Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Jul 2001
Respiratory monitoring in neuromuscular disease - capnography as an additional tool?
Daytime complaints like fatigue, sleepiness and cognitive dysfunction in neuromuscular disease can be due to nocturnal hypercapnia and hypoxemia. Daytime respiratory diagnostics does not reflect sleep disordered breathing. Nocturnal pulse oxymetry and capnography were performed in 11 patients (15-75 years old) with different slowly progressive neuromuscular diseases. ⋯ Daytime symptoms and muscular strength improved markedly. Capnography and pulse oxymetry should be performed during the course of neuromuscular disease to detect respiratory insufficiency. Capnography seems to be a more sensitive indicator for respiratory impairment especially when artificial ventilation has been initiated.
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Clin Neurol Neurosurg · Apr 2001
Results of surgical treatment of intrasylvian hematomas due to ruptured intracranial aneurysms.
In this retrospective study, the surgical outcome of patients with intrasylvian hematomas due to rupture of intracranial aneurysms was analyzed. The authors studied ten patients who underwent aneurysm surgery and evacuation of the hematoma within 12 h of the onset of bleeding. All patients had an intrasylvian hematoma classified with computerized tomography and all patients underwent pre-operative angiography. ⋯ The only significant prognostic factor in those patients who had intrasylvian hematoma was early surgery within 12 h of the bleeding. We suggest that early surgical treatment be performed in patients with intrasylvian hematoma, regardless of the neurological findings and grade on admission. Pre-operative angiography seems to be essential in identifying the source of bleeding.
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Clin Neurol Neurosurg · Dec 2000
Review Case ReportsIntramedullary spinal cord metastasis as a first manifestation of a renal cell carcinoma: report of a case and review of the literature.
The authors report the case of a 70-year-old woman who developed a Brown-Sequard-syndrome within 6 weeks caused by an intramedullary spinal cord metastasis of an occult renal cell carcinoma. Intramedullary metastases are rare and represent only 4-8.5% of central nervous system metastases. An important feature of intramedullary metastases is the rapid progression of neurological deficits which necessitates rapid treatment. ⋯ Neurology 1960;674-8). To the best of our knowledge this is the first report on a patient in whom symptoms from the metastasis of a renal cell carcinoma preceded the detection of the primary tumor. This report presents the clinical, neuroradiological and histopathological findings of an intramedullary metastasis of a renal cell carcinoma and provides an overview of the literature on intramedullary spinal cord metastases.
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Clin Neurol Neurosurg · Sep 2000
Review Case ReportsRuptured cerebral aneurysm in a 39-day-old infant.
A case of middle cerebral artery aneurysm in a 39-day-old infant is discussed. The unique characteristics of aneurysms in the pediatric age group which distinguish them from adults are male predominance, greater frequency in middle cerebral artery and posterior circulation. In addition, they demonstrate a greater frequency of large and giant aneurysms. Theories on the etiology of cerebral aneurysms in children are discussed.
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Clin Neurol Neurosurg · Sep 2000
Case ReportsDiffusion-weighted imaging demonstrates transient cytotoxic edema involving the corpus callosum in a patient with diffuse brain injury.
Reversible T2 hyperintense signal abnormality in the corpus callosum, although frequently seen after diffuse brain injury, has not been well clarified. With some accumulated evidence, we report a case of diffuse brain injury in a 24-year-old man. Magnetic resonance imaging (MRI) demonstrated T2 hyperintense signals in the trunk and the splenium of the corpus callosum 12 days postinjury. ⋯ Follow-up MRI at 6 months showed complete resolution of the T2 signal abnormalities and of the corresponding decreased diffusion. Considering that diffusion-weighted imaging showed transient decreased diffusion, the lesion in the corpus callosum indicated the existence of cytotoxic edema. Also, transient DWI hyperintensity, namely cytotoxic edema, in the trunk and the splenium of the corpus callosum does not necessarily reveal callosal deficits.