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Tumors of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
If the lesion is surgically accessible and the systemic malignancy is limited and/or under good control, surgical resection of the brain lesion prolongs the time to neurologic progression and maintains neurologic function longer.24 Surgical resection is typically followed with focal radiation therapy to the resection cavity. Stereotactic radiosurgery (SRS) to the solitary lesion is an alternative, particularly if the metastasis is surgically inaccessible.
Sex-related functional asymmetry of the amygdala: Preliminary evidence using a case-matched lesion approach
Published in Howard J. Rosen, Robert W. Levenson, Neurocase, 2020
Daniel Tranel, Antoine Bechara
The current findings are from a small number of patients, and they need to be replicated in more cases. Nonetheless, a strength of our approach is that nonspecific factors such as having a neurological disease, having a brain lesion, taking neurological medications, and going through brain surgery, can be dismissed with some confidence, since for each of the ‘affected’ patients (the right-sided man and the left-sided woman), there was a matched patient who had the same nonspecific factors, but who did not experience post-lesion changes. This lends credence to our inference – viz., that the changes in the affected patients are primary consequences of amygdala damage, and not secondary effects of nonspecific factors such as having an acquired brain lesion. It is also worth commenting that although the patients we studied had different occupations with different demands, we find it highly unlikely that this would account for our findings. The left-sided man had responsibilities as a farmer that were as complex as those of the right-sided man who had worked as an independent contractor. And the right-sided woman who worked in a weapons arsenal had a job that was arguably more demanding than that of the left-sided woman who had worked as a secretary/scheduler, and yet it was the left-sided woman who had a post-lesion demise of her occupational status (whilst the right-sided woman continued to perform well in her job following her amygdala damage).
Cerebrovascular Accidents, Intracranial Tumors, and Voiding Dysfunction
Published in Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg, Essentials of the Adult Neurogenic Bladder, 2020
Ahmed Ibrahim, Roger R. Dmochowski
It is unclear whether the sidedness of the brain lesion matters. One study reported that urgency, frequency, and incontinence were more common in right-sided lesions.44 However, other studies found no difference among patients with respect to continence and the side of the lesion.12,23
Patterns of vestibular function in patients with dizziness after COVID-19 vaccination; dual tertiary referral center study
Published in Acta Oto-Laryngologica, 2022
Joonsik Yoon, Min Seok Song, Sang-Yeon Lee, Moo Kyun Park, Jun Ho Lee, Seung Ha Oh, Min Young Lee, Myung-Whan Suh
While every patient had test results suggesting peripheral vestibular functional weakness, 56% of patients’ vestibular function test results showed central vestibulopathy signs (Table 4). The most common sign was periodic nystagmus: nystagmus that comes and goes within the same day. Five patients showed periodic nystagmus. Four out of five patients had the onset of dizziness within a day after vaccination. Among them, periodic (intermittent) positional nystagmus was observed in two patients. Periodic spontaneous nystagmus was observed in one patient. Periodic alternating nystagmus (nystagmus with different directions each time) was observed in one patient. No patients showed rhythmic nystagmus. Periodic alternating nystagmus sustained for 45 days. Patients complained of intermittent dizziness attacks with a duration of less than an hour, recurring about three times a day. Two patients consulted the Department of Neurology for a differential diagnosis. Imaging analyses, such as MRI or single photon emission computed tomography, were performed on nine patients, and a brain lesion was detected in one patient.
Integrating visual search, eye movement training and reversing prism exposure in the treatment of Balint-Holmes syndrome: a single case report
Published in Topics in Stroke Rehabilitation, 2022
Francesco Panico, Angela Arini, Pierluigi Cantone, Claudio Crisci, Luigi Trojano
The above-described findings have to be interpreted with caution due to the limitations related to the single case design adopted here. Indeed, we could not control possible confounding variables, such as test–retest effects. Moreover, we could not assess the long-term effects of the training after discharge. It is also to be acknowledged that spontaneous recovery could be relevant during the first months after a brain lesion. However, as improvements in patient’s performance closely followed treatment periods (and were null during treatment withdrawal), and ventral simultanagnosia did not ameliorate during the rehabilitation period, we would suggest that spontaneous recovery was not a likely explanation of our results. It remains to be assessed whether a more comprehensive rehabilitation plan, including training for the ability of integrating multipart objects, could contribute to ameliorate the entire spectrum of BHS.
An exploration of aphasia therapy dosage in the first six months of stroke recovery
Published in Neuropsychological Rehabilitation, 2021
Emily Brogan, Natalie Ciccone, Erin Godecke
Rehabilitation has progressed from a focus on rheumatic diseases in the nineteenth century, through war time needs, to the present day. More people are surviving brain injury than ever before, resulting in greater demands placed on rehabilitation services (van de Sandt-Koenderman et al., 2012). For rehabilitation to be successful, the brain relies on complex chemical and neuronal mechanisms to induce permanent adaptation in cognitive processes. Learning is a cognitive process essential to successful rehabilitation. Behavioural therapy for impairments after a brain lesion do not aim to provide a cure but to maximize the capacity of the damaged networks to re-learn with experience and for learning to alter the neural functioning at a synaptic level (Murphy & Corbett, 2009; Varley, 2011). Identifying the optimal treatment and its dosage is highly complex given the myriad of factors that may influence the effect of treatment (Kamhi, 2012). Important components of the rehabilitation jigsaw may include dosage, therapeutic relationship, medium of therapy delivery, client motivation, cognitive ability, neurological stability (Whitworth et al., 2014) as well as task-specific practice (Lang et al., 2015). Developing an understanding of the key elements of therapy needed and the dosage with which these should be delivered are likely to be an important piece of the rehabilitation jigsaw.