Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018991 (hemiplegia)
 3,997 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case of a 26 year old woman who had been taking tranexamic acid to prevent uterine bleeding due to an IUD and who died from thrombosis of the left internal carotid artery is reported. The patient's father had died at age 54 of myocardial infarction. Otherwise the family history was entirely negative for thromboembolic disease. The patient was a mild smoker. She had been previously healthy and in particular, she was not affected with hypertension, diabetes, or dyslipidemia. She had carried to term 2 uncomplicated pregnancies. 40 days prior to hospital admission her gynecologist had inserted an IUD. The insertion of the IUD was followed by persistent uterine bleeding, and for this reason she began treatment with tranexamic acid (1.5 g/daily). Uterine bleeding persisted despite this treatment, and the IUD was removed. Because of persistence of a mild uterine bleeding, tranexamic acid was continued. 2 hours before admission the patient suddenly presented a left sided hemiparesis with disarthria and vomiting. On admission she was stuporous. The left side of her face drooped and the strength of the left arm and leg was markedly decreased. Both arm and leg reflexes were symmetrical. Her blood pressure was 110/70. An electroencephalogram on arrival confirmed a right sided cerebral lesion. Subsequently the patient's condition deteriorated rapidly. She developed a full left hemiplegia and became deeply comatose. A CAT scan performed 4 hours after admission showed no abnormalities. A CAT scan performed 3 days after admission showed a large cerebral infarction involving nearly the whole right cerebral hemisphere. The patient's condition remained essentially unchanged until she died 6 days after admission. Permission for autopsy was refused. Antifibrinolytic drugs competitively inhibit plasminogen activators and noncompetitively plasmin. Thromboembolic complications after the administration of antifibrinolytic drugs have long been recognized. The use of IUDs is often associated with troublesome uterine bleeding and particularly excessive menstrual bleeding. To avoid these complaints, antifibrinolytic drugs are increasingly used.
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PMID:Tranexamic acid, intrauterine contraceptive devices and fatal cerebral arterial thrombosis. Case report. 710 62

A forty years old woman with hysterical deafness is reported. Chief complaints were bilateral hearing loss. Nothing particular was found in her past and family history. In 1977, on the 11th day of May, she was admitted to A city hospital because of headache and paresis of right limb. As angiography revealed an aneurysms of her anterior communicating artery, she was undertaken the surgery of clipping and coating of the aneurysms. Post-operatively, left hemiparalysis appeared and paresis of right limb developed because of spasm of right middle cerebral artery. On the 14th day of August, ventricular-peritoneal shunt's operation was performed. As soon as she recovered from postoperative coma, she complained of bilateral hearing loss. Because pure tone audiometry demonstrated complete loss of her hearing, she was referred to ENT department of Teikyo University Hospital. Findings were as follows: 1) She had a queer way of hearing because she could understand to hear limited persons' speech (her doctor and husband). 2) Pure tone audiometry showed complete loss of her hearing but the thresholds of auditory brain stem responses were 15 dB and those of slow vertex responses were 45 dB. These results suggested no lesion in cochlea and brain stem. 3) Rorschach test and sentence complete test were performed. The results of these tests suggested hysterical state or neurotic state. 4) Total intelligent quotients by WAIS were 69 which indicated borderline level. However, this value appeared to be incorrect because she was uncooperative. 5) CT scan revealed low density areas at right temporo-parietal lobes and left temporal lobe which were localized and small. Our findings suggested hysterical deafness but not auditory agnosia. During three years, she was referred to several hospitals for rehabilitation but didn't become well at all. On the third year of the onset, her husband became sick and admitted to her room of the same hospital. During that period, suddenly, she talked her hearing to improve and the pure tone audiometry demonstrated decrease in threshold. In conclusion, this event could give a final diagnosis of hysterical deafness but not auditory agnosia.
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PMID:[A case of hysterical deafness]. 711 92

A primary cerebral rhabdomyosarcoma is reported in a 51-year-old female. She noticed progressive weakness of the left leg in September 1977 and underwent craniotomy for a brain tumor in Tokyo Metropolitan Okubo General Hospital. At the operation the tumor was located on the medial aspect of the right frontal lobe, being attached to the falx. The tumor was 6.0 x 5.0 x 4.0cm in size and subtotally removed. Shortly after operation, she developed a left-sided hemiplegia and was referred to our Kanagawa Rehabilitation Center. During rehabilitation she developed disturbance in recent memory, orientation and speaking. A second operation was done in June 1978, revealing obvious recurrence. A well demarcated extramedullary gray and soft tumor, 7.0 x 5.0 x 3.5cm in size, was found in the previously operated site, being attached to the falx. It was subtotally again. Following surgery her clinical condition was temporally improved. Four months following surgery, however, she developed signs of increased intracranial pressure and died in October 1978 in spite of having chemotherapy and irradiation. Autopsy was not permitted. The tumor was diagnosed as rhabdomyosarcoma with light and electron microscopies and several investigation revealed no primary lesion in elswhere except for the cranium. The histological documentation is also presented and discussed.
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PMID:[A case of primary cerebral rhabdomyosarcoma (author's transl)]. 729 Mar 34

A 66-year-old woman with a right hemiplegia due to cerebral haemorrhage was found to have heterotopic grey matter in the left frontal and right frontal and parietal lobes. She had no neurological disturbance prior to the haemorrhage. Regional cerebral blood flow (rCBF) was measured by xenon-CT (Xe-CT) in the zones of heterotopic grey matter during voluntary movement and sensory stimulation of her left limbs. During voluntary movement, rCBF increased markedly in the heterotopic grey matter of the frontal lobes and the overlying cortex. During sensory stimulation, rCBF increased in the right parietal heterotopic grey matter and the overlying cortex. This strongly suggests that the heterotopic grey matter is functional.
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PMID:Functioning heterotopic grey matter? Increased blood flow with voluntary movement and sensory stimulation. 747 50

We report a 85-year-old woman who developed speech disturbance and left hemiparesis. She had a gradual onset of gait disturbance 3 years prior to the present admission. Five days before admission, she started to pace up and down in her house; she did not want to take food on the following day, and she developed fever of 39 degrees C; it was also noted that she became mute. On the next day, she developed left hemiparesis; she was still mute but was able to communicate by hand writing to some extent. She was admitted to our service on February 24, 1992. On admission, she was alert but mute; her body temperature was 37.1 degrees C, and her BP 110/70 mmHg. The lungs were clear and general physical examination was unremarkable. Neurologic examination revealed that she did not utter even a word. She was unable to understand examiner's simple questions; communication by hand writing was also difficult, but she could draw her name and a circle; repetition was also impaired. Examination of other higher cerebral functions such as praxis and gnosis was impossible. Her optic fundi were unremarkable; no anisocoria was noted; extraocular muscles appeared intact, and the vestibulo-ocular reflex was normally elicited. The nasolabial fold was shallower on the left; the tongue showed a slight deviation to the left. She had near complete spastic left hemiplegia; deep tendon reflexes were increased bilaterally.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A 85-year-old right-handed woman with aphasia and left hemiparesis]. 751 90

A 72 year-old right handed woman had a right sided anterior choroidal artery infarction. She presented the triad of hemiplegia, hemianaesthesia, and homonymous hemianopsia, as well as complete non-determinant hemisphere syndrome that combined: disorientation for place and time, anosognosia, hemiasomatognosia, left spatial neglect, constructional apraxia and spatial fabulation concerning both the present time and the weeks that preceded the vascular event. Language and verbal memory were normal. Spatial memory could not be studied because of the severity of the neglect. The clinical course was poor: when tested one and a half year post-onset, the hemiplegia, the hemianaesthesia, and the hemianopsia as well as left spatial neglect remained severe. Vestibular caloric stimulation, carried out with left ear cold water irrigation, resulted in brief but clear-cut alleviation of the spatial neglect. An MRI with both axial and coronal slices showed a right-sided infarct affecting the whole posterior limb of the internal capsule including the genu, the posterior part of the globus pallidus, the anterior third of the cerebral peduncle and the amygdala but sparing the thalamus and the corona radiata. This crescent-shaped lesion transected entirely the thalamo-cortical connection fibers which resulted in a "thalamic exclusion". The measurement of brain glucose utilisation with (18F)-Fluoro-2-Deoxy-D-Glucose and positron emission tomography performed in the chronic phase (3 months post-onset) showed an exceptionally severe and widespread hypometabolism of the right hemisphere, relative to the left hemisphere, which correlated with both the unusual, severe and protracted non-dominant hemisphere syndrome. All the brain regions on the right side were hypometabolic relative to the left including the temporal region (mostly medial temporal), the left cerebellar lobe, the frontal lobe (mostly prefrontal region), the occipital region and the thalamus. The hypometabolism of the basal ganglia, the sensorimotor area and the parietal cortex was less severe. This most uncommon clinical-metabolic presentation presumably reflects a global thalamo-cortical disconnection inducing a diffuse dysfunction of the whole hemisphere.
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PMID:[Infarction in the area of the right anterior choroidal artery and minor hemisphere syndrome: clinical and metabolic study using positron-emission tomography]. 767 26

We reported a case of malignant rheumatoid arthritis (MRA) with cerebral infarction associated with a possible cause of lupus anticoagulant. The patient was a 68-year-old woman who had received treatment for rheumatoid arthritis (RA) from 15 to 16 years ago. She consulted to our hospital with a major complaint of right hemiplegia. Brain CT revealed a low density area in the left hemisphere. She was diagnosed as cerebral infarction and hospitalized. Since she was noted to have hypocomplementemia, interstitial pneumonia and pericarditis, she was diagnosed as MRA. Coagulation test disclosed positive lupus anticoagulant (LA). Generally, CNS disorders in MRA are uncommon. Cerebral infarction was complicated in the present case, suggesting the involvement of antiphospholipid antibodies as its pathogenesis.
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PMID:[A case of malignant rheumatoid arthritis with lupus anticoagulant and cerebral infarction]. 777 8

The first documented case of cerebrovascular disease occurring in a 13-year-old girl with purine nucleoside phosphorylase deficiency is reported. This patient, the oldest known survivor with purine nucleoside phosphorylase deficiency, had previously experienced multiple sequential neurologic problems. She presented with episodes of transient left hemiparesis, followed shortly thereafter by dense left hemiplegia. Magnetic resonance imaging revealed a right internal capsule infarct; cerebral angiography revealed vasculopathy of the proximal vessels. Proposed mechanisms for neurologic dysfunction and cerebrovascular disease in purine nucleoside phosphorylase deficiency are discussed.
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PMID:Stroke in purine nucleoside phosphorylase deficiency. 777 12

A 75 year-old woman was admitted with a left hemiplegia resulting from an infarct in the right middle artery's territory. Her manual preference was ambiguous from early childhood. She presented with severe bilateral apraxia, autotopoagnosia, finger agnosia, and left spatial neglect. There was, however, no aphasia nor agraphia. When the patient attempted to perform gestures on order, she compulsively produced oral or written language. In this very unusual case, dominance for gesture and dominance for language were strictly independent, each ensured by one hemisphere. The patient's performances in gestual activities, especially dissociation between automatic and voluntary movements, and compulsive linguistic productions, are discussed in relation to this functional lateralization. We suggest that the propositional nature of the responses required in test conditions could activate either voluntary language in the left cerebral hemisphere, or voluntary gestures in the right. A competition between the two hemispheres could explain the patient's linguistic apraxic or behavior in response to orders. Autotopoagnosia, an uncommon symptom, could interfere with apraxia, but is not directly responsible.
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PMID:[Apraxia and autotopoagnosia without aphasia or agraphia with compulsive language activity in right hemispheric lesion]. 786 78

Localized 1H magnetic resonance spectroscopy was performed in a 45-year-old woman with migraine. She developed throbbing headache attacks without aura since thirteen years ago and the attack was accompanied with right hemiplegia since seven years ago. Brain MRI showed no abnormalities and 123I-IMP SPECT revealed mild frontal dominant decrease of cerebral blood flow. It seemed that her condition was positioned between migraine with prolonged aura and migrainous infarction of complicated migraine in the classification of International Headache Society. Spectra obtained from bilateral frontal lobe interictally showed elevation of lactate at left side. Choline, creatine, and N-acetyl-aspartate were almost equal on both side. The above results suggest that slight ischemia which is not detected by MRI is present or there is a disturbance of oxidative glycolysis, which is induced by mitochondrial dysfunction.
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PMID:[Elevation of cerebral lactate detected by localized 1H magnetic resonance spectroscopy in a patient with migraine]. 792 68


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