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Biomedical subjects

V Fernández-Armayor

Publications and source records attributed to V Fernández-Armayor.

8 recordsLinked to original sources

[Neurohagiography. Lamberto Caesaraugustanus, the cephalophoric: holy patron of Spanish neurology?].

Until now Neurology has lacked a patron saint who, taking the most advantage of the rich cultural tradition inherited from our past and independently of the religious ideology of each one, can be helpful approach in the neurologist figure to different people. An Ad Hoc Committee from the Neurology History Study Group of the SEN has researched the medical hagiography with any kind of neurological relationship (neurohagiography), in order to make a hagiography study of every saint related to our speciality, with the added luck of proposing a patron for Neurology with hispanic origin. In this pioneer study of historiographic research different documents related with the medical hagiography have been studied, especially the Index ac Status Causarum, and information coming from different national ecclesiastic archives. A total of 342 saints share the patronage of 137 diseases, of which a 27,7% are related in some way to Neurology. Headache constitutes the prime cause of the invocations, with 20 saints. Another 11 saints plead for epilepsy; to these we also must add another six for so called possessed patients. Therefore, two of the three main causes of invocation (headache, fever and epilepsy) come up to chronic processes. Of all the saints with a hispanic origin candidates to the patronage of the neurologists San Lamberto Caesaraugustanus stands out, who died in the year 303 during Diocletian persecution. Belonging to the selected standing of "cephalophoric martyrs" (those beheahed who carry their own head in their hands), he was able to walk an important distance (about six kilometres) with his head split from the body, a fact only understood as a suprahuman phenomenon thanks to which he has becomes the brain transplant pioneer.

History, 16th Century↗

[Segmental arteriographic anomalies in migranous cerebral infarct].

A migranous cerebral infarct (ICM) has the appearance of an ischaemic cerebral lesion which occurs during a migraine crisis and is shown by neuroimaging techniques to be in the corresponding vascular area. Four young patients are described. They fulfilled the clinical and neuroimaging criteria for compatibility with ICM and the protocol for the aetiological study of stroke was normal. Angiography ruled out other causes of ischaemia (dissection, fibromuscular dysplasia, etc.) and showed segmental images of 'vasculitis appearance' similar to these described in Call's syndrome, in 'benign intracranial angiopathy' and in other intracranial vasculopathies or criteria of 'reversible segmental cerebral vasoconstriction'. The pathogenic significance, as with migraine, is still unknown.

Adolescent↗

[Lateral sinus thrombosis in the first three months of pregnancy].

Thrombosis of the cerebral venous sinuses is characterized by clinical pleomorphism and variable pathogenesis. Although there is a relationship with pregnancy and especially with the puerperium, occurrence during the first trimester of pregnancy is unusual and this may effect the diagnosis and treatment. We describe the case of a 33 years-old patient with lateral sinus thrombosis in the first trimester of pregnancy. This was diagnosed and followed-up by magnetic resonance. Investigations as to its aetiology were inconclusive and it followed a benign course without anticoagulation. Thrombosis of the venous sinuses has been found empirically to be related to states of deficiency of S protein, hypercoagulability, anaemia and deshydration during pregnancy, to having previously taken contraceptive pills. Behçet's disease, other coagulopathies, central or systemic vasculitis, collagen disorders, septic and neoplastic disorders and a large number of cases of unknown aetiology. In our patient neurological deterioration secondary to a venous infarct or intraparenchymatous haemorrhage was not seen. There was full recovery and complete spontaneous canalization of the sinus, as shown on posterior cranial angiography. The controversial decision to use heparin in thrombosis of the cerebral venous sinuses should probably depend on the possible risks and benefits in each individual case, taking into account the clinical findings, aetiology and topography of the thrombosed sinus.

Adult↗

[Kinematic deterministic chaos of fluids and fractal geometry in the carotid system].

INTRODUCTION: Atherosclerosis is a generalized vascular disorder which tends to be localized to specific arterial territories. At the bifurcation of the carotid artery there is a marked predisposition to form plaques of atheroma on the postero-external wall. This tendency is due to the kinematics of fluids and their particular morphological characteristics which are unique in the vascular system. The carotid tree is a physical, non-lineal or in 'non-equilibrium', dynamic system which depends on the fluctuating contribution of energy from the cardiac cycle. It has fractal geometry which follows the Law of Biology of maximum efficiency with a minimum of effort. DEVELOPMENT: The complexity of the relationship between the haemo-rheological and anatomical factors, and the periodic oscillation of flow does not permit use of simple models and classical determinist equations to describe idealized systems of continuous movement and Newtonian fluids. On the contrary, since we are considering a complex dissipative dynamic system. It has marked intrinsic operational freedom adapting its responses to external disturbances well, thus determining vasculo-cerebral autoregulation. The theories of Determinist Chaos and of the Science of Complexity imply the existence of emerging properties which exceed those of the individual elements in the dynamic systems in non-equilibrium, which tend to function in the 'frontier of chaos' at the critical points of phase transition. The carotid tree has non-linear properties, appearance of order and fractal 'sibisemejanza'. Pseudo-chaotic vortices appear--in regions of phase transition between laminar flow and turbulence--with the emergence of a 'strange attractor' near to the postero-external wall of the bulb. CONCLUSIONS: The anatomical and kinematic complexity of the system, together with the irreversibility of the second Law of Thermodynamics, lead to a long-term tendency towards the appearance of a region of stagnant flow with increased Entropy in the territory of the strange attractor which determines--as an inevitable long-term outcome--the tendency to the appearance of atherosclerosis at this particular point.

Arteriosclerosis↗

[Lafora and neuropathology].

This article wants to be a memory to the figure and neuro-pathologic work of D. Gonzalo Rodríguez-Lafora. The tediousness of its neurological work allows to divide it in its slopes neurophatologic, neurophysiologic, clinic and therapy. Also, it embraces other topics outside of the field of the neurology, centered fundamentally in the psychiatry. It is without a doubt the facet neuro-histopathologic the one that provides him bigger national and international prestige and it contributes to deepen in the histopathology of the senility, picking up in a definitive way in their work critical valuation of the discoveries histopathological in the senility (1952) their thought in this respect. Mention separated deserves its more important discovery: The inclusions amylaceous in cells ganglionars, in a certain type of epilepsy myoclonic that today takes its name. Other entities like the illness of Wernicke, the hemorrhages hipofisarias, the Parkinson (for scarce months he is not early to Levy in an important discovery), or the alterations of the malaria in the cerebral fabric plows object of their attention, of the work of Lafora highlights its anatomo-pathologics works next to figures as Kraepelin, Alzheimer, Vogt, Openheim or Brodmann. Professor Lafora's figure is known internationally as neuropathologist, recognizing its contribution, collection in the world literature, to the study of the myoclonic epilepsy: 'Lafora disease. A form of progressive myoclonus epilepsy.

Brain↗

[Untreatable hiccup as un unusual sign in a rostral occlusion syndrome of the basilar artery].

Hiccoughs (singultus) is a habitual physiological phenomenon, the persistence of which might indicate neurological and extraneurological multiple lesions. Its activation involves starting up numerous central and peripheral mechanisms which have yet to be clearly determined. Hiccoughs results from an intermittent myoclonus of the diaphragm, reflex in origin, with unknown authentic cause or physiological significance. It has been suggested that, more than just an abnormal reflex, it could be a type of myoclonus brought on by repeated activity of the 'solitary inspiratory nucleus', by releasing control of the inhibiting-activating upper nervous system activity. We present the case of a patient with uncontrollable hiccoughs lasting over six years as a result of paramedial bilateral thalamic ischaemia (rostral occlusion syndrome of the basilar artery type 1) of cardioembolic origin (auricular fibrillation) secondary to hyperthyroidism.

Administration, Oral↗

[Ischemic infarct, mitral valve prolapse and protein S deficiency].

Ischaemic stroke in young people, that is in those under 45 years of age, forms a distinct entity. Whereas in the case of older patients the main cause is arteriosclerosis, in the younger group a broad spectrum of etiologies can be found. It is for this reason that in these latter cases we must carry out a diagnostic study that is not only more exhaustive but also additionally is aimed at seeking out specific pathologies as for instance a possible association with vasculitis, infectious diseases, hematological abnormalities or unclear cardiopathology. Given the therapeutic transcendency that findings might have, in order to avoid new bouts in patients at the most productive moments in their lives, we believe it to be of great interest to carefully study these patients as exhaustively as need be. In the present work we present the case of a young patient with ischaemic infarct in the region of both upper cerebella which started out with a clinical picture of ataxia and dysarthria with benign course and total recovery. Possible etiologies are discussed in the light of findings made during complementary tests, as well as the unusual location of the lesions.

Adult↗

[The history and social importance of cerebrovascular pathology].

In this work we present a study of the different conceptual, physiopathological, anatomical and clinical aspects that cerebrovascular pathology has had throughout history, from the early pre scientific beginnings of religious medicine, through the Renaissance period up to the Modern and Contemporary Ages. In the second part we emphasise its social importance and economic cost, and new methodologies are proposed for use in its study and pursuit. We also highlight the need for the creation of stroke units.

Cerebrovascular Disorders↗