1/7. Acute reversible cerebral arteritis associated with parenteral ephedrine use.cerebrovascular disorders in association with licit or illicit drugs have rarely been reported. We report a first case of stroke associated with the parenteral use of ephedrine. A 44-year-old woman underwent spinal anaesthesia for varicose vein surgery. She was usually treated with propranolol and occasionally with phenoxazoline. During anaesthesia, ephedrine was administered by the venous route because of arterial hypotension. She developed intracranial hypertension and focal cerebral deficits related to multiple haemorrhagic cerebral infarcts associated with a reversible beading appearance on angiography consistent with the diagnosis of acute cerebral arteritis. The role of ephedrine in this case is discussed beside other causes of acute cerebral arteritis.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/7. Failure to awaken after general anaesthesia secondary to paradoxical venous embolus.A patient is presented who failed to regain consciousness after an apparently uneventful nine-hour revision of a total hip replacement. There were no clinically important haemodynamic changes during the operation, and oxygen saturation, capnography and acid base balance were normal throughout. Postop CT of the head showed a large left MCA infarct with midline shift. At autopsy, the patient was found to have a previously unsuspected patent foramen ovale, and a venous embolus in the left internal carotid artery, which probably had originated from the periprostatic venous plexus with a large infarct in the distribution of the left anterior and middle cerebral arteries. The authors conclude that massive paradoxical venous emboli can occur during surgery with minimal haemodynamic changes.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |
3/7. Residual tactile sensitivity with self-directed stimulation in hemianaesthesia.A case of hemianaesthesia caused by right hemisphere stroke was found to have good sensitivity and cutaneous localisation when she touched her impaired hand with her good contralateral hand or with a probe held by that hand. The capacity did not depend solely upon movement or positioning of her right arm, and she could also discriminate whether her own left fingers, as opposed to someone else's inter-digitated fingers, were being touched, but only when she did the touching. Thus, the threshold of the impaired hand appeared to be markedly affected by active involvement of the contralateral limb in delivering the stimulus.- - - - - - - - - - ranking = 2.5keywords = anaesthesia (Clic here for more details about this article) |
4/7. Unilateral thermal anaesthesia.A patient is described who had a deep parieto-temporal haemorrhage. Following resolution, the patient exhibited contralateral hemi-anaesthesia limited to the temperature sense. The possible mechanisms are discussed.- - - - - - - - - - ranking = 2.5keywords = anaesthesia (Clic here for more details about this article) |
5/7. infarction in the territory of the anterior choroidal artery. A clinical and computerized tomographic study of 16 cases.Sixteen cases of the anterior choroidal artery syndrome are reported. In its completed form, this rare syndrome combines the triad of hemiplegia, hemianaesthesia, and homonymous hemianopia. CT examination confirms the diagnosis by revealing an area of reduced density situated in the posterior limb of the internal capsule, sparing the thalamus medially and encroaching upon the tip of the globus pallidus laterally, and corresponding to the distribution of the anterior choroidal artery. Incomplete forms of the syndrome are more frequent. Left-sided spatial neglect may accompany right-sided lesions, as may slight disorders of speech in left-sided lesions. Clinical-anatomical correlations are discussed.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
6/7. Visually induced central pain and arm withdrawal after right parietal lobe infarction.A 46 year old man with ischaemic infarction of the right parietal cortex had left hemianaesthesia when his eyes were closed. With eyes open, visual stimuli induced withdrawal of the arm and a burning pain in the numb side of the body. Visually induced central pain is a new clinical finding and may be related to damage of cells with anticipatory inhibitory function in the parietal association cortex.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
7/7. Unilateral convulsion after induction of anaesthesia with propofol.We report a case in which a 42-yr-old man suffered a unilateral convulsion immediately after i.v. injection of propofol, and was discovered subsequently to have an old contralateral cerebral infarct. This complication and the current information on the relationship between propofol and abnormal neurological activity are discussed.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |