Electroencephalographic Features in Pediatric Patients with Moyamoya
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Moyanioya Syndrome*
Rey. Argent. Neuroc. 2005; 19: 31 Actualización MOYANIOYA SYNDROME* Edward R. Smith, MD, R. Michael Scott, MD Department of Neurosurgery, The Children's Hospital, Boston RESUMEN El síndrome de Moyamoya es una vasculopatía caracterizada por la estenosis crónica y progresiva de la arteria carótida interna intracraneal. El diagnóstico se realiza en base a hallazgos clínicos y radiológicos que incluyen la muy característica estenosis de la carótida interna con un importante desarrollo de circulación colateral. Los pacientes adultos con Moyamoya con frecuencia se presentan con cuadros hemorrágicos. En cambio, los niños usualmente presentan ataques isquémicos transitorios (AIT) o infartos isquémicos y en ellos es frecuente un diagnóstico más tardío del síndrome Moyamoya. La progresión de la enfermedad puede ser lenta con eventos intermitentes o puede ser fulminante, con un rápido deterioro neurológico. Cualquiera sea laforma de evolucionar, el síndrome de Moyamoya suele presentar un empeoramiento clínico y radiológico progresivo en los pacientes no tratados. La cirugía es recomendada para el tratamiento de pacientes con eventos isquémicos cerebrales recurrentes o progresivos que presentan una reducción de la reserva de perfusión cerebral. Múltiples técnicas operatorias han sido descriptas con el propósito de prevenir injurias cerebrales isquémicas mediante un aumento del flujo sanguíneo colateral en áreas corticales hipoperfundidas utilizando la circulación carotídea externa como vascularización donante. Este trabajo discute las diferentes formas terapéuticas con un énfasis especial en la utilización de la sinangiosis pial como método de revascularización indirecta. La utilización de la sinangiosis pial es unaforma de revascularización cerebral efectiva y durable en el síndrome de Moyamoya y debe ser considerada como una forma primaria de tratamiento de esta entidad, especialmente en la población infantil. -
Poster Sessions
Epilepsia, 52(Suppl. 6):23–263, 2011 doi: 10.1111/j.1528-1167.2011.03207.x 29TH IEC PROCEEDINGS 29th International Epilepsy Congress, Rome, 28 August–1 September 2011 Poster Sessions Poster session: Adult epileptology I of risk of SUDEP hinging on the presence and absence of well recognized risk factors. Monday, 29 August 2011 We aim to present a clinical visual checklist to capture risks factors for SUDEP as evidenced by a detailed review of the current literature. p055 WHAT REALLY MATTERS TO PEOPLE WITH Method: We conducted a careful analysis of the current evidence base EPILEPSY IN 2011? A PAN-EUROPEAN PATIENT via a medline search using the search terms in various permutation and combinations: SUDEP, sudden death in epilepsy, death, epilepsy, risk SURVEY factors, checklist. Cramer JA1, Dupont S2, Goodwin M3, Trinka E4 1Yale Univexrsity School of Medicine, Houston, TX, U.S.A., Results: We divided the identified possible and probable risk factors 2PitiØ-SalpÞtrire Hospital, Paris, France, 3Northampton General into very low, low medium and high risk using the Australian risk map- 4 ping system for safety checklists AS4360. A simple tick box design facil- HospitalNHS Trust, Northampton, UnitedKingdom, Paracelsus itates at a glance profile of an individual’s risk and the overall severity of Medical University, Christian Doppler Klinik, Salzburg,Austria risk on a particular date. Purpose: To conduct a pan-European survey amongst people with epi- Conclusions: We have synthesized the available evidence into an easy lepsy to define issues of importance in their daily lives, correlated with reference checklist which can be quickly completed during a clinic. -
Original Article Outcome of Supratentorial Intraaxial Extra Ventricular Primary Pediatric Brain Tumors
Original Article Outcome of supratentorial intraaxial extra ventricular primary pediatric brain tumors: A prospective study Mohana Rao Patibandla, Suchanda Bhattacharjee1, Megha S. Uppin2, Aniruddh Kumar Purohit1 Department of Neurosurgery, Krishna Institute of Medical Sciences Secunderabad, Departments of 1Neurosurgery and 2Pathology, Nizam’s Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India Address for correspondence: Dr. Mohana Rao Patibandla, Department of Neurosurgery, University of Colorado Denver, 13123, E 16th Ave, Aurora, CO 80045, USA. Email: [email protected] ABSTRACT Introduction: Tumors of the central nervous system (CNS) are the second most frequent malignancy of childhood and the most common solid tumor in this age group. CNS tumors represent approximately 17% of all malignancies in the pediatric age range, including adolescents. Glial neoplasms in children account for up to 60% of supratentorial intraaxial tumors. Their histological distribution and prognostic features differ from that of adults. Aims and Objectives: To study clinical and pathological characteristics, and to analyze the outcome using the Engel’s classification for seizures, Karnofsky’s score during the available follow‑up period of minimum 1 year following the surgical and adjuvant therapy of supratentorial intraaxial extraventricular primary pediatric (SIEPP) brain tumors in children equal or less than 18 years. Materials and Methods: The study design is a prospective study done in NIMS from October 2008 to January 2012. All the patients less than 18 years of age operated for SIEPP brain tumors proven histopathologically were included in the study. All the patients with recurrent or residual primary tumors or secondaries were excluded from the study. Post operative CT or magnetic resonance imaging (MRI) is done following surgery. -
Corpus Callosotomy Outcomes in Paediatric Patients
CORPUS CALLOSOTOMY OUTCOMES IN PAEDIATRIC PATIENTS David Graham Children’s Hospital at Westmead Clinical School Sydney Medical School University of Sydney Supervisor: Russell C Dale, MBChB MSc PhD MRPCH FRCP Co-Supervisors: Deepak Gill, BSc MBBS FRCP Martin M Tisdall, MBBS BA MA MD FRCS This dissertation is submitted for total fulfilment of the degree of Master of Philosophy in Medicine March 2018 Corpus Callosotomy Outcomes in Paediatric Patients David Graham - March 2018 Corpus Callosotomy Outcomes in Paediatric Patients For Kristin, Isadora, and Oscar David Graham - March 2018 Corpus Callosotomy Outcomes in Paediatric Patients David Graham - March 2018 Corpus Callosotomy Outcomes in Paediatric Patients Perhaps no disease has been treated with more perfect empiricism on the one hand, or more rigid rationalism on the other than has epilepsy. John Russell Reynolds, 1861 David Graham - March 2018 Corpus Callosotomy Outcomes in Paediatric Patients David Graham - March 2018 Corpus Callosotomy Outcomes in Paediatric Patients – David Graham DECLARATION This dissertation is the result of my own work and includes nothing that is the outcome of work done in collaboration except where specifically indicated in the text. It has not been previously submitted, in part or whole, to any university of institution for any degree, diploma, or other qualification. The work presented within this thesis has resulted in one paper that has been published in the peer-review literature: Chapters 2-3, Appendix C: Graham D, Gill D, Dale RC, Tisdall MM, for the Corpus Callosotomy Outcomes Study Group. Seizure outcome after corpus callosotomy in a large pediatric series. Developmental Medicine and Child Neurology; doi: 10.1111/dmcn.13592 The work has also resulted in one international conference podium presentation, one local conference podium presentation, and one international conference poster: Graham D, Barnes N, Kothur K, Tahir Z, Dexter M, Cross JH, Varadkar S, Gill D, Dale RC, Tisdall MM, Harkness W. -
Complete Issue (PDF)
JUNE 2018 AJNR VOLUME 39 • PP 993–1191 JUNE 2018 THE JOURNAL OF DIAGNOSTIC AND VOLUME 39 INTERVENTIONAL NEURORADIOLOGY NUMBER 6 WWW.AJNR.ORG Multisite concordance of DSC for brain tumors Comparison of 3T intracranial vessel wall sequences Ophthalmic artery collaterals in Moyamoya disease Official Journal ASNR • ASFNR • ASHNR • ASPNR • ASSR Low-profile Visualized Intraluminal Support Stent Deployment. Refined. Braided Coil Assist Stents with High Neck Coverage, Excellent Visibility and Improved Conformability* Aneurysm Therapy Solutions For more information or a product demonstration, contact your local MicroVention representative: MicroVention Worldwide Innovation Center PH +1.714.247.8000 35 Enterprise *Humanitarian Device: Authorized by Federal Law for use with bare platinum Aliso Viejo, CA 92656 USA embolic coils for the treatment of unruptured, wide neck (neck ≥ 4 mm or dome to neck ratio < 2), intracranial, saccular aneurysms arising from a parent MicroVention UK Limited PH +44 (0) 191 258 6777 vessel with a diameter ≥ 2.5 mm and ≤ 4.5 mm. The effectiveness of this device MicroVention Europe, S.A.R.L. PH +33 (1) 39 21 77 46 for this use has not been demonstrated. MicroVention Deutschland GmbH PH +49 211 210 798-0 microvention.com MICROVENTION and LVIS are registered trademarks of MicroVention, Inc. • Refer to Instructions for Use, contraindications and warnings for additional information. Federal (USA) law restricts this device for sale by or on the order of a physician. ©2018 MicroVention, Inc. Jan. 2018 Now you have 24 hours to make a lifetime of difference in stroke patients like Nora The Trevo Retriever is the only device cleared to reduce disability in stroke patients up to 24 hours from time last seen well. -
Characteristics of Moyamoya Disease in the Older Population: Is It Possible to Define a Typical Presentation and Optimal Therapeutical Management?
Journal of Clinical Medicine Review Characteristics of Moyamoya Disease in the Older Population: Is It Possible to Define a Typical Presentation and Optimal Therapeutical Management? Ignazio G. Vetrano 1,* , Anna Bersano 2 , Isabella Canavero 2, Francesco Restelli 1, Gabriella Raccuia 1, Elisa F. Ciceri 3, Giuseppe Faragò 3, Andrea Gioppo 3, Morgan Broggi 1 , Marco Schiariti 1, Laura Gatti 4 , Paolo Ferroli 1 and Francesco Acerbi 1,5 1 Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; [email protected] (F.R.); [email protected] (G.R.); [email protected] (M.B.); [email protected] (M.S.); [email protected] (P.F.); [email protected] (F.A.) 2 Cerebrovascular Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; [email protected] (A.B.); [email protected] (I.C.) 3 Interventional Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; [email protected] (E.F.C.); [email protected] (G.F.); [email protected] (A.G.) 4 Cellular Neurobiology Laboratory, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; [email protected] 5 Experimental Microsurgical Laboratory, Fondazione IRCCS Istituto Neurologico Carlo Besta, Citation: Vetrano, I.G.; Bersano, A.; 20133 Milan, Italy Canavero, I.; Restelli, F.; Raccuia, G.; * Correspondence: [email protected] Ciceri, E.F.; Faragò, G.; Gioppo, A.; Broggi, M.; Schiariti, M.; et al. Abstract: Whereas several studies have been so far presented about the surgical outcomes in terms of Characteristics of Moyamoya Disease mortality and perioperative complications for elderly patients submitted to neurosurgical treatments, in the Older Population: Is It Possible the management of elderly moyamoya patients is unclear. -
WCN19 Journal Posters Part 2 Revised V1
JNS-0000116542; No. of Pages 131 ARTICLE IN PRESS Journal of the Neurological Sciences (2019) xxx–xxx Contents lists available at ScienceDirect Journal of the Neurological Sciences journal homepage: www.elsevier.com/locate/jns WCN19 Journal Posters Part 2 revised_V1 WCN19-2260 WCN19-2269 Poster shift 01 - Channelopathies /neuroethics /neurooncology / Poster shift 01 - Channelopathies /neuroethics /neurooncology / pain - Part I /sleep disorders - Part I /stem cells and gene therapy - pain - Part I /sleep disorders - Part I /stem cells and gene therapy - Part I /stroke /training in neurology - Part I and traumatic brain Part I /stroke /training in neurology - Part I and traumatic brain injury injury Numb chin syndrome- The first finding in metastatic malignancy Results of surgical treatment in patients with moyamoya disease considering CT-perfusion imaging study N. Mustafayev, A. Bayrakoglu, F. Ilgen Uslu, M. Kolukısa Bezmialem University, Neurology, Istanbul, Turkey O. Harmatinaa, V. Morozb, I. Skorokhodab, I. Tyshb, N. Shahinb,R. Hanemb, U. Maliarb a Numb chin syndrome (NCS) is a sensory neuropathy of the SI «Romodanov Institute of Neurosurgery of NAMS of Ukraine», mental nerve, which is accompanied by hypoesthesia and paresthe- Neuroradiology Department, Kyiv, Ukraine b sia of the jaw and lower lip. Although being well known in neurology SI «Romodanov Institute of Neurosurgery of NAMS of Ukraine», practice, most of the physicians who have not experienced this Emergency Department of Vascular Neurosurgery, Kyiv, Ukraine phenomenon are unaware of this phenomenon since it is rare and can be confused with somatic complaints. This case report aims to Aim point out that NCS may be the first sign and symptom of metastatic To improve the results of surgical treatment of patients with cancers in patients who are not diagnosed. -
The Noninvasive Localisation of Brain Abnormality in Intractable Focal Epilepsy in Childhood
THE NONINVASIVE LOCALISATION OF BRAIN ABNORMALITY IN INTRACTABLE FOCAL EPILEPSY IN CHILDHOOD Thesis submitted for the Degree of Doctor of Philosophy in the Faculty of Medicine by Judith Helen Cross Institute of Child Health University of London 1998 ProQuest Number: U644132 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. uest. ProQuest U644132 Published by ProQuest LLC(2016). Copyright of the Dissertation is held by the Author. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code. Microform Edition © ProQuest LLC. ProQuest LLC 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106-1346 ABSTRACT The work described in this thesis evaluates the role of noninvasive magnetic resonance and nuclear medicine techniques in the investigation of focal epilepsy of childhood, and more specifically in the presurgical evaluation of children who are potential candidates for surgery. Seventy five children were prospectively investigated after referral for assessment and investigation of intractable focal epilepsy. Initial clinical localisation was made on the basis of full clinical assessment with EEG. All underwent magnetic resonance imaging. Abnormalities were found in 88% of children, concordant with the seizure focus in 80%. Further magnetic resonance techniques were assessed with regard to latéralisation of temporal lobe epilepsy (TLE). T2 relaxometry of the hippocampi and proton magnetic resonance spectroscopy (^H MRS) of the mesial temporal lobes were demonstrated to be lateralising in a high proportion of these children, and also showed a high rate of bilateral abnormality. -
Long-Term Outcomes of Epilepsy Surgery
Long-term outcomes of epilepsy surgery Prospective studies regarding seizures, employment and quality of life Anna Edelvik Department of Clinical Neuroscience Institute of Neuroscience and Physiology Sahlgrenska Academy at University of Gothenburg Gothenburg, Sweden 2017 Cover illustration: Electrical brain by Maria Nilsson Long-term outcomes of epilepsy surgery - prospective studies regarding seizures, employment and quality of life © Anna Edelvik 2016 [email protected] ISBN 978-91-629-0003-8 (Print) ISBN 978-91-629-0004-5 (PDF) http://hdl.handle.net/2077/48660 Printed by Ineko AB, Gothenburg, Sweden 2016 ”What’s the most difficult part of coping with epilepsy?” “The memory loss, the fatigue, the school I miss because of fatigue and seizures, the fear that the next one may kill me, knowing I’m killing my body with my meds but needing them to survive.” “It hurts physically, emotionally, economically and socially.” From The Epilepsy Network Facebook community, November 2016 Abstract Epilepsy surgery is a treatment option for selected patients with drug-resistant epilepsy. Patients need individual pre-surgical counselling on chances of seizure freedom and other outcomes in a long-term perspective. The aim of this thesis was to investigate long-term outcomes as to seizures, antiepileptic drugs (AEDs), employment and health-related quality of life (HRQOL) and to investigate prognostic factors for seizure and employment outcomes. All three studies were prospective, longitudinal and population-based. Study I and II were based on outcome data from the Swedish National Epilepsy Surgery Register. Study III was a controlled prospective, cross-sectional, national long- term follow-up study 14 years after epilepsy surgery evaluation where HRQOL was investigated using the 36-item Short Form Health Survey. -
A Case Report of Moyamoya Disease Presenting As Headache in a 35-Year-Old Hispanic Man
Open Access Case Report DOI: 10.7759/cureus.4426 A Case Report of Moyamoya Disease Presenting as Headache in a 35-year-old Hispanic Man Daniel B. Azzam 1 , Ajay N. Sharma 2 , Ekaterina Tiourin 3 , Alvin Y. Chan 1 1. Neurosurgery, University of California, Irvine, USA 2. Dermatology, University of California, Irvine, USA 3. Miscellaneous, University of California, Irvine, USA Corresponding author: Daniel B. Azzam, [email protected] Abstract Moyamoya disease (MMD) is a rare, chronic vaso-occlusive disease affecting the arteries of the Circle of Willis, leading to the development of characteristic collateral vessels. In this paper, we present a case of a 35-year-old Hispanic male who presented to the emergency department with new onset headaches. On examination, Glasgow Coma Scale score was 3T. The patient was investigated with head CT scan and cerebral angiogram, diagnosed as MMD, and treated with emergent ventriculostomy. Ultimately, the patient underwent extracranial-intracranial (EC-IC) bypass surgery for treatment of Moyamoya. Categories: Emergency Medicine, Neurology, Neurosurgery Keywords: moyamoya, headache, hemorrhage, stroke, neurosurgery Introduction Moyamoya disease (MMD) is a progressive cerebrovascular disorder characterized by progressive stenosis of the terminal portions of the intracranial internal carotid arteries due to hypertrophy of smooth muscle in the vessel walls [1-4]. Reduced blood flow to the brain leads to the growth of collateral vasculature such as branches from small leptomeningeal vessels. Imaging of the collateral vasculature was characterized in Japan as a “puff of smoke,” or moyamoya in Japanese. Incidence of MMD is the highest in Japan, where there are three cases per 100,000, and in females (2:1 ratio) [2]. -
Post-Surgical Outcome for Epilepsy Associated with Type I Focal Cortical Dysplasia Subtypes Samantha L Simpson and Richard a Prayson
Modern Pathology (2014) 27, 1455–1460 & 2014 USCAP, Inc. All rights reserved 0893-3952/14 $32.00 1455 Post-surgical outcome for epilepsy associated with type I focal cortical dysplasia subtypes Samantha L Simpson and Richard A Prayson Department of Anatomic Pathology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, OH, USA Focal cortical dysplasias are a well-recognized cause of medically intractable seizures. The clinical relevance of certain subgroups of the International League Against Epilepsy (ILAE) classification scheme remains to be determined. The aim of the present work is to assess the effect of the focal cortical dysplasia type Ib and Ic histologic subtypes on surgical outcome with respect to seizure frequency. This study also provides an opportunity to compare the predictive value of the ILAE and Palmini et al classification schemes with regard to the type I focal cortical dysplasias. We retrospectively reviewed 91 focal cortical dysplasia patients (55% female; median age: 19 years (interquartile range 8–34); median seizure duration: 108 months (interquartile range 36–204)) with chronic epilepsy who underwent surgery. We compared the pathological subtypes, evaluating the patients’ post-surgical outcome with respect to seizure frequency according to the Engel’s classification and the ILAE outcome classification. Both the ILAE classification scheme and Palmini et al classification scheme were utilized to classify the histologic subtype. Using v2 and Fisher’s exact tests, we compared the post- surgical outcomes among these groups. Of the 91 patients, there were 50 patients with ILAE focal cortical dysplasia type Ib, 41 with ILAE focal cortical dysplasia type Ic, 63 with Palmini et al focal cortical dysplasia type IA, and 28 with Palmini et al focal cortical dysplasia type IB. -
Stenosis of the Proximal External Carotid Artery in an Adult with Moyamoya Disease: Moyamoya Or Atherosclerotic Change? —Case Report—
Neurol Med Chir (Tokyo) 47, 356¿359, 2007 Stenosis of the Proximal External Carotid Artery in an Adult With Moyamoya Disease: Moyamoya or Atherosclerotic Change? —Case Report— Seong Jun LEE and Jung Yong AHN Department of Neurosurgery, Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, R.O.K. Abstract A 55-year-old woman presented with moyamoya disease manifesting as recurrent transient ischemic attacks despite taking aspirin and antihypertensive agent. Angiography showed the characteristic angiographic appearance with bilateral internal carotid artery occlusion and abnormal collateral vessels. Left external carotid angiography demonstrated moderate stenosis of the proximal external carotid artery (ECA). A self-expandable stent was successfully placed in the left ECA to improve ipsilateral cerebral perfusion. The patient had an uneventful outcome after a 1-year follow up. Involve- ment of the proximal ECA is very unusual in moyamoya disease, and might result from hemodynamic stress or degenerative atherosclerosis. Revascularization procedures for stenoses of proximal ECA may improve cerebral perfusion in patients with moyamoya disease. Key words: moyamoya disease, external carotid artery, revascularization, stent Introduction recognized decades ago when neurological symp- toms were resolved in patients with occluded ICAs Moyamoya disease is a progressive occlusive ar- and stenotic ECA by surgical endarterectomy and teriopathy, usually affecting the bilateral internal patch angioplasty of the ECA stenoses.11) Patients carotid arteries (ICAs).6,9) The diagnosis depends on with moyamoya disease can be treated by extra- the angiographic features of stenosis of the bilateral cranial-intracranial (EC-IC) bypass, anastomosing ICAs and compensatory enlargement of the prefer- the superficial temporal artery with the middle ring vessels at the base of the brain.7) The symptoms cerebral artery (MCA).