A 96-year-old Man with Consciousness Disturbance, Convulsion, and Left Hemiplegia of Acute Onset.
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Accession number;99A0252789
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| Title;A 96-year-old Man with Consciousness Disturbance, Convulsion, and Left Hemiplegia of Acute Onset. |
| Author;
KANAZAWA AKIRA
(Juntendo Univ., Sch. of Med.)
NODA KAZUYUKI
(Juntendo Univ., Sch. of Med.)
SUZUKI HIROMASA
(Juntendo Univ., Sch. of Med.)
OTA SATORU
(Juntendo Univ., Sch. of Med.)
MORI HIDEO
(Juntendo Univ., Sch. of Med.)
SUDA KOICHI
(Juntendo Univ., Sch. of Med.)
TAKUBO HIDEKI
(Juntendo Univ., Sch. of Med.)
MIZUNO YOSHIKUNI
(Juntendo Univ., Sch. of Med.)
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Journal Title;Brain Nerve
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Journal Code:Z0685A
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ISSN:0006-8969
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VOL.51;NO.1;PAGE.83-93(1999)
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| Figure&Table&Reference;FIG.10, REF.26 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;We report a 96-year-old Japanese man who developed a sudden onset of left hemiplegia and coma. He was found to have diabetes mellitus, hypertension, and atrial fibrillation since 1996 with occasional episodes of congestive heart failure. He was otherwise apparently well until July 5 of 1997 when he developed a sudden onset of unresponsiveness and convulsion involving his right hand and was admitted to our hospital. On admission, his BP was 210/120mmHg, heart rate 76/min and irregular, BT 36.5.DEG.C., and Cheyne-Stockes respiration. General medical examination was otherwise unremarkable. Neurologic examination revealed semicoma, conjugated deviation to the right, loss of oculocephalic response, left facial paresis of central type, flaccid left hemiplegia, and bilateral Babinski sign. Pertinent laboratory findings are as follows: BUN 47mg/dl, creatinine 1.46mg/dl, GPT 69IU/l, LDH 1,142IU/l, and CK 385IU/l. A chest x-ray film revealed cardiac enlargement and EKG showed left ventricular hypertrophy and atrial fibrillation. Cranial CT scan revealed low density areas involving the right anterior cerebral and the right posterior cerebral artery territories. He was treated with an intravenous osmotic agent and short course of intramuscular steroid. He remained unconscious despite these treatment and developed sudden cardiopulmonary arrest three weeks after the admission. The patient was discussed in a neurological CPC and the chief discussant arrived at the conclusion that the patient had suffered from cerebral embolism of cardiac origin. The cause of the death was ascribed to acute subendocardial myocardial infarction. Most of the participants agreed with this conclusion. Postmortem examination revealed all old subendocardial myocardial infarction involving the posterior septal region and posterolateral wall of the left ventricle.... (author abst.) |
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