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Biomedical subjects

A Vighetto

Publications and source records attributed to A Vighetto.

At least 109 records · Page 6Linked to original sources
PubMed1986

[Paralysis of downward gaze and chronic global amnesia as a result of a bilateral thalamo-subthalamic lesion].

A 47 year-old male was found in coma and upon awakening 36 hours later, he showed a selective paralysis of downward gaze and convergence associated to an intellectual impairment. He was euphoric, unconcerned, poorly attentive, and had a severe amnesia for both anterograde and retrograde material. CT scan and NMR demonstrated a bilateral lacunar lesion of thalamic and subthalamic paramedian region. Over the 5 years follow-up, behavioral, personality and amnestic changes remained. On the other hand, supranuclear gaze paralysis improved as documented by EOG recordings with persisting limitations in voluntary down movements amplitude and dramatic reduction of fast components velocity.

Amnesia↗
PubMed1985

Intramedullary sarcoidosis of the cervical spinal cord.

A 26-year-old male with a history of pulmonary sarcoidosis showed clinical, myelographic and intra-operative evidence of a C5-C6 spinal cord tumour, which was diagnosed by biopsy as a pure intramedullary granuloma. Among the 29 published cases of histologically proven cord sarcoidosis, only five presented with pure parenchymatous infiltration without meningeal involvement. Corticosteroids are the most useful therapy, and surgery is indicated only for minimal biopsy when the parenchyma is invaded.

Adult↗
PubMed1985

[Spatial delusion: sign of lesions of the non-dominant hemisphere].

Two cases with respectively an ischemic and a tumoral lesion of the right hemisphere showing a striking and isolated delusional belief to be relocated elsewhere are reported. Delusion had the remarkable intrinsic coherence of a paranoid delirium but was limited to the localization in space. In contrast these patients had no mental clouding or hallucinations and were well orientated for time and persons. Associated findings were a misrepresentation of space in drawing in the first case, and a left hemiparesis, a left sensory extinction, a left hemianopsia, a left visual neglect, a constructional apraxia and a misrepresentation of space in the second case. Such a spatial delirium has been described after severe head injury but rarely after unilateral cerebral lesions. The latter involve constantly the right hemisphere, either in the frontal, temporo-parietal or thalamic region. Usual neurobehavioral correlates in these cases were a disorder of visual memory, a topographical disorientation, a lack of representation and use of visuospatial data, and an anosognosia. The putative role of a 'release' of the left hemisphere is discussed.

Aged↗
PubMed1985

[Pseudo-optic neuritis as a manifestation of craniopharyngioma (2 cases)].

In two case of cystic craniopharyngioma the initial presentation was misleading and suggested acute retrobulbar optic neuritis: 1) isolated and unilateral drop of visual acuity of recent onset; 2) total remission in a few weeks, then a relapsing and steroid-sensitive course; 3) increase of C.S.F. gammaglobulins content in one case, normal CT scan in the second one. The diagnosis was corrected 36 and 18 months respectively after the onset of the clinical disorders.

Adult↗
PubMed1984

[Bilateral parietal syndrome approximating a Balint syndrome].

A patient presented with disorders of saccadic and pursuit movements a wandering gaze, the impossibility to maintain fixation, a concentric shortening of visual attention mainly of the right side, an incomplete right homonymous hemianopia (respecting 10 to 20 degrees), and optical and auditory ataxia predominantly affecting the right hand. Pathology showed a large left parietal glioma in the white matter in the superior and inferior parietal lobes, with microscopic evidence of parietal cortex invasion. A hematoma on the right side was situated entirely parasagitally in the precuneus, approaching the cortex at this level. The two lesions were independent and the splenium was intact. The frontal lobes were normal. A review of nearly 30 cases of bilateral syndrome of the parieto-occipital junction showed that anomalies of visually guided ocular movements were always present. These cases require differentiation from those, such as the present case, which involve mainly a visuomotor coordination disorder and from those with predominant visual disorientation.

Ataxia↗
PubMed1983

[Course of obstructions of the carotid artery in the neck. 69 cases].

This study involved 69 patients with occlusion of the internal carotid artery in the neck confirmed by angiography. Ten patients were operated upon and 59 were treated medically. The clinical course was roughly the same in both group. Of the 62 patients who survived the initial stroke, 50 could be followed-up for a mean period of 57 months at the end of which 12% had died, 16% remained with a major degree of functional impairment and 72% had little or no residual symptoms. All but one deaths were of non-vascular origin. New cerebral vascular accidents occurred in 16% of the cases, always in the territory of the occluded artery. The long-term benefits of surgical cerebral revascularisation are discussed in the light of these findings.

Arterial Occlusive Diseases↗
PubMed1983

[Familial paroxysmal ataxia responsive to acetazolamide].

From their early twenties, a 56 year-old french woman and her 33 year-old son suffered from paroxysmal attacks of gait ataxia, incoordination of both hands, dysarthria and nystagmus. These attacks lasted from one to three hours and occurred at the rate of one to seven per week. On examination between attacks, there was only a bilateral horizontal and upward-beating gaze nystagmus. This was documented by E.O.G. Biological investigations were normal with the exception of a mild elevation of glucose blood level. Treatment with acetazolamide 250 mg daily, completely abolished the attacks in both patients. These cases meet the criteria of familial paroxysmal ataxia, a disorder only described in the United States up to the present. Although rare, this disease should be recognized because of its dramatic response to acetazolamide.

Acetazolamide↗
PubMed1982

[Contribution of lumbar puncture to the diagnosis of cephalalgia].

The authors have reviewed the records of 50 patients hospitalized for treatment of isolated cephalalgia and in whom lumbar puncture was the only investigatory procedure that initially provided some information. In 12 cases, CSF abnormalities reflected a progressive tumoral, vascular or inflammatory intracerebral lesion undetectable by the usual methods (fundus oculi, radiography of the skull, EEG), or by less common examinations (arteriography, scintiscans, CT scans). In 12 other cases, lumbar puncture provided evidence of a minimal meningeal inflammatory process. In 26 cases, the only biochemical change was an excess of CSF proteins which in 7 cases developed in a dome-shaped curve suggesting an independent disease, the significance of which is discussed.

Adult↗
PubMed1982

[Intracranial arteriovenous angioma in adults. A review of 100 medico-surgical cases (author's transl)].

The most frequent clinical presentations were haemorrhage (36 cases) and epilepsy (33 cases). Among the 68 subjects operated upon, 55 benefited from total removal of the angioma. The mortality rate was 10%. The long-term outcome was favourable in 75% of patients. Excision suppressed the risk of bleeding, but its efficacy on epilepsy was more limited. The clinical course in patients not operated upon was less favourable. However, only 4 of them died, and only one recurrence of bleeding was noted.

Adult↗
PubMed1981

[Diagnostic and therapeutic value of Seldinger's technique angiography in 200 neurological patients (author's transl)].

A retrospective study of 200 patients with various neurological diseases who had been investigated by Seldinger's technique cerebral or medullar angiography (STA) was undertaken with the view of evaluating the effective contribution of this technique to diagnosis and treatment. On the whole, STA gave positive results in 106 cases, doubtful results in 15 cases and negative, yet often useful, results in 79 cases. It proved more helpful in establishing the cause (120/200 cases) than the location (117/200 cases) of the lesions and contributed to the therapeutic decision in only 36 patients, latrogenic complications included 1 death from locked-in syndrome, 10 neurological disorders and 4 local reactions. However, the diagnostic and therapeutic value of Seldinger's technique angiography cannot be properly assessed owing to uncertainties surrounding each criterium of judgement.

Adult↗
PubMed1981

[Spatial disorientation. Report of 5 cases (author's transl)].

Five observations characterized by an isolated topographical disorientation without any intellectual impairment are reported. One was associated to a topographical confabulation. Aetiological data and clinical associations are discussed. In three cases, the site of lesion, as indicated by surgery and CT Scan, involves the posterior part of the right hemisphere. The occurrence of this syndrome may be ascribed to three possible factors: amnesia (topographical amnesia) agnosia (topographical agnosia) and apraxia.

Aged↗
PubMed1981

[Optic ataxia: analysis of eye and hand responses in pointing at visual targets (author's transl)].

A visuomotor task was used in three cases of isolated optic ataxia, in patients with an unilateral parietal lesion (one right and two left). Eye and hand movements were recorded in pointing at visual targets in a closed loop condition. Saccades directed to the contralateral side were abnormal in two patients. Hand pointing was always accurate in foveal vision conditions. Errors observed in peripheral vision condition were different according to the side of the lesion. The contribution of oculomotor signals in optic ataxia and the influence of hemispheric specialization are discussed.

Adult↗