ISSN:0039-2499    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Eight patients are described who developed infarctions in the rertebral-basilar artery distribution following chiropractic neck manipulation or spontaneous head turning. The angiographic and autopsy findings indicate that injury to the intima of the vertebral artery at the atlantoaxiaJ joint forms a nidus for thrombus formation which may propogate or embolize to involve other vessels in the vertebral-basilar system and result in progressive brainstem infarction. The role of anticoagulation in these patients is discussed.

ISSN:0039-2499    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The ability of the123Xenon inhalation method to lateralize cerebral infarctions risible on CT scan was tested in 39 patients. At each of 7 hemispheric regions the flow rate in the lesioned hemisphere was divided by that in the unaffected hemisphere and this ratio was compared with the corresponding ratio for normal subjects. Tbe fast compartment relative flow F1correctly laterallzed the lesion In only 6 patients with no false Iateralizations. If the fast compartment relative weight w1was also considered, tbe correct Iateralizations were increased to about 50%. With the less well-known ISI and the Fractional Flow considered together, tbe Iaterality of the lesion was Identified correctly in 85% of cases, with no false Iateralizations. Stroke, Vol 12, No 5, 1981

ISSN:0039-2499    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Management of patients with sudden neurological deficit must be based on complete knowledge of the underlying cause. In about 80% of such patients, a careful history and examination will lead to a precise etiologic and anatomic diagnosis. If the deficit is vascular in etiology, therapy and prognosis depend on its stage of evolution. Stroke, Vol 12, No I, 1981

ISSN:0039-2499    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0039-2499    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

A technique is described by which the size, shape and orientation of the brain with respect to detector positioning can be reproduced by computerized simulation. Head size is estimated from the distance between the external acoustic meatus (EAM) and the outer canthus and head shape is determined from the length and height of the skull. These values are used to magnify and alter the shape of a standard brain outline to comply with individual patient measurements. The location of the EAM and nasion are used to establish the displacement and rotation of the orbito-meatal base line with respect to the detector holding assembly. The corrected brain outline is then rotated, centered and displayed superimposed on the regional flow data. Comparison of flow data from 2 studies is accomplished by mapping each probe location onto the standard brain and projecting these brain coordinates onto the second study. Flow data from the nearest detectors are averaged to obtain the interpolated flow value for that brain region. This method corrects for differences in head size and shape between patients and for changes in head positioning and rotation between studies. Computer simulation studies demonstrated that this correction procedure can significantly reduce the variance of flow measurements for expected ranges of head size and orientation. Stroke, Vol 12, No 1, 1981

ISSN:0039-2499    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

500 consecutive patients were evaluated for extracranial disease of the internal carotid arteries by an automated, air-Ailed, digital oculoplethysmographic system (OPG) of the Kartchner type (Zira) and by supraorbital (SO) and supratrochlear (ST) directional Doppler ultrasonography. Cerebral arteriograms were performed in 58 patients (110 vessels), and OPG timing criteria for detecting hemodynamically significant carotid artery stenosis (60% or greater diameter reduction) were ascertained. Optimal criteria were a delay of one ocular pulse, relative to the other, of greater than 12 msec; and a delay of an ocular pulse, relative to the earlier ear (external carotid) pulse, of greater than 36 msec. These criteria correctly identified 73% of vessels with 0 to 59% stenosis and 76% of vessels with 60 to 100% stenosis. However, in 26% of the vessels, OPG was either inconclusive or inaccurate. Correct diagnosis of bilateral hemodynamically significant carotid artery stenoses was made by OPG in 6 of 9 affected patients. SO Doppler was normal in 70% of vessels with 0-59% stenosis, and abnormal in 75% of vessels with 60-100% stenosis. Corresponding percentages for ST Doppler were 95% and 44%. Abnormal Doppler responses to compression of contralateral facial branches were predictive of intracranial cross-collateralization in only 25% of patients. These results suggest that both quantitative OPG in its present form and directional Doppler studies have serious limitations as non-invasive diagnostic methods. Stroke, Vol 12, No 1, 1981

ISSN:0039-2499    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Thirteen patients with stroke and one with TIA had repeated examinations with computed tomography (CT) of the head, examination of the cerebrospinal fluid (CSF) for adenylate kinase, glutathione, lactate, and albumin and clinical evaluations during the flrst fortnight after onset. In 9 patients with cerebral infarction edema shown on the CT scans was maximal on days 2-5, after which it diminished. In 2 patients with intracerebral hemorrhage the edema appeared early as a zone of low-attenuation around the high-attenuation area. Most patients with large lesions deteriorated clinically during development of the edema. In 3 patients the CT scans were inconclusive, probably because the lesion was too small. Adenylate kinase activity was present in all CSF samples during the period 6 hours-S days, while glutathione was occasionally present in the CSF in 12 of the 14 patients. These findings are believed to indicate cell swelling and a leak in the plasma membrane. Based on these observations, it is suggested that initial ischemic edema is intracellular in patients with cerebral infarction, and that adenylate kinase in CSF is a sensitive marker for this type of edema. Stroke, Vol 12, No 1, 1981

ISSN:0039-2499    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Serial determinations ofβ-microglobulin, lactoferrin and lysozyme in CSF were performed in 14 patients with acute cerebrovascular lesions. Marked elevations were noted in patients with cerebral bleeding or hemorrhagic infarction. Patients with infarction without signs of bleeding or with cerebrovascular lesions undetectable by computed tomography also had an increase in these proteins. The increases in CSF of β-microglobulin, lactoferrin and lysozyme could not be explained by a damaged blood-brain barrier but was believed to be a local product of the central nervous system. Peak levels of lactoferrin and lysozyme were noted on day 2–3 after onset of symptoms. Lactoferrin then declined while lysozyme remained elevated for another few days. β-microglobulin gradually increased reaching peak levels on day 4-5 and remained elevated even 2 weeks after the onset of symptoms. We suggest that the increases of lactoferrin, lysozyme and β-microglobulin reflect various inflammatory reactions mediated by granulocytes, macrophages and lymphocytes, respectively. Stroke, Vol 12, No 1, 1981

ISSN:0039-2499    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

A scintillation camera connected to a dedicated computer system was employed for atraumatic CBF measurements in 43 patients after intravenous injection of 35 to 55 raCiluXe in saline solution. To validate this method results were compared to flow values in the same patients measured after intracarotid Xe injection. While the correlation between i.e. and i.v. values was not satisfactory when a high resolution collimator was used, a high sensitivity collimator improved count rates and yielded CBF values after i.v. in agreement with those from i.e. studies. For mean hemispheric flow, the correlation coefficient between the methods was 0.93 and the standard deviation of the i.v. value for a given i.e. value was 2.93. The correlation coefficients for 13 regions were between 0.55 and 0.85. These correlation coefficients are comparable to those obtained with multidetector equipment. Ischemic regions could be accurately detected, and the flow values in these areas were significantly related (r = 0.81). Values in 6 healthy volunteers were in the normal range reported by other investigators. One disadvantage of the camera is that measurements are restricted to one hemisphere, but selection of recording areas is not limited to the position of single probes and may be changed during analysis of the data permitting analysis of flow in irregularly-shaped, pathologically-perfused regions. The results indicate that the scintillation camera is a useful tool for clinical rCBF studies. Stroke, Vol 12, No 1, 1981

ISSN:0039-2499    

出版商:OVID    

年代:1981

数据来源: OVID