Biomedical subjects
Publications and source records attributed to A Pásztor.
The authors in their case report show a case of induced hallucinatory psychosis induced in a wife of a patient with alcoholic hallucinosis. They deal with the nosological position of "folie a deux hallucinatoire" (induced hallucinatory psychosis) and integrate the consequences of the case to the general psychopathological theory of hallucinations.
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Age-dependent characteristics of the clinical course of traumatic epidural haematomas of the infant and child have been summarized in a survey of 34 cases. Establishing the diagnosis of epidural haematoma is not an immediate indication for surgery in the infant, because there are cases of spontaneous drainage of the haematoma from the intracranial spaces (3 cases), when after 2-3 days of observation surgery can be carried out in an improved peadiatric condition (8 cases) and, as in the presented survey, there were only 9 cases when an immediate surgery had to be done. For the children over the age of 2 years the indication for an immediate surgery was not different in nature from that for the adults.
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This paper reports the use of ultrasound and computed tomography in combination to diagnose a case of meningioma in a 3-month-old infant, and also describes the treatment.
In a case of fetal hydrocephalus the authors repeatedly removed cerebrospinal fluid from the ventricles, transabdominally, by continuous pressure monitoring. Their aim was partly to improve the future functional prospects of the fetus, partly, by reducing the head circumference, to make possible a spontaneous and rapid deliver. After the period of adaptation a ventriculo-peritoneal shunt was implanted.
Age dependent characteristics of the clinical course of traumatic epidural hematomas of the infant and child have been summarized in a survey of 34 cases. Establishing the diagnosis of epidural hematoma is not an immediate indication of surgery in the infant, because there are cases of spontaneous drainage of the hematoma from the intracranial spaces (3 cases), after 2-3 days of observation the surgery could be carried out in an improved pediatric condition (8 cases) and like in the presented survey, there were only (9 cases), when an immediate surgery had the be done. For the children above the age of 2 years the indication for an immediate surgery was not different in nature from that of the adults.
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Among 2493 patients undergoing cerebral angiography 43 children were found to have cerebrovascular occlusion. The diagnosis, aetiology, management and care of the condition is outlined. It is stressed that angiography is indispensable in diagnosis.
In a clinical study carried out in five infants with severe affections, provocation tests of different qualities were employed during the simultaneous recording of the intracranial blood volume (rICBV) and the intracranial pressure (ICP). The systematic use of a hydrostatic pressure test permits, among other things, to provide the theoretical basis for a statement of the volume/pressure response of the cerebrospinal fluid. Simultaneous measurements of rICBV and ICP enable a differenciated appraisal of the individually different critical points above which one must speak of a pathological ICP increase, with special importance being attached to the reactive hyperaemia and its prevention.
In five infants with severe neurologic-neurosurgical affections, correlations between the intracranial blood volume (rICBV) and the intracranial pressure (ICP) could be proved. For the ICP range from 0 to 250 mm H2O, an increase in the pulse amplitude of the rICBV was found with increasing ICP. On the other hand, there were distinct rICBV decreases with increasing ICP in the ICP range from 300 to 450 mm H2O. Subsequent, often only slight ICP decreases in this range resulted in a reactive hyperaemisation. More pronounced hyperaemisations could be associated with moderate ICP increases of the same duration. The results are discussed on the basis of a model.
In infants with severe neurologic illnesses, rhythms found during continuous simultaneous recording of the rICBV and the ICP and their correlation with each other were described and supported by representations of the original curves. There were relations of the rICBV with the cardiac and respiratory rhythmus, with the so-called C- and B-waves, and clinical modes of behaviour. By using different electronic "frequency windows" and different recording speeds, a variety of relations with the clinical behaviour could be established. As a rule, several rhythms occurred at the same time. Problems and possibilities of the use of rhythmic processes for clinical diagnosis were discussed.
A spinal vasomotor reflex that resembles the Cushing response (CR) can be evoked also by isolated intraspinal hypertension. The intensity of the spinal vasomotor reflex (SVR) depends primarily on the length of the isolated spinal cord, i.e., on the total vegetative elements that participate in this mechanism. The vasopressor effect produced by isolated intraspinal hypertension may be the consequence of ischaemia of the spinal vegetative structures. Cur data suggest that in the case of increased intracranial pressure, when craniospinal connections are free and there is no impaction, the CR is due not only the vasomotor centre in the brain stem, but also to spinal vegetative structures.
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