Clinical Neuroscience

[What is neurorehabilitation?]

URBÁN Edina, FÁY Veronika

JUNE 20, 2003

Clinical Neuroscience - 2003;56(05-06)

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Clinical Neuroscience

[Abstracts of the 2nd Pannonian Symposium on CNS Injury]

Clinical Neuroscience

[Combined anterior and posterior approach to the tumours of the cervicothoracic junction: our experience]

BANCZEROWSKI Péter, LIPÓTH László, VERES Róbert

[Introduction - In the past, surgery of the pathologies of cervicothoracic junction carried high risk. Better knowledge of the anatomical situation and the increasing experience with anterior approach, corpectomy and spinal stabilization instruments have all made possible to remove the tumours of the cervicothoracic junction in a combined way. Case reports - The authors present six cases of spinal tumours where removal was done via anterior approach with partial clavicle and sternal resection. In two cases the anterior approach were combined with posterior tumour removal and fixation. Two of the cases were metastatic tumours, one lymphoma, one osteochondroma, one giant cell osteoid tumour and one malignant neurogenic tumour. The ventral approach gave a relatively wide window to explore the tumours and with the help of the operative microscope the tumour removal went fairly well. After total removal of the tumours the cervical spine were stabilized with own clavicle or iliac bone graft, titanium plate and screws. In patients with three-column involvement posterior fixation was made. The immediate recovery of the patients was well and there were no postoperative complications. Postoperative CT and MRI scans have great value in the early control after surgery as well as for the follow up of the patients. Conclusion - The anterior approach with partial clavicle and sternal resection combined with posterior approach and fixation seems to be feasible and safe method to explore and remove cervicothoracic junction pathologies.]

Clinical Neuroscience

[Asymptomatic ischemic cerebrovascular disorders and neuroprotection with vinpocetine]

HADJIEV Dimiter

[The asymptomatic ischemic cerebrovascular disorders (AICVD) is an early manifestation of cerebrovascular disease. It is also known as latent insufficiency of the cerebrovascular circulation or as asymptomatic cerebrovascular disorders. Recently, the term subclinical disease, detected noninvasively, has been introduced by American Heart Association. The diagnosis is based on the following criteria: evidence of vascular risk factors; episodic nonspecific complaints without any focal cerebral symptoms; mild cognitive deficit, detected by neuropsychological tests; carotid ultrasonography often shows intimal-medial thickening, atherosclerotic plaques and carotid stenosis; CT and MRI occasionally reveal silent cerebral infarctions, white matter hyperintensities or cerebral atrophy; regional hypoperfusion above the ischemic threshold is also seen by rCBF measurements. Treatment of the AICVD, modifying the vascular risk factors and using neuroprotective agents, should be the cornerstone of primary prevention of ischemic stroke and cognitive decline, caused by cerebrovascular disorders. Vinpocetine has been found to interfere with various stages of the ischemic cascade: ATP depletion, activation of voltagesensitive Na+- and Ca++-channels, glutamate and free radicals release. The inhibition of the voltage-sensitive Na+- channels appears to be especially relevant to the neuroprotective effect of vinpocetine. Pronounced antioxidant activity of the drug could also contribute to the neuroprotection. PET studies in primates and man showed that 11C labelled vinpocetine passes the blood-brain barrier rapidly. Heterogeneous brain distribution of the compound was observed mainly in the thalamus, basal ganglia, occipital, parietal and temporal cortex, regions which are closely related to the cognitive functions. PET studies in chronic ischemic stroke patients revealed favourable effects of vinpocetine on rCBF and glucose metabolism in the thalamus, basal ganglia and primary visual cortex. It seems, vinpocetine, affecting the multiple mechanisms of the AICVD, could be of benefit for the treatment in this early stage of cerebrovascular disease. Vinpocetine may also become a new therapeutic approach to prophylactic neuroprotection in patients at high risk of ischemic stroke.]

Clinical Neuroscience

[CONGRESS CALENDAR]

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[Society of Környey’s Fellows]

CZOPF József

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[Neurophysiological methods are gaining ground in the diagnosis and therapy of cerebrovascular disease. While the role of the EEG (electroencephalography) in the diagnosis of post-stroke epilepsy is constant, quantitative EEG para-meters, as new indicators of early efficiency after thrombolysis or in prognosis of patient’s condition have proved their effectiveness in several clinical studies. In intensive care units, continuous EEG monitoring of critically ill patients became part of neurointenzive care protocols. SSEP (somatosesnsory evoked potencial) and EEG performed during carotid endarterectomy, are early indicative intraoperativ neuromonitoring methods of poor outcome. Neurorehabilitation is a newly discovered area of neurophysiology. Clinical studies have demonstrated the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in the rehabilitation of stroke patients. Brain computer interface mark the onset of modern rehabi-litation, where the function deficit is replaced by robotic tehnology. ]

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[Antecedents to the commencement and history of the West- Pannonic neurological forum]

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[Introduction - Numerous professional groups and sections for the medical specialities have been organized since 1953 in the West-Transdanubian region of Hungary, but such association of neurologists had not occured. Establishing the West-Pannonic Neurological Forum - The lack of regional collaboration among neurologists was related to several factors, among which the most important factor was the lack of a regional medical university, which could coordinate the professional activities. This severe gap necessitated in 1998 the organization of a professional group, that has become a driver for case-consulting conferences and different postgraduate trainings for the physicians specialized in neurology, neurosurgery and neurorehabilitation in counties of Győr-Moson-Sopron, Vas, Veszprém and Zala. The functioning of the Forum - Meetings are organized twice a year for physicians and paramedical staff (nurses, hospital attendants, physiotherapists) on Thursdays afternoons in different towns of the region, in two sections. The lectures are followed by a buffet, after which everyone can get home before too late. Ocasionally guest-lecturers are invited to present scientific topics from Hungarian universities or abroad. However, the main form of the presentations is defined as case discussion. Conclusions - The numbers of platform and other presentations in the physicians’s section have exceeded half a thousand, while in the paramedical section reached the threehundreds. At the 38. meeting of the Forum in January of this year, the number of participants was more than twohundreds, reflecting that both physicians and their coworkers are greatly interested in this form of interactions.]