Acts Aspect to the result of a cerebral hemorrhagic supratentorial session on the basics of analisys in the tentorial wedge

Author(s):  
V. Bobrova ◽  
L. Shevchenko ◽  
Y. Khokhlov

Cerebral transtentorial herniation determinates the course of progressive focal supratentorial impairments and acute hemorrhagic hemispheric stroke. Clinical and pathomorphological comparisons were done in patients with acute hemorrhagic hemispheric stroke. The following predictors of hemorrhagic hemispheric stroke lethal outcome were verified: 1) acute onset of coma in association with oculomotor dysfunctions; 2) focal hemiplegia in association with peduncular hemiplegia and paratonic rigiditydue due to compression of ipsilateral peduncle; 3) quick addition of vital disorders due to hemorrhagies into tectorium and it’s necrobiosis; 4) lethal outcome caused by herniation into occipital foramen due to necrobiosis of neurons in caudal part of brain stem tectorium.

PEDIATRICS ◽  
1977 ◽  
Vol 59 (2) ◽  
pp. 240-243
Author(s):  
Patricia H. Ellison ◽  
Peggy A. Hanson

Herpes simplex virus was isolated from the tracheal aspirate of a 10-year-old boy presenting with acute onset of multiple cranial nerve palsies and a mild right hemiparesis. There was also an elevated herpes complement-fixation titer with decrease in the following weeks. Although the criteria for diagnosis of central nervous system infection by herpes virus have been debated, we propose that this represents a case of brain-stem encephalitis due to herpes simplex infection. The importance of early diagnosis and evaluation of therapy are emphasized by this case in which the patient recovered completely.


1998 ◽  
Vol 11 (2_suppl) ◽  
pp. 185-188
Author(s):  
C.M. Fitzek ◽  
S.C. Fitzek ◽  
H.C. Hopf ◽  
P. Stoeter

1997 ◽  
Vol 10 (2_suppl) ◽  
pp. 207-210
Author(s):  
S. Mangiafico ◽  
G. Villa ◽  
G.P. Giordano ◽  
V. Scardigli ◽  
C. Pandolfo ◽  
...  

Intra-arterial fibrinolytic therapy in acute vertebrobasilar occlusion is effective in saving the patient's life in 75% of cases if performed within 6 hours after the beginning of an ischemic event, without CT evidence of hypodense focal areas in the brain stem, cerebellum or thalamic nucleus. The initial clinical aspect of vertebrobasilar stroke is more often evolving. Only in 1/3 of cases is coma present at the beginning. In vertebro-basilar occlusion prognosis is determined by clinical and neuroradiological aspects. The outcome depends mainly upon how much brain stem function is lost during the reperfusion time, and the kind of vertebrobasilar occlusion. The case we present concerns a 38 year old man with acute onset of cerebral stroke without initial clinical signs of vertebrobasilar localization due to a basilar artery occlusion distal to AICA. Urokinase infusion was performed within three hours from the clinical onset up to a total amount of 1.400.000 UI. Reperfusion was observed one hour after the beginning of the intravascular therapy. The clinical course was favorable with good recovery (moderate superior right paresis, controlateral light cerebellar syndrome).


1998 ◽  
Vol 80 (1) ◽  
pp. 103-112 ◽  
Author(s):  
T. Wannier ◽  
T. G. Deliagina ◽  
G. N. Orlovsky ◽  
S. Grillner

Wannier, T., T. G. Deliagina, G. N. Orlovsky, and S. Grillner. Differential effects of the reticulospinal system on locomotion in lamprey. J. Neurophysiol. 80: 103–112, 1998. Specific effects of stimulating different parts of the reticulospinal (RS) system on the spinal locomotor pattern are described in lamprey. In the in vitro brain stem and spinal cord preparation, microstimulation in different areas of the reticular formation was performed by ejecting a small amount of d-glutamate from a micropipette. These areas were distributed over the four reticular nuclei of the brain stem: the mesencephalic reticular nucleus (MRN) and the anterior, middle and posterior rhombencephalic reticular nuclei (ARRN, MRRN, and PRRN, respectively). To prevent synaptic spread of excitation within the brain stem, the synaptic transmission was blocked by using a low Ca2+, high Mn2+ physiological saline in the brain stem pool. “Fictive” locomotion was evoked by applying N-methyl-d-aspartate (NMDA) to the spinal cord. Rhythmical discharges of motoneurons were recorded bilaterally in the midbody area, from the ventral roots that had been subdivided in dorsal and ventral branches, supplying the dorsal and ventral part of the myotome, respectively. Two major effects of brain stem stimulation were elicited: a change in the frequency of the locomotory rhythm and an induction of asymmetry (left/right, dorsal/ventral) in the segmental motor output. Approximately 50% of the stimulated sites evoked a change in locomotor frequency. In the PRRN almost all effective sites evoked an increase in frequency (10–50%). In the other nuclei, increase and decrease (10–30%) were observed equally frequently. Most of the stimulated sites (50–80%) in any reticular nucleus evoked asymmetry in the segmental motor output. Distortion of the segmental output symmetry was classified into eight categories by comparing the intensity of locomotor bursts in the dorsal and ventral branches of the two ventral roots, ipsilateral and contralateral to the stimulated side. These categories differed in the direction of the body flexion, which would be evoked during normal swimming: ipsilateral (I), contralateral (C), dorsal (D), ventral (V), ipsilateral and dorsal (ID), ipsilateral and ventral (IV), contralateral and dorsal (CD), and contralateral and ventral (CV). The different categories were not equally represented in each nucleus and across the nuclei. The most pronounced categories for each nucleus were as follow. In MRN: I (33%); ARRN: C (44%); MRRN: rostral part, I (36%) and caudal part, CV (42%); and PRRN: rostral part, I (40%) and caudal part, IV (35%). Other categories were also present but less common in each nucleus. To examine if the effects of brain stem stimulation were uniform along the spinal cord, recordings were performed from distal parts of the cord. Stimulation of a given point in the brain stem produced similar pattern of effects in 59% of cases and different patterns in 41% of cases. The main conclusion of the present study is that the proportion of RS neurons with different influences on the spinal locomotor network differs significantly among different parts of the reticular formation of the lamprey. The specificity of RS influences may represent a basis for modifications of the segmental locomotor output necessary for the control of equilibrium and steering during locomotion.


Medicina ◽  
2019 ◽  
Vol 55 (6) ◽  
pp. 311
Author(s):  
Kozyolkin ◽  
Kuznietsov ◽  
Novikova

Background and objectives. Stroke-induced mortality is the third most common cause of death in developed countries. Intense interest has focused on the recurrent ischemic stroke, which rate makes up 30% during first 5 years after first-ever stroke. This work aims to develop criteria for the prediction of acute recurrent cerebral ischemic hemispheric stroke (RCIHS) outcome on the basis of comprehensive baseline clinical, laboratory, and neuroimaging examinations. Materials and Methods. One hundred thirty-six patients (71 males and 65 females, median age 74 (65; 78)) with acute RCIHS were enrolled in the study. All patients underwent a detailed clinical and neurological examination using National Institutes of Health Stroke Scale (NIHSS), computed tomography of the brain, hematological, and biochemical investigations. In order to detect the dependent and independent risk factors of the lethal outcome of the acute period of RCIHS, univariable and multivariable regression analysis were conducted. A receiver operating characteristic (ROC) analysis with the calculation of sensitivity and specificity was performed to determine the prediction variables. Results. Twenty-five patients died. The independent predictors of the lethal outcome of acute RCIHS were: Baseline NIHSS score (OR 95% CІ 1.33 (1.08–1.64), p = 0.0003), septum pellucidum displacement (OR 95% CI 1.53 (1.17–2.00), p = 0.0021), glucose serum level (OR 95% CI 1.28 (1.09–1.50), p = 0.0022), neutrophil-to-lymphocyte ratio (OR 95% CI 1.11 (1.00–1.21), p = 0.0303). The mathematical model, which included these variables was developed and it could determine the prognosis of lethal outcome of the acute RCIHS with an accuracy of 86.8% (AUC = 0.88 ± 0.04 (0.88–0.93), p < 0.0001).


1979 ◽  
Vol 51 (6) ◽  
pp. 846-851 ◽  
Author(s):  
Seigo Nagao ◽  
Peter Roccaforte ◽  
Robert A. Moody

✓ Movement of the upper brain stem (inferior colliculus) was correlated with the alterations in the amplitude of wave V of the auditory brain-stem responses (BER's) during supratentorial brain compression in cats. In vivo observation of the brain stem and postmortem inspection show that suppression of the amplitude of BER wave V reflects the extent of caudal displacement of the inferior colliculus. Marked suppression of the amplitude of BER wave V (approximately 30% of control) correlates with the beginning of transtentorial herniation, and complete suppression of the wave V indicates complete transtentorial herniation of the brain-stem and supratentorial structures. The BER wave V is thought to be a sensitive index of caudal movement of the upper brain stem due to transtentorial herniation.


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