Neurología : publicación oficial de la Sociedad Española de Neurología
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One of the particular characteristics of Parkinson's disease (PD) is the wide clinical variation as regards the treatment that can be found in the same patient. This occurs with specific treatment for PD, as well as with other drug groups that can make motor function worse. For this reason, the perioperative management of PD requires experience and above all appropriate planning. In this article, the peculiarities of PD and its treatment are reviewed, and a strategy is set out for the perioperative management of these patients.
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PRACTIC is an observational, epidemiological, multi-center, prospective registry of patients admitted to the emergency room with acute stroke. We aim to study the impact of admission to a specialized neurology ward, either a Stroke Unit or by a Stroke Team, on several outcomes. ⋯ in stroke patients, specialized neurological care, either in a Stroke Unit or by a Stroke Team, decreases mortality and hospital complications, thus lowering disability. A better outcome is sustained at 6 months when patients were admitted to an SNW. They have better functional status and lower rate of stroke or other vascular event recurrence. These data reinforce the need for specialized neurological hospital care for stroke patients.
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Cerebral venous thrombosis (CVT) is still a significant diagnostic and therapeutic challenge, due to its high variability of clinical manifestations and its lack of a clear therapeutic consensus. ⋯ CVT represents approximately 0.5% of all stroke cases worldwide. Headache, focal deficits and seizures are the most frequent initial clinical manifestations, representing 89%, 50%, and 35% of appearances, respectively. Magnetic resonance imaging (MRI) in combination with magnetic resonance venography has proved to have the highest sensitivity and specificity in establishing a diagnosis. An equal alternative to MRI is computed tomography venography due to similar diagnostic results. Pharmacological treatment with heparin is widely accepted today. Recurrence and mortality rates of CVT are 2.8 per 100 cases and 10%, respectively, despite of anticoagulation treatment.