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Article ; Online: In-Hospital Stroke: Hidden in Plain Sight.

Dulli, Douglas A

2015 Volume 72, Issue 7, Page(s) 746

MeSH term(s)	Female ; Hospitalization ; Humans ; Male ; Patient Care/methods ; Stroke/diagnosis ; Stroke/therapy ; Time-to-Treatment
Language	English
Publishing date	2015-07
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	2702023-X
ISSN	2168-6157 ; 2168-6149
ISSN (online)	2168-6157
ISSN	2168-6149
DOI	10.1001/jamaneurol.2015.0370
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Article ; Online: The warnings of subarachnoid hemorrhage.

Dulli, Douglas

Southern medical journal

2009 Volume 102, Issue 1, Page(s) 8

MeSH term(s)	Early Diagnosis ; Emergencies ; Headache/diagnosis ; Headache/etiology ; Humans ; Medical History Taking ; Subarachnoid Hemorrhage/complications ; Subarachnoid Hemorrhage/diagnosis
Language	English
Publishing date	2009-01
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	185329-6
ISSN	1541-8243 ; 0038-4348
ISSN (online)	1541-8243
ISSN	0038-4348
DOI	10.1097/SMJ.0b013e3181902077
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Article: Pulsed Radiofrequency for Treating Trigeminal Neuralgia.

Abd-Elsayed, Alaa / Kreuger, Laura / Seeger, Susanne / Dulli, Douglas

The Ochsner journal

2018 Volume 18, Issue 1, Page(s) 63–65

Abstract: Background: Trigeminal neuralgia is the most common cause of facial pain but can be challenging to treat. Some patients fail on medications, and while surgical procedures achieve short-term efficacy, they can be associated with numerous complications. ... ...

Abstract	Background: Trigeminal neuralgia is the most common cause of facial pain but can be challenging to treat. Some patients fail on medications, and while surgical procedures achieve short-term efficacy, they can be associated with numerous complications. We present a case series suggesting the efficacy and safety of using pulsed radiofrequency (PRF) through the transcoronoid approach to treat trigeminal neuralgia. Methods: This retrospective analysis included 8 cases with data collected from the electronic medical record. Outcomes were pain scores before and after the procedure as well as the percent improvement after the procedure (improvement in severity, frequency, and duration). Results: Patients had an average age of 56.4 ± 13 years. All patients reported improvement after the procedure, and 3 patients reported that their improvement was ongoing at the time of follow-up. No complications were reported by any of our patients. Conclusion: PRF through the transcoronoid approach may be a safe and effective approach for treating trigeminal neuralgia in patients resistant to conservative management.
Language	English
Publishing date	2018-03-20
Publishing country	United States
Document type	Journal Article
ISSN	1524-5012
ISSN	1524-5012
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Article: Radiofrequency Ablation of Pericranial Nerves for Treating Headache Conditions: A Promising Option for Patients.

Abd-Elsayed, Alaa / Kreuger, Laura / Wheeler, Shawna / Robillard, Janet / Seeger, Susanne / Dulli, Douglas

The Ochsner journal

2018 Volume 18, Issue 1, Page(s) 59–62

Abstract: Background: Chronic daily headache, including chronic migraine, can be challenging to treat. Medications often only provide limited improvement, and surgical interventions can be associated with significant adverse effects. We present our experience ... ...

Abstract	Background: Chronic daily headache, including chronic migraine, can be challenging to treat. Medications often only provide limited improvement, and surgical interventions can be associated with significant adverse effects. We present our experience with using radiofrequency ablation (RFA) for pericranial nerves to treat chronic headache conditions. Methods: This retrospective analysis included patients who received RFA for pericranial nerves to treat chronic daily headache conditions from January 1, 2015 to June 1, 2016. Outcomes were pain scores as measured on the visual analog scale (with 0 representing no pain and 10 representing the worst pain imaginable) and the patient-reported percent improvement in headache conditions, including pain scores, severity, duration, frequency, and associated symptoms. Results: Of the 57 patients who received 72 RFAs for pericranial nerves to treat headache or pericranial neuralgia, 90.3% of patients had improvement in their headache condition after receiving RFA. In addition, pain scores decreased from 6.6 ± 1.7 preprocedure to 1.9 ± 1.9 postprocedure ( Conclusion: Our study demonstrates the efficacy and safety of RFA in treating pericranial neuralgias associated with chronic daily headache.
Language	English
Publishing date	2018-03-19
Publishing country	United States
Document type	Journal Article
ISSN	1524-5012
ISSN	1524-5012
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Article: Stroke risk, hypertension, and HRTless postmenopausal therapy.

Dulli, Douglas A

Archives of neurology

2003 Volume 60, Issue 10, Page(s) 1363–1364

MeSH term(s)	Denmark/epidemiology ; Estradiol/adverse effects ; Estrogen Replacement Therapy/adverse effects ; Female ; Humans ; Hypertension/complications ; Hypertension/epidemiology ; Middle Aged ; Risk Assessment ; Stroke/chemically induced ; Stroke/epidemiology
Chemical Substances	Estradiol (4TI98Z838E)
Language	English
Publishing date	2003-10
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	80049-1
ISSN	1538-3687 ; 0003-9942
ISSN (online)	1538-3687
ISSN	0003-9942
DOI	10.1001/archneur.60.10.1363
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Article ; Online: Alcohol, ischemic stroke, and lessons from a negative study.

Dulli, Douglas A

Stroke

2002 Volume 33, Issue 4, Page(s) 890–891

MeSH term(s)	Age Factors ; Aged ; Alcohol Drinking/epidemiology ; Bias ; Brain Ischemia/epidemiology ; Brain Ischemia/prevention & control ; Case-Control Studies ; Cohort Studies ; Comorbidity ; Confounding Factors (Epidemiology) ; Ethanol/adverse effects ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Risk Assessment ; Risk Factors ; Sample Size ; Stroke/chemically induced ; Stroke/epidemiology ; Stroke/prevention & control
Chemical Substances	Ethanol (3K9958V90M)
Language	English
Publishing date	2002-04
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/01.str.0000013795.19904.73
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Article: Inpatient and community ischemic strokes in a university hospital.

Dulli, Douglas / Samaniego, Edgar A

Neuroepidemiology

2007 Volume 28, Issue 2, Page(s) 86–92

Abstract: Background: Previous studies have shown that inpatient strokes are common and severe. We sought to characterize the risk factors, stroke subtypes, timing of acute stroke evaluation and frequency of thrombolytic therapy in inpatient ischemic strokes ... ...

Abstract	Background: Previous studies have shown that inpatient strokes are common and severe. We sought to characterize the risk factors, stroke subtypes, timing of acute stroke evaluation and frequency of thrombolytic therapy in inpatient ischemic strokes compared with community ischemic strokes. Design/methods: The hospital records of patients admitted for acute ischemic stroke between 1996 and 2002 were reviewed. Acute stroke was defined as occurrence of stroke symptoms within 72 h, and in-hospital status was assigned if the patient was currently admitted for another illness at the time of the stroke. Patient demographics such as medical versus surgical service, admission diagnoses, clinical features including stroke risk factors, access to thrombolytic therapy and immediate outcome were analyzed. Results: Of 947 patients with acute ischemic stroke, 161 (17.0%) had strokes occurring while already in the hospital (IHIS), compared to 786 (83%) that occurred in the outpatient community (CIS). Approximately two thirds of IHIS occurred on medical services (102, 63.4%) and one third on surgical services (59, 36.7%). Mean age, male gender, atherothrombotic etiology and risk factors including hypertension, diabetes and smoking history were of similar frequencies in IHIS and CIS, but penetrating artery disease was the cause of only 5.6% of IHIS compared to 21.8% of CIS (p<0.0001). The mean modified Rankin scale for IHIS at presentation was 4.33 +/- 0.74, compared to 3.67 +/- 1.03 for CIS (p<0.0001). Of 161 IHIS patients, 21 (13.0%) had neurological assessment within 3 h of symptom onset, compared to 16.0% of CIS patients (p=0.403, n.s.), and the rate of thrombolytic therapy was not significant between IHIS (3.7%) and CIS (5.6%) patients. Conclusions: IHIS are common and severer than CIS. The use of thrombolytic therapy in IHIS patients was limited because of time of recognition and inpatient-associated conditions. Increased vigilance for timely neurological assessment of these patients is warranted.
MeSH term(s)	Aged ; Brain Ischemia/complications ; Brain Ischemia/drug therapy ; Brain Ischemia/epidemiology ; Decision Making ; Female ; Fibrinolytic Agents/therapeutic use ; Hospital Mortality ; Humans ; Inpatients ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Plasminogen Activators/therapeutic use ; Recombinant Proteins/therapeutic use ; Retrospective Studies ; Stroke/drug therapy ; Stroke/epidemiology ; Stroke/etiology ; Tomography, X-Ray Computed ; Wisconsin/epidemiology
Chemical Substances	Fibrinolytic Agents ; Recombinant Proteins ; Plasminogen Activators (EC 3.4.21.-)
Language	English
Publishing date	2007
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	603189-4
ISSN	1423-0208 ; 0251-5350
ISSN (online)	1423-0208
ISSN	0251-5350
DOI	10.1159/000098551
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Article: Inpatient and Community Ischemic Strokes in a University Hospital

Dulli, Douglas / Samaniego, Edgar A.

Neuroepidemiology

2007 Volume 28, Issue 2, Page(s) 86–92

Institution	University of Wisconsin Hospital and Clinics, Madison, Wisc., USA
Abstract	Background: Previous studies have shown that inpatient strokes are common and severe. We sought to characterize the risk factors, stroke subtypes, timing of acute stroke evaluation and frequency of thrombolytic therapy in inpatient ischemic strokes compared with community ischemic strokes. Design/Methods: The hospital records of patients admitted for acute ischemic stroke between 1996 and 2002 were reviewed. Acute stroke was defined as occurrence of stroke symptoms within 72 h, and in-hospital status was assigned if the patient was currently admitted for another illness at the time of the stroke. Patient demographics such as medical versus surgical service, admission diagnoses, clinical features including stroke risk factors, access to thrombolytic therapy and immediate outcome were analyzed. Results: Of 947 patients with acute ischemic stroke, 161 (17.0%) had strokes occurring while already in the hospital (IHIS), compared to 786 (83%) that occurred in the outpatient community (CIS). Approximately two thirds of IHIS occurred on medical services (102, 63.4%) and one third on surgical services (59, 36.7%). Mean age, male gender, atherothrombotic etiology and risk factors including hypertension, diabetes and smoking history were of similar frequencies in IHIS and CIS, but penetrating artery disease was the cause of only 5.6% of IHIS compared to 21.8% of CIS (p < 0.0001). The mean modified Rankin scale for IHIS at presentation was 4.33 ± 0.74, compared to 3.67 ± 1.03 for CIS (p < 0.0001). Of 161 IHIS patients, 21 (13.0%) had neurological assessment within 3 h of symptom onset, compared to 16.0% of CIS patients (p = 0.403, n.s.), and the rate of thrombolytic therapy was not significant between IHIS (3.7%) and CIS (5.6%) patients. Conclusions: IHIS are common and severer than CIS. The use of thrombolytic therapy in IHIS patients was limited because of time of recognition and inpatient-associated conditions. Increased vigilance for timely neurological assessment of these patients is warranted.
Keywords	Inpatient ischemic stroke ; TOAST classification ; Oxfordshire Community Stroke Project classification
Language	English
Publishing date	2007-01-17
Publisher	S. Karger AG
Publishing place	Basel, Switzerland
Document type	Article
Note	Original Paper
ZDB-ID	603189-4
ISSN	1423-0208 ; 0251-5350
ISSN (online)	1423-0208
ISSN	0251-5350
DOI	10.1159/000098551
Database	Karger publisher's database

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Article ; Online: Surgical decision making in temporal lobe epilepsy: a comparison of [(18)F]FDG-PET, MRI, and EEG.

Struck, Aaron F / Hall, Lance T / Floberg, John M / Perlman, Scott B / Dulli, Douglas A

Epilepsy & behavior : E&B

2011 Volume 22, Issue 2, Page(s) 293–297

Abstract: Objectives: The goals of this work were (1) to determine the effect of [(18)F]fluorodeoxyglucose positron emission tomography (FDG-PET), MRI, and EEG on the decision to perform temporal lobe epilepsy (TLE) surgery, and (2) to determine if FDG-PET, MRI, ... ...

Abstract	Objectives: The goals of this work were (1) to determine the effect of [(18)F]fluorodeoxyglucose positron emission tomography (FDG-PET), MRI, and EEG on the decision to perform temporal lobe epilepsy (TLE) surgery, and (2) to determine if FDG-PET, MRI, or EEG predicts surgical outcome. Methods: All PET scans ordered (2000-2010) for epilepsy or seizures were tabulated. Medical records were investigated to determine eligibility and collect data. Statistical analysis included odds ratios, κ statistics, univariate analysis, and logistic regression. Results: Of the 186 patients who underwent FDG-PET, 124 had TLE, 50 were surgical candidates, and 34 had surgery with post-operative follow-up. Median length of follow-up was 24 months. MRI, FDG-PET, and EEG were significant predictors of surgical candidacy (P<0.001) with odds ratios of 42.8, 20.4, and 6.3, respectively. FDG-PET was the only significant predictor of postoperative outcome (P<0.01). Conclusion: MRI showed a trend toward having the most influence on surgical candidacy, but only FDG-PET predicted surgical outcome.
MeSH term(s)	Adult ; Decision Making ; Electroencephalography/methods ; Epilepsy, Temporal Lobe/diagnosis ; Epilepsy, Temporal Lobe/physiopathology ; Epilepsy, Temporal Lobe/surgery ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Neurosurgical Procedures/methods ; Predictive Value of Tests ; Tomography, Emission-Computed/methods ; Treatment Outcome
Chemical Substances	Fluorodeoxyglucose F18 (0Z5B2CJX4D)
Language	English
Publishing date	2011-07-27
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	2010587-3
ISSN	1525-5069 ; 1525-5050
ISSN (online)	1525-5069
ISSN	1525-5050
DOI	10.1016/j.yebeh.2011.06.022
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Article: Serial headache drawings by children with migraine: correlation with clinical headache status.

Stafstrom, Carl E / Goldenholz, Shira R / Dulli, Douglas A

Journal of child neurology

2005 Volume 20, Issue 10, Page(s) 809–813

Abstract: Children's artistic self-depictions of headache provide valuable insights into their experience of pain and aid in the diagnostic differentiation of headache types. In a previous study, we compared the clinical diagnosis (gold standard) and artistic ... ...

Abstract	Children's artistic self-depictions of headache provide valuable insights into their experience of pain and aid in the diagnostic differentiation of headache types. In a previous study, we compared the clinical diagnosis (gold standard) and artistic diagnosis of headaches in 226 children. In approximately 90% of cases, the drawing predicted the clinical diagnosis of migraine versus nonmigraine headache correctly. In the present study, we explored whether headache drawings correlate with clinical improvement after treatment in children with migraine headaches followed longitudinally. Children seen in the Pediatric Neurology Clinic with the chief complaint of headache were asked to draw a picture of what their headache feels like. On subsequent clinic visits, children with the clinical diagnosis of migraine were asked to draw another picture depicting their current headache. The two drawings were compared to assess whether there was improvement; this "artistic response" was then correlated with the child's clinical status (ie, whether the headaches were improved clinically). One hundred eleven children (66 girls, 45 boys) participated in the study, with a mean interval of 5.3 +/- 2.3 (standard error of the mean) months between the first and second visits. The mean age at the first visit was 11.6 +/- 3.1 years. The raters agreed that serial drawings were both improved or both not improved in 99 of the 111 cases (89%; interrater reliability kappa score of 0.767). Fifty-three children had improvements in their headaches and drawings, 3 children had an improved drawing but no clinical headache improvement, 32 children had no improvement in either their drawing or clinical headaches, and 11 children had improved headaches but no improvement in their drawing. The sensitivity of the drawings for clinical improvement was 0.83, and the specificity was 0.91. The predictive value of an improved headache drawing for an improved clinical response was 0.946. There was no correlation between specific treatment modality and artistic response. We concluded that children's headache drawings are a useful adjunct for the diagnosis of headache type and provide valuable insights into their experience of pain. The present data show that headache drawings can be used longitudinally to provide additional information about the clinical course. The technique is simple, inexpensive, and enjoyable for children and can be applied in a variety of clinical settings.
MeSH term(s)	Adolescent ; Art ; Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Longitudinal Studies ; Male ; Migraine Disorders/diagnosis ; Migraine Disorders/psychology ; Pain/psychology ; Predictive Value of Tests ; Self Concept ; Sensitivity and Specificity
Language	English
Publishing date	2005-10
Publishing country	United States
Document type	Evaluation Studies ; Journal Article
ZDB-ID	639288-x
ISSN	1708-8283 ; 0883-0738
ISSN (online)	1708-8283
ISSN	0883-0738
DOI	10.1177/08830738050200100501
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