Acta neurologica最新文献

A rare case of hydatid cyst of the lumbosacral spine, causing extensive destruction of the sacrum and a large pelvis mass, is reported; a cutaneous fistula from the pelvic cavity to the posterior lumbar region was also present. The patient was studied by computerized tomography and operated on by combined anterior and posterior approach. The sacral localization of the spinal hydatidosis and its extension into the pelvic cavity are unusual. CT and MR allow a good definition of the bone destruction and the abdominal and pelvic extensions. Radical removal of spinal hydatid cysts may be rarely accomplished, because of the extensive bone invasion, and multiple recurrences, requiring repeating operations, occur in most cases.

One schizophrenic and two manic-depressive patients who after the administration of zotepine, a new antipsychotic and antimanic drug, developed alopecia areata, a kind of autoimmune disease, are reported. They recovered following the discontinuation or decrease in the dose of zotepine. These three cases of alopecia areata suggest that the antipsychotic drugs may induce autoimmune disease through their neuropsychological effect.

Twenty six asymptomatic patients with internal carotid artery occlusion had ultrasound follow-up for a mean period of 34.3 months. During follow-up 3 patients (11.5%) reported transitory ischemic attacks (TIAs), one of these (3.8%) occurred in the vascular territory ipsilateral to the occlusion. There were not strokes. Annual TIA rate was 4% for all vascular territories, and 1.3% for the territory ipsilateral to the occlusion. Annual mortality was 9.4%. Our data on stroke risk in patients with asymptomatic carotid artery occlusion show a good prognosis in the long-term.

The purpose of this study was to measure the nociceptive threshold in hypothyroid patients by determining when the nociceptive flexion reflex of the lower limb occurs under percutaneous electrical stimulation of the sural nerve, given that this threshold is well correlated with pain sensation. Twelve hypothyroid patients and twelve control subjects participated in the study. In the case of the hypothyroid patients, the nociceptive flexion reflex (or RIII reflex) was measured before and six weeks after the onset of substitution treatment. The results clearly indicate that the nociceptive threshold of the patients with hypothyroidism was significantly higher than that of the control subjects. After six weeks of substitution treatment, the RII threshold return to normal. The analgesia observed in the hypothyroid patients in this study do not appear to be correlated with the blood TSH level. The possible mechanisms of these analgesic effects are discussed.

Differences of frequency and morphology of carotid plaques are studied in 39 patients with ischemic cardiopathy matched for sex and age with 39 patients with various cardiopathies and 78 controls without heart diseases. Ischemic patients have more plaques, and these are more extended along the vessels. The plaques of the other cardiopathies reach greater thickness and degree of stenosis.

The authors have reviewed 6 patients operated on, with histologically proven diagnosis of grade-II astrocytomas who have survived more than 10 years even with many reoperations. Young age, pre- and postoperative neurological status, aspect of the tumor mass on CT and MRI, site of the tumor in non-high functional areas and extent of surgical removal are the most important variables in predicting length of survival. In young patients without severe neurological deficits and with astrocytic tumors located in non high-functional areas, very long survivals may be obtained even with many operations, when the interval between the recurrences is at least three years.

A case of sporadic amyotrophic lateral sclerosis with onset at 18 years of age and death one year after is reported. Only 8 other cases with such an early onset (and the typical clinical and pathological features of ALS) have been reported in the literature. Resemblances between these cases and adult ALS are pointed out, but since all knowledge about their etiology is lacking, the relationship between them remains unclear.

A rare case of rapidly enlarging cavernous angiomas of the cerebral hemispheres and brain stem in a child is reported. Rapid growth of cavernous malformations of the brain is rarely observed; it may be due to different mechanisms, including enlargement of the vascular channels, hemorrhage and cysts formation. The possibility of progressive enlargement of cavernomas makes periodical MR studies necessary in all cases. When the growth is radiologically documented, surgical removal is imperative even in patients with trivial symptoms.

We report the case of a 34-year-old man, treated by chiropractic manipulation for tension-type headache. The patient complained of a sharp occipital pain during the first session, followed by vomiting and loss of consciousness, and remained comatose for five days. Neurological examination detected persistence of dysarthria, ataxia, with delayed responses. Neuroradiological findings reveal an ischemic lesion in left PICA region, confirmed by angiography. Clinical and radiological findings suggested complete remission about two months later.

First described by Schneider in 1954, the syndrome of acute central cervical spinal cord injury is characterized by disproportionately greater motor impairment in the upper compared to the lower extremities, bladder dysfunction and a variable degree of sensory loss below the level of injury. The syndrome has a good prognosis for neurologic and functional recovery. Spontaneous improvement of function is typical. Ten cases are reported. Clinical features, diagnosis and management are discussed.