Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Oct 2006
[Intracranial EEG monitoring for epilepsy surgery using electrode grids--results in the first 22 Dutch patients].
Description of initial experiences with subdural electrode grids in patients with refractory focal epilepsy as additional diagnostic tool for epilepsy surgery. Using these electrodes, the attacks were recorded during a number of days and the cerebral cortex was electrically stimulated in order to map the functional areas. ⋯ Registration with intracranial electrodes makes it possible to treat epileptic patients surgically by excision of brain tissue near critical areas. Such intensive monitoring is, however, not without risk and this must be weighed against the potential benefits.
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Ned Tijdschr Geneeskd · Oct 2006
Review[The relationship between atherosclerosis, cognitive impairment, and depression in old age].
It has been suggested in the literature that atherosclerosis is a common causal pathway of cognitive impairment and late-onset depression, which may explain their co-occurrence in old age. In both the 'Leiden 85-plus Study' and the literature, strong evidence is found for a causal relationship between atherosclerosis and cognitive impairment, but there is less evidence for a causal relationship between atherosclerosis and late-onset depression. In the 'Leiden 85-plus Study', cognitive impairment was a risk factor for the development of late-onset depression, but depression in old age did not predict cognitive decline. This means that the prevention of atherosclerosis might prevent cognitive impairment and hence late-onset depression in old age.
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Ned Tijdschr Geneeskd · Oct 2006
[Endarterectomy is a good treatment option in patients with asymptomatic carotid stenosis].
Among patients with substantial carotid artery stenosis without neurological symptoms, the benefit of carotid endarterectomy had been unclear until this issue was addressed in two randomised trials. The incidence of stroke during follow-up was reduced by approximately one-half after endarterectomy. In appropriate patients, endarterectomy ofa significant asymptomatic carotid stenosis is certainly a treatment option.
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Ned Tijdschr Geneeskd · Oct 2006
[Background and consequences of injuries missed when diagnosing severely injured accident victims in prehospital care in patients transported by ambulance to the University Medical Centre in Utrecht, 1999-2000].
To determine the background and consequences of failing to diagnose injuries in prehospital care. ⋯ Frequently missing an injury prior to hospitalization did not result in a poorer chance of survival or lesser quality of life. The risk of dying was mainly related to a higher age and a poorer general condition at the scene of the accident. According to these findings there is no reason to adapt the current policy with regard to initial care and transport of trauma patients.