Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018991 (hemiplegia)
 3,997 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of familial antithrombin III (AT-III) abnormality accompanied with progressing ischemic stroke. The patient was a 31-year-old female who developed consciousness disturbance and left hemiparesis on December 1 in 1987. She had a history of two transient ischemic attacks and three episodes of thrombophlebitis of the extremities. Cerebral CT scan showed a low density area on the right temporal lobe that had extended to the right parietal and on the left frontal lobe as clinical symptoms worsened. Cerebral angiogram revealed branch occlusions of the right middle cerebral artery and showed no cerebral venous and sinus obstruction. When her symptoms had been progressing to show semi-comatose state, left hemiplegia and transient Cheyne-Stokes respiration, we found her decreased biological activity and normal immunological level of AT-III. The diagnosis of familial AT-III abnormality had been made by familial investigation. As the treatment of AT-III concentrates transfusion was started from the third day, her symptoms gradually recovered and the low density area stopped extending. Further examinations revealed that she was a homozygote of AT-III abnormality presenting no affinity for heparin and that her parents were heterozygotes. It was suggested that the homozygous AT-III abnormality was the main cause of her progressing ischemic stroke.
 ...
PMID:[Familial antithrombin III abnormality accompanied with progressing ischemic stroke]. 269 32

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.
 ...
PMID:The lacunar syndromes. 269 95

About 10% of all elderly dysvascular amputees have had cerebrovascular accidents at some time. This is an often overlooked but important fact which significantly impacts the outcomes of their rehabilitation, especially where prosthetic ambulation is attempted. This study reviews the rehabilitation outcomes of 46 patients with the dual disability of hemiplegia and amputation. The mean age of the patients was 63 years (range 49 to 84). Forty-one (89%) could participate in a trial of physical therapy, and 25 (54%) in a comprehensive rehabilitation program. Seventeen (37%) were fitted with a prosthesis, and 12 (26%) became independent ambulators. Eighteen (39%) achieved independence in their activities of daily living (ADL) and transfers. Patients were reviewed to establish those features predictive of a good outcome. The following factors were associated with regaining independent ambulation: the presence of a mild hemiparesis with residual hand function (p less than 0.001), a below-knee amputation (p less than 0.01), and a history of ambulation before the second disability (p = 0.05). The ADL independence was associated with a mild hemiparesis (p less than 0.001), and age less than 60 years (p less than 0.05). Incontinence of bowel or bladder was strongly predictive of failure to achieve independence in either ADL or ambulation (p less than 0.001). Of those patients who did achieve independent ambulation, 73% were still ambulating a mean of 16.5 months later. These findings should be considered when planning rehabilitation goals for patients with the dual disability of hemiplegia and amputation.
 ...
PMID:Hemiplegia and amputation: rehabilitation in the dual disability. 273 Mar 8

Reciprocal inhibition of H reflexes in the forearm flexor muscles was examined in a group of 16 patients with writer's and other occupational cramps. The early disynaptic phase of reciprocal inhibition was normal. However, there was a reduction in the amount of later, presynaptic inhibition, when compared with age-matched normal subjects. Similar findings were seen in 2 patients with symptomatic hemidystonia in whom structural brain lesions were present. However, this reduction in presynaptic inhibition was not specific to patients with dystonia. In a further group of 13 patients with hemiparesis or hemiplegia due to stroke, abnormalities of both early and later phases of reciprocal inhibition were found. The patients with spasticity exhibited less disynaptic inhibition than those with normal tone or flaccid limbs. The changes in the presynaptic phase of reciprocal inhibition did not correlate with the clinical signs of spasticity and increased muscle tone. These results provide objective evidence of a physiological basis for the action or task-specific focal dystonias such as writer's cramp.
 ...
PMID:Reciprocal inhibition between forearm muscles in patients with writer's cramp and other occupational cramps, symptomatic hemidystonia and hemiparesis due to stroke. 273 Oct 27

Three different cases of cerebral embolism occurring in combination with hyperthyroidism are reported. Case 1; a healthy 37-year-old woman presented with sudden onset of left hemiparesis and left sided hypoesthesia of all modalities. Embolism in area of the right middle cerebral artery was confirmed by angiography and CT scan. Laboratory examination revealed hyperthyroidism and anemia. Antithyroid treatment brought about euthyroid function while slight hemiparesis remained present. Case 2; a 79-year-old woman who suffered from hypertension for one year had sudden onset of disorientation and left hemiparesis. Electrocardiogram showed atrial fibrillation. The CT scan indicated infarction in the right anterior and middle cerebral artery. The patient was diagnosed as having masked hyperthyroidism. Although antithyroid medication reduced it to euthyroid condition, the patient is now bedridden with hemiparesis. Case 3; a 45-year-old man who had partial thyroidectomy for Basedow's disease and had been treated with antithyroid and antiarrhythmic therapy for 10 years. Suddenly, he was in coma with dilated right pupil and left hemiplegia. Atrial fibrillation and hypothyroid function were observed. CT scan indicated hemorrhagic infarction in the territory of the middle cerebral artery with transtentorial herniation. He died on the 59th day of hospitalization following an episode of bronchopneumonia. On the basis of the cases presented here as well as on the basis of those described in the literature it appears that thyrotoxic patients with atrial fibrillation exhibit high incidence of cerebral embolism, and prophylactic anticoagulant therapy may be recommended.
 ...
PMID:Cerebral embolism and hyperthyroidism. 277 Feb 20

Hypoglycemia can result in a transient hemiplegia mimicking a minor cerebral vascular accident. With the widespread use of oral hypoglycemics and insulin this unexpected presentation of hypoglycemia is now being reported more frequently in the medical literature. This article describes a case of hypoglycemic hemiparesis and illustrates the need to consider this diagnosis, especially when the diabetic patient presents with stroke-like symptoms.
 ...
PMID:[Hypoglycemic hemiparesis. A case report]. 281 7

The mean age of the 13 patients studied (9 women, 7 men) was 50.5 +/- 15.7 years. The disease was discovered on account of malaise (3 cases), behavioural disorders (4 cases), coma (3 cases), syncope (1 case) or right hemiparesis (1 case) or in the course of systematic examination (1 case). Eleven patients consulted for evaluation of hypoglycaemia and 2 for behavioural disorders. The history was characteristic, with malaise, loss of consciousness, severe neurological disorders (seizures, hemiparesis, hemiplegia or coma) and psychiatric disorders. These symptoms typically occurred in the morning before breakfast or between meals in 9 patients, and atypically at any point of time or after meals in 4 patients. Their hypoglycaemic nature was demonstrated by blood glucose determination in 11/13 cases and by response to ingestion of sugar in 12/13 cases. The mean period elapsed between the initial symptoms and the final diagnosis was 20.3 +/- 17.3 months. Inappropriate insulin secretion was elicited a.m. before breakfast, during Conn's diet or fasting test, or by calculating the blood insulin/glucose ratio or Turner's coefficient. Prior to surgery, the insulinoma was located by ultrasonography in 3/8 cases, by computerized tomography in 2/6 cases, by selective arteriography in 6/11 cases, and by phlebography with spleno-portal catheterization and staged sampling for insulin and C-peptide assays in 8/9 cases. Histological examination after surgery (11 cases) or necropsy (1 case) showed an adenoma without evidence of malignancy.
 ...
PMID:[Insulinoma: diagnostic elements. 13 cases]. 299 55

Reversible osmotic blood-brain barrier (BBB) modification was used in 38 patients with glioblastoma to enhance the delivery of chemotherapeutic agents. The patients ranged in age from 14 to 70 years (mean, 43), and all had prior surgery and radiation; 5 had also received systemic chemotherapy. Karnofsky Performance Status (KPS) scores ranged from 60 to 100% (mean, 79) on admission to the treatment program. Barrier modification was achieved by intracarotid or intravertebral artery infusion of mannitol, and a chemotherapy regimen of methotrexate, cytoxan, and procarbazine was given in conjunction with barrier modification. The 38 glioblastoma patients were compared to two control groups of patients with glioblastoma; these encompassed 14 patients treated with surgery and radiation and 8 treated with surgery, radiation, and systemic chemotherapy. Survival analysis using the Cox Proportional Hazards Regression Model (corrected for age, sex, presence or absence of necrosis, and functional status) showed that patients receiving chemotherapy with BBB modification had a statistically significant (P = 0.0006) longer expected survival (17.5 months) than the control groups (12.8 and 11.4 months, respectively). Presently 16 patients of the barrier-enhanced treatment group are alive at 5 to 42 months from diagnosis (median, 20) with KPS scores ranging from 40 to 90% (median, 65). The neurological complications seen included a stroke-like syndrome in 3 patients (1 with decreased motor movement in the hand, 1 with marked hemiparesis, and 1 with hemiplegia), transient exacerbation of preexisting neurological deficits lasting 2 to 3 days, and a 15% incidence of seizures during or within 24 hours of the BBB modification. In 2 of the 38 patients, radiographic documentation of central nervous system tumor regression concurrent with the development of new tumor nodule(s) in portions of the brain distant from the region of osmotic BBB opening was seen. These studies indicate that chemotherapeutic drug delivery to tumors (as well as surrounding brain) can be augmented by osmotic BBB modification and that such therapy can result in a prolongation of survival.
 ...
PMID:Therapeutic efficacy of multiagent chemotherapy with drug delivery enhancement by blood-brain barrier modification in glioblastoma. 309 67

In thrombosis of the basilar artery, not infrequently a hemiparesis is present at an early stage, when brain-stem signs may be absent or few, slight or equivocal. It is natural to suspect that such a hemiparesis signifies localization in a cerebral hemisphere, but unexpectedly in a few hours bilateral hemiplegia appears associated with coma or a locked-in syndrome, indicating basilar artery occlusion. I would term this disarming hemiparesis the "herald hemiparesis" of basilar artery occlusion. If the true nature of the condition is recognized early, the use of heparin and other measures may forestall disaster.
 ...
PMID:The 'herald hemiparesis' of basilar artery occlusion. 277 10

This paper reports two cases of crossed dextral aphasia. The first patient was a 60-year-old right-handed male with no family history of sinistrality. He experienced sudden onset of left hemiplegia and loss of consciousness. A CT scan showed high-density area in the right fronto-parietal region. An angiography revealed an arteriovenous malformation (AVM) in the right parietal lobe. It was fed by a branch of the middle cerebral artery and drained through a cortical vein. Neuropsychological examination one week after the surgery showed severe defects of all language moderalities. He was alert and cooperative, but completely mute. He recognized common words by auditory and visual stimuli, but could not perform simple command. He wrote some meaningless letters when asked to write his own name. Auditory and reading comprehension gradually improved thereafter, but Broca's type of aphasia with non-fluent hesitant and effortful output was still present four months after the surgery. The second patient was a 38-year-old right-handed male. All members of this family are right-handed except for one sister who is left-handed. He suddenly suffered left hemiparesis and loss of consciousness. A CT scan disclosed a right parietal intracerebral hematoma. And an AVM which was fed by the angular artery and drained through a cortical vein was angiographically demonstrated in the same area. Postoperatively the left hemiparesis rapidly disappeared, but left homonymous hemianopsia and anomic type of aphasia still persisted. His speech was fluent and daily communication was possible in spite of circumlocutory paraphasic output.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Cerebral lateralization in two cases of crossed dextral aphasia with right-hemisphere arteriovenous malformation]. 321 38


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>