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Biomedical subjects

C M Fisher

Publications and source records attributed to C M Fisher.

161 records · Page 9Linked to original sources

Creutzfeldt-Jakob disease in an adolescent.

A 16-year-old boy was stricken with a progressive neurologic disorder characterized primarily by dementia progressing to severe neurologic debility in 12 months and death 28 months following the first symptoms. Pathologic examination showed a spongiform encephalopathy, consistent witha clinical diagnosis of Creutzfeldt-Jakob disease (CJD). The noteworthy features of the case are the age of onset, the somewhat prolonged course an the amount of white matter change. These are discussed within the frame of reference of CJD and the spongiform encephalopathies of infancy and childhood. Animal inoculation studies employing post-mortem embalmed brain as inoculum are currently in progress to determine the transmissibility of this patient's disease.

Adolescent↗

Pure sensory stroke and allied conditions.

This paper contains an analysis of 135 cases in which numbness, either episodic or persistent, involved one side of the body. In most cases, the patients were candidates for the diagnosis of pure sensory stroke which is usually the result of an occlusive cerebrovascular lesion involving the thalamus. The cases are divided into three main categories, pure sensory stroke, pure sensory TIAs, and atypical cases. The clinical features described in an earlier paper have been confirmed for the most part. A major limitation is the paucity of pathological studies. The lack of reliable criteria for the recognition of migrainous paresthesias has probably resulted in the inadvertent inclusion of some such cases. Some other conditions, hemidysesthesia and cervical disc, which have had to be considered in the differential diagnosis have been included. Cases of occlusive disease of the posterior cerebral internal carotid and middle cerebral arteries have been analyzed for patterns of paresthesias which may serve to distinguish cortical lesions from thalamic.

Adult↗

Vertebral-basilar posterior cerebral territory stroke--delineation by proton nuclear magnetic resonance imaging.

We used three-dimensional proton NMR images to study ischemic infarction in the territory of the vertebral-basilar posterior cerebral circulation. The study includes sixteen cases, eight of which are presented in detail. In seven cases, the infarctions were secondary to demonstrable large artery occlusive disease -- vertebral, basilar, or posterior cerebral. In nine cases, the infarctions were secondary to what was presumably small vessel disease. In fifteen of the sixteen cases, NMR imaging could locate the infarct, inversion recovery and spin-echo pulse sequences being more sensitive than the saturation recovery pulse sequence. This efficiency rests on the high sensitivity of ischemic infarction to changes in T1 and T2 relaxation time, highlighted in the inversion recovery and spin-echo images, respectively. The additional advantages of the three-dimensional approach, and the lack of bone artifact, make NMR imaging superior to CT scanning in identifying areas of infarction in the territory of posterior cerebral circulation.

Adult↗

Late-life migraine accompaniments--further experience.

In 1980, 120 cases with late-life migrainous accompaniments resembling transient ischemic attacks were presented. In the present paper, 85 further cases examined in the past five years are analyzed. The findings support the concept advanced previously. In general, the cases are divided into the same categories: visual--21 cases, visual and paresthesias--6, visual and speech disturbance--2, visual, paresthesias and speech disturbance--3, visual, paresthesias, speech disturbance, and weakness--20, visual and brainstem symptoms--3, and cases without visual symptoms--32. The ages ranged from 40 to 73 years. Headache occurred in association with the episodes in only 40% of cases. There was a history of recurrent headache in 65%. The condition can justifiably be regarded as benign. Migrainous accompaniments account for some of the cases of transient ischemia with normal angiograms. Knowledge of the condition helps in the planning of rational management.

Adolescent↗

Cerebral vasospasm with ruptured saccular aneurysm--the clinical manifestations.

Fifty cases of verified intracranial ruptured saccular aneurysm were analyzed to investigate the relationship of the development of a delayed cerebral ischemic deficit to the presence of cerebral vasospasm visualized on angiography. Twenty-five patients developed a delayed ischemic deficit (DID), and all showed Grade 3+ or 4+ vasospasm. Nineteen patients had Grade 0, 1+, or 2+ vasospasm, and none developed a DID. It was concluded that in this study vasospasm accounted for all DID's and that in the absence of vasospasm DID did not occur. The DID occurred most often on Day 8 (7 of 25 cases).

Adult↗