Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ten right-handed patients suffering from visuospatial impairment were examined. The impairment was ascertained by a test requiring visual organization (picture completion). The patients did not suffer from other neuropsychological disorders (e.g., aphasia, dementia). Furthermore, psychiatric symptoms and defective oculomotion (gaze paresis, ocular paresis) were controlled. CT scan data revealed that in 4 patients the impairment was associated with lesions of the posterior right hemisphere. All lesions involved the central optic pathways and were accompanied by visual field defects. On the other hand, 6 patients turned out as suffering from damage of the cerebellum or brainstem. The available electronystagmographical data revealed impaired visual fixation, an oculomotor defect characterizing gaze apraxia, the diagnostic marker of Balint's syndrome.
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PMID:Visuospatial disorders and related lesions of the brain. 277 81

A case of anaplastic astrocytoma associated with pituitary adenoma is reported. The patient was a 33-year-old male, who was admitted with complaints of sensory aphasia, slight left motor paresis, and visual field defects. Neurological examination disclosed sensory and motor aphasia, Gerstmann's syndrome, slight left motor paresis, right homonymous hemianopsia, and bilateral choked discs. Computed tomography revealed a low density mass lesion with slight enhancement in the left temporal region and a ring-like enhanced mass lesion in the suprasellar region. In MRI, both the left temporal and the suprasellar lesions are depicted as low signal intensity areas in T1 weighted imaging, but as high signal intensity areas in T2 weighted imaging. Craniotomy was performed and both tumors were almost totally removed. The tumor in the left temporal region was diagnosed as anaplastic astrocytoma and the other in the suprasellar region was diagnosed as chromophobe adenoma. Multiple primary intracranial tumors of different cell types are rare. About a hundred cases can be found in medical literature. More than two thirds of them are cases of glioma associated with meningioma, but other combinations of tumors are extremely rare. We now report this case of astrocytoma associated with pituitary adenoma. In the literature, there are only 5 cases of similar combination. It is believed that astrocytoma and pituitary adenoma are histologically different. In three of five reported cases, the tumors were in close proximity to each other, but it is doubtful that their close proximity was related to the fact that they developed concurrently.
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PMID:[A case of anaplastic astrocytoma associated with pituitary adenoma]. 322 1

Carotid endarterectomy in 39 elderly patients was carried out under local anesthesia and neuroleptic analgesia. There were no deaths within 30 days. Two patients required an intraoperative shunt because of signs of ischemic changes (aphasia, motor changes) during two-minute test cross-clamping. In two patients, transient vocal cord paresis was observed, and seven patients (18%) experienced immediate postoperative hypertension. Our results support the contention that in awake elderly patients the need for an intraoperative shunt can be accurately assessed by simple neurological monitoring. Carotid surgery under local anesthesia and neuroleptic analgesia appears to be a safe procedure, and is especially recommended for elderly patients with hypertension, diabetes mellitus or ischemic heart disease.
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PMID:Carotid surgery under local anesthesia in the elderly. 337 34

We studied recovery from hemiparesis in 52 patients who participated in the Hennepin County (Minnesota) Recovery From Aphasia Study. Our intent was to determine the anatomic correlates of recovery from hemiparesis and then to contrast computed tomography (CT)-hemiparesis relationships with CT-aphasia relationships in this same population. Hemiparesis was assessed at one month after onset and again at six months after onset. Computed tomographic scans were obtained five months after onset and analyzed quantitatively for lesion location. The presence or absence of arm paresis was strongly predicted by CT scan findings in the supratentorial corticospinal pathway. However, three of 25 nonparetic patients had lesions in the corticospinal pathway, and one of 22 severely paretic patients lacked an appropriate lesion. This study demonstrated that a small but inherent lack of specificity and sensitivity existed in the predictive power of CT localization of lesions potentially affecting the motor system, suggesting that some caution is necessary in interpreting the lesion-deficit relationships in less well-localized functions, eg, language. Besides considering the lack of precision in localizing with CT, the existence of individual differences both in anatomy and localization of function must be taken into account.
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PMID:The validity of computed tomographic scan findings for the localization of cerebral functions. The relationship between computed tomography and hemiparesis. 395 15

Ideational apraxia is a rare behavioural disturbance observed in patients with a lesion in the posterior part of the hemisphere dominant for language. The main feature is an impairment in carrying out sequences of actions requiring the use of various objects in the correct order necessary to achieve an intended purpose. The syndrome cannot be explained as being due to paresis, aphasia, impaired visual recognition, mental deterioration or a combination of these disorders. It must be considered as a higher order motor disturbance. Perservation plays an important role but can not explain the syndrome. Evidence is presented to suggest that ideational apraxia is a disturbance in the conceptual organization of actions. Lines of future research are indicated.
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PMID:Ideational apraxia. 619 68

Noniatrogenic traumatic extracranial internal carotid artery dissections were encountered in six patients (five men and one woman) 31 to 62 years old. All but one had overt cerebral ischemia manifest by paresis (three), sensory deficits (three), aphasia (three), or amaurosis fugax (two), One patient had an asymptomatic carotid artery bruit. Cerebral arteriography established the diagnosis in all cases. Internal carotid artery impingement between the mandible and transverse processes of the second and third cervical vertebrae, or undue stretching over these vertebral structures, were the most likely primary mechanisms of injury. Secondary complications, a result of distal thromboembolism, were evident in two patients. Direct cerebral revascularization, staged internal carotid artery constriction and ligation, as well as intensive nonoperative therapy were valid therapeutic options. There were no deaths. Treatment relieved transient ischemic symptoms or arrested progression of established neurologic deficits in each case. In select patients, early surgical intervention may lessen attending neurologic sequelae.
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PMID:Extracranial internal carotid artery dissections: noniatrogenic traumatic lesions. 706 89

We presented a rare care who had right frontal lobe infarction, with left side pseudoataxia, and the mechanism, causing pseudoataxia, was considered. The patient, a 51 year-old, righ-handed male, was admitted on August 9, 1980, complaining of left-side pseudoataxia. About p.m. 7:00, July 29, 1980, he suddenly noticed numbness of the left foot, and he found himself difficulty in standing in the next morning. He had a mild paresis and tactile-tactile of the left side including the face, which was rapidly improved. However, there was pseudoataxia of the left extremities, which had not been improved. On physical examination, dysarthria, aphasia, finger agnosia, difficulty in right left orientation or muscle weakness was not recognized, and there was no sensory disturbance except for slight impairment of stereognosis, two point discrimination and vibratory sense. Demonstrable impairment of tactiletactile from was observed in the left hand. Notable dysmetria, terminal tremor and dysdiadochokinesia were seen in the left limbs, which were remarkably worsened with eyes closed. However, tapping and line-drawing tests were normal. Babinski-Weil's test disclosed typical compass gait. There was marked swaying in Romberg position. Tandem gait was impossible with a tendency to decline the left. Deep reflexies were normal except for mildly hyperactive radial reflex in the left. Carotid and vertebral angiographies revealed neither evidence of vascular occlusion nor displacement of vessels CT scan demonstrated a low density area, which included the right inferior and middle frontal gyri, the head of the right caudate nucleus and a part of anterior crus of right internal capsule. There was enlargement of anterior horn of the right lateral ventricle. Caloric test, electronystagmography, eye tracking test or optokinetic nystagmus test disclosed no abnormalities. Vibration induced falling, which is the postural reaction to muscle vibration during standing (Ekuland, G., 1972), was not recognized when the left Achiles' tendon was stimulated. Pseudoataxia of this patient differed from the typical cerebellar or vestibular ataxia. From a review of the literatures concerning frontal pseudoataxia, almost all cases had no distinct cerebellar signs, and showed positive Romberg's sign. The impairment of tactile-tactile form and postural reaction to vibratory stimulation to the left leg, appeared in this case, could be hardly explained by the lesion of parietal lobe or deconnection syndrome. Sensory perception of parietal lobe and pyramidal motor system were thought to be almost normal in this case. Therefore, these findings should be due to impairment of integration center between sensory and motor systems. The pseudoataxia in frontal lesion seems to occur as the results of involvement of this center, in which caudate nucleus maybe has important role, but not as the results of disturbances in the front-ponto-cerebellar or front vestibular pathway.
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PMID:[Frontal pseudoataxia, discussion on its mechanism (author's transl)]. 732 87

We present a rare case of thalamic germinoma with crossed aphasia in a dextral. A patient, 17-year-old righat-handed male, was admitted to Nippon Medical School Hospital with chief complaints of headache, abnormality of visual field and speech disturbance. There were pigmentations on the back of hand, foot and the perineum. Neurological examination revealed left homonymous hemianopsia, right slight degree of ptosis, left facial palsy, a mild paresis of the left upper extremity and motor aphasia. Right carotid angiography showed marked unrolling and midline shift of right anterior cerebral artery. CT scan revealed ring-like high density area in the right thalamic region, which was enhanced after constant infusion. Brain scintigraphy also showed an abnormal accumulation at the same site. The hen-egg sized tumor of 40 g. weight was almost totally removed by the right fronto-parietal craniotomy. The tumor was characterized histologically by the so-called two cell pattern with teratomatous components. As postoperative treatment local injection of adriamycine, irradiation and immunotherapy with picibanil were performed, and then left hemiparesis was markedly improved without sign of recurrence. Language evaluation was performed after operation. There were dysarthria, remarkable word amnesia, paraphasia and perseveration. Repetition was also impaired. His speech function was concluded to be a mixed type aphasia mainly composed of Broca's aphasia. The speech function of thalamus and crossed aphasia with dextrales were discussed.
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PMID:[A case of thalamic germinoma with crossed aphasia in a dextral (author's transl)]. 743 99

We assessed the anatomical findings and auditory comprehension of six patients with transcortical motor aphasia due to medical lesions of the left frontal lobe. All patients were right-handed and were initially mute for several hours after the onset, and they exhibited mild paresis of the right lower extremity. Their spontaneous speech was sparse and not fluent, and sometimes accompanied by echolalia, but their articulation was normal and repetition was excellent. They had difficulty in recalling words. A diagnosis of transcortical motor aphasia was made on the basis of their clinical symptoms. All patients were found to have an infarct in the left medial frontal region by MRI and/or CT. We administered the Western Aphasia Battery and 50 line drawing pointing task in order to evaluate auditory comprehension. Based on the results we concluded that there is no impairment of auditory comprehension of single words when lesions are limited to the superior frontal gyrus, but that lesions extending to the middle frontal gyrus interfere with auditory comprehension of single words. Our observations indicate that the middle frontal gyrus plays an important role in auditory comprehension of single words. All of the patients displayed impaired auditory comprehension of sentences even when their lesions were strictly limited to the medial frontal lobe. This suggests that the medial frontal lobe plays some role in the auditory comprehension of sentences.
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PMID:[Auditory comprehension in transcortical motor aphasia due to a medial lesions of the left frontal lobe]. 749 14

Sudden onset stroke occurred in a right-handed vietnamese woman speaking, reading and writing french fluently. When first seen in our department, the patient had mild right facial paresis and non fluent atypical aphasia. CT scan and MRI showed a left subcortical infarct in the superficial territory of the middle cerebral artery; only white matter of the semiovale centre was involved. Neurological examination revealed linguistic impairment resembling transcortical motor aphasia, with unusual stuttering, hypophonia, occasional semantic paraphasias and phonological reading and writing abnormalities. Non verbal cognitive function, gestural and buccofacial praxes were normal. Cerebral blood flow study by SPECT was consistent with left sylvian functional deactivation.
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PMID:[Aphasia caused by isolated lesion of the semi-ovale centre: contribution of the measurement of cerebral blood flow]. 753 25


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