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)

An anecdotal series of nine patients (three men and six women with an average age of 57 years) presented with progressive neurologic deterioration while on medical therapy for large right hemispheric cerebral infarction. Clinical signs of uncal herniation (anisocoria or fixed and dilated pupils, and/or left hemiplegia with right decerebrate posturing) were present in seven of these nine patients. Computerized tomography of the head confirmed mass effect from cerebral edema. It was the clinical judgment of the treating neurologists and neurosurgeons that each of these nine patients would perish unless surgical decompression of the infarcted brain was performed. Accordingly, each was treated with right hemicraniectomy and dural augmentation. Six patients demonstrated neurologic improvement on the first postoperative day. One patient, with a postoperative diagnosis of lung cancer, died 1 month after surgery. The remaining eight patients are currently living with their families with a follow-up period ranging from 5 to 25 months. Patient outcome as evaluated by the Barthel Index indicates that three individuals are functioning with minimal assistance and that the remaining six patients are functionally dependent. After rehabilitative therapy, four patients returned for elective cranioplasty. These results suggest that hemicraniectomy can be an effective lifesaving procedure for malignant cerebral edema after large hemispheric infarction.
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PMID:Treatment of right hemispheric cerebral infarction by hemicraniectomy. 234 90

Two autopsied cases of massive unilateral cerebral infarction due to occlusion of the middle cerebral artery (MCA) were reported with special reference to presence of the secondary degeneration of the substantia nigra. Case 1 was a 70-year-old male who suddenly suffered from left hemiplegia 3 years and 2 months prior to death. CT scan showed massive infarction involving basal ganglia and fronto-parietal white matter on the right side. Some parkinsonian features such as oily face and rigidity of limbs were noted during the course. At autopsy, the proximal portion of rt MCA was found occluded and the right substantia nigra was found depigmented. Case 2 was a 71 year-old male who suddenly became hemiplegic 4 years prior to death. CT scan revealed a low density area in the corona radiata of the right cerebral hemisphere. On carotid antiography, complete obstruction of the horizontal portion of right MCA at its distal end was observed, which was confirmed at autopsy. Histologically, the right substant a nigra in case 1 showed marked neuronal loss with gliosis as well as presence of many extracellular melanin pigments. These changes were more prominent in its medial portion where chromatolytic neurons were occasionally seen. The adjacent fronto-pontine tract and pyramidal tract showed secondary degeneration. The left substantia nigra appeared normal. In case 2, the substantia nigra on both sides appeared normal. The whole right cerebral peduncle, on the other hand, showed diffuse myelin pallor.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Secondary degeneration of substantia nigra following massive basal ganglia infarction]. 262 20

Fifty-three patients with infarction of the corona radiata adjacent to the body of the lateral ventricle were clinically evaluated in order to determine the clinical characteristics of this infarction and localization of the pyramidal tract in this area, as well as its somatotopy and etiology. Clinical characteristics included the following: (1) this type of infarction was observed in 9.1% of all patients with cerebral infarction; (2) although 81.1% of the patients of this type had clear consciousness and neuropsychological symptoms in some patients; (3) motor paralysis usually occurred in the upper limbs; (4) monoplegia occurred in 13.2% of patients, with monoplegia of upper and lower limbs being associated with infarction of the anterior and posterior portion, respectively, of the corona radiata adjacent to the body of the lateral ventricle; (5) pure motor hemiplegia was observed in 45.3% of patients; (6) facial paralysis and dysarthria were observed in 54.7% and 58.5% of patients, respectively, and the incidence of these symptoms was the highest in the infarction of the anterior portion of the corona radiata; (7) sensory disturbance, which was usually recognized as a mild subjective feeling of abnormality and localized to the limbs, was reported by 47.2% of patients; (8) risk factors included hypertension, diabetes and high hematocrit and triglyceride levels; (9) arteriosclerosis was often noted in areas between the siphon of the internal carotid artery and the main stem of the anterior and middle cerebral arteries; (10) 64.2% of patients were able to conduct independent activities of daily life (ADL) 1 month after the onset of the disease and more marked paralysis remained in the infarction of the middle portion than in the anterior or posterior portion.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical characteristics of infarction of the corona radiata adjacent to the body of the lateral ventricle]. 275 54

A modified method of occluding the middle cerebral artery (MCA) by inserting a tiny copper wire into the lumen of the vessel to make a model for cerebral ischemia in the cat is described. Of 22 rats, 4 were controls and the remaining 18 were divided into two groups. Bipolar electrocoagulation was used in 9 cats and copper wire insertion was used in the other 9 to occlude the MCA through a transorbital approach. Two cats died after surgery and were excluded from this study. Of the 16 cats in two experimental groups, 13 of 14 showed hemiplegia and the other 2 were killed under anesthesia. Typical ischemic changes can be seen in the territory of the occluded MCA. Increased water content and decreased amplitude of somatosensory evoked potentials can be found in the ischemic hemisphere. Histochemical fluorescence study demonstrated that the sympathetic nerve fibers normally existing on the MCA can be completely destroyed by electrocoagulation but may remain intact with the copper wire method. This new method may have less influence on the vascular regulative function of the autonomic nervous system and be more similar to the pathological changes of cerebral infarction in man. We think our method can be useful for further research in cerebral ischemic disease and the regulative effects of the nervous system on brain vessels.
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PMID:Modification of a model for cerebral ischemia in the cat: a new method to occlude the middle cerebral artery. 275 79

A 74-year-old right-handed man with multiple cerebral infarction who presented with dementia simulating dementia of Alzheimer type (DAT) is reported. He had been well until April 20, 1987 when he developed transient right hand palsy lasting overnight. Eleven days later, he became confused, disorientated, and amnestic. He was admitted to this hospital on June 8. Physical examination revealed hypertension (170/90mmHg). On neurological examination, his consciousness was clear but he was demented. He showed disorientation, amnesia, and urinary incontinence. His most prominent symptom was disturbance of speech, including fluent aphasia and alexia with agraphia. Additionally, he showed ideomotor apraxia, construction apraxia, right-left agnosia, finger agnosia, and acalculia. On July 9, he had a transient attack of right hemiplegia with confusion. The brain CT scan performed on admission was unremarkable except for cavum septi pellucidum and a small low density area in the right basal ganglia. However, single photon emission computed tomography (SPECT) by 123I-labeled N-isopropyl-p-iodoamphetamine disclosed hypoperfusion of the cerebral blood flow in the border zones of the temporoparietal and frontal lobes on the left. A follow-up brain CT scan taken one month later demonstrated low density in the new areas corresponding to hypoperfusion shown by SPECT. Although the clinical features of the present case resembled those of DAT, dementia in this case was regarded as the result of multiple cerebral infarction since it occurred acutely with mild motor deficits, and brain CT scans and SPECT showed lesions indicating focal cerebral ischemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Multi-infarct dementia clinically simulating dementia of Alzheimer type. A comparison with angular gyrus syndrome]. 278 20

A case of occipital infarction following herpes zoster involving the maxillary division of the trigeminal nerve is presented. Herpes zoster ophthalmicus is followed occasionally by an angiitis and cerebral infarction, usually manifest as a hemiplegia. Cerebral angiitis has not been reported previously following herpes zoster involving the maxillary or mandibular divisions. Patients with herpes zoster involving any trigeminal division may be at risk for delayed stroke. The distribution of rash and angiitis in this case supports the hypothesis that the virus extends directly to the large vessels adjacent to the gasserian ganglion, instead of being transmitted along intracranial nerves.
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PMID:Herpes zoster maxillaris with delayed occipital infarction. 294 67

A 40-year-old woman was admitted to our hospital because of left hemiplegia. She was affected with myocardial infarction and cerebral infarction. Echocardiogram revealed that the aortic and mitral valves had thick and uneven echoes suggesting vegetations. Judging from the finding that repeated blood cultures were negative, we had considered in her lifetime that myocardial and cerebral infarctions were due to embolization associated with nonbacterial thrombotic endocarditis (NBTE). At autopsy, histological diagnosis was made as ovarian cancer with disseminated intravascular coagulation. From the clinical course and the histological findings, we diagnosed this patient as NBTE.
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PMID:Cerebral and myocardial infarction induced by nonbacterial thrombotic endocarditis in a patient with ovarian cancer: report of a case. 305 70

Varicella zoster (VZ) is an unusual cause of CNS angiitis, usually occurring in older patients and immunocompromised hosts. The infection most commonly presents as herpes zoster ophthalmicus with contralateral hemiplegia. Mycotic aneurysm formation associated with VZ angiitis is rare. We report two cases of VZ angiitis with mycotic aneurysm formation (both aneurysms eventually ruptured) and one case of probable VZ angiitis with distal carotid occlusion and cerebral infarction. The CT and angiographic appearances, clinical course, and histopathology are presented.
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PMID:Mycotic aneurysm in angiitis associated with herpes zoster ophthalmicus. 311 99

Central nervous system is often involved by herpes zoster but it is very rarely seen that contralateral hemiparesis or hemiplegia developed after herpes zoster ophthalmicus. We report a case of herpes zoster ophthalmicus followed by the delayed contralateral hemiparesis. A 33-year-old man developed acute cerebral infarction and resultant right hemiparesis 44 days after herpes zoster ophthalmicus in the left side. Brain CT disclosed hypodense area in the left basal ganglia. Cerebral angiography revealed segmental narrowing of M1 portion of the right middle cerebral artery.
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PMID:Herpes zoster ophthalmicus and delayed contralateral hemiparesis. 326 58

Atrial septal aneurysm is an uncommon occult cardiac source of cerebral embolism. It is usually asymptomatic, and clinical cardiologic examination and electrocardiography fail to reveal its presence. We report a case of a 34-year-old woman with sudden right hemiplegia and aphasia from occlusion of the left carotid siphon in whom an atrial septal aneurysm was detected by two-dimensional echocardiography. The absence of atherosclerotic risk factors and vascular lesions proximal to the carotid occlusion strengthened a causal relation between atrial septal aneurysm and cerebral infarction. Consequently, two-dimensional echocardiography may be advisable in every patient with unexplained ischemic stroke to detect possible occult embolic cardiac abnormalities.
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PMID:Cardioembolic stroke from atrial septal aneurysm. 336


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