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Query: UMLS:C0917798 (cerebral ischemia)
 17,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Long-term outcome and recurrence rate were discussed in 96 patients of TIA out of 792 of cerebral ischemic disease who were admitted to our hospital during the past 11 years. They all had had attacks in the territory of internal carotid artery. Ninety-three patients could be interviewed finally. They included 63 males and 30 females and the age ranged from 36 to 88 years with an average of 60.5 years. The follow-up period ranged from 4 months to 8 years and 10 months with an average of 3 years and 1 month. Cerebral angiography was performed in 88 patients of them and revealed 16 patients of internal carotid artery stenosis, 12 patients of middle cerebral artery stenosis, 19 patients of severe cerebral arteriosclerosis and 41 patients of normal findings. CT scan was performed in 88 patients and showed abnormal findings in 12 patients. Eleven patients of them had lacunar infarction. Twenty-four patients of arterial stenosis (14 patients of internal carotid artery stenosis and 10 patients of middle cerebral artery stenosis) had surgical treatment of STA-MCA anastomosis (the superficial temporal artery-the middle cerebral artery) and carotid endarterectomy because they were considered to be cause of TIA. The other 69 patients were treated conservatively mainly with antiplatelet therapy. Four of 24 surgical treated patients developed another attack of cerebral ischemia thereafter, 2 patients had TIA of the contra-lateral hemisphere, one had cerebral infarction in the territory of posterior cerebral artery and the rest had lacunar infarction in the contra-lateral basal ganglia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Long-term follow-up study of 93 patients with TIA]. 372 72

The gerbil model was used to assess the therapeutic effects of the calcium antagonist nimodipine on cerebral ischemia. Transient cerebral ischemia was produced in each gerbil by bilateral common carotid occlusion of 10-, 15- or 20-min duration. Nimodipine (0.01 or 0.1 mg/kg) was administered intraperitoneally just before the carotid occlusion or 10-30 min after the removal of the arterial clips. Morbidity of each animal was evaluated using the stroke index, and the sum of stroke indices was calculated for evaluating the overall morbidity during a particular period of reperfusion. Mortality was observed for 24 hours after clip removal. Although, depending on the timing of the drug administration, the low-dose (0.01 mg/kg) nimodipine worsened the morbidity in the gerbils with 10-min ischemia, the high-dose (0.1 mg/kg) of the drug had a clear beneficial effect on the mortality associated with cerebral ischemia. These results are considered worthwhile for further trials to assess the usefulness of nimodipine as a therapeutic agent in the management of the acute ischemic stroke.
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PMID:The effect of the calcium antagonist nimodipine on the gerbil model of experimental cerebral ischemia. 373 60

In 101 patients 114 asymptomatic carotid stenoses were treated operatively, complicated by one lesion of hypoglossic nerve and one temporary neurologic deficit. During the follow-up period of 6-89 months cardiovascular diseases were seen in 60% of the patients. There were 9 late deaths, 5 due to myocardial infarction and 2 due to contrahemispheric cerebral ischemia. TIA's or cerebral infarctions were not observed in the hemisphere corresponding to the operated carotid artery. Interdisciplinary patient selection, non-invasive diagnostics and selective shunt protection are considered to be essential risk reducing factors.
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PMID:[Indications and surgical results in asymptomatic stenosis of the carotid artery]. 380 4

Transient ischaemic attacks are common, having an incidence of at least 50 per 100,000 population per annum, and the risk of stroke and/or death is about 10% per annum. Death is more often due to the complications of coronary artery disease than cerebrovascular disease. The most important issues in management are distinguishing transient ischaemic attacks from several other causes of 'transient focal neurological attacks', and managing the risk factors for vascular disease in general, particularly hypertension. The utility of specific 'antithrombotic' treatments is still uncertain, but for long term use aspirin seems to be the most promising. The only dose so far tested in clinical trials has been about 600mg twice daily but lower doses may theoretically be as, or more, effective. Trials of aspirin and other antiplatelet agents, and also of carotid endarterectomy and extracranial-to-intracranial bypass surgery are continuing and should be strongly encouraged. Although transient ischaemic attacks recover - by definition - in 24 hours, the pathophysiology, natural history, and treatment of focal cerebral ischaemia which recovers in a matter of days or weeks is probably rather similar.
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PMID:Transient ischaemic attacks. Current treatment concepts. 389 4

Since the acute revascularization was adopted as a probable means of surgical treatment for the acute cerebral ischemia, it became essential to discuss how the initial symptom at onset can predict the subsequent development of severe or mild cerebral infarction. In the 2 past years, 207 cases of cerebral ischemic lesion were admitted non-selectively and mostly in the early stage after the attack. Excluding 40 cases of surgical treatment, 167 cases were classified into 30 cases of TIA, 13 cases of RIND, 94 cases of minor completed stroke and 30 cases of major completed stroke. In 30 cases of major completed stroke, 21 cases developed severe motor hemiplegia from the onset and the rest 9 cases initially mild hemiparesis which gradually developed to severe hemiplegia thereafter. The cases of minor completed stroke showed mild or moderate hemiparesis initially and did not worsen thereafter. In the group of TIA and RIND, no case had developed severe hemiplegia in any stage of clinical course. The disturbance of consciousness were noted in 5 cases out of 94 cases of minor completed stroke (5%) and 12 cases out of 30 cases of major completed stroke (40%) in the following time course. More than half of the cases of major completed stroke were considered to be cerebral embolism including the retrospective review.
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PMID:[Assessment of major stroke at onset in cerebral ischemia. In consideration of acute revascularization]. 399 Aug 98

Eight patients are described with an unusual form of carotid transient ischemic attack, limb shaking. The basic features included a brief, involuntary, coarse, irregular, wavering movement or tremble involving arm-hand alone, or arm-hand and leg together. In 2 patients limb shaking was the initial manifestation of carotid occlusive disease, and all but one patient had other typical carotid transient ischemic attacks. Major atheromatous carotid occlusive disease was present in all patients on the side opposite the limb movements. Four patients had bilateral carotid occlusive disease. Cerebral ischemia from a carotid territory low-perfusion state may be the pathogenesis of these limb movements, an idea supported by the apparent benefit of surgical revascularization in abolishing or reducing the limb shaking in 6 patients. There was no clinical or EEG evidence to document an epileptiform etiology. Recognition of this uncommon form of carotid transient ischemic attack may be important in the early diagnosis and treatment of carotid occlusive disease.
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PMID:Limb shaking--a carotid TIA. 400 58

Fifteen patients evaluated for acute cerebral ischemia underwent acute cerebral revascularization between March, 1979, and May, 1983. Clinical presentation included crescendo transient ischemic attacks (TIA's) in eight cases, progressing neurological dysfunction in three cases, and completed nonfluctuating deficits in four cases. Nine patients received intravenous heparin but did not improve neurologically. The patients with crescendo TIA's were operated on within 4 hours of their last event; those with progressing deficits were operated on while the deficit was developing, and those with established deficits were operated on 4, 6, 9, and 12 hours, respectively, after the event began. The clinical picture for 10 patients had resolved within 10 hours after surgery. One patient with crescendo TIA's, two with progressing deficits, and two with established deficits had postoperative residual deficits, of which three were mild and two severe. One patient, who had a saphenous vein graft to the middle cerebral artery, developed an intracerebral hematoma. In this prospective noncontrolled nonrandomized study, acute cerebral revascularization was performed safely, had limited risks, and offered the potential to help some patients. Further controlled randomized studies are indicated.
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PMID:Acute cerebral revascularization. 402 Apr 43

Transient ischemic attacks (TIAs) are brief reversible episodes of neurological dysfunction due to temporary focal cerebral ischemia. Angiography should be performed only when operation is indicated or when the diagnosis is in doubt. Surgical treatment is recommended when the patient is a good surgical risk, when the stenosis is more than 70 per cent in the appropriate vessel and in certain patients with less severe stenotic lesions that appear to be a probable source of emboli. Anticoagulant therapy is indicated when there are recurrent TIAs, when the patient is not a good surgical candidate and when no appropriate surgically remediable lesion is found by angiography. If there is any significant contraindication to anticoagulants they should not be given. Discontinuance of anticoagulant therapy when the patient has been symptom-free for six months is recommended. In the experience of the authors the TIA syndrome is more benign in its course than was originally suspected and a conservative approach to surgical and anticoagulant therapy is recommended.
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PMID:Management of transient cerebral ischemic attacks. 607 91

The etiology of cerebrovascular disease (CDV) in young patients is difficult to establish if the common causes of a focal neurological deficit are excluded by appropriate investigations. Since in some observations prolapse of the mitral-valve (MVP), alterations of platelet function, or both have been linked with cerebral ischemic events, we studied the in vivo platelet release reaction and the incidence of MVP in 47 patients (12 males, 35 females) under 45 years of age with TIA or stroke of unknown cause and in an age- and sex-matched control group. The mean plasma beta-thromboglobulin (beta-TG) level of the patients (mean = 54.9 +/- 31.4 ng/ml) was significantly higher than that of the controls (mean = 20.6 /- 6.9 ng/ml, p less than 0.001). MVP was demonstrated in 13 of 47 patients in contrast to 4 of the controls (p less than 0.01). However, the beta-T levels of patients with MVP (n = 13, 52.9 +/- 25.5 ng/ml) did not differ from those of patients without MVP (n = 34, 55.7 +/- 33.7 ng/ml) significantly (p less than 0.4). Our results confirm that the incidence of MVP is higher in young patients with cerebral ischemia of unknown cause than in asymptomatic controls. The significantly elevated plasma beta-TG concentrations in the patient's group indicate an increased platelet activity in vivo. Since there was no significant difference between beta-TG levels of patients with and without MVP, the mitral-valve abnormality can not be the cause for the altered platelet activity.
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PMID:Cerebral ischemia in young patients: it is associated with mitral valve prolapse and abnormal platelet activity in vivo? 621 70

30 patients aged between 45 and 78 years and who had suffered from transient global amnesia (TGA), were seen at the Department of Neurology, Pordenone Public Hospital, in the period 1978 to 1982. 25 patients had one or more risk factors for cerebrovascular disease, such as hypertension, cardiac abnormalities, diabetes and hyperlipidemia. EEG examination revealed abnormal activity only in 7 patients. Brain Computed Tomography showed cerebral atrophy in 10 and hypodense lesions in 3 patients. 16 patients had been followed up for a mean interval of 20 months. During the follow-up period, 4 patients had recurrent TGA and one had a transient ischemic attack in the vertebrobasilar arterial system. In the follow-up group, 15 patients showed permanent memory impairment. The high incidence of risk factors for cerebrovascular disease seems to confirm that TGA is probably due to transient cerebral ischemia. The high rate of permanent memory impairment, almost always connected with the coexistence of cerebrovascular risk factors, is not in agreement with the postulated good prognosis of TGA.
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PMID:Transient global amnesia. 651 86


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