Nederlands tijdschrift voor geneeskunde
-
Ned Tijdschr Geneeskd · Jan 2014
[Practice guideline 'Management of patients with mild traumatic head/brain injury' in the Netherlands].
To evaluate the effect of the revised practice guideline 'Management of patients with mild traumatic head/brain injury' (MHI) in the Netherlands using the number of CT scans of the cerebrum, number of hospital admissions, and the number of intracranial traumatic findings on CT scan. ⋯ After introduction of the current MHI guideline in the Netherlands, percentages of both hospitalization and CT of cerebrum have increased significantly. It was expected that the guideline would result in decreases of this percentages. This increase does not seem to be related to more or serious head/brain injury.
-
Classic idiopathic trigeminal neuralgia is characterized by sharp unilateral shooting pain in the distribution of one or more branches of the trigeminal nerve. It involves a diagnosis of exclusion. Initially, therapy consists of medical therapy, preferably with carbamazepine or oxcarbazepine. ⋯ In case of surgical contraindications, there are other options: radiosurgery or a neurodestructive procedure of the trigeminal ganglion. Short-term outcomes after neurodestructive therapy are good, however effects diminish over time. Every patient with idiopathic trigeminal neuralgia in whom medical therapy has failed, should be counselled at an experienced centre in which neurosurgical treatment is available.
-
Ned Tijdschr Geneeskd · Jan 2014
[People with dementia have more contact with their general practitioners: contact with GPs peaks around the time of diagnosis].
To investigate how often and why people with dementia and their partners have contact with the general practitioner (GP) before and after the diagnosis of dementia. ⋯ People with dementia have more contact with their GP than people without dementia. From 1.5 years before diagnosis they visit the GP with specific complaints more often. Their partners also have regular contact with their GP, especially in the year after diagnosis.
-
Mallet finger is a very common injury, but there is still much discussion about the best treatment. Mallet finger should be operated on if a fracture is larger than 1/3 of the articular surface or in volar subluxation, because otherwise the fracture may remain unstable or there may be loss of function. ⋯ Although there is no significant difference in complications between splinting and surgery, the complications of an operation may be far more serious. In spite of the current operation indication, we should be more reluctant to operate on mallet finger.
-
Alice in Wonderland syndrome (AIWS) is characterised by abnormal perception, such as metamorphopsia, macropsia, micropsia, teleopsia and pelopsia. Although brief and transient, these episodes of visual distortion may lead to great anxiety, especially in children. AIWS seems to be associated with specific viral infections, epilepsy, migraine, and brain tumours. ⋯ The cause of AIWS is unclear. When occurring in the young patient, parents often become worried. In most cases no serious pathological cause is found. Usually, reassurance is sufficient. Therefore, general practitioners should be able to recognise the symptoms.