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Biomedical subjects

J C Brust

Publications and source records attributed to J C Brust.

16 recordsLinked to original sources
PubMed1979

Acute generalized polyneuropathy accompanying lithium poisoning.

A woman with typical symptoms of lithium toxicity had, in addition, severe generalized sensorimotor peripheral neuropathy, which cleared completely as the recovered. Electrodiagnostic studies suggested axonal lesions; autopsy ten months later revealed no residual abnormalities. Previous studies have shown that lithium can affect peripheral nerve function, but this is the first reported case of peripheral neuropathy in association with lithium toxicity.

Adolescent↗
PubMed1979

Internuclear ophthalmoplegia caused by subdural hematoma.

Internuclear ophthalmoplegia (INO) is caused by lesions in the median longitudinal fasciculus. It is generally the result of primary intraaxial disorders, most commonly multiple sclerosis in young adults and infarction in older adults. Rarely, extraaxial disorders cause INO by compressing the brainstem. We report two patients with INO resulting from subdural hematoma with transtentorial herniation. These cases demonstrate that INO is a reliable, but not a pathognomonic, sign of a primary intraaxial disorder.

Adult↗
PubMed1979

The pathology of drop attacks: a case report.

A 65-year-old man had four drop attacks in several days and then a fixed stroke with quadriplegia. At autopsy infarction in the lower pons and upper medulla affected principally the corticospinal tracts. Tegmental destruction included reticular formation nuclei with rostral projections, but spared the lateral reticular formation nuclei, from which arise the descending reticulospinal tracts. This case is the first detailed autopsy report of a patient with drop attacks, and supports the view that at least some drop attacks are caused by transient ischemia of the corticospinal tracts.

Aged↗
PubMed1979

Bilateral facial palsy associated with Stevens-Johnson syndrome.

A 22-year-old man developed acute bilateral peripheral facial paralysis in association with Stevens-Johnson syndrome, probably as a result of ampicillin allergy. All symptoms cleared except the facial paralysis. He is the first patient in whom acute facial palsy and Stevens-Johnson syndrome have occurred simultaneously.

Adult↗
PubMed1977

"Release hallucinations" as the major symptom of posterior cerebral artery occlusion: a report of 2 cases.

Visual hallucinations were the presenting symptoms in 2 patients with probable infarcts in the territory of a posterior cerebral artery. They occurred in areas of paracentral scotomas, right in Patient 1 and left in Patient 2. In Patient 1 they were formed, prolonged, and not apparently related to past experience. In Patient 2 they were at first paroxysmal and unformed, with more prolonged metamorphopsia; later there appeared to be palinoptic formed images, possibly postictal in nature. Such hallucinations appear to be of a "release" type, and may be more common than is generally appreciated in patients with posterior cerebral artery occlusion.

Adult↗
PubMed1977

The Harlem regional stroke program: an overview.

The Harlem regional stroke program has been a demonstration model designed to detect, treat, and follow up stroke and hypertension patients through collaboration with a municipal teaching hospital, community practitioners, local service organizations and a major medical school. Many aspects of the stroke program appear suitable for replication at the local or regional levels in varied settings. In particular, the program has demonstrated the need to link community outreach programs, stressing early detection and preventive-care education, with sustained treatment and follow-up programs. The stroke program has also suggested ways in which specialized programs can be incorporated into long-term comprehensive health planning and care facilities at local and regional levels.

Adolescent↗
PubMed1976

Stroke associated with addiction to heroin.

During a five year period at the Harlem Hospital Center nine heroin addicts were seen with strokes. Four occurred after loss of consciousness following intravenous heroin. Two occurred in patients using heroin at the time, but were not related to overdose or to a particular recent injection. The youth of these patients and lack of other predisposing factors suggests that heroin played a role in their strokes. In the other three patients, the relationships of stroke to heroin is less persuasive. There are several possible mechanisms by which heroin abuse could lead to stroke.

Adult↗
PubMedDate not supplied

Aphasia in acute stroke.

Previous surveys of stroke populations have offered only cursory information on language disturbance, and, conversely, few surveys of aphasic populations have dealth exclusively with stroke or with acute phenomena. This paper describes aphasia in 850 acute stroke patients consecutively registered by the Harlem Regional Stroke Program, of whom 177 (21%) were aphasic; of these, nine were of Broca's type, 24 were of Wernicke's type, 14 were of anomic, ten were conduction, seven were of "isolation" type, and 107 were "mixed." An unexpected finding was a significant over-representation of men among the nonfluent aphasics. During the following four to 12 weeks, 12% of fluent aphasics died, and 12% remained moderately or severely impaired; among survivors, aphasia improved in 74%, and in 44% it cleared completely. During the same period, 32% of nonfluent aphasics died, and 34% remained moderately or severely impaired; among survivors, aphasia improved in 52%, and in only 13% did it clear completely. In both fluent and nonfluent groups, hemiparesis and/or visual field cut were associated with poor prognosis.

Acute Disease↗
PubMedDate not supplied

Frequency and course of pure motor hemiparesis: a clinical study.

A review of 850 acute unselected stroke cases at Harlem Hospital found only 25 (3%) who met a clinical definition of pure motor hemiparesis. Compared to other cerebral infarction survivors, the 23 pure motor syndrome survivors were slightly younger, not much more often hypertensive and did not make a faster recovery. The degree of motor deficit a year later was nearly the same in both groups. Brain scans were positive in one-third of the pure motor patients, which suggests that this clinical picture may be associated with larger brain lesions than had been suspected before, as well as with lacunar infarction.

Aged↗