Neurovascular Complications of Iatrogenic Meningitis.

A multinational outbreak of nosocomial fusarium meningitis occurred among immunocompetent patients who had undergone surgery with epidural anesthesia in Mexico. The pathogen involved had a high predilection for the brain stem and vertebrobasilar arterial system and was associated with high mortality from vessel injury. Effective treatment options remain limited; in vitro susceptibility testing of the organism suggested that it is resistant to all currently approved antifungal medications in the United States.

The impact of intensive patient education on clinical outcome in a clinic-based migraine population.

Objective: To determine whether the addition of patient education to routine medical management improves the clinical status of migraine patients and reduces their utilization of healthcare resources.

Background: Optimal migraine management typically requires effective patient education. Such education often is difficult to accomplish in the busy clinic setting.

Predictors of a negative response to topiramate therapy in patients with chronic migraine.

Objective: To identify variables predictive of a negative response to prophylactic therapy with topiramate in patients with chronic migraine.

Background: While certain of the newer antiepileptic drugs (AEDs) have emerged as promising or definitely effective therapies for migraine prevention, we continue to lack biologic or clinical variables predictive of treatment response to these or other widely used prophylactic therapies.

Methods: A consecutive series of 170 patients with IHS-defined migraine who were experiencing 15 or more days of headache per month were treated with topiramate according to a uniform dosing protocol.