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 37-year-old woman was admitted to Osaka Neurological Institute after the sudden onset of left hemiplegia, hemihypesthesia, and ipsilateral hemianopia on February 4, 1992. Computed tomography (CT) disclosed the presence of hemorrhage in the right thalamus extending to the ipsilateral internal capsule. Cerebral angiography after CT scanning disclosed the presence of a cerebral arteriovenous malformation (AVM) fed by copsulothalamic and lateral geniculate body arteries originating from the right anterior choroidal artery. She was operated on with removal of the AVM using a right orbito-fronto-malar approach (OFM approach), which did not require transection of the cerebral parenchyma. The anterior choroidal artery could be followed distally from its origin and small feeding branches originating from the parent artery were easily identified, and the cerebral base could be examined in greater detail than with the conventional frontotemporal approach. The nidus could be excised in its entirety without difficulty. Postoperative angiography confirmed total excision of the AVM. She was transferred to another hospital for rehabilitation on April 13, 1992. Motor strength on the left side had improved to 3/5 by that time. The OFM approach appears to be potentially useful for the resection of inferolateral thalamic AVMs, because it does not require corticotomy and feeding branches can be identified and dealt with prior to other surgical manipulations.
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PMID:Total excision of a thalamic arteriovenous malformation using an orbito-fronto-malar approach: case report. 797 23

Eighty patients had Computed Tomography (CT) performed for evaluation of epileptic seizures. Abnormal scans were found in 37 of the 80 patients (46.3%). Focal CT abnormalities were seen in 26 of the 80 patients (32.5%). Tumors were present in four and arteriovenous malformation (AVM) in three. Simple partial motor seizures were most strongly correlated with abnormal scans (five, 45.4%). Nineteen out of 21 patients with focal electro-encephalographic (EEG) abnormalities had focal CT abnormality compared to one out of 15 of those with generalised abnormality. 88.9% of patients with hemiplegia had abnormal scans. Whilst focal EEG abnormalities and abnormal neurologic signs pointed to a higher likelihood of CT abnormality, two subjects who were shown to have vascular malformations had normal EEG and neurologic exams. Routine CT scanning for evaluation of patients with recurrent seizures is advocated.
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PMID:Computed tomography in patients with recurrent seizures. 821 94

A Portuguese female, aged 47 years, who had emigrated to Spain, was admitted to the hospital in 1991 for pontine haematoma. The patient, four siblings and her father were affected by a peripheral neuropathy, indicating autosomal dominant inheritance. The patient presented in the 2nd decade with sensory and motor neuropathy beginning in the lower extremities. Alternating constipation and diarrhoea, and urinary incontinence became uncontrollable. She had to be colostomised, and, eventually, confined to a wheelchair from the age of 43. Neurological examination showed bilateral facial involvement, and severe signs of sensory and motor peripheral neuropathy, and later right hemiplegia. There were abnormalities of atrial rhythm and left bundle branch block. Computerised axial tomography and magnetic resonance images demonstrated left-sided pontine haemorrhage. Nerve conduction studies revealed severe diminution of motor conduction velocity and absence or reduction of amplitude of sensory and motor action potentials. Inanition and a respiratory infection led to her death. Clinical diagnosis was type I familial amyloid polyneuropathy (FAP). Postmortem examination demonstrated amyloid deposits in peripheral nerves, including spinal roots and cranial nerves, leptomeninges, thyroid, breasts, heart, adrenal glands, kidneys, intestines, pancreas, and meningeal and some pontine vascular structures. Advanced pontine haematoma was verified. Cerebral haemorrhage usually occurs with cerebrovascular amyloidosis, but exceptionally with FAP. A minority of patients presenting with CNS haemorrhage showed arteriovenous malformation or embolism [Da Silva Horta and Dias Coelho (1960) Arch 'de Vecchi' Anal Patol Med Clin 31 = 163-172].(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Type I familial amyloid polyneuropathy and pontine haemorrhage. 831 Aug 8

A 20-year-old woman with myelomeningocele presented with acute right-ear pain and right hemiplegia which improved, but then progressively deteriorated. Surgery, after MRI, revealed a large arteriovenous malformation (AVM) involving the right side of the upper cervical cord and brainstem. The woman also had two epidermal nevi at the same site as the spinal cord AVMs. There has been no previous report of an association of myelomeningocele, spinal cord AVMs and epidermal nevi syndrome. The same location of the nevus and spinal cord AVMs, with a proposed common pathogenesis, raise the possibility that the association may be more than chance occurrence. Spinal cord AVMs should be considered in patients with myelomeningocele and similar clinical features.
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PMID:Myelomeningocele, spinal arteriovenous malformations and epidermal nevi syndrome: a possible rare association? 833 63

A retrospective study of acute stroke diagnosed in the last ten years (20 cases: 12 girls and 8 boys) with an incidence rate of 1.26 cases per year per 100,000 inhabitants under 15 years of age) in our health area. Average age; 7.83 years (range: 2 months to 15 years). Confirming diagnosis was performed by computerised tomography (CT) scan, magnetic resonance (MR) imaging, echography and/or cerebral arteriography. Ten cases of ischaemic stroke and ten of haemorrhagic stroke were catalogued. Average follow-up was 5.45 years (range: 9 months to 10.8 years). Fibromuscular dysplasia, arthritis and meningitis are predominant in ischaemic stroke etiology, there also being one case of Moya-Moya. Haemorrhagic strokes are mostly produced by arteriovenous malformation. The predominant presenting form of ischaemic stroke was hemiplegia and of haemorrhagic strokes it was intracranial hypertension. There were no deaths as a result of ischaemic accidents but three in the cerebral haemorrhage group. Treatment was surgical in two cases, embolisation in two others and medical support in the remaining sixteen. There were no cases of relapse, except in the Moya-Moya case. Clinical position and the ability to carry on day to day life were most affected in the cerebral attack cases, which would indicate ischaemic stroke recuperation is worse than that for haemorrhagic strokes.
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PMID:[Cerebrovascular accidents in childhood]. 855 8

The hospital charges for all craniotomies and transsphenoidal procedures were gathered for a 4-year period from a single, non-profit hospital serving San Diego. Calif., USA. Of the individuals in this community 65% are covered by a variety of managed health care programs which have greatly discounted hospital receipts on a per diem or capitated payment basis. A total of 104 operative cases were identified. Forty-six patients (44%) were judged to have been eligible for Gamma Knife surgery. The average hospital charge for intracranial surgery on Gamma-Knife-eligible individuals was 14% greater than the nominal Gamma Knife surgery charge would have been. The complication rate for treated Gamma-Knife-eligible individuals was 15% including blindness in one eye after removal of a tuberculum sella meningioma, and hemiplegia following a delayed postoperative hemorrhage after arteriovenous malformation resection in another patient. Actual hospital net receipts were 55% of charges and probably approached the true hospital cost per procedure. When these hospital receipts were compared to the estimated cost per procedure of Gamma-Knife surgery, Gamma Knife surgery had a 30% cost advantage over surgical resection.
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PMID:A comparison of craniotomy and Gamma Knife charges in a community-based Gamma Knife Center. 903 80

An 8-year-old female German Shepherd dog showed first order Horner's syndrome associated with progressive right-sided hemiplegia and mega-oesophagus. Intramedullary and leptomeningeal arteriovenous malformation (AVM) was identified in the cervical spinal cord. The morphological characteristics were arteriovenous shunting, intramedullary multiple thromboses and haemorrhage, non-inflammatory necrosis of white and grey matter around the shunt, and intervening neural gliosis with neovascularization. These findings suggested that the malformation induced a focal circulatory disturbance within the cervical spinal cord and that fatal thrombosis was responsible for the sudden onset of the nervous signs and progressive neurological deterioration. This is the first report of intramedullary spinal AVM in a dog.
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PMID:Arteriovenous malformation of the cervical spinal cord in a dog. 1037 95

Subarachnoid hemorrhage secondary to ruptured intracranial arteriovenous malformation (AVM) during pregnancy, although rare, is a grave complication. We experienced 3 patients with AVM for cesarean section. Case 1: A 24-year-old woman suffered sudden vomiting and headache during the 22nd week of her first pregnancy. She was diagnosed as having the intracranial hemorrhage due to AVM. Because the patient was bleeding again at 29th week of pregnancy, emergency operation was performed. Her neurological symptom improved. Cesarean section was performed under general anesthesia at 34th week of pregnancy. Case 2: A 42-year-old woman of her first pregnancy had past history of subarachnoid hemorrhage due to AVM at the ages of 23, 28, 29 and 36. The malformation was not corrected surgically. Her neurological status was normal. Cesarean section was performed under spinal anesthesia. Case 3: A 29-year-old woman suffered sudden hemiplegia, vomiting and headache during the 40th week of her first pregnancy. She was diagnosed as having intracranial hemorrhage. Cesarean section immediately followed by the removal of an intra cranial hematoma under general anesthesia. Better perinatal outcome is expected when AVM rerupture is prevented by first performing cesarean section.
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PMID:[The anesthetic management for elective or emergent cesarean section in patients with intracranial arteriovenous malformation]. 1068 40

In two hemiplegic patients with acquired cerebral lesions, transcranial magnetic stimulation (TMS) was carried out to examine the contribution of the ipsilateral motor pathways to recovery from hemiplegia. A 13-year-old girl (patient 1) had acute hemiplegia due to a rupture of an arteriovenous malformation, and a 13-year-old boy (patient 2) had subacute hemiplegia due to a brain tumour. They showed complete upper limb palsy but recovered after therapy; patient 1 had slightly disabled motor function of the arm, and patient 2 recovered completely. Motor evoked potentials (MEPs) were recorded from the biceps brachii muscles on both sides. The MEPs of the paretic biceps were only elicited by TMS of the intact hemisphere at the beginning of recovery from hemiplegia, but not by TMS of the affected hemisphere. The MEP amplitudes increased and cortical representation areas for the paretic biceps by TMS were enlarged temporarily during recovery. They regressed in patient 1 and MEPs were not evoked at all in patient 2 after recovery. Conversely, MEPs were obtained by TMS of the affected hemisphere after recovery in both patients. These data indicate that ipsilateral motor pathways play a role in recovery from hemiplegia, especially at the beginning, and become inactivated when the contralateral motor pathways recover.
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PMID:Facilitation of ipsilateral motor pathways during recovery from hemiplegia in two adolescent patients. 1072

The patient is a 35-year-old man who had a medical history of epilepsy in childhood. He came to our hospital because of transient disturbance of consciousness and left hemiplegia just after evacuation. At first, we thought that he had epilepsy with Todd's palsy. But we had to do a differential diagnosis for a transient ischemic attack such as paradoxical embolism, because his symptoms occurred just after evacuation. An electroencephalogram and brain computerized tomography were immediately performed, but no abnormality was detected. Hematologic studies were normal, and no deep vein thrombosis was detected in the veins of the lower extremities by duplex ultrasonography Doppler. But carotid duplex ultrasonography showed an increase in end-diastolic flow velocity and a decrease in vascular resistance in both external carotid arteries. These findings indicated that there was arteriovenous malformation such as moyamoya disease. Brain magnetic resonance imaging showed spotty high signal lesions in the subcortical areas on a fluid-attenuated inversion-recovery(FLAIR) image, and the middle cerebral artery was not visualized on magnetic resonance angiography (MRA). Cerebral angiography demonstrated moyamoya vessels in the brain and collateral circulation from the external carotid artery. Therefore, we diagnosed him as having moyamoya disease. Duplex ultrasonography of the common and, internal carotid, and vertebral arteries is a widely-used technique. Recently, cerebral angiography, MRA and transcranial Doppler have been applied to detect intracranial vascular malformation. But these results suggested that moyamoya disease could be detected by means of carotid duplex ultrasonography. Finally, we considered that carotid duplex ultrasonography was not only a noninvasive screening method but also a useful for the diagnosis of moyamoya disease.
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PMID:[Usefulness of carotid duplex ultrasonography in a patient with moyamoya disease]. 1472 40


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