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

Two young children, 5 and 30 months of age, developed acute transient dyskinesias. The novel features of these patients were classic orobuccal-lingual dyskinesias, their young ages, and the association with asthma and theophylline. The movements resembled tardive dyskinesias of older patients on neuroleptics, but neither patient had any exposure to neuroleptic drugs. Choreiform movements were moderately severe and remitted several hours after discontinuation of theophylline or over days in the patient who remained on the drug. No symptomatic treatment of dyskinesia was required. Both infants otherwise had normal neurologic examinations with no clinical evidence of meningoencephalitis, seizures, or stroke. Both infants required hospitalization for respiratory distress, but not intensive care. The highest theophylline levels measured in these patients were 22 and 25 micrograms/ml and levels determined closest to the appearance of dyskinesias were lower. Urine toxicology screen for other drugs and routine blood work were normal. The infants, examined subsequently for 1 1/2-2 years for asthma, have demonstrated no reappearance of dyskinesias or other neurologic abnormalities. We propose an interaction of theophylline, hypoxemia, or other factors related to asthma in the pathophysiology of reversible dyskinesia in our patients.
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PMID:Acute dyskinesias in young asthmatics treated with theophylline. 158 Sep 64

A 63-year-old man with arterial hypertension suffered from depression and suicidal wish after a cerebrovascular accident and transitory left hemiparesis. He was urgently admitted to hospital in severe metabolic acidosis which caused renal failure and coma, ending fatally within two days. At necropsy calcium oxalate crystals were found in the renal tubules and cerebral vessel walls with chemically induced meningoencephalitis. From these findings glycol poisoning was diagnosed. There was a lethal concentration of ethylene glycol in the urine. The toxic effects of ethylene glycol are due to its metabolites. The oxalate crystals are primarily of diagnostic importance.
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PMID:[Ethylene glycol poisoning]. 337 4

Acute pneumococcal meningitis runs the course of meningoencephalitis morphologically, and when the incidence of meningococcal meningitis is on the increase, this disease may well be mistaken for pneumococcal meningitis (two case reports of such misdiagnosis are presented) or stroke (one case is reported). An effective method for recognizing pneumococcal meningitis at an early stage is bacterioscopic examination of Gram-stained cerebrospinal-fluid smears.
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PMID:[Diagnosis of pneumococcal meningitis]. 343 2

The presented material comprised 17 cases observed in four Warsaw hospitals in a period of 20 years. Nine patients with the pseudotumour syndrome were diagnosed correctly and referred to neurosurgical services. The remaining eight cases died in neurological hospital departments with the following clinical diagnoses: cerebral stroke 3, subarachnoid haemorrhage 1, comatose state preceded by dementia 1, chronic meningoencephalitis 1, status epilepticus 2 cases postmortem investigations demonstrated cerebral cysticercosis in all cases. In four patients with predominant symptoms of cerebrovascular disease lesions were found of the type of residual vasculitis cysticercosa, the sequelae of which might have caused secondary complications independent of concomitant arteriosclerosis. Dementia appeared in a patient with huge hydrocephalus consequent to numerous cysticerci. The patient with the diagnosis of meningoencephalitis had an inflammatory reaction of the ependyma and meninges caused by a cysticercus floating in the IV ventricle. Of the patients dying in status epilepticus attention is called to a 6-year-old girl with a solitary cysticercus localised subcortically in the motor area. The authors suggest that the possibility of cysticercosis should be kept in mind, despite its rarity, in cases with a not completely clear clinical manifestations of cerebrovascular disease, chronic meningoencephalitis and epilepsy or dementia.
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PMID:[Neuropathologic analysis of 8 undiagnosed cases of cerebral cysticercosis]. 344 11

A previously healthy young man presented with an acute stroke syndrome and was found to have cryptococcal organisms in the CSF. Though an initial CSF examination for an infectious etiology was negative, a second lumbar puncture was performed because of hypoglycorrhachia, which established the diagnosis. An uneventful recovery followed the administration of Amphotericin B and 5-Flucytosine. A literature search revealed only one previously reported case of cryptococcal meningoencephalitis presenting as a stroke. The need for performing a CSF examination on young patients presenting with a cerebrovascular event, and the aggressive investigation of unexplained hypoglycorrhachia are emphasized.
Stroke
PMID:Sudden hemiparesis as the presenting sign in cryptococcal meningoencephalitis. 373 61

Peripheral blood leucocyte (PBL) cultures of patients with meningoencephalitis, myasthenia gravis, Alzheimer's dementia, Huntington's chorea as well as patients who were recovering from cerebrovascular accidents or from craniotomy for brain tumours, all had defective interferon-gamma (IFN-gamma) responses to stimulation with concanavalin A (Con A) and phytohaemagglutinin (PHA), similar to those already described for PBL cultures of patients with multiple sclerosis. Specifically, cultures from a significant percentage of the patients failed to produce IFN after stimulation with either of the two mitogens. The yields from those cultures that did respond were not significantly lower than those from cultures of healthy blood donors. With increased doses of Con A, the cerebrovascular accident, meningo-encephalitis and MS groups kept their low response frequencies, while the other groups, i.e., myasthenia gravis, Alzheimer's dementia, Huntington's chorea and post-craniotomy, developed an increased response frequency. A good concordance was found between responsiveness to Con A and PHA. With pokeweed mitogen (PWM) as an inducer, no reduction in response frequencies or IFN yields were seen in any of the patient groups. Also, in general, yields were higher with PWM than with Con A.
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PMID:Interferon-gamma production by peripheral blood leucocytes from patients with multiple sclerosis and other neurological diseases. 391 78

A case of tuberculous meningoencephalitis is described in an elderly patient diagnosed clinically and on gross inspection on autopsy as cerebral stroke. The factors making correct diagnosis difficult are discussed stressing the importance of microscopic examination in the epidemiology of tuberculous meningoencephalitis in adults.
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PMID:[Atypical course of tuberculous meningitis in old age; remarks on the observed case]. 725 76

Approximately 5,000 new cases of neurosyphilis may occur in the United States each year. General paresis and tabes dorsalis, however, have become relatively rare since the introduction of penicillin. Seizures, neuro-ophthalmologic symptoms, stroke and acute meningoencephalitis are currently the most common manifestations of neurosyphilis. In more than a third of patients with neurosyphilis, nontreponemal tests for syphilis (such as VDRL) are negative and should not be used to exclude the diagnosis. Specific treponemal tests are more sensitive and more specific. Examination of the cerebrospinal fluid may show no abnormalities in neurosyphilis and is not an infallible guide to the activity of the infection. Penicillin is the only proven antibiotic treatment of neurosyphilis. However, low-dose regimens do not produce spirocheticidal concentrations in the brain, and high-dose penicillin therapy is recommended to insure eradication of the spirochetes. Doxycycline, a tetracycline derivation that achieves relatively high concentration in the brain, may also be effective.
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PMID:Modern neurosyphilis: a partially treated chronic meningitis. 734 Jan 18

Free-living amebae etiologically associated with central nervous system (CNS) infection in children have included Acanthamoeba, Naegleria, and recently, leptomyxid ameba. Two previously healthy children are reported with CNS infection caused by leptomyxid ameba, recently classified as Balamuthia mandrillaris. One child, a 27-month-old boy, had right hemiparesis and aphasia, and the other, a 13-year-old girl, had headache, right hemiparesis, diplopia, and left facial weakness. Cerebrospinal fluid studies of both children revealed a mononuclear pleocytosis and mildly elevated protein. The younger child developed seizures and progressive cerebrovascular occlusions; both developed hydrocephalus and coma progressing to death 16 days after onset of symptoms. The younger child at autopsy had necrotizing meningoencephalitis, left internal carotid arteritis, and amebic trophozoites and cysts in brain. Perivascular trophozoites were difficult to distinguish morphologically from macrophages in the older child, who had no cyst forms. Indirect immunofluorescence test revealed CNS infection with B. mandrillaris in both. This leptomyxid ameba, formerly considered an innocuous soil organism, should be considered in the differential diagnosis of progressive or atypical childhood stroke.
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PMID:Amebic meningoencephalitis caused by Balamuthia mandrillaris. 806 Apr 31

A 15 year-old boy developed meningoencephalitis two weeks after onset of a respiratory tract infection caused by Mycoplasma pneumoniae. Central nervous complications are seen in 2-7% of patients hospitalized for M pneumoniae infection. Meningoencephalitis, meningitis, ataxia, polyradiculitis, psychosis and a few cases of apoplexy have been reported. In clinical practice one should be aware of M pneumoniae in the differential diagnosis of patients with suspected microbiologically induced central nervous complications. The pathogenetic aspects and prognosis are briefly discussed.
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PMID:[Meningoencephalitis after Mycoplasma pneumoniae infection]. 846 13


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