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Biomedical subjects

D F Cohn

Publications and source records attributed to D F Cohn.

At least 19 recordsLinked to original sources

Electrophysiologic features in patients with chronic neurolathyrism.

Neurolathyrism is a toxic nutritional disorder induced by the ingestion of the chick-pea "lathyrus sativus" and characterized by a pure motor spastic paraparesis. Eight patients with long-standing disease underwent nerve conduction and electromyographic studies. Two of them (25%) showed electrophysiological signs of lower motor neuron disease in their lower limbs. Subclinical affection of the anterior horn cells occurs probably more frequently than expected in chronic neurolathyrism.

Aged

Epilepsy in patients with brain metastases triggered by intravenous contrast medium.

187 patients with histologically proven primary neoplasms underwent computed tomography (CT) of the brain following intravenous administration of contrast medium. Eight developed focal epileptic seizures 2 to 4 minutes after the start of the injection. In three of these patients, in whom there was CT evidence of bilateral mass lesions of the brain, this epileptic activity became generalised into grand mal seizures, and two died in status epilepticus. In the other five patients with unilateral deposits in the brain, the focal fits corresponded to the site of the lesion shown by CT. Three of the patients had follow-up electroencephalography (EEG) examinations which showed unilateral focal activity, and their EEG foci correlated with the CT findings.

Adolescent

Magnetic resonance imaging in patients with progressive myelopathy following spinal surgery.

Thirty one patients with insidious progressive myelopathy 2 to 8 years following surgery of the cervical spine were subjected to magnetic resonance imaging (MRI). In 15 patients operated on for vascular malformations or intramedullary tumours, syringomyelia and cystic lesions of the spinal cord were shown. Seven of these patients also showed a combination of a recurrent tumour and spinal atrophy. Out of 16 patients who had surgery for herniated disc or spinal stenosis of the cervical spine, four had syringomyelia and 12 had spinal cord atrophy. There was no syringomyelia in the 12 patients submitted to MRI prior to surgery.

Adolescent

Generalized epileptic seizures as the presenting symptom of lacunar infarction in the brain.

Five elderly hypertensive patients presented with grand mal seizures and had computed tomographic (CT) findings consistent with lacunar infarction. Three of them had also a recent hemiparesis, contralateral to the side of the CT findings. Follow-up CT scans supported the diagnosis of lacunar infarction. Contrary to the accepted opinion, generalized epileptic seizures may be the presenting symptom of lacunar brain infarction.

Aged

Magnetic resonance imaging (MRI) in patients with complex partial seizures and normal computerized tomography (CT) scan.

Magnetic resonance imaging (MRI) examination was performed in 18 patients with complex partial seizures (CPS) of long duration, who had normal computerized tomographic (CT) scans of the brain. Small MRI abnormalities correlating with the location of the epileptogenic focus in the EEG were demonstrated in 4 cases. The findings with strong signals were better demonstrated in the coronal view with longer time to echo (TE). In one patient, a lower signal lesion was documented, which was better visualized in the axial view with shorter TE. Patients with CPS should be subjected to MRI examinations with coronal and sagittal planes, using short and long TE in each slice. This method minimizes the chance for missing pathology.

Adult

Focal epileptic activity following intravenous contrast material injection in patients with metastatic brain disease.

Four patients with metastatic brain disease were referred for computed tomographic (CT) examination with contrast material injection. Within 2 to 4 minutes after the intravenous administration of water soluble contrast agent, focal epileptic activity occurred. The seizures became generalised in two of the patients who later died following status epilepticus. In the other two patients the focal seizures correlated with the localisation of the metastatic mass lesions. None of the patients had a previous history of epilepsy.

Adenocarcinoma

Computerized tomography, clinical and X-ray correlations in the hemisacralized fifth lumbar vertebra.

One hundred and twenty patients with hemisacralization of the L5 vertebra associated with LBP underwent clinical, conventional X-ray and CT examinations. More than 50% of the patients had scoliosis. One third of the patients had disc lesions. Sacroiliac joint sclerosis was noted in two thirds of the cases. Almost all patients had an articulation between the hemisacralized side of L5 and the sacrum, which usually showed degenerative changes. Clinical symptoms are correlated to the CT and X-ray findings.

Adolescent

Sphenoidal EEG recording in complex partial seizures.

A prospective study was performed to evaluate the usefulness of sphenoidal EEG recording during wakefulness, as compared to routine tracings awake and asleep, for recognizing epileptic electroencephalographic foci in patients with complex partial seizures. Fifty patients were investigated. Following sleep deprivation a routine waking EEG, a sleep tracing and an awake recording with sphenoidal needles were obtained. In nine patients temporal epileptiform activity was apparent in all three conditions (wakefulness, sleep and with sphenoidal electrodes). In 21 patients temporal epileptiform activity was seen during sleep only, while the sphenoidal leads were non-contributory. In 20 patients epileptiform activity was not recorded under any of the above conditions. This study indicates that sphenoidal recording during wakefulness does not contribute to the detection of epileptic discharges in patients with complex partial seizures.

Adult

Computerized tomographic demonstration of intraorbital bone fragments caused by penetrating trauma.

Three patients with fragments of bones lodged in the orbit from apparently non-penetrating trauma, associated with cranio-cerebral injury, are reported. In all three cases the initial symptoms and signs of intraorbital or retrobulbar injury were minimal. The bone fragments were not demonstrable on plain x-ray films of the skull but were clearly shown on computerized tomographic (CT) scans of the orbit. They could easily have been overlooked had reliance been placed on plain x-ray films alone. In patients with suspected non-penetrating orbital trauma, axial and coronal CT views of the orbit are recommended.

Adolescent

Computed tomographic demonstration of brain changes in incontinentia pigmenti.

Incontinentia pigmenti is a rare condition, which may involve the central nervous system. Computed tomographic (CT) examination can supply important information about the dynamics and pathologic nature of this poorly understood syndrome. Two patients suffering from incontinentia pigmenti were examined by CT because of central nervous system symptoms. Large low-density areas in the brain were demonstrated in the CT examination of the first patient a few days after birth, suggesting a local edema. Diffuse brain atrophy was found two years later. Brain atrophy was also found in the second patient in a CT examination done at the age of 11 years.

Atrophy

Painful ophthalmoplegia: the Tolosa-Hunt syndrome.

Painful ophthalmoplegia is characterized by unilateral involvement of the IIIrd, IVth and VIth cranial nerves, as well as supra- and retro-orbital pain, i.e. participation of the Vth cranial nerve. The pain is relieved within 48-72 h with steroid therapy. The paresis of the eye muscles in various combinations usually subsides gradually from within a few weeks to several months. The etiology is unknown. The few pathological examinations reported in the literature showed an unspecific inflammatory granulation tissue around the intracavernous portion of the carotid artery and on the dura mater in the vicinity of the cavernous sinus. Carotid arteriography may show stationary waves of this artery and narrowing of its intracavernous portion. With orbital phlebography the occlusion of the supraorbital vein and obstruction of the cavernous sinus are sometimes demonstrable. The syndrome is well defined and its etiology still unknown.

Adult