Neurology Commons^™

Diagnostic Value Of Electroencephalography With Ten Electrodes In Critically Ill Patients, M. B. Westover, K. Gururangan, M. S. Markert, B. N. Blond, S. Lai, S. Benard, S. Bickel, L. J. Hirsch, J. Parvizi

Journal Articles

No abstract provided.

Neurological Manifestations Of Covid-19 (Sars-Cov-2): A Review, Mu Ahmed, M Hanif, Mj Ali, Ma Haider, D Kherani, Gm Memon, Ah Karim, A Sattar

Journal Articles

No abstract provided.

Acute Seizures Occurring In Association With Sars-Cov-2, S. T. Hwang, A. A. Ballout, U. Mirza, A. N. Sonti, A. Husain, C. Kirsch, R. Kuzniecky, S. Najjar

Journal Articles

© Copyright © 2020 Hwang, Ballout, Mirza, Sonti, Husain, Kirsch, Kuzniecky and Najjar. Seizures are an infrequent and serious neurological complication of SARS-CoV-2 infection, with limited data describing the etiology and the clinical context in which these occur or the associated electrographic and imaging findings. This series details four cases of seizures occurring in patients with COVID-19 with distinct time points, underlying pathology, and proposed physiological mechanisms. An enhanced understanding of seizure manifestations in COVID-19 and their clinical course may allow for earlier detection and improved patient management.

Deep Brain Stimulation For Refractory Obsessive-Compulsive Disorder (Ocd): Emerging Or Established Therapy?, H. Wu, M. Hariz, V. Visser-Vandewalle, L. Zrinzo, V. A. Coenen, S. A. Sheth, C. Bervoets, M. Naesstrom, M. Schulder, B. Nuttin, +45 Additional Authors

Journal Articles

No abstract provided.

Fusiform Superior Cerebellar Artery Aneurysm Treated With Flow Diversion: A Case Report, Y. Serulle, D. Khatri, J. Fletcher, A. Pappas, A. Heidbreder, D. Langer, R. A. Ortiz

Journal Articles

© 2020 Published by Scientific Scholar on behalf of Surgical Neurology International. Background: Fusiform aneurysms of the distal superior cerebellar artery are rare and challenging to treat. Due to the rarity of these lesions, there is little consensus regarding their management. Treatment options have traditionally included parent artery sacrifice with either an endovascular approach or microsurgical clipping. Given the small diameter of the superior cerebellar artery, flow diversion has not been typically considered as a viable treatment option for these aneurysms. Case Description: A 67-year-old female presented complaining of severe sudden onset headache. Noncontrast head CT demonstrated no intracranial hemorrhage. …

Tdp-43 Is Elevated In Plasma Neuronal-Derived Exosomes Of Patients With Alzheimer’S Disease, N. Zhang, D. Gu, M. Meng, M. L. Gordon

Journal Articles

© Copyright © 2020 Zhang, Gu, Meng and Gordon. Background: Recently, TDP-43 has been recognized as a common proteinopathy in the “oldest old” and a neuropathological comorbidity in patients with Alzheimer’s disease (AD). However, since it has a low concentration in cerebrospinal fluid, the presence of TDP-43 in AD is rarely investigated in vivo. Methods: Twenty-four patients with amyloid PET confirmed AD and 15 healthy controls (HCs) were included in this study. TDP-43 level in plasma neuronal-derived exosomes (NDEs) was measured by enzyme-linked immunosorbent assay. Results: TDP-43 level was elevated in patients with AD compared with HCs (median 1.08 ng/ml, …

Simulation Of Status Epilepticus Is Effective Teaching For Junior Neurology Residents, Pankhuri Jha, Navya George, Jeffrey Ratliff

Phase 1

Purpose: Status Epilepticus (SE) represents a potentially fatal neurologic emergency. At Jefferson, acute management of SE falls to the inpatient neurologist, requiring early competency.

Methods: During a 2 week educational “bootcamp”, 9 PGY2 residents participated in a 2 hour simulation of acute SE with two clinical scenarios. Scenarios included a patient with SE requiring adequate benzodiazepine dosing and another with seizures requiring IV anticonvulsant therapy. Prior to and following the simulation, residents took a survey to gauge their knowledge and confidence in managing SE.

Results and Conclusions: There was an increase in the number of residents expressing confidence in their …

Machine Learning Prediction Of Glioblastoma Patient One-Year Survival, Andrew Du '20, Warren Mcgee, Jane Y. Wu

Student Publications & Research

Glioblastoma (GBM) is a grade IV astrocytoma formed primarily from cancerous astrocytes and sustained by intense angiogenesis. GBM often causes non-specific symptoms, creating difficulty for diagnosis. This study aimed to utilize machine learning techniques to provide an accurate one-year survival prognosis for GBM patients using clinical and genomic data from the Chinese Glioma Genome Atlas. Logistic regression (LR), support vector machines (SVM), random forest (RF), and ensemble models were used to identify and select predictors for GBM survival and to classify patients into those with an overall survival (OS) of less than one year and one year or greater. With …

Investigating Aggression In Huntington Disease, Chloe E. Larochelle

Honors Undergraduate Theses

Huntington Disease (HD) is a neurodegenerative disorder that is caused by a CAG trinucleotide repeat expansion in the huntingtin gene. The onset of the disease is defined by the presence of motor deficits, such as chorea. However, cognitive and psychiatric symptoms often develop before motor onset and typically have a larger impact on patient quality of life. Psychiatric symptoms include depression, anxiety, and OCD, but also aggression and irritability, which have been comparatively understudied due to stigma. Currently, treatments to modify these behaviors in premanifest HD patients are not consistently effective and often have side effects, creating a need for …

First Pass Effect In Patients Treated With The Trevo Stent-Retriever: A Track Registry Study Analysis., Maxim Mokin, Christopher T Primiani, Alicia C Castonguay, Raul G Nogueira, Diogo C Haussen, Joey D English, Sudhakar R Satti, Jennifer Chen, Hamed Farid, Candace Borders, Erol Veznedaroglu, Mandy J Binning, Ajit Puri, Nirav A Vora, Ron F Budzik, Guilherme Dabus, Italo Linfante, Vallabh Janardhan, Amer Alshekhlee, Michael G Abraham, Randall Edgell, Muhammad Asif Taqi, Ramy El Khoury, Aniel Q Majjhoo, Mouhammed R Kabbani, Michael T Froehler, Ira Finch, Sameer A Ansari, Roberta Novakovic, Thanh N Nguyen, Osama O Zaidat

Articles, Abstracts, and Reports

Background and Objective: The first pass effect (FPE; achieving complete recanalization with a single thrombectomy device pass) has been shown to be associated with higher rates of good clinical outcomes in patients with acute ischemic stroke. Here, we investigate clinical and radiographic factors associated with FPE in a large U.S. post-marketing registry (TRACK, Trevo Stent-Retriever Acute Stroke). Methods: We analyzed the TRACK database (multicenter registry of 634 patients from 23 centers from March 2013 through August 2015), which 609 patients were included in the final analysis. FPE was defined as a single pass/use of device, TICI 2c/3 recanalization, and no …

Neuromodulation Of Spinal Pathways Involved In Chronic Pain: Implications For Motor Rehabilitation, Taylor Ray Mayberry

MUSC Theses and Dissertations

No abstract provided.

Middle Fossa Extension Of Posterior Fossa Meningiomas Is Associated With Poorer Clinical Outcomes, David Morgan, Donald Y. Ye, Md, Michael P. Baldassari, Omaditya Khanna, Md, Aria Mahtabfar, Md, Tyler Henry, Haley Wendt, David W. Andrews, Md, Christopher J. Farrell, Md, James J. Evans, Md, Kevin D. Judy, Md

Phase 1

Introduction: Progression of posterior fossa meningiomas (PFMs) can lead to extension into the middle cranial fossa. Pre-operative imaging allows for quantification of middle fossa extension (MFE). We aimed to determine the clinical impact of MFE on surgical and clinical outcomes during resection of PFMs.

Methods: Craniotomies for meningiomas performed at a large single center academic institution from January 2012 to December 2018 were identified. Preoperative MRI and CT imaging was reviewed to determine the presence of MFE of posterior fossa meningiomas and correlated to post-operative outcomes.

Results: 65 PFMs were identified and mean follow-up was 28.8 ± 20.1 months. 13/65 …

Measuring The Efficacy Of Medical Management Versus Decompressive Hemicraniectomy In Acute Stroke, Colton Hemphill, Franziska Herpich, Muhammad Athar, Eunice Lee

Phase 1

Introduction: Stroke is a life-threatening condition requiring immediate treatment in order to optimize patient survival and functionality post-hospitalization. At present, the primary treatment modalities used are intensive medical management and surgical decompressive hemicraniectomy. We believe that application of skilled medical management can result in a lower mortality rate and higher functional score at 12 months than aggressive surgical decompressive hemicraniectomy.

Methods: Epic data from Thomas Jefferson University will be used to identify patients with a large stroke (as defined by ischemic area on MRI) managed by the neurology department from 2016 to 2019. A survey will be administered by phone …

Improving The Accuracy Of Dat Scan Interpretation: A Retrospective Study To Identify Variables That Standardize The Review Of Dat Scans For Idiopathic Parkinson’S Disease, Hannah Hackbart, Andrew B. Newberg, Md, Tsao-Wei Liang, Md

Phase 1

Introduction: Until recently, the diagnosis of Parkinson’s disease (PD) has been based solely on clinical observation. The DaT scan is a tool that allows clinicians to visualize areas of neurodegeneration in PD and can help guide diagnosis. However, there is a discordance between clinical judgement and interpretation of DaT scans. In this study, we aim to improve the utility of DaT scans in the diagnosis of PD by identifying factors that can lead to a misdiagnosis and determine which image findings predict a clinical syndrome of parkinsonism.

Methods: We will conduct a retrospective chart review to analyze DaT scans of …

Structural Brain Plasticity In Epilepsy Patients Selected For Laser Interstitial Thermal Therapy: A Study Of Diffusion Tensor Imaging Based Assessment Of Tract Alterations, Umma Fatema, Mahdi Alizadeh

Phase 1

Introduction: The standard of care for drug resistant temporal lobe epilepsy (TLE) involve surgical approaches including anterior temporal lobectomy (ATL) and laser interstitial thermal therapy (LiTT). White matter alterations following ATL are often studied using diffusion tensor imaging (DTI) which utilizes properties of water diffusion to obtain parameters (such as fractional anisotropy or FA) that can be used to detect neural plasticity. Despite being a common procedure, there are very few studies that explore post-surgical neural changes after LiTT. The objective of this study is to evaluate and explore the DTI parameter changes in patients who underwent LiTT.

Methods: DTI …

Falls And Traumatic Brain Injury In The Elderly On Aspirin Or Anticoagulant Therapy, Jonathan Bassig, David Nauheim, Stanton Miller, Patricia Williams, Tingting Zhan

Phase 1

Introduction: Traumatic brain injury (TBI) after a fall in individuals aged 65 and older is a leading cause of morbidity and mortality, but the effect of aspirin and anticoagulant therapy on TBI severity is not fully understood. This study evaluated whether the severity of TBI is associated with use of aspirin or anticoagulant therapy or in combination.

Methods: Using retrospective chart review, we identified patients age 65 or older who fell and sustained head trauma that were admitted to Thomas Jefferson University Hospital trauma service from 2017-2018. Based on final diagnosis, patients were classified into three groups of TBI …

Simulating Status Epilepticus Management For Junior Neurology Trainees, Navya George, Pankhuri Jha, Frank Anzelmi, Md, Allyson Pickard, Md, Jeffrey Ratliff, Md

Phase 1

Purpose/Methods: Status Epilepticus (SE) represents a potentially fatal neurologic emergency. We aimed to create an educational simulation of SE for 9 PGY2 neurology residents. Scenarios included a patient with SE requiring adequate benzodiazepine dosing and another with seizures requiring IV anticonvulsant therapy. Subjects were dichotomized to groups who did and did not feel confident in clinical skills around SE. Knowledge was assessed with a multiple choice quiz. Confidence groups were analyzed with Fisher’s exact test. Quiz scores means were assessed with paired t-test.

Results: There was a trend towards significance in the proportion of residents expressing confidence in their ability …

Polio To The Rescue; New Frontiers In Glioblastoma Treatment, Syed Sarmad Bukhari, Aneela Darbar, Muhammad Shahzad Shamim

Section of Neurosurgery

Lack of substantial progress in effective treatment of glioblastomamultiforme has led investigators to explore unconventional treatment options including the use of tumour treating fields and oncolyticvirotherapy. Herein the authors have reviewed some of the recent literature on oncolyticvirotherapy for the treatment of glioblastomamultiforme.

Experience Of Play Participation And Use Of Lower Extremity Orthoses In Children With Cerebral Palsy: Case Study, Lakyn Elizabeth Jolly-Burchell

Online Theses and Dissertations

This case study sought to understand the experience of a single family of a child with cerebral palsy (CP) using lower extremity orthoses (LEOs) in natural play contexts. CP is the most commonly occurring motor disability in childhood. Associated with CP, impairments in functional mobility, spasticity, varying degrees of muscle tone, ROM, and impaired gross and fine motor control are barriers to meaningful play experiences in this population. LEOs are widely prescribed devices for children with CP, used as walking aids and to improve/offset some of these performance deficits and body structures. Although, the true efficacy of LEOs is yet …

Triggering Receptor Expressed On Myeloid Cell 2 R47h Exacerbates Immune Response In Alzheimer's Disease Brain., Olena Korvatska, Kostantin Kiianitsa, Alexander Ratushny, Mark Matsushita, Neal Beeman, Wei-Ming Chien, Jun-Ichi Satoh, Michael O Dorschner, C Dirk Keene, Theo K Bammler, Thomas D Bird, Wendy H Raskind

Articles, Abstracts, and Reports

The R47H variant in the microglial triggering receptor expressed on myeloid cell 2 (TREM2) receptor is a strong risk factor for Alzheimer's disease (AD). To characterize processes affected by R47H, we performed an integrative network analysis of genes expressed in brains of AD patients with R47H, sporadic AD without the variant, and patients with polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy (PLOSL), systemic disease with early-onset dementia caused by loss-of-function mutations in TREM2 or its adaptor TYRO protein tyrosine kinase-binding protein (TYROBP). Although sporadic AD had few perturbed microglial and immune genes, TREM2 R47H AD demonstrated upregulation of interferon type I …