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)

In recent years there are a considerable increase in alcohol consumption in Taiwan, which may have been accompanied by increased incidence of alcohol-related physical disease. This study was designed for an understanding of neurological problems in chronic alcoholic patients. One hundred and five cases of chronic alcoholics with neurological problems were collected. All had taken more than 100 g alcohol daily for more than 8 years. They were all males, with a mean age of 47.0 +/- 1.3 years, mean daily alcohol consumption of 185.1 +/- 9.0 g (mean +/- S.E.). These chronic alcoholic patients showed various neurological problems. Patients showing typical clinical features of alcoholic neurological disease are now rather rare. Most of the patients had manifestations of more than one problems: polyneuropathy (74.3%), alcoholic tremor (37.1%), hallucinosis (30.5%), myopathy (26.7%), head injury (24.8%), withdrawal seizures (18.1%), Wernicke encephalopathy (15.2%), paranoia (13.3%), and stroke (15.2%). Furthermore, we divided all the patients into 5 categories, they were: encephalopathy, 59 cases (56.2%); stroke, 16 cases (15.2%); cerebellar degeneration, 12 cases (11.4%); neuropathy, 78 case (74.3%); and myopathy, 28 cases (16.7%). The daily alcohol consumption and duration of daily drinking were different significantly (p less than 0.05) among five different syndrome categories.
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PMID:Neurological problems in chronic alcoholics. 165 33

A 74-year-old woman with a history of cerebrovascular disease developed profound central nervous system (CNS) and respiratory depression, generalized hypotonia, sinus bradycardia, and urinary retention following an increase in dose of baclofen, an antispasticity agent. Before receiving baclofen therapy the patient had had minor urinary dysfunction associated with a remote cerebrovascular accident but no urinary retention. Cessation of baclofen therapy and the relief of the urinary obstruction improved mental status and normalized motor function within 24 hours. A withdrawal syndrome of agitation, hallucinosis, and convulsive activity persisted for eight days following discontinuation of the baclofen. Our experience suggests that patients with various forms of CNS disease states may be at risk of serious CNS depression with even small therapeutic doses of baclofen.
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PMID:Aggravated CNS depression with urinary retention secondary to baclofen administration. 402

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

The syndrome of peduncular hallucinosis in characterized by transient visual hallucinations which often consist in animated and mobile characters or animals, and which are often associated with disordered sleep. Although vivid and life) like, these hallucinations are generally not mistaken for reality. In view of the associated neurological symptoms, this syndrome was first believed to occur only with lesions of the mesencephalon. Lesions restricted to the mesencephalon have been identified with MRI in a few cases and were demonstrated by pathological verification in one patient with this syndrome. We describe a patient who experienced very similar hallucinations following a unilateral infarct restricted to the cerebellum, rostral protuberance and posterior thalamus. No lesion was seen in the mesencephalon with MRI. This case confirms that the lesions responsible for peduncular hallucinosis are not restricted to the mesencephalon, which suggests that several interconnected neural structures are probably involved in the genesis of this type of visual hallucinations. During the days following the stroke, our patient also experienced transient sensations of pleasure which he considered as abnormal. In view of the site of the lesions in this case, the visual hallucinations may be explained by a disinhibition of ponto-geniculo-occipital waves. A transient activation of reward-system pathways traveling in the brainstem ventral tegmentum may have contributed to the occurrence of the abnormal sensations of pleasure.
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PMID:[Visual hallucinosis and hyperhedonism in pontine and thalamic infarction]. 968 55

The role of the thalamus in the pathogenesis of the visual and auditory hallucinations has been reported under the name of peduncular hallucinosis, usually with coexisting midbrain involvement. These hallucinations typically take the form of dreamy de novo productions (phanteidolias), less often that of transformations of perceptions into new items (such as seeing faces in clouds) called pareidolias. However, hallucinations taking the form of a complex distortion of perception is a different phenomenon, which to our knowledge has not been reported. We studied 2 patients with complex, 'fantastic', perceptive distortion involving the visual and auditory systems after thalamic stroke limited to the region of the dorsomedial nucleus, sparing the intralaminar nuclei and the midbrain (explaining the lack of disorders of consciousness and confusional state). Our patients reported the modification of usual stimuli (face, body, voices) into unreal, fantastically distorted perceptions (monstrous change of shapes or sounds without appearance of new items). While the exact mechanism leading to such perceptive distortions remains unknown, a release phenomenon due to damage to the dorsomedial thalamus (probably affecting cholinergic system) responsible for a disinhibition of cortical function involved in familiarity of perception seems likely. We suggest that these hallucinations should be called 'distorteidolias'.
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PMID:'Distorteidolias' - fantastic perceptive distortion. A new, pure dorsomedial thalamic syndrome. 2365 61

A traditional and widely used approach for linking neurological symptoms to specific brain regions involves identifying overlap in lesion location across patients with similar symptoms, termed lesion mapping. This approach is powerful and broadly applicable, but has limitations when symptoms do not localize to a single region or stem from dysfunction in regions connected to the lesion site rather than the site itself. A newer approach sensitive to such network effects involves functional neuroimaging of patients, but this requires specialized brain scans beyond routine clinical data, making it less versatile and difficult to apply when symptoms are rare or transient. In this article we show that the traditional approach to lesion mapping can be expanded to incorporate network effects into symptom localization without the need for specialized neuroimaging of patients. Our approach involves three steps: (i) transferring the three-dimensional volume of a brain lesion onto a reference brain; (ii) assessing the intrinsic functional connectivity of the lesion volume with the rest of the brain using normative connectome data; and (iii) overlapping lesion-associated networks to identify regions common to a clinical syndrome. We first tested our approach in peduncular hallucinosis, a syndrome of visual hallucinations following subcortical lesions long hypothesized to be due to network effects on extrastriate visual cortex. While the lesions themselves were heterogeneously distributed with little overlap in lesion location, 22 of 23 lesions were negatively correlated with extrastriate visual cortex. This network overlap was specific compared to other subcortical lesions (P < 10(-5)) and relative to other cortical regions (P < 0.01). Next, we tested for generalizability of our technique by applying it to three additional lesion syndromes: central post-stroke pain, auditory hallucinosis, and subcortical aphasia. In each syndrome, heterogeneous lesions that themselves had little overlap showed significant network overlap in cortical areas previously implicated in symptom expression (P < 10(-4)). These results suggest that (i) heterogeneous lesions producing similar symptoms share functional connectivity to specific brain regions involved in symptom expression; and (ii) publically available human connectome data can be used to incorporate these network effects into traditional lesion mapping approaches. Because the current technique requires no specialized imaging of patients it may prove a versatile and broadly applicable approach for localizing neurological symptoms in the setting of brain lesions.
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PMID:Network localization of neurological symptoms from focal brain lesions. 2626 14

Brainstem lesions causing peduncular hallucinosis (PH) produce vivid visual hallucinations occasionally accompanied by sleep disorders. Overlapping brainstem regions modulate visual pathways and REM sleep functions via gating of thalamocortical networks. A 66-year-old man with paroxysmal atrial fibrillation developed abrupt-onset complex visual hallucinations with preserved insight and violent dream enactment behavior. Brain MRI showed restricted diffusion in the left rostrodorsal pons suggestive of an acute ischemic stroke. REM sleep behavior disorder (RBD) was diagnosed on polysomnography. We investigated the integrity of ponto-geniculate-occipital circuits with seed-based resting-state functional connectivity MRI (rs-fcMRI) in this patient compared to 46 controls. Rs-fcMRI revealed significantly reduced functional connectivity between the lesion and lateral geniculate nuclei (LGN), and between LGN and visual association cortex compared to controls. Conversely, functional connectivity between brainstem and visual association cortex, and between visual association cortex and prefrontal cortex (PFC) was significantly increased in the patient. Focal damage to the rostrodorsal pons is sufficient to cause RBD and PH in humans, suggesting an overlapping mechanism in both syndromes. This lesion produced a pattern of altered functional connectivity consistent with disrupted visual cortex connectivity via de-afferentation of thalamocortical pathways.
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PMID:Altered functional connectivity in lesional peduncular hallucinosis with REM sleep behavior disorder. 2665 84

Acute basilar artery occlusion is a neurological emergency. Unlike anterior circulation stroke presenting with hemiparesis, the symptoms of basilar artery occlusion are challenging to recognise in the emergency setting. Basilar artery occlusion can rarely lead to ischaemia of the auditory pathways, resulting in bizarre, positive auditory hallucinations. Here, we report two cases of basilar artery occlusion presenting with positive auditory phenomena; in both cases the auditory phenomenon resolved upon arterial recanalisation. We discuss the phenomenology of this unusual and distinctive neurological symptom. Acute auditory hallucinosis in the setting of sudden vomiting, dizziness, visual disturbance or other posterior circulation symptoms should prompt emergency imaging of the basilar artery, to avoid a potentially devastating posterior circulation stroke.
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PMID:Auditory hallucination in basilar occlusion: I heard it was the basilar. 2665 82