scholarly journals Evidence of motor injury due to damaged corticospinal tract following acute hemorrhage in the basal ganglia region

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jing Li ◽  
Xue Hu Wei ◽  
Yong Kang Liu ◽  
Ling Shan Chen ◽  
Zheng Qiu Zhu ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Motor Function ◽  
Corticospinal Tract ◽  
Internal Capsule ◽  
Contralateral Side ◽  
Term Outcome ◽  
Acute Hemorrhage ◽  
Long Term Outcome ◽  
Cognitive Studies ◽  
Acute Haemorrhage

Abstract The integrity of the corticospinal tract (CST) is significantly affected following basal ganglia haemorrhage. We aimed to assess the local features of CST and to effectively predict motor function by diffusion characteristics of CST in patients with motor injury following acute haemorrhage in the acute basal ganglia region. We recruited 37 patients with paresis of the lateral limbs caused by acute basal ganglia haemorrhage. Based on the automated fiber quantification method to track CST, assessed the character of each CST segment between the affected and contralateral sides, and correlated these with the Fugl–Meyer (FM) and Barthel Index (BI) scores at 6 months after onset. The fractional anisotropy (FA) values of the injured side of CST showed a significantly lower FA than the contralateral side along the tract profiles (p < 0.05, corrections for multiple comparisons). The FA values of each site at the internal capsule, closed corona radiata were positively correlated with the FM and BI score at 6 months after onset (p < 0.001, respectively). Our findings assessed the character of CST vividly in detail and dementated the primary sites of CST can predict the long-term outcome of motor function. This study may facilitate future clinical and cognitive studies of acute haemorrhage.

scholarly journals Quantitative Corticospinal Tract Assessment in Acute Intracerebral Hemorrhage

2020 ◽  
Author(s):  
Bastian Volbers ◽  
Angelika Mennecke ◽  
Nicola Kästle ◽  
Hagen B. Huttner ◽  
Stefan Schwab ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Acute Phase ◽  
Corticospinal Tract ◽  
Internal Capsule ◽  
Favorable Outcome ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Posterior Limb ◽  
Lobar Hemorrhage ◽  
Acute Intracerebral Hemorrhage

Abstract Intracerebral hemorrhage (ICH) prognostication during the acute phase is often subjective among physicians and often affects treatment decisions. The present study explores objective imaging parameters using quantitative corticospinal tract (CST) fiber reconstruction during the acute phase of ICH and correlates these parameters with functional outcome and patient recovery. We prospectively enrolled nonsurgical spontaneous supratentorial ICH patients and obtained an MRI scan on day 5 ± 1. Q-space diffeomorphic reconstruction was performed using DSI Studio, and quantitative anisotropy (QA) was calculated. The CST was reconstructed based on QA. The dichotomized modified Rankin Scale score on day 90 (favorable outcome = 0–2) and Barthel Index (favorable recovery = 100 on day 90 or improvement between discharge and day 90 > 60%) were assessed. Thirty-three patients, median age 72 years (interquartile range (IQR) 64–83), 21 female (64%), 21 (64%) with lobar hemorrhage, median ICH volume on admission 15.0 (IQR 7.0–27.4) mL, were included. Sixteen patients (48%) had a favorable outcome and 24 (73%) had a favorable recovery. The mean number of ipsilesional reconstructed CST fiber pathways was higher in patients with favorable outcomes (153 (standard deviation (SD) 103) vs. 60 (SD 39), p = 0.003) and predicted outcome after adjustment (Exp(B) = 1.016 (95% CI = 1.002–1.030)). QA in the ipsilesional posterior limb of the internal capsule showed a trend towards an association with favorable outcome (Exp(B) = 1.194 (95% CI = 0.991–1.439 (adjusted))). The total (ipsilesional + contralesional) number of reconstructed fiber pathways was associated with favorable recovery (Exp(B) = 1.025 (95% CI = 1.003–1.047 (adjusted))). Quantitative tractography parameters assessed in the acute phase of ICH may represent a promising predictor of long-term outcome and recovery. This might facilitate prognostic evaluation and organization of rehabilitation.

scholarly journals Long-term neurodevelopment in children born with esophageal atresia: a systematic review

2021 ◽  
Author(s):  
Camille E van Hoorn ◽  
Chantal A ten Kate ◽  
Andre B Rietman ◽  
Leontien C C Toussaint-Duyster ◽  
Robert Jan Stolker ◽  
...  
Keyword(s):  
Cognitive Development ◽  
Motor Function ◽  
Esophageal Atresia ◽  
Current Knowledge ◽  
Neurodevelopmental Outcome ◽  
Cognitive Outcome ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The One

Summary Background Although the survival rate of esophageal atresia (EA) has increased to over 90%, the risk of functional long-term neurodevelopmental deficits is uncertain. Studies on long-term outcomes of children with EA show conflicting results. Therefore, we provide an overview of the current knowledge on the long-term neurodevelopmental outcome of children with EA. Methods We performed a structured literature search in Embase, Medline Ovid, Web of Science, Cochrane CENTRAL, and Google scholar on November 8, 2020 with the keywords ‘esophageal atresia’, ‘long-term outcome’, ‘motor development’, ‘cognitive development’, and ‘neurodevelopment’. Results The initial search identified 945 studies, of which 15 were included. Five of these published outcomes of multiple tests or tested at multiple ages. Regarding infants, one of six studies found impaired neurodevelopment at 1 year of age. Regarding preschoolers, two of five studies found impaired neurodevelopment; the one study assessing cognitive development found normal cognitive outcome. Both studies on motor function reported impairment. Regarding school-agers, the one study on neurodevelopmental outcome reported impairment. Cognitive impairment was found in two out of four studies, and motor function was impaired in both studies studying motor function. Conclusions Long-term neurodevelopment of children born with EA has been assessed with various instruments, with contrasting results. Impairments were mostly found in motor function, but also in cognitive performance. Generally, the long-term outcome of these children is reason for concern. Structured, multidisciplinary long-term follow-up programs for children born with EA would allow to timely detect neurodevelopmental impairments and to intervene, if necessary.

scholarly journals Cavernous Malformation of Brainstem, Thalamus, and Basal Ganglia

Neurosurgery ◽  
2012 ◽  
Vol 72 (4) ◽  
pp. 573-589 ◽  
Author(s):  
Paritosh Pandey ◽  
Erick M. Westbroek ◽  
Peter A. Gooderham ◽  
Gary K. Steinberg
Keyword(s):  
Basal Ganglia ◽  
Neurological Deficits ◽  
Term Outcome ◽  
Cavernous Malformations ◽  
Long Term Outcome ◽  
Brain Malformations ◽  
Hemorrhage Risk ◽  
Clinical Records

Abstract BACKGROUND: Cavernous malformations (CMs) in deep locations account for 9% to 35% of brain malformations and are surgically challenging. OBJECTIVE: To study the clinical features and outcomes following surgery for deep CMs and the complication of hypertrophic olivary degeneration (HOD). METHODS: Clinical records, radiological findings, operative details, and complications of 176 patients with deep CMs were reviewed retrospectively. RESULTS: Of 176 patients with 179 CMs, 136 CMs were in the brainstem, 27 in the basal ganglia, and 16 in the thalamus. Cranial nerve deficits (51.1%), hemiparesis (40.9%), numbness (34.7%), and cerebellar symptoms (38.6%) presented most commonly. Hemorrhage presented in 172 patients (70 single, 102 multiple). The annual retrospective hemorrhage rate was 5.1% (assuming CMs are congenital with uniform hemorrhage risk throughout life); the rebleed rate was 31.5%/patient per year. Surgical approach depended on the proximity of the CM to the pial or ependymal surface. Postoperatively, 121 patients (68.8%) had no new neurological deficits. Follow-up occurred in 170 patients. Delayed postoperative HOD developed in 9/134 (6.7%) patients with brainstem CMs. HOD occurred predominantly following surgery for pontine CMs (9/10 patients). Three patients with HOD had palatal myoclonus, nystagmus, and oscillopsia, whereas 1 patient each had limb tremor and hemiballismus. At follow-up, 105 patients (61.8%) improved, 44 (25.9%) were unchanged, and 19 (11.2%) worsened neurologically. Good preoperative modified Rankin Score (98.2% vs 54.5%, P = .001) and single hemorrhage (89% vs 77.3%, P &lt; .05) were predictive of good long-term outcome. CONCLUSION: Symptomatic deep CMs can be resected with acceptable morbidity and outcomes. Good preoperative modified Rankin Score and single hemorrhage are predictors of good long-term outcome.

Rehabilitation promotes functional movement in atypical populations

1996 ◽  
Vol 19 (1) ◽  
pp. 82-83
Author(s):  
Meg Morris ◽  
Thomas Matyas ◽  
Robert Iansek ◽  
Ross Cunnington
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Motor Function ◽  
Skill Learning ◽  
Motor Skill Learning ◽  
Term Outcome ◽  
Functional Movement ◽  
Long Term Outcome ◽  
Cns Dysfunction

AbstractThe suggestion that movement disorders exhibited by people with central nervous system (CNS) dysfunction should be considered normal and therefore not rehabilitated is rejected from three standpoints: (1) the CNS does not always select the best movement patterns for optimal long term outcome, (2) there is literature demonstrating that rehabilitation enhances motor function and independence, and (3) there exists a capacity for motor recovery and motor skill learning following brain damage.

scholarly journals Lasting Pure-Motor Deficits after Focal Posterior Internal Capsule White-Matter Infarcts in Rats

2015 ◽  
Vol 35 (6) ◽  
pp. 977-984 ◽  
Author(s):  
Francesco Blasi ◽  
Michael J Whalen ◽  
Cenk Ayata
Keyword(s):  
White Matter ◽  
Internal Capsule ◽  
Experimental Models ◽  
White Matter Injury ◽  
Motor Deficits ◽  
Sprague Dawley ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Endothelin 1 ◽  
Pure Motor

Small white-matter infarcts of the internal capsule are clinically prevalent but underrepresented among currently available animal models of ischemic stroke. In particular, the assessment of long-term outcome, a primary end point in clinical practice, has been challenging due to mild deficits and the rapid and often complete recovery in most experimental models. We, therefore, sought to develop a focal white-matter infarction model that can mimic the lasting neurologic deficits commonly observed in stroke patients. The potent vasoconstrictor endothelin-1 ( n = 24) or vehicle ( n = 9) was stereotactically injected into the internal capsule at one of three antero-posterior levels (1, 2, or 3 mm posterior to bregma) in male Sprague-Dawley rats. Endothelin-injected animals showed highly focal (~1 mm3) and reproducible ischemic infarcts, with severe axonal and myelin loss accompanied by cellular infiltration when examined 2 and 4 weeks after injection. Only those rats injected with endothelin-1 at the most posterior location developed robust and pure-motor deficits in adhesive removal, cylinder and foot-fault tests that persisted at 1 month, without detectable sensory impairments. In summary, we present an internal capsule stroke model optimized to produce lasting pure-motor deficits in rats that may be suitable to study neurologic recovery and rehabilitation after white-matter injury.

Caudal cervical intervertebral disk disease in the small dog: role of distraction and stabilization in ventral slot decompression

2000 ◽  
Vol 36 (1) ◽  
pp. 68-74 ◽  
Author(s):  
RB Fitch ◽  
SC Kerwin ◽  
G Hosgood
Keyword(s):  
Motor Function ◽  
Clinical Results ◽  
Intervertebral Disk ◽  
Clinical Effects ◽  
Common Site ◽  
Intervertebral Space ◽  
Term Outcome ◽  
Long Term Outcome

The clinical outcomes in 112 dogs weighing less than 35 pounds that were presented with cervical intervertebral disk protrusions were retrospectively evaluated. Although the second to third cervical (C2 to C3) intervertebral space was the most common site (27%) of disk protrusion, 57% of disk protrusions presented were caudal to the fourth cervical (C4) vertebra. Dogs with cranial intervertebral disk protrusions, including the C2 to C3 and C3 to C4 intervertebral disk spaces, responded favorably to ventral slot decompression. By comparison, caudal intervertebral disk protrusions (within the C4 to the seventh cervical [C7] intervertebral disk spaces) responded less favorably to ventral slot decompression, demonstrating significantly more severe clinical effects in motor function, comfort, recovery, and long-term outcome following surgery. Significant improvement in clinical results was seen in caudal disk protrusions when additional surgical distraction and stabilization were provided following ventral slot decompression.

CAVERNOUS MALFORMATIONS OF THE BASAL GANGLIA AND THALAMUS

Neurosurgery ◽  
2009 ◽  
Vol 65 (1) ◽  
pp. 7-19 ◽  
Author(s):  
Bradley A. Gross ◽  
H. Hunt Batjer ◽  
Issam A. Awad ◽  
Bernard R. Bendok
Keyword(s):  
Basal Ganglia ◽  
Natural History ◽  
French Literature ◽  
Outcome Data ◽  
Therapeutic Modality ◽  
Surgical Morbidity ◽  
Term Outcome ◽  
Cavernous Malformations ◽  
Long Term Outcome

ABSTRACT CAVERNOUS MALFORMATIONS OF the basal ganglia and thalamus present a unique therapeutic challenge to the neurosurgeon given their unclear natural history, the risk of surgical treatment, and the unproven efficacy of radiosurgical therapy. Via a PubMed search of the English and French literature, we have systematically reviewed the natural history and surgical and radiosurgical management of these lesions reported through April 2008. Including rates cited for “deep” cavernous malformations, annual bleeding rates for these lesions varied from 2.8% to 4.1% in the natural history studies. Across surgical series providing postoperative or long-term outcome data on 103 patients, we found an 89% resection rate, a 10% risk of long-term surgical morbidity, and a 1.9% risk of surgical mortality. The decrease in hemorrhage risk reported 2 years after radiosurgery might be a result of natural hemorrhage clustering, underscoring the unproven efficacy of this therapeutic modality. Given the compounded risks of radiation-induced injury and post-radiosurgical rebleeding, radiosurgery at modest dosimetry (12–14 Gy marginal doses) is only an option for patients with surgically inaccessible, aggressive lesions.

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