Neurology Commons^™

Bilateral Cerebellar Stroke With Good Functional Recovery, Maimoona Siddiqui, Farrukh Shohab Khan, Mohammad Salman

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

The Karachi Intracranial Stenosis Study (Kiss) Protocol: An Urban Multicenter Case-Control Investigation Reporting The Clinical, Radiologic And Biochemical Associations Of Intracranial Stenosis In Pakistan., Ayeesha Kamran Kamal, Fawad Taj,, Babar Junaidi, Asif Rasheed, Moazzam Zaidi, Muhammed Murtaza, Naved Iqbal, Fahad Hashmat, Syed Vaqas Alam, Uzma Saleem, Shahan Waheed, Lajpat Bansari, Nabi Shah, Maria Samuel, Madiha Yameen, Sobia Naz, Farrukh Shahab Khan, Naveeduddin Ahmed, Khalid Mahmood, Niaz Sheikh, Karim Ullah Makki, Muhammad Masroor Ahmed, Abdul Rauf Memon, Mohammad Wasay, Nadir Ali Syed, Bhojo A Khealani, Philippe M. Frossard, Danish Saleheen

Department of Medicine

Background: Intracranial stenosis is the most common cause of stroke among Asians. It has a poor prognosis with a high rate of recurrence. No effective medical or surgical treatment modality has been developed for the treatment of stroke due to intracranial stenosis. We aim to identify risk factors and biomarkers for intracranial stenosis and to develop techniques such as use of transcranial doppler to help diagnose intracranial stenosis in a cost-effective manner.

Methods/Design: The Karachi Intracranial Stenosis Study (KISS) is a prospective, observational, case-control study to describe the clinical features and determine the risk factors of patients with stroke due …

Intravenous Inoculation Of A Bat-Associated Rabies Virus Causes Lethal Encephalopathy In Mice Through Invasion Of The Brain Via Neurosecretory Hypothalamic Fibers., Mirjam A R Preuss, Marie-Luise Faber, Gene S Tan, Michael Bette, Bernhard Dietzschold, Eberhard Weihe, Matthias J Schnell

Department of Microbiology and Immunology Faculty Papers

The majority of rabies virus (RV) infections are caused by bites or scratches from rabid carnivores or bats. Usually, RV utilizes the retrograde transport within the neuronal network to spread from the infection site to the central nervous system (CNS) where it replicates in neuronal somata and infects other neurons via trans-synaptic spread. We speculate that in addition to the neuronal transport of the virus, hematogenous spread from the site of infection directly to the brain after accidental spill over into the vascular system might represent an alternative way for RV to invade the CNS. So far, it is unknown …

Classification And Clinical Features Of Headache Disorders In Pakistan: A Retrospective Review Of Clinical Data, Muhammed Murtaza, Mehreen Kisat, Haroon Daniel, Aziz Sonawalla

Department of Medicine

Background: Morbidity associated with primary headache disorders is a major public health problem with an overall prevalence of 46%. Tension-type headache and migraine are the two most prevalent causes. However, headache has not been sufficiently studied as a cause of morbidity in the developing world. Literature on prevalence and classification of these disorders in South Asia is scarce. The aim of this study is to describe the classification and clinical features of headache patients who seek medical advice in Pakistan.

Methods and Results: Medical records of 255 consecutive patients who presented to a headache clinic at a tertiary care hospital …

Prion Protein Glycosylation Is Not Required For Strain-Specific Neurotropism, Justin R. Piro, Brent T. Harris, Koren Nishina, Claudio Soto, Rodrigo Morales, Judy R. Rees, Surachai Supattapone

Dartmouth Scholarship

In this study, we tested the hypothesis that the glycosylation of the pathogenic isoform of the prion protein (PrP^Sc) might encode the selective neurotropism of prion strains. We prepared unglycosylated cellular prion protein (PrP^C) substrate molecules from normal mouse brain by treatment with PNGase F and used reconstituted serial protein cyclic misfolding amplification reactions to produce RML and 301C mouse prions containing unglycosylated PrP^Sc molecules. Both RML- and 301C-derived prions containing unglycosylated PrP^Sc molecules were infectious to wild-type mice, and neuropathological analysis showed that mice inoculated with these samples maintained strain-specific patterns of PrP …

Does Admission Hyperglycemia Predict Intracranial And Extracranial Vasculopathy?, Ather Mohammed Taqui, Ayeesha Kamran Kamal, Saqib Ali Gowani, Bhojo A Khealani, Shafquat Rozi

Community Health Sciences

Objective: To study the association between admission hyperglycaemia and the presence and pattern of intracranial and extracranial vascular disease.
Methods: This retrospective study was conducted at a major tertiary care hospital in Karachi, Pakistan. Patients who had presented with acute stroke and had undergone a carotid ultrasound doppler of the carotids and/or Magnetic Resonance Angiography (MRA) of the brain were included in the study. A multiple logistic regression analysis of variables was done for an abnormal finding on each investigation.
Results: Out of the total of 216 patients, the age of majority of the patients (83.3%) was >50 years …

Does Admission Hyperglycemia Predict Intracranial And Extracranial Vasculopathy?, Ather Mohammed Taqui, Ayeesha Kamran Kamal, Saqib Ali Gowani, Bhojo A. Khealani, Shafquat Rozi

Department of Medicine

Objective: To study the association between admission hyperglycaemia and the presence and pattern of intracranial and extracranial vascular disease.
Methods: This retrospective study was conducted at a major tertiary care hospital in Karachi, Pakistan. Patients who had presented with acute stroke and had undergone a carotid ultrasound doppler of the carotids and/or Magnetic Resonance Angiography (MRA) of the brain were included in the study. A multiple logistic regression analysis of variables was done for an abnormal finding on each investigation.
Results: Out of the total of 216 patients, the age of majority of the patients (83.3%) was >50 years …

The Pakistan Risk Of Myocardial Infarction Study: A Resource For The Study Of Genetic, Lifestyle And Other Determinants Of Myocardial Infarction In South Asia, Danish Saleheen, Moazzam Zaidi, Asif Rasheed, Usman Ahmad, Abdul Hakeem, Muhammed Murtaza, Waleed Kayani, Rashid Jooma, Nadir Khan, Nabi Shah, Asad Ali Shah, Maria Samuel, Farina Hanif, Madiha Yameen, Sobia Naz, Aisha Sultana, Aisha Nazir, Shehzad Raza, Muhammad Shazad, Sana Nasim, Muhammad Ahsan Javed, Syed Saadat Ali, Mehmood Jafree, Muhammad Imran Nisar, Altaf Hussain, Ayeesha Kamran Kamal, Philippe M. Frossard

Department of Biological & Biomedical Sciences

The burden of coronary heart disease (CHD) is increasing at a greater rate in South Asia than in any other region globally, but there is little direct evidence about its determinants. The Pakistan Risk of Myocardial Infarction Study (PROMIS) is an epidemiological resource to enable reliable study of genetic, lifestyle and other determinants of CHD in South Asia. By March 2009, PROMIS had recruited over 5,000 cases of first-ever confirmed acute myocardial infarction (MI) and over 5,000 matched controls aged 30-80 years. For each participant, information has been recorded on demographic factors, lifestyle, medical and family history, anthropometry, and a …

Younger Neurosurgoens —Ambitions, Evircilions Or Dilemma?, Amit Agrawal

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Clinical Evaluation 32 Patients With Jme In Southern Khorasan, Hamid Riasi, Fariba Nakhaei, Kavian Ghandehari, Frood Salehi, Zahra Toraby, Mojtaba Teimoori

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Intrathecal Use Of Polyrnyxinb For Multiresistant Acineobacter Meningitis, Atta-Ul Aleem Bhatti, Aslam Khan, Syed Ather Enam, Rashid Jooma

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

16th Annual Psn Meeting, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Overview Of Surgical Management Of Infectious Non-Suppurative Brain Lesions (Part 1), Muhammad Shahzad Shamim, Ather Enam, Rushna Pervez Ali, Syed Faizan Ali, Mohammad Wasay

Section of Neurosurgery

No abstract provided.

Cerebral Palsy In Adolescents, Rehan Ali, Shakeel Ahmed, Maqbool Qadir

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Changing Patterns Of Visual Hallucinations, Mubashira Hashmi, Ashfaq A. Sharif, Shaista A. Siddiqui, Muhammad Shahid Mustafa

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Gliosarcoma, Rafael Cincu, Juan F. Martín Lázaro, José Luis Capablo Liesa, Jose Eiras

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

External Ventricular Drains — Can Morbidity Be Reduced, Ansar Hayat, Desi Rodrigues, Peter Crawford, David Mendelow

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Diagnostic Accuracy Of Ct Angiography And Surgical Outcome Of Cerebral Aneurysms, Nozaina Khan, Naveed Ashraf, Abdul Hameed, Akmal Muhammed

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Assessment Of Knowledge & Practice Of Contraceptives In Females Of Reproductive Age Group At A Tertiary Care Hospital, Nabeela Fazal Babar, Mahmood Ahmed, Muhammad Babar Khan, Muhammad Wasif Khan

Department of Surgery Docs

Abstract

Objectives: To assess the knowledge & practice of contraceptives in females of reproductive age group.
Study Design: Cross sectional descriptive.
Place and Duration of Study: OPD of Fauji Foundation Hospital from February 2008 – September 2008.
Subjects and Method: 339 Females of age b/w of 15 – 49 years attending OPD of Fauji Foundation Hospital were included in study. A structured questionnaire was used to collect data.
Results: Eighty eight percent of the females in our study sample were familiar with one or more methods of contraception (72.7%were familiar with combined oral contraceptive pill (COCP), 60.7% were aware of …

Fight Against Chronic Diseases (High Blood Pressure, Stroke, Diabetes And Cancer) In Pakistan; Cost-Effective Interventions, Mohammad Wasay, Abdul Jabbar

Department of Medicine

No abstract provided.

Asian Cerebral Venous Thrombosis Registry: Study Protocolv, Mohammad Wasay, Ayeesha Kamal, Bhojo Khealani

Department of Medicine

Introduction:

Cerebral venous thrombosis (CVT) is a well known but poorly reported entity. Most of the studies and registries related to CVT are reported from European countries. No large multi-center or multi- national data base or registry has been reported from Asian countries. CVT is not uncommon in Asia especially in south Asian subcontinent including India, Pakistan and Bangladesh. One study reported from India that CVT accounted for half of all strokes in the young and 40% of strokes in women. Review of CVT cases from Asian countries is suggestive of differences in risk factors profile and outcome in these …

Moyamoya Disease: A Clinical Spectrum, Literature Review And Case Series From A Tertiary Care Hospital In Pakistan., Sana Shoukat, Ahmed Itrat, Ather M. Taqui, Moazzam Zaidi, Ayeesha Kamran Kamal

Department of Medicine

Background: Moyamoya is a rare cerebrovascular disease of unknown etiology. The data on moyamoya disease from Pakistan is sparse. We report a case series of 13 patients who presented with moyamoya disease to a tertiary care hospital in Pakistan with a national referral base.

Methods: We conducted a retrospective review of thirteen patients who presented to The Aga Khan University and diagnosed with "Moyamoya Disease" during the period 1988 – 2006. These patients were identified from existing hospital database via ICD-9 codes. A predesigned questionnaire containing information about clinical presentation, management and neuroimaging was administered to all identified patients. Results: …

Early Ischemic Stroke Presentation In Pakistan, Ayeesha Kamran Kamal, Bhojo A Khealani, Sajjad Ahmed Ansari, Maria Afridi, Nadir Ali Syed

Department of Medicine

Introduction: There are no studies from Pakistan that describe stroke presentation rates or factors associated with early or delayed presentation. This is important to know because current clinical protocols limit the use of recombinant tissue plasminogen activator (rtPA), the only available therapy for acute ischemic stroke, to a three-hour window from symptom onset.
Methods: All patients aged 14 years or above with acute ischemic stroke of < or = 48 hours duration were prospectively identified from the Aga Khan University Stroke Data Bank over a 22-month period ending May 2001.
Results: 269 ischemic stroke patients presented within 48 hours of stroke onset. 55 out of 269 (21%) presented within first three hours and 110 out of 269 (41%) within first six hours. Unawareness of …

A Dissociation Between Perception And Action In The Material‐Weight Illusion, Gavin Buckingham, Jonathan S. Cant, Kai-Ling C. Kao, Melvyn A. Goodale

Psychology Presentations

We examined what forces are applied to objects that elicit this illusion when they are lifted.We predicted that:

(1) Forces on early trials will scale to each participant’s expectations of how much a particular block will weigh ‐ excessive force will be applied to the metal block and insufficient force applied to the polystyrene block.

(2) Forces on later trials will scale to the real weight of each block ‐ identical levels of force applied to all the blocks.

(3) MWI will persist throughout ‐ polystyrene block will feel the heaviest, metal block will feel the lightest.

Grasping And Lifting Different Materials, Gavin Buckingham, Jonathan S. Cant, Melvyn A. Goodale

Psychology Presentations

The material from which an object is made can determine how heavy it feels (Seashore, 1899). Interestingly, a metal block that has been adjusted to have the same size and mass as a polystyrene block will feel lighter than the polystyrene block. We recently showed that participants experiencing this material-weight illusion’ (MWI) do not apply forces that match their perceptual experience of heaviness ‐ just like in the size‐weight illusion ( Flanagan & Beltzner, 2000).

Our previous study showed that forces on early trials were scaled to each participant’s expectations of how much a particular block should weigh ‐ excessive …

A Comparison Of The Observation Of Movement Method And Electromyography Method Of Determining Motor Threshold In Transcranial Magnetic Stimulation, Berry Stephen Anderson

MUSC Theses and Dissertations

Clinicians are using transcranial magnetic stimulation (TMS) as a noninvasive tool to treat depression; however, standards for determining the motor threshold (MT), which often determines the final location of the TMS coil and the intensity of simulation for the depression treatment, are not clear. This study compared the observation of movement (OM) method and electromyography (EMG) method of determining motor threshold in a group of experienced TMS administrators and nurses with no previous MT knowledge. We hypothesized that between methods and groups the MT estimates would vary by ≤ 5% of stimulator output and the ideal motor scalp location between …

A Comparative Analysis Of Structural Brain Mri In The Diagnosis Of Alzheimer’S Disease, Jason Appel, Elizabeth Potter, Qian Shen, Gustavo Pantol, Maria T. Greig, David Loewenstein, Ranjan Duara

Neurology Faculty Publications

Dementia is a debilitating and life-altering disease which leads to both memory impairment and decline of normal executive functioning. While causes of dementia are numerous and varied, the leading cause among patients 60 years and older is Alzheimer’s disease. The gold standard for Alzheimer’s diagnosis remains histological identification of amyloid plaques and neurofibrillary tangles within the medial temporal lobe, more specifically the entorhinal cortex and hippocampus. Although no definitive cure for Alzheimer's disease currently exists, there are treatments targeted at preserving cognition and memory while delaying continued loss of function. Alzheimer's disease exists along a spectrum of cognitive decline and …

Near Fatal Posterior Reversible Encephalopathy Syndrome Complicating Chronic Liver Failure And Treated By Induced Hypothermia And Dialysis: A Case Report., Rashmi Chawla, Daniel Smith, Paul E Marik

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

INTRODUCTION: Posterior reversible encephalopathy syndrome is a clinico-neuroradiological entity characterized by headache, vomiting, altered mental status, blurred vision and seizures with neuroimaging studies demonstrating white-gray matter edema involving predominantly the posterior region of the brain. CASE PRESENTATION: We report a 47-year-old Caucasian man with liver cirrhosis who developed posterior reversible encephalopathy syndrome following an upper gastrointestinal hemorrhage and who was managed with induced hypothermia for control of intracranial hypertension and continuous veno-venous hemodiafiltration for severe hyperammonemia. CONCLUSION: We believe this is the first documented case report of posterior reversible encephalopathy syndrome associated with cirrhosis as well as the first report …

Resting State Default-Mode Network Connectivity In Early Depression Using A Seed Region-Of-Interest Analysis: Decreased Connectivity With Caudate Nucleus, Robyn Bluhm, Peter Williamson, Ruth Lanius, Jean Théberge, Maria Densmore, Robert Bartha, Richard Neufeld, Elizabeth Osuch

Philosophy Faculty Publications

Aim: Reports on resting brain activity in healthy controls have described a default-mode network (DMN) and important differences in DMN connectivity have emerged for several psychiatric conditions. No study to date, however, has investigated resting-state DMN in relatively early depression before years of medication treatment. The objective of the present study was, therefore, to investigate the DMN in patients seeking help from specialized mental health services for the first time for symptoms of depression.

Methods: Fourteen depressed subjects and 15 matched controls were scanned using 4-T functional magnetic resonance imaging while resting with eyes closed. All but one subject was …

Calpain Inhibition Attenuates Inflammatory And Neurodegenerative Events In Animal Models Of Multiple Sclerosis, Mary Kelly Guyton

MUSC Theses and Dissertations

Multiple sclerosis (MS) is an autoimmune, demyelinating disease of the central nervous system (CNS) that affects approximately 400,000 people in the United States every year and results in fatigue, visual dysfunction, and paralysis. Inflammatory events associated with MS include activation of auto-reactive T cells and migration of these and other immune cells into the CNS, leading to production of cytokines and other mediators and to demyelination. Astrogliosis and microgliosis are also prominent inflammatory features of MS. Neurodegenerative events such as axonal damage and loss of neurons and oligodendrocytes also contribute to clinical disease symptoms. Cell death is thought to occur, …