eLetters

616 e-Letters

  • 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...

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  • 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...

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  • 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...

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  • 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...

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  • 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...

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  • 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...

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  • 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...

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  • Ischemic stroke in chagasic patients
    Antonio L. Teixeira Jr

    Dear Editor

    We read with interest the paper by Carod-Artal et al.[1] that showed the relevance of Chagas' disease as a stroke risk factor in patients of South American origin.

    They also confirmed a textbook view [2] (not demonstrated until this paper) that cardioembolism is the main cause of stoke in Chagas' disease (52%). This reflects in part the underlying chagasic cardiomyopathy, characterised by...

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  • Care for stroke patients: the more, the better
    Stefano Ricci

    Dear Editor

    I would like to comment on the table which appeared on page 412 of the editorial by Watson et al.[1] There is no evidence that what is needed is "access to a monitored bed with one-to-one nursing". In fact, it is not clear what monitoring means: in my country (Italy), monitoring means some mechanical control of blood pressure, heart rate, oxygen, etc; however, British colleagues seem to consid...

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  • Neuropsychiatry - however you define it, it is not just functional imaging
    Maurice Preter M.D.

    Dear Editor

    I read with interest your review of "Internet resources for psychiatry and neuropsychiatry".[1]

    I would agree that "[there] are rather fewer resources specifically dedicated to neuropsychiatry [...]. This reflects the nature of the beast - after 50 or more years of sometimes rather heavy-handed attempts to separate neurology from psychiatry (and sometimes, vice-versa) there is now a fair amount of co...

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