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

Ischemic cerebrovascular disease in children is relatively rare. To clarify the clinical features of ischemic stroke occurring in infants and children, we evaluated 54 cases of cerebral infarction, excluding cases of moyamoya disease, in patients less than 16 years old at 24 clinics in the Tohoku (northeast) district of Japan. We observed two incidence peaks, one in little children and the other in junior high school students. Infection and minor head trauma were more frequently seen prior to ischemic strokes than was heart disease. The middle cerebral artery region, including the basal ganglia, was most commonly affected (49 patients, 91%) on computed tomograms. Angiography was performed in 48 patients (89%) and showed various types of occlusive lesions, mostly affecting the middle cerebral artery. Hemiparesis was the most common form of disability following ischemic strokes (48 patients, 89%). Surgical treatment was carried out in seven patients (13%). The clinical course of these cases showed that the recovery of children after a stroke tends to be better than that of adults, but that permanent disabilities, such as hemiparesis or mental retardation, occur commonly. Further investigation of juvenile cerebrovascular disease is important to prevent ischemic strokes in children.
Stroke 1991 May
PMID:Clinical survey of ischemic cerebrovascular disease in children in a district of Japan. 202 86

To clarify the differences in cerebral hemodynamics and metabolism between children and adults with bilateral moyamoya disease, we measured regional cerebral blood flow, regional oxygen extraction fraction, regional metabolic rate for oxygen, regional cerebral blood volume, and regional transit time using positron emission tomography in nine patients (five children and four adults) and compared the values with those in controls (four children with unilateral moyamoya disease and six normal adults). The major differences between pediatric and adult patients were in regional cerebral blood volume and regional oxygen extraction fraction. Regional cerebral blood volume was more markedly increased relative to the control value in the children than in the adults. Also, regional oxygen extraction fraction was greater than control in areas with low blood flow in the children but was never increased in the adults. However, in the adults, only regional transit time was significantly prolonged relative to the control values. The increased regional oxygen extraction fraction relative to the control value observed in children with moyamoya disease may explain why transient ischemic attacks are a common symptom in this group.
Stroke 1990 Feb
PMID:Cerebral hemodynamic change in the child and the adult with moyamoya disease. 230 3

To clarify the morphogenesis of vascular anastomoses in the leptomeninx, we examined the leptomeningeal vessels of six autopsied patients with moyamoya disease who died of cerebral hemorrhage. Sites examined in the brain (the frontal pole, frontoparietal convexity, and lateral occipital region) were selected by the presence of angiographic abnormalities on the convexity of the hemisphere. At all examined sites, neither the vascular density (number of blood vessels per unit length of underlying cortical surface) nor the arterial/venous ratio differed significantly between the patients and 14 controls. All patients showed dilatative changes of both arteries and veins; however, attenuation or disruption of the internal elastic lamina and fibrous intimal thickening were more prominent in those patients who had had moyamoya disease longer. Our results indicate that the leptomeningeal vessels of moyamoya disease are not newly formed but are merely dilated preexisting vessels and that the structural alteration of the vascular walls suggests their adaptability for participation in the collateral circulation at the cerebral surface.
Stroke 1990 Jul
PMID:Histopathologic and morphometric studies of leptomeningeal vessels in moyamoya disease. 236 5

Moyamoya disease has been associated with renal artery stenosis, cerebral hemorrhage, and multiple cranial traumas. We report a unique case of moyamoya disease associated with polycystic kidney disease and eosinophilic granuloma. Although the etiology of moyamoya disease is unknown, a familial pattern of occurrence has been documented. Of particular importance is its presentation with polycystic kidney disease, an autosomal dominant disease, suggesting a hereditary component to the etiology of this unusual vasculitic disease.
Stroke 1989 Aug
PMID:Moyamoya disease associated with polycystic kidney disease and eosinophilic granuloma. 275 42

Twenty-seven new cases of stroke in Down syndrome are reported, two probands, 13 patients from review of institutional records, and 12 patients from a survey of child neurologists. Forty-one patients from previous reports are summarized. Most stroke episodes were related to congenital heart disease and infections. Seven cases were associated with angiographic abnormalities; there were three cases of unknown etiology and four cases of moyamoya. The understanding of moyamoya and other causes of stroke may be advanced by further study of stroke in Down syndrome patients.
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PMID:Moyamoya and other causes of stroke in patients with Down syndrome. 297 27

The method for cerebral blood flow (CBF) measurement using an H215O intravenous injection and positron emission tomography (PET) was implemented, examined and applied to measure cerebrovascular reactivity to PaCO2(VRCO2) and to MABP (VRBP) in normal brain and in ischemic brain. Immediately after bolus intravenous injection of 30-40 mCi H2(15)O, a time-activity curve of H2(15)O concentration in the arterial blood and in the brain were measured for 60 sec by a beta detector and a PET, respectively. The PET was HEADTOME III and measured five planes. CBF was determined by the table-look up method based on the autoradiographic principle. Six volunteers were studied to examine region of VRCO2, and a moyamoya patient and a stroke patient with a bilateral-intracarotid circulation defect were studied to examine VRCO2 and VRBP in ischemic brain. The studies were carried out so as to be followed two or three H2(15)O CBF measurements with changing PaCO2 or MABP after control study at rest condition. In addition, prior to the H2(15)O study O15 gas steady state study was performed on all subjects. Validity of the method examined by simulation studies showed 3% error per 1 sec time shift of the artery curve for 60 sec PET scan duration and the error was rapidly increased to the shorter scan duration. Inhomogeneity of a brain tissue gave mild under-estimation by 5% for 60 sec PET scan duration. VRCO2 in normal brain was revealed to be almost uniform except that the infratentorium area showed a slight higher VRCO2 than the supratentorium area. The ischemic brain showed a negative correlation between VRCO2 and oxygen extraction fraction (OEF), and a positive correlation between VRBP and OEF.
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PMID:[Cerebral blood flow measurement using H2(15)O intravenous injection and positron emission tomography: description of implementation and applications to cerebrovascular reactivity measurement]. 311 65

A 33-month-old boy with recurrent stroke-like episodes had angiographic features characteristic of moyamoya syndrome. Mitochondrial encephalomyopathy was suspected because of lactic acidosis and ptosis. Studies of oxidative metabolism on isolated skeletal muscle mitochondria revealed impairment of NADH-coenzyme Q reductase activity. Mitochondrial metabolic disorders may cause moyamoya syndrome when other known associated factors are absent.
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PMID:Impaired NADH-CoQ reductase activity in a child with moyamoya syndrome. 314 83

The authors studied 34 patients with juvenile ischemic cerebrovascular disease over a 15-year period. Of the 34 patients, 23 had intracranial occlusions attributed to cerebral thrombosis or embolism and 11 had occlusions resulting from moyamoya disease. Clinicopathological features were evaluated in the 23 cases with ischemic stroke, but not those with moyamoya disease. The cause of the arterial occlusion remained undetermined in 11 patients and was found to be an embolism based on congenital heart disease in 8, on trauma in 3, and on infection in 1. Cerebral angiography was performed in 21 patients. Of these, 17 had stenoses or occlusions corresponding to their symptoms. CT scans were performed in 10 patients; the lesion in question showed no stenosis or occlusion with cerebral angiography. With regard to prognosis, patients with unknown etiology had good outcomes compared with those with congenital heart disease. With respect to "acute infantile hemiplegia", 10 patients had convulsive seizures and 4 had a history of an earlier infection. Angiography and CT scans in patients with congenital heart disease demonstrated arterial occlusive sites in the middle cerebral artery region. Three patients had abscesses after their ischemic lesions.
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PMID:Ischemic stroke in infancy, childhood, and adolescence. 324 46

Seven cases of primary intraventricular hemorrhage (PIVH) constituted 3.1% of intracerebral hemorrhages in a prospective stroke series of 2,950 patients. All patients collapsed suddenly and had a depressed state of consciousness. Focal signs, if present, were minimal and contralateral to the major site of hematoma. Angiography in four patients revealed three intracranial arteriovenous malformations and one moyamoya. We conclude that PIVH may be readily diagnosed radiologically and underlying vessel malformations should be sought by angiography. Survival is common (five of seven cases), but a severe amnesic state may be a persisting deficit.
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PMID:Primary intraventricular hemorrhage: clinical and neuropsychological findings in a prospective stroke series. 325 94

Moyamoya disease was diagnosed as the cause of cerebral infarction in eight young adults (seven women, one man), aged 17-40 (mean 33) years. All had angiographic abnormalities characteristic of moyamoya disease. Single-photon emission tomography showed bilateral carotid circulation hypoperfusion and posterior circulation hyperemia in all seven patients with regional cerebral blood flow studies. All seven women had used oral contraceptives before cerebral infarction. Four patients were treated medically; one died of a second cerebral infarction 9 months after diagnosis. Four patients underwent superficial temporal-to-middle cerebral artery anastomosis; they did well. Moyamoya disease should be included in the differential diagnosis of cerebral infarction as well as intracranial hemorrhage in young adults, particularly women. A possible relation between moyamoya disease and oral contraceptive use deserves investigation.
Stroke 1988 Jul
PMID:Cerebral infarction due to moyamoya disease in young adults. 326 Apr 17


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