New ischemic lesions coexisting with acute intracerebral hemorrhage
This study enrolled 97 patients with acute hypertensive intracerebral hemorrhage (ICH) diagnosed within 3 days of onset. Diffusion-weighted and gradient echo T2* -weighted imaging were performed within 5 days. New ischemic lesions occurring together with ICH may be a useful marker to identify patients at high risk of future clinical cerebrovascular events or vascular deaths.
See p. 848
From editorialists Prabhakaran & Sheth: “Proof of ischemia in the setting of acute ICH has real implications and may lead to a new therapeutic paradigm: modifying the risk of secondary ischemia following ICH in order to reduce recurrent stroke risk and improve long-term outcomes.”
See p. 838
MRI abnormalities following febrile status epilepticus in children: The FEBSTAT study
One hundred ninety-nine children presenting with febrile status epilepticus (FSE) were enrolled in FEBSTAT within 72 hours of the FSE episode along with 96 controls with first simple febrile seizures. Children with FSE were at risk for acute hippocampal injury, and a substantial number also had abnormalities in hippocampal development.
Hexanucleotide repeat expansions in C9ORF72 in the spectrum of motor neuron diseases
The authors assessed the frequency and phenotype of hexanucleotide repeat expansions in C9ORF72 in 78 patients with familial amyotrophic lateral sclerosis, 1,422 with sporadic amyotrophic lateral sclerosis, 246 with progressive muscular atrophy, 110 with primary lateral sclerosis, and 768 controls. C9ORF72 repeat expansion may appear in the full clinical spectrum of motor neuron disease.
Glutamate is associated with a higher risk of seizures in patients with gliomas
This study investigated a retrospective (190 patients) and then a prospective (98 patients) cohort of patients who underwent a craniotomy for a supratentorial glioma. Relative increased glutamate concentration in gliomas and altered glutamate transporter expression were associated with the presence of tumor-associated seizures.
Plasma multianalyte profiling in mild cognitive impairment and Alzheimer disease
The authors identified 4 plasma analytes independently associated with mild cognitive impairment and Alzheimer disease in 2 single-center cohorts and the multicenter Alzheimer's Disease Neuroimaging Initiative. For a plasma-based diagnostic panel to be possible, it must only include biomarkers whose association with Alzheimer disease is reproducible in well-characterized cohorts.
Characterizing dementia with Lewy bodies by means of diffusion tensor imaging
Thirty-five patients with dementia with Lewy bodies, 36 with Alzheimer disease, and 35 controls underwent clinical and neuropsychological assessment and diffusion tensor MRI. Despite a similar level of dementia severity, patterns of diffusion tensor imaging changes in Alzheimer disease and dementia with Lewy bodies differed. Further investigation is warranted.
See p. 906
CONTEMPORARY ISSUES IN NEUROLOGIC PRACTICE
Early stroke mortality, patient preferences, and the withdrawal of care bias
Ischemic stroke mortalities at an academic medical center were reviewed to understand better the causes of inpatient stroke mortality. Among 37 deaths or discharges to hospice in 2009, thirty-six occurred after a patient or family decision to withdraw or withhold life-sustaining interventions.
See p. 941
NB: “Resident & Fellow Mystery Case: Isolated hypothalamic hamartoma vs Pallister-Hall syndrome: Imaging and clinical correlation,” see p. 950. To check out other Resident & Fellow submissions, point your browser to www.neurology.org and click on the link to the Resident & Fellow Section.
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