Journal of the neurological sciences
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Comparative Study
Accuracy of osmophobia in the differential diagnosis between migraine and tension-type headache.
Our objective was to determine the accuracy parameters of osmophobia in the differential diagnosis between migraine and tension-type headache. Migraine or tension-type headache patients, diagnosed according to the criteria of the International Classification of Headache Disorders-II, were interviewed about osmophobia during the crisis and in the period between episodes. We studied 200 migraine patients and 200 tension-type headache patients. ⋯ In the period between attacks, osmophobia was restricted to migraine patients (48/200, 24.0%). The areas under ROC curves were: 0.903 ± 0.017 to osmophobia during crisis; 0.784 ± 0.025 between crises; 0.807 ± 0.023 to photophobia/phonophobia, and 0.885 ± 0.017 to pain developed by odors. Osmophobia may be a specific marker to differentiate migraine from tension-type headache, which suggests its inclusion within the criteria to diagnose migraine.
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Review Case Reports
Acute vertigo due to hemispheric stroke: a case report and comprehensive review of the literature.
Acute cortical lesions rarely cause vertigo. We report a 51-year-old patient presenting with an acute vestibular syndrome including spontaneous vertigo and nystagmus, lateropulsion and nausea due to middle cerebral artery infarction. ⋯ A comprehensive literature review on patients with hemispheric stroke manifesting with acute vertigo is provided. Typically, patients with an acute vestibular syndrome due to cortical stroke have involvement of the temporoparietal junction.
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The epidemiology and pathophysiology of iNPH remain unclear. We aimed to investigate the incidence of iNPH in elderly inhabitants of the community, and to identify how ventriculomegaly develops on brain MRIs and how symptoms develop in iNPH patients. ⋯ The estimated incidence of iNPH in a community was higher than those estimated by previous studies where they collected patients at hospitals. There were subclinical or preclinical states before the development of iNPH.
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Observational Study
Blood pressure variability and stroke outcome in patients with internal carotid artery occlusion.
The aim of this study was to evaluate the relationship between arterial blood pressure (BP) variability during the acute phase and the 3-month outcome in ischemic stroke patients with internal carotid artery (ICA) occlusion. ⋯ In a cohort of acute ischemic stroke patients with ipsilateral ICA occlusion BP variability, assessed in the acute phase, was associated with poor clinical outcome. These preliminary exploratory findings are worthy of further study to be conducted to confirm or confute the role of BP variability in predicting stroke outcome. In order to obtain more comprehensive information, it would also be appropriate to consider the possibility of acquiring data related to the pathophysiology of stroke and to cerebral hemodynamic changes.