Aetiology of Acute Hemiplegia in Childhood

Bickerstaff, Edwin R.

doi:10.1136/bmj.2.5401.82

Cited by 156 publications

(55 citation statements)

References 8 publications

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“…Air pictures, if carried out later, showed in hemiparetic cases a slight enlargement of the affected ventricle, often with " peaking " outwards towards the surface-such as is seen commonly after internal carotid lesions in childhood or later life (Bickerstaff, 1964).…”

Section: Previous Experiencementioning

confidence: 97%

Cerebral arterial insufficiency and oral contraceptives.

Bickerstaff¹,

Holmes²

1967

BMJ

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The question of whether there is an association between the use of oral contraceptives and cerebrovascular accidents has been bedevilled by the lack of accurate knowledge of the frequency (or rarity) of Because of the fallacy of trying to make a diagnosis of a cerebral thrombosis from the clinical picture alone, the criteria must be stated on which it was assumed that the patient had had an episode of cerebral arterial insufficiency. These criteria have been applied to all cases in the present study.

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Section: Previous Experiencementioning

confidence: 97%

Cerebral arterial insufficiency and oral contraceptives.

Bickerstaff¹,

Holmes²

1967

BMJ

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“…Varicella lesions have also been suggested to cause stroke via a local irritant effect in the region of the superior cervical ganglion, causing sympathetic stimulation (Ganesan and Kirkham, 1997). An inflammatory carotid arteritis with intimal damage, peripheral embolization, and cerebral lesions ranging from transient ischemia to infarction has been described in children with preceding throat infection (Bickerstaff, 1964).…”

Section: Physical and Circulatory Mechanismsmentioning

confidence: 99%

Inflammation and Infection in Clinical Stroke

Emsley

Tyrrell

2002

J Cereb Blood Flow Metab

202

126

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Summary:Stroke has enormous clinical, social, and economic implications, and demands a significant effort from both basic and clinical science in the search for successful therapies. Atherosclerosis, the pathologic process underlying most coronary artery disease and the majority of ischemic stroke in humans, is an inflammatory process. Complex interactions occur between the classic risk factors for atherosclerosis and its clinical consequences. These interactions appear to involve inflammatory mechanisms both in the periphery and in the CNS. Central nervous system inflammation is important in the pathophysiologic processes occurring after the onset of cerebral ischemia in ischemic stroke, subarachnoid hemorrhage, and head injury. In addition, inflammation in the CNS or in the periphery may be a risk factor for the initial development of cerebral ischemia. Peripheral infection and inflammatory processes are likely to be important in this respect. Thus, it appears that inflammation may be important both before, in predisposing to a stroke, and afterwards, where it is important in the mechanisms of cerebral injury and repair. Inflammation is mediated by both molecular components, including cytokines, and cellular components, such as leukocytes and microglia, many of which possess pro-and/or antiinflammatory properties, with harmful or beneficial effects. Classic acute-phase reactants and body temperature are also modified in stroke, and may be useful in the prediction of events, outcome, and as therapeutic targets. New imaging techniques are important clinically because they facilitate in vivo dynamic evaluation of tissue damage in relation to outcome. Inflammatory conditions such as giant cell arteritis and systemic lupus erythematosus predispose to stroke, as do a range of acute and chronic infections, principally respiratory. Diverse mechanisms have been proposed to account for inflammation and infection-associated stroke, ranging from classic risk factors to disturbances of the immune and coagulation systems. Considerable opportunities therefore exist for the development of novel therapies. It seems likely that drugs currently used in the treatment of stroke, such as aspirin, statins, and modulators of the renin-angiotensin-aldosterone system, act at least partly via antiinflammatory mechanisms. Newer approaches have included antimicrobial and antileukocyte strategies. One of the most promising avenues may be the use of cytokine antagonism, for example, interleukin-1 receptor antagonist.

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“…This paper also included three other children with ischaemic cerebral infarction following dental or throat infection. The postulated mechanism was a focal arteritis secondary to pharyngeal infection, resulting in intimal thrombosis and distal embolization (Bickerstaff 1964).…”

Section: Case Reportmentioning

confidence: 99%

“…Dissection of the internal carotid artery has been described as a rare complication of often apparently minor peritonsillar or lateral palatal trauma (Bickerstaff 1964, Sidhu et al 1996, most commonly in children who fall while holding a blunt object (such as a pencil) in the mouth. There is also some evidence that infection increases the risk of arterial dissection (Grau et al 1999).…”

Section: Case Reportmentioning

confidence: 99%