Isolated sixth nerve palsy due to intracavernous carotid aneurysm in a young woman.

A large intracavernous carotid aneurysm was angiographically demonstrated in a 29 years old woman suffering from a persistent isolated abducens nerve palsy. CT brain scan failed to reveal the lesion. The usefulness of performing angiography in the cases of isolated abducens palsy of undetermined nature, is stressed.

The acid-base balance and the electroencephalographic pattern in patients on biofiltration treatment.

Electroencephalogram (EEG) monitoring and arterial blood gases was performed during biofiltration (BF) treatment and during conventional acetate hemodialysis (HDA). Biofiltration is an ultrashort hemodiafiltration with 3 liters of substitution fluid (Na+ 145 mEq/l, HCO-3 100 mEq/l). Our data show a better correction of acid-base balance during BF than during HDA. Moreover, we observe a lower incidence of EEG disturbancies on BF, that suggests a better neurological tolerance of this treatment.

Transient global amnesia: analysis of 42 consecutive cases.

42 consecutive cases of transient global amnesia are briefly analysed. The relationship with migraine seems more impressive than the importance of cerebrovascular risk factors.

Epileptic transient amnesia.

A patient with epileptic amnesic attacks suffered three prolonged episodes similar to transient global amnesia. Clinical, electroencephalographic and neuropsychological observations during 2 years' follow-up are reported.

Spontaneous dorsal epidural haematoma: usefulness of magnetic resonance imaging and importance of operative treatment even in cases with complete paraplegia.

Spontaneous epidural haematomas are rare at any level of the spinal canal. The radiological diagnosis is usually made by myelography and in a few reported cases by computed tomography (CT). We describe a patient in which the final diagnosis was possible only with Magnetic Resonance Imaging (MRI). Surgical evacuation resulted in partial recovery of an already four days existing complete paraplegia. It is stressed that MRI is the most useful examination to differentiate haematomas from other spinal epidural lesions and that an operative evacuation of a spinal epidural haematoma is indicated even if the patient comes after a complete paraplegia has developed.

A prospective clinical and epidemiological study of head injuries in northern Italy: the Comune of Ravenna.

An analysis of all the head injuries occurring during one year within a well-defined geographical area was conducted in the region served by the Ravenna City Hospital in Northern Italy. This hospital does not have a neurosurgical service, so that patients suspected of having neurosurgical problems are transferred to the neurosurgical unit in Bologna, a distance of 65 Km (40 mi.). Of the 1468 head-injured patients seen in the emergency room, 644 (44%) were hospitalized, with an incidence of 372/10(5) pop/year) and were subjected to X-ray study of the skull (83%), EEG (64%), and CT scan (7.5%). 9 patients were transferred to the neurosurgical unit as emergencies on a clinical basis only, all were found to harbor cerebral lesions, and 7 were operated on. Of the patients hospitalized and subjected to CT scan in Ravenna, only one (0.17%) was found to have a lesion necessitating surgery. Mortality was 7.2% with 83% of these patients dying before admission. Three-month follow-up examination revealed the persistence of some symptoms in 20% of the 379 patients examined, but 91% had already returned to their previous occupation. Analysis of the risk factors present in the patients admitted to a non-specialized hospital seems to show that the presence of skull fracture, abnormal EEG, and alteration of the clinical condition constitute the indications for a CT scan, in order to detect the presence of intracranial lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of clinical and neurological status in elderly patients treated with two different hemodialysis techniques.

Five patients with a mean age of 63.4 years (range 62-67) who had frequent episodes of intradialytic intolerance during acetate hemodialysis (HDA) received biofiltration (BF). For each period of study (6 months on HDA and 6 months on BF), the patients underwent a complete clinical assessment, with evaluation of the electroencephalographic (EEG) pattern and acid-base status. During BF, we observed a reduction of hypotensive episodes (10% on BF vs. 26% on HDA) and EEG disturbances (18% on BF vs. 70% on HDA), with a more physiological correction of uremic acidosis. We conclude that BF improves clinical status and neurological tolerance with a better compensation of acidosis in the elderly.

[Cranial traumas in the city of Ravenna: a prospective study of patients who recovered]. / Traumi cranici nel comune di Ravenna: studio prospettico dei pazienti ricoverati.

A prospective study of head injury patients was carried out in the city of Ravenna in 1984. A complete record was completed for all patients admitted for hospital care. More than 50 clinical and diagnostic variables were evaluated to investigate risk factors on patients admitted to a Non-Neurosurgical Unit with CT facilities. Our report deals with 578 cases and shows some interesting findings: The mortality in the entire trauma-group was 42 cases; 35 (83%) of these died immediately after the accident or while being transported to the hospital. The number of patients hospitalized (42%) was much higher than that in previous reports concerning hospital admission of head injury patients. 9 cases were sent from the First Aid to Regional Neurosurgical Centre (Bellaria Hospital, Bologna). Among the other patients admitted to the Non-Neurosurgical Centre, 12 showed cerebral lesions on the CT (1 extradural haematoma). Risk factors were evaluated by comparing EEG, skull fractures and poor clinical condition with the presence of cerebral lesions. Our data show a peculiar situation here in Italy: a large number of hospital admissions for minor head injuries, of whom relatively few patients are at risk of intracranial post-traumatic haematoma.