Intracranial venous thrombosis associated with severe antithrombin-III deficiency in pregnancy

We report a patient with intracranial venous thrombosis in the third trimester of pregnancy associated with severe antithrombin-III deficiency. The evaluation of protein C, protein S and antithrombin-III levels in patients with thrombotic events during pregnancy may reveal the specific cause of the thrombotic event and thereby influence patient management     

Sildenafil-related cerebral venous sinus thrombosis and papilledema: a case report of a rare entity

Neurological Sciences - We present a rare case of cerebral venous sinus thrombosis associated with long-term and high-dose use of sildenafil. A 29-year-old man was referred to our...     

Headache in primary Sjögren's syndrome: a prevalence study

Objectives –  To determine the prevalence of headache in patients with primary Sjögren's syndrome (pSS) and to examine the relationship between headache types and clinical, serologic features of the disease.
Methods –  The study enclosed 133 patients with the diagnoses of pSS and 97 healthy controls. A questionnaire designed to assess the presence of headache and if present to classify it according to the criteria of the International Headache Society was used.
Results –  In 133 of the pSS patients evaluated, 104 had headache. No association was present between types of headache and the clinical and laboratory manifestations of the disease. Both migraine and tension-type headache were more common in patients with pSS when compared with healthy controls ( P  < 0.001).
Conclusions –  The high prevalence of migraine in pSS patients might be explained by a vascular headache triggered by immuno-mediated disease activity without an obvious clinic or laboratory marker.     

Clinical Assessment of Topiramate Therapy in Patients With Migrainous Vertigo

( Headache 2010;50:77-84)
Objective.— To assess the efficacy of topiramate in reducing both the frequency and the severity of vertigo and headache attacks in patients with migrainous vertigo and to compare 50 and 100 mg/day doses of the drug.
Methods.— Thirty patients diagnosed as definite migrainous vertigo were recruited in the study. Vertigo and headache frequency was determined as the monthly number of attacks whereas severity was determined by visual analog scales measured in millimeters from 0 to 100. Patients were randomized to either 50 or 100 mg/day topiramate for 6 months. Vertigo and headache frequency and severity were evaluated at the end of the study period.
Results.— Number of mothly vertigo attacks decreased significantly in the overall group after treatment (median from 5.5 to 1; P  < .01). The same was true for monthly headache attacks (median from 4 to 1; P  < .01). A statically significant improvement in vertigo severity was noted (median from 80 to 20 mm; P  < .01). Headache severity showed significant improvement as well (median from 60 to 30 mm; P  < .01). No statistically significant difference between high- and low-dose groups was present regarding efficacy ( P  > .05). Four patients in the high-dose group discontinued treatment at the end of the first month because of adverse effects.
Conclusions.— In the overall group, topiramate was found to be effective in reducing the frequency and the severity of vertigo and headache attacks. Both doses of the drug were equally efficacious. The 50 mg/day dose seems to be appropriate as higher adverse effects were noted when 100 mg/day was used.     

Short-Term Effects of Vestibular Rehabilitation in Patients With Chronic Unilateral Vestibular Dysfunction: A Randomized Controlled Study

Giray M, Kirazli Y, Karapolat H, Celebisoy N, Bilgen C, Kirazli T. Short-term effects of vestibular rehabilitation in patients with chronic unilateral vestibular dysfunction: a randomized controlled study.

Objective

To evaluate the short-term effects of vestibular rehabilitation on symptom, disability, balance, and postural stability in patients with chronic unilateral vestibular dysfunction.

Design

Randomized controlled trial.

Setting

Department of Physical Medicine and Rehabilitation, University Hospital.

Participants

Patients (N=42) with chronic vestibular dysfunction were divided into either a rehabilitation group (group 1) or a control group (group 2).

Interventions

Patients in group 1 were treated with a customized exercise program for 4 weeks, while the patients in the control group did not receive any treatment.

Main Outcome Measures

Subjects were assessed before and after the rehabilitation program with respect to symptoms (visual analog scale [VAS]), disability (Dizziness Handicap Inventory [DHI]), balance (Berg Balance Scale [BBS]), and postural stability (modified Clinical Test for Sensory Interaction on Balance [mCTSIB]).

Results

Significant improvements in all parameters (VAS, DHI, BBS, mCTSIB) were observed in group 1 (P<.05). When the 2 groups were compared, there were significant improvements in postexercise VAS, DHI (emotional, functional, physical, total), BBS, and mCTSIB (standing on a firm surface with eyes open, standing on a foam surface with eyes open, standing on a foam surface with eyes closed, mCTSIB mean) in favor of group 1 (P<.05). No significant improvements were seen in any parameters in the control group (P>.05).

Conclusions

Significant improvements were seen in symptom, disability, balance, and postural stability in chronic unilateral vestibular dysfunction after an exercise program. Customized exercise programs are beneficial in treatment of chronic unilateral vestibular dysfunction.