Der Nervenarzt
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The efficacy of interstitial radiosurgery as an alternative or adjuvant to radiotherapy or surgery of cerebral metastases remains unclear. In a retrospective study (1982-1991) we compared 4 therapeutic regimes for cerebral metastases. The first group (n = 38) was treated with interstitial radiosurgery (Iodine-125) with a tumor dose of 60 Gy in combination with percutaneous radiotherapy with 40 Gy. ⋯ No patient died from a locally treated metastasis. Percutaneous radiotherapy was the treatment of choice for multiple or non-circumscribed cerebral metastases. Our results show that for solitary metastases stereotactic interstitial radiosurgery is a beneficial minimally invasive method.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
[Effectiveness and tolerance of amitriptyline oxide in chronic tension headache--a multicenter double-blind study versus amitriptyline versus placebo].
Tricyclic antidepressants, especially amitriptyline, are the medication of first choice in the treatment of chronic tension headache. Few previous studies meet modern standards of study design and statistical analysis. Tolerability and efficacy of 60-90 mg amitriptyline oxide (AO) as a single dose in the evening were compared with 50-75 mg amitriptyline (AM) and placebo (PL) in a double-blind, parallel-group trial consisting of a 4-week baseline phase and 12 weeks of treatment. ⋯ A total of 211 patients were included in this trial. One hundred ninety-seven cases, 87 males and 110 females, with a mean age of 38 +/- 13 (18-68) years, could be analysed completely (66 AO, 67 AM, 64 PL). With regard to the strictly defined primary study endpoint, no significant difference emerged between AO, AM and PL: treatment responders were 30.3% with AO, 22.4% with AM and 21.9% with PL (PAO-PL = 0.3210, PAM-PL = 1.000, PAO-AM = 0.3299 respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
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Vestibular symptoms can be the predominant feature of migraine both in children and adults. Attacks of spontaneous or positional vertigo lasting from minutes to days may occur with or without concomitant headache. ⋯ Diagnosis is based on the individual constellation of typical precipitants and symptoms of migraine and the efficacy of pharmacological migraine prophylaxis. Nine cases are presented.