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)

Although physiological corroboration of the target is essential in functional stereotactic surgery, the collected data can also be used for the offline study of normal and abnormal brain function. Such studies have the advantage of being made in actual clinical states with the unique opportunity of communicating with the patient. Correlations were made between microelectrode recordings and microstimulation at the same thalamic site with the same microelectrode in 'normal' patients, in those with tremor and in those with central and deafferentation pain. Human somatosensory organization is similar to that of subhuman primates. Five types of tremor cells have been identified-unresponsive nonsynchronous, unresponsive synchronous, kinaesthetic, voluntary, and voluntary with receptive field. While the last two qualify in latency and connectivity as tremor pacemakers, system analysis suggests an important element of long loop feedback as well. In the pain patients, five features were identified-somatotopic reorganization, altered firing in reorganized cells, bursting cells induction of burning widespread in thalamus and reproduction of the patient's pain by microstimulation-possibly a 'central allodynia' found in deafferented somatosensory thalamus particularly in patients with allodynia or hyperpathia. All but the latter effects may be merely the consequence of deafferentation and were seen in a 'control' stroke patient with dystonia, sensory loss but no pain.
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PMID:Microelectrode techniques in localization of stereotactic targets. 288 38

Three cases of stroke in childhood are reported. In the 3 cases, an infarct involved the territory of the striato-lenticular arteries. Clinically, there was a pure motor hemiplegia and a dystonia which appeared while the hemiplegia was disappearing. The dystonic syndrome due to stroke appears only if an ischaemic lesion involves the putaminal-capsular-caudate territory, and more often in childhood.
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PMID:[Dystonia caused by putamino-capsulo-caudate infarction in a child]. 342 Mar 56

Etiological factors and clinical course of transient disorders of the cerebral circulation developing at various terms of gestation and in the immediate postpartum period were studied in 132 women. Early symptoms of a cerebral crisis included headache, vertigo, palpitation, dyspnea, darkness in the eyes, noise in the ears or head, paresthesia, and numbness of the legs. Occasionally, it had to be differentiated from a cerebral stroke. The most important etiological factors of this cerebrovascular pathology included toxemia of pregnancy, exacerbation of the rheumatic process, essential hypertension, vegetovascular dystonia, intracranial aneurysm, etc. Various combinations of a number of etiological factors of transient disorders of the cerebral circulation are possible. Recommendations about the management of pregnancy and parturition are offered.
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PMID:[Transient cerebral circulatory disorder in pregnant women]. 342 70

Central hemodynamic (CH) parameters were examined in 288 patients with neurocirculatory dystonia (NCD) and 50 normal subjects, using radiocardiography (RCG), echocardiography (EchoCG) and heart catheterization thermodilution (TD). All the tests were carried out at rest and during bicycle ergometry (BEM), the atrial stimulation test (AST) and the intravenous isadrin test (IT). Patients with severe NCD and basically hyperkinetic hemodynamic type responded to stress with an inadequate rise in the minute volume (MV) and a decline of the stroke index (SI). Thermodilution during the AST demonstrated increased MV, lowered end diastolic left-ventricular pressure and insignificantly reduced SI. TD and EchoCG during stress exposure produced similar results.
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PMID:[Central hemodynamic function of neurocirculatory dystonia patients at rest and during the performance of load tests]. 344 17

In 58 patients with progressive supranuclear palsy (PSP), 19 (32.8%) had CT, MRI, or autopsy evidence of a multi-infarct (MI) state. The clinical findings in the infarct syndrome were similar to idiopathic PSP. Five MI-PSP patients had had a stroke, four had focal dystonia, two had hemiparesis, and one had an intention tremor of recent onset. In contrast, only 5.9% (12.9% of those with CT or MRI) of 426 Parkinson's disease patients had evidence of strokes. One case of PSP studied pathologically was attributed to cerebral amyloid angiopathy.
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PMID:Progressive supranuclear palsy and a multi-infarct state. 356 71

Lacunar infarcts in the basal ganglia are known to cause various movement disorders, such as chorea, focal dystonia, and hemichorea-hemiballismus. We report here a case of putaminal lacunar infarction which presented with "painful tonic spasms" of the contralateral limbs. This consisted of paroxysmal brief, painful, flexor contractures of the upper, and occasionally the lower limb. These were not focal seizures but were controlled with carbamazepine, which has been used for the "painful tonic spasms" well-associated with multiple sclerosis. The putaminal infarct we describe is probably related to a lupus anticoagulant and systemic lupus erythematosus.
Stroke
PMID:Painful tonic spasms caused by putaminal infarction. 381 Jul 37

The hemodynamic reactions of 30 patients with neurocirculatory dystonia (NCD, DaCosta's syndrome) were compared to those of 30 healthy controls during the isometric handgrip test, orthostatic test, Valsalva test and the cold pressor test. The effects of hyperventilation on the ability to hold the breath were studied in both groups using the hyperventilation test. The patients and controls were young men, who were doing their conscript service, and the average age was 20 years in both groups. The diagnosis of NCD was made using the criteria described by Friedman (1947). The patients had several symptoms related to the cardiorespiratory system, the intensity of which varied from time to time and were not closely related to physical effort. In order to exclude organic diseases that could have caused the symptoms the patients were required to have no history of chronic organic diseases. They were also required to have no infectious diseases nor to be convalescents when participating in this study and to have a normal ECG and a normal thorax x-ray. The controls were anamnestically free from chronic diseases. The changes in the blood pressure, heart rate, stroke volume, cardiac index, peripheral vascular resistance and the systolic time intervals during the four tests were measured noninvasively using sphygmomanometry, electro-, phono- and impedance cardiography. The ability to hold the breath after a deep inspiration was similar in the two groups. Immediately after hyperventilation the ability to hold the breath did not improve in the NCD group as much as in the control group. In the orthostatic test the rise in the mean blood pressure was only momentarily greater in the control group than in the NCD group, and the heart rate increased about equally in the two groups. The transthoracic impedance increased significantly more in the controls than in the patients in the head-up position. The alterations in the systolic time intervals immediately after the changes of posture were more rapid in the control group that in the NCD group. During the expiratory strain of the Valsalva maneuver the hemodynamic changes in the two groups did not clearly differ from each other, but after the end of the strain the blood pressure overshoot lasted longer in the NCD group than in the control group. During the cold immersion the stroke volume decreased significantly more in the NCD group than in the control group. The stroke work index increased significantly in the control group, but did not change in the NCD group during the immersion.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Hemodynamic reactions to circulatory stress tests in patients with neurocirculatory dystonia. 659 40

We studied a patient with action-induced rhythmic dystonia that followed a stroke. Postmortem studies showed an infarct in the right posterolateral ventral part of the thalamus. Electrophysiologic analysis indicated that the eliciting factor of the involuntary movement was an impulse, promoting voluntary contraction of muscle. CSF 5-HIAA content was low, and HVA was high. Administration of 5-HTP and clonazepam abolished the involuntary movements.
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PMID:Action-induced rhythmic dystonia: an autopsy case. 660 63

Argentina is facing an increase in cocaine use by adolescents and young adults from every socioeconomic background. It is calculated that up to 10% of all cocaine passing through this country is locally sold and consumed. Nevertheless, local information describing common cocaine-related neurological events is scarce. From August 1988 to March 1993, 13 patients were evaluated with neurological disease associated with cocaine abuse. Among these 13 patients (Table 1), the mean age was 29; 70% were men. Patients most commonly used the nasal route (snorting). Concomitant abuse of other intoxicants, especially alcohol, was frequent (85%). The major neurological complications included one or more seizures (n = 7), ischemic stroke (n = 2) (Fig. 1-2), hemorrhagic stroke (n = 2) associated with arteriovenous malformation (Fig. 3a-b), memory disturbances (n = 1) and paroxysmal dystonia (n = 1). Psychiatric complaints were present in all patients. Mortality was not observed. There was no correlation between the appearance of complications and the amount of cocaine used, or prior experience with this drug. Only one of the 7 patients with seizures had a previous history of seizures. All had generalized tonic-clonic seizures, and one had concomitant absence episodes. Cocaine modulates central neurotransmitters and has direct cerebrovascular effects. The neurological complications appear to be related to cocaine hyperadrenergic effects, striatal dopaminergic receptor hypersensitivity and perhaps vasculitis. Structural changes in the brain of long-term cocaine abusers could explain the persistence of neurologic symptoms after drug withdrawl.
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PMID:[Neurologic complications by cocaine abuse]. 799 Jun 84

Reports of 62 cases with a movement disorder associated with a focal lesion in the thalamus and/or subthalamic region were analyzed. Thirty-three cases had a lesion confined to the thalamus. Sixteen cases had a thalamic lesion extending into the subthalamic region and/or midbrain. Thirteen cases had a lesion in the subthalamic region or a subthalamic lesion extending into the midbrain. Nineteen cases with dystonia, 18 with asterixis, 17 with ballism-chorea, three with paroxysmal dystonia, and five with clonic or myorhythmic movements have been described. No case with isolated tremor has been described. In 53 cases with unilateral thalamic or subthalamic lesions, all but one with bilateral blepharospasm (associated with right posterior thalamic, pontomesencephalic, and bilateral cerebellar lesions) had dyskinesias in the limbs contralateral to the lesion. The other nine cases had bilateral paramedian thalamic lesions; seven developed bilateral dyskinesias, and the remaining two had unilateral dyskinesias. Regarding the 19 patients with dystonia, the two with bilateral blepharospasm had thalamic and upper brainstem lesions, and one with hemidystonia and torticollis had a subthalamic lesion. The other 16 patients all had a unilateral thalamic lesion with contralateral dystonia (10 hemidystonia, five focal dystonia affecting a hand and/or and one segmental dystonia involving face, arm, and hand). The exact location of the thalamic lesion was mentioned in 10 cases; the posterior or posterolateral thalamus was involved in six and the paramedian thalamus in four. These areas are more posterior or medial to the ventrolateral and ventroanterior thalamic nuclei, which receive pallido-thalamic and nigro-thalamic afferents. Two cases developed dystonia immediately after thalamotomy, and one case developed it 4 days after head trauma. The others initially had a hemiplegia and developed dystonia 1-9 months after the acute insult. Fifteen of the 17 patients with chorea had a unilateral lesion in the subthalamic nucleus or subthalamic region (eight due to infarcts, one to hemorrhage, five to mass lesions, and one to multiple sclerosis). All had contralateral hemichorea or hemiballism. One other case had bilateral chorea of the hands and tongue due to paramedian thalamic infarction. Another case with generalized chorea and thalamic atrophy was complicated by stereotaxic surgery. Thirteen of the 18 cases with asterixis had lesions confined to the thalamus. Eight were associated with thalamotomy, and five others had a stroke (four infarction and one hemorrhage) affecting the contralateral thalamus.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Movement disorders following lesions of the thalamus or subthalamic region. 799 Aug 45


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