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Biomedical subjects

D G Sherman

Publications and source records attributed to D G Sherman.

At least 55 records · Page 3Linked to original sources
PubMed1980

Cerebral edema in stroke: a common, often fatal complication.

Brain edema causes herniation and death in many patients with large cerebral infarctions. Evidence suggests that even small infarcts may result in edema that contributes to further ischemia. Thus, ischemic cerebral edema appears to contribute heavily to morbidity and mortality in stroke. Normotension and normothermia should be carefully maintained, as should adequate ventilation and oxygenation. These measures are the most important and the most easily neglected. Various drugs in current use are of limited value in ischemic brain edema, but several new treatments of potential value are being explored.

Adrenal Cortex Hormones↗
PubMed1977

Dieting and peroneal nerve palsy.

In seven patients, peroneal nerve palsies developed while they were on weight-reduction diets. Five palsies were unilateral; two, bilateral. All patients recovered following diet modification. Therapeutic weight loss, of itself, can cause foot-drop. The prognosis is uniformly good.

Adult↗
PubMed1977

Ocular bobbing with superior cerebellar artery aneurysm. Case report.

A teen-age girl became comatose after the sudden onset of headache. Initial angiography did not reveal the site of bleeding. The subsequent onset of ocular bobbing directed attention to the region of the pons. Repeated angiography showed an aneurysm of the superior cerebellar artery. At surgery, the fundus of the aneurysm was adherent to the pons and there was a small hematoma within the pons. Ocular bobbing is rare, but is most commonly seen in association with destructive lesions of the pontine tegmentum, and is a useful localizing sign.

Adolescent↗
PubMed1976

Somatic anxiety attacks and propranolol.

Patients with acute anxiety-like attacks are often evaluated for various medical conditions, and, when nothing is found, their symptoms are attributed to psychogenic causes. "beta-Adrenergic hyperactivity" should be considered in these patients. Six patients are described who, we believe, are suffering from this condition. Low rates of isoproterenol hydrochloride infusion-precipitated symptoms that mimicked their spontaneous somatic anxiety attacks. Treatment with propranolol hydrochloride produced longterm symptomatic relief.

Adult↗
PubMed1976

Syncope.

Syncope is usually easily diagnosed, but sometimes it is confused with hypoglycemia, epilepsy, cerebral vascular disease, "drop attacks", hyperventilation attacks, and hysterical faints. Syncope is usually a benign disorder, but sometimes it is a manifestation of a serious neurologic or cardiac disease. This paper provides an approach to the evaluation and management of patients with this disorder.

Adolescent↗
PubMedDate not supplied

Management of cerebral embolism of cardiac origin.

The cardiac conditions most commonly associated with cerebral embolism are rheumatic heart disease (RHD), atherosclerotic heart disease (myocardial infarction and atrial arrhythmias) and other kinds of nonvalvular atrial fibillation (AF). The natural history of cerebral embolism from these cardiac sources is reviewed. Virtually all rheumatic hearts producing emboli have mitral stenosis, but not all of them are in AF. Of patients with RHD, 10--20% will experience a systemic embolus, and approximately half will have a recurrence, usually early. Of patients with a myocardial infarction, 5--12% will have a clinically apparent systemic embolus, and one-third to one-half have a recurrence, usually early. As many as 10--20% of patients with nonrheumatic AF have a systemic embolus. Anticoagulation reduces systemic embolism to 10--20% of the natural incidence in RHD, and it reduces embolic recurrences to 10--20% of the natural recurrence rate. Anticoagulation diminishes the incidence of emboli in myocardial infarction to 25% of the natural incidence. It is not known what effect anticoagulation has on the incidence of embolism in nonrheumatic AF. The data regarding the effect of valvulotomy and prosthetic valve placement in RHD are briefly reviewed. Recommendations are made for the use and timing of anticoagulation based on the available data.

Anticoagulants↗
PubMedDate not supplied

Abrupt change in head position and cerebral infarction.

Eight patients are described who developed infarctions in the vertebral-basilar artery distribution following chiropractic neck manipulation or spontaneous head turning. The angiographic and autopsy findings indicate that injury to the intima of the vertebral artery at the atlantoaxial joint forms a nidus for thrombus formation which may propogate or embolize to involve other vessels in the vertebral-basilar system and result in progressive brainstem infarction. The role of anticoagulation in these patients is discussed.

Adult↗
PubMedDate not supplied

Stroke and mortality rate in carotid endarterectomy: 228 consecutive operations.

A retrospective study of 228 consecutive carotid endarterectomies was conducted to determine the operative stroke and mortality rate in two 600-bed community hospitals. The combined stroke-mortality rate for the series was 21.1% (48 of 228). Eleven endarterectomies were performed for asymptomatic bruits and the combined stroke-mortality rate was 18.2% (2 of 11). Fifty-seven endarterectomies were performed for transient ischemic attach(s) in the symptomatic carotid artery distribution and the combined stroke-mortality rate was 21.1% (12 of 57). Seventy-one endarterectomies were performed following a mild-moderate stroke in the symptomatic carotid artery distribution and the combined stroke-mortality rate was 21.1% (15 of 71). Twelve endarterectomies were performed following a severe stroke in the symptomatic carotid artery distribution and the combined stroke-mortality rate was 41.7% (5 of 12). There was no trend toward more or less operation strokes or deaths from 1970 to 1976. The similarity of results among the eleven board-certified neurological and vascular surgeons who performed the 228 endarterectomies suggests that the operative stroke and mortality rates for carotid endarterectomy reported here are likely to be representative of those in many other community hospitals in this country in the 1970s.

Aged↗
PubMedDate not supplied

Cervical manipulation and stroke.

Three patients are described who experienced vertebro-basilar distribution infarctions associated with neck manipulation. Two of the manipulations were chiropractic. Twenty-two previously reported cases are reviewed. Evidence favoring the use of anticoagulation in these patients is discussed along with the relative risk of such therapy.

Adult↗