1/442. apomorphine and levodopa challenge in patients with a focal midbrain lesion.Three patients who presented with parkinsonian signs resulting from a focal midbrain lesion are reported. In all patients parkinsonian features occurred acutely and improved following acute challenge with apomorphine but not with levodopa. Remission of parkinsonian signs occurred spontaneously to a different degree. Inconsistent clinical response following administration of levodopa has been well documented in patients with focal midbrain lesions associated with parkinsonian signs; however, the efficacy of apomorphine has not been tested before. Anatomic or etiologic features do not allow us to predict in which cases parkinsonian signs secondary to a midbrain lesion would respond to levodopa or to dopamine agonists. A trial with apomorphine is warranted in all such cases.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/442. Confabulation and delusional misidentification: a four year follow-up study.We describe a patient, AZ, who showed, in addition to an amnesic syndrome which eventually improved, longstanding confabulation and delusional misidentification following bilateral frontal and right temporal post-traumatic lesions. Confabulation appeared in personal recollections and on long-term verbal memory testing. Misidentification concerned mainly his wife and house. During the four year follow-up AZ's confabulation progressively shrinked so as to become restricted to verbal memory tasks. By contrast, misidentification persisted. General semantic memory was unimpaired throughout, while performance on frontal tests was initially poor and partly improved in time. We argue that confabulation and misidentification, though often intermingled and occurring after similar lesion pattern, should be considered as different neuropsychological entities.- - - - - - - - - - ranking = 7.6118571592089E-6keywords = trauma (Clic here for more details about this article) |
3/442. "Pure word deafness": implications for assessment and management in communication disorder--a report of two cases.In "pure word deafness" after acquired brain injury, the auditory comprehension of words is much more impaired than other aspects of communication or cognition. Two cases are presented, one early and one late presentation. The key to diagnosis of communication disorders is to remember to assess all six basic aspects of language function and to be vigilant for coexisting diagnoses that can complicate such assessment (especially psychiatric diagnoses). rehabilitation management of impaired communication should emphasize the teaching of specific coping mechanisms to the patient and to all others who are involved.- - - - - - - - - - ranking = 1.0538604085464keywords = brain injury, brain, injury (Clic here for more details about this article) |
4/442. Postoperative brainstem high intensity is correlated with poor outcomes for patients with spontaneous cerebellar hemorrhage.OBJECTIVE: The outcomes for patients with cerebellar hemorrhage are thought to be influenced by anatomic damage to the brainstem. In this study, we investigated the magnetic resonance imaging findings in the brainstem, to examine the relationship between the degree of brainstem damage and the outcomes for patients with spontaneous cerebellar hemorrhage who are in poor-grade condition. methods: The results for 31 patients with spontaneous cerebellar hemorrhage, with Glasgow coma Scale scores of 8 or less at admission, who underwent magnetic resonance imaging examinations were reviewed. All patients underwent surgical intervention. The patients were divided into two groups according to their glasgow outcome scale scores at the time of discharge, i.e., patients who experienced good recoveries or exhibited moderate disabilities (Group I, n = 8) and patients who exhibited severe disabilities, were in a persistent vegetative state, or had died (Group II, n = 23). We investigated obliteration of the fourth ventricle and the perimesencephalic cistern and the presence of hydrocephalus in initial computed tomographic scans and the presence of areas of high signal intensity in the brainstem in T2-weighted images. RESULTS: Eight patients experienced good outcomes, and 23 patients experienced poor outcomes. The overall mortality rate was 32.3%. There were no significant differences between groups with respect to computed tomographic findings such as hematoma size, but the incidence of high signal intensities in the pons and midbrain in T2-weighted images for Group II was significantly higher than that for Group I (P < 0.01). CONCLUSION: magnetic resonance imaging clearly demonstrated brainstem damage, and high signal intensity in the brainstem was a significant prognostic factor for determining outcomes for patients with spontaneous cerebellar hemorrhage who were in poor-grade condition.- - - - - - - - - - ranking = 1.5714285714286keywords = brain (Clic here for more details about this article) |
5/442. A paradoxical improvement of misreaching in optic ataxia: new evidence for two separate neural systems for visual localization.We tested a patient (A. T.) with bilateral brain damage to the parietal lobes, whose resulting 'optic ataxia' causes her to make large pointing errors when asked to locate single light emitting diodes presented in her visual field. We report here that, unlike normal individuals, A. T.'s pointing accuracy improved when she was required to wait for 5 s before responding. This counter-intuitive result is interpreted as reflecting the very brief time-scale on which visuomotor control systems in the superior parietal lobe operate. When an immediate response was required, A. T.'s damaged visuomotor system caused her to make large errors; but when a delay was required, a different, more flexible, visuospatial coding system--presumably relatively intact in her brain--came into play, resulting in much more accurate responses. The data are consistent with a dual processing theory whereby motor responses made directly to visual stimuli are guided by a dedicated system in the superior parietal and premotor cortices, while responses to remembered stimuli depend on perceptual processing and may thus crucially involve processing within the temporal neocortex.- - - - - - - - - - ranking = 0.28571428571429keywords = brain (Clic here for more details about this article) |
6/442. arthrogryposis multiplex congenita and bilateral mid-brain infarction following maternal overdose of co-proxamol.We report a case of arthrogryposis multiplex congenita secondary to fetal hypokinesia in a 41-week gestation infant following antenatal central nervous system injury. The mother's pregnancy was complicated by an episode of attempted self harm, with an overdose of co-proxamol at 22 weeks of gestational age, and by the use of cocaine in combination with excess alcohol intake. Magnetic resonance imaging showed bilateral mid-brain cysts and marked atrophy of the basal ganglia and thalami.- - - - - - - - - - ranking = 0.71830206854028keywords = brain, injury (Clic here for more details about this article) |
7/442. A case of atypical absence seizures induced by leuprolide acetate.We report a case of a 13-year-old female with atypical absence seizures induced by prolonged administration of long-acting leuprolide acetate (LA). This patient had brain involvement resulting from chemotherapy and radiotherapy for a medulloblastoma. At 13 years of age, administration of long-acting LA was started. After the third dose of long-acting LA, atypical absence seizures appeared. After discontinuing long-acting LA, the seizures stopped without administration of any antiepileptic drugs. However, 2 years, 6 months later, the same seizures again appeared. On the basis of the findings of endocrinologic investigations and the reported data of pharmacokinetics of LA, we speculate that her seizures were induced by LA and that the seizures were associated with the presence of brain damage in the patient. Care should therefore be taken when using long-acting LA or other gonadotropin-releasing hormone analogues for pediatric patients with diffuse brain damage.- - - - - - - - - - ranking = 0.42857142857143keywords = brain (Clic here for more details about this article) |
8/442. When instructions fail. The effects of stimulus control training on brain injury survivors' attending and reporting during hearing screenings.Bedside hearing screenings are routinely conducted by speech and language pathologists for brain injury survivors during rehabilitation. Cognitive deficits resulting from brain injury, however, may interfere with obtaining estimates of auditory thresholds. Poor comprehension or attention deficits often compromise patient abilities to follow procedural instructions. This article describes the effects of jointly applying behavioral methods and psychophysical methods to improve two severely brain-injured survivors' attending and reporting on auditory test stimuli presentation. Treatment consisted of stimulus control training that involved differentially reinforcing responding in the presence and absence of an auditory test tone. Subsequent hearing screenings were conducted with novel auditory test tones and a common titration procedure. Results showed that prior stimulus control training improved attending and reporting such that hearing screenings were conducted and estimates of auditory thresholds were obtained.- - - - - - - - - - ranking = 6.4660195941356keywords = brain injury, brain, injury (Clic here for more details about this article) |
9/442. anorexia nervosa remission during an episode of encephalitis.OBJECTIVE: The case described suggests that there may be a neurobiological aspect to the etiology of anorexia nervosa (AN) and that development of new pharmacological treatment strategies aimed at the central nervous system (CNS) may be possible. METHOD: A 25-year-old female with AN lost her anorexic behaviors following an episode of encephalitis with associated hypoxic brain injury. Once the neurological sequelae resolved, the anorexic behaviors returned. RESULTS: During recovery, the patient's weight increased from 37.8 to 51.1 kg and body fat content by skinfold measurement increased from 7.5% to 18.5%. DISCUSSION: If a neurophysiological mechanism underlying AN could be identified, it might be possible to devise new treatment options.- - - - - - - - - - ranking = 1.0538604085464keywords = brain injury, brain, injury (Clic here for more details about this article) |
10/442. head injury, dissociation and the Ganser syndrome.OBJECTIVE: To describe the clinical characteristics and psychiatric correlates of the Ganser syndrome following mild traumatic brain injury (TBI). METHOD: A retrospective chart review of patients with mild TBI assessed in a tertiary care outpatient clinic. RESULTS: Of 513 patients reviewed in a 1 year period, four subjects with a diagnosis of Ganser syndrome, with the hallmark syndrome of approximate answers ('vorbeigehen') were identified. In three of these patients, symptoms of Acute Stress Disorder (ASD) and/or Post-traumatic Stress Disorder (PTSD) were found. Only one patient was pursuing litigation. CONCLUSIONS: While no epidemiologic conclusions can be drawn from the data, clinicians should, nevertheless, be alert to the possibility of patients presenting with Ganser syndrome following TBI. The findings are discussed in the light of data linking the syndrome to dissociative and post-traumatic stress related disorders.- - - - - - - - - - ranking = 1.5043501334188keywords = brain injury, traumatic brain injury, brain, traumatic brain, injury, trauma (Clic here for more details about this article) |
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