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Biomedical subjects

C M Fisher

Publications and source records attributed to C M Fisher.

At least 73 records · Page 4Linked to original sources
PubMed1988

The 'herald hemiparesis' of basilar artery occlusion.

In thrombosis of the basilar artery, not infrequently a hemiparesis is present at an early stage, when brain-stem signs may be absent or few, slight or equivocal. It is natural to suspect that such a hemiparesis signifies localization in a cerebral hemisphere, but unexpectedly in a few hours bilateral hemiplegia appears associated with coma or a locked-in syndrome, indicating basilar artery occlusion. I would term this disarming hemiparesis the "herald hemiparesis" of basilar artery occlusion. If the true nature of the condition is recognized early, the use of heparin and other measures may forestall disaster.

Adult↗
PubMed1988

Reversible cerebral segmental vasoconstriction.

Vasoconstriction is not recognized as a cause of cerebrovascular disease except in the vasospasm seen following subarachnoid hemorrhage and possibly in migraine. However, we found four patients to have transient, fully reversible vasoconstriction and dilatation prominently involving arteries around the circle of Willis. All four patients were evaluated for severe headaches and fluctuating or recurring motor or sensory deficits. No cause for the clinical syndromes and angiographic abnormalities was found. Similar patients are reported in the literature under various nosologies. This newly recognized clinical-angiographic syndrome should be differentiated from other known causes of vessel constriction and dilatation; the precipitants of reversible vasoconstriction may then be better defined.

Adult↗
PubMed1988

Neurologic fragments. I. Clinical observations in demented patients.

Some 28 clinical observations of behavior, mainly in demented patients, have been singled out for brief description and comment. Most are familiar, and the aim of the presentation is to identify and codify them, complementing formal psychological tests. Several have been given names--eg, insistence, balking, dread of being alone, the obligatory alibi, lability of temper, amphigory, reaching out, etc. Others draw attention to and characterize fragments of behavior--eg, ambient echolalia, periodic repetition of questions and comments, failure to recognize the spouse, turning the back, etc. Finally, a few clinical phenomena are commented upon.

Alzheimer Disease↗
PubMed1987

Lateral medullary infarction extending to the lower pons.

A case of lateral ponto-medullary infarction was studied pathologically using serial sections of the involved region. The infarct involved 4 mm of the lower pons and 10 mm of the upper medulla. The feeding arteries of most of the infarct were traced back to form one small artery 350 micron in diameter which arose from an artery 2 mm in diameter identified as the posterior inferior cerebellar artery. The latter was occluded by a recent thrombus or embolus which blocked the mouth of the branch to ponto-medullary region.

Aged↗
PubMed1986

Unusual vascular events in the territory of the posterior cerebral artery.

There is an unusual type of vascular episode in the territory of the posterior cerebral artery which remains relatively unknown. Ten cases are presented in which a posterior cerebral artery deficit developed suddenly in dramatic fashion with headache, visual symptoms, sensory and motor deficits and signs of third nerve involvement. Nine of the patients were female and one was male. Seven were under the age of 33. In all instances there was a permanent neurologic sequela, usually a hemianopia. A similar case was described in 1901. The nature of the underlying process remains obscure, but the evidence favors accompanied migraine in which a particularly severe attack results in permanent damage. The term "catastrophic migraine" is suggested.

Adolescent↗
PubMed1986

The posterior cerebral artery syndrome.

Embolic and thrombotic infarction in the territory of the posterior cerebral artery (PCA) is described with emphasis on the stroke and cerebrovascular features rather than special neurological syndromes. Of 47 cases of obstruction at the distal bifurcation of the basilar artery, 43 (95%) were consistent with embolism. The clinical categories and pathological findings are presented. Local embolism, vertebral distal-stump embolism, the dynamics of hemorrhagic infarction and embolus-in-transit are briefly described. The prodromal manifestations of PCA thrombotic occlusion include photopsias, hemianopic blackouts, headache, transient episodes of numbness, episodic lightheadedness, spells of bewilderment and rarely tinnitus. Recognition of these may allow prevention of a stroke. Prodromal photopsias did not closely resemble the scintillating displays of migraineurs. When the stroke occurred, visual complaints usually predominated. A sensory deficit occurred in one-third of cases. In 25 cases of memory impairment the dominant hemisphere was involved in 24. The kinds of visual hallucinations, simple and formed, are described.

Aged↗
PubMed1986

In vitro characterization of a thermolabile herpes simplex virus DNA-binding protein.

The major herpes simplex virus DNA-binding protein, ICP8, was purified from cells infected with the herpes simplex virus type 1 temperature-sensitive strain tsHA1. tsHA1 ICP8 bound single-stranded DNA in filter binding assays carried out at room temperature and exhibited nonrandom binding to single-stranded bacteriophage fd DNA circles as determined by electron microscopy. The filter binding assay results and the apparent nucleotide spacing of the DNA complexed with protein were identical, within experimental error, to those observed with wild-type ICP8. Thermal inactivation assays, however, showed that the DNA-binding activity of tsHA1 ICP8 was 50% inactivated at approximately 39 degrees C as compared with 45 degrees C for the wild-type protein. Both wild-type and tsHA1 ICP8 were capable of stimulating viral DNA polymerase activity at permissive temperatures. The stimulatory effect of both proteins was lost at 39 degrees C.

DNA Replication↗
PubMed1986

A clinico-pathologic study of carotid endarterectomy plaques.

Carotid endarterectomy specimens surgically removed in one piece were kept intact, processed pathologically, and serially sectioned at 8 microns. There were 34 cases with multiple hemispheric transient ischemic attacks (TIAs), 23 cases with multiple episodes of transient monocular blindness (TMBs), 33 asymptomatic cases, and 51 cases with prolonged or persisting neurologic deficits. The occurrence of TIAs and TMBs correlated best with severe carotid stenosis (1 mm. or less), less well with the presence of mural thrombus, and not at all with ulceration of plaque and intraplaque hemorrhage. The residual lumen in asymptomatic cases was wider. The persistence of neurologic deficits correlated best with carotid occlusion or near-occlusion (37 of 51). In only 3 cases was there evidence of embolism from ulceration with minor stenosis. There were many variations in the size, form, composition, site, and number of mural thrombi, ulcerations, and hemorrhages; to provide an accurate picture, serial sections are necessary. Large rounded cavities in plaques sometimes were empty, smooth-lined cul-de-sacs rather than eroding ulcerations (16 cases). Mural thrombi are probably not an important source of embolism. Ulceration and hemorrhage into plaque posed little or no threat in the present series. Using the pathologic and clinical data, inferences have been made concerning the relative frequency of embolism and hemodynamic failure in the mechanism of the varied events associated with carotid occlusion. Observations have been made on a few additional points--selective involvement of the lower extremity, prolonged TIAs, the onset of symptoms during sleep, unusual motor disorders, the occurrence of headache, retinal embolism and progression of stenosis.

Arteriosclerosis↗
PubMed1983

Trigeminal sensory neuropathy.

The etiology of trigeminal sensory neuropathy remains obscure. In a recent case, a relationship to herpes simplex virus might be inferred. A woman, aged 63 years, had at least ten episodes of "cold sore," always at the same site on her upper lip. After a typical prodromal burning, she expected a cold sore to appear, but a trigeminal sensory neuropathy began instead, starting at the site where the cold sores had always appeared.

Cranial Nerve Diseases↗