Neurological research
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Neurological research · Apr 2008
Post-carotid endarterectomy neurocognitive decline is associated with cerebral blood flow asymmetry on post-operative magnetic resonance perfusion brain scans.
Up to 25% of patients experience subtle declines in post-operative neurocognitive function following, otherwise uncomplicated, carotid endarterectomy (CEA). We sought to determine if post-CEA neurocognitive deficits are associated with cerebral blood flow (CBF) abnormalities on post-operative MR perfusion brain scans. ⋯ Post-CEA neurocognitive dysfunction is significantly associated with post-operative CBF asymmetry. These results support the hypothesis that post-CEA cognitive impairment is caused by cerebral hemodynamic changes. Further work exploring the relationship between CBF and post-CEA cognitive dysfunction is needed.
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Neurological research · Apr 2008
Vasospasm after SAH due to aneurysm rupture of the anterior circle of Willis: value of TCD monitoring.
The aim of this study was to verify the presence of angiographic vasospasm in patients with transcranial Doppler (TCD) of high velocities after subarachnoid hemorrhage (SAH). ⋯ Our study shows a good correlation between TCD and angiography to detect vasospasm on MCA, but the correlation is low for ACA. TCD alone cannot discriminate different hemodynamic pathways after SAH.
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Neurological research · Apr 2008
Comparative StudyMetabolite concentration ratios in thalami of patients with migraine and trigeminal neuralgia measured with 1H-MRS.
To investigate the metabolite concentration ratios including N-acetylaspartate (NAA), choline-containing compounds (Cho) and creatine plus phosphocreatine (Cr) in thalami of patients with migraine without aura, patients with trigeminal neuralgia and healthy comparison subjects using multi-voxel proton magnetic resonance spectroscopy (1H-MRS). ⋯ It was proved that migraine and trigeminal neuralgia seemed to be associated with an abnormal balance of the neural activity in the thalamus using 1H-MRS. There was some significant difference between metabolite concentration ratios in two diseases. 1H-MRS may serve as a useful non-invasive tool for evaluating thalamic neural activity and therapy effect in clinical performance of patients with migraine without aura.
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Neurological research · Apr 2008
Early cerebral hemodynamic alternations in patients operated on the first, second and third day after aneurysmal subarachnoid hemorrhage.
Surgery timing after aneurysmal subarachnoid hemorrhage (SAH) may influence the risk of vasospasm after early surgical procedure and is correlated with SAH extensiveness. A group consisting of 127 patients with aneurysmal SAH was studied. The changes of mean flow velocity (MFV) were measured in middle cerebral artery (MCA) and in anterior cerebral artery (ACA) by transcranial Doppler sonography (TCD) in three groups of patients divided according to the surgery timing (on the first, second and third day after SAH). ⋯ In patients without SAH (Fisher I group), the MFV values were the lowest, if they were operated on the third day after SAH. In patients with severe SAH (Fisher III group), the lowest risk of vasospasm was observed, if they were operated on the second day after SAH; however, the highest risk was found in patients operated on the first day after SAH. Our study suggests: (1) in patients with severe SAH operated on the second day, the lowest risk of vasospasm was observed, and the highest risk of vasospasm was observed if those were operated on the first day; (2) the highest risk of vasospasm was observed in patients operated within 24 hours with mild and massive SAH and in patients without SAH operated on the third day after SAH.