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Cover Article
Flag
on the Play-Concussion Questions Linger in Football
Saftey strictures have been instituted to make professional and
collegiate football less dangerous for players but what about
high school football? According to a Cleveland Clinic study, 47.2%
of high school-age football players suffer at least one concussion.
While the American Academy of Neurology has issued guidelines
on the appropriate management of concussions in sports, controversy
still swirls around the issues of when a player can safely return
to play and the neuropsychologic ramifications of mild head injury.
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Cover Article
Should Treatment of Alzheimer's Disease Be Less Aggressive in the Long-Term Care Setting?
"Alzheimer's disease is underdiagnosed and undertreated in the long-term setting just as much as it is in the office setting," said Sharon Brangman, MD, at the 2001 Annual Scientific Meeting of the American Geriatrics Society. She noted, however, that the degenerative disease can be successfully managed. Active and aggressive management should not stop when a patient enters a long-term care facility. Educating nursing staff to recognize the disease and implementing better behavior management, she said, may be the key to providing the best care for patients in this setting.
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Cover Article
Is Temporal Lobe Epilepsy a Surgical Disease?
The first head-to-head comparison of surgical versus medical treatment of epilepsy found that at one year, the cumulative proportion of temporal lobe epilepsy patients free of complex partial seizures was 58% in the surgery group compared with 8% in the medical group. Interpretation of these dramatic numbers, however, may not be as straightforward as it would seem. This article summarizes the study findings and offers one expert's rationale for why medical treatment should not be dismissed.
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Cover Article
Early, Aggressive Treatment of MS—Is It for Everyone?
Given the available evidence, early, aggressive treatment is warranted in all patients at risk for multiple sclerosis (MS). While many clinicians would agree with that statement, some feel the jury is still out. In this article, Drs. Richard Rudick and Brian Weinshenker discuss the rationales for both very early treatment of MS and delayed treatment of MS.
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Cover Article
Shooting for the Moon—Bolstered by a New Research Agenda, Parkinson's Disease Researchers Aim High
Researchers interested in Parkinson's Disease are currently scrambling for an alternative, or at least an adjunct, to levodopa therapy. Treatment approaches currently in the research pipeline include transplantation of replacement neurons, drugs designed to prevent neuron destruction, and gene therapy. These strategies, along with deep brain stimulation and new surgical treatments, are expected to get a major boost from the National Institutes of Health's "Parkinson's Disease Research Agenda," which one expert referred to as a "moon shot" targeted at a cure for Parkinson's disease.
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Cover Article
Aspirin Versus Warfarin for Prevention of Secondary Stroke
Reporting the results of what one commentator referred to as "the most eagerly awaited outcome studies," the Warfarin-Aspirin Recurrent Stroke Study (WARRS) researchers announced that aspirin and warfarin are equally effective in preventing recurrent ischemic stroke. While aspirin showed a slight benefit over warfarin, the difference was not statistically significant. Equally interesting was the finding that warfarin was no more dangerous to use than aspirin. Given the complications and cost associated with prescribing warfarin, will these findings result in the gradual abandonment of warfarin in selected patients? Time will tell.
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Cover Article
Alcoholism From a Neurobiologic and Genetic Perspective
While there are many reasons a person may become an alcoholic, once they have begun down that path there is a common neurobiology experienced by all who become addicted. In this article, serotonergic dysfunction, as well as genetic susceptibility, are explored as contributing factors to the pathogenesis and maintenance of alcoholism.
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Cover Article
Mapping the Genome, Targeting Alzheimer's Disease
Mapping of the human genome, and the enhanced knowledge of genetic inheritance it will likely foster, may someday soon enable researchers to predict susceptibility to Alzheimer's disease, design effective treatments for the degenerative disease, and identify in advance a patient's response to treatment.
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Cover Article
Dietary Folate May Reduce Stroke Risk
Data from the first National Health and Nutritional Examination Survey (NHANES I) Epidemiologic Follow-Up Study shows a strong, inverse correlation between dietary intake of folate, which affects homocysteine levels, and the subsequent risk of stroke and cardiovascular disease
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Cover Article
Benign Recurrent TIA or No TIA at All?
Among 1,707 patients admitted to the emergency department of the Northern California Kaiser Permanente system with an initial diagnosis of transient ischemic attack (TIA), researchers identified a subset of patients who seem to have a high risk of recurrent TIA but a low risk of future stroke. Since the clinical characteristics of this group differed from that of patients who went on to have a stroke, the researchers considered whether their observation was evidence for a new clinical entity—benign recurrent TIA—or whether it reflected initial misdiagnosis due to the inherent limitations of current criteria for the TIA diagnosis.
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Cover Article
Uncovering Clues to the Neurobiologic Basis of Emotion and Consciousness
Once considered too intangible to study, the mysteries of emotion and consciousness are beginning to be unraveled. At the 125th Annual Meeting of the American Neurological Association, neuroradiologists, molecular biologists, and researchers in cognitive neuroscience discussed the roles of emotion, memory, and consciousness in the definition and management of various neurologic and psychiatric disorders.
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