Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred sciatic nerve blocks performed for surgery related to lower limb vascular disease were prospectively audited with respect to the techniques used for sciatic nerve localisation and the success rates achieved. Utilising a 22 gauge Quincke point needle, sciatic nerve localisation was performed by initially searching for paraesthesia, followed by the use of a low powered peripheral nerve stimulator. Overall there were 89 successful blocks. Paraesthesia was found in only 44 cases of which 41 were subsequently judged to be successful blocks. A positive response to the nerve stimulator was achieved in 95 cases of which 87 went on to have successful blocks. Our findings suggest that either eliciting paraesthesia or a positive response to the peripheral nerve stimulator carries a high correlation with subsequent successful block, but that the use of the nerve stimulator provides a more consistent and reliable technique for nerve localisation.
 ...
PMID:One hundred sciatic nerve blocks: a comparison of localisation techniques. 844 12

A 30-year-old healthy woman was involved in a road traffic accident. She sustained a fracture dislocation of T11/12 with a complete Frankel A paraplegia below T11. She had no associated injuries. High Dose Methylprednisolone was administered according to the NASCIS III protocol (48 h) together with low molecular weight Heparin and gastroprotected medication. Complete transection of the spinal cord and an anterior haematoma from T11 to T12 were confirmed on X rays, CT's and MRI scans. Posterior surgical stabilisation was performed using Isola instrumentation, starting 8 h post injury. Her post surgical period was uneventful except for some episodes of low blood pressure (85/60 mmHg) from which she had no symptoms. On the 12th post operative day, while in the physiotherapy department, she complained of right scapular pain. This occurred every time she was sat up and was associated with paraesthesia of both upper limbs. Two days later she deteriorated neurologically and her level ascended initially to T8 and then to T3. MRI of the spine with and without gadolinium showed spinal cord oedema between C3 and T1. There was no evidence of haemorrhage or syringomyelia. The authors discussed this case making different hypotheses. They are mainly the following: (1) Gradually ascending ischaemia due to a vascular disorder; (2) Double spinal trauma; (3) Ischaemia related to repeated hypotensive episodes; (4) Low grade intramedullary tumour; and (5) Thrombus of the Radicularis Magna artery. The case has been recognised as being very rare and interesting. In the conclusions, the presenting author stresses the importance of adopting MRI-compatible instrumentation for the surgical stabilisation of the spine, and careful monitoring of blood pressure during the acute phase of spinal cord injury. Dr Aito agrees with Mr El Masry about the opportunity of forming a group of clinicians in order to discuss protocols to cope with this devastating complication.
 ...
PMID:Ascending myelopathy in the early stage of spinal cord injury. 1049 Aug 52

We report the case of a 72-year-old left-handed woman presenting with episodes of paresthesias of the left arm and dysarthria consistent with transient ischemic attacks. The diffusion MRI showed hypersignals of the right corona radiata suggesting recent ischemic process whereas gradient-echo MRI revealed multiple small hypointense regions consistent with petechial hemorrhages restricted to the corticosubcortical regions. Gadolinium-enhanced, T1-weighted MRI showed focal meningeal enhancement. The diagnosis of cerebral amyloid angiopathy was supported by leptomeningeal biopsy. The association of ischemic suffering, petechial haemorrhage and meningeal enhancement as demonstrated by multisequence MRI highly suggest a cerebral amyloid angiopathy.
 ...
PMID:[Cerebral amyloid angiopathy revealed by transient ischemic events: contribution of MRI to diagnosis and pathophysiology study]. 1266 May 74

Dissection of cervical arteries causes ischemic stroke in young adults. This reports the clinical, ultrasonographic, and neuroradiological findings in 24 patients with 28 vertebral artery dissections in the neck (4 occurring bilaterally). In 20 patients (83%), the dissection was temporally related to trauma. No patients had an underlying vascular disease, for example, atherosclerosis or fibromuscular dysplasia. In all, the major initial manifestation was pain in the occipital or neck region. The next most common symptoms were vertigo and nausea (in 17 patients). Clinical manifestations were vertebrobasilar transient ischemic attack (TIA) (5 patients: in 2 patients vestibulocerebellar TIA, in 1 patient visual TIA, in 1 patient motor TIA, and in 1 patient brain stem TIA with perioral paresthesia), cerebellar infarction (10 patients, in 4 patients bilateral), brainstem infarction (5 patients), posterior cerebral artery territory infarction (1 patient), and multiple vertebrobasilar ischemic lesions (3 patients). Typical angiographic findings were irregular narrowing of the vessel lumen or a tapering stenosis with distal occlusion. Magnetic resonance imaging showed a thickened vessel wall with hematoma signal at the site of the dissection. Duplex color-flow imaging was valuable for the early diagnosis of extracranial vertebral artery dissection and for follow-up examinations. The distal V1- and the proximal V2-segment (at the level of C6 vertebra) was the most frequent localization of dissections (in 43%). The outcome was favorable except for 2 patients with basilar artery occlusion. Embolism to the basilar artery may be avoided by early administration of anticoagulants.
 ...
PMID:Dissection of the extracranial vertebral artery: clinical findings and early noninvasive diagnosis in 24 patients. 1648 73

We present a case of brachial artery mycotic aneurysm caused by methicillin-resistant Staphylococcus epidermidis in a patient with infective endocarditis. A 66-year-old woman suffered two transient ischemic attacks over an 8-week period secondary to septic emboli from mitral valve endocarditis. Following valve replacement surgery, the patient was troubled by persisting paresthesia in the right hand. A mycotic aneurysm of the brachial artery was diagnosed, and surgical repair was successfully undertaken. The purpose of this case report is to highlight an unusual causative organism for mycotic aneurysm and to underline the increasing threat of multi-drug-resistant bacteria as a cause of vascular disease.
 ...
PMID:Mycotic aneurysm of the brachial artery secondary to hospital-acquired methicillin-resistant Staphylococcus epidermidis in a complicated case of infective endocarditis. 1673 40

In a recent study, Bos et al. (JAMA 2007) showed that patients with nonfocal transient neurological attacks (TNA) have a higher risk of major vascular disease, comparable to patients with focal TNAs. This may prompt GPs to take a more active approach when dealing with patients experiencing short-lasting attacks of dizziness, paraesthesia and weakness. However, the category of nonfocal TNAs in the abovementioned study was very broad, and subgroup analysis for specific symptoms was not possible. Moreover, a third of nonfocal TNAs consisted of loss of consciousness or decreased consciousness, which might be responsible for the heightened risk of cerebrovascular accident. Also, a quarter of patients with nonfocal TNA had not presented their symptoms to a physician and reported the symptoms during a follow-up meeting, leaving room for recall bias. Since symptoms like dizziness are very frequent among elderly patients and nonfocal TNAs are difficult to recognize, both physicians and education campaigns should be careful not to arouse anxiety without good reason.
 ...
PMID:[Dizziness, tiredness and the risk of a stroke]. 1855 61

We describe here 7 elderly patients with a transient neurological deficit due to a focal subarachnoid haemorrhage, identified from the Dijon Stroke Registry over 4 years. These 7 patients presented a clinical pattern marked by focal paraesthesia, with several stereotyped focal episodes (5 of the 7 cases), lasting less than 30 min (6 of the 7 cases), and associated with a cognitive decline (4 of the 7 cases). Headache was present in only 1 case. Neuroimaging revealed focal haemorrhage present in a cortical sulcus contralateral to the symptoms. No vascular lesions nor epileptic mechanisms nor ischemic lesions were observed. This syndrome could be explained by a spreading depression, and the focal subarachnoid haemorrhage could reflect possible cerebral amyloid angiopathy, suggested by the cognitive decline present in more than 50% of our series. Our observations suggest that focal subarachnoid haemorrhage may be diagnosed by MRI in the absence of acute headache and it may be revealed by transient focal and repetitive sensory perturbations. In medical practice, it is important to evoke this diagnosis in the elderly to avoid inappropriate treatment.
 ...
PMID:Transient ischaemic attack mimics revealing focal subarachnoid haemorrhage. 2094 3

Restless leg syndrome (RLS) is an abnormal sensation disorder. Defining the syndrome is difficult. It is transmitted autosomal dominant genetically, is especially prevalent in the lower limbs, and is seen in both genders. In the differential diagnosis of RLS, nocturnal leg cramps, akathisia, peripheral neuropathy, entrapment neuropathy, and vascular disease (for example, deep vein thrombosis) should be considered. A 52-year-old woman was admitted to our clinic with signs of paresthesia, she had abnormal sensation disorder in both legs and the right arm, which she had difficulty defining. She had applied to another center with the same complaints and had been evaluated as entrapment neuropathy, carpal tunnel syndrome, and/or peripheral neuropathy. Her electromyographic examination carried out by us was normal. The history, neurological examination findings, and results of standard laboratory analyses provided a diagnosis of idiopathic RLS. After the diagnosis of RLS in the proband, we questioned other family members. Her large family had 63 members, 35 males, and 28 females. Of 63 members, 17 also had an RLS diagnosis.
 ...
PMID:Restless leg syndrome in the differential diagnosis of entrapment and peripheral neuropathies. 2106 13

Fibromuscular dysplasia is a rare, nonatherosclerotic, noninflammatory vascular disease that typically affects women between the ages of 20 and 60 years. Although any artery can be affected, fibromuscular dysplasia most commonly affects the renal and carotid arteries. Fibromuscular dysplasia of the renal arteries usually presents with hypertension, while carotid or vertebral artery disease causes transient ischemic attacks, strokes, or dissection. Fibromuscular dysplasia of the brachial arteries is extremely uncommon. It can induce extremity ischemia, nerve compression, or both-causing coldness, discoloration, pain, ulceration or gangrene of the fingers, paresthesias, or paralysis. We report a rare case of multivessel fibromuscular dysplasia manifested by acute stroke in association with type I aortic dissection, which progressed rapidly to ascending aortic false aneurysmal development that necessitated arch replacement. Outcomes of aortic arch replacement in this setting are currently unknown. Therefore, our case might well offer some insight.
 ...
PMID:Acute aortic dissection and stroke in multivessel fibromuscular dysplasia. 2346 36

The authors report on a 49-year-old man with a thoracic spinal dural arteriovenous shunt (dAVS) in which rupture of a varix caused intramedullary hemorrhage. In the literature, patients with a thoracic dAVS predominantly present with congestive myelopathy; however, the patient featured in this report presented without increased deep tendon reflexes or muscle weakness, but instead with intermittent stabbing chest pain and paresthesia. Magnetic resonance images and angiograms demonstrated tortuous enlargement and the formation of a varix-like structure of the draining veins, features compatible with those of high-flow angiopathy. Recognition of this phenomenon is important in thoracic dAVS because intramedullary hemorrhage dramatically degrades outcome. A high index of clinical suspicion can prevent a similar case of thoracic dAVS from progressing to intramedullary hemorrhage.
...
PMID:Spinal dural arteriovenous shunt presenting with intramedullary hemorrhage: case report. 2440 83


<< Previous 1 2 3 Next >>