Neurol Neurochir Pol
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Neurol Neurochir Pol · Jul 2007
Malpractice in diagnosis and treatment of craniocerebral injuries in cases reviewed by the Forensic Medicine Department, Medical University of Łódź.
The aim of the study was to determine the most frequent errors in medical treatment of craniocerebral injuries, based on materials reviewed by the Forensic Medicine Department, Medical University of Łódź, Poland. ⋯ Analyzed material comprised 17 errors during the decision-making process, including 4 diagnostic errors, as well as 1 therapeutic, 1 executive, and 1 organisational error. The most common error was disqualification from hospitalization of patients who should be observed in hospital. It was followed (in order of frequency) by errors related to transportation to the sobering chamber or to another hospital, and failure to perform or misinterpretation of imaging studies. The fewest errors referred to treatment. The main cause of craniocerebral injury was fall of a drunk person, and the alcohol intoxication made diagnosis difficult and delayed.
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Neurol Neurochir Pol · May 2007
Demyelinating lesions in the cervical cord in multiple sclerosis 10 years after onset of the disease. Correlation between MRI parameters and clinical course.
Demyelinating lesions in spinal cord in multiple sclerosis (MS) are found in magnetic resonance imaging (MRI) in 47-90% of patients; spinal cord atrophy, however, which is a measure of axonal loss and correlates with disability, is found in 13-41% of patients. Presence and character of lesions depend on the duration and progression of the disease. The aim of this study was to estimate the presence, character and location of lesions and cervical cord atrophy in MRI performed 10 years after the onset of MS in relation to the clinical course. ⋯ Presence and character of demyelinating lesions in cervical cord ten years after onset of MS is significantly related to the clinical form of the disease. The mid-cervical region of the spinal cord appeared to be the commonest location of the focal lesions. Cervical cord atrophy was more frequent in patients with PPMS and SPMS, but it was not accompanied with intrinsic focal cord lesions.
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Neurol Neurochir Pol · Mar 2007
Clinical TrialAccuracy of intraoperative registration during electromagnetic neuronavigation in intracranial procedures performed in children.
The aim of the study was to evaluate registration accuracy in an electromagnetic navigation system applied to image-guided intracranial procedures in children. ⋯ Electromagnetic neuronavigation, which does not require firm head fixation, can be used in the youngest age group. Nevertheless, registration accuracy is lower in newborns and infants. Neither imaging modality (MRI or CT) used for creation of a three-dimensional model of the patient's head nor registration of more than 6 landmarks have an impact on registration accuracy.
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The pathogenesis of migraine aura, like migraine, remains unclear. The probable cause of migraine aura may be cortical spreading depression (CSD) and cerebral hypoperfusion. ⋯ The focal symptoms during migraine aura may be due to transient constriction of a cerebral artery and headache can result from a sterile inflammatory reaction around the walls of dilated cranial vessels. The development of aura makes a vascular origin a remote possibility, while a primary disturbance of cortical neuron function, probably CSD and activation of the trigeminovascular system, is a more reasonable explanation.
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Neurol Neurochir Pol · Jan 2007
Clinical TrialThe golden hour and the dull reality. Analysis of traumatic brain injury management in pre-hospital and emergency care.
Continuous progress in medical sciences with simultaneous technological development has created an unavoidable need for a reorganisation of Emergency Health Care in Poland. Introduction of modern means of transport in pre-hospital care, formation of air rescue teams, or standardization of emergency information centres (CPR) play an important role in this reorganisation; however, so far, there is still a lack of coherence between the pre-hospital care and the management within the emergency room. ⋯ According to the analysis the authors conclude that there is a need to reorganise the national system of emergency care in Poland. The most important issues are: to standardize the emergency medical records and initial emergency procedures, to organise multitrauma teams, and to decrease the time of the referral process and definitive care.