Arch Neurol Chicago
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Arch Neurol Chicago · May 2004
Historical ArticleThe aura-headache connection in migraine: a historical analysis.
A historical analysis is presented of insights into the pathogenetic mechanisms related to the migraine aura and headache and how the mechanisms connect. In the traditional sequential concept, advanced through the work of Edward Liveing, MD, Harold G. Wolff, MD, and others, the mechanisms are considered causally connected. A noncausal, parallel concept has been proposed as well and is considered in light of the results of recent animal experimental studies.
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Arch Neurol Chicago · Apr 2004
Randomized Controlled Trial Multicenter Study Clinical TrialTopiramate in migraine prevention: results of a large controlled trial.
Open-label trials and small controlled studies report topiramate's efficacy in migraine prevention. ⋯ Topiramate, 100 or 200 mg/d, was effective as a preventive therapy for patients with migraine.
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Arch Neurol Chicago · Apr 2004
Diffusion-weighted magnetic resonance imaging in internal carotid artery dissection.
Acute multiple brain infarction pattern on diffusion-weighted imaging is associated with arterial or cardiac sources of embolism. ⋯ Acute multiple brain infarction pattern with border zone involvement is frequently found in ICA dissection-related strokes. This finding may further support an interaction of hemodynamic and embolic mechanisms as a cause of cerebral ischemia in this condition.
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Arch Neurol Chicago · Apr 2004
Neuropsychological correlates of basal ganglia and medial temporal lobe NAA/Cho reductions in traumatic brain injury.
Proton magnetic resonance spectroscopy can assess neurochemical sequelae in traumatic brain injury. Metabolic abnormalities are present in the acute or subacute period in patients with traumatic brain injury and correlate with outcome on clinical scales. ⋯ Patients with long-term TBI present a regional correlation pattern that may help identify the neurological basis of cognitive sequelae in traumatic brain injury.
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Arch Neurol Chicago · Mar 2004
Comparative StudyUtilization of intravenous tissue plasminogen activator for acute ischemic stroke.
Intravenous tissue plasminogen activator (tPA) is the only approved therapy for acute ischemic stroke, although only 2% of patients with stroke receive intravenous tPA nationally. ⋯ Only 15% of patients arrived within the 3-hour time window for intravenous tPA, making delay in presentation the most common reason patients were ineligible for i.v. thrombolysis. Neurologic criteria were the second most common group of exclusions. Overall tPA use was low, but it was used in nearly half of all patients with no documented contraindications. Intravenous tPA use in a community setting can compare favorably with the rate of use seen in academic medical settings.