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Biomedical subjects

C S Kase

Publications and source records attributed to C S Kase.

At least 73 records · Page 4Linked to original sources
PubMed1985

Cerebellar infarction in the superior cerebellar artery distribution.

Three patients with CT and angiographic documentation of cerebellar infarction in the superior cerebellar artery distribution had ataxic gait with little or no vertigo. Limb ataxia occurred in two patients. Transient chorea and signs of pontine infarction were also noted. CT demonstrated infarcts on the upper surface of a cerebellar hemisphere and/or vermis. Angiograms disclosed occlusion of the top of the basilar artery in two cases and distal superior cerebellar artery (SCA) branches in one. One patient later died after distal basilar artery occlusion; the others recovered.

Adult↗
PubMed1985

Anticoagulant-related intracerebral hemorrhage.

Twenty-four patients had intracerebral hemorrhage while they were being treated with anticoagulants. Hypertension was present in 67% of the cases, head trauma was an uncommon preceding event, and simultaneous bleeding in other organs occurred in only one instance. Neurologic abnormalities progressed for several hours in 58%. Seizures occurred at onset in 12.5%. The location of the hemorrhage was as follows: cerebellum (nine cases), lobar white matter (six), basal ganglia (five), thalamus (two), and hemisphere, unspecified (two). In 61%, the hemorrhages occurred within 6 months of therapy. In 75%, the prothrombin time was beyond 1 1/2 times the control value. Mortality was 62.5%. Survivors had smaller hematomas than did patients with fatal hemorrhage.

Adult↗
PubMed1984

Cysticercosis of the central nervous system: clinical and therapeutic considerations.

In a group of forty cases of cysticercosis of the central nervous system, 59% presented with intracranial hypertension due to obstructive hydrocephalus. Ventricular or cisternal cysts, and chronic cysticercus meningitis were the most common causes of hydrocephalus. Seizures occurred in 40% of the patients, in one-half of them in association with CT-detected parenchymatous cysts. In 20% of the cases progressive mental deterioration was the main clinical feature, at times associated with hydrocephalus. CT scan provided the highest diagnostic yield, being abnormal in 90% of cases. Long term prognosis was poor, with a mortality rate of 38% over a 40-month follow-up period. The most common cause of death (60%) was meningitis. CSF shunting is the treatment of choice for hydrocephalus, irrespective of its mechanism. Surgical resection is indicated in some cases with a single superficial (cortical) or posterior fossa cyst. Supratentorial cysts carry a relatively benign prognosis.

Adolescent↗
PubMed1984

Caudate hemorrhage.

We studied 12 patients with intracerebral hemorrhage in the head of the caudate nucleus. These cases accounted for 7% of a consecutive series of intracerebral hemorrhage. The clinical findings differed from more common varieties of supratentorial hemorrhage. All patients had acute onset of vomiting, headache, stiff neck, decreased level of consciousness, and behavioral changes in a pattern that simulated subarachnoid hemorrhage. Seven patients had gaze paresis and hemiparesis, with or without sensory loss. Two of these seven patients had, in addition, elements of Horner's syndrome. The prognosis for recovery was good. No patient had recurrent hemorrhage or persistent hydrocephalus.

Adult↗
PubMed1983

Cerebral vasospasm. Part I. In cerebral vascular malformations.

This review enumerates the many proposed mechanisms of vasospasm, including cellular elements, agents derived from the blood and injured cerebral tissues, alteration of calcium: magnesium ratios, free radical reactions, hypothalamic injury, clogging of the subarachnoid space, obstructions of the vasa vasorum and necrosis of the media with subintimal proliferation and intraluminal acidosis. At present, no single agent has been demonstrated as the only source of vasospasm, and whether the disorder is spasm or a chronic arteriopathy remains the subject of argument. The factors influencing the frequency, timing, severity and distribution of angiographically documented vasospasm are discussed, including data from our own population-based study over a 3 year period showing an incidence of vasospasm of 73%. Special emphasis is given to the observation that differences in patient populations play a major role in the incidence and severity of reported vasospasm: those from non-selective populations show a higher incidence of vasospasm and a greater severity of the syndromes attributed to spasm. Hypotheses are offered to account for the low frequency of vasospasm in hemorrhages from arteriovenous malformations and mycotic aneurysms. Clinical syndromes of vasospasm are reviewed, with special emphasis on our own material. The mode of onset and subsequent course of syndromes include those of sudden onset consistent with embolism, and those of gradual onset suggesting a low flow state. Their relationship to the severity of the subarachnoid hemorrhage and the vasospasm is presented. The paucity of syndromes of isolated deep infarcts of the lacunar type is noted. An account is given of the many failed therapies and the future hopes for early surgery. Innovations in medical therapy, including the use of some platelet inhibitors available only in some countries, and rationales for the use of aspirin and even heparin is discussed.

Adult↗
PubMed1982

Lobar intracerebral hematomas: clinical and CT analysis of 22 cases.

Twenty-two cases of lobar hematomas occurred among 93 consecutive patients presenting with intracerebral hemorrhage. Arterial hypertension was the leading cause. Most hematomas were found in the parietotemporal region. Common physical findings were hemiparesis, hemisensory syndrome, and visual field defects. Seizures occurred in 23% of the patients, and coma was infrequent at onset. Mortality rate was 32%. Hematoma size on CT correlated with outcome: Patients with small hematomas did well on medical treatment, and those with medium size and large hematomas had mortalities of 14 and 60%, respectively. One-half of the survivors in the latter groups were treated surgically. It is proposed that large and medium size hematomas might benefit from surgical treatment, especially when the level of consciousness progressively deteriorates or CT scan shows prominent midline shift.

Cerebral Hemorrhage↗
PubMed1982

Pathology of an experimental extradural spinal T cell tumor.

Syngeneic mice injected intravenously with a T cell tumor line (line 13) induced by Gross' murine leukemia virus developed paraparesis and sensory loss below the midthoracic level 2 to 3 weeks after inoculation. Although signs of systemic disease coexisted, the animals survived through the development of the neurologic symptoms, and treatment with cytotoxic agents was not required. Pathologic study of the spinal cord and brain revealed tumoral infiltration of the meninges, confined to the extradural spaces, more markedly at spinal than cerebral levels. Equally severe infiltrates occurred in the paravertebral musculature. No leptomeningeal or parenchymal involvement was present, irrespective of the severity of the extradural infiltration. Marked bone marrow and visceral infiltration coexisted with central nervous system involvement. The topography of the extradural and muscular tumor cells collections related to the proximity of the involved bone marrow and areas of direct communication between these spaces were repeatedly identified. On the other hand, line 13 cells injected directly into the brain substance produced diffuse leptomeningeal tumoral infiltration without extradural involvement. These findings suggest that the pathogenesis of this model of spinal T cell tumor proliferation involves a first stage of bone marrow infiltration, followed by extradural involvement. This occurs by direct migration of bone marrow tumor cells through gaps in the vertebral bone. This model offers the opportunity for the study of malignancies that produce bone destruction as a mechanism for tumoral spread.

AKR murine leukemia virus↗
PubMed1981

Hemichorea-hemiballism and lacunar infarction in the basal ganglia.

We present a case of acute hemichorea-hemiballism associated with lacunar infarct documented by computerized tomography scan in the contralateral putamen and caudate nuclei. The pathoanatomic data of similar cases in the literature are reviewed with reference to the location of the responsible lesions. Acute hemichorea-hemiballism is most frequently caused by lacunar infarcts in the basal ganglia contralateral to the dyskinesia.

Basal Ganglia↗
PubMed1981

Shotgun pellet embolus to the middle cerebral artery.

A 24-year-old man had a massive right cerebral infarction after occlusion of the middle cerebral artery trunk by a shotgun pellet that embolized from the heart during external cardiac massage for cardiac arrest. The cerebral infarct was followed by massive edema, uncal herniation, and death.

Adult↗
PubMed1980

Partial pontine hematomas.

Two hypertensive men presented clinically with small, largely unilateral hematomas of the pons and midbrain demonstrated by computerized tomography. Clinical manifestations included "ocular bobbing," complex forms of ophthalmoplegia, Cheyne-Stokes respiration, and pyramidal tract signs. The "typical" sings of massive pontine hemorrhage--including coma, pinpoint pupils, and hyperthermia--were absent.

Adult↗
PubMed1977

Sensorimotor stroke due to thalamocapsular ischemia.

A 61-year-old hypertensive diabetic man awoke with a numb, heavy right arm and leg; symptoms progressed within 30 hours to a dense right hemisensory syndrome involving head, face, trunk, arm, and leg, accompanied by a right hemiparesis, involving tongue, face, arm, and leg with extensor plantar response, leaving him barely able to move the arm and leg against gravity. No impairment in alertness, memory, language, praxic, or visual functions was evident at any time. Improvement in motor function began in 24 hours and progressed to walking status by discharge on day 23. Eight days passed before the sensory deficit showed improvement, and it was still prominent at discharge. Autopsy three months later showed a 4 X 2 X 4-mm lacune in the ventral posterior nucleus of the left thalamus, with a zone of pallor on stained microscopic sections extending into the immediately adjacent posterior limb of the internal capsule. This case appears to be unique in that a sensorimotor stroke has been produced by a confirmed thalamocapsular infarct.

Cerebrovascular Disorders↗
PubMed1977

Global spatial disorientation. Clinico-pathologic correlations.

Two patients presenting with the acute onset of bilateral parietal lobe damage showed initially the features of Balint's syndrome. After most of its manifestations had cleared, both patients exhibited severe disorders of spatial orientation: acoustic ataxia, inability to localize objects in space. In addition, 1 patient showed a topographical disorientation and abnormalities of whole body movements. This patient came to post-mortem examination, which revealed bilateral and fairly symmetrical old and recent infarctions of the superior parietal lobules. In the light of these observations and previous reports, it is suggested that the reported abnormalities of whole body movements can be explained on the basis of a visuo-motor intrahemispheric disconnection due to the bilateral lesion of the dorsal parietal lobe. In addition, the global spatial disorientation is analysed and is thought to be the manifestation of a derangement of a specific function centered in the parietal lobe. Moreover, it is pointed out that topographic disorientation does not require the concomitant failure of oculomotor mechanisms for its production. The topography of the anatomical lesion is considered in relation to current concepts on brain damage after severe hypotension and cardiac arrest. It is concluded that this group of patients is most likely at risk of developing behavioural abnormalities akin to the ones here reported.

Adult↗
PubMed1976

Treatment of tic douloureux with a new anticonvulsant (clonazepam).

Twenty-five patients affected by 30 episodes of tic douloureux were treated with a new anticonvulsant, clonazepam. In 40% there was complete control of the neuralgia and an additional 23.3% were significantly helped by the drug. Sixteen patients had previously been resistant to carbamazepine, and eight of them were completely and one partially relieved by clonazepam. The side-effects, somnolence and unsteadiness of gait, were present to some extent in 80 and 88% of the cases respectively, being severe in about half of them. It is concluded that clonazepam can be considered as a second choice for the treatment of this condition, after proven failure with carbamazepine. Possible mechanisms of action are discussed.

Adult↗
PubMedDate not supplied

Medial medullary infarction from fibrocartilaginous embolism to the anterior spinal artery.

A previously healthy young woman presented with sudden onset of quadriplegia, anesthesia below the C3 dermatome, respiratory paralysis, vertical nystagmus, ocular bobbing and cortical blindness. After partial resolution of the latter deficits, she remained quadriplegic, with a C3 level of anesthesia, and in respiratory paralysis until death from complications of a fulminant pulmonary infection. Autopsy disclosed bilateral infarctions of the medial aspect of the medulla and the upper cervical cord, in the distribution of the anterior spinal artery. Multiple sites of arterial occlusion by fibrocartilaginous material were found in branches of the anterior spinal artery, in correspondence with the sites of infarction. A review of the literature disclosed only 2 examples of medial medullary syndrome from embolism to the anterior spinal artery.

Adult↗
PubMedDate not supplied

Hypertensive putaminal hemorrhage presenting as pure motor hemiparesis.

A 44 year old hypertensive man presented with a pure motor hemiparesis, and CT scan showed a putaminal hemorrhage. The clinical course was characterized by rapid resolution of the deficits. This case illustrates a variety of putaminal hemorrhage of good functional and vital prognosis, and stresses the value of CT scanning as a tool for diagnosis and prognosis.

Adult↗