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Cardiac papillary fibroelastomas are associated with a high risk of systemic embolization in spite of benign nature. We report a case of 85-year-old patient with left supraclinoid internal carotid artery occlusion who treated with aspiration thrombectomy. Despite of the absence of residual mass on echocardiography, we could analyze pathologic specimens using retrieved embolus and confirmed cardiac papillary fibroelastoma as a rare cause of stroke.

Spinal cord infarction is rare, especially cervical cord infarction is lesser than thoracic and lumbar level. We describe two cases of cervical cord infarction following cerebellar infarction with vertebral artery occlusion, which initially presented with chest pain and dyspnea. Blood supply for the cervical cord comes from anterior and posterior spinal artery, which originated from the distal vertebral or posterior inferior cerebellar arteries. Therefore, occlusion of unilateral vertebral artery could cause a cervical cord infarction.

We report a case of anterior choroidal artery territory infarction due to internal carotid artery dissection presumably caused by scuba diving. A 44-year-old man presented with left facial palsy and hemiparesis. He had a history of scuba diving for 18 months. His last dive was 7 days ago, and he skipped decompression practice at that dive. We assumed that repetitive traumas and microbubbles during scuba diving, which made endothelium vulnerable to damage may have caused a carotid dissection.

BACKGROUND AND PURPOSE The clinical implications of echocardiography findings for long-term outcomes in atrial fibrillation (AF)-related stroke patients are unknown. METHODS This was a substudy of the Korean ATrial fibrillaTion EvaluatioN regisTry in Ischemic strOke patieNts (K-ATTENTION), which is a multicenter-based cohort comprising prospective stroke registries from 11 tertiary centers. Stroke survivors who underwent two-dimensional transthoracic echocardiography during hospitalization were enrolled. Echocardiography markers included the left-ventricle (LV) ejection fraction (LVEF), the left atrium diameter, and the ratio of the peak transmitral filling velocity to the mean mitral annular velocity during early diastole (E/e' ratio). LVEF was categorized into normal (≥55%), mildly decreased (>40% and

Background and Purpose The outcome for older stroke patients who undergo endovascular revascularization remains unsatisfactory. We aimed to determine the effect of the extent of baseline ischemia on outcome according to age, testing the hypothesis that the restorative capacity for recovery is only marginal in older patients. Methods Two hundred and thirteen patients who underwent endovascular revascularization due to occlusion in the M1 segment of the middle cerebral artery (with or without internal carotid artery occlusions) were selected for analysis. Patients were categorized into three age groups: group A (75 years). Using pretreatment diffusion-weighted imaging (DWI), the Alberta Stroke Program Early CT Score (ASPECTS) and lesion volume were independently measured and analyzed in relation to a favorable outcome. Results A favorable outcome was achieved in 111 of 213 patients overall: in 60 of the 94 (63.8%) patients in group A, in 36 of the 70 (51.4%) patients in group B, and in 15 of the 49 (30.6%) patients in group C (p=0.001). In older stroke patients (group C), a DWI ASPECTS ≥9 and lesion volume ≤5 mL were found to predict a favorable outcome, which was more restrictive than the cutoffs for their younger counterparts (groups A and B; DWI ASPECTS ≥8 and lesion volume ≤20 mL). Conclusions The age-adjusted pretreatment DWI lesion volume and ASPECTS may represent useful surrogate markers for functional outcome according to age. The use of more-restrictive inclusion criteria for older stroke patients could be warranted, although larger studies are necessary to confirm these findings.

Background and Purpose: Co g n itive imp a irmen ts a re fre que n t c o n s e qu e n c e s o f e p ile p s y, with in te lle c tu a l a bility re p o r te dly bein g lo wer in p a tie n ts with id io p a thic g en er a lize d epi lepsi e s tha n in the g eneral p opul a tio n. Ho we ver, neuropsy c ho lo gi c al in vest ig at io ns ha ve be en r arel y p erf o rme d in p a tie n ts with ju ven ile myo c lo n ic ep ilep s y (JME). We a ime d to qu a n tify the c o g n itive fu n c tio n in JME p a tien ts u s in g va rio us n europsy c ho lo gi c al te st s . M et h ods: We c o mp a re d c o g n itive fu n c tio n in 27 JME p a tie n ts with tha t in 27 he al thy vo lun te ers u si n g te st s exa min in g c o g n itive p er fo rma n c e , s uc h a s the ve rba l a n d vis ua l me mo ry, fro nt a l fu nct io n, a tte nt io n, IQ s core, a nd mo o d . In the JME g ro u p , we e xa min e d ris k fa c to rs fo r c o g n itive fu n c tio n s uc h a s a g e , s ex, fa mily his to r y, ed u c a tio n le vel, a g e a t s e izur e o n s e t, s eizu re fr equ en c y, EEG a bn o rma lity , d is e a s e d u ra tio n , a n d p re vio u s in ta k e o f a n tiepi le pt ic d rugs. Resul t s: Ve rba l learni n g wa s s ig ni fic ant ly lo we r in JME p at ie nt s tha n i n c ont ro ls , a nd a tte nt io n a nd verb a l flu ency wer e imp a ir ed in JME p a tien ts c o mp a r ed with c o n tr o ls . Ho we ve r, g e n e ra l in telle c tu a l a bility a n d mo o d d id n o t d iffe r be twe en the g roups. Ea rly o nset o f s ei zur e a nd lo ng d urat io n o f dis ea s e wer e c lo s ely re la te d to imp a ir ed c o g n itive fu n c tio n . C oncl usi ons: JME p a tie n ts ma y exhibit imp a ire d c o g n itive fu n c tio n , in te rms o f memo ry a n d e xe c utio n , d es p ite ha vin g n o r ma l in tellig en c e a n d mo o d . J Clin Neurol 3(2):86-92, 2007

Received August 20, 2014 Revised October 13, 2014 Accepted October 13, 2014 Address for correspondence: Yang-Ha Hwang, MD Department of Neurology, School of Medicine, Kyungpook National University, 130 Dongduk-ro, Jung-gu, Daegu 700-721, Korea Tel : +82-53-420-5758 Fax : +82-53-422-4265 E-mail : yangha.hwang@gmail.com 69세 남자가 15분간 지속되다가 회복된 우측 상하지의 위약 과 감각이상을 주증상으로 응급실을 방문하였다. 활력징후는 정상이었으며 신경학적진찰에서 이상소견은 없었다. 임상적으 로 일과성허혈발작(transient ischemic attack)이 의심되었고, 뇌

a ; Soon-Hak Kwon, MD, PhD b Background and PurposezzThe risk of suicide or suicide attempts is reported higher in peo- ple with epilepsy (PWE) than in the general population. Although epileptic, psychiatric, and psy- chosocial factors are known risk factors for suicide or suicide attempt, no studies have evaluated the predictors of the severity of suicidal ideation-which is a warning sign for suicide attempts-in PWE. Therefore, we measured the severity of suicidal ideation and its risk factors. MethodszzConsecutive PWE who were medicated with antiepileptic drugs (AEDs) and attended epilepsy clinic were included in the study. The subjects completed self-reported questionnaires, which included the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Symptom Checklist-90-Revised (SCL-90-R), and Scale for Suicide Ideation-Beck (SSI-Beck). We com- pared the patients' demographic and clinical variables, and BDI, BAI, and SCL-90-R scores with their SSI-Beck score, and used our findings to determine the predictors for suicidal ide - ation. ResultszzIn total, 257 PWE were enrolled in the study. SSI-Beck scores correlated strongly with several seizure-related variables, duration of education, IQ, BDI and BAI scores, and nine domains of the SCL-90-R questionnaire. However, the strongest predictor for suicidal ideation was BDI score (β=0.41, p

Background and Purpose: This s tud y c o mp a re d the c o g n itive e ffec ts o f 1 ye a r o f tre a tmen t with la mo trig in e (LTG) a nd o xc arb a ze pi n e (OXC) in e pi le psy p at ient s . Met h ods: This r et ro spect ive s tu dy in ve st ig at e d 60 e pi le psy p at ie nt s u nd ergoi n g n europsy c ho lo gi c al test s who were e ither n ew ly dia gnosed o r u nt re at e d in the p recedi n g 6 mo n ths . The c o g n itive fu n c tio n in 30 p a tie n ts re c e ivin g LTG mo not he rapy a nd 30 a ge- ma tc he d p at ie nt s r ecei vin g OXC mo not he ra py wa s c om p ared a fte r 1 year . The neuropsy c ho lo gi c al s cores a t ba sel in e a nd a ll o f the epi lepsy -r el e va nt va ria bles e xc ept s ei zu re typ e did n ot d iffer be twe en the g ro u p s . The mea n d a ily d o s a g es o f LTG a n d OXC a t 1 ye ar we re 93 mg a nd 825 mg , re spect ively. Resul t s: The p o s ttre a tmen t lis t-le a r n in g p er fo rma n c e wa s bette r in the LTG g roup tha n in the OXC g roup (p