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

A new mathematical method is suggested for making the prognosis of the results of surgery for haemorrhagic strokes due to essential hypertension and atherosclerosis. Twenty-two signs characterizing the patient's state are fed into the computer trained on the basis of 124 case reports of patients, both surviving and dying after surgery. The computer operating in accordance with the "Kopa-3" programme works out a vital prognosis for both the medicamental and surgical treatment. The prognosis proved correct in 90% of the cases. The described method permits an objective determination of the indications for surgery in hemorrhagic stroke.
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PMID:[Prognostication of the outcome of surgical treatment of hemorrhagic strokes using a computer]. 78 27

Apolipoproteins from human plasma high density (HDL), low density (LDL) and very low density lipoproteins (VLDL) were visualized in human arteries employing immunofluorescence techniques. Comparison between the localization patterns in extracranial and intracranial arteries and those in coronary arteries and the aorta was made. ApoA-I from HDL, apoB from LDL, and apoC-III from VLDL, as well as neutral lipid, were all localized to connective tissue and extracellular lipid pools in atherosclerotic lesions, and only to areas of intimal thickening in grossly "uninvolved" arteries. The degree of superposition of localizations was similiar in each vascular bed, and within the error resulting from the structural changes due to the focal nature of the atherosclerotic process. These results suggest a broad specificity in localization of apolipoproteins in most arterial lesions, and suggest that no differences in apolipoprotein accumulation exist between extracranial and intracranial arteries, coronary arteries, or the aorta. Variations in prevalence for atherosclerosis in each arterial bed must be accounted for on other bases.
Stroke
PMID:Apolipoprotein localization in human cranial arteries, coronary arteries, and the aorta. 78 16

Although hypertension is an acknowledged risk factor in ischaemic heart disease (IHD) the question remains whether antihypertensive therapy is necessarily beneficial. A priori, because coronary atherosclerosis is probably irreversible, the time for effective intervention would seem to be well before the development of clinical manifestations. The Australian National Blood Pressure Study, a long term clinical trial of the treatment of mild hypertension, is in principle better suited than previous trials to answer the question because the trial population selected (4000 subjects aged 30-69) contains substantial proportions of younger age groups (26% below 45) and of females (37%) and none had manifest IHD at entry. Sensitivity to the emergence of IHD in the trial population is increased by including as diagnostic indices angina and ischaemic ECG changes, using suitably objective methods, as well as myocardial infarction and sudden death. Thus morbidity and mortality from IHD which currently accounts for 71% of trial end points (cf 19% for stroke) will effectively determine the outcome of the trial. The occurrence of a substantial proportion of subjects withdrawn from randomised treatment will mean that the question will be answered necessarily in two ways: firstly in respect of those subjects remaining on their assigned treatments and secondly in terms of all subjects initially assigned one treatment or other irrespective of the subsequent need to change treatment on ethical grounds or of the degree of compliance.
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PMID:The Australian National Blood Pressure Study: a test of the effectiveness of antihypertensive therapy on the incidence of ischaemic heart disease. 79 27

The authors conducted a study of the histamine system (H), diaminoxidase (DO), histaminopexic index (HPI) using the biological method in 127 patients with hypertensive disease and cerebral atherosclerosis with brain circulation disturbances and in 23 patients with atherosclerotic parkinsonism. It was displayed that in the majority of the patients the H level and HPI value were pathologically changed, but DO activity was disturbed to a lesser degree. The authors demonstrated some correlations between the fluctuations of H-DO-HPI system and the character of the brain circulation disturbances, the period of the stroke, severity of the disease and an etiological factor. According to the authors' opinion changes in H-DO-HPI system were in a direct correlation with fluctuations of the level in the biological fluids of catecholimes, serotonin, acetylcholine, glucocorticoids. Recommendations concerning a discontinuation of histaminemia or its negative effects were given.
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PMID:[Histamine metabolism in patients with cerebral circulatory disorders together with hypertension and cerebral atherosclerosis]. 81 60

The presentation contains the result of a rheoencephalographic study of 67 sons and daughters of the patients with ischemic stroke of a hemispheric localization. Some rheoencephalographic signs testifying to the presence of a cerebro-vascular deficiency in the relatives of the probands were depicted. The use of nitroglycerin sample permitted to reveal in practically healthy relatives certain REG changes which exceeded the normal limits. These shifts were mainly observed in the elder age group of the investigated individuals (above 40 years). The obtained data can promote detection of those individuals who are predisposed to atherosclerosis and hypertensive disease, and to conduct medico-prophylactic measures in due time.
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PMID:[A rheoencephalographic study of the relatives of patients with acute cerebral circulatory disorders]. 81 61

Radionuclide cerebral blood flow (CBF) examinations of 48 patients with atherosclerosis, 18 with occlusion and 30 with stenosis of the internal carotid artery (ICA) were correlated with their respective cerebral angiograms. The following results were obtained. Flow was visually unilaterally diminished in 29 (60%) of 48 patients, including 14 (78%) with occlusion and 15 (50%) with stenosis. Sixty-two percent of the subjects with severe stenoses and 46% of the patients with mild stenoses had a positive flow study. Diminished flow was evident in the neck in 80% of the patients, intracranially in 20%. Positive radionuclide angiograms always pointed to the side with occlusion or the greater degree of stenosis even though bilateral interanl carotid disease was frequently found (54%). The data leading to the differentiation between major and minor ICA stenosis are not sufficient to justify any conclusion.
Stroke
PMID:Radionuclide cerebral blood flow and carotid angiogram. Correlation in internal carotid artery disease. 83 57

The authors conducted a repeated ECG study of 200 patients with atherosclerosis and hypertensive disease in the acute phase of a cerebral stroke (57 patients with intracerebral hemorrhages and 143 with ischemic strokes). It was noted that the frequency and degree of expressed ECG disorders depended upon the character, extensiveness and localization of the focus in cerebral strokes.
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PMID:[Electrocardiographic changes in patients with hemorrhagic and ischemic strokes]. 84 25

The authors present some results of a study of 85 patients with brain strokes which were preceded by transient cerebral ischemic attacks. In most of the cases the brain stroke developed on the background of an ischemic cardiac diabetus, atheroscleorosis of the peripheral vessels, etc. It was established that in patients with atherosclerosis, the strokes developed at earlier periods after the first ischemic attack, than in the group of patients where atherosclerosis developed in combination with arterial hypertension. In disturbance of circulation in the basin of the carotid arteries, the strokes with preceding ischemic attacks developed not only more frequently, but earlier than those due to insufficiency of the circulation in the vertebro-basillar basin. It was also established that crude focal symptomatology appears as a rule in those cases when the stroke develops after the first ischemic attack. In frequent attacks which are repeated during several years, the appearing stroke is characterized by a more light focal symptomatology.
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PMID:[Transient ischemic attacks and stroke]. 89 20

Five patients studied by the authors and 28 mentioned in the literature indicate that recurrent stenosis occurs in no less than 0.6% of patients after carotid endarterectomy. The pathology of the recurrent stenosis was stated in only 10 cases indicating atherosclerotic disease in various stages of development in 7 and a fibrous intimal hyperplasia in 3. Correlation between risk factors for the development of atherosclerosis and the pathology of the recurrent disease was poor. Six patients developed recurrent disease despite postoperative prophylactic oral anticoagulation. Surgical technique appeared to have contributed to re-stenosis in 8 patients (1) by failure to remove the distal tongue of plaque or (2) narrowing of the lumen by the arteriotomy suture or (3) damage by a vascular clamp. In 18 symptomatic patients, 44% had symptoms by 3 years, 67% by 5 years, and 83% by 7 years after operation. The 8 patients with possible errors in surgical technique did not develop symptoms earlier than the other patients. Seventeen symptomatic patients had surgical correction of the re-stenosis (endarterectomy 9, vein patch 6, arterial homograft 1, not detailed 1). The incidence of recurrent stenosis after carotid endarterectomy is low and usually the operation provides a patent artery for life.
Stroke
PMID:Recurrent stenosis at site of carotid endarterectomy. 90 60

To identify metabolic and other concomitants of a single important type of atherosclerotic cerebrovascular disease, 75 patients with angiographically and surgically proven internal carotid stenosis were compared with age and sex matched control subjects with respect to plasma cholesterol, triglycerides and glucose. They were also compared for blood pressure, cigarette smoking, evidence of ischemic heart disease, peripheral vascular disease and for a family history of these diseases. Patients with carotid stenosis had higher systolic and diastolic blood pressures and higher plasma cholesterol and triglyceride concentrations than the control groups. They had, as well, a far greater likelihood of being cigarette smokers and a greater likelihood of having diabetes mellitus and previous evidence of coronary and peripheral vascular disease. Patients with carotid stenosis were far more likely to have 2 or more of these common concomitants of atherosclerosis than were the control subjects. The data suggest that the precursors of carotid stenosis are similar to those of coronary atherosclerosis and raise the hope that modification of these factors may decrease the incidence of this highly prevalent form of cerebrovascular disease.
Stroke
PMID:Concomitants of atherosclerotic carotid artery stenosis. 92 53


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