{"title":"Mechanisms in cerebral lesions in trauma to high cervical portion of the vertebral artery--rotation injury.","authors":"P F Bladin, J Merory","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Three cases have been described illustrating the mechanisms and effects of lesions from acute rotation injury to the vertebral artery. These indicate that the portion of artery at risk is in the C1 to C2 region, where stretching and shearing strains can produce intramural dissection and haemorrhage. Such changes can radically alter flow to produce acute arterial obliteration or later cerebral embolism. Such alteration can also produce a change in relationships between artery and surrounding structures and thus cause intermittent occlusion of a vertebral artery upon cervical rotation.</p>","PeriodicalId":76351,"journal":{"name":"Proceedings of the Australian Association of Neurologists","volume":"12 ","pages":"35-41"},"PeriodicalIF":0.0,"publicationDate":"1975-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12393016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Enteric coated levo-dopa in clinical practice.","authors":"E P Hicks, M W O'Halloran","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The results of a clinical trial of enteric coated Levo-dopa are described for nineteen patients with Parkinsonism. Twelve cases comprise the nuclear group and all were intolerant to therapeutic doses of standard Levo-dopa. Seven cases were receiving Levo-dopa for the first time. Treatment periods ranged from three to twelve months. Of the whole group, 84% have improved. Of the poor responders to standard Levo-dopa 58% have improved markedly and the remaining 42% have improved to a moderate degree using clinical criteria. The mean stabilization dose was 1.5 grams daily and using the Mann-Whitney U test the difference is highly significant when comparison is made with the stabilization dose of 3.0 grams for standard Levo-dopa (P less than .001). The method of stabilization is described; the commonest initial stabilization period is three weeks. Side-effects are dose-related. No side-effects have appeared in 60% of the patients and only mild or transient side-effects have appeared in 20%. A characteristic toxic reaction is described. This enteric-coated preparation of the drug appears to control the \"on-off\" phenomenon in at least 50% of cases with this problem. The preparation is suitable for routine use in outpatients but added care is required to ensure that vitamin tonics are rigorously avoided. Two deaths are recorded during the trial, but analysis shows them to be unrelated causally to the therapy. Enteric coated Levo-dopa is recommended as the primary treatment in all new cases where Levo-dopa therapy is indicated. No adverse interactions have occurred with other commonly used anti-Parkinsonian drugs.</p>","PeriodicalId":76351,"journal":{"name":"Proceedings of the Australian Association of Neurologists","volume":"12 ","pages":"85-91"},"PeriodicalIF":0.0,"publicationDate":"1975-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12391664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Neuromyelitis optica following infectious mononucleosis.","authors":"P M Williamson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A case of moderatley severe neuromyelitis optica following infectious mononucleosis is described as the first reported instance of this complication. Total recovery occurred. Rapid improvement followed the commencement of corticosteroids. It is postulated that the pathological process was one of postinfectious demyelination.</p>","PeriodicalId":76351,"journal":{"name":"Proceedings of the Australian Association of Neurologists","volume":"12 ","pages":"153-5"},"PeriodicalIF":0.0,"publicationDate":"1975-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12393006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The low intracranial pressure syndrome.","authors":"J J Billings, E J Gilford, J K Henderson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The syndrome of low intracranial pressure may develop in a variety of circumstances, e.g. after lumbar puncture, following head injury and intracranial operations. It sometimes occurs after viral meningitis. The case history is described of a woman in whom the disorder was unusually severe and persistent. Interesting radiological features were observed, the appearances being those of herniation of the brain towards the tentorial opening. Simple measures of treatment produced dramatic and lasting relief.</p>","PeriodicalId":76351,"journal":{"name":"Proceedings of the Australian Association of Neurologists","volume":"12 ","pages":"31-4"},"PeriodicalIF":0.0,"publicationDate":"1975-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12393015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A case of spontaneously resolving \"papilloedema\".","authors":"G Selby, G C Hipwell","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A case of spontaenously resolving bilateral papilloedema in an obese 38 year old woman subject to cluster headache is reported. The aetiology of the condition remained obscure after neurological and biochemical investigation.</p>","PeriodicalId":76351,"journal":{"name":"Proceedings of the Australian Association of Neurologists","volume":"12 ","pages":"151-2"},"PeriodicalIF":0.0,"publicationDate":"1975-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12393005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Frontal agraphia, (including a case report).","authors":"J J Vernea, J Merory","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Frontal agraphia has always been a subject of interest, although very few documented case reports have been published. A 57 year old male clerk, suffering from adenocarcinoma of the signoid colon, presented with mild headache and difficulty in writing. Minor features of dysphasia could be detected, but there were no alexia, agnosia or apraxia. Brain scan and angiography confirmed a metastasis in the posterior part of the left prefrontal region. The patient was able to write single letters, and had no difficulty with automatic writing or copying. The writing of words and of sentences was more affected. After a brief review of the literature and discussion, the authors concluded that frontal agraphia is related to frontal lobe diorders, especially the inability to translate verbal signals into motor behaviour (i.e. writing).</p>","PeriodicalId":76351,"journal":{"name":"Proceedings of the Australian Association of Neurologists","volume":"12 ","pages":"93-9"},"PeriodicalIF":0.0,"publicationDate":"1975-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12391665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The surgical management of extracranial cerebrovascular occlusive disease: a review of 200 consecutive surgical cases.","authors":"D A Horton, R D Fine, R G Hicks","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The role of surgery in the treatment of extracranial cerebrovascular disease is essentially a prophylactic one but it should be borne in mind that apart from preventing stroke, such procedures will or should eliminate symptoms. The authors believe that every patient suffering from cerebrovascular insufficiency should be thoroughly evaluated for extracranial cerebrovascular occlusive disease and that arteriograms should be performed on all patients who could be expected to be candidates for surgery. The various indications for surgery have been discussed. The authors believe that people who have severe bilateral disease and who are of an advanced age are probably in a higher risk group. They also believe that surgery should not be offered to people who have a complete stroke and who are in semi-coma or coma, no matter how rapidly they may be transferred to the operating theatre. The authors firmly believe that intra-operative E.E.G. monitoring is an important adjunct to the safe surgical treatment of lesions of the carotid bifurcation, not only to indicate when shunting is necessary but also to indicate how well that shunt is functioning. In spite of the frequent presence of associated heart disease, hypertension and other vascular lesions, operation can be offered with confidence to suitable candidates. Elimination of symptoms can be expected in over 90% of cases. Only one patient has suffered a stroke since leaving hospital and this occurred because of occlusion in his internal carotid artery which was not operated on. Apart from patient selection, the factors which have contributed to the authors' low morbidity and mortality have been the use of intra-operative E.E.G. monitoring, intra-operative heparinisation and the availability of excellent angiographic studies.</p>","PeriodicalId":76351,"journal":{"name":"Proceedings of the Australian Association of Neurologists","volume":"12 ","pages":"101-5"},"PeriodicalIF":0.0,"publicationDate":"1975-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11964449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sodium valproate in the management of intractable epilepsy: comparison with clonazepam.","authors":"J W Lance, M Anthony","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Sodium valproate 400 mg.-1800 mg. daily has been used for 1-4 months in the management of 35 patients with intractable epilepsy. This preliminary report indicates that the agent is a useful addition to anti-convulsant therapy with beneficial effect to the majority of patients with gran mal, petit mal, nyoclonus and akinetic attacks. Temporal lobe epilepsy and other focal cortical seizures responded less well. There were some minor gastrointestinal and neurological side-effects which subsided with time or the reduction of dosage. The transition period while other anticonvulsants were being withdrawn was accompanied by grand mal seizures in 6 patients. It appears that sodium valproate requires 7-10 days to becoms fully active and that other anticonvulsants should be withdrawn only after the patient is established on a maintenance dosage. Comparison with clonazepam suggests that the latter is more effective in the control of petit mal and temporal lobe epilepsy but has more persistent sedative effects. Most patients transferred from other anticonvulsants to sodium valproate felt more alert and able to concentrate better.</p>","PeriodicalId":76351,"journal":{"name":"Proceedings of the Australian Association of Neurologists","volume":"12 ","pages":"55-60"},"PeriodicalIF":0.0,"publicationDate":"1975-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12003257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The chiasmal enigma.","authors":"B Hughes","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76351,"journal":{"name":"Proceedings of the Australian Association of Neurologists","volume":"12 ","pages":"191-5"},"PeriodicalIF":0.0,"publicationDate":"1975-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12003256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Geniculate hemianopias: incongruous visual defects from partial involvement of the lateral geniculate nucleus.","authors":"W F Hoyt","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Quantitative perimetric studies in 4 patients with involvement of a lateral geniculate nucleus revealed strikingly incongruous defects in the corresponding homonymous fields of vision. The patterns of these hemianopias are analysed and correlated anatomically with established retinotopic projections on the six cellular laminae of the geniculate nucleus. Incongruous wedge-shaped field defects appear to be pathognomonic of focal disease in the dorsal crest of the geniculate nucleus. Other patterns typify lesions of the medical or lateral horns of the nucleus. On theoretical grounds monocular hemianopic defects should result from unilaminar geniculate lesions, but this perimetric sign awaits confirmation. In each case of geniculate disease where the retinal nerve fibre layer has been examined specifically for efidence of retrograde homonymous atrophy, typical hemiretinal signs were found to be present.</p>","PeriodicalId":76351,"journal":{"name":"Proceedings of the Australian Association of Neurologists","volume":"12 ","pages":"7-16"},"PeriodicalIF":0.0,"publicationDate":"1975-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12391662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}