[Guidelines for diagnosis, therapy and follow up of Anderson-Fabry disease].

Fabry disease (Anderson-Fabry disease) is one of the most common lysosomal storage diseases (after Gaucher disease) caused by deficient activity of the α-galactosidase A (α-Gal A) enzyme, which leads to progressive accumulation of globotriaosylceramide in various cells, predominantly in endothelium and vascular smooth muscles, with multisystem clinical manifestations. Estimates of the incidence range from one per 40,000 to 60,000 in males, and 1:117,000 in the general population. Pain is usually the first symptom and is present in 60%-80% of affected children, as well as gastrointestinal disturbances, ophthalmologic abnormalities and hearing loss.

The association of inflammatory markers with cerebral vasoreactivity and carotid atherosclerosis in transient ischaemic attack.

Objectives: Inflammatory mediators have an important role in the pathogenesis of stroke. Increased activity of inflammatory mediators initiates the development of atherosclerosis independently of other risk factors, thus compromising brain microcirculation and causing transient ischaemic attack (TIA). The aim of our study was to evaluate the relationship between serum level of cellular adhesion molecules (ICAM-1), interleukin-6 (IL-6) and C-reactive protein (CRP) with carotid intima-media thickness (IMT) and breath-holding index (BHI) in subjects with transient ischaemic attack.

General recommendations for the management of aneurysmal subarachnoid hemorrhage.

Subarachnoid hemorrhage is a neurologic emergency and a detrimental cerebrovascular event with a high rate of death and complications. Recommendations have been developed and based on literature search, evaluation of the results of large international clinical trials, collective experience of the authors, and endorsed by the Croatian Society of Neurovascular Disorders, Croatian Society of Neurology including Section for Neurocritical Care, Croatian Neurosurgical Society, Croatian Society for Difficult Airway Management and Croatian Medical Association. The aim of these guidelines is to provide current and comprehensive recommendations and to assist physicians in making appropriate decisions in the management of subarachnoid hemorrhage.

Recommendations for the management of medical complications in patients following aneurysmal subarachnoid hemorrhage.

These are evidence based guidelines for the management of medical complications in patients following aneurysmal subarachnoid hemorrhage, developed and endorsed by the Croatian Society of Neurovascular Disorders, Croatian Society of Neurology including Section for Neurocritical Care, Croatian Neurosurgical Society, Croatian Society for Difficult Airway Management and Croatian Medical Association. They consist of recommendations for best monitoring, medical treatment and interventions based on the literature, evaluation of the results of large international clinical trials, and collective experience of the authors.

Guidelines for diagnosis, therapy and follow up of Anderson-Fabry disease.

Fabry disease (Anderson-Fabry disease) is one of the most common lysosomal storage diseases (after Gaucher disease) caused by deficient activity of the alpha-galactosidase A (alpha-Gal A) enzyme, which leads to progressive accumulation of globotriaosylceramide in various cells, predominantly in endothelium and vascular smooth muscles, with multisystem clinical manifestations. Estimates of the incidence range from one per 40,000 to 60,000 in males, and 1:117,000 in the general population. Pain is usually the first symptom and is present in 60%-80% of affected children, as well as gastrointestinal disturbances, ophthalmologic abnormalities and hearing loss.

Report of the Croatian Society for Neurovascular Disorders, Croatian Medical Association. Evidence based guidelines for treatment of primary headaches--2012 update.

These guidelines have been developed to assist the physician in making appropriate choices in work-up and treatment of patients with headaches. The specific aim of the Evidence Based Guidelines for Treatment of Primary Headaches--2012 Update is to provide recommendations for establishing an accurate diagnosis and choose the most appropriate therapy in the group of patients with primary headaches, based on a comprehensive review and meta-analysis of scientific evidence with regard to treatment possibilities in Croatia. These data are based on our previous Evidence Based Guidelines for Treatment of Primary Headaches published in 2005 and other recommendations and guidelines for headache treatment.

Diagnostic accuracy of serum brain derived neurotrophic factor concentration in antidepressant naïve patients with first major depression episode.

Diagnosing major depressive disorder (MDD) continues to be based on meeting phenomenological and descriptive criteria. As of yet, there is still no non-invasive, peripheral biomarker that would allow for a certain diagnosis of MDD. The objective of this paper is to use the receiver operating characteristic (ROC) analysis to test the diagnostic value of serum concentrations of brain derived neurotrophic factor (BDNF) in diagnosing the first episode of MDD.

Recommendations for diagnosis and management of multiple sclerosis.

Multiple sclerosis (MS) is a chronic demyelinating neurologic disorder that mainly affects young individuals (aged 20 to 50 years). Approximately 85% of patients experience an initial course with relapses and remissions (relapsing-remitting multiple sclerosis). Guidelines for the management of MS should be focused on three main areas: (a) the diagnosis of MS; (b) treatment of relapses; and (c) long-term preventive treatment including clinical follow up, dose adjustment, drug switch, control of therapeutic efficacy, and disease progression.

Hemispheric asymmetry of visual cortical response by means of functional transcranial Doppler.

We assessed the visual evoked response and investigated side-to-side differences in mean blood flow velocities (MBFVs) by means of functional transcranial Doppler (fTCD) in 49 right-handed patients with severe internal carotid artery (ICA) stenosis and 30 healthy volunteers, simultaneously in both posterior cerebral arteries (PCAs) using 2 MHz probes, successively in the dark and during the white light stimulation. Statistically significant correlation (P = 0.001) was shown in healthy and in patients (P < 0.

Serum Brain-derived neurotrophic factor (BDNF): the severity and symptomatic dimensions of depression.

Introduction: The aim of this study was to compare the concentration of serum Brain-derived neurotrophic factor (BDNF) in patients suffering from major depressive disorder (MDD) considering the severity of MDD episode defined by the Hamilton rating scale for depression (HAMD-17). The other aim was to research the connection between serum BDNF and the symptomatic dimensions of MDD.

Subjects And Methods: The study includes 139 participants with major depressive disorder (MDD).

Diagnostic value of some less frequently considered blink reflex parameters in idiopathic trigeminal neuralgia.

Aim Of The Study: We have done a study investigating the value of some less frequently considered Blink reflex parameters for establishing the diagnosis of idiopathic trigeminal neuralgia.

Patients: The study was done on 50 patients suffering from idiopathic trigeminal neuralgia, diagnosed according to the guidelines of the International Classification of Headache Disorders, with no other apparent illness.

Methods: We have stimulated the supraorbital nerve at the forehead (foramen n.

Cognitive performance in asymptomatic patients with advanced carotid disease.

Objective: : In the absence of stroke or transient ischemic attack, patients with advanced carotid stenosis or occlusion (ICAs/o) are considered asymptomatic, yet they are prone to mostly subtle cognitive impairment.

Background: : The Mini-Mental State Examination (MMSE) often fails to detect mild cognitive impairment. The Montreal Cognitive Assessment (MoCA) is more sensitive in recognizing such changes.

Is iron deficiency anemia related to menstrual migraine? Post hoc analysis of an observational study evaluating clinical characteristics of patients with menstrual migraine.

The aim of this study was to determine the relative prevalence and clinical characteristics of patients with pure menstrual migraine (PMM) and menstrually related migraine (MRM), and to compare them with the women free of it in an outpatient clinic-based population. Adult menstruating women with ICHD-2 migraine were included. Demographic data were obtained by verbal report.

Breath holding index in detection of early cognitive decline.

The aim of the study was to evaluate role of breath holding index (BHI) as a functional parameter for intracranial subclinical atherosclerotic changes in recognizing patients who are at risk for developing cognitive impairment of the vascular type. We included 60 volunteers divided into 3 groups according to age and presence of cognitive impairment (healthy subjects 30-40 years old, controls 60-70 years old and subjects with mild cognitive impairment 60-70 years old). We excluded individuals with moderate and severe carotid stenosis.

Possibilities for rehabilitation after stroke.

The patient's own attitude, activity and social interaction influence functional outcome and quality of life after stroke. Rehabilitation of stroke patients should start as soon as the patient is in a medically stable condition. The concept of early rehabilitation should be provided by an interdisciplinary team, preferably in stroke units.

Serum HDL, LDL and total cholesterol in patients with late-life onset of Alzheimer's disease versus vascular dementia.

Patients with cerebrovascular risk factors are nowadays recognized as being at an increased risk of developing cognitive decline of both types. In this pilot study, we evaluated the levels of cholesterol (total, HDL, LDL) in patients with both vascular dementia (VD) and Alzheimer's type of dementia (AD). Cognitive decline was assessed using Mini Mental State Examination (MMSE) as a standardized method.

Vascular characteristics of patients with dementia.

Arterial beta stiffness index is a potential risk factor for increased stroke occurrence. Vascular component appears to be significant in both Alzheimer's disease (AD) and vascular dementia (VAD). We aimed to further explore vascular characteristics of patients with both types of cognitive decline using non-invasive neurosonological methods.

Can beta stiffness index be proposed as risk factor for dementia.

Background And Aim: Changes of arterial stiffness indicate alteration in arterial mechanics predisposing to the evolution of stroke or vascular dementia. The aim of this pilot study was to investigate whether ultrasound parameters, particularly beta stiffness index (BSI), should be further explored as independent markers or risk factors for dementia.

Patients And Methods: There were 38 demented patients included in this study (72.

Impairment of proprioception after whiplash injury.

Whiplash injury usually occurs in traffic accidents. Persons experienced this injury might have an impairment of proprioception clinically expressed as inability to determine the exact position of their heads. The aim of this study was to examine the loss of proprioception in people who had a whiplash injury.

Mild cognitive impairment in symptomatic and asymptomatic cerebrovascular disease.

We tried to evaluate and to compare usefulness of two brief cognitive tests in early detection of cognitive decline in subjects with increased cerebrovascular (CV) risk. As CV risk factors are recognised as important in etiology of dementia, we also aimed to determine the possible associations of specific CV risk factors and cognitive results. Patients (PGs) with first-ever stroke or TIA (N=110) and CV symptoms-free controls (CGs) with CV risk factors present (N=45) matched for age, gender and education level were tested using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) on admission, at three- and six-month points.

The dissections of craniocervical arteries.

Dissection of craniocervical arteries internal carotid artery (ICA), or vertebral artery (VA) is an increasingly recognized entity and infrequent cause of stroke. We investigated 8 patients (4 women and 4 men) with dissections of the craniocervical arteries. Diagnostic procedures for detection of craniocervical dissection included: extracranial ultrasound-color Doppler flow imaging (CDFI) of carotid and vertebral arteries, transcranial Doppler sonography (TCD) and radiological computed tomography (CT) and digital subtractive angiography (DSA) examinations.

Ultrasound measurement of the volume of musculus quadriceps after knee joint injury.

The monitoring of the recovery of femoral muscles, after the knee-joint injury, is possible by the method of ultrasound measurement of the muscular volume. In a clearly defined longitudinal study, our object was to standardize the method of ultrasound measurement of muscular volume and to evaluate its adequacy in practical application in quadriceps muscle rehabilitation. The ultrasound measurements of m.

[Recommendations for management of patients with cerebral stroke. Part Two: Primary and secondary prevention of cerebral stroke].

Despite the enormous progress done in the course of last years in diagnosis, treatment and rehabilitation of stroke patients, prevention is still main strategy in approaching the stroke. After the comprehensive review of the organization of stroke care, treatment and neurorehabilitation of stroke patients, this part shows the recommendations of the Croatian Society for Neurovascular Disorders of the Croatian Medical Association and the Croatian Stroke Society for primary and secondary prevention of stroke.

[Recommendations for care of patients with cerebral accident. Part One: Organization of care for patients with cerebral accidents, treatment of cerebral accident and neurorehabilitation].

Stroke is the leading cause of disability in modern society. In developed countries stroke is the second or the third cause of death, and in Croatia it is the leading cause of death. Therefore, stroke is not only a great medical, but also economic burden.