By Patricio S. Espinosa MD MPH;Charles D. Smith MD

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Additional info for Focus on Neuroimaging: Neurology Self-Assessment (Neurology Self-Assessment Series)

Sample text

Urgent lumbar puncture c. ) d. Urgent anticoagulation View Answer 5. (D) The best answer is D. Patients with cerebral sinus thrombosis treated with anticoagulants (low molecular weight heparin followed by oral anticoagulation) may have a favorable outcome more often than controls. However, the outcome difference in the cited clinical trial was not statistically significant. 2,3 Other Considerations: There is no need for lumbar puncture because the results of the opening pressure or cerebrospinal fluid will not yield any new information.

4 mg/kg/hour infused for 23 hours b. 4 mg/kg/hour infused for 23 hours c. Methylprednisolone sodium succinate bolus 30 mg/kg over 15 minutes once d. There is no evidence that steroids are effective in the treatment in this condition View Answer 5. (A) A loading dose and a continuous infusion for 24 hours of methylpredinisone is recommended. High-dose methylprednisolone steroid therapy is the only pharmacologic therapy shown to have efficacy in a phase III randomized trial when administered within 8 hours of injury.

D. Urgent anticoagulation View Answer 5. (D) The best answer is D. Patients with cerebral sinus thrombosis treated with anticoagulants (low molecular weight heparin followed by oral anticoagulation) may have a favorable outcome more often than controls. However, the outcome difference in the cited clinical trial was not statistically significant. 2,3 Other Considerations: There is no need for lumbar puncture because the results of the opening pressure or cerebrospinal fluid will not yield any new information.

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