ABSTRACT
Data of literature on the frequency of the nervous system lesions in different variants of leucosis are analyzed. A case of a man with petechial skin rash and bruises on the body, gingival hemorrhage and general sickness is described in details. The hematologic tests revealed acute myeloblast leucosis. A lumbar puncture revealed blood in the cerebrospinal fluid and MRI showed an epidural hematoma in lumbar segments 3 and 4. At this level, the hematoma compressed the dural bag and roots of the horse tail with accompanying vessels (the radicular medullar artery and large radicular veins). A paracentetic removal of the hematoma with the decompression of spinal roots was carried out. The blasts in the cerebrospinal fluid and symptoms of the left facial nerve lesion allowed to diagnose neuroleucosis. This case presented the mixed pathogenesis of myeloischemia. The epidural hematoma compressed not only the roots of the horse tail but the accompanying vessels (arteries and veins). The venous outflow obstruction along radicular veins worsened the microcirculation in the cross-sectional area of the spinal cord. Complex polychemotherapy in the combination with neuroprotectors (cortexin, gliatiline), antiaggregants and vitamins is recommended.
Subject(s)
Leukemia, Myeloid, Acute/complications , Spinal Cord/blood supply , Stroke/etiology , Adult , Aged , Diagnosis, Differential , Humans , Magnetic Resonance Imaging , Male , Spinal Puncture , Stroke/diagnosis , Stroke/physiopathologyABSTRACT
The authors present an analysis of scientific conceptions of epilepsy by the outstanding scientist and physician Herman Boerhaavey. All aspects of the disease, including etiology, pathogenesis, clinical presentations, rehabilitation, treatment, were described in the manuscripts devoted to neurology from the archive of H. Boerhaave in the Military Medical Academy.
Subject(s)
Epilepsy/history , Psychiatry/history , History, 18th Century , Humans , NetherlandsABSTRACT
A sharp (16.4%) increase of blood serum osmolality very close to the critical values was found in acute period of ischemic stroke, while sodiumemia exceeded the normal levels by 50 mmol/l and more. Meanwhile, the concentrations of Na ions in liquor of such patients was not significantly increased. The levels of Ca, K, Mg ions as well as the osmolality of blood serum and liquor were stable too. The alterations of these parameters were not significantly changed in epileptic patients out of fits. Both the analysis of the reasons of hyperosmia and hypersodiumemia development and the search for the methods of their prophylaxis and correction will be quite important in further investigations.
