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

A case of arteriovenous malformation (AVM) with angiographically visualized extravasation of contrast medium on carotid angiography has been reported. The patient, a 9-year-old girl, came to our clinic with chief complaints of unconsciousness and left hemiplegia. On right carotid angiogram, done 4 hours after stroke, an AVM with a large intracerebral hematoma at the region of the right basal ganglia was recognized. The AVM was feeded from several lenticulostriate arteries and a small branch from precentral artery, and drained into thalamostriate vein. The extravasation of contrast medium was seen in a sash like fashion through arterial and venous phase. Extravasation of contrast medium from AVM has been extremely rarely reported, and this is considered as the third reported case. From the study of these 3 cases, we have discussed about the rarity of the extravasation from AVM and the causative factors.
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PMID:[Angiographically visualized extravasation in a case of arteriovenous malformation: the first case in Japan (author's transl)]. 71 52

Artificial embolization of the middle cerebral artery (MCA) was produced in the primate, with a technique similar to that described by Luessenhop and Spence (1960) for the treatment of an inoperable arteriovenous malformation in the territory of the MCA. Silicone spheres (1 to 1.5 mm in diameter) were introduced into the internal carotid artery (ICA) via the external carotid artery (ECA). Emboli (1 to 1.3 mm) passed into the anterior cerebral artery (ACA) in 12%, and into the MCA in 50%. Emboli (1.2 to 1.5 mm) stopped at the ICA bifurcation in 54%. In all primates (82.35%1 in which the emboli occluded the ICA bifurcation or the MCA, immediate contralateral hemiplegia developed. The correlation of the anatomical characteristics of the intracranial vasculature of the ICA bifurcation, the diameter of the emboli, and the anatomical localization of the silicone spheres suggests that this experimental model can produce a selective acute "point" occlusion of the MCA in at least 75% of the cases without violating the cranium, in which the resultant changes in the distribution of water and electrolytes in the brain during the acute ischemic event in the territory of the MCA of the primate can be studied.
Stroke
PMID:Artificial embolization of the middle cerebral artery in primates. Description of an experimental model with extracranial technique. 80 99

Nine cases have been presented in detail to illustrate some of the varied causes of sudden neurological deficit in childhood: arteriovenous malformation, cryptic hamartoma, berry aneurysm, mycotic aneurysm, intraspinal arteriovenous malformation, brain tumor, migraine, arteritis, and multiple sclerosis. The Boston Children's Hospital experience with aneurysms and intracranial arteriovenous malformation has been summarized. It is noteworthy that a cutaneous hemangioma overlay one cranial and one intraspinal arteriovenous malformation. One small but deep cerebral arteriovenous malformation apparently destroyed itself after its second hemorrhage. Not only have multiple sclerosis and a brain tumor mimicked a vascular lesion, but a series of vascular accidents was misdiagnosed first as multiple sclerosis then as a thalamic tumor. The many possible causes of childhood strokes has been thoroughly cataloged in the Report of the Joint Committee for Stroke Facilities in 1973 (11). Children may be more susceptible to strokes because of congenital abnormalities such as congenital heart disease, hemophilia, and sickle cell anemia, or by diseases which more commonly occur in this age group, such as leukemia. The likelihood of brain abscess in cyanotic congenital heart disease is stressed. Arteriographic studies in our series have been safe; however, there have been reports of probable worsening of symptoms in children with multiple cerebral occlusive lesions in the presence of homocystinuria.
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PMID:Strokes in children. 98 45

The differentiation of migraine headache, preceded by visual aura, from cerebral arteriovenous malformation (AVM) is often regarded as difficult. A study of 26 patients with occipital lobe AVM revealed two distinct syndromes in 18 patients--occipital epilepsy and occipital apoplexy. Occipital epilepsy is characterized either by elementary visual phenomena, such as brief flashes of light, or by dimming of a homonymous field. Occipital apoplexy results from hemorrhage and hematoma formation within the occipital lobe and is characterized by sudden headache and homonymous visual field loss. We conclude that patients harboring occipital AVMs may, indeed, have visual phenomena and headache that should not be confused with migraine because either a history of generalized seizure or bruits on examination will probably be present.
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PMID:Occipital lobe arteriovenous malformations. Clinical and radiologic features in 26 cases with comments on differentiation from migraine. 111 66

An uncommon type of stroke in children is presented. An intracranial arteriovenous malformation in a 13-year-old boy spontaneously occluded about 22 months after surgical intervention. Precipitating factors, such as bacterial infections, could not be demonstrated in this patient, who had been attending school since the time of the craniotomy. The histological features of venous encephalomalacia in the galenic territory are contrasted with hemorrhagic encephalomalacia as seen after arterial occlusions: in the former, hemorrhages are more widespread and edema is more pronounced.
Stroke
PMID:Spontaneous thrombosis of deep cerebral veins: a complication of arteriovenous malformation. 112 16

Pure sensory stroke predominantly results from lacunar infarction in the posteroventral nucleus of the thalamus. We report the history of a young nonhypertensive male presenting with pure sensory stroke due to hemorrhage of a small arteriovenous malformation in the dorsolateral part of the pons. In contrast to the extent of the lesion, only minor degree of objective sensory loss was observed. Furthermore, our observation is unique in that it is the first presentation of this syndrome with that particular location.
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PMID:Dorsolateral pontine hemorrhage producing pure sensory stroke. 150 92

Thirty-two patients (17 men and 15 women) are presented in whom the diagnosis Rendu-Osler-Weber disease was established between 1980 and 1990 during hospitalisation in the Leeward Islands of the Netherlands Antilles. Among this group there were eight families, each of which contained two patients. Estimated point-prevalence rate in 1991 was 19.4/100,000, which is ten times higher than has been reported so far. Epistaxis, gastrointestinal blood loss and cerebrovascular accidents (CVA) were the main presenting symptoms. Mean age at diagnosis was 53.2 years. Arteriovenous fistulae in the lung developed in 11 patients (34%). Eleven patients experienced a total of 12 CVAs at a mean age of 48 years; four of these patients had an ischaemic CVA in the presence of pulmonary fistulae, while three patients had a haemorrhagic stroke in the presence of a cerebral arteriovenous malformation. Thus, cerebrovascular accidents at an early age are common complications in Rendu-Osler-Weber disease and warrant further investigation of this disease among inhabitants of the Leeward Islands of the Netherlands Antilles.
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PMID:[Cerebrovascular accidents at a young age in Rendu-Osler-Weber disease; a survey in the Netherlands Antilles]. 154 68

Despite the great capacity for the pediatric brain to recover from stroke, the morbidity and mortality in children who harbor an arteriovenous malformation (AVM) remains high. This study examines the clinical data and management experience with 132 patients with brain AVM from 1949 to 1989. Although the high tendency for a childhood AVM to present with hemorrhage (79%) remained constant for the forty year study period, the associated morbidity and mortality of hemorrhage changed. The mortality rate from hemorrhage for the entire series was 25%, which was reduced from 39% to 16% after the introduction of computed tomography. The mortality from AVM hemorrhage since 1975 was dependent on location; 8 of 14 patients (57%) with a cerebellar AVM died from hemorrhage while only 2 of 44 patients (4.5%) with a cerebral hemisphere AVM died (p less than 0.0001). Sixteen children (12%) presented with a chronic seizure disorder. Surgical excision of the malformation resulted in complete seizure control off anti-convulsant medication in 73% of patients. Although 21% of patients were treated non-operatively (many with terminal poor-grade hemorrhage), 79% had a surgical procedure with total AVM excision achieved in 70 patients (53.1%). Complete AVM resection was followed by a normal neurological outcome in 47 children (67%). Most partial excisions (n = 9) and clipping of feeding arteries (n = 7) were performed in the early years of this study, and did not provide protection from rehemorrhage. Although conservative management has been advocated for selected non-hemorrhagic AVMs, we conclude that essentially all children with an AVM should be treated in order to eliminate the risk of hemorrhage.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Arteriovenous malformations of the brain in children: a forty year experience. 156 6

The complications of hemorrhagic stroke in children begin first with one's failure to establish the correct diagnosis or from the lack of knowledge of attendant phenomena and second, from those events which occur before, during or because of the treatment provided for specific lesions. The fundamental principles of history gathering, clinical evaluation and appropriate neuroimaging will direct safe, uncomplicated patient care. This paper will examine those complications which may arise during the treatment of pediatric aneurysm, arteriovenous malformation and venous angiomas, newborn intraventricular hemorrhage, and cerebral hemorrhage associated with either a preexistent coagulopathy or neoplasm.
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PMID:Complications of hemorrhagic stroke in children. 181 32

The pattern of epilepsy and other convulsive disorders in 1,000 consecutive Saudi nationals is described. These disorders were common with a hospital frequency rate of 8 per 1,000. Men were more frequently affected than women and 60% of the patients were under 10 years old at the onset of their illness. The epilepsies were the commonest type (74%). Febrile convulsions (20%) presented mainly between the ages of one and five years. Isolated seizures (3%) and acute symptomatic convulsions (3%) were uncommon. In the epileptic group, generalised seizures (71%) were more frequent than partial (29%) and complex partial seizures occurred mainly in those above 21 years old. Absences (4%), infantile spasms (3%) and atonic seizures (3%) were uncommon. No specific etiology of the epilepsy was determined in the majority of the cases (63%). The identified major etiologic factors of the epilepsies were perinatal encephalopathy (21%), cerebral trauma (11%), sequelae of meningitis or encephalitis (2%), brain tumors (0.5%), and vascular lesions such as stroke and arteriovenous malformation. Perinatal encephalopathy accounted for 40% of the epilepsies in children less than 5 years old, and trauma for 20% of those above 20 years old. A family history of epilepsy in close relations was obtained in 23% of the cases, and the consanguinity rate among the parents was 53%. The high incidence of associated perinatal encephalopathy found in this study suggests that perinatal factors play a major role in the pathogenesis of epilepsy in Saudi Arabia. The high frequency of cerebral trauma was also striking. Although consanguinity of the parents appeared not to be a major factor in the genetics of convulsive disorders in this environment, it might have potentiated the tendency of familial aggregation of convulsive disorders in this community. Consanguinity may be an important factor in the production of some of these disorders but its precise role has not been determined.
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PMID:Epilepsy and other convulsive disorders in Saudi Arabia: a prospective study of 1,000 consecutive cases. 212 16


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