The aim of this prospective study was to determine the etiologic factors leading to stroke in a group of young adults. We studied 95 patients aged 50 years or under who were admitted with the diagnosis of stroke over a 2-year period. These patients underwent complete clinical and laboratory assessment for stroke. The etiology was established in 73 (76.8%) out of 95 cases. Arterial hypertension, embolism and atherosclerosis were found to be the most frequent causes in patients with ischemic stroke, whereas hypertension and aneurysm rupture were the most prevailing etiologies in patients with hemorrhagic stroke. Miscellaneous causes represented one fourth of all cases of the series. Coagulation abnormalities occurred in some patients, but in these cases there were also other well established causes. Paradoxical embolism was not observed. This study corroborates the importance of thorough diagnostic evaluation to establish an accurate diagnosis.

Adult↗

PubMedDate not supplied

[Daily chronic headache in patients with migraine induced by abuse of ergotamine-analgesics: response due to a protocol of outpatient treatment].

Chronic daily headache appears in migraine patients due to chronic consumption of analgesics-ergotamine. This entity was considered intractable without hospital admission. Our aim was to study the response of this headache to an outpatient treatment protocol. The therapeutic protocol included: 1. Oral information to the patient about the role of analgesics in the chronification of the headache; 2. Abrupt withdrawal of analgesics-ergotamine; 3. Administration of naproxen as symptomatic medication, and 4. Prophylactic treatment. After 2.5 months of treatment we evaluated both the frequency and the intensity of pain episodes as well as analgesic consumption. Thirty patients (8.6% of the outpatient consultations) suffered from chronic daily headache secondary to chronic analgesic abuse. Twenty five were females and 5 were males, their mean age +/- SD being 43 +/- 11 years. The mean +/- SD number of units of analgesics-ergotamine taken per week was 28 +/- 12. Three patients exclusively abused analgesics, the remainder either ergotamine, caffeine and various analgesics (18) or caffeine or several analgesics not containing ergotamine (9). In 29 patients the response was positive. Twenty (67%) showed an excellent improvement (> 75%) in frequency and intensity and completely gave up analgesics. The remaining nine (30%) improved moderately (50-75%). Only 3 patients in this group carried on taking analgesics. One patient showed no improvement. Our work confirms the epidemiological magnitude of chronic daily headache and shows that this is a treatable entity on an outpatient basis combining the abrupt withdrawal of analgesics-ergotamine, and their replacement by naproxen, with prophylactic treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

[Primary Sjogren syndrome with involvement of the nervous system. Description of 4 cases].

Four patients, 2 males and 2 females, with primary Sjögren's syndrome (PSS) and neurologic involvement are described. The first patient presented a progressive axonal polyneuropathy due to endo-epineural vasculitis. The second patient developed an acute and focal lymphocytic meningoencephalitis with increased IgG synthesis and excellent response to corticosteroids. The remaining 2 patients had previously been diagnosed as having definite multiple sclerosis (MS), but after a standardized study both fulfilled PSS diagnostic criteria. These cases illustrate the polymorphism of the neurological manifestations in PSS. Pathogenetic relationships between PSS and MS are briefly reviewed.

Adolescent↗

PubMedDate not supplied

[Mad cows: neurologists in their place].

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Animals↗