Biomedical subjects

D Decoo

Publications and source records attributed to D Decoo.

27 records · Page 2Linked to original sources

PubMed1994

Neurotropin treatment of brain edema accompanying acute middle cerebral artery infarction.

The present study is a second analysis of a randomized double-blind controlled trial on the efficacy of neurotropin on brain edema in a subgroup of patients with acute middle cerebral artery infarct treated within 24 hours. Neurotropin is a biological extract that specifically inhibits the release of bradykinin. The mortality rate was significantly lower in the neurotropin than in the placebo group. In the surviving patients the neurological deficit decreased to a significantly greater extent by neurotropin therapy after 15 days. The CT scan findings in the brain of the neurotropin-treated patients demonstrated a significant reduction in the size of the infarct and of the edematous area. Patients with middle cerebral artery infarct, which is prone to give rise to fatal intracranial hypertension, may derive great benefit from treatment of brain edema with neurotropin.

Aged↗

PubMed1994

Clinical and neurophysiological correlations in patients with refractory partial epilepsy and intracranial structural lesions.

Twenty patients (13 males, 7 females), who presented with refractory partial epilepsy and a CT and/or MR detected intracranial intra-axial structural lesion were admitted to the University of Gent Epilepsy Monitoring Unit. Mean duration of the epilepsy was 17 years (2-47 years). All patients were enrolled in a comprehensive presurgical protocol including neurological examination, video-scalp-EEG monitoring with prolonged interictal and ictal recording, neuropsychological assessment and positron emission tomography (PET). Intracranial EEG monitoring was performed in 5 patients in whom discrepancies between different tests were found during the non-invasive evaluation. Clinical neurological examination was normal in 16 patients; 4 patients had a mild contralateral hemiparesis. Lesions were mainly located in the temporal lobe (55%). Most patients presented with complex partial seizures (90%). Clinical seizure characteristics correlated well with the lesion location in 55% of patients. Interictal EEG showed focal epileptic activity and focal slowing in respectively 85% and 30% of patients. Interictal EEG lateralization was congruent with the side of the lesion in 17 patients (85%). Interictal EEG localization was congruent with the lobe of the lesion in 13 patients (65%). Ictal EEG lateralized correctly in 14 patients (70%) and localized correctly in 10 patients (50%). Neuropsychological assessment lateralized and localized congruently in respectively 8/17 (47%) and 7/17 (41%) of patients. Interictal PET showed focal interictal hypometabolism, congruent with the lesion, in 13/16 (81%) of patients. Intracranial EEG was congruent with the lesion location in 3 patients but non-congruent in 2 patients. All patients underwent surgical procedures: average follow-up was 14 months (6-24 months). Complete surgical removal of the lesion with free margins resulted in a more than 90% reduction of seizures without postoperative neurological deficit in 12/13 patients.

Adolescent↗

PubMed1994

A double-blind study of neurotropin in patients with acute ischemic stroke.

Neurotropin was found to reduce brain oedema in an experimental model of brain infarction in the guinea-pig. A randomized double-blind controlled trial with Neurotropin was performed in 220 patients admitted within 24 h after an acute ischemic stroke. 35 of the neurotropin and 41 of the placebo-randomized patients had to be excluded. 10 included patients in the neurotropin and 13 in the placebo-treated group died within the study period of 15 days. A better clinical outcome was observed in the 65 included surviving neurotropin compared with the 56 placebo-treated patients. The size of the infarct and of the oedema zones was significantly more decreased on CT scans from Day 11 compared with Day 3 after stroke in the neurotropin than in the placebo treated group. Neurotropin is helpful in treating brain oedema, related to acute ischemic stroke.

Aged↗

PubMed1994

Comparison of cerebral haemodynamic and oxygen metabolic changes due to cavernous angiomas and arteriovenous malformations of the brain. A positron emission tomography study.

The cerebral haemodynamic and metabolic changes due to cavernous angiomas in three patients and to arteriovenous malformations in four patients were compared by positron emission tomography, using the steady state technique with 15O. In the brains with a cavernous angioma no important changes in blood flow were observed. Only a decreased oxygen consumption was present in the cortex supplied by the arterial branches of the angioma, most probably related to neuronal deafferentation. In the four cases of arteriovenous malformation cerebral blood flow was significantly increased in the territory of the feeding vessels of the angioma. In the two huge ones the oxygen extraction rate was increased in the other vascular areas remote from the supply territory of the angioma, indicating chronic ischaemia. The present study confirms that chronic vascular steal phenomena can occur in large arteriovenous malformations, while cavernous angiomas do not induce important haemodynamic changes.

Adult↗

PubMed1993

A positron emission tomography study of patients with acute carbon monoxide poisoning treated by hyperbaric oxygen.

Seven patients with an acute and severe carbon monoxide intoxication were treated with hyperbaric oxygen and underwent a positron emission tomographic examination 2-5 days after the acute event. Although the final clinical outcome was good in all patients, ischaemic changes were observed. Three patients with temporary sequelae after hyperbaric oxygen treatment showed the most severe changes, mainly in striatum and thalamus. Although positron emission tomographic examination cannot predict the final outcome, it can show the regions at risk for development of late complications following carbon monoxide poisoning.

Adult↗

PubMed1992

Positron emission tomography study of the human hypothalamus during normal ageing and in ischemic and degenerative disorders.

Regional blood flow and oxygen metabolism were determined by positron emission tomography, using the steady state technique with 15O, in the hypothalamus and in the whole brain of fifty two normal persons and patients suffering from cerebral ischemia and degenerative dementia. During normal ageing regional blood flow and oxygen consumption appeared to increase slightly in the hypothalamus and to decrease in the whole brain in 24 persons. In the young age group the hypothalamus was more protected against ischemia than in the elderly group. In the aged group with cerebral ischemia and degenerative dementia regional blood flow and oxygen consumption were decreased in the hypothalamus to the same extent as in the whole brain.

Adult↗

PubMed1992

Transoesophageal echo-Doppler in patients suspected of a cardiac source of peripheral emboli.

The initial results of a controlled and partly blinded study aimed at evaluating the accuracy of transoesophageal echo-Doppler in detecting cardiac sources of peripheral emboli are reported. A total of 120 consecutive patients suspected of acute embolic events were entered. After completion of all investigations, the patients were classified into three groups: patients who had definitely not suffered an embolic event (controls; n = 56); patients in whom the differentiation between local thrombosis, embolic event originating from a diseased infarct-related artery or embolic event from a cardiac source was not possible (questionable cases; n = 24) and patients in whom a cardiac source of a definite embolic event was highly suspected (cardiac emboli; n = 40). Isolated interatrial septum anomaly and mitral valve prolapse were as frequent in the control group as in the embolism group. Transoesophageal echo-Doppler had a sensitivity of 83% and a specificity of 86% in correctly assigning a patient to the cardiac embolism group or to the control group. The positive and negative predictive values were 80% and 87% respectively. It is concluded that transoesophageal echo-Doppler is highly sensitive but is also specific in demonstrating cardiac sources of peripheral emboli.

Adult↗

PubMed1992

Does the severity of leukoaraiosis contribute to senile dementia? A comparative computerized and positron emission tomographic study.

The present study evaluates the origin, severity and location of leukoaraiosis in senile dementia and in normal ageing. The regional white-matter lucency scores, determined on computed-tomographic scan of the brain, are compared to the regional blood flow, oxygen extraction rate and oxygen consumption, determined by the [15O] steady-state technique with positron emission tomography. Thirty patients, classified according to the presence or absence of leukoaraiosis and their mental status, are examined. The occurrence and severity of dementia appear to be mainly correlated to decreased blood flow and oxygen metabolism in the frontal, temporal and parietal cerebral cortex. Leukoaraiosis in demented and nondemented patients is associated with lowered blood flow in the frontal and parietal white matter. The regional lucency score is increased, and blood flow and oxygen consumption decreased in the frontal white matter of severely demented patients. Frontal leukoaraiosis contributes to dementia and is probably of ischemic origin, while parietal and occipital leukoaraiosis is due to wallerian degeneration.

Aged↗

PubMed1992

Significance of white matter lucencies in posthypoxic-ischemic encephalopathy: comparison of clinical status and of computed and positron emission tomographic findings.

The clinical status and the computed and positron tomographic findings were compared in 10 patients with sequelae of hypoxic-ischemic encephalopathy after cardiopulmonary arrest and successful resuscitation. Conscious patients with moderate neuropsychiatric deficits had no significant computed tomography (CT) scan changes and normal values of regional cerebral blood flow and oxygen consumption, while patients in vegetative state had definite cerebral atrophy on CT scan and a severe and widespread decrease of regional cerebral blood flow and oxygen consumption. This decrease was even more pronounced in vegetative patients with the worst neurological score and with CT scans demonstrating additional diffuse white matter lucencies and hypodensities in the basal ganglia. In this group of patients increased regional oxygen extraction rates mainly in the white matter indicated the occurrence of delayed ischemic changes. The positron emission tomography and CT findings correlated well with the degree of posthypoxic-ischemic damage and the clinical status of the studied subjects.

Adult↗