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

To detect the functional reversibility and hemodynamic process in cerebral ischemia, the EEG topography cased on % time and amplitude was applied. % time and amplitude were obtained by the wave-form recognition method/EEGs were recorded under the resting state and during drug-induced conditions in 18 patients with steno-occlusion of main cerebral artery. The type of ischemic attack was TIA in 2 patients, RIND in 4, minor stroke in 7 and major stroke in 5. Six of 11 patients showed the improvement of EEG under induced hypertension. Four of those 6 patients were operated on ECIC bypass surgery, and all of them showed the improvement of clinical and EEG findings postoperatively. Twelve patients showed the deterioration of EEG under induced hypotension. Eight of them were operated on ECIC bypass surgery, and none of them suffered from reattack of cerebral ischemia postoperatively. Those preoperative EEG changes were observed mainly on the EEG topography of % time. And, the analysis of the EEG topography of % time under drug-induced conditions was available to study the pathophysiology of cerebral ischemia for selecting the suitable treatment.
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PMID:Clinical application of EEG topography in cerebral ischemia: detection of functional reversibility and hemodynamics. 209 4

One hundred patients with ischaemic cerebro vascular disease (TIA/RIND--67% and completed stroke--33%) were evaluated for various clinical and biochemical risk factors. Evidence of extra-cranial carotid vascular disease (ECCVD) was looked for by using Doppler scan and carotid angiography. Of the 28 patients with abnormal Dop scan, 27 were confirmed to have ECCVD by angiography. Though the history of hypertension was elicited in 40%, only 28% had BP of 160/95 mm Hg or more during hospital stay. Hypertension was twice more common in ECCVD group compared to the group with normal carotid vessels. Obesity was seen in 15%, diabetes mellitus in 10% and 1% had hyperuricaemia. Total cholesterol was elevated in 29% and HDL cholesterol fraction was decreased (less than 35 mg%) in 43%. The reduction of HDL cholesterol was more frequent in ECCVD group (63%) and in hypertensive (73%) patients. Lipoproteins, triglycerides, free fatty acids and phospholipids were not significantly affected.
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PMID:Risk factors in extracranial carotid disease. 261 17

In contrast to CT, NMR imaging revealed a high percentage of abnormalities in the TIA-RIND population studied. The various patterns of abnormalities identified should provide further insight into the pathophysiology of ischemic cerebrovascular disease. Age and hypertension appeared to be the most significant clinical risk factors for TIA-RIND. Although periventricular hypodensities have been visualized by CT for many years, their clinical significance has only recently been appreciated. NMR shows the same periventricular changes as increased signal (long T2), but shows it in a more dramatic fashion. These periventricular abnormalities, seen both by CT and NMR, have been shown in some cases to be compatible with the pathologic diagnosis of SAE, or Binswanger's disease. Watershed abnormalities both with and without corresponding cerebral infarctions have been presented. At present, this appears to be a ubiquitous group of cerebrovascular disease with multiple underlying causes. NMR is superior to CT for demonstrating watershed infarctions, not only because it reveals ones missed by CT, but also because it shows a fuller extent of involvement than does CT. The evolution of cerebral infarctions as seen by CT and NMR has been presented. NMR demonstrates abnormalities earlier than CT. The region of infarction appears more extensive than by CT and chronic infarctions show an associated rim of prolonged T2 that may correspond to the ischemic penumbra or regions of ischemic demyelinization. CT phenomena, such as fogging and GME, have their NMR correlates. To date, all regions of GME shown by CT have also been demonstrated by NMR. Cortical infarctions, thought in many instances to be due to emboli have been frequently demonstrated by NMR. NMR imaging is clearly superior to CT for recognizing these lesions because it is not hampered by artifact from bone adjacent to cortex, as is CT. Similarly, posterior fossa and brainstem infarctions may be seen to advantage by NMR.
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PMID:Nuclear magnetic resonance imaging in patients with stroke. 350 56

In a retrospective study the reports of 211 cases of cardiogenic cerebral embolism--diagnosed on the base of neurological and cardiological findings--were analyzed in view of signs and findings of prognostic value. There were 21 patients with TIA, 39 cases of RIND and 151 patients with cerebral infarction, 60 of which showed mild and 91 severe neurological symptoms. 38 patients died during the period of hospitalization. While sex of the patients as well as vascular risk factors (hypertension, diabetes mellitus, cigarette smoking) did not influence the clinical course of the disease, patients with TIA or RIND in general were younger (about 5 years) than those with severe stroke. Prognosis of cardiogenic cerebral embolism depended to a great degree on the underlying heart disease. Cerebral embolism after myocardial infarction showed a better remission of symptoms than embolism in atrial fibrillation. In the group of valvular diseases the course of embolic strokes in mitral lesions was worse than in aortal valve disease. Prognosis was worst in endocarditis, both in view of neurological deficit and of mortality. Mostly, the cardiogenic emboli lead to infarctions of the middle cerebral artery territory (78 per cent) with a predilection for the left hemisphere. In media-syndromes the clinical course was significantly worse in patients with additional homonymous visual defect compared to incomplete infarctions. Initial disturbance of conscience reduced prognosis quoad vitam et restitutionem significantly. Of the neuroradiological findings, the detection of arterial occlusion or circulatory disturbance in angiography as well as the finding of an ischemic lesion in computed axial tomography (CAT) was correlated with a severe course of the embolic stroke. While 7 patients with hemorrhagic infarction in CAT-Scan showed no differences in the clinical course, the 14 patients with pathological cerebral spinal fluid findings in embolism had an unfavourable prognosis. The development of epileptic seizures did not influence the further course of the infarction to a significant extent. Results are compared with the current world literature.
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PMID:[Prognosis of cardiogenic cerebral embolism]. 374 66

From 1978 to 1980, thirty-one patients aged forty years or less, had cerebral ischemic events as TIA, RIND or complete stroke. These patients have been studied, both clinically and with laboratory tests to assess the most common causes of their disorder. It was found that hypertension, excess smoking, diabetes and disorders of the lipid metabolism are the most common causes of the atherosclerosis, which plays a role in enhancing ischemic cerebro-vascular accidents during youth. The detection as well as the localization of the site of the ischemic lesions was difficult; only in six out of the seventeen patients examined it was possible to show angiographically a stenosis of one cerebral vessel. Comparison between the 31 patients and 31 subjects of the same age without clinical symptoms or neurological signs, showed a significant incidence of causes of atherosclerosis in the control subjects. In view of the limited number of controls it was not possible to predict a clearcut prognosis.
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PMID:[Risk of cerebral infarct in young adults (author's transl)]. 711 91

Long-term anticoagulant treatment was given to 25 patients with transient ischemic attacks (TIA) and 49 stroke patients with reversible ischemic neurological deficit or cerebral embolism. Another 16 TIA patients were observed without anticoagulant treatment. Life table analyses, comparing the observed with the expected frequency, revealed increased mortality in the TIA patients irrespective of whether or not they had received anticoagulants. The stroke patients treated with anticoagulants also had a higher mortality than expected. On the other hand, the incidence of subsequent stroke was not higher than expected in the TIA and stroke patients treated with anticoagulants, while it was significantly increased in the TIA patients not treated with anticoagulants. Thus, the risk of stroke, but not the risk of death, was normalized by the anticoagulant treatment. Unacceptably serious bleeding complications were seen in the group of stroke patients with anticoagulant treatment. Bleeding complications, in both TIA and stroke patients, seemed to be related to lengthy treatment, high blood pressure on admission or insufficient patient compliance.
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PMID:The outcome of patients with transient ischemic attacks and stroke treated with anticoagulants. 745 5

To determine the effect of risk factors and trigger factors on cerebrovascular events, 622 patients who survived mitral valve replacement between December 1979 and December 1992 were analyzed. Ninety-six patients suffered 139 nonhemorrhagic cerebrovascular events. Data were available on 138 events in 95 patients. There were 32 transient ischemic attacks (TIAs), 57 reversible ischemic neurological deficits (RINDs), and 49 strokes. Age, sex, atrial fibrillation, left atrial size, systemic hypertension, and abnormal body mass index did not discriminate between patients who suffered events and those who did not. In contrast, smoking status differed significantly between patients who suffered events and those who did not. Among current or recent ex-smokers, the risk of stroke or RIND was significantly higher than in non-smokers (p < < 0.001). The odds ratio of suffering any type of event in patients who smoked at any time postoperatively versus those who did not smoke was 2.9 (95% confidence interval: 1.8 to 4.6). Of 61 patients contacted directly, 30% recalled an infective episode immediately prior to their event. A diurnal and seasonal influence on events was also detected with peaks in the morning and in the winter months, respectively (both p < 0.001). It is concluded that there is persuasive evidence for the involvement of several nonprosthetic factors in the incidence of cerebrovascular events after mitral valve replacement. This has implications for patient management and for future analysis of prosthetic heart valve series.
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PMID:The role of risk factors and trigger factors in cerebrovascular events after mitral valve replacement: implications for antithrombotic management. 818 73

Fifty patients of either sex with acute and chronic cerebrovascular disorders were submitted to an observation protocol and treated with oral nimodipine (tablets or drops) at a daily dosage of 90 mg for 1 to 3 months. Nimodipine proved useful both from the therapeutic point of view and for its easy handling in acute pathology (TIA, RIND, minor stroke, complete stroke) as well as chronic cerebral ischemia. The drug was well tolerated both locally and systemically; in patients with concomitant arterial hypertension, nimodipine reduced blood pressure with a tendency towards stabilization at near-normal levels.
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PMID:[Nimodipine in ischemic cerebropathy]. 847 25

The aim of the study was to establish the role of arterial hypertension, diabetes and cardiac arrhythmias as the risk factors for ischaemic stroke (IS), considering the type of stroke (RIND and completed stroke) and age. The statistical methods commonly.
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PMID:[Arterial hypertension, diabetes and cardiac arrhythmias as risk factor in reversible and completed ischemic stroke]. 904 58

The studied material comprised 280 patients hospitalized for the first time for reversible ischaemic neurological deficit. The clinical condition of the patients, the incidence of hypertension (48.3%), ischaemic heart disease (36.4%) and diabetes (4.3%) was assessed and the indices were calculated of first admissions to hospital and the individual groups of diseases. The annual incidence of the RIND was 22.7/100 thousand, 3.6/100 thousand for TIA in the population of Warsaw City District.
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PMID:[Certain clinical and epidemiological problems of reversible ischemic neurological deficit]. 914 70


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