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Query: UMLS:C0013362 (dysarthria)
 3,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To evaluate diagnostic and aetiological clues for diffuse cerebral atrophy, the statistical correlations between 35 pneumoencephalographic and 97 clinical variables in 268 patients were analysed. Each case of diffuce cerebral atrophy was originally of unknown cause, and all had pneumoencephalography. Ventricular diffuse atrophy correlated positively with psychic and co-ordinative impairment and dysarthria, and cortical diffuse cerebral atrophy with psychic impairment (P smaller than 0.01 to 0.001). There was a close correlation (P smaller than 0.001) of cortical diffuse cerebral atrophy with use of vibrating tools at work. Psychic impairment combined with co-ordinative dysfunction and dysarthria is an unspecific syndrome, but should make one think of diffuse cerebral atrophy, Arteriosclerosis, abuse of alcohol, and vibrating tools at work appear to have aetiological significance for some types of diffuse cerebral atrophy. Thus the number of patients with idiopathic diffuse cerebral atrophy may rapidly decline.
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PMID:Statistical correlations of diffuse cerebral atrophy, with special reference to diagnostic and aetiological clues. 113 Jan 68

Fifty-three patients with infarction of the corona radiata adjacent to the body of the lateral ventricle were clinically evaluated in order to determine the clinical characteristics of this infarction and localization of the pyramidal tract in this area, as well as its somatotopy and etiology. Clinical characteristics included the following: (1) this type of infarction was observed in 9.1% of all patients with cerebral infarction; (2) although 81.1% of the patients of this type had clear consciousness and neuropsychological symptoms in some patients; (3) motor paralysis usually occurred in the upper limbs; (4) monoplegia occurred in 13.2% of patients, with monoplegia of upper and lower limbs being associated with infarction of the anterior and posterior portion, respectively, of the corona radiata adjacent to the body of the lateral ventricle; (5) pure motor hemiplegia was observed in 45.3% of patients; (6) facial paralysis and dysarthria were observed in 54.7% and 58.5% of patients, respectively, and the incidence of these symptoms was the highest in the infarction of the anterior portion of the corona radiata; (7) sensory disturbance, which was usually recognized as a mild subjective feeling of abnormality and localized to the limbs, was reported by 47.2% of patients; (8) risk factors included hypertension, diabetes and high hematocrit and triglyceride levels; (9) arteriosclerosis was often noted in areas between the siphon of the internal carotid artery and the main stem of the anterior and middle cerebral arteries; (10) 64.2% of patients were able to conduct independent activities of daily life (ADL) 1 month after the onset of the disease and more marked paralysis remained in the infarction of the middle portion than in the anterior or posterior portion.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical characteristics of infarction of the corona radiata adjacent to the body of the lateral ventricle]. 275 54

The diagnosis of subcortical arteriosclerotic encephalopathy of Binswanger should be confirmed neuropathologically by postmortem examination. But we expect that it may be possible to diagnose provisionally as Binswanger's disease on the basis of clinical course and findings including computed tomography. Two cases, 57 years old postman (case 1) and 60 years old housewife (case 2) were reported. They had hypertension for over 20 years in their past history and showed a progressive dementia since before one year and 9 years. Transient syncopal attack and epileptiform seizure revealed occasionally. Psychiatrically either of them were apathetic, aspontaneous and autistic. One of them (case 2) showed a striking paranoid-hallucinatory state. Spastic gait disturbance and dysarthria are found neurologically, and moreover in case 1 revealed the incontinence of urine and feces. Arteriosclerotic changes were seen in the fundi. The EEG showed a slow alpha rhythm with scattered theta- and delta-waves. Laboratory data of blood, urine and CSF were normal. On the basis of these clinical course and findings the diagnosis of Binswanger's type of cerebral arteriosclerosis were suspected. The CT-scan of 2 cases proved a symmetrical enlargement of the lateral ventricles and marginated areas of definite abnormal low density in the white matter of the occipital (case 1) and frontal (case 1 and 2) lobes. Conclusively we may provisionally diagnosed our two cases as Binswanger's disease, also supported by the findings of CT.
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PMID:[Two clinical cases diagnosed provisionally as Binswanger type of vascular dementia--on possibility to its clinical recognition from neuropsychiatric findings and computed tomography (author's transl)]. 725 7

This is a report of unruptured aneurysms with occlusion of the basilar artery. A 61-year-old female was admitted to our hospital because of dysarthria and numbness of her left face. Angiography revealed occlusion of the basilar artery and severe arteriosclerosis of the bilateral cerebral carotid arteries. Pcom was not visualized on bilateral carotid angiogram. These neurological signs were considered to be derived from vertebrobasilar insufficiency by occlusion of the basilar artery. Right STA-SCA anatomosis was performed to prevent brain stem infarction. Postoperative angiography showed a good filling of both PCA and SCA by collateral circulation via a right STA and an unruptured basilar top aneurysm. Seven months after the bypass surgery, angiography disclosed that the basilar top aneurysm was visualized clearly, and its size was unchanged. The fact that there was no thrombus formation in the aneurysm was considered to be due to ticlopidine, and the hemodynamic changes after the bypass surgery were suspected to have increased the intraaneurysmal pressure. Therefore we performed neck clipping of the basilar top aneurysm by using a right pterional approach. Two years after the second operation, the patient complained of severe headache and vomiting. CT scan showed subarachnoid hemorrhage, and angiography demonstrated a newly developed aneurysm which might have ruptured on left internal carotid anterior choroidal artery bifurcation. Emergency neck clipping of the second aneurysm was performed, and the patient showed a good postoperative course. The newly developed second aneurysm might have been caused by severe arteriosclerosis and hypertension in addition to hemodynamic stress.
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PMID:[A case of growing up aneurysms with occlusion of basilar artery]. 766 40

A 61-year-old woman was admitted to the hospital on September 18, 1991 because of left hemiparesis, dysphagia, and dysarthria since five days before. She was formerly pointed out diabetes mellitus and hypertension, but she did not receive any treatment. The MRI showed a high signal area in the right paramedian portion of the upper pons on T2 weighted image and proton image. The angiography showed that persistent primitive proatlantal artery originated from the left internal carotid artery and joined to the horizontal portion of the left vertebral artery. The image of carotid-vertebrobasilar system and proatlantal artery showed so severely arteriosclerotic. This is the first report of brainstem infarction with persistent primitive proatlantal artery. In this case, the pontine infarction was thought to occur on the basis of the arteriosclerosis of blood vessels and change of blood flow of carotid-vertebrobasilar system due to persistent primitive proatlantal artery.
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PMID:[A case of pontine infarction with persistent primitive proatlantal artery]. 829 79

Ischaemic stroke in young people, that is in those under 45 years of age, forms a distinct entity. Whereas in the case of older patients the main cause is arteriosclerosis, in the younger group a broad spectrum of etiologies can be found. It is for this reason that in these latter cases we must carry out a diagnostic study that is not only more exhaustive but also additionally is aimed at seeking out specific pathologies as for instance a possible association with vasculitis, infectious diseases, hematological abnormalities or unclear cardiopathology. Given the therapeutic transcendency that findings might have, in order to avoid new bouts in patients at the most productive moments in their lives, we believe it to be of great interest to carefully study these patients as exhaustively as need be. In the present work we present the case of a young patient with ischaemic infarct in the region of both upper cerebella which started out with a clinical picture of ataxia and dysarthria with benign course and total recovery. Possible etiologies are discussed in the light of findings made during complementary tests, as well as the unusual location of the lesions.
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PMID:[Ischemic infarct, mitral valve prolapse and protein S deficiency]. 885 7

Medial medullary infarct is a rare type of brain stem infarction first described in 1908. It was only since the broad use of MRI that an accurate clinical topographical correlation could be documented in survivors. We observed two patients; one of them had an anteromedial unilateral infarction in the upper medulla, and the clinical picture was characterized by contralateral hemiparesis, facial weakness, dysarthria and palatal weakness. The outcome was good. The second patient however showed a severe tetraparesis with only minor brain stem signs, secondary to bilateral anteromedian infarction with a large craniocaudal extension. He survived with severe residual impairment. The most likely cause of infarction was arteriosclerosis of the A. vertebralis and A. spinalis anterior, respectively. These two different cases suggest that the medial medullary syndrome is heterogeneous comprising small unilateral infarctions with mild clinical signs as well as large bilateral infarctions with a poor outcome.
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PMID:[Medial medullary infarct]. 981 32

Bilateral medial medullary infarction is rare. Only 18 cases have been reported previously. We experienced a case of the bilateral lower pons-medullary infarction. A 63-year-old woman was admitted to our hospital because of moderate left hemiparesis. Hyperreflexia in left limbs and positive Babinski's reflex in left foot was observed. Sensory disturbance was mild left hemihypesthesia (in light touch, postural sense and vibration) without facial involvement. She also had lateral gaze nystagmus, dysarthria, and bilateral decreased gag reflex. Respiratory failure was not observed. A conservative therapy for cerebral infarction was performed. But the hemiparesis was deteriorated and progressed to complete quadriparesis on the 5th day. The brain MRI (T2-weighted image and FLAIR) demonstrated bilateral lower pons-medial medullary infarction on the 9th day. Cerebral angiography and 3D-CT angiography revealed no stenosis or occlusions in the major cerebral arteries. The anterior spinal artery was not evaluated enough because of the arteriosclerosis. The prognosis of this patient was favorable except for the quadriparesis. The severe quadriparesis has not been improved for about 2 years. The bilateral medial medullary infarction was quite rare in the literature. The prognoses of these cases were unfavorable for the respiratory failure. Our case was not fatal because of no respiratory paralysis.
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PMID:[A case of bilateral lower pons-medial medullary infarction presenting quadriparesis]. 1463 16

We report 6 patients with Cheiro-oral syndrome (COS), with special reference to clinical features and responsible lesions. The time intervals from the onset of symptoms to arrival in our department were less than 24 hours in 3 patients, 2 days in 2, and 5 days in 1. All patients had subjective sensory disturbance involving the unilateral hand and ipsilateral perioral regions, and 4 patients presented with objective sensory disturbance. The body parts of tingling sensation tended to be larger than those of superficial sensory disturbance. Three patients developed motor disturbance including hemiparesis with or without ataxia, clumsiness of fine finger movements, and dysarthria. Magnetic resonance imaging revealed fresh infarctions around the thalamus, including lacunar infarctions in 5 patients and branch atheromatous disease in 1 patient. The lesion sites responsible for COS were ventral posterolateral (VPL) and ventral posteromedial (VPM) nuclei in the thalamus in 4 patients, thalamic pulvinar nucleus and medial geniculate body in 1, thalamic ventroposterior region-internal capsule-corona radiata in 1. Three patients had asymptomatic brain infarctions. Risk factors were hyperlipidemia, hypertension, diabetes mellitus, smoking, arteriosclerosis of the carotid artery, and polycythemia. In the convalescent stage, 5 patients suffered from residual sensory-motor disturbance, whereas 1 patient recovered from COS. COS has been attributed mainly to small infarctions in the thalamic ventroposterior nuclei. However, it is suggested that damage to ascending sensory fibers projecting to the thalamic VPL and VPM nuclei can cause COS. Because initial symptoms of COS are apt to be overlooked, early diagnosis and treatment are necessary to avoid residual sensory-motor disturbance.
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PMID:[A clinicoanatomical study of thalamic cheiro-oral syndrome]. 1652 19