Asunto(s)

RESUMEN

The history of cerebral trauma is a large subject and this overview is an attempt to summarise the main trends of understanding and management over the millenia. Although beginning with anthropological evidence, papyrology and Homeric times, the main impetus for its scientific study began with Hippocrates, but little progress was made until the Salernitan period. Because the ancients believed it was the fractured bone and not the underlying neurological status that mattered, and determined whether an operation was to be performed, the classification of head injuries was based on the types of skull fracture and not the underlying neurological damage. Only in recent centuries was it realised that it was not skull fractures that were important but the brain lesion. Further improvement in management occurred during warring periods but the lessons learned were not passed on, although mortality from military wounds has steadily declined. Since only a small percentage of head injuries require surgery, consideration should be given to reserve the time and skills of the neurosurgeon to those cases requiring his expertise; this would require that the preliminary care should be undertaken by physicians with a specific interest in this field.

Asunto(s)

RESUMEN

This study investigates variations in motor neuron disease (MND) mortality rates between the counties of England and Wales from 1981 to 1989, and their relationship with gamma-ray dose rates, indoor radon gas concentrations and enhanced general life expectancy. A strong correlation was confirmed between age-adjusted rates of MND mortality and life expectancy. Weaker, but statistically significant, associations were observed between indoor radon gas concentrations, terrestrial gamma radiation and marginal variations in MND mortality. Life expectancy and radon gas concentrations were positively associated with MND mortality rates whilst gamma radiation was negatively associated. The negative correlation of gamma radiation with MND mortality may be understood with reference to its negative effects on overall population life expectancy. Radon gas concentrations seemingly account for a small elevation in MND mortality, amounting to at most 4% of total deaths. Further research is required to investigate this association.

Asunto(s)

Asunto(s)

RESUMEN

Motor neuron disease (MND) is a progressive and invariably fatal disease affecting the nuclei of the pyramidal tract and anterior horn cells. Despite intensive research into environmental agents associated with the onset or course of the disease, there is no single factor that can be confidently linked over time with regional, national or international variations in mortality rates. However, unusual variations in MND mortality rate in Japan from 1950-1990 were found to correlate highly significantly with variations in radioactive fallout released by atmospheric weapons testing in the Pacific. This association could be explained by the ingestion of alpha-emitting radionuclides acting upon a pre-existing susceptible subpopulation, a hypothesis which is consistent with recent research on the epidemiology and pathology of MND. However, it is likely that radiation is only one of many factors that act singly or in combination to accelerate the condition in subpopulations susceptible to MND.

Asunto(s)

RESUMEN

The first descriptions of migraine can be traced back nearly 4,000 years from the ancient civilizations of Mesopotamia (Sumeria and Babylonia) through Egyptian, Greek and Roman epochs. Through Byzantine, Arabic and Medieval times there are only patchy references until the 17th century, when European physicians first gave full case reports.

Asunto(s)

RESUMEN

By tracing in the work of medical authorities, some of whom are not widely quoted, the changing meaning of three neurological terms used in ancient Greece - poplexia, epilepsia and cephalalgia - the development of Greek ideas about neurological science may be appreciated. It may be concluded that the achievement of the schools of Greek medicine was in keeping with the level attained by the ancient Greeks in philosophy and other aspects of civilization.

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

Arm tremor in Parkinson's disease occurs during rest which has been explained by a specific tremulous mechanism activated during rest. During action or posture maintenance, the tremor may persist or recur, but with reduced amplitude. We present 2 patients with idiopathic Parkinson's disease who showed persisting arm tremor which was most marked during action rather than during rest. The patterns of upper limb tremor were investigated during rest, maintenance of fixed posture, and slow movement, using an advanced computerized movement-monitoring system (Coda 3). Four parkinsonian patients showing tremor under all conditions were studied, comparing 2 patients whose tremor was most marked during rest with 2 whose tremor was most marked during action. All showed intermediate amplitudes during posture maintenance. Patterns of tremor frequency were very similar between patients, irrespective of amplitude characteristics. These features suggest that tremors in all patients originate in a single, complex mechanism which may involve both central and peripheral mechanisms.

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

Platelet [3H]imipramine binding was measured in 40 migrainous (7 classical and 33 common) and 17 tension headache patients and in 28 normal controls. A significant reduction in Bmax was found in migraine compared with controls (p less than 0.05) but not in tension headache. In migraine, there was no significant relationship between Bmax and depression or anxiety score on the self-rating Hospital Anxiety and Depression (HAD) Scale, suggesting that the reduction in Bmax is a concomitant of migraine itself rather than a manifestation of associated depression. Preliminary evaluation using the Schedule of Affective Disorders and Schizophrenia-Lifetime Version (SADS-L) tended to confirm this conclusion.

Asunto(s)