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

The study was conducted in 80 patients with ischaemic and 29 with haemorrhagic cerebral stroke. Lactate, pyruvate, the lactate/pyruvate ratio and glucose were determined in the arterial blood and lumbar CSF. A high prognostic value of the CSF lactate content was found in cases of ischaemic stroke. According to the data obtained, an elevation of the CSF lactate concentration above 4.0 mEq/l should be considered life-threatening. Haemorrhagic stroked was found to be accompanied by a reduced CSF glucose level and an elevated lactate content, as well as by a significant proportional elevation of the lactate and red blood cells count in the CSF. The conducted calculations demonstrated that 1/4 to 1/3 of the CSF lactate is formed at the expense of the glycolytic metabolism in the CSF erythrocytes. This constitutes the main reason of the discordance between the CSF lactate content in haemorrhagic stroke and the routine criteria of prognosis in ischaemic stroke. The lactate/pyruvate ratio in the CSF is of no prognostic importance in both forms of cerebral stroke.
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PMID:[The prognostic value of the lactate concentration and lactate/pyruvate ratio in cerebrospinal fluid following acute cerebral circulatory disorders]. 93 57

Feline pial arteries larger than 100 mu in diameter constricted in response to cervical sympathetic nerve stimulation suggests or in response to topical application of norepinephrine. Smaller pial arteries were unresponsive to norepinephrine. This unresponsiveness persisted when norepinephrine was dissolved in CSF with high calcium ion concentration, or in CSF with both high calcium ion and zero magnesium ion concentration, or when it was dissolved in the acid fluid used by Wahl et al. and applied by constant infusion or by intermittent application. Comparison of the responses of the larger pial vessels to norepinephrine and to sympathetic nerve stimulation that maximal activation of sympathetic nerves achieves a concentration of released norepinephrine equal to 5.9 x 10(-6) M. The constriction of the larger pial vessels in response to sympathetic nerve stimulation could account for modest reductions in cerebral blood flow.
Stroke
PMID:Determinants of response of pial arteries to norepinephrine and sympathetic nerve stimulation. 119 30

The authors relate new concepts of the mechanisms of the pathogenesis and compensation of central motor disorders of organic origin, based on experimental exploits of the I.P. Pavlov Physiological Department of the Institute of Experimental Medicine. It is shown that in these mechanisms, of paramount importance is the neurochemical component determining a considerable part of the symptomatology of neurological disorders and process of disturbed functions recovery. Based on the regularities discovered and studies of the properties of the convalescents" CSF, a method of its use has been developed in order to treat residual phenomena after brain stroke or craniocerebral injury. The authors describe the results of the clinical testing of that method, demonstrating its effectiveness in the treatment of chronic neurological patients.
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PMID:[Cerebrospinal fluid therapy in patients with central motor disorders]. 131 56

40 patients of stroke were studied. The results showed that in Cerebral hemorrhage the correlation between ascending Growth hormone (GH) of CSF and insulin of serum was negative, but the positive correlation between ascending GH (CSF) and hyperglycemia. In patients of cerebral thrombosis the results of values above were no correlation. The pathological significance in such cases was discussed.
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PMID:[Relationship among hyperglycemia growth hormone (CSF) and insulin in serum of cerebral hemorrhage]. 149 6

Neurosyphilis, a sexually transmitted disease that can cause neurologic damage, has become increasingly prevalent in the AIDS era. HIV carriers can contract neurosyphilis without the presence of other concurrent opportunistic infections. Because MR findings of neurosyphilis are seldom reported, we retrospectively reviewed and evaluated contrast-enhanced MR images of six young (average age, 33 years) HIV-positive men with high serum and CSF VDRL titers indicative of neurosyphilis. All six patients tested negative for concurrent opportunistic infections. Five patients had acute or subacute strokelike symptoms involving the basal ganglia or middle cerebral arteries; one had a parietal convexity mass mimicking meningioma with headache and ataxia. Contrast-enhanced MR images showed patchy enhancement involving the basal ganglia and middle cerebral artery territories in the first five patients and the convexity mass in the sixth patient. On the basis of brain biopsy, a convexity mass was diagnosed in the patient with syphilitic gumma. The imaging findings of the remaining five patients represented ischemic infarct caused by meningovascular syphilis. After penicillin treatment, serum and CSF VDRL titers decreased, and neurologic signs and symptoms improved in all six patients. A follow-up MR study in the patient with the gumma showed that the lesion resolved almost completely. In young HIV patients with stroke symptoms or a convexity mass, neurosyphilis should be considered. Contrast-enhanced MR can reveal the extent of involvement by neurosyphilis and should be used to facilitate diagnosis and proper treatment.
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PMID:Neurosyphilis in HIV carriers: MR findings in six patients. 159 Jan 35

Glycerol 50 g infused i.v. over 2 to 6 h is widely used to treat cerebral oedema in patients with acute stroke. Its transit through the blood-cerebrospinal fluid barrier in subjects with uninflamed meninges has now been examined. In 7 patients with an external ventriculostomy for occlusive hydrocephalus, each of whom was given 500 ml of a 10% solution IV over 4 h, serum and CSF were repeatedly sampled during and after the infusion and glycerol was measured enzymatically. The highest serum glycerol level of 191-923 mg/l was observed at the end of the infusion. The maximum CSF glycerol of 18.7-110.8 mg/l was attained 0-1 h after the end of the infusion. Elimination both from serum and CSF approximated a single-exponential decay; the elimination half-life from serum was 0.29-0.56 h compared to 1.03-3.68 h from CSF. In six of the seven cases there was a temporary reversal of the serum/CSF concentration gradient during glycerol elimination. The ratios of the AUCs of CSF and serum, which describe the overall penetration of glycerol into CSF, ranged from 0.09-0.31. In conclusion, the serum level of glycerol produced by giving 50 g IV glycerol over 4 h may not be sufficiently high reliably dehydrate to brain tissue in many patients, and the slow elimination of glycerol from the CSF may be related to the so-called rebound phenomenon.
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PMID:Temporary reversal of serum to cerebrospinal fluid glycerol concentration gradient after intravenous infusion of glycerol. 161 50

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

For understanding of the role of monoamines in cerebral ischemia, 3-methoxy-4-hydroxyphenylglycol (MHPG), hydroxyindoleacetic acid (5HIAA) homovanillic acid (HVA) the three major monoamine metabolites in CSF of 33 patients and 18 controls were measured with high-performance liquid chromatography. Results showed MHPG was more sensitive to cerebral ischemia than the two others. All three metabolites were elevated in patients with severe ischemia but only MHPG and 5-HIAA were significantly elevated. A positive correlation between any two of metabolites was found in controls and in patients in the first week after stroke but altered at the end of the second week. Computer assisted multivariate analysis indicated 5-HIAA might contribute more to the state of illness in the acute stage while HVA the least. Clinically, MHPG appeared to be the most significant element on reflecting the degree of the damage and the prognosis of the disease among the metabolites.
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PMID:[The changes of monoamine metabolites in CSF of patients with cerebral stroke]. 171 95

As skull base resections have increased in complexity and magnitude, so have the complications associated with the procedures. In this paper, we have reviewed the major complications of skull base surgery, including CSF leak, bleeding, stroke, meningitis, cranial nerve deficits and recurrent disease. This report summarizes the factors that lead to these complications, as well as measures to prevent them. We have also discussed our approach to the management of these complications, with particular emphasis on CSF leak and vagal nerve paralysis.
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PMID:Complications of skull base surgery. 174 14

A consensus conference on stroke was held on March 22, 1991. Subjects on which consensus was reached were: There are different kinds of cerebral haemorrhage and infarction, which can be differentiated by computerized tomography, and this can have practical consequences. At clinical examination special attention should be paid to cognitive impairment. Angiography is indicated only if carotid surgery or unusual causes are considered. CSF examination and EEG are performed only on special indications. Cardiological consultation is necessary in young patients, or if clinical signs of cardiogenic embolism are present. Coumarin derivatives are prescribed in some of these cardiac causes of stroke, to prevent recurrence. There is as yet no effective medical treatment for cerebral infarction. In lobar and cerebellar haemorrhage surgical treatment may be indicated. In the acute phase of stroke it is always important to prevent aspiration pneumonia, pulmonary embolism and decubitus, and to care for muscles and joints. Advantages and disadvantages of gastric tube and indwelling catheter should be weighed. Treatment of hypertension after the acute phase is indicated to prevent recurrent stroke. After TIA and minor stroke, aspirin is prescribed, which reduces the risk of cerebral and myocardial infarction by 30%. Carotid endarterectomy in symptomatic patients with carotid stenosis of 70% or more, reduces the number of fatal or disabling strokes by 50%, if perioperative complications are less than 4%. Rehabilitation after stroke reduces disability and improves the adaptation of both the patient and his environment. The patient should be stimulated and supported; good information, including the family, is essential. Supplying aids and taking special measures should be done on individual basis, after a period of training.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Consensus cerebrovascular accident]. 174 34


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