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Query: UMLS:C0917798 (cerebral ischemia)
 17,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical findings and laboratory results from 18 patients with clear-cut transient global amnesia (TGA) were compared with the results from 90 nonischemic neurological control patients using case-control analysis. A prior episode of cerebral ischemia, generally in the posterior circulation, was the most significant risk factor for TGA. Other risk factors for cerebrovascular disease were more prominent in the TGA group, but this association became less significant when cerebral ischemia was controlled for. Migraine, epilepsy, and psychiatric disorders were not significantly associated with TGA. In 5 of 13 patients, computed tomography showed focal thalamic and temporal lobe abnormalities. The recurrence rate was 7.0% for both TGA and subsequent cerebral ischemia. We conclude that TGA is closely linked to cerebrovascular disease. Further, prior damage to anatomical structures critical to memory may be necessary for the expression of this syndrome.
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PMID:Transient global amnesia: a case-control study. 408 51

This review summarizes 169 cerebral vascular accidents in women taking oral contraceptives: 94 arterial (including 13 of the authors' cases), 20 venous, 37 neuroophthalmologic (5 of the authors'), and 18 undetermined diagnoses. The arterial accidents involved the carotid in 56, the vertebrobasilar in 27. Few were fatal; most were considered thromboses; none were due to hemorrhage; few could have been due to emboli or dissecting aneurisms. Aggravation or appearance of migraine was noted in 34 and transient focal cerebral ischemia in 28 cases before arterial accident. No definite time span was obvious, but many occurred 1-6 months or over 2 years after starting pills. Venous accidents were usually fatal, often extended thromboses of the superior longitudinal sinus. Clinically there was severe headache (85%), vomiting, fever without rapid pulse, alteration of consciousness, papillary edema, focal cerebral signs. Ophthalmologic accidents included retinal, arterial, and venous occlusion; paralysis of oculomotor nerve; optic neuritis; and pseudo-tumor-cerebri. The authors recommended caution with oral contraceptives in case of cerebral vascular episodes, migraine, visual disturbances, chorea, hyperlipidemia, and hypertension.
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PMID:[Cerebrovacular accidents and oral contraceptives]. 443 14

112 cases of ocular complications related to oral contraceptive therapy have been reported in Great Britain since 1964 for an overall prevalence of 0.07%. These have been divided into 6 main groups: 15 cases of cerebro-vascular disturbances with ocular symptoms; 23 apparently neurological cases with signs and symptoms localized to the eye and orbit; 21 cases of localized vascular disease, including occlusion of a retinal arteriole and of retinal veins; 34 cases of visual disturbances of mild localized symptomatology; 5 cases of contact lens intolerance, 4 after 10-14 months use of oral contraceptives; and a miscellaneous group of 14 cases of a spectrum of ocular disturbances. Some of the adverse effects reported have been related to oral contraceptives (1) by experimental evidence (examples: retinal vascular involvement, vertebro-basilar stroke syndrome) or (2) because they also occur with pregnancy (optic neuritis). There seems to be a connection between migraine and focal cerebral ischemia and patients taking oral contraceptives. A history of migraine or intraocular vascular disease is considered a contraindication to oral contraceptive therapy. Prospective studies have not shown a relationship of oral contraceptives to ocular abnormalities. Incidence of these disturbances may be so low that large numbers of patients will have to be studied before a relationship, if any, is established.
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PMID:Reported adverse effects of oral contraceptives on the eye. 529 50

Calcium is an important intracellular 'second messenger' in the activation of contractile proteins in vascular smooth muscle cells. Intracellular calcium accumulation probably has a major pathological effect in the occurrence of ischemic cell damage. Calcium antagonists are a heterogenous group of substances with one property in common, that is they interfere with the transmembrane movement of calcium. Their therapeutic usefulness in cerebral vasospasms, migraine and cerebral ischemia is reviewed.
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PMID:The role of calcium and the significance of calciumantagonists in some neurological and neurosurgical diseases. 631 48

Patients with classic migraine (69 women and 31 men) selected randomly from a practice list of over 1000 were matched for age, sex and neighbourhood with 100 people who did not have headache problems, and both groups underwent M-mode and two-dimensional echocardiography and clinical examination by cardiologists blinded to the subjects' clinical status. The mean ages were 34.9 +/- 11.3 years for the migraine group and 33.1 +/- 9.9 years for the control group. Definite and possible mitral valve prolapse (MVP), diagnosed according to predefined echocardiographic criteria, were found about twice as often in the migraine group as in the control group (in 15 v. 7 and 16 v. 8 patients respectively); the echocardiograms were definitely normal in 69 migraine patients and 85 controls (chi 2 = 8.39, p less than 0.025). Altogether 25% of the migraine group and 11% of the control group had evidence of MVP from a combination of the echocardiographic and auscultatory findings (chi 2 = 5.72, p less than 0.025). The odds ratio was 2.7, with 95% confidence limits of 1.17 and 6.29. The association between migraine and MVP has implications for the understanding of platelet abnormalities and episodes of cerebral ischemia occurring in both these conditions.
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PMID:Increased prevalence of mitral valve prolapse in patients with migraine. 649 1

The case is described of a 32-year-old female patient who has suffered since puberty from acute migraine attacks and Raynaud syndrome of both hands. In June 1981 acute posterior cerebral ischemia occurred. 11/2 years later the patient was hospitalized for acute myocardial infarction with normal and patent coronary arteries. Thereafter, the patient was treated with nifedipin and anticoagulation, and no other vascular complications have since occurred. The authors suggest that the patient is suffering from a diffuse vasospastic disorder leading to migraine attacks, Raynaud syndrome, cerebrovascular ischemia and myocardial infarction, in view of the fact that the patient has no other known risk factors for early vascular complications.
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PMID:[Vasospastic syndrome in a young women with migraine, Raynaud's disease, cerebral ischemia and myocardial infarction]. 650 63

Seven patients with inoperable cerebral arteriovenous malformations have been treated with embolisation using Silastic spheres and plugs. Indications for using this technique were intractable migraine, episodes of cerebral ischaemia ('steal' syndromes), intracranial haemorrhage, and partial or generalised epilepsy. All 7 patients had been treated medically for between 5 and 25 years with unsatisfactory control of symptoms. Four of the 7 patients obtained some improvement which appeared related to the reduction in flow through the malformation. Although there are risks associated with embolisation, it would seem to be a worthwhile procedure in selected cases.
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PMID:Embolisation of cerebral arteriovenous malformations. 656 22

Twenty-three clinical cases are reported, illustrating the difficulties of diagnosing migrainous focal cerebrovascular accidents. Cases of constituted cerebral infarcts and transient cerebral ischemia occurring during the cephalalgic phase, without headache and in patients with no previous history of typical migrainous attacks are described. Migraine may be considered to be the cause on convincing clinical criteria, but the diagnosis can only be established after negative results of investigations to exclude other causes of focal cerebral ischemia.
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PMID:[Cerebrovascular accidents and migraine]. 661 10

Two pregnant patients with a history of migraine each developed evidence of cerebral ischemia while being treated with subcutaneous terbutaline, for asthma in one case and for tocolysis in the other. The evidence for cerebral ischemia as well as the occurrence of strokes associated with pregnancy or migraine is discussed. Mechanisms by which a selective beta 2 agonist could affect cerebral vasculature are unknown. Until more is known we recommend that pregnant patients with migraine or vascular headache not be given terbutaline.
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PMID:Cerebral ischemia associated with parenteral terbutaline use in pregnant migraine patients. 709 Dec 5

28 patients with transient global amnesia (TGA) were followed for a mean period of 73 months. The patients fell into 3 diagnostic groups: a group where patients had associated symptoms and signs of transient focal cerebral ischemia (TIA), a migraine group and a miscellaneous group. 22 patients had evidence of cerebrovascular disease or risk factors for cerebrovascular disease, and a vascular basis for the amnesic attack was highly suggestive in 25 patients. During the follow-up period 2 patients died, 3 had recurrent TGA and 13 developed a completed stroke or suffered from further TIA's. Permanent memory impairment was encountered in 9 cases. An unfavourable course was related to the presence of other TIA manifestations and/or risk factors for cerebrovascular disease. The study indicates that TGA is probably due to transient ischemia in the vertebrobasilar arterial distribution area. TGA per se has a good prognosis, but the coexistence of risk factor or manifest cerebrovascular disease implies a high rate of a subsequent completed stroke or permanent memory impairment.
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PMID:Transient global amnesia -- its clinical and pathophysiological basis and prognosis. 721 Nov 87


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