ABSTRACT
S. Freud in his "Metapsychological supplement to the theory of dreams" considers dreams and Meynert's "Amentia" as a "Hallucinatory-wishful psychosis". After investigation in resuscitation units and reading of the "Amentia", it seems that this designation by a respectful master of Freud refers to pathological states identical to the ones we observe nowadays with patients getting out of coma. Jensen's "Gradiva" describes a kind of benign madness, since it is an amorous folly. This again is a "Hallucinatory wishful psychosis". Freud tells us that the novel explain precisely how to cure this state. From Meynert's "Amentia" and from Jensen's "Gradiva" commented by Freud, the author goes on with remarks about the illusions of resuscitation and about the means of helping the patient to recover.
Subject(s)
Delusions/psychology , Dreams , Resuscitation/psychology , Humans , Self ConceptABSTRACT
Two cases of dural arteriovenous fistulae of the foramen magnum with perimedullary venous drainage are reported. Their arterial component was a dural branch of a vertebral artery. The localization and the origin of these fistulae appeared very uncommon but could be explained by the embryogenesis of the vertebral arteries, of which the third portion corresponds to the first cervical radicular artery. The first patient had signs and symptoms usually described in this disease, but the second presented a subarachnoid haemorrhage with neither motor and sensory deficit not sphincter disturbance. Myelographic findings, M.R.I. abnormalities and treatment of these rare dural arteriovenous malformations are discussed.
Subject(s)
Arteriovenous Fistula/diagnosis , Dura Mater/blood supply , Foramen Magnum , Spinal Cord/blood supply , Vertebral Artery , Arteriovenous Fistula/diagnostic imaging , Arteriovenous Fistula/therapy , Humans , Male , Middle Aged , Myelography , Subarachnoid Hemorrhage/etiologyABSTRACT
Syringomyelic cavitation of various origins (excluding tumour) has been treated by syringo-peritoneal shunting (SPS) in 10 patients. The main clinical and radiological symptoms are reviewed and postoperative results evaluated; among the symptoms, pain is the most likely to improve after surgery. But the global outcome in the majority of cases remains unchanged, some patients showing neurological deterioration. Although MRI is of fundamental importance in diagnosis, the significance of the postoperative appearances on MRI has still to be elucidated. Other studies are certainly necessary to define the exact place of SPS in the treatment of syringomyelia.
Subject(s)
Cerebrospinal Fluid Shunts , Syringomyelia/surgery , Adult , Aged , Female , Humans , Leg , Male , Middle Aged , Movement Disorders/etiology , Movement Disorders/physiopathology , Pain , Peritoneal Cavity , Postoperative Period , Syringomyelia/complications , Syringomyelia/physiopathologyABSTRACT
The analgesic effect of conventional transcutaneous nerve stimulation has been studied in 29 patients, all having a chronic pain caused by peripheral neurological disease. As already reported in the literature half of patients were improved on a short-term basis. Long-term improvement was observed mainly in patients with traumatic nerve lesions; such cases, thus appear to be the best indication for this method. It should be emphasized that whatever the etiology, the delay between the onset of pain and the beginning of transcutaneous stimulations was a critical factor. Nine out of ten patients suffering for less than one year were satisfactorily improved. This suggests that transcutaneous stimulations should be used as early as possible after the onset of neurological pain.
Subject(s)
Electric Stimulation Therapy/methods , Neuralgia/therapy , Adult , Aged , Chronic Disease , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Neuralgia/etiology , Neuralgia/psychology , Peripheral Nerve Injuries , Peripheral Nervous System Diseases/complications , Psychological Tests , Time FactorsABSTRACT
The study of the effect of transcutanous stimulations shows that 40% of the patients suffering of chronic pain can be relieved or greatly improved by this technic. The best results are obtained with peripheral nerves lesions. On the contrary no results are observed with malignancies or facial pain. This way of stimulation is easy to develop and does not imply any danger for the patient. It can be used as a test prior to percutanous stimulation or implantation of a direct stimulation, or can, by itself be an effective treatment.
