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This study investigated the psychophysiological effects of sleep deprivation on auditory event-related potentials (AERPs) and their relationship with psychological parameters. Twenty-four subjects remained awake for 37 h under continuous surveillance. In the mornings and the evenings of 2 consecutive study days, AERPs were recorded and 4 self-rated scales (sleepiness, fatigue, anxiety, and mood) were quantified. The latencies of P300 and N200 were significantly prolonged (p < 0.001) and their amplitudes decreased (p < 0.05) as a consequence of sleep deprivation. However, the only significant change in N100 and P200 was an increase in the P200 amplitude (p < 0.05). The increase in the latencies of P300 and N200 were correlated with increased sleepiness (p < 0.05), and the increase in P200 amplitude was correlated with negative mood, anxiety, and fatigue (p < 0.05). Although the changes in P300 and N200 induced by sleep deprivation are due to sleepiness, which may slow cognitive processing and decrease the efficiency of mental processing, the increase in P200 may be related with increased anxiety, negative mood, and fatigue.

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Thrombo-embolic events, which can be increased after splenectomy in hemoglobin disorders, can cause potentially lethal complications. Although venous thrombosis has been reported, arterial strokes are rarely reported. A case of stroke in a 52-year-old patient with a previously performed splenectomy for known hemoglobin Madrid, an extremely unstable hemoglobinopathy, led us to investigate the possible causal role of splenectomy. The patient had no history of hypertension, diabetes mellitus, smoking, or other vascular risk factors--but upon autopsy, thrombotic angiopathy was observed in multiple organs, including the lung, liver, kidney, coronary artery and brain. Bone marrow hyperplasia was also observed. A thrombotic middle cerebral artery territory infarction appears to have been caused by chronic recurrent thrombosis, which may have been a result of the splenectomy for unstable hemoglobinopathy. This case supports that splenectomy be strongly considered as an uncommon risk factor for stroke.

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