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Details of neurosurgical management of four patients suffering from intractable epilepsy caused by cavernous angiomas of subcortical eloquent brain areas are presented. Two of four cavernomas were not visualized by CT or angiography but only by MRI. MRI or CT stereotactic image-guided key-hole craniotomy and resection of the lesion from the dominant anterior central gyrus (2 cases), from the dominant superior temporal gyrus or from the dominant supramarginal gyrus were performed without any morbidity. The postoperative hospital stay was 3-5 days and all four patients experienced improved seizure control. We conclude that stereotactic image-guided key-hole craniotomy and microsurgical resection offer significant advantages in the treatment of cavernous malformations. Surgical indications include medically refractory epilepsy, intracerebral haemorrhage and/or progressive neurological deficit.
[106 patients were examined after the first epileptic seizure; they were divided into two groups based on the clinical data. The two groups were: the group of provoked seizure and the group of non-provoked (isolated) seizure. 95 patients were in these two groups. The others showed focal epileptiform EEG alterations or generalized epileptiform activity without seizures and, because of the very low number of patients, the author excluded them from the study. A questionnaire was used to study and to search for the history of the disease and provocative factors. The familial occurrence of epilepsy was quite often among the patients, similar to primary generali zed epilepsy (17.9%). There were no important previous illnesses, except the provoked seizure. The provocative factors played a significant role in the occurrence of the first seizure. The different provocative factors appeared in greater numbers in the different groups. The anxiety occurred as a possible provocative factor in the group of non provoked seizure. The EEG after the first epileptic seizure showed epileptiform activity in the lower percentage than was predictable from the literature. The mobile long term EEG was shown to be an effective method of examination for epileptiform activity.]
[Ploidy and proliferative activity of 72 astrocytomas (except glioblastomas) were examined with nuclear DNA content by computed image analysis. The majority of samples originated from paraffin embedded material but they were partly obtained from surgical biopsy by printing or smear technique. The 72 astrocytomas were classified according to Kernohan's grading system. Different areas of tumours were evaluated according to their ploidy (euploid, diploid, aneuploid and heterogenous ranges), proliferative parameters and DNA indices. The transitional zone sometimes revealed higher proliferative index with euploidy. The DNA distribution showed greater population even in the case of moderate malignancy. Uniform – single population - DNA distribution characterized the benign type in 79% with DNA index within the diploid range. The remaining 21% had aneuploidy with another population (heterogenous). The higher the malignancy the greater the population may be found with the higher percentage of S phase cells. The mitotic forms displayed higher DNA index as well as G 2 phase even in the transitional zone of the tumour. The heterogeneity with higher percentage of S- phase correlated well with the histological type of the tumour. The follow-up study of some astrocytomas sometimes did not show a good correlation with the DNA values. However a good correlation was found between the number of cells with higher S and G 2 phases and the type of histogram in the majority of cases studied. The different parts of the tumours also varied in these respects, which should be taken into consideration during needle biopsies.]
[The classifications of ischemic damage of the brain which have been in use cannot give a suitable orientation about the pathoanatomical background of this disease. As a result of this, the authors investigated the data of 1000 cerebrovascular indoor stroke patients who had been investigated by CT or MRI. The clinical and radiological data were compared. Their conclusion was: more than 80% of the cerebrovascular diseases are ischemic lesions. All of the ischemic patients have some vascular disturbances. In the cases of all patients having some ischemic event (transient ischemic attack, reversible ischemic neurological deficit, prolonged reversible ischemic neurological deficit, completed stroke) there are enduring ischemic lesions which can be demonstrated by CT or MRI. Comparing the neurological signs and the CT or MRI findings of the patients we could establish two groups of ischemic lesions: solitaire and multiplex infarcts. They can be divided into 3 subgroups. Among the solitaire infarcts is subgroup S-1: the patient has no neurological sign and in the CT or MR pictures there is only one lesion under 10 mm in diameter. S-2: mild neurological signs with one infarcted lesion about 15 mm in diameter; as a partial lesion in the territory of a cerebral vessel; S-3: severe neurological signs with total or almost total damage in the territory of a cerebral vessel. Among the multiple infarcted patients there is subgroup M-1: the patient has no neurological sign, but in the CT or MR pictures there are many small (under 5 mm in diameter) infarcted zones; M-2: the patient has mild neurological signs and multiple infarcted zones (5-15 mm in diameter) can be seen in the CT, MRI picture; M-3: the patient has very severe neurological signs and/or dementia. The infarcted areas consist of small and one or more sites of partial or total damage in the territory of a cerebral vessel. This classification is better in showing the state of the patients and the pathoanatomical distur bances. The authors have used this classification in clinical practice without any problems for a year.]
The authors analysed the association of genotype and the intelligence quotient (IQ) examined with age dependent psychological methods (Wechsler, Vineland, Binet, Raven IQ tests) in 41 Duchenne (DMD), 2 intermediate MD, and 14 Becker type muscular dystrophic (BMD) patients (mean age 2.5-37 y). ln 61.4% of the DMD/BMD exon deletion of dystrophin gene was found, while in 38.6% no deletion was detected. The assessment of the genotype was made by using multiple PCR method, examining the most frequent deletion of 18 exons and the muscle specific promoter. Among the deletion patients the distribution of mentol retardation was 28.5%, among patients with non deletion 22.7%. ln 21.4% of BMD patients and in 29.2% DMD patients mentol retardation was detected, the differences were not significant. Similar to the findings of other authors in 4 patients having exon deletions near the 5' end of the gene no mentol retardation was found, but in 14 of 30 patients having deletions near the 5' end of the gene there was. One patient with the largest deletion (exons 12-44) proved to be debil.
[A split cord malformation may be either diastematomyelia or diplomyelia. The former is characterized by two dural sacs and an osseous or osseocartilaginous septum, while the latter has two hemicords within a single dural sac and a nonrigid septum. Consequently, both require a specific neurosurgical technique. The featured case emphasizes the importance of radiological investigations in the differential diagnosis of these rare entities. The 25 year old woman experienced progressive worsening of sensation of her left foot, lower leg atrophy on the same side and gait disturbance. The findings upon physical examination were slight weakness of the left peroneal muscles, diminished touch sensation over the left foot and position sense in the left toes, and an absent ankle jerk reflex. SSEP of the left lower extremity yielded 3-5 ms P40 peak latency. The plain X-ray films and CT images revealed multiple congenital osseous anomalies: scoliosis, lumbalization of s 1 vertebra, hemiblock of the L 1-3 vertebral bodies, spina bifida at the Th 4-5, L 2-5 and S 1 and a bony median septum at L 2-3. The Il and T2 weighted axial, sagittal and coronal MR images showed sagittal spinal cord cleft with asymmetrical hemicords at L 2-4, and rejoining of them below 14. Low position of the conus, tethered cord and lipomatous infiltration of the filum were also detected. The earlier the detection of a split cord malformation, the better the surgical outcome. From the technical point of view, the preoperative classification with CT and MR is paramount.]
[Prognosis of ventricular hemorrhages is variable: parenchymal bleedings with secondary propagation into the ventricles are reported to have high mortality while good recovery is seen in most patients with primary intraventricular hemorrhage. The clinical course and outcome of 7 patients with intraventricular hemorrhage are reported and analysed in this paper. Three of them suffered primary intraventricular hemorrhage. One patient was followed up for 7 years after the onset of his disease. Complete clinical recovery was observed in 4 out of 7 patients, 2 patients had mild residual symptoms and 1 died because of extracranial complications. The favourable outcome of secondary intraventricular bleedings could be explained by the relief of intracranial pressure because of the drainage into the ventricular system. Noncommunicating hydrocephalus is a frequent complication, it should always be considered when signs of increased intracranial pressure develope after transitory improvement. External ventricular drainage of cerebrospinal fluid prevents the permanent neurological consequences of the hydrocephalus. Three out of our 7 patients required this procedure. Regular CSF examination helps the early recognition of drain-ventriculitis.]
[The role of sarcoglycanopathies in the differential diagnosis of limb-belt-type muscular dystrophies. Examination of epileptic twins: a Hungarian multicenter study. Traumatic bilateral carotid interna-dissection. A retrospective study of our cases of internal carotid stenosis. Extraspinal tumor causing spinal stenosis. The role of circadian and ultradian biological rhythms in the temporal distribution of spike wave paroxysms in idiopathic generalized epilepsy. The role of cardiovascular vegetative neuropathy in the development of dizziness complaints in old age. Wernicke encephalopathy caused by hyperemesis gravidarum. Hypertensive encephalopathy: EEG monitoring of the condition. Electromyographic examination of vegetative neuropathies. Care for neurological patients in Scotland and Florida. Hyperexplexia (case report). Evolution of self-esteem as a function of disease duration in patients with migraine and tension headaches. Video EEG monitoring in case of suspicion of photosensitive epileptic phenomena. The aging brain - clinical, neurophysiological and neuroradiological aspects. Cervical epidural hematoma following thrombolysis of acute myocardial infarction. Intramedullary metastatic spinal tumor. Depression and Parkinson's disease: correlations in our class of patients. The role of elevated levels of female sex hormones in the development of cerebral venous diseases (case report). Neuropathy with pressure paresis. Phase epileptic phenomena following eye closure. Giant aneurysm (case report). Analysis of 553 carotid reconstruction surgery. Analysis of our cases of Kearns-Sayre syndrome. Results of acute treatment of ischemic stroke in our department. Appearance of peduncular hallucinosis in bridging hemorrhage reaching the mesencephalon and bilateral thalamus tumor (case report). Our experience with heparin therapy for cardiac cerebral infarction. Headache caused by bulking arachnoid cyst (case report). Significance of functional studies in the preparation of carotid reconstruction surgeries. Data for Guillain-Barré syndrome. Analysis of patient traffic data from the Neurology Department of our hospital. Immunophenotyping of inflammatory polyneuropathies. Detection of right-left shunt by transcranial Doppler method in patients with ischemic cerebrovascular disease. Successful cerebral sinus thrombosis. Monitoring the treatment of orthostatic hypotension by TCD monitoring.]
[Surgical therapy and internal medicine aspects of stroke. Surgical therapy for stroke. Cardiological aspects of syncope. Neurally mediated reflex syncope syndromes. Care of stroke patients in Kecskemét County Hospital. Diabetes mellitus and hypertension in stroke. Syncope in neuropsychiatric diseases.]
[Conservative and surgical treatment of pain. Domestic situation of pain research and pain relief. Newer opiate preparations. Therapeutic options for postosterous neuralgia. Surgical treatment of trigeminal neuralgia. Neurosurgical treatment of neurogenic pain: MR-guided thalamotomy.]
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Clinical Neuroscience
[Headache registry in Szeged: Experiences regarding to migraine patients]2.
Clinical Neuroscience
[The new target population of stroke awareness campaign: Kindergarten students ]3.
Clinical Neuroscience
Is there any difference in mortality rates of atrial fibrillation detected before or after ischemic stroke?4.
Clinical Neuroscience
Factors influencing the level of stigma in Parkinson’s disease in western Turkey5.
Clinical Neuroscience
[The effects of demographic and clinical factors on the severity of poststroke aphasia]1.
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