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Biomedical subjects

G Arnott

Publications and source records attributed to G Arnott.

At least 37 records · Page 2Linked to original sources

[Juvenile distal cerebral ischemia: value of pulp biopsy].

Juvenile distal cerebral ischemia has been attributed to small artery atherosclerosis (Arnold, Benoit, Merlen, Dobbelaere, Delandsheer, 1979), based on clinicopathologic findings in one male patient and results of big toe pulp biopsy in three other cases. Pathological findings were obstruction of small artery lumens by hypertrophic endothelium and loose fibrocellular bands, their origin being the result possibly of partial intimalization of media by elastic neogenesis. Appearances were similar to those described by Dahl in human cerebral atherosclerosis in 1976, and approached those of the initial stages of experimental atheroma (Ross, Glomset, 1976). Arterial exiguity was also present in the 4 cases. Results of biologic, metabolic, inflammatory and immunologic examinations were negative. The present study concerns 4 additional cases of juvenile distal encephalic ischemia. One case in a female patient not on oral contraceptives confirmed the hypothesis of intimalization of media of arterioles of big toe pulp. Elastic neogenesis was present in the tunica media in areas where there was a change of direction of myocytes, and was apparent at a distance from the internal elastic layer. The latter was fragmented, sometimes doubles and of variable color. In another case, a woman taking oral contraceptives, there was almost total obstruction of the pulp arteriolar lumens with a very thin tunica media. Elastic neogenesis encircled two very narrow lumens in the center of the vessel and there were also elastic changes common to both.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Chorea and systemic lupus erythematosus with circulating anticoagulant. 3 cases].

Circulating anticoagulant was detected during the course of choreic manifestations in three young women with systemic lupus erythematosus, associated in two cases with false syphilitic serology due to the presence of antiphospholipid antibodies. The high prevalence of the presence of these antibodies in lupic chorea was confirmed by reports of 41 cases in the literature. These findings could suggest a possible pathogenic role for these antibodies in choreic manifestations by either a thrombotic or auto-immune encephalitis mechanism.

Adolescent↗

[Medullary compression due to vertebral angioma in pregnancy. A case treated by embolization].

A previously healthy 24 year old woman presented a progressive paraplegia during the third trimester of her second pregnancy. Partial improvement occurred after caesarian. The neuroradiological study revealed spinal cord compression by an extensive corporeo-pedicular angioma of the T2 vertebrae. Almost total recovery occurred after selective embolization. The occurrence of neurological complications of vertebral angiomas during pregnancy is rarely reported in the literature. Mechanisms of the spinal cord compression and their relations with the pregnancy are discussed and difficulties for diagnosis and treatment are emphasized. When technically possible, the embolization appears to be the most adapted treatment, especially for these extensive types of vertebral angioma.

Adult↗

[Gerstmann-Sträussler-Scheinker disease. Anatomoclinical and genealogical study].

The patient has been examined clinically and his brain examined. Four related patients are known by hospital records, and two others by history. The mode of transmission is compatible with a mendelian autosomic dominant mechanism through three generations, but the line appears to be broken at the further ascending generation with both parents dying too old to be affected. The disease begins in the early thirties, with tremor and frequent falls; intellectual impairment is soon obvious. Later on, the patients are demented, unruly; a marked dysarthria and severe intention and opposition tremor in the trunk and the extremities are present. Midline reflexes are brisk, other reflexes are normal, a Babinski response is not obtained. Laboratory and E.E.G. data are non contributive. At a terminal stage, the patient is bedridden, cachectic, with extensor hypertonia of the lower extremities and flexor hypertonia of the upper extremities. Total course is about seven years. Neuropathological findings in the propositus were almost entirely restricted to the cerebellar cortex, the molecular layer of which is moderately atrophic and gliotic, and contains numerous plaque-like formations without neuritic component, but differing from kuru plaques by the absence of amyloid characteristics. The condition may be nevertheless ascribed to Gerstmann-Sträussler-Scheinker disease, understood as a provisional clinicopathology group, pending further transmission experiments.

Adult↗

[Total right hemispherectomy: neurophysiological study after twenty-six years].

Twenty-six years after a total right hemispherectomy for tumor when thirteen years old, a right-handed patient presented with disturbances of equilibrium, urinary incontinence, and a marked reduction in motor impulses, in spite of a subnormal intelligence quotient (0.85). Computed tomography examinations suggested the presence of a normal pressure hydrocephalus. However intracranial pressure monitoring and isotopic and cerebrospinal fluid perfusion tests showed the absence of any cerebral obstruction, and free communication between the cerebral and spinal spaces, though intracranial volume capacity accommodation was greatly reduced. Clinical examination demonstrated good quality sensory appreciation by the left half of the body, the possibility of detecting an object in the visual hemifield supposedly blind, and perfect location of a sound source. Somesthetic evoked potentials were studied by stimulating the median nerve in the left and right wrist regions. Left hemisphere evoked potentials from a contralateral stimulus, were of normal latency, amplitude and morphology, the response to an ipsilateral stimulus also presenting an early potential component (N 26 starting at N 21). This exceptional finding in a hemispherectomized patient could be related to activity of the spinoreticulothalamic tracts in the lemniscal or extralemniscal systems. Auditory function tests demonstrated perfect stereoaudiometry and the quality of perception during dichotic listening tests. Auditory evoked potentials in the brain stem included only minor functional-type anomalies, with slightly increased latencies in the pons on the left, and the mesencephalon and pons on the right. The presence of a bilateral wave VI was related to activity of the median geniculate pathway. Visual function tests showed good quality left photomotor reflexes and positive object detection in the anopsic hemifield. Results of these tests were reproducible during the same examination and after an interval of several months. The relevant literature is reviewed.

Adolescent↗

[Successive encephalic ischemic accidents in a young patient: Buerger's disease, buergerian syndrome, or juvenile atheroma? A report in clinical, angiographic, and anatomical findings in one case, compared to three other ones, in which a biopsy of the pulp of the toes was also performed (author's transl)].

A man of 19 years of age was found to have a diffuse livedo, a quadruple asphyxic acrosyndrome, and dementia. Angiography confirmed the presence of distal ischemia with multiple circulatory blocks and a reduced distal network. The patient died at the age of 25 years and histopathological examinations of the vessels demonstrated obstructive atheromatous lesions in the medium sized and small arteries of the brain and viscera. By comparing these findings with those observed in three other cases, in which biopsy of the pulp of the toe was also performed, the hypothesis can be advanced that these juvenile encephalic ischemic accidents are caused by atheroma, which can be detected, at an early stage, by studying the distal arteries in the finger or toe pulp.

Adult↗