Analytic study of clinical presentation of intracranial space-occupying lesions in adult patients

Intracranial space-occupying lesions can be caused by a variety of disease processes, ranging from neoplasms to non-neoplastic lesions including hematomas, abscesses and vascular malformations. This article provides an overview of varied clinical presentations of patients with intracranial space-occupying lesions.Methods:A total of 200 cases of intracranial space-occupying lesions presenting at Neuro Clinic and Care were retrospectively analyzed. Adult patients from all age groups and both genders were included in this study. Results: 165 patients (82.5%) had neoplastic lesions while 35 (17.5%) had non-neoplastic lesions. Metastatic lesions from primary tumor elsewhere in the body comprised the most common group with81 cases (40.5%), followed by meningiomas with 27 cases (13.5%). Males were affected slightly more than females (1:0.8). The most common presenting symptom was headache 87 patients (43.5%,) followed by focal symptoms such as numbness, tingling or weakness being present in 80 (40%)and seizures observed in 65 (32.5%).Conclusion: The study reviews the wide range of symptoms the patients with intracranial space-occupying lesions present with, the most common being headache, followed by focal symptoms such as numbness, tingling or weakness, seizures and vomiting. Knowledge of these typical as well as atypical patterns of clinical presentation can aid physicians in timely detection and prompt application of diagnostic and therapeutic modalities

Efficacy of memantine on cognitive functions of patients with moderate vascular dementia

Introduction: Vascular dementia is a common condition for which there is no effective approved pharmacological treatment available. Absence of effective treatment creates a difficult situation for those suffering from the disease, their caregivers, and healthcare providers. The objective of this study is todetermine the Efficacy of Memantine on cognitive functions in patients with Moderate vascular dementia. Material and methods: This Case series study was carried out inthe Neurology Section of department of Medicine Ziauddin University and Hospitals North Nazimabad campus, Karachifrom 12th March 2010 to 11th March 2011.90 patients were included, who fulfilled the inclusion criteria after taking an informed consent. The SPSS version 11 was applied to the data. Results: There were 55 (59.1%) males and 38 (40.9%) females. Mean ± standard deviation age 69.7 ± 6.6 years, mean duration of symptoms was 1.76 ± 1.1 years. Baseline minimental examination score was 15.14 ± 3.1. Minimental score after 24 weeks of drug therapy was 17.14 ± 4.1. Efficiency was found in 62 (66.7%) patients. Conclusion: Memantine produced only a small benefit in cognition (of uncertain clinical significance) in patients with moderate vascular dementia. Data is insufficient to support widespread use of this drug in vascular dementia. Individual patient analysis is needed to identify subgroups of patients with vascular dementia who might benefit

Hyperhomocysteinemia - An unidentified risk factor for stroke in our population

Introduction: Various studies show that moderate elevation of plasma homocysteine level has been associated with increased risk for cardiovascular and cerebrovascular disease. Objective: To observe the frequency of increased homocysteine level in ischemic stroke patients; and its association with other risk factors. Methodology: Observational pilot study was conducted on a sample of 75 ischemic stroke patients, enrolled regardless of their age, gender and comorbidities, at Ziauddin university hospital, Karachi. Fasting serum homocysteine, folate and vitamin B12 levels were measured. Results were interpreted using spss 20.0. Results and Discussion: Mean homocysteine level in our population was 19.51 (SD: 11.47)micromol/l. It was higher in groups with vitamin B12 and folic acid deficiency, difference being statistically significant (p=0.013 and 0.017, respectively). Males had greater propensity to hyperhomocysteinemia; the mean homocysteine value being higher, and the difference, statistically significant (p=0.010). Other factors that affect homocysteine levels were also evaluated, that is hypertension, increased cholesterol levels and smoking. There was no significant statistical difference in the homocysteine value between the groups of patients who had these risk factors and the groups that did not (p=0.747, 0.252 and 0.565, respectively). Conclusion: It was speculated that hyperhomocysteinemia is an imperative risk factor for stroke