| 1. |
- Lindgren, Arne, et al.
(författare)
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Clinical lacunar syndromes as predictors of lacunar infarcts. A comparison of acute clinical lacunar syndromes and findings on diffusion-weighted MRI
- 2000
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 101:2, s. 128-134
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate if patients with acute lacunar syndromes have acute lacunar infarcts or other types of cerebral lesions on diffusion-weighted MRI. METHODS: Patients with acute lacunar syndromes underwent echo-planar diffusion MRI of the brain within 3 days after stroke onset. Localization and size of lesions with hyperintense signal were determined, compared with clinical characteristics and with findings on follow-up T2-weighted MRI. RESULTS: Twenty-three patients participated in the study. Thirteen patients had pure motor stroke, 1 pure sensory stroke, 8 sensorimotor stroke, and 1 ataxic hemiparesis. Twenty-two patients had at least one lesion with increased signal on diffusion-weighted MR images. These acute lesions were in the internal capsule/ basal ganglia/thalamus in 13 patients, subcortical white matter in 5 patients, brainstem in 2 patients, cortex (multiple small lesions) in 1 patient, and cortex + basal ganglia in 1 patient. The median volume of the lesions was 0.6 ml on the initial examination and on follow-up, of 17 patients after 1 to 5 months, 0.5 ml. CONCLUSIONS: Almost all patients with acute ischemic lacunar syndromes have acute lesions on echo-planar diffusion-weighted MRI within 3 days after stroke onset. These lesions are mostly small and subcortical, compatible with lacunar infarcts caused by single penetrating artery occlusion, but in a minor proportion of patients (2 of 23 in our study) a cortical involvement is found.
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| 2. |
- Brådvik, Björn, et al.
(författare)
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Disturbances of speech prosody following right hemisphere infarcts
- 1991
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Ingår i: Acta Neurologica Scandinavica. - 1600-0404. ; 84:2, s. 114-126
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Tidskriftsartikel (refereegranskat)abstract
- The ability to perceive and express emotional, as well as number of linguistic prosodic qualities of speech was tested in 20 Swedish-speaking patients with right-sided cortical, as well as purely subcortical brain infarcts, and in 18 normal controls. The infarcts were assessed by clinical neurological examination, and by CT, EEG, and measurements of regional cerebral blood flow (rCBF). In the patients the identification of emotional messages was disturbed, as well as the identification and production of several linguistic prosodic qualities. The study supports the claim that prosodic impairment could be linguistic in nature, and not secondary to affective disorder. The total degree of anatomical and functional disturbance of the right hemisphere played a role for both the ability to identify emotional messages and for identification of two of the linguistic prosodic qualities tested. However, it was not possible to find support for the hypothesis that the organization of prosody in the right hemisphere mirrors that of propositional speech on the left side.
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| 3. |
- Brådvik, Björn, et al.
(författare)
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Do single right hemisphere infarcts or transient ischaemic attacks result in aprosody?
- 1990
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Ingår i: Acta Neurologica Scandinavica. - 1600-0404. ; 81:1, s. 61-70
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Tidskriftsartikel (refereegranskat)abstract
- The ability to perceive and express prosodic qualities of speech was tested in 21 patients with a single focal ischaemic disturbance of the right hemisphere, 14 patients having an infarct and 7 transient ischaemic attacks, and in 21 age-matched normal controls. All patients were predominantly right-handed. None showed signs of aphasia. Pure tone audiometry showed acceptable hearing for speech. The cerebral lesions were assessed by clinical neurologic examination, and by CT, EEG and measurement of regional cerebral blood flow (rCBF) using intravenous 133-xenon. The prosodia test included items testing: the ability to perceive accentual and emotional qualities of speech, and the ability to express and vary such qualities. The test did not discriminate between the patients and the controls, although some patients had large right-sided lesions. This negative finding indicates that aprosody in patients with brain lesions appears more difficult to detect than has previously been assumed. Highly sensitive tests are most likely required.
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| 4. |
- Brådvik, Björn, et al.
(författare)
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Spatial impairment following right hemisphere transient ischaemic attacks in patients without carotid artery stenosis
- 1989
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Ingår i: Acta Neurologica Scandinavica. - 1600-0404. ; 80:5, s. 411-418
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Tidskriftsartikel (refereegranskat)abstract
- Neuropsychological testing was performed on: 10 right-handed patients who had had 1-4 right hemisphere transient ischaemic attacks (TIAs), 10 normal controls, 10 house painters with long-term exposure to organic solvents, and 10 patients with liver cirrhosis. The subjects in each group were matched for age and education. No TIA patient had significant internal carotid artery stenosis, and CT was normal except in one patient, although magnetic resonance imaging (MRI) performed 3 years after the testing was abnormal in 4/8 cases. No patient reported additional distinct TIAs during the period between neuropsychological testing and MRI. The TIA patients showed lateralized signs of spatial impairment, whereas the cirrhotics and also (but to a lesser degree) the house painters showed signs of diffuse cerebral dysfunction. The study shows that hemispheric TIAs in patients without significant internal carotid artery stenosis may result in persistent focal cognitive impairment. This can be demonstrated with sensitive neuropsychological instruments even when MRI is normal.
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| 5. |
- Norrving, Bo, et al.
(författare)
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Isolated acute vertigo in the elderly; vestibular or vascular disease?
- 1995
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Ingår i: Acta Neurologica Scandinavica. - 1600-0404. ; 91:1, s. 43-48
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION--Elderly patients with isolated acute vertigo are commonly encountered in clinical practice, but little is known about the underlying cause of the symptoms. MATERIAL & METHODS--We prospectively studied 24 patients aged 50-75 years with the acute onset of isolated vertigo lasting > 48 h and no abnormality on neurological examination other than nystagmus. The study protocol included neuro-imaging (MRI 22 patients, CT 2 patients), Doppler sonography, and electro-oculography. RESULTS--MRI/CT showed the presence of an infarction of the caudal cerebellum in six patients (25%), 3 of whom had a potential cardioembolic source and normal Doppler sonography findings, whereas 3 patients had ipsilateral vertebral artery occlusion and normal cardiac findings. MRI of the posterior fossa was normal in 18 patients. On electro-oculography, ataxic pursuit eye movements was a characteristic finding in patients with cerebellar infarction, whereas caloric test findings were not discriminative. CONCLUSION--A caudal cerebellar infarction may easily be misdiagnosed clinically as a labyrinthine disorder, and was found to be the cause in one fourth of patients presenting with isolated acute vertigo.
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