Neurology Commons^™

Functional Recovery Of Untreated Human Immunodeficiency Virus-Associated Guillain-Barré Syndrome: A Case Report, Adam L. Schreiber, John W. Norbury Iii, Eduardo A. De Sousa

Department of Rehabilitation Medicine Faculty Papers

HIV-associated Guillain-Barré Syndrome is a well-documented phenomenon, typically occurring at seroconversion. GBS may result in functional impairment treated with a combination of medications, plasmapheresis, and rehabilitation. The quantified functional recovery of HIV-associated GBS with or without HIV treatment is not well-described. Utilizing serial FIM scoring, we describe a patient’s recovery from HIV-associated GBS after treatment with IVIg and acute inpatient rehabilitation without HIV treatment.

What Are The Implications Of Accountable Care Organizations For Physical Medicine And Rehabilitation Practices?, John L. Melvin, Greg Worsowicz

Department of Rehabilitation Medicine Faculty Papers

The goal of delivering quality health care at a lower overall cost through accountable care organizations (ACO) as described as part of the Patient Protection and Affordable Care Act of 2010 (ACA) has gained momentum among payers, providers, and the public. The concept includes developing an organization that provides incentives for quality care while lowering the overall cost of the care. If the goals are met, then both providers and payers would be able to share in the financial savings produced by the lower health care costs achieved while improving the quality of care delivered. The Centers for Medicare and …

The Prevalence Of Cervico-Arterial Dissection In Sub-Arachnoid Hemorrhage In The United States, Ali Seifi, Md, Fred Rincon, Md, Msc, Mitchell Maltenfort, Phd, Pascal Jabbour, Md, Rodney Bell, Md, Michael Moussouttas, Md

Department of Neurology Faculty Papers

Objectives: In this study, we sought to determine the prevalence of cervico-arterial dissection in aubarachnoid hemorrhage (SAH) using a large administrative database.

On The Incidence Of Pulmonary Embolism In Spinal Arthrodesis And The Need For Better Evidence And Prevention Guidelines, Zachary J. Senders, Bs, Benjamin Zussman, Bs, James S. Harrop, Md

JHN Journal

Pulmonary Embolism (PE) is a rare but serious event that may occur after spinal surgery. Vascular endothelial damage during surgery and immobilization of the patient after surgery contribute to a higher risk of thrombosis and subsequent PE. Prophylaxis including intermittent pneumatic compression stockings, heparin, and other interventions is often employed by the treatment team to lower the risk of thromboembolic complications. In orthopedic, trauma, burn and other high-risk surgical patients, the incidence of PE has been thoroughly studied, and this knowledge has been used to establish prophylaxis guidelines specifically for these patients. The incidence of PE in spinal fusion patients, …

Surgical Management Of Fungal Vertebral Osteomyelitis, Benjamin M. Zussman, Bs, David L. Penn, Ms, James S. Harrop, Md

JHN Journal

Fungal vertebral osteomyelitis (FVO) is an uncommon but aggressive disease that may cause spinal instability, neurological insult, and possible death. Little data about treatment strategies and patient outcomes exist. A retrospective review of medical and surgical management with follow-up of this disease was performed.

Bevacizumab: A Controversial Agent Against High-Grade Gliomas, Sussan Salas, Md, Miguel Guzman, Md, Kevin Judy, Md

JHN Journal

Glioblastoma multiforme (GBM) is the most common primary malignant brain tumor in adults. Despite the current regimen of surgical resection with subsequent external beam radiotherapy and temozolomide, mean survival is 14.6 months and 2-year survival is 26%. GBM is a highly vascular tumor, a result of its increased expression of vascular endothelial growth factor (VEGF) compared to other brain tumors. VEGF promotes endothelial cell proliferation, and is thought to have a pivotal role during tumor progression. Multiple treatment modalities have targeted VEGF and VEGF receptors (VEGFTs) due to their essential roles in the regulation of angiogenic processes. Bevacizumab is a …

Case Report On Intracranial Hemorrhage Related To Type I Cryoglobulinemia, Richard Dalyai, Md, L. Fernando Gonzalez, Md

JHN Journal

A traumatic intracranial hemorrhage (ICH) is a common neurosurgical pathology that affects about 20 of 100,000 people every year with a mortality of at least 40%. However, a specific etiology, cannot be identified in about 30% of spontaneous ICH. Here, we present a rare case of ICH related to a patient's previously undiagnosed cryoglobinemia.

The Prevalence And Risk Factors Of Acute Myocardial Infarction (Ami) After Acute Ischemic Stroke (Ais) In The United States, Ali Seifi, Md, Fred Rincon, Md, Msc, Michael Moussouttas, Md, Mitchell Maltenfort, Phd, Matthew Vibbert, Md, Rodney Bell, Md, Maria Carissa Pineda, Md, Diana Tzeng, Md, Jacqueline Urtecho, Md, Anish Koka, Md, William Mcbride, Md

Department of Neurology Faculty Papers

Objectives: To determine the prevalence and risk factors for, and the association with in-hospital mortality of, AMI after AIS, and to study the effect of intravenous recombinant tissue plasminogen activator (r-tPA) in this setting. We hypothesized that AMI would be associated with lower survival rate at hospital discharge but that intravenous r-tPA would be associated with lower risk of AMI.

Can Selective Serotonin Reuptake Inhibitors (Ssri) Improve Motor Recovery After Stroke? What Is The Role Of Neuroplasticity?, Farzin Majeed, Ayeesha Kamran Kamal

Section of Neurology

No abstract provided.

Can Selective Serotonin Reuptake Inhibitors (Ssri) Improve Motor Recovery After Stroke? What Is The Role Of Neuroplasticity?, Farzin Majeed, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Deregulation Of Micrornas By Hiv-1 Vpr Protein Leads To The Development Of Neurocognitive Disorders, Ruma Mukerjee, J Robert Chang, Luis Del Valle, Asen Bagashev, Monika M. Gayed, Randolph B. Lyde, Brian J. Hawkins, Eugen Brailoiu, Eric Cohen, Chris Power, S Ausim Azizi, Benjamin B. Gelman, Bassel E. Sawaya

School of Medicine Faculty Publications

Studies have shown that HIV-infected patients develop neurocognitive disorders characterized by neuronal dysfunction. The lack of productive infection of neurons by HIV suggests that viral and cellular proteins, with neurotoxic activities, released from HIV-1-infected target cells can cause this neuronal deregulation. The viral protein R (Vpr), a protein encoded by HIV-1, has been shown to alter the expression of various important cytokines and inflammatory proteins in infected and uninfected cells; however the mechanisms involved remain unclear. Using a human neuronal cell line, we found that Vpr can be taken up by neurons causing: (i) deregulation of calcium homeostasis, (ii) endoplasmic …

Mechanisms Of Neuronal Death Induced By Environmental Toxicants In Murine Cortical Culture, Travis Rush

Dissertations (1934 -)

This study was directed at examining the neurotoxic mechanisms of several classes of environmental toxicants implicated in neurodegenerative disease. Primary cortical cultures were exposed to organophosphorus pesticides, heavy metals and the cyanobacterial toxin, beta-N-methylamino-L-alanine (BMAA). Several components relating to neuronal injury were assessed in each study and novel aspects are described.

The main action of organophosphorous insecticides is generally believed to be the inhibition of acetylcholinesterase. However, these compounds are now recognized to inhibit many other enzymes and cause neuronal death through a variety of mechanisms. I found that exposure to chlorpyrifos or diazinon caused concentration-dependent neurotoxicity that could not …

A Journal For Advocacy Of Neurological Sciences In Pakistan, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Awareness Of Dementia Among General Population Of Islamabad/ Rawalpindi, Maimoona M. Siddiqui, Nauman S. Siddiqui, Ismail A. Khatri, Ahmed Y Javed, Farrukh Mateen, Yousaf Raza

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Psychiatry, Haider A. Naqvi Dr.

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Interobserver Variationbetween Neuroradiologist And Radiology Resident In The Mri Evaluation Of Lumbar Disc Herniation And Nerve Root Compression, Imaad Ur Rehman, Rana Shoaib Hamid, Waseem Akhtar, Rohana Nazqi, Mirza Amanullah Beg, Haji Ismail Siddiq

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Earthquake And Seizures: Experience At Field Hospital Bagh Kashmir Pakistan, Ghulam Shabbir, Assad Ullah, Hazim Brohi, Abdul Malik, Shaukat Ali

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Endovascular Approach As Primary Treatment For Traumatic Carotid Cavernous Fistula: Local Experience From Pakistan, Rana Shoaib Hamid, Tanveer Ul Haq, Muhammad Shahzad Shamim, Syed Faraz Kazim, Basit Salam

Department of Radiology

Objective: To evaluate the technical success, complications and outcome of endovascular management of post traumatic carotid cavernous fistula (CCF) in patients presenting at a tertiary care hospital in Karahci.
Methods: Descriptive case series of 26 patients of post traumatic CCF treated by endovascular techniques was carried out at Radiology and Neurosurgery departments of Aga Khan University hospital between January 2010 to March 2010. Medical records and radiology reports were retrospectively reviewed from November 2000 to December 2009. The diagnosis was primarily clinical and was confirmed in all cases by CT or MRI. Endovascular procedures were performed under general anaesthesia through …

My Patient's Brain Mri Has Cerebral Microbleeds--What Does This Finding Mean, Shaista Anwar Siddiqi, Ayeesha Kamran Kamal

Section of Neurology

No abstract provided.

Keeping A High Index Of Suspicion Of Nonketotic Hyperglycinemia In Neonatal Encephalopathy, Shahnaz Ibrahim

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Typical Mri Findings In Parsonage -Turner Syndrome, Dayananda L, Vaghela V, Kesavadas C, K T.R

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Status Epilepticus In Children: An Update, Nida Akhtar, Anwarul Haque, Khalid Ahmed

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Strain-Dependent Variation In The Early Transcriptional Response To Cns Injury Using A Cortical Explant System, David J. Graber, Brent T. Harris, William F. Hickey

Dartmouth Scholarship

While it is clear that inbred strains of mice have variations in immunological responsiveness, the influence of genetic background following tissue damage in the central nervous system is not fully understood. A cortical explant system was employed as a model for injury to determine whether the immediate transcriptional response to tissue resection revealed differences among three mouse strains. Immunological mRNAs were measured in cerebral cortex from SJL/J, C57BL/6J, and BALB/cJ mice using real time RT-PCR. Freshly isolated cortical tissue and cortical sections incubated in explant medium were examined. Levels of mRNA, normalized to β-actin, were compared using one way analysis …

Cranioplasty After Decompressive Craniectomy: An Institutional Audit And Analysis Of Factors Related To Complications, Zain A. Sobani, Muhammad Shahzad Shamim, Syed Nabeel Zafar, Mohsin Qadeer, Najiha Bilal, Syed Ghulam Murtaza, Ather Enam, Muhammad Ehsan Bari

Section of Neurosurgery

Background:Although a relatively simple procedure, cranioplasties have been associated with high complication rates. Keeping this in perspective, we aimed to determine the factors associated with immediate and long-term complications of cranioplasties at our institution.
Methods: A retrospective review of Patient records was carried out for Patients having undergone reconstructive cranioplasties at our institution during the last 10 years (2001-2010). All case notes, records, and investigations were reviewed and the data were recorded in a predesigned questionnaire. Complications were recorded along with existing comorbids and measures taken for their prevention and management. Univariate and multivariate logistic regression analysis was performed …

B-Cell Lymphoma Of The Brainstem With Central Neurogenic Hyperventilation, S. Ather Enam, Rushna Ali

Section of Neurosurgery

Non-Hodgkin's lymphoma of the brainstem is a rare entity. Central Neurogenic Hyperventilation (CNH), an associated manifestation of this disease, is an even rarer event. We report a case of an immunocompetent individual who presented to us with tachypnea and facial nerve palsy. Neuroimaging showed a Cerebellopontine angle tumour which on histopathology showed feature consistent with a Non-Hodgkin's B-Cell Lymphoma. The patient went on to develop severe respiratory alkalosis with findings consistent with CNH. Chemotherapy with Methotrexate was started and high dose Dexamethasone was added to the regimen a month later. Radiologically, the tumour size decreased by 50% but the patient's …

Uncertain Progress On The Fuzzy Boundaries Of Alzheimer's Disease: Reading Between The Guidelines, Peter J. Whitehouse

Faculty Scholarship

No abstract provided.

Treatment Of Cerebrospinal Fluid Leak During Spinal Cord Stimulator Implantation With Epidural Blood Patches, Farid Kia, Md, Linqiu Zhou, Md, Jason Berk, Md

Department of Rehabilitation Medicine Faculty Papers

Conclusion:

Our data is consistent with prior studies in demonstrating that the incidence of dural puncture and CSF leak with SCS procedures is rare. Based on our experiences, performing an epidural blood patch intra-operatively on the contra-lateral side under fluoroscopy could prevent PDPH. This treatment should especially be considered in patients undergoing SCS trials in order to accurately assess the level of pain reduction. Patients with prior spine surgeries might pose higher risks for dural puncture and more extensive pre-operative assessment could be beneficial.

Brain Activation And Connectivity In Non-Disabled Multiple Sclerosis Patients, Rene A. Colorado

Dissertations and Theses (Open Access)

Multiple sclerosis (MS) is the most common demyelinating disease affecting the central nervous system. There is no cure for MS and current therapies have limited efficacy. While the majority of individuals with MS develop significant clinical disability, a subset experiences a disease course with minimal impairment even in the presence of significant apparent tissue damage on magnetic resonance imaging (MRI). The current studies combined functional MRI and diffusion tensor imaging (DTI) to elucidate brain mechanisms associated with lack of clinical disability in patients with MS. Recent evidence has implicated cortical reorganization as a mechanism to limit the clinical manifestation of …

What Is The Role Of B-Vitamins In Stroke Prevention In Pakistan?, Maria Khan, Emmon Raza, Ayeesha Kamran Kamal

Section of Neurology

No abstract provided.

What Is The Role Of B-Vitamins In Stroke Prevention In Pakistan?, Maria Khan, Emmon Raza, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.