A Hypothesis of Osmotic Endothelial Injury

Norenberg, Michael D.

doi:10.1001/archneur.1983.04050020028004

Cited by 100 publications

(16 citation statements)

References 52 publications

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“…Ke lios te ori jos aið kina, ko dël OM me tu pa þei dþia mas bû tent til tas. Spë ja ma, kad til tas yra jaut res nis os mo si nae mie li no li zae su ke liantiems veiks niams dël sa vo struk tû ri niø ypa tu mø: 1) ja me yra nu si lei dþian èiø ir per si kry þiuo jan èiø lyg tin kle lá su daran èiø skai du lø pluoð tai, 2) bal to sios ir pil ko sios sme ge nø me dþia gos struk tû ros glau dþiai tar pu sa vy je su sie tos, 3) tilte yra di de lis oli go den dro ci tø kie kis [14][15][16][17]. Su pa na ðiu struk tû ri niø vie ne tø ið si dës ty mu sie ja mas ir EPM ið si vysty mas, kai daþ niau siai pa þei dþia mos sme ge në lës (33 % atve jø) ir ðo ni niai ke li niai kû nai [18].…”

Section: Patogenezëunclassified

“…Su pa na ðiu struk tû ri niø vie ne tø ið si dës ty mu sie ja mas ir EPM ið si vysty mas, kai daþ niau siai pa þei dþia mos sme ge në lës (33 % atve jø) ir ðo ni niai ke li niai kû nai [18]. Taip pat EPM bû din gi pa ki ti mai ga li bû ti nu sta to mi ið ori në je kap su lë je, ba za liniuo se gan gli juo se, sme ge nø þie vë je ties bal to sios ir pil kosios sme ge nø me dþia gø jung ti mi, hi po kam pe [13,[17][18][19].…”

Section: Patogenezëunclassified

“…Grei ta nat rio kie kio ko rek ci ja lë ti nës hi po nat re mi jos me tu su ke lia reikð min gà sme ge nø de hid ra ta ci jà, ka dan gi or ga ni niai os mo li tai á làs te les pa ten ka daug lë èiau (per 5-7 die nas) [14,15,17], nei ne or ga ni niai jo nai, ku rie greitai grà þi na mi in tra ce liu lia riai [18]. Ne pa vy kus at kur ti làs -te lës plaz mos to nið ku mo, ið si vys to os mo si nis stre sas, dël ku rio làs te lës su si trau kia, ið yra glau dþio sios jung tys ir paþei dþia mas he ma to en ce fa li nis bar je ras [21].…”

Section: Patogenezëunclassified

“…Ðie poky èiai sà ly go ja krau ja gys liø en do te lio pa þei di mà, su kelian tá va zo ge ni nae ede mà ir mie li no tok si niø me dþia gø pa te - ki mà ið krau ja gys liø. Abu anks èiau ap ra ðy ti me cha niz mai su ke lia de mie li ni za ci jà [9,17,22]. Ti kë ti na, kad trau ku liai, ne re tai pa si reið kian tys esant hi po nat re mi jai, yra su si jae su su trik dy tu ap sau gi niu sme genø me cha niz mu, ið si vys èius sme ge nø ede mai dël pa ki tu sio os mo sið ku mo [23].…”

Section: Patogenezëunclassified

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Osmosinės mielinolizės sindromas (centrinė tilto ir ekstrapontininė mielinolizė): literatūros apžvalga ir atvejo pristatymas

Rutkauskaitė

Klimašauskienė

2018

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Vilniaus universitetas, Medicinos fakultetas, Klinikinës medicinos institutas, Neurologijos ir Neurochirurgijos klinika ÁVADASOs mo si në mie li no li zë (OM) yra re tas ir ûmus de mie li nizuo jan tis su sir gi mas. 1959 m. R. D. Ad ams su ko le go mis [1] pir mie ji ap ra ðë cen tri nae til to mie li no li zae (CTM), ku rià diag no za vo al ko ho liu pik tnau dþiau jan tiems ir pras tai be simai ti nan tiems as me nims. Vë liau nu sta ty ta, kad iden tið ki pa to lo gi niai po ky èiai ga li pa si reikð ti taip pat uþ til to ri bø, jie pa va din ti eks tra pon ti ni ne mie li no li ze (EPM). Vyk dant moks li nius ty ri mus, ið aið kin tas ry ðys tarp OM ir grei tos nat rio ko rek ci jos pa cien tams, ser gan tiems hi po nat re mi ja. EPIDEMIOLOGIJATiks lus OM pa pli ti mas në ra þi no mas. Pir mie ji duo me nys apie OM gau ti au to psi jø me tu. M. Vic tor ir R. Lau re no apra ðy to je 3 548 su au gu siø jø au to psi jø ana li zë je OM bû din gi pa þei di mai ras ti 0,25 % at ve jø [2]. Ki ta me moks li nia me dar be bu vo ið ana li zuo ta 3 000 mi ru siø jø sme ge nø, 0,005 % jø nu sta ty ta asimp to më CTM [3]. Au to psi jø ana li zë je didþiau sias OM pa pli ti mas, nu sta ty tas 30-50-ai siais gy ve nimo me tais, dau giau bû din gas vy rams [4], ta èiau pa to lo giniai po ky èiai pa ste bë ti ir vai kams [5,6]. A. Gocht ir ko le gø [7] au to psi jø stu di jo je ið nag ri në ti 58 OM kli ni ki niai at ve - San trau ka. Cen tri në til to mie li no li zë api bû di na ma kaip os mo si nës mie li no li zës sin dro mas, daþ niau siai ið si vys tan tis kaip kom pli ka ci ja po grei tos hi po nat re mi jos ko rek ci jos. Til to mieli no li zë skirs to ma á cen tri nae til to mie li no li zae ir eks tra pon ti ni nae mie li no li zae. Hi po nat re mi ja daþ nai nu sta to ma pa cien tams, ku rie pik tnau dþiau ja al ko ho liu, pras tai mai ti na si, var to jant tam tik rus vais tus, taip pat ser gant ke pe nø li go mis, esant pa ki tu siai an ti diu re zi nio hor mo no sin te zei, ant inks èiø ne pa kan ka mu mui. Yra ke le tas pa to fi zio lo gi niø me cha niz mø, pa aið kinan èiø os mo si nës mie li no li zës ið si vys ty mà. Bû din ga dvi fa zë li gos ei ga. Pir mie ji simp to mai yra en ce fa lo pa ti ja ir (ar) trau ku liø prie puo liai, pa si reið kae dël hi po nat re mi jos, vë liau ste bi mas at si sta ty mas nor mo nat re mi jos me tu ir po ke liø die nø -pa blo gë ji mas, ga lin tis pa si reikð ti þi -di ni ne neu ro lo gi ne simp to ma ti ka, psi chi kos ir el ge sio su tri ki mais. Anks èiau siai bû din gus pa ki ti mus sme ge ny se ga li ma pa ste bë ti mag ne ti nio re zo nan so to mog ra fi jos DWI re þi mu. Patvir tin tø os mo si nës mie li no li zës gy dy mo re ko men da ci jø në ra, ta èiau li te ra tû ro je ap ra ðo mi sëk min gi at ve jai, pa cien tus gy dant ti rot ro pi nà ið ski rian èiu hor mo nu, gy do mo sio mis afe re zë -mis, gliu ko kor ti koi dais, in tra ve ni niu imu nog lo bu li nu. Os mo si nës mie li no li zës ga li ma ið -veng ti, hi po nat re mi jos me tu nat rio kon cen tra ci j...

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Section: Patogenezëunclassified

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Osmosinės mielinolizės sindromas (centrinė tilto ir ekstrapontininė mielinolizė): literatūros apžvalga ir atvejo pristatymas

Rutkauskaitė

Klimašauskienė

2018

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“…This appears to lead to significant cerebral edema and dehydration of brain cells within the central pons [4][5][6][7]. Lampl and Yazdi (2002) note in their review that extracellular osmotic dysregulation results in the myelin sheath being stripped from the axon [2] such that oligodendrocytes are damaged [8] resulting in myelin toxic substances being released from vascular endothelial cells [9].…”

Section: Introductionmentioning

confidence: 99%

Structural neuroimaging and neuropsychological correlates of a single case of focal central pontine myelinolysis: Intact memory function with decreased intellectual and motor functions

Mulvogue¹,

Robinson²,

Ijaz³

et al. 2012

WJNS

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We report on the case of middle-aged right-handed woman with central pontine myelinolysis (CPM) revealed by high resolution structural T2-weighted FLAIR MRI imaging. There was a general flattening of Wechsler Adult Intelligence Scale-Fourth Edition subtest scores which were 1 standard deviation below expected values. In contrast Wechsler Memory Scale -Fourth Edition visual and auditory memory scores remained within the normal range. Verbal working memory appeared mildly impaired while nonverbal working memory was not. Scores on the Advanced Clinical Solution's Social Perception battery were all in the normal range as were academic skills measured by the Wide Range Achievement Test-Fourth Edition. Performance was impaired on the Delis-Kaplan Executive Function System's counterpart of the TrailMaking Test: Part B. Similarly, on the Draw-A-Person Test there was a discrepancy in that our patient's standard score was 76 compared to her estimated premorbid FSIQ in the average range. She also displayed bilateral motor coordination slowing on the Finger Tapping task collectively suggesting damage to pontine motor tracts. The Minnesota Multiphasic Personality Inventory-Second Edition-Restructured Form profile was consistent with a diagnosis of severe anxiety and depression perhaps due to damage to serotoninergic neural tracts originating within the central pons. Finally, the patient displayed severe sleep disturbances and other signs of reticular activating formation injury. CPM may constitute a unique means of studying reversible subcortical lesions in the central pons in otherwise healthy subjects with benign illness. To our knowledge this is among the first patients with CPM without the usual risk factors for the disorder and who was otherwise healthy. Knowledge of the etiology and neuropsychology of such patients might aid in understanding the interaction of the fronto-ponto-cerebellar tracts in executive functions and motor programming.

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Pontine Myelinolysis and Delayed Encephalopathy Following the Rapid Correction of Acute Hyponatremia

Weissman¹,

Weissman²

1989

Archives of Neurology

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A Hypothesis of Osmotic Endothelial Injury

Cited by 100 publications

References 52 publications

Osmosinės mielinolizės sindromas (centrinė tilto ir ekstrapontininė mielinolizė): literatūros apžvalga ir atvejo pristatymas

Osmosinės mielinolizės sindromas (centrinė tilto ir ekstrapontininė mielinolizė): literatūros apžvalga ir atvejo pristatymas

Structural neuroimaging and neuropsychological correlates of a single case of focal central pontine myelinolysis: Intact memory function with decreased intellectual and motor functions

Pontine Myelinolysis and Delayed Encephalopathy Following the Rapid Correction of Acute Hyponatremia

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