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48 records · Page 3Linked to original sources
PubMed1998

Somatosensory discrimination deficits following pediatric cerebral malaria.

Pathologic studies of central nervous system damage in human falciparum malaria indicate primary localization in the cerebral white matter. We report a sensory-perceptual investigation of 20 Ghanaian children with a recent history of cerebral malaria who were age-, gender-, and education-matched with 20 healthy control subjects. Somatosensory examinations failed to show any evidence of hemianesthesia, pseudohemianesthesia, or extinction to double simultaneous tactile stimulation. While unilateral upper limb testing revealed intact unimanual tactile roughness discrimination, bimanual tactile discrimination, however, was significantly impaired in the cerebral malaria group. A strong negative correlation (r = -0.72) between coma duration and the bimanual tactile roughness discrimination test was also found. An inefficiency in the integrity of callosal fibers appear to account for our findings, although alternative subcortical mechanisms known to be involved in information transfer across the cerebral hemispheres may be compromised as well.

Adolescent↗
PubMed1999

Cerebral arterial gas embolism in air force ground maintenance crew--a report of two cases.

Two cases of cerebral arterial gas embolism (CAGE) occurred after a decompression incident involving five maintenance crew during a cabin leakage system test of a Hercules C-130 aircraft. During the incident, the cabin pressure increased to 8 in Hg (203.2 mm Hg, 27 kPa) above atmospheric pressure causing intense pain in the ears of all the crew inside. The system was rapidly depressurized to ground level. After the incident, one of the crew reported chest discomfort and fatigue. The next morning, he developed a sensation of numbness in the left hand, with persistence of the earlier symptoms. A second crewmember, who only experienced earache and heaviness in the head after the incident, developed retrosternal chest discomfort, restlessness, fatigue and numbness in his left hand the next morning. Both were subsequently referred to a recompression facility 4 d after the incident. Examination by the Diving Medical Officer on duty recorded left-sided hemianesthesia and Grade II middle ear barotrauma as the only abnormalities in both cases. Chest X-rays did not reveal any extra-alveolar gas. Diagnoses of Static Neurological Decompression Illness were made and both patients recompressed on a RN 62 table. The first case recovered fully after two treatments, and the second case after one treatment. Magnetic resonance imaging (MRI) of the brain and bubble contrast echocardiography performed on the first case 6 mo after the incident were reported to be normal. The second case was lost to follow-up. Decompression illness (DCI) generally occurs in occupational groups such as compressed air workers, divers, aviators, and astronauts. This is believed to be the first report of DCI occurring among aircraft's ground maintenance crew.

Adult↗
PubMed2000

[Pontine hemorrhage presenting with Foville syndrome and transient contralateral hyperhidrosis].

This report concerns a 88-year-old diabetic and hypertensive woman with pontine hemorrhage who presented with Foville syndrome and contralateral hyperhidrosis. She was admitted to our hospital for sudden onset of headaches and disturbed consciousness. Neurologic examination revealed bilateral miosis, Foville syndrome and superficial hemianesthesia on the right side of the face and body. No associated Horner syndrome and other autonomic dysfunction were observed. Laboratory data were normal except for diabetic findings. Brain CT and MRI revealed a hematoma in the left side at the lower pons. One month after the onset, hemihyperhidrosis on the face, arm and upper trunk contralateral side of the lesion appeared abruptly, and gradually disappeared a week later. Sweating on the ipsilateral side was normal and no new lesion was seen on the brain CT then. Only a few cases of contralateral hyperhidrosis due to pontine lesion have been reported. We suggest that the contralateral inhibitory sweating pathway was disrupted though the ipsilateral excitatory one was intact. Contralateral hyperhidrosis attributed to imbalance of the perspiratory control can be observed in the subacute or late phase after pontine hemorrhage.

Aged↗
PubMed2003

[Primary central nervous system lymphoma in a patient with systemic lupus erythematosus].

A 36 year-old woman with systemic lupus erythematosus was admitted to our hospital with headache, brachiocrural hemiparesis and hemianesthesia. She had been treated with prednisone and cyclophosphamide. CT scan and MRI revealed a 15 mm nodular mass enhanced with gadolinium in left frontal convexity. CNS biopsy was performed and a diffuse large B-cell lymphoma was diagnosed. She was treated with radiation therapy without response and died. There are few reports of erythematosus systemic lupus associated with primary central nervous system lymphoma.

Adult↗
PubMed2005

[A case of aphasia with preserved repetition due to anterior choroidal artery territory infarction].

A 55-year-old right-handed male patient with atrial fibrillation was admitted to our hospital because of a sudden disturbance of consciousness and right hemiparesis. Neurological examinations revealed left conjugate deviation of the eyes, aphasia, right hemianopsia without macula sparing using a Goldmann perimeter, right hemianesthesia, and right hemiparesis. Magnetic resonance imaging showed low intensity areas (left posterior limb of internal capsule, left cerebral peduncle of middle brain, a part of left substantia nigra, left amygdala, ventral posterior lateral nucleus and ventral anterior nucleus of left thalamus, left lateral geniculate body, and left occipital lobe) in T1 weighted image, due to the infarct in the left anterior choroidal artery territory. Aphasia in this case was accompanied with non-fluent speech, good repetition, naming deficits, and perseveration. We suggest that aphasia with anterior choroidal artery syndrome cannot be classified using the conventional system, and emphasize the importance of accurate descriptions of the symptoms characteristic of aphasia with anterior choroidal artery.

Aphasia↗
PubMed2006

[Endovascular treatment of posterior cerebral artery aneurysm: analysis of 21 patients].

OBJECTIVE: To investigate the effect of endovascular treatment on posterior cerebral artery (PCA) aneurysm. METHODS: The clinical data of 21 patients with PCA aneurysm, 12 males and 9 females, aged 3 - 60, totally 22 aneurysms, 3 located in the P1 segment, 16 (in 15 patients) on the P2 segment, and 3 being serpentine aneurysms and involving P2-3 segment, were analyzed. One patients gave up treatment, 6 patients, with 7 aneurysms, underwent aneurysm sac occlusion, and 14 patients underwent parent vessel occlusion. RESULTS: Complete aneurysm sac occlusion was achieved in 5 patients with 6 aneurysms, and incomplete occlusion was achieved in 1 patient who died of bleeding of aneurysm the next day after the operation. All 14 patients undergoing parent vessel occlusion survived without aneurysm detected by angiography, among which 3 presented hemianesthesia of the contralateral side and 2 recovered completely. CONCLUSION: Endovascular treatment is safe and effective for PCA aneurysm.

Adolescent↗
PubMedDate not supplied

[Attacks of acute headache (author's transl)].

Acute headaches are in most cases significant symptoms or premonitary signs of a neurological condition. From a semiological point of view, they may be: (i) isolated, (ii) associated with neurological symptoms (ophtalmoplegia, hemiplegia, hemianesthesia...). From an etiological point of view, the haemorragic conditions are predominant (30%): encephalic vascular malformation with or without subarachnoidal haemorragia (21%), subarachnoidal haemorragia without malformation (6%) and subdural haematoma (3%). Two types of conditions are also frequently observed: ischemic attacks (22,3%) and inflammatory meningeal syndromes (12%). Rare cases with hypophyseal adenomas, ischemic attacks under oestro-progestative treatment, accidents of mono-amine-oxydase inhibitors and multiple sclerosis are observed. 23,8% of the cases remained without any precise diagnosis. One of the interesting points in the acute headache issue is the possibility of discovering an encephalic vascular malformation without any important bleeding and, therefore, good conditions for surgery.

Acute Disease↗
PubMed1983

[Anterior choroidal artery syndrome. Clinical and computed tomography study of 4 cases].

The author choroidal artery syndrome is a rare disorder associating, in its complete form, a hemiplegia, a hemianesthesia, and a homonymous lateral hemianopia. Four cases are reported in which the diagnosis was confirmed by a CT scan, which demonstrated a low density area in the posterior part of the posterior limb of the internal capsule, sparing the thalamus medially, and extending laterally to the apex of the pallidum thus corresponding to the area supplied by the anterior choroidal artery. The incomplete forms of this syndrome and clinicopathological correlations are discussed.

Aged↗
PubMed1982

[Dejerine-Roussy syndrome].

The description of the thalamic syndrome by J. Dejerine and G. Roussy in 1906 was a consecration of the clinicopathologic method, announcing the end of discussions relative to the role of the thalamus as a sensorial relay center, discussions opposing B. Luys to Türk and to Charcot and which animated the end of the 19th century. Since then, the thalamic syndrome has not ceased to arouse the attention of neurologists, who have developed four major themes: the specificity of the thalamic hemianesthesia; the mechanism of the central pain; the semiologic value and physiopathology of the abnormal movements; and finally the pupillary and vasomotor disorders. Exploration of each of these topics led to a definition of neurologic semiology and to the development of neurophysiology during the second half of the XXth century. By reviewing this the confrontation between different men and schools appears behind the opposition of ideas. The revision of the thalamic syndrome ceased when the discovery of the non-specific functions of the thalamus opened the way to new concepts. Dejerine-Roussy's syndrome expresses the semiology of the relay nuclei. For the last thirty years, experience has accumulated on the semiology of lesions affecting the nuclei of convergence. Neuropsychology of thalamic lesions has demonstrated the regulatory role performed by the thalamus within each hemisphere and in the relative activation of each hemisphere. But this is another story.

France↗
PubMedDate not supplied

[Capsulo-thalamic hemorrhage (author's transl)].

The authors report clinical and scanographic findings in 26 cases of capsulo-thalamic hemorrhage. They stress the frequency of arterial hypertension as a pre-disposing factor. The clinical picture is represented by the association of disorders of consciousness (usually obnubilation), contralateral flaccid hemiplegia with hemianesthesia, oculomotor disorders (disturbance of vertical gaze, miosis) and disorders of linguistic and motor behaviour. The paraclinical examination of choice is scanography which enables the site, volume and extent of the hemorrhage to be estimated, together with the mass effect and intraventricular rupture. Clinical and scanographic follow-up indicates a favourable prognosis for capsulo-thalamic hemorrhage (77% survival). Follow-up findings point to several unfavourable prognostic factors: immediate coma, persistent and massive flaccid hemiplegia, hemorrhage size exceeding 3 cm, and severe intraventricular rupture. In the light of the data in the literature, the authors discuss the clinical and scanographic signs of capsulo-thalamic hemorrhage.

Aged↗
PubMed1995

Cerebral embolism during revision arthroplasty of the hip.

Cerebral embolism poses one of the most perplexing problems in cerebrovascular disease; fat emboli and marantic air emboli occur occasionally. However, the most common cause for a cerebral embolism is degenerative changes in the central arteries. The authors report the case of a 75-year-old female suffering from ischemic cerebrovascular disease of the left dominant hemisphere during a revision arthroplasty of the right hip (cementless Austin Moore hemiarthroplasty to a cemented Charnley total hip replacement); a cement gun was used to introduce the cement; both the induction of anesthesia and the surgical procedure were uneventful. The patient awoke slowly, and when awake she showed a combination of contralateral hemiplegia, and right hemianesthesia with global aphasia; the CT scan showed an ischemic lesion in the territory of the middle cerebral artery; during the following two weeks the patient showed complete recovery from the clinical syndrome. This complication must be recognized by every orthopedic surgeon, and a high clinical index of suspicion remains essential to early diagnosis.

Aged↗
PubMed1995

Multiple cerebral cavernous angiomas. Case report.

This 26-year-old woman was admitted to Neurosurgery Department in 1972 for the first time due to increased intracranial pressure and since observed and treated by ventriculo-peritoneal shunt during next twenty years. First symptoms such as visual disturbances, hemiparesis and hemianesthesia appeared 8 years earlier followed 4 years later by epileptic fits. Ventriculography revealed hydrocephalus and the tumor in the region of the third ventricle. CT scan visualized multiple hyperdense foci. Ventriculo-peritoneal shunt provided good improvement. During the next twenty years condition of the patient gradually worsened. Diagnosis of multiple cavernous angiomas was established only at autopsy.

Adult↗