Biomedical subjects

H Sjøholm

Publications and source records attributed to H Sjøholm.

5 recordsLinked to original sources

PubMed2005

Outcome 1 year after aneurysmal subarachnoid hemorrhage: relation between cognitive performance and neuroimaging.

OBJECTIVE: To assess the cognitive impairment and the association between neuropsychological measures and neuroimaging 1 year after aneurysmal subarachnoid hemorrhage (SAH). METHOD: Forty-two patients were examined clinically according to Glasgow Outcome Scale (GOS). Computed tomography (CT), single photon emission computed tomography (SPECT) and neuropsychological examination were performed. RESULTS: There were no association between GOS and cognitive impairment index based on the neuropsychological examination. CT showed no sign of cerebral ischemia in 17 (40%) and low attenuating areas indicating cerebral infarction(s) in 25 (60%) patients. A significant correlation (P = 0.01) was observed between the cognitive impairment index and the SPECT index (r = 0.6). SPECT measurement was the only independent predictor for cognitive impairment. CONCLUSION: GOS is a crude outcome measure and patients classified with good recoveries may have significant cognitive deficits. Neuropsychological examination is the preferred method for outcome evaluation as this method specifically addresses the disabilities affecting patients' everyday life.

Adult↗

PubMed2002

Beta-CIT-SPECT combined with UPDRS appears to distinguish different parkinsonian conditions.

OBJECTIVES: An earlier study in l-dopa responding patients with idiopathic Parkinson's disease documented that progressive nigro-striatal degeneration shown with single photon emission computed tomography (SPECT) and the cocain analog iodine-123-beta-CIT (beta-CIT) correlated linearly with increasing motor scores in the Unified Parkinson's Disease Rating Scale (UPDRS). Here we have extended the study to include 2 tremor patients with mild parkinsonism, 2 poor l-dopa responders with parkisonism and 2 non l-dopa responders with severe parkinsonism. METHODS: SPECT scanning was performed 20 h after injection of beta-CIT and UPDRS was done at the time of beta-CIT injection. RESULTS: All patients in the present study showed less nigro-striatal degeneration in relation to UPDRS motor scores than the patients with idiopathic Parkinson's disease. CONCLUSION: The results suggest that the the combination of beta-CIT-SPECT and UPDRS motor scores has the potential to differentiate idiopathic Parkinson's disease from other parkinsonian conditions.

Aged↗

PubMed2001

Prophylactic hyperdynamic postoperative fluid therapy after aneurysmal subarachnoid hemorrhage: a clinical, prospective, randomized, controlled study.

OBJECTIVE: To investigate the role of prophylactic hyperdynamic postoperative fluid therapy in preventing delayed ischemic neurological deficits attributable to cerebral vasospasm. METHODS: We designed a prospected, randomized, controlled study and included 32 patients with subarachnoid hemorrhage. Sixteen patients received hypervolemic hypertensive hemodilution fluid therapy; the other 16 patients received normovolemic fluid therapy. All patients were monitored for at least 12 days, with clinical assessments, transcranial Doppler recordings, single-photon emission computed tomographic (SPECT) scanning, and routine computed tomographic scanning. For fluid balance monitoring, a number of blood samples were obtained on a daily basis and continuous central venous pressure and mean arterial blood pressure measurements were performed for both groups. All patients received intravenous nimodipine infusions between Day 1 and Day 12. End points of this study were clinical outcomes, clinically evident and transcranial Doppler sonography-evident vasospasm, SPECT findings, complications, and costs. Clinical examinations (using the Glasgow Outcome Scale) performed 1 year after discharge, together with neuropsychological assessments and SPECT scanning, were the basis for the evaluation of clinical outcomes. RESULTS: No differences were observed between the two groups with respect to cerebral vasospasm (as observed clinically or on transcranial Doppler recordings). When regional cerebral blood flow was evaluated by means of SPECT analysis performed on Day 12 after subarachnoid hemorrhage, no differences were revealed. One-year clinical follow-up assessments (with the Glasgow Outcome Scale), including SPECT findings and neuropsychological function results, did not demonstrate any significant group differences. Costs were higher and complications were more frequent for the hyperdynamic therapy group. CONCLUSION: Neither early nor late outcome measures revealed any significant differences between the two subarachnoid hemorrhage treatment models.

Aged↗

PubMed1999

Organic brain disease in psychogeriatric patients: impact of symptoms and screening methods on the diagnostic process.

Psychogeriatric patients are mentally affected by a heterogeneous group of diseases, traditionally classified as functional or organic brain disorders (OBDs). Here, we evaluate screening procedures with respect to revelation of underlying OBD. Fifty consecutive patients admitted to a psychogeriatric unit dedicated to late-onset psychiatric disease were included. Diagnosis at admission, symptoms, and time of onset of disease were determined blindly by an independent, experienced psychiatrist on the basis of referral documents and the interview written at admission. Subsequently, consensus established a clinical diagnosis (after psychiatric and neurologic evaluations) and a final diagnosis after the screening procedures (Cognistat and MMS-tests, electroencephalograms, computed tomography, and SPECT). Conventional criteria (ICD-10, ICPC) were used for diagnostic classification. Only 10 of the 50 patients were diagnosed with OBD at admission and an additional 7 patients following full clinical evaluations. At final diagnosis, 34 (of 46) patients were diagnosed with significant OBD. The Cognistat test had the largest diagnostic impact, with sensitivity/specificity values of 81%/60% for OBD.

Aged↗

PubMed1997

Nigro-striatal degeneration demonstrated in parkinsonian patients with iodine-123-beta-CIT SPECT: methods of quantitation.

Single photon emission computed tomography (SPECT) images were obtained in 3 healthy volunteers and 7 parkinsonian patients 22 h after injection of 120 MBq iodine-123-beta-CIT. There was a high radioactivity in the striatal region against a uniform background in the volunteers but pronouncedly reduced striatal activity in the patients. Total striatal activity in each hemisphere of each individual was calculated as the sum of all activity in excess of the background in all reconstructed images. There was a high correlation between reduction of striatal activity and motor scores in the unified rating scale for parkinsonism (URSP) for the patients. A method developed for calculation of the activity distribution along the length axis of the striatum indicated a more pronounced degeneration in the putamen compared with the caudate nucleus in the patients. Iodine-123-beta-CIT SPECT appears to be a good quantitative method for nigro-striatal degeneration in parkinsonian patients.

Aged↗