Journal of neurology, neurosurgery, and psychiatry
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Stroke is a heterogeneous syndrome caused by multiple disease mechanisms, but all result in a disruption of cerebral blood flow with subsequent tissue damage. This review covers the mechanisms responsible for regulation of the normal cerebral circulation, and how they are disrupted in disease states. A central concept in treating patients with acute ischaemic stroke is the existence of an ischaemic penumbra of potentially salvageable tissue, and the evidence for its existence in humans is reviewed.
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J. Neurol. Neurosurg. Psychiatr. · Mar 2004
Early pathological changes in the parkinsonian brain demonstrated by diffusion tensor MRI.
To determine whether the fractional anisotropy (FA) of magnetic resonance diffusion tensor imaging is decreased in the nigrostriatal projection in parkinsonian patients. ⋯ Assuming that the loss of FA parallels the neuronal change in the brain, the results are consistent with the view that more than half the dopaminergic neurones in the nigrostriatal projection are lost before the onset of Parkinson's disease. Close comparison of FA in the basal ganglia may contribute to the early diagnosis of Parkinson's disease.
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J. Neurol. Neurosurg. Psychiatr. · Mar 2004
Prospective validation of a proposal for diagnosis and management of patients attending the emergency department for mild head injury.
In mild head injury, predictors to select patients for computed tomography (CT) and/or to plan proper management are needed. The strength of evidence of published recommendations is insufficient for current use. We assessed the diagnostic accuracy and the clinical validity of the proposal of the Neurotraumatology Committee of the World Federation of Neurosurgical Societies on mild head injury from an emergency department perspective. ⋯ The variables prove highly accurate in the prediction of clinically meaningful outcomes, when applied to a consecutive set of patients with mild head injury in the clinical setting of a 1st level emergency department.
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J. Neurol. Neurosurg. Psychiatr. · Mar 2004
Comparative StudyPredicting functional outcome in acute stroke: comparison of a simple six variable model with other predictive systems and informal clinical prediction.
Statistical models that predict functional outcome after stroke using six simple variables (SSV) have recently been developed and validated. ⋯ The SSV models performed as well as or better than other simple predictive systems. These models will be useful in epidemiological studies but should not be used to guide clinical management until their impact on patient care and outcome has been evaluated.