A polygraphic study on resistance to extinction of the somatic (EMG), autonomic (finger plethysmogram, galvanic skin reaction, respiration) and EEG (acoustic-evoked potential and EEG-blocking reaction) components of the orienting reaction elicited by a repetitive auditory stimulus was performed in 67 chronic alcoholics and in 70 matched normal subjects (control group). The study showed a significantly lower resistance to extinction of the orienting reaction in alcoholics than in control normal subjects. The severity of this extinction disturbance depended on the patients' age, type of alcoholism, alcohol consumption intensity and chronicity, as well as the type of resting EEG.
The authors present a case of spontaneous intracerebral hematoma which developed after evacuation of chronic subdural hematoma. Possible mechanisms of the development of this rare complication are discussed.
The study involved 75 patients with diencephalic pathology (58 females and 17 males, mean age 39 years). All patients underwent thorough somatic and neurological check up and examination of the autonomic nervous system as well. The etiology was considered to be infection in 60 patients (60%) and brain injury in the other 15 (20%). Paroxysmal disturbances were established in 23 patients, while in the other 52, the clinical manifestation had a permanent course. Changes in adenohypophyseal (TTH, GH, FSH, LH, ACTH and RRL) hormones were established and for mean basal plasma levels of FSH these changes were statistically significant (p less than 0.05). Catecholamine metabolism was impaired in the patients with diencephalic pathology, manifested by elevation of the urinary levels of dopamine, noradrenaline and adrenalin. The role of adenohypophyseal hormones and catecholamines for the pathogenesis of diencephalic dysfunctions is discussed.
Our study refers to the complex neuropathologic examination of 70 demented patients (40 males and 30 females) above 60 years of age. Proportion of different types of cerebral damage with vascular pathogeny showed that 78% of the vascular dementia cases had as morphological background various aspects of multi-infarct dementia; softenings of variable size and lacunae, associated or not with myelinic rarefactions and pallor specific to subcortical arteriosclerotic encephalopathy; the remaining cases pointed to single anoxic lesion and/or subcortical encephalopathy. Perfect clinico-morphological diagnostic concordance has not always been reached in our sample--as in literature cases--often due to the dementia subtypes overlapping, and to the fact that the same clinical syndrome may show in different cerebral lesions. Likewise, no correlation has been found between lesion type, site or size and clinical picture or dementia course, which was also reported by other authors. On a morphopathogenic basis, we support the view that necrotic lesions of ischemic origin--multi-infarct and lacunar dementias--should be distinguished from myelinic rarefactions and pallor in the white matter, whose pathogeny is still controversial. Due attention is paid to the importance of the venous factor in the development of subcortical encephalopathy.
Personality traits of 46 psychotic depressive patients (PD) were compared with those of two matched control groups of nonpsychotic endogenous (NPED) and nonpsychotic nonendogenous (NPNED) depressive patients. Discriminant analyses using personality variables point to more marked differences between PD and NPNED patients than between PD and NPED ones. PD and NPNED groups had opposite traits on the bipolar personality scales of obsessionality vs. hysteria and self-sufficiency vs. group dependence; anxiety, present in both groups, was more pronounced in the NPNED patients. The dependence, introversion and prominent obsessional traits were the distinctive attributes of PD patients when compared with NPED patients. The results are discussed in terms of the two alternative hypotheses concerning psychotic depression: one considering delusions as a function of depression severity and the other as a distinct pathological trait. Our data do not support the exclusive validity of either of these two models.
An autopsy case of haemangioblastoma of the medulla oblongata is presented. The clinical course was atypical and suggested a.l.s., demyelinization process of the CNS, or systemic disease. Two years before, paresis of IX, X, XII cranial nerves, left-side paresis and positive extensor plantar responses had been found. Pathological EEG recordings from both temporal regions with more pronounced changes on the left side had been observed too. In this case, we have not found any other tumours apart from that in the medulla oblongata.
Analysis of 41 cerebral hemorrhage cases associated or not with intraparenchymatous hematoma and ventricular rupture shows the role played by these associated phenomena in the evaluation and prognosis of these patients. The death rate was 56.25% in simple cerebral hemorrhage, 100% in hemorrhage associated with hematoma, 30.76% in hemorrhage associated with ventricular rupture and 80% in hemorrhage associated with hematoma and ventricular rupture. The authors point out that the mere presence of ventricular rupture is not a really aggravating factor. A particular severity resulting from association of hemorrhage with hematoma seems to be due to the extension of the cerebral lesion produced by the two conditions associated.
We studied in 300 stroke patients (100 carotid ischemic, 100 vertebrobasilar ischemic, and 100 hemorrhagic) the precipitating factors (PF) of stroke. Precipitating factors were observed in 63.7% of cases. Of the 407 PF found in the whole sample, 60% occurred 24 hours before stroke, and 40%-2-3 days before it. The most frequently met PF were: physical effort (32.3%), extreme temperature (29%), psychic trauma (23.3%), and head and body positions that may unfavourably influence cerebral circulation (23%). These PF were usually observed in associations. The differences regarding the PF incidence in the 3 stroke types were not statistically significant.
Simultaneous ERG and VEP investigations were performed in 42 patients presenting reduced visual acuity and characteristic signs of retinopathy on direct ophthalmoscopic inspection: 1) primary retinal pigmentary degeneration - 15 cases; 2) secondary retinopathy - 11 cases; 3) infantile retinal degeneration - 16 cases. Reciprocal relations of ERG--VEP component latency/amplitude in the three types of retinal disorder are described.
The authors report the case of a 31-year-old female patient who 10 years earlier had displayed diabetes insipidus and hyperglycemia and for 4 years galactorrhea and amenorrhea. Since one year her visual acuity had gradually declined to blindness. CT-scan revealed the presence of a tumoural formation in the optic chiasma and hypothalamic region. The histological examination of the operative-removed tumour showed that it was a type B pinealoma. The postoperative course was good for 42 hrs after which the patient died suddenly. Necropsy disclosed the presence of a myocardial infarct. The authors distinguish three categories of ectopic pinealoma: 1. tumours of the pineal gland with an aberrant development at the level of the 3rd ventricle, 2. metastatic pinealoma, and 3. ectopic pinealomas with an independent development in patients with normal pineal gland. The case reported below is of the 3rd category which is also the most veridical.
In a group of 111 students with depressive disorders, 70% presented a concurrent personality disorder and nearly 15% had prominent personality traits. The unstable, obsessive, hysteric and dysthymic types of personality disorders were relatively more frequent, the higher percent of cases (27.3%) being included in the mixed subgroup of these disorders. The patients with personality disorders had: an earlier age of affective illness onset, a more marked depression severity, a higher frequency of recurrent and nonreactive depression forms. Nonbipolar major depressive disorders were associated with the presence of unstable and dysthymic types of personality disorders, while minor depressive disorders were related with hysteric, asthenic and mixed ones.
The effect of hemodilution was studied in 106 acute ischaemic stroke patients (55 hemodiluted and 51 control subjects). The investigation did not show statistically significant differences between the two groups regarding the mortality rate and the degree of rehabilitation (modified Rankin Scale) but revealed a significant neurologic score (proposed by the Scandinavian Stroke Study Group) in the hemodiluted group. A correlation between the favourable score modification and the degree of hematocrit modification was also observed.
Out of 397 patients presenting hypomagnesaemia there were selected for this study only 107 cases with neurotic and neuromuscular clinical picture (sometimes with short and simple loss of consciousness) without any sign of organic cerebral lesion. The dosing of the seric and erythrocytic magnesium was performed by means of a colorimetric method of Mann and Yoe, modified by the authors. In all the cases, the EEG and EMG changes were studied by simultaneous recording of the EEG and EMG before, during and after hyperpnoea. In these 107 selected cases (divided into three groups: children, adolescents and adults) the computerized electroencephalographic maps (CEM) were carried out by an original method, transcribing the primary data of Hjorth's NSD parameters (Amplitudes and Frequencies) into a Romanian M-118 microcomputer, by a technique with analog-digital conversion. The CEM (in white-black and in colour cartography) were performed for various epochs, including the sequential ones (second by second, all along the EEG discharges during and after hyperpnoea). By these methods, we analyzed the dynamic fluctuation and temporo-spatial cortical distribution of the sinusoidal slow waves generated by the reticulate neuronal hypersynchrony. The CEM showed some differences in the three groups of hypomagnesemic syndromes selected.
The paper presents some mechanisms which determine or accompany cellular brain edema: intracellular and extracellular osmolality alteration, neuronal excitation, increased extracellular K+ concentration, anoxia, ischemia and hepatic encephalopathy.
The purpose of the study was to reconsider the somatosensory evoked potential (SEP) morphology in case of thermalgic versus proprioceptive sensory loss. The study was carried out on 70 inpatients affected by uni- or bilateral dissociated sensory disorders and on 45 normal controls. The median or tibial nerves were stimulated (at wrist or ankle), the stimulus intensity being adjusted to elicit a visible muscle response with liminal pain. SEPs were measured with regard to 7 negative components parameters (latency, amplitude) and statistically compared in the three groups. Results show that the initial SEP components (N18, N30, N70) are specifically affected in case of proprioceptive and the late components (N150, N220, N340) in case of thermalgic sensory disorders (N150 having an intermediate position). The intergroup differences were statistically significant. The results are thought to be used in clinical diagnosis.
Using an original method--the Biohertzmetry--the level of hertzian waves capture at body surface was measured in 20 patients with traumatic paraplegia. A statistically significant decrease of the hertzian waves capture level in the toes in comparison with the proximal area has been noted in 12 patients with complete spinal cord lesion. In patients presenting an open or cicatricial decubitus ulcer, at scar level, in the surrounding skin area with modified colour--and even in a contiguous few millimeters large skin strip normally coloured,--a marked decrease of the level of hertzian waves capture in comparison with the healthy skin ares situated off the decubitus ulcers has been pointed out. Thus, the method used permitted to reveal the alterations of the tissue trophicity--including those undetectable with the naked eye--and to make an estimation of the degree of mortification of the tissues and a delimitation of the reduced trophicity area.
A polygraphic study on resistance to extinction of the somatic (EMG), autonomic (finger plethysmogram, galvanic skin reaction, respiration) and EEG (acoustic-evoked potential and EEG-blocking reaction) components of the orienting reaction elicited by a repetitive auditory stimulus was performed in 67 chronic alcoholics and in 70 matched normal subjects (control group). The study showed a significantly lower resistance to extinction of the orienting reaction in alcoholics than in control normal subjects. The severity of this extinction disturbance depended on the patients' age, type of alcoholism, alcohol consumption intensity and chronicity, as well as the type of resting EEG.
