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Biomedical subjects

C M Culver

Publications and source records attributed to C M Culver.

At least 37 records · Page 2Linked to original sources
PubMed1983

Psychosocial and cognitive function after commissurotomy for intractable seizures.

Cerebral commissurotomy appears to be an effective treatment for persons with severe epilepsy that has not responded to pharmacological treatment. Psychosocial and neuropsychological evaluation of eight patients who have received this surgical treatment suggests that patients who have an uncomplicated operative and postoperative course do not experience functionally significant intellectual, emotional, or social impairment. Limiting the operation to extraventricular division of the corpus callosum may significantly reduce postoperative morbidity. The authors suggest ethical guidelines which they believe should be carefully followed when epileptic patients are being considered for this type of surgery.

Cognition↗
PubMed1981

On the definition and criterion of death.

The permanent cessation of functioning of the organism as a whole is the definition underlying the traditional understanding of death. We suggest the total and irreversible loss of functioning of the whole brain as the sole criterion of death; this has always been an implicit criterion of death. If artificial ventilation is present, only completely validated brain dysfunction tests should be used to show that this criterion of death is satisfied. In most cases without artificial ventilation, permanent loss of cardiopulmonary function is sufficient. We propose a statutory definition of death based on the criterion of total and irreversible cessation of whole brain functions but allowing physicians to declare death according to their customary practices in most cases.

Brain↗
PubMed1980

Normal interhemispheric visual transfer with incomplete section of the splenium.

During the removal of a ruptured arteriovenous malformation, a young man underwent partial sectioning of the splenium of the corpus callosum. Postoperative testing showed no deficit to interhemispheric visual or auditory transfer. To understand the extent of the splenial section, we cut ten normal brains in the sagittal plane and analyzed the shape of the splenium. It may be markedly curved or bulbous. Our findings lead us to conclude that a small band of ventral splenial fibers may be adequate to allow a patient to perform normally on tachistoscopic testing. Unless there is postmortem proof of complete spenial section, it may not be justified to invoke nonsplenial mechanisms to explain preservation of interhemispheric visual transfer in human surgical cases.

Adult↗
PubMed1980

ECT and special problems of informed consent.

The authors examine the question of whether severely depressed patients can validly consent to ECT, indeed whether anyone should be asked to consent to a treatment that some have held is disabling and beyond the range of rational choice. They suggest some clarification in the use of the terms "competent" and "rational." The authors present examples of cases where ECT may appropriately be used with and without a patient's consent. They conclude that except in cases in which patients may die without ECT, physicians will not err morally by respecting patients' informed decisions about treatment.

Affective Disorders, Psychotic↗
PubMed1977

Clinical signs in diffuse cerebral dysfunction.

Abnormal responses to 13 questions from a typical mental status examination and 32 signs of neurological dysfunction were correlated with increasing degrees of cognitive impairment as measured by the Halstead-Reitan Neuropsychological Battery. Thirteen of these factors were found to be useful predictors of diffuse cerebral dysfunction when combined into a brief screening examination for application at the bedside.

Adolescent↗
PubMed1977

On the safety of long-term treatment with lithium.

Thirteen patients with bipolar affective illness who had received lithium therapy for 1-5 years were tested retrospectively for evidence of cortical dysfunction. Data on patients younger than 55 show no abnormalities on the Halstead-Reitan Neuropsychological Battery and suggest that chronic lithium therapy is relatively safe. Significantly elevated Halstead Impairment indexes were observed among elderly patients, but these data are difficult to interpret.

Adolescent↗
PubMed1975

The nuchocephalic reflex.

The nuchocephalic reflex, previously undescribed, was investigated in a controlled study of 146 subjects ranging in age from 11 hours to 94 years. In 110 subjects over 16 years of age, the presence of the reflex was correlated directly with evidence of diffuse cerebral dysfunction as measured by a shortened form of the Wechsler Adult Intelligence Scale. Thirty-six children were studied from the newborn period to the age of 16 years. The reflex was found to be uninhibited in infants and to become inhibited by the age of 4 years. Among the adult subjects, the nuchocephalic reflex was found to be sensitive indicator of the status of higher cortical function. The presence or absence of the reflex appears to have somewhat different predictive value at different points in the adult age spectrum.

Adolescent↗