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

In a comparative study of the performance of patients with Alzheimer's disease (AD), aphasia resulting from stroke, and normal elders on a variety of neuropsychological tasks, 3 aphasic patients performed similarly to AD patients in the delayed recall of verbal material. The memory deficit of these aphasic patients raised the question of incipient dementia because memory impairment is the hallmark characteristic of AD. However, when the performance profiles of the aphasic patients on all four memory measures administered in the study were compared to those of AD patients, differences made the presence of dementia unlikely. Nonetheless, the possibility remained that a deficit in delayed free recall might be the primordial symptom of dementia. Therefore, the four memory tasks were readministered to the 3 aphasic patients 2 years later, and intergroup performance comparisons again were made. The performance profiles of the aphasic patients obtained 2 years later were superior to and distinct from the AD patients, confirming the absence of dementia at Test Time 1.
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PMID:Delayed recall deficits in aphasic stroke patients: evidence of Alzheimer's dementia? 169 4

Multi-infarct dementia (MID) indicates a dementia disorder primarily caused by multiple cerebral infarcts. Since other pathogenetic mechanisms cause vascular dementia we evaluated clinical, CT scan and CSF neurochemical parameters of 134 MID and 67 PVD (probable vascular dementia) patients. We found no differences with regard to the presence of major risk factors. Only TIA/stroke episodes and focal neurological signs were significantly more frequent in MID than in PVD cases, an anticipable result on the basis of MID definition. CT scan findings showed a prevalence of subcortical with respect to cortical lesions in both groups, with a higher frequency in MID patients. Subjects with deep infarcts more frequently showed TIA/stroke episodes and diabetes mellitus. No differences were detectable in CSF monoamine metabolite levels. We conclude that in the majority of vascular dementias subcortical damage seems to have a major pathogenetic role.
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PMID:Is multi-infarct dementia representative of vascular dementias? A retrospective study. 169 87

We studied the MRI and clinical factors associated with dementia following stroke by quantifying ventricle-to-brain ratio (VBR), anatomic region of infarction, and cortical, subcortical, and white matter areas of infarction in 24 stroke patients with dementia and 29 nondemented stroke patients. The factors that most strongly correlated with dementia were total white matter lesion (WML) area, left WML, VBR, right WML, age, left cortical infarction area, left parietal infarction area, and total infarction area. Using discriminant analysis, these factors correctly classified 28 of 29 nondemented patients and 18 of 24 demented patients. Both cortical and white matter total infarction area measurements were strongly associated with dementia in stroke patients, suggesting that these factors strongly influenced the development of dementia following stroke. There was a strong association between dementia and left- but not right-hemisphere infarction area. The only demographic factor that strongly associated with dementia was age.
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PMID:A quantitative MRI study of vascular dementia. 173 95

Advances in imaging hardware for positron emission tomography and single-photon emission CT, coupled with a wide variety of radiopharmaceutical agents, have allowed these techniques to be used in the evaluation of neoplasm, stroke, epilepsy, and dementia. Cerebral perfusion agents continue to be the mainstay of single-photon emission CT imaging but, in addition to the evaluation of ischemia, it has seen an increasing role in the study of dementia, neuropsychiatric disorders, and seizures. Positron emission tomography scanning has had similar applications but it is playing a greater part in the evaluation of neoplasms, including primary gliomas and pituitary adenomas. Stable-xenon CT has shown value in the study of ischemia associated with meningitis, sickle cell disease, chronic subdural hematomas, and cerebral arteriovenous malformations. MR diffusion imaging shows promise in the evaluation of white matter pathology and some tumors.
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PMID:Physiologic imaging of the brain. 173 6

In many neuropsychiatric disorders, PET imaging offers functional insights unavailable from anatomic imaging alone. Functional deficits may be more extensive than structural findings would indicate, may occur before the detection of anatomic changes, or may even occur in the absence of any structural lesions. We contrast the current role of PET with that of MRI and CT in the investigation of neuropsychiatric disorders including stroke, tumor, head trauma, epilepsy, schizophrenia, movement disorders, normal aging and dementia.
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PMID:Positron emission tomography in the investigation of neuropsychiatric disorders: update and comparison with magnetic resonance imaging and computerized tomography. 174 81

Lacunae are small deep cerebral infarcts which are believed to occur in hypertensive patients, producing characteristic clinical syndromes. Previous reports suggested to differentiate this type of stroke from other cerebrovascular diseases, but failed to provide any evidence that this classification is useful in clinical practice. We reviewed the present literature concerning pathogenesis, clinical features, diagnostic, and therapeutic aspects of lacunae and we established that current concepts in lacunar stroke are inadequately supported. Although lacunar syndromes are reported to be correlated with lacunar infarcts, these syndromes are also described in patients with different pathological findings. The assumption that lacunae always result from a distinct and specific small-vessel arteriopathy is not confirmed; in fact, an atheroma may occlude a single perforating artery at the base of the brain as well as larger arteries. Lipohyalinosis, initially referred to as the underlying pathologic vascular lesion specific for lacunae, is found most commonly in a subset of patients with severe hypertension associated with multilacunar dementia. Large infarcts and hemorrhages are reported to coexist with lacunae in autoptic and neuroradiological studies; intracranial atherosclerosis is associated with lacunae as well as with large superficial infarcts. The percentage of patients with hypertension is approximately the same regardless of type of the infarct, lacunar or cortical. Diagnostic criteria are not clear-cut: clinical onset, neurological examination, and assessment of risk factors are unable to take lacunae apart from other infarcts; the size of the lesion, but not the site or the pathogenesis, determines clinical course, degree of motor deficit, and prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cerebral infarction: lacunae]. 174 36

A survival study over a period of one thousand days from July 1985 was performed on 177 cases of disabled elderly (aged 65 and over) living in Moriguchi-city, Osaka, who were enrolled as recipients of solatia for the disabled elderly. At the start of this study, subjects or family members were questioned regarding physical and mental status, clinical history and social environment of these elderly and their family. On the basis of these findings, the level of disability of the elderly was estimated by applying scores to identify physical and mental conditions: The score on physical status, named Total Functional Capacity (TFC), is equivalent to the dependent level of ADL: mental status was scored by assessing seven typical psychiatric questions relating to dementia (Mental Status Score: (MSS]. The following findings were obtained. 1) It was confirmed that mortality probability tended to increase by degrees in proportion to lower level of independent ADL which was indicated by high scores of TFC, and a greater number of psychiatric symptoms such as often observed in the case of dementia (i.e. high scores of MSS) in either sex. 2) For males, among the major diseases precipitating disability, the proportion for stroke was about 50%. In females, disability causes were distribute into various categories of diseases, but orthopedic diseases (e.g. accident or a fracture), contributed a large proportion. The percentage of elderly who became disabled due to stroke was higher in the lower age categories for females. 3) TFC scores did not correlate with age among either sex. 4) More than 40% had more than one psychiatric symptom included in the MSS score. The proportion of elderly having any one symptom tended to increase with age for either sex, and was especially significant for females. 5) Correlation was seen between TFC and MSS for only female.
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PMID:[Mental and physical condition group characteristics of disabled elderly living at home and principal diseases related to them]. 174 23

Symptomatic dolichoectasia of the vertebrobasilar system was found in 23 patients (16 males and 7 females, mean age: 62 years) during a 13-year period. Arterial hypertension was noted in 20 cases and associated aortic ectasia in 4. The malformation was identified in all patients on CT completed by angiography in 19, MRI in 7. Autopsy was performed in 5 cases. Fourteen subjects (group 1) presented with a vascular event (ischemic in 13) affecting the brainstem and/or cerebellum. Nine other patients (group 2) had a chronic symptomatology resulting from compression of the cranial nerves, central nervous system and/or CSF pathway. Two patients died of stroke within the first month (rupture of the ectasia in one and occlusion in the other one). The 21 survivors were followed for a mean period of 45.3 months. Eight patients had a stroke, with a significantly higher incidence in group 1 than in group 2 (p less than 0.05). Ten patients (5 in each group) developed progressive dementia possibly resulting from multiple cerebral infarction, hypertensive leucoencephalopathy, and/or hydrocephalus. Twelve patients died during the follow-up (4 of stroke, 6 of profound mental and motor deterioration, one from ruptured ectatic aorta, and the last one of unrecognized cause). The actuarial survival rate was 60% after 3 years of follow-up. Except for the incidence of stroke, inaugural manifestations (stroke vs nervous compression) did not seem to influence the long-term prognosis.
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PMID:[Vertebrobasilar arterial dolichoectasia. Complications and prognosis]. 177 25

Local cerebral blood flow was measured in 19 patients with probable dementia of Alzheimer type (DAT) by using xenon-enhanced computerized tomography (CT) and CT densitometry to accurately differentiate white from gray matter. Patients met standard diagnostic criteria for probable DAT and results were compared with similar measures in 26 age-matched, neurologically and cognitively normal volunteers. Perfusions of frontal and occipital white matter as well as frontal, parietal, temporal, and occipital cortex were reduced in DAT compared with age-matched normals. White matter perfusion differences were not observed among DAT patients with and without risk factors for stroke. Reduced perfusion of frontal white matter correlated significantly with reduced perfusion of thalamus and putamen in patients with DAT. Results confirm the frequent association of white matter abnormalities in patients with DAT that are possibly caused by amyloid angiopathy and may contribute to cognitive impairments.
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PMID:Cerebral white matter perfusion in dementia of Alzheimer type. 178 65

In 1898, Alzheimer wrote an exhaustive update on psychogeriatric issues. He discussed paralytic dementia, involutional melancholia, senile dementia, presenile dementia, arteriosclerotic dementia, Binswanger disease, stroke-induced dementia, and other dementias of vascular origin. In this paper, he appeared to describe his very first case of Alzheimer disease, he anticipated the ischemic score, and outlined his opinion about numerous issues of dementia research that are of current interest.
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PMID:Recent studies on dementia senilis and brain disorders caused by atheromatous vascular disease: by A. Alzheimer, 1898. 178 68


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