Links for Keyword: Stroke
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By Sandra G. Boodman, Of course Diane O’Leary was seriously tired — who wouldn’t be? A doctoral candidate in philosophy with a demanding academic schedule and a 3-year-old son, O’Leary had flown home to Sydney after her family’s annual visit to relatives in Upstate New York. A few days after that 1994 flight, when O’Leary had to stop in the middle of a dance class because she was too exhausted to continue, she chalked it up to bad jet lag. And a week or so later, when she couldn’t walk up a small hill with her son without stopping to rest on a bench, the 33-year-old wasn’t alarmed. “I managed to get myself through it,” she recalled, adding that she was accustomed to being somewhat tired. But a few weeks later, when the exhaustion didn’t recede, O’Leary consulted her general practitioner. He sent her to a specialist, who made a worrisome diagnosis that would prove to be the first of many wrong answers: chronic fatigue syndrome, an illness that is not relieved by rest. Several months later, after she developed joint pain along with the fatigue, doctors decided she had rheumatoid arthritis, a serious inflammatory disorder that can cause joint destruction. The following year, that diagnosis was jettisoned in favor of a severe form of lupus, an autoimmune disease in which the body attacks its own tissues. But after medications that are the mainstay of treating lupus had no effect — and she developed strange new symptoms — O’Leary’s doctors shifted focus, suggesting that she was also suffering from an underlying psychological disorder. She said she remembers one doctor telling her, “You’re just nervous, honey.” © 1996-2012 The Washington Post
Related chapters from BP7e: Chapter 19: Language and Hemispheric Asymmetry; Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 15: Language and Our Divided Brain; Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders
Link ID: 16995 - Posted: 07.03.2012
WASHINGTON — A Covidien device for rare malformed blood vessels can get stuck in the brain and has been linked to nine patient deaths, U.S. regulators warned. The device, made by Covidien unit ev3, uses a spongy material to block off blood flow to abnormal tangles of blood vessels before they are removed by surgery. The material is delivered to the brain through a tube inserted into a groin artery, known as a catheter. But the catheter can get stuck in the spongy material while inside the brain, causing serious complications including hemorrhage and death, the U.S. Food and Drug Administration said in a notice posted to its website on Thursday. Since the device was approved in 2005, the FDA said it has received more than 100 reports of the catheter breaking after it became stuck, including nine deaths. In at least 54 cases, the catheter could not be removed, leaving it implanted in the patient. "Neither (the spongy material) nor the catheter is intended to be long-term implants, and patients may need additional medical interventions to have the catheter removed if it becomes entrapped," the FDA said in the notice. If the catheter is not removed, parts of it can also migrate to other parts of the body. (c) Copyright Thomson Reuters 2012
Elizabeth Armstrong Moore After a stroke, it is often possible -- with months of therapy and determination -- for the brain to relearn how to control a weakened limb. Finding the resources (therapist, finances, time) can be the bigger hurdle. Enter Circus Challenge, the first in a coming suite of action video games designed by Newcastle University stroke experts and the new company Limbs Alive to provide extra in-home therapy. "Eighty percent of patients do not regain full recovery of arm and hand function and this really limits their independence and ability to return to work," pediatric neuroscience professor Janet Eyre at Newcastle, who set up Limbs Alive to produce the games, said in a news release. "Patients need to be able to use both their arms and hands for most everyday activities such as doing up a zip, making a bed, tying shoe laces, unscrewing a jar. With our video game, people get engrossed in the competition and action of the circus characters and forget that the purpose of the game is therapy." Patients use wireless controllers to learn various circus-related skills, from lion taming and juggling to high diving and trapeze work. As they succeed at various tasks, they go on to more challenging quests that involve greater skill, strength, and coordination. © 2012 CBS Interactive.
A simple drawing test may help predict the risk of older men dying after a first stroke, a study in the journal BMJ Open suggests. Taken while healthy, the test involves drawing lines between numbers in ascending order as fast as possible. Men who scored in the bottom third were about three times as likely to die after a stroke compared with those who were in the highest third. The study looked at 1,000 men between the ages of 67 and 75 over 14 years. Of the 155 men who had a stroke, 22 died within a month and more than half within an average of two- and-a-half years. The researchers think that tests are able to pick up hidden damage to brain blood vessels when there are no other obvious signs or symptoms. Dr Clare Walton, from the Stroke Association, said: "This is an interesting study because it suggests there may be early changes in the brain that puts someone at a greater risk of having a fatal stroke. "This is a small study and the causes of poor ability on the drawing task is not known. Although much more research is needed, this task has the potential to screen for those most at risk of a severe or fatal stroke before it occurs so that they can benefit from preventative treatments." BBC © 2012
By GINA KOLATA BALTIMORE — The patient founded a totalitarian state known for its “merciless terror,” Dr. Victoria Giffi told a rapt audience of doctors and medical students on Friday afternoon. He died suddenly at 6:50 p.m. on Jan. 21, 1924, a few months before his 54th birthday. The cause of death: a massive stroke. Experts differ on the likely causes of the stroke that killed Lenin at 53. The man’s cerebral arteries, Dr. Giffi added, were “so calcified that when tapped with tweezers they sounded like stone.” The occasion was a so-called clinicopathological conference, a mainstay of medical schools in which a mysterious medical case is presented to an audience of doctors and medical students. In the end, a pathologist solves the mystery with a diagnosis. But this was a conference with a twist. The patient was long dead — he was, in fact, Vladimir Ilyich Lenin. The questions posed to the conference speakers: Why did he have a fatal stroke at such a young age? Was there something more to his death than history has acknowledged? At the University of Maryland, an clinicopathological conference focused on historical figures has been an annual event for the past 19 years; attending doctors have reviewed the case records of Florence Nightingale, Alexander the Great, Mozart, Beethoven and Edgar Allan Poe. The pathologists’ conclusion that Poe died of rabies even became a final question on the “Jeopardy!” game show. © 2012 The New York Times Company
Kat Austen, CultureLab editor Neuroanatomist and stroke survivor Jill Bolte Taylor explains why she hopes her display of cerebral artwork will raise awareness of the brain Why are you opening an outdoor exhibition of giant brains? I care about the brain. I grew up wanting to study it because I have a brother diagnosed with schizophrenia. Then in 1996, when I was a neuroscience researcher at Harvard Medical School, I experienced a rare form of stroke. A few years later, during my recovery, I was in Chicago, and on the streets they had sculptures of these enormous cows painted by individual artists so that every cow was different. I thought, wouldn't it be cool to have brains on public display for art? So for the past 10 years, I've been dreaming about having brains on display. And last year I started a not-for-profit organisation to raise appreciation for and awareness about the human brain. The Brain Extravaganza in Bloomington, Indiana, where I live, is the first project. There are 22 enormous brains - five feet long, five feet high and four feet wide. Every brain is anatomically correct with 12 pairs of cranial nerves, and each is decorated by a different artist using different kinds of media. © Copyright Reed Business Information Ltd.
Related chapters from BP7e: Chapter 2: Functional Neuroanatomy: The Nervous System and Behavior; Chapter 19: Language and Hemispheric Asymmetry
Related chapters from MM:Chapter 2: Cells and Structures: The Anatomy of the Nervous System; Chapter 15: Language and Our Divided Brain
Link ID: 16731 - Posted: 05.01.2012
By Laura Sanders CHICAGO — A brain zapping technique helps people recover language after a stroke, new research shows. The results may point to a better way for people to relearn how to talk after a brain injury. “I think this work is very promising,” said cognitive neuroscientist Roi Cohen Kadosh of the University of Oxford. The study, presented April 2 at the annual meeting of Cognitive Neuroscience Society, represents one of the first attempts to successfully apply brain stimulation techniques to a clinical population, he said. Speech therapist and neuroscientist Jenny Crinion of University College London and collaborators focused on people who had trouble finding the right word after a stroke. Known as anomia, the condition is frustrating, leaving people unable to call the correct word to mind. Crinion and her colleagues paired a word-training technique with brain stimulation. The training regimen was intense. In the lab and at home, participants studied 150 cards with pictures of one-syllable words of everyday objects: cat, bed, car and so on for a total of about 60 hours over six weeks. Three days a week, six volunteers came into the lab to receive a type of electrical brain stimulation known as transcranial direct current stimulation. Volunteers received the stimulation, which doesn’t seem to cause pain or any ill effects, while training on the vocabulary words. Seven volunteers received a sham treatment without stimulation. © Society for Science & the Public 2000 - 2012
By Lenny Bernstein, Kris Brott was more amazed than alarmed when her tongue suddenly seemed to turn upside down in her mouth. She was in the office at Quince Orchard High School in Gaithersburg, dropping off a check for her son’s baseball team, when she suddenly found herself quite literally tongue-tied. Her puzzlement gave way to panic when she reached her car and looked in the mirror. The left side of her face had collapsed. By the time she reached home, her left arm had gone numb. Soon she was dragging her left leg. It was March 15, 2010, the day before her 45th birthday. This couldn’t be happening, she thought. She was too young and much too fit. “I still kept thinking, ‘I’m not having a stroke,’ ” she recalled. She was wrong. At the hospital, emergency room physicians cleared the clot from her brain, but the damage had been done. When Brott was left with little strength on her left side despite physical therapy, she faced a long, difficult future in a body compromised by a disease of the elderly — until she decided to take control of her own recovery by returning to the gym. Researchers are learning that exercise can help younger stroke victims such as Brott regain function, even years after they are stricken. A widely cited 2011 study provides support for therapeutic approaches like the one Brott stumbled upon when she returned to the gym. © 1996-2012 The Washington Post
Martin E. Schwab & Anita D. Buchli Recently, at the annual retreat of the Zurich Neuroscience Center, we ran into a former colleague who had often helped us to prepare for courses we were teaching. But he was not there to teach — he was participating in a demonstration as a patient. A stroke had left him paralysed on one side, wheelchair-bound and unable to speak. He had been looking forward to interacting with the students, but when he could not communicate with them, he broke into tears. After a difficult rehabilitation, he was able to resume some of his work, but he still cannot speak. His arm and leg will probably remain paralysed for the rest of his life. Our colleague was one of the 8.2 million Europeans who experience stroke every year1. The brain is a source of many devastating disorders — such as Alzheimer's disease, Parkinson's disease and amyotrophic lateral sclerosis — and injuries to the spinal cord or brain can lead to lifelong impairments. At present, disabling spinal-cord injuries affect roughly 350,000 people in Europe and 250,000 in the United States. Traumatic brain injuries are about ten times more common. Treatments that could restore lost functions to people with such injuries would radically change their lives and decrease the burden to their families and social environment. The economic interest to drug companies and health insurers seems obvious. Yet drug companies have withdrawn from neuroscience, more so than from any other disease area. Last year, Novartis closed its preclinical neuroscience research facility in Basel, Switzerland. Pfizer, GlaxoSmithKline and AstraZeneca had already made similar moves. Merck and Sanofi are also cutting research on brain diseases. © 2012 Nature Publishing Group
Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 19: Language and Hemispheric Asymmetry
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders; Chapter 15: Language and Our Divided Brain
Link ID: 16533 - Posted: 03.17.2012
A DRUG which minimises brain damage when given three hours after stroke has proved successful in monkeys and humans. A lack of oxygen in the brain during a stroke can cause fatal brain damage. There is only one approved treatment - tissue plasminogen activator - but it is most effective when administered within 90 minutes after the onset of stroke. Immediate treatment isn't always available, however, so drugs that can be given at a later time have been sought. In a series of experiments, Michael Tymianski and colleagues at Toronto Western Hospital in Ontario, Canada, replicated the effects of stroke in macaques before intravenously administering a PSD-95 inhibitor, or a placebo. PSD-95 inhibitors interfere with the process that triggers cell death when the brain is deprived of oxygen. To test its effectiveness the team used MRI to measure the volume of damaged brain for 30 days following the treatment, and conducted behavioural tests at various intervals within this time. Monkeys treated with the PSD-95 inhibitor one hour after stroke had 55 per cent less damaged tissue in the brain after 24 hours and 70 per cent less after 30 days, compared with those that took a placebo. These animals also did better in behavioural tests. Importantly, the drug was also effective three hours after stroke (Nature, DOI: 10.1038/nature10841). © Copyright Reed Business Information Ltd
Steve Connor Scientists have identified a genetic mutation in one of the 23,000 human genes that can double the risk of a stroke, which kills more than six million people worldwide each year and is the second top cause of death in developed countries. A study of thousands of stroke patients in Britain and Germany found a link between the most common type of stroke – a blocked blood vessel leading to the brain – and a genetic variation in a gene known as HDAC9. Although strokes are known to run in families, this is one of the first studies to identify a precise DNA variant in the human genetic code that doubles a person's risk of developing a blocked artery supplying vital oxygen to the brain. The HDAC9 gene was already known to be involved in the formation of muscle tissue and the development of the heart, but the latest research suggests it is also implicated in a particular kind of illness called large-artery ischaemic stroke. Scientists said the DNA variation occurs on about 10 per cent of the chromosomes carrying the HDAC9 gene. People who inherit two copies of the variant, one from their mother and one from their father, face twice the risk of developing this type of stroke than people with no copies of the gene variant, they said. The study, published in Nature Genetics and funded by the Wellcome Trust charity, used a relatively new scientific technique of genome-wide association studies to compare the DNA of some 10,000 stroke patients with the DNA of 40,000 people who have not had a stroke. © independent.co.uk
Erin Allday, Chronicle Staff Writer Greg Moulton was getting ready for work one morning in 2006 when he suddenly lost all of the strength in his right arm, and he realized he was having a stroke. Thinking fast, he called his wife and left a message for her. Then he called his office to let his boss know that he was having a stroke and "would be in shortly," Moulton said. "I was very naive," said Moulton, 51, last week from his home in Fremont. "I knew what a stroke was, but I didn't know how serious it was." Fortunately for Moulton, his wife did know, and so did the paramedics who arrived at his home a few minutes later. Another lucky turn: Alameda County had just started a new emergency stroke response system, which meant that everyone from the 911 dispatcher Moulton's wife called to the emergency room doctors and nurses at the hospital where he was taken were ready for him and knew immediately how to treat him. Such stroke systems have been popping up all over California in the past six years, and there are now 11 regions in the state - including Alameda, Contra Costa, Santa Clara and San Mateo counties in the Bay Area - that provide coordinated emergency stroke care. Contra Costa was the most recent county to start a system, which launched earlier this month. © 2012 Hearst Communications Inc.
by Richard Knox Debra Meyerson was hiking near Lake Tahoe 15 months ago when a stroke destroyed part of the left side of her brain, leaving her literally speechless. It happens to more than 150,000 Americans a year. But now Meyerson is learning to talk again through an approach that trains the undamaged right side of her brain to "speak." Specifically, it's a region that controls singing. For more than 100 years, it's been known that people who can't speak after injury to the speech centers on the left side of the brain can sing. In the 1970s, Boston researchers started to use a sort of "singing therapy" to help stroke survivors speak again. However, it never caught on much – perhaps because a lot of therapists, not to mention patients, weren't comfortable singing what they wanted to say. And back then, the science wasn't advanced enough to show the actual changes in the brain that result from the therapy. That's changing fast. Congresswoman Gabrielle Giffords, who has had a version of "singing therapy," astounded everyone by her ability to speak again – albeit so far in single words and short phrases. Nearly a year ago, a would-be assassin's bullet tore through the speech center in Giffords' left brain. Copyright 2011 NPR
By NICHOLAS BAKALAR The risk factors that predict stroke also predict mental impairment, a new study has found, even in people who have never had a stroke. Researchers studied a nationally representative sample of 23,752 mentally normal, stroke-free men and women whose average age was 64, using health questionnaires and an in-home physical and mental examination. They recorded seven risk factors for stroke: three types of heart abnormality, high blood pressure, the use of blood pressure medication, diabetes and smoking. Several of the authors have received payments from pharmaceutical companies. The report appears in Neurology. The volunteers were followed for an average of more than four years. After eliminating from consideration any who had had a stroke, the researchers found 1,907 who were cognitively impaired. After controlling for age, sex, race and education, researchers found that high blood pressure and left ventricular hypertrophy independently predicted cognitive impairment, and the more risk factors a person had, the greater the risk for mental problems. The lead author, Frederick W. Unverzagt, a professor of clinical psychology at the Indiana University School of Medicine, had this advice: “The early detection and treatment of high blood pressure is what we’re advocating for folks to preserve their cognitive health.” © 2011 The New York Times Company
Related chapters from BP7e: Chapter 19: Language and Hemispheric Asymmetry; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 15: Language and Our Divided Brain; Chapter 13: Memory, Learning, and Development
Link ID: 16067 - Posted: 11.22.2011
Having a mini-stroke can reduce a person's life expectancy by up to 20 per cent, a new study suggests. In a mini-stroke — known in the medical world as a transient ischemic attack (TIA) — the blood flow to part of the brain is temporarily blocked or reduced. With a mini-stroke, the initial symptoms of blurred vision, numbness, sudden headache, and difficulty speaking or walking (similar to stroke symptoms) soon disappear. In a stroke, the brain incurs permanent damage because the blood flow stays blocked. Having a history of TIA has long been known as a risk factor for strokes. This new study suggests there are also serious impacts on life expectancy. Researchers identified more than 22,000 people hospitalized in Australia because of a mini-stroke between 2000 and 2007 and tracked their medical records for at least two years. Using death registry data from 2009, they then compared this population to those in the general population. Their findings were startling. For those patients who'd had a mini-stroke in 2000, their survival rate nine years later was 20 per cent lower than the population as a whole. Survival rates at the one-year and five year marks were also lower. A year after a mini-stroke, 91.5 per cent of the TIA patients were still alive, versus 95 per cent survival among the general population. Five years after a mini-stroke, 67.2 per cent of the TIA group was alive, compared to 77.4 per cent of the general population. © CBC 2011
By DENISE GRADY An operation that doctors hoped would prevent strokes in people with poor circulation to the brain does not work, researchers are reporting. A $20 million study, paid for by the government, was cut short when it became apparent that the surgery was not helping patients who had complete blockages in one of their two carotid arteries, which run up either side of the neck and feed 80 percent of the brain. The surgery was a bypass that connected a scalp artery to a deeper vessel to improve blood flow to the brain. The new study, published on Wednesday in The Journal of the American Medical Association, is the second in recent months to find that a costly treatment, one that doctors had high hopes for, did not prevent strokes. In September, researchers reported that stents being used to prop open blocked arteries deep in the brain were actually causing strokes. That study was also cut short. Both the stents and the bypass operation seemed to make sense medically, and doctors thought they should work. Their failure highlights the peril of assuming that an apparent improvement on a lab test or X-ray, like better blood flow or a wider artery, will translate into something that actually helps patients, warned an editorial that accompanied the new findings. Only rigorous studies can tell for sure. The editorial writer, Dr. Joseph P. Broderick, chairman of neurology at the University of Cincinnati College of Medicine, also cautioned that other stroke treatments were being used without sufficient study, particularly devices to remove clots. © 2011 The New York Times Company
By Bruce Bower Stroke survivors and other patients trying to relearn how to walk due to weakness on one side of the body may reap benefits from being forced to stumble and stagger. Healthy adults made to switch between a regular and an unusual walking pattern on a special treadmill relearned the strange stride much faster the next day than volunteers who had practiced only the unusual gait, neuroscientist Amy Bastian of the Kennedy Krieger Institute in Baltimore and her colleagues report in a study in the Oct. 19 Journal of Neuroscience. Not surprisingly, participants who learned and then unlearned an unusual walking pattern while adjusting to a new walking style took lots of clumsy steps when trying to relearn the original pattern, some reminiscent of Monty Python’s old skit about the Ministry of Silly Walks. Yet these individuals had the last laugh, because they learned how to correct awkward leg limps and body lurches that occur in the early stages of adapting to a new gait, the researchers propose. Practice at switching gaits helps people learn how to adjust for initial missteps when attempting an alternative walking style, Bastian says. She calls this process “learning to learn” from one’s mistakes, so that movements can be realigned quickly as needed. Gait-switching volunteers weren’t aware that they learned anything, but the next day they realized that it was easier to adopt the odd walking style. © Society for Science & the Public 2000 - 2011
Related chapters from BP7e: Chapter 19: Language and Hemispheric Asymmetry; Chapter 11: Motor Control and Plasticity
Related chapters from MM:Chapter 15: Language and Our Divided Brain; Chapter 5: The Sensorimotor System
Link ID: 15927 - Posted: 10.22.2011
by Linda Geddes The life-saving treatment of therapeutic hypothermia is calling into question the guidelines doctors use to determine brain death IT'S a nightmarish scenario: a 55-year-old man, pronounced dead after a cardiac arrest, is minutes away from organ donation when he begins to show signs of life. "On being moved to the operating room table, the anaesthetist noticed that he was coughing," says neurologist Adam Webb of Emory University School of Medicine in Atlanta, Georgia, who initially pronounced the man brain dead. It transpired that the man had also regained corneal reflexes and was breathing - both signs of a functioning brainstem. Although the man later died, his case has reignited a debate about whether clearer guidelines are needed to determine brain death (Critical Care Medicine, DOI: 10.1097/CCM.0b013e3182186687). At issue is a treatment called therapeutic hypothermia, which Webb's patient had. It involves cooling the body to about 33 °C to minimise damage to tissues and brain cells caused by oxygen deprivation after a cardiac arrest. Since the publication of two landmark papers in 2002 in The New England Journal of Medicine, increasing numbers of hospitals are using therapeutic hypothermia. It saves lives, but the technique muddies the waters when it comes to determining brain death. It is also making it harder to predict who is likely to recover from a coma. © Copyright Reed Business Information Ltd.
By Neil Bowdler Health reporter, BBC News Scientists in the Netherlands are using robotic legs to try to improve the movement of stroke patients. The prototype device is called the Lower-extremity Powered ExoSkeleton, or LOPES, and works by training the body and mind of a patient to recover a more natural step. The machine is also being tested on spinal injury patients who have recovered some restricted movement in their legs. It is hoped a commercial version could be made available to rehabilitation centres around the world as early as next year. Feedback mechanism LOPES has been developed by engineers at the University of Twente in Enschede in the Netherlands over several years. Designed for the rehabilitation clinic, it is not a mobile device but supports the patient as they walk on a treadmill. It can do all the walking for the patient, or it can offer targeted support in either one leg or with one element of the walking process. The machine can also detect what the patient is doing wrong. "For instance, some people cannot lift their foot up appropriately," explains Dr Edwin van Asseldonk, who is working on the project. "What this device does is it senses that the foot is not lifting properly. BBC © 2011
By Nathan Seppa Threading a catheter up into the brain and inserting a device that widens a dangerously narrowed artery might do more harm than good in some patients at risk of stroke. An aggressive course of medications alone appears to be safer, researchers report online September 7 in the New England Journal of Medicine. Mesh cylinders called stents have offered cardiologists an inside-out approach to opening clogged coronary arteries that is less invasive than surgery. Now researchers are using a new generation of tiny stents to tackle similarly narrowed vessels in the brain. Federal regulators approved a brain stent in 2005, and past studies have supported stents’ effectiveness against stroke (SN: 2/17/2007, p. 99). Researchers used the approved stent in the new trial. They enrolled hundreds of patients at 50 hospitals who had just survived a stroke or had a transient ischemic attack, a kind of stroke that clears up within a day, says study coauthor Marc Chimowitz, a neurologist at the Medical University of South Carolina. The average age of the patients was about 60. Brain scans of these patients pinpointed an artery with buildup that obstructed at least 70 percent of blood flow. People with such bottlenecks are at high risk of having a stroke, because a blood clot may form at the narrowed spot and block blood flow, or a loose clot might get lodged at the pinch point. All patients received clot-busting medicines — aspirin and clopidogrel (Plavix) — and were given drugs to lower cholesterol and control blood pressure. © Society for Science & the Public 2000 - 2011