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

One hundred and seventy-one patients with dissecting aneurysm seen between 1951 and 1976 at three hospitals in Manchester were studied. There were 60 proximal dissections, 80 distal dissections, 10 abdominal dissections and in 21 the site of origin was uncertain. Pain was the major symptom in 88 per cent of patients; radiation of pain to the interscapular region was much more common in distal dissections. Systemic hypertension was present in 77 per cent, being commoner in distal dissections (83 per cent) than in proximal dissections (70 per cent). Aortic incompetence, hemiplegia and shock were all more common in proximal dissections. Post-mortem examination was performed in 125 patients. Eighty-four per cent of proximal dissections had ruptured, 74 per cent into the pericardium and five per cent into the left pleural cavity. Seventy per cent of distal dissections had ruptured, 11 per cent into the pericardium and 41 per cent into the left pleural cavity. The extent of the dissection was analysed, and it was shown that 25 per cent of distal dissections had extended proximally into the ascending aorta and arch. This implies that diagnosis of the site of origin of dissection from clinical signs and the plain chest-radiograph is inaccurate. Aortography is required for precise assessment. Since treatment often varies with the site of dissection, aortography should be performed in most patients surviving the first few hours. Attention is drawn to the frequency (10.4 per cent) of multiple aortic lesions, and to the occasional aetiological significance of giant-cell arteritis, and, possibly, hypothyroidism.
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PMID:Dissecting aortic aneurysms: a clinicopathological study. I. Clinical and gross pathological findings. 48 91

The case histories of 125 children with hypertension and no apparent primary CNS disease were analyzed for neurological symptoms or complications. Eleven children had neurological symptoms of high blood pressure. In only one of these patients was the diagnosis of arterial hypertension made before the observation of the neurological findings. The symptoms were severe headache in eight children, convulsions and coma in four, hemiplegia in two, and impaired vision and apraxia in one child. Symptomatology was rapidly reversed by antihypertensive treatment in four children, while six had long-term stigmata and one child died in hypertensive crisis. Because elevated arterial pressure can cause severe neurological disease, routine blood pressure measurement in children--especially those with neurological symptomatology--is stressed.
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PMID:Central nervous system involvement in severe arterial hypertension of childhood. 51 Mar 17

Seven cases of SLE with concomitant neurological syndromes are reported. In 2 cases brain stroke with right-sided hemiplegia and aphasia developed, in the remaining cases brain-stem stroke with subarachnoid haemorrhage, progressive hemiparesis and signs of intracranial hypertension, chorea, status epilepticus in terminal uraemia were observed. In one case myasthenia coexisted. Severe neurological syndromes were preceded by signs of involvement of other organs and in most cases by low-grade signs of central nervous system involvement. Treatment with corticosteroids and immunosuppressants resulted in significant improvement without complete remission. A retrospective survey of clinical material showed that modern therapeutic methods have improved the prognosis in systemic lupus erythematosus independently of central nervous system involvement.
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PMID:[Neurological syndromes in the course of systemic lupus erythematosus]. 52 35

Report on a 10 year-old boy with acute hemiplegia after an ischemic cerebrovascular accident, provoked by an unilateral renovascular disease with malignant hypertension, for which nephrectomy was carried out. The few publications pertinent to cerebrovascular complications in children with hypertension and the value of comprehensive diagnostic operations, are the basic motives for this report.
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PMID:Renovascular hypertension as a cause of cerebrovascular accident in childhood: a case report. 57 1

Three patients with severe postoperative hemiplegia and one with hemiplegia following a subarachnoid hemorrhage are presented. None had hematomas. All were treated with dopamine-induced hypertension, mannitol, and large quantities of intravascular fluids. All showed a remarkable degree of clinical improvement, presumably secondary to an increase in cerebral blood flow.
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PMID:Treatment of aneurysmal hemiplegia with dopamine and mannitol. 69 Jun 80

The authors report 76 cases of carotid obstruction, mainly localized at the origin of the carotid artery, that have been operated upon in emergency. Two types of lesions are considered: occlusion and very tight stenosis. The principle of early surgery in cases of acute occlusion is very controverse. According to the facts reported (38 cases) results are rewarding when operative decision is taken under precise conditions judged as favorable: short lapse of time since occlusive onset, absence of intracranial hypertension, absence of comatose state and no sign of brain oedema. Some patients under go surgery in the priviledged condition of being already in a medico-surgical unit (post operative, post angiographic, embolic occlusions). Majority present the most common hemiplegic attack. However difficulty resides in the inefficient mode of transport to hospital and lack of highly specialized units on admission. A very tight stenosis (at extreme a pseudo-occlusive stenosis) with clinical recurrent deficit, modified Loppler's recording and hemodynamic repercussion at angiography is an operative emergency. When results of early surgery on 38 cases of stenosis are compared to those of late operation in 14 similar cases early decision becomes compulsory once tight stenosis of the carotid artery is identified and operative criteria respected. In the light of this report that "wait and see attitude" needs be somewhat revised when confronted to the dramatic ictal hemiplegia.
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PMID:[Emergency disobliteration of the carotid prepolygonal segment. Personal experience of 76 cases]. 72

The clinical syndrome of "stroke" at first calls for a differentiation between the prognostic more unfavorable massive hemorrhage and the syndromes of cerebral hypoxia or ischemia. The ratio of hemorrhage to ischemia is about 1 to 5. Conclusions may already be drawn on the nature of the apoplectic insult from the clinical symptomatology. For example, the hemorrhagic insult in general begins with severe manifestations of neurological dysfunction such as hemiplegia and coma, while the symptoms of the ischemic insult frequently do not develop all of a sudden but in the course of hours, rarely from 1-2 days. Digitalisation in combination with dextran infusions is the method of choice in treating intermittent ischemias, particularly those provoked by hypertension. Rehabilitation, i.e. passive and active physical exercise, should be started as early as possible. In addition, particular importance must be attributed to prevention and especially to the early recognition of hypertension and of cardiac diseases as a socio-medical problem.
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PMID:[Clinical picture and therapy of cerebral apoplexy]. 85 97

Oppenheimer and Fischberg's vasoconstriction-hypothesis on the pathogenesis of hypertensive encephalopathy was subsequently supported by animal experiments. Later on the role of decompensation of the autoregulatory mechanism of the cerebral blood flow was revealed. The transient symptomatology comprises headache, seizures, focal cerebral symptoms (hemiplegia etc.), visual disturbances, mental disorders, papiledema etc. The age-dependency of the influence of edema is probably expressed by the predominance of seizures in childhood and the long duration of the symptoms in our third and fourth patient. The differentiation between hypertensive encephalopathy and a local complication of hypertension (hemorrhage) can be difficult, not at least because the first disturbance may be followed by the second (patient 3). Hypertension is not always present as initial symptom (patient 1 and 2). Hence a series of blood pressure readings is required in acute cerebral incidents in childhood. Steroid-treatment may lead, especially in patients suffering from a hypocomplementemic form of membranoproliferative glomerulonephritis, to a sudden rise of the blood pressure and subsequently to hypertensive encephalopathy (patients 2 and 3). Hypertensive encephalopathy is a neuropediatric emergency. The urgent treatment with dioxaside, fursemide and sodium nitroprusside is shortly reviewed.
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PMID:Hypertensive encephalopathy in childhood. Diagnostic problems. 98 19

The known risk factors for atherosclerosis do not possess the same significance in young people as in the elderly. Hypercholesterolemia, diabetes and cigarette smoking appear to have a greater bearing below the age of 50 than later, particularly in myocardial infarction but also in apoplexy. On the other hand, hypertension is an important factor in the young and, especially in the case of apoplexy, even more so in advanced age. There is marked difference with regard to preexisting heart disease, which scarcely plays a role in myocardial infarction of the younger patient but is a factor in some 50% of hemiplegia cases. Only one fifth of elderly patients with this disease have no preexisting carcdiopathy. The similarity of the risk factors in elderly patients either with or without apoplexy is due to the fact that arteriosclerosis is already established in both groups and the risk factors which give rise to ischemia, thrombosis or embolism assume prominence. The therapeutic implications are briefly discussed.
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PMID:[Risk factors and age]. 113 58

A 64-year-old right hemiplegic woman, who had been treated for hypertension for 15 years, was admitted to our hospital. Neurologic examination on admission disclosed right hemiplegia and motor aphasia; however, ophthalmoparesis, pupillary abnormality, and blepharoptosis were not evident. Excessive sweating on the right side of the body, which was most marked on the face, was observed. Amount of sweating on the left side of the body was normal. Unilateral hyperhidrosis persisted for more than 2 months. MRI revealed hemorrhagic infarctions in the left basal ganglia, internal capsule, thalamus, hypothalamus, and medial part of the cerebral peduncle. 123I-IMP SPECT disclosed hypoperfusion in the left striatum, thalamus, occipital cortex, and right cerebellar hemisphere. Cerebral angiography revealed arteriosclerotic changes in the basilar artery, but that the left posterior cerebral artery and its branches were not occluded. Unilateral persistent hyperhidrosis is rare after ischemic stroke. Hypothalamic lesion was thought to be responsible for the hyperhidrosis in this patient. As the hypothalamus receives its blood supply from the posterior cerebral artery, unilateral persistent hyperhidrosis may be an important sign of cerebral infarction in the posterior cerebral artery region.
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PMID:[Unilateral persistent hyperhidrosis after ischemic stroke]. 139 37


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