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

The results of the present electrophysiological investigation have shed some light on the mechanisms underlying many clinical signs, at least, in patients with capsular hemiplegia. A tentative interpretation of them is given below. Cerebral lesions due to haemorrhage or infarction in the area of the middle cerebral artery interrupt an extensive part of the corticospinal tract and disturb many other descending pathways involved in voluntary performance. In consequence, a marked reduction in the ability to drive the spinal motor apparatus occurs, resulting in weakness of motor power. Here, we refer only to muscle power but not to performance. For example, the disturbance of voluntary contraction by clonus is disregarded (cf. fig. 8). On the other hand, the same lesions also release the spinal reflexes from inhibition by the higher levels of the brain and cause increased excitability in flexors and extensors. In the lower extremity, this is much more makred in extensors and extensor spasticity becomes a dominant sign clinically. Any release effect on the flexor system is largely cancelled by the high activity of the reciprocal Ia inhibitory pathway from extensors and only a fragment of it is occasionally revealed in some patients as an H-reflex in pre-tibial muscles or as weak Ia inhibition of the triceps surae. Reduced driving power of the brain may be compensated by raised excitability in the spinal cord and spastic extensors are thus naturally in a better condition to preserve motor power. Flexor muscles are doubly crippled by reduced descending impulses and strong reciprocal inhibition by the Ia impulses from the spindles of the extensor muscles.
Brain 1976 Sep
PMID:Reciprocal Ia inhibition in spastic hemiplegia of man. 100 Feb 87

The traditional medical history and physical examination format is disease rather than disability oriented. It has been shown to be incomplete for the total evaluation of rehabilitation patients. Direct applications of Weed's Problem-Oriented Medical Record have proven to be formidable and cumbersome due to the complexity and diversity of rehabilitation. Therefore, we have developed the Rehabilitation Evaluation System (RES) to document functional rehabilitation management and progress during inpatient hospitalization and outpatient follow-up. The system identifies 18 key rehabilitation areas, each with an individual and objective four-point scale. Utilization of this system in our department has been invaluable in formulating goals and continually evaluating the on-going rehabilitation process. We used the RES with equal facility on 46 rehabilitation inpatients including stroke, amputation, spinal cord injury, multiple sclerosis, orthopedic-trauma, rheumatoid arthritis and poliomyelitis. The mechanics of the RES are presented in detail with a specific patient-example of hemiplegia. Its complimentary use with the Problem-Oriented Medical Record is discussed. Practical advantages are seen in patient care, medical student and resident education, record keeping and research.
Arch Phys Med Rehabil 1975 Sep
PMID:A rehabilitation evaluation system which complements the problem-oriented medical record. 108 Jun 59

A 77-year-old man suddenly developed left hemiplegia without sensory impairment, visual or speech difficulties, loss of consciousness, or ataxia. He died one month later of pulmonary embolism, and a cystic infarction in the right medullary pyramid was the only lesion in the corticospinal system.
Arch Neurol 1975 Sep
PMID:Pure motor hemiplegia due to pyramidal infarction. 116 17

Attenuation of cerebral evoked responses after stimulation of the median nerve in the hemiplegic limbs suggested that an apparently pure motor hemiplegia in some patients may not have pure involvement of the corticospinal system. Frontoparietal metastasis, infarction in basis pontis and medullary pyramid, and occlusion of internal carotid artery in the neck resulted in pure motor hemiplegia in some individuals.
J Neurol Neurosurg Psychiatry 1975 Sep
PMID:"Pure" motor hemiplegia. 118 28

Herein we report an adult case of pure yolk sac tumor with brain metastasis. The patient was a 37-year-old male who presented with indulation of his left scrotum for 10 months. The plain computerized tomographic (CT) scan on entry demonstrated tumor metastasis to his lung and liver and serum alpha-fetoprotein (AFP) level was 786 ng/ml. Five days after admission, he developed hemiplegia secondary to the cerebral metastasis and hemorrhage. After chemotherapy and operation of right-posterior lobectomy, PVB (cisplatinum, vinblastine, bleomycin) chemotherapy produced a complete remission and the elevated serum AFP was normalized. However, the second course of chemotherapy had to be discontinued because of drug-induced hepatitis. He died of massive tumor metastasis to his brain 6 months after craniotomy.
Hinyokika Kiyo 1992 Sep
PMID:[Pure yolk sac tumor of the testis with brain metastasis: report of an adult case]. 138 96

A child is described in whom intraventricular tension pneumocephalus developed 10 days after removal of a cerebellar medulloblastoma and 1 day after suture removal. The tension pneumocephalus was associated with hydrocephalus and CSF leakage from the suture line. The symptoms of the pneumocephalus were rapidly progressing loss of consciousness and hemiplegia which were promptly reversed upon aspiration of the intracranial air. A large amount of intraventricular air present in the immediate postoperative period was, however, clinically silent. The characteristics of this unusual presentation, its relation to asymptomatic pneumocephalus, hydrocephalus and the preventive and therapeutic measures required to deal with such conditions are discussed.
Childs Nerv Syst 1992 Sep
PMID:Delayed intraventricular tension pneumocephalus complicating posterior fossa surgery for cerebellar medulloblastoma. 139 84

In spastic hemiplegia mainly one side of the body is affected. In both the upper and the lower extremity the distal parts (hand and foot) are more severely involved than the proximal region. In cases of minor involvement the goal of treatment in the upper extremity is to achieve functional improvement by means of splinting and surgery. In cases of severe alterations cosmetic improvement without much functional gain is all that can be expected. Gait analysis has demonstrated that there are four basic patterns that can be related to the severity of involvement. In type I muscle imbalance exists without a contracture. In type II there is contracture of the muscles of the posterior compartment of the calf. In type III, in addition to the changes around the ankle joint, contractures around the knee are present, and in type IV also hip problems. Functional improvement can be achieved by means of splinting and surgery in all types. Basic principles of treatment have developed as a result of the application of gait analysis and dynamic electromyography. Specific examples of such treatment principles have recently been presented by Gage.
Orthopade 1992 Sep
PMID:[Treatment of deformities of the locomotor system in hemiplegia]. 140 22

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.
Orthopade 1992 Sep
PMID:[The hip in infantile cerebral palsy, natural developmental course and treatment concepts]. 140 25

In 38 patients with spastic cerebral palsy, treatment was carried out for talipes equinovarus. There were 12 children with spastic hemiplegia, while 24 had diplegia or tetraplegia. Surgery was done with the goal of achieving plantigrade and muscle-balanced feet. In 24 feet of 19 children tibialis anterior transfer was performed, while tibialis posterior transfer was done in 20 feet of 19 patients. Without exception, additional surgery was performed on the triceps surae (30 x ATLs and 16 Vulpius operations); medial arthrolysis was also necessary in 6 cases. The clinical results were assessed by the senior author in the weekly neuro-orthopedic clinic an average of 3.2 years after surgery. An additional questionnaire was sent to all patients' families asking for their subjective assessment of the surgery performed. Figures were collected for 30 patients with 38 treated feet. The results were evaluated according to Kling's criteria. We saw good and very good results in 75% of the patients (4 feet very good, 23 feet good), while 25% of the patients (9 feet in 7 patients) showed poor results with over-corrections and calcaneo-valgus foot as the main problem. The best results were seen in spastic hemiplegia and the poorest in patients with severe tetraplegia and total body involvement.
Orthopade 1992 Sep
PMID:[Treatment of spastic club foot]. 140 27

From 1979 to 1990, a series of 59 patients with 59 acoustic neuromas were operated on in five departments of neurosurgery by at least five different neurosurgical teams, employing the suboccipital approach. Perioperative mortality rate was 8.5%. Complications including hematoma, ventricular hemorrhage, meningitis, hemiparalysis, abducens nerve paralysis, recurrent nerve paralysis, postoperative wound infection and CSF leak were observed in 21 patients (35.6%). Total tumor removal was not possible in 17 patients (28.8%). Converting the postoperative facial nerve function to House-Brackmann (HB) classification, 34 patients (57.6%) were regarded as HB 6. Reconstruction of the facial nerve was attempted in 19 patients (32.2%). Attempts at hearing preservation were unsuccessful in all patients. Failure to attain better results and the importance of centralized treatment of acoustic neuroma are emphasized.
Acta Otolaryngol 1992 Sep
PMID:Suboccipital acoustic neuroma surgery: results of decentralized neurosurgical tumor removal in Denmark. 145 36


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