Reversible cerebral arteriopathy associated with the administration of ergot derivatives.

Three cases of intracranial arteriopathy associated with the administration of ergot derivatives are reported. In the first case, excessive doses of dihydroergotamine and of ergotamine tartrate seemed to be the cause, but simultaneous treatment with an antibiotic and the existence of a cytomegalovirus infection could have favoured the arteriopathic process. The second patient also received excessive doses of these two drugs, but in addition she was taking oestrogen and progesteron containing contraceptives. In the third case, an intravenous injection of methylergometrine in a dose of 0.2 mg seemed to have initiated the arteriopathy. Arteriograms were comparable in all three cases, with segmental stenosis of several cerebral arteries, whereas internal carotid and vertebral arteries remained normal. In the first case a control cerebral arteriography was normal one month later. These findings suggest that widespread cerebral arteriopathy can appear in subjects who chronically abuse ergotamine tartrate.

[Lumbar puncture: indications and limitations]. / A propos de la ponction lombaire: indications et limites.

Fast deterioration of the neurological status of patients with raised intracranial pressure after lumbar puncture is not rare. Cerebral coning or rebleeding occur in consequence of cerebrospinal fluid leak. An experimental model correlates leakage with needle gauge. Computed tomography is indicated for diagnosis at the time of the initial examination. Puncture with needles of small diameter (less than 0.5 mm) is recommended.

[Reversibility of the effects of general anesthetics on Schistosoma mansoni]. / Réversibilité de l'action des anesthésiques généraux sur Schistosoma mansoni.

In order to verify whether the migration of Schistosoma mansoni from mesenteric vessels towards the liver under the action of general anesthetics (althesin, ether, enflurane, halothane, propanidid and thiopental sodium) is reversible, 65 mice were submitted to an anaesthetic and then perfused after dissection 24 hours later. The Schistosoma counts from porto-mesenteric vessels of the mice from control groups (60 mice) were compared with those of the mice under experiment. The counts from the hepatic area of the groups were also compared. No significant difference in the counts in the mice under experiment and those of control groups was noted.

[Influence of anesthesia on the localization of Schistosoma mansoni. Intestinal schistosomiasis in white mice]. / Influence de l'anesthésie sur la localisation de Schistosoma mansoni. Cas de la bilharziose intestinale de la souris blanche.

General anesthetics or hypnotics (ketamine, propanidid, thiopental, althesin, halothane, enflurane, ether), were tested on white mice infested with Schistosoma mansoni to study possible changes in the migration of this trematode from the mesentery to the liver. With this in mind, populations of 25 mice of the same sex and age were chosen at random; they were divided into a control group and a group submitted to an anaesthetic agent. The mice were perfused after dissection and catheterization of the abdominal aorta. A vacuum-pump was used to collect separately the parasites from the mesenteric and portal vessels and those from hepatic vessels. The parasite counts in the hepatic vessels of the mice which had received an anesthetic were compared with those found in the vessels of the control group; they were found to be significantly raised. It would appear that anesthetic agents altered the neuromuscular function of the parasite which was thus carried away towards the liver. This massive migration of the parasites would deprive the hepatic lobules of portal blood by worsening the already existing obstruction at the precapillary level caused by the schistosomiasis.