Utility of the Standardized Assessment of Concussion (SAC) to Detect Insufficient Effort in Independent Medical Examinations and Civil Litigation Cases.

Objective: The Standardized Assessment of Concussion (SAC) is a standardized mental status screening instrument initially developed for assessment and tracking of concussion symptoms in athletes. The purpose of the current study was to validate the utility of the SAC as an embedded screening measure for insufficient effort in independent medical examinations (IME) and personal injury cases.

Method: A known-groups design was used to examine the SAC's utility for the detection of insufficient effort in 75 de-identified private IME and civil litigation evaluations.

ERP correlates of malingered executive dysfunction.

Assessment of malingering has become an integral part of many neuropsychological evaluations, particularly in forensic settings. However, traditional malingering measures are known to be vulnerable to both manipulation and coaching. Consequently, recent research has attempted to identify physiological indices of cognitive functioning that are less susceptible to overt manipulation.

Higher levels of coated-platelets are observed in patients with subarachnoid hemorrhage but lower levels are associated with increased mortality at 30 days.

Background: Coated-platelets are procoagulant platelets observed upon dual agonist stimulation with collagen and thrombin. Coated-platelet levels are elevated in non-lacunar ischemic stroke compared to either lacunar stroke or controls. In contrast, coated-platelet levels are decreased in spontaneous intracerebral hemorrhage (ICH) and inversely correlated with bleed size.

Attentional capture by emotional faces in adolescence.

Poor decision making during adolescence occurs most frequently when situations are emotionally charged. However, relatively few studies have measured the development of cognitive control in response to emotional stimuli in this population. This study used both affective (emotional faces) and non-affective (letter) stimuli in two different flanker tasks to assess the ability to ignore task-irrelevant but distracting information, in 25 adults and 25 adolescents.

Recanalization following various endovascular modalities for treatment of anterior circulation acute ischemic strokes.

Currently several endovascular modalities and devices are available for use in acute ischemic stroke setting. Limited data exist regarding the relative efficacy of these different options when used individually or in combination. The primary objective of this study was to retrospectively compare the recanalization rates of various endovascular options when used for the treatment of acute ischemic stroke in the anterior cerebral circulation.

Safety and outcomes of intravenous thrombolysis in stroke mimics: a 6-year, single-care center study and a pooled analysis of reported series.

Background And Purpose: Efforts to increase the availability and shorten the time delivery of intravenous thrombolysis in patients with acute ischemic stroke carry the potential for tissue plasminogen activator administration in patients with diseases other than stroke, that is, stroke mimics (SMs). We aimed to determine safety and to describe outcomes of intravenous thrombolysis in SM.

Methods: We retrospectively analyzed stroke registry data of consecutive acute ischemic stroke admissions treated with intravenous thrombolysis over a 6-year-period.

Expecting the unexpected: an N400 study of risky sentence processing in adolescents.

Teens often engage in risk taking. Avoiding risk may be aided by rapid access to cognitive models for danger. This study investigated whether these schemata are immature in adolescence.

Pre-tissue plasminogen activator blood pressure levels and risk of symptomatic intracerebral hemorrhage.

Background And Purpose: From small pilot studies, uncontrolled pretreatment systolic blood pressure >185 mm Hg and diastolic blood pressure >110 mm Hg in patients with acute ischemic stroke were introduced in the National Institute of Neurological Diseases and Stroke rtPA Stroke Study as a contraindication for thrombolysis. We sought to determine if pretreatment blood pressure protocol violations in patients with acute ischemic stroke receiving intravenous tissue plasminogen activator are related to the subsequent risk of symptomatic intracranial hemorrhage (sICH).

Methods: We reviewed medical records of consecutive ischemic stroke admissions treated with intravenous thrombolysis over a 10-year period at our tertiary care hospital.

Self-reported false confessions and false guilty pleas among offenders with mental illness.

Persons with mental illness may be at risk for false admissions to police and to prosecutors because of the defining characteristics of mental illness, but potentially because of heightened recidivism rates and increased opportunities. We surveyed 1,249 offenders with mental disorders from six sites about false confessions (FCs) and false guilty pleas (FGPs). Self-reports of FC ranged from 9 to 28%, and FGPs ranged from 27 to 41% depending upon site.

Enrollment in mental health courts: voluntariness, knowingness, and adjudicative competence.

Mental health courts (MHCs) are rapidly expanding as a form of diversion from jails and prisons for persons with mental illness charged with crimes. Although intended to be voluntary, little is known about this aspect of the courts. We examined perceptions of voluntariness, and levels of knowingness and legal competence among 200 newly enrolled clients of MHCs at two courts.

Applications and advantages of power motion-mode Doppler in acute posterior circulation cerebral ischemia.

Background And Purpose: Evaluation of posterior circulation with single-gate transcranial Doppler (TCD) is technically challenging and yields lower accuracy parameters in comparison to anterior circulation vessels. Transcranial power motion-mode Doppler (PMD-TCD), in addition to spectral information, simultaneously displays in real-time flow signal intensity and direction over 6 cm of intracranial space. We aimed to evaluate the diagnostic accuracy of PMD-TCD against angiography in detection of acute posterior circulation stenoocclusive disease.

Association of pretreatment ASPECTS scores with tPA-induced arterial recanalization in acute middle cerebral artery occlusion.

Background And Purpose: The Alberta Stroke Program Early CT-Score (ASPECTS) assesses early ischemic changes within the middle cerebral artery (MCA) and predicts poor outcome and increased risk for thrombolysis-related symptomatic ICH. We evaluated the potential relationship between pretreatment ASPECTS and tPA-induced recanalization in patients with MCA occlusions.

Subjects & Methods: Consecutive patients with acute ischemic stroke due to MCA occlusion were treated with standard IV-tPA and assessed with transcranial Doppler (TCD) for arterial recanalization.