Head pain associated with sixth-nerve palsy: spontaneous dissection of the internal carotid artery.
Explore the source record for details and available documents.
Abducens Nerve↗
Biomedical subjects
P Beuriat
Publications and source records attributed to P Beuriat.
Incidence and survival rates during a two-year period of intracerebral and subarachnoid haemorrhages, cortical infarcts, lacunes and transient ischaemic attacks. The Stroke Registry of Dijon: 1985-1989.
The age- and sex-specific incidence and survival rates over two years of intracerebral and subarachnoid haemorrhages, cortical infarcts, lacunes and transient ischaemic attacks (TIA) in a town of 140,000 inhabitants, are reported. During the five years, (1985 to 1989), 984 patients suffering from first stroke were registered by the Dijon Stroke Registry. The diagnosis was established by a CT-Scan in 88% of cases. Intracerebral haemorrhages (ICH) account for 8.8% of strokes, subarachnoid haemorrhages (SH) for 1.5%, cortical infarcts (CI) for 45.6%, lacunes for 16.7%, TIA for 15.8%, and 11% were undetermined. The annual average incidence rates per 100,000 are 13.4 for ICH, 2.0 for SH, 69.0 for Cl, 30.0 for lacunes and 25.5 for TIA. The survival rates for the acute stage (up to four weeks) differ between ICH and SH (46% and 67%), and the other types of strokes: 77% for Cl, 90% for lacunes and 98% for TIA. The survival rates of unclassified stroke are similar to ICH rates. At two years, survival rates of lacune and TIA are the highest. The divergences between public hospital based data and population-registry data are discussed. A population registry is necessary for studying the natural history of stroke.
Adult↗
Cerebral haemorrhage in a French prospective population study.
The incidence of cerebral haemorrhage was studied from a population-based stroke registry. The incidence was 12.3 per 100,000 per year in women and 13.9 per 100,000 per year in men, with a peak in the eighth decade and a male preponderance. Haemorrhages were deep seated and mostly due to hypertension. Recognised clinical characteristics of haemorrhage are acute onset, convulsion, vomiting, and disturbed consciousness. This study showed that cerebral haemorrhage may present with pure motor deficit or transient deficit preceding the stroke. The mortality was 51% in the first month, and 61% by two years.
Adolescent↗
[Natural history of lacunar syndromes. Contribution of the Dijon registry of cerebrovascular complications].
In a consecutive series of 984 first-ever strokes (from 1985 to 1989) in a population based study, 165 (16.7%) had lacunar infarction confirmed by CT-scan or M.R.I. The annual incidence was 35.6/100,000 in women, and 47.8/100,000 in men. Survival rates were 90% at 1 month, and 78% at 2 years. The rate of recurrent strokes was 11% at 2 years. The natural history of lacunar infarction could be drawn in this study which was population-based; 29% of lacunar infarctions are indeed not managed in hospitals. Lacunar infarctions should be identified as such in therapeutic trials since their course is clearly different from other types of strokes.
Adult↗
[Identification of temporal epileptic seizures using percutaneous sphenoidal electrodes].
The authors have evaluated the indications, methods and results of sphenoidal electrodes in epilepsy. This method makes it possible to study the hippocampal area which cannot be studied by extracranial electrodes. It also localizes in a temporal lobe complex seizures without electrical events, or complex seizures giving bilateral temporal spikes or a fronto-temporal focus of spikes. It may even show evidence of temporal focus in cases with bilateral and synchronous spikes. Thus, sphenoidal electrodes enable temporal seizures to be identified and localized, leading to more specific neuroradiological explorations and therefore helping in the selection of patients for specific surgery.
Adolescent↗
[Value of sphenoidal electrodes in the EEG diagnosis of herpes encephalitis].
EEG features in acute necrotizing encephalitis show periodic activity, localized in the temporal area with a slow background activity. Nevertheless, this periodic activity is transient and may lack. Sphenoidal electrodes study of the internal face of the temporal lobe could record such activity in herpes encephalitis. Sphenoidal electrodes were inserted in 4 patients known to have herpes encephalitis. In 2 cases, periodic discharges were observed both on the surface and sphenoidal electrodes, while in 2 cases, periodic discharge was observed under only sphenoidal electrodes. Faced with uncertain diagnosis of herpes encephalitis, it may be useful to insert sphenoidal electrodes to record deep periodic discharges, not seen on surface electrodes, in order to confirm the diagnosis.
Adult↗
[Dense middle cerebral artery: etiologic significance and prognosis].
Five cases of infarction in the territory of the middle cerebral artery (MCA) are reported. The main feature common to these 5 cases was the presence at CT without contrast injection, in the first 24 hours, of a spontaneous hyperdensity of the ipsilateral MCA. In one case, angiography demonstrated that this hyperdensity was associated with occlusion. In 2 other cases, doppler examination showed occlusion of the internal carotid artery. The transient character of these radiological findings is underlined. In the acute phase of an infarction, hyperdensity of the MCA at an early CT scan without contrast injection suggests an occlusive mechanism and massive infarction with poor clinical outcome.
Acute Disease↗
[Epidemiology of cerebrovascular accidents. According to Dijon's registry (1985-1988)].
The results of a 4-year prospective study of stroke in a community of 140,000 people are reported. Eight hundred and forty-two strokes were recorded, 70 per cent in University Hospitals, 20 per cent in private hospitals and 10 per cent at home. Ninety-four per cent of the patients had a CT scan. The annual incidence of stroke was 145/100,000 people, whereas the incidences of infarct, cerebral haemorrhage and subarachnoid haemorrhage were 121, 21 and 6.6/100,000 people respectively. These results, compared with those of other registers, clearly show the superiority of population-based registers over hospital-based registers.
Adolescent↗
[A simplified method of vaccination against rabies after exposure].
Vaccination against rabies after exposure to the risk of contamination is currently performed according to the WHO recommendations: 6 injections in 6 visits. We have studied the serological effectiveness of a simplified method using the human diploid-cell rabies vaccine: the vaccine is injected subcutaneously at the rate of 2 doses on day 0, then one dose on day 7 and one dose on day 21. Fifty subjects were vaccinated, and antiglycoprotein antibodies were assayed in serum by the immunoenzymatic technique (EU/ml). Seroconversion with titres above 0.5 EU/ml was observed in all subjects. The antibody titres were 0.127 +/- 1.57, 11.31 +/- 8.87, 10.2 +/- 7.55, and the numbers of subjects with protective titres were 0/50, 11/50, 46/47 and 36/37 on days 0, 7, 21 and 90 respectively. No undesirable side-effect was recorded. The good results obtained with this 2+1+1 vaccination schedule (4 injections in 3 visits) suggest that the recommended method of post-exposure vaccination could be replaced by this simplified method.
Antibodies, Viral↗
Stroke in a French prospective population study.
Since 1985 there has been a Stroke Registry in Dijon to record every stroke occurring in the population of a city of 140,000 inhabitants. The survey has been exhaustive and included the numerous sources of information as well as CT scanning. The annual incidence is 145/100,000 with an annual specific incidence of 170/100,000 in men, 126/100,000 in women. The annual specific incidence shows a female preponderance until 30 years of age, after which the males lead from the age of 30 to 80, when the rates become equal. Sixty-eight percent of strokes produced by infarct, 12% by lacunae, 5% by subarachnoid hemorrhage and 15% by cerebral hemorrhage. Differences exist in this distribution, with the preponderance of young people in subarachnoid hemorrhage, and cerebral hemorrhage is commoner in the 5th decade while infarct increases with age in both sexes. Infarct appears commoner during winter, transient ischemic attacks during summer, while cerebral hemorrhage has a constant incidence during the year. Mortality is high mainly during the 1st month with 12.5% during the 1st week, 21.5% the 1st month and 30% the 1st year. Our results are in the mean similar to white occidental countries, but opposite to those observed in Japan; they emphasize the importance of the lacunar syndrome, and the seasonal variations in different types of stroke.
Adult↗
Infraclinical neuropathies related to immunodeficiency virus infection associated with higher T-helper cell count.
To assess subclinical involvement of the peripheral nervous system and its relationship to the immunological status of human immunodeficiency virus (HIV)-infected patients, we prospectively studied the peripheral nerve conductions and the subsets of peripheral blood lymphocytes of HIV patients. Fifty-seven patients, aged 20-54 years, 28 homosexuals and 29 heterosexuals, classified as CDC II-III (40 patients) and CDC IV (17 patients) were studied. No neurological symptoms or signs were present on bedside examination or questioning for all of the CDC II-III patients. For each conduction measured (H-reflex, sural and sciatic velocities, sural amplitude), the geometric mean was below normal values (p less than 0.05). Among the 57 HIV-infected patients, 20 (35%) had a significant decrease of at least one electrophysiologic measurement: 10/17 CDC IV patients vs. 10/40 CDC II-III patients (p less than 0.05). Two or more simultaneous abnormalities were more often observed in the CDC IV than in the CDC II-III group (9/10 vs. 4/10) (p less than 0.01). In the CDC II-III group, patients with subclinical neuropathies had higher T-helper and lower T-suppressor cell counts and higher T-helper/T-suppressor ratios than random patients without any neurologic abnormalities (1,057 vs. 657 cells/microliters, p less than 0.05, and 757 vs. 1,304 cells/microliters, p less than 0.01, 1.55 vs. 0.68, p less than 0.01, respectively). We conclude that (a) the peripheral nervous system is precociously and subclinically involved in the HIV disease; (b) the patients with infraclinical neuropathies have a significantly higher T-helper cell count than those without any neurologic involvement. The mechanism and the prognostic value of these two findings remain to be more precisely examined, and further studies are required.
Acquired Immunodeficiency Syndrome↗
[Cerebral vascular complications in the population of Dijon. Incidence-breakdown-mortality].
Since 1985, a stroke registry has registered every stroke in this town, of about 140,000 inhabitants. A CT Scan and numerous sources of information have allowed to achieve an exhaustive survey. The annual incidence of stroke has been 145/100,000. The annual specific incidence for age is 170/100,000 in men, 126/100,000 in women. The annual specific incidence for age and sex has shown a female preponderance until 30 and a male preponderance after this age. At 80, the rates became equal. Sixty-eight per cent of stroke were due to an infarct, 12 p. 100 to lacunae, 5 p. 100 to subarachnoid hemorrhage and 15% to cerebral hemorrhage. A preponderance of young people was found in subarachnoid hemorrhage, of the fifth decade in cerebral hemorrhage, while infarct rose up with age in the 2 sexes. Infarcts appeared predominantly during winter, while transient ischemic attacks appeared more often during summer. Cerebral hemorrhage had a constant incidence over the year. Mortality was high, mainly during the first month with 12.5 p. 100 during the first week, 21.5 p. 100 during the first month, and 30 p. 100 the first year. Our results appear to set in the mean of white occidental countries as opposed to Japan. They emphasize the important and underestimated place of lacunae and the seasonal variations of several causal varieties of stroke.
Age Factors↗
[Incidence of cerebrovascular accidents in a medium-sized French town].
Beginning in 1985, the Dijon Stroke Registry has identified every case of stroke occurring in this city of 140,000 inhabitants. The systematic use of a CT scan and multiple other sources of information ranging from hospital doctors to general practitioners make it possible for us to have virtually exhaustive data on stroke incidence. The gross incidence was 170 per 100,000 among men and 126 per 100,000 among women. Specific incidence by age and sex shows female predominance up to 30 years of age, and male predominance among victims from 30 to 80 years old. Beyond 80, rates were identical for both sexes. In 68% of the cases, the strokes were caused by infarct; in 12%, by lacunae; in 15%, by cerebral hemorrhage; in 5%, by subarachnoid hemorrhage. Significant differences existed in this distribution according to age, with a clear predominance of young people among those having subarachnoid hemorrhage, while, for those over 40, cerebral hemorrhages were frequent; the proportion of infarct increased with age for both sexes. A peak of incidence for infarct appeared during winter, while transient ischemic accident was more frequent in summer. Cerebral hemorrhage had a similar incidence throughout the year. Mortality was high during the first month (12.5% during the first week, 21.5% during the first month), and reached 30% during the first year. These results are comparable to those generally observed among white occidental populations. They confirm the limited incidence of hemorrhages (contrary to what has been observed in Japan), emphasize the important and often underestimated role of lacunar syndromes, and the seasonal variations specific to each mechanism.
Adolescent↗
[Hyperglycemia in the initial phase of cerebral vascular complication. Index of bad prognosis].
The short-term prognostic value of hyperglycemia in acute stroke has been evaluated from the results of the first year of activity of the Stroke Registration unit in Dijon. In 188 patients admitted to hospital for acute hemiplegia blood glucose levels were measured on admission and daily for 7 days thereafter, and a CT scan was performed within a fortnight. Mortality was significantly higher in hyperglycemic patients (more than 2 g of glucose per litre) than in normoglycemic patients. In hyperglycemic patients the increase in blood glucose level was correlated with the initial disturbances of consciousness, the severity of hemiplegia and the presence at CT of an haemorrhage or an infarct with oedematous reaction. Thus, hyperglycemia in acute stroke is related to the severity of the cerebral damage. As a factor of bad prognosis, it is as sensitive as disturbances of consciousness or severe brain lesions at CT.
Aged↗
[Pericardial manifestations of Lyme disease].
Among cardiac manifestations of Lyme disease, pericardic involvement, as the main symptom, seems to be exceptional. We report two cases of pericarditis with typical clinical features. In both cases, pericarditis was the only clinical sign of the disease. Diagnosis was based on significant high serological antibodies levels with no evidence of any other etiological factor. Penicillin was administered and lead in one case to negativation of the serology. As cardiac involvement can occur without any preexisting cutaneous lesion, the frequency of pericardic involvement in Lyme disease is certainly underestimated.
Aged↗
[Hyponatremia under sodium valproate: search a drug interaction].
Explore the source record for details and available documents.
Aged↗