Allopurinol and blood pressure variability following ischemic stroke and transient ischemic attack: a secondary analysis of XILO-FIST.

Blood Pressure Variability (BPV) is associated with cardiovascular risk and serum uric acid level. We investigated whether BPV was lowered by allopurinol and whether it was related to neuroimaging markers of cerebral small vessel disease (CSVD) and cognition. We used data from a randomised, double-blind, placebo-controlled trial of two years allopurinol treatment after recent ischemic stroke or transient ischemic attack.

Neuronal antibody prevalence in children with seizures under 3 years: A prospective national cohort.

Objective: To report the prevalence of anti-neuronal antibodies in a prospective whole-nation cohort of children presenting with seizures before their third birthday.

Methods: This was a prospective population-based national cohort study involving all children presenting with new-onset epilepsy or complex febrile seizures before their third birthday over a 3-year period. Patients with previously identified structural, metabolic, or infectious cause for seizures were excluded.

Missense Mutations of the Pro65 Residue of PCGF2 Cause a Recognizable Syndrome Associated with Craniofacial, Neurological, Cardiovascular, and Skeletal Features.

PCGF2 encodes the polycomb group ring finger 2 protein, a transcriptional repressor involved in cell proliferation, differentiation, and embryogenesis. PCGF2 is a component of the polycomb repressive complex 1 (PRC1), a multiprotein complex which controls gene silencing through histone modification and chromatin remodelling. We report the phenotypic characterization of 13 patients (11 unrelated individuals and a pair of monozygotic twins) with missense mutations in PCGF2.

Xanthine oxidase inhibition for the improvement of long-term outcomes following ischaemic stroke and transient ischaemic attack (XILO-FIST) - Protocol for a randomised double blind placebo-controlled clinical trial.

Background: Allopurinol, a xanthine oxidase inhibitor, reduced progression of carotid-intima media thickness and lowered blood pressure in a small clinical trial in people with ischaemic stroke. Xanthine oxidase inhibition for improvement of long-term outcomes following ischaemic stroke and transient ischaemic attack (XILO-FIST) aims to assess the effect of allopurinol treatment on white matter hyperintensity progression and blood pressure after stroke. This paper describes the XILO-FIST protocol.

Safety, Feasibility, and Efficacy of Vagus Nerve Stimulation Paired With Upper-Limb Rehabilitation After Ischemic Stroke.

Background And Purpose: Recent animal studies demonstrate that vagus nerve stimulation (VNS) paired with movement induces movement-specific plasticity in motor cortex and improves forelimb function after stroke. We conducted a randomized controlled clinical pilot study of VNS paired with rehabilitation on upper-limb function after ischemic stroke.

Methods: Twenty-one participants with ischemic stroke >6 months before and moderate to severe upper-limb impairment were randomized to VNS plus rehabilitation or rehabilitation alone.

Advances in neuroimaging.

Over the last 20 years there have been great advances in the field of neuroimaging. However, information is still lacking for patients with a disorder of sex development (DSD) due to the rarity of these conditions. In this chapter the authors will review newly emerging techniques with a focus on the connectivity of the brain, describe sexually dimorphic brain structures and functions, and summarise what is known about the neuroanatomy and neurochemistry of individuals with a DSD.

Hypocupremia associated cytopenia and myelopathy: a national retrospective review.

Copper is an essential trace element that is involved in a number of important enzymatic processes throughout the body. Recent single case reports and small studies have shown that deficiency of copper can cause reversible haematological changes and irreversible neurological injury. We chose to undertake a national study, looking at all cases of copper deficiency in Scotland over a 5-yr period using information from a national reference laboratory.

Initial experience of 3 Tesla versus conventional field strength magnetic resonance imaging of small functioning pituitary tumours.

Background: Higher field strength magnetic resonance imaging (MRI) is becoming increasingly available and offers improved image quality; however, the clinical usefulness of this technique for the demonstration of surgically treatable functional pituitary adenomas has not been clearly established.

Objective: To determine whether 3 Tesla (3T) MRI improves the detection of ACTH- and GH-secreting microadenomas over conventional imaging at field strengths of up to 1·5 Tesla (1·5T).

Design: Data sets from postgadolinium T1-weighted MRI at 1·5T and 3T were blinded, randomly ordered and assessed for the presence of pituitary tumour by two radiologists.

Impact of GP direct-access computerised tomography for the investigation of chronic daily headache.

Background: Chronic daily headache is a major healthcare problem, with significant resource implications for specialist services. Since 1999, GPs in Greater Glasgow have had direct access to computerised tomography (CT) for investigation of chronic daily headache.

Aim: The purpose of this study is to assess the significance of pathology, impact of the service, and GP satisfaction.

Perioperative ischemic complications of the brain after carotid endarterectomy.

Background: The potential morbidity of cerebral ischemia after carotid endarterectomy (CEA) has been recognized, but its reported incidence varies widely.

Objective: To prospectively evaluate the development of cerebral ischemic complications in patients treated by CEA at a high-volume cerebrovascular center.

Methods: Fifty patients with moderate or severe carotid stenosis awaiting CEA were studied with perioperative diffusion-weighted imaging of the brain and standardized neurological evaluations.

Brain imaging in the unsedated pediatric patient: comparison of periodically rotated overlapping parallel lines with enhanced reconstruction and single-shot fast spin-echo sequences.

Background And Purpose: Periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER or PROP) is an effective means of compensating for head motion during MR imaging in adults. The aim of this study was to assess the value of this novel technique in unsedated children.

Methods: PROP T2-weighted fast spin-echo (FSE) imaging (TR/TE/NEX, 4000/83/2; 50 seconds) and T2-weighted single-shot FSE (SS-FSE) imaging (19,929/92/0.

Effects of zero-filled interpolation on cervical magnetic resonance angiographic measurement.

Background And Purpose: The aim of this study was to assess the effect of zero-filled interpolation (ZIP) on measurements of the cervical arteries because its benefits on the accuracy and precision of measurements in medium-sized arteries remains unknown.

Methods: Three observers measured 36 computer-simulated vessels (2-6.8 mm) and 130 normal cervical vessels (assessed with two-dimensional time-of-flight MR angiography) from 512-, 256-, and 256-ZIP matrix source images.

Improved image quality and detection of acute cerebral infarction with PROPELLER diffusion-weighted MR imaging.

Purpose: To compare periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) multishot fast spin-echo diffusion-weighted magnetic resonance (MR) imaging with single-shot echo-planar diffusion-weighted MR imaging for image quality and visualization of acute cerebral infarction.

Materials And Methods: Seventy subjects (35 men, 35 women; mean age, 55 years +/- 24 [SD]) who were suspected of having acute cerebral infarction (symptom duration, 2.8 days +/- 2.

Changes in brain water diffusion during the 1st year of life.

Purpose: To evaluate the normal water diffusion changes that occur during the 1st year of life.

Materials And Methods: Diffusion-weighted imaging was performed in 40 subjects (age range, birth to 1 year) in whom both magnetic resonance imaging and neurologic assessment results were normal at the time of imaging and, where available, at follow-up. Apparent diffusion coefficient (ADC) was calculated in four areas of white matter (anterior and posterior subcortical and internal capsule) and four of gray matter (cortex, thalamus, head of the caudate nucleus, and lentiform nucleus).

Multishot diffusion-weighted FSE using PROPELLER MRI.

A method for obtaining diffusion-weighted images that are free from the artifacts associated with echo-planar acquisitions, such as signal pile-up and geometric warping, is introduced. It uses an ungated, multishot fast spin-echo (FSE) acquisition that is self-navigated. The phase of the refocusing pulses is alternated to minimize non-Carr-Purcell-Meiboom-Gill (CPMG) artifacts.