Cerebral venous thrombosis (CVT) is an under diagnosed cause for acuteor slowly progressive neurological deficit. It has a wide spectrum ofsymptoms and signs that may be clinically challenging and greatmimicker.We studied 45 patients with CVT at our centre. 41 were females (91%).The mean age was not different between the sexes (18.55 years infemales and 18.35 years in males).Of the 41 females 15 were postpartum (36.5%); five were pregnantwhile the other five were on oral contraceptive pills. Two werepositive for antiphospholipid antibodies (APLA). Only one patienthad protein C deficiency. The associations included, septic abortion(1), non-specific febrile illness (4), SLE (1), neoplasia (2),rheumatoid arthritis on methotrexate therapy (1), and indetermi-nate cause (2). Amongst the four males one had periorbitalcellulitis, one had severe dehydration and the last two were ofindeterminate cause.We will present illustrative cases. One patient had a haemorrhagicinfarct in the left temporal lobe, misdiagnosed as brain tumour. Asecond female patient was diagnosed as multiple sclerosis and wasplanned for disease modifying therapy, the third patient had markedpsychiatric disturbance, while a fourth had periorbital cellulitis anddeveloped a squint.We identified 2 patients with venous sub-arachnoid haemorrhage — aunique presentation and 3with suspected associated viral encephalitis—not previously reported.MRI/MRV was the examination of choice for confirmation of cerebralvenous thrombosis.

doi:10.1016/j.jns.2013.07.752

Abstract — WCN 2013No: 1053Topic: 3 — StrokeIbudilast inhibits Th17 differentiation

K. Kawabe, T. Takazawa, Y. Yanagihashi, Y. Ishikawa, T. Hirayama,K. Murata, O. Kano, K. Ikeda, Y. Iwasaki. Department of Neurology,Toho University Omori Medical Centre, Tokyo, Japan

Background: T helper cells secreting interleukin (IL)-17 (Th17cells) play a crucial role in the pathogenesis of autoimmunediseases, such as multiple sclerosis. In addition, Th17 cells areassociated with secondary inflammation induced by cranial infarc-tion. Ibudilast, a nonselective phosphodiesterase inhibitor thatinfluences inflammation and neurodegeneration in patients withischemic stroke and multiple sclerosis, is used in Japan to treatbronchial asthma and cerebrovascular disorders. Several reportshave shown that ibudilast decreases the production of tumornecrosis factor-alpha, IL-1-beta, IL-6, and interferon-gamma. It alsosuppresses the differentiation of T helper 1 cells. However, itremains unknown whether ibudilast suppresses Th17 differentia-tion and IL-17 production.Methods: For the in vitro study, naïve T cells were isolated from 5healthy volunteers using a magnetic bead kit. These cells werestimulated for Th17 differentiation, with/without ibudilast for 1 week.Population of Th17 was measured by flow cytometry using anti-IL-17antibodies. For the in vivo study, mRNA were isolated from 5 patientswith a history of ischemic stroke before and after ibudilast consumptionfor 6 weeks. We compared the IL-17 mRNA before ibudilast consump-tion with those after ibudilast consumption. This study was approvedby institutional ethics board.Results: In vitro, Th17 differentiation was significantly inhibited byibudilast. In vivo, the IL-17 mRNA were significantly lower inpatients treated with ibudilast than in patients not treated withibudilast.

Conclusion: Ibudilast inhibits Th17 differentiation and may regulateharmful secondary inflammation induced by ischemic changes in thebrain.

doi:10.1016/j.jns.2013.07.753

Abstract — WCN 2013No: 970Topic: 3 — Stroke“Silent” strokes in hydrocephalus

S.V. Lobzina, A.S. Arakelyanb, M.V. Kopelyana. aNeurology, State BudgetInstitution of Higher Education “North-Western State Medical Universitynamed after I.I Mechnikov” under the Ministry of Public Health and SocialAffairs of the Russian Federation, Saint Petersburg, Russia; bNeurology,Volgograd State Budget Institution ‘Volgograd Regional Clinical Hospital1’, Volgograd, Russia

Background: According to the data of WHO, cardio-vascular diseases(CVD) are nowadays one of the major problems of the populationand tend to be growing. Therefore, timely diagnostics of impair-ments, caused by CVD has a great importance for treatment andpredicting complication leading to increased patient morbidity andmortality.Objective: In this article, we report cases of right hemisphere strokesthat had atypical or rare symptomatology and did not get intensive care,due to the absence of severe focal symptoms and some ambiguity inanamnesis. Comparative analysis was performed for detachment of thesimilarities in patients. We also attempted to form some theory ofpathogenesis of such “silent” strokes and performed some tips forpractitioners.Patients andmethods: Three cases of patients (twomales, aged 45 and73, and female, aged 53) with clinically silent stroke were investigated.Patients got treatment in neurological department and underwentstandard clinical analyses, blood coagulation tests, lipoproteinphenotyping tests, neuroimaging scannings and MMSE-2 test. All datawere standardized and compared to normal test results and to eachother.Results: All patients had MR-signs of hydrocephalus, cortex degen-eration and had some insignificant deviations in analyses, pointingon the predisposition to atherosclerosis. All patients had high MMSE-2 scores. Males also had burdened labor anamnesis.Conclusion: We pointed a correlation between the presence of thehydrocephalus and inconsistency of the severity of symptoms in relationto neuroimaging data. We also suggested theory of pathogenesis of suchdiscrepancies.

doi:10.1016/j.jns.2013.07.754

Abstract — WCN 2013No: 1116Topic: 3 — StrokeThe temporal evolutions of Lac, Cr and NAA concentrations in wholebrain hyperacute ischemia rat model detected quantitativelyby HPLC

Y. Xiaoa, H. Wangb, X. Chenga, Z. Shena, Y. Chenc, R. Wua. aThe SecondAffiliated Hospital of Medical College of Shantou University, Shantou,China; bGuang Zhou Women and Children's Medical Center, Guangzhou,China; cShantou University, Shantou, China

Objective: To explore the dynamic changes of brain metabolites inhyperacute ischemia brain injury of rat model.Method: 96 rats were randomly divided into 12 groups. Each group had8 rats and all rats were sacrificed by cutting the head. Concerning the

Abstracts / Journal of the Neurological Sciences 333 (2013) e152–e214 e185