Neurology Commons^™

Management Of Arachnoid Cysts: A Comprehensive Review, Fatima Mustansir, Sanaullah Bashir, Aneela Darbar

Section of Neurosurgery

Arachnoid cysts are non-neoplastic, intracranial cerebrospinal fluid (CSF)-filled spaces lined with arachnoid membranes. Large arachnoid cysts are often symptomatic because they compress surrounding structures; therefore, they must be treated surgically. As several surgical management options exist, we explore the best approach according to each major type of arachnoid cyst: middle cranial fossa cyst, suprasellar cyst, intrahemispheric cyst, and quadrigeminal cyst.

Long-Term Visual Outcomes In Optic Nerve Sheath Meningiomas Following Fractionated Stereotactic Radiotherapy, Sana Dastgheyb, Christian Fernandez, Md, Maria Werner-Wasik, Md, Voichita Bar-Ad, Md, David Andrews Md, James Evans, Md, Kevin Judy, Md, Sara Lally, Md, Carol Shields, Md, Arman Mashayekhi, Md, Wenyin Shi, Md, Phd, Christopher Farrell, Md

Sigma Xi Student Research Day

Introduction

Radiation therapy is often used for tumors of the optic nerve. The challenge with irradiating tumors surrounding structures associated with the eye is the risk of exposing the optic nerve, or other structures important to maintaining vision to potentially damaging radiation.

Fractionated stereotactic radiotherapy (FSRT) is commonly used for the treatment of optic nerve sheath meningiomas (ONSMs) for vision preservation. However, long term visual data in the literature is limited. We investigated visual outcomes in 27 patients with ONSMs after FSRT.

Network Specialization During Adolescence: Hippocampal Effective Connectivity In Boys And Girls, Jeffrey D. Riley, E. Elinor Chen, Jessica Winsell, Elyssia Poggi Davis, Laura M. Glynn, Tallie Z. Baram, Curt A. Sandman, Steven L. Small, Ana Solodkin

Psychology Faculty Articles and Research

Adolescence is a complex period of concurrent mental and physical development that facilitates adult functioning at multiple levels. Despite the growing number of neuroimaging studies of cognitive development in adolescence focusing on regional activation patterns, there remains a paucity of information about the functional interactions across these participating regions that are critical for cognitive functioning, including memory. The current study used structural equation modeling (SEM) to determine how interactions among brain regions critical for memory change over the course of adolescence. We obtained functional MRI in 77 individuals aged 8–16 years old, divided into younger (ages 8–10) and older (ages …

Multiple Sclerosis Identification Based On Fractional Fourier Entropy And A Modified Jaya Algorithm, Shui-Hua Wang, Hong Cheng, Preetha Phillips, Yu-Dong Zhang

Publications and Research

Aim: Currently, identifying multiple sclerosis (MS) by human experts may come across the problem of “normal-appearing white matter”, which causes a low sensitivity. Methods: In this study, we presented a computer vision based approached to identify MS in an automatic way. This proposed method first extracted the fractional Fourier entropy map from a specified brain image. Afterwards, it sent the features to a multilayer perceptron trained by a proposed improved parameter-free Jaya algorithm. We used cost-sensitivity learning to handle the imbalanced data problem. Results: The 10 × 10-fold cross validation showed our method yielded a sensitivity of 97.40 ± 0.60%, …

Effects On Recovery And Neuroplasticity In Brain Injury Patients, Rebekkah Mclellan

Student Scholar Showcase

Abstract

According to the Centers for Disease Control, approximately 1.7 million people sustain a Traumatic Brain Injury each year, making the topic of brain plasticity and patient recovery an important area of study. An added element is understanding whether biological, social, and environmental factors can impact the recovery and plasticity of the patient’s brain.The purpose of this literature review was to evaluate if the environment surrounding an individual who has sustained a brain injury affects their recovery and neuroplasticity. The databases used for the scope of this review included LC OneSearch, Medline, EBSCOhost, and Google Scholar. Keywords included brain injury, …

Stochastic Modeling Of Radiation-Induced Dendritic Damage On In Silico Mouse Hippocampal Neurons, Eliedonna Cacao, Vipan K. Parihar, Charles L. Limoli, Francis A. Cucinotta

Health Physics and Diagnostic Sciences Faculty Research

Cognitive dysfunction associated with radiotherapy for cancer treatment has been correlated to several factors, one of which is changes to the dendritic morphology of neuronal cells. Alterations in dendritic geometry and branching patterns are often accompanied by deficits that impact learning and memory. The purpose of this study is to develop a novel predictive model of neuronal dendritic damages caused by exposure to low linear energy transfer (LET) radiation, such as X-rays, gamma-rays and high-energy protons. We established in silico representations of mouse hippocampal dentate granule cell layer (GCL) and CA1 pyramidal neurons, which are frequently examined in radiation-induced cognitive …

Neurotransmitter, Spring 2018, George Washington Institute For Neuroscience Neurological Institute, George Washington University Hospital

Neurotransmitter

No abstract provided.

Resolution Of Gestational Gigantomastia With Termination Of Pregnancy, Syed Sarmad Bukhari, Haris Manan, Mah Muneer Khan, Syed Shahmeer Raza

Section of Neurosurgery

Less than 100 cases of gestational gigantomastia have been described in literature. The aetiology and risk factors are not well-established. Various treatments have been used with some consensus. We present the case of a 47-year-old female who presented to us with bilateral gigantomastia in her 16th week of gestation. She had massively enlarged breasts which were very painful. Relevant laboratory investigations were normal. An incisional biopsy done prior to, and two trucut samples at presentation to us, showed normal breast tissue proliferation. In the absence of adequate pain control, it was decided to electively terminate the pregnancy and give a …

Prognostic Implications Of Histological Clear Cells In High-Grade Intracranial Ependymal Tumors: A Retrospective Analysis From A Tertiary Care Hospital In Pakistan, Fauzan Alam Hashmi, Hamid Hussain Rai, Muhammad Faheem Khan, Muhammad Ehsan Bari

Section of Neurosurgery

Background: Clear cell variant in ependymal tumors is rare. We aimed to compare the features and outcome of the World Health Organization (WHO) Grade 3 ependymal tumors with clear cells to the WHO Grade 3 classic anaplastic ependymoma (AE).
Materials and methods: A retrospective cohort study conducted at the Department of Neurosurgery, Aga Khan University, Pakistan, from 2003 to 2013. The medical records and radiology of patients with proven histopathology were reviewed. The analysis was done on SPSS 20.
Results: Nine cases of clear cell variant and 23 cases of classic AE were found, both of which combined equated to …

Depression In Adult Patients With Primary Brain Tumours: A Review Of Independent Risk Factors, Anum Sadruddin Pidani, Aaida Mumtaz Rao, Muhammad Shahzad Shamim

Section of Neurosurgery

Depression is considered an under-diagnosed problem, especially in patients with malignancies. Patients with brain tumours in particular, have a relatively higher risk of developing depression, which is multifactorial. Herein, the authors review the recent literature on the prevalence of depression in patients with brain tumours, and explore the various risk factors involved.

Clinical Outcomes Of Endovascular Thrombectomy In Tissue Plasminogen Activator Versus Non-Tissue Plasminogen Activator Patients At Primary Stroke Care Centers., Gregory Imbarrato, Joshua Bentley, Ajeet Gordhan

Articles, Abstracts, and Reports

Background: The effect of intravenous tissue plasminogen activator (IV tPA) administration before endovascular intervention as compared to without at thrombectomy-capable low-volume centers on procedural aspects and patient outcomes has not been investigated.

Methods: Retrospective chart review was performed in all consecutive large vessel cerebrovascular accident patients treated with endovascular therapy at two select rural primary stroke centers between 2011 and 2015. Patients' data regarding age, sex, and medical history, as well as thrombus location by catheter-based cerebral angiography, postprocedural reperfusion status, and clinical outcomes were reviewed. The primary outcome measure of the study was a comparison of modified Rankin scale …

Blood Transfusion And Postoperative Infection In Spine Surgery: A Systematic Review., Christian Fisahn, Cameron Schmidt, Josh E Schroeder, Emiliano Vialle, Isador H Lieberman, Joseph R Dettori, Thomas A Schildhauer

Articles, Abstracts, and Reports

Study Design: Systematic review.

Objectives: Allogeneic blood transfusion-related immunomodulation may relatively suppress the immune system, heightening the risk of infection following spine surgery. This systematic review seeks to determine whether allogeneic blood transfusion increases the risk of postoperative infection and whether there are any factors that modify this association.

Methods: PubMed, Cochrane Central Register of Controlled Trials, and reference lists from included studies were searched from inception to April 20, 2017 to identify studies examining the risk of infection following allogeneic blood transfusion in adult patients receiving surgery for degenerative spine disease.

Results: Eleven retrospective cohort or case-control studies, involving …

Modafinil For The Improvement Of Patient Outcomes Following Traumatic Brain Injury, Amne Borghol, Michael Aucoin, Ifeanyi Onor, Dana Jamero, Fadi Hawawini

Faculty and Staff Publications

Objective.  The authors sought to assess the literature evidence on the efficacy of modafinil use in patients with fatigue or excessive daytime sleepiness (EDS) secondary to traumatic brain injury (TBI).Method of Research. A literature search of Medline and PubMed was performed using the EBSCOhost database. Primary literature, observational studies, meta-analyses, case reports, and systematic reviews were assessed for content regarding modafinil and psychostimulant use in patients with TBI. Of the 23 articles collected, three randomized, controlled studies, three observational studies, one case report, and two systematic reviews gave a description of modafinil use in TBI patients.Results and Conclusion. Modafinil is …

The Dynamics Of Concussion: Mapping Pathophysiology, Persistence, And Recovery With Causal-Loop Diagramming, Erin S. Kenzie, Elle L. Parks, Erin D. Bigler, David W, Wright, Miranda M. Lim, James C. Chesnutt, Gregory W.J. Hawryluk, Wayne Gordon, Wayne Wakeland

Complex Systems Faculty Publications and Presentations

Concussion, also known as mild traumatic brain injury (mTBI),1 is a significant public health issue responsible for a variety of cognitive, emotional, and somatic symptoms and deficits (3). It is unclear why some individuals appear to recover relatively quickly while others suffer prolonged symptoms and impairments (4–7). Robust clinical means of diagnosis, prognosis, and treatment are also lacking (8–11). Research is hindered by an inadequate classification system for traumatic brain injury (TBI) (12), “poor” study quality (13, 14), disagreement about appropriate inclusion and exclusion criteria for concussion (8, 15), and an incomplete understanding of underlying pathophysiology (16–18). The heterogeneity and …

The Famous Names Discrimination Task As A Biomarker Of Alzheimer's Disease Risk: An Erp Study, Elizabeth Rose Paitel

Master's Theses (2009 -)

Current ERP research emphasizes age- and pathology-related declines in neural processing in the form of attenuated amplitudes and prolonged latencies. Notably, there is a gap in the ERP literature regarding neural processing trajectories in the time between healthy young adulthood and clinical MCI/AD samples. fMRI research, however, has demonstrated periods of increased, compensatory activation in healthy, cognitively intact APOE ɛ4 carriers both during resting state and event-related tasks (Bondi, Houston, Eyler, & Brown, 2005; Evans et al., 2014; Filippini et al., 2009; Rao et al., 2015), consistent with compensatory theories of cognitive aging (Cabeza, 2002; Park & Reuter-Lorenz, 2009; Reuter-Lorenz …

Addressing The Targeting Range Of The Abilhand-56 In Relapsing-Remitting Multiple Sclerosis: A Mixed Methods Psychometric Study., Sophie Cleanthous, Sara Strzok, Farrah Pompilus, Stefan Cano, Patrick Marquis, Stanley Cohan, Myla D Goldman, Kiren Kresa-Reahl, Jennifer Petrillo, Carmen Castrillo-Viguera, Diego Cadavid, Shih-Yin Chen

Articles, Abstracts, and Reports

Background: ABILHAND, a manual ability patient-reported outcome instrument originally developed for stroke patients, has been used in multiple sclerosis clinical trials; however, psychometric analyses indicated the measure's limited measurement range and precision in higher-functioning multiple sclerosis patients.

Objective: The purpose of this study was to identify candidate items to expand the measurement range of the ABILHAND-56, thus improving its ability to detect differences in manual ability in higher-functioning multiple sclerosis patients.

Methods: A step-wise mixed methods design strategy was used, comprising two waves of patient interviews, a combination of qualitative (concept elicitation and cognitive debriefing) and quantitative (Rasch measurement theory) …

Development Of A Gait Module To Complement The 12-Item Multiple Sclerosis Walking Scale: A Mixed Methods Study., Sara Strzok, Sophie Cleanthous, Farrah Pompilus, Stefan J Cano, Patrick Marquis, Stanley Cohan, Myla D Goldman, Kiren Kresa-Reahl, Jennifer Petrillo, Carmen Castrillo-Viguera, Diego Cadavid, Shih-Yin Chen

Articles, Abstracts, and Reports

Background and objective: The 12-item Multiple Sclerosis Walking Scale (MSWS-12) is a patient-reported outcome instrument that quantifies the progressive loss of walking ability from the patient perspective. However, previous psychometric analyses indicated floor and ceiling effects across the multiple sclerosis severity spectrum. This study aimed to address floor effects by creating a gait module that can be used in conjunction with the MSWS-12 for better measurement of treatment benefit in the higher functioning multiple sclerosis population.

Methods: We used a step-wise mixed methods study design, with relapsing-remitting multiple sclerosis patients (wave 1,

Results: Thirty-seven walking ability concepts were identified, and …

Short Term Development And Fate Of Mge-Like Neural Progenitor Cells In Jaundiced And Non-Jaundiced Rat Brain., Fu-Chen Yang, Julia Draper, Peter G Smith, Jay L. Vivian, Steven Shapiro, John A. Stanford

Manuscripts, Articles, Book Chapters and Other Papers

Neonatal hyperbilirubinemia targets specific brain regions and can lead to kernicterus. One of the most debilitating symptoms of kernicterus is dystonia, which results from bilirubin toxicity to the globus pallidus (GP). Stem cell transplantation into the GP to replace lost neurons and restore basal ganglia circuits function is a potential therapeutic strategy to treat dystonia in kernicterus. In this study we transplanted human medial ganglionic eminence (MGE)-like neural progenitor cells (NPCs) that we differentiated into a primarily gamma-aminobutyric acid (GABA)ergic phenotype, into the GP of non-immunosuppressed jaundiced (jj) and non-jaundiced (Nj) rats. We assessed the survival and development of graft …

The Role Of Reactive Astrocitose In The Chronological Evolution Of Traumatic Brain Injury, Roxana M. Duncea-Borca, Vladimir Belis, Mihnea Costescu, Relu G. Calota, Reka Kutasi, Cosmin A. Moldovan

Journal of Mind and Medical Sciences

Introduction and objectives. This study aims to investigate whether the cerebral modifications of posttraumatic reactive astrocitose can be considered an objective criterion for determining the age of traumatic cranio-cerebral lesions.

Materials and methods. The present study consists of a series of 23 medico-legal cases that underwent autopsy inTeleormanCounty(Romania) Department of Forensic Medicine during 2007–2016, with full immune-histochemical microscopic examination using GFAP staining. The study consists of two groups, a series of 13 cases with cranio-cerebral trauma with different posttraumatic survival periods and 9 cases as a control group.

Results and discussions. We discovered GFAP+ reactive astrocytes even when death occurred …

Emergency Surgery On Mentally Impaired Patients: Standard In Consenting, Mihai Paduraru, Ahmed Saad, Krystian Pawelec

Journal of Mind and Medical Sciences

Emergency surgery is often performed on the elderly and susceptible patients with significant comorbidities; as a consequence, the risk of death or severe complications are high. Consent for surgery is a fundamental part of medical practice, in line with legal obligations and ethical principles. Obtaining consent for emergency services (for surgical patients with chronic or acute mental incapacity, due to surgical pathology) is particularly challenging, and meeting the standards requires an up-to-date understanding of legislation, professional body guidelines, and ethical or cultural aspects. The guidance related to consent requires physicians and other medical staff to work with patients according to …