Search Results

You are looking at 1 - 10 of 516 items for :

  • Refine by Access: all x
Clear All
Restricted access

J. P. Segundo, R. Arana, and J.D. French

D uring the past five years, many data from animal experimentation have accumulated concerning the physiological mechanisms involved in sleep, arousal, and wakefulness. These observations, made on acute preparations, have indicated that appropriate stimulation of extensive but discrete areas of the central brain stem or cerebral cortex of the monkey may induce a change in the electroencephalogram identical with that observed at the onset of arousal to natural stimuli and called “arousal,” “activation,” or “desynchronization.” Animals capable of so reacting

Restricted access

Alexander A. Aabedi, EunSeon Ahn, Sofia Kakaizada, Claudia Valdivia, Jacob S. Young, Heather Hervey-Jumper, Eric Zhang, Oren Sagher, Daniel H. Weissman, David Brang, and Shawn L. Hervey-Jumper

arousal, the surgical team may want to assess a patient’s arousal with objective measures before functional mapping begins. 6 Commercial measures of arousal such as the bispectral index (BIS) are of limited utility given their poor sensitivity (44%) and relatively modest specificity (74%) for predicting arousal during intraoperative brain mapping procedures. 1 , 7 Further, to the best of our knowledge, no prior studies have sought to quantify intraoperative wakefulness during asleep-awake-asleep craniotomy, especially as it pertains to language processing. We

Free access

Abhijeet Gummadavelli, Adam J. Kundishora, Jon T. Willie, John P. Andrews, Jason L. Gerrard, Dennis D. Spencer, and Hal Blumenfeld

consciousness includes arousal, attention, and awareness. 70 These facets are correlated with an underlying anatomical consciousness network that includes the upper brainstem reticular activating system, medial thalami, basal forebrain, and frontoparietal association cortices. 8 Recent advances in understanding the mechanisms by which different types of seizures impair consciousness suggest disruption of essential nodes in the consciousness network. 8 , 20 Interacting with the networks from which level of consciousness emerges are absence, generalized tonic-clonic, and

Restricted access

Dennis L. Johnson, Charles Fitz, David C. McCullough, and Saul Schwarz

which were associated with obliteration of the perimesencephalic cistern seen on preoperative computerized tomography (CT) scans. The incidence of acute shunt malfunction and the relative importance of cistern obliteration in patients with hydrocephalus is discussed. Summary of Cases A summary of the seven cases in this series is presented in Table 1 . On admission, all patients were lethargic but arousable, and in each case a precipitous decline in neurological status prompted unscheduled emergency shunt revision. The spectrum of diagnoses is representative of

Restricted access

Raul Rudelli and John H. N. Deck

pressure (ICP) acting on the diencephalon. 35, 58 We describe a case of acute vascular injury of the anterior hypothalamus that occurred without compromise of other cerebral functions apart from visual, and without raised ICP. The patient demonstrated changing cardiac arrhythmias, including severe atrial arrhythmias with ventricular escape rhythms, altered thermoregulation, altered patterns of sleep and arousal, and alternating phases of disturbed fluid balance, characterized by the initial development of diabetes insipidus followed by the syndrome of inappropriate

Restricted access

Monika Milian, Ralf Luerding, Annette Ploppa, Karlheinz Decker, Tsambika Psaras, Marcos Tatagiba, Alireza Gharabaghi, and Guenther C. Feigl

) persistent symptoms of increased arousal (Criterion D). The symptoms must be present for more than 1 month (Criterion E) and must cause sufficient distress that leads to occupational or social impairment (Criterion F). 20 Neuropsychological Evaluation of PTSD Symptoms Due to the lack of inventories that evaluate psychological sequelae in awake surgery patients, we were driven to develop an inventory that assesses psychological symptoms dealing with PTSD symptoms for awake surgery patients: the Posttraumatic Stress Disorder Inventory For Awake Surgery Patients. By the

Open access

Bryan Kunkler, Alan Tung, Parag G. Patil, Srinivas Chiravuri, and Vijay Tarnal

requirement of avoiding any alteration or suppression of the patient’s arousal and baseline tremor in the upper extremities during macrosimulation testing. Lotto et al. 7 also used neuraxial techniques to manage two patients with Parkinson’s disease with back pain who were undergoing DBS surgeries, but they instead used intrathecal opioids to manage the back pain rather than local anesthetics as in our situation. Their only documented issue was the lack of efficacy when a bolus dose of intrathecal fentanyl was administered through a continuous spinal catheter. The issue

Restricted access

Masayuki Matsuda, John Stirling Meyer, Vinod D. Deshmukh, and Yukio Tagashira

arousal. All of these changes were highly significant (p < 0.001), while MABP, CPP, and PaCO 2 did not change significantly ( Fig. 1 ). When the same dose of Ach was infused into the internal carotid artery, CBF increased by 8%, CVR decreased by 11%, and CMRO 2 did not change ( Fig. 2 ). The effects of intravenous infusion were not remarkable ( Fig. 3 ). A typical illustration of the record of hemodynamic changes during Ach infusion is shown in Fig. 4 . Fig. 1. Graph showing effect of intravertebral infusion of acetylcholine in 12 animals at 0.01 mg

Restricted access

Won Seok Chang, Midori Nakajima, Ayako Ochi, Elysa Widjaja, James T. Rutka, Ivanna Yau, Shiro Baba, and Hiroshi Otsubo

, spontaneous vaginal delivery without complications. She had no family history of epileptic disorders, and a genetic study revealed no abnormalities. She experienced two types of seizures. The type I seizure began when she was 11 years of age, and the seizure consisted of her arousal from sleep, staring, and a forced head-turning movement to the left, followed by tonic-clonic convulsions. The seizure frequency was 2–8 times per month with clustering despite optimal medical treatment with topiramate, carbamazepine, and clobazam. The type II seizure also began when she was 11

Restricted access

Sleep-induced apnea

Part 1: A respiratory and autonomic dysfunction syndrome following bilateral percutaneous cervical cordotomy

Abbott J. Krieger and Hubert L. Rosomoff

weakness, lethargy, and asthenia as though certain activating or arousing mechanisms were disrupted. This further depravation of reticular influences might potentiate the normal mechanisms that produce respiratory depression during sleep and thus cause apnea. Drugs may also depress brain-stem function and so cause apnea. This notion was nicely demonstrated in the clinical studies of Forrest and Bellville 10 who reported CO 2 response curves on four subjects, awake and asleep, with and without morphine. The pCO 2 required to drive alveolar ventilation to 20 l/min was