Drug management of adult vascular headaches (migraine and cluster headache): Part I--Treatment of the acute attack.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to H Damasio.
Explore the source record for details and available documents.
This article presents a system of human brain templates, depicting territories of cerebrovascular supply and cortical cytoarchitectonic markings. The templates may be used as a guide to localization of abnormal images in standard computed tomographic cuts.
A patient struck with transient amnesia was able to write a detailed account of her experiences during the episode and retained partial memory of the event. The analysis of her report permits an unusual view of transient partial amnesia.
We compared the computed tomographic (CT) scans of 46 patients with dementia with those of 46 normal subjects matched for age and sex. We measured the areas subtended by the third ventricle, frontal horns, bodies of the lateral ventricles, and interhemispheric fissure as depicted in CT sections, then determined the ratio between each of those areas and the entire brain at each level. Patients with dementia had significantly larger ratios on all measures. A multivariate classification procedure showed that a composite formula of two measures, the bodies of the lateral ventricles and the interhemispheric fissure, predicted clinical status in 84% of the cases. Findings indicated that some CT measurements reflected cerebral changes associated with dementia. If appreciated in a suitable probabilistic framework, these data may be clinically useful in supporting or weakening the diagnostic hypothesis of dementia in the many cases in which diagnosis is unclear.
The behavioral and anatomic correlates of pure alexia were analyzed in 16 patients. Right homonymous hemianopia failed to appear in three patients, who had right achromatopsia instead. Color anomia and unilateral optic ataxia were seen in six patients. Memory defects were found in two patients. Visual agnosia was noted in two. No patient had visual disorientation. The crucial anatomic correlate of alexia was a lesion of the paraventricular white matter of the left occipital lobe, capable of compromising both interhemispheric and intrahemispheric visual pathways. The lesion associated with color anomia was in the mesial occipitotemporal junction of the left hemisphere.
Atypical aphasia syndromes were associated with circumscribed nonhemorrhagic infarctions of the anterior limb of the internal capsule and of the striatum, in the dominant hemisphere. None of the several cases could be classified in terms of the classic cortical aphasia syndromes, nor did they correspond to the description of aphasia produced by hemorrhage in the thalamus or putamen. Control subjects without aphasia had lesions in the same structures of the nondominant hemisphere, or they had comparably circumscribed damage, which was located lateral or caudal to the previously indicated locus. The findings raise the question of participation of the dominant striatum, and of the connectional systems that course in the anterior limb of the internal capsule, in language processing.
Critical analysis of postmortem and CT scan data indicates that prosopagnosia is associated with bilateral lesions of the central visual system. Those lesions are located in the mesial occipitotemporal region and are functionally symmetric. The prime factor in the appearance of prosopagnosia is the requirement to evoke the specific context of a given visual stimulus. The "ambiguity" of the stimulus (the frequency with which different members of a group are visually similar) is an adjuvant factor. But prosopagnosia is not specific to human faces. The phenomenon appears in relation to any visually "ambiguous" stimulus whose recognition depends on contextual memory evocation.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
An analysis of the computerized tomography scans of 17 patients with autistic behavior was carried out by investigators independent from those selecting the subjects. Mild abnormalities of the ventricular system were noted in several scans (increased size, altered left/right relation of lateral ventricles), and in three scans major hydrocephalus and circumscribed lesions of the parenchyma were seen. It was not possible to discern a singular abnormal pattern, the abnormalities appearing consequent to a variety of disease processes of the CNS.
Twenty-one patients with cluster headaches participated in an open trial to assess the effectiveness of lithium carbonate in the acute treatment and prevention of cluster headaches. Three women and 18 men ranging from 28 to 70 years of age were divided into episodic cluster [8] and chronic cluster [12]. One patient was in his first cluster. The chronic cluster group was further subdivided into primary chronic (5 patients) and secondary chronic (5 patients). In 11 patients there was absolute improvement, in 5 patients there was partial improvement and in 5 patients there was either no response or the improvement was not sustained. Beneficial results were obtained with dosages lower than those used for effective treatment of bipolar illness. It appears that lithium can be a useful drug in the treatment of cluster headaches provided drug levels and renal function are carefully monitored. No serious effects were noted.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The neuropsychologic, neuroanatomic, and neurophysiologic correlates of achromatopsia were studied in two patients. Prosopagnosia accompanied the color perception defect in the bilateral case but not in the unilateral one. No other neuropsychologic disturbance was present in either case. The lesions compromised the ventromedial sector of the occipital lobe in both cases. Cerebral evoked responses produced by pattern shift stimulation were normal for black and white but abnormal for red and green, when stimulation was given in the achromatopsic field.
Explore the source record for details and available documents.
"Paradoxic" extinction in dichotic listening tasks has been attributed to lesions in the interhemispheric auditory pathways, the anatomic courses of which are unknown. The localization of cerebral lesions related to abnormal patterns of dichotic listening was studied in computerized tomographic (CT) scans with a method of anatomic templates. Paradoxic extinction was found consistently with lesions near the lateral wall of the lateral ventricles at the level of the trigone in both left and right hemispheres. On the basis of these findings, we propose that the pathway leaves the auditory cortex traveling backward and upward to arch around the lateral ventricles and join the callosum in its posterior region.