NeuroRehabilitation
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NeuroRehabilitation · Jan 2012
ReviewPediatric traumatic brain injury: neuroimaging and neurorehabilitation outcome.
Brain injury in the pediatric patient not only occurs in an immature brain, but potentially influences all subsequent brain and neurodevelopmental maturation. This presents unique challenges in neuroimaging the developing central nervous system, which is reviewed herein. ⋯ Pediatric neuroimaging findings of TBI are discussed in terms of techniques that can assess underlying neural networks and provide information about neuroplasticity of recovery. Neuroimaging methods also provide insights into the complexities of brain injury, cognitive and neurobehavioral recovery, and how multimodality contemporary neuroimaging methods best demonstrate underlying neuropathology that affects outcome.
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NeuroRehabilitation · Jan 2012
Case ReportsNeural connection between injured cingulum and pedunculopontine nucleus in a patient with traumatic brain injury.
We report on a patient with traumatic brain injury who showed neural connection between injured cingulum and pedunculopontine nucleus on diffusion tensor tractography (DTT). A 74-year-old male who had suffered a traffic accident underwent conservative management for subarachnoid haemorrhage. Brain MRI which was performed 6 months after onset showed no specific lesions. ⋯ However, the left cingulum was connected to the left PPN via a neural tract that passed through the anterior corona radiata and thalamus. The neural connection between the injured cingulum and PPN seems to be a compensatory phenomenon for the destruction of cholinergic pathways from basal forebrain. We believe that this result might suggest one of recovery mechanisms of injured cingulum following brain injury.
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NeuroRehabilitation · Jan 2012
Predictors of long-term health-related quality of life in patients with aneurysmal subarachnoid hemorrhage.
To determine the predictive value of physical and psychological factors assessed three months after aneurysmal subarachnoid hemorrhage (SAH) for health-related quality of life (HRQoL) one year after the SAH. ⋯ Female gender, cognitive complaints, cognitive functioning and passive coping style assessed at 3 months after SAH are important predictors of HRQoL 1 year after SAH. Early interventions to improve cognitive and emotional functioning should be evaluated for their ability to improve long-term HRQoL after SAH.
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NeuroRehabilitation · Jan 2012
Case ReportsA case of anti-NMDAR (N-methyl-D-aspartate receptor) encephalitis: a rehabilitation perspective.
Anti-NMDAR (N-Methyl-D-Aspartate Receptor) Encephalitis is a rare occurring autoimmune disease that is mediated by antibodies against the NR1 subunit of the NMDA receptor. While this condition has a known predilection for young females with ovarian tumors, heightened awareness has led to increasing recognition of this condition in other population groups as well. Afflicted patients typically evolve through a multi-staged course of neurological, behavioral, cognitive and physical deficits. ⋯ As the recovery of patients with anti-NMDAR encephalitis is often protracted, the role of the rehabilitation is important particularly beyond its acute stages. We describe a case of anti-NMDAR encephalitis in a 17-year-old girl who presented to our rehabilitation centre for management in the gradual recovery phase of her condition. This case illustrates the multiple challenges faced in the rehabilitation of such a patient.
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The term persistent vegetative state (PVS) refers to the only circumstance in which an apparent dissociation of both components of consciousness is found, characterized by preservation of wakefulness with an apparent loss of awareness. Several authors have recently demonstrated by functional neuroimaging studies that a small subset of unresponsive "vegetative" patients may show unambiguous signs of consciousness and command following that is inaccessible to clinical examination at the bedside. The term "estado vegetativo" used in Spanish to describe the PVS syndrome by physicians came from the English-Spanish translation. ⋯ The European Task Force on Disorders of Consciousness has recently proposed a new term, unresponsive wakefulness syndrome (UWS), to assist society in avoiding the depreciatory term vegetative state. Our group has embraced the use of the new term UWS and might suggest that we change our concept and use of the term MCS to minimally responsive wakefulness state (MRWS), or minimally aware wakefulness state (MAWS). Medical terms must be current and avoid any pejorative description of patients, which will promote our abilities to serve humankind and challenge neuroscientists to offer society new and realistic hopes for neurorehabilitation.