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

Eight hundred and eight subjects participated in three surveys of random samples of people aged 65 years or more living in their own homes. Neurological history and examination showed the prevalence of completed stroke to be 73 per 1000. Eighty-seven subjects per 1000 gave a history of transient cerebral ischaemic attacks. These prevalence rates were unaffected by age or sex. Senile dementia was diagnosed in 24 subjects per 1000 under 75 years and 109 per 1000 over that age. The prevalence of dementia of all types was 43 per 1000 under, and 140 per 1000, over 75 years of age. Parkinsonism was diagnosed in 16 subjects per 1000, and essential tremor in 17 per 1000. The prevalence of epilepsy was four subject per 1000. Other neurological disorders were diagnosed in 36 subjects, and a similar number had neurological abnormalities to which a definite diagnosis could not be given.
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PMID:Neurological disorders in the elderly at home. 18 Feb 57

The prerequisites for effective rehabilitation programmes in elderly patients are described, taking into account the specific social, physiological and psychological changes associated with senescence. The special problems facing elderly patients admitted to hospital are discussed and how their needs can be met. The importance of dementia as a factor influencing rehabilitation is considered and the various forms of residential and non-residential care described. Similarly, the paramount importance of accurate diagnosis of the causes of confusional states is emphasized and principles of management described. The fruitfulness of effective liaison between the psychiatrist and geriatrician is underlined and various ways by which this can be achieved, including the place of psychogeriatric assessment unit, and the role of the acute geriatric ward and geriatric rehabilitation unit. The principles of management of the elderly mentally ill in hospital are outlined. As specific examples of the principles and problems of rehabilitation programmes for disorders in the elderly, a detailed description is presented of the rehabilitation of the patient with myocardial infarction and the patient who has developed a hemiplegia following a cerebrovascular accident.
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PMID:Rehabilitation in the elderly. 42 Jul 2

A retrospective case note survey of chronic subdural haematomata was carried out in an attempt to throw some light on the difficulties encountered in clinical diagnosis. The combination of raised intracranial pressure headache, fluctuating drowsiness and mild hemiparesis, although highly suggestive of subdural haematoma, is not always encountered, and epilepsy, aphasia, hemianopia and dense hemiplegia can all occur contrary to 'text book' descriptions. Head injury or other aetiological factors are commonly absent. The presentation may mimic tumour, dementia, cerebrovascular accident or subarachnoid haemorrhage. Non-invasive investigations may yield false negative results, although in the case of radionucleide scanning and computerized axial tomography the reliability is approaching 90 per cent. The diagnosis will, however, remain an unexpected finding at angiography in a percentage of cases.
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PMID:Chronic subdural haematoma. 48 90

248 patients with an ischaemic stroke were investigated with computer tomography. A hypodense lesion was observed in 18% of TIAs, 76% of PRINDS and 95% of completed stroke patients. In the patients with TIA the hypodense lesions were mainly single ones, whereas completed stroke patients also had a significantly higher proportion of more bilateral lesions. Atrophy was present in 44% of TIA patients, 68% of PRIND patients and 82% of completed stroke patients. Atrophy was generalised in 60% of the patients and homolateral in only 16%. Contrast medium enhancement in a hypodense area occurred only in patients with PRIND and completed stroke and never in TIA aptients. Multiple lesions and atrophy were significantly more common in patients with dementia. The time course showed oedema initially in 47% of patients which fell to 25% after the 1st week. Contrast medium enhancement was present initially in 42% of the patients, rose to 70% until the 3rd week and then fell continuously until the 6th week. The change from an indistinct to a distinct outline of a lesion coincided with this.
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PMID:A correlation of clinical findings and CT in ischaemic cerebrovascular disease. 52 3

Transient global amnesia (TGA) is generally believed to be a transient ischemic attack affecting short-term memory centers. A recent three-year follow-up found a high incidence of subsequent dementia and stroke in patients with TGA. We studied the course (average, 46 months) of 32 patients with TGA and found a low rate of recurrence (12.5%), dementia (6%), or transient ischemic attacks (3%). Transient global amnesia would appear to carry a more benign prognosis than classical transient ischemic attacks.
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PMID:Long-term prognosis in transient global amnesia. 75 58

CNS neoplastic angioendothelosis is a treatable primary proliferative disorder of the endothelial cells of blood vessels characterized by a clinical neurological picture of multiple infarct dementia and an inordinate amount of local cerebral edema, so striking that it may simulate primary or metastatic central nervous system tumor. The malignant cells remain within the lumen of the vessels and rarely if ever metastasize or occur in peripheral blood. There is remarkable improvement in symptoms by treating with high dose steroids. Antimetabolites and irradiation are suggested means of additional treatment.
Stroke
PMID:Central nervous system angioendothelosis. A treatable multiple infarct dementia. 84 86

A 51-yearold man with moderate intermittent hypertension had a rapidly progressive, profound dementia in the absence of significant localizing neurological signs. Postmortem examination disclosed the vascular alterations and diffuse white matter degeneration which characterize subcortical arteriosclerotic encephalopathy (SAE) or Binswanger's disease. The case underscores the need to consider vascular disease as an etiology of dementia -- even in the absence of focal neurological deficit.
Stroke
PMID:Subcortical arteriosclerotic encephalopathy (Binswanger's disease). A vascular etiology of dementia. 100 40

Cyclandelate, a vasodilator, was administered to 24 patients with dementia. The dementia in these patients was presumed to be due to cerebral ischemia caused by atherosclerosis in cerebral vessels after other possible causes were ruled out. In a double-blind, cross-over study, patients received 200 mg of cyclandelate four times daily for six weeks and a placebo for six weeks. Six psychological tests, which reflect various aspects of higher cortical ability, were used to evaluate the effect of cyclandelate on the dementia. Cyclandelate was found to be no more effective than placebo in improving higher cortical function in these demented patients.
Stroke
PMID:Effect of cyclandelate on dementia. 110 57

Thirty-five elderly patients underwent a systematic series of cerebrovascular examinations. The patients were divided into three groups on the basis of clinical criteria: normal patients (Group 1), patients with sequelae of a previous stroke or with minor mental disorders (Group 2), and patients with arteriosclerosis dementia (Group 3). The vasomotor reactions of the cerebral arteries were investigated by estimating regional cerebral blood flow (133Xe clearance technique). The authors emphasize the existence of cerebral vasoreactivity in subjects with clinical symptoms of senile dementia. Furthermore, in each of the three groups of elderly patients, there seemed to be a lack of correlation between the clinical symptoms and certain specific vascular examinations.
Stroke
PMID:Comparative study of cerebral vasoactivity in vascular sclerosis of the brain in elderly men. 119 32

The major target organs that suffer from sustained hypertension are the heart, kidneys, and brain. Cardiac adaptation to arterial hypertension consists of left ventricular hypertrophy (LVH) of the concentric type, that is, an increase in wall thickness at the expense of chamber volume. However, LVH can no longer be considered a simple adaptive myocardial process serving to compensate for the increase in afterload and bring left ventricular wall stress back to normal. Data from the Framingham cohort have shown that the occurrence of LVH drastically increases the risk of sudden death and other cardiovascular morbidity and mortality irrespective of the levels of arterial pressure. Renal adaptation to arterial hypertension consists of a decrease in renal blood flow with elevations in filtration fraction and renal vascular resistance. With progressive hypertensive cardiovascular disease, glomerular filtration rate will fall as well. Recent data in patients with mild-to-moderate hypertension demonstrate that despite "efficacious" antihypertensive therapy, one-third to one-half of hypertensive patients may experience a significant decline in renal function. Cerebrovascular adaptation to hypertension consists of micro- and macrovascular disease leading to vascular dementia, or ischemic or hemorrhagic stroke. Cerebrovascular autoregulation, the mechanism by which cerebral blood flow is maintained, despite changes in arterial pressure, may be altered in hypertension.
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PMID:End-organ disease in hypertension: what have we learned? 128 25


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