Gadolinium-based contrast agents (GBCAs) are widely used in magnetic resonance imaging (MRI) to help with the diagnostic and monitoring processes of many diseases, including neurological disorders. Initially, it was assumed that GBCAs carry minimal risk, are safe and well tolerated. But recent reports of GBCA-associated deposition in many body tissues have raised concerns about the broader health impacts of gadolinium exposure. The aim of this review was to summarise knowledge regarding gadolinium deposition, primarily in the brain structures, and of potential GBCA-associated toxicity. Moreover, we discuss the current recommendations on the use of GBCAs, as well as alternative contrast agents and imaging techniques.
Vigabatrin (VGB), a second-generation antiepileptic drug, is effective for the treatment of infantile spasms and focal seizures, primarily in tuberous sclerosis complex (TSC) patients. However, reports of adverse events of VGB, including VGB-associated visual field loss and brain abnormalities in neuroimaging, have raised concerns about the broader use of VGB and thus significantly limited its application.The goal of this review was to summarise the recent therapeutic guidelines, the use of VGB in focal seizures and new VGB applications as a disease-modifying treatment in TSC patients. Moreover, we discuss the current opinions on potential VGB-associated toxicity and the safety of VGB.
Introduction. Stroke is the main cause of disability and the second leading cause of death worldwide. Over 60,000 cases of stroke are diagnosed in Poland each year. In the coming years, due to the aging of the population and the elevation of risk factor prevalence, a further increase in the incidence of stroke in Poland is expected. Aim. Investigation of demographic characteristics, clinical analysis and assessment of risk factors among the stroke patients hospitalized in the UMB Department of Neurology. Material and methods. The retrospective analysis included medical documentation of patients hospitalized due to a stroke in 2016. The neurological condition of patients was assessed at the time of admission and discharge using the National Institutes of Health Stroke Scale (NIHSS). Results. The medical documentation of 402 stroke patients, consisting of 55.47% women and 44.53% men was analyzed. Ischemic (IS) and haemorrhagic strokes (HS) accounted for 91.8 and 8% respectively. The average age of a stroke patient was 74.2 years (women 76.6, men 71.2). The most common risk factors were hypertension (78.6%), dyslipidemia (55.2%) and atrial fibrillation (25.6%). According to the NIHSS scale, 65% of patients received ≤ 5 while 1.8% ≥ 25 points. During hospitalization, the NIHSS clinical improvement was achieved in 71.9%, deterioration in 3.6% and no change was observed in 24.5% of patients. In-hospital mortality amounts to 7.5%. Conclusions. More than two thirds of patients had more than one stroke risk factor, from which the most common one is hypertension. Awareness of modifiable risk factors for stroke is essential for implementation of a secondary prevention.
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