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)

The intention of the present study was to characterize patients with central post-stroke pain (CPSP) with regard to type and location of the cerebrovascular lesion (CVL), the characteristics of the pain and the neurological symptoms and signs in addition to the pain. Twenty men and 7 women with a mean age of 67 years and a mean pain duration of 44 months were examined 9-188 (mean 53) months after their stroke. The clinical symptoms and signs and the CT scans indicated that the CVL were located in the lower brain-stem in 8 patients, involved the thalamus in 9 patients and were located lateral and superior to the thalamus in 6 patients. In the remaining 4 patients the location of the CVL could not be determined with certainty. The 3 identified hematomata were all located in the thalamus. The onset of the pain was immediate in 4 patients, within the first post-stroke months in 10 patients and delayed by 1-34 months in the rest. The pain was on the left side in 18 patients. Twenty patients had hemipain. Most patients experienced more than one type of pain. The most common qualities were burning, aching, pricking and lacerating, with some differences in the frequencies according to the location of the CVL. Burning pain was most common, except among the patients with thalamic CVL, in whom lacerating pain was more common. Aching and pricking pain were also frequent. All patients considered the pain to be a great burden and most rated the pain intensity as high on a visual analogue scale. The intensity was increased by external stimuli, the most common being joint movements, cold and light touch. Five patients reported aggravation by emotional stimuli. Besides pain, the only neurological symptom common to all patients was decreased temperature sensibility, as shown by quantitative methods. It is possible that pain sensibility was also abnormal in all. Hypersensitivities to cutaneous stimuli, including evoked dysesthesias were found in 88% of the patients, while the detection thresholds for touch and vibration were abnormal in only 52% and 41%, respectively. Similarly, low figures were found for paresis and ataxia, which were present in 48% and 62%, respectively. It is concluded that only a minority of patients with central pain after stroke have thalamic lesions.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Central post-stroke pain--neurological symptoms and pain characteristics. 291 91

Pterygium inversum unguis is a nail abnormality in which the distal aspect of the nail bed/hyponychium is adherent to the ventral surface of the nail plate, resulting in obliteration of the distal groove. We present a 50-year-old man who developed this abnormality on his right fingers and toes after a stroke that resulted in paresis of his right side. Unusual features of this case include the association with a neurologic disorder, assymetric distribution, involvement of toes as well as fingers, and occurrence in the male gender.
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PMID:Unilateral pterygium inversum unguis. 306 59

There is continuing controversy about the benefits of decompressive craniectomy in the treatment of lesions causing increased intracranial pressure (ICP) and brain edema. Laboratory work has shown a decrease in ICP after craniectomy, but also a paradoxical enhancement in the formation of underlying cerebral edema, which may act to the detriment of the patient. Since Rengachary et al. advocated craniectomy for massive cerebral infarction and reported their group of three patients, we have managed five patients with acute supratentorial cerebral infarction who progressed to uncal herniation and impending death from raised ICP and brain stem compression. All were treated with frontotemporal craniectomy after conventional medical therapy failed to achieve a response. All patients survived and are walking, despite a paresis appropriate to their original stroke. Two have returned to work. Good results with supratentorial craniectomy after infarction show that this procedure is life-saving and can also give acceptable functional recovery.
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PMID:Functional recovery after decompressive craniectomy for cerebral infarction. 318 72

The authors have investigated the efficacy of training with the help of the method of electromyographic feedback (EMGFB) in 38 patients with post-stroke hemiparesis and the relationships of the training efficacy with the clinical picture of motor disturbances and the status of higher psychic functions. It as been ascertained that the effect of training does not depend on the initial degree of paresis of the trained muscles. Correlation has been established between the capacity of overcoming synergic reactions and concentration of attention, and also the level of working ability. Possible mechanisms of training with the help of EMGFB are discussed.
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PMID:[A method of electromyographic feedback in post-stroke movement disorders]. 323 55

Urinary excretion of total hydroxyproline being an indicator of the metabolism of systemic collagen was determined in 104 patients with ischaemic stroke and in 45 controls. The determinations were done by the method of Prockop-Udenfried in the urine of patients after 2 days on a non-collagen diet. Increased excretion of hydroxyproline was found in the subgroup of patients with high-grade paresis or paralysis, while in the subgroup with mild paresis these results were normal. The excretion of hydroxyproline in patients with severe paralysis increased during 3-60 days after stroke and then decreased in the period from 60 days to 5 years.
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PMID:[Urinary excretion of hydroxyproline in patients with ischemic stroke]. 338 Feb 61

The term "top of the basilar" has been used in reference to a group of signs and symptoms of midbrain, diencephalic, and posteroinferior hemispheric dysfunction. It has been attributed to ischemia in the territory of second- and third-order vessels that arise from the uppermost portion of the basilar artery. We report our experience with four patients who had alteration of consciousness, confusion, and vertical gaze paresis accompanied by other physical abnormalities. Extensive evaluation did not help in documenting the lesions or in understanding their pathogenesis. The top of the basilar syndrome is a not uncommon form of stroke and carries a variable prognosis. Treatment by anticoagulation may prevent further infarction in selected patients who are seen early.
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PMID:Altered sensorium, confusion, and vertical gaze paresis: the top of the basilar syndrome. 339 40

The quality of life for 46 stroke survivors under the age of 65 years in a stroke register was studied 4 years after their first stroke. A questionnaire covering four domains of life (working conditions, activities at home, family relationships, and leisure time activities) was used for investigation of the quality of life. The results showed that in spite of a good recovery in terms of discharge from the hospital, activities of daily living, and return to work, the quality of life of most patients (83%) had not been restored to the prestroke level. Deterioration among the several domains of life ranged from 39% to 80%, the lowest being in the domain of activities at home and the highest in the domain of leisure time activities. Hemispheral localization of the lesion, paresis, coordination disturbances, and especially subjective tendency to depression were highly correlated with a deterioration in the quality of life. Dependence in activities of daily living and an inability to return to work were also associated with the lack of restoration. Our results suggest that much more attention should be paid to the quality of life of stroke patients.
Stroke 1988 Sep
PMID:Quality of life 4 years after stroke. 341 7

A retrospective study of 75 consecutive cases of spontaneous cerebellar haemorrhage was undertaken in order to evaluate the clinical features and natural history of this condition. A wide spectrum of clinical findings contributed to the poor clinical diagnostic accuracy of 23 per cent, with common misdiagnoses including brainstem stroke and vestibular or labyrinthine disturbance. Presentation with, or the later development of stupor or coma strongly correlated with poor outcome (severe disability or death; p = 0.002). The characteristics of conscious patients who remained stable were compared with those who subsequently deteriorated. The initial conscious state (alert, drowsy or confused), severity of symptoms and ataxia, and the size of haemorrhage on CT scan were not reliable prognostic indicators. However, the presence of bilateral gaze paresis, anarthria (present in eight cases), limb weakness, a systolic blood pressure above 200 mmHg and moderate hydrocephalus significantly correlated with a poor outcome. The presence of these signs warrants consideration of urgent surgical intervention at the time of diagnosis. Since no clinical or radiological findings excluded the possibility of further deterioration, careful monitoring in an intensive care unit is necessary within the first 48 h in those conscious patients who are likely to remain stable. Guidelines for making the clinical diagnosis and for selecting those patients who will require transfer to adequately equipped centres are suggested.
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PMID:Cerebellar haemorrhage--diagnosis and treatment: a study of 75 consecutive cases. 344 85

The strength of 16 muscle groups was measured bilaterally in 38 hemiparetic stroke patients. The relationship between the strengths and gender, weight, age, side of paresis and time since onset were calculated for each muscle group. Although often correlated with the strength of the non-paretic muscle groups; gender, weight and age were very rarely correlated with the strength of the paretic muscle groups. Side of paresis was only correlated with the strength of four non-paretic muscle groups. Time since onset was generally unrelated to strength. Final strength was always correlated with initial strength on the paretic side. These results suggest that cerebrovascular accidents disrupt some of the normal strength relationships on the hemiparetic side, and that the severity of the hemiparesis early in rehabilitation may provide a good indication of the severity to be expected later in rehabilitation.
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PMID:Relationship between static strength and various other measures in hemiparetic stroke patients. 355 12

The time course of tension development produced by fast isometric contraction of the quadriceps femoris muscle for knee extension was examined on eight normal subjects and 14 patients with spastic hemiparesis due to stroke. Tension lag time (TLT), the latency from the onset of EMG activities to the rise of tension, and contraction time (FTmax), the period from the rise of tension to its maximum, were longer in the patients than in the normal subjects. The prolongation of FTmax correlated with the decreased rate of tension development. The results indicated that the temporal characteristics of tension development altered in the spastic paresis, reflecting functional changes in the muscle and motor neurons.
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PMID:The altered time course of tension development during the initiation of fast movement in hemiplegic patients. 357 13


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