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)

Low-velocity gunshot fractures of the forearm are complex injuries and previously published studies have not emphasized the problems particular to these forearm lesions. Of the twenty-nine patients in this series, thirteen had peripheral nerve injuries, three had impending Voklmann's ischemia, and ten had delayed union or malunion of fractures after treatment by closed methods. Only thirteen had none of these problems. Eight patients had long-term disability resulting either from permanent nerve damage with loss of sensation or weakness of grip, or from significant loss of motion following delayed union or malunion. Although external fixation was adequate for undisplaced fractures, delayed (seven to fourteen days) primary internal fixation after the initial phase of wound healing had proved benign gave superior results in displaced fractures.
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PMID:Extra-articular low-velocity gunshot fractures of the radius and ulna. 34 6

We present two patients with clinical features of infarction in the distribution of the anterior inferior cerebellar artery (AICA) who had vertigo as an isolated symptom for several months prior to infarction. Both had risk factors for cerebrovascular disease and other episodes of transient neurologic symptoms not associated with vertigo. At the time of infarction they developed vertigo, unilateral hearing loss, tinnitus, facial numbness, and hemiataxia. MRI identified hyperintense lesions in the lateral pons and middle cerebellar peduncle on T2-weighted images. Audiometry and electronystagmography documented absent auditory and vestibular function on the affected side. Since the blood supply to the inner ear and the vestibulocochlear nerve arises from AICA, a combination of peripheral and central symptoms and signs is characteristic of the AICA infarction syndrome. The vertigo that preceded infarction may have resulted from transient ischemia to the inner ear or the vestibular nerve.
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PMID:Vertigo and the anterior inferior cerebellar artery syndrome. 146 78

Five patients with a side-to-side arteriovenous fistula complaining of pain, numbness, and cold sensation were evaluated by pulse oximetry. Low SaO2 was noticed in all five. Closure of a major proximal venous collateral vessel eliminated the steal and resulted in SaO2 correction and was followed by clinical amelioration. Pulse oximetry proved to be a helpful adjunct in the evaluation of the painful hand after creation of an arteriovenous fistula. By applying the pulse oximeter to the patient's affected limb, we were able to determine whether the pain was a result of ischemia and if the correction of the steal improved oxygenation.
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PMID:Pulse oximetry in the evaluation of the painful hand after arteriovenous fistula creation. 192 Jun 51

A 42-year-old woman developed an abrupt onset of severe headache, nausea, vomiting, unstable gait and numbness around the right side of her mouth and in her right hand. Neurological examination revealed bilateral pyramidal tract signs and hypesthesia of her right palmar tip and the right side of her mouth. However, pain and temperature sensibility was preserved. Cerebrospinal fluid was clear and colorless. CT scan showed an enhancing mass in the prepontine cistern compressing the pontine base. Vertebral angiography revealed irregular narrowing of bilateral vertebral arteries (string sign) proximal to a fusiform aneurysm on the entire length of the basilar artery. MRI showed double lumina in the wall of the aneurysm. The medial lemniscus conducts the discriminatory tactile and the deep sensory impulses from the extremities. The ventral ascending tract of the trigeminal nerve conducts the discriminatory tactile sensory impulses from the face. These two tracts lie close together in the pontine tegmentum, which is also a watershed area of the paramedian branches and circumferential branches of the basilar artery. We suggest that in this case the dissecting aneurysm caused ischemia of these two tracts in the left pontine tegmentum, presenting right cheiro-oral syndrome.
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PMID:[A mechanism of cheiro-oral syndrome due to brainstem lesions, a case of a dissecting aneurysm of the basilar artery]. 193 69

Sympathetic nerve activity was recorded with micro-neurography, and this activity in lumbar spine disease was evaluated. The recording was made with 2-5 omega impedance tungsten microelectrodes in human common peroneal nerve. Sympathetic nerve activity was expressed as bursts numbers per minute, and bursts per 100 heart beats. For the skin sympathetic nerve activity, reflex latencies were 0.80 +/- 0.16 seconds. These values were clearly longer than those of myelinated A fiber, reflecting the conduction velocities of unmyelinated C fiber that forms postganglionic sympathetic fiber. Muscle sympathetic nerve activity in lumbar spine disease with leg symptoms increased in comparison with other subjects. These results suggest this condition induces latent ischemia of the leg that may cause coldness or numbness in the leg.
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PMID:[Microneurographic study of sympathetic nerve activity of the lower leg in lumbar spine diseases]. 195 95

Vascular lesions of the hand may be seen in athletes exposed to repetitive blunt trauma. Thirteen athletes seen from 1983 to 1988 experienced symptoms related to hand ischemia. Nine were professional baseball catchers. The majority of patients complained of chronic symptoms, including cold hypersensitivity (four patients), finger numbness (one), finger coolness (three), and finger blanching (three). Two patients had acute symptoms with sudden posttraumatic hand ischemia with finger and palmar pain. Diagnosis was established by history and physical examination and confirmed by noninvasive testing. Testing included use of Doppler examination and cold tolerance examination with thermistors. Two athletes required angiographic evaluation because of severe ischemia and continuous pain. All patients in this group were managed nonoperatively. Those with chronic complaints were counseled regarding cold avoidance and instructed to increase their glove padding. The two patients with acute symptoms required vasodilator (papaverine chloride) infusion, followed by intravenous heparin and dextran. All baseball catchers returned to their sport with dissipation of symptoms.
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PMID:Arterial abnormalities of the hand in athletes. 225 95

Renal transplantation is an accepted treatment for patients with end stage renal disease from insulin-dependent diabetes mellitus. Acute lumbosacral plexopathy developed following renal transplantation in 4 female patients with insulin-dependent diabetes mellitus between January 1, 1981 and June 30, 1988. In all 4 patients the internal iliac artery was used for revascularization of the renal allograft with ligation of the anterior and posterior divisions. Within 24 hours of surgery they complained of ipsilateral buttock pain, numbness in the leg and weakness below the knee. This complication has not been observed in nondiabetic patients at our institution, nor in diabetic patients when the internal iliac artery was not used. However, lumbosacral plexopathy occurred in 4 of 27 (14.8%) female patients with insulin-dependent diabetes mellitus when the internal iliac artery was used (p less than 0.001). Age, duration of insulin-dependent diabetes mellitus, hypertension, cigarette smoking history and kidney donor were not significant predictors of this complication. This unusual and newly recognized complication appears to result from ischemia of the lumbosacral plexus following ligation of the internal iliac artery in patients with severe small vessel disease.
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PMID:Acute lumbosacral plexopathy in diabetic women after renal transplantation. 229 36

Intraaortic balloon (IAB) is a well accepted and useful therapeutic option; the complications reported with it's use are varied. We have observed 4 patients over a period of 6 years, who developed swollen tender calves and loss of sensation and/or function, yet who retained a warm limb with palpable peripheral pulses during or immediately after IAB pumping. At fasciotomy, they had bulging ischemic muscles. We hypothesize that this is compartment syndrome following temporary or partial ischemia due to balloon placement. We have prospectively studied 13 patients by measuring the pressure in the anterior compartment of the lower limb using the slit catheter technique. In 11 of these patients with no evidence of complications, pressure measurements remained below 7 mmHg. In one patient showing signs consistent with compartment syndrome, pressures up to 35 mmHg were recorded and at fasciotomy, the diagnosis was confirmed. A second patient with signs suggestive of compartment syndrome, had pressures below 15 mmHg. This patient was treated conservatively with resolution of the condition. Compartment syndrome after IAB placement has only been rarely described. We believe this is due to inadequate diagnosis and that slit catheter pressure measurements are a valuable tool in its management. We encountered no complications associated with the technique.
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PMID:Compartment syndrome and intraaortic balloon. 243

The scenario is all too familiar. A patient has a surgical procedure. Anesthesia is uneventful and the procedure goes well. Nothing untoward is observed in the recovery room. Later that evening the patient complains of numbness, weakness, or pain, and a neurological deficit is found. A neurologist is called, examines the patient, and it is concluded that a nerve lesion has occurred, because of stretch, ischemia, compression, or laceration. A subsequent electromyogram and nerve conduction study confirm the clinical impression, but offer little in the way of explanation. Over the subsequent months, the patient makes a slow recovery but there has been a prolonged period of pain and disability. Liability issues loom. This scenario could reflect a number of different nerve lesions. This review illustrates the different modes of pathogenesis that may occur and the variable nature of the neurological deficits. We grouped these lesions according to the clinical setting in which they occur.
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PMID:Perioperative nerve lesions. 255 97

Chronic vascular insufficiency of the fingers may turn in acute ischemia with cold. The authors report three cases. The first patient showed on his forefinger a distal thrombosis of the ulnar collateral artery and a very thin radial collateral artery. The second patient has interruption of both indicis collateral arteries. The third patient presented an ischemic fifth finger secondary to a distal ulnar artery stenosis. All of the patients complained of pain, numbness, cyanosis or necrosis of the tip aggravated by cold. Laboratory and vascular investigations included digital Allen Test, plethysmography, Doppler examination, axillary block and angiography. The cause may be local and easily cured by surgery, but sometimes the vasospastic component is predominant. If stopping smoking, vasodilators and calcium-inhibitors are ineffective, Flatt has proposed distal digital artery sympathectomy.
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PMID:[Acute ischemia of the fingers]. 259 99


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