No abstract

The present study is part of a survey of subarachnoid hemorrhage cases observed in 16 neurosurgical and 8 neurological departments in Italy between June 1985 and June 1986. Warning signs preceding major hemorrhage were analyzed in 364 patients with intracranial aneurysms confirmed by angiography and reliable clinical history. Seventy-four (20.3%) had warning signs. Clinical features of premonitory warning signs were compared with symptoms of 78 patients without a history of minor leak and clinical grade 1 (according to the criteria of Hunt & Hess) at admission. Symptoms of warning signs are generally clear enough to be considered a misdiagnosis of intracranial aneurysm. Thunderclap headache described as severe, unusual and sudden was the main symptom in every case though the higher frequency of focal of diffuse signs in groups with a correct diagnosis attracted more careful attention in referral and diagnostic-therapeutic management. Improving the identification of minor leak and defining diagnostic strategy are discussed.

Discrimination between senile dementia Alzheimer type (SDAT) patients (N = 30) and Normal Controls (N = 60) by means of a 6-test set was assessed. Performances on Word Fluency (FL), Memory for Prose (PM) and Finger Agnosia (FA) nearly exhaust the discriminant power of the whole battery, including Constructional Apraxia (CA), Token Test (TT) and Weigl's Sorting Test (WT). The battery, however, leaves some facets of the difference between SDAT patients and Controls unexplored, misclassifying almost 20% of the SDAT patients and 10% of the Controls. We emphasize the role of discriminant analysis in the evaluation of any neuropsychological battery of tests which has to be used for diagnostic purposes.

Varón de 47 años diagnosticado de enfermedad de Crohn hace 13. Resección ileocecal por fístula colovesical al diagnóstico. Seguimiento por digestivo y en tratamiento con azatioprina. En enero de 2016 ingresa en cirugía por proctalagia aguda y dolor abdominal. En la TC se observa colección en fosa isquiorrectal derecha y obstrucción por bridas, que resuelve con tratamiento conservador. Se realiza drenaje de absceso, describiéndose una estenosis anal severa con mucosa en empedrado. Inicia tratamiento con mesalazina rectal. En febrero de 2016 reingresa por proctalgia, realizándose exploración en quirófano, sin nuevos hallazgos. Comienza tratamiento con infliximab, presentado mejoría franca.