Neurology
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Case Reports
Normal pressure hydrocephalus, parkinsonism, and primary empty sella--coincidence or cause-effect?
The triad of normal-pressure hydrocephalus, parkinsonism, and primary empty sella appeared in a 70-year-old woman. There was dramatic resolution of the extrapyramidal signs and symptoms on treatment with levodopa-carbidopa and ventriculojugular shunt. The syndrome may be the result of several mechanisms, but an alteration of cerebrospinal fluid (CSF) pressure dynamics may be the sole etiology for this triad.
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A child had complex partial status epilepticus after resection of a craniopharyngioma. The status epilepticus was manifested by confusion and documented electroencephalographically by continuous focal seizure patterns in the right temporal region. Complex partial status epilepticus is an electroclinical syndrome of prolonged or repetitive complex partial seizures (with continuous interictal confusion) accompanied by electroencephalographic seizure patterns, which are either focal (usually temporal lobe) or secondarily generalized from a focal pacemaker.
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Nine cases of brain abscess, five of subdural empyema, and one of epidural empyema with associated subdural empyema were identified using computed tomography (CT). Smal and multiple abscesses as well as unilateral, bilateral, and parafalcine empyemas were detected. ⋯ No false-negative studies were found in cases of brain abscess or subdural empyema. However, since the appearance of brain abscesses of CT scans is similar to that of neoplastic and vascular lesions, false-positive reports of brain abscess were encountered.
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A retrospective survey of survivors of cardiorespiratory arrest included 34 patients. Twenty-one had a good outcome neurologically and 13 were seriously impaired. ⋯ Coma motor unresponsiveness, absent pupillary light reflexes, and absent oculocephalic responses were closely associated with dismal prognosis for neurologic functioning. This retrospective study cannot provide a basis for discontinuation of life support at any specific time.