In this paper 33 cases of colloid cyst of the 3rd ventricle are presented. The initial symptoms as well as the clinical syndromes are quite variable, but usually consist of a combination of signs of increased intracranial pressure and an organic dementia, progressive or paroxysmal. Computed tomography is an invaluable diagnostic tool and it seems that, since it has become widely used in the evaluation of patients with headaches or dementia, colloid cysts are being recognized with increasing frequency. Different modalities of treatment are discussed. The transcortical and transcallosal approaches are both effective techniques, but the latter is probably preferable in cases with mild ventricular dilatation.
Prior reports of neuroleptic malignant syndrome (NMS) concerned patients with psychiatric disorders, usually schizophrenia, who were taking dopamine receptor blocking agents. We report the syndrome in a patient with Huntington disease who was treated with dopamine-depleting agents. He had a negative evaluation for malignant hyperthermia (MH), and we suggest that NMS differs from MH. The occurrence of NMS caused by dopamine-depleting agents suggests that anticholinergic properties of phenotiazines are not the only cause. Central dopaminergic systems probably participate in thermoregulation, and dopamine depletion probably plays a pathogenetic role in this syndrome.
The effects of substance P on anterior pituitary secretion were studied in 3 female rhesus monkeys. In nine experiments, 100 μg substance P was injected intraventricularly, and the results were compared to those obtained following intraventricular injection of the control vehicle. In 7 out of 9 experiments, substance P induced a significant increase in prolactin secretion within 5 min. Peak levels at 10 min were approximately 15-20 times those of the baseline control. Substance P also induced a slight but significant decrease in GH secretion 20 min following injection, but at other times GH levels were not significantly changed. LH and FSH as well as cortisol concentrations remained unaltered. In 2 monkeys a decrease in systolic pressure of 40–70 mm Hg within 10-60 sec and lasting 180-300 sec was observed following the administration of substance P but not the control vehicle. The results indicate that substance P, which in the monkey has been shown to be associated with hypothalamic regions implicated in the control of anterior pituitary secretion, can alter prolactin and GH release.
This case suggests that relatively low CSFP is a contributor to worsening normal-tension glaucoma, probably by increasing translaminar pressure gradient of the optic nerve.
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