1,721,127 research outputs found

    Limb ataxia and proximal intracranial territory brain infarcts: clinical and topographical correlations

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    BACKGROUND: Limb ataxia is classically attributed to cerebellar hemispheric lesions, although isolated lesions of the inferior cerebellar peduncle (ICP) in the medulla may also cause this sign. It is still unclear why only some patients with acute cerebellar infarcts in the posterior inferior cerebellar artery (PICA) territory present with limb ataxia. The proximal intracranial posterior circulation (P-PC) territory includes structures fed by the intracranial vertebral arteries (ICVAs): the medulla, supplied by small ICVAs branches, and posterior inferior portion of the cerebellum, fed by PICA. ICP and PICA territory cerebellar infarcts most often occur independently but occasionally occur together. OBJECTIVE: To identify structures responsible for limb ataxia in acute P-PC brain infarcts, correlating clinical and topographical findings. METHODS: Sixteen patients (8 women) were included, aged 30-82 years (mean 62 years), with isolated acute strokes in the P-PC territory. RESULTS: The cases reported here indicate that limb ataxia in acute P-PC territory infarcts may be associated with damage to the ICP in the dorsolateral medulla, regardless of a hemispheric cerebellar lesion. In fact, among the nine patients with PICA stroke, limb ataxia was observed only in the two patients who also presented damage to the dorsolateral medulla involving the ICP. Of the seven patients with isolated dorsolateral medullary infarct, only five patients with ICP damage had limb ataxia. CONCLUSIONS: When correlating limb ataxia and acute P-PC infarcts, it is important to take into account the entire ICVA territory

    Prevention of cardioembolic events after intracranial hemorrhage.

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    In high thromboembolic risk patients who experienced hemorrhagic stroke, the prevention of cardioembolic events and recurrence of intracranial bleeding should be guaranteed. The consultant cardiologist should carefully identify the most appropriate therapeutic approach for these patients. Among patients with previous hemorrhagic stroke, only few restart oral anticoagulant therapy (OAT) after cerebral bleeding; however, as reported by some registries, it is likely that resuming OAT exerts a favorable effect on the combined outcome of ischemic stroke/systemic embolism/all-cause death. In these patients, several parameters should be evaluated, such as the type of intracranial bleeding, the presence of a previous thromboembolic event, the global thromboembolic risk, as well as the history of a previous OAT. This review deals with a particularly interesting matter, requiring a number of decision-making turning points, i.e. whether it is appropriate or not to start or resume OAT, what drug class and timing choice in such a case, and the potential valuable alternatives to OAT

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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