Journal of neurology, neurosurgery, and psychiatry
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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.
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J. Neurol. Neurosurg. Psychiatr. · Jun 1991
Case ReportsPartial, non-thrombotic, superior sagittal sinus occlusion due to occipital skull tumours.
Two cases are described in which raised intracranial pressure occurred as a result of superior sagittal sinus (SSS) occlusion by an occipital skull tumour. One was a plasmacytoma, the other a metastatic deposit from a Ewing's sarcoma. The difficulties in diagnosis of this syndrome are illustrated together with the importance and success of appropriate treatment. From the literature it appears possible that these two tumours may be particularly likely to occlude the SSS and the reasons for this are discussed.
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J. Neurol. Neurosurg. Psychiatr. · May 1991
Changes in intracranial CSF volume after lumbar puncture and their relationship to post-LP headache.
Post-lumbar puncture (LP) headache may be due to "low CSF pressure", leading to stretching of pain sensitive intracranial structures. The low intracranial pressure is secondary to net loss of intracranial CSF. It has, however, not been possible to measure intracranial CSF volume accurately during life until recently. ⋯ Most of the CSF was lost from the cortical sulci. Very large reductions in intracranial CSF volume were frequently related to post-LP headache but some patients developed headache with relatively little alteration in the intracranial CSF volume. There was not a measurable change in position of the intracranial structures following LP.
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J. Neurol. Neurosurg. Psychiatr. · May 1991
Case ReportsA case of progressive encephalomyelitis with rigidity and positive antiglutamic acid decarboxylase antibodies [corrected].
A 50 year old woman developed progressive encephalomyelitis with rigidity over a three year period. Her CSF contained oligoclonal bands and both her serum and CSF contained antibodies directed against GABA-ergic synapses (antiglutamic acid decarboxylase [corrected] antibodies). These antibodies have recently been described in cases of stiff man syndrome. Both disorders may be part of a clinical spectrum that has an underlying autoimmune basis.