Abnormal results from neurologic examination are the best clinical parameters to predict structural intracranial pathology; however, in patients 55 years or older with headache of acute onset located in the occipitonuchal region that has associated symptoms, computed tomographic scan of the head is justified as part of their clinical evaluation independently of the findings of the neurologic examination.

Nineteen (30%) of 63 adult survivors of cardiopulmonary arrest had seizures after admission to the hospital. Eleven of 19 had more than one type of seizure. Myoclonic seizures began within 12 hours of the arrest in eight patients, and after 3 or more days in four patients. Only two (17%) patients with myoclonic seizures survived. Partial seizures usually began within 12 hours of the arrest and were controllable with anticonvulsants; 4 of 12 patients survived. Two of four patients with generalized tonic-clonic seizures survived; one of four with "shivering" lived. Overall, patients with seizures had a survival rate of 32% (6 of 19), compared with 43% for patients without seizures. None of the survivors had recurrent seizures within 6 months after hospital admission.

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Seasonal periodicity in the onset of spontaneous intracerebral hemorrhage was studied in 118 consecutive cases occurring during a six-year span. The patients were urban residents of eastern Minnesota, a region characterized by wide seasonal fluctuations in daylight and temperature. The greatest number of cases consistently occurred each year during January and February. Circannual (about one year) periodicity was demonstrated by statistical analysis using rhythmometric techniques. This periodicity coincided with that reported for mortality from cerebrovascular and cardiovascular diseases in the United States and elsewhere. Available information suggests that in populations at high risk for vascular diseases, climatic conditions might act as synchronizers to endogenous rhythms influencing the periodic occurrence of pathological vascular events.

SUMMARY To determine the type and prognostic significance of the various temporal profiles of vertebrobasilar territory infarction, 39 consecutive patients were studied.The following temporal profiles were identified: 1) coma from onset, 5 patients; 2) sudden onset followed by stabilization, 12 patients; 3) gradual onset reaching stabilization within 24 hours, 7 patients; 4) gradual onset with progression beyond 24 hours, 2 patients, and; 5) delayed worsening after stabilization, 13 patients. Patients in Group 1 and those with unstable courses, Groups 4 and 5, had poor outcomes with mortality of 100 and 27 percent, respectively. Mortality for Groups 2 and 3 was 5 percent Overall, hospital mortality was 25.6 percent.Demographic data, risk factors, presenting symptoms and type of neurologic deficit, other than coma, had no correlation with mortality, degree of disability and long term survival. At follow up of 6 to 52 months, median 24, only 7 percent of the survivors had recurrent cerebrovascular events; 2 patients (7%) died due to nonvascular causes and 72 percent of patients re-examined (20 of 28) were either neurologicaJly normal or had only minimal deficits.