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

Thalamic hemorrhage or infarction is one of the common causes of stroke. People who suffer from this type of cerebrovascular disease may develop thalamic syndrome which includes sensory disturbance, motor deficit and psychological problems. In this report, we introduce two cases of thalamic hemorrhage followed up for more than a half year after stroke. Delayed rigidity and choreodystonic type of involuntary movement over their paretic hand developed gradually. The metacarpophalangeal joints of the affected hand were kept flexed and the proximal and distal interphalangeal joints became extended. Thalamic hand is demonstrated in the appended pictures. Once the patient develops a thalamic hand, activities of daily living will be affected due to poor hand performance despite of high motor recovery stage. Early recognition and proper rehabilitation program for the patients with thalamic hand are emphasized.
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PMID:Thalamic hand: a late onset sequela of stroke and its influence on physical function after rehabilitation: two cases report. 140 23

Six patients had isolated hemiataxia and ipsilateral sensory loss, as a manifestation of thalamic infarction in the thalamogeniculate territory. Acute hemiataxia-hypesthesia was not found in 1075 other patients from the Lausanne Stroke Registry who were admitted during the same period. Stroke onset was progressive in five patients and immediately complete in one. Five patients had an objective sensory loss. In two patients this affected light touch, pain and temperature sense, and in another three light touch, pain temperature, position and vibration sense. One patient had a purely subjective sensory disturbance. The sensory deficit cleared or was clearing although the ataxia persisted in all patients. On lesion mapping on CT or MRI, all patients had involvement of the lateral part of the thalamus (ventral posterior nucleus and ventral lateral nucleus). The presumed causes of stroke were cardioembolism in one patient, posterior cerebral artery occlusion in one patient and meningovascular syphilis in one patient, hypertensive small vessel disease in two patients, and undetermined in one patient. Hemiataxia-hypesthesia is a new stroke syndrome involving the perforating branches to the lateral thalamus, but in which small vessel disease may not be the leading cause.
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PMID:Hemiataxia-hypesthesia: a thalamic stroke syndrome. 164 Feb 35

A case of 25-year-old woman with mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) was reported. She had short stature, episodic vomiting with headache, several episodes with homonymous hemianopsia, progressive intellectual decline, generalized convulsion, muscular atrophy, sensory disturbance on the left side of the body, and primary amenorrhea. Lactate, pyruvate and the lactate to pyruvate ratio were elevated in the serum and cerebrospinal fluid. Muscle biopsy revealed ragged-red fibers. On electron microscopy there were subsarcolemmal aggregations of abnormal mitochondria with proliferation of crista and inclusions. Activities of the respiratory chain enzymes of the muscle mitochondria were normal. She showed a failure of GH response to arginine and levodopa and delayed response of serum GH to growth hormone releasing factor (GRF). She also showed decreased gonadotropin levels and delayed response of the hormone to LH-RH. In this case, a dysfunction of the hypothalamo-pituitary axis may be related to the short stature and primary amenorrhea. It is suggested that the hypothalamo-pituitary hypofunction may be one of the characteristic features in MELAS.
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PMID:[Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) associated with hypothalamo-pituitary hypofunction--a case report]. 206 Feb 43

Somatosensory evoked potentials (SEP) were recorded in 125 (n = 151) stroke patients more than 3 weeks after disease onset and in 55 healthy adults. The correlation between sensory disturbance, N20 amplitude ratio, and the central conduction time (CCT) was then investigated. N20 amplitude ratio was given by the amplitude of the affected side divided by that of the unaffected side and presented as a percentage, while CCT represents the time interval between N20 and N13. For the healthy subjects, normal values of CCT were 6.1 +/- 0.4 msec (20-59 years old) and 6.4 +/- 0.4 msec (over 60 years old). Normal amplitude ratios were left side/right side = 97.5 +/- 16.4% and right side/left side = 105.4 +/- 17.7% with the value at the second standard deviation, 64.7%, representing the normal range of the amplitude ratio. Of 98 stroke patients with an abnormal amplitude ratio and 23 with an abnormal CCT, 91.8% and 95.7%, respectively, had sensory disturbance. Conversely, 82.6% of those with sensory disturbance showed an abnormal amplitude ratio, while only 38.6% with sensory disturbance showed an abnormal CCT. There was a definite correlation between sensory disturbance and either CCT or amplitude ratio, however, there was none between CCT and amplitude ratio. On the basis of these results, we concluded that amplitude ratio would be more effective than CCT as a parameter for monitoring sensory disturbance in stroke patients.
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PMID:Correlation between somatosensory evoked potentials and sensory disturbance in stroke patients. 275 86

The purpose of this study was to analyze how the locus of the sway of the center of gravity (LSCG) while standing could serve as a prognostic predictor of the hemiplegic's walking ability. It was demonstrated that the prognosis of the walking ability could be predicted by the size of LSCG while standing. The size of LSCG was based on the results of the rehabilitation of 33 stroke patients with hemiplegia. After rehabilitation treatment, LSCG was significantly small and its level was maintained for a short follow-up. In the deep sensory disturbance group, however, LSCG was still larger after treatment than that of the control group. LSCG was closely correlated with walking ability at admission and discharge. With regard to the predictable factor of the walking ability improvement rate, four important factors in the following order were able to be determined by using multivariate analysis: Walking ability at admission, duration of illness, LSCG with eyes opened at admission and the rate of visual suppression (% VS). Furthermore, with respect to the predictable factor of walking ability at discharge, the following four factors, were able to be concluded: duration of illness, LSCG with eyes opened, % VS and Barthel Index Score (BIS) at the time of admission. It is therefore suggested that LSCG can make it possible to predict the walking ability, i.e., the improvement and the quality of it.
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PMID:Rehabilitation of post-stroke hemiplegic patients. I. Gravity-center-swaying and walking ability. 281 62

Symptomatic common carotid artery occlusion (CCAO) is rare. We studied 17 patients with ischemic cerebrovascular symptoms and unilateral CCAO on angiography to help clarify clinical and radiologic features. Mean age was 62 years; 65% were women. Predominant symptoms and signs included visual-ipsilateral monocular or retrochiasmal symptoms (88%), motor weakness (88%), sensory disturbance (59%), dizziness/lightheadedness (53%), and syncope (24%). Dysarthria, headache, or involuntary limb shaking occurred less frequently. Positionally related symptoms occurred in approximately two-thirds of the patients. TIAs were often multiple and preceded a stroke or occurred without subsequent stroke in 82%. Hemispheric TIAs contralateral to the CCAO occurred in 41%. Ten patients (59%) suffered stroke, seven (70%) of which were ipsilateral to the CCAO. Vascular risk factors included cigarette use (76%), hypertension (71%), diabetes mellitus (41%), and hyperlipidemia (41%); 82% had two or more risk factors. Known cardiac disease was present in 59%. CCAO was present at the origin of the vessel in most patients. Most had atherosclerotic narrowing of multiple extracranial large vessels. During follow-up, none of the patients had a spontaneous second infarct; five had TIAs, including two with amaurosis fugax, all in the CCAO territory. More restricted external carotid collaterals may, in part, explain the higher frequency of ipsilateral stroke and contralateral TIAs than reported for internal carotid occlusion.
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PMID:Common carotid artery occlusion. 279 68

This study aims to establish the frequency of paralysis and other arm problems after stroke; the recovery of lost function; and to compare various tests of the affected arm. Thirteen per cent of the sample had no arm paralysis when first seen within 14 days. At 3 months 24 per cent of survivors had moderate or severe paralysis; 57 per cent could place nine pegs into holes within 50 seconds; 19 per cent had significant sensory disturbance; 5 per cent had shoulder pain; 8 per cent had restricted passive shoulder movement; and 17 per cent had some paralysis of the dominant arm. Between 3 and 6 months, improvement of motor power was seen in 40 per cent of patients, and 13 per cent of patients improved their function. Severity of initial paralysis was an important prognostic factor.
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PMID:Loss of arm function after stroke: measurement, frequency, and recovery. 380

The clinical manifestations and computed tomographic (CT) findings of small intracerebral haematomas (ICHs) were studied in 31 consecutive cases which comprised 6% of 520 cases of non-traumatic, non-neoplastic ICH confirmed by CT in a 3-year period. A small ICH was defined by CT as a sharply demarcated high density area with the maximum dimension not exceeding 20 mm and on no more than two contiguous 10-mm scan sections. The ages ranged from 50 to 85 years, being between 50 and 69 in about two thirds. Twenty-nine patients (93%) were hypertensive. The haematoma was in the capsulothalamus (9 cases), thalamus (6 cases), capsuloputamen (6 cases), subthalmus (2 cases), internal capsule (2 cases) pons (4 cases), midbrain (1 case), and cerebellum (1 case). Headache (4 cases) and vomiting (3 cases) were rare, whereas dizziness was rather frequent (16 cases). None had loss of consciousness. The essential clinical manifestations were sensorimotor deficits in 13 cases, pure motor hemiparesis in 6, pure sensory disturbance in 4, and involuntary movements in 2. Five patients with haemorrhage in the brain stem presented with various syndromes. None of the 31 cases had a fatal outcome directly due to the small haemorrhagic stroke. Two patients had recurrent stroke; a small, deep infarct in 1 and a large haemorrhage in the other. Full neurological and functional recovery was made in 17 cases (56.7%), recovery with mild sequelae in 7 (23.3%) and little recovery in 6. Poor recovery was related to the location (pons), the age (above 75 years), and the presence of involuntary movements. Some clinical features common to lacunar infarcts and small ICHs were discussed, and the possibility of a combination of these two conditions in a same hypertensive patient was raised. Small ICH as a type of benign, non-fatal stroke is not infrequent in communities where the incidence of hypertensive ICH is relatively high. CT scanning in the early stage of stroke even for patients with mild neurological symptoms may enhance the detection rate of such small ICHs.
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PMID:Small intracerebral haemorrhage: a study of clinical manifestations and CT findings on 31 cases. 400 23

A 53-year-old man with hypertension was admitted to our hospital, for somnolence, horizontal gaze palsy, right hemiparesis and right sensory disturbance. Brain CT scan revealed a high density area from the left lower pontine tegmentum to the left tegmentum of the lower midbrain. As he became alert, he reported visual hallucination. Two weeks after onset of stroke, he complained tactile hallucination on his right half body with sensory disturbance. After disappearance of the visual hallucination, the tactile hallucination had been persisted. This is the first report of peduncular hallucinosis with long-persisted tactile hallucination due to brainstem bleeding. Tactile hallucination was suggested to be associated with sensory disturbance and extensive destruction of the brain stem tegmentum.
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PMID:[A case of the brainstem tactile hallucinosis due to pontine hemorrhage]. 761 53

Three patients with unusual unilateral sensory disturbances in the thorax, in addition to hand and mouth, hand and foot, and hand, mouth and foot regions, respectively, after stroke, are described. Magnetic resonance imaging (MRI) showed a causative lesion in the ventral posteromedial and ventral posterolateral nucleus of the contralateral thalamus in two patients and the contralateral thalamocortical projections in one patient. Symptoms in three patients were due to infarction. Objective sensory loss was not found, but subjective paresthesia was observed in the thorax, in addition to the hand and mouth, hand and foot, and hand, mouth and foot regions, respectively. Paresthesia recovery time was evaluated in these three patients in addition to seven patients with cheiro-oral syndrome and eight patients with cheiro-oral-pedal syndrome. All thirteen patients who demonstrated recovery showed regional improvement of paresthesia in the following sequences: thorax, foot, mouth and then hand, which suggests that the detection threshold, from highest to lowest, occurs in the following sequences: thorax>foot>mouth>hand. These three cases with thoracic sensory disturbance form the explanatory links between the cheiro-oral syndrome and the cheiro-oral-pedal syndrome; cases with sensory disturbance in the hand, mouth, foot or thorax could be regarded as cases of sensory hemisyndrome in which the subjective experience of symptoms was restricted to the hand, mouth, foot or thorax. These symptoms may possibly be attributable to differential detection thresholds.
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PMID:Unusual sensory disturbance in the thoracic region after stroke: relationship to cheiro-oral and cheiro-oral-pedal syndrome. 945 81


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