The use of instrumental examinations in the diagnosis of headaches.

Headaches are the most common complaint reported by patients to their physician. They can be divided into spontaneous and symptomatic. The findings of the history and examination may suggest the need for diagnostic testing. The ancillary investigation and management of headache is discussed.

[Differential diagnosis in multiple sclerosis: description of selected cases]. / Diagnostyka róznicowa stwardnienia rozsianego--omówienie na podstawie wybranych przypadków.

Multiple sclerosis (MS) should be differentiated with diseases causing disseminated lesions of central nervous system or imitating clinical course of MS. Clinical course and results of laboratory investigations also immunological tests should be taken into account in differential diagnosis of MS. We present four patients whose proper diagnoses were based on the immunological investigations.

[General cerebral and systemic metabolic disturbances occurring in ischemic stroke with special emphasis on glucose and its metabolites]. / Zasadnicze wewnatrzmózgowe i ogólnoustrojowe zaburzenia metaboliczne wystepujace w udarach mózgu ze szczególnym uwzglednieniem losów glukozy i jej metabolitów.

Ischaemic stroke is a stressogenic factor triggering a complex defensive reaction called "alarm reaction" by Selye. Stress gives rise to liberation of catecholamines, dopamine beta-hydroxylase in the blood, cerebro-spinal fluid and urine. Patients with ischaemic stroke were found to have increased adrenaline, noradrenaline, and 3-metoxy-4-hydroxymandelic acid level in urine and increased cortisol level in blood serum. Patients, especially those with severe ischaemic stroke have increased concentrations of glucose metabolites in blood and cerebro-spinal fluid: pyruvate acid, lactic acid, acetylacetic acid and hydroxybutyric acid.

[Evaluation of lactic acid levels in blood of patients with ischemic stroke in the earliest stage of the disease]. / Ocena zawartosci kwasu mlekowego we krwi chorych z zawalem mózgu w najwczesniejszym okresie choroby.

The aim of the study was the assessment of concentrations of lactic acid in the blood of patients with mild course and severe course of ischaemic stroke in the earliest stage of the disease. The subject of the study were 20 patients with a mild ischaemic stroke and 20 patients with a severe one on its 1st, 3rd and 7th day. Enzymatic method for determining lactic acid content in the blood was used (the kits Test-Combination Lactate fully enzymatic of Boehringer Mannheim). In the group of patients with mild ischaemic stroke increase values of lactic acid were shown on all days of the disease, but the differences were statistically insignificant. In patients with severe ischaemic stroke these values were higher than in controls, and the differences were statistically significant. The study showed a positive correlation between high concentrations of lactic acid and severe clinical condition of patients.

[Evaluation of pyruvic acid concentration in blood of patients with ischemic stroke in the earliest stage of the disease]. / Ocena zawartosci kwasu pirogronowego we krwi chorych z zawalem mózgu w najwczesniejszym okresie choroby.

The aim of the study was the assessment of concentrations of pyruvic acid in the blood of patients with mild course and severe course of ischaemic stroke in the earliest stage of the disease. The subject of the study were 20 patients with a mild ischaemic stroke and 20 patients with a severe one on its 1st, 3rd and 7th day. Enzymatic method for determining pyruvic acid content in the blood was used (ready made reagents Test-Combination Pyruvate by Boerhinger Mannheim). In the group of patients with mild ischaemic stroke the concentrations of pyruvic acid were increased on all days of the disease, compared with controls, but the differences were statistically insignificant. In the group of patients with severe ischaemic stroke the concentrations of pyruvic acid were higher than the ones in control group, but only on the 1st and 3rd day of the disease the differences were statistically significant. The results of determinations indicate that there is a positive correlation between levels of pyruvic acid and severity of the clinical course of the disease.