Cases reported "Cerebrovascular Disorders"

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1/5. The case: voices.

    Six caregivers comment on the aftermath of a patient's disabling stroke. Their remarks about the patient and his family situation reveal much about the dynamics of the hospital hierarchy--and, incidentally, the difficulty of uncovering the "facts."
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ranking = 1
keywords = voice
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2/5. Cerebral and coronary gas embolism from the inhalation of pressurized helium.

    OBJECTIVE: inhalation of helium, which produces a change in the voice, is frequently used among young rock singers to improve their performance. DESIGN: A case report. SETTINGS: adult medical intensive care unit in a university hospital. PATIENT: A 23-yr-old singer, who accidentally inhaled helium from a high pressurized tank without pressure reduction, presented with transient loss of consciousness and chest pain. INTERVENTIONS: Electrocardiogram, chest radiograph, biochemical and toxicological analyses, echocardiography, coronary angiography were performed. MEASUREMENTS AND MAIN RESULTS: At admission, the patient slowly regained consciousness. An electrocardiogram showed significant ST elevations in leads I, aVL, and V4-V6. The chest radiograph was consistent with pulmonary congestion and pneumomediastinum. The echocardiogram showed normal sized heart chambers with hypokinesis of the left ventricular lateral wall. ethanol and urine cannabinoids were present in low concentrations, but no presence of opiates, methadone, cocaine, or amphetamines was documented. troponin t was positive. Elevation of ST segments gradually disappeared within 30 mins, the drowsiness within 10 hrs, and the thoracic pain within 24 hrs. coronary angiography showed normal coronary arteries. The patient was discharged on day 3 without any symptoms and with normal electrocardiogram and chest radiograph. CONCLUSION: Accidental inhalation of helium under high pressure can cause symptomatic cerebral and coronary artery gas embolism.
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ranking = 0.25
keywords = voice
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3/5. Phonagnosia: a dissociation between familiar and unfamiliar voices.

    A dissociation between facial recognition and facial discrimination is well known, but investigations of "phonagnosia" (impairment of voice recognition and discrimination) have not been pursued. Using familiar and unfamiliar voices as stimuli, a marked difference between the ability to recognize familiar voice and the ability to discriminate between unfamiliar voices was identified in five patients, and a sixth showed a severe impairment in both tasks. Clinical and radiologic findings in these cases suggest that recognition of familiar voices is impaired by damage to inferior and lateral parietal regions of the right hemisphere, whereas impairment of voice discrimination abilities is associated with temporal lobe damage of either hemisphere. This dissociation of recognition and discrimination of the human voice suggests that these two functions are mediated by different brain structures and may contribute differentially clinical syndromes.
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ranking = 2.75
keywords = voice
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4/5. On the nature of the foreign accent syndrome: a case study.

    A detailed acoustic analysis was conducted of the speech production of a single patient presenting with the foreign accent syndrome subsequent to a left-hemisphere stroke in the subcortical white matter of the pre-rolandic and post-rolandic gyri at the level of the body of the lateral ventricle. It was the object of this research to determine those changes which contribute to the perception of a "foreign accent." A number of acoustic parameters were investigated, including features of consonant production relating to voice, place, and manner of articulation, vowel production relating to vowel quality and duration, and speech melody relating to fundamental frequency. The results indicated that many attributes which might have contributed to the foreign quality of the patient's speech were similar to those of normal English speakers. However, a number of critical elements involving consonant and vowel production and intonation were impaired. It was hypothesized that the acoustically anomalous features are linked to a common underlying deficit relating to speech prosody. It is suggested that the normal listener categorizes this speech pattern as a foreign accent because the anomalous speech characteristics, while not a part of the English phonetic inventory, reflect stereotypical features which are a part of the universal phonetic properties found in natural language.
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ranking = 0.25
keywords = voice
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5/5. Selective acoustic phonetic impairment and lexical access in an aphasic patient.

    The relationship between acoustic-phonetic disturbances and lexical access was explored in an aphasic patient. M.L. had a restricted disturbance of phonemic discrimination that affected the discrimination of voicing contrasts in nonword stimuli. Despite this impairment, her discrimination of voicing contrasts in words and her comprehension of auditorily presented words containing voiced segments was excellent. Performance on lexical decision was impaired: M.L.'s rejection of nonwords was poor and her reaction times and error rates for word stimuli showed a trend toward being influenced by the lexical status (word or nonword) of the item that would be formed by a change in voicing. The results are consistent with a role for a phonemic code in auditory word recognition, coupled with lexical-to-acoustic/phonetic feedback, but are also compatible with the view that other access codes for the Phonological Input Lexicon are also available.
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ranking = 0.25
keywords = voice
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