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Biomedical subjects

E Schmutzhard

Publications and source records attributed to E Schmutzhard.

At least 91 records · Page 5Linked to original sources
PubMed1993

Isolated pontine lesion in algid cerebral malaria: clinical features, management, and magnetic resonance imaging findings.

Malaria, the most important of all tropical diseases, causes approximately one million deaths per year. In Plasmodium falciparum malaria, the organs most affected are the brain, kidneys, lungs, and liver. Cerebral involvement is the most important lethal complication with a mortality rate of up to 50%. We report a patient with malignant, tertian falciparum malaria with an initial parasitemia rate of 60% and severe cerebral, hepatorenal, and pulmonary involvement. In addition to the severe diffuse encephalopathy, an initial neurologic examination showed signs of a pontine lesion that was confirmed by cerebral magnetic resonance imaging. We therefore conclude that cerebral malaria may be responsible for focal neurologic lesions that can be demonstrated by this procedure.

Adult↗
PubMed1993

[Course and management of tetanus].

Within a span of 18 months 4 patients (2 men, 2 women) were admitted with generalized tetanus to our neurological intensive care unit. The "period of onset" ranged from 2 to 14 days. All patients needed artificial ventilation over 17 to 38 days. The clinical course was complicated by gram-negative pneumonia in 3 of the 4 patients. Time of hospitalization ranged between 35 and 60 days. One patient had never been immunized against tetanus. The other 3 had not received a booster dose for over 10 years. All 4 patients survived, 3 of them without sequelae.

Adult↗
PubMed1993

[Infective pathogens as a possible etiology of idiopathic peripheral facial paralysis].

A prospective clinical study was carried out from 1988 until 1990 on 38 consecutive patients with Bell's palsy at the Neurological Department of Innsbruck University Hospital. The age range was between 16 and 88 years, the female:male ratio was 18:20. Serological methods were employed to study the impact of infectious agents on the aetiology of this disease. 11 out of 38 cases (= 29%) were probably infectious in origin, whereby 6 cases were due to Borrelia burgdorferi, 4 to Varicella zoster virus (VZV) and 1 to Herpes simplex virus (HSV), as determined by elevation of antibody titre or presence of specific IgM. Patients with a significant serological finding were treated with ceftriaxon or tetracycline for borreliosis or with acyclovir for VZV or HSV infection. Altogether, in 36 of the 38 cases a full recovery was seen at the last follow-up investigation.

Adolescent↗
PubMed1992

Magnetic resonance: a noninvasive approach to metabolism, circulation, and morphology in human brain death.

Phosphorus (31P) magnetic resonance spectroscopy and magnetic resonance imaging were used to study the intracellular metabolism, circulation, and morphology in the brains of 3 patients with clinical brain death syndrome due to traumatic brain damage, subarachnoid hemorrhage, and acute occlusive hydrocephalus caused by a colloid cyst. Magnetic resonance spectra were characterized by a complete absence of ATP and were dominated by an intense inorganic phosphate signal. Magnetic resonance imaging revealed a uniform pattern of diffuse brain swelling and tentorial and foraminal herniation. Intracranial blood flow was absent on the magnetic resonance angiography projections. These preliminary findings suggest an important impact of magnetic resonance in the determination of human brain death.

Adenosine Triphosphate↗
PubMed1992

Electrophysiological findings in a case of severe intrathecal baclofen overdose.

Multimodality evoked potentials were examined in a case of serious accidental intrathecal baclofen overdose in a patient who suffered from severe spasticity due to a traumatic brain lesion. Electrophysiological findings during, before and after the intoxication were compared. Transcranial electrical stimulation up to 750 V did not evoke any responses in thenar muscles on the first day of intoxication. An improvement to normal values was observed within 3 days, paralleled by an amelioration of the patient's clinical condition. Cervical electrical stimulation was largely unaffected by baclofen. Median nerve somatosensory and brain-stem acoustic evoked potentials revealed few or no differences during intoxication compared to pre- and post-intoxication responses.

Adolescent↗
PubMed1992

[Neurologic symptoms within the scope of endocrine emergencies].

Functional disturbances of the central and peripheral nervous system can be seen in various internal diseases and it is not unusual that neurological symptoms are the first kind of presentation. The tight anatomical and functional junction between neurology and endocrinology predisposes to the development of neurological derangements such as somnolence, coma, seizures, and focal signs following endocrinological emergencies. In spite of modern imaging and laboratory methods, history and clinical examination are still of great importance to establish the correct diagnosis.

Diagnosis, Differential↗
PubMed1992

[Cerebral and spinal nocardia infection. A case report].

We report a case of multiple cerebral and spinal abscesses due to Nocardia asteroides in a non-immunocompromised patient. The initial central nervous system manifestation was a sterile meningitis, with secondary development of multiple cerebral and spinal abscesses. Since the location of the abscesses did not allow neurosurgical exploration and the cultures remained negative, the diagnosis was finally established by raised antibody titres to Nocardia asteroides. After specific antibiotic therapy, resolution of the spinal and cerebral abscesses was documented on the basis of serial magnetic resonance tomography and computed tomography controls.

Abscess↗
PubMed1992

Diagnosis of tuberculous meningitis by detection of tuberculostearic acid in cerebrospinal fluid.

Tuberculous meningitis still poses a major diagnostic problem. Recently, several new techniques for rapid diagnosis of tuberculous meningitis have been developed. One of these newer techniques is the detection of mycobacterial fatty acids, using gas chromatography--mass spectroscopy. In this study we evaluated the sensitivity and specificity of this recently reported method in a blind trial. The sensitivity was found to be 100%, specificity only 91%. The number of false positive results limits the value of this test in the primary diagnosis of tuberculous meningitis. Nonetheless, we consider this method to be a valuable tool for establishing the diagnosis in culture-negative patients presenting with signs and symptoms suggestive of tuberculous meningitis.

Diagnosis, Differential↗
PubMed1991

Prediction of non-survival after trauma: Innsbruck Coma Scale.

421 severely injured patients admitted to a major trauma centre in Innsbruck during the ten years, 1981 to 1990, were investigated retrospectively for early prediction of survival by means of the Innsbruck Coma Scale (ICS). All 79 patients scoring 0 or 1 died within 21 days. The findings of this study indicate that the ICS allows a highly accurate prediction of non-survival in patients with scores of 0 or 1 even at the time of first examination after trauma.

Adolescent↗
PubMed1991

Intracranial germ cell tumor mimicking anorexia nervosa.

A previously healthy seventeen-year-old boy developed loss of weight, poor appetite, and aversion to food. Physical examination being normal, anorexia nervosa was suspected. Thirteen months later a CT scan revealed a mass in the third ventricle histologically proven to be a malignant teratoma. To our knowledge anorexia nervosa is only extremely rarely the presenting feature of intracranial germ cell tumors.

Adolescent↗
PubMed1991

Cervical herpes zoster and delayed brainstem infarction.

Varicella-zoster (VZ) virus is a rare cause of CNS angiitis, which commonly presents as herpes zoster ophthalmicus with contralateral hemiplegia due to hemispheric infarction. We report the first case of VZ-angiitis with infarction in the ventral pons, following cervical herpes zoster.

Brain Stem↗
PubMed1991

[Determination of tuberculostearic acid--progress in early diagnosis of tuberculous meningitis].

Rapid diagnosis of cerebral tuberculous meningitis is of the greatest importance in determining the outcome of therapy. Since tubercle bacilli are often not seen on microscopy of the cerebrospinal fluid, and culture of Mycobacterium tuberculosis takes many weeks, there is a need for more rapid and sensitive confirmatory tests. The importance of the detection of tuberculostearic acid in the cerebrospinal fluid in combination with magnet resonance imaging will be shown in this case report.

Aged↗