Abstract:
OBJECTIVE:We aimed to determine the risk of short- and long-term stroke, as well as accidental injury, in patients discharged from an emergency department who were given a diagnosis of a peripheral vestibular disorder. METHODS:In this population-based, retrospective, cohort study, we identified all adult patients who were discharged from an emergency department in Ontario, Canada, between 2006 and 2011, with a primary diagnosis of a peripheral vestibular disorder. We assessed hospitalized strokes at 7, 30, 90, and 365 days, as well as subsequent falls, motor vehicle accidents, fractures, and burns. To provide context, we assessed the same outcomes in propensity score-matched discharged emergency department patients with renal colic. RESULTS:Among 41,794 qualifying patients, 76 (0.18%) had a stroke within 30 days. Accidental injury at 30 days ranged from 0.01% (falls) to 0.15% (fractures). The relative risk (RR) of 30-day stroke was 9.3 (95% confidence interval [CI]: 4.3-20.3) times higher than among matched renal colic controls. The RR was highest at 7 days (50.0; 95% CI, 6.9-362.0) and diminished with duration from the emergency department visit: RR 6.1 (95% CI, 3.5-10.7) at 90 days and 2.5 (95% CI, 1.8-3.5) at 1 year. There was no difference in the risk of accidental injury. INTERPRETATION:The frequency of early stroke after discharge from an emergency department with a diagnosis of a peripheral vestibular disorder was extremely low. However, the relative risk was markedly higher than in matched patients with renal colic, suggesting that some strokes, or sentinel events for strokes, are being misdiagnosed as peripheral vestibular disorders.
journal_name
Ann Neuroljournal_title
Annals of neurologyauthors
Atzema CL,Grewal K,Lu H,Kapral MK,Kulkarni G,Austin PCdoi
10.1002/ana.24521subject
Has Abstractpub_date
2016-01-01 00:00:00pages
32-41issue
1eissn
0364-5134issn
1531-8249journal_volume
79pub_type
杂志文章abstract::A previously healty 43-year-old woman developed bilateral middle cerebral artery occlusion, thrombocytopenia, and multiple thrombi of arteries in the spleen. No underlying cause of her thrombotic disease was detected except for a factor VIII level that was elevated fivefold. An etiological relationship between the cer...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410080416
更新日期:1980-10-01 00:00:00
abstract:OBJECTIVE:Small-fiber sensory and autonomic symptoms are early presentations of familial amyloid polyneuropathy (FAP) with transthyretin (TTR) mutations. This study aimed to explore the potential of skin nerve pathologies as early and disease-progression biomarkers and their relationship with skin amyloid deposits. ME...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.25433
更新日期:2019-04-01 00:00:00
abstract::There are no established treatments for patients with acute, severe neurological deficits caused by multiple sclerosis or other inflammatory demyelinating diseases of the central nervous system who fail to recover after treatment with high-dose corticosteroids. We conducted a randomized, sham-controlled, double-masked...
journal_title:Annals of neurology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/1531-8249(199912)46:6<878::aid-ana10>3.0.c
更新日期:1999-12-01 00:00:00
abstract::We report FK506-induced neurotoxicity in 14 of 44 consecutive patients following orthoptic liver transplantation. In 10 of these 14 patients, postural hand tremors were found in the first weeks following surgery, transient apraxia of speech in 3, and generalized tonic-clonic seizures were noted in 2 patients. Other ma...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410350422
更新日期:1994-04-01 00:00:00
abstract:OBJECTIVE:Intracellular amyloid β-protein (Aβ) contributes to neurodegeneration in Alzheimer disease (AD). Apomorphine (APO) is a dopamine receptor agonist for Parkinson disease and also protects against oxidative stress. Efficacy of APO for an AD mouse model and effects of APO on cell cultures are studied. METHODS:Th...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.22319
更新日期:2011-02-01 00:00:00
abstract::We previously reported that the monoclonal antibody Alz-50 recognizes a protein (A68) with an apparent molecular weight of 68,000 daltons in the brains of patients who died with Alzheimer's disease, but not in brain tissue from individuals free of neurological disease. We now report that substantial quantities of this...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410220412
更新日期:1987-10-01 00:00:00
abstract::Two principal features of Alzheimer's disease (AD) are (1) the occurrence of neurofibrillary tangles (NFTs) and senile plaques, and (2) the loss of cortical cholinergic activity because of dysfunction of neurons in the basal forebrain cholinergic system. The relationship of these two abnormalities is an unresolved iss...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410200407
更新日期:1986-10-01 00:00:00
abstract:OBJECTIVE:Migraine is among the most common and debilitating neurological conditions. Familial hemiplegic migraine type 1 (FHM1), a monogenic migraine subtype, is caused by gain-of-function of voltage-gated CaV 2.1 calcium channels. FHM1 mice carry human pathogenic mutations in the α1A subunit of CaV 2.1 channels and a...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.24449
更新日期:2015-08-01 00:00:00
abstract::Several mutations in the amyloid precursor protein (APP) gene have been found to associate with pathologic deposition of the beta-amyloid peptide (Abeta) in neuritic plaques or in the walls of cerebral vessels. We report a mutation at a novel site in APP in a three-generation Iowa family with autosomal dominant dement...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.1009
更新日期:2001-06-01 00:00:00
abstract::Tropical spastic paraparesis (TSP) and other chronic-progressive myelopathies have been clearly associated with increased serum and cerebrospinal fluid antibody titers to human T-lymphotropic virus type I (HTLV-I). However, little is known about the cellular immune function in TSP. In the present study, activated T ly...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410270209
更新日期:1990-02-01 00:00:00
abstract::Although interictal spikes are thought to share pathophysiological mechanisms with partial-onset seizure discharges, positron emission tomographic studies of the interictal state have paradoxically shown focal hypometabolism whereas seizures produce hypermetabolism. To address this question, we performed functional ma...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410350614
更新日期:1994-06-01 00:00:00
abstract::To clarify the influence of gastric emptying on levodopa-related motor fluctuations in Parkinson's disease, we assessed mobility and plasma levodopa concentrations in 10 patients during five modes of levodopa administration: (1) standard intermittent oral (SIO), (2) intermittent duodenal (ID), (3) continuous duodenal ...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410230611
更新日期:1988-06-01 00:00:00
abstract::Regional cerebral blood flow (rCBF) was measured in human subjects during saccadic eye movements by a 254-channel dynamic gamma camera. Focal rCBF increases were repeatedly observed in an area within the middle precentral and premotor regions which corresponds to the frontal eye field in humans. Our findings suggest t...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410050112
更新日期:1979-01-01 00:00:00
abstract::The mechanism by which iron enters the central nervous system from the blood is not well understood. Iron in blood plasma is totally bound to transferrin (Tf), a major plasma glycoprotein. Tf receptors are present on the blood-brain barrier (BBB) endothelium. It is not known whether iron separates from Tf during its p...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410320709
更新日期:1992-01-01 00:00:00
abstract::MK-801 and ketamine are noncompetitive N-methyl-D-aspartate (NMDA) receptor blockers that decrease brain injury in animal models of focal and global ischemia. Recent reports, however, suggested that MK-801 itself can damage neurons. Here we show that MK-801 (0.1 to 5.0 mg/kg) and ketamine (40 to 100 mg/kg) typically i...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410300609
更新日期:1991-12-01 00:00:00
abstract::If patients with left-sided hemispatial neglect bisect lines incorrectly because hemianopia or sensory hemiinattention prevents them from seeing how far the line extends to the left, a strategy that ensures their seeing the left side of the line in their normal field should improve performance. If patients have hemisp...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410050210
更新日期:1979-02-01 00:00:00
abstract:OBJECTIVE:To define the magnitude and mechanism of the effect of brain infarcts on the odds of dementia in a prospective study. METHODS:We examined the effects of brain infarcts and Alzheimer's disease (AD) pathology on the risk for dementia in 179 subjects from the Baltimore Longitudinal Study of Aging Autopsy Progra...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.21413
更新日期:2008-08-01 00:00:00
abstract::The post-poliomyelitis syndrome (PPS) refers to symptoms of new weakness, fatigue, and pain years after recovery from acute poliomyelitis. Oligoclonal IgG bands have been reported in the cerebrospinal fluid (CSF) from PPS patients, suggesting that the syndrome is immune mediated or caused by persistent viral infection...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410260604
更新日期:1989-12-01 00:00:00
abstract:OBJECTIVE:The Epi4K Consortium recently identified 4 de novo mutations in the γ-aminobutyric acid type A (GABAA ) receptor β3 subunit gene GABRB3 and 1 in the β1 subunit gene GABRB1 in children with one of the epileptic encephalopathies (EEs) Lennox-Gastaut syndrome (LGS) and infantile spasms (IS). Because the etiology...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.24631
更新日期:2016-05-01 00:00:00
abstract::Nineteen diabetic patients, 12 type I (insulin-dependent) and 7 type II (late-onset, non-insulin-dependent), underwent nocturnal polygraphic monitoring after a daytime medical evaluation that included tests of vagal responses and, in 6 patients, pulmonary function and hypercapnic and hypoxic responses. Five lean type ...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410170415
更新日期:1985-04-01 00:00:00
abstract:OBJECTIVE:Cognitive impairment is common in epilepsy, particularly in memory function. Interictal spikes (IISs) are thought to disrupt cognition, but it is difficult to delineate their contribution from general impairments in memory produced by etiology and seizures. We investigated the transient impact of focal IISs o...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.21896
更新日期:2010-02-01 00:00:00
abstract::The purpose of this study was to explore the feasibility of obtaining magnetic resonance-measured cerebral metabolic rate of oxygen utilization (MR-CMRO(2)) in acute ischemic stroke patients. Seven stroke patients were serially imaged: 4.5 +/- 0.9 hours (tp1), 3 to 5 days (tp2), and 1 to 3 months (tp3) after symptom o...
journal_title:Annals of neurology
pub_type: 临床试验,杂志文章
doi:10.1002/ana.10433
更新日期:2003-02-01 00:00:00
abstract::Mitochondrial iron accumulation is thought to underlie the pathophysiology of Friedreich ataxia and may occur at the expense of cytosolic iron. Decreases in cytosolic iron induce expression of the transferrin receptor, some of which is released into the serum. Here, we demonstrate that serum transferrin receptor conce...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVE:Cerebellar dysfunction in multiple sclerosis (MS) contributes significantly to disability, is relatively refractory to symptomatic therapy, and often progresses despite treatment with disease-modifying agents. We previously observed that sodium channel Nav1.8, whose expression is normally restricted to the pe...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.22665
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:A study was undertaken to examine the association between overall cardiovascular health as recently defined by the American Heart Association in young adulthood to middle age and cognitive function in midlife. Overall ideal cardiovascular health incorporates 7 metrics, including the avoidance of overweight or...
journal_title:Annals of neurology
pub_type: 杂志文章,多中心研究
doi:10.1002/ana.23836
更新日期:2013-02-01 00:00:00
abstract::Unilateral lesions of the occipital visual areas performed on postnatal day 5 (P5) in the ferret are not compensated by the appearance, in the lesioned hemisphere, of visual responses at ectopic locations. Instead, when parts of the visual areas are spared, they show abnormal retinotopic organizations; furthermore, ca...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.10591
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVE:A 12-month double-blind sham-surgery-controlled trial assessing adeno-associated virus type 2 (AAV2)-neurturin injected into the putamen bilaterally failed to meet its primary endpoint, but showed positive results for the primary endpoint in the subgroup of subjects followed for 18 months and for several seco...
journal_title:Annals of neurology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1002/ana.24436
更新日期:2015-08-01 00:00:00
abstract::Adult GM2 gangliosidosis is a rare disorder that often presents with both neurological and psychiatric syndromes. Effective treatment of the psychotic and affective symptoms associated with this disorder has been complicated by poor treatment response and the concern that many psychotropic agents may worsen the underl...
journal_title:Annals of neurology
pub_type: 杂志文章,评审
doi:10.1002/ana.410310320
更新日期:1992-03-01 00:00:00
abstract::Muscle afferent activity from the triceps surae was recorded during experimentally induced alterations in amplitude of the Achilles tendon jerk. No changes in the neural afferent response to tendon percussion or in the background level of neural activity occurred when the reflex response was altered by discomfort, dis...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410100610
更新日期:1981-12-01 00:00:00
abstract::We describe 5 patients who presented with an acute cauda equina syndrome, which we believe was due to infarction of the conus medullaris. In 3 patients, the onset was spontaneous, and in 2 patients it was secondary to temporary occlusion of the distal aorta during medical manipulation. Pain in the buttocks and posteri...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410210510
更新日期:1987-05-01 00:00:00