Headache patterns in patent foramen ovale patients: beyond migraine with aura.

Patent foramen ovale (PFO) is a common cardiac anomaly linked with cryptogenic strokes and migraine, particularly migraine with aura. This study aims to explore the spectrum of headache disorders in PFO patients, focusing on identifying patterns beyond the well-established migraine-PFO connection. A retrospective observational study was conducted on patients diagnosed with PFO. Headache types were classified using the International Classification of Headache Disorders, 3rd edition. The study analyzed headache prevalence and patterns in PFO patients, comparing those with and without a history of stroke. Of 177 participants, 63 (35.59%) reported headaches. Tension-type headache was the most common (15.25%), followed by migraine without aura (11.30%) and migraine with aura (8.47%). Notably, migraine without aura was more prevalent than migraine with aura, contrasting previous assumptions. No significant differences were found in headache types based on stroke history. The study reveals a diverse spectrum of headache types in PFO patients, with migraine without aura being more common than migraine with aura. These findings suggest a need for broader diagnostic perspective and individualized treatment approaches in PFO patients with headaches.

Why antiplatelet treatment in spontaneous internal carotid dissection?

Spontaneous dissection of the internal carotid artery is a leading cause of stroke and TIA, particularly in young patients. The antithrombotic treatment with or without an interventional procedure is a unanimously accepted indication for the prevention of the ischemic events in these patients. Whether anticoagulants or antiplatelets as antithrombotics are a better option is a matter of debate. The authors, based on clinical and pathophysiological data in the published studies and their own experience argue in favour of antiplatelets in most cases, without excluding the need of anticoagulants in some cases, due to the lack of objective proofs for the superiority of anticoagulants in this pathology and at the same time, a better safety profile of antiplatelets. To have a clear-cut answer to this debate, a large comparative randomized clinical trial between the two types of treatment is desirable.

Factors Associated with Severe Carotid Artery Stenosis in a Population with One of the Highest Incidences of Ischemic Stroke in Europe - Single National Center Analysis.

Introduction: Despite significant advances in its prevention and acute-phase treatment, stroke is still one of the leading causes of disability and death worldwide. Ischemic stroke accounts for 80 to 87% of all strokes, with 15-30% of cases being caused by extracranial carotid artery (CA) stenosis. Methods: This is an observational, cross-sectional, single-center, prospective, registry-based study. The current research presents the preliminary results after analyzing the demographic features, biological data, and cardio- and cerebro-vascular risk factors of the first 74 patients included in the first "Romanian registry for cervical and cerebral arterial stenosis." Results: In our group of patients, the severity of carotid artery stenosis was related to fibrinogen, total cholesterol, and triglyceride blood levels. Moreover, patients who underwent carotid artery stenosis were more prone to having peri-procedural complications if they had a low blood platelet count. Concerning the associated pathologies of patients with severe carotid atheromatosis, the risk of having lower cognitive abilities was higher in subjects with atrial fibrillation, regardless of the severity of carotid artery stenosis. Conclusions: The presented study brings essential information about a population more prone to cerebral ischemic events than that of most other countries. All data obtained until this moment and which will further result from analyzing the clinical, demographic, and biological features of patients included in this registry should be used for implementing populational strategies for preventing further strokes.

Efficacy and safety of Cerebrolysin in patients with hemorrhagic stroke.

UNLABELLED: The purpose of the study was to investigate the efficacy and safety of Cerebrolysin in patients with hemorrhagic stroke. The primary objective of this trial was to assess the clinical efficacy and safety of a 10-days course of therapy with a daily administration of Cerebrolysin (50 mL i.v. per day). The trial had to demonstrate that Cerebrolysin treatment is safe in hemorrhagic stroke. METHODS: The study was performed as a prospective, randomized, double blind, placebo-controlled, parallel group study with 2 treatment groups. Efficacy measures were the Unified Neurological Stroke Scale, Barthel Index, and Syndrome Short Test. The duration of the trial was of 21 days for each patient. Out of 100 randomized patients, a total of 96 (96%) completed the study. RESULTS: Overall, no statistically significant group effects were observed based on single average comparisons at the individual visits. It could be shown that the treatment of hemorrhagic stroke with Cerebrolysin is safe and well tolerated. CONCLUSION: In the changes of UNSS, BI and SST from baseline to day 21, the group differences are not statistically significant; however, the use of Cerebrolysin in hemorrhagic stroke is safe and well tolerated and studies with a larger sample size may provide statistical evidence of Cerebrolysin's efficacy in patients with hemorrhagic stroke.

Study on some reactivity aspects in chronical psychic-organic syndrome.

In the present work, a number of patients with chronic psychic-organic syndromes, with confuse states, with the exaggeration of some personality features during the beginning period of brain atherosclerosis or senility was studied. The anamnestic and psycho-organic syndromes in different dysfunctions degrees, the evolution of dysfunctions with vascular determination, the deficiency of some intelligence compounds were also investigated. We tried to analyse the psychometric results and to distinguish the functional dysfunction from the organic one using Raven's test, Thurstone's scale, WAIS scale and test. We also tried to distinguish the intellectual decrease of medium and deep level. We studied the reactivity, the plasma level of ACTH, ACTH-stimulation test, integrity of the hypophyseo-hypothalamic test. The multitude of results of paraclinical analysis correspond to the multitude of clinical syndromes. These studies are preliminary for a more thorough research of the physiopathology of this kind of patients. The detailed investigation of these patients' specific nature reactivity offers a lot of possibilities used for therapy.

Study on physiopathology of the chronic psychoorganic syndrome. Investigation on the reactivity of the adrenal glands in patients with psychoorganic chronic.

Out of a great number of cases with chronic psychoorganic syndrome studied by us, we have selected, for investigation, a number of 100 cases which presented common symptomatology: a psychosyndrome showing, by a large number of manifestations such as asthenia, fatigability, adynamia with various degrees of intensity building up to reaction latency, diminution or even absence of initiative, basic-negativism, tendency to depression with feeling of futility, anxiety, lowered affective tonus. The intellectual activity is largely diminished, the stream of ideas is poor, and there is a limited domain of preoccupations. All these symptoms alongside with somatic, muscular, renal, respiratory, digestive and cardiovascular disorders have led us to the hypothesis of chronic deficiency of the hormones in the adrenal glands. The adrenal glands have been studied by indirect exploration of the hydroelectrolytic metabolism of the peripheral blood, the Thorn test and the Robinson-Power-Kepler test. For the exploration of the glucocorticoids, a basal test has been used such as the 17-hydroxycorticoid test, which measures cortisol elimination, or as the 11-desoxycorticosteroids and metabolites, or the colorimetric Porter-Silber method. Among the dynamic tests, we have used stimulating tests, the ACTH test (synthetic Synachtene), which measures cortisolemia and the 17-urinary corticosteroids, faster and easier than the Thorn test. In order to assess androgens, we have used the ACTH deposit dynamic test (Synachtene retard), which in the case of normal function of the adrenal glands, in 24 hours, doubles the elimination of 17-hydrocorticosteroids, 17-Ketosteroids, D. H. E. A., pregnandiol, pregnantriol.(ABSTRACT TRUNCATED AT 250 WORDS)