May 02, 2012

May is Stroke Awareness Month: Know the Signs!

David Langer, MD

A stroke is an injury to the brain caused by the obstruction of blood flow to a brain artery-usually by a blood clot or a direct bleed into the brain itself. It can be due to weakness in the vessel wall commonly caused by high blood pressure or cerebral aneurysm.

Stroke is the third leading cause of death and the number one cause of disability in the United States. Stroke or "brain attack" can occur in all ages and nearly one quarter of strokes occurs in people under age 65.

The warning signs of stroke include motor weakness, sensory change (i.e. numbness or tingling of the face, arm or leg), speech difficulty or visual disturbance. Pain is present only in patients with the hemorrhagic form of stroke (a bleed in the brain) which represents only 15 percent of all strokes.

For the most part, the treatment of hemorrhagic stroke remains conservative with therapeutic options to reverse brain injury being very limited. Treatment is surgical only when a blood clot in the brain becomes life threatening. Surgery or catheter-based neurointerventional procedures are often used in patients who suffer bleeds from cerebral aneurysms to prevent a second hemorrhage.

Neurointerventional treatments are becoming more common in treating patients with ischemic stroke-strokes caused by vessel blockage. Along with intravenous clot-busting drugs (called tPA), intra-arterial delivery of these same drugs, as well as new technologies such as intravascular suction catheters and sophisticated mechanical devices, are increasingly being used for patients who either fail medical therapy or who present outside the three-hour time window reserved for the administration of intravenous tPA. Full Post - to Detail View

March 05, 2012

Clouded in Smoke: Cigarettes Dull the Male Brain

Marc Gordon, MD

Everyone knows smoking is dumb. Now it looks like it makes you dumb, too: A recent study in the Archives of General Psychiatry suggests that male smokers of a certain age experience faster loss of brain power.

Researchers found that, compared to men who never smoked, middle-aged men smokers are likely to experience more rapid decline in certain mental abilities over a period of 10 years. Recent ex-smokers also showed greater cognitive loss, although researchers observed no lasting effect in men who had quit more than 10 years earlier. The study also suggests that the negative association between smoking and cognition, especially at advanced ages, may actually be underestimated because of smokers' higher risk of death and drop-out.

Yet how smoking results in decreased mental abilities remains unclear. In this trial, cardiovascular disease, hypertension, elevated cholesterol or impaired lung function did not account for the effect. While the study didn't show an association between smoking and cognitive decline in women, there was a smaller proportion of women (about 30 percent) in the trial group and a higher percentage of women had never smoked. The average pack-years of smoking and number of cigarettes smoked were higher in men than in women and heavy alcohol consumption was considerably higher in men (38.7 percent) as compared to women (23.3 percent) smokers.

This study presents not only more evidence that smoking is bad for you, but it also shows that mid-life smoking is a modifiable risk factor which, left unchecked, will rob your brain of about 10 years.

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January 09, 2012

Headaches after Pediatric Traumatic Brain Injury

Noah Rosen, MD

More than half a million children in the United States sustain a traumatic brain injury (TBI) every year. In a recent study published by Pediatrics, researchers analyzed the prevalence of headaches three and 12 months after mild and moderate or severe TBI in children ages 5 to 17. Three months after a mild TBI, 43 percent of children reported headache, compared to 37 percent of children who had a moderate to severe TBI, and 26 percent of children in the control group. The risk of headache was highest in adolescents and in girls. The researchers concluded that the response to and recovery from TBI is different for children, adolescents and adults and that between boys and girls, there is a difference in symptoms and recovery from TBI.
 
This study is very important for several reasons. First of all, headaches in adolescents and teenagers are often ignored by parents and teachers until it has progressed to the point of disability. This study suggests early awareness and intervention. Secondly, headache disorders during this developmental period can have long term effects because teenagers can miss fundamental information in school that they will have difficulty catching up later. Lastly, undiagnosed post traumatic headache may increase risk for further damage if the teenager continues to play sports without addressing the issue.
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November 11, 2011

Largest Study Shows No Link Between Cell Phones and Brain Tumors

Michael Schulder, MD

According to a recent study published in the British Medical Journal, there is no link between long-term use of mobile phones and brain tumors or tumors of the central nervous system.  One of the largest and longest studies of its kind, Danish researchers found no evidence that the risk of brain tumors was raised among approximately 360,000 cell phone subscribers over an 18-year period.

While this study may put us more at ease, there are still measures one can take to reduce any risk there might be by either not talking for long periods with the cell phone to the ear or by using an earpiece or speaker.  By using these methods, any risk of brain tumor formation from cell phone use can be essentially eliminated.

In reality, the biggest danger from cell phones may not be from brain cancer, but rather from using cell phones while driving.  The risks incurred with cell phone use while driving, whether it is texting, looking at emails, or even holding a phone to one’s ear, are much higher than any theoretical risk of getting a brain tumor.  Common sense and medical studies show this to be the case.

 

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July 29, 2011

Innovative Study Looks at How the Brain Communicates with Itself

Ashesh Mehta, MD

In today’s world, networks operate in diverse situations, from communication networks that permit a cell phone conversation to social networks that link friends on Facebook. These networks have properties (e.g., each computer in your home with a wireless network) and hubs, where multiple separate sub-networks come together (e.g., a person who bridges multiple social networks). 

It is increasingly being recognized that these properties operate in our brain too – in both normal functioning and as a mechanism for disorders of the nervous system, like the spread of seizures across the brain. Functional magnetic resonance imaging (fMRI) is a non-invasive method that can be used to measure the tiny metabolic changes that take place in an active part of the brain. To date, fMRI has been typically used to study what parts of the brain become active when subjects respond to stimuli (e.g., being shown pictures) or perform tasks (e.g., rotating objects in their mind’s eye). Recently, there has been interest in looking at how the brain works at rest, by measuring the fMRI signals in different brain regions and seeing how they activate and deactivate together. By measuring the relationship of activity between different brain areas, it is possible to describe an individual’s brain network, including sub-networks where brain areas with higher correlation are more closely connected (much like friends in a social network). While this has been studied extensively with fMRI, results have been difficult to interpret, because of the unclear relationship between fMRI signals and brain electrical activity. 
 
Validation of this fMRI methodology has recently taken a major step forward, with the findings published in a recent issue of Full Post - to Detail View