Synchronism of reverse ocular bobbing and blinking.
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Biomedical subjects
Publications and source records attributed to J Berney.
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In Geneva at autopsies, 4.8% of the cranial cavities contained metastasis of any origin (872 cases in 19 years), which in 21 cases was prostatic (2.4%). During 7 years, 7592 autopsies were performed, and 159 prostatic cancers discovered (2.1%), among them 10 had intracranial metastasis, in each case in association with other localisations. Multiple localisations were present in 70 cases (44%), unique localisation in 26 cases; no metastasis were discovered in 63 cases (40%). The most frequent localisation was bone. The mean age was 70.5 years when an intracranial localisation was present, 78.3 years when not. Only 3 cases out of 21 were admitted in a neurological or neurosurgical ward and no intracranial operation was performed. This can explain why intracranial mestastasis of prostatic carcinoma is usually considered as a rare condition.
The value of the Glasgow coma scale is definite and widely accepted. It is a help in teaching a difficult subject, in mutual understanding in a few words, and in comparison of cases. It uses accurate and practical observations. It is the best method of measuring the state of consciousness, provided observation of the diameter and light reaction of the pupils is added It avoids what Jamieson and Yelland feared in 1968. "It is tragic if the wardmaid assesses deterioration by recognizing that a patient is not as bright now as earlier while trained staff await the development of the next stage in their preconceived, rigid scale of deterioration."
We studied two patients with eyelid nystagmus induced by ocular convergence. The first patient, a 29-year-old man, had the signs of a cerebellar syndrome after sustaining severe craniocerebral injuries. The second patient, a 12-year-old girl, had a tumor of the anterior vermis cerebelli. After treatment with corticosteroids (Patient 1) and surgery (Patient 2), the eyelid nystagmus gradually disappeared. An alteration in the cerebellar system is the most likely cause of convergence-evoked nystagmus.
Clinical presentation, radiological aspects, surgical treatment and histology of a case of an ependyma-lined cyst of the pons are depicted. Slight psychomotor retardation and long-standing neurological signs associated with a marked dolichocephalic skull and right aortic arch suggest a congenital anomaly. Differential diagnosis of cystic lesions in the posterior fossa is discussed.
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Using a cytochemical staining technique, peripheral blood monocytes have been precisely identified and enumerated in patients with inflammatory bowel disease and compared with healthy and disease control subjects. For ulcerative colitis there was a significant monocytosis, which was closely correlated with the total white cell count and with the activity of the disease. For patients with Crohn's disease, the peripheral blood monocyte count was also raised compared with that of the control groups, but the difference did not reach statistical significance. There was no correlation between the monocyte count in patients with Crohn's disease and the total white cell count or the disease activity. Some of the mechanisms that may influence the production and distribution of peripheral blood monocytes are discussed.
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Two cases of tumours - a pleomorphic poorly differentiated malignant neoplasm and a juvenile angiofibroma - involving the orbit and extending to the base of the skull are reported. In both cases computerized tomography showed with great precision the localization and the extension of the tumours.
The authors report two cases of posttraumatic hematoma in the orbit. The first patient presents an unilateral amaurosis through indirect trauma of the optic nerve. The computerized tomography reveals a hematoma of the optic nerve sheath, confirmed by surgery. The second patient presents a posttraumatic limitation of the ocular motility and the computerized tomography reveals a hematoma of two extraocular muscles.
The swiss neurosurgeons were asked to give their own politics on prophylactic antibiotics. The results of this enquiry are given. Post-operative infections in the Neurosurgical Clinic of Geneva in a four-year period were at a satisfactorily low rate and demonstrated the importance of many factors of risk. Guide lines for a reasonable prophylaxis in three groups of operations are given, with a precise schedule for each group. It is suggested that ones own surgical technique be severely criticized before considering prophylactic antibiotics.
An internuclear ophthalmoplegia was diagnosed and recorded electro-oculographically in a patient with pontomedullary listeriosis. The etiological differential diagnosis in case of internuclear ophthalmoplegia is discussed. It is emphasized that listeria monocytogenes encephalitis should be considered because this pathology may be electively located in the pontomedullary area and because of the encreasing frequency of human listeriosis.
In a survey of 29 hydrocephalic children treated by ventriculoatrial shunt (Holter valve) with a follow-up of 4 years, EEG records before the operation and at least once a year thereafter, the authors can support the view that an epileptogenic focus has developed around the place of insertion of the ventricular catheter in 19 cases, leading to epileptic seizures in 17 up to now. Thus the incidence of convulsions in this particular group of patients is 0.59 (17/29), the limits of confidence 95% being 0.39-0.76. The irritative abnormalities occur usually during the second year after the operation and the delay for the onset of clinical seizures is variable. The age at operation seems to influence the occurrence of the epileptogenic scar. The type of hydrocephalus and especially the presence of an associated cerebral focal lesion can be of importance in the development of clinical seizures.
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