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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Isolated infarcts in the periaqueductal region are rare but have been reported after cardiac catheterization. The authors report a case of dorsal midbrain infarct which caused bilateral ptosis, partial upgaze paresis, and internuclear ophthalmoplegia imaged within eight hours with diffusion-weighted imaging (DWI). The lesion was later confirmed on T2-weighted images. Diffusion-weighted imaging can rapidly confirm the diagnosis of this rare brain-stem infarct.
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PMID:Midbrain ptosis caused by periaqueductal infarct following cardiac catheterization: early detection with diffusion-weighted imaging. 1091 50

On November, 1997, a 15-year-old boy visited our hospital because of headache, fever and arthralgia. He was treated with 5 mg/day of prednisolone thereafter. On October 21, 1998, he was admitted because of remittent fever and multiple arthralgia and diagnosis of juvenile rheumatoid arthritis (JRA) was made. He was also found to have hypertension of 210/110 mmHg, and soon developed ptosis of the eye, facial paresis and perceptive deafness of the right side. Cerebrospinal fluid showed protein of 98 mg/dl and mildly elevated IgG, IgA and IgM levels with normal cell count. Brain MRI examination revealed multiple cerebral lesions in the frontal, parietal and cerebellar areas on the right, whose cause was thought to be vasculitis. Renal angiography demonstrated a right renal artery stenosis, compatible with renovascular hypertension. He was treated with 60 mg of prednisolone per day, which brought about a satisfactory improvement of the above rheumatic and neurologic signs. On November 17, 1998, he received a follow-up study of MRI, which failed to show any cerebral lesions, supporting the effectiveness of prednisolone. An angiotensin converting enzyme inhibitor successfully normalized hypertension and renin activity in serum, although renal blood flow did not increase.
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PMID:[A case with juvenile rheumatoid arthritis who developed cerebral vasculitis and venovascular hypertension]. 1121 60

Unilateral third nerve palsy with bilateral superior rectus paresis and bilateral ptosis is a typical condition for nuclear oculomotor nerve syndrome. We report a case of nuclear oculomotor nerve syndrome due to midbrain hemorrhage, as a rare cause. A 73-year-old man presented with an abrupt onset of double vision and difficulty opening his eyes. He had uncontrolled hypertension in his history. Neurological examination revealed right oculomotor palsy with impairment of bilateral upward gaze and bilateral ptosis. MRI showed a mesencephalic area of increased T1 signal and decreased T2 signal consistent with a subacute hematoma. It is emphasized that isolated mesencephalic hemorrhage may be the cause of the nuclear oculomotor nerve syndrome without associated neurological signs.
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PMID:Isolated nuclear oculomotor nerve syndrome due to mesencephalic hematoma. 1123 82

Fourteen patients with severe neuroparalytic snake envenomation, resulting in acute type II respiratory failure, admitted to respiratory critical care unit for mechanical ventilation during one year period, were studied. Ventilatory requirements, amount of anti snake venom (ASV) infused, period of neurological recovery and hospital survival were evaluated. All patients had severe manifestations such as ptosis, extraocular muscle paresis and limb weakness along with dyspnoea. Seven patients (50%) had additional complaints of dysphagia and dysphonia. ASV was administered to all, with a median requirement of 900 ml. Mechanical ventilation was required for a median duration of 17 hours and all except one patient, who had suffered irreversible hypoxic cerebral injury prior to resuscitation, survived with complete neurological recovery. We conclude, that the timely institution of ventilatory support and anti-venom therapy in such patients, is associated with an excellent outcome.
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PMID:Management of respiratory failure in severe neuroparalytic snake envenomation. 1130 37

Hepatocyte growth factor/scatter factor (HGF/SF) can stimulate growth of gastrointestinal epithelial cells in vitro; however, the physiological role of HGF/SF in the digestive tract is poorly understood. To elucidate this in vivo function, mice were analyzed in which an HGF/SF transgene was overexpressed throughout the digestive tract. Nearly a third of all HGF/SF transgenic mice in this study (28 of 87) died by 6 months of age as a result of sporadic intestinal obstruction of unknown etiology. Enteric ganglia were not overtly affected, indicating that the pathogenesis of this intestinal lesion was different from that operating in Hirschsprung's disease. Transgenic mice also exhibited a rectal inflammatory bowel disease (IBD) with a high incidence of anorectal prolapse. Expression of interleukin-2 was decreased in the transgenic colon, indicating that HGF/SF may influence regulation of the local intestinal immune system within the colon. These results suggest that HGF/SF plays an important role in the development of gastrointestinal paresis and chronic intestinal inflammation. HGF/SF transgenic mice may represent a useful model for the study of molecular mechanisms associated with a subset of IBD and intestinal pseudo-obstruction. Moreover, our data identify previously unappreciated side effects that may be encountered when using HGF/SF as a therapeutic agent.
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PMID:Ulcerative proctitis, rectal prolapse, and intestinal pseudo-obstruction in transgenic mice overexpressing hepatocyte growth factor/scatter factor. 1131 Aug 23

A 75-year-old woman presented with fever and right temporal, periorbital and facial pain for 7 days. Physical examination revealed an ipsilateral paresis of the superior division of the oculomotor nerve with mild exophthalmos. She also had hyperglycemia. CT scan of the paranasal sinuses showed acute sinusitis. Rhinoscopy demonstrated black necrotic tissue in the nasal septum. KOH preparation of tissue biopsy specimen revealed large, non septate hyphae with right angle branching, diagnostic of rhinocerebral mucormycosis. She was treated with amphotericin B, surgical debridement and insulin therapy. Surgical tissue specimen also confirmed mucormycosis. She improved after treatment, but 4 months later, ptosis and upward palsy still persisted.
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PMID:Superior branch palsy of the oculomotor nerve caused by rhinocerebral mucormycosis. 1156 Feb 25

A 17-year-old male presented with a wound on the right temporal region, oozing hemorrhagic necrotic brain tissue and cerebrospinal fluid, following a fall. Computed tomography showed temporoparietal and petrous apex fractures on the right. Neurological examination revealed abducens nerve paresis, ptosis, and myosis on the right side. The patient was treated surgically for the removal of the free bony fragments at the fracture site and to close the dural tear. The abducens nerve paresis, ptosis, and myosis persisted at the 3rd monthly postoperative follow-up examination. The anatomy of the abducens nerve at the petroclival region was studied in four cadaveric heads. Two silicone-injected heads were used for microsurgical dissections and two for histological sections. The abducens nerve has three different angulations in the petroclival region, located at the dural entrance porus, the petrous apex, and the lateral wall of the cavernous segment of the internal carotid artery. The abducens nerve had fine anastomoses with the trigeminal nerve and the periarterial sympathetic plexus. There were fibrous connections extending inside the venous space of the petroclival area. The abducens nerve seems to be vulnerable to damage in the petroclival region, either directly by trauma to its dural porus and petrous apex or indirectly by stretching of the nerve through the nervous and/or fibrous connections. Concurrent functional loss of the abducens nerve and the periarterial sympathetic plexus clinically manifested as incomplete Horner's syndrome in our patient.
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PMID:Isolated abducens nerve paresis associated with incomplete Horner's syndrome caused by petrous apex fracture--case report and anatomical study. 1176 Mar 84

This report describes a female patient with myasthenia gravis who developed respiratory failure due to vocal cord paresis. The diagnosis was delayed due to the absence of other myasthenic symptoms (e.g. ptosis, muscle weakness and dysphagia). On direct laryngoscopy, her vocal cords were seen to be in the paramedian position and to move apart after the intravenous injection of edrophonium. The patient initially presented with ocular myasthenia and later returned with isolated respiratory failure. A review of the pertinent literature revealed few reports on myasthenia gravis presenting in this manner.
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PMID:Respiratory failure due to vocal cord paresis in myasthenia gravis. 1209 77

The incidence of acute subdural hematoma (SDH) due to a ruptured intracranial aneurysm varies from 0.5% to 7.9% of all intracranial aneurysms. Pure acute SDH without subarachnoid hemorrhage (SAH) is rare. According to the literature, only 18 cases (including our case) of pure acute SDH identified by CT scan have been reported. Here we report a case of an internal carotid-posterior communicating artery (IC-PC) aneurysm presenting pure acute SDH identified by CT. We summarize the 18 reported cases. A 55-year-old female experienced severe headache on October 9, 1999, which did not improve after medication. Four days later, left ptosis began. She was admitted to the department of ophthalmology to treat oculomotor nerve paresis. A computed tomography (CT) scan obtained on admission, revealed no obvious abnormality. She was treated by hormonal therapy, but her symptoms continued. Ten days later, she suddenly lost consciousness and was transferred to our hospital. Although the CT scan revealed a thick left SDH with marked midline shift, SAH was absent. Her neurological state was Hunt & Kosnik grade IV. A left carotid angiogram revealed an IC-PC aneurysm with active extravasation. The patient was taken to the operating room for emergency removal of the SDH and aneurysmal neck clipping. During the operation, adhesion between the aneurysmal dome and the arachnoid was observed, but subarachnoid hemorrhage was not identified at all. The aneurysm was successfully clipped. Postoperatively, her consciousness improved immediately. In this case, the pure acute SDH identified by CT was responsible for causing the direct hemorrhage into the subdural space via an adhesive lesion.
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PMID:[A case of internal carotid-posterior communicating artery aneurysm presenting pure acute subdural hematoma]. 1218 32

An increasing number of complications are being noted with the widespread use of oral contraceptives (OCs). In opthalmology, migraine like headaches are frequently encountered. This report presents observations of 4 different neurological manifestations in 4 different individuals in addition to the headache for which they were referred to the Neuro-Ophthalmology Clinic of the Philippine General Hospital. The 4 cases clearly demonstrate that aside from the headache neuro ophthalmologic abnormalities can occur during OC use: left facial paresis, left Horner's syndrome, bilateral ptosis, and left mydriasis. The abnormalities disappeared on withdrawal of the OCs, suggesting that they are caused by the drug. They were reversible after 2 months to 4 years of medication. OCs are combinations of semisynthetic progesterone and estrogen. A study of 2 of the cases suggests that the estrogen portion may be the responsible agent for these pathologies. They did not reappear with the intake of another OC containing a lower concentration of ethinyl estradiol (.035 mg instead of .05 mg). This may present some problems in family planning for it is recommended that at least .05 mg of estrogen be incorporated with progesterone in order to have the pill most effective as a contraceptive agent. Examination of the neurologic complications encountered in these 4 patients suggests that intracerebral vascular deficiency has occurred simulating isolated small arterial occlusions.
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PMID:Neuro-ophthalmological complications of contraceptive pills. 1233 85


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