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)

Radiation angiopathy is a well-known complication accompanying irradiation. But the majority of effected vessels are small vessels. Cases of intracranial major arteries being effected are not so numerous. We report the case of a 47-year-old female patient. The removal of pituitary adenoma was carried out on her in 1982. After that, 4500rad irradiation was performed. It was about six years after irradiation that the first angiography was made. Right MCA occlusion, multiple stenosis of both ACAs and Moya-Moya like vessels were discovered. On admission light paresis on her left lower extremity was recognized and hyperlipidemia was noted. It was interesting that the multiple stenosis was found in an area outside the irradiation field. MCA-STA anastomosis was performed and the prognosis was good. The authors described this case and reviewed the pertinent literature.
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PMID:[Complete occlusion of right middle cerebral artery by radiation therapy after removal of pituitary adenoma: case report]. 223 7

This study reports the effect of intracisternal administration of papaverine in 15 patients with vasospasm due to rupture of aneurysm. All patients had undergone clipping of aneurysm and had neurological deterioration and decreasing level of consciousness. Bolus injection of 40 mg of 1% papaverine hydrochloride was started on day 6.3 +/- 1.7 and continued for 4.4 +/- 1.6 days. In seven cases serial angiogram after initial dose revealed dilatation of IC and/or anterior, middle cerebral arteries at 30 min and further dilatation up to 85% increase in diameter at 60 min, which continued at least 90 min. Arteries with marked vasospasm responded more to papaverine than those with less vasospasm. There was a close correlation between degree of vasospasm and vasodilatation effect (r = 0.88, p less than 0.01). In all but two cases vasodilatation tended to become prominent by repeat doses, twice a day, for two to seven days (r = 0.87, p less than 0.01). Vasodilatation was observed only in IC and proximal trunks of ACA and MCA where papaverine could make direct contact, but not in the distal branches beyond A3 or M3. Neurological examination showed improvement of paresis or level of consciousness in 7 cases but no effect in 6 cases. Intracerebral hematoma occurred in two cases (one by high concentration 4% papaverine) during the treatment. Therefore intracisternal papaverine is the treatment of choice in cases with symptomatic vasospasm with some cautions on concentration to be administered.
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PMID:[Efficacy of intracisternal papaverine on symptomatic vasospasm]. 376 53

A 49-year-old right handed male, who showed three types of visual disturbance, e. g. hemianopsia, obscuration phenomena and unilateral visuospatial agnosia at different times, was reported. At first, he had hemiparesis, hemisensory disturbance and homonymous hemianopsia on the left side because of multiple stenoses of posterior branches of the right middle cerebral artery. His motor and visual field disturbances improved for several days after onset, but there appeared transient obscuration phenomena on the left visual field. CT scan revealed an abnormal low density area in the right temporo-parietal region. At about 4.5 years after the first attack, he again had hemiparesis and homonymous hemianopsia on the left side. Cerebral angiography showed an occlusion of the right middle cerebral artery. Since his paresis was progressive, STA-MCA anastomoses was performed. Hemiparesis was improved, but homonymous hemianopsia remained. Moreover, at about one year after the second attack, left visuospatial agnosia participated in his hemianopsia. Cerebral angiography showed an additional occlusion in the crural segment of the right posterior cerebral artery. CT scan showed a lesion in the right basal ganglia and temporo-parietal lobe. In most cases, unilateral visuospatial agnosia occurs with hemianopsia. But, in this case, these symptoms occurred at different times. This may indicate the differentiation between unilateral visuospatial agnosia and hemianopsia.
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PMID:[Visual disturbances following right cerebral lesion: a case report]. 648 33

Two cases of cerebral aneurysm combined with polycystic kidneys (PCKs) were presented. Case 1, a 24-year-old hypertensive male, was referred to our clinic owing to sudden onset of severe headache at August 20, 1982. Neurological findings on admission were stuporous, right vitreous hemorrhage (so-called Terson's syndrome), and hypertension. CT scans showed subarachnoid hemorrhage, and right MCA bifurcation aneurysm with marked vasospasms by cerebral angiography was revealed. Intentional delayed operation with V-P shunt was performed. He discharged with mild left upper limb paresis, and visual impairment on the right. Bilateral PCKs were confirmed by postoperative DIP and CT scan. Case 2, a 51-year-old female, who suddenly complained of severe headache, was referred to our department 3 days after subarachnoid hemorrhage. One year previously, she had been pointed out PCKs. Neurological findings on admission at February 29, 1980, were drowsy, left third cranial nerve palsy, and hypertension. Cerebral angiography showed multiple aneurysms (bilateral IC-PC & A-com). Neck clipping (1-IC-PC & A-com) and coating (r-IC-PC) were performed at the next day of admission, and V-P shunt operation was followed about 8 weeks after first operation. About 2 weeks after discharge, she suddenly became loss of consciousness and expired. Autopsy revealed intracerebral hemorrhage in left basal ganglia and thalamus. Both kidneys were PCKs of Potter type 3 and cysts of the liver were also noted. In young hypertensive patients with cerebral aneurysms, it should be in mind whether PCKs may be combined or not, and cerebral angiography in PCKs were reasonable to find out harbored cerebral aneurysm.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Two cases of cerebral aneurysms combined with polycystic kidneys]. 652 33

Cerebral arteriovenous malformations (AVMs) are frequently evaluated before therapeutic embolization by superselective injection of anesthetics into individual arterial branches so as to determine whether permanent occlusion would affect eloquent function. In Experiment 1, we used this adaptation of the Wada procedure to study three right-handed adult patients with left frontal cerebral AVMs by injecting vessels in Wernicke's and Broca's areas, respectively, and assessing language functions. The results showed that superselective testing in the inferior division of the left MCA in all three patients produced a dense Wernicke's aphasia. Injections into the left frontal regions, however, resulted in right paresis in all patients, but no language deficits including no loss of fluency. In Experiment 2, Patient 2 underwent fMRI activation for spontaneous word-list generation using multi-slice echo planar BOLD techniques at 1.5 Tesla. A voxel-by-voxel comparison of rest vs activation for each task was performed with a Z-score threshold of 2.5 SD for activated voxels. There was activation in the right hemisphere in the insula, frontal operculum pars opercularis, and inferior frontal gyrus, an area homologous to Broca's area in the left hemisphere. There was also activation in the left hemisphere in the Rolandic region, but language function was unaffected during Wada testing in this area. These data suggested that features of expressive language were no longer controlled by the left frontal lobe where the AVM was located, and provided new evidence for interhemispheric re-organization under conditions of chronic neurovascular disease.
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PMID:Interhemispheric transfer of language in patients with left frontal cerebral arteriovenous malformation. 1086 75

The reported case was a boy aged 13 with, traumatic carotido-cavernous fistula admitted to hospital with right exophthalmos and paresis of right abducens nerve. After two failed trials of endo-vascular closure of the fistula it was decided to use venous bypass ICA-MCA (internal carotid artery in its extracranial part--M1 segment of middle cerebral artery) for bypassing the fistula. This made possible closure of the fistula with regression of neurological symptoms.
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PMID:[Venous bypass ICA-MCA used in a case of traumatic carotid-cavernous fistula]. 1271 92

A comparative study of 48 carotid stent grafting and 23 open carotid endarterectomies was carried out. Patients of both groups were comparable by cerebrovascular insufficiency degree and concomitant diseases. General rate of complications after carotid stent grafting (CSG) was 5.1%. There was a small ischemic stroke with right-sided hemiparesis and aphasia in one patient during CSG. Complete regress of the neurological symptoms was seen on the 5th day. In the nearest postoperative period after CSG there was a big ischemic stroke in the territory of MCA in one patient. Rate of complications after open carotid endarterectomy (OCEAE) was 8.7% Transient ischemic attacks were seen in 2 patients in early postoperative period. Paresis of the IX cranial nerves was in one patient. In long-term postoperative period after CSG 2 patients died due to cardiac causes. One patient died 18 months after OCEAE due to ischemic stroke. In long-term period after OCEAE restenosis of the internal carotid artery was seen in 4.5% cases, while there were no restenosis after CSG. It is concluded that CSG is an effective method of treatment of carotid stenosis with lower lethality and postoperative complications rate compared with OCEAE. Indications for CSG are symptomatic stenosis of ICA (>60%), asymptomatic stenosis of ICA(>70%), two-sided lesions of the carotid arteries, carotid stenosis with lesions of other brachiocephalic arteries, insufficiency of Willis circle.
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PMID:[Comparative assessment of the results of open carotid endarterectomy and carotid aftery stenting]. 1467 98

Superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis is a safe and effective treatment for moyamoya disease, although recent evidence suggests its substantial risk for symptomatic cerebral hyperperfusion. The diagnostic value of single-photon emission computed tomography (SPECT) for postoperative hyperperfusion in moyamoya patients is well established, but that of magnetic resonance (MR) imaging/angiography is undetermined. A 22-year-old woman with hemorrhagic-onset moyamoya disease underwent STA-MCA anastomosis on the right hemisphere, but she suffered from transient left hemiparesis and facial paresis owing to cerebral hyperperfusion from 3 to 11 days after surgery as delineated by SPECT. The time-sequential 3-T MR angiography revealed intense high signal of donor STA and dilated branches of MCA around the site of the anastomosis. These findings were most prominent at 8 days after surgery, when her neurologic signs were most apparent. Intensive blood pressure control relieved her symptom and she was discharged without neurologic deficit. MR findings normalized 3 months later. The characteristic findings of 3-T MR angiography, which was not evident by 1.5-T MR angiography in the previous studies, may reflect intrinsic pathology of postoperative cerebral hyperperfusion. It could be a useful diagnostic tool after revascularization surgery for moyamoya disease.
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PMID:Temporal change of 3-T magnetic resonance imaging/angiography during symptomatic cerebral hyperperfusion following superficial temporal artery-middle cerebral artery anastomosis in a patient with adult-onset moyamoya disease. 1854

Cortical ischemic stroke affecting the precentral "hand knob" area is a rare but well known stroke entity. To date, little is known about the underlying stroke mechanisms and the prognosis. Twenty-nine patients admitted to our service between 2003 and 2007 were included in the study on the basis of an acute ischemic infarct of the cortical "hand knob" area confirmed by diffusion-weighted magnetic resonance imaging with contralateral hand paresis. For all patients clinical, epidemiological as well as imaging data at the time point of admission were analysed retrospectively and follow-up data on all patients was obtained. The majority (n = 21/72%) had an isolated infarct of the cortical "hand knob" area. In 23 (79%) patients it was a first ever stroke. Ten patients (34%) had ipsilateral extracranial stenosis of the internal carotid artery (ICA), whereas potential cardiac embolic sources were less frequent (n = 4/14%). No patient exhibited ipsilateral MCA stenosis. All but two patients (93%) had marked atherosclerotic alterations of the ICA. Hypertension was the most prevalent vascular risk factor (n = 23/79%). At follow-up (mean 25.0 months, range 0.4-47.4 months) no patient had died and only one (3%) experienced a recurrent stroke. The majority of patients (79%) reported improvement of hand paresis, 17 (59%) were asymptomatic (modified Rankin score = 0). Only one patient was significantly disabled due to a recurrent stroke. In conclusion, ischemic infarcts affecting the cortical "hand knob" area are frequently associated with atherosclerotic changes of the carotid artery, suggesting an arterio-arterial thrombembolic stroke mechanism. It mostly reflects first ever ischemic stroke, and follow-up data suggest a rather benign course.
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PMID:Ischemic stroke of the cortical "hand knob" area: stroke mechanisms and prognosis. 1935 29

A 22-year-old woman developed an anaphylactic reaction after two hornet stings. Left-sided hemiparesis and gaze paresis were revealed after extubation 24 hours later. The vasoconstriction of the right MCA together with hypotension are the suggested pathogenetic determinants of the stroke.
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PMID:Cerebral infarction due to vasoconstriction after a hymenoptera stin. 2429 71


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