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)

During the past 5 years 412 patients (189 male, 223 female) presenting with vascular disorders were examined with Doppler ultrasonography (DUSG) of the orbital vessels. DUSG was used as a screening method for detecting additional lesions of the carotid system. The 412 patients were divided into 5 groups according to their clinical symptoms: Group I: amaurosis fugax; group II: occlusions of the central retinal artery; group III: venous circulatory disorders of the retina; group IV: AION and optic disk vasculitis; group V: symptoms of chronic ocular ischemia. DUSG disclosed a high percentage of additional carotid lesions in groups I and II. In retinal venous disorders, in idiopathic non-arteritic AION and in optic disk vasculitis DUSG findings usually were negative. In contrast to this, DUSG furnished valuable diagnostic information in arteritic AION, where nearly 50% of DUSG findings were positive. Carotid angiography, echo-flow examination of the carotid system and temporal biopsy were used as reference methods.
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PMID:[Doppler ultrasonography of orbital vessels in circulatory disorders of the eye]. 293 52

The lupus anticoagulant, an acquired circulating serum gamma-globulin, prolongs all phospholipid-dependent coagulation tests. Recent associations of the lupus anticoagulant and focal cerebral and/or ocular ischemia have been made. We present 5 cases of lupus anticoagulant-associated cerebrovascular ischemia and review all reported cases for the first time. Clinical spectra, cerebral angiographic findings, associated conditions, and response to therapy are presented. Typical features include a relatively young age (mean 39 years), female preponderance, transient ischemic attacks (including amaurosis fugax) or stroke, and normal or large vessel occlusions on angiography. Commonly associated conditions were systemic lupus erythematosus (34%), noncerebral venous thrombosis (31%), hypertension (28%), false-positive VDRL (28%), and spontaneous abortions (22%). Four of our 5 patients (all without systemic lupus erythematosus) and 11 of the 20 (55%) patients in the literature without systemic lupus erythematosus had other definite stroke risk factors coexisting. Response to therapy was highly variable, with no clear beneficial effect of corticosteroids.
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PMID:Cerebrovascular ischemia associated with lupus anticoagulant. 310 Dec 33

The extracranial carotid systems of 105 patients with retinal ischemia were examined using B-mode ultrasonography with integrated pulsed Doppler. Sixty-four patients had amaurosis fugax (AF), 17 central retinal artery occlusions (CRAO), and 21 branch retinal artery occlusions (BRAO). The prevalence of carotid stenosis (greater than or equal to 60%) ipsilateral to the symptomatic eye was low (16%). Eighty-six percent of AF patients had either no plaque causing less than a 60% stenosis. A significant proportion of subjects with normal duplex scans had alternative explanations for their retinal ischemia (eg, migraine, cardiac embolus). Patients with Hollenhorst plaques were more likely to have stenotic or ulcerated plaque (p = 0.04). The degree of carotid stenosis correlated significantly with the number of vascular risk factors identified in individual patients (p = 0.02). The presence of risk factors was more common in CRAO and BRAO patients compared with the AF group. Combined ultrasound-Doppler investigations of the carotid bifurcation are valuable noninvasive tools for the screening of patients with retinal ischemia.
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PMID:Atherosclerotic carotid artery disease in patients with retinal ischemic syndromes. 328 40

Forty-seven consecutive patients presenting acutely with repetitive symptoms indicative of anterior circulation ischemia ("crescendo" transient ischemic attacks) were evaluated to identify clinical features that might reliably predict the presence of significant stenosis, ulceration, or both in the presumably symptomatic internal carotid artery. Angiographic or intraoperative correlation was obtained in all patients, and 26 (55%) were found to have anatomically significant disease. Of 20 patients with signs or symptoms suggestive of cortical ischemia, amaurosis fugax, or both, 17 (85%) had "positive" angiograms; of 18 with numbness/weakness only, 9 (50%) had positive angiograms; of 9 whose symptoms suggested lacunar ischemia, none had positive angiograms.
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PMID:'Crescendo' transient ischemic attacks: clinical and angiographic correlations. 334 Feb 80

Sudden, transient loss of vision in one eye (amaurosis fugax) is associated frequently with atherosclerosis of the internal carotid artery in adults and may herald a stroke. Thus, cerebral angiography is often performed. Amaurosis fugax in children is uncommon and an underlying cause is rarely demonstrated. Recurrent episodes of amaurosis fugax occurred in five adolescents. A characteristic evolution and pattern of visual loss, consistent with choroidal ischemia as the underlying mechanism, was described by four of them. Although none of the episodes were accompanied by headache, four patients had a history of common migraine at other times or a family history of migraine. These episodes of visual loss may represent a migraine variant, and cerebral angiography is not indicated in adolescents with such a history.
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PMID:Amaurosis fugax in teenagers. A migraine variant. 334 21

A consecutive series of 369 asymptomatic patients with a carotid bruit was prospectively followed with Ocular Pneumoplethysmography (OPG). The aim of the study was to identify those patients most prone to cerebrovascular ischemia and/or progression of obstructive carotid disease. During follow-up 13 patients developed a stroke of which six were fatal (two thrombo-embolic and four haemorrhagic strokes). TIA's occurred in 15 patients, including eight patients with amaurosis fugax. TIA's occurred more frequently on the side of a haemodynamically significant stenosis (9% = 9/95) than on the side of a normal, OPG (2% = 6/274). There was no difference in the strokelocated side. The occurrence of symptoms and/or signs of cerebrovascular disease was 4% at two years and 10% at five years. The left hemisphere was affected twice as often as the right. The development of a haemodynamically significant carotid stenosis, according to OPG, was equal for the right and the left carotid arteries, being 18% at two years and 56% after 5 years of follow-up. The major risk factors for progression of obstructive disease were systolic blood pressure above 160 mmHg independent of age, diabetes mellitus and the presence of ischaemic heart and peripheral arterial obstructive disease. This study supports the contention that in a group of patients with an asymptomatic carotid bruit, a group of patients at risk from cerebrovascular accidents can be filtered out by a simple non-invasive test in combination with a complete physical examination.
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PMID:Risk factors in asymptomatic patients with a carotid bruit. 350 60

The authors present a case of acute amaurosis following a retrobulbar injection of anaesthetic. The patient was a mononephric subject in hemodialytic treatment receiving, therefore, a daily therapy by heparin. The ophthalmoscopic feature reveals a pale optic disk oedema, normal arteries and tortuous veins; the fluorescein angiography confirms the papillary oedema and the normal arterial fillings. The echographic picture shows an hematic collection through the nerve sheath. The authors analyze the main pathogenic hypothesis of the amaurosis which should be ascribed to an acute ischemia of the disk caused by the hematoma formed through the nerve sheath. The role of the general conditions of the patient, mononephric in hemodialytic treatment, is emphasized as a possible risk factor even for a retrobulbar injection.
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PMID:[Acute ischemia of the optic nerve after retrobulbar injection]. 354 99

Gaze-evoked amaurosis is a transient monocular loss of vision occurring in a particular direction of eccentric gaze. Six cases are reported with a mean follow-up of 5 years; three with optic nerve sheath meningiomas and three with orbital cavernous hemangiomas. Five of the six patients have had no visual deterioration during follow-up. Bilateral optic nerve sheath meningiomas led to visual deterioration in both eyes of one patient, but gaze-evoked amaurosis was present in only one eye. The symptom of gaze-evoked amaurosis, while alarming, is not predictive of permanent visual loss. Possible mechanisms for gaze-evoked amaurosis include inhibition of axonal impulses or transient optic nerve ischemia.
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PMID:Gaze-evoked amaurosis. 358 95

In a retrospective study, patients with 125 ocular arterial occlusions (71 men, 54 women) observed between 1978 and 1981 were analyzed with regard to etiology, therapy, and course of disease. Particular attention was given to information obtained by means of Doppler sonography. Among our patients the most common condition was occlusion of either the central retinal artery or its branches (62 cases), as opposed to 30 patients with apoplexia papillae, 6 with chronic ocular ischemia (or ischemic ophthalmopathy), and 4 with less common types of occlusion. In the patient collective as a whole, the causes in those over 50 years of age are predominantly hypertony, arteriosclerosis, and emboli, as well as other causes which cannot be determined with certainty. If occlusions of the central artery and its branches and amaurosis fugax are considered alone, emboli are by far the most common cause. According to the findings with Doppler sonography, the most frequent source of emboli appears to be the bifurcation of the carotid artery. A chronic ocular ischemia (also known as ischemic ophthalmopathy) is always indicative of obstruction of the carotid artery. The situation is completely different in apoplexia papillae, which is, as a rule, either secondary to an affection of the smaller vessels, hypertonically arteriosclerotic, or caused by inflammation, as is the case in temporal arteriitis. Doppler sonography is of paramount importance as a simple, non-invasive method for determining the pathogenesis of ocular arterial occlusion. It also provides pointers to further clarifications which could lead to bypass surgery being indicated. In those patients in whom such examinations were possible, the findings were pathologic in all cases of chronic ocular ischemia (6 out of 6), in 84% of the cases of amaurosis fugax, in 62.5% of the cases of occlusion of the central artery or its branches, but only in 23% of the cases of apoplexia papillae, which further distinguishes this later condition from the other forms of occlusion. Frequently suggested therapies, for example RheomacrodexR, failed to produce any convincing results in our patient collective - not only those with central arterial thrombosis but also those with apoplexia papillae. In a statistical comparison, no significant difference could be demonstrated between our treatment of apoplexia papillae without corticosteroids (as long as arteriitis temporalis was not involved) and that of Hayreh, who administered corticosteroid treatment not only for apoplexia papillae but also for arteriosclerotic conditions of the optic disk induced by hypertension.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Arterial occlusive diseases of the eye. Diagnostic contribution of Doppler sonography]. 388 75

Seven patients with occlusion of internal carotid arteries (ICAs) were prospectively followed during a mean period of 14 months. Prior to demonstration of occlusions, four patients suffered a mild stroke, and three isolated transient ischemic attacks (TIAs) or amaurosis fugax. All patients remained alive and with an unchanged functional ability. During follow-up, one patient suffered amaurosis fugax and TIAs followed by a mild stroke, three suffered isolated TIAs or amaurosis fugax, two suffered reversible cerebro-retinal ischemia of more than 24 hours, and one remained symptom free. In three cases, delayed cerebro-retinal ischemia distal to one of the occluded ICAs was systematically triggered by orthostatic, cardiogenic or iatrogenic hypotension, and resolved after adequate medical treatment or restoration of a functional collateral circulation by endarterectomy of a tightly stenosed ipsilateral external carotid artery (ECA), suggesting hemodynamic phenomena. In three cases, micro-emboli originating from a stump or an ulcerated ipsilateral common carotid artery and migrating through well-developed ECA collateral channels explained delayed episodes of ipsilateral TIAs or amaurosis fugax, which disappeared in two cases after adequate anticoagulant therapy was introduced. Bilateral occlusion of ICA may be a relatively benign condition, if the patients are carefully controlled and treated.
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PMID:Cerebro-retinal ischemia after bilateral occlusion of internal carotid artery. A study with prospective follow-up. 401 Sep 24


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