- Email: [email protected]
10. Brain infarcts in patients with bacterial meningitis
and J. van Gijn,
De We\w
Ziekenhuis,
Heerlen.
The Nether-
organisms.
We conclude that brain infarcts are not a rare compll-
cation in some types of bacterial meningitis,
lunds
by occlusion of supratentorial In a prospective study we examined the prognostic value of clinical characteristics in 1.57 consecutive patients with spontaneous supratentorial intracerebral haemorrhage by means of multivariate analysis. Two days after the event 37 (24%) patients had died. Factors which independently contributed to the prediction of two-day mortality were pineal gland displacement on CT of 3 mm or more (P
Coma Scale) and handicap (Rankin distribution of handicap grades after these two groups. We conclude that first two days it is not the cause
(intracerebrdl haemorrhage or cerebral infarction) but the primary extent of the brain lesion that determines the outcome.
10. Brain infarcts in patients with bacterial meningitis - W. Weststrate, A. Hijdra and J. de Gans, Ac,ademic Medica/ Centre,
Amsterdam.
We retrospectively
posterior circulation.
changes after embolization of in11. Neuropathological tracerebral arteriovenous malformations with bucrylate J. de Jonge, H.J.L.M. Teepen and A.A.W. Op de Coul, Sf. Elisahetll
Hospital,
Superselective
Tilhyq.
embolization
The Nrtherlor~d.r
of large inoperable arterio-venous
malformations (AVM) with isobutyl-2-cyanoacrylate (bucrylate) is a well recognized treatment to reduce the size of the AVM which makes it more suitable for surgery. Although there is considerable knowledge about the clinical aspects of the embolization protedure, little is known about the pathological changes in the blood vessels and the surrounding
brain parenchyma.
From 1985 to 1990 fifteen patients were operated on from day I to 62 months after embolization. When necessary multiple enbolization procedures were carried out. Six patients were operated on within 9 days. and 9 patients between 3 and 62 months. 7 he resected AVMs were fixed in formalin and embedded in paraftin. Serial S-pm sections were obtained and stained with haematoxylin-eosin and a modified red 0 stain. Pathological changes were predominantly polymorphonuclear reaction, angionecrosis. and thrombosis in the early operated group. Extravascular bucrylate and foreign body giant cell formation were found in the other group. with still an inflammatory response. Bucrylate wax
12. Chronic
idiopathic
neuropathy
- N.C. Notermans,
J.H.J.
Wokke. H. Franssen, Y. van der Graaf, M. Vermeulen, H. van den Berg and F.G.I. Jennekens. Ncrl,.o-Di\,i.sior1. Acxrdouic, Hospital
Utrwht.
Utrwht.
The Ncthwlumis
The Netherlands
studied the occurrence
of brain infarcts in
adult patients with culture-proven ‘spontaneous’ bacterial meningitis (i.e., not related to recent craniocerebral trauma or intracranial surgery). During a IO-year period 45 such patients were admitted. The microorganisms identified were Streptoc~oc~~~u.spneumorliue in I X. Neisseriu meningirides in 16, Mycohacterium tuherculo.sis in 6. and other organisms (Li.steriu monoc’~to,~erze.s, Hemaphilus irl,f’/uenxe. Eschcrkhia co/i) in 5. Thirteen patients (29%) had focal neurological signs at admission or developed them during the first week after admission. In I2 patients first or follow-up computed tomography of the soon after the first 12 patients infarcts tuberothalamic, or
and are often caused
deep perforators of the anterior and
We prospectively studied the clinical features of 75 patients with chronic idiopathic polyneuropathy presenting in middle or old age. There were 46 men and 29 women. Two major clinlcal types of polyneuropdthy could be identified on clinical grounds: sensorimotor and sensory polyneuropathy. In all patients the symptoms started distally in the legs. The courxe in both types of polyneuropathy was slowly progressive. Electrophysiological studies were compatible with an axonal polyneuropathy.
13. The muscular pain-fasciculation Heijden and F. Spaans, Uniwr-.\it_s
syndrome oflimhw.,q.
- A. van der Mau.stricht.
The
Nctherlumls
brain (CT) showed infarcts; one patient died CT which did not show an infarct. In 8 of the were in the distributions of the lenticulostriate, thalamoperforating arteries. with lesions in
The muscular pain-fasciculation syndrome has been described, in the literature since 1948, in only 17 patients. mostly men. In our
basal ganglia. internal capsule or thalamus. In 4 patients the infarcts had a superficial cortical distribution, compatible with pial artery or cortical vein occlusions. Infarcts were most frequent in patients with pneumococcal (7/18. 3Y%O or tuberculous meningitis (4/6, 67%). It occurred in only 2 of the I6 patients with meningococcal disease (13%). and in none of the 5 with other
department we saw I I males with this disorder in 4 years. rhis discrepancy indicates that this syndrome is probably frequently overlooked. Eight of the I I patients were examined more extensively. The symptoms consisted of fasciculation\. mainly in the calves, muscular pain and cramps, and they frequently developed after
De We\w
Ziekenhuis,
Heerlen.
The Nether-
organisms.
We conclude that brain infarcts are not a rare compll-
cation in some types of bacterial meningitis,
lunds
by occlusion of supratentorial In a prospective study we examined the prognostic value of clinical characteristics in 1.57 consecutive patients with spontaneous supratentorial intracerebral haemorrhage by means of multivariate analysis. Two days after the event 37 (24%) patients had died. Factors which independently contributed to the prediction of two-day mortality were pineal gland displacement on CT of 3 mm or more (P
Coma Scale) and handicap (Rankin distribution of handicap grades after these two groups. We conclude that first two days it is not the cause
(intracerebrdl haemorrhage or cerebral infarction) but the primary extent of the brain lesion that determines the outcome.
10. Brain infarcts in patients with bacterial meningitis - W. Weststrate, A. Hijdra and J. de Gans, Ac,ademic Medica/ Centre,
Amsterdam.
We retrospectively
posterior circulation.
changes after embolization of in11. Neuropathological tracerebral arteriovenous malformations with bucrylate J. de Jonge, H.J.L.M. Teepen and A.A.W. Op de Coul, Sf. Elisahetll
Hospital,
Superselective
Tilhyq.
embolization
The Nrtherlor~d.r
of large inoperable arterio-venous
malformations (AVM) with isobutyl-2-cyanoacrylate (bucrylate) is a well recognized treatment to reduce the size of the AVM which makes it more suitable for surgery. Although there is considerable knowledge about the clinical aspects of the embolization protedure, little is known about the pathological changes in the blood vessels and the surrounding
brain parenchyma.
From 1985 to 1990 fifteen patients were operated on from day I to 62 months after embolization. When necessary multiple enbolization procedures were carried out. Six patients were operated on within 9 days. and 9 patients between 3 and 62 months. 7 he resected AVMs were fixed in formalin and embedded in paraftin. Serial S-pm sections were obtained and stained with haematoxylin-eosin and a modified red 0 stain. Pathological changes were predominantly polymorphonuclear reaction, angionecrosis. and thrombosis in the early operated group. Extravascular bucrylate and foreign body giant cell formation were found in the other group. with still an inflammatory response. Bucrylate wax
12. Chronic
idiopathic
neuropathy
- N.C. Notermans,
J.H.J.
Wokke. H. Franssen, Y. van der Graaf, M. Vermeulen, H. van den Berg and F.G.I. Jennekens. Ncrl,.o-Di\,i.sior1. Acxrdouic, Hospital
Utrwht.
Utrwht.
The Ncthwlumis
The Netherlands
studied the occurrence
of brain infarcts in
adult patients with culture-proven ‘spontaneous’ bacterial meningitis (i.e., not related to recent craniocerebral trauma or intracranial surgery). During a IO-year period 45 such patients were admitted. The microorganisms identified were Streptoc~oc~~~u.spneumorliue in I X. Neisseriu meningirides in 16, Mycohacterium tuherculo.sis in 6. and other organisms (Li.steriu monoc’~to,~erze.s, Hemaphilus irl,f’/uenxe. Eschcrkhia co/i) in 5. Thirteen patients (29%) had focal neurological signs at admission or developed them during the first week after admission. In I2 patients first or follow-up computed tomography of the soon after the first 12 patients infarcts tuberothalamic, or
and are often caused
deep perforators of the anterior and
We prospectively studied the clinical features of 75 patients with chronic idiopathic polyneuropathy presenting in middle or old age. There were 46 men and 29 women. Two major clinlcal types of polyneuropdthy could be identified on clinical grounds: sensorimotor and sensory polyneuropathy. In all patients the symptoms started distally in the legs. The courxe in both types of polyneuropathy was slowly progressive. Electrophysiological studies were compatible with an axonal polyneuropathy.
13. The muscular pain-fasciculation Heijden and F. Spaans, Uniwr-.\it_s
syndrome oflimhw.,q.
- A. van der Mau.stricht.
The
Nctherlumls
brain (CT) showed infarcts; one patient died CT which did not show an infarct. In 8 of the were in the distributions of the lenticulostriate, thalamoperforating arteries. with lesions in
The muscular pain-fasciculation syndrome has been described, in the literature since 1948, in only 17 patients. mostly men. In our
basal ganglia. internal capsule or thalamus. In 4 patients the infarcts had a superficial cortical distribution, compatible with pial artery or cortical vein occlusions. Infarcts were most frequent in patients with pneumococcal (7/18. 3Y%O or tuberculous meningitis (4/6, 67%). It occurred in only 2 of the I6 patients with meningococcal disease (13%). and in none of the 5 with other
department we saw I I males with this disorder in 4 years. rhis discrepancy indicates that this syndrome is probably frequently overlooked. Eight of the I I patients were examined more extensively. The symptoms consisted of fasciculation\. mainly in the calves, muscular pain and cramps, and they frequently developed after