[Clinical relevance of headache in cerebral ischaemia]. / Relevancia clínica de la cefalea en la isquemia cerebral.

TITLE: Relevancia clínica de la cefalea en la isquemia cerebral.

Registros hospitalarios de ictus: similitudes y diferencias / Hospital stroke registers: Similarities and differences

No disponible

Exactitud en las citas históricas. Réplica / Precision in historical quotations. Reply

No disponible

Las primeras sociedades neurológicas catalanas y sus protagonistas / The first Catalan Neurological Societies and their protagonists

Introduction: El conocimiento de las sociedades neurológicas anteriores a la Sociedad Española de Neurología (año 1949) es escaso. Las analizamos partiendo de la pionera Sociedad de Psiquiatría y Neurología de Barcelona, fundada en 1911. Desarrollo: Efectuamos una búsqueda bibliográfica mediante MEDLINE a partir de la palabra clave neurological societies, utilizando también la tesis doctoral de M.G. Fabregas «Història de la Neurologia a Catalunya. De l’any 1882 a l’any 1949» y de fuentes bibliográficas históricas originales de la Biblioteca de la Acadèmia de Ciències Mèdiques de Catalunya i Balears de Barcelona. En Cataluña y en España, la primera sociedad neurológica se creó hace un siglo, y fue la Sociedad de Psiquiatría y Neurología de Barcelona, fundada por Artur Galcerán i Granés en 1911. Posteriormente, se denominaría Societat Catalana de Psiquiatria i Neurologia y en 1934 estaría presidida por Belarmino Rodríguez Arias. Con la guerra civil se disolvió y reaparecería con el nombre de Asociación de Psiquiatría y Neurología y estaría presidida por José Córdoba Rodríguez (1941). Dicha sociedad sería precursora de la Asociación de Ciencias Neurológicas de Barraquer Bordas (año 1968) y ésta lo sería de la Societat Catalana de Neurología, fundada por Codina Puiggrós en 1973. Conclusiones: La Sociedad de Psiquiatria y Neurologia de Barcelona fundada en 1911 por Galcerán i Granés, y precursora de la Societat Catalana de Neurologia, fue la primera sociedad neurológica. Se debe remarcar que en el año 2011 se cumplen 100 años de la fundación de la primera sociedad neurológica catalana y española (AU)

Introduction: Little is known about the first Catalan neurological societies. Our aim was to analyse them from the formation of the pioneering Society of Psychiatry and Neurology of Barcelona founded in 1911. Development: We performed a literature search using MEDLINE using the key words: neurological societies, using the doctoral thesis of MG Fabregas: «History of Neurology in Catalonia: from 1882 to 1949» and original historical bibliographical sources of the Library of the Academy of Sciences Mèdiques de Catalunya i Balears. The presence of neurological societies in Catalunya is relatively recent. The first society was established a century ago, and was the Society of Psychiatry and Neurology of Barcelona, founded by Artur Galcerán i Granés in 1911. This became the Catalan Society of Neurology and Psychiatry in 1934 under the presidency of Belarmino Rodriguez Arias. With the civil war, the society broke up and reappeared under the name Association of Psychiatry and Neurology presided over by José Córdoba Rodríguez (1941), emerging in 1968 as the Association of Neurological Sciences with Lluís Barraquer Bordas as President. In 1973 it assumed the current name of Catalan Society of Neurology under Agustí Codina Puiggrós.Conclusions: The Society of Psychiatry and Neurology of Barcelona founded in 1911 by Galcerán i Granés was the first neurological society and was a precursor of the Catalan Society of Neurology. It should be highlighted that in 2011 it will be 100 years since the founding of the first neurological society in Catalonia and Spain (AU)

[The first Catalan Neurological Societies and their protagonists]. / Las primeras sociedades neurológicas catalanas y sus protagonistas.

INTRODUCTION: Little is known about the first Catalan neurological societies. Our aim was to analyse them from the formation of the pioneering Society of Psychiatry and Neurology of Barcelona founded in 1911. DEVELOPMENT: We performed a literature search using MEDLINE using the key words: neurological societies, using the doctoral thesis of MG Fabregas: «History of Neurology in Catalonia: from 1882 to 1949¼ and original historical bibliographical sources of the Library of the Academy of Sciences Mèdiques de Catalunya i Balears. The presence of neurological societies in Catalunya is relatively recent. The first society was established a century ago, and was the Society of Psychiatry and Neurology of Barcelona, founded by Artur Galcerán i Granés in 1911. This became the Catalan Society of Neurology and Psychiatry in 1934 under the presidency of Belarmino Rodriguez Arias. With the civil war, the society broke up and reappeared under the name Association of Psychiatry and Neurology presided over by José Córdoba Rodríguez (1941), emerging in 1968 as the Association of Neurological Sciences with Lluís Barraquer Bordas as President. In 1973 it assumed the current name of Catalan Society of Neurology under Agustí Codina Puiggrós. CONCLUSIONS: The Society of Psychiatry and Neurology of Barcelona founded in 1911 by Galcerán i Granés was the first neurological society and was a precursor of the Catalan Society of Neurology. It should be highlighted that in 2011 it will be 100 years since the founding of the first neurological society in Catalonia and Spain.

Diagnóstico de la enfermedad de CADASIL en pacientes normotensos y no diabéticos con infarto lacunar / Diagnosis of CADASIL disease in normotensive and non-diabetics with lacunar infarct

Introducción: la enfermedad de CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy) se caracteriza por isquemias cerebrales recurrentes de tipo lacunar, habitualmente en pacientes sin factores de riesgo vascular. Analizamos la frecuencia de enfermedad de CADASIL en pacientes con infarto lacunar sin factores de riesgo vascular clásicos. Métodos: estudiamos pacientes con un primer infarto lacunar menores de 65 años sin hipertensión, diabetes mellitus u otra causa que justificara la isquemia cerebral. Realizamos estudio inmunohistoquímico de 5μm de espesor sobre biopsia cutánea usando el anticuerpo monoclonal anti-Notch 3 (1E4). Además del estudio inmunohistoquímico se realizó en todos los casos el estudio genético del gen Notch 3 de los exones 3, 4, 5, 6, 11 y 19. Resultados: de 1.519 pacientes con infarto lacunar, sólo 57 (3,7%) cumplieron los criterios de selección, y 30 de ellos aceptaron participar en el estudio. Analizamos 30 pacientes con edad media de 53 años; el 50% fueron hombres y todos presentaron un primer infarto cerebral tipo lacunar. El estudio inmunohistoquímico y genético confirmó la enfermedad de CADASIL en dos pacientes (6,6%) en el exón 4 nt 622C/T (Arg 182 Cys) y 694 T/C (Cys206Arg) respectivamente (AU)

Background: CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy) is characterized by recurrent cerebral ischemic episodes of the lacunar subtype usually without traditional vascular risk factors. We investigated the frequency of CADASIL among selected patients with cerebral ischemia of the lacunar subtype. Methods: we studied patients under 65 years old who presented cerebral ischemia of the lacunar subtype without hypertension, diabetes mellitus or other causes that explained the cerebral ischemia. On the skin biopsies, we performed immunostaining analysis on 5μm frozen sections with monoclonal antibody anti-Notch 3 (1E4). We also performed a genetic analysis of the Notch 3 gene (exons 3,4,5,6,11 and 19). Results: of 1.519 patients analyzed, only 57 (3.7%) fulfilled the selection criteria, and 30 of them accepted to participated in the study. We studied 30 patients, mean age was 53 years (range 34 to 65), 50% were men and all patients suffered a lacunar stroke. Immunostaining analysis was positive in two patients (6.6%) and the genetic analysis confirmed a mutation characteristic of CADASIL in exon 4 nt 622C/T (Arg 182 Cys) and 694 T/C (Cys206Arg) respectively. Conclusions: CADASIL disease was present in 6.6% of patients younger than 65 years with a lacunar stroke and without hypertension or diabetes mellitus. Screening for CADASIL should be considered in these patients (AU)

La faceta neurológica del Dr. Artur Galcerán i Granés (1850-1919) / The neurological work of Artur Galcerán i Granés (1850-1919)

Introducción: Analizar la faceta neurológica que es poco conocida de Artur Galcerán i Granés (Girona 1850-Barcelona 1919), fundador de la Sociedad de Psiquiatría y Neurología de Barcelona en 1911.Fuentes: Se efectúa una búsqueda bibliográfica mediante MEDLINE sin límite de fecha a partir de las palabras clave: “Galceran Granés” y “Society of Psychiatry and Neurology of Barcelona”, utilizando también la tesis doctoral de M. G. Fabregas Camps: “Història de la Neurologia a Catalunya. De l’any 1882 a l’any 1949”, y de fuentes bibliográficas históricas originales de la Biblioteca de la Acadèmia de Ciències Mèdiques de Catalunya i Balears de Barcelona. Desarrollo:Artur Galcerán i Granés se denominaba “neurólogo y mentalista”. Discípulo de la escuela de Psiquiatria de Joan Giné i Partagàs. Su obra neurológica fue notable, destacando: 1)“Algunas inducciones sobre estàtica y dinàmica del cerebro, que pueden servir para el esclarecimiento del concepto de localización”; 2) “Tratamiento de las epilepsias”, y 3) “Neuropatología y Psiquiatría generales”. Dirigió “Archivos de Terapéutica de las enfermedades nerviosas y mentales” y “Anales de la Sociedad de Psiquiatría y Neurología”. Fue director del sanatorio mental de Sant Boi de Llobregat y de Pere Mata de Reus. Fundó la primera sociedad neurológica catalana y española en Barcelona en el año 1911.Conclusiones: La faceta neurológica de A. Galcerán i Granés es remarcable y significativa. Fue el fundador de la primera sociedad neurológica catalana y española: la Sociedad de Psiquiatría y Neurología de Barcelona en el año 1911 precursora de la Societat Catalana de Neurologia (AU)

Introduction: To analyze the neurological work of Artur Galcerán i Granés (Girona 1850-Barcelona 1919) founder of the Society of Psychiatry and Neurology of Barcelona in 1911.Methods: We performed a literature search using MEDLINE from the Keywords ‘‘Galceran Granés’’ and ‘‘Society of Psychiatry and Neurology of Barcelona’’, using the doctoral thesis of M. G. Fabregas Camps: ‘‘History of Neurology in Catalonia. From 1882 to 1949 ’’, and original historical bibliographical sources of the Library of the Academy of Sciences Mèdiques de Catalunya i Balears. Results: Artur Galcegán i Granés was a disciple of the school of psychiatry of Dr. Joan Giné iPartagàs. His highlighting eurological work was: 1) ‘‘Some static and dynamic inferences aboutthe brain, which may serve to clarify the concept of localization’’, 2) ‘‘Treatment of epilepsy’’and 3) ‘‘Neuropathology and General Psychiatry’’. He was editor of ‘‘Archivos de Terapeúticade las enfermedades nerviosas y mentales’’ and ‘‘Anales de la Sociedad de Psiquiatría y Neurología’’. He was director of the mental asylum in Sant Boi of Llobregat and Pere Mata of Reus.In 1911 he founded the first Catalan and Spanish neurological society in Barcelona. Conclusions: The neurological work of Artur Galcerán i Granes is remarkable and significant. He was the founder of the first Catalan and Spanish neurological society: The Society of Psychiatry and Neurology of Barcelona in 1911, the forerunner of the Catalan Society of Neurology (AU)

Diagnosis of CADASIL disease in normotensive and non-diabetics with lacunar infarct.

BACKGROUND: CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy) is characterized by recurrent cerebral ischemic episodes of the lacunar subtype usually without traditional vascular risk factors. We investigated the frequency of CADASIL among selected patients with cerebral ischemia of the lacunar subtype. METHODS: we studied patients under 65 years old who presented cerebral ischemia of the lacunar subtype without hypertension, diabetes mellitus or other causes that explained the cerebral ischemia. On the skin biopsies, we performed immunostaining analysis on 5µm frozen sections with monoclonal antibody anti-Notch 3 (1E4). We also performed a genetic analysis of the Notch 3 gene (exons 3,4,5,6,11 and 19). RESULTS: of 1.519 patients analyzed, only 57 (3.7%) fulfilled the selection criteria, and 30 of them accepted to participated in the study. We studied 30 patients, mean age was 53 years (range 34 to 65), 50% were men and all patients suffered a lacunar stroke. Immunostaining analysis was positive in two patients (6.6%) and the genetic analysis confirmed a mutation characteristic of CADASIL in exon 4 nt 622C/T (Arg 182 Cys) and 694 T/C (Cys206Arg) respectively. CONCLUSIONS: CADASIL disease was present in 6.6% of patients younger than 65 years with a lacunar stroke and without hypertension or diabetes mellitus. Screening for CADASIL should be considered in these patients.

Early treatment of obstructive apnoea and stroke outcome: a randomised controlled trial.

The aim of the present study was to assess the impact of nasal continuous positive airway pressure (nCPAP) in ischaemic stroke patients followed for 2 yrs. Stroke patients with an apnoea-hypopnoea index ≥ 20 events·h⁻¹ were randomised to early nCPAP (n = 71; 3-6 days after stroke onset) or conventional treatment (n = 69). The Barthel Index, Canadian Scale, Rankin Scale and Short Form-36 were measured at baseline, and at 1, 3, 12 and 24 months. The percentage of patients with neurological improvement 1 month after stroke was significantly higher in the nCPAP group (Rankin scale 90.9 versus 56.3% (p < 0.01); Canadian scale 88.2 versus 72.7% (p < 0.05)). The mean time until the appearance of cardiovascular events was longer in the nCPAP group (14.9 versus 7.9 months; p = 0.044), although cardiovascular event-free survival after 24 months was similar in both groups. The cardiovascular mortality rate was 0% in the nCPAP group and 4.3% in the control group (p = 0.161). Early use of nCPAP seems to accelerate neurological recovery and to delay the appearance of cardiovascular events, although an improvement in patients' survival or quality of life was not shown.

The neurological work of Artur Galcerán i Granés (1850-1919).

INTRODUCTION: To analyze the neurological work of Artur Galcerán i Granés (Girona 1850-Barcelona 1919) founder of the Society of Psychiatry and Neurology of Barcelona in 1911. METHODS: We performed a literature search using MEDLINE from the keywords"Galceran Granés" and "Society of Psychiatry and Neurology of Barcelona", using the doctoral thesis of M. G. Fabregas Camps: "History of Neurology in Catalonia. From 1882 to 1949 ", and original historical bibliographical sources of the Library of the Academy of Sciences Mèdiques de Catalunya i Balears. RESULTS: Artur Galcerán i Granés was a disciple of the school of psychiatry of Dr. Joan Giné i Partagàs. His highlighting neurological work was: 1) "Some static and dynamic inferences about the brain, which may serve to clarify the concept of localization", 2) "Treatment of epilepsy" and 3) "Neuropathology and General Psychiatry". He was editor of "Archivos de Terapeútica de las enfermedades nerviosas y mentales" and "Anales de la Sociedad de Psiquiatría y Neurología". He was director of the mental asylum in Sant Boi of Llobregat and Pere Mata of Reus. In 1911 he founded the first Catalan and Spanish neurological society in Barcelona. CONCLUSIONS: The neurological work of Artur Galcerán i Granes is remarkable and significant. He was the founder of the first Catalan and Spanish neurological society: The Society of Psychiatry and Neurology of Barcelona in 1911, the forerunner of the Catalan Society of Neurology.

Microstructural white matter changes in metabolic syndrome: a diffusion tensor imaging study.

BACKGROUND: Although metabolic syndrome is associated with cardiovascular disease and stroke, limited information is available on specific brain damage in patients with this syndrome. We investigated the relationship of the syndrome with white matter (WM) alteration using a voxel-based approach with diffusion tensor imaging (DTI). METHODS: We compared fractional anisotropy (FA) and apparent diffusion coefficient (ADC) measurements of DTI in 19 patients with metabolic syndrome aged between 50 and 80 years and 19 age-matched controls without any vascular risk factors for the syndrome. RESULTS: Patients with metabolic syndrome showed an anterior-posterior pattern of deterioration in WM with reduced FA and increased ADC values compared with controls. WM changes were not related to any isolated vascular risk factor. CONCLUSION: Although the mechanism of this damage is not clear, the results indicate microstructural white matter alterations in patients with metabolic syndrome, mainly involving the frontal lobe.

La glucemia basal alterada es un factor de riesgo para el infarto cerebralaterotrombótico o lacunar. Estudio de casos y controles / Impaired fasting glucose as a risk factor for atherothrombotic or lacunar cerebral infarction. A case-control study

Introducción. Los factores de riesgo vasculares modificables(FRVM) para los infartos cerebrales aterotrombóticos y lacunares sonbien conocidos, pero hay pocos estudios poblacionales y desconocemosel riesgo de estados glucémicos previos a la diabetes mellitus(DM). El objetivo del trabajo es estudiar la relación entre la glucemiabasal alterada (GBA) y otros FRVM con los infartos cerebrales aterotrombóticosy lacunares.Métodos. Estudio de casos y controles de base poblacional realizadoen dos centros de salud urbanos. Casos: 236 pacientes con infartoscerebrales aterotrombótico o lacunar diagnosticados mediante tomografíacomputarizada o resonancia magnética. Se excluyeron los infartoscerebrales cardioembólicos de causa infrecuente o indeterminada ylas hemorragias intracerebrales. Controles: 441 pacientes sin infartocerebral, apareados por edad y sexo, seleccionados por muestreo aleatoriosimple. Mediante regresión logística se estudiaron las odds ratio(OR) de los factores de riesgo GBA, DM, tabaquismo, hipertensión arterial(HTA), hipercolesterolemia, hipertrigliceridemia y obesidad.Resultados. La edad media fue de 71,1 años, con un 62% devarones. La prevalencia en los casos de los FRVM fue: GBA, 32,9%;DM, 49,6%; tabaquismo, 26,3%; HTA, 78,8%; hipercolesterolemia,29,3%; hipertrigliceridemia, 18,2 %, y obesidad, 63,5%. Todos losFRVM se asociaron en el análisis crudo con un aumento del riesgo deinfarto cerebral. En el análisis multivariante se asociaron de manerasignificativa la GBA (OR: 3,2; intervalo de confianza [IC] del 95%:1,1-7,9), la DM (OR: 4,5; IC 95%: 1,4-14,9), la HTA (OR: 2,6; IC 95%:1,5-4,5), la hipercolesterolemia (OR: 2,3; IC 95%: 1,4-3,9) y la obesidad(OR: 1,7; IC 95%: 1,0-2,9).Conclusiones. Las alteraciones del metabolismo de la glucosaGBA y DM son un importante FRVM para el IC aterotrombótico ylacunar por la elevada magnitud de la OR y elevada prevalencia en lapoblación con infarto cerebral (AU)

Introduction. Modifiable vascular risk factors (MVRF) foratherotrombotic or lacunar cerebral infarction have been clearlyestablished, even though only a few population studies havebeen conducted and we do not know the risk of glycemic statusprior to the diabetes mellitus (DM). This study has aimed todetermine the relationship between impaired fasting glucose(IFG) and others MVRF with atherothrombotic or lacunar cerebralinfarctions.Methods. A population based case-control study was conductedin two urban health care centers. Cases: 236 patientswith atherothrombotic or lacunar CI, diagnosed by computedtomography scan magnetic resonance imaging. Unusual, indeterminateand cardioembolic cerebral infarction and cerebralhemorrhage were excluded. Controls: 441 patients withoutcerebral infarction, matched by age and gender, selected bymeans of simple random sampling. The odds ratios (OR) of IFG,DM, smoking, high blood pressure, hypercholesterolemia,hypertriglyceridemia, and obesity were measured with logisticregression.Results. Mean age was 71.1 years old, 62 % being male.Prevalence in cases of MVRF was: IFG, 32.9%; DM, 49.6 %;smoking, 26.3%; high blood pressure, 78.8%; hypercholesterolemia,29.3%; hypertriglyceridemia, 18.2%, and obesity, 63.5%.All MVRFs were associated in the crude analysis with increasedrisk of cerebral infarction. In the multivariate analysis, significantassociations were found for IFG (OR: 3.2; 95 % confidenceinterval [CI]:1.1-7.9), DM (OR: 4.5; 95 % CI: 1.4-14.9),high blood pressure (OR: 2.6; 95 % CI: 1.5-4.5), hypercholesterolemia(OR: 2.3; 95 % CI: 1.4-3.9), and obesity (OR: 1.7; 95%CI: 1.0-2.9).Conclusions. Alterations of the glucose metabolism IFG andDM are important MVRF for atherothrombotic or lacunar cerebralinfarction as seen by the high rate of OR and high prevalence inthe population with cerebral infarction (AU)

[Impaired fasting glucose as a risk factor for atherothrombotic or lacunar cerebral infarction. A case-control study]. / La glucemia basal alterada es un factor de riesgo para el infarto cerebral aterotrombótico o lacunar. Estudio de casos y controles.

INTRODUCTION: Modifiable vascular risk factors (MVRF) for atherotrombotic or lacunar cerebral infarction have been clearly established, even though only a few population studies have been conducted and we do not know the risk of glycemic status prior to the diabetes mellitus (DM). This study has aimed to determine the relationship between impaired fasting glucose (IFG) and others MVRF with atherothrombotic or lacunar cerebral infarctions. METHODS: A population based case-control study was conducted in two urban health care centers. CASES: 236 patients with atherothrombotic or lacunar CI, diagnosed by computed tomography scan magnetic resonance imaging. Unusual, indeterminate and cardioembolic cerebral infarction and cerebral hemorrhage were excluded. CONTROLS: 441 patients without cerebral infarction, matched by age and gender, selected by means of simple random sampling. The odds ratios (OR) of IFG, DM, smoking, high blood pressure, hypercholesterolemia, hypertriglyceridemia, and obesity were measured with logistic regression. RESULTS: Mean age was 71.1 years old, 62 % being male. Prevalence in cases of MVRF was: IFG, 32.9%; DM, 49.6 %; smoking, 26.3%; high blood pressure, 78.8%; hypercholesterolemia, 29.3%; hypertriglyceridemia, 18.2%, and obesity, 63.5%. All MVRFs were associated in the crude analysis with increased risk of cerebral infarction. In the multivariate analysis, significant associations were found for IFG (OR: 3.2; 95 % confidence interval [CI]:1.1-7.9), DM (OR: 4.5; 95 % CI: 1.4-14.9), high blood pressure (OR: 2.6; 95 % CI: 1.5-4.5), hypercholesterolemia (OR: 2.3; 95 % CI: 1.4-3.9), and obesity (OR: 1.7; 95% CI: 1.0-2.9). CONCLUSIONS: Alterations of the glucose metabolism IFG and DM are important MVRF for atherothrombotic or lacunar cerebral infarction as seen by the high rate of OR and high prevalence in the population with cerebral infarction.