Microvascular Decompression for Trigeminal Neuralgia

Abstract

Introduction/Objectives: Th e central idea of our presentation is MCI -a conceptual and pathological entity defi ned by Petersen et al. in 1995 and still under debate, surrounded by a sustained attention mainly because it is a stage where suitable medical and nonmedical interventions could potentially be more successful by comparison with later stages in which the changes are more and more dramatic and less susceptible to be amended.Participants, Materials/Methods: Th e fi rst part of our paper attempts the actual issues of the debate upon MCI concept: its usefulness, defi nition, etiology, clinical appearance and evolution, heterogeneity of the assessment scores, scales and criteria of defi nition, conversion predictors, cohorts under study, research outcomes, treatment algorithms etc., as well as to its position in the aging and cognitive pathology matrices. As practical topics, the diff erential diagnosis, prediction, the epidemiologic and risk factors and the drug and non-drug, preventive and curative interventions are also called into discussion. A special attention is paid to the exceptional high complexity of biological and functional changes that determines the MCI heterogeneous appearance.Results: Th e outcomes of our epidemiological, risk factors and the rate of conversion to Alzheimer's Disease studies in a cohort of MCI patients, as part of the EADC's DESCRIPA Project, are also overviewed. Conclusions:Th e main conclusion is that the heterogeneities related to MCI could potentially be overcome by defi ning "clusters" of neuro-pathological, neuro-psychological and functional changes to be monitored in their dynamics, aside to the requirement of "personalized attempt" and ethical issues concerning MCI patients' evaluation and therapeutic intervention design. Introduction/Objectives: Disorders of consciousness is frequent in the acute stroke. Determine the severity of stroke and mortality in relation to the type of disturbance of consciousness in patients in the acute phase of stroke. OUTCOME OF PATIENTS WITH DISORDERS OF CONSCIOUSNESS IN ACUTE STROKEParticipants, Materials/Methods: We retrospectively analyzed 201 patients with acute stroke at the Department of Neurology, University Clinical Center Tuzla, in the period from July 1st to December 31st 2008. Th e stroke was confi rmed in all patients by computed tomography within 24 hours after hospitalization. Disorders of consciousness are divided into quantitative and qualitative. Assessment of disorders of consciousness is performed by Glasgow Coma Scale1 and and the Diagnostic and Statistical Manual of Mental Disorders -Fourth Edition2 after admission. Th e severity of stroke was determined by National Institutes of Health Stroke Scale3. Results: Fifty-four patients had disorders of consciousness in acute phase of stroke (26.9%). Patients with disorders of consciousness on admission (19.9 ± 9.5 vs. 7.9 ± 5.1, p < 0.001) and discharge (11.4 ± 10.5 vs. 4.3 ± 3.9, p = 0.003) had a more severe stroke than patients without disturbances of consciousness. Th...