Clinical Neuroscience

[Data on intracranial space narrowing in the elderly diagnosis and differential diagnosis of intracranial intracranial processes]

GÁTAI György1

NOVEMBER 01, 1963

Clinical Neuroscience - 1963;16(11)

[1. Intracranial space-occupying processes in the elderly differ from the average in both localization and specificity in younger age. The difference is so pronounced that diagnostic conclusions can be drawn on the basis of age as to the location and nature of the process. 2. Multiple tumours are much more common in older age. This fact should be taken into account in the diagnosis of multiple nodal syndromes in old age. 3. Solitary intracranial space-occupying processes in elderly patients are mainly supratentorial. If extraparenchymal, they are mostly not true tumours, are benign and can be successfully treated by surgery; if intraparenchymal, they are predominantly deep-seated, malignant tumours that cannot be surgically manipulated. An exception to the latter are spontaneous intra cerebral haematomas. 4. Axial constrictive processes, especially in the brainstem and cerebellum, are very rare in older age. Such localisations are probably not due to a single tumour. 5. Infratentorial space-occluding processes are significantly less frequent than the average, primarily primary (non-metastatic) small tumours. The majority of infratentorial tumours are pontocerebellar, benign. 6. Intracranial space-occluding processes in the elderly are polarising in terms of specificity: in addition to malignant, incurable tumours, vascular space-occluding processes of surgical origin are becoming more frequent, while the more "benign" tumours, which account for the majority of younger cases, are becoming rare. 7. The vast majority (4/5) of brain tumours with symptomatic onset over 60 years are malignant. Involutional age predisposes to malignant brain tumour development; benign tumours detected in old age usually start to develop before rather than at involutional age. ]

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[The authors aim to contribute to the efforts of the new phase in the fight against alcoholism in the country by drawing on a decade of experience. In grouping their patient material, they identify the development of an awareness of the disease as a primary task, which also determines the direction of psychotherapy. They see the more effective work of the social services as a prerequisite for the content of medical intervention, the avoidance of false results and, last but not least, the elimination of factors that prevent regression, through appropriate preparation. They touch on the link between alcoholism and psychopathy, and attribute the causes of alcoholism, particularly in rural areas, to the underlying motives behind unmet needs. In addition to awakening an awareness of the disease, which is a genuine voluntary activity, the creation of more optimal cultural opportunities is also seen as a key task, in order to develop a greater sense of community. In the case of those subject to enforced withdrawal, it would be preferable to establish appropriate work camps under medical supervision, rather than a purely medical form of treatment. Measures to eradicate alcoholism can only be effective if medical and social action are more closely linked.]

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