THE EFFECT OF THE PRESENCE OF EPILEPTIC ATTACKS ON THE CLINICAL DURATION OF SUPRATENTORIAL BRAIN MENINGIOMAS

The aim: To study the effect of epileptic seizures in patients with supratentorial brain meningiomas on the clinical course of meningiomas in the early and late postoperative period. Materials and methods: A retrospective analysis of the course of the disease was performed in 242 patients with total removed supratentorial meningioma of the brain (general group). Long-term outcome of the disease was estimated in 176 people (a catamnesis group). Results: The occurrence of a new neurological deficit was observed in 18 (18.0±3.8 %) patients out of 100 among patients with epileptic seizures before surgery and in 19 (13.4±2.9 %) out of 142 among those who had no seizures. The mortality rate was 1 (1.0±1.0 %) in the group of patients with seizures and 3 (2.8±1.4 %) in the group of patients without seizures before surgery. The prevalence of new neurological deficits in the catamnesis group is 14 (19.2±4.6 %) of 73 patients with epileptic seizures before surgery and 17 (16.5±3.7 %) of 103 patients without seizures. Mortality was 3 cases (4.1±2.3 %) in patients with seizures and 9 cases (8.7±2.8 %) among patients without seizures. Conclusions: No data have been obtained that the presence of epileptic seizures affects the incidence of new neurological deficits, complications and mortality after surgical treatment of meningiomas in the early and late postoperative period.

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Long-term outcome of low-cost glaucoma drainage device (Aurolab aqueous drainage implant) compared with Ahmed glaucoma valve

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-313942 ◽

2019 ◽

Vol 104 (4) ◽

pp. 557-562 ◽

Cited By ~ 3

Author(s):

Surinder Singh Pandav ◽

Natasha Gautam Seth ◽

Faisal Thattaruthody ◽

Manpreet Kaur ◽

Madhuri Akella ◽

...

Keyword(s):

Postoperative Period ◽

Low Cost ◽

Glaucoma Drainage Device ◽

Ahmed Glaucoma Valve ◽

Term Outcome ◽

Long Term Outcome ◽

Surgical Interventions ◽

Drainage Device ◽

Late Postoperative Period

PurposeTo compare the long-term outcome of Aurolab aqueous drainage device (AADI) and Ahmed glaucoma valve (AGV).MethodRetrospective analysis of patients with refractory glaucoma who underwent AGV (AGV-FP7) and AADI (AADI Model 350) implantation. The outcome measures were intraocular pressure (IOP), requirement of antiglaucoma medications (AGMs) and re-surgery for IOP control. The postoperative complications were classified as early (≤3 months), intermediate (>3 months to ≤1 year) or late (>1 year).Results173 patients (189 eyes) underwent AGV implantation (AGV Group) while 201 patients (206 eyes) underwent AADI implantation (AADI group). The IOP in AADI group was significantly lower than AGV group at all time points till 2 years and comparable at 3 years. AADI group had significantly higher number of AGM in preoperative period and significantly lower number in postoperative period till 3 years compared with AGV group. AADI group had more hypotony-related complications but statistically insignificant (p = 0.07). The surgical interventions were significantly higher in AGV (n = 18) compared with AADI group (n = 5) in late postoperative period (p = 0.01). At 3 years, overall success was seen in 58.18% in AGV and 73.08% in AADI group (p = 0.15). Complete success was seen in 7.27% patients in AGV and 25.00% patients in AADI group (p = 0.02).ConclusionBoth AADI and AGV implant had comparable mean IOP at 3 years with lesser requirement of AGM in the AADI group. Both procedures appear to be safe with slight preponderance of hypotony-related complications in AADI group.

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Cytokine-Laden Extracellular Vesicles Predict Patient Prognosis after Cerebrovascular Accident

International Journal of Molecular Sciences ◽

10.3390/ijms22157847 ◽

2021 ◽

Vol 22 (15) ◽

pp. 7847

Author(s):

Anthony Fringuello ◽

Philip D. Tatman ◽

Tadeusz Wroblewski ◽

John A. Thompson ◽

Xiaoli Yu ◽

...

Keyword(s):

Extracellular Vesicles ◽

Inflammatory Cytokines ◽

Hemorrhagic Stroke ◽

Term Outcome ◽

Long Term Outcome ◽

Interleukin 7 ◽

Poor Outcomes ◽

Patient Prognosis ◽

The Brain

Background: A major contributor to disability after hemorrhagic stroke is secondary brain damage induced by the inflammatory response. Following stroke, global increases in numerous cytokines—many associated with worse outcomes—occur within the brain, cerebrospinal fluid, and peripheral blood. Extracellular vesicles (EVs) may traffic inflammatory cytokines from damaged tissue within the brain, as well as peripheral sources, across the blood–brain barrier, and they may be a critical component of post-stroke neuroinflammatory signaling. Methods: We performed a comprehensive analysis of cytokine concentrations bound to plasma EV surfaces and/or sequestered within the vesicles themselves. These concentrations were correlated to patient acute neurological condition by the Glasgow Coma Scale (GCS) and to chronic, long-term outcome via the Glasgow Outcome Scale-Extended (GOS-E). Results: Pro-inflammatory cytokines detected from plasma EVs were correlated to worse outcomes in hemorrhagic stroke patients. Anti-inflammatory cytokines detected within EVs were still correlated to poor outcomes despite their putative neuroprotective properties. Inflammatory cytokines macrophage-derived chemokine (MDC/CCL2), colony stimulating factor 1 (CSF1), interleukin 7 (IL7), and monokine induced by gamma interferon (MIG/CXCL9) were significantly correlated to both negative GCS and GOS-E when bound to plasma EV membranes. Conclusions: These findings correlate plasma-derived EV cytokine content with detrimental outcomes after stroke, highlighting the potential for EVs to provide cytokines with a means of long-range delivery of inflammatory signals that perpetuate neuroinflammation after stroke, thus hindering recovery.

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Commentary

Case Studies in Clinical Psychological Science ◽

10.1093/med:psych/9780199733668.003.0043 ◽

2013 ◽

pp. 393-399

Author(s):

Carol B. Peterson

Keyword(s):

Eating Disorders ◽

Psychiatric Symptoms ◽

Outcome Data ◽

Medical Complications ◽

Evidence Based ◽

Term Outcome ◽

Long Term Outcome ◽

Bulimic Symptoms ◽

Complications And Mortality

Dr. Cubic’s case presentation eloquently highlights the numerous challenges of using evidence-based interventions in the treatment of eating disorders. As Dr. Cubic emphasizes in her case description, among the different types of eating disorders, anorexia nervosa (AN) (and especially AN accompanied by bulimic symptoms) is particularly difficult to treat effectively, and long-term outcome data indicate high levels of treatment nonresponse, relapse, co-occurring psychiatric symptoms, medical complications, and mortality (...

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Molecular targets of lithium action

Acta Neuropsychiatrica ◽

10.1046/j.1601-5215.2003.00049.x ◽

2003 ◽

Vol 15 (6) ◽

pp. 316-340 ◽

Cited By ~ 22

Author(s):

B Corbella ◽

E Vieta

Keyword(s):

Bipolar Disorder ◽

Molecular Mechanisms ◽

Molecular Targets ◽

Mood Stabilizers ◽

Lithium Cation ◽

Therapeutic Effects ◽

Term Outcome ◽

Long Term Outcome ◽

The Brain

Lithium is an effective drug for both the treatment and prophylaxis of bipolar disorder. However, the precise mechanism of lithium action is not yet well understood. Extensive research aiming to elucidate the molecular mechanisms underlying the therapeutic effects of lithium has revealed several possible targets. The behavioral and physiological manifestations of the illness are complex and are mediated by a network of interconnected neurotransmitter pathways. Thus, lithium's ability to modulate the release of serotonin at presynaptic sites and modulate receptor-mediated supersensitivity in the brain remains a relevant line of investigation. However, it is at the molecular level that some of the most exciting advances in the understanding of the long-term therapeutic action of lithium will continue in the coming years. The lithium cation possesses the selective ability, at clinically relevant concentrations, to alter the PI second-messenger system, potentially altering the activity and dynamic regulation of receptors that are coupled to this intracellular response. Subtypes of muscarinic receptors in the limbic system may represent particularly sensitive targets in this regard. Likewise, preclinical data have shown that lithium regulates arachidonic acid and the protein kinase C signaling cascades. It also indirectly regulates a number of factors involved in cell survival pathways, including cAMP response element binding protein, brain-derived neurotrophic factor, bcl-2 and mitogen-activated protein kinases, and may thus bring about delayed long-term beneficial effects via under-appreciated neurotrophic effects. Identification of the molecular targets for lithium in the brain could lead to the elucidation of the pathophysiology of bipolar disorder and the discovery of a new generation of mood stabilizers, which in turn may lead to improvements in the long-term outcome of this devastating illness (1).

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Cavernous Malformation of Brainstem, Thalamus, and Basal Ganglia

Neurosurgery ◽

10.1227/neu.0b013e318283c9c2 ◽

2012 ◽

Vol 72 (4) ◽

pp. 573-589 ◽

Cited By ~ 65

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 < .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.

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Persistent intrathecal interleukin-8 production in a patient with SARS-CoV-2-related encephalopathy presenting aphasia: a case report.

BMC Neurology ◽

10.1186/s12883-021-02459-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Takuya Kudo ◽

Yuichi Hayashi ◽

Kenjiro Kunieda ◽

Nobuaki Yoshikura ◽

Akio Kimura ◽

...

Keyword(s):

Epileptic Seizures ◽

Neurological Deficits ◽

Central Nervous System Inflammation ◽

Focal Neurological Deficit ◽

Case Presentation ◽

Monocyte Chemoattractant Protein 1 ◽

Monocyte Chemoattractant ◽

Consciousness Disturbance ◽

The Brain

Abstract Background Neurological manifestations of coronavirus disease 2019 (COVID-19) are increasingly recognized and include encephalopathy, although direct infection of the brain by SARS-CoV-2 remains controversial. We herein report the clinical course and cytokine profiles of a patient with severe SARS-CoV-2-related encephalopathy presenting aphasia. Case presentation An 81-year-old man developed acute consciousness disturbance and status epileptics several days after SARS-CoV-2 infection. Following treatment with remdesivir and dexamethasone, his consciousness and epileptic seizures improved; however, amnestic aphasia and agraphia remained. Two months after methylprednisolone pulse and intravenous immunoglobulin, his neurological deficits improved. We found increased levels of interleukin (IL)-6, IL-8, and monocyte chemoattractant protein-1 (MCP-1), but not IL-2 and IL-10 in the serum and cerebrospinal fluid (CSF), and the levels of serum IL-6 and MCP-1 were much higher than those in the CSF. The level of IL-8 in the CSF after immunotherapy was four times higher than that before immunotherapy. Conclusion The cytokine profile of our patient was similar to that seen in severe SARS-CoV-2-related encephalopathy. We demonstrated (i) that the characteristic aphasia can occur as a focal neurological deficit associated with SARS-CoV-2-related encephalopathy, and (ii) that IL8-mediated central nervous system inflammation follows systemic inflammation in SARS-CoV-2-related encephalopathy and can persist and worsen even after immunotherapy. Monitoring IL-8 in CSF, and long-term corticosteroids may be required for treating SARS-CoV-2-related encephalopathy.

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Compressive vertebral hemangiomas with neurological deficits: diagnosis, surgical strategies and long term outcome

British Journal of Neurosurgery ◽

10.1080/02688697.2021.1967878 ◽

2021 ◽

pp. 1-11

Author(s):

Krishnakumar Kesavapisharady ◽

Ganesh Divakar ◽

Tobin George ◽

Jayadevan E. R. ◽

Easwer Venkat Hariharan

Keyword(s):

Neurological Deficits ◽

Term Outcome ◽

Long Term Outcome ◽

Surgical Strategies ◽

Vertebral Hemangiomas

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Antipsychotic-associated neuronal changes in the brain: Toxic, therapeutic, or irrelevant to the long-term outcome of schizophrenia?

Progress in Neuro-Psychopharmacology and Biological Psychiatry ◽

10.1016/j.pnpbp.2005.08.019 ◽

2006 ◽

Vol 30 (2) ◽

pp. 174-189 ◽

Cited By ~ 35

Author(s):

Charles E. Dean

Keyword(s):

Term Outcome ◽

Long Term Outcome ◽

The Brain

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The Unforgettable Encephalitis

Neuroimmunology ◽

10.1093/med/9780190693190.003.0025 ◽

2018 ◽

pp. 133-138

Author(s):

Aaron E. Miller ◽

Tracy M. DeAngelis ◽

Michelle Fabian ◽

Ilana Katz Sand

Keyword(s):

Immunosuppressive Agents ◽

Autoimmune Encephalitis ◽

Hippocampal Damage ◽

Term Outcome ◽

Long Term Outcome ◽

Hyperintense Signal ◽

Laboratory Investigations ◽

Mesial Temporal Lobe ◽

The Brain

Leucine-rich glioma-inactivated 1 (LGI1) limbic encephalitis is an autoimmune encephalitis characterized by subacute cognitive impairment, amnesia, seizures, faciobrachial dystonic seizures (FBDS), and hyponatremia. MRI of the brain typically demonstrates abnormal T2/FLAIR hyperintense signal in the mesial temporal lobe, hippocampal regions. CSF is surprisingly bland, and laboratory investigations often disclose a hyponatremia. Patients with LGI1 encephalitis generally respond to immunotherapies such as glucocorticoids, intravenous immunoglobulin (IVIg), and plasma exchange and steroid-sparing immunosuppressive agents. The etiology of LGI1 encephalitis can be either autoimmune or paraneoplastic, more commonly the former. Reported prognosis is favorable in about two-thirds of cases; however, some patients can relapse, and long-term outcome can be poor if diagnosis is delayed and residual memory impairment from hippocampal damage occurs.

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