摘要:

Following an infarction in the right cerebral hemisphere, massive cerebral edema developed in a woman and led to a marked intracranial hypertension and to a progressive “uncal and central herniation.” The downhill course was reverted with a decompressive operation. Epidural pressure was monitored during the procedure and in the postoperative period. She showed progressive recovery from the initial motor, sensory, and visual field losses. Among 18 reported patients with cerebral infarction who underwent surgical decompression, 11 presented pupillary asymmetry, 14 were in stupor or coma, and 18 were either hemiplegic or hemiparetic preoperatively. Seven died following the operation. Among four cases of cerebellar infarction who underwent similar procedures, there were three survivors. Due to the lack of a controlled study the data available so far are not conclusive as to the beneficial effects of surgical decompression for cerebral or cerebellar infarcts. Some data of clinical relevance on cerebral edema and intracranial hypertension associated with cerebral infarction are reviewed.

ISSN:0039-2499    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

A method was devised to measure gray and white matter cerebral blood flow simultaneously in multiple regions of the brain using133Xenon and a multiple-crystal scintillation camera. Following magnification cerebral arteriography,133Xe was injected into the internal carotid artery and the washout of tracer was monitored with a scintillation camera which consists of 294 individually collimated NaI (TI) crystals. These data, obtained from each crystal overlying the brain, were processed by a weighted least-squares nonlinear regression technique. The blood flow rates of the rapid and slow compartments were calculated by the Kety-Schmidt formula along with 95% confidence limits for each measurement.In four patients, local increases or decreases in regional cerebral flow were correlated with areas of pathology. In one patient with a cerebral arteriovenous malformation, regions of local shunting of tracer were identified. Application of a three-compartment analysis to these curves permitted estimation of the magnitude of shunting along with gray and white matter flow in the lesion. The increased discrimination provided by the multiple-crystal camera and the estimates of measurement accuracy obtained by this mathematical analysis may facilitate more precise localization of regional blood flow abnormalities in intracranial disease.

ISSN:0039-2499    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

There have been numerous reports demonstrating electrocardiographical changes secondary to subarachnoid hemorrhage, consisting of atrial and ventricular arrhythmias, alterations in QRS configuration, Q-T interval prolongation, T-wave abnormalities, and S-T segment elevation or depression. Abnormalities of cardiac muscle and subendocardial hemorrhage have been seen in patients dying of subarachnoid hemorrhage. Experimental work has shown that electrical impulses in the sympathetic nervous system and hypothalamus produce most of these changes, and the implication is that these changes can be prevented by sympathetic blockade. Pulmonary edema also has been shown to occur frequently after subarachnoid hemorrhage, and again the sympathetic nervous system is implicated in the pathophysiology. Studies done illustrating these points are discussed and conclusions drawn with reference to therapy.

ISSN:0039-2499    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

An educational program for family members of patients experiencing a recent stroke is described. The educational sessions involve all members of the rehabilitation team in a round table discussion as well as a question and answer format. Surveys of family members indicate this educational process resulted in a decreased anxiety about stroke, improved communications with the staff and a more supportive role in the therapy of the patient. The group sessions also reduce the inefficiency of each staff member explaining his or her role on an individual basis.

ISSN:0039-2499    

出版商:OVID    

年代:1974

数据来源: OVID

摘要:

Our earlier studies revealed a weak alpha-adrenergic and beta-adrenergic activity of the cerebral vessels of the isolated perfused dog brain. The present investigations were undertaken to determine whether vascular adjustments occur in the cerebral circulation during longer periods of catecholamine infusions. The experiments were performed on six isolated canine brains cross perfused from donor dogs. Norepinephrine (2 μg per minute), epinephrine (2 μg per minute), and isoprenaline (0.2 μg per minute) were applied intra-arterially (i.a.) for a period of ten minutes. Total venous outflow, perfusion pressure in the circle of Willis, and venous O2saturation were monitored continuously. Cerebral vascular resistance (CVR) and cerebral O2consumption (CMRO2) were calculated. Based on the pressure-flow relationship tested in each brain, the indirect effects of catecholamines on CVR caused by autoregulatory influences were calculated and eliminated. During norepinephrine and epinephrine infusions cerebral blood flow (CBF) was found to be decreased by 10.2 ± 6.0% and 4.1 ± 3.3%, respectively, whereas during isoprenaline infusion CBF increased by 9.3 ± 3.6% (mean values ± SD). The maximal changes of CBF were reached in the first or second minute of catecholamine infusion and persisted up to the end of infusion (P > 0.05). After elimination of the indirect effects of catecholamines on CVR, the direct effects on CVR were reduced to about 50% of the original values and remained constant at the level reached during the whole period of infusion. CMRO2was not changed (P > 0.05) during infusion of the different catecholamines. Based on these investigations it is assumed that no pronounced vascular adjustments occur in the cerebral circulation during catecholamine infusions.

ISSN:0039-2499    

出版商:OVID    

年代:1974

数据来源: OVID

ISSN:0039-2499    

出版商:OVID    

年代:1974

数据来源: OVID

ISSN:0039-2499    

出版商:OVID    

年代:1974

数据来源: OVID