A multimodal treatment of basilar artery re-occlusion - case report.

Background: Stroke due to basilar artery occlusion (BAO) is a severe neurovascular condition with only recently proven effectiveness of mechanical thrombectomy as treatment. Early re-occlusion of the basilar artery (RE-BAO) is an even more challenging form of stroke to treat, associated with poor outcomes and still no optimal treatment guidelines. There are only a few reported cases covering this topic thus far.

Revisiting the Epworth sleepiness scale : Is excessive daytime sleepiness still a valid screening tool for obstructive sleep apnea in a population at risk?

Objective: Obstructive sleep apnea (OSA) is a common medical problem with numerous comorbidities and high costs. Since the introduction of the Epworth sleepiness scale (ESS), excessive daytime sleepiness (EDS) has been considered the most common and prominent symptom of OSA. Aim of this study was to re-evaluate the ESS for detection of OSA in a population at risk compared to the gold standard overnight polysomnography (PSG).

OPTIC NERVE SHEATH SONOGRAPHY IS A PROMISING TOOL FOR ASSESSMENT OF RAISED INTRACRANIAL PRESSURE IN PATIENTS ADMITTED TO NEUROLOGICAL INTENSIVE CARE UNIT.

Optic nerve sheath diameter (ONSD) enlargement is detectable in traumatic brain injury patients with raised intracranial pressure (ICP). The aim was to assess its value in neurological patients suspected to have increased ICP. Patient clinical imaging data and hospitalization outcome were analyzed.

Bilateral Vertebral Artery Dissection - Multiple Artery Affection or Early Recurrence?

In a certain percentage of patients with craniocervical artery dissection, dissections affect multiple arteries. Some investigators consider that the dissections diagnosed as multiple might have occurred sequentially within a short time frame. We describe an oligosymptomatic patient with bilateral progressive vertebral artery dissection.

The dynamics of soluble Fas/APO 1 apoptotic biochemical marker in acute ischemic stroke patients.

Purpose: Until recently, neuronal death in ischemic stroke infarction was ascribed exclusively to necrotic process. However, experimental animal models of cerebral ischemia suggest apoptosis to play a role in the pathogenesis of cerebral infarction. The aim of this study was to determine the level and monitor the dynamics of soluble Fas/APO 1 (sFas/APO 1) in serum and cerebrospinal fluid of acute ischemic stroke patients.

Hemispheric asymmetry of visual cortical response by means of functional transcranial Doppler.

We assessed the visual evoked response and investigated side-to-side differences in mean blood flow velocities (MBFVs) by means of functional transcranial Doppler (fTCD) in 49 right-handed patients with severe internal carotid artery (ICA) stenosis and 30 healthy volunteers, simultaneously in both posterior cerebral arteries (PCAs) using 2 MHz probes, successively in the dark and during the white light stimulation. Statistically significant correlation (P = 0.001) was shown in healthy and in patients (P < 0.

Cerebrovascular evoked response to repetitive visual stimulation in severe carotid disease--functional transcranial Doppler study.

Hemodynamic features of the posterior circulation were evaluated by assessing visual evoked response in posterior cerebral artery (PCA) by means of functional transcranial Doppler (fTCD) in 49 patients with high-grade (70%-99%) internal carotid artery (ICA) stenosis or occlusion and 30 healthy subjects. Mean blood flow velocities (MBFV) and mean reaction time (time to peak velocities) (MRT) in each PCA were measured in the dark (closed eyes) and during white light stimulation (opened eyes, looking at the electric bulb), during three consecutive repetitive periods of 1 minute each. In the group of severe carotid disease patients, there was no difference in MRT in PCA during the white light stimulation (P=0.

Visual evoked response in patients with severe carotid disease--functional transcranial doppler study of posterior circulation.

The goal of this study was to evaluate the visual evoked response in posterior cerebral artery (PCA) by means of functional transcranial doppler in patients with severe carotid disease and to determine the hemodynamic effect of severe carotid disease on posterior circulation. Measurements were performed successively in the dark and during the white light stimulation in 49 patients with high-grade (70-99%) internal carotid artery (ICA) stenosis or occlusion and compared with 30 healthy age and sex matched subjects. Mean blood flow velocities (MBFV) (cm/s +/- 2SD) and mean reaction time (MRT) (s +/- 2SD) during three consecutive repetitive periods of 1 minute each were analyzed.

The art: neuroscientific approach.

Scientists have for centuries tried to localize and define artistic talent. Modern diagnostic techniques that enable visualization and measurement of brain morphology and function are positron emission tomography (PET), magnetic resonance imaging (MRI), functional transcranial Doppler (fTCD) and some biochemical methods. In the majority of people, the left hemisphere is dominant, but the right hemisphere is considered to be creative, visual, imaginative and intuitive.

Neuropathic pain.

Neuropathic pain refers to pain that originates from pathology of the nervous system. Common causes of neuropathic pain are diabetes mellitus, reactivation of herpes zoster, nerve compression or radiculopathy, alcohol, chemotherapy or abuse of some drugs, and trigeminal neuralgia. Specific symptoms of neuropathic pain are mechanical allodynia and cold hyperalgesia.

Post-stroke depression.

Depression following a stroke, also referred to as post-stroke depression (PSD), has long been recognized as one of the most common complications of stroke. PSD has significant adverse consequences on the recovery of motor and cognitive deficits, as well as on the risk of mortality associated with stroke. The prevalence of PSD varies over time with an apparent peak 3-6 months after stroke and subsequent decline reaching about 50% of the initial rates at one year.

The association of obesity and cerebrovascular disease in young adults--a pilot study.

Obesity has been recognized as an isolated risk factor for stroke. In obese patients, other risk factors for stroke such as hypertension, hyperlipidemia, ischemic heart disease and obstructive sleep apnea are more frequently present. The aim of this study was to assess the presence of obesity among other risk factors for stroke in younger adult patients with ischemic stroke.

The efficacy of gabapentin in migraine prophylaxis: an observational open label study.

Migraine is often a chronic and disabling disorder. The objective of our study was to assess the efficacy and safety of gabapentin in the prophylaxis of migraine in patients refractory to other prophylactic treatments. The study included 67 migraine patients, 55 women and 12 men; 52 patients completed this prospective, open-label study.

The characterization of blood flow changes in mouse tumor during Photofrin-based photodynamic therapy by using the color Doppler ultrasonography.

Changes in blood flow velocity through the tumors can induce damage of tumor microcirculation and thus may contribute to the final destruction of tumor masses after photodynamic therapy (PDT). The aim of this study was to evaluate the blood flow changes in a SCCVII mouse carcinoma during Photofrin-based photodynamic therapy by analyzing several quantitative spectral Doppler parameters [maximum systolic flow velocity (Vmax), end diastolic velocity (Vmin), resistance index (RI) and pulsatile index (PI)] by using the color Doppler ultrasonography. Blood flow velocities were recorded immediately prior to tumor illumination (0 h) and then 2 and 24 h after the illumination.

Recommendations for neuropathic pain treatment.

Damage to the somatosensory nervous system poses a risk for the development of neuropathic pain. Such an injury to the nervous system results in a series of neurobiological events resulting in sensitization of both the peripheral and central nervous system. The symptoms include continuous background pain (often burning or crushing in nature) and spasmodic pain (shooting, stabbing or "electrical").