Background: The number of persons reaching the age 80 years and over is increasing in most populations. Literature focusing on hypertensive intracerebral hemorrhage (ICH) inthis age group is lacking. Therefore, we aimed to analyze the main clinical characteristics of ICH of the advanced old age, in the context of hypertension. Methods: From 1999 to 2003 we studied 56 hypertensive very elderly patients presenting with ICH (50% women; age 80–99 years). As controls, 168 hypertensive gender-matched persons with ICH, aged <80 years, were randomly selected by a 3:1 factor for clinical comparisons. Results: Compared with their younger counterparts, the very elderly patients had a trend for fewer cases of obesity (34 vs. 49%, p = 0.05) and diabetes mellitus (12 vs. 24%, p = 0.06), had lower systolic, diastolic and mean blood pressure measures (in all, p < 0.01) and more cases with hematoma extension into ventricles (p = 0.02). Thalamic hemorrhage was more frequent in the very elderly patients than in controls (43 vs. 28%, p = 0.04). In multivariate analysis, age, Glasgow coma scale score at hospital admission, ICH volume and infratentorial location were independent predictors of inhospital mortality, in all persons combined. In the very elderly group exclusively, Glasgow coma scale score was the only factor independently associated with mortality. Conclusions: ICH occurring in hypertensive patients aged ≧80 years has several differences from that seen in younger people; however, these differences do not seem to impact on early outcome.

The subventricular zone (SVZ), lining the lateral ventricular system, is the largest germinal region in mammals. In there, neural stem cells express markers related to astoglial lineage that give rise to new neurons and oligodendrocytes in vivo. In the adult human brain, in vitro evidence has also shown that astrocytic cells isolated from the SVZ can generate new neurons and oligodendrocytes. These proliferative cells are strongly controlled by a number of signals and molecules that modulate, activate or repress the cell division, renewal, proliferation and fate of neural stem cells. In this review, we summarize the cellular composition of the adult human SVZ (hSVZ) and discuss the increasing evidence showing that some trophic modulators strongly control the function of neural stem cells in the SVZ.

Background: Choreoacanthocytosis (CHAC) (Online Mendelian Inheritance in Man accession No. 200150) is a hereditary neurodegenerative syndrome characterized by movement disorders, cognitive decline, myopathy, behavioral changes, and acanthocytosis and is caused by mutations in the VPS13A gene.Objective: To describe the cases of 2 Mexican women with clinical and molecular characteristics compatible with CHAC.Design: Case reports.Patients: Choreoacanthocytosis was identified in 2 Mexican mestizo sisters with healthy consanguineous parents. Clinical manifestations began at different ages.Results: The onset of signs and symptoms of CHAC in the proband was at age 32 years and was characterized by balancing problems followed by chorea, compulsive

Osmotic demyelination syndrome (ODS) is the damage over the central nervous system caused by several electrolytes, metabolic and toxic disorders. We aimed to describe cases of unusual forms of ODS. In a 9-year period, 25 consecutive patients with ODS (15 men; mean age 42 years) were registered in our referral institution, among them, four (16 %) with atypical neuroimaging findings were abstracted for this communication. None of them presented cardiorespiratory arrest, head trauma, seizures, neuromyelitis optica spectrum or contact with toxic chemicals. Case 1 was a 33-year-old alcoholic man without hypertension or electrolyte imbalance, who presented a classic central pontine myelinolysis (CPM) and a hemorrhage within the pons. Case 2 was a 34-year-old alcoholic man with hypoglycemia and hyponatremia who presented CPM and diffuse bihemispheric extrapontine myelinolysis (EPM) after correction of serum sodium. Case 3 was a 52-year-old woman with mild hypokalemia and hyponatremia (inadequately corrected), who presented a peduncular and cerebellar EPM. Case 4 was a 67-year-old woman who had a suicidal attempt with antidepressants and carbamazepine without impaired consciousness, who complicated with mild hyponatremia associated with a classical CPM and a spinal cord EPM. Case 2 died and the rest remained with variable neurological impairments at last follow-up visit. With modern neuroimaging, the so-called atypical forms of ODS may not be as rare as previously thought; however, they could have a more adverse outcome than the classical ODS.

No abstract