Frequency of migraine attacks following stroke starts to decrease before PFO closure.
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Adult↗
Biomedical subjects
B Lapergue
Publications and source records attributed to B Lapergue.
Diffusion weighted imaging of cerebellar lesions in Wernicke's encephalopathy.
We report unusual findings on MR imaging in a 62-year-old woman with Wernicke's encephalopathy (WE). Initial fluid-attenuated inversion recovery (FLAIR) and diffusion weighted MR imaging (DW-MRI) showed hyperintense lesions in the cerebellum and medial thalami, with a decreased apparent diffusion coefficient (ADC) in the cerebellum (reduced by 45%). After thiamine supplementation, the T2 and diffusion hyperintensities disappeared. However, clinical examination at three months showed persistent cerebellar impairment. The importance of the ADC values should be further investigated.
Cerebellar Diseases↗
Hydrocephalus and racemose cysticercosis: surgical alternative by endoscopic third ventriculostomy.
BACKGROUND AND PURPOSE: Hydrocephalus is a frequent and potentially serious complication of neurocysticercosis. Its treatment often requires ventricular shunting. The complication rate is high due to obstruction or material infection, which may justify endoscopic third ventriculostomy (ETV). OBSERVATION: We report a case of obstructive hydrocephalus in a 46-year-old man in the context of racemose cysticercosis, presenting with headaches and transient disorders of consciousness. Imaging showed cystic lesions of the cisterna magna, responsible for hydrocephalus which was treated effectively by ETV. Treatment with albendazole decreased the volume of the cisterna magna cysts. RESULTS: The patient was followed for 6 years after ETV with no recurrence of hydrocephalus despite two more symptomatic episodes of the disease with extension of the cysts into the lumen of the fourth ventricle and into the perispinal subarachnoid spaces, effectively treated by albendazole each time. CONCLUSIONS: Treatment of obstructive hydrocephalus secondary to cerebral racemose cysticercosis by ETV seems to be an effective and safety technique. The role of ETV should be evaluated in this indication.
Endoscopy↗
[Inflammation and ischaemic stroke: current status and future perspectives].
INTRODUCTION: Inflammation may play an important role in acute ischemic stroke. Experimental and clinical data suggest that post-stroke inflammatory responses are complex cascade phenomena, which may have detrimental or beneficial effects on outcome. This review focuses on the current understanding of inflammation effector pathways in focal cerebral ischemia and on therapeutic perspectives. STATE OF ARTS/PERSPECTIVES: Somatic markers, such as admission body temperature or C-reactive protein, seem to be correlated with outcome, but data are heterogeous and contradictory, perhaps because their kinetics are complex during the first hours of a stroke. The most studied effectors of inflammation are cellular adhesion molecules--CAM (including integrins, selectins and members of the immunoglobulin superfamily), leucocytes, microglia, and blood brain barrier permeability. Evidence from animal data has lead to some clinical trials investigating anti adhesion molecules and hypothermia. However, current results remain disappointing. Recent experimental data also suggest a possible beneficial role of insulin and statins, which may be mediated by their effects on the inflammatory response. CONCLUSION: Inflammation is an important avenue of therapeutic research in acute stroke. A better understanding of the inflammatory pathophysiology may help to a better design of clinical trials.
Acute Disease↗