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PubMed1976

Modern concepts of status epilepticus.

Among 60 cases of status epilepticus, there were 45 cases of convulsive status and 15 cases of nonconvulsive or confusional status. In 37 cases, status was due to an identifiable cause. The most frequent etiologic factors were vascular (nine cases), traumatic (seven cases), and metabolic (five cases). Four patients with metabolic encephalopathy had focal status. While the possibility of expanding lesions should be investigated in every case of convulsive status, a complete metabolic screening is also necessary. Non-convulsive status was represented by two cases of psychomotor status and 13 cases of absence status. Clinically, these cases were characterized by various impairments of intellectual functioning and confusion. Diagnosis was determined by characteristic changes in the electroencephalogram. Aggressive treatment is indicated by one or more of the major anticonvulsants, supplemented by adequate oxygenation and maintenance of biochemical homeostasis.

Adolescent↗
PubMedDate not supplied

Rigid flatfoot.

The proper management of the rigid flat-foot requires an accurate diagnosis since the condition is treated on causal or rational basis. Calcaneonavicular coalition best seen on an oblique view of the foot may be treated by resection of the coalition with extensor digitorum brevis interposition. If the diagnosis is made sufficiently early, the resection can lead to an essentially normal foot. Coalition between the talus and the calcaneus may occur in the posterior, middle or anterior facet. The most common coalitions are seen in the middle facet area followed by those in the anterior facet with the posterior facet coalition rarely being seen. Coalitions in the area of the middle facet are usually managed nonoperatively; triple arthrodesis is used only if symptoms are not relieved by nonoperative measures. Resection of a talocalcaneal coalition in the middle facet is rarely indicated but occasionally will give relief when the coalition either presses on the medial plantar nerve or causes a mechanical disturbance of the ankle. Anterior facet coalitions should receive a trial of cast immobilization but frequently require triple arthrodesis. Other conditions such as rheumatoid and post-traumatic arthritis will frequently respond to a period of immobilization in a plaster cast. Triple arthrodesis has not been required in rheumatoid arthritis in the author's series but occasionally is necessary in the post-traumatic rigid flatfoot. Other rare causes of the rigid flatfoot should be kept in mind for a complete diagnostic evaluation since even a neoplasm (fibrosarcoma) has been reported to cause this symptom complex.

Arthrodesis↗
PubMed1976

[Study of epilepsy by computer controlled transverse axial tomography of the brain].

The value of computerized azial tomography of the encephalon is considered:--Firstly, in relation to the different electro-clinical varieties of epilepsy (essentially primary, secondary and partial) where it provides information of a high degree of precision concerning the topography, frequency and size of morphological abnormalties of the encephalon.--Secondly, in relation to the various aetiological possibilities (tumour, post-traumatic, post-ischaemic, post-infective, et cetera). This new method is of considerable to specify an aetiology almost unknown up to the present time: post-ischaemic occipital porencephaly secondary to perinatal or infantile occlusion of the posterior cerebral artery.

Adult↗
PubMed1977

[Low back pain from the orthopedic point of view. Diagnosis and differential diagnostic. (author's transl)].

The diagnostic clarification of low back pain from the orthopedic point of view requires a specific exploration of the clinical history and an exact elicitation of findings not only of the vertebral column but also of the hip joints and the lower extremities. In the differential diagnosis of the disease processes which must be considered, congenital deformities, disturbances of statics and functional muscular states, inflammatory, degenerative, metabolic, tumorous and post-traumatic changes of the vertebral column must be demarcated from diseases of other etiology.

Back Pain↗
PubMed1977

[Pseudo-tumoral aspect of a post-traumatic digital synovitis].

A case is described of post-traumatic subacute synovitis of a finger exhibiting pseudo-tumoral appearance and radiographic bony changes. Arteriography showed non-malignant hypervascularisation suggesting a benign synovial tumour. Biopsy established a diagnosis of simple subacute synovitis. The swelling regressed spontaneously over the subsequent months. In the case of simple post-traumatic subacute synovitis differential diagnosis should take into account the possibility of villonodular synovitis which involves histiocyte proliferation.

Child↗
PubMed1977

Uveal melanoma presenting as post-traumatic choroidal hemorrhage and panophthalmitis.

A 63-year-old Caucasian man presented with loss of vision in one eye. The loss of vision was considered to be due to a post-traumatic intraocular hemorrhage. He developed panophthalmitis 3 months later and necrosis in a malignant melanoma was diagnosed. The diagnosis of melanoma in patients with blind eyes and opaque ocular media is discussed.

Choroid↗
PubMed1977

A spectrum of application of autogenous costochondral grafts.

Autogenous costochondral grafts have found application in 26 variegated cases of congenital dysplasia, ankylosis, neoplastic disease, osteoarthritis, and post-traumatic dysfunction. The authors' experience with the grafting procedure has been generally favourable, but various difficulties have also arisen. There is a cursory discussion on the physiological superiority of rib cartilage grafts over those of other autogenous joints in reconstruction of the temporomandibular articulation.

Adolescent↗
PubMed1979

[Role of angiography in studying posttraumatic abdominal masses in pediatric patients].

In infancy and neonatal period, post-traumatic space-occupying masses often can be associated to malignant, clinically not identified, lesions. Radiodiagnostic non-invasive techniques cannot, in many cases, demonstrate extension, nature and localization of such a lesion, when angiography, in personal experience, shows quite even malignancy and extension without false negatives, and is essential, in our opinion, for evaluation of therapeutic policy and follow-up.

Abdominal Injuries↗
PubMed1977

[Diagnosis of skeletal metastases in prostatic cancer using gamma camera (author's transl)].

On 170 patients with histologically proven carcinoma of the prostate scintigraphic studies of the skeleton using gamma camera and follow-up examinations were performed and compared with x-ray as well as serum alkaline and acid phosphatase. Osseous metastases in 47% had no radiological evidence and were only scintigraphically detectable. Positive scans were registered in 48% of the patients with prostatic cancer, 20% of them were positive due to metastases and 28% were false positive caused by osteoarthrotic and arthritic changes, sporadically by post-traumatic lesions and in 3 cases by Paget's disease. At the time of the initial diagnosis of prostatic cancer 21% of 159 patients studied scintigraphically had radiological or scan evidence of osseous metastases. Analyses corresponding stages of tumor revealed an unequivocal dependance of the frequency of metastases upon the extent of the primary tumor. The successful treatment is characterized by the decreased uptake of radioactivity primarily accumulated in skeletal metastases.

Aged↗
PubMed1975

The role of the radiologist in the management of the child with a suspected bone tumor.

The radiologist's most important task in evaluating lesions of the skeleton is to recognize with a great degree of certainty the post-traumatic and the self-limiting and healing tumorous conditions which require neither biopsy nor other surgical treatment. The group of lesions that will need biopsy ranges from those that cannot be absolutely classified in the above group to frankly malignant-appearing tumors. The radiologic differential diagnosis of malignant tumors is of lesser importance because this will be performed by the pathologist. Examples are illustrated and discussed. The importance of consultation among surgeon, radiologists, and pathologist is emphasized, particularly to avoid the possibility of misinterpreting immature callus formation as ostegenic sarcoma.

Adolescent↗
PubMed1977

The empty sella syndrome analysis of 10 cases.

Ten cases of the empty sella syndrome are presented. In four a pituitary adenoma had been treated by surgery with or without radiotherapy. In three women there was a close relation pregnancy, and two boys had congenital malformations. Five cases presented with appearances of pseudotomour, and the remainder had cerebrospinal fluid (CSF) fistula. Four fistulas were spontaneous, one was post-traumatic aggravated by the intrasellar implantation of YT-90. Two were occult CSF fistulas causing recurrent meningitis. Gamma cisternography and iodocisternography proved to be good diagnostic tests, both for the empty sella and for CSF fistulas. Nine cases were operated on. In four na intrasellar cyst was present. In the other five an empty sella with deficient or absent diaphragm was found. Treatment of most cases consisted of covering the floor of the sella with lyophilized dura, which was fixed in place with biological glue.

Adenoma↗
PubMedDate not supplied

[Radiographic and scintigraphic studies of cranial bones].

The authors described 9 cases of pathological changes in cranial bones of the type of osteolytic foci of changed osseous structure, post-traumatic lesions and postoperative changes of cranial bones as well as fibrous degeneration of bones which were found during routine scintigraphic investigations of the brain with 99mTc. In 7 cases it was possible to obtain the correct diagnosis after comparing with plain skull films, in 2 cases scintigraphy had to be supplemented with angiography (in one case it was necessary for ruling out paracerebral haematoma in presence of skull fracture, in the other case it was done for demonstrating the vessels supplying frontal bone haemangioma). In none of these cases it was necessary to supplement this investigation with administration of radioisotope markers accumulating selectively in bones.

Brain Diseases↗
PubMedDate not supplied

[Cold lymphocytotoxins: their relationship with various physiological and pathological conditions].

The significance of cold lymphocytotoxins, observed at 15 degreesC, is not clearly understood at the present time. The frequency of their appearance has been studied in normal subjects (blood donors, aged people, vaccinated subjects, post-traumatic splenectomy) and in patients with a neurologic disease (multiple sclerosis), a neoplasic disease (breast cancer)and hematologic diseases (thrombocytopenia, acute leukemia, chronic lymphatic leukemia, Hodgkin disease and systemic lupus erythematosus). There are no antibodies found in the geriatric group; they are found only in 3,9 % of blood donors and in 18 % of the subjects after vaccinations. A range of 17 to 30 % is found in subjects with breast cancer or multiple sclerosis. More than 50 % of the individuals with Hodgkin disease or lupus erythematosus produce these antibodies (52 % and 73 % respectively). In acute leukemias and chronic lymphatic leukemias, lymphocytotoxic antibodies sometimes appear at 37 degrees, reacting with autologous cells and having no HL-A specificity.

Acute Disease↗
PubMed1976

[Morphological aspects (optical and ultrastructural) of hypertrophy of the olivary bulb].

The present paper is an anatomical study of 3 cases which evolved with hypertrophy of the inferior olives: a case of zoster encephalitis, a multifocal leucoencephalopathy and a post-traumatic encephalopathy. In all three cases a relationship was demonstrated between the dentate nucleus and dento-olivary pathway - a relation of topical order in some instances - and the hypertrophic lesion of the inferior olive. Examination in the electron microscope revealed in the hypertrophic olivary cell not only dystrophic lesions but also progressive intracellular phenomena, such as maintenance of the Nissl bodies, multiplication of the mitochondria and especially marked proliferation of the neuro-filaments. This shows that, at least in some of the evolutive phases, hypertrophy of the inferior olives is based upon a real hypertrophy of the olivary cell. In addition, lesions of the glial system of the hypertrophic inferior olives were noted with the presence of osmiophil degeneration whose morphology clearly differed from that of Rosenthal's fibres.

Adult↗
PubMed1975

Homovanillic acid and 5-hydroxyindole-acetic acid in the csf of patients after a severe head injury. II. Ventricular csf concentrations in acute brain post-traumatic syndromes.

Ventricular concentrations of homovanillic acid (HVA) and 5-hydroxyindole-acetic acid (5HIAA) were measured in 7 patients a few days after a severe traumatic brain injury. Both acid metabolites were elevated in respect to control patients values, however, the rise was more consistent for 5HIAA (258 +/- 86 ng/ml) with a 5HIAA/HVA ratio of 0.85 +/- 0.35. The data support previous hypothesis on the profound involvement of serotoninergic structures in the early stages of acute traumatic brain syndromes and on the role of 5HT in maintaining edema and vasospasm.

Adolescent↗