Clinical Neuroscience

[Double ruptured pituitary aneurysm]

POTONDI András1, GÁBOR István1

APRIL 01, 1960

Clinical Neuroscience - 1960;13(04)

[Aneurysm of the a. comm. ant. ruptured twice. The fatal second rupture followed the first 1% years later. At the site of the old rupture, the scar was histologically detected in the aneurysm wall. The intima around the fresh rupture was necrotic. Brief literature review. ]


  1. Budapesti Orvostudományi Egyetem Igazságügyi Orvostani Intézet



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Clinical Neuroscience

[Experiences and conclusions from using Hirepin]


[The use of Chlorpromazine and Reserpine in psychiatric practice has become common in recent years. The efficacy of these drugs is considered to be at least equivalent to that of existing treatments. More recently, the use of Chlorpromazine and Reserpine in combination has become widespread. The tachycardia, obstipation and dry mouth effects of Chlorpromazine are well counterbalanced by the bradycardic, salivator and bowel motility-enhancing effects of Reserpine, and their psychic effect is synergistic (Deniker, 12). The literature on chlorpromazine and reserpine is almost incomprehensible: Deniker lists 315 works on the subject in his report to the 1957 Zurich Congress (12), and Kleinsorge and Rösner list 1867 in their 1958 monograph (25). Here, I would like to deal with Chlorpromazine and Reserpine (hereafter Chl. and R.) and one of the side effects of the combination of the two and one of the ways to avoid them, in the context of a new Hungarian drug combination, Hirepin.]

Clinical Neuroscience

[Adventitial sarcoma ]


[The author describes a case of adventitial sarcoma and discusses the issue of primary cerebral arterial sarcomas in depth. He concludes that the histogenetically hypothesized division of this tumour group into adventitial, perithelial and reticulum cell sarcoma types is valid. On the basis of histological features, adventitial and reticulum sarcomas can be definitely differentiated, while perithelial sarcomas are divided into two groups according to the interpretation of the term 'perithelial'. In Bailey's interpretation, cases classified as perithelial sarcomas represent a distinct type, whereas in Hanberry's interpretation, cases classified as perithelial can be identified with adventitial sarcomas. The author's subtle karyological observations support the fibroblastic genesis of adventitial sarcoma hypothesized by Környey.]

Clinical Neuroscience

[Modern pneumography in childhood]


[Authors report their experiences with positive pressure pneumography in children. Clinical observations on the compensation of hypertension are made. They describe a fractionated PEG and venticulography methodology. Finally, a summary of the indications for contrast studies is presented in an attempt to define the place of modern studies in paediatric neurosurgery.]

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Clinical Neuroscience

Atypical presentation of late-onset Sandhoff disease: a case report

SALAMON András , SZPISJAK László , ZÁDORI Dénes, LÉNÁRT István, MARÓTI Zoltán, KALMÁR Tibor , BRIERLEY M. H. Charlotte, DEEGAN B. Patrick , KLIVÉNYI Péter

Sandhoff disease is a rare type of hereditary (autosomal recessive) GM2-gangliosidosis, which is caused by mutation of the HEXB gene. Disruption of the β subunit of the hexosaminidase (Hex) enzyme affects the function of both the Hex-A and Hex-B isoforms. The severity and the age of onset of the disease (infantile or classic; juvenile; adult) depends on the residual activity of the enzyme. The late-onset form is characterized by diverse symptomatology, comprising motor neuron disease, ataxia, tremor, dystonia, psychiatric symptoms and neuropathy. A 36-year-old female patient has been presenting progressive, symmetrical lower limb weakness for 9 years. Detailed neurological examination revealed mild symmetrical weakness in the hip flexors without the involvement of other muscle groups. The patellar reflex was decreased on both sides. Laboratory tests showed no relevant alteration and routine electroencephalography and brain MRI were normal. Nerve conduction studies and electromyography revealed alterations corresponding to sensory neuropathy. Muscle biopsy demonstrated signs of mild neurogenic lesion. Her younger brother (32-year-old) was observed with similar symptoms. Detailed genetic study detected a known pathogenic missense mutation and a 15,088 base pair long known pathogenic deletion in the HEXB gene (NM_000521.4:c.1417G>A; NM_000521:c.-376-5836_669+1473del; double heterozygous state). Segregation analysis and hexosaminidase enzyme assay of the family further confirmed the diagnosis of late-onset Sandhoff disease. The purpose of this case report is to draw attention to the significance of late-onset Sandhoff disease amongst disorders presenting with proximal predominant symmetric lower limb muscle weakness in adulthood.

Clinical Neuroscience

[Tension type headache and its treatment possibilities]

ERTSEY Csaba, MAGYAR Máté, GYÜRE Tamás, BALOGH Eszter, BOZSIK György

[Tension type headache, the most common type of primary headaches, affects approximately 80% of the population. Mainly because of its high prevalence, the socio-economic consequences of tension type headache are significant. The pain in tension type headache is usually bilateral, mild to moderate, is of a pressing or tightening quality, and is not accompanied by other symptoms. Patients with frequent or daily occurrence of tension type headache may experience significant distress because of the condition. The two main therapeutic avenues of tension type headache are acute and prophylactic treatment. Simple or combined analgesics are the mainstay of acute treatment. Prophylactic treatment is needed in case of attacks that are frequent and/or difficult to treat. The first drugs of choice as preventatives of tension type headache are tricyclic antidepressants, with a special focus on amitriptyline, the efficacy of which having been documented in multiple double-blind, placebo-controlled studies. Among other antidepressants, the efficacy of mirtazapine and venlafaxine has been documented. There is weaker evidence about the efficacy of gabapentine, topiramate, and tizanidin. Non-pharmacological prophylactic methods of tension type headache with a documented efficacy include certain types of psychotherapy and acupuncture. ]

Clinical Neuroscience

Risk factors related to intracranial infections after transsphenoidal pituitary adenomectomy under endoscope

XU Yifan, HE Yuxin , XU Wu, LU Tianyu, LIANG Weibang, JIN Wei

Background – Up to now, the risk factors related to intracranial infections after transsphenoidal pituitary adenomectomy remain controversial. Purpose – To analyze the risk factors related to intracranial infections after transsphenoidal pituitary adenomectomy under an endoscope, and to provide evidence for preventing and controlling the occurrence and development of infections. A total of 370 patients receiving endoscopic transsphenoidal pituitary adenomectomy in our hospital from January 2014 to October 2017 were selected. The risk factors related to postoperative intracranial infections were analyzed. The hospitalization lengths and expenditures of patients with and without intracranial infections were compared. Of the 370 patients, 18 underwent postoperative intracranial infections, with the infection rate of 4.86%. Intraoperative blood loss >120 mL, cerebrospinal leakage, diabetes, preoperative use of hormones, macroadenoma as well as surgical time >4 h all significantly increased the infection rate (P<0.05). Preoperative use of antibacterial agents prevented intracranial infection. Compared with patients without intracranial infections, the infected ones had significantly prolonged hospitalization length and increased expenditure (P<0.05). Discussion – It is of great clinical significance to analyze the risk factors related to intracranial infection after endoscopic transsphenoidal pituitary adenomectomy, aiming to prevent and to control the onset and progression of infection. Intracranial infections after endoscopic transsphenoidal pituitary adenomectomy were affected by many risk factors, also influencing the prognosis of patients and the economic burden.

Clinical Neuroscience

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Lege Artis Medicinae

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