Mayo Clinic proceedings
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We reviewed the medical records of 70 patients with systemic cancer in whom a subdural hematoma (SDH) developed. Among patients with a solid tumor, trauma and use of anticoagulants were common causes of SDH, and these patients had a relatively favourable outcome. Among patients with a hematologic cancer and in the rest of the patients with a solid tumor, coagulopathies and dural metastatic involvement were the most common causes of SDH. Recurrent SDH and death due to SDH were common in the latter group.
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Multiple sclerosis, an inflammatory disease of the central nervous system, is characterized by primary destruction of myelin. This review covers recent advances in neuropathology, immunogenetics, neuroimmunology, and neurovirology that have provided insights regarding its pathogenesis. ⋯ A paradigm for induction of primary demyelination is proposed in which immune cells recognize "foreign" antigens on the surface of oligodendrocytes in the context of major histocompatibility complex gene products. The final result of this scheme may be "dying-back gliopathy," the alteration being noted first in the most distal extension of the oligodendrocyte--that is, the myelin sheaths.
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Mayo Clinic proceedings · Feb 1989
Case ReportsProper use of aerosol corticosteroids to control asthma.
Aerosol glucocorticoids are highly effective in the treatment of bronchial asthma. Clinically apparent systemic hypercortisolism is virtually nonexistent in patients who receive such therapy, although local effects of candidiasis or dysphonia may occur. ⋯ Furthermore, many patients with asthma require 2 or 3 times the conventional dose of aerosol corticosteroids for optimal control of pulmonary function. Careful coaching is essential for the successful use of aerosol corticosteroids.