Journal of the neurological sciences
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Review Meta Analysis
Effect of cilostazol in patients with aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.
Previous studies with small sample size have shown that cilostazol can reduce the risk of cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage (SAH). The purpose of this study was to determine whether cilostazol is effective in patients with aneurysmal SAH. Studies investigating the effect of cilostazol in patients with aneurysmal SAH were identified using Embase.com without language or publication-type restrictions. ⋯ Mortality rate differences between the two groups were insignificant. No statistical heterogeneity was found for all outcomes. These results show that cilostazol can decrease the incidence of symptomatic vasospasm, severe vasospasm, vasospasm-related new cerebral infarctions, and poor outcome in patients with aneurysmal SAH.
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Case Reports
Fulminant cerebellitis with radiological recurrence in an adult patient with Crohn's disease.
There are few reports of cerebellitis in adults and reports of recurrent cerebellitis are extremely rare. This report highlights both the fulminant course that may follow cerebellitis and a potentially important association with Crohn's disease. A 41-year-old man presented with headache and cerebellar dysfunction a month after ileo-colonic resection for Crohn's disease. ⋯ Adult onset cerebellitis may be fulminant and recurrent. Early immunotherapy in acute relapsing cerebellitis may speed recovery and prevent recurrence. Onset and radiological relapse of cerebellitis during Crohn's disease flare-ups as in our case possibly suggests a shared autoimmune pathogenesis.
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Multicenter Study
Effects of atorvastatin on chronic subdural hematoma: a preliminary report from three medical centers.
Chronic subdural hematoma (CSDH) is common and more prevalent in the aged population. Surgical intervention is the treatment of choice, but its outcomes may not be satisfactory because of recurrence and physical infirmity associated with aging. Aberrant angiogenesis and localized inflammation contribute to the formation of CSDH. Atorvastatin is active in promoting angiogenesis and modulating inflammation. We hypothesize that atorvastatin is effective in reducing CSDH and have tested the hypothesis in a preliminary prospective study of small cohort of patients. ⋯ Results of this preliminary prospective study show that the oral administration of atorvastatin is safe and effective in treating CSDH, offering a cost-effective alternative to surgery. A prospective randomized clinical trial is required to validate the effect of atorvastatin.
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Case Reports
A case of homocystinuria due to CBS gene mutations revealed by cerebral venous thrombosis.
Homocystinuria caused by cystathionine beta synthase (CBS) deficiency is most often diagnosed in childhood and has a variable expressivity. The most frequent abnormalities include intellectual disability, ectopia lentis, myopia, skeletal abnormalities or thromboembolism. ⋯ In patients with CVT, plasma total homocysteine measurement as part of the etiologic work up may reveal severe hyperhomocysteinemia due to CBS or remethylation defects that require specific treatment and management including perhaps protein-restricted diet and/or vitamin therapy for life.