European journal of neurology : the official journal of the European Federation of Neurological Societies
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Mild traumatic brain injury (mTBI) is a common neurological disorder. Whether oral anticoagulation (OAC) use is a risk factor for secondary deterioration in mTBI patients after a normal computed tomography (CT) scan is unclear. Therefore data were retrospectively collected on patients with mTBI who used OAC to determine the incidence of secondary clinical deterioration after an initial normal head CT scan. ⋯ A low risk of secondary deterioration within 24 h in mTBI patients taking OAC with a normal first head CT scan was found. Our study does not support the recommendation of the current guidelines that these patients should be clinically observed for at least 24 h. The fact that in our series the majority of secondary deteriorations occurred between 2 and 28 days after trauma underscores the importance of patient instructions upon discharge from the hospital.
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Case Reports
Leukodystrophies underlying cryptic spastic paraparesis: frequency and phenotype in 76 patients.
In chronic progressive spasticity of the legs many rare causes have to be considered, including leukodystrophies due to neurometabolic disorders. To determine the frequency of leukodystrophies and the phenotypic spectrum patients with cryptic spasticity of the legs were screened for underlying neurometabolic abnormalities. ⋯ Adult patients presenting with cryptic spasticity of the legs should be screened for underlying X-linked adrenoleukodystrophy/adrenomyeloneuropathy and lysosomal disorders, irrespective of the presence of additional complicating symptoms. Leukodystrophies may manifest as late as the sixth decade and hyperintensity of cerebral white matter on magnetic resonance FLAIR images is not obligatory.
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Migraine pathophysiology involves a complex interplay of processes wherein the hormonal, neurotransmitter and inflammatory pathways interact to influence the migraine phenotype. However, all studies pertaining to the role of genetic variants in migraine have been restricted to a specific pathway and none of the studies has looked into inter-pathway genetic analysis. Our aim was to combine all the genetic variants from our previously reported studies to conduct higher order gene-gene interaction analysis using different multi-analytical approaches. ⋯ The present study suggests interactions amongst hormonal, inflammatory and genome-wide associated variants but not with neurotransmitter pathway variants in migraine susceptibility.