Neurology Diagnostics

Author Archive

The results of a study published in the journal Neurology suggests that the declaration of brain death occurs under certain complex circumstances, and is usually performed on patients who are hemodynamically unstable, requiring vasopressors and vasopressin.

In many cases, the apnea test can be completed successfully. In those who could not successfully carry out other tests are required to confirm brain death.

To determine this result performed a detailed review of 228 patients who were declared brain dead at the Mayo Clinic between 1996 and 2007.

Most of these cases were the result of a traumatic brain injury (32%) or intracerebral hematoma, or aneurysmal subarachnoid hemorrhage (39%).

Brain death was declared within 24 hours after admission in 69 patients (30%), 1 to 2 days after admission in 47 patients (21%), between day 2 and 3 in 26 patients (11 %), and after three days in 86 patients (38%).

The proof of apnea can not be done in 16 patients because haemodynamic instability or poor oxygenation at baseline.

Traumatic brain injury in patients with multiple trauma were more significant for patients who could not perform, or in which they had to stop, the apnea test than those who could complete the test.

Positive effects of treadmill training in children with cerebral palsy

The treadmill training with or without partial suspension system achieves a positive weight on the role and spatial parameters of gait in children with cerebral palsy (ICP) and also seems to cause no adverse events.

However, in comparison with other methods of physical therapy, placebo or no treatment, the results of this study are, in most cases, not significant.

In this article, published in Journal of Neurology, included the results of randomized controlled trials or non-randomized controlled trials but autoemparejados from various databases.

Specifically, it included six articles and 127 participants were recruited.

In the systematic review the authors found some limitations that require careful reading of the information provided.

Of the constraints encountered, include the small number of items that recruit few patients, and in addition there is a large clinical diversity, many of these trials did not describe relevant data necessary for critical reading.

The way in which some patients experience delirium, a confusional state, predicted mortality, according to a study by the Institute for Aging Research of Hebrew Senior Life.

Patients with severe hypoactive delirium, characterized by a slowdown or lack of movement and apathy, are the worst survival rates for the next six months, regardless of illness suffered.

People with slightly hypoactive delirium are more likely to die than other patients with milder symptoms.

The study, published in the journal Psichosomatics, is the first to correlate the subtypes of delirium caracteríticas or the severity of the disease.

The four sub-types of delirium are normal hypoactive, hyperactive, and mixed types combining trade items hiccups and hyperactive.

By using two standard screening tools, the researchers examined whether the classic psychomotor subtypes of delirium are reflected in the severity of delirium. In addition, it examined whether the subtypes were able to predict mortality.

Role of the posterior intralaminar nuclei of the thalamus in cognitive processes

The caudal intralaminar nuclei (ILP) of the thalamus are excellent candidates for the investigation of cognitive processes on the core area of psychobiology and clinical neuroscience due to its neuroanatomic and neurophysiological features, and its functional implications.

Are important components of the so-called brain activation systems, such as the ascending reticular activating system and the system of the basal ganglia-thalamic-cortical.

Although considered as functionally homogeneous, non-specific action, anatomical and functional relationships regular processes allow them to attention, learning and memory.

Experimental studies show that lesions of the parafascicular nucleus of rodents or centromedian parafascicular complex of primates to interfere with the processes of care and decrease the ability of learning and memory in different types of tasks.

The fact that there was a significant loss of neurons in the nuclei ILP in some pathologies with cognitive impairment, such as diencephalic amnesia, dementia, Parkinson’s and Alzheimer’s disease and disorders of the states of consciousness, seems also participation in cognitive processes mentioned.

Electroencephalography

Electroencephalography (EEG) is a simple and painless procedure in which are distributed symmetrically 20 wires (electrodes) on the scalp in order to establish the layout and electrical recording of brain activity. Graphic records in waves to detect electrical brain abnormalities associated with epilepsy and, sometimes, some rare metabolic diseases of the brain. In some cases, such as epilepsy difficult to detect, is made

continuous monitoring for 24 hours because, otherwise, the test provides little specific information. Read the rest of this entry »

Ecoencefalografia

The ecoencefalografía creates a graphic record produced by the echoes of sound waves in the brain of children under two years. This is a simple, painless and relatively inexpensive. This technique, which applies in the patient’s bedside, it is useful to detect bleeding or an abnormal dilation of the interior of the brain (hydrocephalus). CT scans or MRI have replaced ecoencefalografía tested for older children and adults.

Positron Emission Tomography

Positron emission tomography (PET) uses positron-emitting (a special type of radioactive isotopes) to produce images of internal brain structures and information about its operation. A substance is injected in the blood that travels to the brain structures, which can measure the activity that the brain develops. The technique can, for example, reveal what part of the brain shows increased activity when someone is performing mathematical calculations. The TEP also provides information about epilepsy, tumors and strokes. This test is mainly used for research. Read the rest of this entry »

Brain Blood Flow

A severe narrowing of the arteries that supply the brain carries the risk of stroke for the individual concerned. The risk is higher in the elderly or those with hypertension, diabetes and diseases of the heart’s arteries. To assess the arteries, the doctor places a stethoscope over the arteries of the neck and try to perceive the sound (murmur) that occurs after forced blood through the area in which it was narrowing. Accurate assessment requires more sophisticated tests such as Doppler ultrasound or cerebral angiography.

Procedures and Diagnostic Tests

Your doctor may order specific tests may be performed to confirm the diagnosis suggested by clinical history, mental status evaluation and physical examination. Read the rest of this entry »

Sensory nerves

Leading to the brain information about pressure, pain, sensations of heat and cold, vibration, position of body parts and the shape of objects.

Check if there is loss of sensation in the body surface. The doctor usually concentrated in the area where the person concerned a sense of numbness, tingling or pain. It uses a needle first and then a round object to determine whether the person perceives the difference between the jab and pressure. You can also test the function of sensory nerves with slight pressure, heat or vibration. The ability to discern the position is examined by asking the patient to close his eyes and move your fingers and then the toes, up and down, asking him to identify such positions. Read the rest of this entry »

Neurological examination revealed disorders of the brain, nerves, muscles and spinal cord. The main components of the neurological examination consisting of medical history, mental status evaluation, physical examination and, if indicated, the selection of diagnostic tests. Unlike the psychiatric exam that evaluates the manifestations of individual behavior, neurological assessment requires a physical exam. However, abnormal behavior is often indicative of the physical state of the brain.

Medical Record

Before the physical examination and selection of diagnostic tests the physician interviews the patient to obtain your medical history. Ask the patient to describe accurately the intensity, distribution, duration and frequency of a symptom and to explain if you can develop a routine daily tasks. Neurological symptoms can include headaches, general aches, weakness, incoordination, sensory disorders, dizziness and confusion. Read the rest of this entry »

Meralgia paresthetica (MP) or femoral nerve sensory neuropathy (NFC) is a relatively common disease, especially in pregnant women or men who have gained weight.

The MP is manifested by burning or tingling sensation unpleasant side or the outer thigh, never below the knee. This discomfort can be permanent and may worsen at night or when you are calmer, and although not disabling, can become very annoying.

The NFC is born of the union of several roots arising from the lumbar spine (L2L3) and running through the abdomen and pelvis from the most dorsal up to the groin, where does the NFC and its branches is given to the sensitivities of the lateral or outer thigh.

The NFC may be compressed by the uterus during pregnancy, especially in more advanced stages of pregnancy. Sometimes, in people who have risen sharply in weight, the NFC is compressed in its output in the groin, l which can also cause the symptoms of MP. Read the rest of this entry »