Mineralizing angiopathy with basal ganglia stroke in an infant

Basal ganglia stroke is known following trivial head trauma. Recently a distinct clinic-radiological entity termed ‘mineralizing angiopathy’ was described. We report an infant who developed basal ganglia stroke following trivial fall. His clinic-radiological features are described.     

Characteristics of basal ganglia aphasia after stroke and the rehabilitative interventions

To introduce the characteristics of basal ganglia aphasia after stroke and the rehabilitative interventions.DATA SOURCES: Articles related to stroke, subcortical aphasia, basal ganglia aphasia and language rehabilitation published in Chinese from January 1988 to December 2005 were searched in Chinese journal full-text database (CJFD) using the keywords of“stroke, basal ganglia aphasia, language rehabilitation“ in Chinese. Meanwhile, English articles about aphasia published from January 1982 to December 2005 were searched in and Pubmed database. Besides, several books associated with the contents were looked through manually.STUDY SELECTION: The data were checked primarily, the articles about the pathomechanism and neurolinguistic characteristics of basal ganglia aphasia, diagnostic methods of aphasia and language rehabilitation were selected, and those had no obvious relation with the above contents were excluded.Inclusive criteria: literatures explain the clinical characteristics of basal ganglia aphasia, neurolinguistic pathogenesis and methods of rehabilitation therapy in details. The repetitive studies were excluded.DATA EXTRACTION: Totally 95 literatures about basal ganglia aphasia were collected, including 31 about the clinical characteristics of basal ganglia aphasia, 45 about its neurolinguistic pathogenesis, 5 about the evaluation and classification of aphasia, and 14 about its rehabilitation therapy. Thirty accorded with the inclusive criteria were used for review, and the other 65 were excluded.DATA SYNTHESIS: Concisely introduced the definition, past investigation of basal ganglia aphasia after stroke, then dwelled on the multiplicity neurolinguistics characteristics. Aphasia evaluation was dependent upon clinical aphasic symptoms. The relationship between symptom and focus of infection was explored, and the mechanism of pathosis language behavior on basal ganglia aphasia patients was understood to provide consequence data that could authenticate the processing of language in brain. On the other hand, the method of rehabilitation on basal ganglia aphasia after stroke was explained.CONCLUSION: Basal ganglia aphasia is manifested as atypical aphasic symptom, the mechanism for the structure of basal ganglia in the speech formation should be further confirmed. It is effective to select pertinent language rehabilitation for basal ganglia aphasia after stroke.     

Prognosis and MRI after ischemic stroke of the basal ganglia.

The clinical courses and long-term prognoses in 16 young patients with infarctions of the basal ganglia were evaluated and the recent magnetic resonance imaging findings in 9 of them were examined. Only 5 of 14 patients (35%) had motor sequelae, 4 had hemiparesis, and 1 had gait disturbance. Secondary dystonia occurred in 1 patient. Magnetic resonance imaging disclosed a circumscribed lesion in the basal ganglia, as reflected by T2 high- and T1 low-intensity signals, in all patients. The abnormal region on T2-weighted images usually was more extensive than that observed on T1-weighted ones. The hemiplegic patients each had an area of abnormal intensity in the internal capsule or corona radiata with relatively high signals on the T2- and proton-density-weighted images. Mild to moderate asymmetric atrophy of the midbrain on the side ipsilateral to the stroke lesion was observed in 8 of 9 patients. The mechanism involved may be remote transsynaptic neuronal death of the substantia nigra, as well as Wallerian degeneration of the pyramidal tract.     

Changes in cognitive function after neuronal cell transplantation for basal ganglia stroke

Reported is the change in cognitive function after neuronal cell transplantation as a treatment for basal ganglia stroke. Nine subjects (two controls, seven transplants), all over 2 years post stroke, completed a comprehensive neuropsychological test battery prior to and 6 months after treatment. Four transplanted subjects who had strokes in the nondominant hemisphere showed marked improvement on the Rey Complex Figure, a test of visuospatial/constructional ability and nonverbal memory.     

Outcomes of children with infantile spasms after perinatal stroke

The object of this study was to describe the outcomes of children with infantile spasms resulting from perinatal stroke. We used International Classification of Diseases, Ninth Revision (ICD-9) searches of billing records to identify 110 children with infantile spasms examined at our hospital from 1998 through 2005. Five of the 99 with symptomatic spasms (5%) had perinatal stroke. An additional five children with spasms caused by perinatal stroke were identified from pediatric stroke clinic records. Seven of the 10 children with spasms due to perinatal stroke presented with stroke as neonates. Three initially appeared healthy but were diagnosed with "presumed perinatal stroke" after radiographic imaging for their spasms evaluation. Median age at last follow-up was 6.3 years: 9 (90%) had epilepsy, 8 (80%) manifested cognitive impairment, and all (100%) had cerebral palsy. The three children who had delayed presentation of "presumed perinatal stroke" had better epilepsy and cognitive outcomes than the seven with neonatal presentation (P = 0.03). Perinatal stroke accounts for 5% of symptomatic spasms and results in high rates of chronic disability similar to those observed with other types of symptomatic spasms. However, a subgroup of children with spasms caused by delayed presentation of "presumed perinatal stroke" appears to have better epilepsy and cognitive outcomes.     

Catecholamine alterations in basal ganglia after hippocampal lesions

Rats were given sham, cortical, or hippocampal lesions and sacrificed 7 or 28 days following surgery. Levels of norepinephrine, dopamine, and the major dopamine metabolites, 3, 4-dihydroxyphenylacetic acid and homovanillic acid (HVA), were assayed in 3 brain regions. At day 7 there was a decrease in dopamine utilization and a decrease in norepinephrine levels in the nucleus accumbens after hippocampal damage but both of these measures returned to normal levels by day 28. In the neostriatum HVA levels decreased at day 7 after hippocampal damage. The utilization of dopamine in the neostriatum was decreased at day 28 in animals that received neocortical lesions but this was not observed in animals with hippocampal destruction. No effects of any lesion at any day were found in the olfactory tubercle region, the third brain region analyzed. It is thought that the removal of hippocampal and neocortical input to the basal ganglia influences catecholamine function reflected in the loss and subsequent recovery of dopamine utilization.     

Cerebral blood flow after experimental basal ganglia hemorrhage

The effect of cerebral hemorrhage on regional cerebral blood flow (RCBF) in awake, unrestrained rats was studied by comparing intracaudate injections of whole blood (N = 14), centrifuged blood (N = 2), and inert plastic (N = 1). RCBF was measured by the polarographic hydrogen clearance technique using chronically implanted electrodes in the cortex and caudate bilaterally. After hemorrhage, animals became comatose and flows diminished 23 to 30% (p < 0.01) below baseline values. Recovery of RCBF to prehemorrhage values was accompanied by awakening and survival while persistently low RCBF in all regions occurred only in the 2 animals that died, suggesting that physiological changes which lower RCBF after hemorrhage may be harmful. Transient hyperfusion of the contralateral cortex occurred in 6 of 10 animals during the first 10 minutes after hemorrhage. In all 8 animals tested daily there was significant hyperperfusion of one or both cortical regions during the second or third day after hemorrhage (mean increase in right cortex RCBF, 30%, p < 0.05; left, 45%, p < 0.01). Injection of an identical volume of plastic was not accompanied by hyperperfusion, suggesting that destruction of the caudate or addition of an inuracerebral mass was not responsible for the increase in blood flow. However, injection of centrifuged blood components caused immediate hyperperfusion, which persisted in some cortical regions on the following day. A substance in cerebral hemorrhage clot may cause increased cortical RCBF.     

Ischaemic stroke in the basal ganglia and internal capsule in childhood

Ischaemic stroke in childhood is rare. In particular, there have only been a few reports of lacunar infarcts in children. In this study, four children with true lacunar infarcts and four with larger subcortical infarcts are described. We compare the clinical features and the possible pathogenesis of ischaemic strokes in the basal ganglia and internal capsule in childhood with those in adults, and discuss diagnostic and therapeutic management.     

基底节卒中患者面孔情绪认知障碍的研究

目的探讨基底节卒中患者是否存在面孔情绪认知障碍,验证基底节参与面孔情绪加工以及选择性参与厌恶面孔加工的特异性神经机制的假说。方法测试32例基底节卒中患者(基底节卒中组)和30名健康者(健康对照组)对70张含有6种基本情绪(喜、惊、恐、悲、厌和怒)和中性面孔照片的辨别能力。结果基底节卒中组对面孔情绪辨别总得分为(106.52±7.83)分,厌恶面孔为(10.42±2.71)分,惊讶面孔为(15.09±2.08)分,较健康对照组[(114.55±9.00)、(14.65±2.25)、(16.35±1.63)分]为低,差异均有显著性(P<0.01、P<0.05、P<0.001)。相对于惊讶面孔,患者对厌恶面孔的辨别障碍更明显(P<0.005)。结论基底节卒中患者存在面孔情绪认知障碍,表现为相对选择性的厌恶面孔认知障碍。     

Brainstem interactions with the basal ganglia

The basal ganglia are a group of interconnected subcortical nuclei that represent one of the brain's fundamental processing units. In humans basal ganglia dysfunctions have been associated with numerous debilitating conditions, including Parkinson's disease. To appreciate fully how complicated systems can malfunction, it may first be necessary to understand how such networks work normally. The present review therefore provides an outline of basal ganglia architecture emphasising their interactions with brainstem structures. The potential functions of the basal ganglia network are then considered together along with resulting insights that may help our understanding of Parkinson's disease and other basal ganglia-related disorders.     

Blepharospasm with bilateral basal ganglia infarction

Severe, involuntary, forceful closure of both eyelids, along with dystonia and rigidity, followed hypoxic encephalopathy in a young man whose computed tomographic scan showed symmetric infarcts of the corpus striatum. Symptomatic blepharospasm can result from bilateral damage to the basal ganglia.     

Mobius syndrome with basal ganglia calcification

Basal ganglia calcification has not been described in Mobius syndrome. A family with two children with Mobius syndrome are reported. Bilateral basal ganglia calcification was seen on computed tomography in both. This is the first family where cerebral involvement has been clearly documented in this syndrome.     

Partial seizures triggering infantile spasms in the presence of a basal ganglia glioma.

Infantile spasms associated with brain tumors have been reported. A focal cortical lesion can induce infantile spasms by triggering the brainstem and basal ganglia in this vulnerable age group. We report the case of a female infant with a low-grade glioma in the right basal ganglia, spreading to the cortical area. She presented at the age of five months with left hemiparesis and partial seizures. She developed infantile spasms at the age of 12 months. This is the first video clip report of partial seizures triggering symmetrical spasms in series, secondary to a basal ganglia glioma extending to the cortex. [Published with video sequences].     

Delayed parkinsonism with a selective symmetric basal ganglia lesion after manual strangulation

A 21-year-old woman, who experienced manual strangulation, developed delayed parkinsonism associated with a selective symmetric basal ganglia lesion. The patient had recovered completely one year after early combination therapy. This case emphasizes the need for greater attention in detecting early brain injuries in those afflicted with strangulation so as to provide optimal management.     

脑卒中后基底节性失语的特点

目的探讨脑卒中后基底核性失语的特点。方法选择急性期单侧皮层下脑卒中后基底核性失语患者29例,行失语症检查,分析其语言学特征。结果基底节性失语有较重的听理解障碍及书写能力的受损,其中理解中度障碍18例(62%);重度障碍11例(38%);书写障碍以描写障碍突出,重度障碍25例(86%);复述相对较好,轻中度障碍24例(83%)。23例(79%)出现语音障碍,包括音韵及音律障碍。8例患者出现言语失用。基底神经节性失语多为轻至中度语言表达障碍,表现为语言减少,口语流畅性差,说话缓慢、费力,启动难,词与词之间缺乏连惯性,词汇单调,理解障碍相对较轻,可有找词困难(说不出恰当词),偶有错语,但复述正常或相对正常。结论基底节性失语在脑卒中后较为常见,其类型复杂,几乎包括所有失语类型,表现为较重的听理解障碍及书写能力的受损,书写障碍以描写障碍突出;复述相对较好;多数患者出现语音障碍,口语流畅性差;言语失用常见;命名障碍较常见。     

Postinfectious encephalomyelitis with localized basal ganglia involvement

The diagnosis of postinfectious encephalomyelitis with symmetric lesions in the basal ganglia was confirmed by magnetic resonance imaging in 2 patients. A 7-year-old patient experienced severe dystonia and hyperreflexia; magnetic resonance imaging demonstrated bilateral lesions in the putamina and basis pontes. The other patient, a 2-year-old female, manifested hypotonia, facial grimacing, and athetosis. Symmetric lesions in the globus pallidus and substantia nigra were demonstrated by imaging studies. The nature and monophasic course of illness in these 2 patients, as well as the symmetric involvement of specific regions of the basal ganglia, may result from an immune-mediated postinfectious demyelinating process.