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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Brain hemorrhage from an intracranial tumor was encountered in 7 males and 6 females during a 4-year period. In 5 patients, hemorrhage was responsible for the first signs of a previously unsuspected neoplasm. The intracranial lesion was demonstrated by computed tomography (CT scanning) in each patient. Characteristic CT scan findings included: a neoplastic core (high or low density); small, multifocal clots usually at the margin of the tumor; and, surrounding, often extensive, edema. Enhancement of the tumor tissue with intravenous injection of 60% Hypaque was observed in the 8 patients so studied. The regions which were enhanced had a peripheral distribution corresponding to the site of hemorrhage. Microscopic examination demonstrated 7 glioblastoma multiforme, 1 oligodendroglioma, 4 metastatic carcinomas (including 1 each of bronchogenic carcinoma, melanoma, hypernephroma, and adrenal carcinoma), and 1 hemangiopericytoma. High-grade malignancy and extensive, abnormal vascularity appeared to be predisposing factors.
Stroke
PMID:Brain hemorrhage from intracranial tumor. 46 14

Fifteen cases of metastatic brain tumors associated with massive subarachnoid, intracerebral, or intraventricular hemorrhage or a combination thereof are reported. Four patients had multiple bleeding cerebral metastasis. In 10 patients, stroke was the first manifestation of the neoplastic disease. It is concluded that metastases of choriocarcinoma, melanoma, and bronchogenic carcinoma are most prone to massive bleeding. The average survival from the beginning of neurologic symptoms was 65 days, but in seven patients, it was 11 days or less. Surgery seems to be beneficial in selected patients. Massive hemorrhage was a complication in 14 percent of our patients with metastases to brain versus 0.8 percent of those with gliomas.
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PMID:Intracranial hemorrhage caused by metastatic tumors. 55 71

Eighty patients with Ewing's sarcoma, bronchogenic carcinoma, and other neoplasms receiving adriamycin were monitored by a Sphygmo-Recording of the pulse wave delay (QKd time interval). The QKd interval, which is the sum of the cardiac pre-ejection period and the pulse transmission time, is sensitive to changes in myocardial contractility and stroke output. The patients were also followed by serial physical examinations, electrocardiograms, chest roentgenograms, serum enzymes, and thyroid function tests; none of these changed during the study period except in a few patients with congestive heart failure (CHF) and/or transient arrhythmias. QKd showed a significant prolongation (greater than 30 msec) within 1-3 weeks after adriamycin administration in a high percentage of patients followed closely. The QKd interval usually returned to pretreatment baseline levels within 4-7 weeks after adriamycin administration. The QKd often showed repeated and sustained elevations after courses of therapy at 3-week intervals. After adriamycin therapy was discontinued the QKd usually returned to normal levels. No statistically significant changes in the QKd were seen in a control group. There were no acute changes in QKd during adriamycin infusions. Of seven patients receiving cumulative doses of adriamycin greater than 550 mg/m2, three developed CHF. QKd intervals in all three of these patients had failed to return to the baseline values 2-3 months prior to any other evidence of CHF. This suggests that failure of QKd to return to pretreatment baseline levels may be of prognostic value. The QKd interval appears to reflect a high incidence of subclinical adriamycin cardiotoxicity. The technique is simple, noninvasive, rapid, and potentially useful for monitoring patients receiving adriamycin and other potentially cardiotoxic drugs.
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PMID:Noninvasive monitoring of adriamycin cardiotoxicity by "Sphygmo-Recording" of the pulse wave delay (QKd interval). 79 46

A unique case is described of a 64-year-old white woman who had silent thromboembolic occlusion of the right pulmonary artery. Over the ensuing months, severe pulmonary hypertension developed, as manifested by marked dilatation and atherosclerosis of the right and left pulmonary arteries and severe right ventricular hypertrophy. Nevertheless, she remained fully ambulatory and felt generally well throughout this time. Eventually, however, the pulmonary arteries became so dilated that they compressed the recurrent laryngeal nerve as it looped under the aortic arch, and it was the resulting hoarseness that first caused the patient to seek medical attention. A work-up disclosed normal peripheral lung fields on x-ray study and a large dense right hilar mass. Accordingly, the patient was subjected to an exploratory thoracotomy on the reasonable but mistaken diagnosis of bronchogenic carcinoma. After the following operation, her condition deteriorated. She developed bronchopneumonia which, when superimposed on her already precariously reduced cardiopulmonary function, precipitated respiratory insufficiency. An independent stroke was the immediate cause of death.
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PMID:Silent, chronic, massive pulmonary thromboembolism masquerading as bronchogenic carcinoma. 96 90

There is accumulating evidence that free radicals may contribute to various diseases such as cancer or cardiovascular disease. Possible health hazards can to some extent be prevented by the body's multilevel defense system against free radicals, which comprises, besides others, antioxidant vitamins. The 12-year mortality follow-up of 2,974 participants of the Basal Study allowed to test the hypothesis that low antioxidant vitamin plasma concentrations (vitamin A, C, E and carotene) were associated with increased death from cancer of various sites and death from atherosclerosis such as ischemic heart disease and stroke, respectively. For the analysis 204 cancer cases, 132 fatalities from ischemic heart disease (IHD) and 31 deaths from cerebral vascular disease were available. Cancer mortality. Overall mortality from cancer was associated with low mean plasma levels of carotene adjusted for cholesterol (p less than 0.01) and of vitamin C (p less than 0.01). Bronchus and stomach cancers were associated with a low mean plasma carotene level (p less than 0.01). Subjects with subsequent stomach cancer had also lower mean vitamin C and lipid-adjusted vitamin A levels than survivors (p less than 0.05). Calculating the relative risk with exclusion of mortality during the first two years of follow-up, low plasma carotene was associated with an increased risk for bronchus cancer (RR 1.8, p less than 0.05), and the small number of stomach cancer cases (RR 2.95, p less than 0.05) low plasma levels of carotene and vitamin A with all cancer types (RR 2.47, p less than 0.01), and low plasma retinol in older subjects (greater than 60 years) with lung cancer (RR 2.17, p less than 0.05). Studies in other cohorts with a poor vitamin E status revealed an increased risk of subsequent cancer at low vitamin E levels as well. It is concluded that low plasma levels of all major essential antioxidants are associated with an increased risk of subsequent cancer mortality. Cardio-vascular mortality. Plasma carotene concentration below quartile 1 was associated with an increased risk for IHD (RR 1.53, p = 0.02). The same was true for low levels of both carotene and vitamin C (RR = 1.96, p = 0.022). The risk of cerebrovascular death was elevated in subjects with low carotene in the presence of low vitamin C plasma concentration (RR 4.17, p less than 0.01). These data confirm and extend recent findings on an inverse correlation of beta-carotene and vitamin C respectively to CVD.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Inverse correlation between essential antioxidants in plasma and subsequent risk to develop cancer, ischemic heart disease and stroke respectively: 12-year follow-up of the Prospective Basel Study. 145 Jun

Resection of pulmonary tissue for bronchial carcinoma causes a decrease in vital capacity of 15% after lobectomy and 35-40% following pneumonectomy. After operation the lung becomes stiffer and elastic recoil pressure and transdiaphragmatic pressure at TLC increase. Maximum effort tolerance decreases after pneumonectomy with a normal pulmonary artery pressure at rest and an increase in pulmonary artery pressure and in pulmonary vascular resistance on effort, compared to preoperative values. Cardiac output and stroke volume during effort show a decrease after operation with an increase in peripheral arterial blood pressure and in peripheral vascular resistance. Arterial oxygen saturation on effort decreases after pneumonectomy, possibly due to the absolute decrease in diffusing capacity. When comparing resting and exercise values at identical work loads, increases in systemic arterial blood pressure, pulmonary and systemic vascular resistance and arteriovenous oxygen difference were similar although generally less pronounced after lobectomy compared to pneumonectomy; cardiac output, stroke volume and oxygen consumption showed the same tendency to decrease after lobectomy and pneumonectomy.
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PMID:Cardiopulmonary function after lobectomy or pneumonectomy for pulmonary neoplasm. 259 37

The case histories of the 49 patients who died in a series of 165 patients admitted to the Medical Unit between 1958 and 1984 with polyarteritis nodosa (PAN) were reviewed. The causes of death of the 29 men and 20 women, mean age 51.44 +/- 7.4 years, were classified into 6 groups. Infection accounted for 26.5% (13/49) of deaths, the initial site of infection being pulmonary, complicated by septicaemia in 6 cases. Cardiovascular events were responsible for death in 24.4% (11/49): terminal cardiac failure (4 cases), myocardial infarction (1 case), ventricular tachycardia (1 case), stroke (1 case), pulmonary embolism (2 cases), fulminant hemoptysis (1 case). Gastrointestinal complications were the cause of death in 16.3% (8/49): ischemic necrosis (5 cases), acute pancreatitis (2 cases), oesophageal ulceration (1 case). Renal failure was observed in 10.2% (5/49), all occurring before 1972: acute renal failure (3 cases), chronic renal failure (2 cases). Cancer was the cause of death in 10.2% (5/49): primary bronchial carcinoma (2 cases), laryngeal carcinoma (1 case), carcinoma of the vulva (1 case), bone metastases (1 case). Finally, 14.2% (7/49) could not be classified in the preceding groups. Sudden death occurred in 3 patients, shock in 1 patient, multivisceral PAN in 2 patients and anaphylactic shock in 1 patient. Three of the 12 patients who had post-mortem studies had signs of progressive vasculitis. The results are compared with other reports in the literature and the pathogenic mechanisms are discussed. The infections and cardiovascular deaths occurred early or late and were not related to the state of the activity of the vasculitis. Immunosuppressive treatment seems to play an important role in their pathogenesis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Causes of death in systemic vasculitis of polyarteritis nodosa. Analysis of a series of 165 patients]. 290 28

N,N,N'-Trimethyl-N'-(2-Hydroxyl-3-Methyl-5-123I Iodobenzyl)-1,3-Propanediamine.Hcl (123I-HIPDM) has been used for diagnosis of patients with strokes and dementias. Since this radiopharmaceutical is also accumulated in the lung, we routinely performed a lung image or images immediately prior to cerebral planar and SPECT images after a 3-5 mCi 123I-HIPDM injection. During the past 14 months, we obtained 78 (age from 41 to 92 years, average 66.7 +/- 8.9 years; 64 males, 14 females) suspected stroke or dementia patients' lung images. All lung images were correlated to chest X-ray (CXR) or CT and other clinical data. Sixty five of 78 patients had normal lungs showing homogeneous distribution of activity throughout the lungs which correlated well to normal CXR and/or CT studies. Abnormal scintigraphic patterns of the 13 patients included lung defect (5 bronchogenic carcinoma with or without atelectasis) and decreased uptake in apices (8 chronic obstructive pulmonary disease). The findings of pulmonary intrathoracic pathologies on lung images with 123I-HIPDM suggests further evaluation of the agent for detection of localized pulmonary diseases and pulmonary physiological studies relating to amine metabolism.
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PMID:Application of I-123 HIPDM as a lung imaging agent. 338 4

From 1981 through 1991, 40 patients 80 years of age or older underwent thoracotomy for curative resection of bronchogenic carcinoma. There were 22 males and 18 females with a mean age of 82.7 years (range 80-88). In three patients, the operation was aborted due to unexpected metastatic disease discovered at the time of thoracotomy. The remaining 37 patients underwent 5 pneumonectomies, 26 lobectomies and 6 segmentectomies or wedge resections. Three of these patients (1 pneumonectomy, 1 lobectomy, and 1 wedge resection) underwent concomitant en bloc chest wall resection. The overall operative mortality rate (in hospital or within 30 days) was 15% (6/40) while there was a 16% mortality rate (6/37) for resected patients. Complications occurred in 18 of 40 patients (45%) but were major in only 12 (30%). Major complications included respiratory insufficiency (6), pneumonia (4), prolonged air leak (2), stroke (1), urinary retention prostatectomy (1), and one unexplained sudden death 2 weeks following discharge. Postoperative stay in the 34 operative survivors averaged 14 +/- 8.8 days (range 3-47). Univariate analysis revealed that neither gender, extent of lung resection, preoperative NYHA class, history of heart disease nor chronic obstructive pulmonary disease (COPD) were predictive of operative mortality in the 37 patients undergoing lung resection. Age was the only predictor of mortality (survivors 82.2 +/- 2.2, non-survivors 84.3 +/- 2.6; P < 0.05). The need for chest wall resection approached but did not quite achieve significance (P < 0.08). Actuarial survival for all 40 patients at 1 and 3 years is 55% and 40%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Lung cancer surgery in the octogenarian. 781 76

There are many reports of familial aggregation in stroke. However, whether familial aggregation is largely due to genetic or environmental factors is not established. Consecutive subjects with stroke were matched with 2 controls per case of the same sex, born in the same year, district, and whose fathers had the same occupation. Presence on parental death certificates of cerebrovascular disease, other vascular disease, bronchial carcinoma, hypertension, diabetes mellitus and other causes of death was recorded. No significant difference in risk was found for cases having mother (odds ratio, OR 1.08, 95% confidence interval, CI, 0.74-1.57), father (OR 0.91, 95% CI 0.58-1.45) or either parent (OR 1.04, 95% CI 0.74-1.46) with cerebrovascular disease. Familial aggregation may reflect socioeconomic and other environmental factors.
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PMID:Parental causes of death in stroke. 1117 96


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