ISSN:0039-2499    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Thirty patients over 35 years of age with one or more episodes of carotid TIA lasting less than one hour were studied. No patient had a history of brain disease and each had an EEG followed by an arteriogram. Arteriographical study showed 15 patients to have occlusive disease of the internal carotid artery, and four of these had intracranial occlusive arterial disease as well. An additional three patients had only intracranial occlusive arterial disease. Twelve patients had normal arteriographical studies. The EEGs of nine patients were diffusely or focally slow. Twenty-one patients had normal records. Six of the nine patients with abnormal EEGs had arteriographical evidence of intracranial occlusive arterial disease. Only one patient with extracranial carotid stenosis alone showed an EEG abnormality. In two patients with an abnormal EEG the arteriogram was completely normal or showed insignificant change. These data indicate that the EEG has the capacity to reflect changes in cerebral function not clinically evident in patients with carotid TIAs. Such changes were present in almost one-third of the patients in this study. Most commonly, generalized or focal EEG slowing in patients with the clinical syndrome of carotid TIA is associated with the presence of intracranial occlusive arterial disease. Alternatively, the finding of a normal EEG in such patients would suggest the absence of intracranial occlusive arterial disease, but occurs with equal frequency in patients with stenosis of neck vessels and in patients with no arteriographically demonstrable lesion.

ISSN:0039-2499    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Cerebral blood flow was measured in four subjects with chronic idiopathic autonomic insufficiency using85Kr inhalation, cerebral A-V samples for scintillation counting, and O2content determination. Blood pressure was varied by up or down tilting and L-norepinephrine infusion. In three patients with typical Shy-Drager syndrome and preganglionic denervation, CBF regulation to pressure and PaCO2change was intact. In a fourth patient with postganglionic denervation, CBF autoregulation was absent to changes in blood pressure but was preserved normally to increases or decreases in PaCO2CBF and CMRO2, at rest were normal (52.6 cc and 3.1 cc). Hyperventilation to PaCO234.3 mm failed to restore autoregulation to increased blood pressure. The results imply a functional role for postganglionic autonomic fibers in CBF autoregulation.

ISSN:0039-2499    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

This study has attempted to identify all patients in the population of Rochester, Minnesota, who had stroke during the period 1955 through 1969, and to determine the course and survival of patients who have had stroke. Cerebral infarction from all causes, including embolic infarction, accounted for 79% of all strokes. Intracerebral hemorrhage accounted for 10% of the cases, and subarachnoid hemorrhage accounted for 6%. The average annual incidence rate for the 15 years of the study was 164 per 100,000 population per year. The rates for all strokes and for cerebral infarction were significantly higher for men than for women, except in the youngest age group. After the end of an earlier study, 1945 through 1954, the average annual incidence rate for all strokes decreased in each succeeding five-year interval and reached 141 during the period 1965 through 1969. The decrease in rates is apparent for all strokes and for cerebral infarction, and is more apparent for women than for men. The prevalence rate on January 1, 1960, and January 1, 1965, of about 700 per 100,000 population was higher than the rate for January 1, 1970, reflecting decreasing incidence rates. A study of the functioning capacity of survivors of stroke after six months indicates that only 4% required total care and nearly 30% were functioning normally. Fifty-four percent had some neurological deficit that may have been benefited by rehabilitative care. Aphasia was an important residual incapacity in 10%. The first-year recurrence rate of stroke was 10%, and the five-year recurrence rate was 20%. Among patients with stroke who died, 38% died of the initial stroke, 10% of a subsequent stroke, and 18% of heart disease. During the 25-year period, 1945 through 1969, there has been a trend toward gradually increasing survival for cerebral infarction in this community.

ISSN:0039-2499    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Alpha receptor adrenergic antagonists were used in chloralose-anesthetized dogs to block cerebral vasoconstriction elicited by stimulation of the sympathetic innervation of the cerebral vessels. A venous outflow technique was used to measure cerebral blood flow with an electromagnetic flow transducer. The brain's arterial supply was left undisturbed. The experiments were performed in both open and closed chest animals and in animals with open and closed craniums. The left sympathetic stellate ganglion was stimulated for 60 seconds at 15 Hz, 3 msec pulse duration, and 3 to 9 v intensity. Control stimulation produced a 65.8% decrease in cerebral blood flow. Dibozane, 1 or 2 mg/kg, or phentolamine, 2 mg/kg, was then administered, and stimulations were repeated with the same stimulus parameters. After alpha receptor blockade, cerebral blood flow decreased only 3.5% with sympathetic stimulation. The effective blockade by two different alpha receptor antagonists, of a different structure, indicated that an alpha receptor was responsible for the sympathetically mediated cerebral vasoconstriction. In conclusion, stimulation of the sympathetic innervation of the cerebral vessels results in a marked decrease in cerebral blood flow which is blocked by alpha receptor antagonists.

ISSN:0039-2499    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

The frequency of death certified as due to cerebral hemorrhage among the brothers and sisters of 180 index patients with a proved cerebral hemorrhage has been compared with its frequency in the population of the same age and sex at the same decennium of the century as given by the Registrar General. There was no statistically significant excess of death certified as due to cerebral hemorrhage except among the brothers of female index patients (p < 0.05). The significance of this finding is discussed.

ISSN:0039-2499    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

It has been proposed by others that adrenergic nerves to cerebral blood vessels bind norepinephrine more avidly than do nerves to vessels outside the brain. This suggestion is supported by the present data which show that in the rat intraperitoneal reserpine depletes norepinephrine less readily from nerves to cerebral blood vessels than from nerves to extracerebral blood vessels. Alternate hypotheses to explain our data are contradicted by available evidence, except for the hypothesis of unequal distribution of reserpine between perivascular nerves in various locations. No evidence has been located to favor the latter hypothesis. The postulate of increased norepinephrine binding by nerves to cerebral vessels not only explains the present data, but also can account for the surprisingly small responses of cerebral vessels to exogenous norepinephrine or to sympathetic stimulation.

ISSN:0039-2499    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Both internal and external carotid artery phasic blood flow and arterial pressure were measured in five patients during a control period and after the intra-arterial injection of 13.8 μg of histamine phosphate into each vessel. In the internal carotid artery, flow for the group increased almost immediately and reached a maximum value of 59% greater than control in ten seconds. The total duration of the response in both pressure and flow lasted approximately one minute. The injection of histamine into the external carotid artery elicited a much more marked response, having a maximum increase in flow of 294% for the group with a total duration of the response lasting two and one-half to three minutes. These data define the magnitude and time course of the action of histamine phosphate on the intracranial and extracranial circulation in man.

ISSN:0039-2499    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

Despite considerable research, the question of whether adrenergic drugs exert direct effects on the cerebral circulation has remained unresolved. With the development of a method for monitoring continuously the entire blood flow to one hemisphere in the unanesthetized goat, we have been able to study this problem directly. The effects of epinephrine, norepinephrine, and isoproterenol administered by close intra-arterial injection were investigated in 15 goats in which an electromagnetic flowmeter had been implanted previously on the internal maxillary artery, which, in this animal, provides the sole blood supply to a hemisphere. Both epinephrine and norepinephrine (0.1 to 5.0 μg) produced dose-dependent reductions in cerebral blood flow, a decrease of 55 ± 3% (SEM) occurring with the highest dose. Alpha receptor blockade of the ipsilateral hemisphere with phenoxybenzamine totally or partially abolished this cerebral vasoconstriction. Isoproterenol (0.01 to 1.0 μg) produced dose-dependent increases in cerebral blood flow, an increment of 75 ± 6% occurring with the highest dose. Beta blockade with propranolol totally or partially abolished the cerebral vasodilation induced by isoproterenol. Thus, epinephrine, norepinephrine, and isoproterenol exert powerful direct effects on the cerebral circulation of the unanesthetized goat, and these effects appear to be mediated by alpha and beta receptors.

ISSN:0039-2499    

出版商:OVID    

年代:1973

数据来源: OVID

摘要:

The ability of facial thermography to detect disease in the internal carotid artery was evaluated. Unilateral forehead cooling of 0.7°C or greater was observed in 57% of 30 cases with angiographically proved stenosis. Two provocative tests, facial cooling and a head clamp, increased the sensitivity rate to 83% The greatest overall sensitivity and specificity was obtained by using a head clamp especially designed to bilaterally occlude superficial temporal arteries. Facial thermography is a useful screening device in detecting carotid occlusive disease. However, the necessity to use a provocative test to increase the sensitivity to acceptable levels will probably limit its use to the screening of high-risk asymptomatic patients. It does not appear to be economically feasible in the mass screening of healthy individuals.

ISSN:0039-2499    

出版商:OVID    

年代:1973

数据来源: OVID