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)

We have observed dot-like low intensity spots (a dot-like hemosiderin spot: dotHS) on T2*-weighted (T2*-w) MRI, subsequently diagnosed histologically as previous microbleeds associated with lipohyalinosis, amyloid angiopathy and cerebral small vessel disease (SVD) including an intracerebral hematoma (ICH) and a lacunar infarction. According to the literature, primary aldosteronism (PA), characterized by hypertension, is related to SVD. A 49-year-old female with a long history of untreated hypertension secondary to PA was admitted to our hospital for medical examinations on July 18th, 2000. She had the stepwise development of dementia, dysarthria and gait disturbance (right hemiparesis). CT and MRI demonstrated multiple lacunar infarctions. She was readmitted to our hospital on Jan 23rd, 2002. A neurological examination revealed right hemiparesis, dysarthria and consciousness disturbance. CT on admission demonstrated ICH in the left midbrain. Six days after the hemorrhage, T2*-w MRI showed thirty-two dotHSs in the basal ganglias and the cortical-subcortical regions. The incidence of ICH in patients with hypertension secondary to PA is reported to be higher than in patients with essential hypertension. Multiple dotHS may be associated with ICH, lacunar infarction, and severe microangiopathy related to hypertension secondary to PA.
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PMID:[Multiple intracerebral microhemorrhages associated with primary aldosteronism: a case report]. 1465 95

A 63-year-old man presented with sudden severe headache. Computed tomography (CT) demonstrated subarachnoid hemorrhage. Cerebral angiography demonstrated an aneurysm of the anterior communicating artery. Left frontotemporal craniotomy and neck clipping of the aneurysm via the pterional approach were performed. CT obtained 18 hours after surgery revealed cerebellar hemorrhage, and magnetic resonance (MR) imaging 17 days postoperatively demonstrated that the hemorrhage was located within the folia. Neurological examination after surgery revealed slight dysarthria after drainage of cerebrospinal fluid (CSF) but no other neurological deficits. Follow-up CT and MR imaging showed characteristic findings of postoperative cerebellar hemorrhage clearly different from those of hypertension. The cerebellar hemorrhage was probably secondary to overdrainage of CSF. He was discharged without deficits.
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PMID:Remote cerebellar hemorrhage following supratentorial craniotomy--case report. 1525 44

An 11-year-old boy developed occlusion of the left internal carotid artery (ICA) following surgical correction of atypical coarctation of the aorta. The patient was admitted to our hospital after presenting with severe hypertension secondary to abdominal aortic hypoplasia and renal artery stenosis. Reconstruction of the abdominal aorta with bypass grafting was performed without complication. However, in the postoperative period, the patient experienced recurrent transient ischemic attacks manifesting as paresthesia of the right upper limbs, dysarthria, and right-sided weakness. Cerebral angiography revealed occlusion of the C(2) portion of the left ICA and decreased resting cerebral blood flow in the left hemisphere. Extracranial-intracranial arterial bypass was performed, and the patient suffered no further adverse neurological events. Coarctation of the aorta is an uncommon congenital condition that may result in cerebral ischemic disease. The cerebrovascular circulation should be evaluated, even in patients without a pre-existing history of cerebral ischemic symptoms.
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PMID:Internal carotid artery occlusion following correction of atypical aortic coarctation-- case report--. 1619 49

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

Although there are indications that beta-blockers affect the skeletal muscle in therapeutic dosages, their influence on mitochondrial disorders is unknown. A 52-year-old woman developed double vision, myalgias, muscle cramps, and hip and thigh muscle stiffness. Clinical neurologic examination revealed ptosis, dysarthria, sore neck muscles, weakness and wasting of the thighs, and generally brisk tendon reflexes. Lactate stress testing was significantly abnormal. Needle electromyography was nonspecifically abnormal and myopathic. Muscle biopsy showed mild myopathic changes, target fibers, and a single COX-negative fiber. Probable mitochondrial disorder was diagnosed. The patient had been on 30 mg of propranolol during 7 years for arterial hypertension. Shortly after discontinuation of the drug, her double vision gradually disappeared, myalgias and muscle cramps gradually resolved, and the patient reported an increase in muscle mass on repeated follow-ups. Long-term administration of propranolol may aggravate a mitochondrial disorder. Discontinuation of propranolol may result in a gradual resolution of these adverse reactions.
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PMID:Mitochondrial disorder aggravated by propranolol. 1686 49

A 60-year-old woman with a history of chronic back pain presented to the emergency department with headache, slurred speech, and altered sensorium reported by her family. The previous day, she had a lumbar catheter placed for symptomatic relief of her chronic back pain. The patient complained only of headache, but otherwise thought she was unaffected. The patient's past medi- cal history was remarkable for diabetes, hypertension, peripheral neuropathy, gastritis, supraventricular tachycardia, and chronic back pain. On physical examination she was alert, fully orientated, and in no acute distress. Her vital signs were normal. Neurological examination revealed subtle word-finding difficulties and dysarthria. There were no physical signs of raised intracranial pressure (ICP). The remainder of her examination was entirely normal.
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PMID:Pneumocephalus secondary to lumbar catheterization. 1696 Feb 96

35-year old patient was admitted to the Department of Neurology, Medical University of Bialystok because of paresis of his left upper limb, progressing over last 10 months and right facial nerve paresis, which started a month ago. During neurological examination he presented with right facial and arm paresis, dysarthric speech, obesity and hypertension. The patient was previously hospitalized in regional hospital, where a lumbar puncture was done revealing normal composition of cerebrospinal fluid. His brain CT revealed bilateral hypodensive areas in frontal and parietal regions of vasogenic character. Doppler ultrasound showed significant slowing of blood flow velocity in both internal carotid arteries. Brain angiography presented with very weak contrast filling of intracranial branches of carotid and vertebral arteries and showed stenosis at the terminal portion of the internal carotid arteries and at the proximal portion of the anterior and middle cerebral arteries. The patient had transthoracic and transesophageal echocardiography, Holter ECG, lab tests (routine lab tests plus coagulation system evaluation with C protein resistance test, anticardiolipne antibodies, antinuclear antibodies, anticytoplasmatic antibodies and thyroid hormones) checked--all tests were within normal range. Based on cerebral angiography and clinical symptoms, after excluding any other reasons of cerebral ischemia, the patient was diagnosed with moyamoya disease and arterial hypertension. The patient was treated pharmacologically with improvement--regression of face assymetry and dysarthria and diminishing of his right arm paresis. The authors of this paper pay attention to moyamoya disease as a rare reason of ischemic strokes in the young in our geographic region. They remind moyamoya disease diagnostic criteria, its etiology and treatment.
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PMID:[Moyamoya disease as a cause of ischemic cerebral stroke in young people]. 1744 85

A 82 year-old male having a long history of hypertension was admitted for dysarthria. Neurological examination revealed dysarthria with mild disturbance of left-sided soft palate elevation. No lingual palsy nor facial weakness were noted. No motor weakness in the upper and lower extremities was noted. Diffusion-weighted image and T2 weighted image revealed a small high signal lesion localized in the medial one-third of the left cerebral peduncle. There were bilateral stenotic lesions of the posterior cerebral artery at P1 portion in intracranial magnetic resonance angiography. Pure dysarthria can be caused by disruption of the supranuclear fiber of glossopharyngeal and vagal nerve nucleus in the corticobulbar tract, which can be localized in the medial portion of the cerebral peduncle.
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PMID:[Cerebral peduncle infarction with pure dysarthria--case report]. 1771 24

We sought to determine the clinical pictures, topography and pathogenesis of patients with unilateral single or multiple corona radiata infarcts. We defined corona radiata ischemic stroke if the patient had a focal neurological deficit and a relevant non-hemorrhagic infarction confined to the vascular territory of a long medullary artery proved by CT and MRI with contrast. We compared risk factors and clinical feature between subtypes of corona radiata infarcts. The study sample represents 1.2% of the patients (68/5500) with first-ever stroke in our Registry, including ischemic and hemorrhagic strokes. There were 37 patients (54%) with single infarct presenting 17 different complete or partial sensory-motor symptoms with dysarthria; 14 patients (21%) with unilateral multiple infarcts in one hemisphere had often complete sensorimotor deficits with some neuropsychological impairment; among 17 patients (25%) with multiple infarcts in both hemisphere, one half had bilateral motor and sensory symptoms, and neuropsychological deficits, visual field defects were uncommon. Seventeen patients (25%) had dysarthria, which was no localizing value. Hypertension was the most frequent vascular risk factor in 62% of patients, smoking in 28%, diabetes mellitus in 26%, hypercholesterolemia in 9%, and atrial fibrillation in 7%. The main cause of corona radiata infarcts was small-artery disease with long-standing hypertension in 40 patients (59%), large-artery disease in 19%, cardioembolism in 12%. Most of the patients (88%) had leukoaraiosis, and patients with bilateral multiple infarcts, leukoaraiosis was more frequent than in those with unilateral single infarct (P = .016; < .05). Despite clinical similarity to that found in superficial and deep infarcts, incomplete motor and sensory symptoms and MRI allows to delineate simultaneous uni- or multiple infarcts in the corona radiata. After an acute and immediate onset, outcome at 6 months of stroke onset is in general benign except those with bilateral infarcts. The coexistence of small-artery disease with leukoaraiosis suggest similar vascular risk factors and physiopathological mechanism.
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PMID:Spectrum of single and multiple corona radiata infarcts: clinical/MRI correlations. 1790 7

We report two cases of reversible brainstem hypertensive encephalopathy (RBHE) with unusual magnetic resonance (MR) findings. Patient 1, an 85-year-old man without a history of hypertension, developed acute severe hypertension and mild consciousness disturbance as the only symptoms. Patient 2, a 46-year-old man with an untreated hypertension, presented with extremely high blood pressure and general fatigue, vertigo, and mild dysarthria as the initial manifestations. In these patients, fluid-attenuated inversion recovery (FLAIR) and T2-weighted MR images revealed diffuse hyperintensities in the brainstem. Diffusion-weighted imaging (DWI) findings were normal, and apparent diffusion coefficient (ADC) values were increased in the brainstem. The supratentorial regions were largely spared, and mildly diffuse hyperintensities were noted in the white matter. There were no accompanying changes in the occipital lobe and cerebellum. The lesions completely resolved after stabilization of blood pressure. The normal DWI findings and high ADC values were consistent with vasogenic edema due to severe hypertension. The characteristics of RBHE are a very high blood pressure, mild clinical and neurologic symptoms, rapidly improved MR findings after initial treatment with the control of hypertension, and a marked clinicoradiologic dissociation.
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PMID:Reversible brainstem hypertensive encephalopathy (RBHE): Clinicoradiologic dissociation. 1867 82


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