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

When a brain scan is abnormal, one can often describe the abnormality in terms of its location, shape, sharpness, brightness, and other descriptive parameters. Certain types of abnormality have been linked to certain specific diagnoses: for example, a crescent-shaped lesion would suggest subdural hematoma to many people, a wedge-shaped lesion would suggest cerebral vascular accident, etc. Some features thought to be characteristic of certain diseases are actually quite nonspecific. For example, the "doughnut" sign--at first believed to be characteristic of brain abscess--has also been found in primary and metastatic tumors, CVA, and subdural hematoma. The "crescent" sign that was at first thought to be specific for subdural hematoma occurs also in meningitis, scalp or skull trauma, meningioma en plaque, etc. Some features of abnormalities are highly specific for certain diseases; e.g., wedge- or flame-shaped lesions are rarely seen with disorders other than CVA, and lesions in the midline or in the posterior fossa are almost invariably tumors. This article reviews the features of abnormalities on brain scans that in the literature have been reportedly associated with specific types of disease and explores the strength and validity of the associations.
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PMID:The abnormal brain scan: specificity of descriptive parameters. 17 59

Using 99mTc-labeled macroaggregated albumin (99mTc-MAA), we made an examination of the cerebral blood flow distribution with various kinds of cerebrovascular diseases in 151 cases. The particle size of MAA used in this study ranged from 10 to 100 micron. Scan was performed after injection of 3 mCi of 99mTc-MAA into common carotid artery. No side effects were observed except for one case with headache. Distribution of 99mTc-MAA was found to be homogeneous in normal cerebral hemisphere but not in the lesion. Most lesion was shown as nonradioactive area. Meningioma with hypervascularity was represented as hot area. By this method cerebral infarct could be easily represented not only in main artery but also in such a very small artery as hardly detected by CAG. This method is therefore useful for detecting cerebral infarct, sequela of cerebral apoplexy, head injury and others. The dose of 99mTc-MAA used in this method is much lower compared with those of common brain scan, its excretion is speedy, and therefore internal radiation exposure is diminished.
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PMID:[Diagnostic evaluation on cerebral hemisphere scintigraphy using 99mTc-MAA (author's transl)]. 54 44

Headache may be the presenting symptom of many diseases in the elderly. Some headaches are caused by significant intracranial disease, and the patient's age and general cardiologic and respiratory status may not allow investigation or neurosurgical management. Conditions that demand urgent neurosurgical attention are subarachnoid hemorrhage, pituitary apoplexy, subdural hematoma, and meningioma. Cranial arteritis, too, should be remembered as a possible medical cause of headache in the elderly.
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PMID:Differentiating causes of headache. 88 44

The cerebral sequential scintigraphy enables a process to be described according to its hemodynamics (Stage I), its degree of vascularization (Stage II), and the extent of the localized disturbance of the blood-brain barrier function (Stage III). For a given lesion, typical scintigraphic behaviour patterns can be described. This report presents the results of a prospective series with 1722 patients examined using this method. The accuracy of the different scintigraphic diagnoses, according to tumor type, was: cerebrovascular accident with brain infarction - 92% (= CVA), metastasis - 90%, bone or meningital process - 89%, malignant glioma - 91%, meningioma - 74%, highly differentiated glioma - 67%, chronic subdural hematoma - 54%, A-V angioma - 54%, brain abscess - 45%. The differential diagnosis between brain tumor and CVA with infarction was possible in approximately 97% of the patients, the differential diagnosis of intracranial space-occupying lesion versus CVA with infarction in approximately 95%. There were 14 false positive results recorded (0.8% of the 1722 patients).
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PMID:[Reliability of positive findings in serial cerebral scintigraphy. Evaluation of a prospective series of 1700 cases]. 117 13

Neurosyphilis, a sexually transmitted disease that can cause neurologic damage, has become increasingly prevalent in the AIDS era. HIV carriers can contract neurosyphilis without the presence of other concurrent opportunistic infections. Because MR findings of neurosyphilis are seldom reported, we retrospectively reviewed and evaluated contrast-enhanced MR images of six young (average age, 33 years) HIV-positive men with high serum and CSF VDRL titers indicative of neurosyphilis. All six patients tested negative for concurrent opportunistic infections. Five patients had acute or subacute strokelike symptoms involving the basal ganglia or middle cerebral arteries; one had a parietal convexity mass mimicking meningioma with headache and ataxia. Contrast-enhanced MR images showed patchy enhancement involving the basal ganglia and middle cerebral artery territories in the first five patients and the convexity mass in the sixth patient. On the basis of brain biopsy, a convexity mass was diagnosed in the patient with syphilitic gumma. The imaging findings of the remaining five patients represented ischemic infarct caused by meningovascular syphilis. After penicillin treatment, serum and CSF VDRL titers decreased, and neurologic signs and symptoms improved in all six patients. A follow-up MR study in the patient with the gumma showed that the lesion resolved almost completely. In young HIV patients with stroke symptoms or a convexity mass, neurosyphilis should be considered. Contrast-enhanced MR can reveal the extent of involvement by neurosyphilis and should be used to facilitate diagnosis and proper treatment.
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PMID:Neurosyphilis in HIV carriers: MR findings in six patients. 159 Jan 35

Dysphagia is more frequently observed in patients with neurologic diseases (stroke, bulbar or pseudo-bulbar syndrome, amyotrophic lateral sclerosis, cranial trauma). Furthermore, the presence of this pathology is obviously more frequently noted in the light of the increase in the length of the human life span. It has become evident that alternative feeding procedures such as the nasogastric tube or gastrostomy may bring about complications and deprive patients of the oral phase of deglutition which plays a leading role in stimulating digestive functions. The Authors report a systematic research on the rehabilitation aspects of neurogenous dysphagia. All the patients studied underwent a neurological examination and oropharyngeal functional evaluation using echo-videorecording of the oral phase of deglutition and fluoro-videorecording of the pharyngeal phase. The data obtained allowed for the selection of five patients considered suitable for the rehabilitation program. One of them had a multi-infarct encephalopathy, two a spastic hemiplegia f.b.c., a fourth a cerebellar syndrome and the last a sequela of meningioma removal of the ponto-cerebellar angle with peripheral paralysis of the right VII, IX, X, XI cranial nerves. This last patient also underwent a crico-pharyngeal myotomy. Therapy consisted in making the patient sensitive to swallowing movements and in training them to assume a compensatory posture as well as functional rehabilitation of the organs involved in deglutition. The first datum emerging from the study is the lack of etiological homogeneity found in the cases treated with evident variability in different deglutition organ impairment, even though there was the common denominator of the dysphagia symptom. With regard to the results obtained, there was a complete resolution in one patient, while in the other four there was such an improvement as to allow the patients a safe autonomous oral assumption of food. The positive results obtained are not only linked to the recovery of damaged organs, but also to the development of compensatory strategies such as the choice of appropriate food consistency and the assumption of postures which protect the respiratory tract from aspiration and favor crico-pharyngeal relaxation.
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PMID:[Rehabilitation of oro-pharyngeal dysphagia of neurogenic etiology using radiological examination: preliminary results]. 163 72

We reviewed retrospectively a series of 100 inpatients with onset of epileptic seizure after the age of 60. All of them were investigated by EEG and 96 by CT scan. The most frequent cause of seizure was previous stroke, with 25 cerebral infarcts and 5 hemorrhages. Neoplastic lesions were present in 18 cases, with glioma (high grade), meningioma and metastases in the same proportion. Other etiologies included toxico-metabolic (18 cases), post-traumatic (9 cases), cerebral atrophy (4 cases) and miscellaneous (14 cases). The causes of seizure remained unknown in 7 patients, of whom 6 had focal signs in either clinical examination or EEG. Focal seizures (with or without secondary generalization) accounted for 65% of all cases and generalized seizures for 35%. The EEG was normal in 12 patients and abnormal in 88, with diffuse slowing in 55 patients and focal signs in 70 (some patients had both diffuse slowing and focal signs). Fourteen patients presented status epilepticus. Ten died during hospitalization. We conclude that epileptic seizure with onset after age 60 is nearly always symptomatic, and neuroradiologic investigations are necessary in the search for cerebral lesions. In our study, the prevalence of "idiopathic epilepsy" is lower than previously described.
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PMID:[Initial epileptic crisis after the age of 60: etiology, clinical aspects and EEG]. 234 61

We studied the occurrence of tumors of the brain and cranial meninges in a cohort of 34,000 California Seventh-Day Adventists who completed a detailed life-style questionnaire in 1976 and who were followed for cancer incidence until the end of 1982. During the period of follow-up, 31 tumors were diagnosed in the cohort (21 gliomas, 10 meningiomas). Increased risk for glioma was associated with rural residence, history of a positive tuberculosis skin test and consumption of pork products; increased meningioma risk was associated with a positive reaction to a tuberculosis skin test, previous stroke, use of tranquillizers and a vegetarian life-style in childhood.
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PMID:Risk factors for tumors of the brain and cranial meninges in Seventh-Day Adventists. 281 86

To determine the outcome of patients with carotid transient ischemic attacks (TIAs) and normal cerebral angiograms, we assessed 68 patients (40 men, 28 women) aged 24-72 (mean 53.5) years for recurrent TIAs and strokes and for the development of cardiac disease over 2-6 (mean 4.4) years. All but one patient had a follow-up interview in early 1987; that patient had died of an unrelated cause (lung cancer) 18 months after the presenting TIA. The diagnosis was changed at the follow-up interview in three patients (multiple sclerosis, meningioma, migraine). Among the 64 remaining patients, at admission cranial computed tomography had shown cerebral infarction in 11 of 64, two-dimensional echocardiography had been abnormal in nine of 61, Holter monitoring had been abnormal in eight of 45, and twelve-lead electrocardiography had been abnormal in three of 64. Two patients had abnormalities on both echocardiography and Holter monitoring. At the follow-up interview of the 64 remaining patients, TIAs had recurred in nine and three had developed a completed stroke; cardiac disease (angina in seven, myocardial infarction in four) was noted in 11 patients. Findings from cardiac investigations on admission in the nine patients with recurrent TIAs had been abnormal in six and normal in three; all three patients who developed a stroke had had abnormal cardiac findings. Overall, further neurologic or cardiac events occurred in 12 of 46 patients (26%) with normal and in 10 of 18 patients (55.5%) with abnormal findings on admission (p less than 0.01). In the presence of normal angiograms, extensive cardiac investigations may help predict the outcome of patients with TIAs.
Stroke 1988 Oct
PMID:Transient ischemic attacks and normal cerebral angiograms: a follow-up study. 317 81

Twelve patients who developed mania after a brain lesion are reported. Ages ranged from 20 to 83 years. Five patients had brain tumors (three frontal meningiomas, one temporal meningioma, and one temporal astrocytoma), four patients had stroke lesions (one frontal, one temporal, and two thalamocapsular), two patients had a traumatic frontal closed head injury, and one patient had a pituitary adenoma resection. Although seven patients had lesions restricted to the right hemisphere, four had bilateral or midline damage and one had a left hemisphere lesion. Damage to structures functionally connected to the obitofrontal cortex, mainly in the right hemisphere, seems to be associated with secondary mania. The possible roles of monoaminergic, genetic, and perinatal factors in the pathogenesis of secondary mania are discussed.
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PMID:Mechanisms of mania after brain injury. 12 case reports and review of the literature. 327 15


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