[Usefulness of current and retrospective markers of glycemia for early prognostication of ischemic stroke in diabetics and non-diabetics]. / Przydatnosc oznaczen aktualnych i retrospektywnych stezen glikemii dla wczesnego rokowania w udarze mózgu niedokrwiennym w zaleznosci od wspólistnienia cukrzycy regulacyjnej.

Diabetes mellitus is associated with an increased incidence of ischaemic stroke but it is not established whether it may exacerbate its clinical course and prognosis. In the study we have assessed relations of fasting (1st-2nd day of illness) and pre-stroke glycaemia (measured as HbA1 and FA) with recent clinical manifestation and outcome within one month in 22 diabetics and 37 non-diabetics with ischaemic brain infarction in the internal carotid territory. Merely enhanced HbA1 in the majority of non-diabetic stroke patients confirmed impaired pre-stroke glucose tolerance but did not influence severity of hemiparesis and further prognosis. Abnormally high both HbA1 and dFA in diabetics, reflecting non-sufficient metabolic control of illness did not exacerbate acute manifestation of stroke and outcome. Fasting post-stroke glycaemia that expresses a stress response of brain origin was determinative for clinical state but not for one-month prognosis in diabetics and non-diabetics with brain infarction.

[Value of glucose, glycosylated hemoglobin and fructosamine in blood of patients with ischemic cerebral infarction without diabetes during the early stage of the disease]. / Zawartosc glukozy, glikozylowanej hemoglobiny i fruktozaminy we krwi osób z niedokrwiennym udarem mózgu, nie obciazonych cukrzyca we wczesnym okresie choroby.

Fasting blood glucose level, glycosylated haemoglobin (HBA1) and fructosamine (FA) were measured in 37 non-diabetic patients with a recent (48 h) brain infarction of the carotid territory. The severity of hemiparesis was assessed on admission, and in the 2nd week and 1st month. The functional outcome and fatality rate was estimated after 1 month. On the basis of elevated the HBA1 concentration the group of 54% patients was diagnosed to have prestroke hyperglycemia. Hyperglycemia predating cerebral infarction did not influence fasting glycemia during the few days after stroke. Fasting blood glucose concentration but not the preceding 2-3 months and 2-3 weeks glycemia correlated strongly with the severity of hemiparesis and predicted stroke outcome. Measurement of HBA1 seems to be useful as a screening test for mild, clinically silent diabetes in patients without other risk factors for cerebral stroke.

Brain neoplasms with development similar to transient brain ischaemia.

Diagnostics of brain tumours still remains a serious problem in neurologist's career. Difficulties in proper diagnosing refer mainly to endocranial tumours with atypical clinical course. Frequency of brain tumours' vascular manifestation is assessed as 1-4%, and in most cases it is the kind of manifestation which corresponds with intracerebral bleedings and more seldom with ischaemic strokes. Reports on brain tumours with developments similar to transient brain ischaemia (1, 2, 3, 4) are published occasionally. In Neurology Clinic of the Medical Academy in Lublin, we conducted observation of two patients with brain tumours (one metastatic and the other one-primary), where the former as well as the latter case were treated as cerebral circulation failures at their initial stage. Application of typical vasoactive treatment brought about temporary regression of symptoms.

[The concentration of glucose, glycosylated hemoglobin and fructosamine in blood of patients with cerebral hemorrhage in the acute stage of the disease]. / Zawartosc glukozy, glikozylowanej hemoglobiny i fruktozaminy we krwi chorych z krwotokiem mózgowym w ostrym okresie choroby.

The level of glucose, fructosamine (FA), glucosylated hemoglobin (HbA1) was determined for 21 patients with cerebral haemorrhage at an early stage of their illness. The correct level of FA and HbA1 shows that in the period of 2-3 weeks and 2-3 months before the stroke the average level of glucose in blood was normal. No significant differences of glucose concentration with respect to patients with a good prognosis and patients with a bad prognosis were found.

[Acute ethylene glycol poisoning with the course resembling the development of intracranial hematoma]. / Ostre zatrucie glikolem etylenowym o przebiegu przypominajacym rozwój krwiaka przymózgowego.

Acute poisoning with ethylene glycol manifests itself often with symptoms of central nervous system involvement. The predominating manifestations include consciousness disturbances, seizures, while focal brain damage signs are less frequent. The reported case was hospitalized after trauma to the head and spine, and had signs suggesting expanding intracranial haematoma. CT excluded haematoma and toxicological investigations demonstrated acute poisoning with ethylene glycol.

[Bilateral peripheral facial nerve palsy in acute poisoning with ethylene glycol]. / Obustronne obwodowe porazenie nerwu twarzowego w przebiegu ostrego zatrucia glikolem etylenowym.

Acute poisonings with polyethylene glycol become more and more frequent. The acute poisoning with polyethylene glycol leads to a considerable metabolic acidosis and acute renal failure. Usually there is no peripheral nervous system involvement. Two cases of the bilateral facial nerve palsy in patients with renal failure due polyethylene glycol poisoning are presented. It seems that it is the first report on the lesions to facial nerve involvement in the course of the acute polyethylene glycol poisoning.