[Babinski-Gendron meningitis necrotoxica reactiva with unusual intensity in the course of middle cerebral artery occlusion].
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Biomedical subjects
Publications and source records attributed to B Gdakowicz.
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The observed group included 91 children aged from 2 to 15 years divided into two groups: I control--25 children, and II--66 children with severe infantile cerebral palsy. The following biochemical investigations were done in the cerebrospinal fluid: total LDH activity and total protein level before and after fluid condensation, and determination of LDH isoenzymes after condensation of fluid. In the group of children with absence of organic lesions of the central nervous system the mean total LDH activity was 17.6 mU/ml, this value was similar to that found by most authors. The isoenzyme pattern in the control group contained 3--4 fractions, the LDH4 fraction was, however, found in 2 cases only. In the group with infantile cerebral palsy the total LDH activity in the cerebrospinal fluid showed a considerable range of variations, its mean value was 32.7 mU/ml and was highly significantly above the mean value in controls. The LDH isoenzyme pattern in this group consisted of 4--5 LDH fractions with a fairly high proportion of cases with LDH4 and LDH5 fractions and with a high absolute activity of these fractions.
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In 320 cases contrast investigations of the vertebral column were carried out injecting by lumbar tap Metrizamide in 174 cases and Amipaque in 126 cases. In 259 cases the investigation was limited to the lumbar part, in 25 cases to the thoracic part, and in 19 cases to the cervical part of the spine. In 12 cases the whole vertebral canal was explored in this way. In 5 cases only epidurography was done. Very good or good contrast filling of the dural sac was obtained in the thoracolumbar segment using contrast medium 200 mg I/ml. In some cases this degree of concentration was inadequate for good visualization of the cervical segment. Side effects included headaches in 52%, nausea in 15%, vomiting in 4% of cases. In 28% of cases fever up to 38 degrees C was observed on the first day after the procedure. In 8 cases of repeated radiculography no evidence of arachnitis was demonstrated.
From a group of 400 radiculographic examinations the authors selected 34 cases operated upon for disc prolapse. These patients had additional signs of prolapse of the neighbouring intervertebral discs. The analysis showed that the latter signs were present mostly in the discs situated above the level of disc prolapse. In only two cases these changes were found in the disc situated below the level of prolapse. The sign of bulging-in dural sac in radiculography may be an impression of bulging disc and, much less frequently, it can be caused by a slight prolapse of the disc. Demonstration of these changes in contrast-medium investigations of the vertebral canal should be taken into account during the planned operation. The importance of disturbances of spinal biomechanics in the development of multilevel discopathy is stressed.