Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 455
Filtrar
4.
Neurology ; 94(23): 1028-1031, 2020 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-32467130

RESUMO

Treatment of functional symptoms has a long history, and interventions were often used in soldiers returning from battle. On the 75th anniversary of the end of the Second World War, I review the portrayal of neurology in documentary film. Two documentaries were released in 1946 and 1948 (Let There Be Light and Shades of Gray, respectively), which showed a number of soldiers with functional neurology including paralysis, stuttering, muteness, and amnesia. The films showed successful treatments with hypnosis and sodium amytal by psychoanalytic psychiatrists. These documentaries link neurology with psychiatry and are remarkable examples of functional neurology and its treatment on screen.

5.
Neurocrit Care ; 32(3): 677-682, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32346841

RESUMO

A clinical history leads to an examination, tests and a diagnosis. This time-honored sequence in medicine remains valid in critical illness, but in the heat of the moment there is a quickly appearing inevitable sketchiness. Intensivists should never be too unquestioning, too comfortable with incomplete information, or too unwilling to start over if information is muddled or contradictory. No scale in neurology looks at history. There is no tool or requirement to provide a standard system of communication. I review the essentials of history taking in a neurocritically ill patient. Examples of the value of a good medical history are shown but also the familiar biases when asking questions. There are obstacles, errors of commission and omission, and the importance of recognition of a clinical trajectory.

6.
Intensive Care Med ; 46(6): 1267-1270, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32333047
9.
10.
Int J Neurosci ; : 1-4, 2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32019398

RESUMO

Objective: Intracranial dural arteriovenous fistulas represent pathological connections between dural arteries and dural veins, dural sinuses or meningeal veins in the absence of an intervening capillary bed. They are thought to be acquired secondary to trauma, surgery, sinus thrombosis, venous hypertension or arterial dysplasia. Methods: A 66-year-old Asian female presented with subarachnoid hemorrhage secondary to ruptured 2-mm saccular aneurysm of the left middle cerebral artery associated with fusiform dilatation. It was successfully treated with endovascular coiling. A right frontal external ventricular drain was also placed to treat her hydrocephalus. On post-bleed day 10, she became acutely unresponsive with a fixed and dilated right pupil. Head CT was obtained and revealed an acute right subdural hematoma which was emergently evacuated. Results: No obvious bleeders were identified during surgery. Patient improved and repeat catheter angiography a week later showed a new dural arteriovenous fistula fed by the anterior falcine artery and the middle meningeal artery to a cortical vein draining into the superior sagittal sinus. Conclusion: We hope that the present report will raise awareness to treating physicians to be cognizant of this unusual complication in their differential diagnosis when treating patients with an EVD in place.

12.
Neurocrit Care ; 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31993952
14.
18.
Neurocrit Care ; 32(2): 620-623, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31981019
19.
Neurocrit Care ; 32(3): 875-879, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31981022
20.
Neurocrit Care ; 32(1): 286-294, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31732848

RESUMO

Immune response against neuronal and glial cell surface and cytosolic antigens is an important cause of encephalitis. It may be triggered by activation of the immune system in response to an infection (para-infectious), cancer (paraneoplastic), or due to a patient's tendency toward autoimmunity. Antibodies directed toward neuronal cell surface antigens are directly pathogenic, whereas antibodies with intracellular targets may become pathogenic if the antigen is transiently exposed to the cell surface or via activation of cytotoxic T cells. Immune-mediated encephalitis is well recognized and may require intensive care due to status epilepticus, need for invasive ventilation, or dysautonomia. Patients with immune-mediated encephalitis may become critically ill and display clinically complex and challenging to treat movement disorders in over 80% of the cases (Zhang et al. in Neurocrit Care 29(2):264-272, 2018). Treatment options include immunotherapy and symptomatic agents affecting dopamine or acetylcholine neurotransmission. There has been no prior published guidance for management of these movement disorders for the intensivist. Herein, we discuss the immune-mediated encephalitis most likely to cause critical illness, clinical features and mechanisms of movement disorders and propose a management algorithm.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA