August 12th, 2011 by Shadowfax in Opinion, True Stories
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Yesterday, I presented the case of a woman with double vision and ptosis and challenged you all to a game of “spot the lesion.” To be honest, I found this stuff impenetrable as a medical student and it was only by sheer force of will that I was able to commit it to memory for exactly long enough to pass a test on it before immediately purging it from my memory. I did this several times for various board exams and such, but it never really “stuck.” Hated neuro beyond words, I did.
As mind-numbing as I found it all in the abstract, I get excited about these cases in application. I may not remember where exactly the internal capsule is or what it does, but when I see someone with an interesting neuro deficit due to a lesion there, all of a sudden it makes so much more sense, and is, dare I say it, cool. I know, kinda sad.
This case is as classic (and cool) as you will ever see. It’s a complete palsy of the Oculomotor Nerve (CN 3 for those keeping score at home).
So how do you approach figuring that out? Read more »
*This blog post was originally published at Movin' Meat*
August 5th, 2011 by RyanDuBosar in Research
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More on the Mediterranean diet shows that olive oil is the key component associated with less stroke risk in seniors, a French study found.
The Mediterranean diet has already been linked to better cardiovascular effects, so researchers poured it on to assess its link to stroke. A study of people 65 and older in the French cities of Bordeaux, Dijon and Montpellier divided 7,625 residents into three categories of olive oil consumption: no use, moderate use for cooking or dressing, or intensive use for both cooking and dressing. Researchers used plasma oleic acid as an indirect biological marker of oleic acid intake from olive oil. (They acknowledged that it could also stem from use of butter and goose or duck fat.) Results appeared in the Aug. 2 issue of Neurology.
In the study, Read more »
*This blog post was originally published at ACP Internist*
July 25th, 2011 by Edwin Leap, M.D. in Opinion
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For years now, we’ve all heard the drum-beat. Bill-boards in cities have proclaimed it. Various medical associations have touted it’s importance. Stroke symptoms have to be treated immediately! Give clot-busting drugs, also known as ‘thrombolytics!’
Until, of course, those in favor of giving the drugs (namely neurologists) realized that a) Not everyone with a stroke, aka ‘brain attack’ has insurance and b) people have a very inconsiderate habit of having said strokes at the most inconvenient of hours. For instance, after 5PM, on the weekend, on holidays. The nerve!
So across the country, physicians in emergency departments like mine are finding themselves expected by the court of public opinion to give a potentially dangerous drug (albeit a sometimes useful drug) without any neurologist being available to evaluate the patient. Our emergency department thought we had a tele-medicine link; even that has failed, as nearby physicians in our regional referral center don’t feel keen to take responsibility for our patients. Our own neurologists, of course, have Read more »
*This blog post was originally published at edwinleap.com*
July 1st, 2011 by Berci in News
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Did you know that Natalie Portman (under the name, Natalie Hershlag) published a paper in a scientific journal in 2002 while at Harvard?
Frontal lobe activation during object permanence: data from near-infrared spectroscopy.
The ability to create and hold a mental schema of an object is one of the milestones in cognitive development. Developmental scientists have named the behavioral manifestation of this competence object permanence. Convergent evidence indicates that frontal lobe maturation plays a critical role in the display of object permanence, but methodological and ethical constrains have made it difficult to collect neurophysiological evidence from awake, behaving infants. Near-infrared spectroscopy provides a noninvasive assessment of changes in oxy- and deoxyhemoglobin and total hemoglobin concentration within a prescribed region. The evidence described in this report reveals that the emergence of object permanence is related to an increase in hemoglobin concentration in frontal cortex.
*This blog post was originally published at ScienceRoll*
June 28th, 2011 by American Journal of Neuroradiology in Research
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Gray matter (GM) damage, in terms of focal lesions,1 “diffuse” tissue injury, and atrophy is a well-known feature of multiple sclerosis (MS). Recently, T1-hyperintensity on unenhanced T1-weighted sequences has been found in the dentate nuclei of patients with MS with severe disability and high T2 lesion load.2 Such an abnormality has been interpreted as an additional sign of the neurodegenerative processes known to occur in the course of MS. This report describes a patient who, despite being mildly disabled and having a low T2 lesion load and no evident brain atrophy, showed a bilateral dentate nucleus T1 hyperintensity.
The patient was a 44-year-old man who had a diagnosis of relapsing-remitting MS (RRMS) in September 1997, after 3 relapses that occurred in June 1995, March 1997, and September 1997. Brain and cord MR imaging and CSF examination were suggestive of MS. After the diagnosis, he started treatment with interferonβ-1α, with clinical stability until January 2009, when he complained of vertigo, which gradually resolved after 5 days of steroidtreatment (methylprednisolone, 1 g daily intravenously). In September 2010, he entered a research protocol and underwent neurologic and neuropsychologic (Rao Brief Repeatable Neuropsychological Battery) evaluations and brain MR imaging on a 3T scanner. The neurologic examination showed Read more »
*This blog post was originally published at AJNR Blog*
