bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anticoagulation in Cerebral Embolism
Authors: Bass Edward 
Published: July 2016

SUMMARY:A case of presumed anticoagulant induced hemorrhage into infarction is presented along with a retrospective study of 110 cases of cerebral embolus.An accurate recommendation for the timing of anticoagulation following cerebral embolism hinges on balancing the risk of hemorrhage into infarction against the benefits of early treatment attributed to preventing recurrent embolism. It is felt that the present literature, concepts of pathogenesis and experimental data provide insufficient information to make absolute clinical decisions. The available evidence implies that the risk of further embolic events is three to four times that of hemorrhage into infarction, yet additional randomized prospective studies and better experimental models are needed to establish a valid treatment plan. It may be possible to distinguish separate mechanisms underlying early diffuse hemorrhage into infarction from sudden delayed massive hematoma formation.
Acute Spinal Cord Injury in the Rat: Comparison of Three Experimental Techniques
Authors: Khan Moe , Griebel Robert 
Published: July 2016

SUMMARY:Three techniques to produce experimental spinal cord injuries in the rat are compared; 1) the weight dropping method, 2) the aneurysm clip compression method and 3) the extradural balloon compression method. In principle, different forces were used in technique one, while a constant force for different durations is maintained in techniques two and three. The relationship between these different types of injuries and subsequent clinical recovery was assessed quantitatively by the inclined plane method of Rivlin and Tator. The weight dropping technique was found unreliable for experimental spinal cord injury in the rat while the aneurysm clip compression technique resulted in consistent cord injuries with respect to subsequent clinical recovery. The extradural balloon compression method invariably resulted in complete recovery after three and five minutes but no recovery after seven minutes of 0.1 cc air inflated balloon compression of the cord indicating a steep dose — response curve. However, using a 0.2 cc air inflated balloon, no recovery was noted after one minute compression. The major factor in the pathogenesis of spinal cord injury produced by the weight dropping technique is believed to be mechanical, while both mechanical and vascular factors seem to operate in the clip and balloon compression techniques.
Computed Tomography in the Evaluation of Plexopathies and Proximal Neuropathies
Authors: Stewart John D. , Schmidt Brian , Wee Roberto 
Published: July 2016

SUMMARY:We describe nine patients with plexopathies or proximal mononeuropathies due to mass lesions. In four, computed tomography (CT) was the only radiological technique to show the cause of the neuropathy. In five patients, CT either unequivocally confirmed the presence of an abnormality or was superior to other imaging techniques in showing its full anatomical extent. CT scanning is a valuable aid in the assessment of lesions of the peripheral nervous system, particularly plexopathies and mononeuropathies caused by retroperitoneal, pelvic or superior pulmonary sulcus tumors.
Background Vascular Headache: Relief with Indomethacin
Authors: Boghen Dan , Desaulniers Nicole 
Published: July 2016

SUMMARY:A patient with long standing sustained unilateral headache (“background vascular”) and occasional multiple jabs received prompt and lasting relief from indomethacin. The effectiveness of the drug was tested in a placebo controlled double-blind trial. Indomethacin may be of value in some types of sustained headache.
Reversal of Acute Experimental Cerebral Vasospasm by Calcium Antagonism with Verapamil
Authors: Leblanc Richard , Feindel William , Yamamoto Lucas , Milton John G. , Frojmovic Mony M. 
Published: July 2016

SUMMARYAcute vasospasm of the transclivally exposed basilar artery of anesthetised cats was produced by the subarachnoid injection of platelet-rich plasma (PRP) treated with enough adenosine diphosphate (ADP) to induce platelet aggregation and secretion. Vasorelaxation was produced by the topical application of the calcium antagonist verapamil. Changes in the internal diameter of the basilar artery were determined by measuring the blood column diameter from photomicrographs taken sequentially, at 5 minute intervals, through the operating microscope. Changes in blood vessel diameter are expressed as a plus or minus percentage of the pretreatment diameter. Arterial blood pressure and blood gas values were kept in the physiological range for the cat.The subarachnoid injection of PRP-ADP produced severe constriction of the basilar artery (mean constriction at 5 minutes after injection: -40.7% ± 2.8 SEM). Platelet-free plasma, ADP alone and Elliott’s A solution had no spasmogenic effect when injected into the subarachnoid space. The topical application of the calcium channel blocker verapamil (0.1 mg per kg) 30 minutes after the injection of PRP-ADP, with the basilar artery still in spasm (mean constriction: -23% ± 3.5 SEM), produced prompt and dramatic vasodilation (mean dilation at 5 minutes after application: + 52.7% ±18.1 SEM). This spasmolytic effect persisted in a decremental fashion for the 60 minute period of observation, by which time the previously constricted vessel had returned to its normal size. These observations indicate that the platelet fraction of whole blood may be involved in the genesis of acute vasospasm following subarachnoid hemmorhage and that this phenomenon can be readily reversed by calcium antagonism.
Friedreich’s Ataxia with Dysautonomia and Labile Hypertension
Authors: Margalith D. , Dunn H.G. , Carter J.E. , Wright J.M. 
Published: July 2016

SUMMARYAn Amerindian girl with Friedreich’s ataxia presented at the age of 14 years with intermittent bifrontal headaches and abdominal aching, often associated with nausea and recurrent vomiting and an evanescent pink, blotchy rash on the upper trunk. In these attacks she also had hypertension up to 210/160 mm Hg. Renal function studies, including intravenous pyelogram and angiography, were normal. Plasma renin activity (2.5 ng/ml/hr) was also normal. Total body CT scan was negative for phaeochromocytoma, and repeated estimations of 24-hour excretion of urinary VMA were normal or borderline high. Levels of total catecholamines in 24-hour urine were normal twice, but two random specimens during the paroxysmal episodes contained abnormally high levels of norepinephrine and dopamine. Plasma catecholamine concentrations were increased but not as high as with phaeochromocytoma. Blood pressure monitoring demonstrated marked fluctuations with position and temperature. A clonidine suppression test showed a substantial fall of plasma catecholamine levels, consistent with dysautonomia and not with phaeochromocytoma. It is concluded that the patient has dysautonomia of central origin, probably as a manifestation of Friedreich’s ataxia. These findings are discussed in relation to the recent demonstration of increased levels of plasma catecholamines in that disease.
Calcium Antagonists, Cerebral Ischemia and Vasospasm
Authors: Weir Bryce 
Published: July 2016

ABSTRACT:The past fifteen years has seen the classification of diverse substances into a group known as calcium antagonists (CAs). They have a common ability to reduce the transmembrane transport of extracellular calcium ions (CAe2+). This flow of calcium into vascular smooth muscle is ultimately associated with the development of tension and vasoconstriction. Some CAs appear to have a predilection for cerebral as opposed to systemic arteries and so may function as specific cerebral arterial vasodilators. It has been proposed that they might be useful in certain types of cerebral ischemia such as that due to arterial occlusion or prolonged vasoconstriction. Animal experiments and initial clinical trials give grounds for cautious optimism that CAs may become as useful in neurology as they have recently become in cardiology.
Lateral Asymmetries and Thalamic Components in Far-Field Somatosensory Evoked Potentials
Authors: Taylor M.J. , Black S.E. 
Published: July 2016

ABSTRACT:To investigate the neural generators of the subcortical somatosensory evoked potential (SEP) waves we studied the far-field SEPs in 20 normal adults. We stimulated the median nerve at the wrist and used a 40k gain, 25 msec sweep and a 150-3000 Hz bandpass. We recorded SEPs simultaneously over C3′ and C4′ using a non-cephalic clavicle reference. The following series of six positive waves were found reliably in all subjects: P9, PI 1, P13, P14, P16 and P17.The P16 and P17 probably arise from the thalamus and/or thalamocortical projections. Recent evidence suggests that the thalamus is not a closed field and thus one should be able to find corresponding waveforms in far-field recordings. We believe that this is a function of the bandpass used and with the above paradigm these components can be reliably recorded.We found significant ipsilateral and contralateral amplitude asymmetries beginning with the negative deflection after P14 and including P16 and P17. The amplitude was greater over the contralateral hemisphere. This suggested that both P13 and P14 are generated prior to decussation of the afferent fibres in the medial lemniscus. Bilateral recording allowed detection of this asymmetry which has not been previously reported as a means of determining the electrophysiological correlates of lateralization.
Ocular and Cerebral Ischemic Mechanisms in Disease of the Internal Carotid Artery
Authors: Ross R.T. , Morrow Ian M. 
Published: July 2016

ABSTRACT:Stenosis of the internal carotid artery reduces the flow velocity in the ophthalmic artery. Lowered velocity permits increased red cell aggregation and decreased red cell deformability which increases viscosity.Contrary to the theory of remotely originating emboli, this is an alternate hypothesis regarding transient attacks of ocular and cerebral ischemia.The ophthalmic artery circulation time was measured in two groups of patients. The circulation time was defined as the interval between the appearance of contrast media in the siphon of the internal carotid artery and in the ocular choroid. The measurement was made on 151 angiograms of 108 subjects. These vessels were normal. An additional 76 patients had 108 angiograms which showed various amounts of internal carotid artery stenosis. These 76 patients had transient ischemic attacks; retinal, cerebral, or both.There is a significant difference in the ophthalmic artery circulation time in the two groups. The slowing in the ophthalmic artery is related to the degree of internal carotid artery narrowing.The circulation time in a cerebral branch of the internal carotid was not measured. It is presumed that stenosis of the internal carotid artery would have the same effect on a cerebral artery as on the ophthalmic artery.
Characteristics of EMG Responses to Imposed Limb Displacement in Patients with Vascular Hemiplegia
Authors: Verrier M.C. , Tatton W.G. , Blair R.D.G. 
Published: July 2016

ABSTRACT:The segmented EMG activity in flexor carpi radialis to imposed wrist movements was studied in 18 hemiplegic subjects with vascular lesions of the sensorimotor cortex or internal capsule and compared to that in age-matched normal subjects. The segmented EMG activity in the stretched muscle was normalized against the maximum M response elicited by electrical stimulation of its peripheral nerve in hemiplegic and normal subjects. This M response was used to estimate the maximal activity of the motoneuron pool. Twelve of the hemiplegic patients showed a stereotyped abnormal segmentation pattern of the EMG activity characterized by: an increased M1 segment of prolonged duration with both an increased sensitivity to low initial velocities of displacement and an increased slope of the input-output relationship for the range of velocities tested; absent or diminished activity during the interval of the normal M2-3 segment; and a late component not evident in normal subjects. The increased magnitude of the EMG activity during the MI interval, markedly exceeded the normal range of control values. A method to demonstrate the response distribution of the interrelationship of the magnitude of the M1 segment using two variables (background EMG activity and initial velocity) for individual responses rather than average responses is presented. The results of the study indicate that: the increased excitability, reflected in the enhanced EMG over the M1 segment does not result from increased levels of resting alpha motoneuron activity and may result from disruption of polysynaptic internuncial influences on alpha motoneurons; the absent or diminished activity over the interval of the normal M2-3 segment may partially result from the interruption of a transcortical reflex by the vascular lesions.
Recurrent Aseptic Meningitis Secondary to Intracranial Epidermoids
Authors: Becker Werner J. , Watters Gordon V. , Chadarevian Jean-Pierre de , Vanasse Michel 
Published: July 2016

ABSTRACT:Two patients with recurrent aseptic meningitis are reported. Intracranial epidermoid tumors were eventually found in both patients. CSF changes in our first case with an epidermoid tumor were similar to those reported in Mollaret’s meningitis, with an initial polymorphonuclear pleocytosis early in each attack, followed by a lymphocytic predominance several days later. Large cells which proved to be macrophages were also seen in the CSF of this patient. Both patients had meningitis attacks for several years before the underlying epidermoid tumor was found. Mollaret’s meningitis remains a diagnosis of exclusion. These patients should remain tumor suspects for many years and deserve careful and repeated investigation.
Relapsing Polychondritis with Multifocal Neurological Abnormalities
Authors: Willis J. , Atack E.A. , Kraag G. 
Published: July 2016

ABSTRACT:A sixty-five year old woman developed relapsing polychondritis with three of the diagnostic criteria established by McAdam et al. (1976), namely bilateral auricular chondritis, ocular inflammation and both cochlear and vestibular dysfunction. Many authors have mentioned other neurological symptoms including unilateral facial weakness. This patient is the first case described with bilateral facial weakness and cerebral manifestations.Relapsing polychondritis, an uncommon, recurrent, inflammatory disorder affecting the cartilaginous tissues of the body (Jaksch-Wartenhorst, 1923; Herman, 1981), is regularly associated with audiovestibular dysfunction (Bollet et al., 1969; Cody et al., 1971; McAdam et al., 1976; Ridgway et al., 1979). McAdam et al. (1976) and Ridgway et al. (1979) have mentioned other neurological symptoms including unilateral facial weakness. We recently observed a patient with polychondritis and multifocal neurological abnormalities. We believe this is the first case described with bilateral facial nerve palsy and with cerebral manifestations.
Partially Reversible Cerebral Atrophy and Functional Improvement in Recently Abstinent Alcoholics
Authors: Carlen P.L. , Wilkinson D.A. , Wortzman G. , Holgate R. 
Published: July 2016

ABSTRACT52 recently abstinent chronic alcoholics were given repeated psychological tests and 20 of these had repeated CT scans. The first scan was done within 5 weeks of the last drink. The degree of measurably reversible cerebral atrophy on CT scan correlated negatively with the interval between the last drink and the first CT scan. Significantly more reversibility of cerebral atrophy was noted in those subjects claiming interscan abstinence. There were positive correlations between functional improvement scores on neurological exam and reversible cerebral atrophy measurements. Significant improvement on psychological test performance was restricted to patients tested initially within 3 weeks of the last drink. Both the CT results and the psychological test results suggest that reversible changes occur soon after the cessation of drinking.
Free Valproic Acid: Steady-State Pharmacokinetics in Patients with Intractable Epilepsy
Authors: Otten N. , Hall K. , Irvine-Meek J. , Leroux M. , Budnik D. , Seshia S. 
Published: July 2016

ABSTRACTFree and total valproic acid (VPA) pharmacokinetic evaluation was carried out at steady state in six young epileptics who were also receiving other anticonvulsants. Subjects received their usual morning dose of VPA after an overnight fast. Blood samples for free and total VPA were taken prior to the dose and frequently thereafter for 12 hours. The calculated pharmacokinetic parameters for total VPA and free VPA were: half-lives of 7.5 ± 1.6 hours and 5.0 ± 1.5 hours, volumes of distribution of 0.189 ± 0.038 l/kg and 1.51 ± 0.98 l/kg, and clearances of 0.30 ± 0.06 and 3.6 ± 2.0 ml/min/kg., respectively. There was a strong correlation between percent free VPA and total VPA (r = 0.81) but marked inter- and intra-subject variations were seen. Studies attempting to correlate VPA levels to clinical response must take such data into account.
The Neurobiological Substrates of Depression in Parkinson’s Disease: A Hypothesis
Authors: Fibiger H.C. 
Published: July 2016

ABSTRACTEvidence from a variety of sources indicates that the mesolimbic-mesocortical dopamine projections may play an important role in some types of reward or reinforcement processes in animals. There is circumstantial evidence that this is also true in humans. Since a reduced ability to experience pleasure or reward (i.e. anhedonia) is a cardinal feature of clinical depression, and since the mesolimbic and mesocortical dopamine projections have been shown to degenerate in Parkinson’s disease, it is suggested that damage to these reward-related systems may contribute directly to the high incidence of depression that has been reported in this disease.
Function of the Basal Ganglia as Revealed by Cognitive and Motor Disorders in Parkinson’s Disease
Authors: Marsden C.D. 
Published: July 2016

ABSTRACTEarly Parkinson’s disease is taken to be the best human model of disordered basal ganglia function. An experimental study in Parkinsonians with swings in motor response to drug treatment suggests that general cognition is not controlled by dopamine mediated striatal activity. The variety of motor disorders in Parkinson’s disease cannot be explained by simple concepts. Although Parkinsonians cannot execute fast ballistic movements, an experimental study shows that they can adopt a predictive motor control strategy. It is argued that simple motor programs are not grossly disturbed in Parkinson’s disease. It is concluded that Parkinsonians cannot automatically execute learned motor plans.
Parkinsonism Induced By 1-Methyl-4-Phenyl-1, 2, 3, 6-Tetrahydropyridine (MPTP): Implications for Treatment and the Pathogenesis of Parkinson’s Disease
Authors: William Langston J. , Ballard Phillip 
Published: July 2016

ABSTRACTOur experience in treating 7 patients with moderate to severe parkinsonism induced by l-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP) is reviewed. Virtually all of the problems typically encountered with dopamine precursor and agonist therapy in treating Parkinson’s disease have been observed during a one and one half year follow-up period, including “end-of-dose” deterioration (or “wearing off’), “peak-dose” dyskinesias, “on-off” phenomena, and psychiatric complications. These have occurred much earlier than is typically seen when treating the idiopathic disease. This rapid evolution of therapeutic side-effects favors the view that at least some of the complications of dopamine precursor therapy may be related to severity of disease rather than the length of levodopa therapy. Finally, we suggest that the occurrence of this full array of therapeutic complications in patients with MPTP-induced parkinsonism furthers the analogy between this syndrome and Parkinson’s disease.
Treatment of Parkinson’s disease with agents other than Levodopa and Dopamine Agonists: controversies and new approaches
Authors: Lang Anthony E. 
Published: July 2016

ABSTRACTParkinson’s disease is associated with a variety of neurotransmitter disturbances which may be further altered by its treatment with dopamine agonists. Based on this information a wide range of pharmacological approaches have been used in search of newer treatment alternatives and in hopes of reducing complications of long-term levodopa use. This paper reviews the various therapies which have had some success in the management of Parkinson’s disease, other than levodopa and dopamine agonists. Special emphasis is placed on the many unresolved questions and controversies that exist in this area of neuropharmacology.
Intraoperative Localization of Intracranial Lesions with Real Time Ultrasound
Authors: Boyd Michael C. , Steinbok Paul , Cooperberg Peter L. 
Published: July 2016

ABSTRACT:High resolution ultrasound has been used intraoperatively on forty-five patients with various intracranial lesions. The technique is quickly and easily carried out under sterile conditions in the operating room. Successful localization of both primary and metastatic tumors of various sizes, depths and consistencies have been made prior to extirpation or biopsy. Several of the biopsies were done through small burr holes. Arteriovenous malformations, abscesses, bone fragments from trauma, gliotic epileptic foci and ventricles for shunt placement have been readily found. No significant complications have been encountered. A new technique for localizing superficial lesions is described. An overall reduction in operating time and unnecessary trauma to the patient has resulted from more accurate intraoperative localization of intracranial lesions with real time ultrasound.
IgDK Multiple Myeloma Presenting as Unilateral Proptosis
Authors: Chu Joseph Y. , Lewis Anthony J. , Cowan Donald H. 
Published: July 2016

ABSTRACT:A 72-year-old woman presented with painful proptosis of the right eye and a large destructive tumour of the middle cranial fossa. A diagnosis of IgDK multiple myeloma was made, based on histopathologic and immunologic studies of the biopsy. Biochemistry and bone marrow examination further confirmed the myeloma as IgDK type. The clinical, radiological, and pathological findings are presented. The patient was treated with radiotherapy with satisfactory results.
Binswanger’s Disease: Progressive Subcortical Encephalopathy or Multi-Infarct Dementia?
Authors: Huang Kewei , Wu Lijuan , Luo Yi 
Published: July 2016

ABSTRACT:Since Binswanger’s description of subcortical arteriosclerotic encephalopathy in 1894, numerous cases have been reported. Several authors doubt the validity of this malady, although the majority consider it to be a disease entity. We report seven cases with this type of pallor of myelin, only two of which are accompanied by a history of dementia. Among the seven cases, two had arteriosclerosis of penetrating arteries and arterioles in cerebral white matter. Electron microscopy showed splitting of myelin sheaths, probably the result of edema. In reviewing the blood supply of the cerebral white matter, we conclude that no pathological alterations of medullary branches of the cerebral arteries, the same vessels supplying the white matter, can give rise to such diffuse pallor of white matter and spare the arcuate fibres. This pallor can only be due to cerebral edema, most likely of hypoxic-ischemic, hypotensive, or acidotic origin. We also contend that arteriosclerosis can only cause dementia through multiple infarcts or lacunae, if it indeed leads to dementia.