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Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 6-year-old boy developed a flaccid hemiplegia and dysarthria following several transient episodes of nausea, vomiting, and ataxia. An anomly of the dens was discovered, permitting subluxation of C-1 on C-2. A segmental occlusion of the right vertebral artery and an aneurysm of the left vertebral artery were found at the C-2 level, as well as a thromboembolic occlusion of the rostral end of the basilar artery. It appeared that the repeated cervical subluxation produced occlusive, aneurysmal, and embolic vascular disease, and that clinical symptoms were the result of ischemia in the territory perfused by the vertebrobasilar arteries.
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PMID:Occlusive vertebrobasilar artery disease associated with cervical spine anomaly. 113 Mar 56

Spontaneously occurring surface wrinkling retinopathy occurreed in 17 eyes of 16 patients and was not related to pervious surgery, retinal vascular disease, or obvious ocular inflammation. Visual symptoms were not severe and follow-up suggests that the usual course of surface wrinkling is usually benign. However, 2 eyes progressed to 20/300, so that there is a chance of considerable visual deterioration in some cases. The vitreous may or may not be detached. The ophthalmoscopic features of a wrinkled shagreen, tortuous vessels pulled toward a nidus, and intraretinal hemorrhages were seen. The leakage of fluorescein into the retina is emphasized in this series and may be fairly marked. The possible causes and mechanism of wrinkling are discussed with emphasis on mild chronic ischemia and posterior vitreous collapse.
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PMID:Spontaneous surface wrinkling retinopathy. 113 79

Small myocardial specimens were obtained from 12 patients undergoing coronary reconstructive surgery and from 12 patients undergoing surgical correction for cyanotic congenital heart defects. The specimens were analyzed for LDH isozyme distribution. A control analysis was performed on myocardial specimens obtained at the time of surgical correction for acyanotic congenital heart defects in seven patients with normal coronary arteries. There was a 42% increase in the proportion of A subunits in the hearts of coronary patients as compared to controls. This represented a shift toward an anaerobic isozyme distribution. There was no change in the percentage of A units from the hearts of cyanotic patients as compared to acyanotic hearts of the same age. Cardiac muscle from patients with coronary vascular disease had an altered LDH subunit composition. Such an alteration was not present with chronic systemic hypoxia. These deficiencies may or may not be related to differing local metabolic responses to the two conditions. However, in the clinical situations, ischemic heart muscle may be oxygen deprived to the point of lactic acid production while hypoxic heart muscle usually is not. Consequently, these findings may represent a compensatory cellular mechanism which provides for continued energy production during chronic ischemia by enhancing glycolysis.
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PMID:Myocardial LDH isozyme distribution in the ischemic and hypoxic heart. 125 85

Coronary thrombolysis with streptokinase or tissue plasminogen activator is useful for the treatment of acute myocardial infarction in selected patients. This treatment is associated with local hemorrhagic complications and age-related cerebral hemorrhage. Coronary thrombolysis is contraindicated in patients with transient cerebral ischemia and stroke, arterial hypertension, cerebral trauma, cerebral aneurysms, and arteriovenous malformations, because of the risk of cerebral hemorrhage. We report the occurrence of a cerebral hemorrhage related to cerebral amyloid angiopathy in a patient who underwent thrombolysis and treatment with heparin for acute myocardial infarction. Despite normal coagulation parameters, the cerebral hematoma enlarged over 36 hours, as documented by sequential computed tomographic scans, to produce significant mass effect, which prompted surgical evacuation. Histological examination of the resected specimen demonstrated the strong affinity for Congo red and yellow-green birefringence that are characteristic of cerebral amyloid angiopathy. Hemostasis was difficult to achieve, as the divided or disrupted amyloid-laden cortical vessels failed to vasoconstrict, their contractile elements replaced by amyloid beta protein. The patient died of recurrent myocardial ischemia 3 days postoperatively. The incidence of cerebral amyloid angiopathy increases with advancing age. It must be considered as a potential source of cerebral hemorrhage in elderly patients undergoing thrombolysis for cardiac ischemia. Such an occurrence presents a difficult challenge because cardiac function is compromised, the coagulation profile may be altered, the cerebral hematoma is life threatening, and intracranial hemostasis is difficult to achieve.
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PMID:Cerebral hemorrhage from amyloid angiopathy and coronary thrombolysis. 140 40

The natural history of peripheral arterial occlusive disease is discussed. Severe limb-threatening ischemia is the most serious consequence of chronic arterial occlusive disease. Severe ischemia and amputation can be considered as an endpoint in peripheral vascular disease. Severe limb ischemia is relatively uncommon in isolated aortoiliac disease and this is more than twice in patients with either femoropopliteal or multisegmental disease. Subsequent studies have also demonstrated that both smoking and diabetes are associated with a substantial risk for sudden ischemia. A clear majority of about 50% deaths are caused by associated coronary artery disease, 15% to stroke and 10% to vascular disease in the abdomen. Ankle systolic blood pressure is one of the most significant factors in the progression of peripheral arterial occlusive disease and also for cardiovascular mortality. In the future, men need to know how therapies as exercise, during regimens would influence the most frequent complications besides severe limb ischemia, namely brain infarction and coronary artery disease.
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PMID:Natural history and evolution of peripheral obstructive arterial disease. 146 Mar 49

Through this work, we reveal the possibility of converting into sinus rhythm the atrial chronic fibrillation based on vascular disease. The drug used for the cardioversion is "amiodarone". The results are excellent. Before the sinus rhythm became stable phenomena occurred that can be interpreted on the basis of an arteriosclerosis and ischemia type. This work has made use of the echographic instrument to prove the progress of the anatomical and functional conditions.
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PMID:[The use of high-dose amiodarone for cardioversion in patients with chronic atrial fibrillation]. 155 22

While the mortality rate in patients with acute vascular mesenteric insufficiency is extremely high when angiography is not performed, it can be lowered by consistent angiographic examination. In a period of 16 years, 62 patients were investigated by angiography. A primarily vascular mechanism had caused the condition in 59 patients. In 25 cases arterial embolism was found, in 11 cases arterial thrombosis, in 3, venous thrombosis, and in 20 cases non-occlusive mesenteric ischemia was present. The mortality was 53%. Thus angiography is indicated whenever there is any suspicion of a mesenteric vascular disorder.
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PMID:[Angiography of the mesenteric artery 1976 to 1991. A change in the indications during mesenteric circulatory disorders?]. 159 10

Renal cortical studies were performed in 19 children with renal transplants. There were 10 normal studies and 9 abnormal studies, 8 of which showed multiple large focal peripheral cortical defects. The following factors showed a positive correlation: (a) the ischemia time of the transplant kidney was significantly shorter in patients with normal studies; (b) cadaver grafts were more likely to have abnormal scan appearances than living related donor grafts; and (c) in four of the five patients with double renal arteries, the scans were abnormal in multiple sites. A possible pathophysiologic mechanism to explain these scan appearances is asymptomatic segmental graft infarction secondary to progressive vascular disease. These infarcts may be a long-term sequela of ischemic insult at the time of or prior to the insertion of the renal allograft.
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PMID:Abnormal cortical appearances in pediatric renal allografts. 165 82

We describe conduction block as an unusual electrophysiologic manifestation in a patient with necrotizing angiopathy. The patient developed subacute symptoms over a 1-month period consisting of progressive pain, tingling, and weakness of the lower extremities. Physical examination revealed a pattern consistent with a polyneuropathy. Electrodiagnostic studies provided evidence of a conduction block in the left ulnar nerve. Pathologic studies confirmed the process to be a necrotizing angiopathy. This report establishes the role of conduction block in human nerve ischemia.
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PMID:Necrotizing angiopathy presenting with multifocal conduction blocks. 162 80

Thromboangitis obliterans, or Buerger's disease, is a progressive vascular disorder that affects the distal extremities of young, otherwise healthy patients. The authors present two case histories of Buerger's disease with spontaneous digital ischemia and gangrene, leading ultimately to digital amputation. A review of the literature is also presented. The natural history of Buerger's disease, current diagnostic techniques, and management of these patients are discussed with emphasis on prevention of the acute attack and long-term sequelae.
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PMID:Distal ischemia with digital gangrene secondary to Buerger's disease. 177 Feb 4


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