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T Büttner

Publications and source records attributed to T Büttner.

At least 55 records · Page 3Linked to original sources
PubMed1997

S-100 protein: serum marker of focal brain damage after ischemic territorial MCA infarction.

BACKGROUND AND PURPOSE: Elevations of protein S-100 (S-100) in cerebrospinal fluid and serum have been reported after cerebral infarctions. The aim of our study was to evaluate the time course of serum S-100 concentrations after territorial middle cerebral artery (MCA) infarctions in correlation with clinical data and prognosis. METHODS: S-100 serum levels were serially determined in 26 patients with an acute infarction in the territory of the MCA at day 0 (within 12 hours after onset of symptoms), day 1 (24 hours after stroke onset), and days 2, 3, 4, 5, 7 or 8, and 10 after stroke and in 26 age- and sex-matched control subjects. S-100 assays were performed using a two-site radioimmunoassay technique. The clinical status was documented using the Scandinavian Stroke Scale. The functional deficit 4 weeks after stroke onset was scored by use of the modified Rankin scale. A cranial computed tomography (CCT) was performed initially and at day 4 or 5. RESULTS: Elevated concentrations of S-100 (> 0.2 microgram/L) were observed in 21 of 26 patients with MCA infarction but in none of the control subjects. S-100 levels peaked at days 2 and 3 after stroke. The S-100 concentrations in serum were significantly higher in patients with severe neurological deficits at admission, with extensive infarctions and a space-occupying effect of ischemic edema as compared with the rest of the population. S-100 values were not significantly correlated with the functional prognosis. CONCLUSIONS: Presence of S-100 in serum after ischemic stroke may be due to combined leakage out of necrotic glial cells and passage through an impaired brain-blood barrier, indicating severe ischemic cell injury. Therefore, S-100 in serum can be used as a peripheral marker of ischemic focal brain damage and may be helpful for therapeutic decisions in acute ischemic stroke.

Aged↗
PubMed1996

[Cranial magnetic resonance tomography--value in diagnosis of dementia. Important additional information for differential diagnosis].

The clinical data and the magnetic resonance imaging (MRI) findings of 41 patients with clinically diagnosed dementia of the Alzheimer type (DAT) and 20 age-matched healthy controls were evaluated with the aim of determining the value of MRI in the diagnosis and differential diagnosis of dementia. Patients and controls with cerebrovascular risk factors, including a history of stroke, were excluded from the analysis. The MRI findings of patients with dementia revealed pathological changes, in particular cerebral atrophy (p < 0.0005), significantly more frequently than did those of controls (p < 0.005). Periventricular demyelinisation and lesions of the white matter were found in 23 (56%) patients, and in 6 (30%) of the controls. MRI revealed one case each of subdural hematoma, hydrocephalus and cerebral amyloid angiopathy. In 14 patients, the detection MRI scans of cerebral infarctions or hematomas suggested a major vascular component of the dementia. In contrast, lesions of the white matter can not reliably by ascribed to a vascular etiology. On the basis of our findings, it is concluded that cranial MRI is of great value for the differential diagnosis of dementia, even when the clinical diagnosis of Alzheimer's dementia is probable and cerebrovascular risk factors are absent.

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PubMed1996

[Secondary cerebral vasculitis in suppurative meningitis. Clinical aspects and findings in color-coded transcranial duplex ultrasound].

Transcranial Doppler ultrasonography carried out in cases of bacterial meningitis has often shown a reversible increase in blood flow velocity in basal cerebral arteries, that is interpreted as caused by segmental vasospasm brought on by vasculitis. We report for the first time on findings of transcranial colour-coded duplex ultrasonography performed on a patient with pneumococcal meningitis who suffered a subcortical infarction in the territory of the right middle cerebral artery. Doppler ultrasonography revealed an increase in blood flow velocity of the right middle basal cerebral artery, while the B-scan revealed thickening of the main trunk on the right. These findings suggest an inflammatory thickening of the blood vessel wall with secondary narrowing of the lumen as a result of secondary vasculitis.

Adult↗
PubMed1996

Visual hallucinosis: the major clinical determinant of distorted chromatic contour perception in Parkinson's disease.

Recently distorted chromatic contour perception has been demonstrated in Parkinson's disease (PD). The aim of our study is to determine the clinical factors which influence chromatic contour perception in PD. Chromatic and achromatic contour perception, colour discrimination and clinical data were evaluated in 73 patients with PD. We used a computer-aided method to determine the chromatic fusion time (CFT) which indicates the acuity of monochromatic contour perception. Chromatic CFT was generally shortened in patients as compared to controls (p < 0.01), whereas achromatic CFT was not significantly different. Variance analysis revealed the ability of colour discrimination and the risk of visual hallucinations as statistically significant (p < 0.05) variables influencing contour perception of certain stimuli. In contrast, disease stage, disease duration and disease severity have no relevant effect on chromatic contour perception in Parkinson's disease. On the basis of those properties one may suggest that distorted chromatic contour perception is due to an impairment at a central stage of visual processing in PD and an imbalance of the serotonergic system. Whether CFT is a reliable method to predict the individual risk of hallucinosis in PD has to be evaluated.

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PubMed1996

Paroxysmal convergence spasm in multiple sclerosis.

Paroxysmal phenomena are rare but relatively typical clinical symptoms of multiple sclerosis (MS) caused by abnormal excitation in demyelinated plaques. We report the case of a 25-year-old woman with ocular convergence spasms as a new type of paroxysmal phenomenon in MS. MRI revealed the associated brainstem lesion in the region of the medial longitudinal fasciculus. Bromocriptine treatment was successful in resolving the paroxysms.

Adult↗
PubMed1996

Chromatic and achromatic visual evoked potentials in Parkinson's disease.

Chromatic and achromatic visual evoked potentials (VEP) were evaluated in 39 patients with idiopathic Parkinson's disease (PD) (age 64.0 +/- 8.6 years) and 43 healthy controls (age 62.8 +/- 8.7 years). The following pattern-reversal checkerboard stimuli were performed: (1) achromatic with luminance contrast 86% (achr.hk.) (2) achromatic with luminance contrast 20% (achr.lk.); (3) chromatic isoluminant blue-yellow (by.); (4) chromatic isoluminant red-green (rg.). The mean latencies N70, P100, and N135 of chromatic and achromatic VEP were significantly delayed in patients with PD as compared to controls. The highest rate (41.0%) of pathological findings could be demonstrated by achromatic stimulation (luminance contrast 86%). Isolated abnormalities of chromatic VEP (in combination with normal achromatic VEP) were found in 5 (12.8%) patients. The delay of VEP-latencies was significantly correlated with the severity of motor symptoms in PD patients. We conclude that VEP are valuable tools to demonstrate a dysfunction of the visual system in PD. Although chromatic VEP are less sensitive than achromatic VEP, the combination of both will increase the diagnostic yield. Therefore, there seems to exist a variety of individual characters of visual impairment in PD.

Adult↗
PubMed1995

Color vision in Parkinson's disease: missing influence of amantadine sulphate.

In recent studies, disorders of chromatic and achromatic vision in parkinsonian patients have been demonstrated; these could be partially restored after application of L-Dopa. In this study, the effect of a 3-day infusion therapy with amantadine sulphate on color vision was evaluated in 19 parkinsonian patients by use of the Farnsworth-Munsell 100-Hue test. Under this treatment, the motor symptoms of parkinsonism improved significantly as assessed by the part "motor examination" of the Unified Parkinson's Disease Rating Scale (UPDRS). However, the total error scores of the Farnsworth-Munsell 100-Hue test before and after amantadine sulphate infusions were unchanged [before therapy, 94.53 (SD = 52.09); after therapy, 99.5 (SD = 58.81)]. From these results, it can be concluded that the pathophysiology of dopaminergic pathways in the visual system differs from that of the basal ganglia.

Aged↗
PubMed1995

Palinopsia as sensory epileptic phenomenon.

Visual perseveration (VP) is defined as persistence or recurrence of visual images, when the stimulus is no longer present. We report three patients with occipital cortical lesions in the right hemisphere and VP. Electroencephalography showed epileptic abnormalities in all cases. In one patient synchronous electroencephalic recordings during the onset of palinopsia-a subtype of VP-revealed, that VP was associated with a clear cut right occipital seizure with a secondary diffusion of the discharge over both hemispheres, which has not been reported in combination with the onset of palinopsia heretofore. In all three patients sensory seizures have to be considered as probable cause of VP.

Adult↗
PubMed1995

Alterations in chromatic contour perception in de novo parkinsonian patients.

Recently abnormalities of chromatic visual perception were reported in treated patients with Parkinson's disease (PD). We studied 28 previously untreated Parkinsonian patients and 28 age- and sex-matched controls using a computer-aided method to determine the chromatic fusion time (CFT). CFT indicates the acuity of the perception of monochromatic contours. Patients with PD have a shortened CFT especially for the light-blue and dark-green stimuli. The chromatic perception disorder is correlated with the severity of PD. It can be concluded from our data that the dysfunction of colour perception is related to the pathophysiology of PD.

Adult↗
PubMed1995

Distorted color discrimination in 'de novo' parkinsonian patients.

We performed the Farnsworth-Munsell 100-hue test in 16 "de novo" patients with Parkinson's disease and 16 age-matched controls to determine their color discrimination ability. The mean total error score in patients was significantly elevated as compared with controls (64.6 in patients versus 16.0 in controls). We conclude that the impairment of color discrimination may be an early sign in Parkinson's disease.

Color Perception↗
PubMed1994

L-Dopa improves colour vision in Parkinson's disease.

In recent studies disorders of colour vision in Parkinsonian patients have been demonstrated. Up to now, the influence of dopaminergic treatment on those phenomena remains unclear. We therefore performed a colour vision test (Farnsworth-Munsell 100 Hue Test) in 19 patients with Parkinson's disease before and after the oral application of the morning dose of L-Dopa. The colour discrimination was significantly improved after the ingestion of L-Dopa. There was no different effect of L-Dopa on the blue-yellow or red-green axis of colour vision. The morphological structures responsible for these colour vision disturbances are unknown, but it can be concluded that the dopamine deficiency in Parkinson's disease is not restricted to the basal ganglia but may involve the visual system as well.

Adult↗
PubMed1994

Temporal arteritis with cerebral complications: report of four cases.

We report on four patients with a histologically proven diagnosis of arteritis temporalis and clinical and/or neuroradiological evidence of severe focal cerebral ischemia due to intracranial vasculitis. While one patient suffered from a transient ischemic attack, CCT and MRI scans of the other patients showed multiple lacunar infarctions, combined with territorial infarctions in two cases. Necropsy in one patient demonstrated generalized giant cell vasculitis in large and small cerebral vessels. We suppose that the cerebral involvement was provoked by insufficient steroid therapy of arteritis temporalis in two patients. In one case, remission could be achieved by a combination of high-dose steroids and cyclophosphamide; one further patient remitted under lower steroid dosage. Steroid therapy was ineffective in two patients, one of whom died due to secondary complications. We conclude that central nervous system affection is a rare but dangerous complication of arteritis temporalis and may present as cerebral micro- and macroangiopathy.

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