Przegla̧d lekarski
-
Neurosurgery in functionally relevant brain structures carries a high risk for surgery induced post-operative neurological deficits. Functional magnetic resonance imaging (fMRI) is one of the most commonly used functional neuroimaging techniques for pre-surgical brain mapping. Preoperative fMRI is optimal method to localize specific functions of the human brain that govern motor, sensory or language functions. fMRI facilitates the selection of the safest treatment and is very helpful to plane and to perform function preserving surgery in patients with brain tumors. This kind of examination is feasible for clinical routine neuroimaging and provides important diagnostic information noninvasively that is otherwise unavailable. fMRI examinations require also advanced software for data analysis.
-
Controlled Clinical Trial
[Influence of visual stimulation on cerebral blood flow and visual evoked potentials in children with migraine with visual aura].
Visual aura is the most common type of migrainous aura. It may occur as a single symptom or precede sensory or speech disturbances. Aura symptoms and order of their appearance may result from propagation of spreading depression phenomenon. Vascular disorders observed during migraine with aura attacks are probably secondary to neuronal changes. Simultaneous registration of cerebral bioelectric activation and changes evoked in cerebral circulation enables their objective estimation, detection of correlation and better understanding of migraine with aura pathogenesis. Studies with transcranial Doppler revealed impaired cerebrovascular response to various stimulations in migraine, especially migraine with aura patients. Combination of Doppler examination with registration of visual evoked potentials (VEP) enables estimation on neurovascular coupling. ⋯ Visual stimulation has significant influence on cerebral blood flow velocities in both migraine with aura patients and controls and these changes are most often observed direct after the beginning of the stimulation. However, no differences in vascular response to visual stimulation between the groups were observed. On the other hand positive correlation between visually evoked changes in cerebral blood flow velocities and VEP amplitudes was found in migraine with aura patients suggesting increased neurovascular coupling in this group when compared with controls.
-
Acute methanol poisoning may cause heart dysfunction accompanied by various electrocardiographic abnormalities. In such cases heart damage is usually secondary to metabolic acidosis and reversible. In this paper the case of fatal methanol poisoning complicated with acute coronary syndrome in a 52-year-old alcohol abuser is presented. The main cause of the myocardial ischaemia was the subtotal stenosis of the anterior interventricular branch of the left coronary artery, whereas metabolic disorders in the course of methanol poisoning probably intensified the ischaemia in the area supplied by that artery.
-
Case Reports
[Acute poisoning due to chemical substances inducing methemoglobinemia--two cases report].
Methemoglobin is an oxidized derivative of hemoglobin. It is generated by oxidization the ferrous form of iron (Fe2+) in the heme molecule to the ferric form (Fe3+). A molecule of methemoglobin is incapable of binding and carrying of oxygen. ⋯ The other case concerns a 49-year-old man who developed methemoglobinemia of 42.7% after suicidal ingestion of an urea-substituted herbicide containing linuron. We observed hemolysis in both of these cases. They were treated symptomatically and with a specific antidote--methylene blue.
-
The case of acute venlafaxine poisoning with fatal outcome is shown. The 52-year-old woman with depression disorder ingested 56 pills of Symfaxin ER 150 venlafaxine as a suicidal attempt. Initially she was observed in the Neurology Department because of seizures, but after her husband found empty packages of medicine she was sent to the Toxicology Department being suspected of venlafaxine poisoning. ⋯ In the course of poisoning rhabdomiolysis, hypotension and consecutive acute renal failure were observed. Finally, severe ventricular tachyarrhythmia occurred leading do cardiac arrest. Despite intensive symptomatic and supportive treatment the patient died.