Journal of neurology, neurosurgery, and psychiatry
-
J. Neurol. Neurosurg. Psychiatr. · May 2013
Clinical risk predictors for cerebral hyperperfusion syndrome after carotid endarterectomy.
Cerebral hyperperfusion syndrome (CHS) is an important complication of carotid endarterectomy (CEA), yet prior research has been limited to small cohorts and retrospective analyses, or studies using radiographic rather than clinical definitions. ⋯ Independent, prospective monitoring of a large cohort of CEA cases identified a brief time interval between ischaemic symptoms and endarterectomy as the clearest risk factor for CHS.
-
J. Neurol. Neurosurg. Psychiatr. · May 2013
The Addenbrooke's Cognitive Examination for the differential diagnosis and longitudinal assessment of patients with parkinsonian disorders.
Differentiating idiopathic Parkinson's disease from atypical parkinsonian syndromes is challenging, especially in the early stages. We assessed whether the Revised Addenbrooke's Cognitive Examination (ACE-R) could differentiate between parkinsonian syndromes and reflect longitudinal changes in cognition in these disorders. ⋯ We propose the ACE-R, particularly the verbal fluency subscore, as a valuable contributor to the differential diagnosis of parkinsonian syndromes in the correct clinical context. The ACE-R may reflect disease progression in PD and CBD.
-
J. Neurol. Neurosurg. Psychiatr. · May 2013
Efficacy of mitoxantrone in neuromyelitis optica spectrum: clinical and neuroradiological study.
To evaluate the efficacy of mitoxantrone (MTX) on clinical and neuroradiological parameters of patients who had a relapse of neuromyelitis optica spectrum (NMOS) within the 12 previous months. ⋯ In this observational NMO study, MTX decreased dramatically the frequency of relapses, which is directly related to progression of disability or even death in this disorder.
-
J. Neurol. Neurosurg. Psychiatr. · May 2013
Long-term outcome of hemispheric surgery at different ages in 61 epilepsy patients.
Hemispheric neurosurgery is an established treatment for severe epilepsy caused by extended unilateral brain pathology. However, it is still an unresolved question at which age surgery should best be performed. In light of decreasing plasticity and the cumulative impact of seizures and anticonvulsants on neurodevelopment, early surgery appears preferable. ⋯ Our data confirm the efficacy and cognitive safety of hemispheric surgeries performed at different ages. Eligible older and high functioning patients can be perfect candidates. Presurgical intelligence serves as indicator of the functional integrity of the contralateral hemisphere, which mainly determines postsurgical cognition and psychosocial outcome. Seizure freedom promotes cognitive improvement. As many unknown factors determined age at surgery, our retrospective data neither question early surgeries nor suggest postponing surgery.
-
J. Neurol. Neurosurg. Psychiatr. · May 2013
Cerebrospinal fluid amyloid-β and phenotypic heterogeneity in de novo Parkinson's disease.
In Parkinson's disease (PD), the motor presentation characterised by postural instability/gait difficulties (PIGD) heralds accelerated motor, functional and cognitive decline, as compared with the more benign tremor-dominant (TD) variant. This makes the PIGD complex an attractive target for the discovery of prognostic biomarkers in PD. ⋯ Motor heterogeneity in de novo PD independently relates to CSF Aβ markers, with low levels found in patients with the PIGD presentation. This suggests that disturbed Aβ metabolism has an effect on PD beyond cognition and may contribute to the variable rate of motor and functional decline in PD.