Pub Date : 2023-02-20DOI: 10.20471/may.2023.59.01.12
A. Pavlovic
Stroke associated with pregnancy and the postpartum period (SiPP) is not common but its consequences can be devastating both for the mother and the child. Pregnancy confers a substantially increased risk of stroke, especially during the third trimester and until 6 weeks postpartum. SiPP is heterogeneous both in aetiology and presentation as it includes both ischemic and haemorrhagic events as well as cerebral venous thrombosis. Specific risk factors for SiPP have been identified and well described, such as hypertensive disorders of pregnancy and a prothrombotic state. However, it is still a controversial issue if pregnancy should be considered a risk factor for stroke, although pregnancy and postpartum period clearly increase the stroke risk compared to non-pregnant time. Recent European Stroke Organization [ESO] guidelines addressed the management of acute SiPP while other issues, particularly primary and secondary prevention are still under investigated. There is also a lack of research and knowledge regarding long-term mother and foetus/child outcomes post-SiPP. This paper addresses current knowledge on SiPP management and prognosis and discusses new challenging clinical scenarios including the relationship between COVID-19 infection and SiPP.
{"title":"Stroke in Pregnancy and Puerperium - Current Knowledge, Questions and Controversies","authors":"A. Pavlovic","doi":"10.20471/may.2023.59.01.12","DOIUrl":"https://doi.org/10.20471/may.2023.59.01.12","url":null,"abstract":"Stroke associated with pregnancy and the postpartum period (SiPP) is not common but its consequences can be devastating both for the mother and the child. Pregnancy confers a substantially increased risk of stroke, especially during the third trimester and until 6 weeks postpartum. SiPP is heterogeneous both in aetiology and presentation as it includes both ischemic and haemorrhagic events as well as cerebral venous thrombosis. Specific risk factors for SiPP have been identified and well described, such as hypertensive disorders of pregnancy and a prothrombotic state. However, it is still a controversial issue if pregnancy should be considered a risk factor for stroke, although pregnancy and postpartum period clearly increase the stroke risk compared to non-pregnant time. Recent European Stroke Organization [ESO] guidelines addressed the management of acute SiPP while other issues, particularly primary and secondary prevention are still under investigated. There is also a lack of research and knowledge regarding long-term mother and foetus/child outcomes post-SiPP. This paper addresses current knowledge on SiPP management and prognosis and discusses new challenging clinical scenarios including the relationship between COVID-19 infection and SiPP.","PeriodicalId":8294,"journal":{"name":"Archives of Psychiatry Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67598829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-20DOI: 10.20471/may.2023.59.01.20
Rafaela Vukasović, Melanija Pintarić, V. Đuranović, A. Lovrenčić‐Huzjan
Fibromuscular dysplasia (FMD) is a group of nonatherosclerotic, noninflammatory arterial diseases that most commonly involve the renal and carotid arteries it typically occurs in women aged between 30 and 50 years. FMD in children is rare and its most common site of involvement are renal arteries. Stroke in children is generally uncommon and due to FMD is even rarer, which is why it is often unrecognized. We present a case of a boy, with an inconspicuous previous anamnesis and orderly development, who woke up at the age of 9 with weakness of the left side of the body and speech disorders. MR showed an ischemic lesion in the irrigation area of the right middle cerebral artery (arteria cerebri media- ACM). In neurological status mild dysarthria with left central facial nerve lesion was noted as well as mild paresis of the left extremities. Neurosonological testing showed segmental extensions and narrowing of the right ACM with underlying dissection, which speaks in favour of fibromuscular dysplasia. Therapy with acetylsalicylic acid 50 mg was initiated, and with further follow-up of the patient, complete regression of symptoms and normal neurological status were recorded.
{"title":"Intracranial Fibromuscular Dysplasia in a Male Child Presented by Middle Cerebral Artery Dissection and Stroke","authors":"Rafaela Vukasović, Melanija Pintarić, V. Đuranović, A. Lovrenčić‐Huzjan","doi":"10.20471/may.2023.59.01.20","DOIUrl":"https://doi.org/10.20471/may.2023.59.01.20","url":null,"abstract":"Fibromuscular dysplasia (FMD) is a group of nonatherosclerotic, noninflammatory arterial diseases that most commonly involve the renal and carotid arteries it typically occurs in women aged between 30 and 50 years. FMD in children is rare and its most common site of involvement are renal arteries. Stroke in children is generally uncommon and due to FMD is even rarer, which is why it is often unrecognized. We present a case of a boy, with an inconspicuous previous anamnesis and orderly development, who woke up at the age of 9 with weakness of the left side of the body and speech disorders. MR showed an ischemic lesion in the irrigation area of the right middle cerebral artery (arteria cerebri media- ACM). In neurological status mild dysarthria with left central facial nerve lesion was noted as well as mild paresis of the left extremities. Neurosonological testing showed segmental extensions and narrowing of the right ACM with underlying dissection, which speaks in favour of fibromuscular dysplasia. Therapy with acetylsalicylic acid 50 mg was initiated, and with further follow-up of the patient, complete regression of symptoms and normal neurological status were recorded.","PeriodicalId":8294,"journal":{"name":"Archives of Psychiatry Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48530979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-20DOI: 10.20471/may.2023.59.01.03
Tihana Gilman Kurić, Z. Popovic, S. Tomic, Jagoda Kragujevic, Tea Mirošević Zubonja, T. Pučić, A. Petek Erić, Igor Kuric
So far there is not much research considering female sex as a risk factor for developing focal cervical dystonia and concomitant psychiatric symptoms such as anxiety. New research proposes ideas of CD baseline pathophysiology targeting neurobiological mechanisms of gamma aminobutyric acid GABAergic function underlying sexual dimorphism and psychiatric symptoms as an intrinsic factor of the disease itself. Our research examines the connection between motor and non-motor symptoms in female patients suffering from focal cervical dystonia and their response to treatment, cit- ing the available literature and hypothesising whether it can be linked to previously described alterations in GABA levels.
{"title":"Psychiatric Symptoms in Women with Focal Cervical Dystonia - Exploring New Pathophysiological Pathways","authors":"Tihana Gilman Kurić, Z. Popovic, S. Tomic, Jagoda Kragujevic, Tea Mirošević Zubonja, T. Pučić, A. Petek Erić, Igor Kuric","doi":"10.20471/may.2023.59.01.03","DOIUrl":"https://doi.org/10.20471/may.2023.59.01.03","url":null,"abstract":"So far there is not much research considering female sex as a risk factor for developing focal cervical dystonia and concomitant psychiatric symptoms such as anxiety. New research proposes ideas of CD baseline pathophysiology targeting neurobiological mechanisms of gamma aminobutyric acid GABAergic function underlying sexual dimorphism and psychiatric symptoms as an intrinsic factor of the disease itself. Our research examines the connection between motor and non-motor symptoms in female patients suffering from focal cervical dystonia and their response to treatment, cit- ing the available literature and hypothesising whether it can be linked to previously described alterations in GABA levels.","PeriodicalId":8294,"journal":{"name":"Archives of Psychiatry Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47399444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-20DOI: 10.20471/may.2023.59.01.13
Ana Sruk, Zurap Raifi, Fabijan Đumbir, L. Friedrich
Pregnancy-related epilepsy issues (PREIs) are crucial in managing women with epilepsy (WWE). The main PREIs are reduced compliance and self-discontinuation of antiseizure medications (ASMs), pharmacokinetic alterations during pregnancy, and the teratogenic potential of particular ASMs. According to a recent study, knowledge of PREIs among reproductive-aged WWE in Croatia is unsatisfactory, as are neurologist consultations about PREIs. Two hundred WWE were polled on their knowledge, sources, and needs for information about PREIs and their current ASMs usage. Prior consultation with a neurologist and increased use of books/brochures were the main predictors of knowledge. Forty-five percent of participants had a prior neurologist consultation on PREIs. Most women (61 %) chose their neurologist as their favourite future source of information, and 13 % favoured Internet. The most usually prescribed ASM was levetiracetam (34.5 %). Valproate was utilized by 26 % of respondents, among which 59 % claimed no prior PREIs consultation with a neurologist. A new campaign called Epilepsy and Pregnancy was launched by the International Bureau for Epilepsy in 2021. In February 2021, a poll of nearly 900 women was conducted across Europe as the first stage in this significant project, including 94 respondents from Croatia. Forty-two percent of Croatian WWE were given no information on pregnancy-related risks. In contrast with the aforementioned study, neurologists provided 82 percent of information about the risks of ASMs. Seventy percent reported they were not given contraception information. Providing clear, accurate and timely information on PREIs should become the norm for all neurologists caring for WWE.
{"title":"A Review of Awareness of Pregnancy-Related Issues Among Reproductive-Aged Croatian Women with Epilepsy","authors":"Ana Sruk, Zurap Raifi, Fabijan Đumbir, L. Friedrich","doi":"10.20471/may.2023.59.01.13","DOIUrl":"https://doi.org/10.20471/may.2023.59.01.13","url":null,"abstract":"Pregnancy-related epilepsy issues (PREIs) are crucial in managing women with epilepsy (WWE). The main PREIs are reduced compliance and self-discontinuation of antiseizure medications (ASMs), pharmacokinetic alterations during pregnancy, and the teratogenic potential of particular ASMs. According to a recent study, knowledge of PREIs among reproductive-aged WWE in Croatia is unsatisfactory, as are neurologist consultations about PREIs. Two hundred WWE were polled on their knowledge, sources, and needs for information about PREIs and their current ASMs usage. Prior consultation with a neurologist and increased use of books/brochures were the main predictors of knowledge. Forty-five percent of participants had a prior neurologist consultation on PREIs. Most women (61 %) chose their neurologist as their favourite future source of information, and 13 % favoured Internet. The most usually prescribed ASM was levetiracetam (34.5 %). Valproate was utilized by 26 % of respondents, among which 59 % claimed no prior PREIs consultation with a neurologist. A new campaign called Epilepsy and Pregnancy was launched by the International Bureau for Epilepsy in 2021. In February 2021, a poll of nearly 900 women was conducted across Europe as the first stage in this significant project, including 94 respondents from Croatia. Forty-two percent of Croatian WWE were given no information on pregnancy-related risks. In contrast with the aforementioned study, neurologists provided 82 percent of information about the risks of ASMs. Seventy percent reported they were not given contraception information. Providing clear, accurate and timely information on PREIs should become the norm for all neurologists caring for WWE.","PeriodicalId":8294,"journal":{"name":"Archives of Psychiatry Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44636144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-20DOI: 10.20471/may.2023.59.01.15
Andrija Meštrović, Zurap Raifi, Ana Sruk, M. Budišić, V. Kalousek, Marina Roje Bedeković, H. Budinčević
An ischemic stroke caused by the occlusion of the artery of Percheron encompasses both posterior thalami, and the resulting clinical presentation can mask the clinical presentation of a stroke. We present the case report of a 62-year-old female patient who was admitted to our emergency department in a soporous state after initial headache and dizziness. A neurological exam found left-sided spasticity and a flexor response to pain. Systemic thrombolysis was administered after an urgent computerized tomography (CT) of the brain with angiography. The interventional radiologist proposed a digital subtraction angiography which found a vasospasm in the right medial cerebral artery from the M2 seg- ment reaching distally, and a balloon dilation was done. Following the endovascular procedure, a CT scan showed ischemia in both posterior thalami. Additionally, the patient’s neurological impairment improved at that moment showing Parinaud syndrome, drowsiness, and left-sided palsy. The patient experienced a possible reversible cerebral vasoconstriction syndrome, the cause of which is still unknown, which resulted in an ischemic stroke. The typical clinical presentation of that syndrome was lacking, probably due to the presence of the artery of Percheron ipsilateral to the vasospasm. Our goal in presenting this case study is to draw attention to the artery of Percheron syndrome as a potential clinical sign of an acute ischemic stroke that can easily lead us to be misled.
{"title":"Brain Infarction in the Artery of Percheron Supply Area due to Reversible Cerebral Vasoconstriction Syndrome","authors":"Andrija Meštrović, Zurap Raifi, Ana Sruk, M. Budišić, V. Kalousek, Marina Roje Bedeković, H. Budinčević","doi":"10.20471/may.2023.59.01.15","DOIUrl":"https://doi.org/10.20471/may.2023.59.01.15","url":null,"abstract":"An ischemic stroke caused by the occlusion of the artery of Percheron encompasses both posterior thalami, and the resulting clinical presentation can mask the clinical presentation of a stroke. We present the case report of a 62-year-old female patient who was admitted to our emergency department in a soporous state after initial headache and dizziness. A neurological exam found left-sided spasticity and a flexor response to pain. Systemic thrombolysis was administered after an urgent computerized tomography (CT) of the brain with angiography. The interventional radiologist proposed a digital subtraction angiography which found a vasospasm in the right medial cerebral artery from the M2 seg- ment reaching distally, and a balloon dilation was done. Following the endovascular procedure, a CT scan showed ischemia in both posterior thalami. Additionally, the patient’s neurological impairment improved at that moment showing Parinaud syndrome, drowsiness, and left-sided palsy. The patient experienced a possible reversible cerebral vasoconstriction syndrome, the cause of which is still unknown, which resulted in an ischemic stroke. The typical clinical presentation of that syndrome was lacking, probably due to the presence of the artery of Percheron ipsilateral to the vasospasm. Our goal in presenting this case study is to draw attention to the artery of Percheron syndrome as a potential clinical sign of an acute ischemic stroke that can easily lead us to be misled.","PeriodicalId":8294,"journal":{"name":"Archives of Psychiatry Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42713825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-20DOI: 10.20471/may.2023.59.01.23
Ivan Puhar
Letter to the Editor
给编辑的信
{"title":"Sex Differences in Periodontology as a Risk Factor for Cerebrovascular Diseases","authors":"Ivan Puhar","doi":"10.20471/may.2023.59.01.23","DOIUrl":"https://doi.org/10.20471/may.2023.59.01.23","url":null,"abstract":"Letter to the Editor","PeriodicalId":8294,"journal":{"name":"Archives of Psychiatry Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48569870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-20DOI: 10.20471/may.2023.59.01.16
Tea Mikula, A. Lovrenčić‐Huzjan
Several studies have shown sex differences regarding help-seeking behaviour in stroke and transient ischemic attack [TIA] patients. Women are less likely to perceive their symptoms as requiring immediate hospital care. They are also more inclined to involve friends and family in decision-making and help-seeking. Delaying transport to the hospital is partly due to behavioural and socio-demographic factors of female patients. These impact help-seeking behaviour and prolong prehospital delay, which may affect patient outcomes. We present a 69-year-old woman exhibiting neurological symptoms indicative of a cerebrovascular event, refusing to go to the hospital. The Emergency medical service [EMS] team made the initial medical assessment, outlining the need for immediate transport. Our patient did not view her symptoms as worrying but finally agreed to go to the hospital. She was persuaded by her children, who had an active role in the patient’s decision-making process. Factors that affected help-seeking behaviour and prehospital delay were analysed, accompanied by a review of literature related to the subject.
{"title":"Less Help-Seeking Behaviour in Female Patients Exhibiting Stroke or TIA - Related Symptoms","authors":"Tea Mikula, A. Lovrenčić‐Huzjan","doi":"10.20471/may.2023.59.01.16","DOIUrl":"https://doi.org/10.20471/may.2023.59.01.16","url":null,"abstract":"Several studies have shown sex differences regarding help-seeking behaviour in stroke and transient ischemic attack [TIA] patients. Women are less likely to perceive their symptoms as requiring immediate hospital care. They are also more inclined to involve friends and family in decision-making and help-seeking. Delaying transport to the hospital is partly due to behavioural and socio-demographic factors of female patients. These impact help-seeking behaviour and prolong prehospital delay, which may affect patient outcomes. We present a 69-year-old woman exhibiting neurological symptoms indicative of a cerebrovascular event, refusing to go to the hospital. The Emergency medical service [EMS] team made the initial medical assessment, outlining the need for immediate transport. Our patient did not view her symptoms as worrying but finally agreed to go to the hospital. She was persuaded by her children, who had an active role in the patient’s decision-making process. Factors that affected help-seeking behaviour and prehospital delay were analysed, accompanied by a review of literature related to the subject.","PeriodicalId":8294,"journal":{"name":"Archives of Psychiatry Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41865325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-20DOI: 10.20471/may.2023.59.01.19
Rafaela Vukasović, Melanija Pintarić, A. Lovrenčić‐Huzjan
Headache is a frequent symptom in emergency department, especially in patients with hypertension. Carotid web, also known as the variant of fibromuscular dysplasia (FMD), is a rare disorder, found in only 1- 1.2 % of patients undergoing angiography, and it should be searched for in patients with cryptogenic stroke. We present a female hyper- tensive patient presented to emergency department with headache and visual symptoms, in whom further work-up revealed carotid web. A 46 years old female patient presented to the ED with headache occurring few days before the examination. It was a constant left temporal headache accompanied with flashes in the right half of the visual field. History taking revealed well-controlled hypertension with calcium channel antagonists. The first manifestation of hypertension was eclampsia during pregnancy. In emergency department normal neurologic status was obtained, brain CT scan was normal. Neurosonological examination revealed right carotid web, confirmed by MSCT angiography.
{"title":"Headache as a Symptom of Carotid Web","authors":"Rafaela Vukasović, Melanija Pintarić, A. Lovrenčić‐Huzjan","doi":"10.20471/may.2023.59.01.19","DOIUrl":"https://doi.org/10.20471/may.2023.59.01.19","url":null,"abstract":"Headache is a frequent symptom in emergency department, especially in patients with hypertension. Carotid web, also known as the variant of fibromuscular dysplasia (FMD), is a rare disorder, found in only 1- 1.2 % of patients undergoing angiography, and it should be searched for in patients with cryptogenic stroke. We present a female hyper- tensive patient presented to emergency department with headache and visual symptoms, in whom further work-up revealed carotid web. A 46 years old female patient presented to the ED with headache occurring few days before the examination. It was a constant left temporal headache accompanied with flashes in the right half of the visual field. History taking revealed well-controlled hypertension with calcium channel antagonists. The first manifestation of hypertension was eclampsia during pregnancy. In emergency department normal neurologic status was obtained, brain CT scan was normal. Neurosonological examination revealed right carotid web, confirmed by MSCT angiography.","PeriodicalId":8294,"journal":{"name":"Archives of Psychiatry Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42127819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-20DOI: 10.20471/may.2023.59.01.07
A. Lovrenčić‐Huzjan
Fibromuscular dysplasia (FMD) is a non-atherosclerotic, non-inflammatory vascular disease with strong female preponderance. However the diagnosis of the disease is low. FMD affects medium-sized muscular arteries, predominantly renal arteries, but equally carotid and vertebral arteries. It leads to artery stenosis, occlusion, aneurysm or dissection. The clinical picture depends on the affected blood vessels. It is most commonly recognized as a cause of hypertension in young female patients. In the case of involvement of cranial and cervical arteries, the clinical picture is mostly nonspecific, with headache, migraine and tinnitus. In registries, females had more frequent classical symptoms of cerebrovascular FMD like pulsatile tinnitus, cervical bruit and neck pain, and males have more frequently visceral affection (abdominal pain, renal impairment and renal infarction). Also, man had more frequently more sever clinical presentation like arterial dissection or arterial aneurysm. At the age of diagnosis males are younger compared to females. Large cohort studies showed the association of FMD with female sex, migraine, and intracranial aneurysm. FMD is an under-recognized vascular disease, more prevalent in females, but exhibiting more sever clinical presentation in males.
{"title":"Fibromuscular Dysplasia – Underrecognized Vasculopathy with Female Preponderance","authors":"A. Lovrenčić‐Huzjan","doi":"10.20471/may.2023.59.01.07","DOIUrl":"https://doi.org/10.20471/may.2023.59.01.07","url":null,"abstract":"Fibromuscular dysplasia (FMD) is a non-atherosclerotic, non-inflammatory vascular disease with strong female preponderance. However the diagnosis of the disease is low. FMD affects medium-sized muscular arteries, predominantly renal arteries, but equally carotid and vertebral arteries. It leads to artery stenosis, occlusion, aneurysm or dissection. The clinical picture depends on the affected blood vessels. It is most commonly recognized as a cause of hypertension in young female patients. In the case of involvement of cranial and cervical arteries, the clinical picture is mostly nonspecific, with headache, migraine and tinnitus. In registries, females had more frequent classical symptoms of cerebrovascular FMD like pulsatile tinnitus, cervical bruit and neck pain, and males have more frequently visceral affection (abdominal pain, renal impairment and renal infarction). Also, man had more frequently more sever clinical presentation like arterial dissection or arterial aneurysm. At the age of diagnosis males are younger compared to females. Large cohort studies showed the association of FMD with female sex, migraine, and intracranial aneurysm. FMD is an under-recognized vascular disease, more prevalent in females, but exhibiting more sever clinical presentation in males.","PeriodicalId":8294,"journal":{"name":"Archives of Psychiatry Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43336477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-20DOI: 10.20471/may.2023.59.01.01
Ivana Vinski, Ivana Kobasić Galić, Lara Pilepić, M. Lisak, Irena Martinić-Popović, A. Lovrenčić‐Huzjan
Transorbital sonography is a reliable method for non-invasive assessment of optic nerve diameter (OND) and optic nerve sheath diameter (ONSD) in patients with increased intracranial pressure. A wide range of regular ONSD values has been reported in the literature. The aim of this study was to determine normal values for OND and ONSD, to determine differences between OND and ONSD considering sex, age, and body mass index (BMI), and to evaluate inter - and intra - examiner variability. The study included 100 healthy subjects, aged 22 - 87 years, who underwent transbulbar sonography by the two examiners, each examiner measuring OND and ONSD twice on both eyes at a depth of 3 mm behind the optic nerve papilla. Measurement and analysis of OND and ONSD was possible in all subjects. Mean OND was 2.39 +/- 0.28 mm and mean ONSD was 4.48 +/- 0.76 mm. In males, mean OND was 2.47 +/- 0.28 mm and in females 2.35 +/- 0.27 mm (p = 0.042). There was no statistically significant difference between mean ONSD values between sexes (p > 0.001). Correlation between age and mean OND and ONSD wasn`t observed. Positive correlation between mean OND and BMI (p = 0.001) was observed. Positive correlation within and between investigator measurements (p < 0.01) was shown. Men have a wider OND compared to women, but no difference in ONSD was observed. Age doesn`t effect on the width of OND and ONSD. BMI correlates positively with OND, but not with ONSD. Positive correlation within and between investigator measurements was shown.
{"title":"Transorbital Sonography in the Evaluation of the Optic Nerve and Optic Nerve Sheath Diameter Considering Specific Demographic Features","authors":"Ivana Vinski, Ivana Kobasić Galić, Lara Pilepić, M. Lisak, Irena Martinić-Popović, A. Lovrenčić‐Huzjan","doi":"10.20471/may.2023.59.01.01","DOIUrl":"https://doi.org/10.20471/may.2023.59.01.01","url":null,"abstract":"Transorbital sonography is a reliable method for non-invasive assessment of optic nerve diameter (OND) and optic nerve sheath diameter (ONSD) in patients with increased intracranial pressure. A wide range of regular ONSD values has been reported in the literature. The aim of this study was to determine normal values for OND and ONSD, to determine differences between OND and ONSD considering sex, age, and body mass index (BMI), and to evaluate inter - and intra - examiner variability. The study included 100 healthy subjects, aged 22 - 87 years, who underwent transbulbar sonography by the two examiners, each examiner measuring OND and ONSD twice on both eyes at a depth of 3 mm behind the optic nerve papilla. Measurement and analysis of OND and ONSD was possible in all subjects. Mean OND was 2.39 +/- 0.28 mm and mean ONSD was 4.48 +/- 0.76 mm. In males, mean OND was 2.47 +/- 0.28 mm and in females 2.35 +/- 0.27 mm (p = 0.042). There was no statistically significant difference between mean ONSD values between sexes (p > 0.001). Correlation between age and mean OND and ONSD wasn`t observed. Positive correlation between mean OND and BMI (p = 0.001) was observed. Positive correlation within and between investigator measurements (p < 0.01) was shown. Men have a wider OND compared to women, but no difference in ONSD was observed. Age doesn`t effect on the width of OND and ONSD. BMI correlates positively with OND, but not with ONSD. Positive correlation within and between investigator measurements was shown.","PeriodicalId":8294,"journal":{"name":"Archives of Psychiatry Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48919466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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