Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
-
Case Reports
Recovery from acute paraplegia due to spontaneous spinal, epidural hematoma under minimal-dose acetyl-salicylic acid.
Spontaneous spinal epidural hematoma (SEH) has not been reported under anti-thrombotic therapy with acetyl-salicylic acid (ASA) in a dosage of 50 mg/d. ⋯ This case shows that SEH occurs under a minimal dose of ASA and that such patients rapidly recover upon immediate surgical decompression and evacuation of the hematoma.
-
The modern treatment of spontaneous intracranial hemorrhages requires a multidisciplinary approach including neurosurgery, interventional neuroredicology, vascular neurology and radiosurgery to determine the best management strategy.
-
Primary intracerebral hemorrhage is the least treatable form of stroke and is associated with high mortality rates. In the thrombolytic era, the attention has bee driven on the first hours of onset, when the hematoma is still growing. ⋯ Even if recombinant activated factor VII administered within 4 h of symptom onset did not improve outcome in a recent phase 3 trial, it reduced hematoma growth. Therefore, the rational for ultra-early hemostatic therapy it is still valid and another trial on hemostatic treatment is warranted.
-
Intracerebral hemorrhage (ICH) accounts for between 10% to 30% of first-ever strokes; outcomes are significantly worse than with ischemic stroke with a 30-day mortality rate up to 50%, furthermore, half of the deaths occur in the acute phase. Intracerebral hemorrhage (ICH) is classified as primary or secondary according to the underlying etiology. Primary ICH (about 80%) comes from the spontaneous rupture of small vessels more often in relation to long-standing or uncontrolled arterial hypertension and is generally located in the basal ganglia and internal capsula. ⋯ Rapid recognition and diagnosis of ICH as well as identification of early prognostic indicators are essential for planning the level of care and avoiding acute rapid progression during the first hours. Hematoma size has been identified as one of the most important predictors of 30-day mortality and its expansion is highly predictive of neurological deterioration. Blood pressure management remains, although controversial, the first-line medical approach along with possible new and effective treatments coming from the numerous between pilot and larger randomized medical trials for ICH completed in the past decade.
-
To assess whether Parkinson Disease (PD) patients are impaired at perceiving emotions from facial and prosodic cues and whether any putative defective performance concerns recognition of a particular emotion. ⋯ Face emotion processing is impaired in PD patients, with a disproportionate deficit involving fear and sadness. The pattern of face expression processing impairment in PD patients might depend on the regional distribution of the pathology. The widespread involvement of both emotional and propositional prosodic processing parallels the aprosodic characteristics of Parkinsonian speech production.