[An unvaccinated man with a painful arm and jaw].

Background: Clostridium tetani is a gram-positive spore-forming bacterium that produces toxins and grows under anaerobic conditions. Infections with this bacterium can lead to local or generalised forms of tetanus.

Case Description: An 83-year-old man presented to the acute cardiac care unit with a painful left arm and jaw.

Low Prevalence of Mixed Dementia in a Cohort of 2,000 Elderly Patients in a Memory Clinic Setting.

Background: It is generally assumed that with increasing age, pathology in clinically diagnosed Alzheimer's disease (AD) becomes more mixed, i.e., co-existence of amyloid plaques and cerebrovascular pathology.

[Myelopathy following influenza vaccination].

A healthy woman aged 56 was vaccinated for the second year in succession against influenza. Three days afterwards she developed a strange sensation in the legs and lower abdomen, accompanied by difficulties of urinating and defaecation. Motor strength and reflexes were normal at neurological examination.

Silent infarction on a second CT scan in 91 patients without manifest stroke in the Dutch TIA trial.

The frequency of silent infarction is an important issue because it is a marker of vascular disease. We studied the occurrence of silent infarction in a sample of patients from the Dutch TIA trial, in which patients were randomized between 30 and 283 mg of aspirin. A total of 91 patients with TIA or non-disabling ischemic stroke and who did not suffer a stroke during a period of one to four years (mean 32 months) underwent CT scanning both on entry and at the end of the study.

Silent stroke in patients with transient ischemic attack or minor ischemic stroke. The Dutch TIA Trial Study Group.

Background And Purpose: We studied silent stroke (i.e., infarcts on computed tomographic scan not related to later symptoms) in patients after transient ischemic attack or minor ischemic stroke.

Influence of transient ischemic attack or small stroke on cessation of smoking.

A retrospective follow-up study was performed on a cohort, which took part in a secondary prevention trial after transient ischemic attack (TIA) or small stroke, to study variables relevant to the cessation of smoking. Of 100 patients, 57 smoked, 1 was lost to follow-up and 18 stopped smoking. Age, gender, amount of cigarettes, hospital admission, and persistence of symptoms were not statistically significant factors in the cessation of smoking in this group, which reported regularly for follow-up in the Dutch TIA trial.

Thrombolysis with recombinant tissue plasminogen activator in acute ischemic stroke: evaluation with rCBF-SPECT.

We treated five patients with hemispheric ischemic stroke with intravenous recombinant tissue plasminogen activator (rtPA), within 3-6 h after stroke onset. Regional cerebral blood flow was evaluated with single photon emission computed tomography (rCBF-SPECT) before and after treatment. One patient with aphasia and a moderately severe hemiparesis, who had a small flow deficit, was treated 5 h and 30 min after the onset of his stroke and had a prompt and complete recovery.

Recombinant tissue plasminogen activator in two patients with basilar artery occlusion.

Two patients with angiographically proved basilar artery occlusion were treated with systemic recombinant tissue plasminogen activator (rtPA) according to protocol. The first patient was in a locked-in state and gradually deteriorated. On repeat angiography the basilar artery remained occluded.

Lymphomatoid granulomatosis: clinical and histopathological report of a patient presenting with spinal cord involvement.

An unusual mode of presentation of lymphomatoid granulomatosis is reported. A 19-year-old man developed spinal cord symptoms, and magnetic resonance imaging of the spinal cord disclosed a compatible lesion. Despite medical therapy the outcome was fatal.