The possible role of oxidative stress marker glutathione in the assessment of cognitive impairment in multiple sclerosis.

Oxidative stress markers have a distinct role in the process of demyelination in multiple sclerosis. This study investigated the potential correlation of markers of oxidative stress (glutathione [GSH], catalase) with the number of demyelinating lesions and the degree of disability, cognitive deficit, and depression in patients with relapsing-remitting multiple sclerosis (RRMS). Sixty subjects meeting the criteria for RRMS (19 men and 41 women), and 66 healthy controls (24 men, 42 women) were included. In this study, GSH significantly negatively correlated with the degree of cognitive impairment. This is the first study of subjects with RRMS that performed the mentioned research of serum GSH levels on the degree of cognitive damage examined by the Montreal Scale of Cognitive Assessment (MoCA) test. The development of cognitive changes, verified by the MoCA test, was statistically significantly influenced by the positive number of magnetic resonance lesions, degree of depression, expanded disability status scale (EDSS), age, and GSH values. Based on these results, it can be concluded that it is necessary to monitor cognitive status early in RRMS patients, especially in those with a larger number of demyelinating lesions and a higher EDSS level and in older subjects. Also, the serum level of GSH is a potential biomarker of disease progression, which could be used more widely in RRMS.

The incidence of stroke at Department of Neurology, Dubrovnik General Hospital in 2008.

Data on all patients admitted in 2008 to the Department of Neurology, Dubrovnik General Hospital, were retrospectively analyzed. In a total of 663 patients, there were 247 (37.25%) stroke patients. Ischemic stroke was diagnosed in 217 (87.85%) and hemorrhagic stroke in 30 (12.15%) patients. In the cohort of stroke patients, there were 136 (55.00%) women and 111 (45.00%) men. The group of patients with ischemic stroke consisted of 124 (57.15%) women and 93 (42.85%) men, and the group of those with hemorrhagic stroke of 12 (40%) women and 18 (60%) men. The majority of patients with ischemic stroke (89.86%) and hemorrhagic stroke (76.66%) were over 60 years of age. Only 9 (4.14%) patients with ischemic stroke and 5 (16.66%) patients with hemorrhagic stroke were employed. The mortality rate was 20.24% in the overall stroke group and 19.35% in the ischemic stroke group. In the group of patients with hemorrhagic stroke, 26.66% of patients died at our Department, however, additional 20% of patients with this type of stroke were transferred to the Hospital Intensive Care Unit or to Departments of Neurosurgery in Split and Zagreb, so precise data on the disease outcome in these patients were missing. Eighteen (7.29%) patients were from other countries, mostly from Bosnia and Herzegovina. The majority of them had ischemic stroke (83.33%) and 12 (66.66%) patients were over 60 years of age.

Benign angiopathy of the central nervous system or reversible cerebral vasoconstriction syndrome.

Benign angiopathy of the central nervous system is a subset of primary angiitis of the central nervous system characterized by "benign" course. It means that changes of cerebral vessels are reversible after treatment with corticosteroids and calcium channel blockers, so these abnormalities are believed to reflect vasospasm rather than true vasculitis. The diagnosis is made on the basis of clinical presentation, brain magnetic resonance imaging and cerebral angiography. We present a young man with acute onset of headache and neurologic impairment secondary to ischemic stroke with intracerebral and subarachnoid hemorrhage. Cerebral angiography showed characteristic findings of diffuse vasculitis but good response to treatment with corticosteroids and calcium channel blockers distinguish this benign angiopathy from the more aggressive form of the central nervous system vasculitis.