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)

Recent advance in vascular surgery have made vascular reconstruction of the carotid artery possible. Since 1990, the authors have performed en bloc resection of the carotid artery and vascular reconstruction of the carotid artery, using a temporary shunt tube, in 10 cases. Among these 10 cases of tumors involving the carotid artery, two cases had carotid body tumors and the other eight cases had metastatic lymph nodes from head and neck cancers. Transient motor paralysis occurred in three cases and disorientation in one after the operation. None has developed severe neurological complications such as death, coma or permanent hemiplegia. Despite preoperative irradiation, local infection was noted in only one case after the operation. Rupture of the vein graft was prevented by using a DP flap to cover dead space at the anastomotic site. The two patients with a carotid body tumor are alive without evidence of recurrence. Among eight patients with cancer, three are still alive and disease free (respectively 44, 30 and 16 months). Two patients died of local recurrence, two of distant metastasis and the other of acute heart failure. Local tumor control was possible in six out of eight patients. We were able to safely perform en bloc resection of the carotid artery and vascular reconstruction of the carotid artery using a temporary shunt tube. In conclusion, we anticipate increasing curability of advanced tumors involving the carotid artery using this procedure.
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PMID:[Vascular reconstruction of the carotid artery--studies of a one stage ipsilateral reconstructive procedure]. 778 73

We report two cases of unilateral spatial neglect associated with an isolated right frontal lobe lesion. Case 1 was a 59-year-old, right-handed man, who developed a left hemiplegia, disorientation, and frontal lobe neglect associated with a haemorrhagic contusion following a head injury. Case 2 was a 55-year-old, right-handed man, who also developed disorientation and frontal lobe neglect secondary to a haemorrhagic contusion following a head injury. 99mTc HM-PAO SPECT revealed an isolated reduction in the regional cerebral blood flow (CBF) around the haematoma in the frontal lobe; blood flow to remaining parts of the brain was normal. Damage to the right frontal lobes of these patients was confirmed as being the cause of the unilateral spatial neglect in accordance with the results of CBF studies.
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PMID:Unilateral spatial neglect due to a haemorrhagic contusion in the right frontal lobe. 856 20

Interactions of physical, emotional, cognitive and behavioural impairments after severe closed head injury (CHI) remain poorly understood. A 47-year-old man was referred to our department 13 months after a severe CHI. He demonstrated severe left hemiplegia and disabling orthopaedic complications (left hip infectious arthritis, after surgical treatment for heterotopic ossification). His hip was blocked and extremely painful. He was totally dependent for daily-life activities (Functional Independence Measure (FIM) score = 18). Moreover he exhibited severe cognitive and behavioural troubles, which had been stable for many months beforehand, e.g. complete disorientation for time and place, major memory disorders, agitation, anxiety, depression, irritability, disinhibition, aggressiveness and lack of initiative. Pain disappeared within a few weeks after treatment. Progressively, functional improvement occurred (sitting position, transfers, walking between parallel bars). The FIM score increased to 63. Aggressiveness, irritability and agitation disappeared. Surprisingly, neuropsychological assessment demonstrated parallel improvement of cognitive functions, especially in regard to orientation, and to a lesser degree attention and memory. Such an observation should encourage use of active treatment of physical disabilities, even in patients presenting with an apparently poor cognitive prognosis at a late stage of severe CHI.
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PMID:Late cognitive and behavioural improvement following treatment of disabling orthopaedic complications of a severe closed head injury. 869 16

A 60-year-old man was admitted to our hospital for investigation of dyspnea and disorientation with right hemiplegia. Echocardiography showed thickened mitral valve leaflets with vegetations and severe mitral regurgitation. Blood cultures grew Staphylococcus aureus. During the operation, perforation and destruction of the mitral valve leaflets and vegetations were confirmed. Debridement of the infected tissues resulted in segmental disruption of the posterior mitral fibrous annulus. Reconstruction of the mitral annulus with porcine pericardium treated with glutaraldehyde and mitral valve replacement were successful. The patient's postoperative course was complicated with metastatic cerebral and splenic abscesses. After splenectomy on the 8th postoperative day, he gradually recovered without major neurologic sequelae. We believe that reconstruction of the mitral valve annulus with pericardium, especially autologous pericardium, is reliable and useful for the treatment of patients with disruption of the mitral valve annulus.
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PMID:Reconstruction of the mitral annulus with porcine pericardium--report of a case with mitral annular disruption due to staphylococcal endocarditis. 872 75

We reported a rare case of cerebral infarction with somatoparaphrenia (SP) caused by involvement of the dominant cerebral hemisphere. The patient was 77-year-old right-handed woman who was noted to have atrial fibrillation, right hemiplegia, hemisensory disturbance and ipsilateral homonymous hemianopsia. Neuropsychologically, there were anosognosia (AG) for hemiplegia and SP arguing her hand as doctor's hand. In addition, there also were noted disorientation, right unilateral spatial neglect and mild amnestic aphasia. Brain CT and MRI demonstrated infarctions in the left lateral thalamus, internal capsule, lateral geniculate body, hippocampus, caudate nucleus and medial occipitotemporal gyrus. IMP-SPECT showed extensive hypoperfusion areas in the left cerebral hemisphere. These lesions were thought to have resulted from occlusion of the left anterior choroidal artery and partial occlusion of the left middle and posterior cerebral arteries caused by cardiogenic embolism. AG persisted and SP disappeared 80 days after the onset. While AG and SP are generally believed to be associated with non-dominant hemispherical lesion, the present case suggests the possibility that those symptoms were seen in the case of dominant hemispherical lesion without severe aphasia.
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PMID:[Somatoparaphrenia caused by the lesion in the dominant cerebral hemisphere--a case report]. 886 40

This is the case report of a 44-year-old woman presented with an acute stroke immediately after electroconvulsive therapy (ECT). The patient had no significant medical history other than chronic depression. She was taking sertraline, and she had had multiple previous ECT treatments without any complications. While being monitored in the recovery room within 10 minutes after the last ECT session, she was found to have sudden onset of left-sided flaccid hemiplegia and numbness along with slurred speech. On arrival to our hospital, she was found to have flaccid hemiplegia on the left side involving the face, arm, and leg (face and arm more than the leg involvement), severe dysarthria, and mild neglect syndrome (National Health Institute Stroke Scale of 14). Noncontrast computed tomography (CT) of the head showed no signs of early ischemia, and iodine contrast CT angiography revealed right middle cerebral artery (MCA) (distal M1 segment) clot. Patient received intravenous recombinant tissue plasminogen (rt-PA) at 2.5 hours after the onset of symptoms, and then a total of 3.0 mg of intra-arterial (IA) rt-PA. Angiography at the end of the procedure showed successful recanalization of the M1 segment and normal vessel caliber with adequate distal flow. After the procedure, the patient made rapid improvements in all of her initial symptoms during the first 24 hours. An extensive stroke workup failed to reveal any cause of the stroke, including usual stroke and hypercoagulable risk factors. This was an acute embolic stroke immediately following an ECT, and without the aggressive thrombolytic therapy, the patient's outcome would have been poor because there was an M1 segment clot with a major MCA syndrome with relatively high National Institute of Health Stroke Scale. The neurological side effect profile of ECT is reported to be minimal with most common symptoms being headache, disorientation, and memory complaints. There is no clear cause-and-effect relationship in this case, and the stroke after ECT is extremely rare. In such rare event of stroke while receiving ECT, there is an effective treatment available using both intravenous and IA thrombolysis as reported in this case.
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PMID:Acute embolic stroke after electroconvulsive therapy. 1663 11

Sarcoidosis is a chronic disease of unknown aetiology. Neurosarcoidosis is registered in 5% of patients with sarcoidosis. Clinical manifestations of sarcoidosis are numerous and diverse. Manifestation of Neurosarcoidosis includes partial- and grand-mal seizures, low-grade fever, headache, increased intracranial pressure, visual disturbances, diabetes insipidus, amenorrhea- galacterorrhea syndrome and pituitary failure, hypogonadotropic hypogonadism, hyperprolactinemia, unilateral and bilateral facial palsy, infiltration of meninges (aseptic meningitis) and nerve roots, leptominingitis, pachymeningitis with cranial neuropathies, pseudotumor, mild cognitive disorder, psychosis, delirium, dementia, disorientation, amnesia, progressive visual deterioration and proptosis, axonal polyneuropathies, mononeuropathies, chronic polyradiculoneuritis, peripheral neuropathy, cranial nerve abnormalities, radiculopathies, peripheral neuropathy, mononeuritis multiplex, progressive numbness and deep sensation disturbance in bilateral lower extremities, hemiplegia, hyperreflexia with pathological reflexes and hypesthesia, upward gaze palsy, spinal cord compression, dysarthria, dysphagia, weakness, episodes of blurred vision, diplopia, intracerebral hemorrhage, neuro-ophthalmic manifestations, intranuclear ophthalmoplegia, dysorientation, vasculitis presenting with strokes, intracranial hypothalamic lesion, paresthesis, hemiparesis, myelopathy in the cervico-thoracic region, lumbar pain, sensory level and inability of lateral gaze (Tab. 2, Ref. 60).
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PMID:Clinical manifestations of neurosarcoidosis. 1982 43

Anosognosia for hemiplegia is a common and striking disorder following stroke. Because it is typically transient and variable, it remains poorly understood and has rarely been investigated at different times in a systematic manner. Our study evaluated a prospective cohort of 58 patients with right-hemisphere stroke and significant motor deficit of the left hemibody, who were examined using a comprehensive neuropsychological battery at 3 days (hyperacute), 1 week (subacute) and 6 months (chronic) after stroke onset. Anosognosia for hemiplegia was frequent in the hyperacute phase (32%), but reduced by almost half 1 week later (18%) and only rarely seen at 6 months (5%). Anosognosia for hemiplegia was correlated with the severity of several other deficits, most notably losses in proprioception, extrapersonal spatial neglect and disorientation. While multiple regression analyses highlighted proprioceptive loss as the most determinant factor for the hyperacute period, and visuospatial neglect and disorientation as more determinant for the subacute phase, patients with both proprioceptive loss and neglect had significantly higher incidence of anosognosia for hemiplegia than those with only one deficit or no deficits (although a few double dissociations were observed). Personal neglect and frontal lobe tests showed no significant relation with anosognosia for hemiplegia, nor did psychological traits such as optimism and mood. Moreover, anosognosia for neglect and prediction of performance in non-motor tasks were unrelated to anosognosia for hemiplegia, suggesting distinct monitoring mechanisms for each of these domains. Finally, by using a voxel-based statistical mapping method to identify lesions associated with a greater severity of anosognosia, we found that damage to the insula (particularly its anterior part) and adjacent subcortical structures was determinant for anosognosia for hemiplegia in the hyperacute period, while additional lesions in the premotor cortex, cingulate gyrus, parietotemporal junction and medial temporal structures (hippocampus and amygdala) were associated with the persistence of anosognosia for hemiplegia in the subacute phase. Taken together, these results suggest that anosognosia for hemiplegia is likely to reflect a multi-component disorder due to lesions affecting a distributed set of brain regions, which can lead to several co-existing deficits in sensation, attention, interoceptive bodily representations, motor programming, error monitoring, memory and even affective processing, possibly with different combinations in different patients.
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PMID:Anosognosia for hemiplegia: a clinical-anatomical prospective study. 2112 95

Buchwald (1878 ) used the term 'mirror writing' to indicate writing in the reverse direction to what is normal in a particular language and in which the individual letters are also reversed. Cases of healthy individuals (i.e., Leonardo da Vinci and Lewis Carroll) as well as brain-damaged patients have been described in the literature. Here, we report the case of PM, a 70-year-old right-handed woman who showed right hemiplegia and mirror writing following a stroke in the left lenticular nucleus and internal capsulae. PM underwent a complete neuropsychological evaluation, which included copying, dictation and spontaneous writing in both hemispaces with both hands. She was also tested for topographical disorientation, visuo-spatial disorders and body schema deficits. We observed isolated mirror writing only when PM wrote with the left hand, without differences between hemispaces. She also showed a left-right disorientation, a body topological map disorder and an egocentric misrepresentation. The presence of mirror writing not confined to one hemispace and the co-presence of executive function disorders, as well as anosognosia, suggests damage to our patient's sub-cortical frontal network. As no previous interpretation fits with PM's symptoms, we hypothesize that mirror writing resulted from damage to her egocentric frame of reference. This hypothesis allows us to interpret the patient's array of disorders, including mirror writing, body topological map disorder, left-right confusion and egocentric representation.
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PMID:Mirror writing resulting from an egocentric representation disorder: a case report. 2183 Aug 64

A 22-year-old woman was diagnosed with thrombotic thrombocytopenic purpura (TTP). She had a high fever and disorientation without renal dysfunction. She immediately underwent plasma exchange and prednisolone treatment, but they proved ineffective. She subsequently suffered from left major cerebral infarction with right-side hemiplegia. Therefore, 375 mg/m(2) of rituximab was administered weekly from day 14 with informed consent. Immediate improvements were noted in not only the hematological and biochemical parameters such as platelet count, hemoglobin level, rate of fragmented red cells, and serum LDH level but also the neurological symptoms and MRI findings. The universal histopathologic findings of TTP are characterized by hyaline thrombi formed by the aggregation of platelets, mostly in small arterioles and capillaries. Therefore, abnormal findings are rarely detected by imaging modalities such as CT and MRI. Moreover, TTP with major stroke is an extremely rare occurrence. In conclusion, we present a patient with refractory TTP with major cerebral infarction, who was effectively treated with rituximab.
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PMID:[Effective treatment with rituximab for primary thrombotic thrombocytopenic purpura complicated with multiple cerebral infarctions]. 2249 52


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