Arch Neurol Chicago
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Arch Neurol Chicago · Mar 1995
Randomized Controlled Trial Comparative Study Clinical TrialThe risk of stroke in patients with first-ever retinal vs hemispheric transient ischemic attacks and high-grade carotid stenosis. North American Symptomatic Carotid Endarterectomy Trial.
The prognosis of amaurosis fugax has been considered to be favorable compared with that of hemispheric transient ischemic attacks. However, this has remained uncertain for patients with significant carotid stenosis as the assessment of progression of the disease has been confounded when patients undergo carotid endarterectomy. In the North American Symptomatic Carotid Endarterectomy Trial, patients with high-grade (70% to 99%) carotid stenosis were randomized to receive either medical or surgical treatment, thus making an unconfounded analysis possible. ⋯ To our knowledge, this study is the first report on the expected outcome for medically treated patients with high-grade (70% to 99%) carotid stenosis in whom the first-ever event was either an RTIA or HTIA. The presence of RTIAs carries a considerable risk of ipsilateral strokes, particularly at higher degrees of stenosis. However, in comparison with HTIAs, patients with RTIAs still have a better prognosis.
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Arch Neurol Chicago · Jan 1995
Cerebrospinal fluid treponemal antibodies in untreated early syphilis.
Examine prevalence and diagnostic utility of cerebrospinal fluid (CSF) treponemal antibodies in early syphilis. ⋯ When criteria to define neurosyphilis depend on cell count or CSF-VDRL reactivity, the sensitivity of CSF treponemal antibodies is high. Nonreactive CSF treponemal tests may help to exclude a diagnosis of neurosyphilis in patients with early syphilis.
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Arch Neurol Chicago · Jul 1994
Traumatic brain injury. Predicting course of recovery and outcome for patients admitted to rehabilitation.
To demonstrate that the prognosis for patients with traumatic brain injury (TBI) admitted to rehabilitation can be established with use of principled neurologic diagnosis and predictor variables of established value in neurosurgical populations. ⋯ The early course of recovery and functional outcome in TBI can be characterized in neurorehabilitation populations and is highly dependent on specific neuropathologic diagnosis, severity, and age. Predictions that employ traditional measures of severity are most relevant in patients with diffuse axonal injury. Age has a potent, complex effect on recovery, particularly beyond age 40 years.
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Arch Neurol Chicago · Jul 1994
Cognitive functioning and depression in patients with chronic fatigue syndrome and multiple sclerosis.
To assess cognitive function in patients with chronic fatigue syndrome (CFS) and multiple sclerosis (MS) and to evaluate the role of depressive symptoms in cognitive performance. ⋯ Patients with CFS compared with MS have more depressive symptoms but less cognitive impairment. Relative to controls, a subset of CFS subjects did poorly on tests of visuomotor search and on the logical memory measure of the Wechsler Memory Scale-revised. Poor performance of logical memory in CFS appears to be related to depression, while visuomotor deficits in CFS are unrelated. Cognitive deficits in patients with MS are more widespread compared with those in patients with CFS and are independent of depressive symptoms.
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To determine the safety of apnea testing. ⋯ Hypotension can pose a significant risk to patients undergoing apnea testing. Constant monitoring of vital signs throughout the test is essential to its safe completion.