Frontiers of Neurology and Neuroscience最新文献_第9页

Neurosurgical Work during the Napoleonic Wars: George James Guthrie's Experience. 拿破仑战争期间的神经外科工作:乔治·詹姆斯·格斯里的经验。

Frontiers of Neurology and Neuroscience Pub Date : 2016-04-04 DOI: 10.1159/000442563

F. Roux

{"title":"Neurosurgical Work during the Napoleonic Wars: George James Guthrie's Experience.","authors":"F. Roux","doi":"10.1159/000442563","DOIUrl":"https://doi.org/10.1159/000442563","url":null,"abstract":"Involved in what is still considered, along with the two world wars of the 20th century, as one of the major conflicts in Europe, George James Guthrie (1785-1856) was the most famous English army surgeon of the Napoleonic wars. After treating the injured throughout the Peninsular Campaign (1808-1814), in 1815 and then in 1842 he published two major books dealing with cranial and brain injuries, among other topics. In these books, we can find, for example, an early description of the plantar reflex further described by Joseph Babinsky, accurate descriptions of the clinical signs of intracranial hypertension, and details of the physiopathology of subdural and epidural haematomas. Skull fractures are also discussed intensively, along with the indications for trepanation, a much-debated issue at the turn of the 19th century. The dura was often the limit of the surgical field for Guthrie. Nevertheless, he tried to rationalize the use of trepanation and favoured its use in two main cases: in cases of depressed skull bones, jammed bone fragments or debris irritating the dura or the brain and in cases of life-threatening cerebral compression caused by supposed blood clots. In their works, Guthrie and his contemporaries did not address neurosurgery in the modern sense of the word, but rather 'cranial surgery' in most cases. Guthrie, who saw so many patients with brain injuries and amputations, failed to understand that cerebral functions could be localized to the cortex and neglected to describe the phantom limb phenomenon, as did most of his contemporaries.","PeriodicalId":35285,"journal":{"name":"Frontiers of Neurology and Neuroscience","volume":"369 1","pages":"10-21"},"PeriodicalIF":0.0,"publicationDate":"2016-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77965565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Neurology and Neurologists during the Franco-Prussian War (1870-1871). 普法战争(1870-1871)期间的神经病学和神经学家。

Frontiers of Neurology and Neuroscience Pub Date : 2016-04-04 DOI: 10.1159/000442595

O. Walusinski

引用次数: 4

Neurotoxic Weapons and Syndromes. 神经毒性武器和综合征。

Frontiers of Neurology and Neuroscience Pub Date : 2016-04-04 DOI: 10.1159/000442658

A. Carota, P. Calabrese, J. Bogousslavsky

{"title":"Neurotoxic Weapons and Syndromes.","authors":"A. Carota, P. Calabrese, J. Bogousslavsky","doi":"10.1159/000442658","DOIUrl":"https://doi.org/10.1159/000442658","url":null,"abstract":"The modern era of chemical and biological warfare began in World War I with the large-scale production and use of blistering and choking agents (chlorine, phosgene and mustard gases) in the battlefield. International treaties (the 1925 Geneva Protocol, the 1975 Biological and Toxin Weapons Convention and the 1993 Chemical Weapons Convention) banned biological and chemical weapons. However, several countries are probably still engaged in their development. Hence, there is risk of these weapons being used in the future. This chapter will focus on neurotoxic weapons (e.g. nerve agents, chemical and biological neurotoxins, psychostimulants), which act specifically or preeminently on the central nervous system and/or the neuromuscular junction. Deeply affecting the function of the nervous system, these agents either have incapacitating effects or cause clusters of casualties who manifest primary symptoms of encephalopathy, seizures, muscle paralysis and respiratory failure. The neurologist should be prepared both to notice patterns of symptoms and signs that are sufficiently consistent to raise the alarm of neurotoxic attacks and to define specific therapeutic interventions. Additionally, extensive knowledge on neurotoxic syndromes should stimulate scientific research to produce more effective antidotes and antibodies (which are still lacking for most neurotoxic weapons) for rapid administration in aerosolized forms in the case of terrorist or warfare scenarios.","PeriodicalId":35285,"journal":{"name":"Frontiers of Neurology and Neuroscience","volume":"3 1","pages":"214-27"},"PeriodicalIF":0.0,"publicationDate":"2016-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73122874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Nostalgia in the Army (17th-19th Centuries). 军队中的乡愁(17 -19世纪)。

Frontiers of Neurology and Neuroscience Pub Date : 2016-04-01 DOI: 10.1159/000442652

M. Battesti

{"title":"Nostalgia in the Army (17th-19th Centuries).","authors":"M. Battesti","doi":"10.1159/000442652","DOIUrl":"https://doi.org/10.1159/000442652","url":null,"abstract":"People died from nostalgia in the army in the 17th-19th centuries. The term 'nostalgia', created by the doctor Johannes Hofer (1669-1752), from Mulhouse, came from the Germanic Heimweh, or 'homesickness'. It affected the young people enrolled in the army, such as Swiss mercenaries. Longing for their native land, they were consumed by an ongoing desire to return home. If it was impossible to do so, they sank into 'a sadness accompanied with insomnia, anorexia and other unpleasant symptoms' that could lead to death. Nostalgia became classified as a disease during the last quarter of the 18th century and ravaged the French army during the Revolution and the Napoleonic wars. However, as soon as the wars ended, it ceased to exist in the army (except the colonial army). It was removed from the nosology in the first half of the 19th century. Rapidly explained as an example of a misdiagnosis or a confusion between 'connection and cause', nostalgia needs to be assessed in regard to the medical debate between 'alienists' and 'organicists'. Creating much concern, nostalgia needs to be considered in the historical context of a society destabilized by modernity, with some individuals uprooted by the sudden transition from civil society to military life. It raises questions about the role that the army played in the creation of the French national union. Nostalgia may have also covered psychic traumatisms later designated as combat fatigue, war neurosis, or post-traumatic stress disorder.","PeriodicalId":35285,"journal":{"name":"Frontiers of Neurology and Neuroscience","volume":"123 1","pages":"132-42"},"PeriodicalIF":0.0,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79602327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

The Influence of the Two World Wars on the Development of Rehabilitation for Spinal Cord Injuries in the United States and Great Britain. 两次世界大战对美国和英国脊髓损伤康复发展的影响

Frontiers of Neurology and Neuroscience Pub Date : 2016-04-01 DOI: 10.1159/000442569

D. Lanska

{"title":"The Influence of the Two World Wars on the Development of Rehabilitation for Spinal Cord Injuries in the United States and Great Britain.","authors":"D. Lanska","doi":"10.1159/000442569","DOIUrl":"https://doi.org/10.1159/000442569","url":null,"abstract":"During World War I, physical and occupational therapies became important adjuncts to surgical practice, particularly for orthopedic casualties, but there was little progress in the management of severe brain and spinal cord injuries (SCIs), largely because of the very high mortality of such injuries at that time. During World War II (WWII), rehabilitation was greatly expanded into an integrated, comprehensive multidisciplinary program in the U.S. military, largely because of the efforts of Howard Rusk (1901-1989), initially in the Army Air Corps and later across all of the services. With Bernard Baruch's (1870-1965) assistance, Rusk was also successful in swaying President Franklin Delano Roosevelt (1882-1945) to support rehabilitation for injured veterans and to give official standing to rehabilitation medicine in the military and the Veterans Administration after WWII. Such WWII developments in rehabilitation medicine had a profound effect on the care, functional outcomes, and survival of veterans with SCIs. Neurosurgeon Donald Munro's (1898-1978) prototype SCI unit at Boston City Hospital in 1936 influenced the U.S. Army to establish several SCI centers during WWII and influenced urologist Ernest Bors (1900-1990) to pioneer SCI care in Veterans Administration medical centers after WWII. In Britain, the organizational leadership of George Riddoch (1888-1947) led to the development of SCI units that saw their greatest development by Ludwig Guttmann (1899-1980) at Stoke-Mandeville Hospital in Aylesbury, near London. These SCI centers provided a comprehensive spectrum of care, including medical, neurological, and surgical management; psychological counseling; and rehabilitation focused on improving self-care, mobility, and re-assimilation into society. After WWII, military developments in comprehensive rehabilitation were promulgated to and developed in the revitalized Veterans Administration and then disseminated to civilian populations.","PeriodicalId":35285,"journal":{"name":"Frontiers of Neurology and Neuroscience","volume":"31 1","pages":"56-67"},"PeriodicalIF":0.0,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84229420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

How to Distinguish between Statistically Significant Results and Clinically Relevant Results. 如何区分统计显著性结果和临床相关结果。

Frontiers of Neurology and Neuroscience Pub Date : 2016-01-01 Epub Date: 2016-07-26 DOI: 10.1159/000445411

Derrick A Bennett

{"title":"How to Distinguish between Statistically Significant Results and Clinically Relevant Results.","authors":"Derrick A Bennett","doi":"10.1159/000445411","DOIUrl":"https://doi.org/10.1159/000445411","url":null,"abstract":"Background: A practicing clinician will often be confronted with the results of a new clinical trial in their relevant field and will be faced with the dilemma of determining whether these results are clinically relevant to their own work. This chapter aims to describe the concepts of statistical significance in randomized clinical trials from a mainly classical statistical inference perspective. This chapter describes approaches to assess clinical significance and illustrates these approaches with examples from the contemporary neurological literature.Results: There are several approaches that have been described in the research literature to assess the clinical significance including the minimal important clinical difference, the fragility index, Bayesian approaches, and a graphical approach. Unfortunately none of these methods have been widely used in the neurological research literature. Examples are provided to illustrate how these methods can be applied to the contemporary neurological literature in order to provide the clinician with some guidance on their use.Conclusions: How the trial is designed can affect the external validity of the results and subsequently the clinical relevance of a randomized clinical trial. Large-scale streamlined clinical trials with inclusion criteria that are not too restrictive can improve the generalizability of trial results. Even highly statistically significant treatment effects can be unreliable if they are based on a small number of events. The approaches described in this chapter should provide the practicing clinician with a starting point in order to determine whether the reported statistically significant results are indeed clinically relevant.","PeriodicalId":35285,"journal":{"name":"Frontiers of Neurology and Neuroscience","volume":"39 ","pages":"37-49"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000445411","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34318540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Clinical Stroke Syndromes. 临床卒中综合征。

Frontiers of Neurology and Neuroscience Pub Date : 2016-01-01 DOI: 10.1159/000448303

J. S. Kim, L. Caplan

{"title":"Clinical Stroke Syndromes.","authors":"J. S. Kim, L. Caplan","doi":"10.1159/000448303","DOIUrl":"https://doi.org/10.1159/000448303","url":null,"abstract":"The main mechanism of stroke in patients who have extracranial atherosclerosis is artery to artery embolism, occasionally associated with hemodynamic disturbances. Although these mechanisms are also important in patients with intracranial atherosclerosis, branch occlusion and in-situ thrombotic occlusion play a relatively more important role in these patients. Accordingly, clinical stroke syndromes differ between extracranial atherosclerosis and intracranial atherosclerosis. In anterior circulation, middle cerebral artery atherosclerosis frequently produces subcortical infarction by way of branch occlusion. The clinical syndromes are similar to lacunar syndromes classically associated with small perforator artery diseases, although a larger size infarction can be accompanied by cortical dysfunction such as aphasia or neglect. In-situ thrombotic occlusion of the large intracranial anterior circulation arteries leads to larger infarction that results in cortical symptoms - however, parts of the cortex are usually spared due to relatively well developed collateral circulation associated with prolonged perfusion impairment. In the posterior circulation, intracranial atherosclerosis is common in the distal vertebral artery and basilar artery that often causes medullary and pontine infarction syndromes, mostly by way of branch occlusion. Posterior cerebral artery atherosclerosis produces pure midbrain or thalamic infarction through branch occlusion. Artery to artery embolisms from posterior fossa intracranial atherosclerosis lead to cortical infarction - cerebellar or temporo-occipital lobe infarction, producing ataxic syndromes, and visual field defects and associated neurobehavioral syndromes, respectively.","PeriodicalId":35285,"journal":{"name":"Frontiers of Neurology and Neuroscience","volume":"49 19","pages":"72-92"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000448303","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72470815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 43

Vessel and Vessel Wall Imaging. 血管和血管壁成像。

Frontiers of Neurology and Neuroscience Pub Date : 2016-01-01 DOI: 10.1159/000448308

S. Jung, D. Kang, T. Turan

{"title":"Vessel and Vessel Wall Imaging.","authors":"S. Jung, D. Kang, T. Turan","doi":"10.1159/000448308","DOIUrl":"https://doi.org/10.1159/000448308","url":null,"abstract":"Angiography is a useful, important, common imaging method, with digital subtraction angiography (DSA) remaining the gold standard for luminal imaging. Computed tomography angiography (CTA) is minimally invasive and quite accurate in the evaluation of stenosis. Magnetic resonance angiography (MRA) is a good screening tool with the least invasiveness. Angiography mostly represents intracranial artery disease as luminal stenosis, which is often not sufficient to evaluate intracranial vascular pathology. The modalities provide indirect information about vascular pathology because luminal change, such as stenosis, results from the changes of vessel walls. Vessel wall imaging using high-resolution magnetic resonance imaging (HR-MRI) has been recently introduced for direct evaluation of vessel walls beyond just luminal information such as the severity of stenosis. HR-MRI for vessel walls can present the characteristic radiological findings for each intracranial artery disease such as atherosclerosis, dissection, moyamoya disease, and vasculitis. The radiological features are useful to differentiate among intracranial artery disease. This chapter discusses the role and radiological features of angiography and HR-MRI for vessel walls.","PeriodicalId":35285,"journal":{"name":"Frontiers of Neurology and Neuroscience","volume":"10 1","pages":"109-123"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87793435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 13

Peculiarities of Neurological Disorders and Study Designs. 神经系统疾病的特点和研究设计。

Frontiers of Neurology and Neuroscience Pub Date : 2016-01-01 Epub Date: 2016-07-26 DOI: 10.1159/000445409

Ettore Beghi, Elisabetta Pupillo, Giorgia Giussani

{"title":"Peculiarities of Neurological Disorders and Study Designs.","authors":"Ettore Beghi, Elisabetta Pupillo, Giorgia Giussani","doi":"10.1159/000445409","DOIUrl":"https://doi.org/10.1159/000445409","url":null,"abstract":"Background: Neurological disorders are heterogeneous clinical conditions with variable course and outcome.Summary: The basic aspects of the commonest neurological disorders are addressed along with the proposed structure of randomized clinical trials (RCTs). Dementing disorders, including Alzheimer's disease (AD), are clinical conditions in which altered cognitive functions are associated with behavioral and personality changes. Parkinson's disease (PD) is a multisystem disorder characterized by motor dysfunction associated with dysautonomia, sleep and olfactory disturbances, cognitive changes, and depression. Amyotrophic lateral sclerosis (ALS) is an invariably fatal clinical condition involving motor neurons. The available treatments are purely symptomatic for PD but virtually ineffective for AD and ALS. Headache disorders, multiple sclerosis, and epilepsy, three diseases characterized by recurrent symptoms and chronic or episodic course, can be fairly easily controlled by current treatments, but cannot be prevented nor cured. The objectives of treatments of neurodegenerative disorders include primary prevention, slowing or arrest of disease progression, and control of symptoms. Stroke is an acute clinical condition causing frequent disability and death, with only one approved treatment. There are many challenges to acute stroke clinical trials; among them, the very short therapeutic window and the issue of stroke heterogeneity. In this chapter, only the core elements of the study designs are outlined.Key messages: The design of an RCT must be adapted to the basic characteristics of each clinical condition.","PeriodicalId":35285,"journal":{"name":"Frontiers of Neurology and Neuroscience","volume":"39 ","pages":"8-23"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000445409","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34707348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Surgical Therapy. 手术治疗。

Frontiers of Neurology and Neuroscience Pub Date : 2016-01-01 DOI: 10.1159/000448312

C. Oh, G. Steinberg

引用次数: 0