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

Circumscribed atherosclerotic involvement of secondary and tertiary branches of major cerebral arteries is a common angiographic finding whose nature is rarely in question. However, widespread and severe changes are unusual, and radiologic interpretation may be more difficult. We recently cared for a patient whose angiogram demonstrated extensive involvement of leptomeningeal vessels and were prompted to review the clinical courses and autopsy findings of a number of other patients with similar angiographic findings. Our observations suggest that the radiological appearance of leptomeningeal artery atherosclerosis can be confused with that of an arteritis. Atherosclerosis of leptomeningeal arteries is strongly associated with a history of arterial hypertension and seems to parallel arterial lesions thought responsible for lacunar infarction and intraparenchymal hemorrhage.
Stroke
PMID:Leptomeningeal artery atherosclerosis visualized by angiography: clinical correlates. 64 27

In 60 patients with brain strokes the changes in serum triglycerides, cholesterol and optic density were determined in various stages of brain stroke. The control group included 60 patients without clinical evidence of atherosclerosis. Changes were observed in serum lipids in patients during brain stroke and they concerned mainly the levels of cholesterol and triglycerides. The intensity of these changes reflected the severity of the condition of the patient. In all patients the serum cholesterol level decreased during the first 7 days of the disease. In the group with favourable outcome a rise was observed in the cholesterol level after 4 weeks of disease. In the group with unfavorable course of the disease the level of cholesterol continued to fall until death. The triglyceride level was significantly lower in all patients in the 1st week of the disease in relation to the control group. After 4 weeks of the disease the triglyceride level rose to values not significantly different from those in the control group. The value of optic density of the serum in the group of patients in different stages of the disease was not statistically different from that in the control group. Determinations of serum lipids in patients with brain strokes together with clinical evaluation of the state of the patient seem to be useful in establishing prognosis in the disease.
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PMID:[Serum lipids in stroke]. 67 18

Cerebral atherosclerosis without luminal narrowing has been found macroscopically and by angiographic examinations in some patients with cerebral hemorrhage. In order to clarify the histology of non-stenotic atherosclerosis of the cerebral vessels, we examined cleared specimens and serial sections of the main trunks of the cerebral arteries. The middle cerebral artery was selected in 20 cases of cerebral hemorrhage and 7 cases of cerebral infarction. Non-stenotic atherosclerosis was found frequently in cases of cerebral hemorrhage, while most patients with cerebral infarction showed stenotic cerebral atherosclerosis. We counted the numbers of medial smooth muscle cells in 10 autopsied cases of cerebral hemorrhage and 6 of cerebral infraction. The mean numbers of smooth muscle cells per unit area in the patient with cerebral hemorrhage were less than those in cerebral infraction. In cerebral hemorrhage, the main trunks of the cerebral arteries were dilated, probably as a result of the damage to medial muscle cells and higher blood pressure during the course of intimal thickening. It is considered that arterial hypertension spreads to the peripheral, small arteries through the main trunks without luminal narrowing of the cerebral vessels.
Stroke
PMID:Comparative angiographic and histological evaluations of intracranial atherosclerosis in hypertensive and normotensive subjects. 67 48

The relationship between the indicence of cerebral infarction and the hematocrit was studied using 432 consecutive autopsied patients with the average age of 77.1 years. The incidence of cerebral infraction was higher in patients with hematocrit values of more than 46%, (the average in younger adult subjects). The increase in the frequency of cerebral infarction with high hematocrit values was more conspicuous in patients with severe cerebral atherosclerosis than in those with slight cerebral atherosclerosis. High blood pressure per se did not influence the relationship between the hematocrit value and the incidence of cerebral infarction. With hematocrit values of more than 41%, cerebral infarction occurred more frequently in patients over 78 years of age than in the younger patients, but the difference was not significant statistically. High hematocrit values are associated with a higher risk of cerebral infarction in deep subcortical structures of the brain than for cartical infarctions. The pathogenetic and preventive implications of these results are discussed in the light of blood rheology.
Stroke
PMID:Importance of the hematocrit as a risk factor in cerebral infarction. 67 49

To assess the significance of the asymptomatic carotid bruit, the subsequent occurrence of symptomatic cerebrovascular insufficiency and stroke in 256 patients who had undergone operation for atherosclerosis arterial occlusive disease of the lower extremities was documented during a period of two to seven years postoperatively. At the time of operation, none had had a stroke or exhibited symptoms of cerebrovascular insufficiency, but 60 of the 256 patients had audible carotid bruits. A statistically significant difference was demonstrated: 21 (35%( of the 60 patients with carotid bruits exhibited manifestations of cerebrovascular insufficiency, in contrast to 30 (16%) of the 196 patients without bruits. It seems that detection of an asymptomatic carotid bruit is not an innocent finding, but rather predicts a higher incidence of cerebrovascular complications than that expected on the basis of generalized atherosclerosis alone.
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PMID:Significance of asymptomatic carotid bruits. 70 55

Between 1969 and 1976, 174 patients were treated surgically for simultaneous carotid and coronary atherosclerosis. In 59 patients, staged carotid endarterectomy was performed a few days to 6 months prior to myocardial revascularization. Severe (more than 60% stenosis) coronary atherosclerosis affected a single vessel in 11 patients (19%), two vessels in 20 patients (34%), and three vessels in 28 patients (47%). Left ventricular contraction was impaired in 30 patients (51%). Nine patients (15%) had previous neurological symptoms, and 50 patients (85%) had asymptomatic carotid stenosis. One patient (1.5%) had a permanent stroke after carotid endarterectomy. There were no permanent strokes after staged myocardial revascularization, and the early mortality rate was 1.7%. Combined carotid endarterectomy and myocardial revascularization were performed in 115 patients with severe cardiac disease. Coronary atherosclerosis affected a single vessel in 10 patients (9%), two vessels in 39 patients (34%), and three vessels in 66 patients (57%). Left ventricular impairment was present in 72 patients (63%). Thirty-five patients (30%) had previous neurological symptoms, and 80 patients (70%) had asymptomatic carotid stenosis. Five patients (4.3%) had permanent strokes after combined revascularization, and four of these patients had occlusion or severe stenosis of the contralateral internal carotid artery. The early mortality rate was 4.3%, but no deaths could be attributed to carotid repair. The results suggest that significant simultaneous carotid and coronary atherosclerosis should be corrected in selected patients by staged operations when feasible. In the presence of severe cardiac disease, a combined precedure may be performed in face of higher risk of intraoperative stroke.
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PMID:Staged and combined surgical approach to simultaneous carotid and coronary vascular disease. 71

Risk factors were compared in 300 patients with brain stroke and 120 patients with neurosis or sciatic pains. It was found that arterial hypertension (p = 0.001) and diabetes (p = 0.01) were significantly more frequent in cases of brain stroke. Disturbances of lipid metabolism, tobacco smoking and obesity showed no significant difference. Extracerebral atherosclerosis (p = 0.001) increased the risk of stroke. Coronary arterial disease was most frequent (48.8%), myocardial infarction (8.3%) and calcifications in the aorta (32%) were second and third in frequency. Presence of at least two risk factors may be an indication to prophylactic treatment.
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PMID:[Risk factors in stroke]. 72 25

Clinical, angiological, and biochemical examinations were performed in 981 men and 30 women with organic afflictions of peripheral arteries, and in 411 men and 50 women without any signs of peripheral arterial lesions. Their family histories were thoroughly recorded with particular reference to the occurrence of myocardial infarction, cerebral accidents before and after the age of 60 years, and death of these causes; further, of hypertension, diabetes mellitus, obliterations and gangraenes, in each patient's siblings, parents, and all four grandparents. Furthermore, the significance of positive family history in combination with other risk factors was investigated. Family history can be considered positive with respect to obliterative atherosclerosis when in anyone of the patient's grandparents, parents, or siblings an obliteration of peripheral arteries is present or when anyone of them died of myocardial infarction or apoplexy, especially when aged under 60 years. Presence of several factors in the specified next of kin accelerates the obliterative process in the patient. A positive family history, however, plays no decisive role either alone or in combination with any other single risk factor, but only in combination with two or more other factors, one of which is always tobacco smoking; it is not significant in any combination with obesity.
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PMID:Positive family history as a risk factor of obliterative atherosclerosis. 72 85

Obesity leads to several complications that affect many body systems. This paper focuses mainly on the cardiovascular complications, which include coronary heart disease, cerebrovascular disease and stroke, and congestive heart failure; the last may be secondary not only to advanced coronary atherosclerosis, but also to other pathogenetic factors. The increased frequency of coronary heart disease in the obese is largely attributable to the commonly associated hypertension, diabetes mellitus and lipoprotein abnormalities, rather than the adiposity. The lipoprotein disorders that have a role in atherogenesis are decreased plasma concentrations of high-density lipoproteins and elevated plasma concentrations of low-density lipoproteins. Abnormalities in cholesterol metabolism are responsible for the increased frequency of cholelithiasis in obese persons. The factors that mediate the development of cardiovascular and gallbladder complications are correctable by an appropriate program of meal planning and physical activity.
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PMID:Medical complications of obesity. 73 18

A comparative study of free aminoacid content in the blood of 27 patients will brain hemorrhages and 32 patients with brain infarctions was conducted during the first 12 hours of brain stroke. A comparison of the data obtained with the results of a study of 16 normals and 24 patients with atherosclerosis and hypertensive disease demonstrated changes in the aminoacids spectrum which is characteristic for a hemorrhagical and ischemic stroke. The differences in the content of 10 aminoacids are shown. The achieved results are discussed in the light of their differential diagnostic significance.
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PMID:[Free serum amino acids in the acute period of cerebral stroke]. 76 Mar 43


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