Entrapment neuropathy of the deep peroneal nerve, also recognized as anterior tibial nerve, typically occurs at the anterior ankle and dorsal foot.
The aim of this study was to analyze one year outcome of the acute stroke patients with sleep apnea in order to gender and age. Methods: It was analyzed 110 patients with acute stroke and sleep apnea. Among them 65(59%) were men. Average age of all participant was 65.13±9.27 years. The same number and gender distribution of participants with stroke and without apnea were in control group. Evaluation of sleep apnea has been done with: “The Sleep Disorders Questionnaire”, “Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome” and “The Epworth Sleepiness Scale”. Results: One year after stroke onset survived 91 (82.7%) out of 110 patients with apnea. Average age of survived patients was 63.66±8.78 years. Among them 52(80%) were men. In control group, without apnea survived 104 (94.5%) patients with average age of 65.00±8.62 years. Among them 62 (95.4%) were men. In men with apnea there is significantly lower survival range in order to patients without apnea (X2=8.22, p=0.004). In women there is no difference. Survival of both gender in patients with apnea (22; 64.7%) was the lowest in group older than 70 years of age. Sex ratio (men : women) was 15 (68.2%):7(58.3%). Survival in both gender in patients without apnea was the same in group older than 70 years of age: 27 (81.2%) out of 33. Average age of patients who died with apnea was significantly higher in order to patients without (t=1.97, p=0.03). Conclusion: One year after stroke, significantly more patients survived without (94.5%) than with apnea (82.7%) (p=0.01). In order to sex survived range was significantly (p=0.004) lover in men with apnea than without but in women there is no difference. Survival range of both gender in patients with apnea was the lowest in group older than 70 years (p=0.03).
The aim of this study was to analyze one year survival outcome of the patients with sleep apnea in acute stroke in order to type and localisation of lesion. Patients and Methods: It was analyzed 110 patients with acute stroke (AS) and verified sleep apnea, treated at Department of Neurology, University Clinical Center Tuzla in the period December 2009 thorough may 2010. Acute stroke has been verified either by computerized tomography or magnetic resonance imaging of the brain. Average age was 65.13±9.27 years and it was 65 (59%) men. Number of participants with no apnea in control group was the same as well as sex distribution, with average age 64±8.69 years. Results: One year after acute stroke survived 78 (84.8%) patients out of 92 with apnea and ischemic stroke (IS). Otherwise, 13 (72.2%) patients survived out of 18 with hemorrhagic stroke (HS). Without apnea 88 (95.7%) patients who survived had IS and 16 (88.9%) HS. Survival of patients with IS and without apnea is significantly better than in patients with IS and apnea (X2=5.46, p=0.02). Survival of patients with HS with/without apnea is not significantly different. Majority (51/87.9%) of 58 patients with apnea who survived had lesions at two or more locations. Otherwise, 12 (100%) patients out of 12 without apnea who survived had lesion in frontal lobe. Survival of patients with/without apnea is not statisticaly different in order to location of lesion. Concerning the side of stroke 23 (85.5%) patients with apnea who survived had lesion(s) in left hemisphere but this difference is not significant. Patients without apnea 48 (96%) had lesion(s) at both sides. Conclusion: Survival of patients without apnea in ischemic stroke is significantly better than in patients with apnea. Survival in patients with/without apnea in hemorrhagic stroke has no statistical difference. Localization and side of lesion do not have influence on survival.
We present a case of a patient with Anton's syndrome (i.e., visual anosognosia with confabulations), who developed bilateral occipital lobe infarct. Bilateral occipital brain damage results in blindness, and patients start to confabulate to fill in the missing sensory input. In addition, the patient occasionally becomes agitated and talks to himself, which indicates that, besides Anton's syndrome, he might have had Charles Bonnet syndrome, characterized by both visual loss and hallucinations. Anton syndrome, is not so frequent condition and is most commonly caused by ischemic stroke. In this particular case, the patient had successive bilateral occipital ischemia as a result of massive stenoses of head and neck arteries.
Background. Previous studies have shown impaired fibrinolysis in multiple sclerosis (MS) and implicated extracellular proteolytic enzymes as important factors in demyelinating neuroinflammatory disorders. Tissue-type plasminogen activator (t-PA) and its inhibitor (PAI-1) are key molecules in both fibrinolysis and extracellular proteolysis. In the present study, an association of the TPA Alu I/D and PAI-1 4G/5G polymorphisms with MS was analyzed within the Genomic Network for Multiple Sclerosis (GENoMS). Methods. The GENoMS includes four populations (Croatian, Slovenian, Serbian, and Bosnian and Herzegovinian) sharing the same geographic location and a similar ethnic background. A total of 885 patients and 656 ethnically matched healthy blood donors with no history of MS in their families were genotyped using PCR-RFLP. Results. TPA DD homozygosity was protective (OR = 0.79, 95% CI 0.63–0.99, P = 0.037) and PAI 5G5G was a risk factor for MS (OR = 1.30, 95% CI 1.01–1.66, P = 0.038). A significant effect of the genotype/carrier combination was detected in 5G5G/I carriers (OR = 1.39 95% CI 1.06–1.82, P = 0.017). Conclusions. We found a significantly harmful effect of the combination of the PAI-1 5G/5G genotype and TPA I allele on MS susceptibility, which indicates the importance of gene-gene interactions in complex diseases such as MS.
The accessory deep peroneal (ADPN) nerve has been regarded as an anomalous nerve derived from the superficial peroneal nerve or its branch and supplies motor innervations for extensor digitorum brevis (EDB) and sensory innervations for the lateral part of the ankle and foot regions. The EDB is usually innervated exclusively by the deep peroneal nerve, a major branch of the the common peroneal nerve, however, in as many as 28% of patients (with same male/female frequency), one or both of the EDB muscles are (partially or exclusively) innervated by the ADPN nerve. This anomaly appears to be inherited in autosomal dominant fashion with incomplete gene penetrance. ADPN existence is of great clinical and surgical importance, and the aim of this study is to describe a very rare case of coexistence ADPN and anterior tarsal tunnel syndrome.
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