Neurología : publicación oficial de la Sociedad Española de Neurología
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Morbidity and mortality of the patients with head injury (HI) admitted to our institution during one year were prospectively evaluated. Four hundred and seventy seven fulfilled the inclusion criterial this represents an incidence of HI of 91/100,000/year for our community. Male/female ratio was 2,9/1. ⋯ Deaths outside the hospital were 95, i.e., 92% of the overall mortality. Our results confirm the public health relevance of HI, the very high prognostic value of the current evaluation scales and the insufficient use of protective measures in our area. Finally, the high rates or death outside the hospital suggest that emergency medical care outside the hospital is poor.
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Malignant external otitis (MEO) is a disease of the external auditive channel (EAC) due to Pseudomonas aeruginosa which usually involves individuals with diabetes mellitus. It may result in the invasion of the cranial base with cranial neuropathy and a high mortality rate despite therapy. We report the clinical features, diagnostic procedures, evolution and therapy of 8 patients with MEO, seven of which had cranial neuropathy. ⋯ Follow up was characterized by common recurrences, and one patient died. The importance of early diagnosis and treatment to prevent the extension and recurrence of MEO are discussed. Cranial neuropathy is considered as a poor prognostic finding.
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This study reports 3 cases of pure hemisensory syndrome due to lacunar infarction at the pons, demonstrated by magnetic resonance. In all patients somatosensory evoked potentials were abnormal. In two out of the 3 cases these potentials remained abnormal even after clinical exploration normalized. ⋯ None of them had data on somatosensory potentials. In our experience the study of somatosensory evoked potentials has a high sensitivity. It appears that the distribution of the sensitive defect is independent of the location of the structural lesion.
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We present the epidemiology and the outcome of the patients younger than 15 years-old who were admitted to our hospital during 1986 with the diagnosis of head injury. One hundred and fifty-five met the required inclusion criteria, this offers an incidence of head injury in children of 139/100,000. The boy/girl ratio was 2.1/1. ⋯ There were two intrahospital deaths, that happened in the 8 patients with severe head injury, giving a mortality rate of 25% for this group; and 5 deaths out of hospital. Thus, the global mortality secondary to head injury for children was 6.3/100,000 and year. These data show: a) the sanitary importance of the head injury in children; b) the necessity of a separate study of the head injury in children since the precipitating causes and the clinical outcome are specific; and c) the shortcomings in the urgent out of hospital medical attention, as indicates an out of hospital mortality rate of 71% which is well above that of other developed countries.
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Fifty patients with subarachnoid hemorrhage (SAH) were evaluated, with attention to past history, age, sex, time from the onset of symptoms to hospital admission, etiology of SAH, diagnostic procedures, therapy and outcome. Of these, 16 who showed ventricular dilatation in the CT during their evolution were analyzed. ⋯ Ten patients required definitive shunt; in 7 of them, SAH had been caused by arterial aneurysm. All had a grade higher than 3 in Hunt and Hess' scale and only one half received fibrinolytic drugs during their treatment.