Clinical neurology and neurosurgery
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The clinical and paraclinical characteristics of acute transverse myelitis (ATM) were analyzed in 31 patients. In some patients there was clinical evidence of complete transection, in others of only partial lesions. Magnetic resonance imaging (MRI) in the acute phase in the first group was normal, but showed cord atrophy subsequently. ⋯ In the patients with circumscribed demyelinating lesions, the symptoms and MRI were suggestive of clinically isolated syndromes (CIS) predictive of multiple sclerosis (MS). Extensive demyelination was indicative of acute disseminated encephalomyelitis (ADEM) due to hyperergic vasculopathy or various forms of chronic vasculitis. In two patients with variable clinical symptoms, a vascular malformation was the cause of the clinical presentation, and in one patient demyelination was due to the disc compression.
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Clin Neurol Neurosurg · Feb 2006
Case ReportsFriday night palsy: an unusual case of brachial plexus neuropathy.
Brachial plexopathy can result from traction injury, radiation injury, local or metastatic cancer, hereditary, or idiopathic causes. However, brachial plexopathy resulting from malposition of an arm during sleep, similar to Saturday night palsy, has not been reported. We report a case of brachial plexus neuropathy that occurred after the patient slept on his shoulder and arm following excessive alcohol consumption on a Friday night.
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Clin Neurol Neurosurg · Feb 2006
The impact of the international subarachnoid aneurysm trial (ISAT) on the management of aneurysmal subarachnoid haemorrhage in a neurosurgical unit in the UK.
To review the changes in the management of aneurysmal subarachnoid haemorrhage (SAH) in a single neurosurgical unit in the UK, following the publication of the international subarachnoid aneurysm trial (ISAT). ⋯ This observational study highlights the changing pattern of management of SAH and the potential difficulties that could be encountered. The proportion of patients undergoing endovascular treatment of aneurysms has increased following the publication of the ISAT study. The associated increase in the delay in obtaining an angiogram may reflect the increased workload encountered by the neuroradiologists.
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Clin Neurol Neurosurg · Dec 2005
Case Reports Comparative Study Clinical TrialPerfusion CT investigation of chronic internal carotid artery occlusion: comparison with SPECT.
This study investigated the usefulness of perfusion computed tomography (CT) for the evaluation of patients with chronic internal carotid artery (ICA) occlusion by comparing the findings with those of iodine-123 iodoamphetamine ([(123)I]IMP) single photon emission computed tomography (SPECT). Twenty five patients with chronic ICA occlusion were investigated on the same day by perfusion CT to measure the cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transient time (MTT), and [(123)I]IMP SPECT to measure the regional CBF, significant correlations were observed between regional CBF measured by SPECT and CBF measured by perfusion CT (r = 0.659, R(2) = 0.434, p < 0.001), regional CBF and CBV (r = -0.406, R(2) = 0.165, p < 0.001) and regional CBF and MTT (r = -0.592, R(2) = 0.350, p < 0.001). Significant correlations were also observed between CBF and CBV (r = -0.153, R(2) = 0.023, p < 0.001), CBF and MTT (r = -0.580, R(2) = 0.337, p < 0.001) and MTT and CBV (r = 0.763, R(2) = 0.582, p < 0.001). Perfusion CT is useful to evaluate the hemodynamic state of patients with chronic major cerebral artery occlusive disorders.
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Clin Neurol Neurosurg · Dec 2005
Sympathetic skin response in idiopathic and diabetic carpal tunnel syndrome.
In carpal tunnel syndrome (CTS), certain changes were expected in sympathetic skin response (SSR) because median nerve carries postganglionic unmyelinated fibres. ⋯ Findings regarding SSR parameters suggest that unmyelinated C fibers were affected in CTS. These values were not useful because they were too small. Data on SSR were not normally distributed and the percentile method seems to be more convenient for finding any abnormality in clinical practice. Also, SSR waveform analysis could give us valuable data and should add to the SSR examination parameters.