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Biomedical subjects

R A Lehman

Publications and source records attributed to R A Lehman.

17 recordsLinked to original sources
PubMed1979

Level and variability of performance on neuropsychological tests.

Compared non-specific variability across subtests and overall level of performance on the Wechsler Adult Intelligence Scale (WAIS) and the Halstead-Reitan Battery (HRB) for normal, schizophrenic, acute and chronic brain-damaged Ss. Both variability and level of performance measures for each of the two test batteries significantly distinguished normal from abnormal Ss, but the HRB measures were more sensitive. Intra-S variability across subtests had a significant negative correlation with level of performance on the HRB, but not on the WAIS. This correlation could not be accounted for fully by a ceiling effect and was thought to represent in part a characteristic feature of ts performance on the HRB. While WAIS variability appeared to be independent of level of performance, it was not much help in differentiating between the four S groups. It was concluded that non-specific variability across subtests is not a helpful independent measure of neuropsychological function on the two batteries studied.

Adult↗
PubMed1979

Meningiomas confined to the optic canal and foramina.

We present two cases, each with a small meningioma arising from the sheath of an optic nerve in the canal. Both cases demonstrate the paucity of clinical and radiographic signs occurring with these tumors. The diagnosis must be strongly suspected when a middle aged white woman slowly and progressively loses vision in one eye in the absence of remission or other neurological findings. We review similar cases reported in the literature that have been proven by biopsy.

Adolescent↗
PubMed1979

Osteomyelitis of the skull.

This retrospective study includes 18 patients who underwent 28 admissions for treatment of osteomyelitis of the skull. Each admission was reviewed separately. Systemic symptoms were rare and signalled the presence of an associated collection of pus. Films of the skull, polytomography and bone scans were all useful in establishing the diagnosis, whereas white blood cell count, erythrocyte sedimentation rate and brain scans were of little value. Complete surgical debridement was found to be of significantly greater value than limited surgical debridement. The surgical results appeared to be improved when surgery was followed by long courses of antibiotics. Each patient who received complete surgical debridement followed by at least six weeks of antibiotic therapy was cured.

Debridement↗
PubMed1978

Lateralized preferences and right-left discrimination in the monkey: choice of mirror-image shape, position of recovered food and hand usage.

Rhesus monkeys were tested for lateral preferences during mirror-image shape discrimination and food recovery from a row of pellets. Position of recovered food was unrelated to hand preference or mirror-image preference. There was no significant difference in the number of individuals preferring right and left lateral mirror-image shapes. Individuals tended to retain the same mirror-image preference to the same degree upon repeated testing. Animals of greater weight had stronger preferences. In all these respects, the features of mirror-image preference resembled those previously described for hand preference during a simple reaching task. The strength of different lateral preferences expressed by each animal were not significantly related thus failing to support the concept that asymmetric bodily responses can serve as cues for right-left discrimination in the environment. However, when the direction as well as strength of preference was considered, there appeared to be a tendency for animals to prefer the mirror-image shape whose reward bias was opposite to that of the preferred hand. This finding might have been due to a positional bias though there was evidence against this possibility.

Animals↗
PubMed1978

The handedness of rhesus monkeys: II. Concurrent reaching.

Of 171 monkeys tested for handedness, 60 were found to make occasional bilateral concurrent reaches. These reaches accounted for only 1.3% of the total of 600 reaches observed for each animal. Younger animals were observed to make such reaches more frequently than older animals. Concurrent reaching was characterized by a lower degree of preference for the overall preferred hand than unilateral reaches made by the same animals at comparable periods of testing.

Animals↗
PubMed1978

Using neuropsychological and personality tests to assess the likelihood of patient employment.

This study assessed the ability deficits and personality disturbances associated with three levels of employment in patients referred for neuropsychological testing. Highly significant group differences were found, with the unemployed group consistently showing greatest pathology on the tests, the full time employed group performing relatively normally, and the part time employed group earning intermediate scores. A discriminant function which used both neuropsychological and personality measures was found to discriminate unemployed from full time employed patients satisfactorily. Classification rates achieved by the function for validation and cross-validation samples support its clinical utility in identifying new patients who are at high risk for unemployment. It appears that psychological tests commonly used in neurological and psychiatric diagnosis can also help predict some aspects of patients' abilities to function in everyday life.

Adolescent↗
PubMed1978

Aspects of interhemispheric subdural haematoma, including the falx syndrome.

Two cases of interhemispheric subdural haematoma are reported. The first patient presented with a falx syndrome of contralateral hemiparesis, most marked in the lower extremity. The second patient had vertex headaches and was diagnosed with computerised tomography. Serial studies suggested that the interhemispheric haematoma may have migrated to a lateral position over the cerebral convexity.

Adult↗
PubMed1978

Neuropsychological and MMPI correlates of patients' future employment characteristics.

Previous research has suggested that patients' neuropsychological test scores correlate not only with neurologic status but also with their success in coping with some of the demands of daily living. This study investigated the utility of such laboratory test scores in predicting several vocational variables. Patients who had recieved neuropsychological evaluations were recontacted and questioned about their employment over the previous 6 mo. Of the 78 individuals who participated, 25 had been chronically unemployed. The remaining 53 were asked about job stability, hours worked, and wages earned, and were administered the Minnsota Job Requirements Questionnaire. Patients' scores on the Halstead-Reitan Battery, the WAIS and the MMPI were highly correlated with employment status (employed or chronically unemployed), income, and skills required on the jobs held. The results suggest that these tests may have clinical utility in assessing patients' employability, as well as the types of jobs for which they are suited.

Adult↗
PubMed1978

Reoperation after lumbar intervertebral disc surgery.

This retrospective study includes 53 patients who underwent reoperation after failure of lumbar disc surgery to relieve pain. All patients had leg pain before reoperation, which was successful in 28% of cases. Most clinical features, such as persistence or mode of recurrence of pain, radicular quality of pain, positive straight-leg raising, and myelographic root sleeve defects, were not helpful in predicting successful and unsuccessful reoperations. However, a significantly larger percentage of women than men had successful reoperations. Patients who had past or pending compensation claims, who had sensory loss involving more than one dermatome, or who failed to have myelographic dural sac indentations resembling those caused by a herniated disc did poorly with reoperation. A very convincing myelographic defect appears to be needed to justify reoperation at a previously unoperated location. Excision of scar alone or dorsal rhizotomy was of no avail in these cases.

Adult↗
PubMed1978

Arachnoid cyst producing recurrent neurological disturbances.

A patient with an arachnoid cyst of the posteriro fossa experienced repeated episodes of transient right upper extremity numbness and weakness. Review of the literature indicates that arachnoid cysts of the posterior fossa and spinal canal as well as extradural spinal cysts may present with symptoms of transient neurological deficit which often suggest the diagnosis of multiple sclerosis.

Adult↗
PubMed1977

Neurological complications of infantile osteopetrosis.

Seven cases of infantile osteopetrosis are presented. Five of these were available for detailed clinical examination and 2 for retrospective review, including autopsy slides. Neurological deficits in these patients are reviewed. Involvement of the central nervous system parenchyma was suggested by observations of delayed development, ocular abnormalities, and reflex changes as well as radiographic and autopsy findings. Cerebral atrophy was present in several of our patients as well as some reported in the literature and may account for the ventricular enlargement found in many of these patients. Though hydrocephalus may be present, it is unclear that this is frequent or that it can occur without antecedent intracranial hemorrhage. The large head size is not accounted for by calvarial thickening or by hydrocephalus. Despite our patients' small stature, pituitary function appeared to be normal. Surgical decompression may stabilize cranial nerve function, particularly when the optic nerves are involved.

Atrophy↗
PubMed1977

Familial osteosclerosis with abnormalities of the nervous system and meninges.

A mother and daughter with osteosclerotic dysplasia are described. The daughter had generalized osteosclerosis, flattening of the angles of the mandibles, high-arched palate, mandibular and facial bone hypoplasia, a large sella turcica, and spacious foramen magnum, platybasia, basilar impression, widened spinal cord with enlarged intervertebral foramina, and scalloping of the posterior surfaces of the vertebral bodies. Radiographic contrast studies and operative intervention revealed multiple thoracic and lumbar meningoceles and an "empty" sella, as well as evidence of maldevelopment of the spinal cord, cerebellum, and cerebral cortex. Many of these skeletal features were noted to a lesser degree in the asymptomatic mother.

Abnormalities, Multiple↗
PubMed1977

Experimental internuclear ophthalmoplegia.

A midline experimental lesion separating the medial longitudinal fasciculi at and below the level of the abducens nuclei without damaging either fasciculus at the level of the nuclei has produced defects of ocular motility resembling those of clinical internuclear ophthalmoplegia. Electromyographic recordings during lateral gaze demonstrate: (1) lack of inhibition of the lateral rectus muscle in the adducting eye, (2) delayed inhibition of the medial rectus muscle in the abducting eye, and (3) occasional evidence of excitation of the medial rectus muscle of the abducting eye probably associated with pupillary constriction. The presumed physiologic mechanisms involved in conjugate gaze movements are discussed in the light of the experimental findings.

Animals↗
PubMed1976

Monitoring of visual function during parasellar surgery.

Damage to the visual system is an unfortunate complication of surgery in the area of the optic chiasm. It is now possible tomonitor the functional status of the visual system intreoperatively at regulat intervals. This is accomplished by recording the Visual Evoked Response to flashes of light from light-emitting-eiodes. These diodes are embedded in a special plastic shell which inserts under the eye lids of each eye. Since the light comes from the diodes in the plastic shell, there is no need to disturb the surgical procedure when a test run is desired. A record is obtained by averaging 100 three-per-second flashes.

Adenoma, Acidophil↗