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Query: UMLS:C0004134 (ataxia)
 15,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective review of colloid cysts diagnosed from 1974 to 1986 emphasizes the presenting symptoms of these lesions, their surgical management, and the contribution of modern imaging techniques to their diagnosis and therapy. In this 12-year period, 84 patients (45 men and 39 women) had a colloid cyst diagnosed. The patients' mean age was 46 years (range, 7-82 years). Surgery was performed in 55 patients, 7 of whom had undergone prior surgery elsewhere. The surgical approaches used were transfrontal-transventricular, transcallosal, computer-assisted stereotactic aspiration and resection by stereotactic craniotomy, and shunting of cerebrospinal fluid without removal of the lesion. There was no operative mortality, but complications occurred in 15 patients (27%). Preoperative imaging showed hydrocephalus in 93% of the patients: severe in 43%, moderate in 36%, and mild in 14%. In the surgically treated group, the most common presenting symptoms were headache, change in mental status, ataxia, nausea and vomiting, visual disturbance, emotional lability/inappropriate affect, depersonalization, and hypersomnolence. Twenty-four patients for whom surgery was not recommended are being followed up closely. Most of these patients had normal ventricles. The symptoms in this group included headache, anxiety/nervousness, ataxia, memory impairment, visual disturbance, and seizures. Five autopsy cases of patients with colloid cysts were available during this period and were reviewed. Direct removal of colloid cysts can be accomplished with low morbidity and mortality, avoiding the frequent revisions and complications related to shunt procedures. There is a subgroup of colloid cysts that can be operated upon electively or followed up closely with serial imaging studies.
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PMID:Colloid cysts: experience with the management of 84 cases since the introduction of computed tomography. 271 77

Thirty-seven consecutive adults and 2 children with tuberculosis of the nervous system were studied. Twenty-eight patients (72%) had intracranial or intraspinal tuberculomas and only 11 patients (28%) had tuberculous meningitis. Of the 14 patients (36%) with intracranial tuberculomas 6 presented with epilepsy of late onset including convulsive status epilepticus(2). The 6 patients with multiple tuberculomas some of which were situated in the infratentorial compartment were surprisingly free of major neurological disability of systemic disturbance. Thirteen patients (33%) presented with spinal cord compression due to tuberculoma. Eight of these had associated bony abnormalities such as collapsed vertebrae and loss of pedicles usually regarded as characteristic of malignant disease and 2 presented with clinical features of acute transverse myelitis. Eleven patients (28%) had tuberculous meningitis. One of these died, 1 had a protracted illness with gait ataxia and hydrocephalus and 1 other patient was disabled by hemiplegia, dysphasia and epilepsy but the remaining 8 recovered fully. Tuberculosis outside the nervous system was found in 13 patients (33%) in 12 (31%) of whom it was pulmonary. Acid fast bacilli were demonstrated by Ziehl-Neelsen stain in 16 patients (52%) out of 31 from whom specimens were available. Mycobacterium tuberculosis was eventually cultured from only 6 specimens. These data suggest that the clinical and radiological features of tuberculosis of the nervous system in Saudi Arabia may differ substantially from those reported from other countries. In our study there was low morbidity and low fatality rate. Two patients had infratentorial tuberculomas, and 8 patients had bony abnormalities in the vertebral column, typical of malignant disease.
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PMID:Tuberculosis of the nervous system. A clinical, radiological and pathological study of 39 consecutive cases in Riyadh, Saudi Arabia. 272 75

Clinico-radiologic correlations, using CT, were studied in 29 patients with ataxic cerebral palsy. The scans were normal or only slightly abnormal in 38%, posterior fossa abnormalities occurred in 28%, and 55% had obvious cerebral abnormalities which always involved the parietal lobes. There were only two cases where the changes were confined to the posterior fossa. Hydrocephalus was present in four, and there was one case of a Dandy-Walker malformation. An absolute association with any clinical subtype was unusual. All cases of simple ataxia had an obviously abnormal scan, but the changes were widespread. Where dysequilibrium was present the scans were either normal or showed widespread change. Only 25% involved the vermis. Although there was some association between hydrocephalus and ataxic diplegia, the majority of this subtype had a normal or only slightly abnormal scan. Most were hypotonic docile infants with delayed speech and motor skills, particularly those with posterior fossa abnormality. Although CT did not predict development well, those with lower IQ's were more likely to have obvious CT change. Where obvious supratentorial change was present, 75% had a history of epilepsy. In ataxic cerebral palsy CT findings are common, but variable. CT change correlates better with IQ and epilepsy than clinical subtype.
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PMID:Ataxic cerebral palsy--clinico-radiologic correlations. 273 80

Isolated central nervous system (CNS) granulomatosis resembling sarcoidosis occurred in a 30-year-old woman who had amenorrhea, ataxia, and obstructive hydrocephalus, and a 9-year course of progressive neurological deterioration with recurrent bouts of diabetes insipidus. Lamellar and nodular meningeal hyalinosis resembling amyloid was noted on an initial brain biopsy. At autopsy, the brain had a non-necrotizing granulomatous meningitis and ventriculitis, most prominent at the base of the brain, including the third ventricle and the hypothalamus, but there were no systemic granulomas.
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PMID:Isolated central nervous system granulomatosis resembling sarcoidosis. 279 4

Five children with ventricular dilatation (4 boys, 1 girl) had features seen on computer tomographic scan that were consistent with suprasellar arachnoid cysts. All children were investigated with a CT ventriculogram and/or CT cisternogram, and no communication with the cyst was demonstrated. Three children were seen in the 1st year of life and the remaining 2 children were between 1 and 5 years of age. Hydrocephalus and developmental delay were the most common presenting features, followed by visual disturbance, squint, or ataxia. Direct surgical decompression was performed in all 5 patients to avoid long-term placement of a ventriculoperitoneal shunt. A temporary shunt was placed in 2 children because of high intracranial pressure. Direct partial excision of the cyst wall to allow long-term drainage into the basal cisterns or ventricular system was successful in all children. The presence of subdural collections postoperatively required temporary shunting in 2 children. After follow-up for between 10 and 22 months no clinical endocrinological sequelae have been detected, but 2 children have raised serum prolactin levels. Three children are developmentally delayed; one of these has regained some skills since surgery. Direct surgical decompression of suprasellar arachnoid cysts to avoid long-term shunt placement is the preferred method of surgical treatment for this condition.
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PMID:Suprasellar arachnoid cysts: management by cyst wall resection. 279 93

Cerebrospinal fluid (CSF) levels of the anxiogenic neuropeptide diazepam binding inhibitor (DBI) were determined by radioimmunoassay in 281 patients who underwent evaluation for neurological problems. Serial dilution curves and reverse-phase high pressure liquid chromatography showed that the immunoreactive material in CSF behaved just as authentic DBI extracted from human brain. Furthermore in the assay there was no evidence of interference from CSF samples deprived of DBI by immunoaffinity. In 82 patients with no evidence of major lesions in the central nervous system, who acted as controls, the CSF DBI content was shown to be age- and sex-related. No correlation was observed with the CSF protein concentration. In patients with different types of dementia, the levels of CSF DBI were significantly increased in a group with normal pressure hydrocephalus. No significant differences were found between Alzheimer's disease, multi-infarct dementia, or dementia with Parkinson's disease and controls. In non-demented patients with Parkinson's disease the levels of DBI were increased in a subgroup with depressive disturbances whereas no differences was observed in the non-depressed cases. The content of DBI was markedly reduced in 5 cases with olivopontocerebellar atrophy and in 4 with spinocerebellar ataxia. In all the other disorders studied the levels of DBI were similar to or slightly lower (multiple sclerosis) than those of the controls. The origin of DBI in cerebrospinal fluid is uncertain; a number of various possibilities are discussed concerning the proposed role of DBI as modulator of brain GABAergic transmission.
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PMID:Diazepam binding inhibitor-like immunoreactivity (DBI-LI) in human CSF. Correlations with neurological disorders. 321 41

An epidemic of bismuth (Bi)-related neurotoxicity in France remains poorly understood, partly because no satisfactory animal model exists. We have now characterized such a model. Single or multiple intraperitoneal injections of Bi subnitrate into female mice produced neurologic signs (myoclonus, ataxia, tremors, convulsions) and blood (1.2 micrograms/g) and brain (8.4 micrograms/g) Bi levels like those in human cases. Hydrocephalus and axonal swellings in spinal cord were the major neuropathologic lesions.
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PMID:Characterization of a murine model for human bismuth encephalopathy. 324 42

Epidermoid tumors located in the fourth ventricle are exceedingly rare. Seven cases of this pathological condition were observed during a 10-year period. Patients were mostly middle-aged men, with a clinical history of relatively short duration (5 months). Clinical symptoms consisted of vertigo and ataxia, followed by incoordination, dysmetria, and tremor at a later stage. Computed tomography scanning represented the main diagnostic technique for these lesions, and typically showed a highly hypodense, round-shaped area within the fourth ventricle, occasionally accompanied by hydrocephaly. Subtotal surgical removal of the cysts produced excellent results in 86% of the cases. The implications of these findings are discussed.
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PMID:Epidermoid cysts of the fourth ventricle. 334 62

In cases of brain insults in infants including those who are superimposed with increased intracranial pressure, the importance of management of cerebral hemodynamics has been stressed. As yet, minimal information is available on hydrocephalus. The aim of this clinical study is to clarify the circumstance of intracranial pressure in hydrocephalic infants with cerebrovascular compromise. Polygraphical and continuous intracranial pressure recordings were done in 20 hydrocephalic newborns and infants of various etiologies including 16 hydrocephalus of preshunted state, two cases of shunt dysfunction and two cases of slit ventricle syndrome. Analysis of intracranial pressure circumstance was done both quantitatively and qualitatively using newly devised microcomputer-aided analyzing system. As a cerebrovascularly compromised index of the intracranial pressure circumstance, the transmission ratio of systemic arterial pressure to intracranial pressure defined by Ikeyama, et al.: eta HB (PP of ICP/PP of SABP) was used. There exists bilinear correlation between ICP and eta HB, and more clearly, between CPP and eta HB. Thus, the correlation graph shows the breakpoint of ICP and CPP in relation to eta HB. Abnormal waves similar to Lundberg's A and B are recorded. They appear under the condition of high range of eta HB, and also, below the level of breakpoint of CPP or ICP, and show the characteristic features of pressure waves. During their appearance, the respiratory pattern shows a uniform sequential changes from dysrhythmia, ataxia to hyperventilation. The breakpoint of CPP in relation to eta HB, which is the critical level of CPP where the less tighter intracranial circumstance is maintained above this level, was clarified in hydrocephalus during infancy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The critical threshold of cerebral perfusion pressure in intracranial pressure circumstance of hydrocephalus during infancy]. 338 80

The results of ventriculo-atrial shunting have been analyzed in 37 patients with normal pressure hydrocephalus. The nature and severity of the symptoms and their progression in time, together with the results of computed tomography and clinical response to CSF withdrawal by lumbar puncture, were compared with the outcome after shunting, in order to define reliable prognostic criteria. In the long term, 43% of the patients improved and 30% died. The complication rate was 22%, including primarily subdural hematoma and shunt malfunction. Amongst the symptoms, ataxia responded best to shunting. Clinical improvement after subtraction of lumbar CSF, and demonstration by computed tomography of ventricular dilation with a hypodense area around the frontal horns in the absence of cortical atrophy, were associated with a favorable outcome.
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PMID:[Normal-pressure hydrocephalus in adults. Analysis of results and complications following ventriculo-cardiac derivation]. 339 62


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