Poststroke epilepsy in long-term survivors of primary intracerebral hemorrhage.

Objective: To identify the incidence and predisposing factors for development of poststroke epilepsy (PSE) after primary intracerebral hemorrhage (PICH) during a long-term follow-up.

Methods: We performed a retrospective study of patients who had had their first-ever PICH between January 1993 and January 2008 in Northern Ostrobothnia, Finland, and who survived for at least 3 months. These patients were followed up for PSE.

Alcohol withdrawal syndrome: mechanisms, manifestations, and management.

The alcohol withdrawal syndrome is a well-known condition occurring after intentional or unintentional abrupt cessation of heavy/constant drinking in patients suffering from alcohol use disorders (AUDs). AUDs are common in neurological departments with patients admitted for coma, epileptic seizures, dementia, polyneuropathy, and gait disturbances. Nonetheless, diagnosis and treatment are often delayed until dramatic symptoms occur.

Risk for All-cause and Traumatic Death in Head Trauma Subjects: A Prospective Population-based Case-control Follow-up Study.

Objective: To investigate long-term mortality for subjects with acute head trauma.

Background: It is not known why long-term mortality after head trauma without traumatic brain injury is elevated.

Methods: All subjects admitted to Oulu University Hospital emergency room in 1999 with an acute head trauma (n = 737) were followed up until February 2014 and compared with age and sex-matched general population controls (n = 2196).

Head Trauma with or without Mild Brain Injury Increases the Risk of Future Traumatic Death: A Controlled Prospective 15-Year Follow-Up Study.

Patients who have recovered from traumatic brain injury (TBI) show an increased risk of premature death. To investigate long-term mortality rates in a population admitted to the hospital for head injury (HI), we conducted a population-based prospective case-control, record-linkage study, All subjects who were living in Northern Ostrobothnia, and who were admitted to Oulu University Hospital in 1999 because of HI (n=737), and 2196 controls matched by age, gender, and residence randomly drawn from the population of Northern Ostrobothnia were included. Death rate and causes of death in HI subjects during 15 years of follow-up was compared with the general population controls.

Predictive value of C-reactive protein for the outcome after primary intracerebral hemorrhage.

Object: Primary intracerebral hemorrhage (ICH) carries high morbidity and mortality rates. Several factors have been suggested as predicting the outcome. The value of C-reactive protein (CRP) levels in predicting a poor outcome is unclear, and findings have been contradictory.

Immediate, early and late seizures after primary intracerebral hemorrhage.

Background: Seizures after primary intracerebral hemorrhage (PICH) are significant and treatable complications, but the factors predicting immediate, early and late seizures are poorly known. We investigated characteristics and outcome with special reference to occurrence and timing of a first seizure among consecutive subjects with PICH.

Methods: A population-based study was conducted in Northern Ostrobothnia, Finland, in 1993-2008 that included all patients with a first-ever primary ICH without any prior diagnosis of epilepsy.

Association between warfarin combined with serotonin-modulating antidepressants and increased case fatality in primary intracerebral hemorrhage: a population-based study.

Object: Patients receiving oral anticoagulants run a higher risk of cerebral hemorrhage with a poor outcome. Serotonin-modulating antidepressants (selective serotonin reuptake inhibitors [SSRIs], serotonin-norepinephrine reuptake inhibitors [SNRIs]) are frequently used in combination with warfarin, but it is unclear whether this combination of drugs influences outcome after primary intracerebral hemorrhage (PICH). The authors investigated case fatality in PICH among patients from a defined population who were receiving warfarin alone, with aspirin, or with serotonin-modulating antidepressants.

Head trauma sustained under the influence of alcohol is a predictor for future traumatic brain injury: a long-term follow-up study.

Background And Purpose: Hazardous drinking may result in recurrent head trauma. It was investigated whether head trauma sustained under the influence of alcohol is a predictor of future traumatic brain injury (TBI).

Methods: All subjects with head trauma (n = 827) brought to the emergency room at Oulu University Hospital during 1999 were identified and followed up until death or the end of 2009.

Diagnosis and management of Marchiafava-Bignami disease: a review of CT/MRI confirmed cases.

Objective: Marchiafava-Bignami disease (MBD) is a rare condition mainly associated with alcoholism, although it may be mimicked by several other disorders that cause corpus callosum lesions. Our objective was to identify helpful features for differential diagnosis and assess whether any treatment can be recommended.

Methods: We reviewed 122 reports containing data on 153 subjects with confirmed MBD that was associated with either alcoholism or malnutrition, and 20 reports with data on 53 subjects with conditions mimicking MBD.

Predictors of new-onset seizures: a 10-year follow-up of head trauma subjects with and without traumatic brain injury.

Background: It is not known whether alcohol-related head trauma predicts the new-onset seizures, particularly alcohol-related seizures.

Objective: We investigated risk factors for new-onset seizures in a cohort of 739 head trauma subjects.

Methods: All subjects with head trauma attending Oulu University Hospital during 1999, including children and very old people but excluding persons with previous seizures and/or neurological diseases, were enrolled and followed up until the end of 2009.

Mortality of subjects with alcohol-related seizures increased after alcohol cheapening.

Objective: To investigate whether the reduction of alcohol prices in Finland (March 1, 2004) associated with an increase in mortality of subjects with alcohol-related seizures.

Patients And Methods: All subjects with head trauma in Oulu University Hospital during 1999 (n = 827) were identified and thereafter followed up until death or the end of 2009. We used National Hospital Discharge Register, hospital charts, and death records from Official Cause-of-Death Statistics to identify seizure visits and alcohol-related deaths.

Mortality from traumatic brain injury after reduction of alcohol prices: a population-based study from northern Finland.

Aims: Traumatic brain injury (TBI) is the leading cause of death after trauma, and alcohol is a major risk factor for TBI. In Finland, alcohol taxes were cut by one third in 2004. This resulted in a marked increase of alcohol consumption.

A population based study of outcomes after evacuation of primary supratentorial intracerebral hemorrhage.

Background And Purpose: The role of surgery after primary intracerebral hemorrhage (ICH) is controversial. To explore whether hematoma evacuation after ICH had improved short-term survival or functional outcome we conducted a retrospective observational population-based study.

Methods: We identified all subjects with primary ICH between 1993 and 2008 among the population of Northern Ostrobothnia, Finland.

Predictors for recurrent primary intracerebral hemorrhage: a retrospective population-based study.

Background And Purpose: Underlying comorbidities, previous strokes, and medication may increase the risk for primary intracerebral hemorrhage (PICH) and its recurrence. The aim of this study was to determine the independent predictors for recurrent PICH.

Methods: We identified 961 subjects with first-ever PICH from 1993 to 2008 among the population of Northern Ostrobothnia, Finland.

Fibrinolytic activity and platelet function in subjects with obstructive sleep apnoea and a patent foramen ovale: is there an option for prevention of ischaemic stroke?

Obstructive sleep apnoea (OSA) carries an increased risk of ischaemic stroke, but the underlying mechanism is not clear. As right-to-left shunting can occur through a patent foramen ovale (PFO) during periods of apnoea, we investigated nocturnal changes in fibrinolytic activity and platelet function in subjects who had OSA with or without PFO and in controls. We determined plasminogen activator inhibitor 1 (PAI-1) activity and antigen and platelet activation parameters.

Mortality of harmful drinkers increased after reduction of alcohol prices in northern Finland: a 10-year follow-up of head trauma subjects.

Objective: Alcohol-related mortality may be influenced by the level of alcohol consumption. We investigated the effect of alcohol price reduction on mortality in a cohort of 827 subjects with head injury.

Methods: We used the Finnish National Hospital Discharge Register to identify all diagnoses recorded during hospital and health center visits for survivors of the index injury during a follow-up of 10 years.

Incidence of moderate-to-severe traumatic brain injuries after reduction in alcohol prices.

Objective: Alcohol may be involved in 40-50% of traumatic brain injuries (TBI). In Finland, the cutting of alcohol taxes by one third in 2004 resulted in a marked increase in per capita alcohol consumption. We investigated the consequences of increased alcohol consumption on the incidence of moderate-to-severe traumatic brain injury among a defined population.

Mild traumatic brain injury diagnosis frequently remains unrecorded in subjects with craniofacial fractures.

Background: Traumatic brain injuries (TBI) in subjects with craniofacial fractures are usually diagnosed by emergency room physicians. We investigated how often TBI remains unrecorded in these subjects, and whether diagnostic accuracy has improved after the implementation of new TBI guidelines.

Methods: All subjects with craniofacial fractures admitted to Oulu University Hospital in 1999 and in 2007 were retrospectively identified.

Effect of increased warfarin use on warfarin-related cerebral hemorrhage: a longitudinal population-based study.

Background And Purpose: Warfarin use has rapidly increased with the aging of the population. We investigated the temporal trends in the incidence and outcome of warfarin-related intracerebral hemorrhages (ICHs) in a defined population.

Methods: We identified all subjects with first-ever primary ICH during 1993 to 2008 among the population of Northern Ostrobothnia, Finland.

Trends in treatment and outcome of stroke patients in Finland from 1999 to 2007. PERFECT Stroke, a nationwide register study.

Introduction: This article in this supplement issue on the Performance, Effectiveness, and Costs of Treatment episodes (PERFECT) project describes trends in Finnish stroke treatment and outcome.

Material And Methods: The PERFECT Stroke study uses multiple national registry linkages at individual patient level to produce a national stroke database with comprehensive follow-up of all hospital-treated stroke patients in Finland.

Results: There were 94,316 incident stroke patients treated in Finnish hospitals from 1999 to 2007.

Direct costs of patients with stroke can be continuously monitored on a national level: performance, effectiveness, and Costs of Treatment episodes in Stroke (PERFECT Stroke) Database in Finland.

Background And Purpose: Treatment of stroke consumes a significant portion of all healthcare expenditure. We developed a system for monitoring costs from individual patient data on a national level in Finland.

Methods: Multiple national administrative registers were linked to gain episode-of-care data on all hospital-treated patients with incident stroke over the years 1999 to 2007 (n = 94,316).