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Biomedical subjects

D I Graham

Publications and source records attributed to D I Graham.

At least 325 records · Page 18Linked to original sources
PubMed1972

"Idiopathic" thrombosis in the vertebrobasilar arterial system in young men.

Two young men died as a result of cerebellar infarction due to thrombosis in the vertebrobasilar arterial system in the absence of atheromatous stenosis, other identifiable intrinsic arterial disease, or embolism. In each case the swollen cerebellar infarct had produced tonsillar herniation and hydrocephalus.

Adult↗
PubMed1970

Effects of large doses of colistin sulphomethate sodium on renal function.

High doses of colistin were used in the treatment of severely ill patients with refractory klebsiella chest and urinary tract infections. At the same time renal function was monitored to determine possible nephrotoxicity. In all patients it produced acute renal failure and in some acute tubular necrosis. Though renal failure contributed to the final cause of death in some cases, in the majority death was due to the primary neurological illness.

Acute Kidney Injury↗
PubMed1970

Fat embolism.

Explore the source record for details and available documents.

Adult↗
PubMed1970

Acquired hepatocerebral degeneration: report of an atypical case.

A case of acquired hepatocerebral degeneration secondary to biliary cirrhosis is described. It differs from the conventional type because of the clinical predominance of cerebellar symptomatology and because the principal neuropathological abnormalities were restricted to the pallidum and to the cerebellum.

Aged↗
PubMedDate not supplied

Neuropathology of the vegetative state after head injury.

A detailed neuropathological study of patients identified clinically after head injury as either severely disabled (SD, n = 30) or vegetative (VS, n = 35) has been carried out to determine the nature and frequency of the various pathologies that form the basis of these clinical states. Patients who were SD were older (SD median 49.5 yrs vs. VS median 38 yrs, p = .04), more likely to have a lucid interval (SD 31% vs. VS 9%, p = .03), and to have had an acute intracranial haematoma (SD 70% vs. VS 26%, p < .001). SD patients less often had severe, Grades (2 or 3) of traumatic diffuse axonal injury (SD 30% vs. VS 71%, p = .001) and less often had thalamic damage (SD 37% vs. VS 80%, p < .001). Similar features of both focal and diffuse damage were present in some SD and VS cases with both groups having considerable damage to white matter and to the thalamus. It is concluded that the principal structural basis of both SD and VS is diffuse traumatic axonal injury (DAI) with widespread damage to white matter and changes in the thalami. However, both ischaemic brain damage and the vascular complications of raised intracranial pressure contributed to the clinical signs and symptoms.

Adolescent↗
PubMedDate not supplied

The contusion index: a reappraisal in human and experimental non-missile head injury.

A previously described method of quantifying cerebral contusions in man (the contusion index) caused by non-missile head injury has been modified and applied to a larger series of cases, and used to assess contusions in experimental head injuries. The initial findings in man have been confirmed, viz. that contusions are most severe in the frontal and temporal lobes; that contusions may be entirely absent in a patient dying as a result of a head injury; that there is no correlation between the severity of contusions and the nature of the injury; that the concept of contrecoup must continue to be questioned; that contusions are more severe in patients who have a fracture of the skull in comparison to those who do not; that contusions are more severe in patients who do not experience a lucid interval than in those who do; and that contusions are less severe in patients with diffuse axonal injury than in those who do not have diffuse axonal injury. The distribution of contusions in subhuman primates is similar to that seen in man, and they occur more frequently with short duration than with long duration acceleration.

Adolescent↗
PubMedDate not supplied

Brain damage in non-missile head injury secondary to high intracranial pressure.

A comprehensive neuropathological analysis was undertaken on 434 patients who died as a result of a non-missile head injury in order to determine the frequency and extent of brain damage secondary to high intracranial pressure (ICP) in head injury. Using the criterion of pressure necrosis in the parahippocampal gyrus as evidence of high ICP due to a supratentorial expanding lesion, it was established that the ICP had been high in 324 cases. In 42 of these there was no other brain damage attributable to a high ICP. There was evidence of secondary brain stem damage in 221 cases and in 44 of these the damage could be seen only microscopically. In 54 cases there was a contralateral peduncular lesion. Other abnormalities were infarction in the territories of various arteries and in the anterior lobe of the pituitary. There was a supracallosal hernia in 80 cases and haemorrhage in the oculomotor nerves in 48 cases. These results further emphasise the frequency and range of brain damage due to secondary vascular factors brought about by high ICP in a patient who has sustained a head injury.

Adolescent↗
PubMedDate not supplied

Correlation of triphenyltetrazolium chloride perfusion staining with conventional neurohistology in the detection of early brain ischaemia.

Triphenyltetrazolium chloride (TTC) has been used to detect experimental brain ischemia but its accuracy has not been established fully, especially in models of early brain ischaemia. We have developed a technique that combines TTC-staining and perfusion-fixation with formalin in the same specimen. The left middle cerebral artery of 12 rats, anaesthetized with halothane were exposed via a subtemporal approach and occluded for 4 h. The animals were perfused transcardially with TTC (2%) and formalin (10%). The forebrain was sliced and the size of the ischaemic area, delineated by TTC, was measured. The brain slices were then processed for light microscopy, and the amount of ischaemic damage determined. The ischaemic volumes of the hemisphere and cortex assessed by TTC (127.4 +/- 21.7 mm3 and 18.4 +/- 3.0 mm3) were larger than the volumes measured by microscopy (104.3 +/- 16.6 mm3 and 15.2 +/- 3.6 mm3) but there was no statistical difference between them. Correlation of the ischaemic volumes in hemisphere and cortex between the two methods was good (r2 = 0.9221, P less than 0.01 and r2 = 0.9243, P less than 0.001), but the correlation of the ischaemic areas at specific coronal planes was poor. The ischaemic volume of caudate nucleus measured by TTC (15.2 +/- 3.6 mm3) was smaller than the volume assessed by microscopy (18.4 +/- 3.0 mm3) and the correlation was poor (r2 = 0.6650) It is concluded that TTC-staining provides only an approximation of the amount of early ischaemic brain damage subsequently identified by conventional light microscopy.

Animals↗
PubMedDate not supplied

A clinico-pathological study of herpes simplex encephalitis.

A retrospective clinical and pathological analysis has been performed of 24 cases of herpes simplex virus encephalitis (HSE) seen at the Institute of Neurological Sciences, Glasgow, between 1972 and 1985. All patients had been diagnosed on the basis of isolation of herpes simplex virus (HSV) from, and/or the demonstration of characteristic histological changes of acute necrotizing encephalitis (ANE) in brain biopsy and/or autopsy tissue. Clinical presentation on admission included a prodromal influenza-like illness (46%), sudden onset of headache and confusion (54%), meningism (38%), deep coma (42%), aphasia (54%) and focal neurological signs (79%). Seizures occurred in 46% of cases during the course of the illness. Of the 24 cases, 14 (58%) died and 10 (42%) survived. Intravenous acyclovir treatment was associated with the best prognosis. Cerebral biopsy of one temporal lobe was performed in 22 cases and in 19 of these a positive histological diagnosis of HSE could be made. HSV was isolated from 15 of the 19 (79%) biopsied cases in whom virus isolation was attempted. Only seven out of the 15 cases (47%) in which immunofluorescence assays for HSV antigens were performed were unequivocally positive. Herpes simplex virus was isolated in culture from all cases which were negative by immunofluorescence. Immunocytochemical analysis on tissue sections of five representative brain biopsies demonstrated the presence of HSV antigens in some astrocytes, neurons and macrophages especially within areas of inflammatory infiltration. In situ hybridization experiments with a cloned HSV DNA probe demonstrated viral RNA in astrocytes, neurons and macrophages in two human biopsies and mouse brains in areas broadly corresponding to the distribution of viral antigen labelling. The combined immunocytochemical and in situ hybridization procedure showed that many but not all of the cells containing viral RNA also contained HSV antigens, indicating a productive infection in these double-labelled cells.

Adolescent↗
PubMedDate not supplied

Experimental intracerebral haematoma in the rat: sequential light microscopical changes.

In a small animal model of controlled intracerebral haemorrhage, changes within the haematoma and surrounding tissues were examined by light microscopy in toluidine blue stained semithin sections. Groups of animals were killed at 2, 6, 15, 24 and 48 hours, 2, 4, 8 and 14 days, and 3 months survival. Sequential changes in neurons, glia and leucocytes, together with the gradual absorption of the blood clot and its replacement by an astrocytic scar are described.

Animals↗