Biomedical subjects

Ole Morten Rønning

Publications and source records attributed to Ole Morten Rønning.

3 recordsLinked to original sources

PubMed2005

[Stroke: when the diagnosis is wrong].

BACKGROUND: There is a lack of knowledge of stroke symptoms in the population and among health professionals. Many non-cerebrovascular diseases present with a strokelike clinical picture. The present study focuses on non-cerebrovascular conditions that were referred to a neurological acute stroke unit as strokes. METHODS: In an observational study, 354 consecutive patients who presented to the stroke unit with a diagnosis of stroke were evaluated. Patients were assessed by neurologists and classified as non-stroke patients or true stroke patients. RESULTS: Eighty-eight were non-stroke patients (25%), who were younger than the true strokes (65.5 vs 71.5). Clinical features were falls (23%), sensory impairment (19%), vertigo (13%), loss of consciousness (11%) and confusion (9%). Half of the non-stroke diagnoses were either migraine, infection, postural vertigo or sequelae after a previous stroke. In 25% another neurological disease was present, such as epilepsy, cranial nerve disorder, neuropathy, transient global amnesia or demyelinating disease. There were 6 patients with previous stroke among the 11 non-stroke patients who had a final diagnosis of infection. DISCUSSION: Misdiagnosis of stroke is common among non-neurologists. Non-stroke patients often have another neurological disease. All stroke patients should be seen by a neurologist in the early phase.

Adult↗

PubMed2004

[Post-stroke epilepsy].

BACKGROUND: Stroke (infarction or haemorrhage) is an important cause of epilepsy in adulthood, especially in the elderly. Because of a high incidence and improved survival, post-stroke epilepsy (PSE) is a great contemporary challenge for physicians. In our studies we have defined PSE as two or more seizures occurring more than four weeks after the stroke. MATERIAL AND METHODS: Based on our studies and a review of the literature, we give an account of the incidence, predictors, pathophysiology, and prognosis of PSE. RESULTS: The incidence in the literature varies greatly, from 2.3% to 43%. Our data shows an incidence of 2.5% after one year, increasing to 4.4% after five years. Severe strokes have higher incidence of PSE than minor strokes. INTERPRETATION: The variation in incidence reflects differences in the patient populations studied, definition of PSE, and study design. Our studies were prospective and in a well-defined area with high focus on admitting patients with any sign of stroke to hospital. This results in a "population" of stroke patients with severe strokes with high mortality rate, and patients with minor strokes not likely to develop PSE. In our material, severe strokes increased the incidence of PSE five-fold compared to minor strokes. We saw almost a doubling of the incidence one year to five years after the stroke. This might be explained by a long epileptogenesis, but it could also be due to high morbidity in this age group.

Aged↗

PubMed2003

Reliability and validity of the Canadian Neurological Scale in retrospective assessment of initial stroke severity.

BACKGROUND: Stroke severity is an important determinant of outcome, however, quantitative data on the initial neurological status might be lacking in retrospective studies. We wanted to assess the reliability and validity of the retrospective use of the Canadian Neurological Scale (CNS). METHODS: In 181 patients with validated stroke, two raters scored the CNS based on medical record review. We assessed interrater reliability and construct validity of the CNS. Predictive validity was assessed by the ability of the CNS to predict 30-day and 1-year mortality. RESULTS: Interrater reliability was high (kappa or weighted kappa 0.76-0.96). Correlations between similar items of prospective Scandinavian Stroke Scale scores and retrospective CNS scores ranged from 0.54 to 0.85. CNS total score was a strong predictor of death within 30 days and 1 year in multivariate models. CONCLUSIONS: The retrospective algorithm for the CNS had a high to substantial interrater reliability and predictive validity. Accordingly, in retrospective stroke studies using medical record information, the CNS can be a feasible instrument to adjust for differences in stroke severity.

Aged↗