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Coated-platelets are procoagulant platelets observed upon dual-agonist stimulation with collagen and thrombin. Coated-platelet levels are elevated in patients with nonlacunar (large-vessel) ischemic stroke and decreased in patients with spontaneous intracerebral hemorrhage as compared with controls. The purpose of this study was to investigate a possible relationship between coated-platelet levels and stroke recurrence in patients with nonlacunar ischemic stroke. We assayed coated-platelet levels in 190 consecutive patients with nonlacunar stroke who were followed for up to 12 months; 20 subjects experienced recurrent stroke. Subjects were categorized into tertiles of coated-platelet levels. The distributions of time-to-recurrent stroke were estimated for each tertile using cumulative incidence curves and compared statistically using a log-rank test. The cumulative incidence of recurrent stroke at 12 months differed among the coated-platelet tertiles: 2% for the first tertile (lowest coated-platelet levels), 18% for the second tertile, and 17% for the third tertile (overall log-rank test, P=0.019). These data suggest that higher levels of coated-platelets, measured shortly after a nonlacunar stroke, are associated with an increased incidence of stroke recurrence. This observation offers an additional tool for identifying patients at highest risk for stroke recurrence following a nonlacunar (large-vessel) infarct. [ABSTRACT FROM AUTHOR]

Most clinical research has focused on intensity differences of facial expressions between the right and left hemi-face to explore lateralization of emotions in the brain. Observations by social psychologists, however, suggest that control of facial expression is organized predominantly across the upper-lower facial axis because of the phenomena of facial blends: simultaneous display of different emotions on the upper and lower face. Facial blends are related to social emotions and development of display rules that allow individuals to sculpt facial expressions for social and manipulative purposes. We have demonstrated that facial blends of emotion are more easily and accurately posed on the upper-lower than right-left hemi-face, and that upper facial emotions are processed preferentially by the right hemisphere whereas lower facial emotions are processed preferentially by the left hemisphere. Based on these results, recent anatomical studies showing separate cortical areas for motor control of upper and lower face and the neurology of posed and spontaneous expressions of emotion, a functional-anatomic model of how the forebrain modulates facial expressions, is presented. The unique human ability to produce facial blends of emotion is, most likely, an adaptive modification linked to the evolution of speech and language. [ABSTRACT FROM AUTHOR]

Clinical research has concentrated on differences in intensity of expression between the right and left hemiface as a means to assess hemispheric differences in motor control. However, observations by social psychologists suggest that control of facial expression may be organized predominantly across the upper-lower hemiface because during social interactions individuals may produce brief facial blends of emotions, in which the upper and lower face display a different emotion. Full facial versus upper/lower and right/left facial blends of emotion were posed by 20 subjects, 10 men and 10 women ranging in age from 20 to 37 years. The subjects rated the difficulty of each pose on a 5-point Likert scale. Digital photographs of the poses were taken and the full and half-facial poses were shown in random order to four judges who indicated what pose was being performed. The results were very robust and confirmed that facial blends of emotion are more easily and accurately posed on the upper-lower than on the right-left hemiface. Our results are consistent with recent anatomical studies showing separate cortical areas for motor control of the upper versus lower face in primates. Based on recent research exploring hemispheric differences in perceiving facial blends of emotion, the left hemisphere may be more involved with modulating lower facial expressions and the right hemisphere more involved with modulating upper facial expressions. [ABSTRACT FROM AUTHOR]

We report a case of familial hemiplegic migraine in an 11-year-old girl who presented with coma and left hemiparesis. Magnetic resonance imaging showed reversible vasospasm and evidence of oligemia, bringing new information regarding neurovascular changes in familial hemiplegic migraine. (J Child Neurol 2002;17:470-472). [ABSTRACT FROM AUTHOR]

The article presents an analysis of coated-platelets and its role in the etiology of ischemic stroke subtypes. A study was conducted to examine the coated-platelet levels in 60 ischemic stroke patients with lacunar and cortical stroke. Coated-platelets are a subpopulation of activated platelets which require dual agonist stimulation with both thrombin and collagen. The analysis aims to understand the relationship between platelet reactivity and stroke susceptibility.