Effect of size and location of unruptured intracranial aneurysms on self-reported headache.

AIM: To describe the relationship between aneurysm size and location and the prevalence of headache at diagnosis and three-and-six-month follow-up in a sample of patients with UIAs. MATERIAL AND METHODS: In this cohort study, patients were diagnosed with UIAs by digital subtraction angiography. Follow-up visits occurred three and six months after the diagnosis. Headache presence was registered and further classified by phenotypes. After DSA, recorded variables were: aneurysm number, morphology, location, and size (diameter [W], neck [N], and dome-neck distance [H]). The aspect ratio (H/N) and the dome/neck ratio (W/N) were calculated. The outcome of this study was the self-reported headache status at follow-up. RESULTS: Data from 42 patients and 46 aneurysms were available, 81.0% women, with a mean age of 57.4±14.3 years. Headache was reported by 61.9% of the patients. The pain phenotype was tension-type in 38.1%, migraine in 11.9%, neuralgia in 2.4%, and unclassifiable in 9.5%. The median (min-max) measurements were W=5.05 (0.89-22.9); N=3.02 (0.52-17.9); H=5.08 (0.92-23.0); aspect ratio 1.59 (0.68-17.69) and W/N ratio 1.65 (0.62-16.92). Thirty-three patients (37 aneurysms) received treatment, 47.8% by surgical clipping and 32.6% by endovascular occlusion. In treated patients, the headache persisted in 14.3% on the first and 9.5% on the second visit. There were no differences in any registered variables between patients with and without headaches at follow-up. CONCLUSION: This study found data that supports that headache in patients with UIAs improves after treatment and that such improvement is probably unrelated to the size and shape of the UIAs.

A Clinical Prognostic Scoring System for Neurocysticercosis.

Objectives In patients with neurocysticercosis (NCC), an accurate risk prediction would allow a better therapeutic approach; however, there are currently no tools that can enhance the accuracy of risk prediction. We designed a prognostic scoring system to be used by neurologists and other physicians managing patients with NCC. Materials and Methods Using data from clinical records of patients from a third-level national reference center for neurological diseases, we assessed demographic, clinical, and tomographic variables among 293 patients diagnosed with NCC. Multivariable logistic regression analyses were used to develop a clinical prognostic scoring instrument. Patients with NCC were assessed for neurological impairment at 3 months after diagnosis. Statistical Analysis Score accuracy was assessed by receiver operating characteristic (ROC) curve analysis. The primary outcome was the presence of neurological impairment, resulting in disability according to self-report or caregiver reports; this outcome was assessed during follow-up visits at 3 ± 1 months after discharge. Results The most common symptoms at presentation were headache (67%) and seizure (63%). A six-item (total score from -4 to + 2) prognostic instrument was constructed on the basis of the presence of seizures/headache at presentation, a leukocyte count above 12x 109/dL, the presence of six to ten parasites, subarachnoid localization, and the use of anthelmintic drugs. Among 113 patients with negative scores, 79.6% developed neurological deficits. Among patients with scores of 1 to 2, 64.6% recovered completely, with an overall accuracy of prediction of 74.7% and area under the ROC curve = 0.722 (95% CI, 0.664-0.780, p < 0.0001). Conclusions The clinical prognostic scoring system for NCC described in this study is a new instrument for use in daily clinical practice. It is simple to administer, and it has a prognostic accuracy of 75%. Its use has the potential to improve the quality of care by guiding appropriate decision-making and early management of patients with NCC.

Demographic, clinical and comorbidity data in a large sample of 1,147 patients with migraine in Mexico City.

The objective was to identify the sociodemographic and clinical characteristics of a large sample of patients with migraine in Mexico City. This cross-sectional study was performed in two tertiary centers in Mexico City and affiliated hospitals. We evaluated the presence of migraine through a standardised interview according to the criteria of the International Headache Society. We studied 1,147 patients. The mean age was 37.1+/-13.6 (6-77) years. Nine hundred and twenty one patients were female (80%). The age of onset of migraine was 19.4+/-10.3 (1-69) years. Six hundred and four patients had migraine with aura (53%) and 543 without aura (47%). The female/male ratio was 4:1. One hundred and forty-seven patients had cardiovascular problems (13%), 72 had neurological problems (6%), 233 had gastrointestinal problems (20%) and 323 had psychiatric problems (28%). In this study we described the clinical characteristics of a large sample of patients with migraine in Mexico City. Our sample has similar characteristics to other countries.

Marinesco-Sjögren syndrome

El síndrome de marinesco Sjögren (MS)esta caracterizado por cataratas, ataxia y retraso mental aunque puede acompañarse de muchos otros síntomas. Existen casos familiares y otros que aparecen sin estas características. Se presenta un caso de MS de aparición temprana en México sin historia. familiar. Un estudio completo se llevó a cabo.

Adenoid cystic carcinoma: a rare cause of cavernous sinus syndrome

Los carcinomas forman parte de las neoplasias epiteliales malignas. Ha sido descrito con distintos nombres. Es un tumor sólido que se presenta en las orbitas o fosas nasales. Se presenta en caso de cavernoma crónico.

Comorbilidad de la cefalea tensional y la migraña en la población abierta del Distrito Federal / Tensional headache and migraine associated in an open study at the Federal District

La cefalea tensional y la migraña representan un problema de salud que se reporta frecuentemente en la población, se ha descrito en la literatura médica mundial que muestran comorbilidad con la ansiedad y la depresión; sin embargo, en México no existen estadísticas actualizadas en relación a este fenómeno, por lo que, el objetivo de este estudio fue identificar la comorbilidad de la cefalea con la ansiedad y la depresión. El estudio fue realizado con 2 500, sujetos, 1 250 hombres y 1 250 mujeres con edades de 18 a 80 años. Para el diagnóstico se utilizó la Clasificación Internacional de Cefaleas se obtuvieron datos de migraña, probable migraña, cefalea tensional y probable cefalea tensional, los resultados mostraron que la migraña presenta mayor comorbilidad con la depresión y la ansiedad así como con insomnio que la cefalea tensional. Igualmente las mujeres presentan mayor frecuencia de alteraciones comorbidas en especial ansiedad.