Oculomotor nerve palsy due to thrombosis of a posterior communicating artery aneurysm following diagnostic angiography

We present a patient who developed a painful third nerve galsy two days after angiography had demonstrated a large aneurysm on the P1 segment of the left posterior cerebral artery. CT at this stage demonstrated extensive thrombus within the previously uncomplicated aneurysm. The haemodynamics of this aneurysm resulted in incomplete clearance of contrast medium from its fundus and we posit that this may have promoted thrombus formation. Six months later the aneurysm was shown angiographically to be completely occluded.     

Abnormal sensorimotor integration is related to disease severity in Parkinson's disease: a TMS study.

Hyperexcitability of the motor system has been reported in Parkinson's disease (PD). We evaluate how cutaneous afferents modulate motor excitability in PD patients and whether abnormal modulation is correlated to parkinsonian symptoms. Digital stimulation causes abnormal enhancement of motor responses in patients. This effect may be one of the features of motor hyperexcitability in PD. Cutaneomotor hyperexcitability correlates with clinical scores, suggesting that abnormal processing of cutaneous inputs might contribute to the pathogenesis of parkinsonian symptoms.     

腰神经通道卡压综合征病因的探讨

为了探讨腰神经通道狭窄的病因，我们对２２４例腰椎间盘突出及腰椎管狭窄症患者进行了腰神经通道探查手术，结果发现其病因以腰部组织变性为主。除外伤及反复慢性腰部损伤引起腰部病变外，活动少，或很少进行腰部锻炼，体形肥胖也是引起腰神经通道狭窄日趋加重的致病因素。在治疗时强调不只满足于切除突出的椎间盘，应沿神经通道探查，清除一切卡压神经根的病变组织才能获得较好的治疗效果。我们随访１９７例，平均随访３ａ，优良率９３５％。     

Possible injury to the branches of the peroneal nerve during fibular osteotomies

Conclusions The peroneal nerves and their blood supply are at risk during high tibial osteotomies. Fixation of nerves by fibrous tissues, compression by tendinous arcades of the peroneus longus tendon, and narrow passages for nerves crossing dense fibrous septa are all factors which favor the development of peroneal nerve lesions. Intraoperative soft tissue retraction and pull by retractors may damage nerves and vessels. The muscle branch for the extensor hallucis longus muscle is particularly at risk during the fibular osteotomy since it runs directly on the bone.     

Auditory and vestibular system findings in patients with vertebrobasilar dolichoectasia

Impairment of the auditory-vestibular system has been reported in patients with vertebrobasilar dolichoectasia (VBD), but little is known about the underlying cause of the symptoms. Auditory testing (pure tone audiometry, auditory brain stem response and stapedius reflex) and vestibular tests (assessment of nystagmus, eye tracking tests, caloric test and rotational test) were performed in 23 patients with auditory-vestibular symptoms and/or cranial nerve impairment associated with VBD. Specific evidence of auditory and/or vestibular system impairment was observed in 19 cases (83%). Among patients with abnormal test findings, 47% had evidence suggesting peripheral impairment, 16% evidence suggesting central dysfunction, and 37% evidence suggesting both peripheral and central dysfunction. Although compression of the vestibulocochlear nerve plays an important role in the genesis of the auditory-vestibular dysfunction in patients with VBD, mechanism such as brain stem-cerebellar ischemia and impaired blood supply to the vestibular labyrinth may be just as important.     

兔自体神经原位移植限制创伤性神经瘤形成机理

本实验采用家兔近端正中神经和尺神经原位移植法研究预防创伤性神经瘤形成之机理。经光镜,透射电镜及免疫组化标记观察表明:(1)自体神经原位移植法能有效地抑制创伤性神经瘤形成。两神经再生的神经纤维在移植段中排列整齐,来自两神经的轴索末端髓鞘对接是抑制创伤性神经瘤形成的关键;(2)移植段中由于雪旺氏细胞增生所形成的雪旺氏鞘对近端神经轴索的再生有趋化和引导作用;(3)单纯吻合法不能抑制创伤性神经瘤的发生。     

荧光染料在视神经脊髓鞘形成期从轴突至少突胶质细胞的扩散

将真蓝(true blue)混悬液注入出生后7、14、28d大鼠眼球内,经过一定时间后,视神经内的轴突和少突胶质细胞被荧光标记。荧光强度在视神经眼球端强于视神经交叉端;出生后14～28d的幼鼠荧光标记明显强于出生后7d的幼鼠;不同年龄组的动物荧光标记普遍在注射荧光染料后的第5d显著增强。本研究表明,荧光染料可被视网膜的节细胞吸收,经轴突输送,然后,横向扩散到少突胶质细胞,扩散的通路可能是朗氏结旁区的轴胶连接。     

Respiratory Sinus Arrhythmia in Cluster Headache Syndrome

SYNOPSIS
Respiratory sinus arrhythmia is regarded as indicative of cardiac vagal integrity. A ratio of the longest R-R interval to the shortest R-R interval during deep breathing test (E:I ratio) was calculated in controls (n=49), cluster headache (n=33) and CPH (n=4) patients, E:I ratio decreased with age but was not dependent upon sex or upon smoking habits. Furthermore, there were no significant differences as regards E:I ratio between cluster headache patients in and outside a bout, or between patients with right-sided and left-sided headache. However, the E:I ratio was found to be significantly lower in the cluster headache group as such, when compared with controls, but the number of patients disclosing pathological or borderline results was small, 2 and 2, respectively. This may indicate that a putative vagal dysfunction in cluster headache is usually less marked than in patients with e.g. diabetic autonomic neuropathy. Significant attack-related change in the E:I ratio were detected in all individual patients though these changes were not of a uniform nature from individual to individual. E:I ratios were rather high in 3 out of 4 CPH patients examined. However, the number of patients in this group is too small to allow definite statements about the difference between CPH end cluster headache with regard to E:I ratios. There was no significant difference between E:I ratios outside and during a mild, short, mechanically precipitated attack in a single CPH patient.     

A comparison of glue and a tube as an anastomotic agent to repair the divided buccal branch of the rat facial nerve

The best anastomotic agent to join nerve ends is controversial. This paper describes a controlled trial between a collagen tube wrap and a tissue glue to anastomose the rat facial nerve. There was no difference in the results using photographic, histological and electrophysiological techniques.     

周围神经小间隙动脉套桥接与外膜缝合比较研究

将大鼠的腓总神经切断后，进行如下４组实验：Ａ．原位３ｍｍ间隙动脉套桥接，Ｂ．原位断端外膜缝合，Ｃ远侧断端旋转１８０°３ｍｍ间隙动脉套桥接，Ｄ远侧端旋转１８０°外膜缝合。术后１２周的电生理学，组织学评价显示，Ｂ组神经再生效果最佳，Ａ、Ｃ两组接近Ｂ组，而Ｄ组较差。