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Query: UMLS:C0038454 (
stroke
)
147,016
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
An isolated oculomotor nerve palsy is very rarely the presenting sign of a pituitary adenoma. It may occur slowly due to mechanical compression or rapidly, secondary to pituitary
apoplexy
. Magnetic resonance imaging (MRI) with and without gadolinium
DTPA
enhancement provides excellent anatomical detail and is useful in the planning of the operative procedure. When correctly diagnosed and treated, the third nerve dysfunction appears to be reversible. We report a case of a pituitary adenoma presenting with an isolated, partial oculomotor nerve palsy in the setting of
apoplexy
. The pathophysiology, prognostic factors and MRI findings of this entity are discussed.
...
PMID:Isolated oculomotor nerve palsy following apoplexy of a pituitary adenoma. 146 70
A 46-year-old woman, who had been treated with anti-arrhythmic drugs and digitalis for mitral stenosis and paroxysmal atrial fibrillation, suddenly developed severe abdominal pain and nausea. There was tenderness around right
CVA
. BUN and serum-creatinine were elevated, 57 mg/dl and 4.5 mg/dl respectively. She was in acute renal failure (ARF). WBC, GOT, GPT, LDH were also elevated. Abdominal ultrasonography showed normal-size right kidney (12 cm) and atrophic left kidney (8.5 cm). Selective right renal angiography revealed right renal arterial embolism, suggesting that ARF developed from right renal infarction complicated by left atrophic kidney. Renal scintigram using 99mTc-
DTPA
indicated non-function type left kidney. Because of the high risk of surgery, she received anticoagulant therapy. Fifteen days later, BUN and serum-creatinine returned to 14mg/dl, 2.2mg/dl, respectively.
...
PMID:[A case of acute renal failure due to left contracted kidney, complicated by right renal infarction]. 147 26
We retrospectively reviewed the findings in 655 consecutive young patients who underwent contrast-enhanced MR examinations (1.5T) of the head or spine. Their ages ranged from 4 months to 20 years (mean 10 years). There was a 1.7% incidence of minor adverse reactions to gadolinium (Gd)-
DTPA
, none of which required treatment; no serious adverse reactions were encountered. Based on the radiologic diagnosis the patients were divided into three groups: (1) normal, (2) CNS neoplasm, (3) abnormal but not neoplasm. There were 178 patients thought to have CNS neoplasms and of these 156 (88%) enhanced. Of 124 histologically confirmed neoplasms 115 (93%) showed enhancement after Gd-
DTPA
. Eight children had histologically confirmed spinal neoplasms; 5 of 6 neurofibromas and 2 ependymomas enhanced. In the 216 patients with abnormalities thought not to be neoplastic, the enhancement rate was 11%; most of the enhancing lesions were vascular malformations. There were very few examples of inflammatory disease, acute trauma or
stroke
among our patients.
...
PMID:Diagnostic role of gadolinium-DTPA in pediatric neuroradiology. A retrospective review of 655 cases. 160 9
Cerebral lesions accompanying
stroke
in male
stroke
-prone spontaneously hypertensive rats (SHRSP, n = 10) were examined by both magnetic resonance imaging (MRI) and histological evaluation. T2-weighted MR images (T2-WI), taken 1-2 days after animals showed behavioral hyperactivity, indicated hyperintense regions in the occipital cortex, caudate putamen and/or thalamus. The areas of hyperintensity on T2-WI corresponded to neurodegenerative regions including edema, gliosis, and softening of the tissue. T1-weighted images (T1-WI) did not show any hyperintense regions. However T1-weighted images enhanced by the contrast media Gd-
DTPA
(Gd-T 1-WI) showed hyperintense spots within some of the hyperintense areas on T2-WI, which exhibited neurodegenerative regions such as thrombus, angionecrosis and hemorrhage in addition to the edematous formation. The hyperintense areas on Gd-T1-WI were smaller than those on T2-WI. In some animals, hypointense spots on T2-, T1- and Gd-T1-WI were found within the hyperintense areas, which corresponded to clots. Extensive histological examination did not reveal any additional cerebral degeneration which had not been detected on the MR images. These findings indicate that MRI is useful for detecting and differentiating various types of cerebrovascular disease in this model.
...
PMID:[MR imaging of cerebral lesions accompanying stroke in stroke-prone spontaneously hypertensive rats]. 164 68
In vivo echo-planar MR imaging was used to measure apparent diffusion coefficients (ADC) of cerebral tissues in a comprehensive noninvasive evaluation of early ischemic brain damage induced by occlusion of the middle cerebral artery (MCA) in a cat model of acute regional
stroke
. Within 10 min after arterial occlusion, ADC was significantly lower in tissues within the vascular territory of the occluded MCA than in normally perfused tissues in the contralateral hemisphere. Sequential echo-planar imaging was then used in conjunction with bolus injections of the magnetic susceptibility contrast agent, dysprosium
DTPA
-BMA, to characterize the underlying cerebrovascular perfusion deficits. Normally perfused regions of brain were identified by a dose-dependent 35-70% loss of signal intensity within 6-8 s of contrast administration, whereas ischemic regions appeared relatively hyperintense. These data indicate that sequential diffusion/perfusion imaging may be useful in differentiating permanently damaged from reversibly ischemic brain tissue.
...
PMID:Diffusion/perfusion MR imaging of acute cerebral ischemia. 188 20
We studied first-pass MRI contrast dilution to compute flow and volume of distribution in a realistic flow phantom. Pulsatile flow was provided by a one-chamber artificial heart. Physiological
stroke
volume, rate, pressure, and flow were adjustable. An elastic tube with dimensions similar to that of the human aorta was imaged at a rate of 2.4 Hz. After contrast injection, an initial increase in signal intensity was followed by a decrease. Signal-intensity time plots demonstrated slightly skewed curves as expected from dispersion theory. After calibration at different gadolinium-
DTPA
concentrations, signal intensities were converted into true gadolinium concentrations, and flow was calculated from the concentration-time curves. Flow was varied between 2.5 and 10.0 l/min and a significant correlation was found between the MRI estimate and true flow. Volume of distribution between injection and detection site was reliably estimated. This study demonstrates rapid 2-D imaging of a paramagnetic contrast bolus in a realistic flow phantom. Reliable estimates of flow and volume are obtained.
...
PMID:[The rapid magnetic resonance tomography measurement of the contrast medium dilution kinetics (gadolinium-DTPA) in a circulatory phantom]. 191 46
We evaluated the temporal and anatomic relationships between changes in diffusion-weighted MR image signal intensity, induced by unilateral occlusion of the middle cerebral artery in cats, and tissue perfusion deficits observed in the same animals on T2-weighted MR images after administration of a nonionic intravascular T2 shortening agent. Diffusion-weighted images obtained with strong diffusion-sensitizing gradient strengths (5.6 gauss/cm, corresponding to gradient attenuation factor, b, values of 1413 sec/mm2) displayed increased signal intensity in the ischemic middle cerebral artery territory less than 1 hr after occlusion, whereas T2-weighted images without contrast usually failed to detect injury for 2-3 hr after
stroke
. After contrast administration (0.5-1.0 mmol/kg by Dy-
DTPA
-BMA, IV), however, T2-weighted images revealed perfusion deficits (relative hyperintensity) within 1 hr after middle cerebral artery occlusion that corresponded closely to the anatomic regions of ischemic injury shown on diffusion-weighted MR images. Close correlations were also found between early increases in diffusion-weighted MR image signal intensity and disrupted phosphorus-31 and proton metabolite levels evaluated with surface coil MR spectroscopy, as well as with postmortem histopathology. These data indicate that diffusion-weighted MR images more accurately reflect early-onset pathophysiologic changes induced by acute cerebral ischemia than do T2-weighted spin-echo images.
...
PMID:Diffusion-weighted MR imaging of acute stroke: correlation with T2-weighted and magnetic susceptibility-enhanced MR imaging in cats. 216 12
Twenty-five patients with clinical and CT findings indicating supratentorial cerebral infarct were prospectively studied with MR. MR examinations were performed between the 3rd and 150th day after
stroke
. T2-weighted axial images were compared with T1-weighted sequences after i.v. administration of Gd-
DTPA
. T2-weighted images demonstrated parenchymal lesions in all 25 patients. Postcontrast T1-weighted images, however, displayed pathologic contrast enhancement in only 19 areas of infarction. In 5 of the 25 patients, the use of Gd-
DTPA
provided additional diagnostic information by demonstrating gyral contrast enhancement as a pattern typical for ischemia. In 2 of the 25 patients, pathologic contrast enhancement was observed in an area that was isointense to the surrounding brain tissue on the T2-weighted images. In one patient, Gd-
DTPA
improved differentiation between areas of subacute and chronic infarction. At present, in the patient with suspected cerebral infarction, MR imaging after i.v. administration of Gd-
DTPA
appears recommended when clinical findings and CT are equivocal.
...
PMID:[Subacute cerebral infarct: native and contrast medium-enhanced MRT]. 255 31
Technetium Tc 99m
DTPA
single photon emission computerized tomography (SPECT) brain scans of 20 patients with acute ischemic
stroke
were reviewed retrospectively and compared with clinical and radiologic (CT) data. Fourteen of the patients had abnormal SPECT studies. The abnormal findings were demonstrated by static views in eight patients, by the flow study in one patient, and by both sets of images in the other five patients. All abnormalities correlated with the clinical syndrome of presentation, and only two of the patients had no corresponding lesions on CT. Of the six patients with normal SPECT scans, two had abnormal CT studies, and in the other four, no lesions were shown at all. The ability of 99mTc
DTPA
SPECT to display cerebral infarctions appears to be, at best, comparable to that of CT. SPECT also provides qualitative information regarding flow dynamics in the affected hemisphere of some patients (6/20 in our review). This, we believe, represents the objective demonstration of the preexisting insufficient collateral flow in the hemisphere at risk for ischemic
stroke
.
...
PMID:Noninvasive evaluation of ischemic stroke with SPECT. 305 27
In nine patients with recent lacunar
stroke
who revealed multiple small lesions in x-ray computed tomography (CT) and magnetic resonance imaging (MRI), CT and MRI enhancement studies were performed on the same day employing iodinated contrast medium and gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA), respectively. In CT, the injection of contrast medium enhanced recent lesions in only four of the nine patients; furthermore, the effect was weak. In MRI, the injection of Gd-
DTPA
enhanced recent lesions in all patients except for one who was examined 4 weeks after ictus, and the effect was excellent. Recent infarcts could be identified only by Gd-
DTPA
-enhanced MRI in four of the nine patients. In patients with multiple small infarctions, identification of recent small infarcted lesions by CT or MRI is sometimes difficult; however, the use of Gd-
DTPA
in MRI makes it possible to distinguish recent infarcts from other lesions definitively.
Stroke
1988 Jul
PMID:Identification of recent lacunar lesions in cases of multiple small infarctions by magnetic resonance imaging. 291 19
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