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T Dalager

Publications and source records attributed to T Dalager.

3 recordsLinked to original sources

[Myotonic dystrophy].

Myotonic dystrophy (MD) is illustrated by a characteristic case report. MD is a dominantly inherited multi-organic disease with complete penetrance, but with highly variable expression illustrated by the near relatives of this patient. The disease usually follows a slow, progressive course. The cardinal symptoms are myotonia, muscle atrophia, cataract and a characteristic facial appearance. Cardial arrhythmias, endocrine and mental changes also occur. The liability to arrhythmias and the weakened respiratory muscles of the patients which lead to ventilatory insufficiency makes anesthesia and surgical operation risky. The diagnosis, which is made by electromyography, is easy in typical cases, but suspicion that the disease is present is seldom raised in very mild cases if there is no recognition of familial cases. Meticulous examination of near relatives of severe cases is therefore essential to take advantage of the possibilities of prenatal diagnosis recently made possible through developments in DNA technology.

Adult

Spasm index in subarachnoid haemorrhage: consequences of vasospasm upon cerebral blood flow and oxygen extraction.

A spasm index, defined as transcranial Doppler detected flow velocity in the middle cerebral artery divided by regional cortical cerebral blood flow (CBF), was used on 24 patients with subarachnoid haemorrhage (SAH). The aim was to estimate degree and time course of vasospasm, even in cases with great day-to-day variation in CBF, and correlate to CBF and oxygen extraction. All patients showed increase in spasm indices with peak index in the second or third week. The index seemed stable in spite of day-to-day fluctuations in CBF. Severe vasospasm were associated with poor clinical condition, reduced CBF (less than 30) and high AVDO2. The same picture could be seen with minor degree of vasospasm, probably, in some cases, due to high intracranial pressure. The results suggest that the spasm index is useful in monitoring patients with subarachnoid haemorrhage, and that severe vasospasm has a negative influence on clinical condition, CBF and oxygen extraction.

Blood Flow Velocity