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)

Different pharmacological properties of almitrine-raubasine show that this combination may be a good therapy for the treatment of age-related cerebral disorders and functional rehabilitation after stroke. Many clinical studies have been carried out in France and in the rest of Europe, confirming the value of this compound in such situations. Without discussing the complexity of clinical trials in both the areas of cognitive disorders and stroke, we shall present two studies demonstrating the beneficial effects of almitrine-raubasine against cognitive impairments. The first is a double-blind controlled study versus placebo with a 3-month follow-up period involving patients (aged between 60 and 85) with memory loss, lack of concentration, impaired mental altertness, and emotional instability. The second is a controlled multicenter study of 155 outpatients (age 70-85) presenting with cognitive decline (assessed by MMSE, SCAG). In both these studies, almitrine-raubasine significantly improved symptomatology and was superior to placebo, especially in the vascular cases. This confirms the validity of previous studies and justifies the indication of these compounds in the treatment of age-related cognitive disorders. Other studies also demonstrated the beneficial effect of this compound on neurosensory vascular disorders, with specific studies carried out on chorioretinal dysfunctions (visual symptomatology) and in vestibular disorders (vertigo associated with electronystagmographic modifications). The appropriate and usual dosage (2 tablets per day) and the good tolerance of the compound have been confirmed in a French multicentric study in 5,361 outpatients.
 ...
PMID:Clinical efficacy of almitrine-raubasine. An overview. 951 74

Magnetic resonance angiography (MRA) is a new, noninvasive, and useful method to estimate the posterior circulation in patients with vertigo. From June 1995 to May 1997, 180 patients were examined by magnetic resonance imaging (MRI) and MRA in our department. One hundred and forty-seven patients were vertiginous patients. We measured the displacement angle of the basilar artery with MRA, and examined the relationship between the findings from some neurological examinations and MRA findings in patients with vertigo and dizziness. One hundred and forty-seven patients with vertigo or dizziness were examined by MRI and MRA. They were diagnosed with MRI images in addition to several neurological examinations. MRA was not used for the diagnosis but rather for measuring the displacement angle of the basilar artery. Eighty-six cases with central vestibular disorders, 11 cases with vertebrobasilar insufficiency, and 26 cases with autonomic nerve disorders were recognized. In the cases of central vestibular disorders, the incidences of hyperlipidemia and hypotension were higher than the incidence of anemia. The average displacement angle of the basilar artery (n = 180) was 153.4 degrees +/- 39.4 degrees (mean +/- S.D.). MRA findings were classified into five categories. Ten patients were classified as category III, which represented unilateral partial vertebral artery stenosis. The detection rate for category III and IV abnormalities by neurological examination was higher than that for the other categories. MRI and MRA are important methods to examine patients with central nervous disorders. Distal vertebral artery stenosis may carry a higher risk of a stroke than brainstem infarction.
 ...
PMID:MR-angiographic findings of patients with central vestibular disorders. 965 12

As isolated symptoms, vertigo, dizziness and imbalance are not regarded by neurologists as reflections of transient ischemia in the vertebrobasilar circulation. The purpose of this retrospective study was to demonstrate that these symptoms can and do occur in isolation. To this end, we analyzed the symptoms, stroke risk factors and diagnostic algorithms in 27 patients with a diagnosis of transient vertebrobasilar ischemia. None of the 27 patients included in the review complained of any associated neurologic symptoms. Against the reference standard of brain imaging, the site of the pathologic lesion was defined in the brainstem/cerebellum with the Torok monothermal caloric test, with a sensitivity greater than 86%. Vestibular decruitment and hyperactive caloric responses were of particular diagnostic value. Thus, we recommend that the neurologic dogma with regard to brainstem cerebellar ischemia be rethought.
 ...
PMID:Diagnosis of vertebrobasilar insufficiency: time to rethink established dogma? 987 36

A random telephone survey on knowledge of stroke was conducted in 1, 238 Hong Kong Chinese. Most respondents realized that effective treatment was available, that stroke was preventable and that it could be fatal or disabling. Sudden unilateral limb weakness, sudden speech and language disturbances, and sudden vertigo and clumsiness were better recognized than other warning symptoms of stroke. A slightly better recognition of symptoms of stroke was seen in those with a belief of knowing about stroke, providing a correct description of stroke, those with a positive household history of stroke and those with a better knowledge of potential risk factors. Most respondents would choose desirable actions if stroke was suspected in their family members or themselves. Friends and relatives, newspapers and magazines, and mass media provided the major sources of their knowledge.
 ...
PMID:Knowledge of stroke in Hong Kong Chinese. 997 56

Unilateral cerebellar infarcts in the territory of the superior cerebellar artery (SCA) have been studied in recent years to delineate the clinical presentation and stroke mechanism, but most studies excluded bilateral infarctions. We have studied patients with bilateral SCA infarctions to provide data on clinical findings, stroke distribution and outcome. We collected data of 8 patients with bilateral SCA infarctions recognized by computed tomography and/or magnetic resonance imaging. The most common clinical presentation of patients with bilateral SCA infarctions were nausea, vomiting or vertigo (6 patients), often associated with ataxia and dysarthria (5 patients). Further symptoms were variable and depended on additional infarcts in other vascular territories. Infarcts were often partial or scattered with equal distribution between the medial and lateral branches of the SCA. Complete infarction within the SCA area occurred in less than half of the cases. Clinical outcome was either benign (full recovery in 3 patients) or fatal (5 patients). Predictors for a good clinical recovery were young age, few vascular risk factors, only partial involvement of the SCA territory without involvement of other vascular territories, and absent limb weakness on clinical presentation.
 ...
PMID:Presentation and prognosis of bilateral infarcts in the territory of the superior cerebellar artery. 1054 90

A patient's dizziness can be caused by a peripheral vestibular disorder, VIIIth nerve compression, brain stem ischemia, or cerebellar stroke. Clues from the history and physical examination are mentioned, and diagnostic entities, such as demyelination, cerebrovascular disease, migraine, Arnold-Chiari malformation, cerebellar degeneration, and neoplastic disease are discussed. Treatment options are outlined so that therapeutic and diagnostic trials can be initiated. Guidelines are offered for when to image the brain or posterior circulation vasculature and when a patient with acute vertigo should be admitted for observation.
 ...
PMID:Distinguishing and treating causes of central vertigo. 1081 38

Spontaneous dissection of the extracranial vertebral artery (VA) may cause ischemic stroke in the posterior circulation. A 22-year-old female and a 38-year-old male presented with sudden onset of vertigo and nausea without trauma. Angiography was initially interpreted as normal, but retrospective examination disclosed extracranial VA dissection in the V3 segment in both cases. Arterial dissection resulting in embolic stroke in the territory of the ipsilateral posterior inferior cerebellar artery was highly suspected. Both patients were treated conservatively without sequelae. Careful angiographic interpretation is important for the diagnosis of extracranial VA dissection. Spontaneous extracranial VA dissection should be suspected in young patients presenting with ischemic stroke but without predisposing risk factors or associated trauma.
 ...
PMID:Embolic cerebellar infarction caused by spontaneous dissection of the extracranial vertebral artery--two case reports. 1089 67

While outpatient management for chronic neurological diseases is well-established, the impact of inpatient neurological examination in emergency room and university hospital remain largely underestimated. We prospectively studied the role of the neurologist in patient management, in a primary care university hospital. Over a period of 12 months, we prospectively recorded the demographics of patients requiring examination in the emergency room, the initial suspected neurological diagnosis of the emergency room, the final diagnosis of the neurology team, and the patients' outcomes. For each patient, the time between admission, the call and the neurological examination were recorded. Neurological examinations were performed in 2220 patients in whom 75.6 p.100 were performed in the emergency room. These latter patients corresponded to 14 p.100 of all patients admitted in the emergency room. Of examined patients, 52 p.100 were male and mean age was 56.9 +/- 21 years. The time between admission and examination was 32 min. (+/- 36 min), irrespective of the day of the week, and depended on the suspected diagnosis: shorter in stroke and status epilepticus (p<0.05), and longer in loss of consciousness and vertigo (p<0.01). Forty-four percent of the examinations took place in the evening and night. The reasons for examinations were: stroke (28.3 p.100), epilepsy (17.7 p.100), headaches (8.4 p.100), loss of consciousness (7.9 p.100), cognitive dysfunctions (4.1 p.100), neuropathies (4 p.100) and miscellaneous (8.1 p.100). Neurological examinations modified neurological diagnosis and treatment in more than 86 p.100 of the patients. Following neurological examination, 17.2 p.100 of the patients were able to go home, while the rest were admitted to the stroke unit (27.2 p.100), the general neurological unit (27.3 p.100) or in other departments (28.3 p.100), of which intensive care unit (5.3 p.100) or neurosurgery (5.9 p.100). Emergency neurologic examination improves neurological diagnosis and has a positive impact both on treatment and, more globally, in patient management.
 ...
PMID:[Emergency neurology consultations in the university hospital setting: contribution of the neurologist to inpatient management]. 1103 12

Vertigo can be the first manifestation of vertebrobasilar ischaemia or brainstem and cerebellar stroke. Chronic isolated vertigo may pose a diagnostic dilemma. We report the case of a patient who presented with chronic isolated vertigo, and highlight the clinical use of magnetic resonance imaging and angiography in his management.
 ...
PMID:Chronic isolated vertigo. 1109 18

A case is reported of the vertebral arterial dissection presenting initially with cerebellar infarction, and which subsequently occurred with subarachnoid hemorrhage 14 days later. A 75-year old male was admitted because of vertigo and ataxia. MR T2-weighted imaging showed a hyperintensity areas on the left cerebellar hemisphere and MR angiography showed multiple stenotic lesions in the left vertebral artery. We diagnosed his illness as dissection of the left vertebral artery and antiplatelet therapy and the blood pressure control were carried out. Fourteen days after the onset, the patient complained of sudden onset of headache and subarachnoid hemorrhage was confirmed on CT scan. Proximal clip occlusion of the left vertebral artery and OA-PICA anastomosis was carried out immediately. The patient was discharged with slight truncal ataxia. We evaluated the features of this vertebral arterial dissection presenting with subarachnoid hemorrhage after ischemic stroke with reference to another reported cases.
 ...
PMID:[Vertebral arterial dissection with subarachnoid hemorrhage after ischemic onset]. 1112 96


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