The primary objective of this narrative review is to evaluate the most frequently recommended structural and functional imaging methods in managing epilepsy cases as effectively as possible from a neurologist’s perspective. This review examines the background of current practice, from the beginnings of neuroimaging by computer tomography to the newly introduced methods and their combination, which helps diagnose and monitor these patients. The neuroimaging investigations required for the presurgical evaluation of patients with epilepsy are presented, and recommendations for specific MRI protocols are provided. The clinical use of functional imaging methods is also considered, and correlations between clinical aspects and specific imaging methods are explored, based on the retrieved data in the literature. In conclusion, this review emphasizes using functional and structural imaging methods, guided by clinical evidence, for better therapeutic management in patients with epilepsy.
Background. Primary headaches are comprised of three big categories: migraines (with or without aura), the third most common and the 6th most disabling disease worldwide, tension-headaches, and trigeminal autonomic cephalalgias, each with different, complex, and not completely understood pathophysiological, clinical, and neuroimagistic characteristics. Structures like the brain stem, hippocampus, or hypothalamus have been depicted as being the main triggers of these types of headaches, which have a significant impact on the quality of life. Methods. We performed a broad literature review on primary headaches from January 2016 to June 2023, analyzing the latest scientific updates and emphasizing the pathophysiological and neuroimagistic characteristics. Results. We provide a concise review of the main neuroimaging studies that help in differential diagnosis between several types of primary headaches. Conclusions. It is difficult to approach the pathophysiology of these three primary headache categories. Keeping in mind that neuroimagistic methods are rapidly developing (especially in the MRI sphere), the most important endpoint of future studies will be to establish a reliable distinction system for all these types of cephalalgias, thus updating the protocols and guidelines. Currently, imaging studies are indicated only in certain circumstances.
Objective: Cerebrovascular Accidents (CVAs) represent the second most prominent cause of death globally, surpassed only by ischemic heart diseases, thus constituting a significant economic burden for healthcare systems. Despite this, little is known about the correlation between the different times of the year and intracerebral hemorrhages. This review investigates said link, as well as seek to identify whether vascular risk factors (i.e. diabetes and high blood pressure) vary through seasons. Method: This paper undertakes the study of 97 patients, all of whom have suffered a hemorrhagic CVA and were hospitalized and treated within the Central Military Emergency University Hospital’s Department of Neurology in Bucharest, in the period between 29th of June, 2017 and 29th of July, 2019. The scope of this study is to optimize prophylaxis within the groups most susceptible to the imminent danger of an intracranial hemorrhage during a certain season. Results: Our study has shown that the season with the highest values of morbidity and mortality is autumn, followed closely by spring. Conclusion: Given the set of yielded data, which is mirrored in the case of risk factors, we conclude that the results vary slightly from those put forward in the literature. Therefore, whilst hemorrhaging CVAs have a consequential impact upon society, both through the disastrous effects of the incident per se, and its disabling nature in the long-term, a positive percentage of them could be avoided by changing one’s behavior during the high-risk periods.
