Current neurology and neuroscience reports
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Intraventricular hemorrhage (IVH) may occur as an isolated event from primary ventricular bleeding or as a complication of brain hemorrhage from another etiology. It is associated with high mortality and morbidity. Recent translational and clinical studies demonstrate that thrombolytic drugs administered intraventricularly through an external ventricular drain to lyse an IVH clot are safe and may reduce morbidity and mortality. ⋯ Preliminary data show marked reduction in time to clot lysis as well as a potential reduction in mortality associated with IVH lysis. A large, phase III, randomized prospective trial to ascertain the true clinical efficacy of this treatment is currently in the planning stages. A review of the use of thrombolytics for treatment of IVH related to other secondary causes is also provided.
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Curr Neurol Neurosci Rep · Sep 2007
ReviewHorner's syndrome, Pseudo-Horner's syndrome, and simple anisocoria.
This discussion reviews the common causes of Horner's syndrome, with emphasis on case reports from the past several years. Much of the recent literature concerns the use of apraclonidine as a diagnostic test for Horner's syndrome, possibly as an alternative for the current gold standard of cocaine eye drops. This new literature is discussed in the context of the current standards for clinical diagnosis.
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The dilated pupil can present a significant challenge to the clinician. Although in most cases a complete history and physical examination is sufficient to make an accurate diagnosis, selected patients will require further investigation, including pharmacologic testing and neuroimaging. This review outlines the physiology, clinical features, and diagnostic approach to the most important causes of the dilated pupil. Particular attention is given to recent publications on this topic.
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Diagnosis and monitoring of Alzheimer's disease and the related dementias have long depended principally on clinical examination, especially cognitive testing. Establishment of biomarkers, which might assist in diagnosis or tracking of disease progression, would be a highly valuable addition to the care of patients. ⋯ As specific disease-modifying therapies for Alzheimer's disease are developed, biomarkers may improve diagnostic accuracy and facilitate clinical trials, allowing a better gauge of treatment response. In this review, we focus on biomarkers in cerebrospinal fluid and plasma, including measurements of the proteins tau and beta-amyloid.