1/31. Selected legal issues in movement disorders.This article explores the long-standing question of whether trauma causes Parkinson's disease, and discusses the impact of informed consent and confidentiality in issues of genetic testing for Huntington's disease. Neurologists are appropriately concerned about the legal aspects of genetic testing, and this article attempts to address that subject from a medical-legal perspective.- - - - - - - - - - ranking = 1keywords = movement (Clic here for more details about this article) |
2/31. Primary brainstem injury: benign course and improved survival.Primary brainstem injury following head injury is a rare event. The victims often have features of supratentorial injury, and a primary isolated injury to the brainstem occurring due to shearing stresses or to injury from the tentorial edge is extremely rare. In the presence of supratentorial injury, these patients may have altered sensorium. Isolated brainstem injury may manifest itself as internuclear ophthalmoplegia, anisocoria, rigidity and cerebellar tremor. Such injuries are now being diagnosed more often due to improved imaging techniques. We treated nine such cases who had sustained primary brainstem injury in road traffic accidents, all but one of whom were subsequently independent. Primary brainstem injuries need not be associated with poor prognosis and mortality and may run a benign course with good quality of survival.- - - - - - - - - - ranking = 7917.8065979789keywords = internuclear ophthalmoplegia, internuclear, ophthalmoplegia (Clic here for more details about this article) |
3/31. magnetic resonance imaging findings of Kernohan-Woltman notch in acute subdural hematoma.OBJECTIVE AND IMPORTANCE: We report the case of a 73-year-old patient who presented a right motor deficit caused by an ipsilateral acute subdural hematoma. A magnetic resonance imaging (MRI) demonstration of Kernohan-Woltman notch phenomenon was obtained. CLINICAL PRESENTATION: The woman sustained a major head injury at home, followed by loss of consciousness. On admission to the emergency room, she was comatose, anisochoric (left > right), and showed a reaction to pain with decerebrating movements of left limbs (glasgow coma scale (GCS) 4/15). A right severe hemiparesis was observed. Cerebral computed tomography scan showed a large right hemispheric subdural hematoma. INTERVENTION AND POST-OPERATIVE COURSE: A wide right craniotomy was performed and the subdural hematoma evacuated. During the post-operative period, the level of consciousness gradually improved. A MRI performed about 2 weeks after operation showed a small area of abnormal signal intensity in the left cerebral peduncle. On discharge, the woman was able to communicate with others, but her right hemiparesis was still severe.- - - - - - - - - - ranking = 0.25keywords = movement (Clic here for more details about this article) |
4/31. propofol for sedation and control of intracranial pressure in children.Following central nervous system insults, control of intracranial pressure may lessen the incidence of morbidity and mortality. Therapies to control intracranial pressure include osmolar agents, prevention of and control of seizures, drainage of cerebrospinal fluid, hypothermia, and barbiturates. Control of agitation and excessive patient movement are additional components in the management of ICP. Although opioids and benzodiazepines are generally effective, in a small subset of patients, alternative agents may be necessary. The authors present 2 children with increased ICP in whom propofol was used to provide sedation and control ICP. The use of propofol in this setting and its possible applications in the children with increased ICP are discussed.- - - - - - - - - - ranking = 0.25keywords = movement (Clic here for more details about this article) |
5/31. Delayed post-traumatic visual loss: a clinical dilemma.A 16-year-old female presented with unilateral blindness in her right eye 2 months after blunt head trauma. optic nerve edema was demonstrated by funduscopic examination, ultrasonography, and magnetic resonance imaging and failed to respond to medical treatment. Delayed post-traumatic blindness may be a severe complication of head trauma. The late appearance leads to delayed diagnosis and resulting unresponsiveness to treatment. patients who experience head trauma that could involve the optic nerves should undergo ultrasonography of the optic nerves. An abnormal finding should be followed by an intensive evaluation to determine possible damage.- - - - - - - - - - ranking = 0.050733515582453keywords = eye (Clic here for more details about this article) |
6/31. Reversible bilateral internuclear ophthalmoplegia following head injury.PURPOSE: Internuclear ophthalmoplegia is a syndrome produced by a lesion in the medial longitudinal fasciculus. head trauma is a rare cause. We describe an unusual case of bilateral internuclear ophthalmoplegia as an isolated sequela following a minor head injury that resolved completely 3 months later. methods: Case report. Magnetic resonance images. RESULTS: A 34-year-old male developed typical bilateral internuclear ophthalmoplegia after closed head injury. Attempted convergence was normal. magnetic resonance imaging clearly delineated the focal hemorrhage in the medial longitudinal fasciculus region by showing a small bright lesion in the pontomesencephalic junction in the midline on both T2-weighted and T1-weighted images. The diplopia resolved 4 weeks later. Three months after the accident, his versions were completely normal. CONCLUSION: Isolated internuclear ophthalmoplegia should be considered in the differential diagnosis when one encounters an adduction deficit in a recently traumatized patient. Magnetic resonance images enhance the ability to correlate the clinical findings with the anatomic lesion.- - - - - - - - - - ranking = 55442.612589933keywords = internuclear ophthalmoplegia, internuclear, ophthalmoplegia (Clic here for more details about this article) |
7/31. Primary isolated brainstem injury producing internuclear ophthalmoplegia.Abstract Brainstem injuries are classically associated with a grave prognosis. We present a case of a male with primary isolated brainstem injury who had a right internuclear ophthalmoplegia who made a complete recovery. A review of literature suggests that the mortality from such injuries is about 6% and most make a good functional recovery.- - - - - - - - - - ranking = 39589.032989894keywords = internuclear ophthalmoplegia, internuclear, ophthalmoplegia (Clic here for more details about this article) |
8/31. Isolated unilateral post-traumatic internuclear ophthalmoplegia.A patient developed an isolated unilateral internuclear ophthalmoplegia (INO) after head trauma. An uncommon complication of closed head trauma, INO usually occurs bilaterally and is often associated with other neurologic deficits. The mechanism may be shear injury caused by angular acceleration leading to downward displacement of the posterior brainstem downward, stretching of the nerve fibers of the medial longitudinal fasciculus, or compression and tearing of its arterial supply.- - - - - - - - - - ranking = 39589.032989894keywords = internuclear ophthalmoplegia, internuclear, ophthalmoplegia (Clic here for more details about this article) |
9/31. Growing fractures of the orbital roof. A report of two cases and a review.Growing fractures rarely arise in the skull base. Only six cases of orbital roof growing fractures were found in the relevant literature. We report two such cases. The first case was a 2-year-old girl who had progressive proptosis for 6 months following a mild head injury 1 year previously. The second case was a 9-year-old girl with a history of injury at the age of 3 months. She developed eye deviation and proptosis for 1 year. Computed tomography scan is excellent for demonstrating bony defects in the orbital roof, while magnetic resonance imaging is more sensitive in showing the intraorbital extension of a leptomeningeal cyst. Both patients were operated successfully and proptosis disappeared postoperatively. The exact pathophysiology of growing fractures is still debated in the literature, but a dural laceration along a fracture line is noted in all cases, and frontobasal brain injury seems to play an important role in the pathogenesis of the fracture growth. Growing fractures of the orbital roof should be suspected if ocular symptoms appear in a child who had sustained a head injury several months or years before.- - - - - - - - - - ranking = 0.22391884853104keywords = ocular, eye (Clic here for more details about this article) |
10/31. Posttraumatic cerebrospinal fluid accumulation within the eyelid: a case report and review of the literature.history AND PRESENTATION. A case of a 3-year-old child with a right upper pulsatile eyelid swelling following a falling injury 3 months before is described. Computerized tomography (CT) and magnetic resonance imaging (MRI) revealed a fracture of the orbital roof, a basofrontal dural tear and a direct communication of the cystic cavity with the subarachnoid space. TREATMENT AND OUTCOME. The patient underwent dural repair for cerebrospinal fluid (CSF) leakage and was discharged in good health.- - - - - - - - - - ranking = 0.25366757791227keywords = eye (Clic here for more details about this article) |
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