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PubMedDate not supplied

[Vascular complication disclosing lung cancer in children].

Stroke are not as rare in pediatric patients as once suspected. Exhaustive diagnostic evaluation must be performed, to identify a cause, evaluate risk factors of recurrence and propose preventive treatment. We report a case in a teen-ager secondary to cerebral embolism. These embols have an exceptional origin: pulmonary venous thrombosis, secondary to undifferentiated sarcoma located in the lung and extended to pulmonary vein. Stroke by cerebral embolism are not always originated from heart disease, and may be misdiagnosed only transthoracic echocardiography is realised.

Adolescent↗
PubMed1978

The Harvard Cooperative Stroke Registry: a prospective registry.

Data from 694 patients hospitalized with stroke were entered in a prospective, computer-based registry. Three hundred and sixty-four patients (53 percent) were diagnosed as having thrombosis, 215 (31 percent)as having cerebral embolism 70 (10 percent) as having intracerebral hematoma, and 45 (6 percent) as having subarachnoid hemorrhage from aneurysm or arteriovenous malformations. The 364 patients diagnosed as having thrombosis were divided into 233 (34 percent of all 694 patients) whose thrombosis was thought to involve a large artery and 131 (19 percent) with lacunar infarction. Many of the findings in this study were comparable to those in previous registries based on postmortem data. New observations include the high incidence of lacunes and cerebral emboli, the absence of an identifiable cardiac origin in 37 percent of all emboli, a nonsudden onset in 21 percent of emboli, and the occurrence of vomiting at onset in 51 percent and the absence of headache at onset in 67 percent of hematomas.

Cerebral Hemorrhage↗
PubMedDate not supplied

Clinical versus C.T. scan diagnosis in stroke--a comparative study of 50 cases.

BACKGROUND: Cerebrovascular disease is one of the three leading causes of death in the world along with cancer and heart disease. Differentiation between cerebral infarction and intracerebral haemorrhage is important because now a days proper management of the acute stroke syndrome is based on the correct diagnosis of the pathological type. This study compared clinical and C.T. scan diagnosis of stroke and determined the reliability of the clinical diagnosis in cases of stroke. METHODS: This study was conducted on 50 patients of stroke at Postgraduate Medical Institution, Lady Reading Hospital, Peshawar from Jan 1995 to May 1996. Clinical diagnoses were made in conformity with criteria for clinical diagnosis of intracranial haemorrhage, cerebral infarction due to embolism or thrombosis. The clinical diagnosis was then compared with the CT diagnosis. RESULTS: We found that from careful history and clinical examination differentiation could be made between cerebral infarction and haemorrhage. In our study at Government Lady Reading Hospital, cerebral hemorrhage accounted for 42% of cases of stroke and cerebral infarction in 58%. CONCLUSIONS: In order to make a clinical diagnosis of stroke, a detailed history and thorough clinical examination is mandatory. As far as treatment planning is concerned clinical diagnosis of stroke is not safe enough as a guide for anticoagulant or thrombolytic therapy. In order to confirm the aetiological diagnosis of stroke one must rely on C.T. scan examination.

Adolescent↗
PubMed1998

Evaluation of acute mental status change in the nonhead injured trauma patient.

Acute mental status change in the first 24 hours after trauma is uncommon in nonhead injured patients who initially present with a normal sensorium. Although arterial hypoxemia is the classic etiology for such a mental status change, three less common etiologies should always be considered: cerebral fat embolism, blunt carotid artery injury, and vertebrobasilar artery thrombosis. Prompt diagnosis and appropriate treatment can significantly improve patient morbidity and mortality. Three nonhead injured trauma patients are described illustrating cerebral fat embolism, blunt carotid artery injury, and vertebrobasilar artery thrombosis as causes of acute mental status change. Each patient initially presented with a clear sensorium, but subsequently developed neurological deficits within 24 hours after admission. All had a normal admission CT scan of the head. MRI or conventional arteriography was diagnostic in each case. Any patient who is initially lucid and subsequently develops a neurological deficit, or a patient whose neurological status does not correlate with brain CT findings should undergo immediate evaluation for possible cerebral fat embolism or cervical vessel injury. An algorithm for management of nonhead injured trauma patients with acute mental status deterioration is presented.

Accidents, Traffic↗