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Sample records for cerebral interictal em

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

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    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)

  2. Transcranial doppler sonography diagnostic value for the cerebral flow velocity changes in the interictal phase of classic migraine

    Science.gov (United States)

    Sedighi, Behnaz; Ali Ebrahimi, Hossein; Jabbarpour, Shirin; Shafiee, Kaveh

    2011-01-01

    Background: An imbalance of the cerebrovascular response during functional activation of the brain has been postulated as a factor in the pathophysiology of migraine. The purpose of this study was to determine the transcranial doppler sonography (TDS) diagnostic value for the cerebral flow velocity changes in the interictal phase of classic migraine. Methods: This study was carried out on 46 patients (23 cases and 23 controls). We used Doppler instrument via trans-temporal window and detected middle cerebral artery, anterior cerebral artery and posterior cerebral artery by 2 MHz probe. The flow velocity in the posterior cerebral artery before, during and immediately after stimulation was recorded. Stimulation was done using a flickering light in 100 seconds. Results: At the baseline, the middle cerebral artery had more peak systolic velocity in migraineurs than the control group. Although peak systolic velocity changes in the mid-photic period is not statistically significant. On the other hand, post-photic peak systolic velocity increased significantly. The diagnostic accuracy of the peak systolic volume (PSV) changes in the posterior cerebral artery (PCA) for the migraine was 72.3%. Conclusion: This stimulation we found altered cerebral vasomotor reactivity in the interictal phase in migraineurs with visual aura. This seemed to be an unavoidable hindrance for the wider implementation of functional TCD in diagnostic work up of migraine patients. PMID:24024011

  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

    .28). There was no correlation between visual or quantitated abnormalities and age, duration of migraine, frequency of attacks or prophylactic medication. No correlation could be established between asymmetries and the usual side of headache or aura symptoms. Two conclusions emerged: (1) visual evaluation of interictal migraine......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...... rCBF images is insufficient to pick up abnormalities; (2) almost 50% of the migraine sufferers had abnormal rCBF/asymmetries. However, these are discrete compared with those typically seen during the aura phase of a migraine attack. One explanation to the patchy rCBF patterns might...

  4. Primary Somatosensory Cortices Contain Altered Patterns of Regional Cerebral Blood Flow in the Interictal Phase of Migraine

    Science.gov (United States)

    Hodkinson, Duncan J.; Veggeberg, Rosanna; Wilcox, Sophie L.; Scrivani, Steven; Burstein, Rami; Becerra, Lino; Borsook, David

    2015-01-01

    The regulation of cerebral blood flow (CBF) is a complex integrated process that is critical for supporting healthy brain function. Studies have demonstrated a high incidence of alterations in CBF in patients suffering from migraine with and without aura during different phases of attacks. However, the CBF data collected interictally has failed to show any distinguishing features or clues as to the underlying pathophysiology of the disease. In this study we used the magnetic resonance imaging (MRI) technique—arterial spin labeling (ASL)—to non-invasively and quantitatively measure regional CBF (rCBF) in a case-controlled study of interictal migraine. We examined both the regional and global CBF differences between the groups, and found a significant increase in rCBF in the primary somatosensory cortex (S1) of migraine patients. The CBF values in S1 were positively correlated with the headache attack frequency, but were unrelated to the duration of illness or age of the patients. Additionally, 82% of patients reported skin hypersensitivity (cutaneous allodynia) during migraine, suggesting atypical processing of somatosensory stimuli. Our results demonstrate the presence of a disease-specific functional deficit in a known region of the trigemino-cortical pathway, which may be driven by adaptive or maladaptive functional plasticity. These findings may in part explain the altered sensory experiences reported between migraine attacks. PMID:26372461

  5. Primary Somatosensory Cortices Contain Altered Patterns of Regional Cerebral Blood Flow in the Interictal Phase of Migraine.

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    Duncan J Hodkinson

    Full Text Available The regulation of cerebral blood flow (CBF is a complex integrated process that is critical for supporting healthy brain function. Studies have demonstrated a high incidence of alterations in CBF in patients suffering from migraine with and without aura during different phases of attacks. However, the CBF data collected interictally has failed to show any distinguishing features or clues as to the underlying pathophysiology of the disease. In this study we used the magnetic resonance imaging (MRI technique-arterial spin labeling (ASL-to non-invasively and quantitatively measure regional CBF (rCBF in a case-controlled study of interictal migraine. We examined both the regional and global CBF differences between the groups, and found a significant increase in rCBF in the primary somatosensory cortex (S1 of migraine patients. The CBF values in S1 were positively correlated with the headache attack frequency, but were unrelated to the duration of illness or age of the patients. Additionally, 82% of patients reported skin hypersensitivity (cutaneous allodynia during migraine, suggesting atypical processing of somatosensory stimuli. Our results demonstrate the presence of a disease-specific functional deficit in a known region of the trigemino-cortical pathway, which may be driven by adaptive or maladaptive functional plasticity. These findings may in part explain the altered sensory experiences reported between migraine attacks.

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

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    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.

  7. Increased interictal cerebral glucose metabolism in a cortical-subcortical network in drug naive patients with cryptogenic temporal lobe epilepsy.

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    Franceschi, M; Lucignani, G; Del Sole, A; Grana, C; Bressi, S; Minicucci, F; Messa, C; Canevini, M P; Fazio, F

    1995-01-01

    Positron emission tomography with [18F]-2-fluoro-2-deoxy-D-glucose ([18F]FDG) has been used to assess the pattern of cerebral metabolism in different types of epilepsies. However, PET with [18F]FDG has never been used to evaluate drug naive patients with cryptogenic temporal lobe epilepsy, in whom the mechanism of origin and diffusion of the epileptic discharge may differ from that underlying other epilepsies. In a group of patients with cryptogenic temporal lobe epilepsy, never treated with antiepileptic drugs, evidence has been found of significant interictal glucose hypermetabolism in a bilateral neural network including the temporal lobes, thalami, basal ganglia, and cingular cortices. The metabolism in these areas and frontal lateral cortex enables the correct classification of all patients with temporal lobe epilepsy and controls by discriminant function analysis. Other cortical areas--namely, frontal basal and lateral, temporal mesial, and cerebellar cortices--had bilateral increases of glucose metabolism ranging from 10 to 15% of normal controls, although lacking stringent statistical significance. This metabolic pattern could represent a pathophysiological state of hyperactivity predisposing to epileptic discharge generation or diffusion, or else a network of inhibitory circuits activated to prevent the diffusion of the epileptic discharge. PMID:7561924

  8. Interictal networks in magnetoencephalography.

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    Malinowska, Urszula; Badier, Jean-Michel; Gavaret, Martine; Bartolomei, Fabrice; Chauvel, Patrick; Bénar, Christian-George

    2014-06-01

    Epileptic networks involve complex relationships across several brain areas. Such networks have been shown on intracerebral EEG (stereotaxic EEG, SEEG), an invasive technique. Magnetoencephalography (MEG) is a noninvasive tool, which was recently proven to be efficient for localizing the generators of epileptiform discharges. However, despite the importance of characterizing non-invasively network aspects in partial epilepsies, only few studies have attempted to retrieve fine spatiotemporal dynamics of interictal discharges with MEG. Our goal was to assess the relevance of magnetoencephalography for detecting and characterizing the brain networks involved in interictal epileptic discharges. We propose here a semi-automatic method based on independent component analysis (ICA) and on co-occurrence of events across components. The method was evaluated in a series of seven patients by comparing its results with networks identified in SEEG. On both MEG and SEEG, we found that interictal discharges can involve remote regions which are acting in synchrony. More regions were identified in SEEG (38 in total) than in MEG (20). All MEG regions were confirmed by SEEG when an electrode was present in the vicinity. In all patients, at least one region could be identified as leading according to our criteria. A majority (71%) of MEG leaders were confirmed by SEEG. We have therefore shown that MEG measurements can extract a significant proportion of the networks visible in SEEG. This suggests that MEG can be a useful tool for defining noninvasively interictal epileptic networks, in terms of regions and patterns of connectivity, in search for a "primary irritative zone".

  9. Babesiose cerebral em bovinos: 20 casos

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    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.

  10. Desempenho cognitivo em pacientes operados de aneurisma cerebral

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    FOBE JEAN-LUC

    1999-01-01

    Full Text Available Vinte e cinco pacientes operados de aneurisma cerebral foram submetidos a avaliação cognitiva pós operatória tardia para linguagem, praxia, orientação, lógica, compreensão, memória, depressão, demência e gnosia visual. Os resultados foram correlacionados com idade, escala de Hunt-Hess à admissão, lado, local e tamanho do aneurisma, sangue à TC (Fisher, vaso-espasmo angiográfico (George. Déficit cognitivo tardio estava ausente em 8 pacientes (32%, era leve em 5 (20%, moderado em 6 (24% e grave em 6 (24%. A função cognitiva isoladamente mais alterada foi a da lógica com acometimento moderado e grave em 7 pacientes (28%, seguida de praxia em 6 (24%, orientação em 5 (20%, linguagem e memória em 4 (16%. A alteração gnósica visual, demência e depressão foram pouco frequentes. A compreensão estava levemente alterada em 3 pacientes. Na faixa etária 25-50 anos ocorreu melhor resultado cognitivo com sequela inexistente ou leve em 9 pacientes (75%. Os aneurismas da artéria comunicante posterior direita apresentaram déficit cognitivo tardio ausente ou leve em 5 pacientes (71,42%, os da artéria cerebral média direita apresentaram resultado equivalente em 2 (66,66%. Os aneurismas de artéria cerebral média esquerda apresentaram o pior resultado com sequela cognitiva moderada e grave em 5 pacientes (71,42%. As sequelas neuropsicológicas tardias apresentaram correlação direta com a idade, Hunt-Hess, sangue à TC, vaso-espasmo angiográfico e localização anatômica do aneurisma.

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

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    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

  12. Using of the interictal EEGs for epilepsy diagnosing

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    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.

  13. 痉挛型偏瘫脑电图癫癎样放电危险因素分析%Risk factors for interictal epileptiform discharges on electroencephalogram in children with spastic hemiplegic cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    李素云; 钱旭光; 赵伊黎; 符文杰; 谭晓如; 刘振寰

    2015-01-01

    目的:探讨痉挛型偏瘫的临床表现及脑电图发作间期癫癎样放电(IED)特征,并分析IED相关危险因素。方法收集83例痉挛型偏瘫患儿的临床资料、视频脑电图、影像学检查及认知功能评定结果等。采用多因素logistic回归分析IED的影响因素。结果13%痉挛型偏瘫患儿伴有癫癎。34%患儿伴IED,IED组癫癎发生率(32%)较非IED组者(4%)显著升高(P<0.01)。存在合并症、皮层受累者IED发生率显著增高(P<0.01);不同认知水平组其IED发生率差异有统计学意义(P<0.01)。皮层受累、认知水平低下是痉挛型偏瘫伴IED的危险因素(OR分别为11.521、2.238,P<0.05)。结论痉挛型偏瘫常伴IED,存在IED者癫癎发生率更高。皮层受累及认知水平低下对痉挛型偏瘫伴IED有预测价值。%ObjectiveTo investigate the clinical symptoms and features of interictal epileptiform discharges (IED) on electroencephalogram (EEG) in children with spastic hemiplegic cerebral palsy (CP) and to analyze the risk factors for IED.MethodsEighty-three children with spastic hemiplegic CP were recruited, and their clinical data, results of video-electroencephalogram, imaging ifndings, and cognitive levels were collected. The inlfuencing factors for IED were determined by multiple logistic regression analysis.ResultsThe incidence of epilepsy was 13% in children with spastic hemiplegic CP; 34% of these cases had IED. The incidence of epilepsy in children with IED (32%) was signiifcantly higher than that in those without IED (4%) (P<0.01). The incidence of IED in children with complications and brain cortex impairment increased signiifcantly (P<0.01). The incidence of IED varied signiifcantly between patients with different cognitive levels (P<0.01). Brain cortex impairment (OR=11.521) and low cognitive level (OR=2.238) were risk factors for IED in children with spastic hemiplegic CP (P<0.05).ConclusionsSpastic hemiplegic CP

  14. Value of interictal/ictal single photon emission computed tomography regional cerebral blood flow imaging in localization of epileptic foci%发作间期/发作期SPECT rCBF显像在癫痫灶定位诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    杨雅娜; 罗焱; 胡云; 苏红媛; 杨辉; 张青

    2012-01-01

    Objective To study the value of interictal/ictal single photon emission computed tomography (SPECT) regional cerebral blood flow (rCBF) imaging in localization of epileptic foci. Methods Interictal/ictal SPECT, EEG, VEEG, CT or MRI, and ECoG of 115 epilepsy patients, who underwent operation in Department of Neurosurgery, Xinqiao Hospital, Third Military Medical University, were retrospectively analyzed and compared. Results The positive detection rate of interictal/ictal SPECT for epilepsy was higher than that of EEG, VEEG, CT and MRI (90.4% va 37.4% , 82.6% , 48. 8% and 54.2% , P <0.05). The localization rate of interictal/ictal SPECT for epileptic foci was higher than that of ECoG (91. 3% vs 71. 2% , P<0.05). Conclusion The interictal/ictal SPECT is highly consistent with ECoG in localization of epileptic foci, thus playing an important role in preoperative localization of epilepsy.%目的 探讨发作间期/发作期SPECT局部脑血流灌注显像(regional cerebral blood flow,rCBF)在癫痫术前定位诊断中的价值.方法 回顾性分析第三军医大学新桥医院神经外科行外科手术治疗的115例癫痫患者,术前分别行发作间期/发作期SPECT显像、常规脑电图(electroencephalogram,EEG)、视频脑电图(vedio-EEC,VEEG)、CT或MRI检查,术中行皮层脑电图(electrocorticogram,ECoG)监测,与发作间期/发作期SPECT、EEG、VEEG、CT和MRI检查结果进行比较分析.结果 发作间期/发作期SPECT检出癫痫的阳性率为90.4%,高于EEG的37.4% (P <0.05)、VEEG的82.6%(P>0.05)、CT的48.8% (P <0.05)和MRI的54.2% (P <0.05).与术中ECoG结果比较,发作间期/发作期SPECT对癫痫灶定侧率为91.3%,定位率为71.2%.结论 术前发作间期/发作期SPECT显像与ECoG在癫痫灶定位诊断上具有较高的一致性,在术前综合定位诊断中具有重要意义.

  15. Linear interictal pain in Epicrania Fugax.

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    Pareja, Juan A; Bandrés, Pablo

    2015-01-01

    Epicrania Fugax is a paroxysmal, short-lasting, head pain moving across one hemicranium, describing a linear or zag trajectory, starting and ending in territories of different nerves. Between attacks, patients are usually free of symptoms. We describe an Epicrania Fugax patient complaining of interictal pain. The interictal pain was line-shaped and extended across the usual starting and ending points of the typical Epicrania Fugax paroxysms. Although rarely encountered, persistent linear pain may be a feature of Epicrania Fugax.

  16. Meningioma em placa atingindo toda a convexidade cerebral "Meningioma en plaque" involving the entire cerebral convexity

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    M. de Almeida

    1967-06-01

    Full Text Available É apresentado caso de extenso meningioma em placa atingindo toda a convexidade e determinando grande hiperostose da calota craniana. O quadro clínico caracterizou-se por aumento do volume do crânio, cefaléia, déficit de visão e convulsões. As radiografias e o estudo necroscópico mostraram que as tábuas ósseas foram substituídas por espículas dispostas radialmente. O aspecto histológico, típico de meningioma, não sugeria malignidade.The case of a patient with hystologically confirmed meningeoma is reported. The tumor extended continuously over the entire cerebral convexity and promoted remarkable hyperostosis of the skull. Headache, blindness, increased skul and convulsions were the main clinical manifestations. The two laminae of the skull were replaced by spikes radially arranged, as suggested by the X-ray picture and confirmed at necropsy. The hystologic aspect of the tumor did not show evidence of malignity.

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

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    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

  18. Comparison of ictal and interictal EEG signals using fractal features.

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    Wang, Yu; Zhou, Weidong; Yuan, Qi; Li, Xueli; Meng, Qingfang; Zhao, Xiuhe; Wang, Jiwen

    2013-12-01

    The feature analysis of epileptic EEG is very significant in diagnosis of epilepsy. This paper introduces two nonlinear features derived from fractal geometry for epileptic EEG analysis. The features of blanket dimension and fractal intercept are extracted to characterize behavior of EEG activities, and then their discriminatory power for ictal and interictal EEGs are compared by means of statistical methods. It is found that there is significant difference of the blanket dimension and fractal intercept between interictal and ictal EEGs, and the difference of the fractal intercept feature between interictal and ictal EEGs is more noticeable than the blanket dimension feature. Furthermore, these two fractal features at multi-scales are combined with support vector machine (SVM) to achieve accuracies of 97.58% for ictal and interictal EEG classification and 97.13% for normal, ictal and interictal EEG classification.

  19. Meningioma em placa atingindo toda a convexidade cerebral

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    M. de Almeida

    1967-06-01

    Full Text Available É apresentado caso de extenso meningioma em placa atingindo toda a convexidade e determinando grande hiperostose da calota craniana. O quadro clínico caracterizou-se por aumento do volume do crânio, cefaléia, déficit de visão e convulsões. As radiografias e o estudo necroscópico mostraram que as tábuas ósseas foram substituídas por espículas dispostas radialmente. O aspecto histológico, típico de meningioma, não sugeria malignidade.

  20. A distensibilidade da aorta prediz o acidente vascular cerebral em pacientes hipertensos

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    Telmo Pereira; João Maldonado; Liliana Pereira; Jorge Conde

    2013-01-01

    FUNDAMENTO: A doença cardiovascular continua a ser principal causa de morte nos países desenvolvidos e não é inteiramente prevista por fatores de risco clássicos. O aumento da rigidez arterial constitui um importante determinante de morbidade e mortalidade cardiovascular. OBJETIVO: Avaliar se a velocidade da onda de pulso prediz a ocorrência de acidente vascular cerebral (AVC) em pacientes hipertensos. MÉTODOS: Estudo de coorte, observacional, prospetivo, multicêntrico, incluindo 1.133 pacien...

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

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    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

  2. Medição do volume do sistema ventricular cerebral em cães mesocefálicos

    OpenAIRE

    Garcia, Bruno Miguel Farinha

    2010-01-01

    Dissertação de Mestrado Integrado em Medicina Veterinária É importante ter um conhecimento geral da anatomia cerebral canina de forma a interpretar os resultados obtidos através da TAC, especialmente pelos cães terem grandes variações a nível do formato do crânio pese embora no estudo terem sido consideradas apenas raças de crânio mesocefálico. A medição quantitativa do volume ventricular cerebral foi feita em 50 cães através de tomografia axial computadorizada (TAC), os quais ...

  3. 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)

  4. Cerebral equine hydatidosis in Southern Brazil Hidatidose cerebral em eqüino no Sul do Brasil

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    Jerônimo Lopes Ruas

    1997-06-01

    Full Text Available Equine cerebral hydatid disease is described in a 7-year-old, crossbred, female horse. Clinical signs were characterized by circling gait, pressing of head against fences or objects and motor incoordination. On gross examination of the brain the hemispheres were swollen, mainly the left one. On transversal sections, a 5cm X 7cm fluid-filled cyst was observed within the lateral ventricle of the left hemisphere. The cyst extended from the parietal to the occipital lobe, and compressed the third ventricle. There was also marked mid line deviation. Histologically, the brain lesion adjacent to the cyst, was characterized by a piogranulomatous process and vacuolization of neuropil. A diagnosis of equine hydatidosis caused by Echinococcus granulosus was made on the basis of the morphometric features of protoscolices hooks.Descreve-se um caso de hidatidose cerebral em um eqüino, cruza, fêmea, de 7 anos de idade, que apresentou sinais clínicos nervosos de torneio, pressão da cabeça contra cercas e objetos e incoordenação motora. Na abertura da caixa craniana observou-se aumento de volume do cérebro, mais acentuado no hemisfério esquerdo. Ao corte observou-se, no interior do ventrículo lateral esquerdo, um cisto de aproximadamente 5cm x 7cm, de parede branca opaca, com conteúdo líquido translúcido, que se estendia desde o lobo parietal até o lobo ocipital, comprimindo o tecido nervoso. No exame histológico do cérebro observou-se, na área contígua à parede do cisto a presença de um processo inflamatório piogranulomatoso e vacuolização da neurópila. Os dados morfométricos do cisto, dos protoescóleces e dos ganchos permitiram concluir que o cisto era de Echinococcus granulosus.

  5. Abscesso cerebral por Nocardia sp em paciente imunossuprimido Brain abscess by Nocardia sp in immunocompromised patient

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    Cristina Hueb Barata

    2000-12-01

    Full Text Available Paciente portadora de anemia hemolítica autoimune e púrpura trombocitopênica idiopática (Síndrome de Evans em uso de terapia imunossupressora (predinisona e azatioprina, desenvolveu quadro de abscesso cerebral não responsivo a 23 dias de terapia antimicrobiana. O diagnóstico de nocardiose foi possível após coleta de material de abscesso peribulbar e observação deste material por período superior há uma semana.Pacient with autoimmune haemolytic anaemia and thrombocytopenic purpura (Evans Syndrome, treated with immunosuppressive therapy (prednisone and azathioprine developed brain abscess unresponsive to antimicrobial therapy, in spite of its 23 days duration. Diagnosis could be possible after recover secretion of peribulbar abscess and maintenance of this material over seven days in incubation.

  6. Gliossarcoma de tronco cerebral em paciente pediátrico: relato de caso

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    Moreira Roger Klein

    2004-01-01

    Full Text Available Os autores relatam o caso de um paciente branco, de quatro anos de idade, com comprometimento neurológico progressivo. Tomografia computadorizada do crânio e ressonância magnética evidenciaram lesão expansiva no tronco cerebral. Subseqüentemente, foi feito diagnóstico histopatológico de gliossarcoma. Trata-se de um tumor raro do sistema nervoso central que, na grande maioria dos casos, acomete pacientes acima dos 40 anos de idade e tem localização supratentorial. Há poucos casos relatados de gliossarcomas em crianças, sobretudo na região infratentorial. Dados epidemiológicos, assim como achados mais freqüentes na tomografia computadorizada e ressonância magnética, são discutidos.

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

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    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

  8. Directed differential connectivity graph of interictal epileptiform discharges

    Science.gov (United States)

    Amini, Ladan; Jutten, Christian; Achard, Sophie; David, Olivier; Soltanian-Zadeh, Hamid; Hossein-Zadeh, Gh. Ali; Kahane, Philippe; Minotti, Lorella; Vercueil, Laurent

    2011-01-01

    In this paper, we study temporal couplings between interictal events of spatially remote regions in order to localize the leading epileptic regions from intracerebral electroencephalogram (iEEG). We aim to assess whether quantitative epileptic graph analysis during interictal period may be helpful to predict the seizure onset zone of ictal iEEG. Using wavelet transform, cross-correlation coefficient, and multiple hypothesis test, we propose a differential connectivity graph (DCG) to represent the connections that change significantly between epileptic and non-epileptic states as defined by the interictal events. Post-processings based on mutual information and multi-objective optimization are proposed to localize the leading epileptic regions through DCG. The suggested approach is applied on iEEG recordings of five patients suffering from focal epilepsy. Quantitative comparisons of the proposed epileptic regions within ictal onset zones detected by visual inspection and using electrically stimulated seizures, reveal good performance of the present method. PMID:21156385

  9. Interictal diffusion and perfusion magnetic resonance imaging features of cats with familial spontaneous epilepsy.

    Science.gov (United States)

    Mizoguchi, Shunta; Hasegawa, Daisuke; Hamamoto, Yuji; Yu, Yoshihiko; Kuwabara, Takayuki; Fujiwara-Igarashi, Aki; Fujita, Michio

    2017-03-01

    OBJECTIVE To evaluate the usefulness of diffusion and perfusion MRI of the cerebrum in cats with familial spontaneous epilepsy (FSECs) and identify microstructural and functional deficit zones in affected cats. ANIMALS 19 FSECs and 12 healthy cats. PROCEDURES Diffusion-weighted, diffusion tensor, and perfusion-weighted MRI of the cerebrum were performed during interictal periods in FSECs. Imaging findings were compared between FSECs and control cats. Diffusion (apparent diffusion coefficient and fractional anisotropy) and perfusion (relative cerebral blood volume [rCBV], relative cerebral blood flow [rCBF], and mean transit time) variables were measured bilaterally in the hippocampus, amygdala, thalamus, parietal cortex gray matter, and subcortical white matter. Asymmetry of these variables in each region was also evaluated and compared between FSECs and control cats. RESULTS The apparent diffusion coefficient of the total amygdala of FSECs was significantly higher, compared with that of control cats. The fractional anisotropy of the right side and total hippocampus of FSECs was significantly lower, compared with that of control cats. The left and right sides and total hippocampal rCBV and rCBF were significantly lower in FSECs than in control cats. The rCBV and rCBF of the parietal cortex gray matter in FSECs were significantly lower than in control cats. CONCLUSIONS AND CLINICAL RELEVANCE In FSECs, diffusion and perfusion MRI detected microstructural changes and hypoperfusion (lowered function) in the cerebrum during interictal periods from that of healthy cats. These findings indicated that diffusion and perfusion MRI may be useful for noninvasive evaluation of epileptogenic foci in cats.

  10. Infarto cerebral em duas crianças infectadas pelo HIV-1

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    Rocha Cristiane

    2003-01-01

    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.

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

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    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.

  12. Regional cerebral blood flow in focal cortical epilepsy

    DEFF Research Database (Denmark)

    Hougaard, Kristina Dupont; Oikawa, T; Sveinsdottir, E;

    1976-01-01

    Regional cerebral blood flow (rCBF) was studied in ten patients with focal cortical epilepsy. The blood flow was measured by the intra-arterial injection of xenon 133 (133Xe), and the isotope clearance was recorded by a multidetector scintillation camera with 254 detectors. Three patients were...... studied both during a seizure and (in the same setting) in the interictal period; six patients were studied only in the interictal period, and one patient was studied only during a seizure. Studies during seizures all showed marked flow increases in areas presumed to participate in the seizure activity....... This finding accords with earlier studies. All nine patients studied in the interictal phase showed, either spontaneously or during activation by intermittent light, focal flow increases in areas presumed to comprise the epileptic focus. These interictal hyperemic foci probably reflect subictal neuronal...

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

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    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.

  14. 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

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    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

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

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    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

  16. The interictal dysphoric disorder of epilepsy: Legend or reality?

    Science.gov (United States)

    Mula, Marco

    2016-05-01

    For a long time, the relationships between epilepsy and mood disorders captured the attention of clinicians and neuroscientists. The existence of a peculiar clinical presentation for mood disorders in epilepsy has been a matter of debate since the early reports of Kraepelin and Bleuler. The interictal dysphoric disorder (IDD) represents the modern reinterpretation of such early observations. This paper reviews current research on this topic discussing clinical implications, phenomenological observations, and directions for future research.

  17. Neuroaminidase reduces interictal spikes in a rat temporal lobe epilepsy model.

    Science.gov (United States)

    Isaev, Dmytro; Zhao, Qian; Kleen, Jonathan K; Lenck-Santini, Pierre Pascal; Adstamongkonkul, Dusit; Isaeva, Elena; Holmes, Gregory L

    2011-03-01

    Interictal spikes have been implicated in epileptogenesis and cognitive dysfunction in epilepsy. Unfortunately, antiepileptic drugs have shown poor efficacy in suppressing interictal discharges; novel therapies are needed. Surface charge on neuronal membranes provides a novel target for abolishing interictal spikes. This property can be modulated through the use of neuraminidase, an enzyme that decreases the amount of negatively charged sialic acid. In the present report we determined whether applying neuraminidase to brains of rats with a history of status epilepticus would reduce number of interictal discharges. Following pilocarpine-induced status epilepticus, rats received intrahippocampal injections of neuraminidase, which significantly decreased the number of interictal spikes recorded in the CA1 region. This study provides evidence that sialic acid degradation can reduce the number of interictal spikes. Furthermore, the results suggest that modifying surface charge created by negatively charged sialic acid may provide new opportunities for reducing aberrant epileptiform events in epilepsy.

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

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    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. Qualidade de vida em sobreviventes de acidente vascular cerebral: instrumentos de avaliação e seus resultados

    OpenAIRE

    Mota,Juliana Ferreira; Nicolato,Rodrigo

    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...

  20. 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

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    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.

  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

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    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. Tumores do tronco cerebral: estudo anatomopatológico em 35 casos de necrópsia

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    Carmen Lúcia Penteado Lancellotti

    1989-09-01

    Full Text Available Os tumores do tronco cerebral são raros e geralmente tratados sem diagnóstico histopatológico. Sua incidência varia na literatura entre 1,09% e 17,5% dos tumores cerebrais. O objetivo do trabalho foi relatar a casuísti desses tumores em 28500 necrópsias realizadas de 1952 a 1985 no Departamento de Anatomia Patológica da Santa Casa de São Paulo. Enfatizamos os aspectos neuropatológicos, comparamos nossos casos com os de outras séries e salientamos os tumores mais observados nessa região, com a finalidade de procurar contribuir para melhor abordagem terapêutica. Utilizamos alguns dados clínicos e, através do exame anatomopatológico, localizamos o tumor no tronco cerebral sendo o diagnóstico microscópico estabelecido segundo os critérios da Organização Mundial da Saúde. Dos 428 tumores intracranianos observados, 35 estavam localizados no tronco cerebral. Foram aqui incluídos os tumores próprios do tronco cerebral e as metástases e excluídos os tumores que infiltravam o tronco. A maior incidência ocorreu na primeira década e a causa de óbito predominante foi edema cerebral. A localização preferencial foi a ponte e o tumor mais freqüente foi o glioblas-tomia multiforme (19 casos. As metástases ficaram em segundo lugar na freqüência (9 casos, na maioria dos casos de origem pulmonar. Apesar de alguns autores se posicionarem contra a biópsia de tumor nessa região, baseando-se no alto risco cirúrgico, discordamos dessa opinião, pois acreditamos que, frente ao diagnóstico de glioma, será importante a caracterização ou não de malignidade. Ainda, não devemos deixar de considerar os diagnósticos diferenciais de processo expansivo no tronco. Enfim, com o diagnóstico anatomopatológico de glioma ou de uma das possibilidades aventadas, o procedimento terapêutico poderá ser mais adequado.

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

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    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.

  4. Identification of the epileptogenic zone in patients with tuberous sclerosis : Concordance of interictal and ictal epileptiform activity

    NARCIS (Netherlands)

    van der Heide, Astrid; van Huffelen, Alexander C.; Spetgens, Willy P. J.; Ferrier, Cyrille H.; van Nieuwenhuizen, Onno; Jansen, Floor E.

    2010-01-01

    Objective: In the majority of patients with tuberous sclerosis complex (TSC) multifocal epileptiform activity is present interictally. Therefore, its value in identifying epilepsy surgery candidates has been doubted. We hypothesize that dominant interictal epileptiform foci are concordant with the i

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

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    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

  6. Expensive cerebral blood flow measurements alone are useless and misinformative in comatose patients: a comprehensive alternative Medidas dispendiosas apenas de fluxo sanguíneo cerebral são inúteis e desinformativas em estados de coma: uma alternativa abrangente

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    Julio Cruz

    2003-06-01

    Full Text Available Since the first report addressing quantification of cerebral blood flow (CBF, concomitant assessment of cerebral oxygen consumption was also carried out. Over the years, however, some investigators have emphatically and mistakenly addressed cerebral ischemia in comatose patients, on the basis of CBF measurements alone. In contrast, we have repeatedly reported that ischemia in these patients must be precisely evaluated based on CBF-metabolism coupling or uncoupling, rather than CBF alone. Based on these previous findings, we therefore propose a comprehensive alternative approach, namely the evaluation of brain ischemia in comatose patients based on cerebral metabolic parameters, such as cerebral extraction of oxygen or cerebral lactate release, without expensive CBF measurements.Desde o primeiro artigo apresentando quantificação de fluxo sanguíneo cerebral (FSC, também se avaliou o consumo cerebral de oxigênio. Todavia, ao longo dos anos, alguns investigadores têm enfaticamente e erroneamente destacado a isquemia cerebral em pacientes comatosos, baseando-se apenas em medidas do FSC. Em contrapartida, temos repetidamente destacado que a avaliação de isquemia cerebral nestes pacientes deve ser baseada no conceito de acoplamento ou desacoplamento entre metabolismo cerebral e FSC, ao invés de alterações no FSC apenas. Baseando-se nestes achados prévios, aqui propomos uma abordagem alternativa e abrangente, a qual envolve a avaliação de isquemia cerebral em pacientes comatosos baseando-se em parâmetros metabólicos cerebrais, tais como a extração cerebral de oxigênio ou a liberação cerebral de lactato, sem medidas dispendiosas de FSC.

  7. Resilience of developing brain networks to interictal epileptiform discharges is associated with cognitive outcome.

    Science.gov (United States)

    Ibrahim, George M; Cassel, Daniel; Morgan, Benjamin R; Smith, Mary Lou; Otsubo, Hiroshi; Ochi, Ayako; Taylor, Margot; Rutka, James T; Snead, O Carter; Doesburg, Sam

    2014-10-01

    The effects of interictal epileptiform discharges on neurocognitive development in children with medically-intractable epilepsy are poorly understood. Such discharges may have a deleterious effect on the brain's intrinsic connectivity networks, which reflect the organization of functional networks at rest, and in turn on neurocognitive development. Using a combined functional magnetic resonance imaging-magnetoencephalography approach, we examine the effects of interictal epileptiform discharges on intrinsic connectivity networks and neurocognitive outcome. Functional magnetic resonance imaging was used to determine the location of regions comprising various intrinsic connectivity networks in 26 children (7-17 years), and magnetoencephalography data were reconstructed from these locations. Inter-regional phase synchronization was then calculated across interictal epileptiform discharges and graph theoretical analysis was applied to measure event-related changes in network topology in the peri-discharge period. The magnitude of change in network topology (network resilience/vulnerability) to interictal epileptiform discharges was associated with neurocognitive outcomes and functional magnetic resonance imaging networks using dual regression. Three main findings are reported: (i) large-scale network changes precede and follow interictal epileptiform discharges; (ii) the resilience of network topologies to interictal discharges is associated with stronger resting-state network connectivity; and (iii) vulnerability to interictal discharges is associated with worse neurocognitive outcomes. By combining the spatial resolution of functional magnetic resonance imaging with the temporal resolution of magnetoencephalography, we describe the effects of interictal epileptiform discharges on neurophysiological synchrony in intrinsic connectivity networks and establish the impact of interictal disruption of functional networks on cognitive outcome in children with epilepsy. The

  8. Interictal EEG discoordination in a rat seizure model.

    Science.gov (United States)

    Neymotin, Samuel A; Lee, Heekyung; Fenton, André A; Lytton, William W

    2010-12-01

    Cognitive and psychiatric comorbidities are common and clinically important in medial temporal lobe epilepsy and are likely caused by ongoing abnormalities in brain activity. In addition, it is unclear how the dynamics of interictal brain activity in medial temporal lobe epilepsy contributes to the generation of seizures. To investigate these issues, the authors evaluated multisite interictal EEG from a perinatal excitotoxic, hippocampal lesion rat model of medial temporal lobe epilepsy. Sample entropy, an information theoretical measure, demonstrated decreased complexity at different time scales and across all channels in epileptic animals. However, higher-order multiarea measures showed evidence of increased variability in population correlation measures. This apparent paradox was resolved by noting that although the EEG from epileptic animals was overall more stereotyped, there were frequent periods where two or more brain areas "broke off" from ongoing brain activity in epileptic animals, producing decorrelations between areas. These decorrelations were particularly apparent across the midline, suggesting impairments of interhemispheric coordination, a form of interhemispheric diaschisis. Both the observed alterations could contribute to a reduction in brain functionality: an overall reduction in complexity and a failure of interhemispheric brain coordination, suggesting a breakdown in communication between hemispheres. The authors speculate that any tendency of areas to lose communication or break away from coordinated brain activity might predispose to seizures in these areas.

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

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    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.

  10. INFLUÊNCIA DA EQUOTERAPIA NO CONTROLE CERVICAL E DE TRONCO EM UMA CRIANÇA COM PARALISIA CEREBRAL

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    Alessanda Gregório

    2013-01-01

    Full Text Available A equoterapia é um método fisioterápico que se baseia na utilização do trote do cavalo como meio de tratamento em pacientes com sequelas sensoriais e motoras decorrentes de distúrbios neurológicos. Por tratar-se de um estudo de caso, o objetivo deste trabalho é avaliar a influência da equoterapia no controle cervical e de tronco em uma criança com paralisia cerebral (PC. A criança participante possui dois anos de idade e diagnóstico médico de tetraparesia espastica. Foram realizadas duas avaliações utilizando a escala de Gross Motor Function Measure (GMFM antes e após todo o período das sessões de equoterapia. Esse método de avaliação consiste em 88 itens divididos em cinco dimensões: A, deitar e rolar; B, sentar; C, engatinhar e ajoelhar; D, em pé; e E, correndo e pulando. Utilizaram-se as dimensões A e B da escala GMFM no presente estudo. A equoterapia foi desenvolvida durante dez sessões de trinta minutos, utilizando montarias distintas. Observou-se que o controle cervical e o controle de tronco estavam presentes ao término do tratamento, que é comprovado com o aumento de 19,5% e 7,7% para as dimensões A e B da escala GMFM, respectivamente. A equoterapia apresentou grande eficiência no ganho do controle cervical e de tronco da criança com PC.

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

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    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

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

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    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.

  13. Toxina botulínica e fisioterapia em crianças com paralisia cerebral espástica: revisão bibliográfica

    OpenAIRE

    Teles,Milena Silva; Mello,Enilda Marta Carneiro de Lima

    2011-01-01

    INTRODUÇÃO: A paralisia cerebral (PC) é definida como uma condição neurológica não progressiva originada em razão de uma lesão no encéfalo imaturo que compromete os movimentos e a postura. A espasticidade está presente em 75% dos casos. Essa patologia tem incidência na população de aproximadamente 2 em cada 1.000 nascidos vivos e pode chegar a até 7 por 1.000 em países em desenvolvimento. O objetivo do estudo foi realizar uma revisão bibliográfica por meio da seleção e análise criteriosa de a...

  14. Bem-estar subjetivo e senso de ajustamento psicológico em idosos que sofreram acidente vascular cerebral: uma revisão

    OpenAIRE

    Rabelo, Dóris Firmino; Néri,Anita Liberalesso

    2006-01-01

    Foi feito um levantamento dos estudos brasileiros e estrangeiros publicados entre 1996 e 2005 que relacionavam bem-estar subjetivo, senso de ajustamento psicológico e acidente vascular cerebral, com o objetivo de identificar variáveis mediadoras dessa relação em idosos. Estudos transversais e prospectivos indicaram que os afetados por acidente vascular cerebral apresentam menor bem-estar subjetivo quando comparados com a população geral. Boa capacidade cognitiva, suporte social efetivo, conti...

  15. <em>Plasmodium bergheiem> ANKA: erythropoietin activates neural stem cells in an experimental cerebral malaria model

    DEFF Research Database (Denmark)

    Core, Andrew; Hempel, Casper; Kurtzhals, Jørgen A L;

    2011-01-01

    Cerebral malaria (CM) causes substantial mortality and neurological sequelae in survivors, and no neuroprotective regimens are currently available for this condition. Erythropoietin (EPO) reduces neuropathology and improves survival in murine CM. Using the Plasmodium berghei model of CM, we...... investigated if EPO's neuroprotective effects include activation of endogenous neural stem cells (NSC). By using immunohistochemical markers of different NSC maturation stages, we show that EPO increased the number of nestin(+) cells in the dentate gyrus and in the sub-ventricular zone of the lateral...... ventricles, relative to control-treatment. 75% of the EPO-treated CM mice displayed migration as nestin(+) NSC. The NSC showed differentiation towards a neural cell lineage as shown by PSA-NCAM binding and NSC maturation and lineage commitment was significantly affected by exogenous EPO and by CM in the sub...

  16. Vasoespasmo cerebral

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    Antonio A. F. de Salles

    1987-09-01

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

  17. Aspectos epidemiológicos de um surto de babesiose cerebral em bovinos em zona livre de carrapato Epidemiological aspects of an outbreak of cerebral babesiosis in cattle in tick free area

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    Ana Lucia Schild

    2008-12-01

    Full Text Available Descrevem-se os aspectos epidemiológicos de um surto de babesiose cerebral ocorrido em bovinos no município de Santa Vitória do Palmar, RS em uma propriedade localizada geograficamente na Latitude S 33°05'23" e Longitude WO 53°09'29", região considerada zona livre de Rhipicephalus (Boophilus microplus. Em meados de novembro de 2007 foram transferidos para essa propriedade quatro touros, quatro novilhas e duas vacas provenientes do município de Minas do Leão,RS localizado geograficamente na Latitude S 30°12'07" e Longitude WO 52°03'25". De um total de 393 animais, 40 bovinos adultos morreram no período entre 19 de janeiro e 2 de março de 2008. O diagnóstico foi realizado pela observação das lesões macroscópicas e pela presença de numerosas formas parasitárias de Babesia bovis em impressões de fragmentos do córtex telencefálico coradas por Giemsa, que foram enviados ao Laboratório Regional de Diagnóstico da Faculdade de Veterinária da UFPel (LRD. Sugere-se que o clima favorável com temperaturas médias entre 23,2°C e 23,6°C e umidade relativa do ar média entre 77,5° e 75,3% observados no período determinaram a ocorrência de uma geração de carrapatos que ao infestarem e inocularem o agente em animais sem nenhuma imunidade contra o mesmo desencadearam o surto.An outbreak of babesiosis by Babesia bovis is reported in cattle in the municipality of Santa Vitória do Palmar, considered a Rhipicephalus (Boophilus microplus free area, in southern Brazil on a farm located at Latitude S 33°05'23" and Longitude WO 53°09'29". In mid November four bulls, four cows and two heifers originated from the municipality of Minas do Leão, RS, a tick endemic area, located at Latitude S 30°12'07" and Longitude WO 52°03'25" were introduced in the herd. Fourty out of 393 adult cattle died. The first bovine died on January 19 and the last on March 2. The diagnosis of babesiosis was performed by the observation of gross lesions and

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

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    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.

  19. Análise do desempenho do vocabulário receptivo e expressivo em indivíduos com Paralisia Cerebral do tipo diplegia

    OpenAIRE

    2012-01-01

    A paralisia cerebral diplégica é definida como transtorno basicamente motor, envolvendo comprometimento bilateral, dos quatro membros, com predomínio dos membros inferiores. Esta limitação motora pode acarretar em dificuldades de interação, influenciando nas habilidades linguísticas. O objetivo deste estudo foi analisar e caracterizar o vocabulário receptivo e expressivo, bem como compará-los, em dois diferentes grupos. Para tanto, participaram 10 indivíduos com diagnóstico de paralisia cereb...

  20. Resultados funcionais da aplicação da toxina botulínica tipo A em pacientes com acidente vascular cerebral

    OpenAIRE

    Vanessa Ribas Massia

    2009-01-01

    O Acidente Vascular Cerebral (AVC), junto com as demais doenças cerebrovasculares, é a terceira causa de óbito em países desenvolvidos e a principal causa de incapacidade em adultos. A espasticidade é a seqüela motora mais incapacitante, limitando as atividades funcionais. A toxina Botulínica (TB) tem se mostrado uma opção terapêutica benéfica, eficaz e segura. Pacientes submetidos à aplicação de TB devem iniciar um tratamento fisioterapeutico a fim de estabelecer a função perdida, tornando-o...

  1. Avaliação de conhecimentos e cuidados de saúde oral em crianças com paralisia cerebral

    OpenAIRE

    Freitas, Marília

    2013-01-01

    Trabalho final do 5º ano com vista à atribuição do grau de mestre no âmbito do ciclo de estudos de Mestrado Integrado em Medicina Dentária apresentado à Faculdade de Medicina da Universidade de Coimbra. Introdução: A Paralisia Cerebral é descrita como um conjunto de perturbações do desenvolvimento motor e postural com limitações a vários níveis, atribuídas a distúrbios não progressivos que ocorrem no cérebro fetal ou infantil em desenvolvimento. Alguns autores referem que as cria...

  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. 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.

  4. Vasoespasmo cerebral

    OpenAIRE

    1987-01-01

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

  5. 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

  6. Interictal lack of habituation of mismatch negativity in migraine.

    Science.gov (United States)

    de Tommaso, M; Guido, M; Libro, G; Losito, L; Difruscolo, O; Sardaro, M; Puca, F M

    2004-08-01

    The aim was to study mismatch negativity features and habituation during the interictal phase of migraine. In migraine patients, a strong negative correlation has been found between the initial amplitude of long latency auditory-evoked potentials and their amplitude increase during subsequent averaging. We studied 12 outpatients with a diagnosis of migraine without aura recorded in a headache-free interval and 10 gender- and age-matched healthy volunteers not suffering from any recurrent headache. The experiment consisted of two sequential blocks of 2000 stimulations, during which 1800 (90%) recordings for standard tones and 200 (10%) for target tones were selected for averaging. The latency of the N1 component was significantly increased in migraine patients in respect of controls in both the first and second repetitions; the MMN latency was increased in the second repetition. In the control group the MMN amplitude decreased on average by 3.2 +/- 1.4 microV in the second trial, whereas in migraine patients it showed a slight increase of 0.21 +/- 0.11 microV in the second repetition. The MMN latency relieved in the second trial was significantly correlated with the duration of illness in the migraine patients (Spearman correlation coefficient: 0.69; P < 0.05). The increases in N1 latency and MMN latency and amplitude, the latter correlated with duration of illness, seemed to be due to a reduced anticipatory effect of stimulus repetition in migraine patients. This suggests that such hypo-activity of automatic cortical processes, subtending the discrimination of acoustic stimuli, may be a basic abnormality in migraine, developing in the course of the disease.

  7. 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

  8. Caracterização de sujeitos com lesão cerebral adquirida em idade produtiva

    Directory of Open Access Journals (Sweden)

    Aline Sarturi Ponte

    Full Text Available RESUMO Objetivo: analisar as condições sociodemográficas e de saúde (inclusive os agravos neurológicos de sujeitos com LEA em idade produtiva, bem como suas condições pregressas e atuais de trabalho. Métodos: estudo de natureza descritiva e de abordagem quantitativa. Os dados foram coletados entre junho e dezembro de 2014, por meio de uma entrevista semiestruturada. Resultados: participaram do estudo 48 sujeitos com Lesão Cerebral Adquirida; a incidência entre o sexo masculino (52,1% e feminino (47,9% foi equilibrada; a média de idade, no momento da lesão, foi de 48,7 anos; 64,5% eram casados; 62,5% possuíam Ensino Fundamental Incompleto; a ocupação anterior à lesão mais frequente foi a de doméstica (18,7%; 47,9% dos sujeitos foram aposentados após a lesão, 6,3% voltaram ao trabalho, e 93,7% gostariam de retornar. Quanto aos comprometimentos neurológicos, 41,1% foram acometidos por Acidente Vascular Cerebral Isquêmico (52,1% apresentaram afasia, e 52,2% tiveram hemiplegia direita. A condição de saúde física de 60,4% foi considerada moderada; 58,3% avaliaram sua saúde mental como ruim; 60,4% nunca fumaram; e 93,7% pararam de ingerir álcool após a lesão. Notou-se, ainda, que 62,5% dos sujeitos eram acompanhados somente por fisioterapeutas e que 54,2% usavam algum recurso assistivo. Ademais, as atividades de lazer de 58,4% dos sujeitos estavam prejudicadas. Conclusão: a média de idade dos sujeitos deste estudo é inferior a outros estudos nacionais; o nível de escolaridade é baixo; as ocupações anteriores à lesão eram de baixo rendimento financeiro; e o índice de aposentadoria após a lesão foi alto. As sequelas neurológicas impactam, assim, negativamente a vida/saúde dos sujeitos, condição agravada pelo fato de os recursos terapêuticos serem incompletos.

  9. Comparison of five directed graph measures for identification of leading interictal epileptic regions

    Science.gov (United States)

    Amini, Ladan; Jutten, Christian; Achard, Sophie; David, Olivier; Kahane, Philippe; Vercueil, Laurent; Minotti, Lorella; Hossein-Zadeh, Gh. Ali; Soltanian-Zadeh, Hamid

    2010-01-01

    Directed graphs (digraphs) derived from interictal periods of intracerebral EEG (iEEG) recordings can be used to estimate the leading interictal epileptic regions for presurgery evaluations. For this purpose, quantification of the emittance contribution of each node to the rest of digraph is important. However, the usual digraph measures are not very well suited for this quantification. Here we compare the efficiency of recently introduced local information measure LI and a new measure called total global efficiency with classical measures like global efficiency, local efficiency and node degree. For evaluation, the estimated leading interictal epileptic regions based on five measures are compared with seizure onset zones obtained by visual inspection of epileptologists for five patients. The comparison revealed the superior performance of LI measure. We showed efficiency of different digraph measures for the purpose of source and sink node identification. PMID:20952817

  10. Avaliação da isquemia cerebral focal induzida pela oclusão da artéria cerebral média e a ação neuroprotetora do cetoprofeno em ratos Focal cerebral ischaemia induced by middle cerebral artery occlusion and the neuroprotective effect of ketoprofen in rats

    Directory of Open Access Journals (Sweden)

    LUIZ ANTONIO ARAUJO DIAS

    2000-12-01

    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

  11. Validação da versão em português da entrevista telefônica para avaliação do estado cognitivo - modificada (TICS-M) em pacientes acometidos por acidente vascular cerebral

    OpenAIRE

    2014-01-01

    Introdução: O AVC (acidente vascular cerebral) é uma das mais importantes causas de alterações neuropsicológicas. Uma avaliação cognitiva inicial realizada por telefone implicaria em um diagnóstico mais precoce de prejuízo cognitivo e demência, reduzindo custos e tempo. Objetivo: Examinar as propriedades psicométricas da versão brasileira da Entrevista Telefônica para Avaliação do Estado Cognitivo - Modificada (TICS-M) em pacientes pós-AVC. Métodos: Previamente à validação da TICS-M em indiví...

  12. 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

  13. Associação entre função executiva e sintomas depressivos em pacientes com acidente  vascular cerebral isquêmico

    OpenAIRE

    2012-01-01

    INTRODUÇÃO: Associação entre sintomas depressivos e prejuízos cognitivos após o acidente vascular cerebral isquêmico tem sido descrito em vários estudos. Estudos recentes tem focado a associação de sintomas depressivos com a função executiva. A hipótese Depression Executive dysfunction tem sido investigada em pacientes com AVC e não se sabe se essa associação ocorre com algum grupo de sintomas depressivos específico. Portanto, o principal objetivo desse estudo, foi o de investigar a associaçã...

  14. 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

    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...

  15. Inter-ictal spike detection using a database of smart templates

    NARCIS (Netherlands)

    Lodder, S.S.; Askamp, J.; Putten, van M.J.A.M.

    2013-01-01

    Objective: Visual analysis of EEG is time consuming and suffers from inter-observer variability. Assisted automated analysis helps by summarizing key aspects for the reviewer and providing consistent feedback. Our objective is to design an accurate and robust system for the detection of inter-ictal

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

    NARCIS (Netherlands)

    Lodder, S.S.; Putten, van M.J.A.M.

    2014-01-01

    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

  17. Toxina botulínica no tratamento de estrabismo horizontal em crianças com paralisia cerebral Botulinum toxin treatment for horizontal strabismus in children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Mônica Fialho Cronemberger

    2006-08-01

    Full Text Available OBJETIVO: Avaliar a eficácia da toxina botulínica no tratamento de estrabismo horizontal em crianças com paralisia cerebral. MÉTODOS: Um grupo de 24 pacientes com paralisia cerebral e estrabismo horizontal (17 esotropias variando de 25delta a 45delta e 7 exotropias variando de 20delta a 45delta, com idades variando entre 6 a 156 meses, foram tratadas com toxina botulínica (34 músculos retos mediais e 14 retos laterais. As crianças foram submetidas a exame oftalmológico completo. A injeção de toxina, utilizando-se a pinça de Mendonça, foi realizada sob sedação. O seguimento foi realizado mediante avaliação aos 7 dias, 15 dias e a seguir mensalmente. O resultado foi considerado bom quando se obteve desvio To evaluate the efficacy of botulinum toxin injection in the treatment of horizontal strabismus in children with cerebral palsy. METHODS: A group of 24 patients, age 6 - 156 months, with cerebral palsy and horizontal strabismus (17 esotropias ranging from 25 to 45 PD and 7 exotropias ranging from 20 to 45 PD were treated with botulinum toxin (34 medial rectus and 14 lateral rectus muscles. The children underwent full ophthalmic examination. The injection treatment was performed after sedation using Mendonça's forceps. The follow-up was done after 7 days, 15 days and monthly. Deviation less or equal of 10 PD after 6 months of follow-up was considered successful. However, if patients did not achieve this result a second application could be performed. RESULTS: In the group of esotropia (n=17 47.1% had successful results with only one application after two years of follow-up. All of these patients had previous deviation less than or equal to 35 PD. In the exotropia group a single injection was not sufficient to achieve successful result. The side effects included: subconjutival hemorrhage in 4 (16.7% patients, transient vertical deviation in 4 (16.7% and transient ptosis in 22 (91.7%. CONCLUSION: The use of botulinum toxin was a

  18. 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

  19. Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy

    Science.gov (United States)

    Papadelis, Christos; Tamilia, Eleonora; Stufflebeam, Steven; Grant, Patricia E.; Madsen, Joseph R.; Pearl, Phillip L.; Tanaka, Naoaki

    2016-01-01

    Crucial to the success of epilepsy surgery is the availability of a robust biomarker that identifies the Epileptogenic Zone (EZ). High Frequency Oscillations (HFOs) have emerged as potential presurgical biomarkers for the identification of the EZ in addition to Interictal Epileptiform Discharges (IEDs) and ictal activity. Although they are promising to localize the EZ, they are not yet suited for the diagnosis or monitoring of epilepsy in clinical practice. Primary barriers remain: the lack of a formal and global definition for HFOs; the consequent heterogeneity of methodological approaches used for their study; and the practical difficulties to detect and localize them noninvasively from scalp recordings. Here, we present a methodology for the recording, detection, and localization of interictal HFOs from pediatric patients with refractory epilepsy. We report representative data of HFOs detected noninvasively from interictal scalp EEG and MEG from two children undergoing surgery. The underlying generators of HFOs were localized by solving the inverse problem and their localization was compared to the Seizure Onset Zone (SOZ) as this was defined by the epileptologists. For both patients, Interictal Epileptogenic Discharges (IEDs) and HFOs were localized with source imaging at concordant locations. For one patient, intracranial EEG (iEEG) data were also available. For this patient, we found that the HFOs localization was concordant between noninvasive and invasive methods. The comparison of iEEG with the results from scalp recordings served to validate these findings. To our best knowledge, this is the first study that presents the source localization of scalp HFOs from simultaneous EEG and MEG recordings comparing the results with invasive recordings. These findings suggest that HFOs can be reliably detected and localized noninvasively with scalp EEG and MEG. We conclude that the noninvasive localization of interictal HFOs could significantly improve the

  20. 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.

  1. 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

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    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

  2. 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

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    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

  3. Interictal dysphoric disorder: a frequent psychiatric comorbidity among patients with epilepsy who were followed in two tertiary centers

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    Pedro Paulo Gomes do Nascimento

    2013-11-01

    Full Text Available Psychiatric disorders are frequent among patients with epilepsy. Data in the literature have shown a heterogeneous clinical presentation of psychiatric disorders in patients with epilepsy. Interictal dysphoric disorder could be a specific psychiatric comorbidity associated with epilepsy, primarily in patients treated in tertiary centers. Objective The present study aimed to determine the prevalence of interictal dysphoric disorder among patients with epilepsy who were followed in two tertiary epilepsy services in Brazil. Method Sixty-five patients with epilepsy completed the Portuguese version of the Interictal Dysphoric Disorder Inventory. Results Thirty-three (50.7% patients fulfilled the diagnostic criteria for interictal dysphoric disorder, although all participants answered positively to having at least one key symptom. Conclusion The high rate of patients with epilepsy who fulfilled the diagnosis of interictal dysphoric disorder confirms an association between epilepsy and psychiatric disorders. However, there is clearly a need to improve diagnostic tools to allow better differentiation between interictal dysphoric disorder and other psychiatric disorders.

  4. White matter abnormalities revealed by DTI correlate with interictal grey matter FDG-PET metabolism in focal childhood epilepsies.

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    Lippé, Sarah; Poupon, Cyril; Cachia, Arnaud; Archambaud, Frédérique; Rodrigo, Sébastian; Dorfmuller, Georg; Chiron, Catherine; Hertz-Pannier, Lucie

    2012-12-01

    For patients with focal epilepsy scheduled for surgery, including MRI-negative cases, (18)FDG-PET was shown to disclose hypometabolism in the seizure onset zone. However, it is not clear whether grey matter hypometabolism is informative of the integrity of the surrounding white matter cerebral tissue. In order to study the relationship between metabolism of the seizure onset zone grey matter and the integrity of the surrounding white matter measured by diffusion tensor imaging (DTI), we performed a monocentric prospective study (from 2006 to 2009) in 15 children with pharmacoresistant focal epilepsy, suitable for interictal (18)FDG-PET, T1-, T2-, FLAIR sequence MRI and DTI. Children had either positive or negative MRI (eight with symptomatic and seven with cryptogenic epilepsies, respectively). Seven children subsequently underwent surgery. Standardised uptake values of grey matter PET metabolism were compared with DTI indices (fractional anisotropy [FA], apparent diffusion coefficient [ADC], parallel diffusion coefficient [PDC], and transverse diffusion coefficient [TDC]) in grey matter within the seizure onset zone and adjacent white matter, using regions of interest automatically drawn from individual sulcal and gyral parcellation. Hypometabolism correlated positively with white matter ADC, PDC, and TDC, and negatively with white matter FA. In the cryptogenic group of children, hypometabolism correlated positively with white matter ADC. Our results demonstrate a relationship between abnormalities of grey matter metabolism in the seizure onset zone and adjacent white matter structural alterations in childhood focal epilepsies, even in cryptogenic epilepsy. This relationship supports the hypothesis that microstructural alterations of the white matter are related to epileptic networks and has potential implications for the evaluation of children with MRI-negative epilepsy.

  5. Habituation of single CO2 laser-evoked responses during interictal phase of migraine.

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    de Tommaso, Marina; Libro, Giuseppe; Guido, Marco; Losito, Luciana; Lamberti, Paolo; Livrea, Paolo

    2005-09-01

    A reduced habituation of averaged laser-evoked potential (LEP) amplitudes was previously found in migraine patients. The aim of the present study was to assess the habituation of single LEP responses and pain sensation during the interictal phase in migraine patients. Fourteen migraine patients were compared with ten control subjects. The pain stimulus was laser pulses, generated by CO2 laser, delivered to right supraorbital zone. Patients were evaluated during attack-free conditions. The LEP habituation was studied by measuring the changes of LEP amplitudes across and within three consecutive repetitions of 21 non-averaged trials. In migraine patients the N2-P2 wave amplitudes did not show a tendency toward habituation across and, above all, within the three repetitions. Anomalous behaviour of nociceptive cortex during the interictal phase of migraine may predispose patients to headache occurrence and persistence.

  6. Preconditioning with L-alanyl-L-glutamine in a Mongolian Gerbil model of acute cerebral ischemia/reperfusion injury Pré-condicionamento com L-alanil-L-glutamina em modelo de isquemia/reperfusão cerebral aguda em Gerbils da Mongólia

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    Vilma Leite de Sousa Pires

    2011-01-01

    Full Text Available PURPOSE: To investigate the effect of L-alanyl-L-glutamine (L-Ala-Gln preconditioning in an acute cerebral ischemia/reperfusion (I/R model in gerbils. METHODS: Thirty-six Mongolian gerbils (Meriones unguiculatus, (60-100g, were randomized in 2 groups (n=18 and preconditioned with saline 2.0 ml (Group-S or 0.75g/Kg of L-Ala-Gln, (Group-G administered into the femoral vein 30 minutes prior to I/R. Each group was divided into three subgroups (n=6. Anesthetized animals (urethane, 1.5g/Kg, i.p. were submitted to bilateral occlusion of common carotid arteries during 15 minutes. Samples (brain tissue and arterial blood were collected at the end of ischemia (T0 and after 30 (T30 and 60 minutes (T60 for glucose, lactate, myeloperoxidase (MPO, thiobarbituric acid reactive substances (TBARS, glutathione (GSH assays and histopathological evaluation. RESULTS: Glucose and lactate levels were not different in studied groups. However glycemia increased significantly in saline groups at the end of the reperfusion period. TBARS levels were significantly different, comparing treated (Group-G and control group after 30 minutes of reperfusion (pOBJETIVO: Investigar o efeito do pré-condicionamento com L-alanil-L-glutamina (L-Ala-Gln em gerbils submetidos à isquemia/reperfusão (I/R cerebral aguda. MÉTODOS: Trinta e seis gerbils (Meriones unguiculatus (60-100g foram divididos em dois grupos (n=18 e pré-condicionados com 2,0 ml de soro fisiológico (Grupo-S ou 0.75g/kg de L-Ala-Gln, (Grupo-G, administrados na veia femoral 30 minutos antes da I / R. Cada grupo foi dividido em três subgrupos (n=6.Animais anestesiados com uretano, 1.5g/kg, ip, foram submetidos à oclusão bilateral das artérias carótidas comuns, durante 15 minutos. Amostras (tecido cerebral e sangue arterial foram coletadas no final da isquemia (T0 e após 30 (T30 e 60 minutos (T60 para a aferição das concentrações de glicose, lactato, mieloperoxidase (MPO, substâncias reagentes ao

  7. Cellular mechanisms underlying spontaneous interictal spikes in an acute model of focal cortical epileptogenesis.

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    de Curtis, M; Radici, C; Forti, M

    1999-01-01

    The cellular mechanisms involved in the generation of spontaneous epileptiform potentials were investigated in the pirifom cortex of the in vitro isolated guinea-pig brain. A single, unilateral injection of bicuculline (150-200 nmol) in the anterior piriform cortex induced locally spontaneous interictal spikes that recurred with a period of 8.81+/-4.47 s and propagated caudally to the ipsi- and contralateral hemispheres. Simultaneous extra- and intracellular recordings from layer II and III principal cells showed that the spontaneous interictal spike correlates to a burst of action potentials followed by a large afterdepolarization. Intracellular application of the sodium conductance blocker, QX-314 (80 mM), abolished bursting activity and unmasked a high-threshold slow spike enhanced by the calcium chelator EGTA (50 mM). The slow spike was abolished by membrane hyperpolarization and by local perfusion with 2 mM cadmium. The depolarizing potential that followed the primary burst was reduced by arterial perfusion with the N-methyl-D-aspartate receptor antagonist, DL-2-amino-5-phosphonopentanoic acid (100-200 microM). The non-N-methyl-D-aspartate glutamate receptor antagonist, 6-cyano-7-nitroquinoxaline-2,3-dione (20 microM), completely and reversibly blocked the spontaneous spikes. The interictal spikes were terminated by a large afterpotential blocked either by intracellular QX-314 (80 mM) or by extracellular application of phaclofen and 2-hydroxysaclofen (10 and 4 mM, respectively). The present study demonstrates that, in an acute model of epileptogenesis, spontaneous interictal spikes are fostered by a primary burst of fast action potentials that ride on a regenerative high-threshold, possibly calcium-mediated spike, which activates a recurrent, glutamate-mediated potential responsible for the entrainment of adjacent and remote cortical regions. The bursting activity is controlled by a GABA(B) receptor-mediated inhibitory synaptic potential.

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

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    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.

  9. 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

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    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

  10. Importância da Hemorreologia clínica no estudo do fluxo sanguíneo cerebral em condições normais e na isquemia Cerebrovascular

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    Roberto Melaragno Filho

    1995-03-01

    Full Text Available É apresentada avaliação crítica da importância da hemorreologia no estabelecimento da conduta terapêutica clínica na insuficiência cerebrovascular aguda. Com essa finalidade são revistos aspectos relativos a fluxo sanguíneo cerebral, insuficiência cerebrovascular e hemorreologia clínica. Em função desses aspectos são avaliados alguns dos principais medicamentos utilizados no presente no tratamento do acidente vascular cerebral e são discutidas normas gerais para prevenção e tratamento das isquemias cerebrais.

  11. Medidas do índice de resistência ao Doppler craniano em recém-nascidos pré-termo com lesão da substância branca cerebral Cranial Doppler resistance index measurement in preterm newborns with cerebral white matter lesion

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    Nayara Argollo

    2006-06-01

    Full Text Available OBJETIVO: Investigar se o índice de resistência (IR, nas primeiras 72 horas de vida de neonatos com lesão da substância branca (LSB cerebral, correlaciona-se com evolução desfavorável da LSB. MÉTODOS: Estudo retrospectivo. Identificaram-se os neonatos com LSB pelo laudo da ultra-sonografia craniana e foram selecionados aqueles com estudo do Doppler e medida do IR. Os neonatos foram divididos em três grupos: aqueles com IR baixo ( 0,85. A amostra foi analisada como um todo, e, posteriormente, estratificada por peso de nascimento. RESULTADOS: O fluxo sangüíneo cerebral medido pelo IR foi anormal em 46 (68,7%, sendo que em 42 (62,7% estava baixo, e em quatro (6%, alto. Dentre aqueles com baixo IR, 15 (35,7% tiveram evolução desfavorável, com sinais ultra-sonográficos de atrofia cerebral em 10 (23,8% e hemorragia intraventricular em cinco (11,9%. Os quatro neonatos com alto IR tiveram evolução desfavorável, sendo um (25% com sinais de atrofia cerebral e três (75% com hemorragia intraventricular. Não houve diferenças estatisticamente significantes entre os grupos de IR em relação à evolução para o óbito. CONCLUSÃO: O estudo demonstrou que, entre neonatos com LSB cerebral, o IR alterado nas primeiras 72 horas esteve associado com complicações na evolução dessa lesão. A alteração do IR não se associou à evolução para o óbito. Portanto, a medida do IR é importante parâmetro a ser avaliado em neonatos.OBJECTIVE: To investigate whether the resistance index (RI within the first 72 hours of life of newborn infants with cerebral white matter lesion (WML is correlated with the adverse outcome of WML. METHODS: Retrospective study. Newborn infants with WML were identified based on cranial ultrasound results, and those with Doppler imaging and RI measurement were selected. The newborn infants were placed in three groups: low ( 0.85 RI. The sample was analyzed as a whole at first and then stratified according to birth

  12. Experimental nodel of C6 brain tumors in athymic rats Modelo experimental de tumor cerebral C6 em ratos atímicos

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    Flávio K. Miura

    2008-06-01

    Full Text Available Malignant brain tumor experimental models tend to employ cells that are immunologically compatible with the receptor animal. In this study, we have proposed an experimental model of encephalic tumor development by injecting C6 cells into athymic Rowett rats, aiming at reaching a model which more closely resembles to the human glioma tumor. In our model, we observed micro-infiltration of tumor cell clusters in the vicinity of the main tumor mass, and of more distal isolated tumor cells immersed in normal encephalic parenchyma. This degree of infiltration is superior to that usually observed in other C6 models.Modelos experimentais de tumores cerebrais malignos geralmente utilizam células imunologicamente compatíveis com o animal receptor. Neste estudo apresentamos um modelo experimental baseado na inoculação de células C6 em ratos atímicos Rowett, visando obter um tumor que se assemelhe mais àqueles observados nos seres humanos. Neste modelo observamos microinfiltração de ilhotas de células na periferia da massa tumoral principal e nas áreas mais distantes, células tumorais isoladas no tecido cerebral normal. Este grau de infiltração é superior àquele observado em outros modelos utilizando as células C6.

  13. Cerebral biopsy: comparison between frame-based stereotaxy and neuronavigation in an oncology center Biópsia cerebral: comparação entre estereotaxia com arco e neuronavegação em um centro de oncologia

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    Carlos Augusto Ferreira Lobão

    2009-09-01

    Full Text Available Treatment of intracranial tumoral lesions is related to its correct histological diagnostic. We present a retrospective analysis of 32 patients submitted to 36 cerebral biopsies using neuronavigation and 44 patients using frame-based stereotaxy. Mean age was 46.6 and 49.3 years old respectively. Sex distribution in both groups was 50% for each. Most of lesions were lobar in both groups. Diagnostic yielding was 91.7% and 83.4%, respectively (p=0.26. We found in the postoperative CT scans intracranial hemorrhages in 13.8% cases of the first group and 9.8% cases in the second. Most of them were mild post-operative hemorrages in the biopsy site. There was one death related to the procedure in each group. Astrocytomas and metastatic adenocarcinomas were the most frequent diagnosis. Diagnostic yielding and the number of postoperative hemorrhage and death were similar on both groups and the same found in the literature.O manejo das lesões intracranianas tumorais está relacionado ao seu diagnóstico histológico adequado. Foi realizado estudo retrospectivo com 32 pacientes submetidos a 36 biópsias cerebrais por neuronavegação e 44 pacientes por estereotaxia com arco. A idade média foi 46,6 e 49,3 anos respectivamente. Nos dois grupos a distribuição por sexo foi 50% para cada. A maioria das lesões biopsiadas eram lobares nos dois grupos. A positividade diagnóstica foi 91,7% para neuronavegação e 83,4% para a estereotaxia com arco, respectivamente (p=0,26. Identificou-se hemorragia intracraniana na TC pós-operatória em 13,8% dos casos no primeiro grupo e em 9,8% no segundo, a maioria de pequena monta sem provocar piora neurológica. Ocorreu uma morte relacionada ao procedimento em cada grupo. Os diagnósticos mais freqüentes foram astrocitomas e adenocarcinomas metastáticos. A positividade diagnóstica, taxas de hemorragia pós-operatória e de mortalidade foram equiparáveis estatisticamente entre os dois métodos e se assemelham com as

  14. Relação entre alinhamento postural e desempenho motor em crianças com paralisia cerebral Relationship between postural alignment and motor performance in children with cerebral palsy

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    Andréa Baraldi Cunha

    2009-03-01

    Full Text Available O objetivo deste estudo foi verificar se há correlação entre alinhamento postural e desempenho motor em crianças com paralisia cerebral (PC, além de compará-las com crianças de desenvolvimento motor típico. Participaram 14 crianças com PC tipo espástico, entre 4 e 12 anos, classificadas nos níveis III, IV e V no sistema de classificação de função motora ampla (GMFCS; e 20 com idades entre 4 e 8 anos e desenvolvimento motor adequado, que constituíram o grupo controle. Foi avaliado o alinhamento de lordose cervical e cifose torácica na postura sentada por meio de fotometria; o desempenho motor foi avaliado pelo índice de função motora ampla (Gross motor function measure, GMFM apenas nas dimensões sentar (B e ficar em pé (D. O subgrupo de PC nível III obteve maiores escores no GMFM do que o dos níveis IV e V, com diferença significativa nas dimensões B (p=0,00 e D (p=0,016. Quanto ao alinhamento postural, os dois subgrupos de PC apresentaram menor angulação da lordose cervical do que o GC, com diferença significativa; também foram medidos ângulos menores da cifose torácica nos subgrupos PC, sendo que o subgrupo dos níveis IV e V apresentou diferença significativa tanto em relação ao outro subgrupo PC quanto ao controle. Foi encontrada correlação positiva (r=0,748 entre o desempenho motor e o alinhamento postural nos subgrupos de PC, mostrando que, quanto melhor o alinhamento postural, melhor o desempenho motor dessas crianças.The purpose was to search for a correlation between postural alignment and motor performance of children with cerebral palsy (CP, and to compare them to typical development children. Twenty of these, aged 4 to 8 years old, formed the control group (CG; and 14 children with CP, aged 4 to 12 years old, were divided into two subgroups (level III, and levels IV and V according to their classification by the Gross Motor Function Classification System. Cervical lordosis and thoracic kyphosis

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

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    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.

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

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    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.

  17. ICTAL AND INTERICTAL EEG ABNORMALITIES IN 100 MIGRAINEURS WITH AND WITHOUT AURA

    OpenAIRE

    2007-01-01

    There are several conflicting reports about the EEG of the migraineurs. In this study we report the ictal and interictal EEGs of 100 migraineurs, in comparison with control group. The range age for patient and control groups were 9-48 (mean: 26 ± 1.8) and 10-46 (mean: 23 ± 2.1) years respectively. 32% of the patients were less than 14 years old and the remaining 68% were more than 14 years. In the patient group, 68% of cases had migraine without aura and 32% suffered fro...

  18. 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

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    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

  19. Interictal SPECT in the pre surgical evaluation in epileptic patients with normal MRI or bilateral mesial temporal sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Marques, Lucia H.N. [Hospital de Base, Sao Jose do Rio Preto, SP (Brazil). Dept. de Neurologia. Centro Cirurgico de Epilepsia; Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil); Ferraz-Filho, Jose R.L. [Hospital de Base, Sao Jose do Rio Preto, SP (Brazil); Lins-Filho, Mario L.M. [Hospital de Base, Sao Jose do Rio Preto, SP (Brazil). Dept. de Radiologia; Maciel, Marina G.; Yoshitake, Rafael; Filetti, Sarah V. [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil)

    2009-07-01

    The aim of this study was to evaluate the sensitivity of interictal compared to ictal SPECT in the lateralization of the epileptogenic focus in refractory temporal lobe epilepsy (TLE) patients that present with normal magnetic resonance imaging (MRI) or bilateral mesial temporal sclerosis (MTS). Thirty patients with TLE, for whom MRI examinations were normal or who presented with bilateral MTS, were retrospectively studied. Using a confidence interval of 95% and a level of significance for p-value <0.05, an estimated agreement rate of 73% with a minimum agreement rate of 57% was calculated comparing interictal and ictal SPECTs. In conclusion the interictal SPECT is only useful when associated with the ictal SPECT and does not substitute it in the localization of epileptogenic areas in patients with normal MRI or bilateral MTS. (author)

  20. Stroke caused auditory attention deficits in children Acidente vascular cerebral causa défices da atenção seletiva auditiva em crianças

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    Karla Maria Ibraim da Freiria Elias

    2012-01-01

    Full Text Available OBJECTIVE: To verify the auditory selective attention in children with stroke. METHODS: Dichotic tests of binaural separation (non-verbal and consonant-vowel and binaural integration - digits and Staggered Spondaic Words Test (SSW - were applied in 13 children (7 boys, from 7 to 16 years, with unilateral stroke confirmed by neurological examination and neuroimaging. RESULTS: The attention performance showed significant differences in comparison to the control group in both kinds of tests. In the non-verbal test, identifications the ear opposite the lesion in the free recall stage was diminished and, in the following stages, a difficulty in directing attention was detected. In the consonant- vowel test, a modification in perceptual asymmetry and difficulty in focusing in the attended stages was found. In the digits and SSW tests, ipsilateral, contralateral and bilateral deficits were detected, depending on the characteristics of the lesions and demand of the task. CONCLUSION: Stroke caused auditory attention deficits when dealing with simultaneous sources of auditory information.OBJETIVO: Verificar a habilidade de atenção seletiva em crianças com acidente vascular cerebral (AVC. MÉTODOS: Foram aplicados testes dicóticos de separação (não verbal e consoante-vogal e integração - dígitos e Staggered Spondaic Words Test (SSW - binaural em 13 crianças (7 meninos, entre 7 e 16 anos, com AVC unilateral confirmado por neuroimagem. RESULTADOS: O desempenho atencional diferiu entre os grupos na realização de ambos os tipos de tarefa. Ao teste não verbal, houve menor quantidade de identificações com a orelha contralateral à lesão em atenção livre e dificuldade de focalizar a atenção nas etapas direcionadas. No teste consoante-vogal, houve modificação da assimetria perceptual e dificuldade de focalizar a atenção nas etapas direcionadas. Nos testes de dígitos e SSW, foram constatados défices ipsilaterais, contralaterais e

  1. Avaliação da velocidade do fluxo sangüineo cerebral através da utilização do Doppler transcraniano em crianças e adolescentes com hidrocefalia Transcranial Doppler ultrasonography for evaluation changes in cerebral blood flow in hydrocephalic children

    Directory of Open Access Journals (Sweden)

    Ricardo Santos Oliveira

    2000-01-01

    Full Text Available Este estudo avaliou a hemodinâmica cerebral através da análise da velocidade de fluxo sangüíneo cerebral a partir da utilização do US- color Doppler (ultra-som Doppler com fluxo a cores em crianças e adolescentes com diagnóstico de hidrocefalia e portadores de derivação liquórica ventrículo peritoneal (DVP. Testes de avaliação funcional foram realizados: teste de compressão da fontanela anterior e teste de vasoreatividade ao CO2. Conclui-se que os valores da Dopplervelocimetria encontrados neste estudo, através do acompanhamento em crianças com hidrocefalia e DVP, utilizando-se a técnica do US-Doppler, forneceram informações acerca da hemodinâmica cerebral nesses pacientes e possibilitaram a realização de testes funcionais não invasivos para avaliação da reatividade vascular e a complacência cerebral nesses pacientes.

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

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    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.

  3. Encephalometry on the medial face of the human brain hemisphere: a necropsy study Encefalometria na face medial do hemisfério cerebral humano: estudo em necropsias

    Directory of Open Access Journals (Sweden)

    Paula J. Ribeiro

    2005-06-01

    Full Text Available This study aims to evaluate the dimensions of the human brain, specifically in the frontal cortex, helping the analysis of neuroimaging. A form was made to register and describe encephalic measurements and 81 cerebral hemispheres (CH were analyzed. Male individuals showed larger CH length; wider superior frontal gyrus in the right CH; bigger encephalic weight and corpus callosum (CC width. The proportion of measurement from the frontal pole to the most anterior part of the CC genu, related to the CH length gets smaller with aging, whereas the average distance from the most posterior part of the splenum of the CC to the occipital pole was bigger in both male CHs and there was a tendency of decrease in this difference with aging.Este estudo visa avaliar as dimensões do cérebro humano, particularmente do córtex frontal, podendo colaborar para as análises de neuroimagem. Foi elaborado um formulário para registro e descrição das medidas encefálicas. A amostra foi constituída por 81 hemisférios cerebrais (HC adultos. Os homens apresentaram maior comprimento do HC; giro frontal superior mais largo no HC direito; maior peso encefálico e largura do corpo caloso (CC. A proporção da medida do pólo frontal à parte mais anterior do joelho do CC, em relação ao comprimento do HC diminui com o avanço da idade. Já a da média da distância da parte mais posterior do esplênio do CC ao pólo occipital foi maior em ambos HC dos homens e houve tendência à diminuição desta proporção com o avanço da idade.

  4. Aneurisma de artéria cerebral em criança com síndrome da imunodeficiência adquirida: relato de caso Cerebral arterial aneurysm in a child with acquired immunodeficiency syndrome: case report

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    Arnolfo de Carvalho Neto

    2001-06-01

    Full Text Available A dilatação aneurismática dos vasos do polígono de Willis é manifestação incomum da infecção pelo vírus da imunodeficiência adquirida (HIV, tendo sido relatados, até o momento, 15 casos na literatura. O presente estudo tem por objetivo relatar um novo caso dessa apresentação rara, além de revisar aspectos importantes relacionados à mesma. Um paciente, do sexo masculino, 6 anos de idade, com síndrome da imunodeficiência adquirida (AIDS de transmissão perinatal e tetraparesia, desenvolveu sintomas caracterizados por episódios de crises distônicas. A tomografia computadorizada de crânio, que inicialmente era normal, mostrou dilatação aneurismática dos vasos do polígono de Willis. A revisão de literatura demonstra que os principais achados patológicos em casos similares, são, principalmente, fibrose de camada média com destruição da lâmina interna e hiperplasia da íntima. A etiologia da vasculite não é conhecida, acreditando-se que o vírus da varicela-zoster e o próprio HIV possam estar relacionados à mesma. Conclui-se que, apesar de incomum, tal complicação apresenta grande importância pelo fato dos aneurismas colocarem esses pacientes em grupo de alto risco para acidentes vasculares. A sobrevida relatada na literatura é de menos de 6 meses após o diagnóstico da arteriopatia aneurismática cerebral.Cerebral aneurysmal arteriopathy of the circle of Willis is an uncommon manifestation of acquired human immunodeficiency virus (HIV infection and up to now only 15 cases have been published in the literature. For this reason we add our experience of this rare case, and review the most important aspects related to this entity. The patient is a 6 year old male with perinatal transmitted AIDS, tetraparethic, developed symptoms characterized by episodes of dystonic postures. The computed tomography of the brain showed aneurismal arteriopathy of the circle of Willis. He had a previous normal examination. The review

  5. Synaptic conductances during interictal discharges in pyramidal neurons of rat entorhinal cortex

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    Dmitry V. Amakhin

    2016-10-01

    Full Text Available In epilepsy, the balance of excitation and inhibition underlying the basis of neural network activity shifts, resulting in neuronal network hyperexcitability and recurrent seizure-associated discharges. Mechanisms involved in ictal and interictal events are not fully understood, in particular, because of controversial data regarding the dynamics of excitatory and inhibitory synaptic conductances. In the present study, we estimated AMPAR-, NMDAR-, and GABAAR-mediated conductances during two distinct types of interictal discharge (IID in pyramidal neurons of rat entorhinal cortex in cortico-hippocampal slices. Repetitively emerging seizure-like events and IIDs were recorded in high extracellular potassium, 4-aminopyridine, and reduced magnesium-containing solution. An original procedure for estimating synaptic conductance during IIDs was based on the differences among the current-voltage characteristics of the synaptic components. The synaptic conductance dynamics obtained revealed that the first type of IID is determined by activity of GABAAR channels with depolarized reversal potential. The second type of IID is determined by the interplay between excitation and inhibition, with prominent early AMPAR and prolonged depolarized GABAAR and NMDAR-mediated components. The study then validated the contribution of these components to IIDs by intracellular pharmacological isolation. These data provide new insights into the mechanisms of seizures generation, development, and cessation.

  6. Cannabinoid antagonist SLV326 induces convulsive seizures and changes in the interictal EEG in rats

    Science.gov (United States)

    de Bruin, Natasja; Heijink, Liesbeth; Kruse, Chris; Vinogradova, Lyudmila; Lüttjohann, Annika; van Luijtelaar, Gilles; van Rijn, Clementina M.

    2017-01-01

    Cannabinoid CB1 antagonists have been investigated for possible treatment of e.g. obesity-related disorders. However, clinical application was halted due to their symptoms of anxiety and depression. In addition to these adverse effects, we have shown earlier that chronic treatment with the CB1 antagonist rimonabant may induce EEG-confirmed convulsive seizures. In a regulatory repeat-dose toxicity study violent episodes of “muscle spasms” were observed in Wistar rats, daily dosed with the CB1 receptor antagonist SLV326 during 5 months. The aim of the present follow-up study was to investigate whether these violent movements were of an epileptic origin. In selected SLV326-treated and control animals, EEG and behavior were monitored for 24 hours. 25% of SLV326 treated animals showed 1 to 21 EEG-confirmed generalized convulsive seizures, whereas controls were seizure-free. The behavioral seizures were typical for a limbic origin. Moreover, interictal spikes were found in 38% of treated animals. The frequency spectrum of the interictal EEG of the treated rats showed a lower theta peak frequency, as well as lower gamma power compared to the controls. These frequency changes were state-dependent: they were only found during high locomotor activity. It is concluded that long term blockade of the endogenous cannabinoid system can provoke limbic seizures in otherwise healthy rats. Additionally, SLV326 alters the frequency spectrum of the EEG when rats are highly active, suggesting effects on complex behavior and cognition. PMID:28151935

  7. Spatiotemporal Mapping of Interictal Spike Propagation: A Novel Methodology Applied to Pediatric Intracranial EEG Recordings.

    Science.gov (United States)

    Tomlinson, Samuel B; Bermudez, Camilo; Conley, Chiara; Brown, Merritt W; Porter, Brenda E; Marsh, Eric D

    2016-01-01

    Synchronized cortical activity is implicated in both normative cognitive functioning and many neurologic disorders. For epilepsy patients with intractable seizures, irregular synchronization within the epileptogenic zone (EZ) is believed to provide the network substrate through which seizures initiate and propagate. Mapping the EZ prior to epilepsy surgery is critical for detecting seizure networks in order to achieve postsurgical seizure control. However, automated techniques for characterizing epileptic networks have yet to gain traction in the clinical setting. Recent advances in signal processing and spike detection have made it possible to examine the spatiotemporal propagation of interictal spike discharges across the epileptic cortex. In this study, we present a novel methodology for detecting, extracting, and visualizing spike propagation and demonstrate its potential utility as a biomarker for the EZ. Eighteen presurgical intracranial EEG recordings were obtained from pediatric patients ultimately experiencing favorable (i.e., seizure-free, n = 9) or unfavorable (i.e., seizure-persistent, n = 9) surgical outcomes. Novel algorithms were applied to extract multichannel spike discharges and visualize their spatiotemporal propagation. Quantitative analysis of spike propagation was performed using trajectory clustering and spatial autocorrelation techniques. Comparison of interictal propagation patterns revealed an increase in trajectory organization (i.e., spatial autocorrelation) among Sz-Free patients compared with Sz-Persist patients. The pathophysiological basis and clinical implications of these findings are considered.

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

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    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.

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

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    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.

  10. 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

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    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

  11. Ataque cerebral

    OpenAIRE

    Takeuchi Tan, Yuri; Fundación Valle de Lili

    1998-01-01

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

  12. Transcranial doppler in sickle cell anaemia: evaluation of brain blood flow parameters in children of Aracaju, Northeast - Brazil Doppler transcraniano em portadores de anemia falciforme: estudo dos parâmetros de fluxo sangüíneo cerebral em crianças de Aracaju, Sergipe

    Directory of Open Access Journals (Sweden)

    Hyder Aragão de Melo

    2008-06-01

    Full Text Available BACKGROUND: Environmental factors interfere on sickle cell anaemia (SCA. Transcanial Doppler (TCD is important to evaluate cerebrovascular disease. OBJECTIVE: To evaluate brain haemodynamic profile of children with SCA in Sergipe. METHODS: Cross sectional study (group1: SCA patients aged 3-18; group2: age and sex matched healthy individuals. Baseline brain flow was evaluated. RESULTS: Group1=34 patients; group 2=81 controls. SCA patients had mean velocity (MV=125.69 cm/s±23.40; pulsatility index (PI=0.66±0.10; middle cerebral artery ratio (MCAr=14.53±15.23; right anterior cerebral artery/right middle cerebral artery=0.77±0.20; left anterior cerebral artery/left middle cerebral artery=0.78±0.20. Controls had MV=79.44±15.54; PI=0.82±0.11; MCAr=13.19±13.77; right anterior cerebral artery/right middle cerebral artery=0.80±0.16; left anterior cerebral artery/left middle cerebral artery=0.84±0.18. MV and PI differences were statistically significant between groups. MV was related to age but not to gender. CONCLUSION: MV evaluation using TCD was similar to international standards and possible to be used in our setting.INTRODUÇÃO: Aspectos ambientais interferem na apresentação da anemia falciforme (AF. Doppler transcraniano (DTC é útil na avaliação do risco para doença cerebrovascular em pacientes com AF. OBJETIVO: Avaliar o perfil hemodinâmico cerebral de crianças com AF em Sergipe. MÉTODO: Estudo transversal (grupo1: portadores de AF 3-18 anos; grupo2: indivíduos saudáveis, pareados por idade e gênero. Foram avaliadas medidas de fluxo sangüíneo cerebral basal. RESULTADOS: Grupo1 (n=34: velocidade média (Vm=125,69 cm/s ±23,40; índice de pulsatilidade (Ip=0,66±0,10; relação entre artéria cerebral média (ACMs=14,53±15,23; artéria cerebral anterior (ACA/ACM direita=0,77±0,20; ACA/ACM esquerda=0,78±0,20. Grupo 2 (n=81: Vm=79,44 cm/s ±15,54; Ip=0,82±0,11, relação entre ACMs=13,19±13,77, ACA/ACM direita=0,80±0

  13. Ictal propagation of high frequency activity is recapitulated in interictal recordings: effective connectivity of epileptogenic networks recorded with intracranial EEG.

    Science.gov (United States)

    Korzeniewska, A; Cervenka, M C; Jouny, C C; Perilla, J R; Harezlak, J; Bergey, G K; Franaszczuk, P J; Crone, N E

    2014-11-01

    Seizures are increasingly understood to arise from epileptogenic networks across which ictal activity is propagated and sustained. In patients undergoing invasive monitoring for epilepsy surgery, high frequency oscillations have been observed within the seizure onset zone during both ictal and interictal intervals. We hypothesized that the patterns by which high frequency activity is propagated would help elucidate epileptogenic networks and thereby identify network nodes relevant for surgical planning. Intracranial EEG recordings were analyzed with a multivariate autoregressive modeling technique (short-time direct directed transfer function--SdDTF), based on the concept of Granger causality, to estimate the directionality and intensity of propagation of high frequency activity (70-175 Hz) during ictal and interictal recordings. These analyses revealed prominent divergence and convergence of high frequency activity propagation at sites identified by epileptologists as part of the ictal onset zone. In contrast, relatively little propagation of this activity was observed among the other analyzed sites. This pattern was observed in both subdural and depth electrode recordings of patients with focal ictal onset, but not in patients with a widely distributed ictal onset. In patients with focal ictal onsets, the patterns of propagation recorded during pre-ictal (up to 5 min immediately preceding ictal onset) and interictal (more than 24h before and after seizures) intervals were very similar to those recorded during seizures. The ability to characterize epileptogenic networks from interictal recordings could have important clinical implications for epilepsy surgery planning by reducing the need for prolonged invasive monitoring to record spontaneous seizures.

  14. A review of the new minimally invasive brain stimulation techniques in psychiatry Revisão de novas técnicas minimamente invasivas de estimulação cerebral em psiquiatria

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    Jeong-Ho Chae

    2001-06-01

    Full Text Available New knowledge about the specific brain regions involved in neuropsychiatric disorders is rapidly evolving due to recent advances in functional neuroimaging techniques. The ability to stimulate the brain in awake alert adults without neurosurgery is a real advance that neuroscientists have long dreamed for. Several novel and minimally invasive techniques to stimulate the brain have recently developed. Among these newer somatic interventions, transcranial magnetic stimulation (TMS, vagus nerve stimulation (VNS and deep brain stimulation (DBS show promise as therapeutic tools in the treatment of neuropsychiatric disorders. This article reviews the history, methodology, and the future of these minimally invasive brain stimulation (MIBS techniques and their emerging research and therapeutic applications in psychiatryO conhecimento acerca de regiões específicas do cérebro envolvidas em transtornos psiquiátricos está em franca expansão como resultado dos avanços recentes em técnicas de neuroimagem funcional. A capacidade de estimular o cérebro em adultos despertos em estado de alerta, sem necessidade de neurocirurgia, é um avanço real sonhado havia muito pelos neurocientistas. Recentemente, desenvolveram-se várias novas técnicas minimamente invasivas para estimular o cérebro. Entre essas novas intervenções somáticas, a estimulação transcraniana magnética (ETM, a estimulação do nervo vago (ENV e a estimulação cerebral profunda (ECP revelam-se promissoras ferramentas terapêuticas no tratamento de transtornos neuropsiquiátricos. Neste artigo se faz uma revisão da história, da metodologia e das perspectivas futuras das técnicas minimamente invasivas de estimulação cerebral (ECMI e das pesquisas e aplicações terapêuticas em psiquiatria

  15. Traqueostomia precoce versus traqueostomia tardia em pacientes com lesão cerebral aguda grave Early versus late tracheostomy in patients with acute severe brain injury

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    Bruno do Valle Pinheiro

    2010-02-01

    Full Text Available OBJETIVO: Comparar os efeitos da traqueostomia precoce e da traqueostomia tardia em pacientes com lesão cerebral aguda grave. MÉTODOS: Estudo retrospectivo com 28 pacientes admitidos na UTI do Hospital Universitário da Universidade Federal de Juiz de Fora com diagnóstico de lesão cerebral aguda grave e apresentando escore na escala de coma de Glasgow (ECG OBJECTIVE: To compare the effects of early tracheostomy and of late tracheostomy in patients with acute severe brain injury. METHODS: A retrospective study involving 28 patients admitted to the ICU of the Federal University of Juiz de Fora University Hospital in Juiz de Fora, Brazil, diagnosed with acute severe brain injury and presenting with a Glasgow coma scale (GCS score < 8 within the first 48 h of hospitalization. The patients were divided into two groups: early tracheostomy (ET, performed within the first 8 days after admission; and late tracheostomy (LT, performed after postadmission day 8. At admission, we collected demographic data and determined the following scores: Acute Physiology and Chronic Health Evaluation (APACHE II, GCS and Sequential Organ Failure Assessment (SOFA. RESULTS: There were no significant differences between the groups (ET vs. LT regarding the demographic data or the scores: APACHE II (26 ± 6 vs. 28 ± 8; p = 0.37, SOFA (6.3 ± 2.7 vs. 7.2 ± 3.0; p = 0.43 and GCS (5.4 ± 1.7 vs. 5.5 ± 1.7; p = 0.87. The 28-day mortality rate was lower in the ET group (9% vs. 47%; p = 0.04. Nosocomial pneumonia occurring within the first 7 days was less common in the ET group, although the difference was not significant (0% vs. 23%; p = 0.13. There were no differences regarding the occurrence of late pneumonia or in the duration of mechanical ventilation between the groups. CONCLUSIONS: On the basis of these findings, early tracheostomy should be considered in patients with acute severe brain injury.

  16. What graph theory actually tells us about resting state interictal MEG epileptic activity.

    Science.gov (United States)

    Niso, Guiomar; Carrasco, Sira; Gudín, María; Maestú, Fernando; Del-Pozo, Francisco; Pereda, Ernesto

    2015-01-01

    Graph theory provides a useful framework to study functional brain networks from neuroimaging data. In epilepsy research, recent findings suggest that it offers unique insight into the fingerprints of this pathology on brain dynamics. Most studies hitherto have focused on seizure activity during focal epilepsy, but less is known about functional epileptic brain networks during interictal activity in frontal focal and generalized epilepsy. Besides, it is not clear yet which measures are most suitable to characterize these networks. To address these issues, we recorded magnetoencephalographic (MEG) data using two orthogonal planar gradiometers from 45 subjects from three groups (15 healthy controls (7 males, 24 ± 6 years), 15 frontal focal (8 male, 32 ± 16 years) and 15 generalized epileptic (6 male, 27 ± 7 years) patients) during interictal resting state with closed eyes. Then, we estimated the total and relative spectral power of the largest principal component of the gradiometers, and the degree of phase synchronization between each sensor site in the frequency range [0.5-40 Hz]. We further calculated a comprehensive battery of 15 graph-theoretic measures and used the affinity propagation clustering algorithm to elucidate the minimum set of them that fully describe these functional brain networks. The results show that differences in spectral power between the control and the other two groups have a distinctive pattern: generalized epilepsy presents higher total power for all frequencies except the alpha band over a widespread set of sensors; frontal focal epilepsy shows higher relative power in the beta band bilaterally in the fronto-central sensors. Moreover, all network indices can be clustered into three groups, whose exemplars are the global network efficiency, the eccentricity and the synchronizability. Again, the patterns of differences were clear: the brain network of the generalized epilepsy patients presented greater efficiency and lower

  17. What graph theory actually tells us about resting state interictal MEG epileptic activity

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    Guiomar Niso

    2015-01-01

    Full Text Available Graph theory provides a useful framework to study functional brain networks from neuroimaging data. In epilepsy research, recent findings suggest that it offers unique insight into the fingerprints of this pathology on brain dynamics. Most studies hitherto have focused on seizure activity during focal epilepsy, but less is known about functional epileptic brain networks during interictal activity in frontal focal and generalized epilepsy. Besides, it is not clear yet which measures are most suitable to characterize these networks. To address these issues, we recorded magnetoencephalographic (MEG data using two orthogonal planar gradiometers from 45 subjects from three groups (15 healthy controls (7 males, 24 ± 6 years, 15 frontal focal (8 male, 32 ± 16 years and 15 generalized epileptic (6 male, 27 ± 7 years patients during interictal resting state with closed eyes. Then, we estimated the total and relative spectral power of the largest principal component of the gradiometers, and the degree of phase synchronization between each sensor site in the frequency range [0.5–40 Hz]. We further calculated a comprehensive battery of 15 graph-theoretic measures and used the affinity propagation clustering algorithm to elucidate the minimum set of them that fully describe these functional brain networks. The results show that differences in spectral power between the control and the other two groups have a distinctive pattern: generalized epilepsy presents higher total power for all frequencies except the alpha band over a widespread set of sensors; frontal focal epilepsy shows higher relative power in the beta band bilaterally in the fronto-central sensors. Moreover, all network indices can be clustered into three groups, whose exemplars are the global network efficiency, the eccentricity and the synchronizability. Again, the patterns of differences were clear: the brain network of the generalized epilepsy patients presented greater

  18. Análise das barreiras à utilização de trombolíticos em casos de acidente vascular cerebral isquêmico em um hospital privado do Rio de Janeiro, Brasil

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    Luiz Henrique de Oliveira Fonseca

    2013-12-01

    Full Text Available O acidente vascular cerebral isquêmico (AVCi é uma importante causa de sequela e morte. A correta utilização do trombolítico enfrenta várias barreiras. O objetivo foi discutir as barreiras à terapia trombolítica em pacientes que chegam, com sintomas de AVCi agudo, à emergência de um hospital privado do Rio de Janeiro, Brasil. Coorte retrospectiva de pacientes entre 2009 e 2011. Foram admitidos 257 pacientes com suspeita de AVCi. Dos pacientes com diagnóstico confirmado (156, 11,5% (18 foram trombolisados. Dos 30 pacientes com diagnóstico de AVCi, dentro da janela terapêutica e com NIHSS na faixa para trombólise, 20 não foram trombolisados, 9 por barreiras administrativas (45%. Neste trabalho o percentual de trombólise foi superior ao observado nos Estados Unidos, mas barreiras impediram o tratamento de 45% dos pacientes com indicação à trombólise. Imagina-se que na rede pública brasileira a situação seja ainda mais desfavorável.

  19. Comparison and spacial correlation of interictal HMPAO-SPECT and FDG-PET in intractable temporal lobe epilepsy.

    Science.gov (United States)

    Coubes, P; Awad, I A; Antar, M; Magdinec, M; Sufka, B

    1993-06-01

    The respective contribution of interictal HMPAO-SPECT and FDG-PET to the imaging of the epileptogenic zone in intractable temporal lobe epilepsy is not known. Ten consecutive patients with drug resistant focal epilepsy of temporal lobe origin were studied with prolonged noninvasive video-EEG monitoring, magnetic resonance imaging, interictal FDG-PET and HMPAO-SPECT. Five patients demonstrated unitemporal and 5 patients bitemporal interictal and/or ictal EEG epileptiform abnormalities. We developed a 3-dimensional semiquantitative method for interpretation and comparison of FDG-PET and HMPAO-SPECT using a 15-compartment model of the temporal lobe. In all 5 patients with unilateral epileptogenicity, interictal hypometabolism and hypoperfusion were recorded on the side of the EEG abnormalities without discrepancy between PET and SPECT. The severity and the extent of focal abnormalities were consistently greater on PET than on SPECT, in agreement with previously well documented better 'sensitivity' of PET. Among the 5 patients with bitemporal epileptogenicity, results of SPECT and PET were convergent in only 2 cases. In this group, SPECT abnormalities appeared more profound but either SPECT or PET were not constantly correlated with the side of predominant EEG epileptogenicity. Abnormalities on PET and SPECT were more frequently limited to mesiobasal structures among cases with unilateral epileptogenicity and tended to involve neocortical structures in bitemporal cases. We conclude that interictal FDG-PET and HMPAO-SPECT provide the same type of information on the side of the epileptogenic zone in cases with clearly unilateral epileptogenicity, with abnormalities more intense and more extensive on PET.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. 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 ...

  1. 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.

  2. EFFECT OF SPIRAPRIL ON THE LENGTH OF INTERICTAL INTERVAL IN PAROXYSMAL ATRIAL FIBRILLATION

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    L. N. Chikhireva

    2015-12-01

    Full Text Available Aim. To evaluate effects of angiotensin converting enzyme inhibitor spirapril on efficacy of preventive antiarrhythmic therapy in patients with paroxysmal atrial fibrillation (AF.Material and methods. 40 patients with paroxysmal AF were involved in open-label, cross-over study with periods of antiarrhythmic drug withdrawal. During 3 months all patients received by turns two types of therapy: combination of preventive antiarrhythmic therapy with spirapril 6 mg once daily - (CT group or preventive antiarrhythmic therapy only (AT group.Results. AF-free intervals to the first and the second AF paroxysms during antiarrhythmic drug withdrawal were comparable in AT and CT groups (p=0,4 and p=0,6, respectively, logrank test.Conclusion. Spirapril added to the basic preventive antiarrhythmic therapy during 3 months had no effect on the length of interictal period in paroxysmal AF.

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

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    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

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

    Science.gov (United States)

    Wu, Jie; Gao, Ming; Rice, Stephen G; Tsang, Candy; Beggs, John; Turner, Dharshaun; Li, Guohui; Yang, Bo; Xia, Kunkun; Gao, Fenfei; Qiu, Shenfeng; Liu, Qiang; Kerrigan, John F

    2016-06-01

    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.

  5. Interictal neurocognitive processing of visual stimuli in migraine: evidence from event-related potentials.

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    Marla J S Mickleborough

    Full Text Available Research has established decreased sensory habituation as a defining feature in migraine, while decreased cognitive habituation has only been found with regard to cognitive assessment of the relative probability of the occurrence of a stimulus event. Our study extended the investigation of interictal habituation in migraine to include cognitive processing when viewing of a series of visually-complex images, similar to those we encounter on the internet everyday. We examined interictal neurocognitive function in migraine from a habituation perspective, using a novel paradigm designed to assess how the response to a series of images changes over time. Two groups of participants--migraineurs (N = 25 and non-migraine controls (N = 25--were asked to view a set of 232 unfamiliar logos in the context of a target identification task as their brain electrical responses were recorded via event-related potentials (ERPs. The set of logos was viewed serially in each of 10 separate trial blocks, with data analysis focusing on how the ERP responses to the logos in frontal electrodes from 200-600 ms changed across time within each group. For the controls, we found that the amplitude of the late positive potential (LPP ERP component elicited by the logos had no significant change across trial blocks. In contrast, in migraineurs we found that the LPP significantly increased in amplitude across trial blocks, an effect consistent with a lack of habituation to visual stimuli seen in previous research. Our findings provide empirical support abnormal cognitive processing of complex visual images across time in migraineurs that goes beyond the sensory-level habituation found in previous research.

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

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    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

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

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    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.

  8. Cerebral malaria Malaria cerebral

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    Silvia Blair Trujillo

    2003-03-01

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

  9. Evaluation of the "spasticity of conjugate gaze phenomenon" in unilateral cerebral lesions Avaliação do "fenômeno do desvio conjugado espástico ocular" em lesões cerebrais unilaterais

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    Eliana Teixeira Maranhão

    2007-06-01

    Full Text Available The spasticity of conjugate gaze phenomenon (SCG is a subtle motor ocular sign that usually indicates unilateral acute cerebral lesion. We analyzed the sensitivity of this sign in a prospective blinded study using 57 patients. All patients had monohemispheric brain lesions without resting deviation of the eyes and no motor complaints. Fourteen individuals without cerebral lesions were included as controls. Patients and controls were submitted to a brain magnetic resonance image. We observed SCG in just 1/57 (sensitivity of 1.7%, while all controls had a normal Bell's phenomenon. We speculate that SCG may disappear over time and is not useful to diagnose a long-lasting unilateral brain lesion.O fenômeno do "desvio conjugado espástico ocular" é um sinal motor ocular sutil que habitualmente indica lesões cerebrais mono-hemisféricas agudas. Avaliamos a sensibilidade deste sinal num estudo prospectivo cego em 57 pacientes. Todos os pacientes apresentavam lesões cerebrais mono-hemisféricas, ausência de queixas motoras ou de desvio conjugado dos olhos em repouso. Quatorze indivíduos sem lesão cerebral foram incluídos como controle. Pacientes e indivíduos controle foram submetidos a exame de ressonância magnética do crânio. Observamos o sinal do desvio conjugado espástico ocular em somente 1/57 pacientes (sensibilidade 1,7%, enquanto todos os controles apresentaram o fenômeno de Bell. Especulamos que este sinal desaparece com o tempo, e que o mesmo não é útil para o diagnóstico de pacientes com lesões cerebrais monohemisféricas de longa duração.

  10. Avaliação dos níveis de hiper-homocisteinemia, vitamina E, selênio, cobre, ceruloplasmina e ferritina em pacientes com diagnóstico de acidente vascular cerebral isquêmico

    OpenAIRE

    Harboe-Gonçalves,Lillian; Vaz,Luiz Sérgio; Marcelo,Buzzi

    2007-01-01

    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 acopla...

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

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    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

  12. 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

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    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

  13. 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.

  14. Avaliação clínica e videofluoroscópica da deglutição em crianças com paralisia cerebral tetraparética espástica

    OpenAIRE

    2003-01-01

    A paralisia cerebral é doença que pode cursar com distúrbios da deglutição (disfagias orofaríngeas). O objetivo deste artigo foi caracterizar e comparar a deglutição em 32 crianças com esta doença, pela avaliação clínica fonoaudiológica e videofluoroscópica, com ênfase na aspiração traqueal, Os resultados mostraram importante comprometimento da fase oral. Na fase faríngea a aspiração, a incompetência velofaríngea e o resíduo em recessos faríngeos, foram os achados mais encontrados. A aspiraçã...

  15. ValidaÃÃo dos resultados de enfermagem estado de deglutiÃÃo e prevenÃÃo da aspiraÃÃo em pacientes apÃs acidente vascular cerebral.

    OpenAIRE

    Ana Railka de Souza Oliveira

    2013-01-01

    Teve-se como proposta construir e validar as definiÃÃes conceituais e os referentes empÃricos dos Resultados de Enfermagem (RE) relacionados ao Estado da deglutiÃÃo e à PrevenÃÃo da aspiraÃÃo em pacientes apÃs acidente vascular cerebral (AVC). Estudo metodolÃgico, realizado em trÃs etapas: anÃlise de conceito, validaÃÃo por especialistas e validaÃÃo clÃnica. Para a AnÃlise de Conceito, realizou-se RevisÃo Integrativa, com acesso on-line a seis bases de dados: Pubmed, Cinahl, Scopus, EMBASE, W...

  16. 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

  17. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seok Ki; Lee, Dong Soo; Yeo, Jeong Seok; Lee, Sang Kun; Kim, Joo Yong; Jeong, Jae Min; Chung, June Key; Lee, Myung Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    1999-02-01

    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.

  19. 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

  20. Imaging diagnosis and clinical findings of cerebral venous thrombosis in full-term neonates without brain damage: a ten-year review;Diagnostico por imagem e aspectos clinicos da trombose venosa cerebral em recem-natos a termo sem dano cerebral: revisao em 10 anos

    Energy Technology Data Exchange (ETDEWEB)

    Monteiro, Alexandra Maria Vieira, E-mail: cmaol@br.inter.ne, E-mail: cmaolima@gmail.co [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Faculdade de Ciencias Medicas; Lima, Claudio Marcio Amaral de Oliveira [Fatima Digital, Nova Iguacu, RJ (Brazil). Centro de Diagnostico por Imagem; Ribeiro, Erica Barreiros [Hospital Sao Jose, Criciuma, SC (Brazil). Servico de Ressonancia Magnetica; Lins, Maria Cristina; Miranda, Silvia; Miranda, Luis Eduardo [Casa de Saude Sao Jose (CSSJ), Rio de Janeiro, RJ (Brazil). Unidade de Terapia Intensiva Neonatal

    2010-05-15

    Objective: to describe and compare imaging methods and clinical findings of cerebral venous thrombosis in four full-term neonates without brain damage, admitted to a neonatal intensive care unit. Materials and methods: ten-year review of four cases diagnosed with cerebral venous thrombosis by transfontanellar ultrasonography associated with Doppler fluxometry and confirmed by magnetic resonance imaging/magnetic resonance angiography in correlation with clinical findings and neurological progression. Results: ultrasonography presented normal results in 75% of cases and magnetic resonance imaging in 100%. Doppler fluxometry and magnetic resonance angiography were abnormal in 100% of cases. Hypoxia (100%) and early seizures (100%) were predominant among clinical findings with evoked potential changes in 50% of cases. In the assessment of the neuro development all the areas remained within normality parameters up to the conclusion of the present study. Conclusion: ultrasonography in association with Doppler can identify changes related to cerebral venous thrombosis and should be complemented with magnetic resonance imaging that is the gold standard for diagnosis in these cases. (author)

  1. An interictal schizophrenia-like psychosis in an adult patient with 22q11.2 deletion syndrome

    Directory of Open Access Journals (Sweden)

    Yasutaka Tastuzawa

    2015-01-01

    Full Text Available In addition to causing polymalformative syndrome, 22q11.2 deletion can lead to various neuropsychiatric disorders including mental retardation, psychosis, and epilepsy. However, few reports regarding epilepsy-related psychosis in 22q11.2 deletion syndrome (22q11.2DS exist. We describe the clinical characteristics and course of 22q11.2DS in a Japanese patient with comorbid mild mental retardation, childhood-onset localization-related epilepsy, and adult-onset, interictal schizophrenia-like psychosis. From a diagnostic viewpoint, early detection of impaired intellectual functioning and hyperprolinemia in patients with epilepsy with 22q11.2DS may be helpful in predicting the developmental timing of interictal psychosis. From a therapeutic viewpoint, special attention needs to be paid to phenytoin-induced hypocalcemia in this syndrome.

  2. Avaliação clínica e videofluoroscópica da deglutição em crianças com paralisia cerebral tetraparética espástica Clinical and videofluoroscopic evaluation of deglutition in children with tetraparetic spastic cerebral palsy

    OpenAIRE

    2003-01-01

    A paralisia cerebral é doença que pode cursar com distúrbios da deglutição (disfagias orofaríngeas). O objetivo deste artigo foi caracterizar e comparar a deglutição em 32 crianças com esta doença, pela avaliação clínica fonoaudiológica e videofluoroscópica, com ênfase na aspiração traqueal, Os resultados mostraram importante comprometimento da fase oral. Na fase faríngea a aspiração, a incompetência velofaríngea e o resíduo em recessos faríngeos, foram os achados mais encontrados. A aspiraçã...

  3. Interictal SPECT of rCBF is of clinical utility in the preoperative evaluation of patients with partial epilepsy

    DEFF Research Database (Denmark)

    Andersen, A.R.; Hansen, B.A.; Hogenhaven, H;

    1996-01-01

    Fifty-eight patients with drug-resistant partial epilepsy were studied preoperatively by interictal rCBF measurements using 99mTc-HMPAO and a dedicated brain SPECT camera (Tomomatic 64). Follow-up of seizure outcome, using the 'Engel score', was at least 3 years. The data were analyzed in a blind...... patients ictal SPECT of rCBF was additionally performed. In 2 cases it added further information to the patient evaluation...

  4. Interictal SPECT of rCBF is of clinical utility in the preoperative evaluation of patients with partial epilepsy

    DEFF Research Database (Denmark)

    Andersen, A R; Hansen, B A; Høgenhaven, H;

    1996-01-01

    Fifty-eight patients with drug-resistant partial epilepsy were studied preoperatively by interictal rCBF measurements using 99mTc-HMPAO and a dedicated brain SPECT camera (Tomomatic 64). Follow-up of seizure outcome, using the "Engel score", was at least 3 years. The data were analyzed in a blind...... patients ictal SPECT of rCBF was additionally performed. In 2 cases it added further information to the patient evaluation....

  5. 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.)

  6. 3D source localization of interictal spikes in epilepsy patients with MRI lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ding Lei [Department of Biomedical Engineering, University of Minnesota, 7-105 BSBE, 312 Church Street, Minneapolis, MN 55455 (United States); Worrell, Gregory A [Department of Neurology, Mayo Clinic, Rochester, MN (United States); Lagerlund, Terrence D [Department of Neurology, Mayo Clinic, Rochester, MN (United States); He Bin [Department of Biomedical Engineering, University of Minnesota, 7-105 BSBE, 312 Church Street, Minneapolis, MN 55455 (United States)

    2006-08-21

    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 R{sup 2} 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 R{sup 2} values achieved by FINE

  7. Evaluation of the neuroprotective effect of ketoprofen on rats submitted to permanent focal brain ischemia Avaliação do efeito neuroprotetor do cetoprofeno em ratos submetidos à isquemia cerebral focal permanente

    Directory of Open Access Journals (Sweden)

    Manoel Nunes da Silva

    2007-12-01

    Full Text Available OBJECTIVE: To study the neurobehavioral, biochemical and histopathological consequences of permanent focal brain ischemia, and the putative neuroprotective action of ketoprofen. METHOD: One-hundred-and-three Wistar rats divided into groups A and B were respectively submitted to 48 hours and 15 days of ischemia. Each group was divided into 4 subgroups: ischemic not treated, ischemic treated, sham not treated, and sham treated. Ischemic animals had the left middle cerebral artery coagulated. Ketoprofen was administered to treated subgroups 15 minutes before arterial coagulation (manipulation in the sham group. RESULTS: Exploratory activity and defecation were reduced in all ischemic animals in the first postoperative days and constant histopathological changes were observed in each group. The total brain glutamate levels were higher in treated animals 48 hours after surgery. CONCLUSION: No clear parallelism among behavioral, biochemical and histopathological findings was observed. Ketoprofen demonstrated no neuroprotective effect on the behavioral or histopathological aspects of focal permanent brain ischemia.OBJETIVO: Estudar as conseqüências comportamentais, bioquímicas e histopatológicas da isquemia cerebral focal permanente e o possível efeito neuroprotetor do cetoprofeno. MÉTODO: Foram utilizados 103 ratos Wistar, divididos em grupos A e B, submetidos, respectivamente, a 48 horas e a 15 dias de isquemia. Cada grupo foi dividido em 4 subgrupos: isquêmico não tratado; isquêmico tratado; sham não tratado; sham tratado. Nos animais isquêmicos foi coagulada a artéria cerebral média esquerda. Os subgrupos tratados receberam cetoprofeno 15 minutos antes da oclusão ou manipulação arterial. RESULTADOS: Os animais isquêmicos reduziram a atividade exploratória e as evacuações nos primeiros dias pós-operatórios e mostraram alterações histopatológicas constantes em cada grupo. As concentrações do glutamato total 48 horas após a

  8. 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

  9. 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

  10. Disfunção intestinal em pacientes com lesão cerebral decorrente de acidente vascular cerebral e traumatismo craniencefálico: estudo retrospectivo de uma série de casos

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    Cinthia Carlos Dourado

    2012-01-01

    Full Text Available La disfunción del intestino es una queja común entre los pacientes con daño cerebral debido a una lesión cerebral traumática y accidente cerebrovascular. Este estudio tuvo como objetivo investigar la prevalencia de disfunción del intestino (incontinencia y constipación en pacientes con daño cerebral debido a una lesión cerebral traumática y accidente cerebrovascular admitidos para la rehabilitación. Este es un estudio retrospectivo de una serie de casos a partir del análisis de los datos de 138 expedientes de los pacientes ingresados en el primer semestre de 2009. La prevalencia de disfunción del intestino fue de 41%, siendo 33 (24% incontinencia anal y 37 (27%, constipación. El comprometimiento motor, ayuda a la movilidad, cambios en la memoria y la comunicación se asocian con la presencia de la incontinencia anal. La prevalencia de disfunción del intestino es alta en esta población, identificar en forma temprana los factores relacionados, y promover el reentrenamiento intestinal pueden ayudar a mejorar la calidad de sus vidas.

  11. DIAGNOSTIC VALUE OF INTERICTAL DIFFUSION-WEIGHTED IMAGING IN EVALUATION OF INTRACTABLE TEMPORAL LOBE EPILEPSY

    Institute of Scientific and Technical Information of China (English)

    Rui Wang; Saying-Li; Min Chen; Cheng Zhou

    2008-01-01

    Objective To explore the ability of interictal diffusion-weighted imaging (DWI) to localize the temporal lobe of seizure origin and to predict postoperative seizure control in patients with temporal lobe epilepsy (TLE).Methods Twenty-seven patients with intractable TLE considered for surgery and 19 healthy volunteers were studied with conventional magnetic resonance imaging (MRI) and DWL Apparent diffusion coefficients (ADCs) of bilateral hippocampi in both TLE patients and control subjects were obtained. Lateralization to either temporal lobe with hippoeampal ADC was based on the threshold values derived from ± 1 SD of fight/left ratios in normal subjects. And the postoperative pathology was reviewed.Results Hippocampal ADCs were higher on the side of surgery compared with those on the contralateral side as well as the ipsilateral side in control subjects [ resected side ( 109. 8±7.3 ) × 10-5 cm2/s, contralateral side (91.7±4. 7) × 10-5 cm2/s, control subjects (81.6±5.2) × 10-5 cm2/s, all P 0.05 ).Conclusions Conventional MRI is a sensitive method to detect hippocampal sclerosis. Accuracy of the right/left hip-pocampal ADC ratio for lateralizing to the side of surgery is very high, but it isn't a better predictor of surgical outcome.

  12. Sistematização da origem, da distribuição e dos territórios da artéria cerebral caudal na superfície do encéfalo em gatos Systematization of the origin, distribution and territory of the caudal cerebral artery on the surface of the encephalon in cats

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    Eduardo Maurício Mendes de Lima

    2010-09-01

    Full Text Available Foram estudados 26 encéfalos de gatos, adultos, sem diferenciação de sexo, sem raça definida, corados com látex e fixados por solução aquosa de formaldeído. As artérias cerebrais caudais, direita e esquerda, apresentaram-se únicas em 96,1 e 88,4% dos casos, respectivamente. Em 69,2% dos casos no antímero direito e 80,8% no esquerdo, a artéria cerebral caudal originou-se pela anastomose entre o ramo caudal da artéria carótida interna, com maior contribuição, e o ramo terminal da artéria basilar. Em 88,4% dos casos no antímero direito e em 84,6% no esquerdo, a artéria cerebral caudal originou a artéria tectal rostral e um ramo caudal. O ramo caudal bifurcou-se e vascularizou os colículos rostrais e caudais dos corpos quadrigêmeos e em alguns casos contribuiu na formação do plexo coroide do terceiro ventrículo. A artéria tectal rostral seguiu ventralmente ao lobo piriforme e durante seu trajeto liberou ramos para o hipocampo e, no antímero esquerdo, supriu a superfície dorsal do tálamo, contribuindo para a formação do plexo coroide do terceiro ventrículo.In this study were used 26 brains of adult cats, without sex differentiation and definable race, colored with latex and fixed in formaldehyde aqueous solution. The right and left caudal cerebral arteries were single in 96.1% and 88.4% of the sample, respectively. In 69.2% of the samples on the right side and 80.8% on the left, the caudal cerebral artery fin from the anastomosis behind the caudal branch of the internal carotid artery, with a large contribution, and the basal artery terminal branch. In 88.4% of the samples on the right side and 84.6% on the left, the caudal cerebral artery showed the tectal rostral artery and one caudal branche. The caudal branch forked in two branches that supplied the rostral and caudal colliculis of the quadruplet bodies and formed the choroid plexus of the third ventricle. The tectal rostral artery followed ventrally to the

  13. Análise da respiração mitocondrial em tecido cerebral de gato após isquemia e reperfusão Analysis of mitochondrial respiration in brain cerebral tissue of cats after ischemia and reperfusion

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    Hiroshi Nakano

    2002-01-01

    Full Text Available INTRODUÇÃO: A isquemia cerebral é uma doença freqüente e de difícil tratamento médico. De particular interesse neurocirúrgico são as situações de vasoespasmo após hemorragia subaracnóidea, de oclusão temporária de vasos nas neurocirurgias e de tromboses de artérias intracranianas. A lesão cerebral resultante da isquemia depende da sua duração e pode ser agravada pela reperfusão do território isquêmico. Vários estudos clínicos e experimentais têm sido realizados para melhor entender esses fenômenos. OBJETIVO: Este trabalho visou a avaliação precoce dos efeitos da isquemia focal seguida da reperfusão no cérebro de gatos. MÉTODOS: A isquemia cerebral foi provocada por clipagem temporária da artéria cerebral média por tempos determinados com reperfusão durante 10 minutos, e avaliação foi efetuada através da análise da respiração mitocondrial no tecido isquemiado. Resultados - Houve redução significativa no consumo de O2 nas amostras de tecido cerebral isquemiado por 60 minutos, seguidos de 10 minutos de reperfusão, quando comparadas ao tecido cerebral contralateral (não isquemiado. CONCLUSÕES: Com base nos resultados obtidos, pode-se concluir que o tempo de duração da isquemia foi um fator determinante na alteração da respiração mitocondrial de gatos submetidos à isquemia e reperfusão de curta duração (alterações significativas apenas após 60 minutos de isquemia seguidos de 10 de reperfusão.OBJECTIVE: Brain ischemia is considered a disease difficult to be treated. Despite many other clinical situations, of particular interest for neurosurgery is its occurrence in cerebral vasoespam following subarachnoid hemorrhage, in temporary occlusion of intracranial vessels during neurosurgeries and, in intracranial arterial thrombosis. The cerebral lesion caused by isquemia is time-related and it can aggravated by the reperfusion of the ischemic site. Many clinical and experimental studies have been

  14. 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?

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    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

  15. Qualidade de vida e grau de ansiedade e depressão em cuidadores de crianças com paralisia cerebral Calidad de vida y grado de ansiedad y depresión en cuidadores de niños con parálisis cerebral Quality of life and level of anxiety and depression in caregivers of children with cerebral palsy

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    Márcia Andreya Zanon

    2012-09-01

    Full Text Available OBJETIVO: Avaliar o grau de ansiedade e depressão e a qualidade de vida dos cuidadores de crianças com crianças com paralisia cerebral. MÉTODOS: Estudo transversal descritivo com cuidadores de crianças acompanhadas na Associação de Pais e Amigos dos Excepcionais (Apae e na Associação dos Deficientes Físicos de Alagoas (Adefal, em Maceió, Alagoas. Para a coleta de dados, realizada com uma amostra de 82 cuidadores, utilizou-se a Escala Hospitalar de Ansiedade e Depressão (HAD e um instrumento genérico de avaliação de qualidade de vida, o SF-36 (Medical Outcomes Study 36 - Item Short-Form Health Survey. Os dados foram analisados utilizando-se média, desvio padrão, mediana e intervalo de confiança de 95% (IC95%. RESULTADOS: A média de idade dos cuidadores foi de 32,4±10,3 anos, variando de 18 a 77. Constatou-se ansiedade em 49% dos cuidadores (IC95% 38 - 60 e depressão em 31% (IC95% 22 - 42. No questionário SF-36, os domínios mais afetados foram: limitação por aspectos emocionais, com 56 pontos (IC95% 46 - 65, e vitalidade, com 57 (IC95% 52 - 62. CONCLUSÕES: Os cuidadores apresentaram alta ansiedade e depressão; não possuíam boa qualidade de vida, especialmente nos domínios "limitação por aspectos emocionais" e "vitalidade".OBJETIVO: Evaluar el grado de ansiedad y depresión y la calidad de vida de los cuidadores de niños con parálisis cerebral. MÉTODOS: Estudio transversal descriptivo, con cuidadores de niños acompañados en la Associação de Pais e Amigos dos Excepcionais (Apae y en la Associação dos Deficientes Físicos de Alagoas (Adefal, en Maceió, Alagoas (Brasil. Para la recolección de los datos, realizada con una muestra de 82 cuidadores, se utilizó la escala hospitalaria de ansiedad y depresión y un instrumento genérico de evaluación de calidad de vida, el SF-36 (Medical Outcomes Study 36 - Item Short-Form Health Survey. Los datos fueron analizados utilizando promedio, desviación est

  16. Alterações eletroneurofisiológicas em anestesia com sevoflurano: estudo comparativo entre pacientes saudáveis e pacientes com paralisia cerebral Alteraciones eletroneurofisiológicas en anestesia con sevoflurano: estudio comparativo entre pacientes saludables y pacientes con parálisis cerebral Electroneourophysiological changes in anesthesia with sevoflurane: comparative study between healthy and cerebral palsy patients

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    Sérgio Silva de Mello

    2003-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Estudos avaliando a farmacodinâmica de drogas anestésicas em Paralisia Cerebral (PC são escassos. O objetivo deste estudo foi comparar a resposta eletroneurofisiológica de pacientes normais e com PC à anestesia com sevoflurano, utilizando o EEG bispectral (BIS e potencial evocado somatossensitivo de curta latência (PESS como técnica de monitorização do grau de profundidade anestésica. MÉTODO: Foram selecionados 24 pacientes de 3 a 18 anos, candidatos a cirurgias na Rede Sarah de Hospitais do Aparelho Locomotor, divididos em 2 grupos: 1. PC - 12 crianças com PC tipo espástica; 2. Controle (C - 12 crianças sem doença do SNC. A anestesia foi realizada com sevoflurano associado a N2O a 60% em ventilação assistida. As variáveis BIS e ondas N9, N13, N19 e P/N 22 do PESS - latência e amplitude - foram avaliadas nas frações expiradas de sevoflurano (FEsev de 1,2 e 2,5% (0,5 e 1 CAM. Foram monitorizadas a temperatura e a P ET CO2. Para análise foram utilizadas média e desvio-padrão para o BIS, e média da variação percentual dos valores de latência e amplitude das ondas do PESS, nas duas concentrações do anestésico. RESULTADOS: Não houve diferença de sexo, idade, peso e temperatura entre os grupos. Sob efeito da anestesia, os valores de BIS foram mais reduzidos no grupo PC, sendo a diferença entre os grupos estatisticamente significante com a FEsev 2,5% (30,3 x 37,5; p JUSTIFICATIVA Y OBJETIVOS: Estudios evaluando la farmacodinámica de drogas anestésicas en Parálisis Cerebral (PC son escasos. El objetivo de este estudio fue comparar la respuesta eletroneurofisiológica de pacientes normales y con PC a la anestesia con sevoflurano, utilizando el EEG bispectral (BIS y potencial evocado somatosensitivo de corta latencia (PESS como técnica de monitorización del grado de profundidad anestésica. MÉTODO: Fueron seleccionados 24 pacientes de 3 a 18 años, candidatos a cirugías en la Red Sarah de

  17. 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

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    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

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

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    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.

  19. Bem-estar subjetivo e senso de ajustamento psicológico em idosos que sofreram acidente vascular cerebral: uma revisão Subjective well being and perceived psychological adjustment among old people affected by stroke: a review

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    Dóris Firmino Rabelo

    2006-08-01

    Full Text Available Foi feito um levantamento dos estudos brasileiros e estrangeiros publicados entre 1996 e 2005 que relacionavam bem-estar subjetivo, senso de ajustamento psicológico e acidente vascular cerebral, com o objetivo de identificar variáveis mediadoras dessa relação em idosos. Estudos transversais e prospectivos indicaram que os afetados por acidente vascular cerebral apresentam menor bem-estar subjetivo quando comparados com a população geral. Boa capacidade cognitiva, suporte social efetivo, continuidade de uma ocupação produtiva, manutenção da competência em atividades instrumentais de vida diária e humor positivo são fatores que podem melhorar o bem-estar subjetivo e psicológico. Variáveis que podem piorar o bem-estar subjetivo e psicológico são incapacidade funcional, déficits cognitivos, depressão, dificuldade em restabelecer a identidade e restrição à possibilidade de desempenhar atividades e papéis que contribuem para a auto-definição. O conhecimento das implicações psicológicas de sofrer acidente vascular cerebral pode beneficiar pacientes, familiares e profissionais no gerenciamento do evento.We gathered data from Brazilian and foreign studies published between 1996 and 2005 which related subjective well-being, sense of psychological adjustment and stroke. The objective was identifying mediator variables of this relation among old people. Prospective and cross-sectional studies indicated that those affected by stroke showed less subjective well-being than the general population. Good cognitive capacity, effective social support, continuity of a productive occupation, keeping the competence in instrumental activities of daily living and good mood are factors which can affect positively the subjective and psychological well-being. Variables which can affect negatively the subjective and psychological well-being are functional incapacity, cognitive deficits, depression, difficulty in re-establishing the identity and

  20. ESTUDO DA PREVALÊNCIA DE BRUXISMO E AVALIAÇÃO DE SAÚDE BUCAL EM PACIENTES COM PARALISIA CEREBRAL

    OpenAIRE

    Cristhiane Oívia Ferreira do Amaral; Juliana Tomiazzi Chagas; Larissa Carvalho Rodrigues

    2010-01-01

    Cerebral palsy is the result of an injury or poor brain development, not progressive in nature, existing since childhood. The lesion that affects the brain, where it is still immature, interferes with normal motor development of children, resulting mainly in a delay or an arrest of development and injury caused often by lack of oxygen to brain cells. The aim of this study was to investigate the bruxism prevalence and to evaluate the oral health of patients with cerebral palsy who attend the c...

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

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    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

  2. 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?

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    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.

  3. ICTAL AND INTERICTAL EEG ABNORMALITIES IN 100 MIGRAINEURS WITH AND WITHOUT AURA

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    H. Pourmahmoodian

    2007-07-01

    Full Text Available There are several conflicting reports about the EEG of the migraineurs. In this study we report the ictal and interictal EEGs of 100 migraineurs, in comparison with control group. The range age for patient and control groups were 9-48 (mean: 26 ± 1.8 and 10-46 (mean: 23 ± 2.1 years respectively. 32% of the patients were less than 14 years old and the remaining 68% were more than 14 years. In the patient group, 68% of cases had migraine without aura and 32% suffered from migraine with aura. Hemiplegic and basilar migraines were observed in one and two of our patients respectively. Gender and age had no effect on the type of migraine. Family history for first degree relatives was found in 64% of patients, without being influenced by gender or type of migraine. Male to female ratio was 1/1.6 (38/62. Abnormal EEG was found to be much more frequent in migraineurs than the control group (47% vs. 7%. Children had an overall somewhat more abnormal EEGs, compared with adult group (53% vs. 44% or 17/32 vs. 30/68, though slow discharges were detected more in adult group. The most common abnormality was slow high voltage waves, which was observed in 33/47 (70% of abnormal recordings. The less common findings, in decreasing order of frequency were: focal (slow, sharps or mixed discharges in 14/47 (29%, epileptiform (alone or associated with slow waves in 4/47 (8.5%, diffuse beta and frontal intermittent delta, activity each being in 1/47 (2.1% of abnormal recordings.

  4. Interictal spike frequency varies with ovarian cycle stage in a rat model of epilepsy.

    Science.gov (United States)

    D'Amour, James; Magagna-Poveda, Alejandra; Moretto, Jillian; Friedman, Daniel; LaFrancois, John J; Pearce, Patrice; Fenton, Andre A; MacLusky, Neil J; Scharfman, Helen E

    2015-07-01

    In catamenial epilepsy, seizures exhibit a cyclic pattern that parallels the menstrual cycle. Many studies suggest that catamenial seizures are caused by fluctuations in gonadal hormones during the menstrual cycle, but this has been difficult to study in rodent models of epilepsy because the ovarian cycle in rodents, called the estrous cycle, is disrupted by severe seizures. Thus, when epilepsy is severe, estrous cycles become irregular or stop. Therefore, we modified kainic acid (KA)- and pilocarpine-induced status epilepticus (SE) models of epilepsy so that seizures were rare for the first months after SE, and conducted video-EEG during this time. The results showed that interictal spikes (IIS) occurred intermittently. All rats with regular 4-day estrous cycles had IIS that waxed and waned with the estrous cycle. The association between the estrous cycle and IIS was strong: if the estrous cycles became irregular transiently, IIS frequency also became irregular, and when the estrous cycle resumed its 4-day pattern, IIS frequency did also. Furthermore, when rats were ovariectomized, or males were recorded, IIS frequency did not show a 4-day pattern. Systemic administration of an estrogen receptor antagonist stopped the estrous cycle transiently, accompanied by transient irregularity of the IIS pattern. Eventually all animals developed severe, frequent seizures and at that time both the estrous cycle and the IIS became irregular. We conclude that the estrous cycle entrains IIS in the modified KA and pilocarpine SE models of epilepsy. The data suggest that the ovarian cycle influences more aspects of epilepsy than seizure susceptibility.

  5. 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

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

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    Wesley Thomas Kerr

    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.

  7. 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

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    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

  8. Cerebral Paragonimiasis.

    Science.gov (United States)

    Miyazaki, I

    1975-01-01

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

  9. 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

  10. Sistematização, descrição e território das artérias cerebral caudal, cerebral média, cerebroetmoidal e cerebelar ventral caudal na superfície do encéfalo em avestruz (Struthio camelus)

    OpenAIRE

    Manoel Brandes Nazer

    2014-01-01

    Nesta tese foi descrito e sistematizado a distribuição e território das artérias cerebrais média e caudal, artéria cerebroetmoidal e artéria cerebelar ventral caudal na superfície do encéfalo de 30 avestruz ((Struthio camelus), 17 machos e 13 fêmeas, jovens e adultos. Os 30 espécimes foram injetados com látex corado em vermelho através das artérias (Aa.) carótidas internas. As artérias carótidas do cérebro e seus ramos foram sistematicamente descritas. A artéria (a.) cerebral caudal foi, à di...

  11. 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

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    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.

  12. Presence of D4 dopamine receptors in human prefrontal cortex: a postmortem study Presença de receptores dopaminérgicos D4 em córtex cerebral humano: um estudo post-mortem

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    Donatella Marazziti

    2007-06-01

    Full Text Available OBJECTIVE: The aim of our study was to explore the presence and the distribution of D4 dopamine receptors in postmortem human prefrontal cortex, by means of the binding of [³H]YM-09151-2, an antagonist that has equal affinity for D2, D3 and D4 receptors. It was therefore necessary to devise a unique assay method in order to distinguish and detect the D4 component. METHOD: Frontal cortex samples were harvested postmortem, during autopsy sessions, from 5 subjects. In the first assay, tissue homogenates were incubated with increasing concentrations of [³H]YM-09151-2, whereas L-745870, which has a high affinity for D4 and a low affinity for D2/D3 receptors, was used as the displacer. In the second assay, raclopride, which has a high affinity for D2/D3 receptors and a low affinity for D4 receptors, was used to block D2/D3. The L-745870 (500 nM was added to both assays in order to determine the nonspecific binding. RESULTS: Our experiments revealed the presence of specific and saturable binding of [³H]YM-09151-2. The blockade of D2 and D3 receptors with raclopride ensured that the D4 receptors were labeled. The mean maximum binding capacity was 88 ± 25 fmol/mg protein, and the dissociation constant was 0.8 ± 0.4 nM. DISCUSSION AND CONCLUSIONS: Our findings, although not conclusive, suggest that the density of D4 receptors is low in the human prefrontal cortex.OBJETIVO: O objetivo deste estudo foi quantificar a presença e a distribuição de receptores dopaminérgicos do tipo 4 (D4 no córtex cerebral humano em amostras post-mortem através do bloqueio com ³H-YM-09151-2 - um antagonista com afinidade equivalente pelos receptores D2, D3 e D4 - e do desenvolvimento de um método para a detecção específica do componente D4. MÉTODO: Foram obtidas amostras de córtex cerebral de cinco cadáveres. Em um primeiro ensaio, os homogeneizados de tecido cerebral foram incubados em concentrações crescentes de ³H-YM-09151-2, enquanto que o L-745

  13. 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

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    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.

  14. 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

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    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

  15. A testbed to explore the optimal electrical stimulation parameters for suppressing inter-ictal spikes in human hippocampal slices.

    Science.gov (United States)

    Min-Chi Hsiao; Pen-Ning Yu; Dong Song; Liu, Charles Y; Heck, Christi N; Millett, David; Berger, Theodore W

    2014-01-01

    New interventions using neuromodulatory devices such as vagus nerve stimulation, deep brain stimulation and responsive neurostimulation are available or under study for the treatment of refractory epilepsy. Since the actual mechanisms of the onset and termination of the seizure are still unclear, most researchers or clinicians determine the optimal stimulation parameters through trial-and-error procedures. It is necessary to further explore what types of electrical stimulation parameters (these may include stimulation frequency, amplitude, duration, interval pattern, and location) constitute a set of optimal stimulation paradigms to suppress seizures. In a previous study, we developed an in vitro epilepsy model using hippocampal slices from patients suffering from mesial temporal lobe epilepsy. Using a planar multi-electrode array system, inter-ictal activity from human hippocampal slices was consistently recorded. In this study, we have further transferred this in vitro seizure model to a testbed for exploring the possible neurostimulation paradigms to inhibit inter-ictal spikes. The methodology used to collect the electrophysiological data, the approach to apply different electrical stimulation parameters to the slices are provided in this paper. The results show that this experimental testbed will provide a platform for testing the optimal stimulation parameters of seizure cessation. We expect this testbed will expedite the process for identifying the most effective parameters, and may ultimately be used to guide programming of new stimulating paradigms for neuromodulatory devices.

  16. Estudo comparativo do tono muscular na paralisia cerebral tetraparética em crianças com lesões predominantemente corticais ou subcorticais na tomografia computadorizada de crânio

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    Iwabe Cristina

    2003-01-01

    Full Text Available OBJETIVO: Comparar a distribuição e intensidade do tono muscular na paralisia cerebral tetraparética espástica (PC-T, correlacionando os dados clínicos com a localização da lesão no sistema nervoso central. MÉTODO: Foram incluídas 12 crianças de dois a quatro anos de idade com lesões predominantemente corticais (seis crianças e subcorticais (seis crianças. O tono foi analisado nos membros superiores (MMSS e inferiores (MMII baseado no protocolo de Durigon e Piemonte. RESULTADOS: Não houve diferença significante quanto à intensidade e distribuição de tono em MMSS e MMII nos dois grupos. Comparando os MMSS e MMII de sujeitos do mesmo grupo, os MMII apresentaram mais assimetrias e maior intensidade do tono do que os MMSS. CONCLUSÃO: Neste estudo, crianças com PC devido a lesões predominantemente corticais ou subcorticais apresentam déficit semelhante na modulação de tono, ocasionando distribuição simétrica e homogênea de hipertonia que predomina em MMII.

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

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    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.

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

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    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

  19. 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

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    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

  20. 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

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    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

  1. 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

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    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

  2. 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/

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    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.

  3. 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

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    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.

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

    OpenAIRE

    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...

  5. Dopplervelocimetria da artéria cerebral média fetal e outros parâmetros de vitalidade fetal na sobrevida neonatal em gestações com insuficiência placentária

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    Roseli Mieko Yamamoto Nomura

    2013-08-01

    Full Text Available OBJETIVO: Estudar a dopplervelocimetria da artéria cerebral média fetal em gestações complicadas pela insuficiência placentária e verificar o seu papel no prognóstico de sobrevida neonatal. MÉTODOS: Trata-se de estudo prospectivo de 93 gestantes com diagnóstico de insuficiência placentária estabelecida antes da 34ª semana. A insuficiência placentária foi caracterizada pelo Doppler de artéria umbilical (AU alterado (> p95. Foram analisados os seguintes parâmetros: índice de pulsatilidade (IP da artéria umbilical (AU, IP da artéria cerebral média (ACM, relação cerebroplacentária -RCP(IP-ACM/IP-AU, pico de velocidade sistólicada ACM (PVS-ACM e IP para veias (IPV do ducto venoso (DV. Os parâmetros foram analisados pelos valores absolutos, em escores zeta (desvios padrão a partir da média ou múltiplos da mediana (MoM. O desfecho investigado foi o óbito neonatal no período de internação após o nascimento. RESULTADOS: Nas 93 gestações analisadas, ocorreram 25 (26,9% óbitos neonatais. No grupo que evoluiu com óbito neonatal, quando comparado com o grupo com sobrevida, houve associação significativa com o diagnóstico de diástole zero ou reversa (88% vs. 23,6%, p < 0,001, com maior mediana do IP da AU (2,9 vs. 1,7, p < 0,001 e seu escore zeta (10,4 vs. 4,9, p < 0,001; maior valor do PVS-ACM MoM (1,4 vs. 1,1, p = 0,012; menor valor da RCP (0,4 vs. 0,7, p < 0,001; maior valor do IPV-DV (1,2 vs. 0,8, p < 0,001 e no escore zeta do DV (3,6 vs.0,6, p<0,001. Na regressão logística, as variáveis independentes para a prediçãodoóbito neonatal foram a idade gestacional no parto (OR = 0,45; IC95% 0,3 a 0,7, p < 0,001 e o escore zeta do IP-AU (OR 1,14, IC95% 1,0 a 1,3, p = 0,046. CONCLUSÃO: Apesar da associação verificada pela análise univariada entre a morte neonatal e os parâmetros da dopplervelocimetria cerebral fetal, a análise multivariada identificou a prematuridadeeograude insuficiência da circula

  6. 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

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    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

  7. 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

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    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

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

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    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

  9. Sensitivity and specificity of interictal EEG-fMRI for detecting the ictal onset zone at different statistical thresholds.

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    Simon eTousseyn

    2014-07-01

    Full Text Available There is currently a lack of knowledge about EEG-fMRI specificity. Our aim was to define sensitivity and specificity of Blood Oxygen Level Dependent (BOLD responses to interictal epileptic spikes during EEG-fMRI for detecting the ictal onset zone (IOZ. We studied 21 refractory focal epilepsy patients who had a well-defined IOZ after a full presurgical evaluation and interictal spikes during EEG-fMRI. Areas of spike-related BOLD changes overlapping the IOZ in patients were considered as true positives; if no overlap was found, they were treated as false negatives. Matched healthy case-controls underwent similar EEG-fMRI in order to determine true negative and false positive fractions. The spike-related regressor of the patient was used in the design matrix of the healthy case-control. Suprathreshold BOLD changes in the brain of controls were considered as false positives, absence of these changes as true negatives. Sensitivity and specificity were calculated for different statistical thresholds at the voxel level combined with different cluster size thresholds and represented in receiver operating characteristic (ROC-curves. Additionally, we calculated the ROC-curves based upon the cluster containing the maximal significant activation. We achieved a combination of 100% specificity and 62% sensitivity, using a Z-threshold in the interval 3.4-3.5 and cluster size threshold of 350 voxels. We could obtain higher sensitivity at the expense of specificity. Similar performance was found when using the cluster containing the maximal significant activation. Our data provide a guideline for different EEG-fMRI settings with their respective sensitivity and specificity for detecting the ictal onset zone. The unique cluster containing the maximal significant BOLD activation was a sensitive and specific marker of the ictal onset zone.

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

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    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.

  11. 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

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    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

  12. No abnormalities of intrinsic brain connectivity in the interictal phase of migraine with aura

    DEFF Research Database (Denmark)

    Hougaard, Anders; Amin, F M; Magon, S

    2015-01-01

    resting-state functional brain connectivity in migraineurs with aura outside of attacks using functional magnetic resonance imaging. METHODS: Forty patients suffering from migraine with visual aura and 40 individually age and gender matched healthy controls with no history or family history of migraine...... if cortical dysfunction is present at rest, i.e. in the absence of any external stimuli. Functional magnetic resonance imaging is a powerful technique for evaluating resting state functional connectivity, i.e. coherence of brain activity across cerebral areas. The objective of this study was to investigate......, and in a data-driven exploratory fashion (dual regression) in order to reveal any possible between-group differences of resting state networks. Age, gender, attack frequency and disease duration were included as nuisance variables. RESULTS: No differences of functional connectivity were found between patients...

  13. 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

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    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

  14. 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

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    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

  15. 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

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    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

  16. 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

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    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

  17. 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

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    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

  18. 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?

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    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

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

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    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

  20. 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

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    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

  1. 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

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    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.

  2. Avaliação de dois modelos experimentais de isquemia e reperfusão cerebral em ratos com oclusão temporária carotídea associada ou não à oclusão vertebral

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    Tardini Daniela Mazza Sundefeld

    2003-01-01

    Full Text Available OBJETIVO: Avaliar a reprodutibilidade de dois modelos experimentais de isquemia e reperfusão cerebral. MÉTODOS: 60 ratos foram distribuídos, aleatoriamente, em três grupos experimentais, com 20 animais cada: I - pinçamento temporário de artéria carótida esquerda; II - cauterização prévia das artérias vertebrais e pinçamento temporário da artéria carótida esquerda; simulado - sem isquemia nem reperfusão. Todos os animais tiveram oclusão definitiva de artéria carótida direita e os três grupos foram subdivididos em dois períodos de reperfusão: A - 60 minutos e B - 120 minutos. Os parâmetros verificados foram: medidas de pressão arterial média sistêmica e fluxo sangüíneo carotídeo; medida de malondialdeído cerebral através do teste TBARS e avaliação histológica do hemisfério cerebral submetido à isquemia e reperfusão. Foi feito também um estudo complementar com angiografia cerebral em 5 animais adicionais. RESULTADOS: Não houve diferenças significativas nas dosagens de malondialdeído cerebral e na freqüência e gravidade das alterações histológicas cerebrais entre os três grupos. Nos grupos GI e GII, a PAM foi significantemente maior no período de isquemia. O fluxo sangüíneo entre os períodos pré e pós-pinçamento aumentou nos grupos IA e IIB, diminuiu no grupo IB e no grupo IIA manteve-se inalterado. As angiografias do estudo complementar mostraram aporte sangüíneo para cérebro através de circulação colateral. CONCLUSÃO: Os modelos de isquemia e reperfusão estudados não demonstraram alterações consistentes de marcadores de lesão cerebral, seja quanto à produção de lipoperóxidos ou de lesões histológicas.

  3. 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

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    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

  4. Tumefação cerebral congestiva em vítimas fatais de acidente de trânsito: frequência e associação com outras lesões cranioencefálicas Congestive brain swelling in victims of fatal road traffic accidents: frequency and association with other head injury lesions

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    SEBASTIÃO SILVA GUSMÃO

    1999-12-01

    Full Text Available Realizou-se estudo anatomopatológico macro e microscópico do encéfalo de 120 vítimas fatais de acidente de trânsito. A tumefação cerebral congestiva (TCC ocorreu em 21 (17,5% pacientes. Consoante com a tumefação cerebral, que determina aumento volumétrico do encéfalo, foi encontrado aumento do peso médio do encéfalo. A contusão cerebral foi a lesão mais frequentemente associada com a TCC (76,2%, enquanto os hematomas intracranianos foram observados em quase metade dos casos.A morphological study, macro and microscopical, was made of brain lesions in 120 victims of fatal road traffic accidents. Congestive brain swelling occurred in 21 (17.5% patients. Owing to the brain swelling that increases the brain volume, an increase of brain weight was also observed. Brain contusion was the most frequent lesion associated with congestive brain swelling (76.2%, while the intracranial haematomas were observed in almost half of the cases.

  5. Emprego dos gangliosidos do cortex cerebral nas neuropatias perifericas

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    James Pitagoras De Mattos

    1981-12-01

    Full Text Available Os autores registram a experiência pessoal com o emprego de gangliosídios do cortex cerebral nas neuropatias periféricas. O ensaio clínico e eletromiográfico revelou-se eficaz em 30 dos 40 casos tratados. Enfatizam os melhores resultados em casos de paralisias faciais periféricas.

  6. Use of interictal (18)F-fluorodeoxyglucose (FDG)-PET and magnetoencephalography (MEG) to localize epileptogenic foci in non-lesional epilepsy in a cohort of 16 patients.

    Science.gov (United States)

    Wang, Yuchun; Liu, Bo; Fu, Liqi; Cui, Zhiqiang

    2015-08-15

    We assessed the efficacy of interictal 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and magnetoencephalography (MEG) for localizing the epileptogenic foci in a small cohort of patients with non-lesional epilepsy. Sixteen patients, aged 8-32 years, with non-lesional epilepsy underwent MRI, continuous scalp video-electroencephalography (EEG) monitoring, interictal (FDG)-PET and MEG at our institution. Each patient subsequently underwent intracranial grid placement. The data from the intracranial grids was correlated with the previous studies to determine the efficacy of FDG-PET and MEG in localizing the epileptogenic zone. Of the 16 patients, the epileptogenic zone was accurately localized in 8 (50%) using FDG-PET and in 12 patients (75%) using MEG. Of the 11 patients with a temporal hypometabolism, only 4 were ultimately confirmed as temporal lobe epilepsy via intracranial grids and 2 additional patients were found to have extra-temporal lobe epilepsy. Compared to interictal FDG-PET, MEG appears to be more sensitive to detection of the epileptogenic zone in this small cohort of non-lesional epilepsy patients though provided more diffuse foci. Our findings can help in determining the surgical eligibility of a patient especially when MRI or video-EEG monitoring are non-localizing, and can help with placement of subdural grids and strips for EEG studies.

  7. Evaluation of the reconstruction method and effect of partial volume in brain scintiscanning; Avaliacao do metodo de reconstrucao e efeito do volume parcial em cintilografia cerebral

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    Pinheiro, Monica Araujo

    2016-10-01

    Alzheimer's disease is a neurodegenerative disorder, on which occurs a progressive and irreversible destruction of neurons. According to the World Health Organization (WHO) 35.6 million people are living with dementia, being recommended that governments prioritize early diagnosis techniques. Laboratory and psychological tests for cognitive assessment are conducted and further complemented by neurological imaging from nuclear medicine exams in order to establish an accurate diagnosis. The image quality evaluation and reconstruction process effects are important tools in clinical routine. In the present work, these quality parameters were studied, and the effects of partial volume (PVE) for lesions of different sizes and geometries that are attributed to the limited resolution of the equipment. In dementia diagnosis, this effect can be confused with intake losses due to cerebral cortex atrophy. The evaluation was conducted by two phantoms of different shapes as suggested by (a) American College of Radiology (ACR) and (b) National Electrical Manufacturers Association (NEMA) for Contrast, Contrast-to-Noise Ratio (CNR) and Recovery Coefficient (RC) calculation versus lesions shape and size. Technetium-99m radionuclide was used in a local brain scintigraphy protocol, for proportions lesion to background of 2:1, 4:1, 6:1, 8:1 and 10:1. Fourteen reconstruction methods were used for each concentration applying different filters and algorithms. Before the analysis of all image properties, the conclusion is that the predominant effect is the partial volume, leading to errors of measurement of more than 80%. Furthermore, it was demonstrate that the most effective method of reconstruction is FBP with Metz filter, providing better contrast and contrast to noise ratio results. In addition, this method shows the best Recovery Coefficients correction for each lesion. The ACR phantom showed the best results assigned to a more precise reconstruction of a cylinder, which does not

  8. 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

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    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

  9. 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

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    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.

  10. The relationship of interictal epileptiform discharges to clinical epilepsy severity: a study of routine electroencephalograms and review of the literature.

    Science.gov (United States)

    Selvitelli, Megan F; Walker, Linsey M; Schomer, Donald L; Chang, Bernard S

    2010-04-01

    Electroencephalograms are widely used to detect interictal epileptiform discharges (IEDs) in patients with a known history of seizures. However, previous studies have not found a consistent association between the presence or frequency of IEDs and clinical epilepsy severity, possibly because of differences in subject characteristics and recording techniques. We sought to investigate this relationship in a population and setting reflective of the most common clinical usage. We analyzed electroencephalograms and clinical records of all consenting patients with a history of at least two presumed focal-onset seizures who presented for routine electroencephalograms recording over 1-year time in an academic neurophysiology laboratory (n = 129). Despite adequate statistical power, we did not find an association between the presence or absence of IEDs or IED frequency and the most recently determined seizure frequency (median, 4 per year). A higher IED incidence was seen in subjects with longer epilepsy duration (P = 0.04). Neither IED incidence nor frequency (median, 10.0 per hour) correlated with age or antiepileptic drug use. Our results differ from those of some previous studies, most of which focused on more narrow subject populations, suggesting that the patient's clinical circumstances must be taken into account before assuming the utility of IEDs on routine electroencephalography in predicting epilepsy severity.

  11. Localization of spatially distributed brain sources after a tensor-based preprocessing of interictal epileptic EEG data.

    Science.gov (United States)

    Albera, L; Becker, H; Karfoul, A; Gribonval, R; Kachenoura, A; Bensaid, S; Senhadji, L; Hernandez, A; Merlet, I

    2015-01-01

    This paper addresses the localization of spatially distributed sources from interictal epileptic electroencephalographic data after a tensor-based preprocessing. Justifying the Canonical Polyadic (CP) model of the space-time-frequency and space-time-wave-vector tensors is not an easy task when two or more extended sources have to be localized. On the other hand, the occurrence of several amplitude modulated spikes originating from the same epileptic region can be used to build a space-time-spike tensor from the EEG data. While the CP model of this tensor appears more justified, the exact computation of its loading matrices can be limited by the presence of highly correlated sources or/and a strong background noise. An efficient extended source localization scheme after the tensor-based preprocessing has then to be set up. Different strategies are thus investigated and compared on realistic simulated data: the "disk algorithm" using a precomputed dictionary of circular patches, a standardized Tikhonov regularization and a fused LASSO scheme.

  12. Nocturnal interictal epileptic discharges in adult Lennox-Gastaut syndrome: the effect of sleep stage and time of night.

    Science.gov (United States)

    Sforza, Emilia; Mahdi, Rima; Roche, Frederic; Maeder, Malin; Foletti, Giovanni

    2016-03-01

    Lennox-Gastaut syndrome (LGS) is characterized by interictal epileptiform discharges (IEDs) occurring during sleep. The aim of this study was to determine whether sleep influences not only the frequency of seizures and IEDs, but also the time-dependent evolution that may support the hypothesis of homeostatic influences on epileptic threshold. Video polysomnography data from our database were reviewed to identify adult LGS patients with at least seven hours of nocturnal recording. Thirteen patients were identified and a second polysomnography was available for nine. The number, duration and index of IEDs, relative to total sleep, sleep stages, and time during the night, were calculated. The majority of IEDs occurred during non-rapid eye movement sleep, mainly in stage 2 and slow-wave sleep. Adjusting for time spent in each sleep stage, we found 45 IEDs/hour in stage 1, 123/hour in stage 2, 106/hour in slow-wave sleep, and 26/hour in rapid eye movement sleep. The temporal distribution of IEDs showed a significant rise in the first three hours of sleep, followed by a progressive decrease at the end of the night (F=85.6; pLGS is facilitated by non-rapid eye movement sleep with an evident effect of stage 2 and slow-wave sleep. The significant IED occurrence in the first part of the night and the subsequent decline suggests a link between epileptic threshold and homeostatic sleep mechanisms. The latter should be considered regarding choice of therapy.

  13. 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

  14. Posturografia na análise do equilíbrio em crianças com paralisia cerebral: revisão de literatura Posturografía en el análisis del equilibrio en niños con parálisis cerebral: revisión de literatura Posturography in the analysis of postural control in children with cerebral palsy: a literature review

    Directory of Open Access Journals (Sweden)

    Guilherme Henrique Ramos Lopes

    2013-03-01

    Full Text Available Crianças com paralisia cerebral (PC apresentam menor equilíbrio postural pelo comprometimento de funções motoras, sensoriais e centrais. Existem diversos protocolos funcionais para análise do equilíbrio, mas poucos estudos têm utilizado a plataforma de força como instrumento de precisão nessa avaliação. O objetivo desta revisão foi identificar artigos publicados que utilizaram essa avaliação em crianças com PC e analisar os protocolos e parâmetros utilizados. Para tanto, foi realizada uma busca nas seguintes bases de dados: LILACS, IBECS, MEDLINE, Biblioteca Cochrane e SciELO, por meio da Biblioteca Virtual em Saúde. Foram encontrados 165 artigos; a partir dos critérios de inclusão e exclusão, foram selecionados 16 artigos. Os estudos mostraram que os parâmetros lineares de deslocamento médio-lateral e anteroposterior do centro de pressão e a razão desses deslocamentos têm sido utilizados com maior frequência, e que o tempo de avaliação na plataforma de força, na maioria dos estudos, não excede os 20 segundos. Foi demonstrado ainda que crianças com desenvolvimento típico apresentam melhor controle postural, e que crianças com PC podem incrementar seu equilíbrio a partir de intervenções específicas, inclusive em plataforma de força.Niños con parálisis cerebral (PC presentan menor equilibrio postural por el compromiso de sus funciones motoras, sensoriales y centrales. Existen diversos protocolos funcionales para el análisis del equilibrio, pero pocos estudios utilizan la plataforma de fuerza como instrumento de precisión en esta evaluación. El objetivo de esta revisión fue identificar artículos publicados que utilizaran esta evaluación en niños con PC y analizar los protocolos y parámetros utilizados. Por lo tanto, fue realizada una búsqueda en las siguientes bases de datos: LILACS, IBECS, MEDLINE, Biblioteca Cochrane y SciELO, por medio de la Biblioteca Virtual en Salud. Fueron encontrados 165 art

  15. Efeitos in vitro do ácido pipecólico sobre parâmetros de estresse oxidativo e a possível prevenção pelo ácido lipoico em córtex cerebral de ratos

    OpenAIRE

    Giovana Reche Dalazen

    2014-01-01

    Os níveis de ácido pipecólico (AP) estão elevados em desordens metabólicas severas do sistema nervoso central como na Síndrome de Zellweger, Doença de Refsum Infantil, Adrenoleucodistrofia neonatal e Hiperlisinemia. Os indivíduos afetados apresentam disfunção neurológica progressiva, hipotonia e retardo no crescimento. Os mecanismos de dano cerebral nestas desordens ainda permanecem pouco compreendidos. Uma vez que o catabolismo do AP pode produzir H2O2 através de oxidases, o estresse oxidati...

  16. Does botulinum toxin improve the function of the patient with spasticity after stroke? Toxina botulínica proporciona melhora funcional em pacientes com espasticidade secundária a acidente vascular cerebral?

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    Eduardo Cardoso

    2007-09-01

    Full Text Available Post-stroke spasticity is an important cause of disability in adults, due to muscle hyperactivity, which results in limb stiffness and muscle spasm. The prognosis for these patients depends on several features such as early management and adequate physical therapy to avoid muscle shortening, pain, and their consequences. Although several papers have shown that intramuscular injections of botulinum toxin type A (BT-A decreases spasticity in post-stroke patients, few authors have demonstrated functional improvement after this therapy. In order to assess if individualized BT-A injections improves upper limb function in post-stroke spastic patients, we prospectively followed 20 consecutive patients of 18 years of age or more with spastic hemiparesis secondary to stroke. Fulg-Meyer scale modified for upper limbs, measure of functional independence (MFI, Ashworth modified scale, and goniometry were applied in the beginning of the investigation and in the 16th and 32nd weeks. BT-A was applied at baseline and in the 16th week. All subjects were submitted to rehabilitation therapy. All patients showed improvement according to Ashworth modified scale and increase in the range of motion, which were sustained until the 32nd week (pEspasticidade secundária a acidente vascular cerebral (AVC é importante causa de incapacidade em adultos. O prognóstico para estes pacientes depende de vários fatores como tratamento precoce e terapia física adequada, evitando encurtamento muscular, dor e outras conseqüências. Vários estudos têm demonstrado que aplicacões intramusculares de toxina botulínica do tipo A (TxB-A reduzem a espasticidade após AVC, entretanto poucos autores observaram melhora funcional de membros superiores com esta terapêutica. Para determinar se aplicações individualizadas de TxB-A melhoram a função no membro superior espástico de pacientes com hemiparesia secundária a AVC, acompanhamos 20 pacientes com história de AVC entre 6 meses

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

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    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

  18. 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

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    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.

  19. Employees with Cerebral Palsy

    Science.gov (United States)

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

  20. United Cerebral Palsy

    Science.gov (United States)

    ... be sure to follow us on Twitter . United Cerebral Palsy UCP educates, advocates and provides support services to ... Partners Merz Logo Sprint Relay Copyright © 2015 United Cerebral Palsy 1825 K Street NW Suite 600 Washington, DC ...

  1. Characterization of interictal epileptiform discharges with time-resolved cortical current maps using the helmholtz-hodge decomposition.

    Science.gov (United States)

    Slater, Jeremy D; Khan, Sheraz; Li, Zhimin; Castillo, Eduardo

    2012-01-01

    Source estimates performed using a single equivalent current dipole (ECD) model for interictal epileptiform discharges (IEDs) which appear unifocal have proven highly accurate in neocortical epilepsies, falling within millimeters of that demonstrated by electrocorticography. Despite this success, the single ECD solution is limited, best describing sources which are temporally stable. Adapted from the field of optics, optical flow analysis of distributed source models of MEG or EEG data has been proposed as a means to estimate the current motion field of cortical activity, or "cortical flow." The motion field so defined can be used to identify dynamic features of interest such as patterns of directional flow, current sources, and sinks. The Helmholtz-Hodge Decomposition (HHD) is a technique frequently applied in fluid dynamics to separate a flow pattern into three components: (1) a non-rotational scalar potential U describing sinks and sources, (2) a non-diverging scalar potential A accounting for vortices, and (3) an harmonic vector field H. As IEDs seem likely to represent periods of highly correlated directional flow of cortical currents, the U component of the HHD suggests itself as a way to characterize spikes in terms of current sources and sinks. In a series of patients with refractory epilepsy who were studied with magnetoencephalography as part of their evaluation for possible resective surgery, spike localization with ECD was compared to HHD applied to an optical flow analysis of the same spike. Reasonable anatomic correlation between the two techniques was seen in the majority of patients, suggesting that this method may offer an additional means of characterization of epileptic discharges.

  2. Reabilitação da disfagia orofaríngea em crianças com paralisia cerebral: uma revisão sistemática da abordagem fonoaudiológica

    OpenAIRE

    Hirata, Gisela Carmona; Santos, Rosane Sampaio

    2012-01-01

    INTRODUÇÃO: Estima-se 30.000 a 40.000 novos casos de paralisia cerebral, por ano, no Brasil. Os transtornos motores causados pela paralisia cerebral podem acarretar alterações na deglutição uma vez que alteram as fases preparatória, oral, faríngea e esofágica. OBJETIVO: Identificar os métodos de reabilitação existentes, na área da disfagia, nos casos de paralisia cerebral, com ênfase na busca por pesquisas que utilizaram os métodos neuroevolutivo Bobath, método Rodolfo Castillo Morales, terap...

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

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    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

  4. Ictal and interictal 99mTc-HMPAO brain SPECT of a MELAS case presented with epilepsy-like visual hallucination.

    Science.gov (United States)

    Wei, Cheng-Yu; Hsiao, Heng-Long; Chen, Shang-Chi; Hung, Guang-Uei; Kao, Chia-Hung

    2012-09-01

    A 55-year-old woman was diagnosed with the syndrome of mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). She was referred for Tc-HMPAO brain SPECT because of visual hallucinations, which were suspected to be related to epileptic seizures. Ictal SPECT images showed remarkable hyperperfusion in the left occipital cortex, which returned to near-normal status on the interictal SPECT images after treatment with anticonvulsants. It is very rare to see such an ictal SPECT image of epileptic or epilepsy-like disorders, especially in the setting of MELAS syndrome with visual hallucination.

  5. 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

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    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

  6. Cerebral microangiopathies; Zerebrale Mikroangiopathien

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-03-15

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

  7. 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

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    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

  8. 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

  9. Cerebral oximetry and cerebral blood flow monitoring in 2 pediatric survivors with out-of-hospital cardiac arrest.

    Science.gov (United States)

    Abramo, Thomas; Aggarwal, Nitin; Kane, Ian; Crossman, Kristen; Meredith, Mark

    2014-04-01

    In pediatric out-of-hospital cardiac arrest (POHCA), cardiovascular monitoring tools have improved resuscitative endeavors and cardiovascular outcomes but with still poor neurologic outcomes. Regarding cardiac arrest in patients with congenital heart disease during surgery, the application of cerebral oximetry with blood volume index (BVI) during the resuscitation has shown significant results and prognostic significance. We present 2 POHCA patients who had cerebral oximetry with BVI monitoring during their arrest and postarrest phase in the emergency department and its potential prognostic aspect.Basic procedures include left and right cerebral oximetry with BVI monitoring at every 5-second interval during cardiac arrest, resuscitation, and postarrest in 2 POHCA patients in the pediatric emergency department.Regional cerebral tissue oxygen saturation (rSo2) with BVI readings in these 2 POHCA survivors demonstrated interesting cerebral physiology, blood flow, and potential prognostic outcome. In 1 patient, the reference range of cerebral rSo2 with positive blood flow during arrest and postarrest phases consistently occurred. This neurologic monitoring had its significance when the resuscitation effectiveness was used and end-tidal CO2 changes were lost. The other patient's cerebral rSo2 with simultaneous BVI readings and trending showed the effectiveness of the emergency medical services (EMS) resuscitation.Cerebral oximetry with cerebral blood flow index monitoring in these POHCA survivors demonstrates compelling periarrest and postarrest cerebral physiology information and prognostication. Cerebral oximetry with cerebral BVI monitoring during these arrest phases has potential as a neurologic monitor for the resuscitative intervention's effectiveness and its possible neurologic prognostic application in the pediatric OCHA patients.

  10. Increased Serum CD14 Level Is Associated with Depletion of TNF-α in Monocytes in Migraine Patients during Interictal Period

    Science.gov (United States)

    Michalak, Slawomir; Kalinowska-Lyszczarz, Alicja; Wegrzyn, Danuta; Niezgoda, Adam; Losy, Jacek; Osztynowicz, Krystyna; Kozubski, Wojciech

    2017-01-01

    The aim of the present study was to investigate the levels of circulating CD14 in relation to the expression of tumor necrosis factor alpha (TNF-α) in monocytes, and serum levels of TNF-α and macrophage inflammatory protein-1 (MIP-1) in migraine patients. Numerous studies revealed controversial changes in the components of the immune system during attacks and the interictal period in migraine patients. Our study included 40 migraineurs and 39 controls. The levels of TNF-α, MIP-1 and CD14 were measured in peripheral monocytes and in sera with the Enzyme-Linked Immunosorbent Assay (ELISA) method, and the monocyte expression of TNF-α was also analysed by immunostaining. Serum CD14 concentrations were higher and the expression of TNF-α in monocytes was decreased in migraineurs. The serum MIP-1 level correlated with Verbal Rating Scale (VRS); the MIP-1:CD14 ratio in monocytes correlated with Visual Analogue Scale (VAS); the MIP-1:CD14 ratio correlated with Migraine Severity (MIGSEV)-Pain scores; and serum CD14 concentration correlated with migraine duration in years. Increased serum CD14 and depletion of TNF-α in monocytes can orchestrate other components of the immune system during the interictal period. PMID:28208835

  11. Increased Serum CD14 Level Is Associated with Depletion of TNF-α in Monocytes in Migraine Patients during Interictal Period

    Directory of Open Access Journals (Sweden)

    Slawomir Michalak

    2017-02-01

    Full Text Available The aim of the present study was to investigate the levels of circulating CD14 in relation to the expression of tumor necrosis factor alpha (TNF-α in monocytes, and serum levels of TNF-α and macrophage inflammatory protein-1 (MIP-1 in migraine patients. Numerous studies revealed controversial changes in the components of the immune system during attacks and the interictal period in migraine patients. Our study included 40 migraineurs and 39 controls. The levels of TNF-α, MIP-1 and CD14 were measured in peripheral monocytes and in sera with the Enzyme-Linked Immunosorbent Assay (ELISA method, and the monocyte expression of TNF-α was also analysed by immunostaining. Serum CD14 concentrations were higher and the expression of TNF-α in monocytes was decreased in migraineurs. The serum MIP-1 level correlated with Verbal Rating Scale (VRS; the MIP-1:CD14 ratio in monocytes correlated with Visual Analogue Scale (VAS; the MIP-1:CD14 ratio correlated with Migraine Severity (MIGSEV-Pain scores; and serum CD14 concentration correlated with migraine duration in years. Increased serum CD14 and depletion of TNF-α in monocytes can orchestrate other components of the immune system during the interictal period.

  12. Papiledema unilateral na síndrome do pseudotumor cerebral

    Directory of Open Access Journals (Sweden)

    Mário L. R. Monteiro

    1985-06-01

    Full Text Available 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.

  13. O BERA como instrumento de avaliação funcional do tronco cerebral em cirurgias com hipotermia profunda e parada circulatória total The ABR as a tool in the evaluation of brainstem function in surgeries with deep hypothermia and total cardiac arrest

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Alves de Sousa

    2003-10-01

    Full Text Available OBJETIVO: Monitoramento do tronco cerebral através da análise dos traçados do BERA em cirurgia cardíaca com hipotermia profunda e parada circulatória total (PCT, registrando a recuperação funcional (eletrofisiológica do tronco cerebral. FORMA DE ESTUDO: Coorte Longitudinal. MATERIAL E MÉTODO: Foram estudados o comportamento do traçado do BERA de 8 pacientes submetidos a cirurgia cardíaca com hipotermia profunda e PCT para correção de aneurisma de aorta torácica. Etapas: resfriamento corporal até 18ºC C; PCT por até 60 minutos; reaquecimento. Registros do BERA: 35ºC, 32ºC, 26ºC, 18ºC, 27ºC, 35ºC. RESULTADOS: Os traçados iniciais (35ºC se apresentavam normais. Aos 26ºC há o desaparecimento de todas as ondas. Aos 18ºC o traçado do BERA mostrava um padrão isoelétrico. Aos 27ºC, recuperação das ondas I, III e V. A partir de 35ºC as latências das ondas retornam ao normal. CONCLUSÃO: O BERA constitui-se em competente instrumento de monitoramento da integridade funcional do tronco cerebral em cirurgia cardíaca com hipotermia profunda e PCT. As ondas desaparecem no período de resfriamento corporal, atingem um padrão isoelétrico a 18ºC, e reaparecem durante o reaquecimento. No final do procedimento, os médicos anestesistas não dispõem de exame clínico fidedigno para acessar a integridade funcional do tronco cerebral, devido ao uso de drogas depressoras do SNC. O reaparecimento das ondas do BERA é o parâmetro proposto para este fim. A manutenção do padrão isoelétrico após o reaquecimento corporal sugere grave comprometimento funcional do tronco cerebral.AIM: The authors propose the use of ABR as an instrument for the detection of brainstem dysfunction in the trans- and post-operatory period of surgeries with total circulatory arrest (TCA and deep hypothermia for correction of aneurysms of the thoracic aorta. STUDY DESIGN: Longitudinal Cohort. MATERIAL AND METHOD: Eight adult patients that underwent

  14. Simple partial status epilepticus localized by single-photon emission computed tomography subtraction in chronic cerebral paragonimiasis.

    Science.gov (United States)

    Joo, Eun Yeon; Kim, Jee Hyun; Tae, Woo Suk; Han, Sun Jung; Kim, Seunghwan; Kim, Myoung-Hee; Byun, Hong Sik; Hong, Seung Bong

    2004-10-01

    A patient with chronic cerebral paragonimiasis began to have new motor seizures of the right face manifested by clonic contractions that occurred several hundred times a day, consistent with simple partial status epilepticus. Ictal electroencephalogram discharges started from the left frontal region and then spread to the left hemisphere with left frontal maximum. But clinical seizures were limited to the right face. The frequent partial seizures were controlled by the intravenous infusion of phenytoin. Brain magnetic resonance imaging showed multiple conglomerated round nodules with encephalomalacia in the left temporal and occipital lobes. Applying the technique of ictal-interictal single-photo emission computed tomography subtraction, the authors were able to localize the focal ictal-hyperperfusion on left precentral cortex adjacent to the lesions that correspond to the anatomical distribution of left face motor area.

  15. 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.

  16. 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.

  17. 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.)

  18. Sintomas de depressão e ansiedade estão associados a alterações na Default Mode Network em pacientes com acidente vascular cerebral isquêmico subagudo

    OpenAIRE

    Jéssica Elias Vicentini

    2016-01-01

    Sintomas de depressão e ansiedade são comuns após um acidente vascular cerebral (AVC) e estão associados à redução na qualidade de vida e pior recuperação física e social. A Default Mode Network (DMN) é uma rede cerebral que desempenha papel importante nos processos emocionais. O presente trabalho objetivou investigar se sintomas de depressão e ansiedade no primeiro mês após AVC isquêmico estão associados a alterações na conectividade funcional da DMN. Trinta e quatro pacientes com AVC isquêm...

  19. Anestesia e paralisia cerebral

    OpenAIRE

    Március Vinícius M Maranhão

    2005-01-01

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

  20. 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.

  1. Demonstration of cerebral vessels by multiplane computed cerebral angiotomography

    Energy Technology Data Exchange (ETDEWEB)

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

    1981-06-01

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

  2. Cerebral venous sinus thrombosis

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-02-01

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

  3. 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...

  4. 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

  5. Cerebral palsy and congenital malformations

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  6. 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

  7. Estudo comparativo do tono muscular na paralisia cerebral tetraparética em crianças com lesões predominantemente corticais ou subcorticais na tomografia computadorizada de crânio

    OpenAIRE

    2003-01-01

    OBJETIVO: Comparar a distribuição e intensidade do tono muscular na paralisia cerebral tetraparética espástica (PC-T), correlacionando os dados clínicos com a localização da lesão no sistema nervoso central. MÉTODO: Foram incluídas 12 crianças de dois a quatro anos de idade com lesões predominantemente corticais (seis crianças) e subcorticais (seis crianças). O tono foi analisado nos membros superiores (MMSS) e inferiores (MMII) baseado no protocolo de Durigon e Piemonte. RESULTADOS: Não houv...

  8. Análise cinemática da marcha em indivíduos com hemiparesia espástica após acidente vascular cerebral = Kinematic analysis of gait in individuals with spastic hemiparesis secondary to stroke

    Directory of Open Access Journals (Sweden)

    Westphal, Patrick Jacobsen

    2016-01-01

    Conclusões: O estudo indicou alterações na cinemática da marcha do membro acometido de indivíduos hemiparéticos após acidente vascular cerebral, comparando com a normalidade e com o membro contralateral, caracterizando a presença de um padrão flexor incomum. Essas alterações podem estar relacionadas com diminuição do equilíbrio e do controle motor, fraqueza muscular, déficit proprioceptivo, aumento do tônus, contraturas e deformidades

  9. 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...

  10. 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

  11. Clinical Neuroimaging of cerebral ischemia

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-06-01

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

  12. Stochastic Behavior of Phase Synchronization Index and Cross-Frequency Couplings in Epileptogenic Zones during Interictal Periods Measured with Scalp dEEG.

    Science.gov (United States)

    Ramon, Ceon; Holmes, Mark D

    2013-01-01

    The stochastic behavior of the phase synchronization index (SI) and cross-frequency couplings on different days during a hospital stay of three epileptic patients was studied for non-invasive localization of the epileptogenic areas from high density, 256-channel, scalp EEG (dEEG) recordings. The study was performed with short-duration (0-180 s), seizure-free, epileptiform-free, and spike-free interictal dEEG data on different days of three subjects. The seizure areas were localized with subdural recordings with an 8 × 8 macro-electrode grid array and strip electrodes. The study was performed in theta (3-7 Hz), alpha (7-12 Hz), beta (12-30 Hz), and low gamma (30-50 Hz) bands. A detrended fluctuation analysis was used to find the long range temporal correlations in the SI that reveals the stochastic behavior of the SI in a given time period. The phase synchronization was computed after taking Hilbert transform of the EEG data. Contour plots were constructed with 20 s time-frames using a montage of the layout of 256 electrode positions. It was found that the stochastic behavior of the SI was higher in epileptogenic areas and in nearby areas on different days for each subject. The low gamma band was found to be the best to localize the epileptic sites. Also, a stable higher pattern of SI emerged after 60-120 s in the epileptogenic areas. The cross-frequency couplings of SI in theta-gamma, beta-gamma, and alpha-gamma bands were decreased and spatial patterns were fragmented in epileptogenic areas. Combinations of an increase in the stochastic behavior of the SI and decrease in cross-frequency couplings are potential markers to assist in localizing epileptogenic areas. These findings suggest that it is possible to localize the epileptogenic areas non-invasively from a short-duration (∼180 s), seizure-free and spike-free interictal scalp dEEG recordings.

  13. Craniotomia descompressiva bifrontal no tratamento do edema cerebral grave

    Directory of Open Access Journals (Sweden)

    Walter C. Pereira

    1977-06-01

    Full Text Available São apresentados os resultados obtidos com craniotomia descompressiva bifrontal ampla em 12 doentes com edema cerebral grave e irreversível com os métodos convencionais de tratamento, provocado em 10 por traumatismo crânio-encefálico. Todos os pacientes apresentavam quadro neurológico muito grave, com sinais de comprometimento do tronco cerebral superior. Angiografia caro-tídea bilateral foi praticada sistematicamente, tanto no pré como no pós-operatório, constituindo-se no fator decisivo para a indicação cirúrgica. Seis (50% dos doentes sobreviveram, apresentando 5 (41,6% recuperação neurológica e psíquica praticamente totais. Levando em conta estes resultados, consideramos esta técnica cirúrgica o melhor recurso de tratamento em tais casos, máxime se indicada precocemente. São necessários, contudo, cuidados pós-operatórios especiais com estes pacientes, que devem, sempre que possível, ser mantidos em unidade de terapia intensiva, em virtude da grande incidência de complicações, mormente respiratórias.

  14. Cerebrovascular disorders in childhood: etiology, clinical presentation, and neuroimaging findings in a case series study Acidente vascular cerebral na infância: etiologia, apresentação clínica e achados de neuroimagem em um estudo de série de casos

    Directory of Open Access Journals (Sweden)

    André P.C. Matta

    2006-06-01

    Full Text Available OBJECTIVE: To describe the main etiologies, neurological manifestations and neuro-imaging findings among children with sequelae of cerebrovascular disorders. METHOD: Case series study of children whose diagnosis was stroke sequelae. Variables studied were age at the time of first episode, number of episodes, etiology, motor deficits, epilepsy, and effected vascular territory. RESULTS: Twenty three patients were studied. Average age at first episode was 6.91 (±2.08 years. Fourteen patients were female. The number of stroke events per patient ranged from one to five. The most frequent etiologies were heart disease and sickle cell anemia. The most frequent neurological deficit was right hemiparesis. Nine patients experienced seizures. The left middle cerebral artery was the most affected vascular area. CONCLUSION: Our findings are similar to those described in the literature. Despite a careful investigation, some causes of stroke remain unidentified.OBJETIVO: Descrever as principais etiologias, manifestações neurológicas e achados de neuroimagem entre crianças com seqüela de acidente vascular cerebral (AVC. MÉTODO: Estudo de série de casos de crianças com seqüela de AVC isquêmico ou hemorrágico, analisando-se as variáveis: idade no primeiro episódio, número de eventos, etiologia, déficit motor, epilepsia e território vascular acometido. RESULTADO: Vinte e três pacientes foram incluídos, sendo 14 do sexo feminino. A idade do primeiro episódio foi 6.91 (±2,08 anos. O número de eventos por paciente variou entre 1 e 5. As etiologias mais freqüentes foram cardiopatia e anemia falciforme. O déficit mais encontrado foi a hemiparesia direita. Nove pacientes apresentaram convulsões. A artéria cerebral média esquerda foi o território vascular mais afetado. COCLUSÃO: Os achados deste trabalho estão de acordo com a literatura em geral. Apesar de extensa investigação, alguns casos permanecem sem definição etiológica.

  15. Cerebral phaeohyphomycosis by Exophiala dermatitidis

    Directory of Open Access Journals (Sweden)

    S Sood

    2014-01-01

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

  16. Cerebral phaeohyphomycosis by Exophiala dermatitidis.

    Science.gov (United States)

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

    2014-01-01

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

  17. 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.

  18. Edema cerebral crônico na neurocisticercose

    Directory of Open Access Journals (Sweden)

    AGAPEJEV SVETLANA

    1998-01-01

    Full Text Available Neste estudo retrospectivo, relatam-se as características clínicas do edema cerebral crônico (ECCr em 34 pacientes com neurocisticercose (NCC, que apresentavam edema cerebral difuso, à tomografia computadorizada (TC, como característica comum. Todos foram tratados com dextroclorofeniramina e, 32 deles, com albendazol. O ECCr predominou no sexo feminino (73,5% na faixa etária dos 11 - 40 anos (92,3%. A cefaléia ocorreu em 94,1% dos pacientes, náuseas/vômitos em 47,1%, crises epilépticas em 41,1% e distúrbios psíquicos em 38,2%. A hiperreflexia ocorreu em 82,3% e o papiledema em 58,8% e o exame neurológico normal em 11,8%. Na TC, o edema esteve associado a calcificações em 61,8% dos casos. As pressões liquóricas foram mais elevadas (p< 0,05 antes do tratamento. Atualmente, estão assintomáticos, ou com melhora clínica, 79,4% dos pacientes (57,1% deles sem medicação. Discute-se a possibilidade do ECCr, na NCC, ser uma manifestação antigênica, sem a presença concomitante de cistos parasitários, e poder representar mais uma condição clínica associada à hipertensão intracraniana benigna.

  19. [Cerebral ischemia and histamine].

    Science.gov (United States)

    Adachi, Naoto

    2002-10-01

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

  20. 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...

  1. Perfusão da artéria pulmonar não melhora os índices de fator natriurético cerebral (BNP em estudo experimental em suínos Pulmonary artery perfusion does not improve brain natriuretic peptide (BNP levels in suine experimental research

    Directory of Open Access Journals (Sweden)

    Edmo Atique Gabriel

    2010-12-01

    Full Text Available OBJETIVO: Avaliar se perfusão controlada do tronco pulmonar durante circulação extracorpórea (CEC modifica os níveis de BNP expressos pelo miocárdio ventricular. MÉTODOS: Estudo experimental com 32 porcos, divididos em dois grupos de acordo com estratégia de CEC - grupo I (cardioplegia e grupo II (coração batendo. Ambos os grupos foram alocados em três subgrupos, de acordo com a estratégia de perfusão pulmonar - subgrupo A (controle: sem perfusão pulmonar, subgrupo B (perfusão pulmonar com sangue arterial e subgrupo C (perfusão com sangue venoso. Nos subgrupos B e C, pulmões foram perfundidos por 30 minutos, utilizando pressão arterial média pulmonar (PAPM préoperatória como pressão de perfusão, a qual foi controlada com manômetro. PAPM e resistência vascular pulmonar (RVP foram medidas após saída de CEC com cateter de Swan-Ganz. No período pré-operatório e após 30 minutos de perfusão pulmonar, fragmentos de miocárdio ventricular direito foram coletados para avaliar expressão de peptídeo natriurético cerebral (BNP e padrão histológico tecidual. Técnicas de imunohistoquímica e hematoxilina-eosina foram utilizadas para determinar, respectivamente, expressão de BNP e lesões inflamatórias miocárdicas. RESULTADOS: Nos animais submetidos à perfusão controlada do tronco pulmonar, houve redução pós-operatória da PAPM (P=0,03 e da RVP (P=0,005. Não houve diferenças entre os subgrupos do grupo I (P=0,228 e subgrupos do grupo II (P=0,325 quanto à expressão pós-operatória de BNP. Não houve diferenças entre subgrupos com e sem perfusão pulmonar quanto à intensidade das lesões inflamatórias miocárdicas identificadas no pós-operatório (P>0,05. CONCLUSÃO: Perfusão controlada do tronco pulmonar por 30 minutos não foi suficiente para promover alterações substanciais na expressão de BNP e no padrão histológico miocárdico do ventrículo direito.OBJECTIVE: Assess if the main pulmonary artery

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

    OpenAIRE

    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 ...

  3. Treino cognitivo em idosos institucionalizados

    OpenAIRE

    Ferreira, Sara Melissa

    2012-01-01

    Face ao crescimento e longevidade da população idosa na sociedade atual torna-se cada vez mais necessário criar estratégias em prol de um Envelhecimento Ativo, ambicionando mais qualidade nos anos vividos. Sabe-se que ao longo do desenvolvimento humano existem perdas e ganhos. Estudos documentam declínio da capacidade da memória em indivíduos de idade avançada. No entanto, existem inúmeras evidências científicas da plasticidade cerebral que fundamentam a intervenção cognitiva através de Progr...

  4. Príncipe Liev Nikoláievitch Míchkin ("O Idiota", Fiódor Dostoevsky e a síndrome de personalidade interictal na epilepsia do lobo temporal Prince Liev Nikoláievitch Míchkin ("The Idiot", Fiódor Dostoevsky and the interictal personality syndrome of temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Leonardo Cruz de Souza

    2004-06-01

    Full Text Available A obra do romancista russo Fiódor Dostoevsky (1821-1881, além de seu extraordinário valor literário, reveste-se de importância especial para neurologistas e epileptologistas. O escritor, que era portador da enfermidade, transmitiu através de seus textos o universo do epiléptico e a maneira como esse é percebido pela sociedade. Seus livros tiveram grande influência na maneira como a cultura ocidental percebe a doença. O romance "O Idiota" tem como protagonista o Príncipe Liev Nikoláievitch Míchkin, um epiléptico com personalidade marcante. Considerando a proposta feita por Geschwind-Waxman (1975 de síndrome de personalidade interictal na epilepsia do lobo temporal, este artigo pretende discutir as alterações comportamentais no paciente epiléptico a partir de Míchkin, personagem principal de "O Idiota", de Fiódor Dostoevsky.Russian romancist Fiódor Dostoevsky's composition, besides its extraordinary literary value, has a special importance for neurologists and epileptologists. The writer, who suffered of epilepsy, transmitted in his texts the epileptic's universe and how the pacient is perceived by the society. His novels had great influence on how epilepsy is perceived by western culture. The romance "The Idiot" has as protagonist Prince Liev Nikoláievitch Míchkin, a epileptic with remarkable personality. Considering the propose made by Geschwind-Waxman (1975 of a interictal personality syndrome in temporal lobe epilepsy, this article intends to discuss the behavioral alterations in epileptic patient, from Míchkin, the main character in Fiódor Dostoevsky's "The Idiot".

  5. Screening for MELAS mutations in young patients with stroke of undetermined origin Mutações relacionadas à síndrome de MELAS em pacientes jovens com acidente vascular cerebral de etiologia indeterminada

    Directory of Open Access Journals (Sweden)

    Adriana Bastos Conforto

    2007-06-01

    Full Text Available PURPOSE: It has been suggested that mitochondrial disease may be responsible for a substantial proportion of strokes of indetermined origin. We have preliminarily screened for MELAS (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes mutations in young patients with cryptogenic strokes. METHOD: The mitochondrial mutations A3243G and T3271C were investigated in 38 subjects aged less than 46 years. Group 1: 15 patients with cryptogenic strokes; Group 2: 3 patients with diagnosis of MELAS syndrome, including stroke-like episodes; Group 3: 20 healthy subjects. RESULTS: The A3243G mutation was absent in all subjects in Groups 1 and 3 but was present in all subjects in Group 2. CONCLUSION: Our results do not support screening for these mutations to diagnose oligosymptomatic forms of MELAS in cryptogenic strokes in the absence of other features of the syndrome. We suggest that clinical findings should guide mitochondrial genetic testing.PROPÓSITO: Foi sugerido que mitocondriopatias possam ser responsáveis por uma proporção substancial de acidentes vasculares cerebrais de etiologia indeterminada. Realizamos um estudo preliminar de pesquisa de mutações relacionadas à síndrome de MELAS (encefalomiopatia mitocondrial, acidose lática e episódios "stroke-like" em pacientes jovens com acidentes vasculares cerebrais criptogênicos. MÉTODO: As mutações mitocondriais A3243G e T3271C em 38 indivíduos com menos de 46 anos. Grupo 1: 15 pacientes com acidentes vasculares cerebrais criptogênicos; Grupo 2: 3 pacientes com diagnóstico de síndrome de MELAS, incluindo episódios "stroke-like"; Grupo 3: 20 voluntários saudáveis. RESULTADOS: A mutação A3243G esteve ausente em todos os indivíduos dos Grupos 1 e 3 mas esteve presente em todos os indivíduos do Grupo 2. CONCLUSÃO: Nossos resultados sugerem que não há utilidade em pesquisar estas mutações para diagnosticar formas oligossintomáticas de MELAS em acidentes

  6. 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)

  7. Human cerebral autoregulation before, during and after spaceflight.

    Science.gov (United States)

    Iwasaki, Ken-ichi; Levine, Benjamin D; Zhang, Rong; Zuckerman, Julie H; Pawelczyk, James A; Diedrich, André; Ertl, Andrew C; Cox, James F; Cooke, William H; Giller, Cole A; Ray, Chester A; Lane, Lynda D; Buckey, Jay C; Baisch, Friedhelm J; Eckberg, Dwain L; Robertson, David; Biaggioni, Italo; Blomqvist, C Gunnar

    2007-03-15

    Exposure to microgravity alters the distribution of body fluids and the degree of distension of cranial blood vessels, and these changes in turn may provoke structural remodelling and altered cerebral autoregulation. Impaired cerebral autoregulation has been documented following weightlessness simulated by head-down bed rest in humans, and is proposed as a mechanism responsible for postspaceflight orthostatic intolerance. In this study, we tested the hypothesis that spaceflight impairs cerebral autoregulation. We studied six astronauts approximately 72 and 23 days before, after 1 and 2 weeks in space (n = 4), on landing day, and 1 day after the 16 day Neurolab space shuttle mission. Beat-by-beat changes of photoplethysmographic mean arterial pressure and transcranial Doppler middle cerebral artery blood flow velocity were measured during 5 min of spontaneous breathing, 30 mmHg lower body suction to simulate standing in space, and 10 min of 60 deg passive upright tilt on Earth. Dynamic cerebral autoregulation was quantified by analysis of the transfer function between spontaneous changes of mean arterial pressure and cerebral artery blood flow velocity, in the very low- (0.02-0.07 Hz), low- (0.07-0.20 Hz) and high-frequency (0.20-0.35 Hz) ranges. Resting middle cerebral artery blood flow velocity did not change significantly from preflight values during or after spaceflight. Reductions of cerebral blood flow velocity during lower body suction were significant before spaceflight (P e.m.) cerebral blood flow velocity after 10 min upright tilt were smaller after than before spaceflight (absolute, -4 +/- 3 cm s(-1) after versus -14 +/- 3 cm s(-1) before, P = 0.001; and percentage, -8.0 +/- 4.8% after versus -24.8 +/- 4.4% before, P < 0.05), consistent with improved rather than impaired cerebral blood flow regulation. Low-frequency gain decreased significantly (P < 0.05) by 26, 23 and 27% after 1 and 2 weeks in space and on landing day, respectively, compared with

  8. 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)

  9. 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.

  10. Experimental Focal Cerebral Ischemia

    DEFF Research Database (Denmark)

    Christensen, Thomas

    2007-01-01

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

  11. Acidente vascular cerebral e demência vascular no idoso

    OpenAIRE

    Ionel, Cristina

    2015-01-01

    Trabalho final de mestrado integrado em Medicina, apresentado à Faculdade de Medicina da Universidade de Coimbra. Em consequência de um fenómeno global de envelhecimento populacional, é expectável um aumento na prevalência de demência. A demência vascular é a segunda causa mais comum de demência, depois da doença de Alzheimer. Trata-se de uma entidade clínica bastante heterogénea, sendo o acidente vascular cerebral (AVC) um dos seus mecanismos subjacentes. No entanto, nem todos os doentes ...

  12. 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

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

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    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.

  14. Análise das camadas retinianas em doentes com lesão isquémica da artéria cerebral posterior unilateral: Um estudo de tomografia de coerência óptica

    OpenAIRE

    Anjos, Rita Serrano

    2016-01-01

    Introdução:  A degeneração transneuronal retrógrada (DTR) das células ganglionares tem sido implicada na fisiopatologia de lesões na via visual posterior. Apesar de estarem descritas alterações nas camadas mais externas da retina na patologia do nervo óptico, esta relação com lesões a nível occipital permanece desconhecida.  O objectivo do presente estudo é a avaliação das camadas nuclear interna (CNi), plexiforme externa (CPe), nuclear externa (CNe) e dos fotoreceptores (CFo) em doentes com ...

  15. 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...

  16. 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...

  17. Parálisis cerebral Cerebral palsy

    Directory of Open Access Journals (Sweden)

    Jorge Malagon Valdez

    2007-01-01

    Full Text Available El término parálisis cerebral (PC engloba a un gran número de síndromes neurológicos clínicos, de etiología diversa. Estos síndromes se caracterizan por tener una sintomatología común: los trastornos motores. Algunos autores prefieren manejar términos como "encefalopatía fija", "encefalopatías no evolutivas". Se mencionan la utilidad de programas de intervención temprana y métodos especiales de rehabilitación, así como el manejo de las deficiencias asociadas como la epilepsia, deficiencia mental, trastornos del lenguaje, audición, visión, déficit de la atención que mejoran el pronóstico de manera significativa. El pronóstico también depende de la gravedad del padecimiento y de las manifestaciones asociadas.The term cerebral palsy (CP, is used for a great number of clinical neurological syndromes. The syndromes are characterized by having a common cause, motor defects. It is important, because they can cause a brain damage by presenting motor defects and some associated deficiencies, such as mental deficiency, epilepsy, language and visual defects and pseudobulbar paralysis, with the nonevolving fact. Some authors prefer using terms such as "non-evolving encephalopathies". In the treatment the utility of prevention programs of early stimulation and special rehabilitation methods, and treatment of associated deficiencies such as epilepsy, mental deficiency, language, audition and visual problems, and the attention deficit improve the prognosis in an important way. The prognosis depends on the severity of the disease and the associated manifestations.

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

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    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.

  19. RESPOSTAS DA ATIVIDADE ENZIMÁTICA HEPÁTICA E CEREBRAL EM FUNÇÃO DE DIFERENTES NÍVEIS DE RESTRIÇÃO ALIMENTAR: I – FOSFATASE

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    OLGA MARIA MASCARENHAS FARIA DE OLIVEIRA

    2007-01-01

    Full Text Available O estudo foi feito para determinar a influência de restrição alimentar estabelecida em vários níveis sobre a atividade enzimática de algumas enzimas. Foram alimentados ratos machos com dieta comercial ad libitum (grupo controle e com restrição de 30% e 40% (grupos experimentais. Após o período experimental que teve duração de 28 dias, os animais foram sacrificados e os fígados, cérebros e rins removidos, homogeneizados e submetidos a diferentes velocidades de centrifugação e, em cada etapa foram realizados estudos cinético-enzimáticos das referidas enzimas e dosagem protéica. Os resultados mostraram que a restrição alimentar afeta a quantidade das enzimas fosfatase alcalina e amilase, além do conteúdo protéico, levando a significativo aumento ou diminuição de acordo com o grau de restrição e com a fase do fracionamento centrífugo estudada. O mesmo observou-se para o exercício físico.

  20. Local cerebral metabolism during partial seizures

    Energy Technology Data Exchange (ETDEWEB)

    Engel, J. Jr.; Kuhl, D.E.; Phelps, M.E.; Rausch, R.; Nuwer, M.

    1983-04-01

    Interictal and ictal fluorodeoxyglucose scans were obtained with positron CT from four patients with spontaneous recurrent partial seizures, one with epilepsia partialis continua, and one with a single partial seizure induced by electrical stimulation of the hippocampus. Ictal metabolic patterns were different for each patient studied. Focal and generalized increased and decreased metabolism were observed. Ictal hypermetabolism may exceed six times the interictal rate and could represent activation of excitatory or inhibitory synapses in the epileptogenic region and its projection fields. Hypometabolism seen on ictal scans most likely reflects postictal depression and may indicate projection fields of inhibited neurons. No quantitative relationship between alterations in metabolism and EEG or behavioral measurements of ictal events could be demonstrated.

  1. Applications of cerebral SPECT

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-15

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

  2. 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

  3. Phenylpropanolamine and cerebral hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

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

    1985-05-01

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

  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. Avaliação funcional cerebral através da espectroscopia de prótons por ressonância magnética em pacientes com lúpus eritematoso sistêmico juvenil

    OpenAIRE

    2016-01-01

    Introdução: O lúpus eritematoso sistêmico juvenil (LESj) é uma doença autoimune causada por um desequilíbrio do sistema imunológico, podendo desencadear lesões e disfunção de vários órgãos e sistemas, incluindo o sistema nervoso central (SNC). O objetivo deste estudo foi determinar as concentrações de metabólitos cerebrais na substância branca em pacientes com LESj e associa-las com indicadores de atividade e dano da doença, manifestações neuropsiquiátricas, exames laboratoriais e tratamento....

  6. Cerebral salt wasting syndrome

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    Harshal Dholke

    2016-01-01

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

  7. Cerebral oxygenation and hyperthermia

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    Anthony Richard Bain

    2014-03-01

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

  8. Low distribution of synaptic vesicle protein 2A and synaptotagimin-1 in the cerebral cortex and hippocampus of spontaneously epileptic rats exhibiting both tonic convulsion and absence seizure.

    Science.gov (United States)

    Hanaya, R; Hosoyama, H; Sugata, S; Tokudome, M; Hirano, H; Tokimura, H; Kurisu, K; Serikawa, T; Sasa, M; Arita, K

    2012-09-27

    The spontaneously epileptic rat (SER) is a double mutant (zi/zi, tm/tm) which begins to exhibit tonic convulsions and absence seizures after 6 weeks of age, and repetitive tonic seizures over time induce sclerosis-like changes in SER hippocampus with high brain-derived neurotrophic factor (BDNF) expression. Levetiracetam, which binds to synaptic vesicle protein 2A (SV2A), inhibited both tonic convulsions and absence seizures in SERs. We studied SER brains histologically and immunohistochemically after verification by electroencephalography (EEG), as SERs exhibit seizure-related alterations in the cerebral cortex and hippocampus. SERs did not show interictal abnormal spikes and slow waves typical of focal epilepsy or symptomatic generalized epilepsy. The difference in neuronal density of the cerebral cortex was insignificant between SER and Wistar rats, and apoptotic neurons did not appear in SERs. BDNF distributions portrayed higher values in the entorhinal and piriform cortices which would relate with hippocampal sclerosis-like changes. Similar synaptophysin expression in the cerebral cortex and hippocampus was found in both animals. Low and diffuse SV2A distribution portrayed in the cerebral cortex and hippocampus of SERs was significantly less than that of all cerebral lobes and inner molecular layer (IML) of the dentate gyrus (DG) of Wistar rats. The extent of low SV2A expression/distribution in SERs was particularly remarkable in the frontal (51% of control) and entorhinal cortices (47%). Lower synaptotagmin-1 expression (vs Wistar rats) was located in the frontal (31%), piriform (13%) and entorhinal (39%) cortices, and IML of the DG (38%) in SER. Focal low distribution of synaptotagmin-1 accompanying low SV2A expression may contribute to epileptogenesis and seizure propagation in SER.

  9. 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.)

  10. Cerebral Autoregulation in Normal Pregnancy and Preeclampsia

    NARCIS (Netherlands)

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

    2013-01-01

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

  11. Molecular pathophysiology of cerebral edema.

    Science.gov (United States)

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

    2016-03-01

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

  12. Avaliação antropométrica dos pacientes com paralisia cerebral: quais as curvas mais adequadas?

    Directory of Open Access Journals (Sweden)

    Liubiana A. Araújo

    2013-06-01

    Full Text Available OBJETIVO: Descrever a avaliação nutricional de crianças com paralisia cerebral, verificando a concordância de curvas de crescimento específicas para paralisia cerebral com curvas gerais, além de avaliar a presença das manifestações digestórias associadas a agravos nutricionais. MÉTODOS: Corte transversal de 187 indivíduos com paralisia cerebral, avaliando-se dados antopométricos em curvas habitualmente utilizadas em pediatria e em curvas específicas para paralisia cerebral, além da descrição da presença de disfagia, constipação intestinal e infecções respiratórias de repetição. RESULTADOS: Dos indivíduos, 58% eram masculinos; média de idade de 5,6 anos ± 3,5 anos. Dados antopométricos de peso abaixo do percentil 10 ocorreu em 10% da amostra, considerando a escala para paralisia cerebral, contra 51% na referência do Center of Disease Control (p < 0,01; Kappa 0,19. A maioria dos indivíduos comprometidos com disfagia, infecções respiratórias de repetição e constipação intestinal encontrava-se abaixo do percentil 50, com porcentagens respectivas de 67%, 75% e 72%. CONCLUSÃO: As referências habitualmente utilizadas em pediatria tendem a superestimar a desnutrição em indivíduos com paralisia cerebral, e sua concordância com referências específicas para paralisia cerebral é baixa. As manifestações digestórias foram encontradas principalmente naqueles indivíduos cujas medidas antropométricas encontram-se abaixo do percentil 50.

  13. O nistagmo espontâneo em otoneurologia

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    Nelson Alvares Cruz

    1964-12-01

    Full Text Available O autor tece considerações sôbre o nistagmo espontâneo baseado em 74 casos: 31 síndromes do ângulo pontocerebelar, 40 do tronco cerebral e 3 dos hemisférios cerebelares. São discutidas as possibilidades do diagnóstico otoneurológico, maiores nas síndromes do ângulo pontocerebelar que nas síndromes do tronco cerebral.

  14. Frequency of stroke types at an emergency hospital in Natal, Brazil Freqüência dos tipos de acidente vascular cerebral em hospital de emergência, Natal, Brasil

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    Antonio N.N. Martins Jr

    2007-12-01

    Full Text Available We performed a cross-sectional study of stroke type frequency at a local emergency hospital, in Natal, Brazil. The sample consisted of all patients who were admitted to an emergency hospital with a presumptive diagnosis of stroke. Of the 416 patients, 328 were studied, 88 were excluded for not meeting inclusion criteria, 74.7% (n= 245 had ischemic stroke 17.7% (n=58 had intracerebral hemorrhage, 7.6% (n=25 had subarachnoid hemorrhage; 173 were men (52.7%. Mean age was 64.1 years. The intrahospital mortality rate was 10.2%, 17.2% and 36% for ischemic stroke, intracerebral hemorrhage and subarachnoid hemorrhage, respectively. The most prevalent modifiable risk factor was hypertension for ischemic stroke (67.6% and hemorrhage stroke (57.8%. Logistic regression analysis identified diabetes (OR=3.70; CI=1.76-7.77 as independent risk factor for ischemic stroke. The ischemic stroke was most common type of stroke. Hypertension and diabetes were important risk factors for stroke.Realizamos um estudo de prevalência para determinar a freqüência dos tipos de acidente vascular cerebral (AVC num hospital de urgência de Natal. Estudaram-se todos os pacientes que foram admitidos no hospital de urgência com diagnóstico presuntivo de AVC. Dos 416 pacientes, 328 foram estudados, 88 foram excluídos por não cumprirem os critérios de inclusão, 74,7% (n= 245 tiveram AVC isquêmico, 17,7% (n=58 hemorragia intracerebral e 7,6% (n=25 hemorragia subaracnóidea. O gênero mais prevalente foi o masculino (52,7%. A média de idade foi 64,1 anos. A letalidade intra-hospitalar foi de 10,2%, 17,2% e 36% para o tipo isquêmico, hemorrágico e hemorragia subaracnóide, respectivamente. O principal fator de risco modificável foi a hipertensão arterial sistêmica (HAS para AVC isquêmico (67,6% e AVC hemorrágico (57,8%. A regressão logística identificou diabetes como fator de risco independente para AVC isquêmico (OR=3,70; IC=1,76-7,77. O AVC isquêmico foi o tipo

  15. 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.

  16. 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

  17. 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

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    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.

  18. O sujeito cerebral e o movimento da neurodiversidade

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    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.

  19. 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...

  20. Resting cerebral blood flow

    Science.gov (United States)

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

    2009-01-01

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

  1. 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

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    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

  2. Cerebral sinus venous thrombosis

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    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.

  3. 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.

  4. Cerebral cartography and connectomics.

    Science.gov (United States)

    Sporns, Olaf

    2015-05-19

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

  5. Cerebral sinus venous thrombosis

    Science.gov (United States)

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

    2013-01-01

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

  6. Complicações da hipertensão arterial em homens e mulheres atendidos em um ambulatório de referência

    OpenAIRE

    Noblat,Antonio Carlos Beisl; Lopes,Marcelo Barreto; Lopes, Gildete Barreto; Lopes, Antonio Alberto

    2004-01-01

    OBJETIVO: Avaliar se o sexo se associa à hipertrofia ventricular esquerda, ao acidente vascular cerebral e à insuficiência renal em hipertensos atendidos em ambulatório de referência. MÉTODOS: Dados de 622 hipertensos, admitidos com diagnóstico de hipertrofia ventricular esquerda baseado no eletrocardiograma, de insuficiência renal, na creatinina > 1,4 mg/dl, e de acidente vascular cerebral em história pregressa e exame físico. Regressão logística foi utilizada para estimar odds ratio da asso...

  7. 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

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    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

  8. 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.

  9. Identificação do diagnóstico de enfermagem "risco de quedas em idosos com acidente vascular cerebral" Identificación del diagnóstico de enfermería riesgo de caídas en ancianos con accidente cerebrovascular Identification of the nursing diagnosis of fall risk in elderly with stroke

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    Huana Carolina Cândido Morais

    2012-06-01

    Full Text Available Estudo proposto para verificar a presença do diagnóstico de enfermagem (DE "Risco de quedas de idosos com acidente vascular cerebral (AVC". Trata-se de estudo observacional, exploratório, transversal, com análise descritiva, realizado em uma associação beneficente de reabilitação em Fortaleza/CE, Brasil, de janeiro a março de 2010, por fonte primária, com entrevista e exame físico, com idosos que tiveram pelo menos um episódio de AVC. Participaram 37 indivíduos: 20 (54,1% mulheres, média de 70,6 anos; 18 (48,6% residiam com companheiro, média de 5,2 anos de estudo. O Risco de quedas foi identificado em todos os idosos. Dentre os fatores de risco identificados, destacaram-se: Equilíbrio prejudicado (100%, Idade acima de 65 anos (83,7% e Déficit proprioceptivo (83,7%. Os enfermeiros devem considerar o risco de quedas como um dos enfoques do cuidado de enfermagem, bem como implementar e avaliar os resultados de intervenções relativas à prevenção de quedas.El propósito del estudio fue evaluar la presencia del diagnóstico de enfermería riesgo de caídas en pacientes ancianos con accidente cerebrovascular. Observacional, exploratorio, descriptivo y transversal. Desarrollado en asociación de rehabilitación en Fortaleza, de enero hasta marzo del 2010 por entrevistas de fuentes primarias y examen físico, hecho en personas con por lo menos un episodio de accidente cerebrovascular. 37 personas participaron, de los cuales 20 (54,1% eran mujeres, con 70,6 años como promedio, 18 (48,6% vivían con compañero, promedio de 5,2 años de estudio. El riesgo de caídas se encuentra en todas las personas mayores. Entre los factores de riesgo identificados se resalta: alteración del equilibrio (100%, Mayores de 65 años (83,7% y Déficit propioceptivo (83,7%. Las enfermeras deben considerar el riesgo de caídas como el foco de atención de enfermería, así como desarrollar y evaluar los resultados de intervenciones para la prevenci

  10. 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

  11. CEREBRAL PALSY AND MUSIC ACHIEVEMENT

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    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.

  12. 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.

  13. Uso do Doppler transcraniano para monitorização do vasoespasmo cerebral secundário à hemorragia subaracnóide

    OpenAIRE

    2001-01-01

    O vasoespasmo cerebral é responsável por aumento de morbidade e mortalidade em pacientes acometidos por hemorragia subaracnóide (HSA). Sua detecção de forma precoce e não-invasiva pelo método de Doppler transcraniano (DTC) pode contribuir para um melhor prognóstico destes doentes. OBJETIVO: Discutir o uso do método de DTC para diagnóstico do vasoespasmo cerebral secundário à HSA espontânea. MÉTODOS: Foram analisados os registros de velocidade de fluxo em artérias intracranianas por DTC em 31 ...

  14. Cerebral toxoplasmosis in AIDS

    Energy Technology Data Exchange (ETDEWEB)

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

    1986-02-01

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

  15. Changes of Cerebral

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

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

  16. Cerebral Arterial Fenestrations

    Science.gov (United States)

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

    2014-01-01

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

  17. 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.

  18. 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...

  19. Neuromodulation of cerebral blood flow

    NARCIS (Netherlands)

    ter Laan, Mark

    2014-01-01

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

  20. 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.

  1. Cerebral Laterality and Verbal Processes

    Science.gov (United States)

    Sherman, Jay L.; And Others

    1976-01-01

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

  2. Decompressive craniectomy in massive cerebral infarction Craniectomia descompressiva no infarto cerebral extenso

    Directory of Open Access Journals (Sweden)

    João Paulo Mattos

    2010-06-01

    Full Text Available Twenty one patients were submitted to decompressive craniectomy for massive cerebral infarct. Ten patients (47.6% presented a good outcome at the 6 months evaluation, eight had a poor outcome (38% and three died (14.2%. There was no outcome statistical difference between surgery before and after 24 hours of ictus, dominant and non-dominant stroke groups. Patients older than 60 years and those who had a Glasgow Coma Scale (GCS8 at pre-surgical exam and decompressive craniectomy before signs of brain herniation represent the main factors related to a better outcome. Dominant hemispheric infarction does not represent exclusion criteria.Vinte e um pacientes foram submetidos a craniectomia descompressiva para o tratamento de infarto cerebral extenso. Dez pacientes (47,6% apresentaram boa evolução em avaliação após 6 meses, 8 apresentaram evolução desfavorável (38% e 3 faleceram (14,2%. Durante o seguimento, não se evidenciou diferença estatística na evolução entre pacientes operados antes e após 24 horas do ictus, nem entre lesões envolvendo o hemisfério dominante versus não dominante. Pacientes com mais de 60 anos e aqueles com Escala de Coma de Glasgow (ECG8 no exame pré-operatório e craniectomia descompressiva antes de sinais de herniação cerebral representam os principais fatores relacionados a uma melhor evolução clínica. Infarto hemisférico envolvendo o hemisfério dominante não representa um critério de exclusão.

  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. Parálisis cerebral :

    OpenAIRE

    Giral Lamenca, Mónica

    2015-01-01

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

  5. 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

  6. Avaliação clínica da relação entre postura, respiração e deglutição em paciente pós-acidente vascular cerebral na fase crônica: relato de caso

    Directory of Open Access Journals (Sweden)

    Sináira Santos Seixas Simão

    2013-10-01

    Full Text Available O Acidente Vascular Cerebral (AVC é a doença neurológica que mais incapacita os adultos. A respiração, a postura e a deglutição possuem uma relação direta nesta doença, necessitando assim de uma intervenção multidisciplinar. O objetivo do presente estudo foi realizar uma avaliação clínica integrada para analisar a relação entres estas disfunções. Trata-se de uma paciente do sexo feminino com 37 anos, com seis anos de diagnóstico de AVC isquêmico com hemiparesia completa à direita de predomínio crural, hipertensão arterial sistêmica, disfagia e disartrofonia. Na anamnese, relatou sintomas referentes à dispnéia, dores na coluna lombar, presença de tosse e engasgos à alimentação e escape anterior de saliva, principalmente durante a fala. A paciente apresenta escoliose, hipercifose torácica e fraqueza dos músculos abdominais. A avaliação respiratória evidenciou uma força expiratória abaixo do limite esperado. O pico de fluxo da tosse está abaixo do esperado, demonstrando não possuir força para tossir. A investigação fonoaudiológica evidenciou alterações no tempo aumentado para se alimentar, necessidade de ingerir líquidos para ajudar na deglutição de sólidos, eventuais escapes anteriores de alimento, necessidade de deglutições múltiplas devido à sensação de estase em cavidade laringo-faríngea e diminuição do paladar, bem como saliva grossa e viscosa. Utilizando-se das avaliações fisioterápicas e fonoaudiológicas, foi possível concluir que uma paciente com AVC na fase crônica apresenta alterações respiratórias que podem impedi-la de proteger com eficiência as vias aéreas inferiores, o que, somado às alterações posturais e na deglutição demonstram a importância da avaliação integrada para futuras intervenções terapêuticas mais eficazes.

  7. Desigualdades entre pacientes hospitalizados por doenças cardíacas e vasculares-cerebrais em localidade do Estado de São Paulo (Brasil, 1986 Inequalities among patients hospitalized for cardiac and cerebral-vascular diseases in the City of the State of S. Paulo, Brazil, 1986

    Directory of Open Access Journals (Sweden)

    Juan Stuardo Yazlle Rocha

    1989-10-01

    Full Text Available Valendo-se de um sistema de informações sobre hospitalizações no Município de Ribeirão Preto, SP (Brasil foram estudadas as características clínico-epidemiológicas referidas dos pacientes internados, em 1986, por doenças cardíacas e vasculares-cerebrais (DCVC. De 43.499 hospitalizações ocorridas naquele ano, 4.673 foram ocasionadas por doenças cardíacas e vasculares-cerebrais. Utilizando a fonte de financiamento da internação como indicador do estrato social ao qual pertence o paciente, foram compostos 4 grupos de estudo: particulares, "outros", previdenciários e "não pagantes"; estes grupos apresentaram diferenças significativas quanto a coeficiente de internações por DCVC, média e mediana de idade na hospitalização, perfil ocupacional, duração da internação, freqüência dos sub-grupos diagnósticos, coeficientes de mortalidade e a idade média e mediana nos casos de óbitos. Estas diferenças foram atribuídas às disparidades sociais no nível de vida e condições de trabalho dos grupos estudados o que determina diferenças no adoecer, ser assistido e no morrer.The clinical and epidemiological characteristics of hospitalizations due to cardiac and cerebral-vascular diseases (CCVD - ICD 390 - 438, which occurred in 1986, were studied on the basis of data from an information system relating to medical care in the City of Ribeirão Preto, State of S. Paulo, Brazil. These causes accounted for 4,673 of the annual total of 43,449 hospital admissions. Using the sources of payment of the hospitalization as an indicator of the patients' social strata, the following four study groups were defined: private, social insurance, non-paying and "others". These groups showed significant differences in relation to the following variables: hospitalization rates due to CCVD, mean and median age at admission and time of death, occupation, average length of stay in the hospital, mortality rates and relative frequencies of specific

  8. Therapeutic implications of melatonin in cerebral edema.

    Science.gov (United States)

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

    2014-12-01

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

  9. Positron computed tomography studies of cerebral glucose metabolism in man: theory and application in nuclear medicine.

    Science.gov (United States)

    Phelps, M E

    1981-01-01

    The capability of positron computed tomography (PCT) to delineate the substructures of the brain and its facility for accurately measuring the local tissue radioactivity concentration allow the application of tracer kinetic models for the study of local cerebral function in man. This principle and an adaptation of the 14C-deoxyglucose (DG) model of Sokoloff et al. with 18F-2-fluoro-deoxy-D-glucose (FDG) is being used at UCLA. Brookhaven National Laboratory, University of Pennsylvania, NIH, and the Massachusetts General Hospital to determine the local cerebral glucose metabolic rate (LCMRGIc) in normal man at rest and during sensory activation and the changes that occur in patients with a variety of cerebral disorders. Kinetic studies with PCT have been employed to measure the rate constants of the model in different gray and white matter structures of the brain in both normal and ischemic states. The precision of the method in normals has been shown to be about +/- 5% for 1.5-2.0 sq cm regions of the brain. Studies in normals have yielded values for hemispheric CMRGIc that are in agreement with measurement using the Kety-Schmidt technique and LCMRGIc values in agreement with values in monkeys using DG autoradiography. Studies in volunteers subjected to visual and auditory stimulation are demonstrating the potential of this technique for investigating the human brain's response to different stimuli. STudies in patients with stroke show excellent correlation between the degree, extent, and particular structures involved and the clinical symptoms. The method consistently detected hypometabolism in cortical, thalamic, and striatal tissues that were dysfunctional due to deactivation or damage but which appeared normal on x-ray CT. Studies in patients with partial epilepsy have shown hypometabolic zones that highly correlated anatomically with interictal EEG spike foci and were associated with normal x-ray CT studies in 77% of the patients studied. The studies on

  10. 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.

  11. Monitoring Cerebral Oxygenation in Neonates: An Update

    Science.gov (United States)

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

    2017-01-01

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

  12. 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.

  13. Pseudotumoral delayed cerebral radionecrosis

    Energy Technology Data Exchange (ETDEWEB)

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

    1985-01-01

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

  14. 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

  15. 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...

  16. Cerebral Salt Wasting Syndrome

    Directory of Open Access Journals (Sweden)

    Mehmet Salih Sevdi

    2016-12-01

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

  17. Tumor cerebral e gravidez Brain tumors and pregnancy

    Directory of Open Access Journals (Sweden)

    José Carlos Lynch

    2007-12-01

    Full Text Available O diagnóstico de um tumor cerebral durante a gravidez é um fato raro que coloca a mãe e o concepto em risco de vida. OBJETIVO: Avaliar a melhor forma de conduzir uma paciente grávida portadora de um tumor cerebral. MÉTODO: Realizamos análise retrospectiva dos prontuários e imagens de seis pacientes grávidas portadoras de tumor cerebral. RESULTADOS: Vários tipos histológicos de tumor cerebral podem estar associados à gravidez. O meningioma é o mais freqüente. Nessa série não observamos óbito cirúrgico materno. Em duas pacientes, o parto ocorreu antes da craniotomia e em outras quatro o parto foi realizado após a neurocirurgia. CONCLUSÃO: O momento mais adequado para a realização da craniotomia para remoção tumoral irá depender da gravidade do quadro neurológico, do tipo histológico presumível da lesão, e da idade gestacional do embrião.BACKGROUND: Despite not being a common fact, the occurrence of brain tumors during pregnancy poses a risk to both the mother and infant. AIM: To identify the best medical procedure to be followed for a pregnant patient harboring a brain tumor. METHOD: The records of 6 patients with brain tumors, diagnosed during pregnancy were examined. RESULTS: Several types of brain tumors have been associated with pregnancy, but the meningioma is, by far, the most frequent. It seems that pregnancy aggravates the clinical course of intracranial tumors. There were no operative mortality in these series. In 2 patients the labor occurred before the craniotomy and in others, the delivery occurred after the surgery. CONCLUSION: The best moment to recommend the craniotomy and the neurosurgical removal of the tumor will depend of the mother’s neurological condition, the tumor histological type as well as the gestational age.

  18. 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.)

  19. Neuronal autophagy in cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  20. 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…

  1. Fenestration of the anterior cerebral artery

    Energy Technology Data Exchange (ETDEWEB)

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

    1981-08-01

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

  2. 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...

  3. Lifetime costs of cerebral palsy

    DEFF Research Database (Denmark)

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

    2009-01-01

    This study quantified the lifetime costs of cerebral palsy (CP) in a register-based setting. It was the first study outside the US to assess the lifetime costs of CP. The lifetime costs attributable to CP were divided into three categories: health care costs, productivity costs, and social costs....... The population analyzed was retrieved from the Danish Cerebral Palsy Register, which covers the eastern part of the country and has registered about half of the Danish population of individuals with CP since 1950. For this study we analyzed 2367 individuals with CP, who were born in 1930 to 2000 and were alive...

  4. 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.

  5. 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...

  6. Relatório de estágio em reabilitação neurológica: intervenção da fisioterapia em crianças com necessidades especiais

    OpenAIRE

    2014-01-01

    Mestrado em Fisioterapia O relatório presente refere-se ao estágio em fisioterapia realizado em clinica de fisioterapia, domicílios, jardim-de-infância e creche, com crianças com necessidades especiais. Num total de 13 pacientes com idades compreendidas entre os 3 e os 19 anos, excepto um adulto de 34 anos de idade que apresentava Acidente Vascular Cerebral. As crianças apresentavam os seguintes diagnósticos: paralisia cerebral, atrofia muscular espinhal, atraso global de desenvolvimento s...

  7. 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.

  8. Embodying Investigations of Cerebral Palsy

    DEFF Research Database (Denmark)

    Martiny, Kristian Møller Moltke

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

  9. Sirt1 in cerebral ischemia

    Science.gov (United States)

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

    2015-01-01

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

  10. Sirt1 in cerebral ischemia

    Directory of Open Access Journals (Sweden)

    Kevin B Koronowski

    2015-01-01

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

  11. Graft selection in cerebral revascularization.

    Science.gov (United States)

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

    2009-05-01

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

  12. Pathogenesis of cerebral amyloid angiopathy.

    NARCIS (Netherlands)

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

    2003-01-01

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

  13. 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)

  14. Ocular defects in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Katoch Sabita

    2007-01-01

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

  15. 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

  16. Digital subtraction angiography in cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-01-15

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

  17. The cerebral perivascular cells.

    Science.gov (United States)

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

    1998-01-01

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

  18. 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

  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. 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.

  1. 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.

  2. Cerebral blood-flow tomography

    DEFF Research Database (Denmark)

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

    1983-01-01

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

  3. 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.

  4. 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.

  5. 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

    Energy Technology Data Exchange (ETDEWEB)

    Wichert-Ana, Lauro [University of Sao Paulo, Center for Epilepsy Surgery, Department of Neurology, Psychiatry and Clinical Psychology, Ribeirao Preto (Brazil); Hospital das Clinicas, USP, Centro de Cirurgia de Epilepsia, CIREP, Ribeirao Preto, SP (Brazil); Mazzoncini de Azevedo-Marques, Paulo; Santos, Antonio C.; Araujo, David [University of Sao Paulo, Center for Imaging Science and Medical Physics, Department of Internal Medicine, Ribeirao Preto (Brazil); Ferrari Oliveira, Lucas [Federal University of Pelotas, Informatics Department, Pelotas, RS (Brazil); Fernandes, Regina M.F.; Velasco, Tonicarlo R.; Sakamoto, Americo C. [University of Sao Paulo, Center for Epilepsy Surgery, Department of Neurology, Psychiatry and Clinical Psychology, Ribeirao Preto (Brazil); Kato, Mery [University of Sao Paulo, Division of Nuclear Medicine, Department of Internal Medicine from the Ribeirao Preto Medical School, Ribeirao Preto (Brazil); Muxfeldt Bianchin, Marino [Rio Grande do Sul Federal University, Neurology Division, HCPA, Porto Alegre, RS (Brazil)

    2008-06-15

    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.)

  6. Cerebral hyperperfusion following carotid endarterectomy

    DEFF Research Database (Denmark)

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

    1987-01-01

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

  7. Hydrocephalus in cerebral venous thrombosis.

    Science.gov (United States)

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

    2015-01-01

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

  8. Cerebral ischaemia: A neuroradiological study

    Energy Technology Data Exchange (ETDEWEB)

    Bories, J.

    1985-01-01

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

  9. 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.

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

    OpenAIRE

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

    2004-01-01

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

  11. Inclusão de alunos com paralisia cerebral no ensino fundamental: contribuições da fisioterapia

    OpenAIRE

    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...

  12. Gliomatose cerebral na infância com evolução favorável: relato de caso

    OpenAIRE

    Val Filho,José Aloysio da Costa; Avelar,Lucília Graciano Silva

    2008-01-01

    OBJETIVO: Relatar caso clínico raro de gliomatose cerebral difusa em criança, que, contrariando o observado na literatura, evoluiu de maneira clinicamente satisfatória. DESCRIÇÃO: Relatamos caso de criança que desenvolveu gliomatose cerebral com manifestações clínicas graves e progressivas. Exames iniciais foram inespecíficos. Melhora clínica inicial após cirurgia neuroendoscópica, porém piorou progressivamente, manifestando hidrocefalia obstrutiva, paraparesia e dificuldade de deambulação. F...

  13. Cerebral Vasospasm Pharmacological Treatment: An Update

    OpenAIRE

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

    2013-01-01

    Aneurysmal subarachnoid hemorrhage- (aSAH-) associated vasospasm constitutes a clinicopathological entity, in which reversible vasculopathy, impaired autoregulatory function, and hypovolemia take place, and lead to the reduction of cerebral perfusion and finally ischemia. Cerebral vasospasm begins most often on the third day after the ictal event and reaches the maximum on the 5th–7th postictal days. Several therapeutic modalities have been employed for preventing or reversing cerebral vasosp...

  14. Cerebral embolic stroke after disappearing takotsubo cardiomyopathy.

    Science.gov (United States)

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

    2013-11-01

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

  15. Quantitative Cerebral Blood Flow Measurements Using MRI

    OpenAIRE

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

    2014-01-01

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

  16. Cerebral energy metabolism during induced mitochondrial dysfunction

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    NARCIS (Netherlands)

    Claassen, J.A.H.R.

    2008-01-01

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  19. 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:…

  20. Middle cerebral artery blood velocity during running

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  1. 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.

  2. Aneurisma gigante da artéria cerebral média Giant aneurysm of the middle cerebral artery: a case report

    Directory of Open Access Journals (Sweden)

    J. Jorge Facure

    1974-03-01

    Full Text Available Relato de um caso de aneurisma gigante da artéria cerebral média esquerda operado com sucesso. O aneurisma que apresentava medidas de 35 x 27 x 23 mm determinou manifestações clínicas de hipertensão intracraniana. A sua exerese total resultou em pronto desaparecimento dos sintomas.A case of giant aneurysm of the left middle cerebral artery, in a 28-year-old right-handed woman, successfuly operated is reported. The aneurysm measur- ing 35 x 27 x 23 mm showed clinical manifestations as a space-occupying lesion. The patient recovered completely after the total excision of the aneurysm.

  3. 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.

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

    Science.gov (United States)

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

    2016-08-01

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

  5. Traumatic brain ischemia during neuro intensive care: myth rather than fact Isquemia cerebral tráumatica durante neuro terapia intensiva: mito ao invés de fato

    Directory of Open Access Journals (Sweden)

    Julio Cruz

    2001-09-01

    Full Text Available In non-missile severe acute brain trauma, brain ischemia was a frequent finding in cadavers. Studies during neuro intensive care, however, have failed to disclose brain ischemia under most circumstances, except when cerebral hemodynamic and metabolic parameters have been misinterpreted, or when cerebral blood flow (CBF alone has been addressed in a biased fashion, without mandatory metabolic data. Indeed, comprehensive and unbiased studies focusing on global cerebral metabolic activity have invariably revealed a condition of normal coupling between reduced CBF and oxygen consumption in the early postinjury hours, which is then followed by a prolonged, sustained pattern of relative cerebral hyperperfusion (the opposite of ischemia. Accordingly, traumatic brain ischemia during intensive care represents myth rather than fact.Em traumatismo cerebral agudo grave excluindo-se ferimentos por arma de fogo, isquemia cerebral foi achado frequente em cadáveres. Entretanto, estudos durante neuro terapia intensiva não têm revelado isquemia cerebral, exceto quando parâmetros hemodinâmicos e metabólicos cerebrais tem sido mal interpretados, ou quando fluxo sanguíneo cerebral (FSC sozinho tem sido enfocado de forma tendenciosa, sem dados metabólicos mandatórios. De fato, estudos abrangentes e não tendenciosos enfocando a atividade metabólica cerebral têm invariavelmente revelado uma condição de ajustamento normal entre FSC e consumo cerebral de oxigênio reduzidos nas primeiras horas após o traumatismo, um padrão seguido de prolongada hiperperfusão relativa (o oposto da isquemia. Assim sendo, isquemia cerebral traumática durante terapia intensiva representa um mito ao invés de um fato.

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

    DEFF Research Database (Denmark)

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

    1991-01-01

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

  7. 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

  8. 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

  9. Sumatriptan and cerebral perfusion in healthy volunteers.

    Science.gov (United States)

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

    1992-04-01

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

  10. Cerebral blood flow response to functional activation

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  11. Cerebral emboli and depressive symptoms in dementia.

    NARCIS (Netherlands)

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

    2006-01-01

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

  12. 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…

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

    Directory of Open Access Journals (Sweden)

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

    2010-11-01

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

  14. Fenilcetonúria: estudo clínico e mediante biópsia cerebral Phenylketonuria: clinical and cerebral biopsy studies

    Directory of Open Access Journals (Sweden)

    Aron J. Diament

    1967-03-01

    Full Text Available Foram relatados 6 casos de fenilcetonúria (oligofrenia fenilpirúvica, sendo os pacientes, irmãos dois a dois, pertencentes a três famílias distintas. Foram feitos estudos genealógico, clínico e laboratorial, incluindo a dosagem de fenilalanina sérica. O interesse maior foi o de mostrar a normalidade do estudo histopatológico realizado por meio de biópsias cerebrais em 4 casos, apesar de não ter sido feito estudo histoquímico, atualmente considerado como necessário. Esta normalidade das biópsias não teve qualquer relação com o nível mental, com as alterações eletrencefalográficas cu com atrofias cerebrais assinaladas em alguns casos mediante encefalografia gasosa. Todos os casos foram tratados com dieta especial (tipo Lofenalac complementada com alimentos de baixo teor em fenilalanina. Dosagens de fenilalanina sérica estão sendo feitas antes e depois do uso de tais dietas, sendo ainda muito cedo para qualquer conclusão.Six cases of phenylketonuria (PKU are reported. The patients belong to three different families — three siblings. Genealogic, clinic and laboratorial studies have been done, including serum phenylalanin. The important aim was to show the normality of the histopathology performed through cerebral biopsy in four cases. Histochemical study has not been done. The normal cerebral biopsy did not show correlation with mental level, electroencephalographic alterations or with cerebral atrophies which were found in two cases by air encephalography. All cases have been treated with special diet (Lofenalac and some food with low phenylalanin level. After and before the diet phenylalanin determinations have been done, nevertheless, it is very soon indeed to conclude anything by now.

  15. Rhinomaxillary mucormycosis with cerebral extension

    Directory of Open Access Journals (Sweden)

    Goel Shikha

    2009-01-01

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

  16. Cerebral salt wasting syndrome: review.

    Science.gov (United States)

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

    2008-06-01

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

  17. Cerebral oximetry in cardiac anesthesia

    Science.gov (United States)

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

    2014-01-01

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

  18. <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.

  19. Adrenoleucodistrofia cerebral ligada ao x

    OpenAIRE

    Ono,Sergio Eiji

    2013-01-01

    Resumo: OBJETIVO: o padrão-ouro em exames de imagem para avaliar a adrenoleucodistrofia ligada ao X é o escore de Loes, baseado na localização, alterações de sinais e grau de atrofia. Os objetivos deste estudo foram avaliar como os parâmetros do tensor de difusão correlacionam com o escore de Loes e avaliar se poderiam indicar alterações estruturais precoces. PACIENTES E MÉTODOS: as medidas do tensor de difusão foram obtidas em 9 locais pré-estabelecidos da substância branca, bilateralmente, ...

  20. 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.

  1. Cerebral hemodynamics: concepts of clinical importance

    Directory of Open Access Journals (Sweden)

    Edson Bor-Seng-Shu

    2012-05-01

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

  2. Cerebral cortex modulation of pain

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  3. Comparative analysis of natural sleep electroencephalogram and routine awake electroencephalogram in the diagnosis of interictal epilepsy%发作间期癫痫患者自然睡眠脑电图与常规清醒脑电图的对比分析

    Institute of Scientific and Technical Information of China (English)

    陆延安; 孙伟

    2013-01-01

    目的 探讨自然睡眠脑电图(EEG)对发作间期癫痫患者的诊断价值.方法 选取2011年4月~2012年2月浙江省东阳市人民医院的73例发作间期癫痫患者、25例间歇期晕厥患者、19例间歇期偏头痛患者、31例发作间期短暂性脑缺血发作患者作为研究对象,分别在自然睡眠状态下、常规清醒状态下对上述研究对象进行EEG检查,比较其灵敏度和特异度.结果 自然睡眠EEG诊断发作间期癫痫患者的灵敏度、特异度分别为75.3%、100.0%.常规清醒EEG诊断发作间期癫痫患者的灵敏度、特异度分别为31.5%、100.0%.自然睡眠EEG诊断发作间期癫痫患者的灵敏度显著高于常规清醒EEG(P< 0.05),两种EEG诊断发作间期癫痫患者的特异度相比差异无统计学意义(P>0.05).结论 与常规清醒EEG相比,自然睡眠EEG诊断发作间期癫痫的灵敏度较高,有利于降低癫痫患者的漏诊率.%Objective To investigate the clinical value of natural sleep electroencephalogram (EEG)in the diagnosis of interictal epilepsy.Methods 73 cases of interictal epilepsy,25 cases of intermittent syncope,19 cases of intermittent migraine and 31 cases of interictal transient ischemic attack in Dongyang People's Hospital of Zhejiang Province from April 2011 to February 2012 were selected as the objects of study,and the natural sleep EEG and routine awake EEG were detected in all before-mentioned patients,the sensitivity and specificity was compared.Results The natural sleep EEG in the diagnosis of interictal epilepsy had a sensitivity of 75.3%,specificity of 100.0%,while the routine awake EEG had a sensitivity of 31.5%,specificity of 100.0%.The sensitivity of natural sleep EEG in the diagnosis of interictal epilepsy was significantly higher than that of routine awake EEG (P < 0.05),and there were no significant differences in the specificity between natural sleep EEG and routine awake EEG (P > 0.05).Conclusion Compared with

  4. Criar uma idiocultura para promover o desenvolvimento de crianças com paralisia cerebral Creating an idioculture to promote the development of children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Lucia Willadino Braga

    2010-04-01

    Full Text Available Este estudo apresenta os resultados preliminares da adaptação de um sistema educacional, chamado Quinta Dimensão, no qual a interação social é um meio para a generalização da informação e base para o desenvolvimento de habilidades. Foi criado originalmente por Michael Cole no Laboratório de Cognição Humana Comparada, Universidade da Califórnia, San Diego, e pela primeira vez é aplicado em um contexto de reabilitação com crianças com lesão cerebral na Rede SARAH de Neurorreabilitação, Brasília. Alunos de graduação em psicologia e pedagogia participam do programa e interagem de maneira lúdica e educativa com crianças com paralisia cerebral. Ambos são envolvidos em atividades de aprendizagem colaborativa. Na interação com a criança, os alunos são encorajados a colocar em prática conceitos teóricos formais e, também, vivências individuais. Resultados indicam efeitos positivos sobre o desenvolvimento da criança e aprendizagem do aluno de graduação e mostram caminhos alternativos na educação da criança deficiente. Neste artigo, descrevemos as alterações feitas no programa original para adaptá-lo à reabilitação configurada, assim como os artefatos que medeiam a atividade, necessário para a interação e expressão da criança com paralisia cerebral. Também são discutidos e apresentados os efeitos da atividade sobre o desenvolvimento da criança - com base em relatórios dos pais - e do impacto sobre o processo de aprendizagem dos alunos de graduação. O programa abre caminhos alternativos para uma reflexão sobre e educação da criança com lesão cerebral, com base no desenvolvimento do potencial individual, o contexto e os interesses.This study presents the preliminary results of the adaptation of an educational system called the Fifth Dimension (5D, in which social interaction is a means for generalizing information and a basis for the development of skills beyond the constituent tasks. Originally

  5. 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.

  6. Aerobic training in children with cerebral palsy.

    Science.gov (United States)

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

    2013-06-01

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

  7. Cerebral blood flow in the neonate.

    Science.gov (United States)

    Vutskits, Laszlo

    2014-01-01

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

  8. 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.

  9. Study on concordance of ictal and interictal epileptiform activity in patients with tuberous sclerosis complex%结节性硬化症癫痫发作期与发作间期痫样放电的一致性研究

    Institute of Scientific and Technical Information of China (English)

    杨志仙; 郭庆辉; 庄嘉鑫; 刘晓燕; 熊晖; 吴晔; 王爽; 常杏芝; 张月华

    2014-01-01

    Objective To analyze the relationship between the ictal onset zone and dominant interictal epileptiform foci in tuberous sclerosis complex (TSC) patients.Method Clinical data of 20 patients with TSC which had epileptic seizures during Video-EEG monitoring was assessed.Consistency and dominance of focal interictal epileptiform activity and the ictal onset zone were identified.Concordance between interictal and ictal findings was analyzed.Result Of the 20 patients,7 were female,and 13 were male.The age of epilepsy onset was from 15 d to 6 years.The Video-EEG monitoring age was from 6 months to 11 years.Family history was found in three cases.Abnormality in neuroimaging existed in 17 of 18 patients who were examined.Interictal EEG showed hypsarrhythmia in 3 patients,multifocal epileptiform activity with a dominant focus in 12 patients,both focal and generalized discharges in 2 patients,and only focal discharges in 3 patients.The seizures types during EEG monitoring included epileptic spasms,partial seizure,atypical absence,and generalized or focal myoclonic seizure.The most common seizure type was partial seizure and then epileptic spasms.EEG in 4 patients with epileptic spasms showed ictal generalized discharges and interictal hypsarrhythmia or generalized discharges.Clinical manifestation of epileptic spasms was asymmetric in 3 patients.Lateralization and location of interictal and ictal discharges were consistent in 2 of the 3 patients,while only lateralization consistency in 1 of the 3 patients.Partial seizures as the only seizure type were monitored in 13 patients.Of the 13 patients,lateralization and location of interictal and ictal discharges were inconsistent in 2 patients (15%),consistent in 8 patients (62%),lateralization or location consistent in 2 patients (15%).One case could not be analyzed because of uncertainty of lateralization and location of seizure onset.Conclusion In the majority of patients with TSC,multifocal interictal epileptiform

  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......, but gestational age was subject to a systematic error, and urinary infections in pregnancy (kappa = 0.43) and placental abruption (kappa = 0.52) were seriously under-reported in the CPR. CONCLUSIONS: Completeness of the Cerebral Palsy Register in Denmark, 1979-1982, has been assessed to maximal 85%, emphasizing...

  11. Cerebral blood flow and metabolism during sleep

    DEFF Research Database (Denmark)

    Madsen, Peter Lund; Vorstrup, S

    1991-01-01

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

  12. 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.

  13. Dihydralazine induces marked cerebral vasodilation in man

    DEFF Research Database (Denmark)

    Schroeder, T; Sillesen, H

    1987-01-01

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

  14. 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...

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

    Science.gov (United States)

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

    2016-12-01

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

  16. 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.

  17. Cerebral malformations in Carpenter syndrome.

    Science.gov (United States)

    Taravath, S; Tonsgard, J H

    1993-01-01

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

  18. 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

  19. Avaliação e tratamento da hiperglicemia em pacientes graves

    OpenAIRE

    Marina Verçoza Viana; Rafael Barberena Moraes; Amanda Rodrigues Fabbrin; Manoella Freitas Santos; Fernando Gerchman

    2014-01-01

    A hiperglicemia é um problema frequentemente encontrado em pacientes graves em ambiente de terapia intensiva. Sua presença se associa ao aumento da morbidade e da mortalidade, independentemente da causa da admissão (infarto agudo do miocárdio, condição após cirurgia cardiovascular, acidente vascular cerebral e sepse). Entretanto, permanecem muitas dúvidas com relação à fisiopatologia e, particularmente, em relação ao tratamento ...

  20. 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

  1. Cerebral palsy in preterm infants

    Directory of Open Access Journals (Sweden)

    Demeši-Drljan Čila

    2016-01-01

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

  2. 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.

  3. Neonatal Phosphate Nutrition Alters <em>in em>Vivo> and <em>in em>Vitro> Satellite Cell Activity in Pigs

    Directory of Open Access Journals (Sweden)

    Chad H. Stahl

    2012-05-01

    Full Text Available Satellite cell activity is necessary for postnatal skeletal muscle growth. Severe phosphate (PO4 deficiency can alter satellite cell activity, however the role of neonatal PO4 nutrition on satellite cell biology remains obscure. Twenty-one piglets (1 day of age, 1.8 ± 0.2 kg BW were pair-fed liquid diets that were either PO4 adequate (0.9% total P, supra-adequate (1.2% total P in PO4 requirement or deficient (0.7% total P in PO4 content for 12 days. Body weight was recorded daily and blood samples collected every 6 days. At day 12, pigs were orally dosed with BrdU and 12 h later, satellite cells were isolated. Satellite cells were also cultured <em>in vitroem> for 7 days to determine if PO4 nutrition alters their ability to proceed through their myogenic lineage. Dietary PO4 deficiency resulted in reduced (<em>P> < 0.05 sera PO4 and parathyroid hormone (PTH concentrations, while supra-adequate dietary PO4 improved (<em>P> < 0.05 feed conversion efficiency as compared to the PO4 adequate group. <em>In vivoem> satellite cell proliferation was reduced (<em>P> < 0.05 among the PO4 deficient pigs, and these cells had altered <em>in vitroem> expression of markers of myogenic progression. Further work to better understand early nutritional programming of satellite cells and the potential benefits of emphasizing early PO4 nutrition for future lean growth potential is warranted.

  4. 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

  5. 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

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

    Science.gov (United States)

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

    2016-01-01

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

  7. Cerebral malaria: gamma-interferon redux

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    Nicholas H Hunt

    2014-08-01

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

  8. Cerebral cysticercosis in a cat : clinical communication

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    E.V. Schwan

    2002-07-01

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

  9. Research progress of cerebral small vessel disease

    Directory of Open Access Journals (Sweden)

    Jun-dong JIA

    2015-03-01

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

  10. Gamma knife radiosurgery for cerebral arteriovenous malformations.

    Science.gov (United States)

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

    2004-01-01

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

  11. Mitochondrial Targeted Antioxidant in Cerebral Ischemia.

    Science.gov (United States)

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

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

  12. Constituents from <em>Vigna em>vexillata> and Their Anti-Inflammatory Activity

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    Guo-Feng Chen

    2012-08-01

    Full Text Available The seeds of <em>Vigna em>genus are important food resources and there have already been many reports regarding their bioactivities. In our preliminary bioassay, the chloroform layer of methanol extracts of<em> V. vexillata em>demonstrated significant anti-inflammatory bioactivity. Therefore, the present research is aimed to purify and identify the anti-inflammatory principles of <em>V. vexillataem>. One new sterol (1 and two new isoflavones (2,3 were reported from the natural sources for the first time and their chemical structures were determined by the spectroscopic and mass spectrometric analyses. In addition, 37 known compounds were identified by comparison of their physical and spectroscopic data with those reported in the literature. Among the isolates, daidzein (23, abscisic acid (25, and quercetin (40 displayed the most significant inhibition of superoxide anion generation and elastase release.

  13. Plasma catecholamine concentrations associated with cerebral vasospasm.

    Science.gov (United States)

    Loach, A B; Benedict, C R

    1980-03-01

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

  14. Clinical Practice Guidelines for Cerebral Abscess Treatment

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    Danny Barrueta Reyes

    2009-03-01

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

  15. Crossed cerebral - cerebellar diaschisis : MRI evaluation.

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    Chakravarty A

    2002-07-01

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

  16. Cerebral microcirculation during experimental normovolaemic anaemia

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    Judith eBellapart

    2016-02-01

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

  17. 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.

  18. Mapping the cerebral subject in contemporary culture

    OpenAIRE

    Ortega,Francisco Javier Guerrero; Vidal, Fernando

    2007-01-01

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

  19. Cerebral perfusion SPECT in transient ischemic attack

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-04-01

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

  20. EMBOLIA GASEOSA CEREBRAL SECUNDARIA A BIOPSIA PULMONAR

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    Luís Rafael Moscote Salazar

    2008-01-01

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

  1. Estudo comparativo do fluxo sanguineo cerebral regional (SPECT) entre pacientes esquizofrenicos e controle normais

    OpenAIRE

    1998-01-01

    A esquizofrenia é um distúrbio psicótico grave, que acomete preferencialmente adultos jovens, causando danos que se prolongam durante toda a vida do indivíduo. É de etiologia multifatorial com aspectos genéticos, ambientais e neurobiológicos implicados na sua gênese. As técnicas de neuroimagem têm demonstrado alterações do metabolismo e do fluxo Sangüíneo Cerebral- regional (FSCr). Neste estudo, objetivamos verificar as alterações do FSCr em esquizofrênicos, quando comparados a controles nonn...

  2. Estudo comparativo do fluxo sanguineo cerebral regional (SPECT) entre pacientes esquizofrenicos e controle normais

    OpenAIRE

    1998-01-01

    Resumo: A esquizofrenia é um distúrbio psicótico grave, que acomete preferencialmente adultos jovens, causando danos que se prolongam durante toda a vida do indivíduo. É de etiologia multifatorial com aspectos genéticos, ambientais e neurobiológicos implicados na sua gênese. As técnicas de neuroimagem têm demonstrado alterações do metabolismo e do fluxo Sangüíneo Cerebral- regional (FSCr). Neste estudo, objetivamos verificar as alterações do FSCr em esquizofrênicos, quando comparados a contro...

  3. Rinoliquorréia e hidrocefalia por gliose do aqueduto cerebral

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    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.

  4. Características salivares de crianças com Paralisia Cerebral

    OpenAIRE

    Nunes, Bruna Sofia Pereira

    2016-01-01

    Trabalho final do 5º ano com vista à atribuição do grau de mestre no âmbito do ciclo de estudos de Mestrado Integrado em Medicina Dentária apresentado à Faculdade de Medicina da Universidade de Coimbra. Introdução: Os pacientes com paralisia cerebral constituem um grupo de risco devido às alterações da cavidade oral inerentes não só à patologia como às dificuldades encontradas nos cuidados de higiene oral e às barreiras que podem existir relativamente à realização de tratamentos dentários....

  5. Purine Metabolism in Acute Cerebral Ischemia

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    Ye. V. Oreshnikov

    2008-01-01

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

  6. Ocular problems in children with cerebral palsy

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    Esra Ayhan Tuzcu

    2012-09-01

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

  7. Severe Cerebral Vasospasm in Patients with Hyperthyroidism

    Science.gov (United States)

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

    2016-01-01

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

  8. Severe Cerebral Vasospasm in Patients with Hyperthyroidism.

    Science.gov (United States)

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

    2016-12-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Yongsheng Chen

    2008-01-01

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

  10. Cerebral ischemia caused by Streptococcus bovis aortic endocarditis: case report Isquemia cerebral causada por endocardite aórtica pelo Streptococcus bovis: relato de caso

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    Leopoldo Santos-Neto

    2005-09-01

    Full Text Available Cerebral ischemic processes associated with infective endocarditis caused by Streptococcus bovis are rare; only 2 cases having been reported. Here we report a case of a 50-year-old man with S. bovis endocarditis who presented signs of frontal, parietal and occipital lobe cerebral ischemia. This is the first case reported in which the presence of hemianopsia preceded the endocarditis diagnosis. Initially, the clinical manifestations suggested a systemic vasculitis. Later, vegetating lesions were identified in the aortic valve and S. bovis grew in blood cultures. Antibiotic use and aortic valve replacement eliminated the infection and ceased thromboembolic events. A videocolonoscopy examination revealed no mucosal lesions as a portal of entry in this case, although such lesions have been encountered in up to 70% of reported cases of S. bovis endocarditis.A associação de isquemia cerebral e endocardite por Streptococcus bovis é um evento raro, tendo sido publicados apenas 2 casos anteriormente. Nós relatamos o caso de um homem de 50 anos com endocardite por S. bovis que apresentou sinais isquêmicos nos lobos frontal, parietal e occipital. Este é o primeiro caso em que a hemianopsia precedeu o diagnóstico de endocardite. Inicialmente, o quadro foi confundido com vasculite. Posteriormente, foi confirmada a presença de vegetações na válvula aórtica e a hemocultura identificou S. bovis. Os eventos tromboembólicos foram controlados com o uso de antibióticos e a troca da válvula aórtica. Estudo videocolonoscópico não identificou nenhuma lesão, apesar de lesões colônicas serem descritas em até 70% dos casos de indivíduos com endocardite por S. bovis.

  11. Descompressão da bainha do nervo óptico para tratamento do papiledema no pseudotumor cerebral

    Directory of Open Access Journals (Sweden)

    Monteiro Mário Luiz Ribeiro

    2002-01-01

    Full Text Available Objetivos: Avaliar a eficácia da descompressão da bainha do nervo óptico (DBNO realizada em olhos com papiledema e perda visual, de pacientes com pseudotumor cerebral. Métodos: Foram estudados 17 pacientes (24 olhos submetidos à descompressão da bainha do nervo óptico entre janeiro de 1991 e janeiro de 1999. Todos tinham diagnóstico de pseudotumor cerebral e foram operados por apresentar perda da acuidade (AV e/ou do campo visual (CV. Duas pacientes não toleraram o tratamento clínico com diuréticos e corticóides e, nos demais, a medicação não surtiu efeito satisfatório. Quatro pacientes já haviam sido submetidas à derivação lombo-peritoneal. Resultados: A cirurgia foi unilateral em dez pacientes e bilateral em sete. Quatro tiveram cirurgia bilateral e simultânea devido à gravidade da perda visual. A acuidade visual e/ou o campos visuais melhorou em 14, permaneceu inalterada em 9 e piorou em apenas 1 dos 24 olhos operados. A paciente que apresentou piora já tinha perda visual acentuada e rapidamente progressiva, com apenas uma ilha paracentral de visão e conta dedos no pré-operatório. Houve resolução do edema em todos os olhos operados, seguido de atrofia óptica em muitos deles. Os pacientes que não melhoraram a função visual foram aqueles operados já com perda acentuada da função visual. Hemorragia moderada trans-operatória ocorreu em duas cirurgias. Conclusões: A descompressão da bainha do nervo óptico pode ser útil para proteger a função visual de pacientes com papiledema por pseudotumor cerebral que não respondem adequadamente ao tratamento clínico, além de poder servir como tratamento complementar para pacientes já submetidos à derivação lombo-peritoneal.

  12. Initial experience with a reversal-of-flow cerebral protection device in carotid angioplasty Experiência inicial com dispositivo de reversão de fluxo para proteção cerebral na angioplastia carotídea

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    Sidnei José Galego

    2013-03-01

    Full Text Available PURPOSE: To report initial findings with the GORE Flow Reversal System®, with a focus on major/minor adverse events in the 30 first postoperative days. METHODS: The first 24 patients submitted to carotid angioplasty using the GORE system, from June 2010 to May 2012, were retrospectively assessed with regard to indications, anatomic details, technical difficulties, and early clinical outcomes, including major (stroke, death, acute myocardial infarction and minor (hematoma adverse events. RESULTS: Systemic hypertension was present in 100% of the patients, diabetes mellitus in 58.3%, and coronary disease in 37.5%. Type II aortic arch was encountered in 62.5% of the patients and atherosclerotic lesion predominantly at the carotid bifurcation affecting the internal and common carotid arteries in 79.2%. Angiographic data revealed contralateral carotid arteries with OBJETIVO: Relatar os achados iniciais da utilização do GORE Flow Reversal System® (Sistema de Fluxo de Reversão, com foco em eventos adversos maiores/menores nos primeiros 30 dias do pós-operatório. MÉTODOS: Os primeiros 24 pacientes submetidos a angioplastia carotídea com a utilização do sistema GORE, de junho de 2010 a maio de 2012, foram avaliados retrospectivamente com relação a indicações, detalhes anatômicos, dificuldades técnicas e desfechos clínicos imediatos, incluindo eventos adversos maiores (acidente vascular cerebral, morte, infarto agudo do miocárdio e menores (hematoma. RESULTADOS: Hipertensão sistêmica estava presente em 100% dos pacientes, diabete melito em 58,3% e doença coronariana em 37,5%. Arco aórtico tipo II foi encontrado em 62,5% dos pacientes e lesão de aterosclerose predominantemente na bifurcação carotídea que afeta as artérias carótidas internas e comuns em 79,2%. Dados angiográficos revelaram artérias carótidas contralaterais com estenose <50% em 95,8% de casos e preservação de fluxo sanguíneo cerebral em 95,8%. Todos os

  13. Observations on the Efficacy of Moxibustion plus Medicinal Tea in Treating Gouty Arthritis During the Interictal Period%艾灸配合药茶治疗痛风性关节炎发作间歇期疗效观察

    Institute of Scientific and Technical Information of China (English)

    张文君; 李建军; 孙秀凤; 吴子成; 汪怀

    2015-01-01

    目的:观察艾灸配合药茶治疗痛风性关节炎发作间歇期的临床疗效。方法治疗组64例采用艾灸配合药茶方法治疗,对照组64例采用饮食控制的方法。结果治疗组总有效率为95.3%,对照组总有效率为75.0%,两组比较差异有统计学意义(P<0.01)。结论采用艾灸配合药茶治疗痛风性关节炎发作间歇期疗效较好。%ObjectiveTo investigate the clinical efficacy of moxibustion plus medicinal tea in treating gouty arthritis during the interictal period.MethodA treatment group of 64 patients received moxibustion plus medicinal tea and the control groupof 64 patients, alimentary control.ResultThe total efficacy rate was 95.3% in the treatment group and 75.0% in the control group; there was a statistically significant difference between the two groups (P<0.01).ConclusionMoxibustion plus medicinal tea has a better therapeutic effect on gouty arthritis during the interictal period.

  14. The Antimicrobial Efficacy of <em>Elaeis guineensisem>: Characterization, <em>in Vitroem> and <em>in Vivoem> Studies

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    Sreenivasan Sasidharan

    2012-04-01

    Full Text Available The urgent need to treat multi-drug resistant pathogenic microorganisms in chronically infected patients has given rise to the development of new antimicrobials from natural resources. We have tested <em>Elaeis guineensis em>Jacq> em>(Arecaceae methanol extract against a variety of bacterial, fungal and yeast strains associated with infections. Our studies have demonstrated that <em>E. guineensisem> exhibits excellent antimicrobial activity <em>in vitroem> and <em>in vivoem> against the bacterial and fungal strains tested. A marked inhibitory effect of the <em>E. guineensisem> extracts was observed against <em>C. albicansem> whereby <em>E. guineensisem> extract at ½, 1, or 2 times the MIC significantly inhibited <em>C. albicansem> growth with a noticeable drop in optical density (OD of the bacterial culture. This finding confirmed the anticandidal activity of the extract on <em>C. albicansem>. Imaging using scanning (SEM and transmission (TEM electron microscopy was done to determine the major alterations in the microstructure of the extract-treated <em>C. albicansem>. The main abnormalities noted via SEM and TEM studies were the alteration in morphology of the yeast cells. <em>In vivoem> antimicrobial activity was studies in mice that had been inoculated with <em>C. albicansem> and exhibited good anticandidal activity. The authors conclude that the extract may be used as a candidate for the development of anticandidal agent.<em> em>

  15. Cranio-cerebral gunshot wounds

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    C. Majer1, G. Iacob2

    2010-11-01

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

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

    Science.gov (United States)

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

    2003-09-01

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

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

    DEFF Research Database (Denmark)

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

    1994-01-01

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

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

    NARCIS (Netherlands)

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

    2002-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  2. São os membros superiores na Paralisia Cerebral negligenciados?

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    Ubiratan Brum Castro

    2014-06-01

    Full Text Available Objetivo: Avaliar se num serviço de atendimento especializado, o membro superior é preterido ou negligenciado no tratamento das alterações motoras da Paralisia Cerebral. Casuística e métodos: Foram analisados 80 pacientes portadores de Paralisia Cerebral menores de dezessete anos tratados institucionalmente. Foram avaliados pelo mesmo examinador quanto à classificação e tratamentos (cirúrgico ou não do aparelho locomotor. Resultados: O membro superior teve a seguinte abordagem terapêutica considerando o grupo de mão comprometida, 1 (2% foi submetido a transferência tendinosa no punho e 53 (98% não foram operados. Quanto a órteses, 9 (17% usavam estabilizadores de punho e 45 (83% não usavam. Quanto à toxina botulínica não houve aplicação nos membros superiores. Nos membros inferiores, considerando o total de pacientes, 16 (20% foram submetidos à cirurgia e 64(80% não foram operados. As cirurgias foram um tratamento cirúrgico de luxação do quadril, 7 a alongamentos múltiplos em membros inferiores, 5 alongamento de tendão calcâneo, 3 tenotomia de adutores. Quanto ao uso de órteses, 49 (61% faziam uso e 31(39% não utilizavam. Dos pacientes que faziam uso de órteses, 48 usavam tala estabilizadora de tornozelo, um usava estabilizador de joelho. Quanto à  o uso de toxina botulínica: 32 tiveram aplicação (40% e 48 não receberam aplicação (60%. Conclusão: No presente estudo, o tratamento do membro superior foi negligenciado.

  3. CLINICO - HAEMATOLOGICAL PROFILE AND OUTCOME OF CEREBRAL MALARIA IN A TEACHING HOSPITAL OF SOUTH EAST RAJASTHAN

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    Gautam Lal

    2015-05-01

    Full Text Available AIM: Evaluation of Clinico - hematological profile and outcome of cerebral malaria in semi urban hospital situated in endemic area. MATERIAL AND METHODS : A cross - sectional hospital - based study was conducted from August to November, 2014 at Department of Paediatrics SRG Zanana Hospital, Jhalawar Rajasthan. Every child, except who was previously abnormal neurologically, of the age of six month to 12 years, presented with a history of fever in the last 7 days, with o r without convulsion, and/or impaired consciousness, screened for malaria by peripheral blood smear examination and rapid diagnostic test for malaria parasite. On the basis of this screening examination, these children were classified definite cerebral mal aria where the peripheral smear was positive and probable cerebral malaria where the peripheral smear was negative. If the patients presented with fever, convulsion, and/or impaired level of consciousness, they were treated with Artesunate intravenously em pirically. Patients were followed - up regularly till they regained consciousness and when, they were able to swallow, treated with oral Artisunate and single dose of Sulphadoxine and Pyrimethamine combination is also given. RESULTS: Of the3332 admissions, 8 69 (26.08% were admitted for fever. Out of these 869 febrile patients 352 patients were having other obvious clinical diagnosis for fever. In remaining 517(59.49% cases were suspected to be suffering from malaria, but all of these children who were admit ted with the diagnosis of fever, were screened for malaria and 74(08.51%were found to be positive for malaria parasite either by peripheral blood smear or rapid diagnostic test or both. Cerebral malaria developed in 37 patients. Most cases were of age gro up of 2 - 5 years, 14children had definite cerebral malaria and 9 were labelled as suspected to have probable cerebral malaria. Neurological symptoms of altered sensorium, convulsion and abnormal behaviour ranged from 35

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

    Institute of Scientific and Technical Information of China (English)

    石广志; 赵继宗; 王硕; 王永刚; 陆铮

    2003-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

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

  7. Ce