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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eighty-seven patients with either amaurosis fugax (40 patients) or hemispheric transient ischemic attacks (47 patients) were studied to determine whether the two symptom groups could be differentiated clinically and arteriographically. Clinical data assessed were age of patient, incidence of cardiac disease, and presence of claudication, hypertension, diabetes, and carotid bruits. Contrary to a prior report, our results indicate no significant difference between the 2 patient groups based on clinical and arteriographic findings.
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PMID:Clinical and arteriographic comparison of amaurosis fugax with hemispheric transient ischemic attacks. 64 24

A prospective study of 80 patients presenting with amaurosis fugax was performed in an attempt to relate clinical features to angiographic findings in the internal carotid artery. Carotid bruit, transient cerebral ischaemic attacks, hypertension, and claudication were associated with a high prevalence of angiographic abnormality. Every patient who showed all these features had an operable lesion, as did 88% of those who had three features. In patients over 50 years of age carotid stenosis and atheromatous ulceration were occasionally found in the absence of bruit and transient cerebral ischaemia, but only one patient aged under 50 had an operable lesion and no associated features. Clinical features were therefore valuable in predicting the outcome of angiography, but it seems prudent to restrict angiography to patients aged over 50, who are most likely to benefit from surgery on the carotid artery.
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PMID:Amaurosis fugax and carotid artery disease: indications for angiography. 89 Mar 27

Eighty days after i.c. cryoextraction of the lens without any complications, intra- or postoperative, choroidal detachment was observed in a 68-year-old woman (hypertension, diabetes m..amaurosis of the right eye after central artery embolism). -Conventional decongestive drugs (Reparil, Tantum, Tanderil) had no effect. Within 6 days of treatment with microwaves, 2.5% Hydrocortisone and atropine eye-drops and Prednisolone (10 mg/die) internally there was complete regression of the detachment.
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PMID:[Late choroidal detachment after i.c. cryoextraction of the lens (author's transl)]. 95 74

The CHAT classification separates various current and historical presentations of cerebrovascular disease in an effort to determine important prognostic clues for management and prognosis. To evaluate known risk factors for late stroke and death, we followed up for an average of 44 months 633 patients who had undergone 714 carotid operations. We analyzed the indication for surgery (by CHAT) and the effect of preoperative risk factors (age, hypertension, cardiac disease, tobacco use, diabetes, hyperlipidemia, renal disease, pulmonary disease, and total risk factor score) on the end points of late stroke and death. Ipsilateral stroke was uncommon after carotid endarterectomy: with life-table analysis, the probability of late stroke at 5 years after carotid endarterectomy was 3%. Among the 127 patients with amaurosis fugax, the incidence of late stroke and of mortality was a combined total of 1% per year, and the 17 patients who had been first seen with permanent ocular stroke (blindness) fared equally well. The 28 patients who were first seen with vertebrobasilar symptoms and were treated by carotid endarterectomy also fared particularly well, with no late strokes or deaths within the first 5 years. Logistic regression analyses revealed that the various indications for carotid endarterectomy were associated with differing patterns of risk factors as significant predictors of late stroke or death. For patients first seen with asymptomatic lesions, only diabetes was an important predictor for late stroke (p = 0.05) and renal disease was the only marker for early death (p = 0.05). On the other hand, those factors were not significant risk factors for patients first seen with amaurosis fugax, for whom tobacco use was a negative predictor for stroke (p = 0.06) and male gender a negative predictor for early death (p = 0.03). After cortical transient ischemic attacks and carotid endarterectomy, there were no risk factors predictive of late stroke or of death. For patients with prior stroke, age was a very strong predictor of stroke (p = 0.01) and both age and a history of cardiac disease were significant risk factors for early death (p = 0.007). In contrast to the results in reports of patients treated medically for transient ischemic attacks and stroke, we found that several risk factors appeared to play relatively minor roles. In conclusion, stroke after carotid endarterectomy was uncommon, least common after ocular symptoms, and most likely after permanent cortical stroke. Specific risk factors were less important for patients after carotid endarterectomy than for the medically treated stroke patient.
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PMID:CHAT analysis of the influence of specific risk factors on late results after carotid endarterectomy. 140 78

The diagnosis-related groups have encouraged physicians to become more efficient in the care of their patients; often, however, raising the question of safety. For 3 years all patients undergoing carotid endarterectomy at our institution were monitored in the intensive care unit for 24 hours and the majority were discharged on the second postoperative day. After review of these patient's hospital records and direct patient interviews, it was clear that many patients did not require a stay in the intensive care unit and could be discharged on the first postoperative day. In January 1991 a prospective policy was established to evaluate the safety and efficacy of outpatient arteriography, same-day admission, selective use of the intensive care unit, and early discharge on the first postoperative day when feasible. During a 10-month period all patients undergoing carotid endarterectomy at our institution were evaluated (n = 52). Eleven patients had had a prior stroke (21%), 31 had either amaurosis fugax or transient ischemic attacks (60%), and 10 had no symptoms (19%). The arteriogram for 49 of the patients was obtained on an outpatient basis or during a prior admission, and these patients were admitted to the hospital on the day of operation. Nine patients were placed under general anesthesia and had shunting procedures, and 43 patients had cervical block anesthesia, eight of whom had shunting (19%). Only five patients required an intensive care unit stay for either hypertension, hypotension, or neurologic complication (one transient ischemic attack and one minor stroke). Forty-six patients (88%) were discharged on the first postoperative day; average length of stay was 1.29 days/patient.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Carotid endarterectomy: a safe cost-efficient approach. 146 Jul 20

The results of every carotid endarterectomy performed contralateral to an internal carotid artery occlusion (n = 36) (group I) were compared with those performed contralateral to a patent internal carotid artery (n = 169) (group II) over the last 10 years. The patients in each group were evenly matched with respect to male gender (66% vs 69%); mean age (66.7 vs 65.9 years); and incidence of hypertension (55.6% vs 53.2%), diabetes (16.7% vs 20.1%), and hyperlipidemia (8.3% vs 11.8%). Patients in group I had a higher incidence of previous myocardial infarction (25% vs 11.8%, p less than 0.05) and exertional angina (55.6% vs 29.6%, p less than 0.01). Indications for carotid endarterectomy were equivalent, including stroke (19.4% vs 21.9%), transient ischemic attacks (36.1% vs 35.5%), amaurosis fugax (16.7% vs 11.8%), nonhemispheric symptoms (5.6% vs 8.3%), and asymptomatic stenoses (22.2% vs 22.5%), respectively. Perioperative strokes occurred in one (2.8%) patient in group I and seven (4.1%) patients in group II (NS). Among the patients in group II the incidence of perioperative stroke did not correlate directly with the degree of contralateral ICA stenosis: greater than 90% (4%); 70% to 90% (6.7%); 50% to 70% (8.7%); and less than 50% (2.8%). The operative mortality rate was 0% among patients in group I and 1.2% among patients in group II (NS). Cardiac complications occurred in two (5.6%) patients in group I and nine (5.3%) patients in group II (NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Does contralateral internal carotid artery occlusion increase the risk of carotid endarterectomy? 152 36

Patients presenting with symptoms suggestive of amaurosis fugax, or with findings of Hollenhorst plaques on fundoscopy are frequently referred for duplex evaluation to detect possible carotid artery disease. To better determine the reliability of monocular visual loss and the presence of Hollenhorst plaques for predicting the presence or significance of carotid artery stenosis, we prospectively studied 66 patients with these ocular signs and symptoms. After evaluation, the patients were categorized as follows: 34 of 66 (52%) patients had amaurosis fugax, 23 (35%) had asymptomatic Hollenhorst plaques, 7 (11%) had retinal artery occlusion, and 2 (3%) had venous stasis retinopathy. All patients were evaluated ophthalmologically, with carotid duplex scanning and spectral analysis. A stenosis of greater than 60% was regarded as significant. The presence of risk factors including hypertension, diabetes, a history of CVA or TIA's, tobacco use and hyperlipidemia was recorded. There were no statistically significant differences (p greater than 0.05) in the incidence of atherosclerotic risk factors between the four groups. Patients with amaurosis fugax were more likely to have a significant carotid artery stenosis than those with asymptomatic Hollenhorst plaques or retinal artery occlusion (53% vs 9% vs 0% respectively) (p less than 0.006). We conclude that routine carotid duplex scanning is indicated in all patients with amaurosis fugax in view of the frequent association with significant carotid stenosis (53%). However, the presence of Hollenhorst plaques in the absence of visual symptoms appears not to have a significant association with carotid disease and may not necessarily require routine screening unless other risk factors for carotid stenosis are present.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Correlation of ophthalmic findings with carotid artery stenosis. 152 43

In the Swedish aspirin low dose trial (SALT) 101 patients were enrolled from the Department of Medicine, Falun. 42 patients had experienced TIA/amaurosis fugax, whereas 59 patients had suffered a minor stroke/retinal infarction. History of hypertension treated or known untreated occurred statistically more frequently in the minor stroke group at randomisation (P less than 0.01) and the mean diastolic blood pressure (DBP) was higher in the minor stroke group during the observation time (P less than 0.05; ANOVA). The minor stroke group had less favourable outcomes according to survival curves (stroke or death) during a mean observation time of 34 months in each group (P less than 0.05 at 29 months). The findings of the present trial suggest that hypertension and the higher mean DBP during the observation time might explain the better outcome of end points of stroke or death in patients with TIA.
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PMID:Differences in the outcome of patients with TIA versus minor stroke. 157 6

Clinical and Doppler sonographic findings on the internal carotid artery of 218 patients with acute central retinal artery obstruction (42), branch retinal artery obstruction (43), anterior ischemic optic neuropathy (AION) (51), amaurosis fugax (AF) (21), and retinal vein occlusions (61) were evaluated. The most prominent finding was that only 1 out of 51 patients with AION and none of 61 patients with retinal vein occlusions showed a relevant stenosis or occlusion of the internal carotid artery. In contrast, however, patients with acute central retinal artery obstruction and branch retinal artery obstruction and those with AF revealed stenoses or occlusions of the internal carotid artery in approximative one-third to one-fourth of the cases. No excavation of the optic disc (cup) occurred in patients' eyes affected by AION or in the other eye. Fourteen of 51 patients with AION showed a "stuttering progression" of their visual function. The patients with progressive loss of vision were significantly younger on average than patients with permanent visual loss due to AION. Some of these cases with progressive field defects revealed an increase in edema of the optic discs and in hemorrhages. Patients with acute central retinal artery obstruction showed very high blood pressure values more often than patients with AION. Retinal emboli (Holenhorst plaques) were very often seen in patients with branch retinal artery obstruction (in 29 of 43 patients; 67%). However, they rarely occurred in patients with acute central retinal artery obstruction (5 of 42 patients). Only 1 of 51 cases with AION showed retinal emboli.
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PMID:[Acute circulatory disorders of the eye. Clinical findings and results of Doppler sonography of the internal carotid artery]. 204 32

A case of cerebral aspergillosis is reported, the presenting symptom was numbness of right face, which worsened after one year. CT-scan showed two enhanced low-density patches in the anterior and basal parts of right temporal lobe. During operation, an abscess in the deep part of right temporal lobe was revealed. The patient gradually felt amaurosis and oculomotor palsy of right eye. About six months later, she died from intracranial hypertension. Biopsy, as well as autopsy findings suggested fungal infection, and was identified as Aspergillus nidulans, which has probably never been reported in the literature.
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PMID:A case of cerebral aspergillosis caused by Aspergillus nidulans. Clinical, pathologic and mycologic identifications. 211 68


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