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)

Acute peripheral arterial occlusion is a medical emergency manifesting with pain, pallor, absence of pulse, paralysis, and paresthesia. Neurological deficits have occasionally been described as the presenting symptoms of acute arterial ischemia. We report a patient with acute bilateral occlusion of the femoral arteries and an underlying severe atherosclerotic aorto-iliac disease who presented with acute painless paraplegia and anesthesia in the lower extremities. The patient underwent arterial thrombectomy of the right and left femoral artery, followed by angioplasty and stent insertion of the right and left common iliac artery within 5 h from the onset of his symptoms. Subsequent physical therapy resulted in rapid improvement in the strength of his lower extremities and the patient was able to walk unaided after two weeks.
 ...
PMID:Acute painless paraparesis due to bilateral femoral artery occlusion. 1796 39

A 51-year-old woman described paresthesias in her right thumb, index, and middle fingers consistent with carpal tunnel syndrome. Using a sterile technique, a 25-G, 1 1/4-in needle was introduced ulnar to the palmaris longus tendon, and a mixture of 1.5 mL of 40 mg/mL of triamcinolone acetonide and 1.5 mL of 1% lidocaine was injected. After the injection, the patient's hand exhibited signs of ischemia including coolness and discoloration. Rewarming of the hand with paraffin was performed immediately, and normative color returned. At follow-up visits, the patient described burning in the hand, and blotchiness of the digits was noted. A magnetic resonance imaging angiogram of the right wrist showed a single deep palmar arch. Electromyography and nerve conduction study weeks after the injection showed bilateral median neuropathies, moderately severe on the right and mild on the left. She underwent an open carpal tunnel release 6 weeks postinjection. The patient did well and returned to her job without restrictions. The exact etiology of the hand ischemia is unclear but may be related to vasospasm as has been described in the spine-injection literature. Regardless of the etiology, this case shows an uncommon adverse event in a commonly performed procedure and raises questions for further review.
 ...
PMID:Digital ischemia after carpal tunnel injection: a case report. 1867 94

Persistent hypocalcemia after total parathyroidectomy and autotransplantation is rare and occasionally has been treated using allotransplantation of parathyroid tissue. We present the case of a 32-year-old woman with terminal renal failure who at age 5 years underwent a first renal transplantation from a brain-dead donor. The graft was lost as a result of acute rejection. Tertiary hypoparathyroidism developed, which was treated with total parathyroidectomy and implantation in the forearm of a standardized amount of parathyroid tissue. The graft failed, and hypoparathyroidism developed. Despite a second implantation of cryopreserved autologous tissue, severe hypocalcemia persisted with a tendency for tetany. Although the patient was highly dependent on high-dose vitamin D(3) (tacalcitol) and calcium supplements, regular paresthesias and tetany developed. At age 9 years, the patient underwent a second renal transplant from a living related donor (her mother). After 18 years, the graft was lost as a result of chronic cyclosporine toxicity and angiosclerosis. Four years later, the patient underwent combined kidney and parathyroid transplantation from a local brain-dead donor. Preservation of the parathyroid glands was in University of Wisconsin solution, with cold ischemia time of 14 hours. Directly after the renal transplantation, parathyroid transplantation was performed, with implantation in the forearm of the total amount of donor parathyroid tissue. Postoperatively, there was recovery of parathyroid function, and the patient was able to discontinue vitamin D and calcium supplements after more than 20 years.
 ...
PMID:Simultaneous kidney-parathyroid allotransplantation from a single donor after 20 years of tetany: a case report. 1932 35

A 70-year-old woman presented with a 7-day history of severe pain, paresthesia, oedema, acrocyanosis and punctate haemorrhagic lesions on her fingertips. The complaints began 2 days after the second cycle of a first-line chemotherapy consisting of cisplatin or carboplatin, and gemcitabine due to advanced urothelial carcinoma. At the fingertips of both hands, haemorrhagic and partly ulcerative lesions were found; these were attributed to vascular toxicity of gemcitabine. Therapeutically sympathicolysis by bilateral blockade of the brachial plexus was performed, accompanied by intravenous administration of the prostacyclin analog iloprost, fractionated heparin subcutaneously and oral therapy with corticosteroids and aspirin. Digital amputation could be avoided. Acral ischemia is a rare but probably underreported adverse effect of gemcitabine therapy and a potential source of misdiagnosis.
 ...
PMID:Gemcitabine induced digital ischaemia and necrosis. 1949 3

We report a case with spinal cord ischemia and consecutive paraplegia following spontaneous isolated abdominal aortic dissection (IAAD). A 63-year-old female was admitted to the surgical emergency room with severe lumbar back pain and accompanying paresthesia of both legs. Contrast enhanced computed tomograpy (CT) of the abdomen showed an infrarenal IAAD in a normal size aorta with patent lumbar arteries. It was assumed that a surgical or interventional approach would not be helpful to improve spinal cord perfusion. Therefore, non operative therapy consisted of lowering blood pressure to prevent further dissection. The patient developed an anterior spinal artery syndrome with permanent paraplegia. Thus, blood pressure was raised for optimal spinal cord perfusion. To lower the spinal pressure, cerebrospinal fluid drainage was attempted. A three month follow-up CT scan showed spontaneous remodelling of the aorta. The neurological deficit persisted. IAAD is a rare differential diagnosis of lumbar back pain and can be associated with paraplegia as the leading symptom. Individualized treatment is indicated. Surgical treatment options concerning paraplegia are limited.
 ...
PMID:Paraplegia after spontaneous dissection of the abdominal aorta. 1973 38

Carpal tunnel syndrome (CTS) is a neurological impairment caused by compression of the median nerve throughout the carpal tunnel, which consequently induces ischemia and mechanical disruption, dysfunctional axonal transport, and epidural blood flow. Most common symptoms include numbness, rather than pain, with a typical night exacerbation, weakness, paresthesia, and loss of sensitive discrimination. In rare cases, such syndrome may present with cutaneous manifestations localized on the distal phalanges of the hands, even without the above mentioned neurological symptoms. We describe a case of a woman who came to our attention complaining of the appearance of recurrent bullous eruptions involving the distal phalanges innervated by the median nerve. She did not report any neurological signs whatsoever. After excluding a bullous disease, we further investigated through additional analysis that revealed a CTS. Hence, physicians should consider CTS as a differential diagnosis when assessing cutaneous lesions of the first three fingers of the hands.
 ...
PMID:Unusual presentation of carpal tunnel syndrome with cutaneous signs: a case report and review of the literature. 2132

A 55-year-old female, presented with a 1-year history of paresthesia and intermittent weakness of her left hand. She had hypertension, and the angiographic findings revealed a "string of beads" appearance in the right renal artery. She underwent balloon angioplasty for left axillary artery stenosis, but it was complicated by dissection. Stenting for axillary artery established TIMI 3 flow to the brachial artery. This case was a result of noninflammatory and probably nonatherosclerotic disease, and the findings in this cases is consistent with those of fibromuscular dysplasia affecting the axillary arterial segment. In summary, we present details of a case presenting with brachial ischemia caused by axillary artery stenosis. We also describe the meticulous investigation required for treating this segmental arterial disease.
 ...
PMID:The interventional therapy for axillary stenosis with fibromuscular dysplasia of renal artery. 2306 12

Fibromuscular dysplasia is a rare, nonatherosclerotic, noninflammatory vascular disease that typically affects women between the ages of 20 and 60 years. Although any artery can be affected, fibromuscular dysplasia most commonly affects the renal and carotid arteries. Fibromuscular dysplasia of the renal arteries usually presents with hypertension, while carotid or vertebral artery disease causes transient ischemic attacks, strokes, or dissection. Fibromuscular dysplasia of the brachial arteries is extremely uncommon. It can induce extremity ischemia, nerve compression, or both-causing coldness, discoloration, pain, ulceration or gangrene of the fingers, paresthesias, or paralysis. We report a rare case of multivessel fibromuscular dysplasia manifested by acute stroke in association with type I aortic dissection, which progressed rapidly to ascending aortic false aneurysmal development that necessitated arch replacement. Outcomes of aortic arch replacement in this setting are currently unknown. Therefore, our case might well offer some insight.
 ...
PMID:Acute aortic dissection and stroke in multivessel fibromuscular dysplasia. 2346 36

Cerebral vasospasm is a well-known consequence of aneurysmal subarachnoid hemorrhage (SAH) triggered by blood breakdown products. Here, we present the first case of cerebral vasospasm with ischemia following a spontaneous spinal SAH. A 67-year-old woman, who was on Coumadin for atrial fibrillation, presented with chest pain radiating to the back accompanied by headache and leg paresthesias. The international normalized ratio (INR) was 4.5. Ten hours after presentation, she developed loss of movement in both legs and lack of sensation below the umbilicus. Spine MRI showed intradural hemorrhage. Her coagulopathy was reversed, and she underwent T2 to T12 laminectomies. A large subarachnoid hematoma was evacuated. Given her complaint of headache preoperatively and the intraoperative finding of spinal SAH, a head CT was done postoperatively that displayed SAH in peripheral sulci. On postoperative day 5, she became obtunded. Brain MRI demonstrated focal restricted diffusion in the left frontoparietal area. Formal angiography revealed vasospasm in anterior cerebral arteries bilaterally and right middle cerebral artery. Vasospasm was treated, and she returned to baseline within 48 hours. Spontaneous spinal SAH can result in the same sequelae typically associated with aneurysmal SAH, and the clinician must have a degree of suspicion in such patients. The pathophysiological mechanisms underlying cerebral vasospasm may explain this unique case.
 ...
PMID:Cerebral Vasospasm with Ischemia following a Spontaneous Spinal Subarachnoid Hemorrhage. 2347 68

Only 5 cases of ruptured aneurysm of the persistent sciatic artery have been previously reported to date. We experienced a case of ruptured aneurysm of the persistent sciatic artery presenting acute lower limb ischemia. Physical examination showed a pulsatile mass with a subcutaneous hemorrhage in the left buttock, drop foot and paresthesia of the foot due to limb ischemia. An enhanced computed tomography scan showed a ruptured aneurysm of the left persistent sciatic artery at the level of the greater trochanter. An exclusion of the aneurysm and creation of common iliac to popliteal artery bypass was performed as an emergency operation.
 ...
PMID:A case of ruptured aneurysm of the persistent sciatic artery presenting acute lower limb ischemia. 2355 62


<< Previous 1 2 3 4 5 6 7 8 9 Next >>