Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 23-year-old woman presented with headache and progressive lethargy. The diagnosis of isolated thrombosis of the straight sinus and of the deep cerebral venous system was established using cranial computerized tomography, magnetic resonance imaging, phase-contrast magnetic resonance venography, and cerebral angiography. Because of the rapid deterioration in the patient's clinical condition, the authors used direct transcatheter infusion of urokinase into the straight sinus. This treatment resulted in a successful outcome.
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PMID:Isolated straight sinus and deep cerebral venous thrombosis: successful treatment with local infusion of urokinase. Case report. 912 Jun 36

A 63-year-old male presented with sudden onset of right hemiplegia and global aphasia. On admission he was stuporous. Computed tomography (CT) revealed no abnormalities except for right intraventricular meningioma found incidentally. Emergency angiography confirmed complete occlusion of the left internal carotid artery (ICA) and left M1 trunk whereas the left ICA bifurcation remained patent. The ipsilateral ICA was permanently occluded with two detachable balloons to prevent thrombus migration into the distal ICA and middle cerebral artery (MCA), followed by thrombolysis of the clot in the ipsilateral M1 through the contralateral ICA with urokinase (total dose 420,000 U) under systemic heparinization. Partial recanalization of the ipsilateral MCA was accomplished. The time interval from onset to recanalization was about 3 hours. Postoperative CT showed no hemorrhagic transformation. Slight right paresis and mild motor aphasia persisted 2 months later and he was transferred to a rehabilitation facility. Thrombolysis of the MCA embolism can be performed through the contralateral ICA in the presence of ipsilateral ICA occlusion.
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PMID:Middle cerebral artery thrombolysis through the contralateral internal carotid artery--case report. 1534 15

We describe the case of a patient with an acute subdural hematoma (SDH) that was removed using urokinase irrigation after burr hole trephination in a limited situation where craniotomy was not possible. A 90-year-old woman was admitted to our hospital with a stuporous mental status. Computed tomography (CT) scans revealed a chronic SDH, and a burr hole procedure was performed. The patient's postoperative progression was good until the third day after surgery when we found that the acute SDH had increased on CT scans. The patient's guardian refused further surgery, and thus we drained the blood from the hematoma by injecting urokinase through a drainage catheter. We used urokinase for two days, and removed the catheter after confirming via CT scans that the hematoma was almost alleviated. The patient recovered gradually; she was discharged with few neurological deficits.
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PMID:Burr Hole Drainage with Urokinase Irrigation for the Treatment of Acute Subdural Hematoma: A Case Report. 3040 34

A 9-day-old female baby presented with complaints of progressively worsening respiratory distress and lethargy. The parents were first cousins with history of multiple fetal losses in previous pregnancies. On examination, the baby was noted to be tachypnoeic, tachycardic with poor peripheral perfusion of the lower extremities. Femoral pulses on both sides were barely palpable. Echocardiography was normal. But cardiac catheterisation revealed the presence of an intraluminal obstruction of the distal aorta by a large thrombus. An attempt to dissolve the thrombus with urokinase infusion was unsuccessful. The affected vessels were then surgically explored and a large thrombus from the common iliac artery and distal abdominal aorta was removed. Following this, the child recovered uneventfully with return of lower limb pulsation. A thrombotic profile revealed the underlying diagnosis of congenital protein C deficiency responsible for the arterial thrombosis. This is an extremely unusual presentation, hardly ever been reported before.
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PMID:Congenital protein C deficiency causing major arterial thrombosis in a neonate. 3159 83