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  • 1
    ISSN: 0942-0940
    Keywords: Atrial natriuretic polypeptide (ANP) ; hyponatremia ; subarachnoid haemorrhage ; cerebral salt wasting syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Measurement of plasma alpha-humanANP (ANP) and antidiuretic hormone (ADH) in 28 cases with aneurysmal subarachnoid haemorrhage (SAH) was carried out, and then compared with control subjects who were infused with hypertonic saline. In cases with hyponatremia (HN), statistical correlation between control subjects and cases without HN was not evident with regards to ANP and plasma osmolality (Posm), excreted fraction of filtrated sodium (FENa) and urinary Na/K. Furthermore, they secreted supernumerarilly in spite of HN. Cases with HN were further subdivided into two groups, they were those cases with negative total sodium balance at the time of appearance of HN, and those cases without total negative sodium balance. In the former, central venous pressure had a tendency to decrease, however, secretion of ANP and ADH was statistically not different in either groups. It appears that ANP regulated urinary sodium excretion against an osmotic or sodium load acts as a maintenance of homeostasis as an osmotic regulator. Cases with HN in which secretion of ADH was physiological, ANP secreted supernumerarilly in spite of hypoosmonaemia and hypovolaemia. Our findings may contribute to a better understanding of the pathophysiological processes leading to hyponatremia in cases with cerebral disorders, and may help to improve the treatment possibilities.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 0942-0940
    Keywords: Intracranial aneurysm ; subarachnoid haemorrhage ; cerebrospinal fluid ; lactic acidosis ; cisternal drainage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Cisternal and/or ventricular cerebrospinal fluid (CSF) and arterial blood lactate and acid-base balance were measured serially in 38 patients with aneurysmal subarachnoid haemorrhage (SAH). Based on daily clinical assessment, the patients and accordingly the samples were divided into two groups according to the grading of the World Federation of Neurosurgical Societies (W.F.N.S.). In cisternal CSF, samples of Grade III–V showed significantly higher lactic acidosis than those of Grade I–II. The time course of lactate and pH in poor prognosis groups had a significant tendency of lactic acidosis, especially on the 5th, 6th, 7th day after SAH. Ventricular CSF lactate increased even without CSF acidosis in Groups III–V. Measurement of CSF lactate, especially from the cisterna magna is useful as an indicator of prognosis and changes of intracranial environment following SAH.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 0942-0940
    Keywords: Akinesia ; dyskinesia ; postero-ventral pallidotomy ; thalamotomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Early onset “juvenile type” Parkinson's disease is commonly associated with disabling bilateral levodopa-induced dyskinesias. We report here a successful contemporaneous bilateral postero-ventral pallidotomy performed on a 46-year-old male with juvenile type Parkinson's and associated levodopa incited symmetric dyskinesias. A comparison of various surgical alternatives is included. Preoperative and postoperative evaluation, operative method and postero-ventral pallidotomy's therapeutic mechanism are presented.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 0942-0940
    Keywords: Akinesia ; deep brain electrical stimulation ; akinesia ; globus pallidum ; Parkinson's disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We present the case of a 51-year-old female who had a four-year history of Parkinson's disease with severe “on-off ” and disabling progression of symptoms on chronic levodopa therapy. After obtaining FDA approval, we implanted a Medtronic deep brain stimulation lead stereotactically into the right anterior pallidum contralateral to her most Symptomatologic side. Intra-operative stimulation trials at 100 Hz caused reproducible reversal of akinetic symptoms and simultaneous microelectrode recording of the posteroventral pallidum revealed decreased neural activity during anterior pallidal stimulation. The patient was evaluated pre-operatively and postoperatively using the Hoehn and Yahr Staging Scale, the Unified Parkinson's Disease Rating Scale (UPDRS), videotape, and a computerized data glove. Six months after implantation, the total UPDRS score was decreased from 68 to 8 and Hoehn and Yahr Staging improved from 3.0 to 1.5 during periods of chronic high frequency stimulation. Dramatic improvements in tremor, dystonia, bradykinesia, and akinesia were noted within seconds of stimulator activation and were also objectively measured using a computerized data glove. This case reveals the potential for therapeutic pallidal stimulation for Parkinson's akinetic symptomatology.
    Type of Medium: Electronic Resource
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