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

The effect of encephalo-duro-arterio-synangiosis (EDAS) upon chronic cerebrovascular ischemia in 65 pediatric moyamoya patients was evaluated by the postoperative interval before complete disappearance of ischemic attacks and changes in pre- and postoperative intelligence (IQ) or development quotients (DQ). The ischemic attacks disappeared after a mean period of 239 days, in three-fourths of patients within a year and in about one-fourth within the second year. This was very fast compared with the natural course of the disease. There was no significant difference in DQ/IQ before and after the operation. The mentally normal (IQ/DQ greater than or equal to 86) population in the postoperative patients was greater than in the natural course of the disease, although fewer in the preoperative group. This shows that EDAS delayed or prevented the deterioration in mental capacity usually present but often overlooked in the natural course of pediatric moyamoya disease.
 ...
PMID:Effects of encephalo-duro-arterio-synangiosis on childhood moyamoya patients--swift disappearance of ischemic attacks and maintenance of mental capacity. 172 58

The authors report four anesthetic experiences of a child with moyamoya disease for two occasions of angiography and bilateral encephalo-duro-arterio-synangiosis (EDAS). For angiography anesthesia was maintained with inhalation of halothane-nitrous oxide-oxygen under spontaneous respiration. During the first angiography PaCO2 was 59.5mmHg and 55.2mmHg and it was 56.0mmHg during the second angiography. For EDAS, anesthesia was managed under controlled ventilation and avoiding hyperventilation. Blood pressure was stable. The patient awoke well. Under anesthetic management of a child with moyamoya disease who has normal cardiopulmonary function, the significant factor causing brain ischemia is hyperventilation.
 ...
PMID:[Anesthetic experience of a child with moyamoya disease]. 279 50

A case of moyamoya disease associated with the persistent primitive trigeminal artery (PTA) is reported. 5 such cases reported in literature are reviewed. A 16-year-old female patient was admitted to our clinic, having complained of right hemiparesis for 8 years. CT scan revealed multiple low density areas in the left frontal, temporal and parietal lobes. In left carotid angiogram, the internal carotid artery was occluded at the C3 portion and basal moyamoya (stage IV) was found. In right carotid angiogram, the internal carotid artery was occluded at the C3 portion and basal moyamoya (stage V) was found. Furthermore the persistent primitive trigeminal artery was seen with marked moyamoya vessels from the posterior cerebral artery. In vertebral angiogram, the posterior cerebral artery was seen bilaterally with moyamoya vessels. In 133Xe-rCBF study, compared with the mean flow in each hemisphere, the flow decreased at the temporal lobe, but, in contrast, increased at the parieto-occipital lobes. Reviewing the literature, the following conclusions are suggested. 1. Persistent primitive trigeminal artery will promote the stage of moyamoya disease. 2. It will protect the brain from hemorrhage and/or ischemia in moyamoya disease.
 ...
PMID:[Moyamoya disease associated with persistent primitive trigeminal artery--a case report and review of literature]. 306 Jul 54

The involvement of the posterior circulation in moyamoya disease was studied in 178 patients. Forty-three had several types of disturbance such as visual field defect, decreased visual acuity, episodes of blindness, and scintillating scotomata. Most of these symptoms were attributed to occlusive lesions in the posterior circulation. Visual disturbances were seen more often in patients with a juvenile onset than in cases of adult onset. Superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis and encephalomyosynangiosis (EMS) improved the cerebral perfusion both in the anterior and posterior circulation by redistribution of blood. In most cases, the visual symptoms subsided or were stabilized after STA-MCA anastomosis and EMS. These surgical procedures did not, however, lead to direct revascularization in cases of ischemia in the visual cortex. In five patients with impending blindness, transplantation of the omentum to the occipital lobe led to improved vision.
 ...
PMID:Study of the posterior circulation in moyamoya disease. Part 2: Visual disturbances and surgical treatment. 376 Sep 53

Moyamoya disease presents clinically as chronic progressive ischemia in the young brain. The brain is surrounded by concentric collateral networks but all of these networks are not available as collaterals in the early stage of cerebral ischemia. The anatomical characteristics precluding their early use include the presence of the watery layer of subarachnoid fluid between the cortical and dural vessels and of a closed bony box intervening between the dural and scalp arterial networks. These barriers isolate the brain from the abundant blood flow of the external carotid system as if they were the moat (the subarachnoid fluid layer) and the walls (the skull) of a castle. Based on these concepts, we have developed a surgical procedure, the encephalo-duro-arterio-synangiosis to treat moyamoya disease in children. This operation surmounts the above mentioned two obstacles to collateral formation to the brain by perforating the castle wall and bridging the moat by granulation tissue, without injuring the collaterals which are already formed. This procedure was performed on 70 sides in 38 pediatric moyamoya patients. Revascularisation of the brain was obtained in 100 percent of the cases with varying improvement in the symptoms.
 ...
PMID:The specificity of the collaterals to the brain through the study and surgical treatment of moyamoya disease. 394 75

Moyamoya disease is an uncommon cerebrovascular disease characterized angiographically by progressive stenosis of the distal internal carotid arteries and proximal anterior and middle cerebral arteries coupled with the development of a fine network of vessels at the base of the brain. In children, the disease causes recurrent hemisphere ischemia. A newly described operative procedure (encephalo-duro-arterio-synangiosis) was recently recommended by Matsushima and Inaba [Child's Brain 11: 155-170, 1984] and was used in a recent patient treated at the UCLA Medical Center. The procedure did not succeed in revascularizing the brain in spite of clinical and angiographic progression of the disease, but a conventional superficial temporal to middle cerebral bypass operation did.
 ...
PMID:Failure of encephalo-duro-arterio-synangiosis procedure in moyamoya disease. 408 Jun 60

Moyamoya disease is a cerebrovascular disease characterized radiologically by progressive narrowing and occlusion of the arteries contributing to the circle of Willis and its branches. There is formation of an exuberant collateral network of blood vessels at the base of the brain, which is thought to arise in response to chronic ischemia. Clinically, the course is variable, with patients having repeated transient ischemic attacks, strokes, migraine, and seizures. Effective treatment is not available. The etiology and pathophysiology of moyamoya disease are largely unknown. Two patients with arteriographically proven moyamoya disease were identified. Both patients were symptomatic before age 5 years. Despite successful encephaloduroarteriosynangiosis revascularization procedures, they continued to experience an inexorable downhill course. A calcium channel blocker (nicardipine HCl) was introduced in order to prevent further symptoms. After the introduction of nicardipine, no further strokes occurred in either patient. There were no further episodes of transient ischemic attacks, seizures, or headache in one patient and decreased frequency in the other. In patients with moyamoya disease, nicardipine may have a beneficial effect on cerebral hemodynamics and may prevent ischemic sequelae by optimizing existing collateral circulation.
 ...
PMID:Use of a calcium channel blocker (nicardipine HCl) in the treatment of childhood moyamoya disease. 782 27

We report a 31-year-old woman in her 4th month of pregnancy who presented with a sudden decrease in her right visual acuity. The right ocular fundus showed marked retinal edema and a cherry-red spot. A cranial computerized tomographic scan showed cerebral infarction. Cerebral angiography disclosed moyamoya disease. Ischemia of the ophthalmic artery due to constriction of the origin of the internal carotid artery and hypercoagulability due to pregnancy have presumably caused visual impairment in this patient.
 ...
PMID:Sudden blindness in the fourth month of pregnancy led to diagnosis of moyamoya disease. 811 9

We report on eight children who suffered from cerebrovascular ischemia or stroke at the age of 2 or up to 11 years. Antiphospholipid antibodies (APLA) were detected in two cases during the ischemic event and in six cases during follow-up examinations (after six weeks or within a span of six years). In two patients multiple stenoses of basal cerebral arteries were found; one of them suffered from moyamoya syndrome. The acute hemiplegia in one patient was linked to an asymptomatic mycoplasmal infection and APLA. In three cases, one of the parents was also APLA-positive. Seven patients were treated with acetylsalicylic acid, and in four cases immunoglobulin infusions were given. Transient ischemic attacks subsided after the child with the moyamoya syndrome received immunoglobulins. No effect of medication could be established in the other children. The concept of the antiphospholipid syndrome is still evolving. As none of the common risk factors pertaining to strokes in adults apply to children, pediatric research may offer a suitable platform for specific investigations on the causal, pathogenetic role of APLA. We propose that all children suffering from stroke or transient ischemic attacks should be tested for APLA.
 ...
PMID:Antiphospholipid antibodies in cerebrovascular ischemia and stroke in childhood. 820 57

While the efficacy of cerebrovascular bypass surgery for Moyamoya disease with ischemic events has been substantiated, the surgical indication for the patients presenting with intracranial hemorrhage is as yet undetermined. In an effort to prevent rebleeding from rupture of Moyamoya vessels, seven patients with intracranial hemorrhage underwent indirect bypass surgery. During the follow-up period between 2 and 11 years (mean 4.9 years), one patient suffered rebleeding 5 years after bypass surgery. Follow-up cerebral angiography failed to show revascularization and reduction of moyamoya vessels in all but one of seven patients. Thus, the author's experience suggests that bypass surgery for Moyamoya disease with hemorrhage is angiographically far less successful compared to that with ischemia. A review of the series including patients with angiographically successful revascularization and reduction of Moyamoya vessels failed to demonstrate the definitive effectiveness in eliminating the risk of further intracranial hemorrhage.
 ...
PMID:Cerebrovascular bypass surgery for the treatment of Moyamoya disease: unsatisfactory outcome in the patients presenting with intracranial hemorrhage. 821 52


1 2 3 4 5 6 7 8 9 10 Next >>