Biomedical subjects
A G Reeves
Publications and source records attributed to A G Reeves.
Corpus callosotomy for intractable seizures in the pediatric age group.
The results of corpus callosotomy in 18 patients 16 years old and younger are presented. Eighty-three percent of our patients have had a significant improvement from the surgery (a decrease in seizure frequency of greater than 80% or no longer having generalized atonic, tonic, or tonic-clonic seizures). The procedure seems to be well tolerated in young patients, and we have not noted a postoperative deterioration in behavior, memory, or language function in our patients. One of our patients died in status epilepticus 3 months after surgery. Nevertheless, we have not encountered any serious morbidity in our other patients. Corpus callosotomy can be considered for children with intractable seizures, especially when generalized atonic, tonic, or tonic-clonic (whether primary or secondary) seizures are the major seizure type.
Alexia without agraphia associated with spleniogeniculate infarction.
Pure alexia, following an infarction in the distribution of the left posterior cerebral artery, is attributed to damage of the left occipital lobe and the splenium of the corpus callosum. We describe a case of pure alexia in a 57-year-old woman with infarction of the left lateral geniculate body and the splenium of the corpus callosum, a variation on this classic disconnection syndrome.
Central corpectomy for cervical spondylotic myelopathy: a consecutive series with long-term follow-up evaluation.
Since 1984, a consecutive series of patients with cervical spondylotic myelopathy has been treated by central corpectomy and strut grafting. This report focuses on 40 cases operated on between 1984 and 1987 and followed from 2 to 5 years. The perioperative complication rate was 47.5%, with a 7.5% incidence of persistent sequelae: severe C-5 radiculopathy in one patient, swallowing dysfunction in one, and hypoglossal nerve palsy in one. No single factor (age, duration of symptoms, or severity of myelopathy) was absolutely predictive of outcome; however, syndromes of short duration had the best likelihood of cure. Similar outcomes were associated, individually, with long duration of symptoms, age over 70 years, and severe myelopathy. After factoring a 5% regression of improvement, the long-term cure rate was 57.5% and the failure rate was 15%. Myelopathy worsening was not documented.
Behavioral changes following corpus callosotomy.
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Asymmetries of the auditory areas of the cerebrum.
A total of 29 human cadaver brains were examined for asymmetries of the left and right Sylvian fissure, Heschl's gyri, and planum temporale. The mean lengths of these structures were all significantly greater on the left side than on the right. There was considerable morphologic variability in these structures as evidenced by the number of Heschl's gyri that ranged from one to three per hemisphere in different brains, although there was no significant asymmetry in the number of Heschl's gyri in individual brains. Asymmetry of the Sylvian fissure was correlated with the greater length of the planum temporale on the left side. Although it is well known that the planum temporale is larger in the left hemisphere than in the right, little has been reported on Heschl's gyri in this regard. It is possible that asymmetries in higher auditory and language function may be attributable to anatomic asymmetries of not only the planum temporale but also Heschl's gyri.
Transient partial oculomotor nerve paresis with posterior communicating artery aneurysm. A case report.
A 38-year-old woman is described who developed a partial right oculomotor paresis which cleared spontaneously prior to clipping of an associated nonhemorrhagic bilobate right anterior communicating artery aneurysm.
Bilateral rhinocerebral phycomycosis.
A 51-year-old diabetic woman developed bilateral rhinoorbitocerebral phycomycosis. Successful treatment was accomplished by correction of the ketoacidosis, surgical debridement, and amphotericin B therapy. Rhinoorbitocerebral phycomycosis is a fulminant and frequently fatal disease most often seen in debilitated hosts. This survival suggests that aggressive therapy is indicated in patients with extensive fungal involvement.
Aphemia with hemiplegic migraine.
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Reflex vertical gaze and the medial longitudinal fasciculus.
Extraocular movements were investigated in a patient with bilateral vascular lesions of the medial longitudinal fasciculus. The patient showed voluntary and reflex horizontal gaze consistent with his lesion, but had absent reflex vertical gaze. Voluntary vertical gaze was present. Necropsy was performed, and the findings suggest that the medial longitudinal fasciculi in the pons conveys impulses for reflex vertical gaze, but are not required for voluntary vertical gaze.
Normal cerebrospinal fluid protein, increased intracranial pressure, and the Guillain-Barré syndrome.
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Prolonged focal epilepsy and hypoxemia as a cause of focal brain damage: a case study.
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Clinical signs in diffuse cerebral dysfunction.
Abnormal responses to 13 questions from a typical mental status examination and 32 signs of neurological dysfunction were correlated with increasing degrees of cognitive impairment as measured by the Halstead-Reitan Neuropsychological Battery. Thirteen of these factors were found to be useful predictors of diffuse cerebral dysfunction when combined into a brief screening examination for application at the bedside.
Behavioral asymmetries following olfactory tubercle lesions in cats.
13 of 17 cats which received unilateral olfactory tubercle lesions exhibited contralateral sensory inattention and ipsilateral circling and hyperresponsiveness. The possible neural substrates involved in these asymmetries are discussed, including ascending amine systems and ascending and descending connections with the orbital cortex.
Alexia without agraphia, hemianopia, or color-naming defect: a disconnection syndrome.
A patient with alexia without agraphia, hemianopia, or color-naming defect was found at operation to have a meningioma arising from the tentorium cerebelli that compressed the inferior aspect of the left temporal-occipital junction. It is presumed to have involved only the left ventral visual association cortex and its inferior outflow tracts to the angular gyrus. The input from the right occipital area also was disconnected from the visual language verbal association area by involvement of the ventral outflow of the splenium of the corpus callosum. Preservation of color naming and matching suggests that these functions are dependent on the integrity of more dorsal occipital association systems.
Letter: Eye findings in the "locked-in" syndrome.
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Letter: Steroids and Guillain-Barré syndrome.
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Agenesis of the corpus callosum with hypothermia.
A patient with episodic hypothermia and agenesis of the corpus callosum had no direct evidence of hypothalamic-pituitary dysfunction. However, it is speculated on the basis of a recent clinicopathologic case study that selective hypothalamic involvement is the cause of the hypothermia. Electroencephalograms and treatment with antiseizure medication did not support an epileptic genesis for the episodic hypothermia. Double, simultaneous, tachistoscopic stimulation studies revealed an asymmetry of response that can be explained by either a functional disconnection of the cerebral hemispheres or bilateral independent and asymmetrical representation of speech mechanisms.