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Biomedical subjects

A Awada

Publications and source records attributed to A Awada.

At least 127 records · Page 7Linked to original sources
PubMed1990

[Wilson's disease in a Saudi Arabian female patient. Rapid changes in cerebral x-ray computed tomography].

Reports on Wilson's disease from Arab countries in the Middle East are rare, while the high frequency of consanguineous marriages should increase the prevalence of autosomal recessive diseases. The case of a 20-year old woman, born from first degree cousins in a relatively isolated area of Saudi Arabia, is reported. The presentation initially led to the diagnosis of catatonic schizophrenia but neurological deterioration occurred rapidly. Brain CT was normal 2 months after the clinical onset of the disease but showed necrosis of both putamens 15 months later. Diagnostic difficulties and the rapid brain CT changes are commented.

Adult↗
PubMed1989

[Isolated cheiro-facial formication caused by a thalamic hematoma].

A 25 year-old Saudi female patient presented with numbness of the left half of the face and the tongue and the left hand. Neurological and neuropsychological examinations were normal. Brain CT showed a small hematoma (5 to 7 mm diameter) of the right thalamus probably destroying or compressing the ventropostero-median and ventropostero-lateral thalamic nuclei. Thalamic hematoma has been reported only twice as a cause of pure sensory stroke. The absence of clinical signs together with the presence of symptoms, and the particular topography of the symptoms are discussed.

Adult↗
PubMed1988

[Dolichoectatic intracranial arteries. Association with aneurysms of the abdominal aorta].

Dolichoectatic intracranial arteries (DIA) have been given several names, e.g. fusiform aneurysms, dolichomega-arteries. It is not an uncommon condition and it raises interesting points: 1) symptoms and signs result from compression (cranial nerve palsies; hydrocephalus) from ischemic or hemorrhagic episodes; 2) the diagnosis is made easier with CT since the arterial wall is often calcified; 3) the pathophysiology has long been assumed to be atherosclerotic in nature, but controversial assumptions are discussed; 4) associated arterial abnormalities are common: one of our cases and approximately half of the post mortem reported DIA were associated with aneurysm of the abdominal aorta. Two cases are reported here: 1) A 56 y/o male presented with progressive gait disorder, deafness and ischemic episodes. CT showed DIA and hydrocephalus. DIA involved the basilar artery, both intracranial carotid arteries, the abdominal aorta and probably one renal artery. A ventriculo-atrial shunt was performed unsuccessfully. Post mortem findings are reported; 2) A 52 y/o male had suffered from trigeminal neuralgia for about one year and from trigeminal permanent pain for two weeks. He had developed left hemiparesis and dysarthria. DIA involved the basilar artery and the left intracranial internal carotid artery. The right internal carotid artery and the right vertebral artery were hypoplastic. Clinical, radiographical and pathophysiological features are reviewed.

Aorta, Abdominal↗
PubMed1986

[Tethered spinal cord and lipoma. Contribution of magnetic resonance imaging].

A 12 year-old boy was investigated for progressive deformity of the left foot developing over 2 years. The foot was hollow with equinus varus and claw toes. Signs of a lesion of left L5 and S1 roots were present and spina bifida at L5 was noted on X-rays. Magnetic resonance imaging (MRI) showed a tethered spinal cord associated with a lipoma at the level of the S1 vertebra. Modes of presentation and physiopathology of disorders related to tethered cords are reviewed and the diagnostic value of MRI is emphasized.

Child↗
PubMed1985

[Recurrent multiple paralysis of cranial nerves. Gougerot-Sjögren syndrome].

A 53 year-old woman presented with 6 episodes of recurrent cranial nerve palsies over seven years, each episode lasting several weeks. She had three episodes of diplopia, one of difficulty with swallowing, a left facial paralysis and two episodes of trigeminal sensory neuropathy. Sjögren's syndrome was diagnosed when the patient developed dryness of the eyes and mouth, 7 years after the first episode. The diagnosis was proved by biopsy of the accessory salivary glands, the presence of a hypergammaglobulinaemia and anti-tissue antibodies.

Cranial Nerve Diseases↗
PubMed1984

[Cavitary orthochromatic leukodystrophy in the adult. Oligodendroglial proliferation and inclusions].

A 41 year-old woman presented with two Grand Mal fits followed by progressive spastic paraparesis and intellectual impairment. After 18 months there was a remission which lasted for 4 years but thereafter inexorable progression of the disease and many fits led to a state of akinetic mutism. Death occurred nine and a half years after the onset of the illness. There was no family history. The neuropathological studies included light and electron microscopy of a cerebral biopsy and a complete post mortem examination. Myelin loss and cavitation of the white matter was associated with the presence of sudanophilic lipid and abundant cells at the periphery of the lesions. These cells had the characteristics of oligodendrocytes. The combination of sudanophilic leucodystrophy, cavitation of white matter and oligodendrocyte proliferation has previously been observed only in childhood.

Adult↗
PubMed1984

[Interatrial septal aneurysm. Echocardiographic diagnosis].

Interatrial septal aneurysm is a rare abnormality and can now be diagnosed by echocardiography. We report the case of a 52 year old woman in whom this condition was diagnosed after an embolic cerebrovascular accident. M mode recordings showed a linear echo in the left atrial cavity in early and mid systole. The aneurysm was directly visualised by 2D echo as a hemispherical bulge in the mid portion of the interatrial septum, which was mobile and had a to-and-fro motion between the two atria in relation to the different phases of the cardiac cycle. The diagnosis was confirmed by angiography, and at surgery. A feature of this case was the close correlation between echocardiographic, angiographic and operative findings. The pathogenesis of this type of aneurysm remains conjectural as does its role in the production of cerebral embolism, the evidence for which was circumstantial in the absence of other demonstrable causes and in the light of previously reported cases.

Angiography↗
PubMed1984

[Thoracic pain and arteriovenous fistula of the spinal cord].

A 58 year old man was admitted with a pseudo-coronary pain. Cardiological investigations (ECG, chest X-ray, enzymes) were normal. Pain however was exacerbated by movement, coughing and pressure over T4 to T10 vertebrae. On the 4th day, the patient developed a weakness of the right lower limb which worsened 15 days later. On examination there were in the right lower limb a combination of central (Babinski sign) and peripheral signs (diminished deep reflexes, loss of sensation to all modalities ipsilateral to the paralysis). Metrizamide myelography was within normal limits. Spinal angiography revealed a dural arteriovenous fistula draining into spinal veins, at the level of T5. Following the removal of the fistula, the pain disappeared and the other symptoms and signs improved.

Arteriovenous Fistula↗
PubMed1983

[Sociological effects of cerebrovascular accidents. What does the clinician expect from the epidemiologist?].

Epidemiological research has developed along two principal paths: determination of the prevalence and incidence of cerebrovascular accidents. In this respect, there is already a useful collection of data, though inadequate and, from a specifically French standpoint, new studies are required; research into risk factors, and in this area, also, available facts are sufficient to determine primary and secondary prevention strategies, though remain inadequate. The Authors suggest widening areas of epidemiological enquiry, in particular involving short, middle and long-term hospital stays, and family or community life following the accident. Mention is made of the value of developing socio-economic studies by methods of human capital and personal preferences.

Cerebrovascular Disorders↗
PubMed1983

[Dystonia musculorum deformans. Favorable effect of bromocriptine].

A 25 year-old woman suffered from a severe dystonia musculorum deformans since the age of 14. No similar cases were recorded in the family. Examination showed torsion spasm and a cogwheel phenomenon in both superior limbs. Signs disappeared on bromocriptine 22,5 mg/day then reappeared when dosages where progressively reduced. With 12.5 mg/day after 1 year of treatment, the patient leads a normal life including university studies.

Adult↗
PubMed1983

[Carotid dysplasias].

Fibro-muscular dysplasia is the principal dysplasia of the internal carotid artery (ICA). It mainly affects women and is usually diagnosed at about the age of 50. The best known lesions are segmental medial defects. They are often associated with other local (aneurysm) or general (mainly renal) malformations. Congenital factors probably play a very important part in its genesis. Ischemic cerebrovascular accidents (transient or permanent), or cerebral haemorrhage are the usual modes of presentation. The diagnosis may be suspected on ultrasonic examination but can only be confirmed by arteriography. Therapy is not standardised as the natural history has not been definitely established. Megadolicho-carotid artery, hypoplasia and other dysplasias of the ICA are briefly described and illustrated.

Arterial Occlusive Diseases↗
PubMed1983

[Images of acute intracranial arterial occlusions obtained by CT scan].

In 1 case of occlusion of the basilar artery and 1 case of occlusion of the left middle cerebral artery a CT Scan performed within 24 hours of onset showed a high density area corresponding to the segmental arterial occlusion. In both cases on repeat CT Scans 5 and 9 days after the onset the high density area had disappeared.

Adult↗
PubMed1982

[Giant aneurysm of both vertebral arteries. Drop-attacks (author's transl)].

A 79 year-old woman suffered from drop-attacks for 2 years. There were in addition disorders of swallowing. She then had a mild right hemiplegia. At age 81, she had a mild spastic quadriparesis with paresis of the right sterno-mastoid and trapezius muscles and of the right side of the tongue. She died from bronchopneumonia. At autopsy a giant aneurysm involving both vertebral arteries was present. This case exemplifies: 1) drop-attacks due to a lesion near the foramen magnum; 2) signs which may suggest an aneurysm of the posterior fossa; 3) an apparently very rare kind of aneurysm of the vertebral arteries.

Aged↗
PubMed1980

[Crossed plantar extension. A clinical and physiological study (author's transl)].

A 44 year-old man was examined for a slowly progressive left hemiplegia predominating on the lower limb. A left sign of Babinski was present. On the right side the plantar response was flexor. Stimulation of the right sole elicited a left extensor plantar response. CT Scan showed calcification sin the right paracentral lobule. The variations of the contralateral soleus H reflex when conditioned by a nociceptive stimulus applied on the right little toe were studied. No modification was seen. This contrasts with the facilitation observed in normal subjects and in patients with a lesion of the cerebral hemisphere not involving the paracentral lobule. It is suggested that this abnormality could contribute to the development of a crossed extensor plantar responses. Possible mechanisms of this phenomenon are briefly considered.

Adult↗
PubMedDate not supplied

A cranio-cervical malformation presenting as acute respiratory failure.

An 18-year-old, previously healthy male presented with bilateral pneumonia and acute respiratory failure with severe carbon dioxide retention. The presence of mild brainstem signs and hypoventilation led to the discovery of a platybasia, basilar invagination, and kinking of the medulla oblongata with early syrinx. He was operated upon but postoperatively was noted to have a mixed type of sleep apnea. This case illustrates the diagnostic challenge in acute respiratory failure in a previously healthy young person and the possible pathogenic mechanisms underlying it.

Adolescent↗
PubMedDate not supplied

The first-of-Ramadan headache.

This study was designed to estimate the frequency and characteristics of headaches occurring on the first day of Ramadan (Moslems' fasting month) and to determine possible causes. One hundred fifty copies of a specially designed questionnaire were distributed on the second day of fasting to a random sample of hospital staff. Completed questionnaires were obtained from 116 subjects (77%). Headaches were reported by 37 (41%) of the 91 persons who had fasted as compared to 2 (8%) of those 25 who did not fast (P = .002). The headache was of tension type in 78% of the cases. Headache frequency increased with the duration of fasting and affected mainly those prone to have headaches, more particularly of the tension type and the most important exogenous-associated factor was caffeine withdrawal. Other factors such as lack of sleep, hypoglycemia, and dehydration may have been contributory in a small number of cases. A progressive reduction of caffeine consumption in the weeks preceding the month of Ramadan and a cup of strong coffee just before the start of the fast may prevent the occurrence of first-of-Ramadan headache.

Adult↗