Artery encephalopathy

Suggested Alternatives for Differential Diagnosis Meningitis, basilar artery blood clots (thrombosis), cardioembolic stroke, cavernous sinus syndromes, cerebral venous blood clots (thrombosis), confusional states and acute memory disorders, epileptic and epileptiform encephalopathies, febrile seizures, haemophilus meningitis, intracranial hemorrhage, leptomeningeal carcinomatosis, subdural pus (empyema), or bruise (hematoma). 

The possibility of cerebrovascular action of PCP was raised by the development of focal seizures and hemiparesis in a 6-year-old boy who had ingested what was presumed to be PCP (18). Hypertensive encephalopathy with a blood pressure of260/160 occurred in an 18-year-old woman who used PCP (43). These clinical findings are compatible with in vitro studies indicating that cerebral artery spasms can be produced by PCP as well as by LSD and mescaline (4). Whether such cerebrovascular actions are pertinent to the mental effects of these drugs is questionable. 

Ibrahim et al. 1963). Aiken and Braitman (1989) determined that cyanide has a direct effect on neurons not mediated by its inhibition of metabolism. Consistent with the view that cyanide toxicity is due to the inability of tissue to utilize oxygen is a report that in cyanide-intoxicated rats, arterial p02 levels rose, while carbon dioxide levels fell (Brierley et al. 1976). The authors suggested that the low levels of carbon dioxide may have led to vasoconstriction and reduction in brain blood flow therefore, brain damage may have been due to both histotoxic and anoxic effects. Partial remyelination after cessation of exposure has been reported, but it is apparent that this process, unlike that in the peripheral nervous system, is slow and incomplete (Hirano et al. 1968). The topographic selectivity of cyanide-induced encephalopathy may be related to the depth of acute intoxication and distribution of blood flow, which may result in selected regions of vascular insufficiency (Levine 1969). 

Susac s syndrome is a rare triad of branch retinal artery occlusions, hearing loss and microangiopathy of the brain causing a subacute encephalopathy, almost always in women (Gross and EUashar 2005). 

Adverse effects. A dose-dependent increase in arterial blood pressure follows the rise in red cell mass and encephalopathy may occur in some previously hypertensive patients. Arteriovenous shunts of dialysis patients, especially those that are compromised, may thrombose as a result of increased blood viscosity. 

Owing to the multitude of factors interfering with the ammonia concentration as well as to the multifactorial pathogenesis of hepatic encephalopathy (HE), it is understandable that there is no correlation between the levels of ammonia and the prevailing HE stage. Nevertheless, a hyperammonia syndrome is generally presumed if concentrations in the venous or arterial plasma reach 135-170 4g/dl. A value of > 150 gg/dl can be attributed to coma stage I. Here, the arterial ammonia level correlates better with HE than do the values found in venous blood, (s. pp 56, 266)... 

Encephalopathy can be triggered by (7.) degenerative causes (cerebral sclerosis, arterial hypertension, diabetes, etc.), (2.) hypoxaemia (chronic cardiac insufficiency, constrictive pericarditis (2), respira-... 

The clinical situation deteriorates rapidly febrile temperatures and leucocytosis as well as subicterus are observed there are also signs of encephalopathy. An arterial murmur can often be heard on auscultation, since the tumour is mainly supplied with blood from the hepatic artery. A sudden blossoming of vascular spider naevi is frequently seen with underlying cirrhosis. Virchow s lymphadenopathy may be present. (84) Fever and leucocytosis frequently occur in tumour necrosis. Clinical findings include ... 

Ciclosporin-induced encephalopathy was precipitated by diltiazem in a 76-year-old white woman with corticosteroid-resistant aplastic anemia and thrombocjdope-nia, type 2 diabetes, and coronary artery disease, who was taking diltiazem for hypertension (28). She became comatose after 13 days of therapy with ciclosporin, and clinical examination and electroencephalography showed diffuse encephalopathy of moderate severity. Ciclosporin was withdrawn and she regained consciousness after 36 hours. 

Transient contrast encephalopathy has been reported after carotid artery stenting (88). 

Dangas G, Monsein LH, Laureno R, Peterson MA, Laird JR Jr, Sailer LF, Mehran R, Leon MB. Transient contrast encephalopathy after carotid artery stenting. J Endovasc Ther 2001 8(2) 111-13. 

Excessive exposure to environmental pollution (e.g. exhaust fumes), ultraviolet light or cigarette smoke and illness can cause the body to produce harmful radicals. It has been estimated, for example, that 1014 radicals, which include NO and N02 are present in one puff of cigarette smoke. Left unchecked, destructive radicals can lead to a number of diseases in humans, including arthritis, cancer and Parkinsonism. Radicals may also start the damage that causes fatty deposits in the arteries, leading eventually to heart disease or a stroke, and experimental work points to the role of radicals in bovine spongiform encephalopathy(BSE). 

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