摘要:

Abstract not available.

ISSN:0039-2499    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Pure motor hemiplegia (PMH) is a well defined syndrome usually caused by ischemic lesions of lacunar type located either in the internal capsule or in the pons. Angiography and isotope scanning are usually normal. CT scan reveals small deep infarcts and appears to be the most reliable investigative method. The CT scan findings are described of thirty patients with PMH of rapid onset (less than 36 hours). In 29 of the 30 cases a lesion was found which could explain the PMH. Small hemorrhages (2 cm in diameter) in the posterior limb of the internal capsule were noted in two cases. Ischemic lesions were found in 27 patients, 22 patients had a single lesion (20 capsular and 2 pontine), while 5 patients had 2 lesions (2 bi-capsular, 3 capsular and pontine). Three varieties of ischemic capsular lesions were observed. We found in 15 cases a capsulo-putamine-caudate infarct (type I); in 8 cases a capsulo-pallidal infarct (type II); and in 2 cases an anterior capsulo-caudate infarct (type III). Type I corresponded to the area of the lateral lenticulostriate branches of the middle cerebral artery. Type II involved the territory of the perforating branches of the anterior choroidal artery. We suggest that type III involves the territory of the internal lenticulostriate branches of the anterior cerebral artery. Lacunes are generally linked to arterial systemic hypertension. However, only 16 of 30 patients in this series were chronically hypertensive.

ISSN:0039-2499    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The effect of indomethacin (3mg/kg IA) preloading on the pathophysiology of a model of acute cerebral ischaemia has been tested. Primates anaesthetised with alpha-chloralose were used. Indomethacin reduced basal blood flow by 39% and reduced CO2 reactivity by 71%. Water content changes of the cerebral cortex and relationships between blood flow and extracellular potassium (Ke), and calcium (Cae) activities have been measured. Indomethacin infusion did not effect the water content of the left side but there was more water in all regions of the right hemisphere which were rendered ischaemic. There water increases were significant for blood flows greater than 5ml/100g/min in exposed areas. There was a significant increase in the flow thresholds for change in Ke and Cae. Possible mechanisms for these changes have been discussed.

ISSN:0039-2499    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Between 1967 and 1976, 314 patients with transient ischemic attack (TIA) were evaluated and treated. Follow-up has been from 2.8 to 13.2 years (mean 7.8). As of 1979, 55 of the patients had succumbed to cardiovascular disease (28), cerebrovascular disease (9), malignancy (10), and other causes (8). During the follow-up period, 15 patients suffered brain infarction (4.8% under the risk) while 40 had myocardial infarction (12.7%) under the risk). Brain infarction occurred as often in patients with carotid TIA as in those with vertebral-basilar TIA, and was more common in patients under anticoagulation therapy than in those without it (p less than 0.05). Arterial hypertension, heart disease, peripheral arterial disease and diabetes did not increase the risk of brain infarction, but all (except diabetes) increased the risk of myocardial infarction. Combination of TIA with arterial hypertension, heat disease, or peripheral arterial disease increased the mortality (p less than 0.001). A life table analysis of surviving 1, 5, and 10 years gave probabilities of 99 and 100%, 89 and 91%, and 60 and 75% for males and females respectively. In the case of normotensive and hypertensive patients, a life table analysis of chances of surviving 1, 5, and 10 years gave probabilities of 100 and 95%. 94 and 80%, and 76 and 49% in both groups respectively. The result clearly emphasize treating of arterial hypertension, and demonstrate that TIA is not only a warning sign of impending stroke but also that of myocardial infarction.

ISSN:0039-2499    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

A standardized protocol was used for duplicate examination by two neurologists of the clinical history and neurological signs in 55 patients with reversible cerebral ischemia. One trained examiner from each of eight clinical centres involved in the Italian Cooperative Study on reversible cerebral ischemia participated in this research. Duplicate examination were compared in order to evaluate the percentage of agreement achieved in the responses. Several discrepancies relating to either historical data or neurological signs were detected. Possible causes of this disagreement are discussed. The inter-observer differences appear to be an important problem to be faced in cooperative studies on reversible ischemic attacks. The purpose of the study was to estimate these differences in the attempt to increase the degree of agreement by repeated training sessions and discussion between the different examiners. These efforts are needed to improve the quality of clinical investigations on reversible cerebral ischemia and to increase the validity of their results.

ISSN:0039-2499    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The hydroxyl radical scavengers dimethyl sulfoxide (DMSO) and glycerol were effective inhibitors of platelet aggregation in an in vivo mouse model of pial arteriolar injury. Aggregability was expressed in terms of the time required for a noxious stimulus (light + dye) to initiate aggregation. These drugs, given 1 hour before the injury, also eliminated the dilation which accompanied the damage. The same drugs failed to influence the constriction which accompanied an identical injury to mouse mesenteric arterioles, but again impaired platelet aggregation in the damaged mesenteric vessel. The data support the concept recently introduced by others, that, in the brain, hydroxyl radicals may mediate vascular damage and/or dilation accompanying the damage. The data also support the concept platelet aggregation may be stimulated, directly or indirectly, by hydroxyl radical. The effects of DMSO and glycerol in this study, irrespective of the molecular basis for the effects, may be relevant to the reported therapeutic benefit of these agents in cerebrovascular disease.

ISSN:0039-2499    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

A striking similarity has been found between the distribution of occlusions in various cerebral arteries and the statistical regularity of the pathways of balloon drifting freely in the blood stream. Based on the assumption that the course of a balloon is determined by the same hydrodynamic laws as that of an embolus of similar size, it is concluded that the majority of occlusions of the cerebral arteries are of embolic origin. Emboli, then, might also be an explanation for most of the TIAs.

ISSN:0039-2499    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The accuracy of the duplex scan with spectral analysis (DS/SA) in predicting the presence of arteriographic carotid stenosis was compared to that of oculoplethysmography/carotid phonoangiography (OPG/CPA) in 234 vessels from 117 patients who had had both non-invasive studies in addition to independently interpreted arteriograms. The DS/SA with 212/234 (91%) overall correct responses was superior to the OPG/CPA which properly classified 181/234 (77%) of the vessels (p less than .01). Of major clinical impact was the superiority of the DS/SA (p less than .001) in identifying the 72 vessels with 50–99% stenosis. The OPG/CPA had a discouraging 39/72 (54%) false-negative rate in this group whereas the DS/SA missed only 9/72 (12%) of these arteries. Of those 39 incorrect responses for the OPG/CPA, 26/39 (67%) were in patients with a 50% or greater stenosis on the contralateral side. This is a recognized area of weakness for that test. Based on the results of this study, we have abandoned the use of the OPG/CPA in the evaluation of patients with suspected carotid stenosis and rely solely on the duplex scan with spectral analysis.

ISSN:0039-2499    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The angiographic, clinical, and genetic characteristics of fibromuscular dysplasia (FMD) are reviewed in 37 patients (mean age 48 years) selected from a pool of 4000 angiograms of carotid or vertebral arteries. FMD was a neglected pathogenic factor in 28 patients with hemorrhagic or ischemic cerebral lesions. The aneurysms found in 19 patients had conventional appearance and were mainly located in the internal carotid or middle cerebral arteries and on the same side as the most affected cervical artery, which suggests that aneurysms and FMD are pathogenically related. A clinical syndrome is presented where headache, ECG-abnormalities, hypertension, mental distress, tinnitus, vertigo, arrhythmia, TIA, and syncope are frequent components. Hemicrania, sometimes combined with ipsilateral Horner's Syndrome, was found in patients with advanced lesions in the carotid artery of the same side. An associated occurrence of stroke in pedigrees, especially among young and middle aged females, indicates that FMD in the majority of cases in inherited as an autosomal dominant trait with reduced penetrance in males.

ISSN:0039-2499    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Eleven hundred cases from the literature of fibromuscular dysplasia (FMD) are reviewed including 300 cases with aortocranial lesions. The male-female ratio is 1:2, and the prevalence seems increased among Caucasians. The clinical diagnosis of FMD is made by angiography, ten years earlier in patients with hypertension (mean age 39 years) than in those with cerebrovascular symptoms (mean age 50 years). Segmental dysplastic lesions are found mainly in primary aortic branches. All age groups may be affected and follow-up studies give evidence for stationary as well as slowly progressive lesions. A multifactorial hypothesis of etiology is presented: congenital minor lesions of tunica medial might predispose to aneurysms and to an abnormal fibroproliferative response to mechanical or circulatory stimuli. The association of FMD and intracranial aneurysmal disease in females is discussed. Inheritance as a dominant trait with reduced penetrance in males is suspected. Current aspects on morphology, symptomatology and clinical management are presented.

ISSN:0039-2499    

出版商:OVID    

年代:1982

数据来源: OVID