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

We report the efficacy and safety of endovascular treatment of basilar tip aneurysms (BTA) in five patients with moyamoya disease. The patients underwent intra-aneurysmal embolisation with detachable platinum coils. Three BTA presented with subarachnoid haemorrhage (SAH); the other two were asymptomatic. In four cases, one embolisation procedure produced >95% angiographic obliteration of the aneurysm. In the other patient, 80-90% obliteration was achieved initially, but due to growth of the residual aneurysm, the procedure was repeated 7 months later. Two patients experienced transient oculomotor paresis as a procedure-related complication. Mean follow-up was 43.6+/-34.0 months (range 8-92 months). One patient died of putaminal haemorrhage unrelated to the aneurysm 15 months after embolisation. The other four had no subsequent SAH and survived without sequelae. Endovascular embolisation using detachable platinum coils proved to be a safe and efficient treatment modality for BTA associated with moyamoya disease.
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PMID:Endovascular treatment of basilar tip aneurysms associated with moyamoya disease. 1277 81

Two cases of complete unilateral oculomotor nerve palsy occurred after subarachnoid hemorrhage (SAH) due to a ruptured anterior communicating artery aneurysm. A 61-year-old female suffered left oculomotor nerve paresis after mild SAH. This paresis was probably related to pre-existing oculomotor nerve stretching caused by abnormal positioning of the posterior cerebral and superior cerebellar arteries in the premesencephalic cistern. A 70-year-old female suffered right oculomotor nerve paresis after severe SAH. Elevated intracranial pressure might have caused this paresis, but the reason for the unilateral occurrence was undetermined. Both patients were treated by clipping of the aneurysm, and the signs of oculomotor nerve paresis gradually resolved. A pattern of pupil-sparing paresis was observed during the early recovery stage in both patients.
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PMID:Unilateral oculomotor nerve paresis associated with anterior communicating artery aneurysm rupture--two case reports. 1462 Jan 99

A case is presented with severe infra- and supratentorial subarachnoid haemorrhage (SAH) caused by intramedullary haemangioblastomas of the cervical spinal cord. The patient initially had a typical SAH symptomatology without neurological deficit. The cerebral angiogram was nondiagnostic. After admission the patient developed slightly progressive right sensorimotor paresis. Angiography of the cervical spine and MRI delineated three intramedullary haemangioblastomas. Retrospectively the diagnosis of von Hippel-Lindau (VHL) disease was made by multiple haemangioblastomas and a positive family history. The three lesions were surgically completely removed.
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PMID:Subarachnoid haemorrhage due to cervical spinal cord haemangioblastomas in a patient with von Hippel-Lindau disease. 1462 7

Paresis of the oculomotor nerve associated with subarachnoid haemorrhage is considered a hallmark of aneurysms located at the junction of the internal carotid artery and posterior communicating artery. Third nerve palsy can also be caused by those aneurysms located in the intracavernous part of the internal carotid artery, basilar artery, posterior cerebral artery and superior cerebellar artery. However, oculomotor nerve paresis caused by an anterior communicating artery aneurysm is a very uncommon occurrence. We report a case of an elderly female with sudden severe headache who developed an acute third nerve paresis. Angiography revealed an anterior communicating artery aneurysm. Management and the pertinent literature are reviewed along with the mechanism of third nerve compression.
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PMID:Unusual neuro-ophthalmic presentation of anterior communicating artery aneurysm with third nerve paresis. 1533 48

Six patients with intracavernous carotid artery aneurysms (ICCAAns) were seen at our department from 1998 to 2002. All patients had only one intracranial aneurysm and their ages at diagnosis ranged from 36 to 72 years (median 56). Five were women and four had a history of hypertension. One patient was pregnant. All of the ICCAAns were symptomatic at diagnosis. Duration of symptoms was 2-30 days. On admission to our department, initial symptom was headache in four patients, visual loss in two, eye pain in one, third nerve paresis in two and subarachnoid hemorrhage (SAH) in one. Spontaneous thrombosis was present in two patients. All of the ICCAAns were saccular. Computed tomography (CT) was superior when compared with magnetic resonance imaging (MRI) for diagnosis of ICCAAns on admission. Angiography remains the gold standard for diagnosis and determination of specific anatomical details, which are necessary to plan treatment.
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PMID:Intracavernous carotid artery aneurysms. 1551 63

We report a case of ruptured internal carotid artery aneurysm with contralateral oculomotor nerve paresis. A 69-year-old female experienced a sudden onset of severe headache. Left-sided mydriasis, absence of light reflex, disability of left ocular movement and ptosis were identified. Computed tomography scan revealed massive subarachnoid hemorrhage. Cerebral angiography showed a right internal carotid artery aneurysm. No abnormal finding was observed in the left internal carotid artery or basilar artery. Magnetic resonance imaging did not show thrombosed aneurysm. The oculomotor nerve paresis lasted for ten days. Ruptured right internal carotid artery aneurysm was surgically confirmed and repaired. We speculated that the contralateral oculomotor nerve paresis was the consequence of bloody jet flow from the ruptured aneurysm.
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PMID:[A case report of ruptured internal carotid artery aneurysm with contralateral oculomotor nerve paresis]. 1583 May 43

In a retrospective study, the outcome of 87 patients with ruptured intracranial aneurysm was assessed. Follow-up included neurological examination, grading of the Glasgow Outcome Scale (GOS) of each patient, and answering a psycho-social questionnaire. This questionnaire was answered by the patients themselves or by a relative when the patient was not able to answer. The follow-up was performed more than 12 months after the occurrence of subarachnoid hemorrhage (SAH) in each patient. The psycho-social questionnaire pertained to the degree of independence in everyday activities, household management, stress endurance, memory and concentration, social and leisure activities, social contacts, occupational status, and marital relationships. By summarizing the results of these domains, the quality of life was then determined using the method described by McKenna et al. Neurological deficits in the form of an incomplete paresis of the third cranial nerve and subjective reduction of memory and concentration were identified in 3.5 % and 34.5-39 % of the patients, respectively. Of the 87 study participants, 58.2 % were fully independent, 22.4 % were able to live at home with the support of their relatives, and 5 patients were fully dependent. The occupational status of 21 patients who were fully employed before SAH was unaffected, whereas 3 patients were placed in positions with less responsibility, and 21 patients were either unable to continue working, unemployed, or retired. The quality of life was not reduced in 57.2 %, while a mild reduction in the quality of life was reported by 23.8 % and a severe reduction by 19.0 % of the participants. The ability of the initial Hunt and Hess grade, the initial Fisher grade, the extent of neurological deficits, and the occupational status after SAH to predict the patient's outcome was also evaluated. For statistical analysis, the Kendall-Tau-b-test for non-parametric correlations was applied. Significant correlations were found between the initial Hunt and Hess grade and the initial Fisher grade, between neurological deficits and GOS, between quality of life and occupational outcome, as well as between the GOS and quality of life assessment, but not between initial Hunt and Hess grade and GOS or quality of life, between neurological deficits and quality of life, between initial Hunt and Hess grade and occupational outcome, between initial Fisher grade and occupational outcome, and also not between initial Fisher grade and GOS or quality of life. Our results suggest that neither the initial Hunt & Hess grade nor the initial Fisher grade are suitable parameters for predicting the outcome of patients with ruptured intracranial aneurysms. The fact that GOS and quality of life correlated significantly confirms the use of GOS as a simple method for evaluating patient outcome, although it is not a grading system for evaluating functional disorders such as memory or subtle cognitive impairments.
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PMID:Neurological and psychosocial outcome after subarachnoid haemorrhage, and the hunt and hess scale as a predictor of clinical outcome. 1611 53

The incidence of intracranial aneurysms in infancy is relatively rare. They are infrequent in children less than 1 year old, and are an exception in the neonatal period. They usually originate in the internal carotid artery bifurcation, posterior circulation and seldom in the territory of the distal middle cerebral artery distribution. Infants often present with nonspecific symptoms: irritability, lethargy, vomiting, seizures and coma. Sometimes, they may present with unexpected clinical symptoms such as peripheral facial palsy. Subarachnoid hemorrhage is the most frequent presentation in this kind of aneurysms. Intracerebral hematoma is unusual. We present the case of a 10-week-old child harboring a middle cerebral artery aneurysm. To our knowledge, this is the first case of an aneurysm presenting as a peripheral facial paresis in a pediatric patient.
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PMID:Congenital aneurysm presenting as peripheral facial paresis. 1799 41

Wide exposure of lesions during the subtemporal approach often leads to temporal lobe injury caused by excessive retraction. A brain retraction technique using gelatin sponge pieces was developed to minimize intraoperative brain retraction during the subtemporal approach. After aspirating cerebrospinal fluid and slackening the temporal lobe, 2-3 pieces of gelatin sponge are inserted between the dura and surfaces of the anterior and posterior parts of the temporal lobe, then covered with cottonoids. The gelatin sponge pieces expand and thus expose the free margin of the tentorium with minimal brain retraction. This technique was used in 50 patients undergoing clipping for cerebral aneurysms. Although computed tomography indicated minor brain injury caused by retraction in three patients with ruptured aneurysm of the basilar artery bifurcation, no patients experienced new neurological deficits other than transient ipsilateral oculomotor nerve paresis. In conclusion, gelatin sponge, with its innate mechanical characteristics and ease of application, seems to offer an alternative retractor in neurosurgical interventions using the subtemporal approach for patients with unruptured aneurysm or non-severe subarachnoid hemorrhage.
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PMID:Brain retraction technique using gelatin sponge in the subtemporal approach. 1836 64

The congenital retinocephalic facial vascular malformation syndrome is characterized by unilateral, nonhereditary retinal and cerebral arteriovenous malformations (AVMs) and is occasionally associated with orbital vascular changes. Typical signs are facial and oral mucosal vascular changes, rarely with changes of the maxilla or mandible. An AVM causes high blood flow because of direct connection (shunting) of major vessels without interposition of capillaries. Ocular complications include retinal and vitreous hemorrhages, edema, venous occlusion (risk of rubeosis iridis and secondary glaucoma). Neuroophthalmological changes comprise optic atrophy, papilledema, proptosis, pupillary changes, hemianopia, gaze paresis, nystagmus, cranial nerve palsies, strabismus, and amblyopia. Neurological complications include headache, subarachnoid hemorrhage, convulsions, cerebral hemorrhages, increased intracranial pressure, hydrocephalus, and stroke with hemiparesis. Threatening oral hemorrhages or epistaxis may rarely occur.
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PMID:[Congenital retinocephalic facial vascular malformation syndrome. Bonnet-Dechaume-Blanc syndrome or Wyburn-Mason syndrome]. 1915 63


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