European neurology
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Clinical Trial
Long-term controlled-release oxycodone and pregabalin in the treatment of non-cancer pain: an observational study.
This study evaluates the efficacy and tolerability of long-term controlled-release (CR) oxycodone + pregabalin in patients with non-cancer pain, in a real-life setting. ⋯ The combination of CR oxycodone + pregabalin could represent a valuable long-term therapeutic addition to existing pharmacological options for the treatment of non-cancer pain.
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Letter Review Case Reports
Ischemic stroke presenting as thunderclap headache: report of two cases and review of the literature.
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Recent research has suggested that a perfusion-weighted image (PWI) relative cerebral blood volume (rCBV) map after acute ischemic stroke (AIS) provides information about the collateral circulation in the ischemic region. In this study, we demonstrate the usefulness of the rCBV ratio in PWI in predicting poor outcome after using IV t-PA in AIS. We recruited 58 stroke patients who were treated with IV t-PA after diagnostic magnetic resonance imaging (MRI). ⋯ Poor outcome also correlated with diffusion-weighted MR images of the lesion volume (p < 0.01), lower rCBV ratio on PWI (p < 0.01), and non-recanalization (p < 0.01). Among these, non-recanalization (p < 0.01), reduced rCBV ratio on PWI (p < 0.01), age (p = 0.04), and serum glucose level (p = 0.01) had an independent significance for predicting it. This suggests that the rCBV ratio on PWI may be used to determine prognosis after thrombolysis in AIS.
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Epidemiological and radiological studies have previously been performed to identify the possible causes of hemiplegic shoulder pain (HSP). Many different etiologies have been postulated, though no clear correlations have emerged, and a multifactorial pathogenesis of HSP has been proposed. Recently, two MRI-based studies have described different shoulder findings as possible causes of pain in chronic stroke survivors. ⋯ Adhesive capsulitis was found to be a possible cause of HSP. However, MRI, which is more expensive than other diagnostic tools, may be considered the gold standard tool for understanding the etiology of HSP.
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Various cerebral pathological changes have been reported to cause leukoaraiosis (LA). We hypothesized that circle of Willis (CoW) anomalies may contribute to LA in severe carotid artery stenosis victims through impaired cerebral autoregulation. We conducted a retrospective review on cerebral magnetic resonance (MR) patterns in patients with severe symptomatic carotid artery stenosis and compared white matter lesion (WML) load between subjects with and without complete CoW. ⋯ Our results support the importance of a complete CoW since it may protect from WML in case of carotid stenosis.