Annals of neurology
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Annals of neurology · Jun 2011
Randomized Controlled Trial Multicenter Study Clinical TrialCollaterals dramatically alter stroke risk in intracranial atherosclerosis.
Stroke risk due to intracranial atherosclerosis increases with degree of arterial stenosis. We evaluated the previously unexplored role of collaterals in modifying stroke risk in intracranial atherosclerosis and impact on subsequent stroke characteristics. ⋯ Collateral circulation is a potent determinant of stroke risk in intracranial atherosclerosis, demonstrating a protective role with severe stenoses and identifying more unstable milder stenoses.
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Annals of neurology · Sep 2010
Randomized Controlled TrialXenon enhances hypothermic neuroprotection in asphyxiated newborn pigs.
To investigate whether inhaling 50% xenon during hypothermia (HT) offers better neuroprotection than xenon or HT alone. ⋯ Combining xenon with HT is a promising therapy for severely encephalopathic infants, doubling the neuroprotection offered by HT alone.
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Annals of neurology · Aug 2010
Randomized Controlled TrialPilot trial of low-dose naltrexone and quality of life in multiple sclerosis.
To evaluate the efficacy of 4.5mg nightly naltrexone on the quality of life of multiple sclerosis (MS) patients. ⋯ LDN significantly improved mental health quality of life indices. Further studies with LDN in MS are warranted.
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Annals of neurology · May 2010
Randomized Controlled TrialRandomized, controlled trial of insulin for acute poststroke hyperglycemia.
Poststroke hyperglycemia is common and is associated with increased risk of death and dependence, but appropriate management remains uncertain. Glucose potassium insulin (GKI) infusion did not benefit patients with moderate poststroke hyperglycemia in a recent trial. Using magnetic resonance imaging (MRI), previous studies identified a relationship between recruitment of ischemic tissue to the final infarct and hyperglycemia, possibly mediated by brain lactic acidosis. ⋯ GKI infusion within 24 hours of stroke lowered blood glucose and attenuated an increase in brain lactate, but did not affect cerebral infarct growth. Exploratory analysis found that GKI infusion was associated with greater infarct growth in patients with persistent arterial occlusion, and with a high incidence of asymptomatic hypoglycemia.
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Annals of neurology · May 2010
Randomized Controlled Trial Comparative Study Clinical TrialCrossover trial of gabapentin and memantine as treatment for acquired nystagmus.
We conducted a masked, crossover, therapeutic trial of gabapentin (1,200mg/day) versus memantine (40 mg/day) for acquired nystagmus in 10 patients (aged 28-61 years; 7 female; 3 multiple sclerosis [MS]; 6 post-stroke; 1 post-traumatic). Nystagmus was pendular in 6 patients (4 oculopalatal tremor; 2 MS) and jerk upbeat, hemi-seesaw, torsional, or upbeat-diagonal in each of the others. ⋯ Side effects included unsteadiness with gabapentin and lethargy with memantine. Both drugs should be considered as treatment for acquired forms of nystagmus.