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Query: UMLS:C0018991 (hemiplegia)
 3,997 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case history is presented of a 17 year-old male admitted with right hemiplegia and motor aphasia. Static and dynamic scintigraphy allowed prediction of a giant aneurysm in the deep left frontotemporal region, and this supposition was confirmed by CT and carotid angiography. CT also revealed the aneurysm to extend farther medially than the other two examinations had indicated, the medial portion of the aneurysm being thrombosed. Evaluation of the diagnostic information obtained from the three procedures, combined with the clinical data, makes possible a reconstruction of the probable course of events. The presenting signs were probably caused by a newly formed thrombus within the aneurysm. Death, which occurred after five days, was apparently due to subarachnoid hemorrhage.
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PMID:Complementary values of static and dynamic scintigraphy, computerized tomography and angiography in the diagnosis of a partially thrombosed giant intracranial aneurysm. 22 82

In an effort to call attention to a lesion which is possibly provoked by ingestion of oral contraceptives, this case report of a 23-year-old woman, who had been taking Minovlar for 3 years admitted to the hospital after sudden onset of complete right-sided hemiplegia and total motor aphasia is presented. There was no clinical evidence of deep vein thrombosis or other cerebral, coronary, or other arterial occlusions due to embolism on admission. 1 week later, bilateral leg venography showed a normal left leg but the right leg showed nonfilling of the deep veins of the calf. In the process of a right-heart catherization, an atrial communication was crossed which proved to be a patent foramen ovale by pulmonary artery pressures and dilution indicator curves. Hence, a clinical diagnosis of paradoxical embolism was made on the grounds of combined evidence of deep vein thrombosis, electrocardiogram changes of acute cor pulmonale, which were entirely different from those known to accompany primary cerebrosvascular lesions, and catheter studies typical of embolism rather than thrombosis. This case prompted the authors to call for prospective studies to reveal paradoxical embolism in oral contraceptive users, rather than venous thrombosis.
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PMID:Paradoxical embolism associated with oral contraceptives: an underdiagnosed lesion? 48 90

A 64-year-old right hemiplegic woman, who had been treated for hypertension for 15 years, was admitted to our hospital. Neurologic examination on admission disclosed right hemiplegia and motor aphasia; however, ophthalmoparesis, pupillary abnormality, and blepharoptosis were not evident. Excessive sweating on the right side of the body, which was most marked on the face, was observed. Amount of sweating on the left side of the body was normal. Unilateral hyperhidrosis persisted for more than 2 months. MRI revealed hemorrhagic infarctions in the left basal ganglia, internal capsule, thalamus, hypothalamus, and medial part of the cerebral peduncle. 123I-IMP SPECT disclosed hypoperfusion in the left striatum, thalamus, occipital cortex, and right cerebellar hemisphere. Cerebral angiography revealed arteriosclerotic changes in the basilar artery, but that the left posterior cerebral artery and its branches were not occluded. Unilateral persistent hyperhidrosis is rare after ischemic stroke. Hypothalamic lesion was thought to be responsible for the hyperhidrosis in this patient. As the hypothalamus receives its blood supply from the posterior cerebral artery, unilateral persistent hyperhidrosis may be an important sign of cerebral infarction in the posterior cerebral artery region.
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PMID:[Unilateral persistent hyperhidrosis after ischemic stroke]. 139 37

According to our clinical observations from various aspects of stroke patients, such as the total incidence of aphasia, the incidence of aphasia after left brain damage of the dextrals, the aphasia that occurs in patients without hemiplegia, and the types of aphasia, a much higher incidence of crossed aphasia is seen among the stroke patients of the Han (the largest ethnic group in China) as compared with the Uighur-Kazaks (U-K) in China and the Occidentals documented in the literature. Motor aphasia is most common and pure sensory or posterior aphasia is rarely seen in Han patients. The distinct features of the Chinese language is a possible explanation for this difference. We suspect that language function of the Han is not localized in the left brain but in the right or both hemispheres. There is no definite Wernicke's area in the left brain of the Chinese people and the neural pathway of the language function in the brain of the Chinese people is not similar to people who speak phonetic languages. Consequently the universal applicability of the theories of cerebral laterality of the language function and dominant hemisphere established by Dax and Broca are questioned in this paper.
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PMID:Crossed aphasia in Chinese: a clinical survey. 170 10

Fifty-nine children with Japanese encephalitis admitted in Maharaj Nakhon Chiang Mai Hospital since 1984-1985 were studied. The male to female ratio was 1.18:1. The age range was between 1 to 14 years old with 74% in the age range of 6-14 years. The symptoms included change of consciousness (100%), fever (96%), headache (76%), convulsions (59%) and vomiting (52%). The neurologic signs, namely positive meningeal signs (61%), hyperreflexia (61%), positive Babinski's sign (49%) hemiplegia (42%), papilledema (22%), and other cranial nerve palsies (23%) were seen. Abnormal respiration were found in 23% and 8% of cases had hypertension. Most children (81%) had blood leukocytosis with predominant neutrophils. The average CSF white blood cell count was 200 cells per mm. with lymphocytosis in 76 percent of the patients. The average CSF protein was higher than normal. Almost all cases had normal CSF sugar levels. The JEV antibody response, mostly primary type, Occurred in about 62 percent of cases. All children received symptomatic and supportive treatment, such as antipyretics, anticonvulsants, anticerebral edema agents, adequate respiration and nutrition and physical and occupational therapies. Associated complications were treated according to the individual's need. The mortality rate and neurological sequelae were found in 17% and 57% of cases respectively. Eighteen percent of the patients suffered severe neurological sequelae. The neurological sequelae included memory deficit (46%), mental retardation (42%), hemiplegia (34%), emotional and behavioral disturbance (24%), epilepsy (20%), motor aphasia (16%), cranial nerve palsies (16%), involuntary limb movement (8%) and blindness (2%).
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PMID:Japanese encephalitis in children in northern Thailand. 256 17

The relationship between location and extent of lesion on CT scan and limitation in spontaneous speech was examined. The severity of spontaneous speech ranged from cases with no speech or only verbal stereotypies (first major group) to those with reduced, hesitant, poorly articulated, agrammatic speech (nonfluent Broca's aphasia, second major group). CT scan analysis revealed no single neuroanatomical area that contained an extensive lesion which could be used to discriminate the most severe cases from the least severe. The two groups were separable, however, on the basis of the CT scan when the extent of the lesion in two subcortical white matter areas were combined: (1) the most medial and rostral portion of the subcallosal fasciculus plus (2) the periventricular white matter near the body of the lateral ventricle, deep to the lower motor/sensory cortex area for the mouth. The most rostral portion of the medial subcallosal fasciculus, located in the lateral angle of the frontal horn (extremely deep to Broca's area), contains projections from the cingulate gyrus (area 24) and the supplementary motor area, to the caudate nucleus. We suggest that one explanation for the more severe limitation in spontaneous speech in the first group is the extensive white matter lesion in these two subcortical pathways had interrupted a large number of connections for (1) initiation and preparation of speech movements, and limbic aspects of speech (lesions in the medial subcallosal fasciculus), and (2) motor execution and sensory feedback for spontaneous speech (lesions in periventricular white matter deep to the motor/sensory cortex area for the mouth). Extensive lesion in only one of these two white matter pathway areas, alone was not sufficient to produce long-lasting severe limitation in spontaneous speech and could not be used to discriminate the two groups on the basis of the CT scans. The patients with less severe limitation in spontaneous speech (nonfluent Broca's aphasia) had less extensive lesion within these two white matter areas combined, and had interrupted a smaller number of these subcortical connections. The sites of the lesions in subcortical white matter in CT scans in Broca's original case who could only produce a verbal stereotypy are similar to those in our first group with the most severe limitation in spontaneous speech. The presence or absence of hemiplegia was not related to severity or recovery of spontaneous speech. Careful examination of lesion extent in these two areas of subcortical white matter on CT scanning appears to be relevant in predicting potential for recovery of spontaneous speech in some stroke patients.
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PMID:Severe nonfluency in aphasia. Role of the medial subcallosal fasciculus and other white matter pathways in recovery of spontaneous speech. 291 72

A 7-year-old boy with sex-linked agammaglobulinaemia developed meningoencephalitis caused by echovirus type 11. He had convulsions, right hemiplegia, cortical motor aphasia, left abducens nerve paralysis, left hypoglossal nerve paralysis, and later became unconscious. Treatment by intravenous injection of conventional gammaglobulin and intrathecal alpha-interferon brought no clinical improvement, but intrathecal administration together with intravenous injection of gammaglobulin containing a high titre of anti-echovirus type 11 antibody was associated with a dramatic improvement in his clinical symptoms. After subsequent periodical (once or twice a week) administration of specific gammaglobulin for 8 months, the echovirus in his cerebrospinal fluid was no longer detected. These findings suggest that intrathecal injection combined with intravenous injection of high titre anti-echovirus type 11 antibody was effective in treating this case of echovirus meningoencephalitis in sex-linked agammaglobulinaemia.
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PMID:Successful treatment of echovirus meningoencephalitis in sex-linked agammaglobulinaemia by intrathecal and intravenous injection of high titre gammaglobulin. 342 97

Case 1. A seven-year-old boy was admitted to our hospital shortly after developing right hemiplegia and motor aphasia during rope-jumping play. Neither cervical trauma nor signs of cervical and pharyngeal inflammation were present. The physical examination was negative. The carotid angiogram on the day of admission gave poor visualization of the middle cerebral artery group, although the computerized tomographic finding was not remarkable. His neurological status gradually got better, while the routine laboratory studies gave only a slight increase of ESR (26 mm/hour) and positive CRP(I+). There were no particular findings of CSF from lumbar tap or of serological studies. The second computerized tomographic scan 42 hours after clinical onset showed a wide low dense area with obscure margin in the left parieto-temporal region, which was enhanced variously with intravenous contrast media. In about ten days his clinical state was remarkably improved. The second carotid angiogram one month after admission showed a poor filling of the middle cerebral artery territory and beaded appearance of the artery. The patient was discharged on the 46th day with a minimum right hemiparesis. Case 2. A ten-year-old boy was admitted with complaint of right hemiparesis and motor aphasia developing at night. The physical examination was negative. The laboratory studies were also negative. The computerized tomographic scan five days after onset showed a low dense area in size of 2 x 1.5 x 2 cm in the region of the left Nucleus lentiformis. No enhancement effect was seen. The left carotid angiogram on the same day revealed stenotic lesions at the M1 and the posterior temporal artery.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cerebral ischemic lesions in children and primary cerebral angiitis: report of two cases]. 380 15

A strongly right-handed man developed sudden mutism and left hemiplegia 2 days after a myocardial infarct. Evaluation 6 1/2 years later revealed persistent Broca's aphasia. There was no clinical, CT, or EEG evidence of left brain injury or disease. This case is another example of dissociation of cerebral dominance for speech and handedness. However, the severe and persistent language disorder is rare. The paucity of documented case reports supports the traditional view of strong interdependence of handedness and speech cerebral lateralization.
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PMID:Persistent Broca's aphasia after right cerebral infarction in a right-hander. 653 84

The possibility of aphasic disorder caused by thalamic lesions has been supported by anatomo-clinical findings, stereotaxic surgery and more recently by radiological investigations with new techniques, i.e. ct and brain scan. A case of thalamic aphasia investigated with these techniques and the Luria's neuropsychological test is reported in this paper. The case concerns a 50 years old woman who developed a sudden right hemiplegia with marked motor aphasia. C.T. and radioisotope brain scan revealed a left capsular haemorrhage with involvement of thalamic structures. Later, when this patient's aphasia decreased, Luria's test showed reduction of spontaneous speech, anomia, paraphasic and disarthric disorder, distractibility without impairment of comprehension and repitition. These findings are similar to those reported by some AA. in left thalamic lesions and similar to aphasic syndromes caused by cortical lesions. Another important observation was the presence of widespread cortical functional disorder involving the left fronto-temporo-parietal region without evidence of cortical anatomical alteration. The above data and those reported in the literature suggest a very close relationship between thalamic structures, other central nuclei and cortical areas particularly in the control of speech.
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PMID:[On a case of aphasia with thalamic lesion (author's transl)]. 703 35


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