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

Computed tomography has proved to be the most effective mode of evaluating cerebral infarction in 143 documented cases. This was especially true when multiple focal infarcts were present. The incidence of contrast enhancement in acute infarcts was 88%. Concomitant acute and old infarcts were observed in 20% of cases. In the acute stage of stroke, radionuclide studies are preferable to contrast angiography since the latter may aggravate the pre-existing focal ischemia. Follow-up CT and radionuclide scans were extremely useful in confirming the diagnosis and demonstrating various postinfarction sequelae.
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PMID:Evaluation of cerebral infarction by computed tomography with special emphasis on microinfarction. 74 Jan 60

In a double-blind study, the effects of a large dose (20 mg per kilogram) of phenoxybenzamine (PBZ) on cerebral infarction were evaluated in 120 Mongolian gerbils. The left common carotid artery was ligated in 100 animals; a sham operation was done in 20 animals. One hour later, 25 animals were given 2 mg per kilogram of PBZ, 25 animals were given 20 mg per kilogram of phenoxybenzamine, and 50 animals were given 0.5 cc of nomal saline, all doses being repeated at 24, 48, and 72 hours. Five sham-operated animals were given 2 mg per kilogram of phenoxybenzamine, five were given 20 mg per kilogram of phenoxybenzamine and ten were given 0.5 cc of normal saline on the same treatment schedule. Morbidity and mortality were recorded for one week and then all surviving animals wer killed. All brains were studied for signs of infarction. Of the saline-treated animals, 32% had cerebral infarction and 81% of these died. Of the animals treated with phenoxybenzamine, 36% of those receiving 2 mg per kilogram and 68% (p less than 0.05) of those receiving 20 mg per kilogram had cerebral infarction and all of those with infarction died during the observation period. The animals receiving phenoxybenzamine had a larger stroke index than those treated with saline. The authors concluded that phenoxybenzamine is harmful in postischemic treatment of strokes.
Stroke
PMID:Cerebral infarction in the Mongolian gerbil exacerbated by phenoxybenzamine treatment. 78 17

Regional cerebral ischemia was produced by common carotid artery occlusion in gerbils and by middle cerebral artery occlusion in dogs, cats, and squirrel monkeys. Anesthesia was induced with either pentobarbital or halothane and maintained for two to three hours after vessel occlusion. In acute studies, the effect of regional cerebral ischemia on cerebral concentrations of ATP, phosphocreatine, lactate, and pyruvate was determined at the end of this period in gerbils, cats, and squirrel monkeys. In chronic studies, the degree of neurological deficit and size of cerebral infarction were determined 48 hours after a two-hour to three-hour period of vessel occlusion in cats and squirrel monkeys and permanent occlusion in dogs. In gerbils, dogs, and cats, there were no differences in the metabolis, functional, or pathological effects of anesthesia with pentobarbital or halothane. However, in the squirrel monkey, in acute studies the metabolic alterations were significantly less with pentobarbital, and in chronic studies the frequency and magnitude of functional deficits and cerebral infarction were significantly less. We conclude that pentobarbital does provide a degree of protection during regional cerebral ischemia but that such effects are only consistently demonstrable in primates. In nonprimates, we assume that variability in the collateral circulation renders demonstration of significant differences difficult or impossible.
Stroke
PMID:Influence of anesthetics on metabolic, functional and pathological responses to regional cerebral ischemia. 80

Cerebral hemispheric blood flow (HBF) and metabolism were measured before and after withdrawal of 20 to 30 ml of cerebrospinal fluid (CSF) over a 10-minute interval in eight patients with recent cerebral infarction and in four patients with Alzheimer's disease (AD). Immediately after CSF removal HBF decreased significantly in the AD group (-14%) but showed no significant change in the stroke group (-5%). There was rapid reduction in cerebral venous O2 content and some increase in cerebral venous PCO2 appearing within 60 seconds of CSF withdrawal, interpreted as a rapid reduction of cerebral blood flow (CBF) as judged by cerebral A-VO2 differences. The reduction in CBF was confirmed by the hydrogen clearance method. Reduction of CBF in response to lowering CSF pressure is presumably of neurogenic origin since it was rapid and occurred without changes in PaCO2 or MABP. Furthermore, measurement of HBF demonstrated that cerebral metabolism constant after CSF removal. It is postulated that in AD, reduction of HBF following CSF withdrawal is mediated by a disordered neurogenic veno-arterial vasoconstriction reflex which is stimulated by rapid reduction in CSF pressure (CSFP). In patients with stroke, when cerebral perfusion pressure is increased by lowering CSFP, CBF is maintained constant most likely by a physiological cerebral veno-arterial vasoconstrictive reflex. Apparently, this vasocontrictive reflex becomes excessive in Alzheimer's disease, possibly due to cerebral neurogenic imbalance.
Stroke
PMID:Effect of cerebrospinal fluid removal on cerebral blood flow and metabolism in patients with Alzheimer's disease versus recent stroke. 83 58

A review of 850 acute unselected stroke cases at Harlem Hospital found only 25 (3%) who met a clinical definition of pure motor hemiparesis. Compared to other cerebral infarction survivors, the 23 pure motor syndrome survivors were slightly younger, not much more often hypertensive and did not make a faster recovery. The degree of motor deficit a year later was nearly the same in both groups. Brain scans were positive in one-third of the pure motor patients, which suggests that this clinical picture may be associated with larger brain lesions than had been suspected before, as well as with lacunar infarction.
Stroke
PMID:Frequency and course of pure motor hemiparesis: a clinical study. 83 59

In a three-year prospective study of acute cerebrovascular accident patients admitted to a geriatric unit within 72 hours of the onset, 12.7% had what was considered to be an associated acute myocardial infarction. In the majority of cases, 71%, there was no clinical indication of an acute myocardial infarction and, had it not been for electrocardiographic and enzyme studies, the concurrence of these two conditions might not have come to light. The possible explanations for the concurrence of these two conditions are explored. Patients were followed-up for five years. The mortality rate for the combined acute myocardial and cerebral infarction cases admitted to hospital was 53% in six weeks, and 64% in one year, compared with 26% and 42%, respectively, in those strokes uncomplicated by a cardiac infarction. Only one patient has survived for five years. The recognition of such cases is important in terms of management and prognosis and this may be achieved by ECG recordings followed by enzyme studies in all cases of acute stroke admitted to hospital.
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PMID:Myocardial infarction coincident with cerebrovascular accidents in the elderly. 84 3

Twenty patients with cerebral infarction were observed with serial computerized tomographic (CT) scans. Seventy percent of those infarctions showed a mass effect that had disappeared in all patients by the eighth week after the ictus. In 63%, there was enhancement after contrast infusion, with a definite temporal relationship to the day of onset of the neurological deficit. Twenty percent of the patients initially had normal CT scans that became abnormal weeks after the stroke. Radionuclide scans were positive in the patients who showed contrast enhancement, and the area of abnormal uptake correlated well with the area of enhancement. The timing of the performance of the CT scan in relation to the onset of neurological deficit is an important factor to consider when evaluating the stroke syndrome with CT.
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PMID:Evaluation of recent cerebral infarction by computerized tomography. 88 67

Since 1971, stroke registers in several countries have been cooperating in a study of stroke epidemiology, initiated by WHO. One of the registers covers the population of Frederiksberg, Copenhagen. During the first two years of registration strokes were recorded in 556 Frederiksberg citizens. A certain diagnosis of cerebral hemorrhage--verified by angiography, spinal fluid examination, or autopsy--was made in 10% of the patients; subarachnoid hemorrhage was demonstrated in only 2%; most of the remaining patients probably had cerebral infarction. The overall annual incidence of stroke, when adjusted for age for the Danish population, was 1.9 per 1,000 for males, and 1.6 per 1,000 for females. For every type of stroke, except subarachnoid hemorrhage, the incidence increased markedly with age. The age-specific stroke incidence rates found in the present investigation are much lower than those demonstrated by Aho in a community-based study in Finland. In view of the strict comparability of the two studies, real differences in the risk of stroke may exist between the two communities.
Stroke
PMID:Incidence of stroke in Frederiksberg, Denmark. 92 52

Seventy-seven patients with cerebral infarction have been re-examined every year and followed for 7 years. Thirty-one patients had normal cranial blood flow (BF) and the remaining 46 had subnormal cranial BF, determined by the intravenous RISA method at the time of the original attack. During a 7-year follow up, 7 patients (22.6%) of the normal cranial BF group died; 3 of stroke and the remaining 4 from other causes, while 24 patients (52.2%) of the subnormal cranial BF group died; 13 of stroke and the remaining 11 of various diseases. The cumulative survival rate was consistently lower in the subnormal cranial BF group than the normal one. This difference reached statistical significance at 5 and 7 years of follow up. However, stroke recurrence did not differ significantly between the 2 groups. This suggests that a decreased cranial BF is an indicator of a poor long-term prognosis.
Stroke
PMID:Long-term prognosis for cerebral infarction in relation to brain circulation--a 7-year follow up study. 92 56

Comparison of the clinical features, especially prognosis, in cerebral infarction was made between nine normotensive subjects and 16 hypertensive patients with an 80% stenosis or occlusion of the intracranial or extracranial arteries. Our own criteria for evaluating hypertension were employed on the basis of the following items: a past history of hypertension, blood pressure levels on admission and during hospitalization, degree of retinopathy, and ECG changes. In 17 of 25 cases, brain circulation was measured by the intravenous RISA technique. Abnormalities of the EEG and reduction of cranial blood flow were greater, and an early prognosis for neurological deficits in the first two months after the onset of stroke was poorer in the hypertensive group than inthe normotensive group. These results are contradictory to the observations of others.
Stroke
PMID:Prognosis of occlusive cerbrovascular diseases in normotensive and hypertensive subjects. 96 Jan 69


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