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)

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

A 62-year-old man was admitted to our hospital, since chronic subdural hematoma was showed after he complained of mild headache and nausea. Two years ago he had head trauma at the left parietal region after drinking. On admission there was no paresis and mild choked disc is detected. Computed tomography with contrast enhancement showed abnormal enhancement and left chronic subdural hematoma. Cerebral angiography showed an aneurysm of the angular artery. Operation was done and the aneurysm was trapped. Aneurysmal wall was histologically a pseudoaneurysm. Post-operative result was good. We considered the relationship between the cortical pseudoaneurysm and chronic subdural hematoma. We reviewed the traumatic middle cerebral artery aneurysm in the literature, 56 cases.
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PMID:[Pseudoaneurysm of the cortical artery associated with chronic subdural hematoma--a consideration on traumatic middle cerebral artery aneurysm]. 382 71

Oculomotor nerve disease is a common cause of diplopia. When strabismus is present, absence of diplopia has to induce the research of either uncovering of visual fields or monocular suppression, amblyopia or blindness. We describe the case of a 41-year-old woman presenting with right oculomotor paresis and left object-centred visual neglect due to a right fronto-parietal haemorrhage expanding to the right peri-mesencephalic cisterna caused by the rupture of a right middle cerebral artery aneurysm. She never complained of diplopia despite binocular vision and progressive recovery of strabismus, excluding uncovering of visual fields. Since all other causes were excluded in this case, we hypothesise that the absence of diplopia was due to the object-centred visual neglect. Partial internal right oculomotor paresis causes an ocular deviation in abduction; the image being perceived deviated contralaterally to the left. Thus, in our case, the neglect of the left image is equivalent to a right monocular functional blindness. However, bell cancellation test clearly worsened when assessed in left monocular vision confirming that eye patching can worsen attentional visual neglect. In conclusion, our case argues for the possibility of a functional monocular blindness induced by visual neglect. We think that in presence of strabismus, absence of diplopia should induce the search for hemispatial visual neglect when supratentorial lesions are suspected.
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PMID:Could visual neglect induce amblyopia? 1574 7

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

The feasibility and reliability of combined use of transcranial and direct cortical motor evoked potential (MEP) monitoring during unruptured aneurysm surgery were evaluated. Forty-eight patients with unruptured cerebral aneurysms underwent craniotomy and neck clipping accompanied by muscle MEP monitoring. MEPs were elicited successfully by transcranial electrical stimulation in all patients. Direct cortical stimulation elicited MEPs in 44 patients. Reduction in MEP amplitude to less than 50% of baseline was considered significant. No postoperative motor paresis occurred in 39 patients in whom transcranial and direct MEPs remained unchanged. Four patients in whom direct MEPs could not be recorded had no intraoperative abnormality in transcranial MEPs and no postoperative motor dysfunction. Four of the other 5 patients manifested significant transient direct MEP changes without transcranial MEP changes. The transient MEP changes were observed in 3 patients during temporary clipping of the parent artery and in one patient with inadequate clipping of an middle cerebral artery aneurysm, and were considered due to insufficiency of blood flow. Decrease or disappearance of direct MEP waves recovered immediately after re-application of the clip and release of the temporary clip. Direct MEP waves disappeared and did not recover until the end of microsurgical procedures in one patient, although transcranial MEP amplitude remained at less than 50% of baseline. She developed hemiparesis postoperatively, which recovered within 6 hours. The duration of temporary occlusion in patients with direct MEP changes was significantly longer than that in patients without (p < 0.05). Direct MEP was sensitive in detecting ischemic stress to descending motor pathways during aneurysm surgery. Transcranial MEPs could be elicited in patients in whom direct MEPs could not be obtained, and during periods such as craniotomy or after dural closure, in which direct MEPs could not be recorded. These findings suggest that combined transcranial and direct cortical MEP recording may improve the feasibility and reliability of MEP monitoring during unruptured aneurysm surgery.
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PMID:Evaluation of combined use of transcranial and direct cortical motor evoked potential monitoring during unruptured aneurysm surgery. 2127 39

We describe a case of internal trapping including the vasa vasorum for a thrombosed giant rapidly growing posterior cerebral artery aneurysm and performing a detailed analysis. A 48-year-old woman was followed up in our hospital for a thrombosed large posterior cerebral artery aneurysm located in the P2 segment. She initially presented after experiencing a sudden headache on two occasions. Head computed tomography and magnetic resonance imaging indicated a larger aneurysm than before. Digital subtraction angiography with balloon occlusion test was assessed, and internal trapping was sequentially conducted. We detected that the vasa vasorum originated from the posterior temporal artery. Therefore, we embolized the posterior temporal artery including the vasa vasorum using N-butyl-2-cyanoacrylate and Lipiodol. Next, the anterior temporal artery was embolized with N-butyl-2-cyanoacrylate and Lipiodol, posterior temporal artery P3 segment and the aneurysm and finally the proximal P2 segment were embolized with coils. Final vertebral and internal carotid angiography showed complete obliteration of the aneurysm. On the day after the procedure her paresis worsened and she developed left upper quadrantanopia, however was finally discharged with no hemiparesis. We reported a case of a rapidly growing thrombosed giant posterior cerebral artery aneurysm treated by parent artery occlusion including the vasa vasorum with detailed image analysis.
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PMID:A case of internal trapping to a thrombosed giant rapidly growing aneurysm at the posterior cerebral artery. 3313 39