ABSTRACT
Reviewing clinical, pathological and neuroimaging findings on idiopathic normal pressure hydrocephalus many clues arise towards an association with cerebrovascular disease. This hypothesis, however, should be confirmed by further studies.
Subject(s)
Hydrocephalus, Normal Pressure/physiopathology , Hydrocephalus/physiopathology , Aged , Aged, 80 and over , Female , Humans , Male , Middle AgedABSTRACT
We report a case of essential thrombocythemia, the only clinical manifestation of which consisted of neurologic symptoms, including anomic aphasia, tactile and painful hypesthesia in the right hand, headache, and Gerstmann syndrome, with a relatively benign and slowly progressive clinical course. Neuroradiologic examination disclosed a large ischemic area in the left temporoparietal region. Cerebral angiography revealed an occlusion of the cortical branches of the left middle cerebral artery with total sparing of the carotid vessel. These findings are discussed in relation to the possible pathogenetic mechanisms of the vascular occlusion due to abnormal platelet function in essential thrombocythemia.
Subject(s)
Brain Ischemia/etiology , Thrombocythemia, Essential/complications , Adult , Arterial Occlusive Diseases/diagnostic imaging , Arterial Occlusive Diseases/etiology , Brain Ischemia/diagnostic imaging , Brain Ischemia/physiopathology , Busulfan/therapeutic use , Cerebral Arterial Diseases/diagnostic imaging , Cerebral Arterial Diseases/etiology , Humans , Magnetic Resonance Imaging , Male , Thrombocythemia, Essential/drug therapy , Tomography, X-Ray ComputedABSTRACT
A case-control study was performed to verify the association between the risk factors for cerebrovascular disease and the syndrome of ventricular enlargement with gait apraxia (VEGAS). This syndrome was defined on the basis of clinical and CT criteria alone; however, it may be representative of patients with idiopathic normal pressure hydrocephalus in whom gait disturbance is the initial symptom. Seventeen patients were matched for age and sex with one hospitalised and two general population controls. Among the risk factors considered we found a significant statistical association between VEGAS and hypertension (odds ratio = 3.14; p = 0.032), ischaemic heart disease (odds ratio = 4.20; p = 0.013), ECG ischaemic changes (odds ratio = 3.67; p = 0.029), low HDL-cholesterol levels (odds ratio = 3.75; p = 0.028) and diabetes (odds ratio = 6.00; p = 0.018). Our findings indicate that risk factors for cerebrovascular disease may play a role in the development of VEGAS.
Subject(s)
Apraxias/etiology , Cerebral Ventricles/pathology , Gait , Hydrocephalus, Normal Pressure/etiology , Hydrocephalus/etiology , Aged , Cholesterol, HDL/blood , Coronary Disease/complications , Diabetes Complications , Dilatation, Pathologic/etiology , Female , Humans , Hypertension/complications , Ischemic Attack, Transient/complications , Male , Middle Aged , Risk Factors , Smoking/adverse effects , Tomography, X-Ray ComputedABSTRACT
An epidemiological survey of the prevalence of snoring and sleep apnoeas was performed on 3479 30-69-year-old men living in Bologna, north-east Italy. First a postal questionnaire was sent. It was returned with appropriate answers by 1170. A 20% random sample of those who did not answer were invited by telephone to return the questionnaire. Among these groups 119 (10%) and 19 (5.6%) respectively answered that they always snored. A random sample of 40 every-night snorers were studied by polysomnography. Based on the frequency of every-night snoring and the results of polysomnography we estimated that the minimal prevalence of sleep apnoea among 30-69-year-old men was 2.7% considering an apnoea + hypopnoea index of 10 or more pathological. According to the Lugaresi classification we had a 2.5% prevalence of heavy snorers' disease (HSD) Stage 1 or higher. These figures indicate that obstructive sleep apnoea during sleep is a major public health problem.
