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

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

Embolic and thrombotic infarction in the territory of the posterior cerebral artery (PCA) is described with emphasis on the stroke and cerebrovascular features rather than special neurological syndromes. Of 47 cases of obstruction at the distal bifurcation of the basilar artery, 43 (95%) were consistent with embolism. The clinical categories and pathological findings are presented. Local embolism, vertebral distal-stump embolism, the dynamics of hemorrhagic infarction and embolus-in-transit are briefly described. The prodromal manifestations of PCA thrombotic occlusion include photopsias, hemianopic blackouts, headache, transient episodes of numbness, episodic lightheadedness, spells of bewilderment and rarely tinnitus. Recognition of these may allow prevention of a stroke. Prodromal photopsias did not closely resemble the scintillating displays of migraineurs. When the stroke occurred, visual complaints usually predominated. A sensory deficit occurred in one-third of cases. In 25 cases of memory impairment the dominant hemisphere was involved in 24. The kinds of visual hallucinations, simple and formed, are described.
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PMID:The posterior cerebral artery syndrome. 374 39

We had a case of patient with pure sensory stroke which was caused by the rapture of a cryptic angioma located on the mesencephalon. The patient was a 41-year-old woman. She visited our clinic with sudden onset of numbness in the left hand, arm, trunk, leg, and face, and of hyposmia of the left side on arising. CT scans revealed a small hematoma with calcification located on the right dorsal mesencephalon, which diminished in size correlating with her recovery of the sensation. Her symptoms were considered to be caused by this hematoma which destroyed only the trigeminothalamic and the spinothalamic tracts excluding the superior colliculi, oculomotor nucleus, and the medial leminiscus. By angiography we failed to demonstrate a cause of the hemorrhage, but the presence of a cryptic angioma was suggested, because the post angiographic CT scan exhibited enhancement of the lesion. Her olfactory sensation was also restored accompanied with the recovery of the superficial sensation, therefore the hyposmia seemed to be due to the damage of the trigeminothalamic tract.
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PMID:[Pure sensory stroke due to midbrain hemorrhage--case report]. 400 74

The clinical effectiveness of flecainide acetate was evaluated in 36 patients (29 male and 7 female, average age 56 years) in whom therapy with previous antiarrhythmic agents had failed. All patients had documented ventricular tachycardia on Holter electrocardiographic recording and 31 of 36 (86%) had had syncope or required cardiopulmonary resuscitation, or both. Angiographic findings demonstrated significant coronary artery disease in 22 (61%) and primary left ventricular dysfunction in 14 (39%), with a left ventricular ejection of 0.39 +/- 0.4. Patients were treated with an average flecainide dose of 302 +/- 76 mg/day. The follow-up time was 101 +/- 156 days. Thirty-two of 36 patients (89%) had complete elimination of ventricular tachycardia from Holter monitoring and only 2 patients had flecainide discontinued because of noncardiac side effects (numbness, blurred vision and ataxia). However, the drug was subsequently discontinued in 5 patients because of cardiac side effects (proarrhythmic effect in 2, sinus bradycardia in 1, complete atrioventricular block in 1 and new left bundle branch block in 1) and 10 patients died during flecainide therapy (1 with cerebral stroke, 3 with congestive heart failure and 6 with incessant ventricular tachycardia). A comparison of the general cardiac features of those who died with those who did not revealed a significantly lower ejection fraction (0.24 +/- 0.1 vs 0.45 +/- 0.1, p less than 0.05) and a significantly higher flecainide dose (350 +/- 85 versus 276 +/- 59 mg/day, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evaluation of flecainide acetate in the management of patients at high risk of sudden cardiac death. 669 14

This paper contains an analysis of 135 cases in which numbness, either episodic or persistent, involved one side of the body. In most cases, the patients were candidates for the diagnosis of pure sensory stroke which is usually the result of an occlusive cerebrovascular lesion involving the thalamus. The cases are divided into three main categories, pure sensory stroke, pure sensory TIAs, and atypical cases. The clinical features described in an earlier paper have been confirmed for the most part. A major limitation is the paucity of pathological studies. The lack of reliable criteria for the recognition of migrainous paresthesias has probably resulted in the inadvertent inclusion of some such cases. Some other conditions, hemidysesthesia and cervical disc, which have had to be considered in the differential diagnosis have been included. Cases of occlusive disease of the posterior cerebral internal carotid and middle cerebral arteries have been analyzed for patterns of paresthesias which may serve to distinguish cortical lesions from thalamic.
Stroke
PMID:Pure sensory stroke and allied conditions. 710 42

In 2793 respondents aged 65 and over in a survey of a geographically defined community, who were asked about falls in the preceding twelve months, the estimated annual prevalence rate (persons) of falls was 28.0%. Standardized for age, the rate was twice as high in women as in men. Rates increased with age but more steeply in men than in women. Compared with non-fallers, fallers had been in more recent contact with their general practitioner, showed higher prevalence of problems with mobility and daily living, a more frequent history of stroke and heart disease, and had more episodes of non-rotatory vertigo, double vision, faints and blackouts and episodes of weakness or numbness. Fallers also showed more frequent evidence suggestive of cognitive impairment. More fallers than non-fallers were taking diuretics and tranquilizers and these associations merit further study.
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PMID:Factors associated with falls in the elderly: a community study. 727 Mar 21

Transient ischemic attack (TIA) is the most powerful predictor of stroke. Estimates of its prevalence in various regions of the world differ depending upon the instruments and exclusion criteria used and the population surveyed. For example, if the questioner uses technical language, or if he or she excludes events lasting but a few seconds and symptoms such as dizziness (without accompanying phenomena), numbness and tingling, and transitory amnesia (euphemistically called forgetfulness), an entirely different prevalence results than if these events and symptoms are included. In a survey of people aged 45 to 64, cross-sectional data were ascertained by means of a standardized TIA/stroke questionnaire and an algorithm. For women the prevalence of TIA-like events was 5% and fr men, 3%, increasing with age for both sexes. These events were more prevalent in African-Americans than Caucasians. The most frequent symptoms were change in speech, followed by dizziness and loss of balance.
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PMID:Transient ischemic attack: awareness and prevalence in the community. 791 66

A case of fibromuscular dysplasia at the internal carotid origin is reported. A 45-year-old, right-handed woman who was in good health, experienced 5-6 second episodes of numbness and tingling in her right hand and lip. She had no history of medical illness or trauma. The patient suffered the same sort of attack almost seven years after her first episode. General examination was unremarkable. There was no sign of residual neurologic deficit. Cerebral angiography demonstrated a discrete filling defect at the internal carotid origin. There was no evidence of atherosclerosis in the intracranial or extracranial vessels. The lesion occluded approximately 58% of the lumen. A carotid endarterectomy was performed and a "web shaped" tissue was removed from the posterior aspect of the right internal carotid artery. Microscopic examination of the surgical specimen demonstrated intimal fibrosis, consistent with the diagnosis of fibromuscular dysplasia. In addition to our patients, eight other cases of cephalic fibromuscular dysplasia have been reported in the form of an internal carotid web. This type of lesion is unique because the changes involve only the intima of the vessels without involvement of the medial structure as is seen in the usual form of fibromuscular dysplasia. Moreover, 5 out of 9 patients reported had the repeated episodes of the ischemic symptom, suggesting patients with this particular lesion have higher risk for stroke than those with the usual "string of beads" lesion. In these patients, surgical treatment should be considered, especially if medical therapy is unsuccessful.
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PMID:[Fibromuscular dysplasia at the internal carotid origin: a case of carotid web]. 832 4

We report a 57-year-old man who developed Wallenberg syndrome and vertebral artery dissection, probably as a complication of neck rotation during golf exercise. He noticed pain in the neck during golf exercise. About 16 hours later, he developed numbness in the right hand, cold sweat, vertigo, hiccup, double vision and ataxia in gait. Neurological examination on the 22nd day revealed a right Wallenberg syndrome. The right vertebral angiogram showed a marked stenosis of the vertebral artery at the portion across the dura, and a dissecting aneurysm in the portion from its entrance into the posterior fossa through the exit of the right posterior inferior cerebellar artery. Quick rotation and/or extension of the neck and head during golf exercise probably caused the vertebral artery dissection, resulting in Wallenberg syndrome. More attention should be paid to relatively trivial trauma as the cause of stroke, especially in the victims of younger ages.
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PMID:[Wallenberg syndrome and vertebral artery dissection probably due to trivial trauma during golf exercise]. 833 99

Three weeks after an automobile accident, a 35-year-old man experienced left throat and neck pain, numbness of the left face and tongue, dysphagia, left arm pain and weakness, and left miosis. At age 27, he had suffered an aneurysmal subarachnoid hemorrhage. Angiography at that time had also demonstrated a fenestration of the left intracranial vertebral artery. At the time of the second presentation, angiography showed that one of the limbs of the fenestration had become occluded. Although the vast majority of intracranial arterial fenestrations are asymptomatic, occlusion of one of the limbs of a fenestration may be the cause of stroke.
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PMID:Traumatic occlusion of one limb of an intracranial arterial fenestration: an uncommon cause of stroke. 871 96


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