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2. The Role of Personalized Virtual Reality in Education for Patients Post Stroke—A Qualitative Case Series

Author

Benjamin J Bailey, Michael McCorriston, Pascal Bou-Haidar, Steven G Faux, Christine T. Shiner, John McGhee, and Angelica G. Thompson-Butel

Subjects
Male, Patient-Specific Modeling, Health Knowledge, Attitudes, Practice, medicine.medical_specialty, medicine.medical_treatment, media_common.quotation_subject, Health Behavior, Virtual reality, Session (web analytics), Young Adult, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Patient Education as Topic, Adaptation, Psychological, medicine, Humans, Closure (psychology), Stroke, visualization, Aged, media_common, Rehabilitation, business.industry, Stroke Rehabilitation, Virtual Reality, Middle Aged, medicine.disease, Health Literacy, Visualization, Treatment Outcome, Caregivers, Feeling, Patient Satisfaction, technology, Post stroke, stroke education, Female, Surgery, stroke prevention, Neurology (clinical), New South Wales, Comprehension, Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery, Preliminary Data
Abstract

Background: Education is essential to promote prevention of recurrent stroke and maximize rehabilitation; however, current techniques are limited and many patients remain dissatisfied. Virtual reality (VR) may provide an alternative way of conveying complex information through a more universal language. Aim: To develop and conduct preliminary assessments on the use of a guided and personalized 3D visualization education session via VR, for stroke survivors and primary caregivers. Methods: Four poststroke patients and their 4 primary caregivers completed the 3D visualization education session as well as pre- and postintervention interviews. Each patient had a different stroke etiology (i.e., ischemic thrombotic stroke, ischemic embolic stroke, hemorrhagic stroke, and transient ischemic attack followed by ischemic stroke, respectively). This new approach uses preintervention interview responses, patient MRI and CT datasets, VR head mounted displays, 3D computer modeling, and game development software to develop the visualization. Pre- and postintervention interview responses were analyzed using a qualitative phenomenological methodology approach. Results: All participants safely completed the study and were highly satisfied with the education session. In this subset of participants, prior formal stroke education provision was limited. All participants demonstrated varied improvements in knowledge areas including brain anatomy and physiology, brain damage and repair, and stroke-specific information such as individual stroke risk factors and acute treatment benefits. These improvements were accompanied by feelings of closure, acceptance, and a greater motivation to manage their stroke risk. Conclusions: Preliminary results suggest this approach provides a safe and promising educational tool to promote understanding of individualized stroke experiences.

Published
2019
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3. Adhesive capsulitis: Review of imaging and treatment

Author

Guy Harris, Craig Harris, and Pascal Bou-Haidar

Subjects
medicine.medical_specialty, Musculoskeletal imaging, medicine.diagnostic_test, business.industry, Ultrasound, Magnetic resonance imaging, medicine.disease, Imaging modalities, Surgery, Capsulitis, Oncology, Clinical diagnosis, medicine, Radiology, Nuclear Medicine and imaging, Radiology, Thickening, Contracture, medicine.symptom, business
Abstract

Adhesive capsulitis is one of the most common conditions affecting the shoulder; however, early clinical diagnosis can be challenging. Treatment is most effective when commenced prior to the onset of capsular thickening and contracture; consequently, the role of imaging is increasing. The aim of this review is to demonstrate the typical imaging appearances of adhesive capsulitis and to examine some of the evidence regarding each of these imaging modalities. An evaluation of the various management options available to the clinician is also presented.

Published
2013
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4. The assessment of pulsatile tinnitus—a systematic review of underlying pathologies and modern diagnostic approaches

Author

Paul A. Fagan, Kiera E. Grierson, Pascal Bou-Haidar, and Jaymi Dumper

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Patient demographics, Magnetic resonance imaging, Physical examination, Otorhinolaryngology, Radiological weapon, Pulsatile Tinnitus, Angiography, Cohort, Medicine, Medical history, Radiology, business
Abstract

Background: Pulsatile tinnitus (PT) is an auditory phenomenon that occurs in the absence of an external stimulus and presents as a humming or whooshing sound synchronous with the subject’s heartbeat. PT has many causes, ranging from the benign to the life threatening. In the following report, we focus on defining the most common causes of PT and explore changing approaches to diagnostic radiology used in the assessment of PT patients, with the goal of providing an updated and practical set of guidelines for the assessment of this complicated condition. Methods: A collection of case studies, retrospective reviews and technical reports were sourced from PubMed’s online database. The initial cohort was filtered by language and content, and then sorted according to patient demographics, presenting symptoms, imaging protocols and relative success of radiological investigations. Results: The most common causes of PT include vascular anomalies, benign or idiopathic intracranial hypertension (BIH/IIH), and certain middle ear masses. We recommend using magnetic resonance imaging (MRI) as the primary imaging modality for investigating most cases of PT, due to an increase in sensitivity and decrease in medical risk for the patient compared to computed tomography (CT) and traditional angiography. We detail protocols for both basic and comprehensive MRI studies to be used in the assessment of PT and provide descriptions of common radiological findings with representative images for reference. Finally, we make an argument in favour of foregoing extensive imaging studies in cases of subjective idiopathic PT, where no risk factors can be identified in the patient’s medical history or physical examination. Conclusions: The diagnosis of pulsatile tinnitus should be guided by comprehensive clinical data and dominated by the conservative use of MRI. In subjective PT where no risk factors are present, we recommend foregoing extensive imaging.

Published
2018
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5. The vestibular dysfunction and anxiety disorder interface: a descriptive study with special reference to the elderly

Author

Nages Nagaratnam, Jerome Ip, and Pascal Bou-Haidar

Subjects
Male, Aging, medicine.medical_specialty, Health (social science), Generalized anxiety disorder, medicine, Humans, Psychiatry, Geriatric Assessment, Aged, Retrospective Studies, Aged, 80 and over, Alprazolam, Panic disorder, Panic, Middle Aged, medicine.disease, Anxiety Disorders, Anti-Anxiety Agents, Vestibular Diseases, Anxiety, Female, Geriatrics and Gerontology, medicine.symptom, Psychology, Gerontology, Somatization, Anxiety disorder, medicine.drug, Clinical psychology, Agoraphobia
Abstract

Vestibular abnormalities co-existing with anxiety disorders are not uncommon and there has been a renewal of interest in recent times. Although well known over centuries, there is often a delay in the recognition of this relationship by the primary care physician and the specialist alike. Dizziness embracing vertigo, unsteadiness and imbalance are common in the elderly, so is generalized anxiety disorder, which is a common psychiatric problem in later life. This is a retrospective study of eight patients with vestibular symptoms and an anxiety disorder present over several years with lack of awareness of their relationship. The diagnoses of the anxiety disorders were based on the Diagnostic and Statistical Manual (DSM-IV) criteria and the effect of treatment measured on a clinician-based impression interview. There was one male and seven females and the mean age was 72 years. Apart from the vestibular symptoms present in all the patients, the anxiety disorders comprised, generalized anxiety disorder in three, panic attacks in five and with agoraphobia in three. Four patients had hyperventilation, one sleep apnea, and two somatization disorders. They had all presented to clinicians in different disciplines and had had several investigations. Five had been treated in this study with alprazolam and three with citalopram, with modest to good results. Two had rehabilitation therapy as well. The cases described mirror the well-documented co-existence of vestibular and anxiety disorders together with hyperventilation and sleep apnea. The positive findings associated with vestibular dysfunction need recognition in addition to the non-specific psychiatric and behavioral symptoms. We emphasize this relationship and review the literature to alert the clinician.

Published
2005
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6. Contributors

Author

Amit Aggarwal, Noriko Aida, Richard Ivan Aviv, Marc Taiwo Awobuluyi, Richard Bitar, Avraham Y. Bluestone, Pascal Bou-Haidar, Richard A. Bronen, Nicholas Butowski, Raymond Francis Carmody, David M. Carpenter, Mauricio Castillo, Soonmee Cha, Bradley N. Delman, Amish H. Doshi, Patrick O. Emanuel, Ramón E. Figueroa, Mary Elizabeth Fowkes, Allan J. Fox, Merav W. Galper, Sasikhan Geibprasert, Edward D. Greenberg, Christopher Paul Hess, Benjamin Y. Huang, Pakorn Jiarakongmun, Blaise V. Jones, Austin D. Jou, Jane J. Kim, George M. Kleinman, Spyros Kollias, Niklaus Krayenbühl, Timo Krings, Pierre L. Lasjaunias, Benjamin C. Lee, Patrick A. Lento, Laurent Létourneau-Guillon, Jennifer Linn, Michael D. Luttrull, Luke A. Massey, Xavier Montalban, Pratik Mukherjee, Frances M. Murphy, Thomas P. Naidich, Johnny C. Ng, Esther A. Nimchinsky, Gen Nishimura, Tetsu Niwa, A. Orlando Ortiz, Yoav Parag, Ellen E. Parker, Pedro Pasik, Aman B. Patel, Puneet S. Pawha, Vitor M. Pereira, Sirintara Pongpech, Derk D. Purcell, John H. Rees, Basil H. Ridha, Jose C. Rios, John L. Ritter, Nancy K. Rollins, Lorne Rosenbloom, Alex Rovira, Mark E. Smethurst, James G. Smirniotopoulos, Alice B. Smith, Evan G. Stein, Jonathan D. Steinberger, Sean P. Symons, Cheuk Ying Tang, Majda M Thurnher, Cheng Hong Toh, Vinodkumar Velayudhan, John D. Waselus, Robert Yeung, Tarek A. Yousry, and Robert D. Zimmerman

Published
2013
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7. White Matter

Author

Thomas P. Naidich, Niklaus Krayenbühl, Spyros Kollias, Pascal Bou-Haidar, Avraham Y. Bluestone, and David M. Carpenter

Published
2013
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11. Contributors

Author

Manzoor Ahmed, Pascal Bou-Haidar, Alessandro Cianfoni, Cesare Colosimo, Marco Essig, Girish M. Fatterpekar, Julia Frühwald-Pallamar, Andre D. Furtado, Rajiv Gupta, Sofia S. Haque, Jane J. Kim, Paul E. Kim, Lale Kostakoglu, Saulo Lacerda, Meng Law, Michael Lev, John K. Lyo, Sunithi Mani, Stephan Meckel, Amit Mehndiratta, Pratik Mukherjee, Thomas P. Naidich, Danielle Nanigian, Darren B. Orbach, Michael Phillips, Stuart Pomerantz, Stefan B. Puchner, Ajit Puri, Andrea Rossi, Peter M. Som, Ruth Thiex, Majda M. Thurnher, Johan W.M. Van Goethem, Alyssa T. Watanabe, Stephan G. Wetzel, Wade Wong, and Robert J. Young

Published
2011
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12. Contributors

Author

Bizhan Aarabi, Rick Abbott, Saleem I. Abdulrauf, Frank L. Acosta, John R. Adler, Nzhde Agazaryan, Manish Aghi, Edward S. Ahn, Ali Alaraj, Gregory W. Albert, Leland Albright, Felipe C. Albuquerque, Tord D. Alden, Michael J. Alexander, Andrei V. Alexandrov, Ossama Al-Mefty, Ron L. Alterman, Lázaro Álvarez, Nduka M. Amankulor, Peter S. Amenta, Christopher P. Ames, Sepideh Amin-Hanjani, Mario Ammirati, Carryn Anderson, Richard C.E. Anderson, William S. Anderson, Peter D. Angevine, Hiba Arif, Jeffrey E. Arle, Rocco Armonda, Paul M. Arnold, Kaveh Asadi-Moghaddam, Ferhan A. Asghar, William W. Ashley, Sabri Aydin, Nafi Aygun, Joachim M. Baehring, Jacob H. Bagley, Diaa Bahgat, Julian E. Bailes, Jonathon R. Ball, Gordon H. Baltuch, Nicholas C. Bambakidis, Scott C. Baraban, Igor J. Barani, Nicholas M. Barbaro, Frederick G. Barker, Gene H. Barnett, Stanley L. Barnwell, Constance M. Barone, Daniel L. Barrow, Fabrice Bartolomei, Juan Bartolomei, Tracy T. Batchelor, H. Hunt Batjer, Andrew M. Bauer, Joel A. Bauman, Thomas K. Baumann, James E. Baumgartner, John Bayouth, Andrew Beaumont, Joshua B. Bederson, Rudolf Beisse, Randy S. Bell, Allan Belzberg, Alim Louis Benabid, Eduardo E. Benarroch, Abdelhamid Benazzouz, Bernard R. Bendok, Edward C. Benzel, Alejandro Berenstein, Mitchel S. Berger, Marvin Bergsneider, Helmut Bertalanffy, Tarun Bhalla, Dani S. Bidros, José Biller, Mark H. Bilsky, Devin K. Binder, William Bingaman, Rolfe Birch, Allen T. Bishop, Peter M. Black, Jeffrey P. Blount, Peter C. Blumbergs, Leif-Erik Bohman, Zackary E. Boomsaad, Frederick A. Boop, Pascal Bou-Haidar, Daniel R. Boué, Blaise F.D. Bourgeois, Robin M. Bowman, Oliver Bozinov, Helen M. Bramlett, Henry Brem, Steven Brem, Gavin W. Britz, Douglas L. Brockmeyer, David J. Brooks, Samuel R. Browd, Paul D. Brown, Robert D. Brown, Jeffrey N. Bruce, Janice E. Brunstrom-Hernandez, John Buatti, M. Ross Bullock, Kim J. Burchiel, Peter C. Burger, Marc R. Bussière, Mohamad Bydon, Richard W. Byrne, Maria Elisa Calcagnotto, Victoria A. Campbell, William Campbell, George M. Cannon, Louis P. Caragine, Benjamin S. Carson, Gregory D. Cascino, Ethan Cascio, Frédéric Castinetti, C. Michael Cawley, Justin S. Cetas, Stéphan Chabardès, Edward F. Chang, Eric C. Chang, Eric L. Chang, Steven D. Chang, Steven W. Chang, Susan M. Chang, Kevin Chao, Paul H. Chapman, Fady T. Charbel, Patrick Chauvel, Grace Chen, Boyle C. Cheng, Joseph S. Cheng, Joshua J. Chern, E. Antonio Chiocca, Ondrej Choutka, Shakeel A. Chowdhry, Cindy W. Christian, Kathy Chuang, Jan Claassen, Richard E. Clatterbuck, Elizabeth B. Claus, Daniel R. Cleary, Robert J. Coffey, Alan R. Cohen, Andrew J. Cole, E. Sander Connolly, Patrick J. Connolly, Anne G. Copay, Jeroen R. Coppens, James J. Corbett, Daniel M. Corcos, Domagoj Coric, Garth Rees Cosgrove, William T. Couldwell, Stirling Craig, Neil R. Crawford, Peter B. Crino, R. Webster Crowley, Bradford A. Curt, Marek Czosnyka, Zofia Czosnyka, Vladimir Y. Dadashev, Andrew T. Dailey, Deepa Danan, Shabbar F. Danish, Shervin R. Dashti, Carlos A. David, David J. David, Arthur L. Day, Antonio A.F. De Salles, Amir R. Dehdashti, Oscar H. Del Brutto, Johnny B. Delashaw, Bradley Delman, Mahlon R. DeLong, Franco DeMonte, Sanjay S. Dhall, Mark S. Dias, Curtis A. Dickman, W. Dalton Dietrich, Michael L. DiLuna, Francesco Di Meco, Peter Dirks, C. Edward Dixon, Jacob A. Donoghue, Ian G. Dorward, Amish H. Doshi, James Drake, Dan Drzymalski, Rose Du, Andrew Ducruet, Ann-Christine Duhaime, Aaron S. Dumont, Christopher D. Duntsch, Joshua R. Dusick, Suzan Dyve, James Eberwine, Paula Eboli, Robert D. Ecker, Richard J. Edwards, Marc E. Eichler, Doortje C. Engel, Nancy E. Epstein, Matthew G. Ewend, Hamad Farhat, Christopher J. Farrell, Michael G. Fehlings, Iman Feiz-Erfan, Neil A. Feldstein, Richard G. Fessler, Juan J. Figueroa, Aaron G. Filler, J. Max Findlay, Michael A. Finn, David J. Fiorella, James L. Fisher, Robert S. Fisher, Eugene S. Flamm, James D. Fleck, Kelly D. Flemming, John C. Flickinger, Laura Flores-Sarnat, Kenneth A. Follett, Kelly D. Foote, Daryl R. Fourney, Valerie Fraix, James L. Frazier, Itzhak Fried, Allan H. Friedman, William A. Friedman, Gerhard M. Friehs, Donald E. Fry, Gregory N. Fuller, Hector H. Garcia, Paul A. Gardner, Mark Garrett, Hugh Garton, Cormac G. Gavin, Alisa D. Gean, Thomas A. Gennarelli, Venelin Gerganov, Anand V. Germanwala, Massimo Gerosa, Elizabeth R. Gerstner, Peter C. Gerszten, Saadi Ghatan, Samer Ghostine, Steven Giannotta, Paul R. Gigante, Frank Gilliam, Holly Gilmer-Hill, Albert Gjedde, Roberta P. Glick, Ziya L. Gokaslan, Yakov Gologorsky, Kiarash Golshani, Nestor R. Gonzalez, James Tait Goodrich, Tessa Gordon, Alessandra A. Gorgulho, Liliana C. Goumnerova, M. Sean Grady, Jordan Grafman, Sylvie Grand, Gerald A. Grant, Gregory P. Graziano, Benjamin Greenberg, James Guest, Abhijit Guha, Murat Günel, Gaurav Gupta, Nalin Gupta, Jorge Guridi, Barton L. Guthrie, Georges F. Haddad, Michael M. Haglund, Regis W. Haid, Stephen J. Haines, Clement Hamani, Bronwyn E. Hamilton, D. Kojo Hamilton, Todd C. Hankinson, Leo T. Happel, Ihtsham Ul Haq, Raqeeb Haque, Robert E. Harbaugh, Ciara D. Harraher, Leo Harris, James S. Harrop, Wael Hassaneen, Cynthia Hawkins, Gregory W.J. Hawryluk, Neal G. Haynes, Robert F. Heary, Amy B. Heimberger, Mary M. Heinricher, Thomas M. Hemmen, Jaimie M. Henderson, Roberto C. Heros, Karl Herrup, Shawn L. Hervey-Jumper, Gregory G. Heuer, Lawrence J. Hirsch, Robert Hirschl, Brian L. Hoh, Daniel J. Hoh, Eric C. Holland, Paul E. Holtzheimer, L. Nelson Hopkins, Philip J. Horner, David A. Hovda, Matthew A. Howard, Patrick Hsieh, Yin C. Hu, Sherwin E. Hua, Jason H. Huang, Judy Huang, Samuel A. Hughes, Thierry A.G.M. Huisman, Matthew A. Hunt, R. John Hurlbert, Robert W. Hurst, Anita Huttner, Steven W. Hwang, Ioannis U. Isaias, Bermans J. Iskandar, Arun Jacob, Kurt A. Jaeckle, Jay Jagannathan, Regina I. Jakacki, George I. Jallo, John A. Jane, Ryan Janicki, Damir Janigro, N u Owase Jeelani, Kurt A. Jellinger, Arthur L. Jenkins, Sarah Jernigan, David F. Jimenez, Conrad E. Johanson, J. Patrick Johnson, Matthew D. Johnson, G. Alexander Jones, Rajni K. Jutla, Koijan Singh Kainth, Michael G. Kaiser, U. Kumar Kakarla, Iain H. Kalfas, Aleksandrs Uldis Kalnins, Hideyuki Kano, Yucel Kanpolat, Adam S. Kanter, Reza J. Karimi, Amin B. Kassam, Bruce A. Kaufman, Christian B. Kaufman, Hiroto Kawasaki, Brian C. Kelley, Christopher P. Kellner, Nicole C. Keong, John R.W. Kestle, Alexander A. Khalessi, Nadia Khan, Vini G. Khurana, Daniel H. Kim, Dong Gyu Kim, Dong H. Kim, Jong Hyun Kim, Louis J. Kim, Paul K. Kim, Thomas Aquinas Kim, Won Kim, James A.J. King, Ryan S. Kitagawa, Neil D. Kitchen, Paul Klimo, David G. Kline, Kazutaka Kobayashi, Patrick M. Kochanek, Douglas Kondziolka, Paul N. Kongkham, Tyler R. Koski, Thomas Kosztowski, Paul Krack, Joachim K. Krauss, Michael A. Kraut, Niklaus Krayenbühl, Thomas Kretschmer, Ajit Krishnaney, Charles Kuntz, Jeffrey V. Kuo, Brian K. Kwon, Nadia N. Issa Laack, Shivanand P. Lad, Alim M. Ladha, Amos K. Ladouceur, Arthur M. Lam, Frederick F. Lang, Giuseppe Lanzino, Sean D. Lavine, Edward R. Laws, Michael T. Lawton, Adrian W. Laxton, Tuong H. Le, Jean François LeBas, Brett D. Lebed, Richard L. Lebow, Amy Lee, Ian Lee, Seon-Kyu Lee, Emily Lehmann, James W. Leiphart, Gregory P. Lekovic, Frederick A. Lenz, Jeffrey R. Leonard, Peter D. LeRoux, Marc Lévêque, Allan D. Levi, Elad I. Levy, Linda M. Liau, Jason Liauw, Roger Lichtenbaum, Terry Lichtor, David D. Limbrick, Hester Lingsma, Michael J. Link, Mark E. Linskey, Brian Litt, Zachary N. Litvack, James K.C. Liu, Kenneth C. Liu, Jay S. Loeffler, Christopher M. Loftus, Russell R. Lonser, Angeliki Louvi, Andres M. Lozano, Daniel C. Lu, Rimas V. Lukas, L. Dade Lunsford, Neal Luther, Pedro Lylyk, Andrew I.R. Maas, R. Loch Macdonald, Andre Machado, Raul Macias, Robert J. Maciunas, Brian N. Maddux, Pierre Magistretti, Martijn J.A. Malessy, Neil R. Malhotra, Donald A. Malone, Adam N. Mamelak, Christopher E. Mandigo, Francesco T. Mangano, Allen H. Maniker, Geoffrey T. Manley, Daniel Marchac, Anthony Marmarou, Joseph C. Maroon, Lawrence F. Marshall, Neil A. Martin, Timothy J. Martin, Alexander M. Mason, Marlon S. Mathews, Helen S. Mayberg, James P. McAllister, J. Gordon McComb, Paul C. McCormick, Ian E. McCutcheon, Michael W. McDermott, Cameron G. McDougall, Matthew McGehee, Cameron C. McIntyre, Guy M. McKhann, M. Sean McKisic, David F. Meaney, Minesh P. Mehta, Vivek Mehta, William P. Melega, Arnold H. Menezes, Patrick Mertens, Fredric B. Meyer, Scott A. Meyer, Philip M. Meyers, Costas Michaelides, Karine Michaud, Rajiv Midha, Vincent J. Miele, Jonathan Miller, Matthew L. Miller, Neil R. Miller, John Mitrofanis, Kevin Y. Miyashiro, J. Mocco, Michael T. Modic, Parham Moftakhar, Avinash Mohan, Stephen J. Monteith, Jacques J. Morcos, Michael Morgan, David E. Morris, S. David Moss, J. Paul Muizelaar, Karim Mukhida, Praveen V. Mummaneni, Gregory J.A. Murad, Karin Muraszko, Antônio C.M. Mussi, Imad Najm, Peter Nakaji, Sandra Narayanan, David W. Newell, M. Kelly Nicholas, Yasunari Niimi, Shahid M. Nimjee, Ajay Niranjan, Richard B. North, Josef Novotny, Turo Nurmikko, Samuel E. Nutt, W. Jerry Oakes, José A. Obeso, Alfred T. Ogden, Lissa Ogieglo, Christopher S. Ogilvy, David O. Okonkwo, Michael S. Okun, Edward H. Oldfield, Alessandro Olivi, Stephen E. Olvey, David Omahen, Brent O'Neill, Rod J. Oskouian, Robert Owen, Koray Özduman, Ali Kemal Ozturk, M. Necmettin Pamir, Dachling Pang, Jamie Pardini, Andrew D. Parent, T.S. Park, Michael D. Partington, Aman B. Patel, Parag G. Patil, Nicola Pavese, Richard D. Penn, Noel I. Perin, John A. Persing, Erika A. Petersen, Anthony L. Petraglia, Brigitte Piallat, Joseph H. Piatt, John D. Pickard, Joseph M. Piepmeier, Webster H. Pilcher, José Pineda, Joseph D. Pinter, Mary L. Pisculli, Thomas Pittman, Ian F. Pollack, Pierre Pollak, Bruce E. Pollock, Francisco A. Ponce, Alyx B. Porter, Randall W. Porter, Kalmon D. Post, Alexander K. Powers, Mark R. Proctor, Robert W. Prost, Jeffrey Pugh, Alfredo Quiñones-Hinojosa, Corey Raffel, Sharad Rajpal, Leonardo Rangel-Castilla, Ganesh Rao, Ahmed Raslan, Peter A. Rasmussen, Dibyendu K. Ray, Shaan M. Raza, Davis L. Reames, Chandan G. Reddy, Andy J. Redmond, Jean Régis, Peter L. Reilly, Dominique Renier, Daniel K. Resnick, Renee Reynolds, Ali R. Rezai, Laurence D. Rhines, Albert L. Rhoton, Teresa Ribalta, R. Mark Richardson, Daniele Rigamonti, Gregory J. Riggins, Jay Riva-Cambrin, Paolo Rizzo, David W. Roberts, Claudia Robertson, Lawrence Robinson, Shenandoah Robinson, Pierre-Hugues Roche, Mark A. Rockoff, Gerald E. Rodts, Pantaleo Romanelli, Mark L. Rosenblum, Joshua M. Rosenow, Michael K. Rosner, Eric S. Rovner, Christina L. Runge-Samuelson, Stephen M. Russell, James T. Rutka, Oren Sagher, Eric G. St. Clair, Madjid Samii, Prakash Sampath, Srinath Samudrala, Nader Sanai, Robert A. Sanford, Paul Santiago, Teresa Santiago-Sim, Harvey B. Sarnat, Raymond Sawaya, W. Michael Scheld, Wouter I. Shirzadi, Nicholas D. Schiff, Clemens M. Schirmer, David Schlesinger, Meic H. Schmidt, Joost W. Schouten, Johannes Schramm, Thomas C. Schuler, James M. Schuster, Theodore H. Schwartz, Judith A. Schwartzbaum, Patrick M. Schweder, R. Michael Scott, Eric Seigneuret, Nathan R. Selden, Warren R. Selman, Christopher I. Shaffrey, Manish N. Shah, Kiarash Shahlaie, William R. Shapiro, Deepak Sharma, Jason P. Sheehan, Jonas M. Sheehan, Arun K. Sherma, James M. Shiflett, Helen A. Shih, Jay L. Shils, Alexander Y. Shin, Ali Shirzadi, Adnan H. Siddiqui, Marc Sindou, Konstantin V. Slavin, Edward R. Smith, Justin S. Smith, Yoland Smith, Matthew D. Smyth, Penny K. Sneed, Brian J. Snyder, Kenneth V. Snyder, Robert A. Solomon, Volker K.H. Sonntag, Leif Sørensen, Sulpicio G. Soriano, Mark M. Souweidane, Julian Spears, David Spencer, Dennis D. Spencer, Robert F. Spetzler, Robert J. Spinner, Brett R. Stacey, William C. Stacey, Robert M. Starke, Philip A. Starr, Gary K. Steinberg, Frederick L. Stephens, Barney J. Stern, Charles B. Stevenson, Eric Stiner, Scellig Stone, Nicole L. Stroud, Robert Morgan Stuart, Brian R. Subach, Patrick A. Sugrue, Dima Suki, Wale A.R. Sulaiman, Daniel L. Surdell, William W. Sutherling, Leslie N. Sutton, Omar N. Syed, Michele Tagliati, Yasushi Takagi, Rafael J. Tamargo, Caroline C. Tan, Nitin Tandon, Marcos Tatagiba, Michael D. Taylor, Steven A. Telian, Charles Teo, Jeffrey M. Tessier, Khoi D. Than, Kamal Thapar, Nicholas Theodore, B. Gregory Thompson, Robert Tiel, Tarik Tihan, Ann Tilton, Shelly D. Timmons, Maria Toledo, Tadanori Tomita, Nestor D. Tomycz, Napoleon Torres, Charles P. Toussaint, Bruce D. Trapp, Vincent C. Traynelis, R. Shane Tubbs, Luis M. Tumialán, Allan R. Tunkel, Atsushi Umemura, Alexander R. Vaccaro, Koen van Besien, Jerrold L. Vitek, Kenneth P. Vives, Timothy W. Vogel, Michael A. Vogelbaum, Dennis G. Vollmer, Gretchen K. Von Allmen, Kajetan L. von Eckardstein, P. Ashley Wackym, Mark Wainwright, Ben Waldau, Marion L. Walker, M. Christopher Wallace, Brian Walsh, Huan Wang, Michael Y. Wang, Vincent Y. Wang, Ronald E. Warnick, Sharon Webb, Ralf Weigel, Robert J. Weil, Jon D. Weingart, Bryce Weir, Martin Weiss, Nirit Weiss, William C. Welch, John C. Wellons, Hung Tzu Wen, Christian Wess, G. Alexander West, Nicholas M. Wetjen, Robert G. Whitmore, Louis A. Whitworth, Thomas Wichmann, Joseph L. Wiemels, Eelco F.M. Wijdicks, Adam C. Wilberger, Jack Wilberger, David M. Wildrick, Jason Wilson, Christopher J. Winfree, H. Richard Winn, Christopher Wolfla, Eric T. Wong, Peter J. Wormald, Margaret Wrensch, Neill M. Wright, Zachary Wright, David Yam, Shinya Yamada, Yoshiya Yamada, Isaac Yang, Victor X.D. Yang, Tom Yao, Chun-Po Yen, H. Kwang Yeoh, Yasuhiro Yonekawa, Alice Yoo, David M. Yousem, Eric C. Yuen, Joseph M. Zabramski, Andrew C. Zacest, J. Christopher Zacko, Gabriel Zada, Ross Zafonte, Eric L. Zager, Hasan A. Zaidi, Hekmat Zarzour, Vasilios A. Zerris, Justin A. Zivin, John G. Zovickian, Alexander Y. Zubkov, and Marike Zwienenberg-Lee

Published
2011
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13. Confused and disturbed behavior in the elderly following silent frontal lobe infarction

Author

Nages Nagaratnam, Harry Leung, and Pascal Bou-Haidar

Subjects
Male, medicine.medical_specialty, Infarction, Audiology, Neuropsychological Tests, Asymptomatic, White matter, 03 medical and health sciences, Behavioral syndrome, 0302 clinical medicine, medicine, Cognitive deterioration, Humans, 030212 general & internal medicine, Confusion, Aged, Aged, 80 and over, Memory Disorders, General Neuroscience, Mental Disorders, Cerebral Infarction, medicine.disease, 030227 psychiatry, Frontal Lobe, Psychiatry and Mental health, Clinical Psychology, medicine.anatomical_structure, Mood, Frontal lobe, Emotional behavior, Female, Geriatrics and Gerontology, medicine.symptom, Psychology, Tomography, X-Ray Computed, Neuroscience
Abstract

It is unclear whether silent frontal lobe infarction is truly asymptomatic; frontal behavioral syndromes following strokes have rarely been reported. We studied 12 elderly patients with silent frontal lobe infarction who were exhibiting confused and disturbed behavior. Ten were male and two female; their ages ranged from 68 to 79 (mean 78). Three groups of symptom clusters emerged: changes in mood and emotional behavior, cognitive deterioration with minor psychiatric symptoms, and a confusional state. When related to the CT scan location, three regions were identified: predominantly orbitofrontal, deep white matter and caudate, and border-zones, respectively. These findings were related to what is known about the neuroanatomic location of the lesions and the role of the frontal subcortical circuitry in relation to behavior. The different manifestations could be explained by damage to the frontal lobe or interruption of the complex frontal subcortical circuits.

Published
2003

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