Acta neurologica Scandinavica
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Acta Neurol. Scand. · Sep 2014
Diffusional kurtosis imaging reveals a distinctive pattern of microstructural alternations in idiopathic generalized epilepsy.
Idiopathic generalized epilepsy (IGE) arises from paroxysmal dysfunctions of the thalamo-cortical network. One of the hallmarks of IGE is the absence of visible abnormalities on routine magnetic resonance imaging (MRI). However, recent quantitative MRI studies showed cortical-subcortical structural abnormalities in IGE, but the extent of abnormalities has been inconsistent in the literature. The inconsistencies may be associated with complex microstructural abnormalities in IGE that are not completely detectable using conventional diffusion tensor imaging methods. The goal of this study was to investigate white-matter (WM) microstructural abnormalities in patients with IGE using diffusional kurtosis imaging (DKI). ⋯ Even though IGE is traditionally considered a 'non-lesional' form of epilepsy, our results demonstrated pervasive thalamo-cortical WM microstructural abnormalities. Particularly, WM abnormalities shown by MK further extended into cortical-cortical projections. This suggests that the extent of microstructural abnormalities in thalamo-cortical projections in IGE may be better assessed through the diffusion metrics provided by DKI.
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The aim of this study was to identify the patient-related risk factors for post-dural puncture headache with same standardized procedures. ⋯ We confirmed the risk factor for post-dural puncture headache such as young age, and newly found that patients who underwent puncture at daytime developed more post-dural puncture headache than those who were performed puncture at nighttime.
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Acta Neurol. Scand. · Sep 2014
Bedside diagnosis of mitochondrial dysfunction in aneurysmal subarachnoid hemorrhage.
Aneurysmal subarachnoid hemorrhage (SAH) is frequently associated with delayed neurological deterioration (DND). Several studies have shown that DND is not always related to vasospasm and ischemia. Experimental and clinical studies have recently documented that it is possible to diagnose and separate cerebral ischemia and mitochondrial dysfunction bedside. The study explores whether cerebral biochemical variables in SAH patients most frequently exhibit a pattern indicating ischemia or mitochondrial dysfunction. ⋯ The study documents that mitochondrial dysfunction is a common cause of disturbed cerebral energy metabolism in patients with SAH. Mitochondrial dysfunction may increase tissue sensitivity to secondary adverse events such as vasospasm and decreased cerebral blood flow. The separation of ischemia and mitochondrial dysfunction bedside by utilizing microdialysis offers a possibility to evaluate new therapies.