scholarly journals Three-Dimensional Mapping of Local Cerebral Perfusion in Alcoholic Encephalopathy with and without Wernicke-Korsakoff Syndrome

1987 ◽  
Vol 7 (1) ◽  
pp. 35-44 ◽  
Author(s):  
Takashi Hata ◽  
John Stirling Meyer ◽  
Norio Tanahashi ◽  
Yoshiki Ishikawa ◽  
Akira Imai ◽  
...  

Seventeen severe chronic alcoholic patients with and without Wernicke-Korsakoff syndrome (WKS) were examined prospectively after being treated by withdrawal from alcohol. The WKS patients also received thiamine supplements. Three-dimensional measurements of local cerebral blood flow (LCBF) and local partition coefficients (LΛ) were made utilizing xenon contrast computed tomography (Xe CT-CBF). Results were displayed as color-coded brain maps before and after treatment and these were correlated with neurological and cognitive examinations. Before treatment chronic alcoholics without WKS (n = 10) showed diffuse reductions of LCBF values throughout all gray matter including hypothalamus, vicinity of nucleus basalis of Meynert, thalamus, and basal ganglia. Similar, but more severe, reductions were seen in patients with WKS (n = 7), however, white matter perfusion was also reduced. In WKS, most prominent reductions of LCBF were also seen in hypothalamus and basal forebrain nuclei but thalamus, basal ganglia, and limbic systems were severely reduced. After treatment, both groups with alcoholic encephalopathy showed marked clinical improvement and cerebral perfusion was restored toward normal. Chronic alcohol abuse, in the absence of thiamine deficiency, reduces CBF by direct neurotoxic effects. If thiamine deficiency is also present, more severe and localized hemodynamic reductions are superimposed.

Psihiatru ro ◽  
2019 ◽  
Vol 58 (3) (1) ◽  
pp. 18-20
Author(s):  
Cătălina Crişan ◽  
Laura Grosu ◽  
Oana Vanţa

Gayet-Wernicke encephalopathy is an acute neuropsychiatric condition caused by thiamine deficiency. Only a small percentage of patients experience all three symptoms, with ophtalmoplegia, ataxia and confusion, and the full triad occurs more frequently among those who have overused alcohol. The evolution is toward full recovery, Korsakoff syndrome, dementia or death. We present the case of a 56-year-old patient, known with a diagnostic of alcoholism, who was admitted for a complicated withdrawal syndrome with delirium and who developed encephalopathy and dementia syndrome.


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haiyang Yang ◽  
Gang Bai ◽  
Yongli Zhang ◽  
Guolong Chen ◽  
Lei Duan ◽  
...  

Abstract Background There are few articles about the surgical techniques of thalamic glioma and the lesions in the basal ganglia area. According to three existing cases and the literature review (Twelve articles were summarized which mainly described the surgical techniques), we discuss the surgical characteristics of lesions of the thalamus and basal ganglia area and summarize the relevant surgical skills. Case presentation Of the three cases, two were thalamic gliomas and one was brain abscess in basal ganglia. According to the three-dimensional concept of the “Four Walls, Two Poles”, lesions of the thalamus and basal ganglia were surgically removed, and the operative effect was analysed by relevant surgical techniques. Surgical resection of the lesions of the thalamus and basal ganglia area according to the three-dimensional concept of the “Four Walls, Two Poles” has achieved good surgical results. Relevant surgical techniques, such as the use of retractors, the use of aspirators, the choice of surgical approaches, and the haemostasis strategy, also played an important role in the operation process. Conclusions In the presented three cases the three-dimensional concept of the “Four Walls, Two Poles” allowed for safe surgical resection of lesions of the thalamus and basal ganglia.


1988 ◽  
Vol 3 (3) ◽  
pp. 181-188 ◽  
Author(s):  
O.M. Lesch ◽  
H. Walter ◽  
R. Mader ◽  
M. Musalek ◽  
K. Zeiler

SummaryRushing (1968) offers two hypotheses for the possible structural connection between suicidal and chronic alcoholic case groups : the “processual cause theory” is based on the idea that alcoholism leads through its problematic nature to suicide attempts. In the “common cause theory” alcoholism and suicidai acts are due to mutually shared factors, e.g., social isolation and enforced social integration.Data on suicide and suicide attempts were obtained as a separate aspect of a comprehensive follow-up investigation. All patients from one particular region in Austria, who had been admitted to hospital between 1976 and 1978 for treatment of chronic alcoholism took part in this study. Follow-up time was 4 to 7 years. 101 patients died during this period. 356 patients remained under close follow-up investigation. In addition to information about basic drinking habits, we attempted to identify predictive factors regarding the course of alcoholism and investigated familial circumstances, development and interactions.In contradiction with both theories forwarded by Rushing, we were able to isolate a special subgroup of chronic alcoholics attempting or committing suicide. This group is characterized by a depressive symptomatology (endogeneous-depressive syndrome, according to the Viennese Diagnostic Criteria), as well as by the presence of other psychiatrie disturbances underlying chronic alcohol abuse. Family histories also uncovered evidence of psychiatric illnesses. Cases of negative alteration in social status and problematical partnerships could be found in this subgroup. Drinking habits themselves did not differ from non suicide-prone alcoholics.


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