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Clinical Neuroscience - 1993;46(03-04)
Content
Clinical Neuroscience
MARCH 20, 1993
[Post-stroke depression]
[The pathogenesis of depression following cerebrovascular accident (post-stroke depression) is poorly understood. Thirty seven (28%) out of 134 patients from the „Budapest Stroke Data Bank" were found to be depressed. Thirty two patients (86%) in this group were affected by depression within three months or the stroke. Diagnosis of depression was bades on CES-D, Ham-D and Zung scales, and a word fluency test was performed with 11 depressed and 11 non-depressed patients. Comparing the frequency of post-stroke depression in groups with ischemic damage of the carotid versus the vertebrobasilar system, as well as the left versus right middle cerebral artery, no significant differences were found. Depression reduced the activities of daily living (score: 7.8) compared to the activities of non-depressed patients (score: 3.8) at the same score of stroke – severity (4.7 versus 4.1). These observations suggest that post-stroke depression influences the rehabilitation of stroke patients, therefore the diagnosis and treatment of post-stroke depression may increase the efficacy of stroke rehabilitation.]
Clinical Neuroscience
MARCH 20, 1993
[The role of brainstem auditory evoked potentials in the diagnosis of vertebrobasilar insufficiency]
[The diagnostic usefulness of brainstem auditory evoked potentials was compared with other diagnostic possibilities. Brainstem auditory evoked potential was examined in patients with vertebrobasilar insufficiency. Based on the duration of clinical symptoms, patients were divided into three groups: 85 patients with transient ischaemic attack (TIA), 31 patients with prolonged ischaemic symptoms, and 35 patients with chronic symptoms were examined. The latency and interpeak latency of the auditory evoked potentials increased in 49,3 per cent. A subgroup within the TIA group was specially tested. The patients belonging to this group were admitted to the clinic soon after the onset of TIA. Acoustic evoked potentials showed increased latencies and interpeak latencies in 45,8 per cent of this group. The increasing latencies of the waves I. and III. and the interpeak latancies of I-II. and I-V. waves were the most frequent differences. Otoneurology demonstrated more frequent functional disturbances in brainstem than in acoustic evoked potentials in the second and third group. Computerized tomography is a really helpful only in examining chronic cases, while the CT reports 3,6 per cent hypodensities in the first group and 17,3 per cent in the third group. Brainstem auditory evoked potential testing is the most sensitive diagnostic method in the diagnosis of transient ischaemic attack.]
Clinical Neuroscience
MARCH 20, 1993
[Spontaneous intracerebral haematomas in children]
[The authors report two cases of spontaneous intracerebral haematomas in children. Both children presented with serious symptoms of acute intracerebral haemorrhage. Investigations do not reveal the cause of the haemorrhage in either of the cases and angiography detected no arteriovenous malformation. The term ,,occult” is reserved for these cases, as spontaneous intracerebral haematomas do not result in space-occupying process or CSF passage blockage and may be treated medically.]
Clinical Neuroscience
MARCH 20, 1993
[The effect of cerebrospinal fluid drainage on middle cerebral artery blood flow velocity in conditions with raised intracarnial pressure]
[Middle cerebral artery (MCA) blood flow velocity and intracranial pressure (ICP) were recorded in 42 patients suffering from raised ICP. A major (ICP25 mmHg) or moderate (251CP15 mmHg) degree of intracranial hypertension was reduced by means of either continuous or intermittent CSF drainage. Measurements of MCA blood flow velocity were carried out with transcranial Doppler sonography (TCD). Three types of reactions were observed with regard to cerebral blood flow velocity (CBFV) changes in response to CSF drainage. Patients in Group 1 demonstrated pressure passive CBFV changes throughout the observed cerebral perfusion pressure (PP) range. In Group 2, cerebrospinal fluid (CSF) drainage brought about a transitory increase in CBFV for a few minutes. In Group 3, the reduction of ICP to the normal level did not influence CBFV at all. The pulsatility index (PI) of the cerebrovascular reserve capacity (CVR), which was highest in Group 1, changed in contrast with the CBFV changes in Groups 1 and 2. The pressure-passive velocity pattern (in Group 1) suggests that the blood vessels were at nearly maximum dilatation and were perhaps failing to constrict properly in response to increased PP. As recovery proceeded (Group 2), the mechanism became effective, thereby reestablishing autoregulation. Whereas clinical signs and computed tomography reveal only the trend of the ICP, TCD provides the possibility of a semi-quantitative evaluation of ICP changes and seems especially promising in the rapid assessment of the efficacy of treatment aimed at ICP reduction.]
Clinical Neuroscience
MARCH 20, 1993
[Measurements of regional cerebral blood flow and blood flow velocity in experimental intracarnial hypertension: infusion via the cisterna magna in rabbits]
[The cerebral blood flow velocity (CBFV), as measured by transcranial Doppler sonography (TCD) via the transorbital route in the intracranial segment of internal carotid artery (ICA), and the regional cerebral blood (volume) flow (rCBF) in the corresponding cortical areas, as measured by the hydrogen clearance technique, were determined in 8 New Zealand White rabbits undergoing cisterna magna infusion for elevation of the intracranial pressure (ICP). In the lower range of autoregulation, i. e. at perfusion pressures (PP) between 80 and 40 mm of mercury and even below this, the changes in (CBFV) and CBF showed a strong correlation (0,86) under conditions with standard PCO2 (PaCO2)=35+2 mm of mercury). Autoregulation was exhausted at 40 mm of mercury and the cerebrovascular resistance (CVR) was minimal. Below this PP, the CBF and CBV dropped sharply, whereas CVR, gradually increased, indicating that, despite the maximally dilated resistance vessels, the intracranial hypertension causes the vascular resistance to increase, possibly via blocking of the venous outflow. Our results confirmed that non-invasive and easily (even at the bedside) applicable measurements of CBFV changes could substitute the cumbersome and expensive isotope measurements of CBF in intracranial hypertension.]
Clinical Neuroscience
MARCH 20, 1993
[Benign focal amyotrophy]
[A 36 year old female is presented with focal segmental atrophy and weakness of the right lower limb affecting predominantly the lower leg. The slight asymmetry presentsince in her childhood started to progress at the beginning of the fourth decade. The EMG and the muscle histology revealed chronic neurogenic changes, which were consistent with spinal motoneuron lesions. The electrophysiological investigations verified the focal segmental localisation of the involvement. The benign course and the good prognosis of this clinical syndrome point out the importance of its recognition and separation from other motoneuron diseases. The cause of this disorder is unknown; probably, it has heterogeneous etiology.]
Clinical Neuroscience
MARCH 20, 1993
[Acute-phase proteins in various psychotic states]
[Some of the so-called acute-phase proteins were identified in the sera of 27 psychotic female patients. Values measured in the acute psychotic state were compared to those measured in the period of stabilization of the same patient, whether an acute psychotic state could be qualified from this point of view as a stress reaction. In agreement with some of the literary data these results did not support the this hypothesis. In psychotic states the concentrations of the measured proteins decrease. In the paranoid group alpha-2-macroglobuline and, in the affective group coeruloplasmine and alpha-2-macro-glycoprotein show this tendency. It seems that the evaluation of acute phase proteins together with other biological indicators may provide new information in psychiatric diagnostics.]
Clinical Neuroscience
MARCH 20, 1993
[Cerebral inorganic and pigment deposits in hallervorden-spatz disease]
[Authors survey the histochemistry of the cerebral deposits (lipofuscin, ceroid, hemosiderin, ferric phosphate and calcium phosphate) occurring in the Hallervorden-Spatz disease.]
Clinical Neuroscience
MARCH 20, 1993
[Stimulated single fiber electromyography]
[The authors review the nethod of stimulated single fiber electromyography, the normal values of stimulated jitter, and the advantages and disadvantages of the method and the pitfalls.]
Clinical Neuroscience
MARCH 20, 1993
[Pharmacotherapeutic protocols in psychiatry]
[Introduction 1. Organic and gerontopsychiatric disorders. 2. Schizophrenic psychoses paranoid states and affective disorders. 3. Alcohol and drug-induced psychoses, dependencies and addictions. 4. Sedatohypnotics, anxiolytics. Note to the plan]
Clinical Neuroscience
MARCH 20, 1993
[Hungarian Society of Neurologists and Mental Doctors]
[Summary of the meeting of the College of Neurology held on 4 December 1992.]
Clinical Neuroscience
MARCH 20, 1993
[The Hungarian Society of Pediatric Neurology, Neurosurgery, Child and Adolescent Psychiatry]
[Summary of the Pediatric Neurology, Neurosurgery, Child and Adolescent Psychiatry Professional College meeting of January 22, 1993.]
Clinical Neuroscience
MARCH 20, 1993
[Hungarian Spine Association]
[Diagnosis and treatment of spondylolisthesis. Book review "Practical Rheumatology". Scientific Programme of the Hungarian Spine Society 1993.]
Clinical Neuroscience
MARCH 20, 1993
[Hungarian branch of the International Antiepileptic League]
[Summary of the 20th session of the International Congress of Epilepsy, July 1993.]
Clinical Neuroscience
MARCH 20, 1993
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