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

To test the hypothesis that psoriasis is associated with an increased incidence of occlusive vascular disease (thrombophlebitis, myocardial infarction, pulmonary embolization, and cerebrovascular accident), the clinical records of 323 psoriatic and 325 non-psoriatic patients admitted to the dermatology service of the Roger Williams General Hospital were examined. The data obtained in this study suggest that (1) the occurrence rate of occlusive vascular disease is significantly greater in the psoriatic than in the non-psoriatic dermatological patient. This is particularly true in the male population; (2) psoriasis predisposes to occlusive vascular disease; and (3) the psoriatic patient with certain predisposing factors is at greater risk of experiencing an occlusive vascular episode than both the non-predisposed psoriatic and the non-psoriatic dermatological patient.
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PMID:Psoriasis and occlusive vascular disease. 70 20

Thrombolytic therapy has been used fairly extensively in the management of acute proximal deep-vein thrombophlebitis of the extremities, acute pulmonary embolism, and acute peripheral arterial thrombosis and embolism in addition to acute thrombotic coronary events. In the presence of acceptable indications and a favorable benefit to risk ratio, this form of therapy, when successful, has served as a useful adjunct in the management of these disorders. In deep-vein thrombophlebitis, lysis of the thrombus before permanent pathological changes (eg, organization, scarring) have occurred can prevent venous valvular dysfunction and postural venous hypertension and its complications, especially the postphlebitic syndrome. In the more severe forms of acute pulmonary embolism, thrombolytic therapy, when applied early after symptom onset, decreases morbidity and is likely to prevent a chronic increase in pulmonary vascular resistance and persistent pulmonary hypertension. In peripheral arterial thrombo-occlusive events, early restoration of flow through thrombolysis has been shown to limit ischemic damage and serve as a useful supplement to angioplasty or surgery. Thrombolytic therapy has been used less extensively in acute strokes. Here the danger of reperfusion causing bleeding into a softened area of brain undergoing infarction has slowed its evaluation for this disorder; its application to stroke remains experimental.
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PMID:Thrombolytic therapy for noncoronary diseases. 200 69

A patient with polycythemia vera who was treated with heparin for superficial septic thrombophlebitis developed heparin-induced thrombocytopenia and cerebral venous thrombosis with superior sagittal sinus occlusion 11 days after the institution of heparin therapy. We suggest that the severe thrombotic response to the heparin-induced platelet disorder in this patient occurred because the polycythemia vera and the purulent infection enhanced the thrombophilia caused by heparin-induced thrombocytopenia. This condition can be avoided in most instances if heparin is used for no longer than 5 days.
Stroke 1990 Oct
PMID:Cerebral venous thrombosis due to heparin-induced thrombocytopenia. 221 18

We report a case of familial antithrombin III (AT-III) abnormality accompanied with progressing ischemic stroke. The patient was a 31-year-old female who developed consciousness disturbance and left hemiparesis on December 1 in 1987. She had a history of two transient ischemic attacks and three episodes of thrombophlebitis of the extremities. Cerebral CT scan showed a low density area on the right temporal lobe that had extended to the right parietal and on the left frontal lobe as clinical symptoms worsened. Cerebral angiogram revealed branch occlusions of the right middle cerebral artery and showed no cerebral venous and sinus obstruction. When her symptoms had been progressing to show semi-comatose state, left hemiplegia and transient Cheyne-Stokes respiration, we found her decreased biological activity and normal immunological level of AT-III. The diagnosis of familial AT-III abnormality had been made by familial investigation. As the treatment of AT-III concentrates transfusion was started from the third day, her symptoms gradually recovered and the low density area stopped extending. Further examinations revealed that she was a homozygote of AT-III abnormality presenting no affinity for heparin and that her parents were heterozygotes. It was suggested that the homozygous AT-III abnormality was the main cause of her progressing ischemic stroke.
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PMID:[Familial antithrombin III abnormality accompanied with progressing ischemic stroke]. 269 32

Midazolam is gradually replacing diazepam in neuroleptanalgesia with fentanyl and sufentanil because of its greater water solubility, greater hypnotic potency, shorter half-life, lack of pharmacologically active metabolites and low incidence of thrombophlebitis. In order to substantiate midazolam as being as safe and effective as diazepam in cardiac patients with severe coronary occlusion, hemodynamic measurements were made before and 10 min after completion of intravenous injection of 0.2 mg/kg i.v. midazolam (n = 45) and 0.4 mg/kg i.v. diazepam (n = 30), the doses which are identical to those used in patients undergoing cardiac catheterization. All 75 patients were spontaneously breathing 40% O2 in air. No positional changes or stimulation of patients were allowed before and during the study. Of hemodynamic variables, systemic systolic blood pressure was significantly reduced by both midazolam and diazepam. Midazolam also caused significant reduction in systemic vascular resistance with reduction in diastolic pressure and left ventricular stroke work index. No changes in heart rate, systolic and diastolic pulmonary artery pressures, cardiac output and index, stroke volume and index, pulmonary vascular resistance, right ventricular stroke work index and rate pressure product were observed following either midazolam or diazepam. No statistically significant differences were observed in any hemodynamic variable between those patients receiving midazolam or diazepam. It is concluded that midazolam is as safe as diazepam in cardiac patients with coronary obstruction.
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PMID:Comparison of the hemodynamic effects of midazolam and diazepam in patients with coronary occlusion. 278 97

Emergency surgery is the only effective treatment of ruptured abdominal aortic aneurysms, even though morbidity and mortality rates remain high. We have studied the feasibility of left retroperitoneal aortic exposure in these cases in an effort to reduce postoperative complications. Over a 33 month period, 29 patients underwent emergency surgery for either a ruptured or symptomatic infrarenal abdominal aortic aneurysm. Of 13 patients with ruptured aneurysms, 4 underwent repair through a midline transperitoneal approach (3 deaths) whereas the remaining 9 were repaired through the retroperitoneal exposure (1 death). Supraceliac aortic clamping through the same incision prior to aneurysm exposure maintained hemodynamic integrity. The remaining 16 patients with symptomatic aneurysms were all treated through the retroperitoneal exposure (3 deaths). In the retroperitoneal groups, the cause of death was cardiac in two patients, hypertensive stroke in one, and necrotizing pancreatitis in one. Morbidity consisted of prolonged intubation, respiratory distress syndrome, and thrombophlebitis in one patient each and acute tubular necrosis in two patients. We believe that the left retroperitoneal approach is a useful option in the emergent treatment of abdominal aortic aneurysms.
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PMID:Selective use of retroperitoneal aortic exposure in the emergency treatment of ruptured and symptomatic abdominal aortic aneurysms. 340 Aug 6

The variable concentration of HbS in individuals with sickle cell trait led us to study the relationship between HbS level and selected vascular events in 355 hospitalized black men with sickle cell trait. There were significant differences in hemoglobin concentration and mean corpuscular volume found in four groups divided by their HbS level, the lowest proportion of HbS (less than 30%) being associated with the lowest hemoglobin concentration (12.6 g/dl) and MCV (77 fl). The percent HbS did not influence the incidence of pulmonary embolism, thrombophlebitis, myocardial infarction, cerebrovascular accident, or idiopathic hematuria. Our results suggest that HbS level does not influence vascular disease, and while certain hematological alterations occur, they are very unlikely to have any clinical significance. Regardless of the proportion of HbS, sickle cell trait in black men is benign.
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PMID:Influence of HbS levels upon the hematological and clinical characteristics of sickle cell trait. 395 66

Strokes of venous origin are relatively infrequent. They usually cause venous infarcts which can be observed in 2 main circumstances: cerebral thrombophlebitis or dural arteriovenous (AV) fistulae draining into cerebral veins. The authors study the CT and angiographic aspects of these venous infarcts and their evolution. Conventional angiography remains indispensable to confirm the diagnosis.
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PMID:Venous infarctions. 408 Jan 57

The existence of cerebral thromboangiitis obliterans (CTAO) has been controversial. The clinical, laboratory and angiographic features of a young woman with recurrent thrombophlebitis, digital gangrene and a bilateral anterior opercular syndrome (Foix-Chavany-Marie) are reported. The cerebral angiogram demonstrated significant narrowing of fronto-opercular branches of both middle cerebral arteries. Histology of small digital muscular arteries revealed segmental adventitial fibrosis, narrowing or occlusion of lumen and mild lymphocitic infiltrates; occasional veins showed phlebitis. An etiologic relationship between cerebral occlusive disease and peripheral thromboangitis obliterans (TAO) is suggested.
Stroke
PMID:A case for cerebral thromboangiitis obliterans. 730 56

Early organization of a coordinated effort is essential in rehabilitating the stroke victim. The basic team, in addition to the attending physician, usually consists of a physical therapist, an occupational therapist and a rehabilitation nurse. A speech pathologist, a social worker, a dietitian or an orthotist may also be needed. Contractures, decubitus ulcers, thrombophlebitis and urinary tract infections can be avoided by vigorous attention to nursing details immediately after the stroke.
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PMID:Rehabilitation of the elderly stroke patient. 741 25


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