Neurology
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To investigate the role of CSF hypovolemia in spontaneous intracranial hypotension (SIH) syndrome because so-called SIH syndrome sometimes lacks intracranial hypotension. ⋯ Since some patients with SIH syndrome have normal CSF pressure and since a downward displacement of the brain due to a reduction of the buoyant action of CSF may induce symptoms, CSF hypovolemia, not intracranial hypotension, may be the cause. Based on the Monro-Kellie doctrine, detecting leaked CSF and venous engorgement (epidural vein dilatation and pachymeningeal enhancement) is an important clue to diagnose so-called SIH syndrome. Dilatation of epidural veins suggests CSF hypovolemia in appropriate conditions.
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To identify risk factors for fever among patients treated in a neurologic intensive care unit (NICU). ⋯ Fever occurs in nearly 25% of NICU patients, and is associated with increased length of stay and depressed level of consciousness. Endotracheal intubation is a risk factor for infectious fever, whereas intraventricular catheterization is a risk factor for unexplained fever, which suggests a role for ventricular hemorrhage in the pathogenesis of "central" fever. Subarachnoid hemorrhage increases the risk of developing fever of all types.
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Comparative Study Clinical Trial Controlled Clinical Trial
Development in pain and neurologic complaints after whiplash: a 1-year prospective study.
To prospectively examine the course of pain and other neurologic complaints in patients with acute whiplash injury and in controls with acute ankle injury. ⋯ Pain occurs with high frequency but low intensity after whiplash and ankle injury. Associated neurologic symptoms were not correlated to pain in ankle-injured controls, but were correlated to pain in patients with whiplash injury. Persistent symptoms in whiplash-injured patients may be caused by both specific neck injury-related factors and nonspecific post-traumatic reactions. Disability was only encountered in the whiplash group.