摘要:

The diagnosis of transient ischemic attacks (TIAs) is subject to considerable interobserver variation. One of the reasons may be that the diagnostic guidelines are phrased in abstract diagnostic terms such as amaurosis fugax, which require an interpretation of symptoms. The reliability of the diagnosis of TIA can be improved if the nature and time course of the symptoms are recorded in plain language. Another reason may be the arbitrary upper time limit of 24 h, while most clinical evidence suggests that TIAs and ischemic strokes should be regarded as a continuum rather than as separated subgroups. The overall risk of stroke or death in untreated TIA patients is approximately 10% per year. Recent studies have identified the following specific risk factors: increased age; male gender, multiple attacks; dysarthria; other vascular diseases, including diabetes, claudication, and angina, and the presence of various abnormalities on CT scan or electrocardiography. Patients with monocular visual symptoms only or vertigo as a main symptom have half the risk of patients with hemispheric attacks. The risk of stroke is specifically associated with an elevated hematocrit, and gradually increases with the duration of symptoms, independent of the classical ''boundaries'' at 24 h and 6 weeks which separate TIAs, reversible ischemic neurological deficits and strokes. Patients with symptoms atypical for a TIA may have a low risk of stroke but a high risk of major cardiac events. These findings underscore the need to (1) stratify patients with cerebral ischemia according to the risk of subsequent vascular events, especially in therapeutic trials, and (2) focus on the nature rather than the duration of symptoms.

ISSN:1015-9770    

DOI:10.1159/000108560

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The long-term prognosis after left tuberothalamic infarction was studied in a selected group of 7 patients who had memory disturbances sufficiently severe to warrant neuropsychological consultation and rehabilitation. The mean age of the patients was 46.7 ± 5.6 years and the mean follow-up time 22.3 ± 15.0 months. At the acute stage 4 patients had dysphasia, 1 hemiparesis, and 1 vertical gaze paresis. These improved well. All 7 had memory disturbances, which remained the dominant disability. Four patients had severe behavioral symptoms (psychosis, depression, anxiety) at the acute stage. The most common residual behavioral symptoms were inactivity and depression. At the end of rehabilitation (mean 15.4 months) clear residual disturbances in verbal memory and learning were still observed. These prevented return to work in all but 1 case. No case of true dementia was foun

ISSN:1015-9770    

DOI:10.1159/000108449

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:1015-9770    

DOI:10.1159/000108564

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:1015-9770    

DOI:10.1159/000108565

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Bilateral horizontal gaze palsies are rare, and we are aware of only 1 previously reported case that was due to a primary pontine hemorrhage (PPH). We report a 2nd patient with a primary pontine tegmental hemorrhage resulting in bilateral horizontal gaze palsy but preserved consciousness. Our case confirms that bilateral horizontal gaze palsies can result from a discrete PPH detected by MRI and that PPH should be considered in the differential diagnosis of this rare and selective ophthalmoplegia. In addition, an attempt is made to explain the disparity between the unimpaired consciousness in this patient and such a pontine lesion.

ISSN:1015-9770    

DOI:10.1159/000108450

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:1015-9770    

DOI:10.1159/000108451

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:1015-9770    

DOI:10.1159/000108452

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:1015-9770    

DOI:10.1159/000108566

出版商:S. Karger AG    

年代:1994

数据来源: Karger