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)

Posterior leukoencephalopathy syndromes have been reported with hypertension, and immunosuppressive and chemotherapy agents. Cerebral vasospasm on MR angiography (MRA) has been noted in cases due to eclampsia. The authors report a case of Balint syndrome with irreversible posterior leukoencephalopathy on MRI following intrathecal methotrexate and cytarabine. Hypertension was not present. Diffuse, reversible arterial irregularities consistent with vasospasm were present on MRA during the acute illness.
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PMID:Posterior leukoencephalopathy following intrathecal chemotherapy with MRA-documented vasospasm. 1255 54

Garcin syndrome is characterized by a progressive ipsilateral involvement of cranial nerves, culminating in paralysis of all or at least seven of them, without sensory or motor long-tract disturbance, with no intracranial hypertension, and with osteoclastic involvement in the skull base on radiographic computed tomography. Giant cell tumor is a primary bone tumor rarely affecting the skull base. An 8-year-old female presented with a 3-month history of increasingly worsening right otalgia, tinnitus, hearing loss, right facial numbness, and diplopia. She was admitted with a 2-week history of swallowing difficulties, voice change, and right shoulder pain. Neurologic examination disclosed unilateral paralysis of the right fifth through twelfth cranial nerves, with no other abnormal neurologic findings. Skull radiographic computed tomography revealed lytic lesions in the right temporal petrous portion. Computed tomographic scan indicated a destructive mass involving the right greater wing of the sphenoid bone and temporal petrous apex. Magnetic resonance imaging demonstrated a tumor arising from the temporosphenoidal region, infiltrating neither the brain nor the brainstem. No hydrocephalus was observed. Biopsy revealed giant cell tumor. Posterior treatment consisted of radiotherapy. At an 8-year follow-up, the patient was well but with functional sequelae. There is no magnetic resonance imaging evidence of tumor growth. No other giant cell tumor presenting as Garcin syndrome is known to have been reported.
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PMID:Garcin syndrome resulting from a giant cell tumor of the skull base in a child. 1287 3

Posterior reversible encephalopathy syndrome is a proposed cliniconeuroradiological entity characterized by headache, altered mental status, cortical blindness, seizures, and other focal neurological signs, and a diagnostic magnetic resonance imaging picture. A variety of different etiologies have been reported like hypertension, pre-eclampsia/eclampsia, cyclosporin A or tacrolimus neurotoxicity, uraemia and porphyria. With early diagnosis and prompt treatment, the syndrome is usually fully reversible. We report a case of recurrent PRES of unknown aetiology following intensive care unit treatment and only moderately elevated blood pressure. Clinicians as well as radiologists must be familiar with this clinically frightening, underdiagnosed condition to assure timely diagnosis and treatment to prevent persistent deficits.
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PMID:Recurrent posterior reversible encephalopathy syndrome (PRES). 1503 79

Posterior leukoencephalopathy syndrome (PLES) is an acute neurological disorder. The most plausible hypothesis for the pathophysiology of PLES is the loss of autoregulation and consequent vasogenic edema. PLES is mostly attributed to severe or sudden elevations of arterial blood pressure. A number of reports, however, describe patients with PLES without severe hypertension. This report presents two patients with nephrotic syndrome who developed PLES without customarily severe hypertension. Proteinuria, low levels of serum albumin, or generalized increase in capillary permeability in nephrotic syndrome can initiate PLES with moderately high arterial blood pressure levels. PLES is increasingly recognized by neurologists, but it should also be remembered by internists when confronted with patients with nephrotic syndrome who present with neurological symptoms, whether or not they have severe hypertension.
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PMID:Posterior leukoencephalopathy and nephrotic syndrome: just a coincidence? 1509 Jul 55

Posterior tibial tendon dysfunction is the most common cause of acquired flatfoot in adults. The posterior tibial tendon is the primary dynamic stabilizer of the medial longitudinal arch of the foot. Various histological alterations in the tendon substance disrupt the normal linear structure of the collagen fibers. As a result the tendon weakens, elongates, tears and its function is compromised. This in turn places the static stabilizers of the arch under excessive stress, which eventually leads to their collapse and formation of pes planovalgus deformity. Many etiologies have been proposed as an underlying cause of posterior tibial tendon dysfunction. The average age at the time of presentation is forty years and many of the patients are women, white, obese and suffer from hypertension. The diagnosis is mainly based on clinical findings and supported by radiographic findings. Posterior tibial tendon dysfunction was classified by Johnson and Strom according to the appearance of pes planovalgus deformity, its flexibility and the development of arthritic changes in the subtalar and ankle joints. In Stage I there is no deformity, in Stage II there is a flexible deformity, in stage III there is a rigid deformity and in stage IV there is an involvement of the ankle joint secondary to long standing rigid deformity of the hindfoot. The initial treatment for any stage should be non-operative and includes immobilization and anti-inflammatory drugs for the acute phase and different kinds of orthotics for the chronic phase. Failure of the non-operative treatment is an indication for surgery. The surgical procedures for the first stage include soft tissue debridement with or without tendon transfer. The surgical procedures for second stage include tendon transfer combined with various osteotomies or joint fusions. The surgical procedures for the third and fourth stages are triple arthrodesis and pantalar arthrodesis respectively.
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PMID:[Posterior tibial tendon dysfunction]. 1514 5

Posterior leukoencephalopathy syndrome is a recently described syndrome involving mainly parieto-occipital gray/white matter of the brain. It occurs secondary to various clinical entities, like hypertension and immunosuppressive therapy. Few cases after combination chemotherapy have been reported. This study describes a 36-year-old woman with primary refractory T-cell lymphoma, who developed central nervous system toxicity due to treatment with intrathecal methotrexate and intravenous ifosfamide, idarubicine and etoposide given as a salvage regimen. Both clinical features as well as magnetic resonance imaging findings were typical for posterior leukoencephalopathy syndrome. The patient died despite anti-hypertensive therapy and haemodialysis. Central nervous system toxicity related to chemotherapeutics and posterior leukoencephalopathy syndrome are discussed briefly.
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PMID:Posterior leukoencephalopathy after combination chemotherapy in a patient with lymphoma. 1635 14

A cohort of 40 male children with Posterior Urethral Valves (PUV) seen in the Paediatric Nephrology/Urology Unit of the University College Hospital, Ibadan are presented. They were reviewed with the aim of determining the clinical course of the disease in a developing country where the facilities for active intervention are not always available. Even though 50% of the patients became symptomatic in the first week of life only 22.5% presented in the whole of the neonatal period. Thirty-seven and a half per-cent (37.5%) presented in the post-neonatal infancy period and the rest beond the first year of life. The interval between the onset of symptoms and definitive therapy was up to three years in some patients. Only 2 patients had antenatal diagnosis of the PUV by ultrasonography. The major renal complications were: (1) Urinary Tract Infections in 40%; (2) Acute Renal failure--10%; (3) Chronic Renal failure--7%; 4) Type IV Renal Tubular Acidosis--10% (5) Sustained hypertension--4.8%. The extra-renal complications were anaemia (30%), malnutrition (10%). Five of the patients died giving a case fatality rate of 12.5%, mainly from overwhelming infections and renal failure. Many of our patients had delayed presentation even though symptomatic and that may partly explain the complications and the poor outcome seen in the short term.
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PMID:A review of cases of posterior urethral valves seen at the University College Hospital, Ibadan (Nigeria). 1636 68

The aim of this study was to evaluate the accuracy of previously reported neuroimaging signs in establishing or excluding the diagnosis of idiopathic intracranial hypertension (IIH). In a retrospective study, 30 patients with confirmed IIH and 56 controls were evaluated with brain magnetic resonance imaging. All examinations were evaluated in a blinded fashion by three neuroradiologists for the presence or absence of the 'traditional' signs of IIH: empty sella turcica, deformation of the pituitary, slit-like ventricles, 'tight' subarachnoid spaces, flattening of the posterior globe, protrusion of the optic nerve, enhancement of the optic nerve head, distension of the optic nerve sheath and vertical tortuosity of the optic nerve. Optic nerve protrusion and enhancement, slit-like ventricles and tight cerebrospinal fluid spaces were not significantly associated with IIH (P>0.05). Posterior globe flattening, optic nerve sheath distension, optic nerve tortuosity, pituitary deformity and empty sella turcica were significantly associated with IIH (P<0.05). However, most of these are not helpful in a clinical setting, with the exception of posterior globe flattening. This is the only sign that, if present, strongly suggests the diagnosis of IIH (specificity 100%, 95% CI 93.6% to 100%; sensitivity 43.5%, 95% CI 27.3% to 60.8%; positive likelihood ratio 49.7). The majority of the reported signs for IIH on cross-sectional imaging are not helpful in establishing or excluding the diagnosis of IIH, and are of no value in the clinical setting. Flattening of the posterior aspect of the globe is the only sign that, if present, is suggestive of the diagnosis of IIH.
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PMID:Idiopathic intracranial hypertension: the validity of cross-sectional neuroimaging signs. 1670 59

Posterior reversible encephalopathy syndrome (PRES), also known as reversible posterior leukoencephalopathy syndrome (RPLS), is most often associated with hypertensive emergencies and is characterized by seizures, mental status changes and visual disturbances. We report a case of a previously healthy young man who developed multiorgan failure and transient cortical blindness following ingestion of a performance-enhancing ephedra-based supplement. Neuroimaging findings confirmed the clinical suspicion of PRES. Radiographic abnormalities and neurologic dysfunction subsequently resolved with correction of his systolic blood pressure. This case emphasizes the need for prompt treatment and consideration of toxic ingestions in patients presenting with hypertension-related end-organ dysfunction.
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PMID:Transient blindness due to posterior reversible encephalopathy syndrome following ephedra overdose. 1671 4

A 17 year-old female with stage IIIc endodermal sinus tumor of the ovary developed transient cortical blindness and severe hypertension after 5 cycles of PVB regimen consisting of cisplatin, vinblastine and bleomycin. Clinical and radiological findings were compatible with Posterior LeukoEncephalopathy (PLE). Her visual acuity and blood pressure completely recovered within a few days after supportive treatment with antihypertensive drug. This condition is unpredictable but it can be reversible without long term sequelae. Most reports suggested that this rare toxicity was from cisplatin therapy. However, the exact pathophysiogenesis of this condition was not known precisely. Prompt reduction in blood pressure and withdrawal of immunosuppressive agents might lead to rapid reversal of this syndrome and prevent permanent brain damage.
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PMID:Transient cortical blindness during chemotherapy (PVB) for ovarian germ cell tumor. 1704 39


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