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Query: UMLS:C0085584 (encephalopathy)
 18,178 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Over the past 10 years, 10 cats with primary central nervous system infection by larvae of Cuterebra flies have been documented at Cornell University. Clinical abnormalities noted in all cats were progressive and most commonly consisted of depression (6/10), blindness (6/10), and behavior changes (2/10). Affected cats presented most commonly in July (2/10) and August (7/10); one cat was presented in September. The diverse histopathologic changes are unique to this aberrant migration and consist of a combination of five characteristic features: 1) parasitic track lesion (7/10), 2) superficial laminar cerebrocortical necrosis (10/10), 3) cerebral infarction (8/10), 4) subependymal rarefaction and astrogliosis with or without ependymal cell loss (7/10), and 5) subpial astrogliosis (7/10). Changes 2-5 occurred throughout the parenchyma unassociated with the track lesion or the parasite in the affected tissue. The larvae have been recovered most commonly in the region of the olfactory bulbs and peduncles, optic nerves, and cribriform plate, suggesting entry from the nasal cavity. Many of the changes noted are suggestive of a toxic factor elaborated by the parasite and borne within the cerebrospinal fluid, as well as vascular compromise as a component in those cats with brain infarction. Because of the prevalence of infarction associated with this syndrome and the lack of reported cases of such lesions in regions of the world devoid of the fly, we propose that aberrant cuterebral larval migration in the brain is the cause of feline ischemic encephalopathy.
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PMID:Cerebrospinal cuterebriasis in cats and its association with feline ischemic encephalopathy. 975 38

We report the case of a 73-year-old man who developed an acute encephalopathy during IVIg therapy for AIDP. The signs and symptoms of the encephalopathy completely resolved after discontinuation of the treatment. We also reviewed the literature over the major neurological complications of IVIg therapy, including aseptic meningitis, cerebral infarction, and acute encephalopathy. About 30 cases of aseptic meningitis are reported. They are probably related to an immunoallergic reaction, caused by the entry of the exogenous IgG into the CSF compartment. CSF examinations usually show a neutrophilic or a mixed pleocytosis. Three cases of cerebral infarction and 2 patients with acute encephalopathy, following IVIg therapy, were also reported in the literature. Cerebral vasospasm, cerebral vasculitis, and/or serum hyperviscosity may be implicated in the pathogenesis of these neurological complications. There is a clinical similarity between these IVIg-related encephalopathy and the "reversible posterior leukoencephalopathy syndrome", described by Hinchey et al., 1996.
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PMID:Neurological complications of intravenous immunoglobulin (IVIg) therapy: an illustrative case of acute encephalopathy following IVIg therapy and a review of the literature. 992 23

The changes of cytokinis status and C-reactive protein were evaluated in cerebrospinal fluid of 50 patients in the acute period of ischemic hemispheric stroke with consideration of influence of the remote consequences of the ischemia, established experimentally, on the mechanisms of cerebral infarction development as well as on the progression of both atherogenesis and vascular encephalopathy in the period after the stroke. Significance both of a surplus releasing of the proinflammatory cytokines and deficiency of the protective antiinflammatory and trophotropic factors in the development of an inflammatory response was established. Immunobiochemical criteria were proposed for grading of process for stroke course prediction and for recovery of the altered neurologic functions. More favourable prognosis was anticipated in the patients in which a the treatment started within of the "therapeutic window".
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PMID:[Clinico-immunobiochemical monitoring of factors of focal inflammation in the acute period of hemispheric ischemic stroke]. 1035 15

The present study retrospectively investigated cerebral complications of coronary artery bypass grafting in 205 consecutive patients aged 70 years or older, who underwent elective cardiopulmonary bypass from 1990 to 1997. Computed tomography of the brain and chest was done before surgery. Ten patients had so-called 'aortic no-touch surgery' and suffered no cerebral complications; the other 195 patients had conventional surgery. Adverse cerebral events occurred in 8.7%, including cerebral infarction (4.1%), diffuse encephalopathy (1.0%), convulsions (1.0%), transient disturbance of consciousness (1.0%), and severe loss of volition (1.5%). Multivariate analysis showed that only the detection of calcification of the ascending aorta was significantly associated with cerebral complications (p = 0.029). Total clamping tended to be superior to partial clamping for prevention of cerebrovascular accidents. The mortality rate was 7.3%. In-hospital death was related to age (p = 0.0062), cerebral complications (p = 0.0032), and a low left-ventricular function (p = 0.018). Therefore, chest computed tomography to assess the ascending aorta should be performed preoperatively. Modified techniques like aortic no-touch surgery or other therapies combined with coronary intervention may be needed in elderly patients with severe calcification of the ascending aorta.
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PMID:Retrospective analysis of cerebral complications after coronary artery bypass grafting in elderly patients. 1065 Dec 6

We describe the clinical utility of echo-planar diffusion-weighted imaging in neonatal cerebral infarction. Eight full-term neonates aged 1 to 8 days referred for neonatal seizures were studied. Patients were followed for a mean of 17 months with detailed neurologic examinations at regular intervals. Head computed tomography (CT) and conventional magnetic resonance (MRI) and diffusion-weighted images were obtained. Percent lesion contrast was evaluated for 19 lesions on T2-weighted and diffusion-weighted images. Follow-up conventional MRIs were obtained in seven patients. The findings on diffusion-weighted imaging were correlated with CT and conventional MRI findings as well as with short-term neurodevelopmental outcome. Four patients had focal cerebral infarctions. Four patients had diffuse injury consistent with hypoxic-ischemic encephalopathy. Percent lesion contrast of all 19 lesions was significantly higher on diffusion-weighted images when compared with T2-weighted images. In five patients, there were lesions visualized only with diffusion-weighted imaging. In all patients, there was increased lesion conspicuity and better definition of lesion extent on the diffusion-weighted images compared with the CT and T2-weighted MR images. In seven of eight patients follow-up imaging confirmed prior infarctions. Short-term neurologic outcome correlated with the extent of injury seen on the initial diffusion-weighted imaging scans for all patients. Diffusion-weighted imaging is useful in the evaluation of acute ischemic brain injury and seizure etiology in neonates. In the acute setting, diffusion-weighted imaging provides information not available on CT and conventional MRI. This information correlates with short-term clinical outcome.
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PMID:Diffusion-weighted imaging in neonatal cerebral infarction: clinical utility and follow-up. 1101 90

Cerebrovascular diseases in patients between 15 and 40 years old are not a frequent subject in Latin-American literature, especially when focusing on neuropathology. We analyzed 47 brains from necropsies performed from 1987 to 1997 and selected on a basis of age and the presence of vascular pathology. From the 47 analyzed brains, 26 belonged to females (55.3%). When distributed among age groups, 12.8% (n=6) affected patients from 15 to 20 yo, 51,1% (n=24) from 21 to 30 yo, 36,2% (n=17) from 31 to 40 yo. The underlying diseases were: cardiac and haemathologic (19.2%), pregnancy complications (12.76%), infections, diseases of blood vessels and neurological (10.1% each) amongst others. The neuropathological abnormalities included cerebral and/or cerebellar herniation (16%), cerebral edema (13.8%), subarachnoid hemorrhage (10%), recent cerebral infarction (9%), intraparenchymatous hemorrhage (8.14%), hypoxic-ischemic encephalopathy (3%) and other events such as Sneddon syndrome and Lupus vasculitis. These findings express that the cerebrovascular phenomena in this age group are unique and closely related with the underlying disease.
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PMID:[Cerebrovascular diseases in patients aged 15 to 40 years: neuropathological findings in 47 cases]. 1173 38

Hypothermia may be an ideal neuroprotective intervention in hypoxic-ischemic encephalopathy after perinatal asphyxia. The present study describes the long-term effects of prolonged resuscitative whole-body hypothermia initiated 2 h after hypoxic-ischemic injury on brain morphology and neuropsychological behavior in 7-d-old rats. After right common carotid artery ligation and exposure to hypoxia of 8% O(2) for 105 min, 10 animals were kept normothermic at 37 degrees C and 10 animals were cooled to 30 degrees C rectal temperature for 26 h, starting 2 h after the hypoxic-ischemic insult. All hypoxic-ischemic animals were gavage fed to guarantee long-term survival. Neuroprotection was evaluated by magnetic resonance imaging and behavioral testing. Hypothermia significantly reduced the final size of cerebral infarction by 23% at 6 wk after the insult. The most extended tissue rescue was found in the hippocampus (21%, p = 0.031), followed by the striatum (13%, p = 0.143) and the cortex (11%, p = 0.160). Cooling salvaged spatial memory deficits verified at 5 wk of recovery with Morris Water Maze test; whereas circling abnormalities after apomorphine injection and sensory motor dysfunctions on rotating treadmill improved, yet did not reach statistical significance. When compared with controls, hypoxic-ischemic animals performed worse in all behavioral tests. Hypothermia did not influence functional outcome in controls. Significant correlations between behavioral performance and corresponding regional brain volumes were found. We conclude that 26 h of mild to moderate resuscitative hypothermia leads not only to brain tissue rescue, but most important to long-lasting behavioral improvement throughout brain maturation despite severity of injury and delayed onset of cooling.
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PMID:Delayed postischemic hypothermia improves long-term behavioral outcome after cerebral hypoxia-ischemia in neonatal rats. 1186 42

The aetiology of Hashimoto's encephalopathy is still unknown. A 52-year-old woman with so far unspecific thyroid disorder presented with acute onset of right-sided sensory loss and visual disturbances. The neurological examination revealed a right upper quadrant anopsia and subtle right-sided sensory loss and weakness. The cranial MRI showed a left-sided cerebral infarction. MR angiography demonstrated a stenosis of the proximal segment of the left posterior cerebral artery, which was confirmed by conventional catheter angiography. The patient had no cardiovascular risk factors, no signs of systemic vasculitis, and no thromboembolic disorder. Thyroid function tests showed a subclinical hypothyroidism with plasma TSH level of 12.0 mU/ml, and thyroid antibodies were markedly elevated (hTG-AB 3390 U/ml, TPO-AB > 8000 U/ml). Typical features of Hashimoto's disease were demonstrated by ultrasound and scintigraphic examination of the thyroid gland. To the best of our knowledge, this is the first description of Hashimoto encephalopathy with localised vasculitis of the posterior cerebral arteries and left posterior infarction. It could be shown that the MR angiogram is a feasible tool to demonstrate regression of the vasculitis under glucocorticoid therapy.
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PMID:[Circumscribed vasculitis with posterior infarct in Hashimoto encephalopathy]. 1259 32

The free radical scavenger 3-methyl-1-phenyl-2-pyrazolin-5-one (MCI-186), which has been approved in Japan for use in patients with cerebral infarction, was used to treat ischemic-hypoxic brain damage in neonatal rats. Seven-day-old rat pups were subjected to a modified Levine procedure, then given either vehicle or MCI-186 (at one of three dosage levels: 3, 6, or 9 mg/kg), and the extent of brain damage was evaluated either 24 h or 7 days later. The administration of MCI-186 significantly attenuated damage, in a dose-dependent manner. These results indicate that MCI-186 is a promising candidate for the treatment of neonatal hypoxic-ischemic encephalopathy.
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PMID:Effect of the free radical scavenger, 3-methyl-1-phenyl-2-pyrazolin-5-one (MCI-186), on hypoxia-ischemia-induced brain injury in neonatal rats. 1216 Dec 56

Neuroimaging shows that both global and focal neurologic deficits after cardiac surgery share an acute, often multifocal, embolic cerebral infarction etiology; yet, analyses of stroke risk factors historically have emphasized the focal deficits. We test if consolidating encephalopathy and coma with focal deficits affects four stroke risk factors and a dummy variable. Overall focal and global events in 575 cardiopulmonary bypass operations identified by retrospective review matched indices reported in large prospective studies. Logistic regression in 189 records selected for completed non-invasive preoperative carotid stenosis screening showed all four conventional stroke risk factors to be independent predictors of overall consolidated global plus focal neurologic risk, specifically: age [odds ratio (OR) 1.90 per decade], carotid stenosis >50% (OR 1.91), pump time (OR 1.67 per hour), open chamber (OR 1.95); and successfully eliminated the dummy variable gender (P = 0.6). This analysis indicates that the design of future stroke risk factor studies in the setting of cardiac surgery can and should adopt a neuroimaging evidence-based investigative approach of consolidating global with focal deficits.
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PMID:Study design validation for consolidating global with focal neurological events in cardiac surgery stroke risk factor analyses. 1253 97


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