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Arteriovenous malformations (AVMs) of the brain are part of the spectrum of intracranial vascular malformations (IVMs). They are the leading cause of intracerebral haemorrhage in young adults, they account for ~10% of non-traumatic subarachnoid haemorrhage, and they also cause epilepsy. Not only are affected individuals subject to the initial consequences of these events, but there are substantial risks of recurrent haemorrhage and epilepsy, and long-term disability. For a disorder discovered as long ago as the mid-nineteenth century, surprisingly little is known about it. In this thesis, I begin by systematically reviewing the sizeable medical literature about brain AVM frequency, presentation, clinical course and prognosis. I did not find a single prospective, truly population-based study, which is why I set up the Scottish Intracran...
It is possible to thrive in the modern world without recourse to the internet. But only just. If you are a “technophobe”, deterred by the daunting size and complexity of this continually evolving medium, JNNP could help you become a “technophile”. Fewer than four decades ago, the cold war motivated the creation of the internet. Academic inspiration subsequently harnessed the internet’s potential in its two best-known components: email and the world wide web. Born of a need for communication and maturing through a hunger for information, these two human desires have made the internet indispensable
This fourth and final review in the JNNPinternet series summarises the essential internet resources for adult and paediatric clinical neurology, neuroradiology, and neurophysiology. This article is freely available on the JNNPwebsite (www.jnnp.com), where—within seconds—the complete list of recommended websites can be easily downloaded and incorporated into your web browser as a Bookmark/Favorite file. The further progress of clinical neurology on the world wide web will be monitored in JNNPNeuronline fillers and JNNP Neurology in Practice supplements.
Across the world rapid changes in the law, technology, and society are reshaping the way identifiable information about patients is handled. In Britain, doctors' longstanding common law duty of confidentiality to their patients has been supplemented by restrictions on processing electronic and paper based records in the Data Protection Act 1998, which came into force on 1 March 2000. This month the United Kingdom's Medical Research Coun­ cil (MRC) is the latest of several professional organisa­ tions to respond to these developments by updating its guidance on confidentiality and the use of personal information (see table on BMJ 's website).1–4 The MRC has provided invaluable, balanced guidance but there is still a real risk that strict and selective application of the other directives could jeopardise audit, clinical govern­ ance, and...
Neurologists are often accused of being interested in only rare incurable diseases. Although this may have been true in the past, today's neurologists claim to be more concerned with common disorders—but are they really? We derived a “publication ratio” to measure the amount of research interest in 44 conditions representative of the spectrum of neurological disorders, for which there are population based estimates of frequency.1 We divided the number of Medline papers published in 1998 about each condition (in which their MeSH term was the focus of the paper) by a measure of their frequency (incidence or prevalence) × 100 000. When counting the number of publications, the investigator (RAS) was blinded to the frequency of each disease
The growing use of email and the world wide web (WWW), by the public, academics, and clinicians—as well as the increasing availability of high quality information on the WWW—make a working knowledge of the internet important. Although this article aims to enhance readers’ existing use of the internet and medical resources on the WWW, it is also intelligible to someone unfamiliar with the internet. A web browser is one of the central pieces of software in modern computing: it is a window on the WWW, file transfer protocol sites, networked newsgroups, and your own computer’s files. Effective use of the internet for professional purposes requires an understanding of the best strategies to search the WWW and the mechanisms for ensuring secure data transfer, as well as a compendium of online resources including journals, textbooks, medical ...
Objective: To conduct a population based study of brain arteriovenous malformation (AVM) prevalence. Methods: Multiple, overlapping sources of case ascertainment were used to establish the point prevalence of brain AVMs in the adult population of the Lothian health board of Scotland. Patients were sought retrospectively from all local general (family) practitioners, neurologists, neurosurgeons, stroke physicians, the specialist AVM clinic at the regional neuroscience centre, and routine coding of hospital discharge data. Case notes, brain imaging, and pathology reports were reviewed to validate each patient’s diagnosis and to ensure that each was alive, over the age of 16 years, and resident in the geographical area of the study on the prevalence date of 30 June 1998. Results: Of 148 potentially eligible people, 93 adults met the inclu...
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