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

With the aid of EMG registrations the author investigated the possibility of using imitational synkinesia (from the normal hand to the affected) in a rehabilitative training of patients with postapopleptic hemiparesis and hemiplegia. A total of 50 individuals were studied (20 normals and 30 patients with hemiparesis). After bioelectrical activity registration in an attempt to make a maximum voluntary flexion or extension of the paretic hand the examinec were to make a combined attempt of voluntary movements at a command and pathological synkinesia of the same type. This synkinesia was forced, i. e. called by a maximum by strength muscular contraction of the normal hand (against resistance). EMG permitted in some cases to overcome the global synkinesia (a posture-statical and nonadaptive by character) by imitational (kinetic). If this effect was not seen the use of this method was considered purposeless. The proposed method is desinhibition of structures with a deficit of excitation, a contralateral alleviation and a new organization of movements, appearing as a result of conditioned combinations.
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PMID:[Forced imitative synkinesis as an approach to rehabilitation in central hemiparesis]. 66 59

A series of 103 consecutive cases admitted to the University of Chicago Hospitals with a recently ruptured supratentorial aneurysm were medically managed by antifibrinolytic medication, and, when applicable, by hypotension, intracranial pressure control, and respiratory support. Nine patients deteriorated and died, and six rebled and died before they were judged fit for surgical treatment. Four were treated by carotid occlusion. Nine, because of refusal or medical judgment, did not have surgical treatment. Sixty-nine of these patients and a further 33, electively admitted, underwent craniotomy. In these 102 patients, there was no mortality. Seven developed postoperative hemiparesis or hemiplegia. Six recovered. One has a residual monoparesis.
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PMID:Management of 136 consecutive supratentorial berry aneurysms. 73 Dec 97

Since 1959, 51 patients underwent open heart surgery for correction of an acute dissecting aneurysm of the ascending aorta. Upon admission, 33 patients were severely hypotensive or in progressive heart failure. Acute aortic insufficiency was found in 24 patients, and hemiplegia or hemiparesis in four. In 45 patients the ascending aorta was reconstructed with a woven Dacron graft. After excision of the dissected part of the aorta, primary anastomosis or patch aortoplasty was performed in six patients. The aortic valve remained intact in 26 patients, and resuspension of the commissures restored competence of the aortic valve in another nine. Sixteen patients required aortic valve replacement because of disrupture of the commissures. Dissection extended into the coronary ostia in nine cases. Reconstruction of the coronary system was accomplished by reimplantation of the ostia, interposition of a vein graft or aortocoronary bypass. Nine patients died within the early postoperative course from uncontrollable hemorrhage (four), further dissection (three) and myocardial infarction (two). Within the first year after surgery, another five patients died from acute aortic dissection (two), pseudomonas infection causing rupture of the proximal graft anastomosis (one) and myocardial infarction (two). Contraindications of antihypertensive treatment of acute dissection of the ascending aorta are discussed. We recommend prompt surgical intervention in acute dissecting aneurysms of the ascending aorta.
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PMID:Surgical treatment of acute dissecting aneurysm of the ascending aorta. 83 90

A case of hypertensive intracerebellar hematoma surgically treated and cured was reported. The 41-year-old male had two cerebrovascular attacks with headache and vomiting followed by left hemiparesis. Drowsiness and dysarthria appeared the next day. The patient was admitted to a hospital, where right facial palsy, loss of right gag reflex and paralytic hemiplegia on the left side were noted. On the 7th day, the patient's consciousness became clear byt the other neurological evidences did not change. On the 14th day, bradycardia and central hyperventilation appeared and he became drowsy again. The patient was transferred to the authors' clinic. When the patient was admitted, he showed typical cerebellar signs such as nystagmus, ataxia, and slurring speech with pyramidal sign on left side and cranial nerves paralysis on right side, and also showed the changes of vital signs as a medullary syndrome in the late stage of the course. The vertebral angiogram revealed a space taking process in the right cerebellar hemisphere. The old blood (30g) was removed by suboccipital craniectomy. The hematoma cavity had a communication with the IVth ventricle through a small perforation in the medial wall of the hematoma. Spontaneour intracerebellar hematoma including of hypertensive origin is not rare in the reports of autopsy but surgically treated case has only rarely been reported. The main reason of few survivals should be in its fulminate course.
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PMID:[A cured case of hypertensive intracerebellar hematoma (author's transl)]. 94 80

The case is presented of a 60 years old man who developed sudden right hemiplegia without other accompanying neurological signs and later a spastic hemiparesis. Neuropathological studies indicated an ischaemic lesion of the left medullary pyramid which was accompanied by hypertrophy of the left inferior olivary nucleus. An additional lesion, demyelination of the right gracile tract, is poorly explained. This case represents the second reported instance of pure motor hemiplegia due to a circumscribed lesion in the medullary pyramid and possibly an unique instance of olivary hypertrophy without obvious damage to the central tegmental tract, ipsilateral superior cerebellar peduncle, or contralateral dentate nucleus. The olivary hypertrophy is thought to have arisen from local damage to the termination of the central tegmental fibres at the left inferior olivary nucleus. The question of the development of spasticity in a pure pyramidal tract lesion is discussed.
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PMID:Pure motor hemiplegia, medullary pyramid lesion, and olivary hypertrophy. 99 9

The case is presented of a 45-year-old man who suffered from a sudden attack of unconsciousness with right hemiplegia and later developed a spastic hemiparesis accompanied by involuntary movement of the right upper limb. CT scan revealed an old putaminal hemorrhage and almost intact thalamus, but neural noise recordings during the stereotactic thalamotomy of this case showed marked decrease of the neural activity in the thalamus suggesting some functional changes.
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PMID:Correlation between the neural noise in the thalamus after cerebrovascular disease and computerized tomography. A case report. 105 98

Dorsal column lesions in the high cervical region of the monkey result in severe defects of movements projected into space and contactual orienting reactions of the forelimbs. The hindlimbs are less affected provided a pathway through the lateral columns, Morin's tract, remains intact. Interruption of this pathway results in a defect of hindlimb function similar to that of the forelimbs. Cerebellar ablations in monkeys result in postural and movement disorders, including hypotonia of limb extensor muscles. An important mechanism underlying the hypotonia is a depression of the responses to muscle extension of spindle primary afferents owing to a decrease of fusimotor activity. In the decerebellate animal abnormalities of limb trajectory during active movements projected into space (cerebellar "dysmetria") appear to result principally from dysfunction of systems separate from the peripheral fusimotor efferent-spindle afferent reflex arc. Precentral cortical ablation results initially in a contralateral hypotonic hemiparesis, later in a hypertonic hemiparesis. A depression of the responses of muscle spindle afferents occurs during the hypotonic phase, but during the hypertonic phase spindle function returns to normal levels. Accordingly a depression of fusimotor function appears to be important in the hypotonic phase of hemiplegia; however, there is no evidence that an enhancement of fusimotor function underlies the hypertonic phase. Bilateral section of the medullary pyramids results in an enduring hypotonic paresis. Abnormalities of contactual orienting responses of limbs are similar to those following dorsal column lesions. Responses of spindle primary afferents are depressed during the initial stages after acute pyramidotomy, then approach but do not reach normal levels. It is concluded that the dorsal columns constitute an afferent, and the pyramidal tracts an efferent, pathway important in oriented contactual reactions of the limbs. The hypotonia resulting from cerebellar lesions, precentral ablation, and pyramidal tract section stems, at least in part, from a depression of the fusimotor innervation of muscle spindle afferent activity.
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PMID:Primate models of postural disorders. 105 89

Since 1959, 51 patients underwent open heart surgery for correction of acute dissection of the ascending aorta. Upon admission 33 patients were severely hypotensive or in porgressive heart failure. Acute aortic insufficiency was found in 24 patients, and hemiplegia or hemiparesis in 4. In 45 patients the ascending aorta was reconstructed with a woven graft. After excision of the dissected part of the aorta primary anastomosis or patch aortoplasty was performed in 6 patients. The aortic valve remained intact in 26 cases, and resuspension of the commissures restored competence of the aortic valve in another 9 patients. Sixteen patients required aortic valve replacement because of disrupture of the commissures. Dissection extended into the coronary ostia in 5 cases. Reconstruction of the coronary system was accomplished by reimplantation of the ostia, interposition of a vein graft or aorto-coronary bypass. Nine patients died within the early postoperative course from uncontrollable hemorrhage (4), further dissection (3) and myocardial infarction (2). Within the first year after surgery another 5 patients died from acute aortic dissection (2), pseudomonas-infection causing rupture of the proximal graft anastomosis (1), and myocardial infarction (2). The contraindications of antihypertensive treatment of actue dissection of the ascending aorta are discussed. We recommend prompt surgical intervention in acute dissecting aneurysm of the ascending aorta.
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PMID:[Surgical treatment of acute dissection of the ascending aorta (author's transl)]. 108 May 86

In the I State Home for Incurables in Lodz (Poland) 195 hemiplegia cases were observed over ten years. 140 women and 55 men. This comprised 8.2% and 17.8% of all ill females and males respectively. Causes of the lesion were vascular 187, trauma 4, neoplasm 4. Hemiparesis was in females most frequent between 60 and 80 years, in males between 50 and 80 years. Communication was absent or difficult in 126 cases (in 22 the cause was aphasia, in 104 dementia). Incontinence was noted in 77 cases, inability to walk (on admission) in 129. During the ten years under survey 135 died, 15 were discharged home, 26 females and 18 males were rehabilitated. Very good improvement in motor activity was obtained in 14 females (3 without kinesitherapy) and 7 males, indicating adequate walking and independence in activities of daily living after prolonged bedfastness. (average 2.5 years in males and 2.7 years in females). Altogether 88 patients improved from the locomotor angle. In cases with dementia, incontinence and severe aphasia prognosis in rehabilitation was found to be poor.
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PMID:10 years observation and rehabilitation of stroke disability. Longitudinal study. 118 16

A 70 years-old man was admitted at our hospital because of unstable angina pectoris. He had essential hypertension and right hemiplegia from a ischemic stroke two years before admission. On neurologic examination, it was found mental disorientation, unstable emotionality, right spastic hemiparesis with right Babinski sign, and segmental myoclonus affecting the superior lip and the palate (palatal nystagmus) on the right side. On the CT scan, a giant aneurysm of the basilar artery was detected. We conclude that the segmental myoclonus could be explained by ischemic lesions in the Guillain-Mollaret triangle.
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PMID:Segmental myoclonus and basilar artery. Giant aneurysm. Case report. 130 61


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