Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Feb 2016
Stroke patients admitted within normal working hours are more likely to achieve process standards and to have better outcomes.
The presence of a 'weekend' effect has been shown across a range of medical conditions, but has not been consistently observed for patients with stroke. ⋯ Patients with stroke admitted out of hours and at weekends or public holidays are less likely to be managed according to current guidelines. They experience poorer short-term outcomes than those admitted during normal working hours, after correcting for known independent predictors of outcome and early mortality.
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J. Neurol. Neurosurg. Psychiatr. · Feb 2016
Predictors for being offered epilepsy surgery: 5-year experience of a tertiary referral centre.
To define factors that predict whether patients with pharmacoresistant focal epilepsy are offered epilepsy surgery (including invasive EEG) and the main reasons for not proceeding with these after non-invasive presurgical evaluation. ⋯ There was a low chance (<10%) of being offered surgery if there were bilateral lesions on MRI and extratemporal lobe epilepsy. Patients should be given advice on the risk/benefit ratio and of realistic outcomes of epilepsy surgery; this may help reduce the number of patients who refuse surgery after comprehensive workup.
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J. Neurol. Neurosurg. Psychiatr. · Feb 2016
Case ReportsHomozygous p.V116* mutation in C12orf65 results in Leigh syndrome.
Leigh syndrome (LS) is an early-onset progressive neurodegenerative disorder associated with mitochondrial dysfunction. LS is characterised by elevated lactate and pyruvate and bilateral symmetric hyperintense lesions in the basal ganglia, thalamus, brainstem, cerebral white matter or spinal cord on T2-weighted MRI. LS is a genetically heterogeneous disease, and to date mutations in approximately 40 genes related to mitochondrial function have been linked to the disorder. ⋯ We demonstrate that the identical nonsense mutation in C12orf65 can result in different clinical features, suggesting the involvement of unknown modifiers.
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J. Neurol. Neurosurg. Psychiatr. · Feb 2016
Cardiovascular risk factors are associated with increased lesion burden and brain atrophy in multiple sclerosis.
Cardiovascular (CV) risk factors have been associated with changes in clinical outcomes in patients with multiple sclerosis (MS). ⋯ Patients with MS with one or more CV risks showed increased lesion burden and more advanced brain atrophy.