Biomedical subjects
Publications and source records attributed to O Gerber.
Infections are a recognized cause of secondary vasculitis. A variety of pathogens have a propensity to involve blood vessels. Vasculitis, non-vasculitic vasculopathy, and mycotic aneurysms lead to infarction and hemorrhage of nervous system tissue. Treatment of infection-related vasculitis should include appropriate antimicrobial therapy directed against the offending pathogen, and appropriate management of cerebrovascular complications.
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We studied a patient who ingested 27 gm (500 mg/kg) of carbaryl (1-naphthyl N-methylcarbamate), a popular carbamate pesticide. After he recovered from acute cholinergic toxicity, acute weakness of arms and legs was accompanied by electrophysiologic findings consistent with axonal peripheral neuropathy. Recovery began at 1 week and continued for 9 months. A similar delayed neuropathy has been described with organophosphates but not with carbamate insecticides.
We report eight patients with cryptococcal meningitis and a cerebrospinal fluid characterized by few or no white blood cells and chemistries that may be near normal. In four of these patients, only testing for cryptococcal antigen allowed the initial diagnosis. Seven of the patients had a certain diagnosis of AIDS. Six have died. Autopsies performed in two cases indicated a poor meningeal inflammatory response. Contrary to the findings in most immunodeficient patients, in AIDS cryptococcal meningitis may present with few cellular or biochemical abnormalities in the cerebrospinal fluid. In AIDS patients presenting with headache and fever or change in mental status, examination of the cerebrospinal fluid should not be limited to routine studies.
We describe eight patients with bilateral paramedian thalamic infarction on CT scanning. Clinically, these patients had infarctions of either the paramedian thalamus alone or the paramedian thalamus with a variable extension to contiguous structures. A single occlusion may result in bilateral paramedian thalamic lesions because of the common occurrence of a single trunk of origin for the paramedian thalamic arteries.
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We describe three patients who had painless dissections of the aorta which resulted in neurologic syndromes at the time of presentation. Two patients had acute hemimotor and sensory findings. In one of these cases progression to paraplegia occurred. In a third patient, acute weakness and ischemia of a leg occurred at presentation. We review previously described painless aortic dissections. Such aortic dissections may be suspected in the setting of an acute neurologic event by abnormalities in the examination of the peripheral pulses and the heart and by attention to characteristic chest x-ray changes.