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

A rare case of mesenchymal chondrosarcoma originating from the thoracic spinal dura was reported. A 10-year-old girl complained of paresis of the right leg in June 1977. Then she became unable to walk early in August, and a complete paraparesis developed on August 18. She was admitted to our department on August 22. On admission she had complete paraparesis, bilateral ankle clonus, upward plantar reflexes, sensory disturbance below T7, shincter disturbance and neck stiffness. Plain thoracic X-ray revealed bilateral decalcification of pedicles of T6. Myodil myelography showed a complete block between T6 and lower end of T7 vertebrae. Bilateral laminectomy from T3 to T8 was performed. A tumor originating from the spinal dura was located in the right dorsal extradural space. The tumor was totally removed together with a small area of the affected dura. Light microscopy showed mesenchymal chondrosarcoma. Her recovery from neurological deficiencies was excellent and now she can run 14 months after surgery. Metastasis or recurrence has not yet been seen.
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PMID:[A case of mesenchymal chondrosarcoma originating from the spinal dura (author's transl)]. 49 58

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

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

The cervical spinal cords of 30 rhesus monkeys were irradiated with 50 MeV d leads to Be neutrons or 60Co gamma rays to evaluate the dose-response relationships for radiation myelopathy. Three groups were treated with 50 MeV d leads to Be neutrons using dosage schedules of 1300 rad n gamma (Group I), 1425 rad n gamma (Group II), or 1550 rad n gamma (Group III) in nine fractions over 29 days. Three groups were irradiated with 60Co gamma rays using dosage schedules of 4620 rad (Group IV), 5390 rad (Group V), or 5940 rad (Group VI) in 22 fractions over 29 days. A significant dose-response relationship was observed for the groups treated with neutrons. Whereas none of the monkeys in Group I showed clinical evidence of neurologic dysfunction, all five animals in Group III became paralyzed. One animal in Group II developed transient neck stiffness and mild unilateral leg paresis. No definitive signs of neurologic injury were seen in any of the animals irradiated with 60Co. The histopathologic changes correlated well with the clinical observations. All of the animals in Group III exhibited moderate to severe malacia and demyelination of the white matter of the cervical spinal cord. The histologic data indicated that the RBE for five times weekly fractionation (approximately 270 rad 60Co fractions) was in the range of 4.2 to 4.6, since the malacia and demyelination in the spinal cords irradiated with 5940 rad of 60Co gamma-rays were greater than that observed in the spinal cords irradiated with 1300 rad n gamma of neutrons but less than the changes in those irradiated with 1425 rad n gamma of neutrons.
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PMID:Late effects of 50 MeV d leads to Be neutron and cobalt-60 irradiation of rhesus monkey cervical spinal cord. 686 59

In a typical case of pituitary apoplexy, a patient, who may or may not be known to harbor a pituitary adenoma, suddenly develops a severe headache. The headache may be retro-orbital, frontal, frontotemporal, or diffuse and may be associated with neck stiffness, neck pain, or both. Ophthalmoplegia may develop within a few hours after the onset of headache. Here we report a rare case of one middle-aged female with pituitary apoplexy initially presenting with acute onset of pupil-involved third cranial nerve palsy, headache and peri-ocular pain. Emergent neuroimaging revealed pituitary apoplexy and immediate intravenous corticosteroid was given and third nerve paresis was improved thereafter. Definite tumor removal was done smoothly after steroid treatment and complete recovery of ophthalmoplegia was noted 2 weeks after operation.
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PMID:Acute painful oculomotor nerve paresis caused by pituitary apoplexy--a case report. 1046 26

Pituitary apoplexy is a rare and underdiagnosed clinical syndrome. It results from hemorrhagic infarction of the pituitary gland. In its classical form it is characterized by acute headache, ophthalmoplegia, visual loss and pituitary insufficiency. Meningeal irritation signs, clinically indistinguishable from infectious meningitis, are considered rare and have not been reported as presenting signs. We report a 53-yr-old man who was admitted to hospital following acute headache, fever, neck stiffness and paresis of the left oculomotor and abducent nerves. A lumbar puncture revealed an increased number of polymorphs but with a sterile cerebral spinal fluid. Magnetic resonance imaging (MRI) showed an intrasellar mass with central necrosis in an enlarged sella. Endocrinological evaluation demonstrated insufficient thyroid, adrenocortical, and gonadal function. Necrosis within a chromophobe adenoma was found upon surgical decompression of the sella. After surgery anterior panhypopituitarism did not recover, while ophthalmoplegia subsided. The patient is now in good health under appropriate hormonal replacement therapy.
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PMID:Acute sterile meningitis as a primary manifestation of pituitary apoplexy. 1466 31

A right-handed woman of 90, taking aspirin 160 mg daily, suffered acute neck pain radiating to the shoulders, with right side hemiparesis and numbness occurring minutes thereafter. On admission 2.5 hrs later, examination showed paresis and hyporeflexia of the right limbs accompanied by neck stiffness and vertebral tenderness in level C7. Acute stroke was the initial working diagnosis. Cerebral CT was normal. Symptoms progressed with left arm numbness and left ancle clonus, and eight hours after symptom onset there was bilateral plantar inversion, reduced skin prick sensibility below C4, bladder paresis and anal sphincter hypotonia. CT myelography revealed an intraspinal mass extending from C2 to C6. 14 hours after symptom onset, a spinal epidural haematoma was removed by spinal laminectomy. Recovery and functional outcome was good. Symptoms, work-up and treatment are discussed with reference to previous publications.
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PMID:[A 90-year-old woman with acute hemiparesis]. 1693 75

A 69-year-old woman was admitted to our hospital because of disturbed consciousness. She awoke to a solid mass in her left breast, but it had been present for about 20 years. On arrival to our hospital, she was comatose, and Babinski's reflexes were present bilaterally. She had no paresis or neck stiffness. Her left breast contained a 10 cm x 12 cm node with multiple ulcers. Blood analysis showed she was in a hypercoagulative state. Computed tomography of the brain demonstrated bilateral hypodensities in the thalamus and hyperdensities at the vein of Galen and at the straight sinus. Angiography showed an absence of flow in the inferior sagittal sinus, in the vein of Galen, and in the straight sinus. Thus, she was diagnosed as having a deep cerebral venous thrombosis. She was treated by continuous heparin infusion, and her consciousness improved gradually. The biopsy of her left breast confirmed the presence of a mucinous carcinoma. The hypercoagulative state associated with the carcinoma was considered to be the cause of her deep cerebral venous thrombosis. It is very rare to diagnose deep cerebral venous thrombosis in a cancer patient while the patient is still alive. In this case, computed tomography of the brain was useful for the diagnosis.
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PMID:[Case of deep cerebral venous thrombosis associated with breast cancer]. 1904 47

Pituitary apoplexy is a rare but life-threatening disorder. Clinical presentation of this condition includes severe headache, impaired consciousness, fever, visual disturbance, and variable ocular paresis. Signs of meningeal irritation are very rare. However, if present and associated with headache, fever, and pleocytosis, meningeal irritation may lead to misinterpretation as infectious meningoencephalitis. To the best of our knowledge, pituitary apoplexy with an initial presentation mimicking infectious meningoencephalitis had rarely been reported in the literature. Here, we report a 57-year-old man who had acute severe headache, high fever, neck stiffness, disturbance in consciousness, and left ocular paresis. Laboratory data showed leukocytosis, an elevated C-reactive protein level, and neutrophilic pleocytosis in the cerebrospinal fluid. Because bacterial meningoencephalitis was suspected, empiric antibiotic therapy was administered but in vain. Further examinations indicated a diagnosis of pituitary adenoma with apoplexy. After the immediate administration of intravenous corticosteroid supplement and surgical decompression, the patient recovered.
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PMID:Pituitary adenoma apoplexy with initial presentation mimicking bacterial meningoencephalitis: a case report. 1955 39

Tuberculosis can involve any organ system of the body. Although rare tuberculosis of nervous system (NS) is not uncommon in our country. In the nervous system tubercle bacilli can cause tuberculous meningitis, abscess , tuberculoma in brain & spinal cord. Untreated Central Nervous System (CNS) tuberculosis is devastating. Early diagnosis & prompt treatment of NS is essential to avoid morbidity & mortality. Tubercle bacilli causes chronic caseating granulomatous lesion. Tubercular meningitis presents with fever, headache, neck stiffness & cranial nerve palsy. Tuberculoma may present with headache, seizure and focal deficit. In the spinal cord tuberculoma or tubercular abscess may result in para paresis or quadri-paresis. For diagnosis of nervous system tuberculosis CSF analysis and neuroimaging are important. CSF cell count, Gram staining, Culture and Polymerase Chain Reaction (PCR) are helpful for diagnosis. Imaging helps in the diagnosis of tuberculoma and tubercular abscess. Computed tomography (CT) guided Fine Needle Aspiration for Cytology (FNAC) helps to establish the histopathological diagnosis. Use of combination antitubercular drugs for long period (12-18 months) is necessary to treat nervous system tuberculosis.
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PMID:Tuberculosis of the central nervous system. 2039 33


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