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)

In eight patients undergoing carotid endarterectomy, the mean velocity and an index of pulse amplitude in the middle cerebral artery were monitored continuously by transcranial doppler ultrasound. rCBF was measured by intracarotid injection of 133 Xenon shortly before and at the time of the carotid artery occlusion, and again a few minutes after carotid flow was reestablished. Comparison of the mean velocity in the MCA and the cortical convexity rCBF revealed relatively little hysteresis in their relationship from prior to after the occlusion. There was however, considerable variability in this relationship among patients. Both the rCBF and the velocity decreased substantially at occlusion in three cases, neither changed very much in three. While in two, though the rCBF decreased significantly, the velocity did not change. The index of pulse amplitude was somewhat more sensitive to the occlusion, decreasing in the seven cases in which it was recorded, including one in which the rCBF did not change.
Stroke
PMID:Transcranial Doppler and rCBF compared in carotid endarterectomy. 294 97

Eight cases of stroke in children treated with surgery are reported. Four of the patients had Moya-moya disease and presented with TIA. They were treated by surgically creating collaterals through the STA-MCA bypass, encephalomyosyangiosis and encephalomyoarteriosynangiosis operations. Three patients with traumatic or idiopathic carotid artery stenosis or occlusion presented with TIA and were treated with STA-MCA bypass. One patient with idiopathic carotid artery stenosis presented with a complaint of a continuous swishing noise in the ear and had a STA-MCA bypass followed by carotid artery ligation. Although stroke in children is usually secondary to systemic disease, there is a group of children with surgically treatable disease who need to be identified and treated. The potential benefit of surgery may depend on the promptness with which a definitive diagnosis is reached.
 ...
PMID:Cerebrovascular occlusive disease in children: a survey. 306 71

The major pharmacological findings with nimodipine reviewed in this chapter are summarized in TABLE 3. On the basis of these findings, the following conclusions appear to be justified: 1. Nimodipine is a 1,4-dihydropyridine with Ca2+ channel antagonist properties. It is more lipophilic than nifedipine and its distribution volume in the brain of rats is higher than that of nifedipine. 2. Nimodipine dilates cerebral vessels at considerably lower concentrations than required for dilatation of peripheral blood vessels. It can, therefore, improve cerebral blood flow at doses that do not reduce systemic arterial pressure. 3. Nimodipine inhibits 45Ca uptake into vascular smooth muscle and neuronal cells. 4. Nimodipine antagonized postischemic cerebral hypoperfusion in cats and prolonged life of stroke-prone spontaneously hypertensive (SH) rats at doses that have little if any effect on arterial blood pressure. 5. Nimodipine reduced neurological deficits in dogs and monkeys with global cerebral ischemia. In focal ischemia (MCA occlusion) nimodipine reduced infarct size and neurological deficits and normalized intracellular brain pH. 6. In addition to its cerebral vasodilator effect, nimodipine appears to have a direct neuronal action. The suggested evidence for the neuronal site of action of nimodipine includes: a. Presence of nimodipine binding sites in brain. b. Blockade by nimodipine of Ca2+ channels in single nerve cells and in endocrine cells under conditions of sustained depolarization. c. Interactions with centrally acting drugs. d. Effects on release of various neurotransmitters from neuronal tissue or endocrine cells. e. Demonstration of anticonvulsant action of nimodipine. f. Blockade of behavioral effects of Ca2+ channel agonists by calcium channel antagonists.
 ...
PMID:Pharmacology of nimodipine. A review. 328 65

In order to establish more strict and objective indication for EC-IC bypass, a retrospective study on the surgical effect on cerebral blood flow (CBF) and neurological function was carried out in 37 cases. STA-MCA bypass was carried out on 20 cases with IC occlusion and 17 cases with MCA occlusion. Twenty-two cases with completed stroke, 9 cases with TIA and 6 cases with RIND. All patients were able to ambulate before surgery, and none of them were hemiplegic. CBF study by 133Xe inhalation method was carried out before and 2 to 4 weeks after surgery. Bypass was patent in all cases. Thirty percent of all cases showed more than 16% increase in CBF (++ group) on the side of bypass surgery and another 30% demonstrated 6 to 15% increase (+). On the other hand 30% of cases appeared to be unchanged (+/-), and 10% showed more than 6% decrease (-). The less the pre-operative CBF value was, the more the post-operative CBF was expected to be increased. Patients with pre-operative CBF less than 60% of normal value (ISI = 63 +/- 4) showed remarkable increase (++), and those with 60 to 70% showed moderate increase (+). Contrarily, cases with more than 70% of normal value showed either no change or decrease. Neurological change was evaluated as to disappearance of TIA attack and improvement of hemiparesis or mental dysfunction. Seventy-seven percent of patients in groups with (++) and (+) effect on CBF showed improvement in neurological function, whereas only 27% of patients in groups with (+/-) and (-) effect demonstrated improvement, which was statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Surgical indication for extracranial-intracranial arterial bypass determined by cerebral blood flow study and neurological function--a retrospective study]. 343 27

A very simple and low-cost brain dedicated, rapidly rotating Single Photon Emission Tomograph SPECT is described. Its use in following patients with ischemic stroke is illustrated by two middle cerebral artery occlusion cases, one with persistent occlusion and low CBF in MCA territory, and one with early lysis of the occlusion having high CBF (massive luxury perfusion) for some weeks. Evidence of this kind may be essential in the evaluation of therapeutic measures in ischemic stroke.
Stroke
PMID:Monitoring CBF in clinical routine by dynamic single photon emission tomography (SPECT) of inhaled xenon-133. 349 85

The papers about cerebral blood flow (CBF) in patients with cerebrovascular diseases have been already reported by positron emission computerized tomography (PET), single photon emission computerized tomography (SPECT), Xray CT (CT) using cold Xe, and so on. However the literature about the CBF changes in acute stage is few. We studied CBF in 68 patients with ischemic cerebrovascular disease within 48 hours after the onsets from February 1984 through February 1985. CBF was measured by a rapidly rotating single photon emission computerized tomography (SPECT) using non-invasive Xenon-133 inhalation method. Our subjects included 51 cases with cerebral infarction (male 37, female 14, average 62.9 years) and 17 cases with TIA (male 13, female 4, average 60.5 years), the patients who had a past history of stroke were excluded from the subjects. The SPECT was performed with use of Tomomatic 64 developed by Dr. Lassen, et al, SPECT and carotid arteriography were simultaneously performed within 48 hours in all cases. CT we used were GE CT 9800 scanner and Hitachi HF CT. The following results have been obtained: 1) SPECT clearly showed an ischemic focus correlated with clinical symptom after the attack rather than CT, the positive finding by SPECT was 92.2% and that by CT was 62.7% within 48 hours after the onset. 2) The remote effect phenomenon so-called crossed cerebellar diaschisis was demonstrated in 7 of 14 cases (50%) with cerebral infarction due to internal carotid artery occlusion and in 9 of 26 cases (34.6%) with that due to middle cerebral artery occlusion. 3) SPECT and CT were performed within 8 hours after the onset in 20 cases with cerebral infarction. SPECT showed decreased CBF in all cases whereas the positive finding by CT was 40.0%. The area of decreased CBF was always larger than the low density area that CT demonstrated. Mean CBF value of the cerebral hemisphere in the cases with ICA occlusion within 8 hours after the onsets was 31.0 (ml/100 g/min), and that of MCA occlusion was 36.0 (ml/100 g/min), and that of MCA occlusion was 36.0 (ml/100 g/min). 4) The positive finding by SPECT on TIA cases was 47% and that by CT was 41.1%, SPECT usually did not demonstrate a small ischemic focus especially at the deep region (ie, basal ganglia region). 5) SPECT using Xe-123 inhalation was useful and non-invasive method for the diagnosis in acute stage with ischemic cerebrovascular disease.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:[Regional cerebral blood flow in the acute stage with ischemic cerebrovascular disease studied by xenon-133 inhalation and single photon emission computerized tomography]. 349 56

Three hundred and fifty-two patients with atherosclerotic middle cerebral artery stenosis (MCAS, 53%) or occlusion (MCAO, 47%) have been systematically studied. The study involved all patients entered into the EC/IC Bypass Study with isolated MCA disease or a tandem lesion predominating in the MCA ipsilateral to the ischemic events (18 patients with a tandem lesion of greater magnitude in the internal carotid artery were not included). The Asian patients represented 58% of all Asians entered into the EC/IC Bypass Study, whereas the white patients represented 18% of all whites and the black patients 34% of all blacks. Isolated TIAs were less frequent in MCAO (12%) than in MCAS (34%). Warning TIAs before a stroke occurred in one third of the cases. Presentation with stroke or isolated TIA was not influenced by sex, age, level of MCA obstruction, collateral circulation nor associated carotid disease. In MCAS, no major difference in presentation was found between severe and moderate stenosis. Pure motor hemiparesis occurred in 15% and pure sensory stroke in 2% of the patients with stroke and 30% of the MCA territory infarcts were small and limited to the lenticulocapsular area, confirming that so-called lacunar infarcts may be due to large vessel disease. During follow-up (42 months) of 164 medically-treated patients, further cerebrovascular events (TIA and stroke) occurred in 11.7% of the patients per year. In MCAO the stroke rate was 10.1% per patient-year and the ipsilateral infarct rate was 7.1% per patient-year. In MCAS, the stroke rate was 9.5% per patient-year and the ipsilateral stroke rate was 7.8% per patient-year.(ABSTRACT TRUNCATED AT 250 WORDS)
Stroke
PMID:Atherosclerotic disease of the middle cerebral artery. 354 47

To elucidate hemodynamic changes and prognosis after STA-MCA anastomosis, thirteen cases with middle cerebral artery stenosis were systematically analyzed from the pre- and postoperative findings of cerebral angiography, CT scan and rCBF. They were followed up about 3 years long on the average postoperatively. Postoperative angiography revealed patent bypass in all cases. No remarkable changes at the site of stenosis were observed in the group A (6 in 13 cases), who had angiographically sufficient inherent collateral circulation. By contrast, group B (7 in 13 cases), who had insufficient inherent collateral circulation, showed remarkable progress in the degree of stenosis and significant changes of flow patterns were observed after operation. However, these postoperative changes did not bring any clinical deterioration. During follow-up period (31.2 months on the average) after operation, no cerebrovascular accident were encountered in all cases and clinically improved. In conclusion, the STA-MCA bypass rendered more beneficial effect to the patient with MCA stenosis when compared with natural histories reported in the literature.
 ...
PMID:[Follow-up results after STA-MCA anastomosis in cases of middle cerebral artery stenosis]. 362 66

We tested the hypothesis that blood flow through cerebral collateral vessels is lower in stroke-prone spontaneously hypertensive rats (SHRSP) than in normotensive Wistar-Kyoto rats (WKY) after occlusion of the middle cerebral artery and during maximal vasodilatation. Cerebral blood flow, measured with microspheres, was similar in adult male SHRSP and WKY under control conditions. In both strains, occlusion of the middle cerebral artery reduced blood flow and vascular conductance to the territory of the occluded artery, as compared with homologous tissue on the side contralateral to the occlusion. The territory distal to the site of occlusion was identified by intravital demarcation with neutral red dye. In both strains, vasodilatation produced by seizures after occlusion of the middle cerebral artery produced minimal increases in blood flow to the territory of the occluded artery. Blood flow and vascular conductance to the territory of the occluded MCA were significantly lower in SHRSP than in WKY (p less than 0.05) after occlusion and during seizure after occlusion. We conclude that after occlusion of the middle cerebral artery, there is less blood flow through cerebral collateral vessels in SHRSP than in WKY. We speculate that the lower blood flow through collateral vessels in SHRSP may be related to structural differences in those vessels. Thus, the tendency toward infarction after occlusion of the middle cerebral artery in SHRSP may be related, at least in part, to a more limited dilator reserve of cerebral collateral vessels in SHRSP.
 ...
PMID:Blood flow through cerebral collateral vessels in hypertensive and normotensive rats. 372 59

A prospective study of mean hemispheric cerebral blood flow (CBF) correlated with clinical status has now been completed for the past 54 months. Thirty-eight patients underwent superficial temporal to middle cerebral artery (STA-MCA) by-pass. They were compared with 22 patients with similar arteriographic lesions and clinical symptoms, treated medically throughout the same interval of time. Assignment to either treatment group was not randomized but depended solely on choice of patient or treating physician. Both groups were matched for age, clinical symptoms, angiographic abnormalities, and CBF values. All patients had proximal occlusion of one internal carotid artery or intracranial occlusive disease of the internal carotid or middle cerebral arteries. CBF measurements and clinical evaluations were repeated at regular intervals up to 54 months following surgery or institution of medical treatment. Mean follow up interval after STA-MCA by-pass was 28.7 months and for medical treatment was 29.7 months. Mean hemispheric CBF values for STA-MCA patients became significantly increased 2 weeks after operation. After that, CBF flow values decreased. At 24 months after surgery, flow values for surgically treated patients were significantly higher than among those treated medically, although there were no differences in flow values between the two groups at 3, 6, 12, 36 and 48 months. Prospective clinical evaluations after STA-MCA by-pass were as follows: 12 (32%) improved with cessation of TIAs and/or neurological improvement, 16 (42%) remained unchanged, 7 (18%) deteriorated (due to new or recurrent strokes) and 3 (8%) expired. Clinical results were the same for medical treatment: 6 (27%) improved, 10 (46%) unchanged, 4 (18%) deteriorated due to new or recurrent stroke, and 2 (9%) expired.
Stroke
PMID:Long-term assessment of cerebral perfusion following STA-MCA by-pass in patients. 396 72


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