Journal of neurology, neurosurgery, and psychiatry
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The records of 21 patients admitted to hospital from January 1985 to December 1988 for acute headache associated with cocaine intoxication were reviewed. Fifteen patients were identified who experienced headaches with migrainous features in the absence of neurological or systemic complications. ⋯ Three possible mechanisms of cocaine-related vascular headaches are discussed which depend on the interval between cocaine ingestion and development of the headache. We postulate that acute headaches following cocaine use may relate to the sympathomimetic or vasoconstrictive effects of cocaine, while headaches following cocaine withdrawal or exacerbated during a cocaine "binge" may relate to cocaine-induced alteration of the serotoninergic system.
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J. Neurol. Neurosurg. Psychiatr. · Sep 1991
The prognosis of hospital-referred transient ischaemic attacks.
A cohort of 469 hospital-referred patients with transient ischaemic attacks (TIA) of the brain (66%) or eye (34%) due to presumed atheromatous thromboembolism, lipohyalinosis or cardiogenic embolism, without prior stroke, was assembled between 1976-86. Follow up was prospective and complete until the patients death or the end of 1986. During a mean period of follow up of 4.1 years there were 82 deaths (58 vascular, 24 non-vascular), 63 first-ever strokes and 58 patients with coronary events. ⋯ The prognosis of this cohort of hospital-referred TIA patients was better than that of TIA patients in the same community who presented to the Oxfordshire Community Stroke Project (OCSP), and reflected the impact of referral bias. The hospital-referred patients were younger, assessed at a later date after their last TIA, and comprised a greater proportion of patients who had had a TIA of the eye (amaurosis fugax), which had a better prognosis than TIA of the brain. Knowledge of the prognosis of different populations of TIA patients not only enhances understanding and interpretation of previous studies but is also required for optimal patient management and the planning of treatment trials.
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J. Neurol. Neurosurg. Psychiatr. · Sep 1991
Biography Historical ArticleLeonardo da Vinci 1452-1519.