Bulletin of clinical neurosciences最新文献

A patient with chronic hypertension presented clinically with the dysarthria--clumsy hand syndrome. A CT scan demonstrated putaminal hemorrhage sparing the internal capsule. This case provides additional evidence that lacunar syndromes may not be due to lacunar infarction. The localization of dysarthria--clumsy hand appears similar to that of ataxic hemiparesis.

Emotion can be considered the result of mood (the inner, subjective feelings), affect (the outer, objective manifestations of feeling), drive, and cognitive control. Research in the past several decades suggests a correlation between characteristic emotional disorders and abnormalities involving restricted neuroanatomical regions. Mood appears to be a product of the basal-limbic structures. Affect is more hemisphere influenced and the difference between nonverbal and verbal affect appears to reflect right and left hemispheric function. Drive can be considered a function of midline anterior anatomical structures while cognitive control, the ability to govern action by thought, seems to depend on frontal convexity and/or orbital frontal function. Emotion is a summation of these activities and emotional disorder may follow disturbance to any one or a combination of these separate functions.

Unilateral electrolytic lesions of the amygdaloid nucleus were made in rats during development to study the timing of sequential connectivity. The patterns of neural degeneration were detected by the Fink-Heimer technique and light microscopy. The main projections were to the accumbens, caudate, septal area, habenula, hypothalamus, cingulum, thalamus, and mesencephalon. In all cases degenerated fibers were progressively more apparent with increasing age. A clear and consistent pattern of degeneration was first observed at 30 days postnatally. Because the amygdala is widely connected with numerous limbostriatal and other CNS structures, the data presented favor the possibility that the amygdaloid complex can be a crucial region for the triggering of patterns of endocrine and autonomic, as well as somatic responses.

Removal of either parenchymal or intraventricular cysts in neurocysticercosis has traditionally necessitated operative intervention with its concomitant morbidity and mortality (L. Stepien and J. Chorobski, Arch Neurol Psychiat Chicago 1949;61:499-527; L. Stepien, J. Neurosurg 1962;19:505-13). To our knowledge, percutaneous parenchymal cyst aspiration to reduce mass effect has not been previously reported. We describe a case of successful CT-guided percutaneous thalamic cyst puncture and aspiration to reduce both obstructive hydrocephalus and raised intracranial pressure.

Cerebral cysticercosis is no longer an uncommon disease in areas such as Southern California to which there is extensive travel and immigration from adjoining areas in which the disease is endemic. The diagnosis of cerebral cysticercosis should be entertained in patients from such an endemic area when they present with neurological symptoms and characteristic CT findings. There is no specific or definitive therapy for the disease; treatment should be directed at alleviating its manifestations. We recommend surgical consideration in those patients with hydrocephalus, intraventricular cysts, solitary cysts producing uncontrolled seizures, and solitary cysts producing significant mass lesion effect.

Radiologic imaging techniques play an important role in the diagnosis and management of neurocysticercosis. Cysticercal involvement of the central nervous system can be classified as parenchymal, ventricular, meningo-cisternal, spinal, and mixed, depending upon the site of involvement. Computerized tomographic scanning has replaced most of the previously used techniques for assessing parenchymal disease and diagnosis has been greatly improved. Ventriculography and myelography are still useful in cases of intraventricular and spinal disease respectively.