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Sample records for acidente vascular cerebral

  1. Primeiro consenso brasileiro do tratamento da fase aguda do acidente vascular cerebral

    2001-01-01

    Full Text Available Este texto apresenta a síntese das conclusões do Iº Consenso Brasileiro do Tratamento da Fase Aguda do Acidente Vascular Cerebral (AVC. Tratou-se de reunião patrocinada e coordenada pela Sociedade Brasileira de Doenças Cerebrovasculares, com neurologistas especializados nas doenças cerebrovasculares, que analisaram os principais itens da conduta dos AVC.

  2. Acidente Vascular Cerebral Hemorrágico Associado ao Consumo de Cocaína

    Conceição, MC; V. Gomes; Baptista, A

    1998-01-01

    Os autores apresentam o caso clínico de um homem de 37 anos, fumador de cocaína, que foi admitido no serviço por acidente vascular cerebral hemorrágico. Faz-se a discussão dos diagnósticos diferenciais e uma referência aos tipos, formas de administração, metabolismo, características clínicas e toxicidade da cocaína.

  3. Dependência funcional dos idosos pós acidente vascular cerebral

    Gonçalves, Cátia Susana Almeida; Martins, Rosa Maria Lopes, orient.

    2011-01-01

    A Dependência Funcional dos Idosos Pós Acidente Vascular Cerebral tem consequências físicas e emocionais, comprometedoras da capacidade funcional, da independência e da autonomia, podendo igualmente ter efeitos sociais e económicos que invadem todos os aspectos da sua vida. Assim este estudo de carácter quantitativo, transversal, descritivo e correlacional foi objectivado no sentido de caracteriza o idoso pós AVC, identificar a sua funcionalidade familiar; variáveis relacion...

  4. Acidente vascular cerebral ou doença encéfalo vascular ?: Revendo a designação e respeitando a anatomia

    João Eliézer Ferri-de-Barros

    1994-01-01

    Desde que a doença vascular que acomete o sistema nervoso central de localização intracraniana pode comprometer estruturas supra ou/e infratentoriais, propomos a mudança de "Acidente vascular cerebral" para "Doença encéfalo vascular".

  5. Herpes Zoster oftálmico e posterior acidente vascular cerebral: relato de caso

    Carlos A. M. Guerreiro

    1984-12-01

    Full Text Available Um caso de acidente vascular cerebral (AVC 14 semanas após a instalação de herpes zoster oftálmico (HZO é apresentado. A tomografia computadorizada craniana documentou comprometimento em território de artéria cerebral média ipsilateral ao HZO. O diagnóstico de probabilidade é o de arterite por herpes zoster com posterior trombose. Os autores reviram a literatura e enfatizam o longo intervalo entre o HZO e a instalação da hemiplegia. Citam as novas drogas antivirais que tornam esta causa de AVC potencialmente passível de ser prevenida.

  6. Confiabilidade de escalas de comprometimento neurológico em pacientes com acidente vascular cerebral

    Caneda Marco Aurélio Gralha de

    2006-01-01

    Full Text Available Escalas de comprometimento neurológico são utilizadas na avaliação de novos tratamentos, no acompanhamento da evolução clínica e em decisões terapêuticas. Estudamos a confiabilidade de três escalas: a Escala de Rankin (ER, o Índice de Barthel (IB e a National Institute of Health Stroke Scale (NIHSS versadas em português, em 51 indivíduos com acidente vascular cerebral, estimando a concordância entre resultados de diferentes examinadores. Utilizamos os coeficientes de concordância Kappa e Coeficiente de Correlação Intraclasse. A ER teve coeficientes moderados, substanciais ou excelentes. No IB estes foram substanciais ou excelentes nos totais e nos itens, assim como quando foi estratificado em agrupamentos prognósticos e funcionais. A NIHSS apresentou coeficientes excelentes nos totais, substanciais nos itens e moderados e excelentes nas estratificações em grupos de pontos e de itens afins. Estes resultados indicam que as versões em português da ER, o IB e a NIHSS apresentam adequada confiabilidade.

  7. Avaliação da linguagem após acidente vascular cerebral em adultos no estado de Sergipe

    João Sigefredo Arruda

    2014-06-01

    Full Text Available Objetivo analisar a ocorrência de distúrbios de linguagem nos indivíduos que sofreram Acidente Vascular Cerebral. Métodos foi avaliada a linguagem de todos os pacientes acometidos por Acidente Vascular Cerebral, atendidos de fevereiro a agosto de 2012, no setor de fisioterapia de centro de referência em educação e saúde do Estado de Sergipe. A avaliação foi baseada no Teste do Rio de Janeiro (2005. A análise dos dados foi realizada por meio de estatística descritiva e probabilística através da distribuição de frequência, cálculos da média, desvio padrão e percentis, do Teste U de Mann-Whitney e Qui-Quadrado. Resultado foram encontrados 31 indivíduos, de ambos os gêneros, com idade variando de 30 a 94 anos. Foi evidenciado que as variáveis: gênero, escolaridade e idade, influenciam no desempenho do teste, verificando-se que o gênero masculino, sujeitos abaixo de 65 anos e os com escolaridade acima de fundamental incompleto pontuam mais. Conclusão maior percentual da amostra apresenta mais alteração na compreensão do que na expressão.

  8. Rastreio cognitivo em pacientes com acidente vascular cerebral: um estudo transversal

    Ana Amália Torres Souza Gandour Dantas

    2014-07-01

    Full Text Available Objetivo O estudo objetivou-se a fazer um rastreio cognitivo nos pacientes com acidente vascular cerebral (AVC, a fim de determinar pontos de corte de acordo com a idade, escolaridade e grau de comprometimento neurológico. Métodos Foi realizado um estudo transversal no qual participaram 109 pacientes ambulatoriais, sendo 61 homens, com média da idade de 59 anos (± 11, média do tempo de escolaridade de 5 anos (± 4 e do tempo de sequela de 16 meses (± 14. Os pacientes foram avaliados por meio do Miniexame do Estado Mental (MEEM e pela National Institute of Health Stroke Scale. Os dados foram analisados pela regressão linear múltipla (stepwise forward. Resultados Verificou-se que as variáveis grau de comprometimento neurológico, idade e escolaridade contribuíram significativamente para o valor global do MEEM e explicaram a variância do estado cognitivo (R2 ajustado = 0,24. Cada aumento do comprometimento neurológico representou diminuição de 0,456 no escore do MEEM. Quanto maior a idade, ocorreu uma diminuição de 0,202 no MEEM, e à medida que diminui o tempo de escolaridade, houve uma diminuição de 0,190 no MEEM. Os pontos de corte variaram de 14 a 22 de acordo com o grau de comprometimento neurológico, idade e escolaridade. Conclusão Os resultados apontaram que, por meio do rastreio positivo de déficit cognitivo, foram encontrados pontos de corte associados ao comprometimento neurológico, necessitando também serem ajustados pela idade e escolaridade, sugerindo que essas associações sejam preferencialmente levadas em consideração na planificação da reabilitação neuropsicológica dos pacientes com AVC.

  9. Predictive factors for spasticity among ischemic stroke patients Fatores preditivos para espasticidade após acidente vascular cerebral

    Rita de Cássia dos Reis Moura

    2009-12-01

    Full Text Available Spasticity is a determining for functional loss following ischemic stroke. OBJECTIVE: To detect possible predictive factors for its occurrence. METHOD: Demographic, clinical and tomographic data on 146 stroke patients were analyzed. RESULTS: Spasticity was noted more frequently among patients who underwent physiotherapy (pA espasticidade é fator determinante para perda funcional após o acidente vascular cerebral isquêmico (AVCI. OBJETIVO: Detectar possíveis fatores preditivos para a ocorrência da espasticidade. MÉTODO: Foram analisados dados demográficos, clínicos e tomográficos de 146 pacientes pós-AVCI. RESULTADOS: Na análise univariada a espasticidade foi notada com maior freqüência em pacientes que realizaram fisioterapia (p<0,0001; OR=19,4; 95% CI: 4,4-84,5, com maior tempo de duração desse tratamento (p=0,028; OR=4,80; 95% CI: 1,1-8,3 e que realizavam trabalho braçal (p=0,041; OR=2,2; 95% CI: 1,02-4,6, renda menor (p=0,038, referência de dor (p<0,0001; OR=107,0; 95% CI: 13,5-847,3 e seu aparecimento simultâneo à espasticidade (p<0,0001, acidente vascular cerebral (AVC pregresso (p=0,001; OR=4,2; 95% CI: 1,7-10,3, fraqueza muscular (p<0,0001; OR=91,9; 95% CI: 12,0-699,4, lesão tomográfica extensa (p=0,01 e lesão afetando mais de um lobo cerebral (p=0,018. Na análise de regressão multivariada a atividade braçal apresentou risco relativo de 2,9; acidente vascular cerebral prévio com risco relativo de 3,9 e lesão tomográfica extensa risco relativo de 3,6. CONCLUSÃO: A espasticidade afetou um quarto da população estudada e esteve associada ao trabalho braçal, AVC pregresso, lesões tomográficas extensas, diminuição da renda individual, realização de fisioterapia, realização de fisioterapia por um período maior, presença de dor, surgimento da dor simultânea à espasticidade e alteração da força.

  10. Uso regular da bicicleta e acidente vascular cerebral: estudo de caso-controlo no Concelho da Murtosa, Aveiro

    Rebimbas, Ana Raquel da Silva

    2015-01-01

    O Acidente Vascular Cerebral (AVC) é a maior causa de morbilidade dos países ocidentais. Portugal não é exceção, com cerca de 25.000 internamentos anuais e dois óbitos por hora motivados por estes episódios. Os efeitos pessoais, sociais e económicos que provocam na sociedade levam a que, cada vez mais, se aposte mais na prevenção dos fatores de risco associados. A adoção de estilos de vida saudáveis, com destaque para a prática regular de atividade física, assume-se benéfica para a saúde, nom...

  11. Incapacidade funcional em doentes com acidente vascular cerebral seis meses após a sua ocorrência

    Correia, Ricardo Miguel Lourenço

    2015-01-01

    Enquadramento: O Acidente Vascular Cerebral (AVC) é uma patologia com profundas implicações na funcionalidade das pessoas, com efeitos significativos não só ao nível do funcionamento físico, mas também a nível emocional, familiar, social e económico. Objetivos: Avaliar níveis de funcionalidade nas pessoas com AVC seis meses após a sua ocorrência e analisar a sua relação com as variáveis sócio demográficas, clínicas e funcionalidade familiar. Métodos: Trata-se de um estudo não experiment...

  12. Acidente vascular cerebral hemorrágico associado à acidente ofídico por serpente do gênero bothrops: relato de caso Hemorrhagic stroke related to snakebite by bothrops genus: a case report

    Amanda Silva Machado

    2010-10-01

    Full Text Available Este trabalho tem como objetivo relatar um caso de acidente vascular cerebral hemorrágico, associado à acidente ofídico por serpente do gênero bothrops e hipertensão arterial sistêmica grave. Apesar do ofidismo botrópico ser frequente no Estado do Pará, tais associações são incomuns, necessitando de uma abordagem especializada e precoce, visando menores complicações.This research reports a clinical case of hemorrhagic stroke due to envenomation by bothrops snakebite associated with severe hypertension. Although bothrops snakebites are frequent in the State of Pará, such associations are uncommon, requiring specialized and early management to avoid severe complications.

  13. Acidente Vascular Cerebral Cardioembólico : fibrilhação auricular e terapêutica antitrombótica

    Reis, Lígia Silva

    2011-01-01

    Introdução: O Acidente Vascular Cerebral constitui a primeira causa de morte em Portugal. A fibrilhação auricular apresenta-se como um factor de alto risco cardioembólico, aumentando 5 vezes o risco de AVC. O CHADS2 score estima o risco de ocorrência de AVC em pacientes com fibrilhação auricular, assim como permite decidir sobre a aplicabilidade de terapêutica anticoagulante ou antiagregante. O HAS-BLED score avalia o risco de sangramento nos pacientes com fibrilhação auricular que estão sob ...

  14. Sobrecarga dos cuidadores de idosos com acidente vascular cerebral Sobrecarga de los cuidadores de ancianos con accidente cerebrovascular Burden on caregivers of elderly victims of cerebrovascular accident

    Roberta Amorim Pereira; Emanuella Barros dos Santos; Jack Roberto Silva Fhon; Sueli Marques; Rosalina Aparecida Partezani Rodrigues

    2013-01-01

    O objetivo deste estudo foi avaliar a sobrecarga dos cuidadores de idosos com acidente vascular cerebral (AVC), assim como correlacioná-la com as horas de cuidado, a idade e a independência funcional dos idosos. Trata-se de estudo transversal feito com 62 idosos com AVC e seus cuidadores. O instrumento continha variáveis sociodemográficas e econômicas, Mini-Exame do Estado Mental, Medida da Independência Funcional (MIF) e a Escala de Zarit. A possível correlação entre os escores da escala de ...

  15. Cuidador familiar de seqüelados de acidente vascular cerebral: significado e implicações Family caregiver of stroke sequel patients: meanings and implications

    Fernanda de Freitas Mendonça; Mara Lúcia Garanhani; Vera Lúcia Martins

    2008-01-01

    O acidente vascular cerebral (AVC) está entre as principais causas de morte no mundo. Diante das incapacidades impostas pelo AVC, surge o cuidador familiar. O objetivo desta pesquisa foi analisar o significado e as implicações de se tornar cuidador de um indivíduo seqüelado de AVC. Trata-se de um estudo qualitativo, realizado com cinco cuidadores, em Londrina-PR, no período de agosto a dezembro de 2005. Os dados foram coletados por meio de entrevistas semi-estruturadas e submetidos à análise ...

  16. Impacto da percepção da imagem corporal após acidente vascular cerebral no desenvolvimento de depressão

    Lourenço, Inês Sofia Correia de Aguiar

    2012-01-01

    Objectivo: Analisar a Ansiedade, a Depressão, a Auto-estima e Estima Corporal numa amostra de indivíduos com diagnóstico de Acidente Vascular Cerebral (AVC). Metodologia: Foi avaliada a estima corporal, a auto-estima, a ansiedade e depressão em 62 sujeitos com diagnóstico de AVC há menos de 24 meses, dos quais 31 eram homens e as outras 31 mulheres, com idades compreendidas entre 25 e os 81 anos e sem alterações cognitivas severas. Resultados: As mulheres após um AVC vivem com maior sofriment...

  17. Análise da tendência da mortalidade por acidente vascular cerebral no Brasil no século XXI Analysis of the mortality trend due to cerebrovascular accident in Brazil in the XXI century

    Célia Regina Garritano; Paula Mendes Luz; Maria Lucia Elias Pires; Maria Teresa Serrano Barbosa; Keila Moreira Batista

    2012-01-01

    FUNDAMENTO: Embora seja mundialmente a segunda principal causa de óbitos, o Acidente Vascular Cerebral (AVC) vem apresentando uma importante redução das taxas de mortalidade nas últimas décadas. OBJETIVO: Avaliar a tendência da taxa de mortalidade por acidente vascular cerebral no Brasil, em ambos os sexos, a partir dos 30 anos de idade, entre 2000 e 2009. MÉTODOS: Os dados populacionais foram obtidos no banco de dados do Instituto Brasileiro de Geografia e Estatística e os óbitos, por meio d...

  18. O espessamento da íntima-média associa-se independentemente ao Acidente Vascular Cerebral Isquêmico

    Dário Freitas

    2012-06-01

    Full Text Available FUNDAMENTO: O Acidente Vascular Cerebral (AVC constitui uma das primeiras causas de morte a nível mundial. A importância do espessamento da íntima-média na estratificação de risco cardiovascular tem sido recorrentemente estudada; contudo, essa relação gera ainda alguma controvérsia. OBJETIVOS: Determinar se o espessamento da íntima-média na Artéria Carótida Comum (ACC pode ser utilizado como um marcador independente de alto risco para a ocorrência do AVC. MÉTODOS: A amostra compreende um grupo de 948 doentes consecutivamente estudados por Triplex Scan Cervical no período compreendido entre janeiro de 2004 e junho de 2009. Esses doentes foram agrupados em razão da presença ou ausência de AVC recente, do que resultou um grupo de doentes com AVC Isquémico (AVC I (n = 452, 48%, outro com AVC Hemorrágico (AVC H (n = 22, 2% e um grupo de doentes Sem Eventos (n = 474, 50%. RESULTADOS: Na análise de regressão logística ajustada para fatores de risco cardiovascular clássicos, o espessamento da íntima-média na ACC associou-se significativamente e de forma aproximadamente linear com o AVC I (Odds Ratio = 1.808, Intervalo de Confiança: 1.291-2.534, p = 0,01, mas não com o AVC H (p = ns. Uma interação significativa com a idade foi também encontrada, demonstrando-se uma capacidade discriminativa do risco de AVC I maior em indivíduos com idade inferior a 50 anos. CONCLUSÕES: O espessamento da íntima-média na ACC revelou-se um preditor de risco independente para o AVC I, mas não para AVC H reforçando assim a utilidade da sua avaliação na prática clínica. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0

  19. Neurofibromatosis, stroke and basilar impression: case report Neurofibromatose, acidente vascular cerebral e impressão basilar: relato de caso

    ELCIO JULIATO PIOVESAN

    1999-06-01

    Full Text Available Neurofibromatosis type 1 (NF1 can virtually affect any organ, presenting most frequently with "cafe au lait" spots and neurofibromas. Vasculopathy is a known complication of NF1, but cerebrovascular disease is rare. We report the case of a 51-year-old man admitted to the hospital with a history of stroke four months before admission. On physical examination, he presented various "cafe au lait" spots and cutaneous neurofibromas. Neurologic examination demonstrated right-sided facial paralysis, right-sided hemiplegia, and aphasia. Computed tomography scan of head showed hypodense areas in the basal ganglia and centrum semiovale. Radiographs of cranium and cervical spine showed basilar impression. Angiography revealed complete occlusion of both vertebral and left internal carotid arteries, and partial stenosis of the right internal carotid artery. A large network of collateral vessels was present (moyamoya syndrome. It is an uncommon case of occlusive cerebrovascular disease associated with NF1, since most cases described in the literature are in young people, and tend to spare the posterior cerebral circulation. Basilar impression associated with this case may be considered a pure coincidence, but rare cases of basilar impression and NF1 have been described.A neurofibromatose tipo 1 (NF1 pode acometer qualquer órgão mas as apresentações mais frequente são manchas café com leite e neurofibromas. O envolvimento de vasos é complicação conhecida da NF1, mas a doença cerebrovascular é rara. Relatamos o caso de paciente do sexo masculino de 51 anos com história de acidente vascular cerebral há quatro meses da admissão. Ao exame físico apresentava várias manchas café com leite e neurofibromas cutâneos. O exame neurológico demonstrou acometimento facial direito, hemiplegia direita e afasia. Tomografia computadorizada de crânio mostrou áreas hipodensas nos gânglios basais e centros semi-ovais. Radiografias do crânio e coluna cervical

  20. O G-CSF na terapia do acidente vascular cerebral The potential role of G-CSF in stroke

    Angelo L. Maset

    2009-05-01

    Full Text Available O fator estimulador de colônias granulocitárias (G-CSF é uma glicoproteína descrita há mais de vinte anos, e é largamente utilizada para tratamento de estados neutropênicos e no transplante de medula óssea. O G-CSF estimula células-tronco hematopoéticas e regula crucialmente a sobrevivência de neutrófilos maduros, pós-mitóticos, através da inibição da apoptose. Além do efeito sistêmico, mais recentemente tem-se demonstrado uma surpreendente atividade do G-CSF no sistema nervoso central. A administração de G-CSF mobiliza células-tronco e progenitoras da medula óssea para o sangue periférico, que, por sua vez, atravessa a barreira hemato-encefálica (BHE e se dirige à área acometida do cérebro. A atividade do G-CSF no sistema nervoso central tem sido caracterizada como multimodal, pois, além do efeito mobilizador de células da medula óssea, demonstrou uma ação direta neuroprotetora através de diferentes mecanismos, tais como a atividade antiapoptótica em neurônios, regeneração da vascularização, efeito anti-inflamatório e estimulação da neurogênese endógena. Este relato sumariza a ação do G-CSF no sistema nervoso central e aborda seu potencial para o emprego no acidente vascular cerebral.The granulocyte colony-stimulating-factor (G-CSF is a glycoproteina which has been described for decades, and it is commonly utilized in the treatment of neutropenic states and bone marrow transplants. G-CSF stimulates hematopoietic stem-cels e crucially regulates the survival of mature neutrophils through a mechanism of apoptosis inhibition. Beyond its systemic effect, recently it has been shown its surprising activity in the central nervous system (CNS. G-CSF administration mobilizes bone marrow stem cells para systemic blood, and those cells cross the blood-brain-barrier e target brain's damaged area. G-CSF's activity in the CNS has been defined as multimodal, because additionally it has been demonstrated a direct

  1. Reabilitação de déficits comunicativos pós-acidente vascular cerebral Rehabilitation of post-stroke communication impairments

    Gigiane Gindri; Rochele Paz Fonseca

    2012-01-01

    Os processamentos comunicativos discursivo, léxico-semântico, pragmático-inferencial e/ou prosódico podem apresentar-se deficitários após um acidente vascular cerebral. Esses prejuízos demandam métodos e programas de intervenção para uma reabilitação efetiva da comunicação. Neste contexto, o objetivo desta revisão sistemática foi identificar e descrever métodos utilizados para reabilitação neuropsicológica da comunicação de adultos acometidos por lesão cerebrovascular, mais especificamente, a...

  2. Cuidados domiciliares ao idoso que sofreu Acidente Vascular Cerebral Atención domiciliaria al anciano que sufrió Accidente Cerebrovascular Home care to the elderly who had stroke

    Larissa Chaves Pedreira; Regina Lúcia Mendonça Lopes

    2010-01-01

    O objetivo foi identificar a produção do conhecimento sobre acidente vascular cerebral no idoso cuidado no domicílio. Estudo bibliográfico cuja coleta foi através dos resumos datados de 1997 a 2007, nos bancos de dados LILACS e SciELO. Utilizou-se como descritores: assistência domiciliar, idoso e acidente cerebrovascular. Foram encontradas 52 referências no LILACS, nove na SciELO Brasil e três no SciELO Cuba. A maioria dos trabalhos foi realizada em 2000. Quanto ao método, pesquisas com abord...

  3. Revascularização clínica e intervencionista no acidente vascular cerebral isquêmico agudo: opinião nacional Clinical and interventional revascularization in the acute ischemic stroke: national opinion

    Cesar N. Raffin

    2006-06-01

    Full Text Available Este artigo apresenta as conclusões sobre revascularização clínica e intervencionista no acidente vascular cerebral isquêmico agudo, um dos temas discutidos na reunião "Opinião Nacional sobre o Tratamento do AVC". Tratou-se de reunião promovida e coordenada pela Sociedade Brasileira de Doenças Cerebrovasculares, com neurologistas especializados em doenças cerebrovasculares, que analisaram e discutiram as evidências e experiências atuais sobre o uso de trombólise e técnicas intervencionistas em pacientes com acidente vascular cerebral isquêmico agudo.The Brazilian Stroke Society constituted a committee composed by specialists from different areas of Brazil that emitted a viewpoint called "National Opinion" , considering the interventional procedures and thrombolysis in the treatment of the acute ischemic stroke. This study presents the conclusions of this committee.

  4. Dieta DASH na redução dos níveis de pressão arterial e prevenção do acidente vascular cerebral = DASH diet in reducing blood pressure and preventing stroke

    Piper, Vanessa Alves

    2012-01-01

    Conclusões: As evidências disponíveis sugerem que modificações no estilo de vida, incluindo a adoção de uma dieta tipo DASH, são estratégias eficazes no controle da hipertensão arterial e na redução de eventos cardiovasculares, como o acidente vascular cerebral

  5. Cuidador familiar de seqüelados de acidente vascular cerebral: significado e implicações Family caregiver of stroke sequel patients: meanings and implications

    Fernanda de Freitas Mendonça

    2008-01-01

    Full Text Available O acidente vascular cerebral (AVC está entre as principais causas de morte no mundo. Diante das incapacidades impostas pelo AVC, surge o cuidador familiar. O objetivo desta pesquisa foi analisar o significado e as implicações de se tornar cuidador de um indivíduo seqüelado de AVC. Trata-se de um estudo qualitativo, realizado com cinco cuidadores, em Londrina-PR, no período de agosto a dezembro de 2005. Os dados foram coletados por meio de entrevistas semi-estruturadas e submetidos à análise de discurso proposta por Martins e Bicudo. Da análise das entrevistas emergiram sete categorias: voltando-se para o Ser cuidado, descrevendo os cuidados, apresentando as mudanças, o apoio da espiritualidade, compreendendo o significado do cuidado, expressando as necessidades para cuidar e perspectivas para o futuro. Os resultados revelaram que ser cuidador familiar é um fenômeno complexo, que gera nos sujeitos sentimentos de alegria e felicidade concomitantes aos sentimentos de medo, ansiedade e revolta.The brain vascular accident (BVA is one of the main death causes worldwide. Due to the impairments imposed by the BVA, there is the family caregiver. This work aims to analyze the meaning and implications of being a caregiver of a stroke sequel person. It is a qualitative research, carried out with five caregivers in Londrina-PR, from August to December 2005. Data were collected in semi-structured interviews and were subjected to discourse analysis proposed by Martins and Bicudo. From the analysis of interviews seven categories arouse: turning to the being cared, describing care, presenting changes, spirituality support, understanding the meaning of care, expressing the needs to take care and future perspectives. Results revealed that being a family caregiver is a complex phenomenon, that creates in the subjects feelings of happiness and along with feelings of fear, anxiety and revolt.

  6. Estudo das freqüências dos principais fatores de risco para acidente vascular cerebral isquêmico em idosos Study of the main risk factors frequencies for ischemic cerebrovascular disease in elderly patients

    Sueli Luciano Pires; Rubens José Gagliardi; Milton Luiz Gorzoni

    2004-01-01

    Foram estudados retrospectivamente 262 pacientes com diagnóstico clínico de acidente vascular cerebral isquêmico (AVCi) permanente, com idade igual ou superior a 60 anos, selecionados dos 1015 registros da Liga de Aterosclerose da Clínica Neurológica da ISCMSP, de 1990 a 2002. O estudo focalizou as freqüências dos fatores de risco modificáveis para AVCi nesta população idosa, considerando-se sexo e faixa etária dos pacientes. Os resultados evidenciaram que a hipertenção arterial sistêmica é s...

  7. Acidente vascular cerebral precoce: implicações para adultos em idade produtiva atendidos pelo Sistema Único de Saúde Early cerebrovascular accident: implications in working-age adults assisted by the Brazilian Public Health System

    Ilka Veras Falcão; Eduardo Maia Freese de Carvalho; Kátia Magdala Lima Barreto; Fabio José Delgado Lessa; Valéria Moura Moreira Leite

    2004-01-01

    OBJETIVOS: conhecer as incapacidades e identificar se há diferenças de gênero, em sobreviventes de primeiro episódio de acidente vascular cerebral (AVC), entre 20 e 59 anos de idade, na cidade do Recife e que tenham sido hospitalizados pelo Sistema Único de Saúde. MÉTODOS: entrevista domiciliar com uma amostra de sobreviventes, investigando-se as incapacidades referidas na vida funcional e produtiva deles. RESULTADOS: amostra equilibrada entre os sexos, média de idade de 52 anos, com nível el...

  8. Qualidade de vida em sobreviventes de acidente vascular cerebral: instrumentos de avaliação e seus resultados Quality of life in stroke survivors: assessment instruments and their outcomes

    Juliana Ferreira Mota; Rodrigo Nicolato

    2008-01-01

    OBJETIVOS: Os objetivos deste estudo foram identificar os instrumentos genéricos e específicos utilizados na avaliação da qualidade de vida (QV) e os seus resultados em sobreviventes de acidente vascular cerebral (AVC). MÉTODOS: Realizou-se revisão da literatura dos últimos dez anos, com população acima de 18 anos, nos bancos de dados MedLine e Lilacs, cujas publicações utilizassem instrumentos padronizados e validados no país de origem. Combinaram-se os descritores quality of life, cerebrova...

  9. Percepção dos familiares cuidadores informais de utentes hospitalizados no serviço de Medicina 1A com diagnóstico de acidente vascular cerebral acerca das ajudas, apoios, ensinos

    Santos, Ana Margarida Alves Corte Fonseca; Moreira, Maria Helena Encarnação, orient.

    2011-01-01

    A escolha do tema “Percepções dos familiares/cuidadores informais de utentes hospitalizados no Serviço de Medicina 1 A com diagnóstico de AVC acerca das ajudas/apoio/ensinos” deve-se ao facto do Acidente Vascular Cerebral (AVC) ser uma das patologias mais comuns da actualidade, resultando em grandes níveis de dependência dos doentes e em muita sobrecarga para os familiares. Este é um problema complexo, resultando na marginalização destes doentes, após a sua alta clínica, jus...

  10. Revascularização clínica e intervencionista no acidente vascular cerebral isquêmico agudo: opinião nacional Clinical and interventional revascularization in the acute ischemic stroke: national opinion

    Cesar N. Raffin; Jefferson Gomes Fernandes; Eli Faria Evaristo; José Ibiapina Siqueira Neto; Maurício Friedrich; Paulo Puglia; Rogério Darwich

    2006-01-01

    Este artigo apresenta as conclusões sobre revascularização clínica e intervencionista no acidente vascular cerebral isquêmico agudo, um dos temas discutidos na reunião "Opinião Nacional sobre o Tratamento do AVC". Tratou-se de reunião promovida e coordenada pela Sociedade Brasileira de Doenças Cerebrovasculares, com neurologistas especializados em doenças cerebrovasculares, que analisaram e discutiram as evidências e experiências atuais sobre o uso de trombólise e técnicas intervencionistas e...

  11. Stroke in ancient times: a reinterpretation of Psalms 137:5,6 Acidente vascular cerebral nos velhos tempos: uma reinterpretação dos Salmos 137 (versículos 5,6

    Luiz Antonio de Lima Resende

    2008-09-01

    Full Text Available Stroke was probably first described in Psalms 136: 5-6 of the Catholic Bible, and Psalms 137:5-6 of the Evangelical Bible. Based on the Portuguese, Spanish, English, German, Dutch, Russian, Greek, and original Hebrew Bible, the significance of this Psalm is the invocation of a punishment, of which the final result would be a stroke of the left middle cerebral artery, causing motor aphasia and right hemiparesis.Acidente vascular cerebral foi descrito pela primeira vez provavelmente na Bíblia, nos Salmos 136, versículos 5 e 6, da bíblia católica, e 137, versículos 5 e 6, da bíblia evangélica. Nas bíblias escritas em português, espanhol, inglês, alemão, holandês, russo, grego e no original hebraico, o significado destes Salmos seria a invocação de um castigo, que poderia corresponder a acidente vascular da artéria cerebral média esquerda, levando a afasia motora com hemiplegia direita.

  12. Aplicabilidade e segurança do nitroprussiato de sódio para controle da pressão arterial durante trombólise no tratamento do acidente vascular cerebral isquêmico agudo = Applicability and safety of sodium nitroprusside to control arterial pressure during thrombolysis in the treatment of acute ischemic stroke

    Oliveira, Fábio Pascotto de; Klant, Charles Luiz; Friedrich, Maurício André Gheller

    2008-01-01

    Objetivos: relatar a experiência com uso do nitroprussiato de sódio na fase aguda do acidente vascular cerebral isquêmico. Métodos: um estudo retrospectivo, consistindo na revisão de prontuários, incluiu os pacientes que sofreram acidente vascular cerebral isquêmico e foram trombolisados com alteplase endovenosa, entre maio de 2005 e julho de 2007. Resultados: dos 48 pacientes que atenderam aos critérios de inclusão, 15 utilizaram nitroprussiato de sódio para controle da pressão arteria...

  13. Cognitive improvement after treatment of depressive symptoms in the acute phase of stroke Melhora cognitiva com tratamento antidepressivo na fase aguda do acidente vascular cerebral

    Samuel Simis

    2006-06-01

    Full Text Available The outcome of antidepressant treatment for depressive symptoms and cognitive impairment at the acute phase of stroke is controversial. We investigated 93 patients, treating with citalopram 36 with severe depressive symptoms (HAM-D: Hamilton Depression Rating Scale >18, whilst 19 patients with mild depressive symptoms, and 38 non-depressed patients, remained untreated. At baseline (two weeks after stroke, patients with severe depressive symptoms had lower scores in total Dementia Rating Scale (DRS and in the attention and memory DRS subscales, than the non-depressed patients (pOs resultados do tratamento com antidepressivo para os sintomas depressivos e comprometimento cognitivo da fase aguda do acidente vascular cerebral não estão estabelecidos. Investigamos 93 pacientes, 36 com sintomas depressivos graves (HAM-D: Escala de Depressão de Hamilton >18 foram tratados com citalopram, enquanto 19 pacientes com sintomas depressivos leves e 38 não-deprimidos não foram tratados. Ao início do tratamento (duas semanas depois do icto, pacientes com sintomas depressivos graves tinham escores mais baixos na Escala de Avaliação de Demência (DRS total e nas subescalas de atenção e de memória da DRS do que os pacientes não-deprimidos (p<0,001. Ao fim de três meses de acompanhamento essas diferenças tinham desaparecido, mas pacientes que inicialmente tinham sintomas depressivos leves passaram a ter escores mais altos no HAM-D do que os não-deprimidos (p=0,015, e escores mais baixos nas subescalas de atenção e memória da DRS (p<0,01 do que os pacientes tratados com citalopram. O tratamento associou-se a melhora de humor, memória e atenção, e demonstra que é necessário um estudo controlado com placebo para o tratamento de sintomas depressivos leves.

  14. Qualidade do cuidado ao acidente vascular cerebral isquêmico no SUS Quality of care for ischemic stroke in the Brazilian Unified National Health System

    Cristina Lúcia Rocha Cubas Rolim

    2011-11-01

    Full Text Available A taxa de mortalidade hospitalar é uma medida do resultado do cuidado, utilizada como indicador da qualidade do cuidado para o acidente vascular cerebral (AVC. A tomografia computadorizada é o principal método de imagem utilizado para o diagnóstico e condução terapêutica dessa patologia. O objetivo deste artigo é avaliar a qualidade do cuidado hospitalar ao AVC isquêmico (AVCi agudo no SUS, considerando o perfil de gravidade dos casos e a realização de tomografia computadorizada. Análise multivariada foi empregada para ajustar a mortalidade por risco, avaliar o uso de tomografia e classificar o desempenho dos hospitais no período entre abril de 2006 e dezembro de 2007. 16.879 internações foram analisadas. A realização de, pelo menos, um exame de tomografia computadorizada equivaleu a 28,6% das internações. A taxa de mortalidade bruta foi 34,3%, e a taxa ajustada, 31,2%. A realização de exame de tomografia computadorizada apresentou um efeito protetor: OR ajustado de 0,27 para um exame e de 0,32 para a realização de dois exames. A subutilização da tomografia computadorizada é um dos fatores limitantes para a boa prática médica no tratamento do AVCi no SUS.The hospital mortality rate is an outcome measure of care used as an indicator of quality of care for stroke. Computerized tomography is the main imaging method for diagnosing and managing stroke. This study aimed to assess the quality of hospital care for acute ischemic stroke (AIS in the Brazilian Unified National Health System (SUS, considering the severity of cases and use of computerized tomography. Multivariate analysis was used to adjust the mortality risk, evaluate the use of computerized tomography, and rank the performance of hospitals from April 2006 to December 2007. 16,879 admissions were analyzed, and at least one CT scan was performed in 28.6% of the admissions. The crude mortality rate was 34.3%, and the adjusted rate was 31.2%. Performance of a CT

  15. Infarto do miocárdio e acidente vascular cerebral associados à alta temperatura e monóxido de carbono em área metropolitana do sudeste do Brasil Miocardic infarcts and cerebral-vascular accidents associated with high temperature and carbon monoxide in an metropolitan area of Southeastern Brazil

    Davi Rumel; Lucia Ferreira Riedel; Maria do Rosario D.O. Latorre; Bruce Bartholow Duncan

    1993-01-01

    Muito se tem publicado e discutido acerca de fatores de risco ligados a estilo de vida e a fatores hereditários em Acidente Vascular Cerebral (AVC) e Infarto do Miocárdio (IM). Porém o estudo da influência de fatores ambientais como poluição por monóxido de carbono e temperatura na determinação nas ocorrências dessas patologias ainda é pouco discutido em nosso meio. Visando preencher esta lacuna, foi verificada a associação existente entre os valores de temperaturas máximas diárias e valores ...

  16. Reabilitação de déficits comunicativos pós-acidente vascular cerebral Rehabilitation of post-stroke communication impairments

    Gigiane Gindri

    2012-01-01

    Full Text Available Os processamentos comunicativos discursivo, léxico-semântico, pragmático-inferencial e/ou prosódico podem apresentar-se deficitários após um acidente vascular cerebral. Esses prejuízos demandam métodos e programas de intervenção para uma reabilitação efetiva da comunicação. Neste contexto, o objetivo desta revisão sistemática foi identificar e descrever métodos utilizados para reabilitação neuropsicológica da comunicação de adultos acometidos por lesão cerebrovascular, mais especificamente, abordagens sistematizadas de intervenção para cada um dos processamentos comunicativos. Foram avaliados resumos publicados nos últimos dez anos na base de dados PubMed, utilizando palavras-chave relacionadas aos construtos reabilitação, acidente vascular cerebral (AVC e comunicação. Para o construto comunicação foram utilizadas, ainda, palavras específicas dos quatro processamentos comunicativos. Inicialmente, foram encontrados 914 abstracts, dos quais, após exclusão dos repetidos, 460 foram analisados. Os critérios de inclusão de abstracts para análise de seus textos completos foram ser estudo empírico, ter a participação de pelo menos um indivíduo adulto pós-AVC, tratar de reabilitação da comunicação, apresentar intervenção para pelo menos um dos quatro processamentos comunicativos, ter avaliação pré e pós-tratamento, estar escrito em inglês, francês ou português, e ter sido publicado nos últimos dez anos. Apenas quatro artigos empíricos cumpriram tais critérios, sendo conduzidos predominantemente com adultos afásicos ou com aprosódia. Assim, tais achados podem ser considerados surpreendentes e alarmantes frente à escassez de estudos sistemáticos de reabilitação de componentes comunicativos. Ressalta-se a necessidade de descrição detalhada de procedimentos de intervenção com objetivos específicos para que estudos possam ser replicados, contribuindo também para a verificação do efeito

  17. Acidente vascular cerebral e outras complicações do sistema nervoso central nas doenças falciformes Stroke and other vascular complications of the central nervous system in sickle cell disease

    Ivan L. Angulo

    2007-09-01

    Full Text Available A principal complicação da doença falciforme na infância é a das artérias cerebrais, mas após os 20 anos também pode se manifestar, como seqüela de lesões anteriores ou neoformadas. A vasculopatia tem a maior importância no desenvolvimento da criança e na qualidade de vida. Além do acidente vascular cerebral completo ou incompleto ("silencioso", existem outras complicações do sistema nervoso central, porém não exclusivas. O diagnóstico da vasculopatia cerebral falciforme necessita auxílio neurorradiológico. O tratamento se faz basicamente com transfusões de eritrócitos contendo hemoglobina A. O objetivo deste trabalho é rever a literatura médica, procurando selecionar a melhor conduta em diagnóstico e tratamento que seja possível empregar de imediato, para reduzir a morbidade e mortalidade da vasculopatia cerebral e elevar a qualidade de vida dos pacientes, principalmente na infância. Os fatores de risco clínicos e laboratoriais, incluindo a triagem por ultra-sonografia Doppler das artérias cerebrais e imagens de ressonância magnética, devem influenciar a decisão de instituir transfusões crônicas e a quelação do ferro transfusional deve acompanhar este tratamento.In children with sickle cell disease, cerebral arteries are prone to lesions that may cause deficiencies and poor quality of life. After the age of 20, new lesions may also occur. Besides stroke and silent cerebral ischemia, other lesions may occur. Radiologic images are necessary to diagnose and blood transfusions to treat. We reviewed the literature to choose best practices and guidelines to reduce morbidity and mortality and improve the quality of life of children with sickle cell disease. Risk factors identified from clinical and laboratory data and screening by Doppler ultrasonography and magnetic resonance must be used in order to make decisions about transfusion and iron chelation therapy.

  18. Função vestibular no acidente vascular cerebral do território carot��deo Vestibular function in carotid territory stroke patients

    Anna Paula Batista de Ávila Pires

    2013-02-01

    Full Text Available Pacientes após Acidente Vascular Cerebral (AVC podem apresentar sintomas otoneurológicos. OBJETIVO: Avaliar a função vestibular de pacientes com antecedente pessoal de AVC no território carotídeo. Desenho científico: estudo de coorte histórica com corte transversal. MÉTODO: Quarenta pacientes foram submetidos à anamnese, exame otorrinolaringológico, Dizziness Handicap Inventory e vectoeletronistagmografia. RESULTADOS: Anormalidades discretas dos movimentos sacádicos foram encontradas em 20 pacientes (50,0%; nove referiram desequilíbrio e um tontura. O ganho do rastreio pendular foi anormal em 17 casos (42,5%; seis referiram desequilíbrio e um tontura. Preponderância direcional anormal do nistagmoperrotatório ocorreu em dois casos (5,0%, que referiram desequilíbrio. A prova calórica identificou três casos (7,5% com predomínio labiríntico anormal e dois (5,0% com preponderância direcional anormal do nistagmo; os cinco casos relataram desequilíbrio. Dos 11 pacientes que não referiram manifestações de alteração do equilíbrio corporal, 10 apresentaram alterações nos movimentos sacádicos e no rastreio pendular e um apresentou exame vestibular normal. CONCLUSÃO: Pacientes com antecedente pessoal de AVC no território carotídeo podem apresentar tontura ou desequilíbrio corporal e sinais de comprometimento da motilidade ocular e da função vestibular.Stroke patients may present otoneurological symptoms. OBJECTIVE: To assess the vestibular function of subjects with a history of carotid territory stroke. METHOD: This historical cohort cross sectional study enrolled 40 patients; subjects answered the Dizziness Handicap Inventory, were interviewed and submitted to ENT examination and vectorelectronystagmography. RESULTS: Mild saccadic movement anomalies were seen in 20 patients (50.0%; nine complained of imbalance and dizziness. Abnormal smooth pursuit gain was seen in 17 cases (42.5%; six subjects reported imbalance and

  19. Sobrecarga dos cuidadores de idosos com acidente vascular cerebral Sobrecarga de los cuidadores de ancianos con accidente cerebrovascular Burden on caregivers of elderly victims of cerebrovascular accident

    Roberta Amorim Pereira

    2013-02-01

    Full Text Available O objetivo deste estudo foi avaliar a sobrecarga dos cuidadores de idosos com acidente vascular cerebral (AVC, assim como correlacioná-la com as horas de cuidado, a idade e a independência funcional dos idosos. Trata-se de estudo transversal feito com 62 idosos com AVC e seus cuidadores. O instrumento continha variáveis sociodemográficas e econômicas, Mini-Exame do Estado Mental, Medida da Independência Funcional (MIF e a Escala de Zarit. A possível correlação entre os escores da escala de Zarit e as outras variáveis foi avaliada por meio do Coeficiente de Correlação de Pearson. A maioria dos cuidadores era adultos, filhos, casados e do sexo feminino. A média do escore de Zarit foi 34,92 (15,8. A MIF apresentou correlação negativa com a sobrecarga do cuidador, porém, não houve correlação com a idade e as horas de cuidado. A sobrecarga da maioria dos cuidadores variou de moderada a severa e parece estar relacionada ao nível de independência funcional dos idosos.Se objetivó evaluar la sobrecarga de cuidadores de ancianos con accidente cerebrovascular (ACV, y correlacionarla con horas de cuidado, edad e independencia funcional de los ancianos. Estudio transversal con 62 ancianos con ACV y sus cuidadores. El instrumento contenía variables sociodemográficas y económicas, Mini-Examen del Estado Mental, Medida de la Independencia Funcional (MIF y la Escala de Zarit. La posible correlación entre los puntajes de la escala de Zarit y las otras variables fue evaluada por Coeficiente de Correlación de Pearson. La mayoría de los cuidadores eran adultos, hijos, casados y de sexo femenino. El promedio de puntaje de Zarit fue 34,92 (15,8. La MIF presentó correlación negativa con la sobrecarga del cuidador, sin embargo no hubo correlación con edad y horas de cuidado. La sobrecarga de la mayoría de los cuidadores varió entre moderada y severa, y parece relacionarse con el nivel de independencia funcional del anciano.The aim was to

  20. Stroke awareness among cardiovascular disease patients Nível de conhecimento sobre acidente vascular cerebral entre pacientes de uma clínica cardiológica

    Rodolfo de Souza Coelho

    2008-06-01

    Full Text Available BACKGROUND: The early recognition of stroke signs and symptoms is of great relevance concerning the outcome, since it enhances the chances of thrombolytic therapy use. PURPOSE: To compare the knowledge of stroke among a community-based sample and patients treated in a cardiologic clinic. METHOD: We applied a questionnaire during one morning to people who were walking in a park (Pa and spontaneously stopped at a health tent and during one week to patients of a cardiologic clinic (Ca. The survey assessed demographic details, awareness of stroke symptoms and signs, risk factors and general concepts of stroke. RESULTS: A total of 222 questionnaires were answered, 109 by the cardiologic clinic group and 113 by the park group. The park group recognized better three associated symptoms: headache (Ca: 39%; Pa: 61%; p: 0.001, loss of vision (Ca: 15.8%; Pa: 30.9%; p: 0.007 and unilateral paralysis/weakness (Ca: 26%; Pa: 41%; p: 0.026. The park group recognized better 3 risk factors: diabetes (Ca: 22.9%; Pa: 37.2%; p: 0.021, smoking (Ca: 51.4%; Pa: 67.2%; p: 0.011 and high cholesterol (Ca: 54.1%; Pa: 69.9%; p: 0.015. CONCLUSION: Our results suggest that patients treated in a cardiologic clinic do not show a better knowledge of stroke when compared to a community-based sample. Campaigns to increase stroke knowledge can have a great impact on public health, especially among enhanced risk groups, such as cardiovascular patients.FUNDAMENTO: O reconhecimento precoce dos sinais e sintomas de um acidente vascular cerebral (AVC é relevante no prognóstico do paciente, pois aumenta a chance do uso da terapia trombolítica. OBJETIVO: Avaliar o conhecimento sobre AVC entre uma amostra de pacientes tratados em uma clínica cardiológica, comparando-o com o de uma amostra da população freqüentadora de um parque recreativo. MÉTODO: Aplicamos um questionário estruturado acerca de conhecimentos gerais sobre AVC a pacientes de uma clínica cardiológica durante uma

  1. Perfil do cuidador familiar do paciente com seqüela de acidente vascular encefálico Profile of the family caregiver caring for patients with sequels of cerebral vascular accident

    Natália da Rosa Fonseca; Aline Fonseca Gueudeville Penna

    2008-01-01

    Este estudo descritivo, por meio de uma abordagem qualitativa, teve como objetivo conhecer quem são os cuidadores familiares e entender como se dá a escolha do cuidador dentro da família de pacientes com seqüela de acidente vascular encefálico. Participaram do estudo dez cuidadores familiares através de entrevistas e anotações de campo. As entrevistas foram gravadas e posteriormente transcritas e analisadas. Entre os entrevistados, predominaram as mulheres, casadas, cônjuges e filhos, com méd...

  2. Imaging findings and cerebral perfusion in arterial ischemic stroke due to transient cerebral arteriopathy in children; Achados de imagem e perfusao arterial cerebral em acidente vascular cerebral isquemico devido a arteriopatia transitoria em crianca

    Barbosa Junior, Alcino Alves, E-mail: alcinojr@uol.com.br [Departamento de Diagnostico por Imagem, Hospital Israelita Albert Einstein - HIAE, Sao Paulo, SP (Brazil); Ellovitch, Saada Resende de Souza [Neuropediatria, Hospital Israelita Albert Einstein - HIAE, Sao Paulo, SP (Brazil); Pincerato, Rita de Cassia Maciel [Hospital Samaritano, Sao Paulo, SP (Brazil)

    2012-04-15

    We report the case of a 4-year-old female child who developed an arterial ischemic stroke in the left middle cerebral artery territory, due to a proximal stenosis of the supraclinoid internal carotid artery, most probably related to transient cerebral arteriopathy of childhood. Computed tomography scan, magnetic resonance imaging, perfusion magnetic resonance and magnetic resonance angiography are presented, as well as follow-up by magnetic resonance and magnetic resonance angiography exams. Changes in cerebral perfusion and diffusion-perfusion mismatch call attention. As far as we know, this is the first report of magnetic resonance perfusion findings in transient cerebral arteriopathy. (author)

  3. Emergency physician's diagnosis of stroke subtype: an accuracy study Diagnóstico dos subtipos de acidente vascular cerebral: um estudo de acurácia com médicos de emergência

    MARLEIDE DA MOTA GOMES

    1998-09-01

    Full Text Available OBJECTIVE: To evaluate the accuracy of clinical unstructured and structured diagnosis of acute stroke subtypes -- cerebral haemorrhage (CH, cerebral infarction (CI, subarachnoid haemorrhage (SAH. METHODS: Sixty consecutive patients with acute stroke admitted to the Emergency Ward of a Brazilian University Hospital were examined by emergency physicians and computerised tomography (CT. We also compared it (physician's unstructured diagnosis to two published clinical scoring systems (structured diagnosis - Guy's Hospital and Siriraj Hospital applied to three other populations -- regarding the operational characteristics of the tests. RESULTS: In our personal data, among 9 variables that could discriminate CH and CI, three have statistically significant difference (p OBJETIVO: Avaliar a acurácia do diagnóstico clínico não estruturado e do estruturado dos subtipos do acidente vascular cerebral (AVC: hemorragia cerebral (HC, infarto cerebral (IC, hemorragia subaracnóide (HSA. MÉTODO: Sessenta pacientes com AVC consecutivamente admitidos em emergência de hospital universitário brasileiro foram examinados por médicos da emergência e por tomografia computadorizada (TC. Nós também comparamos isso (diagnóstico clínico não estruturado com os resultados de dois testes diagnósticos estruturados sobre AVC da literatura (Guy's Hospital e Siriraj Hospital aplicados a três outras populações -- com atenção às características operacionais dos testes. RESULTADOS: Em nossos dados pessoais, entre nove variáveis que poderiam discriminar HC e IC, três apresentaram diferenças significantes estatisticamente (p<0.05: cefaléia (p=0.0002 e vômito (p=0.02 ocorreram mais frequentemente naqueles com HC, mas AVC prévio naqueles com IC (p=0.04. Diagnóstico não estruturado mostrou-se válido para HSA, com +LHR= 39.7; e em menor grau para IC (-LHR= 0,1. No entanto, ele exibiu baixa sensibilidade para o diagnóstico de HC. Testes estruturados (Guy

  4. Transition of care for the elderly after cerebrovascular accidents - from hospital to the home Transición del cuidado del adulto mayor despues del accidente cerebral vascular del hospital para casa Transição do cuidado com o idoso após acidente vascular cerebral do hospital para casa

    Rosalina Aparecida Partezani Rodrigues

    2013-02-01

    codificar, clasificar los datos y formular categorías significativas, lo que generó tipologías de cuidado. RESULTADOS Y DISCUSIÓN: La idea central fue la transición del cuidado y mostró el contexto en tres tipologías: El proceso de cuidar del adulto mayor dependiente, Estrategias para el proceso de cuidar e Impacto y aceptación de las limitaciones. CONCLUSIÓN: Los datos nos indicaron que el cuidado para el adulto mayor, después del accidente cerebral vascular es un desafío para la familia. Los datos posibilitaron elaborar una propuesta de modelo para la organización del trabajo, visando la integralidad del cuidado en los servicios de salud, formando una red de cuidado, lo que representa un avance para el área de enfermería.OBJETIVO: examinar a transição do cuidado em famílias que cuidam de idosos que sofreram o primeiro episódio de acidente vascular cerebral. METODOLOGIA: foi utilizado o estudo de caso etnográfico instrumental. A amostra foi constituída por 20 sujeitos, sendo 10 cuidadores e 10 idosos, com 65 anos ou mais, de ambos os sexos, com diagnóstico de primeiro episódio de acidente vascular cerebral, capazes de se comunicarem, demandando cuidado de um cuidador principal na família. Os dados foram coletados por meio de entrevistas, observações, documentos existentes e notas de campo. Foram utilizadas técnicas de análises qualitativa para codificar, classificar os dados e formular categorias significativas, o que gerou tipologias de cuidado. RESULTADOS E DISCUSSÃO: a ideia central foi a transição do cuidado e mostrou o contexto em três tipologias: o processo de cuidar do idoso dependente, estratégias para o processo de cuidar e impacto e aceitação das limitações. CONCLUSÃO: os dados indicaram que o cuidado com o idoso, após o acidente vascular cerebral, é um desafio para a família. Os dados possibilitaram elaborar uma proposta de modelo para a organização do trabalho, visando a integralidade do cuidado nos serviços de sa

  5. Incidência de acidente cerebro-vascular embólico na cardiopatia chagásica crônica

    A. Spina-França

    1974-09-01

    Full Text Available A incidência de acidente vascular cerebral embólico na cardiopatia chagásica crônica foi avaliada a partir de duas séries consecutivas de casos: a primeira compreendendo 63 pacientes com cardiopatia chagásica crônica e, a segunda, 84 pacientes com acidentes cerebrovasculares, 59 dos quais de tipo não hemorrágico. Em relação aos casos de cardiopatia chagásica crônica a incidência de acidente vascular cerebral embólico mostrou-se da ordem de 3,17%; em relação aos acidentes cerebrovasculares, da ordem de 4,76% e quando considerados apenas aqueles de tipo não hemorrágico, da ordem de 6,78%.

  6. Cuidados domiciliares ao idoso que sofreu Acidente Vascular Cerebral Atención domiciliaria al anciano que sufrió Accidente Cerebrovascular Home care to the elderly who had stroke

    Larissa Chaves Pedreira

    2010-10-01

    Full Text Available O objetivo foi identificar a produção do conhecimento sobre acidente vascular cerebral no idoso cuidado no domicílio. Estudo bibliográfico cuja coleta foi através dos resumos datados de 1997 a 2007, nos bancos de dados LILACS e SciELO. Utilizou-se como descritores: assistência domiciliar, idoso e acidente cerebrovascular. Foram encontradas 52 referências no LILACS, nove na SciELO Brasil e três no SciELO Cuba. A maioria dos trabalhos foi realizada em 2000. Quanto ao método, pesquisas com abordagem qualitativa predominaram, Sendo o tema principal relacionado ao cuidador, aspectos clínicos e epidemiológicos da doença. Observou-se que esse conhecimento está sendo solidificado no Brasil e temas importantes relacionados à pessoa sujeita dos cuidados e a violência domiciliar ao idoso são pouco explorados.El objetivo fue Identificar la producción del conocimiento sobre accidente vascular cerebral en el anciano cuidado en el domicílio. Estudio bibliográfico, cuantitativo, cuya colecta de datos fue realizada en julio de 2007, a través de los resúmenes fechados desde 1997 a 2007, contenidos en los bancos de datos LILACS y SciELO, de países de América Latina y Caribe. Para la colecta fueron utilizados los descriptores: Atención Domiciliaria de Salud, anciano y accidente cerebrovascular. Fueron encontradas 52 referencias en el LILACS, nueve en el SciELO Brasil y trés en el SciELO Cuba. La mayoria de los trabajos fue realizada en 2000, con predominancia en el método cualitativo, y el tema central es relacionado al cuidador, a los aspectos clínicos y epidemiológicos de la enfermedad. Se observó que en Brasil, ese conocimiento aú está siendo solidificado y los temas relacionados a la persona sujeta a la atención y a la violencia domiciliaria al anciano todavia son poco explorados.The purpose was to Identify the knowledge production about the stroke in elderly under home care. Bibliographic research whose data were collected

  7. Perfil lipídico em pacientes com acidente vascular agudo

    Duarte, Jessica

    2009-01-01

    Este projecto teve como objectivo descrever os valores do perfil lipídico, e comparar estes com a gravidade do acidente vascular cerebral (AVC) verificada com base nas incapacidades que o paciente possui. Adicionalmente, conheceu-se o ambiente vivido numa unidade hospitalar, e observou-se os doentes internados no serviço de Neurologia, de modo a verificar o estado inicial do paciente após o AVC, acompanhando as suas dificuldades, incapacidades e o processo de melhoria. O método de estudo ...

  8. O envelhecimento cortical e a reorganização neural após o acidente vascular encefálico (AVE: implicações para a reabilitação Cortical aging and neural reorganization following cerebral vascular accident (CVA: implications for rehabilitation

    Ilka Nicéia D'Aquino Oliveira Teixeira

    2008-12-01

    Full Text Available Este artigo apresenta uma síntese sobre o envelhecimento do córtex cerebral humano e uma revisão das abordagens para a reabilitação do controle motor após o acidente vascular encefálico (AVE. Na discussão sobre as implicações clínicas na compensação das perdas, é enfatizado que os profissionais de reabilitação devem incentivar os pacientes idosos a usarem os dois membros superiores para a realização das atividades da vida diária (AVDs ao invés de reforçarem o uso do membro superior não afetado.This article presents a synthesis on aging of the human cerebral cortex, and also a review of the approaches to motor control rehabilitation following a cerebral vascular accident (CVA. Throughout the discussion on the clinical implications, the author advises the rehabilitation professionals to encourage older patients perform their activities of daily living (ADL using both upper extremities, rather than reinforcing the use of the unaffected upper extremity.

  9. Acidente vascular cerebral isquêmico em uma enfermaria de neurologia: complicações e tempo de internação Stroke in a neurology ward: etiologies, complications and length of stay

    Rodrigo Bomeny de Paulo

    2009-01-01

    Full Text Available OBJETIVOS: Os objetivos deste trabalho foram: avaliar as complicações e o tempo de internação de doentes com acidente vascular cerebral isquêmico (AVCI na fase aguda ou subaguda em uma enfermaria de Neurologia geral em São Paulo; investigar a influência de idade, fatores de risco para doença vascular, território arterial acometido e etiologia sobre as complicações e o tempo de internação. MÉTODOS: Foram coletados prospectivamente dados de 191 doentes com AVCI e posteriormente analisados. RESULTADOS: Cinquenta e um doentes (26,7% apresentaram alguma complicação clínica durante a internação. A pneumonia foi a complicação mais frequente. O tempo médio de internação na enfermaria foi de 16,8±13,8 dias. Na análise multivariável, o único fator que se correlacionou significativamente com menor taxa de complicações foi idade mais jovem (OR=0,92-0,97, p INTRODUCTION: Purposes of this study were: evaluate complications and length of stay of patients admitted with diagnosis of ischemic stroke (IS in the acute or subacute phase, in a general Neurology ward in São paulo, Brazil; investigate the influence of age, risk factors for vascular disease, arterial territory and etiology. METHODS: Data from 191 IS patients were collected prospectively. RESULTS: Fifty-one patients (26.7% presented at least one clinical complication during stay. pneumonia was the most frequent complication. Mean length of stay was 16.8+-13.8 days. Multivariate analysis revealed a correlation between younger age and lower complication rates (OR=0.92-0.97, p < 0.001. presence of complications was the only factor that independently influenced length of stay (OR=4.20; CI=1.928.84; p<0.0001. CONCLUSION: These results should be considered in the planning and organization of IS care in Brazil.

  10. O envelhecimento cortical e a reorganização neural após o acidente vascular encefálico (AVE): implicações para a reabilitação Cortical aging and neural reorganization following cerebral vascular accident (CVA): implications for rehabilitation

    Ilka Nicéia D'Aquino Oliveira Teixeira

    2008-01-01

    Este artigo apresenta uma síntese sobre o envelhecimento do córtex cerebral humano e uma revisão das abordagens para a reabilitação do controle motor após o acidente vascular encefálico (AVE). Na discussão sobre as implicações clínicas na compensação das perdas, é enfatizado que os profissionais de reabilitação devem incentivar os pacientes idosos a usarem os dois membros superiores para a realização das atividades da vida diária (AVDs) ao invés de reforçarem o uso do membro superior não afet...

  11. Casuística sobre a activação da via verde do acidente vascular cerebral no serviço de urgência da unidade hospitalar de Bragança do centro hospitalar do Nordeste, durante o ano de 2010

    Barreira, Ilda; Esteves, Isabel; Preto, Leonel; Ferreira, Vera; Alves, Sandrina

    2011-01-01

    Conseguir que os utentes tenham acesso ao tratamento farmacológico de desobstrução arterial (trombólise), nos casos considerados clinicamente adequados, no tempo útil inferior a três horas após o início dos sintomas, é o principal objectivo do protocolo da Via Verde do Acidente Vascular Cerebral (VV do AVC), já que a fibrinólise pós-enfarte reduz a morbilidade e a mortalidade no AVC isquémico, contribuindo para uma melhor recuperação funcional (Harold., et al., 2003). Neste estudo analisámos ...

  12. Educação em saúde e família: o cuidado ao paciente, vítima de acidente vascular cerebral - DOI: 10.4025/actascihealthsci.v26i1.1663 Health education in family:nursing CVA patients - DOI: 10.4025/actascihealthsci.v26i1.1663

    Ana Ruth Macêdo Monteiro; Natália Rocha Chagas

    2004-01-01

    O presente estudo objetiva identificar o conhecimento dos familiares de pacientes acometidos por AVC (Acidente Vascular Cerebral) sobre a doença e sobre seus cuidados e, ainda, elaborar uma cartilha de orientação quanto aos cuidados domiciliares a esses pacientes. Participaram da presente pesquisa 50 familiares de pacientes acometidos por AVC, os quais estavam acompanhando os pacientes por um período mínimo de 3 dias. Os dados obtidos da análise dos depoimentos dos familiares estão agrupados ...

  13. Vivenciando a sobrecarga ao vir-a-ser um cuidador familiar de pessoa com acidente vascular cerebral (AVC): análise do conhecimento Viviendo la sobrecarga al convertirse en cuidador familiar de personas con accidente cerebrovascular: análisis del conocimiento Living the burden in becoming a family caregiver for a cerebrovascular accident survivor: knowledge analysis

    Silvia Cristina Mangini Bocchi

    2004-01-01

    Trata-se de trabalho do tipo bibliográfico com a finalidade de fazer uma análise temática da produção do conhecimento em periódicos, acerca da sobrecarga em cuidadores familiares de pessoas com Acidente Vascular Cerebral (AVC). O corpus de análise reuniu artigos localizados nas décadas de 80 e 90, a partir das bases de dados Medline, Lilacs e Cinahl. A análise de conteúdo foi o referencial metodológico que permitiu organizar todo o conhecimento, em um corpo de categorias e subcategorias, deno...

  14. Use of decompressive craniectomy in the treatment of hemispheric infarction Uso da craniectomia descompressiva no tratamento do acidente vascular cerebral isquêmico hemisférico

    José Antonio Fiorot Jr.

    2008-06-01

    Full Text Available Decompressive craniectomy (DC has demonstrated efficacy in reducing mortality in hemispheric infarction of the middle cerebral artery. The aim of our study was to compare the outcome of patients submitted to DC to patients treated in a conservative way. Eighteen patients were submitted to DC and 14 received conservative treatment. Neurological status was assessed by the Glasgow Coma Score and National Institutes of Health Stroke Scale score. Mortality, modified Rankin Scale and Barthel Index scores were assessed at 90 days to evaluate outcome. We did not observe reduction in overall mortality and functional outcome in patients submitted to DC. The differences between our group and previously published series are probably related to the neurological status of the patients at the time of therapeutic decision.Craniectomia descompressiva (CD tem demonstrado eficácia em reduzir a mortalidade em pacientes com infarto hemisférico (IH da artéria cerebral média. Este estudo avaliou o prognóstico dos pacientes submetidos a CD comparando a pacientes com IH tratados de maneira conservadora. Dezoito pacientes foram submetidos a CD e 14 receberam tratamento conservador. Escala de Coma de Glasgow e Escala de AVC do National Institutes of Health foram utilizadas para graduar o déficit neurológico. A mortalidade, bem como os escores obtidos na escala modificada de Rankin e índice de Barthel foram avaliados em 90 dias. Não foi observada redução de mortalidade nos pacientes submetidos a CD. Essa diferença entre os nossos resultados e os estudos publicados previamente se deve, provavelmente, à decisão cirúrgica tardia em pacientes com sinais clínicos de herniação cerebral.

  15. Perfil do cuidador familiar do paciente com seqüela de acidente vascular encefálico Profile of the family caregiver caring for patients with sequels of cerebral vascular accident

    Natália da Rosa Fonseca

    2008-08-01

    Full Text Available Este estudo descritivo, por meio de uma abordagem qualitativa, teve como objetivo conhecer quem são os cuidadores familiares e entender como se dá a escolha do cuidador dentro da família de pacientes com seqüela de acidente vascular encefálico. Participaram do estudo dez cuidadores familiares através de entrevistas e anotações de campo. As entrevistas foram gravadas e posteriormente transcritas e analisadas. Entre os entrevistados, predominaram as mulheres, casadas, cônjuges e filhos, com média etária de 54 anos. Em relação os fatores que determinam que o familiar assuma os cuidados, percebe-se que o cuidar é muito mais uma obrigação do que uma opção. No entanto, esse sentimento de obrigação une-se ao afeto proveniente das relações estabelecidas anteriormente à doença.This descriptive study using a qualitative approach aimed to identify who are the family caregivers and to understand how the caregiver is chosen amongst the family members of stroke patients. Data were collected by means of a semi-structured questionnaire applied to ten family caregivers. In addition, these caregivers were observed during the interview.The interviews were recorded, transcribed and analyzed. Most of the caregivers who participated in this study were females, married, partners and daughters, with a mean age of 54 years. The statements demonstrated that the "choice" of taking care is not so much an option but closely related to a feeling of obligation. Besides, this choice is also related to the affective relation established with the patient before the illness.

  16. Qualidade de vida em sobreviventes de acidente vascular cerebral: instrumentos de avaliação e seus resultados Quality of life in stroke survivors: assessment instruments and their outcomes

    Juliana Ferreira Mota

    2008-01-01

    Full Text Available OBJETIVOS: Os objetivos deste estudo foram identificar os instrumentos genéricos e específicos utilizados na avaliação da qualidade de vida (QV e os seus resultados em sobreviventes de acidente vascular cerebral (AVC. MÉTODOS: Realizou-se revisão da literatura dos últimos dez anos, com população acima de 18 anos, nos bancos de dados MedLine e Lilacs, cujas publicações utilizassem instrumentos padronizados e validados no país de origem. Combinaram-se os descritores quality of life, cerebrovascular accident, stroke, QV e acidente cerebrovascular. RESULTADOS: Consideraram-se relevantes 96 estudos e 31 entram neste trabalho, de acordo com os critérios de inclusão. Foram encontrados cinco tipos diferentes de instrumentos genéricos/perfil, nove genérico/utility e dois específicos. O mais freqüente foi o SF-36, em 45,2% dos estudos. Observou-se que a baixa QV relacionou-se, principalmente, ao déficit da função física, à presença de depressão ou de seus sintomas, ser do sexo feminino e ser mais idoso. De modo geral, os sujeitos no pós-AVC possuíam pior QV do que aqueles que não sofreram o evento. CONCLUSÃO: Foram encontrados 16 instrumentos para avaliação da QV. A baixa QV foi prevalente nos sobreviventes pós-AVC e se correlacionou com a função física, a depressão, o sexo e a idade.OBJECTIVE: The purpose of this study is to identify generical and specific instruments used for valueing quality of life (QOL and their outcomes in stroke survivors. METHODS: Review of literature of last 10 years, with people above 18 years old, in MedLine and Lilacs database. The instruments used on the studies were validated for the their countries. 96 articles have been considered relevant and 31 were in accordance with inclusion criteria. Five kind of generic/profile, nine generic/utility and two specific instruments were found. The more frequent was SF-36, on the 45,2% of the studies. It has been observed that poverty in quality of

  17. Estudo das freqüências dos principais fatores de risco para acidente vascular cerebral isquêmico em idosos Study of the main risk factors frequencies for ischemic cerebrovascular disease in elderly patients

    Sueli Luciano Pires

    2004-09-01

    Full Text Available Foram estudados retrospectivamente 262 pacientes com diagnóstico clínico de acidente vascular cerebral isquêmico (AVCi permanente, com idade igual ou superior a 60 anos, selecionados dos 1015 registros da Liga de Aterosclerose da Clínica Neurológica da ISCMSP, de 1990 a 2002. O estudo focalizou as freqüências dos fatores de risco modificáveis para AVCi nesta população idosa, considerando-se sexo e faixa etária dos pacientes. Os resultados evidenciaram que a hipertenção arterial sistêmica é significativamente freqüente (87,8% entre pacientes idosos com AVCi, independentemente do sexo e da faixa etária. Tabagismo (46,9% e etilismo (35,1% revelaram-se fatores de riscos modificáveis freqüentes especialmente entre os homens. As cardiopatias (27,0%, o Diabete Melito (19,9% e as dislipidemias (15,6% também se revelaram fatores de risco modificáveis freqüentes em pacientes idosos com AVCi, em ambos os sexos e em ambas as faixas etárias estudadas (60 a 70 anos e mais que 71 anos. Foi relativamente baixa a freqüência de hiperuricemia nesta amostra.Two hundred and sixty two patients with clinical diagnosis of permanent ischemic stroke, all of them aged 60 or more were retrospectively studied from the 1015 cerebrovascular diseases (CVD records of the Atherosclerosis Ligue of the Neurology Clinics of the ISCMSP, from 1990 to 2002. The study emphasized modifiable risk factors frequencies for ischemic stroke in this population, considering gender and age of the patients. Results have evidenced that systemic arterial hypertension is a main risk factor significantly frequent in old people (87.8%, independently of gender and age. Smoking (46.9% and alcohol consumption (35.1% have revealed to be very frequent important modifiable risk factors especially among men. Lower frequencies have been presented for cardiac diseases (27.0%, Diabetes Melitus (19.9%, and dislipidemia (15.6% as risk factors for ischemic stroke in old people of both

  18. Importance of retardation and fatigue/interest domains for the diagnosis of major depressive episode after stroke: a four months prospective study Lentificação e fadiga/interesse no diagnóstico do episódio depressivo maior após o acidente vascular cerebral: um estudo prospectivo de quatro meses

    Luisa de Marillac Niro Terroni

    2009-09-01

    Full Text Available OBJECTIVE: Post-stroke major depressive episode is very frequent, but underdiagnosed. Researchers have investigated major depressive episode symptomatology, which may increase its detection. This study was developed to identify the depressive symptoms that better differentiate post-stroke patients with major depressive episode from those without major depressive episode. METHOD: We screened 260 consecutive ischemic stroke patients admitted to the neurology clinic of a university hospital. Seventy-three patients were eligible and prospectively evaluated. We assessed the diagnosis of major depressive episode using the Structured Clinical Interview for DSM-IV and the profile of depressive symptoms using the 31-item version of the Hamilton Depression Rating Scale. For data analysis we used cluster analyses and logistic regression equations. RESULTS: Twenty-one (28.8% patients had a major depressive episode. The odds ratio of being diagnosed with major depressive episode was 3.86; (95% CI, 1.23-12.04 for an increase of one unit in the cluster composed by the domains of fatigue/interest and retardation, and 2.39 (95% CI, 1.21-4.71 for an increase of one unit in the cluster composed by the domains of cognitive, accessory and anxiety symptoms. The domains of eating/weight and insomnia did not contribute for the major depressive episode diagnosis. CONCLUSION: The domains of retardation and interest/fatigue are the most relevant for the diagnosis of major depressive episode after stroke.OBJETIVO: O episódio depressivo maior após acidente vascular cerebral é muito frequente, mas é subdiagnosticado. Pesquisas têm investigado a sintomatologia do episódio depressivo maior pós-acidente vascular cerebral, o que pode facilitar sua identificação. Este estudo foi desenvolvido para identificar os sintomas depressivos que melhor diferenciam pacientes com episódio depressivo maior daqueles sem episódio depressivo maior após o acidente vascular cerebral

  19. Análise da tendência da mortalidade por acidente vascular cerebral no Brasil no século XXI Analysis of the mortality trend due to cerebrovascular accident in Brazil in the XXI century

    Célia Regina Garritano

    2012-06-01

    Full Text Available FUNDAMENTO: Embora seja mundialmente a segunda principal causa de óbitos, o Acidente Vascular Cerebral (AVC vem apresentando uma importante redução das taxas de mortalidade nas últimas décadas. OBJETIVO: Avaliar a tendência da taxa de mortalidade por acidente vascular cerebral no Brasil, em ambos os sexos, a partir dos 30 anos de idade, entre 2000 e 2009. MÉTODOS: Os dados populacionais foram obtidos no banco de dados do Instituto Brasileiro de Geografia e Estatística e os óbitos, por meio do Sistema de Informações sobre Mortalidade da Secretaria de Vigilância em Saúde do Ministério da Saúde, sendo incluídos os códigos I60 a I69 de acordo com a 10ª Classificação Internacional de Doenças. Foi calculada a incidência de óbitos/1.000 habitantes, as taxas de mortalidade bruta e padronizada/100.000 habitantes. A modelagem da tendência das taxas foi feita com modelos de regressão. RESULTADOS: Observou-se um aumento na incidência de óbitos até 2006, seguindo-se um declínio até 2009, quando ocorreu a incidência mínima. Comparando os anos 2000 e 2009, nota-se uma tendência de queda da taxa de mortalidade padronizada em ambos os sexos (masculino = -14,69%; feminino = -17% e no total (-14,99%, com oscilações no período. Entre 30 e 49 anos em ambos os sexos, houve uma tendência de redução contínua e linear da taxa de mortalidade, enquanto os demais grupos etários apresentaram uma função curvilínea, culminando com uma efetiva diminuição dos valores. CONCLUSÃO: Houve uma tendência de queda na taxa de mortalidade em todas as faixas etárias e em ambos os sexos. A redução da taxa de mortalidade bruta foi mais acentuada no sexo masculino, enquanto a taxa de mortalidade padronizada mostrou uma maior redução no sexo feminino.BACKGROUND: Although it is the second leading cause of deaths worldwide, the cerebrovascular accident (CVA has shown a significant reduction in mortality rates in recent decades. OBJECTIVE: To

  20. Forame oval patente e acidente vascular cerebral isquêmico em jovens: associação causal ou estatística? Patent foramen ovale and ischemic stroke in young people: statistical association or causal relation?

    Edson Marcio Negrão

    2007-05-01

    Full Text Available OBJETIVOS: Determinar se há evidências de uma relação causal entre forame oval patente (FOP e acidente vascular cerebral isquêmico (AVCI criptogênico em jovens. Analisar essa relação à luz dos critérios de causalidade. MÉTODOS: Avaliaram-se, retrospectivamente, 168 pacientes jovens com AVCI, divididos em dois grupos: criptogênico e de causa definida. Como parte da rotina, os pacientes foram submetidos a pesquisa de FOP por ecocardiograma transesofágico e/ou Doppler transcraniano, ambos associados ao teste de bolhas. Demonstrada a associação estatística univariada entre FOP e AVCI, procedeu-se a análise multivariada. RESULTADOS: Após análise multivariada, a associação FOP e AVCI criptogênico mostrou-se ainda estatisticamente significante, com razão de chance (RCajustada de 3,3 (IC95% 1,5-7,4. O número total de lesões no encéfalo também apresentou associação significativa com o AVCI criptogênico (RCajustada= 0,4 IC95% 0,2-0,9. A associação FOP e AVCI criptogênico satisfez todos os critérios de causalidade. CONCLUSÃO: A relação causal entre o FOP e o AVCI criptogênico em jovens é altamente provável. Esse fato deve ser considerado na decisão terapêutica.OBJECTIVES: To determine if there are evidences of a causal relation between patent foramen ovale (PFO x cryptogenic ischemic stroke (IS in the young population and to analyze this relation in terms of causal criteria. METHODS: A total of 168 young patients with IS was retrospectively evaluated and divided into two groups: cryptogenic and with a defined cause. As a routine procedure, the patients underwent investigation of the PFO by means of transesophageal echocardiogram and/or transcranial Doppler sonography, both of them associated with the bubble test. Multivariate analysis was performed after demonstration of univariate statistical association between PFO x IS. RESULTS: After multivariate analysis, the association between PFO x cryptogenic IS was still

  1. Patent foramen ovale in a cohort of young patients with cryptogenic ischemic stroke Forame oval patente em uma coorte de pacientes jovens com acidente vascular cerebral isquêmico

    Marcus Tulius T. Silva

    2005-06-01

    Full Text Available OBJECTIVE: Although its role is a matter of debate, some studies described a higher prevalence of patent foramen ovale (PFO and atrial septal aneurysm (ASA in young stroke patients, with higher risk with PFO / ASA association (OR 4.96. The aim of this study was determine the prevalence of PFO and ASA in a cohort of cryptogenic ischemic stroke (IS patients younger than 55 years and to follow-up after surgical or percutaneous endovascular closure (PEC. METHOD: In 21 months we identified all patients less than 55 years old with IS who were admitted to our hospital. Cryptogenic IS was considered if there is not an identifiably cause to cerebral ischemia. Transesophageal echocardiography (TEE was performed in all patients. After interatrial septal abnormalities diagnosis, percutaneous device closure was offered to all. Patients were followed monthly and keeped with oral AAS or Clopidogrel. RESULTS: We identified 189 patients with IS and 32 were less than 55 years old (16.9%. In 29 the IS was cryptogenic. TEE was performed in all patients and some form of interatrial septal abnormality was identified in 12 (12/29 - 41.3%; 5 had a PFO and in 7 there was PFO plus ASA. Ten patients were submitted to PEC and 2 were submitted to surgical closure. In mid-term follow-up (28 months no ischemic events occurred and 2 patients related disappearance of migraine symptoms. CONCLUSION: Our small series description is in accordance with other studies and suggests a possible relation between interatrial septal abnormalities and IS in a cohort of young patient.OBJETIVO: A associação das anormalidades do septo interatrial - forame oval patente (FOP e aneurisma de septo interatrial (ASA - com acidente vascular cerebral isquêmico (AVCI ainda é questão de incerteza para muitos autores. No entanto, vários estudo mostram que em pacientes jovens tais anormalidades podem estar relacionadas à gênese de eventos isquêmicos. Nosso objetivo é descrever a prevalência do

  2. Estudo comparativo da deglutição com nasofibrolaringoscopia e videodeglutograma em pacientes com acidente vascular cerebral Comparison of functional endoscopic swallow study (FESS vs. videofluoroscopy (VF in patients with stroke

    Sandra Doria

    2003-10-01

    Full Text Available Os distúrbios da deglutição são bastante freqüentes nos pacientes neurológicos e naqueles com doenças ou seqüelas de cirurgia de cabeça e pescoço, sendo causa de importante morbidade e mortalidade. Apesar do videodeglutograma (VD ser considerado o exame de escolha para a avaliação dos distúrbios da deglutição, este exame apresenta limitações em algumas situações clínicas, além de expor o doente à radiação e ao risco de aspiração do contraste. Em anos recentes, têm sido também utilizadas fibras ópticas flexíveis para avaliar os pacientes com disfagia e outras queixas relacionadas à deglutição. OBJETIVO: Análise comparativa entre os dados obtidos pela NFL e VD em relação a parâmetros estudados por ambos métodos. FORMA DE ESTUDO: Caso controle. MATERIAL E MÉTODO: Foram avaliados prospectivamente 12 pacientes com seqüela de acidente vascular cerebral isquêmico, no período de janeiro a maio de 2002, por meio do estudo dinâmico da deglutição com nasofibrolaringoscopia (NFL e VD, sendo os resultados comparados estatisticamente. RESULTADOS: Enquanto o VD permite a análise da fase preparatória oral e oral da deglutição e o início da fase faríngea, a NFL permite estudo da sensibilidade e mobilidade faringo-laríngea, além da visualização direta do alimento. Através do teste estatístico McNemar, nenhum dos parâmetros analisados apresentou divergência estatisticamente significante (pPatients with dysphagia present great morbidity and mortality, especially those with neurological disorders and/or head and neck surgery, thus warranting a detailed evaluation of swallowing. Videofluoroscopy has been considered the gold standard for evaluating swallowing disorders for many years; however, this test presents limitations in some clinical settings exposing patients to radiation and to the risk of contrast aspiration. In recent years, functional swallow studies using flexible endoscopy (FESS have been

  3. Acidente vascular cerebral precoce: implicações para adultos em idade produtiva atendidos pelo Sistema Único de Saúde Early cerebrovascular accident: implications in working-age adults assisted by the Brazilian Public Health System

    Ilka Veras Falcão

    2004-03-01

    Full Text Available OBJETIVOS: conhecer as incapacidades e identificar se há diferenças de gênero, em sobreviventes de primeiro episódio de acidente vascular cerebral (AVC, entre 20 e 59 anos de idade, na cidade do Recife e que tenham sido hospitalizados pelo Sistema Único de Saúde. MÉTODOS: entrevista domiciliar com uma amostra de sobreviventes, investigando-se as incapacidades referidas na vida funcional e produtiva deles. RESULTADOS: amostra equilibrada entre os sexos, média de idade de 52 anos, com nível elementar de estudos ou analfabeto e trabalhando no setor de serviços, informal ou doméstico. Menos de 20% informam recuperação total após o AVC. Aproximadamente 80% apresentam algum déficit, sendo os problemas de comunicação e os sintomas depressivos mais freqüentes entre as mulheres. Após o AVC aumentou o número de desempregados e aposentados e as incapacidades repercutem negativamente na satisfação de vida de mais de 70% dos entrevistados. CONCLUSÕES: é expressivo o percentual de casos, ainda jovens, com seqüelas pós AVC, sendo este mais precoce e o quadro de incapacidades mais freqüente e/ou grave entre as mulheres. A prevenção e a reabilitação após o AVC são desejáveis, com a implantação de programas, considerando as condições de gênero, para o controle dos riscos e para as seqüelas resultantes do AVC.OBJECTIVES: to assess incapacities and determine whether there are gender differences following an initial episode of cerebrovascular accident among survivors between the ages of 20 and 59 years old living in Recife city, hospitalized in the public health system. METHODS: in-home survey performed with a sample of survivors, investigating incapacities and alterations in the functional and productive life of these individuals. RESULTS: the sample had a balanced proportion between genders and an average age of 52 years old. Individuals were either illiterate or had an elementary education level, holding jobs in the

  4. Are the angiotensin-converting enzime gene and acticity risk factors for stroke? São fatores de risco para acidente vascular cerebral o gene e a atividade da enzima conversora de angiotensina ?

    Miris Dikmen

    2006-06-01

    Full Text Available Stroke is a multifactorial disease in which genetic factors play an important role. This study was carried out to determine angiotensin-converting enzyme (ACE gene polymorphism in Turkish acute stroke patients and to establish whether there is an association of angiotensin-converting enzyme gene I/D polymorphism with clinical parameters. In this study 185 patients and 50 controls were recruited. We have investigated the association among the allelic distribution of the insertion/deletion (I/D polymorphism of the ACE gene identified by polymerase chain reaction. Distribution of ACE gene I/D genotypes and allele frequencies in patients were not significantly different from controls. D allele frequencies were 57.8% in patients versus 53.0% in controls and I allele 42.2% versus 47% respectively. History of hypertension, stroke, renal, heart and vessel diseases incidence and age, gender, systolic-diastolic blood pressures and creatinine levels were significantly high in patients. But these results and ACE activities had no significant differences among the ACE genotypes in patients and controls. Our results suggest that the ACE gene polymorphism is not associated with the pathogenesis of stroke in Turkish stroke patients.O acidente vascular cerebral (AVC é doença multifatorial em que fatores genéticos desempenham papel importante. Este estudo foi desenvolvido para verificar o polimorfismo do gene da enzima conversora da angiotensina (ECA em pacientes turcos com AVC agudo e estabelecer se existe associação do gene I/D da ECA com parâmetros clínicos. O estudo foi realizado com 185 pacientes e 50 controles. A associação entre a distribuição alélica da inserção / deleção (I/D do polimorfismo do gene da ECA foi estudada pela reação em cadeia da polimerase. A distribuição dos genótipos I/D do gene da ECA e suas freqüências não apresentaram significância estatística quando comparados os pacientes e controles. As freqüências dos

  5. Cerebrovascular accident in the aged: changes in family relations El anciano tras accidente cerebrovascular: alteraciones en el relacionamento familiar O idoso após acidente vascular cerebral: alterações no relacionamento familiar

    Sueli Marques

    2006-06-01

    desarrollar un plan de acción que pueda favorecer las relaciones y la adaptación de la familia a las demandas, con vistas a mejorar las condiciones de vida de sus miembros, incluso el anciano.Os objetivos deste estudo foram: identificar os idosos atendidos, na Unidade de Emergência de um hospital governamental do município de Ribeirão Preto-SP, com diagnóstico médico de acidente vascular cerebral, e suas respectivas famílias, bem como identificar as alterações, no relacionamento familiar, que ocorreram após o evento. Utilizou-se a Técnica de Incidentes Críticos adaptada para identificar as alterações no relacionamento familiar ocorridas após a doença e, para a análise, a reflexão do Caminho do Pensamento. A amostra constou de 11 famílias, totalizando 34 participantes. A análise das conseqüências revelou as alterações no relacionamento familiar, que constituíram 13 subcategorias, 5 positivas e 8 negativas, perfazendo o total de 58 alterações, sendo 30 positivas e 28 negativas. O estudo revelou a necessidade de trabalhar com a família para identificar as alterações e desenvolver um plano de ações que possa favorecer as relações e a adaptação da família às demandas, com vistas a melhorar as condições de vida de seus membros, inclusive o idoso.

  6. The physical burden from the perspective of the caregivers of aged family members after a cerebral vascular accident Ônus físico pela ótica das cuidadoras familiares de idosos com episódios de acidente vascular cerebral

    Alessandra Peregrine Primo

    2010-11-01

    Full Text Available

    A proposta deste estudo é refletir sobre o ônus físico (burden enfrentado pelas cuidadoras de idosos dependentes, visto pela ótica da própria cuidadora ao longo da sua experiência no desempenho do seu papel, após um ou mais episódios de acidente vascular cerebral (AVC de pessoa idosa necessitada de cuidados e com perdas de independência física. É uma pesquisa com dados qualitativos realizada no município de Toledo ? PR, em 2004, com cuidadores de oito adultos acometidos por AVC após a alta hospitalar, tendo a cuidadora mais de 50 anos de idade. O procedimento metodológico foi a pesquisa empírica através do uso de questionários aplicados em visitas domiciliares. O instrumento da pesquisa foi composto para contextualizar a sobrecarga do cuidador através da coleta de informações sobre as sensações de seu ônus físico frente às suas tarefas e cuidados com o familiar dependente e dar visibilidade a indicadores de ônus e desgaste do cuidador familiar de idosos para ampliar a visão de elementos subjetivos que compõem as perdas que ocorrem nos cuidadores de idosos dependentes sem apoios externos. Esta dissertação contém três capítulos, além da introdução e das considerações finais. O trabalho está dividido em: o envelhecimento populacional, os desafios enfrentados pelos idosos com as doenças crônico-degenerativas e as dependências instaladas, o ônus emocional e social dos cuidadores, com ênfase no ônus físico. Os dados da pesquisa e seus resultados completam o estudo. Espera-se ter colaborado para aprofundar o conhecimento referente ao cuidador familiar e ao ônus que experimenta, seja ele, físico, emocional e ou social, tendo em vista que a sobrecarga vivida pelo cuidador depende de fatores como estresse, isolamento social, dentre outros, e não apenas do grau de incapacidade do idoso, sendo de grande importância o significado das mudanças e acréscimo nas tarefas diárias para o cuidador. Os

  7. Análise de custo-efetividade da trombólise com alteplase no Acidente Vascular Cerebral Análisis de costo-efectividad de la trombólisis con alteplase en el accidente vascular cerebral Analysis of the cost-effectiveness of thrombolysis with alteplase in stroke

    Denizar Vianna Araújo

    2010-07-01

    Full Text Available FUNDAMENTO: Acidente Vascular Cerebral (AVC é a principal causa de óbito no Brasil e pouca informação está disponível sobre custo do tratamento. OBJETIVO: Elaborar análise de custo-efetividade da trombólise no AVC, até três horas após o início dos sintomas, comparando o tratamento com alteplase versus conservador, sob a perspectiva do Sistema Único de Saúde (SUS. MÉTODOS: Modelo de análise de decisão foi desenvolvido para comparar os dois tratamentos. Ciclos foram considerados, durante os quais pacientes poderiam transitar entre cinco estágios de incapacidade pós-AVC, baseados na escala modificada de Rankin. A probabilidade de apresentar hemorragia intracerebral no primeiro ano foi obtida do ensaio NINDS. Para os anos subsequentes, ciclos de um ano foram considerados, para contabilizar a mortalidade dos pacientes. O desfecho foi expresso em Anos de Vida Ajustados pela Qualidade (QALY. Tanto os custos diretos quanto os indiretos foram considerados na análise. Custos e desfecho foram descontados em 5% ao ano. RESULTADOS: No primeiro ano, o QALY ganho foi de 0,06 para ambos os gêneros, com custo incremental de R$ 2.558 para homens e R$ 2.312 para mulheres. A razão de custo-efetividade incremental em um ano foi de R$ 40.539 / QALY (USD 28.956 para homens e R$ 36.640 / QALY (USD 26.171 para mulheres. Após o segundo ano, o tratamento com alteplase reduziu o custo do tratamento (índice de Paridade do Poder de Compra US$ 1 = R$ 1,4. CONCLUSÃO: Terapia trombolítica com alteplase nas primeiras três horas após o AVC é custo-efetiva no cenário do Sistema Único de Saúde.FUNDAMENTO: Accidente Vascular Cerebral (AVC es la principal causa de óbito en el Brasil y poca información está disponible sobre el costo del tratamiento. OBJETIVO: Elaborar análisis de costo-efectividad de la trombólisis en el AVC, hasta tres horas después del comienzo de los síntomas, comparando el tratamiento con alteplase versus conservador, bajo la

  8. Burden and modifications in life from the perspective of caregivers for patients after stroke Sobrecarga y modificaciones de vida en la perspectiva de los cuidadores de pacientes con accidente vascular cerebral Sobrecarga e modificações de vida na perspectiva dos cuidadores de pacientes com acidente vascular cerebral

    Huana Carolina Cândido Morais

    2012-10-01

    ñados por el Programa de Servicio Domiciliar de tres hospitales. La colecta de los datos ocurrió mediante entrevista para identificar modificaciones de vida, y con la aplicación de tres escalas para investigar la sobrecarga percibida, estado mental y sufrimiento psíquico. Son ellas, respectivamente: Caregiver Burden Scale (CBS, Mini Examen del Estado Mental (MEEM y Self Reported Questionnaire (SRQ. Los cuidadores, en su mayoría, eran del sexo femenino, casados (as e hijo (as de los pacientes después del AVC. Edad Media de 48,2 años (±12,4. Las modificaciones de vida más citadas fueron referentes a la rutina diaria, a las actividades de ocio y agotamiento o cansancio. En cuanto a la sobrecarga, se destacaron las dimensiones Tensión general, Aislamiento y Decepción. Se verificó mayor sobrecarga cuanto más síntomas de sufrimiento psíquico el cuidador presentase, en la ausencia de cuidador secundario y cuando los cuidadores principales relataron percibir modificación en el cuerpo y en la salud. CONCLUSIÓN: no fue observada asociación de la sobrecarga con el estado mental del cuidador. Entender la coyuntura del cuidado, mediante análisis del recargo de trabajo, y del conocimiento de la situación biopsicosocial, suministrará subsidios para la actuación del enfermero para reducir la carga generada para los cuidadores familiares.OBJETIVO: analisar o impacto do cuidar para o cuidador familiar de paciente após acidente vascular cerebral (AVC, correlacionando modificações de vida e sofrimento psíquico com a sobrecarga percebida. MÉTODO: estudo transversal, quantitativo, realizado de janeiro a abril de 2010, em Fortaleza, Ceará, Brasil. RESULTADO: investigaram-se 61 indivíduos, acompanhados pelo Programa de Atendimento Domiciliar (PAD, de três hospitais. A coleta dos dados ocorreu mediante entrevista para identificar modificações de vida, e com a aplicação de três escalas para investigar sobrecarga percebida, estado mental e sofrimento psíquico. S

  9. Botulinum toxin A and physiotherapy intervention in the treatment of the painful shoulder after stroke: case report Toxina botulínica A e intervenção fisioterapêutica no tratamento do ombro doloroso pós acidente vascular cerebral: relato de caso

    Suellen M. Marinho dos Santos Andrade

    2007-10-01

    Full Text Available The syndrome of the painful shoulder is considered a common finding in patients who suffered stroke. Several therapeutic modalities are suggested for the improvement of the patients’ clinical condition. In this report, a case of syndrome of the painful shoulder will be discussed, whose treatment consisted of the use of botulinum toxin A associated to physiotherapy. After a four-month treatment, significant improvements occurred concerning pain, spasticity, range of motion and quality of life, suggesting that this therapeutic association is an efficient tool against the incapacitating effects related to this syndrome. A síndrome do ombro doloroso é considerada um achado comum em pacientes que sofreram acidente vascular cerebral. Várias modalidades terapêuticas são apontadas para melhoria do quadro clínico dos pacientes. Neste relato, será apresentado um caso de síndrome do ombro doloroso, cujo tratamento consistiu no emprego de toxina botulínica A associada à fisioterapia. Após quatro meses de tratamento, houve melhorias significativas quanto à dor, espasticidade, amplitude de movimento e qualidade de vida, e isso sugere ser essa associação terapêutica uma ferramenta eficaz contra os efeitos incapacitantes relacionados a esta síndrome.

  10. Cuidar de pessoa incapacitada por acidente vascular cerebral no domicílio: o fazer do cuidador familiar El cuidado de la persona incapacitada por accidente cerebro vascular en el domicilio: el hacer del cuidador familiar Taking care of persons handicapped by cerebral vascular accident at home: the familial caregiver activity

    Nara Marilene Oliveira Girardon Perlini

    2005-06-01

    incapacitated by cerebral vascular accident. The sample was comprised of 35 family caregivers, most of them women, wives or daughters. The care given is directly related to the degree of incapacity of the person who is being cared for. The orientation received indicated no commitment of professionals for the continuity of the care. The caregivers learn in daily practice how to care, based on observation and assistance to nursing during the internment period. The difficulties are related to physical effort, to lack of information and fear, to the embarassment and the shame of handling someone else's body. The study focuses on the need for preparation for hospital discharge, emphasizes the family as a concrete space for care; and observed an increase in life expectancy.

  11. Educação em saúde e família: o cuidado ao paciente, vítima de acidente vascular cerebral - DOI: 10.4025/actascihealthsci.v26i1.1663 Health education in family:nursing CVA patients - DOI: 10.4025/actascihealthsci.v26i1.1663

    Ana Ruth Macêdo Monteiro

    2004-04-01

    Full Text Available O presente estudo objetiva identificar o conhecimento dos familiares de pacientes acometidos por AVC (Acidente Vascular Cerebral sobre a doença e sobre seus cuidados e, ainda, elaborar uma cartilha de orientação quanto aos cuidados domiciliares a esses pacientes. Participaram da presente pesquisa 50 familiares de pacientes acometidos por AVC, os quais estavam acompanhando os pacientes por um período mínimo de 3 dias. Os dados obtidos da análise dos depoimentos dos familiares estão agrupados em 3 categorias: conhecendo as famílias, identificando o conhecimento dos familiares, atendendo às solicitações dos familiares. A cartilha de orientação, elaborada de acordo com o levantamento das principais dúvidas e/ou dificuldades dos familiares, busca favorecer o processo educativo dessas famílias no ambiente hospitalar, promovendo, assim, seu envolvimento nesse processo. A importância de um trabalho nesse sentido está baseada na possibilidade de uma maior compreensão dos problemas vivenciados pelos pacientes acometidos por AVC e por suas famílias, auxiliando, dessa forma, o enfermeiro a desenvolver ações visando minimizá-los e tornar a situação menos traumática para ambos.The present study aims to identify the knowledge of CVA (Cerebral Vascular Accident patients' close relatives on the disease and its specific cares; and also, to elaborate a guide for the home care of those patients. The present research evaluated family members from 50 CVA patients. These relatives were taking care of the patients for at least 3 days. The data obtained from the testimonies analysis are grouped in three categories: acquainting the families; identifying the family’s knowledge; assisting family’s requests. The guide, organized according to the relatives' main doubts and difficulties, intends to help the educational process of those families in the hospital’s atmosphere, promoting their engagement in the process. This work makes possible a

  12. Papel da curva de agregação plaquetária no controle da antiagregação na prevenção secundária do acidente vascular cerebral isquêmico Platelet aggregation test: application in the control of antiplatelet aggregation in the secondary prevention of stroke

    Patrícia Regina Piedade

    2003-09-01

    Full Text Available INTRODUÇÃO: O acidente vascular cerebral (AVC é atualmente a primeira causa de morte no Brasil. O risco de recorrência de AVC é de aproximadamente 30% em cinco anos. Agentes antiagregantes plaquetários são frequentemente prescritos para a prevenção de recorrência do AVC, porém sem um parâmetro laboratorial de ajuste terapêutico. OBJETIVO: Determinar a aplicabilidade da curva de agregação plaquetária, no controle do antiagregante, na prevenção secundária do acidente vascular cerebral isquêmico (AVCi. MÉTODO: Estudo retrospectivo de janeiro de 1990 a janeiro de 2001; foram analisados 189 pacientes com diagnóstico de AVCi acompanhados durante este período com curva de agregação plaquetária. Foram excluídos os portadores de doenças cardioembólicas. Consideraram-se hipoagregados os doentes com agregação plaquetária ativada pelo ADP e/ou pela adrenalina menor ou igual a 50%. Os doentes tiveram acompanhamento por 1 a 6 anos e a taxa de recorrência de AVCi foi comparada entre os normoagregados e os hipoagregados. RESULTADOS: Nove doentes apresentaram novo AVCi no período do seguimento. Entre os hipoagregados ocorreu 2,6% de recidiva e entre os normoagregados, 15,1% (0,03INTRODUCTION: Stroke is the leading cause of death in Brazil. The risk of suffering a recurrent stroke is around 30% in 5 years. Antiplatelet therapy has been frequently used to prevent recurrent strokes without laboratory control. OBJECTIVE: To determine the value of the platelet aggregation test in the control of antiplatelet aggregation in the secondary stroke prevention. METHOD: Retrospective study from January 1990 to January 2001 with 189 patients with stroke that were followed up during this period with platelet aggregation curve. Patients with cardioembolic disease were excluded. Low aggregation rates of platelet aggregation activated by ADP and/or epinephrine lower or equal to 50% were considered. Patients were followed up for a period from one

  13. Acidentes vasculares encefálicos em pediatria Stroke in children

    Eduardo Mekitarian Filho

    2009-12-01

    Full Text Available OBJETIVOS: Listar 1 as definições e características epidemiológicas de acidentes vasculares encefálicos (AVE em crianças; 2 os principais fatores de risco para a ocorrência de AVE em pediatria e neonatologia; 3 as principais características fisiopatológicas para a ocorrência de lesão cerebral no AVE; 4 as manifestações clínicas e o diagnóstico por imagem; e 5 as recomendações atualizadas para as medidas de suporte, tratamento e profilaxia dos AVE em pediatria. FONTES DOS DADOS: Realizou-se revisão da literatura nas bases de dados PubMed, EMBASE e SciELO utilizando-se como palavras-chave stroke, pediatrics e neonatology, além da utilização de referências bibliográficas importantes dos textos escolhidos. SÍNTESE DOS DADOS: A ocorrência de AVE em pediatria é incomum, com a incidência variando entre duas e oito por 100.000 crianças abaixo de 14 anos, tendo a maioria como denominador comum a ocorrência de doenças de base como cardiopatias congênitas, anemia falciforme e malformações vasculares. Não há padronização nas recomendações de tratamento para o AVE em crianças, embora as medidas fundamentais incluam monitoração, tratamento de suporte e anticoagulação em casos selecionados. O prognóstico depende da extensão de área cerebral acometida e da doença de base, mas as taxas de recorrência são altas na maioria dos casos. CONCLUSÕES: O diagnóstico precoce dos AVE em pediatria é fundamental, e é importante que os pediatras estejam atentos à falta de especificidade dos sintomas para evitar sequelas e melhorar a qualidade de vida dos pacientes acometidos.OBJECTIVES: To summarize 1 the definitions and epidemiological features of stroke in children; 2 the main risk factors that can lead to stroke in pediatrics and neonatology; 3 the main pathophysiological features involved in the genesis of brain injury in stroke; 4 the clinical manifestations and imaging diagnosis; and 5 the latest recommendations

  14. Cuidado de enfermagem no adoecimento por acidente vascular encefálico: revisão integrativa da literatura brasileira

    Samia Jardelle Costa de Freitas Maniva; Consuelo Helena Aires de Freitas

    2012-01-01

    Revisão integrativa que objetivou analisar o conhecimento acerca do cuidado de enfermagem no adoecimento por Acidente Vascular Encefálico na base de dados LILACS. Os critérios de elegibilidade dos artigos foram os seguintes: correspondência aos termos “cuidado” e “acidente vascular encefálico”; publicação em língua portuguesa; disponibilidade de texto completo; ano de publicação no período de 2000 a 2011. Encontraram-se vinte publicações cujos dados foram coletados por meio de formulário. A a...

  15. Hipertensão arterial e doença vascular cerebral: a visão do neurologista

    Correia, M.

    2007-01-01

    As doenças cerebrovasculares são a primeira causa de morte em Portugal, e a correspondente taxa de mortalidade é das mais levedadas entre os países europeus; a incidência do Acidente Vascular Cerebral (AVC) ocupa também um lugar cimeiro, e de entre os doentes sobreviventes de AVC cerca de 50% deles encontram-se dependentes. Embora a doença vascular cerebral seja heterogéneos (enfartes cerebrais, hemorragias intracerebrais primárias, hemorragias subaracnoideias, demência vascular) a hipertensã...

  16. Acidente vascular cerebral de etiologia rara com indicação cirúrgica urgente: caso clínico Stroke of a rare etiology with need of urgent surgery: case report

    Ana Vieira Baptista

    2012-03-01

    Full Text Available Doente de 19 anos com quadro de febre com 8 dias de evolução e posterior instalação súbita de afasia, hemiparésia esquerda e alterações do comportamento. Aumento das proteínas de fase aguda no estudo analítico. TAC e RMN crânio-encefálicas revelaram lesão isquémica temporo-parietal direita. Ecocardiograma excluiu endocardite. Eco-döppler e angio-TAC carotídeo-vertebrais mostraram formação vegetante, móvel com a pulsação cardíaca, na artéria carótida comum direita. Submetido, de urgência, a cirurgia carotídea. Intraoperatoriamente constatou-se a presença de trombo ligeiramente aderente à artéria carótida comum e na dependência de lesão da íntima subjacente, tendo-se procedido à sua exérese e a arteriorrafia primária. Aponta-se como etiologia mais provável do quadro, uma vasculite secundária a infecção por HSV1 (infecção activa ou por Rickettsia conorii.19 years old patient with fever for 8 days associated with sudden aphasia, left hemiparesis and abnormal behavior. Increased acute phase proteins in the analytical study. Head CT scan and MRI revealed a right temporo-parietal ischemic lesion. An echocardiogram excluded endocarditis. Ultrasound and CT angiography scanning of the extracranial cerebral circulation showed a vegetative formation, mobile with the heartbeat, in the right common carotid artery. Submitted, urgently, to carotid surgery. Intraoperatively, a slightly adherent thrombus to the common carotid artery was found and in the dependence of an underlying injury to the intima. The thrombus was ressected and a primary arteriorrhaphy performed. It is pointed out a vasculitis secondary to HSV1 (active infection or to Rickettsia conorii infection as the most likely etiology of the clinic.

  17. Terapia celular no acidente vascular cerebral Cell therapy in strokes

    Rosalia Mendez-Otero

    2009-05-01

    Full Text Available O AVC é o recordista em número de óbitos e a maior causa de incapacidade no Brasil. Apesar das inúmeras pesquisas realizadas ao longo dos últimos anos não há terapias farmacológicas adequadas para este quadro e, neste cenário, as terapias celulares vêm sendo consideradas como alternativas terapêuticas para diminuir as perdas funcionais decorrentes do AVC. Nesta revisão comentaremos os resultados de diversos estudos pré-clinicos e de alguns clínicos que utilizaram diferentes tipos de células-tronco em AVC.Stroke is the leading cause of death and incapacity in Brazil. Over the last few years, numerous preclinical and clinical studies have been carried out, however to date, none of the drugs tested in these studies were effective in patients. The emerging field of stem cell research has raised hope of therapy to ameliorate the functional loss after strokes. In this review we will discuss the results of several preclinical studies and clinical trials using different types of stem cells in the treatment of strokes.

  18. Terapia celular no acidente vascular cerebral Cell therapy in strokes

    Rosalia Mendez-Otero; Arthur Giraldi-Guimarães; Pimentel-Coelho, Pedro M.; Gabriel R. de Freitas

    2009-01-01

    O AVC é o recordista em número de óbitos e a maior causa de incapacidade no Brasil. Apesar das inúmeras pesquisas realizadas ao longo dos últimos anos não há terapias farmacológicas adequadas para este quadro e, neste cenário, as terapias celulares vêm sendo consideradas como alternativas terapêuticas para diminuir as perdas funcionais decorrentes do AVC. Nesta revisão comentaremos os resultados de diversos estudos pré-clinicos e de alguns clínicos que utilizaram diferentes tipos de células-t...

  19. Avaliação dos níveis de hiper-homocisteinemia, vitamina E, selênio, cobre, ceruloplasmina e ferritina em pacientes com diagnóstico de acidente vascular cerebral isquêmico Assesment of homocysteine, vitamin E, selenium, copper, ceruloplasmin and ferritin levels in patients with ischemic stroke diagnosis

    Lillian Harboe-Gonçalves

    2007-02-01

    Full Text Available OBJETIVO: Avaliar níveis sangüíneos de hiper-homocisteinemia, vitamina E, selênio, cobre, ceruloplasmina e ferritina em pacientes com diagnóstico de acidente vascular cerebral isquêmico (AVCI. CASUÍSTICA, MATERIAIS E MÉTODOS: Estudo transversal analítico de 104 pacientes diagnosticados com AVCI e 98 controles. Dosagem de homocisteína e vitamina E feita por cromatografia líquida de alta performance. O selênio foi dosado por tecnologia de espectrometria de massa por plasma indutivamente acoplado; o cobre o foi por colorimetria; a ceruloplasmina, por nefelometria; e a ferritina, por imunoensaio enzimático conjugado à fluorescência (Elfa. Análise estatística feita com testes t de Student e análise de variância. RESULTADOS: Encontrada hiper-homocisteinemia em 43% dos pacientes e 13% dos controles. Os valores obtidos nas dosagens de vitamina E, cobre, ceruloplasmina e ferritina foram significativamente maiores no grupo paciente do que no grupo controle. Quanto ao selênio, a diferença entre os dois grupos não foi significativa. DISCUSSÃO: Níveis de hiper-homocisteinemia foram maiores que os encontrados na literatura, podendo ser conseqüência da genética ou dos hábitos alimentares da população. Os resultados encontrados para vitamina E, selênio, cobre, ceruloplasmina e ferritina coincidem com os de alguns trabalhos publicados, mas o modelo deste estudo não avalia se os níveis de vitamina E e selênio foram alterados pelo AVCI ou por mudanças nos hábitos dos pacientes. A ferritina e a ceruloplasmina podem ser marcadores de AVCI, e não fator causal da sua patogênese. CONCLUSÃO: A hiper-homocisteinemia é mais prevalente nos pacientes diagnosticados com AVCI. Os níveis de vitamina E, cobre, ceruloplasmina e ferritina mais elevados encontrados nos pacientes não podem ser atribuídos à ocorrência de AVCI.OBJECTIVE: To assess blood levels of hyperhomocysteinaemia, vitamin E, selenium, copper, ceruloplasmin and

  20. Vivenciando a sobrecarga ao vir-a-ser um cuidador familiar de pessoa com acidente vascular cerebral (AVC: análise do conhecimento Viviendo la sobrecarga al convertirse en cuidador familiar de personas con accidente cerebrovascular: análisis del conocimiento Living the burden in becoming a family caregiver for a cerebrovascular accident survivor: knowledge analysis

    Silvia Cristina Mangini Bocchi

    2004-02-01

    Full Text Available Trata-se de trabalho do tipo bibliográfico com a finalidade de fazer uma análise temática da produção do conhecimento em periódicos, acerca da sobrecarga em cuidadores familiares de pessoas com Acidente Vascular Cerebral (AVC. O corpus de análise reuniu artigos localizados nas décadas de 80 e 90, a partir das bases de dados Medline, Lilacs e Cinahl. A análise de conteúdo foi o referencial metodológico que permitiu organizar todo o conhecimento, em um corpo de categorias e subcategorias, denominadas: Categoria 1 - As seqüelas do AVC gerando sobrecarga; Categoria 2 - Aspectos gerando sobrecarga, congregando as subcategorias: o isolamento social, as mudanças e as insatisfações conjugais, as dificuldades financeiras e os déficits na saúde física e no autocuidado do cuidador; Categoria 3 - Outras análises relacionadas à sobrecarga em cuidadores familiares.Se trata de un trabajo del tipo bibliográfico con la finalidad de hacer un análisis temático de producción del conocimiento en revistas, sobre la carga de cuidadores familiares de personas con Accidente Cerebrovascular (ACV. El corpus de análisis reunió artículos realizados en las décadas de 80 y 90 a partir de las bases de datos Medline, Lilacs y Cinahl. El análisis de contenido fue el referencial metodológico que permitió organizar todo el conocimiento en un cuerpo de categorías y subcategorías denominadas: categoría 1 - Las secuelas del ACV generando carga, Categoría 2 - Aspectos generadores de la carga que congregan las subcategorías: el aislamiento social, los cambios y las insatisfacciones conyugales, las dificultades financieras y los déficit en la salud física y en el cuidado consigo mismo, Categoría 3 - Otros análisis sobre la carga de cuidadores familiares de personas con ACV.This bibliographical research aims to carry out a thematic analysis of knowledge production in periodicals, about the burden placed on family caregivers of Cerebrovascular

  1. Acute cerebral vascular accident associated with hyperperfusion

    Cerebral radionuclide angiography can demonstrate decreased or normal radioactivity in the affected region during the arterial phase in patients who have sustained a cerebral vascular accident and thus enhances the diagnostic specificity of the static brain image. In an occasional patient, however, a seemingly paradoxical pattern of regional hyperperfusion with a return to normal or subnormal perfusion following the acute phase has been observed. This phenomenon, called luxury perfusion, has been defined using intra-arterial 133Xe for semiquantitative cerebral blood flow measurements and should be kept in mind as a potentially misleading cerebral imaging pattern

  2. Modelling of increased homocysteine in ischaemic stroke: post-hoc cross-sectional matched case-control analysis in young patients Aumento de homocisteína em acidente vascular cerebral isquêmico: análise post-hoc com casos controles em pacientes jovens

    Penka A. Atanassova

    2007-03-01

    Full Text Available BACKGROUND & PURPOSE: Hyperhomocysteinaemia has been postulated to participate in pathogenesis of ischaemic stroke (IS. However, especially in young adults, there is possibility of significantly increased IS risk due to increased ‘normal’ homocysteinaemia, i.e., ‘hidden’ (‘pathologically dormant’ prevalence within a healthy, normally-defined range. We performed a post-hoc modelling investigation on plasma total homocysteinaemia (THCY in gender- and age-matched young patients in the acute IS phase. We evaluated relationships between THCY and prevalence of other potential risk factors in 41 patients vs. 41 healthy controls. METHOD: We used clinical methods, instrumental and neuroimmaging procedures, risk factors examination, total plasma homocysteine measurements and other laboratory and statistical modelling techniques. RESULTS: IS patients and healthy controls were similar not only for matching variables, but also for smoking, main vitamin status, serum creatinine and lipid profile. Patients with IS, however, had lower vitamin B6 levels and higher THCY, fibrinogen and triglycerides (TGL. At multivariate stepwise logistic regression only increased THCY and TGL were significantly and independently associated with the risk for stroke (72% model accuracy, p model=0.001. An increase of THCY with 1.0 µmol/L was associated with 22% higher risk of ischaemic stroke [adjusted OR=1.22 (95%CI 1.03?1.44]. In this way, novel lower cut-off value for HCY of 11.58 µmol/L in younger patients has been revealed (ROC AUC= 0.67, 95CI% 0.55-0.78, p=0.009. CONCLUSION: The new THCY cut-off clearly discriminated between absence and presence of IS (sensitivity>63%, specificity>68% irrespectively of age and gender and may be applied to better evaluate and more precisely define, as earlier as possible, the young patients at increased IS risk.OBJETIVO: Hiperhomocisteinemia tem sido postulada como um dos fatores de risco na patogênese do acidente vascular

  3. Renovascular hypertension causes cerebral vascular remodeling

    Yamei Tang; Xiangpen Li; Yi Li; Qingyu Shen; Xiaoming Rong; Ruxun Huang; Ying Peng

    2011-01-01

    Renovascular hypertensive rats (RHRs) were developed using the 2-kidney, 2-clip method. All RHRs at 10 weeks displayed high permeability of the cerebral surface blood vessels. Vascular casts of the RHRs showed that the vascular network was sparse. The arterioles of the RHRs at 10 weeks had smaller lumen diameters, but thicker vessel walls with hyalinosis formation compared with control animals. The endothelial cell membrane appeared damaged, and microthrombus formed. After ischemia, the infarction size was larger in RHRs than in control animals. These results suggest that cerebral arterioles in RHRs underwent structural remodeling. High blood pressure may aggravate the severity of brain injury in cerebral ischemia and affect the recovery of ischemia.

  4. Advances in the Management of Cerebral Vascular Disease

    Muhammad Imran Qadir; Hina Kanwal

    2015-01-01

    A cerebral vascular disease occurred with the arteries of brain due to the less supply of blood.  Stroke is mostly caused by cerebral vascular disease and it is also a common cause of vascular dementia due to reduced oxygen supply and blood flow to the brain. In industrialized countries, neurologic disability is most frequently caused by cerebeovascular disease. Individuals with cardiovascular disease, diabetes and high blood pressure etc are at higher possibility for cerebral vascular diseas...

  5. Ausência de descenso noturno se associa a acidente vascular cerebral e infarto do miocárdio La ausencia de descenso nocturno de la presión arterial se asocia a accidente cerebrovascular e infarto de miocardio Absence of nocturnal dipping is associated with stroke and myocardium infarction

    Renan Oliveira Vaz-de-Melo

    2010-01-01

    Full Text Available FUNDAMENTO: A pressão arterial (PA varia de acordo com o ciclo circadiano, apresentando quedas fisiológicas durante o sono (descenso noturno - DN. A ausência dessa queda se associa a maior incidência de lesões em órgãos-alvo. OBJETIVO: Analisar a prevalência de DN em indivíduos hipertensos, correlacionar DN aos níveis pressóricos, variáveis clínicas, fatores sociodemográficos e bioquímicos e associá-lo a eventos cardiovasculares (acidente vascular cerebral - AVC e infarto agudo do miocárdio - IAM. MÉTODOS: Foram avaliados 163 hipertensos, submetidos a monitorização ambulatorial da pressão arterial. DN foi definido como queda >10% da PA sistólica do período da vigília para o de sono. RESULTADOS: Os pacientes foram divididos em grupos dipper (D e não dipper (ND. Não houve diferença significante entre os grupos quanto a idade, sexo, raça, tempo de hipertensão, glicemia, LDL-colesterol, colesterol total, triglicérides, escolaridade, tabagismo, história de diabetes. Grupo dipper apresentou PA superior a ND durante a vigília e inferior durante o sono. Grupo ND cursou com maior índice de massa corpórea (IMC (p=0,0377, menor HDL-colesterol (p=0,0189 e maior pressão de pulso durante o sono (p=0,0025. História de AVC ou IAM foram mais frequentes em ND. À regressão logística, apenas a ausência de descenso noturno associou-se independentemente a AVC ou IAM. CONCLUSÃO: A ausência de DN associou-se de maneira independente às lesões em órgãos-alvo analisadas, o que demonstra a sua importância e reforça a necessidade de tratamento mais agressivo com objetivo de se atingir as metas pressóricas e, consequentemente, evitar o desenvolvimento de novos eventos cardiocerebrovasculares.FUNDAMENTO: La presión arterial (PA varía de acuerdo al ciclo circadiano, presentando descensos fisiológicos durante el sueño (descenso nocturno - DN. La ausencia de ese descenso se asocia a mayor incidencia de lesiones en

  6. The physical burden from the perspective of the caregivers of aged family members after a cerebral vascular accident

    Alessandra Peregrine Primo

    2010-01-01

    A proposta deste estudo é refletir sobre o ônus físico (burden) enfrentado pelas cuidadoras de idosos dependentes, visto pela ótica da própria cuidadora ao longo da sua experiência no desempenho do seu papel, após um ou mais episódios de acidente vascular cerebral (AVC) de pessoa idosa necessitada de cuidados e com perdas de independência física. É uma pesquisa com dados qualitativos realizada no município de Toledo ? PR, em 2004, com cuidadores de oito adultos acometidos por AVC apó...

  7. Eficácia da fonoterapia em um caso de afasia expressiva decorrente de acidente vascular encefálico

    Letícia Regina Kunst

    2013-12-01

    Full Text Available O objetivo deste estudo de caso foi relatar e analisar o caso de um paciente afásico adulto em tratamento fonoaudiológico na clínica escola do Curso de Fonoaudiologia de uma instituição federal de ensino. O sujeito estudado é um paciente do sexo masculino, com 68 anos de idade, em tratamento na clínica escola desde maio de 2009, sendo que seu processo terapêutico foi analisado até dezembro de 2010. Quanto à história clínica, o paciente sofreu acidente vascular encefálico isquêmico no hemisfério esquerdo, em janeiro de 2009, quando repentinamente apresentou um quadro de mutismo. Após serem realizadas avaliações fonoaudiológicas, concluiu-se que o mesmo apresentava como hipótese diagnóstica "Afasia de expressão, oral e escrita, decorrente de acidente vascular encefálico isquêmico." Diante disto foi elaborado o planejamento terapêutico. Desde o início do processo de terapia foi possível observar evoluções linguísticas no paciente. O fato de o sujeito ter procurado atendimento fonoaudiológico 15 dias após o acometimento pelo acidente vascular encefálico, provavelmente foi um fator fundamental para sua boa recuperação, pois há um grau de recuperação espontânea em pacientes afásicos, porém a melhora é mínima sem o tratamento adequado. Em aproximadamente um mês de terapia fonoaudiológica, o paciente expandiu consideravelmente seu vocabulário. Apesar de a área lesada ser extensa e fundamental para a linguagem, observou-se avanços bastante positivos com a terapia. Deste modo, acredita-se que a intervenção fonoaudiológica precoce contribuiu, em grande parte, para a reorganização da atividade linguística, visto que o paciente comunica-se satisfatoriamente considerando a grande extensão de sua lesão.

  8. AUTOMATIC REGISTRATION OF CEREBRAL VASCULAR STRUCTURES

    Marwa HERMASSI

    2011-01-01

    Full Text Available In this paper we present a registration method for cerebral vascular structures in the 2D MRA images. The method is based on bifurcation structures. The usual registration methods, based on point matching, largely depend on the branching angels of each bifurcation point. This may cause multiple feature correspondence due to similar branching angels. Hence, bifurcation structures offer better registration. Each bifurcation structure is composed of a master bifurcation point and its three connected neighbors. The characteristic vector of each bifurcation structure consists of the normalized branching angle and length, and it is invariant against translation, rotation, scaling, and even modest distortion. The validation of the registration accuracy is particularly important. Virtual and physical images may provide the gold standard for validation. Also, image databases may in the future provide a source for the objective comparison of different vascular registration methods.

  9. Advances in the Management of Cerebral Vascular Disease

    Muhammad Imran Qadir

    2015-06-01

    Full Text Available A cerebral vascular disease occurred with the arteries of brain due to the less supply of blood.  Stroke is mostly caused by cerebral vascular disease and it is also a common cause of vascular dementia due to reduced oxygen supply and blood flow to the brain. In industrialized countries, neurologic disability is most frequently caused by cerebeovascular disease. Individuals with cardiovascular disease, diabetes and high blood pressure etc are at higher possibility for cerebral vascular disease. After malignancy and heart disease, cerebral vascular disease is the third leading of death and estimated that an average 500,000 new stroke occurred in each year. Advance techniques such as Carotid Endarterectomy, Magnetic resonance imaging, Angiography and Single photon emission computed tomography etc are used for management of cerebral vascular disease.

  10. Escalas para avaliação da sobrecarga de cuidadores de pacientes com Acidente Vascular Encefálico

    Ana Railka de Souza Oliveira

    2012-10-01

    Full Text Available O objetivo do estudo foi avaliar as escalas disponíveis na literatura para medir a sobrecarga de cuidadores de pacientes acometidos por acidente vascular encefálico. Realizou-se uma revisão bibliográfica nas três bases de dados: LILACS, CINAHL e SCOPUS. Selecionaram-se 23 trabalhos e identificaram-se 24 diferentes escalas. Destas, as mais citadas foram o Caregiver Strain Index, a Caregiver Burden Scale, a Caregiver Reaction Assessment, o Sense of Competence Questionnaire, a Relatives Stress Scale e a Zarit Burden Interview. O uso de escalas para mensurar a sobrecarga é uma ferramenta importante para avaliar o contexto no qual está inserido o cuidador, entretanto é mais fidedigno quando associado a outros instrumentos de mensuração. Portanto, é fundamental pesquisas de validação de escalas para essa população.

  11. Vascular permeability in cerebral cavernous malformations

    Mikati, Abdul G; Khanna, Omaditya; Zhang, Lingjiao;

    2015-01-01

    Patients with the familial form of cerebral cavernous malformations (CCMs) are haploinsufficient for the CCM1, CCM2, or CCM3 gene. Loss of corresponding CCM proteins increases RhoA kinase-mediated endothelial permeability in vitro, and in mouse brains in vivo. A prospective case-controlled observ......Patients with the familial form of cerebral cavernous malformations (CCMs) are haploinsufficient for the CCM1, CCM2, or CCM3 gene. Loss of corresponding CCM proteins increases RhoA kinase-mediated endothelial permeability in vitro, and in mouse brains in vivo. A prospective case......-controlled observational study investigated whether the brains of human subjects with familial CCM show vascular hyperpermeability by dynamic contrast-enhanced quantitative perfusion magnetic resonance imaging, in comparison with CCM cases without familial disease, and whether lesional or brain vascular permeability...... correlates with CCM disease activity. Permeability in white matter far (WMF) from lesions was significantly greater in familial than in sporadic cases, but was similar in CCM lesions. Permeability in WMF increased with age in sporadic patients, but not in familial cases. Patients with more aggressive...

  12. [Neurourological signs of chronic cerebral vascular diseases].

    Shvarts, P G; Dutov, V V; Kadykov, A S; Shvedkov, V V; Popov, S V; Plotnikov, A N

    2013-01-01

    Disorders of urination, along with motor and cognitive disorders, are characteristic of different forms of chronic cerebral vascular diseases (CCVD). Irritation symptoms are more frequent in subcortical arteriosclerotic encephalopathy (SAE) and multi infarct hypertonic encephalopathy (MIHE). Overactive urine bladder syndrome (OUBS) caused by neurogenic detrusive hyperactivity manifests itself in frequent urination, nocturia and imperative enuresis and thus decreases quality of life and results in disability of patents with CCVD. At the same time, the character of symptoms points indirectly to the localization of lacunar infarction or the extent of severity of leukoareosis. It is the most frequent form of disorders of urination in the first years of disease that significantly aggravates its course and needs timed diagnosis and pharmacological treatment. Competitive antagonists of muscarinic receptors M2, M3 subtypes are the most effective drugs for treatment of OUBS comorbid to CCVD. PMID:23994932

  13. Vascular disorders in cerebral reversible ischaemic attacks

    In clinical prectice it is rather frequent to find neurological disorders whose etiology is not clear; in particular, it can be difficult to distinguish a cardiac from a more strictly neurological or vascular cause. In attempting to assess this problem, we have undertaken a study on 675 consecutive patients (387 males and 288 females), aged from 20 to 86 years. All patients, who came to our attention because of transient neurological symptoms or signs, underwent studies with Color Doppler Imaging and Doppler Spectral Analysis techniques applied to supraaortic vessels supplying cerebral regions. Our results show that the highest incidence of obstructive vascular findings (positive Doppler scans) is present in the age interval from 71 to 80 years (75%). The period of maximal incidence of pathologic findings is between 51 and 60 years of age (35% of the total), that is, in an age range where surgical therapy can be undertaken. In this decade 58% of examined patients showed abnormal Doppler scans. Short-lasting parcellar symptoms, such as dysphasia nominum and amaurosis fugax, or symptoms considered non-specific, such as loss of consciousness or dizziness, have given a rather high percentual incidence of positive scans; this is also the case with laterocervical murmurs, even if unaccompanied by symptoms. From the diagnostic viewpoint, Doppler imaging has reached its highest accuracy when applied to arteries very close to each other, as is the case with the carotid artery at its bifurcation. In addition, spectral analysis associated to Doppler imaging allows the detection of the frequency dispersion which results from flow turbulence caused by subcritical lesions in the presence of coiling and kinking of arterial vessel. In conclusion, noninvasive diagnostic methods based on Doppler technology (widely available commercially) can help to discriminate pathological cases in patients who present transient neurological disorders

  14. Epidemiological profile of patients with cerebral vascular accident

    Carolline Paulo Neto da Cunha Lima, Marta Miriam Lopes Costa, Maria Julia Guimarães Oliveira Soares

    2009-01-01

    Objectives: to show the profile epidemiological of patients with cerebral vascular accident in a public hospital from João Pessoa city, Paraíba, Brazil; to investigate the social demographic profile; to identify the risk factors, symptoms and sequels of the cerebral vascular accident. Methods: this is about a descriptive and exploratory study, from quantitative approach; the population was configured by sixty handbooks. Data collect was performed with a form from March to April 2007, and then...

  15. Epidemiological profile of patients with cerebral vascular accident

    Carolline Paulo Neto da Cunha Lima, Marta Miriam Lopes Costa, Maria Julia Guimarães Oliveira Soares

    2009-10-01

    Full Text Available Objectives: to show the profile epidemiological of patients with cerebral vascular accident in a public hospital from João Pessoa city, Paraíba, Brazil; to investigate the social demographic profile; to identify the risk factors, symptoms and sequels of the cerebral vascular accident. Methods: this is about a descriptive and exploratory study, from quantitative approach; the population was configured by sixty handbooks. Data collect was performed with a form from March to April 2007, and then data were analyzed and presented in tables and figures. This study was approval by the Ethics Committee under protocol number 58/2007. Results: data has been demonstrated that most of the handbooks belonged to patients from 46 to 85 years old; from female; they came from Mata Paraibana region; they were patients with hypertension; they had cerebral vascular accident of the type hemorrhagic. Conclusion: this study was very important for nurses, since it allowed them to have knowledge to help reduce the number of deaths and sequelae of cerebral vascular accident, also contributed to the basics to change like this, as knowledge of the disease and fitness treatment methods (among them, stand out studies of risk factors and relevance of applying an early prevention of cerebral vascular accident. Thus, the role of nursing is to prevent and detect early complications, educating the population about the disease.

  16. Análise de terapias coadjuvantes de intervenção terapêutica na funcionalidade em doentes com acidente vascular encefálico

    Sousa, João Paulo de

    2015-01-01

    Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em Fisioterapia Objectivo: Analisar as diferentes terapias coadjuvantes de intervenção terapêutica na funcionalidade de doentes com Acidente Vascular Encefálico (AVE). Metodologia: Foi realizada uma pesquisa nas bases de dados PubMed e PEDro. Foram utilizadas as palavras-chave: “stroke”, “physical therapy” e “outcome FIM”. Resultado: Obtiveram-se 144 estudos, após a...

  17. Occupational performance and satisfaction of individuals after cerebral vascular accident

    Kátia Vanessa Pinto de Meneses; Ana Carolina dos Santos Pereira; Vanessa de Oliveira Alencar; Jeanine Schuabb Duarte

    2014-01-01

    Introduction: Scientific studies show that occupational therapy interventions with patients after cerebral vascular accident (CVA) - post-stroke patients, help them resume the performance of important meaningful tasks. Objective: To measure changes in the perception of post-stroke patients on their occupational performance and satisfaction after the intervention of occupational therapy. Methodology: An observational, longitudinal, prospective study with CVA patients treated at occupational...

  18. Associação entre acidentes vasculares encefálicos e doença de Chagas

    Edison Reis Lopes

    1991-06-01

    Full Text Available Foi pesquisada a freqüência de acidentes vasculares encefálicos (A VE, isquêmicos e hemorrágicos, em chagásicos crônicos e em não chagásicos, maiores de 15 anos de idade, necropsiados em Uberaba, de 1979 a 1988, optando-se por estudo emparelhado por sexo e idade em 208 pares. Em 41 (19,7% dos chagásicos e em 55 (26,4% dos não chagásicos foram diagnosticados AVE, diferença não significante ao nível de 5%. Dos chagásicos 12 (75% tiveram infarto e 4 (25% hemorragia encefálica; dos não chagásicos 5 (31,3% tiveram infarto e 11 (68,7% hemorragia. As .diferenças são significantes ao nível de 5%. Os resultados demonstram menor freqüência de AVE hemorrágico em chagásicos que em não chagásicos e comprovam alta freqüência de AVE isqüêmico na doença de Chagas humana.The frequency of strokes was studied in chronic chagasic and years ofage, non-chagasicpatients, older than 15 coming to necropsy in Uberaba, from 1979 than 1988. The study consisted of paired sex and age matched controls. Two hundred and eight pairs were analysed. Either ischemic or hemorrhagic strokes were found in 41 (19,7% of the chagasics and in 55 (26.4% of the non-chagasic, a difference not significant at the level of 5%. Twelve (75% of the former had infarcts and 4(25% had brain hemorrhage; five (31,3% of the non-chagasics had ischemic strokes and 11 (68,7% had hemorrhagic strokes. The differences were significant to the level of 5%. The results indicate a high frequency of ischemic strokes in human Chagas'disease and demonstrate a lesser frequency of hemorrhagic stroke in chagasics when compared with non-chagasics.

  19. Cuidados Paliativos: o necessário para o idoso com acidente vascular encefálico

    Sônia Maria Dorta Ferreira

    2014-03-01

    Full Text Available A expectativa de vida do ser humano tem aumentado nas últimas décadas, o que vem exigindo o avanço da qualidade dos cuidados destinados a pessoas com fragilidades, especialmente em decorrência do crescimento considerável das doenças crônicas. Dentre essas doenças, destaca-se o acidente vascular encefálico (AVE que acomete grande parte da população idosa, ocasionando perdas e sequelas significativas. Formas inovadoras quanto à essência do cuidar devem ser estudadas e praticadas em nossa sociedade, reconhecendo-se como exemplar nesse sentido a intervenção em cuidados paliativos, que pode melhorar a qualidade de vida e confortar uma pessoa nos seus últimos dias. Nessa direção, objetiva este trabalho enfatizar a necessidade e o valor dos cuidados paliativos para a pessoa idosa com AVE e, para tal, foi realizado um levantamento da pesquisa científica sobre a temática nas principais revistas indexadas. Os resultados indicaram um número limitado de produção científica a esse respeito, assim como se verifica a escassez de serviços que assistam os idosos no final da vida, evidenciando ainda o desconhecimento dos serviços de cuidados paliativos à maior parte dos doentes e suas famílias. Os dados mostram que são múltiplos os sintomas físicos e psicológicos que comprometem a qualidade de vida dessas pessoas em terminalidade, e que a comunicação é essencial nas relações entre paciente, cuidador, família e equipe de saúde. No caso de idosos com AVE, a presença dos Cuidados Paliativos torna-se ainda mais relevante na relação desses pacientes com familiares e outros profissionais. Trabalhos futuros envolvendo os variados aspectos dos Cuidados Paliativos são necessários, para que se possa assegurar um atendimento mais competente e efetivo a essa população.

  20. Erythropoietin and cerebral vascular protection: role of nitric oxide

    Anantha Vijay R SANTHANAM; Zvonimir S KATUSIC

    2006-01-01

    Cerebral vasospasm after subarachnoid hemorrhage (SAH) is a major clinical problem causing cerebral ischemia and infarction.The pathogenesis of vasospasm is related to a number of pathological processes including endothelial damage and alterations in vasomotor function leading to narrowing of artefial diameter and a subsequent decrease in cerebral blood flow.Discovery of the tissue protective effects of erythropoietin (EPO) stimulated the search for therapeutic application of EPO for the prevention and treatment of cerebrovascular disease.Recent studies have identified the role of EP0 in vascular protection mediated by the preservation of endothelial cell integrity and stimulation of angiogenesis.In this review, we discuss the EPO-induced activation of endothelial nitric oxide (NO) synthase and its contribution to the prevention of cerebral vasospasm.

  1. Cerebral vascular control and metabolism in heat stress

    Bain, Anthony R; Nybo, Lars; Ainslie, Philip N

    2015-01-01

    This review provides an in-depth update on the impact of heat stress on cerebrovascular functioning. The regulation of cerebral temperature, blood flow, and metabolism are discussed. We further provide an overview of vascular permeability, the neurocognitive changes, and the key clinical implicat......This review provides an in-depth update on the impact of heat stress on cerebrovascular functioning. The regulation of cerebral temperature, blood flow, and metabolism are discussed. We further provide an overview of vascular permeability, the neurocognitive changes, and the key clinical...... implications and pathologies known to confound cerebral functioning during hyperthermia. A reduction in cerebral blood flow (CBF), derived primarily from a respiratory-induced alkalosis, underscores the cerebrovascular changes to hyperthermia. Arterial pressures may also become compromised because of reduced...... is in turn the primary mechanism for impaired tolerance to orthostatic challenges. Any reduction in CBF attenuates the brain's convective heat loss, while the hyperthermic-induced increase in metabolic rate increases the cerebral heat gain. This paradoxical uncoupling of CBF to metabolism increases brain...

  2. Studies on Treatment of Cerebral Vascular Disease with Integrative Medicine

    孙怡; 韩景献; 谢道珍; 李如奎; 高利; 许健鹏

    2003-01-01

    @@Cerebral vascular disease (CVD) also called the cerebral stroke or wind stroke. There are two common types in clinic, that is, thrombotic CVD and hemorrhagic CVD. CVD has both a high incidence rate and a high mortality rate. It has become the most dangerous factor that costs the lives of the urban population in our country. People of different age groups can develop this kind of disease, and the morbidity rate increases dramatically for those middle-aged in recent years. At present, the harms done by CVD to the human heath are more prominent.

  3. Guidance in rehabilitation for patients after cerebral vascular accident

    Awahnde, Magdalene Tonge; Kimengich, Monicah

    2010-01-01

    The purpose of this thesis was to provide guidance in rehabilitation for patients after cerebral vascular accident (CVA). The guidance was aimed at restoring the patient confidence when going home and promotes their abilities to cope independently without institutional care. The study was carried out under GOING HOME project whose aim was to develop and produce guidance and counseling services concept based on caring TV. (www.wlc.fi). It was implemented through a two interactive channel c...

  4. Acupuncture Treatment of Depressive Syndromes after Cerebral Vascular Accidents

    王海荣

    2002-01-01

    @@ Depressive syndrome is a common complication in cerebral vascular accidents (CVA), which accounts for 70% of the complications. A mild case of the syndrome is marked by grief, sleeping disturbance, weakened mental activities, worry, loss of interest, and irritability. A severe case may have worse symptoms and signs, except the above mentioned ones, such as anxiety, reduced appetite, hallucination, delusion, desperation, etc. The author has adopted acupuncture to treat depressive syndromes after CVA with good therapeutic result as reported in the following.

  5. Atividade muscular durante a marcha após acidente vascular encefálico Muscle activity during gait following stroke

    Fernanda Ishida Corrêa; Flávia Soares; Daniel Ventura Andrade; Ricardo Mitsuo Gondo; José Augusto Peres; Antônio Olival Fernandes; João Carlos Ferrari Corrêa

    2005-01-01

    OBJETIVO: Buscar parâmetros da marcha de pacientes após ter sofrido acidente vascular encefálico (AVE) com hemiparesia. MÉTODO: Comparados 15 voluntários pós-AVE e 15 voluntários saudáveis com a mesma idade, gênero e peso. A comparação foi feita por eletromiografia utilizando cinco pares de eletrodos de superfície do lado comprometido (espástico) e um eletrogoniômetro sobre o eixo articular de rotação da articulação do tornozelo em estudo. RESULTADOS: O início da atividade eletromiográfica, a...

  6. Qualidade de vida do doente após acidente vascular cerebral

    Rua, Maria Augusta Gonçalves Alves

    2012-01-01

    Abstract Background: In Portugal, cerebrovascular accident (CVA) is the leading cause of long-term disability and diminished quality of life. The functional rehabilitation of the patient is one of the basic requirements in the treatment post-CVA. In this context, the objective of the present study is to examine how certain circumstantial, sociodemographic, familiar and clinical variables, the family functionality and functional independence are associated with the quality of life of these ...

  7. Monitoring cerebral oxygenation in a pediatric patient undergoing surgery for vascular ring.

    Joshi, Reena K; Motta, Pablo; Horibe, Mayumi; Mossad, Emad

    2006-02-01

    Regional cerebral oxygenation can be monitored using near-infrared spectroscopy (NIRS). Inadequacy of collateral cerebral circulation and regional cerebral ischemia during cardiac and vascular surgery may be detected by the use of NIRS monitoring. We report a 2-year-old child who underwent surgical repair of vascular ring and subclavian reimplantation, where use of NIRS helped in early detection and timely intervention to prevent prolonged cerebral ischemia. PMID:16430416

  8. Serum levels of hsCRP and SF in patients with ischemic cerebral vascular disease

    Objective: To investigate the significance of changes of serum levels of hsCRP and ferritin (SF) in patients with ischemic cerebral vascular disease. Methods: Serum hsCRP and SF levels were measured with scatter velocity turbidimetry in 120 patients with ischemic cerebral vascular accident and 100 controls. Results: The serum levels of hsCRP and SF in patients with ischemic cerebral vascular accident were significantly higher than those in controls (P<0.01). Conclusion: Serum hsCRP and SF levels were markedly increased after ischemic cerebral vascular accident. They might be regarded as independent risk factor and outcome predictor for the disease. (authors)

  9. Atuação da enfermagem no autocuidado e reabilitação de pacientes que sofreram Acidente Vascular Encefálico

    Juliana Cristina Lessmann

    2011-02-01

    Full Text Available Quando o cérebro sofre alterações vasculares podem ocorrer sérias sequelas motoras, sensoriais e na percepção. Nesta perspectiva o estudo objetiva relatar/ compartilhar assistência de Enfermagem ao indivíduo acometido pelo Acidente Vascular Encefálico enfatizando a reabilitação e o autocuidado baseado em Orem. Trata-se de relato de experiência de prática assistencial, realizada de maio a julho de 2006, com 15 indivíduos e seus familiares, em um centro de reabilitação da região sul do Brasil. O cuidado de Enfermagem integral ocorre com atividades de estimulação sensitiva, motora, controle postural, amplitude de movimentos e treino de marcha, sempre acompanhados por ações de educação em saúde. Estas habilidades conferem aos enfermeiros capacidades de atuação proporcionando a redução de danos e incapacidades

  10. Cerebral angiography, blood flow and vascular reactivity in progressive hypertension

    Li, Yunxia; Shen, Qiang; Huang, Shiliang; Li, Wei; Muir, Eric R.; Long, Justin; Duong, Timothy Q.

    2015-01-01

    Chronic hypertension alters cerebral vascular morphology, cerebral blood flow (CBF), cerebrovascular reactivity, increasing susceptibility to neurological disorders. This study evaluated: i) the lumen diameters of major cerebral and downstream arteries using magnetic resonance angiography, and ii) basal CBF, and iii) cerebrovascular reactivity to hypercapnia of multiple brain regions using arterial-spin-labeling technique in spontaneously hypertensive rats (SHR) at different stages. Comparisons were made with age-matched normotensive Wistar Kyoto (WKY) rats. In 10-week SHR, lumen diameter started to reduce, basal CBF, and hypercapnic CBF response were higher from elevated arterial blood pressure, but there was no evidence of stenosis, compared to age-matched WKY. In 20-week SHR, lumen diameter remained reduced, CBF returned toward normal from vasoconstriction, hypercapnic CBF response reversed and became smaller, but without apparent stenosis. In 40-week SHR, lumen diameter remained reduced and basal CBF further decreased, resulting in larger differences compared to WKY. There was significant stenosis in main supplying cerebral vessels. Hypercapnic CBF response further decreased, with some animals showing negative hypercapnic CBF responses in some brain regions, indicative of compromised cerebrovascular reserve. The territory with negative hypercapnia CBF responses corresponded with the severity of stenosis in arteries that supplied those territories. We also found enlargement of downstream vessels and formation of collateral vessels as compensatory responses to vasoconstriction upstream vessels. The middle cerebral and azygos arteries were amongst the most susceptible to hypertension-induced changes. Multimodal MRI provides clinically relevant data that might be useful to characterize disease pathogenesis, stage disease progression, and monitor treatment effects in hypertension. PMID:25731987

  11. Categorical course in neuroradiology cerebral ischemia, hemorrhage, and vascular lesions

    The diagnostic imaging of acute stroke is primarily directed toward identifying the lesion, characterizing it as either intracranial hemorrhage or ischemia, and assessing the anatomic extent of the lesion. The acute medical or surgical management decisions are best aided by a combination of CT and cerebral angiography, the latter used acutely mostly for intracranial hemorrhage, especially subarachnoid hemorrhage. More complex presentations benefit from MR imaging evaluation as well. After the acute phase, the main goal of treatment, especially for patients who have had reasonable recovery from the acute stroke, is the prevention of recurrent, and perhaps more severe, stroke. Treatments such as aneurysm clipping or arteriovenous malformation removal for hemorrhagic lesions, or anticoagulation or carotid endarterectomy for ischemic lesions, require brain and vascular imaging studies for appropriate treatment planning. Angiography to show the anatomic vascular cause for the bleed or ischemia is therefore usually a requirement. The enlarging experience with MR imaging has contributed greatly to the identification of occult vascular lesions of the brain that may be prone to bleeding and to recognizing blood in the brain accurately. For this purpose MR imaging is sometimes more specific than CT

  12. A quantitative evaluation of regional cerebral blood flow in the patients with cerebral vascular accident

    We studied the validity of a new method using 99mTc-HMPAO for quantitative evaluation of regional cerebral blood flow (rCBF) with single-photon emission computed tomography (SPECT). Subjects consisted of 20 patients with various categories of cerebral vascular accident. There were 14 males and six females. Age ranged from 33 to 88 years old with a mean of 67.9. Each category included two cerebral hemorrhages, six atherothrombotic, nine lacunar, and three cardioembolic strokes. By using the method reported by Matsuda et al., rCBF measurements were carried out at least three weeks after the insults. A total of 18 ROIs was set symmetrically on both affected and unaffected hemispheres. Data collected from the frontal, the temporal, and the occipital ROI of the unaffected hemisphere showed 50.5±10.1, 50.4±12.7, and 48.6±8.4ml/100g/min (mean±SD) respectively. Since these values were similar to those measured by other methods including PET, an average of these values was used as a control to evaluate the values of the affected regions. In the affected regions of cerebral hemorrhages, atherothrombotic, and cardioembolic stroke, rCBF showed a significant reduction. No significant decrease in rCBF was revealed in the lesions of lacunar stroke presumably because of relative small lesions. These results suggest that this simple and minimally invasive method is reliable as a quantitative measurement of rCBF and is applicable for clinical uses. (author)

  13. A família também adoece!: mudanças secundárias à ocorrência de um acidente vascular encefálico na família

    Eliana Sales Brito; Elaine Pedreira Rabinovich

    2008-01-01

    Este estudo buscou compreender o impacto da doença incapacitante na família de pacientes vítimas de acidente vascular encefálico (AVE), investigando as mudanças de ordem estrutural, social e emocional. Foram analisadas nove famílias de pacientes com primeiro episódio de AVE identificados pelo registro geral de doenças do Hospital São Rafael, Salvador, Bahia. A coleta dos dados foi realizada mediante aplicação de questionário, roteiro de entrevista, escala de avaliação funcional e observações ...

  14. ESTUDOS SOBRE ABORDAGENS TERAPÊUTICAS PARA O ACIDENTE VASCULAR ENCEFÁLICO (AVE) EM MODELO ANIMAL: USO DE CÉLULAS DERIVADAS DE MEDULA ÓSSEA E DE FLAVONOIDES

    Arthur Giraldi-Guimarães; Maria de Fátima dos Santos Sampaio; Amélia Miranda Gomes Rodrigues; Helder Teixeira de Freitas; Viviane Gomes da Silva; Fralini dos Santos Marcilio; Bárbara de Paula Coelho; Mayara de Almeida Martins Soares; Mariana Gomes Rebel

    2012-01-01

    O Acidente Vascular Encefálico é a maior causa de incapacitação em seres humanos adultos, representandoatualmente um grande custo pessoal e social. Empregando modelos experimentais de lesões cerebrais focais,este projeto tem como objetivo geral avaliar o efeito benéfico de abordagens terapêuticas promissoras notratamento do AVE e de outras lesões cerebrais. Em estudos concluídos, tivemos como objetivo principalavaliar a capacidade de indução de recuperação funcional em testes sensorimotores p...

  15. Hospitalização por acidente vascular encefálico isquêmico no Brasil: estudo ecológico sobre possível impacto do Hiperdia

    Johnnatas Mikael Lopes; Gerônimo José Bouzas Sanchis; Jovany Luiz Alves de Medeiros; Fábio Galvão Dantas

    2016-01-01

    RESUMO: Objetivo: O estudo avaliou a tendência de hospitalização por acidente vascular encefálico isquêmico (HAVEI) e a sua mortalidade hospitalar no Brasil nos últimos 15 anos, assim como o impacto do programa Hiperdia nesse cenário. Métodos: Delineou-se um estudo ecológico com abordagem analítica e dados coletados no Sistema de Internação Hospitalar sobre episódios de AVEI, referentes aos anos de 1998 a 2012. Todos os dados foram estratificados por sexo e faixa etária, criando-se um indi...

  16. Frecuencia de hipertrofia ventricular izquierda en pacientes con enfermedad vascular cerebral

    Juan Manuel Pérez Zúñiga; Alberto Trejo González; Óscar Gerardo Velasco Luna; Víctor García Barrera

    2011-01-01

    Antecedentes: la enfermedad vascular cerebral es la cuarta causa de muerte en México. Los pacientes con hipertrofia ventricular izquierda tienen un cociente de probabilidad de padecerla de incluso 3.0. Objetivo: determinar la frecuencia de hipertrofia ventricular izquierda en pacientes con enfermedad vascular cerebral, en un hospital de tercer nivel del ISSSTE. Pacientes y método: se hizo un estudio observacional, prospectivo, descriptivo, transversal y abierto en pacientes con diagnóstico...

  17. Correction of vegetative-vascular regulation in cerebral palsy by means of sports games.

    Kucherov D.S.

    2011-08-01

    Full Text Available The peculiarities of the physical rehabilitation of sports facilities aimed at correcting the condition of vegetative-vascular regulation of children with cerebral palsy at the age of 11-13 years. The results of heart rate variability. The positive effects of the application of physical rehabilitation with elements of sports in children with cerebral palsy, effective changes in the state of vegetative-vascular regulation and improvement of cardiac regulation.

  18. Occupational performance and satisfaction of individuals after cerebral vascular accident

    Kátia Vanessa Pinto de Meneses

    2014-12-01

    Full Text Available Introduction: Scientific studies show that occupational therapy interventions with patients after cerebral vascular accident (CVA - post-stroke patients, help them resume the performance of important meaningful tasks. Objective: To measure changes in the perception of post-stroke patients on their occupational performance and satisfaction after the intervention of occupational therapy. Methodology: An observational, longitudinal, prospective study with CVA patients treated at occupational therapy service at the ‘Unidade Mista de Taguatinga’, Federal District, Brazil. The Canadian Occupational Performance Measure (COPM was applied in three distinct times: during the initial assessment (time 1, after 3 months (time 2, and after 6 months (time 3 of occupational therapy intervention. Results: The analysis after 3 months of intervention was performed with 17 patients; all showed increased performance scores (p = 0.000, and only one patient presented decrease in satisfaction scores. The analysis after 6 months was conducted with 13 patients; all showed significant improvement (p = 0.000 in scores for performance and satisfaction. Conclusions: The study shows the improvement in satisfaction and occupational performance of CVA patients after occupational therapy intervention. The study suggests that occupational therapy intervention helps the rehabilitation process of post-stroke patients, enabling them to improve their occupational performance and satisfaction and, consequently, their independence.

  19. Cerebral vascular effects of hypovolemia and dopamine infusions

    Holst Hahn, Gitte; Heiring, Christian; Pryds, Ole;

    2012-01-01

    Despite widespread use, effects of volume boluses and dopamine in hypotensive newborn infants remain controversial. We aimed to elucidate if hypovolemia alone impairs cerebral autoregulation (CA) and if dopamine affects cerebral vasculature....

  20. Estudo clínico e videofluoroscópico da disfagia na fase subaguda do acidente vascular encefálico

    Xerez Denise Rodrigues

    2004-01-01

    Full Text Available OBJETIVO: Correlacionar, em pacientes portadores de acidente vascular encefálico (AVE na fase subaguda, as alterações clínicas da deglutição com as observadas na videofluoroscopia. MATERIAIS E MÉTODOS: De 37 portadores de AVE subagudo confirmado por exame de imagem, 26 pacientes de ambos os sexos, com idade média de 59,69 anos, foram avaliados clínica e videofluoroscopicamente. Consideramos como variáveis para pareamento estatístico os parâmetros clínicos indicativos de penetração/aspiração e sua confirmação na videofluoroscopia. RESULTADOS: Identificamos disfagia em 19 (73% dos 26 pacientes que fizeram videofluoroscopia; dez (38,46% apresentaram penetração/aspiração de líquidos. Os dados resultantes mostraram não existir correlação (p < 0,05 entre a presença de disfagia e/ou disartria e a presença de penetração/aspiração de líquidos na videofluoroscopia. Houve correlação entre a presença de penetração/aspiração de líquidos observados na videofluoroscopia com os seguintes parâmetros clínicos: estado dos dentes (p = 0,047, mobilidade (p = 0,019 e sensibilidade da face (p = 0,039 e mobilidade da língua (p = 0,012. CONCLUSÃO: Não foi possível definir a presença de penetração/aspiração de líquidos nas vias aéreas por dados epidemiológicos do AVE. A existência de mau estado de preservação dos dentes, alterações na mobilidade da face e da língua e na sensibilidade da face mostrou risco aumentado de penetração/aspiração para líquidos. Permanece importante a indicação da videofluoroscopia para melhor avaliação dos quadros de disfagia após AVE.

  1. Avaliação da aptidão cardiopulmonar em indivíduos com hemiparesia após acidente vascular encefálico

    Angélica Cristiane Ovando

    2011-02-01

    Full Text Available FUNDAMENTO: Devido à hemiparesia, a avaliação da aptidão cardiorrespiratória de indivíduos após acidente vascular encefálico (AVE, por meio de testes ergométricos com protocolos convencionais, tem se tornado um desafio. OBJETIVO: Realizar teste cardiopulmonar (TCP em hemiparéticos para uma avaliação pré-participação visando uma criteriosa prescrição de exercício aeróbico. MÉTODOS: Participaram do estudo 8 indivíduos com hemiparesia crônica, que foram submetidos a TCP realizado com protocolo individualizado em rampa, desenvolvido a partir da informação da velocidade de marcha dos indivíduos previamente avaliados em teste de pista. Foi considerada a proposta de inclinação variando entre 0 e 10,0%, velocidade inicial correspondente a 70,0% do ritmo de caminhada confortável e velocidade máxima 40,0% superior à velocidade máxima no teste de pista, na expectativa de que o TCP, com este incremento gradativo e constante da intensidade, durasse entre 6 e 8 minutos. RESULTADOS: Em 100,0% dos avaliados, o motivo para a interrupção do teste foi fadiga periférica. O VO2 de pico alcançado foi de 20,6 ± 5,7 ml/kg.min. O Limiar I foi identificado em todos os exames, situando-se em 82,64 ± 4,78% da FC de pico e 73,31 ± 4,97% do VO2 de pico. O quociente respiratório (R do grupo foi de 0,96 ± 0,09, e três dos 8 indivíduos (37,5% atingiram R superior a 1,00, sendo o Limiar II identificado nestes sujeitos. Foram encontradas relações positivas entre variáveis do TCP e escores de equilíbrio, desempenho no teste de caminhada de 6 minutos e velocidade de marcha no solo. CONCLUSÃO: O teste mostrou ser útil para prescrição de atividade física nesses indivíduos.

  2. Lower cranial nerve motor function in unilateral vascular lesions of the cerebral hemisphere

    Willoughby, E W; Anderson, N.E.

    1984-01-01

    Motor function subserved by cranial nerves V, VII, X, XI, and XII was assessed in 100 patients with hemiparesis due to a unilateral vascular lesion of the cerebral hemisphere. Several of the findings were not described clearly in many of the standard textbooks of neurology. Weakness of sternomastoid when present was always contralateral to the hemiparesis. This emphasises the principle that the cerebral hemisphere controls movement of the body parts in or towards the contralateral half of the...

  3. Vascular dysfunction as a target for adjuvant therapy in cerebral malaria

    Leonardo José de Moura Carvalho

    2014-08-01

    Full Text Available Cerebral malaria (CM is a life-threatening complication of Plasmodium falciparum malaria that continues to be a major global health problem. Brain vascular dysfunction is a main factor underlying the pathogenesis of CM and can be a target for the development of adjuvant therapies for the disease. Vascular occlusion by parasitised red blood cells and vasoconstriction/vascular dysfunction results in impaired cerebral blood flow, ischaemia, hypoxia, acidosis and death. In this review, we discuss the mechanisms of vascular dysfunction in CM and the roles of low nitric oxide bioavailability, high levels of endothelin-1 and dysfunction of the angiopoietin-Tie2 axis. We also discuss the usefulness and relevance of the murine experimental model of CM by Plasmodium berghei ANKA to identify mechanisms of disease and to screen potential therapeutic interventions.

  4. Percepção de sabores em pacientes com acidente vascular encefálico Taste perception in stroke patients

    Leda Maria Tavares Alves

    2011-12-01

    Full Text Available OBJETIVO: avaliar a percepção dos sabores amargo, azedo, doce e neutro. MÉTODO: foram estudados 36 pacientes com Acidente Vascular Encefálico (AVE (5 hemorrágicos e 31 isquêmicos e 30 sujeitos controles. Foi realizada avaliação fonoaudiológica estrutural e funcional incluindo postura, vedamento labial, presença de resíduos, tosse, engasgo, e ausculta cervical. Cada sujeito deglutiu em sequência aleatória 5 mL de líquido com os 4 sabores [chá de boldo (amargo, suco de limão diluído (azedo, sacarose diluída (doce e água (neutro] na temperatura ambiente. Entre as deglutições os participantes eram questionados sobre a dificuldade em deglutir e qual o sabor do líquido daquela deglutição. RESULTADOS: entre os pacientes houve maior freqüência de erros na identificação dos sabores amargo (controles: 16,7%, AVE: 47,3%, p=0,01 e azedo (controles: 6,7%, AVE: 27,8%, p=0,05, sem diferenças para o sabores neutro (controles: 10,0%, AVE: 16,7%, p=0,50 e doce (controles: 13,3%, AVE: 16,7%, p=0,80. Os pacientes com AVE tiveram maior dificuldade para deglutir os líquidos do que os controles (pPURPOSE: to assess the perception of bitter, sour, sweet and neutral flavors in stroke patients. METHOD: we studied 36 patients with stroke (5 hemorrhagic and 31 ischemic and had a 30 subjects' control group. W performed a structural and functional oral and pharyngeal evaluation including posture, lip sealing, presence of residues, cough, choking, and cervical auscultation. Five ml of fluids with the 4 flavors ["boldus" tea (bitter, diluted lemon juice (sour, diluted sucrose (sweet, and water (neutral] were offered in random sequence under room temperature. Participants were questioned, between swallows, on the difficulty in swallowing and which flavor they had just swallowed. RESULTS: patients with stroke had greater difficulty in swallowing the fluids than control group (p<0.04. Patients made more mistakes in identifying bitter (control: 16

  5. Atividade muscular durante a marcha após acidente vascular encefálico Muscle activity during gait following stroke

    Fernanda Ishida Corrêa

    2005-09-01

    Full Text Available OBJETIVO: Buscar parâmetros da marcha de pacientes após ter sofrido acidente vascular encefálico (AVE com hemiparesia. MÉTODO: Comparados 15 voluntários pós-AVE e 15 voluntários saudáveis com a mesma idade, gênero e peso. A comparação foi feita por eletromiografia utilizando cinco pares de eletrodos de superfície do lado comprometido (espástico e um eletrogoniômetro sobre o eixo articular de rotação da articulação do tornozelo em estudo. RESULTADOS: O início da atividade eletromiográfica, a partir da fase de apoio, para os músculos glúteo medial, reto femoral, tibial anterior, sóleo, e porção medial dos isquiotibiais foi significantemente ativados anteriormente durante o ciclo da marcha nos voluntários pós-AVE. O final da atividade eletromiográfica para os músculos reto femoral, tibial anterior, sóleo, e porção medial dos isquiotibiais foi significantemente prolongado nos voluntários pós-AVE. Voluntários pós-AVE demonstraram também mais co-ativação dos músculos agonistas e antagonistas da articulação do tornozelo e joelho durante a fase de balanceio. CONCLUSÃO: Essas alterações e co-contrações musculares da marcha permitem que os voluntários pós-AVE adotem um padrão de marcha mais seguro e mais estável para compensar a diminuição da informação sensorial da articulação do tornozelo.OBJECTIVE: To compare muscle activity and joint moments in the lower extremities during walking between subjects with stroke and control subjects. METHOD: We compared fifteen healthy volunteers and fifteen stroke patients, with the same age gender and weight data had been compared by electromyography. The system of signals acquisition used consisted of five pairs of electrodes of surface, beyond one electrogoniometer on the axis articulate of rotation of the joint of the ankle in study. RESULTS: Onset times with respect to heel-strike for the medial gluteus, tibialis anterior, soleus, rectus femoris and medial

  6. Análise de conceito do resultado de enfermagem Mobilidade em pacientes com acidente vascular cerebral

    Rafaella Pessoa Moreira

    2014-06-01

    Full Text Available O objetivo foi realizar análise do conceito do resultado de enfermagem Mobilidade em paciente com AVC. Realizou-se revisão integrativa da literatura, por meio de acesso on-line às bases: Scopus, Pubmed, Cinahl, Cochrane e Lilacs, usando-se os descritores: mobility, stroke, nursing e sinonímias nas línguas portuguesa e espanhola. Identificaram-se 1.521 artigos de que, após seleção criteriosa, resultaram 49. Destacam-se artigos publicados no Canadá (26,7%, a partir de 2001 (95,9%, por fisioterapeutas (34,6%, em unidades de reabilitação (61,5%. Atributos identificados para Mobilidade: andar, ficar em pé, sentar, colocar a perna de um lado para outro, virar-se, iniciar e parar a locomoção, subir escadas, função motora, transferência e habilidade motora. Também foi construído caso modelo, caso contrário e identificados antecedentes: controle postural e equilíbrio; e consequentes: realiza tarefas no interior e exterior da casa e deambula sem dificuldade. Os conceitos do resultado Mobilidade encontrados nesta pesquisa precisam ser validados com especialistas na área e na prática clínica.

  7. Neurofibromatosis, stroke and basilar impression: case report Neurofibromatose, acidente vascular cerebral e impressão basilar: relato de caso

    ELCIO JULIATO PIOVESAN; ROSANA HERMINIA SCOLA; LINEU CESAR WERNECK; Viviane H. Flumignan Zétola; EDISON MATOS NÓVAK; FABIO MASSAITI IWAMOTO; LICIANE MAIA PIOVESAN

    1999-01-01

    Neurofibromatosis type 1 (NF1) can virtually affect any organ, presenting most frequently with "cafe au lait" spots and neurofibromas. Vasculopathy is a known complication of NF1, but cerebrovascular disease is rare. We report the case of a 51-year-old man admitted to the hospital with a history of stroke four months before admission. On physical examination, he presented various "cafe au lait" spots and cutaneous neurofibromas. Neurologic examination demonstrated right-sided facial paralysis...

  8. Holographic demonstration of cerebral vascular and microvascular topography

    The topographic anatomy of the cerebral arterial distribution system is illustrated in three dimensions by holographic displays. Each display was prepared by injecting the internal and external carotid arteries of four excised human brains with polymer material that hardens within the arteries. The polymer material suspends particulates having high x-ray absorption so that 100-μm vessels can be distinguished. A laboratory digital radiography system was used to acquire high-fidelity digital radiographs from points of view separated by 10. The exhibit presents an educationally useful format for learning whole-brain cerebral topography and a scientifically new method (microradiographic holography) for studying cerebral microvasculature in selected regions. Anatomic knowledge from these studies will aid the planning of microsurgery and aneurysm surgery

  9. Study of the Dynamics of Transcephalic Cerebral Impedance Data during Cardio-Vascular Surgery

    Atefi, S. R.; Seoane, F.; Lindecrantz, K.

    2013-04-01

    Postoperative neurological deficits are one of the risks associated with cardio vascular surgery, necessitating development of new techniques for cerebral monitoring. In this study an experimental observation regarding the dynamics of transcephalic Electrical Bioimpedance (EBI) in patients undergoing cardiac surgery with and without extracorporeal circulation (ECC) was conducted to investigate the potential use of electrical Bioimpedance for cerebral monitoring in cardio vascular surgery. Tetrapolar transcephalic EBI measurements at single frequency of 50 kHz were recorded prior to and during cardio vascular surgery. The obtained results show that the transcephalic impedance decreases in both groups of patients as operation starts, however slight differences in these two groups were also observed with the cerebral impedance reduction in patients having no ECC being less common and not as pronounced as in the ECC group. Changes in the cerebral impedance were in agreement with changes of haematocrit and temperature. The origin of EBI changes is still unexplained however these results encourage us to continue investigating the application of electrical bioimpedance cerebral monitoring clinically.

  10. Study of the Dynamics of Transcephalic Cerebral Impedance Data during Cardio-Vascular Surgery

    Postoperative neurological deficits are one of the risks associated with cardio vascular surgery, necessitating development of new techniques for cerebral monitoring. In this study an experimental observation regarding the dynamics of transcephalic Electrical Bioimpedance (EBI) in patients undergoing cardiac surgery with and without extracorporeal circulation (ECC) was conducted to investigate the potential use of electrical Bioimpedance for cerebral monitoring in cardio vascular surgery. Tetrapolar transcephalic EBI measurements at single frequency of 50 kHz were recorded prior to and during cardio vascular surgery. The obtained results show that the transcephalic impedance decreases in both groups of patients as operation starts, however slight differences in these two groups were also observed with the cerebral impedance reduction in patients having no ECC being less common and not as pronounced as in the ECC group. Changes in the cerebral impedance were in agreement with changes of haematocrit and temperature. The origin of EBI changes is still unexplained however these results encourage us to continue investigating the application of electrical bioimpedance cerebral monitoring clinically.

  11. Cerebral vascular effects of loading dose of dexmedetomidine: A Transcranial Color Doppler study

    Appavoo Arulvelan

    2016-01-01

    Full Text Available Background: Dexmedetomidine has been widely used in critical care settings because of its property of maintaining stable hemodynamics and inducing conscious sedation. The use of dexmedetomidine is in increasing trend particularly in patients with neurological disorders. Very few studies have focused on the cerebral hemodynamic effects of dexmedetomidine. This study is aimed to address this issue. Methods: Thirty patients without any intracranial pathology were included in this study. Middle cerebral artery flow velocity obtained from transcranial color Doppler was used to assess the cerebral hemodynamic indices. Mean flow velocity (mFV, pulsatility index (PI, cerebral vascular resistant index (CVRi, estimated cerebral perfusion pressure (eCPP, and zero flow pressure (ZFP were calculated bilaterally at baseline and after infusion of injection Dexmedetomidine 1 mcg/Kg over 10 min. Results: Twenty-six patients completed the study protocol. After administration of loading dose of dexmedetomidine, mFV and eCPP values were significantly decreased in both hemispheres (P < 0.05; PI, CVRi, and ZFP values showed significant increase (P < 0.05 after dexmedetomidine infusion. Conclusion: Increase in PI, CVRi, and ZFP suggests that there is a possibility of an increase in distal cerebral vascular resistance (CVR with loading dose of dexmedetomidine. Decrease in mFV and eCPP along with an increase in CVR may lead to a decrease in cerebral perfusion. This effect can be exaggerated in patients with preexisting neurological illness. Further studies are needed to evaluate the effect of dexmedetomidine on various other pathological conditions involving brain like traumatic brain injury and vascular malformations.

  12. A rare combination of atypical cerebral vascular anatomy.

    Koleilat, Issam; Eidt, John

    2015-10-01

    A 57-year-old woman presented with neurologic deficits consistent with a cerebrovascular accident. Her workup demonstrated the simultaneous occurrence of three uncommon cerebrovascular congenital anomalies in a single patient: (1) persistent trigeminal artery, (2) persistent fetal origin of the posterior cerebral artery and (3) bilateral occurrence of the vertebral arteries terminating in the posterior inferior cerebellar arteries. These persistent fetal cerebrovascular anatomic variants are reviewed and the clinical relevance discussed. PMID:25414171

  13. Vascular risk factors, atherosclerosis, cerebral white matter lesions and cerebral perfusion in a population-based study

    We studied risk factors for cerebral vascular disease (blood pressure and hypertension, factor VIIc, factor VIIIc, fibrinogen), indicators of atherosclerosis (intima-media thickness and plaques in the carotid artery) and cerebral white matter lesions in relation to regional cerebral blood flow (rCBF) in 60 persons (aged 65-85 years) recruited from a population-based study. rCBF was assessed with single-photon emission tomography using technetium-99m d,l-hexamethylpropylene amine oxime (99mTc-HMPAO). Statistical analysis was performed with multiple linear regression with adjustment for age, sex and ventricle-to-brain ratio. A significant positive association was found between systolic and diastolic blood pressure and temporo-parietal rCBF. In analysis with quartiles of the distribution, we found a threshold effect for the relation of low diastolic blood pressure (≤60 mmHg) and low temporo-parietal rCBF. Levels of plasma fibrinogen were inversely related to parietal rCBF, with a threshold effect of high fibrinogen levels (>3.2 g/l) and low rCBF. Increased atherosclerosis was related to low rCBF in all cortical regions, but these associations were not significant. No consistent relation was observed between severity of cerebral white matter lesions and rCBF. Our results may have implications for blood pressure control in the elderly population. (orig.)

  14. Interactive effects of vascular risk burden and advanced age on cerebral blood flow

    Katherine eBangen

    2014-07-01

    Full Text Available Vascular risk factors and cerebral blood flow (CBF reduction have been linked to increased risk of cognitive impairment and Alzheimer’s disease (AD; however the possible moderating effects of age and vascular risk burden on CBF in late life remain understudied. We examined the relationships among elevated vascular risk burden, age, CBF, and cognition. Seventy-one non-demented older adults completed an arterial spin labeling MR scan, neuropsychological assessment, and medical history interview. Relationships among vascular risk burden, age, and CBF were examined in a priori regions of interest (ROIs previously implicated in aging and AD. Interaction effects indicated that, among older adults with elevated vascular risk burden (i.e., multiple vascular risk factors, advancing age was significantly associated with reduced cortical CBF whereas there was no such relationship for those with low vascular risk burden (i.e., no or one vascular risk factor. This pattern was observed in cortical ROIs including medial temporal (hippocampus, parahippocampal gyrus, uncus, inferior parietal (supramarginal gyrus, inferior parietal lobule, angular gyrus, and frontal (anterior cingulate, middle frontal gyrus, medial frontal gyrus cortices. Furthermore, among those with elevated vascular risk, reduced CBF was associated with poorer cognitive performance. Such findings suggest that older adults with elevated vascular risk burden may be particularly vulnerable to cognitive change as a function of CBF reductions. Findings support the use of CBF as a potential biomarker in preclinical AD and suggest that vascular risk burden and regionally-specific CBF changes may contribute to differential age-related cognitive declines.

  15. Acute effects of tibolone on cerebral vascular reactivity in vitro

    Lund, C O; Nilas, Lisbeth; Dalsgaard, T; Pedersen, S H; Ottesen, B

    2003-01-01

    of the hormones on the concentration-response curves with calcium were examined. RESULTS: Tibolone and its metabolites induced a concentration-dependent relaxation comparable to that of 17beta-estradiol (area under the curve (AUC); tibolone vs. 17beta-estradiol: 242 vs. 251; p < 0.05, analysis of...... variance). L-NAME increased the AUC for all substances compared with controls (p < 0.05, Student's t test), except for 17beta-estradiol. Preincubation with TEA induced no changes. The concentration-dependent contraction curves with calcium were shifted rightward by all hormones. CONCLUSIONS: The study...... demonstrates that the acute relaxation induced by tibolone and its metabolites in cerebral arteries in vitro is comparable to that with 17beta-estradiol, and seems to be mediated by inhibition of voltage-gated calcium channels and possibly partly by a nitric oxide-dependent mechanism....

  16. The accessible cerebral vascular proteome in a mouse model of cerebral β-amyloidosis.

    Roesli, Christoph; Fugmann, Tim; Borgia, Beatrice; Schliemann, Christoph; Neri, Dario; Jucker, Mathias

    2011-04-01

    Assessing protein changes in the cerebral vasculature of brain disorders may increase our understanding of disease pathogenesis and facilitate diagnostic and therapeutic intervention. By combining perfusion of mice with a charged reactive biotin derivative and subsequent quantification of the biotinylated proteins, the proteome accessible from the vasculature in an APPPS1 transgenic mouse model of cerebral β-amyloidosis was identified and compared to that in non-transgenic control mice. Our results provide proof-of-concept of this technology for the identification of new targets for antibody-based therapy or pharmacodelivery, and for neuroimaging in neurodegenerative diseases. PMID:21262399

  17. Social inequalities of health and handicap. The example of the cerebral vascular attack

    Aïach, P.; Baumann, Michèle

    2006-01-01

    The social inequalities of health are observed in the field of illness and death. What about the inequalities with a handicap?. The studies and surveys that highlight the relationship between handicap and social health inequalities are cruelly lacking. It is for this reason that we tried to explore this relationship in the scope of a survey carried out in France on the social and family repercussions of a cerebral vascular attack. The method used, a significant national survey in France (1000...

  18. The Prevalence of cerebral vascular accident (CVA) in the postoperative of myocardial revascularization

    Carolina Meireles Rosa; Kassandra Souza Coutinho; Marily Fernandes Domingues; Denise Silva de Moura

    2006-01-01

    The aim of this research was to investigate the prevalence of cerebral vascular accident (AVC) in the postoperative of myocardial revascularization, from January 2000 to September 2003, in a reference Hospital at Ceará state, Brazil, identifying the risk factors related to the occurrence of AVC in the postoperative of this surgery. It was a quantitative study. The study population consisted of patients from both sexes, of all age groups, that had being submitted to myocardial revascularizatio...

  19. Study on the Relationship between Plasma Homocysteine and Acute Cerebral Vascular Disease

    2000-01-01

    The levels of plasma homocysteine were determined by using high-performance liquid chromatographic method. It was found that plasma homocysteine levels were significantly higher in the patients with stroke than that in the controls. There was no correlation between plasma homocysteine levels and hypertension, smoking, concentrations of blood glucose or hypertriglyceridesemia. It was suggested that hyperhomocysteinemia may be an independent risk factor for acute cerebral vascular disease.

  20. Vincamina em pacientes com insuficiencia vascular cerebral Effects of vincamine in patients with cerebrovascular insufficiency

    Sérgio Pereira Novis

    1975-03-01

    Full Text Available Foram estudados, em 20 casos de pacientes com insuficiência vascular cerebral, os efeitos do tratamento com a vincamina. Os doentes foram previamente submetidos a exames neurológico, eletrencefalográfico, laboratoriais, psicométricos (teste de memória, teste de capacidade intelectiva, teste de atenção concentrada, raciocínio abstrato e de personalidade. Os pacientes foram medicados com vincamina na dose de 40 mg nas 24 horas durante o período aproximado de 150 dias, após o que foram novamente submetidos à análise idêntica. Os resultados obtidos, apresentados em tabelas, revelam que, em razoável percentual, foi a vincamina medicamento útil no controle das manifestações clínicas da insuficiência vascular cerebral, sendo evidenciada melhora nos índices de déficit de memória retrógrada e anterógrada observados nos testes objetivos. Houve também melhora no padrão eletrencefalográfico de alguns pacientes.The effects of the treatment with vincamine in 20 patients with cerebral vascular insufficiency are reported. The patients were previously submitted to the following tests: neurologic examination, electroencephalography, laboratory tests, psychometry (memory, intellective capability, concentrated attention, abstract reasoning and personality tests. Patients were medicated with vincamin in a 40 mg dose within 24 hours during approximately a 150 days period, after which were again submitted to an identical analysis. The results obtained revealed that in a reasonable percentage of the cases vincamin is an useful medication in controlling the clinical manifestations of the cerebral vascular insufficiency, an improvement being demonstrated in the retrograde and anterograde deficit rate observed in objective tests. An improvement was also noticed in the electroencephalograpric pattern of a few patients.

  1. Impacto da intubação orotraqueal na deglutição do indivíduo pós-acidente vascular encefálico após cirurgia cardíaca

    Tatiana Magalhães de Almeida

    2015-04-01

    Full Text Available OBJETIVO:associar o grau de disfagia orofaríngea e o tempo de intubação orotraqueal no indivíduo pós-acidente vascular encefálico após cirurgia cardíaca.MÉTODOS:estudo clínico transversal descritivo, retrospectivo, realizado por meio da coleta de dados de protocolos e registros de prontuário, durante seis meses, em Hospital Público de Referência em Cardiologia. Foram analisados 25 protocolos e prontuários de indivíduos submetidos à cirurgia cardíaca, que evoluíram com acidente vascular encefálico e foram assistidos pela equipe de Fonoaudiologia. Os indivíduos foram divididos em dois grupos. O Grupo I (GI constou de 10 indivíduos com intubação orotraqueal menor que 24 horas e o Grupo II (GII de 15 indivíduos com intubação orotraqueal maior que 24 horas. Realizada avaliação clínica da deglutição e analisada a associação entre a classificação clínica do grau de comprometimento para disfagia e o tempo de intubação orotraqueal.RESULTADOS:verificou-se que no GI 40% apresentaram disfagia leve, 30% moderada e 20% grave. No GII 13,3% apresentaram disfagia leve, 33,3% moderada e 53,33% grave. Verificou-se associação linear significante entre o grau de disfagia e o tempo de IOT (p= 0,031, indicando que o número de indivíduos com disfagia moderada e grave foi maior no grupo com mais tempo de intubaçao.CONCLUSÕES:constatou-se que o tempo de intubação orotraqueal maior que 24 horas aumentou o grau da disfagia orofaríngea nesta população.

  2. Atuação da enfermagem no autocuidado e reabilitação de pacientes que sofreram Acidente Vascular Encefálico Actuación de la enfermería en el autocuidado y rehabilitación de pacientes que sufreran Accidente Nursing activities in self-care and rehabilitation of patients who suffered Stroke

    Juliana Cristina Lessmann

    2011-02-01

    Full Text Available Quando o cérebro sofre alterações vasculares podem ocorrer sérias sequelas motoras, sensoriais e na percepção. Nesta perspectiva o estudo objetiva relatar/ compartilhar assistência de Enfermagem ao indivíduo acometido pelo Acidente Vascular Encefálico enfatizando a reabilitação e o autocuidado baseado em Orem. Trata-se de relato de experiência de prática assistencial, realizada de maio a julho de 2006, com 15 indivíduos e seus familiares, em um centro de reabilitação da região sul do Brasil. O cuidado de Enfermagem integral ocorre com atividades de estimulação sensitiva, motora, controle postural, amplitude de movimentos e treino de marcha, sempre acompanhados por ações de educação em saúde. Estas habilidades conferem aos enfermeiros capacidades de atuação proporcionando a redução de danos e incapacidadesCuando o cerebro sufre alteraciones vasculares pueden ocurrir serias secuelas motoras, sensoriales y en la percepción. En esta perspectiva el estudio objetiva relatar/compartir asistencia de Enfermería al individuo afectado por accidente vascular cerebral enfatizando la rehabilitación y autocuidado basado en Orem. Se trata de relato de experiencia de práctica asistencial, realizada de mayo a julio de 2006, con 15 individuos y sus familiares, en un centro de rehabilitación de la región sur do Brasil. El cuidado de Enfermería integral ocurre con actividades de estimulación sensitiva, motora, control postural, amplitud de movimientos y entrenamiento de marcha, siempre acompañados por acciones de educación en salud. Estas habilidades confieren a los enfermeros capacidades de actuación, participando en la reducción de daños e incapacidadesThere can be serious damage to motor, sensatory, and perceptive capabilities when the brain suffers vascular alterations. With this in mind, the objective of this study is to report and share Nursing care to the individual who has suffered a cerebral vascular accident

  3. Autonomic cerebral vascular response to sildenafil in diabetic patient

    Al-Amran Fadhil G

    2012-01-01

    Full Text Available Abstract Background Erectile dysfunction is a common problem in type 2 diabetic patients who are at higher risk of cerebrovascular events, and it's recorded with sildenafil, a drug which is primarily used for erectile dysfunction. Objectives We tested the hypothesis whether or not sildenafil modulates cerebrovascular reactivity (CVR in patients with type 2 diabetes mellitus. Methods A total of 35 male participants were enrolled; eighteen with type 2 diabetes mellitus matched with seventeen normal individuals. Transcranial Doppler Ultrasonographic examination (TCD was performed for all participants to insonate the middle cerebral artery (MCA through a trans-temporal window. CVR was assessed by using breath holding (BH-hyperventilation (HV test, before and after oral 50 mg sildenafil; recordings were analyzed by using SPSS program version 12. Results In normal individuals, sildenafil did not result in statistically significant change in breath holding index (BHI from 0.91 ± 0.11 to 0.81 ± 0.09 and full range of vasodilatation (FVD from (59.4% ± 6.3% to (53.7% ± 4.9%. In diabetic patients, giving sildenafil resulted in significant increase in BHI (from 0.74 ± 0.14 to 1.03 ± 0.14 and FVD (from 60.2% ± 4.96% to 74% ± 4.8%, (p Conclusion Sildenafil significantly improves CVR in type 2 diabetic patients but not in normal subjects.

  4. Cerebral blood flow single-photon emission tomography with 123I-IMP in vascular dementia

    Cerebral blood flow differences between patients with vascular dementia, patients with multiple lacunar infarction without cognitive dysfunction, and age-matched controls were examined. Thirty four patients with vascular dementia (VD) were selected from consecutive referrals to the Memory Clinic at Narita Memorial Hospital. All the patients had routine assessment including history, physical and neurological examinations, neuropsychological assessment, blood tests, EEG, head MRI, and single photon emission computed tomography (SPECT). All of them fulfilled the NINDS-AIREN diagnostic criteria for vascular dementia. Thirty nine patients with multiple lacunar infarction without cognitive dysfunction and 110 age-matched controls were included in this study. Mean cerebral blood flow (mCBF) and regional cerebral blood flow (rCBF) were measured using N-isopropyl-P-123I-iodoamphetamine (123I-IMP) and SPECT imager. The mCBF in VD was 27.6±5.3 ml/100 g/min, while those in the control group and multiple lacunar infarction without cognitive dysfunction were 36.6±6.1 ml/100 g/min and 32.5±5.5 ml/100 g/min, respectively. The patients with VD demonstrated significantly reduced mCBF and rCBF in twenty regions including both cerebellar hemispheres as compared with those of the control group. Although there was no significant rCBF differences in bilateral inferior occipital regions and the right cerebellar hemisphere between patients with VD and multiple lacunar infarction without cognitive dysfunction, we could find significant lower rCBF in the remaining brain areas. In spite of the severity of VD, the diffuse decrease of cerebral blood flow was recognized in all patients with VD. (author)

  5. A família também adoece!: mudanças secundárias à ocorrência de um acidente vascular encefálico na família

    Eliana Sales Brito

    2008-12-01

    Full Text Available Este estudo buscou compreender o impacto da doença incapacitante na família de pacientes vítimas de acidente vascular encefálico (AVE, investigando as mudanças de ordem estrutural, social e emocional. Foram analisadas nove famílias de pacientes com primeiro episódio de AVE identificados pelo registro geral de doenças do Hospital São Rafael, Salvador, Bahia. A coleta dos dados foi realizada mediante aplicação de questionário, roteiro de entrevista, escala de avaliação funcional e observações registradas em diário de campo. O método empregado para análise dos dados foi o discurso do sujeito coletivo, produzindo representações sociais e transformando em um só discurso a fala dos sujeitos pesquisados. Constatou-se que a ocorrência de um AVE é uma experiência marcada por bruscas transformações no cotidiano familiar e na vida de cada um de seus membros. Os resultados indicam a necessidade de se habilitar a família para o cuidado ao paciente e para o autocuidado.

  6. Effects of ginsenosides on vascular reactivity in rat cerebral and renal arteries

    WONG Wing-tak; LEUNG Fung-ping; YUNG Lai-hang; TIAN Xiao-yu; WONG Ricky Ngok Shun; HUANG Yu

    2008-01-01

    Objective To investigate possible mechanisms underlying the antioxidant property (1) and the in vitro vasodilator effects (2) of the two ginsenosides, Rb1 and Rg1, in isolated rat renal and cerebral arteries. Methods Arterial rings were mounted in a multi-channel myograph for recording of isometric tension. To examine the antioxidant activity, some rings were exposed to a free radical-generating reaction (hypoxan-thine and xanthine oxidase) with and without pre-treatment with ginsenosides. The calcium antagonistic effects were tested on rings contracted by membrane depolarization in elevated extracellular potassium ions, a condition that promoted Ca2+ influx in vascular smooth muscle cells. Results Ginsenosides protected endothelial function (endothelial nitric oxide-dependent relaxation) against oxidative stress; (2) ginsenoside Rb1 reduced the high K+ -induced contractions of both renal and cerebral arteries while ginsenoside Rgl relaxed the rat cerebral artery but not the renal artery. Conclusions Ginsenosides are vaso-protective via (1) the antioxidant activity which protects endothelial cell function and (2) the inhibition of Ca2+ influx through voltage-sensitive Ca2+ channels in vascular smooth muscle. The vasodilator effects may suggest the potential preventive or therapeutic values of ginsenosides against stroke and renal hypertension.

  7. Fatores de risco para acidente vascular encefálico após cirurgia de revascularização do miocárdio Risk factors for stroke after coronary artery bypass grafting

    Dinaldo Cavalcanti de Oliveira

    2008-10-01

    Full Text Available FUNDAMENTO: O acidente vascular encefálico (AVE é uma temida complicação após cirurgia de revascularização do miocárdio (CRM, com incidência entre 1,3% e 4,3%. OBJETIVO: Identificar fatores preditores de AVE após CRM, na era moderna da cirurgia cardíaca. MÉTODOS: Este é um estudo caso-controle de 65 pares de pacientes, no qual o pareamento foi realizado por sexo, idade (+ 3 anos e data da CRM (+ 3 meses. Os casos são pacientes submetidos à CRM eletiva com circulação extracorpórea (CEC, que apresentaram AVE (definido como déficit clínico neurológico até 24 horas de pós-operatório e confirmado por exame de imagem, e os controles aqueles submetidos à CRM eletiva com CEC sem AVE. RESULTADOS: A análise univariada revelou que o número de vasos revascularizados foi associado com a ocorrência de AVE após a CRM (3 ± 0,8 vs. 2,76 ± 0,8, p = 0,01. Na análise multivariada por regressão logística condicional, a hipertensão arterial sistêmica [OR: 6,1 (1,5 - 24, p = 0,009] e o diabete melito [OR: 3,1 (1,09 - 11, p= 0,03] foram determinantes de maior chance de AVE após CRM, e o infarto agudo do miocárdio > 1 mês determinante de menor chance [OR: 0,1 (0,03 - 0,36, p = 0,003]. CONCLUSÃO: Hipertensão e diabete melito foram identificados como preditores independentes de AVE nas primeiras 24 horas de pós-operatório de CRM. Em pacientes com tais fatores de risco, é possível que o conhecimento dos mecanismos causadores da injúria cerebral represente uma estratégia capaz de diminuir a incidência de AVE após CRM.BACKGROUND: Stroke is a feared complication after coronary artery bypass grafting surgery (CABG, with an incidence between 1.3 and 4.3%. OBJECTIVE: To identify predictive factors for stroke after CABG in the modern era of cardiac surgery. METHODS: This is a case-control study of 65 pairs of patients, paired by sex, age (+ 3 years and date of CABG (+ 3 months. The cases were patients submitted to elective CABG

  8. Regional cerebral blood flow in vascular depression assessed by 123I-IMP SPECT

    As the prevalence of white matter hyperintensities detected on T2 weighted MRI scans in patients with late-onset depression is higher than that in nondepressed patients, the concept of ''vascular depression'' (VDep) was introduced in 1997. However, the pathology of vascular depression has not been clarified. This study examined the differences in functional imaging between vascular and non-vascular depression (non-VDep). We utilized 123I-IMP single photon emission computed tomography (SPECT) to compare regional cerebral blood flows (rCBF) between 9 patients with VDep (Krishnan criteria) and 11 age- and sex-matched patients with non-VDep in both depressed and remitted states. In both VDep and non-VDep patients, mean rCBF increased significantly as depression improved, partially aided by changes in left anterior temporal blood flow. In addition, compared to non-VDep patients, the left anterior frontal rCBF for VDep patients was significantly lower in both depressed and remitted states. Left anterior temporal rCBF therefore appears to represent a state marker that increases as symptoms associated with late-onset depression improve, regardless of vascular changes. Furthermore, in VDep patients, left anterior frontal rCBF was low in both states compared to non-VDep patients, and might not only represent a trait marker, but also correlated with the duration of disease and likelihood of recurrence and relapse. (author)

  9. Cerebral ischemia upregulates vascular endothelin ET(B) receptors in rat

    Stenman, Emelie; Malmsjö, Malin; Uddman, Erik; Gidö, Gunilla; Wieloch, Tadeuz; Edvinsson, Lars

    2002-01-01

    BACKGROUND AND PURPOSE: Elevated levels of endothelin-1 (ET-1) have been reported in cerebral ischemia. A role for ET may prove more important if the vascular receptors were changed. We addressed whether there is any change in ET receptor expression in cerebral ischemia. METHODS: The right middle......, calculated as percentage of the contractile capacity of 63.5 mmol/L K+]=68+/-68%; P<0.0001), while there was no difference in the responses to ET-1 after cerebral ischemia. Real-time polymerase chain reaction revealed a significant upregulation of both the ET(A) and ET(B) receptors (both P<0.05) in the...... occluded MCA compared with the nonoccluded MCA from the same rats. CONCLUSIONS: Focal cerebral ischemia in rat induces increased transcription of both ET(A) and ET(B) receptors, which results in the appearance of a contractile response to the ET(B) receptor agonist S6c. These results suggest a role for ET...

  10. Late radiation encephalopathy in the dog. A model for cerebral vascular disease

    The Research Group on Industrial and Environmental Neurology has suggested that assessment of cerebral atherosclerosis should be considered as part of its purview of problems of interest. Although the present study is not related to the ordinary environmental or industrial situation, it can apply to accidental over-exposure to external ionizing radiation or radiation therapy and describes an animal model that can be used for fundamental study of cerebral vascular conditions and encephalomalacia. Ionizing radiation damage to nervous tissue may be apparent early after irradiation or may become evident after a variable latent period. The concept of late ionizing radiation-induced neuropathy, the subject of this study, is characterized by a long latent period between exposure and initial clinical signs, an inverse relationship between radiation dose and latency of appearance of late radiation encephalopathy, and an apparent lack of demonstrable physiological, biochemical, and morphological alterations until necrosis becomes manifest. (U.S.)

  11. A case of radiation necrosis with vascular changes on main cerebral arteries

    A 64-year-old woman had received radiotherapy, following surgery of a chromophobe putuitary adenoma. Six years after irradiation she began to complain of headache and dementia. Right vertebrogram demonstrated a right temporal mass lesion, stenosis and dilatation of middle cerebral artery and posterior communicating artery in the field of irradiation. CT scan showed the irregular low density area at the right temporal region, and the irregular enhancement after an intravenous injection of contrast medium was seen at the small part of affected area. From these findings, radiation necrosis at the right temporal lobe was diagnosed. As vascular changes of the main cerebral arteries due to radiation are rare, we discussed on them from ever reported literature. (author)

  12. Estimation of cerebral vascular tone during exercise; evaluation by critical closing pressure in humans

    Ogoh, Shigehiko; Brothers, R Matthew; Jeschke, Monica;

    2010-01-01

    . In addition, the increases in CCP were related to the increases in plasma noradrenaline concentrations (right, P = 0.001; left, P = 0.025) and decreases in the partial pressure of arterial carbon dioxide (right, P = 0.008; left, P = 0.086), but not to changes in mean arterial pressure (right, P = 0.......282; left, P = 0.564) or adrenaline concentrations (right, P = 0.138; left, P = 0.108). We consider that an exercise-induced increase in cerebral vascular tone serves to protect the blood-brain barrier from the exercise-induced hypertension....

  13. Effect of preceding exercise on cerebral and splanchnic vascular responses to mental task

    Someya Nami

    2012-06-01

    Full Text Available Abstract Background To investigate the effect of preceding acute exercise on the peripheral vascular response to a mental task, we measured splanchnic and cerebral blood flow responses to performing a mental task after exercise and resting. Methods In the exercise trial, 11 males exercised for 30 min on a cycle ergometer with a workload set at 70% of the age-predicted maximal heart rate for each individual. After a 15-min recovery period, the subjects rested for 5 min for pre-task baseline measurement and then performed mental arithmetic for 5 min followed by 5 min of post-task measurement. In the resting trial, they rested for 45 min and pre-task baseline data was obtained for 5 min. Then mental arithmetic was performed for 5 min followed by post-task measurement. We measured the mean blood velocity in the middle cerebral artery and superior mesenteric artery and the mean arterial pressure. Results Mean arterial pressure and mean blood velocity in the middle cerebral artery were significantly higher than the baseline during mental arithmetic in both exercise and resting trials. Mean blood velocity in the middle cerebral artery during mental arithmetic was greater in the control trial than the exercise trial. Mean blood velocity in the superior mesenteric artery showed no significant change during mental arithmetic from baseline in both trials. Conclusion These results suggest that acute exercise can moderate the increase in cerebral blood flow induced by a mental task.

  14. Stabiliztin of VEGFR2 Signaling by Cerebral Cavernous Malformation 3 is Critical for Vascular Development

    Y He; H Zhang; L Yu; M Gunel; T Boggon; H Chen; W Min

    2011-12-31

    Cerebral cavernous malformations (CCMs) are human vascular malformations caused by mutations in three genes of unknown function: CCM1, CCM2, and CCM3. CCM3, also known as PDCD10 (programmed cell death 10), was initially identified as a messenger RNA whose abundance was induced by apoptotic stimuli in vitro. However, the in vivo function of CCM3 has not been determined. Here, we describe mice with a deletion of the CCM3 gene either ubiquitously or specifically in the vascular endothelium, smooth muscle cells, or neurons. Mice with global or endothelial cell-specific deletion of CCM3 exhibited defects in embryonic angiogenesis and died at an early embryonic stage. CCM3 deletion reduced vascular endothelial growth factor receptor 2 (VEGFR2) signaling in embryos and endothelial cells. In response to VEGF stimulation, CCM3 was recruited to and stabilized VEGFR2, and the carboxyl-terminal domain of CCM3 was required for the stabilization of VEGFR2. Indeed, the CCM3 mutants found in human patients lacking the carboxyl-terminal domain were labile and were unable to stabilize and activate VEGFR2. These results demonstrate that CCM3 promotes VEGFR2 signaling during vascular development.

  15. Arteriolosclerosis in the cerebral white matter in Binswanger type vascular dementia

    We evaluated the arteriolar adventitial proliferative rate (AP) in the white matter of 118 autopsied brains (58 control cases, C group; 43 hypertensive cases, HT group; and 17 Binswanger type vascular dementia cases, VD group), together with the sclerotic rate (AS) of the middle cerebral artery. In the C group, AP increased with age, advancing rapidly in subjects over 80 years old. In contrast, AS increased slowly in subjects over 80 years old. There was no difference between AS in the VD and HT groups, while the VD group showed a greater AP than did the HT group. The results of CT scans performed in 45 cases revealed that while AP demonstrated a significant correlation with leukoaraiosis(LA), AS showed no such correlation. Our results suggest that arteriolar adventitial proliferation plays a more important role in the onset of Binswanger type vascular dementia and the progress of LA. We also observed a strong relationship between ischemic changes in the cerebral white matter and arteriolar adventitial proliferation. (author)

  16. The physical burden from the perspective of the caregivers of aged family members after a cerebral vascular accident

    Alessandra Peregrine Primo

    2010-11-01

    Full Text Available A proposta deste estudo é refletir sobre o ônus físico (burden enfrentado pelas cuidadoras de idosos dependentes, visto pela ótica da própria cuidadora ao longo da sua experiência no desempenho do seu papel, após um ou mais episódios de acidente vascular cerebral (AVC de pessoa idosa necessitada de cuidados e com perdas de independência física. É uma pesquisa com dados qualitativos realizada no município de Toledo ? PR, em 2004, com cuidadores de oito adultos acometidos por AVC após a alta hospitalar, tendo a cuidadora mais de 50 anos de idade. O procedimento metodológico foi a pesquisa empírica através do uso de questionários aplicados em visitas domiciliares. O instrumento da pesquisa foi composto para contextualizar a sobrecarga do cuidador através da coleta de informações sobre as sensações de seu ônus físico frente às suas tarefas e cuidados com o familiar dependente e dar visibilidade a indicadores de ônus e desgaste do cuidador familiar de idosos para ampliar a visão de elementos subjetivos que compõem as perdas que ocorrem nos cuidadores de idosos dependentes sem apoios externos. Esta dissertação contém três capítulos, além da introdução e das considerações finais. O trabalho está dividido em: o envelhecimento populacional, os desafios enfrentados pelos idosos com as doenças crônico-degenerativas e as dependências instaladas, o ônus emocional e social dos cuidadores, com ênfase no ônus físico. Os dados da pesquisa e seus resultados completam o estudo. Espera-se ter colaborado para aprofundar o conhecimento referente ao cuidador familiar e ao ônus que experimenta, seja ele, físico, emocional e ou social, tendo em vista que a sobrecarga vivida pelo cuidador depende de fatores como estresse, isolamento social, dentre outros, e não apenas do grau de incapacidade do idoso, sendo de grande importância o significado das mudanças e acréscimo nas tarefas diárias para o cuidador. Os resultados

  17. Prediction of vascular cerebral accidents by PET T.D.M. with 18F-F.D.G

    This study is the first to show a relationship between the vascular captation of the F.D.G. in PET and the risk of a later ischemic cerebral vascular accident. this relation seems particularly strong for the sources of the carotids junction, so that the PET with F.D.G. could be useful to evaluate the stability of atheromas injuries in this area. (N.C.)

  18. Regional cerebral blood flow analysis of vascular dementia by the single photon emission computed tomography

    In order to evaluate the relationship between the regional cerebral blood flow (CBF) and cerebrovascular dementia, eleven patients with vascular dementia and eight patients with non-demented infarction were studied and regional CBF were measured quantitatively with single photon emission computed tomography (SPECT) by using N-isopropyl-p-(I-123) iodoamphetamine. All cases were basal infarction and vascular dementia were diagnosed by less than 21.5 of the Hasegawa's dementia score and more than 7 of Hachinsk's ischemic score. The results of the present study were as follows: (1) Cerebrovascular dementia showed lower mean CBF value compared with non-demented group. (2) Regional CBF of bilateral frontal areas and affected basal ganglia were significantly reduced than occipital area in the dementia group. (3) A comparison of regional CBF and the Hasegawa's dementia score revealed a statistically significant correlation at the bilateral frontal areas in the dementia group. It is possible that measuring the regional CBF quantitatively by IMP-SPECT is useful for clinical analysis of vascular dementia. (author)

  19. Efeitos da facilitação neuromuscular proprioceptiva na estabilidade postural e risco de quedas em pacientes com sequela de acidente vascular encefálico: estudo piloto Efectos de la facilitación neuromuscular propioceptiva en la estabilidad postural y riesgo de caídas en pacientes con secuela de accidente vascular encefálico: estudio piloto Effects of proprioceptive neuromuscular facilitation in postural stability and risk of falls in patients with sequelae of stroke: pilot study

    Natália Noman de Lacerda; Érika Baptista Gomes; Hudson Azevedo Pinheiro

    2013-01-01

    O controle do tronco é uma habilidade motora básica necessária para executar diversas tarefas funcionais, e é deficiente em pacientes que sofreram acidente vascular encefálico (AVE). Objetivo: Avaliar o efeito do método facilitação neuromuscular proprioceptiva (PNF) na estabilidade postural e risco de quedas em pacientes com sequela de AVE. Metodologia: Foi realizado estudo de intervenção que consistiu em treinamento da estabilidade postural por meio de um protocolo fixo constituído por 5 exe...

  20. Hemorrhagic stroke after naphazoline exposition: case report Acidente vascular encefálico hemorrágico após exposição à nafazolina: relato de caso

    Jorge A.A. Zavala

    2004-09-01

    Full Text Available Ten percent of all strokes are due to spontaneous cerebral hemorrhages. They are associated to drugs (licit and illicit in 9.5% of all cases in young adults. This is a case report of a 44-year-old man, without previous morbidities, who presented a sudden onset headache and arterial hypertension 24 hours after use of naphazoline as nasal decongestant. Cranial tomography showed right thalamus hemorrhage. Cerebral angiography showed no aneurisms, vascular malformations or vasculitis. No other risk factors were found during investigation in this patient and the stroke was attributed to naphazoline exposition.Dez por cento de todos os eventos vasculares encefálicos são devido às hemorragias intracerebrais espontâneas, associados a drogas (lícitas e ilícitas em 9,5% de todos os casos em adultos jovens. Relatamos o caso de um homem de 44 anos de idade, sem doenças prévias, que apresentou cefaléia súbita e hipertensão arterial 24 horas após o uso de congestionante nasal contendo nafazolina. A tomografia de crânio evidenciou hemorragia talâmica. Durante a investigação não foram encontrados outros fatores de risco e a hemorragia foi atribuída à exposição à nafazolina.

  1. Ways of improving three-dimensional CT angiography images of cervical and cerebral vascular lesions

    We evaluated various ways of improving the image clarity of three-dimensional CT angiography (3D-CTA) for the diagnosis of cervical and cerebral vascular disease in sixty-seven patients (36 males and 31 females). The mean age was 61.4 years, with a rang of 17 to 89 years. The patients were examined with a helical CT scanner (TCT-X vision GX) after intravenous bolus injection of 90 ml nonionic contrast medium (300 mgI/ml) at the rate of 3 ml/sec. Intracranial and cervical 3D-CTA were performed 60 and 12 times, respectively. Our findings were as follows: Reduction of the pre-scanning delay time from 18 to 10 sec after the injection of the contrast medium eliminates much of the cavernous sinus from the image and makes it easier to distinguish the intracavernous internal carotid artery in intracranial 3D-CTA. In cervical 3D-CTA, reduction of the pre-scanning delay time from 15 to 9 sec delays imaging of the jugular vein and makes it easy to distinguish the bifurcation of the common carotid artery. A subtraction image on 3D-CTA is useful for detecting of vascular lesions adjacent to bone, such as lesions on the internal carotid artery. By producing a stereo picture, a closer three-dimensional relationship between the vascular lesion and the vessel circumference organization can be recognized. Vascular lesions can be clearly visualized from inside the artery using a 3D-CT endoscopic image. We were able to obtain a great deal of detailed information from 3D-CTA images with these modifications and we believe they enhance diagnostic accuracy of the technique. (author)

  2. Inhibition of cerebral vascular inflammation by brain endothelium-targeted oligodeoxynucleotide complex.

    Hu, Jing; Al-Waili, Daniah; Hassan, Aishlin; Fan, Guo-Chang; Xin, Mei; Hao, Jiukuan

    2016-08-01

    The present study generated a novel DNA complex to specifically target endothelial NF-κB to inhibit cerebral vascular inflammation. This DNA complex (GS24-NFκB) contains a DNA decoy which inhibits NF-κB activity, and a DNA aptamer (GS-24), a ligand of transferrin receptor (TfR), which allows for targeted delivery of the DNA decoy into cells. The results indicate that GS24-NFκB was successfully delivered into a murine brain-derived endothelial cell line, bEND5, and inhibited inflammatory responses induced by tumor necrosis factor α (TNF-α) or oxygen-glucose deprivation/re-oxygenation (OGD/R) via down-regulation of the nuclear NF-κB subunit, p65, as well as its downstream inflammatory cytokines, inter-cellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule (VCAM-1). The inhibitory effect of the GS24-NFκB was demonstrated by a significant reduction in TNF-α or OGD/R induced monocyte adhesion to the bEND5 cells after GS24-NFκB treatment. Intravenous (i.v.) injection of GS24-'NFκB (15mg/kg) was able to inhibit the levels of phoseph-p65 and VCAM-1 in brain endothelial cells in a mouse lipopolysaccharide (LPS)-induced inflammatory model in vivo. In conclusion, our approach using DNA nanotechnology for DNA decoy delivery could potentially be utilized for inhibition of inflammation in ischemic stroke and other neuro-inflammatory diseases affecting cerebral vasculature. PMID:27132231

  3. Multichannel optical brain imaging to separate cerebral vascular, tissue metabolic, and neuronal effects of cocaine

    Ren, Hugang; Luo, Zhongchi; Yuan, Zhijia; Pan, Yingtian; Du, Congwu

    2012-02-01

    Characterization of cerebral hemodynamic and oxygenation metabolic changes, as well neuronal function is of great importance to study of brain functions and the relevant brain disorders such as drug addiction. Compared with other neuroimaging modalities, optical imaging techniques have the potential for high spatiotemporal resolution and dissection of the changes in cerebral blood flow (CBF), blood volume (CBV), and hemoglobing oxygenation and intracellular Ca ([Ca2+]i), which serves as markers of vascular function, tissue metabolism and neuronal activity, respectively. Recently, we developed a multiwavelength imaging system and integrated it into a surgical microscope. Three LEDs of λ1=530nm, λ2=570nm and λ3=630nm were used for exciting [Ca2+]i fluorescence labeled by Rhod2 (AM) and sensitizing total hemoglobin (i.e., CBV), and deoxygenated-hemoglobin, whereas one LD of λ1=830nm was used for laser speckle imaging to form a CBF mapping of the brain. These light sources were time-sharing for illumination on the brain and synchronized with the exposure of CCD camera for multichannel images of the brain. Our animal studies indicated that this optical approach enabled simultaneous mapping of cocaine-induced changes in CBF, CBV and oxygenated- and deoxygenated hemoglobin as well as [Ca2+]i in the cortical brain. Its high spatiotemporal resolution (30μm, 10Hz) and large field of view (4x5 mm2) are advanced as a neuroimaging tool for brain functional study.

  4. Structure and vascular function of MEKK3–cerebral cavernous malformations 2 complex

    Fisher, Oriana S. [Yale Univ., New Haven, CT (United States); Deng, Hanqiang [Shanghai Jiao Tong Univ. School of Medicine (SJTU-SM), Shanghai (China); Liu, Dou [Yale Univ. School of Medicine, New Haven, CT (United States); Zhang, Ya [Yale Univ. School of Medicine, New Haven, CT (United States); Wei, Rong [Shanghai Jiao Tong Univ. School of Medicine (SJTU-SM), Shanghai (China); Deng, Yong [Yale Univ. School of Medicine, New Haven, CT (United States); Zhang, Fan [Yale Univ. School of Medicine, New Haven, CT (United States); Louvi, Angeliki [Yale Univ. School of Medicine, New Haven, CT (United States); Turk, Benjamin E. [Yale Univ., New Haven, CT (United States); Boggon, Titus J. [Yale Univ., New Haven, CT (United States); Su, Bing [Shanghai Jiao Tong Univ. School of Medicine (SJTU-SM), Shanghai (China)

    2015-08-03

    Cerebral cavernous malformations 2 (CCM2) loss is associated with the familial form of CCM disease. The protein kinase MEKK3 (MAP3K3) is essential for embryonic angiogenesis in mice and interacts physically with CCM2, but how this interaction is mediated and its relevance to cerebral vasculature are unknown. Here we report that Mekk3 plays an intrinsic role in embryonic vascular development. Inducible endothelial Mekk3 knockout in neonatal mice is lethal due to multiple intracranial haemorrhages and brain blood vessels leakage. We discover direct interaction between CCM2 harmonin homology domain (HHD) and the N terminus of MEKK3, and determine a 2.35 Å cocrystal structure. We find Mekk3 deficiency impairs neurovascular integrity, which is partially dependent on Rho–ROCK signalling, and that disruption of MEKK3:CCM2 interaction leads to similar neurovascular leakage. We conclude that CCM2:MEKK3-mediated regulation of Rho signalling is required for maintenance of neurovascular integrity, unravelling a mechanism by which CCM2 loss leads to disease.

  5. Alterações eletromiográficas dos músculos do tronco de pacientes com hemiparesia após acidente vascular encefálico Electromyographic alterations of trunk muscle of patients with post-stroke hemiparesis

    Fernando Cesar Iwamoto Marcucci

    2007-09-01

    Full Text Available O acidente vascular encefálico é a principal causa de incapacidade crônica em adultos, porém poucos estudos avaliaram a motricidade do tronco nestes indivíduos. OBJETIVO: Comparar a atividade mioelétrica do tronco entre indivíduos hemiparéticos e controle. MÉTODO: Foram avaliados oito indivíduos hemiparéticos e oito controles, por meio de eletromiografia de superfície (EMGs, durante atividades de flexão dos membros inferiores e rotação do tronco em supino; levantar e elevação dos membros superiores na posição sentada. RESULTADOS: O músculo reto abdominal parético apresentou maior ativação que o grupo controle (p=0,031 durante a flexão dos membros inferiores. Os músculos oblíquos apresentaram, bilateralmente, maior ativação na elevação dos membros inferiores do que na rotação (p=0,014 e p=0,002, respectivamente. Não houve diferenças entre músculos eretores durante as atividades. CONCLUSÃO: Os músculos flexores do tronco de indivíduos hemiparéticos apresentaram alterações motoras no reto abdominal do lado parético e realizam compensações por meio dos oblíquos externos.Stroke is the main cause of chronic disability in adults, but few studies evaluated the trunk motor activity in affected subjects. OBJECTIVE: To compare the myoelectrical activity of trunk muscle in hemiparetic and control subjects. METHOD: Eight hemiparetic and eight control subjects were assessed during lower extremities flexion and trunk rotation in supine position; stand up and rise up upper extremities in seated position. RESULTS: Paretic rectus abdominis presented a higher activation than control group (p=0.031 during lower extremities elevation. Obliquus externus abdominis showed a bilateral higher activation during lower extremities elevation than rotation activities (p=0.014 and p=0.002, respectively. There was no difference in extension activities comparison. CONCLUSION: Trunk flexor muscles of hemiparetic subjects demonstrated

  6. ESTUDOS SOBRE ABORDAGENS TERAPÊUTICAS PARA O ACIDENTE VASCULAR ENCEFÁLICO (AVE EM MODELO ANIMAL: USO DE CÉLULAS DERIVADAS DE MEDULA ÓSSEA E DE FLAVONOIDES

    Arthur Giraldi-Guimarães

    2012-01-01

    Full Text Available O Acidente Vascular Encefálico é a maior causa de incapacitação em seres humanos adultos, representandoatualmente um grande custo pessoal e social. Empregando modelos experimentais de lesões cerebrais focais,este projeto tem como objetivo geral avaliar o efeito benéfico de abordagens terapêuticas promissoras notratamento do AVE e de outras lesões cerebrais. Em estudos concluídos, tivemos como objetivo principalavaliar a capacidade de indução de recuperação funcional em testes sensorimotores pelas terapias comcélulas derivadas de medula óssea e com o flavonoide rutina. Foram utilizados o modelo de isquemia corticalfocal unilateral por termocoagulação dos vasos cortical superficiais, e o modelo da ablação cortical focalunilateral por sucção, ambos causando lesão de mesma localização e extensão. Nossos resultados mostraramque as células mononucleares de medula óssea (MNMOs e as células-tronco mesenquimais (CTMs foramcapazes de promover recuperação de função sensorimotora em testes de movimentos menos sofisticados, em21ambos os modelos de lesão. Entretanto, as MNMOs não promoveram aumento da recuperação demovimentos de destreza, que envolvem treinamento, como agarrar uma pílula de ração. No estudo com oflavonoide rutina, demonstramos que houve promoção de recuperação sensorimotora após a isquemia, e estase correlacionou com uma ação neuroprotetora do flavonoide. Nossos resultados sugerem que tanto asMNMOs e como a rutina podem ser utilizados como terapias eficazes para o tratamento de lesões cerebrais,quando administradas na fase aguda da doença. Os estudos precisam ser aprofundados no sentido de ampliaros conhecimentos sobre os seus respectivos mecanismos celulares e moleculares de ação.

  7. Modulatory effects of seabuckthorn (Hippophae rhamnoides L.) in hypobaric hypoxia induced cerebral vascular injury.

    Purushothaman, Jayamurthy; Suryakumar, Geetha; Shukla, Dhananjay; Malhotra, Anand Swaroop; Kasiganesan, Harinath; Kumar, Ratan; Sawhney, Ramesh Chand; Chami, Arumughan

    2008-11-25

    Cerebral edema caused by vascular leakage is a major problem in various injuries of the CNS, such as stroke, head injury and high-altitude illness. A common feature of all these disorders is the fact that they are associated with tissue hypoxia. Hypoxia has been suggested to be a major pathogenic factor for the induction of vascular leakage in the brain. The objective of the present study was to evaluate potential of seabuckthorn (SBT) (Hippophae rhamnoides L.) seed oil in curtailing hypoxia induced transvascular fluid leakage in brain of hypoxia-exposed rats. Exposure of animals to hypobaric hypoxia (9144 m, 5h) caused a significant increase in the transvascular leakage studied by measuring water content and leakage of sodium fluorescein dye in the brain. Hypoxic stress also significantly enhanced the oxidative stress markers such as free radicals and malondialdehyde and it accompanied with decreased levels of antioxidants such as glutathione, glutathione peroxidase and superoxide dismutase. Pretreatment of animals with SBT seed oil significantly restricted the hypoxia induced increase in fluorescein dye leakage suggesting protection against hypoxia induced transvascular leakage in the brain. Hypoxia induced increase in the levels of free radicals and malondialdehyde were significantly lowered after SBT pretreatment. The SBT seed oil pretreatment also resulted in the significantly improved hypoxic tolerance as evidenced by increased hypoxic gasping time and survival time and decreased plasma catecholamine levels, as compared to hypoxic animals. These observations suggest that SBT seed oil possesses significant hypoxia protection activity and curtailed hypoxia induced enhanced vascular leakage in the brain. PMID:18824077

  8. Atuação da enfermagem no autocuidado e reabilitação de pacientes que sofreram Acidente Vascular Encefálico Actuación de la enfermería en el autocuidado y rehabilitación de pacientes que sufreran Accidente Nursing activities in self-care and rehabilitation of patients who suffered Stroke

    Juliana Cristina Lessmann; Fernanda De Conto; Greice Ramos; Míriam Susskind Borenstein; Betina Homer Schlindwein Meirelles

    2011-01-01

    Quando o cérebro sofre alterações vasculares podem ocorrer sérias sequelas motoras, sensoriais e na percepção. Nesta perspectiva o estudo objetiva relatar/ compartilhar assistência de Enfermagem ao indivíduo acometido pelo Acidente Vascular Encefálico enfatizando a reabilitação e o autocuidado baseado em Orem. Trata-se de relato de experiência de prática assistencial, realizada de maio a julho de 2006, com 15 indivíduos e seus familiares, em um centro de reabilitação da região sul do Brasil. ...

  9. Vascular endothelial growth factor induced angiogenesis following focal cerebral ischemia/reperfusion injury in rabbits

    Huaijun Liu; Jiping Yang; Fenghai Liu; Qiang Zhang; Hui Li

    2006-01-01

    BACKGROUND: Therapeutic angiogenesis has opened up new pathway for the treatment of ischemic cerebrovascular disease in recent years. The exploration of the effect of vascular endothelial growth factor (VEGF) on inducing angiogenesis following ischemia/reperfusion injury can provide better help for the long-term treatment of cerebrovascular disease in clinic.OBJECTIVE: To observe the effect of VEGF on inducing angiogenesis following focal cerebral ischemia/reperfusion injury in rabbits through the angiogenesis of microvessels reflected by the expression of the factors of vascular pseudohemophilia.DESIGN: A randomized controlled animal trial.SETTING: Department of Medical Imaging, Second Hospital of Hebei Medical University.MATERIALS: Sixty-five healthy male New Zealand rabbits of clean degree, weighing (2.6±0.2) kg, aged4.5-5 months, were used. The polyclonal antibody against vascular pseudohemophilia (Beijing Zhongshan Company), recombinant VEGF165 (Peprotech Company, USA), biotinylated second antibody and ABC compound (Wuhan Boster Company) were applied.METHODS: The experiments were carried out in the Laboratory of Neuromolecular Imaging and Neuropathy,Second Hospital of Hebei Medical University from May to August in 2005. ① The rabbits were randomly divided into three groups: sham-operated group (n=15), control group (n=25) and VEGF-treated group(n=25). In the control group and VEGF-treated group, models were established by middle cerebral artery occlusion (MCAO) induced focal cerebral ischemia/reperfusion. In the VEGF-treated group, VEGF165(2.5 mg/L) was stereotactically injected into the surrounding regions of the infarcted sites immediately after the 2-hour ischemia/reperfusion; Saline of the same dosage was injected in the control group. But the rabobserved on the 3rd, 7th, 14th, 28th and 70th days of the experiment respectively, 3 rabbits in the sham-operated group and 5 in the control group and VEGF-treated group were observed at each time point. The

  10. Effects of acetazolamide on the micro- and macro-vascular cerebral hemodynamics: a diffuse optical and transcranial doppler ultrasound study

    Zirak, Peyman; Delgado-Mederos, Raquel; Martí-Fàbregas, Joan; Durduran, Turgut

    2010-01-01

    Acetazolamide (ACZ) was used to stimulate the cerebral vasculature on ten healthy volunteers to assess the cerebral vasomotor reactivity (CVR). We have combined near infrared spectroscopy (NIRS), diffuse correlation spectroscopy (DCS) and transcranial Doppler (TCD) technologies to non-invasively assess CVR in real-time by measuring oxy- and deoxy-hemoglobin concentrations, using NIRS, local cerebral blood flow (CBF), using DCS, and blood flow velocity (CBFV) in the middle cerebral artery, using TCD. Robust and persistent increases in oxy-hemoglobin concentration, CBF and CBFV were observed. A significant agreement was found between macro-vascular (TCD) and micro-vascular (DCS) hemodynamics, between the NIRS and TCD data, and also within NIRS and DCS results. The relative cerebral metabolic rate of oxygen, rCMRO2, was also determined, and no significant change was observed. Our results showed that the combined diffuse optics-ultrasound technique is viable to follow (CVR) and rCMRO2 changes in adults, continuously, at the bed-side and in real time. PMID:21258561

  11. Systemic and cerebral vascular endothelial growth factor levels increase in murine cerebral malaria along with increased calpain and caspase activity and can be reduced by erythropoietin treatment

    Casper eHempel

    2014-06-01

    Full Text Available The pathogenesis of cerebral malaria includes compromised microvascular perfusion, increased inflammation, cytoadhesion and endothelial activation. These events cause blood-brain barrier disruption and neuropathology and can be associated with the vascular endothelial growth factor (VEGF signalling pathway. We studied this pathway in mice infected with Plasmodium berghei ANKA causing murine cerebral malaria with or without the use of erythropoietin as adjunct therapy. ELISA and western blotting was used for quantification of VEGF and relevant proteins in brain and plasma. Cerebral malaria increased levels of VEGF in brain and plasma and decreased plasma levels of soluble VEGF receptor 2. Erythropoietin treatment normalised VEGF receptor 2 levels and reduced brain VEGF levels. Hypoxia-inducible factor (HIF-1α was significantly upregulated whereas cerebral HIF-2α and erythropoietin levels remained unchanged. Furthermore, we noticed increased caspase-3 and calpain activity in terminally ill mice, as measured by protease-specific cleavage of α-spectrin and p35. In conclusion, we detected increased cerebral and systemic VEGF as well as HIF-1α, which in the brain were reduced to normal in erythropoietin-treated mice. Also caspase and calpain activity was reduced markedly in erythropoietin-treated mice.

  12. CT features on increased cerebral vascular density and its pathological mechanism in patients with cyanotic congenital disease

    Objective: To investigate CT features on increased cerebral vascular density and its pathological mechanism in patients with cyanotic congenital heart disease (CCHD). Methods: Preoperative brain CT scan and clinical data in 82 patients suffering from CCHD were analyzed. According to the increased levels of vascular density, patients were divided into 4 groups: normal, mild, moderate and severe. Relationships between the increased levels of vascular density and Hb, RBC, HCT, as well as the degree of cyanosis,were studied. AVONA was carried out to test blood CT value of cerebral sinuses, Hb, RBC and HCT in different groups. Descriptive analysis and linear regression were adopted to study the correlation between blood CT value and Hb concentration. The relationship of increased vascular density to degrees of cyanosis was analysed by Spearman. Results: Among 82 patients, 12 patients (14.6%) were found in the group of normal vascular density and 70 patients (85.4%) in the increased vascular density group. Among 70 patients with increased vascular density, 22 patients (26.8% ) with (55.4 ± 2.6) HU, (169 ±6)g/L of Hb, (5.8 ±0.3) × 1012/L of RBC and 0.51 ±0.03 of HCT, 29 patients (35.4%) with (61.3 ± 2.9) HU, (209 ± 15 ) g/L, (7.1 ± 0.4) × 1012/L, 0.66 ± 0.06 and 19 patients (23.2%) with (68.8 ± 4.2) HU, (242 ± 23) g/L, (8.3 ± 0.9) × 1012/L, 0.78 ± 0.08 were observed in the mild,moderate and severe group,respectively. There were significant differences in distribution of blood CT value (HU), Hb, RBC and HCT in different groups (F=163.263, 134.703, 120.974, 136.541; P<0.01). Blood CT value was positively correlated with Hb concentration (r=0.98, P<0.01). Vascular density was also positively correlated with the degree of cyanosis (r=0.86, P<0.01). Conclusions: Cerebral vascular density of patients suffering from CCHD presented different levels of increases based on CT scan results due to rise of RBC stimulated by anoxia. The increased level of vascular density

  13. No Additional Prognostic Value of Genetic Information in the Prediction of Vascular Events after Cerebral Ischemia of Arterial Origin: The PROMISe Study

    Achterberg, Sefanja; Kappelle, L. Jaap; de Bakker, Paul I.W.; Traylor, Matthew; Algra, Ale; ,

    2015-01-01

    Background Patients who have suffered from cerebral ischemia have a high risk of recurrent vascular events. Predictive models based on classical risk factors typically have limited prognostic value. Given that cerebral ischemia has a heritable component, genetic information might improve performance of these risk models. Our aim was to develop and compare two models: one containing traditional vascular risk factors, the other also including genetic information. Methods and Results We studied ...

  14. Real-time high resolution laser speckle imaging of cerebral vascular changes in a rodent photothrombosis model

    Liu, Qi; Li, Yao; Hongyang LU; Tong, Shanbao

    2014-01-01

    The study of hemodynamic and vascular changes following ischemic stroke is of great importance in the understanding of physiological and pathological processes during the thrombus formation. The photothrombosis model is preferred by researchers in stroke study for its minimal invasiveness, controllable infarct volume and lesion location. Nevertheless, there is a lack in high spatiotemporal resolution techniques for real time monitoring of cerebral blood flow (CBF) changes in 2D-profile. In th...

  15. Assistance of nursing for the person with cerebral vascular accident - a proposal of study in municipal hospital

    Shirley Rangel Gomes; Monica de Castro Maia Senna

    2007-01-01

    The present study it has for objective to investigate the profile of the customers with Cerebral Vascular Accident taken care of in the Service of Rehabilitation of municipal Hospital, form to characterize its social, economic and demographic condition, the diagnostic and the behaviors of nursing with sights to trace the elaboration of protocols for the nursing assistance. It is configured as a descriptive, comparative research, of quali-quantitative nature in the field of the assistance. The...

  16. Minocycline inhibits neuroinflammation and enhances vascular endothelial growth factor expression in a cerebral ischemia/reperfusion rat model

    Zhiyou Cai; Yong Yan; Changyin Yu; Jun Zhang

    2008-01-01

    BACKGROUND: Brain ischemia involves secondary inflammation, which significantly contributes to the outcome of ischemic insults. Vascular endothelial growth factor (VEGF) may play an important role in the vascular response to cerebral ischemia, because ischemia stimulates VEGF expression in the brain, and VEGF promotes formation of new cerebral blood vessels. Minocyclinc, a tetracycline derivative, protects against cerebral ischemia and reduces inflammation, oxidative stress, and apoptosis.OBJECTIVE: To observe the influence of minocycline on VEGE interleukin-1 beta (IL-1β), and tumor necrosis factor alpha (TNF-α) expression in Wistar rats with focal cerebral ischemia/rcperfusion injury, and to study the neuroproteetion mechanism of minocycline against focal cerebral ischemia/rcpeffusion injury.DESIGN, TIME AND SETTING: Randomized, controlled experiment, which was performed in the Chongqing Key Laboratory of Neurology between March 2007 and March 2008.MATERIALS: A total of 36 female, Wistar rats underwent surgery to insert a thread into the left middle cerebral artery. Animals were randomly divided into sham-operation, minocyclinc treatment, and ischemia/reperfusion groups, with 12 rats in each group. Minocycline (Huishi Pharmaceutical Limited Company, China) was dissolved to 0.5 g/L in normal saline.METHODS: A 0.5- 1.0 cm thread was inserted into rats from the sham-operation group. Rats in the ischemia/reperfusion group underwent ischemia and reperfusion. The minocycline group received minocycline (50 mg/kg) 12 and 24 hours following ischemia and reperfusion, whereas the other groups received saline at the corresponding time points.MAIN OUTCOME MEASURES: mRNA and protein expression of IL-1β and TNF-α was measured by reverse transcriptase-polymerasc chain reaction (RT-PCR) and enzyme linked immunosorbent assay (ELISA), respectively. VEGF mRNA and protein expression was examined by RT-PCR, Western blot, and ELISA.RESULTS: Minocycline decreased the focal infarct

  17. Asthma is a risk factor for acute chest syndrome and cerebral vascular accidents in children with sickle cell disease

    Scott Paul J

    2005-01-01

    Full Text Available Abstract Background Asthma and sickle cell disease are common conditions that both may result in pulmonary complications. We hypothesized that children with sickle cell disease with concomitant asthma have an increased incidence of vaso-occlusive crises that are complicated by episodes of acute chest syndrome. Methods A 5-year retrospective chart analysis was performed investigating 48 children ages 3–18 years with asthma and sickle cell disease and 48 children with sickle cell disease alone. Children were matched for age, gender, and type of sickle cell defect. Hospital admissions were recorded for acute chest syndrome, cerebral vascular accident, vaso-occlusive pain crises, and blood transfusions (total, exchange and chronic. Mann-Whitney test and Chi square analysis were used to assess differences between the groups. Results Children with sickle cell disease and asthma had significantly more episodes of acute chest syndrome (p = 0.03 and cerebral vascular accidents (p = 0.05 compared to children with sickle cell disease without asthma. As expected, these children received more total blood transfusions (p = 0.01 and chronic transfusions (p = 0.04. Admissions for vasoocclusive pain crises and exchange transfusions were not statistically different between cases and controls. SS disease is more severe than SC disease. Conclusions Children with concomitant asthma and sickle cell disease have increased episodes of acute chest syndrome, cerebral vascular accidents and the need for blood transfusions. Whether aggressive asthma therapy can reduce these complications in this subset of children is unknown and requires further studies.

  18. Cronotipo e implicações para sua utilização na fisioterapia em pacientes com acidente vascular encefálico Chronotype and implications for its use in physical therapy in patients with stroke

    Tania Fernandes Campos

    2011-09-01

    Full Text Available Na prática clínica, frequentemente o fisioterapeuta avalia e programa o tratamento do paciente sem levar em consideração a variação temporal de funções e comportamentos. O objetivo do estudo foi analisar a influência do cronotipo, padrão vigília-sono (qualidade do sono e sonolência excessiva e regularidade do estilo de vida na determinação do horário de preferência para a prática de atividades física e mental em pacientes com acidente vascular encefálico (AVE. Participaram 42 pacientes (61±9 anos no estágio crônico do AVE (18±21 meses e 12 indivíduos saudáveis (53±6 anos que responderam ao Questionário de Horne e Östberg (QHO, Índice de Qualidade do Sono de Pittsburgh (IQSP, Sonolência Excessiva de Epworth (SEE e o Social Rhythm Metric (SRM. Foi questionado em qual horário os participantes preferiam realizar atividade física (exercícios e mental (tarefas de raciocínio, considerando apenas seu bem-estar pessoal. Os dados foram analisados através do teste do χ2 e regressão múltipla. Dos pacientes avaliados, 93% eram matutinos, 64% apresentavam qualidade ruim do sono, 43% sonolência excessiva e 57% padrão irregular da rotina diária. Ao final da análise de regressão verificou-se que o cronotipo foi o único fator que teve influência no horário preferencial das atividades. Esses achados sugerem a necessidade da avaliação do cronotipo dos pacientes antes de se estabelecer um horário de atendimento na Fisioterapia.In clinical practice, the physical therapist often evaluates and programs the patient's treatment without taking into account the temporal variation of functions and behaviors. The aim of this study was to analyze the influence of the chronotype (morning type - evening type, sleep-wake state (sleep quality and excessive sleepiness and lifestyle regularity in determining the preferred time of day for physical and mental activities following stroke. Participants responded to the Morningness

  19. Confiabilidade do Perfil de Saúde de Nottingham após acidente vascular encefálico Reliability of the Nottingham Health Profile after suffering a stroke

    Dinalva Lacerda Cabral

    2012-05-01

    Full Text Available O artigo tem o objetivo de avaliar a confiabilidade, a consistência interna e a concordância do instrumento de qualidade de vida (QV Perfil de Saúde de Nottingham (PSN em indivíduos após Acidente Vascular Encefálico (AVE. Estudo do tipo transversal realizado em comunidades da Cidade do Recife-PE. A amostra foi composta por 53 indivíduos na fase crônica do AVE. Após verificação do estado cognitivo foi aplicado o PSN. Utilizou-se estatística descritiva para caracterizar a amostra; a consistência interna foi medida através do alfa (α de Cronbach; a confiabilidade com o coeficiente de correlação intraclasse (CCI e a concordância pelo teste de plotagem Bland and Altman, com nível de significância de 5%. A percepção dos indivíduos sobre suas saúdes teve uma tendência positiva em 83,3% dos domínios do PSN (média > 50 pontos, exceto para o domínio "habilidades físicas" que variou entre 41,5 e 50 pontos. O instrumento obteve boa consistência interna, com α entre 0,81 e 0,87; excelente confiabilidade nos domínios "dor" e "habilidades físicas", ICC >0,90 (p This article seeks to evaluate the reliability, internal consistency and accuracy of the Nottingham Health Profile (NHP, namely a quality of life (QL instrument for individuals after suffering a stroke. This cross-sectional study was carried out in the communities of Recife in the State of Pernambuco. The sample was composed of 53 individuals at the chronic stroke phase. After checking the cognitive state, the NHP was applied. Descriptive statistics were employed for characterization of the sample; Cronbach's alpha (α coefficients were used for evaluation of internal consistency, and intra-class correlation coefficients (ICC were used for investigation of reliability, as well as consistency of the Bland and Altman plotting tests with 5% level of significance. Their perceptions of their own health were 83.3% positive for the majority of NHP criteria (average scores > 50

  20. Avaliação da capacidade funcional de idosos com acidente vascular encefálico Evaluación de la capacidad funcional de adultos mayores con accidente vascular encefálico Evaluation of functional capaciy in elders with encephalic vascular accident

    Keila Cristianne Trindade da Cruz

    2009-10-01

    Full Text Available OBJETIVO: Avaliar a capacidade funcional de idosos com acidente vascular encefálico (AVE e verificar a relação, bem como a influência de variáveis sociodemográficas e de saúde na capacidade funcional desses sujeitos. MÉTODOS: Foram realizadas entrevistas com 44 idosos, vítimas de AVE, durante o atendimento nos locais de coleta de dados. O instrumento de coleta de dados contemplou dados sociodemográficos e clínicos. Para avaliar a capacidade funcional dos sujeitos foi aplicado o instrumento de Medida de Independência Funcional (MIF. RESULTADOS: Houve predomínio da faixa etária entre 60 e 69 anos. A MIF apresentou boa consistência interna. A pontuação total MIF dos apresentou média de 97,0. Os pacientes com acesso ao serviço de saúde apresentaram valores superiores aos dos indivíduos que não tinham acesso (Teste de Mann-Whitney. Foi observada correlação negativa entre a MIF e seus domínios e a idade (Pearson. CONCLUSÃO: O AVE causou alteração na capacidade funcional dos sujeitos da pesquisa, o que aponta para a necessidade de se investir em estratégias de reabilitação que venham a amenizar as perdas funcionais advindas da própria idade e, principalmente, das seqüelas de AVE.OBJETIVO: Evaluar la capacidad funcional de personas adultas mayores con accidente vascular encefálico (AVE y verificar la relación, así como la influencia de variables sociodemográficas y de salud en la capacidad funcional de esos sujetos. MÉTODOS: Fueron entrevistadas 44 personas adultas mayores, víctimas de AVE, durante la atención en los locales de recolección de datos. El instrumento de recolección de datos incluyó datos sociodemográficos y clínicos. Para evaluar la capacidad funcional de los sujetos se aplicó el instrumento de Medida de Independencia Funcional (MIF. RESULTADOS: Hubo predominio del grupo etáreo comprendido entre 60 y 69 años. La MIF presentó buena consistencia interna. La puntuación total de la MIF present

  1. A RELAÇÃO BENÉFICA ENTRE O EXERCÍCIO FÍSICO E A FISIOPATOLOGIA DO ACIDENTE VASCULAR CEREBRAL

    Alanna Severino Duarte Silva

    2014-02-01

    Full Text Available Currently, stroke is a major cause of morbidity in the world and has subsidence exercise as a major agent in the recovery of the potential consequences for this accident occurred. Thus, this study aims to show the relationship of physical activity beneficial to the pathophysiological of stroke and its morph functional changes in the organic system of hemiparetic individuals. To ensure the achievement of the goal described an exploratory study was conducted, operated by means of a literature, as this is a highly appropriate strategy to review, analyze, interpret and criticize theoretical considerations or paradigms, and the selection and location of the references to substantiate the study occurred in reliable databases such as Bireme, Medline, Lilacs, Scielo and Ebsco. Therefore one can say that through this brief review that examined various types and methods of physical exercise programs, that it has a beneficial effect in improving the neurophysiologic squeal of motor perceptual system occurred, giving these individuals a better quality of life, and thus optimizing their functional independence an won the organic system.

  2. A RELAÇÃO BENÉFICA ENTRE O EXERCÍCIO FÍSICO E A FISIOPATOLOGIA DO ACIDENTE VASCULAR CEREBRAL

    Alanna Severino Duarte Silva; Alisson Padilha de Lima; Fabrício Bruno Cardoso

    2014-01-01

    Currently, stroke is a major cause of morbidity in the world and has subsidence exercise as a major agent in the recovery of the potential consequences for this accident occurred. Thus, this study aims to show the relationship of physical activity beneficial to the pathophysiological of stroke and its morph functional changes in the organic system of hemiparetic individuals. To ensure the achievement of the goal described an exploratory study was conducted, operated by means of a literature, ...

  3. Acidente vascular cerebral em pacientes jovens: análise de 164 casos Stroke in young adults: analysis of 164 patients

    Viviane H. Flumignan Zétola

    2001-09-01

    Full Text Available Realizamos análise epidemiológica de 164 pacientes com AVC, cujo primeiro episódio ocorreu entre 15 e 49 anos de idade através de um estudo retrospectivo de pacientes ambulatoriais. O principal tipo de apresentação foi AVC isquêmico (AVCI em 141 pacientes, ocorrendo AVC hemorrágico (AVCH em16 casos e 7 pacientes com trombose venosa. A presença de fatores de risco aterotrombóticos foi prevalente, em 48,22% dos pacientes com AVCI sendo que a hipertensão arterial sistêmica (HAS, nos casos de AVCH, foi a etiologia mais frequente. Em 32% dos casos não se pode determinar a sua causa. Embora a população jovem possua determinantes diferentes e geralmente deva ter uma investigação etiológica mais abrangente, no grupo estudado foram prevalentes os fatores de risco conhecidos e potencialmente controláveis, sugerindo que campanhas de prevenção e detecção precoce devam ser incentivados.We retrospectively analyzed the epidemiological features of 164 out-clinic patients with a first-onset stroke between 15 and 49 years old. Ischemic stroke occurred in 141 patients, hemorrhagic stroke in 16 patients, and venous thrombosis in 7 patients. Forty-eight percent of ischemic strokes were atherothrombotic, but no etiology was found in 32% of patients with ischemic stroke. Systemic arterial hypertension was the most frequent etiology in the hemorrhagic stroke group. The most frequent risk factors were systemic arterial hypertension, smoking, hypercholesterolemia, alcoholism and diabetes mellitus. Although stroke in young adults deserves some specific etiological investigation, we found that ordinary risk factors such as hypertension, tabacco use, hypercolesteremia and diabetes were prevalent in our population. It seems that prevention campaigns should be the target of our work.

  4. O PRODUTO COMO CAUSADOR DE ACIDENTES

    Widomar Carpes Jr

    2004-06-01

    Full Text Available Neste artigo analisa-se a contribuição dos produtos para a geração de acidentes, apresentando-se estatísticas de acidentes de trabalho, de trânsito e aeronáuticos. Além disso, para melhor ilustrar a relação entre produtos e a ocorrência de acidentes, alguns casos de acidentes ocorridos e divulgados pela mídia são comentados. As estatísticas e os casos comentados demonstram a importância do estudo dos acidentes envolvendo produtos, evidenciando que praticamente todos os acidentes estão relacionados com o uso de produtos industrializados. Então, se analisa histórica e criticamente as principais teorias de acidentes de trabalho, porque são as únicas teorias existentes em relação aos acidentes. Além delas, são analisados os diversos conceitos sobre o erro humano e sua ocorrência, pois estes são apontados como grandes causadores de acidentes. Nesta análise, se observa que os acidentes estão mais relacionados aos perigos ou às características perigosas dos produtos do que às atitudes e ao comportamento do usuário. Faz-se uma revisão dos conceitos associados aos acidentes, tais como perigo, risco, acidente e dano, a partir dos quais apresenta-se um fluxograma contendo os elementos necessários para a manifestação dos acidentes. Ao final, conclui-se que a participação dos produtos na ocorrência de acidentes é evidente e que o comportamento do usuário é dependente das características do produto e da situação na qual ele é utilizado.

  5. Effect of isovolemic, isothermic hemodialysis on cerebral perfusion and vascular stiffness using contrast computed tomography and pulse wave velocity.

    Ansgar Reising

    Full Text Available BACKGROUND: Patients undergoing hemodialysis treatment have a six-fold increased risk for stroke relative to the general population. However, the effect of hemodialysis on cerebral blood flow is poorly studied and confounding factors like blood pressure and ultrafiltration as well as temperature changes have rarely been accounted for. The aim of our study was to use state-of-the-art technology to evaluate the effect of a single dialysis session on cerebral perfusion as well as on vascular stiffness. METHODS: Chronic hemodialysis patients (7 male/3 female, mean age 58 years were recruited. Cerebral blood flow and arterial pulse wave velocity were measured before and immediately after a hemodialysis session. To exclude effects of volume changes we kept ultrafiltration to a minimum, allowing no change in body weight. Isothermic conditions were maintained by using the GENIUS single-pass batch-dialysis system with a high-flux polysulfone dialyser. Cerebral blood flow was measured by contrast-enhanced computed tomography. Pulse wave velocity was measured using the SphygmoCor (AtCor Medical, USA device by a single operator. RESULTS: This study shows for the first time that isovolemic, isothermic hemodialysis neither affected blood pressure or heart rate, nor total or regional cerebral perfusion. There was also no change in pulse wave velocity. CONCLUSIONS: Mechanisms other than the dialysis procedure itself might be causative for the high incidence of ischemic strokes in this patient population. Moreover, the sole removal of uremic toxins does not lead to short-term effects on vascular stiffness, underlying the importance of volume control in this patient population.

  6. Prognosis value of the SPECT-ECD in acute phase of cerebral vascular accident

    We have compared prospectively the prognosis value of the neurologic examination with that of the single photon emission tomography (SPET) performed with 99mTc ECD. These two examinations were accomplished very early after admitting 21 patients (average age, 76 years) afflicted by sylvian cerebral vascular accident (CVA). The neurological examination was quantified by means of Orgogozo scale (0 to 100 = normal) at patients' admission (O1). The SPET was performed one hour after injecting 1000 MBq of 99mTc ECD and between 4 and 13 hours after CVA (7 hours in average). The acquisition made use of 3 head camera (Prism 3000, Picker) equipped by ultra high resolution fan beam collimators (FWHM = 9 mm). The counts were analysed semi-quantitatively in terms of intensity and extension of anomalies. Three tracer fixation degrees relative to the series maximum were considered: normal (≥ 60%), necrosis (≤ 25%) and 'ischemic penumbra' (in between 60 and 25%). The extension of CVA was evaluated according to the total or partial range of 7 regions covering the sylvian territory. The neurological state of the patients three months after was measured again by means of Orgogozo scale (O3). The main results are: 1. The neurological evolution between admission and three months was measured by means of the evolution index: EI = (O3 - O1)/(100 - O1). The O1 initial neurological score (NS) does not allow making prediction on the further evolution (NS correlation O1/IE); 2. The relative extension of the 'ischemic penumbra' recorded on SPET-ECD is also well correlated to the neurological prognosis (r = 0.62; p<0.01). This study presents original achievements among which: 1 - the demonstration of the prognosis value of early SPET; 2 - lack of predictive value of the clinical examination at the same moment; 3 - utilisation of ECD in this indication

  7. Response of the sensorimotor cortex of cerebral palsy rats receiving transplantation of vascular endothelial growth factor 165-transfected neural stem cells

    Jielu Tan; Xiangrong Zheng; Shanshan Zhang; Yujia Yang; Xia Wang; Xiaohe Yu; Le Zhong

    2014-01-01

    Neural stem cells are characterized by the ability to differentiate and stably express exogenous ge-nes. Vascular endothelial growth factor plays a role in protecting local blood vessels and neurons of newborn rats with hypoxic-ischemic encephalopathy. Transplantation of vascular endothelial growth factor-transfected neural stem cells may be neuroprotective in rats with cerebral palsy. In this study, 7-day-old Sprague-Dawley rats were divided into ifve groups: (1) sham operation (control), (2) cerebral palsy model alone or with (3) phosphate-buffered saline, (4) vascular en-dothelial growth factor 165 + neural stem cells, or (5) neural stem cells alone. hTe cerebral palsy model was established by ligating the letf common carotid artery followed by exposure to hypox-ia. Phosphate-buffered saline, vascular endothelial growth factor + neural stem cells, and neural stem cells alone were administered into the sensorimotor cortex using the stereotaxic instrument and microsyringe. Atfer transplantation, the radial-arm water maze test and holding test were performed. Immunohistochemistry for vascular endothelial growth factor and histology using hematoxylin-eosin were performed on cerebral cortex. Results revealed that the number of vas-cular endothelial growth factor-positive cells in cerebral palsy rats transplanted with vascular endothelial growth factor-transfected neural stem cells was increased, the time for ifnding water and the ifnding repetitions were reduced, the holding time was prolonged, and the degree of cell degeneration or necrosis was reduced. hTese ifndings indicate that the transplantation of vascu-lar endothelial growth factor-transfected neural stem cells alleviates brain damage and cognitive deifcits, and is neuroprotective in neonatal rats with hypoxia ischemic-mediated cerebral palsy.

  8. Vasculite cerebral e uso de cocaína e crack Cerebral vasculitis and cocaine and crack abuse

    Fernando Madalena Volpe

    1999-09-01

    Full Text Available O abuso de cocaína e crack está associado com importante parcela dos acidentes vasculares cerebrais, especialmente em pacientes jovens. O presente estudo relata o caso de um usuário de cocaína e crack que desenvolveu vasculite do sistema nervoso central, resultando em infartos cerebrais e edema extensos, levando à demência com alterações comportamentais e convulsões. Ressalta-se a importância de suspeitar do uso de drogas em jovens que se apresentam com acidente vascular cerebral, assim como avaliar possíveis lesões cerebrais em usuários de drogas com deterioração cognitiva.Cocaine and crack abuse is strongly related to stroke, particularly in young patients. The present study reports the case of a cocaine and crack abuser who developed central nervous system vasculitis, resulting in extensive cerebral infarctions, leading to dementia, behavioural disturbances and seizures. The relevance of detecting drug abuse in young stroke patients is stressed. Assessing possible brain lesions in drug abusers with cognitive impairment is also important.

  9. Venous angiomas tumors of the vascular structures by the cerebral seizures

    The diagnostic program in cerebral seizures was established: in the case of patients with clinical or EEG focal seizures was indicated CT and MRI examination and cerebral angiography. During the last three years at 8 patients with cerebral venous angiomas (VA) was found. Contrast-enhanced MRI examination demonstrated the lesions, showing the symptoms for cerebral angiomas in 5 patients. Conventional angiography in 7 patients showing the venous angiomas with cerebral veins, the collector and the type drainage. We assumed, that classical angiography has an absolute importance in the examination of focal cerebral seizures (focal clinical or EEG lesion ). MRI is more importance in the correlation with CT, but classical clinical and EEG examination has an important role in clinical diagnosis. (authors). 2 tabs., 3 figs., 8 refs

  10. Temporal variation in memory tests performance in cerebral vascular disease patients / Variação temporal no desempenho em testes de memória em pacientes com doença vascular cerebral

    Tania Fernandes Campos; Damião Ernane Souza; Carolina Dutra Gomes Pinheiro; Alexandre Augusto de Lara Menezes

    2007-01-01

    This study intended to investigate the performance in memory tests in order to adequate the neuropsychological evaluation to the temporal order of the human organism. Twelve cerebral vascular accident patients and 12 controls, of both sexes and 45-65 years old were studied. Two memory tests with visual stimuli (pictures) and two with verbal stimuli (words) were applied three times a day (08:00, 10:00 and 12:00 h) during the first week and twice a day (14:00 and 16:00 h) in the second week, du...

  11. Potential of optical microangiography to monitor cerebral blood perfusion and vascular plasticity following traumatic brain injury in mice in vivo

    Jia, Yali; Alkayed, Nabil; Wang, Ruikang K.

    2009-07-01

    Optical microanglography (OMAG) is a recently developed imaging modality capable of volumetric imaging of dynamic blood perfusion, down to capillary level resolution, with an imaging depth up to 2.00 mm beneath the tissue surface. We report the use of OMAG to monitor the cerebral blood flow (CBF) over the cortex of mouse brain upon traumatic brain injury (TBI), with the cranium left intact, for a period of two weeks on the same animal. We show the ability of OMAG to repeatedly image 3-D cerebral vasculatures during pre- and post-traumatic phases, and to visualize the changes of regulated CBF and the vascular plasticity after TBI. The results indicate the potential of OMAG to explore the mechanism involved in the rehabilitation of TBI.

  12. Escalas para avaliação da sobrecarga de cuidadores de pacientes com Acidente Vascular Encefálico Escalas para evaluación de la sobrecarga de cuidadores de pacientes con Accidente Vascular Encefálico Scales for evaluation of the overload of caregivers of patients with Stroke

    Ana Railka de Souza Oliveira

    2012-10-01

    Full Text Available O objetivo do estudo foi avaliar as escalas disponíveis na literatura para medir a sobrecarga de cuidadores de pacientes acometidos por acidente vascular encefálico. Realizou-se uma revisão bibliográfica nas três bases de dados: LILACS, CINAHL e SCOPUS. Selecionaram-se 23 trabalhos e identificaram-se 24 diferentes escalas. Destas, as mais citadas foram o Caregiver Strain Index, a Caregiver Burden Scale, a Caregiver Reaction Assessment, o Sense of Competence Questionnaire, a Relatives Stress Scale e a Zarit Burden Interview. O uso de escalas para mensurar a sobrecarga é uma ferramenta importante para avaliar o contexto no qual está inserido o cuidador, entretanto é mais fidedigno quando associado a outros instrumentos de mensuração. Portanto, é fundamental pesquisas de validação de escalas para essa população.El objetivo de esto estudio fue evaluar las escalas disponibles en literatura para evaluar la sobrecarga de cuidadores de pacientes acometidos por accidente vascular encefálico. Una revisión bibliográfica fue desarrollada en tres bases de datos: LILAS, CINAHL y SCOPUS. En 23 trabajos seleccionados, 24 diferentes escalas fueron identificadas, siendo las principales: el Caregiver Strain Index, la Caregiver Burden Scale, el Caregiver Reaction Assessment, el Sense of Competence Questionnaire, la Relatives Stress Scale y la Zarit Burden Interview. El uso de escalas para mensurar sobrecarga es una herramienta importante en el contexto donde se inserta el cuidador. Es más confiable utilizar más que uno instrumento de mensuración. Por esto, la validación de escalas es importante para esta población.The objective of the study was to evaluate the available productions in literature about scales to measure the overload of caregivers of patients with stroke. It was carried out a bibliographical revision in three databases: LILACS, CINAHL and SCOPUS. In 23 works, 24 different scales were identified, and the most cited were: the

  13. Regional cerebral blood flow before and after vascular surgery in patients with transient ischemic attacks with 133-xenon inhalation tomography

    Vorstrup, S; Hemmingsen, Ralf; Lindewald, H; Lassen, Niels Alexander

    Cerebral blood flow CBF was studied in 14 patients with transient ischemic attacks TIA and arteriosclerotic neck vessel disease. CBF was measured by a rapidly rotating single photon emission computerized tomograph using Xenon-133 inhalation. This method yields images of 3 brain slices depicting CBF...... with no abnormality on the CT-scan. The abnormal blood flow pattern was found to be unchanged after clinically successful reconstructive vascular surgery. This suggests the presence of irreversible ischemic tissue damage without gross emollition (incomplete infarction). It is concluded, that TIAs are...

  14. Expression of cyclin-dependent protein kinase 5 in the hippocampus of vascular dementia mice after cerebral ischemia and reperfusion

    Tianjun Wang; Peiyuan Lü; Hezhen Zhang; Hebo Wang; Wei Jin; Zongcheng Guo; Changlin Liu

    2009-01-01

    BACKGROUND: The p25-activated cyclin-dependent protein kinase 5 (Cdk5) may induce neuronal cell death and cause the development of dementia following cerebral ischemia and reperfusion. OBJECTIVE: To observe changes in the expression of Cdk5 and p25 in hippocampal tissue of vascular dementia mice at different time points following cerebral ischemia and reperfusion. DESIGN, TIME AND SETTING: A randomized, controlled animal experiment was performed in the clinical trial center of Hebei Provincial People's Hospital between September 2007 and October 2008.MATERIALS: Cdk5 rabbit anti-mouse polyclonal antibody, p35 rabbit anti-mouse polyclonal antibody, and β-actin mouse monoclonal antibody were purchased from Santa Cruz Biotechnology, Inc., USA; horseradish peroxidase-labeled goat anti-rabbit IgG and horseradish peroxidase-labeled goat anti-mice IgG were offered by Beijing Zhongshan Goldenbridye Biotechnology Co.,Ltd., China; the protein quantitative kit was produced by Applygen Gene Technology Corp., Beijing, China; cDNA reverse transcription and PCR amplification reagents were products of TianGen&Biotech (Beijing) Co.,Ltd., China.METHODS: One hundred and sixty male Kunming mice were randomly divided into two groups: a sham-operated group (n=65) and a model group (n=95). Vascular dementia was induced with three periods of transient ischemia and reperfusion of the bilateral common carotid arteries. In the sham-operated group, the bilateral common carotid arteries were not blocked.MAIN OUTCOME MEASURES: Behavioral tests were done at four and six weeks post surgery. Pathological changes in the hippocampal CA1 region were observed with hematoxylin-eosin staining. Cdk5 mRNA expression was examined by RT-PCR, and Western blots were used to evaluate Cdk5 and p25 expression. Learning and memory performance were assayed using the Morris water maze. RESULTS: Vascular dementia reduced learning and memory performance at 4 and 6 weeks post surgery. Vascular dementia also caused

  15. The Association of Type 2 Diabetes Mellitus with Cerebral Gray Matter Volume Is Independent of Retinal Vascular Architecture and Retinopathy

    C. Moran

    2016-01-01

    Full Text Available It is uncertain whether small vessel disease underlies the relationship between Type 2 Diabetes Mellitus (T2DM and brain atrophy. We aimed to study whether retinal vascular architecture, as a proxy for cerebral small vessel disease, may modify or mediate the associations of T2DM with brain volumes. In this cross-sectional study using Magnetic Resonance Imaging (MRI scans and retinal photographs in 451 people with and without T2DM, we measured brain volumes, geometric measures of retinal vascular architecture, clinical retinopathy, and MRI cerebrovascular lesions. There were 270 people with (mean age 67.3 years and 181 without T2DM (mean age 72.9 years. T2DM was associated with lower gray matter volume (p=0.008. T2DM was associated with greater arteriolar diameter (p=0.03 and optimality ratio (p=0.04, but these associations were attenuated by adjustments for age and sex. Only optimality ratio was associated with lower gray matter volume (p=0.03. The inclusion of retinal measures in regression models did not attenuate the association of T2DM with gray matter volume. The association of T2DM with lower gray matter volume was independent of retinal vascular architecture and clinical retinopathy. Retinal vascular measures or retinopathy may not be sufficiently sensitive to confirm a microvascular basis for T2DM-related brain atrophy.

  16. Efeitos da sondagem nasogástrica em pacientes com acidente cerebrovascular e disfagia

    Tahissa Frota Cavalcante

    2014-10-01

    Full Text Available O estudo teve por objetivo analisar os efeitos da sondagem gástrica em pacientes com acidente vascular cerebral e disfagia. Revisão sistemática da literatura, realizada em seis bases de dados, com os descritores stroke e intubation, gastrointestinal. Foram encontrados 120 estudos e selecionados três ensaios clínicos. Os resultados apontaram diferentes desfechos, entre os quais: aumento do nível sérico de albumina (gastrostomia, prognóstico ruim e risco de morte (gastrostomia, aumento das falhas no tratamento devido a bloqueio, deslocamento e reinserção da sonda nasogástrica, e aumento da incidência de hemorragia gastrointestinal (sonda nasogástrica. A partir dos resultados obtidos nesta revisão sistemática, ressaltam-se as seguintes evidências: a sondagem nasogástrica deve ser adotada precocemente como um método de alimentação enteral; as falhas do tratamento são mais comuns naqueles que utilizam a sonda nasogástrica como método de alimentação; os resultados relacionados à melhora do estado funcional dos pacientes foram semelhantes, independente do método de terapia nutricional empregado.

  17. Determination of Vascular Reactivity of Middle Cerebral Arteries from Stroke and Spinal Cord Injury Animal Models Using Pressure Myography.

    Anwar, Mohammad A; Eid, Ali H

    2016-01-01

    Stroke and other neurovascular derangements are main causes of global death. They, along with spinal cord injuries, are responsible for being the principal cause of disability due to neurological and cognitive problems. These problems then lead to a burden on scarce financial resources and societal care facilities as well as have a profound effect on patients' families. The mechanism of action in these debilitating diseases is complex and unclear. An important component of these problems arises from derangement of blood vessels, such as blockage due to clotting/embolism, endothelial dysfunction, and overreactivity to contractile agents, as well as alteration in endothelial permeability. Moreover, the cerebro-vasculature (large vessels and arterioles) is involved in regulating blood flow by facilitating auto-regulatory processes. Moreover, the anterior (middle cerebral artery and the surrounding region) and posterior (basilar artery and its immediate locality) regions of the brain play a significant role in triggering the pathological progression of ischemic stroke particularly due to inflammatory activity and oxidative stress. Interestingly, modifiable and non-modifiable cardiovascular risk factors are responsible for driving ischemic and hemorrhagic stroke and spinal cord injury. There are different stroke animal models to examine the pathophysiology of middle cerebral and basilar arteries. In this context, arterial myography offers an opportunity to determine the etiology of vascular dysfunction in these diseases. Herein, we describe the technique of pressure myography to examine the reactivity of cerebral vessels to contractile and vasodilator agents and a prelude to stroke and spinal cord injury. PMID:27604741

  18. Characteristics of Cerebral Blood Flow in Vascular Dementia using SPM Analysis Compared to Normal Control and Alzheimer's Dementia

    Cerebral perfusion pattern of vascular dementia (VD) was not well established and overlap of cerebral perfusion pattern was reported between VD and Alzheimer's dementia (AD). The aim of this study is to assess the specific patterns of SPECT finding in VD compared with normal control subjects and to disclose differences of cerebral blood flow between subjects with VD and AD were investigated using statistic parametric mapping analysis. Thirty-two VD (mean age ; 67.86.4 years, mean CDR ; 0.980.27), 51 AD (mean age ; 71.47.2 years, CDR ; 1.160.47), which were matched for age and severity of dementia, and 30 normal control subjects (mean age ; 60.17.7 years) participated in this study. The Tc-99m HMPAO brain perfusion SPECT data were analyzed by SPM99. The SPECT data of the patients with VD were compared to those of the control subjects and then compared to the patients with AD. SPM analysis of the SPECT image showed significant perfusion deficits in the both frontal (both cingulate gyrus, both inferior frontal gyrus, B no.47, right frontal rectal gyrus, left frontal subcallosal gyrus, B no.25), both temporal (right insula, B no.13, left superior temporal gyrus, left parahippocampal gyrus, B no.35), occipital (occipital lingual gyrus), right corpus callosum and right cerebellar tonsil regions in subjects with VD compared with normal control subjects (uncorrected p<0.01). Comparison of the two dementia groups (uncorrected p<0.01) revealed significant hypoperfusion in both parietal posterior central gyrus, right inferior frontal gyrus (B no.47), left insula, right thalamus (ventral lateral nucleus), right claustrum and right occipital cuneus regions in VD group compared with AD. There were no typical confined regional hypoperfusion areas but scattered multiple perfusion deficits in VD compared AD. These findings may be helpful to reflect the pathophysiological mechanisms of VD and to disclose differences of cerebral blood flow between subjects with VD and AD

  19. Vivendo o acidente vascular encefálico agudo: significados da doença para pessoas hospitalizadas Viviendo el accidente cerebrovascular agudo: significado de la enfermedad para personas hospitalizadas Experiencing acute stroke: the meaning of the illness for hospitalized patients

    Samia Jardelle Costa de Freitas Maniva

    2013-04-01

    Full Text Available Objetivou-se compreender o significado da experiência vivenciada pela pessoa adoecida por acidente vascular encefálico agudo. Trata-se de estudo qualitativo, fundamentado nos pressupostos teóricos do interacionismo simbólico, realizado em uma unidade especializada no tratamento de acidente vascular encefálico de um hospital terciário, situado na cidade de Fortaleza, CE. Participaram do estudo 10 pacientes. A coleta de dados ocorreu por meio de entrevista aberta e os dados foram organizados e analisados segundo a técnica de enunciação. Cumpriram-se todos os aspectos éticos. O significado da experiência de adoecimento foi construído com base na percepção dos sentimentos surgidos durante a hospitalização, caracterizados por medo da morte e das sequelas da doença; tristeza pelo distanciamento do lar; alívio, ao evidenciar-se melhora do quadro clínico, e desejo de mudança dos hábitos de vida. Apreendeu-se que a experiência de adoecimento por acidente vascular encefálico é complexa, e nela os significados são elaborados com base em sentimentos, ações e comportamentos dos sujeitos.Se objetivó comprender el significado de la experiencia de la persona que padeció accidente cerebrovascular agudo. Estudio cualitativo, fundamentado en los presupuestos teóricos del interaccionismo simbólico, realizado en unidad especializada en tratamiento de accidente cerebrovascular de un hospital terciario en Fortaleza-CE. Participaron diez pacientes. Datos recolectados mediante entrevista abierta, organizados y analizados según técnica de enunciación. Se cumplió con todos los aspectos éticos. El significado de la experiencia del padecimiento fue construido en base a la percepción de los sentimientos surgidos durante la internación, caracterizados por el miedo a la muerte y a las secuelas de la enfermedad; tristeza por alejarse del hogar; alivio al evidenciarse mejoras del cuadro clínico; e intención de cambio de hábitos de vida

  20. MEK1/2 inhibition attenuates vascular ETA and ETB receptor alterations after cerebral ischaemia

    Henriksson, Marie; Stenman, Emelie; Vikman, Petter;

    2007-01-01

    effect of inhibition of the MAP kinase/ERK kinase (MEK)1/2 on ET receptor alteration, brain damage, and neurology in experimental cerebral ischaemia. Transient middle cerebral artery occlusion (MCAO) was induced in male Wistar rats by the intraluminal filament technique. The animals received 100 mg...... MCAO, the contractile responses of the ETA and ETB receptors were augmented in the ipsilateral MCA. U0126 decreased this alteration in ET receptor response. Furthermore, treatment with U0126 significantly decreased the brain damage and improved neurological scores. Immunohistochemistry showed that....../kg intraperitoneally of the MEK1/2 inhibitor U0126 or vehicle in conjunction with the occlusion. After 24 h, the rats were decapitated and the brains removed. The middle cerebral arteries were dissected out and examined with myographs or immunohistochemistry. The ischaemic areas of the brains were compared. After the...

  1. Variação temporal no desempenho em testes de memória em pacientes com doença vascular cerebral Temporal variation in memory tests performance in cerebral vascular disease patients

    Tania Fernandes Campos; Damião Ernane Souza; Carolina Dutra Gomes Pinheiro; Alexandre Augusto de Lara Menezes

    2007-01-01

    Buscando adequar a avaliação neuropsicológica à organização temporal do organismo humano, avaliou-se o desempenho em testes de memória em 12 pacientes pós Doença Vascular Cerebral e 12 indivíduos controle, de ambos os sexos, com idade de 45 a 65 anos. Foram aplicados dois testes de memória com estímulos visuais (figuras) e dois com estímulos verbais (palavras), em 3 dias consecutivos por semana, às 08:00, 10:00 e 12:00 h na primeira semana e às 14:00 e 16:00 h na seguinte. Os pacientes aprese...

  2. Cerebral vasoconstriction after subarachnoid hemorrhage--role of changes in vascular receptor phenotype

    Hansen-Schwartz, Jacob; Ansar, Saema; Edvinsson, Lars

    2008-01-01

    prominent given their ability to elicit powerful constriction of cerebral arteries. Investigating both 5-HT and ET receptors we have observed that there are distinct changes in receptor phenotype after experimental SAH, namely upregulation of the ETB and 5-HT1B receptors, and that this upregulation is...... linked to a higher sensitivity to the endogenous agonists. It has also been shown that reduction in regional cerebral blood flow (CBF) is associated with receptor upregulation and interventional animal experiments have shown a benefit from inhibiting the PKC and MAP kinase pathways on receptor...

  3. Role of soluble epoxide hydrolase in the sex-specific vascular response to cerebral ischemia

    Zhang, Wenri; Iliff, Jeffrey J.; Campbell, Caitlyn J; Wang, Ruikang K.; Hurn, Patricia D.; Alkayed, Nabil J.

    2009-01-01

    Soluble epoxide hydrolase (sEH), a key enzyme in the metabolism of vasodilator eicosanoids called epoxyeicosatrienoic acids (EETs), is sexually dimorphic and suppressed by estrogen. We determined if the sex difference in blood flow during focal cerebral ischemia is linked to sEH. Soluble epoxide hydrolase expression in brain, hydrolase activity in cerebral vessels, and plasma 14,15-dihydroxyeicosatrienoic acid (14,15-DHET) were determined in male and female wild-type (WT) and sEH knockout (sE...

  4. Variação temporal no desempenho em testes de memória em pacientes com doença vascular cerebral Temporal variation in memory tests performance in cerebral vascular disease patients

    Tania Fernandes Campos

    2007-01-01

    Full Text Available Buscando adequar a avaliação neuropsicológica à organização temporal do organismo humano, avaliou-se o desempenho em testes de memória em 12 pacientes pós Doença Vascular Cerebral e 12 indivíduos controle, de ambos os sexos, com idade de 45 a 65 anos. Foram aplicados dois testes de memória com estímulos visuais (figuras e dois com estímulos verbais (palavras, em 3 dias consecutivos por semana, às 08:00, 10:00 e 12:00 h na primeira semana e às 14:00 e 16:00 h na seguinte. Os pacientes apresentaram menor número de acertos do que os indivíduos controle em todos os testes aplicados (pThis study intended to investigate the performance in memory tests in order to adequate the neuropsychological evaluation to the temporal order of the human organism. Twelve cerebral vascular accident patients and 12 controls, of both sexes and 45-65 years old were studied. Two memory tests with visual stimuli (pictures and two with verbal stimuli (words were applied three times a day (08:00, 10:00 and 12:00 h during the first week and twice a day (14:00 and 16:00 h in the second week, during three consecutive days in two consecutive weeks. The patients showed lower scores than control subjects in all applied tests (p<0,05. The greater test sensitivity was at 14:00 h for the free recall test and at 16:00 h for recognition tests. According to these results, it is concluded that neuropsychological evaluations should be conducted preferably in the afternoon, as well for the first evaluation as for the re-evaluations.

  5. Cerebral vasoconstriction after subarachnoid hemorrhage--role of changes in vascular receptor phenotype

    Hansen-Schwartz, J.; Ansar, S.; Edvinsson, L.

    2008-01-01

    linked to a higher sensitivity to the endogenous agonists. It has also been shown that reduction in regional cerebral blood flow (CBF) is associated with receptor upregulation and interventional animal experiments have shown a benefit from inhibiting the PKC and MAP kinase pathways on receptor...

  6. Cerebral blood flow and vascular response to hypercapnia in hypertensive patients with leukoaraiosis

    Both arteriosclerosis and leukoaraiosis have a close relationship with hypertension, but the relationship between cerebral hemodynamics and leukoaraiosis in hypertensive patients has not been fully examined. To clarify this issue, we measured the regional cerebral blood flow (rCBF) and cerebrovascular response to hypercapnia in hypertensive patients with various degrees of leukoaraiosis. The subjects consisted of 7 normotensive normal controls and 17 hypertensive patients. The hypertensive patients were divided into three groups according to the severity of white matter lesions (leukoaraiosis) on MRI and the presence of dementia, namely, negative or mild leukoaraiosis without dementia, moderate to severe leukoaraiosis without dementia and severe leukoaraiosis with dementia. Both the rCBF and the cerebrovascular response to hypercapnia were measured by the O-15 H2O bolus-injection method and positron emission tomography. The rCBF in hypertensive patients without dementia did not decrease when compared with the normotensive controls, but the rCBF in hypertensive patients with dementia markedly decreased in the cerebral cortices and white matter. On the other hand, the cerebrovascular response to hypercapnia declined with the severity of leukoaraiosis, and it decreased most severely in patients with severe leukoaraiosis and dementia. Our results indicate that the reduction in the cerebral hemodynamic reserve capacity has a close relationship with the severity of leukoaraiosis in hypertensive patients, although the rCBF is maintained in hypertensive patients without dementia, and suggest that arteriosclerotic change reduces cerebrovascular CO2 response and causes a leukoaraiosis in hypertensive patients. (author)

  7. 1H-magnetic resonance spectroscopy of vascular endothelial growth factor-induced neuroprotection following acute cerebral ischemia and reperfusion

    Li Yi; Haiou Zhang; Hao Lei; Li Wei

    2008-01-01

    BACKGROUND: It has become generally accepted that measuring N-acetyI-L-aspartic acid through the use of 1H-magnetic resonance spectroscopy (1H-MRS) could be used to evaluate neuronal injury. OBJECTIVE: To study metabolic changes of N-acetyl-L-aspanic acid surrounding the acute cerebral ischcmia area following vascular endothelial growth factor (VEGF) treatment using 1H-MRS imaging, and to evaluate the neuroprotective effects of VEGE.DESIGN, TIME AND SETTING: Randomly controlled animal study, according to one-factor analysis of variance, was performed at the Shenzhen Hospital of Peking University and State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences from August 2003 to December 2005.MATERIALS: Twelve healthy, adult, Sprague Dawley rats were used to establish an ischemia/reperfusion model through the use of middle cerebral artery occlusion. The 4.7T superconducting nuclear magnetic resonance meter was provided by Brucker Company. VEGF164 was purchased from Shenzhen Jingmei Bioengineering Co., Ltd. Titus ancsthesia machine was purchased from Draeger Medical AG & Co. KG.METHODS: The rats were randomly divided into model control (n = 6) and VEGF-injected (n = 6) groups. All animals received 60-minute middle cerebral artery occlusion and 24-hour repcrfusion. Lateral cerebral ventricle injection was performed by stereotaxic technique at respective time points. The VEGF group received 0. 1 μ g/μ L VEGF (5 μL), and the model group received the same amount of normal saline, once daily for 3 days.MAIN OUTCOME MEASURES: Metabolic changes of N-acetyl-L-aspartic acid and lactic acid following cerebral ischemia and reperfusion were detected using 1H-MRS, and the ischemic volume was measured.RESULTS: Twelve rats were included in the final analysis. =H-MRS results revealed that the ischemic volume increased in the control group compared with prior to injection (P < 0.01). In the

  8. Influence of the gender on cerebral vascular diameters observed during the magnetic resonance angiographic examination of willis circle

    Marco Antonio Stefani

    2013-02-01

    Full Text Available The present study evaluated the calibers and anatomic configurations based on the Magnetic Resonance analysis (MRA, assaying the cerebral vascular territories and sex-linked variations. A randomized sample of 30 angiographic examinations in adult patients of both sexes was obtained and components of the circle of Willis were identified. Branch diameters were measured on a transversal cut 5mm from the vessel origin in a typical angiographic frontal incidence. For the comparative statistical analysis, tests were divided in the groups considering the patients' sex and age. The classical Circle of Willis configuration was oberved in only 15 samples (50%. Greater calibers were observed in the arteries of the posterior circulation and multiple linear regression analysis established that the caliber of the posterior circulation was influenced by an independent variable related to the gender. Additional variations included unilateral and bilateral fetal and hypoplasic Posterior communicating arteries. In the anterior cerebral artery (ACA, the presence of an accessory developed ACA, an ACA giving branches to the distal portion of the two hemispheres and a third median ACA the variants were observed. Gender influenced the variations on internal diameters of posterior circulation vessels, with larger measurements in men.

  9. Vitamin D status and vascular dementia due to cerebral small vessel disease in the elderly Asian Indian population.

    Prabhakar, Puttachandra; Chandra, Sadanandavalli Retnaswami; Supriya, Manjunath; Issac, Thomas Gregor; Prasad, Chandrajit; Christopher, Rita

    2015-12-15

    Vitamin D plays vital roles in human health and recent studies have shown its beneficial effect on brain functioning. The present study was designed to evaluate the association of vitamin D with vascular dementia (VaD) due to cerebral small vessel disease (SVD) in Asian Indian population. 140 VaD patients aged ≥ 60 years with neuroimaging evidence of SVD, and 132 age and gender-matched controls, were investigated. Vitamin D status was estimated by measuring serum 25-hydroxy vitamin D. Logistic regression model revealed that deficient levels of vitamin D (vitamin D deficiency and insufficiency (12-20 ng/ml), the odds were increased to 31.6-fold and 14.4-fold, respectively. However, in hypertensives with vitamin D sufficiency (>20 ng/ml), the odds of VaD were increased by 3.8-fold only. Pearson correlation showed that serum vitamin D was inversely associated with systolic and diastolic blood pressure (r=-0.401 and -0.411, pvitamin D-deficient subjects. Since the combined presence of hypertension and vitamin D deficiency increases the probability of developing VaD, screening for vitamin D status in addition to regular monitoring of blood pressure, could reduce the risk of VaD associated with cerebral SVD in the elderly Asian Indian subjects. PMID:26671097

  10. Preferentially affected sites of cerebral arteriosclerosis in vascular dementia of Binswanger type. A study of MRI and MR angiography

    MRI and MR angiography (MRA) were analyzed to evaluate the preferential sites of cerebral arteriosclerosis in 129 normal controls and 27 patients with vascular dementia of Binswanger type (BVD; mean age 75.0 years). Small vessel disease, indicated as advanced high intensity areas on T2-weighted MRI, increased with advancing age, while large vessel sclerosis detected with MRA did not increase after the age of 80 years. Large vessel sclerosis was not always accompanied with advanced high intensity areas. Large vessel sclerosis was found in 12 (44.4%) of 27 patients with BVD, and was as common as that of the controls of the eighth decade. Large vessel sclerosis was frequently seen in the cases suffering from BVD below 70 years of age or with hypertension. In conclusion, patients with BVD develop cerebral arteriosclerosis more preferentially in the small vessels rather than the large vessels especially in aged cases, of which incidence is similar to that of the normal controls over 80 years of age. (author)

  11. Cine gamma-angiography. Aids for the diagnosis of cerebral vascular disease

    Gamma-angioencephalography allows in a simple examination, the bilateral visualization of the injection of the main cerebral vessels, the regional measurement of transit times and, if it occurs, the observation of the diffusion of the tracer in a lesion. These different steps of the investigation are described and its diagnostic value is discussed. Sup(99m)Tc is the radioisotope used. To increase the accuracy of the qualitative data obtained from the gamma camera, a data processing system is used. Regions of interest are selected over the carotid and cerebral middle arteries. Time function curves are generated for each region of interest. From mathematical models, some pathological aspects of transit curves can be explained

  12. Cerebral vascular effects of loading dose of dexmedetomidine: A Transcranial Color Doppler study

    Appavoo Arulvelan; Sethuraman Manikandan; Hari Venkat Easwer; Kesavapisharady Krishnakumar

    2016-01-01

    Background: Dexmedetomidine has been widely used in critical care settings because of its property of maintaining stable hemodynamics and inducing conscious sedation. The use of dexmedetomidine is in increasing trend particularly in patients with neurological disorders. Very few studies have focused on the cerebral hemodynamic effects of dexmedetomidine. This study is aimed to address this issue. Methods: Thirty patients without any intracranial pathology were included in this study. Middle c...

  13. Influence of mild hypothermia on vascular endothelial growth factor and infarct volume in brain tissues after cerebral ischemia in rats

    Fei Ye; Gangming Xi; Biyong Qin; Shifeng Wang; Chengyan Li

    2006-01-01

    BACKGROUND: It has been demonstrated that mild hypothermia has obvious protective effect on both whole and local cerebral ischemia. However, the definite mechanism is still unclear for the brain protection of mild hypothermia on cerebral edema, inhibiting inflammatory reaction, stabilizing blood brain barrier, etc.OBJECTIVE: To investigate the effect of mild hypothermia on the expression of vascular endothelial growth factor and the infarct volume after cerebral ischemia in rats, and analyze the brain protective mechanism of mild hypothermia.DESIGN: A randomized grouping and controlled animal trial.SETTING: Department of Neurology, People's Hospital of Yunyang Medical College.MATERIALS: Twenty adult male SD rats of clean degree, weighing (250±30) g, were provided by the animal experimental center, School of Medicine, Wuhan University. The kits for SP immunohistochemistry were purchased from Beijing Zhongshan Golden Bridge Biotechnology Co., Ltd.METHODS: The experiments were carried out in the laboratory of Department of Neurology, Renmen Hospital of Wuhan University from May to July 2005. ① The 20 rats were divided randomly into normal temperature group (n =10) and mild hypothermia group (n =10). Models of permanent middle cerebral artery occlusion were established with modified nylon suture embolization. The rats were assessed with the Longa standards: O point for without nerve dysfunction; 1 for mild neurological deficit (fore claws could no extend completely); 2 for moderate neurological deficit (circling towards the affected side); 3 for severe neurological deficit (tilting towards the affected side); 4 for coma and unconscious; 1 -3 points represented that models were successfully established. The rats of the normal temperature group were fed at room temperature, and those in the mild hypothermia group were induced by hypothermia from 2 hours postoperatively, and the rectal temperature was kept at 34-35 ℃ for 72 hours. ② Measurement of infarct volume

  14. Cerebral ischemia enhances vascular angiotensin AT1 receptor-mediated contraction in rats

    Stenman, Emelie; Edvinsson, Lars

    2004-01-01

    MCA occlusion (P<0.05). The angiotensin II type 1 (AT1) receptor antagonists candesartan and losartan abolished the enhanced responses to angiotensin II (P<0.05), whereas the AT2 receptor antagonist PD123319 had no effect. The amount of AT1 receptor mRNA was lower in the occluded MCAs compared with....... These results support a role for AT1 receptors in cerebral ischemia, and we think that AT1 receptors might be a future therapeutic target in ischemic stroke....

  15. No Additional Prognostic Value of Genetic Information in the Prediction of Vascular Events after Cerebral Ischemia of Arterial Origin: The PROMISe Study.

    Sefanja Achterberg

    Full Text Available Patients who have suffered from cerebral ischemia have a high risk of recurrent vascular events. Predictive models based on classical risk factors typically have limited prognostic value. Given that cerebral ischemia has a heritable component, genetic information might improve performance of these risk models. Our aim was to develop and compare two models: one containing traditional vascular risk factors, the other also including genetic information.We studied 1020 patients with cerebral ischemia and genotyped them with the Illumina Immunochip. Median follow-up time was 6.5 years; the annual incidence of new ischemic events (primary outcome, n=198 was 3.0%. The prognostic model based on classical vascular risk factors had an area under the receiver operating characteristics curve (AUC-ROC of 0.65 (95% confidence interval 0.61-0.69. When we added a genetic risk score based on prioritized SNPs from a genome-wide association study of ischemic stroke (using summary statistics from the METASTROKE study which included 12389 cases and 62004 controls, the AUC-ROC remained the same. Similar results were found for the secondary outcome ischemic stroke.We found no additional value of genetic information in a prognostic model for the risk of ischemic events in patients with cerebral ischemia of arterial origin. This is consistent with a complex, polygenic architecture, where many genes of weak effect likely act in concert to influence the heritable risk of an individual to develop (recurrent vascular events. At present, genetic information cannot help clinicians to distinguish patients at high risk for recurrent vascular events.

  16. An Active Contour Model Based on Adaptive Threshold for Extraction of Cerebral Vascular Structures.

    Wang, Jiaxin; Zhao, Shifeng; Liu, Zifeng; Tian, Yun; Duan, Fuqing; Pan, Yutong

    2016-01-01

    Cerebral vessel segmentation is essential and helpful for the clinical diagnosis and the related research. However, automatic segmentation of brain vessels remains challenging because of the variable vessel shape and high complex of vessel geometry. This study proposes a new active contour model (ACM) implemented by the level-set method for segmenting vessels from TOF-MRA data. The energy function of the new model, combining both region intensity and boundary information, is composed of two region terms, one boundary term and one penalty term. The global threshold representing the lower gray boundary of the target object by maximum intensity projection (MIP) is defined in the first-region term, and it is used to guide the segmentation of the thick vessels. In the second term, a dynamic intensity threshold is employed to extract the tiny vessels. The boundary term is used to drive the contours to evolve towards the boundaries with high gradients. The penalty term is used to avoid reinitialization of the level-set function. Experimental results on 10 clinical brain data sets demonstrate that our method is not only able to achieve better Dice Similarity Coefficient than the global threshold based method and localized hybrid level-set method but also able to extract whole cerebral vessel trees, including the thin vessels. PMID:27597878

  17. An Active Contour Model Based on Adaptive Threshold for Extraction of Cerebral Vascular Structures

    Wang, Jiaxin; Zhao, Shifeng; Liu, Zifeng; Duan, Fuqing; Pan, Yutong

    2016-01-01

    Cerebral vessel segmentation is essential and helpful for the clinical diagnosis and the related research. However, automatic segmentation of brain vessels remains challenging because of the variable vessel shape and high complex of vessel geometry. This study proposes a new active contour model (ACM) implemented by the level-set method for segmenting vessels from TOF-MRA data. The energy function of the new model, combining both region intensity and boundary information, is composed of two region terms, one boundary term and one penalty term. The global threshold representing the lower gray boundary of the target object by maximum intensity projection (MIP) is defined in the first-region term, and it is used to guide the segmentation of the thick vessels. In the second term, a dynamic intensity threshold is employed to extract the tiny vessels. The boundary term is used to drive the contours to evolve towards the boundaries with high gradients. The penalty term is used to avoid reinitialization of the level-set function. Experimental results on 10 clinical brain data sets demonstrate that our method is not only able to achieve better Dice Similarity Coefficient than the global threshold based method and localized hybrid level-set method but also able to extract whole cerebral vessel trees, including the thin vessels. PMID:27597878

  18. Equol increases cerebral blood flow in rats via activation of large-conductance Ca(2+)-activated K(+) channels in vascular smooth muscle cells.

    Yu, Wei; Wang, Yan; Song, Zheng; Zhao, Li-Mei; Li, Gui-Rong; Deng, Xiu-Ling

    2016-05-01

    The present study was designed to investigate the effect of equol on cerebral blood flow and the underlying molecular mechanisms. The regional cerebral blood flow in parietal lobe of rats was measured by using a laser Doppler flowmetry. Isolated cerebral basilar artery and mesenteric artery rings from rats were used for vascular reactivity measurement with a multi wire myography system. Outward K(+) current in smooth muscle cells of cerebral basilar artery, large-conductance Ca(2+)-activated K(+) (BK) channel current in BK-HEK 293 cells stably expressing both human α (hSlo)- and β1-subunits, and hSlo channel current in hSlo-HEK 293 cells expressing only the α-subunit of BK channels were recorded with whole cell patch-clamp technique. The results showed that equol significantly increased regional cerebral blood flow in rats, and produced a concentration-dependent but endothelium-independent relaxation in rat cerebral basilar arteries. Both paxilline and iberiotoxin, two selective BK channel blockers, significantly inhibited equol-induced vasodilation in cerebral arteries. Outward K(+) currents in smooth muscle cells of cerebral basilar artery were increased by equol and fully reversed by washout or blockade of BK channels with iberiotoxin. Equol remarkably enhanced human BK current in BK-HEK 293 cells, but not hSlo current in hSlo-HEK 293 cells, and the increase was completely abolished by co-application of paxilline. Our findings provide the first information that equol selectively stimulates BK channel current by acting on its β1 subunit, which may in turn contribute to the equol-mediated vasodilation and cerebral blood flow increase. PMID:26995303

  19. A study of radiation-induced cerebral vascular injury in nasopharyngeal carcinoma patients with radiation-induced temporal lobe necrosis.

    Jianhong Ye

    Full Text Available PURPOSE: To investigate radiation-induced carotid and cerebral vascular injury and its relationship with radiation-induced temporal lobe necrosis in nasopharyngeal carcinoma (NPC patients. METHODS AND MATERIALS: Fifty eight NPC patients with radiation-induced temporal lobe necrosis (TLN were recruited in the study. Duplex ultrasonography was used to scan bilateral carotid arterials to evaluate the intima-media thickness (IMT and occurrence of plaque formation. Flow velocities of bilateral middle cerebral arteries (MCAs, internal carotid arteries (ICAs and basal artery (BA were estimated through Transcranial Color Doppler (TCD. The results were compared with data from 33 patients who were free from radiation-induced temporal lobe necrosis after radiotherapy and 29 healthy individuals. RESULTS: Significant differences in IMT, occurrence of plaques of ICAs and flow velocities of both MCAs and ICAs were found between patients after radiotherapy and healthy individuals (p<0.05. IMT had positive correlation with post radiation interval (p = 0.049. Compared with results from patients without radiation-induced TLN, the mean IMT was significantly thicker in patients with TLN (p<0.001. Plaques were more common in patients with TLN than patients without TLN (p = 0.038. In addition, flow velocities of MCAs and ICAs in patients with TLN were much faster (p<0.001, p<0.001. Among patients with unilateral TLN, flow velocity of MCAs was significantly different between ipsilateral and contralateral sides to the lesion (p = 0.001. CONCLUSION: Thickening of IMT, occurrence of plaque formation and hemodynamic abnormality are more common in patients after radiotherapy, especially in those with TLN, compared with healthy individuals.

  20. Clinical significance of measurement of plasma thromboxane B2 and 6-keto-prostaglandin F1α in patients with acute cerebral vascular accident

    Objective: To explore the clinical significance of the variations of plasma concentration of thromboxane B2(TXB2) and 6-keto-prostaglandin F1α (6-K-PGF1α) in patients with acute cerebral vascular accident. Methods: The plasma concentrations of TXB2 and 6-K-PGF1α in patients with acute cerebral infarction (n = 45) and patients with acute cerebral hemorrhage (n = 28) as wall as 40 controls were determined with radioimmunoassay (RIA). Results: Plasma concentration of TXB2 in patients with cerebral infarction were significantly higher than those in controls (p 1α levels were not much changed and T/P ratios (TXB2/6-K-PGF1α) were significantly increased (p 2 and 6-K-PGF1α levels were significantly increased (vs controls: p < 0.05), but T/P ratio remained unchanged. Conclusion: T/P increased obviously in patients with acute cerebral infarction, which suggested that anti-platelet aggregators might have remarkable effect on the treatment of acute cerebral infarction

  1. Elevated circulating vascular cell Adhesion Molecule-1 (sVCAM-1) is associated with concurrent depressive symptoms and cerebral white matter Hyperintensities in older adults

    Tchalla, Achille E.; Wellenius, Gregory A.; Sorond, Farzaneh A.; Travison, Thomas G.; Dantoine, Thierry; Lipsitz, Lewis A.

    2015-01-01

    Background: Circulating vascular adhesion molecule-1 (sVCAM-1) is a presumed marker of endothelial activation and dysfunction, but little is known about its association with mood. We hypothesized that elevated plasma concentrations of sVCAM-1 may be a marker of depressive symptoms due to cerebral vascular disease. Methods: We studied 680 community-dwelling participants in the MOBILIZE Boston Study, aged 65 years and older. sICAM-1 and sVCAM-1 were measured by ELISA assay and depressive sympto...

  2. Luces y sombras de la medicina basada en la evidencia: el ejemplo del accidente vascular cerebral

    Chamorro, Ángel; Alonso, Pedro; Arrizabalaga, Jon; Carné, Xavier; Camps, Victòria

    2001-01-01

    La incidencia de accidentes vasculares cerebrales (AVC) en España es de un caso nuevo cada 6 min. Esta elevada incidencia hace que los AVC representen en nuestro país la primera causa de mortalidad femenina y la segunda de mortalidad masculina. En ambos sexos, los AVC constituyen la primera causa de secuelas neurológicas permanentes. El tratamiento preventivo del AVC debe mantenerse indefinidamente, puesto que la enfermedad tiende a recurrir con el tiempo. El coste sociosanitario de esta enfe...

  3. Temporal variation in memory tests performance in cerebral vascular disease patients / Variação temporal no desempenho em testes de memória em pacientes com doença vascular cerebral

    Tania Fernandes Campos

    2007-01-01

    Full Text Available This study intended to investigate the performance in memory tests in order to adequate the neuropsychological evaluation to the temporal order of the human organism. Twelve cerebral vascular accident patients and 12 controls, of both sexes and 45-65 years old were studied. Two memory tests with visual stimuli (pictures and two with verbal stimuli (words were applied three times a day (08:00, 10:00 and 12:00 h during the first week and twice a day (14:00 and 16:00 h in the second week, during three consecutive days in two consecutive weeks. The patients showed lower scores than control subjects in all applied tests (p<0,05. The greater test sensitivity was at 14:00 h for the free recall test and at 16:00 h for recognition tests. According to these results, it is concluded that neuropsychological evaluations should be conducted preferably in the afternoon, as well for the first evaluation as for the re-evaluations.

  4. Características morfológicas da distribuição vascular cerebral de Sus scrofa Linnaeus (Mammalia, Artiodactyla Morphological characteristics of the cerebral vascular distribution of Sus scrofa Linnaeus (Mammalia, Artiodactyla

    Jurandyr de A. Câmara Filho

    2004-12-01

    Full Text Available O objetivo do presente estudo foi verificar a vascularização arterial do encéfalo do javali, Sus scrofa Linnaeus, 1758, Suidae, e comparar com outras espécies. Cinco machos e cinco fêmeas foram injetados com látex colorido. O suprimento arterial do encéfalo foi descrito e análises morfológicas foram feitas. Nesta espécie o circuito arterial do encéfalo é formado por ramos da artéria carótida interna, como: as artérias comunicantes caudais, o ramo rostral, as artérias cerebrais rostrais, e artérias comunicantes rostrais.The aim this study was to verify the arterial vascularization of the wild boar brain, Sus scrofa Linnaeus, 1758, Suidae, and compare with other species. Five male and five female were injected with colored latex. The arterial supply of the brain was described and were done morphological analyses. In this species the arterial circuit of the brain is formed by the internal carotid artery branches, such as: the caudal communicant arteries, rostral branch, rostral cerebral arteries and rostral communicant arteries.

  5. MR imaging assessment of cerebral vascular disease: A combination of angiographic and parenchymal techniques

    This study tested the accuracy and clinical utility of a three-dimensional MR angiographic technique of the cervical carotids in combination with a routine spin-echo examination of the brain as a screening examination for cerebrovascular disease in 23 patients. The technique used a fast low-angle shot sequence with a reduced echo time and voxel size, gradient refocusing, and time of flight effects to minimize signal loss secondary to phase dispersion and maximize vessel contrast. Subsequent multiplanar three-dimensional reconstructions were obtained at 50 increments about the z-axis via ray-tracing linear thresholding algorithms. Examinations were compared with IV/IA-digital subtraction angiography or Doppler US as the objective of accuracy. Results of this ongoing study indicate that an MR angiographic screening examination can be coupled with routine brain MR imaging with only a 10-14 minute extension of examination time, providing both a vascular and a parenchymal evaluation

  6. Cerebral blood flow before and after reconstructive vascular surgery in patients with TIA by 133-xenon inhalation tomography

    In a previous study in patients with transient ischemic attacks (TIA) and arteriosclerotic neck vessel disease, it was shown that no less than 9 of 14 patients studied with CT scan and cerebral blood flow (CBF) measurement in the symptomfree interval between attacks had evidence of ischemic tissue damage, either complete or incomplete infarction. Based on clinical symptoms and angiographic findings, the patients were classified as either embolic TIAs, whereas chronic hemodynamic insufficiency rendered symptomatic by postural changes was accounted for as eliciting factor in the remaining 4 patients. Four patients showed infarcted areas on the CT scan, lesions in all cases reflected as larger hypoperfused areas on the CBF tomogram. However, an additional 5 patients showed reduction of CBF on the tomographic flow map with no corresponding CT lesion when studied 2-60 days after the most recent TIA. CBF was measured by single photon emission tomography of inhaled xenon-133. The finding of longstanding hypoperfusion with no corresponding CT lesion in patients classified as embolic cases was interpreted as suggestive of ischemic tissue damage without gross infarction, elective parenchymatous necrosis - 'incomplete infarction'. In order to further validate these findings, CBF and CT scan was repeated 3 months after reconstructive vascular surgery. Tomographic procedures and computations are described. (Auth.)

  7. Occult cerebral vascular malformation: High-field (2.0 T) MR imaging and comparison with CT

    Extensive experience with CT has led to the recognition of criteria for the diagnosis of occult cerebral vascular malformation. MR demonstrated all lesions as hemorrhage foci. The most common and typical MR findings of OVCM was circumscribed thick hypointense rim on T2-weighted images (T2-Wls) representing hemosiderin deposit with various central intensities suggesting the presence of hematomas in different stages (11 lesions). Among these. the recurrent hemorrhage in small amount produced the characteristic 'a bunch of grape' appearance. But, small OCVM less than 1 cm in diameter was identified as a small homogeneous hypointense nodule on T2-Wls with sharp (6 lesions) or fade-out (1 lesions) border. There were 2 lesions showing atypical findings such as dense hemosiderin rin with central lacuma or bilobed subacute hematoma. As the associated MR findings which strongly suggest the diagnosis of OCVM signal void due to feeding or draining vessels was found in 4, lesions and the surrounding focal cortical atrophy or leukomalacia in 2 lesions. The predilection site of OCVM was subcortical (8 lesions) and periventricular (6 cases) location. CT depicted 16 of the 20 lesions, but missed 4 lesions of small OCVM. CT alone did not permit definitive diagnosis of OCVM is most cases. Fifteen lesions demonstrated on CT contained somewhat hyperdense area in central or peripheral locations. Peripheral hyperdense area corresponded to the dense hemosiderin deposit on MR and central one to the hematoma formed by recent hemorrhage. Low density area on CT usually corresponded to liquefied subacute hematoma on MR

  8. Detection of vascular cell adhesion molecule-1 expression with USPIO-enhanced molecular MRI in a mouse model of cerebral ischemia

    Vascular damage plays a critical role after stroke, leading notably to edema, hemorrhages and stroke recurrence. Tools to characterize the vascular lesion are thus a real medical need. In this context, the specific nano-particular contrast agent P03011, an USPIO (ultra-small superparamagnetic iron oxide) conjugated to a peptide that targets VCAM-1 (vascular cell adhesion molecule-1), was developed to detect this major component of the vascular inflammatory response. This study aimed to make the proof of concept of the capacity of this targeted USPIO to detect VCAM-1 with MRI after cerebral ischemia in mouse. The time course of VCAM-1 expression was first examined by immunohistochemistry in our model of cerebral ischemia-reperfusion. Secondly, P03011 or non-targeted USPIO P03007 were injected 5 h after ischemia (100 mmol iron kg-1; i.v.) and in vivo and ex vivo MRI were performed 24 h after ischemia onset. Double labeling immunofluorescence was then performed on brain slices in order to detect both USPIO and VCAM-1. VCAM-1 expression was significantly up-regulated 24 h after ischemia in our model. In animals receiving P03011, both in vivo and ex vivo MRI performed 24 h after ischemia onset showed hypointense foci which could correspond to iron particles. Histological analysis showed a co-localization of the targeted USPIO and VCAM-1. This study demonstrates that VCAM-1 detection is possible with the USPIO P03011 in a model of cerebral ischemia. This kind of contrast agent could be an interesting clinical tool to characterize ischemic lesions in terms of vascular damage. (authors)

  9. Regional cerebral blood flow analysis of vascular dementia by the 133Xe inhalation method

    Eighty-one cases of ischemic cerebrovascular disease were investigated using the 133Xe inhalation method. Fifty-six were male and 25 were female. ages ranged from 25 to 84, with a mean age of 65.4 years. Thirty-two had cerebrovascular dementia and 49 had non dementia infarction. Two criteria were used for a diagnosis of cerebrovascular dementia: 1) the presense of cerebrovascular disease and 2) a score of less than 21.5 Hasegawa's dementia scale. By computed tomographic findings all cases were classified into three groups: lesion on a right hemisphere, a left hemisphere and bilateral hemispheres. Regional cerebral blood flow (rCBF) was calculated by 2-compartmental analysis and initial slope index method. The results are as follows: 1) Cases of cerebrovascular dementia tended to have a lower mean rCBF value. (p < 0.001). 2)rCBF patterns showed lower values in the central area for cases of laterality as determined by CT scan. 3) Both interhemispheric mean rCBF and mean rCBF classified from main lesion were no significant different between dementia group and non dementia group. 4) A comparison of mean rCBF with Hasegawa's dementia scale revealed a statistically significant correlation. (p < 0.001). (author)

  10. Avaliação da aptidão cardiopulmonar em indivíduos com hemiparesia após acidente vascular encefálico Evaluación de la aptitud cardiopulmonar en individuos con hemiparesia tras accidente vascular encefálico Evaluation of cardiopulmonary fitness in individuals with hemiparesis after cerebrovascular accident

    Angélica Cristiane Ovando

    2011-02-01

    Full Text Available FUNDAMENTO: Devido à hemiparesia, a avaliação da aptidão cardiorrespiratória de indivíduos após acidente vascular encefálico (AVE, por meio de testes ergométricos com protocolos convencionais, tem se tornado um desafio. OBJETIVO: Realizar teste cardiopulmonar (TCP em hemiparéticos para uma avaliação pré-participação visando uma criteriosa prescrição de exercício aeróbico. MÉTODOS: Participaram do estudo 8 indivíduos com hemiparesia crônica, que foram submetidos a TCP realizado com protocolo individualizado em rampa, desenvolvido a partir da informação da velocidade de marcha dos indivíduos previamente avaliados em teste de pista. Foi considerada a proposta de inclinação variando entre 0 e 10,0%, velocidade inicial correspondente a 70,0% do ritmo de caminhada confortável e velocidade máxima 40,0% superior à velocidade máxima no teste de pista, na expectativa de que o TCP, com este incremento gradativo e constante da intensidade, durasse entre 6 e 8 minutos. RESULTADOS: Em 100,0% dos avaliados, o motivo para a interrupção do teste foi fadiga periférica. O VO2 de pico alcançado foi de 20,6 ± 5,7 ml/kg.min. O Limiar I foi identificado em todos os exames, situando-se em 82,64 ± 4,78% da FC de pico e 73,31 ± 4,97% do VO2 de pico. O quociente respiratório (R do grupo foi de 0,96 ± 0,09, e três dos 8 indivíduos (37,5% atingiram R superior a 1,00, sendo o Limiar II identificado nestes sujeitos. Foram encontradas relações positivas entre variáveis do TCP e escores de equilíbrio, desempenho no teste de caminhada de 6 minutos e velocidade de marcha no solo. CONCLUSÃO: O teste mostrou ser útil para prescrição de atividade física nesses indivíduos.FUNDAMENTO: Debido a la hemiparesia, la evaluación de la aptitud cardiorrespiratoria de individuos después de accidente vascular encefálico (AVE, por medio de pruebas ergométricas con protocolos convencionales, se ha vuelto en un reto. OBJETIVO: Llevar a cabo

  11. O impacto da reabilitação aquática associada à oração no desempenho funcional de pacientes pós-acidente vascular encefálico

    Jaqueline Lopes; Mônica Rouze Lira; Gina Andrade Abdala; Alberto Manoel Sarkis Oliveira

    2010-01-01

    Este artículo analiza las repercusiones de la rehabilitación acuática asociada a la oración, sobre el desempeño funcional de pacientes post-accidente vascular encefálico (AVE). Se trata de un ensayo clínico no randomizado llevado a cabo en la Clínica Adventista de la Bahia/Brasil, en 2008, con una muestra de ocho individuos a quienes les había acometido un AVE. Éstos se distribuyeron en 2 grupos y sometidos al mismo protocolo de terapia, pero el grupo control participó en una oración antes de...

  12. The contribution of CXCL12-expressing radial glia cells to neuro-vascular patterning during human cerebral cortex development

    Mariella eErrede

    2014-10-01

    Full Text Available This study was conducted on human developing brain by laser confocal and transmission electron microscopy to make a detailed analysis of important features of blood-brain barrier microvessels and possible control mechanisms of vessel growth and differentiation during cerebral cortex vascularization. The blood-brain barrier status of cortex microvessels was examined at a defined stage of cortex development, at the end of neuroblast waves of migration and before cortex lamination, with blood-brain barrier-endothelial cell markers, namely tight junction proteins (occludin and claudin-5 and influx and efflux transporters (Glut-1 and P-glycoprotein, the latter supporting evidence for functional effectiveness of the fetal blood-brain barrier. According to the well-known roles of astroglia cells on microvessel growth and differentiation, the early composition of astroglia/endothelial cell relationships was analysed by detecting the appropriate astroglia, endothelial, and pericyte markers. GFAP, chemokine CXCL12, and connexin 43 (Cx43 were utilized as markers of radial glia cells, CD105 (endoglin as a marker of angiogenically activated endothelial cells, and proteoglycan NG2 as a marker of immature pericytes. Immunolabeling for CXCL12 showed the highest level of the ligand in radial glial fibres in contact with the growing cortex microvessels. These specialized contacts, recognizable on both perforating radial vessels and growing collaterals, appeared as CXCL12-reactive en passant, symmetrical and asymmetrical vessel-specific RG fibre swellings. At the highest confocal resolution, these RG varicosities showed a CXCL12-reactive dot-like content whose microvesicular nature was confirmed by ultrastructural observations. A further analysis of radial glial varicosities reveals colocalization of CXCL12 with connexin Cx43, which is possibly implicated in vessel-specific chemokine signalling.

  13. Clinical value of multi-slice helical CT angiography in diagnosis of cerebral vascular diseases%MSCTA在脑血管性疾病诊断中的应用价值

    宁殿秀; 李智勇; 王克礼

    2006-01-01

    Objective: To evaluate the clinical value of multi-slice helical CT angiography (MSCTA) in diagnosis of cerebral vascular diseases.Methods: 52 patients with cerebral vascular diseases were examined with GE Light Speed 4-slice and 16-slice helical CT.Pitch: 0.5-3,slice thickness: 0.625-1.25 mm,adult injection dosage: 90-100 mL,children injection dosage: 2 mL/kg,injection rate: 2.5-4.0 mL/s,delay time: 15-22 s.Intelligent track scan (Smart prep Rx) were adopted in parts of these cases.Three-dimensional cerebral vascular images were processed at ADW 3.1 and ADW 4.2 workstation.Results:MSCTA could clearly display spacious anatomic details of cerebral aneurysm,including its origin,size,neck width,and trend etc.MSCTA results of 19 cases were consistent with those of operations.The diameter of the smallest cerebral aneurysm shown in our research was about 3 mm.As a non-invasive examination,MSCTA could also be applied in post-operational evaluation of cerebral aneurysm by observing the location of silver clip and the distant vessels.Besides,MSCTA could be used to diagnose arteriovenous malformation and moyamoya disease.Of all the three-dimentional imaging methods,volume rendering (VR)is the best means to display the cerebral vascular diseases.Conclusion: As a non-invasive examination,MSCTA plays an important role in detection,pre-operational and post-operational evaluation of cerebral vascular diseases.

  14. Efeitos de curto prazo de um programa de imaginação sobre o medo de queda de indivíduos pós acidente vascular encefálico Short-term effects of imagery intervention on fear of falling in individuals post-stroke

    Larissa Rebola Volpi da Silva

    2013-03-01

    Full Text Available O medo de cair é um dos principais problemas em indivíduos pós acidente vascular encefálico (AVE. A imaginação pode ser uma experiência sucedida para diminuir este aspecto. O objetivo deste estudo foi verificar o efeito de um programa de imaginação de curto prazo no medo de quedas em indivíduos pós-AVE. Sete indivíduos acometidos por AVE participaram do estudo. A Escala Internacional de Eficácia de Quedas (FES-I-Brasil foi aplicada antes (PRÉ, depois (PÓS e sete dias após a intervenção (RET. Foram realizadas quatro sessões de familiarização e seis de prática da imaginação. Não houve diferença significativa no escore total da FES-I-Brasil após intervenção (p=0,46, exceto na tarefa subir/descer escadas (PRÉ e PÓS, p=0,04; PRÉ e RET; p=0,01. Apesar da melhoria na tarefa subir/descer escadas, alterações nos demais itens da escala não foram encontradas o que pode representar um efeito relativamente reduzido do programa de imaginação de curto prazo.The fear of falling is one of the main problems with subjects after stroke. Imagery could be one succeed experience to decrease this issue. The aim of this study was to verify the effect of a short-time imagery intervention in fear of falling in subjects after stroke. Seven individuals affected by stroke participated in the study. The Falls Efficacy Scale International (FES-I-Brazil were used before (PRE, after (POST and seven days after intervention (RET. Four session of familiarization and six of imagery were performed. There were no difference in FES-I-Brazil score after intervention (p=0.46, except in up/down stairs task (PRE and POST, p=0.04; PRÉ and RET, p=0.01. Although, the improvement in up/down stairs task, no more changes were found in the scale items, which could represent a relatively reduced effect of short-time imagery intervention.

  15. Cinesioterapia previne ombro doloroso em pacientes hemiplégicos/paréticos na fase sub-aguda do acidente vascular encefálico Kinesiotherapy prevents shoulder pain in hemiplegic/paretic patients on sub-acute stage post-stroke

    Agnes Irna Horn

    2003-09-01

    Full Text Available CONTEXTO: Ombro doloroso é freqüente em pacientes com hemiplegia/hemiparesia (H/P por acidente vascular encefálico (AVE, dificultando a recuperação neuromotora gerando incapacidade funcional. OBJETIVO: Estudar tratamento fisioterapêutico para a prevenção da dor no ombro com H/P em pacientes com AVE na fase sub-aguda, e analisar desfechos secundários (força muscular do ombro acometido e movimentos funcionais ativos básicos. MÉTODO: Estudaram-se 21 pacientes (12 homens, 9 mulheres; idades 26 a 87 anos com H/P. O tratamento fisioterapêutico consistiu de 30 minutos diários de cinesioterapia, desde as 48 horas após o AVE até a alta hospitalar. Os pacientes foram avaliados antes e após o tratamento em relação à presença ou ausência de dor no ombro H/P, à força dos diversos grupos musculares do ombro e quanto aos movimentos funcionais de transferência e manutenção postural básica. RESULTADOS: Nenhum paciente apresentava dor no ombro H/P na alta (pBACKGROUND: Painful shoulder is considered the most common complication of hemiplegic/parethic (H/P stroke patients. It is a negative factor for neuromotor recovery. PURPOSE: To study the effects of kinesiotherapy treatment on shoulder pain prevention, and as a secondary endpoints, to analyze muscle strength of H/P shoulder looking at basic functional active mobility. METHOD: Twenty one inpatients (12 men, 9 women aged 26 to 87 years, with post-stroke H/P were submitted to thirty minutes daily program kinesiotherapy, started at 48 hours post-stroke up to their hospital discharge. Patients were evaluated pre and post treatment according to the presence or absence of shoulder pain, movements and shoulder strength, and for presence or absence of basic functional movements. RESULTS: No patient complaining of shoulder pain at the hospital discharge (p<0.001. The muscle strength improved signifcantly for elevation, protusion, abduction and flexion of the shoulder (p<0.001. There was

  16. Biorretroalimentação para treinamento do equilíbrio em hemiparéticos por acidente vascular encefálico: estudo preliminar Biofeedback for training of standing balance in post-stroke hemiparetic patients: a preliminary study

    Antonio Vinicius Soares

    2009-06-01

    Full Text Available Como disfunções do equilíbrio são freqüentes nos pacientes hemiparéticos por acidente vascular encefálico (AVE, o treinamento do equilíbrio é meta fundamental em seu tratamento. O objetivo deste estudo preliminar foi verificar os efeitos da biorretroalimentação, por treinamento em plataforma instável computadorizada, em seis pacientes hemiparéticos por AVE (três homens e três mulheres, com idade média de 56,2 anos. Os pacientes foram avaliados, antes e após o tratamento, quanto a mobilidade funcional (pelo teste de levantar e caminhar cronometrado, TUGT na sigla em inglês, alcance funcional, qualidade de vida relacionada à saúde (pelo Perfil de Saúde de Nottingham e equilíbrio sobre prancha instável. O treinamento foi feito na mesma prancha, em 23 sessões de cerca de 30 minutos cada, durante oito semanas. Os resultados indicam melhora do equilíbrio, em média, de 119,1% com pés separados e de 79,6% com pés juntos (pSince balance dysfunction is frequent among poststroke hemiparetic patients, balance training is a fundamental goal in their rehabilitation. The purpose of this study was to assess the effects of biofeedback balance training on an unstable computerized platform in six hemiparetic patients (three men and three women, mean age 56,2 years old. Subjects were assessed, before and after treatment, as to functional mobility (by the timed up-and-go test, TUGT, functional reach, health-related quality of life (by the Nottingham health profile, and as to equilibrium on the unstable platform. The training on an unstable computerized platform took place along 23, 30-minute sessions for 8 weeks. Results showed significant improvement (p<0.001 in standing balance, of 119.1% with feet apart, and of 79.6% with feet together; a 15% increase (p<0.001 in functional reach; a 25.6% improvement in TUGT (p<0.001; and a slight improvement in self-reported quality of life. The program brought thus significant improvements for the

  17. Characteristic pattern of cerebral perfusion in patients with the early stage of subcortical vascular dementia compared with Alzheimer's disease

    Brain perfusion SPECT has been commonly used to evaluate several different types of dementia. The aim of this study is to assess the specific patterns of regional cerebral blood flow (rCBF) in patients with the early stage of subcortical vascular dementia (SVD) and Alzheimer's disease (AD) using Tc-99m HMPAO SPECT, and to compare the differences between the two conditions. Sixteen SVD (mean age; 68.0±7.0 years, educational period; 6.3±5.6 years, CDR; 0.80±0.26). 46 AD (mean age; 69.9±7.4 years, educational period; 5.4±4.7 years, CDR; 0.86±0.23) and 12 normal control subjects (mean age; 67.1±7.7 years, educational period; 6.2±4.2 years) participated in this study. We included the patients with SVD and AD according to NINCDS-ADRDA criteria for probable AD and NINDS-AIREN criteria for probable or possible VD. They were all matched for age, education and clinical dementia scale scores. SPM analysis of the SPECT image showed significant perfusion deficits on the right temporal region and right thalamus, left insula and superior temporal gyrus, both cingulate gyri and frontal subgyral regions in patients with SVD and on the left supramarginal gyrus, superior temporal gyrus, postcentral gyrus and inferior parietal lobule, right fugiform gyrus and both cingulate gyri in patients with AD compared with control subjects (uncorrected p<0.01). SVD patients revealed significant hypoperfusion in the right parahippocampal gyrus, right cingulated gyrus, left insula, and both frontal subgyral regions compared with AD patients (uncorrected p<0.01). SVD patients revealed significant hyperperfusion in right superior frontal gyrus, left pre- and postcentral gyri, left paracentral lobule, left precuneus and both medial frontal gyri compared with AD patients (uncorrected p<0.01). Our study shows characteristic and different pattern of perfusion deficits in patients with SVD and AD, and these results may be helpful to discriminate the two conditions in the early stage of illness

  18. Efeitos da facilitação neuromuscular proprioceptiva na estabilidade postural e risco de quedas em pacientes com sequela de acidente vascular encefálico: estudo piloto Efectos de la facilitación neuromuscular propioceptiva en la estabilidad postural y riesgo de caídas en pacientes con secuela de accidente vascular encefálico: estudio piloto Effects of proprioceptive neuromuscular facilitation in postural stability and risk of falls in patients with sequelae of stroke: pilot study

    Natália Noman de Lacerda

    2013-03-01

    Full Text Available O controle do tronco é uma habilidade motora básica necessária para executar diversas tarefas funcionais, e é deficiente em pacientes que sofreram acidente vascular encefálico (AVE. Objetivo: Avaliar o efeito do método facilitação neuromuscular proprioceptiva (PNF na estabilidade postural e risco de quedas em pacientes com sequela de AVE. Metodologia: Foi realizado estudo de intervenção que consistiu em treinamento da estabilidade postural por meio de um protocolo fixo constituído por 5 exercícios utilizando o método PNF, onde foram realizados 10 atendimentos com frequência de três vezes por semana e duração em média de 45 minutos, e para a avaliação dos desfechos, utilizou-se a escala de equilíbrio de Berg (EEB. Resultados: Foram atendidos 12 homens com hemiparesia à esquerda e no mínimo seis meses de evolução e observou-se diferença altamente significativa entre os valores pré e pós teste por meio da EEB (pEl control del tronco es una habilidad motora básica necesaria para realizar diversas tareas funcionales y es deficiente en los pacientes que han sufrido Accidente Vascular Encefálico (AVE. Objetivo: Evaluar el efecto del método de Facilitación Neuromuscular Propioceptiva (PNF en la estabilidad postural y riesgo de caídas en pacientes con secuela de Accidente Vascular Encefálico (AVE. Metodología: Se realizó un estudio de intervención que consistió en entrenamiento de la estabilidad postural por medio de un protocolo fijo compuesto por cinco ejercicios utilizando el método PNF, donde fueron realizadas 10 sesiones, con frecuencia de tres veces por semana y duración media de 45 minutos. Para la evaluación de los resultados, se utilizó la escala de equilibrio de Berg (EEB. Resultados: Fueron atendidos 12 hombres con hemiparesia izquierda con un mínimo de seis meses de evolución y se observó diferencia altamente significativa entre los valores pre y post test por medio de la EEB (pThe trunk control is

  19. Systemic and cerebral vascular endothelial growth factor levels increase in murine cerebral malaria along with increased Calpain and caspase activity and can be reduced by erythropoietin treatment

    Hempel, Casper; Hoyer, Nils; Kildemoes, Anna;

    2014-01-01

    . Furthermore, we noticed increased caspase-3 and calpain activity in terminally ill mice, as measured by protease-specific cleavage of α-spectrin and p35. In conclusion, we detected increased cerebral and systemic VEGF as well as HIF-1α, which in the brain were reduced to normal in EPO-treated mice. Also...

  20. Cerebral computed tomography angiography using a 70 kVp protocol: improved vascular enhancement with a reduced volume of contrast medium and radiation dose

    Cho, Eun-Suk; Chung, Tae-Sub; Baek, Jang Hun; Suh, Sang Hyun [Gangnam Severance Hospital, Department of Radiology, Yonsei University College of Medicine, Gangnam-gu, Seoul (Korea, Republic of); Ahn, Sung Jun [Severance Hospital, Department of Radiology, Yonsei University College of Medicine, Seodaemun-gu, Seoul (Korea, Republic of); Chong, KyoungHoon [Siemens Healthcare Korea, Seodaemun-gu, Seoul (Korea, Republic of)

    2015-05-01

    To determine the feasibility of using a 70-kVp protocol compared with a 120-kVp protocol for cerebral CT angiography. An additional target was to investigate a possible reduction in the volume of contrast medium (CM) using the 70-kVp protocol. Attenuation value and CNR for iodine were determined at various tube voltage settings using a phantom. Sixty-nine volunteers were randomly assigned to one of three protocols: group A (120-kVp and CM 64 mL), group B (70-kVp and CM 64 mL), or group C (70-kVp and CM 40 mL). The attenuation value, SNR, and CNR of cerebral arteries, subjective image quality, and radiation dose were compared among the groups. The vascular attenuation, SNR, and CNR of group B were significantly higher than those of group A. Group C had a significantly higher vascular attenuation than group A. Groups B and C were significantly better than group A with respect to subjective image quality. An effective dose of 70-kVp was 10 % lower than that of 120-kVp. Using 70-kVp improved arterial enhancement, SNR, and CNR, and provided better subjective image quality, using a 10 % lower effective dose. Furthermore, the 70-kVp protocol may both reduce volume of CM by 37.5 % and improve arterial enhancement. (orig.)

  1. Cuidar de pessoa incapacitada por acidente vascular cerebral no domicílio: o fazer do cuidador familiar El cuidado de la persona incapacitada por accidente cerebro vascular en el domicilio: el hacer del cuidador familiar Taking care of persons handicapped by cerebral vascular accident at home: the familial caregiver activity

    Nara Marilene Oliveira Girardon Perlini; Ana Cristina Mancussi e Faro

    2005-01-01

    Estudo exploratório, descritivo e quantitativo que busca identificar e descrever as atividades do familiar que cuida de pessoas incapacitadas por AVC no domicílio. A amostra constituiu-se de 35 cuidadores familiares, predominantemente mulheres, esposas ou filhas. Os cuidados realizados relacionam-se ao grau de incapacidade do familiar. As orientações recebidas denotam falta de compromisso dos profissionais com a continuidade do cuidado. O cuidador aprende a cuidar no cotidiano, com base na ob...

  2. Contribution of the cerebral SPECT in the field of evaluation of the hemodynamic cerebral vascular accident risk in the Limb shaking syndrome

    The limb shaking syndrome (L.S.S.) is characterized by uncontrollable shaking of members that are caused by a passage in the upright or by an hyper extension of the neck and occur in a patient with internal carotid stenosis. To investigate the pathophysiology of L.S.S. we used brain SPECT (SPECT-E.C.D. or H.M.P.A.O.) to measure cerebral perfusion in the supine position and standing in three patients. (N.C.)

  3. Prediction of vascular cerebral accidents by PET T.D.M. with {sup 18}F-F.D.G; Prediction des accidents vasculaires cerebraux par la TEP -TDM vasculaire au 18F-FDG

    Grandpierre, S.; Chevalier, O.; Thomas, V.; Netter, F.; Meneroux, B.; Karcher, G.; Marie, P.Y. [Service de medecine nucleaire, CHU de Nancy, (France); Desandes, E. [departement d' informatique medical, centre Alexis-Vautrin, Nancy, (France)

    2009-05-15

    This study is the first to show a relationship between the vascular captation of the F.D.G. in PET and the risk of a later ischemic cerebral vascular accident. this relation seems particularly strong for the sources of the carotids junction, so that the PET with F.D.G. could be useful to evaluate the stability of atheromas injuries in this area. (N.C.)

  4. Prevention of hospital-acquired pneumonia with Yupingfeng Powder in patients with acute cerebral vascular diseases: a randomized controlled trial

    Li YAN

    2010-01-01

    Full Text Available Background: An increase in the incidence rate of hospital-acquired pneumonia (HAP has a direct influence on prognosis and survival of patients with acute cerebral vascular diseases (ACVD, and how to prevent HAP is a growing concern to clinicians.Objective: To study the efficacy of Yupingfeng Powder, a compound traditional Chinese herbal medicine, in preventing HAP in patients with ACVD.Design, setting, participants and interventions: Sixty ACVD patients with lung qi deficiency syndrome without concurrent infections were randomly divided into prevention group (28 cases and control group (32 cases. The 60 cases were all from Shanghai Yueyang Hospital of Integrated Traditional Chinese and Western Medicine. Tough measures were taken to prevent cross-infection based on treatment of the primary diseases, well nutrition and support therapy. Yupingfeng Powder was used in the prevention group to prevent HAP. The patients were treated for 10 days.Main outcome measures: The clinical symptoms, physical signs, body temperature, and chest X-ray were observed. The changes of blood immunoglobulin A (IgA, immunoglobulin G (IgG, immunoglobulin M (IgM and interleukin-6 (IL-6 were detected before and after treatment.Results: The total response rate in the prevention group was higher than that in the control group (P<0.05, and the total response rates were 78.57% (22/28 and 31.25% (10/32 respectively. The incidence rate of HAP in the prevention group was lower than that in the control group. There were no significant differences in white blood cell count, neutrophilic granulocyte count, and the levels of IgA, IgG, IgM and IL-6 between the two groups before treatment. The white blood cell count and neutrophilic granulocyte count in the control group increased after treatment, and there was a significant difference between the two groups (P<0.05. There was no significant difference in IgA level in the two groups after treatment, and the IgM levels in the two groups

  5. Epidemiologia dos acidentes cerebrovasculares em Joinville, Brasil: estudo institucional Epidemiology of cerebrovascular disease in Joinville, Brazil: an institutional study

    Norberto L. Cabral

    1997-09-01

    Full Text Available A carência de dados epidemiológicos e a impressão prévia de elevada incidência de acidente vascular cerebral (AVC no Brasil criou o estímulo para estudo institucional prospectivo em Joinville. No período de 1-março-1995 a 1-março-1996, avaliamos o primeiro episódio e episódios recorrentes em AVC, incidência, mortalidade, taxa de fatalidade-caso em 30 dias (letalidade, freqüência de fatores de risco, tempo para admissão hospitalar e distribuição dos infartos cerebrais por subtipos patológicos. Registramos 429 pacientes no período, 320 destes com primeiro episódio. Tomografia de crânio foi realizada em 98% dos casos. A taxa de incidência anual ajustada por idade em primeiro episódio de AVC foi de 156/100000. A distribuição por diagnóstico foi: 73,4% para infarto cerebral, 18.4% para hemorragia cerebral e 7,5% para hemorragia subaracnóide. A taxa de mortalidade anual padronizada foi 25/100000. A letalidade foi 26%. Hipertensão, AVC prévio e diabetes foram os fatores de risco mais freqüentes. Somente 25% dos pacientes chegaram ao hospital nas primeiras três horas iniciais. Concluímos que a taxa de incidência em primeiro episódio de AVC em pacientes institucionalizados em Joinville, Brasil, é elevada. A taxa de mortalidade e letalidade são similares as de outras populações.The paucity of epidemiologic data, and the previous impression of high incidence of cerebrovascular disease in Brazil, made us elaborate a prospective institutional study in Joinville, Brazil, with the objective of identifying first and recurrent episodes in stroke. This study occurred from March 1995 to March 1996. We evaluated during the first episode of stroke: incidence, mortality and fatality-case rate (in 30 days letality, frequency of risk factor, time in hospital and distribution of cerebral infarcts by pathological subtypes. In this period, 429 patients with stroke were registered, 320 with the first episode. 98% of all the patients

  6. Propriedades psicométricas da versão brasileira da escala de qualidade de vida específica para acidente vascular encefálico: aplicação do modelo Rasch Psychometric properties of the Brazilian version of the Stroke Specific Quality of Life Scale: application of the Rasch model

    RCM Lima

    2008-04-01

    Full Text Available CONTEXTUALIZAÇÃO: O acidente vascular encefálico (AVE produz déficits importantes na qualidade de vida (QV dos indivíduos. Medidas específicas de QV são necessárias para compreender e quantificar o impacto dessa patologia. OBJETIVO: O objetivo desse estudo foi adaptar transculturalmente o Stroke Specific Quality of Life Scale (SSQOL para o Português (Brasil e avaliar suas propriedades psicométricas. MATERIAIS E MÉTODOS: O SSQOL foi traduzido e adaptado seguindo instruções padronizadas e submetido a exame de confiabilidade teste-reteste (10 hemiplégicos. As propriedades psicométricas foram investigadas pela análise Rasch em 50 hemiplégicos. RESULTADOS: Foram detectados coeficientes de confiabilidade de 0,92 para itens e indivíduos. O índice de separação dos hemiplégicos foi 3,34 e dos itens, 3,36, ou seja, os itens separaram as pessoas em pelo menos três níveis de QV e em três níveis de QV - baixa, média e alta. Dos 49 itens, quatro não se enquadram no modelo, o que compromete a validade de constructo do instrumento, embora o padrão errático dos itens se justifique na amostra examinada. CONCLUSÕES: O instrumento mostrou-se clinicamente útil na população avaliada. Novos estudos em populações com outras características já estão em andamento.BACKGROUND: Stroke results in important deficits, which reduce individuals’ quality of life (QOL. Specific QOL measurements are necessary to understand and quantify the impact of this pathological condition. OBJECTIVE: The aim of this study was to make a transcultural adaptation of the Stroke Specific Quality of Life Scale (SSQOL into Brazilian Portuguese and to assess its psychometric properties. METHODS: The SSQOL was translated and adapted in accordance with standardized procedures and was subjected to test-retest reliability analysis with 10 hemiplegic subjects. The psychometric properties were investigated using Rasch analysis on 50 hemiplegics. RESULTS: Reliability

  7. Estimulação elétrica funcional na subluxação crônica do ombro após acidente vascular encefálico: relato de casos Functional electrical stimulation for shoulder subluxation after chronic stroke: a case report

    Juliana Barbosa Corrêa

    2009-03-01

    Full Text Available A subluxação do ombro é comum em indivíduos que sofreram acidente vascular encefálico (AVE, podendo gerar dor, lesões do plexo braquial, capsulite adesiva e lesões nos músculos da bainha rotatória, implicando atraso da reabilitação e interferência na qualidade de vida. O objetivo deste estudo foi verificar os efeitos da estimulação elétrica funcional (EEF na subluxação crônica do ombro em pacientes hemiplégicos que sofreram AVE. Foram avaliados três pacientes tendo tido AVE há mais de um ano com subluxação do ombro confirmada por exame de raios X. Foram analisados, antes e após o tratamento, o grau de subluxação e amplitude de movimento (ADM do ombro, função sensório-motora pela escala de Fugl-Meyer e dor em repouso e à movimentação passiva por meio de escala visual analógica. Todos os pacientes foram submetidos a tratamento com fisioterapia convencional e EEF no membro hemiplégico por dez sessões. A análise dos resultados mostrou melhora em relação às medidas iniciais da ADM, da avaliação sensório-motora, dor e subluxação do ombro após o uso da EEF. Concluiu-se que a EEF, asociada à fisioterapia convencional, mostrou-se eficaz em produzir diminuição da subluxação, aumento da função do membro superior e agir no alívio da dor em pacientes com subluxação do ombro pós-AVE.Shoulder subluxation is a common complication among stroke survivors; it may cause pain, brachial plexus injuries, adhesive capsulitis and rotator cuff muscle injuries, leading to rehabilitation delay and interference in patients' quality of life. The purpose of this study was to assess the effects of functional electrical stimulation (FES in post-stroke hemiplegia shoulder subluxation. Three patients with over one year of stroke onset and shoulder subluxation confirmed by X ray were assessed prior to, and after FES treatment, as to: degree of shoulder subluxation and range of motion (ROM; sensory-motor function by the Fugl

  8. Relationship between walking performance and types of community-based activities in people with stroke: an observational study Relação entre desempenho da marcha e tipos de atividades na comunidade após acidente vascular encefálico

    Matar Alzahrani

    2011-02-01

    Full Text Available OBJECTIVES: To examine the relationship between clinical walking performance and amount and type of community activity in people after stroke. METHODS: A cross-sectional observational study of 14 people with stroke living in Sydney and able to walk was carried out. Demographics (such as age, gender, side of stroke, time since stroke, presence of spouse and aspects of walking performance (such as speed, capacity, automaticity, and stairs ability were measured. People with stroke were observed for at least five hours while they carried out activities in the community. These activities were then categorized into four types: domestic intrinsic, domestic extrinsic, leisure without contact, and leisure with contact activity. RESULTS: No relationship was found between walking performance and the amount of community activity. There was no relationship between walking performance and total time spent on domestic intrinsic activity. Walking speed and stairs ability were significantly correlated with leisure with contact activity (r=0.56, p=0.04, and r=0.57, p=0.03 respectively and inversely correlated with leisure without contact (r=-0.72, pOBJETIVOS: Examinar a relação entre o desempenho da marcha e a quantidade e tipo de atividades na comunidade em indivíduos após acidente vascular encefálico (AVE. MÉTODOS: Realizou-se um estudo observacional transversal em 14 indivíduos com AVE, aptos a deambular, residentes em Sydney. Resultados demográficos (como idade, gênero, lado hemiparético, tempo desde o AVE, estado civil e aspectos de desempenho da marcha (como velocidade, resistência, automaticidade e habilidade de usar escadas foram avaliados. Os indivíduos foram observados por pelo menos cinco horas durante suas atividades na comunidade. Essas atividades foram então categorizadas em quatro tipos: intrínseco-doméstica, extrínseco-doméstica, atividade de lazer com contato e atividade de lazer sem contato. RESULTADOS: Nenhuma relação foi

  9. Cerebral Arteriosclerosis

    ... the brain can cause a hemorrhagic stroke. Both types of stroke can be fatal. Cerebral arteriosclerosis is also related to a condition known as vascular dementia, in which small, symptom-free strokes cause cumulative damage and death to neurons (nerve cells) in the brain. Personality changes in ...

  10. Cerebrovascular accident in the aged: changes in family relations El anciano tras accidente cerebrovascular: alteraciones en el relacionamento familiar O idoso após acidente vascular cerebral: alterações no relacionamento familiar

    Sueli Marques; Rosalina Aparecida Partezani Rodrigues; Luciana Kusumota

    2006-01-01

    The aims of this study were: to identify aged persons who were victims of Cerebrovascular Accident and received care at the Emergency Unit of a Public Hospital in Ribeirão Preto-SP, Brazil, and their respective families, as well as to identify the changes in family relations that occurred after the event. In order to identify these changes, the adapted Critical Incident Technique was used, while the analysis was based on the idea of Current of Thought. The sample consisted of 11 families, tot...