Assuntos
Prova Pericial/legislação & jurisprudência , Prova Pericial/normas , Neurologia/legislação & jurisprudência , Neurologia/normas , Sociedades Médicas/legislação & jurisprudência , Sociedades Médicas/normas , Credenciamento/legislação & jurisprudência , Credenciamento/normas , Humanos , Responsabilidade Legal , Imperícia/legislação & jurisprudência , Neurologia/ética , Revisão por Pares/legislação & jurisprudência , Revisão por Pares/normas , Sociedades Médicas/éticaRESUMO
Five generations of a family exhibit a unique autosomal dominant neurologic disorder characterized by the development (usually between 15 and 30 years of age) of ataxia, seizures, choreiform movements, progressive dementia, and death after 15 to 25 years of illness. Neuropathologic findings in two deceased family members revealed remarkably similar findings, including marked neuronal loss of the dentate nucleus, microcalcification of the globus pallidus, neuroaxonal dystrophy of the nucleus gracilis, and demyelination of the centrum semiovale. The clinical and pathologic findings are closely correlated. Ataxia and chorea are related to severe neuronal loss in the dentate nucleus with calcification in the globus pallidus. Dementia occurs with progressive demyelination of the centrum semiovale, and loss of posterior column function occurs with neuroaxonal dystrophy of the nucleus gracilis and nucleus cuneatus.
Assuntos
Ataxia/patologia , Coreia/patologia , Demência/patologia , Convulsões/patologia , Adolescente , Adulto , Ataxia/genética , Encéfalo/patologia , Coreia/genética , Demência/genética , Feminino , Humanos , Masculino , Linhagem , Convulsões/genéticaRESUMO
No deaths occurred among six consecutive cases of subdural empyema complicating meningitis in infants treated between 1968 and 1978 at North Carolina Memorial Hospital, Chapel Hill. Five of the six infants had no neurologic sequelae in follow-up periods ranging from 6 months to 7 years. This contrasts with a mortality rate of 50% in a previously reported series of infants with subdural empyemas treated between 1955 and 1966 at the same hospital. The reasons for improved prognosis include early diagnosis (computed tomography and subdural paracentesis) and adequate surgical drainage during intensive antibiotic therapy.
Assuntos
Abscesso Encefálico/diagnóstico por imagem , Abscesso Encefálico/etiologia , Abscesso Encefálico/cirurgia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Meningite/complicações , Prognóstico , Espaço Subdural , Tomografia Computadorizada por Raios XRESUMO
Enlarged ventricles and prominent sulci are common findings on computed tomography (CT) in elderly demented patients. Three such patients were found to have small, symmetric ventricles and minimal sulci on tomography; these CT scans were considered "hypernormal" for the patients' ages and clinical syndromes. Bilateral isodense subdural hematomas were subsequently diagnosed by isotope brain scans in two cases and by angiography in the third. A "hypernormal" CT scan in an elderly demented patient suggests the possibility of bilateral isodense subdural hematomas, and requires further evaluation with isotope brain scan and, if necessary, angiography.
