Neurology
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Case Reports
Creutzfeldt-Jakob disease after receipt of a previously unimplicated brand of dura mater graft.
Iatrogenic Creutzfeldt-Jakob disease (CJD) transmission via dura mater grafts has been reported in many countries. In September 1998, a 39-year-old Colorado woman was reported as having suspected CJD after receiving a dura mater graft 6 years earlier. ⋯ The patient's age, absence of evidence for other sources of CJD, the latent period, and the report of an unexplained neurologic illness in the donor of the dura mater indicate that the graft was the most likely source of CJD in this patient.
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Two patients with similar courses of neurologic impairment and subsequent recovery after cerebral air embolism complicating cardiac ablation procedures are described. Hyperbaric oxygen therapy, combined with aggressive resuscitative efforts, appears to have contributed to each patient's recovery.
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This report uses Medicare data to provide insight into the patient care services most often provided by neurologists. ⋯ Patient care continues to be the main service of neurologists, with office care more than hospital care. Established patient care is an important part of patient services, confirming the role of the neurologist in principal care. Neurologists' patient care levels of service are higher than for other physicians.