肥厚性硬脑膜脊膜炎一例

患者男性，39岁，因“头颈部疼痛，双上肢麻木4个月”于2005年7月26日入院，患者4个月前感冒后出现颈部胀痛，放射至头，肩背部，伴双上肢麻木，坐位时疼痛剧烈难忍，仅能坚持1min，无恶心呕吐，平卧时疼痛消失，3月20日到当地医院骨科住院，查颈椎磁共振成像（MRI）示：颈1-胸2椎管内异常信号，考虑为炎性病变。予抗感染及营养神经等治疗5d，症状减轻，能坐10min。     

颅内胶质细胞增生症1例报告

颅内胶质细胞增生症的病因及发病机制尚未阐明,临床常误诊为颅内肿瘤。现报告1例如下。1病例女,43岁。因“间断性头痛3月余”于2005年10月25日入院。患者近3个月逐渐出现头顶部间断性疼痛伴双下肢无力,每次持续约半天,无视物模糊、头晕、恶心呕吐等。外院头颅CT显示脑白质密度改变,曾给予降颅压治疗,症状未见缓解。2000年曾患“甲亢”行放疗,2002年转为“甲减”。查体:神志清楚,颈软,双侧瞳孔等大等圆,光反应良好。眼底检查提示慢性视盘水肿。四肢肌力、肌张力及感觉正常,病理反射未引出。血液及脑脊液检查均正常;头颅MR I提示脑白质脱髓…     

低颅压致持续性蛛网膜下腔出血1例报告

低颅压引起蛛网膜下腔出血（SAH）临床上并不常见，长期严重低颅压引起持续的SAH更为少见。现报告1例如下。 1病例男，39岁。因“头痛3d”于2006年5月31日入院。患者入院前4d荡秋千50min，当时无不适感，次日晨起感右枕部疼痛，呈持续性隐痛及发作性跳痛，平卧时头痛立即缓解，坐或站立头痛即出现。     

椎管内硬膜下髓外血管周细胞瘤一例

患者男,36岁.因颈枕部痛、右侧肢体麻木3个月、左上肢麻木无力2个月入院.体检:颈枕部痛觉过敏,左侧躯体痛温觉正常,右侧躯体痛温觉明显减退;左上肢肌力Ⅳ级弱、肌张力略高;左上肢腱反射略亢进.MRI:颈2～3椎管内占位,增强扫描明显欠均匀强化,颈髓受压明显.     

脊髓胶质母细胞瘤合并颅高压症1例报告

脊髓胶质母细胞瘤致颅内高压症罕见 ,现报道 1例如下。1　病例　女 ,32岁。因右下肢疼痛 2年 ,伴双下肢无力、失明 1个月 ,于 1997年 11月 6日入院。患者于入院前 2年出现右下肢疼痛 ,疼痛逐渐加重并从臀部向下放散至左下肢。入院前 3个月出现腰痛 ,曾在当地行腰椎CT检查 ,诊断腰椎间盘突出症。入院前 1个月颈枕部僵硬、疼痛 ,伴恶心、呕吐、视物成双、小便不畅 ,数天后失明。查体 :双瞳孔 7mm ,光反射迟钝 ,视力 1m指数 ,眼底有出血 ,视乳头苍白 ,双眼外展不能 ,双上肢肌力正常 ,双下肢肌肉均匀轻度萎缩 ,肌力Ⅰ级 ,双膝以下痛觉减退 ,双…     

进行性右手肌无力伴肌肉萎缩(上)

患者男 ,3 8岁 ,饭店经理。 5个月前发现患者右手肌无力 ,逐渐加重 ,3个月前出现写字、拿筷子有些困难 ,有“肌肉跳动感” ,主要在右上肢、右肩和双小腿。讲话及吞咽正常。逐渐发现右手肌肉萎缩。大小便正常。 1个月前跑步时自觉双足力弱。无肢体麻木疼痛。在当地门诊行颈MR检查报告 :轻度椎间盘膨出 ,脊髓无受压 ,无异常信号。颈椎片示左侧C3～ 4 椎间孔轻度狭窄。外院查肌电图 :为广泛神经源性损害。曾怀疑运动神经元病 ,给予利鲁唑 (riluzole ,为谷氨酸能神经兴奋性作用拮抗剂 )、神经妥乐平和VitB1 2 治疗 ,治疗 1个月无效。起病前 1…     

原发性低颅内压合并慢性硬膜下血肿1例报告

现将我们收治的1例原发性低颅内压(PIH)合并慢性硬膜下血肿报告如下。 病例报告 患者男,46岁。持续性全头胀痛1个月,坐位及站立时头痛加重,平卧后头痛减轻,重时伴恶心呕吐,无意识障碍及精神障碍,无头部外伤史。查体:神志清,被动体位(卧位)。颈项轻度抵抗,kernig氏征(+)。余神经系统检查阴性。血和尿常规正常,肝功和肾功正常,出血时间及凝血时间正常。腰穿(侧卧位)脑压0.196kpa(20mm     

低颅内压综合征致双侧额颞顶部慢性硬膜下血肿1例

1病例资料患者,男,31岁,阵发性双侧颞部胀痛1月余,站立、坐位和活动时头痛加剧,平卧时头痛消失,头痛剧烈时伴有恶心、呕吐和颈部酸痛。无头部外伤史。在外院以"颈椎骨质增生"行局部理疗,效果不佳,2010年5月1日来我院就诊。体检未发现阳性体征,行颅脑CT检查示:双侧额颞顶部慢性硬膜下血肿,右侧较左侧多。血常规、凝血因子、肝功能、血生     

脑组织活检确诊的隐球菌性脑膜炎1例报告

现报告经脑组织活检确诊的隐球菌性脑膜炎1例如下. 1 病例 男,45岁.因"头痛3个月"于2011年9月2日入院.患者2011年6月初咳嗽、咽痛后出现间歇性头部刺痛,以枕项部为主,每日发作数次,每次持续4 ～5 min,夜间头痛程度加重,无发热、恶心、呕吐.2个月后枕项部疼痛减轻,但出现左侧颞部疼痛.约半个月前出现头顶部疼痛、头晕.本院门诊头颅MRI示"两侧大脑半球病变",考虑脑炎可能性大.既往乙肝病史3年.查体:T 37.9C;腹稍隆起,肝区叩痛,移动性浊音(+),可见蜘蛛痣.神经系统:颈抵抗(+),克氏征(±).     

平山病4例临床和影像学分析

目的探讨平山病的临床特征、影像学特点及发病机制。方法对4例患者的临床、神经电生理、影像学资料进行分析。颈部屈曲位,采用平卧位时骨盆下放置一个定制的楔形物而获得。结果4例均为青春期男性。主要表现为局限于手和前臂的肌萎缩,尺侧肌肉萎缩较重,上肢呈斜坡样。4例手指伸展时出现震颤;3例伴寒冷麻痹。常规颈MR均可见颈髓下段轻度萎缩,均未发现髓内异常信号。屈颈MR均见下段颈髓前移、变平,硬脊膜向前移位;硬脊膜外间隙增宽;硬脊膜外间隙内半月形信号影,在T1加权像与脊髓的信号相同,在T2加权像呈高信号,其中有一些弧线形或圆形的血管流空信号。结论屈颈位MR,出现下颈髓及其硬膜囊的异常表现是平山病的一个显著特点,当遇到青少年(尤其是男性)出现手及前臂不对称的肌无力和萎缩时,应进一步行屈颈MR检查。     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

Abstract

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Presence and severity of anorexia and bulimia among male and female Omani and non-Omani adolescents

OBJECTIVE: The population of Oman is a heterogeneous mix of nationalities providing a natural setting for studying the cross-cultural differences in the presence and severity of eating disorders as well as an opportunity for evaluating the performance of measurement instruments for these disorders. METHOD: Disordered eating screening instruments (the Eating Attitude Test and the Bulimic Investigatory Test) were administered to Omani teenagers, non-Omani teenagers, and Omani adults. RESULTS: On the Eating Attitude Test, 33% of Omani teenagers (29.4% females and 36.4% males) and 9% of non-Omani teenagers (7.5% of males and 10.6% females) showed a propensity for anorexic-like behavior. On the Bulimic Investigatory Test, 12.3% of Omani teenagers showed a propensity for binge eating or bulimia (13.7% females and 10.9% males). Among the non-Omani teenagers, 18.4% showed a tendency toward bulimia, with females showing a slightly greater tendency than males. In contrast, barely 2% of Omani adults showed either a presence of or a severity of disorderly behavior with food. CONCLUSION: Omani teenagers scored significantly higher than other ethnic groups and Omani adults. This finding is discussed in the light of emerging evidence from many parts of the world suggesting that cultural transition, compounded by demographic constraints, plays a significant role in abnormal eating attitudes.     

Relationship Between Sluggish Cognitive Tempo and Age and IQ in Preschool and School-Age Children and Adolescents with Autism and with ADHD

Journal of Autism and Developmental Disorders - Relationships between sluggish cognitive tempo (SCT) and age and IQ were investigated in children with autism and/or ADHD covering broader age and IQ...     

Synaptic plasticity and learning and memory: LTP and beyond.

Long-term potentiation (LTP) of synaptic activity is by far the most popular and widely researched model of synaptic plastic changes that might occur during learning. Numerous recent reports, however, have not found a correlation between the inducibility of LTP in the hippocampus and the ability of animals to learn hippocampus-dependent tasks. For example, some experiments with gene deletion (knockout) mice strains have shown that in some strains LTP is not inducible in the dentate gyrus, in area CA3, or CA1, but the animals are still able to learn spatial tasks. This apparent mismatch has rejuvenated the discussion concerning whether LTP is a good model for mechanisms that underlie memory formation in the nervous system. This review analyzes the conditions under which LTP is induced or learning takes place and suggests reasons for the mismatches that can occur and what we can learn from them. High-frequency stimulation protocols and in vitro assays cannot be seen to resemble natural firing patterns or conditions found in the brain. More physiological experimental conditions, especially in vivo recording in awake animals, could lead the way to the development of improved models of learning mechanisms that better correlate with learning abilities of animals.