1/1063. Benign idiopathic partial epilepsy and brain lesion.A 14-year-old girl had severe head trauma from a dog bite at the age of 9 days. This resulted in extensive brain damage, tetraplegia, mental retardation, and epilepsy. The seizures were of rolandic type, and the EEG showed multifocal sharp waves. The course was benign. The initial diagnosis of a pure symptomatic epilepsy was revised after demonstrating typical benign focal sharp waves in the EEG of the healthy sister. Thus a phenocopy of a benign partial epilepsy by the brain lesion could be excluded with sufficient certainty. This observation allows the conclusion that the genetic disposition underlying the sharp-wave trait characteristic of benign partial epilepsies can be involved also in the pathogenesis of seemingly pure symptomatic epilepsies. EEG studies on siblings of such patients are needed to exclude possible phenocopies.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/1063. Parkinson's syndrome after closed head injury: a single case report.A 36 year old man, who sustained a skull fracture in 1984, was unconscious for 24 hours, and developed signs of Parkinson's syndrome 6 weeks after the injury. When assessed in 1995, neuroimaging disclosed a cerebral infarction due to trauma involving the left caudate and lenticular nucleus. Parkinson's syndrome was predominantly right sided, slowly progressive, and unresponsive to levodopa therapy. reaction time tests showed slowness of movement initiation and execution with both hands, particularly the right. Recording of movement related cortical potentials suggested bilateral deficits in movement preparation. Neuropsychological assessment disclosed no evidence of major deficits on tests assessing executive function or working memory, with the exception of selective impairments on the Stroop and on a test of self ordered random number sequences. There was evidence of abulia. The results are discussed in relation to previous literature on basal ganglia lesions and the effects of damage to different points of the frontostriatal circuits.- - - - - - - - - - ranking = 0.055661948440159keywords = cerebral (Clic here for more details about this article) |
3/1063. The role of early left-brain injury in determining lateralization of cerebral speech functions.Preparatory to craniotomy for the relief of medically refractory focal epilepsy, the lateralization of cerebral speech functions was determined by the Wada intracarotid Amytal test in 134 patients with clinical and radiologic evidence of an early left-hemisphere lesion. Their results were compared with those for 262 patients (140 right-handed, 122 left-handed), who were tested in a similar way. One-third of the patients with early lesions were still right-handed, and 81% of these right-handers were left-hemisphere dominant for speech. In the non-right-handers, speech was represented in the left cerebral hemisphere in nearly a third of the group, in the right hemisphere in half the group, and bilaterally in the remainder. Bilateral speech representation was demonstrated in 15% of the non-right-handers without early left-brain injury and in 19% of those with evidence of such early injury, whereas it was extremely rare in the right-handed groups. In addition, nearly half the patients with bilateral speech representation exhibited a complete or partial dissociation between errors of naming and errors in the repetition of verbal sequences after Amytal injection into left or right hemispheres. This points to the possibility of a functionally asymmetric participation of the two hemispheres in the language processes of some normal left-handers. The results of the Amytal speech tests in this series of patients point to locus of lesion as one of the critical determinants in the lateralization of cerebral speech processes after early left-brain injury. It is argued that in such cases the continuing dominance of the left hemisphere for speech in largely contingent upon the integrity of the frontal and parietal speech zones.- - - - - - - - - - ranking = 1.3896336390811keywords = brain, cerebral (Clic here for more details about this article) |
4/1063. bereavement and mourning in pediatric rehabilitation settings.Developmental changes in children's acquisition of death concepts and in their emotional reactions are reviewed. Moderating variables that may affect the nature of grieving processes after parental or sibling death are discussed, including circumstances of the loss, prior experience with death, and the child's cognitive functioning. Pragmatic issues (such as when and how to inform children of parental or sibling death) regarding bereavement and mourning in children with acquired brain injuries are reviewed and illustrated by means of case studies. Special challenges to rehabilitation professionals who must deal with these issues (including the concurrent treatment of secondary losses, cognitive deficits, and organic personality changes) are discussed.- - - - - - - - - - ranking = 0.16666666666667keywords = brain (Clic here for more details about this article) |
5/1063. Workers Compensation cases with traumatic brain injury: an insurance carrier's analysis of care, costs, and outcomes.The purpose of this survey was to review the medical care, medical costs, and outcomes of 86 Workers Compensation cases involving traumatic brain injury. An analysis of ICD-9 diagnoses, Rancho Los Amigos Cognitive Levels, age, sex, accident description, management techniques, costs, outcomes, and many other factors was conducted. The total indemnity (wage loss) and medical payments amounted to $27.1 million. For example, one case with temporal lobe hematoma, due to a fall in 1972, has had $1.1 million in medical payments since the injury occurred. The current average age is 40 years with 71% still residing at home. Only 10% are currently employed and 40% are known to be receiving other benefits. The increasing frequency and severity of these cases, as well as the extension of survival due to improved care and technology, highlight the need to address the question, "Who will be the caretakers, and what will be the associated costs?" Actuarial projections into the 21st century are given. It is concluded that, while further long-term studies are needed, Workers Compensation carrier representatives and health care providers must continue to work together on the interdisciplinary rehabilitation team.- - - - - - - - - - ranking = 0.83333333333333keywords = brain (Clic here for more details about this article) |
6/1063. diagnosis by electroencephalographic topography.In 5 patients, electroencephalographic (EEG) topography (fourier analysis and topographic display of EEG data) demonstrated clinically significant acute brain lesions not seen by magnetic resonance imaging or computed tomography. EEG topography contributed to patient management more than standard EEG. Additional, carefully designed, prospective studies may indicate how frequently and in which settings EEG topography is a valuable diagnostic test.- - - - - - - - - - ranking = 0.16666666666667keywords = brain (Clic here for more details about this article) |
7/1063. Minor traumatic brain injury: review of clinical data and appropriate evaluation and treatment.The clinical entity of minor traumatic brain injury (MTBI) is secondary to signs and symptoms encompassing neuropathological, neurochemical, neurobehavioral, neuropsychological and behavioral deficits. The patients who suffer this disorder are often given little help, medically, secondary to issues regarding the perceived reality of the disorder. A few individuals deny the existence of MTBI. Some believe the symptom complex to be strictly functional, while others believe that spontaneous recovery will occur and no treatment is necessary. When discussing traumatic brain injury the descriptors, "mild, moderate, and severe," are used to describe the severity of the acute injury. These labels do not describe the severity of the sequelae nor are they indicative of the intensity of specific treatment. A clear understanding of MTBI, its sequelae and necessary treatment is imperative to insure timely intervention. Delay or lack of early intervention appears to be responsible for "persistent sequelae" in MTBI. This paper will describe various aspects of the etiology of MTBI, with recommended evaluation and treatment guidelines. A functional assessment scale specifically for persons with MTBI is also presented. Several case histories are included for illustration purposes.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
8/1063. A novel method for locomotion training.This article describes a novel therapeutic system for locomotion training and learning for patients with a wide range of neurological and musculoskeletal disorders. The technique embraces the notion that locomotion therapy should be goal oriented and task specific. The task specificity includes a partial weight-bearing device that permits the posture/equilibrium, movement, and weight-bearing components of gait function to operate concurrently, even in patients with serious deficits. In addition, it allows interaction with therapists and others to facilitate locomotion control, particularly during the early stages of gait therapy. Neurobiological bases for this technique and early clinical results are discussed, and two case studies of patients with traumatic brain injury (TBI) are presented. Although well-designed efficacy studies are needed, clearly this therapeutic approach to locomotor disorders among TBI patients meets the various criteria for recovery of gait function established in this article.- - - - - - - - - - ranking = 0.16666666666667keywords = brain (Clic here for more details about this article) |
9/1063. Helping brain injured children and their families.For many brain injured children, whether the injury is congenital or the result of subsequent illness or accident, there is little to be done to put right the underlying problem. Treatment programmes, however, can encourage better motor and cognitive function and better nutrition. NHS continuing care for brain injured children is under-resourced, often amounting to only half an hour of physiotherapy fortnightly or even monthly. The British Institute for Brain Injured Children (BIBIC) is a registered charity which exists to help families with a brain injured child to learn to apply simple, practical, inexpensive treatment programmes themselves, in their own homes. Initial assessments and training take place at the BIBIC Centre in Somerset. Families are asked to contribute towards costs if they are in a position to, but treatment does not depend on ability to pay. Treatment sessions often last about 30 minutes and families may be advised to carry out two or more sessions every day. telephone help and continuing support is available from BIBIC, and families are encouraged to retain contact with their GP and hospital consultants, and local services.- - - - - - - - - - ranking = 1.1666666666667keywords = brain (Clic here for more details about this article) |
10/1063. intelligence test scores from infancy to adulthood for a craniopagus twin pair neurosurgically separated at 4 months of age.Long-term effects in a neurosurgically separated twin pair were illuminated by standard psychological test scores obtained over a period from 2 to 38 years of age. Interdigitation of the gyri of their right frontal lobes had necessitated separation in two stages at 4 months of age. One twin clearly suffered some brain injury and showed some impairment during the testing at 5 years of age. The scores of both twins rose at the adult testing. The brighter twin has an IQ comparable to that of the mother. The unique data set is a kind of model for long-term assessment of early brain surgery, particularly with craniopagus twins.- - - - - - - - - - ranking = 0.33333333333333keywords = brain (Clic here for more details about this article) |
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