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)

Six children with acute cerebral insult, ranging in age from 3 days to 8 years, revealed periodic lateralized epileptiform discharges in their electroencephalographic recordings. Their etiologic factors were cerebral infarction, intracranial bleeding, purulent meningitis, acute infantile hemiplegia, and encephalitis. Each patient exhibited a different type of convulsive seizure. Computer tomography or magnetic resonance imaging revealed diffuse lesions covering the cerebral cortex and subcortical white matter in 2 patients, a lesion of the subcortical white matter in 1 patient, a linear lesion in the cortex and along the borderline between the cortex and the subcortical white matter in 1 patient, and localized lesions in the cortex and basal ganglia in 1 patient. There were findings indicating the disconnection of the cerebral cortex with deeper structures in 3 patients. The appearance rate of periodic lateralized epileptiform discharges increased at levels of consciousness from 5 to 7 on a pediatric modification of the Glasgow Coma Scale. At levels of consciousness from 8 to 14 and below 4, the rate was very low.
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PMID:Clinical significance of periodic lateralized epileptiform discharges in children with relation to level of consciousness. 798 89

A case of moyamoya disease associated with thrombotic thrombocytopenic purpura (TTP) was reported. A 26-year-old male patient was admitted on April 11, 1992, with sudden onset of right cerebral hemorrhage. Cerebral angiography revealed moyamoya disease and bilateral encephalo-duro-arterio-synangiosis (EDAS) was performed. In March, 1993, however, he suffered from left cerebral hemorrhage. Neurological examination on the second admission showed disturbance of consciousness, motor aphasia and right hemiplegia. Emergency operation for the hematoma removal was performed and neurological functions rapidly improved. However, on the day following the operation, he was in stupor and restlessness. Microangiopathic hemolytic anemia and severe thrombocytopenia were identified and he gradually sank into a comatose state. Systemic purpura, fever, renal dysfunction also appeared. CT scan 22 days after the onset demonstrated diffuse cerebral infarction in the region of the bilateral anterior and middle cerebral arteries, and cerebral angiography on the next day demonstrated the development of bilateral internal carotid stenosis. Though laboratory findings indicate gradual improvement, he has remained in very weak state. This is the first case of moyamoya disease associated with TTP. The etiology of both diseases was discussed.
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PMID:[Moyamoya disease associated with thrombotic thrombocytopenic purpura (TTP)]. 801 79

Does the use of warm-body perfusion in elderly patients with severe cerebrovascular disease lead to a higher incidence of stroke, due to hypotension secondary to low systemic vascular resistance? Two thousand, three hundred eighty-three (2,383) consecutive myocardial revascularizations were performed (1987-1992) using warm-body (perfusion 37 degrees C), cold-heart surgery (cold cardioplegic arrest). The perfusion pressure was maintained between 50-70 torr; hematocrit was kept around 20%. Prospective data during hospitalization revealed 23 operative deaths (1%), and 24 patients (1%) who developed new neurological signs after surgery. The latter formed three groups: Group I consisted of six patients with severe neurological deficits, who never regained consciousness and died after support systems withdrawal. Group II included 14 patients with postoperative clinical evidence of focal cerebral infarction (9 had hemiplegia, 2 had visual disturbance, and 3 showed alteration of memory), all of whom had residual defects at discharge; Group III was composed of four patients with minor neurological deficits after surgery (hemiparesis, gait disturbance, mental changes) which had cleared up by discharge. These data were compared retrospectively with 1605 patients (1980-1986) undergoing myocardial revascularization with moderate (25-30 degrees C) hypothermia and the same surgical team and operative techniques. Both groups had similar preoperative demographics except the warm group included more elderly patients, higher numbers with unstable angina and poor ejection fraction, and more frequent use of a mammary artery conduit. Neurological complications were 1% and 1.3% for the normothermic and hypothermic perfusion groups respectively. Incremental risk factors of stroke remain: age over 70 years, diffuse atherosclerosis of the aorta, carotid occlusive disease, and severe hypotension during perfusion.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Neurological complications during myocardial revascularization using warm-body, cold-heart surgery. 804 89

A 77-year-old female with left hemiplegia caused by cerebral infarction and with mild senile dementia was admitted for further examination of hematological abnormalities. She was diagnosed as acute myelogenous leukemia (AML-M5a) according to French-American-British classification. Since intensive combination chemotherapy seemed difficult, she was treated with oral administration of cytarabine ocfosfate (200 mg/day, for 14 days), a cytidine deaminase-resistant derivative of Ara-C, resulting in complete remission. Major side effects were nausea, vomiting and appetite loss, but their incidences were reduced tolerably when cytarabine ocfosfate was given just before sleeping. Cytarabine ocfosfate might be useful to treat AML in elderly patients having certain complications such as cerebrovascular disease.
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PMID:[Successful treatment of acute myelogenous leukemia in an elderly patient with cytarabine ocfosfate]. 812 96

A 27-year-old woman visited Kanto Teishin Hospital complaining of fever and petechiae in September, 1992. Her fetus had suddenly died in the uterus two weeks before (in the sixth month of pregnancy). Total white blood cell (WBC) count was 3.2 x 10(3)/microliters with 80% promyelocytes. Bone marrow was hypercellular with 90% promyelocytes. Disseminated intravascular coagulation (DIC) was recognized. She was diagnosed as having acute promyelocytic leukemia (APL), and treatment with daily oral administration of all-trans retinoic acid (ATRA) (70 mg/body/day) was begun. On day 4, hemiplegia and aphasia appeared. Broad cerebral infarction was suspected from computed tomography. On day 9, the WBC count increased rapidly, standard chemotherapy was added and she achieved complete remission. ATRA is known to have stimulatory effects on the differentiation of APL cells, but some reports have described thromboembolic events during the administration of ATRA. In this case, ATRA might have affected coagulability resulting in cerebral infarction.
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PMID:[Acute promyelocytic leukemia (APL) resulting in broad cerebral infarction during all-trans retinoic acid (ATRA) treatment]. 813 18

A 2-year-old girl with Turner syndrome was admitted with left hemiplegia and left facial palsy. Serial cranial computed tomographic scan demonstrated multiple cerebral infarctions in the right putamen and right medial cortical areas. Single photon emission computed tomographic scan revealed hypoperfusion from the right frontal to the right temporal area. Right carotid angiography showed narrowing and occlusion of the right internal carotid artery at the sphenoidal portion. Collateral circulation was not detected between the external and internal carotid arteries. Left carotid angiography revealed that the left anterior artery was narrow, and that the left internal carotid artery provided blood to the right internal carotid artery through the anterior communicating artery. These findings suggested that the cerebrovascular abnormality might be due to congenital hypoplasia of arteries in this patient. The unusual combination of cerebral infarction and Turner syndrome was reported.
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PMID:Turner syndrome and occlusion of the internal carotid artery. 822 41

We report a 37-year-old man with cerebral infarction due to meningovascular neurosyphilis. He developed right hemiplegia and motor aphasia preceded by left retroorbital pain lasting a month. Bilateral tonic pupils were also observed. Magnetic resonance imaging (MRI) disclosed cerebral infarction in the distribution of perforating branches of the left middle cerebral artery. Abnormal enhancement was absent in the meninges on T1-weighted MRI examination. SPECT study with I-123 iodoamphetamine showed decreased perfusion in the area of the left middle cerebral artery on early phase. A delayed SPECT 4 hour later demonstrated redistribution of the cerebral blood flow in the area of its cortical branches. On cerebral angiograms, marked stenoses were disclosed at the supraclinoid segments of the bilateral internal carotid arteries as well as the M1 segment of the left middle cerebral artery. These stenoses were associated with increased collateral circulations on the left side. Atherosclerosis was not apparent, on angiography. The cerebrospinal fluid (CSF) showed pleocytosis and positive TPHA. The CSF/serum ratio of TPHA was 1/16. Oligoclonal IgG band was present in the CSF. CSF IgG index was elevated. These findings were consistent with meningovascular neurosyphilis. Causes of angiitis other than syphilis were excluded. A test for antibodies against human immunodeficiency virus was negative. The clinical course of his recovery was similar to that in patients with atherosclerotic thrombosis. The stenosis of the right internal carotid artery demonstrated by angiography could not be expected from the clinical manifestations and SPECT study.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Bilateral internal carotid artery stenoses in a patient with meningovascular neurosyphilis]. 826

We present the case of a young man who experienced a sudden onset of pure motor hemiplegia in association with ulcerative colitis. Based on a review of earlier reports, ulcerative colitis was suspected to be the background disease leading to cerebral infarction. A cerebral infarction of the lacunar type in the right ventromedial aspect of the upper pons was seen on magnetic resonance images. These images detected small lesions in the brain stem, and were used to follow-up their transitions.
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PMID:A case of pontine lacunar infarction with ulcerative colitis. 834 17

When cerebral infarction determines hemiplegia or hemiparesia which accompany a hemilateral sensitive deficit and hemianopsia and even neuropsychologic symptoms (aphasic alterations in the case of injury to the left hemisphere, heminegligence and anosognosy in the case of injury to the right hemisphere) the involvement of a sylvian artery syndrome is usually considered. Nonetheless, recent contributions have reported that such symptoms may appear in infarctions of the territory of the posterior cerebral artery. Two clinical-radiologic observations in this line are presented. Nuclear magnetic resonance demonstrated injury to the posterior arm of the internal capsule in one case and in the other the lesion developed over three times, in the latter of which injury to the cerebral peduncle was produced causing hemiparesia. The authors emphasize that hemiplegia or hemiparesia in some infarctions of the posterior cerebral artery may be due to 1) mesencephalic infarction in the posterior plane of the retromamillar Foix and Hillemand pediculum (or G. Lazorthes interpedunculum), 2) infarction or "ischemic penumbra" in the internal capsule by involvement of any of the perforating branches of the posterior cerebrum irrigating the thalamus, except for the medial posterior choroid artery or even of the Foix and Hillemand thalamus-tuberian pediculum (or Lazorthes inferior and anterior) which principally initiates at the posterior communicating branch with a fragment of the posterior branch of the internal capsule perhaps not always being under its control. In this case, the thrombus occupying the posterior cerebrum may extend to the cited communicating branch or a hemodynamic deficit may be produced in the territory of the same.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Hemiplegia in posterior cerebral artery infarctions: analysis of various responsible mechanisms]. 835 75

This is a report of an endarterectomy performed upon the horizontal portion of the middle cerebral artery of a 45 year-old male patient. He had been suffering from TIAs (left hemiparesis) since 8 days prior to admission. Since the frequency of TIA episodes had increased from 2 times to 5 or 6 times a day and the episodes lasted from approximately 10 minutes to over 20 minutes on the day before admission, the TIA was considered to be of the crescendo type. On admission, neurological examination and CT scans showed no abnormalities. An angiography revealed a severe stenosis of the horizontal portion (M1) of the right middle cerebral artery. An endarterectomy was performed using a pterional approach on the day of admission because of the crescendo TIA. Heparin was not used during the surgery. The patient showed left hemiplegia after the endarterectomy. Angiography was performed immediately after the surgery, and severe stenosis caused by mural thrombus was found at the operative site. An emergency STA-MCA anastomosis was carried out to prevent cerebral infarction. However, left hemiplegia did not abate, and a CT scan taken a few days after the surgery revealed a low density area which included the right, basal ganglia and internal capsule. Two weeks after the surgery, angiography was again performed to determine the patency of the anastomosis, which showed normal configuration of the M1, indicating that the stenosis had disappeared. It was considered that if heparin had been used during the endarterectomy, the acute mural thrombus formation at the M1 would have been prevented, and neurological deficit would not have appeared.
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PMID:[Middle cerebral artery endarterectomy: a case report]. 837 99


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