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Biomedical subjects

A Pau

Publications and source records attributed to A Pau.

At least 19 recordsLinked to original sources
PubMed1992

The outcome from acute subdural and epidural intracranial haematomas in very elderly patients.

Out of a consecutive series of 1082 operations performed on head-injured patients over a 9-year period, 28 cases of acute subdural haematomas (SDHs) or epidural haematomas (EDHs) occurring in patients aged between 80 and 100 years were selected. Mortality rates in these patients (100% in 2 EDHs, 88% in 26 SDHs) were significantly higher (p less than 0.01) compared with patients under 80 years (12% in 308 EDHs, 57% in 215 SDHs). Pre-existing diseases, primary events precipitating falls, and multiple system failure complicating the postoperative course accounted for most of the deaths. None of the patients operated upon with a Glasgow Coma Scale score of 11 or less survived. A typical 'talk and die' course occurred in two cases. Three patients, all operated on for SDH, survived and returned to their pre-injury conditions. It was concluded that, whilst the question as to whether to submit very old comatose patients to life-prolonging measures remains unsettled, there is a case for the prompt evacuation of extra-axial clots in patients with minimal impairment of consciousness.

Aged↗
PubMed1991

Muscle basal lamina as a grafting material for elongation of axons from rat brain.

Autografts of peripheral nerve or allografts of muscle basal lamina were inserted into the putamen-caudate complex of rats, with the outer end of the implant being sutured to the temporalis muscle. Elongation of central axons within the grafts, as revealed by the horseradish peroxidase retrograde labelling technique, did occur in the presence of basal lamina implants. With both types of grafting materials stained neurones exhibited a comparable distribution, being mainly found in the proximity of the central tip of the grafts. However, labelled cells in the presence of basal lamina were limited in number, compared with peripheral nerve autografts. Therefore, the usefulness of implants of muscle basal lamina into the central nervous system, in order to direct regenerating central axons toward distant target regions, is limited. This material might be suitable, as an alternative grafting material, in experimental models where avoidance of neurological impairment or size and length of the graft are crucial factors.

Animals↗
PubMed1991

Penetrating craniocerebral missile injuries in civilians: a retrospective analysis of 314 cases.

Analysis of 314 cases of penetrating craniocerebral missile injuries in civilians revealed a high rate of early mortality, with 228 victims having died at the scene and a further 38 dead within 3 hours. Surgery was performed in 44 patients who had a preoperative Glasgow Coma Score of at least 4. Out of the 26 survivors, all operated upon, 19 had an adequate recovery (score of 0-3 on the expanded Glasgow Outcome Scale). Vigorous resuscitation and early surgery often resulted in useful survivals and occasionally in spectacular recoveries. However, the high mortality rate on the scene or soon after the injury restricted the possibility of effective management to a minority of cases.

Adolescent↗
PubMed1991

Spinal subarachnoid hematoma of unknown etiology. A case report.

A case of spinal subarachnoid hematoma at T3-T7 level is reported in a 60-year-old hunter, who developed progressive spinal cord impairment after receiving the recoil of his shotgun. Both clinical and neuroradiological investigations, including the selective spinal angiography, failed to demonstrate the origin of the bleeding. The combination of an apparently trivial spinal trauma with temporary increase of the intrathoracic pressure might be considered as possible etiologic factor.

Diagnosis, Differential↗
PubMed1991

Changes in infratentorial blood flow following experimental cerebellar haemorrhage. A preliminary report.

The temporal progression of changes in blood flow within the hemispheric cerebellar cortex, following an experimental cerebellar ipsilateral haemorrhage, was investigated in rats by using the hydrogen clearance technique. Stereotactical injection of 50 microliters of fresh autologous blood into the paramedian white matter was found to produce an early drop of cerebellar blood flow, with subsequent rise toward higher values. An increase of the intracranial pressure only occurred at the time of injection of blood. Arterial blood gases, mean arterial blood pressure and blood glucose levels did not exhibit significant changes. Histochemical evaluations of glycogen phosphorylase showed a posthaemorrhagic pattern of enzyme depletion, consistent with the occurrence of an ischaemic damage in both the cerebellum and the brain stem.

Animals↗
PubMed1991

Formamidines with antinociceptive and antiinflammatory activities.

Pursuing our investigations on 7-amino-2,3-polymethyleneindole derivatives, a set of 7-(dimethylaminomethylene)-amino-2,3-polymethyleneindoles, together with some other aryl or cycloalkyl substituted formamidines, were prepared and tested for analgesic and antiinflammatory activities. Several compounds resulted endowed with one or both of these activities; the indole derivatives 1 and 2 exhibited a good degree of both of them.

Amidines↗
PubMed1990

Gas bubbles within acute intracranial epidural haematomas.

In order to assess the actual incidence of gas bubbles trapped within acute intracranial epidural haematomas, as revealed by computed tomography (CT) of the skull, a series of 204 patients with surgically verified epidural haematomas was retrospectively reviewed. Gas bubbles were observed on CT scan in 22.5% of the cases, with the incidence rising to 37% when CT scanners of the last generation were employed. The available data failed to demonstrate the actual source of intracranial gas. No correlation was found between the presence of gas bubbles and outcome. No patient in the whole series showed any sign of intracranial infection.

Acute Disease↗
PubMed1990

Regional cerebral blood flow after omental transposition to the ischaemic brain in man. A five year follow-up study.

Regional cerebral blood flow, recorded by the 133Xenon inhalation method, was measured preoperatively and over a five years postoperative period in six patients with completed stroke and stabilized neurological deficits, who had undergone omental transposition for revascularization of the ischaemic brain. Comparisons of the preoperative blood flow values with those recorded following surgery demonstrate a postoperative increase of blood flow in five patients, with a high statistical degree of significance in four of them at the final examination. The flow increase was noted over the infarcted areas of the brain, upon which the omentum had been placed, as well as areas of the ischaemic hemisphere without omental placement and the contralateral hemisphere. Out of the five patients who demonstrated preoperative flow values below the expected norm for age, four showed final postoperative cerebral blood flow within the normal limits for their age. The results are consistent with the assumption that the transposed omentum played a role in postoperative blood flow increase, by adding collateral circulation to the ischaemic brain.

Adolescent↗
PubMed1990

Long-term follow-up of the surgical treatment of intracranial coenurosis.

Intracranial infestation by the coenurus of the tapeworm Taenia multiceps is a rare occurrence in humans, with about 55 cases having been reported so far. Although most of these cases were observed in African or South American countries, the illness was occassionally found also in sheep-raising areas of Western Europe and the United States. Out of 4 personal cases, who were operated upon over an 18-year-period, 2 were neurologically intact respectively 20 and 3 years following surgical treatment. CT scans confirmed the absence of a progression of the disease. One patient was able to work 6 years after surgery, when he was killed in a road accident. A further, severely impaired patient remained unchanged and died with intercurrent infection 10 years following the operation.

Adult↗
PubMed1990

The value of some clinical and computer tomographic parameters in the prognosis of surgically treated patients with intracerebral hematoma.

The six-month follow-up of 83 surgically treated cases for intracerebral hematoma (ICH) was examined in relation to some clinical and computer-tomographic parameters (age, sex, accompanying diseases, clinical features, localization, ventricular involvement, time elapsed between stroke and surgery). Clinical and laboratory pre-requisites for admittance to the study were: 1) ICH with subcortical major component greater than 3 cm. in diameter, 2) a Glasgow Coma Scale (GCS) score at/or superior than 5, 3) any evidence of trauma, aneurysm, A-V malformation and tumor and 4) surgery not later than 96 hrs. after onset of bleeding. The role of the clinical picture and the ventricular involvement of ICH was strinkingly significant on both mortality as well as recovery rates while sex, some accompanying diseases and left localization influenced the recovery rate. Time elapsed between bleeding and surgery was not considered an objective parameter due to the variability of some organizatory and human factors. Age was an uninfluential factor.

Brain Damage, Chronic↗
PubMed1990

Transient upper monoballism in the presence of contralateral chronic subdural hematoma.

A case of chronic subdural hematoma associated with contralateral upper monoballism is reported. Intracranial midline shift and transtentorial herniation of the ipsilateral temporal lobe were the only demonstrated CT abnormalities. Complete neurological recovery followed the evacuation of the hematoma. Direct mechanical injury caused by the marked brain compression and distortion, and transient ischemic changes within cerebral areas whose damages may result in ballism, may be considered important causative factors of such an unusual neurological complication.

Chronic Disease↗
PubMed1989

Parkinsonism in the presence of intracranial extracerebral haematomas.

Bilateral Parkinsonism has been observed in a 60-year-old female with a chronic subdural intracranial haematoma. Scattered, poorly marginated, hypodense areas within the ipsilateral pallidus and putamen were evident on the preoperative CT scans. The rapid neurological improvement following the surgical drainage of the subdural clot and the evolution of the densitometric features of the nuclear lesions, which became clear-cut, though smaller, in the following months, suggest a cause-and-effect relation between the haematoma and the clinical symptomatology. To the best of our knowledge this is the first case in which anatomical lesions within the basal ganglia could be detected neuroradiologically.

Basal Ganglia Diseases↗
PubMed1989

Spinal cord dysfunction from lumbar disk herniation.

Two patients with a herniated disk respectively at the level of the L4-L5 and of the L5-S1 intervertebral spaces presented with pyramidal signs, bladder paralysis and radicular impairment. The symptoms subsided immediately following surgical removal of the prolapsed disk. The role of transient ischemia in the lower segments of the spinal cord as possible cause of this uncommon clinical picture is discussed, and the pertinent literature is reviewed.

Female↗
PubMed1988

A plea for postero-lateral orbitotomy for microsurgical removal of tumours of the orbital apex.

Lateral orbitotomy including the lateral rim of the orbit allows adequate surgical exposure for most intraorbital tumours. However, by dealing with intraconal lesions located deep at the orbital apex, the control of the posterior aspect of the growth is often less than optimal. The postero-lateral route, with bone removal mainly confined to the greater sphenoidal wing, allows a more direct approach to the posterior portion of these lesions along a plane tangential to the lateral aspect of the temporal pole. A modified surgical technique is reported, which in three consecutive cases allowed radical removal of pure apical tumours without added neurological deficits.

Humans↗
PubMed1988

Glycosides of the Magydaris pastinacea L.

From the alcoholic extract of fresh rhizomes from Magydaris pastinacea the glycosidic fraction was separated: it appears to be made up of seven different constituents one of which, 7-0-beta-D-glucopyranosil-8(2',3'-dihydroxy-3'methyl)-butylcoum arin isolated and identified by us, is relatively more abundant.

Chemical Phenomena↗
PubMed1988

[Analgesic activity of derivatives of 7-amino-2,3-polymethylenindoles and their congeners].

Some N-trifluoromethylsulphonyl and N-trifluoroacetylderivatives of 7-amino-2,3-polymethyleneindoles and of 7-amino-3-propylindole [(I) - (XIII)] were prepared and tested, together with corresponding aniline derivates [(XIV) - (XIX)] and with N-trifluoromethylsulphonylcyclopentylamine (XX), against formic acid induced writhings in mice. With very few exceptions, at the oral dose of 0.167 mmole/kg, they proved from 2 to 3.4 times more active than acetanilide.

Analgesics↗