Notes

Individual amyotrophic lateral sclerosis excitability phenotype screen: Focus on finding and also validation.
047), an irregular aneurysm (p = 0.004) and the presence of a daughter dome (p = 0.002) were associated with aneurysm rupture. The multivariate analysis showed that a larger size ratio (OR 1.324, 95 % CI, 1.062-1.651; p = 0.013) and the presence of daughter dome (OR 2.462, 95 % CI, 1.123-5.398; p = 0.024) were independently associated with ruptured aneurysms. ABT-199 The threshold of the size ratio for discriminating ruptured and unruptured aneurysms was 2.53 (p  less then  0.001). CONCLUSIONS The size ratio and the presence of a daughter dome were independent predictors of the rupture of MCA bifurcation aneurysms. These parameters may contribute to the evaluation of the risk of rupture of aneurysms. OBJECTIVE Decompressive hemicraniectomy (DH) effectively alleviates increased intracranial pressure (ICP) in patients with traumatic brain injury (TBI) and malignant middle cerebral artery (MCA) infarction. Its role in the management of spontaneous intracranial hemorrhage (SICH) however remains uncertain. This study aims to review the efficacy and safety of DH without clot evacuation in SICH. PATIENTS AND METHODS A systematic literature search of PubMEd, EMBASE, Scopus and Cochrane Library Central Register of Control Trials was performed. Studies were reviewed independently for methodology, inclusion and exclusion criteria and end points. Primary endpoint was overall mortality. Secondary endpoint was functional outcome using modified Rankin scale (mRs) or Glasgow outcome scale (GOS). RESULTS Nine studies with a total of 146 patients who underwent DH without clot evacuation include 1 RCT, 3 cohort, 2 case series, and 3 case-control studies. Age range was 40-60 years, with majority of patients presenting with a relatively depressed preoperative sensorium (GCS 6-8), large hematoma volumes (>50 mL), and deep locations (basal ganglia and thalamus). Pooled analysis showed a favorable outcome in 53 %, a mortality rate of 26 % and a complication rate of 35.8 %. CONCLUSION DH without clot evacuation may offer functional and mortality benefit in patients with spontaneous ICH, based on limited and heterogeneous studies. OBJECTIVE Subjective excessive daytime sleepiness, commonly measured with the Epworth Sleepiness Scale (ESS), is associated with cognitive impairment in Parkinson disease (PD). Significant correlation between subject and informant responses has been reported in neurologically healthy individuals. We sought to assess this correlation in patients with PD. PATIENTS AND METHODS 854 individuals in the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND) had subject as well as informant-completed ESS completed within one year of a movement disorder exam and cognitive assessment. Correlations were evaluated using Spearman's rank correlation coefficients. RESULTS Overall, 397/854(46.5 %) were female with mean age of 77.5 (SD 8.3). 572 (67 %) were cognitively normal (CogNL), 135 (15.8 %) had mild cognitive impairment (MCI) and 147 (17.2 %) dementia. Spearman R correlations (all with p  less then  0.001) between subject and informant ESS responses were 0.73 overall, 0.67 for the CogNL group, 0.79 for the MCI group, 0.79 for those with dementia. Of 175 with clinically probable PD, 115 (65.7 %) were CogNL, 38 had MCI, and 22 (12.6 %) dementia. For subjects with PD correlations (all with p  less then  0.001) were 0.65 for PD-CogNL, 0.83 for PD-MCI, and 0.70 for those with PD-dementia. CONCLUSION These significant correlations between subject and informant-completed ESS can be useful in guiding clinical trials designed to assess efficacy of potential treatments for excessive daytime sleepiness for the general population and for patients with PD, even those having cognitive impairment. V.OBJECTIVES Rhabdomyosarcoma (RMS) involving the spine is rare. The aim of the present study is to explore the clinicopathological features, surgical treatments and outcomes of this rare disease. PATIENTS AND METHODS Eleven patients with spinal RMS who received surgery in our institution between 2012 and 2018 were retrospectively investigated. The literature on spinal RMS was also reviewed. RESULTS Our study consisted of 7 cases of primary RMS and 4 cases of metastatic RMS. Seven primary and one metastatic spinal RMS received radical resection, the remaining three metastatic patients received palliative resection. Eight patients died with a median survival time of 8 months. The mean value of Ki-67 positivity was 48.2 %. Literature review revealed a total of 22 previously reported cases. 54.5 % of the pooled cases of the 33 patients were under the age of 18. Of the 20 patients with primary spinal RMS, 9 cases were diagnosed as embryonal, while 6 of the 13 metastatic patients were diagnosed as alveolar. Multiple modalities, including surgery and concurrent adjuvant therapy were performed in 19 patients. The median overall survival (OS) for 28 patients with detailed follow-up information was 10 months. Radical resection offered a significant longer median OS than non-radical resection (18 vs. 6 months, p = 0.027). CONCLUSION Spinal RMS mainly affects young patients. The embryonal form and alveolar form is the most frequent subtype for primary and metastatic spinal RMS respectively. Spinal RMS is highly aggressive with dismal prognosis. Multimodality therapies are the mainstay of treatment. Radical resection is strongly recommended in eligible patients. Superficial siderosis (SS) is a slowly progressive neurodegenerative disorder caused by persistent or intermittent bleeding into the subarachnoid space. It leads to characteristic clinical and radiographic findings. Dural pathology is believed to be the most common identifiable etiology of SS. It has been suggested that dural tear may be the common pathology of both SS and intracranial hypotension syndrome. We present a patient with SS caused by posttraumatic duropathy that was associated with cerebrospinal fluid (CSF) hypotension headache. Patient was treated surgically with stabilization of neurological deficit and orthostatic headache improvement. It supports the speculated link between both entities and may confirm surgery being a reasonable approach in patients with SS. V.
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