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Biomedical subjects

B Hindfelt

Publications and source records attributed to B Hindfelt.

At least 37 records · Page 2Linked to original sources
PubMed1996

The pupillary response to tropicamide in Alzheimer's disease.

An increased pupillary response to a weak solution of tropicamide has recently been suggested to be diagnostic for Alzheimer's disease. If so, it would have far-reaching implications. We performed a masked study involving 17 patients with Alzheimer's disease and 20 mentally healthy controls with respect to the pupillary response induced by tropicamide. We found no significant difference in pupillary dilatation between patients and controls (19.7 +/- 11% versus 19.1 +/- 9%; p = 0.19).

Aged↗
PubMed1996

Cerebrospinal fluid filtration in a case of severe pneumococcal meningitis.

Current therapy of bacterial meningitis includes high doses of antibiotics and, sometimes, addition of corticosteroids in order to reduce a harmful inflammatory response. The persisting high mortality and rate of sequelae, particularly regarding pneumococcal meningitis, calls for new therapeutic approaches. We report a case of a 71-year-old female with a pneumococcal meningitis treated with extra-corporeal filtration of cerebrospinal fluid (CSF) after 3 days of coma on conventional treatment. The treatment was carried out without complications and the clinical outcome was favourable. We suggest that filtration of the CSF should be considered as a tool to eliminate noxious substances playing a harmful role in deteriorating course of bacterial meningitis.

Aged↗
PubMed1995

Oral function test for monitoring suction and swallowing in the neurologic patient.

Disturbances in swallowing are common in neurologic disease but difficult to evaluate in the clinical setting. Fundamental variables such as bolus volume, swallow capacity (volume ingested over time), and the relation between ingestion and time for important events in oral and pharyngeal swallowing have not been sufficiently studied. We therefore employed a composite method for monitoring oral and pharyngeal swallowing function: the test of Repetitive Oral Suction Swallow (the ROSS test). The technical details are described as well as preliminary results from a pilot study of 20 healthy subjects and 5 patients with neurologic swallowing impairment. The correlation with respect to time sequences for major events in bolus ingestion and oral processing as monitored by the ROSS test and by videoradiography is explained. With this simple and rapid bedside test, the immediate and long-time result of therapeutic interventions in dysphagic patients may be monitored.

Adult↗
PubMed1994

Recurrence of cluster headache after carotid thrombendarterectomy.

The pathophysiology of cluster headache is largely unknown. One important contributing factor may be an abnormal intracranial-extracranial hemodynamic state. A male patient suffered from chronic left-sided cluster headache for about 15 years. After the institution of lithium therapy the symptoms abated. He was completely free from cluster headache for more than 20 years, until the first postoperative day after a thrombo-endarterectomy for symptomatic 70% carotid stenosis. This case report indicates the importance of abrupt carotid hemodynamic changes along with dysfunction of the cephalic sympathetic nervous system in the initiation of cluster headache.

Angiography↗
PubMed1992

Syncope--brain or heart? A case report.

A 44-year-old man suffered from recurrent episodes of unconsciousness, without any other concomitant manifestations. After routine workup, EEG and CT had proven nondiagnostic, prolonged Holter monitoring revealed a single episode of asystole, lasting 7.6 seconds. A pacemaker was inserted but did not abolish his episodic syncope. Subsequently, long-term EEG recording revealed epileptiform activity with independent foci in both temporal lobes. Antiepileptic treatment relieved the patient of his symptoms. This case illustrates the intimate relationship between the heart and the brain that sometimes lies behind syncope.

Adult↗
PubMed1992

CT-scanning and magnetic resonance imaging in idiopathic spasmodic torticollis.

Twenty-five consecutive patients with idiopathic spasmodic torticollis (IST) were investigated with computerized tomography (CT) or magnetic resonance imaging (MRI) of the brain. In only six patients (24%) did CT or MRI reveal brain pathology (focal cortical atrophy and lacunary infarcts). No consistent pathological pattern was detected. Consequently, CT and MRI of the brain provides little diagnostic information in this disorder.

Adult↗
PubMed1992

Long-term prognosis of ischemic stroke in young adults.

Prognostic information is provided for 74 young adults (age 16-40 yrs, mean age at stroke 29.5 yrs), who suffered from ischemic stroke and survived the first month after the stroke. The patients were followed for 13-26 yrs; in total for 1190 yrs after their stroke. At follow-up 12 of the patients were dead, mostly from severe underlying disease that was complicated by ischemic stroke. In 3 cases death was unrelated to cerebrovascular disease. Among the surviving 62 patients, 7 had experienced recurrent ischemic events (3 reinfarctions, 4 TIA:s). These 7 patients all had risk factors for cerebrovascular complications already at the time of their primary stroke. It is concluded that the long-term prognosis for ischemic stroke in the young adult is favourable. The recovery from neurological deficits is usually good (exceptions are occlusions within the internal carotid and middle cerebral arteries), the risk for recurrence is low (1.1-1.2% annually), and the social prognosis with respect to working capacity and family relation is fair.

Adolescent↗
PubMed1991

Cerebral arteriovenous malformation and cluster-like headache.

Cluster headache is considered a clinically distinct entity with no underlying gross pathology. However, in rare cases this kind of headache may be mimicked by an arteriovenous malformation. A 49-year-old male is described who had severe bouts of unilateral headache resembling those of cluster headache. The usual accompanying autonomic manifestations were minor and the headache attacks were prolonged. Treatment with ergotamine tartrate and pizotifen failed. A large ipsilateral arteriovenous malformation was diagnosed. Prospectively, true clustering of the headache attacks could not be documented.

Cerebral Angiography↗
PubMed1986

Migraine treatment with calcium channel blockers.

Irrespective of their mechanism of action, which so far has not been clarified, calcium channel blockers (CCBs) have a documented prophylactic effect on classical and common migraine, as well as on cluster headache. The drugs may reduce migraine prodromes, the frequency of migraine attacks, and also decrease the severity and possibly the duration of these attacks. Notably, their optimum effect is often seen after more than 2 months of treatment. Side effects seem to be few and mild. Whether or not there are differences in therapeutic efficacy between different CCBs is presently unclear. As comparisons with other alternatives of treatment are sparse, the place of CCBs in migraine therapy remains to be established.

Animals↗
PubMed1986

Outcome evaluation following subarachnoid hemorrhage.

Seventy-eight individuals among a population of 1.46 million suffered aneurysmal subarachnoid hemorrhage (SAH) during 1983. Within 24 hours after the bleed, 32 of the 78 patients were in Hunt and Hess neurological Grades I to II, 13 were in Grade III, 21 were in Grades IV to V, and 12 were dead on admission to a hospital or forensic department. When the amount of blood visualized on computerized tomography (CT) scanning was integrated with the Hunt and Hess neurological classification in order to improve prediction of prognosis, only 16 patients were considered to have a good prognosis (CT-modified Grades I to II), 21 had a less favorable prognosis (CT-modified Grade III), and 29 had a poor prognosis (CT-modified Grades IV to V). Assessment at 1 year revealed that only 32 patients (41%) had a good physical recovery. The physical morbidity rate was 22%, and the overall mortality rate was 37%. Twenty-six individuals with a good neurological outcome and five with a fair outcome also underwent reexamination 1 year or more post-SAH, which included a comprehensive evaluation of the quality of life, assessment of cognitive dysfunction, and determination of general adjustment. Five of the patients with a good neurological outcome and all five with a fair outcome (four of whom had had a poor prognosis in the acute stage) showed severe psychosocial and cognitive incapacitation. When functional morbidity, based upon persistent severe cognitive and psychosocial impairment, was included in the outcome assessment, only 33% of the total series was considered to have a favorable outcome. Approximately 60% of the initially good-risk patients (Grades I and II) showed a good physical outcome without concomitant indications of severe cognitive dysfunction and/or psychosocial impairment. Among the good-risk patients with a CT-modified grade, the figure was 70%. It is suggested that in any outcome grading system, persistent cognitive and psychosocial disturbances be taken into account.

Cognition Disorders↗
PubMed1984

Antineural antibodies in Guillain-Barré syndrome and lymphocytic meningoradiculitis (Bannwarth's syndrome).

Antineural antibodies occur in Guillain-Barré syndrome (GBS), but have not been studied in lymphocytic meningoradiculitis (Bannwarth's syndrome), which has clinical features in common with GBS. Employing a sensitive complement-fixation assay with homogenates of nerve root and brain as antigens, we recorded positive serum reactions to either tissue in 14 of 18 samples from patients with GBS during the first three weeks of the disease. Five of nine samples were positive during the fourth to eighth weeks, whereas all seven patients sampled thereafter had negative reactions. Four GBS serum samples reacted only with nerve root, seven reacted only with brain, and eight reacted with both antigen preparations. One of 12 patients with meningoradiculitis and one of 50 supposedly healthy blood donors had serum antibodies to brain. Our results support the concept of an autoimmune mechanism in GBS, while in Bannwarth's syndrome an infectious cause related to that of Lyme disease may be suspected.

Antibodies, Anti-Idiotypic↗
PubMed1984

Effect of sustained portal-systemic shunting on glycolytic and citric-acid cycle intermediates in the rat brain.

The effect of portacaval (PC) shunting on brain glycogen, glucose, glycolytic and citric-acid cycle intermediates was analysed in rats shunted for 3, 8 and 16 weeks. Portal-systemic shunting was accompanied by a progressive fall in brain glucose which was reduced to about half of control after 16 weeks of shunting (P less than 0.05). Glycogen remained unchanged. Glucose-6-phosphate and fructose-1,6-diphosphate were significantly (P less than 0.05) increased and decreased, respectively, which may indicate some inhibition of phosphofructokinase. These changes in brain glucose content and glycolysis may be additive to any further metabolic perturbation and provide one tentative mechanism of sensitization of the brain in liver failure.

Ammonia↗
PubMed1984

Transient neurological symptoms associated with mononuclear pleocytosis of the cerebrospinal fluid.

Brief episodes of neurological dysfunction may sometimes occur in an afebrile patient with no overt vascular disorder, nor any history of previous migraine. In such a case, the cerebrospinal fluid (CSF) may exhibit a predominantly lymphocytic pleocytosis with plasma cells and an increased protein content indicating a lesion of the blood-brain barrier. This syndrome of remitting hemispheric dysfunction is accompanied by migraine-like headache. The available evidence suggests that an aseptic meningitis is the triggering event.

Adult↗
PubMed1983

Reversibility of neurological deficits in vitamin B12 deficiency.

A female patient with subacute neurological deficits secondary to an hereditary vitamin B12 deficiency was repeatedly examined clinically and neurophysiologically. It is concluded that neurological normalization after treatment with vitamin B12 also occurs within the CNS. Such normalization takes place soon after initiating treatment and probably reflects other neuronal mechanisms that remyelination, i.e. recovery from conduction block in fast somatosensory pathways and/or improvement of synaptic transmission.

Evoked Potentials, Somatosensory↗
PubMed1983

Variations between individuals in cerebrovascular responsiveness.

1. Despite extensive research no explanation has been put forward to account for the fact that cerebral arterial spasm complicates the course of disease of many but not all patients suffering from rupture of an intracranial aneurysm. Although vasoactive material in hemorrhagic cerebrospinal fluid (CSF) most probably is of major importance in the pathophysiology of delayed cerebral vasospasm, recent studies have failed to demonstrate a correlation between CSF vasoconstrictor activity and the development of delayed cerebral vasospasm. 2. In the present study the reactivity of isolated human pial arteries to various vasoactive agents [prostaglandin F2 alpha, noradrenaline, serotonin, human plasma and CSF from patients with aneurysmal subarachnoid hemorrhage (SAH)] was investigated. 3. There was a very marked variability in the spectrum of responses between arteries from different individuals with regard to the contractile responses to plasma, hemorrhagic CSF and amines. On the other hand, the contractions produced by prostaglandin F2 alpha and potassium were consistent. 4. The markedly individual profile in terms of reactivity toward vasoactive substances emphasizes the importance of a human cerebral vessel wall factor and may explain the capricious occurrence of cerebral vasospasm after aneurysmal SAH.

Adult↗