摘要:

Experience with radionuclide angiography (RA) utilizing radiosodium pertechnetate and the scintillation camera as a practical means of evaluating cerebral vascular disease (CVD) is presented. The normal RA patterns were established in more than 500 patients without clinical evidence of CVD. Detailed study of the arterial and venous perfusion patterns in cases of CVD showed that certain discrete changes can be classified. The RA patterns were evaluated in 143 patients with strokes and in 120 patients with transient ischemic attacks (TIA) and correlated with symptomatology, clinical hospital course and cerebral angiograms. Although static brain scanning in patients with strokes is reportedly positive in approximately 42%, such scans are rarely positive (3%) in patients with TIA. However, by using the RA in combination with static camera imaging, in those patients wth documented stroke, positive studies were obtained in more than 80%, a twofold increase compared to previous experience. In patients with TIA, a tenfold (33%) increase in positive studies was found related to CVD and, in addition, another 7% were positive as mass lesions. The data presented stress the importance of establishing specific criteria for analysis of RA as well as the greatly enhanced sensitivity of this combined approach in detecting CVD.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Based upon the assumption that oxygen under increased atmospheric pressure (OHP) might improve the verbal and mental function of patients who had suffered vascular infarcts, 32 stroke patients were exposed to such an ambient atmosphere and tested under controlled conditions. The results make it clear that a single exposure to 100% oxygen under two atmospheres of pressure, which is productive of high blood oxygen levels, does not improve the communication and cognitive-perceptual function of these patients.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Electrical control of motor behavior by programmed electrical stimulation of the brain has been described. Such programmed brain stimulation is referred to as a “brain prosthesis,” meaning, in effect, “artificial brain.”Areas in the brain which related to the production of elementary movements were located. From these preliminary experiments it was evident that programmed stimulation of the brain at sites typically unaffected by stroke could produce a “purposive” sequence of motor behaviors.Monkeys were made monoplegic by surgical (two-stage) resection of appropriate cortical and subcortical regions. After recovery electrodes were implanted in the brain. This technique is described.The electrodes are linked to a multiple-electrode programmable brain stimulator. The stimulator and computer programming make it possible to specify which electro-stimulators are to be turned on, and strength and duration of current to produce a pattern of complex motor function.Programs of stimulation, which cause the paralyzed limb to reach out, grasp an object (such as food), and bring the object rapidly and smoothly to the mouth, have been written. The ultimate question of applicability of this model in humans remains to be studied.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Chronic hemorrhagic spasm of the basilar artery was produced in beagle dogs by introducing blood into the cisterna magna. Spasm was evaluated by means of vertebral angiography. Papaverine hydrochloride was administered intravenously, intracisternally as well as intra-arterially. The intracisternal route was the more effective in combating spasm but the effect was transitory. The results suggest that the treatment of spasm by chemical means in subarachnoid hemorrhage using agents currently available would require continuous topical application.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Simple longitudinal arteriotomy was carried out in rabbits to assess the use of a rapid-setting tissue adhesive in shortening the time necessary to carry out microvascular repair. The vessels studied varied from 0.8 to 1.5 mm in diameter and repair was carried out using microsurgical dissection. It was found that the use of the tissue adhesive in conjunction with three sutures would bring about satisfactory repair of the arteriotomy for shortening the time of repair by at least 50%. Toxic reactions or other complications common to micro-anastomosis of small vessels were not encountered with any greater frequency than in controls.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

The influence of heredity factors in Cerebrovascular accidents was investigated by studying the families of 80 patients with a clinical diagnosis of CVA. The frequency of CVA in parents and siblings of these patients was compared with the frequency in the family of the patient's spouse. The frequency of recognized predisposing illnesses to CVA including hypertension, diabetes and heart disease was also studied. The patients and the spouses were excluded from the study population.Analysis of the data obtained on 160 parents and 384 sibs of the proband and on 140 parents and 336 sibs of the spouse revealed a frequency of CVA of 10.7% and 8.6% respectively. This difference was not statistically significant. However, when the sibs and parents were analyzed separately the difference between the sibs was significant (p < 0.025), suggesting the possibility that a small added risk of CVA existed for certain close relatives of a CVA victim.Besides an inherited tendency to CVA, other factors were considered to account for the difference in frequency of CVA. Age, family size and differential reporting of illness failed to account for the difference. However, both hypertension and heart disease occurred with greater frequency in the sibs of the patient. When patients with these predisposing illnesses were excluded and those with CVA alone were compared, it was found that relatives of the patient and the spouse had essentially the same frequency (3.1% and 3.2% respectively). Moreover, hypertension and heart disease were significantly more common in the relatives of the proband. The excess of CVA in the sibs of the proband could, therefore, have been due to an excess of predisposing illnesses such as hypertension and heart disease, and no independent inheritance of CVA was demonstrated. In the absence of certain predisposing illness, close relatives of CVA patients appeared to have no greater risk of CVA than genetically unrelated individuals.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Vasospasm of the basilar artery of the dog was induced by subarachnoid injection of arterial blood through the cisterna magna. Cerebral angiography was employed to evaluate quantitative assessment of the spasm. Chronic vasospasm was successfully induced in 100% of surviving dogs.Biphasic vasoconstriction was observed. The acute phase occurred within 30 minutes after the blood injection and tended to abate. Chronic spasm was demonstrated on the second day's angiograms and persisted to the seventh day in some cases. Etiology of the chronic spasm using this model is now under investigation.Vasospasm was not due to alterations in blood gas concentration or blood pressure, to increased CSF pressure or to injury from contrast medium or direct trauma. The primacy of blood as the offending agent is strongly suggested.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Baseline and follow-up measurements of cerebral hemodynamics were performed in hypertensive patients by the N2O method with a certain time interval. A tendency for some decrease in the CBF was noted, but the difference was not statistically significant.Twelve hypertensive patients suffered from a stroke during the period of observation. The CBF values prior to the stroke varied so widely that there was no predictive value from these measurements.The decrease in CBF in a mild case of cerebral infarction is slight and is followed by little fluctuation. The decrease in a case of moderate severity is marked but returns to normal in two to five months. Clinically severe cases of infarction and hemorrhage are also characterized by a marked decrease in CBF, but this decrease of infarcted cases may be irreversible.A higher incidence of recurrent infarction is noted in those patients in whom recovery of CBF following a stroke is poorest. This is most apparent in those patients suffering a recurrence within one year.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

Fibromuscular dysplasia (FMD) of the extracranial internal carotid arteries is a relatively rare angiographical finding which has been reported as an incidental finding during angiography, as well as in association with a variety of different clinical conditions. A case is reported of transient attacks of amaurosis fugax and hemiparesis. Angiography in this patient revealed bilateral FMD of the internal carotids as well as a small ulcerative plaque involving the right internal carotid artery at the region of carotid bifurcation. Surgical treatment directed toward the ulcerative plaque and not the FMD of the carotid arteries has rendered the patient asymptomatic. Lack of symptoms, despite the persistence of FMD, suggests that FMD is of doubtful pathogenic significance.A small, surgically correctable ulcerative plaque should not be overlooked in the presence of FMD of the internal carotid arteries. The significance of the rare finding of FMD of the internal carotid arteries is not clear.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID

摘要:

The left carotid artery of healthy, male gerbils was surgically ligated to induce a state of cerebral ischemia. The animals were sacrificed two, four, six, 12, 24 and 48 hours postligation to determine whether the induced cerebral ischemia would be reflected by changes in blood chemistry. The gerbil, unlike the rat, has a well-defined circle of Willis and cerebral arterial branches which resemble the arrangement of cerebral arteries found in man.The gerbils withstood the induced cerebral ischemia relatively well with few overt signs of cerebral damage, e.g., muscular paralysis, and a low mortality rate. However, intense lipid mobilization accompanied by depletion of peripheral adipose tissue sites and fatty infiltration of the liver developed very promptly. Marked cerebral edema and definitive foci of cerebral infarction occurred in both the frontal and medial lobes of the brain. The adrenal cortices of the gerbil were markedly depleted of lipid concomitant with severe thymus gland involution indicative of intense corticosteroid release.The serum enzymes, creatine phosphokinase and glutamic oxaloacetic transaminase, both rose promptly, indicating cerebral and hepatic damage respectively. Lipids, i.e., triglycerides, free fatty acids and total cholesterol, all rose promptly and to significantly above-normal levels and remained super-normal throughout the 48-hour course of the experiment. Concomitant with the hyperlipidemia and other metabolic changes there were definite hyperglycemia and elevation of BUN levels in a brisk response to the induced, acute cerebral ischemia. The gerbil adrenal gland produces hydrocortisone predominantly. Blood levels of hydrocortisone rose quickly to super-normal levels in response to the stress of cerebral ischemia but fell to significantly below-normal levels 24 and 48 hours after carotid artery ligation. These findings demonstrate that acute cerebral ischemia constitutes a severe stress in the gerbil which is reflected, almost quantitatively, by temporal changes in such blood constituents as enzymes, lipids, glucose, and adrenal stress hormones.

ISSN:0039-2499    

出版商:OVID    

年代:1972

数据来源: OVID