ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1994.tb00059.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Among patients who underwent cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI) examination during a 5‐year period, we found 18 patients at the multiple sclerosis center of the University of Rome and clinically definite multiple sclerosis, MRI white matter abnormalities, normal CSF examination, a disease duration of at least 1 year and an upper age of<45 years at onset These patients were examined again with a variety of tests screening for different diseases mimicking multiple sclerosis. Alternative diagnoses reached after laboratory tests were: Lyme disease, two cases of vasculitis, mitochondrial encephalomyopathy, multiple ischemic lesions caused by atrial septum aneurysm and olivopontocerebellar atrophy. Hence, six of these 18 patients had a final diagnosis other than multiple sclerosis, while 12 remained with a final diagnosis of “MS with normal CSF”. Our study suggests that in patients with a clinical picture of multiple sclerosis and disseminated white matter MRI lesions but no CSF abnormalities, the classical clinical criteria may not be sufficiently specific, unless confirmed by a very prolonged clinical history with repeate

ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1994.tb00060.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The avidin‐biotin peroxidase complex method and a polyclonal antiserum were used to investigate the expression of endothelin‐like immunoreactivity in human autopsy cases presenting cerebral infarcts and lacunes. Cases with recent infarcts showed loss of immunoreactivity in neurons of the infarcts. Immunoreactive granules started to appear in astrocytic endfeet of microvessels of the border zones. Later on, numerous reactive astrocytes presented immunoreactivity in the entire cell body. Cases with old infarcts had a more widespread presence of astrocytes with endothelin‐like immunoreactivity around the lesions. Macrophages particularly of old infarcts showed a strong immunoreactivity. Cases with old lacunes presented numerous reactive fibrillary astrocytes with endothelin‐like immunoreactivity in the cell body and the processes. Astrocytes of controls showing endothelin‐like immunoreactivity were very rare and such cells were usually confined to the molecular layer of the cerebral cortex. The endothelin‐like immunoreactivity in astrocytes and macrophages of cases with cerebrovascular diseases probably reflects an increased intracellular content of endothelin. If this compound is released from such cells it may act as a mitogen and influence microcirculation by inducing vasoconstriction of intracerebral

ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1994.tb00061.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Acetylsalicylic acid (ASA; aspirin) is one of the most widely used pain reliefs in the world and is certainly effective in the treatment of acute attacks of migraine of moderate severity. It has usually been considered that the action of ASA in migraine is related to peripheral inhibition of mediators of inflammation. Migraine involves episodic head pain that is thought generally to involve intracranial pain structures innervated by the ophthalmic (first) division of the trigeminal nerve, particularly vascular structures that have come to be known as the trigeminovascular system. In this study the effect of ASA on the cerebrovascular effects of the trigeminovascular system were assessed directly with measurements of cerebral blood flow. The trigeminovascular system was activated by stimulation of the superior sagittal sinus (SSS), a midline large venous sinus that is pain sensitive in humans. The SSS was stimulated electrically and cerebral blood flow measured using laser Doppler flowmetry (CBFLDF). Stimulation of the SSS resulted in a stimulus‐locked frequency‐dependent increase in CBFLDFthat reached a mean maximum at 2 Hz with a 60 ± 6% reduction in calculated cerebrovascuiar resistance. Administration of ASA (30 mg/kg i.v.) resulted in a small non‐sustained increase in blood pressure but no change in resting CBFLDF. The CBFLDFresponse to SSS stimulation was reduced at all but one frequency of stimulation to a maximum of a 43 ± 10% reduction in cerebrovascular resistance. Since electrical stimulation involves consecutive depolarization of trigeminovascular axons and bypasses the peripheral nerve vessel interaction it is likely that this effect of ASA is mediated in the central nervous system. Such a possibility draws attention to a possibly novel therapeutic locus of action for ASA and to the importance of central nervous system processing of trigeminovascular inputs that are integral to the clinical expression of m

ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1994.tb00062.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

We examined the presence of quantified electroencephalographic (qEEG) differences between Parkinson's disease (PD) patients with and without dementia, and a group of age‐comparable normal controls. While there were no significant differences in relative power in any of the qEEG bands between PD patients without dementia and normal controls, PD patients showed a significantly greater reactivity in the alpha band. On the other hand, PD patients with dementia showed significantly less alpha and more theta relative power than both the normal control and the PD without dementia groups. When PD patients with dementia were compared with a group of patients with Alzheimer's disease (AD) and a similar severity of dementia, no significant between‐group differences were found in any of the qEEG bands. In conclusion, while our study demonstrated no significant qEEG differences between non‐demented PD patients and normal controls, PD patients with dementia showed qEEG changes similar to those observed in patients wi

ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1994.tb00063.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Colour discrimination and visual contrast perception were investigated in 18 patients with Huntington's disease (HD) and in 18 age‐ and sex‐matched healthy volunteers using the Farnsworth‐Munsell 100 Hue test (FM) and stationary contrast targets. The mean total error score (MTES) and the partial scores for the “red‐green” and the “blue‐yellow” axes in the FM of the patients with HD were significantly elevated as compared to controls (MTES in HD: 113.0 ± 90.8; MTES in controls: 19.2 ± 8.8). The spatial contrast sensitivity in HD patients was normal. The colour perception dysfunction indicates that the visual system is affected in HD. The visual disorder may be related to an imbalance of certain neurotransmitters in the visual system of HD patients. Possible anatomical sites of the dysfunction responsible for colour discrimination abnormalities could be the retinal cone system and/or impaired parvocellular central vi

ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1994.tb00064.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Thirty‐five multiple sclerosis (MS) patients diagnosed according to the Poser criteria were examined in a variety of cognition and memory tasks. Their performance was compared to age‐ and gender‐matched healthy individuals. While there was no difference in overall intellectual performance and short‐term memory between the MS group and control subjects, the patient group showed significant deficits in several everyday memory tasks including story recall, object and face recognition, procedural, topographical and prospective memory tasks. An intra‐group comparison in the MS cohort revealed that those patients with a chronic‐progressive MS course exhibited the most substantial everyday memory impairments and highest EDSS scores. These findings coincide with the neuroradiological, semiquantitative lesion analysis which was also performed. In this analysis, the latter MS subgroup also had the highest lesion score, as a sign of an overall brain

ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1994.tb00065.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Thalamic damage could be responsible for reduced metabolism in anterior cortical areas. In order to investigate an anatomical lesion and impairment of regional blood flow (rCBF) in distant cortical areas, we studied by magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT) a patient with bilateral thalamic infarction, who presented with sudden consciousness impairment, drowsiness, gaze paralysis, dysphagia and bilateral Babinski sign. Three weeks later the neurological symptoms disappeared, but a severe mental deterioration was evident MRI showed thalamic bilateral damage of posterior and medial areas, involving part of the pulvinar, more evident for the right thalamus. A99mTc‐HMPAO SPECT showed a decrease of rCBF over frontal and parietal regions, more evident for the right hemisphere. Six months later a severe memory impairment was still evident and MRI and SPECT picture were unchanged. The persistent memory defect could be related to a loss of cortical activation following the thalamic damage. The absence of primary lesions of cortical regions on CT scan and MRI and the neuroanatomical considerations on the diffuse projections running from medial nuclei and pulvinar to large parts of anterior neocortex supported this hypothesi

ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1994.tb00066.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

We performed neurosonographic examinations in 19 patients with vascular dementia (VD) and compared these findings with those in 21 patients with dementia of the Alzheimer type (DAT) and in 20 controls. There were no significant differences in age and sex among these three subject groups. The severity of dementia quantified by the Mini‐Mental State Examination and Mattis Dementia Rating Scale did not reveal significant differences between VD and DAT. We found that carotid stenosis>50% or occlusion was more frequent in VD compared to controls. The mean flow velocities of both the middle cerebral artery (MCA) and the basilar artery (BA) were decreased in VD and DAT compared with controls. This decrease was statistically significant for left MCA, but not for right MCA and BA. However, we did not find any significant differences between VD and DAT for the mean flow velocities of both MCA and B

ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1994.tb00067.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

At a time of increasing use of simvastatin and other “statin” drugs for cholesterol lowering, we report a case of simvastatin‐induced acute massive rhabdomyolysis with renal failure in a woman with primary biliary cirrhosis, occurring 2 years after starting the drug. The differential diagnosis is highlighted and the literature rev

ISSN:1351-5101    

DOI:10.1111/j.1468-1331.1994.tb00068.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY