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

The authors have studied 30 patients with transient global amnesia aged between 49 and 76 years (median age of 63 years), without focal neurologic signs that have been followed for periods varying between 6 months and 10 years. Three of the patients had recurrent attacks of transient global amnesia, and another three had a stroke, although at some distance from the amnesia attack. Association was noted with certain risk factors including high blood pressure, and angiopathic changes of the eye fundus (in 50% of the patients), dyslipidemia (in 30%), diabetes (in 10%), and essential polyglobulia (in 7%). Coagulation studies including thrombelastograms were carried out in 22 patients, and demonstrated hypercoagulability in 50% of them. Changes in the arterial wall were noted in 85% of the 14 patients in whom carotid sphygmograms were recorded. The presence of these risk factors could explain the occurrence of cerebrovascular accidents in patients with transient global amnesia. Electroencephalograms performed immediately or a short time after the amnesia attack have evidenced in 18 patients rapid-type dysrhythmia, or diffuse theta waves, predominantly located in the deep layers of the left and right temporal areas. The EEG tracings were either flat or normal in the remaining 12 patients. Of the 30 patients presenting with global transient amnesia only two had migraine in antecedents, and another six had headache during the evolution of amnesia. The neurologic examination did not reveal any abnormality in 27 of the patients. Sequelar signs of neurological deficits were noted in the remaining three patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Transient global amnesia (a study of 30 cases)]. 223 8

Oral contraceptives are clearly contraindicated in patients with a history of thromboembolic disease, ischemic heart attack, or cerebral stroke. Patients requiring long-term anticoagulant treatment can be treated with gonadotropin-releasing hormone analogs to prevent ovulation, because ruptured follicles can cause massive intraperitoneal bleeding. Patients with essential hypertension and severe liver diseases should also discontinue treatment 4 weeks before major elective surgery. Migraine and diabetes mellitus are regarded as relative contraindications, depending on the individual situation. Long-term diseases, such as Crohn's disease, epilepsy, and sickle cell anemia, also require individualized consultation.
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PMID:Oral contraception in disease states. 225 29

Magnetic resonance imaging (MRI) of the brain was performed in 18 patients with non-epileptiform basilar artery migraine (BAM). In a few subjects, mild enlargement of the cortical sulci and white matter T2 weighted increased signal intensity were present. Twelve of the patients also underwent computerized tomography (CT) of the head: 6 of the latter individuals had abnormalities on their MRI not detected by CT, but their finding did not modify the pre-existing diagnosis or influence clinical management. No evidence of biologic markers (i.e. congenital anomalies of the brainstem) was encountered and no signs of prior traumatic lesions, demyelinating disease or complicating stroke. MRI is a useful but limited complementary diagnostic tool in BAM.
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PMID:MRI studies in basilar artery migraine. 230 52

Strokes in young adults are uncommon and often a diagnostic challenge. A retrospective study of strokes due to intracerebral hemorrhage, subarachnoid hemorrhage, or cerebral infarction was undertaken. We reviewed the medical records of 113 young patients aged 15-45 years who were admitted to the Medical Center Hospital of Vermont with a diagnosis of stroke between 1982 and 1987. This group comprised 8.5% of patients of all ages admitted for stroke, 2.3 times the proportion observed in the National Survey of Stroke. Nontraumatic intracerebral hemorrhage was diagnosed in 46 young patients (41%); the main causes included aneurysms, arteriovenous malformations, hypertension, and tumors. Subarachnoid hemorrhage was found in 19 young patients (17%); the majority were due to aneurysms. The remaining 48 young patients (42%) had cerebral infarction, the majority due to cardiogenic emboli and premature atherosclerosis. Mitral valve prolapse, the use of oral contraceptives, alcohol drinking, and migraine were infrequent sole causes of cerebral infarction in the absence of other risk factors. The case-fatality rate for this group of young patients with stroke was 20.4% compared with 23.9% for the National Survey of Stroke. Young adults with stroke deserve an extensive but tailored evaluation, which should include angiography and echocardiography.
Stroke 1990 Mar
PMID:Stroke in young adults. 230 61

A 25-year-old woman with a history of basilar migraine attacks ultimately resulting in a basilar artery migraine stroke is described. Brain computed tomography showed bilateral hypodense lesions in the cerebellar hemispheres. A survey of literature on basilar artery migraine is presented and the relation between stroke and migraine is discussed.
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PMID:Basilar artery migraine stroke. 232 15

The authors investigated 100 patients (55 males and 45 females) aged 16 to 45 years who experienced cerebral ischemic attack, excluding venous thrombosis. Transient ischemic attacks accounted for 12% only. Attacks were related to usual causes of brain ischemia in 49 cases (premature atherosclerosis in 26, cardiopathy in 20 and lacunar stroke in 3). Thirty-eight events were attributed to most uncommon etiologies. Nonatherosclerotic arteriopathies (10 cases) such as spontaneous dissection, dysplasia or megadolichoarteries were easily diagnosed by angiography. Oral contraceptives (14 cases) and migraine (2 cases) were diagnosis of exclusion. Hematological disorders were a possible cause in 10 patients. Etiology remained undetermined in 13 cases. Four patients died acutely. Follow-up data were obtained in 93 survivors with a mean duration of 26 months (range, 6 to 60 months). Four subjects died during follow-up and 6 experienced recurrent stroke (annual recurrence rate: 3%). In activities of daily living, 64% of patients had complete autonomy while 13% had mild residual disability and 23% had severe handicap.
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PMID:[Cerebral arterial ischemic complications in young adults. Etiology and prognosis]. 232 55

We describe three cases of extracranial vertebral artery dissection that are unusual in both their modes of presentation and their associations with other pathologic conditions. The first patient had Marfan's syndrome and migraine; his dissection was asymptomatic and was diagnosed by chance at the time of repeat angiography following a previous internal carotid artery dissection. The second patient had systemic lupus erythematosus and presented with a subarachnoid hemorrhage attributed to an intracranial vertebral artery dissection by the demonstration of an extracranial dissection. The third patient had a minor basilar artery stroke in which dissection had occurred beside a congenital hemivertebra deformity.
Stroke 1990 Apr
PMID:Three cases of spontaneous extracranial vertebral artery dissection. 232 44

Brainstem auditory evoked potentials (BAEPs) are affected by stroke or migraine in the vertebrobasilar arterial system. Some studies have reported BAEP changes in vertebrobasilar transient ischemic attacks (TIAs), but others have shown no alterations. We recorded BAEPs in 35 patients with TIAs in the vertebrobasilar system who did not have a stroke, other neurologic disease or significant hearing loss. Thirty patients were recorded after resolution of symptoms, while five individuals still had some resolving signs or symptoms. TIA patients as a group had longer interpeak latencies, but I-III, III-V, and I-V latencies were not significantly longer than in controls. Wave V was significantly longer in latency and lower in amplitude in TIA patients, however. The patients whose TIAs had resolved at absolute and interpeak latencies were within normal limits, but three of five had interpeak latencies at or above three standard deviations beyond the normal mean in the still symptomatic group. One of these was later tested and found to be within normal limits. BAEPs after subsidence of symptoms may add little to the evaluation of vertebrobasilar ischemia, but further AEP analysis may show more definitive differences of diagnostic use. The occasional BAEP abnormality during the resolving transient ischemia supports the recently suggested continuum between ischemia and infarction in the vertebrobasilar territory.
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PMID:Auditory evoked potentials in vertebrobasilar transient ischemic attacks. 233 45

In the five year period 1972-1977, 27 patients aged 15-45 years were admitted to a neurological department in the Copenhagen area because of acute focal neurological deficits, lasting more than 24 hours and of presumably vascular origin i.e. stroke. In seven cases, the neurological deficits were of thromboembolic origin and in further seven cases the deficits occurred in relation to migraine with aura. Two cases were classified as migraine-equivalents. In the remaining eleven cases it was not possible to decide whether the persisting neurological deficits were of migrainous or thromboembolic origin. Nine of these 11 patients were women. Nine had headache and six had nausea/vomiting or photo/phonofobia. Cerebral angiography was performed in five of these 11 patients and in all the angiograms were normal. Migraine-aura was most probably the cause of the persisting deficits in some of these 11 patients. It is concluded, that migraine-aura is relatively often the cause of stroke in young adults.
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PMID:[Migraine aura as the cause of apoplexy in young adults]. 236 Feb 67

A prospective study on 386 consecutive patients affected of ischemic stroke (IS) has been analysed in relation to etiologies, comparing them with a control group of 100 people. The atherotrombotic etiology subgroups are associated with family history of stroke, risk factors, atheromatosis, occlusive peripheral arteriopathy, previous of stroke, high levels of hematocrit and hemoglobin, impaired lipid fractions and high levels of uric acid. The cardiac embolism etiology subgroups are associated with the presence of personal history of stroke, just as the mitral valva prolapse (MVP) patients group. The migraine group is significantly related with the intake of oral contraceptives.
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PMID:Ischemic stroke in young adults. II. Analysis of risk factors in the etiological subgroups. 236 Mar 98


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