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Biomedical subjects

F Regli

Publications and source records attributed to F Regli.

At least 289 records · Page 16Linked to original sources
PubMed1983

Prognosis of symptomatic intracranial obstruction of internal carotid artery.

21 patients with intracranial obstruction of an internal carotid artery (ICA) (15 stenoses, 6 occlusions) were studied for angiographic, clinical and prognostic evaluation. Evidence of atheromatous changes and associated risk factors did not significantly differ from age- and sex-matched controls with extracranial ICA disease. No significant difference occurred between matched groups with extra- or intracranial ICA obstruction in functional outcome, delayed strokes, TIAs and death, suggesting that prognosis was more related to age, sex and degree of obstruction than to level of obstruction. 80% intracranial stenosis patients had the worst functional outcome, 30-60% stenosis patients the best, and occlusion patients were intermediate. This corresponded to higher risk of delayed stroke in patients with 80% stenosis. The prognosis was better in patients without evidence of proximal atheromatosis. Only 1 patient with intracranial occlusion suffered delayed homolateral TIAs in which atheromatous embolization from stenosed contralateral ICA was hypothetized.

Arterial Occlusive Diseases↗
PubMed1983

[Isolation syndrome of the language area. Neuropsychologic and pathologic study].

A 60 year-old patient in whom spontaneous language was abolished still had a marked capacity for completing phrases and an irrepressible echolalia. From a formal point of view, linguistic ability remained at a high level. Auditory verbal comprehension was severely affected, but was not completely abolished. There was occipital blindness. Pathologic examination reveated extensive bilateral lesions in the regions supplied by the anterior and posterior cerebral arteries. Bilateral destruction of the supplementary motor areas was noted, but the perisylvian language areas were intact. These disorders constitute a syndrome of isolation of language areas which can be used to study anatomical correlations and particularly the role of the supplementary motor area in linguistic and paralinguistic processes.

Akinetic Mutism↗
PubMed1983

[Paralytic and non-paralytic pontine exotropia].

Paralytic pontine exotropia is a form of the one-and-a half syndrome of Fisher, in which an acute lesion of the paramedian pontine reticular formation (PPRF) is present. We compared such a case with a case of pontine exotropia without lateral gaze palsy, but in which the alteration of the ipsilateral saccades suggested a partial lesion of the PPRF. We suggest to call this oculomotor disturbance "non paralytic pontine exotropia".

Aged↗
PubMed1983

[Symptomatic stenoses of the middle cerebral artery].

The clinical angiographic and prognostic features of 13 patients with symptomatic stenosis of the middle cerebral artery (MCA) admitted between 1970 and 1981 have been reviewed. The etiology of the stenosis was probably atherosclerosis, except in 1 case due to fibro-muscular dysplasia, 1 with post-radiation angiopathy and 2 related to oral contraceptives. Two main clinical groups were delineated: 1) transitory and minor ischemic accidents always arising in the same arterial area; these occurred in older patients with multiples atheromatous lesions along the carotid artery. 2) progressive--or stepwise--strokes occurring in younger patients, mainly females, with isolated MCA stenosis. These cerebrovascular symptoms and signs, in the absence of carotid bruit, Doppler ultrasonography abnormality or evidence of cardiac embolism should suggest intracranial stenosis and require appropriate therapy to avoid complete occlusion. Our study shows that early medical treatment--anti-coagulation, then antiaggregation--provides a suitable alternative to EC/IC bypass. This is suggested by evidence for micro-embolization in addition to hemodynamic mechanisms.

Adult↗
PubMed1983

[Transient ischemic attacks before and after occlusion of the internal carotid artery].

Among 60 cases with occlusion of an internal carotid artery (ICA), 47 p. 100 suffered warning TIA's in the corresponding area. In 7 p. 100 the TIA's were the only manifestation of the disease. The occurrence of warning TIA's significantly correlated with a small volume (less than 20 cm3, p 0,001) and a deep localization (p less than 0,002) of infarction, and also with a better initial neurologic ability and long-term functional prognosis (p less than 0,05) than in patients without warning TIA's. Twenty eight p. 100 of the 60 cases showed delayed TIA's distal to the occlusion. In 12 p. 100 TIA's had not been present before the occlusion. The delayed TIA's were strongly (p less than 0,0001) associated with an atheromatous stenosis of the external carotid artery (ECA) or a stump of the occluded ICA and an important collateral supply through ECA channels, suggesting a micro-embolic mechanism via ECA pathways. Much more rarely hemodynamic factors, and exceptionally probable emboli from the contralateral ICA, appeared to be involved. The occurrence of delayed TIA's was not a warning sign of further stroke, and did not correspond to a poorer functional prognosis. Three p. 100 of the 60 cases suffered TIA's in the contralateral ICA territory, in relation to an atheromatous stenosis of the ICA. Twenty p. 100 showed vertebrobasilar TIA's, usually without associated disease of the vertebral or subclavian arteries (75 p. 100). This point and the evidence of absent or weak collateral circulation (p less than 0,0001) and of an associated contralateral ICA stenosis (p less than 0,01), suggested a hemodynamic mechanism with an intracranial steal from the vertebrobasilar system towards the carotid circulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Arterial Occlusive Diseases↗
PubMed1982

[Early evoked auditory potentials for the assessment of prognosis in cerebral resuscitation].

Four patients who fulfilled all the clinical criteria for brain death, and 17 patients who did not, were tested with brainstem auditory evoked responses (BAER). Of the brain-dead patients, 3 had no waves present in the BAER, including wave. I. Initially BAER were intact in none of the brain-dead patients and then showed a decrease in amplitude and a prolongation of latency of the later components (7 cases) until finally wave I alone was present (6 cases). Normal data suggested toxic or metabolic comatose patients (2 cases). BAER are an objective measure of one of the sensory pathways traversing the brainstem and can be used to evaluate the functional states of the brainstem in patients in whom brain death must be considered. The association of short-latency somatosensory evoked responses (SER) has greater clinical utility in the brain death setting because it is important to have a wave present which establishes that the input signal has reached the central nervous system.

Brain Death↗
PubMed1982

Subacute myelopathy as the presenting manifestation of sarcoidosis.

We studied a patient with progressive myelopathy, in whom systemic sarcoidosis was discovered. Involvement of other organs was asymptomatic. The myelopathy considerably improved after corticosteroid therapy. Spinal cord involvement in sarcoidosis is very uncommon, and its occurrence as a presenting manifestation is even rarer. Prompt recognition is emphasized, because it is a treatable condition.

Adult↗