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Results for “Brain Stem Infarctions”

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At least 721 records · Page 40Linked to original sources
PubMed1983

Heterotopic ossification heralded by a knee effusion.

A knee effusion suddenly appeared in a 44-year-old woman one month after she suffered a neurological catastrophe. Heterotopic ossification (HO) subsequently developed above her knee. Because treatment of HO with disodium etidronate may be successful if started early, awareness of the association between acute arthritis and new bone formation in certain clinical settings is important.

Adult↗
PubMed1994

[Disorders of autonomic heart rate regulation in patients with brain stem lesions].

The present study investigates the frequency of alterations of autonomic cardiac innervation in patients with brain stem lesions by testing cardio-vascular reflexes tests. In the neurological ICU, we tested 22 patients aged 19 to 78 years (mean age 54 +/- 17 years) suffering from ischemic brain stem lesions. The variability of heart rate was at first evaluated at rest. Mean heart rate, coefficient of variation (VK) and RMSSD (root mean square of successive differences) were calculated. In addition, a spectral analysis of the heart frequency was computed by a fast fourier transformation and the spectral powers in the frequency bands 0.02-0.09 Hz, 0.09-0.15 Hz and 0.20-0.30 Hz, respectively were determined. An atropine test was then carried out. 5 minutes after the beginning of injection of atropine sulfate, further rate and spectral analyses were again computed. The VK was pathologically diminished in 59% of the patients, the RMSSD in 55% and both, VK and RMSSD, in 45%. In 32% of the patients VK and RMSSD were within normal range. Spectral power was diminished in all three frequency bands in 4 out of 22 patients with pathological heart rate variability. Most abnormal results in spectral analysis could be obtained in the frequency band 0.09-0.15 Hz (73%), followed by the frequency band 0.20-0.30 Hz (45%) and the 0.02-0.09 Hz frequency band (32%). There were significant correlations between the heart rate variability; the spectral power in the 0.09-0.15 Hz and 0.20-0.30 Hz frequency bands (p < 0.05; Spearman). 88% of the patients with abnormal results at rest had diminished heart rate responses to atropine.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Percutaneous transluminal angioplasty for progressing stroke caused by severe basilar artery stenosis: case report].

We encountered one case of progressing stroke caused by severe basilar artery stenosis. The patient was treated with emergent percutaneous transluminal angioplasty (PTA) with satisfactory results. A 54 year-old woman was admitted 15 minutes after the sudden onset of rt. hemiparesis, rt. hemidysesthesia, dysarthria and consciousness disturbance. CT scan on admission showed no abnormal findings. The consciousness level of the patient deteriorated rapidly from JCS 1 to JCS 20 within 30 minutes from the ictus. An emergent angiogram revealed severe basilar artery stenosis at its middle portion and poorly developed collateral circulation. One hour after the stroke occurred, PTA was performed. Using a 3mm diameter balloon catheter, we introduced the balloon into the stenotic lesion and inflated it 6 times from 4 atm to 8 atm pressure. The patient recovered immediately on the operating table improving from JCS 20 to JCS 1. Rt. hemiparesis also improved. Follow-up MRI showed a small area of ischemic change in the brain stem, but no large infarction appeared. The patient was discharged with no neurosurgical deficits after 30 days of PTA. PTA for basilar artery stenosis is still a controversial subject. One reason is the risk of basilar artery perforating branches occlusion by balloon catheter and the other is the difficulty of introducing a flexible balloon catheter into the basilar artery beyond the acute angulation of the vertebral artery. If those two problems were solved, PTA would be the first-choice therapy for basilar artery stenosis in both acute and chronic stages.

Acute Disease↗
PubMed1993

[Cerebral vasculitis in Crohn disease].

Central nervous system vasculitis in Crohn's disease. A 36-years old man was referred to the hospital because of severe headache, vertigo and right sided combined motor-sensory hemiparesis. There was a history of Crohn's disease with an acute exacerbation only two months ago. Magnetic resonance imaging detected a vascular lesion of the left brainstem and serologic investigations revealed circulating immunocomplexes and p-antineutrophil cytoplasmic autoantibodies (p-ANCA). Further investigations care no evidence of arteriosclerotic cerebrovascular disease. These findings therefore suggest that cerebral vasculitis secondary to Crohn's disease was the underlying cause of this focal neurologic deficit.

Adult↗
PubMed1998

Zenker's diverticulum in the elderly: a neurologic etiology?

Though described in 1769, the etiology of Zenker's diverticulum remains unclear. Various primary esophageal motor disorders have been proposed, but no consistent manometric pattern or anatomic etiology has been uniformly recognized. An association with clinical neurologic disease at our institution prompted a review of 12 cases of Zenker's diverticulum in patients over 60 years of age, treated in the last 8 years. Nine patients (75%) underwent cricopharyngeus myotomy and diverticulectomy, with uniformly good results. Ten patients (83%) had an associated neurologic disorder, substantiated by cranial CT or MRI, in most cases. A wide range of neurologic problems were identified, but a strong trend toward brainstem or basilar lesions was present. As expected, the etiology of the neurologic abnormality in most patients in this group was cerebrovascular disease, but two patients had peripheral neuropathies. We suggest that the etiology of Zenker's diverticulum in the elderly may be neurologic in origin. Esophageal motor disorders, including incomplete upper esophageal sphincter opening and increased hypopharyngeal pressures, which may result in Zenker's diverticulum, may be a manifestation of central or peripheral neurologic disease in the elderly.

Aged↗
PubMed1989

Subcortical cerebral infarctions in sickle cell trait.

At necropsy, two patients with sickle cell trait and progressive motor and visual deficits, lethargy and coma showed infarctions of the deep cerebral white matter and brain stem. The findings in these patients and another reported in the literature suggest that subcortical infarctions may be more common in sickle cell trait than has been recognised and should be suspected in any patient with sickle cell trait who presents with an unusual neurological illness.

Adult↗
PubMed1995

Massive persistent release of excitatory amino acids following human occlusive stroke.

BACKGROUND: Animal stroke models demonstrate excitatory amino acid (EAA) release in ischemic tissue, as measured by microdialysis. Currently glutamate antagonist drugs are being developed to protect brain tissue after ischemic events. However, the role of EAAs in human occlusive stroke is not well known. We therefore measured glutamate and aspartate release in a patient after occlusive stroke. CASE DESCRIPTION: We describe a case of occlusive stroke in a 50-year-old man. A partial temporal lobectomy was done to remove infarcted tissue and to prevent brain stem compression as well as uncal herniation. A microdialysis probe was placed into the cortex to measure EAAs. Massively increased levels of glutamate and aspartate were detected in the extracellular fluid in this patient (> 300 times normal levels 6 days after infarction). CONCLUSIONS: These findings indicate that EAAs are tremendously increased in brain tissue after occlusive stroke. The time course of the release of EAAs is much longer than animal studies have suggested previously. Administration of EAA antagonists to patients with ischemic stroke may therefore be beneficial.

Aspartic Acid↗