Clinical Neuroscience

[Five recurrent subarachnoid haemorrhages from a cerebrovascular arterio-venous vessel]

FORNÁDI Ferenc1, SZEGEDY László1, HAITS Géza1

JANUARY 01, 1967

Clinical Neuroscience - 1967;20(01)

[The authors describe a 45-year-old female patient who has been clinically treated 5 times in 15 years for recurrent subarachnoid hemorrhages. The clinical interest of the case is given by the good general condition of the patient and her relatively well-preserved personality during the time between each bleeding episode. The bleeding was due to an arteriovenous aneurysm in the upper third of the mesencephalon. Presumably, this aneurysm, in addition to the recurrent bleeding, may have played a role in the development of the very marked cerebral atrophy and the strikingly severe arteriosclerotic vascular lesions by altering the hemodynamic relationships. ]

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  1. BOTE Psychiatriai Klinika

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Clinical Neuroscience

[Changes in the clinical picture of neurological diseases due to drug therapy]

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[In our medical practice, we often do not fully and correctly use all the possibilities of drug therapy. Medical thinking tends to be biased towards simple, easy-to-remember, templated treatment procedures. But in any case, we will only exhaust the potential of drug therapy if, on the basis of careful consideration of all the circumstances, we know the mechanism of action of the drug and the pathophysiology of the disease, we give the right drug at the right time, in the most appropriate dose, distribution and manner. Perhaps not enough emphasis is placed in university clinical education on the principles of drug therapy.]

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[Neuropathological lesions in animal studies of B12-avitaminosis]

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[induced central and peripheral nervous system lesions in white rats with B. deficiency. These were essentially identical to the typical neuropathological lesions of anaemia perniciosa (myelopathy, neuronal proliferation). The discrepancy, such as the rare or absent glial reactions and the extensive and severe damage to nerve cells, was explained by the more intense biochemical effects of experimental B12 deficiency. ]

Clinical Neuroscience

[Clinical significance of the Circulus arteriosus Willisi with special reference to hypoplasia]

LEEL-ŐSSY Lóránt

[After a detailed anatomical description of the circulus arteriosus Willisi, the first part of the paper describes the occurrence of hypoplasia in each branch. In the second part, the dynamic characteristics of the blood circulating in the CAW are used to illustrate the crucial regulatory, distributive and collateral role of the formula in the first stage of cerebral circulation. In the third part, the clinical relevance of anomalies (mainly hypoplasia) is highlighted. A study of the brains of 100 cerebrovascular and 100 non-cerebrovascular deceased individuals shows the well-known fact that CAW anomalies are twice as common in cerebrovascular diseases as in non-vascular diseases. It describes the predisposing, preforming, pathoplastic effects of anomalies in emollients, haemorrhages and thromboses. The frequent occurrence of anomalies is known in pituitary aneurysms, and anomalies often allow the development of severe arteriosclerosis in the basal vessels, if the mechanical theory of anteriosclerosis is considered. In relation to general CAW hypoplasia, he lists 19 cases of vascular injury or other disease, functionally modified by the anomaly. Among the latter, he points out the atypical course of three endogenous pathologies in particular. ]

Clinical Neuroscience

[Effect of metopirone on cerebral electrical activity]

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[Authors have studied the effects of Metopiron on brain electrical activity in endocrinology patients. In 5 of 13 patients studied, regularisation of electrogenesis was observed. It is hypothesized that the resulting lesion is due to a direct or indirect effect of Metopirone on the hypothalamus. In their further conclusions, they point to the possibility of a relationship between diurnal fluctuations in ACTH synthesis and the chronometric function of alpha-rhytmus.]

Clinical Neuroscience

[Clinical interpretation of Evipan sleep-activated EEG abnormalities in non-epileptic psychiatric patients]

NAGY A. Tibor, KAJTOR Ferenc, HALÁSZ Péter, KLEININGER Ottó

[Authors search for correlation between activated EEG abnormalities in 86 patients and various non-epileptic psychiatric disorders. They hypothesize organic brain damage and varying degrees of cerebral atrophy as causal factors underlying chronic clinical syndromes classified as neurosis - psychopathy - psychosis. It is not considered acceptable to extend the concept of epilepsy to all those with abnormal EEG findings without clinical epileptic manifestations. Linked to this, the question of the specificity of the seizure potential is raised. They include in the concept of "organic psychopathy" those with EEG abnormalities and PEG findings suggestive of a cerebral dysfunction, which may take other forms besides personality changes, due to pathoplastic factors. ]

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Rapid changes of stroke management in recent years facilitate the need for accurate and easy-to-use screening methods for early detection of large vessel occlusion (LVO) in acute ischemic stroke (AIS). Our aim was to evaluate the ability of various stroke scales to discriminate an LVO in AIS. We have performed a cross-sectional, observational study based on a registry of consecutive patients with first ever AIS admitted up to 4.5 hours after symptom onset to a comprehensive stroke centre. The diagnostic capability of 14 stroke scales were investigated using receiver operating characteristic (ROC) analysis. Area under the curve (AUC) values of NIHSS, modified NIHSS, shortened NIHSS-EMS, sNIHSS-8, sNIHSS-5 and Rapid Arterial Occlusion Evaluation (RACE) scales were among the highest (>0.800 respectively). A total of 6 scales had cut-off values providing at least 80% specificity and 50% sensitivity, and 5 scales had cut-off values with at least 70% specificity and 75% sensitivity. Certain stroke scales may be suitable for discriminating an LVO in AIS. The NIHSS and modified NIHSS are primarily suitable for use in hospital settings. However, sNIHSS-EMS, sNIHSS-8, sNIHSS-5, RACE and 3-Item Stroke Scale (3I-SS) are easier to perform and interpret, hence their use may be more advantageous in the prehospital setting. Prospective (prehospital) validation of these scales could be the scope of future studies.

Clinical Neuroscience

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Clinical Neuroscience

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Clinical Neuroscience

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