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Biomedical subjects

P Yarnell

Publications and source records attributed to P Yarnell.

At least 19 recordsLinked to original sources
PubMed1992

Lightning strikes: nature of neurological damage in patients evaluated in hospital emergency departments.

Emergency physicians and staff are usually the first to evaluate and manage victims of lightning strikes. Damage to the nervous system is often the most devastating consequence of lightning strikes. Contrary to most articles in the literature in which neurological disorders are said to be either transient or delayed, we report the cases of six patients with severe, immediate, and in at least three, permanent clinical problems. Patients with signs of spinal cord lesions are most likely to have permanent disabilities.

Adolescent↗
PubMed1986

Poor outcome after lateral medullary infarcts.

In two patients, lateral medullary infarcts were followed by repeated brainstem ischemia. One patient had posturally sensitive vertebrobasilar TIAs, and the other had TIAs followed by quadriparesis. Both had angiographic evidence of intracranial vertebral artery occlusion on one side and severe stenosis of the contralateral vertebral artery. Propagation or embolization of clot from the occluded vertebral artery or decreased blood flow caused by stenosis of the contralateral vertebral artery can cause a bad outcome.

Arterial Occlusive Diseases↗
PubMed1978

Global hemianaesthesia: a parietal perceptual distortion suggesting non-organic illness.

In two patients, lesions in the non-dominant parietal lobe were associated with global anaesthesia to all sensory modalities affecting the opposite half of the body. A striking inconsistency existed between the complaints of limb anaesthesia and the grossly preserved motor and postural control of the involved limb. The gross discrepancy between complaint and functional ability prompted early consideration of a "non-organic" diagnosis. It is suggested that this unusual sensory deficit may be due to distorted perception of somatosensory stimuli, representing another disorder of body schema associated with parietal lobe lesions. The diagnosis of non-organic illness may then be avoided by focusing on a search for parietal disease.

Adolescent↗
PubMed1975

Amorphosynthesis on the chess board.

Visual spatial perception difficulities on the chest board have been studied in a patient with a dominant hemisphere infarction. The game of chess can be useful to demonstrate and follow the evolution of amorphosynthesis.

Adult↗
PubMedDate not supplied

Light touch thresholds in normal persons and cerebral vascular disease patient: bilateral deficit after unilateral lesion.

Sensory thresholds, using the 2-alternative forced choice technique, were studied in normal subjects and in patients with unilateral cerebral vascular disease, as documented by clinical-radiologic correlation. In normal person the absolute threshold for light touch increased with age. Bilateral impairment of sensation with unilateral cerebral vascular lesions occurred in 30% of the patients. Tactile deficit was always greater on the side contralateral to infarction or hemorrhage. An ipsilateral deficit did not exist independent of contralateral deficity, and was more likely to occur with complete sensory loss contralaterally. There was a tendency for persons with larger lesions as determined clinically and by CAT scan to have ipsilateral as well as contralateral deficit. The incidence or severity of ipsilateral deficit was not related to lesion laterality.

Adult↗
PubMedDate not supplied

Aphasia outcome in stroke: a clinical neuroradiological correlation.

Fourteen aphasic patients with acute onset of thromboembolic cerebrovascular insults demonstrable by angiography or radioscintigrams who were available for long-term follow-up have been studied. Their aphasia evolution was compared with acute angiographical and radioisotopic findings, and the lesions shown by follow-up computerized axial tomography (CT). Angiographical site of occlusion, evidence of early reopening of occluded vessels, and radioisotopic flow asymmetries including the "hot-stroke" luxury perfusion failed to correlate with aphasia outcome. Radioisotopic static images were more helpful by depicting lesion location and number but lacked the definition seen on the CT scan. The long-term CT scan by showing the size, location and number of lesions had a good correlation with aphasia outcome. Those patients with large dominant hemisphere involvements, either one large or many smaller lesions, fared poorly while those with lesser lesions did better. Bilateral lesions, at times evasive clinically, helped to account for significant aphasia residuals.

Adult↗
PubMedDate not supplied

Primary non-traumatic intracranial hemorrhage. A municipal emergency hospital viewpoint.

The devastating natural history of 138 consecutive admissions for non-traumatic intracranial hemorrhage to a major emergency care municipal hospital is reviewed. Sixty-four percent of the patients had demonstrable intracranial hematomas while 36% had mainly subarachnoid hemorrhage. Hypertension was a related condition in 43% of the parenchymal hematoma patients, while proved aneurysms accounted for 74% of the subarachnoid hemorrhage patients. There was only a 14% survivorship for patients requiring emergent surgery. All operated hematoma patients survived delayed surgery with improved level of responsiveness. The overall mortality was 74% for intracranial hematoma patients and 58% for aneurysm-caused subarachnoid hemorrhage patients.

Adult↗