scholarly journals Profound hypertension with dexmedetomidine during insertion of deep brain stimulator

2015 ◽  
Vol 02 (01) ◽  
pp. 055-057
Author(s):  
Allison Tedder ◽  
Evgeny Rakhman ◽  
Pirjo Manninen ◽  
Lashmikumar Venkatraghavan
Keyword(s):  
Computed Tomography ◽  
Blood Pressure ◽  
Disease Process ◽  
Underlying Disease ◽  
Anaesthetic Management ◽  
Loading Dose ◽  
Deep Brain Stimulator ◽  
The Brain ◽  
Deep Brain ◽  
Rule Out

AbstractDexmedetomidine is now frequently used in the anaesthetic management of patients undergoing deep brain stimulator insertion for movement disorders. We present two patients with Parkinson’s disease and dystonia who developed marked increase in blood pressure and level of sedation during the infusion of a loading dose of dexmedetomidine (1 mcg/kg over 10 min). Both patients required treatment of their blood pressure. The first patient also had a computed tomography of the brain to rule out an intracranial event. The patients recovered from these untoward events in approximately 30 min. The possible explanations for both the hypertension and oversedation were underestimation of the severity of the patients’ underlying disease process and a relative overdose of the loading dose of dexmedetomidine.

Awake Craniotomy for Tumour, Epilepsy, and Functional Neurosurgery

2019 ◽  
pp. 235-244
Author(s):  
Lashmi Venkatraghavan ◽  
Pirjo Manninen
Keyword(s):  
Epilepsy Surgery ◽  
Brain Function ◽  
Anaesthetic Management ◽  
Awake Craniotomy ◽  
Epileptic Focus ◽  
Awake Patient ◽  
Functional Neurosurgery ◽  
Deep Brain Stimulator ◽  
Deep Brain

An awake craniotomy for tumour and epilepsy surgery allows for the mapping of eloquent brain function to minimize its injury and/or for the localization of an epileptic focus. The insertion of deep brain stimulators for the treatment of functional neurosurgical disorders is also frequently performed with an awake patient. The role of the anaesthetist is important in order to have a comfortable and cooperative patient, for the use of appropriate sedation to allow for mapping, and careful vigilance to rapidly diagnose and treat any complication. This chapter discusses the overall rationale for, and the anaesthetic management of, patients undergoing awake craniotomy for tumours, epilepsy surgery, or deep brain stimulator placement.

Pharmacological treatment of Alzheimer’s disease

2017 ◽  
Author(s):  
Krishna Chinthapalli
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Pharmacological Treatment ◽  
Daily Living ◽  
Disease Process ◽  
Acetylcholinesterase Inhibitors ◽  
Underlying Disease ◽  
Global Function ◽  
Glutamate Antagonist ◽  
The Brain

Pharmacological treatment of Alzheimer’s disease is an important part of management of the condition. There are only four drugs available for treatment of the disease and none halt the disease process, however they have a benefit on cognition, behaviour, activities of daily living, and global function. Acetylcholinesterase inhibitors are thought to work by enhancing cholinergic transmission in the brain and are particularly effective in mild and moderate AD, with recent evidence suggesting donepezil is also effective in severe AD. Memantine is the only glutamate antagonist that is available for AD and is limited for use in moderate or severe AD. The choice of drug depends on route of administration, adverse effects, and medical comorbidities. There is intense research on alternative treatments especially those that may stop the underlying disease process.

Decreased level of consciousness due to a depleted deep brain stimulator battery: Paving the way to wake up the brain?

2019 ◽  
Vol 175 (4) ◽  
pp. 274-275
Author(s):  
W.A. Kamel ◽  
J.Y. Al-Hashel ◽  
P. Damier ◽  
A.J. Abdulsalam
Keyword(s):  
Deep Brain Stimulator ◽  
Level Of Consciousness ◽  
The Brain ◽  
Deep Brain ◽  
The Way

scholarly journals Neuroplasticity of excitatory and inhibitory cortical circuits in schizophrenia

2009 ◽  
Vol 11 (3) ◽  
pp. 269-280
Keyword(s):  
Cognitive Processes ◽  
Dorsolateral Prefrontal Cortex ◽  
Neurodevelopmental Disorder ◽  
Disease Process ◽  
Underlying Disease ◽  
Cortical Circuits ◽  
Dorsolateral Prefrontal ◽  
Inhibitory Components ◽  
The Brain ◽  
Novel Therapeutic

Schizophrenia is a neurodevelopmental disorder characterized by deficits in cognitive processes mediated by the circuitry of the dorsolateral prefrontal cortex (DLPFC). These deficits are associated with a range of alterations in DLPFC circuitry, some of which reflect the pathology of the illness and others of which reflect the neuroplasticity of the brain in response to the underlying disease process. This article reviews disturbances in excitatory and inhibitory components of DLPFC circuitry from the perspective of developmental neuroplasticity and discusses their implications for the identification of novel therapeutic targets.

Bilateral jugular foraminal stenosis in a patient with benign osteopetrosis associated with pseudotumor cerebri syndrome

2009 ◽  
Vol 110 (4) ◽  
pp. 804-807 ◽  
Author(s):  
Sayed Mohammad Haji Mirsadeghi ◽  
Ali Tayebi Meybodi ◽  
Farideh Nejat ◽  
Hooshang Saberi
Keyword(s):  
Disease Process ◽  
Signs And Symptoms ◽  
Pseudotumor Cerebri ◽  
Underlying Disease ◽  
Foraminal Stenosis ◽  
Laboratory Studies ◽  
Venous Outflow ◽  
Shunt Insertion ◽  
Pseudotumor Cerebri Syndrome ◽  
The Brain

One of the prominent causes of pseudotumor cerebri (PTC) syndrome is increased impedance of the venous outflow tracts of the brain. Theoretically, this is a justified mechanism for raised intracranial pressure; yet, there had been few cases of such a scenario reported in the literature, and to the authors' knowledge no case of PTC due to benign osteopetrosis has been reported to date. The present case occurred in a 19-year-old woman with a constellation of signs and symptoms compatible with PTC syndrome, whose radiological and laboratory studies confirmed the diagnosis of osteopetrosis. Magnetic resonance venography demonstrated bilateral jugular foraminal stenosis regarding the underlying disease process. The patient did well after she underwent a lumboperitoneal shunt insertion procedure.

Drug-Induced Movement Disorders

2015 ◽  
Vol 25 (2) ◽  
pp. 70-77
Author(s):  
Amy Lustig ◽  
Cesar Ruiz
Keyword(s):  
Movement Disorders ◽  
Medical Management ◽  
Disease Process ◽  
Underlying Disease ◽  
Extrapyramidal Symptoms ◽  
Drug Induced ◽  
General Overview ◽  
Management Approaches ◽  
Broad Understanding ◽  
Underlying Disease Process

The purpose of this article is to present a general overview of the features of drug-induced movement disorders (DIMDs) comprised by Parkinsonism and extrapyramidal symptoms. Speech-language pathologists (SLPs) who work with patients presenting with these issues must have a broad understanding of the underlying disease process. This article will provide a brief introduction to the neuropathophysiology of DIMDs, a discussion of the associated symptomatology, the pharmacology implicated in causing DIMDs, and the medical management approaches currently in use.

RAS in the Central Nervous System: Potential Role in Neuropsychiatric Disorders

2018 ◽  
Vol 25 (28) ◽  
pp. 3333-3352 ◽  
Author(s):  
Natalia Pessoa Rocha ◽  
Ana Cristina Simoes e Silva ◽  
Thiago Ruiz Rodrigues Prestes ◽  
Victor Feracin ◽  
Caroline Amaral Machado ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Central Nervous System ◽  
Nervous System ◽  
Therapeutic Potential ◽  
Neuropsychiatric Disorders ◽  
Extensive Literature ◽  
Ang Ii ◽  
Mas Receptor ◽  
The Central Nervous System ◽  
The Brain

Background: The Renin-Angiotensin System (RAS) is a key regulator of cardiovascular and renal homeostasis, but also plays important roles in mediating physiological functions in the central nervous system (CNS). The effects of the RAS were classically described as mediated by angiotensin (Ang) II via angiotensin type 1 (AT1) receptors. However, another arm of the RAS formed by the angiotensin converting enzyme 2 (ACE2), Ang-(1-7) and the Mas receptor has been a matter of investigation due to its important physiological roles, usually counterbalancing the classical effects exerted by Ang II. Objective: We aim to provide an overview of effects elicited by the RAS, especially Ang-(1-7), in the brain. We also aim to discuss the therapeutic potential for neuropsychiatric disorders for the modulation of RAS. Method: We carried out an extensive literature search in PubMed central. Results: Within the brain, Ang-(1-7) contributes to the regulation of blood pressure by acting at regions that control cardiovascular functions. In contrast with Ang II, Ang-(1-7) improves baroreflex sensitivity and plays an inhibitory role in hypothalamic noradrenergic neurotransmission. Ang-(1-7) not only exerts effects related to blood pressure regulation, but also acts as a neuroprotective component of the RAS, for instance, by reducing cerebral infarct size, inflammation, oxidative stress and neuronal apoptosis. Conclusion: Pre-clinical evidence supports a relevant role for ACE2/Ang-(1-7)/Mas receptor axis in several neuropsychiatric conditions, including stress-related and mood disorders, cerebrovascular ischemic and hemorrhagic lesions and neurodegenerative diseases. However, very few data are available regarding the ACE2/Ang-(1-7)/Mas receptor axis in human CNS.

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