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)

Moyamoya disease usually presents itself in children as recurrent episodes of transient cerebral ischemia, such as acute motor and sensory deficits, speech disturbance, headache and seizures. Its initial symptoms rarely include mental disturbance. We experienced a nine-year-old girl with Moyamoya disease who showed choreic involuntary movements of the left upper and lower limbs. In spite of mental disturbance which began around the age of four, she had never visited hospital. CT and MRI detected multiple ischemic lesions in the frontal, parietal and occipital areas. SPECT demonstrated low perfusion of these regions as well as of the right corpora striata, which appeared to be normal in MRI. She underwent right and left superficial temporal artery-middle cerebral artery (STA-MCA) anastomoses with an interval of three months. The choreic movement completely disappeared but her intelligence showed no improvement. The cerebral blood flow increased, but there was no change in the infarction area. Moyamoya disease should be considered in the differential diagnosis of mental disturbance in young children.
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PMID:[Moyamoya disease presenting initially with mental disturbance]. 939 2

Six patients with cerebral ischaemia who presented evolving isolated hand palsy were studied, five prospectively and one retrospectively. The motor deficit involved only the hand and the wrist in some cases. In almost all cases the motor deficit was pseudo-ulnar. None of them had a Babinski sign, all had mild sensory symptoms or signs in the affected hand. CT and MRI disclosed recent infarctions contralateral to the affected hand, in the white matter of the angular gyrus, in a vascular borderzone. Five had a tight stenosis of the internal carotid artery. The pyramidal tract was anatomically spared in three cases, even considering its parietal origin. Consistent with previous data, our study suggests that the parietal lobe is involved in the control of the motor function of the hand. We propose the existence of a new entity, characterized by an evolving non-pyramidal motor deficit in the hand following infarction of the angular gyrus of the inferior parietal lobe.
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PMID:Evolving isolated hand palsy: a parietal lobe syndrome associated with carotid artery disease. 944 80

Cytosolic Ca2+ overload has been proposed as a main cause of neuronal injury during cerebral ischemia. SNX-111, a synthetic product of the naturally occurring omega-conotoxin MVIIA, is a novel, presynaptic N-type Ca2+ channel antagonist and has been reported to be neuroprotective against cerebral ischemia. We studied the neuroprotective effects of SNX-111 in a rabbit model of focal cerebral ischemia. New Zealand white male rabbits (2.5-3.5 kg) were given 1 mg/kg/h i.v. SNX-111 (n=8) or normal saline (n=8) 10 min after onset of a 2-h period of transient focal cerebral ischemia induced by occlusion of the left middle cerebral, anterior cerebral and internal carotid arteries followed by 4 h reperfusion. SNX-111 significantly attenuated overall cortical ischemic neuronal damage by 44% (saline, 38.7+/-3.0%; SNX-111, 21.5+/-6.0%, P<0.05) and regions of hyperintensity on T2-weighted MRI by 30% (saline, 70.6+/-4.0%; SNX-111, 49.3+/-11.0%, P<0.05). No significant difference in (regional cerebral blood flow) rCBF or MAP (mean arterial blood pressure) was found between SNX-111- and saline-treated rabbits suggesting that neuroprotection is due to a cellular effect. We conclude that SNX-111 reduces ischemic injury in this model. Its use as a clinical neuroprotective agent for cerebrovascular surgery or stroke should be investigated further.
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PMID:SNX-111, a novel, presynaptic N-type calcium channel antagonist, is neuroprotective against focal cerebral ischemia in rabbits. 945 74

The effect of anti-intercellular adhesion molecule-1 (anti-ICAM-1) antibody treatment of transient (2 h) middle cerebral artery (MCA) occlusion in the rat was measured using diffusion (DWI)-, T2 (T2I)- and perfusion (PWI)-weighted magnetic resonance imaging. Rats were treated upon reperfusion with an anti-ICAM-1 monoclonal antibody (n=11) or a control antibody (n=7). DWI, T2I and PWI were performed before, during, and after induction of focal cerebral ischemia from 1 h to 7 days. In both groups, the apparent diffusion coefficient of water (ADCw) and cerebral blood flow (CBF) values in the ischemic region significantly declined from the preischemic ADCw values (p<0. 05). The post ischemic increase in T2 of the control group was significantly higher at 48 h than in the anti-ICAM-1 treated group (p<0.05). CBF was not significantly different between the two groups. The temporal profiles of MRI cluster analysis, which combines ADCw and T2 maps into a single image, was significantly different between groups. These data suggest that the neuroprotective effect of anti-ICAM-1 antibody treatment is reflected in reductions of T2 and lesion growth during reperfusion and may not be associated with increased cerebral perfusion.
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PMID:Diffusion, perfusion, and T2 magnetic resonance imaging of anti-intercellular adhesion molecule 1 antibody treatment of transient middle cerebral artery occlusion in rat. 955 9

Thrombolytic therapy during the hyperacute stage is important for salvaging dying cerebral tissue. To date, however, accurate non-invasive assessment of an ischemic lesion during the hyperacute stage has not been possible. Perfusion MRI may be the key to the quick diagnosis of ischemic lesions. To assess the feasibility of dynamic contrast enhanced perfusion MRI, echo planar imaging was performed in 10 patients with ischemic stroke. The relative cerebral blood volume (rCBV), mean transit time (MTT), and relative cerebral blood flow(rCBF) were measured based on moment analysis and the gamma variate method. These measurements, however, are not suitable for the detection of cerebral ischemia during the hyperacute stage. Therefore, we additionally studied the changes in a concentration curve (time-delta R* curve) of Gd-DTPA, injected into the median vein of the forearm. From the curve the SUM (delta R*) time to peak and the delta R* peak, which may be calculated quickly, were determined and were compared to rCBV, MTT, and rCBF, respectively. The rCBV and the rCBF in the ischemic regions were less than those in the contralateral healthy regions (p < 0.05), and the MTT in the ischemic regions was longer than that in the contralateral healthy regions (p < 0.05). Additionally, SUM (delta R*) and the delta R* peak in the ischemic regions were less, and the time to peak in the ischemic regions was longer than the value in the contralateral healthy regions (p < 0.05), correlating well to the rCBV, rCBF, and MTT measurements. Also, images of these parameters, depicting the ischemic lesion earlier than conventional T2 weighted images, can be easily made by using an MRI console. These results suggest that the SUM (delta R*), time to peak and the delta R* peak images calculated with dynamic contrast enhanced perfusion MRI may be one of the best techniques for the detection of cerebral ischemic lesions during the hyperacute stage.
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PMID:[An evaluation of ischemic stroke using dynamic contrast enhanced perfusion MRI]. 959 50

We performed diffusion-weighted MRI (DWI) on a standard 1.5-tesla MRI scanner using a high-speed stimulated echo pulse sequence (turboSTEAM) in 9 stroke patients and 9 control subjects to investigate whether this technique can be used clinically to assist in ischaemic stroke diagnosis within the time frame for potential therapy. Stroke patients underwent DWI between 3.75 h and 3 days after stroke onset. Three patients were studied on more than one occasion. DWI was normal in the 9 controls. Seven of 9 stroke patients showed areas of increased signal on DWI. DWI detected cerebral ischaemia 3.75 h after stroke onset when both CT and T2-weighted MRI were normal. In 6 DWI-positive patients studied at later times, increased signal on T2-weighted images was present at the same time. Two patients had normal CT, T2-weighted and DWI images; both made good neurological recoveries. For the routine assessment of stroke patients, DWI implemented on a standard MRI system can provide additional information of clinical value to that obtained with conventional pulse sequences. In particular it facilitates early detection of cerebral ischaemia during the first few hours after stroke.
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PMID:Experience with diffusion-weighted imaging in an acute stroke unit. 961 95

Although hypercalcemia may cause drowsiness, lethargy, weakness, confusion and coma it rarely causes seizures or cerebral infarction. The patient presented had a clinical evolution from hallucinosis to a generalized tonic-clonic seizure, and subsequent cortical blindness with occipital cerebral ischemia as evidenced by SPECT and MRI scans. EEG revealed occipital PLEDs. With reversal of hypercalcemia, there was a return of vision, resolution of EEG epileptiform activity, although with some residual occipital infarction. This case, in concert with a literature review of hypercalcemia, reveals examples of occipital and watershed ischemia, blindness, seizures and hypertension, a pattern markedly similar to that of eclampsia. Furthermore, medications such as magnesium sulfate, believed to reverse cerebrovasospasm responsible for the eclamptic neurologic findings, may counter the effects of hypercalcemia at a cellular level, lending support to a calcium-mediated injury in eclampsia.
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PMID:Reversible hypercalcemic cerebral vasoconstriction with seizures and blindness: a paradigm for eclampsia? 966 11

We present a patient with transient global amnesia (TGA) whose diffusion-weighted MRI (DWI) showed increased signal in the splenium of the corpus callosum and in the left parahippocampal gyrus. The absence of high signal on the corresponding apparent diffusion coefficient (ADC) images supports the diagnosis of an acute infarction. This finding provides a temporal relation between cerebral ischemia and infarction in the territory of posterior cerebral artery and in certain cases of TGA. An early means of detecting ischemia in TGA by DWI may influence clinical decisions made in patient evaluation and management.
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PMID:Diffusion-weighted MRI characterizes the ischemic lesion in transient global amnesia. 1040 77

The authors report a patient with migraine in whom they measured brain oxygenation indirectly during a visual aura by means of T2-weighted MRI. An aura of left homonomous quadrantanopia was accompanied by increased T2-weighted contrast intensity of bilateral regions in the occipital cortex, and the red nucleus and substantia nigra bilaterally. The mechanisms of these changes remain to be determined, but in this patient the migraine aura was associated with probable hyperoxia and not cerebral ischemia.
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PMID:MRI of the occipital cortex, red nucleus, and substantia nigra during visual aura of migraine. 981 84

The severity and progression of ventricular enlargement, the occurrence of cerebral edema, and the localization of ischemic metabolic changes were investigated in a rat model of hydrocephalus, using in vivo 1H MR spectroscopic imaging (SI) and diffusion weighted MRI (DW MRI). Hydrocephalic rats were studied 1, 2, 4, and 8 weeks after injection of kaolin into the cisterna magna. Parametric images of the apparent diffusion coefficient (ADC) revealed a varying degree of ventriculomegaly in all rats, with different time courses of ventricular expansion. Extracellular white matter edema was observed during the early stages of hydrocephalus, most extensively in cases of progressive ventriculomegaly. In gray matter regions, ADC values were not changed, compared with controls. In case of fatal hydrocephalus, high lactate levels were observed throughout the whole brain. In all other rats, at all time points after kaolin injection, lactate was detected only in voxels containing cerebrospinal fluid. This suggests accumulation of lactate in the ventricles, and/or an ongoing periventricular production of lactate as a consequence of cerebral ischemia in experimental hydrocephalus.
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PMID:In vivo 1H MR spectroscopic imaging and diffusion weighted MRI in experimental hydrocephalus. 984 Aug 27


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