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Capturing multidimensionality in stroke aphasia: mapping principal behavioural components to neural structures
We present a novel approach to separating the principal aspects of chronic aphasic performance and isolating their neural bases. Principal components analysis was used to extract core factors underlying performance of 31 participants with chronic stroke aphasia on a large, detailed battery of behavioural assessments. The rotated principle components analysis revealed three key factors, which we labelled as phonology, semantic and executive/cognition on the basis of the common elements in the tests that loaded most strongly on each component. The phonology factor explained the most variance, followed by the semantic factor ...
Source: Brain - November 19, 2014 Category: Neurology Authors: Butler, R. A., Lambon Ralph, M. A., Woollams, A. M. Tags: Original Articles Source Type: research

Successful endovascular repair of an unusual right-to-left shunt presenting with cerebral ischemia
We report a 54-year-old man with a stroke due to a unique right-to-left shunt who underwent successful endovascular treatment. This patient developed acute onset of right arm weakness with facial droop and aphasia which improved after intravenous thrombolysis. An MRI showed acute cerebral ischemia in the left middle cerebral artery and left posterior cerebral artery distribution. The patient developed recurrent stroke symptoms during agitated saline injection while undergoing a transthoracic echocardiogram which showed right-to-left shunting. Chest CT scan and conventional angiography revealed near occlusion of the superio...
Source: Journal of Clinical Neuroscience - November 3, 2014 Category: Neuroscience Source Type: research

Multiple cerebral aneurysms after myxomatous stroke
A 14-year-old girl presented with transient fever and painful rash on the distal extremities. Two months later, she had a syncopal episode after swimming in a pool. She also had a transient left hemiparesis with expressive aphasia. The findings of a head CT scan were negative. An MRI of the brain demonstrated scattered restricted diffusion, consistent with acute arterial infarction (figure 1A). An echocardiogram demonstrated a large mobile intracardiac mass measuring 4 cm in diameter (figure 1B). She underwent emergency surgical resection of the tumour, the pathology of which was consistent with cardiac myxoma. Seven ...
Source: Archives of Disease in Childhood - August 17, 2014 Category: Pediatrics Authors: Takenouchi, T., Sasaki, A., Takahashi, T. Tags: Miscellanea Source Type: research

Multiple variant type thalamic infarcts: pure and combined types
ConclusionsWe described multiple variant topographic patterns of thalamic infarction with distinct manifestations and etiologies. We thought that multiple variant infarcts are the result of variation in thalamic arterial supply or reflect a source of embolism.
Source: Acta Neurologica Scandinavica - August 1, 2014 Category: Neurology Authors: E. Kumral, E. E. Deveci, A. Y. Çolak, A. D. Çağında, C. Erdoğan Tags: Original Article Source Type: research

Intensive therapy induces contralateral white matter changes in chronic stroke patients with Broca's aphasia.
Abstract Using a pre-post design, eleven chronic stroke patients with large left hemisphere lesions and nonfluent aphasia underwent diffusion tensor imaging and language testing before and after receiving 15weeks of an intensive intonation-based speech therapy. This treated patient group was compared to an untreated patient group (n=9) scanned twice over a similar time period. Our results showed that the treated group, but not the untreated group, had reductions in fractional anisotropy in the white matter underlying the right inferior frontal gyrus (IFG, pars opercularis and pars triangularis), the right posterio...
Source: Brain and Language - July 17, 2014 Category: Neurology Authors: Wan CY, Zheng X, Marchina S, Norton A, Schlaug G Tags: Brain Lang Source Type: research

Anatomical predictors of aphasia recovery: a tractography study of bilateral perisylvian language networks
Stroke-induced aphasia is associated with adverse effects on quality of life and the ability to return to work. For patients and clinicians the possibility of relying on valid predictors of recovery is an important asset in the clinical management of stroke-related impairment. Age, level of education, type and severity of initial symptoms are established predictors of recovery. However, anatomical predictors are still poorly understood. In this prospective longitudinal study, we intended to assess anatomical predictors of recovery derived from diffusion tractography of the perisylvian language networks. Our study focused o...
Source: Brain - June 20, 2014 Category: Neurology Authors: Forkel, S. J., Thiebaut de Schotten, M., Dell'Acqua, F., Kalra, L., Murphy, D. G. M., Williams, S. C. R., Catani, M. Tags: Original Articles Source Type: research

Vessel perforation during withdrawal of Trevo ProVue stent retriever during mechanical thrombectomy for acute ischemic stroke.
Abstract The authors report a case of an intracranial extravasation during the withdrawal of a Trevo ProVue stent retriever device in a patient being treated for acute ischemic stroke. An 82-year-old woman developed sudden left hemiparesis and aphasia during an urgent cardiac catheterization procedure for a non-ST elevation myocardial infarction. She had a baseline National Institutes of Health Stroke Scale (NIHSS) score of at least 10 and no improvement with intravenous administration of tissue plasminogen activator (tPA). Cerebral angiography was performed with conscious sedation, confirming an occlusion of the ...
Source: Journal of Neurosurgery - June 13, 2014 Category: Neurosurgery Authors: Leishangthem L, Satti SR Tags: J Neurosurg Source Type: research

Stroke Mortality And Its Predictors In Nigeria: Results Of A Hospital-Based Study (I10-1.008)
Conclusion: The 30-day case fatality rate among our stroke patients is high while the independent predictors of this outcome are severity of stroke on admission and presence of complications. Continuing health education of the public on stroke recognition and the need for early hospital presentation is necessary while optimal management of cases in a stroke care unit is advocated in order to improve outcome.Disclosure: Dr. Wahab has nothing to disclose. Dr. Sanya has nothing to disclose. Dr. Ademiluyi has nothing to disclose. Dr. Abiodun has nothing to disclose. Dr. Alaofin has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Wahab, K., Sanya, E., Ademiluyi, B., Abiodun, B., Alaofin, W. Tags: The Global Burden of Neurological Diseases Poster Presentations Source Type: research

Intravenous Thrombolysis Resulting In Acute Ischemic Stroke Recanalization Can Lead To Cerebral Hyperperfusion Syndrome (P7.123)
Conclusion- Cerebral hyperperfusion syndrome after intravenous thrombolysis in acute ischemic stroke should be suspected in patients that achieve arterial recanalization and develop unexplained new neuropsychiatric manifestations.Disclosure: Dr. Ong has nothing to disclose. Dr. Yeo has nothing to disclose. Dr. Ting has nothing to disclose. Dr. Sinha has nothing to disclose. Dr. Teoh has nothing to disclose. Dr. Chan has nothing to disclose. Dr. Seet has nothing to disclose. Dr. Sharma has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Ong, J., Yeo, L., Ting, E., Sinha, A., Teoh, H. L., Chan, B., Seet, C. S., Sharma, V. Tags: Cerebrovascular Disease and Interventional Neurology: Issues in Acute Stroke Treatment Source Type: research

Stroke Mortality And Its Predictors In Nigeria: Results Of A Hospital-Based Study (P2.120)
Conclusion: The 30-day case fatality rate among our stroke patients is high while the independent predictors of this outcome are severity of stroke on admission and presence of complications. Continuing health education of the public on stroke recognition and the need for early hospital presentation is necessary while optimal management of cases in a stroke care unit is advocated in order to improve outcome.Disclosure: Dr. Wahab has nothing to disclose. Dr. Sanya has nothing to disclose. Dr. Ademiluyi has nothing to disclose. Dr. Abiodun has nothing to disclose. Dr. Alaofin has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Wahab, K., Sanya, E., Ademiluyi, B., Abiodun, B., Alaofin, W. Tags: Cerebrovascular Disease and Interventional Neurology: Behavioral, Cognitive, and Miscellaneous Source Type: research

Intracerebral Hemorrhage Associated with Oral Phenylephrine Use (P5.138)
CONCLUSION: It is scientifically plausible that Phe may cause strokes given that it is consistent with the pharmacological properties and adverse event profiles of similar amphetamine-like sympathomimetics. As RCVS has been well-described in association with over the counter sympathomimetics, these lines of evidence support a likely, although not definitive, causal relationship between Phe and ICH.Disclosure: Dr. Tark has nothing to disclose. Dr. Messe has received personal compensation for activities with GlaxoSmithKline, Inc. Dr. Messe has received research support from WL Gore, and GlaxoSmithKline, Inc. Dr. Balucani has...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Tark, B., Messe, S., Balucani, C., Levine, S. Tags: Cerebrovascular Disease and Interventional Neurology: Intracerebral Hemorrhage and Other Hemorrhages Source Type: research

Assessing the Clinical Effect of Residual Cortical Disconnection After Ischemic Strokes Clinical Sciences
Conclusions— We suggest that cortical disconnection, as measured by the structural connectome, is an independent predictor of naming impairment in patients with chronic aphasia. The full extent of clinically relevant brain damage after an ischemic stroke may be underappreciated by visual inspection of cortical necrosis alone.
Source: Stroke - March 24, 2014 Category: Neurology Authors: Bonilha, L., Rorden, C., Fridriksson, J. Tags: Exercise/exercise testing/rehabilitation, Other imaging Clinical Sciences Source Type: research

Cognitive control and its impact on recovery from aphasic stroke
Aphasic deficits are usually only interpreted in terms of domain-specific language processes. However, effective human communication and tests that probe this complex cognitive skill are also dependent on domain-general processes. In the clinical context, it is a pragmatic observation that impaired attention and executive functions interfere with the rehabilitation of aphasia. One system that is important in cognitive control is the salience network, which includes dorsal anterior cingulate cortex and adjacent cortex in the superior frontal gyrus (midline frontal cortex). This functional imaging study assessed domain-gener...
Source: Brain - January 13, 2014 Category: Neurology Authors: Brownsett, S. L. E., Warren, J. E., Geranmayeh, F., Woodhead, Z., Leech, R., Wise, R. J. S. Tags: Original Articles Source Type: research

Diffusion mr correlates of motor function recovery after stroke: a systematic review
Conclusions FA is the most commonly measured metric but there was considerable heterogeneity in study design and analysis. Most studies were cross–sectional, confined to sub–cortical, ischaemic strokes at late stages, and involved younger patients than typical of the stroke population. Further evaluation of the utility of DTI as a biomarker for use in stroke recovery trials is needed.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Kalladka, D., Muir, K. Tags: Stroke, Radiology, Radiology (diagnostics) Association of British Neurologists (ABN) joint meeting with the Royal College of Physicians (RCP), London, 23-24 October 2013 Source Type: research

Reversible leukoencephalopathy as a presentation of cerebral amyloid angiopathy
A 73 year old man with a past medical history of hypertension, osteoathritis and asthma presented to the local district general hospital with recurrent episodes of spontaneously resolving encephalopathy. The initial presentation was characterised by acute confusion and visual hallucinations followed by a generalised tonic–clonic seizure. On examination his blood pressure was 215/115 mmHg. Neurological examination did not reveal any lateralising signs but the patient was found to be encephalopathic with a Montreal Cognitive Assessment (MOCA) score of 9/30. Routine blood tests were unremarkable. A CT brain scan showed ...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Lilleker, J., Vassallo, J., Punter, M. Tags: Genetics, Immunology (including allergy), Epilepsy and seizures, Stroke, Hypertension, Drugs: psychiatry, Radiology, Surgical diagnostic tests Association of British Neurologists (ABN) joint meeting with the Royal College of Physicians (RCP), London, 23 Source Type: research

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