RESUMO
The Authors report on 150 cases of patients suffering from Parkinson's disease. The patients represent 8.3% of total parkinsonian patients and are selected on the basis of clinical and laboratory criteria that allow the diagnosis of "angiopathic parkinsonism" as an autonomous entity. Cerebral blood flow alterations in Parkinson's disease and associated dementing symptoms are also discussed. In conclusion, the Authors emphasize the usefulness of recognizing the "angiopathic parkinsonism" in view of therapeutical implications.
Assuntos
Doenças Cardiovasculares/complicações , Doença de Parkinson/diagnóstico , Terminologia como Assunto , Adulto , Idoso , Gânglios da Base/fisiopatologia , Doenças Cardiovasculares/diagnóstico , Circulação Cerebrovascular , Dopamina/sangue , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Doença de Parkinson/fisiopatologia , Fluxo Sanguíneo Regional , Tomografia Computadorizada por Raios XRESUMO
We describe the pathogenesis and the typical clinical and laboratory features of the hyperthermia syndromes that may develop during neuroleptic drug treatment, environmental exposure or following the use of inhalational anesthetics. Since the features are similar and confusion is possible we emphasize the need for prompt diagnosis so that appropriate treatment, can be started without delay. Hyperthermic reactions have common pathophysiological mechanisms and they may be seen as an abnormal individual response to organic and functional stressors.
Assuntos
Antipsicóticos/efeitos adversos , Febre/fisiopatologia , Exaustão por Calor/fisiopatologia , Animais , Febre/induzido quimicamente , Humanos , Hipertermia Maligna/etiologia , Síndrome Maligna Neuroléptica/etiologiaAssuntos
Haloperidol/efeitos adversos , Metotrimeprazina/efeitos adversos , Trombocitopenia/induzido quimicamente , Adulto , Azatioprina/uso terapêutico , Feminino , Humanos , Contagem de Plaquetas , Transtornos Psicóticos/tratamento farmacológico , Trombocitopenia/sangue , Trombocitopenia/tratamento farmacológicoAssuntos
Transtornos Cerebrovasculares/diagnóstico , Transtornos Cognitivos/etiologia , Esclerose Múltipla/diagnóstico , Adulto , Ventrículos Cerebrais/patologia , Transtornos Cerebrovasculares/complicações , Transtornos Cerebrovasculares/patologia , Erros de Diagnóstico , Feminino , Humanos , Imageamento por Ressonância Magnética , Tempo de Reação , Fatores de RiscoRESUMO
A 28-year-old primigravida woman was referred for ultrasound studies at 27 weeks' gestation. Sonographic examination found enlarged cerebral ventricles, communicating lateral ventricles, bilateral cleft lip and palate. A 2500 gm male infant was delivered at 36 weeks' gestation, after which the diagnosis of septo-optic dysplasia was made.
Assuntos
Disco Óptico/anormalidades , Septo Pelúcido/anormalidades , Anormalidades Múltiplas/diagnóstico por imagem , Adulto , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Ultrassonografia Pré-NatalRESUMO
The sonographic findings in nine cases of agenesis of the corpus callosum examined before and after birth are reported. Agenesis of the corpus callosum was suspected in utero due to a typical configuration of the lateral ventricles, which included enlargement of the atria and occipital horns and marked separation of the bodies. In three cases pregnancy was terminated because of severe associated anomalies. In the remaining six cases postnatal ultrasound examination allowed a certain diagnosis by demonstrating the abnormal configuration of the lateral ventricles, varying degrees of enlargement, and upward displacement of the third ventricle and absence of the corpus callosum.
Assuntos
Agenesia do Corpo Caloso , Diagnóstico Pré-Natal/métodos , Ultrassonografia , Ventrículos Cerebrais/anormalidades , Ventrículos Cerebrais/patologia , Corpo Caloso/patologia , Idade Gestacional , Humanos , Recém-NascidoRESUMO
The Authors report the results obtained by long-term clinical and radiological evaluation of patients who had undergone cervical multiple bilateral laminectomy to relieve the compression exerted on the cord by different diseases (spondylarthrosis, syringohydromyelia, intramedullary and extramedullary tumours, leptomeningeal cysts and extradural tumours). 98 patients were reviewed, the follow-up ranging from 8 to 24 years (mean 14 years). The results demonstrate that the most severe post-laminectomy changes are recorded in patients with intramedullary lesions and when middle-low cervical spine levels (C4-C7) are affected. The significance of spinal deformities such as kyphosis, spondylolisthesis and swan-neck is also discussed.
Assuntos
Laminectomia , Doenças da Coluna Vertebral/cirurgia , Atividades Cotidianas , Adolescente , Adulto , Criança , Seguimentos , Humanos , Pescoço , Radiografia , Doenças da Coluna Vertebral/diagnóstico por imagem , Doenças da Coluna Vertebral/fisiopatologia , Fatores de TempoRESUMO
Very few cases of Pisa syndrome have been reported. The syndrome consists of dystonic symptoms, namely, tonic flexion of the trunk to one side and its slight rotation. It appears to be a side effect of prolonged antipsychotic therapy. We report on a case of Pisa syndrome in which withdrawal significantly improved the dystonic symptoms. However, a severe exacerbation of schizophrenic symptoms required the immediate resumption of neuroleptic therapy which was followed by the reappearance of dystonic symptoms. Associated anticholinergic medication led to only a slight improvement.
Assuntos
Antipsicóticos/efeitos adversos , Discinesia Induzida por Medicamentos/fisiopatologia , Haloperidol/efeitos adversos , Adulto , Amissulprida , Humanos , Masculino , Esquizofrenia/tratamento farmacológico , Sulpirida/análogos & derivados , Sulpirida/uso terapêutico , SíndromeRESUMO
The authors report long-term results in 17 patients with surgically treated congenital intradural spinal arachnoid cysts. Comparison between the immediate and long-term results demonstrates that surgical removal of the cyst allowed a significant neurological improvement in all cases, but clinical worsening of various degrees was observed later. The authors attempt to explain the results in terms of mechanical and vascular factors.
Assuntos
Aracnoide-Máter/cirurgia , Cistos/cirurgia , Doenças da Medula Espinal/cirurgia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Cistos/complicações , Cistos/congênito , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/cirurgia , Doenças da Medula Espinal/complicações , Doenças da Medula Espinal/congênitoRESUMO
The Authors describe an experimental model (rat) performed in order to evaluate the cerebrovascular changes which occur following the venous outflow impedance increase. This increase was obtained by bilateral occlusion of the external jugular veins at the neck. The rat was chosen because its intracranial and extracranial circulation is very similar to the human one, thus allowing the recording of blood flow velocity changes in the common carotid artery by means of a noninvasive technique such as Doppler ultrasound. Ligature of both the external jugular veins, performed on 35 rats, produced a decrease of common carotid artery blood flow velocity in 2/3 of the animals. The remaining 1/3 presented increased common carotid velocity. These changes were recorded within 15 minutes after ligation of the veins. On the contrary, the epidural pressure, measured in 6 cases, showed a constant increase. The results demonstrate that the different patterns of CBF and EDP do not permit univocal interpretation of the cerebrovascular reactivity control mechanisms, that is, myogenic, metabolic or neurogenic.
Assuntos
Circulação Cerebrovascular , Animais , Velocidade do Fluxo Sanguíneo , Artérias Carótidas/fisiologia , Hemodinâmica , Pressão Intracraniana , Veias Jugulares/fisiologia , Ligadura , Ratos , Ratos Endogâmicos , Sístole , Ultrassonografia , Pressão VenosaRESUMO
An original device for the epidural pressure measurement in the rat is presented. The reliability of epidural pressure as an index of intracranial pressure is discussed and several possible causes of error are examined. The device has been tested under conditions both of transient and prolonged cerebral blood volume increase, obtained by venous outflow obstruction.
Assuntos
Espaço Epidural/fisiologia , Pressão Intracraniana , Canal Medular/fisiologia , Animais , Masculino , Ratos , Ratos EndogâmicosRESUMO
The Authors discuss the incidence, the etiology, the pathology and the pathophysiology of congenital hydrocephalus. Furthermore, the problems of intrauterine surgical procedures are in particular discussed. On the light of the experimental and clinical results the Authors believe that the shunting fetal procedures should be considered anything but experimental and, therefore, subject to rigorous limitations. The results of the postnatal surgical procedures in congenital hydrocephalus are also discussed. Owing to the fact that early treatment of hydrocephalus in newborns seems to obtain the most satisfactory results, particular regard is reserved to that diagnostic techniques which could allow to recognize the right and early moment for surgical intervention, such as transfontanelle Doppler ultrasound examination.
Assuntos
Hidrocefalia/cirurgia , Feminino , Doenças Fetais/terapia , Humanos , Hidrocefalia/diagnóstico , Hidrocefalia/etiologia , Recém-Nascido , Gravidez , Diagnóstico Pré-Natal , UltrassonografiaRESUMO
A case of left extracranial internal carotid artery occlusion, associated with ipsilateral parietal glioblastoma, is reported. The clinical and radiological aspects are discussed. The Authors stress the usefulness of a complete investigation in patients with symptoms of cerebrovascular insufficiency.
Assuntos
Neoplasias Encefálicas/complicações , Doenças das Artérias Carótidas/complicações , Glioblastoma/complicações , Lobo Parietal , Idoso , Constrição Patológica/complicações , Humanos , MasculinoRESUMO
The mega cisterna magna is a congenital developmental malformation which in the majority of instances is symptomless and does not require further study or surgical treatment. However, differential diagnosis with other cerebellar diseases is often necessary especially in newborn infants. Ultrasonographic recognition of the mega cisterna magna in a newborn infant is reported. The reported case demonstrates the usefulness of the ultrasonographic technique in the study of the posterior cranial fossa abnormalities of newborn infants.
Assuntos
Cisterna Magna/anormalidades , Humanos , Recém-Nascido , UltrassonografiaRESUMO
Long-term results of 16 surgically treated brainstem gliomas are reported. The results have been reviewed with reference to the clinical and pathological criteria defined by Hoffman and co-workers (1980) in the attempt to differentiate a distinct group of benign tumours. A good correlation has been obtained. The usefulness of surgical treatment of brainstem gliomas has been stressed in view of the survival time as well quality of survival.
Assuntos
Neoplasias Encefálicas/cirurgia , Tronco Encefálico , Glioma/cirurgia , Adolescente , Adulto , Biópsia , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/mortalidade , Tronco Encefálico/cirurgia , Criança , Pré-Escolar , Feminino , Seguimentos , Glioma/diagnóstico , Glioma/mortalidade , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Cuidados Pós-Operatórios , Complicações Pós-Operatórias , Fatores de TempoRESUMO
Doppler ultrasound investigation of cerebral blood flow velocity was performed in hydrocephalic infants through the anterior fontanelle. Systolic (S) and end-diastolic (D) frequency values recorded on the anterior cerebral artery were used to define the pulsatility index (PI) calculated from the equation PI=S-D/S. Comparison between systolic, end-diastolic and pulsatility index values of 50 normal infants and 10 hydrocephalic infants showed a statistically significant difference (P less than 0.05) for systolic and pulsatility index values. However, no significant difference was found for end-diastolic values. The authors believe that the phenomenon could be explained as an increase of the cerebrovascular compliance which counteracts the increase of the perivascular pressure in an attempt to maintain a normal cerebral blood flow. Therefore, the transfontanelle Doppler ultrasound technique may provide a useful and early tool in diagnosing cerebral blood-flow changes in hydrocephalic infants.
Assuntos
Hidrocefalia/fisiopatologia , Ultrassonografia , Velocidade do Fluxo Sanguíneo , Humanos , Recém-NascidoRESUMO
A case of unusual Neuro-Behçet syndrome is reported. Four years of follow-up revealed at beginning later the occurrence of acute meningoencephalitis caractherized by two convulsive fits. CSF examination revealed high albumin and cells contents. CT examination of the head was negative. Incomplete clinical improvement was obtained by using steroids. Differential diagnosis is finally discussed.