Clinical Neuroscience

Die medizinische Psychologie als Theoretische Grundlage der allgemeinen Medizin

W. Iwanow

JULY 01, 1985

Clinical Neuroscience - 1985;38(07)

Die medizinische Psychologie ist gerade das Fach, das diese wesentliche Schwäche der heutigen Medizin überwindet und einen vollständigen Zugang zum Kranken zu schaffen (oder dazu beizutragen) pflegt. Hier geht es nicht nur um eine ,,mechanische Vereinigung" des Somas und der Psyche, sondern um ein tiefstes und vollständigstes Verstehen des psycho-physiologischen Wesens des Menschen.



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Clinical Neuroscience

[Spontaneous dissection of the neck of the carotid intesna artery]


[The authors describe a case of spontaneous dissection of the internal carotid artery in the neck, in which the lesion was associated with fibromuscular dysplasia and distal type of occlusion of the artery. A brief literature review on the origin of the vascular lesion and its angiographic lesions is given. ]

Clinical Neuroscience

[Posterior scala duralis arterio-venosus malformation ]


[The authors describe a case of dural arteriovenous malformation localized to the posterior scala. In doing so, they discuss the aetiology, clinical and radiographic features of the atheromaly. An interesting feature of their case is that, in addition to the shunt discovered on angiography, a similar abnormality was found in the pons at autopsy. ]

Clinical Neuroscience

Unemployment and Mental Disorder

VILLE Lehtinen

Unemployment is a major social problem in Finland. Same is the case in most of the western societies. In some OECD countries the unemployment rate has already exceeded 10%. The effect and meaning of unemployment experience on mental health have been discussed, especially concerning the youth.

Clinical Neuroscience

[Unemployment and mental illness]

KOPP Mária

[Unemployment is a major social problem in most Western countries, including Finland, with unemployment rates exceeding 10% in some countries. This study analyses the possible links between mental illness and unemployment, in particular the impact of unemployment on young people. ]

Clinical Neuroscience

[Ophthalmoplegia migraine and sclerosis multiplex ]

GUSEO András

[The author describes two cases of ophthalmoplegic migraine in which Sandomigran stopped a series of recurrent oculomotor paresis every 20 and 11 years respectively. He analyses the problems of differential diagnosis and stresses the importance of taking a detailed anamnesis. ]

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[The connection between the socioeconomic status and stroke in Budapest]


[The well-known gap bet­ween stroke mortality of Eastern and Western Euro­pean countries may reflect the effect of socioeconomic diffe­rences. Such a gap may be present between neighborhoods of different wealth within one city. We set forth to compare age distribution, incidence, case fatality, mortality, and risk factor profile of stroke patients of the poorest (District 8) and wealthiest (District 12) districts of Budapest. We synthesize the results of our former comparative epidemiological investigations focusing on the association of socioeconomic background and features of stroke in two districts of the capital city of Hungary. The “Budapest District 8–12 project” pointed out the younger age of stroke patients of the poorer district, and established that the prevalence of smoking, alcohol-consumption, and untreated hypertension is also higher in District 8. The “Six Years in Two Districts” project involving 4779 patients with a 10-year follow-up revealed higher incidence, case fatality and mortality of stroke in the less wealthy district. The younger patients of the poorer region show higher risk-factor prevalence, die younger and their fatality grows faster during long-term follow-up. The higher prevalence of risk factors and the higher fatality of the younger age groups in the socioeconomically deprived district reflect the higher vulnerability of the population in District 8. The missing link between poverty and stroke outcome seems to be lifestyle risk-factors and lack of adherence to primary preventive efforts. Public health campaigns on stroke prevention should focus on the young generation of socioeconomi­cally deprived neighborhoods. ]

Clinical Neuroscience

[Effective therapy in highly active pediatric multiple sclerosis ]

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[Multiple sclerosis (MS) is typically a disease of young adults. Childhood MS can be defined in patients under 18 years of age, although some authors set the limit un­der the age of 16 formerly known as “early-onset multiple sclerosis” or “juvenile multiple sclerosis”, seen in 3-5% of all MS patients. Nowadays, owing to ever-evolving, better diagnostic tools and well-traced, strictly defined diagnostic criteria, childhood MS is showing an increasing incidence worldwide (0.05-2.85/100 000). MS is characterized by recurrent episodes of the central nervous system with demyelination separated in space and time. In childhood almost exclusively the relapsing-remitting (RR) type of MS occurs. Based on experience in adults, the goal in the pediatric population is also the early diagnosis, to initiate adequate DMT as soon as possible and to achieve symptom relief and good quality of life. Based on efficacy and safety studies in the adult population, inter­feron β-1a and glatiramer acetate were first approved by the FDA and EMA for the treatment of childhood MS also. The increased relapse rate and rapid progression of childhood MS and unfavorable therapeutic response to nearly 45% of the first DMT necessitated the testing of more effective and second-line drugs in the population under 18 years of age (PARADIGMS, CONNECT). Although natalizumab was reported to be effective and well-tolerated in highly active RRMS in childhood, evidence based studies were not yet available when our patients’ treatment started. In this article, we report on the successful treatment of three active RRMS patients with individually authorized off-label use of natalizumab.]

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[Cerebrovascular diseases in patients with chronic kidney disease]

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[The reason of the unfavourable life expectancy of patients with chronic kidney disease (CKD) is not only the development of end-stage renal failure but the frequent appearance of cardiovascular diseases (CVD). Chronic kidney damage itself is a cardiovascular risk state and the occurrence of CVD/associated diseases is significantly higher in chronic kidney failure. Beside risk stratification and valid treatment of CVD (hypertension, diabetes mellitus, ischemic heart disease e.g.) we and the international nephrological community have left the cerebrovascular diseases of CKD patients out of consideration. However, up to 50% of patients suffering a stroke will die immediately, only 10% of stroke survivors can continue his/her profession, but the others will be permanently disabled. High blood pressure is a strong predictor of stroke and of other CVD in most of the patients. In stroke risk reduction it is particularly important to reach the target blood pressure values. The main object of the “Live under 140/90 mmHg” programme of the Hungarian Society of Hypertension is to familiarize with target blood pressure itself and how to reach target blood pressure. In 2010, prevention, early diagnosis and management of stroke are the most important challenges of this programme (The Brain Control Programme). We think it is advisable to prepare and publish a clinical practice guideline in collaboration with stroke societies which is similar to the guidelines of international societies and of the Hungarian Society of Stroke but specific for CKD patients. This guideline would help to give a uniform, up-to-date treatment for the cerebrovascular diseases of CKD patients.]

Clinical Neuroscience

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[Mephistopheles of the human faced psychiatry. Klára Muhi – András Dér: The crazy circles of freedom]

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