European neurology
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Biography Historical Article
Virginia Apgar (1909-1974): neurological evaluation of the newborn infant.
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Comparative Study
Predictors of outcome in patients with normal-pressure hydrocephalus.
Despite emerging knowledge of over 40 years, the postoperative results after shunt implantations in patients diagnosed for normal-pressure hydrocephalus (NPH) have not improved significantly in the last decade. For this reason, predictors have to be identified in order to preoperatively predict the course of disease. From 1982 to 2000, we examined in a prospective study 200 patients diagnosed for NPH. ⋯ In 80 patients with an early stage NPH (without cerebral atrophy) and a short course of disease (<1 year), slightly distinct dementia and an implanted Miethke Dual-Switch valve were significant predictors for a positive postoperative outcome. The outflow resistance measured in the intrathecal infusion test showed only a minimal relevance for the outcome. Those 75 patients with a late state NPH (with cerebral atrophy) had a better outcome when dementia was not present, the outflow resistance was >20 mm Hg.min/ml, the CSF tap test was positive and a Miethke Dual-Switch valve was implanted.
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Case Reports Comparative Study
Cardiac cephalalgia. Case report and review of the literature with new ICHD-II criteria revisited.
We report a patient with cardiac cephalalgia and review reported cases from the English-language literature based on the new diagnostic criteria published in the International Classification of Headache Disorders, ed 2. Twenty-two patients, including ours, with headaches of cardiac origin were reviewed. The cases fit three of the four new criteria well: Criteria B (acute myocardial ischemia has occurred, 100%), C (headache developed concomitantly with acute myocardial ischemia, 100%), and D (headache resolved and does not recur after effective medical or surgical treatment for myocardial ischemia, 83%). The cases in which we had exceptions were to the proposed headache features (criterion A), which were generally not fulfilled, with nausea as the least frequent finding (27%); this criterion might not be mandatory for diagnosis.