The Journal of neuropsychiatry and clinical neurosciences
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J Neuropsychiatry Clin Neurosci · Jan 2000
Review Historical ArticleSurgical treatment of mental illness: impact of imaging.
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J Neuropsychiatry Clin Neurosci · Jan 2000
Biography Historical Article Classical ArticleLoss of recent memory after bilateral hippocampal lesions. 1957.
Bilateral medial temporal lobe resection in man results in a persistent impairment of recent memory whenever the removal is carried far enough posteriorly to damage portions of the anterior hippocampus and hippocampal gyrus. This conclusion is based on formal psychological testing of nine cases (eight psychotic and one epileptic) carried out from one and one-half to four years after operation. The degree of memory loss appears to depend on the extent of hippocampal removal. ⋯ There was no deterioration in personality or general intelligence, and no complex perceptual disturbance such as is seen after a more complete bilateral temporal lobectomy. It is concluded that the anterior hippocampus and hippocampal gyrus, either separately or together, are critically concerned in the retention of current experience. It is not known whether the amygdala plays any part in this mechanismi, since the hippocampal complex has not been removed alone, but always together with uncus and amygdala.
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J Neuropsychiatry Clin Neurosci · Jan 2000
Is delirium after cardiac surgery related to plasma amino acids and physical condition?
The authors studied interrelationships between plasma levels of amino acids, physical condition (as apparent from cortisol, albumin, and thyroid hormone concentrations), and postoperative delirium in 296 patients undergoing elective cardiac surgery. Both plasma tryptophan (Trp) and ratio of Trp to the other large neutral amino acids (oLNAA) were reduced in delirious patients compared with control patients. ⋯ Delirious patients were also in poorer physical condition than nondelirious patients, having decreased albumin level and increased ratio of inactive reverse triiodothyronine (T3) to active T3. Decreased Trp and increased Phe availability may give rise to an imbalance in cerebral neurotransmitters and thus contribute to delirium.
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J Neuropsychiatry Clin Neurosci · Jan 1999
Safety and efficacy of ECT in patients with head injury: a case series.
Electroconvulsive therapy (ECT) is a safe and effective treatment for certain psychiatric disorders. Eleven patients who had sustained a closed head injury were treated with ECT for their psychiatric symptoms. ⋯ Eight patients received cECT, without any lasting cognitive side effects. These findings indicate that ECT can be used effectively in patients with a history of closed head injury, without adverse effects on cognitive functioning.