ISSN:0039-2499    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0039-2499    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0039-2499    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0039-2499    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

A case‐control analysis is used to examine the relation of cigarette smoking, hypertension and the risk of subarachnoid hemorrhage in men and women aged 35–64 years. 45 men and 70 women with subarachnoid hemorrhage were identified as part of a large community based study of stroke, and the controls, 1017 men and 569 women, came from a survey of cardiovascular risk factors conducted in the same community. Cigarette smokers, after adjusting for age, had a significantly increased risk of subarachnoid hemorrhage compared with nonsmokers with relative risks of 3.0 for men and 4.7 for women. The strength of the risk increased with the amount smoked. The association remained significant for each sex after adjusting for hypertension. Those who both smoked and had a history of hypertension had an increased risk of subarachnoid hemorrhage of almost 15 fold compared to those who neither smoked nor had been treated for hypertension. The estimated population attributable risk of subarachnoid hemorrhage associated with cigarette smoking (43%) was greater than that of hypertension (28%) in this population.

ISSN:0039-2499    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

To obtain information about the early changes of experimentally induced cerebral aneurysms in rats, the luminal surface of branching areas of their cerebral arteries was examined with a scanning electron microscope. At the branching sites of major cerebral arteries in the control animals, the intima just distal to the apex markedly protruded into the lumen forming a linear bank‐like intimal pad. Along and distal to this pad, there was a shallow long groove (juxta‐apical groove). Such grooves were much deeper and wider in experimental animals than those hi the control rats. By studying various stages of early aneurysmal changes, cerebral aneurysms were proven to develop from such grooves. In deep juxta‐apical grooves and small aneurysms, round regenerated endothelial cells with a large number of mkrovilli were diffusely present. Degenerated cells with balloons and craters were observed intermingled with such regenerated cells. Interendothelial gaps were also seen.The present study showed the complex structure of the apex of arterial bifurcation in rats, including bank‐like intimal pads. Such complex structures of the branching sites were considered to be responsible for the initiation of cerebral aneurysms due to endothelial injury possibly caused by turbulent flow there.

ISSN:0039-2499    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

A total of 462 patients (mean age 52 years) affected by reversible focal ischemic attacks (RIAs) were followed prospectively in 8 neurologic institutions in Italy for 4 years. All cases were evaluated with a cerebral angiography and 21 % of angiograms were normal. At the end of the follow‐up period the cumulated probability for death, stroke, cardiac event and new RIA was respectively 7%, 8%, 3% and 36%.The predictive value of the baseline characteristics of this series was evaluated by a mul tifactorial analysis which showed that RIA and stroke (specific cerebrovascular risk) were more likely to develop In patients with a history of more than one RIA and in those in whom multiple vascular territories were involved. Moreover, previous myocardial infarction, Intermittent claudkation, angina pectoris, time elapsed since the first attack, and duration and severity of the attack Itself were independently associated with general cardiovascular risk (death, stroke and myocardial infarction). We conclude that predictive factors, and thus also pathogenetic mechanisms, may be different for general cardiovascular risk and specific cerebrovascular risk in RIA patients.

ISSN:0039-2499    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

An objective, retrospective review of 358 carotid endarterectomies performed in the neurosurgical teaching units of the University of Toronto in the year 1982 demonstrated a perioperative stroke rate of 3.9% and a death rate of 1.5%.Most (82%) surgical neurological complications occurred after the immediate post‐operative period (24 hours). This high incidence of delayed stroke suggests that most perioperative strokes are embolic rather than hemodynamic. Careful operative technique and the use of anticoagulants and antiplatelet agents may be more important in preventing postoperative deficits than intraoperative monitoring and intraluminal shunting.Our figures and those of current published data indicate that a 5–6% combined morbidity and mortality should be expected in carotid endarterectomy. These data are critical both to decision making with the individual patient as well as in the planning of future carotid surgery trials.

ISSN:0039-2499    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Forty‐four studies of regional cerebral blood flow (rCBF), fractional oxygen extraction (rOER) and oxygen consumption (rCMRO2) were made on twenty‐five patients with recent internal carotid artery territory infarcts. The purpose was to study flow‐metabolism relationships in the contralaterai hemispheres, and to investigate whether contralaterai rCMRO2was depressed as a result of the recent infarcts. Two groups of controls were included for comparison – seventeen normal volunteers, and ten patients with proven extracranial cerebrovascular disease but without evidence of cerebral infarction. The results demonstrated that: 1) contralaterai hemispheric rCMRO2was less variable than regional oxygen availability (the product of rCBF and arterial oxygen content). This was due, in part, to the effect of individual variations in PaCO2on rCBF, but other uncontrolled factors, such as IntracraniaJ pressure, may have had influences. As a result, rCMRC2did not correlate with rCBF; 2) mean rCMROj in the contralaterai hemispheres was 12% lower than normal (a significant difference), but was not different from the value found in patients with extracranial vascular disease in whom there was no evidence of infarction or ischemia; 3) contralaterai rCMRO2did not correlate with the size of the infarct in the opposite hemisphere. It is conchided that rCMRO2cannot be inferred from rCBF measurements in uncontrolled human studies (as frequently done in the past), and that depression of contralaterai rCMRO2may have preceded infarction in the opposite hemisphere, a consequence of the previous influences of diseases that predispose to stroke.

ISSN:0039-2499    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The natural course of blood pressure (BP) was studied after emergency hospitalization in 209 consecutive stroke patients and as many age and sex matched controls. Histories of hypertension were more common among patients than controls (46% vs 26%). On admission 69% of the stroke group and 36% of the controls had BP 2: 170/100 mm Hg. In the first four days there was a spontaneous BP decline, which was greater the higher the initial values. During the whole hospitalization though, stroke patients with previous hypertension had the highest BP levels and previously normotensive controls the lowest.Even if WHO as well as the Joint Committee for Stroke have recommended cautious antihypertensive therapy in stroke patients with extreme hypertension, such therapy is not evaluated. If this is to be done, the present findings have to be taken into consideration. Stroke controls, matched according to the initial BP level, will thus be required.

ISSN:0039-2499    

出版商:OVID    

年代:1986

数据来源: OVID