Nervous System Diseases Commons^™

A Stroke Of Fate: Overcoming Varicella Encephalitis’S Unexpected Consequences, Karissa Charles, Sean Gibbs

South Atlantic Division GME Research Day 2024

No abstract provided.

A Challenging Case Of Bilateral Medial Medullary Infarction Resembling Guillain-Barré Syndrome, Alexis Bialousz, Havird Mclean Skalak, Nicholas Carbo, Amanda Westbrook

South Atlantic Division GME Research Day 2024

No abstract provided.

Stroke Chameleon: A Case Of High Grade Glioma, Zachary T. Lowery, Mary M. Carter

South Atlantic Division GME Research Day 2024

No abstract provided.

Isolated Case Of Alexia Following Cardiac Ablation: A Rare Stroke Presentation, Matthew M. Mason, Nantian Harsell, Bryan Kharbanda

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Multi-Site Identification And Generalization Of Clusters Of Walking Behaviors In Individuals With Chronic Stroke And Neurotypical Controls, Natalia Sánchez, Nicolas Schweighofer, Sara J. Mulroy, Ryan T. Roemmich, Trisha M. Keshar, Gelsy Torres-Oviedo, Beth E. Fisher, James M. Finley, Carolee J. Winstein

Physical Therapy Faculty Articles and Research

Background

Objectives

Methods

The Role Of Extracellular Heat Shock Proteins In Cardiovascular Diseases, Soumya Patnaik, Sriram Nathan, Biswajit Kar, Igor D Gregoric, Yi-Ping Li

Faculty, Staff and Student Publications

In the early 1960s, heat shock proteins (HSPs) were first identified as vital intracellular proteinaceous components that help in stress physiology and reprogram the cellular responses to enable the organism's survival. By the early 1990s, HSPs were detected in extracellular spaces and found to activate gamma-delta T-lymphocytes. Subsequent investigations identified their association with varied disease conditions, including autoimmune disorders, diabetes, cancer, hepatic, pancreatic, and renal disorders, and cachexia. In cardiology, extracellular HSPs play a definite, but still unclear, role in atherosclerosis, acute coronary syndromes, and heart failure. The possibility of HSP-targeted novel molecular therapeutics has generated much interest and hope …

The Effectiveness And Outcomes Of Oculomotor And Visual Field Deficit Rehabilitation Secondary To Ischemic Cerebrovascular Accident: A Literature Review, Maanas Chiplunkar

Rowan-Virtua Research Day

Visual field loss and oculomotor dysfunctions are two common vision deficits caused by cerebrovascular accidents. Oftentimes these deficits can result in a loss of independence for patients and depression. Neurovisual rehabilitation is a frequently overlooked aspect of stroke rehabilitation, so investigating the current rehab approaches and the factors that play a role in the effectiveness of these methods is crucial so that clinicians can provide more direct and focused treatment for their patients. This literature review research process used PubMed, NCBI, and EbscoHost as primary databases. Preliminary results showed that restitutive and compensatory rehabilitation approaches are effective for treating visual …

Case Study Of Horner Syndrome Due To Internal Carotid Artery Dissection, Kajel Patel

Rowan-Virtua Research Day

Carotid artery dissection can occur either spontaneously or because of trauma. It is usually the most common cause of stroke in middle-aged patients. The symptoms can be transient or persistent and typically occur a few days after the inciting traumatic event.

Acute Thalamic Stroke In A Covid Positive Adult: A Case Report, Norberto Escobales, Daniel Kiehl, Michelle Militello, Aleger Vorbes

South Atlantic Division GME Research Day 2023

No abstract provided.

Community Support Post-Hospitalization: A Practitioner Resource, Della Dupre

Post-Professional Occupational Therapy Doctorate - Innovations in OT Symposium: Transforming Possibilities into Practice

No abstract provided.

Tea, Toast, And Strokes, Mark Azmy, Jennifer Broyles, Sean Quinonez, Admir Seferovic

West Florida Division GME Research Day 2023

No abstract provided.

Subacute Stroke Like Presentation Likely Due To Disseminated Histoplasmosis In An Immunocompromised Patient, Ashley R. Diaz, Priya Mohan, Utmitha Konda, Alfonso Manotas, Issac Ichoa

East Florida Division GME Research Day 2023

Histoplasmosis capsulatum is an opportunistic fungal infection that is largely asymptomatic and found to have nonspecific signs and symptoms. It predominates in Central and North America, and is one of the leading causes of hospitalization among the fungal family. However, in the right host, such as in this case, a patient with significant immunosuppression can develop serious manifestations as it disseminates outside of the pulmonary system. The challenging element of disseminated histoplasmosis is that despite proper treatment immunocompromised patients will frequently relapse with worsening presentation. There is limited literature on subacute stroke-like presentation in a patient with chronic infection of …

Time Is Brain: Improving Door To Iv Tpa Time In Emergency Department, Habiba Khan, Dallin Ollerton, George Matus, Ramesh Komaragiri

Central & West Texas GME Research Day 2023

No abstract provided.

Community Socioeconomic And Urban-Rural Differences In Emergency Medical Services Times For Suspected Stroke In North Carolina, Srihari V Chari, Eric R Cui, Haylie E Fehl, Antonio R Fernandez, Jane H Brice, Mehul D Patel

Faculty, Staff and Student Publications

OBJECTIVE: Our objectives were to describe time intervals of EMS encounters for suspected stroke patients in North Carolina (NC) and evaluate differences in EMS time intervals by community socioeconomic status (SES) and rurality.

METHODS: This cross-sectional study used statewide data on EMS encounters of suspected stroke in NC in 2019. Eligible patients were adults requiring EMS transport to a hospital following a 9-1-1 call for stroke-like symptoms. Incident street addresses were geocoded to census tracts and linked to American Community Survey SES data and to rural-urban commuting area (RUCA) codes. Community SES was defined as high, medium, or low based …

Exploring The Efficacy Of Mir-33 Antagonism In Promoting Regression Of Intracranial Atherosclerosis In A Nonhuman Primate Model, Peter Hecker

Theses and Dissertations--Pharmacology and Nutritional Sciences

Atherosclerosis, characterized by lipid accumulation and arterial inflammation, is a major contributor to global morbidity and mortality. Despite significant progress in understanding atherosclerosis in extracranial arteries, the study of intracranial atherosclerosis (ICAS) has been relatively neglected, despite its crucial role in stroke and vascular cognitive impairment. Challenges related to ICAS, including its location within the cranium and limited availability of suitable animal models, have hindered research progress in this area. Although nonhuman primates (NHPs) are commonly used for studying extracranial atherosclerosis, a comprehensive understanding of ICAS pathophysiology in these animals is lacking. By subjecting NHPs to a high-fat/cholesterol diet, we …

Crel And Wnt5a/Frizzled 5 Receptor-Mediated Inflammatory Regulation Reveal Novel Neuroprotectin D1 Targets For Neuroprotection, Jorgelina M. Calandria, Khanh V. Do, Sayantani Kala-Bhattacharjee, Andre Obenaus, Ludmila Belayev, Nicolas G. Bazan

School of Medicine Faculty Publications

Abstract: Wnt5a triggers inflammatory responses and damage via NFkB/p65 in retinal pigment epithelial (RPE) cells undergoing uncompensated oxidative stress (UOS) and in experimental ischemic stroke. We found that Wnt5a-Clathrin-mediated uptake leads to NFkB/p65 activation and that Wnt5a is secreted in an exosome-independent fashion. We uncovered that docosahexaenoic acid (DHA) and its derivative, Neuroprotectin D1 (NPD1), upregulate c-Rel expression that, as a result, blunts Wnt5a abundance by competing with NFkB/p65 on the Wnt5a promoter A. Wnt5a increases in ischemic stroke penumbra and blood, while DHA reduces Wnt5a abundance with concomitant neuroprotection. Peptide inhibitor of Wnt5a binding, Box5, is also neuroprotective. DHA-decreased …

Associations Between Residential Greenspace, Socioeconomic Status, And Stroke: A Matched Case-Control Study, Heloise Cheruvalath, Jennifer Homa, Maharaj Singh, Paul Vilar, Amin Kassam, Richard A. Rovin

Journal of Patient-Centered Research and Reviews

Purpose: Studies have shown increased residential greenspace is associated with improved outcome following stroke. This study sought to determine if residential greenspace is an independent stroke risk factor.

Methods: A retrospective 1:4 matched case-control study involving 1174 stroke and 4696 control patients over a 3-year period from Milwaukee County, Wisconsin, was conducted. Greenspace was determined using normalized difference vegetation index (NDVI) for a 250-meter radius surrounding a subject’s residence. The area deprivation index (ADI) for the census block tract of a subject’s residence was obtained from the Neighborhood Atlas® (University of Wisconsin School of Medicine and Public Health). …

The Company Prosodic Deficits Keep Following Right Hemisphere Stroke: A Systematic Review, Shannon M. Sheppard, Melissa D. Stockbridge, Lynsey M. Keator, Laura L. Murray, Margaret Lehman Blake

Communication Sciences and Disorders Faculty Articles and Research

Objectives:

The aim of this systematic review was to identify the presence and nature of relationships between specific forms of aprosodia (i.e., expressive and receptive emotional and linguistic prosodic deficits) and other cognitive-communication deficits and disorders in individuals with right hemisphere damage (RHD) due to stroke.

Methods:

One hundred and ninety articles from 1970 to February 2020 investigating receptive and expressive prosody in patients with relatively focal right hemisphere brain damage were identified via database searches.

Results:

Fourteen articles were identified that met inclusion criteria, passed quality reviews, and included sufficient information about prosody and potential co-occurring …

The Benefit Of Bdnf Modification In The Treatment Of Post-Stroke Depression, Christine Gordynskiy-Ageyev

Capstone Showcase

Neuroplasticity has been a rapidly expanding area of research, and its findings have elucidated the potential of taking advantage of some of its components for the treatment of various neural pathologies. Stroke is the most common cause of long-term disability, and it is a disease process that affects many people. There are many rehabilitation programs that seek to restore a patient’s motor and cognitive functions after stroke; if not fully, then at least partially. Unfortunately, mental health changes contribute in large part to the overall disability of a patient, but these changes are not always targeted in these programs. In …

Intensive Care Bundle With Blood Pressure Reduction In Acute Cerebral Hemorrhage Trial (Interact3): Study Protocol For A Pragmatic Stepped-Wedge Cluster-Randomized Controlled Trial, Lili Song, Xin Hu, Lu Ma, Xiaoying Chen, Menglu Ouyang, Laurent Billot, Qiang Li, Paula Muñoz-Venturelli, Carlos Abanto, Mohammad Wasay

Section of Neurology

Background: Early intensive blood pressure (BP) lowering remains the most promising treatment for acute intracerebral hemorrhage (ICH), despite discordant results between clinical trials and potential variation in the treatment effects by approach to control BP. As the third in a series of clinical trials on this topic, the INTEnsive care bundle with blood pressure Reduction in Acute Cerebral hemorrhage Trial (INTERACT3) aims to determine the effectiveness of a goal-directed care bundle protocol of early physiological control (intensive BP lowering, glycemic control, and pyrexia treatment) and reversal of anticoagulation, in acute ICH.
Methods: INTERACT3 is a pragmatic, international, multicenter, stepped-wedge (4 …

Stroke Care In Pakistan, Anjum Farooq, Narayanaswamy Venketasubramanian, Mohammad Wasay

Section of Neurology

Increasing incidence of stroke and lack of infrastructure in both urban and rural areas needs immediate attention in Pakistan. There is a high proportion of young stroke with poor stroke outcomes. Acute stroke care is scarce in Pakistan due to the small number of neurologists (1 neurologist per 1 million population), few stroke units, and limited availability of alteplase (recombinant tissue plasminogen activator) in the country.

Lesion Loci Of Impaired Affective Prosody: A Systematic Review Of Evidence From Stroke, Alexandra Zezinka Durfee, Shannon M. Sheppard, Margaret L. Blake, Argye E. Hillis

Communication Sciences and Disorders Faculty Articles and Research

Affective prosody, or the changes in rate, rhythm, pitch, and loudness that convey emotion, has long been implicated as a function of the right hemisphere (RH), yet there is a dearth of literature identifying the specific neural regions associated with its processing. The current systematic review aimed to evaluate the evidence on affective prosody localization in the RH. One hundred and ninety articles from 1970 to February 2020 investigating affective prosody comprehension and production in patients with focal brain damage were identified via database searches. Eleven articles met inclusion criteria, passed quality reviews, and were analyzed for affective prosody localization. …

Neural Regions Underlying Object And Action Naming: Complementary Evidence From Acute Stroke And Primary Progressive Aphasia, Bonnie L. Breining, Andreia V. Feria, Brian Caffo, Erin L. Meier, Shannon M. Sheppard, Rajani Sebastian, Donna C. Tippett, Argye E. Hillis

Communication Sciences and Disorders Faculty Articles and Research

Background: Naming impairment is commonly noted in individuals with aphasia. However, object naming receives more attention than action naming. Furthermore, most studies include participants with aphasia due to only one aetiology, commonly stroke. We developed a new assessment, the Hopkins Action Naming Assessment (HANA), to evaluate action naming impairments.

Methods >& Procedures: Participants (N = 138 PPA, N = 37 acute stroke) completed the BNT and HANA. Behavioural performance was compared. A subset of participants (N = 31 PPA, N = 37 acute stroke) provided neuroimaging data. The whole brain was automatically segmented into regions of interest (ROIs). …

Cerebral Venous Thrombosis Associated With Covid-19 Infection: An Observational, Multicenter Study, Sajid Hameed, Mohammad Wasay, Bashir A. Soomro, Ossama Mansour, Foad Abd-Allah, Tianming Tu, Raja Farhat, Naila Shahbaz, Husnain Hashim, Wasim Alamgir

Section of Neurology

Background and purpose: Coronavirus disease 2019 (CO-VID-19) has an increased propensity for systemic hypercoagulability and thromboembolism. An association with cerebrovascular diseases, especially cerebral venous thrombosis (CVT), has been reported among these patients. The objective of the present study was to identify risk factors for CVT as well as its presentation and outcome in COVID-19 patients.
Methods: This is a multicenter and multinational observational study. Ten centers in 4 countries (Pakistan, Egypt, Singapore, and the United Arab Emirates) participated in this study. The study included patients (aged >18 years) with symptomatic CVT and recent COVID-19 infection.
Results: Twenty patients (70% men) …

Case Report: Repeated Use Of Tetrahydrocannabinol Associated With Severe Cerebral Vasoconstriction, Pooja Patel, Ryna Then, Dena Little

Rowan-Virtua Research Day

Reversible Cerebral Vasoconstriction Syndrome (RCVS) is a rare neurological syndrome. The classic presentation consists of recurrent, severe, ”thunderclap” headaches with neuroimaging findings consistent with segmental vasoconstriction of cerebral arteries. Sympathomimetics including cannabinoids have been found to be triggers in many cases of RCVS. Complications include subarachnoid hemorrhage, intracerebral hemorrhage, cerebral edema and ischemic infarction.

This case highlights the potential devastating and irreversible effects of RCVS precipitated by exposure to a sympathomimetic agent. The case emphasizes the importance of patient counseling regarding abstinence from agents that may provoke RCVS.

Characterizing Subtypes And Neural Correlates Of Receptive Aprosodia In Acute Right Hemisphere Stroke, Shannon M. Sheppard, Erin L. Meier, Alexandra Zezinka Durfee, Alex Walker, Jennifer Shea, Argye E. Hillis

Communication Sciences and Disorders Faculty Articles and Research

Introduction: Speakers naturally produce prosodic variations depending on their emotional state. Receptive prosody has several processing stages. We aimed to conduct lesion-symptom mapping to determine whether damage (core infarct or hypoperfusion) to specific brain areas was associated with receptive aprosodia or with impairment at different processing stages in individuals with acute right hemisphere stroke. We also aimed to determine whether different subtypes of receptive aprosodia exist that are characterized by distinctive behavioral performance patterns.

Methods: Twenty patients with receptive aprosodia following right hemisphere ischemic stroke were enrolled within five days of stroke; clinical imaging was acquired. Participants completed …

Potential Perioperative Complications Due To Difference In Timing Of Systemic Heparinization During Ruptured Aneurysm Coiling, Rouzbeh Kotaki, Ameer E. Hassan, Wondwossen G. Tekle

MEDI 9331 Scholarly Activities Clinical Years

Potential Perioperative Complications Due To Differences in Timing Of Systemic Heparin Distribution During Ruptured Aneurysm Coiling

Introduction:

In general, systematic heparin anticoagulation is standard in regards to neurovascular intervention. When coiling ruptured aneurysms, many neurointerventionalists have their own protocol as to timing of systemic heparinization. There is ample research and literature reviewing the frequency of perioperative events, predictors and outcomes, as well as the efficacy in the use of anticoagulants and/or antiplatelets before, during, and after neurovascular procedures to prevent adverse outcomes. However, there currently exists a dearth of research in regards to timing of distribution of heparin intraoperatively and …

Diagnosing And Managing Post-Stroke Aphasia, Shannon M. Sheppard, Rajani Sebastian

Communication Sciences and Disorders Faculty Articles and Research

Introduction: Aphasia is a debilitating language disorder and even mild forms of aphasia can negatively affect functional outcomes, mood, quality of life, social participation, and the ability to return to work. Language deficits after post-stroke aphasia are heterogeneous.

Areas covered: The first part of this manuscript reviews the traditional syndrome-based classification approach as well as recent advances in aphasia classification that incorporate automatic speech recognition for aphasia classification. The second part of this manuscript reviews the behavioral approaches to aphasia treatment and recent advances such as noninvasive brain stimulation techniques and pharmacotherapy options to augment the effectiveness of …

Gains Across Who Dimensions Of Function After Robot-Based Therapy In Stroke Subjects, Jennifer Wu, Lucy Dodakian, Jill See, Erin Burke Quinlan, Lisa Meng, Jeby Abraham, Ellen C. Wong, Vu Le, Alison Mckenzie, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Background

Studies examining the effects of therapeutic interventions after stroke often focus on changes in loss of body function/structure (impairment). However, improvements in activities limitations and participation restriction are often higher patient priorities, and the relationship that these measures have with loss of body function/structure is unclear.

Objective

This study measured gains across WHO International Classification of Function (ICF) dimensions and examined their interrelationships.

Methods

Subjects were recruited 11 to 26 weeks after hemiparetic stroke. Over a 3-week period, subjects received 12 sessions of intensive robot-based therapy targeting the distal arm. Each subject was assessed at baseline and at 1 …

Ct Rapid Implementation In A 600+ Bed Hospital Serving 35 Counties In The Southeast, Christopher Burns Do, Adam Kassar Md, Jacob Beltz Md, Klie Hoffa, Peter Britt

Radiology

No abstract provided.