Przegla̧d lekarski
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Neurosurgery in functionally relevant brain structures carries a high risk for surgery induced post-operative neurological deficits. Functional magnetic resonance imaging (fMRI) is one of the most commonly used functional neuroimaging techniques for pre-surgical brain mapping. Preoperative fMRI is optimal method to localize specific functions of the human brain that govern motor, sensory or language functions. fMRI facilitates the selection of the safest treatment and is very helpful to plane and to perform function preserving surgery in patients with brain tumors. This kind of examination is feasible for clinical routine neuroimaging and provides important diagnostic information noninvasively that is otherwise unavailable. fMRI examinations require also advanced software for data analysis.
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Smoking tobacco still remains one of the basic health and social-economic issues, both in Poland and around the world. Popularity of smoking, dissemination of this habit, and continually high levels of its social acceptance make physicians feel helpless, and often relieved from the obligation of counteracting the phenomenon. ⋯ Additionally, a pattern of psychological assistance or intervention actions has been developed which has proved to be extremely successful within a truly short time span, called minimum (anti-nicotine) intervention. The goal of this article is to popularise those methods and invite physicians to become familiar with the new ideas, in view of their future application to working with the patient.
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Controlled Clinical Trial
[Influence of visual stimulation on cerebral blood flow and visual evoked potentials in children with migraine with visual aura].
Visual aura is the most common type of migrainous aura. It may occur as a single symptom or precede sensory or speech disturbances. Aura symptoms and order of their appearance may result from propagation of spreading depression phenomenon. Vascular disorders observed during migraine with aura attacks are probably secondary to neuronal changes. Simultaneous registration of cerebral bioelectric activation and changes evoked in cerebral circulation enables their objective estimation, detection of correlation and better understanding of migraine with aura pathogenesis. Studies with transcranial Doppler revealed impaired cerebrovascular response to various stimulations in migraine, especially migraine with aura patients. Combination of Doppler examination with registration of visual evoked potentials (VEP) enables estimation on neurovascular coupling. ⋯ Visual stimulation has significant influence on cerebral blood flow velocities in both migraine with aura patients and controls and these changes are most often observed direct after the beginning of the stimulation. However, no differences in vascular response to visual stimulation between the groups were observed. On the other hand positive correlation between visually evoked changes in cerebral blood flow velocities and VEP amplitudes was found in migraine with aura patients suggesting increased neurovascular coupling in this group when compared with controls.
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Gelastic epilepsy is usually symptomatic and most often associated with hypothalamic hamartoma. Usually, in the course of this epilepsy different seizure types develop, partial and generalized as well. Moreover, progressive behavioral disorders are observed. Pharmacological treatment is usually ineffective and surgical resection of the lesion is the only chance of clinical improvement. ⋯ Diagnosis of gelastic epilepsy is often delayed due to untypical character of the seizures, treated as non-epileptic behavioral disorders. Drug resistance in this type of epilepsy cause search of better and better surgical techniques and establishment of criteria enabling to choose optimal method for every patient.
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Acute methanol poisoning may cause heart dysfunction accompanied by various electrocardiographic abnormalities. In such cases heart damage is usually secondary to metabolic acidosis and reversible. In this paper the case of fatal methanol poisoning complicated with acute coronary syndrome in a 52-year-old alcohol abuser is presented. The main cause of the myocardial ischaemia was the subtotal stenosis of the anterior interventricular branch of the left coronary artery, whereas metabolic disorders in the course of methanol poisoning probably intensified the ischaemia in the area supplied by that artery.