Abstract:
OBJECTIVES:Determine the frequency of and the predictive factors for abnormal ocular fundus findings among emergency department (ED) headache patients. METHODS:Cross-sectional study of prospectively enrolled adult patients presenting to our ED with a chief complaint of headache. Ocular fundus photographs were obtained using a nonmydriatic fundus camera that does not require pupillary dilation. Demographic and neuroimaging information was collected. Photographs were reviewed independently by 2 neuroophthalmologists for findings relevant to acute care. The results were analyzed using univariate statistics and logistic regression modeling. RESULTS:We included 497 patients (median age: 40 years, 73% women), among whom 42 (8.5%, 95% confidence interval: 6%-11%) had ocular fundus abnormalities. Of these 42 patients, 12 had disc edema, 9 had optic nerve pallor, 6 had grade III/IV hypertensive retinopathy, and 15 had isolated retinal hemorrhages. Body mass index ≥ 35 kg/m(2) (odds ratio [OR]: 2.3, p = 0.02), younger age (OR: 0.7 per 10-year increase, p = 0.02), and higher mean arterial blood pressure (OR: 1.3 per 10-mm Hg increase, p = 0.003) were predictive of abnormal retinal photography. Patients with an abnormal fundus had a higher percentage of hospital admission (21% vs 10%, p = 0.04). Among the 34 patients with abnormal ocular fundi who had brain imaging, 14 (41%) had normal imaging. CONCLUSIONS:Ocular fundus abnormalities were found in 8.5% of patients with headache presenting to our ED. Predictors of abnormal funduscopic findings included higher body mass index, younger age, and higher blood pressure. Our study confirms the importance of funduscopic examination in patients with headache, particularly in the ED, and reaffirms the utility of nonmydriatic fundus photography in this setting.
journal_name
Neurologyjournal_title
Neurologyauthors
Thulasi P,Fraser CL,Biousse V,Wright DW,Newman NJ,Bruce BBdoi
10.1212/WNL.0b013e31827f0f20subject
Has Abstractpub_date
2013-01-29 00:00:00pages
432-7issue
5eissn
0028-3878issn
1526-632Xpii
WNL.0b013e31827f0f20journal_volume
80pub_type
杂志文章相关文献
NEUROLOGY文献大全abstract:OBJECTIVES:To examine whether preadmission use of nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) influenced 30-day stroke mortality. METHODS:We conducted a nationwide population-based cohort study. Using medical databases, we identified all first-time stroke hospitalizations in Denmark between 2004 and 2012 ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000001024
更新日期:2014-11-25 00:00:00
abstract:BACKGROUND:Brodmann brain maps, assembled in 1909, are still in use, but understanding of their animal-human homology is uncertain. Furthermore, in 1909, Brodmann did not identify human area 12 (BA12), a location now important to understanding of frontotemporal lobar degeneration (FTLD). METHODS:We re-examined Brodman...
journal_title:Neurology
pub_type: 历史文章,杂志文章
doi:10.1212/WNL.0b013e3182190cd8
更新日期:2011-05-03 00:00:00
abstract:OBJECTIVE:To characterize brain functional connectivity in subjects with prechiasmatic visual system damage and relate functional connectivity features to extent of vision loss. METHODS:In this case-control study, resting-state, eyes-closed EEG activity was recorded in patients with partial optic nerve damage (n = 15)...
journal_title:Neurology
pub_type: 杂志文章,随机对照试验
doi:10.1212/WNL.0000000000000672
更新日期:2014-08-05 00:00:00
abstract:OBJECTIVE:To test the hypothesis that brain pathology is associated with total daily physical activity proximate to death in older adults. METHODS:We studied brain autopsies from 428 decedents of the Rush Memory and Aging Project. The quantity of all physical activity was measured continuously for up to 10 days with a...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000005552
更新日期:2018-05-22 00:00:00
abstract::Phenotypic heterogeneity of sporadic Creutzfeldt-Jakob disease (CJD) has been linked to biochemically distinct types of the protease-resistant form of the prion protein (type 1 and type 2 PrP(Sc)). We investigated 14 cases of sporadic CJD and found that both type 1 and type 2 PrP(Sc) coexisted in 5 subjects. The disti...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.53.9.2173
更新日期:1999-12-10 00:00:00
abstract:OBJECTIVE:The current literature provides discrepant results regarding preoperative sociodemographic and clinical factors, and no information about preoperative cerebral metabolic patterns associated with apathy after subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson disease. METHODS:To resolve this is...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000000941
更新日期:2014-10-28 00:00:00
abstract::Ten patients with refractory temporal lobe epilepsy performed a word-position association learning task every 24 hours during video EEG monitoring. On 55 occasions recall performance was tested 30 minutes and 24 hours after the initial learning phase. Patients with left- but not right-sided temporal lobe epilepsy exhi...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.57.1.125
更新日期:2001-07-10 00:00:00
abstract::Four toluene abusers had evidence of severe multifocal central nervous system damage. Impairment of cognitive, cerebellar, brainstem, auditory, and pyramidal tract function, as well as CT evidence of cerebral cortical, cerebellar, and brainstem atrophy, have been noted. In addition, we found opsoclonus, ocular flutter...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.33.10.1337
更新日期:1983-10-01 00:00:00
abstract:BACKGROUND:Metals are suspected of being involved in the pathogenesis of various neurologic diseases. We previously found a complex imbalance in serum chemical elements and oxidative status in patients with clinically definite multiple sclerosis (CDMS). OBJECTIVE:To understand whether this imbalance affects people wit...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e31820af7de
更新日期:2011-02-08 00:00:00
abstract::We performed an open-label study testing the effects of GM1 ganglioside on 10 Parkinson's disease (PD) patients. Patients received 1,000 mg of GM1 by IV infusion after the last of three baseline functional assessments. Patients then self-administered GM1 at a dose of 200 mg/d, by subcutaneous injection, for 18 weeks. ...
journal_title:Neurology
pub_type: 临床试验,杂志文章
doi:10.1212/wnl.45.6.1149
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVE:To characterize a large family with X-linked Charcot-Marie-Tooth (CMT) neuropathy without mutations in the gap junction protein B1 (GJB1) gene, which has an unusual phenotype that is different in some aspects from classic CMTX1. METHODS:We tested CMT families consistent with X-linked inheritance for GJB1 mut...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000247271.40782.b7
更新日期:2006-12-12 00:00:00
abstract:OBJECTIVE:To determine the clinical value of JC virus (JCV) detection in various anatomic compartments for the diagnosis of progressive multifocal leukoencephalopathy (PML). METHODS:CSF, peripheral blood mononuclear cells (PBMC), plasma, and urine samples were evaluated from HIV-infected and uninfected individuals. JC...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.52.2.253
更新日期:1999-01-15 00:00:00
abstract:OBJECTIVE:Paroxysmal kinesigenic dyskinesia (PKD) is a rare disorder characterized by recurrent attacks of hyperkinetic movements. PKD can be isolated or associated with benign infantile seizures as part of the infantile convulsions with choreoathetosis (ICCA) syndrome. Mutations in the PRRT2 gene were recently identif...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e31825f06c3
更新日期:2012-07-10 00:00:00
abstract:BACKGROUND:Although the Mini-Mental State Examination (MMSE) is widely used in clinical practice, few norms exist for healthy populations covering a broad range of ages. OBJECTIVE:To obtain MMSE norms specific for age, gender, and education in healthy adults. METHODS:From the population registers of seven communities...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.53.2.315
更新日期:1999-07-22 00:00:00
abstract::We investigated the influence of age on the occurrence of cognitive disturbances in Parkinson's disease (PD), by evaluating neuropsychological performances in early- and late-onset groups of patients (less than 45 and greater than 65 years, respectively), individually paired for all the variables of parkinsonism and c...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.40.1.38
更新日期:1990-01-01 00:00:00
abstract::Most gliomas in neurofibromatosis type 1 (NF1) are pilocytic astrocytomas (PAs) of the optic pathway occurring in young children. However, some individuals develop gliomas that lack the typical NF1-associated clinical features or radiographic appearance. We identified 17 atypical presentations from a review of 100 pat...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000240076.31298.47
更新日期:2006-10-24 00:00:00
abstract::We report a Japanese Becker muscular dystrophy (BMD) patient with occasional myalgia and cramps during normal activity that developed at the age of 28 months. His family history was negative for neuromuscular diseases. Muscle biopsy analyses, including dystrophin immunostaining, disclosed no clinically relevant findin...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.46.5.1347
更新日期:1996-05-01 00:00:00
abstract::Medical therapy is the mainstay for epilepsy, with most patients well controlled on a single antiepileptic drug (AED). In this non-refractory group, many patients have medication side effects and occasional seizures. Approximately 30% of patients with partial epilepsy and 25% of patients with generalized epilepsy are ...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:10.1212/wnl.64.12_suppl_3.s2
更新日期:2005-06-28 00:00:00
abstract::Inhibitory antibody to von Willebrand factor (vWF)-cleaving protease (ADAMTS13) was detected in a patient with intravascular lymphomatosis. The increased serum level of the antibody paralleled an increase in the expression of uncleaved vWF, which might cause microvascular thrombosis and platelet consumption. Malignant...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000143065.55002.67
更新日期:2004-11-09 00:00:00
abstract:OBJECTIVE:To determine the prevalence and incidence of epilepsy among U.S. Medicare beneficiaries aged 65 years old and over, and to compare rates across demographic groups. METHODS:We performed a retrospective analysis of Medicare administrative claims for 2001-2005, defining prevalent cases as persons with ≥1 claim ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e3182477edc
更新日期:2012-02-14 00:00:00
abstract:OBJECTIVES:Deep brain stimulation of the internal pallidum (GPi-DBS) is an established therapeutic option in treatment-refractory dystonia, and the identification of factors predicting surgical outcome is needed to optimize patient selection. METHODS:In this retrospective multicenter study, GPi-DBS outcome of 8 patien...
journal_title:Neurology
pub_type: 杂志文章,多中心研究
doi:10.1212/WNL.0000000000001312
更新日期:2015-03-03 00:00:00
abstract:OBJECTIVE:To determine the mechanism of ictal downbeat nystagmus in Ménière disease (MD), we compared the head impulse gain of the vestibulo-ocular reflex (VOR) for each semicircular canal between patients with (n = 7) and without (n = 70) downbeat nystagmus during attacks of MD. METHODS:We retrospectively analyzed th...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000010653
更新日期:2020-10-27 00:00:00
abstract:OBJECTIVE:To determine the usefulness of the 14-3-3 test in patients with dementia of various causes. BACKGROUND:Recent reports have suggested that the detection of the 14-3-3 protein in the CSF of patients with Creutzfeldt--Jakob disease is a highly sensitive and specific marker of the disease that might be used as a...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.56.11.1528
更新日期:2001-06-12 00:00:00
abstract::Previous reports and the Physicians' Desk Reference caution against the use of levodopa in Parkinson's disease (PD) patients with melanoma. A critical review of the literature reveals only anecdotal evidence to support a link between levodopa and melanoma. In fact, levodopa has an antitumor effect on melanoma. We repo...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:10.1212/wnl.43.4.674
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:A European (EU) and a North American (NA) placebo-controlled study with interferon beta-1b (IFNB-1b) in secondary progressive multiple sclerosis (SPMS) showed divergent results with regard to their primary outcome of sustained Expanded Disability Status Scale (EDSS) progression, while effects were similar on...
journal_title:Neurology
pub_type: 杂志文章,meta分析
doi:10.1212/01.wnl.0000145561.08973.4f
更新日期:2004-11-23 00:00:00
abstract::To determine the extent that different dopamine (DA) neuronal markers provide similar estimates of striatal (caudate and putamen) DA nerve terminal loss in idiopathic Parkinson's disease (PD), we compared, in postmortem striatum of 12 patients with PD and 10 matched controls, levels of five different DA neuronal marke...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.47.3.718
更新日期:1996-09-01 00:00:00
abstract::The scanning electronmicroscope was used to study the development of anencephaly in an experimental model. Anencephaly was produced consistently, using vitamin A as the teratogen. Embryos destined to become anencephalic displayed failure of opposing sides of the rostral neural tube to fuse. Subsequently, the neural fo...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.32.9.992
更新日期:1982-09-01 00:00:00
abstract::Two cohorts of 20 patients diagnosed with neoplastic meningitis (NM) with or without encephalopathy were matched with respect to age, sex, primary tumor, and performance status. Median survival was 10 weeks (range 6 to 20 weeks) in the cohort with NM-related encephalopathy compared to 24 weeks (range 8 to 40 weeks) in...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000145599.06491.71
更新日期:2004-12-14 00:00:00
abstract:BACKGROUND:The Babinski sign is a well-known sign of upper motor neuron dysfunction that is widely considered an essential element of a complete neurologic examination. Little is known about reliability and validity of this sign. A less well-known sign of upper motor neuron dysfunction, decreased speed of foot tapping,...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000180608.76190.10
更新日期:2005-10-25 00:00:00
abstract::People with AD have deficient contrast sensitivity and impaired face discrimination. The authors presented photographs of unfamiliar faces of three different sizes to enhance the low, middle, or high facial frequency information (cycles per face). Patients with AD demonstrated normal discrimination of small faces only...
journal_title:Neurology
pub_type: 临床试验,杂志文章
doi:10.1212/wnl.54.12.2316
更新日期:2000-06-27 00:00:00