7^th International Conference on Neurological Disorders & Stroke September 20-21, 2018 Rome, Italy

Biography:

Muhammad Awais Khan, MD has completed his Residency and Fellowship from University of Arizona, Tucson, USA. He completed his Medical School from Aga Khan University, Pakistan. He is double Board Certified in General Neuropathy and Clinical Neurophysiology.

Abstract:

Biography:

Carlos Alberto Diaz Pacheco earned his Medical Degree from the University of Antioquia (UdeA), Medellin, Colombia, followed by Radiology Residency at the same university. He subsequently completed a Interventional Neuroradiology Fellowship at SILAN (Ibero Latin American Society of Neurointervention) in Barcelona (Spain). He has extensive expertise in the minimally invasive treatment of cerebrovascular diseases including cerebral aneurysms, AVM and stroke as well as in the interventional treatment of craniofacial vascular malformations and chemosurgery for the treatment of retinoblastoma. He has several national and international publications, review articles and book chapters to his credit. He is an active Lecturer and serves as a Reviewer for scientific journals. He is a Member of the Colombian Association of Radiology and Member of its scientific committee. He served as the Director of Radiology- Faculty of Medicine at UdeA.

Abstract:

Introduction: Prompt recanalization of occluded brain arteries in patients with stroke requires the use of multiple strategies. We report a retrospectively collected clinical experience in Medellin – Colombia using a combination of a direct first pass technique with Sofia 6 Plus (Micro Vention-Terumo, Inc., Tustin, CA) Reperfusion Catheter in combination with Solitaire™ FR (SFR) (ev3 Inc, Irvine, California, USA) in the treatment of AIS (acute ischemic stroke). Materials & Methodology: Between March 2016 and Nov 2017 data from 32 patients treated with “SOFITAIRE” approach within 8 h of AIS symptom onset were selected. Procedural data including TICI score (Thrombolysis in cerebral infarction), timing, adverse events and outcome were analyzed. Results: SOFITAIRE approach was successful in achieving complete recanalization in 24 patients (75%) with a final score of 3 according to the TICI. A partial recanalization (TICI 1 -2a) was obtained in four patients (12.5%). Treatment failure was observed in four cases. 80.6% of strokes were in anterior circulation. Five cases were presented with tandem lesions involving cervical ICA. Median time from groin puncture to revascularization was 39 minutes. None adverse events were recorded. Two patients, not re-vascularized died during the hospitalization due to massive MCA infarction. Marked improvement of National Institutes of Health Stroke Scale from baseline to 24 h after recanalization were obtained in all survivals. Conclusions: SOFITAIRE approach was effective and fast in achieving a high rate of complete artery recanalization with a low rate of complications. The combined use of reperfusion catheters with retrievers may be considered as a promising tool for endovascular revascularization.

Biography:

Eduardo Flores Alvarez pursued his Master´s Degree from National Autonomous University of Mexico (UNAM) School of Medicine, Mexico with focus on the application of advanced magnetic resonance in glioblastomas. He completed his neurosurgical training program from General Hospital of Mexico of the UNAM and is the Head of Endoscopic NeuroSurgery Department. His area of research include: the advanced analysis of magnetic resonance.

Abstract:

Introduction: The Diffusion tensor image (DTI) is leading the analysis of brain lesions, and its derived biomarker the fractional anisotropy (FA) can be related to invasion, infiltration, and extension of brain neoplasms. Aim: We aim to evaluate FA values in three tumor regions of patients with glioblastoma (GB) and its association with intervals of overall survival (OS) using survival and correspondence analyses. Methodology: A retrospective study in 36 patients with GB: 23 (63.9%) males, 4614 y; and 13 (36.1%) females, 5313 y. Patients were followed up for 36 months. We measured DTI-derived FA at edema, enhancing rim and necrosis. To account for the tumor location, we used a four-level MRI-based classification based on the GB involvement of the subventricular zone and cortex. Kaplan-Meier method and the Log-Rank test assessed the survival curves between four subgroups based on tumor location. Correspondence analysis evaluated the association between OS (grouped in 7 six-month intervals) and FA measurements in the tumor regions. Results: Median FA values were higher in the normal brain regions (0.351), followed by peritumoral edema (0.190), enhancing ring (0.116) and necrosis (0.071). Comparisons among FA values among tumor regions showed a significant difference, p<.001. The Kaplan–Meier estimates indicated that the median OS for all patients was 19.3 months; the Log-Rank test to compare differences in the OS curves among subgroups was significant χ2 (3)=8.48, p=0.037. Correspondence analysis showed that a positive association between FA values in the edema region and the survival intervals was significant χ2 (18)=30.996, p=0.029. Conclusions: The alternative multivariate assessment of correspondence analysis might supplement the traditional survival analysis in patients with GB. A close follow-up of the variability of FA in the peritumoral edema region is predictive of the OS within specific six-month interval subgroup. Further studies should focus on a predictive model combining surgical and DTI biomarkers

Biography:

Rinat Esenaliev pursued his PhD in Applied Biophysics at the Institute of Spectroscopy, Russian Academy of Sciences and is currently the Professor in the Department of Neuroscience, Cell Biology and Anatomy and Director of Laboratory for Optical Sensing and Monitoring at the University of Texas Medical Branch, USA. He has more than 28 years of experience in biomedical optoacoustics, optoacoustic instrumentation and applications in monitoring, sensing and imaging. He has pioneered a number of optoacoustic applications in biomedical imaging, sensing and monitoring as well as in opto acoustic therapy and theranostics.

Abstract:

Opto acoustics is an emerging diagnostic imaging modality. We propose to use optoacoustics for biomedical applications working on it for more than 25 years starting from idea of basic science to clinical studies. Biomedical optoacoustics is based on detection and analysis of optoacoustic waves generated in tissues via thermoelastic mechanism by short optical pulses. We proposed a number of important diagnostic, therapeutic and theranostic applications; developed and built opto acoustic systems and performed animal and clinical studies. The proposed diagnostic applications include noninvasive transcranial mapping, monitoring and imaging for management of patients with intracranial hematomas, stroke and other neurological conditions. In this paper, we present an overview of our works for these applications from idea to study of tissues in vitro and to animal and clinical studies. We developed and built optoacoustic systems for early detection of intracranial hematomas and mapping of cerebral blood oxygenation. We tested the systems in small (rats) and large (sheep) animals and then in adults (healthy volunteers and patients with traumatic brain injury) and neonates (both term and premature). The obtained data demonstrated that the optoacoustic systems can be used for early detection and characterization of hematomas as well as for measurements of cerebral venous blood oxygenation with high resolution and accuracy. Our results suggest that the optoacoustic imaging modality may be used for early detection and characterization of stroke (ischemic vs., hemorrhagic). 

Biography:

Husham Bayazed pursued his PhD from College of Medicine, University of Mosul,Iraq. He is now a Consultant at the Scientific Research Center, University of Zakho/ Kurdistan Region, Iraq. He is a Specialist and Consultant in Microbiology & Immunology and has published more than 25 papers in reputed journals and has been serving as Scientific Reviewer of many local and international medical journals. In addition, he has a Fellowship of ISC, Infection, Cancer, Immunology Advisory Board Member (EUROMDnet) (Belgium); Membership of World Stroke Organization; Membership of Metabolomics (USA) and Membership of American Association of Science & Technology with more than 20 participations in international scientific meetings all over the world to his credit.

Abstract:

Anti-phospholipid syndrome (APS) is an autoimmune disease. Cerebral ischemia associated with APS occurs at a younger age than typical atherothrombotic cerebrovascular disease is often recurrent, and is associated with high positive IgG anti-phospholipid (GPL) unit levels. This study sought to determine the frequency rates of anti-cardiolipin (aCL) dependent on the presence of β2GPI, anti-β2-glycoprotein I (aβ2-GPI) and anti-phosphatidyl serine (aPS) IgG autoantibodies among stroke patients and thus demonstrate the importance of testing for aβ2-GPI autoantibodies. Stroke patients and control subjects recruited from Mosul, Erbil and Dohuk provinces in Northern Iraq were evaluated. All cases were under 50 years of age and had no recognizable risk factors. Using ELISA to evaluate the presence of IgG isotype of aCL, aβ2-GPI, and aPS autoantibodies in their blood, the results indicated that the frequency of aβ2-GPI was 14/50 (28%), aCL was 11/50 (22%), and aPS was 9/50 (18%) among stroke patients. In contrast, aCL was detected in 2/30 (6.7%) of control subjects; each of the other anti-phospholipid antibodies (APLA) was never observed. Of all the aβ2-GPI+ cases, the incidence of stroke patients having the combined profile of aβ2GPI + aCL was 11/14 (78.6%) and of aβ2GPI + aPS was 9/14 (64.3%). Among these only 2/14 (14.3%) of these aβ2-GPI+ patients expressed aCL in the absence of aPS. The frequency of patients expressing all three markers was only 9/14 (64.3 %). In none of the APS/stroke patients were aCL or aPS expressed in the absence of the aβ2-GPI. Conversely, IgG aβ2-GPI as a sole marker was seen in 3/14 (21.4%) of these patients (i.e., in absence of either other marker). It can be concluded from these studies that the among the three major forms of APLA examined, the presence of IgG aβ2-GPI autoantibodies appeared to correlate best with stroke in patients who were concurrently suffering APS. 

Biography:

Manolya Acar Özköslü is currently a PhD student at Hacettepe University, Turkey and a Lecturer in the Phytotherapy and Rehabilitation Department, Health Science Faculty, Baskent University at the same time. She is currently working on her PhD thesis and is interested in neurological and cardiopulmonary rehabilitation. She has published 8 papers in reputed journals.

Abstract:

The aim of our study is to investigate the acute effects of proprioceptive neuromuscular facilitation (PNF) techniques on pain, chest expansion, vital signs and mobility in stroke patient. Thirty eight stroke patients were allocated two groups: PNF and NDT-BOBATH (Neurodevelopmental Treatment-Bobath) methods group (n=20, mean age=62.90±9.59 year) and NDTBOBATH method group (n=18, mean age=58.67±12.68 year). The upper extremity exercises to be compatible with the natural development of human mobility were applied in NDT-BOBATH method group. PNF and NDT-BOBATH methods group performed PNF exercises that include scapula, neck, upper extremity patterns by using facilitation and rhythmic initiation techniques in addition to NDT-BOBATH method. PNF and NDT-Bobath methods were applied in single session (30 minutes). The pain (Visual Analog Scale-VAS), chest expansion (measuring of the chest circumference with a tape measure axillary, epigastric, subcostal region), vital signs (heart rate, blood pressure, respiratory rate), mobility (Functional Reach Test) were evaluated before and after the intervention. The heart rate (p=0.026) and respiratory rate (p=0.024) scores were significantly increased in PNF and NDT-BOBATH methods group. The diastolic blood pressure (p=0.026), respiratory rate (p=0.049) and Functional Reach Test scores (p=0.011) were significantly increased in PNF and NDT-BOBATH methods group. There were statistically significant differences in VAS score (p=0.043) between two groups. It appears that PNF techniques have immediate effects on mobility and reducing pain in stroke patients. It is thought that PNF techniques are one of the safe and useful rehabilitation component to increase upper extremity function.

Biography:

Sami Tetri pursued his PhD at the Oulu University, Finland in 2009 and Postdoctoral studies in Neurosurgery in USA from Harvard University, USA. He is an Adjunct Professor and a Consultant Neurosurgeon in Oulu University Hospital, Finland. He has published more than 25 papers mainly concerning the treatment of intracerebral hemorrhage and is a Member of several Editorial Boards.

Abstract:

Every sixth person suffers stroke during their life. Cerebral haemorrhage is the most serious form of stroke and it has a death rate of 50%. Primary cerebral haemorrhage means spontaneous bleeding inside the cerebral tissue which is not caused by trauma, tumour or abnormalities in the cerebral veins. The incidence on cerebral haemorrhage vary depending on the source and the figures range between 23-31/100,000 people. The rate is double compared to subarachnoid haemorrhage. Cerebral hemorrhages often lead to permanent disability or death with no specific treatment options which would improve the prognosis. Surgical treatment of cerebral hemorrhage remains controversial. In his presentation the author will go through most important evidence-based data, current treatment policy and effect of surgical hematoma evacuation on outcome. Modern, minimally invasive techniques are also discussed in the presentation.

Biography:

Angela Ruban pursued her PhD from Ben-Gurion University of the Negev and Postdoctoral studies from Weizmann Institute of Science, Turkey respectively. She is curently pursuing his career as an Independent Neurobiology Researcher at Tel Aviv University, with a specific expertise in understanding mechanism of glutamate excitotoxicity and therapeutic targeting of neurodegenerative and brain metastatic diseases.

Abstract:

Background: Subarachnoid hemorrhage (SAH) is a life-threatening condition. Cumulative morbidity and mortality following SAH remain high, despite the considerable efforts of neuroclinicians worldwide. Traditionally, rebleeding and cerebral vasospasm have been regarded as the main causes of poor outcome in these cases. Several lines of evidence suggest that glutamate (Glu) and aspartate (Asp) are involved in the secondary damage of SAH. Objective: The objective of this study is to analyze the pattern of Glu and Asp concentrations in cerebra-spinal fluid (CSF) of patients with SAH and their correlation with neurological status at admission and outcome. Methods: Fifty seven CSF samples were collected from 19 patients on days 1-3, 5-7 and 14 post-SAH. Concentrations of Glu and Asp amino acids were analyzed by liquid chromatography. Patients were neurologically evaluated at admission using Glasgow Coma Scale (GCS) and at discharge with Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS). Results: We found a significant correlation between CSF Glu and Asp levels at days 1-3 and GCS at admission (p≤0.046). The Glu levels increased continuously in CSF up to day 14 (mean value at day 1-3 11.97±7.75, day 5-7 20.61±37.57, day 14 28.06±47.23). Moreover, we found a significant correlation between CSF Glu and Asp levels at 5-7 and 14 days post-SAH and mRS at discharge (p≤0.0001, p≤0.016, p≤0.023 at day 1-3, 5-7 and 14 respectively). Conclusions: Molecular markers of early neurologic deterioration in SAH may play a role in monitoring of SAH progression and severity. SAH leads to a significant long-term increase of Glu and Asp amino acids in CSF. The patterns differ between good and poor outcome cases. We found that increased excitatory amino acids are strongly indicative of neurological status at admission and outcome.

Biography:

Philip Anthony McMillan pursued his MBBS Degree from Royal College of Physicians, UK (1994). He is a Consultant Geriatrician at the National Health Service with an interest in dementia and stroke. He has over 23 years of clinical experience with a broad range of skills in medicine and business. He has collaborated (for his further publications) on the theory of dementia and the potential of reversal with a Professor in USA.

Abstract:

Delirium is a significant problem in older hospital admissions, with worse clinical outcomes, prolonged hospital stays and functional disability. This presentation will cover the clinical experience of managing these complex patients during their hospital stay. Looking at explaining an integrated theory of delirium, based on brain glutamate and ammonia management, the work aims to demonstrate the biochemical aspects of the condition. Anecdotal experience of reversing delirium using this biochemical framework and use of simple medication in hospital has been very successful with up to 70% of patients demonstrating clinical improvement. This theory has the potential to revolutionize our care of older patients and give insight into the links between delirium and dementia.

Biography:

Eduardo Flores Alvarez pursued his Master´s Degree from National Autonomous University of Mexico (UNAM) School of Medicine, Mexico with focus on the application of advanced magnetic resonance in glioblastomas. He completed his neurosurgical training program from General Hospital of Mexico of the UNAM and is the Head of Endoscopic Neuro Surgery Department. His area of research include: the advanced analysis of magnetic resonance.

Abstract:

Background: Pituitary adenoma is the most common tumor in the sella turcica and constitutes 10-15% of the intracranial neoplasms, making them the third most common primary brain tumor in adults after meningiomas and gliomas. It is estimated that between 20 and 25% of the general population could have small hypophyseal tumors without symptoms. Aim: Our retrospective study carried out in the General Hospital of Mexico, Mexico city aimed to determine the advantage of endoscopic endonasal approach for surgical treatment of pituitary adenomas with suprasellar extension. Methodology: A series of 48 patients from December 2014 to December 2017 including patients from 18-75 years old were operated using an endoscopic endonasal approach, measurement of size, extension and invasion was performed based on the Knops and Wilson Hardy classification in the pre-operative and in the post-operative period using magnetic resonance imaging, endocrinological evaluations were performed in addition to the visual function evaluations, post-surgical complications were also documented. Evaluation of the volume of resection is done by comparing the pre-operative and post-operative magnetic resonance studies. Results: Of the total 48 patients less than 30% have non-functioning pituitary adenomas, study groups were comprising patients with surgical resection greater than 80%, resection between 50-80% and patients with resection less than 50% resulting respectively 73%, 22% and 5%. Only one deaths occurred and no group differences were noted in the post-operative complications (p=0.021). The endoscopic endonasal approach is safe, improving vision, illumination and degree of resection in the case of adenomas with supraselar extension.

Biography:

Yun Hee Kim pursued her PhD in Neuroanatomy (1996); MD (College of Medicine- 1982) respectively from Yonsei University, Republic of South Korea. She is a Board Certified PM&R specialist (1986). Her clinical specialty is neurological rehabilitation and her main research interest is investigating human neural plasticity using functional neuroimaging and noninvasive brain stimulation. She has published more than 200 peer-reviewed articles in famous international and domestic academic journals such as Neurology (2006), NeurolImage (1999, 2008, 2015), NeurolImage Clinical (2017), Stroke (2006, 2011, 2017), Neurorehabilitation and Neural Repair (2009, 2012, 2015), and 10 chapters of books in the field of neurological rehabilitation.

Abstract:

The purpose of this study is to investigate the modulating effect of hip-assist robot on cortical activation during gait in stroke patients. Twenty stroke patients participated in this study. A wearable type hip-assist robot, gait enhancing mechatronic system (GEMS, Samsung Electronics Co., Ltd., Korea) was used. Each patient randomly performed assigned two sets of treadmill walking sessions at self-selected speed with assistance of GEMS and without assistance of GEMS. An experimental session began with a fixed standing condition (60s), followed by one of the two walking conditions (60s) and then a resting condition (60s) for five repetitions. Cerebral oxygenation was measured by oxyhemoglobin (OxyHb) concentration using the 49 channels of functional near infrared spectroscopy (fNIRS) imaging system (NIRScout, Germany) covering bilateral prefrontal cortices (PFC), premotor cortices (PMC), supplemental motor areas (SMA) and lower limb sensorimotor cortices (SMC). In GEMS condition, stroke patients demonstrated improved spatio-temporal gait parameters, such as speed and symmetricity. We also observed less OxyHb concentration over the lower limb SMC, SMA and PMC regions in the late phase of gait between 31 and 60 seconds after initiating walking task with GEMS than No GEMS conditions. Less activation in the lower limb SMC, PMC and SMA in the late phase of walking with GEMS may indicate that GEMS helps producing rhythmic and symmetric hip flexion and extension movement and allows more coordinated gait pattern. 

Biography:

Christo Ranguelov is currently Consultant neurosurgeon at University Hospital Sofiamed, Sofia, Bulgaria. He is experienced Assistant Professor with a demonstrated history of working in the hospital & health care industry. Skilled in Emergency Medicine, Public Speaking, Neurosurgery, Healthcare Information Technology (HIT), and Grant Writing. Strong education professional graduated from Medical University/Medical Academy, Sofia. He did his MD from Medical Academy, Sofia from 1968-1975.

Abstract:

Stroke is still one of the leading healthcare problems worldwide. We present you some important points from our 5 years’ experience. In this retrospective review we analyze a series of about 500 pts with ischemic stroke (IS) treated last 2y at stroke centers in Sofia, so as another 500 pts with hemorrhagic stroke treated at NS Clinic, Sv. Ivan Rilsky Hospital, and Department of Neurosurgery at Sofiamed hospital, Sofia. Bulgaria is a small country and the capital Sofia has about 2 million inhabitants. In NS Clinics there is a tradition with neurosurgical treatment of hemorrhagic stroke and aneurysms, but since year 2011 progressively growing number of endovascular procedures for hemorrhagic stroke and aneurysms: more than 500 pts, incl. 411 aneurysms, 79 brain AVM, 10 spinal AVM. Since year 2015/16 started acute treatment of ischemic stroke at 2 stroke centers, so as endovascular treatment of ischemia. From more than 50000 pts with IS annually 330 are treated with tPA during first 3 h. Recently there are 250 pts with tPa, and 60 with additionally endovascular thrombectomy following initial venous thrombolysis. Inspite of huge number of patients only 1.6% of them can be treated with tPa, and lately with endovascular. Mortality rate among surgical and endovascular treatment of hemorrhagic stroke patients is about 5%, morbidity – 10% Mortality rate in ischemic. We discuss the cause of delay and how to increase further this type of treatment, and how to improve the outcome.

Biography:

Lystratenko Oleksandr Ivanovich has completed his study at the age of 25 years from Donetsk National University and internship from Donetsk National University – postgraduate department as neurosurgeon. He is the Deputy Chief Neurosurgical Clinic by DOKTMO. He has published more than 22 papers in reputed journals and has been serving as an editorial board member of repute.

Abstract:

This work contains information about military neurosurgical traumas with their complications. Here will be spoken about neurosurgical medical treatment in the present military actions (local military conflict in Donbass from 2014 till nowadays). You can realize what kind of neurosurgical treatment could be used in megapolis which appears under fire. Content of the work: soft tissue- damages, open not penetrating wounds, open penetrating wounds with- and without- brain perforation. In addition will be noticed the difference between projectile (shrapnel) wounds and bullet wounds with their following treatment based on numerous cases of such kind of injuries. This work has a lot of pictures in order to show pre- and post- operative patient’s condition.

Biography:

Mariel Pietri is currently a PhD student at the University of Nice Sophia Antipolis, France, under the guidance of the Drs Catherine Heurteaux and Marc Borsotto. Her work mainly focuses is the development of new treatment for stroke and depression, targeting the TREK-1 channel. She works on the development of spadin and its analogs as a new medicine and her thesis project focuses more specifically on the protection against stroke. She has her expertise in surgery of small animal, behavioural mouse models, immunochemistry and biochemical analyses.

Abstract:

Stroke is a major disease associated with high mortality and serious long-term disability. Unfortunately, usual treatments fail to improve long-term recovery and thrombolysis, which is the unique short-term treatment, is efficient only on 10% of patients. Consequently, developing new treatments is necessary. The TREK-1 channel represents an interesting target since its activity has recently been shown to be protective against stroke. We have identified a short molecule (spadin or PE 12-28) derived from a larger endogenous peptide, which is a potent antidepressant and is able to specifically inhibit TREK-1, as a potential new treatment. Using the in vivo model of MCAO in mice, we demonstrated that chronic treatment with spadin or a shorter analog (PE 22-28) improved the post stoke recovery from days to months after the ischemia. The protocol we used was designed thanks to electrophysiology studies and consisted in a two phase treatment, a low dose for one week followed by a high dose treatment for several weeks. Treated mice showed a significant reduction of the immobility time in the Forced Swimming Test. The eat latency in the Novelty Suppressed Feeding test was significantly reduced. The learning capacity was increased in the Morris Water Maze and the motor coordination was improved in both rotarod and pole test. The increase in neurogenesis, measured by BrdU incorporation was still present even at 10 weeks post trauma. Taken together our results suggest that spadin or its analog are very potent candidates for the development of new treatments improving stroke recovery

Biography:

Yoon Kyum Shin completed her PT, MSc from Yonsei University College of Medicine, Republic of Korea and is pursuing Doctoral course from Brain Korea 21 PLUS Project for Medical Science at Yonsei University College of Medicine. She is interested especially in the therapeutic strategies for patients with cerebral palsy and neurologic disorders. She has contributed in 14 papers and published 8 papers as the first-author in the field of neurorehabilitation medicine.

Abstract:

Cerebral palsy (CP) is a static lesion occurring in the immature brain from multifactorial causes including hypoxicischemia, resulting a life long motor impairment. Of note, severe patients with CP suffer from bone loss due to prolonged conditions of limited weight bearing in adulthood. In the transcriptome analysis, osteopontin (SPP1) gene expression in the peripheral blood mononuclear cells was significantly down regulated in adults with CP (n=13) than healthy adults. (n=13; fold change=-70.10). The osteopontin has multifaceted function of biomineralization by involving bone resorption and formation. A novel collagen binding motif (CBM) of osteopontin, is recently identified to induce bone formation via facilitating osteogenesis and inhibiting adipogenesis. We aim to propose reasonable therapeutic evidences for patients with CP who have osteopenia or osteoporosis by applying a novel osteoporosis medication in an animal model of neonatal hypoxic-ischemic (HI) brain injury. 7-day-old CD-1 pup mice underwent ischemic brain injury induced by unilateral right common carotid artery ligation and induced hypoxic condition. Severe HI brain injured mice were included to CBM administration for eight weeks. In the bone geometrical analysis, bone surface density and trabecular number were significantly increased after long term administration of CBM, while trabecular separation was significantly reduced compared to saline control. Through enzyme linked immunosorbent assay, we identified bone turnover markers including C - terminal telopeptide and procollagen type I were highly regulated in CBM treatment group compared to saline control. In an animal model of neonatal hypoxic-ischemic (HI) brain injury, the CBM improved bone geometrical components and bone turn over activity. This clinically translational investigation using the CBM shed lights on therapeutic administration for bone loss in adults with CP.

Biography:

Surbhi Chaturvedi is pursuing her Doctorate (DM) in Neurology, and, is in her final year at the age of 30 years from Mahatma Gandhi Medical College & Hospital, Jaipur, India. She did her MBBS from Jiangsu Medical College, China and completed her MD in Medicine from Mahatma Gandhi Medical College & Hospital, India. Surbhi Chaturvedi did her thesis in Medicine assessing impact of iron and vitamin B12 deficieny anameia on glycosylated Hb level. While doing her MD, she explored other fields of Medicine apart from Neurology by completing a post-graduate program in Cardiology by John Hopkins University School of Medicine, ECG education programme, course on Diabetes certified by Public Health Foundation of India. She developed a strong interest in Neurology which led her to specialize in the field and publish several research articles relating to stroke, epilepsy and headache. Currently, she is working on clinical profiling of stroke patients to provide critical insights on the etiology, clinical presentation, radiological findings and the role of various drugs with a special interest in stroke in young patients. Additionally, she is involved in “Epilepsy in Pregnancy” registry which is the first of its kind in North India.

Abstract:

The issue of stroke in young in the world has long been of interest to the neurologists. Though the traditional risk factors of stroke play a significant role in young age group also, the presence of high number of cryptogenic strokes, cardio-embolic and venous strokes makes diagnostic evaluation in this age group more challenging. Here, we report 2 cases of young patients with stroke as a rare manifestation of vasculitis and emphasize the need for thourough evaluation of young patients with stroke to establish the underlying etiology. Our 1st patient was a young female of 35 years with recurrant stroke (2 episodes till now and this time 2nd episode), presented with few episodes of TIA followed by aphasia and right hemiparesis with skin lesions in form of livedo retucularis and digital infarction and 1 episode of left focal seizure. MRI was suggestive of infarcts in different stages both acute and chronic in different vascular distribution. Possibility of vasculitis and embolic event was there. Skin biopsy was suggestive of Sneedon syndrome that matched our clinical presentation as well. Our 2nd patient was a young female of 13 years with young onset acute right hemiplegia, global aphasia with absent left carotid, brachial and radial pulse. MRI brain was suggestive of acute infarct in left MCA territory. CT angiography showed significant stenosis(80-90%) at the origin of left CCA and subclavian artery. ESR, CRP, ANA and anticardiolipin antibody was positive. So she was diagnosed to have Takayasu arteritis with APLA syndrome. Total 9 cases of TA with APS have been reported as yet.