The physician who decides to administer a thrombolytic therapy to a patient with acute stroke, has to consider both the results of randomized controlled trials, a complex matter itself, and problems related to consent, with its deontological and legal aspects, in the difficult contest of the emergency situations and acute stroke care. Although the analysis of studies on thrombolysis in medical literature has been ample and may be redundant, the latter aspect, i.e. that of how to cope with the problem of consent, has never been treated adequately. The problem of consent is particularly important and delicate in Italy and in most countries of the European Union, where thrombolytic therapy can be used only off label or within experimental studies. This document aims to provide the tools needed to overcome the gap between the generic indication for thrombolytic therapy in acute stroke, coming from clinical studies, and its effective use.

Brain Ischemia↗

PubMed1994

Superficial siderosis of the central nervous system after brachial plexus injury. Case report.

Superficial siderosis is a rare condition characterized by deposition of hemosiderin in the leptomeninges and in the subpial layers of the brain and spinal cord. It is associated with cerebrospinal fluid abnormalities consistent with recurrent bleeding into the subarachnoid space. The usual symptoms are hearing loss, ataxia, spastic paraparesis, sensory and sphincter deficits, and mental deterioration. A case is presented of severe superficial siderosis of the central nervous system in a 51-year-old man who had suffered a brachial plexus injury at the age of 20 years. The diagnosis was made by means of magnetic resonance imaging 16 years after the initial symptoms, which comprised bilateral hearing loss and anosmia. Subarachnoid bleeding was due to traumatic pseudomeningocele of the brachial plexus, a very unusual cause of superficial siderosis. This case is interesting insofar as the surgical treatment prevented further bleeding and possibly progression of the disease.

Brachial Plexus↗

PubMed1991

Different patterns of dissociation in unilateral spatial neglect.

The aim of this paper is to discuss the issue of dissociations found in unilateral spatial neglect according to the modality of space exploration and the nature of the task. For this purpose we present a reanalysis of the data from a recent paper of Gentilini et al. (1989) comparing visual and blindfolded exploration of a computer keyboard and discuss the performance of a left-brain-damaged patient with right visuospatial neglect and left-sided neglect dyslexia. We conclude that unilateral spatial neglect cannot be interpreted as a disruption of a single attentional mechanism, but rather it reflects impaired attentional mechanisms at several levels of cognitive processing.

Adult↗

PubMed1990

VEP and EEG in cortical blindness: a case with a complicated course.

We report a case of cortical blindness secondary to an extensive bilateral occipital ischemic infarct and complicated by the onset of bilateral optic nerve ischemia. We discuss the behavior of the VEP, present--an unusual finding--in the first phase of the occipital ischemic lesion, and the value of the alpha band rhythm in the EEG record.

Aged↗

PubMed1986

Three-year neuropsychological follow-up of patients with reversible ischemic attacks.

A short neuropsychological test battery designed to measure language, memory and visuospatial abilities was administered to 217 patients with reversible ischemic attacks. Patients were tested twice: the first time more than one month, but less than one year, from the last ischemic episode, and the second time three years later. A comparison between the first and the second testing session did not disclose any significant worsening. The degree of atherosclerosis and the occurrence of further ischemic episodes during the follow-up period were found to be unrelated to change in performance at the test battery. These results seems to challenge the hypothesis that multi-infarct dementia may follow apparently reversible, or even clinically silent, ischemic episodes.

Follow-Up Studies↗

PubMed1984

Spatial thinking disturbances: on a simple task in brain damaged patients.

Explore the source record for details and available documents.

Brain Damage, Chronic↗

PubMedDate not supplied

[Lupus anticoagulant antibody (LAC) and juvenile cerebral ischemic attack: a clinical case].

The lupus anticoagulant (LAC) is an acquired circulating serum immunoglobulin that prolongs all phospholipid-dependent coagulation tests. It has been recently associated with focal cerebral ischemia. We present here a case of LAC associated multiple cerebral ischemic events in a young adult and discuss laboratory criteria for a reliable diagnosis. In order to detect the presence of LAC, both the activated partial thromboplastin time (PTT), the kaolin clotting time (Exner assay) and the tissue thromboplastin inhibition assay (Schleider assay) should be evaluated. We conclude that LAC should be looked for in all young stroke patients with otherwise unexplained cerebral infarctions.

Adult↗

PubMedDate not supplied

[Licorice-induced myopathy. Report of a new case].

A 64 year-old man, who had been ingesting 20 g of licorice daily for about five months, developed a progressive, diffuse muscle weakness, with myoglobinuria, severe hypokalemia and elevated serum muscle enzymes. Electromyography and muscle biopsy results were consistent with a necrotizing myopathy. Following licorice withdrawal and appropriate electrolyte administration, complete clinical recovery was observed within about ten days. Previous reports of similar cases are reviewed and causative factors of this kind of myopathy are discussed.

Foodborne Diseases↗