Presentation
Abstract Three cases of bilateral anterior cerebral artery occlusion are presented with akinetic mutism. [ncbi.nlm.nih.gov]
Unique Presentation of Akinetic Mutism and Coexisting Thyroid Storm Relating to Stroke. [connection.ebscohost.com]
Callosal marginal artery: A commonly present terminal branch of the ACA, which bifurcates from the pericallosal artery. [fmritools.com]
Akinetic mutism and bilateral anterior cerebral artery occlusion Abstract Three cases of bilateral anterior cerebral artery occlusion are presented with akinetic mutism. [jnnp.bmj.com]
As two typical clinical features observed in previous cases, sudden onset headache and lower-extremity dominant hemiparesis were present on admission in the present case. [spandidos-publications.com]
Entire Body System
- Weakness
Health Science Center at Brooklyn has no relevant financial relationships to disclose. ) Originally released May 30, 2002; last updated April 1, 2019; expires April 1, 2022 This article includes discussion of anterior cerebral artery stroke syndromes, weakness [medlink.com]
Beside contralateral weakness, they had a clinical picture of extrapyramidal symptomatology, which was designated as pseudoparkinsonian syndrome (group 2). [ncbi.nlm.nih.gov]
Also check for a palmar drift or hand or arm weakness. Right side vs. left side Laterality of an MCA stroke determines additional signs and symptoms. [americannursetoday.com]
Paralysis or weakness of the contralateral foot and leg due to involvement of Motor leg area Cortical Sensory loss in the contralateral foot and leg Gait apraxia Impairment of gait and stance Abulia akinetic mutism, slowness and lack of spontaneity Urinary [fmritools.com]
- Inflammation
A Patient's Guide to Olecranon Bursitis Introduction Olecranon bursitis is inflammation of a small sac of fluid located on the tip of the elbow. This inflammation can cause many problems in the elbow. [midwestbonejoint.com]
There are three general causes of olecranon bursitis: Inflammation, such as from pressure on the bursa or from inflammatory conditions. This is the most common cause of olecranon bursitis. [healthlinkbc.ca]
It is also possible that the inflammation is due to infection, called septic bursitis. [physio-pedia.com]
Managing your inflammation. Bursa inflammation it best eased via ice therapy and techniques or exercises that de-load the inflamed structures. Your physiotherapist will use an array of treatment tools to reduce your pain and inflammation. [physioworks.com.au]
As previously stated, the superficial location of the olecranon bursa makes it susceptible to inflammation from acute or repetitive trauma. [emedicine.medscape.com]
Respiratoric
- Pneumonia
Case Report: A 32 year old woman with APL presented generalized edema, pneumonia, pulmonary edema, and pericardial effusion 3days after ATRA therapy. [e-jnc.org]
Causes of death included herniation of the brain in 1, sudden death in 1, pneumonia in 1 and septicaemia in 1. The median length of hospitalization was 12 days (25th–75th percentile, 10–24 days). [bmcneurol.biomedcentral.com]
Respiratory complications include aspiration, pneumonia, airway obstruction, hypoventilation, and atelectasis. Urinary complications include incontinence and urinary tract infections. [emedicine.medscape.com]
Gastrointestinal
- Constipation
Nutritional, metabolic, and gastrointestinal complications include stress ulcers, gastrointestinal bleeding, constipation, dehydration, electrolyte disturbances, malnutrition, and hyperglycemia. [emedicine.medscape.com]
Eyes
- Hemianopsia
Partially thrombosed aneurysm presenting as the sudden onset of bitemporal hemianopsia. Neurosurgery. 1988 Mar;22(3):564-6. PMID 3362325. ^ Johnson MK, O'Connor M, Cantor J. Confabulation, memory deficits, and frontal dysfunction. [en.wikipedia.org]
Click Image to Enlarge Clinical symptoms associated with occlusion of the posterior cerebral artery depend on the location of the occlusion and may include thalamic syndrome, thalamic perforate syndrome, Weber’s syndrome, contralateral hemplegia, hemianopsia [strokecenter.org]
For example, a blockage in the right middle cerebral artery will cause left hemianopsia or blindness in the left visual field of both eyes. [csuchico.edu]
[…] the posterior communicating artery posterior artery of the choroid plexus Therefore, the full clinical syndrome of contralateral hemiplegia in the form of (paralysis of the muscles on the opposite side), hemianesthesia (hypoesthesia) and gomonimnoy hemianopsia [minclinic.ru]
- Transient Blindness
Approximately 25% of clinically manifested occlusion (blockage of the lumen) of the internal carotid artery occasionally arises transient blindness in one eye. In the future a high probability of permanent blindness. [minclinic.ru]
Musculoskeletal
- Fracture
[…] or osteophyte findings swollen bursa, fracture, or olecranon spurs Studies Labs indicated only when septic bursitis is suspected ↑ white blood cell count ↑ erythrocyte sedimentation rate Needle aspiration of bursa with Gram stain and culture indication [step2.medbullets.com]
Traumatic fracture or calcification in gout or CPPD may be evident. Ultrasound May show a fluid collection in the olecranon bursa, features of synovial proliferation and/or hyperemia. [radiopaedia.org]
If the swelling is the result of an injury, X-rays may be necessary to determine whether the elbow is fractured. [healthlinkbc.ca]
If the patient reports elbow pain during active or passive ROM and if a history of trauma exists, this may increase the clinical suspicion of an olecranon process fracture.[1][2] Diagnostic Procedures Laboratory tests are essential to differentiate septic [physio-pedia.com]
The uric acid level should be checked in order to assess for gout. [7] Plain radiographs of the elbow should be performed to assess for a possible olecranon fracture if significant trauma occurred or if an avulsed osteophyte is present at the triceps [emedicine.medscape.com]
Neurologic
- Aphasia
Aphasia may be expressive (difficulty converting thoughts into language), receptive (difficulty understanding verbal and written language), or both. [americannursetoday.com]
[…] and cognitive impairment caused by anterior cerebral artery infarction. 61 Zhou XY...Zhang SQ 24165417 2013 12 Acute loss of bladder control in a stroke of the frontal cortex. 61 Woessner H...Barrett K 23983877 2012 13 Crossed transcortical motor aphasia [malacards.org]
NEUROVASCULAR SYNDROME Anterior Cerebral Arteries at their stems results in infarction of the anteromedial surface of the cerebral hemispheres: Paraplegia Incontinence Abulic and motor aphasia Personality change Contralateral grasp reflex. [meddean.luc.edu]
On admission, he was mute and abulic with receptive aphasia and bilateral lower limb weakness. [casereports.bmj.com]
Disturbance of judgment and/or emotion Transcortical motor aphasia (with dominant lesions) Non-dominant limb apraxia (with dominant lesions) Urinary dysfunction Middle Cerebral Artery Stroke The MCA is the largest of the intracranial cerebral vessels [casemed.case.edu]
- Neglect
[…] impairment caused by anterior cerebral artery infarction. 61 Zhou XY...Zhang SQ 24165417 2013 12 Acute loss of bladder control in a stroke of the frontal cortex. 61 Woessner H...Barrett K 23983877 2012 13 Crossed transcortical motor aphasia, left spatial neglect [malacards.org]
Neglect is most often associated with right-hemisphere strokes, so expect a patient with left-sided weakness to have neglect as well—and stay especially alert for this sign. [americannursetoday.com]
[…] disclose. ) Originally released May 30, 2002; last updated April 1, 2019; expires April 1, 2022 This article includes discussion of anterior cerebral artery stroke syndromes, weakness, extrapyramidal symptoms, sensory symptoms, gait apraxia, incontinence, neglect [medlink.com]
Contralateral homonymous hemianopia Gaze preference to the ipsilateral side of stroke Aphasia, global (dominant hemisphere) Neglect syndrome (non-dominant hemisphere) High risk of increased intracranial pressure, herniation and death Internal Carotid [casemed.case.edu]
- Irritability
The bursa in the elbow lies just beneath the skin, and its delicate membrane can be easily irritated and inflamed, leading to a condition called elbow bursitis. [arthritis-health.com]
This repeated injury can lead to irritation and thickening of the bursa over time. The chronic irritation leads to the same condition in the end: olecranon bursitis. The olecranon bursa can also become infected. [midwestbonejoint.com]
Too much pressure: Leaning your elbow against a hard surface over a long time can irritate the bursa. Plumbers, air-conditioning technicians, and others who have to work on their elbows are more likely to get this. [webmd.com]
The olecranon bursa is located on the elbow, and can become irritated and inflamed from a traumatic blow experienced or simply from being rubbed the wrong way. [pinnacle-ortho.com]
- Confusion
Method-Findings: A 66-year-old man who presented with drowsiness and confusion was diagnosed to harbor a giant ovoid (30×25 mm) aneurysm originating from the right A1. The aneurysm arose from the mid 3/5th of the artery and there was no neck. [link.springer.com]
Usually this leads to asymmetry in the size of the carotid artery as well, which sometimes generates confusion as regads potential dissection or long segment stenosis. [neuroangio.org]
Lacunes may be confused with other empty spaces, such as enlarged perivascular Virchow-Robin spaces (VRS). The VRS are extensions of the subarachnoid space that accompany vessels entering the brain parenchyma. [radiologyassistant.nl]
Confused language, or a language indicative of cognitive impairment, may also occur. The Middle Cerebral Arteries These large arteries have tree-like branches that bring blood to most of the lateral cortex of each cerebral hemisphere. [csuchico.edu]
- Receptive Aphasia
On admission, he was mute and abulic with receptive aphasia and bilateral lower limb weakness. [casereports.bmj.com]
Aphasia may be expressive (difficulty converting thoughts into language), receptive (difficulty understanding verbal and written language), or both. [americannursetoday.com]
Aboulia parietal lobe: Receptive aphasia Hemispatial neglect Gerstmann syndrome Astereognosis occipital lobe: Bálint's syndrome Cortical blindness Pure alexia temporal lobe: Cortical deafness Prosopagnosia Thalamus Thalamic syndrome Other Subclavian [en.wikipedia.org]
Workup
Workup Usually, laboratory studies are necessary only if the clinician suspects that an underlying condition is present. [emedicine.medscape.com]
Diagnostic Workup Physical Exam A unilateral distended bursa can be 6-7 cm long by 2.5 cm wide overlying the proximal ulna. Erythema is present in 63-100% of cases of septic bursitis and 25% of aseptic cases. [cancertherapyadvisor.com]
Treatment
Discussion ACA emboli may occur before or during intra-arterial treatment of an ICA or MCA occlusion. [ajnr.org]
Treatment of distal anterior cerebral artery aneurysms with the Pipeline Embolization Device. [scholars.northwestern.edu]
In the latter subjects we assessed the frequency of treatment-induced anterior cerebral artery emboli. [ajnrdigest.org]
Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med 2015; 372: 1019–1030. Google Scholar | Crossref | Medline | ISI 5. Pfaff, J, Herweh, C, Pham, M. [journals.sagepub.com]
More Invasive Treatments If these treatments fail to provide relief of symptoms, more invasive treatments may be considered. [verywellhealth.com]
Prognosis
Prognosis Patients with this bursitis tend to do very well with the conservative treatment, and as previously stated, only few patients ever tend to need surgical intervention. [pinnacle-ortho.com]
[…] repetitive trauma causes inflammation of the olecranon bursa septic bursitis infection from microorganisms transferred via trauma to the skin overlying the bursa Associated conditions rheumatoid arthritis crystalline diseases e.g., gout or pseudogout Prognosis [step2.medbullets.com]
Septic bursitis: presentation, treatment and prognosis. J Rheumatol 1987;14:1160-3. As cited in Reilly D, Kamineni S. Olecranon bursitis. J Shoulder Elbow Surg. 2016 Jan;25(1):158-67. doi: 10.1016/j.jse.2015.08.032. Epub 2015 Nov 11. Review. [arthritis-health.com]
Abstract Background Little is known about clinical features and prognosis of patients with ischaemic stroke caused by infarction in the territory of the anterior cerebral artery (ACA). [bmcneurol.biomedcentral.com]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
In this article, the authors provide a comprehensive description of the clinical manifestations, topographical distribution, etiology, and outcome of anterior cerebral artery stroke. [medlink.com]
Etiologies: Most often embolic from heart, aorta or the internal carotid artery. Rarely, due to intrinsic atherosclerotic disease of the ACA. [casemed.case.edu]
[…] the most common superficial bursitis location the bursa that overlies the olecranon process at the proximal aspect of the ulna risk factors sports diabetes uremia manual jobs with elbow use chronic hemodialysis requires prolonged pressure on the elbow Etiology [step2.medbullets.com]
Epidemiology
Introduction Clinical definition inflammation of the olecranon bursa septic or nonseptic Epidemiology demographics male >> female 30-60 years of age the most common superficial bursitis location the bursa that overlies the olecranon process at the proximal [step2.medbullets.com]
Olecranon Bursitis in a Military Population: Epidemiology and Evidence for Prolonged Morbidity in Combat Recruits. Mil Med. 2017 Sep;182(9):e1976-e1980. doi: 10.7205/MILMED-D-16-00402. PubMed PMID: 28885965. 6. Roschmann RA, Bell CL. [arthritis-health.com]
Similar in PUBMED :: Search Pubmed for Kothari M A Pathare A V Burkule N J Joshi V V Chikhalikar A A Dalvi S G :: Search in Google Scholar for Kothari M A Pathare A V Burkule N J Joshi V V Chikhalikar A A Dalvi S G ::Related articles Abnormalities epidemiology [jpgmonline.com]
[…] nonseptic bursitis. [3] Nevertheless this type of bursitis is less common. [1][2] However the olecranon bursa normally provides a mechanism with which the skin can glide freely over the olecranon process, consequently the bursa prevents tissue tears.[1] Epidemiology [physio-pedia.com]
American Society of Interventional Pain Physicians: Comprehensive review of epidemiology, scope, and impact of spinal pain. [neuro.psychiatryonline.org]
Pathophysiology
Gain fresh perspectives and up-to-date insights from the world’s leading authorities on the pathophysiology, diagnosis, and management of stroke. [books.google.com]
Along with usual causes of anomalous vasculature in such infarcts, we should always rule out possibilities of other pathophysiology including thrombosis and of course dissection as in our case. [casereports.bmj.com]
Posterior Cerebral Artery The posterior cerebral arteries stem in most individuals from the basilar artery but sometimes originate from the ipsilateral internal carotid artery [Garcia JH et al., In Barnett HJM at al (eds) Stroke Pathophysiology, Diagnosis [strokecenter.org]
Patients with similar clinical syndromes may have markedly different pathophysiologic profiles. [emedicine.medscape.com]
Prevention
Stay up to date on hot topics such as mechanisms of action of commonly used drugs, neuronal angiogenesis and stem cells, basic mechanisms of spasm and hemorrhage, prevention of stroke, genetics/predisposing risk factors, and much more. [books.google.com]
Efforts to prevent elbow bursitis are far preferable to treatments that may have side-effects and complications. For that reason, focusing on prevention is probably the most important step in treatment. Thanks for your feedback! [verywellhealth.com]
Certain exercises can help strengthen the muscles near the elbow to reduce pain and prevent problems in the future. Consult with a healthcare professional before trying elbow rehabilitation exercises. [healthline.com]
A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. N Engl J Med. 2005 Mar 31. 352(13):1293-304. [Medline]. [Guideline] Hughes S. New AHA/ASA Stroke Secondary Prevention Guidelines. [medscape.com]
The olecranon bursa is a subcutaneous sac that overlies the olecranon process and contains a small amount of fluid to prevent against injury of subcutaneous tissue and skin from the uncovered bony olecranon. [radiopaedia.org]