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

Cerebrovascular insufficiency in infancy and childhood is well documented and has a diverse and often unknown etiology. Reported here is a polycythemic, microciphalic infant girl of 43 week's gestation with bilateral cerebral infarction occurring in the perinatal period. Infarction was the result of bilateral carotid artery stenosis produced by massive reduplication of the internal elastic lamina. Review of the literature failed to reveal any reports of similar arterial lesions. The angiographical picture was also unique. The etiology of this unusual defect is not known, but we believe the problem was congenital perhaps due to an intrauterine infectious process.
Stroke
PMID:Carotid arterial elastic hyperplasia in a newborn. 115 76

The relationship between the rCBF and the electroencephalographic (EEG) frequency was investigated in the contralateral hemisphere of 22 patients with acute cerebral infarction. Reduced rCBF was observed in all patients studied. The degree of rCBF reduction was mild, moderate, or severe and ranged between 6 and 80% from the lowest age-matched normal values obtained in our laboratory. The frequency indices remained within normal limits (mean - 10.4 Hz) in 16 patients. Slower frequencies (mean - 6.3 Hz) were recorded in 6 patients. No correlation was found between the two parameters (P = 0.89). Both the EEG frequency and the rCBF are known to be closely related to the cerebral metabolic rate. The observed rCBF depression without concomitant changes in the EEG frequency raises the question of the role of globally-reduced cerebral metabolism as the cause of rCBF reduction in the noninfarcted hemisphere in stroke patients. Our findings constitute additional evidence that the contralateral hemisphere is involved in the haemodynamic changes occurring in acute cerebral infarction.
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PMID:Correlation between regional cerebral blood flow and EEG frequency in the contralateral hemisphere in acute cerebral infarction. 115 56

The rCBF response to hypocapnia induced by active short-term hyperventilation was determined in the contralateral hemispheres of ten patients with acute unilateral cerebral infarction. Overall rCBF reduction occurred in only two patients. Regional or widespread abnormal responses to Paco2 reduction manifested as either no change or a paradoxical increase in the rCBF were observed in eight patients. The hemispheric mean rCBF reduction following hypocapnia was diminished as compared with control subjects. Our findings suggest that an impairment of the chemical control of rCBF may occur in the non-infarcted hemisphere during the early period following the onset of cerebral infarction. The pathophysiological mechanisms which may underlie this abnormal rCBF reactivity to Paco2 reduction are considered.
Stroke
PMID:Regional cerebral blood flow response to hypocapnia in the contralateral hemisphere of patients with acute cerebral infarction. 117 57

Cerebrospinal fluid (CSF) abnormalities were correlated with pathological diagnoses in 61 patients with autopsy-verified intracerebral hemorrhage or cerebral infarction. Lumbar punctures were performed within one week of onset of symptoms. The CSF color and red blood cell counts were the most useful CSF parameters in differentiating between intracerebral hemorrhage and cerebral infarction. In 75% of the patients with intracerebral hemorrhage, the CSF was either grossly bloody or xanthochromic; in 25%, the CSF was clear. In patients with cerebral infarction, the CSF was never grossly bloody; in two patients with hemorrhagic infarction, the CSF was xanthochromic. The CSF pressure, protein values and leukocyte counts were less useful in differentiating intracerebral hemorrhage from cerebral infarction. Cases with hemorrhagic infarction could not be separated from those with ischemic infarction on the basis of CSF analysis. In clear CSF, the polymorphonuclear neutrophilic leukocyte (PNL) counts were never greater than 20 per cubic millimeter. In xanthochromic or cloudy CSF, leukocyte counts, especially PNLs, were frequently elevated, occasionally to the high levels.
Stroke
PMID:Cerebrospinal fluid in cerebral hemorrhage and infarction. 119 28

Three hundred and sixty-three cases of cerebral infarction were reviewed: 19 had anisocoria. Eighty percent had the larger pupil contralateral to the hemispheric lesion. The mydriasis was associated with long tract signs in all instances. If the abnormal pupil and long tract signs are not on the same side, the long tract signs are the most accurate evidence of the side of thhe hemispheric lesions. When the pupil was 4 mm or larger and reacted sluggishly, the prognosis was poor. The mechanism of the production of the anisocoria is still uncertain; the lesion is probably "cortical" and in the contralateral hemisphere.
Stroke
PMID:The Behr pupil revisited. Anisocoria following cerebrovascular accidents. 119 35

An investigation limited to patients under 70 years of age was undertaken to study the incidence of new cerebrovascular strokes (cerebral hemorrhage, cerebral infarction, and cerebral embolism) in all cases from Uppsala county between 1967-1971. The total incidence of stroke is 36/1000,000 in this age category; the mean age was 59.9 years for men and 60.8 years for women. Of the total number, 25% were recurrences. The occurrence of a moderate but significant decrease during the period of study has been attributed to an extended and improved treatment of hypertension. All of the 6 females who had suffered strokes below 40 years of age had been on oral contraceptives at the time. A high incidence of diabetes and symptoms of cardiovascula r impairment (hypertension, transient ischemic attack, cardiosclerotic disease) was found. A high incidence of myocardial infarction and of strokes was found among parents of those suffering cerebral hemorrhage and cerebral infarctions, respectively.
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PMID:Studies on cerebrovascular stroke. I. Epidemiology of first-time strokes in persons under 70 years of age. 120 87

37 patients below the age of 50 have been observed following acute 1st-time cerebrovascular lesion. Predisposing factors were found in nearly all cases. Hypertension was found to be present in about 1/2 of the patients suffering from cerebral hemorrhage and in 1/4 of those with cerebral infarction, 6 females were on oral contraceptives. Mortality within 1 month was 35% and was essentially caused by a very high mortality among patients with cerebral hemorrhage. A check after 30 months showed that 16 patients were still alive and 11 were able to perform some sort of work. A high incidence of diabetes and impaired glucose metabolism was exhibited among the survivors as seen from intravenous glucose tolerance tests. As compared with higher age groups, those younger stroke survivors have fairly good chances of going back to work. Health surveys, screening of the relatives of patients wi th hypertension or other vascular diseases, and rehabilitative resources are needed to trace possible stroke victims early and to rehabilitate those who have already been stricken.
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PMID:Stroke before fifty. Experiences from a five-year study. 120 88

Fifty-three patients with acute cerebral infarction were treated in a double-blind study with either dexamethasone or placebo within 24 hours of the onset of stroke. Forty-one of these survived for longer than 28 days, and the patients treated with the steroid fared slightly worse than those treated with placebo at the end of this time. Two of the five patients who died in the placebo group died of cerebral edema, compared with three out of seven patients who died in the steroid group. Infectious complications, gastrointestinal hemorrhage, and occasional serious exacerbations of diabetes occurred more commonly in the steroid group.
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PMID:Steroid therapy in acute cerebral infarction. 124 99

The angiographic appearance of the carotid bifurcation was compared in groups of patients aged 50-59 suffering from transient ischaemic attacks (40 cases), cerebral infarction with completed stroke (44 cases), and cerebral hemisphere tumour (66 cases). Carotid occlusion was found in 14% of those with infarcts and 5% of those with transient ischaemic attacks. Carotid stenosis was found in 40% of those with ischaemic attacks and 14% of those with infarcts. Minor irregularity of the carotid arterial wall was equally common in all three groups.
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PMID:Angiographic appearance of carotid bifurcation in pateints with completed stroke, transient ischaemic attacks, and cerebral tumour. 124 79

Platelet survival was studied by using 51Cr-labeled platelets in stroke-prone spontaneously hypertensive rats (SHRSP), stroke-resistant SHR (SHRSR) and normotensive control rats of the Wistar-Kyoto (WK) strain. Relatively young animals of the same age prior to the development of cerebrovascular lesions (cerebral infarction and/or hemorrhage) were used. Platelet half-life time in SHRSP was slightly but significantly shorter than in any other groups or rats, irrespective of the type of platelet donors. Mean platelet consumption was also significantly increased in SHRSP only. Platelets of SHRSP injected into SHRSR showed normal survival. These data support the concept that the shortened platelet survival in SHRSP is brought about by some extracorpuscular abnormalities. Although the vascular changes in SHRSP could be the most likely explanation for the shortened platelet survival, its mechanism remains to be solved. This investigation suggests that studies of the platelet survival in hypertension may be useful in predicting the development of stroke before its clinical recognition.
Stroke
PMID:Platelet survival studies in stroke-prone spontaneously hypertensive rats (SHRSP). 125 6


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