Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013362 (dysarthria)
 3,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A spontaneous internal carotid artery dissection of an aneurysmal form is reported. The patient, a fifty-eight-year-old man, had manifested recurrent transient left hemiparesis, dysesthesia of the left upper limb, and dysarthria for three months. After administration of ticlopidine, the transient ischemic attacks completely disappeared. Three months later, the follow-up angiographic study revealed the same form of dissection in the same portion as compared with the initial study. Conservative therapy was successful.
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PMID:TIAs in a spontaneously dissecting aneurysm of the internal carotid artery--a case report. 162 43

Nine cases (seven men and two women, mean age 64.5 years) of classical lacunar syndromes due to intracerebral hemorrhage are reported. Three patients presented with pure motor hemiparesis (two putaminal hematomas with proportional weakness and one cortical hemorrhage with brachio-crural hemiparesis). Four patients presented with sensorimotor stroke due to thalamo-capsular hemorrhage. The last two patients had thalamic hemorrhage causing ataxic hemiparesis or dysarthria-clumsy hand syndrome. Four subjects had arterial hypertension, one was diabetic, and two were treated with anti-vitamin K. Abrupt onset was noted in all instances. Only one patient experienced moderate inaugural headaches. Good recovery occurred in all cases. Lacunar syndromes are a very uncommon presentation of intracerebral bleeding. Hemorrhages are yet the second etiology of such syndromes. Distinguishing hemorrhage from infarction is not clinically possible and needs early unenhanced CT scan.
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PMID:[Lacunar syndromes due to intracerebral hemorrhage]. 163 70

A 40-year-old female, who had taken low-dose oral contraceptives for 2 months before onset, developed transient dysarthria, left hemiparesis, and left hemihypesthesia. One month later, a computed tomography (CT) scan revealed a uniformly enhanced, convex-shaped, hypertrophic membrane with a lobulated lumen in the subdural space of the right parietal region. A right parietal craniotomy was performed. The membrane, consisting of elastic-hard, hypertrophic granulation tissue and yellowish, sticky fluid in the lumen, was readily freed and totally extirpated. Subsequently, the patient recovered without persistent symptoms. Light microscopic examination detected the sinusoidal channel layer and the fibrous layer in an alternating configuration, along with intramembranous hemorrhagic foci. Such hypertrophy must have been caused by repeated intramembranous hemorrhages and reactive granulation. Such findings of hematoma membrane have never previously been reported. Thus, this is an interesting case, clearly distinguished from typical chronic subdural hematoma.
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PMID:[Chronic subdural hematoma with a markedly fibrous hypertrophic membrane. Case report]. 170 61

A 53-year-old male complained of frequent left motor-sensory transient ischemic attack for 4 months. On admission, he demonstrated mild right hemiparesis, dysarthria, and right hemisensory disturbance of all modalities. Cerebral angiography demonstrated complete occlusion of the left internal carotid artery just above the origin of the ophthalmic artery and a stenotic lesion at the horizontal segment of the right middle cerebral artery. Renal angiography showed severe stenosis of the right renal artery. Systolic blood pressure was over 200 mmHg and marked circadian variation of blood pressure was noted. Serum renin was 4.0 ng/ml/hr. Four months after superficial temporal artery-middle cerebral artery anastomosis, left carotid angiography showed good patency of the bypass and the ischemic symptoms completely disappeared. Single photon emission computed tomography (SPECT) showed increased cerebral blood flow (CBF), especially in the left hemisphere after surgery. Six months after the bypass surgery, he complained of mild right hemiparesis again. Shortly after percutaneous transluminal angioplasty (PTA) for renal arterial stenosis, his hemiparesis was improved and the systolic blood pressure stabilized to 150-170 mmHg. SPECT showed the CBF had also recovered in both hemispheres. The improvement in ischemic symptoms and increased CBF after PTA were probably related to stabilization of the systemic blood pressure or inhibition of serum renin-angiotensin.
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PMID:[Improvement of ischemic symptoms and cerebral blood flow after percutaneous transluminal angioplasty for renovascular hypertension. Report of a case with multiple cerebrovascular occlusive disease]. 172 58

Recently attention has been drawn to postoperative cerebral hyperperfusion after carotid endarterectomy (CEA) associated with a preoperative state of impaired cerebral hemodynamics. Rarely postoperative neurological deficits are caused by cerebral edema due to hyperperfusion. The patient was a 65-year-old male with dysarthria and right hemiparesis. Because of the presence of severe stenosis of the left carotid artery, CEA was performed. On the 6th postoperative day, he developed severe right hemiparesis and aphasia due to cerebral edema in the subcortical region of the left cerebral hemisphere. Left carotid angiography showed normal circulation without evidence of the carotid stenosis. Later the cerebral edema and the neurological deficits gradually disappeared.
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PMID:[Neurological deterioration due to cerebral hyperperfusion following carotid endarterectomy. Case report]. 172 61

A 55-year-old man came to us with dysarthria and right hemiparesis. The cerebral angiography showed segmental narrowing and irregularity of the left anterior cerebral artery. The patient responded well to corticosteroid therapy and there was later angiographic evidence of healing. After systemic angiitis and central nervous system infection were excluded, the diagnosis of isolated benign cerebral vasculitis was made. According to past reports, at least 13 patients have been described as having isolated benign cerebral vasculitis. The common features of isolated benign cerebral vasculitis are as follows: 1) benign evolution, 2) sensitiveness to corticosteroids, 3) absence or minimal change of CSF findings, 4) angiographic pattern of arteritis, 5) the most common symptom is headache. We suggest that early corticosteroid therapy is necessary in any case of cerebral vasculitis.
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PMID:[A case of what was regarded as isolated benign cerebral vasculitis]. 176 43

We investigated the types of clinical syndrome, location, sizes and presumed causes of 49 patients with capsular lacunar infarction. Clinical syndromes were classified according to Fisher's criteria into pure motor hemiparesis (PM), sensorimotor stroke (SM) and ataxic hemiparesis (AH) including dysarthria clumsy hand syndrome. Cases who had higher brain dysfunctions or brainstem syndromes were excluded. The size of infarcts was expressed as the volume on brain CT. All patients underwent 12-lead ECG and 2-dimension echocardiography. Twenty three patients (47%) underwent angiography or carotid ultrasonography. Lesion sites on CT were divided into three groups, i.e., perforating branch of ACA (PACA), perforating branch of MCA (PMCA) and anterior choroidal artery (AC). Lesion sizes of AH were significantly smaller than those of SM and tended to be smaller than those of PM. In AH patients, no cardioembolic sources nor large arterial lesions could be detected, whereas 40% in SM patients and 30% in PM patients had cardioembolic sources and 33% in SM patients and 75% of PM patients had large arterial lesions. The lesion volume was classified into two groups, larger and smaller than 1 ml. The larger volume group had more frequent cardioembolic sources than the small volume group (42% and 17% respectively, p less than 0.05), but no significant difference in frequency of large artery lesions was found among the two groups. Patients with "large striatocapsular infarct" had frequent cardiac and arterial lesions (60% and 40% respectively). Patients with AC territory infarction had more infrequent but not significant cardiac and arterial lesions than patients with PMCA territory infarction. All patients with PACA territory infarction presented PM.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Type of syndrome, location, size and etiology of capsular lacunar infarction]. 180 63

Three cases of anterior choroidal artery territorial infarction, diagnosed by computerized tomography, with the triad of hemiplegia, hemianaesthesia and hemianopia, pure motor stroke and ataxic hemiparesis are described. Major and minor (lacular) infarctions in the territory of the anterior choroidal artery involve almost exclusively the basal segment of the posterior limb of the internal capsule and manifest themselves by symptoms of long pathway lesion. Based on the published case reports and the authors' own observations, the complete capsular syndrome characterized by the triad of hemiplegia, hemianaesthesia and hemianopia was differentiated from partial capsular syndromes including the following forms: pure motor stroke, pure sensory stroke, sensorimotor stroke, sensory stroke with hemiataxia, ataxic hemiparesis, dysarthria and/or clumsy hand, and homonymous hemianopia (quadrantanopia or sectoranopia). The characteristic features of the above types of capsular syndromes were analyzed. Distant symptoms of territorial infarctions involving the anterior choroidal artery are transcortical sensory or motor aphasias and construction apraxia in the dominant hemisphere, left side perception failure and visual-construction apraxia in the non-dominant hemisphere, and cerebellar hemiataxia. These distant symptoms are a manifestation of distant cortical or cerebellar metabolic depression due to the mechanism of diaschisis.
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PMID:[Anterior choroidal artery syndromes]. 180 18

A case of persistent primitive proatlantal intersegmental artery (PPPIA) is reported. A 65-year-old male with treated hypertension was admitted to our clinic complaining of dysarthria and hemiparesis of sudden onset two days after the ictus. CT revealed spotty low-density lesions in the left corona radiata and bilateral thalami with bilateral watershed infarction. MRI findings were also compatible with cerebral infarction. Left common carotid angiography demonstrated a large anastomosis between the external carotid artery and the vertebral artery at the proatlantal region. Neither of the vertebral arteries were visualized on digital subtraction aortography. All the blood circulation of the vertebro-basilar system was through this anastomotic artery (PPPIA). A flow study revealed hypoperfusion in the territory of the left middle cerebral artery on 133Xe SPECT. Bone window CT of cervical vertebrae revealed hypoplasia of the left transverse foramen in C2, C3, C4, C5, C6 vertebrae. This case is very suggestive of an anaplasia or hypoplasia of the vertebral arteries. The etiology of his left frontal infarction seemed to be a blood-stealing phenomenon of long standing, from the anterior to the posterior circulation through the PPPIA.
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PMID:[Persistent primitive proatlantal intersegmental artery (PPPIA) presenting with cerebral infarction]. 188 24

Case 1. A 46-year-old man suddenly developed mild gait disturbance and left hemiparesis. On examination, gross strength was slightly reduced in the left extremities. The finger-to-nose and heel-to-knee tests disclosed moderate dyssynergia and dysmetria on the left side that could not be explained by the muscular weakness. Deep tendon reflexes were more brisk in the left extremities. There was no Babinski sign. Magnetic resonance imaging showed a region of high signal intensity in the right posterior limb of internal capsule with extension into lateral thalamus. The lesion involved the cortico-ponto-cerebellar pathway and partly the dentato-rubro-thalamo-cortical pathway. No lesions were seen in the brainstem. Single photon emission CT with 123I-IMP showed left cerebellar hypoperfusion termed crossed cerebellar diaschisis by Baron et al. Case 2. A 65-year-old female developed weakness of the left extremities and gait disturbance. On examination, there was a horizontal nystagmus on lateral gaze to each side. She showed dysarthria, mild left hemiparesis and slight left hypesthesia. The finger-nose and heel-knees tests revealed moderate dysmetria and dyssynergia on the left side. Deep tendon reflexes were hyperactive in the left extremities with left Babinski sign. CT showed a low density area in the right basis pontis at about middle level. Intravenous digital subtraction angiography revealed a slight stenosis of right vertebral artery, but no other abnormality. The lesion involved the cortico-ponto-cerebellar pathway. Single photon emission CT with 123I-IMP showed left cerebellar hypoperfusion. The right cerebellar blood flow was normal.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Analysis of hemiparesis with homolateral ataxia by single photon emission CT]. 189 73


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