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  • 1
    ISSN: 1432-1084
    Keywords: Key words: Dural arteriovenous fistula – MR imaging – Endovascular therapy – Myelopathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We report on a 46-year-old patient in whom an intracranial dural arteriovenous (AV) fistula, supplied by a branch of the ascending pharyngeal artery, drained into spinal veins and produced rapidly progressive symptoms of myelopathy and brainstem dysfunction including respiratory insufficiency. Magnetic resonance imaging studies demonstrated brainstem oedema and dilated veins of the brainstem and spinal cord. Endovascular embolization of the fistula led to good neurological recovery, although the patient had been paraplegic for 24 h prior to embolization. This case demonstrates the MRI characteristics of an intracranial dural AV fistula with spinal drainage and illustrates the importance of early diagnosis and treatment. Even paraplegia may be reversible, if angiography is performed and the fistula treated before ischaemic and gliotic changes become irreversible.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Schlaganfall ; Paraneoplastische Hämostasestörung ; Trousseau-Syndrom ; Ovarialtumor ; Atypische Endosalpingiose ; Key words Stroke ; Paraneoplastic hemostasis ; Trousseau’s syndrom ; Ovarian tumor ; Atypical endosalpingiosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Thrombembolic events as paraneoplastic complications in malignant disease account for severe morbidity and mortality in these patients. In some cases disturbance in hemostasis is the first manifestation of a neoplastic process. We report the cases of two patients with cerebral and extracerebral vessel occlusions, in whom epithelial tumors of low malignant potential (borderline-tumors) of ovar and peritoneum were diagnosed later on. In one case the removal of the tumor stopped the coagulation problems. The second patient died a few days after the first symptoms with devastating multiple vessel occlusion. In stroke of unknown aetiology a paraneoplastic process should be kept in mind. The diagnosis is more probable with recurrent thrombembolism in different body regions and when warfarin therapie was ineffective. Thoughtful coagulation studies and a tumor search program is recommended in these cases.
    Notes: Zusammenfassung Thrombembolische Komplikationen treten paraneoplastisch bei malignen Erkrankungen auf und tragen zu Morbidität und Mortalität bei. In einigen Fällen sind Hämostasestörungen die erste Manifestation eines neoplastischen Prozesses. Wir beschreiben die Fälle von zwei Patientinnen mit zerebralen und extrazerebralen Gefäßverschlüssen, bei denen nach der Gefäßmanifestation epitheliale Tumoren mit niedrigem Malignitätspotential (Borderline-Tumoren) an Ovar und Peritoneum diagnostiziert wurden. Paraneoplastische Hämostasestörungen sind bei diesen Tumoren mit per se guter Prognose bisher nicht beschrieben worden. In einem Fall führte die Tumorentfernung zum Sistieren der Gerinnungsstörung. Die zweite Patientin starb wenige Tage nach den ersten Symptomen an den Folgen multipler Gefäßverschlüsse. Bei Schlaganfällen unklarer Ätiologie sollte auch an eine paraneoplastische Genese gedacht werden. Besonders wahrscheinlich ist die Diagnose bei rezidivierenden venösen und arteriellen Gefäßverschlüssen in verschiedenen Körperregionen und bei der Resistenz auf die Therapie mit Vitamin-K-Antagonisten. Eine sorgfältige Gerinnungsdiagnostik und ein Tumorsuchprogramm sind in diesen Fällen zu empfehlen.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1749-6632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Natural Sciences in General
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1573-7373
    Keywords: meningeal neoplasm ; methotrexate ; cerebral artery disease ; cerebral infarction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report on a 33-year-old woman with carcinomatous meningitis due to carcinoma of the breast who developed multiple cerebral infarctions within four days after intrathecal chemotherapy with methotrexate. MR angiography revealed a narrowing of basal cerebral arteries, which is consistent with vasculopathy. The vasculopathy was probably due to carcinomatous meningitis itself, an acute toxic effect of methotrexate, or a combination of both.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1459
    Keywords: Aseptic meningitis ; Radiculitis ; Spirochaetales ; Spirochaetales infections
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In all the sera of four patients with meningoradiculitis of Bannwarth admitted to the neurological department of the University Clinic Grosshadern in Munich in 1983, we found antibodies against Ixodes dammini spirochetes. In three patients antibodies were also present in the CSF. In one patient, we isolated spirochetes from the CSF and demonstrated specific IgG antibodies in serum and CSF. This spirochete was morphologically indistinguishable from the I. dammini spirochete and a spirochete isolated from the thick I. ricinus in the Munich area. Despite distinct differences in the clinical manifestation of Lyme disease when accompanied by neurological complications and meningoradiculitis of Bannwarth, we suggest that both diseases are caused by spirochetes.
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  • 6
    ISSN: 1432-1459
    Keywords: Myelin basic protein ; AIDS ; HIV encephalopathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The major pathological abnormalities of HIV encephalopathy are infiltrates of macrophages, multinucleated giant cells, microglial nodules and demyelination. Elevated myelin basic protein (MBP) levels in the cerebrospinal fluid (CSF) provide a marker for central nervous system demyelination. The purpose of this study was to investigate the possible role of CSF MBP as a useful and early marker for HIV encephalopathy. The CSF of 40 consecutive patients with HIV infection of various clinical stages was investigated, including 13 patients with clinical signs of HIV encephalopathy. CSF MBP was elevated in 2 patients (5.0 and 5.3 ng/ml), both of whom had moderate to severe HIV encephalopathy. The course of the disease was rapid in both patients. In the remaining 38 patients, CSF MBP levels were marginally elevated (n=12) or normal (n=26). Our results suggest that CSF MBP is not a sensitive marker for the diagnosis and evaluation of HIV encephalopathy, but may be an indicator of prognosis for the course of the disease. There were only few findings of elevated CSF MBP levels in patients with HIV encephalopathy in the current study, and this may be because the disorder progressed slowly in most patients. It is possible that CSF MBP levels in HIV encephalopathy may only be elevated with acute clinical deterioration but are normal in slowly progressive forms of demyelination, as seen in multiple sclerosis.
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Infection 24 (1996), S. 391-391 
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Infection 18 (1990), S. 262-262 
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Infection 23 (1995), S. 221-221 
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 10
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Ein indirekter Immunfluoreszenztest zum Nachweis von Antikörpern gegen durch Zecken des Genus Ixodes übertragene Spirochäten wird eingehend beschrieben. Unterschiede in der Reaktivität vonIxodes dammini- undIxodes ricinus-Spirochätenantigen im indirekten Immunfluoreszenztest wurden nicht beobachtet. Kreuzreaktionen durch Antikörper gegenTreponema pallidum undTreponema phagedenis können durch eine erschöpfende Absorption der Seren mitT. phagedenis sicher vermieden werden. Kreuzreaktionen mit Leptospiren konnten im Immunfluoreszenztest nicht beobachtet werden. Beim Nachweis von IgM Antikörpern ist damit zu rechnen, daß durch Interferenz von erregerspezifischen IgG Antikörpern bedingt falsch negative sowie durch Rheumafaktoraktivität bedingt falsch positive Ergebnisse auftreten, was durch Untersuchung der 19S-Fraktion oder von anti-IgG-behandeltem Serum vermieden wird. Signifikant erhöhte Titer gegen Zeckenspirochäten wurden bei 44 Fällen von Erythema migrans-Krankheit in 45%, bei 29 Fällen mit lymphozytärer Meningoradikulitis in 72%, bei allen neun Fällen von Acrodermatitis chronica atrophicans sowie bei allen vier bislang untersuchten Fällen von Lymphozytom (Lymphadenosis benigna cutis) festgestellt.
    Notes: Summary An indirect immunofluorescence technique for the determination of antibodies against ixodid tick spirochetes is described. Differences in the reactivity betweenIxodes ricinus spirochete andIxodes dammini spirochete antigens were not observed. Cross-reacting antibodies againstTreponema pallidum andTreponema phagedenis can be eliminated by quantitative absorption withT. phagedenis. Cross-reactions with leptospira were not observed by immunofluorescence. In the IgM test, false negative reactions caused by high-titered specific IgG antibodies or false positive reactions caused by rheumatoid factor occur. This can be avoided by testing the IgM fraction (19S-IgM-test) or using sera previously treated with anti-IgG serum. Significantly elevated antibody titers against ixodid tick spirochetes were observed in 45% of 44 cases with erythema migrans disease, in 72% of 29 cases of lymphocytic meningoradiculitis, in all of nine patients with acrodermatitis chronica atrophicans and in all of four investigated patients with lymphocytoma (lymphadenosis benigna cutis).
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