The fast aging human population requires new approaches to reliable diagnosis and proper treatment of dementia in elderly patients with psychiatric disorders such as bipolar disorder (BD) and schizophrenia (SCZ). As c...The fast aging human population requires new approaches to reliable diagnosis and proper treatment of dementia in elderly patients with psychiatric disorders such as bipolar disorder (BD) and schizophrenia (SCZ). As compared to other psychiatric disorders, BD and SCZ are characterized by increased and similar risk for dementia as well as cerebrovascular (CVD) and Parkinson’s (PD) diseases independent of the patient’s age. There are reports in the literature suggesting BD and SCZ in older patients could cause dementia without contribution from the neurodegenerative diseases, including Alzheimer’s disease (AD), due to the absence of the known neuropathology associated with cognitive decline in such individuals. This view contradicts a plethora of data highlighting AD as a major cause of dementia in the elderly. This issue was addressed by examining postmortem cerebral pathology in an 83-year-old female diagnosed with BD, SCZ, and PD (D1) and comparing it to that of a second donor (D2), an age-matched male diagnosed with Lewy Body Dementia (LBD). Upon thorough histochemical and immunohistochemical examinations of both brains, the PD and LBD diagnoses in D1 and D2 were not confirmed. Instead, AD-related pathology was observed in both subjects with AD advancing to its clinical stage (mild to moderate) only in D1. Diffuse β-amyloid peptide 1-42 (Aβ1-42) staining, most likely reflecting a presence of the Aβ1-42 soluble form, was also detected in cerebellar neurons and cerebellar extracellular space in D1 and D2. Cerebrovascular pathology was pronounced and distinct in both brains and included amyloid angiopathy, hyaline atherosclerosis, microbleeds, and dilated Virchow Robin spaces in D1 as well as thick-walled blood vessels with microbleeds in D2. It was concluded that a mixed AD and cerebrovascular pathology could mimic Lewy Body Disease and potentially contribute to dementia development in elderly BD and SCZ patients.展开更多
Extraintestinal manifestations occur in about one-third of patients living with inflammatory bowel disease(IBD) and may precede the onset of gastrointestinal symptoms by many years. Neurologic disorders associated wit...Extraintestinal manifestations occur in about one-third of patients living with inflammatory bowel disease(IBD) and may precede the onset of gastrointestinal symptoms by many years. Neurologic disorders associated with IBD are not frequent, being reported in 3% of patients, but they often represent an important cause of morbidity and a relevant diagnostic issue. In addition, the increasing use of immunosuppressant and biological therapies for IBD may also play a pivotal role in the development of neurological disorders of different type and pathogenesis. Hence, we provide a complete and profound review of the main features of neurological complications associated with IBD, with particular reference to those related to drugs and with a specific focus on their clinical presentation and possible pathophysiological mechanisms.展开更多
209220 Clinical features and treatment of the hemorrhagic moyamoya disease/Duan Lian(Dept Neurosurg,Research Clinic,Acad Mil Med Sci,PLA,Beijing 100071)…∥Chin J Neurosurg.-2009,25(3).-201~204Objective To study th...209220 Clinical features and treatment of the hemorrhagic moyamoya disease/Duan Lian(Dept Neurosurg,Research Clinic,Acad Mil Med Sci,PLA,Beijing 100071)…∥Chin J Neurosurg.-2009,25(3).-201~204Objective To study the clinical features,bleeding reasons and strategies of the treatment of 61 patients with hemorrhagic moyamoya disease.Methods The clinical features of onset,bleeding location of the lesions and the type,characteristics of DSA images and therapeutic results were studied retrospectively.Results In all 61 patients,57 patients were adults.Most of them were cerebral hemorrhage breaking into ventricles.In all the hemisphere of hemorrhage,dilatation and abnormal branching of the AChA and P-CoM were observed in 52 patients,118 procedures of EDAS were performed,including superficial temporal basilar tip in 116 hemispheres and occipital artery in 2 hemispheres.There was no recurrence of hemorrhage in those operation patients.But 2 patients without EDAS died due to recurrence of hemorrhage Conclusion Dilatation and abnormal branching of the AChA and/or P-CoM are one of the main reasons for hemorrhagic events.The treatment of EDAS may be an effective method for preventing the recurrence of hemorrhage of hemorrhagic moyamoya disease.17 refs,2 figs.展开更多
文摘The fast aging human population requires new approaches to reliable diagnosis and proper treatment of dementia in elderly patients with psychiatric disorders such as bipolar disorder (BD) and schizophrenia (SCZ). As compared to other psychiatric disorders, BD and SCZ are characterized by increased and similar risk for dementia as well as cerebrovascular (CVD) and Parkinson’s (PD) diseases independent of the patient’s age. There are reports in the literature suggesting BD and SCZ in older patients could cause dementia without contribution from the neurodegenerative diseases, including Alzheimer’s disease (AD), due to the absence of the known neuropathology associated with cognitive decline in such individuals. This view contradicts a plethora of data highlighting AD as a major cause of dementia in the elderly. This issue was addressed by examining postmortem cerebral pathology in an 83-year-old female diagnosed with BD, SCZ, and PD (D1) and comparing it to that of a second donor (D2), an age-matched male diagnosed with Lewy Body Dementia (LBD). Upon thorough histochemical and immunohistochemical examinations of both brains, the PD and LBD diagnoses in D1 and D2 were not confirmed. Instead, AD-related pathology was observed in both subjects with AD advancing to its clinical stage (mild to moderate) only in D1. Diffuse β-amyloid peptide 1-42 (Aβ1-42) staining, most likely reflecting a presence of the Aβ1-42 soluble form, was also detected in cerebellar neurons and cerebellar extracellular space in D1 and D2. Cerebrovascular pathology was pronounced and distinct in both brains and included amyloid angiopathy, hyaline atherosclerosis, microbleeds, and dilated Virchow Robin spaces in D1 as well as thick-walled blood vessels with microbleeds in D2. It was concluded that a mixed AD and cerebrovascular pathology could mimic Lewy Body Disease and potentially contribute to dementia development in elderly BD and SCZ patients.
文摘Extraintestinal manifestations occur in about one-third of patients living with inflammatory bowel disease(IBD) and may precede the onset of gastrointestinal symptoms by many years. Neurologic disorders associated with IBD are not frequent, being reported in 3% of patients, but they often represent an important cause of morbidity and a relevant diagnostic issue. In addition, the increasing use of immunosuppressant and biological therapies for IBD may also play a pivotal role in the development of neurological disorders of different type and pathogenesis. Hence, we provide a complete and profound review of the main features of neurological complications associated with IBD, with particular reference to those related to drugs and with a specific focus on their clinical presentation and possible pathophysiological mechanisms.
文摘209220 Clinical features and treatment of the hemorrhagic moyamoya disease/Duan Lian(Dept Neurosurg,Research Clinic,Acad Mil Med Sci,PLA,Beijing 100071)…∥Chin J Neurosurg.-2009,25(3).-201~204Objective To study the clinical features,bleeding reasons and strategies of the treatment of 61 patients with hemorrhagic moyamoya disease.Methods The clinical features of onset,bleeding location of the lesions and the type,characteristics of DSA images and therapeutic results were studied retrospectively.Results In all 61 patients,57 patients were adults.Most of them were cerebral hemorrhage breaking into ventricles.In all the hemisphere of hemorrhage,dilatation and abnormal branching of the AChA and P-CoM were observed in 52 patients,118 procedures of EDAS were performed,including superficial temporal basilar tip in 116 hemispheres and occipital artery in 2 hemispheres.There was no recurrence of hemorrhage in those operation patients.But 2 patients without EDAS died due to recurrence of hemorrhage Conclusion Dilatation and abnormal branching of the AChA and/or P-CoM are one of the main reasons for hemorrhagic events.The treatment of EDAS may be an effective method for preventing the recurrence of hemorrhage of hemorrhagic moyamoya disease.17 refs,2 figs.
