Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Apr 1988
Enlargement of the third ventricle and hyponatraemia in aneurysmal subarachnoid haemorrhage.
Hyponatraemia following aneurysmal subarachnoid haemorrhage is associated with an increased risk of cerebral infarction. Whether the development of hyponatraemia was related to enlargement of the third ventricle on the admission CT scan was investigated in a consecutive series of 133 patients who were seen within 72 hours of aneurysmal haemorrhage. ⋯ The significant relationship between enlargement of the third ventricle and hyponatraemia remained after adjustment for the amount of cisternal blood, but not after adjustment for the amount of intraventricular blood. These results suggest that the size of the third ventricle is an important but not the only factor in the relationship between acute hydrocephalus and hyponatraemia in patients with aneurysmal subarachnoid haemorrhage.
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J. Neurol. Neurosurg. Psychiatr. · Mar 1988
Xanthochromia revisited: a re-evaluation of lumbar puncture and CT scanning in the diagnosis of subarachnoid haemorrhage.
The CT and cerebrospinal fluid (CSF) findings of 100 patients with ruptured intracranial aneurysms were reviewed. Forty six percent of the 68 patients who had a lumbar puncture had blood stained CSF but with no xanthochromia. ⋯ It is concluded that it is blood stained CSF that is important in the diagnosis of subarachnoid haemorrhage (SAH), and not xanthochromia, and that a normal CT scan (EMI 1010) and the absence of xanthochromia in the CSF do not exclude a ruptured intracranial aneurysm. To diagnose SAH, it may be necessary to perform both investigations; the CT scan as the primary investigation in those patients in whom lumbar puncture is judged to be hazardous; the lumbar puncture as the secondary investigation in those patients with a normal CT scan.
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J. Neurol. Neurosurg. Psychiatr. · Mar 1988
Comparative Study Clinical Trial Controlled Clinical TrialPropranolol and propranolol-LA in essential tremor: a double blind comparative study.
In a double blind, comparative study with 15 patients, a long-acting formulation of propranolol taken once daily (at doses of 160, 240 and 320 mg), was shown to be as effective as conventional propranolol (80 mg three times daily) in reducing the amplitude of essential tremor. The specific protocol employed demonstrated problems inherent in chronic pharmacological trials in essential tremor which have implications for future studies.
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J. Neurol. Neurosurg. Psychiatr. · Feb 1988
Multiple sclerosis: correlation of magnetic resonance imaging with cerebrospinal fluid findings.
MRI examination of 41 patients with clinical definite multiple sclerosis showed white matter lesions of high proton T2 signal consistent with demyelination in 76% and CSF abnormalities present in 76%. Of patients with CSF abnormalities, 26% had normal MRI scans; conversely 26% of patients with MRI abnormalities had negative CSF studies. Thus a significant number of multiple sclerosis patients had negative results on either MRI or CSF examination, while only 5% had normal results on both tests.
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J. Neurol. Neurosurg. Psychiatr. · Feb 1988
Case ReportsMarked depletion of dorsal spinal cord substance P and calcitonin gene-related peptide with intact skin flare responses in multiple system atrophy.
In view of the presence of neuropeptides in spinal cord autonomic pathways, their regional concentration was studied in post mortem thoracic cord from four cases of multiple system atrophy with progressive autonomic failure (MSA). A marked depletion was observed of substance P, its related peptide substance K, and of calcitonin gene-related peptide (CGRP), particularly in dorsal regions where peptide-containing sensory fibres terminate. As substance P and CGRP in primary sensory fibres are considered mediators of skin flares in Lewis' triple response, histamine-induced skin flares were measured in 12 MSA patients and were found to be preserved. These results provide a new key to the classification and aetiology of autonomic and multiple system degenerations, as well as a model to study the role of sensory neuropeptides in man.