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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied 36 patients (21 women and 15 men) with spontaneous dissection of the internal carotid arteries. The ages of these patients ranged from 21 to 63 years. Focal unilateral headache was the most common symptom. Other common clinical manifestations (in decreasing order of frequency) included focal cerebral ischemic symptoms, oculosympathetic paresis, bruits, light-headedness, and neck pain. Less common symptoms were syncope, amaurosis fugax, scalp tenderness, swelling in the neck, and dysgeusia. Common angiographic manifestations (in decreasing order of frequency) were elongated, irregular, and frequently tapered narrowing of the lumen; abrupt luminal reconstitution (often at the carotid canal); aneurysms; intimal flaps; slow internal carotid artery--middle cerebral artery flow; tapered occlusion; and distal branch occlusions. The incidence of hypertension in these patients was considerably higher than that in the general population. Angiographic evidence of fibromuscular dysplasia was found in 14% of the patients, but atherosclerotic changes were uncommon. Follow-up ranged from 14 to 140 months (mean, 58.5 months). Twenty-three patients with 29 dissected internal carotid arteries were also restudied angiographically. The stenosis of the internal carotid artery either completely resolved or substantially improved in more than 85% of the dissected vessels. About two-thirds of the dissecting aneurysms either resolved or decreased in size. Clinically more than 85% of the patients had an excellent or complete recovery. Recurrence of the dissection or rupture of a dissecting aneurysm was not noted. Despite their disconcerting appearance on angiography, spontaneous dissections of the internal carotid arteries are often associated with a good prognosis.
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PMID:Spontaneous dissection of the cervical internal carotid artery. 396 55

We compared the clinical associations, arteriographic findings, and long-term outcome of 93 patients with amaurosis fugax and 212 patients with focal cerebral ischemia (transient ischemic attacks [TIAs]). The group of patients with cerebral TIAs included a significantly larger proportion of blacks and had a higher prevalence of hypertension than the group with amaurosis. Operable atherosclerotic lesions of the carotid arteries were more often associated with amaurosis (66%) than with cerebral TIAs (51%). The seven-year cumulative rate of cerebral infarction, however, was less in patients with amaurosis (14%) than in those with cerebral TIAs (27%; p less than 0.02). This difference in outcome persisted after adjustment for race, hypertension, and type of therapy. There were no significant differences, however, in the cumulative rates either of recurrent TIAs or of myocardial infarction or sudden death in the two groups of patients.
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PMID:Comparison of amaurosis fugax and transient cerebral ischemia: a prospective clinical and arteriographic study. 408 52

Blindness is a rare complication of acute glomerulonephritis. During three years (1980-82) 32 cases of acute glomerulonephritis are admitted in a Pediatric Department. Five children had neurologic complications among whom three developed complete, bilateral and transient blindness. In all cases blindness is associated with hypertension and intracranial pressure. The mechanism suggested in this kind of amaurosis is cerebral oedema, and the adequate treatment of this oedema permit a complete recovery of the vision.
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PMID:[Glomerulonephritis and blindness. Apropos of 3 cases]. 653 74

Forty-four unselected patients with amaurosis fugax (AF) have been followed for 4.6 years (mean 2.6). Thirty per cent had atheromatous lesions, 20% had miscellaneous diagnoses (temporal arteritis 5, transitory ocular hypertension 2, glaucomatous iritis 1, benign intracraniel hypertension 1), 50% consisted of young, mainly women, in whom no cause was found. Prior to AF 2 had hemiplegia, 4 TCI, one optic atrophy and suspicion in 3. None died, one developed hemiparesis and one macular degeneration. An individual conservative attitude to AF seems justified in this material.
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PMID:Amaurosis fugax. A unselected material. 663 19

All contributory factors to the unusual occurrence of stroke in young people were evaluated in patients under age 40 admitted to the Stroke Unit of the Austin Hospital in Melbourne, Australia. Over the August 1977 to December 1980 period there were 700 admissions. Of these 14 patients were under the age of 40. There were 7 males and 7 females whose ages ranged from 17-38 years. Each patient was screened for factors which might contribute to premature vascular disease including hypertension, diabetes, smoking, obesity, and hyperlipidemia. In addition, the following tests were performed to exclude an arteritic process: full blood examination; ESR; protein electrophoresis; syphilis serology; and the presence of antinuclear factor. Each of the 14 patients suffered cerebral infarction. A summary of each case is presented in a table. In 9 patients, infarction occurred in the carotid territory of supply. Large cortical infarcts with or without subcortical involvement occurred in cases 1-8, of whom 5 had major vessel occlusion demonstrated angiographically and another had stenosing and ulcerative atheromatous disease at the extracranial carotid bifurcation. In a further 4 patients, infarction occurred within the vertebrobasilar territory and was either confined to the brain stem, the occiptal cortex, or involved both. Angiograms were performed in 2 of these patients and showed irregular narrowing of the vertebral artery which was interpreted as spasm and segmentally narrowing of the basilar artery. The final patient had several ischemic events which included right sided amaurosis fugax, and left frontal, right parieto-occipital and left occipital infarctions. Angiography was normal. All patients survived the stroke and were able to go home. There may be an interrelationship between the pathological findings of Irey et al. (1978) and the effect oral contraceptives (OCs) has on migraine. This is relevant to Case 13. Sustained exposure to OCs may produce the pathological changes described (visible as segmental narrowing angiographically). In 2 patients cerebral infarction was caused by atheromatous or hypertensive occlusive vascular disease. In Case 3 an embolus occluded the middle cerebral artery. Infarction complicating migraine was diagnosed confidently in 4 patients on the basis of typical migrainous symptomatology in the past and accompanying the stroke. Of the 12 patients fully evaluated, there were no cases of polycythemia or thrombocytosis. There were no abnormalities of the clotting factors. Almost every patient had some form of emotional upset, and there were 7 who had significant psychiatric illness and emotional problems of extreme magnitide.
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PMID:Stroke syndromes in young people. 692 82

A follow up study has been performed in thirteen patients suffering from (amaurosis fugax) (A.F.). From the case material analysis and from the review of the current literature it has been possible to infer that the current pathogenetic hypotheses (cerebral and/or retinal microembolism) of the amaurosis fugax and of the transient ischemic cerebral attacks without ocular symptoms are similar, at least in the most of the cases. In all the cases of amaurosis fugax examined, the clinical symptomatology, the frequency of the episodes and the time required for its complete recovery have been described. Some (risk factors) of cerebrovascular disease, such as hypertension, diabetes mellitus and high plasma levels of cholesterol and triglycerides, have been statistically analyzed using Student's t test and chi-square. As regards other possible risk factors (ischemic heart disease, peripheral vascular diseases, chronic obstructive pulmonary disease) only a statistical frequency analysis has been performed. The results of the anti-platelet therapy in modifying the frequency of the A.F. episodes have been discussed. It has been lastly considered the results of the follow-up study in regard to the prognosis of the A.F.
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PMID:[Amaurosis fugax]. 702 16

Patients with amaurosis fugax (transient monocular blindness) have been studied including an ophthalmodynamometry. In most of the cases there were general circulatory disturbances with marked orthostatic decrease of the ophthalmic pressure, and comparatively seldom carotid stenosis and hypertension.
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PMID:[Temporary blindness as a symptoms of circulatory disorder]. 730 Jul 86

During a 10-year period from January 1983 to December 1992, 79 carotid endarterectomies were performed in patients aged 80 years or older. This represented 7.4% of the total patient population undergoing carotid endarterectomy at Emory University Hospital. The indications for surgery in this elderly population were transient ischemic attacks in 24 (30.3%), cerebrovascular accident in 12 (15.2%), amaurosis fugax in seven (8.9%), vascular tinnitus in one (1.3%), and asymptomatic stenosis in 35 (44.3%). The average degree of ipsilateral stenosis was 76.8%. Concomitant risk factors included coronary artery disease in 43%, systemic arterial hypertension in 51.9%, diabetes mellitus in 10.1%, and significant smoking history in 53.2%. Seventy-six percent of the procedures were performed under local anesthesia, and in all but two intraluminal shunts were used. Combined 30-day mortality and postoperative stroke morbidity in this population was 1.3% (one patient). Long-term follow-up ranging from 1 to 10 years (average 35 months) revealed no ipsilateral strokes. This experience suggests that carotid endarterectomy can be performed in an elderly population with morbidity and mortality rates similar to those in a younger cohort.
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PMID:Carotid endarterectomy in the octogenarian. 781 78

Seventy-two patients (69 women and 3 men) with benign intracranial hypertension were examined. Besides general clinical signs, such as headache in 71, giddiness in 29, vomiting in 19, poor health in general in 18, painful movements of the eyeballs in 11, unsteady walking in 10, ringing in the ears in 9, noise in the head in 3, all the patients developed changes in the organ of vision. Congestive optic disks were detected in all the cases. Obnubilations were detected in 34 (47.2%) patients, diplopia in 5 (6.9%). Vision acuity was reduced in 33 (45.8%) patients, visual field was limited in 23 (31.9%). Forty-three patients completely recovered, negligible residual symptoms of benign intracranial hypertension persisted in 16, and all symptoms of the condition were virtually unchanged in 13 patients. Vision acuity remained reduced in 10 (13.9%) patients, and one female patient developed amaurosis of both eyes.
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PMID:[Visual functional disorders in benign intracranial hypertension]. 807 84

Amaurosis fugax has frequently been related to carotid artery disease. In order to determine the relationship between amaurosis fugax and significant carotid artery stenosis, we prospectively studied 81 consecutive patients presenting to an ophthalmologist with this symptom. Neurologic and vascular evaluation with PPG and Duplex-scan were performed. A stenosis of greater than 70% was regarded as significant. DSA was performed in patients with significant stenosis (55 of 81). The presence of risk factors such as hypertension, diabetes, coronary artery disease, tobacco and hyperlipidemia was considered. Mean age was 64.96 years. There was a high prevalence of hypertension, smoking and previous CVA/TIAs. Patients with significant carotid stenosis were endarterectomized. Carotid atheromata plaques were classified in three groups: hemorrhagic plaque (5), dystrophic calcification (8) and ulcerated plaque (42). There was a high correlation (0.87) between ulcerated plaque and amaurosis fugax. We conclude that amaurosis fugax is an important symptom to allocate patients with high risk of carotid disease, specially carotid stenosis complicated with ulcerated plaque. Carotid duplex scan must be done if this symptom is present.
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PMID:Amaurosis fugax as a symptom of carotid artery stenosis. Its relationship with ulcerated plaque. 812 72


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