Revista de neurologia
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Revista de neurologia · May 2004
Historical Article[Neurological paleopathology in the pre-Columbine cultures of the coast and the Andean plateau (II). The history of cranial trepanations].
Trepanation is one of the earliest examples of a surgical procedure being carried out by human beings and was performed from the Neolithic period onwards in a large number of primitive cultures throughout the five continents. Trepanation and cranial deformation were both common in the pre-Columbine cultures. The aim of this work was to study the trepanations carried out by the ancient Paraca, Nazca, Huari, Tiahuanaco and Inca cultures. To do so, we conducted a field study involving visits to archaeological remains and anthropological museums on the Andean plateau and the Peruvian coast. ⋯ Cranial trepanation was very successful despite the rudimentary methods and instruments employed to perform it.
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Revista de neurologia · Apr 2004
Case Reports[Anatomical variations of the middle cerebral artery: duplication and accessory artery. Implications in the treatment of acute stroke].
Less than half of all subjects display a normal configuration of the Circle of Willis, according to anatomical studies. Variations of the middle cerebral artery (MCA) such as duplication or accessory MCA are infrequent but nevertheless have important clinical implications. We report the case of two patients with these variations of the MCA and their repercussions in the management of acute stroke are discussed. ⋯ The double vascularisation of the hemisphere in cases of anatomical duplication can give rise to strokes with a better progression and prognosis, despite the occlusion of one of the MCA. The presence of anatomical variations of the MCA can lead to mistaken interpretations of the transcranial Doppler scan and may affect decision making as regards the therapy to be employed in patients with acute stroke.
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Revista de neurologia · Mar 2004
[Modification of clinical profile of stroke in atrial fibrillation patients. Effect of antithrombotic treatment].
Atrial fibrillation is present in 24% of the population over 60 and it increases the risk of stroke by 2,4% 3%/year. Antithrombotic treatment is considered as the treatment of choice for cardioembolic stroke prevention in this patients. As far as we know there are not relevant data about the influence of these treatments on the type of stroke that may develop in these patients. ⋯ Antithrombotic treatment not only prevents strokes but may also contribute to the development of less severe strokes with a better functional prognosis in patients with AF and does not contribute to increase complications in these group of patients.
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Revista de neurologia · Feb 2004
Case Reports[Arterial gas embolism progressing to a massive stroke].
Arterial gas embolism (AGE) is a main iatrogenic complication resulting from the use of invasive procedures. It is difficult to diagnose if it is not clinically suspected. ⋯ It is not clear what caused the air embolism in this patient but it can most probably be explained by air accidentally entering a peripheral vein. Carrying out an early cranial CAT scan can provide us with a diagnosis and a later CAT scan can evaluate the consequences of the embolism.