Biomedical subjects
Publications and source records attributed to F Bermejo.
We report a case of acute confusional state (ACS) resulted from bilateral occlusion of anterior cerebral artery. This case is outstanding because development of ACS was caused by a focal lesion, without the presentation of focal neurologic signs. Then, cerebrovascular disease must be included in differential diagnosis of ACS, despite the lack of clinically detectable deficit.
In a prospective study conducted in the Emergency Area of a general hospital during a period of 6 months, the Neurology Service was consulted in 45 cases of acute confusional syndrome. Twenty nine of these patients had no immediate apparent etiology. Among the studied patients 5 had a subarachnoid hemorrhage, 4 suffered a central nervous system infection, 3 had a cerebral infarction, 3 presented a metabolic encephalopathy, and the remaining patients had variate etiologies. Clinical signs and symptoms were insufficient to establish the diagnosis and in several cases complementary tests were required (cerebral tomography and cerebrospinal liquid examination). Even in these cases the diagnosis could not be obtained in some patients. The clinical implications of the present findings were discussed.
We have carried out a retrospective study of 90 patients who were diagnosed of non traumatic supratentorial intracerebral hematoma by computerized tomography and received conservative treatment. Clinical features and laboratory and radiographic findings during acute stage as well as the course of the patients during hospital stay (mean, 34 days) are analyzed. The overall mortality rate was 21%. The factors having a significant influence on prognosis were: degree of neurologic impairment at admission, degree of motor impairment at admission, progression of neurologic impairment after the admission, level of glycemia at admission, extent of the hematoma, and presence of mass effect in CT. We conclude that the extent of the hematoma and the level of glycemia at admission are the primary prognostic factors without being related to each other. The "critical" values were 40 cc for the extent of the hematoma and 130 mg/dl for glycemia at admission. Patients with higher values had a poorer prognosis with a worse clinical condition at discharge.
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Existing information has been revised regarding the accompanying medication (permitted medication) for patients suffering from Alzheimer's disease (AD) who have been treated in a clinical study. Information obtained shows a highly variable attitude in the various clinical studies carried out on this illness. This fact, together with our limited knowledge of the psychotropic effects of many drugs frequently used on elderly patients with Alzheimer's disease has resulted in the impression that there are no unanimously agreed-upon guidelines as regards the prescription of this type of medication. The data afforded by the revision suggests certain guidelines for the suitable prescription of accompanying medication in clinical studies of Alzheimer's disease.