Neurología : publicación oficial de la Sociedad Española de Neurología
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Review Case Reports
[Anticoagulant treatment in hemorrhagic brains infarts due to large sinus venous thrombosis].
Cerebral venous and sinus thrombosis is an infrequent condition which presents with a wide spectrum of signs and a variable mode of onset. Sinus thrombosis may cause isolated intracranial hypertension but also may cause cerebral venous infarcts, which are frequently hemorrhagic. Treatment with antithrombotic agents is controversial because there is only one randomised controlled trial with unfractionated heparin. ⋯ The G20210A mutation in the prothrombin gene was detected as a likely risk factor for venous thrombosis. Therapeutical and diagnosis aspects are discussed. We review the previous literature on the topic.
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Bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) or globus pallidus internus (GPi) have demonstrated efficacy in advanced Parkinson's disease (PD). We aimed to assess the clinical utility of these procedures in terms of the quality of life, and to determine the pre and postsurgical characteristics related to the outcome. ⋯ Bilateral DBS demonstrated middle-term efficacy and clinical utility in the treatment of advanced PD. The presurgical levodopa-equivalent dose was a predictor of the efficacy and clinical utility of DBS.
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Respecting the patient's autonomy is one of the fundamental principles on which biomedical ethics is based. The principle of autonomy considers the patient's freedom and responsibility, who decides what is good for himself/herself, although this is not shared by the physician. In the field of medical research, there are codes and guidelines that guarantee the protection of persons as research subjects. ⋯ The LAP establishes the obligation of obtaining the free and voluntary consent of the patient prior to any type of intervention, after offering him/her the adequate information. This basic guideline specifies the situations in which the informed consent is given in writing as well as the exceptions to this consent. Finally, the LAP details when the informed consent is advisable by representation, closely linked to the patient's capacity as well as the regulation of previous instructions.