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Undetected spinal fractures can cause damage of the spinal cord and lead to adverse neurological outcomes. A recent study on a pediatric cohort has shown that noncontiguous spinal injuries are often missed on primary radiographic examination, highlighting the need for combined radiographic, clinical and neurophysiological examinations to detect these lesions.
Down syndrome (DS) is associated with early onset of neuropathology that is indistinguishable from Alzheimer disease (AD), and is typically followed by cognitive decline two decades later. A recent study has reported that the AD drug memantine failed to improve cognitive performance and function in middle-aged patients with DS.
An accepted classification system exists for ischaemic stroke in adults; however, this system is of limited use for categorizing strokes in children, as the aetiology of paediatric stroke is often different from that in adults. A new anatomically based classification system provides standardized criteria specifically for paediatric stroke.
MRI-based diagnostic criteria for multiple sclerosis (MS) have been devised for use in adult populations, but diagnosis of MS in children remains a challenge. To address this issue, a new study attempts to identify MRI characteristics that predict development of MS in children with acute demyelinating syndromes.
Recent guidelines, based on evidence of detrimental pharmacokinetic interactions between antiepileptic drugs (AEDs) and antiretroviral drugs, provide a new framework for the selection of AED medication for HIV-infected individuals. However, AED use, antiretroviral therapy and HIV infection all have overlapping nonpharmacokinetic outcomes, which the guidelines do not address.
The hippocampus is a dynamic structure that can change in size throughout life. Hippocampal atrophy, which is associated with cognitive decline and late-life dementia, can be exacerbated by a number of medical conditions. In this Review, Fotuhi and colleagues examine the modifiable factors that can affect hippocampal size, and discuss lifestyle and therapeutic interventions that might prevent or even reverse hippocampal atrophy.
Tourette syndrome is a complex neurobehavioural disorder that is believed to have a strong genetic component, but the exact aetiopathology of the disorder remains unclear. Denget al. provide an update on the genetics of Tourette syndrome, highlighting investigations into chromosomal aberrations and genetic mutations in patients with the disorder, and discussing how these studies have improved our understanding of the aetiology of Tourette syndrome.
Therapeutic hypothermia is widely recognized to have neuroprotective effects in various clinical settings, from cardiac arrest to traumatic brain injury; however, the practical application of this therapy is not without risk. Choi et al. highlight current methods and protocols of targeted temperature management, and discuss the practical considerations for hypothermia as a therapy for patients with acute brain injury.
Antiplatelet drugs are the treatment of choice for preventing recurrence of noncardioembolic ischaemic stroke, but numerous updates to clinical guidelines, most recently in 2011 in the USA, have made selection of the appropriate antiplatelet agent difficult. In their Review, Craig Williams and colleagues provide an overview of the evolving guidelines in the context of results from the many large clinical trials in this field.
