Clinical Neuroscience

[Data on the cerebral hemisphere and lobes sclerosis]

TARISKA István1

APRIL 01, 1959

Clinical Neuroscience - 1959;12(04)

[It can be concluded that the extensive cortical damage that is the hallmark of hemispheric atrophies and lobar scleroses is, according to the literature and our own case studies, the result of an anoxic-vascular disturbance, which is particularly predisposed to occur as a consequence of a disturbance of the flow through relatively large pial arterial trunks or arterial border zones. This is associated with convulsions in the majority of cases, but convulsions must be accompanied by some other factor perhaps more pathogenetically important than convulsions ; respiratory disturbances, stagnant anoxia, fever, hypoglycaemia, immunobiological processes. ]

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Clinical Neuroscience

[A case of pubertal psychosis ]

DRIETOMSZKY Jenő

[Authors have taken different paths, emphasising the dominance of different characteristics in relation to the pubertal period. It is generally accepted that this age is characterised by a breakdown of the previous relative somatic and psychic equilibrium, which, together with the heightened susceptibility to stimuli from the outside world, which is also observed at this age, may be the basis for a number of dangers, including undesirable, possibly pathological, personality development. A particular interpretation of this aspect is given by Ruckert, who says that "in this age, ... everyone has before his eyes the image of what he should be, not as an abstract formula of a categorical imperative, but as a plastic image, an entelechy of the ideal constitution of his own soul..."]

Clinical Neuroscience

[Diffuse CSF invasion of oligodendroglioma ]

BALAJTHY Béla

[In our oligodendroglioma case, the histopathological examination revealed a ",total metastasis" of the tu. liquor pathways. The connective tissue elements are actively involved in the process of expansion in the subarachnoid space and show excitatory phenomena which we assume to be related to the blastomatous stimulus acting on them. The term "tumorous meningitis" is not uninteresting to designate the picture. The fact that this phenomenon occurs only exceptionally in oligodendroglioma cases could be explained by the fact that tu does not always succeed in overcoming the resistance of the meninges. Diffuse subarachnoid expansion is likely to occur only in conditions where the tu. reaches the brain surface extensively and acts on the meninges over a large surface area. ]

Clinical Neuroscience

[A case of congenital word blindness ]

SZECSŐDY Imre

[In summary, we believe that congenital word blindness is not a single pathology, but rather a syndrome, in which in many cases there may indeed be an anatomical abnormality, but which, as in aphasia, never causes the loss of a specific isolated function, but which, by disrupting the dynamic unity of the nervous functions, is the main symptom of a general disorder. It is therefore plausible to assume a milder degree of mental retardation, with symptoms that are more dominant than dominant in literacy, since the literacy mechanism is the result of a complex and highly complex synthesising and analysing activity, the fragility of which can be easily assumed from the complexity of the reflex processes that are layered on top of each other. ]

Clinical Neuroscience

[Electroclinical study with temporal lobectomy in Ammon's horn sclerosis epileptics]

KAJTOR Ferenc, HABERLAND Katalin, HULLAY József, ÁNGYÁN András

[Seven patients with temporal lobe epilepsy in whom biopsy histology showed Ammon's horn sclerosis were subjected to electroclinical observations. The clinical features were high seizure activity during sleep, frequency of vegetative seizure phenomena and automatisms, personality abnormalities without intellectual impairment, intense mediobasal (garati) and hippocampal spasmodic activity. Temporal lobectomy provided the best results in the areas of EEG, seizure freedom and personality changes. Authors raise the possibility of an epileptogenic role of Ammon's horn sclerosis. ]

Clinical Neuroscience

[Report]

OROSZ Éva

[The author reports on the meeting of the French-speaking Society of Neurosurgery held on 2-3 December 1958.]

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Fluoxetine use is associated with improved survival of patients with COVID-19 pneumonia: A retrospective case-control study

NÉMETH Klára Zsófia, SZÛCS Anna , VITRAI József , JUHÁSZ Dóra , NÉMETH Pál János , HOLLÓ András

We aimed to investigate the association between fluoxetine use and the survival of hospitalised coronavirus disease (COVID-19) pneumonia patients. This retrospective case-control study used data extracted from the medical records of adult patients hospitalised with moderate or severe COVID-19 pneumonia at the Uzsoki Teaching Hospital of the Semmelweis University in Budapest, Hungary between 17 March and 22 April 2021. As a part of standard medical treatment, patients received anti-COVID-19 therapies as favipiravir, remdesivir, baricitinib or a combination of these drugs; and 110 of them received 20 mg fluoxetine capsules once daily as an adjuvant medication. Multivariable logistic regression was used to evaluate the association between fluoxetine use and mortality. For excluding a fluoxetine-selection bias potentially influencing our results, we compared baseline prognostic markers in the two groups treated versus not treated with fluoxetine. Out of the 269 participants, 205 (76.2%) survived and 64 (23.8%) died between days 2 and 28 after hospitalisation. Greater age (OR [95% CI] 1.08 [1.05–1.11], p<0.001), radiographic severity based on chest X-ray (OR [95% CI] 2.03 [1.27–3.25], p=0.003) and higher score of shortened National Early Warning Score (sNEWS) (OR [95% CI] 1.20 [1.01-1.43], p=0.04) were associated with higher mortality. Fluoxetine use was associated with an important (70%) decrease of mortality (OR [95% CI] 0.33 [0.16–0.68], p=0.002) compared to the non-fluoxetine group. Age, gender, LDH, CRP, and D-dimer levels, sNEWS, Chest X-ray score did not show statistical difference between the fluoxetine and non-fluoxetine groups supporting the reliability of our finding. Provisional to confirmation in randomised controlled studies, fluoxetine may be a potent treatment increasing the survival for COVID-19 pneumonia.

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Cases of inborn errors of metabolism diagnosed in children with autism

CAKAR Emel Nafiye, YILMAZBAS Pınar

Autism spectrum disorder is a neurodevelopmental disorder with a heterogeneous presentation, the etiology of which is not clearly elucidated. In recent years, comorbidity has become more evident with the increase in the frequency of autism and diagnostic possibilities of inborn errors of metabolism. One hundred and seventy-nine patients with diagnosis of autism spectrum disorder who presented to the Pediatric Metabolism outpatient clinic between 01/September/2018-29/February/2020 constituted the study population. The personal information, routine and specific metabolic tests of the patients were analyzed retrospectively. Out of the 3261 patients who presented to our outpatient clinic, 179 (5.48%) were diagnosed with autism spectrum disorder and were included in the study. As a result of specific metabolic examinations performed, 6 (3.3%) patients were diagnosed with inborn errors of metabolism. Two of our patients were diagnosed with classical phenylketonuria, two with classical homocystinuria, one with mucopolysaccharidosis type 3D (Sanfilippo syndrome) and one with 3-methylchrotonyl Co-A carboxylase deficiency. Inborn errors of metabolism may rarely present with autism spectrum disorder symptoms. Careful evaluation of the history, physical examination and additional findings in patients diagnosed with autism spectrum disorder will guide the clinician in the decision-making process and chose the appropriate specific metabolic investigation. An underlying inborn errors of metabolism may be a treatable cause of autism.

Clinical Neuroscience

Late simultaneous carcinomatous meningitis, temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting with mono-symptomatic vertigo – a clinico-pathological case reporT

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Although vertigo is one of the most common complaints, intracranial malignant tumors rarely cause sudden asymmetry between the tone of the vestibular peripheries masquerading as a peripheral-like disorder. Here we report a case of simultaneous temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting as acute unilateral vestibular syndrome, due to the reawakening of a primary gastric signet ring cell carcinoma. Purpose – Our objective was to identify those pathophysiological steps that may explain the complex process of tumor reawakening, dissemination. The possible causes of vestibular asymmetry were also traced. A 56-year-old male patient’s interdisciplinary medical data had been retrospectively analyzed. Original clinical and pathological results have been collected and thoroughly reevaluated, then new histological staining and immunohistochemistry methods have been added to the diagnostic pool. During the autopsy the cerebrum and cerebellum was edematous. The apex of the left petrous bone was infiltrated and destructed by a tumor mass of 2x2 cm in size. Histological reexamination of the original gastric resection specimen slides revealed focal submucosal tumorous infiltration with a vascular invasion. By immunohistochemistry mainly single infiltrating tumor cells were observed with Cytokeratin 7 and Vimentin positivity and partial loss of E-cadherin staining. The subsequent histological examination of necropsy tissue specimens confirmed the disseminated, multi-organ microscopic tumorous invasion. Discussion – It has been recently reported that the expression of Vimentin and the loss of E-cadherin is significantly associated with advanced stage, lymph node metastasis, vascular and neural invasion and undifferentiated type with p<0.05 significance. As our patient was middle aged and had no immune-deficiency, the promoting factor of the reawakening of the primary GC malignant disease after a 9-year-long period of dormancy remained undiscovered. The organ-specific tropism explained by the “seed and soil” theory was unexpected, due to rare occurrence of gastric cancer to metastasize in the meninges given that only a minority of these cells would be capable of crossing the blood brain barrier. Patients with past malignancies and new onset of neurological symptoms should alert the physician to central nervous system involvement, and the appropriate, targeted diagnostic and therapeutic work-up should be established immediately. Targeted staining with specific antibodies is recommended. Recent studies on cell lines indicate that metformin strongly inhibits epithelial-mesenchymal transition of gastric cancer cells. Therefore, further studies need to be performed on cases positive for epithelial-mesenchymal transition.

Clinical Neuroscience

Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease

SENGUL Yildizhan, KOCAK Müge, CORAKCI Zeynep, SENGUL Serdar Hakan, USTUN Ismet

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Clinical Neuroscience

[The role of sleep in the relational memory processes ]

CSÁBI Eszter, ZÁMBÓ Ágnes, PROKECZ Lídia

[A growing body of evidence suggests that sleep plays an essential role in the consolidation of different memory systems, but less is known about the beneficial effect of sleep on relational memory processes and the recognition of emotional facial expressions, however, it is a fundamental cognitive skill in human everyday life. Thus, the study aims to investigate the effect of timing of learning and the role of sleep in relational memory processes. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. Our results suggest that the timing of learning and sleep plays an important role in the stabilizing process of memory representation to resist against forgetting.]