摘要:

Seven cases are reported in which extravasation of contrast medium from the lateral lenticulostriate artery was observed on cerebral angiography performed in the early stage of hypertensive intracerebral hemorrhage.We advance the theory that continuous bleeding from the ruptured artery with mechanical destruction and displacement of cerebral tissue is the cause of massive hematoma formation, and discuss the possibility of surgical treatment of the acute stage of hypertensive intracerebral hemorrhage.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Reperfusion of cerebral vessels is impaired following total cerebral ischemia of more than five minutes; this is possibly the initial factor responsible for neurological sequela. Failure of cellular ion transport mechanisms during ischemia was thought to lead to swelling of endothelial cells and perivascular glia and this, in turn, was thought to be the primary cause of the impairment of recirculation. A method of quantitating this circulatory impairment in rabbits was devised after infusing carbon black into the ischemic cerebral vasculature in a standardized way. The amount of circulatory impairment was shown to be unaffected by heparin, inversely related to the infusion pressure of the carbon black, and greatly reduced by acute hemodilution with saline. This latter observation does not support the theory that cellular swelling is the major cause of the postischemic vascular impairment, but rather implicates changes in the blood itself, possibly erythrocyte aggregation which is responsible for increased blood viscosity in low flow and no flow states.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Serial studies were made of glucose utilization and insulin and growth hormone secretion following intravenous glucose tolerance tests given to 16 patients during recovery from acute cerebrovascular disease. Three groups of patients were identified based on the pattern of change of glucose utilization during the first month of convalescence. A small group showed a persistent defective insulin response to glucose and appeared to have had pre-existing unrecognized adult-onset diabetes mellitus. The two other groups showed either an immediate suppression of glucose utilization or delayed development of glucose intolerance associated with an increase in total insulin secretion. Both of these responses returned to normal by the end of the fourth week. Growth hormone secretion correlated with the severity of the stroke. Alterations in glucose metabolism and insulin secretion seem to occur in most patients following recovery from stroke and undoubtedly reflect transient hormonal or metabolic changes related to either acute stress or tissue injury, depending on the interval after the onset of the vascular episode.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Ischemic infarction was obtained in the basal ganglia and internal capsule of the Rhesus monkey by clipping the middle cerebral artery at its origin through a transorbital approach.The postmortem microvasculature was demonstrated using microtized barium (Micropaque) and soft x-ray technology. The effects on this microvasculature induced by antemortem variations in Paco2in tne normal and the acutely infarcted animal were studied. Microangiography was shown to be useful in the study of dynamic vascular changes in the deep structures of the ischemic brain.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

The influence of aminophylline infusion into the internal carotid artery on cerebral blood flow (CBF) was studied in 12 patients. Six of them were studied using the N2O saturation technique of Kety and Schmidt, and the other six using the Xenon-133 intra-arterial injection method of Lassen and Ingvar. Intracarotid infusion of aminophylline resulted in a significant decrease of CBF. Previous studies have shown that aminophylline also reduced CBF when injected intravenously. Furthermore, in the present study it was demonstrated that a small dose of aminophylline which was without cerebral vasoconstricting effect when infused intravenously still reduced CBF when infused into the internal carotid artery. Thus aminophylline is a cerebral vasoconstrictor due to a local action on the cerebral vessels.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Hypocapnic-hyperventilation has a profound, but probably temporary, effect on CBF, producing approximately a 2% decline in CBF for each 1 torr decline in Pco2. This effect appears to be mediated through changes in perivascular pH of the cerebral resistance vessels acting directly on the vessel wall. At low Pco2the vasoconstrictor effect of short-term hypocapnic-hyperventilation is attenuated by resultant cerebral hypoxia. During prolonged hyperventilation CBF returns toward normal as the pH in the CSF is restored.Short-term hypocapnic-hyperventilation can be lifesaving in the treatment of acute intracranial hypertension. On the other hand,prolongedhyperventilation has not been convincingly shown to benefit patients, whether with severe head injury or cerebral infarction, or during carotid endarterectomy without bypass.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

The importance of hypoglossal nerve in performing carotid arterial reconstructions has been illustrated by two case reports. Unilateral palsy is troublesome but bilateral damage may result in upper airway obstruction. Simple surgical maneuvers consisting of division of the sternocleidomastoid artery and vein and freeing up of the descendens hypoglossus permit nontraumatic retraction of the nerve, avoiding tongue paralysis.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

The Committee on Criteria and Methods of the Epidemiological Council of the American Heart Association conducted a survey of epidemiological studies of stroke. A questionnaire was sent to investigators who were involved in stroke epidemiological research. Forty studies have been reviewed.Stroke epidemiological studies include a wide range of populations and geographic areas of the United States. Of the 12 prospective studies only five were primarily stroke-oriented, while the remaining initially involved the study of coronary artery disease.Relatively few stroke studies identify cases by clinical examination at the time of the stroke; most depend on examination sometime after the stroke, review of hospital records, physician's reports and patient interviews. In relatively few of the studies are the cases being examined by a neurologist.There is a need for better methods of stroke-case ascertainment, for standardized diagnostic techniques that can be used in field studies, and for the evaluation of specific disabilities following a stroke.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

A canine lingual-basilar system has been helpful to study the use of extracranial vessels for perfusion of the cerebral circulation. This experimental system was patent in all nine long-term animals and enlarged with time.The principles derived from this experimental investigation have been applied to six patients in whom the superficial temporal artery was used to enhance cerebral perfusion by anastomosis to a cortical branch of the middle cerebral artery. The first four patients have had follow-up arteriography which demonstrates patency of all five new vascular channels.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Cerebral arteriovenous (A-V) shunts have been described in some histological studies, but their existence has been denied in others. Previous attempts to detect the presence and amount of A-V shunting using radioactive microspheres have suggested that large amounts of blood could bypass cerebral capillaries in this fashion. A reappraisal seemed indicated.The present study, using the radioactive microsphere technique, confined the injected spheres specifically to the cerebral circulation of a nonhuman primate. The conclusion of this study is that structural, noncapillary A-V shunting definitely occurs, but is very small and variable in amount.The implications of this finding in relation to previous studies and to the clinical phenomena of red cerebral veins and early venous filling are discussed.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID