Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
Πληροφορίες
Ετικέτες
Δευτέρα 27 Ιανουαρίου 2020
Basilar artery thrombosis during sexual intercourse.
Basilar artery thrombosis during sexual intercourse.:
Related Articles
Basilar artery thrombosis during sexual intercourse.
J Clin Neurosci. 2020 Jan 22;:
Authors: Posa A, Mueller T, Ungurs O, Kornhuber M, Zierz S
Abstract
An ischemic stroke during sexual intercourse is very rare. A basilar artery thrombosis during sexual intercourse has not been described previously. We report a young woman with a life-threatening basilar artery thrombosis during sexual intercourse, with a resulting locked-in syndrome. The positive high intensity transient signals (HITS) diagnosis showed a right-to-left shunt and is in line with paradoxic embolism. The molecular genetics revealed a homozygosity 4G/4G in the region PAI1, -675 (promoter polymorphism) as a risk factor for ischemic stroke. Sexual intercourse is a possible, albeit unusual stroke cause, especially in young people.
PMID: 31982277 [PubMed - as supplied by publisher]
Locked-in syndrome
From Wikipedia, the free encyclopedia
Jump to navigationJump to search
Locked-in syndrome
Other names Cerebromedullospinal disconnection,[1] de-efferented state, pseudocoma,[2] ventral pontine syndrome
Locked-in syndrome can be caused by a stroke at the level of the basilar artery denying blood to the pons, among other causes.
Specialty Neurology, Psychiatry
Locked-in syndrome (LIS), also known as pseudocoma, is a condition in which a patient is aware but cannot move or communicate verbally due to complete paralysis of nearly all voluntary muscles in the body except for vertical eye movements and blinking. The individual is conscious and sufficiently intact cognitively to be able to communicate with eye movements.[3] The EEG is normal in locked-in syndrome. Total locked-in syndrome, or completely locked-in state (CLIS), is a version of locked-in syndrome wherein the eyes are paralyzed as well.[4] Fred Plum and Jerome Posner coined the term for this disorder in 1966.[5][6]
Contents
1Signs and symptoms
2Causes
3Diagnosis
3.1Similar conditions
4Treatment
5Prognosis
6Research
7See also
8References
9Further reading
10External links
Signs and symptoms[edit]
Locked-in syndrome usually results from quadriplegia and the inability to speak in otherwise cognitively intact individuals. Those with locked-in syndrome may be able to communicate with others through coded messages by blinking or moving their eyes, which are often not affected by the paralysis. The symptoms are similar to those of sleep paralysis. Patients who have locked-in syndrome are conscious and aware, with no loss of cognitive function. They can sometimes retain proprioception and sensation throughout their bodies. Some patients may have the ability to move certain facial muscles, and most often some or all of the extraocular muscles. Individuals with the syndrome lack coordination between breathing and voice.[7] This prevents them from producing voluntary sounds, though the vocal cords may not be paralysed.[7]
Causes[edit]
In children, the most common cause is a stroke of the ventral pons.[8]
Unlike persistent vegetative state, in which the upper portions of the brain are damaged and the lower portions are spared, locked-in syndrome is caused by damage to specific portions of the lower brain and brainstem, with no damage to the upper brain.
Possible causes of locked-in syndrome include:
Poisoning cases – More frequently from a krait bite and other neurotoxic venoms, as they cannot, usually, cross the blood–brain barrier
Brainstem stroke
Diseases of the circulatory system
Medication overdose[examples needed]
Damage to nerve cells, particularly destruction of the myelin sheath, caused by disease or osmotic demyelination syndrome (formerly designated central pontine myelinolysis) secondary to excessively rapid correction of hyponatremia [>1 mEq/L/h])[9]
A stroke or brain hemorrhage, usually of the basilar artery
Traumatic brain injury
Result from lesion of the brain-stem
Curare poisoning mimics a total locked-in syndrome by causing paralysis of all voluntarily controlled skeletal muscles.[10] The respiratory muscles are also paralyzed, but the victim can be kept alive by artificial respiration, such as mouth-to-mouth resuscitation. In a study of 29 army volunteers who were paralyzed with curare, artificial respiration kept oxygen saturation above 85%,[11] a level at which there is no evidence of altered state of consciousness.[12] Spontaneous breathing is resumed after the end of the duration of action of curare, which is generally between 30 minutes[13] and eight hours,[14] depending on the variant of the toxin and dosage.
Diagnosis[edit]
Locked-in syndrome can be difficult to diagnose. In a 2002 survey of 44 people with LIS, it took almost 3 months to recognize and diagnose the condition after it had begun.[15] Locked-in syndrome may mimic loss of consciousness in patients, or, in the case that respiratory control is lost, may even resemble death. People are also unable to actuate standard motor responses such as withdrawal from pain; as a result, testing often requires making requests of the patient such as blinking or vertical eye movement.
Brain imaging may provide additional indicators of locked-in syndrome, as brain imaging provides clues as to whether or not brain function has been lost. Additionally, an EEG can allow the observation of sleep-wake patterns indicating that the patient is not unconscious but simply unable to move.[16]
Similar conditions[edit]
Amyotrophic lateral sclerosis (ALS)
Bilateral brainstem tumors
Brain death (of the whole brain or the brain stem or other part)
Coma (deep and/or irreversible)
Guillain–Barré syndrome
Myasthenia gravis
Poliomyelitis
Polyneuritis
Vegetative state (chronic or otherwise)
Treatment[edit]
Neither a standard treatment nor a cure is available. Stimulation of muscle reflexes with electrodes (NMES) has been known to help patients regain some muscle function. Other courses of treatment are often symptomatic.[17] Assistive computer interface technologies such as Dasher, combined with eye tracking, may be used to help people with LIS communicate with their environment.
Prognosis[edit]
It is extremely rare for any significant motor function to return. The majority of locked-in syndrome patients do not regain motor control. However, some people with the condition continue to live much longer,[18][19] while in exceptional cases, like that of Kerry Pink[20] and Kate Allatt,[21] a full spontaneous recovery may be achieved.
Research[edit]
New brain-computer interfaces (BCIs) may provide future remedies. One effort in 2002 allowed a fully locked-in patient to answer yes-or-no questions.[22][23] In 2006, researchers created and successfully tested a neural interface which allowed someone with locked-in syndrome to operate a web browser.[24]. Some scientists have reported that they have developed a technique that allows locked-in patients to communicate via sniffing.[25]
See also[edit]
Akinetic mutism
List of people with locked-in syndrome
References[edit]
^ Nordgren RE, Markesbery WR, Fukuda K, Reeves AG (1971). "Seven cases of cerebromedullospinal disconnection: the "locked-in" syndrome". Neurology. 21 (11): 1140–8. doi:10.1212/wnl.21.11.1140. PMID 5166219.
^ Flügel KA, Fuchs HH, Druschky KF (1977). "The "locked-in" syndrome: pseudocoma in thrombosis of the basilar artery (author's trans.)". Dtsch. Med. Wochenschr. (in German). 102(13): 465–70. doi:10.1055/s-0028-1104912. PMID 844425.
^ Duffy, Joseph. motor speech disorders substrates, differential diagnosis, and management. Elsevier. p. 295.
^ Bauer, G.; Gerstenbrand, F. & Rumpl, E. (1979). "Varieties of the locked-in syndrome". Journal of Neurology. 221 (2): 77–91. doi:10.1007/BF00313105. PMID 92545.
^ Agranoff, Adam B. "Stroke Motor Impairment". eMedicine. Retrieved 2007-11-29.
^ Plum, F; Posner, JB (1966), The diagnosis of stupor and coma, Philadelphia, PA, USA: FA Davis, 197 pp.
^ Jump up to:a b Fager, Susan; Beukelman, Dave; Karantounis, Renee; Jakobs, Tom (2006). "Use of safe-laser access technology to increase head movements in persons with severe motor impairments: a series of case reports". Augmentative and Alternative Communication. 22 (3): 222–29. doi:10.1080/07434610600650318. PMID 17114165.
^ Bruno MA, Schnakers C, Damas F, et al. (October 2009). "Locked-in syndrome in children: report of five cases and review of the literature". Pediatr. Neurol. 41 (4): 237–46. doi:10.1016/j.pediatrneurol.2009.05.001. PMID 19748042.
^ Aminoff, Michael (2015). Clinical Neurology (9nth ed.). Lange. p. 76. ISBN 978-0-07-184142-9.
^ Page 357 in: Damasio, Antonio R. (1999). The feeling of what happens: body and emotion in the making of consciousness. San Diego: Harcourt Brace. ISBN 978-0-15-601075-7.
^ Page 520 in: Paradis, Norman A. (2007). Cardiac arrest: the science and practice of resuscitation medicine. Cambridge, UK: Cambridge University Press. ISBN 978-0-521-84700-1.
^ Oxymoron: Our Love-Hate Relationship with Oxygen, By Mike McEvoy at Albany Medical College, New York. 10/12/2010
^ For therapeutic dose of tubocurarine by shorter limit as given at page 151 in: Rang, H. P. (2003). Pharmacology. Edinburgh: Churchill Livingstone. ISBN 978-0-443-07145-4. OCLC 51622037.
^ For 20-fold paralytic dose of toxiferine ("calebas curare"), according to: Page 330 in: The Alkaloids: v. 1: A Review of Chemical Literature (Specialist Periodical Reports). Cambridge, Eng: Royal Society of Chemistry. 1971. ISBN 978-0-85186-257-6.
^ León-Carrión, J.; van Eeckhout, P.; Domínguez-Morales Mdel, R.; Pérez-Santamaría, F. J. (2002). "The locked-in syndrome: a syndrome looking for a therapy". Brain Inj. 16(7): 571–82. doi:10.1080/02699050110119781. PMID 12119076.
^ Maiese, Kenneth (March 2014). "Locked-in Syndrome".
^ Locked-in syndrome at NINDS
^ Joshua Foer (October 2, 2008). "The Unspeakable Odyssey of the Motionless Boy". Esquire.
^ Piotr Kniecicki "An art of graceful dying". Clitheroe: Łukasz Świderski, 2014, s. 73. ISBN 978-0-9928486-0-6
^ Stephen Nolan (August 16, 2010). "I recovered from locked-in syndrome". BBC Radio 5 Live.
^ "Woman's recovery from 'locked-in' syndrome". BBC News. March 14, 2012.
^ Parker, I., "Reading Minds," The New Yorker, January 20, 2003, 52–63
^ Keiper, Adam (Winter 2006). "The Age of Neuroelectronics". The New Atlantis. pp. 4–41. Archived from the original on 2016-02-12.
^ Karim AA, Hinterberger T, Richter J, Mellinger J, Neumann N, Flor H, Kübler A, Birbaumer N. "Neural internet: Web surfing with brain potentials for the completely paralyzed". Neurorehabilitation & Neural Repair. 40 (4): 508–515.
^ "'Locked-In' Patients Can Follow Their Noses". Science Mag. 26 Jul 2010. Retrieved 27 Dec 2016.
Αναρτήθηκε από
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
στις
10:39 μ.μ.
Ετικέτες
00302841026182,
00306932607174,
alsfakia@gmail.com,
Anapafseos 5 Agios Nikolaos 72100 Crete Greece,
Medicine by Alexandros G. Sfakianakis,
Telephone consultation 11855 int 1193
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Αρχειοθήκη ιστολογίου
-
►
2023
(276)
- ► Φεβρουαρίου (133)
- ► Ιανουαρίου (143)
-
►
2022
(1976)
- ► Δεκεμβρίου (116)
- ► Σεπτεμβρίου (158)
- ► Φεβρουαρίου (165)
- ► Ιανουαρίου (161)
-
►
2021
(3661)
- ► Δεκεμβρίου (161)
- ► Σεπτεμβρίου (274)
- ► Φεβρουαρίου (64)
- ► Ιανουαρίου (368)
-
▼
2020
(4554)
- ► Δεκεμβρίου (400)
- ► Σεπτεμβρίου (381)
- ► Φεβρουαρίου (638)
-
▼
Ιανουαρίου
(691)
- Medicine by Alexandros G. Sfakianakis,Anapafseos 5...
- 49 journals
- MDPI
- MDPI
- Antioxidant potential of Sargassum horneri extract...
- Tuberculous Retropharyngeal Abscess
- Opioids and Cannabinoids for Osteoarthritis: Eithe...
- Risk factors for sepsis and associated mortality a...
- Microbiome Composition in Pediatric Populations fr...
- In vivo MRS measurement of 2‐hydroxyglutarate in p...
- Thirty-Day Hospital Readmissions in a Care Transit...
- Mammary Extranodal Rosai-Dorfman Disease With and ...
- Oral health-related quality of life in tumour pati...
- Regulation of immune cell metabolism by cancer cel...
- Recurrent RET Gene Fusions in Pediatric Spindle Me...
- Elevated levels of tumor apolipoprotein-D independ...
- Digital pathology for primary diagnosis of screen-...
- Aberrant von Willebrand Factor Expression of Sinus...
- Molecular basis and restoration of function defici...
- Evolutionary repression of chondrogenic genes in t...
- Protein scaffold involving MSMEG_1285 maintain cel...
- Human proteinase 3 resistance to inhibition extend...
- The role of regulatory T cells in allergic rhiniti...
- Videolaryngoscope-assisted coblation of epiglottic...
- Mid-term evaluation of perioperative i.v. corticos...
- Lymph node density as a predictive factor for wors...
- Intravenous immunoglobulin for suspected or proven...
- Intravenous immunoglobulin for preventing infectio...
- Baricitinib in Patients with Moderate-to-Severe At...
- The life cycle of cancer-associated fibroblasts wi...
- High Neutrophil Count as a Negative Prognostic Fac...
- Age-related structural alterations of skeletal mus...
- Printability of pulp derived crystal, fibril and b...
- Nasal septum deviation can be a normal variation a...
- New features in the management of labio-maxillo-pa...
- Psychological morbidity among forcibly displaced c...
- Effects of chronic low-dose aspirin treatment on t...
- Thrombosis among patients with JAK2V617F -mutated ...
- Economics of alternative dosing strategies for pem...
- Septicemia after chemotherapy for childhood acute ...
- Detection of perilymphatic fistula in labyrinthine...
- Role of the human papillomavirus in malignant tran...
- The Protective Effect of Echinochrome A on Extrace...
- Tools for Analysis of the Microbiome
- Retrograde Transvenous Obliteration (RTO): A New T...
- Diet and Gut Microbes Act Coordinately to Enhance ...
- Microbial-Based and Microbial-Targeted Therapies f...
- Theory and applications of differential scanning f...
- Design and Synthesis of Arf1-Targeting γ-Dipeptide...
- Asiatic Acid, Extracted from Centella asiatica and...
- Calcium Electroporation -A Novel Cancer Treatment ...
- Detection of early adenocarcinoma of the esophagog...
- Deaf patients with bi-allelic and mono-allelic GJB...
- Hypoglossal nerve stimulation therapy does not alt...
- White matter alteration and autonomic impairment i...
- Study Design Considerations for Sleep Disordered B...
- Utility of the modified Mallampati grade and Fried...
- The detection of Cryptococcus in skeletal infectio...
- Developing a virus-microRNA interactome using cyto...
- The Influence of ACE Inhibition on C1-Inhibitor: A...
- Cranio-Corpo-Graphy (CCG) is a medical investigati...
- Usefulness of Ultrasound-Computer-Craniocorpograph...
- Mid-term evaluation of perioperative i.v. corticos...
- Lymph node density as a predictive factor for wors...
- HPV16 is sufficient to induce squamous cell carcin...
- Stathmin guides personalized therapy in oral squam...
- Histological characteristics of early-stage oral t...
- Multi-Institutional Regional Otolaryngology Bootcamp.
- Are Children Scheduled for Ventilation Tubes Inser...
- Cerumen Management: An Updated Clinical Review and...
- Pou3f4-Expressing Otic Mesenchyme Cells Promote Sp...
- Antibiotic prescription rate for upper respiratory...
- Effect of Poguntano leaves extract (Picria fel-ter...
- Presentation of Infantile Hemangiopericytoma/Solit...
- Elucidating Molecular Interactions of Ten Natural ...
- Correlation between work impairment, scores of rhi...
- Study of the Expression Transition of Cardiac Myos...
- Medicine by Alexandros G. Sfakianakis,Anapafseos 5...
- Medicine by Alexandros G. Sfakianakis,Anapafseos 5...
- 63 JOURNALS
- MDPI
- MDPI
- MDPI
- Trends in nutritional intake and coronary risk fac...
- Efficacy and safety of interleukin‐17 inhibitors f...
- Identification of functional domains of the minor ...
- miR-331-3p Inhibits Proliferation and Promotes Apo...
- Teleassessment of Gait and Gait Aids: Validity and...
- Piezosurgery in Translabyrinthine-Approach Exposur...
- Performing MRI Scans on Cochlear Implant and Audit...
- High-Dose Furosemide Enhances the Magnetic Resonan...
- Anatomical and Functional Characterization in Chil...
- Metallothioneins conferring cardioprotection in pu...
- Reducing the progression of Alzheimer's disease in...
- Enhanced topical cutaneous delivery of indocyanine...
- Contrast-Enhanced Ultrasound-Guided Percutaneous B...
- Diagnosis of Acute Heart Failure Using Inferior Ve...
- The modified bipedicled flap for reconstruction of...
- Correlation between superficial and deep lymphatic...
- Immunological response of allogeneic bone grafting...
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου