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Biomedical subjects

R W Brennan

Publications and source records attributed to R W Brennan.

8 recordsLinked to original sources
PubMed1978

Amanita mushroom poisoning with recovery from coma: a case report.

The incidence of Amanita mushroom poisoning seems to be increasing in the United States. Its neurological aspects contribute importantly to morbidity and mortality. In reported series, mortality has ranged from 50 to 90%, and survival following the appearance of coma was exceptional. The cause of nervous system involvement was uncertain. In the patient presented here, clinical and electroencephalographic observations were consistent with severe hepatic encephalopathy and correlated closely with liver function abnormalities. Despite the development of coma, full recovery followed the use of thioctic acid, an experimental therapeutic agent.

Amanita↗
PubMed1978

Cerebral blood flow and oxygen consumption in the newborn dog.

Cerebral blood flow (CBF), CBF responses to changes in arterial CO2 tension, and cerebral metabolic rate for oxygen (CMRO2) were measured in newborn dogs, by means of a modification of the Kety and Schmidt technique employing 133Xe. Mongrel dogs of 1-7 days of age were paralyzed and passively ventilated with 70% N2O and 30% O2. CBF was derived by analysis of paired serial 20-microliter samples of arterial and of cerebral venous blood from the superior sagittal sinus. At an arterial PCO2 of 36.9 +/- 3.7 Torr and a mean arterial blood pressure of 62 +/- 10 Torr, CBF was 23 +/- 8 ml/min per 100 g. The arteriovenous oxygen content difference averaged 5.6 vol%, and CMRO2 was 1.13 +/- 0.30 ml O2/min per 100 g. CBF increased or decreased by 0.58 ml/min/100 g per Torr change in PCO2. Our results suggest that in the newborn, basal CBF and CBF responses to CO2 are considerably lower than in the adult and parallel the lower metabolic needs of the newborn brain.

Animals↗
PubMed1978

Neurologic complications of acute myelomonoblastic leukemia of four years' duration.

An adult with acute nonlymphoblastic leukemia involving the central nervous system is presented. Unusual features included: (1) Focal signs and radiographic evidence of sagittal sinus occlusion early in the course of disease; (2) progressive meningeal, cranial nerve, and spinal nerve involvement despite a 4-year bone marrow remission; (3) intracerebral tumor formation, and (4) retrobulbar optic neuritis associated with microscopic findings of herpeslike viral particles. The incidence of clinically overt neurologic disease in adults with acute nonlymphoblastic leukemia seems to have increased in tandem with improved chemotherapy. The prophylactic treatment of the central nervous system during prolonged remission of adult acute nonlymphoblastic leukemia may prove of benefit to these patients.

Adult↗
PubMed1977

Acute cerebellar hemorrhage. Analysis of clinical findings and outcome in 12 cases.

Although a majority of reported cases of cerebellar hemorrhage are subacute or chronic, an acute form of cerebellar hemorrhage occurs that results in coma within 48 hours of onset and is probably always fatal without surgical intervention. Our experience with 12 consecutive patients with proved acute cerebellar hemorrhage is summarized. Of three patients treated with aggressive medical therapy alone, none survived more than 48 hours. In seven of nine operated cases, emergency surgery was undertaken solely on the strength of clinical diagnosis without radiologic confirmation. Three died postoperatively. Of six survivors, two recovered fully, and two show mild and two moderate residua. The major factors influencing survival were the rate of evolution of signs and the level of consciousness at the moment of surgery.

Acute Disease↗
PubMedDate not supplied

Cerebral blood flow autoregulation in the rat.

Cerebral blood flow autoregulation (CBFA) to changes in perfusion pressure has not been previously reported in the rat. A modification of the Kety and Schmidt technique employing 133Xenon was used to measure cerebral blood flow (CBF) in paralyzed adult Sprague Dawley rats passively ventilated with 70% nitrous oxide and 30% oxygen. At a mean arterial blood pressure (MABP) of 121 +/- 19 mm Hg, and a mean arterial PCO2 of 36.2 +/- 2.9 mm Hg, mean CBF was 103 +/- 22 ml/min/100 gm of brain. CBF responses to hypercarbia were 4.9 ml/min/100 gm per mm Hg change in arterial PCO2. CBF was measured during steady state levels of hypo- and hypertension induced by phlebotomy, or by intravenous metaraminol, over the MABP range of 48-205 mm Hg. From a MABP of 80 to 160 mm Hg. CBF remained nearly constant, indicating the presence of CBFA. However, when MABP exceeded 160 mm Hg, CBF became pressure dependent, indicating a "breakthrough" of autoregulation in acute severe hypertension.

Animals↗