Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three cases of chronic subdural hematoma (CSDH) revealed by transient neurological accidents are reported. Although well-known this condition is rare: 1 to 9 p. 100 of CSDHs. Questioning may bring out a history of cranial injury and headache, even minor ones, which are unusual in transient ischemic accidents (TIA). Transient phenomena, such as motor aphasia or speech interruption, point to the diagnosis, especially in male patients over 60 years of age. The finding at electroencephalography of a delta activity more than 48 hours after a TND should exclude the diagnosis of TIA until a CT scan is performed. Since the causes of neurological deficits regressing within less than 24 hours may be ischemia as well a hemorrhage or tumour, the term of transient neurological accident (TNA) should preferably be used, and an emergency CT scan should be performed for diagnostic and therapeutic purposes. Owing to the possibility of another concomitant cause of TNA, the finding of a subdural haematoma should not deter from pursuing cardiovascular examinations. The mechanism of TNA probably involves a vascular factor, as suggested by I-123 IMP cerebral SPECT which shows an intercritical decrease in cerebral blood flow and/or an epileptic factor.
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PMID:[Chronic subdural hematoma and transient neurologic deficits]. 219 36

The relationship between recovery from aphasia and regional cerebral blood flow (CBF) was compared in 87 patients, 44 with cerebral hemorrhage and 43 with non-embolic cerebral infarction. CBF values correlated poorly with aphasia outcome in patients with cerebral hemorrhage whereas a tight correlation was demonstrated in patients with non-embolic cerebral infarction. A marked variability of CBF values in the acute and subacute stage might account for the poor correlation between CBF and aphasia outcome in patients with cerebral hemorrhage. On the other hand, a sharp discrimination was achieved between those with a good recovery from aphasia and those with a poor recovery by the dimensions of the hematoma on CT. In non-embolic cerebral infarction, a relative frontal ischemia was associated with motor aphasia while a relative temporal ischemia was associated with sensory aphasia. This dichotomy was not demonstrated in the regional CBF values in patients with cerebral hemorrhage.
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PMID:Regional cerebral blood flow correlates of aphasia outcome in cerebral hemorrhage and cerebral infarction. 371 38

We described a 67-year-old right handed man with a left internal carotid artery occlusion, who developed monocular photopsia that supervened neovascular glaucoma. He had an antecedent transient motor aphasia. His photopsia, exaggerated by light, persisted intermittently. Orbital bruit was obtained on the left, more clearly during the photopsia. Brain MRI, cerebral angiography, and duplex sonography of carotid and ophthalmic arteries indicated left internal carotid artery (ICA) occlusion with collateral circulation through the ophthalmic artery. Visual evoked potentials (VEPs) revealed a prechiasmal disturbance of the optic pathway of the left side. The patient had carotid endarterectomy of the left ICA, and his visual disturbance has gradually improved. Ocular symptoms due to ICA ischemia are commonly transient visual loss with dark background known as amaurosis fugax. Neovascular glaucoma is sometimes complicated with carotid artery occlusion. However, photopsia associated with carotid artery occlusion is rare. Photopsia mimics scintillating scotomata, but the latter precedes migraine and is biocular and homonymous, ascribable to spreading depression from the occipital lobe. Retinal or prechiasmal optic pathway might be influenced by poor circulation of the ophthalmic artery. In addition, disturbance of light adaptation due to retinal hypoperfusion may be possible reason. Neovascular glaucoma is intractable, once developed. Therefore, atypical scintillating visual disturbance must be recognized as a sign of carotid artery insufficiency and supervened glaucoma to prevent it.
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PMID:[Monocular photopsia preceding with neovascular glaucoma due to internal carotid artery occlusion; a case report]. 874 54

Unilateral auditory hallucinations are a rare lateralization phenomenon experienced in one ear or from one direction. We recently encountered a 63-year-old right-handed man who developed transient unilateral auditory hallucinations associated with pure word deafness. The patient had a past history of myocardial infarction, lung cancer and aortic aneurysm, but no previous psychiatric or convulsive disorders. About six months before admission, he developed right hemiparesis and motor aphasia caused by a hemorrhagic left parietal infarct. These symptoms gradually improved over three weeks. Two days before admission, he suddenly lost the ability to understand spoken words. He concurrently experienced auditory hallucinations arising from the right anterior direction. On admission, he was very embarrassed to simple verbal commands. He was unable to comprehend spoken words and repeat speech, although he could fairly follow written commands. Confrontation naming, reading aloud, comprehension, spontaneous writing remained relatively unaffected, although he occasionally made paraphasic errors. He could distinguish environmental sounds such as a telephone ringing or running water. After gradual improvement of his auditory incomprehension, he began to describe auditory hallucinations of verbal, musical and elementary types. He was fully aware of the hallucinatory nature of his experience, and took some notes. Two days before admission, from the right anterior side of his head he heard a familiar radio announcer reporting news about the earthquake in Osaka Prefecture and the recommended places of refuge. After similar experiences over several days, he repetitively heard a familiar Japanese traditional song from the right side, which was followed by elementary auditory hallucinations such as a car engine and a siren. These symptoms spontaneously disappeared after nine days. Besides his auditory hallucinations, visual hallucinations and illusional emotion were temporarily present. The Wechsler adult intelligence scale revealed a verbal IQ of 91 and a performance IQ of 100. Pure tone audiometry revealed bilateral, mild peripheral sensorineural hearing loss. Brainstem auditory evoked potentials were unrevealing. The EEG showed slow activities in the left temporoparietal region. Magnetic resonance imaging of the brain failed to reveal any relevant abnormalities except for an old hemorrhagic parietal infarct. The SPECT with Tc99m-HMPAO, however, showed reduced blood flow in the left temporal lobe including the first temporal convolution as well as in the left parietal lobe. Based on the SPECT findings, unilateral auditory hallucinations in our patient are considered to have resulted from the left temporal lobe ischemia. Our case indicates that unilateral auditory hallucinations may have a clinicoanatomical correlation with contralateral temporal lobe lesions.
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PMID:[Unilateral auditory hallucinations due to left temporal lobe ischemia: a case report]. 882 99

Apraxia of speech and Broca's aphasia both affect voice onset time (VOT) whereas phonemic vowel length distinctions seem to be preserved. Assuming a close cooperation of anterior perisylvian language zones and the cerebellum with respect to speech timing, a similar profile of segment durations must be expected in ataxic dysarthria. In order to test this hypothesis, patients with cerebellar atrophy or cerebellar ischemia were asked to produce sentence utterances including either one of the German lexial items "Rate" (/ra:t(h)e/, 'installment'), "Ratte" (/rat(h)e/, 'rat'), "Gram" (/gra:m/, 'grief'), "Gramm" (/gram/, 'gramm'), "Taten" (/t(h)atn/, 'actions'), or "Daten" (/datn/, 'data'). At the acoustic signal, the duration of the target vowels /a/ and /a:/ as well as the VOT of the word-initial alveolar stops /d/ and /t/ were determined. In addition, a master tape comprising the target words from patients and controls in randomized order was played to three listeners for perceptual evaluation. In accordance with a previous study, first, the cerebellar subjects presented with a reduced categorical separation of the VOT of voiced and unvoiced stop consonants. Second, vowel length distinctions were only compromised in case of the minimal pair "Gram"/"Gramm." In contrast to "Rate"/"Ratte", production of the former lexical items requires coordination of several orofacial structures. Disruption of vowel length contrasts would, thus, depend upon the complexity of the underlying articulatory pattern.
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PMID:Phonemic vowel length contrasts in cerebellar disorders. 1009 44