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Biomedical subjects

A Molins

Publications and source records attributed to A Molins.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Cluster headache. A clinical study].

The personal experience with cluster headache in 108 patients is reported. Significant clinical findings included a clear male predominance, with a male/female prevalence ratio of 4.7/1, the persistent homolateral character of pain during the attacks, seen in 100% of cases, and the tendency to repeat the attacks on the same side (96%). The cluster headache predominated during spring and the painful crisis, in our experience, had a clear nocturnal predominance. Regarding the signs and symptoms accompanying pain, our series was similar to those in the international literature, except for a smaller prevalence of Horner's sign in our cases. The association with tenderness of the carotid territory ipsilateral to pain is reported here for the first time. The importance of a correct anamnesis of all parameters associated with pain is emphasized in the present study, as in many patients only a detailed investigation permits an adequate clinical definition.

Adult↗
PubMed1990

Cisternographic pattern of spontaneous liquoral hypotension.

We describe five cases of headache due to spontaneous liquoral hypotension, the syndrome comprising sudden, intense and oppressive orthostatic holocranial headache. The headache improved in the recumbent position and was accompanied by nausea and sometimes vomiting. There was no history of lumbar puncture or previous trauma. CSF tension was low or negative. The CSF showed a raised protein content and increased red and white cell counts. CT scan was normal or showed a slit ventricular system. Improvement was complete three to eight weeks from onset. The treatment consisted of bed rest and oral and parenteral fluid replacement. An isotope cisternography carried out in all patients while the headache was present showed a cisternographic pattern characterized by a combination of premature elimination and failure to detect the isotope at the cerebral convexity. Scan images did not show CSF leakage at any site. This stereotyped reaction pattern suggests that CSF hyperabsorption is the most likely pathophysiological mechanism of this entity.

Adult↗
PubMed1989

[Symptomatic cluster headache? Apropos of 4 case reports].

Four patients were referred to our headache unit with characteristic clinical features of cluster headache which was subsequently attributed to other underlying conditions. To the previously reported occurrence of meningioma of the lesser wing of the sphenoid and cerebral arteriovenous malformation, we may now add for the first time two cases of maxillary sinusitis. In addition to accurate history taking, some factors are relevant for the diagnosis of these symptomatic forms of cluster headache, such as the occurrence of neurological abnormalities during or between the attacks; these should prompt the clinician to carry out neuroradiological studies, in spite of the low prevalence of these symptomatic forms in our series of 100 patients. We review the several etiologies reported in the literature, and we discuss the pathogenetical mechanism whereby these conditions may result in a type of headache of such peculiar chronological features.

Adult↗
PubMed1989

Migraine-related stroke: brain infarction in superior cerebellar artery territory demonstrated by nuclear magnetic resonance.

We report 4 cases of migraine-related stroke in young females. Two patients were taking oral contraceptives and one was pregnant. The results of the computerized tomography of the brain were negative in 3 patients and partially positive in one, while NMR showed ischemic lesions in the posterior fossa in each case. We would like to highlight the value of NMR in the assessment of migraine associated with prolonged focal neurologic deficiencies when the clinical examination revealed brain stem or cerebellar signs and the peculiar localization of the ischemic lesion that corresponded in all 4 cases to the area irrigated by the superior cerebellar artery. An hormonal factor is suspected as the precipitating event of this complication in 3 of these patients.

Adult↗
PubMed1989

[Adult T-cell lymphoblastic lymphoma associated with quiescent multiple myeloma].

We report the case history of a female patient suffering of a T lymphoblastic lymphoma with an atypical presentation and evolution, consisting of pleuropericardiac effusion without mediastinic masses that coexists with a plasma cell dyscrasia that fulfils the criteria for stationary multiple myeloma. The possible pathogenic relationship between both processes is discussed, emphasizing the functional evolutive dissociation between the cellular constituents of both neoplasias, immature T lymphoblasts and plasma cells, respectively; this constitutes the first reported case in literature.

Aged↗
PubMedDate not supplied

[Antiepileptic drugs in the elderly , pregnant women, children and in systemic disorders].

OBJECTIVE: To review the known pharmacokinetic and pharmacodynamic bases of current antiepileptic drugs in the elderly, pregnant and child populations, and in patients with systemic disorders so as to offer recommendations as to their use. DEVELOPMENT: In the elderly it should be pointed out that there is a slower rate of metabolism of drugs due to poorer liver function and also slower renal clearance leading to slower elimination from the body. In children there is slower metabolism in the new-born, but metabolism increases as the child grows and becomes normal when he reaches adolescence. In childhood the adverse effects of antiepileptic drugs may have an important effect on the proper growth of the body. In pregnant women there are several reasons why the levels of antiepileptic drugs may drop, and following child-birth the risk of toxicity increase considerably. The terratogenic effect of antiepileptic drugs is well known and seems to be related to the level of antiepileptic drugs and of polytherapy. Early administration of folic acid may help to avoid some of the more serious malformations. Patients with chronic liver or kidney disease should be treated with drugs eliminated via the more healthy organ. CONCLUSIONS: Because of their specific pharmacological properties, the new antiepileptic drugs would seem to be the treatment of choice in the groups at risk which have been considered, although there is still insufficient experience to recommend their use in pregnant women.

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