Posttraumatic epilepsy is result of head trauma. The aim of our research was to establish how many patients after head trauma developed posttraumatic epilepsy (PTE). Retrospectively we analyzed 50 ...patients with head trauma different severity in period from 1989 to 2008, which we werified radiological, electroenfephalographic, and psychical changes were established according pto psychiatric examination. From 50 patient with head trauma, 40 developed seizures (3 in the firs 24 hours and 6 after first 24 hours to the end of first week, 31 after first week). By introducing antiepileptic therapy (AETh), 30 patients were seizure free, 10 patients had 1-2 epileptic seizure monthly (EPA/CPA), 10 patients got prophylactic AETh in period 6-12 months. 14 patients developed psychical changes which were verified by psychiatrist. The experience and literature show that posttraumatic epilepsy is good for treating with 1 or 2 antiepileptic, and remission is more difficult in case psychiatric comorbidity.
Aim To investigate influence of therapy with new generation antiepileptic drugs (AEDs) in fastening of posttraumatic epilepsy (PTE) remission comparing to therapy with standard AEDs, as well as the ...time to remission in the presence of psychiatric comorbidities. Methods The study was conducted during the 1988-2008 period and included 113 patients (47 females and 67 males) with PTE and 113 patients (93 females and 20 males) suffering from complex partial seizures (CPS) of temporal lobe origin. In both patient groups, epileptic seizure phenotype, brain magnetic resonance imaging (1.5 T and 3.0 T) and electroencephalogram were analyzed within 24 hours of epileptic seizure and after 5 years of treatment. Psychological testing was administered prior to therapy initiation. Results The patients treated with standard AEDs achieved remission in 82 (73%) cases as compared with 87 (77%) patients administered with a new generation AEDs; in the latter group, remission was achieved faster (1.85 vs. 1.6 months). In both patient groups, psychiatric comorbidity prolonged time to remission by 3.4 months. Conclusion Therapy with new generation AEDs enables achieving faster and complete remission in PTE patients.
Provider: - Institution: - Data provided by Europeana Collections- Ciljevi: Oboljeli od posttraumatske epilepsije postižu remisiju brže pri primjeni antiepileptika nove generacije u odnosu na ...standardne antiepileptike. Nacrt studije: Podatci su prikupljani djelomično retrospektivno (1988. – 2003.), djelomično prospektivno ( 2003. – 2008.), istraživanje je završeno 2013.g. Analizirali smo: anamnezu, kliničku sliku, neuroradiološku obradu (CT/MR mozga), EEG (inicijalni i kontrolni), psihologijsko testiranje, psihijatrijski pregled. Podijeljeni su u dvije skupine: na terapiji standardnim antiepilepticima i na terapiji antiepilepticima nove generacije. Analizirano je vrijeme potrebno za postizanje remisije bolesti u obje podskupine, na terapiji standardnim antiepilepticima i antiepilepticima nove generacije, promjene u EEG-u prije i nakon provedene antiepileptične terapije, te utjecaj psihijatrijskih komorbiditeta na vrijeme postizanja remisije bolesti. Ispitanici i metode: U istraživanju je sudjelovalo 226 ispitanika. 113 ispitanika s doživljenom traumom glave u periodu od 1998. do 2008. i dokazanom posttraumatskom epilepsijom (PTE), praćeni do 2013, MR s patomorfološkim supstratom, obrađeni i praćeni u Ambulanti za epilepsije od 1988. do 2013. Kontrolnu skupinu činilo je 113 bolesnika oboljelih od idiopatske epilepsije (IE), MR bez patomorfološkog supstrata. Rezultati: Bolesnici oboljeli od posttraumatske epilepsije liječeni antiepilepticima nove generacije postigli su remisiju ranije u odnosu na bolesnike iste skupine koji su liječeni standardnim antiepilepticima ( 3 mjeseca u odnosu na 3 - 5 mjeseci). Psihijatrijski komorbiditet produljuje vrijeme postizanja remisije u obje podskupine bolesnika – za 3,4 mjeseca. Zaključak: Terapija antiepilepticima nove generacije u odnosu na terapiju standardnim antiepilepticima dovodi do ranije remisije bolesti posttraumatska epilepsija. Psihijatrijski komorbiditeti produljuju vrijeme postizanja remisije u obje podskupine bolesnika, na terapiji antiepilepticima nove generacije i standardnim antiepilepticima.- Objectives: Patients with posttraumatic epilepsy achieved remission faster with coadministration new generation of antiepileptic drugs (AEDs) than with standard antepileptics. Study design: Data collected partly retrospective ( 1988-2003), partly prospective (2003-2008). The research completed at 2013. The study included 226 patients: 113 with posttraumatic epilepsy (PTE) and 113 with idiopathic epilepsy (IE). We analyzed: a medical history, clinical presentation, neuroradiology (CT / MRI), EEG (initial and control), psychological testing, psychiatric examination. All respondents are divided into two groups: on the therapy with standard antiepileptics (AED) and on the therapy of new generation antiepileptics. The time required to achieve remission of the disease in both subgroups with standard AED and new generation AED, EEG changes before and after AED therapy and the influence of psychiatric comorbidities at the time of remission of the disease were analyzed. Patients and methods: The study included 113 patients with head trauma experienced in the period from 1988 to 2008 and the proven posttraumatic epilepsy, followed by 2013, MRI positive, 18 years and older, treated and followed up at the Outpatient Department for epilepsy 1988 - 2013 . The control group consisted of 113 patients with IE, MRI negative, 18 years and older. Results: : Patients suffering from posttraumatic epilepsy treated with antiepileptic drugs of the new generation have achieved remission earlier than patients treated with standard antiepileptics (up to 3 months compared to 3-5 months). Psychiatric comorbidity prolonged time to achieve remission in both subgroups - 3.4 months. Conclusion: The treatment with new generation antiepileptic drugs leads to earlier remission posttraumatic epilepsy. Psychiatric comorbidity prolong the time to achieve remission in both subgroups.- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
Traumatic brain injury (TBI) is the most common cause of acquired disability and death in children. Retrospective analysis showed 350 children, 128 (36.6%) girls and 222 (63.4%) boys who were ...hospitalized for injury of neurocranium in a 5 year-period in Dr. Josip Bencević General Hospital in Slavonski Brod. Most of them had both contusion and commotion (46.8%), followed by just contusion of the head (12.5%) and fractures of the skull (10.5%). The haemorrhages and hemathomas were less common (epidural, subdural, SAH) (3.2%). The procedures performed showed that in almost all children X-rays had been performed (99.7%). The most commonly X-rays performed were those of the head (craniogram) and/or cervical spine, followed by CT, EEG, ultrasound and NMR. The occurence of complications was recorded in only 2% of injured children (seizure, syncopa, febrile convulsions). Analysis of treatment methods showed that in most children (89.6%) therapy was conservative. The injured children were hospitalizated mostly for 2 days (34.5%) or 3 days (32.5%), while longer hospitalization was less common. Regarding extra consultation of other specialists (besides neurosurgeons), the most commonly consulted were pediatrician, surgeon/traumatologist, specialist of ENT/maxilofacial surgery, neuropediatrician, pediatric surgeon, ophthalmologist and others. It can be said that the prognosis of TBI in children depends on the age, neurological status and kind of injury, and on the quality of care, which involves availability of neurosurgeons and other specialists.
Giant aneurysm of basilar artery Sapina, Lidija; Lojen, Gordana; Janjetović, Zeljka ...
Collegium antropologicum
35, Številka:
2
Journal Article
Recenzirano
In the article we showed the patient, a woman with unruptured giant aneurysm of basilar artery, we showed the done examinations, and therapy dilemmas about what to do in the given case. We found in ...literature a number of examples which suggest operation treatment, but of embolisation too, some suggest conservative treatment.
A 57-year-old woman presented to the eye clinic for impaired vision on the left eye persisting for three months. Clinical examination revealed massive peripapillary exudate and stellate macular ...exudate, raising suspicion of a cat-scratch disease. Tetracycline therapy was introduced, followed by azithromycin and topical corticosteroids. Serologic testing for Bartonella henselae and Bartonella quintana was performed. In the first sample, Bartonella quintana IgG titer was 128, and IgM titer 20, whereas in repeat sample the respective findings were 64 and negative. Such a titer dynamics pointed to Bartonella quintana infection. The prescribed therapy resulted in vision improvement and normalization of the clinical picture. After nine months of therapy initiation, macular exudate had almost completely disappeared. Based on the patient's history, symptoms, therapeutic response and IgM pattern, the neuroretinitis must have developed secondary to Bartonella quintana infection.
Ocular dirofilariasis: a case report Janjetović, Zeljka; Arar, Zeljka Vuković; Paradzik, Maja Tomić ...
Acta medica Croatica
64, Številka:
1
Journal Article
A case of ocular dirofilariasis in a female patient is presented. The zoonosis caused by parasites of the genus Dirofilaria is relatively rare in humans, with a higher incidence in south and central ...Europe, Asia and Africa. In Europe, dirofilariasis is mostly caused by the species Dirofilaria repens. In the past 50 years, the number of individuals involved has been on an increase, with about 780 cases reported in the literature to date. Dirofilaria is a parasite found in the dog, cat, racoon and bear. The parasite replicates in the animal's body and enters circulation in the form of microfilariae. These microfilariae reach the insect's digestive tract and are transmitted to another animal or human with subsequent mosquito bites. When transmitted to humans, the parasite is found in the skin and subcutaneous tissue, mucous membranes, and less frequently visceral organs. Concerning ocular involvement, infections of the eye and adnexa oculi and tumorous noninfectious growth of eyelid or orbit have been described to date. The symptoms of the disease vary and include local pain, proptosis, diplopia, palpebral and conjunctival edema, redness, feeling of foreign body, and impaired vision. The diagnosis is generally made by histologic identification of the parasite micro- and macroscopic characteristics, Dirofilaria DNA analysis by the method of polymerase chain reaction, and serology (ELISA) demonstrating the presence of Dirofilaria antibodies in serum. Treatment includes surgical excision of the parasite as an appropriate and efficient therapeutic procedure. A 76-old-female patient presented to outpatient ophthalmology clinic for occasional sensation of pain, rubbing and redness in her right eye. Initial therapy was introduced, resulting in short-lasting improvement. In two weeks, the patient was re-examined for recurrence of discomforts. Slit lamp examination performed temporally revealed a whitish motile, live parasite under the injected and chemotic bulbar conjunctiva. Upon surgical extirpation of the parasite, the diagnosis of dirofilariasis was verified by microbiologic identification.
Traumatske ozljede mozga (TOM) su jedan od vodećih uzroka stečene nesposobnosti i smrti djece. Retrospektivnom analizom utvrđeno je 350 djece, 128 (36,6%) djevojčica i 222 (63,4%) dječaka, ...hospitalizirane zbog ozljeda neurokranija u 5-godišnjem razdoblju u Općoj bolnici «Josip Benčević» u Slavonskom Brodu. Najviše je ozlijeđene djece imalo istodobno kontuziju i komociju (46,8%), zatim samu kontuziju glave (12,5%), te frakture kosti lubanje (10,5%). Rjeđa su bila krvarenja i hematomi (epiduralni, subduralni, subarahnoidna hemoragija) (3,2%). Analiza obrade je pokazala da je u gotovo sve djece učinjena rentgenska pretraga (99,7%). Najčešće je učinjen RTG glave (kraniogram) i/ili vratne kralježnice, zatim CT, EEG, UZV, te NMR. Pojava komplikacija zabilježena je u samo 2% ozljeđene djece (epileptički napadi, sinkopa, febrilne konvulzije). Praćenje kirurških zahvata pokazalo je da je u većine djece (89,6%) liječenje provedeno konzervativno. Dužina liječenja ozlijeđene djece najčešće je iznosila 2 dana (34,5%) ili 3 dana (32,5%), dok je duže liječenje bilo rjeđe. S obzirom na dodatnu konzultaciju drugih specijalista (uz neurokirurga) najčešće je konzultiran pedijatar, kirurg/traumatolog, specijalist ORL/maksilofacijalne kirurgije, neuropedijatar, dječji kirurg, oftalmolog i dr. Može se reći da prognoza TOM u djece ovisi o dobi, neurološkom statusu i vrsti ozljede, te kvaliteti skrbi koja uključuje dostupnost neurokirurga i drugih specijalista.
Ne razmišlja se dovoljno o anksioznim i depresivnim simptomima kod bolesnika s akutnim moždanim udarom, iako se zna da ovi problemi utječu na neurološki ishod. Cilj studije bio je utvrditi učestalost ...anksioznih i depresivnih simptoma u akutnoj fazi ishemijskog moždanog udara te koji čimbenici utječu na ove probleme. Anksiozni i depresivni simptomi ocjenjivali su se pomoću Bolničke skale za anksioznost i depresiju kod 40 bolesnika s akutnim moždanim udarom primljenih tijekom jednog mjeseca. U statističkoj analizi primijenio se program SigmaStat (Version 2.0). Depresivni simptomi su bili prisutni kod 55%, a anksiozni simptomi kod 40% bolesnika, koji su svi istodobno imali i depresivne simptome. Nađena je korelacija depresivnih simptoma s MMSE (p<0,001), dobi (p=0,003) i BI(p<0,001), te anksioznih simptoma s MMSE (p<0,001) i BI (p=0,01). Nije bilo značajne povezanosti anksioznih i depresivnih simptoma s drugim osobinama bolesnika. Depresivni simptomi bili su češći u akutnoj fazi ishemijskog moždanog udara. Naši bolesnici imali su vrlo visoku učestalost obiju skupina simptoma. Znatno veću pozornost treba već u jedinicama moždanog udara posvetiti anksioznim i depresivnim simptomima i nastojati bolesnike osloboditi emocionalnog stresa i patnje, što će poboljšati njihov neurološki ishod.
Posttraumatic epilepsy is result of head trauma. The aim of our research was to establish how many patients after head trauma developed posttraumatic epilepsy (PTE). Retrospectively we analyzed 50 ...patients with head trauma different severity in period from 1989. to 2008., which we werified radiological, electroenfephalographic, and psychical changes were established according pto psychiatric examination. From 50 patient with head trauma, 40 developed seizures (3 in the firs 24 hours and 6 after first 24 hours to the end of first week, 31 after first week). By introducing antiepileptic therapy (AETh), 30 patients were seizure free, 10 patients had 1-2 epileptic seizure monthly (EPA/CPA), 10 patients got prophylactic AETh in period 6-12 months. 14 patients developed psychical changes which were verified by psychiatrist. The experience and literature show that posttraumatic epilepsy is good for treating with 1 or 2 antiepileptic, and remission is more difficult in case psychiatric comorbidity.
