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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Somatosensory evoked potentials (SEP) were investigated in 140 patients suffering from cerebro-vascular ischemic disease (CVD). Data were compared to age-correlated normal persons (n = 26; male 16, mean age 55.6 years SD 10.9). Patients with asymptomatic vascular diseases (n = 10; male 7, mean age 63.8 years SD 10.4) showed bilateral prolonged CCT (left side p less than 0.05). Patients with TIA (n = 44; male 21, 58.3 years SD 12.3), complicated migraine (n = 3, all female, 24, 40, 63 years) and RIND (n = 17; male 10, 56.5 years SD 16.8) showed no abnormalities of CCT and AR as compared to normals. Abnormalities of PHAS were only seen in patients with RIND of the right carotic supply. In patients suffering from completed stroke (n = 40; male 29, mean age 56.9 years SD 14.4) bilateral prolongation of CCT was seen in those with ischemia of the right carotic supply; those with ischemia of the left carotic supply showed a significant asymmetry of CCT and deviation of AR l/r. In two patients with infarction of the pons an increase of CCT and decrease of AR at the side of the lesion was found. Patients with MID (n = 27; male 20, 69.7 years SD 10.3) showed significant bilateral prolongation of CCT, increase of AR (at the side of stimulation) and deviation of AR l/r (1.63).
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PMID:[Early somatosensory evoked potentials in ischemic diseases--II: Normal values and findings in asymptomatic vascular stenoses/occlusions, complicated migraine, transitory ischemic attacks, reversible ischemic neurologic deficit, complete stroke and multi-infarct dementia]. 313 Nov 9

The hemorheologic changes in three groups of patients suffering from acute and chronic cerebrovascular diseases were studied. Firstly, a horizontal study on 57 patients with definite stroke and on 49 patients with TIA was made. Plasma viscosity, whole blood filtration rate, fibrinogen concentration and hematocrit were evaluated as markers of the rheological property of blood. Blood samples were drawn within 6 h from the onset of vascular syndrome. The findings were compared with values obtained in 112 as controls. At the same time, washed red cell filtration rate, together with lactoferrin, betaglucuronidase and beta-thromboglobulin plasma level were assayed. In both groups the onset of the vascular storm was associated with a marked increase of plasma fibrinogen and of blood and plasma viscosity and a significant decrease of whole blood filterability. Lactoferrin, betaglucuronidase and beta-thromboglobulin levels were also significantly increased. Following this, a longitudinal study was performed on 27 patients with definite stroke and 32 patients with TIA. The clinical regression of acute stroke was associated with the progressive reduction of rheological abnormalities. Finally, 81 patients with clinical diagnosis of cerebrovascular disease due to previous stroke or repeated TIA were studied together. An increase of blood viscosity, of fibrinogen concentration and of hematocrit and a decrease of blood filtration rate together with higher levels of beta-thromboglobulin were registered. These results confirm the existence of an association between CVD and hemorheological alterations and suggest more in depth research directed towards identifying the significance of these alterations in the pathogenesis of tissue ischemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hemorheological factors in the pathophysiology of acute and chronic cerebrovascular disease. 316 Apr 74

It remains uncertain whether platelet activation in ischemic stroke is contributory or secondary to brain ischemia. The efficacy of aspirin (ASA) in stroke prevention suggests that platelet activation contributes to the occurrence of stroke. On the other hand, platelet activation may be simply a generalized consequence of cerebral ischemic damage. To examine this issue, plasma levels of the platelet specific proteins beta-thromboglobulin (beta-TG) and platelet factor 4 (PF4) were measured in fifty-eight patients with various defined types of acute ischemic strokes. beta-TG was a broader indicator of platelet activation than PF4. Compared with an age-matched control group, thromboembolic and cardioembolic stroke patients had significantly elevated beta-TG levels (p less than 0.001). Also, beta-TG levels in these stroke categories were significantly higher in samples drawn within the first week after the event than in those drawn later (p less than 0.001). In contrast, beta-TG levels in lacunar stroke patients and in most TIA patients were normal. beta-TG levels did not correlate with the volume of cerebral infarction as measured by planimetry from CT scans. Moreover, beta-TG levels in patients on chronic ASA therapy at the time of stroke did not differ from those in patients of the same diagnostic categories not taking aspirin. These data indicate that platelet activation may be important in some, but not all, subtypes of ischemic stroke and that platelet activation can occur in stroke even though the platelet cyclooxygenase pathway is suppressed.
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PMID:Enhanced in vivo platelet activation in subtypes of ischemic stroke. 316 Dec 20

Eighty-two patients presenting with subclavian steal syndrome (36 men, 46 women; median age, 66.5 years) were studied. All patients underwent clinical and noninvasive evaluation. Diagnosis was based on both a 20 mmHg difference in blood pressure between arms and reversed blood flow in the vertebral artery. Twenty-one patients (25.6%) had a transient ischemic attack or cerebrovascular accident before the study. In 16 patients (19.5%), the anterior circulation was involved and the vertebrobasilar circulation was effected in 5 patients (4.8%). Fifty-five patients were followed for one to six years (mean 4.1 years). During this period three patients died. Noninvasive studies showed that 39 patients (70.9%) had progression of disease in the carotid arteries and that 10 of these 39 (12.1%) exhibited a transient ischemic attack or cerebrovascular accident, and eight patients (9.7%) required carotid endarterectomy. No patient had a stroke involving the vertebrobasilar circulation, but four patients (4.8%) had a transient ischemic attack. Three other patients had revascularization procedures performed for arm ischemia. Patients with subclavian steal syndrome are more likely to experience a transient ischemic attack or cerebrovascular accident involving the carotid circulation than the vertebrobasilar circulation. Noninvasive evaluation of the carotid arteries and the posterior circulation should be included in the long-term follow-up of these patients.
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PMID:Natural history of subclavian steal syndrome. 318 98

Two hundred and twenty-one patients with cerebral cerebral ischemic attack in the middle cerebral artery territory were investigated. Those patients manifested several clinical types, TIA: 31, stroke with full recovery: 50, minor completed stroke: 54 and major completed stroke: 86 cases. CT classification was made 3 weeks after the ischemic attack based on the characteristic arterial topography. We discussed in this paper what kind of ischemic lesion had greater possibility of recovery from ischemic lesion had greater possibility of recovery from ischemia focusing on the retrospective study of clinical symptoms, CT classification and angiographic findings. We also referred to the other factors influencing the reversibility of an ischemia such as lacunae and PVH (periventricular hypodensity). The extent of and LDA on CT scan closely correlated with clinical symptoms, CT classification and angiographic findings. We also referred to the other factors influencing the reversibility of an ischemia such as lacunae and PVH (periventricular hypodensity). The extent of an LDA on CT scan closely correlated with clinical types (Table 2). The reversibility of type I was excellent, however aged patients over 70 with PVH and ventricular dilatation developed permanent neurological impairment associated with dementia. The reversibility of a small infarction in the basal ganglia (type II) depended mainly on the involvement of the internal capsule. Infarction involving a cortex (type IV and type V) invariably resulted in permanent neurological deficits except for the rare cases with involvement of silent areas. CT classification of type III, so called demarcation zone infarction, developed various clinical types, and showed transient functional disturbance of the cortex without an infarction i the cortico-subcortical region.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cerebral ischemia (1)--Reversibility of ischemic lesion and CT findings]. 320 63

A consecutive series of 369 asymptomatic patients with a carotid bruit was prospectively followed with Ocular Pneumoplethysmography (OPG). The aim of the study was to identify those patients most prone to cerebrovascular ischemia and/or progression of obstructive carotid disease. During follow-up 13 patients developed a stroke of which six were fatal (two thrombo-embolic and four haemorrhagic strokes). TIA's occurred in 15 patients, including eight patients with amaurosis fugax. TIA's occurred more frequently on the side of a haemodynamically significant stenosis (9% = 9/95) than on the side of a normal, OPG (2% = 6/274). There was no difference in the strokelocated side. The occurrence of symptoms and/or signs of cerebrovascular disease was 4% at two years and 10% at five years. The left hemisphere was affected twice as often as the right. The development of a haemodynamically significant carotid stenosis, according to OPG, was equal for the right and the left carotid arteries, being 18% at two years and 56% after 5 years of follow-up. The major risk factors for progression of obstructive disease were systolic blood pressure above 160 mmHg independent of age, diabetes mellitus and the presence of ischaemic heart and peripheral arterial obstructive disease. This study supports the contention that in a group of patients with an asymptomatic carotid bruit, a group of patients at risk from cerebrovascular accidents can be filtered out by a simple non-invasive test in combination with a complete physical examination.
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PMID:Risk factors in asymptomatic patients with a carotid bruit. 350 60

Transient global amnesia is a benign condition of sudden onset that resolves spontaneously. Retrograde amnesia prevents recall of events antedating the episode by hours to years, and anterograde amnesia produces the characteristic features of inability to learn new material and repetitious questioning. Laboratory investigation of these patients is generally unrewarding. Transient global amnesia is easily distinguished from amnesia caused by head trauma or transient ischemic attack, confusional state, and functional amnesia. Although transient global amnesia is most likely caused by transient ischemia of brain structures important for memory, thromboembolic cerebrovascular disease is not the cause. The patient with transient global amnesia should be treated conservatively.
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PMID:Transient global amnesia. When memory temporarily disappears. 360 46

In summary NVAF is an important risk factor for stroke identifying a population at a six fold increased stroke risk. When stroke occurs it tends to be large and without a preceding TIA. These patients commonly have other cardiovascular disorders that must be considered as a potential cause of brain ischemia. The appropriate management of these patients to prevent cardioembolic stroke is unknown and must be individualized pending appropriate clinical trials. Following a cardioembolic stroke anticoagulation should be considered only in patients with small or moderate sized infarcts who have no evidence of hemorrhagic infarction on a CT scan and delayed until 36-48 hours post stroke onset.
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PMID:Atrial fibrillation and stroke: the view from neurology. 366 Dec 95

Eighty-three patients, 43 women and 40 men, with hemispheric transient ischemic attacks (TIAs) and normal angiograms were studied. Fifty-two of the patients had a single episode of transient ischemia, whereas 31 had multiple episodes prompting initial evaluation. Follow-up ranging from 3 to 132 months was obtained for all patients. In this period, six patients suffered a cerebrovascular accident and five had further hemispheric TIAs. These results are in contrast to our earlier data, which suggested a benign prognosis in this group of patients. Results of this updated study show that the prognosis of patients with hemispheric TIAs and normal angiograms is not so benign as originally reported. Those patients with multiple events before initial evaluation are at increased risk of subsequent cerebrovascular accident or TIA. Close observation of this group of patients is recommended.
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PMID:Life history of patients with transient ischemic attacks and essentially normal angiograms. 369 52

The gerbil model was used to assess the therapeutic effects of the calcium antagonist nimodipine on cerebral ischemia. Transient cerebral ischemia was produced in each gerbil by bilateral common carotid occlusion of 10-, 15- or 20-min duration. Nimodipine (0.01 or 0.1 mg/kg) was administered intraperitoneally just before the carotid occlusion or 10-30 min after the removal of the arterial clips. Morbidity of each animal was evaluated using the stroke index, and the sum of stroke indices was calculated for evaluating the overall morbidity during a particular period of reperfusion. Mortality was observed for 24 hours after clip removal. Although, depending on the timing of the drug administration, the low-dose (0.01 mg/kg) nimodipine worsened the morbidity in the gerbils with 10-min ischemia, the high-dose (0.1 mg/kg) of the drug had a clear beneficial effect on the mortality associated with cerebral ischemia. These results are considered worthwhile for further trials to assess the usefulness of nimodipine as a therapeutic agent in the management of the acute ischemic stroke.
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PMID:The effect of the calcium antagonist nimodipine on the gerbil model of experimental cerebral ischemia. 373 60


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