Cerebrovascular incidents differ in patients with permanent and paroxysmal atrial fibrillation.
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Aged↗
Biomedical subjects
Jacek Staszewski
Publications and source records attributed to Jacek Staszewski.
[Effects of atrial fibrillation on clinical outcome of cerebral ischemic stroke].
Atrial fibrillation is one of the most common cardiac arrhythmia met in clinical practice. Nonregular heart rhythm leads to haemodynamic disturbances and favors thromboembolic complications--most frequently ischemic strokes. Cardioembolic strokes have different symptomatology compared with atherothrombotic strokes. They are characterised by more sudden onset, frequent haemorrhagic transformation and worse prognosis. Until now there is no clear explanation of unfavourable course of stroke in these patients. Concomitant diseases and sudden artery closure in subjects with undeveloped collateral circulation are considered as resulting in more extensive infarct size. Also impact of different forms of atrial fibrillation on the course of cerebrovascular events is not established. Paroxysmal and chronic atrial fibrillation have different influence on haemodynamic and hemostatic parameters what may play an important role in course of acute phase of ischemic stroke. Based on the results of clinical and preclinical studies, the set of data concerning the effects of different forms of atrial fibrillation on acute stroke outcome and actual guidelines of cardioembolic acute stroke treatment are presented.
Atrial Fibrillation↗
[Acute, stroke or thunderclap headache?].
Sudden, acute headache occurring for the first time in life may represent subarachnoid or perimesencephalic haemorrhage but it can also occur in the absence of pathologic conditions. This headache is widely named as "thunderclap" (TCH) or "stroke headache". Pathogenesis, diagnostic evaluation and headache characteristics is presented basing on retrospective evaluation of such patients admitted to Neurological Department between 1990-2002 with symptoms of TCH. The diagnosis of idiopathic TCH was established in 74 (21%) of 368 patients. No clinically significant difference between clinical manifestation of idiopathic and symptomatic TCH was observed. The most common concomitant diseases in idiopathic TCH patients were acute or chronic infections and hypertension. 40% of those patients had elevated inflammatory markers which normalised during hospitalisation in 20% of cases. We observed seasonal incidence with the highest incidence in summer and winter. 20% of patients presented to Neurological Dept with TCH consist of idiopathic, benign condition of unknown aetiology. Observed seasonal incidence with coexisting signs of infection may suggest the role of inflammatory process in benign TCH pathogenesis.
Acute Disease↗
[Reversible demyelinisation of corpus callosum in the course of Marchiafava-Bignami disease].
Marchiafava-Bignami disease is a rare disorder of an unknown aetiology that is marked by focal demyelinisation in the corpus callosum. Chronic alcohol abuse plays an important role in its development. Its course is unfavourable, although rare cases of clinical improvement confirmed in MRI have been reported. Until now, no case of Marchiafava-Bignami disease diagnosed intra vitam was so far described on the territory of Poland. The authors present such a case with favourable course. A 52-year-old male with chronic alcoholism was hospitalised due to altered consciousness which developed subacutely prior to admission. The first MRI scans yielded demyelinating lesions in the corpus callosum. The clinical and radiological findings were consistent with the diagnosis of Marchiafava-Bignami disease. Thiamine, vitamin B12, folic acid and amantadine were administered, which resulted in an improvement in both motor and cognitive functions. Control MRI scans revealed remyelinisation of the corpus callosum. Hence, this technique proved itself to be useful in monitoring the course of the disease.
Alcohol-Induced Disorders, Nervous System↗