European neurology
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To examine the incidence of post-lumbar puncture headache (PLPH) in patients admitted for cognitive disturbances. ⋯ The incidence of PLPH in patients with cognitive disturbances is low and CSF analyses can thus be part of the diagnostic work-up at memory clinics.
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Historical Article
Sleepwalking in Italian operas: a window on popular and scientific knowledge on sleep disorders in the 19th century.
There is little knowledge on sleepwalking in ancient times even though it is a very common condition. The aim of this report is to describe the backgrounds of medical knowledge on somnambulism in the 19th century, a key period in the development of neurosciences, by analysing its representation in two famous Italian operas: La Sonnambula by Vincenzo Bellini and Macbeth by Giuseppe Verdi. The 19th-century operas may be considered as a crossing point between the popular and intellectual world because they mirror popular answers to phenomena that were still awaiting scientific explanations. ⋯ The analysed Italian operas provide two different views on sleepwalking, probably because they are based on texts belonging to different periods. Their examination allows one to understand the gradual evolution of theories on sleepwalking, from demoniac possession to mental disorder and sleep disease. At the same time, this analysis throws some light on the history of psychological illnesses.
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We investigated the relationship between injury of the spino-thalamo-cortical pathway (STP) and central post-stroke pain (CPSP) in patients with intracerebral hemorrhage, using diffusion tensor tractography (DTT). ⋯ Decrease of tract volume without changes in the STP FA or MD values in the CPSP group indicates partial injury of STP. Therefore, injury of the STP seems to be a requirement for the development of CPSP in patients with intracerebral hemorrhage.
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Transcranial Doppler (TCD) is a sensitive technique for circulatory arrest diagnosis in brain death when patterns such as reverberant flow and short systolic spikes are observed. In infants, the nonossified fontanelles compensate for intracranial hypertension. We describe TCD patterns in infants with brain death, different from adults, with the hemodynamic modifications induced by anterior fontanelle compression. ⋯ TCD for brain death diagnosis should be done cautiously in infants. In these cases, reverberating flow may be indicative of circulatory arrest even if with a large peak and with a high peak systolic velocity. Heavy fontanelle compression may reproduce the classical adult TCD patterns of brain death, thus supporting the diagnosis of cerebral circulatory arrest.
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Analysis of lesions and symptoms in patients with brain tumors combined with information from diffusion tensor imaging provides direct evidence of the anatomical localization of brain function. Using these methods, we evaluated 8 patients who underwent surgery for metastatic brain tumors located in the left occipital lobes between 2007 and 2009. Preoperatively, 4 patients (cases 1-4) had alexia with agraphia while the other 4 patients (cases 5-8) did not. ⋯ The SLF was compressed and disrupted in the white matter of the IPL near the upper portion of area 19 in case 1. In cases 5-8, the brain tumors were not located in the upper portion of area 19. These results suggest that damage to the upper portion of area 19 and to the white matter in the left IPL, including the SLF, resulted in alexia with agraphia.