ISSN:0039-2499    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0039-2499    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0039-2499    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Thirty-two patients with acute cerebral infarction received either prostacyclin or placebo intermittently for 65 hours. Pulse and blood pressure were not altered by prostacyclin. After infusion there was no change in infarct volume or cerebral blood flow in either group. After normalisation for starting values, age and site of cerebral infarction there was a >10% improvement in speech in the prostacyclin group, but minimal changes in neurological score or disability status. Age is related to neurological score at 14 days after stroke by decreasing improvement by 6.8% for each additional 10 years.This study has not been able to demonstrate that prostacyclin is effective in the treatment of ischaemic stroke, but due to the sample size the chance of proving this statistically (the power) was small. Similarly any conclusion that prostacyclin is not effective may be wrong becauses of the Type II error probability being high.

ISSN:0039-2499    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

As part of an on-going longitudinal study, 7895 men of Japanese ancestry living on the island of Oahu, aged 45–68 and free of evidence of prior stroke at entry examination, have been followed by reexaminations and surveillance. During ten years of follow-up 154 men developed thromboembolic stroke, 65 developed intracranial hemorrhage, and 19 developed stroke of unknown type. There were 79 deaths attributed to stroke. The independent risk factors for thrombo-embolic stroke were elevated blood pressure, glucose intolerance, age, electrocardiographic evidence of left ventricular hypertrophy or strain, cigarette smoking and proteinuria. Attributes associated with increased risk of intracranial hemorrhage were age, elevated blood pressure, cigarette smoking, serum uric acid and, inversely, serum cholesterol level. Electrocardiographic evidence of left ventricular hypertrophy or strain significantly increased the risk of cerebral hemorrhage, but was not associated with subarachnoid hemorrhage.In univariate analysis, there was an inverse relation between dietary fat intake and thrombo-embolic and total stroke incidence. An inverse relation was also shown between protein intake and total stroke incidence. These dietary relations became statistically not significant in multivariate analysis. No relation was found between salt intake and the incidence of stroke.

ISSN:0039-2499    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

This report summarizes the protocol of a randomized trial of superficial temporal arterymiddle cerebral artery (STA-MCA) bypass procedure and presents the entry characteristics of its patients. The trial has been designed to determine whether this EC/IC bypass reduces the rate of subsequent stroke among patients with recent hemispheric or retinal strokes and/or transient ischemic attacks who have angiographically proven atherosclerotic narrowing or occlusion of the ipsilateral internal carotid or middle cerebral artery.Of the 1377 eligible patients entered from the 71 participating centers, 714 (52%) have been assigned to medical treatment alone (daily aspirin and aggressive hypertension control) while 663 (48%) have been assigned to receive STA-MCA bypass in addition to medical therapy. The two treatment groups have been well balanced for important prognostic factors. Bypass patency rates of 95% have been documented. At the end of the study in mid-1985, an average follow-up of five years and a minimum follow-up of 33 months will have been achieved.On both clinical and methodologic grounds, this study will have provided a rigorous test of the STA-MCA bypass procedure.

ISSN:0039-2499    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The Persantine® Aspirin Trial focused on the question of whether the administration of the combination of aspirin and dipyridamole (Persantine) would result in a lower incidence of cerebral or retinal infarction or death than the administration of aspirin alone for persons with a history of recent carotid territory transient ischemic attacks (TIAs).Fifteen centers in the United States and Canada participated and 890 individuals were admitted and randomly allocated to either aspirin (325 mg) plus placebo or aspirin (325 mg) plus Persantine (75 mg) four times daily. Ninety eight percent of the subjects were followed for at least one year; many were followed for four to five years.The results of life table analysis indicate that the overall endpoint rates for the “aspirin only” and “aspirin plus Persantine” groups are identical. Thus, for TIA patients taking aspirin, the addition of Persantine contributes nothing. There was a clustering of stroke endpoints during the first month after randomization. Deaths from all causes were essentially equally divided between the two treatment groups.

ISSN:0039-2499    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Four hundred and thirty-eight patients who had suffered a thromboembolic stroke not less than two weeks or more than four months previously, were entered into a placebo-controlled randomized clinical trial to determine whether suloctidil (200 mg t.i.d.) would influence the subsequent recurrence of stroke, the occurrence of myocardial infarction, or cardiovascular death.The two treatment groups were comparable at baseline with respect to important prognostic variables and there was good adherence to the study protocol during an average follow-up of 20 months. Significantly more patients complained of side-effects in the suloctidil group and more hepatotoxicity was also reported in the suloctidil group. Four cases of clinical hepatitis were suspected to be due to suloctidil, each of which was reversible on termination of study treatment; relative increases in SGOT and SGPT at three months in the suloctidil group were found to be mild and transient.The primary analysis of efficacy was based on the incidence of the first event of stroke, myocardial infarction or cardiovascualr death, but excluding events that occurred more than 28 days after complete withdrawal from study medication for whatever reason. Thus, the primary analysis included 38 events in the suloctidil group and 47 in the placebo group (p = 0.17) representing a risk reduction of 24%. If total mortality is substituted for cardiovascular death, the corresponding figures are 47 in the suloctidil group and 58 in the placebo group (p = 0.08). There were interesting differences seen in an analysis of cardiovascular mortality alone (p = 0.06), and total mortality alone (p = 0.04), and specifically in terms of cardiac death where there were 15 deaths in the placebo group and only five in the suloctidil group. A total of 31 patients in the suloctidil group had a recurrence of stroke, fatal or non-fatal, compared with only 28 in the placebo group. As might be expected, the absolute differences in outcomes in the two treatment groups were similar, but statistically less impressive, when analyzed on an intention-to-treat basis.Thus, there is no evidence of benefit of suloctidil in preventing the recurrence of stroke, but in view of the observed difference in cardiac death further studies with suloctidil may be warranted.

ISSN:0039-2499    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Twenty five patients with manifestations of cerebrovascular ischemic disease were evaluated with high resolution computed tomography of the neck, following intravenous infusion of a contrast agent. Computed tomography images of extracranial carotid arteries revealed atherosclerotic plaque formations and their complications: stenosis, occlusion, ulceration, calcification and mural lucent defects. Histologic analysis of 15 endarterectomy specimens obtained from symptomatic patients who had computed tomography images of discrete lucent defects in carotid plaques demonstrated subintimal hemorrhage of varying age in 13, focal necrosis in 1 and excessive subintimal thickening in 1. It is concluded that lucent images observed in computed tomography of extracranial carotid arteries represent vascular wall lesions within carotid plaques suggestive of subintimal hemorrhage, focal necrosis and/or excessive subintimal thickening. Computed tomography of the extracranial carotid arteries is a relatively non-invasive method that permits the diagnosis of plaque hemorrhages in symptomatic and asymptomatic carotid arteries.

ISSN:0039-2499    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Cerebral ischemic events associated with arteriography are usually attributed to catheterinduced emboli. We present three patients with cerebral ischemia occuring 6 to 48 hours post-arteriography. We suspected that alternate pathogenic mechanisms were in effect. To evaluate the possibility that sustained platelet activation occurs in association with arteriography, we measured the platelet-specific protein beta thromboglobulin (BTG) prior to and 24 hours following arteriography in two groups of patients. Group I had arteriography performed shortly after venipuncture, while Group II patients did not have arteriography between samples. Seven of eight Group I patients had an increase of BTG on day two, compared with two of eight group II patients (p<05). When compared to Group II changes, Group I had a significant increase of BTG on day two (p<·05). We conclude that cerebral ischemic events associated with arteriography may occur on a delayed basis, and that platelet activation, manifested by increased BTG levels, may be one mechanism contributing to this phenomenon.

ISSN:0039-2499    

出版商:OVID    

年代:1985

数据来源: OVID