Slovo úvodem

prof. MUDr. Ivan Rektor, CSc.

Neurol. praxi. 2011;12(2):75  

Spontánní intracerebrální krvácení - úvod tématu

MUDr.Miroslav Kalina -, editor hlavního tématu

Neurol. praxi. 2011;12(2):79  

Causes, clinical presentation and diffrential diagnosis of spontaneus intracerebral haemorrhage

MUDr.Miroslav Kalina

Neurol. praxi. 2011;12(2):80-83  

Main causes od intracerebral hemorrhage (ICH) are described, and include: acute and chronic hypertension, small vessel disease, amyloid angiopathy, arterial aneurysms, arteriovenous malformations, cavernomas, venous angiomas, teleangiectasias, dural arteriovenous fistulae, traumatic ICH, hemorrhage into metastatic tumors, vasculitis, septic arteritis and mycotic aneurysms, moya moya, arterial dissections, carotidocavernous fistula, anticoagulant and antiaggregation therapy, thrombolytic therapy and others. Important clinically relevant issues are mentioned. Variations of clinical presentations and differential diagnostics are described with...

Nonsurgical management of spontaneous intracerebral hemorrhage

MUDr.Denisa Vondráčková

Neurol. praxi. 2011;12(2):84-87  

Since spontaneous intracerebral hemorrhage (SIH) is an acute neurological condition with a persistently high mortality and morbidity risk, some degree of therapeutic nihilism concerning SIH was embraced by many. This attitude has, however, been recently replaced by a more optimistic approach. There is mounting evidence suggesting that an aggressive treatment of SIH based on permanently innovated guidelines can lead to better clinical outcomes. Conservative therapy of SIH forms a part of a complex approach to these patients including also good-quality diagnostic procedures, surgical therapy and post-surgical care. We review the current evidencebased...

Surgical treatment of spontaneous intracerebral hemorrhage

MUDr.Martin Kovář

Neurol. praxi. 2011;12(2):88-90  

Surgery offers a powerful solution to intracranial hypertension caused by intracerebral hemorrhage. Hematoma type, size and location are the main criteria for surgical efficacy, while always keeping in mind that surgery may sometimes save life but not improve its quality. Except for some specific situations (e.g. space-occupying cerebellar hemorrhage) no definite recommendations concerning surgery indications for intracerebral hemorrhage exist so far. Randomised controlled trials are still recruiting patients to prove efficacy of surgical treatment of superficially located middle-sized lobar hemorrhage. Besides craniotomy, minimally-invasive...

Optimal antiepileptic treatment, choice on two axes: Axis I. according to the type of epileptic seizures/syndrome

doc.MUDr.Jiří Hovorka, CSc.

Neurol. praxi. 2011;12(2):91-97  

and the priorities of antiepileptic drugs; Axis II. according to patiens individuality Contemporarry options of pharmacological epilepsy treatment are very broad. They allow us to go further than just to the schematic treatment depending on the type of epileptic seizure/syndrome. In our article we divide the komplex factors important for the choosing the optimal antiepileptic treatment on two axis: Axis I reflects the clasic choice of treatment depending on the type of epileptic seizure/ syndrome and also by wider priorities of a particular drug. Axis II reflects the choice of treatment according to specific patiens type, individuality in...

Mood and behaviour disorder in dementias

MUDr.Pavel Ressner, Ph.D., MUDr.Petra Bártová, Ph.D., Mgr.Petr Nilius, Mgr.Dagmar Beránková, Mgr.Petra Szajterová, MUDr.Michal Bar, Ph.D., doc.MUDr.David Školoudík, Ph.D.

Neurol. praxi. 2011;12(2):98-103  

According to various sources in the literature, dementia is caused by Alzheimer’s dementia in approximately 50–60 %, vascular dementia in 10 % and dementia with Lewy bodies in 15–20 %. In addition to these untreatable or difficult-to-treat conditions, there are causes of dementias which are reversible and these account for about 10 % of dementias. Cognitive disorder is the main symptom in all aetiologies of dementias; however, the risk of patient institutionalization is rather dependent on the severity of noncognitive disorders in dementia syndromes, i. e. behavioural and psychological symptoms in dementia (BPSD). BPSD represent...

Neuropathic component of chronic low back pain

MUDr.Tomáš Nedělka, MUDr.Jiří Nedělka, Ing.Jakub Schlenker, MUDr.Radim Mazanec, Ph.D.

Neurol. praxi. 2011;12(2):104-109  

Chronic low back pain (CBBP) is a common symptom affecting around 10 % of adult population in Western societies. Neuropathic component is common, affecting around 1/3 of CBBP patients. It consists of local neuropathic pain within the degenerated intervertebral disc and surrounding soft tissues as well as radicular pain which is caused by local nerve root compression, swelling or inflamation. Clinical manifestation of neuropathic low back pain depends on affected nerve structures. Compression of nerve root or ventral rami of spinal nerve usually causes sciatica. Symptoms of local neuropathic pain vary from latent trigger points or segmental...

Sudden unexpected death in epilepsy (SUDEP)

MUDr.Tomáš Procházka

Neurol. praxi. 2011;12(2):110-113  

Patients with epilepsy have increased mortality and sudden unexpected death (SUDEP) is the most frequent direct epilepsy-related cause of death. In this review the author summarizes risk factor, proposed mechanisms and potential preventive strategies. Universal discussion of SUDEP with all patients remains controversial.

Excessive daytime sleepiness and its treatment

MUDr.Vilém Novák, MUDr.Marie Kunčíková

Neurol. praxi. 2011;12(2):114-119  

Excessive daytime sleepiness (EDS) is defined as the inability to stay awake and alert during the usual awake period of the day with unintended episodes of drowsiness and/or sleep. EDS increases the risk of accidents and errors and may also be a symptom of serious underlying disease. Diagnosis is based on patient history and paraclinical examinations, particularly polysomnography. If possible, the treatment of EDS consists in removing the cause. When causal treatment is not possible or sufficiently effective, it is advisable to use psychostimulants. Most psychostimulants enhance the activity of the adrenergic system in the CNS.

Fibromyalgia

MUDr.Martin Šimo, MUDr.Miloslav Dvorák, PhD.

Neurol. praxi. 2011;12(2):120-124  

Fibromyalgia is a painful, often chronic and disabling condition with a poor prognosis for patients treated by physicians of various specializations, which may even cause them to undergo unnecessary diagnostic procedures. In fact, the disease can be identified early and relatively easily by detecting the typical symptoms and applying the diagnostic criteria. As a result of the above, patients lack access to adequate treatment and support and it is difficult for them to live a full and independent life.

Headaches in seniors

MUDr.Ingrid Niedermayerová

Neurol. praxi. 2011;12(2):125-128  

Some types of primary headaches in the elderly age occur less often (migraine, cluster headache), others are typical for this period (hypnic headache). The occurence of secondary headaches increases. Red flags help in differential diagnostic of serious secondary headaches. The most important kinds of primary and secondary headaches in senior age are described in the text. Lower doses of medication are used more frequently. Some drugs (triptans, amitriptylin) are inappropriate in elderly age. It is necessary to pay attention to the combinations of drugs with regard to the occurence of sides effects (warfarin).

Complications of ischaemic stroke

doc.MUDr.Edvard Ehler, CSc., MUDr.Aleš Kopal, MSN Petra Mandysová, MUDr.Ján Latta

Neurol. praxi. 2011;12(2):129-134  

Patients with ischemic cerebrovascular accident (CVA) can develop complications. About 30 % of patients experience progression of focal or global brain changes. In this case, the CVA is progressive, which is a neurological complication. As a general rule, complications affecting organ systems other than just the brain are called medical complications. They occur both in the acute stage of ischemic CVA, due to pathological changes existing already before a CVA occurs (e. g., hypertension, diabetes mellitus, and ischemic heart disease), and in association with the type and severity of a CVA (impairment of consciousness, edema). In the first week,...

Old and new diagnostic criteria for Alzheimer’s disease in the conditions of the Czech Republic

doc.MUDr.Roman Jirák, CSc.

Neurol. praxi. 2011;12(2):135-137  

In spite of the fact, that we don´t correctly know the ethiopatogenesis of Alzheimer´s disease and thus we are unable to cure this disease, it is important timely diagnostics. At the case of the determination of correct diagnose we are able to start therapy in time. This therapy is able to remove the advanced stadia of the disease, to extend the mild stadia of the disease, to improve of the quality of live of the patiens. For the diagnostics there are still used McKhann´s kriteria, going out of the clinical picture of the disease. In 2007 there were elaborated by prof. Dubois et al. the new criterias, based on the determination of the protein...

Ictal bradycardia and asystole in patients with focal epilepsy - a retrospective study

doc.MUDr.Robert Kuba, Ph.D., MUDr.Nikola Vojvodic, Ph.D., MUDr.Ivana Tyrlíková, prof.MUDr.Milan Brázdil, Ph.D., prof.MUDr.Ivan Rektor, CSc.

Neurol. praxi. 2011;12(2):138-141  

We retrospectively analyzed the data of all patients with focal epilepsy who underwent a video EEG test at the Brno Epilepsy Centre during a period of two years (from 2/2008 to 2/2010). A total of 193 patients and 894 seizures were analyzed. We evaluated the ECG 1 minute prior to the seizure, during the seizure and 3 minutes post-seizure. Ictal bradycardia or asystole was found in three patients (1,5 %) and eight seizures (0,9 %). One patient (2 seizures) had ictal bradycardia and two patients (6 seizures) had ictal asystole.

Transthyretin-related hereditory amyloidosis and its neurological manifestations

MUDr.Jana Laštovičková

Neurol. praxi. 2011;12(2):142-144  

Amyloidosis is a group of diseases characterized by deposition of amyloid in tissues. Hereditary amyloidosis with defect of transthyretin is a disease with deposition of deficient protein transthyretin. Polyneuropathy, vitritis, kardiomyopathy, gastrointestinal disorder with malabsorbtion, hepatomegaly are dominant in the clinical picture. A liver transplantation is the most effective therapy, because the place of synthesis of deficient protein is removed. I present the case of a woman suffering from this disease and describe the way, how her diagnosis has been proved.

Publikujeme v zahraničí

Neurol. praxi. 2011;12(2):144  

Autodidaktický test 2/2011

Neurol. praxi. 2011;12(2)