Biomedical subjects
Publications and source records attributed to K W Walsh.
Of the higher disorders associated with posterior cerebral lesions two have received considerable attention in the past decade. These are prosopagnosia, the so-called agnosia for faces, and alexia without agraphia. Major aspects of these disorders are reviewed briefly.
The "hangover" hypothesis proposes that there is some residual effect of low to moderate alcohol intake on the nervous system after the blood alcohol level has returned to zero. This notion has been invoked to explain the putative effects of moderate alcohol consumption on mental ability. We evaluated the hangover hypothesis by attempting to predict cognitive performance from self-reports of alcohol consumed during the week prior to testing. We found no meaningful evidence to support the notion that moderate alcohol ingestion produces a measurable toxic effect on brain function after the period of acute intoxication.
Seven cases of primary intraventricular hemorrhage (PIVH) constituted 3.1% of intracerebral hemorrhages in a prospective stroke series of 2,950 patients. All patients collapsed suddenly and had a depressed state of consciousness. Focal signs, if present, were minimal and contralateral to the major site of hematoma. Angiography in four patients revealed three intracranial arteriovenous malformations and one moyamoya. We conclude that PIVH may be readily diagnosed radiologically and underlying vessel malformations should be sought by angiography. Survival is common (five of seven cases), but a severe amnesic state may be a persisting deficit.
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A comatose patient with seizures and focal neurological signs was given vidarabine because herpes simplex encephalitis was a likely diagnosis. Investigations showed that the illness was due to infectious mononucleosis. Although recovery is usual in infectious mononucleosis encephalitis, the complete clinical and neuropsychological recovery documented in this severe case raises the possibility that vidarabine may have exerted a therapeutic effect.
Previous workers have clearly established that the central core limbic structures of the brain are primarily concerned in the production of amnesia of the axial or mesial type. The blood supply to these structures derives primarily from the posterior cerebral circulation. This was the rationale for Benson's work on 'amnesic stroke' in patients with posterior cerebral artery occlusion. We have extended this concept to show that a similar axial amnesia, as demonstrated by a classical response on Wechsler Memory Scale testing, exists in patients with vertebrobasilar insufficiency. Relative permanency of the amnesic syndrome was demonstrated by repeat testing at may be of assistance in the diagnosis of vertebrobasilar insufficiency.