Prognostic implications of hyperglycemia and reduced cerebral blood flow in childhood near-drowning.

Abstract:

:We retrospectively examined the clinical courses of 20 children with severe near-drowning and divided their outcomes into 3 groups: normal (4), persistent vegetative state (9), and dead (7). We reviewed serial blood glucose levels and cerebral blood flow measured by stable xenon computed tomography within the 1st 48 hours of admission to determine whether they were predictive of outcome. Total, frontal gray, frontal white, and temporal and parietal gray matter cerebral blood flows were significantly decreased in children who died compared with those who completely recovered. Only 1/2 the children surviving in a vegetative state had decreased flows compared with those who recovered. An elevated initial blood glucose was highly predictive of those patients who died (mean, 511 +/- 110 mg%) or those with vegetative survival (465 +/- 104 mg%) compared with those who recovered completely (238 +/- 170 mg%). The predictive value of initial blood glucose alone (68%) or CBF alone (50%) was similar to that of clinical rating scales or immersion/resuscitation times. The combination of blood glucose with CBF improved predictability to 79%. Our results suggest that CBF measurements are predictive of eventual death but cannot differentiate normal from vegetative survival. Combining multiple laboratory studies may be of value in predetermining the eventual outcome in near-drowning.

journal_name

Neurology

journal_title

Neurology

authors

Ashwal S,Schneider S,Tomasi L,Thompson J

doi

10.1212/wnl.40.5.820

subject

Has Abstract

pub_date

1990-05-01 00:00:00

pages

820-3

issue

5

eissn

0028-3878

issn

1526-632X

journal_volume

40

pub_type

杂志文章
  • Mixed-location cerebral hemorrhage/microbleeds: Underlying microangiopathy and recurrence risk.

    abstract:OBJECTIVE:To assess the predominant type of cerebral small vessel disease (SVD) and recurrence risk in patients who present with a combination of lobar and deep intracerebral hemorrhage (ICH)/microbleed locations (mixed ICH). METHODS:Of 391 consecutive patients with primary ICH enrolled in a prospective registry, 75 (...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000004797

    authors: Pasi M,Charidimou A,Boulouis G,Auriel E,Ayres A,Schwab KM,Goldstein JN,Rosand J,Viswanathan A,Pantoni L,Greenberg SM,Gurol ME

    更新日期:2018-01-09 00:00:00

  • Pituitary enlargement in patients with intracranial hypotension syndrome.

    abstract::Article abstract-The authors analyzed whether the pituitary gland enlarges in intracranial hypotension syndrome by studying 11 consecutive patients. Initial MRI scans showed pituitary gland enlargement with a convex superior margin. Follow-up MRI studies revealed that the size of the gland invariably diminished in all...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.55.12.1895

    authors: Alvarez-Linera J,Escribano J,Benito-León J,Porta-Etessam J,Rovira A

    更新日期:2000-12-26 00:00:00

  • Vestibular function assessment using the NIH Toolbox.

    abstract:OBJECTIVE:Development of an easy to administer, low-cost test of vestibular function. METHODS:Members of the NIH Toolbox Sensory Domain Vestibular, Vision, and Motor subdomain teams collaborated to identify 2 tests: 1) Dynamic Visual Acuity (DVA), and 2) the Balance Accelerometry Measure (BAM). Extensive work was comp...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0b013e3182872c6a

    authors: Rine RM,Schubert MC,Whitney SL,Roberts D,Redfern MS,Musolino MC,Roche JL,Steed DP,Corbin B,Lin CC,Marchetti GF,Beaumont J,Carey JP,Shepard NP,Jacobson GP,Wrisley DM,Hoffman HJ,Furman G,Slotkin J

    更新日期:2013-03-12 00:00:00

  • Brain atrophy and lesion load in a large population of patients with multiple sclerosis.

    abstract:OBJECTIVE:To measure white matter (WM) and gray matter (GM) atrophy and lesion load in a large population of patients with multiple sclerosis (MS) using a fully automated, operator-independent, multiparametric segmentation method. METHODS:The study population consisted of 597 patients with MS and 104 control subjects....

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/01.wnl.0000168837.87351.1f

    authors: Tedeschi G,Lavorgna L,Russo P,Prinster A,Dinacci D,Savettieri G,Quattrone A,Livrea P,Messina C,Reggio A,Bresciamorra V,Orefice G,Paciello M,Brunetti A,Coniglio G,Bonavita S,Di Costanzo A,Bellacosa A,Valentino P,Quar

    更新日期:2005-07-26 00:00:00

  • Further characterization of patients with amnesia after cardiac arrest: preserved recognition memory.

    abstract::We observed that patients with amnesia after cardiac arrest had preserved recognition memory despite profound loss of recall memory. In the present study, rate of forgetting was measured in six amnesic subjects for both recall and recognition memory of verbal material. The data show that recall decayed significantly f...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.36.3.408

    authors: Volpe BT,Holtzman JD,Hirst W

    更新日期:1986-03-01 00:00:00

  • The childhood type of dermatomyositis.

    abstract::The childhood type fo dermatomyositis, which occurs in children and young adults, shows a specific constellation of pathologic changes in muscle. Capillary necrosis leads to capillary loss, generally starting on the periphery of muscle fascicles. Electron microscopy discloses undulating tubules in endothelial cells, l...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.26.10.952

    authors: Carpenter S,Karpati G,Rothman S,Watters G

    更新日期:1976-10-01 00:00:00

  • Diffuse "anoxic" myelopathy.

    abstract::Pathologic changes and distribution of lesions of the spinal cord were studied in 16 patients who suffered from "anoxic" episodes. The lesions were symmetrical and limited to the gray matter. The vulnerability of the spinal cord was most marked in the lumbosacral region, although almost every nucleus throughout the sp...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.27.11.1049

    authors: Azzarelli B,Roessmann U

    更新日期:1977-11-01 00:00:00

  • Paradoxical longevity in obese patients with intracerebral hemorrhage.

    abstract:BACKGROUND:The paradoxical phenomenon of relative longevity among obese patients with established diseases has been reported for various disease conditions. The authors sought to investigate whether the obesity paradox also applies to intracerebral hemorrhage (ICH) survivors. METHODS:A total of 1,604 patients with ICH...

    journal_title:Neurology

    pub_type: 杂志文章,多中心研究

    doi:10.1212/WNL.0b013e31820b7667

    authors: Kim BJ,Lee SH,Ryu WS,Kim CK,Lee J,Yoon BW

    更新日期:2011-02-08 00:00:00

  • Characteristic features and progression of abnormalities on MRI for CARASIL.

    abstract:OBJECTIVES:The objective of this study was to clarify the characteristic brain MRI findings for genetically diagnosed CARASIL (cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy). METHODS:Seven patients with CARASIL carrying HTRA1 mutations (representing 6 Japanese families) we...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000001803

    authors: Nozaki H,Sekine Y,Fukutake T,Nishimoto Y,Shimoe Y,Shirata A,Yanagawa S,Hirayama M,Tamura M,Nishizawa M,Onodera O

    更新日期:2015-08-04 00:00:00

  • Scanning electronmicroscopy of experimental anencephaly development.

    abstract::The scanning electronmicroscope was used to study the development of anencephaly in an experimental model. Anencephaly was produced consistently, using vitamin A as the teratogen. Embryos destined to become anencephalic displayed failure of opposing sides of the rostral neural tube to fuse. Subsequently, the neural fo...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.32.9.992

    authors: Smith MT,Wood LR,Honig SR

    更新日期:1982-09-01 00:00:00

  • Defective auditory interhemispheric transfer in a patient with a PAX6 mutation.

    abstract::Heterozygous PAX6 mutation is associated with an absent or hypoplastic anterior commissure and a reduction in the area of the corpus callosum. The authors found deficient auditory interhemispheric transfer in a 53-year-old woman with a PAX6 mutation who had an absent anterior commissure but normal callosal volume. ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/01.wnl.0000106950.74155.0a

    authors: Bamiou DE,Musiek FE,Sisodiya SM,Free SL,Mitchell TN,Davies RA

    更新日期:2004-02-10 00:00:00

  • APOE ε4 worsens hippocampal CA1 apical neuropil atrophy and episodic memory.

    abstract:OBJECTIVES:Using high-resolution structural MRI, we endeavored to study the relationships among APOE ε4, hippocampal subfield and stratal anatomy, and episodic memory. METHODS:Using a cross-sectional design, we studied 11 patients with Alzheimer disease dementia, 14 patients with amnestic mild cognitive impairment, an...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000000154

    authors: Kerchner GA,Berdnik D,Shen JC,Bernstein JD,Fenesy MC,Deutsch GK,Wyss-Coray T,Rutt BK

    更新日期:2014-02-25 00:00:00

  • Surgical treatment of carpal tunnel syndrome in patients with peripheral neuropathy.

    abstract::Outcome after carpal tunnel surgery was studied retrospectively in 32 patients with peripheral neuropathy and carpal tunnel syndrome. Nocturnal paresthesias were almost universally relieved, followed in order of responsiveness by pain, numbness, and weakness. Twenty-five of 28 patients said they would have the surgery...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.49.4.1159

    authors: Morgenlander JC,Lynch JR,Sanders DB

    更新日期:1997-10-01 00:00:00

  • Congenital lethal motor neuron disease with a novel defect in ribosome biogenesis.

    abstract:OBJECTIVE:We describe a novel congenital motor neuron disease with early demise due to respiratory insufficiency with clinical overlap with spinal muscular atrophy with respiratory distress (SMARD) type 1 but lacking a mutation in the IGHMBP2 gene. METHODS:Exome sequencing was used to identify a de novo mutation in th...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000000305

    authors: Butterfield RJ,Stevenson TJ,Xing L,Newcomb TM,Nelson B,Zeng W,Li X,Lu HM,Lu H,Farwell Gonzalez KD,Wei JP,Chao EC,Prior TW,Snyder PJ,Bonkowsky JL,Swoboda KJ

    更新日期:2014-04-15 00:00:00

  • Lambert-Eaton syndrome IgG inhibits transmitter release via P/Q Ca2+ channels.

    abstract:OBJECTIVE:To determine whether immunoglobulin G (IgG) from patients with Lambert-Eaton myasthenic syndrome (LEMS) decreases action potential–evoked synaptic vesicle exocytosis,and whether the effect is mediated by P/Q-type voltage-gated calcium channels (VGCCs). METHODS:IgG was obtained from 4 patients with LEMS (3 ma...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000001225

    authors: Spillane J,Ermolyuk Y,Cano-Jaimez M,Lang B,Vincent A,Volynski KE,Kullmann DM

    更新日期:2015-02-10 00:00:00

  • NOTCH3 mutation involving three cysteine residues in a family with typical CADASIL.

    abstract::Mutations in NOTCH3 are the cause of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), a hereditary angiopathy causing stroke and vascular dementia. All CADASIL mutations identified so far result in the loss or gain of one cysteine residue within epidermal growth fac...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.57.9.1714

    authors: Dichgans M,Herzog J,Gasser T

    更新日期:2001-11-13 00:00:00

  • Psychometric evaluation of a new sensory scale in immune-mediated polyneuropathies. Inflammatory Neuropathy Cause and Treatment (INCAT) Group.

    abstract:OBJECTIVE:To perform a psychometric evaluation of the inflammatory neuropathy cause and treatment (INCAT) sensory sumscore (ISS) in sensory-motor immune-mediated polyneuropathies. This new sensory scale was evaluated to strive for uniformity in assessing sensory deficit in these disorders. METHODS:The ISS comprises vi...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.54.4.943

    authors: Merkies IS,Schmitz PI,van der Meché FG,van Doorn PA

    更新日期:2000-02-22 00:00:00

  • Detection and cellular localization of enterovirus RNA sequences in spinal cord of patients with ALS.

    abstract:OBJECTIVE:To investigate the possible association of persistent enterovirus (EV) infection with the development of ALS. BACKGROUND:Although ALS is a clinically well-defined motor neuron disease, little is known about the etiology and pathogenesis of the sporadic cases. Among the different causes that have been hypothe...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.54.1.20

    authors: Berger MM,Kopp N,Vital C,Redl B,Aymard M,Lina B

    更新日期:2000-01-11 00:00:00

  • Rapidly progressive hippocampal atrophy: evidence for a seizure-induced mechanism.

    abstract::Hippocampal formation atrophy (HFA) developed in an adult, who did not have epilepsy previously, after the occurrence of new-onset partial seizures from acute thrombosis of an ipsilateral parietal venous angioma. There was no evidence of hippocampal injury, and the patient had only one brief, generalized tonic-clonic ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.58.10.1553

    authors: Worrell GA,Sencakova D,Jack CR,Flemming KD,Fulgham JR,So EL

    更新日期:2002-05-28 00:00:00

  • Manganese intoxication in the rhesus monkey: a clinical, imaging, pathologic, and biochemical study.

    abstract::We gave three adult rhesus monkeys seven IV injections of manganese chloride at approximately 1-week intervals. We evaluated neurologic status by serial clinical examinations and performed a levodopa test if the animal developed features of basal ganglia dysfunction. After the animals were killed, we performed neuropa...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.46.2.492

    authors: Olanow CW,Good PF,Shinotoh H,Hewitt KA,Vingerhoets F,Snow BJ,Beal MF,Calne DB,Perl DP

    更新日期:1996-02-01 00:00:00

  • Biologic impact of interferon antibodies, and complexities in assessing their clinical significance.

    abstract::The relevance of neutralizing antibodies (NAb) to interferon-beta (IFNbeta) for patients with MS treated with IFNbeta injections has been controversial. Published data from several double-blind, randomized clinical trials demonstrate that disease activity in IFNbeta-treated patients with MS is similar to placebo-treat...

    journal_title:Neurology

    pub_type: 杂志文章,评审

    doi:10.1212/01.wnl.0000092363.40248.0e

    authors: Rudick RA

    更新日期:2003-11-11 00:00:00

  • Bilateral orbital signs predict cortical venous drainage in cavernous sinus dural AVMs.

    abstract:BACKGROUND:Most cavernous sinus dural arteriovenous malformations (CSdAVM) have a benign clinical course. Those CSdAVM that drain into cortical veins have an increased risk for neurologic complications. OBJECTIVE:To find whether a specific clinical sign predicts cortical venous drainage (CVD) in CSdAVM. METHODS:The r...

    journal_title:Neurology

    pub_type: 杂志文章,评审

    doi:10.1212/wnl.58.10.1521

    authors: Stiebel-Kalish H,Setton A,Berenstein A,Kalish Y,Nimii Y,Kupersmith MJ

    更新日期:2002-05-28 00:00:00

  • Cerebral amyloid angiopathy and cognitive function: the HAAS autopsy study.

    abstract:OBJECTIVE:To investigate the relationship between cerebral amyloid angiopathy (CAA), dementia, and cognitive function in an autopsy sample of 211 Japanese-American men from the population-based Honolulu-Asia Aging Study. METHODS:Starting in 1991, participants were assessed with the Cognitive Abilities Screening Instru...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.58.11.1629

    authors: Pfeifer LA,White LR,Ross GW,Petrovitch H,Launer LJ

    更新日期:2002-06-11 00:00:00

  • Limited role for extended maintenance temozolomide for newly diagnosed glioblastoma.

    abstract:OBJECTIVE:To explore an association with survival of modifying the current standard of care for patients with newly diagnosed glioblastoma of surgery followed by radiotherapy plus concurrent and 6 cycles of maintenance temozolomide chemotherapy (TMZ/RT → TMZ) by extending TMZ beyond 6 cycles. METHODS:The German Glioma...

    journal_title:Neurology

    pub_type: 杂志文章,多中心研究

    doi:10.1212/WNL.0000000000003809

    authors: Gramatzki D,Kickingereder P,Hentschel B,Felsberg J,Herrlinger U,Schackert G,Tonn JC,Westphal M,Sabel M,Schlegel U,Wick W,Pietsch T,Reifenberger G,Loeffler M,Bendszus M,Weller M

    更新日期:2017-04-11 00:00:00

  • Expression and regulation of IFNalpha/beta receptor in IFNbeta-treated patients with multiple sclerosis.

    abstract:BACKGROUND:The cytokine interferon beta (IFNbeta) is successfully used in the treatment of multiple sclerosis (MS), although there is a high degree of variability in the response. A common mechanism involved in the modulation of responsiveness to cytokines is represented by regulation of their receptor expression throu...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/01.wnl.0000327340.50284.8d

    authors: Gilli F,Valentino P,Caldano M,Granieri L,Capobianco M,Malucchi S,Sala A,Marnetto F,Bertolotto A

    更新日期:2008-12-09 00:00:00

  • Localizing value of torsional nystagmus in small midbrain lesions.

    abstract:BACKGROUND:The topodiagnostic value and specificity of nystagmus in patients with mesencephalic lesions and its relation to tonic torsional deficits and vertical saccade deficits is controversial and anecdotal. METHODS:The authors examined 11 patients with vascular MRI-identified mesencephalic lesions and clinical evi...

    journal_title:Neurology

    pub_type: 临床试验,杂志文章

    doi:10.1212/01.wnl.0000038387.90128.8d

    authors: Helmchen C,Rambold H,Kempermann U,Büttner-Ennever JA,Büttner U

    更新日期:2002-12-24 00:00:00

  • Network dysfunction predicts speech production after left hemisphere stroke.

    abstract:OBJECTIVE:To investigate the role of multiple distributed brain networks, including the default mode, fronto-temporo-parietal, and cingulo-opercular networks, which mediate domain-general and task-specific processes during speech production after aphasic stroke. METHODS:We conducted an observational functional MRI stu...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000002537

    authors: Geranmayeh F,Leech R,Wise RJS

    更新日期:2016-04-05 00:00:00

  • Longitudinal study of blood pressure and white matter hyperintensities: the EVA MRI Cohort.

    abstract:OBJECTIVE:To investigate the relationship between baseline hypertension and severity of white matter hyperintensities (WMH) at 4-year follow-up in a sample of subjects aged 59 to 71 years old at entry. METHODS:Subjects were participants in the Epidemiology of Vascular Ageing study, a longitudinal study on vascular agi...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.56.7.921

    authors: Dufouil C,de Kersaint-Gilly A,Besançon V,Levy C,Auffray E,Brunnereau L,Alpérovitch A,Tzourio C

    更新日期:2001-04-10 00:00:00

  • Laryngeal botulinum toxin injections for disabling stuttering in adults.

    abstract::Stuttering is an action-induced speech disorder with involuntary, audible, or silent repetitions or prolongations in the utterance of short speech elements (sounds, syllables) and words. Symptomatic treatment programs frequently have initial success; persistent benefit is variable and many patients remain disabled. St...

    journal_title:Neurology

    pub_type: 临床试验,杂志文章

    doi:10.1212/wnl.44.12.2262

    authors: Brin MF,Stewart C,Blitzer A,Diamond B

    更新日期:1994-12-01 00:00:00

  • Stem cell therapy in ischemic stroke: role of IV and intra-arterial therapy.

    abstract:OBJECTIVE:Cell-based therapies are being investigated as an adjunct to IV thrombolysis or mechanical thrombectomy in ischemic stroke. This review summarizes the potential applications as well as challenges of intravascular cell delivery in ischemic stroke. METHOD:We conducted a search of Medline as well as the clinica...

    journal_title:Neurology

    pub_type: 杂志文章,评审

    doi:10.1212/WNL.0b013e31826959d2

    authors: Misra V,Ritchie MM,Stone LL,Low WC,Janardhan V

    更新日期:2012-09-25 00:00:00