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

We report an 11-year-old girl with a very rare tumour, mesenchymal chondrosarcoma of the brain, presenting as a haemorrhagic stroke, in whom angiography originally showed a distal arterial aneurysm. One month later MRI showed a solid tumour in addition to evidence of haemorrhage, and angiography then demonstrated pathological vascularity. The diagnosis was made following craniotomy.
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PMID:Case report: primary mesenchymal chondrosarcoma of the brain. 160 5

Among patients who had undergone MRI examinations with a clinical suspicion of stroke, we selected 82 patients with initial cerebral infarction being located only in a unilateral cerebral hemisphere. Seventeen (21%) subjects had wedge-shaped lesions including cerebral cortex (the cortical type), 65 (79%) had them predominantly in white matter and/or territory of the deep perforators (the subcortical type). Fifty nine cases out of total 82 (72%:9 in the cortical type, 50 in the subcortical type) had the silent cerebral infarction in the contralateral hemisphere to the affected side found on the 1.5 tesla superconductive system T2 weighted magnetic resonance imaging. Among them, 57 had the contralateral small cortical and/or subcortical (white matter) infarction, the other 2 cases had the contralateral lacunar infarction in the basal ganglia-internal capsule area as the silent lesion. The incidence of the cortical type was high in cases without the silent cerebral infarction in the contralateral hemisphere. It might be suspected that the cortical type had tendency to present clinical symptoms caused by initial stroke without prior silent cerebral infarction. The author proposed that the cerebral embolism might play an important role in showing the sudden onset clinical symptoms of the cortical type. And the author also proposed that there might be a difference in the development of clinical symptoms between the silent cerebral infarction located in the basal ganglia-internal capsule area and the cortical-subcortical (white matter) area.
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PMID:[Silent intracerebral lesions identified on magnetic resonance imaging in patients presenting with initial stroke--comparative studies of the affected hemisphere and the contralateral one]. 161 74

Assessments of higher cortical functioning are often neglected in patients with possible coarse neurobehavioral psychiatric disease, such as dementia, stroke, or focal cerebral lesions. When performed, the short Folstein Mini-Mental State Exam (MMSE) is typically used. The authors' research on 45 neuropsychiatric patients compared the MMSE with a new 20-30-minute bedside examination, the Screening Cerebral Assessment of Neppe (BROCAS SCAN). This screens 10 areas: recall, recognition, orientation, organization of thought, concentration, calculation, agnosia, apraxia, speech, and sensory-motor-reflex phenomena. The BROCAS SCAN (total) correlated extremely well with neuropsychiatric prediction, MRI changes, and neuropsychological testing, and distinguished diagnoses, demonstrating construct and face validity. It also accounted for a larger proportion of variance than the MMSE in correlating with these parameters and was more sensitive in mildly cognitive impaired patients. The briefer first section of the BROCAS SCAN, the core SCAN, also showed statistically relevant relationships to age, diagnosis, MRI, and neuropsychiatric prediction.
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PMID:The application of the Screening Cerebral Assessment of Neppe (BROCAS SCAN) to a neuropsychiatric population. 162 69

Six patients had isolated hemiataxia and ipsilateral sensory loss, as a manifestation of thalamic infarction in the thalamogeniculate territory. Acute hemiataxia-hypesthesia was not found in 1075 other patients from the Lausanne Stroke Registry who were admitted during the same period. Stroke onset was progressive in five patients and immediately complete in one. Five patients had an objective sensory loss. In two patients this affected light touch, pain and temperature sense, and in another three light touch, pain temperature, position and vibration sense. One patient had a purely subjective sensory disturbance. The sensory deficit cleared or was clearing although the ataxia persisted in all patients. On lesion mapping on CT or MRI, all patients had involvement of the lateral part of the thalamus (ventral posterior nucleus and ventral lateral nucleus). The presumed causes of stroke were cardioembolism in one patient, posterior cerebral artery occlusion in one patient and meningovascular syphilis in one patient, hypertensive small vessel disease in two patients, and undetermined in one patient. Hemiataxia-hypesthesia is a new stroke syndrome involving the perforating branches to the lateral thalamus, but in which small vessel disease may not be the leading cause.
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PMID:Hemiataxia-hypesthesia: a thalamic stroke syndrome. 164 Feb 35

In order to determine a possible role of ischemic white matter lesion in producing neuropsychological symptoms, we conducted a retrospective survey. Subjects were 206 consecutive patients who had been admitted to our neurology service under the diagnosis of ischemic stroke from April 1988 to November 1989 and had received brain CT as well as SPECT scans. From this cohort only patients that had circumscribed white matter lesion on CT scans were selected. Patients who had lesion in basal ganglia or thalamus were rigidly excluded. Eight subjects (3.9%) fulfilled above criteria, i.e. 5 with left hemispheric, 2 with right hemispheric and 1 with bilateral white matter lesions. Then we supplemented MRI information which had happened to be available for all the eight subjects. Exclusion of grey matter lesion based on MRI reduced the number of cases with exclusive white matter lesion into 4, i.e. 3 with left hemispheric and 1 with right hemispheric lesion. Of these, only one case with a discrete lesion in the genu of the left internal capsule had manifested mild neuropsychological impairments in naming, comprehension and writing. I123 amphetamine SPECT study revealed low uptake in the anterior half of the left middle cerebral artery in this case. We conclude that the role of a circumscribed white matter lesion as a cause of neuropsychological symptom seems to be much less clear than has been postulated.
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PMID:[Does circumscribed ischemic white matter lesion produce neuropsychological symptoms?]. 171 61

A right handed man had a massive left middle cerebral artery stroke. CT and MRI revealed extensive destruction of both anterior and posterior areas typically associated with language. There was, however, no aphasia, but instead a marked limb apraxia, dyscalculia, dense right visual neglect, and anosognosia. These uncommon dissociations and associations support the hypothesis that cerebral control of motor function of the limbs is not fundamentally related to the motor control involved in speech, and the notion that handedness is related to laterality of motor control, and only accidentally to laterality of language control.
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PMID:Limb apraxia without aphasia from a left sided lesion in a right handed patient. 171 36

We studied the MRI and clinical factors associated with dementia following stroke by quantifying ventricle-to-brain ratio (VBR), anatomic region of infarction, and cortical, subcortical, and white matter areas of infarction in 24 stroke patients with dementia and 29 nondemented stroke patients. The factors that most strongly correlated with dementia were total white matter lesion (WML) area, left WML, VBR, right WML, age, left cortical infarction area, left parietal infarction area, and total infarction area. Using discriminant analysis, these factors correctly classified 28 of 29 nondemented patients and 18 of 24 demented patients. Both cortical and white matter total infarction area measurements were strongly associated with dementia in stroke patients, suggesting that these factors strongly influenced the development of dementia following stroke. There was a strong association between dementia and left- but not right-hemisphere infarction area. The only demographic factor that strongly associated with dementia was age.
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PMID:A quantitative MRI study of vascular dementia. 173 95

The role of individual structures within the diencephalon for memory functioning is unknown. We present anatomic localization of lesions and a longitudinal neuropsychological profile of a young man who had a bilateral diencephalic stroke in the interpeduncular profundus arterial territory. MRI localized the lesions to the mamillothalamic tracts and inferior thalamic peduncle. The amnesia was characterized by severe impairment in explicit recall of new facts and events, while word-completion priming and remote memory were intact. We suggest that the memory deficit results from a disconnection of the diencephalon from the medial temporal region.
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PMID:Memory in a case of bilateral thalamic infarction. 173 98

In many neuropsychiatric disorders, PET imaging offers functional insights unavailable from anatomic imaging alone. Functional deficits may be more extensive than structural findings would indicate, may occur before the detection of anatomic changes, or may even occur in the absence of any structural lesions. We contrast the current role of PET with that of MRI and CT in the investigation of neuropsychiatric disorders including stroke, tumor, head trauma, epilepsy, schizophrenia, movement disorders, normal aging and dementia.
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PMID:Positron emission tomography in the investigation of neuropsychiatric disorders: update and comparison with magnetic resonance imaging and computerized tomography. 174 81

Symptomatic dolichoectasia of the vertebrobasilar system was found in 23 patients (16 males and 7 females, mean age: 62 years) during a 13-year period. Arterial hypertension was noted in 20 cases and associated aortic ectasia in 4. The malformation was identified in all patients on CT completed by angiography in 19, MRI in 7. Autopsy was performed in 5 cases. Fourteen subjects (group 1) presented with a vascular event (ischemic in 13) affecting the brainstem and/or cerebellum. Nine other patients (group 2) had a chronic symptomatology resulting from compression of the cranial nerves, central nervous system and/or CSF pathway. Two patients died of stroke within the first month (rupture of the ectasia in one and occlusion in the other one). The 21 survivors were followed for a mean period of 45.3 months. Eight patients had a stroke, with a significantly higher incidence in group 1 than in group 2 (p less than 0.05). Ten patients (5 in each group) developed progressive dementia possibly resulting from multiple cerebral infarction, hypertensive leucoencephalopathy, and/or hydrocephalus. Twelve patients died during the follow-up (4 of stroke, 6 of profound mental and motor deterioration, one from ruptured ectatic aorta, and the last one of unrecognized cause). The actuarial survival rate was 60% after 3 years of follow-up. Except for the incidence of stroke, inaugural manifestations (stroke vs nervous compression) did not seem to influence the long-term prognosis.
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PMID:[Vertebrobasilar arterial dolichoectasia. Complications and prognosis]. 177 25


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