Clinical Neuroscience

[Foreign Language Summaries]

DECEMBER 19, 1951

Clinical Neuroscience - 1951;4(04)

[A summary of the articles published in the issue in Russian and German]

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Clinical Neuroscience

[Parietal syndromes (Gerstmann's syndrome, attitudinal diseases) in the light of conditioned reflexology]

JUBA Adolf

[Anomia, parietal agraphia and alexia, and finally ujjagnosia were found in three circumscribed skull lesions of the left parietal landscape (the fossa in case 1 affecting the junction of the gyr. angularis, gyr. supramarginalis and the peduncular segment of the 1st temporal gyrus, in observations 2 and 3 the gyr. angularis and partly the occipital cortex). The anomia can be interpreted, following the Pavlovian doctrines, in terms of increased iraddition of the stimulus, reduced concentration, and ultimately degradation of differential inhibition: patients vocalise a series of similar words but do not always reach the adaequate word trace. A similar mechanism is at work in the development of agraphia and alexia, exacerbated by the limitation of dynamic stereotypy to capture the word composed of letters. Parietal foci thus limit speech in its entirety and the pathology of the lesion cannot be seen as a negative of the normal functioning of the site. Finger agnosia in case 1 presented as a simple finger anomaly; in cases 2 and 3, where the occipital cortex was also damaged, the disorder corresponded to Gerstmann's true finger agnosia. Here, a multilayered inhibition of the conditional connections is expected, in which the relaxation of the kinaesthesia-optic junction plays a major role. In a fourth brain lesion in j.o., the foci were located in the more superior lip of the posterior segment of the right interparietal sulcus. In the aura of the epileptic seizures, there was a rotating dizziness, with an onset of contralateral adversion, all of which could be evaluated as focal symptoms. Macropsia developed during the aura and can be understood as a distortion of the optic and oculomotor connections (Pavlov), which indicate the size of objects, and developed in response to the pathological stimulus.]

Clinical Neuroscience

[Data on cerebral histological changes and their origin after CO intoxication]

FAZEKAS I. Gyula, GERÉB Tibor

[The brain of a 33-year-old man who died 3 months after CO poisoning was examined histologically with the following results: 1. There was a high degree of fatty degeneration of the cortical and medullary nuclei and endothelial fatty degeneration of both the cortical and medullary vessels with perivascular granule cell accumulation. No calcification of blood vessels was observed. 2. In addition, a marked proliferation of microglia, hypertrophy and hyperplasia of macroglia, and the transformation of microglia and oliodendroglia into granule cells were observed, accompanied by generalized watery phenomena. 3. In addition to lens opacities on both sides, diffuse patchy demyelination was found in the white matter of the cerebrum, with ring-like sparing of the vascular surroundings. Both demyelination and rings of sparing, as well as a high degree of fat deposition (fat-filled granular cells) were observed in other intact-appearing brain areas. 4 Our case suggests that white matter disease can be diffuse and extensive even in the presence of negative or insignificant lesions in the medulla. 5. We consider the anoxaemic state to be a primary factor in the pathomechanism of CO poisoning. In addition, however, there is no doubt that CO itself plays a role in the development of brain tissue lesions through its direct tissue paralysis effect. 6. Based on the histological picture of our case and recent physiological observations, we do not exclude Hallervorden's view that oedema may also play a role in the development of white matter lesions, probably by obstructing cerebral blood flow and thus increasing anoxaemia by increasing intracranial and cerebral pressure, which leads to the development of pathological lesions. The perivascular sparing rings are explained by the fact that the blood vessels in the immediate vicinity still receive enough oxygen from the circulating blood to prevent severe destruction of their tissue elements, but that the more distant tissue elements no longer receive sufficient oxygen and that the anoxic condition leads to the destruction of these tissue elements.]

Clinical Neuroscience

[Clinically observed retroolivarial softening]

SOÓS Imre

[Five clinically observed cases of retroolivar ankylosis with typhoidal history and symptomatic pathology were described. The pathology is characterized by an ictus-like onset, nodal cerebellar symptoms, crossed anaesthesia, and lacunar lesions of the bulbar nuclei on the same side as signs of damage to the posterior landscape of the olive. In our cases, by following the behaviour of sensory disturbances during the course of the disease, a certain regularity was observed, in that the initial sensory loss was replaced over time by hypersensitivity or central sensory disturbances (dysaesthesias, contraer heat sensations). Blood pressure was persistently subnormal in all our patients. Of our five patients, three had obstruction of the art. fossae. lat. bulbi described by Foix, and two had typus Wallenberg's syndrome. This fact speaks in favour of the high relative frequency of retroolivar tissue softening.]

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Clinical Neuroscience

[The Comprehensive Aphasia Test in Hungarian]

ZAKARIÁS Lilla, RÓZSA Sándor, LUKÁCS Ágnes

[In this paper we present the Comprehensive Aphasia Test-Hungarian (CAT-H; Zakariás and Lukács, in preparation), an assessment tool newly adapted to Hungarian, currently under standardisation. The test is suitable for the assessment of an acquired language disorder, post-stroke aphasia. The aims of this paper are to present 1) the main characteristics of the test, its areas of application, and the process of the Hungarian adaptation and standardisation, 2) the first results from a sample of Hungarian people with aphasia and healthy controls. Ninety-nine people with aphasia, mostly with unilateral, left hemisphere stroke, and 19 neurologically intact control participants were administered the CAT-H. In addition, we developed a questionnaire assessing demographic and clinical information. The CAT-H consists of two parts, a Cognitive Screening Test and a Language Test. People with aphasia performed significantly worse than the control group in all language and almost all cognitive subtests of the CAT-H. Consistent with our expectations, the control group performed close to ceiling in all subtests, whereas people with aphasia exhibited great individual variability both in the language and the cognitive subtests. In addition, we found that age, time post-onset, and type of stroke were associated with cognitive and linguistic abilities measured by the CAT-H. Our results and our experiences clearly show that the CAT-H provides a comprehensive profile of a person’s impaired and intact language abilities and can be used to monitor language recovery as well as to screen for basic cognitive deficits in aphasia. We hope that the CAT-H will be a unique resource for rehabilitation professionals and aphasia researchers in aphasia assessment and diagnostics in Hungary. ]

Lege Artis Medicinae

[Focus on Lege Artis Medicinae (LAM)]

VASAS Lívia, GEGES József

[Three decades ago, LAM was launched with the goal of providing scientific information about medicine and its frontiers. From the very beginning, LAM has also concerned a special subject area while connecting medicine with the world of art. In the palette of medical articles, it remained a special feature to this day. The analysis of the history of LAM to date was performed using internationally accepted publication guidelines and scientific databases as a pledge of objectivity. We examined the practice of LAM if it meets the main criteria, the professional expectations of our days, when publishing contents of the traditional printed edition and its electronic version. We explored the visibility of articles in the largest bibliographic and scientific metric databases, and reviewed the LAM's place among the Hun­ga­rian professional journals. Our results show that in recent years LAM has gained international reputation des­pite publishing in Hungarian spoken by a few people. This is due to articles with foreign co-authors as well as references to LAM in articles written exclusively by foreign researchers. The journal is of course full readable in the Hungarian bibliographic databases, and its popularity is among the leading ones. The great virtue of the journal is the wide spectrum of the authors' affiliation, with which they cover almost completely the Hungarian health care institutional sys­tem. The special feature of its columns is enhanced by the publication of writings on art, which may increase Hungarian and foreign interest like that of medical articles.]

Clinical Neuroscience

Neuroscience highlights: The mirror inside our brain

KRABÓTH Zoltán, KÁLMÁN Bernadette

Over the second half of the 19th century, numerous theories arose concerning mechanisms involved in understanding of action, imitative learning, language development and theory of mind. These explorations gained new momentum with the discovery of the so called “mirror neurons”. Rizzolatti’s work inspired large groups of scientists seeking explanation in a new and hitherto unexplored area of how we perceive and understand the actions and intentions of others, how we learn through imitation to help our own survival, and what mechanisms have helped us to develop a unique human trait, language. Numerous studies have addressed these questions over the years, gathering information about mirror neurons themselves, their subtypes, the different brain areas involved in the mirror neuron system, their role in the above mentioned mechanisms, and the varying consequences of their dysfunction in human life. In this short review, we summarize the most important theories and discoveries that argue for the existence of the mirror neuron system, and its essential function in normal human life or some pathological conditions.

Journal of Nursing Theory and Practice

[Nursing Difficulties during the Treatment of Patients from different Cultures]

ČERVENÝ Martin, KILÍKOVÁ Mária

[Introduction: Inspecting the difficulties of Hungarian nurses during the treatment of patients from different cultures. Materials and methods: Anonymous online questionnaire for the subjective examination of nursing difficulties. Results: The research model consists of 122 responder. Specific questions were answered by applicable 111 responders only. It was discovered that communication is a significant difficulty for 56.76% of the respondents (63 people). Furthermore the patients from different cultures show significant distrust towards the nursing staff. Conclusion: The numbers of lessons in foreign languages need to be increased for Hungarian nurses, researches and presentations are needed in the area of multicultural patient care, communicational instructions and further trainings are required for nurses working in practice.]

Clinical Neuroscience

[MR imaging of acute disseminated encephalomyelitis and multiple sclerosis in children. A review (in English language)]

PATAY Zoltán

[Inflammatory diseases of the central nervous system (CNS) are relatively rare in children, but their relevance to public health is considerable due to frequent and significant long term morbidity and even mortality. As in adults, acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS) and their variants are the most common entities in this group of pathologies in the pediatric patient population. Recent efforts have focused on establishing standardized diagnostic criteria schemes to facilitate the diagnosis and differential diagnosis of these diseases, however especially with multiple sclerosis those have not been fully validated yet for disease occurring in children. In recent decades the role of MRI has been constantly increasing in the diagnostic work-up of suspected inflammatory diseases of the CNS as well as in the follow-up of patients with confirmed disease. Currently, MRI is the first-line diagnostic imaging modality in ADEM and MS and is fully integrated in the most widely used diagnostic criteria schemes, but it has a key role in clinical therapeutic research trials as well. This paper provides an update on the current concepts and strategies of MRI in inflammatory diseases of the CNS, as well as a review of the imaging semiology of the various disease entities and variants with emphasis on clinical and imaging particularities relevant to the pediatric patient population.]