Perinatal Cerebral Hemorrhage: Morphology, Clinical Diagnosis, Treatment and Follow-Up

1983 ◽  
pp. 150-156 ◽  
Author(s):  
H. C. Nahser ◽  
H. E. Nau ◽  
L. Gerhard ◽  
V. Reinhardt ◽  
I. Stude ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Cerebral Hemorrhage

scholarly journals Diagnostic accuracy of imaging brain vesicular monoamine transporter type 2 (VMAT2) in clinically uncertain parkinsonian syndrome (CUPS): a 3-year follow-up study in community patients

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e025533 ◽  
Author(s):  
San San Xu ◽  
Paschal K Alexander ◽  
Yenni Lie ◽  
Vincent Dore ◽  
Svetlana Bozinovski ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Clinical Diagnosis ◽  
Pet Scan ◽  
Vesicular Monoamine Transporter ◽  
Monoamine Transporter ◽  
Rubral Tremor ◽  
Diagnostic Changes ◽  
Community Patients

ObjectivesTo further validate the diagnostic utility of 18F-AV-133 vesicular monoamine transporter type 2 (VMAT2) positron emission tomography (PET) in patients with clinically uncertain parkinsonian syndromes (CUPS) by comparison to clinical diagnosis at 3 years follow-up.Design, setting and participantsIn a previous study, we reported that 18F-AV-133 PET in community patients with CUPS changed diagnosis and management and increased diagnostic confidence. The current diagnosis of this cohort was obtained from the patient and treating specialist and compared with the diagnosis suggested 3 years earlier by the 18F-AV-133 PET. A second 18F-AV-133 PET was available in those with a discordant or inconclusive final diagnosis.Study outcome measuresThe primary end point was the proportion of patients who had a follow-up clinical diagnosis, which was concordant with their initial 18F-AV-133 PET scan. Secondary end points were the proportion of patients who had the same diagnosis at follow-up as that reached after the initial scan and the stability of diagnostic changes made after the first scan.Results81 of the 85 patients previously recruited to the CUPS study had follow-up of which 79 had a clinical diagnosis and 2 remained CUPS. The diagnosis was in agreement with the initial 18F-AV-133 PET scan result in 74 cases. Five patients had a discordant diagnosis; one patient with rubral tremor had a severely abnormal scan that had worsened when rescanned; four cases with normal initial and repeat scans had a clinical diagnosis of Parkinson’s disease. Two patients with suspected genetic disorders remained classified as CUPS and both had normal scans. In the 24 CUPS cohort patients where 18F-AV-133 PET initially changed diagnosis, this change was supported by follow-up diagnosis in all but the one rubral tremor case.Conclusion18F-AV-133 PET is a useful tool in improving diagnostic accuracy in CUPS providing results and diagnostic changes that remain robust after 3 years follow-up.

scholarly journals Decompressive Hemicraniectomy for Massive Cerebral Hemorrhage

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 357-357
Author(s):  
Stephan A Mayer ◽  
E Sander Connolly ◽  
Joseph E Bates ◽  
Allan Sim ◽  
Guy M McKhann ◽  
...  
Keyword(s):  
Cerebral Hemorrhage ◽  
Telephone Interview ◽  
Clinical Course ◽  
Hematoma Volume ◽  
Aneurysmal Rupture ◽  
Decompressive Hemicraniectomy ◽  
Malignant Mca Infarction ◽  
Promising Treatment ◽  
Hypertensive Intracerebral Hemorrhage

P103 Background: Hemicraniectomy and durotomy has been shown to be a promising treatment for malignant MCA infarction, but has not been evaluated for cerebral hemorrhage. Methods: We analyzed the clinical course and outcome of 15 patients treated with decompressive surgery for space-occupying cerebral hematomas between 9/98 and 6/00. All patients were treated with duroplasty and either hemicraniectomy (n=13) or a “floating” bone flap (n=2); in some patients, hematoma (n=5) and subdural clot (n=2) evacuation was also performed. Outcomes were assessed by telephone interview using the modified Rankin scale (mRS). Results: Mean age was 49 years (range 33–66); 8 were women; the lesion was left-sided in 7. Hematoma formation was related to spontaneous aneurysmal rupture (n=7), intra-operative aneurysmal rupture (n=3), hypertensive intracerebral hemorrhage (n= 3), and hemorrhagic infarction (n=2). Surgery was peformed <24 hours after onset in 5 patients, between 24–48 hours in 6, and between 3–5 days in 4. On the day of surgery, mean hematoma volume was 63 ml (range 6–216 ml), mean GCS was 6.3 (range 4–10), and mean NIHSS was 22 (range 13–28); 5 patients had clinical herniation signs. Postoperative CT scans showed significant reductions in both mean septal shift (from 10.3 to 6.1 mm) and pineal shift (from 6.4 to 3.5 mm) (both P<.02). Eighty percent (12/15) of patients survived to discharge, and one died after discharge. After a mean follow up of 5.7 months (range 1–13), one survivor (9%) had no disability (mRS 0–1), four (36%) had slight or moderate disability (mRS 2–3), and six (54%) had moderate or severe disability (mRS 4–5). Conclusion: Duroplasty and hemicraniectomy, with or without concurrent hematoma evacuation, may improve survival and recovery in comatose patients with large aneurysmal, hypertensive, or infarct-related cerebral hemorrhages.

Blood amyloid β oligomerization as a biomarker of Alzheimer’s disease: a blinded validation study

2020 ◽  
Author(s):  
Young Chul Youn ◽  
Byoung Sub Lee ◽  
Gwang Je Kim ◽  
Ji Sun Ryu ◽  
Kuntaek Lim ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Sensitivity And Specificity ◽  
Detection System ◽  
Amyloid Β ◽  
High Sensitivity ◽  
Community Based ◽  
Clinical Sensitivity ◽  
Aβ Oligomerization ◽  
Normal Cognition

Abstract INTRODUCTION: Oligomeric amyloid ß (Aß) is one of the major contributors to the pathomechanism of AD; Aß oligomerization in plasma can be measured using a Multimer Detection System-Oligomeric Aß (MDS-OAß) after incubation with spiked synthetic Aß. METHODS: We evaluated the clinical sensitivity and specificity of the MDS-OAß values by inBlood TM OAß test using heparin-treated plasma samples from 52 AD patients in comparison with 52 community-based subjects with normal cognition (NC). The inclusion criterion was proposed by the NINCDS-ADRDA and additionally required for the least 6 months of follow-up from the initial clinical diagnosis in the course of AD. RESULTS: The MDS-OAβ values were 1.43 ± 0.30 ng/ml in AD and 0.45 ± 0.19 ( p <0.001) in NC, respectively. Using a cut-off value of 0.78 ng/ml, the results revealed that 100% sensitivity 92.31% specificity. DISCUSSION: MDS-OAß to measure plasma Aβ oligomerization is a valuable blood-based biomarker for clinical diagnosis of AD, with high sensitivity and specificity.

scholarly journals Analysis and Follow up of Endoscopy Results in 1099 Patients with Terminal Ileum Lesions

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Qinglian Zhong ◽  
Anye Zhang ◽  
Jian Huang ◽  
Wen Yan ◽  
Jiayu Lin ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Diagnostic Accuracy ◽  
Clinical Diagnosis ◽  
Terminal Ileum ◽  
Diagnostic Yield ◽  
Delayed Diagnosis ◽  
Clinical Treatment ◽  
Diagnosis And Management

Objective. We aim to analyze the diagnostic yield, diagnostic accuracy, and delayed diagnosis of patients with terminal ileum lesions, providing follow-up suggestions for suspected patients. Methods. We carried out an analysis of 1099 patients who had terminal ileum lesions in our hospital from 2009 to 2019. The endoscopy reports and histopathology reports of terminal ileal biopsies were recorded. Clinical diagnosis and management were reviewed to determine whether there was a need to correct after a follow-up endoscopy result. Results. A total of 1099 patients were found to have terminal ileum lesions, among which 959 in 1099 patients (87.26%) were diagnosed as benign, 17 in 1099 patients (1.55%) were diagnosed as malignant, and 123 in 1099 patients (11.19%) were diagnosed as suspected. The diagnostic accuracies of terminal ileal polyp, cyst, cancer, eosinophilic enteritis, parasite, lymphofollicular hyperplasia, and amyloidosis were 100%. The diagnosis was delayed in 9.93% of Crohn’s disease (CD) and 12.5% of lymphoma. Among the definite cases, the diagnosis was corrected during the follow-up in 12.5% of the patients, while the clinical treatment was corrected during the follow-up in 17.86% of the patients. Among the suspected cases, the diagnosis and treatment was corrected in 61.11% of the patients during the follow-up. Conclusion. Coincident diagnosis of ileitis and ileum ulcer is low. Delayed diagnosis of Crohn’s disease and lymphoma were observed in a certain proportion of patients with terminal ileum lesions. A follow-up endoscopy was strongly recommended for these suspected patients with terminal ileum lesions.

scholarly journals Bilateral acute depigmentation of iris: 3-year follow-up of a case

2018 ◽  
Vol 10 ◽  
pp. 251584141878798 ◽  
Author(s):  
Cemile Ucgul Atilgan ◽  
Pinar Kosekahya ◽  
Mehtap Caglayan ◽  
Nilufer Berker
Keyword(s):  
Differential Diagnosis ◽  
Anterior Chamber ◽  
Female Patient ◽  
Clinical Diagnosis ◽  
Young Women ◽  
Inflammatory Reaction ◽  
Trabecular Meshwork ◽  
Keratic Precipitates ◽  
Iris Depigmentation

Bilateral acute depigmentation of the iris (BADI) usually affecting young women, is a newly defined clinical diagnosis with bilateral symmetrical pigment loss of iris stroma without iris transillumination defect. Herein, we want to share the results of a 3-year-long follow-up of a 23-year old female patient with BADI. She was admitted to our clinic with a complaint of discoloration of both her brown irises. An ocular evaluation of the patient revealed symmetrical pigment deposition in trabecular meshwork. No iris transillumination defect, pupillary sphincter paralysis, keratic precipitates, and inflammatory reaction in anterior chamber were seen. The depigmented iris stroma became repigmented symmetrically after 3-year follow-up period. Although it is rare, BADI should be considered in the differential diagnosis of the diseases with bilateral iris depigmentation.

scholarly journals The Computerized Tomographic Assessment of Brain Infarcts

1981 ◽  
Vol 8 (2) ◽  
pp. 121-126 ◽  
Author(s):  
D.E. Tubman ◽  
R. Ethier ◽  
D. Melançon ◽  
G. Bélanger ◽  
S. Taylor
Keyword(s):  
Cerebral Infarction ◽  
Clinical Diagnosis ◽  
Computed Tomographic ◽  
Brain Infarcts ◽  
Follow Up Studies

SUMMARY:The computed tomographic (CT) examinations of one hundred and sixty patients with a clinical diagnosis of cerebral infarction were reviewed. A characteristic CT pattern was noted. Infused scans and follow-up studies allowed for considerable accuracy in diagnosis.

Duplexsonographie bei Riesenzellarteriitis – Abschätzung von Schweregrad und möglicher Erblindung

2020 ◽  
Vol 2 (4) ◽  
pp. 158-160
Author(s):  
Sabine Adler
Keyword(s):  
Diagnostic Accuracy ◽  
Clinical Diagnosis ◽  
Ultrasound Examination ◽  
Vascular Inflammation ◽  
Temporal Artery ◽  
Clinical Factors ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
A Prospective Study

<b>Objectives:</b> Ultrasound of temporal and axillary arteries may reveal vessel wall inflammation in patients with giant cell arteritis (GCA). We developed a ultrasound scoring system to quantify the extent of vascular inflammation and investigated its diagnostic accuracy and association with clinical factors in GCA. <b>Methods:</b> This is a prospective study including 89 patients suspected of having GCA, of whom 58 had a confirmed clinical diagnosis of GCA after 6 months follow-up. All patients underwent bilateral ultrasound examination of the three temporal artery (TA) segments and axillary arteries, prior to TA biopsy. The extent of vascular inflammation was quantified by (1) counting the number of TA segments and axillary arteries with a halo and (2) calculating a composite Halo Score that also incorporated the thickness of each halo. <b>Results:</b> Halo counts and Halo Scores showed moderate diagnostic accuracy for a clinical diagnosis of GCA. They correlated positively with systemic inflammation. When compared with the halo count, the Halo Score correlated better with C-reactive protein (CRP) levels and allowed to firmly establish the diagnosis of GCA in more patients. Higher halo counts and Halo Scores were associated with a higher risk of ocular ischaemia. They allowed to identify subgroups of patients with low risk (≤5%) and high risk of ocular ischaemia (&#x3e;30%). <b>Conclusion:</b> Ultrasound halo scoring allows to quantify the extent of vascular inflammation in GCA. Extensive vascular inflammation on ultrasound may provide strong diagnostic confirmation and associates with ocular ischaemia in GCA.

Reflex sympathetic dystrophy. Objective clinical signs in diagnosis and treatment

1991 ◽  
Vol 81 (11) ◽  
pp. 580-584 ◽  
Author(s):  
TM Van Wyngarden ◽  
AL Bleyaert
Keyword(s):  
Early Diagnosis ◽  
Clinical Diagnosis ◽  
Temperature Difference ◽  
Reflex Sympathetic Dystrophy ◽  
Clinical Signs ◽  
Aggressive Treatment ◽  
Nerve Blocks ◽  
Clinical Resolution ◽  
Burning Pain

Diagnosis and follow-up treatment of reflex sympathetic dystrophy is difficult because of the subjective, nonspecific nature of its primary symptom, burning pain. Early diagnosis and aggressive treatment of reflex sympathetic dystrophy with epidural nerve blocks improves clinical resolution. Temperature difference between extremities and dependent cyanosis are reliable objective signs for clinical diagnosis and the evaluation of progress for treatment for reflex sympathetic dystrophy.

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