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

Although cerebral angiography should be approached with caution in the diagnosis of inflammatory cerebro-vascular disease there are some characteristic angiographic findings which may be helpful for classification and differential diagnosis. The proximal cerebral arteries are favourably affected by basal meningitis and thrombangiitis obliterans with resulting stenoses and occlusions. Whereas those inflammations originating from neighbouring skull structures mostly involve the intracavernous parts of the carotid artery, the tuberculous and mycotic arteritis prefer the supraclinoid carotid siphon. Peripheral vascular changes are found in luetic endangiitis, necrotizing and toxic angiitis and in collagenoses. Simultaneous involvement of the temporal arteries is of great diagnostic importance demonstrating the systemic character of the inflammatory process; in Horton's arteritis it can be a pathognomonic finding. Infectious endocarditis, some mycoses and malaria may lead to embolic occlusion of cerebral vessels. Mycotic aneurysms mostly have a broad base or a fusiform shape and do not prefer the localizations of congenital aneurysms. Angiographically, abscesses, tuberculomas and viral encephalitis may result in circumscribed hypervascularized areas. The characteristic angiographic findings are exemplified and discussed on the basis of 8 cases of inflammatory cerebro-vascular disease (tuberculosis, pneumococcal and unspecific bacterial meningitis, syphilis, mycosis, Takayasu-syndrome, panarteritis nodosa, temporal arteritis).
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PMID:[Inflammatory cerebro-vascular disease: angiographic findings and distribution patterns (author's transl)]. 0 27

By Takayasu-Onishi's arteritis is meant an arteritic process with unknown aetiology which electively affects young women, seemingly of prevalently Asiatic stock. The disease concerns almost exclusively large elastic arteries and presents clinically with early preocclusive symptomatology followed, after a varying period, by a picture of obstructive angiopathy. Here, the most recent aetiopathogenetic findings are considered. The disease's predilection for the young female, together with certain clinical and experimental observations, suggest that a dysendocrine condition may have some pathogenetic responsibility, at least in a favourable sense; this responsibility is documented by the finding of high levels of oestrogenuria during the entire cycle in patients suffering from the disease. On the other hand, the angiopathy localization in the large elastic arteries and in certain segments of the aortic arch and epiaortic trunks means that the role of topographic moments whould not be underestimated. As regards infectious factors, the tubercular and streptococcic continue to be of great importance even today. Neither acts directly, however, but by way of an abnormal immunitary reaction which they seem able to trigger off. The infectious moment would thus appear to be related to the immunitary moment, and the latter would seem to play the part of perpetuating the pathological vascular involvement promoted by contact of the organism with the aetiological agent.
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PMID:[Takayasu-Onishi arteritis. Current etiopathogenetic aspects]. 0 24

A unique case of a Chinese boy with Wiskott-Aldrich syndrome (WAS) associated with Takayasu's arteritis is reported. He had eczema, epistaxis and recurrent infections since early infancy and was found to have thrombocytopenia, negative delayed-type skin hypersensitivity, low T cell number and impaired lymphocyte proliferation to phytohaemagglutinin and concanavalin A. He had high normal serum immunoglobulin (Ig)G and IgA with low IgM and isohaemagglutinin. He presented with hypertensive encephalopathy at 5.5 years of age and an aortogram demonstrated abdominal aortic aneurysm with bilateral stenosis of renal arteries resulting in renovascular hypertension. His hypertension was difficult to control medically and autotransplant of his kidneys to the iliac arteries was performed, but he died in the immediate postoperative period. The relationship between immunodeficiency and collagen-vascular disease was discussed.
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PMID:Takayasu's arteritis associated with Wiskott-Aldrich syndrome. 135 86

Takayasu arteritis is a non-specific chronic inflammatory vascular disease of unknown etiology. Since the incidence of this disease in the child-bearing years is relatively high, the management of pregnancies with this disease is of great importance in clinical obstetrics. This study is aimed at discussing the maternal management and obstetrical outcome, based on the clinical data obtained from 23 pregnancies of 15 patients treated in our hospital in the past 12 years. Since the disease was in the active state, artificial abortions were conducted in four cases in the 1st trimester of pregnancy. Among the remaining 16 cases, 3, who exhibited neither hypertension nor other complications, vaginally delivered neonates weighing 2,660-3,100 g with Apgar scores of nine after 37 weeks' gestation. C-sections were performed for 13 patients who showed sustained hypertension or/and developed other vascular disorders. Their gestational periods ranged from 34 to 40 weeks and the body weight of the infants varied from 1,425 to 3,024 g. No adverse influence of pregnancy and delivery on Takayasu arteritis was detected in the puerperium of any patients. It is suggested that the state of Takayasu arteritis in early pregnancy and the magnitude of blood pressure elevation in the late gestational period are the most critical and definitive factors in determining the management of pregnancy of a patient with Takayasu arteritis. Cooperative managements by the specialists in obstetrics, internal medicine, and perinatology are required to provide a satisfactory clinical outcome.
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PMID:Clinical gynecologic features of pregnancy in Takayasu arteritis. 136 Sep 58

The guidelines for medical treatment of Takayasu arteritis established in 1987 by the Systemic Vascular Disorders Research Committee, Ministry of Health and Welfare of Japan are presented. The first part of the guidelines concerns treatment with adrenocorticosteroids and the second part concerns other medical treatment. A review of the literature referring to steroid therapy and other medical treatment of Takayasu arteritis is also included.
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PMID:Medical treatment of Takayasu arteritis. 136 Sep 59

Six children presented with severe hypertension caused by Takayasu's arteritis (TA), of whom four had bilateral renal artery narrowing and two coarctation syndrome. Two presented with hypertensive encephalopathy and four with congestive cardiac failure. All had a strongly positive skin reactions to purified protein derivative of mycobacterium tuberculosis. Bilateral renal arterial bypass grafts performed in two children resulted in prolonged normalization of their blood pressures, but the grafts clotted 12-18 months later. Primary renal autotransplantation was unsuccessful in two children, one with bilateral renal arterial narrowing and iliac vessel involvement and one with a long coarctation. Secondary renal autotransplantation was successful in a third child with localized aortitis. A successful aortic patch graft was performed in one child with coarctation of the aorta. Angiotensin-converting-enzyme inhibitors should be used with caution in treating the hypertension caused by TA, since bilateral renal arterial narrowing is common and their administration may result in renal insufficiency. The long-term prognosis is guarded in severely hypertensive children with extensive vascular disease due to TA.
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PMID:Management of severe hypertension in childhood Takayasu's arteritis. 167 62

This study reports on 13 cases of extra-intracranial bypass procedures using saphenous vein grafts. Ten patients had arteriosclerotic occlusive vascular disease, one patient had a giant aneurysm of the internal carotid artery, another 2 females, 18 and 28 years of age, respectively, suffered from Takayasu's disease. Preoperatively all patients had severe neurological symptoms. To keep the venous graft as short as possible, as a first choice the carotid artery, in case of occlusive disease of the latter as a second choice the ipsilateral subclavian artery, or as a third choice the ascending aorta, were used as donor vessels. Perioperatively, one patient sustained an intracerebral/intraventricular hemorrhage and, despite immediate reoperation, died in a vegetative state early postoperatively. Another patient had a minor perioperative cerebral stroke with complete recovery. None of the other patients had any additional neurological deficit perioperatively, and they had complete relief from ischemic attacks postoperatively. There was one early occlusion due to high competitive collateral flow, and one late occlusion due to technical problems. The overall patency rate of surviving patients was 83.3% (follow-up 3 to 23 months).
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PMID:Extra-intracranial bypass procedure with saphenous vein grafts. 242 52

Nonspecific aortoarteritis is a systemic autoimmune disease eventuating in gradual stenosis of the aorta and the main vessels with ischemia of the respective organs. Ophthalmologic symptoms have been examined in 54 patients with nonspecific aortoarteritis. Subjective disorders of vision (short-term binocular blindness, metamorphopsia, pain behind the eye, amaurosis fugax) have been detected in 52% of the examinees. Organic lesions of the eye have been diagnosed in 60% of the patients: hypertensive angiopathy (22%), venous stasis retinopathy (17%), occlusion of the central retinal artery (1%), etc. Three possible mechanisms of the development of ocular symptoms have been established: (1) a result of symptomatic hypertension, (2) chronic ocular ischemia, (3) acute hemodynamic ocular circulation insufficiency.
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PMID:[Ophthamologic pathology in non-specific aortoarteritis]. 256 80

Thirty patients with Takayasu's arteritis treated surgically were followed for more than ten years postoperatively, 28 women and 2 men. The average age at the initial operation was 29 years. The clinicopathological finding was classified in four types; the distribution of cases was 6 in Type I, 17 in Type II, 4 in Type III, and 3 in Type IV. Surgical procedures performed were carotid artery reconstruction in 9 patients, thoraco-abdominal aortic bypass in 5, renal artery reconstruction in 10, combined procedures in 2, aneurysmectomy in 2, and other procedures in 2 patients. Twenty-six patients survived; four died during the study period. Twenty-three patients (77%) are well with good function of the reconstructed arteries. Six women had safe deliveries after successful operations. However, anastomotic false aneurysms occurred in 5 patients. The surgical management of Takayasu's arteritis must be distinguished from that of atherosclerotic vascular disease.
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PMID:Surgical treatment for Takayasu's arteritis. A long-term follow-up study. 257 Jul 82

Takayasu disease is an arteritis of unknown etiology involving the aorta and its major branches. Untreated, 75% of patients die within two years. A 6-month-old black female presented with a right focal seizure, a flaccid right hemiparesis, decreased pulses in the right arm, a large left frontoparietal hypodense area on computed tomography, and an elevated erythrocyte sedimentation rate. Cerebral angiography demonstrated irregular dilatation of both carotid arteries and narrowing of the left middle cerebral artery. Aneurysm of the right sinus of Valsalva, dilatation of the aortic root, narrowing of the origins of both carotid arteries, and beading of the descending aorta were demonstrated by cardiac angiography. The patient was treated with prednisone (2 mg/kg/day) and azathioprine (1 mg/kg/day). There was gradual return of the erythrocyte sedimentation rate to normal over the ensuing 3-10 months, resolution of the hemiparesis, and acquisition of normal developmental milestones. Digital subtraction angiography revealed improvement in the appearance of the descending aorta and of the common carotid arteries with the disappearance of the arterial wall irregularities. Early diagnosis and vigorous immunosuppression may improve outcome in this rare and often fatal vascular disease in childhood.
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PMID:Takayasu arteritis: a treatable cause of stroke in infancy. 290 58


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