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Clinical Neuroscience - 1969;22(10)
Content
Clinical Neuroscience
OCTOBER 01, 1969
[Choosing how to explore in lumbar hernia operations, based on 373 cases over four years - 1965-1968]
[It is the authors' understanding that the most important criteria for the successful surgical treatment of lumbar hernias are the correct indication and timing of surgery, avoidance of myelography, minimal bone resection, but always complete root decompression. These criteria were applied in 373 operations between 1965 and 1968, with inter-arch exploration in 87.64% of cases. The situations which make each type of exploration possible or necessary are analysed. It is stressed that inter-arch exploration can be used to remove hernias causing cauda-unusual hernias and that this method of exploration can also be used in reoperations.]
Clinical Neuroscience
OCTOBER 01, 1969
[About granulomas in the dorsal root ganglia of the spinal cord]
[In the study of spinal ganglion cysts, we have monitored granulomas that occur in the posterior gyri of the spinal cord. Although these granulomas also contain a chronic inflammatory component, they are also populated by endothelial, or more recently meningothelial, cells of the arachnoid. According to Verga and Rexed and Wennström, these granulomas are important as causative factors in the formation of cysts in spinal ganglia. Veith has observed granulomas in the root nerves in connection with chronic infectious diseases of other organs (chronic polyarthritis, chronic cholecystitis, and malignant tumours), which he considers to be of non-specific origin. He raised the question of whether Richter's tabes granulomas are specific or non-specific. In cases of pemphigus, granulomas similar to those described by Veith in various chronic infectious diseases occur in the dorsal root ganglia of the spinal cord. The question of whether Richter's specific syphilitic granulomas are identical to Veith's non-specific granulomas due to chronic infectious diseases needs further investigation. A similar finding was reported on the subject raised, that of a disease which started with chronic inflammation (tuboovarial abscess) and was associated with granulomas in the root nerves, the clinical course leading to death in the form of multiple neurotic gangrene of the skin.]
Clinical Neuroscience
OCTOBER 01, 1969
Mélanoblastose et neurofibromatose
Les observations cliniques et génétiques rapportées indiquent que la blastomatose méningée et cutano-méningée, lorsqu'elle se présente comme une blastomatose isolable et sévère, entretient un lien, en apparence et surtout en familiarité, avec les dysplasies génétiques du système nerveux central. La conception mésoectodermique de l'ontogenèse de la mélanine explique non seulement l'apparition des neurinomes, des gliomes et des méningiomes, mais aussi la possibilité d'observer des processus mélaniques dans des phacomatoses telles que la neurofibromatose, la sclérose tubéreuse et l'angiomatose.
Clinical Neuroscience
OCTOBER 01, 1969
[Encephalodystrophy progressiva paranatalis]
[The author analyses the histopathological picture of the subacute and chronic stages of paranatal asphyxia based on 3 observations. In the chronic stage, he suggests the name "status microcysticus" for the spongy loosening of the cortex and cortical bone, which should be distinguished from the van Bogaert and Leigh type "status spongiosus". The status microcysticus is the result of a functional or organic vascular lesion. Finally, he discusses Alpers' disease and considers that the majority of the findings to date do not correspond to Alpers' disease.]
Clinical Neuroscience
OCTOBER 01, 1969
Oro-lingual dyskinesia: a neurological enigma
Author draws attention to a specialised dystonic syndrome involving mainly the muscles of the mouth, lips and tongue. Spasms can become so extensive that they can prevent the patient from writing, walking and standing. In particular, the muscles of the face and tongue may be affected. The pathogenesis and pathogenesis are not uniform. In the past, most cases of the disease were late complications of encephalitis. Nowadays this pathology is unlikely. Some cases strongly suggest a psychogenic origin, others are more likely to be of degenerative or ischaemic origin. This is particularly the case in elderly patients. Finally, in a proportion of cases, an organic syndrome due to unusual sensitivity to prolonged use of phenothiazides or other medications is likely.
Clinical Neuroscience
OCTOBER 01, 1969
[Cerebrovascular accidents with psychiatric symptoms]
[We have described and illustrated it with "model" cases: a) The acute reversible psychotic symptom complex of hypertensive encephalopathic meningo-cerebral oedema, which we reported in 1956, which presents as a cerebral vascular catastrophe and can be distinguished from the progressive form of meningo-cerebral oedema, the latter being known from an earlier date. b) Psychotic episodes of shorter or longer duration in the Binswanger-Grünthal form of cerebral vascular atherosclerosis, which, although presenting as cerebral vascular catastrophes, are considered to be a form of generalised circulatory insufficiency, beginning with cerebral circulatory insufficiency. c) We have also isolated, on the basis of clinical and EEG features, the temporal lobe Korsakow variant. In our case, we also found a diffuse cerebral small vessel sedation with acute onset and recurrent psychotic symptomatology over many years.]
Clinical Neuroscience
OCTOBER 01, 1969
[Data for the differential diagnosis of carotid circulation disorders]
[Carotid circulation was found in 5% of the 1250 patients examined indiscriminately. According to literature pathology data, we should probably expect a higher prevalence rate. The history and clinical picture cannot be used to distinguish it from other pathological processes and cannot provide a definite indication of the location of the vascular lesion causing the carotid circulation defect. In addition to the usual investigative procedures, physical and instrumental examination of the carotid arteries, together with the usual examination procedures, provide the main data to prove or exclude the presence of a pathology.]
Clinical Neuroscience
OCTOBER 01, 1969
[Electromyography controlled relaxation and Nivalin decurarisation]
[Authors checked the degree of curarisation and decurarisation in 20 cases of anaesthetised patients by electromyography. In 5 cases, decurarization was started at the time of maximal relaxation with Nivalin at 10 mg per dose, under electromyographic control until complete decurarization. It is concluded that doses higher than those reported in the literature can be used safely and that the drug is suitable for the suspension of complete curarization. No adverse side effects or recurarization have been observed, and in their opinion Nivalin is the ideal curare antidote.]
Clinical Neuroscience
OCTOBER 01, 1969
[Data on the plasticity of alpha activity clinical evaluation]
[The alpha reactivity of 11 patients changed in parallel with the change in their mental stress state after light exposure. The analysis concluded that the adaptive capacity of the regulation maintaining the optimal level of arousal was not impaired.]
Clinical Neuroscience
OCTOBER 01, 1969
[Myositis of the eye muscles]
[The author describes two cases of chronic orbital cellulitis with myositis. He reviews the clinical forms of orbital myositis, the names and classifications used in the literature, differential diagnostic methods and therapeutic options. ]
Clinical Neuroscience
OCTOBER 01, 1969
[On muscular and spinal cord disorders in old age]
[In old age, the skeletal muscles progressively atrophy. There are significant individual differences in the time of onset, localisation and rate of progression of atrophy. It is usually most pronounced in the small muscles of the hand, forearm and leg. The conditions for its development are not known. It is probable that non-diminishing muscle activity delays the onset of atrophy. However, we have observed relatively early onset of atrophy in labourers and farmers with heavy physical work, which cannot be explained by any nerve or muscle disease. On the other hand, we did not observe more individuals with mental work around the age of 70-72 who never had any serious muscle involvement. Perhaps it develops later and more slowly in pyknotic subjects than in leptosomes. Our observations suggest that nutritional conditions are likely to have an effect on the development of muscle atrophy.]
Clinical Neuroscience
OCTOBER 01, 1969
[Biochemical research problems in multiple sclerosis]
[In this short publication, I will attempt to give a brief overview of the problems that we need to know about the chemical mechanisms of MS pathomechanisms in order to design our research and evaluate the results in a useful way, based on current neurobiological concepts.]
Clinical Neuroscience
OCTOBER 01, 1969
[Factors for aesthetic choice]
[Our experimental studies show that children's aesthetic choices are influenced by the qualities of images in the following order: colour - style - content. Among the characteristics of the subjects, age seems to be the most important factor, gender being the next most important. It should be noted that the children in our report all come from middle-class backgrounds in Boston and its environs with the appropriate socio-cultural background.]
Clinical Neuroscience
OCTOBER 01, 1969
[Lumbar anaesthesia for severe neurological complications]
[While in our first case the flaccid paresis and neuralgia pains of the left lower limb are most probably the result of a direct nervous system injury, in our second case we can exclude a direct nervous system injury. The acute headache, dizziness, nausea and tinnitus after the operation were probably the result of meningeal excitement. The symptoms suggest an accumulation of cerebrospinal fluid in the cerebellar spinal cord (meningitis serosa, circumscripta). The paralysis may be caused by meningeal irritation accompanied by arachnitis with secondary sweating. Consequent symptoms may be due to cerebral dysregulation caused by aseptic meningitis. According to the literature, abducens paralysis occurs between 2 and 12 days after anaesthesia. In most cases, paralysis resolves within days or a few weeks. It is possible and, as our case demonstrates, permanent paralysis. In such cases, an allergic mechanism may play a role in triggering the more severe meningitis.]
Clinical Neuroscience
OCTOBER 01, 1969
[Some questions about the use of antiepileptic drugs]
[The practice of using antiepileptic drugs has evolved from everyday, essentially casual experience. The practice, which in principle appears to be correct, has been steadily differentiated over the years. At present, however, the nearly 30-year history of modern antiepileptic therapy, which we can expect from the introduction of hydantoin use, allows a realistic assessment of this practice based on the therapeutic effectus of a large number of patients' medical histories. Recent literature provides more valuable data in this respect. Our own clinical experience also calls for a review of the practice guidelines developed so far. This paper does not aim to be exhaustive, but merely to highlight some of the issues.]
Clinical Neuroscience
OCTOBER 01, 1969
[Status and tasks of neuropathology]
[The word neuropathology has acquired its current meaning in the last 15-20 years, when it became synonymous with the pathology of the nervous system. Previously, "neuropathology" was used in the sense of "neurocognitive pathology". The change in terminology is a return to the custom of incorporating pathology and pathological pathology into the term pathology, and is still used in many places to refer to this dual profession and its institutions.]
Clinical Neuroscience
OCTOBER 01, 1969
[The medical-psychological analysis of the poetry of Michelangelo and Shakespeare]
[An analysis of the poetry of Michelangelo and Shakespeare, two giants of the mind, raises many interesting problems from the point of view of medical psychology. I wish to emphasise that I am concerned only with the sonnets of both, that is to say, with the collection of poems in which these two greatest geniuses of humanity express themselves with the utmost subjectivity.]
Clinical Neuroscience
OCTOBER 01, 1969
[Evolution of the body's regulatory function in the face of hypoxia during ontogenesis]
[Authors investigated the change in 02 consumption in dogs aged 3-17 days during 3 or more episodes of associatively induced hypoxia and conditioned signalling. They found that there is a difference in the autonomic reactions to the application of the conditioned stimulus in relation to the ontogenetic development of the nervous system. At the youngest age, before about 20-30 days of age depending on the species, the nervous system undergoes an increase in vegetative changes mimicking the unconditioned response, indicating a lower level of need-to-regulate. During the transition period, the conditioned response becomes bidirectional: it starts with a change of the same nature as the unconditioned stimulus and then switches in the opposite direction to produce a metabolic increase. Finally, in the more advanced organism, over 30 days of age, the stabilisation of the need value during the triggering is reflected in a vegetative change in the opposite direction to the unconditioned stimulus, in an increase in 02 consumption.]
Clinical Neuroscience
OCTOBER 01, 1969
[Pathophysiology of subacute encephalopathies]
[The author concludes, on the basis of neuropathological studies, that the criteria for the classification of Creutzfeldt-Jakob disease and related conditions into groups, neither by the quality of histological lesions nor by their topographical distribution, are sufficiently certain to be implemented without objection. In the vast majority of cases, histopathological signs of subacute spongiform encephalopathy are present; the classic Creutzfedt-Jakob syndrome is rare. The nature of the lesions suggests exogenous pathogenesis, primarily through damage to astrocytes. He attributes histological signs suggestive of a pathogenetic responsibility of the circulatory, oxidative or vasodilator (area maxima near poles or at vascular boundaries) to general craniocerebral dynamics known in diffuse brain diseases and not primarily to pathological factors. It argues that Creutzfeldt-Jakob disease is a disorder distinct from Pick's and Alzheimer's disease. Nevertheless, there are difficulties in differentiating (circumscribed brain atrophy, argyrophilic lesions). In one case of amyotrophic dementia, hyaline inclusions were observed in motor neurons of the spinal cord.]
Clinical Neuroscience
OCTOBER 01, 1969
[Carotid angiography detected during the procedure, signs of pathogenesis]
[Authors have observed the resistance of the vessel wall and its surroundings, the distance of the blood column from the puncture needle, and the neurological and reflex symptoms of vessel compression during the technical performance of 960 carotid angiography. The empirical data thus obtained, in agreement with the signs found on angiograms, will help to clarify the vascular pathologies of the brain. ]
Clinical Neuroscience
OCTOBER 01, 1969
[Forensic aspects of psychogenic disorders]
[Nyírő's 1959 summary of psychogenic reactions discusses psychogenic reactions primarily in terms of disorders of consciousness, but raised many other issues worthy of discussion. In discussing disorders of consciousness, I would stick to Nyírő's definition and division of disorders of consciousness as energetic changes and distinguish between integrative and lucid disorders. The integration of consciousness can be tight or loose, in pathological states tight or disintegrated. "With regard to lucid disturbances of consciousness, we distinguish between two groups: the state of consciousness representing the various phases of the sleep-wake transition and the dullness, fogginess, delirium, resulting from pathological causes." ]
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