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

A case with ocular (corneal crystals and retinal pigment epithelial mottling), muscle (oropharyngeal and hand weakness and atrophy), and renal (proteinuria and hypertension) abnormalities is described. We believe that this represents a previously unrecognized syndrome.
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PMID:Corneal crystals, myopathy and nephropathy: a new syndrome? 359 37

A case of intravenous labetalol in the treatment of a resistant hypertensive emergency is reported. Although there have been several reports of the use of oral labetalol in resistant hypertension, no intravenous administration in hypertensive emergency resistant to other drugs has been reported to date. A 36-year-old black female with BP of 270/160 mm Hg with complaints greater than one month's duration of dizziness, severe headaches, blurred vision, shortness of breath, vomiting, palpitations, flushing, agitation, diarrhea, weakness, and weight loss, was treated successfully with intravenous labetalol after she failed to respond to other established parenteral antihypertensive drugs. The patient received labetalol 20 mg iv bolus, and then 20 mg every ten minutes until a cumulative dose of 200 mg was attained. Labetalol produced a prompt but smooth reduction in BP without any reflex tachycardia or other adverse effects. Intravenous labetalol may be safe and effective for the management of rapid BP control in hypertensive emergencies resistant to other parenteral antihypertensive agents.
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PMID:Intravenous labetalol in the management of resistant hypertensive emergency. 360 97

A rare case of extracranial internal carotid occlusion with a coexisting ipsilateral internal carotid aneurysm is reported. A 50-year-old male had a sudden onset of severe headache, vomiting and right motor weakness on May 14, 1984. Two days later the patient was transferred to our hospital. On admission he was alert but presented with nuchal rigidity and right moderate hemiparesis. He had an episode of a blunt head injury 12 years previously, but no history of hypertension, diabetes mellitus or cerebral stroke. A computed tomography revealed mild subarachnoid hemorrhage and mild ventricular dilatation. A cerebral angiography did not demonstrate any aneurysms but it revealed occlusion of the right internal carotid artery at the cervical bifurcation. The repeated angiography on May 31 disclosed a saccular aneurysm arising anteromedially at the level of the junction of the right posterior communicating artery and the internal carotid artery. The cervical internal carotid artery remained occluded at the same site. The middle cerebral artery was supplied through the well-developed posterior communicating artery, and the right anterior cerebral artery was supplied through the anterior communicating artery. Clipping of the aneurysm was attempted but it was forcibly trapped because of premature bleeding on June 5. The right V-P shunt was performed for the progressive ventricular dilatation on June 12. The patient was discharged with no paresis on June 20. It has been well known that the uni- or bilateral carotid occlusion, whatever the origins are, are often associated with cerebral aneurysms.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Extracranial internal carotid occlusion and coexisting ipsilateral intracranial internal carotid aneurysm]. 361 34

Eight cases, 5 males and 3 females, of Chiari type 1 malformation aged from 9 to 51 years (mean 33.3 years) were analysed. The average age of the onset of symptoms was 29.6 years, between 7 and 44 years, and that from the onset of symptoms to the presentation to the hospital was 3.3 years ranged from 1 month to 16 years. Pain (87%) in the head or in the cervical region was the most common symptoms, the former was 5 cases and the latter was 2. The next common symptoms were unsteadiness and gait disturbance (50%). Weakness of one or more limbs was the complaints of 3 (38%) of the patients, and sensory impairment was 38%. Other symptoms included stiffness of the neck and shoulder, limitation of the neck movement, abnormal head posture, rectourinary incontinence and so on. In physical examination, foramen magnum compression signs (63%) and cerebellar signs (63% were most common and lower cranial nerve palsy (38%) and intracranial hypertension (25%) were included. Abnormalities of the skull and cervical spine were common on X-ray films. The were cervical fusion or occipitalization and basilar impression. On the angiograms, descended PICA was visualized in all cases. CT metrizamide myelography was performed in 2 cases and MRI was done in 1 case. They could clearly demonstrate the descended tonsils and were found to be the most reliable radiographic examination in the disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical study of late onset Chiari type I malformation]. 362 Feb 19

Static and dynamic forces exerted on 6-0 polypropylene suture material after carotid arteriotomy were measured in 22 adult mongrel dogs. Force was measured in 11 normotensive animals (Group I) before and 6 weeks after carotid artery repair. Force was measured in the remaining animals during normotension and induced hypertension before and 6 weeks after operation. The tensile strength of each suture used in the study was measured by the manufacturer. The mean force required to break a 6-0 polypropylene suture measured 436.9 +/- 2 g, whereas knotting of the suture decreased the tensile strength to 316.9 +/- 3.9 g (p less than 0.001). The static and dynamic axial forces exerted on the suture after carotid arteriotomy in Group I was in the range of 26 g and decreased to 18 g at 6 weeks, whereas the 45 degree force exerted during the static dynamic phase measured in the range of 23 g and decreased to 16 g at 6 weeks (not statistically significant). The axial and 45 degree forces exerted on 6-0 polypropylene suture material in Group II under normotensive conditions were in the range of 14 g after carotid arteriotomy and ranged between 12 to 14 g at 6 weeks. Systolic hypertension did not result in a significant increase in axial or 45 degree forces during static or dynamic measurements, both in the range of 15 g after carotid arteriotomy. Measurements were similar at 6 weeks and ranged between 14 and 16 g. Our data indicate that 6-0 polypropylene suture material is an appropriate choice for repair of the carotid artery and that the suture material has sufficient inherent tensile strength to withstand forces generated in the neck region. Furthermore, our data indicate that spontaneous carotid artery suture line disruption is most likely related to damage to the suture strand during carotid artery repair rather than an inherent weakness in the suture material.
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PMID:Effect of force on anastomotic suture line disruption after carotid arteriotomy. 363 10

Retrospective clinical studies of 211 thyreotoxic patients having received 131I-therapy were performed and processed by computer. The patients' mean age was 58 years, the male-female ratio 7.1 to 1. The incidence of symptoms and associated diseases was in agreement with data in the literature. Of the clinical symptoms, weight loss, weakness, fatigability, a fine tremor, decompensation and nervousness, called attention to the condition. Of the ECG changes, an absolute arrhythmia of atrial fibrillation and extrasystole may be indicative of hyperthyroidism. Clinically, there is an essential difference between juvenile and old-age thyrotoxicosis. Differences could also be noted between patients with toxic adenoma and those with non-toxic one. Toxic adenoma patients were more advanced in age and the female-male ratio was higher than in non-toxic cases. Absolute arrhythmia of atrial fibrillation, extrasystole, repolarization disorders, diabetes, hypertension and arteriocardiosclerosis occurred more often, while ophthalmopathy and immune disease were less frequent. The clinical picture may raise the suspicion of old-age thyrotoxicosis. Following laboratory diagnosis, treatment should be administered without delay.
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PMID:Experience with 131I-therapy. Hyperthyroidism in old age. 367 Oct 18

The authors describe their experience with four cases of dural arteriovenous malformation (AVM) which led them to analyze the clinical aspects of these lesions in an attempt to understand their pathophysiology. An additional 191 previously reported cases of dural AVM's were reviewed with special attention to the mechanism of intradural, central, and peripheral nervous system manifestations. Apart from the peripheral cranial nerve symptoms, which are most likely due to arterial steal, the central nervous system (CNS) symptoms appear to be related to passive venous hypertension and/or congestion. Generalized CNS symptoms can be related to cerebrospinal fluid malabsorption due either to increased pressure in the superior sagittal sinus, to venous sinus thrombosis, or to meningeal reaction resulting from minimal subarachnoid hemorrhages. These phenomena are not related to the anatomical type of venous drainage. On the other hand, focal CNS symptoms are specifically indicative of cortical venous drainage. Seizures, transient ischemic attacks, motor weakness, and brain-stem and cerebellar symptoms can be encountered depending on the territory of the draining vein or veins. Therefore, the localizing value of focal CNS symptomatology relates to the venous territory and not to the nidus or to the arterial supply characteristics of dural AVM's. Furthermore, the venous patterns of various dural AVM's at the base of the skull are expressed by differences in their clinical presentation. Dural AVM's of the floor of the anterior cranial fossa and of the tentorium are almost always drained by the cortical veins and, therefore, have a high risk of intradural bleeding. The remarkable similarities in the manifestations of dural and brain AVM's and the differences in the manifestations of dural and spinal dural AMV's are pointed out. High-quality angiograms and a multidisciplinary approach to the study of dural AVM's will provide the best understanding of their symptoms and, therefore, the most appropriate treatment strategy.
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PMID:Neurological manifestations of intracranial dural arteriovenous malformations. 370 21

A 32-year-old female was admitted complaining of pain over the whole body and dysesthesia in all extremities. On admission, physical examination revealed hypertension, tachycardia, abdominal distension and urinary retention. Neurological examination revealed sensory impairment over the whole body and mild muscular weakness with absent deep tendon reflexes. Abdominal roentgenogram showed gaseous distension of the bowels. CT scans showed low density areas on the bilateral parieto-occipital lobes. CAG showed diffuse narrowing of the cerebral arteries. Laboratory examinations showed an albumino-cytologic dissociation (cells; 21/3mm, prot.; 78 mg/dl) of the cerebrospinal fluid and increased levels of norepinephrine (214 micrograms/day) and epinephrine (16.1 micrograms/day) in the urine. Motor nerve conduction velocities of the median nerves was 42.8 m/sec in the right and 50.0 m/sec in the left. The autonomic function tests revealed hyper-responsiveness to 10 mg of phentolamine and low baroreflex sensitivity. Within 2 months, most symptoms improved. Repeated CT scans showed no abnormality, while CAG showed only mild arterial narrowing. This case was diagnosed as having acute autonomic and sensory neuropathy which was a subtype of acute polyradiculoneuritis. Occult encephalitis or autonomic dysfunction was considered to contribute to the peculiar findings on CT and CAG.
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PMID:[A case of polyradiculoneuropathy associated with diffuse arterial narrowing]. 376 86

The average annual incidence of Bell's palsy per 100,000 population in Rochester, Minnesota, for 1968 through 1982 was 25.0 for both sexes combined; crude rates for males and females were 22.8 and 26.9, respectively, based on 85 males and 121 females. The relationship between various clinical features, patient characteristics, and the type of recovery was analyzed. In 206 patients, 28 (14%) experienced incomplete recovery and 178 (86%) had complete recovery, based on evidence in the medical records. Using logistic regression, complete facial weakness, non-ear pain, and hypertension were identified as the most important risk factors for incomplete recovery. Patients were divided into two groups for comparison of treatment results; one group (n = 94) was without any of the three identified risk factors, and the other group (n = 112) consisted of patients who had one or more risk factors. Results suggested that among the latter group, those treated with steroids fared better than those in any of the other treatment groups.
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PMID:Incidence, clinical features, and prognosis in Bell's palsy, Rochester, Minnesota, 1968-1982. 378 75

Five cases with a sudden onset of dysarthria in the setting of hypertension are presented. No case had limb weakness or other neurological deficits. Computed tomographic scan demonstrated a small low density lesion in the anterior part of the internal capsule or the adjacent corona radiata. All cases showed a good recovery from dysarthria within two to four weeks.
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PMID:Pure dysarthria due to anterior internal capsule and/or corona radiata infarction: a report of five cases. 380 21


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