摘要:

We studied 8 symptomatic patients aged 32-56 years with isolated stenosis of the middle cerebral artery who had TIAs or minor strokes. Angiography showed MCA stenosis in the Ml segment in 7 patients, and proximal Ml occlusion that later recanalized with persistent stenosis in 1 patient, without evidence of more widespread atherosclerotic disease. A potential cardiac source of embolism was detected in only 2 patients with mitral valve prolapse. During follow-up for 39-82 months, no further ischemic events occurred, and transcranial Doppler showed unchanged or decreased stenosis in 6 patients. We conclude that isolated MCA stenosis in younger patients may be a unique pathologic entity with a benign long-term course, although previous embolism with partial recanalization appears possible in some patients.

ISSN:0014-3022    

DOI:10.1159/000117209

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Thirty human immunodeficiency virus (HIV) infected individuals entered a longitudinal study without signs of dysfunction of the central nervous system (CNS). Nine of these individuals developed a systemic illness between study visits, and 7 of these 9 patients (78%) had neurological signs at the next examination (e.g., action-intention tremors, abnormal gait, release signs, abnormal deep tendon reflexes). Only 2/21 (9.5%) of the subjects who did not develop systemic illness showed such signs. These data are consistent with the hypothesis that other factors (e.g. cytokines) as well as the HIV may cause subtle CNS dysfunction.

ISSN:0014-3022    

DOI:10.1159/000117210

出版商:S. Karger AG    

年代:1996

数据来源: Karger

ISSN:0014-3022    

DOI:10.1159/000117211

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Although little is known on the pathophysiologic mechanism of migraine-related stroke, the prevailing attitude is that vasoconstriction and activation of clotting factors play a primary role. In 2 female patients presenting with migraine and stroke, risk profiles and history were consistent with this pathophysiologic mechanism. Cerebro- and cardiovascular workup, however, led to a diagnosis of paradoxical cardioembolic stroke through a patent foramen ovale. Since there is hardly any evidence in the literature that migraine acts as a risk factor for stroke on its own, these case reports emphasize the importance of complete cardiovascular evaluation in patients with suspected migrainous stroke.

ISSN:0014-3022    

DOI:10.1159/000117212

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Sixteen children with definite multiple sclerosis (MS; aged 6–17 years, mean 11.4 ± 2.7; 8 boys, 8 girls) were reviewed. Cerebellar symptoms and signs were frequent at initial presentation. Among laboratory studies, the cerebrospinal fluid (CSF) IgG index or oligoclonal bands were informative in 75%, evoked potentials in 70%, electroencephalography (EEG) in 83%, magnetic resonance imaging in 80% and computed tomography in 45%. When compared with patients with other neurological disorders and similar presentation (non-MS group, n = 13), MS patients were more likely to recover from the first attack without significant sequelae. CSF protein was usually normal in MS and high in non-MS patients. The CSF IgG index and/or oligoclonal bands were also helpful in differentiating these two groups. The absence of female preponderance, the frequency of EEG abnormalities and the lower yield from CSF analysis are particularly interesting in this childhood series. Different pathogenetic mechanisms may be involved in MS from different ages, genetic backgrounds, or environmen

ISSN:0014-3022    

DOI:10.1159/000117213

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

We examined the relationship between the hemoglobin concentration and the risk of ischemic stroke using data from a hospital-based case-control study. A total of 143 patients (age 30-69 years) with a diagnosis of cerebral infarction confirmed by computerized tomography scan and 143 age- and sex-matched controls entered the study. Hemoglobin was higher in the patients with stroke (14.2 ± 1.6 g/l, mean ± SD) than in controls (13.7 ± 1.6 g/l; p< 0.05). Compared with subjects with hemoglobin levels of less than 13 g/l (reference category), the relative risk of ischemic stroke, after allowance for potential risk factors, was 2.0 (95% CI 0.8-4.9) for the 13-13.9 g/l quartile, 2.8 (95% CI 1.2-6.5) for the 14-14.9 g/1 quartile, and 3.2 (95% CI 1.4-7.4) for the 14+ g/1 quartile (χ2 for linear trend 7.27, p < 0.01). We conclude that the hemoglobin concentration may be an indicator of risk for ischemic str

ISSN:0014-3022    

DOI:10.1159/000117214

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Inclusion body myositis affects primarily the proximal muscles but distal limb muscles are involved too in this chronic myopathy. Characteristic histopathologic findings include ‘rimmed vacuoles’, inflammation and typical cytoplasmic and nuclear filamentous inclusions. The patients are usually unresponsive to steroids. We present four inclusion body myositis patients with atypical clinical presentations: one with scapuloperoneal syndrome, one with post-polio-like syndrome and two with associated immune-mediated diseases (one with undefined autoimmune disorder and the second with scleroderma). Two patients responded to high-dose steroid therapy. We suggest that the clinical spectrum of inclusion body myositis is wider than previously apprecia

ISSN:0014-3022    

DOI:10.1159/000117215

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

We report an elderly case who had demonstrated progressive memory disturbance and disorientation for 4 years. The clinical features were indistinguishable from late-onset dementia of the Alzheimer type (DAT). Neuropathologically, however, senile plaques (SPs) were almost absent throughout the brain. In contrast, numerous neurofibrillary tangles (NFTs) were observed in the hippocampus and neighboring regions, with much higher density than age-mateched normal controls. The immunohistochemical and ultrastructural properties of the NFTs were identical to those of typical DAT. The present case is histologically different from DAT because of the scarce SPs and indicates that numerous NFTs in the hippocampal region can be formed independently of the existence of SPs.

ISSN:0014-3022    

DOI:10.1159/000117216

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Fibers called ragged red fibers are generally considered the morphological characteristic of mitochondrial encephalomyopathies. These fibers appear red in the modified Gomori trichrome (Tri) stain due to subsarcolemmal and interfibrillar increase in mitochondrial number and volume. Other accepted morphological abnormalities include partial cytochrome c oxidase deficiency and subsarcolemmal increase in succinate dehydrogenase and NADH tetrazolium reductase stain. We were interested to see which of these abnormalities would be the most specific for mitochondrial cytopathies such as Kearns-Sayre syndrome and chronic progressive external opthalmoplegia. We analyzed five patients and found 74 fibers compatible with mitochondrial abnormalities as defined above. The modified Gomori Tri stain turned out to be the most specific and reliable technique.

ISSN:0014-3022    

DOI:10.1159/000117217

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

In a population-based study of 198 patients with probable early-onset Alzheimer’s disease (AD), we studied the occurrence of extrapyramidal signs (tremors and rigidity), myoclonus, psychosis and seizures, as well as their predictive value for mortality. The presence of tremors was significantly associated with the presence of rigidity. The occurrence of myoclonus was significantly associated with the occurrence of seizures. Psychosis and seizures in AD patients were not associated with mortality. The occurrence of extrapyramidal signs and myoclonus at any point in time during the course of AD increased the risk of mortality significantly. When evaluating their relative importance, extrapyramidal signs appeared to be the most important predictor of mortalit

ISSN:0014-3022    

DOI:10.1159/000117218

出版商:S. Karger AG    

年代:1996

数据来源: Karger