Neurology and Stroke Unit

Milano, Italy

Neurology and Stroke Unit

Milano, Italy
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Agostoni E.,Neurology and Stroke Unit | Zagaria M.,Neurology and Stroke Unit | Longoni M.,Neurology and Stroke Unit
Neurological Sciences | Year: 2015

Headache is a critical problem in the emergency setting. In this paper we briefly review the epidemiological data regarding headache in Subarachnoid Hemorrhage (SAH), considering the role of headache as a warning symptom and the other clinical manifestation of SAH. We have also introduced a recent clinical entity, represented by headache associated to intracranial endovascular procedures (IEPs). © 2015, Springer-Verlag Italia.


PubMed | University of Rome La Sapienza, Neurology and Stroke Unit and Innsbruck Medical University
Type: Journal Article | Journal: Clinical autonomic research : official journal of the Clinical Autonomic Research Society | Year: 2016

Supine hypertension (SH) is a feature of cardiovascular autonomic failure that often accompanies orthostatic hypotension and may represent a negative prognostic factor in parkinsonian syndromes. Here we investigated the frequency rate as well as the clinical and tilt test correlates of SH in Parkinsons disease (PD) and multiple system atrophy (MSA).197 PD (33 demented) and 78 MSA (24 MSA-Cerebellar, 54 MSA-Parkinsonian) patients who had undergone a tilt test examination were retrospectively included. Clinical-demographic characteristics were collected from clinical records at the time of the tilt test examination.SH (>140mmHg systolic, >90mmHg diastolic) occurred in 34% of PD patients (n=66, mild in 71% of patients, moderate in 27%, severe in 2%) and 37% of MSA ones (n=29, mild in 55% of patients, moderate in 17%, severe in 28%). No difference was observed in SH frequency between demented versus gender-, age- and disease duration-matched non-demented PD patients, or between patients with the parkinsonian (MSA-P) versus the cerebellar (MSA-C) variant of MSA. In PD, SH was associated with presence of cardiovascular comorbidities (p=0.002) and greater systolic (p=0.007) and diastolic (p=0.002) orthostatic blood pressure fall. Orthostatic hypotension (p=0.002), and to a lesser degree, lower daily dopaminergic intake (p=0.01) and use of anti-hypertensive medications (p=0.04) were associated with SH in MSA.One-third of PD and MSA patients suffer from mild to severe SH, independently of age, disease duration or stage. In PD, cardiovascular comorbidities significantly contribute to the development of SH, while in MSA, SH appears to reflect cardiovascular autonomic failure.


PubMed | Neurology and Stroke Unit
Type: | Journal: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology | Year: 2015

Headache is a critical problem in the emergency setting. In this paper we briefly review the epidemiological data regarding headache in Subarachnoid Hemorrhage (SAH), considering the role of headache as a warning symptom and the other clinical manifestation of SAH. We have also introduced a recent clinical entity, represented by headache associated to intracranial endovascular procedures (IEPs).

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