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Coutts et al. analyzed the risk of recurrent imaging events in 143 patients with minor stroke or TIA. Imaging was completed at baseline and at 1 month. Patients had evidence of recurrent lesions on MRI (9.8%). Of these, 43% were asymptomatic.
see page 513
The incidence of deep and lobar intracerebral hemorrhage
Labovitz et al. studied the incidence of deep and lobar intracerebral hemorrhage in white, black, and Hispanic patients living in Northern Manhattan. Higher risk of intracerebral hemorrhage accounted for the difference in intracerebral hemorrhage risk between men and women but not for differences between race/ethnic groups.
see page 518
The role of propofol in pediatric status epilepticus
Van Gestel et al. reviewed 34 episodes of status epilepticus in children that had been treated with propofol or thiopental. Both drugs were effective. When used appropriately, propofol resulted in fewer side effects. Propofol may be preferable to thiopental.
see page 591
The Schor and Riviello editorial notes that studies in adults suggest that the anesthetic agents propofol and thiopental are effective for status epilepticus refractory to conventional IV anticonvulsants. The van Gestel et al. retrospective study of propofol or thiopental in children raises the possibility that propofol should be primary therapy for status epilepticus and underscores the need for a systematic, prospective study in children. While propofol has a rapid onset and short duration of action, it may cause metabolic acidosis and cardiovascular collapse with prolonged use or with infusion rates greater than 5 mg/kg/hour—the so-called propofol infusion syndrome.
see page 506
Vascular risk factors and AD
A longitudinal study by Luchsinger et al. found the risk of incident AD increased with the number of vascular risk factors. They also found that diabetes and current smoking were strong risk factors alone or clustered with other risk factors.
see page 545
Prognosis of migraine and tension-type headache
At a 12-year follow-up of a general population, Lyngberg et al. found 80% of migraineurs had a good prognosis and a low attack frequency. Forty-seven percent of subjects with chronic tension-type headache had remitted, while 12% with episodic tension-type headache had developed chronic headaches.
see page 580
White matter lesions and gender in Fabry disease
Fellgiebel et al. quantified white matter lesions (WMLs) in clinically equally affected men and women with Fabry disease and found comparable frequencies of significant WML load in both groups.
see page 600
The editorial by Percy and Kaye notes that in an X-linked disorder, males are expected to express Fabry disease, but similar involvement in females is not expected. However, Fabry disease often behaves more as a dominant than a recessive condition. The risk for stroke in young adults with Fabry disease has not received sufficient emphasis: at least 24% of men (mean age 40) and at least 7% of women (mean age 42). Although this study is small, it points to as high a frequency of white matter lesions in females as in males, emphasizing the need for additional careful studies of the CNS in patients with Fabry disease.
see page 508
Prognosis of ischemic stroke in young patients without risk factors
Naess et al. shows that long-term secondary preventive medication may not be indicated in young ischemic stroke patients without traditional risk factors because of low rates of later vascular events.
see page 609
Abciximab for acute stroke
In an open-label study, Mitsias et al. assessed the effect of IV abciximab in 29 patients with sub-24 hour stroke. Their results suggest that this treatment improved the early post-treatment neurologic status and often reduced ischemic lesion size.
see page 612
Mutation in the glutamate transporter EAAT1
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Jen et al. identified a de novo mutation in SLC1A3, the gene that encodes for the glutamate transporter EAAT1, in a child with episodic ataxia, seizures, migraine, and alternating hemiplegia. Mutant EAAT1 showed markedly decreased glutamate uptake and a dominant negative effect when coexpressed with wild type EAAT1.
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see page 529
Related articles in Neurology:
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