Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Jun 1999
Development of obstructive hydrocephalus with lumboperitoneal shunting following subarachnoid hemorrhage.
Hydrocephalus is a frequent complication of subarachnoid hemorrhage (SAH). The optimum method of treating hydrocephalus in this setting has not been determined. We review our experience with patients developing communicating hydrocephalus secondary to SAH and subsequently treated with lumboperitoneal (LP) shunts. ⋯ These seven patients underwent replacement with a VP shunt and have not had further complications. In the setting of post-SAH communicating hydrocephalus, obstructive hydrocephalus may develop after LP shunt placement. Patients who develop this complication and have their LP shunts converted to VP shunts have a favorable prognosis.
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Clin Neurol Neurosurg · Mar 1999
Case ReportsProthrombin gene variant (G20210A) in a patient with cerebral venous sinus thrombosis.
We describe a 33-year-old woman, who presented with lowered consciousness level and seizures, due to cerebral venous sinus thrombosis with venous haemorrhagic infarcts. The patient. who was taking oral contraceptives, appeared to be heterozygous for a prothrombin gene variant, which is due to a G-->A transition at position 20210. This 20210A prothrombin has recently been established as an important risk factor for cerebral venous sinus thrombosis, which interacts with oral contraceptive use.
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The Netherlands Society of Neurology evolved from the Society of Psychiatry founded in 1871. The name was changed into Netherlands Society of Psychiatry and Neurology (NSPN) in 1897. In the same year, the word neurology was also added to the name of the journal. ⋯ Following an initiative of Brouwer, the first neurological university clinic opened its doors in Amsterdam in 1929. In the 20th century, a number specialised peripheral neurological clinics and epilepsy institutes were founded. In 1909, the the Central Institute for Brain Research was established in Amsterdam.
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Clin Neurol Neurosurg · Mar 1998
Case ReportsBeneficial gamma-knife radiosurgery in a patient with Nelson's syndrome.
A 50-year-old female patient with Cushing's disease had undergone transsphenoidal removal of the pituitary adenoma and conventional radiotherapy in 1988. Since no remission was achieved, she underwent bilateral adrenalectomy in May 1989. During out-patient follow-up, she developed signs and symptoms due to invasive Adrenocorticotrophic hormone (ACTH)-producing macroadenoma (Nelson's syndrome) in 1994. ⋯ During a follow-up of more than 2 years, no recurrence, but even a minor reduction of tumour mass was observed by magnetic resonance imaging (MRI). Plasma ACTH levels decreased gradually to levels between 200 and 400 ng/l, and ophthalmologic complaints disappeared. It is concluded that gamma-knife radiosurgery may be a good alternative for patients with Nelson's syndrome who have rapidly recurring disease.
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Eight cases of pure bilateral cheiro-oral syndrome (COS) are reported. The location and etiology of lesion were well defined in six cases, including pontine infarct in three, and brainstem hemorrhage, unilateral thalamic infarct and bilateral subdural hematoma in one patient each respectively. Neuroimaging and neurophysiological studies were normal in another two patients. Taken together with the previous five reported cases of bilateral COS, pons is the most frequent site for presentation even in the absence of associated brainstem signs.