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

The computed tomography (CT) scans of 132 patients with late onset epilepsy were compared with the CT scans of an age- and sex-matched control group. Patients with neurologic symptoms in addition to epilepsy, patients with a definite antecedent cause for epilepsy, and patients with tumours on CT scanning were excluded. Fifteen of the patients with epilepsy, as opposed to two of the controls, had infarcts on their CT scans (p = 0.003 Fisher exact test, two-tailed). In nine of these patients only lacunar infarcts were present. No patient had a history of stroke. We concluded that cerebrovascular disease was the major underlying contributory factor to the development of epilepsy in these patients. Twelve of the 15 patients were aged greater than 60 years, representing 21% of the patients in this age group. There was no difference between the epileptic patients and controls in the presence of clinical features of systemic vascular and cardiac disease. CT scan evidence of cerebral atrophy was as common in the control subjects as in the patients with epilepsy.
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PMID:Clinically unsuspected cerebral infarction revealed by computed tomography scanning in late onset epilepsy. 334 70

The relation between cerebral lesions studied by computed tomography and the dementia syndrome has been evaluated in 40 patients with multi-infarct dementia, in 44 nondemented subjects with multiple infarcts, and in 30 controls matched for age and sex. Our study of the volume of ischemic lesions showed a slightly greater loss of cerebral substance in patients with multi-infarct dementia than in nondemented subjects with multiple infarcts, particularly in subjects with unilateral focal lesions and in patients with bilateral multiple cortical and subcortical lesions. The dementia syndrome was significantly associated with multiple locations of lesions in the thalamic and cortical areas supplied by the middle cerebral arteries. Moreover, patients with the dementia syndrome showed a significantly higher degree of cerebral atrophy than nondemented subjects and controls as evaluated by measurements of ventricular size, area of ventricular space, and area of subarachnoid space.
Stroke 1988 May
PMID:Intellectual impairment and cerebral lesions in multiple cerebral infarcts. A clinical-computed tomography study. 336 88

The clinical findings, EEG and CT examinations of the brain were compared at three time intervals in patients with ischaemic stroke. No evident correlation was found between the intensity of clinical signs, the intensity of EEG changes and the size of the ischaemic focus in the CT. It was observed that with increasing time interval after the onset of the disease the clinical state and EEG changes improved while the CT image was not changed or even became worse. In the observations a greater tendency clinical for improvement was found in the group of cases of lesions in the left parietal lobe than in those with lesions in the right parietal lobe. Another observation was that patients with ischaemic focus developing in brain with evidence of atrophy in CT had a much lower tendency for clinical improvement than those without brain atrophy.
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PMID:[Clinical, electroencephalographic and cerebral computerized-tomographic findings in patients with ischemic stroke]. 338 Feb 66

Cerebral atrophy and regional cerebral blood flow (CBF) were examined in 52 chronic stroke patients with dementia, pre-dementia or non-dementia (according to the Dementia Scale). The index of cerebral atrophy was estimated on computed tomography, and CBF was determined using 133Xe inhalation method. Cerebral atrophy indices were not significantly different among various degrees of dementia except a slightly increased cella media index in pre-dementia group. Average values for CBF were bilaterally reduced in dementia, being 28.5 +/- 4.4 for affected hemisphere and 31.0 +/- 3.2 ml/100g/min for non-affected one. Compared with those, CBF were higher in pre-dementia (37.3 +/- 8.7 and 39.4 +/- 8.2 ml/100 g/min, p less than 0.05 vs dementia, respectively) and more higher in non-dementia (45.8 +/- 10.2 and 48.5 +/- 10.4 ml/100 g/min, p less than 0.01 vs pre-dementia, respectively). Of 11 recurrent stroke patients, 5 with newly developed dementia after the second attack presented the preceding CBF reduction 10 to 34 months prior to the recurrence. Present results suggest that bilateral reduction of CBF may be the primarily important factor for the initiation or development of vascular dementia, and the CBF reduction seems to precede the symptom of dementia.
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PMID:Regional cerebral blood flow in chronic stroke patients with dementia. 341 81

Sixty-one patients who were undergoing an 8-week course of physical rehabilitation, which started on average 30 days after a cerebrovascular accident, were entered into a controlled double-blind, randomized study of 600 mg naftidrofuryl daily against identical placebo. The following parameters were measured before, and at 4 and 8 weeks after onset of treatment: neurological examinations by a weighted-assessment system, walking ability, and independence in activities of daily living. At the same time, the degree of cerebral lesion and brain atrophy were evaluated by CT scan and the size of the EEG deformations were estimated. During the first 4 weeks of rehabilitation, the placebo patients showed a significant improvement in the neurological symptoms which did not continue during the second period of treatment. On the contrary, the naftidrofuryl patients showed a continuous improvement in the neurological impairment during the whole period of treatment. Thus, at the end of treatment, there was a statistical difference between both groups. An explorative analysis of the most frequent symptoms showed a significant improvement in the naftidrofuryl group in independence in activities of daily living, walking, bladder control and sensory syndrome, whilst the changes in the placebo group were not statistically significant. Another significant change under treatment with naftidrofuryl was found in EEG evaluation which, at the end of the treatment period, showed less moderate and severe pathological alterations. Thus the value of naftidrofuryl treatment in patients with cerebral vascular accidents may be explained by an activation of cerebral metabolism in partially damaged regions of the brain, leading to an improvement in learning ability. In this way the recovery process that occurs during rehabilitation may be accelerated.
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PMID:Evaluation of a vasoactive substance, naftidrofuryl, during the rehabilitation phase after an ischaemic insult. 369 55

The clinical and computed tomographic (CT) findings in 17 patients with neurological manifestations of systemic lupus erythematosus were analyzed. Two patients presented with stroke syndromes; they did not have systemic manifestations of SLE at the time the neurological disturbances developed. Of 15 patients with prominent systemic evidence of SLE, 9 presented with stroke syndromes or seizures. CT showed a hypodense lesions representing infarction (7 cases) or hyperdense lesions representing intracerebral hematomas (2 cases). Six patients with gradual onset of neurobehavioral symptoms showed cerebral atrophy without infarction or hemorrhage.
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PMID:The cranial computed tomographic findings in patients with neurologic manifestations of systemic lupus erythematosus. 395 92

Bone marrow transplantation, used in the treatment of cancer, aplastic anemia, and metabolic diseases, involves the use of potentially neurotoxic agents to suppress immunity and eradicate malignancy. Fifty-seven patients with a median age of 11 years (age range, 6 months to 24 years) underwent bone marrow transplantation at the Children's Hospital of Philadelphia. Fifty-nine percent developed neurological abnormalities. Twenty-six patients (46%) had central nervous system (CNS) dysfunction, including infection (8), cerebrovascular accident (5), CNS leukemia (7), metabolic encephalopathy (5), and paraparesis with CNS toxoplasmosis (1). Neuropsychological dysfunction was present in 4 of 5 long-term survivors who were tested. Fourteen of 19 patients (74%) on whom postmortem examination was performed were found to have CNS abnormalities, including cerebral atrophy (10), focal cerebral injury (6), leukemia (5), and infection (3). Fourteen patients (24%) had peripheral nervous system dysfunction. CNS dysfunction was more common in patients with lymphoreticular malignancies. Cerebrovascular accidents (in patients with lymphoreticular malignancies) and infections (in our general population and in patients with lymphoreticular malignancies) occurred more often in our patients than in patients with similar illnesses who did not undergo bone marrow transplantation. The combination of prior treatment and preparative therapy for bone marrow transplantation predisposes patients to neurological and neuropsychological sequelae.
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PMID:Neurological complications of bone marrow transplantation in childhood. 639 64

Five cases of subdural hematoma from arterial rupture (SDH-AR) are described and other 39 reported cases are reviewed. The average age of the patient is 59 and male to female ratio is 2:1. Fifty two percent of the patients have history of recent head injuries most of which are trivial. A very few patient have initial loss of consciousness. Approximately half of the patients with history of head trauma have long lucid interval (average of 7 days). Those patients without history of head trauma have spontaneous onset of the symptoms and some of the have acute onset of headache and loss of consciousness, simulating cerebrovascular accident. Natural history of the SDH-AR is progressing deterioration of the symptoms, resulting in coma and death. Skull fracture is seldom demonstrated in the patients with SDH-AR. Angiography shows and extracerebral avascular mass over the cerebral convexity with marked midline shift. In 3 cases including our 2 cases, extravasation of the contrast medium from the cortical artery is observed and this is a useful finding for making diagnosis of this disease. Computerized tomography reveals high density extracerebral mass with remarkable mass effect. Craniotomy discloses subdural clot and spurting arterial rupture from a branch of the cortical artery around the Sylvian fissure. In some cases, subarachnoid hemorrhage is observed but in none of the cases, cerebral contusion or laceration is present. It is presumed that the mechanism of the arterial rupture is gliding movement of the brain within the skull upon injury, tearing an arterial twig with dural attachment. Hypertension, arteriosclerosis and brain atrophy may be important contributing factors to this mechanism. Pseudoaneurysm of the cortical artery caused by closed head injury is also associated with this mechanism and may explain delayed sudden onset of the symptoms in some patients with SDH-AR.
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PMID:[Subdural hematoma from arterial rupture -mechanism of arterial rupture in minor head injury]. 713 4

CT examination in 100 patients affected by chronic cerebrovascular insufficiency showed a normal picture in 16 cases, while 84 subjects showed different degrees of atrophy, generalised and focal, controlateral or sometime omolateral to the infarct, with differing patterns. The mean age of subjects with normal CT was significantly lower in comparison with patients with definite atrophy. Besides the neurological picture and the time course, the patients' psychiatric status was also assessed: no definite relationship seems to exist between psychiatric disturbances and brain atrophy. Pseudobulbar syndrome was found in 46 cases and many of them showed cortical and mainly ventricular atrophy. This picture was very seldom found in patients with vertebro-basilar insufficiency. Localised cortical atrophy, on the contrary, was often associated with ischaemic stroke. The incidence of predisposing risk factors (hypertension, diabetes mellitus or high lipid levels) was greater in subjects with brain atrophy and older age than in patients with normal CT scan.
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PMID:[CT findings in chronic cerebrovascular insufficiency (author's transl)]. 729 86

Three percent of epileptic patients have their first seizure after the age of 60. More than at other ages, the real nature of such fits is very difficult to assert. Most of the reversible attacks occurring at this age are not of grave nature, syncopes are much more frequent. Some semeiological aspects are discussed. Focal seizures are more frequent after the age of 60. Absence status may be the first epileptic symptom in some rare cases (almost all of them being women). 100 patients whose ages ranged from 60 to 83 years, were examined after their first seizure and aetiological problems were examined. The following topics are discussed:--The possible onset of a primary epilepsy, extremely rare at that age;--The incidence of neoplasms, not exceeding 10% for patients whose late onset epilepsy is still an isolated symptom, and who have not been selected from specialized neurological or neurosurgical hospital departments;--The role of vascular epilepsy; in a very few cases, but of great practical interest, the epilepsy may announce a cerebrovascular accident which will occur later. It is, however, difficult to specify the vascular origin of a certain number of temporary unexplained late onset epilepsies. Some other aetiological factors are taken into account: antecedents of trauma, alcoholism, and dementia. The authors agree that in 50% of the cases the aetiology is not obvious. In this group of unknown aetiology it seemed interesting to isolate the following electroclinical form;--Epilepsy grand mal, with apparently generalized seizures; no special pathological antecedents; the neuropsychological and neurological examinations are normal, showing no intellectual disorders; the EEG generally shows slight modifications: quick rhythms, some sharp waves; a global cerebral atrophy is seen by the scanner. Such patients have been called victims of 'secondary late-onset generalized epilepsy'. They form 16% of a series of 156 epileptic patients who were over 65 years old, and 21% of our own 100 patients.
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PMID:[Seizures after the age of sixty (author's transl)]. 734 7


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