Two years' experience of implementing a comprehensive telemedical stroke network comprising in mainly rural region: the Transregional Network for Stroke Intervention with Telemedicine (TRANSIT-Stroke).

Background: Telemedicine improves the quality of acute stroke care in rural regions with limited access to specialized stroke care. We report the first 2 years' experience of implementing a comprehensive telemedical stroke network comprising all levels of stroke care in a defined region.

Methods: The TRANSIT-Stroke network covers a mainly rural region in north-western Bavaria (Germany).

Resistance to apoptosis and autophagy leads to enhanced survival in Sertoli cells.

Study Question: What is the underlying mechanism of Sertoli cell (SC) resistance to cell death?

Summary Answer: High expression of prosurvival B-cell lymphoma-2 (BCL2) proteins and inhibition of apoptosis and autophagy prolongs SC survival upon exposure to stress stimuli.

What Is Known Already: In human and in experimental models of orchitis, tolerogenic SC survive stress conditions, while germ cells undergo massive apoptosis. In general, non-dividing highly differentiated cells tend to resist stress conditions for a longer time by favoring activation of prosurvival mechanisms and inhibition of cell death pathways.

[Home-based telerehabilitation after stroke].

The use of modern information and telecommunication technologies enables telerehabilitation of neurological deficits in the domestic environment. The current state of studies on rehabilitative teletherapy for improvement of motor function and mobility deficits due to stroke is reviewed. Two neurolinguistic proof of concept studies investigating the efficacy of online interactive telespeech therapy are reported, which compared virtual screen to screen interactive telerehabilitation of aphasia after stroke and dysarthrophonia in Parkinson's disease to conventional face to face rehabilitation.

[Telemedical prenotification in acute stroke treatment : Experiences from the Stroke Angel initiative from 2004 until the present].

Objective: The Stroke Angel initiative investigates the implementation of telemedicine for improvement of preclinical communication between emergency medical services (EMS) and stroke units in cases of acute stroke.

Material And Methods: Stroke Angel is a technical system for the telemedical prenotification of patients in cases of suspected stroke at a stroke unit by the EMS. Within the framework of an observational study, the team has been investigating the effects of the system on door-to-computed tomography (CT) and door-to-needle times as well as the lysis rate in the neighboring regions of Rhön-Grabfeld and Bad Kissingen since 2005.

Post-traumatic headache: is it for real? Crossfire debates on headache: pro.

Mild traumatic brain injury is very common in Western societies, affecting approximately 1.8 million individuals in the USA. Even though between 30% and 90% of patients develop post-traumatic headache, post-traumatic headache remains a very controversial disorder.

Incidence and predictors of chronic headache attributed to whiplash injury.

We identified clinical, demographic and psychological predictive factors that may contribute to the development of chronic headache associated with mild to moderate whiplash injury [Quebec Task Force (QTF) ≤ II] and determined the incidence of this chronic pain state. Patients were recruited prospectively from six participating accident and emergency departments. While 4.

On the neural basis of focused and divided attention.

Concepts of higher attention functions distinguish focused and divided attention. The present study investigated whether these mental abilities are mediated by common or distinct neural substrates. In a first experiment, 19 healthy subjects were examined with functional brain imaging (fMRI) while they attended to either one or both of two simultaneously presented visual information streams and responded to repetitive stimuli.

Reorganization of motor execution rather than preparation in poststroke hemiparesis.

Background And Purpose: The aim of the present study was to examine movement-related potentials (MRPs) in patients in the "chronic" stage after cortical stroke with recovered hemiparesis compared with healthy control subjects.

Methods: Right index finger MRPs were derived from 12 patients > or =1 year after infarction in the territory of the left middle cerebral artery as well as from 12 control subjects. MRP components were compared between groups.

[Familial cavernous malformations of the central nervous system. A clinical and genetic study of 15 German families].

In 1928, Hugo Friedrich Kufs reported on a family with cerebral, retinal, and cutaneous cavernous malformations. Since then, more than 300 families with inherited cavernous malformations have been reported. Genetic studies showed three loci, on chromosomes 7q21-q22 (with the gene CCM1), 7p15-p13 (CCM2), and 3q25.

Prospective PC-interactive pressure algesimetry of post-traumatic neck pain after whiplash injury.

Cervical pain is a prominent symptom in both acute whiplash injury and late whiplash syndrome. However, no systematic analysis of post-traumatic pain development covering several weeks has yet been performed in whiplash patients. It was the aim of the present study to analyse the duration and course of post-traumatic muscle pain due to whiplash injury in a prospective follow-up examination with short investigation intervals.

[Quantification of acute muscle pain after whiplash injury using computer-aided pressure algesimetry].

Objective And Method: The present study utilised the PC-interactive pressure algesimetry to quantify cervical pain after whiplash injury. Pressure painfulness of the splenius and trapezius muscles was investigated in patients with an acute cervical syndrome after whiplash injury and compared to that of healthy subjects.

Results: Pressure painfulness of neck and shoulder muscles was significantly increased in whiplash patients.

[Reduced contralateral preponderance of the movement-related potential during execution of self-initiated movements in acute prefrontal traumatic brain injury].

Objectives: An enhanced ipsilateral motor potential after prefrontal TBI is known. Our aim was to examine, whether this contributes to movement initiation or execution.

Methods: EEGs of 22 patients and 28 healthy controls were recorded.

Presumed pharmacologically induced change from upbeat- to downbeat nystagmus in a patient with Wernicke's encephalopathy.

A case of Wernicke's encephalopathy due to proven thiamine deficiency suffering from upbeat nystagmus (UN) changing to downbeat nystagmus (DN) after a latency of 1 year is presented. The case was also notable for the finding of positive oligoclonal bands in the CSF. The underlying pathophysiological mechanisms and a possible effect of baclofen treatment are discussed.

Quantification of acute neck pain following whiplash injury by computer-aided pressure algesimetry.

Until now the clinical investigation of cervical pain due to whiplash injury is mainly based on finger palpation. The present study introduces a PC-interactive pressure algesimetry to standardize cervical pain measurement. Pressure pain scores of the splenius and trapezius muscles of 23 patients with an acute cervical syndrome after whiplash injury were compared to those of 24 healthy subjects.

Recovery of movement-related potentials in the temporal course after prefrontal traumatic brain injury: a follow-up study.

Objective: The movement-related potential (MRP) is an EEG measure related to self-initiated movements, consisting of the Bereitschaftspotential (BP), the negative slope, and the motor potential. Since in a former study the BP was reduced in acute prefrontal traumatic brain injury (TBI) patients, the present study examined the MRPs' course in follow-up examinations.

Methods: Right index finger MRPs of 22 patients with contusions of the prefrontal cortex were recorded 12, 26, and 52 weeks after TBI and compared to controls.

Movement preparation in self-initiated versus externally triggered movements: an event-related fMRI-study.

In the present study, we used fMRI to investigate whether event-related preparatory processes of self-initiated and externally triggered movements differ. Twenty subjects were examined with 1000 T2*-weighted images in two consecutive sessions. During the first session subjects performed self-initiated abductions of the right index finger.

Sparse imaging and continuous event-related fMRI in the visual domain: a systematic comparison.

Continuous image acquisition as used in most functional magnetic resonance imaging (fMRI) designs may conflict with specific experimental settings due to attendant, noisy gradient switching. In sparse fMRI, single images are recorded with a delay that allows the registration of the predicted peak of an evoked hemodynamic response (HDR). The aim of this study was to assess validity and sensitivity of single-trial sparse imaging within the visual domain.

Temporal order of nonlinear dynamics in human brain.

In previous spectral analysis investigations, we demonstrated that the spontaneous activity of the alpha EEG is not stationary but rather shows cyclic alterations with a circa 1-min periodicity. Following the conclusion that a power increase in the alpha band implies a neuronal synchronization, and vice versa, an associated decrease of the EEG complexity was postulated. Accordingly, a rhythmic variation, i.

Impaired movement-related potentials in acute frontal traumatic brain injury.

Objective: Focal brain lesions due to traumatic brain injury (TBI) do not only lead to functional deficits in the lesion area, but also disturb the structurally intact neuronal network connected to the lesion site. Therefore we hypothesized dysfunctions of the cortical motor network after frontal TBI. The movement related potential (MRP) is an EEG component related to voluntary movement consisting of the Bereitschaftspotential (BP), the negative slope (NS), and the motor potential (MP).