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  • 1
    Electronic Resource
    Electronic Resource
    Neuropsychological profile in myotonic dystrophy (1990)
    Springer
    Journal of neurology 237 (1990), S. 251-256 
    Details
    ISSN: 1432-1459
    Keywords: Myotonic dystrophy ; Neuropsychology ; Intellectual impairment ; Visuo-spatial functions ; Constructional functions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Twenty patients with myotonic dystrophy underwent neuropsychological evaluation. Performances were analysed with respect to general cognitive profile, family patterns of cognitive impairment, relation with sex, age, extent of muscular involvement, and sex of affected parent. Results showed severe intellectual deficit in 50% of patients and selective impairment of visuospatial and constructional functions. Female patients showed significantly worse global intellectual status than males. No difference in intellectual level was observed in patients with respect to age, extent of muscular involvement and sex of affected parent. No family pattern of cognitive impairment could be identified. Our results show that an extensive neuropsychological battery can reveal the existence of selective mental impairment. It may provide further data on cognitive impairment onset, progression and relation to muscular involvement.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00314629
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  • 2
    Electronic Resource
    Electronic Resource
    Reversible multifocal encephalopathy following tuberculous infection (1989)
    Springer
    Neurological sciences 10 (1989), S. 163-170 
    Details
    ISSN: 1590-3478
    Keywords: Tuberculous encephalopathy ; tuberculomas ; localized encephalitis ; computed tomography ; magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario L'infezione encefalica tubercolare è comunemente descritta come esclusiva di individui asiatici o africani, o di soggetti che vivono in scadenti condizioni igieniche; molto spesso essa segue la meningite nei pazienti con evidente tubercolosi polmonare. Vengono qui descritti tre casi di encefalopatia tubercolare multifocale in pazienti italiani di buona condizione socio-economica. Due di essi non mostravano né meningite né tubercolosi polmonare quando comparvero i segni di compromissione del S.N.C. In particolare viene descritto il completo recupero dopo terapia medica e vengono riportate le caratteristiche TAC e, in un caso, di Risonanza Magnetica Nucleare. I dati strumentali suggeriscono che questi casi rappresentano una forma localizzata di encefalite, sensibile al trattamento medico, a differenza dei tubercolomi che richiedono spesso il trattamento chirurgico. Il verificarsi di infezione encefalica tubercolare in pazienti occidentali di buon livello socio-economico suggerisce che la encefalopatia tubercolare deve rientrare nella diagnosi differenziale delle lesioni cerebrali multifocali.
    Notes: Abstract Tuberculous encephalic infection is commonly reported as confined to Asians or Africans or people living in poor hygienic conditions; very often it follows meningitis in patients with lung TB infection. We describe three western patients coming from good social environment and suffering from multifocal tuberculous encephalopathy. Two of them showed neither meningitis or lung TB when CNS involvement appeared. Complete recovery after therapy is described, together with the evolution of brain CT and, in 1 case, MRI features. The instrumental findings accompanying the complete recovery suggest that the lesions described in these cases are a localized form of encephalitis responsive to medical treatment, unlike tuberculomas, which often need surgical treatment. The occurrence of tuberculous encephalic infection in western, middle-class patients with or without meningitis emphasizes that tuberculous encephalopathy must be considered in the differential diagnosis of multifocal brain lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02333613
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  • 3
    Electronic Resource
    Electronic Resource
    Cerebral venous thrombosis in young adults (1996)
    Springer
    Neurological sciences 17 (1996), S. 419-422 
    Details
    ISSN: 1590-3478
    Keywords: Cerebral venous thrombosis ; Stroke ; Oral contraceptives
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Descriviamo 9 casi di trombosi dei seni venosi cerebrali di età inferiore a 45 anni, ricoverati consecutivamente nel nostro reparto dal 1988 al 1994. Due erano uomini e sette donne. In otto la cefalea era stata il sintomo iniziale, spesso associata ad altri segni di ipertensione endocranica. Sette pazienti avevano deficit motori focali e quattro crisi comiziali. Nessun paziente è deceduto e solamente uno è rimasto gravemente disabile, mentre gli altri hanno recuperato la autosufficienza in due mesi. Nelle donne l'uso di contraccettivi orali sembrava essere fortemente associato con la trombosi dei seni venosi. La trombosi venosa cerebrale va sempre ricordata nella diagnosi differenziale dell'ictus nei pazienti giovani.
    Notes: Abstract We report a series of nine patients younger than 45 years with angiographically-documented cerebral venous thrombosis, consecutively referred to our Stroke Unit from 1988 to 1994. Two of them were men and seven women. Eight patients initially complained of headache, often associated with other symptoms of increased intracranial pressure. Seven patients had focal motor deficits and four suffered from epileptic seizures. None of the patients died. Only one patient remained severely disabled, whereas the others recovered self-sufficiency within two months. The use of oral contraceptives was closely associated with the occurrence of venous thrombosis in the women. Cerebral venous thrombosis is to be kept in mind in the differential diagnosis of stroke in the young.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01997716
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  • 4
    Electronic Resource
    Electronic Resource
    Acute rhabdomyolysis associated with acute cocaine intoxication. A case report (1993)
    Springer
    Neurological sciences 14 (1993), S. 325-327 
    Details
    ISSN: 1590-3478
    Keywords: Cocaine ; rhabdomyolysis ; HIV infection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Viene descritto un caso di rabdomiolisi acuta associata ad intossicazione acuta da cocaina in un giovane HIV-positivo asintomatico e sono discussi i possibili meccanismi patogenetici del danno muscolare. Si sottolinea che una recente assunzione di cocaina deve essere considerata tra le cause di rabdomiolisi acuta senza fattori precipitanti evidenti anche nel nostro paese. L'atteggiamento tipicamente poco collaborante degli abituali consumatori di stupefacenti può rendere molto difficile il completamento della diagnosi differenziale.
    Notes: Abstract We report a case of acute rhabdomyolysis associated with acute intravenous cocaine intoxication in an asymptomatic HIV-positive young man and discuss the possible pathogenetic mechanisms. Recent cocaine use must be considered among the causes of acute rhabdomyolysis without obvious precipitanting factors in our country too. The characteristically uncollaborative attitude of habitual drug users may make differential diagnosis very difficult to establish.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02339300
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  • 5
    Electronic Resource
    Electronic Resource
    Essential thrombocytemia and ischemic stroke: Report of six cases (1994)
    Springer
    Neurological sciences 15 (1994), S. 359-362 
    Details
    ISSN: 1590-3478
    Keywords: essential thrombocytemia ; stroke ; large artery obstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario La Trombocitemia Essenziale è una malattia mieloproliferativa a cause ignota caratterizzata da un aumentato numero di piastrine apparentemente normali. Associata a numerose e generalmente lievi complicazioni ischemiche, più raramente è stata riportata la sua associazione a stroke acuto da documentata ostruzione dei grossi vasi. Noi qui descriviamo 6 pazienti con stroke ischemico acuto associato a Trombocitemia Essenziale. Si tratta di 4 uomini e 2 donne di età media 61,7 anni (limiti 49–78). La diagnosi di Trombocitemia Essenziale fu fatta dopo l'evento ischemico. Il numero di piastrine non è mai risultato particolarmente elevato in fase ictale. In 2 pazienti non vi erano fattori maggiori di rischio cardiovascolare. In 3 vi era interessamento della circolazione posteriore, in 2 della anteriore e in uno del territorio di confine. In tutti è stata documentata ostruzione di grossi vasi arteriosi extra o intracranici. Tutti i pazienti sono stati trattati con terapia antiaggregante (aspirina o ticlopidina). L'evoluzione è stata favorevole in 3 pazienti, discreta in 1 e mediocre in 2. Si ipotizza che la Trombocitemia Essenziale possa essere considerata tra le cause associate a stroke acuto da ostruzione dei grossi vasi.
    Notes: Abstract Essential thrombocytemia (ET) is a clonal myeloproliferative disorder of unknown cause, characterized by an increased number of apparently normal platelets. It has been related to a large number of mild ischemic complications, but rarely to acute stroke associated with documented large vessel thrombosis. We report the cases of 6 patients with acute ischemic stroke associated with ET (4 men and 2 women; mean age 61.7: range 49–78 years). The diagnosis of ET followed the onset of the stroke. The number of platelets was never greatly increased at the time of the stroke, and two patients presented no major risk factors for stroke. The involvement of the posterior circulation was observed in three patients, that of the anterior circulation in two patient and that of the border territory in one. The obstruction of large intracranial or extracranial vessles was detected in all of the patients, and all of them were treated with antiplatelet agents (aspirin or ticlopidine). The outcome was good in 3 patients, fair in one and bad in two. We retain that ET might be a cause of acute ischemic stroke as a result of large vessel obstruction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02339933
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  • 6
    Electronic Resource
    Electronic Resource
    Length of hospitalization of patients with transient ischemic attacks (2000)
    Springer
    Neurological sciences 21 (2000), S. 223-228 
    Details
    ISSN: 1590-3478
    Keywords: Key words Transient ischemic attack ; Stroke ; Costs ; Cost analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective. To investigate factors that influence length of stay (LOS) in patients hospitalized for transient ischemic attacks (TIAs). This may help to reduce unnecessary days of hospitalization. Design. Retrospective study. Setting. A large, non-academic general hospital. Patients. All patients hospitalized for TIAs during the year 1996–1998 were retrospectively studied. We analyzed the relationship between demographic, clinical and management features and LOS. Results. We studied 157 patients. Median LOS was 8 days (range, 1 to 21 days). Statistical analysis showed that female sex, being hospitalized in 1996, hospitalization from Wednesday through Saturday, and second-level cardiological, neuroradiological and miscellaneous investigations significantly increased LOS. Conclusions. The LOS of patients with TIAs may be reduced through measures that accelerate the diagnostic work-up and by scheduling the admission to the first days of the week, when this is possible.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100720070080
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  • 7
    Electronic Resource
    Electronic Resource
    Commissurotomy in intractable epilepsy: clinical and surgical comment (1987)
    Springer
    Neurological sciences 8 (1987), S. 571-577 
    Details
    ISSN: 1590-3478
    Keywords: Intractable epilepsy ; Commissurotomy ; Surgical procedure ; Disconnection syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Due pazienti con crisi epilettiche resistenti alla terapia medica sono stati sottoposti a commissurotomia “centrale” in due tempi. In un paziente si è eseguito per prima la callosotomia anteriore; nell'altro la procedura chirurgica è stata eseguita in ordine inverso. Vengono riportati gli aspetti clinici, EEG e neuropsicologici dei due pazienti prima dell'intervento, tra il primo ed il secondo tempo dell'intervento e dopo il completamento della commissurotomia. Sono descritti in dettaglio gli aspetti chirurgici delle due diverse procedure ed i quadri clinici ad essi correlati.
    Notes: Abstract Two patients suffering from seizures unresponsive to medical treatment underwent two-stage “central” commissurotomy. In one patient anterior callosotomy was carried out first; in the other the surgical procedure was performed in the reverse order. The clinical, EEG, and neuropsychological features of the two patients are reported before the operation, between stage 1 and stage 2 of the procedure, and after completion of the commissurotomy. The surgical aspects of the two different procedures and the related clinical pictures are described in detail.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02333664
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  • 8
    Electronic Resource
    Electronic Resource
    Unusual findings in Creutzfeldt-Jakob disease. Case report (1988)
    Springer
    Neurological sciences 9 (1988), S. 279-282 
    Details
    ISSN: 1590-3478
    Keywords: Creutzfeldt-Jakob disease (CJD) ; CSF oligoclonal bands ; visual evoked responses (VER)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Il significato neurobiologico e il valore per la diagnosi differenziale delle alterazioni dei PEV e della presenza di bande oligoclonali nel CSF nella CJD viene discusso in un caso.
    Notes: Abstract We present a definite case of Creutzfeldt-Jakob disease (CJD) with visual evoked response (VER) and CSF oligoclonal band abnormalities and discuss the neurobiological significance and diagnostic value of these findings.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02334054
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  • 9
    Electronic Resource
    Electronic Resource
    Cognitive behavior in asymptomatic (CDC stage II and III) HIV — seropositive intravenous drug users (IVDUs) (1993)
    Springer
    Neurological sciences 14 (1993), S. 619-625 
    Details
    ISSN: 1590-3478
    Keywords: HIV infection ; intravenous drug users ; cognitive functions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Allo scopo di valutare la presenza di una compromissione cognitiva in soggetti tossicodipendenti sieropositivi per l'infezione da HIV, asintomatici, abbiamo studiato 39 pazienti (stadio II e III CDC) che avevano quale unico fattore di rischio l'assunzione di eroina endovenosa. Come gruppo di controllo sono stati studiati 30 soggetti tossicodipendenti privi di infezione da HIV. Tutti sono stati sottoposti ad una valutazione neuropsicologica mediante una batteria testistica rivolta allo studio delle abilità intellettive globali e delle singole funzioni cognitive. Si sono riscontrate differenze statisticamente significative fra pazienti e controlli nei tests di attenzione e di abilità visuo-motoria; il 20% dei sieropositivi asintomatici e con PGL ha mostrato alterazioni in 2 o più test cognitivi rispetto al 3% dei controlli (p〈0.001). I nostri risultati mostrano la presenza di deficit cognitivi in una percentuale significativa di pazienti tossicodipendenti da eroina in fase asintomatica di infezione. Il deficit appare selettivo per la funzione attentiva e le capacità visuo-motorie risparmiando le capacità intellettive globali.
    Notes: Abstract To evaluate cognitive impairment in the early stages of HIV infection in intravenous drug users (IVDUs) we have studied 39 consecutive HIV-infected subjects (CDC stage II–III) whose only known risk factor for the infection was intravenous heroin addiction. The control group was represented by 30 seronegative IVDUs. All subjects were tested with an extensive neuropsychological battery assessing general intellectual abilities and single cognitive functions. The patients differed from controls only for tests of attention and visual-motor abilities: 20% of asymptomatic seronegative and PGL patients showed alterations in two or more cognitive tests, as opposed to 3% of controls (p〈0.001). Our findings suggest that cognitive deficits seem to be present in a substantial percentage of IVDUs with asymptomatic HIV infection. Cognitive damage at this stage seems to selectively involve attention and visual-motor abilities, sparing general intellectual performances.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02339246
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  • 10
    Electronic Resource
    Electronic Resource
    Prognostic use of ultrasonography in acute non-hemorrhagic carotid stroke (1996)
    Springer
    Neurological sciences 17 (1996), S. 215-218 
    Details
    ISSN: 1590-3478
    Keywords: Ultrasonography transcranial doppler ; Ischemic carotid stroke ; Internal carotid artery ; Outcome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Abbiamo sottoposto 76 pazienti consecutivi, di età media di 68.1±8.9 anni, ricoverati per un primo ictus ischemico nei territori carotidei, a studio ecodoppler delle biforcazioni carotidee e a doppler transcraniale delle arterie del basicranio, per valutare se le informazioni ricavate dagli studi ultrasonori potessero essere di aiuto a fini prognostici, 43 pazienti (56.6%) presentavano occlusione di una appropriata arteria agli ultrasuoni. A 30 giorni dall'ictus, 22 pazienti (28.9%) erano autosufficienti, 41 pazienti (53.9%) erano dipendenti e 13 pazienti (17.1%) erano morti. Al test del Chi quadrato, i risultati degli ultrasuoni erano significativamente correlati alla prognosi a 30 giorni (p=.0003). Dopo analisi di regressione logistica multipla, i risultati degli ultrasuoni rimanevano indicatori prognostici indipendenti (p=.0129) insieme alle dimensioni della lesione ischemica alla TAC encefalo ripetuta tra il 4° e il 7° giorno dallo stroke e alla gravità neurologica a 24 ore dall'esordio dei sintomi. Il nostro studio suggerisce che gli ultrasuoni potrebbero essere utili nelle decisioni cliniche dei pazienti con stroke ischemico carotideo quali indicatori precoci di prognosi.
    Notes: Abstract In order to evaluate whether the results of ultrasound examination may be associated with 30-day outcome, 76 consecutive patients (43 men and 33 women; mean age 68.1±8.9 years) underwent duplex scanning of the carotid bifurcations and transcranial doppler investigation of the basal skull arteries within the first few hours of the onset of an acute carotid stroke. Forty-three patients (56.6%) had appropriate arterial occlusion at ultrasounds examination. On day 30, 22 patients (28.9%) were self-sufficient, 41 (53.9%) were disabled and 13 (17.1%) were dead. The chisquared test showed that the ultrasound results were significantly related to 30-day outcome (p=.0003). After logistic regression analysis, the ultrasound results remained independent predictors of 30-days outcome (p=.0129), together with neurological impairment 24 hours after stroke onset and lesion size at control computed tomography. Our study suggests that the results of ultrasound examination may be useful in the management of acute carotid stroke as an early indicator of patients with a worse prognosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01995686
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