摘要:

An epidemiological study was made of cerebrovascular disease in a bi-racial Southern community. The study population comprised about 3,000 men and women aged 15 to 75 years at the time of entry into the study. During the 87-month period between the initial and second examinations, 94 persons developed their first cerebrovascular event.The incidence of stroke among white men (4.77/1,000/year) was almost four times that in white women and more than twice that reported for white men in other sections of the country. The incidence rates of stroke in Negro men and women were equal (5.8/1,000/year).The risk factors predisposing to stroke in white men appeared to be severe hypertension, obesity, high hematocrit levels, and antecedent electrocardiographical abnormalities These factors were not as prominent among the other race-sex groups.The high incidence of cerebrovascular disease found in this semirural population of Georgia supports previous reports of increased mortality rates for stroke in this section of the country and represents a unique situation, the exact cause for which remains to be determined.

ISSN:0039-2499    

出版商:OVID    

年代:1971

数据来源: OVID

摘要:

The regional cerebral blood flow can be calculated from the initial slope of the logarithmically displayed clearance curve following intra-arterial injection of133Xe (rCBFinitial). The relationship between this parameter and the values resulting from stochastic (height over area) and compartmental analyses is extensively discussed. Experimental results demonstrate the theoretically expected close relationship between rCBFinitialand flow of gray substance (rCBFinitial20% to 30% lower than Fg). It is shown how the cerebral clearance curve (normally biexponential) with low flow values becomes gradually monoexponential. Thus only flow of gray substance changes, whereas flow of white substance is independent of CBF∞. CBF10was shown to overestimate CBF∞with about 15% independent of the flow level. Correlation between CBFinitialand CBF10was linear (r=0.98) at CBF10values above 20 ml/100 gm/min.The CBFinitialnormal value is found to be 64±9 ml/100 gm/min, and the interchannel coefficient of variation is 8.2%. A correction for remaining radioactivity from previous measurements is described. Using this, no significant difference was found between repeated resting state measurements.The CBFinitial-Paco2relationship was found to be best described as exponential. In a group of patients with various intracranial diseases, 1 mm Hg change in Paco2resulted in 4% change of CBFinitialquite independent of the CBFinitiallevel.

ISSN:0039-2499    

出版商:OVID    

年代:1971

数据来源: OVID

摘要:

The sites, sources, and incidence of cerebral embolization were established in an unselected series of hospitalized patients using recommended epidemiological criteria. Criteria for diagnosis of cerebral embolization as a cause of stroke are defined.Forty-two (15%) from a total of 280 patients with various forms of cerebrovascular disease were diagnosed as having cerebral embolization. The epidemiology has been altered by antibiotics and cardiac surgery, particularly the use of prosthetic heart valves. In this series, the mortality rate was 9.5%, which is lower than in previously reported series probably due to emergency medical treatment. The heart was the most common source. Prosthetic heart valves emerged as the most common source of emboli in this series. Ulcerated plaques of the carotid arteries in the neck ranked second. Seizures occurred in 42.8% of cases. The left cerebral hemisphere was involved approximately twice as frequently as the right one.Possible explanations based on the anatomy of the great vessels are described which predispose to embolization of the left carotid artery. Recommendations are suggested for preventing further embolization and for treatment of acute embolic cerebral infarction by the use of anticonvulsant drugs and hyperosmolar agents designed to reduce cerebral edema.

ISSN:0039-2499    

出版商:OVID    

年代:1971

数据来源: OVID

摘要:

Utilizing an in vitro method for activated and nonactivated whole blood clotlysis determinations, the antifibrinolytic effect of epsilon-aminocaproic acid therapy was evaluated. Initially, the induced antifibrinolytic activity diminished within two hours after the previous dose. Continuing therapy for three to six days resulted in sustained fibrinolytic inhibition.

ISSN:0039-2499    

出版商:OVID    

年代:1971

数据来源: OVID

摘要:

An unusual syndrome is described consisting of right hemiplegia, right hemisensory loss, mild naming disturbance, and severe alexia coupled with normal expressive language and ability to write. The clinical syndrome of alexia without agraphia strongly suggests involvement of the left posterior cerebral artery. A study of the territory of distribution of the posterior cerebral artery would appear to confirm the possibility that occlusion of this vessel could produce the entire symptom picture. Of particular interest was the unusual hemiplegia, involving both limbs and face equally, but with a minimum of spasticity.

ISSN:0039-2499    

出版商:OVID    

年代:1971

数据来源: OVID

摘要:

CSF lactic acid rises quickly and then gradually declines toward normal after severe cerebral ischemia in the dog. In animals in whom recovery can be postulated, the increase in lactic acid would appear to be transitory, and more severe insults produce higher levels. The increase in blood levels of lactic acid occurs more rapidly than that in the CSF, and the blood level returns to normal sooner than the CSF.

ISSN:0039-2499    

出版商:OVID    

年代:1971

数据来源: OVID

摘要:

Crowell RM, Olsson Y, Klatzo I, Ommaya AK: Temporary Occlusion of the Middle Cerebral Artery in the Monkey: Clinical and Pathological Observations. Stroke 1: 439–448 (Nov–Dec) 1970.The legends to figures 2 and 4 (page 442 and page 444) should be reversed.

ISSN:0039-2499    

出版商:OVID    

年代:1971

数据来源: OVID

摘要:

This is a study of 45 patients who underwent angiography and surgery of one or both carotid arteries (56 surgical procedures). All patients had detailed neuro-ophthalmological evaluations including determination of retinal artery pressure (RAP) and scrutiny for emboli in small vessels. Preoperatively, the absolute RAP value has a high correlation with the degree of stenosis of the ipsilateral carotid artery when that stenosis exceeds 80%. The asymmetry of RAP values is greatest when the stenosis is much more severe in one artery than in the other. Both RAP values may show an absolute decrease when the stenosis is severe bilaterally. In these patients, postoperatively there usually is not only an increase in the RAP on the side operated on but also on the side contralateral to the initial procedure. Almost without exception, RAP should be normal after carotid artery surgery. The finding of a subnormal RAP after operation demands immediate investigation.

ISSN:0039-2499    

出版商:OVID    

年代:1971

数据来源: OVID

摘要:

The orbicularis oculi reflex elicited by electrical stimulation of the supraorbital nerve was studied in 39 cases with vascular lesions of the brainstem (four mesencephalic, 14 pontine, 13 medullary and eight multilevel), six cases following severe anoxic episodes and two cases of traumatic brainstem lesions. The early reflex (normal latency: 10.6 ± 2.5 msec) was delayed in 20 out of 22 cases with pontine or multilevel brainstem strokes and in all the eight cases of anoxic or traumatic brainstem lesions. The direct (31 ± 10 msec) and consensual (32 ± 11 msec) late reflexes, analogously to the pupillary light reflex, were useful in distinguishing afferent, efferent, and other blocks. In all the seven comatose patients, the late reflex was virtually absent. However, a relatively normal early reflex was present in four of these. The findings of this study indicate that the brainstem conduction altered by vascular and anoxic lesions can be measured simply and objectively by the orbicularis oculi reflex. A delay of the early reflex is relatively specific to pontine lesions. The late reflex is not only altered by brainstem lesions but is also totally depressed in coma, presumably reflecting diffuse suppression in multisynaptic reticular system.

ISSN:0039-2499    

出版商:OVID    

年代:1971

数据来源: OVID

摘要:

Biochemical changes signaling irreversible damage in brain cells following hypoxia are incompletely understood. Disruption of membrane structure may play a role in this process. Lipids and long-chain fatty acids are important constituents of neural membranes and could serve as markers of membrane breakdown. The present study was undertaken to assess the brain lipid profile and the process of fatty acid elongation in adult rats subjected to hypoxia and unilateral carotid ligation. Following functional recovery from hypoxia, the brain lipids were analyzed in both hemispheres and disclosed a significant reduction of inositide glycerophosphatide (PI) and serine glycerophosphatide (PS). Mitochondrial fatty acid elongation was increased by more than 100% and the pattern of elongation more closely resembled that seen during myelination rather than maturity. Although the degree of brain hypoxia is not predictable in the rat model, the lipid alterations indicate a reparative process following a suppression of lipid metabolism during hypoxia. Delineation of biochemical processes signaling irreversible brain damage will await further studies on regional and subcellular changes.

ISSN:0039-2499    

出版商:OVID    

年代:1971

数据来源: OVID