Early and Progressive Cognitive Disorder Imposes CADASIL Syndrome in the Diagnostic Assumption

2021 ◽  
Author(s):  
Mircea-Catalin Fortofoiu
Keyword(s):  
Brain Mri ◽  
Cognitive Disorder ◽  
Personal History ◽  
Emotional Lability ◽  
State Of Health ◽  
Diagnostic Challenge ◽  
The Family ◽  
History Of ◽  
Skin Biopsies ◽  
Multiple Treatments

The case presented is a diagnostic challenge considering the family and medical history of the 65-year-old patient with a family history of migraine depression, emotional lability, and gait disorders manifested at his grandmother, his mother, and his sister. After multiple hospitalizations for the described symptoms and multiple treatments with questionable results, the diagnosis was imposed by the appearance described by brain MRI to which were added the data from the patient's family and personal history. Of course, a full confirmation of the diagnosis would have required skin biopsies and genetic testing that the patient refused to perform. However, due to its peculiarities, the presented case tries to offer a diagnostic orientation path for practitioners in situations where previous diagnoses and treatments are not sufficiently conclusive either due to the impossibility of performing specific tests at that time or either because of the patient's indifference to his state of health.

The Pre-Psychotic Schizoid: A Character Study

1931 ◽  
Vol 77 (319) ◽  
pp. 804-818
Author(s):  
Stanley M. Coleman
Keyword(s):  
Personal History ◽  
Character Study ◽  
The Family ◽  
History Of

This paper is an attempt to study the family and personal history of a schizoid individual, J. M—, who developed schizophrenia (dementia paranoides) at the age of 22.

scholarly journals HYPERVASCULAR LIVER LESIONS IN RADIOLOGICALLY NORMAL LIVER

2017 ◽  
Vol 30 (1) ◽  
pp. 21-26
Author(s):  
Enio Campos AMICO ◽  
José Roberto ALVES ◽  
Dyego Leandro Bezerra de SOUZA ◽  
Fellipe Alexandre Macena SALVIANO ◽  
Samir Assi JOÃO ◽  
...  
Keyword(s):  
Risk Factors ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Normal Liver ◽  
Personal History ◽  
Liver Lesions ◽  
Diagnostic Challenge ◽  
Imaging Characteristics ◽  
History Of ◽  
History Of Cancer

ABSTRACT Background: The hypervascular liver lesions represent a diagnostic challenge. Aim: To identify risk factors for cancer in patients with non-hemangiomatous hypervascular hepatic lesions in radiologically normal liver. Method: This prospective study included patients with hypervascular liver lesions in radiologically normal liver. The diagnosis was made by biopsy or was presumed on the basis of radiologic stability in follow-up period of one year. Cirrhosis or patients with typical imaging characteristics of haemangioma were excluded. Results: Eighty-eight patients were included. The average age was 42.4. The lesions were unique and were between 2-5 cm in size in most cases. Liver biopsy was performed in approximately 1/3 of cases. The lesions were benign or most likely benign in 81.8%, while cancer was diagnosed in 12.5% of cases. Univariate analysis showed that age >45 years (p< 0.001), personal history of cancer (p=0.020), presence of >3 nodules (p=0.003) and elevated alkaline phosphatase (p=0.013) were significant risk factors for cancer. Conclusion: It is safe to observe hypervascular liver lesions in normal liver in patients up to 45 years, normal alanine aminotransaminase, up to three nodules and no personal history of cancer. Lesion biopsies are safe in patients with atypical lesions and define the treatment to be established for most of these patients.

When real life conditions do not follow textbook diagnosis: A diagnostic challenge from a neuropsychiatric clinic

2020 ◽  
pp. 009121742097962
Author(s):  
Mahdi Razafsha ◽  
Karen Buch ◽  
Ottavio V Vitolo ◽  
Zeina Chemali
Keyword(s):  
Financial Management ◽  
Neurodevelopmental Disorder ◽  
Real Life ◽  
Memory Loss ◽  
Cognitive Disorders ◽  
Cognitive Disorder ◽  
Childhood Development ◽  
Diagnostic Challenge ◽  
Elderly Parents ◽  
History Of

We present the case of a 61-year-old retired catholic priest, who was adopted at a very young age, with psychiatric history of anxiety and depression presenting for evaluation of at least 4 year memory loss and word finding difficulties. Over the preceding couple of years his cognitive functions had rapidly declined. As a result, he became dependent on his elderly parents for most of his instrumental activities of daily living including administration of medication, financial management, and driving. He continues to be independent in his personal care. His presentation offered diagnostic challenges due to the interplay of anxiety and cognitive disorders involving both memory and language domains. In addition, he resisted to repeat formal neuropsychological evaluation. At the bedside, his poor effort on testing was often blamed on his severe anxiety confounding the clinical picture. Lack of knowledge of his family history and his childhood development, and unclear premorbid functioning complicated the diagnostic formulation. A differential diagnosis ranging from possible functional cognitive disorder to neurodevelopmental disorder and neurodegenerative disorders will be discussed.

scholarly journals XXVI.—Memoir on the Practice of Banishment, as it obtained in the Reign of James II. among those who were sentenced to death for their Participation in the Rebellion of the Duke of Monmouth. By George Roberts, Esq.

Archaeologia ◽  
1852 ◽  
Vol 34 (2) ◽  
pp. 350-356
Author(s):  
George Roberts
Keyword(s):  
Personal History ◽  
General Treatment ◽  
The Public ◽  
The Family ◽  
History Of

At the time I was engaged in collecting materials for my “Life, Progresses, and Rebellion of James Duke of Monmouth,” in 2 vols. 8vo. published in 1844, scarcely any detailed information could be procured respecting any of the exiled followers of the duke. The fate of only four individuals was actually ascertained; and the intimate personal history of no one, much less the general treatment, transportation, and return of any, could be learned from whatever quarter. A lady wrote to me, and obligingly supplied what is to so many an object of great interest, in the shape of a MS. narrative of the transportation, sale, and labour of John Coad; which I advised should be forwarded to Mr. Macaulay for his then expected work. An imperfect copy was accordingly sent, which has since been printed, the deficient part being supplied before the issue to the public from, I believe, the copy lent to me. Another of the kind contributors to my labours was one of the family of the late John Frederick Pinney, Esq. of Somerton Erleigh, who searched amongst old family papers, and has had the gratification of having produced for my use matter important to general history and biography.

LT: Yes, I think so. You move between and among all those different states. In a way desire, libido, that sort of drive, that energy— without it you probably wouldn’t do anything. But when you have it, when you’re experiencing it very, very strongly, so that it’s pushing you in all sorts of ways, you’re also at its mercy. You can feel content, maybe, in the moment when you’re not feeling that, but you’re also in a static state. You may have a period of equilibrium but you’re always going to head toward a state of disequilibrium. PN: There are several moments in Cast in Doubt where Horace finds himself ‘without or separate from desire’; ‘Indeed I felt blank’, he says (C, 141). LT: Yes—a desire not to desire. I’m working on a story now in which a woman likes to watch pornography. But to say ‘I like this’, or to say ‘I want to see this’, means that those things are not in her life. That’s the implication. That’s why nobody wants to be caught wanting. We’re filled with desires, but you’re not supposed to say that you have them. Because if you have them, it means that you’re lacking. At the ICA panel on Straight Sex, Lynne Segal in November talked about female heterosexual agency in so-called straight sex that everybody agrees is not so straight. Later all I could think about was that implied in the term ‘I desire’ is its own negation, a negation of agency. If you desire then you have a problem. But you can always say, ‘I wanted him and I got him.’ PN: But he wasn’t good enough! LT: Then I wanted someone else! PN: Can we go back to your first book, Haunted Houses? I gather the title comes from a passage in H.D.’s Tribute to Freud where she says that ‘We are all haunted houses.’ At the end of the novel that haunting is described as ‘A bad feeling that someone or something is never going to let you alone’ (H, 206). What kind of someone or something were you trying to get at in this novel? LT: I guess it’s a question of personal history, psychological history, of one’s family, which never leaves you alone. The idea that you can be completely free of that is bogus. Moving from personal history into public history, your present is always inflected by your past. I believe one can move, with a lot of psychological work, further away from the neurosis of the family, but perhaps never completely. PN: There’s certainly a lot of interest in this first book in forms of recollection and repetition. The young women in the novel fear they will repeat the lives of their mothers, and it’s as if the

2005 ◽  
pp. 53-53
Keyword(s):  
Young Women ◽  
Public History ◽  
Personal History ◽  
The Novel ◽  
Static State ◽  
The Family ◽  
History Of ◽  
The Moment ◽  
Haunted Houses ◽  
As If

The Prevalence of Hereditary Antithrombin-III Deficiency in Patients with a History of Venous Thromboembolism

1985 ◽  
Vol 54 (04) ◽  
pp. 744-745 ◽  
Author(s):  
R Vikydal ◽  
C Korninger ◽  
P A Kyrle ◽  
H Niessner ◽  
I Pabinger ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Antithrombin Iii ◽  
Positive Family History ◽  
Normal Range ◽  
The Family ◽  
History Of ◽  
Antithrombin Iii Deficiency ◽  
Recurrent Venous Thrombosis ◽  
Antithrombin Iii Activity ◽  
Slight Deficiency

SummaryAntithrombin-III activity was determined in 752 patients with a history of venous thrombosis and/or pulmonary embolism. 54 patients (7.18%) had an antithrombin-III activity below the normal range. Among these were 13 patients (1.73%) with proven hereditary deficiency. 14 patients were judged to have probable hereditary antithrombin-III deficiency, because they had a positive family history, but antithrombin-III deficiency could not be verified in other members of the family. In the 27 remaining patients (most of them with only slight deficiency) hereditary antithrombin-III deficiency was unlikely. The prevalence of hereditary antithrombin-III deficiency was higher in patients with recurrent venous thrombosis.

Can a Narcissist Ever Marry?: James Fisher and The Uninvited Guest

2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Brett Kahr
Keyword(s):  
Clinical Material ◽  
Couple Relationships ◽  
Cocktail Party ◽  
False Self ◽  
Winter's Tale ◽  
Pathological Narcissism ◽  
The Family ◽  
History Of ◽  
Marital Partners

Few books in the burgeoning field of couple psychoanalysis have garnered as much admiration as James Fisher's The Uninvited Guest: Emerging from Narcissism towards Marriage. In this memorial essay, the author pays tribute to the late Dr Fisher and to his perennial book which explores the ways in which pathological narcissism, among other factors, inhibit the development of spousal intimacy, often destroying partnerships entirely. The author describes the creative way in which Fisher drew upon great works of literature, most notably William Shakespeare's A Winter's Tale, and T. S. Eliot's The Cocktail Party, as well as long-forgotten clinical material from Fisher's predecessors at the Family Discussion Bureau (forerunner of the Tavistock Centre for Couple Relationships), in order to understand the ways in which marital partners struggle with false self couplings. The author assesses the importance of Fisher's contribution in the context of the history of couple psychoanalysis.

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