Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0264733 (ventricular dilatation)
 2,163 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This report describes the analysis of 216 CT pictures of 85 patients with ruptured aneurysms which consist of 29 anterior communicating, 27 internal carotid, 27 middle cerebral and 2 basilar arterial aneurysms, including 18 cases with multiple aneurysms. The intervals between CT scanning and the last subarachnoid hemorrhage were various from 6 hours to 4 months. The first CT scanning was made in 40 cases within 3 days, in 54 cases within 7 days and in 11 cases more than one month after the hemorrhage. CT findings showed no abnormality in 9 patients who were classified as Grade I (Hunt and Kosnik) and examined more than 2 weeks after the subarachnoid hemorrhage. Seventy-six patients had some abnormal findings in the first CT scans, which were 55 cases of subarachnoid clot, 16 cases of intracerebral hematoma, 24 cases of intraventricular clot, 16 cases of low density suggesting brain edema or softening and 42 cases of ventricular enlargement. There was a good correlation between CT findings and clinical grade of Hunt and Kosnik. In Grade I and II, abnormal findings other than subarachnoid clot were seldom seen. Iin Grade III, there were intracerebral hematoma (20%), low density (20%) and frequent ventricular dilatation; in Grade IV, massive intracerebral hematoma (80%); in Grade V, massive intracerebral hematoma and ventricular tamponade with blood clot; in Grade Ia, moderate ventricular dilatation and/or diffuse cerebral infarction. Cerebral vasospasm could be anticipated by CT pictures because it occurred frequently in the patients with massive and long-standing subarachnoid blood clot. The determination of the side and location of the ruptured aneurysm was possible in 82% of the patients who had subarachnoid clot, intracerebral hematoma or low density. This is useful to decide the side of the first angiography and the aneurysm to be approached at first in the cases of multiple aneurysms.
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PMID:[Diagnosis and pathological analysis of ruptured cerebral aneurysm by CT (author's transl)]. 52 53

This paper investigates 21 patients (16 infants and 5 children) with Pneumococcal meningitis, 15 of which presented with a severe form. Intracranial pressure (IP) monitoring was performed in 7 patients who all had severe (4) or mild (3) intracranial hypertension (IH). Twelve children had a favourable outcome, 7 had sequelae (3 severe) and 2 died from coning, one before monitoring, the second after exhibiting the highest IP and the lowest cerebral perfusion pressure of the series. The 3 children with severe sequelae had a severe form (2) or a mild but prolonged form (1) of IH. The 4 patients who recovered with moderate sequelae presented severe (1), mild IH (1) or were not monitored (2). There were 14 cases with neurological complications. In 8 patients, this seemed to be related to cerebral oedema and IH; coning caused the death of 2 of them; the 6 others exhibited lesions of cerebral oedema on CT-scan, isolated or associated with cerebral infarction or subdural effusion. In the 6 others patients, IP monitoring was not performed; there was no evidence of cerebral oedema on CT-scan; 2 exhibited cerebral infarction and 3 a moderate ventricular dilatation; 2 had hemodynamic problems from acute pneumococcemia in one case and neurovegetative disturbances associated with cerebral infarction in the second. Pneumococcus meningitis remains a severe disease. The prognosis of severe forms can be improved by IP monitoring since IH seems to be the most frequent mechanism of complication.
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PMID:[Suppurated pneumococcal meningitis in infants and children: complications and prognostic factors]. 319 66

The auditory brainstem response (ABR), short latency somatosensory evoked potential (SSEP) and visual evoked potential (VEP) of patients in the persistent vegetative state (PVS) are reported, and the correlations between the electrophysiological findings and the CT scan findings with the three clinical grades of the PVS (transitional, incomplete and complete vegetative syndromes) are discussed. Twenty two patients in a vegetative state caused by subarachnoid hemorrhage (3), hypertensive intracerebral hemorrhage (5), cerebral infarction (6), head injury (3), cerebral anoxia (4) and brain tumor (1). Each evoked response was evaluated for the presence or absence of abnormalities and assigned a grade ranked I to III. Briefly an evoked response was assigned a grade I, II, III if it satisfied the respective criteria of normal, moderately abnormal and severely abnormal or absent electrical activity. On the other hand CT scan findings in the PVS were evaluated for abnormal low density areas, ventricular dilatation and enlargement of the sulci and cisterns indicative of atrophy of the brain parenchyma. SSEP and VEP were better correlated with the clinical grade than ABR, and upper brainstem atrophy and abnormal low density area in CT scan findings were more valuable as an index to expresses the clinical features than ventricular dilatation. On the basis of these results, it is concluded that studies of ABR, SSEP and VEP associated with CT scan findings in the PVS could be a useful diagnostic aid to evaluate the lesions of these patients.
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PMID:[Clinicophysiological study of multimodality evoked potentials and computed tomographic findings in persistent vegetative state]. 340 4

In a series of 404 patients with intracranial saccular aneurysm, 61 were over 65 years of age. Ten of these aged patients had no surgery. The operative mortality in the aged patients was 11.8%. While the mortality rate in patients below 65 years was 6.1%. The main complication following intracranial surgery for aneurysm consisted of cerebral infarction due to vasospasm, hydrocephalus, intracranial hematoma and general complications. The incidence of angiographical vasospasm was 22.6% in the aged patients and 43.6% in the young patients. There is no significant difference in vasospasm following subarachnoid hemorrhage between the aged and young patients. Cerebral infarction occurred in 27.5% of the aged patients and in 24.6% of the young patients. Severe cerebral infarction was found in 92.9% of the aged patients and in 58% of the young patients. Vasospasm resulted in broad cerebral infarction significantly more frequently in the aged patients, but cerebral infarction proved was non-fatal in the aged patients. Ventricular dilatation detected by CT was found in 33.3% of the aged patients and in 24.2% of the young patients. In patients with ventricular dilatation, 82.4% of the aged patients needed ventriculo-peritoneal shunt (V-P shunt). On the other hand, 39.3% of the young patients had V-P shunt. There was no significant difference for ventricular dilatation detected by CT between the aged and young patients. The aged patients depended on V-P shunt significantly more than did the young patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Therapeutic problems in aged patients with intracranial aneurysms]. 361 29

There has been much argument in recent years about the diagnostic and pathogenetic differences between normal pressure hydrocephalus (NPH) and vascular dementia (Multi-infarct dementia) or Binswanger's disease. We experienced an interesting patient, a 54-year-old male, who had left hemiparesis due to two past attacks of cerebral infarction and possible hydrocephalus had been pointed out by CT findings in 1981. He was seen on May 22, 1982, with the chief complaints of dementia, gait disturbance and urinary incontinence. He had the clinical and pathogenetic features, common to NPH and MID or Binswanger's disease. The followings were observed. These symptoms (dementia, gait disturbance, urinary incontinence) and computed tomographic findings (bilateral ventricular dilatation, periventricular lucency), as is often the case in NPH, are at times similar to those of MID or Binswanger's disease and it is difficult to distinguish NPH from MID or Binswanger's disease. We consider that there are probably many patients who are on the borderline of these three diseases. For treatment, the V-P shunt was very effective in combination with the preceding bilateral STA-MCA shunt but it is not clear whether the preceding STA-MCA shunt was required before the V-P shunt. We believe that the clinical symptoms will not appear until the ventricle is dilated to a critical degree. There was a correlation between the degree of dementia and Huckman number, one of the assessment methods for ventricular dilatation.
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PMID:[A case of normal pressure hydrocephalus associated with cerebrovascular disorders]. 652 20

Subjects ranging in age from 50 to 89 years old, either with or without dementia were studied by both ELISA for anti-human T-cell lymphotropic virus type I (HTLV-I) gag 100-130 antibody and by cranial CT in order to clarify the relationship between HTLV-I infection and dementia. The frequency of anti-HTLV-I antibody was found to be significantly higher in the patients with dementia (24/130, 18.5%) than in those without dementia (11/139, 7.9%) (P=0.0169). Among the various types of dementia, HTLV-I seropositivity was found to be significantly associated with vascular dementia (11/48, 23%) (P=0.0087), but not with Alzheimer type dementia. In addition, HTLV-I seropositivity was also associated with Babinski sign, and the severity of cerebral infarction, ventricular dilatation and periventricular lucency on CT. The presence of HTLV-I therefore appears to be one of the risk factors for vascular dementia in HTLV-I endemic areas.
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PMID:An association of human T-cell lymphotropic virus type I infection with vascular dementia. 940

To estimate the usefulness of the bedside swallowing assessment proposed by Smithard et al and neuroimaging findings characteristic for dysphagia, we studied the outcome of 102 patients with chronic cerebral infarction after assessment of swallowing by this test with brain computerized tomography (CT). All patients had a variety of motor disturbance and were admitted on a long-term medicare basis. They were divided into two groups according to the findings: the positive group (n = 33), who showed any of the listed types of difficulty in swallowing water, and the negative group (n = 69). Followed up to 2.2 years, their outcomes were studied. CT findings were studied on type of infarction, number and laterality of infarction, grade of periventricular lucency (PVL), presence of ventricular dilatation (VD), and severity of cortical atrophy (CA). The mean age was 76.4 years at registration and 61 were men. The frequency of severe dementia and disturbed ADL were significantly higher in the positive group. Eighteen patients died during the observation period and 15 of those were in the positive group, indicating higher annual death rate (29.9% vs 2.2% in the negative group). All of the 15 patients in the positive group died of pneumonia. CT findings showed high incidence of multiple infarction, bilateral hemispheric lesion, severe PVL, VD, and severe CA in the positive group. These findings indicated that this evaluation method was useful in screening swallow function for patients with cerebral infarction in the chronic phase. Furthermore, CT findings suggested that severe white matter lesion, VD, and severe CA as well as multiple infarction seen in bilateral hemisphere was related to dysphagia, probably due to multiple factors involving pyramidal- and extrapyramidal-tracts with higher brain function.
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PMID:[Findings of bedside swallowing assessment and brain computerized tomography in patients with chronic cerebral infarction, and their outcome]. 1160 14

Case records of HIV infected patients were analyzed for identifying neurological manifestations. Eight patients (7 males) were identified to have probable HIV encephalopathy (in a period of 24 months) as per the CDC revised classification system. Their ages ranged from one year to ten years. The neurological manifestations noted included-developmental delay (2 cases), seizures (6 cases), acute onset alteration of sensorium (4 cases), aphasia (2 cases), loss of vision (2 cases), focal neurological deficits (6 cases), brisk deep tendon reflexes (7 cases), extensor plantar responses (5 cases) and signs of cerebellar dysfunction (2 cases). Other clinical features included growth failure, microcephaly, fever, lymphadenopathy, hepatomegaly, splenomegaly, pneumonia, otorrhea and oral candidiasis. Cerebrospinal fluid studies were normal. The neuroimaging features included cerebral atrophy and ventricular dilatation, cerebral infarction, basal ganglia calcification and cerebellar atrophy. Childhood HIV infection may have a variety of neurological abnormalities. HIV infection should be suspected in children presenting with unexplained neurological manifestations and growth failure.
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PMID:Neurological manifestations of HIV infection. 1265 56

Long-term prognosis in dialysis is poor compared to that in healthy control persons. A worsening of the prognosis is noted especially for patients who at initiation of dialysis have congestive heart failure, ischemic heart disease, or left ventricular dysfunction or hypertrophy. This is the main reason that cardiovascular causes are the most common for morbidity in these patients. The weight obtained when normal urine output is present is the dry weight. With reduced ability to excrete the volume by the kidneys in end-stage renal disease (ESRD), the body will retain water and the patient will gain weight. This extra weight is due to volume overload. While volume overload may induce a rise in blood pressure, if the heart is in acceptable condition, a fast removal of fluid by ultrafiltration (UF) during dialysis may instead cause hypotension. Ultrafiltration failure in peritoneal dialysis (PD) patients may lead to successive water retention and overhydration with subsequent cardiac failure, while volume overload may occur over a few days in hemodialysis (HD) patients. Anemia or even too-high hematocrit may impair cardiac function further and worsen conditions caused by wrong dry weight. Thus, during long-term and sustained volume overload, left ventricular (LV) hypertrophy will occur in an eccentric manner. A sustained overload then may lead to cell death and LV dilatation and, eventually, systolic dysfunction. Once a severe left ventricular dilatation has developed, the blood pressure may decrease during volume overload. A worsened prognosis is seen if malnutrition and low albumin levels are present. Volume overload necessitates ultrafiltration to achieve dry weight. Thereby, volume contraction contributes to exaggerated stimulation of or response to activation of the RAS and alpha-adrenergic sympathetic systems. If ultrafiltration goes beyond these compensatory mechanisms, hypotension will occur and increase the risk for hypoperfusion of vital organs. Such episodes may cause cardiac morbidity, aspiration pneumonia, vascular access closure, or neurological complications (seizures, cerebral infarction), besides a more rapid lowering of residual renal function. Preventive measures are, first, finding the right dry weight; second, minimizing interdialytic weight gain; third, optimizing the target for hemoglobin (110-120 g/l); fourth, lowering dialysate calcium (1.25 mmol/l); and fifth, eventually using higher dialysate potassium if long dialyses are performed.
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PMID:Ultrafiltration and dry weight-what are the cardiovascular effects? 1266 7

A Japanese male showed gradually progressing dementia with psychiatric symptoms including abnormal behavior, night and day reversal, nocturnal delirium, loud shouting, agitation, resistance to care, and loud soliloquy. The patient had a history of right cerebral embolism due to atrial fibrillation 1 month before the onset of dementia. Head CT revealed widespread cerebral infarction in the right cerebral hemisphere with bilateral lateral ventricular dilatation. The patient died at the age of 83, 10 months after the onset of cerebral embolism. The clinical diagnosis was mixed-type dementia. On autopsy the brain weighed 1,160 g. Widespread cerebral amyloid angiopathy (CAA) was observed, with distribution most severe in the cerebral cortical vessels and slightly milder in the leptomeningial and subarachnoid vessels. The artery, arteriole, and capillary walls were thickened by the deposition of amorphous, eosinophilic and beta-protein immunopositive amyloid. Abeta-deposition was more severe in capillaries and CAA tended to be more severe in the occipital regions. Multiple cortical microinfarcts were found, particularly in the crests of the cerebral gyri of watershed zones. Cerebral white matter, basal ganglia, thalamus, brainstem and spinal cord were relatively preserved from CAA. Infarction was not apparent, except for an embolic lesion in the right cerebral hemisphere and the cortical microinfarcts. We did not observe fibrinoid necrosis, granulomatous angiitis or giant cell reaction associated with CAA-vasculopathies. Rare instances were observed of neurofibrillary tangles and senile plaques corresponding to Braak stages II and A, respectively. We thought the multiple cortical microinfarcts occurred due to chronic hypoperfusion associated with CAA-associated vasculopathies of capillaries in the cerebral cortex. We suspected that the dementia was influenced by the CAA with multiple cortical microinfarcts. Pathologic findings of the patient suggest that CAA without AD-related Abeta-deposition might exist and that capillary Abeta-deposition might be an important factor of hemodynamic perturbation.
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PMID:[An autopsy case of senile dementia suspected to be influenced by cerebral amyloid angiopathy with multiple cortical microinfarcts]. 2096 Sep 31


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