Clinical Neuroscience

[Pathologically proven cases of inferior posterior cerebellar artery occlusion. The two types of bulbar s lateralis syndrome]


MAY 01, 1963

Clinical Neuroscience - 1963;16(05)

[In our two clinically classic cases of Wallenberg's syndrome, we established a diagnosis of infernal post-thrombotic occlusion of the cerebellum. In both cases, the pathological findings confirmed that the lateral syndrome observed was caused by infernal post-thrombotic occlusion of the cerebellar. The literature data and our own older observations suggest that there is an upper lateral oblongata syndrome (occlusion of the a. fossae bulbi) and a lower lateral oblongata syndrome due to occlusion of the inf. post. a. cerebelli. In the latter syndrome there is vocal cord paresis, and accordingly in our cases we have demonstrated severe laesions of the middle and lower part of the nucl. ambiguus. ]


  1. Bács-Kiskun Megyei Tanács Kórháza Ideggyógyászata és Kórbonctana



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Clinical Neuroscience

[Analysis of 19 cases of syncope]

DÚS Vince

[In summary, 1. with the exception of the 3 cases with epilepsy, resting electrical activity, even if abnormal, does not appear to be specific and cannot be associated with syncope; 2. syncope, although in the majority of cases an independent pathology, may be associated with epilepsy (cases 1 and 2) and even, we hypothesize, may be a trigger of epilepsy (case 3); In case 3, the electrographic findings support the conclusion that the cause of the malocclusions is, as Gastaut et al. have already shown, cerebral anoxia caused by asystole or bradycardia; 4 Our case 4 suggests that the pathomechanism of cough syncope may involve a vagocardial reflex mechanism; 5. syncope can be induced by Megimide in addition to Cardiazolone. To our present knowledge, there is no link between epilepsy and the pathomechanism of syncope. However, syncope provoked by Cardiazole and Megimide deserves further study in the direction of the nature of the central mechanism that leads to the suspension of cardiac function.]

Clinical Neuroscience

[Topical use of streptomycin in the treatment of pain syndromes]


[Authors have reported local pain reduction with streptomycin in the local treatment of laryngeal TB. On the basis of this observation, they have regularly treated post-tooth extraction and neuralgia pain with str. The clinical data of 24 patients with trigeminal neuralgia and 1 patient with glossopharyngeal neuralgia are described in detail. Their observations indicate that the above effect of str. is produced by functional blockade of the nerve pathways that conduct pain. ]

Clinical Neuroscience

[Cerebral ventricular rupture in hydrocephalus occlusus]


[The authors describe their 25-year case of hydrocephalus. The aquaeductus sylvii was occluded by a 1 mm thick glial membrane, causing occlusive hydrocephalus. During the development of hydrocephalus, spontaneous improvement occurred because the ventricular wall in the left frontal convexity was ruptured and CSF was allowed to be absorbed into the subarachnoid space. In their case, he was familiar with the forms of aquaeductal obstruction, the atrophy of brain matter in hydrocephalus and the outcome, including the possibility of spontaneous recovery.]

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Clinical Neuroscience

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.

Clinical Neuroscience

Cases of inborn errors of metabolism diagnosed in children with autism

CAKAR Emel Nafiye, YILMAZBAS Pınar

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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

[The role of sleep in the relational memory processes ]

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Clinical Neuroscience

Electrophysiological investigation for autonomic dysfunction in patients with myasthenia gravis: A prospective study


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