Romanian journal of neurology and psychiatry = Revue roumaine de neurologie et psychiatrie最新文献

A polygraphic study on resistance to habituation of the somatic, autonomic and EEG components of the orienting reaction elicited by a repetitive auditory stimulus was performed in 39 epileptics with therapy-resistant generalized seizures (TRGS) and in 119 matched subjects in two control groups. The study showed a significantly higher resistance to habituation of the orienting reaction in epileptics with TRGS vs. the normal subjects of control group I. A significantly higher resistance to habituation was also noted in epileptics with therapy-controlled generalized seizures of control group II. The correlational analysis of data showed that the severity of these habituation disturbances in epileptics with TRGS depended on the patients' age, type of electroclinical seizures, pretrial seizure frequency, type of resting EEG, administered treatment (no. of administered antiepileptic drugs/patient), daily dose, as well as on the serum level of these drugs. The multivariate regression analysis showed that the most significant predictive variables for the habituation disturbances were the pretrial seizure frequency, type of electroclinical seizures, daily dose of administered antiepileptic drugs and their serum level. The data also evidenced that the antiepileptic treatment improves the interictal habituation disturbances, the effect being the more marked as the treatment was more sustained. The above-mentioned habituation changes in epileptics with TRGS should be ascribed to some disturbances in nervous excitability.

The study presents an analysis of demographic, clinical and paraclinical characteristics of 50 cases as well as the surgical treatment results of 50 cases with traumatic intracerebral hematoma (TIH) out of 70 admitted. The men showed the greatest incidence, the male/female ratio was 5:1. Age mean was 55.3 yrs. Hematomas were caused in one third of the cases by traffic collisions, followed by severe cranial traumata associated or not with other traumatic lesions and/or preceding diseases. The most frequent location was anterior in the frontal (30%) and temporal lobes (26%). Diagnosis was confirmed by arteriography and tomography. Specific paraclinical aspects of TIH were discussed together with those of the primary intracerebral hematoma (PIH). All patients were operated on under general anesthesia. A minimum craniectomy was carried out aimed at the lesion. Surgery was planned after a full neurological examination. Postoperative mortality was increased (42%) due to the severity of trauma (88%) in patients with a Glasgow coma scale assessment under 8, to age (50% of the patients were over 50 yrs), to hematoma size (84-100% in patients with a diameter of the hematoma between 50 and 100 cu cm, and over 100 cu cm, respectively) and to the location (66% in the frontal hematomas compared to 33% in temporal ones).

Deceased cases with cerebral infarction and hemorrhage constituted the subjects of the present study. They were divided into two groups: 127 cases in group 1 (1954-1959) and 427 cases in group 2 (1977-1982). The purpose of the study was to compare clinical data to evidence any statistical difference between groups. No statistically significant difference was noticed, except the increase of age mean in both diagnoses due to the overall increase of age mean of the population (2.5-10 yrs).

General considerations on recurrent cranial polyneuropathy are made. In addition, a study carried out in 42 patients with recurrent cranial polyneuropathy (RCP) permitted the assessment of some parameters closely related to age, sex and evolution in order to elaborate an etiopathologic hypothesis. Female cases prevailed (31 females, 11 males); the interval between two episodes varied from 1 month to 39 years. 117 episodes were found (from 2 to 8 episodes in one patient). Immune, vascular and entrapment aspects are discussed.

The study investigated the evolution of 72-nifedipine treated cases with ischemic stroke. Dipyridamole was administered to 72 controls. Subjects showed clinical improvement, thus calcium blockers can constitute a therapy alternative. A good influence of nifedipine was remarked in blood pressure.

Clinical study and laboratory investigations were performed in 166 carotid ischaemic stroke (CIS) patients and 64 vertebro-basilar ischaemic stroke (VBIS) patients. The study revealed some features of VBIS: significant male predominance (p < 0.001), better outcome (for modified Rankin Scale (MRS)) (p < 0.01), significant number of different triggering factors (p < 0.001). Nonsignificant differences in mortality were found in both groups (p > 0.05). Myocardial infarction was an important associated cause of death.

The present study is based on the evolution of 219 cases of temporal compressive craniocerebral trauma admitted to the neurotraumatology department between 1985 and 1990. Correlations are made between the accident-operation time interval and the results obtained. Special emphasis is laid on the paraclinical methods used to make an accurate and complete diagnosis, of which computerized tomography is the most reliable for head injuries. The most frequent compressive lesions found in this series were the indirect cerebral lacerations. Their approach was done by a trephine opening aimed at the anterior 1/3 of the temporal lobe, in its basal part. The prognosis depends on the state of consciousness (patients in deep coma had small chances for survival) and on the time interval between accident and surgery, a rapid and adequately equipped transport of the patient being also of utmost importance.