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Biomedical subjects

X Beristain

Publications and source records attributed to X Beristain.

6 recordsLinked to original sources

Microanatomy of the perforators of the anterior communicating artery complex.

We describe the microanatomy of the perforating arteries arising from the anterior communicating artery complex (5 mm distal of the anterior cerebral artery, the anterior communicating artery, and 5 mm proximal of the distal anterior cerebral artery). Thirteen unfixed human brains were used in this study. The origin and number of perforators are described, as is the site of brain penetration, and results are correlated with previous studies. The hemodynamics of blood flow in relation to the formation of an anterior communicating artery aneurysm and different surgical approaches are mentioned. The neuropsychological outcome after aneurysm clipping with regards to the pattern of blood supply from the anterior cerebral artery complex is also discussed.

Brain

Evaluation of outcome after intracranial aneurysm surgery: the neuropsychiatric approach.

BACKGROUND: With the reduction of mortality and gross neurologic morbidity of patients undergoing intracranial aneurysm surgery, the interest in outcome is shifting towards more subtle aspects such as cognitive deficits and psychosocial adjustment. METHODS: We discuss two different ways of measuring outcome in a sample of 20 patients who had intracranial aneurysm surgery. Patients were evaluated at discharge using the Karnofsky Scale and the Glasgow Outcome Scale. Six months after discharge we conducted a neuropsychiatric evaluation including cognitive, behavioral, and mood status assessment. RESULTS: Although 13 of out patients had a "good recovery, " 18 had some neuropsychiatric impairment. Comparing patients with "good recovery" with the remainder, patients with poorer outcomes tended to have a left pterional approach, a poorer "drive", and language disorders (p < 0.05). There was no correlation between out cognitive, mood, and behavioral assessment and the results of the Karnofsky and Glasgow Outcome Scales ( p > 0.05). CONCLUSIONS: we conclude that neuropsychiatric deficits are common after intracranial aneurysm surgery and that for our study the Karnofsky Scale and Glasgow Outcome Scale were not sensitive enough to detect residual impairment. therefore, it is important to develop brief tests and scales able to identify these problems and to complement the standard clinical neurological examination.

Adult

Do we evaluate outcome appropriately?

We discuss two different ways of measuring outcome in a sample of 20 patients who had intracranial aneurysm surgery. Patients were evaluated at discharge using the Karnofsky Scale and the Glasgow Outcome Scale. Six months after discharge we conducted a neuropsychiatric evaluation including cognitive, behavioral, and mood status assessment. Although 13 of our patients had a "good recovery', 18 had some neuropsychiatric impairment. We did not find statistical relationships between the discharge evaluation and the neuropsychiatric assessment at follow-up. We discuss the need for developing new outcome measures to pick-up neuropsychiatric deficits, beyond the traditional neurologic semiology.

Adult

[Posterior cortical atrophy with progressive visual agnosia].

Interest in progressive focal cerebral syndromes associated with classical degenerative diseases has increased in recent years. Descriptions of posterior cortical atrophy with progressive visual agnosia are relatively rare. We present 5 patients (2 women) ranging in age between 57 and 72 years old. In all cases symptoms began and progressed with no known etiology. All cases were sporadic. The main clinical signs are difficulty in recognizing objects, colors, persons or places; topographical disorientation and visual memory alterations; alexia, simultagnosia, loss of ocular fixing and optic ataxia. Some patients presented other disturbances of praxis or memory and 2 progressed to global dementia. Language function was preserved and behavioral disturbances did not develop. The amplitude of the P100 visual evoked potential was low but latency was normal in 4 patients and prolonged in 1. Brain images showed atrophy and hypoperfusion in the parieto-occipital area. The neuropathology status of these patients is unknown.

Adult