RESUMEN
The aim of the study was to discuss physiology and pathology of speech and review of the literature on speech disorders in Parkinson disease. Additionally, the most effective methods to diagnose the speech disorders in Parkinson disease were also stressed. Afterward, articulatory, respiratory, acoustic and pragmatic factors contributing to the exacerbation of the speech disorders were discussed. Furthermore, the study dealt with the most important types of speech treatment techniques available (pharmacological and behavioral) and a significance of Lee Silverman Voice Treatment was highlighted.
Asunto(s)
Enfermedad de Parkinson/complicaciones , Acústica del Lenguaje , Trastornos del Habla/clasificación , Trastornos del Habla/etiología , Inteligibilidad del Habla , Disartria/etiología , Humanos , Calidad de Vida , Habla , Trastornos del Habla/prevención & control , Medición de la Producción del Habla , Logopedia/métodosRESUMEN
The aim of the present study was to evaluate the contribution of MAOB, COMT, NAT2 and CYP2D6 gene polymorphisms to early onset Parkinson's disease (PD). The study enrolled 134 patients with Parkinson's disease (early onset-EOPD--67 patients, and late onset--LOPD--patients), and 66 healthy individuals. Polymerane chain reaction restriction fragment length polymorphism (PCR-RFLP) methods were used for genotyping. Univariate analysis revealed a significant two-fold higher EOPD risk among carriers of MAOB allele A or AA genotype. Multivariate analysis revealed that MAOB allele A was an independent factor predisposing to EOPD. It was shown that neither NAT2, CYP2D6 nor COMT genotype was associated with PD.
Asunto(s)
Enfermedad de Alzheimer/genética , Arilamina N-Acetiltransferasa/genética , Catecol O-Metiltransferasa/genética , Citocromo P-450 CYP2D6/genética , Monoaminooxidasa/genética , Polimorfismo Genético/genética , Adulto , Anciano , Anciano de 80 o más Años , Alelos , Femenino , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis MultivarianteRESUMEN
OBJECTIVES: The etiology of sporadic idiopathic Parkinson's disease (PD) is considered multifactorial with both genetic and environmental factors modifying the disease expression. Recent studies suggest that polymorphism in monoamine oxidase B (MAOB) and catechol-O-methyltransferase (COMT) might influence the risk and treatment of PD. The aim of the study was to evaluate the effect of MAOB and COMT genetic polymorphism on effective daily dose of levodopa applied during the first 5 years of treatment, and to find out if a relationship exists between MAOB and COMT haplotypes and motor disturbances onset in PD patients treated with levodopa preparations. MATERIALS AND METHODS: A total of 95 patients (40 females and 55 males) of Polish origin diagnosed with sporadic PD were enrolled into the study, and were divided into two groups. Group 1 - patients treated with doses of levodopa below 500 mg/day during the first 5 years of treatment. Group 2 - patients requiring levodopa doses exceeding 500 mg/24 h during the first 5 years of treatment. Low activity alleles of MAOB and COMT, i.e. MAOB allele A and COMT(L) as well as high activity ones, i.e. MAOB allele G and COMT(H), were determined using PCR-RFLP method. RESULTS: No statistically significant differences were found in MAOB and COMT allele distribution in the two groups. However, the frequency of COMT(L/L) homozygotes was higher in the group treated with low doses of levodopa when compared with the second group. MAOB and COMT AG-HH haplotype predominated in the group of females treated with high daily doses of levodopa when compared with AG-LL haplotype in the group of females treated with low daily doses of levodopa (<500 mg/24 h). CONCLUSION: The results of the study suggest that patients with COMT(L/L) genotype and possibly MAOB genotype A may benefit from more efficient and safer levodopa therapy.
Asunto(s)
Antiparkinsonianos/administración & dosificación , Catecol O-Metiltransferasa/genética , Levodopa/administración & dosificación , Monoaminooxidasa/genética , Enfermedad de Parkinson/genética , Polimorfismo Genético , Adulto , Edad de Inicio , Anciano , Anciano de 80 o más Años , Relación Dosis-Respuesta a Droga , Femenino , Haplotipos , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/tratamiento farmacológico , Enfermedad de Parkinson/enzimología , Estudios RetrospectivosRESUMEN
BACKGROUND AND AIM: Von Willebrand factor (vWF) and fibrinogen (Fb) have recently emerged as plausible familial determinants of atherothrombosis. We investigated whether the vWF and Fb levels in patients with ischemic cerebrovascular stroke (ICS) correlate with those in their children. METHODS AND RESULTS: The study group consisted of 28 families (56 parents and 34 children) with one parent who had suffered an ICS at least three months before the study. All of the ICS patients had hyperlipoproteinemia and most arterial hypertension. The control group consisted of 15 families (30 parents and 20 children). The age of the parents and children did not exceed 55 and 16 years. The ICS parents had significantly higher vWF, Fb and protein C (PC) levels than the controls (vWF--fathers: 121.0 +/- 42.5% vs 79.2 +/- 23.4%; vWF--mothers: 110.7 +/- 40.1% vs 82.4 +/- 20.9%; Fb--fathers: 4.12 +/- 0.74 g/L vs 3.01 +/- 0.54 g/L; Fb--mothers: 3.64 +/- 0.84 gL vs 2.98 +/- 0.35 g/L; PC--fathers: 116.0 +/- 12.3% vs 105.6 +/- 13.7%; PC--mothers: 114.4 +/- 15.8% vs 105.0 +/- 12.2%). The children of the ICS parents had significantly higher PC and body mass index (BMI) values than the controls (PC: 102.6 +/- 13.7% vs 92.7 +/- 10.7%; BMI: 20.6 +/- 3.8 vs 17.8 +/- 3.5 Kg/m2), as well as an atherogenic lipid profile, higher blood pressure (BP) and a tendency toward higher vWF levels. Correlations between the ICS parents and their children were found for vWF, factor VIIc, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and BP, which were closer in the case of fathers. CONCLUSION: Regardless of gender, the parents with a history of ICS had a procoagulant state, with high levels of vWF, Fb and PC. In terms of inheritance, the most adverse risk factor profile was found in the children of ICS fathers.
Asunto(s)
Fibrinógeno/análisis , Predisposición Genética a la Enfermedad , Accidente Cerebrovascular/epidemiología , Trombosis/epidemiología , Factor de von Willebrand/análisis , Adulto , Distribución por Edad , Análisis de Varianza , Biomarcadores/análisis , Análisis Químico de la Sangre , Determinación de la Presión Sanguínea , Estudios de Casos y Controles , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Probabilidad , Valores de Referencia , Factores de Riesgo , Sensibilidad y Especificidad , Distribución por Sexo , Estadísticas no Paramétricas , Accidente Cerebrovascular/genética , Trombosis/genéticaRESUMEN
27 patients (22 women, 5 men); age 17 to 56 yr. (mean age 37 yr.) were included in this study, 4 had primary antiphospholipid syndrome and 18 secondary antiphospholipid syndrome in the course of systemic connective tissue disease and in 5 cases increased levels of anticardiolipid antibodies were found which did not meet the criteria necessary for diagnosis of secondary antiphospholipid syndrome. The mean duration of the disease was 8 yrs. Among primary antiphospholipid syndrome patients two had ischaemic stroke, one migraine-like headache and seizures. 18 patients had lupus erythematosus, two mixed connective tissue disease, one rheumatoid arthritis, one Sjögren syndrome, one Behçet disease. In 55% of patients migraine-like headache, polyneuropathies, encephalophaties, stroke, seizures and vision disturbances were present. In 18.5% of patients EEG exam revealed focal lesions with tendency for generalisation. On brain stem auditory evoked potentials examination, in 11.1% of patients conductivity lesions in mesencephalon and pons were found, visual evoked potentials, in 11.1% of patients in visual tracts. In 37% of patients, neuropathy was found on EMG exam. Neurological symptoms are one of the most frequent disorders in systemic connective tissue disease associated with the presence of anicardiolipin antibodies.
Asunto(s)
Anticuerpos Anticardiolipina/inmunología , Síndrome Antifosfolípido/complicaciones , Síndrome Antifosfolípido/inmunología , Isquemia Encefálica/complicaciones , Adolescente , Adulto , Encéfalo/irrigación sanguínea , Isquemia Encefálica/diagnóstico , Enfermedades del Tejido Conjuntivo/complicaciones , Enfermedades del Tejido Conjuntivo/inmunología , Electroencefalografía , Electromiografía , Ensayo de Inmunoadsorción Enzimática , Potenciales Evocados Auditivos del Tronco Encefálico/fisiología , Potenciales Evocados Visuales/fisiología , Extremidades/fisiopatología , Femenino , Humanos , Masculino , Mesencéfalo/fisiopatología , Persona de Mediana Edad , Conducción Nerviosa/fisiología , Puente/fisiopatologíaRESUMEN
BACKGROUND AND AIM: High plasma lipoprotein(a) [Lp(a)] and homocysteine (HCY) levels are now considered to be independent risk factors for cerebro- and cardiovascular atherosclerotic occlusive disease, but little is known about the influence of Lp(a) and HCY on the early events of ischemic disease or their significance in subjects with a positive family history of ischemia. The aim of this study was to evaluate the relationship between HCY levels and the severity of ischemic cerebral stroke, and investigate whether there was a correlation between Lp(a) and HCY levels in the stroke patients and their children. METHODS: The study involved 35 patients with early ischemic cerebral stroke aged 46.1 +/- 6.6 years and their 50 children aged 17.2 +/- 5.5 years. The patients were grouped on the basis of the form of the stroke (transient, progressive or complete stroke), and their levels of Lp(a), HCY, uric acid (UA), fibrinogen (Fb) and factor VII (FVII) activity were measured. RESULTS: HCY and Lp(a) concentrations increased with the severity of the ischemia, being highest in the patients with complete stroke (15.1 +/- 2.9 mumol/L and 32.9 +/- 37.6 mg/dL respectively). A similar trend was found in the offspring, with the highest HCY and Lp(a) values in the children of complete stroke patients (12.6 +/- 4.4 mumol/L and 23.0 +/- 24.6 mg/dL). The control values were respectively 8.7 +/- 1.6 mumol/L and 5.35 +/- 7.05 mg/dL. The following correlations between the parents and children were noted: Lp(a) (r = 0.87 p < 0.0001), UA (r = 0.71 p < 0.001), HCY (r = 0.45 p < 0.05), FVII (r = 0.45 p < 0.05), and Fb (r = 0.42 p = 0.06). Correlations between Lp(a) and HCY (r = 0.47 p < 0.05) and Fb and FVII (r = 0.60 p < 0.01) were found in the children. Multiple regression analysis revealed that only Lp(a) and Fb significantly influenced HCY levels in the offspring with a positive family history. CONCLUSIONS: HCY levels correlate with the severity of ischemic cerebral stroke and, in families with a history of ischemic cerebral stroke, the levels of the risk factors in children are determined by the levels in their parents.
Asunto(s)
Isquemia Encefálica/sangre , Homocisteína/sangre , Lipoproteína(a)/sangre , Accidente Cerebrovascular/sangre , Adolescente , Adulto , Isquemia Encefálica/genética , Factor VII/análisis , Femenino , Fibrinógeno/análisis , Predisposición Genética a la Enfermedad , Humanos , Masculino , Persona de Mediana Edad , Análisis de Regresión , Factores de Riesgo , Índice de Severidad de la Enfermedad , Accidente Cerebrovascular/genética , Ácido Úrico/sangreRESUMEN
The study included 55 patients (18 females, 37 males); aged 32-75 yr. who divided into three groups according to the severity of clinical picture: 12 people with reversible ischaemic stroke (RIS), 20 with progressive ischaemic stroke (PIS), 23 with complete stroke (CS). Levels of total cholesterol, high density lipoproteins (HDL), apolipoproteins A1 and B (ApoA1 and ApoB), fibrinogen (Fb) and Lp (a) were measured. Lipid factor of atherosclerosis (ATHi) was quantified. Qualitative evaluation of lipids contents in cerebrospinal fluid (CSR) was performed. Distribution of cholesterol--containing lipids among the fractions, despite low values, had clearly atherogenic profile. 12% patients with irreversible ischaemic stroke, 16% with progressive ischaemic stroke and 85% with complete stroke had Fb level above 4 g/l. Lp (a) levels in all cases were significantly higher in the cells isolated from CSF. The severity of the stroke correlated with increasing levels of lipids in the cells isolated from SF. There was correlation between LDL cholesterol and content of lipids in the cells from CSF.
Asunto(s)
Isquemia Encefálica/etiología , Encéfalo/irrigación sanguínea , Fibrinógeno/metabolismo , Lípidos/líquido cefalorraquídeo , Isquemia Encefálica/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la EnfermedadRESUMEN
49 patients diagnosed as amyotrophic lateral sclerosis (ALS), hospitalized between 1986-1995, inhabitants of Szczecin-City were included in this study. ALS was diagnosed according to WFN criteria. The control group consisted of 60 people. Men:women ratio was 1.57:1. The mean age at ALS onset was 53.2 years. The disease was most often present between 51 and 60 years. Only one ALS patient was observed in the group of patients aged 21-30 and in the group of individuals older than 70 years. ALS incidence was 0.9 per 100,000 inhabitants and its prevalence in 1995 was 2.7 per 100,000 inhabitants. The mean duration was 30.8 months and was slightly higher in women. The shortest duration was observed in the bulbar form of ALS--21 months. Patients with ALS had been exposed to head trauma and contact with animals more often than the average population. There is no difference between Szczecin and previously analysed Polish cities in the considered epidemiological parameters. No discrepancies of clinical picture and course of the disease were found in comparison with other reported by other authors.
Asunto(s)
Esclerosis Amiotrófica Lateral/diagnóstico , Esclerosis Amiotrófica Lateral/epidemiología , Adulto , Distribución por Edad , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polonia/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Distribución por Sexo , Factores de TiempoRESUMEN
Clinical investigations on the case of a 61-year-old woman with a few year history of neurological symptoms, who underwent mastectomy caused by ductal carcinoma, 12 years prior to the appearance of the clinical syndrome did not reveal the cause of the disease. On the post-mortem examination solitary metastasis of adenocarcinoma to the retroperitoneal lymph node was present. Histologically, in the cerebellum the degeneration of the Purkinje cells with extensive Bergmann glia reaction was diagnosed. The authors discuss the connection between lesions of CNS and neoplastic disease.
Asunto(s)
Neoplasias de la Mama/complicaciones , Carcinoma Ductal de Mama/complicaciones , Enfermedades Cerebelosas/etiología , Cerebelo/patología , Síndromes Paraneoplásicos/etiología , Carcinoma Ductal de Mama/secundario , Enfermedades Cerebelosas/patología , Resultado Fatal , Femenino , Gliosis/etiología , Gliosis/patología , Humanos , Persona de Mediana Edad , Degeneración Nerviosa , Síndromes Paraneoplásicos/patología , Paraplejía/etiología , Paraplejía/patología , Neoplasias Retroperitoneales/secundario , Factores de TiempoRESUMEN
A case of 33-year-old man, who underwent numerous hospital admissions caused by multiple progressing disseminated neurological abnormalities is presented. At first multiple sclerosis was a tentative diagnosis. Because of persistent eosinophilia, after exclusion of other causes of increased eosinophil count, idiopathic hyperoesinophilic syndrome was diagnosed. The case was confirmed neuropathologically. The authors discuss causes of idiopathic hyperoesinophilic syndrome. Very exceptional history of the syndrome, with dominant CNS involvement, is discussed.
Asunto(s)
Encéfalo/fisiopatología , Eosinofilia/fisiopatología , Adulto , Diagnóstico Diferencial , Electrocardiografía , Electroencefalografía , Eosinofilia/diagnóstico , Resultado Fatal , Humanos , Masculino , Esclerosis Múltiple/diagnóstico , SíndromeRESUMEN
A 14-year-old boy was admitted to our Department due to peripheral palsy of right VII and bilateral of the VI cranial nerves, spasticity, cerebellar symptoms as well as to dysphagia and dysarthria. In general, he was hospitalized 13 times because of the disease of a relapsing-remitting and next progressive course. He died 31 years after onset of the disease. Multiple sclerosis was diagnosed. Brain autopsy revealed tumor involving almost all brain stem structures and a part of right cerebellar hemisphere. Histologically, cavernous angioma was diagnosed.
Asunto(s)
Neoplasias Encefálicas/diagnóstico , Hemangioma Cavernoso/diagnóstico , Esclerosis Múltiple/diagnóstico , Adolescente , Encéfalo/patología , Diagnóstico Diferencial , Resultado Fatal , Humanos , MasculinoRESUMEN
A case of 32-year-old woman was described in which progressive bilateral hearing and visual loss, hypokinesia, epileptic focal seizures were present. The brain CT-scan after a few years of the disease onset, showed the presence of multiple extracerebral tumors. Multiple meningiomas were diagnosed, probably associated with von Recklinghausen's disease. On the post-mortem examination 48 tumors of the different size and location in subdural space were found. Histologically transitional meningiomas with predominance of fibroblastic component were diagnosed. It was very interesting that apart from intracranial location of meningiomas, the same type of tumor was found within thoracic spinal root. The authors discuss the mechanisms of the development of multiple meningiomas and its association with neurofibromatosis.
Asunto(s)
Neoplasias Encefálicas/patología , Duramadre/patología , Meningioma/patología , Neoplasias Primarias Múltiples , Adulto , Edad de Inicio , Neoplasias Encefálicas/cirugía , Neoplasias Encefálicas/ultraestructura , Duramadre/cirugía , Duramadre/ultraestructura , Resultado Fatal , Femenino , Humanos , Meningioma/cirugía , Meningioma/ultraestructura , Tomografía Computarizada por Rayos XRESUMEN
The reported case was diagnosed formerly as multiple sclerosis. On autopsy it was found that disseminated neurological symptoms were caused by a neurofibroma of the foramen magnum. The diagnostic difficulties in cases of tumours in this location are discussed.
Asunto(s)
Neoplasias Encefálicas/diagnóstico , Foramen Magno , Neurofibroma/diagnóstico , Neoplasias de la Médula Espinal/diagnóstico , Adulto , Neoplasias Encefálicas/patología , Femenino , Humanos , Neurofibroma/patología , Neoplasias de la Médula Espinal/patologíaRESUMEN
The reported analysis comprised 81 patients dying of acute non-lymphoblastic leukaemia type M1, M2, M4 and blastic crises in chronic myelocytic leukaemia. It was observed that the number of cases of cerebellar granular layer atrophy rose markedly in the years 1984-1990 as compared with 1976-1983 (45.4% vs 16.2%). It is suggested that this was due to the introduction of cytostatic treatment schedules with higher doses of cytosine arabinoside (ARAC), especially TAD (6-thioguanine, ARAC, daunorubicin). Cerebellar granular layer atrophy seems to be dependent rather on the cumulative dose of ARAC and not on a single high dose of that drug.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Crisis Blástica/tratamiento farmacológico , Corteza Cerebelosa/patología , Citarabina/efectos adversos , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Leucemia Mieloide Aguda/tratamiento farmacológico , Adolescente , Adulto , Anciano , Aminoglutetimida/administración & dosificación , Atrofia/inducido químicamente , Crisis Blástica/patología , Corteza Cerebelosa/efectos de los fármacos , Ciclofosfamida/administración & dosificación , Citarabina/administración & dosificación , Danazol/administración & dosificación , Relación Dosis-Respuesta a Droga , Doxorrubicina/administración & dosificación , Femenino , Humanos , Leucemia Mielógena Crónica BCR-ABL Positiva/patología , Leucemia Mieloide Aguda/patología , Masculino , Persona de Mediana Edad , Prednisolona/administración & dosificación , Prednisona/administración & dosificación , Tamoxifeno/administración & dosificación , Vincristina/administración & dosificaciónRESUMEN
Neuropathological analysis of spinal cord and spinal roots as well as spinal leptomeninges after intrathecal methotrexate (MTX) therapy was performed in 44 cases of non-Hodgkin's lymphomas of high malignancy. It was showed that MTX applied according to the program applied as a prophylaxis against lymphomatous infiltrations in the central nervous system, caused demyelination of spinal roots and fibrosis of leptomeninges and their blood vessels. However, it does not affect spinal cord structures. Described morphological changes remained clinically mute, therefore they do not seem counterindicate prophylactic intrathecal MTX application.
Asunto(s)
Linfoma no Hodgkin/tratamiento farmacológico , Linfoma no Hodgkin/patología , Metotrexato/uso terapéutico , Neoplasias de la Médula Espinal/patología , Médula Espinal/patología , Raíces Nerviosas Espinales/patología , Adolescente , Adulto , Anciano , Cauda Equina/patología , Cauda Equina/ultraestructura , Enfermedades Desmielinizantes , Femenino , Humanos , Inyecciones Espinales , Linfoma no Hodgkin/diagnóstico , Linfoma no Hodgkin/ultraestructura , Masculino , Metotrexato/administración & dosificación , Persona de Mediana Edad , Vaina de Mielina/ultraestructura , Médula Espinal/ultraestructura , Neoplasias de la Médula Espinal/diagnóstico , Neoplasias de la Médula Espinal/ultraestructura , Raíces Nerviosas Espinales/ultraestructuraRESUMEN
Neuropathological investigations have been performed on 61 patients of both sexes, aged 17-60 years, deceased owing to nonlymphoblastic leukemias. The cerebellar degenerative changes appeared in 51 percent of cases mainly in the grey matter. Distinct rarefaction or atrophy of the cerebellar granular layer and the dentate nuclei were frequent phenomena. The following classification of the cerebellar granular layer damage was used: I degrees - focal rarefaction, II degrees - diffuse distinct rarefaction, III degrees - focal atrophy, IV degrees - diffuse atrophy. The investigations suggest that polychemotherapy is one of the causes of cerebellar degenerative changes, especially atrophy of the granular layer and dentate nuclei, as well as demyelination. In leukemias of short duration more frequently than in the remaining cases lymphocytic perivenous infiltrations appeared in the white matter. It seems to be a consequence of immunopathological reactions between the neoplasm and the nervous tissue in cases with more dynamic course of the disease.
Asunto(s)
Cerebelo/patología , Leucemia Monocítica Aguda/patología , Leucemia Mieloide Aguda/patología , Leucemia Mielomonocítica Aguda/patología , Adolescente , Adulto , Atrofia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Células de Purkinje/patologíaRESUMEN
The authors present an analysis of the clinical course of 6 cases of Creutzfeldt-Jakob disease (patients were aged from 27 to 59 years). The diagnosis was established during the life of the patients. In the neurological status dementia and syndromes of pyramidal and extrapyramidal lesions predominated. Neuropathological examinations in 5 cases demonstrated also considerable cerebellar damage, however, clinical signs of this damage were noted in two patients only. EEG findings were of greatest importance among the laboratory investigations.
Asunto(s)
Síndrome de Creutzfeldt-Jakob/diagnóstico , Adulto , Enfermedades de los Ganglios Basales/clasificación , Enfermedades de los Ganglios Basales/diagnóstico , Enfermedades Cerebelosas/diagnóstico , Síndrome de Creutzfeldt-Jakob/clasificación , Demencia/clasificación , Demencia/diagnóstico , Diagnóstico Diferencial , Electroencefalografía , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
On the basis of experimental investigations the authors describe the causes of certain complications after extracorporeal circulation. The experiments were carried out in 11 sheep. The duration of extracorporeal circulation was from 1 to 2 hours. It was found that the intracranial pressure, which is an indicator of intracranial expansion, increased with increasing time of cannule introduction into the heart and veins, with the volume of perfusing fluid given during the procedure, with falling value of the arterial blood pressure and impairment of venous return. The intracranial pressure increased also with the duration of extracorporeal circulation. Falls of the arterial blood pressure and venous return occurred simultaneously with impairment of the cerebral blood flow causing cerebral hypoxia. The results of histological examinations of brain tissue were consistent with central nervous system hypoxia, and showed also that these changes developed within the first hour of extracorporeal circulation. The complications arising after extracorporeal circulation may be due to brain oedema. Thus it would be recommendable to pay attention during preoperative management of the patients to the possibility of brain oedema as a complication of the procedure.