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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three cases of brain abscess following an occlusion of the internal carotid artery were reported. Case 1: A 6-year-old girl with congenital heart disease was admitted with headache, disturbance of consciousness and left hemiparesis. Right carotid angiography revealed an occlusion of the right internal carotid artery. After 6 months, she was readmitted with high fever. CT scan revealed a low density area and a ring-like shadow at the same site of cerebral infarction. Case 2: A 69-year-old man was admitted in semicoma and with right hemiplegia. Left angiography revealed an occlusion of the left internal carotid artery. After 2 months, a brain abscess was noted in the infarcted area. Case 3: A 20-year-old man with congenital heart disease, was admitted due to headache, vomiting and high fever. CT scan revealed a brain abscess in the right frontal lobe. Carotid angiography showed bilateral internal carotid artery occlusion. We concluded that diminution of cerebral oxygen and encephalomalacia are predisposing factors to the evolution of brain abscess.
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PMID:[Brain abscess (Part 5)--Brain abscess following internal carotid occlusion (author's transl)]. 49 56

Ischemic cerebrovascular disease in children is relatively rare. To clarify the clinical features of ischemic stroke occurring in infants and children, we evaluated 54 cases of cerebral infarction, excluding cases of moyamoya disease, in patients less than 16 years old at 24 clinics in the Tohoku (northeast) district of Japan. We observed two incidence peaks, one in little children and the other in junior high school students. Infection and minor head trauma were more frequently seen prior to ischemic strokes than was heart disease. The middle cerebral artery region, including the basal ganglia, was most commonly affected (49 patients, 91%) on computed tomograms. Angiography was performed in 48 patients (89%) and showed various types of occlusive lesions, mostly affecting the middle cerebral artery. Hemiparesis was the most common form of disability following ischemic strokes (48 patients, 89%). Surgical treatment was carried out in seven patients (13%). The clinical course of these cases showed that the recovery of children after a stroke tends to be better than that of adults, but that permanent disabilities, such as hemiparesis or mental retardation, occur commonly. Further investigation of juvenile cerebrovascular disease is important to prevent ischemic strokes in children.
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PMID:Clinical survey of ischemic cerebrovascular disease in children in a district of Japan. 202 86

Moya-Moya disease has been associated to a number of disease entities including Down syndrome. Initial clinical manifestations in our patient were alternating lateralizing seizures with sudden onset hemiparesis. Ct scan demonstrated several infarcts in different stages of evolution, in the territory of left middle cerebral artery. Single digital subtraction angiography showed bilateral occlusion, predominantly on the left side of the supraclinoid portion of the interna carotid arteries with formation of collateral circulation in the diencephalic territory. The association of Moya-Moya disease and Down syndrome is not fortuitous and it is probably due to a congenital vascular dysplasia. It should be suspected in children with trisomy 21 (with or without congenital heart disease) who presents with alternating hemiplegia and convulsions or acute hemiplegia.
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PMID:[Acute hemiplegia in childhood and alternating hemiconvulsions secondary to Moya-Moya disease. Report of a case associated with Down's syndrome]. 228 71

From a total number of 227 patients with lacunar infarcts of the brain assisted during a period of 7 consecutive years, 18 (8%) had an age equal or below 45 years. This group of patients represent 1.1% of strokes and 1.6 of the ischemic cerebral infarcts treated in a Neurology Service during the study period. Eleven patients (64%) were male. The most relevant cerebrovascular risk factors are: arterial hypertension (55%), cardiopathy (26%), and diabetes mellitus (11%). The most common syndrome was pure motor hemiparesis (61%), pure sensitive syndrome (22%), and atypical lacunar syndrome (17%). Computerized axial tomography of the brain was positive in 44.5% of cases. The mean systolic arterial pressure during the first 24 hours of the illness was significantly lower (p less than 0.03) in the young patients. Our results indicate that lacunar cerebral infarcts in young patients: a) are uncommon, and b) constitute a group with some differential clinical characteristics and with a better immediate prognosis with respect to the remaining patients with lacunar infarcts.
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PMID:[Cerebral infarctions of the lacunar type in young adults]. 226 Nov 90

61 of 1,590 (3.8%) patients with cerebrovascular disease showed suprabulbar palsy of the pure form (42 patients; 2 had autopsy) and striate form (19 patients; 3 had autopsy). 25 patients with the pallidopyramidal syndrome were included since the clinical picture bordered on the striate form. The pure variety was characterized by dysarthria, dysphagia and automatic voluntary dissociation of facial movements. Half of the patients also had hemiparesis, primitive reflexes and short-step gait. In the striate form, the main signs were dysarthria, dysphagia, automatic voluntary dissociation, rigidity and hypokinesia. Brisk tendon reflexes, primitive reflexes, short-step gait and mental deterioration were also present in half of the patients. The pure variety was caused by multiple infarcts and/or lacunae (85.7%), while the striate form had vascular lesions by computed tomography in only 36.8% of the cases. Histological findings, showing lipohyalinosis of the arterial wall leading to stenosis and occlusion of the lumen and tissue rarefaction and disintegration, support the assumption that microinfarctions, sometimes found only by histopathological examination, are the leading pathogenetic factor in this form. Hypertension, cardiopathy, smoking habit, dyslipemia and diabetes are the most frequent risk factors in both forms.
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PMID:Pseudobulbar palsy: a clinical computed tomography study. 229 26

We describe an analysis of 227 patients with lacunar infarcts; 177 were inpatients and the remaining 50 were outpatients. The group comprised 11% of all inpatients with cerebrovascular pathology and 16% of all consecutive inpatients with brain infarcts studied at the Department of Neurology of the Hospital de la Santa Creu i Sant Pau. The main risk factors identified in these patients were arterial hypertension in 164 (72%), diabetes mellitus in 64 (28%), and heart disease in 58 (26%). The most common clinical syndromes were pure motor hemiparesis in 125 (55%), pure hemisensory stroke in 42 (18%), the sensorimotor deficit syndrome in 34 (15%), ataxic hemiparesis in seven (3%), and the dysarthria-clumsy hand syndrome in four (2%); atypical syndromes were observed in 15 patients (7%). Lacunes were demonstrated by computed tomography in 100 patients (44%) and by magnetic resonance imaging in 35 (78%) of the 45 patients in which it was applied. Magnetic resonance imaging was significantly better (p less than 0.001) than computed tomography for imaging lacunes, especially those located in either the pons (p less than 0.005) or the internal capsule (p less than 0.001). After the acute phase, mild or no neurologic disability was detected in 178 patients (78.4%), moderate disability persisted in 48 patients (21.1%), and severe disability was recorded in one case (0.4%). Lacunar infarcts are a clearly defined entity with characteristic clinical features and an excellent short-term prognosis. Magnetic resonance imaging is the current method of choice for demonstrating these small brain lesions.
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PMID:Clinical study of 227 patients with lacunar infarcts. 234 85

A worker exposed to fluorocarbons in an automobile plant for seven years experienced shortness of breath (in 1977) and was referred to the hospital. The clinical examination revealed electrocardiographic abnormalities. He recovered quickly and returned to work. During the following year (1978) he suffered subarachnoid bleeding with hemiparesis, and four years later he had an operation for a thymoma. Hygienic measurements in 1980-1981 showed large variations in the fluorocarbon concentrations in the plant, the average 8-h concentrations being below the occupational exposure limit of 500 ppm but several short-time measurements reaching levels of over 750 ppm. It was suggested that, persons with heart disease do not necessarily have to be removed from work with fluorocarbons without careful review of the exposure but that the evaluation of the exposure should not only be based on time-weighted average concentrations, but also on values for brief periods, in that such concentrations can often be decreased by simple and cheap measures.
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PMID:Exposure to fluorocarbons during the filling and repair of air-conditioning systems in cars--a case report. 343 54

Brain abscesses in the young are rare. Only 14 such abscesses have been seen at Texas Children's Hospital since 1968. Most abscesses developed in association with congenital heart disease (5), although sinusitis and mastoiditis were precipitating causes in two patients and one patient, respectively. The latter three patients' cases are reviewed in detail. Clinical and bacteriologic findings in all patients are discussed. There were signs of increased intracranial pressure in nine patients (64%). All abscesses were drained; in several, repeated drainage was necessary. Anaerobic organisms were recovered in six patients (43%), aerobic organisms were recovered in five (36%), and both were recovered in two (14%). In one patient no growth was reported. Antimicrobial therapy was administered to all patients but one, whose abscess was completely excised. Morbidity and mortality remained significant: three patients (21%) died and one has a residual hemiparesis.
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PMID:Brain abscesses in the young. 393 Oct 20

An abscess of the brain is a serious complication in patients with congenital heart malformation. The great majority of cases are limited to cyanotic congenital heart disease and a peak in the age distribution can be seen in childhood. We report on a 40-year-old man with progressive right hemiparesis due to an abscess in the left basal ganglia. Clinical aspects and additional diagnostic assessment are described. By cardiologic examination including transoesophageal cross-sectional echocardiography a bidirectional sinus-venosus defect could be detected. This finding supported the diagnosis of a so-called 'paradoxical' brain abscess.
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PMID:[Brain abscess in a bidirectional atrial septal defect in adulthood]. 406 Aug 33

Of 76 patients in the pediatric age group suffering from cerebrovascular diseases treated in the years 1970-1983, 26 patients (34%) did not harbor intracranial vascular malformations (aneurysms or arteriovenous malformations). Two groups of patients were identified: (a) those suffering from a spontaneous intracranial hemorrhage (16 cases); (b) those suffering from an ischemic stroke (10 cases). Of those with spontaneous intracranial hemorrhage, 10 patients underwent surgery and evacuation of the hematoma. In 2 cases the hematoma was located in the posterior fossa, in 1 case in the upper brain stem, and in 3 cases in the basal ganglia; in the remainder the hematoma was supratentorial. Two patients died soon after the hemorrhage. Eight of the surviving patients completely recovered. In those with ischemic stroke, none suffered from congenital heart disease, a well-known predisposing factor. In this second group 1 patient died and 9 survived. Only one patient showed complete recovery. The data indicate that a hemorrhagic stroke is more common than an ischemic stroke in a child presenting with acute onset of hemiparesis and/or loss of consciousness: thus the value of CT scan as the first diagnostic procedure is clear, owing to the possibility of emergency surgical treatment. In children with ischemic strokes, a complete laboratory/clinical evaluation should be undertaken in order to exclude preexisting heart disease, coagulation disorders or lipoprotein abnormalities, and less common systemic diseases.
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PMID:Childhood cerebrovascular diseases not associated with vascular malformations. 408 10


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