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Biomedical subjects

F A Rubino

Publications and source records attributed to F A Rubino.

At least 19 recordsLinked to original sources
PubMed2004

Routine use of gradient-echo MRI to screen for cerebral amyloid angiopathy in elderly patients.

OBJECTIVE: The objective of this study was to evaluate the routine use of gradient-refocused echo MRI sequences in the detection of cortical cerebral microbleeding suggestive of cerebral amyloid angiopathy in elderly patients (> 70 years old). CONCLUSION: The addition of gradient-refocused echo sequences to routine brain MRI resulted in the identification of cerebral amyloid angiopathy-related microbleeding in 15.5% of elderly patients. In most (86.7%) of these patients with positive findings, cerebral amyloid angiopathy was not suspected clinically, and 46.7% of these patients were undergoing anticoagulant or aspirin therapy, placing them at an increased risk of recurrent intracranial hemorrhage and catastrophic stroke.

Aged↗
PubMed1993

Gait disorders in the elderly. Distinguishing between normal and dysfunctional gaits.

Normal gaits in the elderly population vary widely. Characteristics of normal and abnormal gaits often overlap, making diagnosis of ambulation disorders difficult in some patients. Abnormal gaits are usually caused by musculoskeletal and/or neurologic abnormalities, which can be readily identified in the clinical setting. Prompt diagnosis and appropriate treatment may save an elderly patient from immobility, fall-related injury, loneliness, and depression.

Aged↗
PubMed1993

Neurological involvement in Wegener's granulomatosis: an analysis of 324 consecutive patients at the Mayo Clinic.

Neurological involvement in Wegener's granulomatosis was studied by reviewing the charts of 324 consecutive patients in whom the diagnosis was made at the Mayo Clinic. One hundred nine patients (33.6%) had neurological involvement. Peripheral neuropathy occurred in 53; cranial neuropathy, in 21; external ophthalmoplegia, in 16; cerebrovascular events, in 13; seizures, in 10; cerebritis, in 5; and miscellaneous involvement, in 25. The mean age and sex ratio were similar in the patients with and those without neurological involvement. Among the patients with peripheral neuropathy, 42 had mononeuropathy multiplex; 6, distal symmetrical polyneuropathy; and 5, unclassified peripheral neuropathy. Multiple mononeuropathy was a major presenting symptom in 8 patients. A significantly higher percentage of patients with peripheral neuropathy, compared to those without peripheral neuropathy, had kidney involvement (p < 0.001). The second, sixth, and seventh cranial nerves were most frequently affected. Multiple cranial nerves were affected in 8 patients. Unusual neurological manifestations in the miscellaneous group were spastic paraparesis, temporal arteritis, Horner's syndrome, and papilledema.

Adolescent↗
PubMed1993

Wegener's granulomatosis associated with vasculitis of the temporal artery: report of five cases.

Between January 1973 and October 1991 at the Mayo Clinic, 5 of 345 patients with Wegener's granulomatosis initially had features suggestive of giant cell arteritis and subsequently were found to have biopsy-proven vasculitis of the temporal artery. All five patients were older than 60 years of age and had jaw claudication, sudden loss of vision, severe headache with or without diplopia, or polymyalgia rheumatica at the time of initial examination. The erythrocyte sedimentation rate was high at the time of onset of symptoms in four patients (and unavailable in one patient). A temporal artery biopsy specimen revealed giant cell arteritis in one patient and non-giant cell arteritis in four patients. All five patients subsequently had pulmonary and renal lesions characteristic of Wegener's granulomatosis, with typical histopathologic features on biopsy or positive cytoplasmic staining antineutrophil cytoplasmic antibodies. Thus, overlapping features of giant cell arteritis and Wegener's granulomatosis do occur in some patients.

Aged↗
PubMed1993

Horner's syndrome in Wegener's granulomatosis: report of four cases.

Four patients with active Wegener's granulomatosis had Horner's syndrome, which was the only neurological involvement in one. Two others had multiple mononeuropathy and one a multiple cranial neuropathy. Horner's syndrome occurred in the active stage and improved with treatment of Wegener's granulomatosis.

Adolescent↗
PubMed1993

The spectrum of neurologic involvement in Wegener's granulomatosis.

Four patients with Wegener's granulomatosis (WG) presented with unique neurologic manifestations. On initial presentation, these patients had multiple mononeuropathy, multiple cranial neuropathy, myelopathy, and cerebritis. This series demonstrates that WG can present with a spectrum of neurologic manifestations.

Adult↗
PubMed1992

Neurologic complications of alcoholism.

Alcohol is still the most abused drug today and may affect the peripheral, central, and autonomic nervous system in many ways. There are several pathophysiologic mechanisms that include direct effects through intoxication, withdrawal effects, secondary effects from nutritional problems and systemic diseases, and, of course, syndromes of unknown etiology. The alcoholic is also susceptible to trauma to both the central and peripheral nervous system. In many of the clinical entities, multiple factors play a role.

Alcohol Withdrawal Delirium↗
PubMed1990

Cranial neuropathy in systemic malignancy in a VA population.

We studied 30 men with cranial neuropathy (CN) and systemic malignancy to determine the etiology and prognosis of CN. The most common malignancy was prostate (33%), followed by lung (27%). The etiology of CN was metastatic in 25 (83%) and nonmetastatic in 5 (17%). Only 6 patients improved: 3 metastatic and 3 nonmetastatic. Although prognosis for recovery was better in the nonmetastatic group, there was no significant difference in survival between the metastatic and the nonmetastatic groups.

Adult↗
PubMed1989

Fusiform aneurysm of the vertebrobasilar arterial system.

We retrospectively evaluated the clinical features and therapeutic outcomes in 13 consecutive patients with the diagnosis of fusiform aneurysm of the vertebrobasilar system. Four patients (31%) presented with compressive symptoms and 10 (77%) with ischemic symptoms; one patient presented with both types of symptoms. No patient presented with rupture of the fusiform aneurysm. Based on the attending physician's choice, treatment included antiplatelet therapy in five patients, anticoagulation in seven, and no medication in one. Five patients died, four treated with antiplatelet agents and one not treated with any medication. The cause of death was progressive brainstem ischemia in three, sepsis in one, and gastrointestinal bleeding in one patient. All seven patients who received anticoagulants were alive, with no recurrence of symptoms or hemorrhagic complications after a mean follow-up period of 18 months. Based on previous and current series, we conclude that rupture of fusiform aneurysms is rare. Our results suggest a more favorable outcome in the management of these aneurysms with anticoagulation therapy to prevent progressive thrombosis and embolization.

Aged↗
PubMed1988

Periventricular white matter changes and dementia. Clinical, neuropsychological, radiological, and pathological correlation.

Forty-three patients with computed tomographic scan findings of decreased attenuation in the periventricular white matter (PVWM) region were studied. Clinical evaluation revealed presence of hypertension in 36 patients (84%) and cerebrovascular risk factors in 41 patients (95%). Unilateral or bilateral neurological deficits were present in 40 patients (93%). Neuropsychological evaluation in 27 of them revealed features of subcortical dementia. Magnetic resonance imaging in seven cases demonstrated high-intensity areas in the deep white matter region on T2-weighted imaging. Pathological evaluation in four patients revealed demyelination without inflammatory cells and infarctions in the PVWM region, lacunar infarctions in the basal ganglia and brain stem, and marked arteriosclerosis. The study indicated that most (95% in this series) of the patients with computed tomographic scan findings of decreased attenuation in the PVWM region had cerebrovascular risk factors and various neurological and neuropsychological features of subcortical dementia. Pathologically, these lesions represented areas of infarction and demyelination, along with diffuse arteriosclerosis.

Adult↗
PubMed1988

Postinfarction seizures. A clinical study.

We retrospectively studied 90 patients with postinfarction seizures to determine the clinical features (onset, number, type), prognosis, and electroencephalographic and computed tomographic findings; we included infarctions of all etiologies. Thirty-three percent of the 90 seizures appeared early (within 2 weeks after the infarction), and 90% of the 30 early seizures appeared within 24 hours after the infarction. Seventy-three percent of the 90 seizures occurred within the first year, and only 2% occurred greater than 2 years after the infarction. Fifty-six percent of the 90 seizures were single, and status epilepticus was seen in only 8%. Early-onset seizures were more likely to be partial (57% of 30); late-onset seizures were more likely to be generalized (65% of 60). Thirty-nine percent of the 90 initial seizures recurred, and there was no significant difference in recurrence rate between early- or late-onset initial seizures. Twenty-two percent of the 90 initial seizures became multiple recurrent seizures, and we could identify a precipitating factor in 86% of the 35 recurrent seizures. The most common electroencephalographic abnormality in the 61 patients so examined was focal slowing (61%), but recurrent seizures occurred in 100% of the four patients with periodic lateralized epileptiform discharges and in 75% of the eight patients with diffuse slowing. Computed tomography in 61 patients showed that large infarctions were associated with early (p less than 0.021) and multiple (p less than 0.05) seizures. Deep infarctions on computed tomograms (cortical infarctions extending to subcortical structures) tended to cause recurrent seizures (p less than 0.057). Seizures in 88% of the 90 patients could be managed with monotherapy.

Adult↗
PubMed1987

Essential tremor variants: effect of treatment.

Essential tremor may not represent a single condition. Subclassifications include kinetic predominant tremor; combined resting-postural tremor; primary writing tremor; isolated voice, chin, or tongue tremor; and orthostatic truncal tremor. We report patients with these disorders. An association of these conditions with essential tremor is suggested by a high occurrence of a family history of essential tremor, frequent presence of a mild postural tremor, and tremor reduction with alcohol ingestion. Pharmacologic responsiveness is different for these disorders. Propranolol and primidone often have beneficial effects but clonazepam was the only drug effective in some cases of kinetic predominant tremor and in orthostatic truncal tremor. Combined resting-postural tremor and voice tremor were often unresponsive to treatment.

Adult↗
PubMed1985

Combined resting-postural tremors.

We studied eight patients with combined resting-postural tremors, which are classified as a subtype of essential tremor. Trihexyphenidyl hydrochloride, levodopa, and propranolol hydrochloride therapy were not effective in reducing these tremors.

Aged↗
PubMed1985

Autonomic dysfunction and Eaton Lambert syndrome.

Autonomic dysfunction associated with Eaton Lambert syndrome in a patient with oat cell carcinoma of the lung is reported. Widespread postganglionic adrenergic and cholinergic defects suggested the presence of autonomic neuropathy. Clinical remission accompanied tumor regression after combined chemotherapy and radiation.

Autonomic Nervous System↗
PubMed1985

Long survival of primary cerebral lymphoma with progressive radiation necrosis.

A 56-year-old man lived 8 years after excision and irradiation of a primary cerebral lymphoma. Delayed radiation necrosis caused progressive neurologic deterioration and probably his steroid-responsive episodes of obtundation. Vasogenic edema induced by radiation may account for the latter. An incidental extraneural lymphoma was found postmortem without evidence of CNS lymphoma.

Brain Neoplasms↗
PubMed1984

Management of lobar intracerebral hemorrhage: medical or surgical.

Two case histories of left parietal hemorrhage, with CTs, were evaluated by 88 board-certified neurologists and 114 board-certified neurosurgeons. Among the neurologists, 24% would have referred both patients for removal of the hemorrhage, 24% would have referred one of them, and 52% would have referred neither. Among the neurosurgeons, 47% would have operated on both patients, 25% on one of them, and 28% on neither. The lack of consensus probably results from an imperfect understanding of the natural history of these lesions. Controlled studies, or at least large retrospective studies, are needed to clarify this important therapeutic issue.

Cerebral Hemorrhage↗