摘要:

ABSTRACT –The study describes a reproducible model of complete brain ischemia in rats. Rats with different plasma glucose concentrations were exposed to 10 min of complete cerebral ischemia achieved by compression of neck vessels by a pneumatic cuff. All 30 rats, except one, in which pre‐ischemic plasma glucose level were lower than 22 mM (range 1.6–22) survived 10 min complete ischemia and made a similar recovery. Ten rats with pre‐ischemic plasma glucose levels above 22 mM (range 22–47.2) died from seizures in the post‐ischemic period.Post‐ischemic treatment of seizures and hyperglycemia in the hyperglycemic rats significantly improved recovery.In conclusion, pre‐ischemic hyperglycemia above 22 mM impairs recovery after complete ischemia by inducing seizures, post‐ischemic hyperglycemia an

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1985.tb03224.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACT –The sexual behaviour and hormonal profiles in 97 patients with chronic epilepsy from an epilepsy centre were studied. Sexual behaviour relating to numbers of sexual contacts, orgasms, spontaneous erections, and early morning erections, whether there was difficulty in obtaining or maintaining an erection, or in ejaculation, was assessed at interview. Hormonal profiles consisted of LH, FSH, prolactin, total testosterone, free testosterone, and SHBG. Information was obtained relating to type of seizure, seizure frequency, age of onset, likely pathology, IQ, and medication. The study showed that this patient group was profoundly hyposexual and had a high level of sexual dysfunction. Serum free testosterone levels were low, and it is suggested that the high level of sexual dysfunction and lack of sexual interest may well have a hormonal basis. The reasons for this are discusse

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1985.tb03225.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACT –219 patients diagnosed as having hydrocephalus before the age of 5 years were traced 21 to 35 years after birth. Fifty‐four patients had had operations, but those used before the introduction of ventriculo‐atrial shunts did not influence the outcome; the series may be considered to represent the natural history of hydrocephalus.Based on available information in the case notes, patients were divided into 2 groups: 1) proven hydrocephalus, and 2) unproven hydrocephalus. Strict criteria were used.Ninety‐nine patients (45 %) had died. Serious prognostic factors as to survival were early admission, increasing head circumference, downward displacement of the eyes, and seizures. Together with the criteria suggested for proven hydrocephalus, the above factors may act as a guideline to operative treatment.Fifty‐seven percent of 116 known survivors were able to work, 9 % lived independently but had no working ability, and 34 % needed permanent care or supervision. This outcome is similar to that of shunt‐operated patients followed for a shorter period. The only parameters indicative of socio‐economic independence in adult life were early admission and absence of seizures

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1985.tb03226.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACT –18 epileptic patients on polypharmacy were assessed, using a battery of psychometric tests including the Wechsler Adult Intelligence Scale, Benton Visual Retention Test and Alertness and Concentration tests. The same patients were reassessed one year later following a trial to reduce their polypharmacy. The results for 12 patients whose treatment was reduced to monotherapy were statistically analysed, using the Wilcoxon Matched Pairs Test. Significant changes were found on a number of test scores which included Full Scale WAIS I.Q., W.A.I.S. Performance I.Q., Digit Symbol, Block Design and Object Assembly, Benton Visual Retention Test Error Score and Concentration Test Score.The other tests showed no improvement over baseline. The results point to the improvement in some areas of cognitive function which follows a reduction in polypharmacy to monotherap

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1985.tb03227.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACT –In order to delineate the critical blood flow pattern during the Cushing response in intracranial hypertension, regional cerebral blood flow was measured with radioactive microspheres in 12 anesthetized dogs at respiratory arrest caused either by expansion of an epidural supratentorial balloon or by cisternal infusion. Regional cerebrospinal fluid pressures were recorded and the local cerebral perfusion pressure calculated in various cerebrospinal compartments. In the 8 dogs of the balloon expansion group, the systemic arterial pressure was unmanipulated in 4, while it was kept at a constant low level (48 and 70 mm Hg) in 2 dogs and, in another 2 dogs, at a constant high level (150 and 160 mm Hg) induced by infusion of Aramine.At respiratory arrest, regional cerebral blood flow had a stereotyped pattern and was largely independent of the blood pressure level. In contrast, concomitant pressure gradients between the various cerebrospinal compartments varied markedly in the 3 animal groups, increasing with higher arterial pressure. Flow decreased by 85–100% supratentorially and by 70–100% in the upper brain stem down to the level of the upper pons, while changes in the lower brain stem were minor, on the average 25%.When intracranial pressure was raised by cisternal infusion in 4 dogs, the supratentorial blood flow pattern at respiratory arrest was approximately similar to the flow pattern in the balloon inflation group. However, blood flow decreased markedly (74–85%) also in the lower brain stem.The results constitute another argument in favour of the Cushing response in supratentorial expansion being caused by ischemia in the brain stem. The critical ischemic region seems to be located rostrally to the oblongate medulla, probably in t

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1985.tb03228.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACT –During a 5‐year period, 85 patients with TIAs, 65 patients with embolic brain ischemia of cardiac source and 50 patients with progressing stroke received intravenous heparin within 96 h. Twelve (6%) developed an early bleeding in the area involved by ischemia. In the 2 cases with transient ischemic attacks (TIAs) (2.3%), major functional sequelae persisted and the 2 cases with emboli from heart (3.2%) died, whereas among the 8 cases with progressing stroke (16%), only 3 worsened from anticoagulant‐induced bleeding. Intracerebral bleeding was not associated with excessive anticoagulation or high blood pressure and was related to a large infarction only in the cases with emboli from the heart. Among the 108 patients who were placed on acenocoumarol during 3–12 months after heparin therapy, only one (0.9%) suffered a hemorrhagic infarct from a probable recurrent embolization. The risk of anticoagulant‐induced intracerebral bleeding is quite different between the varieties of preceding ischemic events, with different subsequent impact on

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1985.tb03229.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACT –A retrospective analysis was made of the natural history and treatment of 44 patients with syringomyelia, followed for a median interval of 10 years after diagnosis. Twenty‐four patients were treated surgically. Four of 12 patients who had a laminectomy with aspiration of the syrinx or syringostomy, and 7 of 15 patients who underwent decompression and exploration of the cervicomedullary junction, showed sustained improvement or stabilisation of their neurological deficits. When symptoms had been present for more than 2 years, when there was a moderate or severe neurological disability, and when the patient was more than 40 years old, the long‐term outlook of posterior fossa surgery was usually poor. Of the 20 patients who did not have an operation, 7 had no further progression in symptoms after presentation and prolonged survival was usual. It is concluded that in many cases syringomyelia is compatible with prolonged survival, and although improvement can follow surgery, its influence on the disease in the long‐term is un

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1985.tb03230.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACT –A systematic investigation of the cognitive functions of 22 patients affected with motor neuron disease (MND) compared to 36 controls matched for age and education was performed. The MND group showed cognitive performances slightly but significantly lower than the control group; 6 MND patients, however, had decidedly pathological values. Cognitive impairment was stereotyped and global, with sparing of memory. There was no significant difference between patients with isolated involvement of the lower motor neuron and those with associated pyramidal involvement. Our neuropsychological findings are in agreement with previous clinical, neuroradiological and pathological reports indicating extra‐motor cerebral involvement in

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1985.tb03231.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACT –From December 1976 through March 1982, 188 patients entered an open non‐random study carried out on hospitalized patients with a history of transient ischemic attacks or amaurosis fugax. Ninety‐two patients received peroral anticoagulants usually combined with heparin treatment during the first days of treatment, and 96 patients enteric‐coated acetylsalicylic acid 0,5 g twice daily plus dipyridamole 75 mg twice daily. The patients were followed up to March 1983, irrespective of whether treatment was changed or not. Recurrent transient ischemic attack or amaurosis fugax occurred more frequently (P<0.01) from 2 months of follow‐up and throughout the observation period in the antiplatelet‐treated group. There were no statistically significant differences between the 2 groups on the originally given treatment for endpoints such as stroke (6 patients on anticoagulants, 12 patients on antiplatelet therapy) or stroke or death (11 patients on anticoagulants, 17 patients on antiplatelet therapy).The findings from this trial suggest that anticoagulant treatment is superior to antiplatelet therapy given in the prevention of ischemic attacks and that this difference mainly exists during the first one to 2 months after onset of transient ischemic attacks or amau

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1985.tb03232.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACT –L‐Deprenyl, a specific monoamine oxidase subtype B inhibitor, has been reported a valuable adjunct to conventional treatment of Parkinsonism. A double‐blind cross‐over controlled study was performed in 19 parkinsonian patients with on‐off type problems. Five mg L‐Deprenyl per day reduced the number of on‐off episodes. Side effects such as hyperkinesias, vivid dreams, dizziness with diaphoresis were frequent. Severe side effects such as nightmares, postural hypotension, confusion, and dizziness with headaches necessitated discontinuation of the drug in 4 patients. L‐Deprenyl was of limited value in this group of patients with longstandi

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1985.tb03233.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY