Journal of neurology
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Journal of neurology · Feb 2011
An early rise in body temperature is related to unfavorable outcome after stroke: data from the PAIS study.
Subfebrile temperature or fever is present in about a third of patients on the first day after stroke onset and is associated with poor outcome. However, the temporal profile of this association is not well established. We aimed to assess the relationship between body temperature on admission as well as the change in body temperature from admission to 24 h thereafter and functional outcome and death. ⋯ No relation was found between admission body temperature and poor outcome (aOR 1.06; 95% CI 0.85-1.32) and death (aOR 1.23; 95% CI 0.95-1.60). In contrast, increased body temperature in the first 24 h after stroke onset was associated with poor outcome (aOR 1.30; 95% CI 1.05-1.63) and death (aOR 1.51; 95% CI 1.15-1.98). An early rise in body temperature rather than high body temperature on admission is a risk factor for unfavorable outcome in patients with acute stroke.
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Journal of neurology · Feb 2011
Case ReportsPure alexia caused by separate lesions of the splenium and optic radiation.
Pure alexia is severe difficulty in reading and understanding written language but with normal oral language and writing abilities. We report a patient with pure alexia caused by two different infarct lesions in the left lateral thalamus and the left splenium of the corpus callosum. A 56-year-old right-handed man was admitted to hospital with right homonymous hemianopia associated with pure alexia. ⋯ Magnetic resonance angiography showed mild stenosis at the origin of the right vertebral artery and stenosis of the left distal posterior cerebral artery. The mechanism of developing pure alexia can be simply explained by disconnection. We assumed that agraphia of kanji was caused by the effect of ischemia and edema following transient obstruction in branches from the distal posterior cerebral artery.
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Journal of neurology · Feb 2011
FDG-PET SUV can distinguish between spinal sarcoidosis and myelopathy with canal stenosis.
Spinal cord sarcoidosis is a rare manifestation of sarcoidosis. Magnetic resonance imaging (MRI) of spinal cord sarcoidosis sometimes resembles that of the non-inflammatory spinal cord lesion. (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) is an effective method to detect both systemic and central nervous system lesions in sarcoidosis. This study compared the standard uptake value (SUV) of FDG-PET between spinal cord sarcoidosis and non-inflammatory spinal cord lesions. ⋯ The SUV of FDG-PET thus may be able to distinguish spinal cord sarcoidosis from other non-inflammatory lesions. FDG-PET can play an important role in the diagnosis of spinal cord sarcoidosis because the gadolinium enhancement in MRI is sometimes seen in spondylotic myelopathy or vascular malformation. FDG-PET is informative for the accurate diagnosis of spinal cord sarcoidosis and may enable clinicians to start treatment at an earlier stage.
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Journal of neurology · Jan 2011
ReviewTuberculous meningitis in patients infected with human immunodeficiency virus.
Tuberculosis is the most common opportunistic infection in human immunodeficiency virus (HIV) infected persons. HIV-infected patients have a high incidence of tuberculous meningitis as well. The exact incidence and prevalence of tuberculous meningitis in HIV-infected patients are not known. ⋯ Some studies have demonstrated a significant impact of HIV co-infection on mortality from tuberculous meningitis. HIV-infected patients with multidrug-resistant tuberculous meningitis have significantly higher mortality. The best way to prevent HIV-associated tuberculous meningitis is to diagnose and isolate infectious cases of tuberculosis promptly and administer appropriate treatment.
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Journal of neurology · Jan 2011
Deep brain stimulation for camptocormia in dystonia and Parkinson's disease.
Camptocormia, or "bent spine syndrome", may occur in various movement disorders such as primary dystonia or idiopathic Parkinson's disease (PD). Although deep brain stimulation (DBS) is an established treatment in refractory primary dystonia and advanced PD, few data are available on the effect of DBS on camptocormia comparing these two conditions. Seven patients (4 with dystonia, 3 with PD; mean age 60.3 years at surgery, range 39-73 years) with camptocormia were included in the study. ⋯ GPi DBS is an effective treatment for camptocormia in dystonia. The response of camptocormia to chronic STN or GPi DBS in PD is more heterogenous. The latter may be due to a variety of causes and needs further clarification.