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

The terms Binswanger's disease and arteriosclerotic subcortical encephalopathy are often applied to elderly patients with dementia and a diffuse hypodensity of the white matter on CT scan (or increased signal on MRI). Recently, similar white matter abnormalities have been reported in non-hypertensive patients with Alzheimer's disease and in elderly healthy people, casting doubt upon Binswanger's disease as an entity. These findings also suggest that the descriptive term leukoaraiosis meaning rarefied white matter is more appropriate than the term leucoencephalopathy. Nevertheless, within the group of patients with an ischemic stroke, several data suggest that leukoaraiosis is not a fortuitous finding and does not simply reflect ageing. Actually, these patients have a particular clinical profile, with intellectual deterioration, chronic hypertension, usually patent carotid arteries, and a deep location of the presenting infarct. Moreover hypertension seems to be still more strongly associated with leukoaraiosis than with a deep location of the infarct (lacunar infarction).
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PMID:[Leukoencephalopathy, leukoaraiosis and cerebral infarction]. 327 83

Pseudobulbar mutism is rarely attributed to bilateral discrete posterior limb internal capsule-medial globus pallidus infarction. Few cases of bilateral anterior choroidal (AchA) artery territory infarction have been reported. We present 8 patients with ischaemic stroke in this location and vascular distribution who have a characterizable syndrome. All had the abrupt onset of inability to speak, swallow or phonate, accompanied by varying degrees of facial diplegia, hemiparesis, hemisensory loss, lethargy, neglect and change in affect. The appearance of clinical signs depends upon the presence of a new infarct contralateral to an older lesion in mirror position. The pathogenesis and progression of neurological deficit appears to be intimately related to hypertension. The role of intrinsic intracranial vascular pathology related to diabetes mellitus, embolism of cardiac origin and atherosclerosis is currently undefined. The prognosis for recovery is poor. Half of our patients died within a year of onset of symptoms. Capsular pseudobulbar mutism is recognized by the abrupt appearance of neurological deficit consistent with internal capsular pathology and is confirmed by CT scan or MRI.
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PMID:Acute pseudobulbar mutism due to discrete bilateral capsular infarction in the territory of the anterior choroidal artery. 338 10

Topographic EEG brain mapping was performed on 100 patients referred for both EEG and neuroimaging procedures. Topographic maps were abnormal in 78% of patients with stroke, 50% with head trauma and 100% of those with space occupying lesions (tumor, abscess or intracerebral hematoma). Of the patients with abnormal EEG maps 30% had either sole or better localization with mapping than routine EEG or neuroimaging procedures. In no cases were there false localizing abnormalities by EEG mapping. Topographic mapping appears to provide better detection of low amplitude slow activity not easily discernible by routine EEG. It also provides faithful correspondence with localization of many lesions on neuroimaging procedures, and at times distinguishes abnormalities not immediately definable by CT/MRI. Topographic EEG mapping is a valuable adjunct to routine EEG.
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PMID:Clinical utility of topographic EEG brain mapping. 341 98

Amines like N-isopropyl-p-123I-iodoamphetamine (IMP) and hydroxy 123I-iodobenzyl propyl diamine (HIPDM) associated with brain tomoscintigraphy have proved their worth for detecting ischaemic abnormalities. Even though the chemistry of their metabolism and their biodistribution are not fully understood, their application in the study of parenchymal impairment in stroke and reversible ischaemia yields additional information compared to the other methods of imaging like CT or MRI. The concept of a steady state in brain with a wash in/wash out model has been considered especially with IMP, to explain the evolution of the activity pattern with time when comparing early and delayed images. (This review leads to foresee the prognosis of of ischaemic diseases when redistribution is taken into account.)
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PMID:Amines for brain tomoscintigraphy. 350 Apr 37

In 58 patients with progressive supranuclear palsy (PSP), 19 (32.8%) had CT, MRI, or autopsy evidence of a multi-infarct (MI) state. The clinical findings in the infarct syndrome were similar to idiopathic PSP. Five MI-PSP patients had had a stroke, four had focal dystonia, two had hemiparesis, and one had an intention tremor of recent onset. In contrast, only 5.9% (12.9% of those with CT or MRI) of 426 Parkinson's disease patients had evidence of strokes. One case of PSP studied pathologically was attributed to cerebral amyloid angiopathy.
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PMID:Progressive supranuclear palsy and a multi-infarct state. 356 71

A 34-year-old man presented with transient downward gaze paralysis and impairment of convergence together with prominent psychic disturbances. Cranial CT and MRI clearly demonstrated a symmetric infarction extending from the bilateral thalamus to the rostral medial midbrain. The existence of downward gaze paralysis following ischemic stroke is contributory to the diagnosis of not only the location of but also the responsible artery for the infarction.
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PMID:Bilateral thalamic infarction associated with selective downward gaze paralysis. 359 65

There are many positive aspects to the use of MRI in the evaluation of cerebrovascular disease. First, the MR imaging technique appears to be essentially without hazard. It does not rely on ionizing radiation, and no intravenous injections of contrast agent are necessary. MRI exploits the tissue's inherent biophysical characteristics to provide superior contrast. Infarctions are well delineated by MRI, often better and earlier than CT. Because of the lack of MRI signal from bone and thus the lack of transverse artifact from bone often seen with CT, lesions in the posterior fossa are very well visualized. With MRI it is possible to obtain images in the transverse, coronal, and sagittal planes, which provides for good evaluation of lesion size and extent. Arteriovenous malformations have been visualized by MRI, but it is still too early to know whether MRI has any detection capability over CT in this disorder. Subdural hematomas have been well visualized by MRI, including cases of isodense subdurals not visualized by CT. On the other hand, MRI has not proven to have any advantage over CT in the evaluation of intracerebral hemorrhage, hemorrhagic infarction, and subarachnoid hemorrhage. In fact, for detection of intracerebral hemorrhage and subarachnoid hemorrhage, CT may be better at the present time. In chronic infarction the surrounding area of Wallerian degeneration may cause the area of infarction to appear larger than it actually is. Hopefully, with further research into the use of different pulse sequence techniques and with good neuropathological correlation, the present limitations of MRI can be eliminated.(ABSTRACT TRUNCATED AT 250 WORDS)
Stroke
PMID:Clinical use of nuclear magnetic resonance imaging in stroke. 396 43

MRI of twenty patients with cerebral infarction were reported with their X-CT. MRI with long SE mode clearly showed the ischemic lesion at 18 hours after insult, whereas X-CT performed immediately after MRI scanning showed no abnormality. The signal contrast of the lesion with long SE mode seemed to increase slightly during the patient's course, for a period of several months. The MRI images with long SE at the chronic stage were varied: small lesions appeared as hot areas, whereas large lesions appeared as cold areas and were accompanied with signal enhancement in the surrounding areas. A phantom study was also performed and it was determined that MRI was superior to X-CT in its ability to detect tissue water. One of the reasons for the high diagnostic capability of MRI for acute stroke was, therefore, attributed to this experimental result.
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PMID:MRI of brain infarction. 408 Nov 9

Severe or even mild hyperhomocysteinaemia can cause a wide range of neurological problems. In recent years its vascular complications, including cerebral stroke, in children and young adults have gained special interest, because hyperhomocysteinaemia is treatable and recurrence of vascular incidents may be preventable. Current knowledge about biochemical mechanisms leading to hyperhomocysteinaemia, the pathogenesis of vascular pathology and neurological disfunction, and the various patterns of cerebral damage are reviewed. The significance of MRI in diagnosis, follow-up and research on hyperhomocysteinaemia is discussed.
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PMID:Hyperhomocysteinaemia; with reference to its neuroradiological aspects. 747 43

The carbohydrate-deficient glycoprotein syndrome is a newly recognised genetic disorder characterised by mental retardation, liver disfunction during infancy, cerebellar ataxia and atrophy, polyneuropathy, growth retardation, stroke-like episodes, and the appearance of carbohydrate-deficient fractions of multiple glycoproteins in the serum. The neuroradiological findings have been known as features of olivopontocerebellar atrophy. However, whether the abnormalities in the cerebellum and brain stem progress after birth is not known. We have carried out serial CT and MRI on three Japanese patients with this syndrome at different ages. A small cerebellum, with peculiar enlargement of the cisterna magna, and a small brain stem are present in infancy and atrophy of the anterior vermis and from before backwards in the cerebellar hemispheres seem to progress throughout early childhood.
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PMID:Neuroradiological findings in the carbohydrate-deficient glycoprotein syndrome. 747 67


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