ABSTRACT
We report a case of acute deafness secondary to bilateral hemorrhages involving the external capsule and extending to both temporal isthmi. The lesions probably disrupted both auditory radiations. Deafness disappeared within 2 weeks leading to a transient auditory agnosia for environmental and verbal sounds. Performance on audiological and neurolinguistic tests were consistent with the hypothesis of a deficit of non-specific auditory processes. Psychoacoustical deficits related to subcortical lesions are very rare and might differ from those due to cortical lesions by the lack of aphasia. The present case and both previous cases with subcortical lesions might suffer from auditory agnosia of apperceptive type. Its characteristics and the role of non-specific auditory processes are discussed using the data obtained from this third case.
Subject(s)
Agnosia/etiology , Auditory Perceptual Disorders/etiology , Cerebral Hemorrhage/complications , Deafness/etiology , Agnosia/diagnosis , Audiometry, Speech , Auditory Perceptual Disorders/diagnosis , Cerebral Hemorrhage/diagnosis , Cerebral Hemorrhage/diagnostic imaging , Cerebrovascular Circulation , Evoked Potentials, Auditory, Brain Stem , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Neuropsychological Tests , Psychoacoustics , Tomography, Emission-ComputedABSTRACT
Antiphospholipid antibody is associated with a clinical syndrome of vascular thrombosis, thrombocytopenia, recurrent fetal loss and livedo reticularis, whether or not a clinical diagnosis of systemic lupus erythematosus (SLE) coexists. Central nervous system involvement in SLE is multifactorial, thrombotic events, antineuronal antibodies, hypertension, infection, side effects of drugs etc. Antiphospholipid antibodies may play a role in focal neurological manifestations in SLE. In the absence of SLE, different neurological symptoms are well associated with antiphospholipid antibodies including stroke, seizures, dementia, migraine, ocular ischemia, chorea, transverse myelopathy, cerebral phlebitis. Other association are more controversal like Guillain Barré syndrome, motor neuron disease, communicating hydrocephalus. In all patients with antiphospholipid antibodies with neurological involvement, cerebral MRI may be performed with an echocardiographic study because a possible association with Libman and Sacks endocarditis, valve dysfunction or cardiac thrombus source of cerebral ischemia.
Subject(s)
Antibodies, Antiphospholipid/physiology , Central Nervous System Diseases/immunology , Lupus Erythematosus, Systemic/immunology , Antiphospholipid Syndrome/complications , Antiphospholipid Syndrome/immunology , Central Nervous System Diseases/etiology , Humans , Lupus Erythematosus, Systemic/complicationsSubject(s)
Cerebral Infarction/complications , Dominance, Cerebral/physiology , Movement Disorders/etiology , Neuromuscular Diseases/etiology , Substantia Nigra/blood supply , Aged , Cerebral Infarction/diagnosis , Humans , Magnetic Resonance Imaging , Male , Movement Disorders/diagnosis , Neuromuscular Diseases/diagnosis , Restless Legs Syndrome/diagnosis , Restless Legs Syndrome/etiology , Stereotyped Behavior/physiology , Substantia Nigra/pathologyABSTRACT
PURPOSE: To improve a method of stereotaxic localization with digital subtraction angiography that does not require use of a localization frame fixed to the patient's skull during examination. MATERIALS AND METHODS: An independent, low-cost, stereotaxic computing system was devised. Software programs used magnetic resonance images, computed tomographic scans, and digitized radiographs of plastic bone implants with head landmarks to establish reference trihedrons in each imaging system, transpose target coordinates from one system to another, adjust surgical instruments, help plan radiation surgery, and compute and display isodose curves. RESULTS: The geometric distortions of the image intensifier were corrected. Distortion problems of the conic projection were solved, and three-dimensional localization was achieved with only two associated front and lateral views. Accuracy to within 1 mm was achieved for the three coordinates. CONCLUSION: This frameless stereotaxic localization technique is highly accurate and reliable. The system allows maximum automation of examination procedures.
