scholarly journals Frequency, Aetiology, and Outcome of Small Cerebellar Infarction

2017 ◽  
Vol 7 (3) ◽  
pp. 173-180 ◽  
Author(s):  
Zeljka Calic ◽  
Cecilia Cappelen-Smith ◽  
Ramesh Cuganesan ◽  
Craig S. Anderson ◽  
Miriam Welgampola ◽  
...  
Keyword(s):  
Clinical Features ◽  
Anterior Lobe ◽  
Cerebellar Infarction ◽  
Posterior Lobe ◽  
Imaging Features ◽  
Vascular Risk ◽  
Limb Ataxia ◽  
Scale Scores ◽  
The Mean ◽  
Supratentorial White Matter

Background and Purpose: Strokes due to small (<2 cm) cerebellar infarction are under-recognised, and their profile and aetiology have not been well characterised. We aimed to determine the frequency, clinical features, aetiology, and outcome of small as compared to large cerebellar infarction. Methods: This study is a retrospective analysis of clinical and imaging features of a prospectively assessed series of 108 consecutive patients with acute cerebellar infarction admitted to Liverpool Hospital, Sydney, NSW, Australia, during 2011–2015. Results: The mean age of the patients was 67 years, and 33 (31%) had small cerebellar infarction. Compared to large cerebellar infarction, those with small cerebellar infarction had a comparable distribution of vascular risk factors but significantly less nausea and vomiting, gait disturbance, limb ataxia, and dysarthria. The posterior (n = 22, 67%) lobe was most commonly affected, followed by the anterior (n = 9, 27%) and flocculonodular (n = 2) lobes. Dizziness, limb ataxia, and nystagmus were significantly more common in patients with anterior lobe infarction. Vertebrobasilar disease was the presumed aetiology in 40 patients (37%), and was less commonly seen in small as compared to large cerebellar infarction. Cardioembolism affected 37% of the patients, irrespective of the size or topography of the cerebellar infarction, and there was no relation of supratentorial white matter lucencies (WMLs) to the size of cerebellar infarction. At 3 months, 65% of the patients were functionally independent (according to modified Rankin Scale scores of 0–2), and having a poor outcome was significantly related to moderate-to-severe supratentorial WML and large cerebellar infarction. Conclusions: Small cerebellar infarction accounted for one-third of the ischaemic strokes in this location, most often involved the posterior lobe, causing fewer clinical features, and had a better clinical outcome than large cerebellar infarction. Patients with small cerebellar infarction require appropriate vascular management including investigation for a cardioembolic source.

Effects of stimulating the cerebellar surface on the activity in penicillin foci

1978 ◽  
Vol 48 (1) ◽  
pp. 69-84 ◽  
Author(s):  
Heinrich Bantli ◽  
James R. Bloedel ◽  
Gary Anderson ◽  
Ronald McRoberts ◽  
Eric Sandberg
Keyword(s):  
Sensorimotor Cortex ◽  
Receptive Fields ◽  
Anterior Lobe ◽  
Evoked Response ◽  
Control Group ◽  
Posterior Lobe ◽  
Content Type ◽  
Current Densities ◽  
The Mean ◽  
Experimental Group

✓ The effect of stimulating the cerebellar surface on the activity of acute penicillin foci (20,000 units) was investigated in a statistically designed study. All animals were randomly assigned either to an experimental group in which the dura over the posterior lobe was opened and a bipolar surface electrode placed over the vermis of the anterior lobe, or else to a control group in which only the dura was opened. After surgery, the animals in the experimental group were randomly assigned to a stimulated or an unstimulated group. The cerebellar surface was stimulated at a frequency of 10/sec using capacitatively coupled pulses with peak current densities of 26.0 mA/sq cm and a duration of 0.1 msec. The effectiveness of the stimuli for activating neuronal elements in the cerebellum was evaluated 1) by recording the cerebellar evoked response from the sensorimotor cortex, and 2) by measuring the effect of a conditioning cerebellar stimulus on the percent change in the amplitude of the cortical response evoked by stimulating the receptive fields of the trigeminal nerve. A statistical comparison of the mean number of seizures for successive 10-minute intervals between control and experimental groups indicated that any difference in the means of these parameters occurred by chance with a high probability and did not result from any treatment. The duration of the seizures, however, was significantly affected by stimulation of the cerebellar surface. Further, the total number of seizures and the amplitude of the cerebellar evoked response in the same animal were inversely correlated. Thus, stimuli that evoked large-amplitude responses over the sensorimotor cortex may have produced a decrease in the number of seizures, whereas stimuli that evoked small-amplitude responses may have produced an increase in the total number of seizures with respect to the control group.

Clinical Features and Outcomes of Takayasu Arteritis with Neurological Symptoms in China: A Retrospective Study

2015 ◽  
Vol 42 (10) ◽  
pp. 1846-1852 ◽  
Author(s):  
Lirui Yang ◽  
Huimin Zhang ◽  
Xiongjing Jiang ◽  
Lei Song ◽  
Fang Qin ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Features ◽  
Takayasu Arteritis ◽  
Hemorrhagic Stroke ◽  
Disease Onset ◽  
Neurological Symptoms ◽  
Imaging Features ◽  
Descending Aorta ◽  
Neurological Features ◽  
The Mean

Objective.To describe the clinical features and longterm outcomes of patients with Takayasu arteritis (TA) in China who experienced neurological symptoms.Methods.A retrospective study was undertaken of patients with TA who attended a single study center from 2002 to 2013, who also exhibited neurological symptoms (n = 274). Clinical and imaging features were analyzed, as well as longterm outcomes.Results.The mean age at disease onset was 28.2 ± 11.2 years, with a female-to-male ratio of 4.3:1. The most common neurological manifestation was dizziness (214, 78.1%), the most frequent type of TA was type III (112, 40.9%), and the most common affected artery was the left subclavian (147, 53.6%). Involvement of 3 or 4 branches of the aortic arch was observed in 28% of patients. Among 30 patients experiencing a stroke (10.9%), steno-occlusive lesions of the subclavian artery and common carotid artery were frequently observed in patients with ischemic stroke, while steno-occlusive lesions of the descending aorta, abdominal aorta, and/or renal arteries were more frequently observed with hemorrhagic stroke. Heart failure was the most common cardiovascular event in those who died (n = 6) and in surviving cohorts.Conclusion.Neurological features in patients with TA were variable, and correlated with the number of arteries and the site of artery involvement. Resistant hypertension was one of the most important risk factors for hemorrhagic stroke in patients with TA.

scholarly journals POS1288 TUBERCULOUS SPONDYLODISCITIS IN ELDERLY: EPIDEMIOLOGY, CLINICAL, FEATURES, TREATMENT AND OUTCOMES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 926.1-926
Author(s):  
M. Mrabet ◽  
S. Boussaid ◽  
S. Jemmali ◽  
H. Sahli ◽  
H. Ajlani ◽  
...  
Keyword(s):  
Clinical Features ◽  
The Elderly ◽  
Lumbar Pain ◽  
Elderly Subjects ◽  
Normocytic Anemia ◽  
Imaging Features ◽  
X Rays ◽  
Significant Difference ◽  
Young Subjects ◽  
Tuberculous Spondylodiscitis

Background:Tuberculosis is still endemic all over the world. The incidence of tuberculous spondylodiscitis (TS) is steadily increasing. Clinical features and outcomes of this affection are various and depending on various parameters, including age.Objectives:Our objective was to explore the differences in presentation and the results of further investigations and the prognosis of TS between young and elderly subjects.Methods:We conduct a retrospective and descriptive study in a single rheumatology department. Data were collected from files of patients hospitalized in the past 20 years (2000-2020) who have been diagnosed with TS. We carried out a comparative study concerning the clinical biological, imaging features and outcomes between young subjects and subjects aged over 65 years.Results:Fifty-two cases of TS were collected (37F/15M). The mean age of the population was 55.21 years ± 17.79 [19-91]. Thirty-three patients (69.2%) were classified as young versus 16 elderly patients (30.8%), with female predominance in both groups (69.4% and 75% respectively, p = 0.57). Young subjects was more frequently vaccinated (88.9%) by Bacillus Calmette–Guérin (BCG) (p < 0.001). A delayed diagnosis was noted in both groups (p = 0.24). Lumbar spine involvement was the most common (57.7%). In the two age ranges, the onset of the disease was progressive (p = 0.22), characterized by segmental spine stiffness (p = 0.57) and lumbar pain with general signs (p = 0.27), such as: impaired general condition, fever, night sweats and weight loss. Biological inflammatory syndrome and normochrome normocytic anemia were encountered in both cases (p = 0.08 and p = 0.2, respectively). Standard X-rays and Computed tomography were more performed in young subjects (94.4% and 69.4%, respectively; p < 0.001), unlike magnetic resonance imaging which was more common in elderly subjects but with no statistically significant difference (p = 0.22). Disc pinch, erosion of vertebral plateaus and vertebral collapse were the major signs (82.7%, 65.4% and 67.3%, respectively). Clinical, biological and imaging arguments contributed to positive diagnosis in both groups (p = 0.24). Common medical treatment was anti-tuberculosis: Isoniazid (H), Rifampicin (R), Pyrazinamide (Z), Ethambutol (E) and physical treatment such as immobilization witch was more common in the eldery (56.3%, p = 0.16). The evolution of the disease was characterized by a clear improvement of young subjects during the second week of treatment (p < 0.001). A more frequent clinical improvement in older subjects was during the fourth week but with no statistically significant difference (p = 0.13). The occurrence of immediate complications was more frequent in the elderly (p = 0.23) with a predominance for drug complications (56.3%) such as: hepatic cytolysis (12.5%), hyperuricemia (18.8%) and major intolerance to anti-tuberculosis (18.8%).Conclusion:TS is a frequent condition that needs to be treated rapidly. the clinical presentation of TS in the elderly is less noisy which leads to more frequent complications and mortality.Disclosure of Interests:None declared

Imaging and clinical features of neurocutaneous melanosis in the pediatric population.

2021 ◽  
Vol 17 ◽  
Author(s):  
Mormina Enricomaria ◽  
Granata Francesca ◽  
Vinci Sergio Lucio ◽  
Coglitore Alessandra ◽  
Caragliano Antonio Armando ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Clinical Features ◽  
Pediatric Population ◽  
Cord Compression ◽  
Imaging Method ◽  
Imaging Features ◽  
Multisystem Disease ◽  
Neurocutaneous Melanosis ◽  
Pubmed Database

Background: Neurocutaneous melanosis (NCM) is a rare nonfamilial phakomatosis characterized by the presence of congenital melanocytic nevi and abnormal melanocytes infiltration of the leptomeninges. Objective & Methods: This paper shows the importance of early diagnosis and the most important imaging features of the disease on CT and MR scans. PubMed database was searched from January 1972 to September 2020. Papers including imaging findings of NCM, clinical, follow-up, and treatment features were collected, selecting only 89 studies. Discussion: NCM is a term used for the first time by van Bogaert in 1948. It refers to a condition caused by an error during morphogenesis and migration leading to leptomeningeal melanocytic accumulation. Although histological findings are the gold standard for diagnosis confirmation, neuroimaging and clinical features strongly support the suspect of NCM. Localization and extension of the lesions are predictive of neurological manifestations related to increased intracranial pressure, mass lesions, or spinal cord compression. CT demonstrates sites of increased density in the anterior temporal lobe - mainly the amygdala - thalami, cerebellum, and frontal lobes base. However, MRI is the best imaging method to diagnose central nervous system lesions, often appearing as T1-short signal areas of the cerebral parenchyma, indicative of central nervous system melanosis. MRI can also reveal associated intracranial and intraspinal abnormalities. Conclusion: Early imaging, when available, is helpful if NCM suspect is raised and may be of guidance in comparing later studies. NCM requires a multidisciplinary approach since it is a multisystem disease with a genetic component.

Abstract WMP14: Association of Systolic Blood Pressure, LDL Cholesterol, and Hgb A1c With White Matter Hyperintensity on MRI in the ACCORDION MIND Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adam H de Havenon ◽  
Tanya Turan ◽  
Rebecca Gottesman ◽  
Sharon Yeatts ◽  
Shyam Prabhakaran ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Regression Models ◽  
Ldl Cholesterol ◽  
Vascular Risk Factor ◽  
White Matter Hyperintensity ◽  
Vascular Risk ◽  
Linear Regression Models ◽  
Risk Factor Profile ◽  
The Mean

Introduction: While retrospective studies have shown that poor control of vascular risk factors is associated with progression of white matter hyperintensity (WMH), it has not been studied prospectively. Hypothesis: We hypothesize that higher systolic blood pressure (SBP) mean, LDL cholesterol, and Hgb A1c will be correlated with WMH progression in diabetics. Methods: This is a secondary analysis of the Memory in Diabetes (MIND) substudy of the Action to Control Cardiovascular Risk in Diabetes Follow-on Study (ACCORDION). The primary outcome was WMH progression, evaluated by fitting linear regression models to the WMH volume on the month 80 MRI and adjusting for the WMH volume on the baseline MRI. The primary predictors were the mean values of SBP, LDL, and A1c from baseline to month 80. We defined a good vascular risk factor profile as mean SBP <120 mm Hg and mean LDL <120 mg/dL. Results: We included 292 patients, with a mean (SD) age of 62.6 (5.3) years and 55.8% male. The mean number of SBP, LDL, and A1c measurements per patient was 17, 5, and 12. We identified 86 (29.4%) patients with good vascular risk factor profile. In the linear regression models, mean SBP and LDL were associated with WMH progression and in a second fully adjusted model they both remained associated with WMH progression (Table). Those with a good vascular risk factor profile had less WMH progression (β Coefficient -0.80, 95% CI -1.42, -0.18, p=0.012). Conclusions: Our data reinforce prior research showing that higher SBP and LDL is associated with progression of WMH in diabetics, likely secondary to chronic microvascular ischemia, and suggest that control of these factors may have protective effects. This study has unique strengths, including prospective serial measurement of the exposures, validated algorithmic measurement methodology for WMH, and rigorous adjudication of study data. Clinical trials are needed to investigate the effect of vascular risk factor reduction on WMH progression.

On the content of prolan in the pituitary gland

1934 ◽  
Vol 30 (6) ◽  
pp. 634-634
Author(s):  
P. Badul
Keyword(s):  
Pituitary Gland ◽  
Histological Examination ◽  
Anterior Lobe ◽  
Posterior Lobe ◽  
Posterior Pituitary ◽  
Posterior Pituitary Lobe

The posterior lobe of the pituitary gland in a bull is free of prolan, while in a human it contains prolan. Only here it can be found in that part of the posterior pituitary lobe adjacent to the anterior lobe. In the bull, too, this part of the pituitary gland is completely free of prolan content. Histological examination shows that in humans, this part of the posterior lobe is crossed by bands of cells from the anterior lobe, which consist exclusively of basophilic cells.

Adaptation to Visuomotor Rotation and Force Field Perturbation Is Correlated to Different Brain Areas in Patients With Cerebellar Degeneration

2009 ◽  
Vol 101 (4) ◽  
pp. 1961-1971 ◽  
Author(s):  
K. Rabe ◽  
O. Livne ◽  
E. R. Gizewski ◽  
V. Aurich ◽  
A. Beck ◽  
...  
Keyword(s):  
Force Field ◽  
Decisive Role ◽  
Anterior Lobe ◽  
Magnetic Resonance Images ◽  
Cerebellar Degeneration ◽  
The Other ◽  
Posterior Lobe ◽  
Visuomotor Rotation ◽  
Dynamic Errors ◽  
And Gender

Although it is widely agreed that the cerebellum is necessary for learning and consolidation of new motor tasks, it is not known whether adaptation to kinematic and dynamic errors is processed by the same cerebellar areas or whether different parts play a decisive role. We investigated arm movements in a visuomotor (VM) rotation and a force field (FF) perturbation task in 14 participants with cerebellar degeneration and 14 age- and gender-matched controls. Magnetic resonance images were used to calculate the volume of cerebellar areas (medial, intermediate, and lateral zones of the anterior and posterior lobes) and to identify cerebellar structure important for the two tasks. Corroborating previous studies, cerebellar participants showed deficits in adaptation to both tasks compared with controls ( P < 0.001). However, it was not possible to draw conclusions from the performance in one task on the performance in the other task because an individual participant could show severe impairment in one task and perform relatively well in the other (ρ = 0.1; P = 0.73). We found that atrophy of distinct cerebellar areas correlated with impairment in different tasks. Whereas atrophy of the intermediate and lateral zone of the anterior lobe correlated with impairment in the FF task (ρ = 0.72, 0.70; P = 0.003, 0.005, respectively), atrophy of the intermediate zone of the posterior lobe correlated with adaptation deficits in the VM task (ρ = 0.64; P = 0.015). Our results suggest that adaptation to the different tasks is processed independently and relies on different cerebellar structures.

scholarly journals Comparison of Clinical Features Between Patients with Positive and Negative Appendectomy

2020 ◽  
Author(s):  
Guner Cakmak ◽  
Baris Mantoglu ◽  
Emre Gonullu ◽  
Kayhan Ozdemir ◽  
Burak Kamburoglu
Keyword(s):  
Acute Appendicitis ◽  
Clinical Features ◽  
Total Bilirubin ◽  
Negative Appendectomy ◽  
C Reactive Protein ◽  
Future Studies ◽  
Female Patients ◽  
Reactive Protein ◽  
Male Patients ◽  
The Mean

Abstract Background: The objective of this study was to retrospectively compare clinical features and prognostic values between the patients who were referred to the general surgery clinic of our hospital with the presumed diagnosis of acute appendicitis and underwent positive or negative appendectomy.Methods: Patients were divided into two groups as positive (PA) (n:362) and negative appendectomy (NA) (n:284) and the data obtained were compared between these two groups.Laboratory investigations were performed in all patients, and white blood cell (WBC), mean platelet volume (MPV), neutrophils count (NEU), neutrophils (%) (NEU%), C-reactive protein (CRP) and total bilirubin (TBIL) values were studied.Results: The mean MPV value was found as 7.88 fl in PA groups and 8.09 fl in NA group, and the mean MPV value was not statistically significantly difference in PA group, compared to NA groups (p=0.012). Laboratory parameters were also compared between genders. Accordingly, the mean MPV value was statistically significantly higher in female patients compared to male patients in PA group (p = 0.04). The mean TBIL value was 0.97 mg/dl in PA group and 0.69 mg/dl in NA group, and the mean TBIL value was statistically significantly higher in PA group (p< 0.001). Finally, TBIL value was statistically significantly lower in female patients compared to male patients in NA and PA group (p < 0.05).Conclusions: According to the results of our study, MPV and T. BIL values differ in PA and NA groups depending on gender. Therefore, these values may not be used as specific biomarkers in predicting positive acute appendicitis. We believe that these results will contribute to the literature and will be guiding for future studies.

scholarly journals Childhood accidental poisoning among hospitalised children in a tertiary health care in North Central Nigeria - A two year prospective report

2020 ◽  
Vol 47 (3) ◽  
Author(s):  
P.A. Ahmed ◽  
V.E. Nwatah ◽  
C.C. Ulonnam
Keyword(s):  
Hospital Stay ◽  
Clinical Features ◽  
Acute Poisoning ◽  
Accidental Poisoning ◽  
Time Interval ◽  
Fisher Exact Test ◽  
Severity Scores ◽  
Childhood Poisoning ◽  
Home Intervention ◽  
The Mean

Background: The young child can be at risk of accidental poisoning because of its being very inquisitive to mouth objects. The prevalence and typesof poisoning vary within Nigeria and different parts of the world. Aim: To describe the sociodemographics, clinical features and outcome in childhood poisoning seen at the National hospital Abuja (NHA) Nigeria. Subjects and Methods: A descriptive prospective study on children admitted for acute poisoning from September 2014 -August 2016. Consecutive children with a history of poisoning were recruited during the study period. The children were examined, and poison severity scores were recorded into a proforma, and followed up till discharge or demise. Results: Twenty-two children were admitted for acute poisoning, out of the 2336 children seen during the study period, with a prevalence rate of 0.94%. Fourteen (63.6%) were of upper social class, with 12 (54. 5%) mothers having tertiary level education. The mean time (±SD) of presentation was 11.9 ± 23.9 hours, while the mean (SD) duration of hospital stay was 4.8 ± 6.2 days; hospital stay was significant with types of poisoning (Fisher exact test 22.062, p<0.0001). The common poisoning agents were kerosene and organophosphate, 8(36.4%) each, while main clinical features were  cough in 8 (36.4%), tachypnoea in 7(31.8%), fever in 6 (27.3%) and 8(36.4%) had home intervention. Two (9.1%) and 4(18.2%) had poison severity  scores (PSS) of 3 and 4 respectively, which was significant for time interval of presentation and use of harmful home intervention (Fisher exact test3.697, p=0.024) and (Fisher exact test10.04, p=0.018) respectively. Fatality was 18.2%. Conclusion: kerosene and organophosphate were most common poison agents, while PSS was related to time of presentation, home intervention and types of poisoning agents. Key words: childhood, poisoning, hospitalized, outcome.

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