Intracranial phosphaturic mesenchymal tumor, mixed connective tissue variant presenting without oncogenic osteomalacia.

Background: Phosphaturic mesenchymal tumor, mixed connective tissue variant (PMTMCT) is a rare tumor typically occurring in soft tissues and bone, causing oncogenic (tumor-induced) osteomalacia (TIO) through secretion of the phosphaturic hormone, fibroblast growth factor-23 (FGF-23). Rare tumors identical to PMTMCT occur without known TIO. Intracranial localization of PMTMCT is extremely rare, with only two cases reported in the literature.

Validation of frontal near-infrared spectroscopy as noninvasive bedside monitoring for regional cerebral blood flow in brain-injured patients.

Object: Near-infrared spectroscopy (NIRS) offers noninvasive bedside measurement of direct regional cerebral arteriovenous (mixed) brain oxygenation. To validate the accuracy of this monitoring technique, the authors analyzed the statistical correlation of NIRS and CT perfusion with respect to regional cerebral blood flow (CBF) measurements.

Methods: The authors retrospectively reviewed all cases in which NIRS measurements were obtained at a single, academic neurointensive care unit from February 2008 to June 2011 in which CT perfusion was performed at the same time as NIRS data was collected.

Medical therapy for ischemic stroke: review of intravenous and intra-arterial treatment options.

Background: Thrombolytic therapy is of proven and substantial benefit for select patients with acute cerebral ischemia. Diagnostic options and medical treatment options for acute stroke ischemia have undergone enormous changes in the past decades. Whereas initially stroke treatment was reduced to prevention, management of symptoms, and rehabilitation, nowadays a multitude of different fibrinolytic drugs are available.

Angiographic reversed flow ratio as an indicator of high-grade internal carotid stenosis.

Purpose: To examine differential flow through internal carotid artery (ICA) and external carotid artery (ECA) circulations on digital subtraction angiography (DSA) as an indicator of carotid stenosis.

Materials And Methods: Carotid and cerebral angiograms (N = 148) were retrospectively evaluated, with flow through ICA and ECA circulations scored on a five-point flow scale ratio: a score of 1 indicated ICA flow arrived at the vertex at least 1 second before ECA flow, a score of 3 indicated ICA and ECA flow arrived at the same time, and a score of 5 indicated ECA flow reached the vertex at least 1 second before ICA flow. Sensitivities and specificities for ICA stenosis detection were determined for flow ratios.

MicroNester coils as an adjunct to endovascular embolization.

Objectives/background: In June 2003, detachable balloons were removed from the US market and were supplanted with coil embolization for parent artery sacrifice in difficult or nonsurgical aneurysms and other vascular pathologies. The current series examines the use of MicroNester pushable coils (Cook Medical, Bloomington, IN) as a low-cost and effective adjunct to detachable coils in the treatment of selected neurovascular pathologies.

Methods: A retrospective analysis of all patients undergoing neurointerventional procedures from November 2003 through May 2008 was performed to identify patients in whom MicroNester coils were used as part of treatment.

Safety of early ambulation after diagnostic and therapeutic neuroendovascular procedures without use of closure devices.

Objective: To evaluate the safety of manual compression and early ambulation after diagnostic and therapeutic neuroendovascular procedures.

Methods: Data were prospectively collected and retrospectively analyzed for consecutive patients undergoing diagnostic or therapeutic neuroendovascular procedures. Manual compression at the femoral access site was applied.

Going viral: fusiform vertebrobasilar and internal carotid aneurysms with varicella angiitis and common variable immunodeficiency.

Intracranial aneurysms in the pediatric population are relatively rare entities. Immunocompromised patients (often from HIV/AIDS or pharmacological immunosuppression) represent a significant fraction of children with cerebral aneurysms. One proposed mechanism of aneurysm formation in these patients is from direct infection of the affected arteries.

Real-time myocardial perfusion contrast echocardiography and regional wall motion abnormalities after aneurysmal subarachnoid hemorrhage. Clinical article.

Object: The pathophysiology of myocardial dysfunction after subarachnoid hemorrhage (SAH) remains unclear. Using myocardial real-time perfusion contrast echocardiography (RTP-CE), the authors evaluated microvascular function in patients with acute SAH.

Methods: Over a 15-month period, 10 patients with acute SAH and evidence of cardiac dysfunction were prospectively enrolled.

Myocardial contrast echocardiography in subarachnoid hemorrhage-induced cardiac dysfunction: case report.

Objective: Cardiac dysfunction is a well-known complication of aneurysmal subarachnoid hemorrhage (SAH) that is generally regarded as secondary to catecholamine excess rather than overt ischemia. Myocardial contrast echocardiography (MCE) is a novel method of evaluating cardiac function and perfusion. We report the use of MCE in a patient with SAH and correlate the results to coronary angiography.

Protection of mitochondrial function and improvement in cognitive recovery in rats treated with hyperbaric oxygen following lateral fluid-percussion injury.

Object: Hyperbaric oxygen (HBO2) has been shown to improve outcome after severe traumatic brain injury, but its underlying mechanisms are unknown. Following lateral fluid-percussion injury (FPI), the authors tested the effects of HBO2 treatment as well as enhanced normobaric oxygenation on mitochondrial function, as measured by both cognitive recovery and cellular adenosine triphosphate (ATP) levels.

Methods: Adult male Sprague-Dawley rats were subjected to moderate lateral FPI or sham injury and were allocated to one of four treatment groups: 1) FPI treated with 4 hours of normobaric 30% O2; 2) FPI treated with 4 hours of normobaric 100% O2; 3) FPI treated with 1 hour of HBO2 plus 3 hours of normobaric 100% O2; and 4) sham-injured treated with normobaric 30% O2.

Effect of perfluorocarbons on brain oxygenation and ischemic damage in an acute subdural hematoma model in rats.

Object: This study was conducted to determine whether perfluorocarbons (PFCs) improve brain oxygenation and reduce ischemic brain damage in an acute subdural hematoma (SDH) model in rats.

Methods: Forty adult male Sprague-Dawley rats were allocated to four groups: (1) controls, acute SDH treated with saline and 30% O2; (2) 30-PFC group, acute SDH treated with PFC infusion in 30% O2; (3) 100-O2 group, acute SDH treated with 100% O2; and (4) 100-PFC group, acute SDH treated with PFC plus 100% O2. Ten minutes after the induction of acute SDH, a single dose of PFC was infused and 30% or 100% O2 was administered simultaneously.

Cell proliferation and neuronal differentiation in the dentate gyrus in juvenile and adult rats following traumatic brain injury.

It is well known that the cognitive functions of juveniles recover to a greater extent than adult patients following traumatic brain injury (TBI). The exact mechanisms underlying this age-related disparity are unknown; however, we speculate that this improved recovery in juveniles following TBI may be associated with an endogenous neurogenic response in the hippocampus. We, therefore, examined the effects of TBI on cellular proliferation and differentiation in the dentate gyrus (DG) of the hippocampus in juvenile and adult rats following lateral fluid percussion injury (FPI).

Effects of hyperbaric oxygen therapy on cerebral oxygenation and mitochondrial function following moderate lateral fluid-percussion injury in rats.

Object: In the current study, the authors examined the effects of hyperbaric O2 (HBO) following fluid-percussion brain injury and its implications on brain tissue oxygenation (PO2) and O2 consumption (VO2) and mitochondrial function (redox potential).

Methods: Cerebral tissue PO2 was measured following induction of a lateral fluid-percussion brain injury in rats. Hyperbaric O2 treatment (100% O2 at 1.

Perfluorocarbon emulsion improves cerebral oxygenation and mitochondrial function after fluid percussion brain injury in rats.

Objective: Cerebral ischemia is a common secondary sequela of traumatic brain injury (TBI). Experimental models of stroke have demonstrated reductions in ischemia after perfluorocarbon (PFC) administration; however, there are no published reports of PFC efficacy after TBI. The current study analyzed the effect of the PFC emulsion Oxygent (AF0144; Alliance Pharmaceutical Corp.

Brain oxygenation and energy metabolism: part I-biological function and pathophysiology.

CONTINUOUS OXYGEN DELIVERY and CO(2) clearance are paramount in the maintenance of normal brain function and tissue integrity. Under normal conditions, aerobic metabolism is the major source of energy in the brain, but this system may be compromised by the interruption of substrate delivery and disturbances in cerebral metabolism. These disruptions are major factors contributing to ischemic and hypoxic brain damage resulting from traumatic brain injury, stroke, and subarachnoid hemorrhage.

Stress-induced activation of median raphe serotonergic neurons in rats is potentiated by the neurotensin antagonist, SR 48692.

The activation of rostrally projecting serotonergic (5-HT) neurons by acute sound stress is blocked by exogenous administration of the tridecapeptide neurotensin (NT). 5-HT neurons respond to acute sound stress within the median raphe nucleus (MRN), but not within the dorsal raphe nucleus or hindbrain regions. By use of the NT antagonist, SR 48692, the present study examines the involvement of endogenous NT in modulating the preferential activation of MRN 5-HT neurons by sound stress, and extends the findings with sound stress to two other stressors (swim and tail shock).