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E Mostacero

Publications and source records attributed to E Mostacero.

At least 19 recordsLinked to original sources
PubMed1998

The hypnic headache syndrome: report of three new cases.

Three new cases compatible with hypnic headache syndrome (HHS) are presented. The patients were 70, 77, and 79 years of age (2F, 1M). They described a history of nocturnal headache ranging from 5 months to 7 years. One patient was afflicted with diffuse pain but the other two had unilateral pain. In one patient headache was clearly related with dreams, but in the other two this point could not be confirmed. Except for headache being unilateral in two cases, the remaining HHS criteria were present. It is noteworthy that pain responded to flunarizine in two patients.

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PubMed1998

[Mitochondrial respiratory chain deficiency may present as multiple sclerosis].

Defects of the mitochondrial respiratory chain are associated with a great variety of clinical disorders. In addition to the well recognized syndromes, a significant number of patients present non-specific encephalopathic disorders. In consequence these types of mitochondrial disorder are very difficult to diagnose on clinical features alone. In this paper, we describe the clinical and the magnetic resonance findings of 2 patients with a neurological syndrome indistinguishable from multiple sclerosis (Poser). Muscle biochemistry revealed defect of complex IV of the respiratory chain. We think that these patients have a mitochondrial encephalomyopathy. We suggest that in patients presenting as atypical multiple sclerosis it could be necessary investigating mitocondrial encephalopathy.

Adult↗
PubMed1998

[The referral of hospitalized patients with cerebrovascular pathology. Where, when and why. A cross-sectional multicenter study of the referral of patients with ischemia and predisposing factors].

OBJECTIVES: Referral of patients with ictus on discharge from hospital is a daily problem for neurologists, both because of the suitability of one place or another for maximum recovery of the patient and because of the effect on average stay, complications and use of resources. The aim of this study was to determine where and when patients with ictus were referred and what factors affect whether a patient goes to one place or another. PATIENTS AND METHODS: A transversal multicentric study (3 months) using a questionnaire was sent to all Insalud hospitals in Aragon, recording data of 128 patients from four hospitals. There were questions on medical, functional, demographic and socio-economic factors which might affect referral. RESULTS: On discharge 20% of the patients did not return to their own homes. In 50% of the cases where patients went to a supporting hospital (SH) socio-economic factors were decisive and in 20% were the only cause. Referral to SH was related to functional state and type of ictus, need for nursing care or rehabilitation, age, sex, marital status and place of residence. CONCLUSIONS: Apart from clinical criteria, many socio-economic factors determine the need for referral of patients to one place or another.

Adult↗
PubMed1997

[Reading-induced epilepsy: three new cases].

INTRODUCTION: Primary epilepsy of reading is a rare syndrome in which patients present with mandibular myoclonia when reading texts. Seizures are also frequently provoked by other stimuli. Occasionally they may be followed by generalized tonic-clonic seizures. CLINICAL CASES: We present the clinical features and electroencephalographs of three patients with epilepsy of reading, one of them also had seizures when playing chess and after doing arithmetic and the third after reading music. Treatment with valproic acid and clonazepam completely controlled the seizures in all three patients. In two cases we saw epileptiform activity on EEG whilst they were reading, although the basal EEG was normal. CONCLUSIONS: We believe that epilepsy of reading is under-diagnosed and emphasize the importance of careful questioning of epileptic patients as to factors which may precipitate the seizures. In view of the social problems which may arise, early recognition of the syndrome is important for the patient.

Adult↗
PubMed1997

[Hormonal response to stress after cerebrovascular accident: relation to type, size and site of the lesion].

OBJECTIVE: To study the relationship between the hormone response to stress seen after ACV (CVA) and the type, size and site of the lesion. MATERIAL AND METHODS: We made a prospective study of the relationship between stress hormones and the radiological characteristics of the lesion in 82 patients admitted to hospital for non AIT ACV (CVA). We assessed the 24 hour urine catecholamines (total catecholamines, adrenaline, noradrenaline, vanillylmandelic acid, metanephrines and dopamine) and the 24 hour urine cortisol, collected on the second and third day after admission respectively. The type, size and site of the lesions were studies on CT scans done between 3 and 7 days after admission. RESULTS: We studied 82 patients, 43 men and 39 women with an average age of 71.7. In 7 patients the lesion was parenchymatous haemorrhage; in 75 it was an infarct, which was small (< 6 cm3) in 30.5%, moderate sized (6-60 cm3) in 38.6% and large in 30.6%. In the cases of infarct, only the cortisol was significantly different in the three groups (average (DE) standard deviation, respectively: 80.6 (50), 114 (124) and 246 (207); p = 0.0014). This relationship persisted when the cortisol level was compared with the volume in cm3 (p = 0.0028). The cortical infarcts had significantly higher levels of cortisol than the more deeply situated infarcts (83.2 (55) as compared to 174 (184); p = 0.0321), but the latter were smaller and no difference was seen when size was taken into account. All findings were similar in haemorrhages and infarcts of equal size. CONCLUSIONS: There was no relationship between the catecholamines and the type or size of the lesion. In our series, the site of the lesion did not appear to have any effect on the characteristics or intensity of the hormone response.

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PubMed1996

[Clinical pathogenic heterogeneity and subcortical infarcts prognosis].

We present a descriptive study of 55 consecutive patients with subcortical infarct seen during the year 1993. We divided our sample into two groups: the first included a total of 49 patients with lacunar infarct (ischaemic lesion equal to or less than 20 mm in diameter or lacunar syndrome with no objective lesion). The second group consisted of six patients with subcortical infarct greater than 20 mm at its largest diameter. We touch upon vascular risk factors, probable etiology, clinical history and prognosis, trying to determine as to whether differences existed between the two groups or not. The sole case showing statistically significant difference was the clinical presentation syndrome although results are hardly conclusive given the small size of our sample groups.

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PubMed1994

Vascular malformation of the cerebellopontine angle associated with "SUNCT" syndrome.

A 70-year-old man complained of two distinct types of unilateral headache during the past fifteen years. When the illness began, the pain was intermittent and short-lasting. In successive years, the crises appeared in clusters and lasted weeks to months. At present, the pain occurs daily, and is located on the right side, from the forehead supraorbitally to the temporal region. Some attacks last 30 sec and are accompanied by tearing, conjunctival injection, rhinorrhea and a subjective need to micturate. Other headaches last 1/2-1 h and are occasionally accompanied by local ipsilateral dysautonomic symptoms. Attacks of pain are provoked by movements of the trunk and neck. A vascular malformation in the right cerebellopontine angle was demonstrated on cranial CT and MRI, and by angiography.

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PubMed1994

[Silent myocardial ischemia in patients with transient ischemic attacks].

Given evidence that ischemic heart disease is the most frequent cause of death in patients with cerebrovascular disease, we used ergometrics to screen 80 patients with TIA for silent myocardial ischemia (SMI) at the neurological unit of Hospital Clínico Universitario in Zaragoza, Spain. The patients were compared with a control group of 80 with no signs of heart disease. Neither the patients nor the controls had ever shown clinical signs of coronary ischemia and their baseline electrocardiograms were normal. Stress test results were positive in 25 (31%) of the TIA patients, and in 4 (5%) (p < 0.001) of the controls, showing that the prevalence of SMI is significantly higher in TIA patients than in the general population. Hiperlipidemia (75% testing positive versus 43% negative, p < 0.01) and diabetes (31% testing positive versus 13% negative, p < 0.01) were the risk factors statistically related with a positive stress test.

Adult↗
PubMed1992

[Peripheral neuropathy and correlation with risk factors in material from autopsies and amputations].

A morphological study of a series of 100 human peroneal nerves proceeding from autopsies and amputations of patients hospitalized for different diseases was performed. A relation between the morphologic findings and the risk factors of neuropathy to which the patients may have been exposed is established. Following the analysis of their results the authors found that peripheral neuropathy is more frequent than suspected in clinical practice. The peripheral nerve is relatively resistant to regional ischemia. The risk factors considered in the casuist included diabetes as that which most influences in determining morphological alterations compatible with neuropathy.

Adolescent↗
PubMed1992

[Morphologic and morphometric study of the superficial peroneal nerve. Use of material from autopsies and amputations].

A series of 100 human peroneal nerves proceeding from autopsies and amputations were studied by histologic and morphometric techniques with a qualitative and quantitative analysis of each being performed following the morphological criteria of Dick et al (1985). After evaluating the results the authors consider that the peripheral nerve proceeding from autopsies and amputations is useful for basic morphologic study providing it is adequately processed within the first 29 hours post-mortem and post-amputation. Previous studies demonstrating the existence of minimum morphological alterations in normal nerves is corroborated. In order to perform a correct morphological evaluation of the peripheral nerve a mere qualitative analysis is not sufficient but rather statistically evaluated quantitative parameters must be employed.

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PubMed1979

[Spontaneous carotid-cavernous fistula: angiogammagraphic findings and computer analysis (author's transl)].

The case of a 74-year-old woman with a carotid-cavernous fistula is reported. She was admitted to hospital with oliguria and generalized edema. After improvement of the edematous condition she suddenly presented intense, pulsatile, frontal cephalea. It was more intense on the right side and was accompanied by nausea and vomiting and swelling of the right eye with reddening, sharp pains, difficulty of movement, and loss of vision. Cerebral angiogammagraphy was practiced in anterior-posterior and right lateral view. A righ carotid-cavernous fistula was discovered with drainage through the superior ophthalmic vein and the deep venous system. The angiogammagraphic findings can be considered characteristic; it is important to obtain activity/time curves from various areas of interest in order to evaluate the degree of shunting and the pathway of drainage from the fistula. There was a good coorelation with the arteriographic findings. Eight cases of carotid-cavernous fistulas diagnosed with radionuclids have been published previously, though the activity/time curves were not determined by computer for any of them.

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PubMedDate not supplied

Long-term evolution of a laughing headache associated with Chiari type 1 malformation.

We describe an acute-onset, sharp, short-lasting (few seconds) headache at the vertex, that first occurred 10 years ago in a 44-year-old woman. Attacks were triggered by vigorous laughing. A magnetic resonance imaging study showed a Chiari type 1 malformation. To our knowledge, laugh-induced headache with long-term evolution in association with Chiari type 1 malformation has not been previously reported.

Adult↗
PubMedDate not supplied

[Functional prognosis of stroke patients after 3 months: determining factors].

OBJECTIVE: To analyze the factors involved in the functional prognosis of stroke patients three months after onset. PATIENTS AND METHODS: We made a prospective study of 288 patients with non-transient strokes who had been admitted consecutively to our hospital. Data was collected on a standardized questionnaire: age, sex, risk factors, latency of admission, interval of neurological attention (INA), severity of defect (classified on the Scandinavian scale: slight-moderate: SSS > 30/serious: SSS < or = 30), stay in hospital, development of complications and previous quality of life, after seven and ninety days. Two groups were considered according to Barthel's index (BI): acceptable recuperation: BI > 60 and poor recuperation BI < or = 60. RESULTS: The average age was 70.72 years and the latency of admission was 9.71 hours. After three months the functional prognosis was good in 145 patients. On bivariate analysis the latency of admission, severity of the stroke, age, development of complications, INA and BI, one week later were significant. Multivariate analysis confirmed as independent indicators of poor prognosis after 90 days: advanced age of the patient (p = 0.006), the development of complications (p = 0.0235), serious neurological defect (p = 0.0274) and the BI after seven days (p = 0.006). CONCLUSIONS: Advanced age of the patient, the extent of the defect and appearance of complications whilst in hospital were associated with poorer quality of life after three months. The INA > 6 hours also had a negative influence, although it was not confirmed to be an independent variable.

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PubMedDate not supplied

[Thalamic hematomas: etiology, clinical findings and prognosis].

INTRODUCTION: The appearance of new neuroimaging techniques has permitted study of large series of thalamic hematomas, amongst which differences have been observed according to the size and arterial territory affected. OBJECTIVE: To determine the existence or not of differences between thalamic hematomas, according to their arterial territory and size, with regard to the aetiology, clinical findings and short term prognosis. PATIENTS AND METHODS: A retrospective study was made of 60 patients admitted to hospital with the diagnosis of thalamic hematoma (between January 1987 and July 1997) classified according to localization as: anterior, dorsal, posterolateral, posteromedial and global, and according to size as: large (> 20 mm), and small (< 20 mm) in which we analyzed the aetiology, clinical signs and prognosis up to discharge from hospital. RESULTS: The commonest aetiology was found to be arterial hypertension (60%); with regard to the arterial territory involved we have observed different clinical and prognostic features but the number of patients in each group was too small to permit statistical analysis. Significant differences were shown with regard to the size of the hematoma: large hematomas more often extended to nearby structures, caused hydrocephalia, were associated with alteration in the level of consciousness, severe motor deficit, oculomotor changes, alteration in superior functions and hemianopsia, and had worse prognosis and increased mortality and dependence in everyday activity than small hematomas. CONCLUSION: According to their size, thalamic hematomas show statistically significant clinical and prognostic differences.

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