Bruce S. Schoenberg

Cerebrovascular disease in infants and children: a study of incidence, clinical features, and survival.

A 10-year review of the Mayo Clinic experience with childhood cerebrovascular disease unrelated to birth, intracranial infection, or trauma identified 69 patients (38 with ischemic stroke, and 31 with subarachnoid or intracerebral hemorrhage). Although children with cerebral infarction had better survival, they experienced more residual disability than children with cerebral hemorrhage. The medical records-linkage system for Rochester, Minnesota residents made it possible for the first time to study cerebrovascular disease in a well-defined childhood population. Records from all medical facilities serving this population (average of 15,834 resident children) showed four strokes over 10 years (average annual incidence rate of 2.52 cases per 100,000 per year).

Risk factors for clinically diagnosed Alzheimer's disease A case‐control study of an Italian population

We conducted a case-control study of 116 patients with the clinical diagnosis of Alzheimers disease (AD) in seven Italian centers. One hundred sixteen hospital controls and 97 population controls were matched by age, sex, and region of residence to the cases. A structured questionnaire was administered to the next-of-kin of cases and controls by trained interviewers to identify possible risk factors. Genetic, viral, toxic, immunologic, medical, surgical, and personality factors were investigated. Dementia among first- or second-degree relatives and advanced age of the mother at subjects birth (age over 40) were associated with AD. Head trauma was more frequent in cases than in either hospital or population controls, but the differences were not significant. Our data did not confirm the previously reported association with antecedent thyroid disease or family history of Downs syndrome.

Nervous system neoplasms and primary malignancies of other sites: The unique association between meningiomas and breast cancer

To determine whether nervous system neoplasms are associated with primary malignancies elsewhere, we studied the frequency of multiple primary tumors in patients in whom at least one of the primary tumors was within the nervous system. The patients were Connecticut residents with tumors diagnosed between 1935 and 1964. Of 135 patients, 130 had two primary tumors, four had three primary tumors, and one had four primary tumors. Only with multiple primary tumors involving the brain and breast did the number of observed cases significantly exceed the number of expected cases; eight patients who had a meningioma associated with a breast cancer accounted for this excess. Patients with breast cancer presenting with signs or symptoms of an intracranial neoplasm should be carefully evaluated, for the intracranial lesion may be a potentially curable meningioma.

Prevalence and natural history of progressive supranuclear palsy

We surveyed neurologists and chronic care facilities in and near two New Jersey counties with a combined population of 799,022, regarding cases of progressive supranuclear palsy. All suspected cases were examined personally, using rigid criteria. The prevalence ratio was 1.39/100,000. A total of 50 New Jersey cases yielded median intervals to onset of requiring gait assistance, 3.1 years; visual symptoms, 3.9 years; dysarthria, 3.4 years; dysphagia, 4.4 years; requiring wheelchair, 8.2 years; and death, 9.7 years.

Prevalence of Parkinson's disease in the biracial population of Copiah County, Mississippi

A door-to-door survey of major neurologic disorders was conducted in the essentially biracial population of Copiah County, MS, using a pretested screening questionnaire. All those suspected of having Parkinsons disease were requested to have a neurologic examination by board-certified neurologists. The study also included those living in institutions. The prevalence of Parkinsons disease (age 40 +) was 347 per 100,000 inhabitants. No substantial differences in the age-adjusted prevalence ratios by race or by sex were found in the population studied. Age-specific prevalence ratios for Parkinsons disease increase with advancing age. Over 40% of identified cases were newly diagnosed during the study.

Calculating Confidence Intervals for Rates and Ratios

Since the probability of developing or dying from most neurologic disorders is relatively small, the Poisson distribution is often utilized to establish confidence intervals around rates or ratios for

Prevalence and Clinical Features of Epilepsy in a Biracial United States Population

Summary: A need for prevalence information emphasizing racial differences prompted a door‐to‐door survey of all residents of Copiah County, Mississippi. The fieldwork involved a complete census and an extensive screening questionnaire inquiring about diagnoses, signs, and symptoms of neurologic disease. Residents who lived in institutions or had screening responses suggestive of epilepsy were requested to have an examination by neurologists who used defined diagnostic criteria. Prevalence day was 1 January 1978, and the survey yielded prevalence ratios of 1,043/100,000 inhabitants for epilepsy and 678/100,000 inhabitants for active epilepsy. Age‐adjusted prevalence ratios were somewhat higher for males and for blacks. Of the 246 identified cases of epilepsy, 37% were judged symptomatic. The leading (putative) cause was head trauma, especially among white males. About 57% of the 246 cases had been evaluated previously by a neurologist or neurosurgeon, while 7% had never been evaluated medically before the survey.

Cerebrovascular disease in the People's Republic of China: epidemiologic and clinical features.

A door-to-door survey was carried out in six cities of the Peoples Republic of China (PRC). There was 100% cooperation with the survey. Among 63,195 screened individuals, there were 392 prevalent cases of completed stroke and 115 incidence cases. Prevalence ratios and incidence rates for completed stroke showed a south-to-north gradient. The highest point prevalence ratio and incidence rate (age-adjusted to the 1960 US population) were documented in Harbin in northeast PRC (1,249/100,000; 441/100,00O/yr). The majority of new completed strokes were cerebral infarction, but the percentage of intracerebral hemorrhage (44%) was much greater than that reported among Caucasian populations.

Research Protocol for Measuring the Prevalence of Neurologic Disorders in Developing Countries

Because of the scarcity of trained personnel in neurology in developing countries, we designed a protocol utilizing, in large part, non-doctor primary health care personnel for collecting data in a do

Trends in incidence of dementing illness in Rochester, Minnesota, in three quinquennial periods, 1960–1974

We ascertained the incidence of dementias of all causes between 1960 and 1975 among citizens of Rochester, Minnesota. Study of all medical records yielded incidence rates for the quinquennial periods of 1960–1964, 1965–1969, and 1970–1974. In the population at risk (30 years or older), the age-adjusted rates (per 100,000 population/year) for Alzheimers disease (clinically diagnosed or pathologically confirmed, or both) in the three periods were: 104.9, 80.8, and 96.6. The rates for dementia of all causes were: 160.6, 122.0, and 136.8. Calculation of 95% confidence intervals showed that the incidence rate for dementia or Alzheimers disease has not changed in this 15-year period in Rochester, Minnesota. Assuming no demented patients younger than 29 years, the incidence rates in the three quinquennial periods for all dements were 79.4, 60.3, and 67.7; for Alzheimers disease they were 51.9, 40.0, and 47.8.