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Biomedical subjects

L G Lazzarino

Publications and source records attributed to L G Lazzarino.

At least 19 recordsLinked to original sources
PubMed1996

Large striatocapsular infarcts: clinical features and risk factors.

We defined large striatocapsular infarcts as subcortical softenings of more than 20 mm in diameter involving the territories of the lateral and medial groups of lenticulostriate arteries. The aim of this study of 56 patients was to compare the clinical features and risk factors of these infarcts with those of cortical and lacunar infarcts. On the whole, our data suggest that both the clinical features and risk factors of large striatocapsular infarcts are similar to those of cortical infarcts, but significantly different from those of lacunar infarcts. The clinical manifestations of large striatocapsular infarcts with a maximum diameter of less than 50 mm may sometimes resemble those of lacunar infarcts because neuropsychological disorders are less frequent; however, our study indicates that, even in these cases, cardioembolic sources and artery-to-artery embolism are significantly more frequent in large striatocapsular than in lacunar infarcts, thus suggesting a different pathogenesis.

Aged↗
PubMed1994

Acute confusional states secondary to infarctions in the territory of the posterior cerebral artery in elderly patients.

Acute confusional states and agitated delirium are among the most common psychopathologic disorders in the elderly. However, they are rarely reported in the course of infarcts in the territory of the posterior cerebral artery. This study involving thirteen patients aged more than 65 years suggests that acute confusional states from posterior cerebral artery infarcts are less rare than usually thought, although the diagnosis may be difficult during the acute phase. The risk factors are no different from those observed for infarcts in other cortical areas, suggesting that this syndrome is due to structural damage of the brain rather than the other, usual causes of confusion in the elderly (intoxications, dysmetabolic diseases or dementia). The recognition of acute confusional states from posterior cerebral artery infarcts and its distinction from other causes of confusion is important in elderly patients because of the different diagnostic, prognostic and therapeutic implications involved.

Acute Disease↗
PubMed1994

Paraballism associated with anterior opercular syndrome: a case report.

We describe the combination of acute bilateral ballism and anterior opercular syndrome in a 75-year-old female hypertensive patient with bilateral multiple small infarcts involving the basal ganglia, the subcortical white matter and the area of the subthalamic nucleus, detected by CT scan and MRI. These clinical manifestations were accompanied by apathy, somnolence and cognitive changes usually observed in cortical involvement. Pathogenetic mechanisms for this unusual clinical picture are discussed on the basis of CT, MRI, and SPECT findings.

Aged↗
PubMed1994

Dementia syndrome in patients with postsurgical hypoparathyroidism and extensive brain calcifications.

The authors report the cases of 2 patients with extensive brain calcifications after thyroidectomy, showing behavioral and cognitive changes suggesting a subcortical dementia syndrome. On the basis of clinical, neuroradiologic and SPECT features they discuss the role of the brain calcifications in the pathophysiology of associated cognitive disorders and the putative mechanisms for the observed neuropsychological disorders.

Aged↗
PubMed1993

Lacunar syndromes due to non ischaemic causes: prevalence and clinical findings (study of 19 patients).

137 consecutive patients with Lacunar Syndrome (LS) were studied in order to evaluate the prevalence between ischaemic and not ischaemic forms. The lacunar infarcts (LI) were 118, the not ischaemic ones 19. These latter were caused by primary intracerebral hemorrhages with rapid recovery (12 cases), multiple sclerosis (3 cases) and unruptured top of the basilar aneurysm, chronic subdural haematoma, Arnold-Chiari malformation type 1, multiple metastases (1 case respectively). In this paper we discussed the probable pathogenetic mechanism and the clinical features in the 19 cases of not ischaemic LS. Moreover, FISHER'S opinion that LS are nearly always due to LI is here discussed.

Adult↗
PubMed1993

Painful tonic spasms associated with subcortical infarction.

The authors describe the case of a patient in whom painful tonic spasms developed as a consequence of a small infarct involving the lateral aspect of the putamen, the external capsule, and the subcortical white matter of the posterior insular region. Possible pathogenetic mechanisms explaining painful tonic spasms are discussed.

Brain↗
PubMed1992

Late onset unilateral asterixis secondary to posterior cerebral artery infarction.

Unilateral asterixis developed in a 56 year old man, 5 months after an infarct in the posterior cerebral artery territory, involving the posterolateral nuclear complex of the thalamus, documented by CT-scan and MRI. Unilateral asterixis in rarely reported in association with thalamic lesions and usually develops as an immediate postictal phenomenon. We discuss possible physiopathological mechanisms explaining the occurrence and the delayed onset of these involuntary movements.

Brain↗
PubMed1992

Opsoclonus in a patient with Guillain-Barré syndrome.

A 54 year-old woman showed the unusual association of a Guillain-Barré syndrome and opsoclonus, a rare eye movement characterized by involuntary bursts of jerking, ataxic and multidirectional saccades, without an intersaccadic interval. Since opsoclonus is a phenomenon described exclusively in CNS diseases, the case reported supports the hypothesis of CNS involvement in some cases of Guillain-Barré syndrome. The latter is generally considered an immune-mediated disease and an immune pathogenesis is also supposed in opsoclonus associated with systemic malignancies; besides, in the patient reported, the self-limiting nature of the disturbance and the lack of MRI lesions suggest that opsoclonus may result from an immune-related phenomenon causing a functional and transitory dysfunction of the CNS.

Brain Stem↗
PubMed1992

Proliferative retinopathy: value of the oscillatory potentials.

Oscillatory potentials (OPs) and retinal fluorescein angiography (RFA) were performed in 45 patients with diabetes mellitus. OPs were normal in 28 patients, altered (increased latencies and or inter-peak times) but with normal shape in 9, changes in morphology in 8: none of these patients had normal RFA, 2 had no proliferative retinopathy, 6 proliferative retinopathy (PR). In the authors' opinion OP changes in morphology are nearly always caused by a serious diabetic retinopathy, often by a PR. The authors emphasize the usefulness of OPs for studying the neurophysiologic properties of the retina of diabetic patients, particularly in PR.

Action Potentials↗
PubMed1991

Language disturbances from mesencephalo-thalamic infarcts. Identification of thalamic nuclei by CT-reconstructions.

The authors report the cases of two patients with CT-documented paramedian mesencephalo-thalamic infarcts, showing language disturbances. The first patient showed a non fluent, transcortical motor-like aphasia, the other had a fluent but severely paraphasic language disorder. The CT study disclosed that it was the dorso-median thalamic nucleus that was mostly involved in both cases. These findings agree with a few previous pathological studies suggesting that the paramedian thalamic nuclei, particularly the dorso-median nucleus may play some role in language disturbances. However the anatomical basis for thalamic aphasia remains speculative, taking into account the importance of cortical connections in the origin of subcortical neuropsychological disturbances.

Aged↗
PubMed1991

Aphonia due to paramedian thalamo-subthalamic infarction. Remarks on two cases.

We describe two patients in whom CT brain scans imaged paramedian thalamo-subthalamic infarcts in the territory of the thalamo-mesencephalic arteries. Such infarcts give rise to a complex syndrome marked by disturbances of consciousness and of eye movement and neuropsychological disorders, including attentional, memory and, more rarely, language deficits. A loss of voice volume may accompany aphasic disturbances but is exceedingly rare in isolation. In the cases described the aphonia, total but transient, was the only language disorder. The physiopathological mechanisms involved in aphonia are complex and controversial.

Aged↗
PubMed1991

Acute transient cerebral intoxication induced by low doses of baclofen.

We report a case of acute transient encephalopathy with confusion, drowsiness, myoclonic jerks, periodic triphasic sharp wave EEG patterns induced by low doses of baclofen. We discuss the pathogenesis and the differential diagnosis from the subacute spongiform encephalopathy of sudden onset.

Acute Disease↗
PubMed1991

[Infarction of the anterior choroidal territory. Clinical and tomodensitometric study of 11 cases].

Clinical features of anterior choroidal artery (ACA) territory infarct are hemiplegia, hemi-anaesthesia and homonymous hemianopia. However this syndrome in its complete form is of rare occurrence, since one or more signs or symptoms may be lacking. The Authors describe 11 patients with CT-documented infarctions in the (ACA) territory in order to establish clinical-CT correlations and possible risk factors. Among the investigated risk factors arterial hypertension is the most frequent in these patients. This finding, and the small size of the ischemic lesions make the ACA territory infarctions similar to Lacunar Infarcts. The Authors, emphasize that, as in lacunar infarcts, a thromboembolic mechanism cannot always be ruled out in ACA infarctions. Therefore a cause other than arterial hypertension should be considered in each patient for a better management of this type of infarcts.

Aged↗