Biomedical subjects
Publications and source records attributed to O Guard.
The authors report 2 cases of stroke in 2 young women using oral contraception with production of anti-ethinyl-oestradiol antibodies. From literature, they recall the mechanisms of production of theses antibodies, their frequence in women with and without stroke and the different hypothesis lied to their pathogen action.
Clinical, neuropsychological, and CT scan data are reported in a patient with a right prefrontal hematoma following meningeal hemorrhage due to the rupture of an aneurysm of the anterior communicating artery. Over a period of six weeks, before and after surgery, the patient presented a particular type of language disorder characterized by incoherent speech, verbal paraphasias, unexpected or guided along ideic perseverations, emphatic and affected terms, and impossibility of brief responses, particularly in denomination tests. Contrasting with the absurdity of the discourse, the respect of oral comprehension, the absence of grammatical disorders, and the perfect phonemic and phonetic organization provided evidence of the integrity of the linguistic code. The purely semantic disturbance, however, was the cause of the apparent alteration in reasoning and judgment. A major amnestic syndrome was also present. It improved concomitantly with the language disorders. The explanation proposed is that of a disturbance of an attention process and of word selection due to a prefrontal lesion.
Observation of a patient suffering from a double softening of the brain (inner side of right temporal lobe, left occipital lobe). Clinically, Korsakoff's syndrome, right quadranopsia, pure alexia, tactile and visual agnosia concerning objects, colors and faces. Relative integrity of elementary perceptions (matching tests), impairments of stimulus identification (Lissauer's associative agnosia). Phenomena of sensoriphasic interactions are reported: normal speech in conversation, contrasting with confabulant anomia when naming or describing visual or tactile stimuli: then, escaping the control of sight, a relative "autonomy" of speech appears, with word perseverations and semantic "slipping" and filiations. Discussion of optical aphasia.
Clinical and pathological findings in a case of subacute combined degeneration of the cord are described. The patient was a severe alcoholic but there was no vitamin B12 deficiency. Lesions were similar to those observed in Lichtheim's disease. Biological tests demonstrated frank folic acid deficiency, with very low serum and red cells levels. Clinical features included only mild macrocytic anemia, and flexion quadriplegia after a period of disorders of equilibrium. Higher functions were unaffected. Apart from alcoholism, no other toxic or digestive causative factors were found.
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The authors reported the late results of a serie of fifteen intracranial aneurysm treated by plastic coating. These fifteen patients belong to a group of twenty cases operated with this technic. Four patients were pre-operatively in stade V. One patient died massive pre-frontal infract probably to retractor. In the same period, seventy-two others patients were operated for intracranial aneurysm by usual clip. The fifteen patients with plastic coating have been from two years to seven years observed. One case of minor epilepsy, one case of meningitis good imprevoded were noted. In this serie, no relapsing meningeal hemorrhage, is noted.
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A study of the cerebral metabolism of dopamine and serotonin has been realized by the probenecid test in 17 patients. The diagnosis of Alzheimer's disease (13 patients) and Pick's disease (4 patients) has been made on clinical and radiological grounds. No important anomaly of this metabolism was discovered. In subjects with Alzheimer's disease, the renewal rates of H.V.A. and 5 H.I.A.A. were diminished in comparison to the values measured in normal individuals, but this difference was not significant. In patients with Pick's disease, the accumulation of H.V.A. after probenecid was in the normal bounds, whereas that of 5 H.I.A.A. was non-significantly decreased. The results are compared with those of the literature.
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Six cases of ischaemic stroke which occurred during sporting activities are reported. The authors insist on the unusual features of the ischaemic events which had the same characteristics as other ischaemic strokes in young subjects: frequent involvement of the main cerebral arteries, good vital and functional prognosis in short--and mid-term. They consider that three factors might have concurred in precipitating the ischaemic accident, viz.: fibromuscular dysplasia (observed in 3 patients), warm summer weather encouraging haemoconcentration and poor physical training in 5 out of 6 cases.
A clinical history typical of multisclerosis began in a 20-year old man with transient, then permanent manifestations involving the optic tract and the pyramidal, extrapyramidal and cerebellar systems. The patient died at the age of 62, at the end-stage of a complex clinical situation which included paraplegia, bilateral cerebellar syndrome, optic nerve atrophy, epileptic seizures and dementia. When the patient was 54 years old, laboratory findings suggestive of systemic lupus erythematosus (SLE) were discovered, namely: antinuclear, native anti-DNA, anti-Sm antibodies, circulating anticoagulant, cryoglobulinaemia and low complement level. These abnormalities persisted up to the patient's death, 8 years later, without any non-neurological sign of SLE. Post-mortem examination showed lesions of focal demyelination characteristic of multiple sclerosis, but no evidence of cerebral or extracerebral SLE. This case raises the problem of borderlines or associations between systemic lupus erythematosus and multiple sclerosis. In our case, as in other cases of "lupoid sclerosis" reported in the literature, there was a frank and isolated elevation of serum IgM levels.
The syndrome of interhemispheric disconnexion has been systematically researched in 10 cases of medial and posterior callosal tumours. The cases have been documented with CT Scann and two of them were anatomically verified. Two had a complete disconnexion syndrome; another, whose lesion was situated on the forceps major, had no sign of disconnexion. In the others, the semiology was proportional to the extent of the tumour, sometimes minimal and in this case, only corresponding to an extinction of the left ear in the dichotic test, which therefore appeared in our series as the most constant sign of a transfer-trouble. Among the other signs, left tactile anomia was found in two patients, left ideomotor apraxia in three, left visual anomia in five. Seven patients had a right constructional apraxia, which was bilateral in five of them. Left agraphia was noted in five patients, among which three had also a right hand dysgraphia, whose physiopathology is discussed. Tactile alexia was noted in three patients, two had a trouble of somesthesic information's transfer, one had a pure alexia (left occipital lesion plus splenium). Signs of hemispheric independence were uncommon: one patient presented a "foreign-hand sign".
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