibility were measured using the Wells’ Flexometer. There was a significant increase in the flexibility of posterior muscle chain of the patients after each session of hydrotherapy, both in the individual evaluation and in the group, as well as before the first session of hydrotherapy compared to the last. The study suggests that hydrotherapy promotes the improvement of flexibility, by relaxation of muscle tone of children with diplegic CP, in relation to the posterior muscle chain, when combined with passive stretching exercises.

  2. Valor preditivo da ultra-sonografia do cérebro em recém-natos com diagnóstico de meningite bacteriana neonatal: seguimento de 12 anos Predictive value of cerebral ultrasound with respect to clinical outcome in infants diagnoses on neonatal meningitis: a focus 12 years later

    Directory of Open Access Journals (Sweden)

    Alexandra Maria Vieira Monteiro

    2006-06-01

    Full Text Available OBJETIVO: Avaliar o valor preditivo da ultra-sonografia do cérebro, para o dano cerebral, em crianças com diagnóstico de meningite neonatal. MÉTODO: Estudo retrospectivo realizado no Instituto Fernandes Figueira (FIOCRUZ-RJ em 16 crianças que realizaram ultra-sonografia do cérebro por diagnóstico de meningite no período neonatal e tiveram seguimento neurológico até 12 anos. Foram calculados: valores preditivos positivo e negativo, sensibilidade e especificidade. RESULTADOS: 56,25% eram do sexo masculino e 81,25% prematuros. Hidrocefalia foi o achado mais freqüente (56,25%, seguido pelo exame normal (43,75%. Achados de hidrocefalia (9, somente em um havendo evolução favorável e achados normais (7, em 4 (57,14% não havendo déficit neurológico. Achados de ventriculite (4 e abscesso cerebral (2: todos evoluíram com dano cerebral. Diagnóstico de encefalomalácia (2; em 50% havendo desenvolvimento cognitivo satisfatório. Diagnostico de atrofia (2, todos com dano cerebral severo. CONCLUSÃO: Valor preditivo positivo de 88,89%, negativo de 57,14%, sensibilidade de 72,73% e especificidade de 80%.OBJECTIVE: To evaluate the predictive value of cerebral ultrasound in infants diagnoses on meningitis neonatal to the neurological outcome. METHOD: A retrospective study of 16 children admitted at Institute Fernandes Figueira RJ - Brazil, who had neonatal meningitis and were examined by cerebral ultrasound. The neurologic outcome was evaluated until 12 years of age. Positive and negative predictive values, sensitivity and specificity were calculated. RESULTS: 56.25% were male and 81.25% premature. Hydrocephalus was the most frequent finding (56.25% followed by normal exam (43.75%. Findings of hydrocephalus (9 only one had good neurologic outcome; and normal exam (7: only 57.14% without brain damage. Findings of ventriculitis (4 and brain abscesses (2 all had neurologic damage. Diagnosis of encephalomalacia (2: only one had good cognitive

  3. Fatores associados a perfusão cerebral anormal em dependentes de cocaína Factors related to abnormal brain perfusion in cocaine addicts

    OpenAIRE

    Dartiu X da Silveira; Marcelo Fernandes; Antonio Barbieri; Eliseu Labigalini; Evelyn D Silveira

    2001-01-01

    OBJETIVO: Avaliar a relação entre o padrão de uso da cocaína e a perfusão cerebral de dependentes da substância. MÉTODOS: Estudou-se uma amostra de 30 dependentes de cocaína por meio de tomografia computadorizada por emissão de fóton único (single photon emission computed tomography - SPECT) com hexametil-propileno-amina-oxima, marcada com tecnécio 99 m (99 m-Tc-HMPAO), e comparou-se o padrão de perfusão cerebral com o padrão de consumo da droga. RESULTADOS: Dos dependentes, 80% apresentaram ...

  4. Brain SPECT in mesial temporal lobe epilepsy: comparison between visual analysis and SPM SPECT cerebral na epilepsia de lobo temporal mesial: comparação entre análise visual e SPM

    Directory of Open Access Journals (Sweden)

    Bárbara Juarez Amorim

    2010-04-01

    Full Text Available OBJECTIVE: To compare the accuracy of SPM and visual analysis of brain SPECT in patients with mesial temporal lobe epilepsy (MTLE. METHOD: Interictal and ictal SPECTs of 22 patients with MTLE were performed. Visual analysis were performed in interictal (VISUAL(inter and ictal (VISUAL(ictal/inter studies. SPM analysis consisted of comparing interictal (SPM(inter and ictal SPECTs (SPM(ictal of each patient to control group and by comparing perfusion of temporal lobes in ictal and interictal studies among themselves (SPM(ictal/inter. RESULTS: For detection of the epileptogenic focus, the sensitivities were as follows: VISUAL(inter=68%; VISUAL(ictal/inter=100%; SPM(inter=45%; SPM(ictal=64% and SPM(ictal/inter=77%. SPM was able to detect more areas of hyperperfusion and hypoperfusion. CONCLUSION: SPM did not improve the sensitivity to detect epileptogenic focus. However, SPM detected different regions of hypoperfusion and hyperperfusion and is therefore a helpful tool for better understand pathophysiology of seizures in MTLE.OBJETIVO: Comparar a acurácia do SPM com a análise visual na detecção do foco epileptogênico e alterações perfusionais à distância no SPECT cerebral. MÉTODO: Foram realizados os SPECTs ictal e interictal de 22 pacientes com epilepsia de lobo temporal mesial (ELTM. A análise visual foi realizada nos estudos interictal (VISUAL(inter e ictal (VISUAL(ictal/inter. Na análise com SPM foi comparado o estudo interictal (SPM(inter e ictal (SPM(ictal de cada paciente com o grupo controle e comparou-se a perfusão dos lobos temporais entre os estudos ictal e interictal (SPM(ictal/inter. RESULTADOS: Para a detecção do foco epileptogênico, as sensibilidades foram as seguintes: VISUAL(inter=68%; VISUAL(ictal/inter=100%; SPM(inter=45%; SPM(ictal=64% and SPM(ictal/inter=77%. O SPM foi capaz de detectar mais áreas de hiperperfusão e hipoperfusão. CONCLUSÃO: O SPM não aumentou a sensibilidade na detecção do foco epileptog

  5. Tratamento da escoliose em crianças com paralisia cerebral utilizando a prótese vertical expansível de titânio para costela (VEPTR Tratamiento de la escoliosis en niños con parálisis cerebral mediante la prótesis vertical expansible de titanio para las costillas (VEPTR Treatment of scoliosis in children with cerebral palsy using the vertical expandable prosthetic titanium rib (VEPTR

    Directory of Open Access Journals (Sweden)

    Kiyomori de Quental Tyba

    2011-01-01

    Full Text Available OBJETIVO: Avaliar o uso da prótese vertical expansível de titânio (VEPTR como opção de tratamento inicial da escoliose em crianças de baixa idade portadoras de paralisia cerebral. MÉTODOS: Foram avaliados 10 pacientes portadores de paralisia cerebral (PC tratados com VEPTR pelo grupo de escoliose da AACD de São Paulo. Caracterizavam-se por imaturidade esquelética e escoliose progressiva; sem deformidade grave no plano sagital. Realizamos avaliação da curva pelo método de Cobb no pré e pós-operatório e após dois anos de seguimento. RESULTADOS: A correção obtida com o uso do VEPTR no pós-operatório imediato foi em média de 41,4% nas radiografias iniciais sem tração (p = 0,005 e 9,1% (p = 0,055 nas radiografias com tração. Após quatro meses de pós-operatório mantiveram-se ganhos de 27,2% com relação ao início. Houve correção da obliquidade pélvica de 10,2º no pré-operatório para 5,4º em média (p = 0,007. As complicações ocorreram em seis pacientes (60% e em apenas um paciente foi necessária a retirada do VEPTR. CONCLUSÃO: O VEPTR é um método que obteve correção significativa no tratamento provisório das escolioses na PC, apesar de frequentes complicações de baixa morbidade.OBJETIVO: Evaluar el uso de la prótesis vertical expansible de titanio (VEPTR como opción de tratamiento inicial para la escoliosis en niños pequeños con parálisis cerebral. MÉTODOS: 10 pacientes con parálisis cerebral (PC fueron evaluados y tratados con VEPTR por el grupo de escoliosis de la AACD en Sao Paulo. Caracterizados por escoliosis progresiva inmadurez esquelética, sin deformidad grave en el plano sagital. Se evaluó la curva por el método de Cobb en el preoperatorio, posoperatorio, y después de dos años de seguimiento. RESULTADOS: LA CORRECCIón, obtenida con el uso de VEPTR en el posoperatorio inmediato, fue en promedio 41,4% en relación a las radiografías iniciales sin tracción (p = 0,005 y 9,1% (p = 0

  6. Highlighting intracranial pressure monitoring in patients with severe acute brain trauma Ressaltando a monitorização da pressão intracraniana em pacientes com traumatismo cerebral agudo grave

    Directory of Open Access Journals (Sweden)

    Antonio L. E Falcão

    1995-09-01

    Full Text Available Intracranial pressure (ICP monitoring was carried out in 100 patients with severe acute brain trauma, primarily by means of a subarachnoid catheter. Statistical associations were evaluated between maximum ICP values and: 1 Glasgow Coma Scale (GCS scores; 2 findings on computed tomography (CT scans of the head; and 3 mortality. A significant association was found between low GCS scores (3 to 5 and high ICP levels, as well as between focal lesions on CT scans and elevated ICP. Mortality was significantly higher in patients with ICP > 40 mm Hg than in those with ICP Monitorização da pressão intracraniana (PIC foi adotada em 100 pacientes com traumatismo cerebral agudo grave, usando-se preferencialmente um catéter subaracnóide. Associações estatísticas foram avaliadas entre valores máximos de PIC e : 1 número de pontos na Escala de Coma de Glasgow (ECG; 2 achados na tomografia computadorizada (TC da cabeça; e 3 mortalidade. Encontrou-se associação significante entre baixo número de pontos (3 a 5 na ECG e PIC elevada, assim como entre lesões focais na TC e hipertensão intracraniana. A mortalidade foi significantemente maior em pacientes com PIC > 40 mm Hg do que naqueles com PIC < 20 mm Hg.

  7. Fatores prognósticos de sobrevida pós-reanimação cardiorrespiratória cerebral em hospital geral In-hospital post-cardiopulmonary-cerebral resuscitation survival prognostic factors

    Directory of Open Access Journals (Sweden)

    André Mansur de Carvalho Guanaes Gomes

    2005-10-01

    Full Text Available OBJETIVO: Analisar as características clínicas e demográficas dos pacientes que receberam reanimação cardiorrespiratória e detectar fatores prognósticos de sobrevivência a curto e longo prazo. MÉTODOS: Analisamos, prospectivamente, 452 pacientes que receberam reanimação em hospitais gerais de Salvador. Utilizou-se análise uni, bivariada e estratificada nas associações entre as variáveis e a curva de sobrevida de Kaplan-Meier e a regressão de Cox para análise de nove anos de evolução. RESULTADOS: A idade variou de 14 a 93 anos, media de 54,11 anos; predominou o sexo masculino; metade dos pacientes tinha ao menos uma doença de base, enfermidade cardiovascular foi etiologia responsável em metade dos casos. Parada cardíaca foi testemunhada em 77% dos casos e em apenas 69% dos pacientes foi iniciada imediatamente a reanimação. O ritmo cardíaco inicial não foi diagnosticado em 59% dos pacientes. Assistolia foi o ritmo mais freqüente (42%, seguida de arritmia ventricular (35%. A sobrevida imediata foi de 24% e sobrevida à alta hospitalar de 5%. Foram identificados como fatores prognósticos em curto prazo: etiologia da parada; diagnóstico do ritmo cardíaco inicial; fibrilação ou taquicardia ventricular como mecanismo de parada; tempo estimado préreanimação menor ou igual a 5 minutos e, tempo de reanimação menor ou igual a 15 minutos. Os fatores prognósticos de sobrevivência em nove anos de evolução foram: não ter recebido epinefrina; ser reanimado em hospital privado e tempo de reanimação menor ou igual a 15 minutos. CONCLUSÃO: Os dados observados podem servir de subsídios para os profissionais de saúde decidir quando iniciar ou parar uma reanimação no ambiente hospitalar.OBJECTIVE: To assess clinical and demographic characteristics of patients who had cardiopulmonary resuscitation and identify short- and long-term survival prognostic factors. METHODS: Four hundred and fifty-two (452 resuscitated

  8. Tuberculoma cerebral

    OpenAIRE

    BARROSO ELIZABETH CLARA; OLIVEIRA TÂNIA REGINA BRÍGIDO DE; AMARAL ANA MARIA DANTAS DO; PINHEIRO VALÉRIA GÓES FERREIRA; SOUSA ANA LÚCIA DE OLIVEIRA

    2002-01-01

    Relata-se o caso de paciente com crises convulsivas de início recente. A tomografia computadorizada cerebral evidenciou imagem sugestiva de lesão expansiva metastática frontoparietal direita. A investigação de tumor primário ou outra doença foi negativa e o exame histopatológico do tecido cerebral diagnosticou tuberculoma. As convulsões foram controladas com a associação de hidantoína 300mg/dia ao esquema específico, utilizado por 18 meses. A tuberculose do sistema nervoso central representa ...

  9. Avaliação e participação do fisioterapeuta na prescrição do mobiliário escolar utilizado por alunos com paralisia cerebral em escolas estaduais públicas da rede regular de ensino Evaluation and participation of physical therapists on the school furniture prescription for students with cerebral palsy in public schools of the regular school network

    Directory of Open Access Journals (Sweden)

    Luzia Lívia Oliveira Saraiva

    2011-08-01

    Full Text Available O estudo teve como objetivo avaliar as condições do mobiliário escolar disponibilizado aos alunos com paralisia cerebral nas escolas estaduais da cidade do Natal/RN em 2008 e a participação do fisioterapeuta na prescrição deste mobiliário. Os dados foram coletados através de um protocolo de avaliação junto a cinco alunos com paralisia cerebral e formulário aplicado aos diretores das instituições de ensino, sendo analisados por meio das categorias suscitadas. Os resultados apontaram a presença de mobiliário escolar que não atende as necessidades específicas de posicionamento dos alunos avaliados e a ausência do fisioterapeuta na prescrição desse mobiliário. Constata-se a necessidade dos órgãos gestores no âmbito da educação de Natal/RN em cumprir o que determina a lei e disponibilizar mobiliário escolar adequado aos alunos pesquisados. Assim, procurou-se garantir os recursos necessários para promover um ensino de qualidade para os educandos com paralisia cerebral no contexto da escola regular.The objective of this study was to evaluate the conditions of school furniture available for students with cerebral palsy in public schools in the city Natal, Rio Grande do Norte in 2008, looking at how physical therapists participated in the process of prescribing such furniture. The data was collected using an evaluation protocol with students with cerebral palsy and with school principals who filled out forms. The analysis was undertaken according to the categories that arose from the data. The results indicated that: 1 school furniture doesn’t meet the specific positioning needs of the students that were evaluated and 2 physical therapists do not participate in prescribing appropriate furniture. The study showed that in Natal, Rio Grande do Norte, educational administrators need to carry out the policies that have been determined by law in order to make proper school furniture available to students with cerebral palsy. The

  10. Electrical source imaging of interictal spikes using multiple sparse volumetric priors for presurgical epileptogenic focus localization.

    Science.gov (United States)

    Strobbe, Gregor; Carrette, Evelien; López, José David; Montes Restrepo, Victoria; Van Roost, Dirk; Meurs, Alfred; Vonck, Kristl; Boon, Paul; Vandenberghe, Stefaan; van Mierlo, Pieter

    2016-01-01

    Electrical source imaging of interictal spikes observed in EEG recordings of patients with refractory epilepsy provides useful information to localize the epileptogenic focus during the presurgical evaluation. However, the selection of the time points or time epochs of the spikes in order to estimate the origin of the activity remains a challenge. In this study, we consider a Bayesian EEG source imaging technique for distributed sources, i.e. the multiple volumetric sparse priors (MSVP) approach. The approach allows to estimate the time courses of the intensity of the sources corresponding with a specific time epoch of the spike. Based on presurgical averaged interictal spikes in six patients who were successfully treated with surgery, we estimated the time courses of the source intensities for three different time epochs: (i) an epoch starting 50 ms before the spike peak and ending at 50% of the spike peak during the rising phase of the spike, (ii) an epoch starting 50 ms before the spike peak and ending at the spike peak and (iii) an epoch containing the full spike time period starting 50 ms before the spike peak and ending 230 ms after the spike peak. To identify the primary source of the spike activity, the source with the maximum energy from 50 ms before the spike peak till 50% of the spike peak was subsequently selected for each of the time windows. For comparison, the activity at the spike peaks and at 50% of the peaks was localized using the LORETA inversion technique and an ECD approach. Both patient-specific spherical forward models and patient-specific 5-layered finite difference models were considered to evaluate the influence of the forward model. Based on the resected zones in each of the patients, extracted from post-operative MR images, we compared the distances to the resection border of the estimated activity. Using the spherical models, the distances to the resection border for the MSVP approach and each of the different time epochs were in

  11. Electrical source imaging of interictal spikes using multiple sparse volumetric priors for presurgical epileptogenic focus localization

    Directory of Open Access Journals (Sweden)

    Gregor Strobbe

    2016-01-01

    Full Text Available Electrical source imaging of interictal spikes observed in EEG recordings of patients with refractory epilepsy provides useful information to localize the epileptogenic focus during the presurgical evaluation. However, the selection of the time points or time epochs of the spikes in order to estimate the origin of the activity remains a challenge. In this study, we consider a Bayesian EEG source imaging technique for distributed sources, i.e. the multiple volumetric sparse priors (MSVP approach. The approach allows to estimate the time courses of the intensity of the sources corresponding with a specific time epoch of the spike. Based on presurgical averaged interictal spikes in six patients who were successfully treated with surgery, we estimated the time courses of the source intensities for three different time epochs: (i an epoch starting 50 ms before the spike peak and ending at 50% of the spike peak during the rising phase of the spike, (ii an epoch starting 50 ms before the spike peak and ending at the spike peak and (iii an epoch containing the full spike time period starting 50 ms before the spike peak and ending 230 ms after the spike peak. To identify the primary source of the spike activity, the source with the maximum energy from 50 ms before the spike peak till 50% of the spike peak was subsequently selected for each of the time windows. For comparison, the activity at the spike peaks and at 50% of the peaks was localized using the LORETA inversion technique and an ECD approach. Both patient-specific spherical forward models and patient-specific 5-layered finite difference models were considered to evaluate the influence of the forward model. Based on the resected zones in each of the patients, extracted from post-operative MR images, we compared the distances to the resection border of the estimated activity. Using the spherical models, the distances to the resection border for the MSVP approach and each of the different time

  12. Patent foramen ovale in a cohort of young patients with cryptogenic ischemic stroke Forame oval patente em uma coorte de pacientes jovens com acidente vascular cerebral isquêmico

    Directory of Open Access Journals (Sweden)

    Marcus Tulius T. Silva

    2005-06-01

    Full Text Available OBJECTIVE: Although its role is a matter of debate, some studies described a higher prevalence of patent foramen ovale (PFO and atrial septal aneurysm (ASA in young stroke patients, with higher risk with PFO / ASA association (OR 4.96. The aim of this study was determine the prevalence of PFO and ASA in a cohort of cryptogenic ischemic stroke (IS patients younger than 55 years and to follow-up after surgical or percutaneous endovascular closure (PEC. METHOD: In 21 months we identified all patients less than 55 years old with IS who were admitted to our hospital. Cryptogenic IS was considered if there is not an identifiably cause to cerebral ischemia. Transesophageal echocardiography (TEE was performed in all patients. After interatrial septal abnormalities diagnosis, percutaneous device closure was offered to all. Patients were followed monthly and keeped with oral AAS or Clopidogrel. RESULTS: We identified 189 patients with IS and 32 were less than 55 years old (16.9%. In 29 the IS was cryptogenic. TEE was performed in all patients and some form of interatrial septal abnormality was identified in 12 (12/29 - 41.3%; 5 had a PFO and in 7 there was PFO plus ASA. Ten patients were submitted to PEC and 2 were submitted to surgical closure. In mid-term follow-up (28 months no ischemic events occurred and 2 patients related disappearance of migraine symptoms. CONCLUSION: Our small series description is in accordance with other studies and suggests a possible relation between interatrial septal abnormalities and IS in a cohort of young patient.OBJETIVO: A associação das anormalidades do septo interatrial - forame oval patente (FOP e aneurisma de septo interatrial (ASA - com acidente vascular cerebral isquêmico (AVCI ainda é questão de incerteza para muitos autores. No entanto, vários estudo mostram que em pacientes jovens tais anormalidades podem estar relacionadas à gênese de eventos isquêmicos. Nosso objetivo é descrever a prevalência do

  13. Hemodynamic response to Interictal Epileptiform Discharges addressed by personalized EEG-fNIRS recordings

    Directory of Open Access Journals (Sweden)

    Giovanni ePellegrino

    2016-03-01

    Full Text Available Objective: We aimed at studying the hemodynamic response (HR to Interictal Epileptic Discharges (IEDs using patient-specific and prolonged simultaneous ElectroEncephaloGraphy (EEG and functional Near InfraRed Spectroscopy (fNIRS recordings. Methods: The epileptic generator was localized using Magnetoencephalography source imaging. fNIRS montage was tailored for each patient, using an algorithm to optimize the sensitivity to the epileptic generator. Optodes were glued using collodion to achieve prolonged acquisition with high quality signal. fNIRS data analysis was handled with no a priori constraint on HR time course, averaging fNIRS signals to similar IEDs. Cluster-permutation analysis was performed on 3D reconstructed fNIRS data to identify significant spatio-temporal HR clusters. Standard (GLM with fixed HRF and cluster-permutation EEG-fMRI analyses were performed for comparison purposes. Results: fNIRS detected HR to IEDs for 8/9 patients. It mainly consisted oxy-hemoglobin increases (7 patients, followed by oxy-hemoglobin decreases (6 patients. HR was lateralized in 6 patients and lasted from 8.5 to 30s. Standard EEG-fMRI analysis detected an HR in 4/9 patients (4/9 without enough IEDs, 1/9 unreliable result. The cluster-permutation EEG-fMRI analysis restricted to the region investigated by fNIRS showed additional strong and non-canonical BOLD responses starting earlier than the IEDs and lasting up to 30s. Conclusions: i EEG-fNIRS is suitable to detect the HR to IEDs and can outperform EEG-fMRI because of prolonged recordings and greater chance to detect IEDs; ii cluster-permutation analysis unveils additional HR features underestimated when imposing a canonical HR function iii the HR is often bilateral and lasts up to 30s.

  14. Computer aided diagnosis and localization of lateralized temporal lobe epilepsy using interictal FDG-PET

    Directory of Open Access Journals (Sweden)

    WesleyThomasKerr

    2013-04-01

    Full Text Available Interictal FDG-PET (iPET is a core tool for localizing the epileptogenic focus, potentially before structural MRI, that does not require rare and transient epileptiform discharges or seizures on EEG. The visual interpretation of iPET is challenging and requires years of epilepsy-specific expertise. We have developed an automated computer-aided diagnostic (CAD tool that has the potential to work both independent of and synergistically with expert analysis. Our tool operates on distributed metabolic changes across the whole brain measured by iPET to both diagnose and lateralize temporal lobe epilepsy. When diagnosing left temporal lobe epilepsy (LTLE or right TLE (RTLE versus non-epileptic seizures (NES, our accuracy in reproducing the results of the gold standard long term video-EEG monitoring was 82% (95% confidence interval [CI] 69-90% or 88% (95% CI 76-94%, respectively. The classifier that both diagnosed and lateralized the disease had overall accuracy of 76% (95% CI 66-84%, where 89% (95% CI 77-96% of patients correctly identified with epilepsy were correctly lateralized. When identifying LTLE, our CAD tool utilized metabolic changes across the entire brain. By contrast, only temporal regions and the right frontal lobe cortex, were needed to identify RTLE accurately, a finding consistent with clinical observations and indicative of a potential pathophysiological difference between RTLE and LTLE. The goal of CADs is to complement—not replace—expert analysis. In our dataset, the accuracy of manual analysis of iPET (~80% was similar to CAD. The square correlation between our CAD tool and manual analysis, however, was only 30%, indicating that our CAD tool does not recreate manual analysis. The addition of clinical information to our CAD, however, did not substantively change performance. These results suggest that automated analysis might provide clinically valuable information to focus treatment more effectively.

  15. Interictal epileptiform discharge effects on neuropsychological assessment and epilepsy surgical planning.

    Science.gov (United States)

    Drane, Daniel L; Ojemann, Jeffrey G; Kim, Michelle S; Gross, Robert E; Miller, John W; Faught, R Edward; Loring, David W

    2016-03-01

    Both animal research and human research suggest that interictal epileptiform discharges (IEDs) may affect cognition, although the significance of such findings remains controversial. We review a wide range of literature with bearing on this topic and present relevant epilepsy surgery cases, which suggest that the effects of IEDs may be substantial and informative for surgical planning. In the first case, we present a patient with epilepsy with left anterior temporal lobe (TL) seizure onset who experienced frequent IEDs during preoperative neuropsychological assessment. Cognitive results strongly lateralized to the left TL. Because the patient failed performance validity tests and appeared amnestic for verbal materials inconsistent with his work history, selected neuropsychological tests were repeated 6 weeks later. Scores improved one to two standard deviations over the initial evaluation and because of this improvement, were only mildly suggestive of left TL impairment. The second case involves another patient with documented left TL epilepsy who experienced epileptiform activity while undergoing neurocognitive testing and simultaneous ambulatory EEG recording. This patient's verbal memory performance was impaired during the period that IEDs were present but near normal when such activity was absent. Overall, although the presence of IEDs may be helpful in confirming laterality of seizure onset, frequent IEDs might disrupt focal cognitive functions and distort accurate measurement of neuropsychological ability, interfering with accurate characterization of surgical risks and benefits. Such transient effects on daily performance may also contribute to significant functional compromise. We include a discussion of the manner in which IED effects during presurgical assessment can hinder individual patient presurgical planning as well as distort outcome research (e.g., IEDs occurring during presurgical assessment may lead to an underestimation of postoperative

  16. Influence of metallic artifact filtering on MEG signals for source localization during interictal epileptiform activity

    Science.gov (United States)

    Migliorelli, Carolina; Alonso, Joan F.; Romero, Sergio; Mañanas, Miguel A.; Nowak, Rafał; Russi, Antonio

    2016-04-01

    Objective. Medical intractable epilepsy is a common condition that affects 40% of epileptic patients that generally have to undergo resective surgery. Magnetoencephalography (MEG) has been increasingly used to identify the epileptogenic foci through equivalent current dipole (ECD) modeling, one of the most accepted methods to obtain an accurate localization of interictal epileptiform discharges (IEDs). Modeling requires that MEG signals are adequately preprocessed to reduce interferences, a task that has been greatly improved by the use of blind source separation (BSS) methods. MEG recordings are highly sensitive to metallic interferences originated inside the head by implanted intracranial electrodes, dental prosthesis, etc and also coming from external sources such as pacemakers or vagal stimulators. To reduce these artifacts, a BSS-based fully automatic procedure was recently developed and validated, showing an effective reduction of metallic artifacts in simulated and real signals (Migliorelli et al 2015 J. Neural Eng. 12 046001). The main objective of this study was to evaluate its effects in the detection of IEDs and ECD modeling of patients with focal epilepsy and metallic interference. Approach. A comparison between the resulting positions of ECDs was performed: without removing metallic interference; rejecting only channels with large metallic artifacts; and after BSS-based reduction. Measures of dispersion and distance of ECDs were defined to analyze the results. Main results. The relationship between the artifact-to-signal ratio and ECD fitting showed that higher values of metallic interference produced highly scattered dipoles. Results revealed a significant reduction on dispersion using the BSS-based reduction procedure, yielding feasible locations of ECDs in contrast to the other two approaches. Significance. The automatic BSS-based method can be applied to MEG datasets affected by metallic artifacts as a processing step to improve the localization of

  17. Detection of Intracranial Signatures of Interictal Epileptiform Discharges from Concurrent Scalp EEG.

    Science.gov (United States)

    Spyrou, Loukianos; Martín-Lopez, David; Valentín, Antonio; Alarcón, Gonzalo; Sanei, Saeid

    2016-06-01

    Interictal epileptiform discharges (IEDs) are transient neural electrical activities that occur in the brain of patients with epilepsy. A problem with the inspection of IEDs from the scalp electroencephalogram (sEEG) is that for a subset of epileptic patients, there are no visually discernible IEDs on the scalp, rendering the above procedures ineffective, both for detection purposes and algorithm evaluation. On the other hand, intracranially placed electrodes yield a much higher incidence of visible IEDs as compared to concurrent scalp electrodes. In this work, we utilize concurrent scalp and intracranial EEG (iEEG) from a group of temporal lobe epilepsy (TLE) patients with low number of scalp-visible IEDs. The aim is to determine whether by considering the timing information of the IEDs from iEEG, the resulting concurrent sEEG contains enough information for the IEDs to be reliably distinguished from non-IED segments. We develop an automatic detection algorithm which is tested in a leave-subject-out fashion, where each test subject's detection algorithm is based on the other patients' data. The algorithm obtained a [Formula: see text] accuracy in recognizing scalp IED from non-IED segments with [Formula: see text] accuracy when trained and tested on the same subject. Also, it was able to identify nonscalp-visible IED events for most patients with a low number of false positive detections. Our results represent a proof of concept that IED information for TLE patients is contained in scalp EEG even if they are not visually identifiable and also that between subject differences in the IED topology and shape are small enough such that a generic algorithm can be used. PMID:27052034

  18. Clinical value of scatter correction for interictal brain 99m Tc-HMPAO SPECT in mesial temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Aim: It is well known that some patients with temporal lobe epilepsy (TLE) show normal perfusion during interictal SPECT study. The aim of this research was to evaluate if the scatter radiation has some influence on this kind of result. Materials and Methods: We studied 15 patients with TLE by clinical diagnosis and by video-EEG monitoring with surface electrodes (11 left TLE, 4 right TLE), which showed normal perfusion during interictal brain 99mTc-HMPAO SPECT. The SPECT data were reconstructed by filtered backprojection without scatter correction (A). The same SPECT data were reconstructed after the projections were corrected by dual energy window method of scatter correction (B). Attenuation was corrected in all cases using first order Chang Method. For A and B images groups, cerebellum perfusion ratios were calculated on irregular regions of interest (ROI) drawn on anterior (ATL), lateral (LTL), mesial (MTL) and whole temporal lobe (WTL). To evaluate the influence of scatter radiation, the cerebellum perfusion ratios of each subject were compared with a normal database of 10 normal subjects, with and without scatter correction, using z-score analysis. Results: In group A, the z-score was less than 2 in all cases. In group B, the z-score was more than 2 in 6 cases, 4 in MTL (3 left, 1 right) and 2 in left LTL, which were coincident with the EEG localization. All images of group B showed better contrast than images of group A. Conclusions: These results suggest that scatter correction could improve the sensitivity of interictal brain SPECT to identify epileptic focus in patients with TLE

  19. Cerebral Arteriosclerosis

    Science.gov (United States)

    ... the brain can cause a hemorrhagic stroke. Both types of stroke can be fatal. Cerebral arteriosclerosis is also related to a condition known as vascular dementia, in which small, symptom-free strokes cause cumulative damage and death to neurons (nerve cells) in the brain. Personality changes in ...

  20. Epileptic patterns of local cerebral metabolism and perfusion in man determined by emission computed tomography of /sup 18/FDG and /sup 13/NH/sub 3/

    Energy Technology Data Exchange (ETDEWEB)

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

    1979-01-01

    Seventeen patients with partial epilepsy had EEG monitoring concurrent with cerebral emission computed tomography (ECT) after /sup 18/F-fluorodeoxyglucose (/sup 18/FDG) and /sup 13/N-ammonia were given intravenously as indicators of local cerebral glucose utilization (LCMR/sub glc/) and relative perfusion, respectively. In 12 of 15 patients who had unilateral or focal electrical abnormalities, interictal /sup 18/FDG scan patterns clearly showed localized regions of decreased (20% to 50%) LCMR/sub glc/, which correlated anatomically with the eventual EEG localization. These hypometabolic zones appeared normal on x-ray computed tomography in all but three patients and were unchanged on scans repeated on different days. In 5 of 6 patients who underwent temporal lobectomy, the interictal /sup 18/FDG scan correctly detected the pathologically confirmed lesion as a hypometabolic zone, and removal of the lesion site resulted in marked clinical improvement. In contrast, the ictal /sup 18/FDG scan patterns clearly showed foci of increased (82% to 130%) LCMR/sub glc/, which correlated temporally and anatomically with ictal EEG spike foci and were within the zones of interictal hypometabolism (3 studies in 2 patients). /sup 13/NH/sub 3/ distributions paralleled /sup 18/FDG increases and decreases in abnormal zones, but /sup 13/NH/sub 3/ differences were of lesser magnitude. When the relationship of /sup 13/NH/sub 3/ uptake to local blood flow found in dog brain was applied as a correction to the patients' /sup 13/NH/sub 3/ scan data, local alterations in perfusion and glucose utilization were usually matched, both in the interictal and ictal states.

  1. A gênese cerebral da imagem corporal: algumas considerações sobre o fenômeno dos membros fantasmas em Ramachandran The cerebral genesis of body image: some considerations about phantom-limbs in Ramachandran

    Directory of Open Access Journals (Sweden)

    Sergio Gomes da Silva

    2013-01-01

    Full Text Available Os distúrbios da imagem do corpo, na forma conferida pelo fenômeno dos "membros fantasmas", tomaram grande parte dos estudos do neurologista indiano V. S. Ramachandran. Seu trabalho, por meio de testes psicofísicos e estudos de imagem funcional em pacientes com "membros fantasmas", demonstrou aquilo que ele denominou "plasticidade neural" ou "plasticidade cortical" em cérebros humanos adultos. Este artigo tem por objetivo analisar criticamente a construção da imagem do corpo, da interioridade e do self a partir das principais teses neurológicas de Ramachandran sobre o fenômeno dos "membros fantasmas". Defende-se a ideia de que, apesar de o autor apresentar novas modalidades de descrições subjetivas e narrativas da mente, a experiência subjetiva e a construção da imagem corporal também devem ser explicadas em termos da relação corpo-ambiente ou corpo-mundo, na qual se destaca o papel da linguagem e das narrativas de si.The body image problems, as provided by "phantom limbs", took most studies of Indian neurologist V. S. Ramachandran. His work, through psychophysical tests and functional imaging studies in patients with "phantom limbs", demonstrated the "neural plasticity" or "cortical plasticity" in the adult human brain. This paper aims to examine the construction of body image, the inner life and the "self" from the Ramachandran neurological approaches on the phenomenon of "phantom limbs." We supports the idea that although the author presents new subjective and narrative descriptions of mind, the subjective experience and the construction of body image should also be explained in terms of the body-environment or body-world relationship, in which the role language and self-narratives stand out.

  2. Hemorragia intracraniana espontânea em pediatria: relato de paciente hemofílico que sobreviveu devido a cisto cerebral

    OpenAIRE

    José Colleti Junior; Walter Koga; Werther Brunow de Carvalho

    2015-01-01

    RESUMO Relatamos o caso de um uma criança de 2 anos de idade que sobreviveu após um episódio agudo de hemorragia intracraniana espontânea grave com sinais clínicos e radiológicos de hipertensão intracraniana e herniação transtentorial. O paciente foi para cirurgia de urgência para drenagem do hematoma, sendo inserido um cateter para monitorar a pressão intracraniana. Na análise da tomografia de crânio inicial, antes da drenagem do hematoma, constatou-se um cisto cerebral contralateral ao hema...

  3. Percepção de conflito em uma família recasada constituída por um filho com paralisia cerebral Perception of conflict in a stepfamily with a child with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Hilda Rosa Moraes de Freitas

    2012-03-01

    Full Text Available O aumento no número de separação/divórcio favorece o surgimento de novas estruturas familiares. Nesse sentido, o recasamento desponta como uma possibilidade de ordenamento do grupo familiar, que impõe à nova família uma reorganização, sobretudo nas vidas afetiva, social e econômica, assim como maior flexibilidade para negociar questões de associação, espaço, autoridade e tempo. O objetivo deste artigo foi descrever a estrutura e a dinâmica de uma família recasada, na qual há uma criança com paralisia cerebral, a partir de suas representações acerca de situações de conflito. Neste estudo de caso, foi pesquisada uma família, constituída, por três membros, mãe, filho e padrasto; foram aplicados um roteiro de entrevista semiestruturado e o Family System Test (FAST. Os escores obtidos no FAST demonstraram proximidade na díade mãe-filho e distanciamento na díade padrasto-enteado, com a hierarquia concentrada na mãe; quanto à flexibilidade das fronteiras, a percepção do casal indicou fronteiras rígidas tanto no sistema familiar quanto no parental, diferenciando-se da percepção do filho sobre o sistema familiar com uma fronteira difusa. Portanto, alguns fatores destacados na literatura e presentes nessa família como: diferença no ciclo de vida do casal; pouco tempo de união; bagagem emocional entre mãe e filho, associados às demandas de cuidado da criança, seus recursos biopsicológicos e disposições; configuraram um padrão rígido, com baixa flexibilidade, o que dificulta a inserção do padrasto no grupo e, consequente, assunção de co-paternidade nos cuidados e criação do enteado.The increase in the number of separation/divorce has favored the emergence of new family structures. Thus, remarriage becomes a possibility for developing the family group which requires emotional, social and economic reorganization of the family, as well as greater flexibility to negotiate association, space, time and

  4. Avaliação da flexibilidade pelo método do Flexômetro de Wells em crianças com Paralisia Cerebral submetidas a tratamento hidroterapêutico: estudo de casos - doi: 10.4025/actascihealthsci.v32i2.8019 Flexibility evaluation by the method of Wells’ Flexometer in children with Cerebral Palsy submitted to hydrotherapy treatment: study of the cases - doi: 10.4025/actascihealthsci.v32i2.8019

    OpenAIRE

    Vicente de Paula Antunes Teixeira; Marlene Antônia Reis; Débora Tavares Resende Silva Abate; Camila Souza de Oliveira Guimarães; Millena Prata Jammal; Ana Paula Espindula

    2010-01-01

    Avaliar a flexibilidade da cadeia muscular posterior, utilizando o método proposto por Wells e Dillon, antes e após cada sessão de hidroterapia. Foi verificada a flexibilidade de três crianças com Paralisia Cerebral (PC) diparéticas, com idades entre sete a dez anos. Os valores de flexibilidade foram aferidos, utilizando o Flexômetro de Wells. Houve aumento significativo da flexibilidade da cadeia muscular posterior dos pacientes após cada sessão de hidroterapia, tanto na avaliação em grupo q...

  5. Avaliação dos achados ao exame dos potenciais evocados do tronco cerebral em indivíduos com síndrome de West Evaluation of the brainstem evoked potentials in West syndrome

    Directory of Open Access Journals (Sweden)

    Alfredo Lopes Pereira Filho

    2004-01-01

    Full Text Available A síndrome de West é um tipo de espasmo infantil caracterizado por encefalopatia epiléptica associado a espasmos em flexão e deficiência mental de instalação no primeiro ano de vida e de etiologia incerta. Acredita-se ser determinada por diferentes fatores etiológicos como infeção intrauterina, esclerose tuberosa, asfixia perinatal ou afecções pós-natais. FORMA DE ESTUDO: Observacional coorte com corte transversal. MATERIAL E MÉTODO: No presente estudo dez pacientes com Síndrome de West foram submetidos ao exame de Potencial Evocado de Tronco Cerebral (BERA para avaliar o envolvimento do tronco cerebral e das vias auditivas a este nível. RESULTADO: Os achados anormais ao BERA incluem alteração na morfologia das curvas com reprodutibilidade apenas de onda I e II, (caso 7, aumento do intervalo interpico da onda I-V (casos 1, 2 e 9, aumento da proporção de amplitude da onda I/V (caso 8 e alteração do limiar eletrofisiológico (caso 7. Tais achados ao BERA sugerem que a disfunção do sistema nervoso resulte principalmente da hipogênese ou degeneração das células nervosas, em parte como resultado da dismielinização. CONCLUSÃO: Os autores recomendam o uso de estudos eletrofisiológicos para avaliar a disfunção do sistema nervoso central no paciente com suspeita de espasmo infantil.The West syndrome is a pediatric disease that involves muscular spasm, mental deficiency and epileptic encephalopathy. This disease tends to be noticed in the first year of life and has no etiology known. It is believed to be caused by different etiology factors as uterine infection, tuberous sclerosis, perinatal asphyxia, or post-born diseases. STUDY DESIGN: Observacional cohort with transversal cut. MATERIAL AND METHOD: In this study, ten West Syndrome patients were submitted to Auditory Brainstem Response (ABR to evaluate the involvement of the hearing system. RESULTS: The abnormal results consisted in morphological alterations (case 7

  6. Profilaxia de tromboembolismo venoso em pacientes com lesão cerebral traumática Venous thromboembolism prophylaxis in patients with traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Tanya L. Zakrison

    2012-12-01

    Full Text Available Traumatismo crânio-encefálico (TCE, com hemorragia intracraniana associada (HIC ocorre com frequência em trauma. Pacientes vítimas de trauma também estão em alto risco de desenvolver complicações venosas tromboembólicas (TEV. Heparina de Baixo Peso Molecular (HBPM é utilizada em pacientes de trauma, como profilaxia para reduzir o risco de eventos de TEV. Ainda não está claro, no entanto, se a HBPM é segura para uso em pacientes com trauma com HIC por receio da progressão do hematoma. O Clube de Revista "Telemedicina Baseada em Evidências: Cirurgia do Trauma e Emergência (TBE-CiTE" realizou uma apreciação crítica de três estudos recentes e mais relevantes no tocante ao momento de início da profilaxia, à segurança e ao uso de HBPM em pacientes com trauma e HIC. Especificamente, três estudos foram revisados: i uma revisão crítica da literatura sobre o tema, ii um estudo multicêntrico, estudo de coorte retrospectivo avaliando a segurança de HBPM em pacientes com trauma, e com HIC e iii um estudo piloto randomizado, avaliando a viabilidade e as taxas de eventos de progressão de HIC, servindo como base para futuros ensaios clínicos randomizados (ECR sobre o tema. Alguns resultados são conflitantes, com o maior nível de evidência sendo o ECR piloto demonstrando a segurança para o uso precoce de HBPM no TCE associado com HIC. Grande parte desta pesquisa, porém, foi gerada por um único centro e, consequentemente, carece de validade externa. Além disso, as recomendações clínicas não podem ser geradas com base em estudos-piloto. Diretrizes baseadas em evidências e recomendações não podem ser feitas, neste momento, até a realização de outros estudos sobre este assunto desafiador.Traumatic brain injury (TBI with associated intracranial hemorrhage (ICH occurs frequently in trauma. Trauma patients are also at high risk of developing venous thromboembolic (VTE complications. Low Molecular Weight Heparin (LMWH is

  7. Employees with Cerebral Palsy

    Science.gov (United States)

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

  8. Acidente vascular cerebral em pacientes jovens: análise de 164 casos Stroke in young adults: analysis of 164 patients

    Directory of Open Access Journals (Sweden)

    Viviane H. Flumignan Zétola

    2001-09-01

    Full Text Available Realizamos análise epidemiológica de 164 pacientes com AVC, cujo primeiro episódio ocorreu entre 15 e 49 anos de idade através de um estudo retrospectivo de pacientes ambulatoriais. O principal tipo de apresentação foi AVC isquêmico (AVCI em 141 pacientes, ocorrendo AVC hemorrágico (AVCH em16 casos e 7 pacientes com trombose venosa. A presença de fatores de risco aterotrombóticos foi prevalente, em 48,22% dos pacientes com AVCI sendo que a hipertensão arterial sistêmica (HAS, nos casos de AVCH, foi a etiologia mais frequente. Em 32% dos casos não se pode determinar a sua causa. Embora a população jovem possua determinantes diferentes e geralmente deva ter uma investigação etiológica mais abrangente, no grupo estudado foram prevalentes os fatores de risco conhecidos e potencialmente controláveis, sugerindo que campanhas de prevenção e detecção precoce devam ser incentivados.We retrospectively analyzed the epidemiological features of 164 out-clinic patients with a first-onset stroke between 15 and 49 years old. Ischemic stroke occurred in 141 patients, hemorrhagic stroke in 16 patients, and venous thrombosis in 7 patients. Forty-eight percent of ischemic strokes were atherothrombotic, but no etiology was found in 32% of patients with ischemic stroke. Systemic arterial hypertension was the most frequent etiology in the hemorrhagic stroke group. The most frequent risk factors were systemic arterial hypertension, smoking, hypercholesterolemia, alcoholism and diabetes mellitus. Although stroke in young adults deserves some specific etiological investigation, we found that ordinary risk factors such as hypertension, tabacco use, hypercolesteremia and diabetes were prevalent in our population. It seems that prevention campaigns should be the target of our work.

  9. Short-term prognosis for speech and language in first stroke patients Prognóstico em curto prazo para fala e linguagem em pacientes acometidos de infarto cerebral único

    Directory of Open Access Journals (Sweden)

    Fabricio F. Oliveira

    2009-09-01

    Full Text Available OBJECTIVE: To evaluate the factors that can influence evolution of communication after a first stroke. METHOD: Thirty-seven adult patients were evaluated for speech and language within 72 hours after a single first-ever ischemic brain injury and later on. Patients who were comatose, with decompensated systemic diseases, or history of chronic alcoholism or illicit drug use were not included. Brain CT and/or 2T-MR exams were solicited for topographic correlation. Size of infarct was classified as large or small according to the TOAST classification. RESULTS: Patients who survived had lesser chances of presenting with aphasia or dysarthria 3 months after the stroke if the infarct size was small (p=0.017. Gender, age, schooling, aphasia subtype, infarct side and topography were non-significant in our sample. Subjects with global aphasia or lone cortical dysarthria had a slower evolution. CONCLUSION: Brain injury size was the most influential factor for neurological outcome at 3 months post-stroke.OBJETIVO: Avaliar os fatores que podem influenciar o desempenho neurolinguístico após um primeiro acidente vascular cerebral isquêmico. MÉTODO: Foram avaliados 37 pacientes quanto a fala e linguagem dentro de 72 horas após um primeiro infarto cerebral e posteriormente. Pacientes comatosos, com doenças sistêmicas descompensadas, história de etilismo crônico ou uso de drogas ilícitas não foram incluídos. TC e/ou RMN-2T cerebrais foram solicitadas para correlação topográfica. Utilizou-se a classificação TOAST para o tamanho do infarto (grande ou pequeno. RESULTADOS: Sobreviventes tiveram menores chances de apresentarem-se afásicos ou disártricos 3 meses após o evento agudo caso o infarto fosse pequeno (p=0.017. Gênero, idade, escolaridade, subtipo de afasia, lado e topografia da lesão cerebral não foram fatores estatisticamente significativos. Pacientes portadores de afasia global ou disartria cortical isolada evoluíram mais lentamente

  10. Interictal brain SPECT in patients with medically refractory temporal lobe epilepsy

    International Nuclear Information System (INIS)

    The brain single photon emission computed tomography (SPECT) is s functional neuroimaging method that can detect localized changes in cerebral blood flow. The temporal lobe epilepsy (TLE) is the most common epileptic syndrome in adults, and more than 50% are medically refractory. The SPECT can contribute to investigation of epileptogenic focus and is one of the methods of pre-surgical evaluation of these patients. (author)

  11. Técnica para quantificação e qualificação de material coletado em filtros de proteção cerebral Technique for quantifying and qualifying debris captured in embolic protection filters

    Directory of Open Access Journals (Sweden)

    Gabriel Santos Novaes

    2009-12-01

    Full Text Available Contexto: A qualidade e a quantidade de partículas coletadas em filtros de proteção cerebral (FPC durante angioplastia transluminal percutânea com stent (ATPS podem esclarecer a importância desses dispositivos no tratamento de estenoses carotídeas. Objetivos: Analisar o conteúdo retido por FPC em pacientes submetidos a ATPS de artéria carótida interna com nova técnica de análise qualiquantitativa. Métodos: O material coletado em 10 FPC durante ATPS da bifurcação da carótida em pacientes com alto risco cirúrgico foi submetido a análise microscópica qualiquantitativa. Fotografias digitais das lâminas com material corado com hematoxilina e eosina foram analisadas com o programa Axio Vision LE Release 4.1, que calculou a área das partículas em micrômetros/metro quadrado (µm². Resultados: O exame histopatológico evidenciou material em 100% dos filtros consistindo predominantemente de restos hemáticos, cristais de colesterol e cálcio. A área média de fragmentos coletados foi expressiva (1.570.310 µm², e houve ampla variância desses valores. Conclusões: Os FPC coletam quantidade importante de fragmentos de placas de ateroma, e a grande variância nas quantidades de material coletado pode estar associada com a gravidade da lesão, motivo pelo qual se tornam relevantes estudos que utilizem técnica padronizada para a quantificação desses fragmentos e para a compreensão de seu real significado clínico.Background: Quality and quantity of the content retained in embolic protection filters (EPFs used in percutaneous transluminal angioplasty and stenting may possibly indicate the importance of EPFs in the management of carotid stenosis. Objectives: To analyze the content retained by EPFs in patients undergoing percutaneous transluminal angioplasty and stenting of the internal carotid artery using a new technique for qualitative and quantitative analysis. Methods: Material captured in 10 EPFs during percutaneous

  12. Changes in joint kinematics in children with cerebral palsy while walking with and without a floor reaction ankle-foot orthosis Mudanças na cinemática articular em crianças com paralisia cerebral durante o andar com e sem órteses de reação ao solo

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Garcia Lucareli

    2007-02-01

    apoio da marcha de crianças com paralisia cerebral, comparando a marcha descalça e com o uso das órteses MÉTODOS: Após um estudo retrospectivo de 2200 pacientes avaliados no laboratório de marcha, 71 pacientes com diagnóstico de paralisia cerebral do tipo diparesia espástica e idade média de 12.2 ± 3.9 foram selecionados (142 membros. Nenhum deles apresentou contratura em flexão dos quadris, joelhos e tornozelos. Todos usavam órteses do tipo reação ao solo articulada durante a avaliação da marcha. Os pacientes foram divididos em três grupos: Grupo I Extensão Limitada (pico de extensão do joelho menor que 15º; Grupo II Extenão Moderadamente Limitada (pico de extensão do joelho entre 15º e 30º e Grupo III Agachamento (pico de extensão do joelho no apoio maior que 30º. RESULTADOS: Os resultados demostraram que o pico de extensão do joelho e o pico de dorsiflexão tiveram alterações significantes nos grupos II e III enquanto que o grupo I não apresentou alteração. O pico de extensão do quadril não mostrou alteração nos três grupos CONCLUSÃO: A órtese de reação ao solo é eficaz quando indicada para aumentar a extensão do joelho e tornozelo durante a fase de apoio da marcha de crianças com paralisia cerebral

  13. Cerebral palsy

    International Nuclear Information System (INIS)

    This paper reviews cranial MR findings in patients with cerebral palsy (CP) to clarify and categorize this disorder. The MR images of 40 patients with clinical CP were retrospectively reviewed. All patients suffered either varying spastic plegias, hypotonicity, or choreoathetosis. Concomitantly, the patients suffered from static encephalopathy, developmental delay, and/or microcephaly. Twenty-four patients were born at or near term, 10 were premature, and incomplete birth histories were available in six. The MR images revealed mild to severe degrees of white matter damage in 24 patients (12 term, nine premature, three unknown)

  14. Eixo hormônio de crescimento/fator de crescimento semelhante à insulina-1: um possível fator não nutricional para o retardo de crescimento em crianças com paralisia cerebral

    Directory of Open Access Journals (Sweden)

    Moustafa A. Hegazi

    2012-06-01

    Full Text Available OBJETIVO: Avaliar o eixo hormônio de crescimento (GH/fator de crescimento semelhante à insulina 1 (IGF-1 como possível fator não nutricional para o retardo de crescimento em crianças com paralisia cerebral (PC. MÉTODOS: Um estudo caso-controle foi realizado em um hospital universitário terciário. Trinta crianças com PC [sete crianças com crescimento normal (PC-N e 23 com retardo de crescimento (PC-R], 30 crianças com desnutrição proteico-energética (DPE, e 30 crianças sadias (grupo REF tiveram avaliados seus parâmetros de crescimento, IGF-1 sérico, GH basal, e pico de GH após estímulo com insulina. RESULTADOS: Os pacientes com DPE apresentaram níveis basais mais elevados de GH do que os grupos PC-N, PC-R e REF (p = 0,026, p < 0,001 e p = 0,001, respectivamente. Após estímulo com insulina, os grupos PC-N, PC-R e DPE apresentaram níveis menores de GH se comparados ao grupo REF (p = 0,04, p = 0,007, p = 0,036, respectivamente. O nível de IGF-1 foi menor no grupo PC-R se comparado aos grupos PC-N e REF (p = 0,037 e p < 0,001, respectivamente, e no grupo DPE se comparado aos grupos PC-N e REF (p < 0,001 e p < 0,001, respectivamente. CONCLUSÕES: Os pacientes com PC-R não demonstraram a mesma resposta basal elevada do GH apresentada pelos pacientes com DPE, e responderam de forma inadequada ao estímulo com insulina, mas apresentaram níveis de IGF-1 comparáveis aos dos pacientes com DPE. Por outro lado, os pacientes com PC-N tiveram comportamento semelhante ao dos controles com relação aos níveis basais de GH e IGF-1, mas não responderam adequadamente ao estímulo com insulina. O grupo DPE apresentou GH basal elevado e IGF-1 baixo. Esses achados sugerem que fatores não nutricionais contribuem para o retardo de crescimento em crianças com PC.

  15. Estudo das freqüências dos principais fatores de risco para acidente vascular cerebral isquêmico em idosos Study of the main risk factors frequencies for ischemic cerebrovascular disease in elderly patients

    Directory of Open Access Journals (Sweden)

    Sueli Luciano Pires

    2004-09-01

    Full Text Available Foram estudados retrospectivamente 262 pacientes com diagnóstico clínico de acidente vascular cerebral isquêmico (AVCi permanente, com idade igual ou superior a 60 anos, selecionados dos 1015 registros da Liga de Aterosclerose da Clínica Neurológica da ISCMSP, de 1990 a 2002. O estudo focalizou as freqüências dos fatores de risco modificáveis para AVCi nesta população idosa, considerando-se sexo e faixa etária dos pacientes. Os resultados evidenciaram que a hipertenção arterial sistêmica é significativamente freqüente (87,8% entre pacientes idosos com AVCi, independentemente do sexo e da faixa etária. Tabagismo (46,9% e etilismo (35,1% revelaram-se fatores de riscos modificáveis freqüentes especialmente entre os homens. As cardiopatias (27,0%, o Diabete Melito (19,9% e as dislipidemias (15,6% também se revelaram fatores de risco modificáveis freqüentes em pacientes idosos com AVCi, em ambos os sexos e em ambas as faixas etárias estudadas (60 a 70 anos e mais que 71 anos. Foi relativamente baixa a freqüência de hiperuricemia nesta amostra.Two hundred and sixty two patients with clinical diagnosis of permanent ischemic stroke, all of them aged 60 or more were retrospectively studied from the 1015 cerebrovascular diseases (CVD records of the Atherosclerosis Ligue of the Neurology Clinics of the ISCMSP, from 1990 to 2002. The study emphasized modifiable risk factors frequencies for ischemic stroke in this population, considering gender and age of the patients. Results have evidenced that systemic arterial hypertension is a main risk factor significantly frequent in old people (87.8%, independently of gender and age. Smoking (46.9% and alcohol consumption (35.1% have revealed to be very frequent important modifiable risk factors especially among men. Lower frequencies have been presented for cardiac diseases (27.0%, Diabetes Melitus (19.9%, and dislipidemia (15.6% as risk factors for ischemic stroke in old people of both

  16. Coexistência das síndromes de Capgras e Frégoli associadas à redução de volume frontotemporal e hiperintensidades em substância branca cerebral Coexistence of Capgras and Frégoli syndromes associated to frontotemporal volume reduction and cerebral white matter hyperintensities

    Directory of Open Access Journals (Sweden)

    Gizela Turkiewicz

    2009-01-01

    Full Text Available CONTEXTO: Transtornos delirantes de identificação são condições nas quais os pacientes identificam de maneira patologicamente equivocada pessoas, lugares, objetos ou eventos. Esses transtornos têm sido categorizados em quatro diferentes subtipos: Capgras, Frégoli, intermetamorfose e síndrome do duplo subjetivo. Tais síndromes podem estar presentes em diferentes transtornos psiquiátricos, como esquizofrenia e transtornos do humor, bem como em diferentes doenças neurológicas, como Alzheimer, Parkinson, lesões cerebrais traumáticas ou vasculares. OBJETIVOS: Descrever e discutir um caso de coexistência entre as síndromes de Capgras e Frégoli em uma paciente com esquizofrenia paranoide e com alterações cerebrais. MÉTODOS: Entrevista psiquiátrica e ressonância magnética de crânio. RESULTADOS: A paciente apresentava hiperintensidades periventriculares em aquisição flair e de substância branca subcortical concentradas principalmente na região frontotemporal direita, bem como perda do volume da região frontotemporal bilateral. DISCUSSÃO: As alterações descritas podem representar substrato orgânico das síndromes dos transtornos delirantes de identificação. Os delírios nas síndromes de Capgras e Frégoli podem ocorrer como resultado de uma desconexão têmporo-límbica-frontal direita, resultando em uma impossibilidade de associar memórias prévias a novas informações, levando consequentemente a alterações na capacidade de reconhecimento. Ademais, uma perda do volume de tais regiões cerebrais também pode desempenhar papel importante no desenvolvimento de tais síndromes delirantes de identificação.BACKGROUND: Delusional misidentification syndromes are conditions in which the patients pathologically misidentify people, places, objects or events. They have been categorized in four subtypes: Capgras, Frégoli, intermetamorphosis and subjective double syndromes. Such syndromes may be present in patients with

  17. Predicting mobility gains among children with cerebral palsy after application of botulinum toxin A Predizendo ganhos de mobilidade em crianças com paralisia cerebral após aplicação de toxina botulínica A

    Directory of Open Access Journals (Sweden)

    VCR Cury

    2009-02-01

    Full Text Available BACKGROUND: Botulinum toxin A (BTA is commonly used to treat children with cerebral palsy (CP. However, the variables measured before BTA application and associated with motor function and independent mobility, known as predictors of functional outcomes, have not been well defined. OBJECTIVE: To identify clinical predictors of gains in functional motor skills and independence of mobility among children with CP, three and six months after BTA application. METHODS: This was a convenience sample of children with spastic CP (n=35. Measurements of quantitative gains in motor skills and independence of mobility were taken three and six months after BTA application. These outcomes were observed through repeated applications of two functional tests: GMFM (Gross Motor Function Measure and PEDI (Pediatric Evaluation of Disability Inventory. These tests evaluated gross motor function while sitting or standing and during transitions between these postures, and also during dynamic activities such as walking, running and jumping, along with the children's independence in mobility tasks. The independent variables included the children's characteristics such as age, severity, topographic diagnosis, neuromuscular-skeletal parameters (range of motion and spasticity, gait quality and performance in the functional tests before BTA. RESULTS: Four predictive models were developed (R² between 0.58 and 0.83; pCONTEXTUALIZAÇÃO: A toxina botulínica A (TBA é comumente utilizada em crianças com paralisia cerebral (PC, entretanto preditores de desfechos funcionais, ou seja, variáveis mensuradas pré-aplicação da TBA e associadas a ganho na função motora e independência na mobilidade não são bem definidos. OBJETIVO: Identificar preditores clínicos de ganho em habilidades motoras funcionais e independência em mobilidade em crianças com PC, aos três e seis meses pós-aplicação de TBA. MÉTODOS: Amostra de conveniência de crianças com PC espástica (n=35

  18. Uso de dexmedetomidina em anestesia geral para tratamento cirúrgico de aneurisma cerebral, em paciente gestante, portadora de doença hipertensiva específica da gestação: relato de caso Uso de dexmedetomidina en anestesia general para tratamiento quirúrgico de aneurisma cerebral, en paciente embarazada, portadora de enfermedad hipertensiva específica del embarazo: relato de caso Dexmedetomidine in general anesthesia for surgical treatment of cerebral aneurysm in pregnant patient with specific hypertensive disease of pregnancy: case report

    Directory of Open Access Journals (Sweden)

    Kleber Machareth de Souza

    2005-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A incidência de cirurgias não obstétricas em pacientes gestantes é de 0,36% a 2%. No entanto, cirurgias visando o tratamento cirúrgico de aneurisma cerebral em gestantes são extremamente raras. A doença hipertensiva específica da gestação, apresenta prevalência clínica de 10% na população gestante. Trata-se de uma doença de elevada complexidade clínica, acometendo múltiplos órgãos e sistemas. A dexmedetomidina, fármaco agonista alfa2, apresenta importante seletividade para estes receptores, quando utilizada em doses clínicas terapêuticas e promove adequada estabilidade hemodinâmica, se empregada no período peri-operatório. O objetivo deste relato foi apresentar uma técnica com a qual fosse possível a manutenção da homeostase materna, preservando ao máximo o fluxo sangüíneo útero-placentário e a vitalidade fetal, sem deixar de lado aspectos fundamentais relativos à otimização da relação oferta/demanda de oxigênio cerebral e adequação das condições do tecido cerebral propícias ao manuseio cirúrgico. RELATO DO CASO: Gestante com 19 anos encaminhada para tratamento cirúrgico de aneurisma cerebral, estando na vigésima sétima semana de gestação. No pré-operatório, apresentava-se consciente, orientada, com presença de déficit à esquerda e quadro clínico compatível com toxemia gravídica. Foi administrada dexmedetomidina (1 µg.kg-1 em 20 minutos, seguida de indução anestésica com propofol (2,5 mg.kg-1, fentanil (7,5 µg.kg-1, lidocaína (1 mg.kg-1 e rocurônio (2 mg.kg-1 em seqüência rápida. A manutenção da anestesia foi obtida com propofol (50 µg.kg-1.min-1, alfentanil (1 µg.kg-1.min-1 e dexmedetomidina (0,7 µg.kg-1.min-1. A cirurgia foi realizada sem qualquer intercorrência, não havendo seqüela neurológica subjacente. CONCLUSÕES: Neste caso o uso da dexmedetomidina tornou possível um adequado manuseio hemodinâmico, mantendo otimizado o fluxo sang

  19. Forame oval patente e acidente vascular cerebral isquêmico em jovens: associação causal ou estatística? Patent foramen ovale and ischemic stroke in young people: statistical association or causal relation?

    Directory of Open Access Journals (Sweden)

    Edson Marcio Negrão

    2007-05-01

    Full Text Available OBJETIVOS: Determinar se há evidências de uma relação causal entre forame oval patente (FOP e acidente vascular cerebral isquêmico (AVCI criptogênico em jovens. Analisar essa relação à luz dos critérios de causalidade. MÉTODOS: Avaliaram-se, retrospectivamente, 168 pacientes jovens com AVCI, divididos em dois grupos: criptogênico e de causa definida. Como parte da rotina, os pacientes foram submetidos a pesquisa de FOP por ecocardiograma transesofágico e/ou Doppler transcraniano, ambos associados ao teste de bolhas. Demonstrada a associação estatística univariada entre FOP e AVCI, procedeu-se a análise multivariada. RESULTADOS: Após análise multivariada, a associação FOP e AVCI criptogênico mostrou-se ainda estatisticamente significante, com razão de chance (RCajustada de 3,3 (IC95% 1,5-7,4. O número total de lesões no encéfalo também apresentou associação significativa com o AVCI criptogênico (RCajustada= 0,4 IC95% 0,2-0,9. A associação FOP e AVCI criptogênico satisfez todos os critérios de causalidade. CONCLUSÃO: A relação causal entre o FOP e o AVCI criptogênico em jovens é altamente provável. Esse fato deve ser considerado na decisão terapêutica.OBJECTIVES: To determine if there are evidences of a causal relation between patent foramen ovale (PFO x cryptogenic ischemic stroke (IS in the young population and to analyze this relation in terms of causal criteria. METHODS: A total of 168 young patients with IS was retrospectively evaluated and divided into two groups: cryptogenic and with a defined cause. As a routine procedure, the patients underwent investigation of the PFO by means of transesophageal echocardiogram and/or transcranial Doppler sonography, both of them associated with the bubble test. Multivariate analysis was performed after demonstration of univariate statistical association between PFO x IS. RESULTS: After multivariate analysis, the association between PFO x cryptogenic IS was still

  20. Brain injury markers (S100B and NSE in chronic cocaine dependents Marcadores de lesão cerebral (S100B e NSE em dependentes crônicos de cocaína

    Directory of Open Access Journals (Sweden)

    Felix Henrique Paim Kessler

    2007-06-01

    Full Text Available OBJECTIVE: Studies have shown signs of brain damage caused by different mechanisms in cocaine users. The serum neuron specific enolase and S100B protein are considered specific biochemical markers of neuronal and glial cell injury. This study aimed at comparing blood levels of S100B and NSE in chronic cocaine users and in volunteers who did not use cocaine or other illicit drugs. METHOD: Twenty subjects dependent on cocaine but not on alcohol or marijuana, and 20 non-substance using controls were recruited. Subjects were selected by consecutive and non-probabilistic sampling. Neuron specific enolase and S100B levels were determined by luminescence assay. RESULTS: Cocaine users had significantly higher scores than controls in all psychiatric dimensions of the SCL-90 and had cognitive deficits in the subtest cubes of WAIS and the word span. Mean serum S100B level was 0.09 ± 0.04 µg/l among cocaine users and 0.08 ± 0.04 µg/l among controls. Mean serum neuron specific enolase level was 9.7 ± 3.5 ng/l among cocaine users and 8.3 ± 2.6 ng/l among controls. CONCLUSIONS: In this first study using these specific brain damage markers in cocaine users, serum levels of S100B and neuron specific enolase were not statistically different between cocaine dependent subjects and controls.OBJETIVO: Estudos têm demonstrado sinais de lesão cerebral causadas por diferentes mecanismos em usuários de cocaína. A enolase sérica neurônio-específica e a proteína S100B são consideradas marcadores bioquímicos específicos de lesão neuronal e glial. Este estudo objetivou comparar os níveis sangüíneos de S100B e enolase sérica neurônio-específica em usuários crônicos de cocaína e em voluntários que não usam cocaína ou outras drogas ilícitas. MÉTODO: Vinte sujeitos dependentes de cocaína, mas não dependentes de álcool, maconha ou outra droga, e 20 sujeitos controles não usuários de drogas foram recrutados. Os sujeitos foram selecionados por

  1. Cerebral malaria.

    Science.gov (United States)

    Postels, Douglas G; Birbeck, Gretchen L

    2013-01-01

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

  2. Inibição da atividade da citrato sintase cerebral em um modelo animal de sepse Inhibition of brain citrate synthase activity in an animal model of sepsis

    Directory of Open Access Journals (Sweden)

    Giselli Scaini

    2011-06-01

    Full Text Available OBJETIVO: Um amplo corpo de evidência oriundo de estudos experimentais indica que a sepse se associa com um aumento da produção de espécies de oxigênio reativo, depleção de antioxidantes, e acúmulo de marcadores de estresse oxidativo. Além disto, a disfunção mitocondrial foi implicada na patogênese da síndrome de disfunção de múltiplos órgãos. A citrato sintase é uma enzima que se localiza no interior das células, na matriz mitocondrial, sendo uma etapa importante do ciclo de Krebs; esta enzima foi utilizada como um marcador enzimático quantitativo da presença de mitocôndrias intactas. Assim, investigamos a atividade da citrato sintase no cérebro de ratos submetidos ao modelo sepse com de ligadura e punção do ceco. MÉTODOS: Em diferentes horários (3, 6, 12, 24 e 48 horas após cirurgia de ligadura e punção do ceco, seis ratos foram sacrificados por decapitação, sendo seus cérebros removidos e dissecados o hipocampo, estriato, cerebelo, córtex cerebral e córtex pré-frontal, e utilizados para determinação da atividade de citrato sintase. RESULTADOS: Verificamos que a atividade de citrato sintase no córtex pré-frontal estava inibida após 12, 24 e 48 horas da ligadura e punção do ceco. No córtex cerebral, esta atividade estava inibida após 3, 12, 24 e 48 horas da ligadura e punção do ceco. Por outro lado a citrato sintase não foi afetada no hipocampo, estriato e cerebelo até 48 horas após a ligadura e punção do ceco. CONCLUSÃO: Considerando-se que é bem descrito o comprometimento da energia decorrente da disfunção mitocondrial na sepse, e que o estresse oxidativo desempenha um papel essencial no desenvolvimento da sepse, acreditamos que o comprometimento da energia pode também estar evolvido nestes processos. Se a inibição da citrato sintase também ocorre em um modelo de sepse, é tentador especular que a redução do metabolismo cerebral pode provavelmente estar relacionada com a

  3. Risk factors for unpleasant paresthesiae induced by paresthesiae - producing deep brain stimulation Fatores de risco para parestesia dolorosa induzida por estimulação cerebral profuda em sítios produtores de parestesia

    Directory of Open Access Journals (Sweden)

    Osvaldo Vilela Filho

    1996-03-01

    . Revendo os primeiros 60 pacientes com DIN submetidos à ECP na Division of Neurosurgery, Toronto Hospital, University of Toronto, no período 1978/ 1991, observamos que 6 destes pacientes apresentaram parestesia dolorosa à estimulação de VC/LM/ CI, prevenindo a definitiva implantação do sistema em todos eles e totalizando 15% (6 dentre 40 das falhas em nossa série. Em uma tentativa de se melhorar a seleção de pacientes para a ECP e, com isto, seus resultados globais, revimos nossos casos, considerando uma série de parâmetros, de modo a determinar os fatores de risco para parestesia dolorosa. Os resultados mostraram que esta resposta à estimulação de VC/LM/CI é exclusiva de pacientes com dor central cerebral, secundária a lesão supratentorial, apresentando dor evocada como parte do quadro doloroso. Nem todos os pacientes com estas características, porém, apresentavam parestesia dolorosa. O estudo comparativo destes dois subgrupos (dor central cerebral + dor evocada + parestesia dolorosa e dor central cerebral + dor evocada + parestesia dolorosa permitiu definir que: 1. Parestesia dolorosa à estimulação da coluna dorsal da medula espinhal, lesão restrita ao tálamo à tomografia computorizada e dor intermitente como parte do quadro doloroso são fatores de risco maiores para parestesia dolorosa à estimulação de VC / LM / Cl; 2. Alodínia ao frio ou hiperpatia isoladamente e ausência de deficit sensitivo ao exame neurológico são fatores de risco menores; e 3. Idade, sexo, duração da dor, qualidade da dor constante, dimensões da lesão causal e sítio (VC, LM ou Cl ou tipo (macro ou microeletrodo da exploração cirúrgica não parecem ser fatores de risco relevantes. O autor sugere também os prováveis mecanismos fisiopatológicos envolvidos na gênese da parestesia dolorosa à estimulação de VC / LM / Cl.

  4. Correlação entre a Visual Gait Assessment Scale, Edinburgh Visual Gait Scale e Escala Observacional da Marcha em crianças com paralisia cerebral diparética espástica Correlation among the Visual Gait Assessment Scale, Edinburgh Visual Gait Scale and Observational Gait Scale in children with spastic diplegic cerebral palsy

    Directory of Open Access Journals (Sweden)

    Geruza P. Bella

    2012-04-01

    Full Text Available CONTEXTUALIZAÇÃO: Desordens da marcha são comuns em crianças com paralisia cerebral (PC diparética espástica. Com o intuito de aprimorar a marcha dessas crianças e quantificar os desfechos de tal intervenção, torna-se necessário que se faça uma análise instrumentada pré e pós-intervenção. OBJETIVOS: Correlacionar a Edinburgh Visual Gait Scale (EVGS, a Visual Gait Assessment Scale (VGAS e a Escala Observacional de Marcha (EOM. MÉTODOS: Estudo transversal de análise da marcha por meio das escalas EVGS, VGAS e EOM, envolvendo oito crianças com PC diparética espástica, nível I ou II do Gross Motor Function Classification System (GMFCS, avaliadas por três examinadores. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Estadual de Campinas - UNICAMP. Os dados foram analisados pelo índice Kappa ponderado, considerando um nível de significância de 5%. RESULTADOS: O estudo intra-avaliadores mostrou que a concordância entre os métodos na classificação dos sujeitos foi de moderada a excelente (k=0,41, 1,00, sendo a comparação entre a VGAS e a EVGS a de maior índice de concordância, enquanto a EOM obteve grande discordância em comparação com as outras escalas. A concordância interavaliadores se mostrou predominantemente alta. CONCLUSÃO: Os resultados fornecem evidências de que a VGAS e a EVGS são mais adequados para avaliação da marcha de crianças com PC diparética quando comparadas à EOM.BACKGROUND: Gait disorders are very common in children with spastic diplegia cerebral palsy (CP. In order to improve the CP children's gait and to quantify the outcomes of this intervention it becomes essential to perform an instrumented analysis before and after the intervention. OBJECTIVES: To analyze the correlation among the Edinburgh Visual Gait Scale (EVGS, the Visual Gait Assessment Scale (VGAS and the Observational Gait Scale (OGS. METHODS: Cross sectional study aiming to analyze the gait of 8

  5. Cerebral cysticercosis

    International Nuclear Information System (INIS)

    Two cases of histologically proven cerebral cysticercosis are presented. In both cases subcutaneous tissue nodules, a rare feature, were present. Several disease patterns are apparent - meningeal, parenchymatous and ventricular, spinal cord lesions and mixed patterns. Epilepsy is by far the major presenting symptom of cysticercosis, which in turn plays a significant role in the causation of adult-onset epilepsy in Blacks. Despite its drawbacks, the haemag-glutination inhibition test remains the most satisfactory serological method at present available for the diagnosis of cysticercosis; it is positive in up to 85% of cases of proven cysticercosis. With the advent of computed tomography many cases of unsuspected cysticercosis (symptomatic or asymptomatic) are being discovered

  6. Acidente vascular cerebral isquêmico em uma enfermaria de neurologia: complicações e tempo de internação Stroke in a neurology ward: etiologies, complications and length of stay

    Directory of Open Access Journals (Sweden)

    Rodrigo Bomeny de Paulo

    2009-01-01

    Full Text Available OBJETIVOS: Os objetivos deste trabalho foram: avaliar as complicações e o tempo de internação de doentes com acidente vascular cerebral isquêmico (AVCI na fase aguda ou subaguda em uma enfermaria de Neurologia geral em São Paulo; investigar a influência de idade, fatores de risco para doença vascular, território arterial acometido e etiologia sobre as complicações e o tempo de internação. MÉTODOS: Foram coletados prospectivamente dados de 191 doentes com AVCI e posteriormente analisados. RESULTADOS: Cinquenta e um doentes (26,7% apresentaram alguma complicação clínica durante a internação. A pneumonia foi a complicação mais frequente. O tempo médio de internação na enfermaria foi de 16,8±13,8 dias. Na análise multivariável, o único fator que se correlacionou significativamente com menor taxa de complicações foi idade mais jovem (OR=0,92-0,97, p INTRODUCTION: Purposes of this study were: evaluate complications and length of stay of patients admitted with diagnosis of ischemic stroke (IS in the acute or subacute phase, in a general Neurology ward in São paulo, Brazil; investigate the influence of age, risk factors for vascular disease, arterial territory and etiology. METHODS: Data from 191 IS patients were collected prospectively. RESULTS: Fifty-one patients (26.7% presented at least one clinical complication during stay. pneumonia was the most frequent complication. Mean length of stay was 16.8+-13.8 days. Multivariate analysis revealed a correlation between younger age and lower complication rates (OR=0.92-0.97, p < 0.001. presence of complications was the only factor that independently influenced length of stay (OR=4.20; CI=1.928.84; p<0.0001. CONCLUSION: These results should be considered in the planning and organization of IS care in Brazil.

  7. Conduta anestésica em cesariana em gestante com aneurisma intracraniano não roto Conducta anestésica en cesárea en embarazada con aneurisma cerebral íntegro Anesthetic conduct in cesarean section in a parturient with unruptured intracranial aneurysm

    Directory of Open Access Journals (Sweden)

    Luciana de Souza Cota Carvalho

    2009-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O manuseio anestésico para cesariana programada em gestante com aneurisma intracraniano não roto é particularmente interessante, pois apresenta diversas particularidades relacionadas às alterações fisiológicas da gestação acrescida dos riscos de ruptura do aneurisma durante o procedimento anestésico. A literatura é escassa nesse assunto, sendo assim importante a divulgação dos casos. RELATO DO CASO: Gestante de termo, 31 anos, com aneurisma intracraniano não roto submetida à cesariana programada sob anestesia peridural simples. O procedimento evoluiu sem intercorrências para mãe e filho. CONCLUSÕES: Recomendações baseadas em evidências para anestesia obstétrica em pacientes portadoras de aneurisma intracraniano não roto não existem. Não há dados experimentais ou clínicos que confirmem ou refutem anestesia geral ou regional nesse contexto. Dessa forma, a decisão de qual técnica utilizar deve ser feita com bases individuais, ponderando os riscos e benefícios de cada procedimento e a experiência do profissional que irá conduzi-la.JUSTIFICATIVA Y OBJETIVOS: El manejo anestésico para la cesárea programada en embarazada con aneurisma cerebral íntegro es particularmente interesante, porque presenta diversas particularidades relacionadas con las alteraciones fisiológicas del embarazo y por añadidura, con los riesgos de ruptura del aneurisma durante el procedimiento anestésico. La literatura es parca en ese asunto, siendo muy importante la divulgación de los casos. RELATO DEL CASO: Embarazada de término, 31 años, con aneurisma cerebral no roto y sometida a la cesárea programada bajo anestesia epidural simple. El procedimiento evolucionó sin intercurrencias para la madre y el hijo. CONCLUSIONES: No existen recomendaciones basadas en evidencias, para la anestesia obstétrica en pacientes portadoras de aneurisma cerebral no roto. No hay datos experimentales o clínicos que confirmen o que

  8. Habilidades comunicativas receptivas em criança com bilingüismo português-japonês e paralisia cerebral: relato de caso Communicative receptive ability in a child with cerebral palsy who is bilingual in portuguese -japanese: case report

    Directory of Open Access Journals (Sweden)

    Roberto Minoru Yoshimura

    2006-12-01

    Full Text Available O objetivo do presente estudo foi descrever habilidades receptivas de uma criança com paralisia cerebral diplégica espástica, filha de brasileiros, nascida no Japão, exposta aos idiomas português e japonês. Método: Para a avaliação das habilidades receptivas foi realizada a observação do comportamento comunicativo por meio de atividades comunicativas, utilizando-se materiais lúdicos; provas de reconhecimento semântico, com o uso das figuras do ABFW e provas de discriminação auditiva. Nas atividades propostas utilizou-se dos idiomas português falado no Brasil e japonês. Também foi realizada a avaliação audiológica, que constou de imitânciometria e audiometria tonal liminar. Resultados: Na avaliação audiológica obteve resultados dentro dos padrões de normalidade. Nas atividades comunicativas demonstrou compreender ordens simples em contextos imediatos, com referenciais presentes e ausentes, em ambas as línguas. Apesar da gravidade do quadro motor e da criança não fazer uso de comunicação oral, a compreensão de conceitos nas duas línguas foi considerado satisfatória, demonstrando habilidades receptivas preservadas. A experimentação ambiental e a estimulação familiar permitiram o desenvolvimento da habilidade receptiva. Conclusões: Apesar da gravidade das alterações motoras, as capacidades intrínsecas desta criança, as possibilidades senso-perceptivas e estimulação ambiental favoreceram o desempenho receptivo nos idiomas japonês e português.The purpose of this study was to describe the receptive abilities of a child with spastic diplegic cerebral palsy, born to Brazilian parents in Japan, thus exposed to both Portuguese and Japanese. Method: In order to assess receptive abilities, communication behavior was observed during communicative activities occurring with play materials, through application of semantic recognition tests (pictures from the ABFW and auditory discrimination tests. During the

  9. Efeito de um programa de fisioterapia funcional em crianças com paralisia cerebral associado a orientações aos cuidadores: estudo preliminar Effect of a functional physical therapy program on cerebral palsy children, associated to guidance for their caregivers: a preliminary study

    Directory of Open Access Journals (Sweden)

    Ana Carolina Gama e Silva Brianeze

    2009-03-01

    Full Text Available O objetivo foi verificar o efeito de um programa de fisioterapia funcional para crianças com paralisia cerebral, associado a orientações aos pais e/ou cuidadores; e verificar a correlação entre as habilidades funcionais e a assistência do cuidador, utilizando o Inventário de Avaliação Pediátrica de Incapacidade (PEDI. Participaram quatro crianças entre 24 e 43 meses de idade, hemiplégicas, espásticas e nível I no sistema de classificação da função motora ampla (GMFCS. Foram realizadas quatro avaliações - uma antes do início do programa, as demais aos 30, 60 e 90 dias após a primeira -, empregando-se as partes I (Habilidades funcionais e II (Assistência do cuidador do PEDI. As crianças foram submetidas a sessões de uma hora de fisioterapia funcional três vezes por semana, durante três meses: duas vezes a sessão era de fisioterapia com base no conceito neuroevolutivo Bobath e uma vez, treino de atividades da vida diária. Também foram dadas orientações por escrito aos pais e/ou cuidadores quanto à assistência à criança, incentivando-os a praticá-la em casa. A análise dos resultados mostrou que, na última avaliação, as crianças obtiveram escores significativamente maiores que na primeira. Foi verificada correlação altamente significativa (r=1,0; p=0,083 entre as partes I e II. O programa de fisioterapia funcional associado às orientações aos pais e/ou cuidadores foi efetivo em melhorar o desempenho funcional de crianças nível I com hemiplegia espástica.The purpose was to verify the effect of a functional physical therapy program on children with cerebral palsy, associated to guidance to parents and/or caregivers; and to search for correlations between the child's functional abilities and caregivers' assistance, by means of the Pediatric Evaluation Disability Inventory (PEDI. Four hemiplegic, spastic children between 24 and 43 months old, classified at the Gross Motor Function Classification System

  10. Determinação do peptídeo natriurético cerebral humano em portadores da doença de Chagas Measurement of human brain natriuretic peptide in patients with Chagas' disease

    Directory of Open Access Journals (Sweden)

    Railton Bezerra de Melo

    2005-02-01

    Full Text Available OBJETIVO: Determinar os níveis séricos do peptídeo natriurético cerebral (PNB em pacientes com cardiopatia chagásica crônica e em indivíduos com sorologia positiva para doença de Chagas sem comprometimento cardíaco, e correlacionar os níveis de PNB com o grau de comprometimento cardíaco, dimensões cardíacas, presença de marcapasso e fração de ejeção. MÉTODOS: Concentrações séricas de PNB foram determinadas através do Triage® - BNP Test, produzido pela BIOSITE®. Foi avaliado o PNB sérico de 25 indivíduos do ambulatório de doença de Chagas do Hospital Universitário Oswaldo Cruz, distribuídos em 2 grupos, um, G1; composto por 13 portadores de sorologia positiva para doença de Chagas, assintomáticos e sem cardiopatia detectável pelo eletrocardiograma, radiografia do tórax e ecocardiograma, o outro, G2; por 12 portadores da doença de Chagas com comprometimento cardíaco. RESULTADOS: Níveis significativamente mais elevados de PNB foram detectados nos pacientes chagásicos com comprometimento cardíaco: (G1=4,4±4,4 pg/ml, G2=293,0±460,2 pg/ml pOBJECTIVE: To measure the serum levels of brain natriuretic peptide (BNP in patients with chronic chagasic heart disease and in individuals with positive serology for Chagas' disease and no heart impairment, and to correlate the serum BNP levels with the degree of cardiac impairment, cardiac dimensions, presence of a pacemaker, and ejection fraction. METHODS: Serum BNP concentrations were determined by use of the Triage - BNP Test produced by BIOSITE. Serum BNP was assessed in 25 patients from the Chagas' disease outpatient clinic of the Hospital Universitário Oswaldo Cruz, who were divided into 2 groups as follows: 1 G1 - comprising 13 assymptomatic patients with positive serology for Chagas' disease and no heart disease detectable on electrocardiography, chest X-ray, and echocardiography; and 2 G2 - comprising 12 patients with Chagas' disease and heart impairment. RESULTS

  11. Estudo comparativo da deglutição com nasofibrolaringoscopia e videodeglutograma em pacientes com acidente vascular cerebral Comparison of functional endoscopic swallow study (FESS vs. videofluoroscopy (VF in patients with stroke

    Directory of Open Access Journals (Sweden)

    Sandra Doria

    2003-10-01

    Full Text Available Os distúrbios da deglutição são bastante freqüentes nos pacientes neurológicos e naqueles com doenças ou seqüelas de cirurgia de cabeça e pescoço, sendo causa de importante morbidade e mortalidade. Apesar do videodeglutograma (VD ser considerado o exame de escolha para a avaliação dos distúrbios da deglutição, este exame apresenta limitações em algumas situações clínicas, além de expor o doente à radiação e ao risco de aspiração do contraste. Em anos recentes, têm sido também utilizadas fibras ópticas flexíveis para avaliar os pacientes com disfagia e outras queixas relacionadas à deglutição. OBJETIVO: Análise comparativa entre os dados obtidos pela NFL e VD em relação a parâmetros estudados por ambos métodos. FORMA DE ESTUDO: Caso controle. MATERIAL E MÉTODO: Foram avaliados prospectivamente 12 pacientes com seqüela de acidente vascular cerebral isquêmico, no período de janeiro a maio de 2002, por meio do estudo dinâmico da deglutição com nasofibrolaringoscopia (NFL e VD, sendo os resultados comparados estatisticamente. RESULTADOS: Enquanto o VD permite a análise da fase preparatória oral e oral da deglutição e o início da fase faríngea, a NFL permite estudo da sensibilidade e mobilidade faringo-laríngea, além da visualização direta do alimento. Através do teste estatístico McNemar, nenhum dos parâmetros analisados apresentou divergência estatisticamente significante (pPatients with dysphagia present great morbidity and mortality, especially those with neurological disorders and/or head and neck surgery, thus warranting a detailed evaluation of swallowing. Videofluoroscopy has been considered the gold standard for evaluating swallowing disorders for many years; however, this test presents limitations in some clinical settings exposing patients to radiation and to the risk of contrast aspiration. In recent years, functional swallow studies using flexible endoscopy (FESS have been

  12. United Cerebral Palsy

    Science.gov (United States)

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

  13. Avaliação da flexibilidade pelo método do Flexômetro de Wells em crianças com Paralisia Cerebral submetidas a tratamento hidroterapêutico: estudo de casos - doi: 10.4025/actascihealthsci.v32i2.8019 Flexibility evaluation by the method of Wells’ Flexometer in children with Cerebral Palsy submitted to hydrotherapy treatment: study of the cases - doi: 10.4025/actascihealthsci.v32i2.8019

    Directory of Open Access Journals (Sweden)

    Vicente de Paula Antunes Teixeira

    2010-09-01

    Full Text Available Avaliar a flexibilidade da cadeia muscular posterior, utilizando o método proposto por Wells e Dillon, antes e após cada sessão de hidroterapia. Foi verificada a flexibilidade de três crianças com Paralisia Cerebral (PC diparéticas, com idades entre sete a dez anos. Os valores de flexibilidade foram aferidos, utilizando o Flexômetro de Wells. Houve aumento significativo da flexibilidade da cadeia muscular posterior dos pacientes após cada sessão de hidroterapia, tanto na avaliação em grupo quanto individual, assim como antes da primeira sessão de hidroterapia quando comparada com a última. O estudo sugere que a hidroterapia promove melhora da flexibilidade em relação à cadeia muscular posterior de crianças com PC diparéticas, pelo relaxamento global e consequente diminuição do tônus muscular, quando associada a exercícios de alongamentos passivos.To evaluate the flexibility of the posterior muscle chain using the method proposed by Wells and Dillon, before and after each hydrotherapy session. The study verified the flexibility of three children with diplegic cerebral palsy (CP, aged 7 to 10. The values of flexibility were measured using the Wells’ Flexometer. There was a significant increase in the flexibility of posterior muscle chain of the patients after each session of hydrotherapy, both in the individual evaluation and in the group, as well as before the first session of hydrotherapy compared to the last. The study suggests that hydrotherapy promotes the improvement of flexibility, by relaxation of muscle tone of children with diplegic CP, in relation to the posterior muscle chain, when combined with passive stretching exercises.

  14. Cerebral palsy and epilepsy

    OpenAIRE

    Knežević-Pogančev Marija

    2010-01-01

    Introduction. Cerebral palsy is the most common cause of physical disability in early childhood. Epilepsy is known to have a high association with cerebral palsy. All types of epileptic seizures can be seen in patients with cerebral palsy. Complex partial and secondary generalized ones are the most frequent seizure types. In persons with cerebral palsy and mental retardation, the diagnosis of epilepsy presents unique difficulties. Generally they are not able to describe the epileptic ev...

  15. 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

  16. Pesquisa do antígeno circulante de Cryptococcus neoformans em líquido cefalorraqueano pelo teste de coaglutinação Coaglutination test (COA for Cryptococcus neoformans circulating antigen detection in cerebral spinal fluid (CSF

    Directory of Open Access Journals (Sweden)

    Maria Isabel Nogueira Cano

    1990-12-01

    Full Text Available Foram utilizadas 82 LCR de transplantados renais (24 pacientes, 43 LCR de pacientes com críptococose comprovada (controles positivos, 35 LCR de pacientes com outras doenças (histoplasmose, paracoccidioidomicose e infecções bacterianas como controles negativos. Os primeiros foram cultivados em ágar Sabouraud com sementes de girassol e juntamente com os demais examinado pelo teste de látex para pesquisa de antígeno circulante de C. neoformans, qualitativamente. O teste de Coaglutinação foi realizado qualitativamente e quantitativamente, encontrando-se títulos até a diluição 1:2048. Não foram detectadas reações falso-positivas ou falso-negativas entre os controles. Como prova de valor diagnóstico demonstrou: sensibilidade - 92,1%; especificidade - 92,6% e eficiência - 92,3%. Provou também ser um teste rápido, exato e econômico, embora sua escolha dependa do pré-tratamento de LCR (80ºC por 3 a 5 minutos e soros (diluição ou álcali-precipitação para evitar autoaglutinação e aumentar a sensibilidade da reação.We tested 82 CSF of 24 renal transplanted patients (RT with cerebral cryptococcosis, 8 CSF of asymptomatic RT patients, 43 CSF of proven cryptococcosis cases (positive control and 35 CSF of patients with other diseases (histoplasmosis, paracoccidioidomycosis and bacterial infections as negative control. The RT CSF were cultured in Sabouraud agar slant added with sunflower seeds and both control and RT CSF were qualitatively examined by cryptococcosis latex test (Crypto-LA test. The COA test was developed both qualitatively and quantitatively. The highest titre encountered was 1:2048. No false reactions appeared among the controls. The diagnostic value demonstrated by Galen and Gambino's method was: sensitivity - 92.1%; specificity - 92.6% and efficiency - 92.3%. Besides that, the COA proved to be quick, exact and cheap, but it depends on CSF and sera pre-treatment, in order to avoid autoagglutination and increase

  17. Vasopressin serum levels in patients with severe brain lesions and in brain-dead patients Níveis séricos de arginina vasopressina em pacientes com lesão cerebral grave e em pacientes com morte encefálica

    Directory of Open Access Journals (Sweden)

    Eliane de Araújo Cintra

    2004-06-01

    Full Text Available INTRODUCTION: Patients with severe brain lesions (SBL and brain-dead patients (BD frequently present with vasopressin (AVP secretion disorders. OBJECTIVE: To evaluate AVP serum levels in SBL and BD patients. DESIGN: Prospective, open label, observational trial. SETTING: A general teaching hospital. METHOD: Three groups of adult subjects (age> 18y of both sexes were included in this study: control group: 29 healthy volunteers; SBL group: 17 patients with Glasgow Coma Scale (GCSINTRODUÇÃO: Pacientes com lesão cerebral grave (LCG ou com morte encefálica (ME freqüentemente apresentam alterações na secreção de vasopressina (AVP. OBJETIVO: Avaliar os níveis séricos de AVP em pacientes com LCG e ME. DESENHO: Estudo prospectivo, aberto, observacional. LOCAL: Um hospital geral universitário. MÉTODO: Sujeitos adultos (idade >18 anos, de ambos os sexos, foram divididos em três grupos: grupo controle: 29 voluntários sadios; grupo LCG: 17 pacientes com pontuação na Escala de Coma de Glasgow (ECG<8; grupo ME: 11 pacientes com diagnóstico de ME. Amostras de sangue venoso foram colhidas pela manhã, em repouso, nos pacientes do grupo controle, e de 8/8h, por 24h, nos pacientes dos grupos LCG e ME, para dosagens de AVP. Variáveis clínicas e laboratoriais de interesse foram anotadas concomitantemente. RESULTADOS: Os valores da AVP (pg/ml foram [média (DP; mediana]: grupo controle [2,2(1,1; 2,0]; grupo LCG [5,7(6,3; 2,9] e grupo ME [2,6(1,0; 2,8]. Observou-se maior variação dos níveis séricos de AVP no grupo LCG, mas sem diferença estatisticamente significativa em relação aos demais (p=0,06. Hipotensão (p=0,02, hipernatremia (p=0,0001, hiperosmolaridade sérica (p=0,0001 e hiposmolaridade urinária (p=0,003 foram proeminentes no grupo ME em relação ao grupo LCG. CONCLUSÃO: Não foram encontradas diferenças estatisticamente significativas nos níveis de AVP entre os grupos, notando-se apenas uma maior variação de seus níveis s

  18. Brain white matter lesions correlated to newborns death and lethality Fatores correlacionados ao óbito e à letalidade hospitalar em neonatos com lesão da substância branca cerebral

    Directory of Open Access Journals (Sweden)

    Nayara Argollo

    2006-06-01

    Full Text Available OBJECTIVES: to describe hospital lethality rates and factors correlated to death in neonates with brain white matter lesions. METHODS: a retrospective study was performed from January 1994 to December 2001. Neonates with white brain matter lesions were divided into survival and death groups and their medical files reviewed through the single blind method to determine evolution. Death certificates provided the cause of death. The groups were compared through correlation coefficients. Hospital lethality rate was calculated. RESULTS: ninety three cases of white brain matter lesions and seven deaths were determined. Hospital lethality rate was of 8.2.% (95%CI: 2.4-14.0 independently from lesion occurrence time, and of 10.3% (95%CI: 3.3-17.3 for deaths occurred during prenatal and perinatal periods. Death was correlated to: Apgar score, non-cephalic presentation, gestational age, hyperglicemia, hypercalcemia, convulsion, respiratory insufficiency and atelectasy. CONCLUSIONS: hospital lethality was of 10.3% generating the following hypothesis: perinatal asphyxia must be the principal direct and indirect etiologic factor (aggravating the expression of prematurity and infection diseases, of prenatal and perinatal mortality among newborns with white brain matter lesions; and OBJETIVOS: descrever a taxa de letalidade hospitalar e fatores correlacionados com o óbito em crianças com lesão da substância branca cerebral (LSB. MÉTODOS: estudo retrospectivo realizado de janeiro de 1994 a dezembro de 2001. Os neonatos com LSB foram divididos em sobreviventes ou óbito, e seus prontuários revisados de forma cega para a evolução. Dos atestados de óbito, a causa de morte. Os grupos foram comparados por coeficientes de correlação. Calculada a taxa de letalidade hospitalar. RESULTADOS: foram encontrados 93 casos de LSB e sete óbitos. A taxa de letalidade hospitalar foi de 8,2%, (IC95%: 2,4-14,0, independentemente da época de instalação da lesão, e de

  19. Qualidade de vida em sobreviventes de acidente vascular cerebral: instrumentos de avaliação e seus resultados Quality of life in stroke survivors: assessment instruments and their outcomes

    Directory of Open Access Journals (Sweden)

    Juliana Ferreira Mota

    2008-01-01

    Full Text Available OBJETIVOS: Os objetivos deste estudo foram identificar os instrumentos genéricos e específicos utilizados na avaliação da qualidade de vida (QV e os seus resultados em sobreviventes de acidente vascular cerebral (AVC. MÉTODOS: Realizou-se revisão da literatura dos últimos dez anos, com população acima de 18 anos, nos bancos de dados MedLine e Lilacs, cujas publicações utilizassem instrumentos padronizados e validados no país de origem. Combinaram-se os descritores quality of life, cerebrovascular accident, stroke, QV e acidente cerebrovascular. RESULTADOS: Consideraram-se relevantes 96 estudos e 31 entram neste trabalho, de acordo com os critérios de inclusão. Foram encontrados cinco tipos diferentes de instrumentos genéricos/perfil, nove genérico/utility e dois específicos. O mais freqüente foi o SF-36, em 45,2% dos estudos. Observou-se que a baixa QV relacionou-se, principalmente, ao déficit da função física, à presença de depressão ou de seus sintomas, ser do sexo feminino e ser mais idoso. De modo geral, os sujeitos no pós-AVC possuíam pior QV do que aqueles que não sofreram o evento. CONCLUSÃO: Foram encontrados 16 instrumentos para avaliação da QV. A baixa QV foi prevalente nos sobreviventes pós-AVC e se correlacionou com a função física, a depressão, o sexo e a idade.OBJECTIVE: The purpose of this study is to identify generical and specific instruments used for valueing quality of life (QOL and their outcomes in stroke survivors. METHODS: Review of literature of last 10 years, with people above 18 years old, in MedLine and Lilacs database. The instruments used on the studies were validated for the their countries. 96 articles have been considered relevant and 31 were in accordance with inclusion criteria. Five kind of generic/profile, nine generic/utility and two specific instruments were found. The more frequent was SF-36, on the 45,2% of the studies. It has been observed that poverty in quality of

  20. Cerebral angiography in leptomeningitis and cerebritis

    International Nuclear Information System (INIS)

    This is a report of the cerebral angiographic findings in cases of meningitis and cerebritis. Fifty-nine patients, 38 of whom were under 1 year of age, underwent cerebral angiography by means of femoral catheterization. All the patients had signs of increased intracranial pressure, seizures, focal cerebral signs, positive transillumination of the head, and or abnormal brain scan findings. A few patients who did not respond to systemic antibiotics as was expected were also evaluated by means of cerebral angiography. The following characteristic angiographic findings were observed in 18 cases of active meningitis: (1) A hasy appearance around the arteries (halo formation) between the late arterial and capillary phases. (2) Narrowing of the arteries in the basal cistern. This sometimes extended to the peripheral arteries. (3) Irregular caliber following the narrowing of arteries (in few cases). (4) Circulation time so slow that veins could be seen in the late arterial phase. (5) Halo formation around the anterior chroidal artery and the clear appearance of the choroid plexus in the venous phase (when the infectious process reached the choroid plexus). Cerebritis could be identified on the angiograms by two signs: (1) local swelling of the brain (mainly the temporal lobe) and (2) staining around the veins without any abnormal signs in the arterial phase (laminar staining). In conclusion, angiography is a meaningful test by which to determine the phase of meningitis and cerebritis. These two conditions should be treated based on valid information obtained by means of CSF examinations and neuroradiological tests, especially CT scan and cerebral angiography. (author)

  1. Papiledema unilateral na síndrome do pseudotumor cerebral

    OpenAIRE

    Mário L. R. Monteiro; Hoyt, William F.; Richard K. Imes; Michael Narahara

    1985-01-01

    São apresentadas as fotografias de fundo de olho de 6 mulheres com papiledema unilateral e a síndrome do pseudotumor cerebral. Achados associados foram: obesidade em 5 e a sindrome da sela vazia parcial em 2. São discutidas as possíveis explicações para o desenvolvimento de papiledema unilateral nesses pacientes e que favorecem um mecanismo presente na porção distal dos nervos ópticos.

  2. Acidente vascular cerebral precoce: implicações para adultos em idade produtiva atendidos pelo Sistema Único de Saúde Early cerebrovascular accident: implications in working-age adults assisted by the Brazilian Public Health System

    Directory of Open Access Journals (Sweden)

    Ilka Veras Falcão

    2004-03-01

    Full Text Available OBJETIVOS: conhecer as incapacidades e identificar se há diferenças de gênero, em sobreviventes de primeiro episódio de acidente vascular cerebral (AVC, entre 20 e 59 anos de idade, na cidade do Recife e que tenham sido hospitalizados pelo Sistema Único de Saúde. MÉTODOS: entrevista domiciliar com uma amostra de sobreviventes, investigando-se as incapacidades referidas na vida funcional e produtiva deles. RESULTADOS: amostra equilibrada entre os sexos, média de idade de 52 anos, com nível elementar de estudos ou analfabeto e trabalhando no setor de serviços, informal ou doméstico. Menos de 20% informam recuperação total após o AVC. Aproximadamente 80% apresentam algum déficit, sendo os problemas de comunicação e os sintomas depressivos mais freqüentes entre as mulheres. Após o AVC aumentou o número de desempregados e aposentados e as incapacidades repercutem negativamente na satisfação de vida de mais de 70% dos entrevistados. CONCLUSÕES: é expressivo o percentual de casos, ainda jovens, com seqüelas pós AVC, sendo este mais precoce e o quadro de incapacidades mais freqüente e/ou grave entre as mulheres. A prevenção e a reabilitação após o AVC são desejáveis, com a implantação de programas, considerando as condições de gênero, para o controle dos riscos e para as seqüelas resultantes do AVC.OBJECTIVES: to assess incapacities and determine whether there are gender differences following an initial episode of cerebrovascular accident among survivors between the ages of 20 and 59 years old living in Recife city, hospitalized in the public health system. METHODS: in-home survey performed with a sample of survivors, investigating incapacities and alterations in the functional and productive life of these individuals. RESULTS: the sample had a balanced proportion between genders and an average age of 52 years old. Individuals were either illiterate or had an elementary education level, holding jobs in the

  3. Cerebral Palsy (CP) Quiz

    Science.gov (United States)

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

  4. 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.

  5. Quantitative measurement of cerebral oxygen extraction fraction using MRI in patients with MELAS.

    Directory of Open Access Journals (Sweden)

    Lei Yu

    Full Text Available OBJECTIVE: To quantify the cerebral OEF at different phases of stroke-like episodes in patients with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS by using MRI. METHODS: We recruited 32 patients with MELAS confirmed by gene analysis. Conventional MRI scanning, as well as functional MRI including arterial spin labeling and oxygen extraction fraction imaging, was undertaken to obtain the pathological and metabolic information of the brains at different stages of stroke-like episodes in patients. A total of 16 MRI examinations at the acute and subacute phase and 19 examinations at the interictal phase were performed. In addition, 24 healthy volunteers were recruited for control subjects. Six regions of interest were placed in the anterior, middle, and posterior parts of the bilateral hemispheres to measure the OEF of the brain or the lesions. RESULTS: OEF was reduced significantly in brains of patients at both the acute and subacute phase (0.266 ± 0.026 and at the interictal phase (0.295 ± 0.009, compared with normal controls (0.316 ± 0.025. In the brains at the acute and subacute phase of the episode, 13 ROIs were prescribed on the stroke-like lesions, which showed decreased OEF compared with the contralateral spared brain regions. Increased blood flow was revealed in the stroke-like lesions at the acute and subacute phase, which was confined to the lesions. CONCLUSION: MRI can quantitatively show changes in OEF at different phases of stroke-like episodes. The utilization of oxygen in the brain seems to be reduced more severely after the onset of episodes in MELAS, especially for those brain tissues involved in the episodes.

  6. Cerebral haematocrit measurement

    International Nuclear Information System (INIS)

    Regional cerebral haematocrit was measured in a group of sixteen subjects by the single-photon emission computerized tomography method. This group included three normal subjects as controls and thirteen patients affected with ischaemic cerebral disease presenting clinically with transient ischaemic attacks-six patients - or recent cerebral stroke - seven patients. Two intravenous radioactive tracers - technetium-99m labelled autologous red blood cells and Tc-99m human serum albumin were used. Cerebral tomographic imaging was performed using a rotating scintillation camera. The values of cerebral haematocrit obtained, taken as a ratio to venous haematocrit, range between 0.65-0.88 in the subjects studied. As a general finding in normal subjects and in patients with transient ischaemic attacks, no significant difference between right and left hemispheric haematocrit value was noted. However, in the group of patients affected with stroke, a significant difference in the right versus left hemispheric Hct was observed in 3 patients, the higher Hct value corresponding to the affected side. The clinical implication is on the emphasis of cerebral Hct measurement when the measurement of cerebral blood flow or volume is sought. Also the variation in regional Hct value observed in patients with stroke, above mentioned, points to a regulation mechanism of the blood composition for optimal oxygen delivery to the brain that is impaired in these patients. 14 refs. (Author)

  7. Unilateral cerebral polymicrogyria with ipsilateral cerebral hemiatrophy

    International Nuclear Information System (INIS)

    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.)

  8. 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.)

  9. Emergindo a complexidade do cuidado de enfermagem ao ser em morte encefálica Complejidad emergente del cuidado de enfermería al paciente con muerte cerebral Emerging the complexity of nursing care facing a brain death

    OpenAIRE

    Aline Lima Pestana; Alacoque Lorenzini Erdmann; Francisca Georgina Macêdo de Sousa

    2012-01-01

    O estudo objetivou desvelar a complexidade do cuidado de enfermagem ao ser em morte encefálica. Utilizaram-se como referenciais teórico e metodológico o pensamento complexo e a Grounded Theory, respectivamente. Os dados foram coletados em um hospital universitário do nordeste brasileiro, de dezembro de 2010 a junho de 2011, por meio de entrevistas não estruturadas. A amostra teórica constituiu-se de 12 enfermeiros, distribuídos em três grupos amostrais. O fenômeno "Desvelando relações e inter...

  10. Regional cerebral blood flow in status epileptics measured by single photon emission computed tomography (SPECT)

    International Nuclear Information System (INIS)

    We have performed single photon emission computed tomography (SPECT) with 99mTc-hexamethylpropylene amineoxime (HM-PAO) to evaluate regional cerebral blood flow (rCBF) in status epileptics (SE) caused by a cerebral vascular accident. In addition, we have discussed the neurophysiology of SE based on the SPECT findings. A total of sixteen patients (5 males and 11 females, average age; 78.2 years old) with SE who were suffering from prolonged consciousness disturbance were investigated. When SPECT was performed in the ictal state, there was a remarkable increase in radio isotope (RI) uptake at the focus which correlated well with EEG findings. However, in other cortical regions, basal ganglia and thalamus, there was a relatively demonstrated decrease in RI uptake compared with that of the focus. Additionally in the interictal state, we found a decrease in RI uptake in the epileptic foci and normal recovery of the RI uptake level in other cerebral regions. We speculate that these characteristic patterns of cerebral blood flow distribution shown by SPECT scans in the ictal state reflect the state of consciousness disturbance due to SE. In general, in the elderly, it is difficult to make a differential diagnosis between prolonged consciousness disturbance due to nonconvulsive SE and other diseases such as cardiovascular diseases, dehydration, metabolic disorder, etc. Nevertheless, nonconvulsive SE causes diffuse cell loss and irreversible brain damage. Therefore the elderly who have suffered from prolonged consciousness disturbance due to SE need an exact diagnosis and immediate medical treatment. When we diagnose a nonconvulsive SE, the characteristic findings of SPECT scans in the ictal state are very clear and useful. In conclusion, SPECT is a very simple and non-invasive method that demonstrates abnormalities of brain function exactly. Therefore, we should perform not only EEC but also SPECT scans when making a diagnosis of SE. (author)

  11. Modelling of increased homocysteine in ischaemic stroke: post-hoc cross-sectional matched case-control analysis in young patients Aumento de homocisteína em acidente vascular cerebral isquêmico: análise post-hoc com casos controles em pacientes jovens

    Directory of Open Access Journals (Sweden)

    Penka A. Atanassova

    2007-03-01

    cerebral isquêmico (AVCI. Todavia, em adultos jovens existe a possibilidade de aumento significativo de risco de AVCI devido a aumento "normal" da homocisteinemia, "oculta" (patologicamente adormecida dentro de uma variação definida como normal. Neste trabalho foi investigado um modelo post-hoc de dosagem de homocisteina no plasma (HC em pacientes jovens com AVCI agudo pareados por gênero e idade. Foi avaliado também relações entre HC e prevalência de outros fatores de risco para AVCI em 41 pacientes e 41 controles normais. MÉTODO: Foi utilizado exame clínico, procedimentos instrumentais e de neuroimagem, exame de fatores de risco, dosagem da homocisteína no plasma, outros exames laboratoriais e análise estatística. RESULTADOS: Não foram encontradas diferenças quanto a presença de fumantes, dosagem de vitaminas, creatinina sérica e perfil lipídico entre os pacientes com AVCI e os controles normais. Todavia os pacientes com AVCI apresentaram diminuição de níveis de vitamina B6 e aumento de homocisteína, fibrinogênio e trigliceridios. A análise multivariada de regressão logística mostrou diferenças significativas apenas para HC e trigliceridios independentemente associadas para fatores de risco para AVCI (72% acuracia, p= 0,001. Um aumento de homocisteína de 1,0 µmol/L estava associado com aumento de 22% de risco de AVCI [OR=1,22 (95%IC 1,03-1,44]. Foi evidenciado portanto um novo valor de cut-off para HC de 11,58 µmol/L em pacientes jovens com AVCI (ROC auc=0,67, 95% IC 0,55-0,78, p= 0,009. CONCLUSÃO: Este novo valor de cut-offpara a homocisteína discrimina claramente a ausência ou presença de AVCI (sensibilidade >63%, especificidade >68% independente do gênero ou idade e deve ser aplicado para uma melhor avaliação precoce de pacientes jovens com risco de AVCI.

  12. Neonatal Cerebral Sinovenous Thrombosis

    OpenAIRE

    J Gordon Millichap

    2006-01-01

    The presentation, treatment, and outcome of neonatal cerebral sinovenous thrombosis (SVT) were studied in 42 children, using neurology clinic records (1986-2005) at Indiana University School of Medicine.

  13. Cerebral Aneurysms Fact Sheet

    Science.gov (United States)

    ... cerebral aneurysm from forming. People with a diagnosed brain aneurysm should carefully control high blood pressure, stop smoking, and avoid cocaine use or other stimulant drugs. They should also ...

  14. Cerebral amyloid angiopathy

    Science.gov (United States)

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

  15. 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...

  16. Cerebral aneurysms and inflammation

    Directory of Open Access Journals (Sweden)

    Toshihiro Yokoi

    2015-06-01

    Full Text Available Multiple inflammatory factors, playing a crucial role in cerebral aneurysm formation, have been identified. tumor necrosis factor-alpha (TNF-α has been revealed to have a close connection with several risk factors that affect aneurysm formation. Remarkable expression in aneurysm walls of mRNA for TNF-α has been observed in humans. Possible therapeutic interventions to reduce the formation of cerebral aneurysms may include the inhibition of mediators of inflammation.

  17. Rehabilitation in cerebral palsy.

    OpenAIRE

    Molnar, G. E.

    1991-01-01

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

  18. Cerebral Palsy Litigation

    OpenAIRE

    Sartwelle, Thomas P.; Johnston, James C.

    2015-01-01

    The cardinal driver of cerebral palsy litigation is electronic fetal monitoring, which has continued unabated for 40 years. Electronic fetal monitoring, however, is based on 19th-century childbirth myths, a virtually nonexistent scientific foundation, and has a false positive rate exceeding 99%. It has not affected the incidence of cerebral palsy. Electronic fetal monitoring has, however, increased the cesarian section rate, with the expected increase in mortality and morbidity risks to mothe...

  19. Attitudes towards Augmentative and Alternative Communication for young children with cerebral palsy = As atitudes dos cuidadores em relação à utilização de Sistemas de Comunicação Alternativa e Aumentativa na interação com crianças com paralisia cerebral

    OpenAIRE

    Rosangela Bertelli; Eduardo Chaves Cruz; José João Pinhanços de Bianchi

    2011-01-01

    Considering that the use of Augmentative and Alternative Communication Systems (AACS) has been recommended for children who are severely impaired in their development of communicative abilities, it may be assumed that caregivers' attitudes toward AACS would be driven by children's degree of cognitive and linguistic impairments. To verify this, 40 dyads of children with cerebral palsy and their primary caregivers participated in this study evaluating children's degree of cognitive and linguist...

  20. Quality of life of children with cerebral palsy treated with botulinum toxin: are well-being measures appropriate? Qualidade de vida em crianças com paralisia cerebral tratadas com toxina botulínica: estas avaliações são adequadas?

    OpenAIRE

    Taísa R. Simões de Assis; Edilson Forlin; Isac Bruck

    2008-01-01

    AIM: To analyze quality of life (QOL) of children with cerebral palsy (CP) treated with botulinum toxin type A (BTXA). METHOD: Two QOL evaluation tools, translated into Portuguese, were used: Pediatric Outcomes Data Collection Instrument (PODCI) and Child's Caregiver Questionnaire (CCQ). Questionnaires were answered by caregivers on two occasions. Patients were divided into 3 groups: I - patients who had been previously treated with BTXA and who underwent a session of BTXA; II - patients who ...

  1. Perfil populacional de pacientes com distúrbios da comunicação humana decorrentes de lesão cerebral, assistidos em hospital terciário Populational profile of patients with human communication disorders after brain injury, assisted in a tertiary hospital

    Directory of Open Access Journals (Sweden)

    Thais Rodrigues Talarico

    2011-04-01

    Full Text Available OBJETIVO: caracterizar a população de pacientes com lesão neurológica, queixa e presença de distúrbio da comunicação, assistidos num Hospital Terciário. Os objetivos específicos foram: verificar a prevalência de cada tipo de transtorno de fala e/ou de linguagem, da etiologia neurológica e a origem dos encaminhamentos em relação ao total de pacientes. MÉTODO: Trata-se de um estudo retrospectivo, em que foram analisados todos os prontuários dos pacientes atendidos em 5 anos (2002 a 2006, no Núcleo de Investigação e Intervenção Fonoaudiológica em Neuropsicolingüística do Departamento de Fonoaudiologia da Universidade Federal de São Paulo,. RESULTADOS: o estudo revelou 244 casos atendidos entre 2002 e 2006. Quanto à caracterização da amostra encontramos: quanto ao sexo, 56% eram homens; quanto à idade, 44,3% encontraram-se entre 41- 64 anos; quanto à escolaridade, 39,8% dos pacientes apresentaram 1 a 4 anos de escolaridade; quanto aos encaminhamentos para o atendimento no setor 35,7% eram procedentes do ambulatório de Neurologia da UNIFESP; quanto à etiologia da lesão, 69,3% foram diagnosticados com Acidente Vascular Cerebral (AVC. Sobre o diagnóstico fonoaudiológico, 56,1% foram diagnosticados com Afasia em relação à linguagem e 33% com Disartria em relação à fala. CONCLUSÃO: a afasia foi o transtorno de linguagem mais prevalente; o mesmo ocorreu com a disartria em relação à fala; o AVC foi a etiologia neurológica predominante; em relação ao número geral de casos avaliado verificou-se que 50% do grupo atendido estavam em programas de reabilitação; a maioria dos pacientes foram encaminhados pelo serviço de Neurologia do Hospital São Paulo - UNIFESP.PURPOSE: to characterize the population of patients with neurological lesion with communication disorders, assisted by a Tertiary Hospital. Specific objectives0 to check the prevalence of each type of speech and / or language disorder, neurological

  2. Midazolam por via oral como medicação pré-anestésica em crianças e adolescentes com paralisia cerebral: estudo comparativo das variações do índice bispectral Midazolam por vía oral como medicación preanestésica en niños y adolescentes con parálisis cerebral: estudio comparativo de las variaciones del índice bispectral Oral midazolam as pre-anesthetic medication in children and teenagers with cerebral palsy: a comparative study on the variations of the bispectral index

    Directory of Open Access Journals (Sweden)

    Verônica Vieira da Costa

    2009-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O midazolam é um derivado benzodiazepínico com ação hipnótica e muito utilizado como medicação pré-anestésica em anestesia pediátrica. As crianças com paralisia cerebral (PC também se beneficiam do uso do midazolam, mas seus efeitos são ainda desconhecidos sobre esse grupo de pacientes que apresentam uma série de particularidades, com alterações inclusive no local de ação do midazolam. O objetivo do estudo foi avaliar a ação do midazolam utilizado como medicação pré-anestésica sobre o índice bispectral (EEG-BIS dos pacientes com paralisia cerebral. MÉTODO: Foram avaliados dois grupos de pacientes: um com diagnóstico de PC e outro sem doença do sistema nervoso central (SNC e periférico. Foram registrados valores de EEG-BIS na enfermaria na véspera da operação e no dia da operação, 40 minutos depois da administração de 0,6 mg.kg-1 de midazolam via oral. Foram excluídos pacientes com história de reação paradoxal ao midazolam e pacientes do grupo-controle que estivessem em uso de outra medicação. RESULTADOS: Foram estudados 77 pacientes de ambos os sexos, entre 4 e 18 anos de idade. Não houve diferença entre os valores de EEG-BIS basal entre os grupos estudados. Após o uso do midazolam houve diminuição dos valores do EEG-BIS nos dois grupos estudados, com diferença estatística significativa em cada grupo. Na comparação entre grupos não houve diferença estatística. CONCLUSÕES: O midazolam administrado como medicação pré-anestésica na dose de 0,6 mg.kg-1 diminui os valores basais do EEG-BIS sem caracterizar hipnose e sem diferença estatística nos grupos estudados.JUSTIFICATIVA Y OBJETIVOS: El midazolam es un derivado benzodiazepínico con acción hipnótica y muy utilizado como medicación preanestésica en anestesia pediátrica. Los niños con parálisis cerebral (PC también se benefician del uso del midazolam, pero sus efectos todavía se desconocen sobre ese

  3. Computer-aided diagnosis of interictal 18F-FDG PET images for presurgical evaluation of epileptic foci in extratemporal lobe epilepsy

    International Nuclear Information System (INIS)

    Interictal 18F-FDG PET is beneficial to patients with epilepsy to define the epileptic foci before operation, especially to decide the laterality of temporal lobe epilepsy (TLE). However usefulness has not been clearly established in extra TLE. We retrospectively applied Z-score analysis to interictal preoperative 18F-FDG PET images for detection of the epileptic foci in order to achieve better performance. Seventeen epileptic patients (women/men; 8/9, age; 11-55 yrs) underwent resection of epileptic foci with good outcome (Engel's stage of I or II) even after more than a year from operation. Presurgical 18F-FDG PET images were spatially normalized using statistical parametric mapping 99 (SPM99) with an original Japanese template for 18F-FDG and compared with normal database constructed from 31 healthy volunteers (women/men; 14/17, age; 19-59 yrs). A software program, easy Z-score imaging system (eZIS), for analysis of patient data was developed by calculating Z-score in each voxel and visualizing the score in a standardized stereotactic space; Z-score=(normal mean-patient's value)/a standard deviation of normal data. Detectability of epileptic foci for this computer-aided analysis was compared with visual inspection of original 18F-FDG PET images by five radiologists without any clinical information. In all cases, there was significant reduction of glucose metabolism in the operated area. The sensitivities of the detection of epileptic foci obtained from visual inspection were 47-59%. In contrast to, computer analysis by eZIS showed 71% sensitivity when we defined the highest Z-score in the cerebrum to be the focus diagnosed by eZIS. Computer-aided diagnosis with eZIS for 18F-FDG PET study is useful for detecting epileptic foci in extra TLE. (author)

  4. 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

  5. Estudo das freqüências dos principais fatores de risco para acidente vascular cerebral isquêmico em idosos Study of the main risk factors frequencies for ischemic cerebrovascular disease in elderly patients

    OpenAIRE

    Sueli Luciano Pires; Rubens José Gagliardi; Milton Luiz Gorzoni

    2004-01-01

    Foram estudados retrospectivamente 262 pacientes com diagnóstico clínico de acidente vascular cerebral isquêmico (AVCi) permanente, com idade igual ou superior a 60 anos, selecionados dos 1015 registros da Liga de Aterosclerose da Clínica Neurológica da ISCMSP, de 1990 a 2002. O estudo focalizou as freqüências dos fatores de risco modificáveis para AVCi nesta população idosa, considerando-se sexo e faixa etária dos pacientes. Os resultados evidenciaram que a hipertenção arterial sistêmica é s...

  6. Clinical Neuroimaging of cerebral ischemia

    International Nuclear Information System (INIS)

    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.)

  7. Synthesis and Protective Effect of Scutellarein on Focal Cerebral Ischemia/Reperfusion in Rats

    Directory of Open Access Journals (Sweden)

    Nian-Guang Li

    2012-09-01

    Full Text Available Scutellarein, the main metabolite of scutellarin <em>in vivoem>, has relatively better solubility, bioavailability and bio-activity than scutellarin. However, compared with scutellarin, it is very difficult to obtain scutellarein from Nature. Therefore, the present study focused on establishing an efficient route for the synthesis of scutellarein by hydrolyzing scutellarin. Neurological deficit score and cerebral infarction volume with the administration of scutellarein were then used to compare its neuroprotective effects on focal cerebral ischemia/reperfusion in rats induced by middle cerebral artery occlusion (MCAO with those of scutellarin. The results showed that scutellarein had better protective effect on focal cerebral ischemia/reperfusion than scutellarin, which laid the foundation for further research and development of scutellarein as a promising candidate for ischemic cerebro-vascular disease.

  8. Cerebral palsy and multiple births.

    OpenAIRE

    Pharoah, P. O.; Cooke, T

    1996-01-01

    AIM: To compare the birthweight specific prevalence of cerebral palsy in singleton and multiple births. METHODS: Registered births of babies with cerebral palsy born to mothers resident in the counties of Merseyside and Cheshire during the period 1982 to 1989 were ascertained. RESULTS: The crude prevalence of cerebral palsy was 2.3 per 1000 infant survivors in singletons, 12.6 in twins, and 44.8 in triplets. The prevalence of cerebral palsy rose with decreasing birthweight. The birthweight sp...

  9. Experimental Focal Cerebral Ischemia

    DEFF Research Database (Denmark)

    Christensen, Thomas

    2007-01-01

    Focal cerebral ischemia due to occlusion of a major cerebral artery is the cause of ischemic stroke which is a major reason of mortality, morbidity and disability in the populations of the developed countries. In the seven studies summarized in the thesis focal ischemia in rats induced by occlusion...... 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...... radical scavenger α-PBN on the periinfarct depolarizations and infarct volume was investigated. In study number six, the activity of the mitochondrial electron transport complexes I, II and IV was evaluated histochemically during reperfusion after MCAO in order to assess the possible role of mitochondrial...

  10. 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 not...

  11. Cerebral abscess in children

    International Nuclear Information System (INIS)

    A cerebral abscess (CA) is a focal, infectious process only or multiple, located in the cerebral parenchyma that produces tisular lysis and it behaves like a lesion of space occupative, being a suppurative illness, who origin is a distant infection, or for continuity that studies initially as an area of focal cerebritis and it is developed to a collection surrounded purulent. At the moment they are perfecting technical and protocols diagnoses and therapeutic and measures for allow to control the natural history of the illness, making from the confrontation to this pathology a necessarily interdisciplinary complicated art, stiller in the infantile population, due to their difficulty in the diagnosis and the relevance of the same one. The paper includes epidemiology, etiology, risk factors, localization, pathology, clinic, diagnoses, treatment and diagnostic images

  12. Study on the diagnostic value of emergency-electroencephalogram and hypnogram to acute cerebral infarction

    International Nuclear Information System (INIS)

    Objective: To investigate the diagnostic value of emergency-EEG (EmEEG) and sleep electroencephalogram to acute cerebral infarction. Methods: Forty-two patients with acute cerebral infarction were collected. The first 30 minutes artifact-free segment of CEEG was selected as EmEEG, and its diagnostic value was compared with CT. Results: The EmEEG revealed that acute cerebral infarction abnormal accounted for 71.4%, while the number was 59.5% for the first CT scanning. Among those suffering from subcortical and cortical infarct, the EmEEG was more valuable in showing the ill lateral or site than those suffering from lacunar infarct. Along with the time elapsing, the positive rate of CT increased, while EmEEG's advantage of diagnostic value weakened. The abnormal rate of hypnogram was 79.31. Conclusion: The diagnostic value of EmEEG is higher in the patient who is excluded hemorrhage and found no ischemia focus by CT scanning in the earlier stage of acute cerebral infarction. (authors)

  13. A importância da musicoterapia na paralisia cerebral:perceção da equipa multiprofissional

    OpenAIRE

    Ribeiro, Emanuela Aurora Nunes

    2013-01-01

    Esta dissertação foca quais os benefícios que uma criança com Paralisia Cerebral pode alcançar ao frequentar a Musicoterapia. Neste sentido, a temática-alvo em análise é a paralisia cerebral, debruçando-se no contributo da área da Música no desenvolvimento cognitivo de uma criança com Paralisia Cerebral segundo vários autores e segundo uma equipa multiprofissional. O indivíduo com paralisia cerebral pode ter os seus movimentos afetados bem como a postura que pode ser causada por uma lesão ...

  14. Cerebral fat embolism

    International Nuclear Information System (INIS)

    A case of cerebral fat embolism is reported. A 18-year-old patient with multiple bone fractures was in semiconma immediately after an injury. Brain CT showed no brain swelling or intracranial hematoma. Hypoxemia and alcoholemia were noted on admission, which returned to normal without improvement of consciousness level. In addition, respiratory symptoms with positive radiographic changes, tachycardia, pyrexia, sudden drop in hemoglobin level, and sudden thrombocytopenia developed. These symptoms were compatible with Gurd's criteria of systemic fat embolism. Eight days after injury, multiple low density areas appeared on CT and disappeared within the subsequent two weeks, and subdural effusion with cerebral atrophy developed. These CT findings were not considered due to cerebral trauma. Diagnosis of cerebral fat embolism was made. The subdural effusion was drained. Neurologic and pulmonary recoveries took place slowly and one month following the injury the patient became alert and exhibited fully coordinated limb movement. The CT scans of the present case well corresponded with hitherto reported pathological findings. Petechiae in the white matter must have developed on the day of injury, which could not be detected by CT examination. It is suggested that some petechial regions fused to purpuras and then gradually resolved when they were detected as multiple low density areas on CT. CT in the purpuras phase would have shown these lesions as high density areas. These lesions must have healed with formation of tiny scars and blood pigment which were demonstrated as the disappearance of multiple low density areas by CT examination. Cerebral atrophy and subsequent subdural effusion developed as a result of demyelination. The patient took the typical clinical course of cerebral fat embolism and serial CT scans served for its assessment. (author)

  15. Cerebral palsy and congenital malformations

    DEFF Research Database (Denmark)

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

    2007-01-01

    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...

  16. Cerebral atrophic and degenerative changes following various cerebral diseases, (1)

    International Nuclear Information System (INIS)

    Patients having cerebral atrophic and degenerative changes following hypoglycemia, cerebral contusion, or cerebral hypoxia including cerebrovascular disorders were reported. Description was made as to cerebral changes visualized on CT images and clinical courses of a patient who revived 10 minutes after heart stoppage during neurosurgery, a newborn with asphyxia, a patient with hypoglycemia, a patient who suffered from asphyxia by an accident 10 years before, a patient with carbon monoxide poisoning at an acute stage, a patient who had carbon monoxide poisoning 10 years before, a patient with diffuse cerebral ischemic changes, a patient with cerebral edema around metastatic tumor, a patient with respiration brain, a patient with neurological sequelae after cerebral contusion, a patient who had an operation to excise right parietal lobe artery malformation, and a patient who was shooted by a machine gun and had a lead in the brain for 34 years. (Tsunoda, M.)

  17. Prevalence of brain atrophy in dogs submitted to cranial tomography in FMVZ - UNESP Botucatu: retrospective study; Prevalencia de atrofia cerebral em caes submetidos a tomografia craniana na FMVZ - UNESP Botucatu: estudo retrospectivo

    Energy Technology Data Exchange (ETDEWEB)

    Babicsak, Viviam Rocco; Belotta, Alexandra Frey; Oliveira, Hugo Salvador de; Zardo, Karen Maciel; Santos, Debora Rodrigues dos; Mamprim, Maria Jaqueline; Machado, Vania Maria de Vasconcelos; Vulcano, Luiz Carlos, E-mail: viviam.babicsak@gmail.com [Universidade Estadual Paulista Julio de Mesquita Filho (FMVZ/UNESP), Botucatu, SP (Brazil). Faculdade de Medicina Veterinaria e Zootecnia . Dept. de Reproducao Animal e Radiologia Veterinaria

    2012-07-01

    Brain atrophy is diagnosed by imaging methods that allow the verification of the widening of cerebral sulci and ventricular dilatation. In this retrospective study, in which the cranial CT scans of 150 dogs were evaluated, brain atrophy was identified in 16 animals. Mixed breed dogs were the most affected, followed by poodles, maltese, dachshunds, yorkshires, pinschers and cockers. Brain atrophy was observed in animals of all age groups, being more prevalent in middle aged dogs followed by elderly animals, in which this alteration can be commonly found. The identification of reduced brain volume, however, may not be the cause of neurological signs expressed by animals since in some dogs of this study it was considered a finding. (author)

  18. Comparative study of muscular tonus in spastic tetra paretic cerebral palsy in children with predominantly cortical and subcortical lesions in computerized tomography of the skull; Estudo comparativo do tono muscular na paralisia cerebral tetraparetica em criancas com lesoes predominantemente corticais ou subcorticais na tomografia computadorizada de cranio

    Energy Technology Data Exchange (ETDEWEB)

    Iwabe, Cristina [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas. Dept. de Neurologia; Piovesana, Ana Maria Sedrez Gonzaga [Universidade Estadual de Campinas, SP (Brazil). Ambulatorio Multidisciplinar de Paralisia Cerebral e Neurologia Infantil

    2003-09-01

    The objective was to compare distribution and intensity of muscular tonus in spastic tetra paretic cerebral palsy (CP), correlating the clinical data with lesion location in the central nervous system. Twelve children aged two to four years old with predominantly cortical lesions (six children) and subcortical lesions (six children) were included. The tonus was analyzed in the upper (UULL) and lower limbs (LLLL) based on Durigon and Piemonte protocol. The result showed that there was no significant difference regarding tonus intensity and distribution in the UULL and LLLL in both groups. Comparing the upper and lower limbs of subjects in the same group, the LLLL presented more asymmetry and higher tonus intensity than the UULL. It was concluded that in this study children with CP as a result of predominantly cortical or subcortical lesions present a similar deficit in tonus modulation, causing a symmetric and homogeneous distribution of hypertonicity, which is predominant in the LLLL. (author)

  19. Recurrent cerebral thrombosis

    International Nuclear Information System (INIS)

    Neuroradiological techniques were used to elucidate pathophysiology of recurrent cerebral thrombosis. Twenty-two patients with cerebral thrombosis who suffered a second attack under stable conditions more than 22 days after the initial stroke were studied. Hypertension, diabetes mellitus, and hypercholesterolemia were also seen in 20, 8, and 12 patients, respectively. The patients were divided into three groups according to their symptoms: (I) symptoms differed between the first and second strokes (n=12); (II) initial symptoms were suddenly deteriorated (n=6); and (III) symptoms occurring in groups I and II were seen (n=4). In group I, contralateral hemiparesis or suprabulbar palsy was often associated with the initial hemiparesis. The time of recurrent stroke varied from 4 months to 9 years. CT and MRI showed not only lacunae in both hemispheres, but also deep white-matter ischemia of the centrum semi-ovale. In group II, hemiparesis or visual field defect was deteriorated early after the initial stroke. In addition, neuroimaging revealed that infarction in the posterior cerebral artery was progressed on the contralateral side, or that white matter lesion in the middle artery was enlarged in spite of small lesion in the left cerebral hemisphere. All patients in group III had deterioration of right hemiparesis associated with aphasia. CT, MRI, SPECT, and angiography indicated deep white-matter ischemia caused by main trunk lesions in the left hemisphere. Group III seemed to be equivalent to group II, except for laterality of the lesion. Neuroradiological assessment of the initial stroke may help to predict the mode of recurrence, although pathophysiology of cerebral thrombosis is complicated and varies from patient to patient. (N.K.)

  20. Attitudes towards Augmentative and Alternative Communication for young children with cerebral palsy = As atitudes dos cuidadores em relação à utilização de Sistemas de Comunicação Alternativa e Aumentativa na interação com crianças com paralisia cerebral

    Directory of Open Access Journals (Sweden)

    Rosangela Bertelli

    2011-07-01

    Full Text Available Considering that the use of Augmentative and Alternative Communication Systems (AACS has been recommended for children who are severely impaired in their development of communicative abilities, it may be assumed that caregivers' attitudes toward AACS would be driven by children's degree of cognitive and linguistic impairments. To verify this, 40 dyads of children with cerebral palsy and their primary caregivers participated in this study evaluating children's degree of cognitive and linguistic impairments through the use of Battelle's questionnaire, and the caregivers' attitudes toward AACS by means of a Likert scale containing 15 items. Results showed that the provider's most negative attitudes toward the use of AACS were found among those caring for children with the most severe impairments.Pode admitir-se que o grau de limitação cognitiva e linguística de crianças com capacidades comunicativas gravemente prejudicadas condiciona as atitudes dos respectivos cuidadores, no uso de Sistemas de Comunicação Alternativa e Aumentativa (SCAA que têm vindo a ser recomendados para facilitar a relação com elas e promover o seu desenvolvimento. Para testar esta possibilidade, neste estudo averiguou-se qual a relação entre o grau de limitação cognitiva e linguística de 40 crianças com paralisia cerebral, avaliado por meio do questionário de Batelle, e as atitudes dos respectivos cuidadores primários perante os SCAA, determinadas através de uma escala de Likert com 15 itens. Os resultados mostraram que as atitudes mais negativas face ao uso de SCAA foram manifestadas por cuidadores de crianças com limitações mais drásticas.

  1. Padrões de ativação cerebral em idosos sadios durante tarefa de memória verbal de reconhecimento: a single-photon emission computerized tomography study Brain activation patterns during verbal recognition memory in elderly healthy volunteers

    Directory of Open Access Journals (Sweden)

    Geraldo Busatto Filho

    2001-06-01

    Full Text Available INTRODUÇÃO: Estudos que utilizam as técnicas de PET, SPECT e ressonância magnética funcional têm permitido o mapeamento dos circuitos cerebrais ativados durante diversas tarefas cognitivas. O campo da memória declarativa tem sido um dos mais intensamente estudados. No presente estudo, usa-se a técnica de mapeamento do fluxo sangüíneo cerebral regional (FSCr por SPECT para investigar mudanças na atividade cerebral durante uma tarefa de memória episódica, em voluntários idosos sadios (n=15. MÉTODOS: Duas avaliações de SPECT foram realizadas na mesma sessão, usando a técnica de dose dividida do traçador 99 m-Tc-HMPAO. Medidas de FSCr foram registradas durante uma tarefa de reconhecimento de material verbal previamente aprendido e durante uma tarefa-controle mais simples. Comparações de FSCr foram realizadas automaticamente, utilizando o programa Statistical Parametric Mapping (SPM. RESULTADOS: Observou-se aumento de FSCr durante a tarefa de memória em várias regiões cerebrais, incluindo: córtex pré-frontal lateral bilateralmente (mais acentuadamente à esquerda; porções posteriores e mediais de córtex parieto-occipital à esquerda; hemisférios cerebelares bilateralmente; e córtex temporal lateral bilateralmente (pINTRODUCTION: PET, SPECT and functional magnetic resonance imaging studies have allowed the delineation of brain circuits activated during several types of cognitive tasks. The field of declarative memory has been one of the most extensively investigated. In the present study, the regional cerebral blood flow (rCBF SPECT technique was used to investigate changes in brain activity during a verbal memory task in a group of elderly healthy volunteers (n=15. METHODS:Two SPECT acquisitions were performed in the same session, using the split-dose 99mTc-HMPAO technique. Measures of rCBF were taken during a recognition memory task and a simpler control task. Between-task comparisons were performed automatically

  2. Paralisia cerebral, novas perspectivas terapêuticas Cerebral palsy, new therapeutic possibilities

    Directory of Open Access Journals (Sweden)

    Newra Tellechea Rotta

    2002-08-01

    Full Text Available Objetivo: a revisão da paralisia cerebral tem como objetivo oferecer ao pediatra informações atualizadas sobre o diagnóstico e tratamento. Fontes dos dados: foram utilizados dados de revisão bibliográfica não sistematizada e da experiência no atendimento dos pacientes da Unidade de Neurologia do Serviço de Pediatria do HCPA-UFRGS. Síntese dos dados: o diagnóstico e tratamento da paralisia cerebral é multidisciplinar. Ao lado do sintoma principal motor, estão os sintomas associados que requerem igual atenção. Os exames de neuroimagem são importantes para melhor localizar a lesão, e mostrar sua extensão e características. O EEG auxilia no diagnóstico das epilepsias associadas. O tratamento principal é fisioterápico, auxiliado pelo tratamento da espasticidade, com antiespásticos orais, ou com toxina botulínica injetável. O tratamento de epilepsia secundária varia de acordo com o tipo de crise. Conclusões: o pediatra é o primeiro médico a entrar em contato com a criança com paralisia cerebral, e deve estar apto para reconhecer precocemente os desvios do desenvolvimento, orientar o manejo e, dentro das possibilidades e necessidades, encaminhar ao especialista.Objective: to provide pediatrician with updated information about diagnoses and treatment of cerebral palsy. This articles aims at supplying pediatricians with tools that will help them diagnose and treat cerebral palsy. Sources: non-systematic review of literature combined with personal experience at the Neurology Unit of Pediatrics Service of Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul. Summary of the findings: the cerebral palsy diagnosis and treatment are based on multidisciplinary clinical exam, EEG, CT and MR. Conclusions: pediatricians are the first physician that see the patient with cerebral palsy. Thus, they should be able to diagnose an treat it.

  3. 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...

  4. 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.

  5. Avaliação dos achados ao exame dos potenciais evocados do tronco cerebral em indivíduos com síndrome de West Evaluation of the brainstem evoked potentials in West syndrome

    OpenAIRE

    Alfredo Lopes Pereira Filho; Diego Augusto de Brito Malucelli; Líscia Lamenha Apolinario Ferreira; Fabiana Gonçalez-D'Ottaviano; José Alexandre Médicis da Silveira

    2004-01-01

    A síndrome de West é um tipo de espasmo infantil caracterizado por encefalopatia epiléptica associado a espasmos em flexão e deficiência mental de instalação no primeiro ano de vida e de etiologia incerta. Acredita-se ser determinada por diferentes fatores etiológicos como infeção intrauterina, esclerose tuberosa, asfixia perinatal ou afecções pós-natais. FORMA DE ESTUDO: Observacional coorte com corte transversal. MATERIAL E MÉTODO: No presente estudo dez pacientes com Síndrome de West foram...

  6. Cerebral infarction showed hyperperfusion pattern on radionuclide cerebral angiography

    International Nuclear Information System (INIS)

    Four patients of middle cerebral infarctin showed hyperperfusion on radionuclide cerebral angiography and fan-shape accumulation at the area of middle cerebral artery on early and delayed brain scan. In these patients, bone scanning agents such as sup(99m)Tc-EHDP or sup(99m)Tc-MDP also prominently accumulated at the area of infarction. These findings were observed on the study when it was performed within seventeen days after attack, but reexamination tended to show normal or decreased perfusion on radionuclide cerebral angiography and improve abnormal accumulation on brain scans. The clinical diagnosis of these three patients were cerebral embolism with heart disease, but one patient was internal carotid artery occlusion. The prognosis of all patients were very good. The hyperperfusion on radionuclide cerebral angiography of these patients represents the luxury perfusion in the lesion and these infarction has been called hot stroke by Yarnell et al. (author)

  7. Avaliação do desempenho motor em indivíduos com paralisia cerebral após hipoterapia - doi: 10.5102/ucs.v10i2.1734

    Directory of Open Access Journals (Sweden)

    Marianne Lucena

    2012-12-01

    Full Text Available Este estudo teve como objetivo comparar escores de desempenho motor, antes e após sessões de hipoterapia através da escala de Medida da Função Motora Grossa (GMFM. Como método, foi realizado um estudo quantitativo descritivo de intervenção do tipo antes e depois, com 3 casos de paralisia cerebral (PC,de ambos os sexos, com idades entre 5 e 7 anos, escolhidos de forma não probabilista, com quadro motor de quadriplegia mista. Foi obtida, como resultado, FAB, RFC e BES apresentaram melhora de 88.35%, 96% e 31%, respectivamente na dimensão A deitar e rola e 16.65%, 31.66% e 33% na dimensão B: sentar. RFC e BES também apresentaram melhoras na dimensão C: engatinhar e ajoelhar de 2.38% e 40.47%, respectivamente. Este estudo conclui que indivíduos com PC melhoram controle de tronco e cervical, sendo que com os índices da escala GMFM foi possível quantificar os ganhos motores.

  8. Phenylpropanolamine and cerebral hemorrhage

    International Nuclear Information System (INIS)

    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

  9. Nanomedicine in cerebral palsy

    OpenAIRE

    Balakrishnan B; Nance E; Johnston MV; Kannan R; Kannan S

    2013-01-01

    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...

  10. Cerebral palsy and aging

    OpenAIRE

    Haak, Peterson; Lenski, Madeleine; HIDECKER, MARY JO COOLEY; Li, Min; Paneth, Nigel

    2009-01-01

    Cerebral palsy (CP), the most common major disabling motor disorder of childhood, is frequently thought of as a condition that affects only children. Deaths in children with CP, never common, have in recent years become very rare, unless the child is very severely and multiply disabled. Thus, virtually all children assigned the diagnosis of CP will survive into adulthood. Attention to the adult with CP has been sparse, and the evolution of the motor disorder as the individual moves through ad...

  11. Osteopenia in cerebral palsy.

    OpenAIRE

    Shaw, N J; White, C. P.; Fraser, W. D.; ROSENBLOOM, L.

    1994-01-01

    The bone mineral density of the lumbar spine was assessed in nine non-ambulant children with cerebral palsy combined with measurements of serum 25-hydroxyvitamin D, parathyroid hormone, and urinary calcium excretion. Three children with recurrent fractures received treatment with bisphosphonates for periods ranging from 12-18 months. All the children demonstrated a severe reduction in bone mineral density even when allowance was made for their body weight. There were no consistent abnormaliti...

  12. Radiopharmaceuticals for cerebral studies

    International Nuclear Information System (INIS)

    For obtain good brain scintillation images in nuclear medicine must be used several radiopharmaceuticals. Cerebral studies give a tumors visual image as well as brain anomalities detection and are helpful in the diagnostic diseases . Are described in this work: a cerebrum radiopharmaceuticals classification,labelled compounds proceeding and Tc 99m good properties in for your fast caption, post administration and blood purification for renal way

  13. Plasticidad cerebral y lenguaje

    OpenAIRE

    Moreno-Torres Sánchez, Ignacio; Berthier Torres, Marcelo Luís

    2012-01-01

    Hace pocos años se daba por sentado que la recuperación del lenguaje tras una lesión cerebral era imposible, al igual que adquirir la lengua materna más allá de los tres primeros años de vida. Sin embargo, las últimas indagaciones muestran que nuestra capacidad de aprender es mucho mayor.

  14. Dysphagia in cerebral palsy

    OpenAIRE

    Salghetti, Annamaria; Martinuzzi, Andrea

    2013-01-01

    Abstract. Feeding problemsare often present in children with neuromotor impairment: dysphagia is usuallyseen in the most severe form of cerebral palsy and it’s defined as thedifficulty with any of the four phases of swallowing. Clinical consequences aremalnutrition and recurrent chest infections that reduce expected duration andquality of life. In order to prevent these consequences it’s important todetect with clinical and instrumental examinations dysphagia symptoms and totreat them. Clinic...

  15. Usefulness of corregistration and post-processing of MR and interictal SPECT images for localization of epileptogenic focus in children – preliminary report

    International Nuclear Information System (INIS)

    Children with focal epilepsy unresponsive to anticonvulsant therapy may become surgical candidates. Inter-ictal SPECT (SPECT-IN) studies demonstrate an area of hypoperfusion within the seizure focus in up to 50% of patients. The goal of this study was to evaluate the usefulness of corregistration of MR and SPECT-IN images for localization of the epileptogenic focus. Brain MRI and SPECT-IN were performed in 20 children (mean age 9.5). We found multifocal (3–6 perfusion deficits in 10 patients) or diffuse perfusion deficits (lobar) in all patients. In fused MR and SPECT images we evaluated average activity in volumes-of-interest (VOIs) outlined in each gray matter region with deficits. Average VOI activity below average total brain activity with at least 15% difference to the mirror VOI in the brain cortex on the opposite side of was considered as “true” perfusion deficit (TPD). In all children from our group, MRI and SPECT-IN image fusion and evaluation of TPD allowed to verify most of multifocal or diffuse deficits: in each of 12 patients we found 1 TPD, in each of 6 patients 2 TPD and in each of 2 patients 3 TPD. In 8 patients with 2 or 3 TPD we used scalp EEG or ictal SPECT for identification of one probable location of epileptogenic focus. In children with refractory focal epilepsy, image fusion of MRI and SPECT-IN with evaluation of TPD has potential clinical utility in localization of epileptogenic focus

  16. Multichannel continuous electroencephalography-functional near-infrared spectroscopy recording of focal seizures and interictal epileptiform discharges in human epilepsy: a review.

    Science.gov (United States)

    Peng, Ke; Pouliot, Philippe; Lesage, Frédéric; Nguyen, Dang Khoa

    2016-07-01

    Functional near-infrared spectroscopy (fNIRS) has emerged as a promising neuroimaging technique as it allows noninvasive and long-term monitoring of cortical hemodynamics. Recent work by our group and others has revealed the potential of fNIRS, combined with electroencephalography (EEG), in the context of human epilepsy. Hemodynamic brain responses attributed to epileptic events, such as seizures and interictal epileptiform discharges (IEDs), are routinely observed with a good degree of statistical significance and in concordance with clinical presentation. Recording done with over 100 channels allows sufficiently large coverage of the epileptic focus and other areas. Three types of seizures have been documented: frontal lobe seizures, temporal lobe seizures, and posterior seizures. Increased oxygenation was observed in the epileptic focus in most cases, while rapid but similar hemodynamic variations were identified in the contralateral homologous region. While investigating IEDs, it was shown that their hemodynamic effect is observable with fNIRS, that their response is associated with significant (inhibitive) nonlinearities, and that the sensitivity and specificity of fNIRS to localize the epileptic focus can be estimated in a sample of 40 patients. This paper first reviews recent EEG-fNIRS developments in epilepsy research and then describes applications to the study of focal seizures and IEDs. PMID:26958576

  17. Perfusion MRI in cerebral infarction

    International Nuclear Information System (INIS)

    Purpose: To investigate the hemodynamic changes in patients with acute cerebral stroke by perfusion MRI. Materials and methods: In 12 patients with acute stroke in the territory of the middle cerebral artery, perfusion MRI was performed. Peak time, mean transit time, regional cerebral blood volume and regional cerebral blood flow were calculated in the infarction, the peri-infarction area and the contralateral hemisphere. Results: In the infarction the mean blood flow was 29 ml/100 g/min, compared to about 40 ml/100 g/min in the peri-infarction area and the contralateral hemisphere. In two patients increased cortical blood flow was found in the infarction due to luxury perfusion. The cerebral blood volume was reduced in the infarction, but significantly increased, to 7.3 ml/100 g, in the peri-infarction tissue. Conclusion: Perfusion MRI allows one to differentiate various patterns of perfusion disorders in patients with acute cerebral stroke. (orig./AJ)

  18. 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 the......This review summarizes evidence in humans for an association between hyperventilation (HV)-induced hypocapnia and a reduction in cerebral perfusion leading to syncope defined as transient loss of consciousness (TLOC). The cerebral vasculature is sensitive to changes in both the arterial carbon...... contribution of a low PaCO2 to the early postural reduction in middle cerebral artery blood velocity is transient. HV together with postural stress does not reduce cerebral perfusion to such an extent that TLOC develops. However when HV is combined with cardiovascular stressors like cold immersion or reduced...

  19. [Insomnia and cerebral hypoperfusion].

    Science.gov (United States)

    Káposzta, Zoltán; Rácz, Klára

    2007-11-18

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

  20. Cerebral oxygenation and hyperthermia

    Directory of Open Access Journals (Sweden)

    AnthonyRichardBain

    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.

  1. Ação do anticonvulsivante isolado e associado ao midazolam como medicação pré-anestésica sobre o índice bispectral (BIS em pacientes com paralisa cerebral Acción del antiepiléptico aislado y asociado al midazolam como medicación preanestésica sobre el índice bispectral (BIS en pacientes con parálisis cerebral Effect of isolated anticonvulsant drug use and associated to midazolam as pre-anesthetic medication on the bispectral index (BIS in patients with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Verônica Vieira da Costa

    2010-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Os pacientes com paralisia cerebral (PC frequentemente usam fármacos para tratamento de doenças concomitantes, como convulsões. O midazolam é o hipnótico mais utilizado como medicação pré-anestésica e suas interações medicamentosas nos pacientes com PC são desconhecidas. O objetivo deste estudo foi avaliar o midazolam como medicação pré-anestésica no BIS dos pacientes com PC em uso crônico de anticonvulsivantes. MÉTODO: Foram avaliados três grupos de pacientes: PC sem uso de anticonvulsivantes, PC em uso de anticonvulsivante e outro grupo sem doença e sem uso de medicações (Grupo Controle. Na véspera da cirurgia, com os pacientes despertos e em decúbito dorsal, foi colocado o monitor do BIS e foram registrados os valores basais do BIS. No dia seguinte, 40 minutos antes da cirurgia, os pacientes receberam 0,6 mg.kg-1 de midazolam por via oral. Antes do início da anestesia, foi realizado o mesmo procedimento para registro do BIS, após o uso do midazolam. RESULTADOS: Foram estudados 107 pacientes - 39 pacientes do Grupo Controle e 68 com diagnóstico de PC. Desses, 17 faziam uso de anticonvulsivante. Com relação ao valor médio de BIS após o uso do midazolam, não houve diferença entres os pacientes do Grupo Controle e do Grupo PC que não tomavam anticonvulsivante, enquanto entre os pacientes que faziam uso de anticonvulsivantes houve diferença (p = 0,003. A possibilidade de diminuição do BIS após o uso do midazolam aumenta de acordo com o número de anticonvulsivantes usados pelo paciente. CONCLUSÕES: O uso crônico de anticonvulsivante associado ao midazolam via oral como medicação pré-anestésica pode levar à diminuição dos valores de BIS, configurando níveis profundos de hipnose.JUSTIFICATIVA Y OBJETIVOS: Los pacientes con parálisis cerebral (PC, a menudo usan fármacos para el tratamiento de enfermedades concomitantes, como las convulsiones. El midazolam es el hipnótico m

  2. Cerebral malformations without antenatal diagnosis

    International Nuclear Information System (INIS)

    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.)

  3. 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.)

  4. Educação em saúde e família: o cuidado ao paciente, vítima de acidente vascular cerebral - DOI: 10.4025/actascihealthsci.v26i1.1663 Health education in family:nursing CVA patients - DOI: 10.4025/actascihealthsci.v26i1.1663

    Directory of Open Access Journals (Sweden)

    Ana Ruth Macêdo Monteiro

    2004-04-01

    Full Text Available O presente estudo objetiva identificar o conhecimento dos familiares de pacientes acometidos por AVC (Acidente Vascular Cerebral sobre a doença e sobre seus cuidados e, ainda, elaborar uma cartilha de orientação quanto aos cuidados domiciliares a esses pacientes. Participaram da presente pesquisa 50 familiares de pacientes acometidos por AVC, os quais estavam acompanhando os pacientes por um período mínimo de 3 dias. Os dados obtidos da análise dos depoimentos dos familiares estão agrupados em 3 categorias: conhecendo as famílias, identificando o conhecimento dos familiares, atendendo às solicitações dos familiares. A cartilha de orientação, elaborada de acordo com o levantamento das principais dúvidas e/ou dificuldades dos familiares, busca favorecer o processo educativo dessas famílias no ambiente hospitalar, promovendo, assim, seu envolvimento nesse processo. A importância de um trabalho nesse sentido está baseada na possibilidade de uma maior compreensão dos problemas vivenciados pelos pacientes acometidos por AVC e por suas famílias, auxiliando, dessa forma, o enfermeiro a desenvolver ações visando minimizá-los e tornar a situação menos traumática para ambos.The present study aims to identify the knowledge of CVA (Cerebral Vascular Accident patients' close relatives on the disease and its specific cares; and also, to elaborate a guide for the home care of those patients. The present research evaluated family members from 50 CVA patients. These relatives were taking care of the patients for at least 3 days. The data obtained from the testimonies analysis are grouped in three categories: acquainting the families; identifying the family’s knowledge; assisting family’s requests. The guide, organized according to the relatives' main doubts and difficulties, intends to help the educational process of those families in the hospital’s atmosphere, promoting their engagement in the process. This work makes possible a

  5. Natriuretic peptides and cerebral hemodynamics

    DEFF Research Database (Denmark)

    Guo, Song; Barringer, Filippa; Zois, Nora Elisabeth;

    2014-01-01

    decompensated disease. In contrast, their biological effects on the cerebral hemodynamics are poorly understood. In this mini-review, we summarize the hemodynamic effects of the natriuretic peptides with a focus on the cerebral hemodynamics. In addition, we will discuss its potential implications in diseases...... where alteration of the cerebral hemodynamics plays a role such as migraine and acute brain injury including stroke. We conclude that a possible role of the peptides is feasible as evaluated from animal and in vitro studies, but more research is needed in humans to determine the precise response on...... cerebral vessels....

  6. Hematoma intraparenquimatoso cerebral espontâneo: aspectos à tomografia computadorizada Spontaneous cerebral intraparenchymatous hematoma: computed tomography findings

    Directory of Open Access Journals (Sweden)

    Celso Monteiro Soares

    2005-02-01

    Full Text Available OBJETIVO: Identificar os aspectos mais freqüentes do hematoma intraparenquimatoso cerebral espontâneo observados na tomografia computadorizada. MATERIAIS E MÉTODOS: Foram analisados, retrospectivamente, os exames de tomografia computadorizada de 250 pacientes com hematoma intraparenquimatoso cerebral espontâneo, provenientes de três diferentes hospitais da cidade do Rio de Janeiro. RESULTADOS: O hematoma intraparenquimatoso cerebral profundo foi o de maior incidência, equivalendo a 54,4% (136 casos, seguido do lobar com 34,8% (87 casos. Mais raramente, observou-se sangramento cerebelar em 8,4% (21 casos e do tronco cerebral em 2,4% (seis casos dos pacientes. CONCLUSÃO: A cefaléia foi o sintoma mais comum e a hipertensão arterial foi o sinal mais freqüentemente apresentado. A drenagem do hematoma para o sistema ventricular ocorreu mais comumente nos hematoma profundos.OBJECTIVE: To identify the most frequent aspects of spontaneous cerebral intraparenchymatous hematoma found at computed tomography examinations. MATERIALS AND METHODS: We reviewed, retrospectively, the computed tomography studies of 250 patients with spontaneous intracerebral hemorrhage carried out in three hospitals in Rio de Janeiro, Brazil. RESULTS: Deep intracerebral hematomas showed the highest incidence and were observed in 54.4% of the cases (136 patients followed by lobar hemorrhage in 34.8% of the cases (87 patients. Cerebelar hemorrhage and brainstem bleeding were more rarely observed, occurring in 8.4% (21 patients and 2.4% (six patients of the cases, respectively. CONCLUSION: Chronic headache was the most frequent symptom whereas hypertension was observed in the majority of the cases. Blood draining into the ventricular system occurred more frequently in patients with deep hematomas.

  7. Vasculite cerebral e uso de cocaína e crack Cerebral vasculitis and cocaine and crack abuse

    Directory of Open Access Journals (Sweden)

    Fernando Madalena Volpe

    1999-09-01

    Full Text Available O abuso de cocaína e crack está associado com importante parcela dos acidentes vasculares cerebrais, especialmente em pacientes jovens. O presente estudo relata o caso de um usuário de cocaína e crack que desenvolveu vasculite do sistema nervoso central, resultando em infartos cerebrais e edema extensos, levando à demência com alterações comportamentais e convulsões. Ressalta-se a importância de suspeitar do uso de drogas em jovens que se apresentam com acidente vascular cerebral, assim como avaliar possíveis lesões cerebrais em usuários de drogas com deterioração cognitiva.Cocaine and crack abuse is strongly related to stroke, particularly in young patients. The present study reports the case of a cocaine and crack abuser who developed central nervous system vasculitis, resulting in extensive cerebral infarctions, leading to dementia, behavioural disturbances and seizures. The relevance of detecting drug abuse in young stroke patients is stressed. Assessing possible brain lesions in drug abusers with cognitive impairment is also important.

  8. O sujeito cerebral e o movimento da neurodiversidade

    Directory of Open Access Journals (Sweden)

    Francisco Ortega

    2008-10-01

    Full Text Available Este artigo analisa o movimento da neurodiversidade organizado basicamente por autistas chamados de alto funcionamento que consideram que o autismo não é uma doença a ser tratada, mas uma diferença humana, a qual deve ser respeitada como outras diferenças. O movimento da "neurodiversidade" deve ser inserido em um marco sociocultural e histórico mais amplo que incorpore o impacto crescente no imaginário cultural dos saberes e das práticas neurocientíficas com o paradigma do sujeito cerebral e a expansão da neurocultura. No contexto do sujeito cerebral, o cérebro responde por tudo o que outrora costumávamos atribuir à pessoa e vem se tornando um critério biossocial de agrupamento fundamental. O artigo mostra como uma ideologia solipsista, reducionista e cientificista - o sujeito cerebral - pode servir de base para a formação de identidade e de redes de sociabilidade e comunidade.This article analyzes the neurodiversity movement, organized mostly by so-called high-functioning autists, who consider that autism is not a disease to be treated, but rather a human difference that should be respected alongside other differences. The "neurodiversity" movement must be set within a wider sociocultural and historical field that incorporates the growing impact of neuroscientific knowledge and practices in the cultural imagination with the paradigm of the cerebral subject and the expansion of neuroculture. In the context of the cerebral subject, the brain accounts for all that we used to attribute to the person, and it is becoming a fundamental criterion for biosocial grouping. The article shows how a solipsist, reductionist and scientificist ideology - the cerebral subject - can act as the basis for the formation of identity and networks of sociability and community.

  9. Inhibitory action of antioxidants (ascorbic acid or α-tocopherol on seizures and brain damage induced by pilocarpine in rats Ação inibitória de antioxidantes (ácido ascórbico e α-tocoferol nas convulsões e dano cerebral em ratos induzidos pela pilocarpina

    Directory of Open Access Journals (Sweden)

    Adriana da Rocha Tomé

    2010-06-01

    Full Text Available Temporal lobe epilepsy is the most common form of epilepsy in humans. Oxidative stress is a mechanism of cell death induced by seizures. Antioxidant compounds have neuroprotective effects due to their ability to inhibit free radical production. The objectives of this work were to comparatively study the inhibitory action of antioxidants (ascorbic acid or α-tocopherol on behavioral changes and brain damage induced by high doses of pilocarpine, aiming to further clarify the mechanism of action of these antioxidant compounds. In order to determinate neuroprotective effects, we studied the effects of ascorbic acid (250 or 500 mg/kg, i.p. and α-tocopherol (200 or 400 mg/kg, i.p. on the behavior and brain lesions observed after seizures induced by pilocarpine (400 mg/kg, i.p., P400 model in rats. Ascorbic acid or α-tocopherol injections prior to pilocarpine suppressed behavioral seizure episodes. These findings suggested that free radicals can be produced during brain damage induced by seizures. In the P400 model, ascorbic acid and α-tocopherol significantly decreased cerebral damage percentage. Antioxidant compounds can exert neuroprotective effects associated with inhibition of free radical production. These results highlighted the promising therapeutic potential of ascorbic acid and α-tocopherol in treatments for neurodegenerative diseases.A epilepsia de lobo temporal é a mais comum forma de epilepsia em humanos. O estresse oxidativo é um dos mecanismos de morte celular induzida pelas crises convulsivas. Os compostos antioxidantes apresentam efeitos neuroprotetores devido à sua capacidade de inibir a produção de radicais livres. Os objetivos do presente trabalho foram estudar de forma comparativa a ação inibitória de antioxidantes (ácido ascórbico e α-tocoferol sobre as alterações comportamentais e histopatológicas no hipocampo de ratos após convulsões induzidas pela pilocarpina. A fim de determinar os efeitos neuroprotetores

  10. Vasopressin serum levels and disorders of sodium and water balance in patients with severe brain injury Níveis séricos de vasopressina e distúrbios de sódio e água em pacientes com lesão cerebral grave

    Directory of Open Access Journals (Sweden)

    Eliane de Araújo Cintra

    2007-12-01

    Full Text Available BACKGROUND: Disorders of water and sodium balance are frequently seen in patients with severe brain injury (SBI, and may worsen their prognosis. PURPOSE: To evaluate vasopressin (AVP serum levels and sodium and water balance disorders during the first week post-injury in patients with SBI. METHOD: Thirty-six adult patients with SBI (admission Glasgow Coma Scale score ANTECEDENTES: Desordens do balanço de água e sódio são frequentemente vistas em pacientes com lesão cerebral grave (LCG, podendo agravar o prognóstico. OBJETIVO: Avaliar os níveis séricos de vasopressina (AVP e a incidência de distúrbios da água e sódio na primeira semana pós-lesão em pacientes com LCG. MÉTODO: Trinta e seis pacientes adultos com LCG (pontuação inicial na escala de coma de Glasgow < 8 e tempo estimado de lesão < 72h foram estudados prospectivamente. Dados laboratoriais e clínicos foram registrados e os níveis séricos de AVP foram mensurados no 1º, 2º, 3º e 5º dias pós-inclusão. RESULTADOS: A AVP manteve-se dentro da faixa de normalidade nestes pacientes, mas mostrando-se proporcionalmente mais elevada nos pacientes que não sobreviveram (p=0,025 no 3º dia. A mortalidade intra-hospitalar foi 43% (15/36 e as variações do sódio e osmolalidade plasmáticos foram maiores nos pacientes que não sobreviveram durante o período de observação (p<0,001. CONCLUSÃO: Os níveis séricos de AVP mantiveram-se dentro da faixa de normalidade nestes pacientes com LCG, mas aqueles não sobreviventes mostraram maior incidência de anormalidades do balanço de água e sódio durante a primeira semana de evolução.

  11. Cerebral oxygenation after birth

    DEFF Research Database (Denmark)

    Hessel, Trine W; Hyttel-Sorensen, Simon; Greisen, Gorm

    2014-01-01

    AIM: To compare absolute values of regional cerebral tissue oxygenation (cStO2 ) during haemodynamic transition after birth and repeatability during steady state for two commercial near-infrared spectroscopy (NIRS) devices. METHODS: In a prospective observational study, the INVOS 5100C and FORE...... INVOS and FORE-SIGHT cStO2 estimates showed oxygenation-level-dependent difference during birth transition. The better repeatability of FORE-SIGHT could be due to the lower response to change in saturation....

  12. Techniques in cerebral protection

    International Nuclear Information System (INIS)

    Carotid angioplasty and stenting is a valid alternative option to conventional carotid endarterectomy in the treatment of carotid artery stenosis. During the stenting process, however, distal embolization can occur with neurological consequences. To avoid this, cerebral protection devices have been introduced. Three principal types of protection system have been developed: distal balloon occlusion, distal filters and proximal protection with or without reversal of flow. As protection devices became the focus of interest by manufactures and physicians, several trials are going on worldwide to analyze the characteristics of each of them and to evaluate their efficacy to reduce the rate of distal embolization

  13. Therapeutic interventions in cerebral palsy.

    Science.gov (United States)

    Patel, Dilip R

    2005-11-01

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

  14. Cerebral hemodynamics in moyamoya disease

    International Nuclear Information System (INIS)

    Rebuild-up phenomenon, an electroencephalographic pathological finding in moyamoya disease, was evaluated in the context of dynamic changes in cerebral circulation after hyperventilation. Sequential functional angiography after hyperventilation, measurement of cerebral blood flow (CBF) by the outflow method, and Kr-81m single photon emission tomography were employed for clarification of the sequential dynamic changes in cerebral circulation after hyperventilation. In most cases there was a persistent decrease in CBF even after arterial carbon dioxide tension (PaCO2) had been normalized, which suggests that the response of the cerebral circulation to the changes in PaCO2 is delayed. Moreover, this feature was most prominent in the superficial layer of the cerebrum. For the most part, coincidence and synchronization were documented between rebuild-up and the delayed response of the cerebral circulation. These findings indicate that the delayed CBF response to hyperventilation contributes pathogenetically to rebuild-up in moyamoya disease. (author)

  15. Cerebral Hemorrhage and APOE genotype

    Institute of Scientific and Technical Information of China (English)

    Sun xiaojiang; Wu ping; Zhang jing; Lu shanqing; Li bing

    2000-01-01

    Background and Purpose: Current evidence Suggests that the apolipoprotein E (APOE)ε 4 allele predisposes to cerebral amyloid angiopathy (CAA) whereas ε 2 is associated with CAA-zelated hemorrhage. In this study we examined potential clinical risk factors inpatients with cerebral hemorrhage and assessed these with respect to APOE genotype. Methoeds: 146 patinas with cerebral hemorrhage and 70 normal controls were investigated. APOE genotypes were determined with use of polymerase Chain reaction techniques.Results: The frequency of allele gene ( 0.180 ) and the percentage of the APOE ε 4 genotype in the cerebral hemorrhage group were Significantly higher as compared with the e 4 prequency ( O.O72 ) in the control group respectively ( p=O.O389 ) .Conelusious: APOE ε 4 :allele is a risk gene for cerebral hemorrhage.

  16. 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.

  17. Cerebral imaging in pediatrics

    International Nuclear Information System (INIS)

    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

  18. Cerebral sinus venous thrombosis.

    Science.gov (United States)

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

    2013-10-01

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

  19. 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.

  20. Nonthyroidal illness syndrome in patients with subarachnoid hemorrhage due to intracranial aneurysm Sindrome da doença não tiroideana em pacientes com hemorragia subaracnoidea devida a aneurisma cerebral

    Directory of Open Access Journals (Sweden)

    Luiz Augusto Casulari

    2004-03-01

    Full Text Available We have previously reported that subarachnoid hemorrhage due to ruptured intracranial aneurysm (SH is associated with changes in the hormonal profile in the first 24 hours after the event. We proposed that the hormonal changes observed are due to the intense stress to which the patients are exposed. However, the thyroidal hormonal profile is indicative of the presence of a nonthyroidal illness syndrome (NTIS. In this paper, we examined whether the change in the thyroid hormone profile is compatible with a NTIS. Two groups of patients were included in the study: A 30 patients with SH (21 females and 9 males; 41.7±11.4 years and B a control group including 25 patients with benign diseases of the spine (BDS (lumbar disc hernia or stable spinal trauma (8 females and 17 males; 41.3±14.2 years. In a subgroup of eight patients of each group serum triiodothyronine (T3 and reverse T3 levels were measured. The blood samples were obtained between 8:00 and 9:00 AM. The following results were obtained: The SH group had smaller serum T3 and free T4 levels than the BDS group (pNós apresentamos previamente que a hemorragia subaracnoidea devido à ruptura de aneurisma intracraniano (SH está associada com alterações no perfil hormonal nas primeiras 24 horas após o evento. Nós propusemos que as alterações hormonais observadas são devidas ao intenso estresse ao qual os pacientes estão expostos. Contudo, o perfil hormonal tireoidiano é indicativo da presença da síndrome da doença não tireoidiana (NTIS. Neste trabalho, examinamos se as alterações no perfil dos hormônios tireoidianos são compatíveis com a NTIS. Dois grupos de pacientes foram incluídos no estudo: A 30 pacientes com SH (21 mulheres e 9 homens; 41,7±11,4 anos e B um grupo controle incluindo 25 pacientes com doenças benignas da coluna (BDS (hérnia de disco lombar ou estável trauma da coluna (8 mulheres e 17 homens; 41,3±14,2 anos. Em um subgrupo de oito pacientes de cada grupo

  1. Participação de crianças com paralisia cerebral nos ambientes da escola Participation of children with cerebral palsy in school environments

    OpenAIRE

    Daniela Baleroni Rodrigues Silva; Cláudia Maria Simões Martinez; Jair Licio Ferreira Santos

    2012-01-01

    Diante do amplo debate acerca da inclusão do educando com necessidades especiais em escola regular, esta pesquisa teve como objetivo descrever a participação da criança com paralisia cerebral nas atividades funcionais nos diferentes ambientes da escola, a partir da percepção de seus professores. Participaram deste estudo 10 professores e seus respectivos alunos com paralisia cerebral do município de São Paulo. Foi realizada a aplicação da parte I da School Function Assessment junto aos profes...

  2. Obstructive hydrocephalus resulting from cerebral venous thrombosis

    OpenAIRE

    2011-01-01

    Cerebral venous thrombosis is a rare form of stroke in childhood. Increased intracranial pressure is a well-defined complication of cerebral venous thrombosis but obstructive hydrocephalus as a presentation finding of cerebral venous thrombosis is rarely described. A child case of cerebral sinus thrombosis presenting with obstructive hydrocephalus and management of clinical condition is presented with discussion of reported cases and treatment recommendations.

  3. 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.

  4. Microsurgical clipping in forty patients with unruptured anterior cerebral circulation aneurysms: an investigation into cognitive outcome Clipagem microcirúrgica em 40 pacientes com aneurisma de circulação cerebral anterior não-roto: uma investigação cognitiva

    Directory of Open Access Journals (Sweden)

    Arthur A Pereira-Filho

    2010-10-01

    Full Text Available OBJECTIVE: It is a consensus that most unruptured intracranial aneurysms (UIA can be treated with acceptably low morbidity. However, some studies recently reported postoperative cognitive impairment, suggesting that it could be attributable to surgical damage. Our goal is to evaluate cognitive function before and after microsurgical clipping in patients with UIA. METHOD: A consecutive series of 40 patients who underwent microsurgical clipping for UIA were studied. The cognitive assessment (Mini Mental State Examination, MMSE was performed immediately before and at least one month after surgery. Paired Student's "t" test and analysis of variance (ANOVA were used for statistical purposes. RESULTS: The mean MMSE score in the preoperative analysis was 28.12 (SD, 1.34. In the postoperative period the mean MMSE score was 28.40 (SD, 1.46. Paired Student's "t" test was applied to the scores and no significant difference was found (p=0.315. ANOVA did not find independent associations between MMSE scores and age, hypertension, smoking, dyslipidemia, education, aneurysm location, number, laterality or size. CONCLUSION: The present study suggests that microsurgical clipping for UIA does not result in major cognitive dysfunction as determined by the MMSEOBJETIVO: É consenso que a maioria dos aneurismas intracranianos não-rotos (AINR podem ser tratados com aceitável taxa de morbidade. Entretanto, alguns estudos reportaram déficits cognitivos no pós-operatório, sugerindo que poderiam ser atribuídos ao dano cirúrgico. O objetivo desse estudo é avaliar a função cognitiva antes e após clipagem microcirúrgica em pacientes com AINR. MÉTODO: Uma série de 40 pacientes com AINR submetidos à clipagem microcirúrgica foi estudada. A avaliação cognitiva (Mini Exame do Estado Mental, MEEM foi realizada antes e após a intervenção cirúrgica. A análise estatística foi realizada com teste "t" de Student e análise de variância (ANOVA. RESULTADOS: A m

  5. Phytochemical and Biological Studies of <em>Agave em>attenuata>

    OpenAIRE

    Vincenzo De Feo; Muhammad Riaz; Nasir Rasool; Muhammad Zubair; Komal Rizwan; Muhammad Zia-Ul-Haq

    2012-01-01

    The present study was conducted to examine various biological activities of a methanol extract of <em>Agave attenuataem> leaves. GC-MS analysis of the <em>n>-hexane fraction from the extract revealed the presence of 31 compounds, with mono-2-ethylhexyl phthalate (11.37%), 1,2-benzenedicarboxylic acid (6.33%), <em>n>-docosane (6.30%) and eicosane (6.02%) as the major components. The leaves contained appreciable levels of total phenolic contents (10...

  6. Sistemas suplementares e alternativos de comunicação nas habilidades expressivas de um aluno com paralisia cerebral Augmentative and alternative systems in the expressive abilities of a cerebral palsy student

    OpenAIRE

    Débora Deliberato

    2011-01-01

    O objetivo desta pesquisa foi descrever o uso do sistema de comunicação suplementar e alternativo de um aluno com paralisia cerebral submetido à intervenção. Participou desta investigação um aluno com paralisia cerebral de 10 anos de idade, gênero masculino, que frequentava classe especial para deficientes físicos em uma escola estadual de uma cidade do interior de São Paulo. As atividades programadas foram realizadas duas vezes por semana, durante dois anos, em um Laboratório de Educação Esp...

  7. 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.

  8. 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.

  9. Alterações fisiológicas da morte encefálica em potenciais doadores de órgãos e tecidos para transplantes Los cambios fisiológicos de la muerte cerebral en potenciales donadores de órganos y tejidos para trasplante Physiological changes of brain death in potential donors of organs and tissues for transplantation

    Directory of Open Access Journals (Sweden)

    Sarah Gabriel Freire

    2012-12-01

    Full Text Available Objetivou-se descrever as alterações fisiológicas da morte encefálica em potenciais doadores de órgãos e tecidos para transplantes. Estudo exploratório descritivo com dados prospectivos e abordagem quantitativa realizado nas unidades de emergência e terapia intensiva adulto de um hospital de Pernambuco no período de abril a outubro de 2011. A população constou de 32 potenciais doadores de órgãos e tecidos para transplantes. Após aprovação do Comitê de Ética em Pesquisa, os dados foram coletados, tabulados e analisados pela estatística descritiva pelo software SPSS 15.0 e apresentados em forma de tabelas. As alterações fisiológicas foram: hipotensão arterial (100%, hipotermia (75,0%, hipernatremia (62,5%, diabetes insipidus (37,5%, hiperglicemia (32,3%, infecção (25,0%, hipertensão arterial (9,4% e úlcera de córnea (3,1%. Acredita-se que o conhecimento dessas alterações possibilita à equipe de saúde direcionar o cuidado ao potencial doador segundo as suas necessidades e, assim, manter o órgão/tecido viável para transplante.El objetivo del estudio fue describir los cambios fisiológicos de la muerte cerebral en los potenciales donadores de órganos y tejidos para trasplante. Investigación exploratoria, descriptiva, con datos prospectivos y enfoque cuantitativo, hecho en las unidades de emergencia y de cuidados intensivos de adultos de un hospital de Pernambuco en el periodo de abril a octubre de 2011. La población fue formada por 32 potenciales donadores de órganos y tejidos para trasplante. Después de la aprobación en el Comité Ético de Investigación, los datos han sido recogidos, tabulados y analizados mediante estadística descriptiva por el programa informático SPSS 15.0, siendo presentados en forma de tablas. Los cambios fisiológicos fueron: hipotensión (100%, hipotermia (75,0%, hipernatremia (62,5%, diabetes insípida (37,5%, infección (25,0%, hipertensión arterial (9,4% y la úlcera de c

  10. CEREBRAL PALSY AND MUSIC ACHIEVEMENT

    OpenAIRE

    Miodrag L. STOSHLJEVIKJ; EMINOVIKJ Fadilj N.; NIKIKJ Radmila M.; Gordana I. ACHIKJ; Sanela R. PACIKJ

    2015-01-01

    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 pal...

  11. Cerebral toxoplasmosis in AIDS

    International Nuclear Information System (INIS)

    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. (orig.)

  12. Cerebral white matter hypoplasia

    International Nuclear Information System (INIS)

    This paper demonstrates the MR imaging findings in children with cerebral white matter hypoplasia (CWMH). The MR studies of four children, aged 3-7 y (mean age, 2.3 y) with a diagnosis of CWMH were reviewed. In all cases multiplanar T1-weighted and T2-weighted spin-echo images were obtained. All children had similar histories of severe developmental delay and nonprogressive neurologic deficits despite normal gestational and birth histories. In two cases there was a history of maternal cocaine abuse. Autopsy correlation was available in one child. The MR images of all four children demonstrated diffuse lack of white matter and enlarged ventricles but normal-appearing gray matter. The corpus callosum, although completely formed, was severely thinned. There was no evidence of gliosis or porencephaly, and the distribution of myelin deposition was normal for age in all cases. Autopsy finding in one child correlated exactly with the MR finding

  13. Acute ischemic cerebral attack

    Directory of Open Access Journals (Sweden)

    Franco-Garcia Samir

    2010-12-01

    Full Text Available 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 violent death in the world and the first of disability. Many risk factors favor the presentation of these events and some of them are susceptible of modification and therfore are objetives of primary prevention just as the control of diabetes, hypertension and the practice of healthy habits of life. The advances in the knowledge of the physiopatology, had taken to sustantial change in the nomenclature and management of ischemic ACS. Within these changes it was substituted the term cerebrovascular accident fo acute stroke, making emphasis in the key rol of a timely management with goals of time similiar to the acute coronary syndrome. It was redefined the time of acute ischemic attack to a one hour. Once stablished the cerebrovascular attack the semiology of symtoms with frecuency will led us make a topographic diagnosis of the in injury that joined to the cerebral TAC will allow us to exclude an hemorragic event and to start the treatment. In the management of these patients its essential the coordination of the differents teams of work, from the early recognition of symtoms on the part of patients andthe family, the rapid activation and response of emergency systems and the gearing of health care institutions. Are pillars of treatment: the abcde of reanimatiion, to avoid the hiperpirexis, the seizures, the hipoglicemy, the hiperglicemy, to achieve the thrombolysis in the first three hours of the begining of symtoms, to use antiplatelets, antithrombotic profilaxis

  14. 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...

  15. Diagnostic Assessment of Cerebral Palsy

    OpenAIRE

    J Gordon Millichap

    2004-01-01

    The Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society have developed practice parameters for the diagnosis of cerebral palsy (CP).

  16. 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.

  17. Diagnostic Assessment of Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2004-04-01

    Full Text Available The Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society have developed practice parameters for the diagnosis of cerebral palsy (CP.

  18. Cerebral venous thrombosis: diagnosis dilemma

    OpenAIRE

    2011-01-01

    Cerebral venous thrombosis is increasing common disease in daily practice with sharing clinical nonspecific symptoms. This disorder is potentially lethal but treatable, oftenly it was overlooked in both clinical and radiologic in routine practice. Whenever, clinical suspected, prompt investigation by noninvasive imaging Magnetic resonance (MR) or advanced modilities such as cerebral venous thrombosis (CVT), MRV (MR Venography) will helpful in prompt diagnosis and treatment. These imaging moda...

  19. Cerebral involvement in Whipple's disease

    International Nuclear Information System (INIS)

    Whipple's disease is a rare protean disease. Cerebral involvement occurs in ten percent of the cases. CCT findings in two patients with cerebral symptoms are presented. There was an unspecific atrophy in one patient. Patient two had hydrocephalus occlusus and a temporal lesion enhanced by contrast agent. A specific diagnosis on the sole basis of the CCT without additional clinical data does not seem possible. (orig.)

  20. Sirt1 in cerebral ischemia

    OpenAIRE

    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 seve...

  1. NEYROPSYCHOLOGICAL CONSECUENCES OF CEREBRAL PALSY

    OpenAIRE

    ANA MARÍA NAVARRO MELENDRO; ANDREA PATRICIA RESTREPO IBIZA

    2005-01-01

    Cerebral Palsy is defined as a movement alteration result of a non progressive damage witch is permanent in anencephalon that has not acquired its final maturation. Patients that suffer cerebral palsy present learning disabilities,that varies between being completely normal to severe as a consequence of memory, gnosis, praxis, perceptive andlanguage impairments. Nevertheless the consequences of this disease are not always predictable. This paper pretendsto make a description of the cognitive ...

  2. Cerebral candidiasis. Computed tomography appearance

    International Nuclear Information System (INIS)

    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.)

  3. 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.).

  4. Cerebral palsy: classification and etiology

    OpenAIRE

    Bialik, Gad M.; Givon, Uri

    2004-01-01

    Cerebral palsy (CP), a common condition of abnormalities in the brain, arises early in life. Since the term was first introduced in 1843, many authors have tried to define and classify CP. The most recent definition was released by the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) in 2005. This article summarizes the latest and familiar classifications of, and etiologies associated with CP.

  5. Cerebral hyperperfusion following carotid endarterectomy

    DEFF Research Database (Denmark)

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

    1987-01-01

    Serial measurements of cerebral blood flow (CBF) were performed in 56 patients before and one to four times after uncomplicated carotid endarterectomy. The findings were related to the ratio between internal carotid artery (ICA) and common carotid artery (CCA) mean pressures. Within the 1st...... 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....

  6. CEREBRAL PALSY : ANTENATAL RISK FACTORS

    OpenAIRE

    Srinivasa Rao; Vidyullatha; Subbalakshmi

    2015-01-01

    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 cere...

  7. Bone age in cerebral palsy

    OpenAIRE

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

    2013-01-01

    Objective To compare the chronological age and bone age among cerebral palsy patients in the outpatient clinic and its correlation with the type of neurological involvement, gender and functional status. Methods 401 patients with spastic cerebral palsy, and ages ranging from three months to 20 years old, submitted to radiological examination for bone age and analyzed by two independent observers according Greulich & Pyle. Results In the topographic distribution, there was a significant delay (p

  8. Sentimentos vivenciados por fisioterapeutas no atendimento a pessoas com paralisia cerebral Physiotherapist's feelings on attending people with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Dinael Corrêa de Campos

    2009-08-01

    Full Text Available Considerando que os estudos sobre a relação profissional de saúde e cliente contribuíram para o surgimento da proposta do modelo humanizado de atendimento, esta pesquisa investigou os possíveis sentimentos de fisioterapeutas em relação ao atendimento de pessoas com paralisia cerebral, já que esta condição, a paralisia cerebral, é considerada sem cura pela medicina e com possibilidades de melhora diretamente vinculadas aos exercícios fisioterapêuticos. Utilizando um instrumento contendo perguntas abertas, foram realizadas entrevistas com fisioterapeutas que atendem aos casos com sequelas mais graves: ausência total da linguagem verbal e comprometimentos motores que levam os pacientes à situação de acamados. Mediante a análise de conteúdo, verificou-se que a paralisia cerebral é reconhecida pelos fisioterapeutas como um quadro neurológico e as limitações no alcance de resultados terapêuticos são vistas como normais. Assim, as mudanças, mesmo sendo reduzidas e obtidas em longo prazo, tornam o atendimento gratificante para os fisioterapeutas por representarem uma superação de desafios.Considering the studies about professional relation among health and clients contributted to arise the purposes about a humanized model of assistance. This research shows the physiotherapists' feelings on attending people with cerebral palsy, taking in accounting the cerebral palsy is presented by the medicine as a reverseless decease and having possibilities of changing entailed to the physiotherapy. By means of interviews and questionaries answered by physiotherapists, and using the contents of analysis, we can notice that the cerebral palsy is understood by the professional of physiotherapy like a neurological condition, so the limitations on reaching are noticed as normal. Thus, even the changes reduced in the long run, they make the attendance to be rewarding for the professional of physiotherapy, because these changes represent the

  9. Quantification of respiratory parameters in patients with temporal lobe epilepsy Quantificação de parâmetros respiratórios em pacientes com epilepsia do lobo temporal

    Directory of Open Access Journals (Sweden)

    Fulvio Alexandre Scorza

    2007-06-01

    Full Text Available Dysfunction affecting cardiac or pulmonary systems has been postulated as a major factor in sudden death in epilepsy (SUDEP. Whilst the majority of studies of cardiorespiratory function have focused on changes during seizures, here we investigate whether epilepsy influences basal respiratory parameters in patients with temporal lobe epilepsy (TLE during the interictal period. Spirometry was performed in 10 females and 10 males. Measurements of Vital Capacity (VC, Forced Vital Capacity (FVC, Forced Expiratory Volume in the first second (FEV1 and ratios of FEV1 to FVC (FEV1/FVC were obtained, and these values were analyzed as percentages of predicted values. None of the patients had chronic obstructive pulmonary disease and no significant alterations in respiratory function tests were found among these patients. No association between seizure frequency, antiepileptic drugs and SUDEP could be found in this study. Although the study did not identify any specific respiratory abnormality in TLE patients during the interictal period, re-evaluation of clinical data on pulmonary disorders in people with epilepsy should be better investigated.Alterações cardíacas e pulmonares têm sido propostas como principais fatores de risco no fenômeno da morte súbita em epilepsia (SUDEP. Enquanto a maioria dos estudos tem verificado as alterações da função cardiorrespiratória durante as crises epilépticas, nosso estudo avaliou a função pulmonar de indivíduos com epilepsia do lobo temporal (ELT no período interictal. Vinte pacientes com ELT (10 homens e 10 mulheres participaram de nosso estudo. Nos testes de função pulmonar foram mensurados os seguintes parâmetros: Capacidade Vital Forçada (CVF, Capacidade Vital Lenta (CVL, Volume Expiratório Forçado no primeiro segundo (VEF1 e o Índice VEF1/CVF. Os resultados foram comparados aos valores de normalidade preditos na literatura. Nenhum dos pacientes apresentou doença pulmonar obstrutiva ou

  10. 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...... haemodynamics' includes cerebral blood flow (CBF), cerebral blood flow velocity, and cerebral blood volume (CBV). Therapy aimed at changing vascular anatomy is not available. Therefore, prevention of disturbances in CBF and CBV is pivotal. However, continuous monitoring of CBF and CBV is still unavailable for....... Using it even without knowing the exact level of CBF and CBV, it is possible to aim to keep CBF and CBV stable. Futureresearch should focus on development of monitoring tools, gaining more insight in neonatal cerebral autoregulation, and demonstrating clinical benefits of a 'cerebral perfusion...

  11. Pathogenesis of cerebral malaria

    International Nuclear Information System (INIS)

    Full text: Cerebral Malaria (CM) is the most severe complication of malaria and a major cause of death. The mechanisms underlying human CM pathogenesis might be due to mechanical cause, as demonstrated by cytoadherence of parasitised erythrocytes pRB, or to excessive cytokine production by the host in response to Plasmodium falciparum, or a combination of the two together with neuronal injury by malaria toxins. Antibody response, genetic traits and other factors have been proposed to explain why only some episodes have life-threatening complications. The microvascular endothelial cell is a major target of inflammatory cytokines overproduced in infectious diseases. Fatal CM is associated with widespread induction of endothelial activation markers, with significant higher levels of ICAM, VCAM and E-selectin expression on vessels in the brain. 199 patients were admitted at the hospital and were classified with malaria-based neurological disfunctions, such as acute psychosis, ataxia, hallucinations, fever and convulsions, prostration or coma. On a flow chart, 65 of those patients with the most acute syndromes mentioned above, were found to have negative BSN (blood slide), compared to 124 where the BSN showed to be positive. Identically to the 10 other patients from the severe form group, also presented positive BSN. The condition of some of these two subgroup patients (15), will later evolve into a more severe form with acute neurological disfunctions attributed to the cerebral malaria. The interesting aspect in regards to the 65 patients considered as having CM, upon severe manifestations of the disease, show no or little peripheral parasitemia. This fact confirms our experimental conclusion that, in the process of pRB adhesion to the microvessels of the brain, they are sequestered by monocytes and platelets, leading to vessel rupture. This fact could be an explanation of the lower % of circulating pRB and low peripheral parasitemia. There is a relationship between

  12. Effects of Hyperglycemia and Effects of Ketosis on Cerebral Perfusion, Cerebral Water Distribution, and Cerebral Metabolism

    OpenAIRE

    Glaser, Nicole; Ngo, Catherine; Anderson, Steven; Yuen, Natalie; Trifu, Alexandra; O’Donnell, Martha

    2012-01-01

    Diabetic ketoacidosis (DKA) may cause brain injuries in children. The mechanisms responsible are difficult to elucidate because DKA involves multiple metabolic derangements. We aimed to determine the independent effects of hyperglycemia and ketosis on cerebral metabolism, blood flow, and water distribution. We used magnetic resonance spectroscopy to measure ratios of cerebral metabolites (ATP to inorganic phosphate [Pi], phosphocreatine [PCr] to Pi, N-acetyl aspartate [NAA] to creatine [Cr], ...

  13. 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.

  14. Avaliação dos níveis de hiper-homocisteinemia, vitamina E, selênio, cobre, ceruloplasmina e ferritina em pacientes com diagnóstico de acidente vascular cerebral isquêmico Assesment of homocysteine, vitamin E, selenium, copper, ceruloplasmin and ferritin levels in patients with ischemic stroke diagnosis

    Directory of Open Access Journals (Sweden)

    Lillian Harboe-Gonçalves

    2007-02-01

    Full Text Available OBJETIVO: Avaliar níveis sangüíneos de hiper-homocisteinemia, vitamina E, selênio, cobre, ceruloplasmina e ferritina em pacientes com diagnóstico de acidente vascular cerebral isquêmico (AVCI. CASUÍSTICA, MATERIAIS E MÉTODOS: Estudo transversal analítico de 104 pacientes diagnosticados com AVCI e 98 controles. Dosagem de homocisteína e vitamina E feita por cromatografia líquida de alta performance. O selênio foi dosado por tecnologia de espectrometria de massa por plasma indutivamente acoplado; o cobre o foi por colorimetria; a ceruloplasmina, por nefelometria; e a ferritina, por imunoensaio enzimático conjugado à fluorescência (Elfa. Análise estatística feita com testes t de Student e análise de variância. RESULTADOS: Encontrada hiper-homocisteinemia em 43% dos pacientes e 13% dos controles. Os valores obtidos nas dosagens de vitamina E, cobre, ceruloplasmina e ferritina foram significativamente maiores no grupo paciente do que no grupo controle. Quanto ao selênio, a diferença entre os dois grupos não foi significativa. DISCUSSÃO: Níveis de hiper-homocisteinemia foram maiores que os encontrados na literatura, podendo ser conseqüência da genética ou dos hábitos alimentares da população. Os resultados encontrados para vitamina E, selênio, cobre, ceruloplasmina e ferritina coincidem com os de alguns trabalhos publicados, mas o modelo deste estudo não avalia se os níveis de vitamina E e selênio foram alterados pelo AVCI ou por mudanças nos hábitos dos pacientes. A ferritina e a ceruloplasmina podem ser marcadores de AVCI, e não fator causal da sua patogênese. CONCLUSÃO: A hiper-homocisteinemia é mais prevalente nos pacientes diagnosticados com AVCI. Os níveis de vitamina E, cobre, ceruloplasmina e ferritina mais elevados encontrados nos pacientes não podem ser atribuídos à ocorrência de AVCI.OBJECTIVE: To assess blood levels of hyperhomocysteinaemia, vitamin E, selenium, copper, ceruloplasmin and

  15. Asymptomatic ischemic cerebral lesions

    International Nuclear Information System (INIS)

    For the purpose of studying the incidence, pathomorphology and etiology of asymptomatic ischemic cerebral lesions, we carried out a brain MRI study on 65 patients with diabetes mellitus accompanied with hypertension who are thought to belong to a high risk group of ischemic cerebrovascular diseases. Excluding the abnormality of tendon reflex due to diabetic neuropathy, sixty percent of the total patients had some mild neurological signs and symptoms, most of them was discrepancy in tendon reflex. The percentage of the patients in whom MRI disclosed some abnormalities was as high as 70%, they were lacunar stroke, multiple lacunar state, cortical infarct, and patchy high signal lesions visible only in the T2 weighted image. Lacunes or these patchy high signal lesions (considered to be the dilatation of the perivascular space or true lacunes) tended to be found along the border zone or the terminal zone. These results indicate that asymptomatic patients in whom MRI discloses the abnormalities should be considered as candidates for the future onset of multi-infarct. (author)

  16. 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.

  17. [Plasma osmolarity and cerebral volume].

    Science.gov (United States)

    Boulard, G

    2001-02-01

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

  18. Preconditioning with oil mixes of high ratio Omega-9: Omega-6 and a low ratio Omega-6:Omega-3 in rats subjected to brain ischemia/reperfusion Pré-condicionamento com misturas de óleos com Ômega-9: Ômega-6 (alta relação e Ômega-6:Ômega-3 (baixa relação em ratos submetidos à isquemia/reperfusão cerebral

    Directory of Open Access Journals (Sweden)

    Petrúcia Maria Antero Pinheiro

    2011-01-01

    Full Text Available PURPOSE: This study aimed to assess the effects of preconditioning with mixtures of oils containing high/low ratio of ω-6/ω-3 and ω-9/ω-6, respectively, in an experimental model of cerebral ischemia-reperfusion (I/R. METHODS: Forty-two Wistar rats were randomly distributed into two groups: control (n=24 and test (n=18. Control group was subdivided in 4 subgroups (n=6: G1: Sham-Water; G2: I/R-Water; G3: Sham-Isolipidic and G4: I/R-Isolipid. The animals received water or a isolipid mixture containing ω-3 oils (8:1 ratio and ω-9/ω-6 (0.4:1 ratio by gavage for seven days. Test group included 3 subgroups (n=6 G5: I/R-Mix1, G: 6 I/R-Mix2 and G7: I/R-Mix3. Test group animals received oily mixtures of ω-3 (1.4:1 ratio and ω-6 (3.4:1 ratio, differing only in source of ω-3: G5 (alpha-linolenic acid; G6 (alpha-linolenic, docosahexaenoic and eicosapentaenoic acids, and G7 (alpha-linolenic and docosahexaenoic acids. On day 7 I/R rats underwent cerebral ischemia with bilateral occlusion of common carotid arteries for 1 hour followed by reperfusion for 3 hours. G1 and G3 animals underwent sham operation. Concluded the experiment, animals were decapitated and their brains sliced for red neurons (RN count in CA3 area of the hippocampus. Variables were compared using ANOVA-Tukey test. RESULTS: The use of different mix preparations promoted a decrease in red cell count in all three groups (G5/G6/G7, compared with G2/G4, confirming the protective effect of different oil blends, regardless of ω-3 source. CONCLUSION: Pre-conditioning with mixtures of oils containing high ratio ω-6/ω-3 and low ω-9/ω-6 relationship protects brain neurons against I/R injury in an experimental model.OBJETIVO: Avaliar os efeitos do pré-condicionamento com misturas de óleos contendo relação alta/baixa de ω-6/ω-3 e ω-9/ω-6, respectivamente, em um modelo experimental de isquemia/reperfusão (I/R cerebral. MÉTODOS: Quarenta e dois ratos foram distribu

  19. Efeito do estresse térmico agudo sobre os níveis da proteína e RNA mensageiro da Hsp70, em fígado e cérebro de pintos de corte de diferentes linhagens Effect of acute heat stress on hepatic and cerebral messenger RNA heat shock protein 70 and heat shock protein 70 level of broiler chicks from 2 to 5 days old of different strains

    Directory of Open Access Journals (Sweden)

    Nelson José Laurino Dionello

    2001-10-01

    Full Text Available Oitenta pintos de corte de duas linhagens, pescoço pelado (Na/na e Hubbard-Pettersen, entre 2 e 5 dias de idade, foram expostos a estresse térmico agudo (36-37°C, durante cinco horas. Foram avaliados temperatura cloacal e peso corporal individuais ao início e final do período de estresse térmico agudo. Os pintos foram sacrificados ao final e amostras de fígado e cérebro foram coletadas e analisadas por Western Blotting e Northern Blotting, para quantificação da proteína e RNA mensageiro da Hsp70, respectivamente. Os resultados apresentaram maiores níveis protéicos de Hsp70 no tecido cerebral do que no hepático. Antes do estresse térmico, não houve diferenças de linhagens para expressão e síntese de Hsp70, em ambos os tecidos. Após o estresse térmico, as aves estressadas apresentaram maiores níveis protéicos de Hsp70, quando o tecido analisado foi o fígado (para as pescoço pelado nas idades de 4 e 5 dias, e menores níveis, em relação às controles, quando o tecido analisado foi o cérebro (para as Pescoço pelado na idade de 2 dias. O tamanho do transcrito de RNA mensageiro de Hsp70 foi de 2,7 kb. Os resultados do presente experimento sugerem que, para o tecido cerebral, a indução de Hsp70 ocorreu em níveis transcripcional e traducional e para o tecido hepático foi detectada apenas alteração em nível traducional, para ambas as linhagens.Eighty broiler chicks, Naked neck (Na/na and Hubbard-Pettersen strains, were exposed to acute heat stress (36-37°C, from 2 to 5 days of age, and body weight and cloacal temperature were measured in the beginning and at the end of the heat stress period (5 h. Birds were sacrificed at the end and liver and brain samples were collected and analyzed using Western Blotting and Northern Blotting to quantify Hsp70 levels and mRNA Hsp70 transcript, respectively. The brain tissue had higher Hsp70 level than liver tissue. Before heat stress it was not observed difference in the Hsp70

  20. What You Should Know about Cerebral Aneurysms

    Science.gov (United States)

    ... T. Quiz 5 Things to Know About Stroke What You Should Know About Cerebral Aneurysms Updated:Jun ... Damage Treatments Click image to view an animation What is a cerebral aneurysm? An aneurysm is a ...

  1. Cerebral abscess in the recently born

    International Nuclear Information System (INIS)

    An unusual case of cerebral abscess in a newborn is reported. Emphasis is made in the paramount importance of its early diagnosis; mainly with imaging modalities like cerebral ultrasound and CT, in order to establisher the most appropriate therapy

  2. 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...

  3. Primary cerebral lymphoma

    International Nuclear Information System (INIS)

    The aim of this study is to compare the survival of the patients treated with radiotherapy alone vs. patients treated with a combined schedule of radio-chemotherapy. Our results will be compared with currently published data and main prognostic factors will be briefly discussed. Patients and methods: Between 1974 and 1990, 27 cases of primary cerebral lymphoma were diagnosed at our institution. All patients had biopsy-proven disease, the pathology of which was reviewed for this study. Results: The overall median survival time was 24 months and one-, two- and three-year overall survival was 59, 46 and 29% respectively. The median radiation dose was 46 Gy, ranging from 19.5 to 60 Gy. The median dose per fraction was 2 Gy (ranging from 1.61 to 3 Gy). The median elapsed treatment time was 32 days (ranging from three to 45 days). We were not able to demonstrate any statistically significant difference between patients who received radiotherapy alone (n = 14, median survival time = 24 months) and those who received a combination of chemotherapy and radiotherapy (n = 11, median survival time = 30 months), (p = 0.4). Prognostic factors of survival were tested using a univariate analysis (Wilcoxon test). Parameters such as mass appearance (unilobular, p = 0.048), performance status at the time of the diagnosis (0 to 1, p = 0.014), and CT imaging (hypodense, p = 0.043) influenced positively survival. Centroblastic histology (Kiel) was found associated with a negative prognosis (p = 0.043). (orig./MG)

  4. Cerebral edema associated with acute hepatic failure.

    OpenAIRE

    Fujiwara, Masachika; Watanabe,Akiharu; Yamauchi,Yasuhiko; Hashimoto, Makoto; Nakatsukasa, Harushige; Kobayashi, Michio; Higashi,Toshihiro; Nagashima,Hideo

    1985-01-01

    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 fre...

  5. Cerebritis: an unusual complication of Klebsiella pneumoniae.

    Science.gov (United States)

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

    2009-01-01

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

  6. Cerebritis: An unusual complication of Klebsiella pneumoniae

    OpenAIRE

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

    2009-01-01

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

  7. Cerebritis: An unusual complication of Klebsiella pneumoniae

    Science.gov (United States)

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

    2009-01-01

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

  8. The clinical characteristics of interictal dysphoric disorder in adults with epilepsy%成年癫痫患者伴发作间期抑郁的临床特点

    Institute of Scientific and Technical Information of China (English)

    陈葵; 王得新; 潘映辐; 伍文清; 许春伶

    2011-01-01

    Objective To understand the clinical characteristics of interictal dysphoric disorder in adults with epilepsy. Methods Sixty-one adults with epilepsy were diagnosed as interictal dysphoric disorder. Their symptoms, including the depressive moods, anergia, insomnia, anxiety, irritability, phobic fears and fatigue, suicide, inattention, intolerance, self abasement, lower ability, were analyzed. Results Forty-six adults were intractable epilepsy (75.4%). The rang of symptoms based on frequency were fatigue(85.2%), anxiety(83.6%), sleep disorder(82%), anergia(78.7%), inattention (75.4%), self abasement (70.5%), depressive moods (65.6%), suicide thought and/or behavior abnormalities (36.1%). Conclusions Interictal dysphoric disorder in adults with epilepsy usually is co -morbid intractable epilepsy. The symptoms are complex, often present as depression, anxiety, sleep disorder, cognitive dysfunction and self abasement Some patients may be at high risk of suicide.%目的 总结成年癫痫患者伴发作间期抑郁的临床特点.方法 对61例成年癫痫患者伴发作间期抑郁进行研究,分析的抑郁症状包括抑郁情绪,兴趣缺乏,睡眠障碍,过分担优,害怕/恐惧,焦虑不安,易怒(易激惹),疲劳,注意力不集中,自杀,偏执,自卑,能力减退等方面,并进行分析.结果 61例成年癫痫伴发作间期抑郁障碍患者中,难治性癫痫46例(75.4%).抑郁症状:疲乏无力52例(85.2%),焦虑51例(83.6%),睡眠障碍 50例(82%),兴趣缺乏48例(78.7%),注意力不集中46例(75.4%),自卑感43例(70.5%),抑郁情绪40例(65.6%),有自杀想法和行为者22例(36.1%),结论癫痫伴发作间期抑郁障碍多见于难治性癫痫患者,以抑郁症状群、焦虑/恐惧症状群、睡眠障碍症状群、认知功能障碍症状群、自卑感较为常见.

  9. Mechanisms of cerebral radiation syndrome

    International Nuclear Information System (INIS)

    Ability of exogenous succinate to prevent the postradiation violations in neuronal respiration and to correct the manifestations of cerebral radiation syndrome is studied. Rats-males were used for experiments. RUM-17 X-ray therapeutic apparatus was applied for irradiation at the dose rate of 25 Gy/min. It is established that the neurological violations in rats following X-ray exposure at 150 Gy dose depend on cerebral energy deficiency connected with NAD neuronal pool depletion. Efficiency is demonstrated of two approaches to the prevention of cerebral radiation syndrome providing: a) retroinhibition of adenosine diphosphoribosyltransferase, b) administration of NAD - independently oxidated bioenergetic substrate. It is marked that the application of sodium succinate may be of special interest in the cases when the dose for forthcoming irradiation is unknown

  10. 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.)

  11. Cerebral venous thrombosis in childhood

    International Nuclear Information System (INIS)

    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.)

  12. 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…

  13. 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...

  14. Cerebral vasculitis associated with cocaine abuse

    International Nuclear Information System (INIS)

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

  15. 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...

  16. 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.

  17. Vortex Dynamics in Cerebral Aneurysms

    CERN Document Server

    Byrne, Greg

    2013-01-01

    We use an autonomous three-dimensional dynamical system to study embedded vortex structures that are observed to form in computational fluid dynamic simulations of patient-specific cerebral aneurysm geometries. These structures, described by a vortex which is enclosed within a larger vortex flowing in the opposite direction, are created and destroyed in phase space as fixed points undergo saddle-node bifurcations along vortex core lines. We illustrate how saddle-node bifurcations along vortex core lines also govern the formation and evolution of embedded vortices in cerebral aneurysms under variable inflow rates during the cardiac cycle.

  18. Radiosurgery for cerebral cavernomas.

    Science.gov (United States)

    Nagy, G; Kemeny, A A

    2015-09-01

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

  19. What is cerebral small vessel disease?

    International Nuclear Information System (INIS)

    An accumulating amount of evidence suggests that the white matter hyperintensities on T2 weighted brain magnetic resonance imaging predict an increased risk of dementia and gait disturbance. This state has been proposed as cerebral small vessel disease, including leukoaraiosis, Binswanger's disease, lacunar stroke and cerebral microbleeds. However, the concept of cerebral small vessel disease is still obscure. To understand the cerebral small vessel disease, the precise structure and function of cerebral small vessels must be clarified. Cerebral small vessels include several different arteries which have different anatomical structures and functions. Important functions of the cerebral small vessels are blood-brain barrier and perivasucular drainage of interstitial fluid from the brain parenchyma. Cerebral capillaries and glial endfeet, take an important role for these functions. However, the previous pathological investigations on cerebral small vessels have focused on larger arteries than capillaries. Therefore little is known about the pathology of capillaries in small vessel disease. The recent discoveries of genes which cause the cerebral small vessel disease indicate that the cerebral small vessel diseases are caused by a distinct molecular mechanism. One of the pathological findings in hereditary cerebral small vessel disease is the loss of smooth muscle cells, which is an also well-recognized finding in sporadic cerebral small vessel disease. Since pericytes have similar character with the smooth muscle cells, the pericytes should be investigated in these disorders. In addition, the loss of smooth muscle cells may result in dysfunction of drainage of interstitial fluid from capillaries. The precise correlation between the loss of smooth muscle cells and white matter disease is still unknown. However, the function that is specific to cerebral small vessel may be associated with the pathogenesis of cerebral small vessel disease. (author)

  20. Caffeine induced changes in cerebral circulation

    International Nuclear Information System (INIS)

    While the caffeine induced cerebral vasoconstriction is well documented, the effects of oral ingestion of the drug in a dose range comparable to the quantities in which it is usually consumed and the intensity and duration of the associated reduction in cerebral circulation are unknown. Cerebral blood flow was measured via the 133Xenon inhalation technique before and thirty and ninety minutes after the oral administration of 250 mg of caffeine or a placebo, under double-blind conditions. Caffeine ingestion was found to be associated with significant reductions in cerebral perfusion thirty and ninety minutes later. The placebo group showed no differences between the three sets of cerebral blood flow values

  1. 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...

  2. Vasculite cerebral e doença de Basedow-Graves: relato de dois casos

    Directory of Open Access Journals (Sweden)

    Rocha Maria Sheila Guimarães

    2001-01-01

    Full Text Available OBJETIVO: Relatar dois casos de pacientes com vasculite cerebral associada à doença de Basedow-Graves. RELATO DOS CASOS: O primeiro é uma paciente de 22 anos de idade com quadro súbito de disartria e déficit motor em dimídio esquerdo. Ao exame clínico, apresentava taquicardia, exoftalmia bilateral e bócio difuso. Referia tratamento para hipertiroidismo há um mês. O segundo é uma paciente de 15 anos de idade, que apresentou quadro súbito de perda da consciência seguindo-se distúrbio de linguagem e déficit motor em hemicorpo direito. RESULTADOS: Os exames de imagem revelaram áreas de lesão cerebral sugestivas de isquemia. Os estudos angiográficos cerebrais evidenciaram estenoses vasculares múltiplas compatíveis com arterite. Foram descartadas outras causas possíveis de vasculite cerebral. Os exames laboratoriais revelaram hipertiroidismo e presença dos anticorpos antimicrossomais e antitireoglobulina. As duas pacientes receberam tratamento para o hipertiroidismo. CONCLUSÃO: A associação entre arterite cerebral e doença de Basedow-Graves sugere que possa existir um elo na patogenia das duas doenças através de mecanismo auto-imune comum a ambas.

  3. A neurotoxicidade da Cannabis sativa e suas repercussões sobre a morfologia do tecido cerebral

    OpenAIRE

    Bárbara da Silva Santos; Marcelo Coertjens

    2014-01-01

    Para a compreensão das repercussões psicológicas e comportamentais verificadas em usuários de Cannabis sativa, experimentos têm sido desenvolvidos analisando a relação entre a intensidade do uso da droga e biomarcadores de lesão e inflamação. Dessa forma, este estudo teve como objetivo realizar pesquisa bibliográfica, relacionando marcadores bioquímicos de neurotoxicidade e suas repercussões sobre a morfologia do tecido cerebral em usuários de Cannabis sativa, durante a exposição ao ∆9-THC po...

  4. Bilateral posterior cerebral artery infarction

    OpenAIRE

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

    2010-01-01

    We report the case of a 70-year-old man who presented with short-term memory impairment and a homonymous left inferior quadrantanopia secondary to simultaneous bilateral posterior cerebral artery (PCA) territory infarction. As in more than a quarter of cases of PCA

  5. Investigating cerebral oedema using poroelasticity.

    Science.gov (United States)

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

    2016-01-01

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

  6. 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)

  7. Cerebral imaging revealing Alzheimer's disease

    International Nuclear Information System (INIS)

    Cerebral imaging is the only non-invasive means of examining the brain and is essential in studying Alzheimer's disease. As a tool for early diagnosis, evaluation and treatment monitoring, this technology is at the heart of the research being done to further improve its reliability and sensitivity. (authors)

  8. Cerebral Palsy and Neonatal Encephalopathy

    OpenAIRE

    J Gordon Millichap

    2005-01-01

    The type and severity of cerebral palsy (CP) and pattern of associated disability in children with or without preceding neonatal encephalopathy (NE) were compared in a population-based case-control study of patients followed for 6 years at the Children’s Hospital, Westmead, Sydney, Australia.

  9. Ocular defects in cerebral palsy

    OpenAIRE

    Katoch Sabita; Devi Anjana; Kulkarni Prajakta

    2007-01-01

    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.

  10. [Cerebral ischemia in young adults].

    Science.gov (United States)

    Berlit, P; Endemann, B; Vetter, P

    1991-08-01

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

  11. CT of cerebral hydatid disease

    International Nuclear Information System (INIS)

    Six cases of cerebral hydatid disease (CHD) were seen in Kuwait over a period of 8 years. The typical CT appearance of a large well-defined spherical nonenhanced unilocular cyst was seen in four cases. Two unusual but characteristic types of calcification were seen, one in each of the remaining two cases. (orig.)

  12. MR imaging of cerebral palsy

    International Nuclear Information System (INIS)

    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)

  13. [Should cerebral autoregulation be reassessed?

    DEFF Research Database (Denmark)

    Secher, Niels H.

    2009-01-01

    Maintained cardiac output (CO) and cerebral oxygenation (ScO2) are of importance for a reduction in perioperative complications. Normovolaemia is defined as a central blood volume that does not limit CO for the supine patient and is maintained by individualized goal directed fluid therapy. Thereby...

  14. 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

  15. Late cerebral ischaemia after subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Edvinsson, L; Povlsen, G K

    2011-01-01

    Late cerebral ischaemia after subarachnoid haemorrhage (SAH) carries high morbidity and mortality because of reduced cerebral blood flow (CBF) and subsequent cerebral ischaemia. This is associated with upregulation of contractile receptors in cerebral artery smooth muscles via the activation of...... intracellular signalling. In addition, delayed cerebral ischaemia after SAH is associated with inflammation and disruption of the blood-brain barrier (BBB). This article reviews recent evidence concerning the roles of vasoconstrictor receptor upregulation, inflammation and BBB breakdown in delayed cerebral...... ischaemia after SAH. In addition, recent studies investigating the role of various intracellular signalling pathways in these processes and the possibilities of targeting signalling components in SAH treatment are discussed. Studies using a rat SAH model have demonstrated that cerebral arteries increase...

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

    Directory of Open Access Journals (Sweden)

    FILGUEIRAS Carlos Luiz

    1997-01-01

    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.

  17. Tríplice artrodese na paralisia cerebral Triple arthrodesis in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Kotoe Umeda

    2010-01-01

    Full Text Available OBJETIVOS: Avaliar o resultados clínicos díplice artrodese em portadores de paralisia cerebral espástica, verificar a correspondência entre os resultados e a escala AOFAS e os ângulos nos períodos pré e pós-operatórios. MÉTODOS: Entre 1985 e 2005, foram avaliados 34 pacientes (40 pés submetidos a tríplice artrodese do pé, com acompanhamento médio de 91 meses, quanto a satisfação e dor, apoio plantígrado, deformidade residual e o arco de movimento do tornozelo e escala AOFAS. Foram avaliadas artrose de tornozelo, pseudoartrose das articulações e medidos os ângulos: talocalcâneo, talo-primeiro metatarsiano (APM e tíbio-talar, e talocalcâneos (ATC e o calcâneo-solo (ACS. RESULTADOS: Obtivemos bons resultados em 32,4% dos casos e regulares em 44,1%. 85,3% dos pacientes estavam satisfeitos; 88,2% tinham apoio plantígrado. Houve 33,3% de resultados bons pela escala AOFAS e 24,2% regulares. Na radiografia com incidência ântero-posterior, o APM apresentou melhora em média de 15º; no ACS, na incidência em perfil, melhora de 7º. No ATC, nas duas incidências, houve melhora de 1º. CONCLUSÕES: A triplice artrodese corrige ou melhora as deformidades, com grau de satisfação elevada, dando ao paciente pés plantígrados. A escala AOFAS teve fraca concordância com o resultado. Os APM e ACS foram os mais sensíveis na avaliação do procedimento cirúrgico.OBJECTIVE: To demonstrate the clinical results of triple arthrodesis in Cerebral Palsy patients and determine whether there is any correspondence between the results and the AOFAS scale, and changes in radiographic angles between the pre- and postoperative periods. METHODS: Between 1985 and 2005, thirty-four patients (40 feet were submitted to triple arthrodesis of the foot, with an average follow-up time of ninety-one months. The evaluation consisted of the patient's satisfaction and the presence of pain, plantigrade support, residual deformity, range of movement of the

  18. Digital subtraction angiography in cerebral infarction

    International Nuclear Information System (INIS)

    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

  19. 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

  20. What's new in cerebral palsy.

    Science.gov (United States)

    JONES, M H

    1953-11-01

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

  1. Clinical application of cerebral dynamic perfusion studies

    International Nuclear Information System (INIS)

    Radionuclide cerebral perfusion studies are assuming a far greater importance in the detection and differential diagnosis of cerebral lesions. Perfusion studies not only contribute to the differential diagnosis of lesions but in certain cases are the preferred methods by which more accurate clinical interpretations can be made. The characteristic blood flow of arterio-venous malformations readily differentiates this lesion from neoplasms. The decreased perfusion or absent perfusion observed in cerebral infarctions is diagnostic without concurrent evidence from static images. Changes in rates and direction of blood flow contribute fundamental information to the status of stenosis and vascular occlusion and, in addition, offer valuable information on the competency and routes of collateral circulation. The degree of cerebral perfusion after cerebral vascular accidents appears to be directly related to patient recovery, particularly muscular function. Cerebral perfusion adds a new parameter in the diagnosis of subdural haematomas and concussion and in the differentiation of obscuring radioactivity from superficial trauma. Although pictorial displays of perfusion blood flow will offer information in most cerebral vascular problems, the addition of computer analysis better defines temporal relationships of regional blood flow, quantitative changes in flow and the detection of the more subtle increases or decreases in cerebral blood flow. The status of radionuclide cerebral perfusion studies has taken on an importance making it the primary modality for the diagnosis of cerebral lesions. (author)

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

    Science.gov (United States)

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

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

  3. Alterações sialoquímicas e sialométricas de pacientes com paralisia cerebral: uma revisão de literatura Sialochemical and sialometric alterations in patients with cerebral palsy: a literature review

    OpenAIRE

    Miriam Yumi Matsui; Maria Julia Pereira Coelho Ferraz; Mônica Fernandes Gomes; Cybelle Mori Hiraoka

    2011-01-01

    TEMA: paralisia cerebral e alterações salivares. O paciente com paralisia cerebral é acometido por diversas desordens no Sistema Estomatognático, sendo muitas delas expressas sob a forma de alterações no fluxo e composição salivar. A variação da concentração de constituintes da saliva está diretamente relacionada com sua capacidade tampão, antioxidante, imunológica, digestiva e lubrificante, além de sofrer variações em função da velocidade do fluxo salivar, o qual está intimamente relacionado...

  4. Inclusão de alunos com paralisia cerebral no ensino fundamental: contribuições da fisioterapia Inclusion of students with cerebral palsy in elementary education: contributions of physiotherapy

    OpenAIRE

    Simone Massaneiro Silva; Rosângela Ribeiro de Castro Neri Santos; Cristiane Gonçalves Ribas

    2011-01-01

    Este estudo teve como objetivo apontar como o fisioterapeuta pode atuar no processo de inclusão de alunos com paralisia cerebral (PC) no sistema regular de ensino. A presente pesquisa foi realizada em três escolas públicas municipais de ensino fundamental, pertencentes a uma Regional de Ensino da cidade de Curitiba. Cada escola foi visitada cinco vezes entre março e abril de 2009, para coleta de dados. A amostra foi composta por três alunos com diagnóstico de Paralisia Cerebral, cognitivo pre...

  5. 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.

  6. 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.

  7. 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.

  8. Bilateral posterior cerebral artery infarction.

    Science.gov (United States)

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

    2010-01-01

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

  9. Clinical studies on cerebral infarction

    International Nuclear Information System (INIS)

    Hemorrhagic infarction (HI) is termed as the infarction in which a large part of the necrotic tissue is stippled with small hemorrhage. The pathogenetic mechanism of this disease still remains controversial. Cerebral infarction has long been divided into two subtypes-thrombosis and embolism-according to the pathogenetic mechanisms. Clinical studies were carried out in 31 cases of HI with cerebral thrombosis. CT findings of these cases were classified into five groups according to both size of low density area which indicates regions of infarction and distribution of arterial supply. The low density area of Type I-Type III were observed in the area of the middle cerebral artery. That of Type IV was observed in the area of the internal capsule and basal ganglia. That of Type V was observed in the area of the posterior cerebral artery. CT reveals two patterns of HI -pattern A and pattern B-. The CT finding of pattern A is appearance of high density area in the low density area. The CT finding of pattern B is appearance of iso density area in the low density area. rCBF was measured by 133Xe inhalation technique in 21 patients with CT type I, II and III. Thereafter, with regard to the various findings in CT, the clinical findings and CBF findings, a comparative study was carried out on these ten groups. From the results of present studies, it is concluded that sequential changes of CBF in cases with pattern A are different from those with pattern B, and that CBF measurement does not permit an estimation of a patient's chance for functionary recovery after a stroke in acute and subacute stage but permits estimation of functional outcome in chronic stage. (J.P.N.)

  10. Cerebral palsy and neonatal encephalopathy.

    OpenAIRE

    Gaffney, G; Flavell, V; Johnson, A; Squier, M.; Sellers, S

    1994-01-01

    A retrospective cohort study was carried out to test the hypothesis that children born at term with cerebral palsy with signs of neurological dysfunction preceded by depression at birth (termed neonatal encephalopathy) differ from those without such signs in the frequency of antenatal and perinatal factors, and in the severity and characteristics of their impairment and disability. The study was carried out in the area covered by Oxford Regional Health Authority. Antenatal, intrapartum, neona...

  11. Visual disorders in cerebral palsy

    OpenAIRE

    Govind Amita; Lamba P

    1988-01-01

    Seventy children with cere-bral palsy were examined for aetiological factors responsible, type of disorder and ocular abnormalities. The overall inci-dence of ocular abnormalities was 68.69%, the highest frequency being of squint (35.7%). Other anomalies detected inclu-ded refractive errors (28.5%), optic atrophy (10%) and coloboma (2.9%). Most children were spastic quadriplegics with asphyxia as the major aetiological factor. The study created an awareness ...

  12. Primary cerebral lymphoma: radiological findings

    International Nuclear Information System (INIS)

    We present four cases of primary cerebral lymphoma in non-immunodepressed adult patients. All cases were dsemonstrated with pathological study. CAT study showed solitary or multiple isodense lesions, which incorporated avidly and homoneneously the contrast. Arteriography performed in three patients and magnetic resonance, performed in one did not help for diagnosis. We also review the radiological findings obtained with different imaging methods, and suggest the criteria which could be useful for early diagnosis (Author)

  13. Baclofen in Spastic Cerebral Palsy

    OpenAIRE

    J Akhundian

    2002-01-01

    To evaluate the effect of oral baclofen in spastic cerebral palsy (cp), we studied 40 children with different clinical types of spastic cp. Half of these children served as control group and the others received oral baclofen. All of them were treated with physiotherapy under equal conditions for 6 weeks. We used two methods, modified Ashworth scale and range of motion for evaluation. At the end of therapy we found a significant improvement in the baclofen group compared to control group. As a...

  14. Cerebral palsy in preterm infants

    OpenAIRE

    Demeši-Drljan Čila; Mikov Aleksandra; Filipović Karmela; Tomašević-Todorović Snežana; Knežević Aleksandar; Krasnik Rastislava

    2016-01-01

    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 w...

  15. Cerebral Palsy: A Dental Update

    OpenAIRE

    Sehrawat, Nidhi; Marwaha, Mohita; Bansal, Kalpana; Chopra, Radhika

    2014-01-01

    ABSTRACT Special and medically compromised patients present a unique population that challenges the dentist’s skill and knowledge. Providing oral care to people with cerebral palsy (CP) requires adaptation of the skills we use everyday. In fact, most people with mild or moderate forms of CP can be treated successfully in the general practice setting. This article is to review various dental considerations and management of a CP patient. How to cite this article: Sehrawat N, Marwaha M, Bansal ...

  16. Acute hypoxia increases the cerebral metabolic rate

    DEFF Research Database (Denmark)

    Vestergaard, Mark Bitsch; Lindberg, Ulrich; Aachmann-Andersen, Niels Jacob;

    2016-01-01

    imaging techniques were used to measure global cerebral blood flow and the venous oxygen saturation in the sagittal sinus. Global cerebral metabolic rate of oxygen was quantified from cerebral blood flow and arteriovenous oxygen saturation difference. Concentrations of lactate, glutamate, N......-acetylaspartate, creatine and phosphocreatine were measured in the visual cortex by magnetic resonance spectroscopy. Twenty-three young healthy males were scanned for 60 min during normoxia, followed by 40 min of breathing hypoxic air. Inhalation of hypoxic air resulted in an increase in cerebral blood flow of 15.5% (p = 0.......058), and an increase in cerebral metabolic rate of oxygen of 8.5% (p = 0.035). Cerebral lactate concentration increased by 180.3% ([Formula: see text]), glutamate increased by 4.7% ([Formula: see text]) and creatine and phosphocreatine decreased by 15.2% (p[Formula: see text]). The N-acetylaspartate concentration...

  17. Reference Gene Selection in the Desert Plant <em>Eremosparton songoricuem>m>

    Directory of Open Access Journals (Sweden)

    Dao-Yuan Zhang

    2012-06-01

    Full Text Available <em>Eremosparton songoricum em>(Litv. Vass. (<em>E. songoricumem> is a rare and extremely drought-tolerant desert plant that holds promise as a model organism for the identification of genes associated with water deficit stress. Here, we cloned and evaluated the expression of eight candidate reference genes using quantitative real-time reverse transcriptase polymerase chain reactions. The expression of these candidate reference genes was analyzed in a diverse set of 20 samples including various <em>E. songoricumem> plant tissues exposed to multiple environmental stresses. GeNorm analysis indicated that expression stability varied between the reference genes in the different experimental conditions, but the two most stable reference genes were sufficient for normalization in most conditions.<em> EsEFem> and <em>Esα-TUB> were sufficient for various stress conditions, <em>EsEF> and <em>EsACT> were suitable for samples of differing germination stages, and <em>EsGAPDH>and <em>Es>UBQ em>were most stable across multiple adult tissue samples. The <em>Es18Sem> gene was unsuitable as a reference gene in our analysis. In addition, the expression level of the drought-stress related transcription factor <em>EsDREB2em>> em>verified the utility of<em> E. songoricumem> reference genes and indicated that no single gene was adequate for normalization on its own. This is the first systematic report on the selection of reference genes in <em>E. songoricumem>, and these data will facilitate future work on gene expression in this species.

  18. Behcet's disease with cerebral vasculitis

    International Nuclear Information System (INIS)

    The case presented illustrates the diagnostic dilemma off neurological involvement in Behcet's disease and other inflammatory diseases. 'Psychiatric' symptoms were present for 2 years without abnormalities on SPECT or MRI and without CSF pleocytosis. Even at the time of fitting, no CSF abnormalities were observed. The preceding psychiatric presentations may have been due to cerebral vasculitis that was exacerbated by withdrawal of steroids. Magnetic resonance imaging is currently the most sensitive imaging modality. Lesions are usually in the brainstem, cerebellum, basal ganglia region or periventricular white matter, and the pons and the mesencephalon are commonly affected. In our patient there was no diencephalic or brainstem involvement. The inflammatory process can appear as a very large lesion, with gadolinium enhancement and significant mass effect, as in our patient. Brain magnetic resonance imaging. Postgadolinium-diethylenetriamine pentaacetic acid, axial image shows two large lesions in the right frontal lobe, with the larger, posterior lesion demonstrating vivid ring enhancement. A central nodule is isodense, with the cerebral white matter within the larger lesion. Surrounding low T1 signal involves the hemispheric white matter without cortical extension and is consistent with vasogenic oedema. Minor mass effect is demonstrated with bowing of the anterior falx cerebri to the left. Biopsy shows prominent fibrinoid necrosis in small calibre postcapillary venules and cerebral white matter. There are surrounding acute and chronic inflammatory cells and nuclear debris, consistent with vasculitis

  19. 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.

  20. MR findings of cerebral palsy

    International Nuclear Information System (INIS)

    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

  1. Hipertensão arterial e doença vascular cerebral: a visão do neurologista

    OpenAIRE

    Correia, M.

    2007-01-01

    As doenças cerebrovasculares são a primeira causa de morte em Portugal, e a correspondente taxa de mortalidade é das mais levedadas entre os países europeus; a incidência do Acidente Vascular Cerebral (AVC) ocupa também um lugar cimeiro, e de entre os doentes sobreviventes de AVC cerca de 50% deles encontram-se dependentes. Embora a doença vascular cerebral seja heterogéneos (enfartes cerebrais, hemorragias intracerebrais primárias, hemorragias subaracnoideias, demência vascular) a hipertensã...

  2. Parental age, genetic mutation, and cerebral palsy.

    OpenAIRE

    Fletcher, N A; Foley, J

    1993-01-01

    Parental age and birth order were studied in 251 patients with cerebral palsy. No parental age or birth order effects were observed in spastic quadriplegia or diplegia, but a paternal age effect was detected in those with athetoid/dystonic cerebral palsy and congenital hemiplegia. These observations indicate that some cases of athetoid/dystonic or hemiplegic cerebral palsy might arise by fresh dominant genetic mutation.

  3. Cerebral palsy in very low birthweight infants.

    OpenAIRE

    Cooke, R W

    1990-01-01

    Eighty one very low birthweight survivors with cerebral palsy were matched with controls by sex, gestational age, and place of birth. Using discriminant analysis, the perinatal profiles for infants with cerebral palsy and their controls were shown to differ significantly. When infants with various types of cerebral palsy were analysed with their controls the discriminating variables differed. Diplegic infants could be differentiated from controls on antenatal variables alone, but significant ...

  4. Evaluation measures for children with cerebral palsy

    OpenAIRE

    Sršen, Katja Groleger

    2013-01-01

    Abstract. Cerebral palsy is a well-recognized neurodevelopmental condition. The most recentdefinition describes cerebral palsy as a group of disorders of movement andposture, causing activity limitation. An important step in the process of(re)habilitation is evaluation of functional abilities of an individual. To beas accurate as possible in the evaluation of functioning, proper measurementinstruments have to be used. There are many different measurement tools forchildren with cerebral palsy,...

  5. Dental characteristics of children with cerebral palsy

    OpenAIRE

    Stevanović Radoje; Jovičić Olivera

    2004-01-01

    Cerebral palsy is one of the commonest children's physical handicaps with frequency of 1.5-3/1000. Beside many other disturbances, these children may have serious disorders caused by dental diseases. Concerning this fact, the objective of our study was to examine children with cerebral palsy in our country and determine condition of dental health and suggest adequate protective measures. A total of 116 children, 3-18 years old, with cerebral palsy were examined and the results were compared t...

  6. Epilepsy in children with cerebral palsy

    OpenAIRE

    J Akhundian

    2013-01-01

    Epilepsy occurs in 15-60% of children with cerebral palsy (CP). However, its clinical course is not well defined. This retrospective study reviews the prevalence, nature and prognosis of epilepsy in cerebral palsy. 53 of 133 children with cerebral palsy seen in the neuropediatric clinic in Mashhad emam Reza hospital between 1999 and 2001 had epilepsy. A control group of 70 epileptic children with normal neurodevelopment status was seen during the same period. Epilepsy most commonly affected p...

  7. Epilepsy in children with cerebral palsy

    OpenAIRE

    Bruck Isac; Antoniuk Sérgio Antônio; Spessatto Adriane; Bem Ricardo Schmitt de; Hausberger Romeu; Pacheco Carlos Gustavo

    2001-01-01

    OBJECTIVE: To describe the prevalence and characteristics of epilepsy in patients with cerebral palsy in a tertiary center. METHODS: a total of 100 consecutive patients with cerebral palsy were retrospectively studied. Criteria for inclusion were follow-up period for at least 2 years. Types and incidence of epilepsy were correlated with the different forms of cerebral palsy. Other factors associated with epilepsy such as age of first seizure, neonatal seizures and family history of epilepsy w...

  8. 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...... 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....

  9. Assessment of the hand in cerebral palsy

    OpenAIRE

    Praveen Bhardwaj; S Raja Sabapathy

    2011-01-01

    Cerebral palsy is the musculoskeletal manifestation of a nonprogressive central nervous system lesion that usually occurs due to a perinatal insult to the brain. Though the cerebral insult is static the musculoskeletal pathology is progressive. Some patients with cerebral palsy whose hands are affected can be made better by surgery. The surgical procedures as such are not very technically demanding but the assessment, decision-making, and selecting the procedures for the given patient make th...

  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. A study on the pathogenesis of human cerebral malaria and cerebral babesiosis

    Directory of Open Access Journals (Sweden)

    Masamichi Aikawa

    1992-01-01

    Full Text Available Cerebral complications are important, but poorly understood pathological features of infections caused by some species of Plasmodium and Babesia. Patients dying from P. falciparum were classified as cerebral or non-cerebral cases according to the cerebral malaria coma scale. Light microscopy revealed that cerebral microvessels of cerebral malaria patients were field with a mixture of parazited and unparazited erythrocytes, with 94% of the vessels showing parasitized red blood cell (PRBC sequestration. Some degree of PRBC sequestration was also found in non-cerebral malaria patients, but the percentage of microvessls with sequestered PRBC was only 13% Electron microscopy demonstrated knobs on the membrane of PRBC that formed focal junctions with the capillary endothelium. A number of host cell molecules such as CD36, thrombospondim (TSP and intracellular adhesion molecule I (ICAM-1 may function as endothelial cell surfacereports for P. falciparum-infected erythrocytes. Affinity labeling of CD36 and TSP to the PRBC surface showed these molecules specifically bind to the knobs. Babesia bovis infected erythrocytes procedure projections of the erythrocyte membrane that are similar to knobs. When brain tissue from B. bovis-infected cattle was examined, cerebral capillaries were packed with PRBC. Infected erythrocytes formed focal attachments with cerebral endothelial cells at the site of these knob-like projections. These findings indicate that cerebral pathology caused by B. bovis is similar to human cerebral malaria. A search for cytoadherence proteins in the endothelial cells may lead to a better understanding of the pathogenisis of cerebral babesiosis.

  12. Neuroprotective Activity of Lavender Oil on Transient Focal Cerebral Ischemia in Mice

    Directory of Open Access Journals (Sweden)

    Qiusheng Zheng

    2012-08-01

    Full Text Available The air-<em>dried aerial partsem> of<em> Lavandula angustifoliaem> Mill, a traditional Uygur herbal drug, is used as resuscitation-inducing therapy to treat neurodisfunctions, such as stroke. This study was designed to assess the neuroprotective effects of lavender oil against ischemia/reperfusion (IR injury in mice. Focal cerebral ischemia was induced by the intraluminal occlusion method with a nylon string. The neurodysfuntion was evaluated by neurological deficit and the infarct area was showed by 2,3,5-triphenyltetrazolium chloride (TTC staining. The histopathological changes were observed by hematoxylin and eosin staining. The levels of mitochondria-generated reactive oxygen species (ROS, malondialdehyde (MDA and carbonyl, the ratio of reduced glutathione (GSH/glutathione disulfide (GSSG, the activities of superoxide dismutase (SOD, catalase (CAT and glutathion peroxidase (GSH-Px in brain tissue were measured to estimate the oxidative stress state. Neurological deficit, infarct size, histopathology changes and oxidative stress markers were evaluated after 22 h of reperfusion. In comparison with the model group, treatment with lavender oil significantly decreased neurological deficit scores, infarct size, the levels of MDA, carbonyl and ROS, and attenuated neuronal damage, upregulated SOD, CAT, GSH-Px activities and GSH/GSSG ratio. These results suggested that the neuroprotective effects of lavender oil against cerebral ischemia/reperfusion injury may be attributed to its antioxidant effects.

  13. Magnetic resonance imaging (MRI) of cerebral infarction

    International Nuclear Information System (INIS)

    Fifty-five patients with cerebral infarction were studied with magnetic resonance imaging (MRI) and correlative CT scans. MRI was more sensitive than CT for detecting cerebral infarction, and T2-weighted spin-echo (SE) pulse sequence was most sensitive for detecting cerebral infarction except for some subcortical infarction. The size of infarcted areas on MRI was larger than that on CT in 29 of 51 infarcted areas, equal in 22. The pulse sequence using long repetition time (TR) and double echo delay time (TE), such as SE (2000/30, 90), improved the detectability of cerebral infarction. (author)

  14. Acute cerebral vascular accident associated with hyperperfusion

    International Nuclear Information System (INIS)

    Cerebral radionuclide angiography can demonstrate decreased or normal radioactivity in the affected region during the arterial phase in patients who have sustained a cerebral vascular accident and thus enhances the diagnostic specificity of the static brain image. In an occasional patient, however, a seemingly paradoxical pattern of regional hyperperfusion with a return to normal or subnormal perfusion following the acute phase has been observed. This phenomenon, called luxury perfusion, has been defined using intra-arterial 133Xe for semiquantitative cerebral blood flow measurements and should be kept in mind as a potentially misleading cerebral imaging pattern

  15. Cerebritis: An unusual complication of Klebsiella pneumoniae

    Directory of Open Access Journals (Sweden)

    Majumdar Mainak

    2009-01-01

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

  16. Forma tumoral da cisticercose cerebral: diagnostico pela tomografia computadorizada

    Directory of Open Access Journals (Sweden)

    Milton K. Shibata

    1980-12-01

    Full Text Available A TC permitiu identificar a forma tumoral da cisticercose cerebral em 6 pacientes, durante investigação para esclarecimento de síndromes convulsivas. As alterações angiográficas eram mínimas. As imagens tomográficas, por sua vez, não forneceram dados que permitissem o diagnóstico diferencial com neoplasias cerebrais. O exame do LCR também não contribuiu para estabelecer o diagnóstico etiológico, que só foi firmado após a extirpação da lesão.

  17. Diagnóstico clínico diferencial entre oclusão da artéria carótida interna e da artéria cerebral média A comparative symptomatological study of internal carotid artery occlusion and middle cerebral artery occlusion

    Directory of Open Access Journals (Sweden)

    Roberto Melaragno

    1971-03-01

    Full Text Available Foi feito um estudo comparativo entre o quadro clínico inicial de 61 casos de oclusão da artéria carótida interna e o de 23 casos de oclusão da artéria cerebral média, diagnosticados pela angiografia cerebral e/ou pela necropsia em pacientes submetidos ou não à cirurgia vascular. Os autores comparam a idade dos pacientes, o sexo, o modo de início da afecção, a existência ou não de convulsões e/ou cefaléias, a ocorrência do acidente cerebral durante o sono ou em vigília, a existência de ictos prévios, os níveis de pressão arterial, o grau de consciência, a força muscular, os achados eletrencefalográficos, a palpação e ausculta das carótidas em nível cervical. Os resultados são demonstrados em índices percentuais, pelos quais os autores inferem que não há significância estatística nesses elementos com três exceções: a maior ocorrência de convulsões nas oclusões da artéria cerebral média em relação às da carótida, a oftalmodinamometria e a sintomatologia carotídea cervical. A oftalmodinamometria revela valores significantemente menores nas pressões da artéria central da retina, no mesmo lado da trombose da carótida em 70,0% dos casos, enquanto que medidas normais e simétricas verificaram-se em todos os casos de oclusão da artéria cerebral média em que o exame foi realizado. No que concerne a sinais arteriais no pescoço, havia anormalidades palpatórias e auscultatórias em 52,4% dos pacientes com trombose da carótida e em 8,6% dos casos com oclusão da cerebral média. Concluem os autores, portanto, que apenas a angiografia cerebral permite um diagnóstico seguro entre ambas as sedes da oclusão.A comparative study of the early clinical picture in 61 cases of internal carotid artery occlusion and 23 cases of middle cerebral artery occlusion, diagnosed by cerebral angiography and/or necropsy in patients who were either submitted to surgery or not operated upon is reported. The authors had

  18. Synthesis, Crystal Structure and Luminescent Property of Cd (II Complex with <em>N-Benzenesulphonyl-L>-leucine

    Directory of Open Access Journals (Sweden)

    Xishi Tai

    2012-09-01

    Full Text Available A new trinuclear Cd (II complex [Cd3(L6(2,2-bipyridine3] [L =<em> Nem>-phenylsulfonyl-L>-leucinato] has been synthesized and characterized by elemental analysis, IR and X-ray single crystal diffraction analysis. The results show that the complex belongs to the orthorhombic, space group<em> Pem>212121 with<em> aem> = 16.877(3 Å, <em>b> em>= 22.875(5 Å, <em>c em>= 29.495(6 Å, <em>α> em>= <emem>= <emem>= 90°, <em>V> em>= 11387(4 Å3, <em>Z> em>= 4, <em>Dc>= 1.416 μg·m−3, <emem>= 0.737 mm−1, <em>F> em>(000 = 4992, and final <em>R>1 = 0.0390, <em>ωR>2 = 0.0989. The complex comprises two seven-coordinated Cd (II atoms, with a N2O5 distorted pengonal bipyramidal coordination environment and a six-coordinated Cd (II atom, with a N2O4 distorted octahedral coordination environment. The molecules form one dimensional chain structure by the interaction of bridged carboxylato groups, hydrogen bonds and p-p interaction of 2,2-bipyridine. The luminescent properties of the Cd (II complex and <em>N-Benzenesulphonyl-L>-leucine in solid and in CH3OH solution also have been investigated.

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

    International Nuclear Information System (INIS)

    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 99mTc-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, p99mTc-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

  20. Comparative analysis of the results of various physical therapy techniques in the treatment of patients with primary open-angle glaucoma with chronic cerebral ischemia

    Directory of Open Access Journals (Sweden)

    Lazarev М.S.

    2012-06-01

    Full Text Available

    <em>Aim of the study: em>to evaluate the effectiveness of the techniques of dynamic simultaneous transcranial magnetic therapy and resonance, and electrical stimulation, transcranial magnetic therapy and dynamic laser stimulation, magnetic simpatokorrektsii in the treatment of patients with primary open-angle glaucoma with chronic cerebral ischemia. <em>Techniques. em>We observed 184 patients diagnosed with primary open-angle glaucoma who received different physical therapy techniques. <em>Results>. Patients treated with transcranial magnetic therapy and electrical stimulation or laser stimulation, in addition to improving visual function and improve the bioelectrical activity of the visual cortex, more pronounced than in other groups also observed the activation of the intraocular blood fow. Application of magnetic simpatokorrektsii allows for improvement of basic functional, electrophysiological and hemodynamic performance by reducing the activity of the sympathetic nervous system and reduce the vasopressor effect. <em>Conclusion>. Transcranial magnetic therapy in combination with electrical stimulation or laser stimulation is effective in the treatment of patients with POAG. In patients with primary open-angle glaucoma with chronic cerebral ischemia technique of magnetic sim-patokorrektsii compared with traditional methods of vasoactive therapy is more effective, which is manifested not only increase the visual functions, but also a decrease in cognitive impairment.

  1. Clinicopathological features of cerebral lipoastrocytoma

    Directory of Open Access Journals (Sweden)

    Shuang WEN

    2014-01-01

    Full Text Available Objective To explore the clinicopathological features, immune phenotype, diagnosis and differential diagnosis, treatment and prognosis of cerebral lipoastrocytoma. Methods Retrospective analysis of the clinical manifestations, histopathological and immunohistochemical features were conducted in one case of cerebral lipoastrocytoma. Results A 48-year-old male presented with numbness and inflexibility of the fourth and little fingers of his left hand over the previous 2 weeks. Cranial MRI revealed a space-occupying lesion with cystic degeneration in the right parietal lobe that showed obvious enhancement after contrast administration. The patient subsequently underwent craniotomy with stereotactic gross total excision of the lesion. Adjuvant chemotherapy and radiation therapy were not administered. Histologically the tumor showed classical features of low-grade astrocytoma, including a few scattered medium-large neuron-like cells with prominent nucleoli and abundant cytoplasm. Most notably, the glial cells contained fat droplets or vacuoles giving an appearance of mature adipocytes. Focally microcystic change was evident resulting from adipocyte-like cells fusion with each other. Immunohistochemically, the tumor cells were reactive for glial fibrillary acidic protein (GFAP and S-100 protein (S-100, focally positive for WT-1, weakly positive for oligodendrocytes transcription factor-2 (Olig-2, and negative for isocitrate dehydrogenase 1 (IDH1. Meanwhile, the tumor cells also expressed several neuronal markers including synaptophysin (Syn, microtube-associated protein-2 (MAP-2, neurofilament (NF, neuron specific enolase (NSE and CD34. P53 protein was weakly expressed in 5% of tumor cells. Ki-67 labeling index was low (1% . The patient remained well without recurrence 20 months after surgery. Conclusions Cerebral lipoastrocytoma is an extremely rare tumor. Histologically, the tumor showed classical features of low-grade astrocytoma and extensive

  2. MRI of sickle cell cerebral infarction

    International Nuclear Information System (INIS)

    Eleven patients with sickle cell disease and neurological symptoms underwent MRI examination. Cerebral infarcts of two types were found, those in the vascular distribution of the middle cerebral artery and those in the deep white matter. In the patient whose hydration and whose oxygenation of erythrocytes has been treated, MRI offers diagnostic advantages over arteriography and CT. (orig.)

  3. 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…

  4. Ataxic cerebral palsy and genetic predisposition.

    OpenAIRE

    Miller, G.

    1988-01-01

    It was calculated that in the 962 family members of 36 patients with ataxic cerebral palsy there were 75 (8%) with a history of neurodevelopmental disorder and 31 (3%) with a major congenital malformation. This was not significantly greater than expected, and does not support the hypothesis of a genetic non-Mendelian role in the aetiology of ataxic cerebral palsy.

  5. 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

  6. 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...

  7. Assistive technology for people with cerebral palsy

    OpenAIRE

    Zupan, Anton; Jenko, Mojca

    2013-01-01

    Abstract. Assistive technology includes equipment, devicesand software solutions that increase functional capabilities of people withdisabilities and improve the quality of their lives. The article presentsassistive technology for people with cerebral palsy. These are mobility aidsthat enable people with cerebral palsy independent walking. For those whocannot walk, proper seating is very important. People, who cannot propel manualwheelchair, can control electric wheelchair with various contro...

  8. Mechanical Impedance of Cerebral Material

    Directory of Open Access Journals (Sweden)

    Hédi Ben Ghozlen

    2012-03-01

    Full Text Available The tentative variation of the mechanical impedance, of a cylindrical sample of cerebral material, has been achieved by Vibrometer Laser according to the frequency. The studied matter is supposed homogeneous, isotropic and stationary. A multilayered mechanical model has been associated to the studied sample to simulate its vibration. The theoretical expression of mechanical impedance has been determined while taking the mechanical/electric analogy as a basis. A good adjustment of theoretical model parameters permitted us to have a good agreement theory/experience of the mechanical impedance variation according to the sample vibration frequency.

  9. 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...... sampling, 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....

  10. ECG changes during cerebral angiography

    Energy Technology Data Exchange (ETDEWEB)

    Hayakawa, K.; Nishimura, Y.; Yoshida, M.; Itoh, K.; Hayashi, N.; Aoki, J.; Nakamura, K.; Imai, M.; Ono, T.; Morikawa, S.

    1984-09-01

    We have analyzed HR changes greater than 20% among 334 patients and 942 cerebral angiographies. A tachycardial effect was seen in 14.9% of patients, while a bradycardial effect was seen in 7.1% including two patients having cardiac standstill (0.5%). These two patients were examined without atropine premedication after subarachnoid hemorrhage. Patients under 19 years of age, unpremedicated with atropine sulfate and suffering from subarachnoid hemorrhage secondary to ruptured aneurysm or arteriovenous malformation showed a significantly high incidence of bradycardia. On the other hand, patients with the neoplastic disease and having an initial sinus bradycardia showed a significantly high incidence of a tachycardial effect.

  11. 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.

  12. CT findings in patients with cerebral palsy

    International Nuclear Information System (INIS)

    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. (Ueda, J.)

  13. Dilemas éticos da vida humana: a trajetória hospitalar de crianças portadoras de paralisia cerebral grave The ethical dilemmas of human life: the hospital history of children with serious cerebral palsy

    Directory of Open Access Journals (Sweden)

    Debora Diniz

    1996-09-01

    Full Text Available O artigo é um estudo antropológico que aborda os pressupostos éticos do tratamento médico ministrado em crianças portadoras de paralisia cerebral grave. A pesquisa foi realizada a partir de um trabalho etnográfico de oito meses, com pacientes em tratamento no Centro de Paralisia Cerebral do Hospital Sarah, Salvador. A observação da terapêutica ministrada a estas crianças, que apresentam pouquíssimas mudanças do quadro clínico, levou ao questionamento já bastante sugerido em discussões relativas à deontologia médica: Qual o objetivo do tratamento médico empregado nestas crianças? Na verdade, os resultados desta pesquisa indicaram a existência de explicações sócio-humanistas que estariam além da explicação médico-científica oficial, a qual resumiria a terapêutica a um fisicalismo corporal.This study deals with the ethical premises of medical treatment for children with serious cerebral palsy. Eight months of ethnographic research were carried out with patients at the Cerebral Palsy Center in the Sarah Hospital in Salvador, Bahia, Brazil. Observation of treatment for these children, who displayed limited clinical change, led to the following question, as suggested by discussions from medical deontology: What is the purpose of medical treatment for children with serious cerebral palsy? The results of our research point to social and humanist explanations going beyond the official medical scientific explanation, which limits treatment to corporal mechanicism.

  14. Evaluation of Antioxidant and Antiproliferative Properties of Three <em>Actinidia> (<em>Actinidia> <em>kolomikta>, <em>Actinidia argutaem>, <em>Actinidia> <em>chinensis> Extracts <em>in Vitroem>

    Directory of Open Access Journals (Sweden)

    Jia-Ren Liu

    2012-05-01

    Full Text Available The total phenolic content, total flavonoid content, vitamin C content, and antioxidant activities of ethanol extracts from different kiwifruit varieties (<em>Actinidia> <em>kolomikta>, <em>Actinidia argutaem>, <em>Actinidia> <em>chinensis> were determined in this study. Multiple scavenging activity assays including the hydroxyl radical, O2·radical, DPPH, and the ABTS+ radical scavenging activity assays were used to identify the antioxidant activities of <em>Actinidia> extracts. The cell viability of HepG2 and HT-29 cells was also examined in this study. The results demonstrated that the <em>Actinidia kolomiktaem> extract had a higher antioxidant activity than the other two <em>Actinidia> extracts. There is a positive correlation between antioxidant activity and the polyphenols and vitamin C content in all three extracts (<em>R>2 ≥ 0.712, <em>p> em>< 0.05. The <em>Actinidia argutaem> extract had the highest inhibitory effect on HepG2 and HT-29 cell growth. These results provide new insight into the health functions of fruit and demonstrate that <em>Actinidia> extracts can potentially have health benefits.

  15. Ictal technetium-99 m ethyl cysteinate dimer single-photon emission tomographic findings in epileptic patients with polymicrogyria syndromes: A subtraction of ictal-interictal SPECT coregistered to MRI study

    International Nuclear Information System (INIS)

    To describe the ictal technetium-99 m-ECD SPECT findings in polymicrogyria syndromes (PMG) during epileptic seizures. We investigated 17 patients with PMG syndromes during presurgical workup, which included long-term video-electroencephalographic (EEG) monitoring, neurological and psychiatry assessments, invasive EEG, and the subtraction of ictal-interictal SPECT coregistered to magnetic resonance imaging (MRI) (SISCOM). The analysis of the PMG cortex, using SISCOM, revealed intense hyperperfusion in the polymicrogyric lesion during epileptic seizures in all patients. Interestingly, other localizing investigations showed heterogeneous findings. Twelve patients underwent epilepsy surgery, three achieved seizure-freedom, five have worthwhile improvement, and four patients remained unchanged. Our study strongly suggests the involvement of PMG in seizure generation or early propagation. Both conventional ictal single-photon emission computed tomography (SPECT) and SISCOM appeared as the single contributive exam to suggest the localization of the epileptogenic zone. Despite the limited number of resective epilepsy surgery in our study (n = 9), we found a strong prognostic role of SISCOM in predicting surgical outcome. This result may be of great value on surgical decision-making of whether or not the whole or part of the PMG lesion should be surgically resected. (orig.)

  16. Increased eosinophil activity in acute <em>Plasmodium falciparumem> infection - association with cerebral malaria

    DEFF Research Database (Denmark)

    Kurtzhals, J A; Reimert, C M; Tette, E;

    1998-01-01

    To assess the eosinophil response to Plasmodium falciparum infection a cohort of initially parasite-free Ghanaian children was followed for 3 months. Seven of nine children who acquired an asymptomatic P. falciparum infection showed increase in eosinophil counts, while a decrease was found in sev...

  17. 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.

  18. [Cerebral vasospasm after subarachnoid hemorrhage].

    Science.gov (United States)

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

    2008-01-01

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

  19. Cerebral lateralization in simultaneous interpretation.

    Science.gov (United States)

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

    1990-07-01

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

  20. MRI of acute cerebral infarction

    International Nuclear Information System (INIS)

    Sequential changes of magnetic resonance imaging (MRI) in sixteen patients with acute cerebral infarction are studied in comparison with the findings of computed tomography (CT). The sixteen patients were examined within 36 hours from the onset of syptoms on resistive type MRI (0.15T) using T1 weighted image (IR2000/500) and T2 weighted image (SE2000/80), and on CT. In general, large infarcted lesions of the cortexsubcortex seemed to be visualized earlier than small lesions of the basal ganglia and brainstem. In 8 patients, the infarcted lesions were detected on MRI earlier than on CT. For example, early detecting time within 12 hours were 2, 6, 7, and 10 hours after onset. In two patients of this group, lesions were detected on T2 weighted image earlier than on T1-weighted image. In two cases, small lesions of the brainstem were detected only on MRI. The size of abnormal findings gradually developed and reached a maximum on days 5 to 7 sequentially. The difference between infarction and perifocal edema was not clear even on MRI. The changes gradually subsided and assumed a stable size after about 2 months. Contrast enhancement effect was observed in four patients. In two of these cases, the signal intensity of T2-weighted imaging was decreased just at the region which was enhanced with contrast medium. MRI is useful for early diagnosis of ischemic cerebral infarction, and may eludidate some aspects of the pathophysiology of ischemic stroke. (author)

  1. <em>α>-Glucosidase Inhibitory Constituents from <em>Acanthopanax senticosusem> Harm Leaves

    Directory of Open Access Journals (Sweden)

    Hai-Xue Kuang

    2012-05-01

    Full Text Available A new triterpene glycoside, 3-<em>O-[(α>-L-rhamnopyranosyl(1→2]-[<em>β>-D-glucuronopyranosyl-6-<em>O>-methyl ester]-olean-12-ene-28-olic acid (1 and a new indole alkaloid, 5-methoxy-2-oxoindolin-3-acetic acid methyl ester (5 were isolated from the leaves of <em>Acanthopanax senticosusem> Harms along with six known compounds. The structures of the new compounds were determined by means of 2D-NMR experiments and chemical methods. All the isolated compounds were evaluated for their glycosidase inhibition activities and compound 6 showed significant <em>α>-glucosidase inhibition activity.

  2. Acolhendo e atuando com alunos que apresentam paralisia cerebral na classe regular: a organização da escola Reveiving and working with pupils who present cerebral palsy in the regular classroom: school organization

    OpenAIRE

    Francisco Ricardo Lins Vieira de Melo; Lúcia de Araújo Ramos Martins

    2007-01-01

    Este estudo tem como objetivo situar aspectos relativos a uma análise empreendida em duas escolas regulares da cidade do Natal/RN, a respeito de como têm se organizado, do ponto de vista ambiental e pedagógico, para incluir o aluno com paralisia cerebral em seu contexto. Com base no objetivo proposto, foi realizado um estudo descritivo do tipo estudo de caso. A coleta de informações realizou-se através da observação e da entrevista semi-estruturada. Os dados foram analisados tomando por base ...

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

    Science.gov (United States)

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

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

  4. Educação em saúde e família: o cuidado ao paciente, vítima de acidente vascular cerebral - DOI: 10.4025/actascihealthsci.v26i1.1663 Health education in family:nursing CVA patients - DOI: 10.4025/actascihealthsci.v26i1.1663

    OpenAIRE

    Ana Ruth Macêdo Monteiro; Natália Rocha Chagas

    2004-01-01

    O presente estudo objetiva identificar o conhecimento dos familiares de pacientes acometidos por AVC (Acidente Vascular Cerebral) sobre a doença e sobre seus cuidados e, ainda, elaborar uma cartilha de orientação quanto aos cuidados domiciliares a esses pacientes. Participaram da presente pesquisa 50 familiares de pacientes acometidos por AVC, os quais estavam acompanhando os pacientes por um período mínimo de 3 dias. Os dados obtidos da análise dos depoimentos dos familiares estão agrupados ...

  5. Herpes Zoster oftálmico e posterior acidente vascular cerebral: relato de caso

    Directory of Open Access Journals (Sweden)

    Carlos A. M. Guerreiro

    1984-12-01

    Full Text Available Um caso de acidente vascular cerebral (AVC 14 semanas após a instalação de herpes zoster oftálmico (HZO é apresentado. A tomografia computadorizada craniana documentou comprometimento em território de artéria cerebral média ipsilateral ao HZO. O diagnóstico de probabilidade é o de arterite por herpes zoster com posterior trombose. Os autores reviram a literatura e enfatizam o longo intervalo entre o HZO e a instalação da hemiplegia. Citam as novas drogas antivirais que tornam esta causa de AVC potencialmente passível de ser prevenida.

  6. Three New Myrsinol Diterpenes from <em>Euphorbia proliferaem> and Their Neuroprotective Activities

    Directory of Open Access Journals (Sweden)

    Yuanqiang Guo

    2012-08-01

    Full Text Available Three new myrsinol diterpenes were isolated from the roots of<em> em>>Euphorbia proliferaem>. Their structures were elucidated as 2<em>α-O>-isobutyryl-3<em>β>,5<em>α>,7<em>β>,10,15<em>β-penta-O>-acetyl-14<em>α-O>-benzoyl-10,18-dihydromyrsinol (1, 2<em>α-O>-isobutyryl-3<em>β-O>-propion-yl-5<em>α>,7<em>β>,10,15<em>β-tetra-O>-acetyl-10,18-dihydromyrsinol (2, and 2<em>α>,14<em>α-di-O>-benzoyl-3<em>β>,5<em>α>,7<em>β>,10,15<em>β-penta-O>-acetyl-10,18-dihydromyrsinol (3 on the basis of spectroscopic data analyses (IR, ESI-MS, HR-ESI-MS, and 1D and 2D NMR. Their neuroprotective activities were evaluated and compounds 1 and 2 showed neuroprotective effects against MPP+-induced neuronal cell death in SH-SY5Y cells.

  7. Cerebral Hypoperfusion Precedes Nausea During Centrifugation

    Science.gov (United States)

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

    2004-01-01

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

  8. Perspectivas atuais do tratamento da cetoacidose diabética em pediatria Current perspectives for treating children with diabetic ketoacidosis

    OpenAIRE

    Jefferson P. Piva; Mauro Czepielewski; Pedro Celiny R Garcia; Denise Machado

    2007-01-01

    OBJETIVO: Revisar os conceitos atuais da fisiopatologia, diagnóstico e tratamento da cetoacidose diabética (CAD) na infância, assim como as medidas preventivas para evitar o edema cerebral. FONTES DOS DADOS: Os autores selecionaram artigos na MEDLINE com as palavras-chave diabetes, cetoacidose, hiperglicemia e edema cerebral, priorizando estudos realizados em crianças, que tenham textos completos publicados em inglês, português ou espanhol. Revisaram, ainda, capítulos de livros publicados no ...

  9. Aspectos clínico-epidemiológicos das neoplasias cerebrais na faixa etária pediátrica no Estado da Bahia, Brasil Clinical epidemiological aspects of cerebral neoplams in childhood in the State of Bahia, Brazil

    OpenAIRE

    NAYARA ARGOLLO; INES LESSA

    1999-01-01

    O estudo tem como objetivo descrever aspectos relevantes da clínica e da epidemiologia das neoplasias cerebrais em crianças entre 1 e 15 anos, no Estado da Bahia, primeiro semestre de 1995. Utilizou-se desenho de corte transversal para o levantamento de todos os casos novos e preexistentes de neoplasia cerebral diagnosticados através da neuroimagem entre todas as crianças que realizaram estes exames. Em 2 128 exames foram diagnosticados 48 casos de neoplasia cerebral, sendo 19 deles incidente...

  10. 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...... 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...

  11. EPILEPSY IN CHILDREN WITH CEREBRAL PALSY

    OpenAIRE

    S. Pour Ahmadi; M. Jafarzadeh; Abbas, M; J Akhondian

    2008-01-01

    ObjectiveEpilepsy occurs in 12 % to 90 % of children with cerebral palsy (CP). However its clinical course is not well defined. This investigation was undertaken to study and determine the characteristics and prevalence of epilepsy in children with cerebral palsy.Materials & MethodsOf 133 children with cerebral palsy, seen between 1998 and 2001, in the pediatric neurology clinic of the Imam Reza hospital, fifty-three had epilepsy.During the same period, a group of 70 epileptic children with n...

  12. Human cerebral circulation. Positron emission tomography studies

    International Nuclear Information System (INIS)

    We reviewed the literature on human cerebral circulation and oxygen metabolism, as measured by positron emission tomography (PET), with respect to normal values and of regulation of cerebral circulation. A multicenter study in Japan showed that between-center variations in cerebral blood flow (CBF), cerebral blood volume (CBV), cerebral oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO2) values were not considerably larger than the corresponding within-center variations. Overall mean±SD values in cerebral cortical regions of normal human subjects were as follows: CBF=44.4±6.5 ml/100 ml/min; CBV=3.8±0.7 ml/100 ml; OEF=0.44±0.06; CMRO2=3.3±0.5 ml/100 ml/min (11 PET centers, 70 subjects). Intrinsic regulation of cerebral circulation involves several factors. Autoregulation maintains CBF in response to changes in cerebral perfusion pressure; chemical factors such as PaCO2 affect cerebral vascular tone and alter CBF; changes in neural activity cause changes in cerebral energy metabolism and CBF; neurogenic control of CBF occurs by sympathetic innervation. Regional differences in vascular response to changes in PaCO2 have been reported, indicating regional differences in cerebral vascular tone. Relations between CBF and CBV during changes in PaCO2 and during changes in neural activity were in good agreement with Poiseuille's law. The mechanisms of vascular response to neural activation and deactivation were independent on those of responses to PaCO2 changes. CBV in a brain region is the sum of three components: arterial, capillary and venous blood volumes. It has been reported that the arterial blood volume fraction is approximately 30% in humans and that changes in human CBV during changes in PaCO2 are caused by changes in arterial blood volume without changes in venous blood volume. These findings should be considered in future studies of the pathophysiology of cerebrovascular diseases. (author) 136 refs

  13. 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.

  14. Trends in birth prevalence of cerebral palsy.

    OpenAIRE

    Pharoah, P O; Cooke, T.; Rosenbloom, I; Cooke, R W

    1987-01-01

    A register of children with cerebral palsy born in the period 1966-77 to mothers resident in the Mersey region was compiled from several different data sources. There were 685 cases, with a male:female ratio of 1.4:1. The birth prevalence of cerebral palsy ranged from 1.18 to 1.97 per 1000 live births each year, with a mean of 1.51 per 1000 live births. There was no discernible trend in overall prevalence, but there was a highly significant upward trend in the prevalence of cerebral palsy amo...

  15. Dynamic Cerebral Autoregulation after Cardiopulmonary Bypass

    DEFF Research Database (Denmark)

    Christiansen, Claus Behrend; Berg, Ronan M G; Plovsing, Ronni;

    2016-01-01

    Background Cerebral hemodynamic disturbances in the peri- or postoperative period may contribute to postoperative cognitive dysfunction (POCD) in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). We therefore examined dynamic cerebral autoregulation (d......CA) post-CPB and changes in neurocognitive function in patients that had undergone CABG. Materials and Methods We assessed dCA by transfer function analysis of spontaneous oscillations between arterial blood pressure and middle cerebral artery blood flow velocity measured by transcranial Doppler ultrasound...

  16. Hemiparetic cerebral palsy: etiological risk factors and neuroimaging Paralisia cerebral hemiparética: fatores de risco etiológico e neuroimagem

    Directory of Open Access Journals (Sweden)

    Ana Maria Sedrez Gonzaga Piovesana

    2001-03-01

    Full Text Available The purpose of this paper, which was conducted on 175 children with hemiparetic cerebral palsy (H-CP, was to verify the etiological risk period for this disease. Etiological risk factors (ERF were detected through anamnesis: 23% in the prenatal period, 18% in the perinatal period and 59% of the patients the period was undefined (ERF in the prenatal and perinatal period was 41% and no ERF was 18% of the cases. The computerized tomographic scan (CT and MRI were performed on all the patients, who were then classified according to their etiopathogenic data: CT1= normal (18%; CT 2= unilateral ventricular enlargement (25%; CT 3= cortical/ subcortical cavities (28%; CT4= hemispheric atrophy and other findings (14%; CT 5= malformations (15%. CT 5 was associated with physical malformations beyond the central nervous system and with prenatal ERF's , while CT 2 was associated with the perinatal ERF's, mainly in premature births. Magnetic resonance imaging was performed on 57 patients and demonstrated a good degree of concordance with the CT. Etiology remained undefined in only 37% of the cases after neuroimaging was related to ERF. A high perinatal RF frequency (59% was observed and emphasized the need for special care during this period.Foram estudadas 175 crianças com paralisia cerebral hemiparética (PC-H para elucidar o período de risco etiológico. Através da anamnese constataram-se fatores de risco para etiologia (FRE pré-natal em 23%, perinatal em18% e período indefinido em 59% dos pacientes (com FRE pré e perinatal 41% e sem FRE 18%. A tomografia computadorizada (TC foi realizada em todos os sujeitos e classificada de acordo com dados etiopatogênicos em: TC1= normal (18%; TC2= alargamento ventricular unilateral (25%; TC3= cavidades córtico-subcorticais (28%; TC4= atrofia hemisférica e outros achados (14%; TC5= malformações (15%. A TC5 se associada a malformações físicas fora do sistema nervoso central e aos FRE pré-natais e a TC2 aos

  17. Intraaortic Balloon Pump Counterpulsation and Cerebral Autoregulation: an observational study

    OpenAIRE

    Boots Rob; Barnett Adrian G; Timms Daniel; Dunster Kimble; Geng Shureng; Bellapart Judith; Fraser John F

    2010-01-01

    Abstract Background The use of Intra-aortic counterpulsation is a well established supportive therapy for patients in cardiac failure or after cardiac surgery. Blood pressure variations induced by counterpulsation are transmitted to the cerebral arteries, challenging cerebral autoregulatory mechanisms in order to maintain a stable cerebral blood flow. This study aims to assess the effects on cerebral autoregulation and variability of cerebral blood flow due to intra-aortic balloon pump and in...

  18. Cerebral Metabolic Alterations in Rats With Diabetic Ketoacidosis

    OpenAIRE

    Glaser, Nicole; Yuen, Natalie; Anderson, Steven E; Tancredi, Daniel J.; O'Donnell, Martha E.

    2009-01-01

    OBJECTIVE Cerebral edema is a life-threatening complication of diabetic ketoacidosis (DKA) in children. Recent data suggest that cerebral hypoperfusion and activation of cerebral ion transporters may be involved, but data describing cerebral metabolic alterations during DKA are lacking. RESEARCH DESIGN AND METHODS We evaluated 50 juvenile rats with DKA and 21 normal control rats using proton and phosphorus magnetic resonance spectroscopy (MRS). MRS measured cerebral intracellular pH and ratio...

  19. 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...

  20. Clinical significance of determination of plasma NPY levels and serum lipid profile in patients with cerebral hemorrhage and cerebral infarction

    International Nuclear Information System (INIS)

    Objective: To study the clinical significance of changes of plasma NPY levels and serum lipid profile in patients with cerebral hemorrhage and cerebral infarction. Methods: Plasma NPY levels (with RIA) and serum lipid profile (with biochemistry) were determined in (1) 48 patients with acute cerebral hemorrhage (2) 46 patients with acute cerebral infarction and (3) controls.Results Plasma NPY levels in both patients with cerebral hemorrhage and patients with cerebral infarction were significantly higher than those in controls (P0.05). Conclusion: NPY played important roles in the development and pathogenesis of cerebral vascular accidents. Lipid profile changes was the basic etiological factor. (authors)

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

    OpenAIRE

    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 in brain cortical tissue concentrations of hemoglobin. These techniques are non-invasive, and can be performed with the subject in supine, sitting or standing position. Together with photoplethysmog...

  2. Malignant cerebral swelling following cranioplasty.

    Science.gov (United States)

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

    2016-07-01

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

  3. Endovascular therapy of cerebral AVMs

    International Nuclear Information System (INIS)

    This paper evaluates the results of completed endovascular treatment on all patients with cerebral arteriovenous malformations (AVMs). Between 1985 and 1989, 125 patients with AVMs completed endovascular treatment. Treatment decisions were made by means of multidisciplinary consultation (neuroradiology, neurosurgery, neurology, and radiation therapy) depending on the presentation, location, size, and angioarchitecture of the lesion (hemorrhage in 87 patients, seizures in seven, headaches in nine, and progressive neurologic deficit in 22). Superselective catheterization of feeding pedicles to the AVM nidus was performed with either microcatheters delivered by a propulsion chamber or variable-stiffness catheters. Tiny quantities (0.08--0.15 mL) or varying dilutions of NBCA Pantopaque were injected by means of a sandwich technique, drop by drop

  4. Computed tomography of cerebral palsy

    International Nuclear Information System (INIS)

    Seventy patients who had suffered from severe damages in the brain in their early lives were examined using a CT scanner, DELTA-25. The results are summerized as follows: 1. CT findings of the brain were classified into four groups; (1) low density in 11 cases, (2) atrophy in 23, (3) hydrocephalus in 12, and (4) no findings in 24. 2. The low density in the CT finding was assumed as cystic degeneration due to circulatory disturbance in the cerebral hemispheres in their early developmental stages. 3. The ''acerebrate'' state denotes no or little development in mental and motor functions which is attributed to a severe damage in the developing brain. According to the CT findings, the ''acerebrate'' state was resulted from extensive destruction in the greater part of both hemispheres. (author)

  5. 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.

  6. A case of cerebral cryptococcosis

    International Nuclear Information System (INIS)

    A 66-year-old female was admitted to our hospital with chief complaint of vertigo, gait disturbance and dysarthria. These symptoms started about one year before admission and worsened. Vomiting and urinary incontinence appeared. Neurological examination revealed left cerebellar ataxia and dysarthria. In plain CT (computerized tomography) irregular ill-defined low density area was noted in the cerebellar vermis and bilateral cerebellar hemispheres. And slight ventricular dilatation was found. Irregular shape of ring-like enhancement corresponding to capsule and patchy or mottled enhancement inside the tumor were seen. Suboccipital craniectomy was performed and yellowish necrotic tumor with hard capsule was removed. Histological diagnosis was not neoplasm or tuberculoma. Postoperatively liver function progressively worsened. She died due to disseminated intravascular coagulation. Autopsy revealed typical liver cirrhosis without malignant change. 3.0 x 2.5 cm sized, slightly hard, yellowish lesion was found on upper part of cerebellar hemispheres. This had extremely necrotic tissue and a great number of cryptococcus neoformans were found. And other intracranial lesion was not confirmed. Finding of pulmonary cryptococcosis was not gained. Our case is very rare because of solitary cerebellar abscess and absence of meningitic episode or pulmonary cryptococcosis. There are three types of inflammation in cerebral cryptococcosis. The commonest manifestation is the meningitic type, the second mode is granulomatous lesion and the third and the least presentation is intracranial abscess formatior. CT reveals various finidngs according to clinical stage. CT findings are those of meningitis, meningoencephalitis, granuloma and abscess. Cryptococcal granuloma or abscess often simulates brain abscess, glioma and metastatic brain tumor. We discussed CT findings of cerebral cryptococcosis and examined the CT number of our case. (J.P.N.)

  7. Effect of prostaglandin E1 on cerebral blood flow in patients with chronic cerebral infarction

    International Nuclear Information System (INIS)

    The effect of prostaglandin E1 (PGE1) on cerebral blood flow (CBF) was studied in 10 patients with chronic cerebral infarction. Regional cerebral blood flow (rCBF) was measured by single photon emission computed tomography before and after they received PGE1 120 μg daily for 2 weeks. The rCBF of the brainstem, cerebellum, and frontal, temporal, and parietal lobes increased significantly after PGE1 administration. PGE1 also significantly increased the rCBF of the non-infarcted area adjacent to infarction. The results indicate that PGE1 increases the CBF of patients with chronic cerebral infarction without causing the intracerebral steal phenomenon. (author)

  8. CT classification and clinical prognosis of cerebral infarction in the area of middle cerebral artery

    International Nuclear Information System (INIS)

    Computerized tomographies (CT) were repeatedly scanned on 70 patients with cerebral infarction in the middle cerebral artery. Low density area (LDA) was measured with HounFsfield's Unit (HU) and studied on the progressive changes. Classification of LDA was attempted and studied on correlation with mass effect, contrast enhancement, angiographical findings, clinical symptoms and prognosis. It was considered that important points of diagnosis of cerebral infarction were timing of examination of CT and determination of LDA with HUF. It was also thought that CT classification of LDA was usefull to estimate prognosis of the patients with cerebral infarction. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  10. 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

  11. Avaliação da sobrecarga do cuidador de crianças com paralisia cerebral através da escala Burden Interview Assessment of the caregiver burden of children with cerebral palsy using the Burden Interview scale

    Directory of Open Access Journals (Sweden)

    Ana Cristina Resende Camargos

    2009-03-01

    Full Text Available OBJETIVOS: avaliar fatores que influenciam na sobrecarga dos cuidadores de crianças com paralisia cerebral. MÉTODOS: foram entrevistados 56 cuidadores de crianças com paralisia cerebral com idade entre um e 15 anos. Para avaliar a sobrecarga dos cuidadores foi utilizada a escala Burden Interview e foram coletados dados sobre nível socioeconômico da família, gravidade do comprometimento motor, diagnóstico topográfico e idade das crianças com paralisia cerebral. Para análise dos dados foram utilizados os testes Mann-Whitney e Kruskal-Wallis. RESULTADOS: um menor nível socioeconômico da família (p=0,03 e uma menor gravidade do comprometimento motor (p=0,05 das crianças com paralisia cerebral foram associados com maior sobrecarga do cuidador. Não houve diferença significativa em relação ao diagnóstico topográfico (p=0,71 e à idade das crianças com paralisia cerebral (p=0,35. CONCLUSÕES: o conhecimento de fatores que influenciam a sobrecarga dos cuidadores de crianças com paralisia cerebral é mais um dado a ser agregado no planejamento de atenção e intervenção a esse público específico.OBJECTIVES: to evaluate factors that influence the caregiver burden of children with cerebral palsy. METHODS: 56 caregivers who worked with children with cerebral palsy aged between one and fifteen years old were evaluated. To evaluate the caregiver burden the Burden Interview scale was used, along with data on the social and economic circumstances of the children's families, the severity of motor impairment, topographic diagnosis and age of child. The Mann-Whitney and Kruskal-Wallis test were used for data analysis. RESULTS: poorer social and economic circumstances of the children's families (p=0.03 and a lower severity of motor impairment (p=0.05 in the child with cerebral palsy were associated to a heavier caregiver burden. There was no significant difference in the case of topographic diagnosis (p=0.71 and age of child with cerebral

  12. Cerebral circulation and metabolism in cerebral infarction of middle cerebral artery territory

    International Nuclear Information System (INIS)

    Regional cerebral blood flow (rCBF), oxygen metabolism (rCMRO2), oxygen extraction fraction (rOEF) and blood volume (rCBV) were measured with a high performance positron CT (HEADTOME-III) and the 15O labeled gas steady-state method. Seven normal volunteers and 13 patients with ischemic infarction located in the territory of unilateral middle cerebral artery (MCA) were subjected to the positron CT measurement. In the present study, over estimation of rOEF and rCMRO2 were corrected by rCBV using the principle described by Lammertsma and Jones. From these paremeters we also calculated an rCBV/rCBF which meant regional blood transient time of cerebral vessels (rTT). Early ischemic lesions showed two types of uncoupling between rCBF and rCMRO2. Patients studied within the 5th day of the onset showed high rOEF with low rCBF in the infarcted forcus (misery perfusion). About a week after onset rOEF was changed into low level with decreased rCMRO2 and recovered rCBF, and the change lasted to a month after onset recovered rCBF, and the change lasted to a month after onset (luxury perfusion). Then, about two months later, the lesions gradually went to matched change of rCBF and rCMRO2 (coupled perfusion). These changes of rCBF and rCMRO2 described above will reveal the natural course of ischemic brain tissue with acute onset. It was also proved that there was positive correlation between rTT and rOEF. A parameter of rTT will be important to presume rOEF from a single photon emission CT measurement, which has not been able to study oxygen metabolism but could measure rCBF and rCBV. The threshold levels of rCBF and rCMRO2 for morphological tissue damages assessed as a low density area on a X-ray CT were clinically estimated from the present study. The thresholds evaluated in patients within a day of onset, were 12 ml/100 ml/min, and 1.5 ml/ 100 ml/min for rCBF and rCMRO2, respectively. (J.P.N.)

  13. Práticas e nível de conhecimento sobre doença cerebrovascular em um hospital universitário: Parte 1. Educação do corpo de enfermagem: prioridade para o tratamento do infarto cerebral Knowledge and attitudes regarding stroke in a Brazilian teaching hospital: Part 1. Results in health care workers and non-health care workers

    Directory of Open Access Journals (Sweden)

    Charles André

    1997-09-01

    Full Text Available CONTEXTO E OBJETIVOS: Em um hospital universitário, entrevista direta de amostras estratificadas dos 3587 funcionários, visando determinar o nível de conhecimento e a conduta prática do corpo social diante do acidente vascular cerebral ou encefálico (AVE. Estabelecer prioridades para esforços educacionais. MÉTODO: Pré-teste para otimização do instrumento e cálculo amostrai. Entrevista de 309 funcionários sorteados. Inquérito consistindo em 32 questões sobre fisiopatologia, epidemiologia e mortalidade, clínica, fatores de risco, evolução e tratamento, comportamento pessoal diante da doença. Teste de Kruskal-Wallis para múltiplas comparações de dados não-paramétricos. RESULTADOS: O corpo social do hospital exibiu baixo nível de conhecimento teórico sobre o AVE e atitudes errôneas diante da doença. A performance dos enfermeiros foi superior à de auxiliares, técnicos e atendentes de enfermagem. O corpo de enfermagem, apesar de pontuar melhor na entrevista que a população leiga, mantém-se desinformado sobre as novas possibilidades terapêuticas e dissemina mitos sobre a doença. Entre os grupos profissionais leigos, o nível de educação formal não influenciou a performance na entrevista. CONCLUSÕES: A comunidade leiga e de saúde do HUCFF não reconhece adequadamente os sintomas típicos, a evolução provável dos pacientes e a necessidade de intervir rapidamente diante da doença cerebrovascular. O corpo de enfermagem não está preparado para a tarefa de difundir conceitos corretos sobre a doença. Somente programas específicos de educação continuada podem reverter este quadro, e devem ser considerados prioritários.BACKGROUND AND PURPOSE: This study was undertaken to evaluate professionals working at a university hospital as to their knowledge and attitudes towards stroke. METHODS: Individuals working in the hospital were divided in two groups, health care workers (HCW and non-health care workers (NHCW, and

  14. Intra Cerebral Hemorrhage Following Scorpion Sting

    OpenAIRE

    Mathur P C; Trikha Sushma; Kohli Ritesh

    2005-01-01

    Central nervous system manifestations following scorpion sting have been infrequently reported in literature. To emphasise the fact that this form of clinical presentation is not unusual we are reporting a case of scorpion sting associated with intra cerebral hemorrhage.

  15. Scorpion bite and multiple cerebral infarcts.

    OpenAIRE

    Thacker A; Lal R; Misra M

    2002-01-01

    Multiple cerebral infarcts, bilateral optic neuropathy with limb ischemia, following scorpion bite is documented. Vasospasm and autonomic storm due to envenomation is a plausible explanation for this symptom complex.

  16. Reversible cerebral vasoconstriction syndrome: a comprehensive update.

    Science.gov (United States)

    Mehdi, Ali; Hajj-Ali, Rula A

    2014-09-01

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

  17. Cerebral Ischemic Events with Sickle Cell Anemia

    OpenAIRE

    J Gordon Millichap

    2013-01-01

    Researchers at Cincinnati Children's Hospital and several additional centers in the US and UK studied the incidence of acute silent cerebral ischemic events (ASCIEs) in MRIs of children with asymptomatic sickle cell anemia (SCA).

  18. Increased Prevalence of Dyskinetic Cerebral Palsy

    OpenAIRE

    J Gordon Millichap

    2010-01-01

    The prevalence and severity of dyskinetic cerebral palsy (DCP) in European children born 1976-1996 were analyzed in a multicenter study in Goteborg, Sweden; Cork, Ireland; Tubingen, Germany; and Grenoble, France.

  19. Spastic Diplegic and Tetraplegic Cerebral Palsy Compared

    OpenAIRE

    J Gordon Millichap

    2005-01-01

    Risk factors of cerebral palsy (CP), seizures, CP severity, EEG, and MRI findings were compared in 38 children with spastic diplegic (DCP) and 48 with spastic tetraplegic (TCP), in a report from Medical University of Bialystok, Poland.

  20. Cerebral cysticercosis in a cat : clinical communication

    Directory of Open Access Journals (Sweden)

    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.

  1. Cerebral blood flow: Physiologic and clinical aspects

    International Nuclear Information System (INIS)

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

  2. Genetics Home Reference: hereditary cerebral amyloid angiopathy

    Science.gov (United States)

    ... prognosis of a genetic condition? Genetic and Rare Diseases Information Center Frequency The prevalence of hereditary cerebral amyloid angiopathy is unknown. The Dutch type is the most common, with over 200 ...

  3. Cerebral Microcirculation during Experimental Normovolaemic Anemia

    Science.gov (United States)

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

    2016-01-01

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

  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. Pathophysiology of dysarthria in cerebral palsy.

    OpenAIRE

    Neilson, P D; O'Dwyer, N J

    1981-01-01

    Electromyograms were recorded with hooked-wire electrodes from sixteen lip, tongue and jaw muscles in six normal and seven cerebral palsied adult subjects during a variety of speech and non-speech tasks. The recorded patterns of muscle activity fail to support a number of theories concerning the pathophysiology of dysarthria in cerebral palsy. There was no indication of weakness in individual articulator muscles. There was no evidence of uncontrolled sustained background activity or of abnorm...

  6. The changing epidemiology of cerebral palsy.

    OpenAIRE

    Pharoah, P. O.; Platt, M J; Cooke, T

    1996-01-01

    AIM: To determine the prevalence of cerebral palsy in a specific population. METHODS: Multiple sources of ascertainment were used to create and maintain a register of all cases of cerebral palsy born to mothers resident in the counties of Merseyside and Cheshire in the years 1966 to 1989. Denominator data of infant births and deaths from 1966 to 1981 were obtained from statutory notifications made to health authorities and, for the period 1982-89, from statutory birth and death registrations....

  7. Growth hormone deficiency and cerebral palsy

    OpenAIRE

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

    2010-01-01

    Cerebral palsy (CP) is a catastrophic acquired disease, occurring during development of the fetal or infant brain. It mainly affects the motor control centres of the developing brain, but can also affect cognitive functions, and is usually accompanied by a cohort of symptoms including lack of communication, epilepsy, and alterations in behavior. Most children with cerebral palsy exhibit a short stature, progressively declining from birth to puberty. We tested here whether this lack of normal ...

  8. Clinical Practice Guidelines for Cerebral Abscess Treatment

    OpenAIRE

    Danny Barrueta Reyes; Néstor Pulido Ríos

    2009-01-01

    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 accom...

  9. Clinical Practice Guidelines for Cerebral Abscess Treatment

    Directory of Open Access Journals (Sweden)

    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.

  10. Hyperdense lesions in CT of cerebral toxoplasmosis

    International Nuclear Information System (INIS)

    We report a case of cerebral toxoplasmosis in a patient with stage IV C1 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

  11. Crossed cerebral - cerebellar diaschisis : MRI evaluation.

    Directory of Open Access Journals (Sweden)

    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.

  12. Applications of cerebral MRI in neonatology

    International Nuclear Information System (INIS)

    Magnetic resonance tomography (MRT) has become the most important method in the workup of infantile cerebral complications after primary sonography. Cerebral MR examination and image interpretation during the infantile period require extensive knowledge of morphological manifestations, their pathophysiological background, and frequency. The choice of imaging parameters and image interpretation is demonstrated in infarctions and hemorrhages of the mature and immature brain. A review of the main differential diagnoses is also given. The relevance of MR spectroscopy and fetal MRI is discussed. (orig.)

  13. Joubert syndrome labeled as hypotonic cerebral palsy

    OpenAIRE

    Dekair, Lubna H.; Kamel, Hussein; El-Bashir, Haitham O.

    2014-01-01

    Joubert syndrome (JS) is a rare autosomal recessive disorder with cerebellar vermis hypoplasia and complex brainstem malformation. The diagnosis of cases can be difficult as the presentation can be similar to cases of cerebral palsy. We present a case of JS in an 18-month-old girl who presented to pediatric rehabilitation with a diagnosis of hypotonic cerebral palsy and abnormal eye movements. The brain MRI confirmed the typical brain malformations.

  14. Tongue mobility in patients with cerebral palsy

    OpenAIRE

    Živković Zorica; Golubović Slavica

    2012-01-01

    Background/Aim. In children with cerebral palsy speech is a big problem. Speech of these children is more or less understandable, depending on the degree of reduced mobility of articulatory organs. Reduced mobility is affected by inability to control facial grimacing and poor muscle strength when performing targeted movements. The aim of this study was to determine the mobility of tongue in patients with cerebral palsy. Methods. The study included a sample of 34 children - patients with...

  15. Ocular problems in children with cerebral palsy

    OpenAIRE

    Esra Ayhan Tuzcu; Fatmagül Başarslan; Cahide Yılmaz; Seçil Arıca; Nilgün Üstün; Özgür İlhan; Mesut Coşkun; Uğurcan Keskin

    2012-01-01

    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...

  16. PRETERM BIRTH ASSOCIATION WITH CEREBRAL PALSY

    OpenAIRE

    Srinivasa Rao; Vidyullatha; Subbalakshmi

    2015-01-01

    INTRODUCTION: Cerebral palsy ( CP ) is a group of permanent movement disorders that appear in early childhood. Preterm birth is the birth of baby before 37 completed weeks, a full term birth is birth at 37 to 42 weeks of gestation . AIM: To show the extent of association of preterm deliveries as a risk factor in development of cerebral palsy. MATERIALS AND METHODS: This r etrospective cohort study wa...

  17. Temperament of premature infants with cerebral palsy

    OpenAIRE

    Ryu, Hyo Jeong; Don Kim, Kyoung

    2015-01-01

    [Purpose] The purpose of this study was to examine the infant temperaments of children with cerebral palsy due to premature birth. [Subjects and Methods] Data were collected through questionnaires sent to 118 mothers of infants diagnosed with cerebral palsy due to premature birth. [Results] Different infant temperament scores were obtained according to the degrees of disability, type of palsy, birth weights, gestational age, and periods of hospitalization in an NICU; however, the differences ...

  18. Vasculite cerebral e doença de Basedow-Graves: relato de dois casos

    OpenAIRE

    Rocha Maria Sheila Guimarães; Brucki Sônia Maria Dozzi; Ferraz Ana Cláudia

    2001-01-01

    OBJETIVO: Relatar dois casos de pacientes com vasculite cerebral associada à doença de Basedow-Graves. RELATO DOS CASOS: O primeiro é uma paciente de 22 anos de idade com quadro súbito de disartria e déficit motor em dimídio esquerdo. Ao exame clínico, apresentava taquicardia, exoftalmia bilateral e bócio difuso. Referia tratamento para hipertiroidismo há um mês. O segundo é uma paciente de 15 anos de idade, que apresentou quadro súbito de perda da consciência seguindo-se distúrbio de linguag...

  19. Software Plaphoons na comunicação de indivíduo com paralisia cerebral

    OpenAIRE

    Miguel Maia

    2014-01-01

    Neste artigo propomo-nos abordar as vantagens do uso de um software de comunicação alternativa, Plaphoons na comunicação de um aluno com Paralisia Cerebral (PC) cuja comunicação está fortemente comprometida por limitações físicas. Após uma breve abordagem teórica sobre a PC e a Tecnologia de Apoio mostraremos as potencialidades e vantagens do uso do Plaphoons na comunicação e em que medida este poderá ajudar o indivíduo no desenvolvimento da sua competência comunicativa. ...

  20. Rinoliquorréia e hidrocefalia por gliose do aqueduto cerebral

    Directory of Open Access Journals (Sweden)

    Walter C. Pereira

    1967-03-01

    Full Text Available É relatado um caso de hidrocefalia tardia, determinada por gliose do aqueduto cerebral, complicada com rinoliquorréia. A fístula do líquido cefalorraqueano se estabeleceu em conseqüência da erosão da sela turca pelo assoalho do 3.° ventriculo hipertenso e dilatado, determinando comunicação entre a cavidade ventricular e o seio esfenoidal. O paciente foi operado, tendo a fístula sido ocluída satisfatoriamente; previamente foi feita derivação ventrículo-peritoneal para evitar recidiva da hipertensão do sistema ventricular.