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I Escalza

Publications and source records attributed to I Escalza.

6 recordsLinked to original sources
PubMedDate not supplied

[Diabetes mellitus and stroke].

INTRODUCTION: Diabetes mellitus (DM) is an important risk factor in cerebral vascular disease since it causes endothelial proliferation and thickening of the plasmatic membrane in the small blood vessels. The pathogenic mechanism is thus different from that of athero-thrombosis or emboli. Our objective was to determine whether there are differences between strokes in diabetic patients and strokes secondary to other diseases. PATIENTS AND METHODS: We made a prospective study of 415 stroke patients admitted to hospital consecutively over one year. Transient ischaemia and subarachnoid hemorrhage were excluded. We analysed age, sex, risk factors, severity (Canadian scale), mortality and functional prognosis one week later. RESULTS: Of the 415 patients, 354 were diagnosed as having cerebral infarcts and 61 parenchymatous hemorrhage. The average age was 72.2 years. The commonest risk factor was arterial hypertension (n = 241). There were 95 patients with DM. Bivariate and multivariate analysis showed independent variables associated with DM to be the onset of cerebrovascular pathology at a younger age (p = 0.009), association with arterial hypertension (p = 0.002) and poor previous quality of life (p = 0.003). We did not find a higher incidence of lacunar infarcts amongst the diabetic patients. CONCLUSIONS: The diabetic patient is younger and often also has arterial hypertension. There was no difference in mortality or type of stroke (ischemic compared with hemorrhagic). No significant relationship was found with lacunar infarcts.

Adult↗
PubMedDate not supplied

[Cardioembolic infarction: clinical course and characteristics].

INTRODUCTION: Approximately 20% of all ischemic strokes are due to cardioembolism and occur more frequently in the younger patients. Our objective was to determine the clinical characteristics and course of cardioembolic infarcts (ICCE) comparing them with infarcts due to other aetiologies (ICNCE). PATIENTS AND METHODS: We made a prospective study of 354 patients admitted to hospital over a period of one year, after excluding transient ischaemia and parenchymatous/subarachnoid hemorrhage. Two groups were established: ICCE (29.4%) and ICNCE (70.6%), comparing age, sex, risk factors and course of the illness. Subsequently a study lasing two years was done to assess the recurrence rate. RESULTS: The ICCE patients were older (75.89 compared with 72.58, p = 0.004), often know the exact time of onset of their symptoms (p = 0.015) and usually are admitted to hospital during the first six hours of their illness (p = 0.01). There was a significantly higher incidence of ischemic cardiopathy or auricular fibrillation (p = 0.0052); p = 0.005); more complications arose (p = 0.000); stay in hospital was longer (13.62 as compared to 11.8 days; p = 0.035), there was a lower weekly BI score (p = 0.0023) and higher mortality (p = 0.000). In the subgroup of 70 patients evaluated two years later 11 cases recurred, with no difference observed between the anticoagulant and anti-aggregant groups. CONCLUSION: The ICCE occurs in older patients, they develop worse neurological defects, have a worse short-term prognosis, develop more complications and have significantly greater mortality.

Adult↗
PubMedDate not supplied

[Tuberculous meningioma en plaque without extracerebral tuberculosis. A case report].

INTRODUCTION: Tuberculosis continues to be an intensly extended disease in under developed countries in immunodepressed and immunocompetent persons. In the central nervous system tuberculous lesions are the most frequent cause of space occupying lesions. CLINICAL CASE: We report the case of a young, immunocompetent woman from Guinea, currently living in Spain. Following a seizure, neuro imaging showed there to be a right frontal space occupying lesion. The characteristics of the MR images obtained were fundamental to the determination of the meningeal site of the lesion en plaque and to suggest the aetiology as being an infectious inflammatory process, although a meningioma could not be ruled out. The absence of signs of extracerebral disease, the localization and distribution of the lesion and lack of short term response to medical treatment, which covered the different diagnostic possibilities, made it necessary to do a diagnostic meningeal biopsy. CONCLUSIONS: MR imaging is a great help in the diagnosis of tuberculous lesions of the central nervous system. The differential diagnosis between tuberculous pachymeningitis and meningioma, both in the form of plaques, is extremely difficult without obtaining a biopsy specimen. The finding of epithelioid granulomas with caseous necrosis and/or acid alcohol fast bacilli in the biopsy specimen is diagnostic of tuberculosis. A single meningeal lesion situated in the cortex but with no associated extracerebral disease causes considerable difficulty in diagnosis. Tuberculosis must always be remembered in view of the increasing number of immigrants from under developed countries.

Adult↗