摘要:

Case histories are reported of seven patients in whom the diagnosis of cerebellar (four) or pontine hemorrhage (three) was made by computerized axial tomography (CT). In all of the patients except two the diagnosis, established on the basis of a space-occupying high absorption lesion, was proved by either operation or autopsy. In the two remaining cases, the evolution on CT was typical for an intracerebral hematoma, i.e., the high absorption zone was transformed into an area of reduced density. It is concluded that CT is a highly reliable method for the diagnosis and location of posterior fossa hematomas. A CT syndrome, observed in four of the seven cases, is described consisting of a hydrocephalus with the tips of the posterior horns being filled with blood. This seems to be specific for a posterior fossa hematoma having penetrated into the fourth ventricle.

ISSN:0039-2499    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The characteristics of stroke in baboons produced by transcranial occlusion of the middle cerebral artery were studied by clinical examination and serial cinematographic studies, the animals being maintained for three years following the stroke. The characteristic deficit in all animals was an initial, fairly dense faciobrachial weakness with, in a few instances, some accompanying leg weakness for a few days, rapidly improving over the first few months. Some animals retained very evident arm weakness; most animals retained weakness of the face; the majority showed recovery of reaching and placing reactions and some movement in all joints ofthe upper limb, although fine movements of the fingers remained invariably impaired. Homonymous hemianopia, at least to attention, also appeared to be characteristic, but all of the animals recovered a normal gait and leaping was regained. The close correlation between this and human stroke appears to confirm that middle cerebral artery occlusion in the baboon is a reliable, repeatable and acceptable stroke model.

ISSN:0039-2499    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Blood flow in the hemispheres of baboons three years after middle cerebral artery occlusion has been assessed by the hydrogen clearance technique. Blood flow in the infarct itself varied from very low (8 ml/100 gm per minute) to very high (89 ml/100 gm per minute) values and, averaging the values for the infarct as a whole, it was impossible to distinguish average flows in the infarct from those of the normal hemisphere. Flow values in surrounding zones of the infarct remained significantly lower than those of comparable normal hemispheres, and, excluding the infarct, the mean average hemispheral blood flow was 35.2 ml/100 gm per minute. This indicates a significant reduction in flow in the cortex, subsequently shown histologically to be normal, compared with normal blood flow values for the baboon hemisphere. Autoregulation was lost in the infarct and impaired in surrounding tissue. CO2reactivity was grossly reduced in the hemisphere as a whole but was present in all areas, even occasionally in electrode placements within the infarct itself. After perfusion fixation of the head, pathological study of the area of infarction showed a fairly consistent distribution, the infarct itself consisting of many dilated blood vessels of non-capillary nature scattered among fibrous tissue in what was virtually a glial scar.

ISSN:0039-2499    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Amaurosis fugax (transient monocular blindness) is a symptom of retinal ischemia just as contralateral hemiparesis and sensory loss are symptoms of cerebral ischemia. These symptoms are produced by atherosclerotic stenosis of the carotid vessels at the ipsilateral carotid bifurcation and emboli from these areas causing focal, repetitive, retinal ischemia.A study of 31 endarterectomy patients was undertaken to see if eight patients with amaurosis fugax (25%) could be differentiated from 22 patients with transient cerebral ischemia. The patients with amaurosis fugax were found to be younger. They all had 75% or greater stenosis of the internal carotid artery at the bifurcation on the symptomatic side. They all had unilateral visual symptoms and these symptoms were relieved by surgery. The patients with amaurosis fugax were devoid of cardiac disease, while 45% of the cerebral ischemic patients had documented myocardial disease.Amaurosis fugax (transient monocular blindness) in the setting of clinically significant atheroslerosis of the carotid vessels is an indication for carotid endarterectomy.

ISSN:0039-2499    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Using the arteriovenous oxygen difference method autoregulation of cerebral blood flow (CBF) was tested in 16 long-term diabetics and eight control patients. Blood pressure was raise by angiotensin infusion and lowered by trimethaphan camsylate infusion, in some cases combined with head-up tilting of the patient. Regression analysis was carried out on the results in order to quantify autoregulatory capacity.In the control patients CBF did not vary with moderate blood pressure variations, indicating normal autoregulation. In four of the 16 diabetic patients CBF showed significant pressure dependency, indicating impaired autoregulation. The cause of impaired autoregulation in some long-term diabetics is believed to be diffuse or multifocal dysfunction of cerebral arterioles due to diabetic vascular disease. Other conditions with impaired autoregulation are discussed and compared with that seen in long-term diabetes.

ISSN:0039-2499    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The rCBF response to hypocapnia induced by active short-term hyperventilation was determined in the contralateral hemispheres of ten patients with acute unilateral cerebral infarction. Overall rCBF reduction occurred in only two patients. Regional or widespread abnormal responses to Paco2reduction manifested as either no change or a paradoxical increase in the rCBF were observed in eight patients. The hemispheric mean rCBF reduction following hypocapnia was diminished as compared with control subjects. Our findings suggest that an impairment of the chemical control of rCBF may occur in the non-infarcted hemisphere during the early period following the onset of cerebral infarction. The pathophysiological mechanisms which may underlie this abnormal rCBF reactivity to Paco2, reduction are considered.

ISSN:0039-2499    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

A 45-year-old woman is described who, during the two-year course of her illness, had abdominal pain, gastrointestinal damage, and hypertension. Platelet “white bodies’ also were seen to appear in her arterial circulation.

ISSN:0039-2499    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

A 54-year-old woman with transient global amnesia (TGA) was found to have digitalisinduced bradyarrhythmia with atrioventricular dissociation. The amnesia cleared only upon resolution of the arrhythmia. Cardiac arrhythmia has been postulated as a cause, but TGA in the setting of cardiac arrhythmia has not been documented previously. Cardiac arrhythmia should be excluded in patients with TGA, and TGA, a syndrome diagnosed on clinical grounds alone, must be recognized as one possible manifestation of treatable, potentially serious cardiac or cerebrovascular disease.

ISSN:0039-2499    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Two patients with left middle cerebral artery (MCA) distribution infarctions fulfilled the “hot stroke” criteria on sequential 99m Tc pertechnetate flow and static gamma camera studies. The radioisotopic finding of a paradoxical relative increased flow to the affected hemisphere correlated with serial angiography showing multiple MCA branch occlusions becoming patent with a vascular blush and early venous drainage. The angiographical finding of transient vascular occlusions suggests embolism. Using the present cases together with prior observations, some transient vascular occlusions can be diagnosed by finding an increase in relative radioisotopic flow to the involved hemisphere within a few days to weeks of the infarction. This finding should launch a search for a possible embolic source.

ISSN:0039-2499    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

In order to evaluate the pathogenetic importance of platelet aggregates in cerebrovascular disease, a platelet count ratio method was used to study 66 patients with transient ischemic attacks (TIAs). Thirty normal subjects and 22 patients without thromboembolic disorders were also included as controls. The mean platelet aggregate ratio of the TIA group was 0.75 ± 0.03 SEM which was significantly lower than that of normal subjects (0.90 ± 0.02) or patient controls (0.88 ± 0.01) (P < 0.01). Seventeen patients with TIA were then treated with aspirin (1,200 mg) and dipyridamole (200 mg) daily. The platelet aggregate ratios were normalized in 13 patients. Of four patients who did not respond to this regimen, one did respond to sulfinpyrazone. When sulfinpyrazone was discontinued, recurrence of symptoms was preceded by an increase in platelet aggregates. These findings suggest that platelet aggregates may play an important role in the pathogenesis of cerebrovascular insufficiency. The determination of platelet aggregates appears useful in selecting patients for antiplatelet therapy.

ISSN:0039-2499    

出版商:OVID    

年代:1975

数据来源: OVID