Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients who are unable to be adequately nourished owing to cerebral dysfunction do not tolerate nasogastric tubes for enteral nutrition well. They are threatened by active or passive dislocation of the tube into the oesophagus with subsequent aspiration. Although these risks are minimized by percutaneous gastrostomy (PEG), aspiration cannot be completely prevented even when this method of feeding is employed. Enteral nutrition was provided by PEG in 33 patients with different cerebral disorders. PEG was indicated when adequate oral intake of food and fluids proved impossible 8 to 12 days after an acute hypoxaemic cerebrovascular event. 3 of 23 patients who had suffered a stroke, 2 of 8 patients with hypoxaemic brain damage and 3 of 5 patients with decompensated cerebral sclerosis regained the ability to eat between the 21st and 50th day of treatment, so that the gastrostomy could be dispensed with. The other patients died of their severe underlying disease. 6 patients aspirated. In 2 cases this complication occurred during acute aggravation of the underlying disease after several weeks of satisfactory enteral tube feeding. 2 patients aspirated after returning to oral nutrition, whereby feeding was certainly implicated in 1 patient and probable in the other patient. PEG enables adequate enteral nutrition of patients with severe neurological impairment. The advantages of PEG over parenteral nutrition are fewer complications, lower costs and, above all, its superiority in meeting physiological requirements.
 ...
PMID:[Percutaneous endoscopic gastrostomy--a possibility for enteral feeding of patients with severe cerebral dysfunctions]. 313 70

Although ICH continues to decline as a cause of stroke, ICH must be considered in every patient with acute onset of focal cerebral dysfunction even if headache is absent. A variety of diseases leads to the occurrence of ICH, with hypertension continuing to head the list. The prognosis for recovery depends on the cause of the hemorrhage, the site and size of the lesion, and the patient's neurologic status. Each case must be treated individually. Both medical and surgical therapies are important in the management of these difficult problems. As more information is obtained on the natural history of ICH, treatment strategies will continue to evolve.
 ...
PMID:Diagnosis and treatment of spontaneous intracerebral hemorrhage. 331 94

To determine the prevalence of unrecognized brain dysfunction accompanying chronic severe cardiac disease, we examined 20 clinically stable consecutive admissions to a cardiac rehabilitation service who were free of known stroke or dementia. Age range was 47 to 85 years (mean +/- SEM, 72.5 +/- 2.1 years), the male: female ratio was 10:10. Multiple cognitive deficits including significant memory impairment and disorientation were present in eight patients (40%), and seven of these eight patients were unable to administer their own medications reliably. An additional six patients (30%) showed milder impairments. One patient was found to be normal after neurological examination, four showed evidence of a single brain lesion, and 15 of 20 (75%) had multiple neurological abnormalities suggesting multifocal brain disease. The mechanism of cognitive deficits in cardiac patients is unclear, and it may be related to multiple infarcts, or acute or chronic hypoxic damage secondary to arrhythmias, cardiac failure, or small vessel disease of the brain. The term "circulatory dementia" is proposed to describe patients with vascular disease and non-Alzheimer type dementia. Patients with cardiac disease should undergo cognitive screening, as early identification of patients at risk of progressive intellectual loss may allow early use of preventive therapy.
 ...
PMID:Unrecognized cognitive impairment in cardiac rehabilitation patients. 333 26

The effects of cytidine 5'-diphosphocholine (CDP-choline) on neurologic deficits and cerebral glucose metabolism were studied in a rat model of transient cerebral ischemia. Cerebral ischemia was induced by occluding both common carotid arteries for 20 or 30 minutes 24 hours after the vertebral arteries were permanently occluded by electrocautery. CDP-choline was administered intraperitoneally twice daily for 4 days after reestablishing carotid blood flow. CDP-choline at two dosages (50 and 250 mg/kg) shortened the time required for recovery of spontaneous motor activity in a dose-related manner; recovery time was measured early after reperfusion. Neurologic signs were observed for 10 days. High-dose CDP-choline improved neurologic signs in the rats within 20-30 minutes of ischemia. When cerebral glucose metabolism was assessed on Day 4, increases in the levels of glucose and pyruvate were accompanied by decreases in the synthesis of labeled acetylcholine from uniformly labeled [14C]glucose measured in the cerebral cortex of rats with 30 minutes of ischemia. High-dose CDP-choline also attenuated changes in these variables. CDP-[1,2-14C]choline injected intravenously 10 minutes after reperfusion was used for membrane lipid biosynthesis. These results indicate that CDP-choline has beneficial effects on brain dysfunction induced by cerebral ischemia, which may be due in part to the restorative effects of CDP-choline on disturbed cerebral glucose metabolism, probably by stimulating phospholipid biosynthesis.
Stroke 1988 Feb
PMID:Effects of CDP-choline on neurologic deficits and cerebral glucose metabolism in a rat model of cerebral ischemia. 334 38

Regional cerebral blood flow (rCBF) was measured with the xenon-133 inhalation technique in 15 patients with unilateral cerebral infarction and 12 matched controls. Measurements were performed during a standard resting baseline condition and during the performance of standardized verbal analogies and spatial line orientation tasks. Resting and activated CBF were lower in patients than in controls, and there were differences in the hemispheric pattern of activated CBF. Control subjects replicated earlier findings of asymmetric increase in CBF for the cognitive tasks, whereas patients showed abnormalities in lateralized CBF changes consistent with side of infarction. These findings underscore the utility of cognitive challenges in the study of rCBF in stroke. This can lead to an experimental paradigm in clinical studies of the relation between behavioral deficits and regional brain dysfunction and may also improve the utility of CBF measurements in clinical settings.
Stroke
PMID:Regional cerebral blood flow in stroke: hemispheric effects of cognitive activity. 360 4

A prospective 5 years' neuropsychological, neurological, cardiological and electroencephalographical follow-up study was carried out in 44 patients who had undergone open-heart surgery for valve replacement. A distinct interrelationship was found between the clinical outcome immediately after operation and the neuropsychological long-term course despite the rapid recovery of occasional clinical disorders related to operative procedures. In fact, the psychometric performance scores of those who did not develop clinical signs of cerebral dysfunction induced in operation showed a significant difference only years after operation. Similarly, the harmful effects of long perfusion time (extracorporeal circulation) in operation were reflected in the long-term neuropsychological performance. Some evidence seemed to suggest that the correction of the prolonged circulatory disorder might possibly afford real enhancement of higher cerebral functions. The long-term results not only emphasize the importance of a careful clinical evaluation but also emphasize the necessity of considering the subclinical level of events both before and after operation when assessing the overall outcome and cerebral safety of cardiac surgery patients.
Stroke
PMID:Long-term cerebral outcome after open-heart surgery. A five-year neuropsychological follow-up study. 371 37

Noninvasive electrophysiological evaluation with sensory evoked potentials would be of clear diagnostic and prognostic value in evaluating comatose patients with stroke or severe head injury. In order to protect the brain from such kinds of insults, barbiturate coma therapy has been employed and its effectiveness has been already established. However, in the barbiturate coma therapy, it is occasionally difficult to distinguish the pharmacological effect of barbiturate from the preexisting brain dysfunction caused by the underlying process of the disease. In adult cats, authors studied changes of sensory evoked potentials following cumulative intravenous administration of thiopental which is used clinically for barbiturate coma therapy. P1 and N1 of cortical SEP showed tendency of gradual decrease in amplitude. However, no significant changes occurred in latency by stepwise increment of thiopental dose. Changes in amplitude of P1 and N1 of cortical SEP preceded to the flattening on electroencephalogram. Around at the level of the concentration where EEG changes began, I-II interpeak latency of BAEP and latency of wave I of short latency SEP started to increase. BAEP and early components of SEP (I.II.III.IV) persisted even in by far the higher level of serum concentration of thiopental than that of clinical use. Furthermore, most of these parameters showed no statistically significant change neither in amplitude nor in latency. These experimental results suggest that sensory evoked potentials will provide us with useful information in the assessment of the brainstem function in patients under thiopental induced deep coma.
 ...
PMID:[Effects of thiopental on sensory evoked potentials in the cat]. 373 Jan 99

To ask if the determination of central-nervous-system-derived catecholamine metabolites in peripheral circulation could be a useful index of brain dysfunction after subarachnoid hemorrhage, 3-methoxy-4-hydroxyphenylethyleneglycol and homovanillic acid concentrations in plasma, together with those of free catecholamines (noradrenaline, adrenaline, and dopamine), were serially measured for up to 3 weeks after the initiation of symptoms in 23 patients with aneurysmal subarachnoid hemorrhage as compared to 17 healthy and 9 patient controls. Catecholamines and their metabolites were determined by using high-performance liquid chromatography with electrochemical detection. Plasma 3-methoxy-4-hydroxyphenylethyleneglycol concentrations were markedly elevated in subarachnoid hemorrhage patients with coma compared to those without, and the maximal concentrations observed in comatose patients never occurred in normal subjects or in patients with other neurological disorders. The mean maximal plasma concentrations of free catecholamines did not differ significantly between the comatose and noncomatose groups. Combining 3-methoxy-4-hydroxyphenylethyleneglycol with homovanillic acid level data more clearly discriminated between the comatose and noncomatose subarachnoid hemorrhage groups. The results suggest that plasma concentration of 3-methoxy-4-hydroxyphenylethyleneglycol, a major metabolite of brain noradrenaline, can be a prognostic discriminator for patients with subarachnoid hemorrhage and its discriminating power can be strengthened by combining it with homovanillic acid data.
Stroke
PMID:Plasma 3-methoxy-4-hydroxyphenylethyleneglycol and homovanillic acid concentrations in patients with subarachnoid hemorrhage. 381 Jul 57

Changes in multimodality evoked potentials (MEP's), consisting of somatosensory evoked potentials (SEP's), visual evoked potentials (VEP's), and auditory evoked brainstem responses (AEBR's), were studied in 36 patients with hypertensive putaminal hemorrhage to ascertain the relation among areas and distribution of brain dysfunction, the size of hemorrhage on computerized tomographic scan, and the clinical outcome. Among MEP's, SEP's were most significantly involved in all patients. Abnormalities in VEP's and AEBR's remained mild or moderate when the hemorrhage did not extend to the diencephalon. If SEP's were normal or mildly abnormal, they improved early the ictus. These patients did well clinically. If SEP's were absent, the patients had poor outcome even when the hemorrhage was small and located outside the internal capsule. In contrast, deterioration or persistence of MEP's indicated secondary insult to the brain and poor patient outcome. Early and serial MEP studies are useful in evaluating primary and secondary brain dysfunction and in predicting patient outcome in hypertensive putaminal hemorrhage.
Stroke
PMID:Evaluation of brain dysfunction in hypertensive putaminal hemorrhage with multimodality evoked potentials. 381 Jul 73

Positron emission tomography (PET) using 18F-fluorodeoxyglucose (FDG) was used to map local cerebral glucose utilization in the study of local cerebral function. This information differs fundamentally from structural assessment by means of computed tomography (CT). In normal human volunteers, the FDG scan was used to determine the cerebral metabolic response to controlled sensory stimulation and the effects of aging. After stroke, regional brain dysfunction is more extensive than had been suspected on the basis of CT scans. Cerebral metabolic patterns are distinctive among depressed and demented elderly patients. The FDG scan appears normal in the depressed patient, studded with multiple metabolic defects in patients with multiple infarct dementia, and in the patients with Alzheimer disease, metabolism is particularly reduced in the parietal cortex, but only slightly reduced in the caudate and thalamus. The caudate is markedly hypometabolic in Huntington disease, even in the absence of caudate atrophy, and possibly may be mildly hypometabolic even before the appearance of symptoms. The interictal FDG scan effectively detects hypometabolic brain zones that are sites of onset for seizures in patients with partial epilepsy, even though these zones usually appear normal on CT scans. The future prospects of PET are discussed.
 ...
PMID:Imaging local brain function with emission computed tomography. 660 81


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>