Neuropsychological sequelae of aneurysmal sub-arachnoid haemorrhage in patients without neurological deficits 6 to 8 months post operatively : an exploratory study

Bibliography: pages i-vii.Relatively little is known about the neuropsychological sequelae of sub-arachnoid haemorrhage (SAH) and to date, there has only been one study (Ljunggren et al, 1985) focussing on patients without neurological deficits after aneurysm surgery for major SAH. A detailed exploratory study was designed to investigate the physical, cognitive, emotional, personality and behavioural sequelae of SAH in this group of patients. Neuropsychological sequelae were investigated in terms of a wide range of variables which could affect prognosis, viz location of aneurysm, timing of surgery, severity of the initial bleed, age, gender, educational level and estimated premorbid intelligence. An opportunity sample (N = 18) was drawn from patients treated at the Neurosurgery Department, Groote Schuur Hospital, Cape Town from May to November 1986. Patients were assessed 6.1 to 8.0 months post-operatively (mean 7.0 months) by means of an extensive neuropsychological test battery. A detailed structured interview was also conducted with the patient and somebody who was familiar with the patient's everyday functioning. Subjects ranged in age from 17 to 67 years (mean 38.8 years) and had a mean educational level of Standard 6 (range 2-10). Results were analysed in terms of the total sample and then according to successive subdivisions of subjects, on the basis of prognostic variables. The incidence and severity of symptoms ascribed to SAH are reported. Test data was interpreted in terms of two complementary psychometric theories (cognitive fall-off, and specific cognitive ability models). Results of the various aspects of the assessment were integrated in terms of ratings of general functional outcome. A diffuse SAH-induced encephalopathy was detected, which confirmed the findings of Ljunggren et al (1985). Impairment in functional ability was present in 61% of the sample. Similarities were noted with the Ljunggren et al (1985) study in terms of the cognitive abilities that were impaired, as well as the physical, personality and Differences in emotional, behavioural symptoms that were reported. studies are critically interpretation discussed and between the implications two for rehabilitation based examined. prognostic study with Further, variables regard on integrated functional assessment are tentative findings on the effects of are reported. The implications of this to neuropsychological assessment and further research are discussed

Degenerates in the Army

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Cerebellar Atrophy Related To Chronic Exposure To Toluene. Case Report.

A 31-year-old woman presented slowly progressing ataxia and neurasthenic symptoms after 14-year occupational exposure to low concentration toluene vapour. Examination disclosed only cerebellar signs. Cognitive functions were normal except moderate visuo-spatial and constructive deficit. CT imaging showed severe pancerebellar atrophy without pathological signs in other brain structures. Two years after she was removed from workplace, CT imaging and ataxia showed no worsening, while visuo-constructive function improved. The authors warn against possible neurotoxic risk associated with this kind of exposure.5290-

Atrofia cerebelar relacionada à exposição ocupacional crônica ao tolueno: relato de caso

A 31-year-old woman presented slowly progressing ataxia and neurasthenic symptoms after 14-year occupational exposure to low concentration toluene vapour. Examination disclosed only cerebellar signs. Cognitive functions were normal except moderate visuo-spatial and constructive deficit CT imaging showed severe pancerebellar atrophy without pathological signs in other brain structures. Two years after she was removed from workplace, CT imaging and ataxia showed no worsening, while visuo-constructive function improved. The authors warn against possible neurotoxic risk associated with this kind of exposure.Uma mulher de 31 anos desenvolveu síndrome cerebelar e neurastênica, de evolução lentamente progressiva, após 14 anos de exposição ocupacional a vapores de tolueno em baixas concentrações. Os únicos achados do exame neurológico e neuropsicológico foram sinais cerebelares (severos) e déficit visuo-espacial e práxico-construcional (moderado). A neuroimagem tomográfica mostrava acentuada atrofia pancerebelar, com preservação das outras estruturas cerebrais. Dois anos após interrompida a exposição, a ataxia e a neuroimagem (TC) estavam inalteradas, enquanto a função visuo-construcional havia parcialmente melhorado. Os autores chamam a atenção para o possível risco neurotóxico relacionado a esse tipo de exposição, numa tentativa de prevenção de casos semelhantes.909

Philadelphia Journal of Osteopathy

Articles in this issue include: The Osteopathic Lesion by Earlr S. Willard Bacterio-Therapy in Diphtheria by Lawrence J. Kelly An Osteopathic Profession of Faith by Raymond W. Bailey Differential Diagnosis Between Neurasthenia and Hysteria by Charles J. Muttarthttps://digitalcommons.pcom.edu/phila_j_osteopathy/1036/thumbnail.jp

Professional competence and the classification and selection of pupils for schools for “feebleminded” children in the Netherlands (1900-1940)

This article explores the tensions between medical and pedagogical professionals involved with the classification and selection of pupils for the special day-schools for “feebleminded” children that were established from 1900 in the Netherlands to promote compulsory mass schooling’s efficiency. These are set against the increasing influence of child sciences, including the new technique of intelligence testing. These schools were meant for educable learning-disabled children, the classification of whom involved a child’s (ab)normality and (in)educability. The article discusses the categories defined and labels inscribed on children with learning disabilities. These focused mainly on a child’s capacity to communicate and learn to adapt to society, as the special schools aimed to educate productive members of society. In spite of the recognised merits of the schools, theorists turned out to be most concerned about undue placements of not “essentially backward” children, who would benefit more from educational support in a regular school. The selection and admission procedure of the schools was standardised by the introduction in 1920 of intelligence testing as part of a developing scientific assessment culture, which for want of psychologists and despite the headmasters’ professionalisation continued to be dominated by the medical profession up to the Second World War