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)

Periventricular arteriovenous malformations (AVMs) have often been deemed inoperable because of their location in critical structures. Furthermore, the excision of large lesions may be complicated by the potential for serious brain swelling and hemorrhage due to "autoregulation breakthrough." Nonetheless, the unfavorable natural history of the untreated disease in a symptomatic young patient has induced us to approach these lesions using staged microsurgical excision combined with elective barbiturate coma for maximal cerebral protection. Between 1979 and 1983, six patients (four female, aged 12 to 60 years, and 2 male, aged 14 and 29) who harbored large AVMs in the basal ganglia, thalamic, and hypothalamic areas presented with subarachnoid hemorrhage (2 cases), progressive neural deficits (3 cases), and intractable headache (1 case). Nineteen staged operations were performed for the complete excision of these lesions. Among the first three patients, there was one death due to "autoregulation breakthrough" hemorrhage into the lateral ventricle during the excision of a lesion approached through the sylvian fissure using standard anesthesia techniques. This led to the adoption of the transventricular surgical approach and elective barbiturate coma to facilitate exposure of the lesion and to protect the adjacent vital structures from potential ischemia. Three patients were treated in this fashion uneventfully. Of the five successfully treated patients, two have returned to their preoperative status and one has completely recovered from global hemispheric ischemia and hemiplegia. The hemiparesis in one patient worsened as a result of postoperative hypertensive intraventricular hemorrhage, and one patient developed mild dysphasia and hemiparesis. This experience suggests that this approach offers a valid therapeutic regimen for the treatment of this disease. During the same period, three patients--one man (age 23) and two women (aged 29 and 22)--harboring four intraventricular AVMs presented with intraventricular hemorrhage. After the acute effects of chemical ventriculitis and hydrocephalus were overcome with cerebrospinal fluid diversion, all four lesions were excised microsurgically using the transtemporal approach. One patient demonstrated significant and progressive improvement of her preoperative memory deficit. The remaining two patients have both returned to their preoperative employment.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Microsurgical excision of paraventricular arteriovenous malformations. 398 6

It is said that the prognosis is generally unfavorable in patients with hypertensive intracerebral hemorrhage showed extravasation on angiogram. Recently, we experienced a case whose prognosis was eventful after the removal of hematoma. So we reported this case and discussed between alcoholism and intracerebral hemorrhage accompanied with extravasation on angiogram in this paper. A 59-year-old male was transferred to our emergency center because of right hemiplegia and mild clouding of consciousness at around nine in the evening on December 12, 1983. At the time of admission, his neurological state was classified into grade II, exhibiting the right putamenal hemorrhage and pyramidal destruction type of hematoma by CT scan with 58 ml of hematoma volume. The right carotid angiography was immediately performed and confirmed the hematoma being of lateral type. At that time, extravasation proximal to the lateral lenticulostriate artery was noted. Repeated CT scan revealed the enlarged hematoma (105 ml) accompanying with ventricular hemorrhage. At the completion of these examinations, the neurological grade was III. The hematoma was surgically removed after 4 hours following the onset of cerebral hemorrhage. His postoperative course was very favorable. Although acute hydrocephalus appeared later on, it was cured by ventricular drainage. The patient become possible to walk with a helper by 1 month after operation. CT scan obtained 1 month after operation revealed a remarkable brain atrophy, which was probably derived from chronic alcoholism.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case favorably progressed after operation for hypertensive intracerebral hemorrhage showed extravasation on angiogram occurred in chronic alcoholism]. 401 3

A case of herpes zoster ophthalmicus complicated by contralateral hemiplegia and normal pressure hydrocephalus is presented. The hydrocephalus is considered to be caused by recurrent haemorrhage from extensive cerebral arteritis.
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PMID:Herpes zoster ophthalmicus with contralateral hemiplegia and normal pressure hydrocephalus. 661 Jul 27

The incidence of infections of the central nervous system caused by Mycoplasma hominis in newborn infants is not known. However, such infections occur in both full-term and premature infants, either with or without malformations such as myelomeningocele. M. hominis has also been recovered from brain abscesses. Infected infants usually present with signs of meningitis or meningoencephalitis. Hydrocephalus may develop. The cerebrospinal fluid characteristically has a reduced glucose content and an elevated protein concentration. The white blood cell count is high, with a predominance of either mono- or polymorphonuclear leukocytes. Cerebrospinal fluid yields M. hominis but not other bacteria. Some newborn infants with M. hominis infection of the central nervous system die, whereas others survive and become healthy. In spite of adequate antibiotic therapy, some of those infected develop sequelae such as hemiplegia. Therapy with tetracycline or lincomycin can rapidly eradicate the organism from cerebrospinal fluid.
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PMID:Mycoplasma hominis infection of the central nervous system in newborn infants. 666 77

Ventriculitis developed suddenly in a patient with an undiagnosed abscess and was accompanied by obtundation, fever, meningismus, and hemiplegia. Aspiration of a streptococcal thalamic abscess and high doses of intravenous penicillin produced marked improvement. Increasing dysphasia 5 weeks later was accompanied by ventricular dilatation, most marked on the left, with no evidence of recurrent abscess. The left foramen of Monro was demonstrably patent. Shunting relieved the symptoms of aphasia; they recurred with one episode of malfunction of the shunt. This case lends support to the belief that parenchymal characteristics are important in hydrocephalus and demonstrates how asymmetrical ventricular dilatation can produce focal symptoms.
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PMID:Asymmetrical hydrocephalus following ventriculitis from rupture of a thalamic abscess. 685 81

The serious, late complication of superficial cerebral hemosiderosis, which appears after several years in 1/4-1/3 of patients who have undergone hemispherectomy, has resulted in recent years in a considerable reluctance to carry out this operation despite the fact it has proved to be highly effective in patients with medically refractory seizures associated with hemiplegia. Preservation of a small portion of the hemisphere, usually the frontal or occipital pole, has proved to be effective in preventing this late complication, but at the cost of a significant reduction in the effectiveness of the operation in reducing the patients' seizure tendency. Preserving the frontal and occipital poles but disconnecting them from the rest of the brain, resulting in a functional complete but anatomical subtotal hemispherectomy, retains the therapeutic effectiveness of a complete hemispherectomy while still protecting adequately against the serious late postoperative complication of superficial cerebral hemosiderosis and its associated neurologic deterioration, hydrocephalus and sometimes death.
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PMID:Hemispherectomy for seizures revisited. 686 Oct 11

In congenital porencephalies, diverticulation of the lateral ventricle is a dynamic process producing compression and stretching of the brain tissue bordering the diverticulum, bulging of the overlying skull, macrocephaly, and occasionally progessive neurologic signs (hemiplegia, raised intracranial pressure), even when the rest of the ventricular system is not dilated and the CSF pressure is normal. Ventriculoperitoneal shunting can result in remarkable improvement of focal motor deficits and may apparently also play a beneficial role on further mental development. Successive computed tomography scans demonstrate that the brain parenchyma, which had been stretched by the porencephalic pouch, is capable of regaining near normal thickness. Congenital porencephalies are initiated by a limited destructive brain lesion, but the gradual expansion of the ventricular herniation may imply a mechanism identical to that which has been postulated in normal pressure hydrocephalus. Nine cases of unilateral "expanding" congenital porencephalies are presented and the treatment of this condition is discussed.
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PMID:Progressive expanding congenital porencephalies: a treatable cause of progressive encephalopathy. 726 26

Prospective follow-up studies were done on 62 term infants who were treated as neonates for clinical evidence of postasphyxial encephalopathy. Computed tomographic studies were done during the first two weeks of life and repeated at six months of age. All children were followed a minimum of 18 months, at which time they underwent a psychometric and a neurologic evaluation. Major neurodevelopmental sequelae consisted of: hydrocephalus; spastic quadriplegia, hemiplegia, or diplegia; or a mean Bayley score less than 70. Major sequelae were present in 29 (47%) of the children: all were severely handicapped. Five other children scored between 70 and 85 on the Bayley test. Computed tomographic scans were highly predictive of status at 18 months. Eleven of the 15 with intraventricular or parenchymal hemorrhage were severely handicapped. Eighteen of 20 with extensive areas of hypodensity of the white and gray matter (neonatal CT) were abnormal at 18 months. All but two were severely handicapped. The results suggest that CT studies are very useful in the care of the asphyxiated term infant who has clinical signs of encephalopathy.
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PMID:The prognostic value of computed tomography as an adjunct to assessment of the term infant with postasphyxial encephalopathy. 729 58

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

Of the 26 cystinotic patients over 19 years of age followed in our institution, 7 developed CNS complications at a mean age of 23 years. Two forms were observed. The first, associating cerebellar and pyramidal signs, mental deterioration and finally pseudo-bulbar palsy, may be called cystinosis encephalopathy. The other form resembled a stroke-like episode with coma and hemiplegia or milder symptoms. Hydrocephalus was rare and not associated with clinical symptoms in this series. Cysteamine was administered for longer than 6 months to 4 of the patients with encephalopathy. Two had an almost complete disappearance of their symptoms including the gross abnormalities of MR imaging in one; one improved partially and remained stable, and one continued to deteriorate but was suspected of non-compliance. These results suggest that cysteamine may be an effective treatment of cystinosis encephalopathy and encourage prescription of this drug in cystinosis in order to prevent this complication.
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PMID:Clinical polymorphism of cystinosis encephalopathy. Results of treatment with cysteamine. 883 Jan 79


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