Neurology
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Comment Letter Case Reports
Re: Status epilepticus: an independent outcome predictor after cerebral anoxia.
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Comparative Study
Executive dysfunction and memory impairment in idiopathic REM sleep behavior disorder.
Idiopathic REM sleep behavior disorder (iRBD) might be a stage in the development of neurodegenerative disorders, especially Parkinson disease and dementia with Lewy bodies. Recent studies showing a slowing of waking EEG in iRBD suggest that iRBD is associated with cognitive impairment. ⋯ This study shows a co-occurrence of impaired cognitive profile and waking EEG slowing in patients with idiopathic REM sleep behavior disorder similar to that observed in early stages of some synucleinopathies.
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In our metropolitan area, the Stroke Code (SC) system allows immediate transfer of patients with acute stroke to a stroke center. It may be activated by community hospitals (A), emergency medical services (EMS, B), or the emergency department of the stroke center (C). Our aim was to analyze whether the SC activation source influences the access to thrombolytic therapy and outcome of patients with ischemic stroke. ⋯ Patients arriving directly to the stroke center via emergency medical services or on their own receive neurologic attention sooner, are more frequently treated with tPA, and have better clinical outcome than those patients who are first taken to a community hospital.
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Autopsy studies in patients who have been declared brain dead are rare. Total brain necrosis ("respirator brain") has been a common finding in the distant past. The time to brain fixation has been shortened as a result of timely organ transplant protocols, therefore the neuropathologic findings may be different than previously described. ⋯ No distinctive neuropathologic features were apparent in our series of patients with brain death. Neuronal ischemic changes were frequently profound, but mild changes were present in a third of the examined hemispheres and in half of the brainstems. Respirator brain with extensive ischemic neuronal loss and tissue fragmentation was not observed. Neuropathologic examination is therefore not diagnostic of brain death.