Rosario Martin

Occurrence of Transient Ischemic Attacks in Alcoi: Descriptive Epidemiology

A door-to-door survey of transient ischemic attack (TIA) and stroke was conducted in 3 towns of the Alcoi health area. The prevalence ratios found for TIA and stroke were 13/1,000 people (95% CI 8.8-17.9) and 21.5/1,000 (95% CI 15.8-27.2), respectively. The crude incidence rates for both TIA and stroke were 2.8/1,000 (95% CI 0.7-4.9). Methodological differences in the ascertainment of the cases may explain the variations in the rates between the present work and other studies in the literature.

Embolic versus Nonembolic Causes of Ischemic Stroke

Determination of the stroke type may be crucial to rational treatment and prediction of outcome. Patients with infarct in the anterior or posterior circulation, and patients with lacunar infarcts may

Striatocapsular Infarction and ‘Release’ Visual Hallucinations

Elaborate visual hallucinations limited to a hemifield are exceedingly rare. We report a patient with a right striatocapsular infarct who developed formed complex visual hallucinations restricted to t

Cardiovascular reflexes in Parkinson disease.

We have investigated the autonomic function of 95 patients with Parkinson disease (PD) by testing their cardiovascular reflexes and compared the results with those of 53 healthy volunteers. 51.1% of the patients were on antiparkinsonian therapy. The patients showed a smaller heart rate response to deep breathing with a mean exhalation-inspiration difference of 87.73±7 (p: 0.0005), a smaller heart rate response to standing with a mean 30 ∶ 15 index of 1.18±0.25 (p∶ 0.01), and a smaller blood pressure rise to handgrip with a mean rise of 9.53±8.76 mmHG (p∶ 0.005). We found a higher percentage of patients with established sympathetic lesion (41% vs 34%) or atypical patterns of global autonomic function involvement (33% vs 26%), but the percentage of subjects with parasympathetic lesion was similar in both, patients and controls (16% vs 15%). We found no significant difference on cardiovascular performance between treated and untreated patients. The patients with autonomic impairment were older than the patients with normal autonomic function. Our findings suggest that patients with PD have a true autonomic dysfunction.SommarioAbbiamo studiato la funzionalità del Sistema Nervoso Autonomo in 95 pazienti affetti da Malattia di Parkinson (PD), valutando i riflessi cardiovascolari e confrontando i risultati con quelli ottenuti da 53 volontari sani.Il 51.1% dei pazienti Parkinsoniani era in trattamento farmacologico. I pazienti hanno mostrato una ridotta risposta della frequenza cardiaca alla ventilazione profonda, alla stazione eretta e un ridotto aumento pressorio dopo esercizio isometrico. È stata riscontrata una più alta percentuale di pazienti con lesioni simpatiche stabilite (41% vs 34%) e con quadro atipico di coinvolgimento globale della funzione autonomica (33% vs 26%), ma la percentuale di soggetti con lesioni parasimpatiche era simile nei pazienti e nei soggetti di controllo (16% vs 15%). Non è stata riscontrata una significativa differenza alle performance cardiovascolari tra pazienti in trattamento farmacologico e non trattati. I pazienti con disturbi autonomici erano più anziani di quelli con normale funzione autonomica. I dati suggeriscono la presenza di una vera disfunzione autonomica nei pazienti affetti da PD.

Floating Thrombus in the Innominate Artery as a Cause of Cerebral Infarction in Young Adults

Intraluminal thrombi in the carotid circulation are uncommonly reported as a cause of stroke in young adults. We report two young women who suffered an embolic cerebral infarction from a floating thrombus in the innominate artery, without clotting abnormalities. Intraluminal thrombus at that level may have been previously overlooked as a cause of embolic cerebral infarction in young patients, because of the lack of a systematic assessment of the aortic arch and its proximal branches. Taking into account the fact that the evolution may be rapidly fatal, this possibility should be considered early in young patients without a clear etiology of stroke.