Neurology
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We studied the delayed neurologic complications of left atrial myxoma in 2 patients and analyzed 47 previously published cases. Embolic cerebral infarctions may occur before surgical removal of the primary cardiac tumor, but aneurysm formation and hemorrhage may be delayed, whether or not there is evidence of neurologic disorder at the time of initial surgery. ⋯ Resultant aneurysms may show progressive enlargement, and treatment with doxorubicin failed to prevent aneurysm enlargement in one patient. Better guidelines are needed for clinical management in these patients.
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Thirty-eight survivors from among 117 patients hospitalized after out-of-hospital cardiac arrest were evaluated approximately 3 1/2 years later. Twenty patients were living; 18 had died. ⋯ Satisfactory long-term outcome was associated statistically with the patient's being awake on admission or awakening to follow simple commands within 2 days, and with good neurologic status at the time of discharge from the hospital. None of nine patients with poor neurologic function at discharge subsequently resumed working or independent living.
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Vincristine sulfate was inadvertently given intrathecally to a woman with lymphoma, producing ascending sensory and motor dysfunction followed by encephalopathy and death. Pathologically, neurons were swollen by aggregates of neurofilaments similar to the neurofilaments described in experimental models of vincristine neurotoxicity.
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Letter Case Reports
Computed tomography in a verified case of tuberculous meningitis.
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Case Reports
Ischiadic nerve entrapment by an extra- and intrapelvic lipoma: a rare cause of sciatica.
A 60-year-old woman had persistent left-sided ischialgia. After several years, a left-sided subgluteal mass extended to the pelvis. Computed tomography (CT) disclosed a large subgluteal and intrapelvic lipoma. Symptoms were relieved by excision of the tumor.