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Biomedical subjects

A A Cherif

Publications and source records attributed to A A Cherif.

15 recordsLinked to original sources

Gordona terrae central nervous system infection in an immunocompetent patient.

The bacterial genus Gordona includes seven species of mycolic acid-containing actinomycetes which are cultured from environmental sources and rarely from clinical samples. They have been implicated in primary pulmonary diseases, nosocomial wound infections, and central nervous system infections in two immunocompromised patients. We isolated Gordona terrae from the cerebrospinal fluid sample of an immunocompetent patient with meningitis and multiple brain abscesses and detected Gordona terrae DNA in the abscesses. The outcome was good at the 4-year follow-up, after prolonged treatment with trimethoprim-sulfamethoxazole. Phenotypic identification of this isolate was confirmed by analysis of the 16S rRNA gene sequence, which shared 100% homology with that of G. terrae reference strains. Physicians and clinical microbiologists must be aware of the occurrence of Gordona species infection not only among immunocompromised patients but among all patients. Accurate identification of Gordona species may be accomplished by molecular techniques.

Actinomycetales↗

[Spinal dural fistula with peri-medullar venous drainage].

Clinical and neuroradiological findings of 8 patients with a spinal dural arteriovenous fistula are reviewed. Disturbance of micturition or defecation and weakness of the legs were always present and the most frequent initial symptom was a progressive spastic paraparesis. Duration of symptoms before diagnosis was 2 years. Lumbar puncture showed elevation of proteins and myelography demonstrated dilated perimedullar posterior veins. In every case, magnetic resonance imaging of the spinal cord (T2- weighted images) revealed intramedullary high signal intensity of the conus medullaris and selective angiography confirmed the site of the dural fistula. Each patient was treated with endovascular method consisting in liquid adhesive embolization (0.2 cc of N-butyl cyanoacrylate) with hyperselective catheterism of the dorsospinal artery. Embolization procedure was successful in 6 cases with large improvement of leg weakness and partial regression of disturbed micturition and defecation. The pathophysiological mechanisms explaining the clinical signs are discussed.

Aged↗

Transient global amnesia followed by vertebrobasilar ischemia in a case of dolichoectatic basilar artery.

A 59-year-old hypertensive patient presented with transient global amnesia without neurological signs or symptoms. During the following 3 years, he experienced several attacks of vertebrobasilar insufficiency and a cerebellar infarction. CT scan and MRI found a partially thrombosed dolichoectatic basilar artery but no significant lesion within the limbic system. These data suggest transient global amnesia was due to a transient ischemia in the basilar artery distribution.

Amnesia↗

[Binswanger's subcortical encephalopathy. Study of a case with predominant left hemispheric lesion (author's transl)].

We report the clinical and pathological study of a patient with vascular leucoencephalopathy almost restricted to the left posterior hemisphere. A 65 year--old right handed hypertensive woman has presented with a neuropsychological symptomatology of transcortical sensorial aphasia. We discuss the following points: 1) the patient's disease must be considered as Binswanger's subcortical encephalopathy despite the asymetric topography of the lesions ; 2) particular hemodynamic cerebral factors has possibly determined the asymetric nature of the disease ; 3) a lesion of the left temporo-parieto-occipital area that was strictly sub-cortical, with complete destruction of the posterior part of the arcuate fasciculus has presented with the clinical picture of a transcortical sensorial aphasia.

Aged↗

[NEOLOGISMS AND MOTOR APHASIA. (Afferent pathology?)].

The authors describe a case of post-traumatic aphasia in a 39-year-old man. The linguistic disturbances were marked by the unusual association of oral expression consisting mainly of neologisms, normal comprehension and almost normal written expression. A physiological interpretation based on disturbance of treatment of the sensory afferent nerves from the bucco-phonator organs is suggested to account for the neologisms in this particular form of aphasia.

Adult↗

[Acute psychiatric pathology disclosing subcortical lesion in neuro-AIDS].

Maccario et al. described, in 1987, the case of an HIV-positive patient whose psychotic symptomatology was the expression of right centrum semi-ovale lesion. We report the case of a patient who suffered a sudden delirium, expression of a probable right lenticular cerebral toxoplasmosis. This 35-year-old male homosexual, who had no psychiatric history, suddenly developed in November 1988 the following psychiatric signs: he started to walk back and forth incessantly, he had the impression that he was the subject of the conversations of the passers-by, that all the posters and notices refer to him, and that he was God. He was admitted in a psychiatric department where the symptoms were progressively curbed by neuroleptics (cyamemazine 75 mg, and haloperidol 15 mg). The episode was not questioned by the patient, but attributed to bad eating habits. HIV-positivity had been discovered a year later (during systematic screening). A computerized tomographic (CT) scan performed subsequently to this delirium was interpreted as normal. Four weeks later the patient was referred to us. The psychiatric condition was stabilized in spite of a certain aggressiveness and the probable persistence of an underlying delirium state. Laboratory examinations showed the following: blood count revealed leukopenia (2.2 G/l) and thrombocytopenia (135 G/l; OKT4/OKT8 ratio was 0.08; CSF: normal; sputum culture evidenced the presence of pneumocystis carinii; EEG were normal. Neuropsychological symptoms concerned in particular a lack of concentration during the different tests with a definitive wavering of attention. Lexical retrieval was poor whatever the topic proposed.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗