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Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The incidence of essential hypertension has been retrospectively studied in a group of sixty-four fatal cases of ruptured berry aneurysm, and compared with a non-fatal group. Hypertension is more frequent in the fatal group, and is associated with a higher incidence of multiple aneurysms, a smaller size of aneurysm at rupture and a poorer survival after two haemorrhages when comparison is made with normotensive patients. The possible role of hypertension in the development and rupture of aneurysms is discussed, and it is concluded that it may contribute to both. Following rupture it carries a poor prognosis with a resulting over emphasis of its significance in autopsy series. Possible mechanisms for this effect include diffuse vascular disease, and an increased liability to oedema or spasm following rupture of an aneurysm.
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PMID:Prognostic factors in ruptured aneurysms of the circle of Willis: the significance of systemic hypertension. 68 59

Percutaneous transluminal angioplasty (PTA) has become an established treatment for peripheral, renal and coronary vascular disease, where the success rate approaches 90% with complications occurring in less than 5% of patients. There has been a reluctance to recommend PTA of the internal carotid artery (ICA) because of concern about the risks of cerebral embolism. However, there are now a number of reports of technically successful PTA for ICA stenosis, as well as stenosis of other brachiocephalic arteries, demonstrating an improvement in vessel diameter and contour. Complications to date include transient neurological symptoms, asymptomatic carotid dissection and arterial spasm, but the risk of permanent stroke seems to be relatively low. The risks of embolization may be reduced by anticoagulation and avoiding arteries with obvious thrombus or ulceration. Current technical difficulties are likely to be surmounted by improvements in catheter design. PTA is most suitable for smooth ICA stenosis causing haemodynamic symptoms, fibromuscular dysplasia, surgically inaccessible stenosis, and patients with medical risk factors increasing the risks of carotid endarterectomy, such as ischaemic heart disease. Only brief admission is required, avoiding the surgical and anaesthetic risks of carotid endarterectomy. The preliminary results are encouraging enough to set up a randomized trial to determine the risks and benefits. It remains to be seen whether alterations in the calibre or contour of the vessel wall will reduce subsequent stroke. Whether cerebrovascular PTA will enter general use will depend on the balance of the risk-benefit equation.
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PMID:Balloon angioplasty for cerebrovascular disease. 135 77

Casts were produced of the arterial networks of 25 human hearts obtained at autopsy from subjects who were not diagnosed as having cardiovascular disease. Many casts showed imprints of atherosclerotic plaques, remnants of calcified masses, and fine vascular meshes near the lumen of the major coronary arteries. Of 25 casts produced, 14 contained one or more of these anomalies, seven contained vascular meshes, and five of these related to imprints and/or calcified masses. Analysis of these findings in the context of atherosclerosis, intramural hemorrhage, and vascular spasm, suggests possible relationships between them. The findings support the hypothesis that neovasculature in the walls of coronary arteries may play a role in the pathogenesis of vascular disease and malfunction.
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PMID:Vasculature in the walls of human coronary arteries. 240 50

Studies on animal models demonstrate that platelet products contribute to vascular spasm in ischemic syndromes and that this is reversible with administration of ketanserin and thromboxane synthesis inhibitors. Laboratory animals (dogs, rabbits, and rats) that had femoral artery ligations exhibited supersensitivity to serotonin within days in their collateral blood vessels. This supersensitivity lasted at least 6 months. The response to serotonin was reversed by ketanserin, but not by 5HT-1 antagonists. Supersensitivity does not extend to norepinephrine, and alpha blockers do not influence the response to serotonin. It appears that platelet activation by endothelial injury contributes to ischemia through blood vessel occlusion and vascular spasm. When platelet activation occurs in vivo, blood vessel occlusion and vascular spasm are reversible in part by using ketanserin or agents that block thromboxane synthesis or its action. Combining both classes of agents reverses spasm completely. These findings support existing evidence that platelet products contribute to vascular disease, and provide an approach to improved management with currently available pharmacologic agents.
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PMID:Serotonin, atherosclerosis, and collateral vessel spasm. 304 34

Heroin, cocaine, amphetamines, sympathomimetic drugs can cause cerebral angiopathy. We report 2 patients with cerebrovascular disorders after ingestion of a nasal vasoconstrictor containing phenylpropanolamine (P.P.A.). The first patient had two acute repetitive attacks of severe headache and vomiting, occurring after a daily treatment with 180 mg of P.P.A. during 6 weeks. The second patient had an intracerebral hemorrhage, occurring some hours after taking for the first time 120 mg of P.P.A. In both cases, cerebral angiography, performed in the next week, demonstrated segmental narrowing and dilatations of medium-size intracranial arteries. None of the usual causes of cerebral vasculitis were present. The outcome was favorable and follow-up angiograms showed the disappearance of the beading pattern. P.P.A. is widely used over the counter in diet pills and stimulants. Cerebral vascular complications have been rarely reported, always hemorrhagic and often associated with cerebral vasculitis. They are unrelated to duration or dosage of treatment. The mechanism is unclear but could result from several factors: chronic or paroxystic high blood pressure, immuno-allergic vasculitis, arterial spasm, direct "toxic" effect of the P.P.A. on the arterial wall may be increased by other drugs and caffeine.
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PMID:[Benign cerebral angiopathies and phenylpropanolamine]. 304 37

The 6 cases reported here constitute, with 5 previously published cases, a special nosological entity tentatively called "acute benign cerebral angiopathy" by the authors. These 11 cases have in common certain radiological and clinical features. Arteriography shows segmental, multifocal and assymetrical stenoses involving the cerebral arteries between Willis' circle and the terminal arterioles and looking like "strings of sausages". The lesions disappear within one month and present the radiological characteristics of arteritis of medium caliber vessels. The clinical symptoms are suggestive of meningeal haemorrhage or acute cerebromeningeal oedema, with acute repetitive attacks of severe headache and agitation with obnubilation; epileptic seizures and transient neurological deficit may occur. True meningeal haemorrhage confirmed by lumbar puncture is seen in nearly one half of the cases; it seems to be due to alterations in the blood-brain barrier induced by the angiopathy. Intracerebral haematoma may develop, but the disease is usually benign and regresses spontaneously in a few days. None of the usual causes of cerebral arteritis (intra-cranial infection, collagen disease, allergic or toxic angitis) has been found. Pseudo-arteritis (notably spasm of ruptured arterial aneurysms) has been excluded. No aetiological factor common to the 11 cases reported has been elicited, although 6 of the patients had recently given birth and our 6 patients had benign virus infection before or during the clinical manifestations of the disease. In the authors' opinion, the most rewarding line of research would be the role of short acute attacks of arterial hypertension.
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PMID:[Acute benign cerebral angiopathy. 6 cases]. 622 47

New techniques, the manudouche and the pedidouche, were tested at Barbotan on various diseases of the peripheral circulation (artery, vein, lymphatic) after an overall assessment of the treatment based on more than 200 patients and on rheographic recordings. These treatments aim to relieve the vascular spasm in the limbs and to reduce the threshold of sympathetic excitability. This paper outlines the techniques, the thermal agents used and the immediate results. The author concludes that these techniques are of value in the treatment of peripheral circulatory disease and proposes a review of the general thermal nomenclature involving the classification and the indications of thermal resorts aimed at treating vascular disease (heart, artery, vein, lymphatic).
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PMID:[Experimental monitoring of the effects of hand and foot douches at Barbotan on peripheral circulation]. 662 47

The most frequent cause of acute ischaemia of the lower limbs is arterial: thrombotic, embolic and spastic. In cases of arterial embolism, the site of origin is the left side of the heart in 9 cases out of 10: ischaemic heart disease in 2/3 of cases, with atrial fibrillation (A.F.) in 50% of cases, rheumatic valvular disease with A.F. in 1/5 of cases and more rarely, idiopathic A.F., auricular disease and cardiomyopathies. Arterial emboli can be fragments from a wall thrombus (aortic or arterial aneurysm), or atheromatous material from an ulcerated plaque. In 11% of cases the origin of the embolus is never found. Arterial thrombosis is due to chronic vascular disease in 1/3 of cases, popliteal aneurysm and thromboangiitis obliterans. The iatrogenic causes are rare: use of the arterial route, and arterial prosthesis, accidental intra-arterial injection during sclerotherapy for varicose veins. Arterial spasm is seen in cases of phlegmatia caerulea dolens. It ben be iatrogenic (ergotamine tartrate, dihydroergotamine, methysergide), toxic (L.S.D.) or spontaneous.
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PMID:[Etiology of acute ischemia of the lower limbs]. 684 90

All contributory factors to the unusual occurrence of stroke in young people were evaluated in patients under age 40 admitted to the Stroke Unit of the Austin Hospital in Melbourne, Australia. Over the August 1977 to December 1980 period there were 700 admissions. Of these 14 patients were under the age of 40. There were 7 males and 7 females whose ages ranged from 17-38 years. Each patient was screened for factors which might contribute to premature vascular disease including hypertension, diabetes, smoking, obesity, and hyperlipidemia. In addition, the following tests were performed to exclude an arteritic process: full blood examination; ESR; protein electrophoresis; syphilis serology; and the presence of antinuclear factor. Each of the 14 patients suffered cerebral infarction. A summary of each case is presented in a table. In 9 patients, infarction occurred in the carotid territory of supply. Large cortical infarcts with or without subcortical involvement occurred in cases 1-8, of whom 5 had major vessel occlusion demonstrated angiographically and another had stenosing and ulcerative atheromatous disease at the extracranial carotid bifurcation. In a further 4 patients, infarction occurred within the vertebrobasilar territory and was either confined to the brain stem, the occiptal cortex, or involved both. Angiograms were performed in 2 of these patients and showed irregular narrowing of the vertebral artery which was interpreted as spasm and segmentally narrowing of the basilar artery. The final patient had several ischemic events which included right sided amaurosis fugax, and left frontal, right parieto-occipital and left occipital infarctions. Angiography was normal. All patients survived the stroke and were able to go home. There may be an interrelationship between the pathological findings of Irey et al. (1978) and the effect oral contraceptives (OCs) has on migraine. This is relevant to Case 13. Sustained exposure to OCs may produce the pathological changes described (visible as segmental narrowing angiographically). In 2 patients cerebral infarction was caused by atheromatous or hypertensive occlusive vascular disease. In Case 3 an embolus occluded the middle cerebral artery. Infarction complicating migraine was diagnosed confidently in 4 patients on the basis of typical migrainous symptomatology in the past and accompanying the stroke. Of the 12 patients fully evaluated, there were no cases of polycythemia or thrombocytosis. There were no abnormalities of the clotting factors. Almost every patient had some form of emotional upset, and there were 7 who had significant psychiatric illness and emotional problems of extreme magnitide.
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PMID:Stroke syndromes in young people. 692 82

The authors use the term "complicated migraine" to describe the onset of neurological disorder occurring during an acute attack in a patient with chronic migraine. The disturbance may last for long periods or may be permanent, and these irreversible cerebral lesions have to be differentiated from the transient neurological effects characteristic of ophthalmic on secondary migraine. Patients with migraine and retinal lesions, as well as those with ophthalmoplegic or familial hemiplegic migraine, were excluded from the study. The seven cases reported included 5 women and 2 men with an average age of 30 years (from 14 to 51 years). A more or less severe lesion in a hemisphere was present, which led to sensory-motor signs of a hemiplegia (4 cases), an aphasia (4 cases), and a homonymous lateral hemianopia (3 cases). Exploration revealed the presence of an ischemic cerebral lesion in all cases. One or more arterial occlusions were also noted in 5 out of the 6 patients who were investigated by angiography. All cases showed the presence of the criteria thought to be essential for associating the cerebral ischemic lesion with migraine. 1) the patient had true migraine, 2) there was a close chronological relationship between the migraine attack and the lasting neurological disorder, 3) no other associated vascular disease was present (atheroma, cardiopathy). The very severe and prolonged spasm, which could be the cause of neurological disturbances in secondary and ophthalmic migraine, does not appear to be sufficient for producing an irreversible ischemic lesion and, more especially, a persistent vascular obstruction. The roles played by edema of the arterial wall and parietal changes in the vessels are discussed. It could be that thrombosis formation is encouraged by the changes in blood coagulability which may be associated with a migraine attack. The fact that anomalies in platelet aggregation have been demonstrated merits closer study.
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PMID:[Cerebral ischemic accidents during migraine attacks. A report on "complicated migraine"]. 746 14


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