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Biomedical subjects

A Arboix

Publications and source records attributed to A Arboix.

At least 109 records · Page 6Linked to original sources
PubMed1990

[Cerebral infarct in a young adult, as the presenting form of myeloencephalopathic syndrome with lactic acidosis and cerebral ischemia].

We report a 26-year-old male who developed aphasia due to an ischemic cerebral infarction caused by MELAS (myoencephalophatic syndrome with lactic acidosis and cerebral ischemia). The most common causes of cerebral infarction in young patients were ruled out by laboratory investigations. The diagnosis of MELAS was suspected on the basis of past history of epilepsy, migraine and progressive sensory deafness, and increased resting blood lactic acid. Cerebral computed tomography showed bilateral caudate-putamen-pallidal calcification and nuclear magnetic resonance scan disclosed a left ischemic parietal-temporal-occipital infarction. The diagnosis was confirmed by muscular biopsy, which was characteristic of mitochondrial myopathy showing "red disarrayed" fibers in the histologic modified trichromic Gomori stain. Our patient showed that MELAS should be considered in young adults with cerebral infarction. The diagnosis should initially be suspected on a clinical basis, and confirmed by the presence of "red disarrayed" fibers with modified trichromic Gomori stain histologic muscle study.

Acidosis, Lactic↗
PubMed1990

[Affective disorders in subcortical ischemic cerebrovascular pathology. Prospective clinical study of 43 patients].

To evaluate the prevalence and clinical features of affective disorders (AD) associated with subcortical ischemic cerebrovascular disease (mainly localized in the deep areas depending from the anterior, middle and posterior cerebral arteries), a prospective clinical study was carried out in 43 patients with lacunar infarctions (LI). It was found that AD were uncommon in these patients (25%) (1/43). The prevalences of depression in the major lacunar syndromes of the series were the following, from more to less common: pure motor hemiparesis (35%) (7/20); dysarthria-clumsy hand (25%) (1/4); pure sensorial syndrome (16.5%) (2/12), and atypical syndromes (no patient). The capsular topography was associated with AD in 32% (7/22); this association was more uncommon in thalamic (15%) (2/13) or pontine (25%) (1/4) areas. AD had a significant predominance (p = 0.027) in the lesions involving the dominant cerebral hemisphere (63.5%), mainly when these resulted in clinically mild or moderate/severe disability. Past history of AD was also significantly associated with depression (p = 0.0018). Our results show that affective disorders in lacunar infarctions are usually associated with: 1) the type of clinical syndrome; 2) the topography of the lesion; 3) the involved cerebral hemisphere; 4) the associate neurological focality, and 5) the previous occurrence of affective disorders.

Adult↗
PubMed1990

Auditory ear extinction in lacunar syndromes.

A dichotic listening test was administered to 28 patients with lacunar syndromes in order to contribute to the investigation of the subcortical route of interhemispheric auditory pathways. Topographic study showed that lesions in the external capsule or in the anterior limb of the internal capsule in both hemispheres produced left ear extinction. The possibility that some of the auditory fibres travel through the external capsule, as well as the anterior limb of the internal capsule, before crossing the contralateral cerebral lobe is suggested.

Adult↗
PubMed1990

Lacunar cerebral infarct and nuclear magnetic resonance. A review of sixty cases.

A prospective series of 60 consecutive patients with lacunar cerebral infarcts (LI), studied using nuclear magnetic resonance (MR) and brain computerized tomography (CT), is presented. A significantly greater number of positive results (p less than 0.001) was observed in the MR (78%) in comparison with the CT scan (30%). In pure motor hemiparesis, the number of positive results obtained with MR was maximal (85%) and greater than with CT scan (35%; p less than 0.001). In pure sensory stroke, the positivity was 40% in MR and 20% in CT. In pontine and capsular topography, MR showed a greater sensitivity than CT scan (p less than 0.001). A significantly (p less than 0.001 greater number of silent infarcts were detected by MR (42%) than by CT scan (18.5%). Nowadays, MR is the complementary examination of choice in the topographic diagnosis of LI and should be carried out whenever possible in all patients presenting with this pathology.

Adult↗
PubMed1990

Clinical study of 227 patients with lacunar infarcts.

We describe an analysis of 227 patients with lacunar infarcts; 177 were inpatients and the remaining 50 were outpatients. The group comprised 11% of all inpatients with cerebrovascular pathology and 16% of all consecutive inpatients with brain infarcts studied at the Department of Neurology of the Hospital de la Santa Creu i Sant Pau. The main risk factors identified in these patients were arterial hypertension in 164 (72%), diabetes mellitus in 64 (28%), and heart disease in 58 (26%). The most common clinical syndromes were pure motor hemiparesis in 125 (55%), pure hemisensory stroke in 42 (18%), the sensorimotor deficit syndrome in 34 (15%), ataxic hemiparesis in seven (3%), and the dysarthria-clumsy hand syndrome in four (2%); atypical syndromes were observed in 15 patients (7%). Lacunes were demonstrated by computed tomography in 100 patients (44%) and by magnetic resonance imaging in 35 (78%) of the 45 patients in which it was applied. Magnetic resonance imaging was significantly better (p less than 0.001) than computed tomography for imaging lacunes, especially those located in either the pons (p less than 0.005) or the internal capsule (p less than 0.001). After the acute phase, mild or no neurologic disability was detected in 178 patients (78.4%), moderate disability persisted in 48 patients (21.1%), and severe disability was recorded in one case (0.4%). Lacunar infarcts are a clearly defined entity with characteristic clinical features and an excellent short-term prognosis. Magnetic resonance imaging is the current method of choice for demonstrating these small brain lesions.

Age Factors↗
PubMed1990

[Affective disorders in the chronic phase of ischemic cerebrovascular disease].

Thirty-nine percent (33/83) of patients in this study present affective disorders in the chronic phase of ischemic cerebral vascular disease (ICV). The incidence of depression reaches its maximum in atherothrombotic infarcts (52%, 15/29) and in infarcts of cardiac embolic origin (71%, 5/7), and its minimum in lacunar infarcts (25%, 11/43). Affective disorders are more common (27%) in patients with previous history of depression (p = 0.005) and they are more common when the infarcts are extensive (87%, 7/8), they are located in the carotid territory (42%, 25/59), in the dominant cerebral hemisphere (60%, 20/33) and they are more frequent at cortical level (55%, 15/27) (p = 0.03), mainly when they produce a clinical situation with moderate (50%, 10/20) or severe (87%, 7/8) (p = 0.006) limitation. Our results demonstrate that affective disorders are frequent in the chronic phase of ischemic cerebral vascular disease and it is mandatory its correct diagnosis in order to perform an adequate treatment and to improve the clinical symptoms of these patients.

Brain Ischemia↗
PubMed1990

[Locked-in syndrome of reversible clinical course].

A 72-year-old female developed a "locked-in" syndrome due to bilateral ventral pontine infarction. The symptoms improved 72 hours after the beginning of the clinical features. At the end of the acute phase of the disease, only a pseudobulbar syndrome of pontocerebellar type persisted. Usually, the evolution of "locked-in" syndrome is irreversible. However, our case shows that a satisfactory outcome can be possible, with a partial regression of the initially established neurological symptoms.

Aged↗
PubMed1988

Complicated coital cephalalgia. Three cases with benign evolution.

Three patients with a history of migraine and type-II coital cephalalgia with signs of vertebrobasilar deficiency are presented. Extensive studies including angiography did not show any vascular malformation. Together with the few reports in the literature our cases outline a benign form of complicated coital cephalalgia, possibly resulting from ischaemic disturbances triggered by haemodynamic changes occurring in orgasm.

Adult↗