1/3. neurologic manifestations of intravascular coagulation in patients with cancer. A clinicopathologic analysis of 12 cases.Among 1,459 autopsied patients with cancer, 12 had multifocal infarcts of the brain that appeared to be caused by intravascular coagulation. Most of these patients were women with leukemia or lymphoma, and all had a clinical course in which neurologic signs and symptoms were prominent. All had evidence of generalized brain disease (delirium and stupor or coma), and several also had focal brain disease (focal seizures, hemiparesis). All patients had laboratory evidence of coagulation abnormalities, although these were often not severe when neurologic symptoms began. Pathologically, there were multifocal hemorrhagic or ischemic infarcts in the distribution of several cerebral vessels, without a systemic source for cerebral emboli. fibrin thrombi were identified in cerebral vessels and in vessels of several other organs. The clinical findings fit the pathologic picture, and in most instances the correct diagnosis might have been made earlier had it been considered.- - - - - - - - - - ranking = 1keywords = stupor (Clic here for more details about this article) |
2/3. hypoglycemia: causes, neurological manifestations, and outcome.During a 12-month prospective study there were 125 visits to the Harlem Hospital Emergency Room for symptomatic hypoglycemia. Sixty-five patients had obtundation, stupor, or coma; 38 had confusion or bizarre behavior; 10 were dizzy or tremulous; 9 had had seizures; and 3 had suffered sudden hemiparesis. diabetes mellitus, alcoholism, and sepsis, alone or in combination, accounted for 90% of predisposing conditions; others included fasting, terminal cancer, gastroenteritis, insulin abuse, and myxedema. Average blood glucose levels were lower among comatose than among obtunded patients, but overlap was considerable, and overall there was little correlation among cause, blood glucose levels, and symptoms. Although mortality was 11%, only one death was attributable to hypoglycemia per se, and only four survivors had focal neurological residua.- - - - - - - - - - ranking = 1keywords = stupor (Clic here for more details about this article) |
3/3. Variola minor in Braganca Paulista county, 1956. Observations on the clinical course of variola minor and on pregnancy in women with the disease.Occasional observations on the clinical course of 485 cases of variola minor composing an epidemic are reported. 17% of the cases showed a complication. otitis was observed in one case. An erythematous rash limited to the upper chest, neck and head appeared, instead of the pock eruption, after the pre-eruptive phase, in a previously vaccinated case. Convulsions, drowsiness, stupor, delusions, dizziness or deafness were observed in 23 patients whose individual characteristics are also presented. One of these cases showed a definite neurologicl syndrome: encephalitis. Neurologic complications were mostly seen in patients with medium to severe variola minor. Neither abortion nor death were seen among 4 pregnant women who developed variola minor, even though one of them delivered, on term, a dead foetus, 4 months after developing variola minor.- - - - - - - - - - ranking = 1keywords = stupor (Clic here for more details about this article) |