摘要:

The effects of intravenous tranexamic acid were compared with placebo in 64 patients with subarachnoid hemorrhage. A double-blind procedure was used. One gram of tranexamic acid was given intravenously every 4 hours up to the time of operation on an intracranial arterial aneurysm or for up to 21 days after the first bleeding if operative treatment was not feasible. There were no differences in re-bleeds, morbidity or mortality between the tranexamic and placebo-treated groups. No thromboemboiic complications were noted in either group. Our results do not support the use of tranexamic acid in subarachnoid hemorrhage in daily doses of 6 g.

ISSN:0039-2499    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

In a previous study occlusion of a middle cerebral artery (MCA) followed by 48 h of hypothermia (29°) was lethal in 5 of 5 monkeys as compared to only 3 of 9 normothermic animals. The present study extended these observations in monkeys and cats with or without MCA occlusion. In monkeys MCA occlusion plus 48 h of hypothermia was consistently lethal. Without MCA occlusion 2 of 3 monkeys survived, but were comatose the first 12 h post-hypothermia. In normothermic cats, MCA occlusion was lethal in only one of 5 animals whereas hypothermia was lethal in 20 of 21 cats with or without MCA occlusion. The detrimental effects of hypothermia were not favorably influenced either by hemodilution or by deliberate alterations in PacOj. The effect of 48 h of hypothermia and rewarming on cerebral blood flow (CBF) and cerebral metabolites was evaluated in 6 normal monkeys. CBF was reduced 60 to 70 percent at 29°C and returned to only a maximum of 50 percent of control with re-warming. Prior to re-warming distribution of CBF was inhomogeneous. Cerebral metabolites were borderline normal prior to re-warming but energy stores decreased while lactate increased with re-warming.

ISSN:0039-2499    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

One hundred seventeen patients, 31 with TIA and 86 with cerebral infarction, had angiographically verified atherosclerosis within the relevant carotid artery territory and normal CSF. They were treated with anticoagulants for a mean of 11.1 months. No TIA but 1 cerebral infarction, appearing during inadequate anticoagulant therapy, was registered. Seventy-six of the patients, 20 with TIA and 56 with infarction, were followed for a mean of 4.4 months after cessation of anticoagulants or during inadequate anticoagulant treatment. Ten patients, 1 with initial TIA and 9 with initial infarction, developed cerebral infarction necessitating re-institution of anticoagulant therapy.Long-term, anticoagulant treatment can be recommended in carefully selected patients with TIA, and also with infarction in the carotid territory.

ISSN:0039-2499    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

As an offshoot of a larger prospective cardiovascular population study, the present study aimed to determine the 12 months frequency of focal cerebral transient ischemic attacks (TIAs) in persons randomly, selected after age stratification from the Copenhagen city population register. A questionnaire of S questions pertaining to cerebrovascular attacks sustained within the last 12 months was distributed to 2357 persons. The TIA-questionnaire was returned by 88%, of whom 22% responded affirmatively to one or more questions. The positive responders were interviewed by phone, and when suspected of having TIAs they were examined by a neurologist. A total of 11 persons proved to have had TIAs, which for the age group of 60 years and over gives a 12 months frequency of 8/1000. Dizziness, ophthalmologic problems and migraine were the most frequent causes of a “false” positive response.

ISSN:0039-2499    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The cat basilar artery was exposed using the transclival approach. After administration of 5% ethanol via intravenous infusion, vasospasm was produced by applying the animal's fresh arterial blood to the exposed artery. The resultant vasospasm was of markedly reduced intensity and duration as compared to vasospasm in control animals. In ethanol-treated animals with spasm induced from non-autogenous fresh arterial blood free of ethanol, a reduction in the duration of vasospasm was noted although the initial intensity of spasm was similar to control animals. There was no anti-spasm effect if the ethanol infusion followed the production of vasospasm.

ISSN:0039-2499    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

A method for induction of subarachnoid hemorrhage (SAH) in a rat model is described. Resolution of the hemorrhage was documented photographically and microscopically at intervals from 1 hr to 8 days. Photographs indicated that most of the hemorrhage was resorbed within 3 days, an observation confirmed microscopically by the amount of red blood cells in the subarachnoid space. Significant cerebral vasospasm was documented within the first 2 days after the induction of hemorrhage with the basilar artery returning to baseline values at an average of 3 days followed by moderate dilatation at 5 to 8 days. The suitability of the rat as an animal model for further investigation of subarachnoid hemorrhage is discussed.

ISSN:0039-2499    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The left cerebral hemisphere of Mongolian gerbils was used to elucidate the mechanisms of brain edema which develop during cerebral ischemia and after restoration of cerebral blood flow following temporary ischemia. Water content was measured by the tissue-drying method. Sodium and potassium ion concentration was measured by flame photometry. Passage of131I-albumin (RISA) from blood to the cerebral parenchyma was measured on a gamma scintillation counter. Our findings indicate that pure cytotoxic edema develops during ischemia and during a short period after restoration of cerebral blood flow. Vasogenic edema, which is accelerated by the leakage of plasma constitutents from blood due to blood-brain barrier damage, developed after restoration of the cerebral blood flow. After less than 1 hr of ischemia, restoration of the cerebral blood flow drastically reduced the degree of brain edema. However, restoration of the cerebral blood flow greatly worsened the brain edema following more than 3 hr of ischemia.

ISSN:0039-2499    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Serum cardiac enzyme levels (CK, LDH, SCOT) were estimated and the ECG recorded for days following admission of 288 patients (Group I) to a stroke intensive care unit. Sixty-four of these patients, subsequently found not to have strokes, served as controls. Mean serum levels of all 3 cardiac enzymes were elevated in 8% of the 224 patients with stroke. The mean serum enzyme levels in patients with transient ischemic attacks (TIA) did not differ from controls. In a second group of 230 patients with stroke (Group II) serum CK levels were measured and the isoenzymes were fractionated to determine the tissue source of the enzymes. One hundred and one patients had raised total CK values and 25 of these (11≤) had raised CK-MB (heart) iso-enzyme, the remainder having CKMM (skeletal muscle) fraction. No serum CK-BB (brain) iso-enzyme was detected in any patient. Patients with positive serum levels of CK-MB had more evidence of acute myocardial ischemia on ECG (p≤ 0.05), and more cardiac arrhythmias (p≤ 0.001) than those with normal CK levels. Scattered areas of myocytolysis were found in the myocardium at autopsy in one patient. The acute rise in serum cardiac enzymes which we have recorded in the initial stages of stroke suggest that acute myocardial involvement is a commoner complication than is generally recognized. Also, since the CKMB rises were modest and progressive, it is more likely that this acute myocardial dysfunction is a consequence, rather than a cause, of the acute cerebrovascular lesion.

ISSN:0039-2499    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

We measured total and regional cerebral blood flow (CBF,rCBF) and cerebral metabolic rate (CMR) of oxygen (O2), glucose (G), and lactate (L) levels for 4 h after 16 min global brain ischemia in rhesus monkeys with and without post-insult thiopental therapy. Eleven monkeys weighing 4-5 kg anesthetized with 1 percent halothane, 66 percent nitrous oxide and 33 percent oxygen, were subjected to 16 min global brain ischemia by a combination of trimethaphan hypotension (to a mean arterial pressure of SO torr) and a high pressure (1500 torr) neck tourniquet. Post-ischemia, 7 monkeys were untreated (controls) and 4 received thiopental 90 mg/kg infused intravenously over 60 min, beginning at 5 min post-ischemia. Total CBF andrCBF were measured by continuous monitoring of cerebral venous (torcula) and parietal-occipital (external scintillation)133Xe activity, respectively, after intra-innominate artery injection of 500 μCi133Xe in saline. In control monkeys, hyperemia inrCBF, but not in total CBF was observed at 6-7 min post-ischemia, whereas both total CBF and rCBF increased in thiopental treated monkeys. The hyperemia in thiopental treated monkeys coincided with an increase in CMRG without a proportional increase in CMRO2or lactate levels. Indeed, CMRO2was depressed in the first 30 min post-ischemia. At 30 min post-ischemia, CMRO2rose to twofold greater than pre-ischemia in control monkeys, but only to pre-ischemic levels in thiopental treated monkeys. The data suggest that thiopental therapy improves distribution of brain blood flow and brain glucose uptake early post-ischemia and depresses CMROa later post-ischemia.

ISSN:0039-2499    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Body fluid gas pressure and electrolytes of patients with ruptured aneurysm were continuously analyzed. Intracranial pressure (ICP) was regulated at the level of 120-100 mm H2O by cerebral ventricular drainage. There was no significant change in the pH, Pco2, Hco3, Na+, K+, Ca++ in the cerebrospinal fluid (CSF) of patients with slight or moderate disturbance of consciousness (lethargic-drowsy state). The Pcaro2of the patients with marked disturbances of consciousness (semicoma-coma) was significantly low. PcarO2of the patients with cerebral vasospasm was significantly lower than for those without vasospasms. PC8rO2/Pao2 was 0.27 ± 0.01 in the patients with vasospasm and 0.50 ± 0.01 in those with vasospasm. Pcaro2tended to decrease in patients with markedly bloody CSF. When the bloody CSF was cleared by ventricular drainage, PCBfo2 increased. PcarO2did not return to a normal value in the patients with marked disturbances of consciousness despite sufficient arterial oxygen tension. This suggests that Pcaro2and Pcaro3/Pao2should provide a convenient index for the prognosis of patients with ruptured aneurysm.

ISSN:0039-2499    

出版商:OVID    

年代:1979

数据来源: OVID