Journal of neurology, neurosurgery, and psychiatry
-
J. Neurol. Neurosurg. Psychiatr. · Jul 2003
Meta AnalysisHead injury as a risk factor for Alzheimer's disease: the evidence 10 years on; a partial replication.
To determine, using a systematic review of case-control studies, whether head injury is a significant risk factor for Alzheimer's disease. We sought to replicate the findings of the meta-analysis of Mortimer et al (1991). ⋯ This study provides support for an association between a history of previous head injury and the risk of developing Alzheimer's disease.
-
J. Neurol. Neurosurg. Psychiatr. · Jul 2003
Meta AnalysisOutcome of contemporary surgery for chronic subdural haematoma: evidence based review.
To evaluate the results of surgical treatment options for chronic subdural haematoma in contemporary neurosurgery according to evidence based criteria. ⋯ The three principal techniques-twist drill craniostomy, burr hole craniostomy, and craniotomy-used in contemporary neurosurgery for chronic subdural haematoma have different profiles for morbidity, mortality, recurrence rate, and cure rate. Twist drill and burr hole craniostomy can be considered first tier treatment, while craniotomy may be used as second tier treatment. A cumulative summary of data shows that, overall, the postoperative outcome of chronic subdural haematoma has not improved substantially over the past 20 years.
-
J. Neurol. Neurosurg. Psychiatr. · Jul 2003
Comparative Study Clinical TrialDifferences in the diagnostic accuracy of acute stroke clinical subtypes defined by multimodal magnetic resonance imaging.
Despite its importance for acute stroke management, little is known about the underlying pathophysiology when patients with acute stroke are classified using clinical methods. ⋯ There is more inaccuracy in patients presenting with acute PACS or clinically mild to moderate anterior circulation stroke than in those with TACS or severe acute stroke syndromes. The latter appear more likely to be the targets for acute stroke interventions, as they include a significantly higher proportion of patients with persisting occlusion and diffusion/perfusion mismatch.
-
J. Neurol. Neurosurg. Psychiatr. · Jul 2003
Case ReportsAutoantibodies to glutamic acid decarboxylase in downbeat nystagmus.
The cause of downbeat nystagmus (DBN) remains undiagnosed in about 40% of patients. This paper reports the presence of antiglutamic acid decarboxylase antibodies (GAD-Ab) in a patient with DBN. Antibodies against GABAergic neurons located in the vestibular complex may induce chemical denervation of the floccular neurons, which normally suppress the peripheral imbalance between vertical semicircular canal systems, thereby causing DBN. Testing for GAD-Ab may be indicated in DBN patients without an identifiable anatomical brain lesion.