Striking the capillary portion of measles to the brain

I. Breakdown of the Roland area, that is, the anterior and posterior central parts are characterized by the appearance of robust or sensitive functions on the protylezhny boat. Vognischa in the region front central area viklikayut, lightning, central parallel or paresis. On the basis of the size of the internal capsule, which gives a picture of more hemiplegia, measles control is often more intermittent (monoplegia), the growth of Betz's cells is less compact, there are fewer fibers in the capsule. You can prevent hemiparesis from obvious changes in the hands, legs or individuals; not a little bit of a pure monoplegia. The problem of the legs depends on the localization of the process in the upper parts of the anterior central part, the hands in the middle part and in the lower part.

at teased The regions of the anterior central area are suspicious of a tonic and clonal character in the muscles, innervated by the irritated dilyanka - seizures of cortical, either Jacksonian, epilepsy, about how the report will be said below, but in some other way.

Vognischa in the region rear central zivini wicket the differences of sensitivity on the opposite side of the floor. For cortical lesions, the loss of a thickened-muscular feeling, tactile, painful, temperature, localization, subtle development of the character and the stage of development, etc. is characteristic. For corks (і vzagalі "nadtalamіcheskіkh") striking is characteristic of a natural "splitting" of sensitivity: one hour at the second all meaningful types of sensitivity, especially sharp, rude, more and more temperature-reducing dovgo trivayut vidchuttya - hyperpathy(Chapter I).

II. ^ Striking the frontal part (Areas that have been expanded in front of the anterior central part) in the right-hand side (for right-handed people) may not give various manifestations in terms of visualization or development of functions. Often, there is a problem in the whole worn-out area of ​​the "pre-turn" of the eyes and the head. Ruynuvannya її wiklik I'll look parallel in the opposite direction. Call it a symptom that is unstable and is the head of the brain when there are processes in the frontal lobe. In addition to saving symmetrical zones in the іnshіy pіvkulі vinikak seeing apples(Often - heads) in bik vognischa. When you are teased, you can win judgment of the eyes and head in the opposite direction(Report in section V, a group of nerves in the face-to-face messages). This kind of attack can also be referred to as cortical, or Jacksonian, epilepsy.

Until the number frontal symptoms, the same way is spared in the same way when defeated, both right and left, lobova ataxia, most often manifested in the common tulub and wiklikak, the head rank, the level of standing and walking. In case of important problems with ailments, do not cause parallels, do not take the vertical position of the body and, being put on your feet, you fall (Astaziya) because, forcibly streaming on your feet, you can't walk (Abasia). In more light drops of frontal dislocations, the ailments appear when walking, there is no sharpness on turns and a tendency to turn, often in bik, against a severe breech. In the same manifestation of frontal ataxia, which helps to prevent one during the "test of witness" (div. It is easy to explain the diagnosis of cerebellar dislocations in case of severe frontal patches, if you can guess about the connection of the whole area of ​​measles with anti-inflammatory disease of the corns (stars, as it is meant to be a viscera, to fix the frontal path of the micectus - cerebellar-trabellar

The light at the frontal part of the house is spared to make a good deal - hapal phenomena. "Automatic grabbing" to be called mimovilne shopliuvannya hand of an object when doty їm to the valley of the sick; "Obsessive hapannya"є Mimovіlnіa praznennya zakoplyuvat navkolishnі objects or follow with your hand to approach and go out from the hand of the sick object with a tendency to drowning. Automated manifestations clearly rotate in the norm in small children and mavp; when the frontal part of the ancient onto- and phylogenesis is damaged, the hapra reflex is disinhibited and can appear with sufficient variation 35.

Until the number of similar symptoms of the frontal part of the frontal part, "Phenomenon prop"("Resistance"): when trying to get that part of the sick person from the current position, the antagonistic language will automatically be loaded, due to which it is possible to see the singing description. I have no respect for the whole symptom of the fact that one should be susceptible to, mabut, not grow, not hapal phenomena; as a last, a whole symptom of vinikє in case of massive і, on our hostility, often in bilateral frontal battles.

Yak chastkovy viy in the described "pillar phenomenon" can be recognized by our teacher І.Yu. Kokhanovsky symptom. "Zmikannya stolittya": when trying to take the upper part of a sick person (and if he doesn’t resist), he’s not going to see it.

^ razladi psycho There can be a winicatization in any localization of the process in the cerebral cortex, especially diffuse ones. When the frontal plots are severe, the stench is recognized more often and more often than not, as it is characteristic of the "frontal" psychic derailments. Apathy, torpidity of the psyche, weakening of memory and respect, the appearance of critical confession, underestimation of the importance of impairment are evident. More often, not depressive, I become more eager to become euphoria, smartness to hotness, hospitality, sometimes to be flat and rude. To achieve the typical lack of care, the lack of care of the sick (sechovialization in the ward for a pidlog, in a lodge).

There is a small amount of variability and lumpiness of an individual and a backward hypothesis to be explained in the frontal views, connected from the extrapiracy system (Div. Chapter VII about the hypocrisy)

The change in activity, as well as the change in behavior, can be explained and how the destruction of life in everyday life can be explained. lobova(Abo "akinetic") apraxia. We are built especially with perverted confusion of behavior in case of sechavipuskanny in ailments from the defeat of the frontal patches. It seems like it’s a little bit to get up from the sled, go to the door, let’s go, don’t finish your work until the end of the day, urinate in the shati, and in some droplets, reaching the level of absorption, let it float on the door of the rest; Innocent, not going out of the house, to urinate on the pidlog; leash in extreme steps rozladіv ailments neohainі in lіzhku. It is not the style of the plan, although it is incomplete, not completed until the end of the day 36.

In the vicinity of the drops, when the frontal part is affected, there is a need to avoid isolations (without the other ones) central paresis antiquity facial muscles.

We turn to the examination of symptoms that occur during the processes only in the left frontal part (or in the right in the left).

^ Motorna aphasia winery in the affected area of ​​Broca, that is, back view of the third frontal zivini... When there is a wide range of illnesses, it takes a lot of talk, ale zberigak in the main building of the mind. On the vidminu of an anarthritis, how to lay down in parallel to the movable muscles, ailments vіlno ruhaє with my lips, altogether turning in the navichki (PRAKS) of the movable muscles. Immediately at the second, move the vineyard and agraphia; Having lost the tips of the sound move, the ailments cannot come to the fore in writing, but at the same time the power of the ailments cannot be overcome not because of aphasia, but because of anarthria, that is, in parallel with moving. With an uncommon motor aphasia (a part of Brok's area, or at the stage of renewed function), there is a sick mob, a little stock of lines of confinement, ailments to speak more often, forcibly, admitting pardons (agrammatism), like in the same time. In more light cases of ailments, Volodya has all the reserves of words, or even to speak of the cloak, "stumbling" in the warehouses. Mova such a sick little girl rice dysarthria abo zaykannya.

Isolated (not confused with Broca's area and not obtained with motor aphasia) agraphia є as a result of the smacking of a measles dilemma, rosted in the rear end of the middle (other) frontal spine of the liver) (in right-handed people). Sickness consumes the health of the sheets, the health of the main functions (the sound of the message, the mind and the good mind of the written). Yak motor aphasia, so agraphia is a special type of apraxia.

III. ^ Departure of the tim'yanoi part wiklika is the head rank of sensitive rozladi. A collection of symptoms can be discerned that occur in the early world when the infection is severe.

astereognosisє As a result of striking both the rear central area and the area, the area was removed from the rear. The pure form of Astereognosis is susceptible to varying degrees; if the function of the sensitive projection field (rear central zone) is saved, then the ailments, which are taken in the opposite arm of the arm, can be seen and described about the power of the person (shape, shape, size, features, surfaces, temperature) the image of an object and і zdіsniti yogo "gnozіyu", "dіznatisya" yogo. Assessment of the subject to be lost in such a way, like won bula b, yakbi obmatsuvati absolutely do not know ric. In opposing the "pure" form of Astereognosis, the lack of recognition of the subject in the presence of the back central aspect will be remembered: through the loss of all kinds of sensitivity, one cannot find the power and quality of an object to be established.

Bilsh in the form of agnosia є autotopoagnosis, for the lack of recognition of the parts of the vlast body, because of the lack of recognition. In case of autotope diagnostics, there is a wicked breakdown, a manifestation of vlasne tilo: the ailment of a rogue right side from lіvoї, seeming to indulge in spіvvіdnoshennya around the edges of the body (for example, the brush is given to thymus mediocre extension of the shoulder, and not to the front), see the appearance of the third hand or legs; rogue the last of the fingers, etc. Seeing the appearance of gracious pictures and of their parts to wear new ones pseudo-files(P.A.Ostankiv - V.M.Bekhterov). In the winnies of the cich of free dislocations, it is not just that, but maybe not the style of the cut of the measles of the small part (the leading rank of the area of ​​the interparietal furrow, fissurae interparietalis), but of the crimson of the areas of the small Autotopoagnosis can be winicati, mabut, in case of ugly, as well as right-sided lengths.

Autotopoagnosis is not easy to drop from anosognosia, at any time, there is a lack of evidence of a defect, often for everything - a parallel. Khvory stverdzhu, scho vin ruhaє with paralized pictures, describe how vin їkh pіdnyav, zignuv і etc. Anosognosis є the result of striking the right side of the part and sparing only with left side hemiplegia (in the right-hand side). Both autotopoagnosis and anosognosia are found on aphids of a loamy soil, paralleling and degradation of particularity.

One of the ways to diagnose measles in a small part, є apraxia. Yak vzhe Bulo zaznacheno, naybіlsh viraznі FORMS apraxia vinikayut at urazhennyah in oblastі krayovoї zvivini - gyrus supramarginalis, vіrnіshe at bіlsh glibokomu roztashuvannі vognischa in bіlіy rechovinі, pid her: hvor vtrachaє zdatnіst viroblyati skladnі tsіlespryamovanі dії at vіdsutnostі paralіchіv i Povny zberezhennya elementarnih ruhіv. In the case of acutely swiveling apraxia, Lyudin becomes absolutely irresponsible; So, the ailment can not be self-supporting, you just can't; trickery, do not bring them to the end, be careful when you are connected with this object, or with an instrument, etc. The behavior of people can be tortured to such a world that ailments can cope with the feud of God. In case of apraxia, it’s too easy to destroy the "plan" of ruins, for which it is foldable, for the plan will not be ruined, due to which the end of the ruins is lost. The order with іnshim folding actions, there can be included tips and symbolic rucks: the presentation of a vіyskogo vіtannya, a gesture with a finger, etc.

With midges in the area of ​​gyrus supramarginalis, there is a little bit of apraxia in both hands; If the anterior central part is involved in the process, then apraxia is spontaneous in the left hand with right-handed hemiplegia. In small cases, such as corpus callosum, apraxia may be isolated in the liver.

In case of severe kutovoy zivini - gyrus angularis - in liviy tim'yaniy dilyantsi in right-handers (and in right in livshiv) alexia - the loss of the decryption of letter signs is the reason for writing. One hour wakes up and leaves the leaves. Sickness doesn’t appear in general agraphia, as in case of other frontal zivini, to redraw a number of pardons on the leaves, misspelling words, often letters - as much as anything written. Alexia is one of the species of healthy agnosia.

In addition to symptoms in vypadannaya funktsii, in case of lesions of those who are long, there may be teasing symptoms. In cich vipadkah there are sensitive phenomena, about which it will be said below.

IV. ^ striking early part right-handed people (in right-handers) may not give clear symptoms. All the same, in a large number of symptoms, it appears that the symptoms of the disease or the development of symptoms are characteristic for both diseases.

^ Quadrant hemianopsia, to move step by step with progressive processes in the same hemianopsia of the anti-winter fields, and in one of the early symptoms of the lower limb part. The reason for quadrant hemianopsia lies in the incomplete lesion of the fibers of the Graciole's bundle (radiatio optica).

ataxia, rіzkіshe is turned (yak and lobova) into a tulub, wiklikє is the head rank of standing and walking.

The rise of the tulub and the strength to the fall back and to the side, often against the deterioration of the school, are implicated. In the event of a test, it is possible to prevent a miss to the middle in the prototype of the ruts. Atactic breakdowns during processes in the skrone part are caused by the deterioration of quiet areas, the signs of repairing the pylitic-skrone path of the bridge (tractus oortico-ponto-cerebellaris), which ring the skrone part with the protruding cornucopia.

^ Rumors, smells і savor hallucinations,є Inodi cob symptom ("auroyu") of an epileptic attack, the essence of the manifestation is the development of common analysts, so it is localized in the fringe parts. Ruinuvannya tsikh sensitive zones (one-sided) dimmed in the hearing, scent and relish is not wicked (the skin is tied with its own devices to the periphery from both sides - its own and the opposite). To deliver the slides to vvazhaty characteristic for the training of the low-lying part attack the vestibular-cortical obstruction, supravodzhuyutsya to see the destruction of spacious spіvvіdnoshen sick with navkolishnіmi objects (іsnu representativeness of the vestibular apparatus in the cortex of the early part); unrepentant after such zapomorochennya with auditory hallucinations (noise, noise, dzizhchannya).

On the vidminu from the start of the right pivkul, midway in left skronevoy part(For right-handers) it is often difficult to pull along with them.

Most common symptom є sensory aphasia, as a result of the battle of the region early zivini... Ailments are lost in health benefits mov. Sensitive words and phrases do not ring with common expressions, understanders or objects; mova to a sick person is absolutely nezumiloyu absolutely, as yakby they spoke to him in unknown youmu movi. Establish from such a kind, we are ailing contact for help, it is extremely important: it’s not a matter of mind, what I want to see, just ask for it and don’t miss it. One hour from the tsim pereymaєtsya і vlasna mova sick. Vernika can say and often see a problem with a motor aphasia, and often see a problem with a motor aphasia, a problem with a poor region; substitute for the required word to be taken for granted; At important vipadkah mova sick sta is absolutely impertinent, representing a lack of eyeshadows accumulation of sleeps and warehouses ("salad from sleeps"). Violation of the correctness of the move, unaffected by the protection of Broca's area, it will be explained, as a result of the defeat of the area, Vernike gained control over his move. Ailment with sensory aphasia is not intelligence, not only someone else's language, ale and his own: there were a number of pardons, irregularities, etc. (Paraphasia). Defects in their promises do not help. As soon as the ailment with motor aphasia narrates on itself and its own safety in mov, then the ailment with the sensory aphasia for an hour is attributed to people who cannot have its intelligence.

Oscillations of reading and writing є in clicks, adding more to the sound of speech and of the functions of lexemes and of graphs, being in the greatest depletion because of the function of intelligence in the field i sheets.

Rovnyuchi chits of the new functions, due to the ailment of the children in the brain, it is possible to get more tight є the reduction of the rear view of the other frontal spine; ailments rozumіє brutal to her mother, speak it myself; disagreement to be interrupted by the unwillingness of writing and, in a snarling way, to read. The dissection of gyms angularis wiklikє in the new nonsense of what is written and in the link with alex - in the layout of the leaves (agraphia, paragraph); іnakshe kazuchi, ailments become unwritten, ale zberіgaє the power of communication and the ability to speak. When Broca's area is affected, the ailments involve the state of speaking (motor aphasia) and - conjugally - writing; then you can save the sound of the sound. Nareshty, the most obtrusive є the defense of the region Vernike: the ailment is not the wickedness of the brutal thing to the new move, it is wrong, but only because it was unreasonable to speak for yourself, you can’t read and write. Establish contact from this kind of ailment and make yourself appear supremely important.

The most common kind of aphasia є amnestic aphasia - a symptom of an increase in the posterior aspect of the early and lower aspect of the temporal part. In case of a wide range of problems, the establishment of a “naming of objects” is possible. If we are sick, it is not immediately possible to notice the defect of this promotion: to speak ailments in a proper way, I will be correct in my promises, for those who feel comfortable. All the same, it’s okay, that ailments are often "forgotten" words and phrases yogo bіdnі іmenniki. A defect will appear immediately, as if proponutizing a sick person to name an object: replace the name of an attempt to describe the sign of power. So, not naming olivets, it is ailment to say: "tse - shchobi write"; about tsukru shmatok: "put, zavazhayut, shy licorice, p'yut", etc. If you give the name of the ailment, the correctness of the problem is correct, if the subject is named incorrectly. I’ll explain my ailments, Tim, “forgetting” I’ll name that subject (the term “amnestic aphasia”).

Until the end of the hour, there was no backward explanation of the free-standing "isolated" distribution of the mobile function; the tsikave and the overturning of the smudge of the original distribution is known from E.K. Seppa. On the yogo dummy, the spider, with the development of the move, the field 37 (div. Fig. 62) was formed between the kirkovy "center" and the kirkovy "center" of hearing. The whole field is a mice of fixation with the receipt of healthy and auditory children, the ear of the meaning of the new sounds; We will stay in a healthy way of the object, which you show and name: the name is knitted from the healthy image of the object. at given development and accelerated modern functions, name the visible objects, move “to be admitted” in the auditory-auditory associative field, that is, in the field 37. We are very intelligent, which when the affected field breaks down. The function of the move will not break down. From the point of view, we became intelligent, to whom the territory, fighting against amnestic aphasia, only respected the rear view of the lower wing of the brain, and those of the lower age of the day. The first, and the second regions store field 37, with the resulting fields of healthy and auditory gnosis (i.e., Іnkshe kazuchi, і vіrnіshe, associates of the way among them).

Rozdil aphasias is here shortly victorious, in the forgiven viglyad; not given a detailed classification of aphasia, pidvid and basic forms. There is a development of a meaningful world of intelligence: the form of aphasia is isolated and developed rather. Name one type of element to the aphasia of one type.

^ doslіgennya aphasia (Even a short one) is carried out in such a rank.

1. To change the mind of the beastly to the prelude to moving the way of the projection of the old people: to go right hand, Lay Liva behind the back; close your eyes, etc. (Touch function movi). Like mothers on the street, but the failure to register or the wrong definition can be found not in the area of ​​Vernike, but in obvious apractical ways.

2. Vivchaєtsya vlásná mova doslіjuvanogo: it is possible to speak, to speak correctly, to have an ample supply of words, to petty paraphasia, etc. (Motor function movi). The repetition of Movi Doslidzhu will be propagated.

3. To revise the state of mind of the letter of the nobility written by the gentry: turn that chi інshy ruh, take that chi інshy object, etc. (Reading function).

4. Reverse, as if you were writing it: it’s not difficult, if the phrase is correctly prompted, which is not a paragraph, and so on. It’s a matter of fact, when it’s just read and write, it’s necessary to make an amendment to the level of literacy before reading it.

5. Proponate with the mark of the inclusion of amnestic aphasia of nazivati ​​objects.

V. ^ The section of the tilting area as an area, tied with a functional zoru, wikklica zorovi rozladi. Vignes in the area of ​​fissurae calcarinae, spread on the inner surface of the capillary part (Fig. 66), vyklikayut vypadannya protolezhny fields to the side of both eyes, which is pulling behind itself such a rash.

^ Hemianopsia is the same. If not the entire area of ​​the green projection field is affected, but only the territory, the fissurae calcarinae - cuneus is roasted, then the vine is not new, but the quadrant hemianopsia of the lower lower quadrants is deprived; in the early world with severe gyrus lingualis (lower fissurae calcarinae), there are fields of the upper upper quadrants. Even less significant in the middle there may be defects in viglyadi islands in the winter fields called cattle. The scotomies appear in both fields and in the same quadrants. Fallen from the step of the battle may not be hemianopsia, but hemianopsia - a decrease in zoru in other fields. One of the early symptoms of a healthy analyzer is the visualization of the number of views in the opposite fields of the horizon; In addition, a hundred and a half and until the field dawn is not only for beige, but for blue and red color. In case of progressive hemianopsia, it is possible to settle down in the "soft" fields at the sight of light perception and to take away objects. To navigate in great bilateral lesions of the fissurae calcarinae rarely insist on slap: you want to be so called central, or macular, field of vision of both eyes.

During the processes that occur on the great territories of the potent fields, the sprout from the lesions of the outer surface of the potent part (in right-handers), the onset of the phenomenon can be spared.

^ Zorova agnosia: ailments are not є we understand, we must bach everything, bypass the crossroads, ale the healthiness of recognizing the objects from the rykhnyogo viglyad. When obmatsuvannі objects, wines, like slips, are easily recognizable їх (behind the middle of the stereognostic sense). In important cases, the situation of the sick person in the navkolishny area is difficult: light seems to them to resemble the order of unknown objects with invisible signs and stasis. Variations on the floor of a very pronounced green agnosia in the region of birth. Mabut, for the recognition of such a layout, it is not enough to hit one single part of the road, but it is not necessary to immediately see the function of a symmetrically expanded field in the other part of the road.

Variations of a private green agnosia occur often often, but all the more and smells to finish off the riches: there can be agnozia only pa colora, you can be unrecognized by individuals (ailments are not known to others, etc.)

It’s zealous, so at once from the bright agnostic development and lack of recognition of the written (leaves), i.e. E. Alexia.

One of the manifestations of healthy agnosia є і is so called metamorphopsia, if the correct representation of the contours of objects is broken: the remains appear to be corrupted, wicked, incorrect.

In the case of this kind of problems, there is a significant breakdown of the links in the polyilic region from the frontal area, which is accounted for before the assessment of the wide openings (cortical form of the vestibular analyzer).

Before the appearances razdratuvannya, as it can be spared during the processes in the physical particles, the offensive is carried forward.

^ Good hallucinations: when the projected green field in the area of ​​fissurae calcarinae is subdivided, there is a "simple" hallucination (Photomist), that is, light, some colonic appearances in viglyadi iscor, half, and so on. The development of the most popular surface areas of the city gives "foldable" hallucinations at the sight of figures, objects, sometimes collapsing, often daunting and fearful (metamorphoses), so to speak about the closeness of the fortress to the part. Call the healthy hallucinations є to develop an epileptic attack next to them, with the first court, attacking for the healthy hallucinations, but often turn the head and eyes into the opposing beck (guessingly about the rosy, often wiklikaє turn the eyes and the head to the opposite side).

^

Symptoms of measles brain tease

Repeatedly repaying and three reports on manifestations, which develop as a result razdratuvannya brain.

For the vognischevs, the attack is characteristic private, abo Jacksonian, epilepsy, I really want to have seizures like foreign epilepsy. Typical for the Jacksonian epilepsy є a cob by a court with a group of mussels with a clear confluence of evidence. The attack can be і obmezhitiya, ale іnodі "generalizes", proceeding step by step to a seizure seizure with a second witness, inodі nontrimannyh slaughter, bite move, etc. In defense of the Jacksonian epilepsy, a seizure of the epilepsy epilepsy should immediately be repaired in court and lost evidence. Evidence of Jackson attacks often leads to a message about localization of the process in the area of ​​the brain. The most important symptom is attack, but it will cause the initial development of the disease, the localization of the process.

Deyaki areas at їkh subdivisions give singular, characteristic for them type of seizure (Fig. 67).

1. ^ Restoration of the anterior central part viclikak attack, how to mend from the group of mischief, in which you follow the path towards the defeated viddil zivini (m'yazy feet, hands, denouncing). In case of generalization, a seizure is widened in the midst of the group, as a rule, in the mid-crust territory.

Small. 67. crusty fields, razdratuvannya viklikє characteristic pictures of court attacks (by fjorsters).

2. Recovery of the back view of another, abo middle, frontal zivini yes a seizure, how to reclaim for the smacking of apples and heads in the opposite direction; In general, it is possible to transfer the approval to the current territory and generalization by the court.

3. razdratuvannya so called front adversary fields - back view of the upper frontal zivini - viclika raptus to the court at once of all the anti-muscle muscles of the body. One hour a turn of the head, eyes, tuluba, sudom and kintzivok. Svidomost inviting you to be involved on the cob to attack.

4. ^ Development of the opercular area, roztashovanoy down to the bottom of the central zvivins, vicious seizures of rhythmic juveniles, chomps, licking, kovtalnykh rukhiv with a quick generalization by the court.

The growth of the viscera of the fields is characterized by sudomas, which develop without an in front sensitive aura, for example, as a "signal symptom", seizures are repaired, but they grow lower.

5. ^ Development of the rear central area vicious attack on the "sensitive" Jacksonian epilepsy - paresthesia in the areas of the protylezhny side of the floor in the areas of the antiquated side of the floor. When the attack is extended, the paresthesia "rasplyayutsya" according to the suspicion. Most often, however, the transmission of teasing is seen directly in the anterior central area with the development of a sensitive aura of umbilical manifestations.

6. ^ Development of the rear adversary fields - upper temporal lobules - similarly mimicking the anterior adversary field, a vicious rapt attack of paresthesias at once at all prototypal half of the body, and not an action of extended paresthesias, as in the case of a mimicking of the central back link. Followed by a sensitive aura, followed by attacks, characteristic of the front adversary field - sudomi, which immediately appear in all the muscles of the protruding side of the body (or at once a transcendental seizure).

7. ^ Restoration of the tiled part viclikaє attack, you can repair yourself from healthy hallucinations; distant to promote the turn of the eyes and head to the opposite side, during the course of the development in the direct territory of the cordon, along the road and in the same part; in a fake one, you develop a convulsive seizure.

8. ^ Restoration of the early part in the area of ​​upper skronevoy zivini, vicliks attack the aura of the viglyadi of auditory hallucinations. It is located in the uncus gyri huppocampi (on internal parties parts), then a signaling symptom of scent hallucinations. Do not wait for the onset of a symptom є a seizure: during processes in a skinny part, a snake Jacksonian or an epileptic attack can be attacked by the described type of aura, which is spared to attack "a little epilepsy" (petit mal) in the later More typical for the development of a low-lying part, one can see “in the imagined form of sensitive auras (or without them) I’ll be like ").

^ Shock me to the brain characterized by the head rank lesions of the cranial nerves.

Processes in the region anterior cranial fossa(Div. Fig. 27) in case of unilateral lesions of the zorotic nerve with amaurosis or amaurosis on the sides of the injury and loss of scent (anosmia) as a result of the lesions of bulbus or tractus olfactorii.

symptoms of urea middle cranial fossaє Vipadata of the functions of okorukhovy, partial and block nerves (III, VI and IV), including ocular ophthalmoparesis or ophthalmoplegia on the side of the lesion, as well as symptoms of subtlety (neuralgia) and impaired connectivity

Processes for the presentation of the brain in the region nіzhki to the brain alternating parallel to Weber's type: stripes on the sides є parallel n. oculomotorii and on the prototype bots - the central parallel of the symptoms in the case of a decrease in the lower brain of the pyramidal bundle, which is crossed lower.

strikes cerebral epididymis(Hypophysis), the sprout of chubby yogo, is supervised by bitemporal hemianopsia through the clenching of the middle sections of healthy nerves (div. In Chapter V, healthy nerves) and a number of endocrine dislocations. In some cases, acromegaly can be promoted (gigantic growth of movement, nose, lower slits, hands and nig), in others - dystrophia adiposo-genitalis (pathological obesity, viscosity Nareshti, as a result of the deterioration of the infrastructure region (Chapter IX), there may be pathological spraga and hunger (polydipsia and bulimia), sleep, etc.

Strikes in the area posterior cranial fossa characterized by lesions of the auditory and facial nerves (VIII and VII), in some cases as well as double and triple (VI and V) in different localization process in the so-called cerebellar bridge. With a greater caudal localization, there may be an enemy of the bloating, ovipopharyngeal and pidyazic nerves (X, IX, XII). Mozochkovy changes during processes in the region of the posterior cranial fossa are indicated at the battle, while at the same time, on their own, on both sides.

Those who look here are referred to the category of so-called "first" symptoms of the defeat of this part of the brain. With swelling of the brain, abscesses and cysts, with correct value in the field of battle є it is practically especially important to look at the necessary operative engagement with them, in some cases the non-abnormal meaning is so called “second” symptoms or “symptoms by reason” (one and only on the left). With the chubby, the part of the brain was damaged to repair the grip on the suspicious areas due to the fact that there were any problems with blood and liquor.

So, for puffs of a frontal dilyanka as a result of the grip on the side of the brain, one-sided anosmia and primary atrophy of the healthy nerve can be promoted; It is characteristic to reach the end of the development on the protylezhny botsі of the congestive nipple of the zorotic nerve (through the podvischennya of the internal cranial grip - a symptom of Foster-Kennedy). Behind our caution, it is also possible that in case of the presence of bilateral stagnant nipples in the growing and widening of the growth on the sides of the fire, it is absolutely not possible to see any more good sight on the prototype battlefield.

with chubby front views of the frontal part(Frontal pole) through the proximity of the process to the ochinic and fissura orbitalis superior, parallels of the nerves around the cortex can develop (III, IV and VI), i.e.

at puffs of the early part as a symptom of the second in Persha Chergu is guilty of buty predictions paresis n. oculomotorii with ptosis and enlargement of the brain, it is not easy to go back to the central hemiparesis on the opposite side - the result of the depression of the cerebral lower limb ("pseudo-Weberian" alternating syndrome). M.Yu. Rapoport admitted to the secondary symptom with swelling of the lower part of the sympathetic intramural syndrome, which develops from a sloppy exophthalmos, enlargement of the brain and dull pains in otsі (drawing out pretty fibers). Nareshty, then name the striation of the tripartite nerve, call the part - this chi of the yogi gilki. Most often, it means that it is isolated on the side of the damage to the corneal reflex, because of the loss of sensitivity and, in the future, the loss of the rupture of the threefold nerve - unilateral breakdown of the innervation of the cheaters, in order to start

at pukhlinas tilichnyh part of insanely diagnosing mesenteric tantrum syndrome (V.V.Kramer, M.M.Burdenko, M.Yu. Rapoport) very apple; sposterіgaєtsya slozotachea, pain in the grip on the inside of the apple and in the case of Russia.

Ridchet, with great puffs, the tentorium cerebelli "sags" downward and the symptoms of a lesion of the cerebellum appear; You may be able to avoid the loss of the corneal reflex and the reduction of the accessory (VI) nerve, but, however, it is more likely to look at it as a manifestation of the lateral movement of the internal cranial vice.

^

The bark of the great pivkul І VNUTRISHNI ORGANI

It’s home to the state of affairs, nervousness, As it passes through the cerebral cortex, may appear in the internal organs and systems of the body and navpaki, whether it is a change of the internal middle so that it is necessary to be recognized at the functional stage nerve centers and on the nerve's power. Respected, the representation of visceral energy in the cerebral cortex is not insane; so vischі center, scho regulate the internal processes of the body, roztashovanі in the sub-tuberous area, but not in the bark. Nareshty, accepted, that the role of measles in the visceral energy is diffuse, but the action of the small areas of measles on the internal organisms and processes are the same.

The old robots V.M. Bekhtereva, N.L. Mislavsky and I. shlunkovo-intestinal tract, Pechinki, nirok і ін.). Otrimano boules and related materials from key points. A number of experimental and clinical robots A.M. Grinstein and his scientists, showing the abandonment of the body and the quality of the internal organs and systems of the damage to the surrounding parts of the brain.

However, the knowledge of nutrition about the representation in the singing territories of measles and the innervation of the internal organs is not possible. So, K.M. Bikov with sportsmen, the best nutrition about the importance of visual energy in dogs, premotor field internal organs after the extirpation of the named field. K.M. Bikov has arrived to visnovka, but in the cerebral cortex there is not enough precise localization of the mechanisms of regulation of internal organs.

Those who have appreciated the achievements of radio science will be left with an hour to establish the very principle of insane representation in the cerebral cortex of the innervations of visceral organs. Prodovzhuyuchi i vchenya vchenya І.P. Pavlova in addition to the internal middle organism, K.M. Bikov і th school opened a report on interoreception and cortical-visceral regulation. Bulo rozvinene position I.P. Pavlova about the inflow of zvnіshnіh officials through the cerebral cortex in all processes that flow into the body; brought the universality of Pavlovsky mental reflex for all internal organs; the regularity of the order of the internal processes of the central nervous systems- cerebral cortex.

Immediately, with many proofs of the unity of the external and internal in the activity of the organisms, the preliminaries of these schools appeared, which showed the infusion of internal processes into the activity of the brain, measles great pіvkul 37 .

^

DIAGNOSTIC METHODS

A valuable method for topical diagnostics of brain damage є pneumoencephalo-і ventriculography. The cerebrospial pathway of the shlunochkіv and the outer subarachnoid space is replaced in a frequent way, or, more beautifully, sourly, for which X-ray of the skull is carried out. Alas, being a contrasting speech, yes, on the signs, you can see the skirts and can be seen in the everlasting subarachnoid space. In case of puddles, scho to resent, hush or vikonuyut shlunok, a normal little one of his changes and additional help is not often used in roasting puffs. So, with internal occlusive dropsy, the slugs are stretched, with swelling (Fig. 68, 69).

The introduction of a turn for encephalography is carried out by way of lumbar or cisternal punctures. Alternatively, 5-10 ml each, spinal cord ridin is dispensed, for which a syringe is injected through the puncture head with a syringe 12 cm 3 per 10 ml ridin (when the temperature is injected, it expands more and more). For diagnostics, you can add up to 30 - 40 cm 3 with suboccipital introduction, and 80 - 100 cm 3 with lumbar puncture.

pneumoencephalography, Especially with puffs, it is not easy to carry it: cyanosis, changes in energy and heart rate, and colaps are more likely to occur. Tom Danish method pre-river liche in clever hands and we are comfortable in quiet vipadki, since the data of clerical prelude is not enough for topical diagnostics.

Mensch is not safe є ventriculography: in this vipadku, it should be inserted without a second into the baby's mouth after an additional ventriculopuncture, which is also operative (opening the opening). The value of contrast radiography for topical diagnostics of brain fluff is even greater. With a suspicion of localization of the process in the posterior cranial fossa, with far gone stagnant nipples, with localization in the skinny part, with a significant decrease in health, ventriculography is acceptable. angiography. A contrasting speech is introduced into the sleep artery, for which, on x-rays, the little ones of the system and the internal sleep artery (angiogram) of their side can be recognized, and in a few seconds - veins and sinuses (phlebograms). With the presence of puffiness, a normal little one of the blood-bearing vessels changes (Fig. 70), and with the puffins with richly rosy vessels, one can see її tin (or a tangle of sudins).

Small. 68. Pneumoencephalogram of a sick person with a traumatic cyst of the right pivkul.

^ 1 - trepanation defect of the brush; 2 - normal configuration of the lone slut; 3 - change of configuration and change of right side slingshot, Stretched scar up to trepanation opening; 4 - k_sta, obtained with a snorkel.

Small. 69. Ventriculogram of ailments with chubby in the right fronto-temporal area.

There is a great deal of favor from the left and the front horn to the bottom.

Small. 70. Angiogram of the Right of Pivkul.

Siphon of the internal sleepy artery of forward movement. Front and middle to middle brain artery arched to burn. Spasmodic anterior villous and posterior cerebral artery are bent down. Neirinoma, as you go from the right Gasser university (according to Galperin).

For otrimannya malunka (angiograms) sudin in the region of the posterior cranial fossa, the introduction of a contrasting speech into a. vertebralis.

An even more valuable additional method of diagnostics of the lesion of the brain є і electroencephalography.... Recordings of biostructures in the brain are carried out for additional overhead on the head of special electrodes, as the number of electrical potentials is removed, as it will be possible to make up 1 - 2 million.

The recordings on the electroencephalogram (EEG) may have a different frequency (rhythm), amplitude and form. Have great people overload alpha-xvili(Frequency 8 - 12 waves per second; amplitude 10 - 50, up to 100 μV) і beta hvili(The frequency is 15 - 32 per second; the amplitude is 2 - 4 times less, the amplitude is lower, the amplitude is alpha, so the beta rhythm should be rescheduled without sensitive cathodic oscillographs). The alpha rhythm is the most beautiful bends over the ciliary lobes, and the beta rhythm is in the anterior cerebral lobes ( foreheads, central zivini), Yak tse can be seen in Fig. 71.

Small. 71. Biostrum the brain in a healthy person.

^ I- potilichnі (О), II - lobes (F), III - skronevі (T) introduction, s - liva, d - pivkulya rights. From the first crooked - view of the hour, the right-hander from her - kalibruvannya (in y. V). In the case of strong reports, there are good turns of alpha-xvili; in the frontal areas, especially in the frontal areas, the beta rhythm is transformed.

^ Poor people, the frequency of kolivan is less than 8 per second, or delta-khvili, in healthy, grown-up people z'yavayutsya at the moment of zasipannya. The appearance of delta-hvil can be caused by that chi pathology. To pathological signs on the EEG are also used change the rhythmі formy hwil, withers, shvidky dysrhythmias - heartless, paroxysmal or persistent colony at viglyads, gostrykh hwil, once a tooth and common sickness, which is spontaneous, for example, with epilepsy (Fig. 72). For the rest, the temporal amplitude is also characteristic.

For the identification of the localization of the pathological vognisch in the brain, behind the aid of the EEG, bipolar electrodes are fixed, so that the differential potentials are reestablished in two points above the brain. Pathological weaknesses appear in quiet drops, if one of a pair of electrodes rots over the head of the battle; at the same time, there can be a change in the rotation of the rotary phases (Fig. 73), that is, changes directly in the number (in the norm, directly on the number of all entries is unambiguous).

Pathological changes on the EEG during a series of illnesses (especially with epilepsy) can be prevented not permanently, but periodically, paroxysmally. For the purpose of the development of additional methods of functional adjustment: lighting (M.N. Livanov) and sound (G.V. Such additional benefits expand the diagnostic capabilities of electroencephalography.

Small. 72. Pathological disabilities on EEG at epilepsy (according to Jasper).

^ I- a single peak on tlі dysrhythmias; II - gostrі hvili; III- many peaks; IV - complexes "povilna hvilya - pik"; V - most of the sick. Kalibruvannya 100 (jl V(Vertical stackers are right-handed from curves).

Small. 73. Localization of the brain in the brain with bipolar connections, the method of reverse phases (according to R.N. Lur'є).

1 - 2,2 - 3,3 - 4 і 4 - b - elektrodi, z'єднані in pairs with oscillographs. electrod ^ 4 rozstasovany over the vignisch urazhennya. At information IIIі IV pathologic failures are re-structured in the period of developmental phases.

Three guessed ways to stimulate pathological changes biostrum in the brain in ailments for the epilepsy we will expand hyperventilation. However, do not try to reach out to reach. Our teacher A.I. Shvarev rozrobiv і proponuvav for diagnostics іn the second method - dosed hypoxic injection, found effective results for the detection of symptoms organic exercise the brain (cerebral, cerebellar, autonomic asymmetries and іnsh). Short-term (5 - 6 chilines) inhaling the sum of nitrogen and twilight, I will waste 8 - 9% acidity, I will appear in ailments on the epilepsy characteristic of the general ailment of anomalies of biostructures in the brain more often, less often; At the same time, the price of navantazhennya is carried by the ailments lighter, not the rapists forsovane dikhannya.

The one who modified the method of restoration of biostructures in the brain є elektrokort_kografiya - the introduction of the measles operation without a break before the hour of the operation. Electrocorticography started all the more often in neurosurgical practice for making suggestions and clarifying the localization of epileptogenic and other pathological indications in the brain.

Ostannim, the best new, with a suitable method of topical diagnostics, the cream of the brain fluff, є storage of radioactive isotopes. Zastosovuєtsya isotope to iodine - 93 I; in front of the "blocking" of the thyroid gland due to the Lugol's range, when an isotope of iodine is injected with a special filter (dosimeter), it is possible due to the concentration of microorganisms in the pathological war.

With a special method, it is mainly broken up in the Leningrad neurosurgical institute. A.A. Polunova (G.S. Levin, T.S.Malisheva, M.M. Visotskiy), suitable for testing the side of the brain, for the development of supra-types. leaks (relapses) є method of testing double-sided mad dreaming. It remains to be restructured and is not counted for an additional imposition on the offense of the vivid ducts near vines vacuum chambers Leshly - Yushchenko - Krasnogorskiy. Subsidiary є Dose the gross mucus by means of different concentrations of citric acid (up to 30 mm 0.26 - 0.5 і 1.0 by pulling 3 quiline).

Do not focus on the details of the diagnosis, there is sufficient reliability for the definition of the important buildings, the simplicity and availability of storage in the outpatient minds. Suttuve meaning method can be used for dispensary care for operative ailments.

During operations on the brain, it is necessary to design parts of the brain on the skull, and then circulate trepanation in the required area. Suttuvo plunged onto the rolling stock and Sylvian furrow, which does not matter, it is not important to namitit the position of the brain. For a wide variety of singing points on the head (nipple-like appendage, rumor passages, roots of the nose), to draw out the lines and lines, before them under the singing cut. Broken down special circuits (for example, Kroenlein), which are guided in the instructions for topographic anatomy and what surgeons and neurosurgeons reproach for promptly s drive pukhlin, abscesses and deyakykh zhvoryuvan brain.

21-12-2012, 02:11

Central homonymous hemianopsia in cerebral infarctions

With ischemic strokes, all may form central homonymous hemianopsia. Distant symptoms, such as occur with ischemic strokes, to the warehouse of which to enter, or even central homonymous hemianopsia, may be unstable.

Stenosis and thrombosis of the internal carotid artery in the shia ... Variations stenosis and to induce occlusion of extracranial carotid artery or extracranial appearance of internal carotid artery may not be superimposed on the development of cerebral infarction, as well as villisia colossal hemorrhage. When colateral blood circulation is defective, stenosis of the extracranial appearance of the internal carotid artery is against the period of passing damage to the cerebral blood circulation. Symptoms are common when there are many symptoms, and they are aware of prolonged periods of time and rocky conditions, persistent low symptoms.

For the occlusion of the internal sleepy artery in the country it is characteristic development of transverse optic-pyramid syndrome (alternating amaurosis-hemiplegic syndrome): slap or decreased clearance on the artery occlusion and hemiplegia (hemiparesis) on the opposite side. The step of lowering the state of mind, or the development of the slit, lie in the form of a change in the blood flow in the internal artery (a. Ophthalmica) - the first great internal cranial throat of the internal sleepy artery. On the other hand, on the face-to-face day of the urazhenny eye, there is a simple atrophy of the disk of the healthy nerve. If the anastomoses are between the full-body artery and the sleepy artery, then the decrease in the gap may not be. The most persistent symptom of occlusion of the internal sleepy artery on the shoulder є paresis of the protagonists of the disease, in the past anyway. The stench can be found in viglyad hemiplegia, hemiparesis (in the hands) or monoparesis of the hand. In case of severe dominant alcohol (left in right-handed people), it is more likely that aphasia is present, it is more importantly motor. The destruction of these cerebral functions (apraxia, acalculia, digital agnosia, the destruction of the right oriєntation) is even worse, only with one-hour carotid-vertebral stenosis,

not unambiguously hemіgіpesthesia і homonymous hemianopsia, I can unite with the clinker of the flared perekhresny optic-pyramidal syndrome, or to admit only with paresis of the dots on the protolezhny middle of the bots. Homonic hemianopsia is tied to the lesions of the Graziole bundle. It will be won over to the protection of the projection of the region with the help of another, because the homonymous hemianopsia is often desired.

If there are any symptoms, in a number of cases it is possible epileptiform seizures of the cortical type... Often on the side of the lesion, Horner's syndrome is caused by any of the other components (ringing of the heart, earlier than the ringing of the internal line), which is associated with the damage of peri-arterial sympathetic gossip in the area of ​​occlusion of the internal sleepy artery. In case of stenosis of the cob ulceration of the internal sleepy artery, symptoms of impaired functions of the carotid sinus apparatus in vigilia colony of heart rate and heart rate may be more severe. arterial vise.

Stenosis and thrombosis of the internal carotid artery in the middle of the skull ... The occlusion of the intracranial segment of the internal sleepy artery in the area of ​​the siphon is developing more rapidly, lower in the extracranial visualization. Stenosis of the internal cranial viddilu of the internal carotid artery in case of defective colateral blood circulation in the cob period is not common in those who pass through the cerebral blood circulation (transient ischemic attacks). With internal cranial occlusion (thrombosis), internal sleepy artery rose great brain ... In some cases of illnesses, if stenosis or thrombosis occurs before the occurrence of an intrauterine artery disease, if it is distal to it, all will not be able to get a picture of the intensity of the blood intensity. shi. Only with the whole pulsation of the internal sleepy artery in the world it is possible to get better and better.

Occlusion of the internal sleepy artery distal visualization of intramural arteries of non-vicious unilateral changes in the eye (decreased health, slap, atrophy of the healthy nerve). Do not bother with a whole and lower grip in the central artery of the picture. With such a localization, the thrombus grows up to a Willis cola, rose and triple in the back, middle and anterior cerebral artery, causing extensive cerebral infarction with a reactive block. Tse supravodzhutsya apoplektiformnа vinyknennyam important klinіchnoi picture, yak nagadu bleeding in the brain. Symptoms of gross swelling: riska head b_l and blotch. Hemiplegia, hemianesthesia and homonymous hemianopsia develop rapidly. In case of severe dominant pituitary (left in right-handed people), total aphasia is often promoted, and in severe subdominant pituitary (right in right-handed people) - anosognosia. The svidomost of the ailments will quickly collapse. Burlivian development of the nipple can be developed to the development of stagnant discs of healthy nerves, if the growth of the stagnant nipples is weak (infarction to the brain and localization) should not be produced until the development of the socket. In a large number of vipads through a few days, death has occurred due to the pressure and replacement of the stovbur to the brain of the hippocampus with a wedge wedged into the tentorial opening. In case of occlusion of the internal sleepy artery in the area of ​​the siphon, there is often a severe blepharospasm on the side of the lesion, which is tied to the development of the opening of the first leg of the tricyclic nerve.

Infarction of the anterior cerebral artery is not supervised by homonymous hemianopsia.

Total infarction in the basin of the middle brain artery ... Also, the training is supervised to develop on the protype botsi of hemiplegia, hemianesthesia and homonymous hemianopsia. In case of severe dominant alcohol (even in right-handed people), the importance of aphasia develops: of a small type, or total. With urazhennі subdominant pіvkulі (right in right-handed people), anosognosia. In a large number of patients with total infarction in the basin of the middle cerebral artery paresis looking in the direction of paralized pictures, Central paresis of the facial and lateral nerves. If the posterior cortical-infantile arteries of the middle cerebral artery are not affected, then the hemianopsia is lost, the sensitivity of the mens gliboki (hemigipesthesia) is impaired, the mova is impaired due to the type of motor aphasia. The posterior cortical-cortical arteries of the middle cerebral artery are deprived of the toddler, if they function badly with the meningeal-cortical anastomoses from the posterior cerebral artery when the vertebrobasilar artery is affected and the spinal cord artery is affected.

Great cortical-subcortical infarction in the basin of the middle cerebral artery ... Contralateral hemiplegia develops, or hemiparesis with the vital functions of the hand, as well as the lower muscles and the muscles of the body; In some cases there is paralysis of the hand and paresis of the leg or monoplegia of the hand. On the other side, hemianesthesia is also referred to as hemianesthesia of all types of sensitiveness, as well as homonymous hemianopsia. In case of severe dominant alcohol, aphasia of the wicked type is total, ruined rakhunka, reading, letters, apraxia. In case of infarction in the subdominant period, anosognosia and auto diagnostics occur during the state period of insult. With good functioning of the minor-cortical anastomoses from the posterior cerebral artery, the pool of the rear cortical-infantile arteries of the middle cerebral artery is not affected, because of the sensitivity of the lower hemorrhages,

Infarction in the pool gliboys middle cerebral arteries, infarction in the basin of the zagalny stovbur of the upper arteries and near the upper arteries of the middle cerebral arteries are not supervised by the development of homonymous hemianopsia.

Infarction in the basin of the rear hylok of the middle cerebral artery (A. Parietalis posterior, a. Temporalis posterior, a. Angularis). The same is the feud of the cerebral arteries in the case of occlusion of the back view of the middle cerebral artery, the distal appearance of the upper arteries. Tim'yano-skronevo-kutovy syndrome develops. It is manifested by homonymic hemianopsia (multiple abo-quadrant) and hemipesthesia with astereognosis. Rukhov's sphere is not rudely awful, however, in conjunction with the deterioration of sensitiveness, especially glib, it can be so called the afferent paresis of children; it is not often a simple atrophy of the languages ​​\ u200b \ u200bof the prototypes. In case of infarction in the dominant episode (even in right-handed people), sensory and amnestic aphasia, apraxia, acalculia, agraphia and digital agnosia (Gerstmann-Schilder syndrome) are considered. In case of urazhennі subdominant pіvkulі (right in right-handers), there may be problems with the scheme of til.

Infarction in the basin of the anterior artery of court gossip (A. Chorioidea anterior). grow key syndrome This includes hemiplegia, hemianesthesia, one hemianopsy, vasomotor damage in the area of ​​paralyzed symptoms. On the basis of an infarction in the basin of the middle cerebral artery, aphasia is on the day.

Infarction in the basin of the anterior artery of court gossip and infarction in the basin of the middle cerebral artery (Total and great cortical-subcortical) more often, the development of the central homonymous hemianopsia is victorious as a result of the defeat of the Graziole bundle, before the development of the healthy tract with the development of the homonymous hemianopsia tractus is possible. Tse vimagaє differential diagnostics central and tractus hemianopsia.

V cool paintings The defeat of the spinal arteries on the lower ravines shows two main groups of symptoms. First group of symptoms amazed by the lack of blood circulation in the entire vertebrobasilar system, distal to the level of occlusion, most often in the peripheral spines of the ridge and the main arteries, to go to the lower levels of the cortex of the cerebral stub, thalamus There are no symptoms at the back, how to supervise the occlusion of the spinal arteries on the lower rims, to develop the extracranial lesions. Characteristic for the symptoms of the first group is the appearance of healthy and gallstones with a breakdown of statics, coordination of robots and spoiled ones. At the same time, the brain is characterized by "plyamist", in connection with the classic alternating stubbrow syndromes, it is rare, the symptomatology is caused by polymorphism. Good times are very common. The stench is manifested in the viglyadi photopsies (Photomist, flashy scotomy), metamorphoses, ambiguity of the backing of objects ("veil" in front of the ochima, clouding the zoru), defects in the zoru field (scotomy, concentrically sounding of the zoru field, homonymous hematics hemianopsia).

A number of symptocomplexes for another group, Enhanced occlusion of the spinal artery on the basis of the appearance of her lower posterior artery of the cornsus, vertebral spinal and paramedial arteries. These syndromes are characteristic for occlusion of intracranial arteries. Smell the stink key symptoms first group.

Symptoms of the first group are most often of a time-consuming nature, and with sufficient collateral blood supply, they are known in the nearest years or days after an insult. Syndromes of other groups є, as a rule, persistent. Tsya rіznitsya vikoristovutsya in topical diagnostics.

It is necessary to note that the damage to the extracranial artery to the spinal artery may not only be caused by stenosis, or thrombosis, or if the arteries are affected by osteophytes, or by the adipose ridges of arterial spine ridges. Tsya pathology manifests itself when turning the head with a clink of passing symptoms of the first group, the symptoms of the first group are severe.

Stenosis and thrombosis of the extracranial artery to the spinal cord ... In a trickle hour, the past symptoms of vertebrobasilar insufficiency in viglyad bilateral cerebellar-vestibular, healthy, okoruchikh, not coarse bulbar, but also provident (ruffy and sensitive) dislocations occur. Periodically, there are symptoms of lesion of the hypothalamic region and reticular formation of the brain. This is due to a greater variety of localization and character, including those that are subtle to triheminal. In some cases, the syndrome of vertebral spinal lesions develops with amyotrophic and segmental sensitive dislocations in the area of ​​dermatomes and provocative sensitive lesions with an appearing upper boundary (Bogorodinskiy D.K., 1965).
Zorovi rozladi often fly at the viglyadi vipadannya healthy functions : Seeing the shroud in front of the eyes and clouded dawn, cattle, attack again at the end of the dawn. Often these are the first signs of extracranial occlusion of the ridge artery. In some cases, it is more difficult to grow more and more poorly, but rather to the sound of the field, it’s possible to create a protestant slap in the endless rakhunka to a slit, a protest slap in case of occlusion of extracranial arteries.

cerebral symptoms more often it is not possible to accept it when the arterial grip is lowered, and when the head is turned. In some cases of stenosis of the proximal spinal artery, secondary thrombi distal views with a typical line of high occlusions. Uncommon stenosis - thrombosis of the proximal spinal artery arteries.

Behind the nature of persistent vignischevic symptoms, they see subacute, chronic (pseudotumorous) and apoplectiform key forms... Subacute and chronic forms are most often developed. Symptoms tend to develop due to the tricky period of passing breaks, meaning that the stink grows apoplectiform.

Intracranial thrombosis of the spinal artery ... The thrombosis in the majority of cases in half of the vypadkiv may reflect the character of the segmental, in the other vapors of stench, which are continued in the extracranial viddil of the ridge artery, or in the main artery. Characterized by the appearance of persistent alternating syndromes dovzhastogo brain with the past symptoms of oral symptoms of the cerebral stubbore and pylichny parts (symptoms of the first group - symptoms on the back). Most often Wallenberg-Zakharchenko syndrome, Ridsche - Babinsky-Nagotte syndrome and infarction syndromes in the basin of the paramedian arteries of the large brain (Jackson's syndrome and іnshі). Characterized by a raptor cob, burlivy growth of symptoms, apoplectiform abnormalities of development of a stiff midsection syndrome. In the state period of insult, secretory, vasomotor, vegetative-visceral changes. by mean small pains in the context of the irradiation in the time, the forehead and the vivid fossa, the ringing of the heart, the reduction of the horny reflex on the side of thrombosis. Inodі sposterіgaєt in the position of the head. Meningeal symptoms may occur, which are due to the build-up of the cerebral mucosa and reactive worms in the cerebral membranes.

zorovi rozladi to see through ischemia measles in a frequent part in the area of ​​the pole and spur furrow and have a time-based character. All symptoms of the first group can be spared. Often, thymic amaurosis (cortical slit). Symptoms of a healthy way are often accompanied by passing gagging injuries, which occur through the damage of the nuclei III, VI and IV of the nerves or internuclear ligaments in the posterior lateral bundle.

The occlusion of one ridge artery is often a cause of death for ailments. In case of bilateral thrombosis of spinal arteries, ailments die, as in thrombosis of the main artery, in cases of bulbar paralysis.

Thrombosis of the main artery ... Isolation of thrombosis of the main artery is rare, the main artery is often thrombosed on the backbone. A characteristic short period of passing blood circulation problems in the vertebrobasilar system (a few days, older days). Symptoms of the overhaul of the Varoliyev bridge with the spread of evidence right up to the Komi period develop rapidly. With a whole stretch of 2-5 days, bilateral parallel cranial nerves and cranial nerves and cranial nerves and cranial nerves and cranial nerves build up (to tetraplegia); vegetative-visceral crises develop, health problems up to amaurosis, psychomotor stimulation with hallucinations.

The occlusion of the proximal types of the main artery is characterized by more general and more actionable, but also progressive interruptions from the swings of bulbar deterioration and more serious problems of witness.

The prognosis for thrombosis of the main artery of unpleasantness.

Infarction in the basin of the rear brain artery ... The stink of a yak at the sound of the occlusion of the artery itself, or of the gilok, as well as of the sound of the main arteries of the spine. There is a lot of buzz and training in arteries. The back of the brain artery anastomoses with the back arteries (the middle of the brain artery, the anterior cerebral artery, the arteries of the vertebral artery, the back of the main artery), in connection with the total artery of the back

Infarction in the basin of the large throats of the posterior cerebral artery (A. Thalamo - geniculata). In case of severe disease of the region, the classic Dejerine-Russi syndrome is diagnosed, to the extent of which these symptoms are:

1. Hemіgіpesthesia, or hemianesthesia on the protylnyh botsі; the most stylish sensitivity is ruined in the ruts; on the face of you you can be saved; suffer from all kinds of sensitiveness, especially sharp - gliboka.
2. Hyperpathy and dysesthesia (twisting of the spine) of sensitive teasing on the opposite side, which manifests itself more often after an hour after the insult.
3. Thalamic pain in the opposite side of the body; I hurt even more painfully, for an hour "intolerable".
4. Minute contralateral hemiparesis (for the rakhunok of timchakovy discirculation at the inner capsule).

Homonymous hemianopsia, hyperkinesia of athetosis and choreoathetosis nature, hemiataxia, trophic and vegetative damage are minimally promoted. Homoneous hemianopsia is associated with a change in the number of times.

Infarction in the pool a. thalamo - perforata wiklikє rubrothalamic syndrome ( upper syndrome of the red nucleus Kyari - Foy - Nikolescu). Homonic hemianopsia should not be included in the syndrome.

Infarction in the basin of the cortical-infarction of the posterior cerebral artery ... Let's clear up the symptom of such an infarction - the central homonymous hemianopsia. Often, the projection of the region is taken care of, so the ailment does not mean a defect in the field. In case of bilateral lesions, bilateral hemianopsia with a high macular vision, and in some cortical slump. To reach the often homonymous hemianopsia in the viglyadі of the upper quadrant homonymous hemianopsia. With a partial reduction of cytoarchitectonic fields 17 can be winicati іnshі zorovі ruin: Hemianopsia on colory (Hemichromatopsia) with a buried growth of light and deterioration and preserving the recognition of objects by the level of strength and brightness, the loss of the form of an object and deterioration. Separation of poliv 18 and 19 can lead to the appearance of metamorphoses and green agnosia, often in viglyadi subject agnosia, later - in viglyadi agnosia in guise and colori. Zorova agnosia can be found in severe cases of both left and right breeding, and more often than not in case of bilateral midsections. It is also necessary to note that, for the appearance of gnostic damage, it is especially necessary to damage the right brain. The separation of the rear views of the measles of the small part on the cordon from the potilichnoy valley should be brought to the destruction of the optically spacious Gnosis.

In case of infarction in the basin of the posterior cerebral artery in the dominant pivcule (livom in right-handed people) may be spasmodic alexia and not very severely affected by sensory aphasia... In case of extended infarction on the medial basement of the early part (of the hipocampus), there is a change in the memory of the type of Korsakov's syndrome with overwhelming damage to the short-term (operative) memory in the most recent period. Disorder in the moment and in the hour, as well as retrograde and anterograde amnesia, sometimes confabulation and pseudo-remission, are significant. At the same time, the destruction of all types of memory is characteristic: smell, relish, rumors, healthy and tactile. "Intellect is not suffering". Stiff damages of memory and transient amnesia. Amnestic syndrome is most readable in case of severe hipocampus of both hemispheres, but it can be spontaneous in the process of visualization of the limbic system, during the winter of the mammary bodies, and of the thalamus, as well as in the case of the guardianship.

In case of severe uncus(Shock) can be caused by the deterioration of the identification of smells (agnosia on smells).

Separation of the medical basal species of measles in the early part I will cause some to emotional-affective damage in the presence of anxiety-depressive syndrome; The descriptions of psychopathological problems can be permanent or paroxysmal. Some of the scent, savor, goodness, rumors, illusions and hallucinations.

Sudinna Skroneva Epilepsia... The first manifestation of what may be but also in the state of the period of insult, as a result of being included in the structure of the attack is paroxysmal, psychopathological, vegetative and visceral symptoms (tachycardia, nausea, bloating, after Epileptic paroxysms are characterized by polymorphism. There can be some great epileptic attacks, a little more characteristic psychomotor seizures, psychic equivalents, small seizures and absences. Psychomotor seizures often occur in the middle of the day. Psychic equivalents can be used with special camps of the type deja vu or jamais vu.

In most cases of infarction in the basin of the posterior cerebral artery, they are deprived of the central homonymous hemianopsia and optically spacious deranged. Described symptoms of measles infection are early and potent lobes.

Central homonymous hemianopsia in cerebral venous thrombosis

Vein thrombosis in the brain suffer from infections, vaginitis and curtains, cranial injuries, severe thrombophlebitis, blue heart defects, chills to the brain. Rіdshe wіn grow in during the operational period, With abortion. Wien can be followed by venous thrombosis lower kintzivok and pislyapologic thrombophlebitis.

With thrombosis of cerebral veins, develop local abo diffuse nodule to the brain... Stasis, diapedesic hemorrhage, and other symptoms of necrosis are evident, especially in the brain. Hemorrhagic infarction develops in the cortex and in the adjoining bile speech. Trivial venous congestion to produce swelling atrophic changes in cerebral measles in the area of ​​necrosis of the cyst and porencephaly.

Vein thrombosis in the brain develops in a step-by-step manner. There are headaches, nudota, blues, stiff discs of healthy nerves, increased temperature, accelerated SHOE. To appear in liquor mild pleocytosis and increase in the place of small, inodi shelter... Characteristic attack of the Jacksonian type, zatmarennya svidomostі, earlier - zalny ships attack. Already from the localization of the lesion of the veins, the symptoms develop: aphasia, alexia, hemianopsia, paresis and parallel symptoms, impaired sensitivity. In half of the vapors, the rigidity of the mucous membranes (hemorrhages in the membranes and cerebrospinal fluid space) is determined. Characteristics of the incidence of symptoms. The wake is squeamishly friendly, the symptoms are not easy to recognize a significant abnormal regression, or a recurrence of ailments is possible. Buvak and povilne chronic interruption on the advanced days of the month and the new rock. For cerebral vein thrombosis, it is not uncommon for excessive manifestations in mental disorders, aphasia, court attacks and paresis of children.

Thrombosis of the superficial medial veins characterized by the development of central homonymous hemianopsia. In case of thrombosis of the lower superficial veins and venous anastomosis of Labbe, hemorrhagic infarction develops in the temporal and hypertensive parts of the brain, and in the clinical picture on the first plan, aphasia appears (with homogeneous central) With thrombosis of the posterior superficial vein, symptoms of a lesion of the mediobasal area of ​​the upper part of the brain develop: fog in front of the eye, collapse of the colora, a decrease in vision right up to dullness, photopsia, central homonymous hemianopsia.

Traumatic brain injury

Central homonymous hemianopsia can occur in cases of severe and closed TBI.

In the case of head injury, in cases of brain injury and blunt trauma to the skull, it is often necessary to lead to the level of the central neuron of the healthy path and measles, below the head injury.

In the wounds of the skull and brain in the middle of the war often the reason development of central hemianopsia. Most often, pathology is spontaneous in case of injuries in the area of ​​the head, or in case of injury in the area of ​​sleep, earlier - in case of injuries in the area of ​​the skin. If there is an entrance opening in the frontal area, the metal side is penetrating the wound canal, penetrating to the capillary lobes, then central hemianopsia can also be promoted. Tse buvaє viklyuchno rarely in case of serious injury, often insane in lives.

A characteristic feature of hemianopsia in case of cranial wounds to the skull є deeper decrease in the state of food in the first hour of injury... At that hour, there were only one wounded, who came to the side for obscurity, but they still think too much of a subject matter (rakhunok fingers, the recognition of great objects), in which they are meant to be deprived of illumination of the corpus (or in case of loss). Nadal gostrota zoru step by step be updated to normal or slightly lower values. The stiffness of the double-sided slap is developed viciously.

Riske reduction of state property zoru pislya wounded amumbled by the increase in the highlighted part as a result of the blood and the embryo... At the same time, I will build a small part of the hemi-sphere and wicklack in ny vimikannya yak measles of a dark field, as well as the central neuron of a healthy way. The additional factor є the extension from the area of ​​the wounded guard galmuvannya to the cortical healthy center of the protidezhny pylitic part. As a result, there is more and more slap on the offense.

renewal of the zoru in case of traumatic cortical sloughing, go through two stages. At the first stage of renewal, there is a great deal of light perception: the impression of a weak diffuse illumination (like on a svitanka), as a result of illumination of a sick person with a strong dzherel light. The idea of ​​being weak is not played by the light projection, but at the same time it’s the sprinkling of the rucks. Dalі to update the definition of the shape of the subject - as unclear to the most accurate. In the remainder of the chergu, there are colorovidchuttya, a sprinkling of chervonia, and then on the other colors. In drugіy stadії vіdnovlennya Zorov funktsіy sposterіgaєtsya cerebral astenopіya, tobto Shvidka stomlyuvanіst vsіh Zorov spriynyattya: when trivalіy fіksatsії Look object contour rozplivaєtsya, zabarvlennya vitsvіtaє font zlivaєtsya, buvayut photopsias - proyav rozdratuvannya measles potilichnoї chastki, hvorі skarzhatsya on vіdchuttya oslіplennya at neіntensivnomu osvіtlennі scho tied to the reduction of adaptation to the light.

In the early period of the cranial lesions of the skull, on the face of the day, you are encouraged to avoid stiff nipples. At the beginning of the period, the discs of healthy nerves are stagnant, and it’s rare to talk about the manifestation of traumatic accelerations (abscesses to the brain, basal arachnoids, etc.).

For cranial wounds to the skull can prevent all forms of central homonymous hemianopsia Often, there is a homonymous hemianopsia for some of them. There is no straight fallowness due to the nature of the injury and damage to the healthy way. The prevalence of fallowness due to the nature of the injury and damage to the healthy path is also supported by the same form of hemianopsia, which can be caused by wounds of the skull of a serious severity. Tse is tied together, so that the manifestation of homonymous hemianopsia can not be the direct anatomical ruin of the central neuron of the zorovaya path and measles, but a grip of splinters, hemorrhages, and the brain. Such changes can be used for important and minor injuries to the skull. There is a need for real-time monitoring of the field in case of all injuries in the tilting, temporary and early regions, right from the stage of gravity.

Central hemianopsia with extracranial wounds to the skull may have some special features:

• the frequency of bilateral hemianopsia is high;
• the frequent presence of the region's projection by other beaches;
• the dynamism of changes in the field is significant;
• value of the frequency of asymmetry defects in the field of view.

bilateral hemianopsia when the brain becomes ill, it grows on the ground of hemorrhagic and hemorrhagic insults, and even with them, it will be a little bit hard. Bilateral hemianopsia with exogenous cranial injuries is much more common, which is associated with different non-mediated reasons for the reduction of the central neuron of the healthy path and measles of both hemispheres. In a number of vypadkіv to produce localization of the wounded region of the region close to the middle line. In addition, bilateral hemianopsia can be a viclican in case of severe injuries during the course of the wound canal, or in case of further injuries in the appearance of an intracranial outside body on the side facing the entrance opening.

The projection of the area with the help of the central hemianopsia on the ground in the fire is often not taken care of. The reason is that they are wounded in the fire, as a rule, there are more large ruins in the area of ​​the rear pole of the tilted lobes, less insult. In addition, in case of cranial injuries of the skull, there is no sign of the peculiarity of the blood supply to the poles of the cavernous lobes, as, in the main, it saves a greater frequency of the projection of the area with central hemianopsia on the soil of the brain.

central hemianopsia with vognepalny wounds of the skull, they are characterized by great dynamism of defects in the field of vision, as well as by a partial or rotational development. It is tied with a rosette to a thread, blood and fiery appendages, which develop in the event of a brain injury. Zvorotny development of cich processes can occur during partial abnormal renewal of defects in the field of vision. Central hemianopsia in case of cerebral disease in a large number of cases become stationary. The dynamism of hemianopsia is more significant in case of cranial injuries to the skull, which is explained by more sharp reactive changes, but not in judgmentsі puffs of the brain.

Central hemianopsias are characterized by symmetrical field defects. In some cases and asymmetry of defects. In case of vognepalny wounds of the skull, the chain is more frequent, less than in case of brain damage. Central hemianopsia with asymmetric defects in the field of vision in case of extra-focal wounds can be divided into three groups:

• more homonymous hemianopsia with different sounds of sparing halves of the field in view on both eyes;
• homonymous hemianopsia with unequal rosettes and sizes of half of the field of vision;
• development of an absolute defect in the field of one eye and an obvious defect in the same distance of the field to the eye of the other.

In case of injuries to the pylitic area, two pain phenomena may develop: the pylitic-tentorial syndrome and a symptom of "electric shock". Potilino-tentorial syndrome Burdenko-Kramer be characterized severe pain in the area of ​​the eyes, which is superfluous to swallow and fear of fear, one hour to see the eyes. Syndrome of wickedness to sensitive nerves of the dura mater in the posterior cranial fossa, and the arnold's rotary throat itself from the first wrist of the tricular nerve. The intensity of this syndrome in the first hour of injury can be significant, then step by step. Symptom "electrical discharge"(A.V. triumph) to be susceptible to cranial wounds in the cranium. When the heads are nailed, they see the electric struma, radiating to the pictures. Symptom of a chain of changes and dressings with scars of the dura mater. Most often it is spared in case of injuries in the area.

When there is a TBI on the ground with blunt ears, it is significant that the central neuron of the healthy path and measles is hit more rapidly, less in the case of wounds. The main reasons for producing up to such shit are slaughtering the head or hitting with blunt objects. In the area of ​​injuries, make a dent in the brush for the coverage of splinter fractures with the details of the hard cerebral sheath and cerebral speech. Possibility of speech to the brain is tied with the introduction of cystic fragments, the development of blood and traumatic encephalitis. Clinic, central hemianopsia in blunt trauma to the skull does not appear as a clinical hemianopsy in case of epileptic cranial injuries.

When the head injury is closed, the central neuron of the healthy path and measles are tied to the head and the brain. Do not produce the strius of the brain of the nicoli until the onset of central hemianopsia, Yak and іnshih vognischevykh symptoms in the lesion of the brain. Central homonymous hemianopsia at close-up TBI may be tied not only to the anatomical ears of the central neuron of the healthy path (in the presence of brain growth and parenchymal hemorrhage), but also to the growth of the brain on the ground. The backward development of the block and the pressure of the brain can be caused by partial abnormal renewal of defects in the field of the eye. In the last period of closed TBI, there is a homonymous defect in the field of vision of only the anatomical ears of the central neuron of the healthy path and measles of the headland. The difference is related to the dynamics of changes and the number of defects in the field of vision in the different period of closed TBI. The appearance of central homonymous hemianopsia with stagnant nipples on a full-time day at close-up TBI is more severe, lower at onset. The emergence of such accelerated congestive nipples is an important diagnostic symptom, which can lead to an important interruption of a closed head injury.

neuroinfections

Abscesses of the headlands More often, the central homonymous hemianopsia, less abscesses with the temporal and early part. Striking the central neuron of a healthy way and measles on the ground, abscesses in the brain develop on the ground, but not when the brain is swollen. The link with the cystic abscess of the brain may have a small mean ethiological officials central homonymous hemianopsia.

In case of abscesses, the brain is susceptible to spontaneous, as well as partial and quadrant hemianopsia. Ridko with abscesses of the early part of the upper quadrant homonymous hemianopsia through the lesion of the lower part of the fibers of the Graziole bundle in the Mayor loop. Bilateral hemianopsia in case of abscesses in the brain is very rare, often in case of localization of an abscess in the polyparticle. Inodi double-sided hemianopsia of vinikє in case of a common yak timchasov manifestation. Rarely metastatic abscesses in both areas can lead to cortical slough- Slap both eyes to save your reaction to light.

With central homonymous hemianopsia on the ground, abscesses in the brain are often indicated at once stiff nipples... Stagnant nipples in case of abscesses to the brain develop earlier, less in case of swelling of the brain, that and after the central homonymous hemianopsia with stagnant nipples in abscesses, the brain will grow older, lower in case of swelling in the brain.