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

A 45-year-old woman with hypertension suffered four episodes of right hemiparesis and two attacks of left hemiparesis, within seven months. On examination she showed weakness and cerebellar ataxia of all four limbs. Computed tomography demonstrated a radiolucent area in the base of the pons, consistent with lacunar infarction.
 ...
PMID:Ataxic tetraparesis from lacunar infarction in the pons. 688 7

Twenty-two cases of lobar hematomas occurred among 93 consecutive patients presenting with intracerebral hemorrhage. Arterial hypertension was the leading cause. Most hematomas were found in the parietotemporal region. Common physical findings were hemiparesis, hemisensory syndrome, and visual field defects. Seizures occurred in 23% of the patients, and coma was infrequent at onset. Mortality rate was 32%. Hematoma size on CT correlated with outcome: Patients with small hematomas did well on medical treatment, and those with medium size and large hematomas had mortalities of 14 and 60%, respectively. One-half of the survivors in the latter groups were treated surgically. It is proposed that large and medium size hematomas might benefit from surgical treatment, especially when the level of consciousness progressively deteriorates or CT scan shows prominent midline shift.
 ...
PMID:Lobar intracerebral hematomas: clinical and CT analysis of 22 cases. 688 99

The main clinical, evolutive and therapeutic features of thalamic tumors are reviewed in 38 children. Signs of increased intracranial pressure (76% of the cases) and of controlateral hemiparesis of varying degree (76% of the cases) were the main clinical symptoms. CT-scan is the best means of investigation. Therapeutic protocols that seem to obtain the best results consist of radiotherapy (between 45 and 55 grays) associated with shunting, when intracranial hypertension results from obstruction of an interventricular foramen by the tumor. Surgery is contra-indicated in most tumors in this area.
 ...
PMID:[Thalamic tumors in children. A study of 38 cases (author's transl)]. 707 39

The case of a 26 year old woman who had been taking tranexamic acid to prevent uterine bleeding due to an IUD and who died from thrombosis of the left internal carotid artery is reported. The patient's father had died at age 54 of myocardial infarction. Otherwise the family history was entirely negative for thromboembolic disease. The patient was a mild smoker. She had been previously healthy and in particular, she was not affected with hypertension, diabetes, or dyslipidemia. She had carried to term 2 uncomplicated pregnancies. 40 days prior to hospital admission her gynecologist had inserted an IUD. The insertion of the IUD was followed by persistent uterine bleeding, and for this reason she began treatment with tranexamic acid (1.5 g/daily). Uterine bleeding persisted despite this treatment, and the IUD was removed. Because of persistence of a mild uterine bleeding, tranexamic acid was continued. 2 hours before admission the patient suddenly presented a left sided hemiparesis with disarthria and vomiting. On admission she was stuporous. The left side of her face drooped and the strength of the left arm and leg was markedly decreased. Both arm and leg reflexes were symmetrical. Her blood pressure was 110/70. An electroencephalogram on arrival confirmed a right sided cerebral lesion. Subsequently the patient's condition deteriorated rapidly. She developed a full left hemiplegia and became deeply comatose. A CAT scan performed 4 hours after admission showed no abnormalities. A CAT scan performed 3 days after admission showed a large cerebral infarction involving nearly the whole right cerebral hemisphere. The patient's condition remained essentially unchanged until she died 6 days after admission. Permission for autopsy was refused. Antifibrinolytic drugs competitively inhibit plasminogen activators and noncompetitively plasmin. Thromboembolic complications after the administration of antifibrinolytic drugs have long been recognized. The use of IUDs is often associated with troublesome uterine bleeding and particularly excessive menstrual bleeding. To avoid these complaints, antifibrinolytic drugs are increasingly used.
 ...
PMID:Tranexamic acid, intrauterine contraceptive devices and fatal cerebral arterial thrombosis. Case report. 710 62

We reported two cases of germinoma originating in the basal ganglia among the 50 cases of intracranial germinoma which were experienced at the Department of Neurosurgery, Hokkaido University Hospital. (Case 1) A 8-year-old boy was admitted to our hospital in October 1977, because of precocious puberty and left hemiparesis. Plain CT showed an irregularly-defined high density lesion in the right basal ganglia, which had several low density spots and was moderately enhanced on contrast CT. Endocrinological examination by radioimmunoassay revealed abnormally high level of serum luteinizing hormone and scanty level of serum follicle stimulating hormone. Beta-subunit of human chorionic gonadotropin (HCG) showed 46.4 ng/ml. Following radiation, the lesion on CT disappeared and beta-subunit turned to be in the normal range. It was concluded that the precocious puberty was due to hypersecretion of HCG by the tumor. About 2 years after the first admission, the tumors were disseminated to the spinal cord, followed several months later by the intracranial recurrence. The neurosurgical exploration was performed to both intracranial and spinal tumor lesions, which were proved to be germinoma by histological examination. Postoperative course was uneventful without recurrent signs. (Case 2) A 10-year-old boy was admitted to our hospital with 6-month history of right hemiparesis in February, 1979. CT at the first admission disclosed a slight high density lesion in the left basal ganglia, which had low density area suggesting cyst formation and was moderately enhanced on contrast CT. CT after one year showed multiple cysts in the tumor and displacement of neighboring structures. In February, 1980, a piece of the tumor was removed under bifrontal craniotomy and histologically diagnosed to be germinoma. Following radiation, the tumor disappeared on CT and his clinical features improved. In August, 1981, no recurrent signs were noted. From our 2 cases and review of the literature, it can be concluded that germinoma originating in the basal ganglia is rare and have high radiosensitivity as well as germinoma arising in the other sites, and common symptoms and signs are hemiparesis in all cases, not accompanied by intracranial hypertension in the early stage.
 ...
PMID:[Germinoma originating in the basal ganglia--report of 2 cases]. 717 32

A 10 years old school boy, who had been known to have a small ventricular septal defect from 2 months after birth, was admitted to us with a diagnosis of subarachnoid hemorrhage on October 24, 1978. On admission, neurological examination revealed mild right hemiparesis and miotic pupils in semicomatose state, and thrilling, that was equivalent to Levine III, pansystolic murmur and cyanosis of nails were noticed. By CT scan, intraventricular hemorrhage originated from hemorrhage in the basal ganglia was shown and the left CAG revealed an arteriovenous malformation in the left basal ganglia. Electrocardiogram showed mild cardiac failure and chest x-ray showed pulmonary congestion. Neurological symptoms and abnormal cardiopulmonary changes made well manageable after bilateral ventricular drainage. Twenty four cases of arteriovenous malformation associated with congenital heart disease were reviewed in the reported literature, and 20 cases were found to combine with Galenic aneurysm with congenital heart disease. All of those cases had been in a little pause after the birth and the most of congenital heart diseases were of patient ductus arteriosus. The rest of cases including our present case were 4 cases, who had rather small arteriovenous malformation, and the severity of the congenital heart disease was attributable to the patients mortality. In all of the report at present only our case was the single survival. Embryological investigation on arteriovenous malformation of the brain and congenital heart disease indicated that association of both conditions could be attributable to the vascular malformation in a very limited gestational stage, and that the incidence should be much less than reported. Our case showed the intracranial hypertension was found to create serious cardio-pulmonary dysfunction when congenital heart disease being accompanied, and it was presumably relating to the relatively higher incidence of Galenic aneurysm associated with ductus arteriosus.
 ...
PMID:[Arteriovenous malformation associated with congenital heart disease, with a remark on accompanying cardiopulmonary dysfunction (author's transl)]. 724 22

Multiple Sclerosis (MS) cases found at autopsy in patients who had died from other diseases and in whom no sign or symptom could be related to MS are called "asymptomatic". Three cases are reported. The first patient was a 62 year old man who presented with a slowly progressive disturbance of gait, incontinence and deterioration of intellectual function. A falx meningioma was surgically removed. The patient died 3 years later with an acute respiratory illness. Examination of the brain disclosed evidence of the operation and numerous old plaques disseminated through the cerebral hemispheres (centrum semi-ovale, periventricular regions, internal thalamus and junction between cortex and white matter) and in the brain stem. The second case, a 77 year old woman with diabetes mellitus and hypertension, presented with cortical blindness and disturbances of memory of acute onset. She died one year later. Examination of the brain showed multiple infarcts involving the territories of both posterior cerebral arteries and the left middle cerebral artery. Numerous old plaques were seen in the periventricular regions, in the corpus callosum and in the left middle cerebellar peduncle. The third case, a 60 year old woman with mitral and aortic stenosis, presented with cortical deafness and transient right hemiparesis. She died 5 years later. Brain examination showed infarcts involving both middle cerebral artery territories. There was also many old plaques in the periventricular areas, thalamus, internal capsule, centrum semi-ovale, brain stem and right nucleus dentatus. In the 3 cases, the optic tracts were normal. The spinal cord, examined only in the first case, was also normal. The asymptomatic character of these MS cases can be explained first by the location of the plaques and the lack of spinal cord and optic tract involvement. It could also be due to the small size of the plaques and to axonal preservation. Such features are rare since our 3 observations have been selected from a pathological collection of 125 MS cases and 9,300 general neuropathological records. Six other cases have been previously reported by other authors.
 ...
PMID:[Asymptomatic multiple sclerosis - 3 cases (author's transl)]. 733 73

Recently, a case of intracranial germinoma in the right basal ganglia was experienced in our department. He was a 14-years old boy with left motor hemiparesis. On repeated CT studies (7 times), developmental process of the tumor was observed for about 2 years. The tumor developed from the right putamen and invaded toward it's neighboring area (right basal ganglia, thalamus and hypothalamus). As the tumor grew larger, multiple cysts were formed in the tumor tissue and dislocation of ventricles occurred. On 21 December 1978, right temporal craniotomy was performed and a piece of the tumor was removed. It's tissue was diagnosed as germinoma by pathohistological examination. As the effect of postoperative 60Co irradiation and chemotherapy (Vicristine, CCNU), tumor stain (high density area) on CT scann disappeared and remained only as a well margined low density area. On CT scan in September 1979, recurrence sign was not noted. Clinical features of the germinoma located in the basal ganglia has not been well known, because of it's rarity. As a result of the survey of 7 cases reported in the Japanese literature and our case, it has been made clear that most of them are characterized by motor hemiparesis in the early stage, not accompanied by intracranial hypertension.
 ...
PMID:[Intracerebral germinoma developing in the right basal ganglia--report of a case followed up by CTscan and review of the literature (author's transl)]. 737 2

This retrospective study from two hospitals is about a hundred patients who have been operated upon a spontaneous cerebral hematoma. By a spontaneous cerebral hematoma we mean a hematoma without a proven tumor, without aneurysm, without arteriovenous malformation, without preceding trauma, without aortical phlebitis and without pathology of the vessel-wall. In this study patients with coagulopathy, arterial hypertension and artherosclerosis are included. In order to comply with these conditions an angiography will have to take place pre-operatively as well as postoperatively. Moreover histological examination of the wall of the hematoma will have to be done. The etiology of the spontaneous cerebral hematoma is not clear in most cases. The indication to operate, the way of operating and the moment in which the operation takes place, vary strongly in medical literature. We operate when there is an aggravation of the clinical picture, persisting severe headache and neurological paresis which does not improve. As a rule we abide for one week before operating, if the clinical picture allows this. After the operation unconscious patients may recover and a hemiparesis may improve. The best way of diagnosing a cerebral hematoma is computerised tomography.
 ...
PMID:[The spontaneous cerebral hematoma (author's transl)]. 744 12

Treatment of ischemic deficits caused by vasospasm relies on enhancing cardiac output, inducing arterial hypertension, and expanding the intravascular volume in an attempt to improve CBF. Different treatment protocols exist from institution to institution to achieve these goals. The role of calcium-channel blockers now is well established. The newest focus on prevention of vasospasm includes tPA and a variety of anti-inflammatory drugs and potential neuroprotective drugs under research. Endovascular therapy for vasospasm has an increasing role in treating patients who are unable to tolerate induced hypertension or aggressive volume augmentation. We will return to our index case of the 63-year-old woman with SAH caused by an ACoA aneurysm to review some major management issues. After placing a ventriculostomy and slowly lowering ICP, the patient became alert and was fully oriented. She had aneurysm surgery on hospital day 2, with an uncomplicated immediate postoperative course. A Swan-Ganz catheter, placed for intraoperative monitoring, was kept in place and she was hydrated with 125 mL/hour of normal saline, achieving a PAWP of 10 to 16 mm Hg. Her mean arterial blood pressure without pharmacologic intervention was 95 to 110 mm Hg. She had continued clinical improvement with resolution of her left hemiparesis. On hospital day 5, her ventriculostomy was clamped because cerebrospinal fluid drainage was minimal. The following morning, the patient was arousable only to deep pain and her left side was flaccid. An emergent CT scan demonstrated no new hemorrhage, no increase in ventricular size, and no infarct. Vasospasm was considered the most likely cause. Hypertensive therapy was about to be initiated with a phenylephrine drip, but within an hour she was fully alert and moving all extremities equally. A search for other potential causes of neurologic decline was undertaken and revealed a phenytoin level of 5.5. It was thought that the patient most likely had had a seizure and that her clinical deterioration represented a postictal state. She received a bolus infusion of phenytoin. On hospital day 7, the patient became confused, insisting that her nurse was her son and ordering him out of her "apartment." Lower extremity weakness was detected. CT scan was unchanged. Phenylephrine was started but she developed precordial lead ST elevation and elevated cardiac enzymes. Topical nitrate therapy was initiated and phenylephrine was discontinued. The patient underwent emergent cerebral angiography, which demonstrated moderate to severe bilateral ACA spasm and moderate right MCA spasm.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Management of aneurysmal subarachnoid hemorrhage. 747 15


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>