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)

A 54 year-old female expired at her residence. Her husband, a physician, signed a certificate stating that her death was due to cerebrovascular accident (CVA) and released her body to a funeral home, where she was embalmed. Since the deceased had a long history of medical problems and drug abuse, an autopsy was performed and no evidence of CVA was found. Toxicological analyses of body fluids and tissues revealed the presence of ethchlorvynol in high concentration in the bile (112 mg/l). The bloody fluid collected from the heart contained a concentration of ethchlorvynol below the limit for quantitation. Other findings included phenobarbital (32.8 mg/l) in heart bloody fluid and methanol (an ingredient of embalming fluid). The significance of the findings is discussed in relation to embalmment prior to autopsy and toxicological analyses. Ethchlorvynol concentration in the bile is compared to other fatal cases due to ethchlorvynol overdose.
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PMID:Determination of ethchlorvynol in body tissues and fluids after embalmment. 340 56

A 71 year old man had a massive left sensory deficit and hemiplegia, with left heminanopia, visual neglect and constructional apraxia. Moreover he experienced an extra-left arm and illusions of movements. 3 weeks later he suffered "thalamic" pain on left side; he died suddenly 6 weeks after the stroke. Post-mortem examination revealed: a) a right inner temporal and occipital infarction; b) a right thalamic infarction in the thalamogeniculate and paramedian territories; c) an infarction in the adjacent right internal capsule. Considering this case and pertinent literature on clinicopathological studies of right thalamic infarction, the authors suggest that a simultaneous ischaemia of thalamogeniculate and paramedian territories should be necessary to induce somatognosic and visuospatial disturbances.
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PMID:[Non-dominant hemisphere syndrome as a result of a right thalamic infarct: an anatomoclinical case]. 382 9

A 71-year-old man with atrial fibrillation suddenly had an embolism in the right middle cerebral artery. Single-photon emission CT was performed 4 hours after the onset of stroke and revealed markedly elevated 99mTc-hexamethylpropyleneamine oxime (HMPAO) uptake in the right frontotemporoparietal region. This area of HMPAO hyperfixation corresponded to the area of infarction, as determined by CT and MR. Our findings showed that HMPAO single-photon emission CT overestimated reflow hyperemia after reperfusion in the acute stage of embolic stroke, as it does in the subacute stage.
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PMID:Spurious hyperfixation of hexamethylpropyleneamine oxime in acute embolic stroke. 873 79

A 71-year-old man was admitted to our hospital because of headache and left hemiparesis. Brain CT scan showed hemorrhagic infarction of the right frontal lobe. Intravenous digital subtraction angiography revealed no occlusion of cerebral arteries. No arrhythmias were observed by the holter ECG. Transthoracic echocardiography showed no abnormalities. Anticoagulation therapy (heparin and warfarin) was started under the diagnosis of cerebral embolism without definite embolic source and there was no recurrence during following four years. Transesophageal echocardiography showed an atrial septal aneurysm (ASA) without patent foramen ovale. A potential cause of cerebral embolism due to atrial septal aneurysm is paradoxical embolization through an interatrial shunt (patent foramen ovale). It was speculated that ASA was a direct source of thrombus formation in this case (lone ASA). Transesophageal echocardiography should be performed to find atrial septal aneurysm in patients with cryptogenic stroke, especially embolic stroke without definite embolic sources.
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PMID:[Cerebral embolism due to lone atrial septal aneurysm]. 943 Oct 4

Background and Purpose-The fornix connects various structures involved in memory. We report a patient with anterograde amnesia after an acute ischemic infarct in the anterior fornix. Case Description-A 71-year-old female with acute-onset amnesia had neuroimaging studies showing ischemic infarction of both columns and the body of the fornix and the genu of the corpus callosum. Neuropsychological evaluation revealed anterograde amnesia without evidence of callosal disconnection. The patient showed marked improvement in her memory function on the follow-up visit. Conclusions-Amnesia in this case is likely due to infarction of the anterior fornix structures.
Stroke 2000 Jun
PMID:Amnesia due to fornix infarction. 1083 65

A 71-year-old woman underwent right coronary artery (RCA) bare metal stenting during an acute myocardial infarction. Seven months later the patient received a sirolimus-eluting stent as treatment for an 80% left anterior descending coronary artery (LAD) stenosis. She remained asymptomatic until she presented with unstable angina 16 months later. Angiography demonstrated subtotal occlusion of the left obtuse marginal branch. The LAD sirolimus-eluting stent showed 0% stenosis. The RCA stent showed 30% restenosis. The left obtuse marginal branch lesion was successfully stented, but the patient suffered a fatal stroke 24 hours after the coronary intervention. At autopsy the 16-month-old LAD sirolimus-eluting stent was widely patent with a minute thrombus near the ostium of a small side branch. The stent surface appeared free of any other irregularities. Scanning light microscopy showed mild neointimal thickening. Scanning electron microscopy showed > 80% endothelialization of the stent. The 24-month-old RCA bare metal stent showed mild to moderate neointimal growth with > 90% endothelialization.
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PMID:Drug-eluting versus bare metal coronary stents: long-term human pathology. Findings from different coronary arteries in the same patient. 1466 85

We experienced a case of subarachnoid hemorrhage with different BIS values observed between the right and left forehead. A 71-year-old woman was scheduled for endovascular coiling. She had been already intubated and showed little response to painful stimulation without sedation (Japan coma scale; III-200). Anesthesia was induced and maintained with propofol. BIS monitoring was started from the right forehead before anesthetic induction (r-BIS), and additional monitoring from the left side was started after induction (1-BIS). When the operation was started, 1-BIS was 40 and r-BIS was 30. During the operation, 1-BIS was always higher than r-BIS; 1-BIS was 49 +/- 10 and r-BIS was 37 +/- 7 (mean +/- SD). The difference between r-BIS and 1-BIS was more than 10 for 68% of operation time. Since abnormal EEG pattern was observed, we concluded that abnormal EEG influenced BIS value, and 1-BIS after anesthesia was higher than that of her actual conscious level. EEG of a patient with acute stroke sometimes shows an abnormal pattern. Anesthesiologists should keep in mind the possibility that an abnormal EEG might influence BIS value.
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PMID:[A case of subarachnoid hemorrhage with different BIS values observed between the right and left forehead]. 1802 9

Ballism is characterized by continuous, coarse, flinging involuntary movements involving the limbs. Although persistent involuntary movements caused by cerebrovascular diseases mostly in middle-aged patients are well known, transient involuntary movements are an unusual manifestation of cerebrovascular diseases. We describe a rare case of reversible ischemic neurologic deficit (RIND) presented as hemiballism. A 71-year-old man was admitted to our hospital for hemiballism in the right limbs. On magnetic resonance (MR) imagings, there was no evidence of acute ischemic stroke, but MR angiography revealed severe stenosis of left middle cerebral artery. Electroencephalogram showed no epileptic discharge. For hemiballism, chlorpromazine and haloperidol were administered in addition to antiplatelet management for ischemic attack, and the patient completely recovered on the 5 days of hospitalization. Transient ischemic attacks (TIA) or RIND typically present with neurological deficits such as loss of muscle power, reduced sensation, or visual loss. Involuntary movements are not generally regarded to be TIA or RIND. Involuntary movements such as hemiballism, however, can occur as a symptom of TIA or RIND, which should be recognized and differentiated from conditions like partial seizures. Moreover, they may be an indicator of severe carotid stenotic or occlusive diseases, and patients may be at high risk of ischemic events. Early diagnosis and timely treatment are required to prevent ischemic events.
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PMID:[Case of reversible ischemic neurological deficit presented as hemiballism]. 1908 46

Bow hunter's stroke is a rare symptomatic vertebrobasilar insufficiency in which vertebral artery (VA) is mechanically occluded during head rotation. Various pathologic conditions have been reported as causes of bow hunter's stroke. However, bow hunter's stroke caused by facet hypertrophy of C1-2 has not been reported. A 71-year-old woman presented with symptoms of vertebrobasilar insufficiency. Spine computed tomography showed massive facet hypertrophy on the left side of C1-2 level. A VA angiogram with her head rotated to the right revealed significant stenosis of left VA. C1-2 posterior fixation and fusion was performed to prevent serious neurologic deficit from vertebrobasilar stroke.
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PMID:Bow Hunter's Stroke Caused by a Severe Facet Hypertrophy of C1-2. 2022 13

Gonadotrophin-releasing hormone agonists (GnRHAs) are used in many clinical conditions, particularly prostate cancer. There have been a few case reports of apoplexy from a previously undiagnosed pituitary tumour, occurring within hours to days of initiation of GnRHA therapy. We report a case of delayed onset pituitary apoplexy following GnRHA therapy. A 71-year-old man presented three weeks after onset of headache and vision loss. On examination, he was blind in the right eye with an intact nasal field of vision in the left eye. Two months before presentation, he had a subcutaneous GnRHA (Goserelin) implant for treatment of locally advanced prostate cancer (Gleeson 4+3). An MRI scan revealed a large sellar/suprasellar mass. His follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels were grossly elevated. A trans-sphenoidal endoscopic decompression of the pituitary tumour was performed. His vision improved post-operatively and his FSH, LH, testosterone, prostate specific antigen (PSA) levels returned to normal levels. Histopathologic studies revealed a pituitary adenoma, which stained positive for FSH and LH. The prostate cancer management was changed to an anti-androgen agent and a GnRH antagonist. This case demonstrates that pituitary apoplexy can develop up to eight weeks after the initiation of treatment for prostate cancer with GnRHAs.
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PMID:Delayed pituitary apoplexy in patient with advanced prostate cancer treated with gonadotrophin-releasing hormone agonists. 2060 67


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