Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Dec 2006
Review Meta AnalysisEffects of apolipoprotein E genotype on outcome after ischaemic stroke, intracerebral haemorrhage and subarachnoid haemorrhage.
Rodent models of acute ischaemic stroke and head injury suggest that apolipoprotein E (APOE) genotype influences neuronal repair, regeneration and survival after brain injury. Possession of an APOE epsilon4 allele is associated with poor outcome after head injury in clinical studies. APOE might therefore influence outcome after acute stroke in humans. ⋯ APOE may differentially affect outcome after the three main pathological types of stroke. Further, large studies are needed to confirm or refute these findings, and to assess the possibility of an interaction between the effects of APOE and age.
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J. Neurol. Neurosurg. Psychiatr. · Dec 2006
Clinical TrialEffect of levodopa on cognitive function in Parkinson's disease with and without dementia and dementia with Lewy bodies.
Levodopa (L-dopa) is the gold standard treatment for Parkinson's disease, but a lack of clear efficacy combined with a perceived liability to neuropsychiatric side effects has limited L-dopa use in patients with parkinsonism and dementia. Therefore, the effect of L-dopa on the cognitive profile of dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD) is unclear. ⋯ The use of L-dopa in patients with parkinsonism with dementia does not adversely affect cognitive function.
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J. Neurol. Neurosurg. Psychiatr. · Dec 2006
Acute physiological derangement is associated with early radiographic cerebral infarction after subarachnoid haemorrhage.
Cerebral infarction after aneurysmal subarachnoid haemorrhage (SAH) is presumed to be due to cerebral vasospasm, defined as arterial lumen narrowing from days 3 to 14. ⋯ Many cerebral infarctions after SAH are unlikely to be caused by vasospasm because they occur too soon after SAH or because angiography shows no vasospasm in a referable artery, or both. Physiological derangement and cerebral oedema may be worthwhile targets for intervention to decrease the occurrence and clinical impact of cerebral infarction after SAH.
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J. Neurol. Neurosurg. Psychiatr. · Dec 2006
Editorial CommentPrevention of delayed cerebral ischaemia after subarachnoid haemorrhage.
Physiological abnormalities are a worthwhile target