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)

Between May, 1974, and March, 1991, 104 patients with moyamoya disease, all under 16 years old at the time of first surgery, underwent superficial temporal-to-middle cerebral artery anastomosis and/or encephalomyosynangiosis. The mean follow-up period was 9.6 years (range 4.8 to 16.0 years). Hemiplegia was the most frequent symptom before the first operation. Transient ischemic attacks (TIA's) were noted in 57 patients and minor stroke with hemiplegia in 44. The most frequent type of cortical dysfunction was aphasia (21 cases). Postoperatively, the incidence of TIA's and/or completed stroke with motor weakness of the extremities was markedly decreased, but visual disturbance progressed and major or minor stroke with visual disturbance was found in two cases. In patients under the age of 3 years, a major stroke prior to surgery resulted in a poor outcome in 36% of cases. Preoperative major stroke in patients between the ages of 3 and 7 years was less frequent, and poor outcomes were seen in 17% of this group. There were no major preoperative strokes in patients with surgery after the age of 7 years, and no poor outcomes were recorded in this group. A major preoperative stroke prior to surgery had adverse impact on the ultimate patient intelligence quotient (IQ) following surgery. All patients operated on after the age of 7 years had a normal or borderline IQ at follow-up examination.
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PMID:Long-term follow-up study after extracranial-intracranial bypass surgery for anterior circulation ischemia in childhood moyamoya disease. 160 76

Clinical, radiological, and immunohistochemical findings in brain biopsy specimens from six patients with cerebral amyloid angiopathy-associated intracerebral hemorrhage were reviewed. Acute clinical presentations included headache, nausea and vomiting, loss of consciousness, and focal neurological deficits such as hemiplegia and blindness. Transient ischemic attacks experienced by one patient and referable to one hemisphere did not indicate impending hemorrhage in that region. Computed tomographic scans revealed acute, irregular, superficial, lobar hemorrhage with occasional ring enhancement. Immunohistochemical studies were performed on biopsy specimens using primary antibodies against portions of the Alzheimer A4 (beta-) peptide or gamma-trace peptide (the vascular amyloid protein in patients with hereditary cerebral hemorrhage with amyloidosis-Icelandic type). In all patients, anti-A4 and anti-gamma-trace labeled cerebral microvessels. Immunoreactive senile plaques were few compared with the numbers of stained microvessels. Reactive astrocytes in some patients were labeled by both antiserum samples, suggesting uptake or production of these proteins by the astrocytes. This study demonstrates the heterogeneous clinical and radiological features of cerebral amyloid angiopathy-related brain hemorrhage and the value of anti-A4 and anti-gamma-trace immunohistochemical study of biopsy material from patients with suspected cerebral amyloid angiopathy-related intraparenchymal bleeding.
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PMID:Cerebral hemorrhage with biopsy-proved amyloid angiopathy. 172 64

The experience of 500 transcranial Doppler (TCD) sonographies at Siriraj Hospital between April 1988- June 1989 were reported. The indications for TCD study were hemiplegia 156 (31.20%), vertigo 119 (23.80%), transient ischemic attack (TIA) 26 (5.20%), hemihypalgesia 14 (2.80%), dysarthria-dysphagia syndrome 13(2.60%), visual problem 13(2.60%), syncope 10(2.00%), memory loss 8(1.60%), aphasia 6(1.20%), carotid bruit 6(1.20%), miscellaneous (artereovenous malformation, aneurysm, arteritis, carotico-cavernous fistula, tinnitus, etc) 25(5.00%), and healthy subjects 92(18.4%). Abnormal TCD studies were found in various conditions of different percentages, i.e. 91.03 per cent in hemiplegia, 76.47 per cent in vertigo, 65.38 per cent in TIA, 71.43 per cent in hemihypalgesia, 61.54 per cent in dysarthria - dysphagia syndrome, 38.46 per cent in visual problem and 30.43 per cent in normal subject. TCD is noninvasive, safe and painless. It is a useful screening test for prophylaxis of cerebrovascular disease in the elderly.
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PMID:Transcranial Doppler ultrasonography: experience of 500 patients. 228 86

Carotid artery resection and reconstruction by unreversed autogenous saphenous vein grafting was undertaken in six patients undergoing extensive resection for malignancy over a four-year period. There were two deaths within 30 days of operation: one from secondary hemorrhage and one from bronchopneumonia. One patient died at six months and one at three months from recurrence, one died at 12 months from recurrence and one died free of disease at 10 months from aspiration. Vascular complications in three patients included a single TIA at 14 days, graft thrombosis with hemiplegia and a secondary hemorrhage from the graft requiring graft ligature with a subsequent normal neurological status. Malignant involvement of the extracranial carotid artery is associated with poor survival. Treatment by carotid artery resection and grafting should be considered in such cases, particularly where the pharynx or oral cavity are not entered.
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PMID:Resection of the extra cranial carotid artery in head and neck cancer. 258 94

The term lacuna or lacunar cavity defines the pathological lesion while the clinical pictures due to lacuna or lacunes are referred to as 'lacunar syndromes'. The lacunar syndromes include: (1) the typical lacunar syndromes or lacunar syndromes proper--pure motor hemiplegia, pure sensory stroke, ataxic hemiparesis including dysarthria and clumsy hand, sensorimotor stroke and abnormal movement syndromes, (2) reversible ischemic attacks (TIA and/or PTIA or RIND), (3) other clinical syndromes which may be due to lacunar lesions such as suprabulbar palsy; lacunar dementia, or subacute arteriosclerotic encephalopathy (or Binswanger's disease). The different clinical pictures are reviewed, some mechanisms underlying the lacunar lesion are briefly discussed and the old label 'small vessel diseases' in cases with lacunes is reconsidered.
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PMID:The lacunar syndromes. 269 95

The incidence of neurological complications following operative treatment of concomitant occlusive disease of coronary and carotid arteries has been reported to be between 0.7 and 18 per cent by different preoperative screening methods and surgical strategy. From the opening of our institution in November 1984 until March 1988 5443 open-heart procedures were performed. In 116 patients of 3540 consecutive coronary artery bypass grafting (CABG) candidates simultaneous carotid endarterectomy (TEA) was carried out because of hemodynamically relevant stenosis of one or both carotid arteries; 50 patients were neurologically symptomatic with TIA's and amaurosis fugax preoperatively. Sixty of 66 patients with asymptomatic carotid artery stenosis had either a morphologically severe stenosis of the carotid artery or multifocal occlusive disease of the extracranial supraaortic arteries. Prior to carotid-TEA cardiopulmonary bypass was inserted with mild hypothermia maintaining a beating heart for pulsatile body perfusion. An intraluminal shunt was only used in patients with bilateral carotid stenosis. Intraoperative EEG-monitoring was carried out to detect cerebrovascular insufficiency. In 108/116 patients no neurological complications were observed, but 6/116 patients had transient minor neurological symptoms. Two of 116 patients sustained a severe neurological deficit with hemiplegia and one of them died on the 21st postoperative day. Based on these data we conclude that patients requiring carotid TEA and CABG should be operated upon simultaneously using cardiopulmonary bypass for both procedures.
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PMID:Management of concomitant occlusive disease of coronary and carotid arteries using cardiopulmonary bypass for both procedures. 280 90

Since the acute revascularization was adopted as a probable means of surgical treatment for the acute cerebral ischemia, it became essential to discuss how the initial symptom at onset can predict the subsequent development of severe or mild cerebral infarction. In the 2 past years, 207 cases of cerebral ischemic lesion were admitted non-selectively and mostly in the early stage after the attack. Excluding 40 cases of surgical treatment, 167 cases were classified into 30 cases of TIA, 13 cases of RIND, 94 cases of minor completed stroke and 30 cases of major completed stroke. In 30 cases of major completed stroke, 21 cases developed severe motor hemiplegia from the onset and the rest 9 cases initially mild hemiparesis which gradually developed to severe hemiplegia thereafter. The cases of minor completed stroke showed mild or moderate hemiparesis initially and did not worsen thereafter. In the group of TIA and RIND, no case had developed severe hemiplegia in any stage of clinical course. The disturbance of consciousness were noted in 5 cases out of 94 cases of minor completed stroke (5%) and 12 cases out of 30 cases of major completed stroke (40%) in the following time course. More than half of the cases of major completed stroke were considered to be cerebral embolism including the retrospective review.
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PMID:[Assessment of major stroke at onset in cerebral ischemia. In consideration of acute revascularization]. 399 Aug 98

Fibromuscular dysplasia of the internal carotid artery is the most frequent extracranial localization of the disease. It can produce TIA or cerebral infarct through formation of fibrinous thrombi or complete occlusion of the artery. Seven cases are presented with disease localized in the distal segment of the carotid artery, usually considered inaccessible through standard exposure. A surgical approach is described to treat these lesions by performing a mandible osteotomy. This allows a resection of the internal carotid and its replacement with autologous saphenous vein graft as performed in six cases. The distal anastomosis was performed 1 or 2 cm. below the base of the skull. One case could not be corrected due to disease extending into the skull. All patients were operated on for TIA and one had a cerebral infarct. Six patients had an uneventful recovery and no further neurological symptoms. One patient had a postoperative hemiplegia. Pathologic specimens were described as fibromuscular dysplasia in all cases. Three of them had also a dissecting aneurysm, two of these also showed a ruptured intima. Intraluminal dilatation is regarded as a potentially risky procedure; resection and replacement through a mandible osteotomy is recommended for very distal internal carotid lesions.
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PMID:Fibromuscular dysplasia of the distal cervical internal carotid artery. 727 76

Seventy-three consecutive children younger than 17 years of age seen from 1978 to 1992 with acute hemiplegia from stroke, were retrospectively reviewed to evaluate the incidence of seizures and the risks of recurrent seizures after stroke. The population consisted of 56 children with cerebral infarction, 12 with intracranial hemorrhage, and 5 with transient ischemic attack. Children whose strokes occurred in the neonatal period and those secondary to trauma, malignancy, or infection were excluded. Mean follow-up time was 43.5 months (range: 12-156 months). At least 1 seizure occurred in 36 patients (49.3%) and recurrent seizures occurred in 21 patients (28.8%). Recurrent seizures developed more often among patients who had initial seizures with delayed onset (P < .05). In 56 patients with cerebral infarction, 16 of 31 patients (51.6%) with cortical involvement documented by neuroradiologic studies and 1 of 25 patients (4%) without cortical involvement developed recurrent seizures (P < .01). In 12 patients with intracranial hemorrhage, 3 of 10 patients with cortical involvement and none of 2 patients without cortical involvement developed recurrent seizures. It is concluded that seizures commonly occur in childhood stroke. Risk factors for recurrent seizures include later onset of initial seizures and presence of cortical involvement.
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PMID:Seizures associated with stroke in childhood. 777 11

Four children with a cerebrovascular occlusive accident and protein C deficiency are described. Two patients presented with an acute hemiplegia, the others suffered from a transient ischemic attack and a progressive hydrocephalus as the result of sinus thrombosis. In all cases protein C deficiency, Type 1, was diagnosed. Other causes of cerebrovascular disease were excluded. Although venous thrombosis has been extensively reported in protein C deficiency, these cases indicate that protein C deficiency is also related to arterial thrombosis. In evaluating children with cerebrovascular accidents, protein C deficiency should also be considered.
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PMID:Neurological complications in children with protein C deficiency. 820 45


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