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)

A study was performed to compare the follow-up results of superficial temporal artery-middle cerebral artery anastomosis between a group of nine elderly patients (aged 70 years or over) and another group of 24 non-elderly patients (aged less than 70 years) with cerebral ischemia. The 33 patients, comprising 26 males and seven females, were evaluated pre- and postoperatively by four-vessel angiography, CT scan, MRI and cerebral blood flow (CBF) examination using either xenon inhalation or 123I-IMP SPECT. In some patients, additional evaluations were done. For those with dementia, the minimental scale (MMS), P300 event-related potential, the Hachinski ischemia score, and the vowel word counting test (Kaneko's KANAHIROI) were used, and for the hemiplegic, the Barthel index indicating ability of daily life (ADL) was employed. The results of follow-up for periods ranging from 12 to 55 months were "excellent" (returned to previous job) or "good" (able to perform self-care) in 27 of the 33 patients (81.8%) including six (66.6%) of the elderly group and 21 (87.5%) of the non-elderly group. There was no significant difference between the two groups by statistical evaluation. Among the nine patients with dementia (five under 70, four 70 years of age or over), eight (four under 70, four 70 or over) showed "rapid recovery" with improved postoperative MMS, P300, vowel word counting score and CBF. One patient under 70 (Case 5; a 47-year-old male) with a delayed 2-day recovery from general anesthesia, took as long as 6 months to obtain the self-care ability in daily life. Excluding this patient, all of the remaining eight patients responded quickly to surgery and were able to go home with their families after 2 to 4 weeks, there being no significant difference between the two age groups. In the 14 patients with hemiplegia/paresis (nine under 70, five 70 or over), a definitely better result was obtained for the non-elderly group. Eight of the nine non-elderly patients (89%) showed full ADL (Barthel index 100), whereas only one of three elderly patients (33.3%) showed almost full ADL (Barthel index 97). In five progressive stroke patients, (three under 70, two 70 or over) ultra-early bypass was performed within 8 hours postictus. Definitely better results were obtained in the patients aged less than 70, who showed rapid recovery and were able to return to their previous jobs 1 to 3 months after surgery. In contrast, the two patients aged 70 or over showed no improvement. In this report, we discuss the clinical and physiological variables that may be important for selection of elderly patients for cerebrovascular bypass surgery.
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PMID:[Results of superficial temporal artery-middle cerebral artery anastomosis for elderly and non-elderly patients with cerebral ischemia]. 782 13

Localized 1H magnetic resonance spectroscopy was performed in a 45-year-old woman with migraine. She developed throbbing headache attacks without aura since thirteen years ago and the attack was accompanied with right hemiplegia since seven years ago. Brain MRI showed no abnormalities and 123I-IMP SPECT revealed mild frontal dominant decrease of cerebral blood flow. It seemed that her condition was positioned between migraine with prolonged aura and migrainous infarction of complicated migraine in the classification of International Headache Society. Spectra obtained from bilateral frontal lobe interictally showed elevation of lactate at left side. Choline, creatine, and N-acetyl-aspartate were almost equal on both side. The above results suggest that slight ischemia which is not detected by MRI is present or there is a disturbance of oxidative glycolysis, which is induced by mitochondrial dysfunction.
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PMID:[Elevation of cerebral lactate detected by localized 1H magnetic resonance spectroscopy in a patient with migraine]. 792 68

We report on eight children who suffered from cerebrovascular ischemia or stroke at the age of 2 or up to 11 years. Antiphospholipid antibodies (APLA) were detected in two cases during the ischemic event and in six cases during follow-up examinations (after six weeks or within a span of six years). In two patients multiple stenoses of basal cerebral arteries were found; one of them suffered from moyamoya syndrome. The acute hemiplegia in one patient was linked to an asymptomatic mycoplasmal infection and APLA. In three cases, one of the parents was also APLA-positive. Seven patients were treated with acetylsalicylic acid, and in four cases immunoglobulin infusions were given. Transient ischemic attacks subsided after the child with the moyamoya syndrome received immunoglobulins. No effect of medication could be established in the other children. The concept of the antiphospholipid syndrome is still evolving. As none of the common risk factors pertaining to strokes in adults apply to children, pediatric research may offer a suitable platform for specific investigations on the causal, pathogenetic role of APLA. We propose that all children suffering from stroke or transient ischemic attacks should be tested for APLA.
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PMID:Antiphospholipid antibodies in cerebrovascular ischemia and stroke in childhood. 820 57

We reported a patient with internal carotid artery occlusion (ICAO) who developed cough-induced transient hemiplegia. A 63-year-old man with chronic obstructive pulmonary disease experienced several episodes of cough-induced left hemiplegia during drinking and smoking. Selective cerebral angiography demonstrated right ICAO at the vessel origin, with 50% stenosis of the left internal carotid artery. Collateral circulation from the right external to internal carotid artery branches and through the anterior communicating artery was poorly observed on the angiograms. Right middle cerebral artery branches were well visualized on vertebral angiograms at the late phase through the posterior and anterior pericallosal arteries. Due to this collateral blood supply, the right middle cerebral artery territory formed the most distal part of the cerebral circulation and was vulnerable to a reduction of cerebral blood flow. We considered that systemic hemodynamic disturbances by identical mechanisms to those observed in cough syncope may have brought about transient ischemia in the right middle cerebral artery territory which was manifested in the patient's unusual clinical presentation of ICAO "cough hemiplegia".
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PMID:[A case of cough hemiplegia]. 825 26

The subclavian steal syndrome (SSS) is often associated with occlusive disease involving the subclavian or innominate arteries, but an asymptomatic subclavian steal, called the "subclavian steal phenomenon" (SSP), is not uncommon. Though intracranial collaterals had been postulated as one of the etiologies for the SSP's being asymptomatic, little has been accomplished in the investigation of extracranial channels. To study the hemodynamic role of cervical collateral channels, an angiographical study was done in three cases with SSP. The three cases were admitted to the hospital because of carotid ischemic symptoms, such as right hemiplegia or sensory aphasia. Each case had a blood pressure difference between the two arms, but in all of them the past history or the exercise test was negative for vertebrobasilar or arm ischemia. On angiography, occlusions of the unilateral proximal subclavian artery, the left in case 1 and the right in case 2, or a tight stenosis of the innominate artery was found in case 3. In each case, the vertebral artery flow in the affected side was inverted, siphoning off from the opposite vertebral artery into the affected subclavian artery. In addition to the vertebral siphoning; muscular branches of ipsilateral external carotid origin in cases 1 and 2, or the thyrocervical trunk via the inferior thyroid artery in case 3 was also found to function as a collateral channel to the vertebral artery on the affected side.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The significance of cervical collaterals in the subclavian steal phenomenon]. 829 73

A patient with cerebral vasospasm following subarachnoid hemorrhage (SAH) was investigated by serial measurement of cerebral blood flow (CBF) using the xenon-133 emission tomography method. The CBF was measured before and after acetazolamide injection. On Day 2 after SAH, there was early local hyperperfusion in the middle cerebral artery (MCA) territory, ipsilateral to the left posterior communicating artery aneurysm. The regional CBF of this arterial territory decreased slightly after acetazolamide injection, probably because of vasoplegia and the "steal" phenomenon, and thus surgery was delayed. A right hemiplegia with aphasia and disturbed consciousness occurred 4 days later (on Day 6 after SAH) due to arterial vasospasm, despite treatment with a calcium-channel blocker. The initial hyperemia of the left MCA territory was followed by ischemia. The vasodilation induced by acetazolamide administration was significantly subnormal until Day 13, at which time CBF and vasoreactivity amplitude returned to normal and the patient's clinical condition improved. Surgery on Day 14 and outcome were without complication. It is concluded that serial CBF measurements plus acetazolamide injection are useful for monitoring the development of cerebral vasospasm to determine the most appropriate time for aneurysm surgery.
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PMID:Abnormal cerebral vasodilation in aneurysmal subarachnoid hemorrhage: use of serial 133Xe cerebral blood flow measurement plus acetazolamide to assess cerebral vasospasm. 841 Feb 15

We investigated the effects of RGH-2202 (posatirelin, (-)-(2S)-N-[(1S)-1-[[(2S)-2-carbamoyl-1-pyrrolidinyl[carbonyl]-3- methylbutyl]-6-oxopipecolamide), a thyrotropin-releasing hormone (TRH) analog, on behavioral changes during a chronic phase of focal ischemia in rats in comparison with the parent peptide. The left middle cerebral artery (MCA) was occluded under halothane anesthesia, and the subsequent behavioral changes were observed for 35 days. RGH-2202 (1, 3, and 10 mg/kg) and TRH (10 mg/kg) were given IP just after the operation and afterward once a day for 14 days. MCA-occluded rats exhibited neurologic symptoms including hemiplegia and abnormal posture and disturbance of passive avoidance learning during the entire 35-day observation period. The repeated treatment with either peptides improved the neurologic and cognitive deficits. In addition, a recovery from deficits was still advanced after discontinuation of the drug treatment. In these effects, RGH-2202 was about three times more potent than TRH. Neural tissue damage in drug-treated groups, measured by omega 3 binding site densities 35 days after MCA occlusion, was included to be less than that in the vehicle-treated group. These results suggest that appropriate treatment with RGH-2202 may be useful in the treatment of functional disturbances after focal cerebral ischemia.
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PMID:Effects of RGH-2202 on behavioral deficits after focal cerebral ischemia in rats. 858 7

Ocular ischemic syndrome is extremely rare in childhood. Patients with moyamoya disease may be particularly susceptible to the development of ocular ischemia due to the associated carotid occlusion. A 19-month-old boy presented with neurofibromatosis and signs of ocular ischemia. At 29 months of age, he developed dense right vitreous hemorrhage and eventually lost vision in that eye due to phthisis. At almost six years of age, he developed an acute hemiplegia and was then diagnosed with moyamoya disease. This rare instance of childhood ocular ischemia in conjunction with moyamoya disease and neurofibromatosis demonstrates the serious ocular and systemic sequelae of occlusive vascular disease.
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PMID:Ocular ischemic syndrome in a child with moyamoya disease and neurofibromatosis. 872 42

We have recently shown that long-term, but not acute, treatment with lithium robustly protects cultured CNS neurons against excitotoxicity mediated by NMDA receptors. Since NMDA receptor over-excitation has been strongly implicated in the ischemic brain injury, we examined the effects of chronic lithium treatment on neurological deficit and brain infarct induced by occlusion of the left middle cerebral artery in rats. Subcutaneous injection of LiCl for 16 days significantly improved neurological deficits, including abnormal posture and hemiplegia, measured 24 h after artery occlusion. Importantly, the size of ischemic infarct was reduced by 56% after lithium pretreatment. These results raise the possibility that lithium may be useful for reducing focal ischemia-induced brain damage and neurological abnormalities.
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PMID:Neuroprotective effects of chronic lithium on focal cerebral ischemia in rats. 967 97

The hydatic cyst is a pathology observed in developing countries. Multiple cerebral localizations with a cardiac origin are exceptional and are sometimes diagnosed only after onset of complications. We present the case of a 22-year-old male student: the diagnosis of multiple cerebral hydatic cysts caused by rupture of a cardiac hydatic cyst was established after an episode of ischemia of the limbs with cerebral hemorrhage induced by heparin. One year later, the clinical situation consisted in intracranial hypertension, hemiplegia and convulsive seizures. We observed no cardiac symptoms. The brain CT showed 9 hydatic cysts and echocardiography showed a myxomatous cystic tumor. Abdominal CT detected renal and splenic hydatic cysts. The patient underwent total ablation of the cerebral and abdominal cysts and made a full recovery. After surgical removal of the cardiac cyst, the patient has been lost to follow-up. Cerebral hydatidosis of cardiac origin is highly exceptional and, due to nonspecific symptomatology, may go undiagnosed. In general, prognosis is good in case of a cerebral localization but the cardiac localization is associated with high mortality.
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PMID:[Multiple cerebral hydatic cysts of cardiac origin. A case report]. 1071 96


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