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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We assayed plasma concentrations of fibrinogen, fibrinopeptide A, plasmin-alpha 2 plasmin inhibitor complex, D dimer, and antithrombin III activity in 40 patients with cerebral thrombosis and nine patients with cerebral embolism during the acute (less than 7 days), subacute (7-27 days), and chronic (greater than or equal to 28 days) periods and compared these with 69 controls. In cerebral thrombosis, fibrinogen and fibrinopeptide A levels were elevated significantly in all stages (p less than 0.001), whereas plasmin-alpha 2 plasmin inhibitor complex and D dimer levels were elevated significantly in the subacute and chronic periods. The antithrombin III activity was significantly decreased in the acute stage. The elevation of fibrinogen and plasmin-alpha 2 plasmin inhibitor complex levels in the acute stage was significantly greater in patients with an infarct size greater than 10 mm2 compared to patients with an infarct size less than 10 mm2. We observed similar changes in patients with cerebral embolism. These results suggest that enhanced coagulation exists at all stages and endogenous fibrinolysis is activated in the subacute and chronic periods in a large proportion of patients with cerebral thrombosis and embolism.
Stroke 1990 Dec
PMID:Coagulation-fibrinolysis abnormalities in acute and chronic phases of cerebral thrombosis and embolism. 214 32

The effectiveness and safety of a very low molecular weight heparin fraction were evaluated in the prevention of deep-vein thrombosis in patients confined to bed due to hemiplegia consecutive to a recent cerebral infarction. CY 222 was administered within 48 hours of the stroke by one single daily subcutaneous injection of 0.6 ml (= 15,000 U AXa IC) during 14 days. This randomized pilot study involved 30 patients. The effects of CY 222 were assessed in a group of 15 patients compared with a control group of 15 untreated patients. No deep-vein thrombosis was detected by the labelled fibrinogen test in the treated group, as against 12 patients in the control group. Six patients (3 in each group) died during the study. One case of lethal pulmonary embolism was observed and confirmed at autopsy in the control group. In the remaining 5 patients, no systematic autopsy which would have asserted the absence of pulmonary embolism or drug-induced haemorrhage was performed. Numerous standard laboratory tests confirmed that CY 222 was well tolerated.
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PMID:[Prevention of deep venous thrombosis of the leg by a very low molecular weight heparin fraction (CY 222) in patients with hemiplegia following cerebral infarction: a randomized pilot study (30 patients)]. 215 40

The authors describe the role of changes in osmotic homeostasis and hemorheology in the pathogenesis of ischemic brain stroke. 48 patients experiencing an acute period of ischemic brain stroke were examined. For this purpose the following methods were employed: measurements of blood, urine and CSF osmolality by Knauer osmometer; glucose and urea by the enzymatic assay; blood electrolytes by flame photometer; aggregation of platelets, red blood cells, blood viscosity, fibrinogen, hematocrit; the ethanol test, and thromboelastography. The data obtained demonstrate that the unfavorable prognostic signs may include steady and increasing hyperosmia, rise of the mmol discriminant of osmolality to over 35-40 mOsm/l, a progressive decrease of the rheological blood parameters and of colloid-osmotic pressure together with a progressive reduction of the urine/blood osmolality, which points to the rupture of the compensation for osmotic homeostasis and decompensation for the functional system regulating the blood aggregation state.
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PMID:[Osmotic homeostasis and blood rheology in patients in the acute period of ischemic cerebral infarction]. 217 76

Clot lysis is desirable in patients with thrombi in arteries and arterioles by a safe rapidly-acting thrombolytic agent. Ancrod cleaves fibrinogen; the resulting circulating ancrod-fibrin stimulates fibrinolysis. Ancrod action and effect were studied in 20 patients with acute developing stroke in a double-blind, placebo-controlled study. Patients were randomly assigned to one of two treatment groups, and received either normal saline or ancrod 0.5 mu/kg in normal saline administered as a constant-rate intravenous infusion over 6 hours. Subsequent doses of ancrod (or saline placebo) were determined daily thereafter for a total treatment period of 7 days. Neither bleeding nor re-thrombosis occurred within the 90 day follow-up period. That ancrod acted rapidly was shown by a significant decrease in functional plasminogen activator inhibitor (PA-I) within 60 minutes, and by significant elevations of fibrin(ogen) degradation products (FDP) and D-dimer within 3 and 4 hours. The biological effect of fibrinolysis in ancrod infused patients was demonstrated by a greater improvement in stroke score when compared to those infused with saline.
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PMID:Ancrod causes rapid thrombolysis in patients with acute stroke. 218 30

There can be no doubt about the relevance of various established risk factors of stroke, which therefore will not be discussed. When trying to manipulate factors as hypertension, hyperlipoproteinemia and smoking, in most cases an improvement of the flow properties of blood can be observed. This makes flow properties at least very likely to trigger cerebral ischaemia and stroke. Furthermore there is increasing evidence, that single factors, contributing to a deterioration of blood rheology (i.e. haematocrit, fibrinogen, plasma viscosity, red cell rigidity) may be considered risk factors of apoplexie depending on the quality of interaction. There seem to exist positive correlations to the extent of atherosclerotic alterations of the vessel system. Blood viscositiy and red cell aggregation can be interpreted as the respective state of different pathologic profiles of blood rheology and thus might reach pathologic levels already before it is notified by single factors. In conclusion there is a good chance for blood viscosity and red cell aggregation to play an independent role as risk factors of apoplexie derived from cerebral ischaemia.
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PMID:[Rheologic risk factors of apoplexy]. 220 40

Risk factors for coronary heart disease (CHD), stroke, congestive heart failure and total mortality were analysed in two random population samples of men in Gothenburg, Sweden, aged 50 and 47-55 years, respectively, at entry. A series of potential risk factors for the above mentioned end-points have been analysed in univariate and multivariate logistic analyses. Population attributable risks were also calculated. Significant risk factors in multivariate analyses are summarized. For CHD they were: family history of CHD, hypercholesterolemia, hypertension, tobacco smoking, psychologic stress, low social class and diabetes mellitus. In hypertensives, proteinuria was measured and found to be significant also. Stroke risk factors were: family history of stroke, blood pressure, smoking, high waist/hip ratio, high plasma fibrinogen, psychologic stress, proteinuria, atria fibrillation and transitory ischemic attacks. Hypertension, smoking, high waist/hip ratio and psychologic stress were risk factors for congestive heart failure.
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PMID:Synergistic effects of risk factors. 220 55

Thirty-seven patients, aged 47 +/- 22 years, diagnosed suffering from vertebrobasilar insufficiency (VBI), underwent a hemorheological examination; 20% of these patients had no vascular risk-factor but none showed complete normal hemorheological findings. The distribution of hemorheological parameters was comparable to those in patients suffering from stroke or TIA. Abnormal were platelet-reactivity in 78%, plasma-viscosity in 57%, fibrinogen in 23%, red-blood-cell-aggregation in 13% and hematocrit in 11% of all cases. To obtain more information on how to classify common clinical symptoms i.e. headache in combination with vertigo it may be useful to introduce hemorheological parameters as platelet-reactivity, plasma-viscosity, fibrinogen, in the further laboratory examination of those patients.
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PMID:Abnormal hemorheological parameters in vertebrobasilar-insufficiency. 222 Mar 11

The levels of some cardiovascular risk factors (lipids, apolipoproteins and fibrinogen) were measured in groups of Type-2 diabetic patients with lower limb proximal (ileofemoral) and distal (trifurcational) artery macroangiopathy, diagnosed by Doppler ultrasound, and in a group of diabetics without macroangiopathy. The highest mean levels of total and LDL-cholesterol, apolipoprotein B and triacylglycerols were observed in patients with proximal vessel involvement. Significant correlations were found between the thigh/arm index and total cholesterol, LDL-cholesterol, apolipoprotein B and stroke prevalence. On the other hand, a significant correlation was found between ankle/thigh index and fibrinogen. The results of the study suggest that different pathogenetic mechanisms may play a role in the development of ileofemoral and trifurcational vessel disease.
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PMID:Different levels of cardiovascular risk factors in type-2 diabetic patients with lower limb proximal and distal vessel macroangiopathy. 222 80

One hundred and three consecutive out-patients with ischaemic rest pain were studied. There were 77 men and 26 women with a mean (s.d.) age of 71 (10) years. Thirty-six (35.0%) patients had rest pain alone, 41 (39.8%) in association with an ischaemic ulcer and 26 (25.2%) with digital gangrene. A significantly increased risk of amputation was seen in those patients with an elevated serum cholesterol (greater than 5.2 mmol/l; P = 0.01), white blood cell count of greater than 10 x 10(9)/l (P = 0.05), fibrinogen greater than 4g/l (P = 0.04), and in women with elevated triglyceride levels (greater than 1.8 mmol/l; P less than 0.03). An increased risk of death for all patients was also associated with elevated triglyceride levels (P = 0.03). Few of the women smoked (P less than 0.0004), but they were more likely to have suffered a stroke (P = 0.01). They also had a significantly increased cholesterol level (P = 0.03) and tended to have a higher mortality rate than the men (P = 0.08). Surprisingly, smokers did not have a significantly higher amputation or death rate than non-smokers. Elevated plasma viscosity, packed cell volume, platelet count, haemoglobin and creatinine levels were not independent risk factors for any group. At 30 days after presentation the limb salvage rate was 73% (75/103), amputation was required in 15 (14.6%) cases and 13 (12.6%) patients died. Patients with ischaemic rest pain constitute a heterogeneous group with multiple diseases and risk factors. Early identification and treatment of risk factors may help to improve limb salvage and the mortality rate in this condition.
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PMID:Risk factors in patients with ischaemic rest pain of the lower limbs. 223 94

We analyzed the association between hematologic factors and blood velocity of the middle cerebral artery in 42 healthy ambulatory subjects aged 63-86 years. We found a significant inverse association between mean velocity and both hematocrit (r = -0.37, p less than 0.02) and fibrinogen concentration (r = -0.42, p less than 0.005). These two variables are independently associated with velocity and together explain 29% of the variance in mean velocity. Both hematocrit and fibrinogen concentration should be considered in the interpretation of transcranial Doppler findings in this population.
Stroke 1990 Nov
PMID:Correlates of middle cerebral artery blood velocity in the elderly. 223 52


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