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Biomedical subjects

C M Fisher

Publications and source records attributed to C M Fisher.

At least 55 records · Page 3Linked to original sources
PubMed1993

Complex hallucinatory state occurring postsurgery: a case report.

A patient had unpleasant complex hallucinatory activity beginning 36 h postsurgery that lasted 48 h. Closing the eyes precipitated a flood of visual imagery that immediately roused the patient and prevented sleep. The imagery was predominantly visual, but there were auditory and narrative components suggesting a relationship to dreaming. An electroencephalogram showed that the hallucinatory activity was related to a recurring sequence of drowsiness, a few vertex slow waves, a myoclonic jerk, and arousal. Morphine was a prime suspect as the causative agent. The basic disturbance probably lay in the sleep-dream system. The syndrome has not been fully defined in the past.

Aged↗
PubMed1993

The visual variant of Alzheimer's disease: a clinicopathologic case study.

A 59-year-old man developed problems with reading and driving. When first examined, he had great difficulty locating and identifying items by sight. Visual acuity was normal, but contrast sensitivity for low spatial frequencies was severely impaired. The peripheral visual fields were moderately constricted with depressed flicker fusion frequencies, more on the right. Color identification was preserved. The difficulties in identifying and locating objects by sight were aggravated by increasing the complexity and multiplicity of the items in the field of vision and by changing the ambient illumination. Intellect and memory were relatively intact, except for difficulty with calculations. Over a 12-year course the visual defects steadily worsened, and eventually memory and language skills failed. Social manners, perseverance, and affect remained normal. Postmortem examination showed cortical atrophy, predominantly posterior, with abundant neurofibrillary tangles and senile plaques. The density of the tangles was correlated with the severity of the atrophy, being highest in the occipitoparietal areas and lowest in the frontal lobes. Alzheimer's disease can preferentially affect the posterior cerebral hemispheres and cause a dementia presenting with, and dominated by, visual disturbances.

Alzheimer Disease↗
PubMed1992

Stroke.

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Atrial Fibrillation↗
PubMed1992

The combination of liquid crystal thermography and duplex scanning in the diagnosis of deep vein thrombosis.

One hundred patients with clinically suspected deep vein thrombosis (DVT) were studied by liquid crystal thermography (LCT), duplex scanning and venography. Liquid crystal thermography was found to have a negative predictive value of 97% if performed within 1 week of the onset of symptoms. Duplex scanning had a sensitivity of 93% and specificity of 91% for all thrombi (proximal and calf). On the basis of these results a plan of investigation has been formulated that would avoid duplex scanning and venography in 39 of the 100 patients. Duplex scanning alone would be appropriate in 56 of the remaining 61 patients. Only six patients would be unsuitable for duplex scanning because of a very tense tender leg and require venography. The plan would miss one calf thrombus and result in treating three patients unnecessarily. This policy would be not only effective but also cost-effective.

Female↗
PubMed1992

Amnestic syndrome associated with propranolol toxicity: a case report.

An elderly woman developed an Alzheimer-like subacute dementia as a result of propranolol toxicity. Analysis of the manifestations showed that severe impairment of memory accounted for virtually all of the abnormalities. There is evidence that cerebral reactions to drug toxicity can exhibit patterns that suggest highly selective involvement of functional subdivisions of the brain.

Aged↗
PubMed1992

Information content of dentists' Yellow Pages advertising.

Content analysis was performed on 1,007 Yellow Pages dental display ads to investigate whether such advertisements include the information important to consumers. The authors found a significant information gap between what consumers considered important when selecting a dentist and the information provided in the advertisements. The research was supported in part by a grant to Caroline Fisher from the American Marketing Association.

Advertising↗
PubMed1992

Concerning the mechanism of recovery in stroke hemiplegia.

Two patients with pure motor hemiplegia were regaining strength in the affected limbs when a pure motor stroke developed on the opposite side. At the same time as the new hemiplegia appeared, the recovering side became re-paralyzed, suggesting that activity in the contralateral corticospinal tract had participated in the recovery process. Pathological studies were confirmatory. The literature pertaining to contralateral motor compensation is reviewed.

Aged↗
PubMed1991

Visual hallucinations and racing thoughts on eye closure after minor surgery.

Two hours after minor surgery under local anesthesia, a 67-year-old man developed vivid visual hallucinations that were present only when he closed his eyes. After lasting 4 hours, the hallucinations were succeeded by racing thoughts, lasting 2 hours, and then by illusionary movements of his body. The reaction was attributed to the effect of lidocaine. The case resembles one previously reported.

Aged↗
PubMed1991

Visual hallucinations on eye closure associated with atropine toxicity. A neurological analysis and comparison with other visual hallucinations.

Visual hallucinations of remarkable intensity began shortly after intravenous atropine and persisted for 11 days. They were present only when the eyes were closed and were associated with heightened dreaming and disturbed sleep. The patient remained lucid and described his experiences to his attendants. Our patient's hallucinations bore some resemblance to hypnagogic hallucinations and this became the basis for the hypothesis that the hallucinations originated in the sleep-dream system of the brain stem. It is speculated that a similar site--a metabolic locus minoris resistentiae may play a part in other types of visual hallucinations and in delirium.

Atropine↗
PubMed1991

Brain death--a review of the concept.

The early origins of the concept of brain death have been retraced. Using practical examples from clinical experience it has been demonstrated that conventionally, cardiac death is always accompanied by brain death. Cardiac death implies brain death. The two are inseparably linked or coupled. Death on a ventilator uncouples the two, revealing death of the brain as the true determinant of the cessation of a person's life and the heartbeat as a false measure.

Advance Directives↗
PubMed1990

Hospital advertising: does it influence consumers?

Though consumers generally favor hospital advertising, it has not emerged as a major factor in hospital choice research. A survey examined the effectiveness of hospital advertising and its strength as a factor in hospital choice. The majority of the respondents approved of hospital advertising and showed knowledge of hospital specialties. However, hospital choice was influenced primarily by physician recommendation and location, rather than advertising.

Advertising↗
PubMed1990

Ocular flutter.

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Adult↗
PubMed1989

Lacunar infarct of the tegmentum of the lower lateral pons.

A stroke with a somewhat unusual neurologic formula was correlated with a small linear high-intensity T2 focus in the lateral tegmentum of the lower third of the pons. The clinical features included dysarthria, staggering gait, incoordination of handwriting, right facial weakness, nystagmus, ocular overshoot, right appendicular ataxia, and left-sided dissociated sensory loss for pain and temperature. Lacunar lesions of the tegmentum in the region of the pontomedullary junction, while not uncommon, have not been studied pathologically and have not been reported in the magnetic resonance imaging literature, to my knowledge.

Cerebral Infarction↗
PubMed1989

'Catatonia' due to disulfiram toxicity.

In an alcoholic patient, catatonia developed while he was receiving disulfiram (Antabuse). Resolution of the question whether his state was classically catatonic required a detailed review of the literature on the subject. The conclusion reached is that the original definition still holds for psychiatric illness, but application of the term to neurological and metabolic states has often been based on imprecise criteria and failure to consider akinetic mutism and extrapyramidal motor disturbances as factors. The action of disulfiram as an inhibitor of dopamine beta hydroxylase provides a possible mechanism for the cerebral toxic effect, but nonetheless the various interpretations remain largely speculative.

Alcoholism↗
PubMed1989

Binswanger's encephalopathy: a review.

Binswanger's encephalopathy is reviewed in respect to history, computed tomography, magnetic resonance imaging, epidemiology, pathology, clinical picture, laboratory findings, differential diagnosis, and treatment. The various viewpoints on the pathogenesis of the process are discussed, in particular the role of ischemia, vascular disease, high blood pressure, lacunar infarction, hypoxia, edema, and hydrocephalus. The white matter hypomyelination of congophilic angiopathy and Alzheimer's disease should provide clues. A unifying hypothesis has not been attained.

Atrophy↗
PubMed1989

Neurologic fragments. II. Remarks on anosognosia, confabulation, memory, and other topics; and an appendix on self-observation.

This is an account of an informal presentation of personal views and opinions concerning behavioral phenomena--anosognosia, confabulation, memory and amnesia, perseveration and agitation, plus a few interesting brief case histories that make a neurologic point. Finally, the practice of self-observation is recommended for neurologists, and a few examples from personal experience are described.

Amnesia↗