Potential neurotoxicity of titanium implants: Prospective, in-vivo and in-vitro study.

Titanium dioxide (TiO) is a frequently used biomaterial, particularly in orthopedic and dental implants, and it is considered an inert and benign compound. This has resulted in toxicological scrutiny for TiO in the past decade, with numerus studies showing potential pathologic downstream effects. Herein we describe case report of a 77-year-old male with subacute CNS dysfunction, secondary to breakdown of a titanium-based carotid stent and leading to blood levels 1000 times higher (3 ppm) than the reported normal.

Regional cerebral blood flow following single-dose and continuous-dose tadalafil after stroke.

Purpose: Tadalafil is a potent and selective phosphodiesterase type 5 inhibitor that provides effective treatment for erectile dysfunction (ED). The purpose of this study was to explore the effect of a single on-demand dose of tadalafil compared to low-dose continuous administration on regional cerebral blood flow (rCBF), in patients after stroke.

Methods: Thirty consecutive male patients (mean age 58.

Migraine and vascular risk factors in the elderly.

Aim: The association between migraine and cerebrovascular disease is well documented in younger migraine patients, especially those with aura. Prevalence estimates of vascular risk factors among elderly migraine sufferers are lacking. The present study was designed to estimate the prevalence of vascular risk factors in the elderly population with late onset of migraine without aura.

Seizures after very mild head or spine trauma.

Traumatic brain injury (TBI) is a major cause of seizures in the general population. Several studies have shown an increased risk of epilepsy after traumatic brain injury, depending on risk factors, such as severity and time post trauma. The aim of our study was to evaluate the appearance of late seizures after a very mild head trauma or whiplash injury.

SPECT-DTPA as a tool for evaluating the blood-brain barrier in post-stroke seizures.

Stroke is a well-known cause for seizures in the adult population. Research in animal models indicates that abnormalities in the blood-brain barrier (BBB) permeability can play a role in the development of spontaneous seizures or status epilepticus. The integrity of the BBB was investigated in patients with late post-stroke seizures by performing DTPA-SPECT studies to evaluate the correlation of BBB dysfunction in late post-stroke seizures.

Are post intracerebral hemorrhage seizures prevented by anti-epileptic treatment?

Prophylactic antiepileptic treatment in patients with non-traumatic, non-aneurysmatic spontaneous intracerebral hemorrhage (SICH) is controversial. The purpose of our study was to assess the occurrence of seizures and neurologic outcome in SICH patients who were treated with valproic acid or a placebo for a period of one month and follow-up of one year in a hospital inpatient neurologic department and ambulatory clinic settings. The study is a prospective randomized, double-blind, placebo-controlled clinical trial.

Chronic non-paroxysmal neuropathic pain - Novel phenotype of mutation in the sodium channel SCN9A gene.

Background: Gain-of-function mutations in the SCN9A gene (encoding to NaV1.7 voltage-gated sodium channel) cause two rare paroxysmal pain disorders: inherited erythromelalgia (IEM) and paroxysmal extreme pain disorder (PEDP). These phenotypes are characterized by episodic extreme localized pain with cutaneous autonomic signs.

Early outcome of acute ischemic stroke in hyperlipidemic patients under atorvastatin versus simvastatin.

Background: Studies designed to evaluate the efficacy of atorvastatin on stroke suggest that, in addition to cholesterol lowering, this drug may play a role in poststroke neuroprotection. The objective of this historical-prospective study was to analyze the efficacy of atorvastatin (40-80 mg) or simvastatin (at an optimal dose) during the first 2 weeks after stroke in hyperlipidemic patients treated with simvastatin before stroke onset.

Methods: Medical records of all adult (aged >18 years) patients diagnosed with acute stroke were reviewed.

The effect of sildenafil citrate (Viagra) on cerebral blood flow in patients with cerebrovascular risk factors.

Objectives: Sildenafil citrate is widely used for erectile dysfunction. The present study examined the short-term effects of sildenafil administration in individuals with cerebrovascular risk factors, including patients with a history of stroke.

Materials And Methods: Twenty-five consecutive male patients with erectile dysfunction and vascular risk factors were included in the study.

Simultaneous bilateral Bell's palsy during pregnancy.

Idiopathic bilateral facial paralysis, although rare, seems to be more frequent during the last trimester of pregnancy and in the early puerperium. Unlike unilateral facial paralysis where the cause is mostly idiopathic, bilateral facial palsy is less often idiopathic, and various etiologies had been suggested.We present herein, an unusual case of simultaneous idiopathic bilateral Bell's palsy during the third trimester of pregnancy.

Use of a single [123I]-FP-CIT SPECT to predict the severity of clinical symptoms of Parkinson disease.

The aim of this study was to assess the ability of a single SPECT performed in the early stage of Parkinson's disease (PD) to predict disease severity in 19 patients with early PD. [(123)I]-FP-CIT striatal uptake was expressed as a ratio of specific:nonspecific uptake for defined brain areas. Clinical severity was determined by the UPDRS at baseline and 12-15 months following the SPECT procedure.

Acute painful neuropathy induced by rapid correction of serum glucose levels in diabetic patients.

We report on acute painful neuropathy following reduction of high serum glucose levels in six diabetic patients, aged 27-52 (5 males). Initial glucose levels ranging between 270 and 600 mg/dL decreased to 60-160 mg/dL following insulin, pharmacologic or dietary treatment. Four patients had long-standing untreated diabetes (3-5 years).

Treatment of status epilepticus and acute repetitive seizures with i.v. valproic acid vs phenytoin.

Objective: To evaluate the efficacy and tolerability of the treatment with valproic acid (VPA) in patients with status epilepticus (SE) or acute repetitive seizures (ARS) comparing it with phenytoin (PHT) treatment.

Materials And Methods: Patients with SE or ARS were treated in a consecutive manner with either VPA or PHT intravenously. The primary endpoint was defined as clinical seizure cessation; the secondary endpoint was evaluation of drug tolerability.

[Guideliness for the management of stroke--2008 invasive measures for prevention of ischemic stroke].

Stroke is a major cause of morbidity and mortality in Israel and the main cause for neurological disability among adults. Continued efforts for its prevention and treatment began a long time ago and currently persist. During the last decade, these efforts have resulted in a number of significant breakthroughs.

Surgical resection of left atrial myxoma presenting with acute multiple hemorrhagic cerebral infarctions: a case report.

Brain ischemia resulting from left atrial myxoma embolization has been well documented. In contrast, the link between the development of intracerebral hemorrhage and myxoma in these patients has little coverage in the literature. The main theory describing this relationship stems from the fact that cardiac myxoma cells metastasize to the brain's vessels, causing destruction of the arterial wall with subsequent formation of fusiform aneurysm and further intracranial bleeding.

Lamotrigine and catamenial epilepsy.

Catamenial epilepsy (CE) is characterized by epileptic seizures in the female occurring rhythmatically with the menstrual cycle. Hormonal mechanisms have been proposed as a cause of this epileptic form. Few reports about the efficacy of anti-epileptic drugs (AEDs) have been published.

DP-b99, a membrane-activated metal ion chelator, as neuroprotective therapy in ischemic stroke.

Background And Purpose: DP-b99 is a chelator of zinc and calcium ions that acts selectively within cell membranes and has neuroprotective properties in animal models of stroke. We present the results of a multicenter, double-blind, placebo-controlled, randomized trial to assess the safety and potential protective effects of DP-b99 in acute ischemic stroke.

Methods: One hundred and fifty stroke patients with signs of cortical involvement and a National Institutes of Health Stroke Scale (NIHSS) score of 7 to 20 received a 4-day course of intravenous 1 mg/kg per day DP-b99 or placebo within 1 to 9 hours of stroke onset.

I-123 MIBG cardiac scintigraphy and autonomic test evaluation in multiple sclerosis patients.

Autonomic symptoms are common in multiple sclerosis (MS) patients and may cause significant disability. The purpose of this study was to evaluate direct cardiac sympathetic denervation in MS patients with I-123 MIBG cardiac scintigraphy compared with other parasympathetic electrophysiological examinations of autonomic dysfunction. Ten patients with MS and 7 age- and sex-matched control subjects were prospectively evaluated.

Minocycline treatment in acute stroke: an open-label, evaluator-blinded study.

Background: Ischemic animal model studies have shown a neuroprotective effect of minocycline.

Objective: To analyze the effect of minocycline treatment in human acute ischemic stroke.

Methods: We performed an open-label, evaluator-blinded study.

Monotherapy of lamotrigine versus carbamazepine in patients with poststroke seizure.

Objectives: The incidence of seizures is known to be high in the elderly. The most common cause of an unprovoked seizure in the elderly population is stroke. These patients require effective and well-tolerated antiepileptic treatment because they frequently experience other medical conditions and use other medications that can interact with the antiepileptic treatment.

Laser treatment for stroke.

Low-level laser therapy is an irradiation technique that has the ability to induce biological processes using photon energy. There are studies showing proliferation and angiogenesis after irradiation in skeletal muscle post-myocardial infarction tissue cells. Most evidence of efficacy is based on the increase in energy state and the activation of mitochondrial pathways.

[Guidelines for the management of stroke--2007 prevention of ischemic stroke--general approach and medical treatment].

Stroke is a major cause of morbidity and mortality in Israel, the third most common cause of death and the main cause for neurological disability among adults. During the last decade several significant breakthroughs have occurred in the management of stroke and consequently several new guidelines and consensus statements from Europe and North America have been published. The new data necessitate a reappraisal of our approach to the management of stroke as well as to its primary prevention.

Infrared laser therapy for ischemic stroke: a new treatment strategy: results of the NeuroThera Effectiveness and Safety Trial-1 (NEST-1).

Background And Purpose: The NeuroThera Effectiveness and Safety Trial-1 (NEST-1) study evaluated the safety and preliminary effectiveness of the NeuroThera Laser System in the ability to improve 90-day outcomes in ischemic stroke patients treated within 24 hours from stroke onset. The NeuroThera Laser System therapeutic approach involves use of infrared laser technology and has shown significant and sustained beneficial effects in animal models of ischemic stroke.

Methods: This was a prospective, intention-to-treat, multicenter, international, double-blind, trial involving 120 ischemic stroke patients treated, randomized 2:1 ratio, with 79 patients in the active treatment group and 41 in the sham (placebo) control group.