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

A rare case of widespread fibromuscular dysplasia (F.M.D.) is reported, involving the cervico-cephalic arteries associated with multiple dissections, saccular aneurysms and a carotid-cavernous fistula. A detailed post-mortem examination revealed FMD involvement of the intracranial vessels, not demonstrated by arteriography.
Stroke
PMID:Fibromuscular dysplasia of cervico-cephalic arteries with multiple dissections and a carotid-cavernous fistula. A pathological study. 397 64

An otherwise healthy 35-year-old woman suffered spontaneous dissections of both internal carotid arteries. She made an excellent recovery but was left with occlusion of the left internal carotid artery and a residual subcranial dissecting aneurysm of the right artery--both were asymptomatic. Eight years later, spontaneous dissections of both renal arteries occurred. The exact nature of the underlying arterial disease is not clear. Although fibromuscular dysplasia is suspected, other undetermined arteriopathy cannot be excluded.
Stroke
PMID:Spontaneous dissections of the renal arteries in a patient with previous spontaneous dissections of the internal carotid arteries. 408 28

Of 199 patients with clinico-laboratory evidence of vasculitis, 42 were submitted to cerebral angiography; 35 angiograms were abnormal, but only 21 were characteristic of the particular disease process. A pattern consistent with vasculitis diagnosed in 19 angiograms, was due to neoplasm in 4 and neurofibromatosis, DXT and amphetamines each in 1 case. Moya-Moya type collaterals shown in 20 angiograms were due to the idiopathic disease in 10 but due to non-inflammatory pathologies in 7. Fibromuscular dysplasia shown in 28 angiograms was an incidental finding in 20 of these. Of 56 cerebral angiograms for ischaemic stroke in patients under 15 years old, 17 were normal and only 8 vascular lesions were likely to have been of inflammatory origin. In routine clinical practice cerebral angiography, though essential in the management of mycotic aneurysm and in the diagnosis of Moya-Moya disease isolated vasculitis and fibromuscular dysplasia, plays only a limited role in the diagnosis of other types of vasculitis.
 ...
PMID:Cerebral angiography in vasculitis affecting the nervous system. 615 Aug 52

The authors report on the case of a 48-year-old woman, with no history of cardiovascular disease, presenting with a progressive right cerebral deficiency syndrome predominating in the parietal region. X-ray, arteriography and CT scan findings led to the diagnosis of right middle cerebral artery ischemic stroke, in the proximal territory, due to a practically complete occlusion of the right internal carotid artery. The patient recovered and a right carotid arteriography performed 8 months after the initial one showed repermeation of the carotid artery, as well as evidence of fibromuscular dysplasia (FMD). The authors then reviewed the literature dealing with cervico-cephalic FMD and concluded that FMD only exceptionally leads to arterial occlusion, whether by arterial dissection, intimal hyperplasia or thrombosis. This case is remarkable by its favorable outcome: the thrombus, which was unquestionably responsible for the clinical picture, dissolved spontaneously.
 ...
PMID:[Incomplete regressive obstruction of the internal carotid artery in a female patient with fibromuscular dysplasia]. 630 24

From 1977 to 1984, 752 reconstructions of the supra-aortic arteries were performed at our service. In a group of 31 patients presenting with transient ischemic attacks (13) or minor strokes (15), preoperative multiplane angiograms identified lesions from various causes in extremely high locations (fibromuscular dysplasia, 10; atherosclerosis, 6; traumatic changes, 10; spontaneous dissection, 3; and mycotic aneurysms and others, 4) in 34 internal carotid arteries (aneurysms, 10; and stenosis, 24). Surgery was performed on 30 patients. Flow restoration was achieved by resection and vein graft replacement (20), gradual dilatation (5), thromboendarterectomy (6), and tangential clip for exclusion of a lateral aneurysm (1). Only one patient was treated with an extracranial-intracranial anastomosis because the stenosis extended into the carotid siphon. One patient was treated with heparin. Exposure of the internal carotid artery (ICA) at the base of the skull required dissection of the digastric muscle, careful mobilization of the cranial nerves, and detachment of the styloid process in 29 patients. Partial resection of the mastoid process was helpful in two patients. The carotid bone canal was opened from the lateral side in four cases to allow the most distal anastomosis 1 cm within the carotid canal. Back-bleeding was controlled by a balloon catheter. A shunt was impossible to use and clamping time averaged 62 +/- 40 minutes. Except for one recurrent stroke and two transient ischemic attacks no other neurologic deficits occurred. Cranial nerve damage could not be avoided in 21 cases (nervus recurrens, 7; nervus glossopharyngeus, 16; and nervus facialis, 4) but disappeared clinically within a 1- to 6-month period in all but two. Each surgical patient underwent control angiography, which demonstrated 30 arteries to be patent, two became occluded, and one had an insignificant stenosis. We conclude that standard surgical techniques are unsuitable for repair of highly located lesions of the ICA. Although extracranial-intracranial anastomosis has been proposed in patients with planned ligation of the ICA, the anatomic reconstruction remains advantageous because flow is restored to normal and the source of emboli is eliminated. With the use of a special approach, graft replacement can be performed up to the base of the skull.
 ...
PMID:Progress in carotid artery surgery at the base of the skull. 654 33

A young man with cerebral infarction, skeletal, cardiac and renal malformations was found to have on angiography a rare lesion involving the cervical left internal carotid artery, formed by the superposition of two arterial lumina. Anti-platelet therapy did not prevent thrombosis of the lesion and reinfarction. Extracranial-intracranial bypass graft was performed, followed by excision of the arterial lesion. Pathological examination revealed fibromuscular dysplasia and dissecting aneurysm. The few reported cases associating fibromuscular dysplasia of the internal carotid artery with dissecting aneurysm are reviewed. Surgical therapy is recommended in such cases when symptomatology progresses. Fibromuscular dysplasia occasionally coexists with somatic malformations, suggesting a congenital origin of this condition.
Stroke
PMID:Double lumen dissecting aneurysms of the internal carotid artery in fibromuscular dysplasia: case report. 665 71

Eleven hundred cases from the literature of fibromuscular dysplasia (FMD) are reviewed including 300 cases with aortocranial lesions. The male-female ratio is 1:2, and the prevalence seems increased among Caucasians. The clinical diagnosis of FMD is made by angiography, ten years earlier in patients with hypertension (mean age 39 years) than in those with cerebrovascular symptoms (mean age 50 years). Segmental dysplastic lesions are found mainly in primary aortic branches. All age groups may be affected and follow-up studies give evidence for stationary as well as slowly progressive lesions. A multifactorial hypothesis of etiology is presented: congenital minor lesions of tunica medial might predispose to aneurysms and to an abnormal fibroproliferative response to mechanical or circulatory stimuli. The association of FMD and intracranial aneurysmal disease in females is discussed. Inheritance as a dominant trait with reduced penetrance in males is suspected. Current aspects on morphology, symptomatology and clinical management are presented.
Stroke
PMID:Fibromuscular dysplasia and the brain. II. Current concept of the disease. 703 3

The angiographic, clinical, and genetic characteristics of fibromuscular dysplasia (FMD) are reviewed in 37 patients (mean age 48 years) selected from a pool of 4000 angiograms of carotid or vertebral arteries. FMD was a neglected pathogenic factor in 28 patients with hemorrhagic or ischemic cerebral lesions. The aneurysms found in 19 patients had conventional appearance and were mainly located in the internal carotid or middle cerebral arteries and on the same side as the most affected cervical artery, which suggests that aneurysms and FMD are pathogenically related. A clinical syndrome is presented where headache, ECG-abnormalities, hypertension, mental distress, tinnitus, vertigo, arrhythmia, TIA, and syncope are frequent components. Hemicrania, sometimes combined with ipsilateral Horner's Syndrome, was found in patients with advanced lesions in the carotid artery of the same side. An associated occurrence of stroke in pedigrees, especially among young and middle aged females, indicates that FMD in the majority of cases in inherited as an autosomal dominant trait with reduced penetrance in males.
Stroke
PMID:Fibromuscular dysplasia and the brain. I. Observations on angiographic, clinical and genetic characteristics. 706 80

The natural history of extracranial cerebrovascular disease and available alternatives in its treatment are reviewed. An evaluation of the evidence suggests that carotid endarterectomy is the treatment of choice in patients with transient ischemic deficits, provided that an anatomically appropriate lesion can be identified. These patients have a 25-38% chance of stroke if untreated, which can be reduced to 5-10% by carotid endarterectomy. Patients with asymptomatic carotid stenosis who are good operative risks are also candidates for surgery, although this issue remains controversial. Patients with small asymptomatic ulcerated carotid plaques have a relatively benign prognosis and should not undergo preventive carotid surgery. Carotid surgery is occasionally indicated in patients with vertebral basilar insufficiency and carotid stenoses, fibromuscular dysplasia, or carotid kinks associated with symptoms of ischemia. Carotid endarterectomy may be performed with an overall mortality of 1-2% and morbidity of 2-5% if the patients are carefully selected and the surgical team is expert.
 ...
PMID:The current status of carotid artery surgery. 709 1

A case of fibromuscular dysplasia (FMD) of the internal carotid artery that caused acute stroke was successfully treated, with total removal of the FMD rings along with their attached thrombus without segmental excision of the artery. The natural history of this disease is unknown, which raises a concern in management of the many patients with FMD who are asymptomatic. Transient ischemic attack and repeated strokes may be attributable to embolic phenomenon of the thrombus or to platelet aggregates from the FMD segment of the artery. The FMD syndrome can appear as an acute stroke in the young age group. Symptomatic lesions have been managed by excision and arterial reconstruction, by patch angioplasty, or by dilation alone. To our knowledge, this is the first report of total removal of FMD rings without segmental excision of the artery.
 ...
PMID:Fibromuscular dysplasia of the internal carotid artery: its occurrence with acute stroke and its surgical reversal. 739 8


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>