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Biomedical subjects

L Hernández Echebarría

Publications and source records attributed to L Hernández Echebarría.

4 recordsLinked to original sources
PubMed2002

[Hashimoto's encephalopathy].

Hashimoto's autoimmune thyroiditis is a common cause of thyroid disease. Neurological dysfunction related to thyroid hypo or hyperfunction is well known. Not so is autoimmune thyroid disease-associated or Hashimoto's encephalopathy, which includes different neurological manifestations appearing in the context of autoimmune thyroiditis with normal hormone levels. Around fifty cases have been reported since the first description by Brain in 1966. Pathogenesis is unknown, although the most accepted theory points out to an autoimmune cerebral dysfunction. There are two different clinical presentations. The vasculitic type is characterized by relapsing-remitting stroke-like episodes. The diffuse-progressive type shows insidious cognitive impairment, confusion, psychosis, somnolence and coma. Cerebrospinal fluid is abnormal in more than 80% of patients, with high protein levels and mononuclear pleocytosis. Steroids are the treatment of choice, although favourable evolution have been reported spontaneously or after thyroxine treatment.

Autoimmune Diseases↗
PubMed1995

[Lacunar infarcts. A comparative study of risk factors and carotid stenosis].

OBJECTIVE: In order to evaluate the pathogenic role of carotid atheromatosis and risk factors for the lacunar type of cerebral ischaemia a comparative analysis was made between a group of patients with this type of stroke and other with non-lacunar infarctions. Unlike previous works, patients with clinical-radiological criteria for ischaemia in the carotid territory were included in both groups. METHODS: Ninety-eight patients with a first episode of stroke were selected prospectively. Strokes were classified as lacunar (52 patients) and non-lacunar (46 patients). The following risk factors were evaluated: age, sex, increased blood pressure, left ventricle enlargement, smoking, alcohol intake, lipid profile, history of previous transient stroke, arterial retinopathy, diabetes, ischaemic heart disease and presence of peripheral arteriopathy. The narrowing degree of the carotid artery was determined by means of Doppler ultrasonography. RESULTS: Significant differences were found for the presence of two variables: hypertensive retinopathy was more prevalent in the lacunar group (p = 0.003) and history of transient ischaemic stroke was recorded more frequently in association with non-lacunar infarction (p = 0.01). A 50%-70% degree of narrowing in the upper carotid artery was observed more frequently in association with non-lacunar infarctions (p < 0.001) in the ipsilateral artery to the symptomatic hemisphere. In the heterolateral artery the narrowing degree was similar for both groups (p = 0.87). CONCLUSIONS: Lacunar and non-lacunar infarctions share the same risk factors; nevertheless, the distribution of atheromatous lesions was different. The presence of hypertensive retinopathy is an excellent marker for perforant arterial disease. The carotid stenosis is an unusual pathogenic mechanism for the development of ischaemic lacunar syndrome with an appropriate injury visualized by CT.

Adult↗