Arch Neurol Chicago
-
Arch Neurol Chicago · Jul 1989
Neurological outcome after out-of-hospital cardiac arrest. Prediction by cerebrospinal fluid enzyme analysis.
The prognostic value of cerebrospinal fluid (CSF) and serum neuron-specific enolase and brain-type creatine kinase isozyme (CK-BB) measurements was studied in 75 consecutive victims of out-of-hospital cardiac arrest. All patients with a CSF neuron-specific enolase level of more than 24 ng/mL 24 hours after cardiac arrest remained unconscious and died. ⋯ Cerebrospinal fluid neuron-specific enolase, CSF CK-BB and serum neuron-specific enolase levels correlated with the neurological outcome at 3 months. Thus, the analysis of these enzymes in CSF seems to be useful in the early prognostic assessment of cardiac arrest victims.
-
Arch Neurol Chicago · Jul 1989
Case ReportsMetamorphopsia and palinopsia. Association with periodic lateralized epileptiform discharges in a patient with malignant astrocytoma.
A patient with a right parietal glioma developed palinopsia and various forms of metamorphopsia that were temporally related to the electrographic presence of periodic lateralized epileptiform discharges. These symptoms occurred in an alert woman with normal visual fields. ⋯ We believe that continuous repetitive electrical stimulation caused our patient's unusual symptoms by altering the association pathways through which visual data are experienced. To our knowledge, the association between periodic lateralized epileptiform discharges and metamorphopsia or palinopsia has heretofore not been reported.
-
Arch Neurol Chicago · Jul 1989
Factors associated with hydrocephalus after subarachnoid hemorrhage. A report of the Cooperative Aneurysm Study.
Hydrocephalus is an important complication of subarachnoid hemorrhage (SAH). We analyzed several factors possibly related to hydrocephalus following SAH in 3521 patients from the International Study on the Timing of Aneurysm Surgery. Hydrocephalus was diagnosed on admission computed tomographic (CT) scans in 15% of patients and was thought to be clinically symptomatic in 13.2% of patients. ⋯ We conclude that the development of hydrocephalus after SAH is multifactorial. Factors that compromise cerebrospinal fluid circulation acutely (eg, intraventricular hemorrhage, hemorrhage from a posterior circulation site of aneurysm, and diffuse spread of subarachnoid blood) contribute to the development of acute hydrocephalus. These same factors, plus the use of antifibrinolytic drugs preoperatively, are also important in the pathogenesis of clinical hydrocephalus, perhaps by promoting subarachnoid fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS)