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Biomedical subjects

F Gerstenbrand

Publications and source records attributed to F Gerstenbrand.

At least 91 records · Page 5Linked to original sources
PubMed1983

[Jopamidol, a non-ionic x-ray contrast medium--tolerance from a neurological viewpoint].

A double-blind trial was carried out in 80 patients, whereby jopamidol, the first stabilized non-ionic contrast medium, and meglumine iodamine were compared in 40 patients undergoing cranial computed tomography and 40 patients subjected to cerebral angiography. There was no difference in the quality of the radiographs. Jopamidol was better tolerated and caused significantly fewer side effects or complications than meglumine iodamine. Our evidence suggests that jopamidol has significant advantages over currently employed contrast media for cranial computed tomography and cerebral angiography.

Adolescent↗
PubMed1983

[Biosynthesis of amino acids from glucose in the central nervous system in the Parkinson syndrome].

The incorporation of labelled carbon from glucose U-14C into CSF amino acids was investigated in three patients with Parkinson's disease and in three control persons with comparable age and physical stature. Comparing the specific radioactivities of serum and CSF one can postulate that the labelled amino acids found in the CSF are synthesized mainly by brain tissue. The resorption of glucose into the CNS and therefore the synthesis of amino acids from glucose was more rapid in controls; labelled alanine and glutamine appeared later in the CSF of the patients. As expected, in the controls the specific radioactivity of glutamic acid was found to be higher than that of glutamine, in patients the labelling of glutamine was higher as was that of serine, glycine, aspartic acid and asparagine. From our knowledge concerning the compartmentation of the metabolism of glutamate, we assume that in Parkinsonism the metabolic activity of neurons is reduced but that of astroglia is enhanced.

Aged↗
PubMed1983

Central somatosensory conduction time and short latency somatosensory evoked potentials in post-traumatic coma.

Short latency evoked potentials (SEPs) were elicited by stimulation of the median nerve at the wrist and recorded simultaneously from the neck and the contralateral scalp in 44 comatose patients with signs of brain stem impairment due to head injury. Thirty-four patients were studied in acute coma on day 1 or 2 after brain injury. Twenty-three patients were studied in prolonged coma during days 3-12 after trauma. Six patients were examined in brain death. Brain stem involvement was divided clinically and by CT scan into secondary lesions due to supratentorial mass displacement and primary lesions due to direct violence to the brain stem. The central somatosensory conduction time (CCT) was measured by subtracting the peak latency of the major response from the neck (N14) from that of the primary scalp response (N20). The amplitude ratios (ARs) N20/N14 were calculated for each trace. Further asymmetries and absence of SEP over one or both hemispheres were noted. In cases in coma due to supratentorial lesions CCT and AR were close to normal in patients with good outcome. CCT increased and AR decreased with the worsening of outcome both in acute and prolonged coma. Asymmetries of SEPs indicated moderate or severe final disability. Patients with absent SEPs over one or both hemispheres due to supratentorial lesions died or survived severely disabled (1 case). In patients suffering from primary brain stem dysfunction, confirmed by a normal or slightly abnormal CT scan, prolonged CCT, asymmetric but also absent SEPs were also found in patients with good outcome both in acute and prolonged coma. AR was generally low in these cases. Early appearance of SEPs or early recovery of initially distorted SEPs and decrease of CCT in prolonged coma or during recovery was a favourable prognostic sign. Therefore even absent or severely distorted SEPs should be interpreted cautiously in patients who may suffer from primary brain stem involvement. Scalp SEPs were totally absent in patients with brain death.

Adolescent↗
PubMed1983

Incidence and prognostic value of spindles in post-traumatic coma.

One hundred and thirty-three EEGs were analysed from 80 comatose patients with signs of brain stem impairment due to head/brain injury. Seventy EEGs were taken in acute coma on day 1 or 2 after brain injury. Sixty-three EEGs were recorded in prolonged coma 3-12 days after brain injury. Brain stem involvement was divided by neurological signs and by CT scan into secondary lesions due to supratentorial mass displacement and primary lesions due do direct violence to the brain stem. Different EEG patterns were observed, but spindle activity was of special interest. Spindles were classified as typical (easily recognizable, well organized, 12-14 c/sec activity) or atypical (hardly recognizable, distorted form, 6-11 c/sec activity). Furthermore, asymmetries of spindles were noted. The spindles and their alterations were related to different stages of outcome. Spindles were seen in 91% of the EEGs in acute coma and in 30% in prolonged coma. In acute coma due to secondary brain stem involvement a good outcome was heralded by the occurrence of typical symmetrical spindles combined with early stages of secondary brain stem impairment at neurological examination. In cases of primary brain stem involvement typical spindles also suggested a good prognosis despite the observation of serious clinical signs (decerebrate posturing). The percentage of spindle activity decreased, and distortion and asymmetry of spindles increased with the worsening of outcome. Severe intracerebral lesions (confirmed by clinical and CT scan examinations) led to distortion, asymmetry and finally disappearance of spindles. In prolonged coma spindle activity was markedly reduced regardless of the final outcome. When spindles were present atypical and asymmetric forms significantly increased in patients with bad outcome. There were no significant differences in spindle activity in the different outcome categories, if primary and secondary brain stem lesions were compared.

Adolescent↗
PubMed1983

Klüver-Bucy syndrome in man: experiences with posttraumatic cases.

After the original description of characteristic behavioral changes in rhesus monkeys after bilateral resection of major portions of the temporal lobes by Klüver and Bucy in 1937 [11], similar syndromes have repeatedly been reported in human pathology. The present paper is based on clinical analysis of 40 cases of traumatic apallic syndrome (TAS), 30 of whom developed a complete or partial Klüver-Bucy syndrome during recovery. The dynamics in the development of a Klüver-Bucy syndrome during remission of a TAS are analyzed. The delineation between a pre-stage, full-stage and remission-stage of the Klüver-Bucy syndrome is suggested.

Adolescent↗
PubMed1983

Deprenyl (selegiline) in combination treatment of Parkinson's disease.

Long-term treatment of parkinsonian patients with levodopa (plus decarboxylase inhibitor) leads to decreasing levodopa efficacy and increasing side-effects. Then main therapeutic problems are on-off phenomena, end-of-dose akinesia and levodopa-induced dyskinesias. Deprenyl, a selective MAO-B inhibitor, has produced good therapeutic effects in combination either with levodopa alone or with levodopa plus decarboxylase inhibitor in the treatment of end-of-dose akinesia and on-off phenomena. In an open trial with 48 parkinsonian patients deprenyl was added to previous levodopa plus decarboxylase-inhibitor therapy. Good effects were achieved in respect of mild on-off phenomena and end-of-dose akinesia, minor success in the alleviation of dyskinesia and depression. In four further patients with a post-traumatic parkinsonian syndrome, no improvement of rigidospasticity and vigilance was demonstrable.

Aged↗
PubMed1983

Premorbid personality of Parkinson patients.

In a preliminary study 28 patients with idiopathic Parkinson's disease (14 males, 14 females; mean age 67 years, mean disease duration 9 years) were tested with the GIESSEN-TEST (GT) personality inventory in an attempt to define distinctive premorbid personality features of Parkinson's disease. Patients and close relatives were asked to fill out the test questionnaires with a retrospective judgement of healthy times; at the same time patients and relatives were interviewed for premorbid habits and personality traits of the patients. The results obtained suggest that parkinsonian patients are of an introverted and anancastic premorbid personality type. In the GIESSEN-TEST (GT) marked trends toward "overcontrol"; "depressiveness", "positive social resonance", and "social impotency" were observed. The results are discussed and related to findings of distinctive premorbid smoking and drinking habits of parkinsonian patients.

Aged↗
PubMed1982

[Rare primitive motor patterns of the oral sense (author's transl)].

This case report presents two types of primitive motor patterns of the oral sense, the rooting reflex in an apallic patient due to encephalitis and a cobra-bite-like motor pattern in a patient with a hypoxic apallic syndrome. In the apallic syndrome the disintegration of cerebral functions to a mesodiencephalic level is a characteristic feature. The reappearance of primitive motor patterns of the oral sense in the apallic syndrome thus gives further evidence for the integration of primitive motor patterns (e.g. rooting reflex) in the brainstem reticular formation. The cobra-bite-like motor pattern combined with aggressive actions might be due to the connection between brainstem functions and limbic structures.

Adult↗
PubMed1982

Some observations on the blink reflex in posttraumatic coma.

Blink reflex studies were carried out on 51 comatose patients with signs of brain stem impairment due to head injury. Twenty-five patients were studied in acute coma on day 1 or 2 after trauma. Twenty-six patients were studied in prolonged coma during days 3-12 after brain injury. Brain stem involvement was divided clinically and by CT scan into secondary lesions due to supratentorial mass displacement and primary lesions due to direct violence to the brain stem. Further, the comatose states were separated by behavioural and EEG signs of sleep into "sleep' and more "alert' states. The blink reflexes were recorded after mechanical and electrical stimulation. Mechanical stimulation appeared to be more effective in evoking late responses than the electrical stimulus. The elicitability of the late responses was also dependent on the time of stimulation. During "sleep', usually accompanied by a spindle-EEG, the late responses were totally absent after both mechanical and electrical stimulation in acute coma. In more "alert' states, usually accompanied by high voltage delta waves in the EEG, the late responses, especially direct R2, could be frequently elicited by mechanical stimulation. These differences decreased during prolonged coma. All patients with signs of secondary brain stem involvement who had at least one late component in the acute stage of coma recovered well. So did all patients, with one exception, with primary brain stem injuries. Early recovery of the blink reflexes in cases of primary brain stem injury was a further favourable sign. Consistent absence of R2 (and R1) in prolonged coma indicated a bad outcome. The presence of all components in prolonged coma was of less prognostic significance than in the acute stage.

Adult↗
PubMed1981

[Epidural spinal electrostimulation (ESES) in patients with chronic pain and central motor disturbances (author's transl)].

Epidural spinal electrostimulation (ESES), as method in the treatment of patients with chronic pain or severe central motor disturbances, especially spastic paresis of spinal origin and bladder dysfunction, is indicated when conservative measures prove ineffectual and before surgical intervention is considered. The biochemical and innervation processes which are brought about by ESES are discussed, as well as the literature on the efficacy and possible complications of the method. Twenty cases were subjected to a test stimulation and in twelve of these the stimulation system was implanted. Spinal spasticity and the range of mobility were improved by 20 to 30% in 8 patients with multiple sclerosis and 3 other patients with myelopathy of varied aetiology. In addition, spastic cramps of abrupt onset, with or without pain, disappeared almost completely following ESES in all cases. Three cases with chronic pain, two after a caudal lesion and one with cervical radicular damage, were markedly improved.

Adult↗