[Peer review of routine clinical case reports - an instrument of quality management? Results of a pilot investigation]. / Peer-Review neurologischer Arztbriefe - ein Instrument zur Erfassung der Prozess- und Ergebnisqualität? Ergebnisse einer Pilotuntersuchung.

A scoring system for quality assessment of neurological routine case reports was developed in cooperation with the Quality Management Commission of the German Neurological Society (DGN). Five clinical departments of neurology submitted eight anonymized reports for each of seven tracer diagnoses (CNS hemorrhage, ischemic infarction in the anterior circulation, epilepsy, Parkinsonism, bacterial CNS infection, multiple sclerosis (initial diagnosis), polyneuropathy) which were reviewed by two neurologists from different departments. The reports reflect differences between departments concerning certain procedures, especially technical investigations and the use of standardized scores. Interrater reliability was low. However, there were significant and meaningful differences between departments, which can be used for quality improvement. The approach can be recommended for use in peer audits between hospitals.

[The early prognosis of massive infarcts of the cerebral cortex. Follow-up of 49 patients]. / Frühprognose von Masseninfarkten des Grosshirns. Beobachtungen an 49 Patienten.

Mass cerebral infarction have a high lethality already in the first week after onset. Surviving patients often have severe residual neurological deficits. We analysed the clinical course of 49 patients with space-occupying cerebral infarctions in a retrospective study. We differ subtotal infarction in the region of middle cerebral artery (MCA) from complete infarction and from complete infarction in the region of MCA with additional infarction on the same hemisphere. The quick development from depression of consciousness, the Babinski-phenomena on both sides and the central failure of respiration were the most valuable clinical predictors. Together with the clinical parameters, the Mathew-score and the CT and EEG-results it is possible, to estimate a reliable prognosis. The reduction and termination of no longer useful treatments will be discussed.

[Acute course of arthropathia syringomyelica. A case history contribution to the differential diagnosis of acute affection of the shoulder joint (author's transl)]. / Akuter Verlauf bei Arthropathia syringomyelica. Ein kasuistischer Beitrag zur Differentialdiagnose der akuten Schultergelenksaffektion.

Basing on own observations of a typical base, the article presents the clinical and X-ray symptoms of an acute arthropathia syringomyelica of only 3 weeks' duration. Differential diagnosis of inflammatory or tumorous processes of the shoulder joint is performed and it is pointed out that accurate diagnosis is possible despite the rare occurrence of the condition. Contrary to the opinion held by other authors, the present study seems to permit the interpretation that destruction of the joint originates from the bony joint mouse.