11/79. Tumor-like presentation of multiple sclerosis.multiple sclerosis patients may present with clinical data suggestive of cerebral tumor, however, most of the lesions do not show expansive signs in computerized tomography of brain or magnetic resonance imaging. We report in this paper, 2 patients who had shown expansive radiological signs suggestive of neoplasm. Cerebral biopsy was an important diagnostic procedure in these 2 cases which revealed the diagnosis of demyelinating disease.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
12/79. The effect of a dopamine agonist on dysarthric speech production: a case study.The effect of Permax (pergolide mesylate), a dopamine agonist, was assessed in an individual with traumatic brain injury. The participant evidenced symptoms of hypokinetic dysarthria. His performance on and off Permax was evaluated in a BABA design. Measures were obtained across physiological systems. There were few differences in the on and off conditions. In the on condition, he evidenced an abnormally large velopharyngeal orifice area, dysfluencies in stimulus sentences, and less precise articulation. However, listeners perceived him to be more animated in the on condition. In addition, he reported better performance in the on condition. The study highlights potential discrepancies among participant report, listener perception, and objective measures. learning outcomes: As a result of this activity, the participant will be able (1) to recognize the effect of dopamine agonists as an adjunct to other pharmacological interventions and (2) to determine potential discrepancies among participant report, listener perception and objective physiological and acoustic measures.- - - - - - - - - - ranking = 9.1336346580102keywords = brain injury, traumatic brain injury, brain, traumatic brain, injury, trauma (Clic here for more details about this article) |
13/79. Evaluation and outcome of aphasia in patients with severe closed head trauma.In this study long-term observation of 12 patients with aphasia secondary to severe closed head trauma took place. The most frequent symptoms were amnestic aphasia and verbal paraphasia. Only one patient with a constant slow wave EEG focus in the dominant hemisphere had severe receptive symptoms. In all other patients the aphasia recovered rather well, though not totally, but the presence and degree of concomitant neuropsychological disorders were most important for the final outcome.- - - - - - - - - - ranking = 0.0032157245494752keywords = trauma (Clic here for more details about this article) |
14/79. On the role of quantitative brain imaging in the differential diagnosis of speech disorders.We present the case of a 71-year-old woman with an 11-year history of slowly progressive decline of motor speech. Normal clinical investigations including routine magnetic resonance imaging (MRI) at 7, 8 and 10 years after the onset of speech dysfunction led to the suggestion of a psychogenic disorder. Extensive clinical, neuropsychological and neuroimaging investigations including 18F-desoxyglucose-positron emission tomography (PET), quantitative MRI and MR spectroscopy were performed to look for subtle brain pathology. Quantitative assessment of 3D-MRI, F-desoxyglucose-PET and magnetic resonance spectroscopy all demonstrated clear evidence of multifocal frontotemporal brain pathology that had not been picked up on routine MRI investigations on previous admissions. This is the longest benign history of slowly progressive anarthria reported so far. It demonstrates a possible role of quantitative neuroimaging techniques in the diagnosis of complex neuropsychiatric disorders.- - - - - - - - - - ranking = 6keywords = brain (Clic here for more details about this article) |
15/79. Thyroplasty type I (lateral compression) for dysphonia due to vocal cord paralysis or atrophy.Based on the experimental results of thyroplasty, thyroplasty type I which aims at medical shifting the vocal cord was performed on 8 patients with dysphonia, 6 with vocal cord paralysis and 2 with vocal cord atrophy. The surgery was conducted on either in- or out-patient basis and local anesthesia was used. Usually, a rectangular incision was made on the thyroid cartilage at the level of the vocal cord, and the fragmemt was depressed inward. A cartilage piece taken from the opposite side was used as a wedge, if necessary, to enhance the effect of lateral compression of the vocal cord. The voice after surgery was generally satisfactory, except in one case of traumatic vocal cord paralysis. Complications such as stridor or dyspnea were nil. As surgical intervention inside the thyroid cartilage is minimal, fine and reliable adjustment of depression is possible during the surgery.- - - - - - - - - - ranking = 0.00064314490989503keywords = trauma (Clic here for more details about this article) |
16/79. Delayed hypoglossal palsy following occipital condyle fracture--case report.Occipital condyle fractures are rare. When present, they produce lower cranial palsies and/or brainstem dysfunction. A 32 year old man sustained multiple injuries. At the time of admission the patient had no neurological deficits. Three weeks after the accident, the patient complained of slurring of speech. Clinical examination revealed an isolated hypoglossal palsy. Radiological evaluation revealed an occipital condyle fracture. The patient was treated with a rigid collar. Eighteen months after the injury, the patient noted slight improvement in his speech. However, clinical examination showed a persistent hypoglosssal palsy. Occipital condyle fractures are rare. They may be associated with lower cranial nerve palsies. As demonstrated by this case, this entity should be included in the differential diagnosis of hypoglossal palsy. Since occipital condyle fractures can exist without neurological deficits, special attention should be paid to imaging of the craniovertebral junction in patients with head injury.- - - - - - - - - - ranking = 1.199221931246keywords = brain, injury (Clic here for more details about this article) |
17/79. Nothing to say, something to sing: primary progressive dynamic aphasia.We describe a 76-year-old man (ADY) with dynamic aphasia in the setting of a degenerative frontal lobe dementia: primary progressive dynamic aphasia. He displayed a striking paucity of propositional speech despite intact speech production, and preserved singing and prosody. Vocal expression in the verbal and musical domains was investigated in a series of neuropsychological experiments based on novel language and musical tasks that were designed to establish the nature and specificity of the verbal output deficit. The features of the language disorder indicated that the speech output pathway was disrupted at the early stage of generation of a new pre-verbal message. In contrast, tests of musical output demonstrated that the generation of new musical ideas was unimpaired. The domain-specificity of dynamic aphasia may result from the disruption of specific cognitive processes necessary for the creation of verbal messages, as well as selective damage of brain regions involved in language production.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
18/79. High-altitude decompression illness: case report and discussion.decompression illness (DCI) can occur in a variety of contexts, including scuba diving and flight in nonpressurized aircraft. It is characterized by joint pain, neurologic injury, and respiratory or constitutional symptoms. To prepare flight crews for accidental decompression events, the Canadian Armed Forces regularly conducts controlled and supervised depressurization exercises in specialized chambers. We present the cases of 3 Canadian Armed Forces personnel who successfully completed such decompression exercises but experienced DCI after they took a 3-hour commercial flight 6 hours after the completion of training. All 3 patients were treated in a hyperbaric oxygen chamber. The pathophysiology, diagnosis and management of DCI and the travel implications for military personnel who have undergone such training exercises are discussed. Although DCI is relatively uncommon, physicians may see it and should be aware of its presentation and treatment.- - - - - - - - - - ranking = 0.099610965623009keywords = injury (Clic here for more details about this article) |
19/79. May 2003: 57-year-old-woman with acute loss of strength in her right upper extremity and slurred speech.The May 2003 COM. A 57-year-old woman presented with slurring of her speech and right arm weakness. Her past medical history included idiopathic hypertrophic subendocardial stenosis (IHSS), arthritis, asthma, congestive heart failure, hypertension and NIDDM. Neurological examination showed persistent word finding difficulty but her motor and sensory function had essentially returned to normal. Extensive laboratory studies were unrevealing. Imaging studies showed a meningeal lesion over the left posterior parietal lobe and the findings suggested an infectious or inflammatory process. A biopsy of the involved dura and meninges was performed and revealed leptomeningeal Rosai-Dorfman disease. emperipolesis was noted. The finding of emperipolesis is characteristic of Rosai-Dorfman disease of the leptomeninges, but in 30% of cases, this feature will not be identified. Large pale histiocytes of Rosai-Dorfman disease are immunoreactive for S-100 protein and KP1, but negative for CD1a. The differential diagnosis of a chronic inflammatory infiltrate containing numerous, large histiocytes includes granulomatous diseases such as Wegener graulomatosis and sarcoid, hodgkin disease, and Langerhans histiocytosis. CNS Rosai-Dorfman most commonly involves patients between 20- and 40-years-old, with a slight male predominance. Approximately 75% of cases are intracranial, whereas 20% involve the spine. Over 90% of CNS Rosai-Dorfman cases involve the leptomeninges and are seen by neuroimaging as a dural-based, contrast-enhancing masses that often elicit vasogenic edema in the underlying brain. Thus, clinically and radiologically, the disease is thought to represent meningioma. Leptomeningeal Rosai-Dorfman disease is considered a benign condition and in most cases surgical resection is the treatment of choice. Although the number of cases in the literature is small, disease progression following surgical resection is uncommon. Little is known regarding the pathogenesis of Rosai-Dorfman disease. Most have suggested that it represents either an autoimmune disease or a reaction to an infectious agent that has yet to be discovered. Currently it is best considered a benign, idiopathic histiocytosis.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
20/79. hysteria following brain injury.Of 167 patients referred to a unit treating severe behaviour disorders after brain injury, 54 showed clinical features closely resembling those of gross hysteria as described by Charcot. Close correlation was found with very diffuse insults (hypoxia and hypoglycaemia), but not with severity of injury or with family or personal history of hysterical or other psychiatric disorder. The findings may have implications for the understanding of the nature of hysteria.- - - - - - - - - - ranking = 34.750120024384keywords = brain injury, brain, injury (Clic here for more details about this article) |
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