Biomedical subjects

Yair Lampl

Publications and source records attributed to Yair Lampl.

23 records · Page 2Linked to original sources

PubMed2002

Brain SPECT evaluation of amnestic ED patients after mild head trauma.

A short period of amnesia is a common complaint after mild head injury. In this study we compare the duration of amnesia after mild head trauma to single photon emission computed tomography (SPECT) perfusion imaging shortly after admission to the emergency department (ED). Sixteen patients consecutively admitted to the ED were prospectively evaluated. The amnesia was scored according to the Extended Glasgow Coma Score. A computed tomography (CT) scan was performed to all patients. All patients had anterograde amnesia. Eleven patients had amnesia of grade 2 (69%) and 5 patients of grade 3 (31%). All patients had a normal CT scan. Twelve of sixteen patients (75%) showed regional perfusion abnormalities on the SPECT study. Decreased perfusion was observed at least in one region (8/12 patients had 2 abnormal regions). The logistic regression analysis showed that SPECT results significantly predicted the severity of amnesia (r = 0.9, P <.0001). Additionally, the SPECT accounted for approximately 84% of the variation in amnesia. We conclude that amnesia after mild head injury is associated with a high incidence of early regional cerebral perfusion abnormalities. Amnesia lasting more than half an hour is associated with bilateral cerebral hypoperfusion. SPECT evaluation in the ED may by a useful additional tool in the objective assessment of posttraumatic amnesia.

Adolescent↗

PubMed2002

Tc-99m ethylcysteinate dimer brain SPECT perfusion imaging in ictal nonepileptic visual hallucinations.

PURPOSE: Visual hallucinations can occur within the central nervous system and may be associated with a lesion anywhere in the visual pathway. The purpose of this study was to assess "ictal" regional cerebral blood flow with Tc-99m ethylcysteinate dimer (ECD) SPECT in patients having acute hallucinations, and to compare the findings to the "interictal" state. METHODS: A prospective study was performed to evaluate patients admitted to the neurology department with nonpsychiatric and nonepileptic visual hallucinations. The nine patients included in the study underwent thorough neurologic and psychiatric evaluations. A computed tomographic (CT) scan was performed when each patient was admitted, and electroencephalographic (EEG) recordings were made during their hallucinations. All patients underwent a brain SPECT while having acute hallucinations (ictal SPECT), and a follow-up scan was obtained 2 to 3 weeks later. RESULTS: All patients had normal ictal EEG findings during the hallucinations. Seven of nine patients had increased perfusion on the SPECT studies in one or more regions, with a mean lesion-to-contralateral ratio of 2.1 (range, 1.5 to 2.7). Three of the seven patients had findings consistent with a cerebrovascular accident. After treatment, the hallucinations disappeared in two patients and the motor deficit improved dramatically. The follow-up SPECT study showed significant improvement in all patients 1 week later. Charles Bonnet syndrome, frontal lobe dementia, and Anton syndrome were diagnosed in three other patients, and the last one had no identifiable background disease, all with normal findings of EEG, CT, and magnetic resonance examinations. They all responded readily to carbamazepine therapy, and the follow-up SPECT study showed resolution of the findings. Two of nine patients showed posterior cortical hypoperfusion, and eventually Lewy body disease was diagnosed. The SPECT showed no evidence of regional hyperperfusion. CONCLUSIONS: This prospective preliminary study suggests that brain imaging using SPECT may be useful in identifying the mechanisms and evolution of blood flow abnormalities in certain subgroups of patients who have visual hallucinations and may assist in the selection of specific therapy.

Aged↗

PubMed2002

Late whiplash syndrome: correlation of brain SPECT with neuropsychological tests and P300 event-related potential.

BACKGROUND: The acceleration forces infringing the cervical spine in whiplash injury are frequently associated with multiple cerebral symptoms. The purpose of this study was to determine whether there is a correlation between cerebral perfusion findings, P300 recording (an electrophysiologic marker of cognitive ability), and neuropsychological tests in patients with whiplash injury. METHODS: Twenty patients with chronic whiplash injury underwent extensive clinical evaluation and neuropsychological testing. A brain single-photon emission computed tomography (SPECT) study using 99mTc-HMPAO was performed in all patients within 24 hours of neuropsychological evaluation. P300 event-related potentials were performed in 15 patients and in 9 normal volunteers. RESULTS: Thirteen of 20 patients had brain perfusion abnormalities on the SPECT studies, in one or more regions. Eight of 15 patients had abnormal P300 studies. Seven of eight patients with abnormal P300 had also an abnormal SPECT study. Seven of 15 patients had normal P300 results, 6 of them with a normal SPECT and 1 with SPECT abnormalities. There was no significant correlation between the SPECT findings or the P300 results and the scores of attention and working memory. There was, however, close agreement between the SPECT and P300. CONCLUSION: SPECT perfusion abnormalities in patients with chronic whiplash syndrome correlate well with P300 recording. The combination of these studies with neurocognitive and neurobehavioral tests may be useful in identifying a subgroup of patients having organic brain lesions.

Adult↗

PubMed1998

Self and body esteem perception in multiple sclerosis.

Self esteem and body esteem were examined in a group of 35 relapsing-remitting multiple sclerosis (MS) patients using the Body Esteem Scale (BES) and the Eysenck Self Esteem Scale (ESES) and compared to age and sex matched normal controls. There were 23 females and 12 males in the MS patient's group; average age 38.9 years (range: 22-52). All participants completed the self-rated BES evaluating the following subscales: females - sexual attractiveness, physical condition and weight concern; males - physical attractiveness, physical condition and upper body strength. In addition all participants were scored, following a semi-structured interview, on the ESES. Psychiatric co-morbidity was excluded using a semi-structured interview by the consulting psychiatrist. All evaluations were carried out during the remitting phase. Statistical analysis, comparing patients to healthy controls, demonstrated lowered self-rating of the physical condition (males < 0.05, females < 0.001). On the other hand, no significant differences were found in the physical (male) or sexual (female)--attractiveness subscales. The mean ESES score in the patients group was 23.2 +/- 4.0, slightly above the reported average. The controls mean ESES was 28.4 +/- 3.6, (P < 0.05). No correlation was found between self and body esteem amongst M.S. patients. This study emphasizes impaired perception of body esteem in multiple sclerosis patients even in remission. The preservation of physical and sexual attractiveness may be related to the non-disfiguring nature of the disease. Preservation of self-esteem in MS patients suggests that body-esteem should be the focus of supportive treatment.

Journal Article↗

PubMedDate not supplied

The significance of prestroke aspirin dosage in fatal outcome of acute stroke.

BACKGROUND: Aspirin is an effective and generally accepted treatment drug during the acute stage of ischemic brain infarction. The association between the pretreatment aspirin dosage and fatal outcome among these treated patient groups has not been analyzed previously. OBJECTIVE: The aim of the study was to evaluate 14- and 30-day poststroke survival in patients treated with 325 mg immediately on admission to the hospital for prestroke antiaggregation/anticoagulation treatment. METHODS: This prospective study was conducted in a government tertiary care facility. The medical records of all 1245 patients admitted to the hospital for stroke from 1997 to 2002 were reviewed. The association between demographic parameters, stroke risk factors, stroke subtype, prestroke antiaggregation/anticoagulation treatment, and risk of fatal poststroke outcome, 14 days and 30 days after the event, was analyzed using Cox survival analyses. RESULTS: During the 14-day poststroke period, 320 patients (25%) died. By day 30 poststroke, 386 patients (31%) had died. Older age, female gender, chronic heart disease, and cardiac arrhythmias were associated with increased risk of increased fatal outcome. Mortality was higher in patients with stroke caused by cardioembolism (P < 0.0001) and was significantly lower in patients with small-vessel occlusion (P < 0.0001). Prestroke medium-dose aspirin treatment was associated with a relative reduction in 30-day poststroke period mortality (P < 0.0001). Conversely, prestroke low-dose aspirin treatment was associated with increased mortality (P < 0.0001). CONCLUSION: Prestroke medium-dose aspirin treatment was associated with reduced 30-day poststroke mortality, whereas low-dose prestroke aspirin therapy was associated with increased 30-day poststroke mortality.

Aged↗