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 16-year-old boy, who had sudden left-sided hemiplegia, died two weeks following onset of symptoms. A right carotid angiogram showed stenosis at the termination of the internal carotid artery. The middle cerebral artery had a beaded appearance and some of its branches were occluded. A basal "moyamoya" syndrome and transdural anastomoses were present. At autopsy, multiple intracranial dissecting aneurysms were found. Arteries of the body displayed fibromuscular dysplasia (FMD). The relevance of dysplastic changes of intracranial arteries and the relationship to moyamoya syndrome are discussed.
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PMID:Fibromuscular dysplasia and multiple dissecting aneurysms of intracranial arteries. A further cause of Moyamoya syndrome. 96 Jan 59

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

Moyamoya disease is a chronic occlusive cerebrovascular disorder characterized by stenosis of the intracranial internal carotid artery often accompanied by stenosis of the anterior and/or middle cerebral arteries. This results in cerebral ischemia, which manifests clinically as transient, repetitive episodes of hemiplegia, dysarthria, and involuntary movements. This case report documents a patient in whom an initial extracranial-intracranial bypass (superficial temporal-middle cerebral artery) failed to alleviate the ischemic symptoms. In a subsequent procedure, a pedicle graft of omentum was created and through a subcutaneous tunnel was placed on the right cerebral cortex. Over a 2 1/2-year period, this has resulted in a dramatic resolution of the patient's symptomatology. The report delineates the condition and reviews other therapeutic options.
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PMID:Encephalo-omental synangiosis in the management of moyamoya disease. 173 85

This case was 36-year-old female with the past history of pulmonary tuberculosis on her 10 years old. During the treatment for pulmonary tuberculosis, transient tetraparesis appeared, and improved completely. She was admitted to our hospital, complaining sensory disturbance of left face and arm on July 25, 1983. Plain skull roentogenogram showed calcification at the base of brain. Computerized tomography (CT scan) showed dilatation of lateral and third ventricles. Cerebral angiograms revealed an occlusion of the right internal carotid artery and the left middle cerebral artery, the stenosis of the basilar artery and bilateral posterior cerebral arteries, transdural anastomosis (so-called vault moyamoya), leptomeningeal anastomosis and moyamoya vessels at the base of brain. Four days after the admission, left hemiplegia appeared suddenly. Because the findings of CT scan and angiogram showed no change, conservative treatment was performed and motor disturbance improved. Biopsy of the calcified mass was carried out and histological findings suggested an old inflammation. Based on the clinical course and examination, it was considered that moyamoya vessels of this case had been formed as a result of tuberculous meningitis. Up to now, only 6 cases with moyamoya vessels at the base of brain coursed by tuberculous meningitis Up to now, only 6 cases with moyamoya vessels at the base of brain coursed by tuberculous meningitis have been reported. In our case, neurological symptoms appeared 26 years after tuberculous meningitis and occlusive changes were seen in bilateral carotid system and vertebrobasilar system.
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PMID:[A case showing angiographically moyamoya vessels combined with intracranial calcification]. 370 37

In many cases, intracranial occlusive strokes in children are treated symptomatically, with a diagnosis of acute infantile hemiplegia. This is because angiography is more difficult in children and, even if occlusive cerebral arterial disease is diagnosed, there is no definite therapeutic procedure. A case is reported of left internal carotid artery occlusion presenting with acute infantile hemiplegia and followed by repeated transient ischemic attacks. Encephalo-duro-arterio-synangiosis--developed as an operation for moyamoya disease--was performed on this patient, resulting in a marked revascularization of the brain in 8 postoperative months with good improvement in symptoms. This suggests that the operation may be effective in chronic cerebral ischemic diseases other than moyamoya disease.
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PMID:A case of internal carotid artery occlusion successfully treated by encephalo-duro-arterio-synangiosis. 383 39

Clinical features of cerebrovascular occlusive disease with the moyamoya network (group 1: twenty-nine children) and those without this network (group 2: nine children) are reported herein. Group 1 was characterized by female preponderance, recurrent and transient ischemic attacks, progression of mental deterioration, rebuild-up after hyperventilation on EEG and wide-spread lesions on CT scan. Group 2 had one or two attacks which led to a rather long-lasting hemiplegia but not to mental deterioration, rare rebuild-up findings on EEG and unilateral focal lesion on CT scan. Precipitating factors for ischemic attacks included deep breathing, changes in body temperature or sleep-waking transition were present in both groups. Etiology in some children was considered to be congenital.
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PMID:Cerebrovascular occlusive disease with and without the moyamoya vascular network in children. 397

Clinical features of ten Japanese children with cerebrovascular Moyamoya disease are reported and non-Japanese paediatric cases of the disease are reviewed from the world literature. The most common initial manifestations were headache in four cases (40%), motor deficit and convulsion in three cases (30%). As their recurrent and/or residual symptoms, eight children (80%) developed motor deficit consisting of hemiplegia in five cases and paresis or weakness of the extremities in three cases, and four (40%) had headaches. The mode of presentation in our cases was similar to that of non-Japanese cases, in addition to a female preponderance. Electroencephalographic findings of prominent high voltage delta bursts following hyperventilation and slowness of returning to the normal pattern, seen in all hyperventilated cases, is one of the features. Of 15 carotid arteries visualised in ten patients, sites of occlusion or stenosis were seen between the bifurcation of the posterior communicating artery and that of the anterior cerebral artery or the middle cerebral artery in 13 arteries, with a vascular network in the basal ganglia. This study suggests that if hyperventilation procedures produce prominent high voltage delta bursts during electroencephalography in children with headache and/or motor deficit, cerebrovascular disease, especially Moyamoya disease, should be suspected.
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PMID:Cerebrovascular Moyamoya disease. 637 Jun 99

Dissecting intracranial arterial aneurysms were identified in a 16-year-old girl and a 48-year-old man with moyamoya disease. Hemiplegia or tetraplegia rapidly developed. Angiography revealed bilateral stenoses or occlusion of the bifurcation of the internal carotid arteries (ICA's) and an unusual vascular network at the base of the brain. Autopsy confirmed massive hemorrhage from the thalamus and putamen, with intraventricular extension. The intracranial segments of both ICA's were markedly stenotic in both patients, due to eccentric fibroelastic intimal thickening. In one patient, a dissecting aneurysm was identified microscopically, involving the proximal segment of the left anterior cerebral artery. In the other patient, the right middle cerebral artery (MCA) was dissected beneath the internal elastic lamina along the entire length of the horizontal segment of the MCA. Thus, cerebral dissecting aneurysms may be present in patients with moyamoya disease.
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PMID:Cerebral dissecting aneurysms in patients with moyamoya disease. Report of two cases. 684 98

In the present study the pathology and treatment of occlusion of cerebral arteries in children were investigated in an attempt to find out an approach to the surgical treatment of cerebral arterial occlusive disease of childhood. We had a total of 55 children with cerebrovascular disorders seen at our Institute during the past 11 years. In this series there were 19 cases of cerebral arterial occlusive disease. The causes in 15 cases of cerebral arterial occlusive disease except for moyamoya disease were heart disease in 7 cases, trauma in 2 cases and unknown in 6 cases. The cerebral arterial occlusive disease had its onset at the age of less than 6 years in 12 of 15 cases. The disease began with hemiplegia of sudden onset. The disease onset was also attended frequently by a convulsive seizure, which distinguishes the condition from that in adults. In 10 of all 15 lesions the site of occlusion was in the distribution of the middle cerebral artery. One case in which there was occlusion of the basilar artery occurring in association with trauma was described in detail. In one instance the treatment consisted of STA-MCA anastomosis. Paroxysmal black out attacks, which had been of frequent occurrence in addition to hemiplegia were relieved postoperatively. In our opinion, STA-MCA anastomosis for cerebral arterial occlusive disease in children should be considered to be indicated only when 1) cerebral angiographic evidence of occlusion or stenosis of a trunk of cerebral artery is still present after the acute stage or 2) no extensive low density area is demonstrable on CT scan. Surgery is generally less indicated in those instances in which the occlusion is due to embolism. However since abscess may arise from such an arterial lesion, surgery should be considered, or at least its feasibility be evaluated, whenever 1) the underlying cardiac pathology well permits surgical intervention and 2) half a year has passed since an initial attack.
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PMID:[Cerebral arterial occlusive disease in children -- clinical aspects and surgical treatment (author's transl)]. 727 22

We report a 10-year-old boy who has Fanconi's anemia and was admitted because of acute hemiplegia of the left side. Internal carotid arteriography disclosed a moyamoya cerebrovascular pattern on the right side. Although this condition may be acquired, it is suggested that in this case the moyamoya might pertain to the array of congenital malformations associated with Fanconi's anemia. Intracranial accidents occurring in Fanconi's anemia are generally ascribed to the bleeding tendency; however, the possibility of an underlying vascular anomaly should also be considered.
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PMID:Moyamoya and Fanconi's anemia. 736 89


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