ABSTRACT
A case of lumbosacral polyradiculitis in an HIV-1-positive man (CDC IIB) leading to a flaccid paraplegia below the level of L4 is reported. A detailed analysis of several cerebrospinal fluid samples led to the suspicion of a bacterial infection. After treatment with antibiotics and tuberculostatic agents the neuropathy improved and the patient has survived for 2 years. In contrast to similar cases that were probably caused by cytomegalovirus in terminal stages of AIDS, it is argued that an unidentified bacterial infection was the cause of the polyradiculitis in the present case.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Bacterial Infections/complications , HIV-1 , Nerve Compression Syndromes/etiology , Spinal Nerve Roots , Adult , Anti-Bacterial Agents/therapeutic use , Bacterial Infections/drug therapy , Humans , Male , Nerve Compression Syndromes/cerebrospinal fluid , Paraplegia/etiology , Remission InductionABSTRACT
Transoesophageal ultrasound imaging of the spinal canal through an intervertebral disc was successfully achieved in 44 of 50 adults (18 women and 32 men; mean age 56 years, range 22-79) who, for cardiological indications had transoesophageal echocardiography. On average, five (range 1-11), usually sequential, segments were visualized. In 37 patients pulse-synchronous sagittal displacement of the spinal cord was noted, presumably caused by cerebrospinal fluid pulsation. In one woman, with known syringomyelia, the spinal cord cavity was well shown. Real-time demonstration of dynamic events in the spinal canal opens up new possibilities for the diagnosis and follow-up monitoring of spinal diseases.
Subject(s)
Spinal Canal , Ultrasonography , Adult , Aged , Echocardiography , Esophagus , Female , Humans , Male , Middle Aged , Spinal Cord Diseases/diagnosis , Spinal Diseases/diagnosis , Ultrasonography/methodsSubject(s)
Angioplasty, Balloon , Subclavian Steal Syndrome/surgery , Aged , Humans , Intraoperative Period , Male , Middle AgedABSTRACT
Ligation of one common carotid artery and exposure to carbon monoxide has proved to be a reliable method of producing unilateral cerebral infarcts in the rat, allowing controlled experiments in any given sample size. Pathophysiological measurements in awake and narcotized rats has shown that, in contrast to hypoxic hypoxia, the carbon monoxide-induced functional anaemia (3000 ppm in room air) did not stimulate chemoreceptors, thus causing a severe systemic hypotension owing to peripheral vascular dilatation. This hypotension is likely to represent the main pathogenetic factor in this model. An inhibition of ferro-enzymes by carbon monoxide did not seem to be involved. The only cause of death was shown to be diffuse ipsilateral brain oedema with or without extra-vasation of serum proteins. The EEG, the systemic arterial pressure, rotational behaviour, and carotidal stump pressure proved to be reliable predictors of outcome.
Subject(s)
Cerebral Infarction , Disease Models, Animal , Animals , Blood Gas Analysis , Blood Pressure , Blood-Brain Barrier , Carbon Monoxide Poisoning/complications , Carotid Artery Diseases/complications , Cerebral Infarction/etiology , Cerebral Infarction/physiopathology , Male , Movement , RatsABSTRACT
Unilateral cerebral infarcts were produced in the rat by ligation of one common carotid artery and a subsequent exposure to carbon monoxide. In animals which had undergone an additional ligation of the external jugular veins leading to a moderate increase of the cephalic venous pressure the outcome of the procedure was ameliorated significantly. Venous pressure elevation was thought to reduce the venous vascular resistance effectively by preventing the leptomeningeal veins from collapsing. Collapse of the leptomeningeal veins probably occurred during the severe carbon monoxide-induced hypotension causing a steep increase of cerebral vascular resistance.
Subject(s)
Cerebral Infarction/physiopathology , Venous Pressure , Animals , Brain/blood supply , Carbon Monoxide Poisoning/complications , Carotid Artery Diseases/complications , Cerebral Infarction/etiology , Disease Models, Animal , Male , Meninges/blood supply , Rats , Vascular Resistance , Veins/physiopathologyABSTRACT
Unilateral cerebral infarcts were produced in the rat by ligation of one common carotid artery and subsequent exposure to carbon monoxide. The incidence and extension of brain infarcts was increased in animals with additional ipsilateral cervical preganglionic sympathectomy. Sympathectomy did not affect markedly the respiration and systemic circulation. The effect of sympathectomy was attributed to a cutaneous vasodilation, leading to an extracranial steal phenomenon.
Subject(s)
Cerebral Infarction/physiopathology , Sympathetic Nervous System/physiopathology , Animals , Carbon Monoxide Poisoning/complications , Carotid Artery Diseases/complications , Carotid Sinus/physiopathology , Cerebral Infarction/etiology , Cerebral Infarction/pathology , Cerebrovascular Circulation , Disease Models, Animal , Male , Rats , SympathectomyABSTRACT
A report given of a 32-year-old female patient who exhibited a unilateral paradoxical pupillary reaction to light, but was obviously healthy in all other respects. All of the neuroophthalmological findings, including the infrared reflex-pupillographic results registered, are indicated and discussed in detail in the report. An analysis of the findings leads to the conclusion that this disturbance has a central, prenuclear location. Apart from a stenosis at the junction of the arteria vertebralis, which was determined angiographically, further examination did not reveal any pathological findings.
