[Coma and the vegetative states].
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Coma↗
Biomedical subjects
F Danzé
Publications and source records attributed to F Danzé.
[Problems of surveillance and nursing in chronic coma].
Impaired consciousness after severe brain damage is coma, the next step being vegetative state with a high mortality rate. Some vegetative patients may in fact improve, although they usually stay dependent. The entire attending and rehabilitation team looks for responses to simple orders, which mean return of consciousness, and watches the patient's articular state and potential complications. It is also necessary to maintain the patient's dignity at this stage of wakefulness without awareness, and to prevent neuro-orthopaedic and cutaneous complications by positions and mobilizations, in order to provide optimal conditions for a possible physical and/or mental recovery and to reduce the degree of dependence.
Coma↗
Cholinergic-dependent cognitive deficits in Parkinson's disease.
In a double-blind cross-over study, the effects of a subthreshold dose of scopolamine (0.25 mg) on memory were compared in 32 control subjects and 32 parkinsonian patients who were without any sign of intellectual and mnemic impairment. Although the scores of the controls in the memory test battery showed no deterioration after the administration of scopolamine, the same dose resulted in significantly reduced memory performance in parkinsonian patients in two tests which involved the recognition of meaningless drawings. The selective vulnerability of parkinsonian subjects without cognitive impairment to a subthreshold dose of scopolamine suggests the existence of an underlying alteration of central cholinergic transmission. The neuropsychological findings in our study agree with postmortem biochemical data, which showed decreased cortical choline acetyltransferase activity in all parkinsonian patients, suggesting the existence of neuronal compensation in parkinsonian patients who are without cognitive impairment.
Acetylcholine↗
Computerized tomography and nuclear magnetic resonance imaging in Marchiafava-Bignami disease.
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Alcoholism↗
[Benign intracranial hypertension (pseudotumor cerebri). 12 cases].
Twelve cases of benign intracranial hypertension (BIH) are reported, there being a higher proportion of women patients and a greater frequency of those in the 3rd decade of life. Symptoms were principally headache (11 patients) and/or transient or permanent visual disorders (10 patients). Bilateral papillary edema was often associated with diminished visual acuity (5 cases) and/or amputation of the visual field (5 cases). Cerebral venous occlusion was detected in 3 patients and an infective focus in 7 cases. Three patients were receiving some treatment but none of the women was taking oral contraceptives. Two were pregnant. The CSF was abnormal in 5 of the 7 patients (mixed cell reaction and red blood cells: 1 case; pleiocytosis: 3 cases; raised protein levels: 1 case), and CT scans were normal except for reduced ventricular system size in 9 patients. Follow-up for a mean of 1 year showed total disappearance of symptoms and signs in 4 cases. Papillary edema had not totally regressed at the last ophthalmological examinations performed on 5 patients, and visual sequelae (visual acuity and/or visual field anomalies) were present in 5 cases. Two patients relapsed. The conventional acceptance of the benign nature of BIH must be tempered by the possible onset of possible serious visual disorders. Two factors appear to be determinant: the presence of severe visual disorders initially and/or the existence of arterial hypertension. Various physiopathogenic hypotheses have been evoked to explain BIH. The essential mechanism appears to be an anomaly of absorption of CSF, either from increased pressure in the dural venous sinuses or lesions of the arachnoid villi, but the role of cerebral edema and/or increased cerebral blood volume cannot be excluded. Incomplete understanding of physiopathogenic mechanisms account for the numerous treatments proposed and for some confusion in their indications.
Adolescent↗
[Meningo-myelitis with a favorable course after measles vaccination].
A 27 year-old woman complained of symptoms and signs due to a meningo-myelitis, 5 days after anti-rubella vaccination. Among the earliest symptoms she experienced pain and sensory deficit in the inoculated arm. The disease worsened until the 15th day, then improved spontaneously.
Adult↗