Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case reported here and others like it indicate that thyrotoxicosis can be manifested by psychosis or bizarre neurologic signs. Thus, hyperthyroidism in late life may be overlooked and the patient given the diagnosis of psychosis secondary to organic brain syndrome or cerebrovascular accident. Thyrotoxicosis, which is treatable, should be looked for as a possible cause of deterioration of mental function with or without focal neurologic signs.
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PMID:Thyrotoxicosis as a mimic of dementia and/or stroke-like syndrome. 48 77

A 57-year-old man with no personal or family history of manic-depressive disease developed symptoms of hypomania after a cerebrovascular accident and surgical trauma to the brain. The patient responded well to lithium carbonate treatment over a 2-year period. Although this therapy is contraindicated in cases of organic brain syndrome, the authors suggest that it should be considered in the management of hypomanic behavior following organic brain dysfunction.
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PMID:Positive therapeutic response to lithium in hypomania secondary to organic brain syndrome. 116 80

In a review of our experience with systemic lupus erythematosus (SLE) since 1975, we found 48 of 266 patients with major central nervous system (CNS) manifestations for which a non-SLE explanation could not be identified. Eleven patients developed more than one type of CNS event. The commonest symptom was seizure (18 patients), followed by brainstem dysfunction (12 patients), psychosis (11 patients), organic brain syndrome (11 patients) and stroke (7 patients). In 19% of cases, CNS manifestations were accompanied by a flare of multisystem SLE disease activity. Anticonvulsants were able to be discontinued safely in the majority of patients with seizures. Most CNS events were self-limited, reversible and not associated with poor outcome unless accompanied by multisystem disease activity. Therapy with corticosteroids did not appear to offer substantial benefit.
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PMID:The incidence and prognosis of central nervous system disease in systemic lupus erythematosus. 155 99

Poststroke depression can be accompanied by suicidal ideation, yet reports of suicide among stroke patients are rare. When untreated, depression can become prolonged and severe. Risk factors for suicide include depression, severe insomnia, chronic illness, and organic brain syndrome. Early clinical assessment of suicide risk factors is essential in the rehabilitation setting. Two patients who developed mood disturbances in the acute poststroke period and eventually committed suicide are presented. Neither patient openly expressed suicidal thoughts to staff or family members. Retrospective analysis of medical records was compared to established suicide risk factors reported in the medical literature. Indirect verbal cues and nonverbal behavior patterns indicating potential suicide risk may have been present. Strategies for evaluation and management of suicidal behavior are discussed. These cases emphasize the need for early assessment of suicide risk by the entire rehabilitation team.
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PMID:Assessing suicide risk in stroke patients: review of two cases. 224 37

Physician practice patterns and attitudes about the use of nasogastric (NG) feeding tubes in a group of elderly patients with severe chronic illness were explored in a community-based teaching hospital in Rochester, NY, using a physician questionnaire and a chart review. The physician questionnaire showed considerable divergence in beliefs about whether this treatment is extraordinary (42%), ordinary (21%), or comfort oriented (37%). Physicians who believed it was extraordinary treatment said they would recommend it less often than those who believed it to be ordinary or comfort oriented in the abstract scenario of a chronically ill, elderly patient who was not maintaining adequate nutrition. Most physician-respondents believed that the patient's wishes should guide the decision. Independently, medical records were retrospectively reviewed for all patients admitted to the hospital in the previous year who had an NG feeding tube placed, who were over the age of 70 years, and who had primary diagnoses of cerebrovascular accident, organic brain syndrome, or metastatic cancer. Contrary to the questionnaire responses, oral or written consent was documented in only 2 of 51 insertions of NG tubes. Of the 7 charts where a surrogate gave consent, only one expressed consideration of the patient's actual wishes. The clinical reasoning leading to the decision documented in the chart emphasized biomedical concerns much more than the patient's quality of life (8:1 ratio). Sixty-four percent (35/55) of patients in the study group died in the hospital, including 90% (19/21) of those who were to be treated with a comfort orientation. In only 2 of 55 patients was medical improvement cited as the reason for discontinuing use of the NG feeding tube. Restraints were used in 53% of the patients to keep the tube in. Recommendations are made that emphasize the need for active patient and family participation in the decision to use an NG feeding tube, requiring a balanced presentation of potential benefits, burdens, and limitations in patients with severe irreversible illnesses.
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PMID:Utilization of nasogastric feeding tubes in a group of chronically ill, elderly patients in a community hospital. 212 Nov 15

The images of cranial computed tomographies on 7.921 patients aging between 50 and 98 years were analyzed retrospectively concerning the occurrence of WMLA. 3.344 patients were suffering from psychogeriatric disorders (organic brain syndrome, dementia, depressive or delusional psychoses). Neurological diagnoses (stroke, TIA, Parkinson's disease, Huntington's disease, space occupying lesions, seizures, cerebral trauma, vertigo, chronic headache) occurred in 4.577 patients. WMLA was established in 761 cases. The combination of WMLA with cerebral atrophies, with single or multiple infarcts and with both infarcts and atrophy will be demonstrated within 4 groups: 1. organic brain syndrome and dementia, 2. depression and delusional states, 3. stroke and TIA, 4. other neurological diagnoses. In group one the combination of WMLA with atrophy and infarcts is the most common finding in CT. In group two WMLA without atrophies and infarcts are the main tissue changes in CT. Group three is marked mainly by the occurrence of recent infarcts together with WMLA. In group four again WMLA only, in some cases together with multiple infarcts, do occur mainly. Compared to the cases without WMLA in each group WMLA is seen in cases with organic brain syndromes and dementias three to five times more than in the other diagnostic groups. WMLA in computed tomography seems to be a common finding in patients and healthy individuals of old age. Therefore the diagnostic and differential diagnostic significance for brain diseases in old age is limited. Nevertheless in the field of psychogeriatric disorders it may be possess a certain value to understand the nature of such diseases. This value will be discussed and demonstrated considering the pathogenesis of WMLA on the basis of neuropathological results.
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PMID:[Periventricular attenuation of the density of cerebral hemisphere white matter in computerized tomography of neuropsychiatric patients in the 2d half of life. Diagnostic significance and pathogenesis]. 322 Apr 19

Nutritional problems in the elderly are complex and individually diverse, and therefore a differentiated approach ist mandatory. Interactions of social, psychological and biological factors in the nutrition of the elderly are discussed in four clinical cases: problems of procurement and preparation of food in a patient with sensory aphasia and mild organic brain syndrome; problems of food intake and mastication in a patient with stroke; problems surrounding nutritional requirements and absorption of nutrients in a patient with osteoporosis, and problems relating to nutritional components in a patient with constipation. The clinical vignettes illustrate the difficulty of changing eating habits in elderly people. Nutritional policy for the aged involves a dilemma: on one hand, their survival attests to the essential adequacy of their life-long eating practices. On the other hand, the biological, psychological and social changes of old age appear to make some individually tailored adaptation of nutrition appropriate.
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PMID:[Nutritional problems in old age]. 360 71

The Psychogeriatric Department of the Bezirkskrankenhaus Regensburg is an open ward of acute cases with intensive care facilities; it exists since 2 years. There are 39 beds, admission rate is about 20-25 patients per month; patients both male and female suffer from neuropsychiatric disorders and concomitant internal diseases. There is a technical examination of all patients by EEG, CCT, cranial x-ray, and in most cases also by Doppler-sonography. The statistical evaluation aims at an attribution of neurological and psychiatric disorders resp. to technical findings. The study comprises 207 in-patients with organic brain syndromes or functional psychiatric-endogenous or psychogenic disorders. There is a better concordance in the differential diagnosis between organic brain syndrome and functional psychiatric disorders resp. and EEG than CCT, it is a statistically significant difference. Most of the psychogeriatric patients demonstrate a marked atrophy of the brain in CCT, and relation to clinical diagnosis is rare, while--apart from some exceptional cases--there is a good concordance between EEG and the clinical diagnosis "organically disturbed" or "organically normal". Though CCT being the appropriate technical method of diagnosis in cerebrovascular stroke, EEG sometimes demonstrates the localisation of an infarction at an earlier stage. EEG and CCT are indispensible in the psychogeriatric diagnostics, EEG has shown to be superior to CCT in the differential diagnosis "organic brain syndrome" vs. "functional psychiatric disorder".
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PMID:[Correlation of the organic psychosyndrome in the aged with technical findings--value of EEG and CCT in psychiatric diseases in the aged]. 409 78

In the first study of combined chemotherapy and radiation therapy for small cell lung cancer by the Southwest Oncology Group, 17 patients survived more than five years after treatment was initiated (4.6 percent). Late relapse, or a second primary malignancy three to six years after diagnosis, accounted for death in five of these patients. Late recurrences involved the chest, bone, and liver; none occurred in the central nervous system. Disease-free survival continues in 10 patients (6 percent of those with limited disease and 1 percent of those with extensive-stage diseases) at a minimal follow-up in excess of six years. One definite case of chronic treatment-related toxicity occurred: congestive cardiomyopathy after 450 mg/m2 of doxorubicin, successfully managed with digitalis and diuretics. One severe neurologic problem (orthostatic hypotension with preterminal dementia) and two less severe neurologic complications (occasional falling episodes without documented cause and cerebrovascular accident) may be treatment-related. Progressive pulmonary disability, post-herpetic pain syndromes, organic brain syndrome, and hematologic abnormalities have not been observed to date. Nitrosourea administration and/or co-administration of a nitrosourea or methotrexate during the induction phase of treatment with radiotherapy to the brain may account for the higher incidence of complications observed by others in long-term survivors.
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PMID:Long-term survival and toxicity in small cell lung cancer. Southwest Oncology Group study. 608 60

Urinary incontinence and a program to treat it were studied in a geriatric hospital. Of 161 men, 58 (36%) were incontinent. The most common probable causes were cerebrovascular accident and organic brain syndrome. Evaluation by cystometry (after treatment of infections) in 30 patients showed 24 (80%) to have detrusor hyperreflexia. Twenty patients with hyperreflexia completed a timed-voiding routine, which benefited 17 of them (85%).
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PMID:Behavioural treatment of urinary incontinence in geriatric patients. 713 6


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