Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 32-year-old primigravida showed signs of pre-eclampsia before delivery of a healthy boy at term. The CSF-space was accidentally punctured during epidural anaesthesia in labour. One day later hypertension was noted and the patient had a single generalized fit. For the next three weeks she had postural headaches, fluctuating hypertension, intermittent hearing loss and double-vision. On the 22nd day of postpartum, the patient had the first of a series of partial and later generalized seizures, followed by hemiparesis, alteration of consciousness, and finally slow recovery with corticosteroid therapy. Bilateral subdural effusions and generalized meningeal thickening were found on MR scans. Repeated MRI excluded sinus thrombosis and documented the response to treatment.
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PMID:Neurological cause of late postpartum seizures. 201 11

We studied 13 patients with supranuclear lower cranial nerve ("pseudobulbar" or "suprabulbar") palsy of acute onset. While seven patients had had a prior stroke, six patients had no history of stroke. Eight patients experienced a complete bilateral supranuclear lower cranial nerve palsy, which was isolated in five patients and associated with hemiplegia and with hemiparesis in three patients. Pseudobulbar palsy was partial in five patients. Only one patient had neuropsychologic impairment. The pseudobulbar features improved or recovered within a few weeks in all patients. The common characteristic of the lesions on computed tomography or magnetic resonance imaging was the interruption of the corticonuclear pathways contrasting with marked sparing of the corticospinal pathways in both hemispheres. These lesions were either an opercular infarct, or a deep infarct in the corona radiata or internal capsule, or a lenticular hemorrhage. Hypertension was the most prevalent concomitant. Our findings suggest that acute pseudobulbar or suprabulbar palsy has rather stereotyped anatomic-vascular correlates and time course.
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PMID:Acute pseudobulbar or suprabulbar palsy. 202 63

Seventy-nine children with the Haemolytic Uraemic Syndrome were referred to our unit between 1972 and 1988. The typical summer peak incidence was seen. A diarrhoeal prodrome occurred in 71 (90%). Fifty-nine (75%) required dialysis and 74 (94%) blood transfusion. Extra-renal disease was documented: neurological 32 (40%); abdominal 11 (14%); diabetes mellitus one case. Fifty-one (61%) had acute hypertension. The acute mortality rate was 9%. Children with neurological features had greater biochemical disturbances and longer duration of dialysis. Fifty-nine children were followed for a mean 47.4 months. Forty-four (75%) are healthy. Nine (15%) have renal impairment, two have proteinuria, one hypertension and one has a residual hemiparesis. There were two late deaths. Presence of acute neurological features increased risk of early death or survival with sequelae. Prolonged dialysis was significantly associated with poorer outcome. However, there were no reliable early indicators of poor prognosis.
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PMID:Haemolytic uraemic syndrome: 17 years' experience in a Scottish paediatric renal unit. 203 Nov 74

We studied clinical characteristics and coexisting causes of stroke in 305 patients admitted to a population-based primary care center with an initial ischemic stroke and a potential cardiac source of embolism (PCSE). Using systematic standardized cardiac, arterial, and cerebral investigations and the logistics of the prospective Lausanne Stroke Registry, we found that nonprogressive onset, hemianopia without hemiparesis or hemisensory disturbances, Wernicke's aphasia, ideomotor apraxia, involvement of specific territories (posterior division of middle cerebral artery, anterior cerebral artery, cerebellum, multiple territories), and a hemorrhagic component were associated with the presence of a PCSE, as compared with 1,006 initial ischemic stroke patients without PCSE. Although age and sex did not differ, the frequency of hypertension, diabetes, cigarette smoking, elevated blood cholesterol, and deep hemispheric or brainstem infarcts was higher in the patients without a PCSE. Nearly one-fourth of the patients with a PCSE had a coexisting potential arterial cause of stroke (large artery greater than or equal to 50% stenosis or small-vessel disease). In the majority of patients with a PCSE (76.7%), cardioembolism was the most likely cause of stroke, although a direct source of embolism was uncommon (4.3%) and intracranial embolic occlusions were present in less than one-half of the patients who were angiographed.
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PMID:Cardiac sources of embolism and cerebral infarction--clinical consequences and vascular concomitants: the Lausanne Stroke Registry. 204 30

Computerized tomography of the head was done in 5021 patients aged 21 to 81 years from various neurological, neurosurgical and neurotraumatological indications. Brain atrophy as an only finding (primary) was noted in 11.5%- and in 5.4% of cases it was associated with other changes. The neurological-radiological correlations were established in 200 cases of primary strophy. History data included: headaches in 54.5%, dizziness in 15.0%, epilepsy in 24.5%. Objective examination showed: slight hemiparesis in 37.5%, spastic-atactic gait disturbances in 31.5%, isolated damage to the corticospinal tracts with signs limited to one side of the body was more frequent in cortical atrophy, and these signs associated with ataxia were more frequent in subcortional atrophy. The authors explain this as a loss of cortical cells or damage to the paraventricularly coursing nerve fibres. A probable aetiology of "primary" atrophy was established in 405% of cases (hypertension, atherosclerosis, minor craniocerebral trauma). No signs or neurological syndromes were observed which could be regarded as more or less characteristic of brain atrophy.
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PMID:[Brain atrophy: radiological-neurological correlations]. 213 53

Secondary mania is increasingly recognized clinically, and consists of acute exhibition of manic symptoms without past or family history of affective disorder. It has been reported with toxic and metabolic disturbances, primary and metastatic brain tumors, epilepsy, and cerebrovascular events. A multifactorial etiology has been suggested. We report two men, 52 and 56 years old, who developed grandiosity, sleeplessness, irritable mood, hyperactivity, and paranoid and religious delusions, with attempted violence in one case. Both had no premorbid psychiatric history and were healthy except for hypertension. One patient had a normal neurologic examination, and the other had mild left hemiparesis and hyperreflexia. EEGs, brainstem auditory-evoked responses, and median nerve somatosensory-evoked potentials were normal. Magnetic resonance studies demonstrated infarction of the ventral pons (on the right in the patient with left-sided signs and on the left in the patient with normal neurologic examination). The two patients responded to lithium carbonate and neuroleptics and have not had further psychiatric symptoms in 18 months of follow-up. These cases emphasize the relationship of late-onset mania with predisposing brain disease, and they suggest that brainstem disturbances can influence mood, sleep, libido, and thought.
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PMID:Secondary mania after ventral pontine infarction. 213 93

Two cases of germ cell tumors (GCTs) of the basal ganglia are presented and 40 previously reported cases are reviewed. The incidence of GCTs of the basal ganglia and thalamus was estimated as less than 14% of all intracranial GCTs. All patients except for two (95%) were male, aged 7-19 years. The clinical course was usually slow. The major symptoms were hemiparesis, mental deterioration such as dementia or character change, precocious puberty, diabetes insipidus, oculomotor palsy, speech disturbance, and hemianopsia. Signs of intracranial hypertension did not occur until the late stages of the disease. The plain CT finding was characterized by an irregularly defined, slightly high-density area frequently accompanied by central low-density areas without significant mass effect. The tumors showed mild to moderate and nonhomogeneous contrast enhancement. An ipsilateral cerebral hemiatrophy was often found. MR images demonstrated the corresponding findings. GCTs of the basal ganglia had a high possibility of containing components other than germinoma such as choriocarcinoma, endodermal sinus tumor, and embryonal carcinoma. Thus, tumor markers in the serum, CSF, or cyst fluid were frequently positive. With recent refinement of microsurgical techniques as well as immunohistochemical study and measurements of tumor markers of serum, CSF, and cyst fluid, major resections of tumor, accurate pretreatment histologic diagnosis, and early determination of the specific types of this tumor appear to be readily possible. This is essential for effective treatment of patients not only with radiosensitive germinoma, but also those with radioinsensitive nongerminoma variants and a combination of them located in this region.
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PMID:Germ cell tumors of the thalamus and the basal ganglia. 217 73

A 3-year-old child with minimal change nephrotic syndrome (MCNS) developed an acute hypertensive encephalopathy characterized by coma, focal seizures, right hemiparesis, global aphasia and cortical blindness. Episodic hypertension and seizures persisted for 24 h despite intervention with antihypertensive and anticonvulsant therapy. Clinical suspicion of cortical blindness was confirmed by visual-evoked potential studies. CT scans performed 14 and 21 days after the acute episode demonstrated symmetric occipital white matter lucencies compatible with ischemia and/or associated edema. Hypertensive encephalopathy with cortical blindness and symmetric white matter hypodense lesions visualized on CT scan have recently also been described in eclampsia of pregnancy. This report documents an unusual acute hypertensive encephalopathy in childhood MCNS, unassociated with membranoproliferative glomerulonephritis, or progressive focal glomerulosclerosis.
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PMID:Acute hypertensive encephalopathy in minimal change nephrotic syndrome. 225 60

A 73-year-old man was admitted complaining of violent involuntary movement in the left upper and lower extremities. He had a ten-year history of hypertension and had had a left thalamic hemorrhage 6 years before admission. On neurological examination Horner's sign in the right eye, typical hemiballism in the left extremities and right hemiparesis, which was caused by the previous left thalamic hemorrhage, were observed. CT scan and MRI revealed recent hemorrhage in the right subthalamic nucleus. Haloperidol, tiapride and diazepam were administered to ameliorate the ballism, but they had to be reduced in amount because of the development of parkinsonism. Two months after onset, when there was still moderate ballism, he suffocated due to a swallowing disturbance. After two hours' coma, consciousness returned gradually. Twenty-four hours after suffocation, the neurological examination revealed normal consciousness and no deterioration in other neurological symptoms, but the ballism had almost disappeared without medication. No change was detected in MRI findings and the blood flows in the basal ganglia before and after suffocation. It is interesting that transient hypoxia due to suffocation reduced hemiballism in this patient without neuroradiological findings of ischemia in the basal ganglia. The mechanisms of reduction of hemiballism after transient hypoxia were discussed.
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PMID:[Improvement in hemiballism after transient hypoxia in a case of subthalamic hemorrhage]. 225 25

From a total number of 227 patients with lacunar infarcts of the brain assisted during a period of 7 consecutive years, 18 (8%) had an age equal or below 45 years. This group of patients represent 1.1% of strokes and 1.6 of the ischemic cerebral infarcts treated in a Neurology Service during the study period. Eleven patients (64%) were male. The most relevant cerebrovascular risk factors are: arterial hypertension (55%), cardiopathy (26%), and diabetes mellitus (11%). The most common syndrome was pure motor hemiparesis (61%), pure sensitive syndrome (22%), and atypical lacunar syndrome (17%). Computerized axial tomography of the brain was positive in 44.5% of cases. The mean systolic arterial pressure during the first 24 hours of the illness was significantly lower (p less than 0.03) in the young patients. Our results indicate that lacunar cerebral infarcts in young patients: a) are uncommon, and b) constitute a group with some differential clinical characteristics and with a better immediate prognosis with respect to the remaining patients with lacunar infarcts.
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PMID:[Cerebral infarctions of the lacunar type in young adults]. 226 Nov 90


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