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)

A 25-year-old white man presented with acute multiple sclerosis manifested by right blindness, difficulty urinating, and paresthesias and weakness of both legs. Retinal examination revealed a distal occlusion of the descending branch of the superior temporal arteriole leading to an area of retinal ischemia of the right eye. The optic disc was edematous, and there were focal areas of periphlebitis. All retinal signs resolved in three weeks, and the only abnormality that persisted was a pale right optic disc. The finding of small arteriolar disease is unusual and may represent another possible pathogenetic mechanism in multiple sclerosis.
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PMID:Retinal arteriolar occlusion in multiple sclerosis. 371 37

In Japan, diabetic patients are known to be able to sit on the floor for a prolonged time because of mildness or absence of ischemic paresthesia. In order to investigate this resistance to ischemia quantitatively, the mixed nerve function of the median nerve was studied during 30 min of ischemia using surface electrodes in 60 diabetic patients and 15 normal subjects. In studies of 33 unequivocal diabetics, potential amplitudes decreased during ischemia more slowly than in the controls, and at 15 min of ischemia, potential amplitudes were greater in all 33 diabetics than in the 15 normal subjects. The relationship between the resistance to ischemia and various aspects of diabetes was studied further in the 60 diabetics including the 33 aforementioned patients. Resistance to ischemia was found in almost all diabetics and no significant correlation was shown with values for fasting blood glucose and HbA1c, other diabetic complications or duration of diabetes. However, values for potential amplitudes declined to the normal range in seven of 18 patients after strict glucose control. These results suggest that resistance to ischemia is the earliest manifestation of peripheral nerve dysfunction and is different from classical diabetic neuropathy. Furthermore, the method employed in this study is simple, noninvasive and clinically very useful.
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PMID:Effect of ischemia on peripheral nerve function in diabetes mellitus. 378 Mar 80

From January 1975 to December 1985, 1454 patients had an intra-aortic balloon inserted for cardiac assistance. Eighty balloon-dependent patients had severe limb ischemia and required a femorofemoral graft (FFG) (5% of the total group of patients). Twenty-nine of the 80 patients with grafts (or 36%) left the hospital and 28 were followed up for an average of 40 months to determine late complications associated with the crossover grafts. All grafts remained patent. The 28 patients were classified into five groups according to the degree and type of lower limb ischemia. Group I consisted of 13 asymptomatic patients (46%); group II had four (14%) patients with mild claudication caused by preexisting peripheral arteriosclerosis; group III comprised four patients (14%) without preexisting disease but claudication subsequent to the FFG; group IV had five patients with irreversible ischemic sequelae before grafting ending in amputation, foot drop, or persistent paresthesia; and group V consisted of two patients with graft infection (7%). The perioperative mortality rate of the balloon-dependent patients with an FFG (64%) reflects the gravity of the cardiac condition. Placement of an FFG to relieve limb ischemia in these patients is followed by few immediate or late complications in the survivors and any persistent limb changes were related to the prolonged ischemia present before revascularization. Our data suggest that in balloon-dependent patients with limb-threatening ischemia, aggressive use of the FFG is limb-saving, durable, and allows continuation of balloon support.
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PMID:Femorofemoral grafts for lower limb ischemia caused by intra-aortic balloon pump. 379 84

Double tourniquets linked to separate Freon cannisters and two mercury manometers have been effective in maintaining ischemia in over 1,000 consecutive hand surgery operations. The mercury manometers permit constant accurate monitoring of the tourniquet pressure. The cuffs are used alternately. Each is inflated for up to 1 hour in order to limit the duration of nerve compression deep to the cuff. If there is malfunction of either cuff, the other cuff may be inflated at once. This system has permitted sustained ischemia in the upper extremity for up to 3 1/2 hours at a constant tourniquet pressure with no permanent clinically apparent sequellae. There has been no permanent nerve injury, although patients with more than 2 hours of tourniquet time often note hypoesthesia or paresthesia for 1 or 2 days. The alternating double tourniquet linked to a mercury manometer permits up to 3 1/2 hours of continuous ischemia of the upper limb with little risk of nerve damage.
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PMID:Double tourniquet with linked mercury manometers for hand surgery. 664 76

Controlled external compression was applied to the medium nerve of 16 volunteer subjects. Tissue fluid pressure in the carpal canal was monitored with a wick catheter and pressures of 30, 60 and 90 mm Hg were induced for periods varying from 30 to 90 minutes.l Sensory and motor conduction and two-point discrimination were continuously monitored. Tissue compression at 30 mm Hg caused mild neurophysiological changes and symptoms of hand paresthesias. Compression at both 60 and 90 mm Hg induced a rapid, complete sensory conduction block which consistently preceded a motor block by 10 to 30 minutes. Frequently, two-point discrimination remained normal until the last stages of preserved sensory fiber conduction. In three cases, a modification of the model utilizing an arm tourniquet, demonstrated that ischemia rather than mechanical deformation was the primary cause of the functional deterioration. It was concluded that there is a critical pressure level between 30 and 60 mm Hg where nerve fiber viability is acutely jeopardized.
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PMID:Median nerve compression in the carpal tunnel--functional response to experimentally induced controlled pressure. 708 92

Spinal cord injury in children often occurs without evidence of fracture or dislocation. The mechanisms of neural damage in this syndrome of spinal cord injury without radiographic abnormality (SCIWORA) include flexion, hyperextension, longitudinal distraction, and ischemia. Inherent elasticity of the vertebral column in infants and young children, among other age-related anatomical peculiarities, render the pediatric spine exceedingly vulnerable to deforming forces. The neurological lesions encountered in this syndrome include a high incidence of complete and severe partial cord lesions. Children younger than 8 years old sustain more serious neurological damage and suffer a larger number of upper cervical cord lesions than children aged over 8 years. Of the children with SCIWORA, 52% have delayed onset of paralysis up to 4 days after injury, and most of these children recall transient paresthesia, numbness, or subjective paralysis. Management includes tomography and flexion-extension films to rule out incipient instability, and immobilization with a cervical collar. Delayed dynamic films are essential to exclude late instability, which, if present, should be managed with Halo fixation or surgical fusion. The long-term prognosis in cases of SCIWORA is grim. Most children with complete and severe lesions do not recover; only those with initially mild neural injuries make satisfactory neurological recovery.
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PMID:Spinal cord injury without radiographic abnormalities in children. 708 88

This case report deals with a 29 year-old female patient with a prior history of a vestibular syndrome and elapsing optic neuritis that presented paroxystic episodes of painful tonic contractions affecting the right hemibody, especially the upper limb. In the hand the clinical picture was similar to that of the carpal spasm of tetany. When inducing a crisis with ischemia the electromyogram showed diplets, triplets, and multiplets following the appearance of an interference pattern syncronous with contraction of the hand. Occasionally an interference pattern was observed that was associated only to a subjective sensation of paresthesia. During the crisis and in the intercritical periods the following measurements gave normal results: serum calcium, phosphorus, sodium, potassium, magnesium, pH, and pCO2. The administration of calcium had no effect on the frequency and intensity of the crisis. The response to carbemazepine was dramatic, with complete cessation of the crisis and disappearance of the spontaneous activity in the electromyogram. Interruption of treatment one year later was followed by relapse of the painful tonic crisis. The importance of certain electromyographic features and the therapeutic response to carbemazepine in the differential diagnosis of painful tonic crisis and tetany are emphasized. The existence of two clinical-electromyographic patterns in painful tonic crisis is pointed out.
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PMID:[Painful tonic seizures in multiple sclerosis. Clinical and electromyographic aspects (author's transl)]. 724 68

Fibromuscular dysplasia is an uncommon angiopathy that is principally observed in the renal and carotid arteries. Digital ischemia resulting from fibromuscular dysplasia of the forearm arteries is a rare occurrence. This article describes a case of distal radial and ulnar artery fibromuscular dysplasia presenting as paresthesia, claudication, and finger ulceration. Angiography was diagnostic in visualizing the characteristic "string of beads" appearance. In addition to the typical histological findings, we also observed a previously undescribed pathological finding. Surgical management involved resection of the diseased segment and primary anastomosis.
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PMID:Fibromuscular dysplasia of distal radial and ulnar arteries: uncommon cause of digital ischemia. 788 60

We present a 52-year-old patient who came to the emergency room with non-specific symptoms and whose clinical profile after 24 hours included acute abdomen and paresthesia in both lower extremities. A chest film revealed mediastinic enlargement; embolism was suspected. During surgery intestinal ischemia was found in the superior mesenteric artery; this was resected and termino-terminal anastomosis was accomplished with the remaining jejunum and the descending colon. At the same time, some flaccid vesicles were removed along with embolis in the femoral arteries, leading to suspicion of hydatid embolism. Transthoracic and transesophageal echocardiography showed multivessicular masses with internal blood flow in the posterior-inferior mediastinum, suggestive a ruptured hydatid cyst in the thoracic aorta. This was confirmed by thoracic-abdominal computed tomography. The patient's condition worsened, with acute renal failure, ischemia, necrosis of both legs and multiorgan failure leading to death. We discuss the rarity of this case, the use of imaging tools for diagnosis, and the inexorability of the disease in spite of treatment.
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PMID:[Phreno-mediastinal hydatidosis and cysto-aortic fistula with multiple systemic embolism]. 793 63

A 52 year old heavy smoker complained of paresthesiae and pain at the ventral side of the right thigh and the antero-medial side of the right lower leg as well as weakness of the right quadriceps femoris during exercise. Clinical examination revealed a paresis of the right quadriceps, hypesthesia and hypalgesia in the area of the femoral nerve and a reduced right patellar reflex after 10 min walking. An occlusion of the right common iliac artery was diagnosed by angiography. Following transluminal angioplasty and implantation of an intravascular stent, the patient was free of symptoms. On the basis of the clinical observations following recanalisation of the common iliac artery, the symptoms can best be explained by a reduced perfusion of the iliolumbar artery supplying the upper part of the femoral nerve, causing ischemia of the femoral nerve during exercise. In conclusion, stenosis/occlusion of the common iliac artery should be considered as a differential diagnosis of quadriceps weakness and paresthesia in the area of the femoral nerve associated with exercise.
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PMID:[Neurogenic intermittent claudication of the femoral nerve caused by occlusion of the common iliac artery]. 823 83


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