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 79-year-old man with a cardiac pacemaker for bradycardia fell down and presented with sudden onset of right hemiplegia and aphasia. Initial computed tomography (CT) showed no cerebral infarction but angiography revealed occlusion of the left middle cerebral artery (MCA). Local intra-arterial thrombolysis with tissue plasminogen activator (tPA; tisokinase, 1,600,000 units) was performed 3 hours after the onset, and the MCA was partially recanalized. Further administration of tPA was suspended because of nosebleed. However, the patient's neurological findings did not improve. His consciousness gradually deteriorated to coma and quadriplegia with dilation of the left pupil 2.5 hours after thrombolysis. CT disclosed marked mass effect with a left acute subdural hematoma and a small intracerebral hematoma in the left frontal lobe. He underwent urgent craniotomy and removal of the subdural hematoma. The subdural hematoma originated in a frontal cerebral contusion. He died of severe brain edema 2 days after surgery. Acute subdural hematoma is a very rare complication of intra-arterial thrombolysis. Presumably he had suffered head trauma at the first onset. Evidence of head trauma should be considered a contraindication for the use of thrombolytic agents in a patient with acute stroke.
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PMID:Acute subdural hematoma after intra-arterial thrombolysis for acute ischemic stroke--case report. 1672 23

A 2(8/12)-year old boy suffered from hemiplegia secondary to a post-varicella arteriopathy. His clinical status improved and after 4 years of follow-up he had no recurrent stroke or transient ischemic attack. Regular improvement of arterial lesions, demonstated by serial transcranial Doppler investigations, excluded a progressive arteriopathy. Aspirin therapy was initiated and continued during 2,5 years. Transcranial Doppler is a portable, non-invasive tool that can be easily used on a regular basis to follow-up children with post-varicella arteriopathy.
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PMID:Post-varicella arteriopathy: benefits of using serial transcranial Doppler examinations. 1676 21

We herein report the findings of a 2-year-6-month-old boy, who had been experiencing monocular pendular nystagmus, strabismus, and episodic eye deviation nystagmus, intractable dystonia and apneic attack which all began when he was 2 days of age. He underwent a complete blood count test, blood chemistry test, analysis of amino acids in the blood and urine, analysis of pyruvate/lactate in blood and cerebrospinal fluid, head computed tomography and magnetic resonance imaging and no abnormal results were identified. His attacks were resistant to multiple antiepileptic and dopaminergic drugs. He showed transient left and/or right hemiplegia after nystagmus, dystonia and/or apneic attacks at 8-months of age with retardation in intelligence. We diagnosed him to have alternating hemiplegia of childhood (AHC). We were unsure how to deal with his attacks after he was discharged from the hospital, however, resuscitation with the ambu bag by his mother at home and the intravenous infusion of diazepam or thiamylal at the hospital together was proven to be an effective method for treating his severe apneic attacks. The effect of diazepam and amantadine on these attacks was transient, however, the administration of flunarizine with amantadine resulted in an improvement in his attacks. We therefore consider the administration of flunarizine to be essential for the effective treatment of AHC in this case.
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PMID:[A boy with nystagmus, refractory dystonia and apneic attack due to alternating hemiplegia of childhood]. 1763 86

We report a case of the intra-atrial vegetation removal under cardiopulmonary bypass (CPB) in a case complicated with left middle cerebral artery embolism caused by postoperative infective endocarditis. The patient was a 14-month-old boy. Two months after intracardiac repair for a complex congenital heart disease, he presented with low-grade fever and was placed on oral antibiotics. A month later an echocardiography revealed 2 vegetations on the tricuspid valve. Although the vegetations became smaller with intravenous antibiotics, right hemiplegia was noted 5 weeks later. Brain CT and MR-angiography demonstrated left middle cerebral artery embolism. For fear of another embolism caused by a remaining movable vegetation on the tricuspid valve, intra-atrial vegetation removal under CPB was performed 5 days after cerebral infarction. Intraoperative transesophageal echocardiography was utilized to locate the vegetation and confirm its removal. His postoperative course was uneventful without a recurrence of cerebral infarction or bleeding. He was weaned from the ventilator on postoperative day (POD) 1, started to move the right extremities on POD 5 and was discharged home on POD 66.
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PMID:[Intra-atrial vegetation removal in a 14-month-old boy complicated with postoperative infective endocarditis and left middle cerebral artery embolism]. 1796 24

Brain edema after cardiac surgery is unusual and often asymptomatic. We encountered a 34-year-old man who had postoperative left flaccid hemiplegia and anosognosia after undergoing composite root replacement and closure of a patent foramen ovale. Computed tomographic and magnetic resonance imaging (MRI) scans showed profound white matter changes indicative of brain edema predominantly in the right hemisphere. His symptoms resolved spontaneously within 3 days with resolution of MRI abnormality. No evidence of cerebral infarction was documented on diffusion-weighted imaging and apparent diffusion coefficient mapping, or on the follow-up MRI obtained 25 days after presentation. The cause for the unilateral brain edema is unknown, but the patient's clinical course and imaging are supportive for a variant of a hyperperfusion syndrome or reversible encephalopathy. The outcome was excellent.
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PMID:Reversible unilateral brain edema presenting with major neurologic deficit after valve repair. 1864 Mar 46

A 60-year-old male with chronic lymphatic leukemia (CLL) after 6 months of fludarabine therapy was admitted with status epilepticus and developed left hemiplegia. His magnetic resonance imaging revealed multiple T2 hyperintense lesions in the right frontal and left parieto-occipital lesion, simulating progressive multifocal leucoencephalopathy (PML). Cerebrospinal fluid Polymerase Chain Reaction (PCR) for JC virus was negative. We suggest the possible role of fludarabine in producing PML-like lesions in patients with Chronic Lymphocytic Leukemia (CLL).
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PMID:Magnetic resonance imaging may simulate progressive multifocal leucoencephalopathy in a patient with chronic lymphocytic leukemia after fludarabine therapy. 1989 50

We report a case of a perinatally HIV-infected patient aged 9 years, who presented with right-sided hemiplegia. His initial CD4 T-cell was of 0.21% (4 cells/muL) and plasma HIV RNA virus of 185 976 copies/mL (log 5.27). Plasma and CSF samples were subsequently positive for JCV. Twelve days after the initiation of highly active antiretroviral therapy (HAART), the MRI showed progressive white matter lesions with asymmetrical deep and subcortical white matter lesions over the left frontotemporoparietal region and the right frontal lobe. Immune Reconstitution Inflammatory Syndrome (IRIS) was suspected, and the patient was treated with methylprednisolone. His clinical symptoms worsened and despite therapy the patient deteriorated.
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PMID:Progressive Multifocal Leukoencephalopathy in HIV-Infected Children: A Case Report and Literature Review. 2004 Oct 4

A male intravenous drug abuser who was infected with hepatitis B and C, presented with a slowly progressive hemiplegia. Contrast enhanced computerized tomography of the head showed a solitary ring-enhanced mass with surrounding edema. Clinically brain tumor was suspected but a brain biopsy confirmed cerebral toxoplasmosis. An HIV test was not considered until the result of brain biopsy. He also had lymphopenia and positive serum toxoplasma antibody. His subsequent HIV test was positive. He deteriorated after a brain biopsy. Empirical antitoxoplasma treatment is recommended in HIV-positive patients with ring-enhanced lesions with surrounding edema and with positive toxoplasma serology. Cerebral toxoplasmosis is still the commonest cerebral opportunistic infection in HIV-infected patients even though the incidence has declined with the use of antiretroviral therapy. It is often diagnosed in those patients as an initial presentation of HIV infection or in those who failed to attend for disease monitoring. Clinical features and differential diagnosis of cerebral toxoplasmosis in immunocompromised patients are discussed.
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PMID:A 'brain tumor' in an intravenous drug abuser. 2036 Aug 90

Hamburger, former colleague of Thomassen at the Veterinary School in Utrecht, and then professor of Physiology in Groningen, reviewed the career and merits of Thomassen. After graduation as veterinary surgeon (Utrecht 1869) Thomassen developped a succesful veterinary practice in Maastricht, in the neighbourhood of which city he was born. He attracted attention by his publications in foreign veterinary journals. In 1881 he was appointed as clinical teacher at his old school. Next to internal medicine, his teachings encompassed diagnostics, general therapy, pharmacology and history of veterinary medicine. His inquiring spirit led him to manifold investigations. His therapy of bovine actinomycosis by potassium-iodine (1885) was that succesful that the American government set up a committee of inquiry, that only could confirm the effectiveness. The field of nervous diseases in domestic animals was hardly developed at his time. His broad and systematic research on the pathology and etiology of laryngeal hemiplegia was masterly executed. It was followed by a great number of investigations on the disorders of the peripheral and central nervous system. He made himself familiar with the necessary technics of microscopical pathological investigation. He devoted his attention also to the emerging field of bacteriology and its clinical implications. He studied endocarditis acuta in the horse, bacterial nephritis in calves, chronic nephritis in horses, but especially tuberculosis. His transmission experiments showed reciprocal infectivity of tuberculosis between animals and man. Therefore, he could rightfully oppose Robert Koch, who proclaimed the non-infectivity of bovine tuberculosis for humans at the International Tuberculosis Congress in London of 1901. The author draws a contrasting picture of Thomassen's results with the poor surroundings at the Veterinary School in his days and the shortage of tools that he had at his disposal. His true genius and original mind could overcome those difficulties. His wide range of talents manifested itself in his cultivation of the art of singing, his language abilities and his historical writings on Dutch national history of the 16th century and on veterinary medicine in classical Antiquity. He was an excellent teacher and very much appreciated as speaker at international congresses.
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PMID:[Oration held at the occasion of the bestowal of the honorary doctor's degree to M. H. J. P Thomassen by the Senate of the University of Groningen on 21 June 1905]. 2064 35

We report a case of surgical resection of a pulmonary pleomorphic carcinoma after 6 years follow-up. A 75-year-old male patient was referred to our department for an irregular shadow (32 x 17 mm) in the left upper lung lobe. Chest computed tomography (CT) conducted 6 years before showed an 8 x 5 mm nodule in the same location; after 3 years prior the nodule had a thin wall cavity, and 2 years ago a new nodule was observed within the cavity. The nodule and cavity had been growing gradually as shown by chest CT. The patient underwent wedge resection of the left lung without any adjuvant therapy because of poor physical condition due to right hemiplegia, old myocardial infarction, aortic stenosis, and a poor status after esophageal and colon cancer resection. Histopathology of the resected specimen revealed that the nodule contained a component with spindle cell features while the parenchymal side of the cavity was composed of bronchioalveolar carcinoma (BAC). Immunohistochemistry showed that the adenocarcinoma was positive for AE1/AE3 and thyroid transcription factor (TTF)-1, while the spindle cells were positive for AE1/AE3, with only a small portion being positive for TTF-1. The final diagnosis was pleomorphic carcinoma. His postoperative course has been uneventful over the 4 months since surgery.
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PMID:[Resected pleomorphic carcinoma after long-time follow-up]. 2066 32


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