[Meningitis due to infection with Borrelia hispanica].

BACKGROUND Tick-borne relapsing fever is a disease that is caused by infection with a Borrelia bacterium, and is transmitted by ticks. This infectious disease is characterised by relapsing episodes of high fever, often accompanied by aspecific symptoms. CASE DESCRIPTION We describe the history of a 20-year-old woman who developed recurrent episodes of fever with headache and vomiting after a holiday in Morocco.

Predicting disease progression in high-grade glioma with neuropsychological parameters: the value of personalized longitudinal assessment.

Purpose: Progressive disease in patients with high-grade glioma may be reflected in cognitive decline. However, the cognitive functions most sensitive to progression may differ between patients. We investigated whether decline on a personalized selection of tests predicted progressive disease according to RANO criteria in high-grade glioma patients.

Internet-based guided self-help for glioma patients with depressive symptoms: a randomized controlled trial.

Depressive symptoms are common in glioma patients, and can negatively affect health-related quality of life (HRQOL). We performed a nation-wide randomized controlled trial to evaluate the effects of an online guided self-help intervention for depressive symptoms in adult glioma patients. Glioma patients with depressive symptoms were randomized to a 5-week online course based on problem-solving therapy, or a waiting list control group.

CT within 6 hours of headache onset to rule out subarachnoid hemorrhage in nonacademic hospitals.

Objective: To investigate whether staff radiologists working in nonacademic hospitals can adequately rule out subarachnoid hemorrhage (SAH) on head CT <6 hours after headache onset.

Methods: In a multicenter, retrospective study, we studied a consecutive series of patients presenting with acute headache to 11 nonacademic hospitals. Inclusion criteria were (1) normal level of consciousness without focal deficits, (2) head CT <6 hours after headache onset and reported negative for the presence of SAH by a staff radiologist, and (3) subsequent CSF spectrophotometry.

[Meningitis after a mouse bite].

Background: Infection with the lymphocytic choriomeningitis virus is a human zoonosis caused by a rodent-borne arenavirus and is often seen in autumn and winter when mice retreat into houses. Infection in humans is acquired after inhalation of aerosols or direct contact with excreta of an infected rodent.

Case Description: A 37-year-old woman was referred to St.

How often is thunderclap headache caused by the reversible cerebral vasoconstriction syndrome?

Background: Thunderclap headache (TCH) has a broad differential diagnosis that includes the reversible cerebral vasoconstriction syndrome (RCVS). It is believed to be caused by a dysregulation of vascular tone, which leads to reversible and segmental vasoconstriction and may cause permanent neurological deficits. One of the remaining mysteries is the incidence of the syndrome in a general hospital setting.

[Intracranial hypotension syndrome following manipulation of the cervical spine].

Background: Chiropractic interventions such as manipulation of the cervical spine can incidentally lead to severe neurological complications.

Case Description: A 63-year-old female patient presented at the Neurology outpatient clinic with a five-week history of severe postural headache, tinnitus and nausea. The onset of these symptoms was concurrent with chiropractic manipulation of the cervical spine because of cervical pain.

Health-related quality of life and cognitive functioning in long-term anaplastic oligodendroglioma and oligoastrocytoma survivors.

Overall survival of patients with anaplastic oligodendroglial tumors has been improved due to the addition of procarbazine, lomustine and vincristine (PCV) chemotherapy to radiotherapy (RT), especially in 1p/19q-codeleted tumors. With improved survival, quality of survival becomes pivotal. We evaluated cognitive functioning and health-related quality of life (HRQOL) in a cohort of long-term anaplastic oligodendroglioma survivors.

New clinical, pathological and molecular prognostic models and calculators in patients with locally diagnosed anaplastic oligodendroglioma or oligoastrocytoma. A prognostic factor analysis of European Organisation for Research and Treatment of Cancer Brain Tumour Group Study 26951.

Background: The prognosis of patients with anaplastic oligodendrogliomas (AOD) and oligoastrocytomas (AOA) is variable. Biomarkers might be helpful to identify more homogeneous disease subtypes and improve therapeutic index. The aim of this study is to develop new clinical, pathological and molecular prognostic models for locally diagnosed anaplastic gliomas with oligodendroglial features (AOD or AOA).

Identification of drug-related problems by a clinical pharmacist in addition to computerized alerts.

Background: Both clinical pharmacists and computerized physician order entry systems with clinical decision support (CPOE/CDSS) can reduce drug-related problems (DRPs). However, the contribution of a clinical pharmacist in addition to CPOE/CDSS has not been established in a prospective study.

Objective: To determine which DRPs can be identified by a clinical pharmacist in a setting with routine use of CPOE/CDSS.

Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC brain tumor group study 26951.

Purpose: Anaplastic oligodendroglioma are chemotherapy-sensitive tumors. We now present the long-term follow-up findings of a randomized phase III study on the addition of six cycles of procarbazine, lomustine, and vincristine (PCV) chemotherapy to radiotherapy (RT).

Patients And Methods: Adult patients with newly diagnosed anaplastic oligodendroglial tumors were randomly assigned to either 59.

Atypical transformation in sacral drop metastasis from posterior fossa choroid plexus papilloma.

Choroid plexus papillomas (CPP) are rare tumours and spinal metastases of CPP are even less common. We report a 50-year-old woman with spinal drop metastases at Th9 and S1-2 6 years after total resection of a posterior fossa CPP. The metastasis at S1-2 was resected and histological examination showed transformation to an atypical CPP.

[Ocular myasthenia gravis: diagnosis often delayed].

When a patient complains of a fluctuating ptosis or diplopia the diagnosis 'ocular myasthenia gravis' must be considered. The diagnosis can be difficult because of the subtle symptoms and less sensitive diagnostic testing. Because of this, there is often a patient and doctors delay.

[A man with decreased consciousness, weeks after head trauma].

A 76-year-old man had decreased consciousness, 6 weeks after head trauma. Cerebral CT-scan revealed bilateral subdural haematomas with old and recent components.

IDH1 and IDH2 mutations are prognostic but not predictive for outcome in anaplastic oligodendroglial tumors: a report of the European Organization for Research and Treatment of Cancer Brain Tumor Group.

Purpose: Recent studies have shown the prognostic significance of IDH1 mutations in glioma. It is yet unclear if IDH1 mutations are predictive for outcome to chemotherapy. We determined the effect of IDH1 mutations on progression-free survival and overall survival (OS), and its correlation with other clinical and molecular features in the prospective randomized European Organization for Research and Treatment of Cancer study 26951 on adjuvant procarbazine, 1-(2-chloroethyl)-3-cyclohexyl-l-nitrosourea, and vincristine (PCV) in anaplastic oligodendroglioma.

Myoclonus-dystonia and spinocerebellar ataxia type 14 presenting with similar phenotypes: trunk tremor, myoclonus, and dystonia.

We describe three genetically confirmed myoclonus dystonia (M-D) patients and one spinocerebellar ataxia type 14 (SCA14) patient, presenting with a combination of trunk tremor, multifocal myoclonus and axial dystonia as predominant clinical features. We suggest that in patients with this M-D phenotype, without a mutation in the DYT11 gene, SCA14 should be considered.

Prognostic value of health-related quality-of-life data in predicting survival in patients with anaplastic oligodendrogliomas, from a phase III EORTC brain cancer group study.

Purpose: This is one of a few studies that have explored the value of baseline symptoms and health-related quality of life (HRQOL) in predicting survival in patients with brain cancer.

Patients And Methods: Baseline HRQOL scores (from the European Organisation for Research and Treatment of Cancer [EORTC] Quality of Life Questionnaire C30 and the EORTC Brain Cancer Module) were examined in 247 patients with anaplastic oligodendrogliomas to determine the relationship with overall survival by using Cox proportional hazards regression models. Refined techniques as the bootstrap resampling procedure and the computation of C indexes and R2 coefficients were used to explore the stability of the models as well as better assess the potential benefit of using HRQOL to predict survival in clinical practice and research.

Health-related quality of life in patients treated for anaplastic oligodendroglioma with adjuvant chemotherapy: results of a European Organisation for Research and Treatment of Cancer randomized clinical trial.

Purpose: Little is known about the health-related quality of life (HRQOL) of patients treated for anaplastic oligodendrogliomas. The impact of combined procarbazine, CCNU (lomustine), and vincristine (PCV) chemotherapy after radiotherapy (RT) compared with RT alone on HRQOL in the randomized European Organisation for Research and Treatment of Cancer (EORTC) 26951 trial was studied.

Patients And Methods: Adult patients with anaplastic oligodendrogliomas received RT alone or RT plus PCV chemotherapy.

Adjuvant procarbazine, lomustine, and vincristine improves progression-free survival but not overall survival in newly diagnosed anaplastic oligodendrogliomas and oligoastrocytomas: a randomized European Organisation for Research and Treatment of Cancer phase III trial.

Purpose: Anaplastic oligodendrogliomas are more responsive to chemotherapy than high-grade astrocytomas. We investigated, in a multicenter randomized controlled trial, whether adjuvant procarbazine, lomustine, and vincristine (PCV) chemotherapy improves overall survival (OS) in newly diagnosed patients with anaplastic oligodendrogliomas or anaplastic oligoastrocytomas.

Patients And Methods: The primary end point of the study was OS; secondary end points were progression-free survival (PFS) and toxicity.

Embolization of spinal dural arteriovenous fistulas: importance of occlusion of the draining vein.

Object: The aim of this study was to assess whether glue-induced occlusion of the draining vein predicts permanent closure of the fistula following embolization of spinal dural arteriovenous fistulas (SDAVFs).

Methods: Between 1994 and 2004, 36 consecutive patients with an SDAVF were treated at the authors' institution. Twelve patients underwent surgery and 24 glue-based embolization.

Effect of low-intensity acenocoumarol on frequency and severity of migraine attacks.

Objective: To investigate the effect of low-intensity acenocoumarol treatment (target INR 1.5 to 2.0) on the frequency and severity of migraine attacks.