164 research outputs found

    Redeeming Rhetoric: Augustine\u27s Use of Rhetoric in His Preaching Ministry

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    The art and practice of rhetoric occupied a fundamental place in the ancient Roman world. It is thus not surprising that Augustine (354-430 AD) was deeply committed to the art of speaking well. He spent his youth mastering the theory of rhetoric, putting into practice what he had learned during a preaching career of almost forty years. This essay examines elements of rhetoric in Augustine’s preaching, arguing that he purposely appropriated common rhetorical elements in his preaching for the purpose of making Scripture both plain and compelling to his audience. Augustine’s training in rhetoric is summarized, followed by an overview of the context, Scriptural basis, and style of his preaching. His thoughts on the use of rhetoric in preaching are discussed, primarily by summarizing his arguments from Book Four of his treatise On Christian Doctrine. The essay concludes by offering several examples of rhetorical devices used by Augustine in his preaching

    Astrocytoma in the Third Ventricle and Hypothalamus Presenting with Parkinsonism

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    Parkinsonism secondary to intracranial mass lesions usually results from compression or distortion of the basal ganglia. Secondary parkinsonism due to midbrain infiltration or compression is rare and generally associated with other neurologic signs caused by pyramidal tract and/or cranial nerve involvement. We report a case of 30-year-old woman in whom mild parkinsonism was the major clinical manifestation of an astrocytoma in the anterior third ventricle and hypothalamus. She underwent surgical resection, ventriculoperitoneal shunt and radiation therapy. All symptoms of parkinsonism were completely recovered 3 months after the treatment. Brain tumors can be manifested only by the symptoms of parkinsonism. This case emphasizes the significance of neuroimaging in the evaluation of parkinsonism

    Speech disorders in cerebellar disease

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    The areas of cerebellar damage most commonly associated with dysarthria were sought by reviewing the clinical, radiographic, surgical, and autopsy findings in patients with nondegenerative cerebellar disease. Case histories on 162 patients with focal cerebellar lesions were reviewed. All but 15 of the patients underwent surgery, and 28 had autopsies. Thirty-one of the 122 patients with adequate descriptions of speech had dysarthria. Twenty-two of these 31 dysarthric patients had exclusively or predominantly left cerebellar hemisphere disease; 7 had right hemisphere disease; and 2 had vermal disease. Only 19 of 41 patients with exclusively or predominantly left hemisphere disease had had normal speech before surgery. Dysarthria developed in isolated cases following cerebellar resections extending into the paravermal segments of the left hemisphere. There was no correlation between the extent of vermal damage and development of abnormal speech. Cerebellar speech function was most commonly affected with damage to the superior portion of the left cerebellar hemisphere.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/50292/1/410030402_ftp.pd

    Opalski's Syndrome with Cerebellar Infarction

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    A 64-year-old man presented with sudden onset of right-sided hemiparesis, headache, gait disturbance, and recurrent vomiting. A physical examination revealed right-sided hemiparesis, right Horner syndrome, ataxia of the right limbs, and diminished sensation on the left side of his body. Diffusion-weighted MRI revealed an acute right lateral medullary infarction extending from the rostral medulla to the upper cervical cord, and an acute cerebellar infarction in the territory of the medial branch of the posterior inferior cerebellar artery. Magnetic resonance angiography revealed suspicious severe stenosis or near occlusion of the proximal and distal parts of the right vertebral artery, and hypoplasia of the left vertebral artery. We diagnosed ipsilateral hemiparesis with lateral medullary infarction (Opalski's syndrome) and concomitant cerebellar infarction

    New England Medical Center Posterior Circulation Stroke Registry II. Vascular Lesions

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    Among 407 New England Medical Center Posterior Circulation Registry (NEMC-PCR) patients, the extracranial (ECVA) and intracranial vertebral arteries (ICVA) were the commonest sites of severe occlusive disease followed by the basilar artery (BA). Severe occlusive lesions were found in >1 large artery in 148 patients; 134 had unilateral or bilateral severe disease at one arterial location. Single arterial site occlusive disease occurred most often in the ECVA (52 patients, 15 bilateral) followed by the ICVA (40 patients, 12 bilateral) and the BA (46 patients). Involvement of the ICVAs and the BA was very common and some patients also had ECVA lesions. Hypertension, smoking, and coronary and peripheral vascular disease were most prevalent in patients with extracranial disease while diabetes and hyperlipidemia were more common when occlusive lesions were only intracranial. Intra-arterial embolism was the most common mechanism of brain infarction in patients with ECVA and ICVA occlusive disease. ICVA occlusive lesions infrequently caused infarction limited to the proximal territory (medulla and posterior inferior cerebellum). BA lesions most often caused infarcts limited to the middle posterior circulation territory (pons and anterior inferior cerebellum). Posterior cerebral artery occlusive lesions were predominantly embolic. Penetrating artery disease caused mostly pontine and thalamic infarcts. Prognosis was poorest in patients with BA disease. The best prognosis surprisingly was in patients who had multiple arterial occlusive lesions; they often had position-sensitive transient ischemic attacks during months or years

    New England Medical Center Posterior Circulation Stroke Registry: I. Methods, Data Base, Distribution of Brain Lesions, Stroke Mechanisms, and Outcomes

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    Among 407 New England Medical Center Posterior Circulation Registry (NEMC-PCR) patients, 59% had strokes without transient ischemic attacks (TIAs), 24% had TIAs before strokes, and 16% had only posterior circulation TIAs. Embolism was the commonest stroke mechanism accounting for 40% of cases (24% cardiac origin, 14% arterial origin, 2% had potential cardiac and arterial sources). In 32%, large artery occlusive lesions caused hemodynamic brain infarction. Stroke mechanisms in the posterior and anterior circulation are very similar. Infarcts most often included the distal posterior circulation territory (rostral brainstem, superior cerebellum and occipital and temporal lobes), while the proximal (medulla and posterior inferior cerebellum) and middle (pons and anterior inferior cerebellum) territories were equally involved. Infarcts that included the distal territory were twice as common as those that included the proximal or middle territories. Most distal territory infarcts were attributable to embolism. Thirty day mortality was low (3.6%). Embolic stroke mechanism, distal territory location, and basilar artery occlusive disease conveyed the worst prognosis

    Cerebral cortex neurons with extra spikes: a normal substrate for epileptic discharges?

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    Double spikes during otherwise rhythmic discharge were frequently observed in 'fast' pyramidal tract neurons in response to steady depolarizing currents injected through the recording micropipette. The extra spike appears to arise from a large depolarizing afterpotential crossing the falling threshold several milliseconds following a spike; extra spikes themselves may generate further extra spikes in a similar manner, generating burst patterns which are strikingly similar to those of epileptic neurons
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