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

A 67 year-old normotensive woman had a syncope followed by shock and remained anuric after hemodynamic stabilization. Paraplegia and paresis of the right upper limb, as well as signs of ischemia of the distal lower limbs were noted. The possibility of acute aortic dissection was raised and confirmed by computed tomography. The paraplegia was attributed to an ischemic infarction of the spinal cord. The patient died on the fourth hospital day due to a pericardial temponade. This rare and not well recognized complication of aortic dissection is briefly reviewed.
Arq Bras Cardiol 1998 Apr
PMID:[Acute paraplegia. A rare complication of aortic dissection]. 968 28

Antihypertensive treatment achieves its greatest benefit in the primary prevention of stroke. Primary prevention studies show 38% fewer strokes when systolic/diastolic values are reduced by 10-12/5-6 mmHg. Secondary stroke prevention has been less investigated, but restrokes seems to be reduced with antihypertensive treatment. Secondary prevention achieves 25-30% less strokes, if diastolic BP can be reduced by 3-4 mmHg. Today's guidelines for antihypertensive therapy in acute ischemic stroke suggest reducing BP values over 220 mmHg systolic (AHA) or 200/110 (German Hypertension Society). No data are available about antihypertensive treatment in acute stroke patients. No intervention trials have so far evaluated an immediate BP reduction on the clinical outcome of the patients neurological status (morbidity) or mortality rates in the acute stroke situation. However, some studies show an increase in mortality after a quick and rapid BP reduction in a short time interval. The ACCESS study was designed to evaluate the possible benefits of a careful and moderate, but immediate blood pressure reduction in patients with an acute stroke compared to a restrictive antihypertensive therapy. Candesartan cilexetil was selected as the antihypertensive drug for its slow onset of action and moderate BP reduction, as well as its very good tolerability. Experimental studies point at possible advantages in acute stroke. The study was designed as a prospective, randomized, double-blind, placebo-controlled, multicenter trial (500 patients). Inclusion criteria were an acute ischemic stroke with a motor paresis and severe hypertension. Primary endpoints were the patients morbidity (functional status measured with Rankin and Barthel index, degree of motor deficity by NIH scale) and mortality rates after three months. First results are presented.
Basic Res Cardiol 1998
PMID:Hypertension and stroke--rationale behind the ACCESS trial. Acute Candesartan Cilexetil Evaluation in Stroke Survivors. 983 67

The so-called nonpathogenic neisseriae are common inhabitants of the upper respiratory tract in humans and are not usually regarded as pathogens. Neisseria meningitidis on the contrary may cause severe disease. These organisms are an uncommon cause of infective endocarditis. The authors report a case of a 64 year-old male, type II diabetic, previously asymptomatic, admitted to hospital because of fever, aphasia and right hemi-paresis. A systolic murmur was heard at the cardiac apex, and three blood cultures were positive for Neisseria meningitidis. The echocardiogram showed a vegetation on the posterior leaflet of the mitral valve, allowing the diagnosis of meningococcal endocarditis. The patient's clinical condition improved on intravenous penicillin therapy, and regression of fever, disappearance of the neurological signs and of the mitral valve vegetation were observed.
Rev Port Cardiol 2001 Sep
PMID:Neisseria meningitidis native valve endocarditis. A case report. 1176 99

Deep vein thrombosis is a frequent disease with an annual incidence reaching 5 per thousand among subjects over 75 years. Major acquired risk factors for venous thrombosis include surgery, neoplasm, reduced mobility or paresis, and a previous episode of deep vein thrombosis. Among women, hormonal status (pregnancy, oral contraceptive, hormone replacement therapy) is responsible for the majority of all venous thrombotic events. The impact of other factors is controversial: obesity, tobacco use and varicose veins. Venous thrombosis is a multifactorial disease and analysis of the interactions between acquired and inherited risk factors is an extremely interesting field of investigation.
Ann Cardiol Angeiol (Paris) 2002 Jun
PMID:[Deep venous thrombosis: epidemiology, acquired risk factors]. 1247 41

We document the presentation profiles, treatment strategies, and clinical outcomes in a relatively large cohort of pediatric patients with intracardiac thrombi (ICT). We performed a retrospective review of patients diagnosed with ICT by echocardiography at a tertiary pediatric hospital during a 10-year period. These patients received medical therapy or thrombectomy. We provided echocardiographic descriptions of the ICT-size, chamber location, and mobility/morphology. The outcome measures were ICT (persistence, resolution, or embolization), effectiveness of therapy, and patient morbidity and mortality. There were 40 ICT diagnosed in 31 patients (22 males and 9 females). Mean age at diagnosis was 8.8 years (range, 15 days to 18 years). Overall mortality was 12/31 patients (39%); only one death was attributed to ICT embolization. Embolic events occurred in 4/31 patients (13%). The most common initial therapies included heparin infusion (n = 15), warfarin (n = 7), and aspirin (n = 7). The ICT resolved with medical therapy alone in 19/30 patients (63%). One patient required surgical thrombectomy. The cohort was divided into group 1 (dilated cardiomyopathy), group 2 (status post Fontan operation), and group 3 (other diagnoses). In group 1 (n = 11), there were 8 deaths. Embolization occurred in 2/5 large ICT, resulting in cerebral infarction and death (n = 1) and renal infarction (n = 1). The most common ICT location was the left ventricle (n = 10). Severe ventricular systolic dysfunction was present in 10/11 patients (91%). In group 2 (n = 9), there was 1 death. Embolization occurred in 1/7 large ICT, resulting in seizures and temporary paresis. All ICT were located in the Fontan pathway. Severe ventricular systolic dysfunction was present in 2/9 patients (22%). In group 3 (n = 11), there were 3 deaths. Embolization occurred in 1/9 small ICT, resulting in coronary emboli. ICT are most commonly diagnosed in pediatric patients with dilated cardiomyopathy or patients status post Fontan operation. The majority of ICT resolve with medical therapy. Larger ICT tend to embolize more frequently, and the morbidity secondary to embolization is significant. Rarely is mortality due to ICT embolization. The prognosis is poor for patients with left ventricular ICT or ICT in the presence of ventricular systolic dysfunction.
Pediatr Cardiol
PMID:Intracardiac thrombi in pediatric patients: presentation profiles and clinical outcomes. 1740 82

The medical records of all patients born between 1 September, 2000, and 31 August, 2002, and undergoing the first stage of Norwood reconstruction, were retrospectively reviewed for details of the perioperative course. We found 99 consecutive patients who met the criterions for inclusion. Hospital mortality for the entire cohort was 15.2%, but was 7.3%, with 4 of 55 dying, in the setting of a "standard" risk profile, as opposed to 25.0% for those with a "high" risk profile, 11 of 44 patients dying in this group. Extracorporeal membrane oxygenation was utilized in 7 patients, with 6 deaths. Median postoperative length of stay in the hospital was 14 days, with a range from 2 to 85 days, and stay in the cardiac intensive care unit was 11 days, with a range from 2 to 85 days. Delayed sternal closure was performed in 18.2%, with a median of 1 day until closure, with a range from zero to 5 days. Excluding isolated delayed sternal closure, and cannulation and decannulation for extracorporeal support, 24 patients underwent 33 cardiothoracic reoperations, including exploration for bleeding in 12, diaphragmatic plication in 4; shunt revision in 4, and other procedures in 13. The median duration of total mechanical ventilation was 4.0 days, with a range from 0.7 to 80.5 days. Excluding those who died, the median total duration of mechanical ventilation was 3.8 days, with a range from 0.9 to 46.3 days. Reintubation for cardiorespiratory failure or upper airway obstruction was performed in 31 patients. Postoperative electroencephalographic and/or clinical seizures occurred in 13 patients, with 7 discharged on anti-convulsant medications. Postoperative renal failure, defined as a level of creatinine greater than 1.5 mg/dl, was present in 13 patients. Eleven had significant thrombocytopenia, with fewer than 20,000 platelets per microl, and injury to the vocal cords was identified in eight patients. Risk factors for longer length of stay included lower Apgar scores, preoperative intubation, early reoperations, reintubation and sepsis, but not weight at birth, genetic syndromes, the specific surgeon, or the duration of surgery. Although mortality rates after the first stage of reconstruction continue to fall, the course in the intensive care unit is remarkable for significant morbidity, especially involving the cardiac, pulmonary and central nervous systems. These patients utilize significant resources during the first hospitalization. Further studies are necessary to stratify the risks faced by patients with hypoplasia of the left heart in whom the first stage of Norwood reconstruction is planned, to determine methods to reduce perioperative morbidity, and to determine the long-term implications of short-term complications, such as diaphragmatic paresis, injury to the vocal cords, prolonged mechanical ventilation, and postoperative seizures.
Cardiol Young 2007 Dec
PMID:Postoperative course in the cardiac intensive care unit following the first stage of Norwood reconstruction. 1798 64

The authors present the case of a 35-year-old woman admitted to her local hospital with right upper limb paresis, which led to a diagnosis of ischemic stroke, confirmed by brain magnetic resonance imaging (MRI). Investigation of the embolic source by transesophageal echocardiography (TEE) revealed a patent foramen ovale (PFO), with spontaneous right-to-left shunt. In May 2009 percutaneous closure of the PFO was performed with a BioSTAR bioabsorbable implant, under TEE and fluoroscopic control. Transthoracic echocardiography was performed one, three and six months after the procedure, and TEE was repeated after nine months, in each case showing correct implant positioning, with no residual leak. The patient has been asymptomatic since the stroke episode. The authors discuss the importance of bioabsorbable implants for PFO closure, and their advantages over the previously used permanent synthetic implants.
Rev Port Cardiol 2010 Nov
PMID:Patent foramen ovale closure with the BioSTAR bioabsorbable implant. 2130 60

The Williams-Beuren syndrome is a rare genetic disease characterized by: (a) typical facial features; (b) psychomotor retardation with a specific neurocognitive profile; (c) cardiovascular condition and (d) likely transient hypocalcemia in infancy. The objective of this study was to describe the clinic evolution and diagnosis of patient with this syndrome that was associated with endocarditis caused by Streptococcus parasanguis in the ascending aorta and an aneurism located in the fronto-temporal area, which produced a parenchymal hematoma in the left lobe, and subarachnoid hemorrhage. He was treated with ceftriaxone and dicloxacillin. Then we proceeded to correct the aneurysm and perform vegetation resection in aortic arteries with supravalvular aortic stenosis correction. The evolution after one year has been favorable and is currently without neurologic sequelae. A 5-year-old male patient presented a diagnosis of supravalvular aortic stenosis. After cardiac catheterization was performed, he presented a fever and right side paresis. The echocardiogram showed multiple vegetations in the ascendant aortic arch and the supraortic arteries. The blood cultures reported S. parasanguis. The magnetic resonance showed a subarachnoid hemorrhage with an aneurysm and a hematoma.
Arch Cardiol Mex
PMID:Supravalvular aortic stenosis associated to infectious endocarditis and cerebral vascular disease in a patient with Williams-Beuren Syndrome. 2588 7

Thrombosis can affect any venous circulation. Venous thromboembolism (VTE) includes deep-vein thrombosis of the leg or pelvis, and its complication, pulmonary embolism. VTE is a fairly common disease, particularly in older age, and is associated with reduced survival, substantial health-care costs, and a high rate of recurrence. VTE is a complex (multifactorial) disease, involving interactions between acquired or inherited predispositions to thrombosis and various risk factors. Major risk factors for incident VTE include hospitalization for surgery or acute illness, active cancer, neurological disease with leg paresis, nursing-home confinement, trauma or fracture, superficial vein thrombosis, and-in women-pregnancy and puerperium, oral contraception, and hormone therapy. Although independent risk factors for incident VTE and predictors of VTE recurrence have been identified, and effective primary and secondary prophylaxis is available, the occurrence of VTE seems to be fairly constant, or even increasing.
Nat Rev Cardiol 2015 Aug
PMID:Epidemiology of venous thromboembolism. 2607 49

Recurrent laryngeal palsies are relatively common. Frequently, surgical procedures precede paresis. In rare cases a compression of the recurrent laryngeal nerve can be caused by enlarged cardiovascular structures. The phenomenon of compression of the left recurrent laryngeal nerve is explicitly designated as Ortner's syndrome, first described in 1897 by Norbert Ortner. Nowadays the compression of the right recurrent laryngeal nerve by cardiovascular structures is also associated with Ortner's syndrome. We report two cases of an 82- and a 71-year-old patient who presented with hoarseness and each right- and left-sided vocal cord paralysis for further diagnosis. The ear, nose, and throat (ENT) examinations revealed no clarifying findings besides the vocal cord palsy, so extensive imaging techniques were used. The cause of left-sided recurrent laryngeal nerve palsy was a penetrated aortic ulcer caused by large thrombosed aneurysm of the aortic arch. The right-sided paresis arose due to aneurysmal enlargement of the brachiocephalic trunk and an aneurysm of right subclavian artery. These cases demonstrate that interdisciplinary medical work is important. The internal medical presentation of a patient with hoarseness without ENT medical findings should be considered. <Learning objective: Ortner's syndrome is described as the compression of the recurrent laryngeal nerve of pathologically enlarged cardiac structures such as left atrium in mitral stenosis, aortic aneurysm, and others. It is a rare cause of vocal cord paralysis and thus hoarseness but should be considered as a differential diagnosis, particularly if the patient has a cardiac history.>.
J Cardiol Cases 2017 Mar
PMID:Unilateral recurrent nerve palsy and cardiovascular disease - Ortner's syndrome. 3027 47


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