Journal of neurology
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Stroke is the third most common cause of death and the leading cause of long-term neurological disability in the world. Conventional vascular risk factors for stroke contribute approximately to only forty to fifty percent of stroke risk. Genetic factors may therefore contribute to a significant proportion of stroke and may be polygenic, monogenic or multi-factorial. ⋯ Monogenic stroke disorders include conditions such as cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) and hereditary endotheliopathy, retinopathy, nephropathy and stroke (HERNS). In addition, other monogenic conditions such as sickle cell and Fabry disease also lead to stroke. These monogenic disorders cause either small vessel or large vessel stroke (or a combination of both) and serve as useful models for understanding and studying conventional stroke and cerebrovascular disease and its accompaniments such as vascular dementia.
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Journal of neurology · Jun 2006
Comparative StudyMislocalization of tactile stimulation in patients with complex regional pain syndrome.
Complex-Regional-Pain-Syndromes (CRPS) are characterized by sensory,motor and autonomic dysfunctions. Patterns of sensory symptoms suggest changes within the central nervous system (CNS). Recently, we could show substantial reorganization of somatotopic maps within the central nervous system of patients with CRPS using functional imaging techniques (Maihofner et al. ⋯ Presence of mechanical hyperalgesia significantly predicted the occurrence of mislocalizations. In contrast, in a healthy control group, no mislocalizations were found. Thus, our results further support the concept of pain-induced reorganization in the somatosensory system of CRPS patients.
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Journal of neurology · May 2006
Comparative StudyDexamethasone and prognostic factors in adults with bacterial meningitis.
To determine the effect of dexamethasone on prognostic factors in adults with bacterial meningitis. ⋯ Routine use of dexamethasone therapy may lead towards new risk stratification in adults with bacterial meningitis.
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Journal of neurology · May 2006
Comparative StudyFluid-attenuated inversion recovery (FLAIR) sequences for the assessment of acute stroke: inter observer and inter technique reproducibility.
Diffusion-weighted magnetic resonance (MR) imaging (DWI), and three-dimensional (3D) time-of-flight (TOF) MR angiography (MRA), are highly sensitive for the early detection of stroke and arterial occlusion. However, only a few studies have evaluated the sensitivity of conventional MR sequences that are usually included in the imaging protocol. The aim of this study was to evaluate interobserver and intertechnique reproducibility of Fluid-Attenuated Inversion Recovery (FLAIR) sequences for the diagnosis of early brain ischemia and arterial occlusion. ⋯ Although DWI is the most sensitive technique with which to detect acute stroke, FLAIR imaging may also be useful to demonstrate both acute ischemia and arterial occlusion with an excellent interobserver reproducibility.
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Journal of neurology · May 2006
Comparative StudyLong-term intrathecal baclofen therapy in ambulatory patients with spasticity.
Intrathecal baclofen (ITB) is an effective treatment for severe spasticity. In ambulatory patients with spasticity, it is possible that ITB treatment may compromise ambulatory function by unmasking underlying muscle weakness. This retrospective study is designed to determine the long-term ambulatory function in patients receiving ITB. ⋯ ITB therapy may be used in selected ambulatory patients with spasticity and is not associated with loss of ambulatory function.