Assuntos
Morte Encefálica , Morte , Tronco Encefálico/fisiopatologia , História do Século XX , História Antiga , HumanosAssuntos
Axônios/ultraestrutura , Doenças do Sistema Nervoso Central/patologia , Degeneração Neural , Animais , Doenças do Sistema Nervoso Central/induzido quimicamente , Doenças do Sistema Nervoso Central/fisiopatologia , Clioquinol , Modelos Animais de Doenças , Cães , Humanos , Latirismo/patologia , Papio , Paraplegia/patologia , SíndromeRESUMO
The ankle jerks of 200 consecutive patients admitted to a geriatric department were assessed on the second or third hospital days by two independent observers. The test consisted of a "plantar" rather than Achilles tendon strike with a standard patellar hammer. 188 patients had ankle jerks. This finding is at variance with most previous reports on the subject. This difference may be due to, amongst other factors, the timing and method of testing.
Assuntos
Idoso , Reflexo de Estiramento , Tendão do Calcâneo/fisiopatologia , Tornozelo/fisiopatologia , Feminino , Humanos , Masculino , Métodos , Tono Muscular , Estudos ProspectivosAssuntos
Clioquinol/efeitos adversos , Hidroxiquinolinas/efeitos adversos , Atrofia Óptica/induzido quimicamente , Doenças da Medula Espinal/induzido quimicamente , Diagnóstico Diferencial , Humanos , Japão , Atrofia Óptica/diagnóstico , Atrofia Óptica/epidemiologia , Doenças da Medula Espinal/diagnóstico , Doenças da Medula Espinal/epidemiologia , SíndromeRESUMO
A 62 year old Irish woman with an eight year history of probable coeliac disease developed brain stem signs, unilateral facial numbness and weakness, wasting and anaesthesia in both lower limbs. Over the next two years, a progressive deterioration in neurological function and in intestinal absorption, and the development of anaemia led to a suspicion of malignancy. Bone marrow biopsy revealed malignant histiocytosis. Treatment with cytotoxic drugs led to a transient, marked improvement in intestinal structure and function, and in power of the lower limbs. Relapse was associated with bone marrow failure, resulting in overwhelming infection. Post mortem examination confirmed the presence of an unusual demyelinating encephalomyelopathy affecting the brain stem and the posterior columns of the spinal cord.
Assuntos
Encefalopatias/etiologia , Doença Celíaca/complicações , Doenças Linfáticas/etiologia , Doenças da Medula Espinal/etiologia , Raízes Nervosas Espinhais , Feminino , Humanos , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/etiologiaAssuntos
Síndromes de Malabsorção/complicações , Doenças do Sistema Nervoso/etiologia , Alcoolismo/complicações , Doença de Hartnup/complicações , Humanos , Fator Intrínseco/deficiência , Síndromes de Malabsorção/congênito , Distúrbios Nutricionais/complicações , Pelagra/etiologia , Deficiência de Vitaminas do Complexo B/complicaçõesRESUMO
Four main areas generating confusion in discussion on brain death are identified as a) the relation of criteria of death to concepts of death, b) the argument about whether death is an event or a process, c) the inadequate differentiation of different neurological entities having different cardiac prognoses, and d) insufficient awareness of the separate issues of 'determining death' and 'allowing to die'. It is argued that if by death we mean the dissolution of the human 'organism as a whole', then whole-brain death is death. Behavioural patterns, legitimate in the presence of a cadaver, should be legitimate from the time whole-brain death is diagnosed.
KIE: Disagreeing with the viewpoint expressed by Alister Browne in a preceding article, Pallis contends that codifying the definition of death as whole-brain death is both practical and conceptually valid. He discusses the different meanings of "a vegetative state," "whole-brain death," and "brain-stem death," and concludes that it is legitimate to tie decisions on such medical procedures as maintaining life support systems to a whole-brain definition of death.
