Takeuki and Nishimoto's syndrome has been described as more common though not exclusive in the Japanese people; it occurs in the pediatric or young adult age. The clinical syndrome is most variable (transitory ischemic attacks or circulatory insufficiencies with permanent neurological deficit, as well as subarachnoid hemorrhage). Conversely, the angiographic syndrome is quite typical: I) stenosis of both internal carotid arteries and the anterior part of Willis circle; II) presence of an angiomatous net at the level of the basal ganglia; III) presence of several anastomosis between internal and external carotid arteries. The essential pathogenetic event seems to be the slow occlusion of the two internal carotid arteries and of the anterior part of the anterior part of the circle of Willis of unknown aetiology. The observations reported in the present article cover angiographic, nefrological, microbiological, metabolic and immunological studies in a clinical case of Takeuki and Nishimoto's syndrome. This was clinically revealed by a subarachnoid hemorhage, indicating that carotid stenosis may be a fairly selective process. The temporal evolution of such a process and the slow invasion of distal arterial segments support the interpretation of the process itself as not congenital.

Adult↗

PubMedDate not supplied

Kinking and coiling of the internal carotid artery: Clinical-statistical observations and surgical perspectives.

The incidence of kinking and coiling of the internal carotid artery in an unselected series of 1,010 angiographies is reported. The angiographies of patients with cerebrovascular insufficiency and those of patients with other brain diseases were separately reviewed. On the basis of a statistical comparison, the finding of kinks and coils appears significantly higher in "vascular" than in "non-vascular" patients. The greater difference concerns age subgroups up to 50 years. These data give support to the assumption that both kinking and coiling of the internal carotid artery may play a role in determining cerebral ischemic attacks. Surgical experience concerns a series of 19 patients operated by various corrective procedures, including resection of the internal carotid artery and end-to-end anastomosis. It is felt that surgery, performed in appropriately selected cases, can afford significant benefits to cerebrovascular patients, especially those presenting recurrent ischemic episodes.

Adult↗

PubMedDate not supplied

Neuroleptic malignant syndrome: description of two cases with prolonged clinical course.

Two cases of neuroleptic malignant syndrome presenting an unusual clinical course are reported. The first patient was untreated for the syndrome and recovered completely only after four months, while the other one was given dopaminergic and myorelaxing drugs only 10 days after the onset of the symptoms and died about six months later with an unmodified clinical picture. In both cases the treatment seemed to influence the clinical course, a delay or lack of drug intake worsening the prognosis.

Adult↗

PubMedDate not supplied

Voiding disorders in patients with cerebrovascular disease.

Eighty patients affected by ischemic cerebrovascular disease (ICVD) in stable conditions were studied: brain CT scan was performed in all patients to evaluate site/extension of brain injury, while urodynamic tests were employed in those patients who showed urinary bladder symptomatology (n = 30). Twenty-six complained of urgency and urge incontinence, only 4 patients showed urinary retention. Micturition abnormalities seem to occur mostly in patients with multiple infarcts and cerebral atrophy and particularly among those with bilateral lesions.

Aged↗

PubMedDate not supplied

[Analysis of rapid eye movements in sleep in insomnic patients treated with flurazepam and phenobarbital].

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Adult↗

PubMedDate not supplied

[Behavior of facial paraspasm during various phases of physiological nocturnal sleep].

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Adult↗

PubMedDate not supplied

[Longitudinal study of 5 patients with "primary empty sella" (author's transl)].

The clinical symptoms and the radiographic findings of five female patients with "primary empty sella" were studied. The patients were treated with corticosteroid therapy and the clinical syndrome, with the exception of optic subatrophy of the left eye in one patient and of both eyes in another patients, improved in all of them. In subsequent controls, the radiographic findings did not show any evolution suggesting that the cause of the empty sella syndrome is a potentially regressive element (endocranial hypertension?). The small number of our cases does not prove with any certainty that corticosteroid treatment, was beneficial but as improvement occurred and in all the subjects this therapy should be tried in other patients with "empty sella" syndrome. The possible improvement of the empty sella syndrome has to be taken into account before deciding on surgical intervention.

Adrenal Cortex Hormones↗