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

At the light of authors' present experience, radicletomy appears as an excellent antalgic operative procedure in the case of roots with high functional risk (brachial plexus and lumbar plexus). In the absence of any motor deficiency or ataxia, it appears that radicletomy is of help in the cure of severe hypertonies of the extremities (sequelae of cerebral stem contusions). Conversely, in the spastic sequelae of hemi- or paraparesias, lumbar-sacral posterior selective radicotomy is a sure procedure that procures results nearly super-imposable to radicletomy with an appreciable gain in time. At last, for what concerns the motor involvements of the upper extremity ending in spasticity, selective radicletomy recovers its rights and has to be preferred to S.P.R. The indications may be summarized as follows: -- At the level of the lower extremities: in the case of paraparetic sequelae or of sequelae due to spastic paraplegia, a S.P.R. has to be performed; for what concerns antalgic surgery, in the absence of motor deficiency, the best indication is radicletomy. -- At the level of the upper extremities: in the case of dystonic sequeale of the cerebral stem, spastic pain bound with hemiplegia or with carcinoma etc. (herpes zoster..), radicletomy constitutes the ideal surgical procedure.
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PMID:[Results of selective posterior radiculetomy at the lumbar and cervical level]. 5 51

From 1969 through 1973, 68 (12.5%) of 540 rehabilitation inpatients with hemiplegia were diagnosed as having shoulder-hand syndrome. Care was used to distinguish these patients from those with other shoulder pathologic conditions and pain syndromes. Patients were evaluated with respect to side of hemiplegia, dates of onset of hemiplegia and of pain, age, sex, handedness, sensory losses, associated medical diseases and treatment response. All patients became pain-free within three weeks with a therapeutic regimen of low doses of steroids orally, passive range of motion to pain tolerance, use of a hemiplegia sling and the application of physical modalities for symptomatic relief. Losses of range of motion in the affected extremity responded less well to treatment. No complications or side effects attributable to steroids were observed. The full syndrome recurred in six patients, all of whom responded to a second course of treatment.
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PMID:Shoulder-hand syndrome in a hemiplegic population: a 5-year retrospective study. 6 26

Metrizamide, a non-ionic contrast medium of low osmolality was compared with meglumine ioxithalamate, the ionic angiographic contrast medium currently in use in our department in a double-blind study. Criteria upon which the comparison was based were: 1) the pain reaction of the patient upon intra-arterial contrast injection, 2) bradycardial reactions upon common carotid injection and 3) the quality of the contrast image. Metrizamide induced significantly less painful sensations than meglumine ioxithalamate in those vessels in which injections of contrast medium are frequently painful (external carotid artery, vertebral artery). No significant difference in the degree of bradycardia was caused by the two contrast media. The degree of bradycardia was also found to be poorly reproducible upon successive injections of the same contrast medium in the same patient, thus raising questions as to the suitability of this method for determining the toxicity of the contrast medium. The quality of the angiograms obtained did not differ significantly with the two media. Spasm, when it occurred during selective external carotid injections, was found to be independent of the contrast agent used, being correlated instead with the depth of distal advance of the catheter tip into the external carotid. Of the 51 patients included in the study, two patients suffered transient neurological deficit after angiography with metrizamide, and one patient suffered a permanent hemiplegia after angiography with meglumine ioxithalamate.
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PMID:Comparative evaluation of metrizamide and meglumine ioxithalamate in angiography of the vessels of the head and neck. 36 33

One hundred and seventy-one patients with dissecting aneurysm seen between 1951 and 1976 at three hospitals in Manchester were studied. There were 60 proximal dissections, 80 distal dissections, 10 abdominal dissections and in 21 the site of origin was uncertain. Pain was the major symptom in 88 per cent of patients; radiation of pain to the interscapular region was much more common in distal dissections. Systemic hypertension was present in 77 per cent, being commoner in distal dissections (83 per cent) than in proximal dissections (70 per cent). Aortic incompetence, hemiplegia and shock were all more common in proximal dissections. Post-mortem examination was performed in 125 patients. Eighty-four per cent of proximal dissections had ruptured, 74 per cent into the pericardium and five per cent into the left pleural cavity. Seventy per cent of distal dissections had ruptured, 11 per cent into the pericardium and 41 per cent into the left pleural cavity. The extent of the dissection was analysed, and it was shown that 25 per cent of distal dissections had extended proximally into the ascending aorta and arch. This implies that diagnosis of the site of origin of dissection from clinical signs and the plain chest-radiograph is inaccurate. Aortography is required for precise assessment. Since treatment often varies with the site of dissection, aortography should be performed in most patients surviving the first few hours. Attention is drawn to the frequency (10.4 per cent) of multiple aortic lesions, and to the occasional aetiological significance of giant-cell arteritis, and, possibly, hypothyroidism.
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PMID:Dissecting aortic aneurysms: a clinicopathological study. I. Clinical and gross pathological findings. 48 91

186 patients with periarthritis of the shoulder have been studied. The sex ratio was female:male, 1-52:1. The peak age of onset was 54-59 years in both sexes. Over 40% of the patients were referred to the clinic after 6 months had elapsed from the time of onset of the disease. The right shoulder was more frequently involved than the left, particularly in the men. One shoulder only was affected in 75% of patients. There was frequently a previous history of 'rheumatism' before the episode of periarthritis. In one-third of the women 'nonspecific rheumatism' had occurred. Cervicobrachial pain and a previous episode of shoulder pain had occurred more often in the women. There were a number of associated diseases, ischaemic heart disease, thyroid disease among women, diabetes among women, hemiplegia, pulmonary tuberculosis, chronic bronchitis, and epilepsy. Acute trauma was rarely a precipitating factor. Manual workers were more frequently seen than sedentary workers in the sample, and there were more in the sample than in the general population of Leeds. The general psychological background was no different from a control group. The Maudsley Personality Inventory gave no different results among patients with periarthritis of the shoulder than among a control group and among the general population. It is suggested that there is no evidence in this study for a 'periarthritic personality'. It is suggested that the cause of periarthritis of the shoulder is likely to be related to chronic trauma occurring in an age range when changes in connective tissue are occurring. Certain associated diseases may predispose the patient to this disorder.
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PMID:Periarthritis of the shoulder. I. Aetiological considerations with particular reference to personality factors. 98 1

Classification of cerebral palsy according to the topographical distribution of clinical phenomena permits determination of a prognosis of the natural history of CP and the probability of hip problems to some extent. In 55 patients with CP, 101 muscle release operations were performed between 1971 and 1988. Preoperatively, the diagnosis was established by the neuropediatrician, function was evaluated according to the Rancho-los-amigos system, and the X-rays of the hip were assessed according to Reimers. For the postoperative evaluation patients were grouped according to neurologic diagnosis: hemiplegia (4), diplegia (19), total body involvement (31). Patients with hemiplegia had no functional or radiological changes as a result of the operation. In diplegia functional deterioration was seen in 4 cases (21%); in 3 cases (16%) this meant loss of the ability to walk. The migration percentage was improved from 48% to 39% on average. In 19 cerebral palsy patients with total body involvement surgery was considered to be indicated on the basis of a suspected dislocation of the hip. No functional changes occurred as a result of surgery. Hip dislocation was successfully prevented in 90% of the cases. The migration percentage was improved from 73% to 33%. In another 12 patients with total body involvement, adductor and iliopsoas release was performed to allow better hygiene and care and for pain relief. These goals were achieved; neither the Rancho-Los-Amigos function classification system nor X-rays were used to evaluate the results.
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PMID:[The hip in infantile cerebral palsy, natural developmental course and treatment concepts]. 140 25

Shoulder pain frequently superimposes substantial disability on a limb already limited by hemiplegia. The subscapularis muscle is a major internal rotator of the shoulder and, therefore, plays a role in the flexor synergy pattern commonly seen in spastic hemiplegia. Thirteen patients with spastic hemiplegia, limited range of motion, and painful shoulders underwent percutaneous phenol blocks to the nerves to the subscapularis. Patients' ages ranged from 22 to 76 (x 46 years) and the duration of hemiplegia from two to 13 months. Immediate and significant (p < 0.01) improvements in range of motion were observed in abduction (21 degrees), flexion (40 degrees), and external rotation (38 degrees). Relief of pain was also noted with the previously painful movement. Subscapularis nerve block is a new and potentially useful technique in the management of the painful hemiplegic shoulder.
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PMID:Subscapular nerve block in the painful hemiplegic shoulder. 144 68

Shoulder pain is a common problem in hemiplegia. This preliminary study attempted to identify pain-producing structures by evaluating the results of injecting 1% lidocaine into several sites in the shoulder area. Sixty-seven patients with shoulder problems were identified, examined, and characterized. The amount of pain was related most to loss of motion; it was unrelated to subluxation, spasticity, strength, or sensation. Of 28 patients who received a subacromial injection, approximately one-half obtained moderate or marked relief of pain and improved range of motion, suggesting that the subacromial area of the shoulder is a location of pain-producing structure in a significant number of cases.
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PMID:The source of shoulder pain in hemiplegia. 158 Jul 65

Angina pectoris results from an insufficient flow of oxygen to the myocardia cells. It is not an unusual complication in the dental office, the most frequent factors that trigger angina are: -stress, -pain, -exercise. The treatment consists in providing oxygen and vasodilators. Hypertension is characterized by an increase in the diastolic arterial blood pressure over 120 mmHg and by other clinical manifestations. Stress, pain, and exercise are the most frequent factors responsible for hypertensive disease. Hypertensive disease can lead to various complications ranging from a headache to myocardial infarct or hemiplegia. Treatment consists of different types of vasodilators.
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PMID:[Angina pectoris and hypertension]. 181 3

Patients with both resectable lung cancer and coronary artery disease require preoperative cardiac evaluation in order to determine and prevent the surgical risk and to discuss the desirability of preventive myocardial revascularization. The results of thoracic surgery in coronary disease patients have been studied in a series of 51 patients operated upon for lung cancer at the Marie Lannelongue hospital, Paris, between 1985 and 1988. Thirty-two patients underwent non invasive exploration prior to surgery (exertion ECG in 22, myocardial radioisotope scanning in 10); 35 patients had coronary arteriography at the last moment, and 9 asymptomatic patients with an old history of myocardial infarction had no specific exploration. Forty-nine patients had lung surgery alone, preceded in 5 cases by percutaneous coronary angioplasty; one patient had pulmonary surgery and coronary surgery simultaneously, and another patient had coronary surgery first, later followed by lung surgery. No perioperative death was due to cardiovascular causes. A 75-year old male patient died of respiratory failure 30 days after lobectomy. The postoperative period was totally uneventful in 39 patients. No perioperative myocardial infarction was recorded; 4 patients experienced an episode of thoracic pain with ECG signs of myocardial infarction but no rise in serum enzyme concentrations. One patient had a cerebral vascular accident responsible for hemiplegia. Two late sudden deaths, probably of cardiac origin, occurred 4 and 11 months respectively after surgery. The actuarial survival rate at 3 months was 48 percent. In all survivors, the coronary symptoms were controlled by medical treatment. It seems, therefore, that perioperative complications in this type of patient can be avoided by preoperative evaluation of the coronary disease and by preventive myocardial revascularization in case of critical coronary stenosis.
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PMID:[Lung resection for cancer in coronary patients. Immediate and medium-term results. Retrospective study in a series of 51 patients]. 182 64


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