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Results for “Brain Stem Infarctions”

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At least 685 records · Page 38Linked to original sources
PubMed1987

Localising value of primary position upbeating nystagmus.

Primary position upbeating nystagmus has been associated clinically with intra-axial brainstem and cerebellar lesions but evidence for more precise localisation to the ponto-mesencephalic and ponto-medullary junctions is accumulating. We report the occurrence of primary position upbeating nystagmus in three patients who had clinical signs of pontine lesions at the ponto-mesencephalic and ponto-medullary junctions. Radiological confirmation was possible in two cases.

Adult↗
PubMed1980

Localizing brain stem lesions with brain stem auditory evoked potentials.

Based on a survey of brain stem auditory evoked potentials (BAEPs) in animals and humans with localized brain stem lesions compared to the recognizability of BAEP components in normal materials, it was concluded that BAEP examination might localize lesions to a high or low level and diffusely within the brain stem. In 155 patients with multiple sclerosis, vascular disorders or other lesions from a neurological department, the involvement of the brain stem was clinically estimated to be negative, situated at a high or low level or diffuse. Correlation between location of the lesions assessed by clinical versus BAEP examination showed correspondence between negative and diffusely abnormal findings, but not with regard to levels within the brain stem. CT-scanning similarly failed to localize lesions to various levels. This was probably due to poorly circumscribed or widespread lesions. The main value of BAEP in neurological patients was to establish clinically silent lesions, especially in patients with multiple sclerosis and only spinal signs.

Animals↗
PubMed1992

Oscillatory activity in different motor subsystems in palatal myoclonus. A case report.

In a patient with palatal myoclonus the mutual interaction between voluntary movements and the myoclonic activity was analysed. Amplitude and frequency of myoclonic activity in hand muscles were modulated by flexions and extensions. A 1:1 relationship was found between EMG-bursts in hand muscles and palatal movements. A 1:2 relationship was found between eye and finger movements. Resetting of myoclonus in the abductor digiti minimi muscle occurred after cutaneous ulnar nerve stimulation. It is suggested that feedback plays an important role in the generation of the oscillatory activity in PM in addition to pacemaker activity in brainstem neurons.

Aged↗
PubMed1991

Wildervanck or cervico-oculo-acoustic syndrome and MRI findings.

In 1952, Wildervanck described the first case of what he styled the cervico-oculo-acoustic (COA) syndrome. This comprises Klippel Feil's (KF) anomaly (congenitally fused cervical vertebrae), congenital sensorineural deafness and Duane's retraction syndrome (deficient abduction with retraction on adduction). Since that original paper, there have been further reports describing this triad, either completely or incompletely. A further case of this syndrome is reported and the first report of MRI head scan findings in this condition is presented. In addition, the origin of mirror movements observed as part of the KF syndrome are discussed.

Abducens Nerve↗
PubMed2006

Therapy of basilar artery occlusion: a systematic analysis comparing intra-arterial and intravenous thrombolysis.

BACKGROUND AND PURPOSE: Basilar artery occlusion (BAO) is an infrequent form of acute stroke, which invariably leads to death or long-term disability if not recanalized. A traditional recanalization approach based on historical controls and pathophysiological consideration is local intra-arterial thrombolysis (IAT) in eligible patients. This necessitates diagnostic evaluation and treatment in stroke centers equipped with an interventional neuroradiological service on a 24-hour basis, but its superiority to the technically simple intravenous thrombolysis (IVT) remains unproven. METHODS: We analyzed systematically published case series of substantial size reporting the outcome of BAO after IAT or IVT. RESULTS: In 420 BAO patients treated with IVT (76) and IAT (344), death or dependency were equally common: 78% (59 of 76) and 76% (260 of 344), respectively (P=0.82). Recanalization was achieved more frequently with IAT (225 of 344; 65%) than with IVT (40 of 76; 53%; P=0.05), but survival rates after IVT (38 of 76; 50%) and IAT (154 of 344; 45%) were equal (P=0.48). A total of 24% of patients treated with IAT and 22% treated with IVT reached good outcomes (P=0.82). Without recanalization, the likelihood of good outcome was close to nil (2%). CONCLUSIONS: Recanalization occurs in more than half of BAO patients treated with IAT or IVT, and 45% to 55% of survivors regain functional independence. Although improved therapy forms for BAO are necessary, hospitals not equipped for IAT may set up IVT protocols. The effect of IVT is probably not much different from the effect of IAT. IVT represents probably the best treatment that can be offered to victims of acute BAO in such hospitals.

Aged↗
PubMedDate not supplied

Central nervous system complications of coronary artery bypass graft surgery: prospective analysis of 421 patients.

A prospective analysis of 421 patients undergoing coronary artery bypass graft (CABG) surgery as the sole cardiac procedure was carried out to assess the frequency of central nervous system (CNS) complications. In all, 451 variables were assessed in each patient. Stroke occurred in 5.2% but was severe in only 2%. Prolonged encephalopathy occurred in 11.6% but usually resolved before discharge. No statistically significant pre- or intraoperative risk variables for CNS complications were found; specifically, age or pump times in excess of two hours were not significant factors. Postoperative use of an intraaortic balloon pump and pressor agents were significantly correlated with prolonged encephalopathy. The frequency of CNS injury in CABG surgery is similar to that in other forms of open heart surgery, and there has been little change in the frequency of CNS complications over the past seven years. Possible mechanisms of CNS damage during CABG surgery are discussed.

Adult↗
PubMed1989

MRI findings in two cases of acute facial paralysis.

This article describes the use of magnetic resonance imaging (MRI) in the evaluation of the facial nerve paralysis of Bell's palsy and herpes zoster oticus. Identification of the nature of inflammatory facial nerve paralysis often presents a diagnostic dilemma. The site of involvement along the course of the nerve may have importance when treatment options are being considered. We have found MRI to be a unique method for localizing the site of nerve injury in both Bell's palsy and Ramsay Hunt syndrome.

Adult↗
PubMed1983

Disturbances of the sleep-waking cycle in patients with vascular brain stem lesions.

Continuous polygraphic recordings of six patients with vascular brain stem lesions were evaluated to investigate the relationship between 1) the localization or extent of the lesions and the alteration of the sleep-waking cycle, and 2) the evolution of the clinical condition and the sleep-waking cycle. Absent REM sleep and severely disorganized NREM sleep were associated with extensive pontine lesions involving the pontine tegmentum. In "locked-in" syndrome, the neural mechanisms responsible for both REM and NREM sleep continued to function, but the sleep-waking cycle was disturbed and marked by sleep-onset REM periods. Lesions in the lower brain stem resulted in absent slow-wave sleep and sleep-onset REM, suggesting that vascular lesions may involve the neural mechanisms responsible for slow-wave sleep. In general, the acute stage of illness was marked by increased awakenings and time spent awake, absent REM sleep, and little or no slow-wave sleep. These results indicate that continuous polygraphic recordings can reveal severe abnormalities due to vascular lesions of the brain stem whereas the waking EEG can only detect mild abnormalities. Improvement in the organization of the sleep-waking cycle in successive polygraphic examinations is likely to be followed by an improvement of the clinical condition. Continuous polygraphic recording is thus a valuable prognostic indicator for vascular brain stem lesions.

Aged↗
PubMed1981

Neuropsychiatric disturbances following brainstem lesions.

Two patients are described who developed behavioural changes following brainstem injuries. Both patients had neuro-ophthalmological signs indicative of lesions of the rostral brainstem, which were confirmed by CT scanning. It is suggested that the behavioural changes were related to interruption of nearby limbic, hypothalamic and reticular structures.

Adult↗
PubMed1980

Lateral medullary syndrome after neck injury.

Several reported cases of brainstem stroke followed neck manipulation or trauma. We describe a 28-year-old man who had a lateral medullary syndrome after cervical hyperextension in an automobile accident. Angiography revealed complete occlusion of the left vertebral artery.

Adult↗