ABSTRACT
We assessed a screening instrument, adapted from a model suggested by WHO, aimed to perform population studies on the prevalence of cerebrovascular disease in Chile. Sixty-two subjects, 31 with cerebrovascular diseases and 31 without, were asked about symptoms and requested to do simple movements by trained interviewers. The results of the instrument were compared with a neurological examination performed by two specialists. Global sensitivity and specificity of the instrument, using WHO evaluation criteria, were 100 and 38.7 percent respectively. When three or more symptoms and one positive sign were considered as cutoff points, global specificity increased to 61 percent and sensitivity decreased to 93 percent. It is concluded that the present instrument is highly sensitive but lacks specificity
Subject(s)
Humans , Male , Female , Middle Aged , Cerebrovascular Disorders/epidemiology , Mass Screening , Cross-Sectional Studies , Predictive Value of Tests , Surveys and Questionnaires , Sensitivity and Specificity , Age Distribution , Sex Distribution , Neurologic Examination/methodsABSTRACT
Vertebral artery dissection seems to be a frequent cause of stroke in young adults. We report a 34 years old female that suffered a cardiac arrest while practicing aerobics, with complete recovery and four months later developed an acute Wallenberg`s syndrome. Magnetic resonance imaging showed an infarction in the right cerebellar hemisphere. Angiography revealed an occlusion of the third segment (V3) of the right vertebral artery which was hypoplastic. The patient was anticoagulated with a favorable clinical outcome. A follow up angiography, performed six months later, showed an incomplete recanalization of the vessel. Vertebral artery dissection should be suspected in every patient with ischemic symptoms or signs related to the vertebrobacilar territory, specially in young or middle aged patients with a history of trauma. magnetic resonance imaging and ultrasound-doppler examinations are the diagnostic test of choice