Background and Purpose: Cerebellar infarction displays diflerent clinical features, depending on the vascular territory involved. We studied patients with infarcts in the territories of the posterior inferior cerebellar artery or the superior cerebellar artery to compare their clinical presentation, course, and prognosis.Methods: We retrospectively analyzed the clinical features, laboratory data, and imaging studies of 66 patients with cerebellar infarction collected consecutively at five institutions. All the cerebellar infarcts were documented on computed tomographic scan or magnetic resonance imaging.Results: Two distinct profiles emerged, depending on the vascular territory involved. In 36 patients with posterior inferior cerebellar artery territory infarcts, a triad of vertigo, headache, and gait imbalance predominated at stroke onset. Computed tomography showed severe cerebellar mass effect in 11 cases (30%1), with associated hydrocephalus in seven. In these seven patients (19%), postinfarct swelling led to brain stem compression that resulted in four deaths. In 30 patients with superior cerebellar artery infarcts, gait disturbance predominated at onset; vertigo and headache were significantly less common.
The anatomy of the distal incus, including the lenticular process, was examined in histological sections from 270 normal cadaveric human temporal bones aged between less than 1 month and 100 years. All but nine of these sectioned specimens showed signs of a bony connection between the long process of the incus and the flattened plate of the lenticular process, and in 108 specimens a complete bony attachment was observed in a single 20 microm section. In these 108 ears, the bony lenticular process consisted of a proximal narrow "pedicle" connected to a distal flattened "plate" that forms the incudal component of the incudo-stapedial joint. A fibrous joint capsule extended from the stapes head to the pedicle of the lenticular process on all sides, where it was considerably thickened. Three-dimensional reconstructions made from serial 20 microm sections of four bones provided views from all directions that easily convey the anatomical features of this region. Morphometric measurements of the bony architecture of the distal incus in 103 temporal bones were made, including lengths and cross-sectional areas, estimates of the percentage of lacunae containing osteocytes, and the degree of bone resorption. These measurements, analyzed as a function of age, provided an anatomic description over a large age range that can serve as a normal baseline against which structural pathology can be compared. Although none of the bony dimensions showed significant age dependence, the estimated percentage of bony lacunae that contain osteocytes decreased significantly with age. The results have implications for the roles of specific components on the coupling of ossicular motion across the incudo-stapedial joint, and provide insights regarding bone resorption at the level of the distal incus, which occurs clinically in some patients with chronic otitis media or after stapedectomy.
Subjects recalled an affect-eliciting event that had occurred to them in either an achievement situation or an interpersonalsituation. Recalling a positive or negative achievement experience (for which Subjects appeared to take personal responsibility) influenced judgments of their competence in achievement situations. whereas thinking about a positive or negative interpersonal experience (for which subjects appeared to deny responsibility) did not influence judgments of their competence in social situations. On the other hand, both types of affect-eliciting experiences influenced subjects 'judgments of their competence in the domain to which these experiences had no direct implications, and also judgments of their general self-esteem. Implications of these results for a more general conceptualization of self-esteem and its stability are discussed.
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