Progression in Moyamoya Disease: Clinical Feature, Neuroimaging Evaluation and Treatment

: Moyamoya disease (MMD) is a chronic cerebrovascular disease characterized by progressive stenosis of the arteries of the circle of Willis, with the formation of the collateral vascular network at the base of the brain. Its clinical manifestations are complicated. Numerous studies have attempted to clarify the clinical features of MMD, including its epidemiology, genetic characteristics, and pathophysiology. With the development of neuroimaging techniques, various neuroimaging modalities with different advantages have deepened the understanding of MMD in structural, functional, spatial, and temporal dimensions. At present, the main treatment for MMD focuses on neurological protection, cerebral blood flow reconstruction, and neurological rehabilitation, such as pharmacological treatment, surgical revascularization, and cognitive rehabilitation. In this review, we discuss recent progress in understanding the clinical features, neuroimaging evaluation, and treatment of MMD.

Induced Hypothermia: From Bench to Bedside in Systemic and Neurological Protection After Resuscitation From Cardiac Arrest

Introduction: Cardiac arrest outside medical center is a major cause of death. The survival rates ranges from 5 percent to 35 percent. In patients who are initially resuscitated, anoxic neurologic injury is the prime cause of morbidity and mortality, besides hazards in multiple organs as the kidneys, for example. Induced hypothermia has proven to improve the prognosis after resuscitation from cardiac arrest. Objective: To demonstrate in experiments where induced mild hypothermia has been able to reduce ischemic and inflammatory damage in animal’s brains and consequently the multiplicity of the other organs. Methods: Experiments were carried out with rabbits and rats when mild hypothermia was induced in order to demonstrate its neuroprotective properties. Results: Induced mild hypothermia demonstrated to be able to reduce the deleterious effects caused by brain ischemia and brain inflammation. Conclusions: Hypothermia may be helpful in reducing the ischemic process as well as in reducing the inflammatory cascade caused by ischemia. We believe that induced hypothermia improves prognosis after resuscitation from cardiac arrest reinforcing the application of mild hypothermia in cases of cerebral ischemia mainly after cardiac arrest.

Intraoperative Neuromonitoring During Resection of Gliomas Involving Eloquent Areas

In the case of resection of gliomas involving eloquent areas, equal consideration should be given to maintain maximal extent of resection (EOR) and neurological protection, for which the intraoperative neuromonitoring (IONM) proves an effective and admirable approach. IONM techniques applied in clinical practice currently consist of somatosensory evoked potential (SSEP), direct electrical stimulation (DES), motor evoked potential (MEP), electromyography (EMG), and electrocorticography (ECoG). The combined use of DES and ECoG has been adopted widely. With the development of technology, more effective IONM tactics and programs would be proposed. The ultimate goal would be strengthening the localization of eloquent areas and epilepsy foci, reducing the incidence of postoperative dysfunction and epilepsy improving the life quality of patients.

Neurological and mental health consequences of COVID-19: potential implications for well-being and labor force

Recent case studies show that the SARS-CoV-2 infectious disease, COVID-19, is associated with accelerated decline of mental health, in particular, cognition in elderly individuals, but also with neurological and neuropsychiatric illness in young people. Recent studies also show a bidirectional link between COVID-19 and mental health in that people with previous history of psychiatric illness have a higher risk for contracting COVID-19 and that COVID-19 patients display a variety of psychiatric illnesses. Risk factors and the response of the central nervous system to the virus show large overlaps with pathophysiological processes associated with Alzheimer’s disease, delirium, post-operative cognitive dysfunction and acute disseminated encephalomyelitis, all characterized by cognitive impairment. These similarities lead to the hypothesis that the neurological symptoms could arise from neuroinflammation and immune cell dysfunction both in the periphery as well as in the central nervous system and the assumption that long-term consequences of COVID-19 may lead to cognitive impairment in the well-being of the patient and thus in today’s workforce, resulting in large loss of productivity. Therefore, particular attention should be paid to neurological protection during treatment and recovery of COVID-19, while cognitive consequences may require monitoring.

Herbal Medicine as Neuroprotective Potential Agent in Human and Animal Models: A Historical Overview

Neurodegenerative disorders could be a most important health issue within the 21st century. In the recent past; there has been a growing interest in medicinal plants. Chemical fruits and vegetables are said to decrease the possibility of many chief ailments, together with cardiovascular and cancer disorders as well as neurodegenerative ailments. Hence, who eat more fruits and vegetables may be less threaten for developing certain diseases caused by neurological dysfunction. The present review provides an overview of the about 14 most important plants used for neurological disorders and explores their neurological protection for the development of new pharmacological potential drugs. The data sources including the publications on Google Scholar, PubMed, and Science Direct. Publications searched with no particular time restriction in order to get a holistic and comprehensive view of the research done on this topic so far. Therefore, we present a systematic approach for herbal medicine as neuroprotective agent. From ancient time the herbal medicines are used to cure neurological symptoms. While the exact pharmacology of these herbs has not yet been set on, some of them have anti-inflammatory or antioxidant properties on different peripheral systems. The significant variety of medicinal plants makes it an essential source of healthy compounds compared to current therapeutic agents. In this review, the importance of phytochemicals for the function of neurological protection and other related disorders, in particular, the process mechanism and therapeutic prospective will be emphasize.

Application of Cerebral Protection System in Open Mitral Replacement with Extensive Calcified Left Atrial Thrombus

Neurological complications remain a major burden in cardiac surgery, despite various intraoperative measures attempting to reduce its occurrence. Advancement of percutaneous approach in valve replacement has brought focus to the use of cerebral protection system (CPS). We reported a novel application of percutaneous CPS in open heart surgery for a patient with an extensive calcified left atrial thrombus to reduce risk of embolic stroke. Although, there is no evidence to advocate routine use of CPS in all open cardiac surgical patients, we believe it is a technically feasible and probably safe approach for neurological protection in high-risk patients.

Progression in Vascular Cognitive Impairment: Pathogenesis, Neuroimaging Evaluation, and Treatment

Vascular cognitive impairment (VCI) defines an entire spectrum of neurologic disorders from mild cognitive impairment to dementia caused by cerebral vascular disease. The pathogenesis of VCI includes ischemic factors (e.g., large vessel occlusion and small vessel dysfunction); hemorrhagic factors (e.g., intracerebral hemorrhage and subarachnoid hemorrhage); and other factors (combined with Alzheimer’s disease). Clinical evaluations of VCI mainly refer to neuropsychological testing and imaging assessments, including structural and functional neuroimaging, with different advantages. At present, the main treatment for VCI focuses on neurological protection, cerebral blood flow reconstruction, and neurological rehabilitation, such as pharmacological treatment, revascularization, and cognitive training. In this review, we discuss the pathogenesis, neuroimaging evaluation, and treatment of VCI.