Current neurology and neuroscience reports
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Curr Neurol Neurosci Rep · Mar 2002
ReviewHemicrania continua: recent treatment strategies and diagnostic evaluation.
Hemicrania continua (HC) is a primary headache disorder that is characterized by a continuous unilateral headache of moderate severity, exacerbations of severe pain, and complete responsiveness to indomethacin. HC was once thought to be a rare headache disorder, but now many cases have been reported. ⋯ Variants such as hemicrania continua with aura have been described, and secondary cases may occur. Indomethacin is the best treatment, although HC could respond to other nonsteroidal anti-inflammatory drugs, such as the selective cyclo-oxygenase-2 inhibitors.
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Tremendous progress has been made in the diagnosis, prevention, and treatment of pediatric stroke. With a complete investigation, stroke etiology can be determined in most children, and multiple factors are commonly identified. ⋯ The prognosis after pediatric stroke is usually good, but today we can identify and initiate treatment in selected patients at risk for long-term problems. This article reviews recent advances in the identification, prevention, treatment, and outcome in pediatric ischemic stroke.
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Outcomes research is a new and developing field that attempts to better measure the results of medical care. Neurocritical care is a relatively new field of medicine focusing on the care of critically ill patients with primary or secondary neurologic problems. Much needs to be done to examine the outcomes of neurocritical care, and the following is a review of the pertinent concepts of both outcomes and neurocritical care research.
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Neglect, a failure to attend or act in one part of space, is a common disturbance following cerebral lesions. This article outlines the signs and symptoms of neglect. ⋯ Neglect in directions other than the horizontal is discussed, as are directional biases found in normal control subjects. The article also examines the anatomy of lesions causing neglect and theoretical models of the cerebral mechanisms underlying neglect.
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Curr Neurol Neurosci Rep · Nov 2001
ReviewCritical care of intracerebral and subarachnoid hemorrhage.
The acute management of primary intracerebral or aneurysmal subarachnoid hemorrhage requires a comprehensive approach involving stabilization of the patient, surgical intervention, and continued intensive care treatment of medical and neurologic complications. The are several causes of intracerebral hemorrhage (ICH), including hypertension, cerebral amyloid angiopathy, sympathomimetic drugs, and coagulopathies. More recently, use of thrombolytic agents in the treatment of acute ischemic stroke has increased the risk of ICH. ⋯ Patients with aneurysmal subarachnoid hemorrhage may experience rebleeding, symptomatic vasospasm, or hydrocephalus. Medical management in the intensive care unit with careful attention to fluid and electrolyte balance, nutrition, cardiopulmonary monitoring, and close observation for changes in the neurologic exam is vital. This review examines the diagnosis and intensive care management of patients with intracerebral or subarachnoid hemorrhage, and reviews some of the newer therapies for treatment of these disorders.