Slovo úvodem

prof. MUDr. Ivan Rektor, CSc., FCMA, FANA, FEAN

Neurol. praxi. 2020;21(3):171  

Akutní péče o pacienty s cévní mozkovou příhodou

doc. MUDr. Michal Bar, Ph.D. - editor hlavního tématu

Neurol. praxi. 2020;21(3):175  

Organization of stroke care in the Czech Republic

doc. MUDr. Michal Bar, Ph.D., MUDr. Aleš Tomek, Ph.D.

Neurol. praxi. 2020;21(3):176-180 | DOI: 10.36290/neu.2020.001  

Intravenous thrombolysis in the treatment of acute ischemic stroke led to the establishment of a network of stroke centers in the Czech Republic. The authors present an overview of the conditions of the stroke network in the Czech Republic in 2011 and evaluate the positive factors of its development in the last 8 years.

Prehospital triage of acute stroke patients

MUDr. Martin Čábal, MUDr. Daniel Václavík, Ph.D.

Neurol. praxi. 2020;21(3):181-185 | DOI: 10.36290/neu.2020.071  

Ischemic stroke is one of the leading causes of mortality or morbidity in the world. Early therapeutic intervention is important for final clinical outcome and that can be obtained by quick and correct prehospital triage, which is managed by paramedics. The patient with a stroke must by quickly diagnosed and transported to the nearest stroke center, or when a large vessel occlusion is suspected to the comprehensive stroke center to a possible thrombectomy. This decision can be made with different prehospital triage tests. "FAST PLUS" test was introduced in Moravian-Silesian region in year 2016 and it is focused on presence of a severe hemiparesis....

Reperfusion therapy in acute ischemic stroke - intravenous thrombolysis

MUDr. Stanislava Jakubíček, prof. MUDr. Robert Mikulík, Ph.D.

Neurol. praxi. 2020;21(3):186-190 | DOI: 10.36290/neu.2020.072  

The early recanalization of an occluded artery is the primary aim of reperfusion treatment in acute ischemic stroke and is an important predictor of clinical outcome. In the past, the standard treatment of ischemic stroke was intravenous thrombolysis with alteplase within the time window of 4,5 hours from symptom onset. Recent clinical trials have provided evidence for perfusion multimodal imaging-based effective reperfusion therapy within an extended time window and stroke with unknown onset. WAKE-UP trial confirmed the efficacy and safety of intravenous thrombolysis with alteplase in patients with unknown onset stroke based on DWI-FLAIR (diffusion...

Acute therapy of ischemic stroke - news in mechanical trombectomy

MUDr. Kateřina Vališ, MUDr. Petra Cimflová, doc. MUDr. Jiří Vaníček, Ph.D., MUDr. Ondřej Volný, Ph.D.

Neurol. praxi. 2020;21(3):191-196 | DOI: 10.36290/neu.2020.034  

The treatment of acute stroke has undergone dramatic changes in last few years. Randomized controlled trials have demonstrated safety and efficacy of endovascular therapy (EVT) in patients with proven proximal anterior circulation occlusion/s. It represents one of the most effective treatment methods of current medicine. There is an ongoing intensive clinical research focused on the broadening of EVT indication criteria (extending the time window of EVT procedures, CT perfusion-based patient selection, EVT of more distal occlusions, treatment of tandem occlusions). We briefly summarize the results of EVT randomized controlled trials, their clinical...

Statins and their influence on peripheral nervous system

doc. MUDr. Edvard Ehler, CSc.

Neurol. praxi. 2020;21(3):198-200 | DOI: 10.36290/neu.2020.073  

Manifestation of artherosclerosis is the most frequent patogenetic factor. Statins, fibrates and ezetimib are used in prevention and therapy of arterosclerosis. Statins are inhibitors HMG-CoA reductasis and they are blocking not only cholesterol synthesis, but also synthesis of other important substances - e.g. coenzyme Q10. From the unwanted effects of statins the muscle disorders are the most frequent, neuromuscular junction disorders are rare and there are described peripheral nervous system disorders. Nowadays, the former epidemiological statistical data were reevaluated and occurence of peripheral statin-induced neuropathy (sensory-motor, axonal,...

Multiple sclerosis (MS) is autoimmune disorder affecting the central nervous system

MUDr. Miriam Fedičová, MUDr. Marianna Vitková, PhD., doc. MUDr. Jarmila Szilasiová, PhD., prof. MUDr. Zuzana Gdovinová, CSc., FESO, FEAN

Neurol. praxi. 2020;21(3):203-208 | DOI: 10.36290/neu.2020.074  

Currently, we have a fairly wide range of disease - modifying drugs (DMD) with different mechanisms of action and different efficiencies. To obtain the most efficient therapeutic results we need to choose an individual approach for appropriate therapy. It is also very important to keep in mind the risk of this therapy for appropriate patient. The continual clinical and laboratory monitoring of the patients is unavoidable.

Migraine and depression: cooperation of a neurologist and a psychologist

MUDr. Markéta Škodová, Mgr. Ondřej Škoda

Neurol. praxi. 2020;21(3):209-213 | DOI: 10.36290/neu.2020.066  

Along with anxiety, depressive syndrome is among the most common comorbidities of migraine. The presence of depressive symptoms in migraine is known to be a risk factor for migraine progression to a chronic condition. Early detection of patients at risk and treatment of depression can reverse this trend. Although a clear guideline on when and how to perform screening has not been published so far, it is advisable to search for psychiatric comorbidities in migraine patients. When depressive or anxiety symptoms have been confirmed, the physician should initiate pharmacotherapy and follow up the patient to observe its success. If these primary steps are...

Ocrelizumab is dampening the harm inflammation in patients with multiple sclerosis with little impact on protective immunity

prof. RNDr. Jan Krejsek, CSc.

Neurol. praxi. 2020;21(3):214-220  

Multiple sclerosis (MS) is immunopathological neurodegenerative disease in which the key role was up to recently gained to the abnormaly polarized Th1 and Th17 subsets of T cells. The participation of B cell system has been for long time almost neglected. Recently, it has been evidenced both experimentally and clinically that B cells are an integral part of the immunopathogenesis of MS. Biological therapy targeting the molecule CD20 specifically expressed on mature B cells clearly demonstrated that this previous assumption was wrong as an excellent clinical response is achieved by this therapy with favourite safety profile. Protective components of...

Depressive symptoms in selected neurological disorders

doc. MUDr. Dana Kamarádová Končelíková, Ph.D.

Neurol. praxi. 2020;21(3):222-225 | DOI: 10.36290/neu.2020.047  

Neurological and psychiatric disorders are interwined and share a number of symptomps. Neurological disorders may be associated with variety of psychological problems. This article aims to acquaint the reader with basic information about the depression in patients with stroke, multiple sclerosis, Parkinson's disease and migraine.

Current position of nimesulide in a variety of non-opioid analgesics

MUDr. Jiří Slíva, Ph.D.

Neurol. praxi. 2020;21(3):226-229 | DOI: 10.36290/neu.2020.042  

Non-steroidal anti-inflammatory drugs (NSAIDs) are the cornerstone of the treatment of a wide range of painful conditions. Their efficiency and safety are well known. For more than three decades, nimesulide has been a successful representative of a subgroup of preferentially-acting NSAIDs. This text summarizes its basic characteristics, in the context of its obvious benefits and potential risks that define its position among other NSAIDs.

Familial cerebral cavernous malformation: clinical case

MUDr. Júlia Travkina, MUDr. Eva Gödöllová, MUDr. Oto Petrík, MPH

Neurol. praxi. 2020;21(3):230-234 | DOI: 10.36290/neu.2019.032  

Familial cerebral cavernous malformation is a rare genetically conditioned vascular, affecting predominantly the central nervous system, causing neurological symptomatology, epilepsy, recurrent intracerebral hemorrhages. We would like to present the case of a young female patient, which was diagnosed with familial cerebral cavernous malformation in its rarest genetic form.

Commander of the Order of the British Empire, holder of the California State record in weightlifting (full squat, 600 lbs, 1961), long-distance swimmer, biker, writer… and a neurologist as well: Oliver Sacks, MD, FRCP, CBE (1933-2015)

prof. MUDr. Petr Kaňovský, CSc., FEAN, doc. MUDr. Kateřina Menšíková, Ph.D., FEAN

Neurol. praxi. 2020;21(3):241-246 | DOI: 10.36290/neu.2020.076  

Oliver Sacks was born in London into a family of medical doctors. He studied at St. Paul's College and then physiology and biology in Oxford under Sinclair's direction in Sherrington's laboratory; while in Oxford, he also studied medicine, graduating in 1960. He took his residency in London at Middlesex Hospital where he was house officer to Richard Asher; he then continued in neurology, working as fellow to Kremer and Gilliatt. After a year spent in London hospitals, he moved to the United States and became a resident at San Francisco's Mount Zion Hospital, finally completing his fellowship in neurology at UCLA General Hospital in Los Angeles. Following...

Uvažuji o odchodu ze zaměstnaneckého poměru v nemocnici a založení vlastní ambulance. Hodilo by se mi nějaké shrnutí, jak už teď plánovat prodej ambulance, abych pak za 25 let nemusel spoléhat jen na státní důchod a měl jsem v záloze příjem z prodeje ordinace.

JUDr. Miroslav Špecián, Ph.D.

Neurol. praxi. 2020;21(3):248-249 | DOI: 10.36290/neu.2020.077  

Pacientka s mnohočetným nádorovým postižením CNS

MUDr. Richard Novobilský, MUDr. Linda Kašičková, MUDr. Ondřej Volný, Ph.D., doc. MUDr. Michal Bar, Ph.D., doc. MUDr. Petr Krupa, CSc.

Neurol. praxi. 2020;21(3):237-238 | DOI: 10.36290/neu.2020.075