http://hdl.handle.net/10451/4798 2013-05-21T08:03:14Z 2013-05-21T08:03:14Z Coutinho, J. M. Seelig, R. Bousser, M.-G. Canhão, P. Ferro, J. M. Stam, J. http://hdl.handle.net/10451/5215 2012-02-09T17:35:22Z 2011-09-01T00:00:00Z

Title: Treatment variations in cerebral venous thrombosis : an international survey Authors: Coutinho, J. M.; Seelig, R.; Bousser, M.-G.; Canhão, P.; Ferro, J. M.; Stam, J. Abstract: Introduction A variety of therapies are available to treat cerebral venous thrombosis (CVT), but evidence supporting the efficacy of most therapies is scarce. Heparin is considered the primary therapy [1] , but there is no consensus whether to use unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH). The ‘European Federation of Neurological Societies’ (EFNS) guideline recommends LMWH because of practical advantages and based upon data from randomized trials in leg-vein thrombosis [2] . In the ‘International Study on Cerebral Vein and Dural Sinus Thrombosis’ (ISCVT), however, UFH was used in the majority of patients [3] . Endovascular thrombolysis is generally reserved for severe cases, but no randomized trials have been performed [4] . The use of prophylactic anti-epileptic drugs (AED) in CVT is controversial [5, 6] . We hypothesized that considerable variations in treatment for CVT may exist among physicians. The aim of the present study is to determine how physicians worldwide treat CVT, using an online survey that was distributed among physicians with an interest in CVT.

2011-09-01T00:00:00Z Santos, Catarina Oliveira Caeiro, Lara Ferro, José M. Figueira, Maria Luísa http://hdl.handle.net/10451/5210 2012-02-09T17:06:50Z 2011-10-01T00:00:00Z

Title: A study of suicidal thoughts in acute stroke patients Authors: Santos, Catarina Oliveira; Caeiro, Lara; Ferro, José M.; Figueira, Maria Luísa Abstract: BACKGROUND: In previous studies, suicidal thoughts in stroke patients were related to depression and recurrent stroke. The aim of this study was to describe the presence and correlates of suicidal thoughts in acute stroke patients. METHODS: We assessed the presence of suicidal thoughts in a sample of 177 consecutive acute stroke patients (≤4 days), using the item "suicidal thoughts" of the Montgomery and Asberg Depression Rating Scale. RESULTS: Fifteen percent of acute stroke patients had suicidal thoughts, 22% of them with explicit plans to complete suicide. Suicidal thoughts were more frequent in patients with a lower educational level (Chi-square 4.69; P = .05), previous mood disorder (Chi-square 12.80; P = .001), diabetes (Chi-square 5.48; P = .04), and acute depression (Chi-square 16.59; P = .001). In logistic regression, a lower educational level (odds ratio [OR] 5.13; 95% confidence interval [CI] 0.80-33.29), diabetes (OR 3.15; 95% CI 0.81-12.28), a previous mood disorder (OR 4.22; 95% CI 1.12-15.86), and depression (OR 7.82; 95% CI 1.58-38.71) were independent factors predicting suicidal thoughts (R(2) = 0.39%). The 23 depressed acute stroke patients with suicidal thoughts were similar in demographic, clinical, and lesion variables, and were similar in profile of depression to the 63 patients with depression but without suicidal thoughts, except for a higher frequency of a previous mood disorder in the former group (Chi-square 7.87; P = .01). CONCLUSIONS: Suicidal thoughts may develop shortly after the onset of acute stroke, especially in patients with a lower educational level, a previous mood disorder, and those who developed depressive symptoms in the acute phase of stroke. The high frequency of suicidal thoughts makes the assessment of suicidal behavior in patients with acute stroke an important clinical issue.

2011-10-01T00:00:00Z Ferro, José M. Massaro, Ayrton R. Mas, Jean-Louis http://hdl.handle.net/10451/4823 2012-01-05T16:04:25Z 2010-11-01T00:00:00Z

Title: Aetiological diagnosis of ischaemic stroke in young adults Authors: Ferro, José M.; Massaro, Ayrton R.; Mas, Jean-Louis Abstract: Despite improvements in diagnosis and treatment, ischaemic stroke in young adults remains a catastrophic event from the patients’ perspective. Stroke can cause death, disability, and hamper quality of life. For the neurologist treating a young adult with suspected ischaemic stroke, the diagnostic challenge is to identify its cause. Contemporary neuroimaging of the brain and its vessels, and a comprehensive cardiac assessment, will enable identifi cation of the most frequent causes of stroke in this age group: cardioembolism and arterial dissection. Specifi c diagnostic tests for the many other rare causes of ischaemic stroke in young adults (angiography, CSF examination, screening for vasculitis and thrombophilia, genetic testing, and ophthalmological examination) should be guided by suspected clinical fi ndings or by the high prevalence of diseases associated with stroke in some countries.

2010-11-01T00:00:00Z