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Query: UMLS:C0018991 (hemiplegia)
 3,997 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

We reviewed the charts of all patients with pathologically proven meningiomas who were admitted to the Montreal General Hospital between 1960 and 1977. Of the 80 patients reviewed, we found approximately one third of them had ophthalmological symptoms of which visual loss, field defect, and diplopia were the most common. Most of these patients also had neurological symptoms, but they were often nonspecific. One half of the patients presented with chronic symptomatology such as headache, mental change, and visual loss. One third of the patients presented acutely with seizures, hemiplegia, or dysphasia. Of the investigations done, the angiogram and brain scan were most often diagnostic, while the skull x-ray and EEG were often normal. Meningioma of the sphenoidal ridge, parasellar area, and occiput most often produced visual deficits. In almost one half of these patients, the visual deficit was initially misdiagnosed.
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PMID:Meningioma and the ophthalmologist. A review of 80 cases. 733 2

Ten cases of arteriovenous malformations located in critical areas of the cerebrum, i.e., motor and speech areas, the insular cortex, the corpus callosum, and the basal ganglia, were treated surgically by radical removal of the lesion. In four of the cases a neurologic examination before surgery was negative; five cases exhibited only mild hemiparesis or dysphasia; only one exhibited hemiplegia and stupor. There were no postoperative deaths and a residual permanent deficit was noted in only one patient. Postoperative control angiograms failed to show any filling of the arteriovenous malformations in any of the cases. Recovery of the ability to work was achieved in all of the patients. The operating microscope and controlled hypotension made possible a precise resection at the edges of the lesion, and damage to surrounding important cerebral structures was thus avoided. Based on these results, microsurgery should be considered as an elective therapy for these kinds of arteriovenous malformations, even when preoperative symptoms are minimal.
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PMID:Microsurgical treatment of ten arteriovenous malformations in critical areas of the cerebrum. 743 Sep 39

Fifty-seven young stroke patients (aged 45 years and below) admitted to a rehabilitation centre were assessed for underlying risk factor/aetiology and functional outcome after rehabilitation. The mean age was 37.2 +/- 6.3 years and the mean length of stay in the rehabilitation ward 38.3 +/- 19.9 days. There were 37 (64.9%) haemorrhagic and 20 (35.1%) ischaemic strokes. Hypertension was the single most important risk factor accounting for 49.1% of all strokes. Vascular abnormalities (arteriovenous malformation, mycotic aneurysm, vasculitis and Moya-moya disease) and cardiogenic embolism secondary to rheumatic valvular heart disease were also significant causes. There was significant improvement in functional status--activities of daily living (ADL) and mobility--after rehabilitation, the mean Functional Status score improving from 9.76 +/- 2.2 on admission to 5.07 +/- 1.95 on discharge (P < 0.01). Higher ADL and mobility function and upper and lower limb motor power of grade 3 and above on admission, absence of dysphasia, left hemiplegia, age less than 40 years and rehabilitation stay of less than 28 days were associated with better functional outcome whilst sex, nature and site of stroke, and length of stay in the acute ward had no significant bearing.
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PMID:Functional outcome in young strokes. 760 88

Stroke although rare in children, is an important cause of morbidity in the paediatric age group. Over a period of 8 years, 43 children (17 boys and 26 girls) in the age groups of 1-16 years (mean 8.02 yrs) presented with stroke which constituted 10% of all strokes in the young and 0.7% of all paediatric admissions. The chief clinical features were hemiplegia (86%), convulsions (27%), fever (23%), dysphasia (23%), headache (11%) and altered level of consciousness (11%). Routine laboratory tests were non-contributory. Cranial computerized tomography (CCT) on 21 patients was abnormal in 95% and was useful in revealing the extent of infarction. Infarction was confined to middle cerebral artery territory, often involving basal ganglionic structures and was associated with focal or diffuse atrophy. Angiograms were abnormal in 78% of the patients (18/23) and were complimentary to the CCT. Etiological factors identified were: Moya-moya disease 6, arteritis 5, fibromuscular dysplasia 2, scorpion sting 2, and venous sinus thrombosis and small vessel occlusion one each. Though 23% of the patients had fever at onset, no obvious evidence of systemic or CNS infection was noticed. Stroke in children continues to pose a diagnostic challenge.
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PMID:Cerebrovascular disease in children. 783 10

The drugs used to treat diabetes mellitus are diverse and include several classes. One class is sulfonylureas which primarily cause serum glucose reduction by stimulating the release of preformed insulin from the pancreatic islets. Gliclazide, a second generation sulfonylurea, is used to control glycemic levels in non-insulin-dependent diabetes mellitus. We report a 14 year-old non-diabetic girl who developed hepatitis, hemiplegia and dysphasia after ingestion of an overdose of gliclazide (20 mg/kg/day) in a suicide attempt. Our purpose is to draw attention to the severity of gliclazide-induced neurological signs. To the best of our knowledge, gliclazide-induced hemiplegia and dysphasia have not been previously reported in the literature.
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PMID:Gliclazide-induced hepatitis, hemiplegia and dysphasia in a suicide attempt. 1159 75

This paper describes the case of a 32-year-old man presenting with dense right hemiplegia and global aphasia caused by an acute left middle cerebral artery infarct that underwent successful endovascular therapy after being determined ineligible for intravenous tissue plasminogen activator. Clot transversion and balloon disruption followed by intra-arterial Alteplase resulted in successful re-canalization of his middle cerebral artery at 7 h 30 min. At 3 months post stroke, the patient had moderately severe expressive dysphasia but was mobilizing independently with normal right upper and lower limb strength. In conclusion, the 3 month outcome suggests that the therapeutic time window for endovascular therapy might exceed 6 h post stroke.
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PMID:Endovascular treatment of an acute left middle cerebral artery >6 h post stroke in a patient presenting with dysphasia and dense right hemiplegia. 1825 34

Aneurysms arising from the internal carotid circulation represent 85% of all intracranial aneurysms. The intimate relationship of the internal carotid artery and its branches with the brain and cranial nerves, and the distribution of the internal carotid artery flow, make these aneurysms challenging, and potentially complicated in their surgical management. Great attention to detail, and clear understanding of the operative anatomy of the carotid system, facilitate the safe and successful treatment of these aneurysms. The surgical experience with 475 anterior circulation aneurysms treated from 1980 to 1992 is presented. The aneurysms arose from the internal carotid artery: 230(40%), middle cerebral artery: 152(32%), and anterior cerebral artery: 133(28%). Of aneurysms arising from the internal carotid artery, there were 142(30%) from the posterior communicating artery; internal carotid bifurcation: 29(6%), and anterior choroidal artery: 19(4%). There were 62(13%) giant aneurysms evenly distributed among the middle cerebral, internal carotid bifurcation and anterior cerebral artery. Serious neurological morbidity was observed in 13(3%) patients, who presented a combination of different neurological symptoms including: hemiplegia 3, hemiparesis 6, dysphasia 7, and loss of vision 4. Two patients developed a myocardial infarct and survived. Mortality occurred in 16(3%); these patients died from: a hemispheric infarction 7, severe vasospasm 6, myocardial infarction 2, and pulmonary emboli 1. All aneurysms appeared angiographically obliterated. Vasospasm was observed in 75(16%) patients of which nine were symptomatic, and six of them died. Six major arterial trunks were occluded in the post-operative angiogram, and three patients had occlusion of the internal carotid artery, not identified during surgery. Three of these patients with unexpected occlusions died from a major cerebral infarction, and three had lasting hemipareses and dysphasia. Surgical correction of internal carotid aneurysms can be conducted safely when the anatomical characteristics of the intracranial vessels is preserved, and when these patients are treated with appropriate medical support.
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PMID:Anterior circulation aneurysms: surgical perspectives. 1863 66

We describe three cousins who presented with agitation, dysphasia and/or coma, and developed hemiplegia following initial onset of symptoms. Two cases followed minor head injuries, two were pyrexial and two were associated with neutrophilia. Two cases required ventilatory support on the intensive care unit. Magnetic resonance imaging in all three cases showed cortical swelling, and one had evidence of restricted water diffusion on diffusion-weighted imaging, suggestive of ischaemia/infarction. A complete family history at the time of presentation would have led to an earlier diagnosis of profound encephalopathy in familial hemiplegic migraine, which would have enabled better prognostication of their clinical course and caused less distress for the families.
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PMID:Profound encephalopathy with complete recovery in three children with familial hemiplegic migraine. 1931 60

The authors describe a case of L-asparaginase induced intracranial thrombosis and subsequent haemorrhage in a newly diagnosed 30-year-old man with acute lymphoblastic leukaemia who was successfully managed by surgical intervention. At presentation, he had a Glasgow Coma Score of 7/15, was aphasic and had dense right hemiplegia. Neuroimaging revealed an acute anterior left middle cerebral artery infarct with parenchymal haemorrhagic conversion, mass effect and subfalcine herniation. He subsequently underwent left frontal craniotomy and evacuation of large frontal haematoma and decompressive craniectomy for cerebral oedema. Six months postoperatively he underwent titanium cranioplasty. He had made good clinical recovery and is currently mobilising independently with mild occasional episodes of expressive dysphasia, difficulty with fine motor movement on the right side, and has remained seizure free. This is the first documented case of L-asparaginase induced haemorrhagic stroke managed by neurosurgical intervention. The authors emphasise the possible role of surgery in managing chemotherapy induced intracranial complications.
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PMID:Neurosurgical management of L-asparaginase induced haemorrhagic stroke. 2260 98


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