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

The records of 179 consecutive patients with acute carotid system cerebral infarction were studied to describe the temporal profile of the clinical events during the first week of the illness. Only those patients admitted to the cerebrovascular hospital service within 36 hours of the onset of the first symptom were included. The neurological status of 39% was stable (unchanged) at the end of seven days; 35% of the patients gradually improved. Nineteen percent had a progressing neurological deficit from the onset which stabilized within 48 hours of onset. Six patients (3%) had a remitting-relapsing course during the first 36 hours. Eight patients (4%) had a significant late worsening, after 48 hours of stable or improving course. Mortality was 11% for the entire group. However, a high risk of death group was identified - the mortality was 41% for those patients who had any degree of decreased level of consciousness and hemiplegia at the time of admission.
Stroke
PMID:Temporal profile (clinical course) of acute carotid system cerebral infarction. 125 7

A pathological examination was performed on normotensive rats (NTR) and spontaneously hypertensive rats (SHR) following bilateral common carotid artery ligation. After ligation, diffuse and extensive cerebral infarcts in the carotid artery territory occurred frequently in SHR, while NTR occasionally had well-circumscribed small infarcts. The posterior communicating arteries, which are the major anastomotic channels connecting the carotid and vertebrobasilar systems, did not show any anomalies and were well developed in SHR and NTR. Vascular changes secondary to hypertension, such as fibrinoid necrosis or thickening of the wall, were not observed in SHR. Because of the paucity of structural difference of the blood vessels, the more diffuse and extensive cerebral infarcts in SHR after carotid occlusion were attributed to the hemodynamic difference rather than the morphological difference between the two groups. The results of the present experiment suggest that hypertension per se, i.e., hemodynamic factors, may be operative for the development of cerebral infarction.
Stroke
PMID:Cerebral infarction following bilateral carotid artery ligation in normotensive and spontaneously hypertensive rats: a pathological study. 125 5

Forty patients were studied by computerized tomography and by radionuclide brain imaging. The final diagnosis was infarction in 29 patients, intracerebral hematoma in seven, acute SAH in one, and old cerebrovascular accidents in three. CT was far superior to RN in detecting intracerebral hematomas and distinguishing them from cerebral infarction. The results of CT and RN tests were comparable regarding the percentage of abnormalities. However, the results in the same patients were not identical in 55% of the cases, indicating a complementary role for the two tests. There was no relationship between the frequency of abnormalities on CT and the time lapse after the onset of cerebral infarction. RN uptake was not seen in patients with old cerebrovascular accidents.
Stroke
PMID:Comparison of computerized tomography and radionuclide imaging in "stroke". 126 2

Thirty-one patients with acute cerebral infarction were treated with the thrombolytic agent urokinase for either a single or a double infusion period, each of ten hours. The effects of urokinase therapy administered at dosage rates of 1,200, 1,500 or 1,700 CTA urokinase units per pound of body weight per hour were followed by serial blood coagulation and other biochemical studies. In the dosage used, urokinase produced a prompt sustained increase, 20-fold to 40-fold, of plasma thrombolytic activity with relatively minor disturbance of the blood coagulation system. Nevertheless, hemorrhagic complications occurred in several patients and distinctly favorable therapeutic effects were not observed.
Stroke
PMID:A pilot study of urokinase therapy in cerebral infarction. 126 5

This study was undertaken to establish the incidence and mortality for various types of cerebrovascular disease in the population of Tartu. All medical records for this population were reviewed for the period 1970 through 1973, and those with a diagnosis of brain infarction, transient ischemic attacks, cerebral hemorrhage or subarachnoid hemorrhage were identified. Only the first stroke was considered when determining incidence. A total of 786 cases were included in the study. Without cases of transient ischemic attacks, the number was 667 (e.g., cases of stroke). Cerebral infarction accounted for 80% of all strokes, cerebral hemorrhage for 13.5% and subarachnoid hemorrhage for 6.5%. The incidence rate for stroke was higher for men than for women and significantly increased in each older age group. The rate for all persons was 184 per 100,000 population per year. The incidence of transient ischemic attacks was 33 per 100,000 population per year. The mortality rate for stroke for this population was 98/100,000 per year. The data on incidence of stroke and its type, its dependence on age and sex, and mortality rate are close to the corresponding data reported from other countries.
Stroke
PMID:Epidemiology of cerebrovascular disease in Tartu, Estonia, USSR, 1970 through 1973. 126 11

Forty patients with cerebral infarction associated with occlusion of the internal carotid artery (ICA) or the middle cerebral artery (MCA) were treated with hyperbaric oxygenation (HO). EEG analyses were performed regularly in order to assess the course of the cerebral lesion. Patients in an early post-stroke stage (III B) and patients in a chronic post-stroke stage (IV) had the changes in EEG analysis and neurological distributed evenly between these two groups.
Stroke
PMID:Reversibility of the chronic post-stroke state. 127 8

For an early and definitive diagnosis of acute cerebral infarction by computed tomography (CT), we retrospectively analyzed the initial CT findings of 14 patients with proven acute middle cerebral artery (MCA) infarction within 4 hours after stroke onset. The following results were obtained: (a) abnormal CT findings could be recognized quite early in 13 patients (92.9%), (b) the most common and earliest finding was loss of defination of the gray-white interface at the lateral margins of the insula. This sign was recognized in 12 patients (85.7%) and could be detected as early as 1 hour after stroke onset, (c) the next common finding was narrowing or blurring of the Sylvian fissure in 10 patients (71.4%) and could be detected 1.5 hours after stroke onset, (d) an obscured outline or partial disappearance of the lentiform nucleus was recognized in 7 patients (50%) and could be detected 1.5 hours after stroke onset, (e) effacement of the cerebral sulci was found in 6 patients (42.9%) and could be detected 2.5 hours after stroke onset, (f) increased density in MCA or its major branches was not seen in our patients.
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PMID:Early CT findings of acute cerebral infarction in the middle cerebral artery territory. 131 45

Proton nuclear magnetic resonance spectroscopy is a noninvasive technique allowing the localized, in vivo detection of proton-containing brain metabolites. We used this technique to study eight patients with cerebral infarction or ischemia. A stimulated echo-pulse sequence with chemical shift imaging was used to acquire spectra from multiple contiguous 4-cc volumes extending from the site of ischemia to the opposite hemisphere. Six patients had a reduction in the signal from N-acetyl groups (NAG) in the stroke area compared with controls, and those with the lowest NAG to phosphocreatine/creatine ratios had the least recovery of function. Lactate was observed within the infarcted region in two patients at 9 and 11 days after infarction and may have been present in other patients up to 15 weeks after stroke.
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PMID:Multivoxel 1H-MRS of stroke. 132 Feb 20

Blood viscosity studies were carried out in fourteen patients with acute stroke, eight with cerebral infarction, six with cerebral haemorrhage and in thirteen controls. We observed a statistically significant higher values of plasma, red cell and whole viscosity in patients with acute stroke than in normal controls. Plasma fibrinogen levels were statistically higher (p less than 0.01) in patients than in normal controls. The platelet aggregation was increased in two young adults with acute stroke. The results suggest that the haemorheological factors play an important role in the pathophysiology of stroke patients.
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PMID:Haemorheological factors in the pathophysiology of acute stroke. 135 98

With demographic change, Western populations are becoming older. The prolonged decline in incidence of stroke, already a very costly illness, may soon reverse. This paper briefly reviews medical treatments of acute stroke that have been popular in the past and finds that they have been generally of little value. The place of naftidrofuryl, a drug with a complex pharmacological profile that includes selective S2-receptor blockade, is discussed in greater detail. Two clinical studies have indicated that, although it may not alter death rate in acute stroke, naftidrofuryl therapy enhances recovery from the disabling effects of cerebral infarction. One important consequence of this is a potentially major reduction in time spent in hospital by stroke patients. Hospital bed occupancy has been identified as a principal component in the cost of stroke to health services. Drug treatments that reduce death rate without improving recovery in survivors have an opposite effect, as has been seen in an important trial of glycerol.
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PMID:Naftidrofuryl after acute stroke: a review and a hypothesis. 136 21


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