Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1762617 (weakness)
 37,932 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of left common carotid artery dissection showing complete remission in the short term. A 48-year-old man presented a 1-week history of weakness in the right arm. Neurological findings revealed mild motor weakness of the right upper extremity. Magnetic resonance imaging (MRI) showed sporadic cerebral infarction and hemorrhagic infarction in the area of the left middle cerebral artery (MCA) and the posterior border zone. Computed tomographic angiography (CTA) revealed irregular stenosis with a smooth surface in the left common carotid artery and ultrasonography indicated an iso-echoic lesion in the same area. ECD-single-photon emission tomography (SPECT) showed low perfusion only in the infarcted territory. Conservative therapy using a free radical scavenger and aspirin was carried out and the patient displayed full neurological recovery. After a 3-week follow-up period, carotid angiography and CTA showed almost complete disappearance of the stenotic lesion.
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PMID:[A case of common carotid artery dissection showing remission in short-term]. 1567 73

A 56-year-old man presented with weakness in his right arm and leg. Throbbing headache occurred several hours prior to his weakness. Brain CT obtained on day 3 demonstrated low density areas in the medial part of the left frontal lobe. Cerebral angiography on day 14 demonstrated dilatation and narrowing of the left anterior cerebral artery (ACA) corresponding to "pearl and string sign". The diagnosis of spontaneous ACA dissection was established with clinical features, laboratory findings, and angiographic findings. Antiplatelet therapy was undertaken for the prevention of ischemic events. Serial Brain CT demonstrated hemorrhagic change in the area of infarction. However, there was no definite clinical deterioration. Antiplatelet therapy was withdrawn after hemorrhagic change was noted. Cerebral angiography on day 35 showed improvement of both dilatation and narrowing. Possible reperfusion injury caused by absorption of intramural hematoma seems to be responsible for hemorrhagic change. In patients with cerebral infarction due to dissection of intracranial arteries, antithrombotic therapy is controversial as hemorrhagic complications including hemorrhagic infarction as well as subarachnoidal hemorrhage can occur. Further accumulation of cases is required.
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PMID:[A case of anterior cerebral artery dissection causing hemorrhagic infarction]. 1571

The objective of this study was to determine the relationship between disuse weakness due to acute or subacute stroke and cardiorespiratory fitness. The participants were 15 men (average age 48.4 years) who were acute admissions to a hospital specializing in the management of stroke, 11 with cerebral infarction and four with intracerebral hemorrhage. All participants received physiotherapy (40 min/day, 5 days/week) at their bedside until leaving hospital. None of them received physiotherapy in an outpatient clinic. The anaerobic threshold (AT) was measured twice: during admission (an average of 37.3 days after onset) and after discharge (in an outpatient clinic, an average of 37 days after discharge and 42.7 days after the first test). The average AT was 12.5 ml/kg/min in the first test and 14.2 ml/kg/min in the second test (P<0.05). Because ATs in patients were lower after discharge than for healthy control individuals, physiotherapy during admission for stroke should be qualitatively and quantitatively reexamined for the prevention of disuse weakness. After discharge, it is important to give patients a more active rehabilitation program to improve their fitness.
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PMID:Cardiorespiratory fitness of post-stroke patients: as inpatients and as outpatients. 1604 25

To date most studies that have addressed prognostic factors in patients who have had a transient ischaemic attack (TIA) have determined the risk of cerebral infarction during the first 3 years following TIA. Two recent studies have investigated the very long-term and very short-term risks. The long-term study found that the risk unexpectedly increased after 3 years. The short-term study found the very early risk of cerebral infarct (< 7 days) to be substantial at 10%. The proposed ABCD score enables the physician to easily identify patients at particularly high risk: (A) 1 point for age > or =6o years, (B) 1 for systolic blood pressure >140 mmHg and/or diastolic pressure >90 mmHg, (C) 2 points for unilateral weakness, 1 for speech disturbance without weakness, (D) 2 points for an attack lasting > or =1 h and 1 point for an attack lasting 10-59 min. A patient with a total score of 5 has a risk of 12.1% of developing a cerebral infarct within 7 days. In a patient with a score of 6 this risk is 31.4%.
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PMID:[Predictable risk of cerebral infarction following a transient ischaemic attack]. 1610 9

A 68-year-old woman with no history of cardiac events suffered acute myocardial infarction after surgery for middle cerebral artery (MCA) occlusion manifesting as transient left motor weakness. Diffusion-weighted magnetic resonance imaging revealed multiple infarctions in the right cerebral hemisphere. Magnetic resonance angiography and cerebral angiography demonstrated an occlusion at the horizontal segment of the right MCA and no collateral circulation. Cerebral blood flow study 6 weeks after the initial presentation indicated decreased blood flow in the right cerebral hemisphere. Superficial temporal artery-MCA anastomosis was conducted to prevent recurrent cerebral infarction. Two hours after surgery, her systolic blood pressure fell to 60 mmHg and her consciousness worsened. Emergency coronary angiography indicated occlusion of the right coronary artery. Percutaneous coronary intervention was successfully performed and the subsequent course was uneventful. Preoperative evaluation of the coronary artery may be necessary before surgery for cerebral ischemic disease in both the intracranial and extracranial arteries.
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PMID:Middle cerebral artery occlusion associated with acute myocardial infarction in the perioperative period--case report. 1649 19

We report a case treated successfully by emergency carotid endarterectomy (CEA) for progressing stroke resulting from pseudo-occlusion of the internal carotid artery (ICA). A 67-year-old male was admitted to our hospital with dysarthria. Neurological examination on admission revealed mild left-sided motor weakness and dysarthria. Computed tomography (CT) showed cerebral infarction in the territory of the perforating artery of right middle cerebral artery (MCA). Magnetic resonance (MR) imaging indicated similar findings and cervical MR angiography revealed occlusion of right cervical ICA. Cerebral conventional angiography and CT angiography revealed pseudo-occlusion of the right ICA. ECD-single photon emission tomography (SPECT) indicated low perfusion in the territory of the right ICA. Conservative therapy was performed using free radical scavengers and antiplatelet drugs, but neurological signs deteriorated. Revascularization using CEA was therefore performed. After surgery, the patient was restless with neurological abnormalities, and trans-cranial Doppler (TCD), INVOS-3100 and MRA revealed hyperperfusion. Strict control of blood pressure under propofol anesthesia allowed effective management of hyperperfusion syndrome. After a 1-month follow-up period, the patient was discharged with only mild left hemiparesis.
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PMID:[A case of emergency carotid endarterectomy for severe stenosis of the cervical internal carotid artery presenting with progressing stroke: importance of managing blood pressure postoperatively]. 1652 23

We report two cases of Duchenne muscular dystrophy (DMD) complicated with dilated cardiomyopathy (DCM), who were affected with cerebral infarction. Case 1 suddenly developed dysarthria and right facial weakness at age 21. Cranial CT study disclosed a low density area in the left basal ganglia and internal capsule. Case 2 had a history of transient ischemic attack (TIA) at age 21. Five months after the TIA, he developed right hemiplegia and dysarthria, and a low density area in the corona radiate in left cerebral hemisphere was observed in cranial CT. These two cases showed the radiographic cardiomegaly with cardio thoracic ratio (CTR) of 72.8% and 66.6%, the decreased echocardiographic left ventricular ejection fraction below 20%, and the elevated titer of thrombin-anti-thrombin III complex (TAT) and D-dimer. The autopsy of Case 2 at age 26 disclosed the remarkable degeneration and fibrosis of myocardium and old ischemic lesion in the left cerebral frontal cortex. Despite the negative finding of the emboli in the left heart, cardiogenic cerebral infarction secondary to DCM was strongly suspected in both cases.
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PMID:[Two cases of Duchenne muscular dystrophy complicated with dilated cardiomyopathy and cerebral infarction]. 1662 52

A 61-year-old male presented with left hand motor weakness associated with cerebral infarction in the right frontal lobe. Right common carotid angiography demonstrated a 66% stenosis and carotid duplex scan demonstrated intermediate echogenic plaque, indicating typical carotid plaque. Carotid endarterectomy was performed 22 weeks after the ischemic onset. During exposure of the carotid artery, a soft and yellowish mass (5 x 5 mm) was observed in the lateral wall of the carotid bulbus, which was not covered with adventitia but with thin connective tissue. The mass was removed en-bloc with a small part of the surrounding arterial wall combined with ordinary endarterectomy. The artery was closed with a collagen-impregnated polyester patch graft (Hemashield patch) to maintain adequate arterial lumen. Histological examination of the removed plaque confirmed that atheroma had protruded from the intima through the media as well as the adventitia and formed an extra-arterial mass. Such a case requires great care to dissect the carotid artery to prevent premature disintegration of the atheroma.
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PMID:Penetrating atheroma in cervical carotid artery stenosis. 1699 76

We report 2 cases of multiple aneurysms (AN) associated with main trunk artery occlusion. CASE 1: A 52-year-old male was admitted to our hospital with dysarthria and weakness of the right side of the body. Computed tomography (CT) showed cerebral infarction in the left corona radiata. MR angiography and conventional angiography showed occlusion of the left middle cerebral artery (MCA) and saccular aneurysms (ANs) at the origin of the anterior communicating artery (A-com) and bifurcation of the right MCA. Subsequent 123I-IMP-single photon emission tomography (SPECT) revealed marked reduction of cerebral blood flow and disturbed reactivity to acetazolamide in the left cerebral hemisphere. Superficial temporal artery (STA)-MCA anastomosis was performed to improve cerebral blood flow and reduce hemodynamic stress for AN of the A-com and right MCA. At 5 months after the first operation, neck clipping was performed successfully for the non-ruptured A-com AN and right MCA AN. CASE 2: A 65-year-old male was admitted to our hospital. CT revealed subarachnoid hemorrhage (SAH), and 3D-computed tomographic angiography (CTA) and cerebral angiography showed basilar top AN, A-com AN and right MCA AN associated with right internal carotid artery occlusion. Right ACA and MCA territories were visualized from the A-com artery and posterior cerebral artery. STA-MCA anastomosis was performed to improve cerebral blood flow and reduce hemodynamic stress for ANs. In the same operation, successful neck clipping was performed for BA top AN and right MCA AN. In such cases as these, particularly in ischemic cases associated with main trunk artery occlusion, it was important to consider surgery for AN after STA-MCA anastomosis in anticipation of improved cerebral blood flow and reduce hemodynamic stress for AN.
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PMID:[Two cases of main trunk artery occlusion associated with multiple cerebral aneurysms]. 1708 68

A 70-year-old woman was admitted to our hospital with a complaint of numbness and clumsiness of the left hand. On physical examination 23 days after the onset of cerebral infarction, she showed no apparent muscle weakness. Although her elementary somatosensory function was mostly intact with a minimal joint position sensation disturbance, she showed disturbances in tactile recognition, two-point discrimination, and weight perception. She also had difficulty in discrete finger movement of her left hand, especially when her eyes were closed. Brain MRI disclosed a small infarction localized to Brodmann areas 1 and 2 in the right postcentral gyrus. In the left median nerve short-latency somatosensory evoked potentials (s-SEPs), the N20 potential was normally evoked. This finding also indicated that the area 3b was preserved. The sensory symptoms observed in this patient were compatible with the hierarchical somatosensory processing model in the postcentral gyrus proposed by Iwamura et al, in which the elementary sensation recognized in area 3 is transferred to areas 1 and 2, and then processed to discriminative sensation. The disturbed discrete finger movement in this patient probably resulted from impaired tactile recognition which could be compensated for by visual information.
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PMID:[A case of combined sensation disturbance and clumsiness of the left hand caused by an infarction localized to brodmann areas 1 and 2]. 1751 Dec 85


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