摘要:

Sonographic patterns for the Doppler ophthalmic test (DOT) were determined by reviewing the type of graphic record obtained from 25 patients who had undergone angiography. Three principal patterns were identified, depending upon whether there was augmentation (Type 1), diminution (Type 2) or no change (Type 3) in the character of the supraorbital Doppler signal upon temporal artery compression. Type 1 records were seen in 28 of 33 instances where the carotid arteries remained patent. Type 2 records occurred in 10 of 14 instances where there was significant carotid stenoses or tortuosity and in two instances in a patient with a subclavian steal syndrome. A "false-positive" test was recorded in one instance in a patient with vascular headaches. There were three Type 3 records.

ISSN:0039-2499    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

One hundred seventy-eight patients with transient ischemic attacks (TIAs) or small strokes with slight symptoms persisting for more than 24 hours (incomplete recovery = IR) (TIA-IR) from both the carotid and the vertebrobasilar systems were treated with anticoagulants. Ten patients stopped the treatment because of severe side effects. Only one patient had a lethal cerebral infarction when the thrombotest values were above the therapeutic level; no other infarction happened during the treatment period. Moreover, the frequency of TIA decreased during the treatment, compared with descriptions of the natural course of TIA. One hundred four patients were observed for a mean of 21 months after the anticoagulant treatment ended. During the observation period, six patients had cerebral infarctions. This was a sixfold increase compared with the stroke incidence during treatment, and was almost identical with the incidence of strokes seen during the natural course of TIA. All the cerebral infarctions were in patients who had their initial TIA/TIA-IR from the carotid territory (within the. same carotid artery which earlier had given symptoms). The investigation shows that long-term anticoagulant treatment is useful, especially in patients with carotid TIA/TIA-IR, and that this treatment should continue as long as the patients can manage it. In patients with vertebrobasilar symptoms of malignant character, it seems feasible to terminate the treatment after about one year. The mechanism of the anticoagulant treatment is obscure, but it does not appear to influence the progress of the atherosclerotic process.

ISSN:0039-2499    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

One hundred consecutive patients were randomly given hypocarbic (Paco2 < 25 torr) or hypercarbic (Paco2 > 60 torr) general anesthesia during carotid endarterectomy to test the effect of the two regimens upon the incidence of postoperative neurological deficit. An indwelling shunt was not used. One patient died, two have permanent neurological deficits and two have temporary neurological deficits. Although hypocarbic patients had fewer neurological complications than hypercarbic patients, the difference was not statistically significant (p < 0.13). Hypercarbia significantly increased the incidence of intraoperative arrhythmia. Also, no relationship was found between the incidence of postoperative stroke and the internal carotid back pressure or the time of carotid occlusion.

ISSN:0039-2499    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

Regional cerebral blood flow (CBF) was measured in both middle ectosylvian gyri of ten cats by recording the clearance of molecular hydrogen (H2) with implanted polarized electrodes 125 n in diameter, before and up to seven days after occlusion of the left middle cerebral artery (MCA) with a device implanted in the intact cranium. Five patterns of changes of CBF were recorded with the leftsided electrodes. In eight cats MCA occlusion caused immediate decreases of CBF; in the other two cats CBF values were lowest two days after occlusion, presumably because of ischemic edema. Both persistent severe ischemia and early spontaneous postischemic hyperemia were associated with severe neurological deficits, marked swelling of the left cerebral hemispheres, and large infarcts. Late postischemic hyperemia was associated with less severe deficits, less swelling, and smaller infarcts, but the least severe deficits and smallest infarcts were noted in association with persistent moderate ischemia. No consistent patterns were recorded with the rightsided electrodes in this study. Hyperemia which develops spontaneously or is induced shortly after the onset of cerebral ischemia potentially may be harmful because of secondary increases of cerebral edema.

ISSN:0039-2499    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

A gastroendoscopic study was performed on 177 patients with acute stroke. Gastric changes were found in 92 among them (52%), including ten with acute ulcer. A high frequency of gastric changes was found in patients with serious stroke and/or in patients whose cerebral lesions were located close to the hypothalamus or its centrifugal tract. The mortality in patients with gastric changes was high, especially in patients with acute ulcers, multiple erosions and petechiae. The frequency of brown gastric juice and coffee grounds at gastroendoscopic examination (gastric hemorrhage) was three times as high as that of melena and/or hematoemesis. On the other hand, the mortality of patients with gastric hemorrhage differed little from that of patients with melena and/or hematoemesis.

ISSN:0039-2499    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

To investigate the relationships between gastric change accompanying patients with acute stroke and the function of the autonomic nervous system and pituitary-adrenal system, studies on the gastroendoscopic technique and biochemical observations were done in 122 patients. The mean urinary noradrenalin and adrenalin excretions were elevated in patients with acute gastric changes, especially in patients with multiple erosions and acute ulcers. An elevation of the mean fasting serum gastrin concentration was found in patients with acute ulcers and no acute gastric changes. The mean urinary 17-OHCS excretion was increased in patients with multiple erosions, petechiae and acute ulcers. In conclusion, the sympathetic and parasympathetic nervous system and the pituitary-adrenal system have respectively different roles in the production of various types of acute gastric changes in patients.

ISSN:0039-2499    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

The effect of several agents active on autonomic nervous system functions was tested on brain oxygen autoregulation parameters. It was found that atropine, propranolol and isoproterenol had no influence in abolishing the measured parameters. Phenoxybenzamine, tolazoline and dibenamine all suppress autoregulation. In an additional experimental series, a phenoxybenzamine infusion was given during O2 breathing. The infusion induced, in most cases, an additional rise in TpO2 (tissue pressure of oxygen, which refers to the partial pressure [in mm Hg] of this gas at the measuring tip of the electrode). It is concluded that an a-adrenergic mechanism is part of the autoregulation process. Also, the increase in brain TpO2 induced by 95% O2-S% CO2 breathing seems to be blocked or reversed by a-adrenolytic drugs, thus supporting the thinking that the effect of CO, on cerebral blood flow is at least in part mediated through an a-adrenergic response.

ISSN:0039-2499    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

Comparison of the clinical features, especially prognosis, in cerebral infarctionwas made between nine normotensive subjects and 16 hypertensive patients with an 80% stenosis or occlusion of the intracranial or extracranial arteries. Our own criteria for evaluating hypertension were employed on the basis of the following items: a past history of hypertension, blood pressure levels on admission and during hospitalization, degree of retinopathy, and ECG changes. In 17 of 25 cases, brain circulation was measured by the intravenous RISA technique. Abnormalities of the EEG and reduction of cranial blood flow were greater, and an early prognosis for neurological deficits in the first two months after the onset of stroke was poorer in the hypertensive group than in the normotensive group. These results are contradictory to the observations of others.

ISSN:0039-2499    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

A new micro T-tube, 0.6 mm in outer diameter, has been constructed. Use of this tube has allowed 1-mm common carotid artery (CCA) bypass for periods of time up to 22 minutes. After bypass, scanning electron microscopic observation of sutured CCA endothelium showed widespread destruction, scattered attached platelets and other formed blood elements, as well as microthrombi both at suture lines and in areas in contact with T-tubes. Despite microthrombi, 41 of 42 CCAs were patent after anastomosis. Silicone cuffs and 8-0 ties secured T-tubes inside vessels with no apparent difference in underlying endothelial destruction.

ISSN:0039-2499    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

One hundred fifty-five patients (121 men and 34 women) had an angiographically verified unilateral internal carotid artery (ICA) occlusion immediately after carotid bifurcation. The median follow-up period was 53 months. Forty-fire percent of the patients were fully independent in the activities of daily living (ADL), 22% required assistance in ADL, 11% were disabled, and 22% died within the follow-up period. The mortality rate was exceptionally low compared with previous series. A life-table analysis of the material gave a 94% probability of surviving the first year, 84% the third year, and 78% the fifth year. Young age was favorable in regard to functional recovery, but it had no influence on mortality. The condition at the acute stage was the most important clinical sign in predicting the prognosis. The prognosis of mortality and functional recovery was poorer for smokers than for nonsmokers, and hypertension had no effect on prognosis. Cerebrovascular disease and coronary heart disease were found to be the cause of death with equal frequency in this study.

ISSN:0039-2499    

出版商:OVID    

年代:1976

数据来源: OVID