eLetters

589 e-Letters

  • Authors' response to Gupta
    Massimo Filippi

    Dear Editor

    We read with interest the letter by Dr Gupta on our paper entitled “A diffusion tensor magnetic resonance imaging study of brain tissue from patients with migraine”.[1] Nevertheless, we believe that he missed the main result of this study as well as the scope for which it was designed and conducted. The aim of this study was to investigate whether occult’ tissue damage, which goes undetected when usin...

    Show More
  • Diffusion tensor magnetic resonance imaging in migraine: clinical perspective.
    Vinod K Gupta

    Dear Editor

    Rocca and colleagues, using diffusion tensor magnetic resonance imaging (DT-MRI) found white matter abnormalities in normal appearing brain tissue occult to conventional MRI.[1] As these authors underscore, the nature of such abnormalities remain obscure and are unlikely to ever be resolved by histopathological studies. The biological significance of these subtle white matter abnormalities, nevertheless, w...

    Show More
  • Immune vasculopathy mediated neural damage in diabetes: link to occult sarcoidosis?
    Vinod K Gupta

    Dear Editor

    Kelkar and Parry [1] regard perivascular inflammatory infiltrates as indicative of an immune microvasculitis that contributes to nerve damage in diabetes mellitus (DM), in particular mononeuritis multiplex. These authors believe that the variable therapeutic responses to corticosteroids alone or in combination with chlorambucil that they observed support the concept of immunopathogenesis of neural damage...

    Show More
  • Author´s reply
    Florian Masuhr

    Dear Editor

    We thank Dr Kumar for his interest[1] in our article.[2] I agree, that our data are not sufficient to evaluate the true risk of recurrence of cerebral venous and sinus thrombosis (CVST) in women with inherited thrombophilic disorders. However, we stated in our article that the risk of recurrence is probably higher if a thrombophilia is present and that all women with either prior cerebral or extrace...

    Show More
  • Screening people with HHT for brain AVMs is not yet justified
    Rustam Al-Shahi

    Dear Editor

    Have test, will screen. Screening people with hereditary haemorrhagic telangiectasia (HHT) for brain arteriovenous malformations (AVMs) could be relatively easy – and therefore attractive – but where lies the balance between risk (both physical and psychological) and benefit?

    The ideal screening test should aim to detect a disease that significantly impacts upon public health, before the disease...

    Show More
  • Migraine following haemorrhage in brain stem cavernous angioma: pathophysiological considerations.
    Vinod K Gupta

    Dear Editor

    Afridi and Goadsby present a case of new onset migraine in a patient who developed a pontine bleeding episode from a cavernous angioma.[1] These authors believe that the pontine bleed triggered the migraine attacks in this patient and seek a parallel with the headaches observed following implantation of stimulating electrodes [2] into the periaqueductal gray matter (PAG).

    Structural changes fol...

    Show More
  • Risk of recurrent cerebral venous and sinus thrombosis during subsequent pregnancy and puerperium
    Sudhir Kumar

    Dear Editor

    I read with great interest the recent article by Mehraein et al.[1] They have studied an important aspect of risk of recurrence of cerebral and venous sinus thrombosis (CVST) and concluded that subsequent pregnancies can be safely advised in women with this condition. However, we would like to make certain observations.

    As the authors have mentioned, thrombophilic states have not b...

    Show More
  • Over-reporting of asthma among pseudoseizure patients may be a chance finding
    Sudhir Kumar

    Dear Editor

    I read with interest the recent article by Wet CJ de et al.[1] Their finding of a higher prevalence of asthma patients among pseudoseizures is an interesting one. However, I feel that this could be a mere chance association.

    It is well known that psychosomatic disorders are more common among patients with chronic medical conditions including hypertension,[2] diabetes mellitus [3] and...

    Show More
  • Neuroendocrine adaptation in large brain infarcts
    Vinod K Gupta

    Dear Editor

    Schwarz et al. report neuroendocrine alterations in critically ill patients with large infarctions of the brain.[1] They regard suppression of plasma adrenocorticotropic hormone (ACTH) and cortisol levels as indicating absence of endogenous stress response while attributing sustained elevation of prolactin levels to impaired central suprapituitary inhibition involving dopaminergic pathways. Also, t...

    Show More
  • Chlamydia pneumoniae and atherosclerosis: a speculative hypothesis.
    Vinod K Gupta

    Dear Editor

    Cagli et al.[1] did not detect Chlamydia pneumoniae (C. pneumoniae) DNA in aneurysmal sac tissue. In a process as complex as atherosclerosis that will continue throughout life in all individuals, seroepidemiological studies and direct detection of the organism in atherosclerotic plaques should not be regarded as strong links between C. pneumoniae and pathogenesis of atheroscler...

    Show More

Pages