PubMed Health⌕ Search

Biomedical subjects

B Ljunggren

Publications and source records attributed to B Ljunggren.

At least 55 records · Page 3Linked to original sources
PubMed1989

Late magnetic resonance imaging related to neurobehavioral functioning after aneurysmal subarachnoid hemorrhage.

Twenty patients who underwent early aneurysm surgery--that is, surgery within 72 hours after rupture--underwent further follow-up examination including magnetic resonance imaging (MRI) of the brain and a comprehensive neuropsychological assessment. Significant statistical correlation between tissue loss as seen on a late MRI scan and neurobehavioral deficits could not be established. Among 9 patients with no tissue loss seen on MRI, 3 exhibited substantial cognitive dysfunction and 6 had mild impairment. Three patients showed minor but corresponding tissue loss and deficits. In 3 patients with pronounced pathological indications on MRI, evidence of cognitive dysfunction was absent in 2, and 1 patient showed substantial impairment. The remaining 5 individuals displayed moderate pathological indications on MRI, with no obvious correspondence to cognitive functioning. In 7 patients, small white matter lesions, probably silent infarcts not seen on computed tomographic scan, were discovered on MRI. There was a clear relationship between arterial hypertension prior to aneurysm rupture and the extent of tissue loss seen on MRI. Absence of pathological findings on MRI scan did not exclude cognitive malfunctioning, and vice-versa.

Adult↗
PubMed1989

Cognitive functioning after subarachnoid haemorrhage of unknown origin.

Twenty patients, who had sustained a proven subarachnoid haemorrhage (SAH) and in whom cerebral panangiography had failed to reveal any source of the bleeding (SAH-NUD), were subjected to a neuropsychological examination involving memory functions, spatial perceptual organization, visuoconstructive abilities, reasoning, perceptual speed and accuracy, and concept formation. Cognitive functioning in SAH-NUD patients was compared with normal reference values and also related to the cognitive performance of neurologically intact patients having sustained an aneurysmal bleeding (SAH-AN). SAH-NUD patients showed significant reduction of verbal learning and retention, and of abilities involving abstract attitude and concept formation, i.e., functions related to frontotemporal structures. In all other respects the performance of these patients approached normality. Unexpectedly, there were no significant differences in mean test scores separating SAH-NUD from aneurysmal SAH patients. Collapsing the patient groups produced an increased number of significant deviations from normality, which was interpreted as the effect of the contribution of a greater number of relatively more impaired SAH-AN patients. This was supported by the finding that the ratio of impaired individuals to total number of subjects differed in the groups; the proportion of individuals showing cognitive sequelae was larger among SAH-AN patients throughout all comparisons but one. Although SAH of unknown aetiology represents much less of a catastrophe as compared with haemorrhage of aneurysmal origin, it does not preclude cognitive disturbances. Thus, the presence of blood per se anywhere in the subarachnoid spaces appears to affect higher brain function(s).

Adolescent↗
PubMed1989

HLA-typing in a family with six intracranial aneurysms.

The pedigree of a family where three of nine siblings had suffered from aneurysmal subarachnoid haemorrhage (SAH) was explored, by means of interviews and revisions of population and medical records. We thus found two nephews with previously ruptured intracranial aneurysms. Subsequently high resolution computerised tomography (CT) scans were performed in the remaining six siblings, one of which was shown to harbor an intracranial aneurysm. This individual was subjected to uncomplicated clipping of the aneurysm. Typing of human leukocyte antigen (HLA) was performed in 15 individuals of the pedigree. Three of the six HLA-antigens recently reported to occur in increased frequently in a series of (non-familial) patients with ruptured aneurysm were found, namely B7, DR2 and Cw2. Most noteable was the expression of the antigen B7 in five of the six individuals with aneurysm in the investigated family. At present HLA-typing is not a useful screening tool to identify individuals in the general population with an increased risk of developing intracranial aneurysms. The present study shows that HLA-typing could neither be used to predict the occurrence of intracranial aneurysms in the siblings in the investigated family. HLA-typing may provide further clues to our understanding of the etiology of intracranial aneurysms, especially concerning possible genetic factors. The authors thus would like to encourage HLA-typing in previously known and newly detected families with accumulation of intracranial aneurysms.

Adult↗
PubMed1989

Magnetic resonance imaging and aneurysm clips. Magnetic properties and image artifacts.

The magnetic properties of 12 different types of aneurysm clip were investigated in order to identify which clips allow postoperative magnetic resonance (MR) imaging without risk. Clip-induced MR artifacts were also quantitatively studied using a geometrical phantom. Nonferromagnetic aneurysm clips like the Yaşargil Phynox, Sugita Elgiloy, and Vari-Angle McFadden clips do not appear to contraindicate MR studies performed with a FONAR beta-3000M imager. There is no clip movement upon introduction of the phantom into the MR imager, and the image artifacts caused by the clips are so limited that patients harboring such clips may well be considered for MR imaging. This examination may reveal information not obtainable by any other radiological modality.

Aneurysm↗
PubMed1989

Transcranial Doppler sonography within 12 hours after subarachnoid hemorrhage.

Twenty-one patients were subjected to repeated assessment of cerebral blood flow velocities by means of transcranial Doppler sonography (TCDS) during the first 12 hours after subarachnoid hemorrhage (SAH). In 19 patients the study was performed following the first SAH, and in two after early rebleeds. Flow velocities did not indicate an early phase of arterial narrowing in any case. Following the first TCDS assessment, flows were evaluated repeatedly in the 19 survivors. Increased flow velocities suggesting arterial narrowing or vasospasm occurred only after a delay of at least 4 days. The results of this study favor the restoration of normal velocity patterns in surviving patients and do not indicate that an acute phase of vasospasm exists either immediately after or in the first 12 hours after SAH.

Blood Flow Velocity↗
PubMed1989

Dynamics of systemic quinidine photoallergy in the mouse.

Photoallergy to systemically administered quinidine was induced in the mouse, and the minimal time for sensitization as well as the duration of the allergy were studied. When groups of female albino mice, pretreated with cyclophosphamide, were exposed to quinidine 100 mg/kg i.p. followed by 0.1 J/cm2 UVB and 5.0 J/cm2 UVA, a positive challenge reaction, measured as ear edema, could be registered as early as the third day after induction and peaked on days 5-12. When animals photosensitized as above were photochallenged after 7 days, and again after 2 and 8 months, strong reactions were obtained on all 3 occasions, suggesting a duration of systemically induced photoallery to quinidine of more than 8 months. In the absence of quinidine, no photosensitivity could be demonstrated with UVA only. Phototoxicity controls were negative. These results suggest that photoallergy induced by systemic administration behaves similarly to contact and photocontact allergy.

Animals↗
PubMed1988

Realignment and surgical fixation of atlanto-axial and subaxial dislocations in rheumatoid arthritis (RA) patients.

One hundred consecutive patients with atlanto-axial dislocation(s) were subjected to posterior occipito-cervical fusion and followed up to 16 1/2 years postoperatively (mean: 4 1/2 years). The mean age at surgery was 60.3 years. At the time of follow-up, 45 patients had died, mostly due to cardiopulmonary disease. Out of the 100 patients, 67% showed a major improvement and in an additional 14% there was a slight or moderate improvement. Some patients with a stable fusion later developed subaxial dislocation(s) necessitating an anterior fusion which in patients with RA is difficult due to poor bone quality. MRI revealed pannus formation around the odontoid peg in many patients, in several to such a degree that cord compression was evident. Following the posterior fixation, the pannus disappeared or was reduced which may at least partly explain the generally favourable operative outcome following the fixation procedure. Early occipito-cervical fusion appears to prevent further vertical dislocation or upwards migration of the odontoid which is a more severe condition, and does not appear to result in increased incidence of subsequent subaxial dislocation(s). Such luxation(s) pose a technically difficult problem since the quality of the patients' own bone usually does not permit a common anterior fusion procedure with autologous graft. In such cases with cord compression, acrylic cement may be used to obtain a normalized realignment.

Adult↗
PubMed1988

Cerebrovascular and cerebral effects of nimodipine--an update.

A survey is given on the vascular and neuronal effects of calcium antagonists under physiological and pathological conditions. Special emphasis is put on vasospasm caused by subarachnoid haemorrhage and on postischaemic cerebral hypoperfusion following different forms of cerebral ischaemia, and on the attempts to influence these phenomena pharmacologically. Regarding its neuronal effects it seems likely that nimodipine potently blocks calcium entry during pathological conditions like cerebral ischaemia and spreading cortical depression. Positive effects also have been seen during epileptic seizures and withdrawal syndromes, whereas calcium entry under normal physiological conditions does not appear to be affected. Possible clinical consequences are discussed.

Animals↗
PubMed1988

Does intravenous nimodipine treatment influence cognition in patients subjected to early aneurysm operation?

Following aneurysmal subarachnoid hemorrhage (SAH) many patients complain of and exhibit disturbances of a cognitive nature. The etiology behind this encephalopathy is less well understood. Disturbed CSF-hydrodynamics and/or spasm in the lentriculostriate and thalamoperforating vessels might be responsible for such disturbances. This study comprised 56 patients subjected to early aneurysm operation, of whom 21 received intravenous nimodipine during the critical phase for SAH-induced vasoconstriction. There was no difference in cognitive disturbances measured with a specifically conceived battery of psychometric test instruments 2 years or more after SAH and surgery.

Adult↗
PubMed1988

Thromboxane B2 levels in serum during continuous administration of nimodipine to patients with aneurysmal subarachnoid hemorrhage.

Twenty-four patients with subarachnoid hemorrhage due to rupture of a supratentorial aneurysm underwent surgery within 72 hours after subarachnoid hemorrhage. Immediately after clipping of the aneurysm the patients were treated with intravenous nimodipine for at least 7 days and then received the drug orally for another week. Nine patients had a documented or probable intake of aspirin or other nonsteroid anti-inflammatory drug during the days preceding admission. In all patients there was a gradual increase in serum thromboxane B2 concentration from low to normal levels during the treatment period, the increase being most pronounced in patients with prior nonsteroid anti-inflammatory drug intake. Thromboxane B2 concentrations were similar to those of four control patients not receiving nimodipine. In three patients who developed delayed ischemic dysfunction despite "therapeutic" nimodipine plasma concentrations, the thromboxane B2 levels were low or normal. Our present results do not support the idea that nimodipine exerts an effect on platelet function in patients with aneurysmal subarachnoid hemorrhage.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1988

Aneurysmal subarachnoid haemorrhage: overall outcome and incidence of early recurrent haemorrhage despite a policy of acute stage operation.

A series of 480 patients who were alive upon admission following an aneurysmal subarachnoid haemorrhage (SAH) is reported. These patients represented 40% of the total Swedish incidence during a 3-year period. The three neurosurgical referral centres covering this population had a similar policy of early diagnosis and acute state surgery in all patients considered of having a potential to survive without permanent disabling cerebral malfunction. At 2-year follow up 45% showed a good neurological recovery, the morbidity was 25% and the mortality was 30%. Some more lives might have been saved with an improved ultra-early referral system since there were 21 initially good-to-fair risk patients (4% of the total SAH population) who rebled fatally before surgery and within 48 h. For comparison, in the Kingdom of Denmark, with a general policy of delayed operation, out of 1076 patients who were alive upon admission, 27.5% made a good recovery, while the morbidity was 27%, and the mortality was 45.5%.

Humans↗
PubMed1988

Reduction of rheumatoid periodontoid pannus following posterior occipito-cervical fusion visualised by magnetic resonance imaging.

Nine patients (four females and five males) with chronic rheumatoid arthritis (RA) and atlanto-axial (AA) instability subjected to occipito-cervical fusion were evaluated clinically and radiologically. All of them had soft tissue formation (pannus) around the odontoid peg. The age ranged from 50 to 79 years (mean: 66). The duration of the RA disease was 3-48 years (mean: 18.5). All patients were seropositive. Both conventional radiography and magnetic resonance imaging (MR) were performed pre- and postoperatively. All fusions except one were stable. One patient was re-fused after 2 months because of wire break. With regard to pain all patients had improved and eight were pain free. Six patients who experienced signs of myelopathy prior to the fusion had improved at follow up. MR revealed reduction of pannus in all nine cases. This was obvious in one patient within 6 weeks postoperatively. The MR findings of a reduction or even disappearance of pannus following posterior fusion should decrease the need for transoral surgery.

Aged↗