Aphasia syndromes in brain tumors. Clinico-pathological correlations]

A clinica-psychological and pathoanatomical analysis of 40 observations with neoplasms of the brain in the left dominant hemisphere and 4 observations with neoplasms in the right subdominant hemisphere, has been carried out. In 36 cases, a desintegration in the language in a form of aphasia, has been established, while in 4 cases this was not present. In 22 observations the established neuro-psychological syndrome completely indicated and coincided with the localization of the neoplasm in the corresponding part or parts of the brain, in 10 it only partialy coincided, while in 4 cases it did not coincide with the localization of the neoplasm in the brain. The established neuro-psychological syndrome in observations with neoplasms in the right subdominant hemisphere possesses only a tentative topico-diagnostical significance. In conclusion the authors consider that the established syndromes of aphasia in patients with neoplasms of the brain may be of a considerable significance and help in substantiating a precise topical diagnosis.     

Disorders of higher mentae functions as first symptoms in patients with brain tumors]

It has been established that in 29 (or 36,25%) of examined patients with neoplasms of the brain in the left dominant hemisphere, disturbances in the psychic functions seem to be the first and most early symptoms of the disease. They develop slowly, progressively, or in the form of epileptic language equivalents (in 5% of examined patients). As early symptoms, disturbances in language indicate existance of a brain disease and give cause to suspect a neoplasm, in this way stating the necessity of further examination, and from the other side - in some cases show the localization of the process.     

Acoustically evoked brain stem potential in Wilson disease

By 48 patients with Wilson's disease the brainstem acoustic evoked potentials were stated. There were 35 pathological findings (73%), 13 were normal (27%). The waves, determined by the middle and upper brainstem (Pons and Mesencephalon) showed most of all pathological changes. Those patients with forms of Wilson's disease called Pseudoskelerose and Pseudoparkinson showed the most pathological findings. But one could watch these findings by about 30% of patients in preclinical stage. This method can possibly be used for early detection of disorders of brainstem functions and in the same way it can be used for control of treatment by patients in preclinical stage.     

Attention and memory in children with brain tumors.

The Rey Auditory Verbal Learning Test was utilized to examine attention, learning, and memory abilities in 42 children with cerebellar (N = 18) and third ventricle tumors (N = 24). Children with cerebellar tumors exhibited significant auditory attentional impairments and displayed adequate encoding and retrieval across subsequent learning and memory trials. In contrast, children with third ventricle tumors exhibited average auditory attentional abilities, but they displayed mild encoding deficits across trials 2-5. Furthermore, the third ventricle group's compromised performance on the delayed recall trial and average performance on the delayed recognition trial is suggestive of underlying retrieval deficits.     

Psychiatric disorders and growth of brain tumors

In 49 of 365 clinical and patho-anatomical intracranial tumour cases the tumours were indicated in the anamnesis only by mental disturbances before acute signs of brain pressure appeared. With reference to the relations between the psychopathological syndromes and the types of locations of tumours attention is drawn to factors that may complicate the early detection of tumours.     

Acoustically evoked brain stem potentials in acute alcoholic intoxication

Under the acute influence of alcohol with blood alcohol concentrations (BAK) ranging between 0.62 to 2.04%, the IPL prolongations of our subjects were within standard deviations compared with normal data. Depending on the BAK, these minor IPL alterations hint at a special vulnerability in the pontomesodiencephal area. The increase in BAK significantly correlates with the reduction of body temperature. The BAEP proves to be suitable for defining undear states of coma different origin.     

Judgement of Authenticity of Smiles and Detection of Facial indexes]

The smile is one of the most often expressed emotions during social interactions. It can be authentic, that is, associated with a joyful emotional state in the person expressing it, but it can also be false, that is, deliberately produced in the absence of that emotional state in order to deceive one or more individuals (Ekman, 1993). Even though the fake smile very much resembles the authentic smile, it generally does not constitute the perfect simile. The fake smile more often has a certain degree of asymmetry than the authentic smile (Ekman, Hager, & Friesen, 1981) and it uses the cheek raiser action less often than with the authentic smile (Ekman, Friesen, & O'Sullivan, 1988; Frank, Ekman, & Friesen, 1993). This study looked at the knowledge that adults have of these differences as well as their perceptive ability to detect them. The visual stimuli presented to participants were prepared using the Facial Action Coding System (Ekman & Friesen, 1978). Results show that participants detected the differences between the two types of smile and that detection was better using smile asymmetry than with the cheek raiser action. Analysis of the use of response categories in the detection task indicated that participants underestimated the differences between smiles when they were different and that this tendency was more apparent with the cheek raiser detection method than for asymmetry detection. Participants also demonstrated a better knowledge of smile asymmetry than cheek raiser action. The knowledge gathered suggests that the ability of the receptor to judge smile authenticity is limited by perceptive factors. However, the mediation analyses that we conducted show the judging smile authenticity is not limited to simple perceptive detection of facial clues. Detecting facial clues is a necessary condition for correctly assessing smile authenticity, but it does not explain the variance in these assessments. We believe that this variance would be due more to the importance that participants give to facial clues. Finally, our results show that the capacity to detect differences between authentic and fake smiles is not easy to change. Participants who received modified information on changes of appearance linked to the two facial parameters were not more likely to detect the differences than participants who did not receive information.     

The fibrinolytic tissue activity of various brain tumors

In tissue samples of 45 operated astrocytomas and of 45 meningiomas the fibrinolytic and proteolytic activity was determined by means of fibrin-agar-plate-method. In astrocytomas significant higher values of fibrinolysis were found than in the meningiomas. In the course of tumor cell necrosis or as a result of brain damage caused by the operation, proteins inducing fibrinolysis are liberated. In some cases they can lead to localized or generalized disturbances of haemostasis.     

Acoustically evoked brain stem potentials in chronic alcoholism and withdrawal

BAEP studies hint at different neurophysiological findings between gamma and delta alcoholics. On the first day of withdrawal gamma alcoholics show slight vegetative withdrawal symptoms in the form of CNS hyperexitability trough the shortening of the early IPL. However delta alcoholics show prolongations of the late IPL which can be interpreted as a consequence of brain stem transmission disorders resulting from chronic intoxication. After four weeks the BAEP deviations found in both groups indicate a clear tendency of recovery which points to functional disorders.     

Acoustic evoked brain stem potentials in chronic alcoholic Korsakoff syndrome

29 patients with Korsakoff syndrome (KS) were examined by means of brainstem auditory evoked potentials. The interpeak-latencies were delayed cumulative with the most accentuation of IPL I-VI. BAEP are suitable for subdividing of KS. It is suggested that BAEP shall observed in alcoholics for detection of norm-deviations.     

State dependent modification of auditory brain stem potentials

It is well known, amplitudes and latencies of auditory brain stem potentials are almost independent of viligance state. Contrary to that, simple cognitive requirements effect amplitude changes (enhancement of variance, amplitude reduction) in a part 2/3) of the subjects.     

Diagnostic assessment of cerebrospinal fluid protein in brain and spinal tumors

The cerebrospinal fluid of 69 patients with tumors of the brain and the spine was examined for total protein content, IgG concentration, IgG total protein quotient, and electrophoretic protein pattern. There is no specific finding in the case of the central nervous system. At best characteristic constellations may be established.     

Verbal memory abilities of children with brain tumors.

Several critical neuroanatomical structures and pathways for memory performance are located in the third ventricle region. This led us to predict that verbal memory abilities would be more impaired in children treated for third ventricle tumors compared to those treated for cerebellar tumors. Archival data was obtained from 24 pediatric patients with third ventricle region tumors and 18 pediatric patients with cerebellar tumors. Neuroradiological verifications of tumor involvement and hydrocephalus severity (i.e., Evans Index) on preoperative scans and MRIs proximal to the time of the neuropsychological evaluation were conducted. The potential confounds of hydrocephalus severity, seizure medication, age, radiation treatment, and chemotherapy were addressed. Verbal IQ was comparable between tumor groups and in the Average range. The third ventricle region group performed significantly worse on list learning and delayed list recall compared to the cerebellar group. Their mean performance was in the clinically impaired range on both trials. The third ventricle region tumor group performed better than the cerebellar tumor group on Digit Span, a basic repetition, attention span task. These findings support the hypothesis that pediatric patients with third ventricle region brain tumors are more likely to be impaired on verbal recall tasks compared to pediatric patients with cerebellar brain tumors. In contrast, patients who were treated for cerebellar tumors were more impaired on the basic repetition, attention span task compared to patients who were treated for third ventricle tumors. Future studies should examine the specific neuroanatomical structures and pathways that are damaged and may influence differential cognitive impairments in children.