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"These data provide treatment guidelines when reduction in arterial pressure is necessary."
Powers et al. report no changes in regional cerebral blood flow in 14 hypertensive patients with acute intracerebral hemorrhage after pharmacologic reductions of 15% in arterial blood pressure. Although not addressing outcome, these data provide treatment guidelines when reduction in arterial pressure is deemed necessary.
see page 18
In the accompanying editorial, Morgenstern and Yonas note that this study did not include patients in the initial 6 hours following hemorrhage and that the hemorrhages were relatively small. However, they note that the demonstrated safety of reducing blood pressure provides crucial safety data to defend a multicenter study of whether blood pressure lowering will improve outcomes.
see page 5
Connective tissue abnormalities in cervical artery dissections (CAD)
Brandt et al. detected connective tissue abnormalities in skin biopsies of 36 of 65 (55%) patients with nontraumatic CAD by electron microscopy. Only three of the patients had any other signs of a connective tissue disease. A structural defect in the extracellular matrix is suggested. Brandt et al. also found the same connective tissue abnormalities in family members, suggesting that a skin biopsy can identify a phenotype useful in genetic studies of patients with dissections.
see page 24
Working memory in children with febrile seizures (FS)
"Most febrile seizures do not adversely affect intelligence. . .or memory."
Chang et al. report on a population-based study of FS comparing learning and spatial and sequential working memory in 87 school-aged children with a history of FS vs 87 controls. They found that children with FS demonstrated significantly better mnemonic capacity, more flexible mental processing, and higher impulsivity than control subjects. However, those with FS occurring <1 year of age had impaired learning and memory.
see page 37
In the accompanying editorial, Shinnar and Baram note that since hippocampal injury has been documented to occur in humans and animal models with prolonged FS, the data of this study provide important reassurance that memory is not lost in most cases of FS. They also caution that only a few of the Chang et al. patients had prolonged FS, which are more likely to cause permanent damage.
see page 7
Localization of reading in normal children by fMRI
Gaillard et al. used fMRI to identify brain regions involved in two reading tasks: reading stories and naming-to-description in nine children between 8 and 13 years. They found strongly lateralized activation in the left hemisphere in areas classically associated with language processing: left middle and superior temporal cortex as well as left inferior and middle frontal cortex. Their study lays the foundation for using reading tasks to localize language cortex in patients being evaluated for epilepsy surgery.
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see page 47
Autologous stem cell transplantation for multiple sclerosis
Mancardi et al. studied the effect of autologous hematopoietic stem cell transplantation on MRI activity in 10 rapidly evolving, secondary progressive MS cases. High-dose cyclophosphamide followed by a conditioning regimen completely suppressed MRI enhancement (assessed by a 3x dose of gadolinium). The effect persisted in follow-up for a median of 15 months.
see page 62
Testosterone supplementation: Effects on cognition in men
Cherrier et al. studied the effects of testosterone supplementation on cognition in 25 healthy men (aged 50 to 80). They found significant improvements in verbal and spatial navigation memory and spatial abilities. This improvement in verbal memory could be from testosterone itself or its aromatization metabolic product, estradiol. This study raises the possibility that gonadal steroids influence cognition throughout the lifespan.
see page 80
APOE 
4 affects age-related cognitive decline
Studying age-related cognitive decline (assessed by the Wechsler Adult Intelligence Scale) from age 50 to 80, Mortensen et al. showed an association with APOE 4-genotype in women, but not in men. In women, 4-carriers showed greater decline in performance IQ than noncarriers.
see page 89
Action tremor in elderly males carrying the fragile X premutation
Hagerman et al. describe five males age 58 to 70 with the fragile X premutation who have a progressive cerebellar tremor and executive function deficits. Imaging showed brain atrophy and molecular studies, elevated FMRI messenger RNA (mRNA). Carriers of the fragile X premutation have a high prevalence in the general population: 1 in 700 men and 1 in 250 women. The current study adds to evidence that premutation carriers can have neurologic abnormalities and show the mRNA elevation seen in fragile X syndrome.
see page 127
Nerve growth factor (NGF) levels in CSF in chronic daily headache (CDH)
Sarchielli et al. found elevated levels of NGF in the CSF of CDH patients. NGF levels correlated significantly with CSF values of the sensory neuropeptides, substance P, and calcitonin gene–related peptide. Thus NGF may be involved in the long-lasting sensitization and activation of the trigeminal system in CDH.
see page 132
Muscle aches and fatigue from a tubulinopathy?
Vu et al. characterized sarcoplasmic crystals from a 61-year-old man with muscle aches and fatigue and an elevated creatine kinase level. The crystalline inclusions reacted with antibodies to tubulin and had other characteristics that suggested their similarity to tubulin.
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see page 149
Tremor of normal people: Genetic influence
Louis et al. used videotape analyses to show that tremor aggregates in normal families. There was an association between tremor scores among first- but not second-degree relatives. Over 30% of the variability in tremor scores were attributable to family-specific factors.
see page 110
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