Gait disorders of unknown cause in the elderly: Clinical and MRI findings.

Background: Disequilibrium of unknown cause in older people has been associated with white matter lesions on neuroimaging studies.

Objective: To investigate the relationship between gait and balance problems in the elderly, white matter hyperintensities, and vascular risk factors.

Methods: We studied clinical and neuroimaging features in 30 people older than 65 years of age with gait disorders of unknown cause and 30 age- and sex-matched controls.

[Gait and stability disorders of the elderly. Clinical analysis of a series of 259 patients older than 70 years].

Introduction: Gait and stability disorders of the elderly are frequent and a cause of disability, but studies on their clinical features and etiology are scarce, including the relationship between both disorders.

Objectives: To evaluate an extensive series of patients with gait and stability disorders, its clinical variants and posible pathogenic significance.

Patients And Methods: 259 patients older than 70 years consulting for chronic gait and stability symptoms in an outpatients neurologic clinic were retrospectively reviewed.

Time window for clinical effectiveness of mass evacuation in a rat balloon model mimicking an intraparenchymatous hematoma.

The purpose of this study is to evaluate in a rat model if the early removal of an experimental intracerebral mass mimicking an extensive subcortical hematoma improves neurological outcome. Fifty six male Wistar rats were studied. A balloon was placed sterotactically at the level of the striatum.

[Estimation of the neurologic demand in a health care area of Madrid, Spain (area 11, University Hospital, 12 of October)].

Objectives: To analyse the demand for neurologic care and the neurological resources in a health district.

Patients And Methods: Demographic, medical care aspects, neurologic care demands and neurological resources of the health district 11 of Madrid (University Hospital "12 de Octubre"), referred to 1996, were reviewed.

Results: The rate of aging (17%) and the consulting rates in the National Health System (86%) versus private care were high in this health district.

[Reversible dementia in neurology outpatient clinics].

Introduction: The dementias are one of the commonest conditions seen in Neurology Clinics. Potentially reversible causes are described amongst the various aetiologies although there are doubts as to whether the use of indiscriminate testing to detect them is worthwhile.

Objective: In a group of demented persons to determine how many had a potentially reversible condition and how many improved, in a prospective, descriptive study in a Neurology Outpatient Clinic.

[Guidelines for headaches and dizziness for general physicians: analysis of their impact on visit frequency to outpatient neurological ambulatory services].

Background: The work of neurologists in the Public Health Service is absolutely determined by the demand of the general physicians, who have occasionally been considered to be not too selective. For this reason we have tried to change this demand.

Methods: In our outpatient clinic we have developed some guidelines for the general physicians to orientate them in the selection of patients referred with neurological disease.

Early complete recanalization in internal carotid artery embolism treated with high-dose t-PA: a sequential angiographic study in a novel model of embolism in rats.

Complete early recanalization rate of human internal carotid artery embolic occlusion treated with thrombolytic drugs is low. To study factors related with this difficulty to recanalize we have developed a novel model of rat ica embolism using a fragment of human embolus. In 50 male Wistar rats the ica was embolized through the external carotid artery with a fragment of an embolus obtained from a human embolectomy passed through a catheter of 0.

[Chronic disequilibrium in the older patient: investigation of reversible cases in a 22-patient series].

Chronic instability is a frequent complaint in elderly patients. As literature on the subject is scarce, we investigated reversible causes, evaluating patients over 65 years of age referred to a regional neurological practice for disequilibrium lasting longer than three months. Clinical features were analyzed.

[Multiple cerebral hematomas: review of 7 cases].

We present seven patients with multiple spontaneous cerebral haemorrhages, diagnosed by CT scan, in a 10-year period in the Hospital 12 de Octubre. The clinical presentation, radiologic features, and prognosis of this entity are analyzed, and the diverse etiologic factors are discussed. All of the patients in this series were over 50 years of age, the majority not hypertensive (57%, n = 4), and in almost half the cases (43%, n = 3) the brain haemorrhages were associated with diverse coagulation disorders.

Benign Valsalva's maneuver-related headache: an MRI study of six cases.

Cough headache is not infrequent, but there have not been any series studied with current neuroimaging techniques, and effective therapy has seldom been reported. In a large series from an outpatient clinic of a general hospital, we have studied, with MRI, eight cases of headache related to situations provoking sudden increase of intrathoracic pressure (cough, straining, stooping), similar to that elicited by a Valsalva's maneuver. One case showed hindbrain herniation and another showed isolated hydrocephalus.

[Temporal threshold for middle cerebral artery infarction].

We describe a rat model for middle cerebral artery occlusion and discuss its usefulness for the study of structural consequences of various ischemic periods. We inserted 4/0 polyethylene sutures into the external carotid artery of 48 Wistar rats. The tips were rounded and coated with a thin layer of dental silicone.

Risk factors, diet and carotid atheromatosis in TIAs and minor ischemic strokes (MISs) in a Mediterranean country.

Eighty-two patients with transient ischemic attacks (TIAs) or minor ischemic strokes (MISs) were prospectively recruited from the emergency room of a general hospital within 1 month of the event with the aim of providing a group for comparison - regarding the pathogenetic profile - with similar series from Northern Europe and USA. Patients were asked a diet questionnaire, and serum lipid analysis, CT scan and carotid duplex were performed in each case. Relevant features were antecedents of hypertension in 61%, current smoking in 23.

Acute headache of recent onset and subarachnoid hemorrhage: a prospective study.

Twenty-seven patients with acute severe headache of recent onset were prospectively recruited in the Emergency Room. Mean duration of headache was 61 hours. CT scan disclosed subarachnoid bleeding in 4 patients and spinal tap revealed subarachnoid hemorrhage (SAH) in 5 patients with normal CT scan.

[Acute confusional syndrome due to bilateral occlusion of the anterior cerebral artery].

We report a case of acute confusional state (ACS) resulted from bilateral occlusion of anterior cerebral artery. This case is outstanding because development of ACS was caused by a focal lesion, without the presentation of focal neurologic signs. Then, cerebrovascular disease must be included in differential diagnosis of ACS, despite the lack of clinically detectable deficit.

Long-term outcome of TIAs, RINDs and infarctions with minimum residuum. A prospective study in Madrid.

A group of patients with transient ischemic attacks (65 cases), reversible ischemic neurologic deficits (37 cases) and infarctions with minimum residuum (41 cases) was included in a prospective follow-up for a mean period of 5.2 years. Most of the patients were treated with acetylsalicylic acid or other antiplatelet agents, or with anticoagulants.

[Acute confusional syndrome of unknown cause. Prospective study in the emergency room].

In a prospective study conducted in the Emergency Area of a general hospital during a period of 6 months, the Neurology Service was consulted in 45 cases of acute confusional syndrome. Twenty nine of these patients had no immediate apparent etiology. Among the studied patients 5 had a subarachnoid hemorrhage, 4 suffered a central nervous system infection, 3 had a cerebral infarction, 3 presented a metabolic encephalopathy, and the remaining patients had variate etiologies.

[Myoclonic encephalopathy caused by bismuth salts. Efficacy of treatment with dimercaprol].

Three patients with myoclonic encephalopathy caused by bismuth salts are reported, one with the severe and another with the mild form; dimercaprol was effective for the rapid improvement of the symptoms in both. In one of the patients in whom the clearance of bismuth was calculated it was found to be increased after dimercaprol therapy. We think that dimercaprol is an effective drug for the therapy of myoclonic encephalopathy caused by bismuth salts.

Myoclonic encephalopathy due to bismuth salts: treatment with dimercaprol and analysis of CSF transmitters.

Two cases of myoclonic encephalopathy due to bismuth salts intoxication are reported. In both, treatment with dimercaprol led to clinical recovery. This therapy was shown to enhance bismuth clearance.

[Prognosis factors in conservatively treated patients with non-traumatic supratentorial intracerebral hematoma].

We have carried out a retrospective study of 90 patients who were diagnosed of non traumatic supratentorial intracerebral hematoma by computerized tomography and received conservative treatment. Clinical features and laboratory and radiographic findings during acute stage as well as the course of the patients during hospital stay (mean, 34 days) are analyzed. The overall mortality rate was 21%.