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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An operative case of 12-year-old boy with a saccular aneurysm at the anterior communicating artery was reported. He had episodes of occasional headache during one year before admission. He was attacked by a severe headache associated with nausea and vomiting, and was admitted to Ooita Pref. Hospital under the diagnosis of subarachnoid hemorrhage four days later. On admission physical examinations revealed almost normal findings except for moderate dehydration and a blood pressure of 130/70 mmHg. Routine examinations (blood, serum including total cholesterol, urine, ECG and plain chest X-film) were normal. Neurologically there were lethalgic state, moderate nuchal rigidity and bilateral abducens paresis. Slightly hemorrhagic and xanthochromic CSF was demonstrated by a spinal puncture. An aneurysm was found at the anterior communicating artery on the right carotid arteriogram. The left carotid and the left vertebral arteriograms showed no pathologic findings. Operation via right fronto-temporal approach disclosed a berry aneurysm about 4 mm in diameter arising from the bifurcation of the right anterior cerebral and the anterior communicating artery. There was a plaque presumably an atherosclerotic change at the neck of the aneurysm. Clipping of the aneurysmal neck was done. The aneurysm was not visualized on the postoperative arteriogram, and the patient was discharged in good condition two weeks after the operation. It is true that this patient had a lesion which seemed to be an atherosclerotic plaque at the neck of the aneurysm macroscopically, but he did not have any evidence of generalized atherosclerosis or other metabolic disturbance. This plaque may be of special significance in etiological respect. In general, however, degenerative lesions like atherosclerosis occur predominantly in larger arteries than smaller arteries of the brain. Also the location of this aneurysm was at the anterior communicating artery which is reported to be implicated in anomalous vascularity on occasion. From these facts the authors considered combined congenital and acquired factors in the development of this aneurysm.
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PMID:[Intracranial aneurysm in a child--a case report and some considerations on etiology (author's transl)]. 94 72

An episode of subarachnoid hemorrhage was seen on a 22-year-old married woman, which followed vaginal spotting and convulsive seizure. The neurological examination revealed bilateral papilledema, retinal hemorrhage, neck stiffness, Kernig's sign abducens paresis on the right. The chest X-ray film showed a spherical mass lesion in the right lung. The pelvic examination disclosed no pathological findings, however, HCG (human chorionic gonadotropin) in the urine increased significantly. Intracranial metastasis of chorioepithelioma was the tentative diagnosis at the admission and the right caroid angiography was performed, which demonstrated a fusiform aneruysm of the right middle cerebral artery beside arterial shift indicating a metastatic mass lesion in the parietal lobe. At surgery the tumor was removed and the arterial change was resected. Histologically the tumor was verified and the aneurysm was produced by metastasis of the tumor to the intima and interruption of the internal elastic membrane. She was placed on the anticarcinogenic agent and later the mass lesion in the chest was operated and irradiated. The postoperative carotid angiography showed another berry-shaped aneurysm arising from the right calloso-marginal artery. After the serial treatment with Actinomycin D the aneurysm disappeared completely and the arterial branch distal to the aneurysm was thrombosed. The patient is still alive 3 years after the onset of illness. An emphasis was placed that the neurosurgeon should be aware of cerebrovascular changes due to metastasis of the chorioepithelioma while making diagnosis of subarachnoid hemorrhage of the female patients who belong to the reproductive age. Intracranial aneurysmal change due to metastatic infiltration to the arterial wall was reported.
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PMID:[Subarachnoid hemmorrhage and aneurysmal change of cerebral arteries due to metastases of chorioepithelioma (author's transl)]. 123 92

The clinical and pathologic findings of a 10-month-old girl with congenital heart disease who died after rupture of a congenital distal basilar artery aneurysm are reported. The patient developed transient minimal oculomotor nerve paresis 7 days prior to suffering a massive subarachnoid hemorrhage. The finding of transient third nerve dysfunction, particularly in the context of recurrent syncope, should prompt investigation for an intracranial arterial aneurysm.
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PMID:Transient oculomotor nerve paresis in congenital distal basilar artery aneurysm. 138 22

A 25-year-old female suddenly developed headache and diplopia. On admission, neurological examination revealed neck stiffness and left abducens nerve paresis. A computed tomographic scan suggested subarachnoid hemorrhage. Left vertebral angiogram showed an aneurysm on the anterior pontine segment of the right superior cerebellar artery (SCA) and marked flexion and meandering of the basilar artery to the left. At surgery, an atherosclerotic, fusiform aneurysm was found through the right subtemporal transtentorial approach, and the right SCA was clipped just proximal to the aneurysm. Thirteen cases of SCA aneurysm have been described in the literature, but none was a fusiform aneurysm.
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PMID:Fusiform superior cerebellar artery aneurysm presenting with contralateral abducens nerve paresis--case report. 169 32

A 48-year-old female suffered from severe headache, vomiting, and disturbance of consciousness. On admission, she was somnolent with mild paresis of the left leg. Precontrast computed tomography (CT) scans showed a high-density area in the left sylvian fissure and the posterior horn of the left lateral ventricle. Angiographically, a right middle cerebral artery aneurysm and a basilar artery aneurysm were recognized. Furthermore, on the venous phase of bilateral carotid angiograms, superior sagittal sinus (SSS) thrombosis was recognized. Subarachnoid hemorrhage (SAH) was probably induced by rupture of a dilated vein associated with SSS thrombosis, because high-density area on CT scan and location of the aneurysms were different. The patient was initially treated conservatively. Two months later, craniotomy was performed which did not disclose any trace of hemorrhage around the aneurysms and aneurysms themselves. Postoperatively, acute brain swelling and generalized convulsion were induced. The patient became ambulatory 5 months after surgery. In SAH cases, the venous phase should be examined at least in one side of the carotid arteries. In such a SAH case induced by venous thrombosis complicated by aneurysms it is very difficult to decide the timing of surgery for aneurysms.
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PMID:[Superior sagittal sinus thrombosis complicated with multiple aneurysms presenting as subarachnoid hemorrhage. Case report]. 172 64

Thirty-seven patients with 44 intracavernous carotid artery aneurysms (ICCAAns) were seen at one institution from 1976 through 1988. Fifteen patients had multiple intracranial aneurysms and 7 had bilateral ICCAAns. Age at diagnosis ranged from 15 to 80 (median 61). Thirty patients were women. Sixteen had a history of hypertension. In 34% of patients the ICCAAns were asymptomatic at diagnosis, 36% were associated with headache, and 57% had associated signs or symptoms of mass effect including sixth nerve paresis (43%), trigeminal pain or sensory loss (32%), third nerve paresis (20%), decreased vision or visual field cut (18%), fourth nerve paresis (16%), and Horner's syndrome (7%). In 4 patients the ICCAAns ruptured, leading to subarachnoid hemorrhage in 3 and epistaxis in 1. Two patients with ICCAAns were seen with spontaneous thrombosis of the ipsilateral internal carotid artery leading to distal ischemic symptoms in 1. More than 90% of the ICCAAns were saccular. Thirty-four percent were small (less than 1 cm), 48% were large (1 to 2.5 cm), and 16% were giant (greater than 2.5 cm). The majority arose from the anterior genu of the intracavernous internal carotid artery, followed in frequency by the horizontal segment, and then the posterior genu. Magnetic resonance imaging is superior to computed tomography for diagnosing ICCAAns and is the screening procedure of choice. Angiography remains the "gold standard" for diagnosis and determining specific anatomic details necessary to plan therapy. Analyzing the radiographic anatomy of 44 ICCAAns. we conclude that theories attributing the origin of aneurysms to arterial bifurcations may be inadequate to explain the point of origin and direction of take off of up to one-fourth of ICCAAns.
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PMID:Aneurysms of the intracavernous carotid artery: clinical presentation, radiographic features, and pathogenesis. 229 81

Ninety patients were studied who had been admitted to Dijkzigt Hospital in Rotterdam between January 1980 and April 1987 with subarachnoid haemorrhage (SAH) due to an aneurysm at or near the junction of the internal carotid artery with the posterior communicating artery (IC-PC). An evaluation was made of the early neuro-opthalmological symptoms and the mortality in patients with paresis of the oculomotor nerve (N.III). The importance of early recognition of the condition is emphasized and a prospective investigation of the early symptoms of SAH in ophthalmological practices in the Netherlands is proposed.
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PMID:Early symptoms of subarachnoid haemorrhage due to aneurysms of the posterior communicating artery. 323 93

During the 6 year period from January 1980 to December 1985 44 patients with infection of the central nervous system by Gnathostoma spinigerum or Angiostrongylus cantonensis were admitted to the Division of Neurology, Ramathibodi Hospital, Bangkok, Thailand. In 16 patients the diagnosis could be confirmed serologically by means of ELISA techniques. In gnathostomiasis encephalitis, myelitis, radiculitis and subarachnoid haemorrhage formed the majority of clinical syndromes. Intracerebral haematoma and transitory obstructive hydrocephalus are described in this report as being caused by Gnathostoma spinigerum infection for the first time. In angiostronglyus infections the clinical syndrome of meningitis was predominant, but one patient, whose angiostrongyliasis was proved serologically, also showed bilateral paresis of abducens nerve. The main laboratory finding was eosinophilic pleocytosis in the CSF (greater than 10%) which in patients originating or returning from South-East-Asia, particularly Thailand, is highly suggestive of these parasitic infections. Increasing transcontinental travel, influx of refugees and those seeking asylum as well as importation of food from South East Asian countries demand greater awareness of these parasitic infections even in Central Europe.
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PMID:Eosinophilic meningitis and radiculomyelitis in Thailand, caused by CNS invasion of Gnathostoma spinigerum and Angiostrongylus cantonensis. 335 33

Somatosensory evoked potentials (SEP) were used intraoperatively 25 cerebral aneurysm cases during the temporary occlusion of the parent artery of the aneurysm under moderate hypothermia. This technique of vascular occlusion is very useful in facilitating the dissection of difficult aneurysms as well as in reducing the risk of intraoperative rupture. Middle cerebral artery (MCA) cases in Hunt & Hess's grade III, undergoing early surgery, who had shown a transient neurological deficit at the time of subarachnoid haemorrhage or where vasospasm was evident in intraoperatively were prominent among 6 cases where the median nerve SEP was lost within 13 minutes of temporary MCA occlusion at 28.6 degrees C to 31.1 degrees C. A transient neurological deficit was seen in one of these and a permanently increased deficit in the other. In contrast, the SEP was well maintained during occlusion times of upto 52 minutes in 8 cases in the absence of any of the above circumstances. The SEP was lost after 7 minutes in one of 5 cases of internal carotid artery occlusion; this was followed by a paresis of a few hours' duration. The posterior tibial nerve SEP was absent for one minute in one of 5 cases of bilateral A1 segment occlusion; none of these cases showed a postoperative deficit. It is concluded that 1. appropriate SEP monitoring can make a major contribution to patient safety in aneurysm surgery, 2. substantially longer cerebrovascular occlusion times are permissible during hypothermia than at normal temperatures and 3. the employment of additional cerebral protective measures should be considered in cases at high risk from ischaemic damage.
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PMID:Somatosensory evoked potentials in cerebral aneurysm surgery. 339 99

Development of epilepsy was studied prospectively in a group of 77 consecutive stroke patients. Included were stroke patients less than 75 years old admitted within the first 3 days after the stroke. Excluded were patients with subarachnoid hemorrhage, vertebrobasilar stroke, and patients with other severe diseases. Cerebral angiography, CT, and EEG were performed in all patients. The patients were followed clinically for 2 to 4 years. Seven patients (9%) developed epilepsy. Of 23 patients with lesions involving the cortex, 6 (26%) developed epilepsy. Of 54 patients in whom the cortex was not involved, only 1 (2%) developed epilepsy. Patients with persisting paresis and cortical involvement seem to be at particularly high risk of developing epilepsy, as 50% of such patients (6 of 12) developed the disease.
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PMID:Epilepsy after stroke. 360 Oct 84


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