Jan van Gijn

..Data on long term risks are scarce. We compared the long term risks of death and vascular events (VE) between these groups...

..A small fourth ventricle does not necessarily accompany obstructive hydrocephalus and is therefore not a contraindication for lumbar drainage...

..Hydrocephalus might cause gradual obtundation in the first few hours or days; it can be treated by lumbar puncture or ventricular drainage, dependent on the site of obstruction...

..Oddly enough some regard this as an advantage. In general it is a shoddy substitute because teaching is an art, because students cherish proper explanations and because the students are deprived of...

..Scrupulous reasoning about probabilities is required, not only of physicians but also of judges and politicians...

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..Patients will continue to seek magic cures from 'quacks with a knife' as long as medical specialists are insufficiently trained to deal with unexplained somatic symptoms...

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..Therefore, the planned primary analysis of the PAIS study has been changed from fixed dichotomization of the mRS to a sliding dichotomy analysis...

..In this study we compared risk factors, clinical features, and stroke recurrence in a large series of patients with large subcortical, cortical, or small deep infarcts...

..30; 95% CI 1.05-1.63) and death (aOR 1.51; 95% CI 1.15-1.98). An early rise in body temperature rather than high body temperature on admission is a risk factor for unfavorable outcome in patients with acute stroke...

..Secondary prevention trials after myocardial infarction indicate that treatment with vitamin K antagonists is associated with a risk reduction approximately twice that of treatment with antiplatelet therapy...

..We studied the risk of rebleeding in patients with subarachnoid hemorrhage during treatment for acute hydrocephalus...

..The aim of HAMLET was to assess the effect of decompressive surgery within 4 days of the onset of symptoms in patients with space-occupying hemispheric infarction...

..76 to 1.85). CONCLUSIONS: Our data indicate that antiplatelet drugs reduce the risk of DCI in patients with subarachnoid hemorrhage. A randomized clinical trial is warranted to assess the effect on overall outcome...

..The Paracetamol (Acetaminophen) In Stroke (PAIS) trial aimed to assess whether early treatment with paracetamol improves functional outcome in patients with acute stroke by reducing body temperature and preventing fever...

..The benefit of repeated screening and the interval at which screening should be performed are unknown. We studied patient compliance and the yield of repeated screening for familial intracranial aneurysms...

..We studied the prognostic value for DCI of 2 factors: the duration of unconsciousness after the hemorrhage and the presence of risk factors for atherosclerosis...

..CONCLUSIONS: Most studies on treatment strategies in SAH suffer from methodological weaknesses. This implies that current management of patients with SAH is based on weak evidence...

..His clinical expertise was greatest in disorders of muscle and the peripheral nervous system...

..We analyzed the relationships of concentrations to initial clinical conditions, treatment modalities, and the occurrence of delayed cerebral ischemia...

..To determine the test characteristics of magnetic resonance (MR) angiography in the assessment of occlusion of aneurysms treated with coil placement...

..With precise rules, agreement in the classification of death after stroke strongly improved...

..Ideally, evidence on this issue should come from a randomised clinical trial. However, such a trial or even a prospective study are unlikely to be ever performed because of the rapid development of endovascular coiling...

..We performed a randomized controlled trial to assess whether acetylsalicylic acid (ASA) reduces the risk of delayed ischemic neurological deficit (DIND) in patients with SAH...

..Platelet aggregation can probably still occur despite complete acetylation of platelets, via pathways other than COX-1 inhibition, but in vitro aggregation tests are an unreliable measure...

..Secondary prevention trials after myocardial infarction indicate that treatment with oral anticoagulants is associated with a risk reduction approximately twice that of treatment with antiplatelet therapy...

..e. outside the primary pathways for sensory stimuli. More accurate insight into the underlying cerebral processes opens up possibilities for the diagnosis and treatment of chronic unexplained pain...

..Patients who survive after subarachnoid hemorrhage (SAH) are at risk for a recurrence despite successful treatment of the ruptured aneurysm and may therefore benefit from screening for new aneurysms...

..How these brain-imaging abnormalities evolve over time is unknown. The present study aims to quantify cerebral atrophy and WMH progression over 4 years in type 2 diabetes...

..In addition, we investigated the effect of treatment with aspirin or oral anticoagulation on recurrent stroke rate and assessed whether the incidence of recurrent stroke has decreased over the years...

..How this cognitive profile evolves over time is uncertain. The present study aims to provide detailed information on the evolution of cognitive decrements in type 2 diabetes over time...

..Increased sensitivity for pain and other stimuli is often implied as an underlying mechanism. Attentional processes influence central pain processing and might mediate hypersensitivity at a cerebral level...

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..63 (95% CI 0.58 to 0.68)) and in ESPS 2 with female sex and absence of ischaemic lesions on imaging (area under the ROC curve 0.64 (95% CI 0.59 to 0.69))...

..Type 2 diabetes mellitus is associated with an increased risk of cognitive decline and dementia. We examined brain imaging correlates and vascular and metabolic risk factors of accelerated cognitive decline in patients with type 2 diabetes...

..There was no evidence that dipyridamole alone was more efficacious than aspirin. Further trials comparing the effects of the combination of dipyridamole plus aspirin with aspirin alone are justified...

..The proposed method is particularly suited to analyze WMH distribution differences at the level of the lateral ventricles between large groups of patients...

..In a phase II randomized clinical trial of 283 patients, magnesium treatment reduced the risk of DCI by 34% and of poor outcome by 23%...

..Quincke not only contributed to several other clinical observations, but also pioneered the lumbar puncture, initially not for diagnostic purposes, but to relieve headache in hydrocephalic children...

..Physicians still speculate more often than they care to admit...

..This combination had been described several times before, but Fallot was the first to recognise the consistency and pathophysiological interrelationship of the four abnormalities...

..He also advocated early surgical treatment and described a variety of surgical techniques...

..The second issue is the variability and overlap of terms used to describe each phenomenon. This makes comparisons among studies difficult...

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..The authors compared the size of ruptured aneurysms and the number of aneurysms between patients with familial subarachnoid hemorrhage (SAH) and those with sporadic SAH...

..We investigated determinants of non-adherence in patients who used aspirin or oral anticoagulation after cerebral ischaemia of arterial origin...

..Post mortem examination showed the oesophagus had been torn off in the chest. Later generations have linked Boerhaave's name with spontaneous rupture of the oesophagus...

..Especially in his later years, Hodgkin devoted much time and effort to the emancipation of oppressed or destitute minorities, especially abroad. He died of dysentery on a journey to Palestine and lies buried in Jaffa...

..Snellen was a gifted surgeon for a variety of ophthalmologic disorders. In 1877 he was appointed Professor of Ophthalmology at Utrecht and in 1884 he succeeded Donders as director of the eye hospital...

..This arterial circle had been incompletely described by others in the past and fully, but only in writing, by Wepfer in 1658...

..In the text Spigelius calls attention to the aponeurotic fascia of the transverse and oblique abdominal muscles, on either side of the rectus abdominis muscle. He proposes the name linea semilunaris, now the official term...

..Vesalius published a courteous riposte in which he still denied the existence of such an opening. The tubes Falloppius had described were eventually named after him...

..She remained single; in her private life she enjoyed fly fishing, took lessons in aviation and was an accomplished violinist...

..The book would remain influential for several decades, until the advent of pathological anatomy...

..He attributed this condition to a disorder of the inner ear; this went against the prevailing opinion, which attributed most vertiginous attacks to cerebral congestion...

..Treitz taught in Czech and became increasingly involved in patriotic agitations which estranged him from most of his colleagues. Eventually, his mental as well as physical health deteriorated...

..His name - and that of Ebstein - is linked to periodic fever in combination with enlargement of the spleen and the lymphatic system. It is contested whether the patients in question had Hodgkin's disease...

..The phenomenon of weakening and slowing of the pulse by an increase in intrathoracic pressure was first described in the 19th century, but has also been named the 'Valsalva manoeuvre'...

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..In milder, autosomal dominant forms of the disease, the protein is partly deficient or abnormal...

..Bell also slightly erred on the functions of the trigeminal and facial nerve, but his description of the features of idiopathic facial palsy is unrivalled...

..At the age of 72 he published a monumental atlas of the brain. In 1950 the municipal hospital in Leiden for short-term psychiatric treatment was named after him...

..Both her clinical condition improved and the lesions disappeared completely after withdrawal of tacrolimus, suggesting that her condition could be explained by a tacrolimus encephalopathy...

..We assessed functional outcome and quality of life (QoL) in patients with SAH and their partners...

..Subdivisions according to the center of hemorrhage once the anterior cisterns are involved is not helpful in identifying patients with good or poor outcome...

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..Once ischaemia has occurred, treatment regimens such as a combination of induced hypertension and hypervolaemia, or transluminal angioplasty, are plausible, but of unproven benefit...

..The need for measuring comorbidity with regard to functional status is recommended in research on stroke outcome...

..We aimed to assess whether magnesium reduces the frequency of delayed cerebral ischemia (DCI) in patients with aneurysmal SAH...

..Predictive factors for risk of vascular events were similar to those for risk of death. INTERPRETATION: Long-term secondary prevention in patients with cerebral ischaemia still has room for further improvement...

..The Wenckebach rhythm is now also known as type I second-degree atrioventricular block. Wenckebach subsequently became a professor of medicine in Groningen (1901), Strasbourg (1911) and Vienna (1914-1929)...

..A street in the city of Groningen near its present-day University Medical Centre has been named after him...

..This debate has continued to this day...

..In articles published in this journal, he had written about 3 patients who suffered from an inexplicable triad of symptoms: eye problems, oral en genital ulcers. This oculo-urogenital syndrome now bears his name: 'Behçet's disease'...

..In 1961, he moved to Miami Beach as head of a new cancer centre, but suddenly died a few months later...

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..In 1909 he was awarded the Nobel prize for Physiology or Medicine. Five years later thyroxin was isolated...

..Most of Van Helmont's work was published only after his death, through a verdict of the Spanish Inquisition...

..As a trustee of the 'Madhouse' in Utrecht and subsequently national inspector for psychiatric institutions, he initiated substantial improvements...

..In 1864 he published a widely acclaimed treatise on disorders of refraction and accommodation. In 1862 he was appointed full professor of physiology in Utrecht. Subsequently he published on a variety of physiological subjects...

..He practised successfully as a physician in Amsterdam from 1641 onwards, until he was recalled to the chair of medicine in Leiden in 1658. He emphasized the role of chemical processes in the human body (iatrochemistry)...

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..Normansfield continued on under the supervision of John's two sons and a grandson, but was eventually closed down in the 1970s. The buildings have been preserved and contain a famous Victorian theatre...

..If the deficiency is partial, the disease manifests later in life, as muscle weakness. Enzyme replacement therapy is now feasible...

..The sign is absent in about 60% of patients with these conditions. It is also absent in patients with pemphigoid diseases, because in these patients it is the splitting of deeper layers of the skin that causes blistering...

..His gifts as a diagnostician and teacher are evident from his book Bedside medicine (1960)...

..Eventually a full-time radiologist, he also developed the 'somersault' technique of ventriculography and pioneered isotope scintigraphy...

..He divided the birth canal into four virtual and parallel planes through pelvic protuberances, a method still widely used. He also developed a pessary that is now mainly used in stress incontinence...

..His method was adopted worldwide within a decade. Mathijsen never married and spent his old age with relatives in the south of the Netherlands...

..An alternative explanation is recall bias. The clinical and radiological features of patients with SAH were studied in relation to previous headaches or later rebleeding...

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..We sought to assess whether MRI, MR angiography, or (1)H MR spectroscopy can be used to identify patients with symptomatic carotid artery occlusion (CAO) who are at high risk of recurrent ipsilateral cerebral ischemic events...

..Little information is available on the type of subsequent ischaemic strokes that may occur (anterior or posterior circulation and small vessel or large vessel)...

..In familial intracranial aneurysms there is evidence for genetic heterogeneity, probably from mutations at separate loci...