Schweizer Archiv fur Neurologie, Neurochirurgie und Psychiatrie = Archives suisses de neurologie, neurochirurgie et de psychiatrie最新文献

Intracranial pressure was measured in 82 patients in the Neurosurgical Clinic, Basle, from 1978-1982. The methods used werette Gobiet Screw (62 patients), the Gealtec Probe (17 patients) and intraventricular drainage. Intracranial pressure monitoring was carried out in 54 patients with severe craniocerebral injury in 12 patients with large cranial bone defects and a subsequent cranioplasty, in 12 patients to diagnose hydrocephalus and in 4 patients for other reasons. Indications for intracranial monitoring results and therapy are discussed.

46 migraine patients and 4 patients suffering from "nonmigrainous" vascular headache were treated with 250 mg salicylate daily for 2 months. Platelet aggregability before and under treatment was measured in all patients and in 10 controls. The results confirm platelet hyperaggregability in migraine patients and a reduction of aggregability under salicylate out provide no evidence of any significant clinical improvement, thus falsifying the hypothesis of migraine as a platelet aggregation disorder.

Of the basic principles of the brief analytic psychotherapy taught at the PPU of Lausanne, the comparison of different psychotherapy technics seems to show clearly the influence of the setting on the therapeutic process. Placed strictly on the freudian hypothesis that transference is at the same time factor of resistances and of changement, the author shows that it is possible to respect the psychoanalytic principles edicted by Freud in psychotherapy as well as in psychoanalysis: free associations, neutrality, lack of focalisation, interpretation, if the changes in psychic functioning provoked by the psychotherapeutic context are understood. An example illustrates this hypothesis.

The notion of energy became dominant in physics around 1850. It was transferred into psychology by Th. Fechner, W. Wundt, F. Nietzsche and others. For S. Freud and his pupils it became basic. During the last decades it has turned marginal.

We studied clinical, CT, angiographic and prognostic parameters in 60 cases with an occlusion, 48 with a tight stenosis, and 42 with a moderate stenosis of an internal carotid artery (ICA). The volume of infarction ranged from 0 to more than 600 cm3. It was significantly related to the degree of ICA obstruction, the number of risk factors, but not to age or sex. The quality of the collateral supply did not significantly influence the size or localization of infarctions, although it was better in the patients with occlusion than in those with tight stenosis. Deep infarcts were associated with diabetes and hypertension. The volume of infarction and early/late neurological disability were closely related to each other. Early death was associated with large infarctions (greater than or equal to 250 cm3). Thus, massive sylvian infarction corresponded to a poor prognosis (life and neurological function), whereas no visible infarction on CT corresponded to a good prognosis. Superficial infarctions had a variable prognosis, and evolution of deep infarctions was size-dependent. Late death or delayed stroke were not predictable from CT parameters. The quality of collateral supply did not markedly influence the functional prognosis. The development of a unilateral ipsilateral ventricular dilation and cortical atrophy was related to the degree of obstruction and to the weakness of the collateral circulation. In occlusion patients, the occurrence of ventricular dilation was related to the volume of infarction; cortical atrophy developed later and was associated with superficial infarctions. In ICA occlusion or stenosis, the study of CT parameters may help delineate prognostic features and may thus ameliorate the therapeutic follow-up.

What is apparently the first reported case of neuroaxonal dystrophy associated with juvenile neurolipidosis is described. Details of the clinical evolution and the macroscopic, microscopic, histochemical and ultrastructural anatomo-pathology are given. The topographical distributions are given of the two characteristic lesions: swelling of neuronal cell bodies and swelling of axons. Biochemical and histochemical analyses were made but since the specimen had been preserved in acetone it was not possible to identify which lipids were present in excess. The case is compared to 5 somewhat similar cases in the literature.