Journal of neurology, neurosurgery, and psychiatry
-
J. Neurol. Neurosurg. Psychiatr. · Sep 2009
Comparative StudyDistinctive retinal nerve fibre layer and vascular changes in neuromyelitis optica following optic neuritis.
This is a cross sectional study comparing the retinal features of optic neuritis (ON) between 20 multiple sclerosis (MS) and 16 neuromyelitis optica (NMO) patients with a history of ON (visual acuity at time of attack >20/100) matched for age and gender using optical coherence tomography (OCT) and fundoscopy. ⋯ These NFL and fundoscopic findings suggest that some of the injury seen in NMO may be vascularly mediated. These inner retinal vascular changes are reminiscent of blood vessel wall thickening previously reported in the optic nerve and spinal cord at autopsy. If the retinal changes share a common pathology to those in the spinal cord and optic nerve, these observations suggest that vascular changes may be detectable during life.
-
J. Neurol. Neurosurg. Psychiatr. · Aug 2009
Poststroke dementia predicts poor survival in long-term follow-up: influence of prestroke cognitive decline and previous stroke.
The aim of this study was to investigate the influence of poststroke dementia on long-term survival after acute stroke and also to assess the possible influence of prestroke cognitive decline and previous stroke on this relationship. ⋯ Long-term follow-up of our large well-defined poststroke cohort indicated that in patients with acute stroke, dementia is a significant predictor of poor long-term survival and death from brain-associated causes. Prestroke cognitive decline seems to have an additional negative influence on survival, but previous stroke does not seem to affect survival.
-
J. Neurol. Neurosurg. Psychiatr. · Aug 2009
Sociodemographic differences in return to work after stroke: the South London Stroke Register (SLSR).
Loss of employment contributes significantly to the burden of stroke on individuals and society. There is limited information on factors influencing return to work after stroke. ⋯ There were important sociodemographic differences in return to work after stroke that were independent of clinical and service use variables included in the analysis. A large proportion of patients did not resume work despite excellent functional outcome.
-
J. Neurol. Neurosurg. Psychiatr. · Aug 2009
Effect of mannitol and hypertonic saline on cerebral oxygenation in patients with severe traumatic brain injury and refractory intracranial hypertension.
The impact of osmotic therapies on brain oxygen has not been extensively studied in humans. We examined the effects on brain tissue oxygen tension (PbtO(2)) of mannitol and hypertonic saline (HTS) in patients with severe traumatic brain injury (TBI) and refractory intracranial hypertension. ⋯ In patients with severe TBI and elevated ICP refractory to previous mannitol treatment, 7.5% hypertonic saline administered as second tier therapy is associated with a significant increase in brain oxygenation, and improved cerebral and systemic haemodynamics.