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

Type I glutaric aciduria (GA1) results from mitochondrial matrix flavoprotein glutaryl-CoA dehydrogenase deficiency and is a cause of acute striatal necrosis in infancy. We present detailed clinical, neuroradiologic, molecular, biochemical, and functional data on 77 patients with GA1 representative of a 14-year clinical experience. Microencephalic macrocephaly at birth is the earliest sign of GA1 and is associated with stretched bridging veins that can be a cause of subdural hematoma and acute retinal hemorrhage. Acute striatal necrosis during infancy is the principal cause of morbidity and mortality and leads to chronic oromotor, gastroesophageal, skeletal, and respiratory complications of dystonia. Injury to the putamen is heralded by abrupt-onset behavioral arrest. Tissue degeneration is stroke-like in pace, radiologic appearance, and irreversibility. It is uniformly symmetric, regionally selective, confined to children under 18 months of age, and occurs almost always during an infectious illness. Our knowledge of disease mechanisms, though incomplete, is sufficient to allow a rational approach to management of encephalopathic crises. Screening of asymptomatic newborns with GA1 followed by thoughtful prospective care reduces the incidence of radiologically and clinically evident basal ganglia injury from approximately 90% to 35%. Uninjured children have good developmental outcomes and thrive within Amish and non-Amish communities.
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PMID:Type I glutaric aciduria, part 1: natural history of 77 patients. 1288 85

Intrathecal baclofen has been successfully used for control of severe spasticity. Baclofen, an agonist of GABA-B receptor, has other potential effects on pain and recovery from coma. Sporadic episodes of dramatic recovery from persistent vegetative state are reported after intrathecal administration of baclofen. There are also reports on the use of baclofen for neuropathic pain including post-stroke central pain syndrome. Baclofen is also used for control of dystonia due to cerebral palsy or reflex sympathetic dystrophy. On the other hand, epidural spinal cord stimulation has been used for pain, spasticity, dystonia, or attempt to improve deteriorated consciousness, though the effects seem variable and modest. Similarity between baclofen and spinal cord stimulation is interesting in that both involves in spinal GABAergic system. The GABAergic system in the spinal cord plays a pivotal role in various clinical effects of these procedures.
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PMID:Clinical application of drug pump for spasticity, pain, and restorative neurosurgery: other clinical applications of intrathecal baclofen. 1451 20

A 3 year review of neurologic admissions into the adult medical wards at the UCH, Ibadan, Nigeria between January 1998 and December 2000 is presented. The study design involved the scrutiny of the records of all the neurological admissions, male and female to the medical ward. The identified cases were then classified and only cases confirmed as neurological were further analysed. Stroke, predominantly non-hemorrhagic accounted for 50.4% of cases for the period of study. Stroke is therefore the most common cause of adult neurologic admissions on medical wards of UCH. Central nervous system infections, comprising mainly of tetanus and meningitis accounted for 14.2% (111) and 12.4% (97) of case respectively. The myelopathies were the cause of neurologic admissions in 8.1% (63) of cases followed by seizure disorders. Headache was the reason for admission in 0.9% (7) of cases. Parkinsons disease, hypertensive encephalopathy, Guillian Barne syndrome, seasonal ataxic neuropathy, cavernous sinus thrombophlebitis, normal pressure hydrocephalus were rarely the cause of admission. Similarly, dystonia, and cerebral malaria recorded 0.13% (1) of cases each. A case is made for the establishment of regional stroke units in Nigeria.
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PMID:A 3-year review of neurologic admissions in University College Hospital Ibadan, Nigeria. 1452 26

Animal and human research over the past decades have increasingly detailed the brain's capacity for reorganization of neural network architecture to adapt to environmental needs. In this article, the authors outline the range of reorganization of human representational cortex, encompassing 1) reconstruction in concurrence with enhanced behaviorally relevant afferent activity (examples include skilled musicians and blind Braille readers); 2) injury-related response dynamics as, for instance, driven by loss of input (examples include stroke, amputation, or in blind individuals); and 3) maladaptive reorganization pushed by the interaction between neuroplastic processes and aberrant environmental requirements (examples include synchronicity of input nurturing focal hand dystonia). These types of neuroplasticity have consequences for both understanding pathological dynamics and therapeutic options. This will be illustrated in examples of motor and language rehabilitation after stroke, the treatment of focal hand dystonia, and concomitants of injury-related reorganization such as phantom limb pain.
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PMID:Reorganization of human cerebral cortex: the range of changes following use and injury. 1507 Apr 87

Involuntary movements are rare ischemic stroke complication. Hemichorea, hemibalism and dystonia cases were described, especially during haemorrhage into basal ganglia and thalamus. The case of 73 years old woman is presented who was admitted to our Clinic cause of sudden choreatic involuntary movements occurrence within axial muscles and limbs. Computed Tomography showed ischemic focus in basal ganglia (head of caudate nucleus and lentiformis nucleus) and anterior branch of internal capsule. Cerebral angio--CT confirmed partial occlusion both medial arteries and atherosclerotical changes within the rest of cerebral arteries.
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PMID:[Generalized choreic involuntary movements in the course of stroke: case report]. 1509 30

We describe an uncommon movement disorder after stroke. A 70-year-old man was admitted for a right thalamic haemorrhage and 1 week later developed bilateral contractions of the face. Electromyographic study revealed a bilateral facial dystonia. The association of this bilateral facial dystonia and vertical gaze palsy produced the aspect of a "risus sardonicus."
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PMID:Risus sardonicus after thalamic haemorrhage. 1525 44

Reorganization of motor execution and imagination networks was studied in six patients with unilateral dystonia secondary to a subcortical stroke and compared with seven control subjects using fMRI. Patients performed imagined and real auditory-cued hand movements. Movements of the dystonic hand resulted in overactivity in bilateral motor, premotor, and prefrontal cortex, insula, precuneus, and cerebellum, in parietal areas and the striatum contralateral to the lesion. Movements of the unaffected hand resulted in overactivity in bilateral preSMA, prefrontal, and parietal areas, insula and cerebellum, the ipsilateral premotor cortex and the contralateral striatum to the lesion. Mental representation of movements with each hand resulted in overactivity in bilateral parietal, premotor and prefrontal areas. These results suggest that execution and mental representation of movement are altered in these patients.
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PMID:Motor execution and imagination networks in post-stroke dystonia. 1530 30

More than 8,000 researchers, clinicians and exhibitors from around the world gathered in San Francisco for the American Academy of Neurology 56th Annual Meeting, April 24 to May 1, 2004. Of the 1,300 studies at the conference, researchers presented more than 200 abstracts each on multiple sclerosis, stroke and dementia, 145 on epilepsy, 159 on Parkinson's disease, 132 on pain and about 50 each on tremor and dystonia. The use of brain imaging technology also figured strongly in the program, with 300 abstracts that mentioned magnetic resonance imaging and 50 that included positron emission tomography. Highlights included promising Parkinson's disease studies involving gene therapy and treatments using glial-cell-derived neurotrophic factor, but also new evidence of cardiac valve regurgitation associated with pergolide. Other highlights included studies on neural repair, new guidelines for the treatment of epilepsy and important studies comparing the thrombin inhibitor ximelagatran to warfarin for the prevention of stroke.
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PMID:New developments in the treatment of neurological diseases. 1533 92

Research during the last decades has greatly increased our understanding of brain plasticity, i.e. how neuronal circuits can be modified by experience, learning and in response to brain lesions. Currently available neuroimaging techniques that make it possible to study the function of the human brain in vivo have had an important impact. Cross-modal plasticity during development is demonstrated by cortical reorganization in blind or deaf children. Early musical training has lasting effects in shaping the brain. Albeit the plasticity is largest during childhood, the adult brain retains a capacity for functional and structural reorganization that earlier has been underestimated. Recent research on Huntington's disease has revealed the possibility of environmental interaction even with dominant genes. Scientifically based training methods are now being applied in rehabilitation of patients after stroke and trauma, and in the sensory retraining techniques currently applied in the treatment of focal hand dystonia as well as in sensory re-education after nerve repair in hand surgery. There is evidence that frequent participation in challenging and stimulating activities is associated with reduced cognitive decline during aging. The current concept of brain plasticity has wide implication for areas outside neuroscience and for all human life.
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PMID:Brain plasticity in health and disease. 1564 28

We report on a female with segmental dystonia of the upper limb after an anatomically related ischemic stroke. Dystonia developed almost 3 years after the onset of the stroke and immediately following the removal of the cast because of a bone fracture in the same limb. We discuss the case considering issues such as: delay-onset, lesion topography and pathophysiology, peripheral input and their possible contribution to the development of secondary dystonia.
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PMID:Dystonia after a bone fracture of the arm in a patient with a history of striato-pallidal ischemic stroke: a case report. 1582 86


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