Cognitive dysfunction and mortality in multiple sclerosis: Long-term retrospective review

2021 ◽  
pp. 135245852110665
Author(s):  
Sara Cavaco ◽  
Inês Ferreira ◽  
Inês Moreira ◽  
Ernestina Santos ◽  
Raquel Samões ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Dysfunction ◽  
Retrospective Review ◽  
Progressive Disease ◽  
Disease Course ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Study Results ◽  
Clinical Records

Background: Cognitive dysfunction as a predictor of clinical progression and mortality in multiple sclerosis (MS) is still a matter of debate. Objective: The aim of this study was to explore the long-term outcome associated with neuropsychological performance in a cohort of patients with MS. Methods: A series of 408 MS patients had previously undergone a comprehensive neuropsychological assessment and a contemporaneous neurological evaluation (T1). A retrospective review of the clinical records was conducted 102–192 months after T1. Demographic and clinical data regarding the last clinical appointment with EDSS measurement (T2) were collected and the date of the last clinical contact or death (TS) was recorded. Results: This review revealed that cognitive dysfunction (T1) was associated with higher odds of transitioning from relapsing–remitting course to a progressive disease course (adjusted odds ratio (OR) = 2.29, p = 0.043) and higher hazard of death in the total sample (adjusted hazard ratio (HR) = 3.07, p = 0.006) and the progressive disease course subgroup (adjusted HR = 3.68, p = 0.007), even when adjusting for other covariates. Discussion: The study results demonstrate that cognitive dysfunction in MS is predictive of poorer prognosis and mortality.

scholarly journals Primary sclerosing cholangitis and pregnancy

2011 ◽  
Vol 1 (3) ◽  
pp. 55 ◽  
Author(s):  
Casper Q. Kammeijer ◽  
Robert A. De Man ◽  
Christianne J.M. De Groot
Keyword(s):  
Ursodeoxycholic Acid ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Rare Case ◽  
Progressive Disease ◽  
High Dose ◽  
Term Outcome ◽  
Long Term Outcome ◽  
In Pregnancy

Primary sclerosing cholangitis is a progressive disease, and coincidentally in pregnancy it is rare. It is characterized by progressive inflammation and destruction of bile ducts finally resulting in liver failure. A rare case of primary sclerosing cholangitis in pregnancy is presented. The course of the pregnancy was marked by threatened preterm delivery and exacerbation of cholestasis. She was successfully treated with ursodeoxycholic acid (UDCA). Although, primary sclerosing cholangitis has both maternal and fetal effects on pregnancy, the overall outcome is favorable. Only few cases have been reported using high dose ursodeoxycholic acid for primary sclerosing cholangitis in pregnancy, it often improves pruritus but has no protection against stillbirth. Data on the safety to the fetus or neonate and long-term outcome are scarce.

Predictors of long-term outcome in multiple sclerosis patients treated with interferon beta

2013 ◽  
Vol 73 (1) ◽  
pp. 95-103 ◽  
Author(s):  
Robert A. Bermel ◽  
Xiaojun You ◽  
Pamela Foulds ◽  
Robert Hyde ◽  
Jack H. Simon ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Interferon Beta ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Multiple Sclerosis Patients

Occurrence and long-term outcome of tumefactive demyelinating lesions in multiple sclerosis

2016 ◽  
Vol 37 (7) ◽  
pp. 1113-1117 ◽  
Author(s):  
Rocco Totaro ◽  
C. Di Carmine ◽  
A. Splendiani ◽  
S. Torlone ◽  
L. Patriarca ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Demyelinating Lesions

scholarly journals Cavernous Malformation of Brainstem, Thalamus, and Basal Ganglia

Neurosurgery ◽  
2012 ◽  
Vol 72 (4) ◽  
pp. 573-589 ◽  
Author(s):  
Paritosh Pandey ◽  
Erick M. Westbroek ◽  
Peter A. Gooderham ◽  
Gary K. Steinberg
Keyword(s):  
Basal Ganglia ◽  
Neurological Deficits ◽  
Term Outcome ◽  
Cavernous Malformations ◽  
Long Term Outcome ◽  
Brain Malformations ◽  
Hemorrhage Risk ◽  
Clinical Records

Abstract BACKGROUND: Cavernous malformations (CMs) in deep locations account for 9% to 35% of brain malformations and are surgically challenging. OBJECTIVE: To study the clinical features and outcomes following surgery for deep CMs and the complication of hypertrophic olivary degeneration (HOD). METHODS: Clinical records, radiological findings, operative details, and complications of 176 patients with deep CMs were reviewed retrospectively. RESULTS: Of 176 patients with 179 CMs, 136 CMs were in the brainstem, 27 in the basal ganglia, and 16 in the thalamus. Cranial nerve deficits (51.1%), hemiparesis (40.9%), numbness (34.7%), and cerebellar symptoms (38.6%) presented most commonly. Hemorrhage presented in 172 patients (70 single, 102 multiple). The annual retrospective hemorrhage rate was 5.1% (assuming CMs are congenital with uniform hemorrhage risk throughout life); the rebleed rate was 31.5%/patient per year. Surgical approach depended on the proximity of the CM to the pial or ependymal surface. Postoperatively, 121 patients (68.8%) had no new neurological deficits. Follow-up occurred in 170 patients. Delayed postoperative HOD developed in 9/134 (6.7%) patients with brainstem CMs. HOD occurred predominantly following surgery for pontine CMs (9/10 patients). Three patients with HOD had palatal myoclonus, nystagmus, and oscillopsia, whereas 1 patient each had limb tremor and hemiballismus. At follow-up, 105 patients (61.8%) improved, 44 (25.9%) were unchanged, and 19 (11.2%) worsened neurologically. Good preoperative modified Rankin Score (98.2% vs 54.5%, P = .001) and single hemorrhage (89% vs 77.3%, P < .05) were predictive of good long-term outcome. CONCLUSION: Symptomatic deep CMs can be resected with acceptable morbidity and outcomes. Good preoperative modified Rankin Score and single hemorrhage are predictors of good long-term outcome.

scholarly journals Long-term outcome in rheumatoid arthritis: A simple algorithm of baseline parameters can predict radiographic damage, disability, and disease course at 12-year followup

2002 ◽  
Vol 47 (4) ◽  
pp. 383-390 ◽  
Author(s):  
K. W. Drossaers-Bakker ◽  
A. H. Zwinderman ◽  
T. P. M. Vliet Vlieland ◽  
D. Van Zeben ◽  
K. Vos ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Simple Algorithm ◽  
Disease Course ◽  
Term Outcome ◽  
Radiographic Damage ◽  
Long Term Outcome

Long-term outcome of paediatric-onset multiple sclerosis: a population-based study

2012 ◽  
Vol 84 (2) ◽  
pp. 141-147 ◽  
Author(s):  
Katharine E Harding ◽  
Kate Liang ◽  
Mark D Cossburn ◽  
Gillian Ingram ◽  
Claire L Hirst ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Population Based ◽  
Term Outcome ◽  
Population Based Study ◽  
Long Term Outcome

Complex basilar artery aneurysms treated using surgical basilar occlusion: a modern case series

2011 ◽  
Vol 115 (2) ◽  
pp. 319-327 ◽  
Author(s):  
Christopher P. Kellner ◽  
Raqeeb M. Haque ◽  
Philip M. Meyers ◽  
Sean D. Lavine ◽  
E. Sander Connolly ◽  
...  
Keyword(s):  
Basilar Artery ◽  
Case Series ◽  
Endovascular Techniques ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Complex Aneurysms ◽  
Long Term Follow Up ◽  
Clinical Records

Object Complex aneurysms of the basilar artery (BA) apex can be successfully treated using surgical occlusion of the proximal BA. Since the introduction of the Guglielmi detachable coil in 1991, the focus on treating BA aneurysms has been on using endovascular techniques. Outcomes with endovascular techniques have been less than optimal for large and complex aneurysms. The authors therefore report on their current 22-year experience with surgical BA occlusion for complex BA aneurysms and long-term outcome. Methods Fifteen patients underwent surgical BA occlusion at Columbia University Medical Center for complex basilar apex aneurysms between 1987 and 2009. The clinical records of each patient were reviewed for details of presentation, hospital course, operative intervention, and outcome. Results Postoperatively, all patient encounters were recorded at discharge, at the 1-month and 1-year follow-up evaluations, and at long-term outcome. Twelve (80%) of 15 patients experienced no new postoperative neurological deficits. Three patients presenting with severe neurological impairment (modified Rankin Scale [mRS] score > 3) made excellent recoveries (mRS Scores 1–2) at long-term follow-up. One patient died, 1 suffered a stroke during the postoperative angiogram which resulted in hemiparesis, and 1 suffered internuclear ophthalmoplegia which resolved by the 1-month follow-up. Long-term follow-up occurred at an average of 3 ± 4.5 years, ranging from 2 months (for a recently treated patient) to 18 years. The average mRS score at long-term follow-up was 1 ± 1.5. No patient experienced postoperative hemorrhage, rebleeding, or delayed neurological deterioration. Conclusions Surgical occlusion of the BA is an effective treatment option offering a high rate of angiographic cure in a single procedure for patients with complex BA aneurysms. The ability to surgically perform point occlusion of the BA without impairment of brainstem perforators, while maintaining collateral blood flow to the posterior circulation branch vessels, may provide an advantage compared with endovascular treatments.

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