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

We assayed plasma concentrations of fibrinogen, fibrinopeptide A, plasmin-alpha 2 plasmin inhibitor complex, D dimer, and antithrombin III activity in 40 patients with cerebral thrombosis and nine patients with cerebral embolism during the acute (less than 7 days), subacute (7-27 days), and chronic (greater than or equal to 28 days) periods and compared these with 69 controls. In cerebral thrombosis, fibrinogen and fibrinopeptide A levels were elevated significantly in all stages (p less than 0.001), whereas plasmin-alpha 2 plasmin inhibitor complex and D dimer levels were elevated significantly in the subacute and chronic periods. The antithrombin III activity was significantly decreased in the acute stage. The elevation of fibrinogen and plasmin-alpha 2 plasmin inhibitor complex levels in the acute stage was significantly greater in patients with an infarct size greater than 10 mm2 compared to patients with an infarct size less than 10 mm2. We observed similar changes in patients with cerebral embolism. These results suggest that enhanced coagulation exists at all stages and endogenous fibrinolysis is activated in the subacute and chronic periods in a large proportion of patients with cerebral thrombosis and embolism.
Stroke 1990 Dec
PMID:Coagulation-fibrinolysis abnormalities in acute and chronic phases of cerebral thrombosis and embolism. 214 32

The coagulability of plasmas from 63 patients with acute ischemic stroke (cerebral thrombosis and cerebral embolism) was analyzed by an automated method for prothrombin time using a fluorogenic peptide substrate. The fluorogenic prothrombin time (FPT) of patients' plasmas collected within 48 hr after onset, as expressed as percent of control plasma, was significantly higher in cerebral thrombosis than in an age-matched control group (p less than 0.01). The high values of FPT in cerebral thrombosis patients were observed until the 30th day after onset. On the other hand, FPT values in cerebral embolism patients were not significantly different than that of the control group. Factor VII activity levels in cerebral thrombosis patients were significantly higher than those of the control group and cerebral embolism patients, while levels of factor X activity were not significantly different among these groups. Although FPT and factor VII activity in these stroke patients did not significantly correlate, factor VII activity did correlate well with factor VII antigen. Decreased levels of antithrombin III and elevated levels of FDP and alpha 2-antiplasmin-plasmin complexes were observed only in cerebral embolism patients. Our findings strongly suggest that patients with cerebral thrombosis have been in a hypercoagulable state before the onset of symptoms, which was caused in part by an increase of factor VII activity/antigen, and in part by other unknown mechanisms. In contrast, patients with cerebral embolism were in a low grade consumptive coagulopathy.
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PMID:Hypercoagulability in acute ischemic stroke: analysis of the extrinsic coagulation reactions in plasma by a highly sensitive automated method. 236 33

Serum thyroid hormones were measured in 62 cases of acute cerebrovascular apoplexy. Compared with the control group, T3, FT3 were markedly lowered and rT3, T4 and TSH were significantly increased with lowered T3/rT3 ratio. The patients were divided into two groups, according to whether there was hemorrhage in their CSF. Changes of serum thyroid hormones in cerebral haemorrhage were more remarkable than those observed in cerebral thrombosis. 16 cases with increased T4, FT4 were diagnosed as euthyroid hyperthyroxinemia. It was found that the amount of thyroid hormone changes appeared to be in proportion to the severity of acute cerebrovascular apoplexy. The determination of serum thyroid hormones would be useful in evaluating the severity of the strokes and in studying the thyroid function in acute cerebrovascular apoplexy.
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PMID:[Changes in serum thyroid hormones in acute cerebrovascular apoplexy and their clinical significance]. 239 Aug 78

The oral administration of the thrombolytic agent urokinase was studied. Its intestinal absorption was demonstrated in dogs by the observation of a prolonged urokinase activity in plasma with a concomitant lytic effect on artificial thrombi after intraduodenal administration. In situ intestine-liver perfusion experiments in dogs revealed that a plasminogen activator, distinct from the administered urokinase--thus presumed to be a tissue plasminogen activator--was liberated into the circulation in association with intestinal absorption of urokinase. Its absorption in men was demonstrated in a cross-over double blind study of oral urokinase on healthy subjects. On the basis of these results a double blind clinical trial of oral urokinase was performed on 101 patients with cerebral thrombosis. The results showed the usefulness of urokinase treatment, particularly in the early phase after the onset of stroke. The clinical effect was influenced by the plasma plasminogen level.
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PMID:Oral urokinase: absorption, mechanisms of fibrinolytic enhancement and clinical effect on cerebral thrombosis. 242 93

In some forms of cerebrovascular disease, such as intracranial hemorrhage, headaches are well known as a prominent symptom and often are a valuable clue to diagnosis. There are difficulties, sometimes, in distinguishing between a small subarachnoid hemorrhage and a severe migraine headache, but these can be resolved using clinical observations, CT scan, and lumbar puncture. It seems less well known that headaches may accompany or precede cerebral thrombosis and embolism. When these headaches are recognized as a forerunner to stroke, they may allow an opportunity for preventive treatment.
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PMID:Headache as a symptom of cerebrovascular disease. 252 Mar 91

A study of glutamic oxaloacetic transaminase (GOT) and lactic dehydrogenase (LDH) enzymes in serum and cerebrospinal fluid (CSF) was carried out on 30 cases of acute cerebrovascular accident (CVA) to determine their role in precise diagnosis and prognosis of the cases. The CSF GOT and LDH activities were well correlated with the severity, mortality and peak and proper timing in relation to infarct, same is about serum GOT. A characteristic rise of GOT and LDH was observed in cerebral haemorrhage especially in fatal cases. However, in cerebral thrombosis and embolism specially in non-fatal cases, the enzyme change was not so marked. GOT and LDH enzyme pattern in CSF and serum may, therefore, serve as an early, relatively easy and widely available tool for differential diagnosis and prognosis of cases of acute CVA.
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PMID:Comparative value of glutamic oxaloacetic transaminase and lactic dehydrogenase enzyme pattern in serum and cerebrospinal fluid in acute cerebrovascular accidents. 263 May 98

The acute phase of cerebral thrombosis demands intense nursing management to minimize potential complications. Actions must be based on knowledge of the pathophysiological processes involved. This article will briefly define a stroke (CVA) and focus on important aspects of nursing assessment and management.
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PMID:Cerebral thrombosis: assessment and nursing management of the acute phase. 293 42

Over 8000 patients with cerebral thrombosis (ICD-8 number 433) hospitalised between 1970 and 1980 were surveyed retrospectively for outcome and additional diseases. The case-fatality rates and long-term prognosis of the patients were strongly affected by age, and the number of patients requiring permanent hospital care rose sharply with increasing age. The case-fatality rates in the different age groups were as follows: under 50 years 6%, 50-64 years 16%, 65-74 years 32%, 75-84 years 48% and over 85 years 66%. The cumulative survival rates at 1 and 5 years were as follows: under 50 years 54 and 46%, 50-64 years and 38%, 65-74 years 60 and 20% and over 75 years 45 and 10%. Clinical manifest coronary heart disease clearly affected the prognosis of patients under 75 years, but the impact diminished with rising age. Although hypertension led to an earlier onset of ischemic stroke, it did not significantly influence the survival prognosis. In patients over 75 years additional diseases, e.g. diabetes, had no significant effect on case-fatality or long-term prognosis underlining the malignant nature of cerebral thrombosis itself.
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PMID:Prognosis of elderly hospital patients with cerebral thrombosis. 314 11

The authors studied 34 patients with juvenile ischemic cerebrovascular disease over a 15-year period. Of the 34 patients, 23 had intracranial occlusions attributed to cerebral thrombosis or embolism and 11 had occlusions resulting from moyamoya disease. Clinicopathological features were evaluated in the 23 cases with ischemic stroke, but not those with moyamoya disease. The cause of the arterial occlusion remained undetermined in 11 patients and was found to be an embolism based on congenital heart disease in 8, on trauma in 3, and on infection in 1. Cerebral angiography was performed in 21 patients. Of these, 17 had stenoses or occlusions corresponding to their symptoms. CT scans were performed in 10 patients; the lesion in question showed no stenosis or occlusion with cerebral angiography. With regard to prognosis, patients with unknown etiology had good outcomes compared with those with congenital heart disease. With respect to "acute infantile hemiplegia", 10 patients had convulsive seizures and 4 had a history of an earlier infection. Angiography and CT scans in patients with congenital heart disease demonstrated arterial occlusive sites in the middle cerebral artery region. Three patients had abscesses after their ischemic lesions.
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PMID:Ischemic stroke in infancy, childhood, and adolescence. 324 46

Over 21,000 hospital episodes due to cerebrovascular disease (CVD, ICD-8 nos. 430-438) were registered in the Helsinki hospitals in 1970-1980. Of those 17,629 were identified as new cases. The age-adjusted incidence of haemorrhagic and thrombotic stroke (430-433) declined during the period 1970-1975 from 221 to 139 cases/100,000 inhabitants, whereafter no further decrease was observed. The decline in incidence was significant in both sexes. Analysis by diagnosis group showed that the decrease was confined to the incidence of haemorrhagic stroke (430-432), whereas the incidence of thromboembolic stroke (433, 434) and transient ischaemic attacks (435) remained virtually unchanged. Survival was mainly determined by patient age and type of CVD. Intracerebral haemorrhage and occlusion of precerebral arteries exhibited the poorest short-term prognosis. About half of the patients hospitalised due to cerebral thrombosis and embolism survived over one year. Long-term prognosis of the major CVD groups was very poor with only 10% of the patients alive after eight years. Transient cerebral ischaemia and subarachnoid haemorrhage had a clearly better prognosis, the survival rates after eight years being 45 and 30%, respectively.
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PMID:The incidence and prognosis of cerebrovascular disease in hospital patients in Helsinki, Finland, in the decade 1970-1980. 359 65


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