Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0917798 (cerebral ischemia)
 17,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Since 1978, the authors have observed 7 cases of dissecting aneurysm in the internal carotid artery. Symptoms were severe headache and subsequent neurologic deficit in young persons (3 women, 4 men; mean age 35 years). The underlying pathology was spontaneous dissection of the cervical internal carotid artery, with surgical confirmation in 3 cases and typical angiographic patterns in all cases. Spontaneous dissection of the cervical internal carotid artery is being increasingly recognized as a cause of cerebral ischemia in young adults. Moreover this clinicopathologic event is more common than had previously been supposed. The etiology remains unclear, except in 15% of cases in which dystrophy of the media (Marfan's syndrome) is in cause. No history of cervical trauma can be found. Typical clinical features consist in ipsilateral headache preceding an abrupt neurologic deficit in a 40-year-old person. An incomplete Horner syndrome (oculosympathetic paresis without facial anhidrosis) associated with facial pain and numbness is pathognomonic, but the majority of dissections are less typical. The typical angiographic pattern is an elongated regular stenosis of the high cervical internal carotid artery, 2 cm above the non-involved bulbus ("string sign"). The dissection may modify to a tapered occlusion above the point of origin of the internal carotid artery. The natural course is spontaneous resolution of the stricture, without relapse. Optimal management is non-operative since medical treatment has proved to be efficient. These cases confirm the benign course and overall good prognosis of spontaneous dissections of the internal carotid artery which are not as rare as the scarcity of reports might indicate.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Spontaneous dissection of the internal carotid artery. Apropos of 7 cases and a review of the literature]. 217 45

Patients with classical migraine whose auras included paraesthesiae or numbness in the hands have been reviewed. In 55 of 111 patients the symptoms were on the same side of the body as the headache and in only 20 on the opposite side to the headache. In the remaining 36 patients one or other was incompletely lateralised. Five right handed patients described dysphasia at the same time as paraesthesiae in the their non-dominant hand. These findings are incompatible with the notion that the headache is due to reactive hyperaemia following localised cerebral ischaemia, and it is suggested that the ischaemic and hyperaemic processes are both the result of some more generalised vasomotor disturbance.
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PMID:Asymmetry of the aura and pain in migraine. 731 Apr 27

A 29-year-old female presented with Basedow's disease manifesting as sudden vomiting, diarrhea, fever over 38 degrees C, transient aphasia, and numbness in her extremities. These symptoms were considered due to cerebral ischemia at a local clinic. Magnetic resonance angiography indicated stenosis of the bilateral distal internal carotid arteries and the bilateral proximal anterior cerebral and middle cerebral arteries. Thyroid swelling and exophthalmos were observed. She was transferred to our hospital. Endocrine function tests showed hyperthyroidism. The diagnosis was Basedow's disease. Her symptoms disappeared after receiving intravenous drip infusion of fluid replacement, and antithyroid and antiplatelet medication. After she became euthyroid, cerebral angiography and magnetic resonance angiography revealed improvement of the stenosis of the cerebral arteries. Stenosis of the terminal portion of the internal carotid artery associated with Basedow's disease is extremely rare. Conservative treatment mainly including antithyroid medications for Basedow's disease, and antiplatelet drugs and intravenous replacement fluid for the ischemic manifestations should be the first choice of treatment unless immediate vascular reconstruction is necessary.
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PMID:Improvement of cerebral arterial stenosis associated with Basedow's disease. Case report. 1630 17

Seckel syndrome is an autosomal recessive disorder characterized by intrauterine and postnatal growth delay, microcephaly with mental retardation, and facial dysmorphisms including micrognathia, a recessed forehead, and a large beaked nose. Occurring in 1 in 10,000 children without sex preference, it is the most common primordial microcephalic osteodysplastic dwarfism and has been associated with a variety of congenital brain malformations and intracranial aneurysms. Moyamoya syndrome is an idiopathic, chronic, progressive cerebrovascular disorder marked by stenosis of the intracranial internal carotid arteries and concurrent development of hypertrophied collateral vessels. These tortuous arterial collaterals appear radiographically as "puffs of smoke," giving the syndrome its name. In this report, the authors describe the case of a 16-year-old girl with coincident Seckel and moyamoya syndromes. To their knowledge, this is the first reported case of such an association being treated with surgical revascularization. The patient presented with persistent headaches and a 2-year history of progressive hand, arm, and face numbness. Imaging studies revealed multiple completed cerebral infarcts, global ischemic changes, and vascular anatomy consistent with moyamoya syndrome. Bilateral pial synangioses successfully revascularized each hemisphere with resolution of the patient's symptoms. The patient died 1 year later of complications related to treatment of a rapidly progressing intracranial aneurysm. This report documents the first case associating moyamoya and Seckel syndromes. In addition, the report reveals the rapid development of an intracranial aneurysm in a patient with this syndrome. When coupled with previous reports of other types of cerebrovascular disease in patients with Seckel syndrome or other primordial dwarfisms, the authors' findings are important because they suggest that physicians treating patients with dwarfism should consider the diagnosis of moyamoya syndrome when symptoms suggestive of cerebral ischemia are present. Prompt diagnosis and treatment of moyamoya syndrome, including the use of proven surgical revascularization procedures such as pial synangiosis, may significantly improve the long-term outcomes of these patients.
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PMID:Seckel syndrome and moyamoya. 1933 12

The neurological manifestations of chronic hepatitis C is most often a peripheral sensory neuropathy characterised by numbness, burning and sensation of "pins and needles". Peripheral motor neuropathy, mononeuropathy, mononeuropathy multiplex and transverse myelitis also occur. Ischemic stroke and transient cerebral ischemia have also been reported. Anterior ischemic optic neuropathy is seen, often following interferon therapy. We report an exceptional case of neuromyelitis optica in chronic hepatitis C infection in the absence of interferon therapy.
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PMID:Chronic hepatitis C infection associated with neuromyelitis optica and antinuclear antibodies. 2065 57

Superficial temporal artery-middle cerebral artery anastomosis is generally considered as an effective method in improving damage associated with intracerebral occlusions in moyamoya disease. Hemodynamic changes caused by revascularization are the cause of many postoperative complications. Of the 186 consecutive surgeries for moyamoya disease at our hospital from 2015, we herein presented one case of adult-onset moyamoya disease that manifested symptomatic local cerebral edema and local hypoperfusion caused by the 'watershed shift'. A 67-year-old woman presented with limb numbness on the right side and underwent superficial temporal artery-middle cerebral artery anastomosis, resulting in neurological dysfunction and the formation of a reversible high-signal lesion at left frontotemporal lobes on T2-weighted images along with a decrease in perfusion values on 123I N-isopropyl-p-iodoamphetamine single-photon emission computed tomography, while the anastomotic vessel was patent on magnetic resonance angiography. This phenomenon of hypoperfusion area (left frontotemporal lobe) remote to anastomotic site (left temporal lobe area) led to the diagnosis of the 'watershed shift' phenomenon. In light of the hypoperfusion induced by 'watershed shift', the patient was treated with fluid replacement. With the gradual recovery of perfusion, the patient presented significantly improvement both on the magnetic resonance imaging findings and neurological symptoms. In conclusion, regional cerebral edema with hypoperfusion, possibly due to cerebral ischemia and the 'watershed shift' phenomenon, may be another novel entity that needs to be considered as a potential complication after extracranial-intracranial bypass for moyamoya disease.
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PMID:Paradoxical association of symptomatic cerebral edema with local hypoperfusion caused by the 'watershed shift' after revascularization surgery for adult moyamoya disease: a case report. 3159 40