Neurology International

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Open AccessReview

Advances in Functional Neuroimaging in Dementias and Potential Pitfalls

by Katherine Standley, Charles Brock and Michael Hoffmann

Neurol. Int. 2012, 4(1), e7; https://doi.org/10.4081/ni.2012.e7 - 27 Mar 2012

Cited by 2 | Viewed by 1

Neuroimaging is continuously advancing at a rapid rate and has progressed from excluding relatively uncommon secondary causes (stroke, tumor) to assisting with early diagnosis and subtype of dementia. Structural imaging has given way to functional, metabolic and receptor imaging. Full article

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Open AccessCase Report

Thalamic Semantic Paralexia

by Michael Hoffmann

Neurol. Int. 2012, 4(1), e6; https://doi.org/10.4081/ni.2012.e6 - 26 Mar 2012

Cited by 4 | Viewed by 1

Abstract

Alexia may be divided into different subtypes, with semantic paralexia being particularly rare. A 57 year old woman with a discreet left thalamic stroke and semantic paralexia is described. Language evalution with the Boston Diagnostic Aphasia Battery confirmed the semantic paralexia (deep alexia). [...] Read more.

Alexia may be divided into different subtypes, with semantic paralexia being particularly rare. A 57 year old woman with a discreet left thalamic stroke and semantic paralexia is described. Language evalution with the Boston Diagnostic Aphasia Battery confirmed the semantic paralexia (deep alexia). Multimodality magnetic resonance imaging brain scanning excluded other cerebral lesions. A good recovery ensued. Full article

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Open AccessArticle

A Randomized Controlled Trial of an Enhanced Interdisciplinary Community Based Group Program for People with Parkinson’s Disease: Study Rationale and Protocol

by Catherine Peters, Michelle Currin, Sara Tyson, Anthea Rogers, Susan Healy, Steven McPhail, Sandra G. Brauer, Kathy Heathcote and Tracy Comans

Neurol. Int. 2012, 4(1), e3; https://doi.org/10.4081/ni.2012.e3 - 26 Mar 2012

Cited by 8 | Viewed by 1

Abstract

Parkinson’s disease (PD) is a progressive, chronic neurodegenerative disorder for which there is no known cure. Physical exercise programs may be used to assist with the physical management of PD. Several studies have demonstrated that community based physical therapy programs are effective in [...] Read more.

Parkinson’s disease (PD) is a progressive, chronic neurodegenerative disorder for which there is no known cure. Physical exercise programs may be used to assist with the physical management of PD. Several studies have demonstrated that community based physical therapy programs are effective in reducing physical aspects of disability among people with PD. While multidisciplinary therapy interventions may have the potential to reduce disability and improve the quality of life of people with PD, there is very limited clinical trial evidence to support or refute the use of a community based multidisciplinary or interdisciplinary programs for people with PD. A two group randomized trial is being undertaken within a community rehabilitation service in Brisbane, Australia. Community dwelling adults with a diagnosis of Idiopathic Parkinson’s disease are being recruited. Eligible participants are randomly allocated to a standard exercise rehabilitation group program or an intervention group which incorporates physical, cognitive and speech activities in a multi-tasking framework. Outcomes will be measured at 6-week intervals for a period of six months. Primary outcome measures are the Montreal Cognitive Assessment (MoCA) and the Timed Up and Go (TUG) cognitive test. Secondary outcomes include changes in health related quality of life, communication, social participation, mobility, strength and balance, and carer burden measures. This study will determine the immediate and long-term effectiveness of a unique multifocal, interdisciplinary, dual-tasking approach to the management of PD as compared to an exercise only program. We anticipate that the results of this study will have implications for the development of cost effective evidence based best practice for the treatment of people with PD living in the community. Full article

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Open AccessCase Report

Case Series of 64 Slice Computed Tomography-Computed Tomographic Angiography with 3D Reconstruction to Diagnose Symptomatic Cerebral Aneurysms: New Standard of Care?

by Dietrich Jehle, Floria Chae, Jonathan Wai, Sam Cloud, David Pierce and Michael Meyer

Neurol. Int. 2012, 4(1), e2; https://doi.org/10.4081/ni.2012.e2 - 23 Feb 2012

Cited by 3 | Viewed by 2

Abstract

CT angiography (CTA) has improved significantly over the past few years such that the reconstructed images of the cerebral arteries may now be equivalent to conventional digital angiography. The new technology of 64 slice multi-detector CTA can reconstruct detailed images that can reliably [...] Read more.

CT angiography (CTA) has improved significantly over the past few years such that the reconstructed images of the cerebral arteries may now be equivalent to conventional digital angiography. The new technology of 64 slice multi-detector CTA can reconstruct detailed images that can reliably identify small cerebral aneurysms, even those <3mm. In addition, it is estimated that CT followed by lumbar puncture (LP) misses up to 4% of symptomatic aneurysms. We present a series of cases that illustrates how CT followed by CTA may be replacing CT-LP as the standard of care in working up patients for symptomatic cerebral aneurysms and the importance of performing three dimensional (3D) reconstructions. A series of seven cases of symptomatic cerebral aneurysms were identified that illustrate the sensitivity of CT-CTA versus CT-LP and the importance of 3D reconstruction in identifying these aneurysms. Surgical treatment was recommended for 6 of the 7 patients with aneurysms and strict hypertension control was recommended for the seventh patient. Some of these patients demonstrated subarachnoid hemorrhage on presentation while others had negative LPs. A number of these patients with negative LPs were clearly symptomatic from their aneurysms. At least one of these cerebral aneurysms was not apparent on CTA without 3D reconstruction. 3D reconstruction of CTA is crucial to adequately identify cerebral aneurysms. This case series helps reinforce the importance of 3D reconstruction. There is some data to suggest that 64 slice CT-CTA may be equivalent or superior to CT-LP in the detection of symptomatic cerebral aneurysms. Full article

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Open AccessCase Report

Two Cases of Possible Neuro-Sweet Disease with Meningoencephalitis as the Initial Manifestation

by Go Makimoto, Yasuhiro Manabe, Chizuru Yamakawa, Daiki Fujii, Yasuko Ikeda-Sakai, Hisashi Narai, Nobuhiko Omori and Koji Abe

Neurol. Int. 2012, 4(1), e5; https://doi.org/10.4081/ni.2012.e5 - 09 Feb 2012

Cited by 10 | Viewed by 1

Abstract

We report 2 cases that were considered to be neuro-Sweet disease. They initially manifested with meningoencephalitis and no skin lesions, and rapidly improved with corticosteroid therapy. In both cases, patients complained of meningitic symptoms such as fever and headache, and HLA-B54 and -Cw1 [...] Read more.

We report 2 cases that were considered to be neuro-Sweet disease. They initially manifested with meningoencephalitis and no skin lesions, and rapidly improved with corticosteroid therapy. In both cases, patients complained of meningitic symptoms such as fever and headache, and HLA-B54 and -Cw1 turned out to be positive over the clinical course. Cerebrospinal fluid analysis showed increased levels of lymphocytes and protein. In case #1, fluid-attenuated inversion recovery (FLAIR), magnetic resonance imaging (MRI) and diffusion-weighted images (DWI) showed high-intensity signals in the right dorsal medulla oblongata, bilateral dorsal midbrain, and left thalamus. In case #2, FLAIR and DWI showed high-intensity signals in the bilateral cerebellar cortex and left caudate nucleus. Symptoms and MRI images were markedly improved in both cases after corticosteroid pulse therapy. According to published diagnostic criteria, these 2 cases were considered possible neuro-Sweet disease. These cases suggest that the combination of meningoencephalitis and HLA specificity is important to consider the possibility of neuro-Sweet disease, even without skin lesions. Full article

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Open AccessCase Report

Thalamic Alexia with Agraphia

by Fábio Henrique de Gobbi Porto, Maria Isabel d’Ávila Freitas, Maira Okada de Oliveira, Leandro Tavares Lucato, Marco Orsini, Sara Lúcia Silveira de Menezes, Regina Miksian Magaldi, Cláudia Sellitto Porto, Sonia Maria Dozzi Brucki and Ricardo Nitrini

Neurol. Int. 2012, 4(1), e4; https://doi.org/10.4081/ni.2012.e4 - 09 Feb 2012

Cited by 3 | Viewed by 1

Abstract

Alexia with agraphia is defined as an acquired impairment affecting reading and writing ability. It can be associated with aphasia, but can also occur as an isolated entity. This impairment has classically been associated with a left angular gyrus lesion In the present [...] Read more.

Alexia with agraphia is defined as an acquired impairment affecting reading and writing ability. It can be associated with aphasia, but can also occur as an isolated entity. This impairment has classically been associated with a left angular gyrus lesion In the present study, we describe a case involving a patient who developed alexia with agraphia and other cognitive deficits after a thalamic hemorrhage. In addition, we discuss potential mechanisms of this cortical dysfunction syndrome caused by subcortical injury. We examined a patient who presented with alexia with agraphia and other cognitive deficits due to a hemorrhage in the left thalamus. Neuropsychological evaluation showed attention, executive function, arithmetic and memory impairments. In addition, language tests revealed severe alexia with agraphia in the absence of aphasia. Imaging studies disclosed an old thalamic hemorrhage involving the anterior, dorsomedial and pulvinar nuclei. Tractography revealed asymmetric thalamocortical radiations in the parietal region (left - right), and single photon emission computed tomography demonstrated hypoperfusion in the left thalamus that extended to the frontal and parietal cortices. Cortical cognitive deficits, including alexia with agraphia, may occur as the result of thalamic lesions. The probable mechanism is a diaschisis phenomenon involving thalamic tract disconnections. Full article

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Open AccessCase Report

Improvement of Astatikopsia (Riddoch’s Phenomenon) after Correction of Vertebral Stenoses with Angioplasty

by Yamille Vidal and Michael Hoffmann

Neurol. Int. 2012, 4(1), e1; https://doi.org/10.4081/ni.2012.e1 - 09 Jan 2012

Cited by 2 | Viewed by 2

Abstract

Visual perception disorder detection may be challenging with several dozen different syndromes identifiable. These may range from hypofunction to hyperfunction in the topological as well as hodological dimensions of cerebral structure. We report here a case of a 61- year-old white man presented [...] Read more.

Visual perception disorder detection may be challenging with several dozen different syndromes identifiable. These may range from hypofunction to hyperfunction in the topological as well as hodological dimensions of cerebral structure. We report here a case of a 61- year-old white man presented with dizziness and visual impairment. Full article

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Neurol. Int., Volume 4, Issue 1 (January 2012) – 7 articles

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