Wednesday, June 25, 2014

AF Detection Should Take Priority After Cryptogenic Stroke

AF Detection Should Take Priority After Cryptogenic Stroke
Medscape NeurologyHeadlines

Two trials of prolonged AF monitoring, CRYSTAL-AF and EMBRACE, have practice implications for the management of patients with cryptogenic stroke, researchers suggest.
Medscape Medical News

Original Article: http://www.medscape.com/viewarticle/827346?src=rss
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Surgey in Normal Pressure Hydrocephalus: Dont wait to shunt!

Surgey in Normal Pressure Hydrocephalus: Dont wait to shunt!
JNNP blog

Normal pressure hydrocephalus (NPH), a misnomer as the intracranial pressure is increased, may be a debilitating disorder presenting with cognitive decline, gait abnormalities and urinary incontinence.  Surgery may arrest and reverse the neurological deficits.  The consequences of postponing shunting surgery remain unknown, although the eager neurologist may be reassured by the neurosurgeons that there may be time.  In this issue of JNNP, Andren and colleagues dispel this myth and suggest that early intervention may be best and should be performed soon after the diagnosis.  Importantly, all three deficits seemed to be impacted.

 

MUST READ http://jnnp.bmj.com/content/85/7/806.abstract

Neurol Neurosurg Psychiatry 2014;85:806-810 doi:10.1136/jnnp-2013-306117
  • Neurosurgery
  • Research paper


Original Article: http://blogs.bmj.com/jnnp/2014/06/19/surgey-in-normal-pressure-hydrocephalus-dont-wait-to-shunt/
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Doctor-Patient Cancer Screening Talks: Often Not Ideal

Doctor-Patient Cancer Screening Talks: Often Not Ideal
Medscape Today- Medscape

These discussions do not regularly meet the criteria for shared decision making, especially when the patient is a woman, according to a new study.
Medscape Medical News

Original Article: http://www.medscape.com/viewarticle/827060?src=rss
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Neuroendocrinology: A long pain-free life

Neuroendocrinology: A long pain-free life
Nature Reviews Neuroscience - Issue - nature.com science feeds

Nature Reviews Neuroscience 15, 426 (2014). doi:10.1038/nrn3778

Author: Natasha Bray

Pain-sensitive sensory neurons in the dorsal root ganglion release calcitonin gene-related peptide, which could over time have long-term consequences on metabolism and longevity by reducing pancreatic release of insulin.



Original Article: http://feeds.nature.com/~r/nrn/rss/current/~3/ivuHXgHyeCo/nrn3778
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Chlorhexidine-Impregnated Dressing for Prevention of Catheter-Related Bloodstream Infection: A Meta-Analysis*

Chlorhexidine-Impregnated Dressing for Prevention of Catheter-Related Bloodstream Infection: A Meta-Analysis*
Critical Care Medicine - Most Popular Articles

imageObjective: To assess the efficacy of a chlorhexidine-impregnated dressing for prevention of central venous catheter–related colonization and catheter-related bloodstream infection using meta-analysis. Data Sources: Multiple computerized database searches supplemented by manual searches including relevant conference proceedings. Study Selection: Randomized controlled trials evaluating the efficacy of a chlorhexidine-impregnated dressing compared with conventional dressings for prevention of catheter colonization and catheter-related bloodstream infection. Data Extraction: Data were extracted on patient and catheter characteristics and outcomes. Data Synthesis: Nine randomized controlled trials met the inclusion criteria. Use of a chlorhexidine-impregnated dressing resulted in a reduced prevalence of catheter-related bloodstream infection (random effects relative risk, 0.60; 95% CI, 0.41–0.88, p = 0.009). The prevalence of catheter colonization was also markedly reduced in the chlorhexidine-impregnated dressing group (random effects relative risk, 0.52; 95% CI, 0.43–0.64; p < 0.001). There was significant benefit for prevention of catheter colonization and catheter-related bloodstream infection, including arterial catheters used for hemodynamic monitoring. Other than in low birth weight infants, adverse effects were rare and minor. Conclusions: Our analysis shows that a chlorhexidine-impregnated dressing is beneficial in preventing catheter colonization and, more importantly, catheter-related bloodstream infection and warrants routine use in patients at high risk of catheter-related bloodstream infection and central venous catheter or arterial catheter colonization.

Original Article: http://journals.lww.com/ccmjournal/Fulltext/2014/07000/Chlorhexidine_Impregnated_Dressing_for_Prevention.14.aspx
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Musical training 'improves executive brain function'

Musical training 'improves executive brain function'
Neurology News & Neuroscience News from Medical News Today

People with musical training show higher executive brain function than those without musical training, according to a new study by researchers from Boston Children's Hospital.

Original Article: http://www.medicalnewstoday.com/articles/278469.php
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Seizures and malignant MCS strokes: A real problem!

Seizures and malignant MCS strokes: A real problem!
JNNP blog

The risk of seizures after structural brain lesions, such as strokes, would be expected to be high, although this has not been studied in detail.  Clearly, such issues would have great bearing on patient management.  In this issue of JNNP, the risk of seizures in patients post malignant MCA territory strokes that underwent decompressive hemicraniectomy was reportedly high, impacting on patient recovery and management.   None-the-less, all patients would have chosen surgery irrespective of seizure risk.   These issues should be discussed with families of patients who are in this predicament, putting a brighter picture on outlook.

 

Read more at :  http://jnnp.bmj.com/content/85/7/721.abstract

J Neurol Neurosurg Psychiatry 2014;85:721-725 doi:10.1136/jnnp-2013-305678
  • Cerebrovascular disease
  • Research paper

Seizures after decompressive hemicraniectomy for ischaemic stroke

  1. C J Creutzfeldt,
  2. D L Tirschwell,
  3. L J Kim,
  4. G B Schubert,
  5. W T Longstreth Jr,
  6. K J Becker

DEAR BLOGGERS, I WILL BE AWAY FOR THE NEXT 2 WEEKS.  WILL CATCH UP AGAIN ON JULY 6TH

 

BULA FROM FIJI:)))

 



Original Article: http://blogs.bmj.com/jnnp/2014/06/22/seizures-and-malignant-mcs-strokes-a-real-problem/
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Discussion, criticism and advice-giving: content analysis of health blogs.

Discussion, criticism and advice-giving: content analysis of health blogs.
Scientific American: Mind and Brain

My PhD mostly dealt with research blogs from ResearchBlogging.org (RB) an aggregator of blog posts covering peer-reviewed research. In this article, we (Prof.

-- Read more on ScientificAmerican.com


Original Article: http://www.scientificamerican.com/blog/post/health-bloggers-offer-more-advice-than-criticism/
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Newer Anticoagulants Can Be Used Off-Label [Controversies in Stroke]

Newer Anticoagulants Can Be Used Off-Label [Controversies in Stroke]
Stroke current issue



Original Article: http://stroke.ahajournals.org/cgi/content/short/45/7/2154?rss=1
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Traumatic brain injury: a case of too much oxygen?

Traumatic brain injury: a case of too much oxygen?
JNNP blog

The term itself is scary enough-"traumatic brain injury" (TBI). What exactly does it mean? Well, it is possibly the commonest cause of death and disability worldwide. It refers to neurological symptoms that occur as a consequence of sudden trauma to the brain. It is most commonly due to a direct blow to the head, but some authorities also include other accidents in this definition, such as episodes of acute acceleration/deceleration which lead to brain injury, such as being thrown from a moving object. The symptoms vary significantly from one individual to another. A lot of sufferers who survive the acute injury develop chronic symptoms that may last a lifetime and for which there is no definite cure. These symptoms include changes in cognition, impaired mobility, problems with concentration and changes in personality and mood. These impairments affect not only the patient, but may have significant impact on friends and family. What is even more distressing for patients, is that these deficits cannot be directly measured and there is no simple test that tells the patient how severe the damage is or what the prognosis is likely to be. While some cases of TBI are mild and resolve, other patients have very serious brain injury which may affect long-term function and, in acute cases, possibly even survival.

In these severe cases, there has been considerable research on how these patients should be managed in the setting of an intensive care unit. In this issue of JNNP, there is a very important paper by Rincon and colleagues that looks at the role of oxygenation in determining the outcome of TBI http://jnnp.bmj.com/content/85/7/799.full . As noted in the accompanying Editorial http://jnnp.bmj.com/content/85/7/711.full , one of the principles of intensive care management is the provision of adequate oxygenation for the patient. The study by Rincon et al however explores an alternative possibility in TBI: what if we are doing damage by giving too much oxygen? Their results provide evidence that high levels of oxygen were associated with a worse outcome in patients with severe TBI. Why is this case? They suggest that providing high levels of oxygen may actually result in a reduction in oxygen delivery to the brain due to changes in cardiac output and that these reductions may impair the metabolic activities of neurons.

This is a large multi-centre study with interesting conclusions. Importantly from a clinical perspective, the study has implications for how we manage patients with severe TBI.



Original Article: http://blogs.bmj.com/jnnp/2014/06/24/traumatic-brain-injury-a-case-of-too-much-oxygen/
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Computational Fractal-Based Analysis of Brain Arteriovenous Malformation Angioarchitecture

Computational Fractal-Based Analysis of Brain Arteriovenous Malformation Angioarchitecture
Neurosurgery - Current Issue

imageBACKGROUND: Neuroimaging is the gold standard for diagnosis and follow-up of brain arteriovenous malformations (bAVMs), but no objective parameter has been validated for the assessment of the nidus angioarchitecture and for prognostication following treatment. The fractal dimension (FD), which is a mathematical parameter able to quantify the space-filling properties and roughness of natural objects, may be useful in quantifying the geometrical complexity of bAVMs nidus. OBJECTIVE: To propose FD as a neuroimaging biomarker of the nidus angioarchitecture, which might be related to radiosurgical outcome. METHODS: We retrospectively analyzed 54 patients who had undergone stereotactic radiosurgery for the treatment of bAVMs. The quantification of the geometric complexity of the vessels forming the nidus, imaged in magnetic resonance imaging, was assessed by means of the box-counting method to obtain the fractal dimension. RESULTS: FD was found to be significantly associated with the size (P = .03) and volume (P < .001) of the nidus, in addition to several angioarchitectural parameters. A nonsignificant association between clinical outcome and FD was observed (area under the curve, 0.637 [95% confidence interval, 0.49-0.79]), indicative of a potential inverse relationship between FD and bAVM obliteration. CONCLUSION: In our exploratory methodological research, we showed that the FD is an objective computer-aided parameter for quantifying the geometrical complexity and roughness of the bAVM nidus. The results suggest that more complex bAVM angioarchitecture, having higher FD values, might be related to decreased response to radiosurgery and that the FD of the bAVM nidus could be used as a morphometric neuroimaging biomarker. ABBREVIATIONS: AVM, arteriovenous malformation bAVM, brain arteriovenous malformation CTA, computed tomographic angiography FD, fractal dimension nrAVM, nonruptured arteriovenous malformation ROI, region of interest

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/07000/Computational_Fractal_Based_Analysis_of_Brain.9.aspx
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Computational Fractal-Based Analysis of Brain Arteriovenous Malformation Angioarchitecture

Computational Fractal-Based Analysis of Brain Arteriovenous Malformation Angioarchitecture
Neurosurgery - Current Issue

imageBACKGROUND: Neuroimaging is the gold standard for diagnosis and follow-up of brain arteriovenous malformations (bAVMs), but no objective parameter has been validated for the assessment of the nidus angioarchitecture and for prognostication following treatment. The fractal dimension (FD), which is a mathematical parameter able to quantify the space-filling properties and roughness of natural objects, may be useful in quantifying the geometrical complexity of bAVMs nidus. OBJECTIVE: To propose FD as a neuroimaging biomarker of the nidus angioarchitecture, which might be related to radiosurgical outcome. METHODS: We retrospectively analyzed 54 patients who had undergone stereotactic radiosurgery for the treatment of bAVMs. The quantification of the geometric complexity of the vessels forming the nidus, imaged in magnetic resonance imaging, was assessed by means of the box-counting method to obtain the fractal dimension. RESULTS: FD was found to be significantly associated with the size (P = .03) and volume (P < .001) of the nidus, in addition to several angioarchitectural parameters. A nonsignificant association between clinical outcome and FD was observed (area under the curve, 0.637 [95% confidence interval, 0.49-0.79]), indicative of a potential inverse relationship between FD and bAVM obliteration. CONCLUSION: In our exploratory methodological research, we showed that the FD is an objective computer-aided parameter for quantifying the geometrical complexity and roughness of the bAVM nidus. The results suggest that more complex bAVM angioarchitecture, having higher FD values, might be related to decreased response to radiosurgery and that the FD of the bAVM nidus could be used as a morphometric neuroimaging biomarker. ABBREVIATIONS: AVM, arteriovenous malformation bAVM, brain arteriovenous malformation CTA, computed tomographic angiography FD, fractal dimension nrAVM, nonruptured arteriovenous malformation ROI, region of interest

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/07000/Computational_Fractal_Based_Analysis_of_Brain.9.aspx
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Internal Maxillary Artery-Middle Cerebral Artery Bypass: Infratemporal Approach for Subcranial-Intracranial (SC-IC) Bypass

Internal Maxillary Artery-Middle Cerebral Artery Bypass: Infratemporal Approach for Subcranial-Intracranial (SC-IC) Bypass
Neurosurgery - Current Issue

imageBACKGROUND: Internal maxillary artery (IMax)–middle cerebral artery (MCA) bypass has been recently described as an alternative to cervical extracranial-intracranial bypass. This technique uses a "keyhole" craniectomy in the temporal fossa that requires a technically challenging end-to-side anastomosis. OBJECTIVE: To describe a lateral subtemporal craniectomy of the middle cranial fossa floor to facilitate wide exposure of the IMax to facilitate bypass. METHODS: Orbitozygomatic osteotomy is used followed by frontotemporal craniotomy and subsequently laterotemporal fossa craniectomy, reaching its medial border at a virtual line connecting the foramen rotundum and foramen ovale. The IMax was identified by using established anatomic landmarks, neuronavigation, and micro Doppler probe (Mizuho Inc. Tokyo, Japan). Additionally, we studied the approach in a cadaveric specimen in preparation for microsurgical bypass. RESULTS: There were 4 cases in which the technique was used. One bypass was performed for flow augmentation in a hypoperfused hemisphere. The other 3 were performed as part of treatment paradigms for giant middle cerebral artery aneurysms. Vein grafts were used in all patients. The proximal anastomosis was performed in an end-to-side fashion in 1 patient and end-to-end in 3 patients. Intraoperative graft flow measured with the Transonic flow probe ranged from 20 to 60 mL/min. Postoperative angiography demonstrated good filling of the graft with robust distal flow in all cases. All patients tolerated the procedure well. CONCLUSION: IMax to middle cerebral artery subcranial-intracranial bypass is safe and efficacious. The laterotemporal fossa craniectomy technique resulted in reliable identification and wide exposure of the IMax, facilitating the proximal anastomosis. ABBREVIATIONS: EC-IC, extracranial-intracranial IMax, internal maxillary artery MCA, middle cerebral artery SC-IC, subcranial-intracranial STA, superficial temporal artery

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/07000/Internal_Maxillary_Artery_Middle_Cerebral_Artery.11.aspx
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Contralateral Interhemispheric Approach to Deep-Seated Cavernous Malformations: Surgical Considerations and Clinical Outcomes in 31 Consecutive Cases

Contralateral Interhemispheric Approach to Deep-Seated Cavernous Malformations: Surgical Considerations and Clinical Outcomes in 31 Consecutive Cases
Neurosurgery - Current Issue

imageBACKGROUND: Deep-seated periventricular cavernous malformations of the basal ganglia or thalamus can be approached via an interhemispheric craniotomy. OBJECTIVE: To determine surgical efficacy and clinical outcomes of the contralateral interhemispheric approach. METHODS: Retrospective chart review was performed on patients undergoing an interhemispheric approach for the resection of deep-seated cavernous malformation by the senior author (R.F.S.) between 2005 and 2013. Demographic data and clinical outcomes were reviewed. Pre- and postoperative imaging were analyzed for lesion location, size, associated venous anomaly, proximity to ventricle, and presence of residual. RESULTS: Twenty-one patients underwent a contralateral interhemispheric-transventricular approach, 7 patients had a contralateral interhemispheric-transcingulate approach and 3 patients had a contralateral interhemispheric-transchoroidal approach. Mean age was 40.1 years, and the majority were female (58.1%). Mean maximum cavernoma diameter was 1.97 cm, and 43.8% reached the surface of the ventricle. Average follow-up was 8.9 months, with complete resection achieved in 96.8% of patients. At last follow-up, 61.3% of patients remained stable and 29.0% had improved. Of the patients, 6.5% experienced transient weakness that resolved at last follow-up, and 1 patient (3.2%) had short-term memory problems. There were no surgical mortalities. CONCLUSION: The contralateral interhemispheric approach is a safe, clinically well tolerated, and surgically efficacious approach to deep-seated cavernomas. ABBREVIATIONS: EVD, external ventricular drain POD, postoperative day

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/07000/Contralateral_Interhemispheric_Approach_to.10.aspx
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The Effects of Multiple Mild Traumatic Brain Injuries on Acute Injury Presentation and Neuropsychological Recovery in Children

The Effects of Multiple Mild Traumatic Brain Injuries on Acute Injury Presentation and Neuropsychological Recovery in Children
Neurosurgery - Most Popular Articles

imageBACKGROUND: Although research focused on mild traumatic brain injury (mTBI) has proliferated in recent years, few studies have examined the significance of a previous history of mTBI in children. OBJECTIVE: To compare the acute injury presentation and neuropsychological recovery in a pediatric sample after mTBI. METHODS: Participants 8 to 16 years of age were divided into 4 groups: no previous injury history, history of 1 mTBI, history of 2 mTBIs, and history of ≥ 3 mTBIs. Participants were evaluated within 3 months of the most recent injury by clinical interview and an abbreviated neuropsychological test battery. RESULTS: After the index mTBI, the groups did not differ in their likelihood to display a loss of consciousness, nor did they differ on neuropsychological test performance. CONCLUSION: Overall, contrary to our hypotheses, we found no demonstrable difference between those children with a self-reported mTBI history and those without after an index mTBI. ABBREVIATIONS: MANCOVA, multivariate analysis of covariance mTBI, mild traumatic brain injury TBI, traumatic brain injury WISC-IV, Wechsler Intelligence Scale for Children-Fourth Edition

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/07000/The_Effects_of_Multiple_Mild_Traumatic_Brain.4.aspx
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How to Disappear from the Web

How to Disappear from the Web
Scientific American: Mind and Brain

If you've ever been the victim of identity theft, or a stalker, or you just value your privacy, Tech Talker has the tools to help you ditch the digital age and remove your presence from the web.

-- Read more on ScientificAmerican.com


Original Article: http://www.scientificamerican.com/article/how-to-disappear-from-the-web/
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More Evidence Links Traumatic Brain Injury to Dementia

More Evidence Links Traumatic Brain Injury to Dementia
Medscape NeurologyHeadlines

The findings in veterans add weight to evidence that head injuries have long-term consequences, authors of a new study say.
Medscape Medical News

Original Article: http://www.medscape.com/viewarticle/827353?src=rss
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Incidence of subsequent vertebral body fractures after vertebroplasty

Incidence of subsequent vertebral body fractures after vertebroplasty
ScienceDirect Publication: Journal of Clinical Neuroscience

Publication date:
Source:Journal of Clinical Neuroscience
Author(s): Ying-Ze Zhang , Ling-De Kong , Jun-Ming Cao , Wen-Yuan Ding , Yong Shen




Original Article: http://rss.sciencedirect.com/action/redirectFile?&zone=main¤tActivity=feed&usageType=outward&url=http://www.sciencedirect.com/science?_ob=GatewayURL&_origin=IRSSSEARCH&_method=citationSearch&_piikey=S0967586814001301&_version=1&md5=131efe37157f1d1fd1a1f48729d5ab1d
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Thursday, June 19, 2014

FDA Panel Mixed on Implanted Weight-Loss Device

FDA Panel Mixed on Implanted Weight-Loss Device
Medscape Today- Medscape

An FDA advisory panel split votes on an implant device for severe obesity treatment.
Medscape Medical News

Original Article: http://www.medscape.com/viewarticle/826946?src=rss
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Sedation, Sleep Promotion, and Delirium Screening Practices in the Care of Mechanically Ventilated Children: A Wake-Up Call for the Pediatric Critical Care Community*

Sedation, Sleep Promotion, and Delirium Screening Practices in the Care of Mechanically Ventilated Children: A Wake-Up Call for the Pediatric Critical Care Community*
Critical Care Medicine - Current Issue

imageObjectives: To examine pediatric intensivist sedation management, sleep promotion, and delirium screening practices for intubated and mechanically ventilated children. Design: An international, online survey of questions regarding sedative and analgesic medication choices and availability, sedation protocols, sleep optimization, and delirium recognition and treatment. Setting: Member societies of the World Federation of Pediatric Intensive and Critical Care Societies were asked to send the survey to their mailing lists; responses were collected from July 2012 to January 2013. Subjects: Pediatric critical care providers. Interventions: Survey. Measurements and Main Results: The survey was completed by 341 respondents, the majority of whom were from North America (70%). Twenty-seven percent of respondents reported having written sedation protocols. Most respondents worked in PICUs with sedation scoring systems (70%), although only 42% of those with access to scoring systems reported routine daily use for goal-directed sedation management. The State Behavioral Scale was the most commonly used scoring system in North America (22%), with the COMFORT score more prevalent in all other countries (39%). The most commonly used sedation regimen for intubated children was a combination of opioid and benzodiazepine (72%). Most intensivists chose fentanyl as their first-line opioid (66%) and midazolam as their first-line benzodiazepine (86%) and prefer to administer these medications as continuous infusions. Propofol and dexmedetomidine were the most commonly restricted medications in PICUs internationally. Use of earplugs, eye masks, noise reduction, and lighting optimization for sleep promotion was uncommon. Delirium screening was not practiced in 71% of respondent's PICUs, and only 2% reported routine screening at least twice a day. Conclusions: The results highlight the heterogeneity in sedation practices among intensivists who care for critically ill children as well as a paucity of sleep promotion and delirium screening in PICUs worldwide.

Original Article: http://journals.lww.com/ccmjournal/Fulltext/2014/07000/Sedation,_Sleep_Promotion,_and_Delirium_Screening.2.aspx
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In Parkinson's model, brain protected by increased dopamine packaging

In Parkinson's model, brain protected by increased dopamine packaging
Neurology News & Neuroscience News from Medical News Today

Researchers from Emory's Rollins School of Public Health discovered that an increase in the protein that helps store dopamine, a critical brain chemical, led to enhanced dopamine neurotransmission...

Original Article: http://www.medicalnewstoday.com/releases/278433.php
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External Ventricular Drain-Related Ventriculitis Prevention: Standard Preventive Measures Still Work

External Ventricular Drain-Related Ventriculitis Prevention: Standard Preventive Measures Still Work
Critical Care Medicine - Current Issue

No abstract available

Original Article: http://journals.lww.com/ccmjournal/Fulltext/2014/07000/External_Ventricular_Drain_Related_Ventriculitis.48.aspx
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Wednesday, June 18, 2014

Confira "Dor de Cabeça" App

https://play.google.com/store/apps/details?id=com.sodavirtual.headache
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Venha participar da Discussão de Casos Neurocirúrgicos - Evento Gratuito!

Caso não visualize esse email adequadamente acesse este link
Informações sobre o evento
Discussão de casos neurocirúrgicos…
Acesse o site para mais informações

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Brazil and Other Big Players Lead in South American Science

Brazil and Other Big Players Lead in South American Science
Scientific American: Mind and Brain

Despite myriad problems in many countries, pockets of excellence thrive in Chile, Colombia, Brazil and Argentina

-- Read more on ScientificAmerican.com


Original Article: http://www.scientificamerican.com/article/brazil-and-other-big-players-lead-in-south-american-science/
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[Comment] Are statins to be STASHed in subarachnoid haemorrhage?

[Comment] Are statins to be STASHed in subarachnoid haemorrhage?
The Lancet Neurology

In The Lancet Neurology, Peter Kirkpatrick and colleagues report the results of an important randomised trial of simvastatin treatment for aneurysmal subarachnoid hemorrhage (SAH). Unfortunately, simvastatin 40 mg per day, started within 96 h of subarachnoid haemorrhage and given for up to 21 days, had no effect on outcome measured on the modified Rankin Scale at 6 months. The only secondary endpoint improved by statin use was a reduction in need for extended hypervolaemic treatment, which is of unknown clinical importance because it emerges alone among other measures that should be associated with delayed cerebral ischaemia.

Original Article: http://www.thelancet.com/journals/laneur/article/PIIS1474-4422(14)70095-X/fulltext?rss=yes
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New therapies for brain infections and cancers likely following discovery of fungal protein that can cross blood-brain barrier

New therapies for brain infections and cancers likely following discovery of fungal protein that can cross blood-brain barrier
Neurology News & Neuroscience News from Medical News Today

In a remarkable series of experiments on a fungus that causes cryptococcal meningitis, a deadly infection of the membranes that cover the spinal cord and brain, investigators at UC Davis have...

Original Article: http://www.medicalnewstoday.com/releases/278204.php
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New insight into how the brain regulates its blood flow

New insight into how the brain regulates its blood flow
Neurology News & Neuroscience News from Medical News Today

In a new study published online in the Journal of the American Heart Association, researchers at Columbia Engineering report that they have identified a new component of the biological mechanism that...

Original Article: http://www.medicalnewstoday.com/releases/278219.php
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What Happens to Children With Epilepsy When They Become Adults? Some Facts and Opinions

What Happens to Children With Epilepsy When They Become Adults? Some Facts and Opinions
Pediatric Neurology

Abstract: Background: The adult outcome after childhood onset epilepsy is a complex subject because seizure types and severity are diverse, comorbidities are common, and additional factors influence social outcome. We review selected data about seizure remission or persistence and social outcome in adulthood.Methods: Information came from published literature, especially population-based studies.Results: In general, approximately 50-60% of children with epilepsy eventually have complete seizure remission (i.e., seizure free and off antiepileptic drug treatment): with longer follow-up, the remission rate improves. Predicting remission, persistent or intractable epilepsy is often inaccurate for an individual patient. A tiny proportion of children with epilepsy die as the result of seizures or sudden unexpected death in epilepsy patients; however, an otherwise normal child has the same risk of death as the reference population. When uncontrolled epilepsy persists into adulthood, the rate of sudden unexpected death in epilepsy patients possibly increases. Reports about social outcome in adulthood are increasing. For those with intellectual disability, a lifetime of dependency is to be expected. For those with normal intelligence, adult life is often unsatisfactory with high rates of incomplete education, unemployment, poverty, social isolation, inadvertent pregnancy, and psychiatric disorders. Seizure remission does not ensure good adult social outcome.Conclusions: Although seizure control in childhood is important, anticipating poor social outcome in adulthood may allow earlier interventions. A well-orchestrated transition from pediatric to adult health care may be beneficial for the 40-50% with persistent seizures and for the majority who are at risk for adult social difficulties.

Original Article: http://www.pedneur.com/article/S0887-8994(14)00148-9/abstract?rss=yes
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The Prognosis of Pediatric Headaches—A 30-Year Follow-up Study

The Prognosis of Pediatric Headaches—A 30-Year Follow-up Study
Pediatric Neurology

Abstract: Background: Although headaches in childhood are common, there are few data available on their long-term prognosis. We have monitored a group of patients since diagnosis in 1983.Methods: Patients who were part of the 20-year follow-up study in 2003 were contacted, and data were collected using a standardized telephone interview. Details of headache characteristics and identified precipitants and alleviating factors were gathered. The most effective means of controlling the headaches were also recorded.Results: Follow-up was achieved for 28 of 60 patients (47%). Over the 30 years since diagnosis, eight patients (29%) reported a complete resolution of headaches, including three whose headaches resolved between the 20- and 30-year follow-up studies. The type of headache varied over the 30-year time interval with only three patients maintaining the same headache type at all four time periods of 1983, 1993, 2003, and 2013. Only one patient used prescription medication as the primary method for controlling headaches. The most commonly used intervention was nonprescription analgesia, self-relaxation and/or hypnosis, and precipitant avoidance.Conclusions: Headaches persist in approximately 70% of children 30 years after diagnosis. Encouraging children to manage their headaches with simple analgesia and precipitant avoidance appears to have long-term benefits.

Original Article: http://www.pedneur.com/article/S0887-8994(14)00150-7/abstract?rss=yes
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The World Cup's Climate Wild Card

The World Cup's Climate Wild Card
Scientific American: Mind and Brain

When I read that the soccer balls used for World Cup games have been specially designed for the climate in Brazil, that got me wondering - which climate?

-- Read more on ScientificAmerican.com


Original Article: http://www.scientificamerican.com/blog/post/the-world-cup-s-climate-wild-card/
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Comment: Intracerebral hemorrhage incidence declines, but it is still highly fatal

Comment: Intracerebral hemorrhage incidence declines, but it is still highly fatal
Neurology current issue

Overall stroke mortality has declined over the last decades—a welcome trend.1 However, recent trends in intracerebral hemorrhage (ICH) incidence are not as clear. On the one hand, there has been increasingly good population control of hypertension; on the other hand, there is increasing use of anticoagulants and antithrombotic drugs, an epidemic of obesity and diabetes, and changing racial and ethnic demographics.



Original Article: http://www.neurology.org/cgi/content/short/82/24/2185?rss=1
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