Current neurology and neuroscience reports
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Curr Neurol Neurosci Rep · Jan 2015
ReviewThe value of extent of resection of glioblastomas: clinical evidence and current approach.
Glioblastomas (GBM), one of the most common tumors of the central nervous system, are associated with poor prognosis, even with all the scientific development of the last decades. Individual survival, however, is not homogenous among GBM patients, and multiple factors are related to their outcome, including age, biological characteristics of the tumor, and extent of treatment. ⋯ To reach this objective, different technologies and surgical techniques have been introduced in neuro-oncology surgery, including functional neuronavigation systems, ultrasound surgery, intraoperative MRI scan, and intraoperative cortical and subcortical mapping techniques. In the current manuscript, we examine the impact of EOR on the prognosis of GBM patients and the benefits and limitations of modern adjuvant techniques used for resection of these lesions.
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Curr Neurol Neurosci Rep · Nov 2014
ReviewParoxysmal sympathetic hyperactivity after severe brain injury.
Paroxysmal sympathetic hyperactivity (PSH) is characterized by the rapid onset and paroxysmal cycling of agitation and dystonia in association with autonomic symptoms. These symptoms may include the following: tachycardia, hypertension, tachypnea, fever, pupil dilation, decreased level of consciousness, diaphoresis, and ventilator dyssynchrony. ⋯ While this phenomenon has been frequently observed in the traumatic brain injured population, management is highly variable, prompting this review of the literature. This article aims to outline the evidence base for the management of PSH, as well as to describe an algorithm for management developed at our institution.
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Curr Neurol Neurosci Rep · Sep 2014
ReviewHypertonic saline for the treatment of intracranial hypertension.
Intracranial hypertension is caused by brain edema generated by different disorders, the commonest of which is traumatic brain injury. The treatment of brain edema focuses on drawing water out of brain tissue into the intravascular space. ⋯ However, reports suffer from inconsistencies in dose, frequency, concentration, and route of administration. Side effect profile, potential complications, and contraindications to administration need to be factored in when considering which first-line osmotherapy to choose for a given patient with head injury.
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Curr Neurol Neurosci Rep · Sep 2014
ReviewThe molecular landscape of pediatric brain tumors in the next-generation sequencing era.
Pediatric brain tumors are a leading cause of cancer-related death in children. In recent years, the application of next-generation sequencing and other high-throughput technologies to analysis of pediatric brain tumors has generated an abundance of molecular information. ⋯ In this review, we provide an overview of our evolving molecular knowledge of the commonest pediatric brain tumors, pilocytic astrocytomas, ependymomas, medulloblastomas, and pediatric glioblastomas, as well as the biological and potential clinical implications of this new knowledge. Studies aimed at investigating intratumoral heterogeneity are also discussed.
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Curr Neurol Neurosci Rep · Aug 2014
ReviewImaging the role of amyloid in PD dementia and dementia with Lewy bodies.
Cognitive impairment and dementia are significant sequelae of Parkinson disease (PD) and comprise a key feature of dementia with Lewy bodies (DLB), a disease with similar clinical and neuropathological features. Multiple independent causes have been implicated in PD dementia (PDD) and DLB, among them the accumulation of β-amyloid, a neuropathological hallmark of Alzheimer disease. ⋯ Current data suggest that brain amyloid deposition tends to be more marked in DLB, yet contributes to cognitive impairment in both DLB and PD. These results are broadly consistent with neuropathology and CSF studies. β-Amyloid may interact synergistically with other pathological processes in PD and DLB to contribute to cognitive impairment.