Neurology
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We measured wrist tremor and forearm EMG in 18 patients with essential tremor on two occasions separated by periods of 4 to 8 years. The frequency of tremor decreased 0.28 Hz to 3.21 Hz in 10 patients and changed less than 0.25 Hz in the remaining eight patients. Thus, the frequency of essential tremor may decrease over time.
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Case Reports
Toxoplasmosis with early intracerebral hemorrhage in a patient with the acquired immunodeficiency syndrome.
Cerebral hemorrhage is a rare complication of the acquired immunodeficiency syndrome. We report a case of multifocal hemorrhage in a 37-year-old homosexual man with cerebral toxoplasmosis. Histopathologic examination, performed at cerebral autopsy, confirmed the findings on CT and MRI.
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We determined the prevalence of dementia and probable senile dementia of the Alzheimer type (SDAT) for biennial Exam 17 of the Framingham cohort (1982/1983). The prevalence of dementia was 30.5/1,000 for men and 48.2/1,000 for women and increased with advancing age. ⋯ Prevalence of dementia and probable SDAT were greater for women than men. The female:male ratio of prevalence for cohort members 75 years of age and older was 1.8 for all cases of dementia and 2.8 for cases of probable SDAT.
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Review Comparative Study
A comparative study of the cerebrovascular complications of cocaine: alkaloidal versus hydrochloride--a review.
Cocaine, especially in its alkaloidal or "crack" form, has been increasingly associated with cerebrovascular disease. Before the crack epidemic, cocaine hydrochloride (HCl) was also implicated as a cause of stroke. However, less is known about the differences in stroke subtypes, age at stroke onset, or presence of underlying structural cerebrovascular disease with different forms of cocaine use. ⋯ Cerebral infarction was significantly more common among the alkaloidal cocaine users than in all the cocaine HCl users, and this was also true when alkaloidal cocaine users were compared with parenteral cocaine HCl (intravenous and intramuscular) users. Only hemorrhagic stroke has been reported with intravenous cocaine HCl use. We conclude that the pathogenesis of cocaine-related stroke is heterogeneous, and depends, in part, on the form of cocaine used.