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Biomedical subjects

B Croisile

Publications and source records attributed to B Croisile.

At least 37 records · Page 2Linked to original sources
PubMed1991

Cerebral metastases as first symptom of bronchogenic carcinoma. A prospective study of 37 cases.

Among the patients showing evidence of cerebral metastases without previously known cancer history, lung cancer has been found 37 times as the primary tumor in our institution. There were 34 men and three women and all but two were heavy smokers. Only one presented at diagnosis with thoracic symptoms but the chest radiograph was abnormal in 34. The histologic type of the primary tumor was obtained in 32 cases as a result of thoracic investigations and in five cases from metastatic tumor tissue. The primary tumor appeared to be non-small cell lung carcinoma in 26 cases and small cell lung carcinoma in 11 cases. These results show that patients treated with surgery (20 cases) have a better survival (median 10 months versus 4.5) than the others, and among surgically treated patients only those treated with bifocal resection (eight patients) are long-term survivors. Also, in four of six patients, objective regression of the neurologic symptoms was seen after radiation therapy alone. Central nervous system relapse was seen in 12 patients, but in none of the patients treated with postoperative radiation therapy. Conventional chemotherapy (11 patients) induced objective responses only in the small cell type and proved to be too toxic when used simultaneously with radiation therapy in inoperable patients.

Adult↗
PubMed1991

[Visuo-constructional disorders and alexia-agraphia associated with posterior cortical atrophy].

A 57 year-old woman developed a slowly progressive environmental agnosia and dressing apraxia without disturbances of language, memory, orientation and social activities. Two years later, alexia, agraphia, visual agnosia, constructional apraxia, simultagnosia and imitation apraxia of nonsymbolic gestures were also noted. Ophthalmic examination demonstrated a left inferior quadranopsia. Oral comprehension was normal. There was no loss of insight, and behavioral response was appropriately concerned. Computed tomography and magnetic resonance imaging revealed bilateral cortical atrophy in parieto-occipital areas, most pronounced on the right side, with enlargement of the ventricles. Positron emission tomography demonstrated low flow and metabolism values in the right parietal, temporal and occipital regions. This case is very similar to those of posterior cortical atrophy recently reported by Benson et al. (1988). It suggests a selectively degenerative dysfunction of posterior association cortex, sparing oral language and verbal memory.

Agnosia↗
PubMed1991

[Different clinical types of degenerative aphasia].

The authors report 3 cases of slowly progressive aphasia with different language disturbances: anomia, pure word deafness and Broca's aphasia. All patients were independent in daily life activities. Insight, judgement and overall behaviour were intact. There was no major disturbance of other cognitive functions, but psychometric tests showed mild deficits suggesting widespread involvement. CT scans and magnetic resonance imaging showed focal dilatation of the left sylvian fissure. A positron emission tomographic study showed left perisylvian hypometabolism. A review of the literature yielded an increasing number of cases of this degenerative syndrome affecting dominant hemisphere language areas. Our cases confirm the clinical heterogeneity of degenerative aphasia. Postmortem neuropathological examinations are rare and many causes are found: Pick's disease, Alzheimer's disease or aspecific gliosis.

Aged↗
PubMed1990

Pure agraphia after deep left hemisphere haematoma.

Pure agraphia is reported following haematoma in the left centrum semiovale sparing both parietal and frontal cortices. There was total inability to produce graphemes in the absence of limb apraxia. The lesion is assumed to have prevented linguistic and graphemic systems from gaining access to the frontal motor programme.

Adult↗
PubMed1990

[Large-cell intravascular malignant lymphoma].

Neoplastic angioendotheliosis is a rare, severe, disease characterized by neoplastic proliferation of mononuclear cells within the lumen of small blood vessels. The clinical signs are usually dermatological and neurological. We report the case of a 57 year old woman who died after 20 months of subacute dementia. She had had also transient recurrent episodes of right paresthesiae and paresis. CSF proteins were increased. MRI showed areas of high signal in the white matter. Post-mortem showed widespread ischemic lesions, mainly in the subcortical white matter. Microscopically there was marked proliferation of cells in most CNS blood vessels. Similar cells were present in adrenals, liver, uterus, lungs and kidneys. Immunohistochemical studies showed intensive staining for leukocyte common antigen and negative staining for factor VIII-related antigen, a specific endothelial cell marker.

Brain Neoplasms↗
PubMed1990

[Disorders of voluntary motor activity and lesions of caudate nuclei].

Three clinical cases are reported, resulting in apathy, uninterest, flattened affect and lack of initiative for usual daily activities. Intellectual performances were normal and there was no depression. This syndrome was reversible when patients were stimulated. Stereotyped behaviors resembling compulsions were frequent. One of the patients presented with prolonged akinetic episodes reversible by verbal stimulation. CT and MRI showed bilateral lesions, mainly in and around the head of the caudate nucleus. Such behavioral disorders have been termed psychic akinesia or athymhormia syndrome, suggesting that the patients suffered from a loss of drive and motivation. The lesions involved bilaterally the globus pallidus, the striatum or the frontal lobe. Recently, anatomical findings have shown several circuits through the basal ganglia additional to the motor circuit. The caudate nucleus receives inputs from the prefrontal and limbic cortex. These inputs are transmitted to the globus pallidus, then to the thalamus and ultimately return to the dorsolateral prefrontal, lateral orbitofrontal and anterior cingulate areas. Lesions in any part of these cortico-subcortical loops may be responsible for a dramatic behavioral syndrome, emphasizing their functional specificity in drive. However, a procedural learning impairment in neostriatal dysfunction could possibly explain the disorders observed in our patients.

Brain Diseases↗
PubMed1990

[Chiasmal radionecrosis after irradiation of the sella turcica using a conventional dosage. Contribution of magnetic resonance imaging].

A 47 year-old man developed rapid visual loss, visual field defects and memory disturbances after radiotherapy with conventional doses for a pituitary metastasis from a renal carcinoma. CT and MRI did not show recurrent tumour, pituitary apoplexy or empty sella. Eventually, T2-weighted MRI images showed abnormal high signals in the optic chiasm, the left mesial temporal lobe and the right inferior frontal lobe, supporting the diagnosis of delayed radionecrosis. The role of chemotherapy associated with radiotherapy is discussed.

Female↗
PubMed1989

[Neck pain and isolated torticollis revealing neurologic lesions].

Neck pain and torticollis are very common symptoms, but they may reveal an intracranial or cervical neurological disease. Such diseases are easily diagnosed when these two symptoms are associated with others, but in some rare cases, and especially when it is isolated, torticollis may be mistaken for common neck pain. This is what happened in 21 cases and in some patients the neurological disease had been present for a very long time before it was diagnosed. Prior to admission, most patients were treated with massages, cervical collar or manipulations which sometimes resulted in deterioration. A search for atypical features of neck pain and torticollis should avoid delays in diagnosis.

Adult↗
PubMed1989

Loss of motivation for speaking with bilateral lacunes in the anterior limb of the internal capsule.

A 76-year-old man suddenly presented with loss of motivation for speaking. He had no aphasia, depression or dementia, but he did not want to speak with other people. CT scan showed hypodensities, presumably lacunes, mainly in the anterior limb of the two internal capsules. Global behavioral changes with loss of self psychic activation have been reported, but in our patient the disturbance was restricted to oral language. The role of activating cortico-subcortical loops is discussed.

Aged↗
PubMed1989

[Lexical agraphia caused by left temporoparietal hematoma].

A patient presented with dysorthographia associated with amnestic aphasia due to a left temporo-parietal hematoma. Reading, copying, graphism of letters were normal. Dictation showed better results for logatomes and regular words, without orthographical difficulty, than for those with orthographical problems (ambiguous and irregular words). The overall features suggested a disorder of the lexical system in which orthography of words known to patients is present. The phonological pathway of phoneme-grapheme conversion was preserved since errors were usually phonologically correct. Initially it was possible to conclude to a disorder of the semantic value of words in their visual form. Oral spelling, auditory reading and written denomination also showed more errors for words of difficult orthography. This patient presented a disorder of visual representation of words. Comparison of this case with the few reported ones showed that the latter often had amnestic aphasia and differed from our case in the associated lexical or phonologic alexia. A common feature of the lesions is involvement of the left angular gyrus is right-handed patients.

Aged↗
PubMed1989

[Pure agraphia. Apropos of 2 cases].

Pure agraphia is a disorder of written language without aphasia, alexia or apraxia. Its existence has long been disputed. We report 2 cases due to a left parietal hematoma. In the first patient, with a deep precuneate lesion, agraphia included disorders in handwriting and orthographic problems in copying or writing from dictation with the two hands. The second patient, with a lesion of the postero-inferior part of the left angular gyrus, made errors in choice and combination of letters during dictation, whereas these same letters were well-written and copying was normal. The first cases of pure agraphia were ascribed to frontal lesions and then confusional states. Current opinion tends to implicate parietal lesions of various types: superior or inferior, internal or external. Findings in the present 2 cases and those reported indicate that pure parietal agraphia is heterogeneous.

Aged↗
PubMed1988

[Aneurysm of the internal carotid artery and cervical mega-dolicho-arteries in Marfan syndrome].

The authors describe the case of a Marfan syndrome who presented a giant intracranial internal carotid aneurysm associated with elongation and tortuosity of internal carotid and vertebral arteries on both sides. The skin microscopic examination showed fragmentation and distorsion of elastic fibers. There was no microscopic study of the vessels. Extra and intracranial vascular abnormalities are rarely reported in marfan syndrome: cardiovascular changes are seen mostly in aorta and pulmonary artery. In the literature are reported some giant aneurysms, dissections and dilatations of carotid, basilar and vertebral arteries. Usually the microscopic examination of the vessels show cystic medial necrosis. Other connective tissue diseases (pseudo-xanthoma elasticum, Ehlers-Danlos syndrome, progeria) are described with such clinical abnormalities. Reference is made to the possibility of unknown histological and chemical lesions weakening the vessels in patients without connective tissue disorders and presenting with arterial dissection or arterial aneurysm. So vessels would be more sensible to aging, arteriosclerosis or hypertension.

Aneurysm↗
PubMed1987

[Amnesic ictus and cerebral blood flow].

Cerebral blood flow determinations using the Xenon inhalation test in two patients with transient global amnesia showed overall decreases during the attack with a more marked fall in temporal-inferior frontal flow in one case and in temporal flow in the other. In the latter patient the temporal anomaly was reversible after naloxone injection but clinical improvement was lacking. Blood flow determinations in a further patient with transient global amnesia, after 2 mg of ergotamine tartrate plus caffeine, showed a global decline in flow without focal anomaly, with recovery after ten days. Values obtained in two other patients 24 and 38 hours respectively after typical transient global amnesia attacks were normal. The effect of naloxone appears related to a direct neuronal action although the role of endorphins in this affection is not conclusive. Comparison of these anomalies with those noted by Reichle with position emission tomography imaging suggests a primary neuronal mechanism.

Aged↗
PubMedDate not supplied

Agraphia in Alzheimer's disease.

Writing disorders are an early manifestation of Alzheimer's disease (AD), often more severe than language difficulties. AD patients produce shorter and less informative written descriptions of a complex picture than controls. These abbreviated texts also include many intrusions, semantic substitutions, and misspellings. Syntactic difficulties are characterized by a reduction of subordinate clauses rather than by the occurrence of grammatical errors. Lexical spelling is systematically more impaired and affected earlier than phonological spelling. With disease progression, the deficits of central writing processes extend to graphic difficulties and alteration of handwriting spatial organization. In the context of a semiotic hierarchy, an inverse relationship is suggested between writing acquisition during childhood and subsequent writing degradation in AD. The writing disturbance in AD is evidently related to a disruption in the anatomicofunctional cerebral network designed for writing processes, mainly in the parietal regions.

Aged↗