The effect of antihypertensive therapy withdrawal in acute ischaemic stroke patients was assessed in order to establish possible correlations between blood pressure values and the modified Rankin Scale (mRS) outcome. One hundred and twelve consecutive patients with acute ischaemic stroke and hypertension were treated with relatively similar regimen. Seventy-two hours following the onset of stroke, systolic blood pressure decreased to < or = 180 mmHg in 110 patients. Antihypertensive therapy was randomly discontinued in 59 patients. Clinical outcome and mortality were compared in patients with and without antihypertensive therapy withdrawal, no statistically significant differences (p > 0.05) between the two groups being found. Statistically significant positive correlations (p < 0.05) between mRS outcome and the decrease of systolic and diastolic blood pressure values were in patients treated with anticoagulant and antihypertensive therapy. Statistically significant negative correlations (p < 0.05) between mRS outcome and low levels of diastolic blood pressure were noted in patients who discontinued antihypertensive therapy. Our findings emphasize the need to associate antihypertensive and anticoagulant therapy in acute ischaemic stroke patients with hypertension. Spontaneous decrease of diastolic blood pressure values showed poor outcome. The management of hypertension associated with acute ischaemic stroke should be reconsidered.

Aged↗

PubMedDate not supplied

Neuromyotonia in alcoholic patients with gastrectomy.

Four patients with severe muscle cramps were reported. In two of them the electrical signs of neuromyotonia were demonstrated. All the patients had undergone gastrectomy and all were immoderate consumers of alcohol. The neuromuscular disorder was reversible in all the patients.

Adult↗

PubMedDate not supplied

Amino acid content of the brain in rats focal penicillin induced epilepsy.

The initial objective of the present study was to investigate the role of excitatory and inhibitory amino acids in generalized as compared to focal epilepsy, both forms being induced by the same convulsant agent, i.e. penicillin. Our attempts to obtain in the rat the generalized epilepsy, constantly induced in cats by systemic administration of penicillin, were unsuccessful. This is probably due to the rudimentary development of the cerebral cortex in rodents as compared to the feline cortex. The tentative conclusion was drawn that the cortex is the brain structure mainly involved in the genesis of petit mal seizures. Penicillin was applied to the cortex of 40 white Wistar rats and the electrical cortical activity was registered. The concentrations of glutamate, aspartate, glycine, GABA and serine were determined in the cerebral cortex, the brain stem and the cerebellum. The same amino acids were determined in the brain of 20 controls. No significant changes in the amino acid contents were obtained in the cerebral cortex. In the brain stem the glutamate level was significantly increased while the glycine content was markedly decreased. These findings are consistent with the involvement of the brain stem structures in seizure activity.

Amino Acids↗

PubMedDate not supplied

Increased susceptibility to audiogenic seizures following withdrawal of progesterone.

This investigation was performed to verify a previous hypothesis which correlates the catamenial seizures with the stoppage of progesterone secretion. White rats from a Wistar strain were tested with an electric bell. Thirty-five animals refractory to the acoustic stimulus were selected for the experiment. Each animal received 9 daily injections with progesterone, 5 mgr/day. The animals were tested with the acoustic stimulus after the 5th and the 9th injections, 24 hours after the administration of the last dose. Audiogenic seizures were obtained in 29.4% of the rats tested after 5 injections and in 40.0% of the rats tested after the 9th injection. The increased seizure susceptibility lasted 3-8 days after the hormone withdrawal. In conclusion, the withdrawal of high doses of progesterone exerts a seizure-activating effect.

Acoustic Stimulation↗

PubMedDate not supplied

Transient peripheral ischemia may restore quickly the motility in patients with compression neuropathy.

Transient ischemia of the extremities was applied in compression or traumatic neuropathies affecting radial nerve (17 cases), ulnar nerve (3 cases), upper brachial plexus (4 cases) or peroneal nerve (10 cases). The limb opposite to that displaying paresis was submitted repeatedly to a 15-minute-period of ischemia every other day for two weeks. The procedure induced in most patients (27 out of 34 cases) a motor improvement of variable degree. In some patients (13 cases) the motor recovery occurred two days or more after starting the procedures, while in others (14 cases) during the very day in which the initial session of ischemia was made or even during the first hour of procedure application. The most beneficial effects of peripheral ischemia were noted in compression neuropathy of peroneal nerve palsy, 9 out of 10 patients with such a disorder being improved by the procedure. We suppose that the method of therapy proposed by us restores promptly the motility of patients with compression neuropathy by inducing a long-lasting activation of some central neural mechanisms.

Adult↗

PubMedDate not supplied

The cerebral content of excitatory and inhibitory amino acids in rats following withdrawal of antiepileptic drugs.

The aim of the present study was to investigate the role of amino acids in the increased seizure susceptibility induced by withdrawal of antiepileptic drugs (AEDs). Fifty white Wistar rats treated with AEDs and 30 controls were used. The animals were previously exposed to the acoustic stimulus and only the non responsive were used. The administered AEDs were morphosuximide, ethosuximide, phenobarbital, valproate and gluthetimide. The treatment was discontinued after 2 weeks. The acoustic stimulation was repeated after 2-4 days of abstention. The animals were sacrificed and the amino acids glutamate, aspartate, GABA, glycine and serine were determined in the cortex and the brain stem. The withdrawal of AEDs induced seizure susceptibility in 71% of the rats treated with phenobarbital and in 76% of those receiving morphosuximide. A significant increase of glutamate levels was found in the brain stem following withdrawal of both morphosuximide and ethosuximide. The level of GABA was elevated in the brain stem after valproate and morphosuximide withdrawal. The increase of glutamate concentration can be correlated with the increased seizure susceptibility. The unexpected rise of the GABA level could be interpreted as a compensatory inhibitory mechanism.

Acoustic Stimulation↗

PubMedDate not supplied

Degenerative neuromuscular diseases with a late onset. Clinical, electrophysiological and morphological study.

This study carried out clinical, electrophysiological and morphological investigations (sural nerve and gastrocnemius muscle biopsies) in a group of 47 patients with neuromuscular disease of a certain or supposed degenerative origin and a late onset (over the age of 30 yrs.). It aimed the evidence of the eventual particularities of such diseases with a delayed onset. The equal involvement of sexes, the insidious onset, the clinical picture similar to that of the corresponding diseases with an onset at the usual age were observed. Regardless of the age, some interesting associations of the polyneuropathy with other diseases or its presence with in these diseases (Parkinsonism, Addison's disease, multiple symmetrical lipomatosis, etc.) were noticed, too. Electrophysiological examinations showed no particularities. Neither did the muscular morphological picture in most of the cases presenting neurogenic lesions with a moderate intensity. The sural nerve biopsy evidenced in 70% of the cases a moderately intense neuropathy of an axonal type ("dying back"), with or without secondary lesions of segmental demyelination and with the signs of a live regenerative activity.

Adult↗

PubMedDate not supplied

Ménière's attacks associated with facial paralysis.

An 85-year-old man developed in the last 5 years three attacks on Ménière's syndrome associated with facial paralysis. The syndrome could be interpreted as a transient ischemic attack in the territory of the anterior inferior cerebellar artery. An alternative hypothesis could be to admit a Ménière's disease with compression of the facial nerve during the attacks of labyrinthine hydrops.

Aged↗

PubMedDate not supplied

Carotid endarterectomy.

Our study is based on 102 patients who underwent 104 carotid endarterectomies between 1980 and 1992. Sixty-three patients (61.8%) has surgery at left carotid artery bifurcation. 37 (36.2%) at right carotid artery bifurcation and in 2 cases (1.96%) the operation was performed at both carotid bifurcations. The patients' age ranged from 33 years to 73 years. The most frequently affected age group was between 41 and 50 years (47 cases). Postoperative death due to myocardial infarction occurred in one patient and other patient developed thrombosis of the internal carotid artery operated on. The remaining patients had a good surgical outcome.

Adult↗

PubMedDate not supplied

Epiliptic discharges induced by hypothalamic cobalt focus in chronic cats.

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Animals↗

PubMedDate not supplied

The present status of encephalitis lethargica.

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Adolescent↗