Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Aug 2003
Comparative StudyThe management of refractory generalised convulsive and complex partial status epilepticus in three European countries: a survey among epileptologists and critical care neurologists.
To survey the current clinical treatment of refractory status epilepticus and to identify steps in its management which may need further investigation. ⋯ The management of refractory status epilepticus is heterogeneous in many aspects, even among clinicians who are most familiar with this severe condition. Randomised trials are needed to compare the efficacy, side effects, optimal duration, and depth of general anaesthesia.
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J. Neurol. Neurosurg. Psychiatr. · Aug 2003
Long term neuropsychological outcome after head injury: relation to APOE genotype.
Existing evidence suggests that some patients who sustain a head injury suffer cognitive decline many years later, and that head injury and possession of the APOE epsilon 4 allele are each risk factors for Alzheimer's disease. ⋯ Although this study provides additional evidence that a late decline may occur after head injury, there was no clear relation to APOE genotype. Despite the follow up interval of 15 to 25 years, the cohort is still too young (mean age 42.1 years) to assess the risk of Alzheimer's disease.
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J. Neurol. Neurosurg. Psychiatr. · Aug 2003
Antithrombotic drugs in secondary stroke prevention among a community dwelling older population.
Patients who suffer a cerebrovascular event are at high risk of a recurrence. Secondary prevention is crucial in reducing the burden of cerebrovascular disease. ⋯ Negative attitudes among physicians with respect to secondary stroke prevention are prevalent and reinforce the need for increased awareness of existing data on the risks and benefits for elderly individuals. Social problems and functional impairment may be issues concerning physicians when deciding whether or not the risks of treatment exceed the benefit.
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J. Neurol. Neurosurg. Psychiatr. · Aug 2003
Case ReportsPseudosubarachnoid haemorrhage in subdural haematoma.
Two patients with large bilateral subdural haematomas with patterns of non-enhanced brain computed tomography (CT) falsely suggesting coexistent subarachnoid haemorrhage are presented. The CT images showed marked effacement of the basal cisterns with hyperdense signal along the tentorium, sylvian fissure, and the perimesencephalic cisterns. In both cases, the suspicion of subarachnoid haemorrhage led to the performance of angiographic studies to rule out vascular lesions. Thus, recognition of this radiological feature is important to avoid unnecessary testing and treatment delay.
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J. Neurol. Neurosurg. Psychiatr. · Aug 2003
Case ReportsProgressive multifocal leucoencephalopathy with unusual inflammatory response during antiretroviral treatment.
A case of biopsy verified progressive multifocal leucoencephalopathy (PML) in an HIV patient is presented. Imaging and histological examination confirmed remarkable inflammatory activity accompanied by an unusually benign clinical course despite no clear evidence of immune reconstitution after the start of antiretroviral treatment. This case not only raises several questions regarding the pathophysiology of PML, but gives also evidence that AIDS associated inflammatory PML must be considered another clinical entity in the expanding range of diseases now commonly referred to as the immune reconstitution syndrome.