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)

This is a report of an endarterectomy performed upon the horizontal portion of the middle cerebral artery of a 45 year-old male patient. He had been suffering from TIAs (left hemiparesis) since 8 days prior to admission. Since the frequency of TIA episodes had increased from 2 times to 5 or 6 times a day and the episodes lasted from approximately 10 minutes to over 20 minutes on the day before admission, the TIA was considered to be of the crescendo type. On admission, neurological examination and CT scans showed no abnormalities. An angiography revealed a severe stenosis of the horizontal portion (M1) of the right middle cerebral artery. An endarterectomy was performed using a pterional approach on the day of admission because of the crescendo TIA. Heparin was not used during the surgery. The patient showed left hemiplegia after the endarterectomy. Angiography was performed immediately after the surgery, and severe stenosis caused by mural thrombus was found at the operative site. An emergency STA-MCA anastomosis was carried out to prevent cerebral infarction. However, left hemiplegia did not abate, and a CT scan taken a few days after the surgery revealed a low density area which included the right, basal ganglia and internal capsule. Two weeks after the surgery, angiography was again performed to determine the patency of the anastomosis, which showed normal configuration of the M1, indicating that the stenosis had disappeared. It was considered that if heparin had been used during the endarterectomy, the acute mural thrombus formation at the M1 would have been prevented, and neurological deficit would not have appeared.
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PMID:[Middle cerebral artery endarterectomy: a case report]. 837 99

We describe a case of a 38-year-old male who presented with acute onset of right-sided hemiplegia and aphasia, who was transferred for emergent percutaneous intervention. Angiography revealed a dissection with total occlusion of the left internal carotid artery (ICA) with propagation of thrombus in the distribution of the middle cerebral artery (MCA). Therapy was directed at the MCA and not the ICA. Intra-arterial thrombolysis was performed on the M1 and M2 branches of the left middle cerebral artery, resulting in almost complete resolution of symptoms during the angiography procedure. Heparin was continued postprocedure, and the patient was discharged home on warfarin and aspirin with minimal residual symptoms.
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PMID:Intra-arterial thrombolysis in a patient presenting with an ischemic stroke due to spontaneous internal carotid artery dissection. 1052 37

The common causes of pseudoaneurysms of internal carotid artery (ICA) in the neck are penetrating trauma, head and neck surgeries, carotid endarterectomies, infiltrating metastatic lymph nodes and neoplasms. We report a young male patient who presented with a swelling in left upper neck diagnosed as carotid body tumor with ultrasonography and magnetic resonance imaging. Subadventitial excision of the tumor was done. The patient developed dense right hemiplegia in the immediate postoperative period. Doppler study of neck revealed left ICA dissection with partial thrombosis of the lumen. Computed tomography of the brain revealed nonhemorrhagic left capsuloganglionic infarct and he was managed conservatively with heparin. Follow-up Doppler study done 2 weeks later revealed pseudoaneurysm of the ICA. Attempts to obliterate the pseudoaneurysm by interventional procedures failed due to the narrow neck of the pseudoaneurysm. Heparin was stopped and patient was maintained only on oral aspirin. Doppler study repeated 1 week later showed spontaneous thrombosis of the pseudoaneurysm with good flow in the distal ICA. To the best of our knowledge, only one case of pseudo-pseudoaneurysm complicating surgical resection of carotid body tumor has been reported so far The etiology, imaging features, and treatment options of pseudoaneurysms are discussed.
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PMID:Pseudoaneurysm of internal carotid artery after carotid body tumor excision. 2434 49

The procoagulant status of neoplastic patients is well known in medical literature, but in the last years there is attempted a correlation between the histological types of neoplasia and the risk for thrombotic strokes. We present the case of a 44-years-old patient undergoing early menopause, who was diagnosed with cervical tumor of the serous adenocarcinoma type. The patient underwent external radiotherapy, and, in the seventh day of treatment, she suffered a frontal-temporal-parietal ischemic stroke with left hemiplegia. The blood testing highlighted procoagulant products (double fibrinogen compared to normal values, deficit of antithrombin and a high number of thrombocytes). The patient received neurological and rehabilitation treatment, at first with Heparin, followed by the administration of an antiaggregant. During this treatment, the deficit remained unchanged. She continued the neurological and rehabilitation treatment, followed by radiotherapy, with a good evolution. Six months after the stroke, it was decided the surgical tumor ablation of cytoreduction. The post-surgery histological examination highlighted specific changes due to post-surgery radiotherapy, without the presence of any neoplastic cells. The imagistic evaluation, computed tomography (CT) every three months after surgery, did not highlight any suggestive dissemination elements. The occurrence of an ischemic stroke in a patient with endocervical neoplasm of the adenocarcinoma type during radiotherapy imposed the discharge of chemotherapy, with subsequent imaging, biological and histopathological monitoring after surgery. The cause of stroke in this case is determined by the hypercoagulant status in the context of the developed neoplasia, the patient being free of any other risk factors.
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PMID:Cervical adenocarcinoma generator of procoagulant status and ischemic stroke. 2955 44