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A Prospective, Randomized, Blinded Assessment of Multitarget Thalamic and Pallidal Deep Brain Stimulation in a case of Hemidystonia
Objective Dystonia is increasingly being interpreted as a multi-nodal “network” disorder. We aimed to investigate multitarget DBS (pallidal and thalamic) versus each target alone in a prospective, randomized, blinded trial in a case of hemidystonia secondary to putaminal stroke.Methods DBS leads were implanted in the GPi and Vim/Vop and each stimulation combination (GPi, Vim/Vop, and both) was tested for three months in a single patient. Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) and Short-Form 36 (SF-36) were completed at the end of each trial period.
Source: Clinical Neurology and Neurosurgery - July 28, 2015 Category: Neurosurgery Authors: Philipp J Slotty, Anujan Poologaindran, Christopher R Honey Source Type: research

Association between renal dysfunction and 3-year mortality in patients with acute first-ever ischemic stroke
Stroke is a continuously evolving medical problem, being the third leading cause of death in Taiwan [1,2]. Chronic kidney disease (CKD) is a worldwide public health concern; its prevalence and incidence in Taiwan is among the highest worldwide [3–5]. Patients with CKD have a higher prevalence of cardiovascular and cerebrovascular diseases [6–9]. Recent studies suggested that CKD is associated with increased risk of incident stroke among patients with pre-existing atherothrombotic disease [10–12].
Source: Clinical Neurology and Neurosurgery - June 17, 2015 Category: Neurosurgery Authors: Shun-Wen Lin, Wei-Chieh Weng, Yu-Hua Huang, Feng-Chieh Su, Tsung-I. Peng, Yu-Yi Chien, Chia-Lun Wu, Kuang-Yung Lee, Yi-Jing Yu, Jun-Xiao Zhu, Wen-Yi Huang Source Type: research

Aspirin Response Test role in platelet transfusion following intracerebral hemorrhage
Intracerebral hemorrhage (ICH) comprises 4–15% of acute stroke cases and is the most fatal form of all stroke subtypes [1], with mortality at least 40% after 1 month [2]. Volume and growth of hemorrhage were shown to be strong predictors of mortality and functional outcome [3,4].
Source: Clinical Neurology and Neurosurgery - June 13, 2015 Category: Neurosurgery Authors: Einat Engel-Haber, Anat Horev, Priyanka Chablani, Natan M. Bornstein, Ashutosh Jadhav, Tudor G. Jovin, Vivek Reddy, Maxim D. Hammer Source Type: research

Aspirin Response Test Role in Platelet Transfusion Following Intracerebral Hemorrhage*
Intracerebral hemorrhage (ICH) comprises 4-15% of acute stroke cases and is the most fatal form of all stroke subtypes[1], with mortality at least 40% after one month[2]. Volume and growth of hemorrhage were shown to be strong predictors of mortality and functional outcome[3,4]
Source: Clinical Neurology and Neurosurgery - June 13, 2015 Category: Neurosurgery Authors: Einat Engel-Haber, Anat Horev, Priyanka Chablani, Natan M. Bornstein, Ashutosh Jadhav, Tudor G. Jovin, Vivek Reddy, Maxim D. Hammer Source Type: research

Rivaroxaban and intracranial haemorrhage after mild traumatic brain injury: A dangerous combination?
The novel direct anticoagulant rivaroxaban has been approved in 2011 for the prophylaxis of thromboembolic events in patients with atrial fibrillation. Its mechanisms of action involve direct inhibition of factor Xa and a large multicentre trial has demonstrated at least non-inferiority compared with warfarin regarding the prevention of ischemic stroke [1]. This trial has also demonstrated that the risk of major bleeding was not increased with rivaroxaban and indeed, intracranial and fatal bleeding occurred less frequently in rivaroxaban-treated patients.
Source: Clinical Neurology and Neurosurgery - May 30, 2015 Category: Neurosurgery Authors: Christopher Beynon, Anna Potzy, Oliver W. Sakowitz, Andreas W. Unterberg Source Type: research

Barriers to Administering Intravenous Tissue Plasminogen Activator (tPA) for Acute Ischemic Stroke in the Emergency Department: A Cross-Sectional Survey of Stroke Centers
The logistics involved in administration of IV tPA for acute ischemic stroke patients are complex, and may contribute to variability in door-to-needle times between different hospitals. We sought to identify practice patterns in stroke centers related to IV tPA use. We hypothesized that there would be significant variability in logistics related to ancillary staff (i.e. nursing, pharmacists) processes in the emergency room setting.
Source: Clinical Neurology and Neurosurgery - May 22, 2015 Category: Neurosurgery Authors: Mitch Hargis, Jharna N. Shah, Janine Mazabob, Chethan Venkatasubba Rao, Jose I. Suarez, Eric Bershad Source Type: research

Giant cell arteritis presenting as spinal cord infarction
Giant cell arteritis is easily recognised in older patients presenting with headache, scalp tenderness and raised inflammatory markers. Timely treatment with steroids can prevent serious complications such as stroke and visual loss. As our case demonstrates, giant cell arteritis can lead to less well recognised neurological manifestations that may not prompt immediate consideration of the diagnosis.
Source: Clinical Neurology and Neurosurgery - May 20, 2015 Category: Neurosurgery Authors: Adrian R Parry-Jones, Chinenye Ilozue, Daniel du Plessis, David McKee Tags: Case Report Source Type: research

Factors Affecting the Evacuation Rate of Intracerebral Hemorrhage in Basal Ganglia Treated by Minimally Invasive Craniopuncture
Intracerebral hemorrhage (ICH) is one of the most lethal types of stroke and has occurred more frequently among Chinese than the western populations [1]. The role of surgical treatment of ICH has been controversial for many years [2,3]. A clinical trial showed that conventional aggressive surgery had no significant benefit over conservative medical treatment for ICH [4]. More recently, a meta-analysis concluded that patients with supratentorial ICH may benefit more from minimally invasive surgeries than other treatment options [5].
Source: Clinical Neurology and Neurosurgery - May 4, 2015 Category: Neurosurgery Authors: Tingzhong Wang, Yongchang Guan, Jinghua Du, Guojun Liu, Fei Gao, Xianlin Zhao Source Type: research

Selective use of transradial access for endovascular treatment of severe intracranial vertebrobasilar artery stenosis
Endovascular treatment remained an important option for selected patients with medically refractory intracranial vertebrobasilar stenosis, as the risk of recurrent stroke is high, up to 33% in the first 3 months post first event [1,2]. Although the controversial SAMMPRIS study did not demonstrate superiority of endovascular treatment over medical treatment, most of the ischemic events in SAMMPRIS and in a recent meta-analysis of intracranial vertebrobasilar intervention occurred perioperatively [3,4].
Source: Clinical Neurology and Neurosurgery - April 29, 2015 Category: Neurosurgery Authors: Feng Gao, WaiTing Joyce Lo, Xuan Sun, Ning Ma, DaPeng Mo, XiaoTong Xu, ZhongRong Miao Source Type: research

MRI Diagnosis of Dural Sinus - Cortical Venous Thrombosis: Immediate Post-contrast 3D GRE T1-weighted Imaging versus Unenhanced MR Venography and Conventional MR Sequences
Cerebral dural venous sinus (DVS) thrombosis is a relatively uncommon disorder when compared with other stroke etiologies. It occurs in three to four people per one million and is responsible for nearly 1-2% of strokes in young adults [1,2]. Its incidence is probably underestimated due to lack of noninvasive accurate imaging modalities and challenging interpretation of available MRI sequences [3,4]. Early diagnosis and treatment are crucial for accurate management. In untreated patients, DVS thrombosis can cause impaired consciousness, coma, and death.
Source: Clinical Neurology and Neurosurgery - April 22, 2015 Category: Neurosurgery Authors: Sebahattin Sari, Samet Verim, Salih Hamcan, Bilal Battal, Veysel Akgun, Hakan Akgun, Serhat Celikkanat, Mustafa Tasar Tags: Original Research Source Type: research

MRI diagnosis of dural sinus—Cortical venous thrombosis: Immediate post-contrast 3D GRE T1-weighted imaging versus unenhanced MR venography and conventional MR sequences
Cerebral dural venous sinus (DVS) thrombosis is a relatively uncommon disorder when compared with other stroke etiologies. It occurs in three to four people per one million and is responsible for nearly 1–2% of strokes in young adults [1,2]. Its incidence is probably underestimated due to lack of noninvasive accurate imaging modalities and challenging interpretation of available MRI sequences [3,4]. Early diagnosis and treatment are crucial for accurate management. In untreated patients, DVS thrombosis can cause impaired consciousness, coma, and death.
Source: Clinical Neurology and Neurosurgery - April 22, 2015 Category: Neurosurgery Authors: Sebahattin Sari, Samet Verim, Salih Hamcan, Bilal Battal, Veysel Akgun, Hakan Akgun, Serhat Celikkanat, Mustafa Tasar Source Type: research

Changes in brain calculated diffusion parameters in patients with unilateral internal carotid artery stenosis undergoing carotid endarterectomy without per-operative shunt
Carotid artery stenosis (CAS) is related to an increased risk of stroke and more prominent chronic ischemic lesions [1,2]. In several randomized clinical trials, carotid endarterectomy (CEA) has been proven to be effective in decreasing the risk of stroke [3].
Source: Clinical Neurology and Neurosurgery - March 17, 2015 Category: Neurosurgery Authors: Neslin Sahin, Aynur Solak, Berhan Genc, Mehmet Besir Akpinar, Ugur Kulu, Hakan Cengiz Source Type: research

Brain diffusion changes in unilateral carotid artery stenosis with non-shunt endarterectomy: Correlation with white matter lesions
Carotid artery stenosis (CAS) is related to an increased risk of stroke and more prominent chronic ischemic lesions [1,2]. In several randomized clinical trials, carotid endarterectomy (CEA) has been proven to be effective in decreasing the risk of stroke [3].
Source: Clinical Neurology and Neurosurgery - March 17, 2015 Category: Neurosurgery Authors: Neslin Sahin, Aynur Solak, Berhan Genc, Mehmet Besir Akpinar, Ugur Kulu, Hakan Cengiz Source Type: research

Primary decompressive craniectomy for poor-grade middle cerebral artery aneurysms with associated intracerebral hemorrhage
Poor-grade middle cerebral artery (MCA) aneurysm with associated intracerebral hemorrhage (ICH) is associated with poor clinical condition and poor outcome [1–7]. Aggressive aneurysm clipping and hematoma evacuation seems mandatory. However, the outcome is still poor [6,8,9]. Decompressive craniectomy (DC) can reduce increased intracranial pressure and improve cerebral perfusion. It has been reported to be used in the treatment of massive ischemic stroke, severe traumatic brain injury and aneurysmal subarachnoid hemorrhage (aSAH)[10–16].
Source: Clinical Neurology and Neurosurgery - March 15, 2015 Category: Neurosurgery Authors: Bing Zhao, Yuanli Zhao, Xianxi Tan, Yong Cao, Jun Wu, Ming Zhong, Shuo Wang Source Type: research

Functional Outcome after Recanalization for Acute Pure M1 Occlusion of the Middle Cerebral Artery as Assessed by Collateral CTA Flow
Collateral flow is important for maintaining blood flow to salvageable brain tissue (the penumbra) before recanalization for acute occlusion of the cerebral artery. Several studies have showed the importance of collateral flow in predicting clinical outcome after an acute ischemic stroke. A correlation has been demonstrated between the status of the collateral circulation and infarct volume, hemorrhagic transformation, recanalization rate, and functional status. [1–9] However, many patients included in prior studies of collateral flow as a predictor for patient response to recanalization, were not homogenous with regard ...
Source: Clinical Neurology and Neurosurgery - February 11, 2015 Category: Neurosurgery Authors: Sang Min Sung, Tae Hong Lee, Han Jin Cho, Tae Ho Kang, Dae Soo Jung, Kyung Pil Park, Min Kyu Park, Jae Il Lee, Jun Kyeung Ko Source Type: research

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