Thursday, July 31, 2014

HIV Tx: Cognition Problems Seen in Some Patients

HIV Tx: Cognition Problems Seen in Some Patients
MedPage Today Neurology

(MedPage Today) -- MELBOURNE, Australia -- Some HIV patients still experienced neurocognitive decline, even with effective treatment, according to researchers here.

Original Article: http://www.medpagetoday.com/MeetingCoverage/IAC/46963
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Rats Experience Feelings of Regret

Rats Experience Feelings of Regret
Scientific American: Mind and Brain

New study reveals rat's remorse — another way other animals are like humans

-- Read more on ScientificAmerican.com


Original Article: http://www.scientificamerican.com/article/rats-experience-feelings-of-regret/
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Fear: How Statistics Can Spin Out of Control (CME/CE)

Fear: How Statistics Can Spin Out of Control (CME/CE)
MedPage Today Neurology

(MedPage Today) -- Loss of consciousness may be statistically associated with clinically significant TBI, but that doesn't make it useful for decision-making, argues Rory Spiegel, MD.

Original Article: http://www.medpagetoday.com/EmergencyMedicine/EmergencyMedicine/46978
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Thunderclap headache and subarachnoid haemorrhage: yes, it’s as bad as it sounds.

Thunderclap headache and subarachnoid haemorrhage: yes, it's as bad as it sounds.
JNNP blog

Aside from publishing ground-breaking insights into the mechanisms of neurological disease, JNNP also publishes many manuscripts that focus on common hard-to-manage clinical problems, things that neurologists come across on a daily basis. In this issue of JNNP, there is a very interesting paper from Bakker and colleagues http://jnnp.bmj.com/content/85/8/885.abstract that concerns one of the most feared neurological disorders, namely subarachnoid haemorrhage (SAH). This condition is due to rupture of a cerebral aneurysm and the condition is commonly fatal. Many of you would have heard about patients who have had emergency surgery for this condition and survived and possibly of others who died despite treatment or in whom the diagnosis was missed.

In my current cohort of final year medical students, all were able to provide clear descriptions of how SAH presents and how you diagnose and treat this condition, which is reassuring. There does however remain one area of contention. If someone has a CT scan of the brain which does not show any evidence of acute bleeding but has evidence of 'old blood' in their spinal fluid (obtained by lumbar puncture), how far do you go looking for an aneurysm?

In this paper, Bakker et al have addressed this very issue . Patients who were CT negative but lumbar puncture positive, were put through a rigorous set of additional tests. This included a CT angiogram and in patients who were CT angio negative, a follow-up formal cerebral angiogram. The key finding was that >40% of patients who were investigated in this way had evidence of an aneurysm. This is a very significant proportion and it demonstrates the lengths to which one needs to go to detect these abnormalities. Overall, patients in this study had a favourable outcome, which underscores the benefits of intense investigations in this potentially fatal condition.



Original Article: http://blogs.bmj.com/jnnp/2014/07/30/thunderclap-headache-and-subarachnoid-haemorrhage-yes-its-as-bad-as-it-sounds/
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Researchers shed light on how depression is related to dementia

Researchers shed light on how depression is related to dementia
Neurology News & Neuroscience News from Medical News Today

Past studies have linked depression to higher risk of dementia, but the reasons behind this have been unclear. Now, a new study provides insight into the association.

Original Article: http://www.medicalnewstoday.com/articles/280266.php
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Symptom relief following non-endoscopic migraine surgery

Symptom relief following non-endoscopic migraine surgery
Neurology News & Neuroscience News from Medical News Today

A revised version of a surgical procedure to treat severe chronic migraine headaches led to significant symptom relief more than 90 percent of the time in patients treated at Massachusetts General...

Original Article: http://www.medicalnewstoday.com/releases/280309.php
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Saturday, July 26, 2014

New Brain Implant Conquers Vertigo

New Brain Implant Conquers Vertigo
Scientific American: Mind and Brain

Surgeons have implanted a new prosthesis in four patients to correct disabling dizziness. The device may someday restore balance to hundreds of thousands more

-- Read more on ScientificAmerican.com


Original Article: http://www.scientificamerican.com/article/new-brain-implant-conquers-vertigo/
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A new cause of mental disease?

A new cause of mental disease?
Neurology News & Neuroscience News from Medical News Today

Astrocytes, the cells that make the background of the brain and support neurons, might be behind mental disorders such as depression and schizophrenia, according to new research by a Portuguese...

Original Article: http://www.medicalnewstoday.com/releases/280046.php
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Carotid Endarterectomy: Comparison of Complications Between Transverse and Longitudinal Incision

Carotid Endarterectomy: Comparison of Complications Between Transverse and Longitudinal Incision
Neurosurgery - Current Issue

imageBACKGROUND: Cranial nerve injury (CNI) is the most common neurological complication associated with carotid endarterectomy (CEA). Some authors postulate that the transverse skin incision leads to increased risk of CNI. OBJECTIVE: We compared the incidence of CNI associated with the transverse and longitudinal skin incisions in a high-volume cerebrovascular center. METHODS: We reviewed the charts of 226 consecutive patients who underwent CEAs between January 2007 and August 2009. Pre- and postoperative standardized neurological evaluations were performed by faculty neurologists and neurosurgeons. RESULTS: One hundred sixty nine of 226 (75%) CEAs were performed with the use of a transverse incision. The longitudinal incision was generally reserved for patients with a high-riding carotid bifurcation. Mean patient age was 69 years (range, 45-91 years); 62% were men; 59% of patients were symptomatic and had high-grade stenosis (70%-99%). CNI occurred in 8 cases (3.5%): 5 (3%) in transverse and 3 (5.3%) with longitudinal incisions (P = .42). There were 2 marginal mandibular nerve injuries, 1 (0.6%) transverse and 1 longitudinal; 5 recurrent laryngeal nerve injuries, 4 transverse and 1 longitudinal; and 1 case of hypoglossal nerve injury associated with longitudinal incision. One hematoma was associated with CNI. All injuries were transient. Fourteen wound hematomas required surgical evacuation. CONCLUSION: The transverse skin incision for CEAs is not associated with an increased risk of CNI (P =.42). In this study, the incidence of CNI associated with the transverse incision was 3% (n = 5) vs 5% (n = 3) for longitudinal incisions. All CNIs were temporary. ABBREVIATIONS: CEA, carotid endarterectomy CNI, cranial nerve injury ECST, European Carotid Surgery Trial ICA, internal carotid artery MI, myocardial infarction

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/08000/Carotid_Endarterectomy___Comparison_of.14.aspx
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Percutaneous Endoscopic Lumbar Foraminotomy: An Advanced Surgical Technique and Clinical Outcomes

Percutaneous Endoscopic Lumbar Foraminotomy: An Advanced Surgical Technique and Clinical Outcomes
Neurosurgery - Current Issue

imageBACKGROUND: Although several authors have reported the use of endoscopic techniques to treat lumbar foraminal stenosis, the practical application of these techniques has been limited to soft disc herniation. OBJECTIVE: To describe the details of the percutaneous endoscopic lumbar foraminotomy (ELF) technique for bony foraminal stenosis and to demonstrate the clinical outcomes. METHODS: Two years of prospective data were collected from 33 consecutive patients with lumbar foraminal stenosis who underwent ELF. The surgical outcomes were assessed using the visual analog scale, Oswestry Disability Index, and modified MacNab criteria. The procedure begins at the safer extraforaminal zone rather than the riskier intraforaminal zone. Then, a full-scale foraminal decompression can be performed using a burr and punches under endoscopic control. RESULTS: The mean age of the 18 female and 15 male patients was 64.2 years. The mean visual analog scale score for leg pain improved from 8.36 at baseline to 3.36 at 6 weeks, 2.03 at 1 year, and 1.97 at 2 years post-surgery (P < .001). The mean Oswestry Disability Index improved from 65.8 at baseline to 31.6 at 6 weeks, 19.7 at 1 year, and 19.3 at 2 years post-surgery (P < .001). Based on the modified MacNab criteria, excellent or good results were obtained in 81.8% of the patients, and symptomatic improvements were obtained in 93.9%. CONCLUSION: Percutaneous ELF under local anesthesia could be an efficacious surgical procedure for the treatment of foraminal stenosis. This procedure may offer safe and reproducible results, especially for elderly or medically compromised patients. ABBREVIATIONS: ELF,endoscopic lumbar foraminotomy ODI, Oswestry Disability Index VAS, visual analog scale

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/08000/Percutaneous_Endoscopic_Lumbar_Foraminotomy___An.16.aspx
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A Randomized Clinical Trial to Assess the Benefit of Decompressive Craniectomy in Older Patients With a Large Middle Cerebral Artery Infarction

A Randomized Clinical Trial to Assess the Benefit of Decompressive Craniectomy in Older Patients With a Large Middle Cerebral Artery Infarction
Neurosurgery - Current Issue

imageNo abstract available

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/08000/A_Randomized_Clinical_Trial_to_Assess_the_Benefit.9.aspx
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Mechanical Tissue Resuscitation at the Site of Traumatic Brain Injuries Reduces the Volume of Injury and Hemorrhage in a Swine Model

Mechanical Tissue Resuscitation at the Site of Traumatic Brain Injuries Reduces the Volume of Injury and Hemorrhage in a Swine Model
Neurosurgery - Current Issue

imageBACKGROUND: Traumatic brain injuries (TBIs) continue to be a devastating problem with limited treatment options. Previous research applying controlled vacuum to TBI in a rat model resulted in smaller injuries and more rapid recovery. OBJECTIVE: To examine the effects of the application of a controlled vacuum (mechanical tissue resuscitation) to TBI in a large-animal model. The magnitude of vacuum, length of application, and length of delay between injury and the application of mechanical tissue resuscitation were investigated. METHODS: Localized, controlled cortical injuries were created in swine. Vacuums of −50 and −100 mm Hg were compared. Mechanical tissue resuscitation for 3 or 5 days was compared. Delays of 0, 3, or 6 hours between the creation of the TBI and the initiation of mechanical tissue resuscitation were examined. Analysis included histological assessments, computed tomographic perfusion, and magnetic resonance imaging (T2, proton magnetic spectra). RESULTS: A −100 mm Hg vacuum resulted in significantly smaller mean contused brain and hemorrhage volumes compared with −50 mm Hg and controls. Magnetic resonance spectra of treated animals returned to near baseline values. All 10 animals with 5-day mechanical tissue resuscitation treatment survived. Three of 6 animals treated for 3 days died after the discontinuation of treatment. A 3-hour delay resulted in similar results as immediate treatment. A 6-hour delay produced significant, but lesser responses. CONCLUSION: Application of mechanical tissue resuscitation to TBI was efficacious in the large-animal model. Application of −100 mm Hg for 5 days resulted in significantly improved outcomes. Delays of up to 3 hours between injury and the initiation of treatment did not diminish the efficacy of the mechanical tissue resuscitation treatment. ABBREVIATIONS: BP, blood pressure CBF, cerebral blood flow CCI, controlled cortical injury EEG, electroencephalogram ICP, intracranial pressure TBI, traumatic brain injury

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/08000/Mechanical_Tissue_Resuscitation_at_the_Site_of.19.aspx
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Best Initial Therapy for Parkinson Disease

Best Initial Therapy for Parkinson Disease
Medscape NeurologyHeadlines

The benefits of levodopa vs levodopa-sparing therapies are tested in this large, open-label trial.
Medscape Neurology

Original Article: http://www.medscape.com/viewarticle/828509?src=rss
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Don't Learn on Me — Are Teaching Hospitals Patient-Centered?

Don't Learn on Me — Are Teaching Hospitals Patient-Centered?
The New England Journal of Medicine: Research & Review Articles on ...

New England Journal of Medicine, Volume 371, Issue 4, Page 293-295, July 2014.


Original Article: http://www.nejm.org/doi/full/10.1056/NEJMp1405709?af=R&rss=currentIssue
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Cryopreservation versus subcutaneous preservation of autologous bone flaps for cranioplasty: Comparison of the surgical site infection and bone resorption rates

Cryopreservation versus subcutaneous preservation of autologous bone flaps for cranioplasty: Comparison of the surgical site infection and bone resorption rates
Neurosurgery News

Clinical Neurology and Neurosurgery

Original Article: http://www.mdlinx.com/neurology/news-article.cfm/5391818/?xml
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What Processes in the Brain Allow You to Remember Dreams?

What Processes in the Brain Allow You to Remember Dreams?
Scientific American: Mind and Brain



-- Read more on ScientificAmerican.com


Original Article: http://www.scientificamerican.com/article/what-processes-in-the-brain-allow-you-to-remember-dreams/
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Characteristics of Posterior Cerebral Artery Aneurysms: An Angiographic Analysis of 93 Aneurysms in 81 Patients

Characteristics of Posterior Cerebral Artery Aneurysms: An Angiographic Analysis of 93 Aneurysms in 81 Patients
Neurosurgery - Most Popular Articles

imageBACKGROUND: Posterior cerebral artery (PCA) aneurysms are rare lesions. Because of their low incidence, the individual or institutional experience is usually limited. OBJECTIVE: To identify specific anatomic features related to PCA aneurysms based on the analyses of pretreatment angiograms. METHODS: We performed a detailed angiographic study of 81 patients with a diagnosis of 93 PCA aneurysms. Fifty-three patients underwent computed tomography angiography, 49 underwent digital subtraction angiography, and 6 underwent magnetic resonance angiography. Between 1980 and 2012, a total of 120 patients with 136 PCA aneurysms and 11 352 patients with 16 444 intracranial aneurysms were treated at our institutions. RESULTS: There were 29 ruptured and 64 unruptured PCA aneurysms. The distribution of the aneurysms along the PCA segments was P1 (n = 39; 9 ruptured), P1/P2 junction (n = 25; 9 ruptured), P2 (n = 21; 5 ruptured), and P3 (n = 8; 6 ruptured). The median aneurysm size was 7 mm for the ruptured and 4 mm for the unruptured aneurysms. Saccular aneurysms (n = 69, 74%) had a typical projection for each location: P1 segment, upward (67%); P1/P2 junction, anterior/upward (80%); P2 segment, lateral (67%); and P3 segment, posterior (50%). Multiple aneurysms were seen in 43 patients. PCA aneurysms related to arteriovenous malformations were observed in 10 patients. CONCLUSION: PCA aneurysms are infrequent lesions, often associated with multiple aneurysms and arteriovenous malformations and are fusiform in shape. Most ruptured PCA aneurysms are smaller than 10 mm and usually distally located. At each PCA segment, saccular PCA aneurysms have a typical dome orientation. ABBREVIATIONS: ACA, anterior cerebral artery AVM, arteriovenous malformation CTA, computed tomography angiography DSA, digital subtraction angiography MCA, middle cerebral artery PCA, posterior cerebral artery PCoA, posterior communicating artery

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/08000/Characteristics_of_Posterior_Cerebral_Artery.17.aspx
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Are Aneurysms Treated With Balloon-Assisted Coiling and Stent-Assisted Coiling Different? Morphological Analysis of 113 Unruptured Wide-Necked Aneurysms Treated With Adjunctive Devices

Are Aneurysms Treated With Balloon-Assisted Coiling and Stent-Assisted Coiling Different? Morphological Analysis of 113 Unruptured Wide-Necked Aneurysms Treated With Adjunctive Devices
Neurosurgery - Most Popular Articles

imageBACKGROUND: In the endovascular treatment of wide-necked unruptured aneurysms, there is controversy over which adjunctive device (stent vs balloon) is appropriate. At the payer level it has been posited that stents and balloons treat the same aneurysms, and, as such, the more expensive stents should not be reimbursed. OBJECTIVE: We challenge this assertion, and instead hypothesize that aneurysms treated with stent assistance are morphologically different than those selected for balloon assistance. METHODS: Retrospective review of unruptured aneurysms treated with an adjunctive device between 2008 and 2010. Morphological analysis was performed on the pretreatment 2-D catheter angiogram. The immediate posttreatment Raymond score was compared with that seen on the 12-month follow-up angiogram. RESULTS: One hundred six unruptured aneurysms were treated with an adjunctive device and followed for a mean of 24.5 months. Morphological analysis revealed a lower dome-to-neck ratio (1.5 vs 1.2) and aspect ratio (1.44 vs 1.16) in the aneurysms treated with stent assistance vs balloon assistance. Of the 15.3% that were worse on follow-up angiography, there was no statistical difference between those treated with a stent vs a balloon (17.1% vs 14.2%). The overall re-treatment rate was 10.2% and was not statistically different between the 2 groups (12.7% vs 5.7%). CONCLUSION: We found that unruptured aneurysms selected for treatment with stent-assisted coiling are morphologically different from those selected for treatment with balloon assistance. Despite the more challenging morphology, Raymond scores and re-treatment rates at 1 year were not statistically different between the 2 groups, suggesting an important role for stents in the treatment of unruptured aneurysms. ABBREVIATIONS: DSA, digital subtraction angiography TE, thromboembolic

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/08000/Are_Aneurysms_Treated_With_Balloon_Assisted.18.aspx
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Therapies focus on areas of memory and learning in the brain to treat obesity

Therapies focus on areas of memory and learning in the brain to treat obesity
Neurology News & Neuroscience News from Medical News Today

Unlocking the secrets to better treating the pernicious disorders of obesity and dementia reside in the brain, according to a paper from American University's Center for Behavioral Neuroscience.

Original Article: http://www.medicalnewstoday.com/releases/280079.php
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Thursday, July 24, 2014

Amyloid plaque in Alzheimer's disease may affect remote regions of the brain

Amyloid plaque in Alzheimer's disease may affect remote regions of the brain
Neurology News & Neuroscience News from Medical News Today

In Alzheimer's disease, accumulation of amyloid plaque in the brain is believed to play an important role in many characteristic disease symptoms, including memory loss and other mental state changes.

Original Article: http://www.medicalnewstoday.com/releases/279957.php
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Outcome for unruptured middle cerebral artery aneurysm treatment: surgical and endovascular approach in a single center

Outcome for unruptured middle cerebral artery aneurysm treatment: surgical and endovascular approach in a single center
Neurosurgery News

Neurosurgical Review

Original Article: http://www.mdlinx.com/neurology/news-article.cfm/5386787/?xml
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Epigenetic tie to neuropsychiatric disorders

Epigenetic tie to neuropsychiatric disorders
Neurology News & Neuroscience News from Medical News Today

Flawed dopamine signaling linked to mass alteration of gene activity in prefrontal cortexDysfunction in dopamine signaling profoundly changes the activity level of about 2,000 genes in the...

Original Article: http://www.medicalnewstoday.com/releases/279981.php
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Wednesday, July 23, 2014

Children's impulsive behaviour is related to their brain connectivity

Children's impulsive behaviour is related to their brain connectivity
Neurology News & Neuroscience News from Medical News Today

Researchers from the University of Murcia have studied the changes in the brain that are associated with impulsiveness, a personality trait that causes difficulties in inhibiting a response in the...

Original Article: http://www.medicalnewstoday.com/releases/279974.php
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Livro Impresso: Escrito Em Letra de Médico

Livros Escrito Em Letra de Médico - Julio Pereira (8564855704) - 5% de Economia - Buscapé


http://www.buscape.com.br/escrito-em-letra-de-medico-julio-pereira-8564855704.html#precos
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More than 100 Genetic Locations Found to Be Linked to Schizophrenia

More than 100 Genetic Locations Found to Be Linked to Schizophrenia
Scientific American: Mind and Brain

The news comes on the same day as a $650-million donation to expand psychiatric research

-- Read more on ScientificAmerican.com


Original Article: http://www.scientificamerican.com/article/more-than-100-genetic-locations-found-to-be-linked-to-schizophrenia/
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Stress and Parkinsons disease: A potential link

Stress and Parkinsons disease: A potential link
JNNP blog

The era of the 20th century, while associated with tremendous progress, has also heralded the era of chronic diseases that were not prevalent in our ancestors. Stress has been portrayed, at least in the lay media and amongst patients, as an important factor in this. Stress is associated with definite physiological changes. In this issue of JNNP, Professor Andrew Lees proposes a link between chronic emotional stress and biological abnormalities that may contribute to development of neurodegenerative diseases such as PD. Importantly novel avenues for research are highlighted, that could yet unlock the mystery of PD.

Read more at: http://jnnp.bmj.com/content/85/8/878.full

The importance of relaxing

Dont fret!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



Original Article: http://blogs.bmj.com/jnnp/2014/07/23/stress-and-parkinsons-disease-a-potential-link/
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"Investments in Basic Research are just that: Investments"

Neal F. Lane: "Investments in Basic Research are just that: Investments"
Scientific American: Mind and Brain

Written testimony for the U.S. Senate Committee on Commerce, Science, and Transportation hearing "The Federal Research Portfolio: Capitalizing on Investments in R&D" held on July 17,...

-- Read more on ScientificAmerican.com


Original Article: http://www.scientificamerican.com/article/neal-f-lane-investments-in-basic-research-are-just-that-investments/
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