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Sample records for acidente vascular cerebral

  1. Acidente vascular cerebral e demência vascular no idoso

    OpenAIRE

    Ionel, Cristina

    2015-01-01

    Trabalho final de mestrado integrado em Medicina, apresentado à Faculdade de Medicina da Universidade de Coimbra. Em consequência de um fenómeno global de envelhecimento populacional, é expectável um aumento na prevalência de demência. A demência vascular é a segunda causa mais comum de demência, depois da doença de Alzheimer. Trata-se de uma entidade clínica bastante heterogénea, sendo o acidente vascular cerebral (AVC) um dos seus mecanismos subjacentes. No entanto, nem todos os doentes ...

  2. Sobrecarga dos cuidadores de idosos com acidente vascular cerebral

    Directory of Open Access Journals (Sweden)

    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.

  3. Sobrecarga dos cuidadores de idosos com acidente vascular cerebral

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    Roberta Amorim Pereira

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. A distensibilidade da aorta prediz o acidente vascular cerebral em pacientes hipertensos

    OpenAIRE

    Telmo Pereira; João Maldonado; Liliana Pereira; Jorge Conde

    2013-01-01

    FUNDAMENTO: A doença cardiovascular continua a ser principal causa de morte nos países desenvolvidos e não é inteiramente prevista por fatores de risco clássicos. O aumento da rigidez arterial constitui um importante determinante de morbidade e mortalidade cardiovascular. OBJETIVO: Avaliar se a velocidade da onda de pulso prediz a ocorrência de acidente vascular cerebral (AVC) em pacientes hipertensos. MÉTODOS: Estudo de coorte, observacional, prospetivo, multicêntrico, incluindo 1.133 pacien...

  6. Crioterapia e cinesioterapia no membro superior espástico no acidente vascular cerebral

    OpenAIRE

    Correia,Andreza de Cássia Souza; Silva,Jonathan Danilo Santos; Silva,Lícia Vasconcelos Carvalho da; Oliveira,Daniella Araujo de; Cabral,Etenildo Dantas

    2010-01-01

    INTRODUÇÃO: A espasticidade no paciente com sequela de Acidente Vascular Cerebral (AVC) acarreta limitações nas atividades de vida diária e torna-se um importante fator de risco para o desenvolvimento de deformidades estáticas quando não tratada. OBJETIVO: Avaliar o efeito da crioterapia associada à cinesioterapia no padrão postural flexor e no grau de espasticidade do membro superior de pacientes com AVC. METODOLOGIA: Participaram desta pesquisa sete voluntários que apresentavam espasticidad...

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

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    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.

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

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    João Eliézer Ferri-de-Barros

    1994-06-01

    Full Text Available 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".

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

    OpenAIRE

    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".

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

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    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.

  11. Investigação de negligência espacial unilateral após Acidente Vascular Cerebral

    OpenAIRE

    Luvizutto, Gustavo José

    2016-01-01

    Introdução: A negligência espacial unilateral (NEU) é caracterizada pela incapacidade de reportar ou responder pessoas ou objetos do lado contralateral à lesão cerebral, e ocorre principalmente após Acidente Vascular Cerebral (AVC) do lobo parietal direito, sendo associada à pior desfecho funcional à longo prazo. Objetivo: Os objetivos desta tese foram: normatizar os principais testes diagnósticos de NEU e verificar a relação com fatores sócio-demográficos na população brasileira; avaliar as ...

  12. Qualidade de vida em sobreviventes de acidente vascular cerebral: instrumentos de avaliação e seus resultados

    OpenAIRE

    Mota,Juliana Ferreira; Nicolato, Rodrigo

    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...

  13. Qualidade de vida em sobreviventes de acidente vascular cerebral: instrumentos de avaliação e seus resultados

    OpenAIRE

    Mota,Juliana Ferreira; Nicolato,Rodrigo

    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...

  14. Bem-estar subjetivo e senso de ajustamento psicológico em idosos que sofreram acidente vascular cerebral: uma revisão

    OpenAIRE

    Rabelo, Dóris Firmino; Néri,Anita Liberalesso

    2006-01-01

    Foi feito um levantamento dos estudos brasileiros e estrangeiros publicados entre 1996 e 2005 que relacionavam bem-estar subjetivo, senso de ajustamento psicológico e acidente vascular cerebral, com o objetivo de identificar variáveis mediadoras dessa relação em idosos. Estudos transversais e prospectivos indicaram que os afetados por acidente vascular cerebral apresentam menor bem-estar subjetivo quando comparados com a população geral. Boa capacidade cognitiva, suporte social efetivo, conti...

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

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    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.

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

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    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.

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

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    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.

  18. PERFIL DA DISFAGIA APÓS UM ACIDENTE VASCULAR CEREBRAL: UMA REVISÃO INTEGRATIVA

    OpenAIRE

    CARINA TEIXEIRA PAIXÃO; LOLITA DOPICO DA SILVA; FLAVIA GIRON CAMERINI

    2010-01-01

    Este artículo trata de disfagia decurrente de una enfermedad vascular cerebral (EVC). El objetivo fue determinar el perfil de las publicaciones acerca de la disfagia en pacientes víctimas de EVC. Investigación de revisión integradora que usó los mismos descriptores en las bases Medline, Scielo e Lilacs, seleccionando 17 artículos entre 1998 a 2008. Los datos fueron analizados a partir de las categorías correspondientes a los enfoques de las publicaciones encontradas. Los resultados muestran d...

  19. Estudo prospectivo sobre a incidência de infecção sistémica que precede um acidente vascular cerebral : tipos de infecção e tipos de acidentes vasculares cerebrais

    OpenAIRE

    Silva, Daniela Patrícia Leitão

    2010-01-01

    Introdução: O papel da infecção aguda como factor de risco para Acidente Vascular Cerebral tem sido objecto de discussão há já muitos anos, e vários são os estudos que demonstram que a infecção na semana prévia, pode precipitar enfartes isquémicos, em todos os grupos etários, com uma prevalência que varia de 10-35%. Os estudos já realizados atribuem às infecções respiratórias, particularmente bacterianas, uma função de gatilho mais preponderante. Objectivos: Este estudo t...

  20. PERFIL DA DISFAGIA APÓS UM ACIDENTE VASCULAR CEREBRAL: UMA REVISÃO INTEGRATIVA

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    CARINA TEIXEIRA PAIXÃO

    2010-01-01

    Full Text Available Este artículo trata de disfagia decurrente de una enfermedad vascular cerebral (EVC. El objetivo fue determinar el perfil de las publicaciones acerca de la disfagia en pacientes víctimas de EVC. Investigación de revisión integradora que usó los mismos descriptores en las bases Medline, Scielo e Lilacs, seleccionando 17 artículos entre 1998 a 2008. Los datos fueron analizados a partir de las categorías correspondientes a los enfoques de las publicaciones encontradas. Los resultados muestran diecisiete artículos agrupados en dos categorías, la que trató de la incidencia y características de la disfagia (9 y la que discutió las complicaciones de la disfagia (8. Las publicaciones de la primera categoría muestran una incidencia de la disfagia entre 30% a 91% e indican que tamaño y localización de la lesión son determinantes en la gravedad de la disfagia. La segunda categoría presenta la pulmonía y desnutrición como consecuencias de la disfagia. Se concluye que el enfermero debe guiar los cuidados direccionados a limitar el efecto de la disfagia post EVC y sus complicaciones para el paciente.

  1. Resultados funcionais da aplicação da toxina botulínica tipo A em pacientes com acidente vascular cerebral

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    Vanessa Ribas Massia

    2009-01-01

    O Acidente Vascular Cerebral (AVC), junto com as demais doenças cerebrovasculares, é a terceira causa de óbito em países desenvolvidos e a principal causa de incapacidade em adultos. A espasticidade é a seqüela motora mais incapacitante, limitando as atividades funcionais. A toxina Botulínica (TB) tem se mostrado uma opção terapêutica benéfica, eficaz e segura. Pacientes submetidos à aplicação de TB devem iniciar um tratamento fisioterapeutico a fim de estabelecer a função perdida, tornando-o...

  2. A prevalência de Acidente Vascular Cerebral (AVC) no pós-operatório de revascularizaçao do miocárdio - doi:10.5020/18061230.2006.p25

    OpenAIRE

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

    2012-01-01

    Esta pesquisa objetivou investigar a prevalência de acidente vascular cerebral (AVC) no pós-operatório de revascularização do miocárdio, de janeiro de 2000 a setembro de 2003, em um hospital que é centro de referência em cirurgia cardíaca no estado do Ceará, identificando os fatores de risco relacionados à ocorrência de acidente vascular cerebral no pós-operatório. A natureza da pesquisa foi quantitativa. A população de estudo foi constituída de pacientes de ambos os sexos, abrangendo todas a...

  3. Papel da curva de agregação plaquetária no controle da antiagregação na prevenção secundária do acidente vascular cerebral isquêmico

    OpenAIRE

    Piedade Patrícia Regina; Gagliardi Rubens José; Damiani Ibsen Thadeo; Nassar Junior Antonio Paulo; Fuzaro Melissa Martins; Sanvito Wilson Luiz

    2003-01-01

    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 isquêmic...

  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

    OpenAIRE

    Piper, Vanessa Alves

    2012-01-01

    Objetivos: Revisar a literatura científica buscando apurar o papel da dieta DASH (Dietary Approach to Stop Hypertension) na redução dos níveis de pressão arterial e na prevenção do acidente vascular cerebral Fonte de dados: Foi realizada uma revisão narrativa da literatura, utilizando as bases de dados Medline/PubMed, LILACS e SciELO. Buscaram-se artigos nos idiomas português e inglês, utilizando-se os descritores: acidente vascular cerebral/stroke, dieta/diet, hipertensão/hypertension e p...

  5. Estudo comparativo da deglutição com nasofibrolaringoscopia e videodeglutograma em pacientes com acidente vascular cerebral

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    Doria Sandra

    2003-01-01

    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 (p<0,05 quando comparados os resultados na NFL e VD. CONCLUSÕES: A análise comparativa entre os dados obtidos pelo NFL e VD em relação a parâmetros avaliados por ambos métodos, em pacientes com disfagia, mostraram não haver diferenças significativas entre eles.

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

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    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

  7. Associação entre função executiva e sintomas depressivos em pacientes com acidente  vascular cerebral isquêmico

    OpenAIRE

    2012-01-01

    INTRODUÇÃO: Associação entre sintomas depressivos e prejuízos cognitivos após o acidente vascular cerebral isquêmico tem sido descrito em vários estudos. Estudos recentes tem focado a associação de sintomas depressivos com a função executiva. A hipótese Depression Executive dysfunction tem sido investigada em pacientes com AVC e não se sabe se essa associação ocorre com algum grupo de sintomas depressivos específico. Portanto, o principal objetivo desse estudo, foi o de investigar a associaçã...

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

    Directory of Open Access Journals (Sweden)

    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

  9. As incapacidades físicas de pacientes com acidente vascular cerebral: açoes de enfermagem.

    OpenAIRE

    Paixão Teixeira, C.; Silva, LD.

    2009-01-01

    Este artículo trata de las discapacidades físicas causadas por un accidente vascular cerebral (AVC). Objetivos: identificar el perfil de las discapacidades físicas como una secuela del AVC presente en artículos y discutir las acciones de enfermería en la orientación del enfermo y su familia acerca de las discapacidades. Metodología: revisión narrativa que ha empleado los mismos descriptores en todas las bases electrónicas, seleccionando artículos entre los años de 1997 a 2...

  10. Análise da tendência da mortalidade por acidente vascular cerebral no Brasil no século XXI

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    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.

  11. O uso de tomografia computadorizada nas internações por Acidente Vascular Cerebral no Sistema Único de Saúde no Brasil Computerized tomography utilization for stroke inpatients in the Brazilian Health System

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    Cristina Lúcia Rocha Cubas Rolim

    2012-03-01

    Full Text Available O Acidente Vascular Cerebral é um dos principais motivos de internação no Sistema Único de Saúde. O exame de tomografia computadoriza tem sido indicado como o principal método diagnóstico de imagem para a definição do tratamento do Acidente Vascular Cerebral. O objetivo desse artigo é avaliar a utilização de exames de tomografia computadorizada em internações por Acidente Vascular Cerebral com base nas informações do Sistema de Informação Hospitalar do Sistema Único de Saúde. O universo de estudo incluiu as internações de pacientes adultos ocorridas no Brasil e financiadas pelo Sistema Único de Saúde entre abril de 2006 e dezembro de 2007. A análise dos dados foi descritiva para o conjunto de casos de Acidente Vascular Cerebral e para cada subgrupo separadamente. Das 328.087 internações por Acidente Vascular Cerebral, observou-se que em 73,5% o exame não foi realizado. Nas internações que realizaram tomografia computadorizada, 22,3% tiveram acesso a um exame e somente 4,2% a dois exames. Além de subutilizado, o exame de tomografia computadorizada, quando realizado, não trouxe melhora na codificação adequada do subgrupo da doença.Stroke is a leading reason for hospitalization in the Brazilian Health System. Computerized tomography has been indicated as the main diagnostic method to define stroke treatment. The aim of this paper was to evaluate the utilization of computerized tomography in hospitalizations due to stroke. The source of data was the Brazilian hospital information system. The study population comprised adult stroke inpatients in Brazil in the Brazilian Health System, between April 2006 and December 2007. Data analysis was descriptive for stroke and for each separate subgroup. Of the 328,087 stroke inpatients, 73.5% had not done a computerized tomography scan. Among hospitalizations that underwent a computed tomography scan, 22.3% had access to one test, and only 4.2% had two tests. Besides underuse

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

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    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.

  13. Time of presentation of stroke patients in São Paulo Hospital Tempo de chegada do paciente com acidente vascular cerebral no Hospital São Paulo

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    José Fábio Santos Leopoldino

    2003-06-01

    Full Text Available With the advent of time-dependent thrombolytic therapy for ischemic stroke it has become increasingly important for stroke patients to arrive at the hospital quickly. This study investigated the time that our patients took since the recognition of the symptoms until the stroke diagnosis in a hospital in the city of São Paulo. We concluded that in our hospital medical personnel and paramedics did not consider stroke as a medical emergency before neurological evaluation. Social problems as lack of access to an effective emergency medical service are another important factor that was responsible for patient's delay. Our study was important in order to identify the problems that stroke patients face in our country until the diagnosis is established.Com o uso da terapia trombolítica para acidente vascular cerebral (AVC isquêmico, torna-se importante o tempo de chegada do paciente nos serviços de referência. Neste estudo foi investigado o tempo entre o reconhecimento dos sintomas e o diagnóstico de AVC em hospital universitário na cidade de São Paulo. Concluímos que neste serviço, os profissionais da saúde não consideravam AVC uma emergência antes da avaliação neurológica. Outro fator que contribuiu para o atraso na chegada ao hospital foi dificuldade de transporte aos serviços públicos. Este estudo foi importante para a identificação dos problemas que os pacientes com AVC enfrentam para ter o diagnóstico e tratamento, o que possibilitou implantação de programas para melhora do atendimento.

  14. Avaliação dos níveis de hiper-homocisteinemia, vitamina E, selênio, cobre, ceruloplasmina e ferritina em pacientes com diagnóstico de acidente vascular cerebral isquêmico

    OpenAIRE

    Harboe-Gonçalves,Lillian; Vaz,Luiz Sérgio; Marcelo,Buzzi

    2007-01-01

    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 acopla...

  15. 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

    OpenAIRE

    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...

  16. A prevalência de Acidente Vascular Cerebral (AVC no pós-operatório de revascularizaçao do miocárdio - doi:10.5020/18061230.2006.p25

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    Carolina Meireles Rosa

    2012-01-01

    Full Text Available Esta pesquisa objetivou investigar a prevalência de acidente vascular cerebral (AVC no pós-operatório de revascularização do miocárdio, de janeiro de 2000 a setembro de 2003, em um hospital que é centro de referência em cirurgia cardíaca no estado do Ceará, identificando os fatores de risco relacionados à ocorrência de acidente vascular cerebral no pós-operatório. A natureza da pesquisa foi quantitativa. A população de estudo foi constituída de pacientes de ambos os sexos, abrangendo todas as faixas etárias que se submeteram a cirurgia de revascularização do miocárdio e que no pós-operatório apresentaram ou não complicações, entre elas o AVC. As variáveis estudadas foram o sexo, idade, tempo de internação, número de óbitos, fatores de risco, tipo de cirurgia, utilização de circulação extracorpórea no trans-operatório e o tipo de complicações pós-operatórias. Os resultados obtidos demonstraram que a cirurgia de revascularização predominou em homens entre 60 e 69 anos. Em relação aos fatores de risco, somente 18 (2,8% dos 650 pacientes investigados não apresentaram nenhum fator de risco. Encontraram-se 53 casos de acidente vascular cerebral pós-operatório, e destes, 52 (98,1% foram isquêmicos e 1 (1,9% hemorrágico. Dentre as complicações que mais surgiram no pós-operatório destacaram-se o infarto agudo do miocárdio, seguido de infecção respiratória e derrame pleural. Dos 58 pacientes que foram a óbito, 27,6% tiveram AVC pós-operatório. Pelos dados obtidos concluiu-se que não houve significância estatística na associação entre a ocorrência de acidente vascular cerebral pós-operatório e cirurgia de revascularização do miocárdio.

  17. Intervenções de enfermagem na promoção da autonomia/independência face ao autocuidado após acidente vascular cerebral : uma revisão sistemática da literatura

    OpenAIRE

    Neves, Cátia Sofia

    2014-01-01

    O Acidente Vascular Cerebral (AVC) constitui uma das principais causas de incapacidade funcional com repercussão a nível do desempenho do autocuidado. Tendo em atenção o perfil demográfico e as alterações nos estilos de vida das populações, prevê-se uma crescente incidência deste evento gerador de dependência, aumentando com a idade, sendo o género masculino mais afetado. As transformações decorrentes do AVC ocorrem de forma súbita e inesperada, dificultando a preparação psicológica, a integr...

  18. Análise cinemática da marcha em indivíduos com hemiparesia espástica após acidente vascular cerebral = Kinematic analysis of gait in individuals with spastic hemiparesis secondary to stroke

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    Westphal, Patrick Jacobsen

    2016-01-01

    Conclusões: O estudo indicou alterações na cinemática da marcha do membro acometido de indivíduos hemiparéticos após acidente vascular cerebral, comparando com a normalidade e com o membro contralateral, caracterizando a presença de um padrão flexor incomum. Essas alterações podem estar relacionadas com diminuição do equilíbrio e do controle motor, fraqueza muscular, déficit proprioceptivo, aumento do tônus, contraturas e deformidades

  19. 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

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    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.

  20. 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

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    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.

  1. Stroke caused auditory attention deficits in children Acidente vascular cerebral causa défices da atenção seletiva auditiva em crianças

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    Karla Maria Ibraim da Freiria Elias

    2012-01-01

    Full Text Available OBJECTIVE: To verify the auditory selective attention in children with stroke. METHODS: Dichotic tests of binaural separation (non-verbal and consonant-vowel and binaural integration - digits and Staggered Spondaic Words Test (SSW - were applied in 13 children (7 boys, from 7 to 16 years, with unilateral stroke confirmed by neurological examination and neuroimaging. RESULTS: The attention performance showed significant differences in comparison to the control group in both kinds of tests. In the non-verbal test, identifications the ear opposite the lesion in the free recall stage was diminished and, in the following stages, a difficulty in directing attention was detected. In the consonant- vowel test, a modification in perceptual asymmetry and difficulty in focusing in the attended stages was found. In the digits and SSW tests, ipsilateral, contralateral and bilateral deficits were detected, depending on the characteristics of the lesions and demand of the task. CONCLUSION: Stroke caused auditory attention deficits when dealing with simultaneous sources of auditory information.OBJETIVO: Verificar a habilidade de atenção seletiva em crianças com acidente vascular cerebral (AVC. MÉTODOS: Foram aplicados testes dicóticos de separação (não verbal e consoante-vogal e integração - dígitos e Staggered Spondaic Words Test (SSW - binaural em 13 crianças (7 meninos, entre 7 e 16 anos, com AVC unilateral confirmado por neuroimagem. RESULTADOS: O desempenho atencional diferiu entre os grupos na realização de ambos os tipos de tarefa. Ao teste não verbal, houve menor quantidade de identificações com a orelha contralateral à lesão em atenção livre e dificuldade de focalizar a atenção nas etapas direcionadas. No teste consoante-vogal, houve modificação da assimetria perceptual e dificuldade de focalizar a atenção nas etapas direcionadas. Nos testes de dígitos e SSW, foram constatados défices ipsilaterais, contralaterais e

  2. Ischemic stroke in children: a study of the associated alterations Acidente vascular cerebral isquêmico na infância: estudo das alterações associadas

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    Josiane Ranzan

    2004-09-01

    Full Text Available Arterial ischemic stroke (AIS in children is a relatively rare disease, not yet clearly understood and with a multifactored etiology. It can cause a severe impact on the child and be the first manifestation of a systemic disease. Delayed diagnosis is still common and research on the subject in our field practically does not exist. Prothrombotic disorders have been described as important causative factors of the ischemic event in children. Forty-six patients from zero to 18 years of age diagnosed with AIS were studied in the period between March 2002 and September 2003. Laboratory tests were realised including coagulation proteins and echocardiogram. AIS of the newborn occurred in 37% of the cases. Focal seizures and hemiparesis were the most frequent symptoms; 40% of the patients presented prior pathologies. Abnormalities of the S and C proteins occurred in 22% and 17%. Associated alterations, particularly those that generate a hypercoagulability state, indicate more than one risk factor for this disease in childhood.Acidente vascular cerebral Isquêmico (AVCI na infância é relativamente raro, de conhecimento ainda obscuro, e com etiologia multifatorial. Pode causar grave impacto na criança e ser a primeira manifestação de doença sistêmica. O subdiagnóstico ainda é comum e são praticamente inexistentes as pesquisas sobre o assunto no nosso meio. Desordens protrombóticas têm sido descritas como importantes fatores causais do evento isquêmico na infância. Foram estudados 46 pacientes de zero a 18 anos, com diagnóstico de AVCI, no período de março/2002 a setembro/2003. Exames laboratoriais, incluindo proteínas de coagulação e ecocardiograma foram realizados. AVCI neonatal ocorreu em 35% dos casos. Crise focal e hemiparesia foram os sintomas iniciais mais freqüentes; 40% dos casos apresentaram patologia prévia. Anormalidades nas proteínas S e C ocorreram em 22% e 17% da amostra. Alterações associadas, principalmente as que

  3. A stepwise approach to stroke surveillance in Brazil: the EMMA (Estudo de Mortalidade e Morbidade do Acidente Vascular Cerebral) study.

    Science.gov (United States)

    Goulart, Alessandra C; Bustos, Iara R; Abe, Ivana M; Pereira, Alexandre C; Fedeli, Ligia M; Benseñor, Isabela M; Lotufo, Paulo A

    2010-08-01

    Stroke mortality rates in Brazil are the highest in the Americas. Deaths from cerebrovascular disease surpass coronary heart disease. To verify stroke mortality rates and morbidity in an area of São Paulo, Brazil, using the World Health Organization Stepwise Approach to Stroke Surveillance. We used the World Health Organization Stepwise Approach to Stroke Surveillance structure of stroke surveillance. The hospital-based data comprised fatal and nonfatal stroke (Step 1). We gathered stroke-related mortality data in the community using World Health Organization questionnaires (Step 2). The questionnaire determining stroke prevalence was activated door to door in a family-health-programme neighbourhood (Step 3). A total of 682 patients 18 years and above, including 472 incident cases, presented with cerebrovascular disease and were enrolled in Step 1 during April-May 2009. Cerebral infarction (84.3%) and first-ever stroke (85.2%) were the most frequent. In Step 2, 256 deaths from stroke were identified during 2006-2007. Forty-four per cent of deaths were classified as unspecified stroke, 1/3 as ischaemic stroke, and 1/4 due to haemorrhagic subtype. In Step 3, 577 subjects over 35 years old were evaluated at home, and 244 cases of stroke survival were diagnosed via a questionnaire, validated by a board-certified neurologist. The population demographic characteristics were similar in the three steps, except in terms of age and gender. By including data from all settings, World Health Organization stroke surveillance can provide data to help plan future resources that meet the needs of the public-health system.

  4. Estado neurológico e cognição de pacientes pós-acidente vascular cerebral

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    Fabrícia Azevêdo da Costa

    2011-10-01

    Full Text Available Objetivou-se investigar por meio de uma equipe multidisciplinar o estado neurológico e o desempenho cognitivo de pacientes pós-AVC mediante um estudo transversal com 45 pacientes em processo de reabilitação após um AVC agudo. Utilizaram-se como instrumentos de coleta de dados uma ficha de avaliação, o Mini Mental-MEEM e o National International Health Stroke Scale-NIHSS. Amostra mostrou-se predominantemente feminina (55,6%, AVC Isquêmico (86,7%, hemisfério cerebral direito (60% e Escolarizados (68,8%. A média do MEEM para escolarizados e analfabetos foi de 19,3 ± 5,0 e 15,92 ± 3,7, respectivamente. A média geral do estado neurológico encontrado foi 13,0±4,8. Houve diferença significativa entre as médias cognitivas dos pacientes quanto à escolaridade (p valor=0,017 e relação significativa entre o estado neurológico e o desempenho cognitivo (r=-0,44 p valor=0,002. O estado neurológico e o nível cognitivo de pacientes pós-AVC agudo parecem estar diretamente relacionados, o que evidencia a necessidade de maior atenção à questão cognitiva envolvida no início do processo de reabilitação.

  5. Sintomas de depressão e ansiedade estão associados a alterações na Default Mode Network em pacientes com acidente vascular cerebral isquêmico subagudo

    OpenAIRE

    Jéssica Elias Vicentini

    2016-01-01

    Resumo: Sintomas de depressão e ansiedade são comuns após um acidente vascular cerebral (AVC) e estão associados à redução na qualidade de vida e pior recuperação física e social. A Default Mode Network (DMN) é uma rede cerebral que desempenha papel importante nos processos emocionais. O presente trabalho objetivou investigar se sintomas de depressão e ansiedade no primeiro mês após AVC isquêmico estão associados a alterações na conectividade funcional da DMN. Trinta e quatro pacientes com AV...

  6. Sintomas de depressão e ansiedade estão associados a alterações na Default Mode Network em pacientes com acidente vascular cerebral isquêmico subagudo

    OpenAIRE

    Jéssica Elias Vicentini

    2016-01-01

    Sintomas de depressão e ansiedade são comuns após um acidente vascular cerebral (AVC) e estão associados à redução na qualidade de vida e pior recuperação física e social. A Default Mode Network (DMN) é uma rede cerebral que desempenha papel importante nos processos emocionais. O presente trabalho objetivou investigar se sintomas de depressão e ansiedade no primeiro mês após AVC isquêmico estão associados a alterações na conectividade funcional da DMN. Trinta e quatro pacientes com AVC isquêm...

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

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    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

  8. Estudo de fatores clínicos preditivos para crises epilépticas após acidente vascular cerebral isquêmico Preditive clinical factors for epileptic seizures after ischemic stroke

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    Marcia Maiumi Fukujima

    1996-06-01

    Full Text Available Apresentamos aspectos clínicos de 35 pacientes com acidente vascular cerebral isquêmico que evoluíram com crises epilépticas (Grupo 1, comparando-os a 35 pacientes com AVCI sem crises epilépticas (Grupo 2. A comparação das idades entre os grupos não mostrou diferença significante. O sexo masculino e a raça branca predominaram em ambos os grupos. Diabetes melito, hipertensão arterial, ataque isquêmico transitório, acidente vascular cerebral pregresso, enxaqueca, doença de Chagas, embolia cerebral cardiogênica e uso de anticoncepcional oral não diferiram significantemente entre os grupos. Tabagismo e etilismo foram significantemente mais freqüentes no Grupo 1 (pPreditive clinical factors for epileptic seizures after ischemic stroke. Clinical features of 35 patients with ischemic stroke who developed epilepsy (Group 1 were compared with those of 35 patients with ischemic stroke without epilepsy (Group 2. The age of the patients did not differ between the groups. There were more men than women and more white than other races in both groups. Diabetes melitus, hypertension, transient ischemic attack, previous stroke, migraine, Chagas disease, cerebral embolism of cardiac origin and use of oral contraceptive did not differ between the groups. Smokers and alcohol users were more frequent in Group 1 (p<0,05. Most patients of Group 1 presented with hemiparesis; none presented cerebellar or brainstem involvement. Perhaps strokes in smokers have some different aspects, that let them more epileptogenic than in non smokers.

  9. 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

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    Oliveira, Fábio Pascotto de

    2008-01-01

    Conclusões: o nitroprussiato de sódio foi aplicável e seguro para uso no acidente vascular cerebral isquêmico. São necessários estudos maiores e prospectivos para corroborar estes resultados e avaliar o seu potencial efeito neuroprotetor

  10. Bem-estar subjetivo e senso de ajustamento psicológico em idosos que sofreram acidente vascular cerebral: uma revisão Subjective well being and perceived psychological adjustment among old people affected by stroke: a review

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    Dóris Firmino Rabelo

    2006-08-01

    Full Text Available Foi feito um levantamento dos estudos brasileiros e estrangeiros publicados entre 1996 e 2005 que relacionavam bem-estar subjetivo, senso de ajustamento psicológico e acidente vascular cerebral, com o objetivo de identificar variáveis mediadoras dessa relação em idosos. Estudos transversais e prospectivos indicaram que os afetados por acidente vascular cerebral apresentam menor bem-estar subjetivo quando comparados com a população geral. Boa capacidade cognitiva, suporte social efetivo, continuidade de uma ocupação produtiva, manutenção da competência em atividades instrumentais de vida diária e humor positivo são fatores que podem melhorar o bem-estar subjetivo e psicológico. Variáveis que podem piorar o bem-estar subjetivo e psicológico são incapacidade funcional, déficits cognitivos, depressão, dificuldade em restabelecer a identidade e restrição à possibilidade de desempenhar atividades e papéis que contribuem para a auto-definição. O conhecimento das implicações psicológicas de sofrer acidente vascular cerebral pode beneficiar pacientes, familiares e profissionais no gerenciamento do evento.We gathered data from Brazilian and foreign studies published between 1996 and 2005 which related subjective well-being, sense of psychological adjustment and stroke. The objective was identifying mediator variables of this relation among old people. Prospective and cross-sectional studies indicated that those affected by stroke showed less subjective well-being than the general population. Good cognitive capacity, effective social support, continuity of a productive occupation, keeping the competence in instrumental activities of daily living and good mood are factors which can affect positively the subjective and psychological well-being. Variables which can affect negatively the subjective and psychological well-being are functional incapacity, cognitive deficits, depression, difficulty in re-establishing the identity and

  11. 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

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    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.

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

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    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

  13. 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

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    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

  14. ValidaÃÃo dos resultados de enfermagem estado de deglutiÃÃo e prevenÃÃo da aspiraÃÃo em pacientes apÃs acidente vascular cerebral.

    OpenAIRE

    Ana Railka de Souza Oliveira

    2013-01-01

    Teve-se como proposta construir e validar as definiÃÃes conceituais e os referentes empÃricos dos Resultados de Enfermagem (RE) relacionados ao Estado da deglutiÃÃo e à PrevenÃÃo da aspiraÃÃo em pacientes apÃs acidente vascular cerebral (AVC). Estudo metodolÃgico, realizado em trÃs etapas: anÃlise de conceito, validaÃÃo por especialistas e validaÃÃo clÃnica. Para a AnÃlise de Conceito, realizou-se RevisÃo Integrativa, com acesso on-line a seis bases de dados: Pubmed, Cinahl, Scopus, EMBASE, W...

  15. Validação da versão em português da entrevista telefônica para avaliação do estado cognitivo - modificada (TICS-M) em pacientes acometidos por acidente vascular cerebral

    OpenAIRE

    2014-01-01

    Introdução: O AVC (acidente vascular cerebral) é uma das mais importantes causas de alterações neuropsicológicas. Uma avaliação cognitiva inicial realizada por telefone implicaria em um diagnóstico mais precoce de prejuízo cognitivo e demência, reduzindo custos e tempo. Objetivo: Examinar as propriedades psicométricas da versão brasileira da Entrevista Telefônica para Avaliação do Estado Cognitivo - Modificada (TICS-M) em pacientes pós-AVC. Métodos: Previamente à validação da TICS-M em indiví...

  16. Segurança do transplante autólogo, intra-arterial, de células mononucleares da medula óssea na fase aguda do acidente vascular cerebral isquêmico

    OpenAIRE

    Maria Lúcia Furtado de Mendonça; Freitas,Gabriel R.; Suzana Alves da Silva; Aquiles Manfrim; Carlos Henrique Eiras Falcão; Constantino Gonzáles; Charles André; Hans Fernando Rocha Dohmann; Radovan Borojevic; Rosália Mendez Otero

    2006-01-01

    O acidente vascular cerebral (AVC) é a terceira causa de óbito e a principal causa de incapacidade em indivíduos adultos. Embora a mortalidade do AVC esteja diminuindo em alguns países, a morbidade tem aumentado em razão do envelhecimento da população e do aumento da sobrevida dos pacientes¹. O tratamento com ativador do plasminogênio tissular recombinante (rt-PA) é eficaz quando instituído em até 3 horas após o início dos sintomas², porém seu uso está limitado a cerca de 5% dos pacientes na ...

  17. BREVE ESTUDO DO ESTADO DA ARTE SOBRE ACIDENTE VASCULAR CEREBRAL E SERIOUS GAMES PARA APLICAÇAO NO PROJETO “AVC” DO NÚCLEO DE TECNOLOGIA ASSISTIVA DA UFS

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    Saulo Lordão Andrade Barros

    2013-03-01

    Full Text Available O Acidente Vascular Cerebral é uma das principais causas de morte e de sequelas no mundo. A doença atinge cerca de 16 milhões de pessoas anualmente, dessas, seis milhões morrem. No Brasil, é a principal causa de morte e incapacidade, gerando impactos econômicos e sociais. O trabalho de recuperação desses pacientes é de suma importância para diminuir os impactos causados. Para isto, o presente artigo traz uma revisão da literatura existente sobre a doença e seu tratamento, com foco na utilização de novas tecnologias, como o uso de jogos eletrônicos sérios, a fim de aprimorar o trabalho de recuperação tanto no âmbito físico quanto no emocional.

  18. Papel da curva de agregação plaquetária no controle da antiagregação na prevenção secundária do acidente vascular cerebral isquêmico

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    Piedade Patrícia Regina

    2003-01-01

    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% (0,03

  19. 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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  20. Análise das barreiras à utilização de trombolíticos em casos de acidente vascular cerebral isquêmico em um hospital privado do Rio de Janeiro, Brasil

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    Luiz Henrique de Oliveira Fonseca

    2013-12-01

    Full Text Available O acidente vascular cerebral isquêmico (AVCi é uma importante causa de sequela e morte. A correta utilização do trombolítico enfrenta várias barreiras. O objetivo foi discutir as barreiras à terapia trombolítica em pacientes que chegam, com sintomas de AVCi agudo, à emergência de um hospital privado do Rio de Janeiro, Brasil. Coorte retrospectiva de pacientes entre 2009 e 2011. Foram admitidos 257 pacientes com suspeita de AVCi. Dos pacientes com diagnóstico confirmado (156, 11,5% (18 foram trombolisados. Dos 30 pacientes com diagnóstico de AVCi, dentro da janela terapêutica e com NIHSS na faixa para trombólise, 20 não foram trombolisados, 9 por barreiras administrativas (45%. Neste trabalho o percentual de trombólise foi superior ao observado nos Estados Unidos, mas barreiras impediram o tratamento de 45% dos pacientes com indicação à trombólise. Imagina-se que na rede pública brasileira a situação seja ainda mais desfavorável.

  1. 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

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    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

  2. Uso incorreto de medicamentos por pacientes após acidente vascular cerebral Uso incorrecto de medicamentos por pacientes después de un accidente cerebro vascular Incorrect use of medicines by patients post cerebrovascular accident

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    Lolita Dopico da Silva

    2011-07-01

    Full Text Available Objetivo. Avaliar o emprego de medicamentos no lar pelos pacientes vítimas de um acidente vascular cerebral (AVC. Metodologia. Estudo transversal de uma mostra representativa de 30 pacientes que recebiam atendimento público domiciliário no Rio de Janeiro (Brasil em 2008. Por meio de entrevista estruturada aos pacientes se tomou informação sobre os fatores de risco para AVC, os medicamentos que estavam tomando e o uso correto ou incorreto dos mesmos, utilizando para isto a classificação de DRUGDEX® System. Resultados. Os participantes de idade avançada e com predomínio de mulheres. A média de medicamentos por foi 3.3. As causas do erro mais comuns foram: a tomada do medicamento com alimentos e com outras medicações. As proporções mais altas de uso incorreto de medicamento em mais de 50% das doses foram: espironolactona, glibenclamida e atenolol (a cada uma com 100.0%, sinvastatina (87.5%, furosemida (83.3%, captropril (72.5% e insulina NPH (66.7%. Conclusão. Uma grande proporção de pacientes depois de um AVC usam incorretamente os medicamentos prescritos para o tratamento no lar.Objetivo. Evaluar el empleo de medicamentos en el hogar por los pacientes víctimas de un accidente cerebrovascular (ACV. Metodología. Estudio transversal de una muestra representativa de 30 pacientes que recibían atención pública domiciliario en Río de Janeiro (Brasil en 2008. En la muestra predominaron las mujeres y los pacientes de edad avanzada. Por medio de entrevista estructurada a los pacientes se tomó información sobre los factores de riesgo para ACV, los medicamentos que estaban tomando y el uso correcto o incorrecto de los mismos, utilizando para esto la clasificación de DRUGDEX® System. Resultados. El promedio de medicamentos por fue 3.3. Las causas más comunes de error fueron la toma del medicamento con alimentos y con otras medicaciones. Las proporciones más altas de uso incorrecto de medicamento en más del 50% de las dosis

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

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    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%.

  4. 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

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    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

  5. Temperature variation in the 24 hours before the initial symptoms of stroke Variação da temperatura nas 24 horas anteriores aos sintomas iniciais do acidente vascular cerebral

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    Fernando Morgadinho Santos Coelho

    2010-04-01

    Full Text Available A few studies have performed to evaluate the temperature variation influences over on the stroke rates in Brazil. METHOD: 176 medical records of inpatients were analyzed after having had a stroke between 2004 and 2006 at Hospital Israelita Albert Einstein. The temperature preceding the occurrence of the symptoms was recorded, as well as the temperature 6, 12 and 24 hours before the symptoms in 6 different weather substations, closest to their houses in São Paulo. RESULTS: Strokes occurred more frequently after a variation of 3ºC between 6 and 24 hours before the symptoms. There were most hospitalizations between 23-24ºC. CONCLUSION: Incidence of stroke on these patients was increased after a variation of 3º Celsius within 24 hours before the ictus. The temperature variations could be an important factor in the occurrence of strokes in this population.Poucos trabalhos têm estudado a variação sazonal e de temperatura em acidente vascular cerebral (AVC no Brasil. MÉTODO: Foram analisados 176 registros de pacientes com AVC no Hospital Israelita Albert Einstein entre 2004 e 2006. Foram anotadas as temperaturas ambientes do início dos sintomas, bem como as temperaturas de 6, 12 e 24 horas antes dos sintomas, em 6 diferentes subestações metereológicas mais próximas da casa do paciente em São Paulo. RESULTADOS: Houve aumento da incidência do AVC com a variação de 3ºC entre 6 e 24 horas antes do início dos sintomas. Houve um pico de internação entre 23-24ºC. CONCLUSÃO: A variação de temperatura de 3ºC nas 24 horas que antecederam o início dos sintomas pode ter sido um fator importante na ocorrência do AVC.

  6. 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

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    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

  7. 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

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    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.

  8. Avaliação por ressonância magnética funcional e estimulação magnética transcraniana da intervenção única da terapia espelho em pacientes após acidente vascular cerebral isquêmico

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    Novaes, Morgana Menezes

    2012-01-01

    A Terapia Espelho (TE) vem sendo usada como ferramenta de reabilitação para várias doenças, incluindo o Acidente Vascular Cerebral (AVC). Embora alguns estudos tenham mostrado sua eficácia clínica, pouco se sabe sobre os mecanismos neurais que levam à melhora observada. Desse modo, este estudo teve como objetivo avaliar a neuromodulação cortical promovida pela intervenção única da TE em pacientes acometidos por AVC, por meio da Ressonância Magnética funcional (fMRI, do inglês ...

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

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    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.

  10. 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

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    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

  11. 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

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    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.

  12. Screening for MELAS mutations in young patients with stroke of undetermined origin Mutações relacionadas à síndrome de MELAS em pacientes jovens com acidente vascular cerebral de etiologia indeterminada

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    Adriana Bastos Conforto

    2007-06-01

    Full Text Available PURPOSE: It has been suggested that mitochondrial disease may be responsible for a substantial proportion of strokes of indetermined origin. We have preliminarily screened for MELAS (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes mutations in young patients with cryptogenic strokes. METHOD: The mitochondrial mutations A3243G and T3271C were investigated in 38 subjects aged less than 46 years. Group 1: 15 patients with cryptogenic strokes; Group 2: 3 patients with diagnosis of MELAS syndrome, including stroke-like episodes; Group 3: 20 healthy subjects. RESULTS: The A3243G mutation was absent in all subjects in Groups 1 and 3 but was present in all subjects in Group 2. CONCLUSION: Our results do not support screening for these mutations to diagnose oligosymptomatic forms of MELAS in cryptogenic strokes in the absence of other features of the syndrome. We suggest that clinical findings should guide mitochondrial genetic testing.PROPÓSITO: Foi sugerido que mitocondriopatias possam ser responsáveis por uma proporção substancial de acidentes vasculares cerebrais de etiologia indeterminada. Realizamos um estudo preliminar de pesquisa de mutações relacionadas à síndrome de MELAS (encefalomiopatia mitocondrial, acidose lática e episódios "stroke-like" em pacientes jovens com acidentes vasculares cerebrais criptogênicos. MÉTODO: As mutações mitocondriais A3243G e T3271C em 38 indivíduos com menos de 46 anos. Grupo 1: 15 pacientes com acidentes vasculares cerebrais criptogênicos; Grupo 2: 3 pacientes com diagnóstico de síndrome de MELAS, incluindo episódios "stroke-like"; Grupo 3: 20 voluntários saudáveis. RESULTADOS: A mutação A3243G esteve ausente em todos os indivíduos dos Grupos 1 e 3 mas esteve presente em todos os indivíduos do Grupo 2. CONCLUSÃO: Nossos resultados sugerem que não há utilidade em pesquisar estas mutações para diagnosticar formas oligossintomáticas de MELAS em acidentes

  13. 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

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    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

  14. Frequency of stroke types at an emergency hospital in Natal, Brazil Freqüência dos tipos de acidente vascular cerebral em hospital de emergência, Natal, Brasil

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    Antonio N.N. Martins Jr

    2007-12-01

    Full Text Available We performed a cross-sectional study of stroke type frequency at a local emergency hospital, in Natal, Brazil. The sample consisted of all patients who were admitted to an emergency hospital with a presumptive diagnosis of stroke. Of the 416 patients, 328 were studied, 88 were excluded for not meeting inclusion criteria, 74.7% (n= 245 had ischemic stroke 17.7% (n=58 had intracerebral hemorrhage, 7.6% (n=25 had subarachnoid hemorrhage; 173 were men (52.7%. Mean age was 64.1 years. The intrahospital mortality rate was 10.2%, 17.2% and 36% for ischemic stroke, intracerebral hemorrhage and subarachnoid hemorrhage, respectively. The most prevalent modifiable risk factor was hypertension for ischemic stroke (67.6% and hemorrhage stroke (57.8%. Logistic regression analysis identified diabetes (OR=3.70; CI=1.76-7.77 as independent risk factor for ischemic stroke. The ischemic stroke was most common type of stroke. Hypertension and diabetes were important risk factors for stroke.Realizamos um estudo de prevalência para determinar a freqüência dos tipos de acidente vascular cerebral (AVC num hospital de urgência de Natal. Estudaram-se todos os pacientes que foram admitidos no hospital de urgência com diagnóstico presuntivo de AVC. Dos 416 pacientes, 328 foram estudados, 88 foram excluídos por não cumprirem os critérios de inclusão, 74,7% (n= 245 tiveram AVC isquêmico, 17,7% (n=58 hemorragia intracerebral e 7,6% (n=25 hemorragia subaracnóidea. O gênero mais prevalente foi o masculino (52,7%. A média de idade foi 64,1 anos. A letalidade intra-hospitalar foi de 10,2%, 17,2% e 36% para o tipo isquêmico, hemorrágico e hemorragia subaracnóide, respectivamente. O principal fator de risco modificável foi a hipertensão arterial sistêmica (HAS para AVC isquêmico (67,6% e AVC hemorrágico (57,8%. A regressão logística identificou diabetes como fator de risco independente para AVC isquêmico (OR=3,70; IC=1,76-7,77. O AVC isquêmico foi o tipo

  15. 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

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    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

  16. 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

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    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

  17. 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

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    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

  18. 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?

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    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

  19. Diagnóstico de acidente vascular isquémico no Serviço de Urgência : concordância entre a classificação clínica da Oxfordshire Community Stroke Project e os dados imagiológicos na tomografia computorizada

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    Brito, Daniela Sofia Barbosa

    2009-01-01

    Introdução: O acidente vascular cerebral é a primeira causa de morte em Portugal. A tomografia computorizada é um dos exames de referência na abordagem inicial do doente. A classificação da Oxfordshire Community Stroke Project consiste numa classificação clínica do acidente vascular cerebral isquémico. Objectivos: Determinar se existe concordância entre a classificação da Oxfordshire Community Stroke Project do acidente vascular cerebral isquémico agudo durante o internamento e os dados do re...

  20. 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

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    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.

  1. 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 ?

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    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

  2. Does botulinum toxin improve the function of the patient with spasticity after stroke? Toxina botulínica proporciona melhora funcional em pacientes com espasticidade secundária a acidente vascular cerebral?

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    Eduardo Cardoso

    2007-09-01

    Full Text Available Post-stroke spasticity is an important cause of disability in adults, due to muscle hyperactivity, which results in limb stiffness and muscle spasm. The prognosis for these patients depends on several features such as early management and adequate physical therapy to avoid muscle shortening, pain, and their consequences. Although several papers have shown that intramuscular injections of botulinum toxin type A (BT-A decreases spasticity in post-stroke patients, few authors have demonstrated functional improvement after this therapy. In order to assess if individualized BT-A injections improves upper limb function in post-stroke spastic patients, we prospectively followed 20 consecutive patients of 18 years of age or more with spastic hemiparesis secondary to stroke. Fulg-Meyer scale modified for upper limbs, measure of functional independence (MFI, Ashworth modified scale, and goniometry were applied in the beginning of the investigation and in the 16th and 32nd weeks. BT-A was applied at baseline and in the 16th week. All subjects were submitted to rehabilitation therapy. All patients showed improvement according to Ashworth modified scale and increase in the range of motion, which were sustained until the 32nd week (pEspasticidade secundária a acidente vascular cerebral (AVC é importante causa de incapacidade em adultos. O prognóstico para estes pacientes depende de vários fatores como tratamento precoce e terapia física adequada, evitando encurtamento muscular, dor e outras conseqüências. Vários estudos têm demonstrado que aplicacões intramusculares de toxina botulínica do tipo A (TxB-A reduzem a espasticidade após AVC, entretanto poucos autores observaram melhora funcional de membros superiores com esta terapêutica. Para determinar se aplicações individualizadas de TxB-A melhoram a função no membro superior espástico de pacientes com hemiparesia secundária a AVC, acompanhamos 20 pacientes com história de AVC entre 6 meses

  3. Efeito da administração de uma dieta enteral com antioxidantes sobre as concentrações plasmáticas de tióis totais, carbonilas de proteínas e malondialdeído após acidente vascular cerebral

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    Lorene Simioni Yassin; Chika Fukui; Pamela Cristiani Dias Pereira; Marcia Olandoski; Paulo Roberto Aveles; Silvia Carolina Pinto; Caroline Resnauer; Lia Sumie Nakao; Ivone Ikeda Morimoto

    2012-01-01

    OBJETIVO: Avaliar o efeito da administração de uma dieta enteral industrializada com antioxidantes sobre as concentrações plasmáticas de tióis totais, carbonilas de proteínas e malondialdeído em pacientes após acidente vascular cerebral. MÉTODOS: A amostra foi constituída de 14 pacientes de um hospital geral que iniciaram nutrição enteral 48 horas após o evento. Falência múltipla, insuficiência hepática, obesidade mórbida e diabetes Mellitus associados foram critérios de exclusão. A dieta ind...

  4. Estudo da resposta inflamatória em pacientes com acidente vascular cerebral isquêmico agudo (AVCI) : sua relação com os subtipos de AVCI, déficit neurológico e evolução clínica

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    Márcio Francisco Lehmann

    2015-01-01

    O acidente vascular cerebral isquêmico (AVCI) é uma das principais causas de morte e incapacidade em todo o mundo. As vias fisiológicas do metabolismo lipídico, resposta inflamatória crônica, coagulação e hemostasia, regulação da pressão sanguínea e adesão celular têm sido implicadas na fisiopatologia do AVCI em estudos realizados em diferentes populações mundiais. O objetivo deste estudo foi avaliar a associação entre os marcadores demográficos, epidemiológicos, inflamatórios e metabólicos c...

  5. Avaliação e intervenção sensorial para a extremidade superior contralateral e hipotermia da extremidade ipsilateral ao acidente vascular cerebral = : Assessment and sensorial training of contralesional upper-extremity and ipsilesional hypothermia in stroke patients

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    Núbia Maria Freire Vieira Lima

    2014-01-01

    Mais da metade das vítimas de Acidente Vascular Cerebral (AVC) apresentará algum grau de incapacidade, especialmente na extremidade superior (ES), e esta pode ser agravada pelos déficits sensoriais protopáticos e/ou epicríticos. Astereognosia, déficits das sensações táteis, dolorosas, térmicas e proprioceptivas são frequentes e podem afetar ambas as ES, resultando em prejuízos no alcance/preensão e dependência da orientação visual (OV). A redução do input sensorial da ES ipsilateral ao AVC é ...

  6. Acidentes vasculares cerebrais embólicos na cardiopatia chagásica crônica

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    Israel Nussenzveig

    1953-12-01

    Full Text Available Os autores apresentam oito casos de cardiopatia crônica chagásica, comprovada pela reação de Machado-Guerrero, em cuja evolução ocorreram acidentes vasculares cerebrais. Discutem a etiología dêsses acidentes, afastando os fatôres etiológicos conhecidos e formulando a hipótese de embolia cerebral a partir de trombose mural cardíaca. Quatro casos foram fatais, tendo sido necropsiados. Em dois dêles os achados anátomo-patológicos vieram comprovar a hipótese, enquanto, dos dois restantes, em um havia concomitantemente artériosclérose cerebral difusa e no outro verificou-se amolecimento cerebral, na ausência de qualquer dos fatôres etiológicos conhecidos, mas não havia trombose nas cavidades esquerdas do coração; é lembrada a possibilidade de trombo mural fracamente aderido ao endocárdio, que se tivesse desprendido in totum. Embora não tivessem conseguido a comprovação de sua hipótese, os autores são de opinião que êste foi o mecanismo patogênico nos 8 casos apresentados e chamam a atenção para a doença de Chagas como fator etiológico da embolia cerebral.

  7. Neck circumference, a bedside clinical feature related to mortality of acute ischemic stroke Perímetro cervical, uma medida à beira do leito relacionada com a mortalidade no acidente vascular cerebral isquêmico

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    Camila Andrade Mendes Medeiros

    2011-10-01

    Full Text Available OBJECTIVE: The aim of this study was to evaluate clinical/demographic factors, sleep alterations and one year mortality in acute ischemic stroke. METHODS: This was a prospective study of 89 consecutive patients (mean age 64.39 ± 8.51 years with acute ischemic stroke. High risk of obstructive sleep apnea (OSA was evaluated by the Berlin questionnaire, daytime somnolence by the Epworth Sleepiness Scale (> 10 and subjective sleep quality by the Pittsburgh Sleep Quality Index (> 5. Clinical and anthropometric data including body mass index, hip-waist ratio, neck circumference (NC were obtained. Increased NC was defined if > 43 cm in men and > 38 cm in women. Stroke severity was estimated by the Barthel Index and the modified Rankin Scale. The end-point was death after 12 months follow-up. RESULT: One-year mortality was 8.9%. Non-survivors were older (p = 0.006 and had larger NC (p = 0.02. Among all cases, large NC was related to high risk of OSA, diabetes and hypertension (Fisher's exact test. Compared to men, women showed relatively larger NC. Overall, family history of stroke (74.2 %, diabetes (33.7% and hypertension (78.6% were frequent; obesity (11.2% was uncommon. Daytime sleepiness (34.8 %, poor sleep quality (65.2% and risk of OSA (58.42% were frequently found. CONCLUSION: Poor sleep quality, excessive daytime sleepiness and high risk of OSA are frequent in this sample with acute ischemic stroke. One-year mortality was related to older age and large NC. As obesity is uncommon in acute stroke patients, a large NC should be taken as a significant clinical sign related to mortality.OBJETIVO: O objetivo do estudo é avaliar em pacientes com acidente vascular cerebral (AVC isquêmico, os fatores clínico/demográficos, alterações do sono e a mortalidade após um ano. MÉTODOS: Trata-se de estudo prospectivo envolvendo 89 pacientes consecutivos (64,39 ± 8,51 anos com AVC isquêmico agudo. Foram avaliados o risco elevado de apneia obstrutiva do

  8. 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

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    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

  9. Disfunção intestinal em pacientes com lesão cerebral decorrente de acidente vascular cerebral e traumatismo craniencefálico: estudo retrospectivo de uma série de casos

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    Cinthia Carlos Dourado

    2012-01-01

    Full Text Available La disfunción del intestino es una queja común entre los pacientes con daño cerebral debido a una lesión cerebral traumática y accidente cerebrovascular. Este estudio tuvo como objetivo investigar la prevalencia de disfunción del intestino (incontinencia y constipación en pacientes con daño cerebral debido a una lesión cerebral traumática y accidente cerebrovascular admitidos para la rehabilitación. Este es un estudio retrospectivo de una serie de casos a partir del análisis de los datos de 138 expedientes de los pacientes ingresados en el primer semestre de 2009. La prevalencia de disfunción del intestino fue de 41%, siendo 33 (24% incontinencia anal y 37 (27%, constipación. El comprometimiento motor, ayuda a la movilidad, cambios en la memoria y la comunicación se asocian con la presencia de la incontinencia anal. La prevalencia de disfunción del intestino es alta en esta población, identificar en forma temprana los factores relacionados, y promover el reentrenamiento intestinal pueden ayudar a mejorar la calidad de sus vidas.

  10. 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

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    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

  11. 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

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    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

  12. A problemática do cuidador familiar do portador de acidente vascular cerebral La problemática del cuidador familiar con el portador de accidente cerebral vascular The problematic aspects of the family caregiver of people who suffered strokes

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    Luciene Miranda de Andrade

    2009-03-01

    Full Text Available Objetivou-se identificar a problemática da família de pessoas acometidas de acidente vascular cerebral hospitalizadas e discutir as dificuldades do cuidador familiar para o cuidado no âmbito domiciliar. A amostra constou de 154 famílias de pacientes internados em um hospital da rede pública de saúde, Fortaleza-CE. Conforme os resultados denotam, a maioria dos cuidadores são mulheres, 104 (67,5%; 122 casos (79,2% apresentam comprometimento familiar e alterações na vida diária em 115 dos acompanhantes (74,7%; 150 (97,4% não receberam orientações acerca dos cuidados, mas 143 (92,9% sentem-se seguros para acompanhá-los. O sentimento predominante foi a tristeza, 125 (81,2%, e as dúvidas principais foram: alimentação, 64 (41,6%, administração de medicamentos, 49 (29,9%, e possíveis complicações clínicas após a alta, 49 (29,9%. Estes resultados alertam para o papel do enfermeiro como educador, não somente na prevenção das doenças crônico-degenerativas, mas, também, na orientação aos cuidadores familiares sobre os cuidados dispensados após a alta hospitalar.El objetivo fue identificar la problemática de la familia de personas acometidas de accidente vascular cerebral hospitalizadas y discutir las dificultades del cuidador familiar en el ámbito domiciliar. La muestra fue constituida por 154 familias de pacientes internados en un hospital de la red pública de salud, en Fortaleza, CE. Conforme los resultados denotan, la mayoría de los cuidadores son mujeres, 104 (67,5%, 122 casos (79,2% presentan comprometimiento familiar y alteraciones en la vida diaria en 115 de los acompañantes (74,7%; 150 (97,4% no recibieron orientaciones acerca de los cuidados; sin embargo 143 (92,9% se sienten seguros para acompañarlos. El sentimiento predominante fue la tristeza, 125 (81,2%, y las dudas principales fueron: alimentación, 64 (41,6%, administración de medicamentos, 49 (29,9%, y posibles complicaciones clínicas después del

  13. Cerebrovascular disorders in childhood: etiology, clinical presentation, and neuroimaging findings in a case series study Acidente vascular cerebral na infância: etiologia, apresentação clínica e achados de neuroimagem em um estudo de série de casos

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    André P.C. Matta

    2006-06-01

    Full Text Available OBJECTIVE: To describe the main etiologies, neurological manifestations and neuro-imaging findings among children with sequelae of cerebrovascular disorders. METHOD: Case series study of children whose diagnosis was stroke sequelae. Variables studied were age at the time of first episode, number of episodes, etiology, motor deficits, epilepsy, and effected vascular territory. RESULTS: Twenty three patients were studied. Average age at first episode was 6.91 (±2.08 years. Fourteen patients were female. The number of stroke events per patient ranged from one to five. The most frequent etiologies were heart disease and sickle cell anemia. The most frequent neurological deficit was right hemiparesis. Nine patients experienced seizures. The left middle cerebral artery was the most affected vascular area. CONCLUSION: Our findings are similar to those described in the literature. Despite a careful investigation, some causes of stroke remain unidentified.OBJETIVO: Descrever as principais etiologias, manifestações neurológicas e achados de neuroimagem entre crianças com seqüela de acidente vascular cerebral (AVC. MÉTODO: Estudo de série de casos de crianças com seqüela de AVC isquêmico ou hemorrágico, analisando-se as variáveis: idade no primeiro episódio, número de eventos, etiologia, déficit motor, epilepsia e território vascular acometido. RESULTADO: Vinte e três pacientes foram incluídos, sendo 14 do sexo feminino. A idade do primeiro episódio foi 6.91 (±2,08 anos. O número de eventos por paciente variou entre 1 e 5. As etiologias mais freqüentes foram cardiopatia e anemia falciforme. O déficit mais encontrado foi a hemiparesia direita. Nove pacientes apresentaram convulsões. A artéria cerebral média esquerda foi o território vascular mais afetado. COCLUSÃO: Os achados deste trabalho estão de acordo com a literatura em geral. Apesar de extensa investigação, alguns casos permanecem sem definição etiológica.

  14. 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

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    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.

  15. Sobrecarga de cuidadores familiares de idosos com acidente vascular encefálico

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    Tatiana Ferreira da Costa

    2015-06-01

    Full Text Available Objetivo: Investigar a prevalência e associação da sobrecarga com características do indivíduo com sequela de acidente vascular encefálico e do cuidador. Métodos: Estudo descritivo, transversal, com abordagem quantitativa, realizado na cidade de João Pessoa - PB. Os participantes foram 136 cuidadores familiares. Para a coleta de dados, aplicou-se a escala de Barthel e Zarit Burden Interview. Resultados: Evidencia-se alta prevalência de sobrecarga entre os cuidadores (77,2%, a qual apresentou associação estatisticamente significativa com as seguintes características: indivíduos com sequela de acidente vascular encefálico com 65 anos ou mais, com grau de dependência muito grave, cuidadores do sexo feminino, com faixa etária adulta e com baixo grau de escolaridade. Conclusão: Destaca-se a importância prática de intervenções realizadas por enfermeiros e demais profissionais de saúde com relação às orientações e supervisões referentes ao cuidado dispensado ao cuidador familiar de indivíduos com sequela de acidente vascular encefálico.

  16. 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

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    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.

  17. 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

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    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

  18. Acidentes vasculares encefálicos em pediatria Stroke in children

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    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

  19. Dinamometria de preensão manual como parâmetro de avaliação funcional do membro superior de pacientes hemiparéticos por acidente vascular cerebral Handgrip dynamometry as a parameter of functional evaluation of the upper extremity hemiparetic after stroke

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    Antonio Vinicius Soares

    2011-12-01

    Full Text Available A força muscular é a valência física mais importante. É provável que exista correlação entre a força de preensão manual e outros testes para o membro superior afetado por um acidente vascular cerebral (AVC. O propósito deste estudo é analisar o valor preditivo da dinamometria de preensão manual (DPM para recuperação do membro superior parético por AVC. Foram avaliados 43 pacientes hemiparéticos pós-AVC (60,7 anos±12,1. Vários testes (Escala de movimento da mão (EMM, Estesiometria, Teste de caixa e blocos, 9 buracos e pinos, Escala de Ashworth modificada e Índice de Barthel foram relacionados com a DPM. Os resultados apontaram que a DPM apresenta boa correlação com EMM e, contrariamente, os testes de destreza manual, a sensibilidade e o índice de independência funcional não apresentaram valores significativos. A DPM é um teste rápido, fácil e acessível, e pode fazer parte dos protocolos de avaliação funcional do membro superior de pacientes hemiparéticos por AVC.Muscle strength is the most important physical valence. It is likely that there is a correlation between handgrip strength and other tests for the upper extremity affected by stroke. The purpose of this study is to analyze the predictive value of handgrip dynamometry (HD for upper limb recovery in stroke. Were studied 43 hemiparetic patients after stroke (60.7 years±12.1. Several tests (Hand moviment scale (HMS, Esthesiometry, Box and blocks test, 9 hole and peg test, Modified Ashworth scale and Barthel index were related to HD. The results showed that there is good correlation of the HD with HMS and, by contrast, the tests of manual dexterity, the sensitivity and index of functional independence showed no significant values. The HD is a quick, easy and affordable test, and can be part of protocols for functional evaluation of upper extremity of hemiparetic patients by stroke.

  20. Avaliação clínica da relação entre postura, respiração e deglutição em paciente pós-acidente vascular cerebral na fase crônica: relato de caso

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    Sináira Santos Seixas Simão

    2013-10-01

    Full Text Available O Acidente Vascular Cerebral (AVC é a doença neurológica que mais incapacita os adultos. A respiração, a postura e a deglutição possuem uma relação direta nesta doença, necessitando assim de uma intervenção multidisciplinar. O objetivo do presente estudo foi realizar uma avaliação clínica integrada para analisar a relação entres estas disfunções. Trata-se de uma paciente do sexo feminino com 37 anos, com seis anos de diagnóstico de AVC isquêmico com hemiparesia completa à direita de predomínio crural, hipertensão arterial sistêmica, disfagia e disartrofonia. Na anamnese, relatou sintomas referentes à dispnéia, dores na coluna lombar, presença de tosse e engasgos à alimentação e escape anterior de saliva, principalmente durante a fala. A paciente apresenta escoliose, hipercifose torácica e fraqueza dos músculos abdominais. A avaliação respiratória evidenciou uma força expiratória abaixo do limite esperado. O pico de fluxo da tosse está abaixo do esperado, demonstrando não possuir força para tossir. A investigação fonoaudiológica evidenciou alterações no tempo aumentado para se alimentar, necessidade de ingerir líquidos para ajudar na deglutição de sólidos, eventuais escapes anteriores de alimento, necessidade de deglutições múltiplas devido à sensação de estase em cavidade laringo-faríngea e diminuição do paladar, bem como saliva grossa e viscosa. Utilizando-se das avaliações fisioterápicas e fonoaudiológicas, foi possível concluir que uma paciente com AVC na fase crônica apresenta alterações respiratórias que podem impedi-la de proteger com eficiência as vias aéreas inferiores, o que, somado às alterações posturais e na deglutição demonstram a importância da avaliação integrada para futuras intervenções terapêuticas mais eficazes.

  1. Efeito da administração de uma dieta enteral com antioxidantes sobre as concentrações plasmáticas de tióis totais, carbonilas de proteínas e malondialdeído após acidente vascular cerebral

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    Lorene Simioni Yassin

    2012-04-01

    Full Text Available OBJETIVO: Avaliar o efeito da administração de uma dieta enteral industrializada com antioxidantes sobre as concentrações plasmáticas de tióis totais, carbonilas de proteínas e malondialdeído em pacientes após acidente vascular cerebral. MÉTODOS: A amostra foi constituída de 14 pacientes de um hospital geral que iniciaram nutrição enteral 48 horas após o evento. Falência múltipla, insuficiência hepática, obesidade mórbida e diabetes Mellitus associados foram critérios de exclusão. A dieta industrializada ofertada por gotejamento contínuo, com uso de bombas infusoras, continha mix de carotenoides, vitaminas C, E e minerais Se, Zn e Cu em sua formulação. As amostras de sangue foram coletadas antes do início da administração da dieta e após cinco dias de início da dieta enteral, somente de pacientes que tivessem recebido o volume necessário para completar o gasto energético total. Tióis plasmáticos e carbonilas de proteína foram determinados por meio do Reagente de Ellman e pela reação com dinitrofenilhidrazina respectivamente. O malondialdeído foi obtido pela determinação de substâncias reativas do ácido tiobarbitúrico. RESULTADOS: A média de idade foi M=70,3, DP=14,1 anos. Todos receberam acima de 100% da Dietary Reference Intakes para nutrientes antioxidantes, que não ultrapassaram os limites superiores toleráveis de ingestão. Não houve alteração da concentração de tióis, mas houve aumento da formação de carbonilas de proteínas (p=0,034. Nos pacientes entubados, esse marcador mostrou-se significativamente maior (p=0,048 após administração da dieta. Não houve diferença nas concentrações de malondialdeído após a oferta de antioxidantes dietéticos. CONCLUSÃO: A análise de biomarcadores não demonstrou redução do estresse oxidativo após administração de dieta enteral industrializada com antioxidantes.

  2. Associação entre níveis plasmáticos de homocisteína e acidente vascular cerebral isquêmico: estudo transversal analítico Association between plasmatic levels of homocysteine and stroke: a transversal analytic study

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    Lillian Harboe-Gonçalves

    2005-03-01

    Full Text Available OBJETIVO: Verificar associação entre valores de homocisteína plasmática e ocorrência de acidente vascular cerebral isquêmico (AVCI, considerando idade, sexo, tabagismo, hipertensão, diabetes, etiologia do AVCI e tempo decorrido do episódio. MÉTODO: Estudo transversal analítico de 104 pacientes diagnosticados com AVCI e 98 controles. Dosagem de homocisteína por cromatografia líquida de alta eficiência. Análise estatística feita com testes t de Student e Kruskal-Wallis, análise de variância, análise de regressão linear, regressão logística e coeficiente de correlação linear de Pearson. RESULTADOS: O grupo-pacientes apresentou valores maiores de homocisteína (15,4 ± 11,7 µ mol L-1 comparados aos controles (10,5 ± 4,2µ mol L-1. Dividindo os dois grupos em faixas etárias foram encontradas diferenças nas faixas de 40-49 anos e 50-59 anos. Nos pacientes encontraram-se valores maiores de homocisteína nos casos de hipertensão e etiologia aterotrombótica. Estudo de regressão logística dos dados dos pacientes mostrou relação de aterosclerose com homocisteína. CONCLUSÃO: Homocisteína está associada a AVCI.PURPOSE: To determine the association of homocysteine with ischemic stroke, considering age, gender, cigarette smoking, hypertension, diabetes and etiology of cerebrovascular disease. METHOD: Transversal analytic observational study of 104 patients with the diagnosis of ischemic stroke and 98 healthy controls had blood homocysteine analyzed by high performance liquid chromatography. Statistics was performed with Student's t and Kruskal-Wallis' tests, analysis of variance, linear regression analysis, logistic regression and Pearson's linear correlation coefficient. RESULTS: Patients had higher values for homocysteine (15.4 ± 11.7 µmol L-1 than controls (10.5 ± 4.2 µmol L-1. Dividing both groups into four groups according to age, significant differences in homocysteine values were found between patients and

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

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    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.

  4. Intervenções de enfermagem aos pacientes com acidente vascular encefálico: uma revisão integrativa de literatura

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    Tahissa Frota Cavalcante

    2011-12-01

    Full Text Available O objetivo do estudo foi analisar o conhecimento sobre as intervenções de enfermagem aos pacientes hospitalizados por acidente vascular encefálico. Realizou-se uma revisão integrativa da literatura a partir de acesso on-line a cinco bases de dados, no mês de setembro de 2009. Utilizou-se os descritores Cuidados de Enfermagem e Acidente Cerebral Vascular nas línguas portuguesa, inglesa e espanhola. Foram encontrados 223 artigos e selecionados 12. Identificou-se nos artigos um maior número de intervenções de enfermagem assistenciais, seguidas das educacionais, gerenciais e de pesquisa. As do domínio assistencial estão mais relacionadas aos aspectos biológicos dos pacientes. Em relação às educativas, os artigos apontam o papel fundamental do enfermeiro, bem como dos familiares e dos cuidadores. A principal intervenção gerencial foi a coordenação dos cuidados. Quanto às intervenções de pesquisa foi identificada apenas uma descrita como o desenvolvimento e aprimoramento da prática de cuidados por meio de evidências clínicas.

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

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

    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...

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

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    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.

  7. 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

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    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

  8. Segurança do transplante autólogo, intra-arterial, de células mononucleares da medula óssea na fase aguda do acidente vascular cerebral isquêmico Intra-arterial autologous bone marrow mononuclear cell transplantation for acute ischemic stroke

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    Maria Lúcia Furtado de Mendonça

    2006-01-01

    Full Text Available O acidente vascular cerebral (AVC é a terceira causa de óbito e a principal causa de incapacidade em indivíduos adultos. Embora a mortalidade do AVC esteja diminuindo em alguns países, a morbidade tem aumentado em razão do envelhecimento da população e do aumento da sobrevida dos pacientes¹. O tratamento com ativador do plasminogênio tissular recombinante (rt-PA é eficaz quando instituído em até 3 horas após o início dos sintomas², porém seu uso está limitado a cerca de 5% dos pacientes na fase aguda do AVC isquêmico. Além disso, nenhum agente para neuroproteção teve sua eficácia comprovada em estudos clínicos em humanos. Portanto, outras estratégias terapêuticas precisam ser desenvolvidas. Em modelos animais, o uso de células-tronco correlacionou-se com melhora funcional após o AVC³. Publicações recentes têm demonstrado a segurança do tratamento com células mononucleares da medula óssea (CMMO injetadas via intracoronária em pacientes portadores de cardiopatia isquêmica aguda ou crônica4,5. Baseado nesses dados iniciais, há crescente interesse no estudo do transplante com CMMO na fase aguda do AVC. Relatamos o primeiro caso de transplante autólogo de CMMO via intra-arterial na fase aguda do AVC isquêmico.Stroke is the third cause of death and the leading cause of disability in adult subjects. Although stroke mortality has been declining in some countries, stroke morbidity has been increasing due to the aging of population and patients improved survival.¹ Treatment with recombinant tissue plasminogen activator (rtPA is successful provided it is administered within 3 hours of symptoms onset,² but its use is limited to about 5% of the patients with acute ischemic stroke. Furthermore, no neuroprotective agent has yet been proven effective in human clinical trials. The development of other therapeutic strategies is, therefore, warranted. The use of stem cells in animal models has led to functional improvement

  9. Identificação do diagnóstico de enfermagem "risco de quedas em idosos com acidente vascular cerebral" Identificación del diagnóstico de enfermería riesgo de caídas en ancianos con accidente cerebrovascular Identification of the nursing diagnosis of fall risk in elderly with stroke

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    Huana Carolina Cândido Morais

    2012-06-01

    Full Text Available Estudo proposto para verificar a presença do diagnóstico de enfermagem (DE "Risco de quedas de idosos com acidente vascular cerebral (AVC". Trata-se de estudo observacional, exploratório, transversal, com análise descritiva, realizado em uma associação beneficente de reabilitação em Fortaleza/CE, Brasil, de janeiro a março de 2010, por fonte primária, com entrevista e exame físico, com idosos que tiveram pelo menos um episódio de AVC. Participaram 37 indivíduos: 20 (54,1% mulheres, média de 70,6 anos; 18 (48,6% residiam com companheiro, média de 5,2 anos de estudo. O Risco de quedas foi identificado em todos os idosos. Dentre os fatores de risco identificados, destacaram-se: Equilíbrio prejudicado (100%, Idade acima de 65 anos (83,7% e Déficit proprioceptivo (83,7%. Os enfermeiros devem considerar o risco de quedas como um dos enfoques do cuidado de enfermagem, bem como implementar e avaliar os resultados de intervenções relativas à prevenção de quedas.El propósito del estudio fue evaluar la presencia del diagnóstico de enfermería riesgo de caídas en pacientes ancianos con accidente cerebrovascular. Observacional, exploratorio, descriptivo y transversal. Desarrollado en asociación de rehabilitación en Fortaleza, de enero hasta marzo del 2010 por entrevistas de fuentes primarias y examen físico, hecho en personas con por lo menos un episodio de accidente cerebrovascular. 37 personas participaron, de los cuales 20 (54,1% eran mujeres, con 70,6 años como promedio, 18 (48,6% vivían con compañero, promedio de 5,2 años de estudio. El riesgo de caídas se encuentra en todas las personas mayores. Entre los factores de riesgo identificados se resalta: alteración del equilibrio (100%, Mayores de 65 años (83,7% y Déficit propioceptivo (83,7%. Las enfermeras deben considerar el riesgo de caídas como el foco de atención de enfermería, así como desarrollar y evaluar los resultados de intervenciones para la prevenci

  10. 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

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    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

  11. Vivendo o acidente vascular encefálico agudo: significados da doença para pessoas hospitalizadas

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    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.

  12. Vivendo o acidente vascular encefálico agudo: significados da doença para pessoas hospitalizadas

    Directory of Open Access Journals (Sweden)

    Samia Jardelle Costa de Freitas Maniva

    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.

  13. Fatores de risco para o acidente vascular encefálico - doi: 10.5102/ucs.v3i1.551

    Directory of Open Access Journals (Sweden)

    Luciana Leite Melo e Silva

    2008-04-01

    Full Text Available O acidente vascular encefálico é uma patologia que ocorre no território vascular do encéfalo. Pode ser classificado como isquêmico ou hemorrágico. Após um acidente vascular encefálico, a pessoa pode apresentar tipos de incapacidades, tanto físicas quanto emocionais. São muitos os fatores de risco que podem levar ao acidente vascular encefálico, como: a hipertensão arterial, a obesidade, o sedentarismo, a diabetes mellitus e o tabagismo. Assim, é importante que haja a prevenção dos fatores de risco, além do conhecimento de cada um deles, para o melhor tratamento do paciente.

  14. Acidente vascular de tronco encefálico estudo de 21 casos

    Directory of Open Access Journals (Sweden)

    Manoel Baldoíno Leal Filho

    1995-03-01

    Full Text Available Através de estudo prospective foram acompanhados 21 casos de acidente vascular de tronco encefálico, durante 12 meses, entre 1991 e 1992. O objetivo foi observar a relação entre o tipo de lesão, a apresentação clínica e a evolução. Com o exame neurológico, a tomografia computadorizada (CT e, em alguns casos, angiografia e ressonância magnética (MRI demonstrou-se a topografia da lesão. A hemorragia pontomesencefálica foi o achado mais freqüente. A hipertensão arterial sistêmica estava presente em 67% dos casos e a sexta década de vida foi a mais atingida. Todos os pacientes receberam tratamento clínico visando as doenças associadas. Utilizou-se o Glasgow Outcome Scale (GOS para avaliar a evolução: 28% tiveram GOS 5, 24% GOS 4, 5% GOS 3, 28% GOS 2 e 14% GOS 1. Notou-se, por esta experiência, tratar-se de uma patologia grave e com várias formas de apresentação. Quando o paciente foi admitido em coma e com lesão mista, a evolução foi desfavorável (p < 0,01. Muitas vezes foi difícil correlacionar os casos com as descrições clássicas da literatura, por isto chamamos a atenção para o fato de que se deva observar individualmente as características de cada caso.

  15. 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

    Directory of Open Access Journals (Sweden)

    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

  16. Paralisia cerebral hemiplégica e trombofilias geneticamente determinadas

    OpenAIRE

    Alexandre Castelo Branco Araujo

    2009-01-01

    Realizar uma análise detalhada relativa ao papel das trombofilias geneticamente determinadas como fatores predisponentes ao aparecimento de paralisia cerebral hemiplégica relacionada a acidente vascular cerebral isquêmico, abordando os principais aspectos conceituais, epidemiológicos e fisiopatológicos. O levantamento de artigos sobre o tema foi pesquisado nas bases de dados Medline, Lilacs, Embase, Cinahl e Cochrane, com palavras-chave acidente vascular cerebral, antitrombina, fator V Lei...

  17. 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

    Directory of Open Access Journals (Sweden)

    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

  18. [Transcranial electrostimulation in chronic cerebral vascular insufficiency].

    Science.gov (United States)

    Voropaev, A A; Mochalov, A D

    2006-01-01

    The method of transcranial electrostimulation (TCES) has been used for treatment of 68 patients with chronic cerebral vascular insufficiency, stages I and II. A treatment course included 7 daily procedures. The influence of TCES was evaluated clinically, by EEG, transcranial ultrasonic Doppler study and hemodynamic indices in arteries and veins as well as by expression of trait and state anxiety. All the parameters were compared to those of the control group which was treated using conventional methods. TCES resulted in normalization of cerebral vascular reactivity, a decrease of venous circulation disturbances, positive influence on cerebral blood flow and EEG parameters, that corresponded to global improvement of the patients' state, regress of cephalgic syndrome and reduction of trait and state anxiety. The method is simple and safety and can be recommended for wide application including outpatient setting.

  19. Renovascular hypertension causes cerebral vascular remodeling

    Institute of Scientific and Technical Information of China (English)

    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.

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

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    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.

  1. Correlação entre qualidade de vida e morbidade do cuidador de idoso com acidente vascular encefálico

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    Nilce Maria de Freitas Santos

    2012-08-01

    Full Text Available Este estudo objetivou descrever as características sociodemográficas e a qualidade de vida dos cuidadores de idosos com histórico de acidente vascular cerebral e correlacionar o número de morbidades com os escores de qualidade de vida do cuidador. Inquérito domiciliar transversal que entrevistou cuidadores de idosos utilizando-se de instrumentos: semi-estruturado; World Health Organization Quality of Life-abreviado e Brazilian Multidimensional Functional Assessment Questionnaire. Foi realizada análise descritiva e correlação de Pearson (p<0,05. Prevaleceu o sexo feminino (93,5%, idade média de 55,4±14,17 anos, casados ou moram com companheiro (58,7%, com 4| - 8 anos de estudo (28,3% e renda de 1 salário mínimo (34,8%. O maior escore de qualidade de vida foi no domínio relações sociais (67,57 e, menor no meio ambiente (54,82. O maior número de morbidades do cuidador correlacionou-se com menores escores em todos os domínios de qualidade de vida.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Aneurisma luético de arco aórtico roto, complicado pela oclusão de vasos braquiocefálicos e acidente vascular encefálico isquêmico: relato de caso tratado cirurgicamente

    OpenAIRE

    CORSO,Ricardo Barros; KRAYCHETE,Nadja; NARDELI,Sidnei; Moitinho,Rilson; OURIVES,Cristiano; BARBOSA,Paulo J.; PEREIRA Ricardo Eloy

    2002-01-01

    Homem de 44 anos, com dor torácica crônica há um ano, apresentou dois episódios de acidentes vasculares encefálicos isquêmicos, desencadeados pela oclusão e trombose das artérias carótida e subclávia esquerdas, em aneurisma sifilítico gigante de arco aórtico roto. O paciente foi submetido à correção cirúrgica com sucesso via esternotomia mediana, utilizando-se proteção cerebral anterógrada e perfusão corporal distal contínuas. Aspectos referentes à técnica operatória utilizada e ampla revisão...

  4. Características das pessoas com Acidente Vascular Encefálico atendidas em um centro de referência estadual Characteristics of Encephalic Vascular Accident patients treated at a state reference center

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    Andrea Regina Schuch Grumann

    2017-04-01

    Full Text Available Acidente Vascular Encefálico (AVE é uma disfunção cerebral que causa lesões permanentes e irreversíveis. Objetivo: Avaliar as idades, os sexos e a data do primeiro atendimento das pessoas com AVE atendidas no centro de reabilitação do Estado de Santa Catarina. Métodos: É um estudo quantitativo, descritivo e transversal, sendo a coleta de dados realizada com base documental nos prontuários. O presente estudo foi avaliado pelo Comitê de Ética em Pesquisa com Seres Humanos (CEPSH, Reitoria de Pesquisa e Extensão da Universidade Federal de Santa Catarina de número 1024. Resultados: O AVE afeta 25,11% de mulheres entre 71-80 anos e 34,09% de homens entre 61-70 anos. Observou-se que a sequela mais comum é a hemiplegia e que muitos somente procuravam tratamento após muitos anos de sequelas. Conclusão: Os dados encontrados mostram a importância da terapia física para que os pacientes reaprendam tarefas diárias e auxilia na reintegração social.

  5. Nursing diagnoses in patients with cerebral vascular accident: an integrative review.

    Science.gov (United States)

    Lima, Ana Carolina Maria Araújo Chagas Costa; Silva, Aurilene Lima da; Guerra, Débora Rodrigues; Barbosa, Islene Victor; Bezerra, Karine de Castro; Oriá, Mônica Oliveira Batista

    2016-01-01

    to verify the nursing diagnoses in patients affected by CVAs. this is an integrative review of the literature. The search was conducted on LILACS, Scielo, Medline, CINAHL, and Scopus databases between February and March 2015, using the following keywords: "Enfermagem", "Acidente Vascular Cerebral", "Diagnóstico de Enfermagem"; and "Nursing", "Stroke", and "Nursing Diagnosis". we found 9 articles published between 2009 and 2015; most of them were Brazilian, cross-sectional, and exploratory, with a level of evidence of 6. The evidence from the publications was classified as: "Evaluation and validation of specific nursing diagnoses for subjects affected by CVAs" and "Application of the nursing process on subjects affected by CVAs". we noticed the publications focused on nursing diagnoses related to motor disorders, such as risk of falls and impaired physical mobility. Domains regarding safety/protection (domain 11) and sleep/resting (domain 4) were present in most evaluated publications.

  6. Advances in the Management of Cerebral Vascular Disease

    Directory of Open Access Journals (Sweden)

    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.

  7. Vascular permeability in cerebral cavernous malformations

    DEFF Research Database (Denmark)

    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...

  8. Vascular permeability in cerebral cavernous malformations.

    Science.gov (United States)

    Mikati, Abdul G; Khanna, Omaditya; Zhang, Lingjiao; Girard, Romuald; Shenkar, Robert; Guo, Xiaodong; Shah, Akash; Larsson, Henrik B W; Tan, Huan; Li, Luying; Wishnoff, Matthew S; Shi, Changbin; Christoforidis, Gregory A; Awad, Issam A

    2015-10-01

    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 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 familial CCM disease had greater WMF permeability compared to those with milder disease phenotype, but similar lesion permeability. Subjects receiving statin medications for routine cardiovascular indications had a trend of lower WMF, but not lesion, permeability. This is the first demonstration of brain vascular hyperpermeability in humans with an autosomal dominant disease, as predicted mechanistically. Brain permeability, more than lesion permeability, may serve as a biomarker of CCM disease activity, and help calibrate potential drug therapy.

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

    OpenAIRE

    Sousa, João Paulo

    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...

  10. Versão brasileira da Escala de Comprometimento do Tronco: um estudo de validade em sujeitos pós-acidente vascular encefálico

    OpenAIRE

    Lima, Núbia Maria Freire Vieira; Rodrigues,Silvia Yukie; Fillipo, Thais Martins; De Oliveira, Roberta; Oberg, Telma Dagmar; Cacho, Enio Walker Azevedo

    2008-01-01

    O controle de tronco - uma habilidade motora básica indispensável à execução de muitas tarefas funcionais - encontra-se deficitário em pacientes que sofreram acidente vascular encefálico (AVE). Há poucas referências estrangeiras, e nenhuma em português, que focalizem a avaliação de tronco de forma quantitativa. Este estudo teve como objetivo traduzir e verificar a confiabilidade inter e intra-examinador, validade construtiva e consistência interna da versão brasileira da ECT - Escala de Compr...

  11. PERFIL SOCIOECONÔMICO DE PACIENTES INTERNADOS POR ACIDENTE VASCULAR ENCEFÁLICO

    Directory of Open Access Journals (Sweden)

    Tahissa Frota Cavalcante

    2010-01-01

    Full Text Available Crece el número de personas con accidente vascular encefálico (AVE, tornándose importante la realización de estudios con esta población. El objetivo del estudio fue analizar los factores socioeconómicos en pacientes hospitalizados por AVE. Estudio transversal, realizado en un hospital de Fortaleza, con 91 pacientes con AVE. Datos recolectados de octubre del 2007 a abril del 2008, a través de un formulario. El AVE isquémico fue más frecuente (42,9% y la edad promedio fue de más de 60 años. La mayoría era del sexo femenino (54,9%, jubilados (59,3%, católicos (87,9%, vivía con su pareja (54,9% y procedente del interior (59,3%. En cuanto a la escolaridad y el promedio de renta fue 1,0 año. No hubo diferencia en el perfil socioeconómico cuanto al tipo de AVE. Se concluye que los pacientes con AVE poseían condiciones socioeconómicas precarias, lo cual puede contribuir para el surgimiento y la agravación de la enfermedad.

  12. Associação entre acidentes vasculares encefálicos e doença de Chagas

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Aneurisma luético de arco aórtico roto, complicado pela oclusão de vasos braquiocefálicos e acidente vascular encefálico isquêmico: relato de caso tratado cirurgicamente

    Directory of Open Access Journals (Sweden)

    CORSO Ricardo Barros

    2002-01-01

    Full Text Available Homem de 44 anos, com dor torácica crônica há um ano, apresentou dois episódios de acidentes vasculares encefálicos isquêmicos, desencadeados pela oclusão e trombose das artérias carótida e subclávia esquerdas, em aneurisma sifilítico gigante de arco aórtico roto. O paciente foi submetido à correção cirúrgica com sucesso via esternotomia mediana, utilizando-se proteção cerebral anterógrada e perfusão corporal distal contínuas. Aspectos referentes à técnica operatória utilizada e ampla revisão bibliográfica das diferentes formas de apresentação do comprometimento cardiovascular na sífilis terciária são discutidos.

  15. Velocidade de marcha e autoeficácia em quedas em indivíduos com hemiparesia após Acidente Vascular Encefálico

    OpenAIRE

    Ricci, Natalia Aquaroni; Ferrarias,Giovana Paschoalette; Molina, Karina Iglesia; Dib,Priscila Masullo; Alouche, Sandra Regina

    2015-01-01

    Indivíduos após Acidente Vascular Encefálico (AVE) apresentam com frequência alterações no padrão da marcha, instabilidade e maior suscetibilidade para quedas. O objetivo deste estudo foi verificar a relação entre a velocidade de marcha e autoeficácia para quedas em indivíduos hemiparéticos. A amostra foi composta por 23 indivíduos com hemiparesia pós-AVE com idade média de 60,6±11,26 anos e tempo de evolução do AVE de 53,2±35,4 meses. Os participantes foram avaliados quanto ao senso de autoe...

  16. Uso de alteplase no tratamento do acidente vascular encefálico isquêmico agudo: o que sabem os enfermeiros?

    Directory of Open Access Journals (Sweden)

    Samia Jardelle Costa de Freitas Maniva

    2012-06-01

    Full Text Available O estudo objetivou analisar o conhecimento de enfermeiros acerca do uso de alteplase no tratamento do acidente vascular encefálico (AVE isquêmico agudo. Estudo descritivo-exploratório realizado em uma unidade de AVE de um hospital público localizado na cidade de Fortaleza-CE, durante o mês de outubro de 2010. Participaram do estudo dez enfermeiros, com idade média de 25 anos. Os benefícios da medicação foram apresentados em justaposição com as limitações do uso. Estratégias para ampliar a utilização de alteplase foram apontadas pelos enfermeiros. O conhecimento da realidade investigada contribui na construção do saber de enfermagem e pode auxiliar o enfermeiro que presta assistência direta ao paciente que se submete a este tratamento.

  17. Eficácia da fonoterapia em um caso de afasia expressiva decorrente de acidente vascular encefálico Speech therapy effectiveness in a case of expressive aphasia resulting from stroke

    Directory of Open Access Journals (Sweden)

    Letícia Regina Kunst

    2012-01-01

    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.The purpose of this article was doing a report case of an aphasic client subjected to speech therapy in the clinic of a Speech Pathology and Audiology course of a federal university. The studied subject is

  18. Pré-diabetes e o risco de acidente vascular cerebral

    OpenAIRE

    Pinto, Patrícia Alexandra Teixeira

    2013-01-01

    Introdução: A Diabetes Mellitus (DM) é uma doença metabólica com múltipla etiologia caracterizada por um estado de hiperglicémia crónica com distúrbios no metabolismo dos hidratos de carbono, lípidos e proteínas que resultam em defeitos na secreção de insulina, na sua ação, ou na combinação entre ambos. Pré-diabetes define-se como uma elevação da glicose plasmática acima do valor normal mas inferior à DM clínica. Assim, pode ser definida como uma alteração da tolerância à glicose (ATG) ou ...

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    Juliana Cristina Lessmann

    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

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

    Institute of Scientific and Technical Information of China (English)

    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.

  2. Role of Mitochondria in Cerebral Vascular Function: Energy Production, Cellular Protection, and Regulation of Vascular Tone.

    Science.gov (United States)

    Busija, David W; Rutkai, Ibolya; Dutta, Somhrita; Katakam, Prasad V

    2016-06-13

    Mitochondria not only produce energy in the form of ATP to support the activities of cells comprising the neurovascular unit, but mitochondrial events, such as depolarization and/or ROS release, also initiate signaling events which protect the endothelium and neurons against lethal stresses via pre-/postconditioning as well as promote changes in cerebral vascular tone. Mitochondrial depolarization in vascular smooth muscle (VSM), via pharmacological activation of the ATP-dependent potassium channels on the inner mitochondrial membrane (mitoKATP channels), leads to vasorelaxation through generation of calcium sparks by the sarcoplasmic reticulum and subsequent downstream signaling mechanisms. Increased release of ROS by mitochondria has similar effects. Relaxation of VSM can also be indirectly achieved via actions of nitric oxide (NO) and other vasoactive agents produced by endothelium, perivascular and parenchymal nerves, and astroglia following mitochondrial activation. Additionally, NO production following mitochondrial activation is involved in neuronal preconditioning. Cerebral arteries from female rats have greater mitochondrial mass and respiration and enhanced cerebral arterial dilation to mitochondrial activators. Preexisting chronic conditions such as insulin resistance and/or diabetes impair mitoKATP channel relaxation of cerebral arteries and preconditioning. Surprisingly, mitoKATP channel function after transient ischemia appears to be retained in the endothelium of large cerebral arteries despite generalized cerebral vascular dysfunction. Thus, mitochondrial mechanisms may represent the elusive signaling link between metabolic rate and blood flow as well as mediators of vascular change according to physiological status. Mitochondrial mechanisms are an important, but underutilized target for improving vascular function and decreasing brain injury in stroke patients. © 2016 American Physiological Society. Compr Physiol 6:1529-1548, 2016.

  3. Cerebral vascular accident: some characteristics of occupational therapy evaluation forms.

    Science.gov (United States)

    Ottenbacher, K

    1980-04-01

    To determine areas most commonly evaluated by occupational therapists and to ascertain methods in which evaluative information is gathered, 35 evaluation forms currently employed by occupational therapists to assess dysfunction in patients with cerebral vascular accident were collected. Five general areas including motor function, sensory deficit, hadn function, activities of daily living, and visual perception were found to be most frequently listed on the forms. These areas were divided into sub areas to operationally define the information collected. Analysis revealed that the level of measurement most frequently employed by therapists to record evaluate findings was the descriptive level. There was a tendency to collect data at "higher" or more sophisticated levels of measurement in those areas evaluated most frequently. The findings are discussed in relation to professional competency concerns and the need to develop unique occupational therapy evaluative instruments for areas of practice such as cerebral vascular accident.

  4. Pediatric Stroke: The Importance of Cerebral Arteriopathy and Vascular Malformations

    OpenAIRE

    Beslow, Lauren A.; Jordan, Lori C

    2010-01-01

    Stroke is an important cause of neurologic morbidity in childhood. Population-based estimates of the annual incidence of childhood stroke range from 2 to 13 per 100,000 children. This article will review recent literature on both hemorrhagic and ischemic stroke in children with a focus on cerebral arteriopathy and vascular malformations as stroke risk factors. Additional risk factors include congenital heart disease, sickle cell disease, and hematologic abnormalities among others. Outcomes ar...

  5. Acupuncture Treatment of Depressive Syndromes after Cerebral Vascular Accidents

    Institute of Scientific and Technical Information of China (English)

    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.

  6. Pathogenesis of diabetic cerebral vascular diseasecomplication

    Institute of Scientific and Technical Information of China (English)

    Ren-Shi Xu

    2015-01-01

    Diabetes mellitus is one of the most potent independentrisk factors for the development of diabetic cerebralvascular disease (CVD). Many evidences suggested thathyperglycemia caused excess free fatty acids, the lossof endothelium-derived nitric oxide, insulin resistance,the prothrombotic state, endothelial dysfunction,the abnormal release of endothelial vasoactivators,vascular smooth muscle dysfunction, oxidative stress,and the downregulation of miRs participated in vesselgeneration and recovery as well as the balance ofendotheliocytes. In turn, these abnormalities, mainly viaphosphatidylinositol 3 kinase, mitogen-activated proteinkinase, polyol, hexosamine, protein kinase C activation,and increased generation of advanced glycosylation endproducts pathway, play an important role in inducingdiabetic CVD complication. A deeper comprehensionof pathogenesis producing diabetic CVD could offerbase for developing new therapeutic ways preventingdiabetic CVD complications, therefore, in the paper wemainly reviewed present information about the possiblepathogenesis of diabetic CVD complication.

  7. 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

    OpenAIRE

    Fernando Cesar Iwamoto Marcucci; Nathália Sigilló Cardoso; Karla de Souza Berteli; Márcia Regina Garanhani; Jefferson Rosa Cardoso

    2007-01-01

    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 sup...

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

    OpenAIRE

    2014-01-01

    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...

  9. Value of cerebral perfusion and vascular reserve for the treatment of symptomatic intracranial arterial stenosis

    Institute of Scientific and Technical Information of China (English)

    Li'an Huang; Xuewen Song; Anding Xu

    2008-01-01

    BACKGROUND: It is crucial to understand cerebral perfusion and vascular reserve in stegnotic arterial blood-supply regions to treat ischemic cerebrovascular diseases. However, effects on symptomatic intracrani-al arterial stenosis (SICAS) need to be further studied in additional applications. OBJECTIVE: To evaluate and summarize the effects of cerebral perfusion and vascular reserve on the treatment of SICAS. RETRIEVAL STRATEGY: A computer-based online search of English language publications from January 2000 to July 2007 was conducted in PubMed to identify publications that addressed cerebral perfusion and vascular reserve of SICAS. Search key words were "intracranial stenosis, perfusion, brain reserve". Relevant data were also searched with the China Journal Net, using the same key words in Chinese from January 2000 to January 2007. In total, 101 articles were retrieved. Inclusion criteria: ① Articles describing the current status for the diagnosis and treatment of SICAS; ② Articles concerning research developments of cerebral perfusion and vascular reserve of SICAS. Exclusion criteria: duplicated articles. LITERATURE EVALUATION: This study included 21 articles of experimental studies and conference re-ports.DATA SYNTHESIS: When performing interventional surgery in SICAS patients, it is important to under-stand cerebral perfusion and vascular reserve in addition to knowing the clinical symptoms and degrees of arterial stenosis. In recent years, there are a growing number of reports on measurements of vascular reserve through the use of magnetic resonance perfusion imaging (MR-PWI). Investigations demonstrate cerebral perfusion and vascular reserve decrease in many SICAS patients. Many studies show that both improve after surgical intervention. CONCLUSION: Cerebral perfusion could provide direct evidence of whether ischemia has occurred in the brain. Because of lateral circulation and cerebral vascular reserve, intracranial vascular stenosis and/or decreased

  10. Arterioles in cerebral amyloid angiopathy and vascular dementia

    Institute of Scientific and Technical Information of China (English)

    ZHU Guang-ming; ZHANG Wei-wei; LIU Ying; LI Juan

    2009-01-01

    Background Small cerebrovascular lesions are one of the most important factors in cerebral amyloid angiopathy (CM) and vascular dementia (VaD). We analyzed the difference of arteriolar pathology between CM patients (CMs) and vascular dementia patients without CAA (VaDs).Methods Ten deceased CMs and twelve deceased VaDs were available for this study. Five deceased patients without known cerebrovascular diseases served as controls. These patients were all autopsy cases. All transversely cut arterioles in the gray matter and white matter with an external diameter equal to or larger than 30 μm and with a maximum of 300 μm were examined. The internal and external diameters of arterioles were measured. Results The external diameter of gray matter arterioles in the CAAs was significantly greater than in controls. In gray matter arterioles, the diameter of the lumen in VaDs was markedly smaller than in the CAAs, whereas there was no significant difference between CAAs and controls. CMs and VaDs may cause remarkable thickening of the arteriolar walls in either white matter or gray matter. The sclerotic index of arterioles in VaDs was significantly greater than in CAAs and controls. Conclusions Stenosis of arterioles occurred in both CM and VaD, but the tendency was greater in VaD. Arterioles of CM were also expanded in gray matter, which may be related to lobar hemorrhage. The loss and/or degeneration of vascular smooth muscle cells was predominant in CM, while the over-proliferation of vascular smooth muscle cells was greater in VaD.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Proteínas totais do LCR no prognóstico do paciente com acidente vascular encefálico hemorrágico

    Directory of Open Access Journals (Sweden)

    João Baptista dos Reis-Filho

    1995-03-01

    Full Text Available O prognóstico dos pacientes com acidente vascular encefálico hemorrágico (AVEH é reservado, apresentando altas taxas de morbidade e mortalidade. Estudos experimentais sugerem que existe alteração da barreira hematoencefálica nos AVEH experimentais e que estas alterações estão relacionadas ao desenvolvimento do vasoespasmo e pior prognóstico. Distúrbios da barreira hematoencefálica podem ser avaliados pelo estudo da taxa das proteínas totais do LCR. O propósito deste estudo é avaliar o valor da taxa de proteínas totais no prognóstico, em relação à sobrevida, de pacientes com derrame de sangue no espaço subaracnóideo. Para tanto foram estudadas 254 fichas de pacientes do Departamento de Neurologia e Neurocirurgia da Escola Paulista de Medicina, com diagnóstico de AVEH, 144 do sexo masculino e 110 do sexo feminino, com idade variando de 8 a 84 anos. Foi verificado que a taxa de proteínas totais está diretamente correlacionada ao prognóstico, em relação à sobrevida, nos pacientes com AVEH. Quanto mais elevada a taxa de proteínas, pior o prognóstico; no material deste estudo todos os pacientes, em número de 1S, que tiveram taxa de proteínas totais no LCR acima de 3000 mg/100 ml faleceram. Este achado indica que a taxa de proteínas totais no LCR de paciente com AVEH é um preditor de óbito. A análise comparativa entre os sexos não mostrou diferença estatística. Porém quando foram correlacionados o sexo, a idade e taxa de proteínas, verificou-se que homens acima de 50 anos tiveram taxa de proteínas mais elevadas que mulheres na mesma faixa etária, demonstrando que homens idosos têm pior prognóstico que as mulheres nessa mesma faixa etária.

  13. Functional independence measure evaluation in individuals with stroke disability Avaliação da medida de independência funcional de indivíduos com seqüelas de acidente vascular encefálico (AVE

    Directory of Open Access Journals (Sweden)

    Simone Nunes Ávila

    2008-12-01

    Full Text Available Introduction: The stroke is characterized by a lesion that strikes one of the vessels that irrigates the cerebral region. People who have suffered a stroke present functional loss, showing difficulties in locomotion and self-care. Objective: To evaluate the functional independence mesure of individuals with stroke’s sequalae during the realization of their routinal activities, submitted to physical therapy in a hospital phase (considered acute phase and in an outpatient phase (considered chronic phase. Materials and Methods: In the period between March 2007 and May 2008, 26 patients have been evaluated, 12 in the hospitalar phase and 14 in the outpatient phase, with ages between 44 and 80. Patients were from both genders and presented sequalae of stroke. The data was collected using the Functional Independence Measure (FIM instrument. Results: On the hospitalar group, a significant difference has been noticed between the initial score and the final score (p=0,011. The items “self-care”, “locomotion” and “communication” were the ones that presented the highest evolution. On the outpatient group, there were no significant differences between scores of both evaluations (p>0,10. Conclusions: In the hospitalar phase, patients who have suffered a stroke presented a faster recovery in the first weeks. On the other hand, those patients in the outpatient phase have remained stable.Introdução: O acidente vascular encefálico (AVE é caracterizado por uma lesão que acomete um dos vasos que irrigam a região cerebral. Pessoas que sofrem AVE apresentam perda funcional, manifestando dificuldades na locomoção e no cuidado pessoal. Objetivo: O objetivo deste estudo foi avaliar a evolução da capacidade de independência funcional de indivíduos com seqüela de AVE na realização de atividades da vida diária, submetidos a tratamento fisioterapêutico na fase hospitalar (considerada fase aguda e na fase ambulatorial (considerada fase cr

  14. [Impact of premature birth on long term cardio-cerebral vascular events of puerpera].

    Science.gov (United States)

    Li, Dongqing; Tao, Jie; Dong, Yan; Zhao, Haiyan; Gao, Xinying; Ji, Chunpeng; Wang, Lijiao; Xiang, Honghu; Wu, Shouling

    2014-07-01

    To investigate the impact of premature birth on long term cardio-cerebral vascular events of puerpera. Ambispective cohort study method was used and 3 659 pregnant women giving birth during October 1976 to December 2008 at Kailuan medical group were included and divided into premature birth (PTB) group (n = 226) and non-PTB (NPTB) group (n = 3 433) by the history of PTB. Incidence of cardio-cerebral vascular events (myocardial infarction, cerebral infarction and cerebral hemorrhage) was obtained during follow-up. Multivariable Cox proportional hazards regression models was used to assess the relative risk of cardio-cerebral vascular events. (1) The childbearing age, proportion of pregnancy-induced hypertension, systolic blood pressure and diastolic blood pressure before delivery were significantly higher while weight and height of newborn were significantly less in PTB group than in NPTB group (P < 0.05 or 0.01). (2) There were 71 cardio-cerebral vascular events during the follow-up of (15.19 ± 7.75) years. In PTB group, the incidence of cardio-cerebral vascular events and myocardial infarction was 3.23/1 000 person-years and 2.05/1 000 person-years, respectively, while the corresponding incidence was 1.15/1 000 person-years and 0.42/1 000 person-years, respectively in NPTB group (all P < 0.05). After adjustment for other traditional cardiovascular risk factors, the risk of total cardio-cerebral vascular events, myocardial infarction in PTB group was 2.03 fold (95% CI: 1.02-4.04, P = 0.002) and 3.11 fold (95% CI: 1.18-8.18, P < 0.001) higher than in NPTB group. PTB is an independent risk factor for total cardio-cerebral vascular events, especially myocardial infarction of puerpera.

  15. ESTUDIO DEL EFECTO DE LA CRANEOACUPUNTURA EN PACIENTES CON ENFERMEDAD VASCULAR CEREBRAL. (EVC)

    OpenAIRE

    PEREZ BRAVO, MIGUEL

    2009-01-01

    LA ENFERMEDAD VASCULAR CEREBRAL (EVC) EN MEXICO ES UN IMPORTANTE PROBLEMA DE SALUD PUBLICA, ES LA TERCERA CAUSA DE MUERTE Y LA SEGUNDA EN PRODUCIR INCAPACIDAD NEUROLOGICA. EL OBJETIVO DE ESTE ESTUDIO FUE EVALUAR EL EFECTO DE LA CRANEOACUPUNTURA EN PACIENTES CON ENFERMEDAD VASCULAR CEREBRAL (ZHONG FENG). EL PRESENTE ES UN ESTUDIO EXPERIMENTAL, PROSPECTIVO Y LONGITUDINAL, REALIZADO EN EL HOSPITAL DEL ISSSTE DE LA CIUDAD DE PUEBLA, A UN GRUPO DE 11 PACIENTES DE AMBOS SEXOS, CON...

  16. ESTUDIO DEL EFECTO DE LA CRANEOACUPUNTURA EN PACIENTES CON ENFERMEDAD VASCULAR CEREBRAL. (EVC)

    OpenAIRE

    PEREZ BRAVO, MIGUEL

    2009-01-01

    LA ENFERMEDAD VASCULAR CEREBRAL (EVC) EN MEXICO ES UN IMPORTANTE PROBLEMA DE SALUD PUBLICA, ES LA TERCERA CAUSA DE MUERTE Y LA SEGUNDA EN PRODUCIR INCAPACIDAD NEUROLOGICA. EL OBJETIVO DE ESTE ESTUDIO FUE EVALUAR EL EFECTO DE LA CRANEOACUPUNTURA EN PACIENTES CON ENFERMEDAD VASCULAR CEREBRAL (ZHONG FENG). EL PRESENTE ES UN ESTUDIO EXPERIMENTAL, PROSPECTIVO Y LONGITUDINAL, REALIZADO EN EL HOSPITAL DEL ISSSTE DE LA CIUDAD DE PUEBLA, A UN GRUPO DE 11 PACIENTES DE AMBOS SEXOS, CON...

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

    Directory of Open Access Journals (Sweden)

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

    Directory of Open Access Journals (Sweden)

    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

  19. Presión arterial sistólica y pronóstico funcional en pacientes con enfermedad vascular cerebral aguda: Registro mexicano de enfermedad vascular cerebral

    OpenAIRE

    Baños-González,Manuel; Cantú-Brito,Carlos; Chiquete,Erwin; Arauz, Antonio; Ruiz-Sandoval,José Luís; Villarreal-Careaga,Jorge; Barinagarrementeria,Fernando; Lozano,José Juan

    2011-01-01

    Objetivo: Analizar la asociación de la presión arterial sistólica (PAS) al ingreso hospitalario y la evolución clínica a 30 días en pacientes con enfermedad vascular cerebral (EVC) aguda. Métodos: El REgistro NAcional Mexicano de Enfermedad VAScular Cerebral (RENAMEVASC) es un registro hospitalario multicéntrico realizado de noviembre de 2002 a octubre de 2004. Se registraron 2000 pacientes con distintos síndromes clínicos de EVC aguda confirmados por neuroimagen. La estratificación de la evo...

  20. Presión arterial sistólica y pronóstico funcional en pacientes con enfermedad vascular cerebral aguda: Registro mexicano de enfermedad vascular cerebral

    OpenAIRE

    Baños-González,Manuel; Cantú-Brito, Carlos; Chiquete, Erwin; Arauz, Antonio; Ruiz-Sandoval,José Luís; Villarreal-Careaga,Jorge; Barinagarrementeria,Fernando; Lozano,José Juan

    2011-01-01

    Objetivo: Analizar la asociación de la presión arterial sistólica (PAS) al ingreso hospitalario y la evolución clínica a 30 días en pacientes con enfermedad vascular cerebral (EVC) aguda. Métodos: El REgistro NAcional Mexicano de Enfermedad VAScular Cerebral (RENAMEVASC) es un registro hospitalario multicéntrico realizado de noviembre de 2002 a octubre de 2004. Se registraron 2000 pacientes con distintos síndromes clínicos de EVC aguda confirmados por neuroimagen. La estratificación de la evo...

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Efeitos da imagem mental na reabilitação da função motora do membro superior na hemiplegia após-acidente vascular encefálico

    OpenAIRE

    Trevisan,Claudia Morais

    2007-01-01

    O objetivo deste estudo foi investigar os efeitos da imagem mental em resposta ao estímulo visual em espelho na reabilitação da função motora do membro superior na hemiplegia, em fase crônica, por seqüela de acidente vascular encefálico. Foram selecionados, vinte voluntários, de maneira randômica simples, na faixa etária entre 40 e 60 anos, de ambos os sexos, que freqüentavam serviços de reabilitação comunitários da cidade de Santa Maria/RS. Os critérios de inclusão foram um único AVC, isquêm...

  3. Cinemática e desempenho muscular do tronco e a atividade de sentado para de pé em indivíduos pós-acidente vascular encefálico e saudáveis

    OpenAIRE

    Paula Fernanda de Sousa Silva

    2014-01-01

    Indivíduos acometidos por Acidente Vascular Encefálico (AVE) comumente apresentam deficiências em estruturas e funções do tronco e limitações no sentado para de pé (ST-DP). Em indivíduos saudáveis, a biomecânica desta atividade é comumente caracterizada pela cinemática e desempenho muscular do tronco. Entretanto, na população pós-AVE, a investigação destas variáveis e suas relações com o desempenho no ST-DP ainda não foram adequadamente exploradas. Assim, os objetivos do presente estudo foram...

  4. Confiabilidade das medidas de dinamometria isocinética computadorizada para os movimentos do tronco em sobreviventes de acidente vascular encefálico com hemiparesia crônica

    OpenAIRE

    Rabelo, Michelle

    2016-01-01

    As doenças no sistema nervoso estão entre as mais incapacitantes que afetam a autonomia e a independência do indivíduo com repercussões na função muscular. O acidente vascular encefálico, lidera as estatísticas assumindo a posição de maior causa de incapacidade crônica como a fraqueza muscular conhecida como hemiparesia, repercutindo no equilíbrio estático e dinâmico, tendo no tronco o eixo central para a maioria de suas atividades de vida diária. Evidências pela análise de parâmetros do dese...

  5. Comportamento do tronco na fase inicial da sequência de movimento de sentado para de pé, em indivíduos com Acidente Vascular Encefálico, em fase aguda

    OpenAIRE

    Barbosa, Marta

    2013-01-01

    As alterações do controlo postural do tronco observadas em indivíduos pós acidente vascular encefálico (AVE) podem traduzir-se em dificuldades na realização da sequência de movimento de sentado para de pé (STS). Desta forma, o presente estudo teve como objetivo descrever o comportamento do tronco, durante a primeira fase do STS, em cinco indivíduos pós-AVE, em fase aguda. Para tal, os indivíduos foram avaliados em dois momentos, antes (M0) e após (M1) um período de intervenção de 3 meses. ...

  6. Efeitos da imagem mental na reabilitação da função motora do membro superior na hemiplegia após-acidente vascular encefálico

    OpenAIRE

    Trevisan,Claudia Morais

    2007-01-01

    O objetivo deste estudo foi investigar os efeitos da imagem mental em resposta ao estímulo visual em espelho na reabilitação da função motora do membro superior na hemiplegia, em fase crônica, por seqüela de acidente vascular encefálico. Foram selecionados, vinte voluntários, de maneira randômica simples, na faixa etária entre 40 e 60 anos, de ambos os sexos, que freqüentavam serviços de reabilitação comunitários da cidade de Santa Maria/RS. Os critérios de inclusão foram um único AVC, isquêm...

  7. Cerebral vascular effects of hypovolemia and dopamine infusions

    DEFF Research Database (Denmark)

    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.......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....

  8. Acidente vascular cerebral isquêmico na infância: estudo das alterações associadas

    OpenAIRE

    Josiane Ranzan; Newra Tellechea Rotta

    2004-01-01

    Arterial ischemic stroke (AIS) in children is a relatively rare disease, not yet clearly understood and with a multifactored etiology. It can cause a severe impact on the child and be the first manifestation of a systemic disease. Delayed diagnosis is still common and research on the subject in our field practically does not exist. Prothrombotic disorders have been described as important causative factors of the ischemic event in children. Forty-six patients from zero to 18 years of age diagn...

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Competências essenciais de programas de assistência domiciliar para pacientes com acidente vascular cerebral

    Directory of Open Access Journals (Sweden)

    Ana Railka de Souza Oliveira

    2013-06-01

    Full Text Available O Programa de Atendimento Domiciliar agrega em suas atribuições inúmeras Competências Essenciais, tais como as propostas pela Agência de Saúde Pública do Canadá. Dessa forma, buscou-se avaliar a inserção dessas competências essenciais neste programa. Trata-se de um estudo transversal, realizado de janeiro a abril de 2010, com cuidadores e pacientes assistidos pelo programa. Utilizaram-se formulários e diário de campo para a coleta de dados e posteriormente buscou-se avaliar as atividades exercidas no âmbito das competências essenciais preconizadas. Assim, foi possível perceber que as atribuições exercidas pelo programa ainda se encontram aquém do que é almejado, haja vista a lógica biomédica empregada, que conduziu à implementação parcial de Competências Essenciais como: Políticas de Saúde Pública; Planejamento e Implementação; Parceria, Colaboração e Apoio e Liderança. Tal fato denota a necessidade de maiores esforços governamentais e por parte dos profissionais envolvidos no programa com vistas à melhoria da atenção oferecida.

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

    DEFF Research Database (Denmark)

    Stenman, Emelie; Malmsjö, Malin; Uddman, Erik;

    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...... receptors in the pathogenesis of a vascular component after cerebral ischemia....... cerebral artery (MCA) was occluded in male Wistar rats for 2 hours with the intraluminal filament method. The basilar artery and both MCAs were removed after 46 hours of recirculation. The contractile responses to ET-1, a combined ET(A) and ET(B) receptor agonist, and sarafotoxin 6c (S6c), a selective ET...

  12. Cerebral vascular control and metabolism in heat stress

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...

  13. Tratamento da hipertensão e declínio da mortalidade por acidentes vasculares cerebrais The treatment of hypertension and the decline of mortality from cerebrovascular accidents

    Directory of Open Access Journals (Sweden)

    José Eluf Neto

    1990-08-01

    Full Text Available É discutida a possível relação causa-efeito entre o declínio da mortalidade por acidentes vasculares cerebrais (AVC e o melhor tratamento da hipertensão arterial. Para isto são revistos criticamente na literatura internacional os possíveis artefatos estatísticos para a enumeração dos AVCs, a letalidade e a incidência de AVC a prevalência de outros fatores de risco como hipercolesterolemia, tabagismo, ingestão de sódio, potássio e álcool, a obesidade e também a contribuição da assistência médica.A possible cause-effect relation ship between the decline of mortality from cerebro-vascular accidents (CVA and a better control of arterial hypertension is discussed. The international literature on the subject is critically reviewed in the light of the possible statistical artifacts for enumeration of CVAs, the incidence and fatality of the disease, the prevalence of other risk factors such as hypercholesterolemia, smoking, and the consumption of sodium, potassium and alcohol, and obesity, as well as the contribution of health care.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    The aim of the present study was to calculate critical closing pressure (CCP) of the cerebral vasculature at rest and during exercise to estimate cerebral vascular tone. Five men and two women were seated upright for 15 min and then performed 15 min of right-legged knee extension exercise at 40, 60...... and 75% of their maximal workload (WL(max)). Middle cerebral artery blood velocity (MCA V) and blood pressure in the radial artery were recorded. The CCP was calculated by linear extrapolation from 1 min recordings of pairs of systolic and diastolic pressure and MCA V waveforms from both the right...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  17. 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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    Eliana Sales Brito

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Endovascular treatment of cerebral aneurysms at Altai Regional Vascular Center

    Directory of Open Access Journals (Sweden)

    Д. А. Долженко

    2015-10-01

    Full Text Available A retrospective analysis of the results of endovascular treatment of patients with the brain aneurysms was carried out at the Neurosurgical Department of Regional Clinical Hospital in Barnaul over a period from 2009 to 2011. 52 patients with 57 cerebral aneurysms were included in the study and 55 endovascular interventions were performed. Total embolization (type A was used in 77% of patients, embolization type B was performed in 19% of cases, incomplete embolization (type C occurred in 4% of cases. 14 (26,9% patients were operated in the acute period of SAH. Conclusions are made relating to the effectiveness and relative safety of intravascular treatment of aneurysms, the need for differentiated approaches to the tactics of surgical treatment of patients in the acute period of hemorrhagic stroke due to the rupture of a cerebral aneurysm.

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

    Directory of Open Access Journals (Sweden)

    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

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

    DEFF Research Database (Denmark)

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

    2007-01-01

    Cerebral ischaemia is associated with elevated levels of endothelin B (ETB) receptors in the ipsilateral middle cerebral artery (MCA). This up-regulation of ET receptors occurs via de novo transcription involving mitogen-activated protein kinases (MAPK). The aim of this study was to examine the e......, neurological symptoms, and ET receptor alteration. The vascular effects of U0126 provide new perspective on possible mechanisms of actions of MAPK inhibition in cerebral ischaemia.......Cerebral ischaemia is associated with elevated levels of endothelin B (ETB) receptors in the ipsilateral middle cerebral artery (MCA). This up-regulation of ET receptors occurs via de novo transcription involving mitogen-activated protein kinases (MAPK). The aim of this study was to examine...... the 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...

  4. Cerebral vascular findings in PAPA syndrome: cerebral arterial vasculopathy or vasculitis and a posterior cerebral artery dissecting aneurysm.

    Science.gov (United States)

    Khatibi, Kasra; Heit, Jeremy J; Telischak, Nicholas A; Elbers, Jorina M; Do, Huy M

    2016-08-01

    A young patient with PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome developed an unusual cerebral arterial vasculopathy/vasculitis (CAV) that resulted in subarachnoid hemorrhage from a ruptured dissecting posterior cerebral artery (PCA) aneurysm. This aneurysm was successfully treated by endovascular coil sacrifice of the affected segment of the PCA. The patient made an excellent recovery with no significant residual neurologic deficit.

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

    Energy Technology Data Exchange (ETDEWEB)

    Claus, J.J. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Breteler, M.M.B. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Hasan, D. [Dept. of Neurology, Univ. Hospital Rotterdam Dijkzigt, Rotterdam (Netherlands); Krenning, E.P. [Dept. of Nuclear Medicine, Univ. Hospital Rotterdam Dijkzigt, Rotterdam (Netherlands); Bots, M.L. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Grobbee, D.E. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Swieten, J.C. van [Dept. of Neurology, Univ. Hospital Rotterdam Dijkzigt, Rotterdam (Netherlands); Harskamp, F. van [Dept. of Neurology, Univ. Hospital Rotterdam Dijkzigt, Rotterdam (Netherlands); Hofman, A. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands)

    1996-06-01

    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 ({sup 99m}Tc-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.)

  6. The effect of ASK1 on vascular permeability and edema formation in cerebral ischemia.

    Science.gov (United States)

    Song, Juhyun; Cheon, So Yeong; Lee, Won Taek; Park, Kyung Ah; Lee, Jong Eun

    2015-01-21

    Apoptosis signal-regulating kinase-1 (ASK1) is the mitogen-activated protein kinase kinase kinase (MAPKKK) and participates in the various central nervous system (CNS) signaling pathways. In cerebral ischemia, vascular permeability in the brain is an important issue because regulation failure of it results in edema formation and blood-brain barrier (BBB) disruption. To determine the role of ASK1 on vascular permeability and edema formation following cerebral ischemia, we first investigated ASK1-related gene expression using microarray analyses of ischemic brain tissue. We then measured protein levels of ASK1 and vascular endothelial growth factor (VEGF) in brain endothelial cells after hypoxia injury. We also examined protein expression of ASK1 and VEGF, edema formation, and morphological alteration through cresyl violet staining in ischemic brain tissue using ASK1-small interference RNA (ASK1-siRNA). Finally, immunohistochemistry was performed to examine VEGF and aquaporin-1 (AQP-1) expression in ischemic brain injury. Based on our findings, we propose that ASK1 is a regulating factor of vascular permeability and edema formation in cerebral ischemia.

  7. 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

    OpenAIRE

    Angélica Cristiane Ovando; Stella Maris Michaelsen; Tales de Carvalho; Vanessa Herber

    2011-01-01

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Cerebral cavernous malformations as a disease of vascular permeability: from bench to bedside with caution.

    Science.gov (United States)

    Yadla, Sanjay; Jabbour, Pascal M; Shenkar, Robert; Shi, Changbin; Campbell, Peter G; Awad, Issam A

    2010-09-01

    Tremendous insight into the molecular and genetic pathogenesis of cerebral cavernous malformations (CCMs) has been gained over the past 2 decades. This includes the identification of 3 distinct genes involved in familial CCMs. Still, a number of unanswered questions regarding the process from gene mutation to vascular malformation remain. It is becoming more evident that the disruption of interendothelial junctions and ensuing vascular hyperpermeability play a principal role. The purpose of this review is to summarize the current understanding of CCM genes, associated proteins, and functional pathways. Promising molecular and genetic therapies targeted at identified molecular aberrations are discussed as well.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  11. Estudo comparativo do equilíbrio de pacientes com disfunção cerebelar e com sequelas de acidente vascular encefálico - doi:10.5020/18061230.2005.p157

    Directory of Open Access Journals (Sweden)

    Sandra Souza Queiroz

    2012-01-01

    Full Text Available O acidente vascular encefálico (AVE e a ataxia cerebelar (AC constituem condições de comprometimento central que de forma freqüente cursam com alterações de equilíbrio. O objetivo deste trabalho foi comparar e quantificar as alterações de equilíbrio em pacientes portadores de AC e seqüelas de AVE, em diferentes bases de suporte e sob influência de diferentes situações impostas ao sistema visual e vestibular. O método empregado consistiu da utilização de teste de estratégias de balance, topografando os sistemas que influenciam nestas estratégias e comparando os graus de dificuldades entre pacientes com disfunção cerebelar e encefálica. As posturas em pé, com pés alinhados e em apoio unipodal foram utilizadas, tendo como variáveis os olhos fechados, abertos e com a utilização de lanterna japonesa, podendo a superfície ser estável ou instável. Os resultados obtidos foram que o grupo de hemiplégicos apresentou maior dificuldade na realização da tarefa com o uso da lanterna, sensibilizando o sistema vestibular. O grupo portador de AC apresentou maior dificuldade na realização da tarefa com os olhos fechados quando comparado ao grupo de AVE. Concluiu-se que as duas classes de pacientes estudados utilizam estratégias próprias para manutenção de equilíbrio, possibilitando apresentar diferenças no desempenho nas estratégias de balance.

  12. Role of endovascular embolization for trigeminal neuralgia related to cerebral vascular malformation.

    Science.gov (United States)

    Ge, Huijian; Lv, Xianli; Jin, Hengwei; He, Hongwei; Li, Youxiang

    2016-10-01

    The objective of this article is to describe the trigeminal neuralgia related to cerebral vascular malformation that is rarely reported and the experience referring to endovascular treatment. A total of 10 patients who had cerebral vascular malformation (AVM and dAVF) in a single center presented with trigeminal neuralgia. Clinical and angiographic presentations as well as their clinical outcomes after embolization were reviewed. Of the 10 cases, seven dAVFs and three AVMs were detected. In contrast to the dilated feeding arteries, an ectasia of the draining vein that is adjacent to the root entry zone of the trigeminal nerve such as the petrosal vein and lateral mesencephalic vein has the major role in causing the trigeminal neuralgia. All of these patients had relief of facial pain after endovascular embolization during follow-up (mean 57.3 months, range 5 to 100 months). There were no permanent neurological deficits. Endovascular embolization is an effective method in treating trigeminal neuralgia related to cerebral vascular malformation. © The Author(s) 2016.

  13. Autonomic cerebral vascular response to sildenafil in diabetic patient

    Directory of Open Access Journals (Sweden)

    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.

  14. LIMITAÇÃO DA MOBILIDADE FÍSICA EM PACIENTES APÓS O ACIDENTE VASCULAR ENCEFÁLICO NO DOMICÍLIO: PROPOSTA DE UM CONCEITO

    Directory of Open Access Journals (Sweden)

    Rafaella Pessoa Moreira

    2013-01-01

    Full Text Available El objetivo fue construir el concepto de limitación de la movilidad en el hogar, basado en la identificación de antecedentes, atributos y consecuencias en pacientes después del accidente cerebrovascular. Se realizó análisis de conceptos a través del acceso on-line a tres bases de datos en octubre de 2009. Se utilizó los descriptores Limitación de la Movilidad y Accidente cerebrovascular, en inglés, portugués y español. Fueron encontrados 140 artículos y seleccionados 13. Antecedentes principales: derrame cerebral, disminución de la fuerza muscular en extremidades inferiores y pérdida del equilibrio; atributos: capacidad de caminar perjudicada y disminución de la velocidad al caminar; consecuencias: disminución de la calidad de vida, reducción de la participación en sociedad, disminución de las actividades de vida diaria y actividades instrumentales de vida diaria y caídas. Esta investigación puede apoyar la creación de estudios sobre este tema y permitir que enfermeros mejoren sus prácticas de atención a estos pacientes.

  15. 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

    OpenAIRE

    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...

  16. 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

    OpenAIRE

    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...

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

    Institute of Scientific and Technical Information of China (English)

    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.

  18. Cerebral cavernous malformations proteins inhibit Rho kinase to stabilize vascular integrity.

    Science.gov (United States)

    Stockton, Rebecca A; Shenkar, Robert; Awad, Issam A; Ginsberg, Mark H

    2010-04-12

    Endothelial cell-cell junctions regulate vascular permeability, vasculogenesis, and angiogenesis. Familial cerebral cavernous malformations (CCMs) in humans result from mutations of CCM2 (malcavernin, OSM, MGC4607), PDCD10 (CCM3), or KRIT1 (CCM1), a Rap1 effector which stabilizes endothelial cell-cell junctions. Homozygous loss of KRIT1 or CCM2 produces lethal vascular phenotypes in mice and zebrafish. We report that the physical interaction of KRIT1 and CCM2 proteins is required for endothelial cell-cell junctional localization, and lack of either protein destabilizes barrier function by sustaining activity of RhoA and its effector Rho kinase (ROCK). Protein haploinsufficient Krit1(+/-) or Ccm2(+/-) mouse endothelial cells manifested increased monolayer permeability in vitro, and both Krit1(+/-) and Ccm2(+/-) mice exhibited increased vascular leak in vivo, reversible by fasudil, a ROCK inhibitor. Furthermore, we show that ROCK hyperactivity occurs in sporadic and familial human CCM endothelium as judged by increased phosphorylation of myosin light chain. These data establish that KRIT1-CCM2 interaction regulates vascular barrier function by suppressing Rho/ROCK signaling and that this pathway is dysregulated in human CCM endothelium, and they suggest that fasudil could ameliorate both CCM disease and vascular leak.

  19. A theoretical framework for determining cerebral vascular function and heterogeneity from dynamic susceptibility contrast MRI.

    Science.gov (United States)

    Digernes, Ingrid; Bjørnerud, Atle; Vatnehol, Svein Are S; Løvland, Grete; Courivaud, Frédéric; Vik-Mo, Einar; Meling, Torstein R; Emblem, Kyrre E

    2017-06-01

    Mapping the complex heterogeneity of vascular tissue in the brain is important for understanding cerebrovascular disease. In this translational study, we build on previous work using vessel architectural imaging (VAI) and present a theoretical framework for determining cerebral vascular function and heterogeneity from dynamic susceptibility contrast magnetic resonance imaging (MRI). Our tissue model covers realistic structural architectures for vessel branching and orientations, as well as a range of hemodynamic scenarios for blood flow, capillary transit times and oxygenation. In a typical image voxel, our findings show that the apparent MRI relaxation rates are independent of the mean vessel orientation and that the vortex area, a VAI-based parameter, is determined by the relative oxygen saturation level and the vessel branching of the tissue. Finally, in both simulated and patient data, we show that the relative distributions of the vortex area parameter as a function of capillary transit times show unique characteristics in normal-appearing white and gray matter tissue, whereas tumour-voxels in comparison display a heterogeneous distribution. Collectively, our study presents a comprehensive framework that may serve as a roadmap for in vivo and per-voxel determination of vascular status and heterogeneity in cerebral tissue.

  20. MMP-2 Is Mainly Expressed in Arterioles and Contributes to Cerebral Vascular Remodeling Associated with TGF-β1 Signaling.

    Science.gov (United States)

    Hua, Ye; Zhang, Weifeng; Xie, Zhenying; Xu, Nanfei; Lu, Yunnan

    2016-07-01

    There is increasing evidence to suggest that matrix metalloproteinases (MMPs) play a crucial role in vascular remodeling. It has been reported that hypoxia stimulated MMP-9 expression in brain endothelial cells and MMP-9 plays an important role in cerebral vascular remodeling. However, little is known about MMP-2 in the cerebral vessels remodeling. Herein, the aim of this study is to examine the class of vessel and cell type expressing MMP-2 in cerebral vessels and to investigate its potential role in vascular remodeling. In the present study, dual-immunofluorescence assay showed that MMP-2 was mainly expressed in arterioles. In addition, we found that MMP-2 expression in cerebral vessels was derived from endothelial cells, not astrocyte cells. Notably, in the normoxic central nervous system (CNS), there was no effect on vascular development, integrity, or endothelial proliferation when MMP-2 was knocked out, but lack of MMP-2 led to defective arteriolar remodeling and associated with transforming growth factor β1 (TGF-β1) signaling in CNS. Moreover, blocking TGF-β with SB431542, a specific TGF-β inhibitor, significantly reduced the messenger RNA (mRNA) and protein expression levels of MMP-2 in human umbilical vein endothelial cells (HUVECs). Our findings reveal that the level of MMP-2 is high in arteriolar endothelial cells and demonstrate a novel connection between MMP-2 and TGF-β1 signaling in cerebral vascular remodeling.

  1. 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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    Johnnatas Mikael Lopes

    2016-03-01

    Full Text Available 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 indicador para HAVEI e proporção de mortalidade hospitalar. A fim de estimar a tendência dos dados criou-se uma curva polinomial de melhor aderência e para a averiguar o impacto do Hiperdia aplicou-se o Modelo Linear Generalizado tomados como desfecho a HAVEI e a mortalidade hospitalar. Adotou-se um nível de significância de 5% para minimizar um erro tipo I. Resultados: Foi evidenciada redução das HAVEI de 37,57/105 habitantes em 1998 a 2001 para 10,33/105 habitantes em 2002 a 2005, declinando 73,64%. A redução aconteceu em ambos os sexos, assim como para todas as faixas etárias. A mortalidade hospitalar por AVEI também declinou no Brasil a partir de 2002, tanto em homens como em mulheres, porém em menos de 3% e apenas nas faixas entre 0 e 14 anos e acima de 80 anos não detectamos tendência. Conclusão: Portanto, o declínio das HAVEI coincidiu temporalmente com a implementação do Hiperdia no ano de 2002 e essa tendência se mantém até hoje.

  3. Estudo clínico e videofluoroscópico da disfagia na fase subaguda do acidente vascular encefálico Clinical and videofluoroscopic study of dysphagia in patients with cerebrovascular accident in the subacute phase

    Directory of Open Access Journals (Sweden)

    Denise Rodrigues Xerez

    2004-02-01

    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 OBJECTIVE: To compare the clinical signs of swallowing abnormalities with videofluoroscopy findings in patients with cerebrovascular accident (CVA in the subacute phase. MATERIALS AND METHODS: From a group of 37 patients with subacute CVA confirmed by imaging examinations, 26 patients (male and female; mean age of 59.69 years were clinically and videofluoroscopically evaluated. The clinical parameters for penetration/aspiration of fluids and the confirmation by videofluoroscopy were used for the statistical analysis. RESULTS: Dysphagia was identified in 19 (73% of the 26 patients who were submitted to videofluoroscopy; 10 (38.6% patients presented penetration/aspiration of fluids. The results demonstrated that there was no correlation (p < 0.05 between the occurrence of dysphagia and/or dysartria and penetration/aspiration of fluids observed on videofluoroscopy. There was correlation between penetration/aspiration of liquids observed on videofluoroscopy and the following parameters: condition of the teeth (p = 0.047, face motility (p = 0.019 and sensibility (p = 0.039, and tongue motility (p = 0.012. CONCLUSION: It was not possible to determine the presence of penetration/aspiration of

  4. Controle autonômico do coração e fração de ejeção na fase crônica do acidente vascular encefálico

    Directory of Open Access Journals (Sweden)

    Suenimeire Vieira

    2014-12-01

    Full Text Available Introdução: Sujeitos acometidos por acidente vascular encefálico (AVE podem apresentar alterações na estrutura e função do coração e na modulação autonômica. Objetivo: Verificar função autonômica e cardíaca sistólica em homens após AVE, e se estas variáveis estão associadas. Métodos: Foram avaliados oito homens, com idade entre 55 e 65 anos, acometidos por lesão cerebrovascular há pelo menos seis meses e todos com hemiparesia. Foram realizadas as seguintes avaliações: 1 Ecocardiografia, para avaliar a função cardíaca sistólica. 2 Registro da frequência cardíaca (FC e dos intervalos R-R (IRR, batimento a batimento, para avaliação do controle neural do coração. Esses dados foram analisados no domínio da frequência, por meio das análises dos seguintes componentes espectrais: alta frequência; baixa frequência e a razão BF/AF. Foi aplicado o teste de correlação de Pearson (p ≤ 0,05. Resultados: Características demográficas, antropométricas e fisiológicas: Idade = 58,62 ± 2,88 anos; IMC = 27,41 ± 5,33 kg/m2 ; BF = 61,78 ± 26,79 (un; AF = 38,23 ± 26,79 (un; BF/AF = 3,41 ± 3,38; FE = 0,65 ± 0,04. Não houve correlação estatisticamente significativa entre os índices espectrais BF e AF com fração de ejeção e a presença de fatores de risco para AVE. Conclusão: No presente estudo, a fração de ejeção do ventrículo esquerdo encontra-se normal e o controle neural do coração pode estar normal ou não, mesmo na presença de fatores de risco para o AVE.

  5. Effects of cerebrolysin on moderate cognitive impairments in cerebral vascular insufficiency (a clinical-electrophysiological study).

    Science.gov (United States)

    Damulin, I V; Koberskaya, N N; Mkhitaryan, E A

    2008-07-01

    The efficacy of treatment with cerebrolysin was studied in 40 patients with cerebral vascular insufficiency. Cerebrolysin (20 daily i.v. infusions of 10 ml in 200 ml of physiological saline) was found to be an effective means of treating this group of patients. Courses of cerebrolysin treatment decreased the severity of memory and attention impairments, improving the overall cognitive status of the patients. Clinical observations and neuropsychological testing were supported by electrophysiological results, in terms of the P300 cognitive evoked potential. The effects of treatment at the doses used here were delayed and were seen three months after completion of treatment.

  6. Factores asociados a crisis epilépticas en pacientes con enfermedad vascular cerebral aguda.

    OpenAIRE

    Salirrosas-Alegría, Cristopher; Médico residente de Psiquiatría, Instituto Nacional de Salud Mental Honorio Delgado - Hideyo Noguchi. Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia. Lima.; Pereda-Vásquez, Firdusi; Profesor Principal de Neurología Clínica y de Semiología Neurológica. Facultad de Medicina. Universidad Nacional de Trujillo. Coordinador Académico del Residentado de Neurología de la Facultad de Medicina. Universidad Nacional de Trujillo. Trujillo, Perú.

    2013-01-01

    Objetivos: Determinar la asociación entre el tipo de enfermedad vascular cerebral (EVC), la extensión de la lesióncerebral, la presencia de cardiopatía isquémica y/o fibrilación auricular; y las crisis epilépticas en pacientes con EVCaguda. Material y métodos: Se realizó un estudio descriptivo, de tipo casos y controles. Se estudiaron a los pacientesque presentaron crisis epilépticas luego de la EVC. Las variables fueron: crisis epilépticas, tipo de EVC, cardiopatíaisquémica, fibrilación auri...

  7. Vascular permeability and iron deposition biomarkers in longitudinal follow-up of cerebral cavernous malformations

    DEFF Research Database (Denmark)

    Girard, Romuald; Fam, Maged D; Zeineddine, Hussein A

    2017-01-01

    OBJECTIVE Vascular permeability and iron leakage are central features of cerebral cavernous malformation (CCM) pathogenesis. The authors aimed to correlate prospective clinical behavior of CCM lesions with longitudinal changes in biomarkers of dynamic contrast-enhanced quantitative permeability...... (DCEQP) and quantitative susceptibility mapping (QSM) assessed by MRI. METHODS Forty-six patients with CCMs underwent 2 or more permeability and/or susceptibility studies in conjunction with baseline and follow-up imaging and clinical surveillance during a mean 12.05 months of follow-up (range 2...... permeability at baseline (p = 0.001), as well as higher regional permeability (p = 0.003) in the area that would later develop a new lesion as compared with the homologous contralateral brain region. CONCLUSIONS In vivo assessment of vascular permeability and iron deposition on MRI can serve as objective...

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

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    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  10. Low Cerebral Glucose Metabolism: A Potential Predictor for the Severity of Vascular Parkinsonism and Parkinson's Disease.

    Science.gov (United States)

    Xu, Yunqi; Wei, Xiaobo; Liu, Xu; Liao, Jinchi; Lin, Jiaping; Zhu, Cansheng; Meng, Xiaochun; Xie, Dongsi; Chao, Dongman; Fenoy, Albert J; Cheng, Muhua; Tang, Beisha; Zhang, Zhuohua; Xia, Ying; Wang, Qing

    2015-11-01

    This study explored the association between cerebral metabolic rates of glucose (CMRGlc) and the severity of Vascular Parkinsonism (VP) and Parkinson's disease (PD). A cross-sectional study was performed to compare CMRGlc in normal subjects vs. VP and PD patients. Twelve normal subjects, 22 VP, and 11 PD patients were evaluated with the H&Y and MMSE, and underwent 18F-FDG measurements. Pearson's correlations were used to identify potential associations between the severity of VP/PD and CMRGlc. A pronounced reduction of CMRGlc in the frontal lobe and caudate putamen was detected in patients with VP and PD when compared with normal subjects. The VP patients displayed a slight CMRGlc decrease in the caudate putamen and frontal lobe in comparison with PD patients. These decreases in CMRGlc in the frontal lobe and caudate putamen were significantly correlated with the VP patients' H&Y, UPDRS II, UPDRS III, MMSE, cardiovascular, and attention/memory scores. Similarly, significant correlations were observed in patients with PD. This is the first clinical study finding strong evidence for an association between low cerebral glucose metabolism and the severity of VP and PD. Our findings suggest that these changes in glucose metabolism in the frontal lobe and caudate putamen may underlie the pathophysiological mechanisms of VP and PD. As the scramble to find imaging biomarkers or predictors of the disease intensifies, a better understanding of the roles of cerebral glucose metabolism may give us insight into the pathogenesis of VP and PD.

  11. EFFECT OF ELECTROACUPUNCTURE ON CEREBRAL BLOOD FLOW,VIP AND ET IN RATS WITH VASCULAR DEMENTIA

    Institute of Scientific and Technical Information of China (English)

    申国明; 徐颖; 何峰; 许冠荪

    2004-01-01

    Objective: To investigate the relationship between electroacupuncture (EA)-induced improvement of regional cerebral blood flow and the alternations of vasoactive intestinal peptide (VIP) and endothelin (ET) in rats with experimental vascular dementia (VD).Methods: 40 Wistar rats were evenly randomized into sham-operation, model, medication (Nimotone) and EA groups.Vascular dementia model was established by repeated cerebral ischemia-reperfusion which was induced by occlusion and reopen of the bilateral common carotid arteries.EA (2~200 Hz, 2~3 mA) was applied to "Baihui"(GV 20), "Dazhui"(GV 14) and "Zusanli"(ST 36) for 30 min, once daily and continuously for 15 days.The regional cerebral blood flow (rCBF) in parietal lobe and hippocampus was determined with method of hydrogen clearance; a step-down avoidance test was adopted to observe the rats' behavior change; and plasma VIP and ET contents were assayed by radioimmunoassay.Results: In comparison with sham-operation group, the correct rate of step-down avoidance test, rCBF in parietal lobe and hippocampus and plasma VIP level in VD model group lowered significantly (P<0.01) and plasma ET increased considerably (P<0.01).However, compared with model group, the correct rate of step-down avoidance test, rCBF values and plasma VIP in EA group raised obviously while plasma ET declined significantly.No significant differences were found between EA and medication groups in the 4 indexes.Conclusion: EA can raise rCBF in the parietal lobe and hippocampus, elevate plasma VIP level and reduce plasma ET in rats with VD.

  12. A Voxel-based Morphometric Analysis of Cerebral Gray Matter in Subcortical Ischemic Vascular Dementia Patients and Normal Aged Controls

    Directory of Open Access Journals (Sweden)

    Chuanming Li, Hanjian Du, Jian Zheng, Jian Wang

    2011-01-01

    Full Text Available BACKGROUND AND PURPOSE: The present study was designed to detect the abnormalities of the cerebral grey-matter density in subcortical ischemic vascular dementia patients by FSL-VBM method to promote the early diagnosis of it.METHODS: Nine subcortical ischemic vascular dementia patients and nine age-matched normal controls underwent MRI brain structure scanning that was performed on a SIEMENS AVANTO 1.5 Tesla scanner and standard T1-weighted high-resolution anatomic scans of MPRAGE sequence were obtained. The 3-demensional MPRAGE images were processed with FSL-VBM package and the cerebral gray matter density was compared between the subcortical ischemic vascular dementia patients and normal controls.RESULTS: Compared with the normal control group, the cerebral gray matter density of subcortical ischemic vascular dementia patients was found significantly decreasing, including brain regions of thalamus, parietal lobe, frontal lobe and temporal lobe (P<0.05.CONCLUSIONS: The cerebral gray matter density alterations have closed correlation with cognitive dysfunction in subcortical ischemic vascular dementia patient and can be detected by MRI. MRI has some potential value in the diagnosis of them.

  13. Multiple or mixed cerebral microbleeds and dementia in patients with vascular risk factors.

    Science.gov (United States)

    Miwa, Kaori; Tanaka, Makiko; Okazaki, Shuhei; Yagita, Yoshiki; Sakaguchi, Manabu; Mochizuki, Hideki; Kitagawa, Kazuo

    2014-08-12

    To investigate whether cerebral microbleeds (CMBs) are independently associated with incident dementia in patients with vascular risk factors. Using data from a Japanese cohort of participants with vascular risk factors in an observational study from 2001, we evaluated the association between CMBs at baseline and incident dementia. Baseline brain MRI was used to determine small-vessel disease (CMBs, lacunar infarcts, and white matter hyperintensities) and brain atrophy. Cox proportional hazards analyses were performed for predictors of dementia adjusting for age, sex, APOE ε4 allele, educational level, baseline Mini-Mental State Examination score, cerebrovascular events, vascular risk factors, and MRI findings. Of the 524 subjects (mean age 68 ± 8.3 years, 57.6% male, 12.8 ± 2.6 years of schooling, 21.6% CMBs), 44 patients with incident dementia (20 Alzheimer disease, 18 vascular dementia, 3 mixed-type, and 3 other) were diagnosed during the median 7.5-year follow-up. In multivariate analysis, the presence of overall CMBs was not associated with an increased risk of incident all-cause dementia (p = 0.15). However, multiple CMBs (≥ 2) or mixed (lobar and deep) CMBs were associated with the increased risk of all-cause dementia, whereas strictly lobar CMBs showed no association with any dementia. Multiple CMBs or mixed CMBs independently showed higher risk of all-cause dementia. Our results reinforce the hypothesis that CMBs exert deleterious effects on dementia incidence, suggesting that this association may be mediated by vascular burden. © 2014 American Academy of Neurology.

  14. O PRODUTO COMO CAUSADOR DE ACIDENTES

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    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.

  15. Cerebral microvascular amyloid beta protein deposition induces vascular degeneration and neuroinflammation in transgenic mice expressing human vasculotropic mutant amyloid beta precursor protein.

    NARCIS (Netherlands)

    Miao, J.; Xu, F.; Davis, J.; Otte-Holler, I.; Verbeek, M.M.; Nostrand, W.E. van

    2005-01-01

    Cerebral vascular amyloid beta-protein (Abeta) deposition, also known as cerebral amyloid angiopathy, is a common pathological feature of Alzheimer's disease. Additionally, several familial forms of cerebral amyloid angiopathy exist including the Dutch (E22Q) and Iowa (D23N) mutations of Abeta. Incr

  16. Effect of combined VEGF165/ SDF-1 gene therapy on vascular remodeling and blood perfusion in cerebral ischemia.

    Science.gov (United States)

    Hu, Guo-Jie; Feng, Yu-Gong; Lu, Wen-Peng; Li, Huan-Ting; Xie, Hong-Wei; Li, Shi-Fang

    2016-12-16

    OBJECTIVE Therapeutic neovascularization is a promising strategy for treating patients after an ischemic stroke; however, single-factor therapy has limitations. Stromal cell-derived factor 1 (SDF-1) and vascular endothelial growth factor (VEGF) proteins synergistically promote angiogenesis. In this study, the authors assessed the effect of combined gene therapy with VEGF165 and SDF-1 in a rat model of cerebral infarction. METHODS An adenoviral vector expressing VEGF165 and SDF-1 connected via an internal ribosome entry site was constructed (Ad- VEGF165-SDF-1). A rat model of middle cerebral artery occlusion (MCAO) was established; either Ad- VEGF165-SDF-1 or control adenovirus Ad- LacZ was stereotactically microinjected into the lateral ventricle of 80 rats 24 hours after MCAO. Coexpression and distribution of VEGF165 and SDF-1 were examined by reverse-transcription polymerase chain reaction, Western blotting, and immunofluorescence. The neurological severity score of each rat was measured on Days 3, 7, 14, 21, and 28 after MCAO. Angiogenesis and vascular remodeling were evaluated via bromodeoxyuridine and CD34 immunofluorescence labeling. Relative cerebral infarction volumes were determined by T2-weighted MRI and triphenyltetrazolium chloride staining. Cerebral blood flow, relative cerebral blood volume, and relative mean transmit time were assessed using perfusion-weighted MRI. RESULTS The Ad- VEGF165-SDF-1 vector mediated coexpression of VEGF165 and SDF-1 in multiple sites around the ischemic core, including the cortex, corpus striatum, and hippocampal granular layer. Coexpression of VEGF165 and SDF-1 improved neural function, reduced cerebral infarction volume, increased microvascular density and promoted angiogenesis in the ischemic penumbra, and improved cerebral blood flow and perfusion. CONCLUSIONS Combined VEGF165 and SDF-1 gene therapy represents a potential strategy for improving vascular remodeling and recovery of neural function after cerebral

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

    Directory of Open Access Journals (Sweden)

    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

  18. Estratégias de prevenção do acidente vascular encefálico cardioembólico na doença de Chagas Prevention strategies of cardioembolic ischemic stroke in Chagas' disease

    Directory of Open Access Journals (Sweden)

    Andréa Silvestre de Sousa

    2008-11-01

    Full Text Available FUNDAMENTO: O acidente vascular encefálico isquêmico (AVEi cardioembólico é uma manifestação clínica importante da cardiopatia chagásica crônica, no entanto, ainda não foram definidos sua incidência e os fatores de risco associados a este evento. OBJETIVO: Definir estratégias de prevenção de uma complicação freqüente e incapacitante da doença de Chagas, o AVEi cardioembólico. MÉTODOS: No período de março de 1990 a março de 2002, 1.043 pacientes com doença de Chagas foram recrutados e acompanhados até março de 2003 em um estudo prospectivo e observacional de coorte. Por meio da regressão de Cox foi desenvolvido um escore de risco de AVEi, que se correlacionou com a incidência anual desse evento: 4-5 pontos, > 4%; 3 pontos, 2% a 4%; 2 pontos, 1% a 2 %; e 0-1 ponto, 48 anos sendo desenvolvido um escore de risco de AVEi, que se relacionou com a incidência anual desse evento. No grupo 2, não houve complicações hemorrágicas, e a incidência anual de AVEi foi de 3,2%, todos em pacientes com 4-5 pontos. CONCLUSÃO: Por meio da análise de risco-benefício, varfarina estaria indicada aos pacientes com 4-5 pontos, cuja incidência de evento supera a taxa de sangramento maior. No subgrupo de 3 pontos, as taxas de evento e sangramento com anticoagulante se equivalem, sendo indicados AAS ou varfarina, conforme o risco individual de sangramento ou embolização. Nos pacientes com 2 pontos, com baixa incidência de AVEi, seriam recomendados AAS ou nenhuma profilaxia. Os pacientes com 0-1 ponto, com incidência do evento próxima a zero, não necessitam de profilaxia.BACKGROUND: The cardioembolic (CE ischemic stroke is an important clinical manifestation of chronic chagasic cardiopathy; however, its incidence and the risk factors associated to this event have yet to be defined. OBJECTIVE: To determine prevention strategies for a common and devastating complication of Chagas' disease, the cardioembolic (CE ischemic stroke

  19. [Clinical analysis of 7 patients with Gerstmann syndrome secondary to cerebral vascular disease].

    Science.gov (United States)

    Zhou, Xiang-qin; He, Rui; Liu, Zhi; Wang, Chang-qing

    2002-10-01

    To analyze clinical features of patients with Gerstmann syndrome (GS). We retrospectively analysed the clinical manifestations of 7 patients (6 men and 1 woman) with GS secondary to cerebral vascular diseases and reviewed the literatures. The age ranged from 51 to 70 years with a mean of 70 years. They all had sudden onset and the tetrad of GS-finger agnosia, left-right disorientation, agraphia and acalculia, 3 patients accompanied by incomplete aphasia, 3 by anomic aphasia, 2 by alexia and 1 by constructional apraxia. Cranial computed tomographic scan showed low-density focus of the left parietal lobe in 6 cases and high-density focus of the left parietal lobe in 1 case. GS has the high value in localization and the lesion is mainly localized to angular gyrus of the dominant hemisphere.

  20. Matrix metalloproteinase-9 mediates post-hypoxic vascular pruning of cerebral blood vessels by degrading laminin and claudin-5.

    Science.gov (United States)

    Boroujerdi, Amin; Welser-Alves, Jennifer V; Milner, Richard

    2015-07-01

    Vascular remodeling involves a highly coordinated break-down and build-up of the vascular basal lamina and inter-endothelial tight junction proteins. In light of the important role of matrix metalloproteinases (MMPs) in tissue remodeling, the goal of this study was to examine the role of MMP-9 in remodeling of cerebral blood vessels, both in hypoxia-induced angiogenesis and in the vascular pruning that accompanies the switch from hypoxia back to normoxia. In a chronic mild hypoxia model of cerebrovascular remodeling, gel zymography revealed that MMP-9 levels were increased, both during hypoxic-induced angiogenesis and in the post-hypoxic pruning response. Interestingly, compared to wild-type mice, MMP-9 KO mice showed no alteration in hypoxic-induced angiogenesis, but did show marked delay in post-hypoxic vascular pruning. In wild-type mice, vascular pruning was associated with fragmentation of vascular laminin and the tight junction protein claudin-5, while this process was markedly attenuated in MMP-9 KO mice. In vitro experiments showed that hypoxia stimulated MMP-9 expression in brain endothelial cells but not pericytes. These results show that while MMP-9 is not essential for hypoxic-induced cerebral angiogenesis, it plays an important role in post-hypoxic vascular pruning by degrading laminin and claudin-5.

  1. Tumefação cerebral congestiva em vítimas fatais de acidente de trânsito: frequência e associação com outras lesões cranioencefálicas Congestive brain swelling in victims of fatal road traffic accidents: frequency and association with other head injury lesions

    Directory of Open Access Journals (Sweden)

    SEBASTIÃO SILVA GUSMÃO

    1999-12-01

    Full Text Available Realizou-se estudo anatomopatológico macro e microscópico do encéfalo de 120 vítimas fatais de acidente de trânsito. A tumefação cerebral congestiva (TCC ocorreu em 21 (17,5% pacientes. Consoante com a tumefação cerebral, que determina aumento volumétrico do encéfalo, foi encontrado aumento do peso médio do encéfalo. A contusão cerebral foi a lesão mais frequentemente associada com a TCC (76,2%, enquanto os hematomas intracranianos foram observados em quase metade dos casos.A morphological study, macro and microscopical, was made of brain lesions in 120 victims of fatal road traffic accidents. Congestive brain swelling occurred in 21 (17.5% patients. Owing to the brain swelling that increases the brain volume, an increase of brain weight was also observed. Brain contusion was the most frequent lesion associated with congestive brain swelling (76.2%, while the intracranial haematomas were observed in almost half of the cases.

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

    Science.gov (United States)

    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.

  3. Doppler Ultrasonographic Parameters for Predicting Cerebral Vascular Reserve in Patients with Acute Ischemic Stroke

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Han Young; Lee, Hui Joong; Kim, Hye Jung; Kim, Yong Sun; Kang, Duk Sik [Kyungpook National University Hospital, Daegu (Korea, Republic of)

    2006-03-15

    We investigated Doppler ultrasonographic (US) parameters of patients with acute stroke to predict the cerebral vascular reserve (CVR) measured by SPECT. We reviewed the flow velocity and cross-sectional area of the circular vessel at the common, external, and internal carotid arteries (ICA) and the vertebral arteries (VA) in 109 acute stroke patients who underwent SPECT. Flow volume (FV) of each artery was calculated as the product of the angle-corrected time averaged flow velocity and cross-sectional area of the circular vessel. Total cerebral FV (TCBFV) was determined as the sum of the FVs of the right and left ICA and VA. We compared the Doppler US parameters between 44 cases of preserved and 65 cases of impaired CVR. In the preserved CVR group, ICA FV, anterior circulating FV (ACFV) and TCBFV were higher than in the impaired CVR group (p < 0.05, independent t-test). In the impaired CVR group, the ROC curves showed ACFV and TCBFV were suitable parameters to predict CVR (p < 0.05). Doppler US was helpful for understanding the hemodynamic state of acute stroke. FV measurement by Doppler US was useful for predicting CVR

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

    Energy Technology Data Exchange (ETDEWEB)

    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. 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

    Directory of Open Access Journals (Sweden)

    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

  6. [Diabetes mellitus and aging as a risk factor for cerebral vascular disease: epidemiology, pathophysiology and prevention].

    Science.gov (United States)

    Cantú-Brito, Carlos; Mimenza-Alvarado, Alberto; Sánchez-Hernández, Juan José

    2010-01-01

    Older patients with diabetes have a high risk of vascular complications. They have an increase of approximately 3 times for developing stroke compared with subjects without diabetes. In addition, up to 75-80% of deaths in diabetic patients are associated with major cardiovascular events including stroke. The risk of stroke is high within 5 years of diagnosis for type 2 diabetes is 9% (mortality 21%), that is more than doubles the rate for the general population. From observational registries in a collaborative stroke study in Mexico, we analyzed clinical data, risk factors, and outcome of 1182 diabetic patients with cerebral ischemia, with focus in elderly subjects. There was a high frequency of hyperglycemia during the acute phase of stroke: the median value was 140 mg/dL and 40% had values higher than 180 mg/dL. Clinical outcome was usually unfavorable in elderly stroke patients with diabetes: case fatality rate was 30% at 30 days and survivors had moderate to severe disability, usually as consequence of the propensity to develop more systemic medical complications during hospital stay. Primary stroke prevention studies in patients with diabetes reveal that tight control of glucose is not associated with reduction in stroke risk. Therefore, proper control of other vascular risk factors is mandatory in patients with diabetes, in particular of arterial hypertension.

  7. Vascular inward rectifier K+ channels as external K+ sensors in the control of cerebral blood flow.

    Science.gov (United States)

    Longden, Thomas A; Nelson, Mark T

    2015-04-01

    For decades it has been known that external K(+) ions are rapid and potent vasodilators that increase CBF. Recent studies have implicated the local release of K(+) from astrocytic endfeet-which encase the entirety of the parenchymal vasculature-in the dynamic regulation of local CBF during NVC. It has been proposed that the activation of KIR channels in the vascular wall by external K(+) is a central component of these hyperemic responses; however, a number of significant gaps in our knowledge remain. Here, we explore the concept that vascular KIR channels are the major extracellular K(+) sensors in the control of CBF. We propose that K(+) is an ideal mediator of NVC, and discuss KIR channels as effectors that produce rapid hyperpolarization and robust vasodilation of cerebral arterioles. We provide evidence that KIR channels, of the KIR 2 subtype in particular, are present in both the endothelial and SM cells of parenchymal arterioles and propose that this dual positioning of KIR 2 channels increases the robustness of the vasodilation to external K(+), enables the endothelium to be actively engaged in NVC, and permits electrical signaling through the endothelial syncytium to promote upstream vasodilation to modulate CBF.

  8. Both acute and prolonged administration of EPO reduce cerebral and systemic vascular conductance in humans.

    Science.gov (United States)

    Rasmussen, Peter; Kim, Yu-Sok; Krogh-Madsen, Rikke; Lundby, Carsten; Olsen, Niels V; Secher, Niels H; van Lieshout, Johannes J

    2012-03-01

    Administration of erythropoietin (EPO) has been linked to cerebrovascular events. EPO reduces vascular conductance, possibly because of the increase in hematocrit. Whether EPO in itself affects the vasculature remains unknown; here it was evaluated in healthy males by determining systemic and cerebrovascular variables following acute (30,000 IU/d for 3 d; n=8) and chronic (5000 IU/week for 13 wk; n=8) administration of EPO, while the responsiveness of the vasculature was challenged during cycling exercise, with and without hypoxia. Prolonged administration of EPO increased hematocrit from 42.5 ± 3.7 to 47.6 ± 4.1% (PEPO administration. Yet, the two EPO regimes increased arterial pressure similarly (by 8±4 and 7±3 mmHg, respectively; P=0.01) through reduced vascular conductance (by 7±3 and 5±2%; PEPO regimes widened the arterial-to-jugular O(2) differences at rest as well as during normoxic and hypoxic exercise (PEPO to healthy humans lowers systemic and cerebral conductance independent of its effect on hematocrit.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Vascular permeability and iron deposition biomarkers in longitudinal follow-up of cerebral cavernous malformations.

    Science.gov (United States)

    Girard, Romuald; Fam, Maged D; Zeineddine, Hussein A; Tan, Huan; Mikati, Abdul Ghani; Shi, Changbin; Jesselson, Michael; Shenkar, Robert; Wu, Meijing; Cao, Ying; Hobson, Nicholas; Larsson, Henrik B W; Christoforidis, Gregory A; Awad, Issam A

    2016-08-05

    OBJECTIVE Vascular permeability and iron leakage are central features of cerebral cavernous malformation (CCM) pathogenesis. The authors aimed to correlate prospective clinical behavior of CCM lesions with longitudinal changes in biomarkers of dynamic contrast-enhanced quantitative permeability (DCEQP) and quantitative susceptibility mapping (QSM) assessed by MRI. METHODS Forty-six patients with CCMs underwent 2 or more permeability and/or susceptibility studies in conjunction with baseline and follow-up imaging and clinical surveillance during a mean 12.05 months of follow-up (range 2.4-31.27 months). Based on clinical and imaging features, cases/lesions were classified as stable, unstable, or recovering. Associated and predictive changes in quantitative permeability and susceptibility were investigated. RESULTS Lesional mean permeability and QSM values were not significantly different in stable versus unstable lesions at baseline. Mean lesional permeability in unstable CCMs with lesional bleeding or growth increased significantly (+85.9% change; p = 0.005), while mean permeability in stable and recovering lesions did not significantly change. Mean lesional QSM values significantly increased in unstable lesions (+44.1% change; p = 0.01), decreased slightly with statistical significance in stable lesions (-3.2% change; p = 0.003), and did not significantly change in recovering lesions. Familial cases developing new lesions during the follow-up period showed a higher background brain permeability at baseline (p = 0.001), as well as higher regional permeability (p = 0.003) in the area that would later develop a new lesion as compared with the homologous contralateral brain region. CONCLUSIONS In vivo assessment of vascular permeability and iron deposition on MRI can serve as objective and quantifiable biomarkers of disease activity in CCMs. This may be applied in natural history studies and may help calibrate clinical trials. The 2 techniques are likely applicable in

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

    Institute of Scientific and Technical Information of China (English)

    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

  12. Relation between prognosis and collateral circulation or recanalization in occlusive cerebral vascular diseases

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Yuko (Tokyo Women' s Medical Coll. (Japan))

    1982-09-01

    CT images and angiograms were compared, in occlusive cerebral vascular diseases with complete stroke in the region of internal carotid artery, and following subjects were discussed. 1) Relation between size of final low density area on CT and prognosis. 2) Effectiveness of collateral circulation and recanalization to the low density area on CT in the territory of occluded artery. For the subject 1,100 cases of infarction of the region of middle cerebral artery were chosen at random, and the prognosis was compared with the size of low density area on CT. For the subject 2,186 cases of infarction in the region on internal carotid artery were selected, and CT images and angiograms were compared, considering the duration between stroke and angiography. With these studies, following conclusions were obtained. There is tendency that cases with the smaller low density areas on CT have the better prognosis. The low density on CT appears inside of the territory of the occluded artery. When there is neither collateral circulation nor recanalization, appearance of the low density on CT is not avoided. Collateral circulation or recanalization is able to rescue the affected area from appearance of low density on CT, even if it is formed later than 6 hours after ictus. The critical period when collateral circulation or recanalization effects on the involved area is variable depending on each cases, but it is suspected to be 24 or 72 hours after onset. Blood supply which begins later than 73 hours after occlusion of artery does not effect on the involved area.

  13. Deviation from optimal vascular caliber control at middle cerebral artery bifurcations harboring aneurysms.

    Science.gov (United States)

    Baharoglu, Merih I; Lauric, Alexandra; Wu, Chengyuan; Hippelheuser, James; Malek, Adel M

    2014-10-17

    Cerebral aneurysms form preferentially at arterial bifurcations. The vascular optimality principle (VOP) decrees that minimal energy loss across bifurcations requires optimal caliber control between radii of parent (r₀) and daughter branches (r1 and r2): r₀(n)=r₁(n)+r₂(n), with n approximating three. VOP entails constant wall shear stress (WSS), an endothelial phenotype regulator. We sought to determine if caliber control is maintained in aneurysmal intracranial bifurcations. Three-dimensional rotational angiographic volumes of 159 middle cerebral artery (MCA) bifurcations (62 aneurysmal) were processed using 3D gradient edge-detection filtering, enabling threshold-insensitive radius measurement. Radius ratio (RR)=r₀(3)/(r₁(3)+r₂(3)) and estimated junction exponent (n) were compared between aneurysmal and non-aneurysmal bifurcations using Student t-test and Wilcoxon rank-sum analysis. The results show that non-aneurysmal bifurcations display optimal caliber control with mean RR of 1.05 and median n of 2.84. In contrast, aneurysmal bifurcations had significantly lower RR (0.76, pbifurcations revealed a daughter branch larger than its parent vessel, an absolute violation of optimality, not witnessed in non-aneurysmal bifurcations. The aneurysms originated more often off the smaller daughter (52%) vs. larger daughter branch (16%). Aneurysm size was not statistically correlated to RR or n. Aneurysmal males showed higher deviation from VOP. Non-aneurysmal MCA bifurcations contralateral to aneurysmal ones showed optimal caliber control. Aneurysmal bifurcations, in contrast to non-aneurysmal counterparts, disobey the VOP and may exhibit dysregulation in WSS-mediated caliber control. The mechanism of this focal divergence from optimality may underlie aneurysm pathogenesis and requires further study.

  14. 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

    Directory of Open Access Journals (Sweden)

    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

  15. Bacterial toxins activation of abbreviated urea cycle in porcine cerebral vascular smooth muscle cells.

    Science.gov (United States)

    Mishra, Rajesh G; Tseng, Tzu-Ling; Chen, Mei-Fang; Chen, Po-Yi; Lee, Tony J-F

    2016-12-01

    Nitric oxide (NO) overproduction via induction of inducible nitric oxide synthase (iNOS) is implicated in vasodilatory shock in sepsis, leading to septic encephalopathy and accelerating cerebral ischemic injury. An abbreviated urea-cycle (l-citrulline-l-arginine-NO cycle) has been demonstrated in cerebral perivascular nitrergic nerves and endothelial cells but not in normal cerebral vascular smooth muscle cell (CVSMC). This cycle indicates that argininosuccinate synthase (ASS) catalyzes l-citrulline (l-cit) conversion to form argininosuccinate (AS), and subsequent AS cleavage by argininosuccinate lyase (ASL) forms l-arginine (l-arg), the substrate for NO synthesis. The possibility that ASS enzyme in this cycle was induced in the CVSMC in sepsis was examined. Blood-vessel myography technique was used for measuring porcine isolated basilar arterial tone. NO in cultured CVSMC and in condition mediums were estimated by diaminofluorescein (DAF)-induced fluorescence and Griess reaction, respectively. Immunohistochemical and immunoblotting analyses were used to examine iNOS and ASS induction. l-cit and l-arg, which did not relax endothelium-denuded normal basilar arteries precontracted by U-46619, induced significant vasorelaxation with increased NO production in these arteries and the CVSMCs following 6-hour exposure to 20μg/ml lipopolysaccharide (LPS) or lipoteichoic acid (LTA). Pre-treatment with pyrrolidine dithiocarbamate (PDTC) and salicylate (SAL) (NFκB inhibitors), aminoguanidine (AG, an iNOS inhibitor), and nitro-l-arg (NLA, a non-specific NOS inhibitor) blocked NO synthesis in the CVSMC and attenuated l-cit- and l-arg-induced relaxation of LPS- and LTA-treated arteries. Furthermore, immunohistochemical and immunoblotting studies demonstrated that expression of basal iNOS and ASS in the smooth muscle cell of arterial segments denuded of endothelium and the cultured CVSMCs was significantly increased following 6-hour incubation with LPS or LTA. This increased i

  16. Vascular endothelial growth factor improves recovery of sensorimotor and cognitive deficits after focal cerebral ischemia in the rat.

    Science.gov (United States)

    Wang, Yaoming; Galvan, Veronica; Gorostiza, Olivia; Ataie, Marina; Jin, Kunlin; Greenberg, David A

    2006-10-18

    Vascular endothelial growth factor (VEGF) is an angiogenesis factor with neurotrophic, neuroprotective and neuroproliferative effects. Depending on the dose, route and time of administration in relation to focal cerebral ischemia, VEGF can improve histological outcome and sensorimotor function in rodents. However, VEGF also increases vascular permeability, which can lead to brain edema and exacerbate ischemic brain injury. Thus, although VEGF is a candidate therapeutic for stroke and other ischemic disorders, its benefit relative to risk is uncertain. Considering that functional rather than histological measures of outcome are probably most relevant to therapeutic prospects for human stroke, we investigated the effects of VEGF after middle cerebral artery occlusion in rats using a series of behavioral tests. We report that VEGF improves functional outcome in ischemic rats, including both sensorimotor and cognitive deficiencies.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. The follow-up research on the value of the plasma homocystine after methionine loading test on the recurrent ischemic vascular event in cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    刘怀翔

    2014-01-01

    Objective To evaluate the effect of the plasma homocystine(Hcy)after methionine loading test(MLT)on the recurrence of ischemic vascular event,including cerebral infarction,transient ischemic attack(TIA),acute coronary syndrome,other vascular embolism in cerebral infarction patients.Methods The fasting plasma homocystine(FHcy)and homocystine after MLT(PHcy)levels were measured by high-performance liquid chromatog-

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

    Institute of Scientific and Technical Information of China (English)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 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

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    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

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Optical measures of changes in cerebral vascular tone during voluntary breath holding and a Sternberg memory task.

    Science.gov (United States)

    Tan, Chin Hong; Low, Kathy A; Schneider-Garces, Nils; Zimmerman, Benjamin; Fletcher, Mark A; Maclin, Edward L; Chiarelli, Antonio M; Gratton, Gabriele; Fabiani, Monica

    2016-07-01

    The human cerebral vasculature responds to changes in blood pressure and demands for oxygenation via cerebral autoregulation. Changes in cerebrovascular tone (vasoconstriction and vasodilation) also mediate the changes in blood flow measured by the BOLD fMRI signal. This cerebrovascular reactivity is known to vary with age. In two experiments, we demonstrate that cerebral pulse parameters measured using optical imaging can quantify changes in cerebral vascular tone, both globally and locally. In experiment 1, 51 older adults (age range=55-87) performed a voluntary breath-holding task while cerebral pulse amplitude measures were taken. We found significant pulse amplitude variations across breath-holding periods, indicating vasodilation during, and vasoconstriction after breath holding. The breath-holding index (BHI), a measure of cerebrovascular reactivity (CVR) was derived and found to correlate with age. BHI was also correlated with performance in the Modified Mini-Mental Status Examination, even after controlling for age and education. In experiment 2, the same participants performed a Sternberg task, and changes in regional pulse amplitude between high (set-size 6) and low (set-size 2) task loads were compared. Only task-related areas in the fronto-parietal network (FPN) showed significant reduction in pulse amplitude, indicating vasodilation. Non-task-related areas such as the somatosensory and auditory cortices did not show such reductions. Taken together, these experiments suggest that optical pulse parameters can index changes in brain vascular tone both globally and locally, using both physiological and cognitive load manipulations. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Beta adrenergic overstimulation impaired vascular contractility via actin-cytoskeleton disorganization in rabbit cerebral artery.

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    Hyoung Kyu Kim

    Full Text Available BACKGROUND AND PURPOSE: Beta adrenergic overstimulation may increase the vascular damage and stroke. However, the underlying mechanisms of beta adrenergic overstimulation in cerebrovascular dysfunctions are not well known. We investigated the possible cerebrovascular dysfunction response to isoproterenol induced beta-adrenergic overstimulation (ISO in rabbit cerebral arteries (CAs. METHODS: ISO was induced in six weeks aged male New Zealand white rabbit (0.8-1.0 kg by 7-days isoproterenol injection (300 μg/kg/day. We investigated the alteration of protein expression in ISO treated CAs using 2DE proteomics and western blot analysis. Systemic properties of 2DE proteomics result were analyzed using bioinformatics software. ROS generation and following DNA damage were assessed to evaluate deteriorative effect of ISO on CAs. Intracellular Ca(2+ level change and vascular contractile response to vasoactive drug, angiotensin II (Ang II, were assessed to evaluate functional alteration of ISO treated CAs. Ang II-induced ROS generation was assessed to evaluated involvement of ROS generation in CA contractility. RESULTS: Proteomic analysis revealed remarkably decreased expression of cytoskeleton organizing proteins (e.g. actin related protein 1A and 2, α-actin, capping protein Z beta, and vimentin and anti-oxidative stress proteins (e.g. heat shock protein 9A and stress-induced-phosphoprotein 1 in ISO-CAs. As a cause of dysregulation of actin-cytoskeleton organization, we found decreased level of RhoA and ROCK1, which are major regulators of actin-cytoskeleton organization. As functional consequences of proteomic alteration, we found the decreased transient Ca(2+ efflux and constriction response to angiotensin II and high K(+ in ISO-CAs. ISO also increased basal ROS generation and induced oxidative damage in CA; however, it decreased the Ang II-induced ROS generation rate. These results indicate that ISO disrupted actin cytoskeleton proteome network

  6. Importância da Hemorreologia clínica no estudo do fluxo sanguíneo cerebral em condições normais e na isquemia Cerebrovascular

    Directory of Open Access Journals (Sweden)

    Roberto Melaragno Filho

    1995-03-01

    Full Text Available É apresentada avaliação crítica da importância da hemorreologia no estabelecimento da conduta terapêutica clínica na insuficiência cerebrovascular aguda. Com essa finalidade são revistos aspectos relativos a fluxo sanguíneo cerebral, insuficiência cerebrovascular e hemorreologia clínica. Em função desses aspectos são avaliados alguns dos principais medicamentos utilizados no presente no tratamento do acidente vascular cerebral e são discutidas normas gerais para prevenção e tratamento das isquemias cerebrais.

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

    Institute of Scientific and Technical Information of China (English)

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

    Science.gov (United States)

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

    2014-10-01

    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 five groups: (1) sham operation (control), (2) cerebral palsy model alone or with (3) phosphate-buffered saline, (4) vascular endothelial growth factor 165 + neural stem cells, or (5) neural stem cells alone. The cerebral palsy model was established by ligating the left common carotid artery followed by exposure to hypoxia. 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. After 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 vascular endothelial growth factor-positive cells in cerebral palsy rats transplanted with vascular endothelial growth factor-transfected neural stem cells was increased, the time for finding water and the finding repetitions were reduced, the holding time was prolonged, and the degree of cell degeneration or necrosis was reduced. These findings indicate that the transplantation of vascular endothelial growth factor-transfected neural stem cells alleviates brain damage and cognitive deficits, and is neuroprotective in neonatal rats with hypoxia ischemic-mediated cerebral palsy.

  9. Environmental pollutants and stroke-related hospital admissions Poluentes ambientais e internações devido a acidente vasculoencéfalico

    Directory of Open Access Journals (Sweden)

    Luiz Fernando Costa Nascimento

    2012-07-01

    Full Text Available Some effects of environmental pollution on human health are known, especially those affecting the respiratory and cardiovascular systems. The current study aimed to estimate these effects on the production of hospital admissions for stroke. This was an ecological study using hospital admissions data in São José dos Campos, São Paulo State, Brazil, with diagnosis of stroke, from January 1, 2007, to April 30, 2008. The target pollutants were particulate matter, sulfur dioxide, and ozone. Use of a Poisson linear regression model showed that same-day exposure to particulate matter was associated with hospitalization for stroke (RR = 1.013; 95%CI: 1.001-1.025. An increase of 10µg/m³ in this pollutant increased the risk of hospitalization by 12% (RR = 1.137; 95%CI: 1.014-1.276. In the multi-pollutant model, it was thus possible to identify particulate matter as associated with hospitalization for stroke in a medium-sized city like São José dos Campos.Alguns dos efeitos da poluição ambiental na saúde humana são conhecidos, destacando aqueles nos sistemas respiratório e cardiovascular. Este trabalho tem por objetivo estimar esses efeitos na gênese das internações por acidente vasculoencefálico. Foi um estudo ecológico realizado com dados de internações da cidade de São José dos Campos, São Paulo, Brasil, relativos aos diagnósticos de acidente vascular cerebral, entre 1º de janeiro de 2007 e 30 de abril de 2008. Os poluentes estudados foram material particulado, dióxido de enxofre e ozônio. Utilizando-se de modelo linear generalizado da regressão de Poisson, foi possível identificar exposição ao material particulado, no mesmo dia, como associado à internação por acidente vasculoencefálico (RR = 1,013; IC95%: 1,001-1,025. O aumento de 10µg/m3 desse poluente aumenta o risco de internação em 12% (RR = 1,137; IC95%: 1,014-1,276. Assim, foi possível identificar o material particulado, no modelo multipoluente, como

  10. Human apolipoprotein E ɛ4 expression impairs cerebral vascularization and blood–brain barrier function in mice

    Science.gov (United States)

    Alata, Wael; Ye, Yue; St-Amour, Isabelle; Vandal, Milène; Calon, Frédéric

    2015-01-01

    Human apolipoprotein E (APOE) exists in three isoforms ɛ2, ɛ3, and ɛ4, of which APOE4 is the main genetic risk factor of Alzheimer's disease (AD). As cerebrovascular defects are associated with AD, we tested whether APOE genotype has an impact on the integrity and function of the blood–brain barrier (BBB) in human APOE-targeted replacement mice. Using the quantitative in situ brain perfusion technique, we first found lower (13.0% and 17.0%) brain transport coefficient (Clup) of [3H]-diazepam in APOE4 mice at 4 and 12 months, compared with APOE2 and APOE3 mice, reflecting a decrease in cerebral vascularization. Accordingly, results from immunohistofluorescence experiments revealed a structurally reduced cerebral vascularization (26% and 38%) and thinner basement membranes (30% and 35%) in 12-month-old APOE4 mice compared with APOE2 and APOE3 mice, suggesting vascular atrophy. In addition, APOE4 mice displayed a 29% reduction in [3H]-d-glucose transport through the BBB compared with APOE2 mice without significant changes in the expression of its transporter GLUT1 in brain capillaries. However, an increase of 41.3% of receptor for advanced glycation end products (RAGE) was found in brain capillaries of 12-month-old APOE4 mice. In conclusion, profound divergences were observed between APOE genotypes at the cerebrovascular interface, suggesting that APOE4-induced BBB anomalies may contribute to AD development. PMID:25335802

  11. Human apolipoprotein E ɛ4 expression impairs cerebral vascularization and blood-brain barrier function in mice.

    Science.gov (United States)

    Alata, Wael; Ye, Yue; St-Amour, Isabelle; Vandal, Milène; Calon, Frédéric

    2015-01-01

    Human apolipoprotein E (APOE) exists in three isoforms ɛ2, ɛ3, and ɛ4, of which APOE4 is the main genetic risk factor of Alzheimer's disease (AD). As cerebrovascular defects are associated with AD, we tested whether APOE genotype has an impact on the integrity and function of the blood-brain barrier (BBB) in human APOE-targeted replacement mice. Using the quantitative in situ brain perfusion technique, we first found lower (13.0% and 17.0%) brain transport coefficient (Clup) of [(3)H]-diazepam in APOE4 mice at 4 and 12 months, compared with APOE2 and APOE3 mice, reflecting a decrease in cerebral vascularization. Accordingly, results from immunohistofluorescence experiments revealed a structurally reduced cerebral vascularization (26% and 38%) and thinner basement membranes (30% and 35%) in 12-month-old APOE4 mice compared with APOE2 and APOE3 mice, suggesting vascular atrophy. In addition, APOE4 mice displayed a 29% reduction in [(3)H]-d-glucose transport through the BBB compared with APOE2 mice without significant changes in the expression of its transporter GLUT1 in brain capillaries. However, an increase of 41.3% of receptor for advanced glycation end products (RAGE) was found in brain capillaries of 12-month-old APOE4 mice. In conclusion, profound divergences were observed between APOE genotypes at the cerebrovascular interface, suggesting that APOE4-induced BBB anomalies may contribute to AD development.

  12. Effect of Solitaire AB stent thrombectomy on vascular endothelial function and inflammatory cytokines in patients with progressive cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Zhi-Bao Wu; Xue-Juan Han; Zi-Hao Zhang; Wen-Liang Zhang; Liang Liu

    2016-01-01

    Objective:To observe the effect of Solitaire AB stent thrombectomy on the vascular endothelial function and inflammatory cytokines in patients with progressive cerebral infarction.Methods:A total of 58 patients with progressive cerebral infarction who were admitted in our hospital were included in the study and divided into the observation group and the control group according to different treatment protocols with 29 cases in each group. The patients in the control group were given the conservation treatment. On this basis, the patients in the observation group were given Solitaire AB stent thrombectomy. The changes of vascular endothelial function and inflammatory cytokines before and after treatment in the two groups were compared.Results:ET-1 after treatment in the two groups was significantly reduced, while NO and CGRP were significantly elevated when compared with before treatment (P<0.05). ET-1 after treatment in the observation group was significantly lower than that in the control group (P<0.05), while NO and CGRP were significantly higher than those in the control group (P<0.05). S100β protein, IL-6, TNF-α, hs-CRP, and MMP-9 levels after treatment in the two groups were significantly reduced when compared with before treatment (P<0.05). The above indicators after treatment in the observation group were significantly lower than those in the control group (P<0.05). MCA and ACA blood flow velocity after treatment in the two groups were significantly elevated when compared with before treatment (P<0.05). MCA and ACA blood flow velocity after treatment in the observation group were significantly higher than those in the control group (P<0.05).Conclusions:Solitaire AB stent thrombectomy can effectively reduce the inflammatory reaction in patients with progressive cerebral infarction, and improve the vascular endothelial function and blood supply for brain tissues.

  13. Requirement for Tumor Necrosis Factor Receptor 2 Expression on Vascular Cells To Induce Experimental Cerebral Malaria

    OpenAIRE

    Stoelcker, Benjamin; Hehlgans, Thomas; Weigl, Karin; Bluethmann, Horst; Grau, Georges E.; Männel, Daniela N

    2002-01-01

    Using tumor necrosis factor receptor type 2 (TNFR2)-deficient mice and generating bone marrow chimeras which express TNFR2 on either hematopoietic or nonhematopoietic cells, we demonstrated the requirement for TNFR2 expression on tissue cells to induce lethal cerebral malaria. Thus, TNFR2 on the brain vasculature mediates tumor necrosis factor-induced neurovascular lesions in experimental cerebral malaria.

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

    Institute of Scientific and Technical Information of China (English)

    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

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    The pathological constriction of cerebral arteries known as cerebral vasospasm (CVS) is with a delay of 4 to 10 days linked to subarachnoid hemorrhage. Several agents have been suggested as being responsible; amongst these perhaps 5-hydroxytryptamine (5-HT) and endothelin-1 (ET-1) are the most...... 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...

  17. Doxycycline, a matrix metalloprotease inhibitor, reduces vascular remodeling and damage after cerebral ischemia in stroke-prone spontaneously hypertensive rats.

    Science.gov (United States)

    Pires, Paulo W; Rogers, Curt T; McClain, Jonathon L; Garver, Hannah S; Fink, Gregory D; Dorrance, Anne M

    2011-07-01

    Matrix metalloproteases (MMPs) are a family of zinc peptidases involved in extracellular matrix turnover. There is evidence that increased MMP activity is involved in remodeling of resistance vessels in chronic hypertension. Thus we hypothesized that inhibition of MMP activity with doxycycline (DOX) would attenuate vascular remodeling. Six-week-old male stroke-prone spontaneously hypertensive rats (SHRSP) were treated with DOX (50 mg·kg(-1)·day(-1) in the drinking water) for 6 wk. Untreated SHRSP were controls. Blood pressure was measured by telemetry during the last week. Middle cerebral artery (MCA) and mesenteric resistance artery (MRA) passive structures were assessed by pressure myography. MMP-2 expression in aortas was measured by Western blot. All results are means ± SE. DOX caused a small increase in mean arterial pressure (SHRSP, 154 ± 1; SHRSP + DOX, 159 ± 3 mmHg; P Damage after transient cerebral ischemia (transient MCA occlusion) was reduced in SHRSP + DOX (20.7 ± 4 vs. 45.5 ± 5% of hemisphere infarcted; P damage after cerebral ischemia.

  18. Demographic Factors and Risk Indicators of Stroke: Comparison Between Inhabitants of Fortaleza Municipal District and the National Profile Factores demográficos e indicadores de riesgo de accidente vascular encefálico: comparación entre residentes del municipio de Fortaleza con el perfil nacional Fatores demográficos e indicadores de risco de acidente vascular encefálico: comparação entre moradores do município de Fortaleza e o perfil nacional

    Directory of Open Access Journals (Sweden)

    Tahissa Frota Cavalcante

    2010-08-01

    que existen factores específicos que influyen en la ocurrencia del accidente vascular encefálico.O objetivo deste estudo foi comparar fatores demográficos e indicadores de risco para o aparecimento de acidente vascular encefálico (AVE, entre o município de Fortaleza e outros municípios, com base em estudos nacionais. É um estudo transversal, desenvolvido com 180 pacientes que apresentaram o diagnóstico de AVE, no período de outubro de 2007 a abril de 2008. Referidos pacientes foram captados em nove instituições públicas. Para a coleta de dados, aplicou-se formulário, por meio de entrevista, ao paciente e/ou acompanhante. Para análise comparativa dos dados epidemiológicos, foram utilizados os seguintes testes estatísticos: teste qui-quadrado para aderência e teste t para média. Os portadores de AVE avaliados em Fortaleza são mais jovens e apresentaram maiores índices de hipertensão arterial. Em contrapartida, são menos etilistas e tabagistas. É necessário ampliar o conhecimento sobre a saúde da população brasileira, estratificada por regiões, já que existem fatores influenciadores específicos para a ocorrência do acidente vascular encefálico.

  19. Effect of large decompressive craniectomy combined with vascular reconstruction on cerebral perfusion in patients with severe brain injury

    Directory of Open Access Journals (Sweden)

    Liang-zhen HUANG

    2015-11-01

    Full Text Available Objective To compare the efficacies of large decompressive craniectomy combined with vascular reconstruction and traditional decompressive craniectomy in treatment of severe brain injury. Methods Forty-eight patients with severe brain injury, which was dominated by brain contusion to the frontoparietal lobes, admitted to our hospital from March 2012 to March 2014 were divided equally into experimental group and control group. The patients in the experimental group underwent large decompressive craniectomy combined with vascular reconstruction, and the patients in the control group received traditional decompressive craniectomy. The hemodynamic changes including cerebral blood flow (CBF, cerebral blood volume (CBV, mean transit time (MTT, time to peak (TTP and the ratios of these values (rCBF, rCBV, rMTT and rTTP on two sides were observed by CT perfusion imaging, and the Glasgow outcome score (GOS was analyzed 6 months after operation. Results The CBF and CBV scores in experimental group were higher than those in the control group at 1 week and 1 month after the operation (P0.05. The rate of satisfactory recovery (including good recovery and moderate disability was higher in the experimental group than in the control group, while the rate of poor recovery (including severe disability, vegetative state and death was lower in the experimental group than in the control group (P<0.05. Conclusion The large decompressive craniectomy combined with vascular reconstruction can not only decrease the intracranial pressure, but also recover the blood supply of brain, thus deserving the clinical application and popularization. DOI: 10.11855/j.issn.0577-7402.2015.11.15

  20. Tratamento cirúrgico da hemorragia cerebral: considerações a propósito de 11 casos

    Directory of Open Access Journals (Sweden)

    Walter C. Pereira

    1977-03-01

    Full Text Available Após breves comentários sobre os achados angiográficos em 298 doentes com acidente vascular cerebral isquêmico ou hemorrágico, é realçada a importância da angiografia cerebral como o método ideal de diagnóstico, tendo em vista a variedade de fatores fisiopatogênicos e etiológicos envolvidos na gênese dessas síndromes. São discutidos a seguir, particularmente, os resultados obtidos com o tratamento cirúrgico de 11 pacientes com hematoma intracerebral espontâneo. Apesar da divergência de opiniões a este propósito, a melhora acentuada que observamos em 54,6% de nossos doentes, motiva-nos a considerar o tratamento cirúrgico indicado na maioria dos casos de hemorragia cerebral primária.

  1. Reduced cerebral oxygen–carbohydrate index during endotracheal intubation in vascular surgical patients

    DEFF Research Database (Denmark)

    Fabricius-Bjerre, Andreas; Overgaard, Anders; Winther-Olesen, Marie

    2015-01-01

    Brain activation reduces balance between cerebral consumption of oxygen versus carbohydrate as expressed by the so-called cerebral oxygen-carbohydrate-index (OCI). We evaluated whether preparation for surgery, anaesthesia including tracheal intubation and surgery affect OCI. In patients undergoing.......2 versus 0.7 ± 0.2 mmol l(-1) , Pintubation (P... to 4.6 ± 1.4 during surgery and to 5.6 ± 1.7 in the recovery room. In conclusion, preparation for surgery and tracheal intubation decrease OCI that recovers during surgery under the influence of sensory blockade....

  2. Both acute and prolonged administration of EPO reduce cerebral and systemic vascular conductance in humans

    DEFF Research Database (Denmark)

    Rasmussen, Peter; Kim, Yu-Sok; Krogh-Madsen, Rikke

    2012-01-01

    Administration of erythropoietin (EPO) has been linked to cerebrovascular events. EPO reduces vascular conductance, possibly because of the increase in hematocrit. Whether EPO in itself affects the vasculature remains unknown; here it was evaluated in healthy males by determining systemic...

  3. 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

    Directory of Open Access Journals (Sweden)

    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.

  4. Investigação do efeito neuroprotetor da toxina tx3-4 da aranha phoneutria nigriventer na isquemia cerebral em ratos

    OpenAIRE

    Maira de Castro Lima

    2010-01-01

    Os acidentes vasculares encefálicos são a principal causa de morte e incapacidade funcional no Brasil e na América do Sul. A busca por uma droga neuroprotetora que evite a morte neuronal e conseqüente dano neurológico é intensa na comunidade científica. O objetivo desse estudo foi investigar o potencial neuroprotetor da toxina Tx3-4, antagonista de canais para cálcio voltagem dependente, em casos de isquemia cerebral em ratos. Foi investigado o efeito da injeção central da toxina através de r...

  5. Identificação do risco de quedas em idosos após acidente vascular encefálico Identicación del riesgo de caídas en ancianos después de accidente cerebrovascular Identification of the risk of falls in elderly after stroke

    Directory of Open Access Journals (Sweden)

    Alice Gabrielle de Sousa Costa

    2010-12-01

    Full Text Available O objetivo desse estudo foi identificar a ocorrência do diagnóstico de enfermagem Risco de quedas em indivíduos idosos acometidos por acidente vascular encefálico. Estudo do tipo exploratório, realizado em unidades de reabilitação, no período de novembro de 2007 a março de 2008, por meio de entrevista e exame físico. Utilizou-se a Taxonomia II da Nursing American North Diagnosis Association quanto à nomeação diagnóstica. A população foi composta por 73 idosos com idade média de 69,5 anos, predominância do sexo feminino, baixo nível de escolaridade e renda financeira. Encontrou-se média de 1,6 episódio de acidente vascular encefálico em 2,4 anos. O diagnóstico esteve presente na totalidade dos participantes, e os fatores de risco mais percebidos foram: Força diminuída nas extremidades inferiores, Mobilidade física prejudicada, Dificuldades na marcha e Equilíbrio prejudicado. Assim, a avaliação diagnóstica contínua e individualizada faz-se imprescindível para nortear ações preventivas aos problemas de saúde dos idosos.El estudio tuvo como objetivo identificar la ocurrencia del diagnóstico de enfermería Riesgo de caídas en ancianos con enfermedad cerebrovascular. Estudio exploratorio, desarrollado en unidades de rehabilitación, de noviembre de 2007 a marzo de 2008, por medio de entrevista y examen físico. Se utilizó la Taxonomía II de la Nursing American North Diagnosis Association para la designación del diagnóstico. La populación fue compuesta por 73 ancianos con 69,5 años en media, predominancia de mujeres, bajo nivel educacional y renta financiera. Se encontró media de 1,6 episodios de enfermedad cerebrovascular en 2,4 años. El diagnóstico fue presente en la totalidad de los participantes y los factores de riesgo más percibidos fueron: Disminución de la fuerza en las extremidades inferiores, Movilidad física perjudicada, Dificultades en la marcha y Equilibrio perjudicado. La evaluación diagn

  6. 急性脑梗死患者合并脑微出血的心脑血管事件发生的研究%Effect of cerebral microbleeds on cardiac and cerebral vascular events following acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    李晓晴; 毕齐; 王力; 王力峰

    2012-01-01

    目的 研究急性脑梗死合并脑微出血(CMB)患者后期心脑血管事件的发生率和危险因素.方法 将109例急性脑梗死患者分为CMB组38例和无CMB组71例,对其进行前瞻性研究,给予梯度回波T2* WI或磁敏感加权成像,并对患者的临床资料和影像学特点进行分析.平均随访(9.5±3.7)个月.结果 与无CMB组比较,CMB组脑梗死和脑出血两者兼有,单纯脑出血比例明显升高(7.9% vs 1.4%,P<0.05;10.5% vs 0,P<0.01).CMB组共检出CMB 153个.在随访中,16例患者再发脑卒中,包括11例脑梗死,5例脑出血.5例脑出血患者中有3例服用阿司匹林,2例接受抗凝治疗.CMB组有2例脑出血患者的出血部位与CMB部位相同.结论 CMB是脑微小血管病变特征之一;是急性缺血性脑血管病患者后期发生脑出血的危险因素之一;CMB对脑卒中患者长期服用阿司匹林或者抗凝治疗具有重要意义.%Objective To study the incidence and risk factor of cardiac and cerebral vascular events in patients with acute cerebral infarction accompanying cerebral mierobleeds(CMB). Methods One hundred and nine acute cerebral infarction patients were divided into CMB group(n = 38) and non-CMB group (n = 71). The patients underwent gradient echo T2-weighted MRI or magnetic susceptibility-weighted imaging. Their clinical data and imaging characteristics were analyzed. The patients were followed up for 9. 5 + 3. 7 months. Results The proportions of acute cerebral infarction and CMB were significantly higher in CMB group than in non-CMB group(7. 9% vs 1.4%,P<0. 05)10. 5% vs 0,P<0.01).One hundred and fifty-three CMB were detected in CMB group. Of the 16 patients who had relapse of cerebral stroke during the follow-up, 11 had cerebral infarction and 5 had intracerebral hemorrhage(3 were treated with aspirin and 2 received anti-coagulant therapy). The bleeding site was similar to that of CMB in 2 patients of CMB group. Conclusion CMB are one of the

  7. Tratamento cirúrgico das patologias vasculares cerebrais nos pacientes epilépticos Surgical treatment of cerebral vascular pathologies in epiletic patients

    Directory of Open Access Journals (Sweden)

    Aziz Rassi-Neto

    1997-09-01

    Full Text Available A cirurgia das malformações arteriovenosas (MAV e dos cavernomas (angioma cavernoso na maioria das vezes é indicada após episódios de sangramento. Com o desenvolvimento das técnicas de diagnóstico e cirúrgicas na epilepsia de difícil controle, passou a ser cada vez maior a indicação cirúrgica destas lesões vasculares. Apresentamos nove pacientes com lesões vasculares cerebrais e crises muito frequentes, apesar do tratamento clínico adequado. A faixa etária variou de 12 a 42 anos de idade, com média de 25 anos; houve prevalência no sexo masculino (2:1. A cirurgia consistiu na exérese da lesão em todos os casos. Em quatro casos houve também ressecção da área irritativa perilesional, que foi demostrada pela eletrocorticografia. O estudo anatomopatológico das lesões mostrou cinco casos de cavernoma, três de MAV e um de angioma venoso. Quanto à localização, observamos três lesões no lobo temporal, quatro no frontal e duas na região parietal. O acompanhamento ambulatorial mostrou redução das crises em todos os pacientes, sendo que sete evoluíram sem crises após a cirurgia.Surgery of arteriovenous malformations (AVM and of cavernous angiomas (cavernoma in the majority of cases is indicated subsequently to episodes of bleeding. With the development of techniques for diagnosis and surgery for epilepsy of difficult control, indication for surgery of these vascular lesions has become greater. We present nine patients with cerebral vascular lesions and very frequent crises in spite of adequate clinical treatment. Ages ranged from 12 to 42 years with an average of 25 years; there was a prevalence of the male sex (2:1. Surgery consisted of exeresis of the lesion in all cases and in four there was also resection of the perilesional irritative area shown by electrocorticography. The pathologic study of lesions showed five cases of cavernoma, three cases of AVM, and one case of venous angioma. As to localization, we observed

  8. Transcranial Doppler blood flow measurement during cesarean section in two patients with cerebral vascular disease.

    Science.gov (United States)

    Smiley, R M; Ridley, D M; Hartmann, A; Ciliberto, C F; Baxi, L

    2002-07-01

    We present two cases of neurovascular disease in pregnancy in which transcranial Doppler was used to assess the status of the cerebral circulation during cesarean section under regional anesthesia. One woman had been found to have moyamoya disease, following a series of transient ischemic attacks during her first pregnancy, which ended in spontaneous abortion. On this occasion she was delivered by cesarean section under slowly-induced epidural anesthesia, using ephedrine to maintain the blood pressure, and transcranial Doppler revealed no change in signal in her left middle cerebral artery. Both mother and baby had an uneventful post natal course. The second case involved a primiparous woman with a large arteriovenous malformation that had been detected following generalized seizures, which were treated with valproic acid. Her cesarean section was conducted under spinal anesthesia, and her blood pressure maintained with ephedrine. Again transcranial Doppler revealed no change in signal in her middle cerebral artery during the procedure. We believe this is a potentially useful technique to monitor the cerebral circulation intraoperatively in the presence of cerebrovascular disease.

  9. A functional electric orthesis on the paretic leg improves quality of life of stroke patients Órtese elétrica funcional usada no membro inferior parético melhora a qualidade de vida em pacientes com acidente vascular encefálico

    Directory of Open Access Journals (Sweden)

    Mara Renata Fernandes

    2006-03-01

    Full Text Available CONTEXT: Hemiparesia changes quality of life of patients with stroke making difficult a normal life. OBJECTIVE: To evaluate the effect of Functional Eletric Orthesis (FEO applied over the paretic leg in the quality of life of stroke patients. METHOD: The quality of life of 50 stroke patients of Associacao de Assistencia a Crianca Deficiente (AACD was evaluated with SF-36 questionnaire before and after the treatment with a FEO for rehabilitation of walking. We analyzed data according to gender and affected hemisphere. RESULTS: The average values from all domains of SF-36 improved significantly (pCONTEXTO: A hemiparesia altera a qualidade de vida de pacientes com acidente vascular encefálico (AVE dificultando uma vida normal. OBJETIVO: Avaliar o efeito da Órtese Elétrica Funcional (OEF colocada na perna parética, sobre a qualidade de vida de pacientes com AVE. MÉTODO: A qualidade de vida de 50 pacientes da AACD foi avaliada pelo questionário SF-36 antes e após o tratamento com OEF. Os dados foram analisados segundo sexo e lado do corpo acometido pelo AVE. RESULTADOS: As médias em todas as categorias do SF-36 foram significantemente maiores após tratamento com OEF (p<0,001. Pacientes do sexo feminino apresentaram resultados superiores aos do sexo masculino nos Aspectos Emocionais (p=0,04 e apresentaram tendência a melhora em Dor e Aspectos Sociais. Pacientes com hemiparesia direita obtiveram resultados superiores aos com hemiparesia esquerda nos Aspectos Emocionais (p=0,02. CONCLUSÃO: A utilização da OEF na perna parética por AVE é eficaz em melhorar a qualidade de vida dos pacientes.

  10. 1H-magnetic resonance spectroscopy of vascular endothelial growth factor-induced neuroprotection following acute cerebral ischemia and reperfusion

    Institute of Scientific and Technical Information of China (English)

    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

  11. Vascular structure and binomial statistics for response modeling in radiosurgery of cerebral arteriovenous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Andisheh, Bahram; Mavroidis, Panayiotis; Brahme, Anders; Lind, Bengt K [Department of Medical Radiation Physics, Karolinska Institutet and Stockholm University, Stockholm (Sweden); Bitaraf, Mohammad A [Department of Neurosurgery, Tehran University of Medical Sciences and Iran Gamma Knife Center, Tehran (Iran, Islamic Republic of)

    2010-04-07

    Radiation treatment of arteriovenous malformations (AVMs) has a slow and progressive vaso-occlusive effect. Some studies suggested the possible role of vascular structure in this process. A detailed biomathematical model has been used, where the morphological, biophysical and hemodynamic characteristics of intracranial AVM vessels are faithfully reproduced. The effect of radiation on plexiform and fistulous AVM nidus vessels was simulated using this theoretical model. The similarities between vascular and electrical networks were used to construct this biomathematical AVM model and provide an accurate rendering of transnidal and intranidal hemodynamics. The response of different vessels to radiation and their obliteration probability as a function of different angiostructures were simulated and total obliteration was defined as the probability of obliteration of all possible vascular pathways. The dose response of the whole AVM is observed to depend on the vascular structure of the intra-nidus AVM. Furthermore, a plexiform AVM appears to be more prone to obliteration compared with an AVM of the same size but having more arteriovenous fistulas. Finally, a binomial model was introduced, which considers the number of crucial vessels and is able to predict the dose response behavior of AVMs with a complex vascular structure.

  12. Cerebro vascular reactivity (CVR) of middle cerebral artery in response to CO2 5% inhalation in preeclamptic women.

    Science.gov (United States)

    Sariri, Elaheh; Vahdat, Mansoureh; Behbahani, Afsaneh Shariati; Rohani, Mohammad; Kashanian, Maryam

    2013-07-01

    To compare the cerebro vascular reactivity (CVR) of middle cerebral artery (MCA) in response to CO2 5% inhalation between preeclamptic and normotensive pregnant women, also, between mild and severe preeclampsia. A comparative study was performed on 61 women with preeclampsia and 65 normotensive pregnant women who were in the third trimester of gestation. MCA transcranial Doppler ultrasound was used to measure CVR in response to CO2 5% inhalation. Pulsatility index (PI), resistance index (RI), blood pressure, maternal age, gestational age and gravidity were also recorded. Baseline PI and RI were lower in the preeclamptic group (p < 0.05). Inhalation of CO2 5% caused significant increase in CVR among normotensive pregnant women in comparison with preeclamptic group (1.006 ± 0.229 versus 0.503 ± 0.209, p = 0.0001). Significantly, more cerebral vasodilatation was found among mild preeclamptic women in comparison with severe preeclamptic women (0.583 ± 0.193 versus 0.383 ± 0.173, p = 0.0001). The receiver operating characteristics curve analysis revealed acceptable difference between CO2 stimulation test of preeclamptic and normotensive women (Area under curve = 0.973, p = 0.0001). CVR in response to CO2 5% is less in preeclamptic pregnant women than normotensives, also, in severe preeclampsia, it is less than mild preeclampsia.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Hipertensão arterial pulmonar e acidente vascular encefálico em paciente com Arterite de Takayasu Pulmonary arterial hypertension and cerebrovascular disease in patient with Takayasu Arteritis

    Directory of Open Access Journals (Sweden)

    Carlos Frederico Rodrigues Parchen

    2006-12-01

    Full Text Available Arterite de Takayasu (AT é uma doença rara caracterizada por vasculite dos grandes vasos, principalmente aorta e seus ramos. A inflamação vascular leva a irregularidades na parede do vaso, causando estenoses e aneurismas. O envolvimento da artéria pulmonar (AP é freqüente na AT. Apesar disso, o desenvolvimento de hipertensão arterial pulmonar (HAP é menos comum, alterando o tratamento e o prognóstico dos pacientes. Descrevemos um caso de uma paciente com AT com estenoses múltiplas em artérias pulmonares, HAP e doença cerebrovascular, além de revisão de literatura sobre o assunto.Takayasu arteritis (TA is a rare illness characterized by vasculitis of great vessels, mainly of aorta and its branches. The vascular inflammation leads to irregularities of the vessel wall causing stenosis and aneurysms. The pulmonary artery (PA involvement is frequent in TA. Despite this, the development of pulmonary arterial hypertension is less common, modifying the treatment and the prognosis of the patients. We describe a case of a patient with TA with multiple stenosis in pulmonary arteries, pulmonary arterial hypertension and cerebrovascular disease, as well as review of the literature on the subject.

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

    Institute of Scientific and Technical Information of China (English)

    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

  16. 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

    Directory of Open Access Journals (Sweden)

    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

  17. Ataque cerebral

    OpenAIRE

    Takeuchi Tan, Yuri; Fundación Valle de Lili

    1998-01-01

    ¿Qué es un ataque cerebral?/¿Qué tipos de ataque cerebral existen?/¿Cuáles son los síntomas de un ataque cerebral?/Factores de riesgo para un ataque cerebral/Tratamiento médico del ataque cerebral/¿por qué es importante acudir temprano cuando se presentan las señales de alarma?/ Manejo preventivo del ataque cerebral isquémico/Tratamiento quirúrgico del ataque cerebral/Enfermedad vascular cerebral hemorrágica/¿Cómo está constituido el grupo de ataque cerebral de la fundación Clínica Valle d...

  18. Ataque cerebral

    OpenAIRE

    Takeuchi Tan, Yuri; Fundación Valle de Lili

    1998-01-01

    ¿Qué es un ataque cerebral?/¿Qué tipos de ataque cerebral existen?/¿Cuáles son los síntomas de un ataque cerebral?/Factores de riesgo para un ataque cerebral/Tratamiento médico del ataque cerebral/¿por qué es importante acudir temprano cuando se presentan las señales de alarma?/ Manejo preventivo del ataque cerebral isquémico/Tratamiento quirúrgico del ataque cerebral/Enfermedad vascular cerebral hemorrágica/¿Cómo está constituido el grupo de ataque cerebral de la fundación Clínica Valle d...

  19. An improvement of cerebral hemodynamics in a newly developed perfusion area evaluated by intra-arterial SPECT following vascular reconstructive surgery

    Energy Technology Data Exchange (ETDEWEB)

    Nochide, Ichiro [Ehime Univ., Shigenobu (Japan). School of Medicine

    1999-06-01

    The purpose of this study was to evaluate the changes in regional cerebral blood flow (rCBF) and vascular reserve ({Delta}CBF) responding to acetazolamide loading by {sup 133}Xe SPECT. In combination, this study assessed the newly developed region of cerebral perfusion via bypass arteries after surgical vascular reconstruction in 11 hemispheres of 11 patients with atherosclerotic arterial occlusive disease and adult onset moyamoya disease. In patients with atherosclerotic occlusive disease, the cerebral perfusion from bypass arteries mainly developed in the preoperatively low {Delta}CBF territory. Although rCBF did not significantly alter after vascular reconstruction, preoperatively low {Delta}CBF was significantly improved to the normal range in the promotion of postoperatively newly born perfusion from bypass arteries. In 21 hemispheres of 13 patients with adult onset moyamoya disease, the postoperatively newly born perfusion from bypass arteries was significantly developed in the regions with either preoperative low rCBF or low {Delta}CBF. Although both rCBF and {Delta}CBF were significantly improved after the operation, {Delta}CBF was not restored satisfactorily up to the normal range in contrast to the sufficient increase of rCBF, even where the perfusion from the bypass artery was observed after the reconstructive surgeries. Vascular reconstructive surgeries were beneficial for the improvement of {Delta}CBF in the atherosclerotic arterial occlusive disease and rCBF in the adult-onset moyamoya disease, respectively. (author)

  20. Reduced cerebral oxygen-carbohydrate index during endotracheal intubation in vascular surgical patients.

    Science.gov (United States)

    Fabricius-Bjerre, Andreas; Overgaard, Anders; Winther-Olesen, Marie; Lönn, Lars; Secher, Niels H; Nielsen, Henning B

    2015-09-01

    Brain activation reduces balance between cerebral consumption of oxygen versus carbohydrate as expressed by the so-called cerebral oxygen-carbohydrate-index (OCI). We evaluated whether preparation for surgery, anaesthesia including tracheal intubation and surgery affect OCI. In patients undergoing aortic surgery, arterial to internal jugular venous (a-v) concentration differences for oxygen versus lactate and glucose were determined from before anaesthesia to when the patient left the recovery room. Intravenous anaesthesia was supplemented with thoracic epidural anaesthesia for open aortic surgery (n = 5) and infiltration with bupivacaine for endovascular procedures (n = 14). The a-v difference for O2 decreased throughout anaesthesia and in the recovery room (1.6 ± 1.9 versus 3.2 ± 0.8 mmol l(-1), mean ± SD), and while a-v glucose decreased during surgery and into the recovery (0.4 ± 0.2 versus 0.7 ± 0.2 mmol l(-1) , Pintubation (Pintubation decrease OCI that recovers during surgery under the influence of sensory blockade. © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  1. Edema and vascular permeability in cerebral ischemia: comparison between ischemic neuronal damage and infarction.

    Science.gov (United States)

    Petito, C K; Pulsinelli, W A; Jacobson, G; Plum, F

    1982-07-01

    The respective influences of ischemic neuronal damage and infarction on the development of abnormal blood-brain barrier (BBB) permeability and cerebral edema were evaluated in a rat model of temporary four-vessel occlusion in which ischemic neuronal damage with only infrequent infarction is produced. Survival times ranged from 40 minutes to 5 days after ischemia. Evans blue and horseradish peroxidase (HRP) were given before sacrifice. The majority of brain showed moderate ischemic neuronal damage inthe striatum. In these areas there was neither leakage of Evans blue nor extravasation of HRP. Astrocytic processes were moderately swollen. Large, grossly-visible unilateral infarcts were present in only 5 animals, and all showed abnormal BBB permeability of HRP which occurred via enchanced pinocytosis, and occasionally via diffuse leakage through necrotic vessels. Astrocytic processes were markedly swollen and their plasma membranes were disrupted. Whole brain and regional water content in a parallel series of animals were measured from 15 minutes (min) to 48 hours (h) postischemia. They showed a transient, 1% increase in whole brain water content from 15 to 60 min postischemia, but no increase in regional water content at any postischemic interval. These studies suggest that ischemia produces BBB permeability to large molecules, and sustained cerebral edema only when the process damages blood vessels and astrocytes; neuronal necrosis alone is insufficient.

  2. Modelling Cerebral Blood Flow and Temperature Using a Vascular Porous Model

    Science.gov (United States)

    Blowers, Stephen; Thrippleton, Michael; Marshall, Ian; Harris, Bridget; Andrews, Peter; Valluri, Prashant

    2016-11-01

    Macro-modelling of cerebral blood flow can assist in determining the impact of temperature intervention to reduce permanent tissue damage during instances of brain trauma. Here we present a 3D two phase fluid-porous model for simulating blood flow through the capillary region linked to intersecting 1D arterial and venous vessel trees. This combined vasculature porous (VaPor) model simulates both flow and energy balances, including heat from metabolism, using a vasculature extracted from MRI data which are expanded upon using a tree generation algorithm. Validation of temperature balance has been achieved using rodent brain data. Direct flow validation is not as straight forward due to the method used in determining regional cerebral blood flow (rCBF). In-vivo measurements are achieved using a tracer, which disagree with direct measurements of simulated flow. However, by modelling a virtual tracer, rCBF values are obtained that agree with those found in literature. Temperature profiles generated with the VaPor model show a reduction in core brain temperature after cooling the scalp not seen previously in other models.

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

    Directory of Open Access Journals (Sweden)

    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.

  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

    Directory of Open Access Journals (Sweden)

    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. Versão brasileira da Escala de Comprometimento do Tronco: um estudo de validade em sujeitos pós-acidente vascular encefálico Brazilian version of the Trunk Impairment Scale: a reliability study in post-stroke subjects

    Directory of Open Access Journals (Sweden)

    Núbia Maria Freire Vieira Lima

    2008-09-01

    Full Text Available O controle de tronco - uma habilidade motora básica indispensável à execução de muitas tarefas funcionais - encontra-se deficitário em pacientes que sofreram acidente vascular encefálico (AVE. Há poucas referências estrangeiras, e nenhuma em português, que focalizem a avaliação de tronco de forma quantitativa. Este estudo teve como objetivo traduzir e verificar a confiabilidade inter e intra-examinador, validade construtiva e consistência interna da versão brasileira da ECT - Escala de Comprometimento do Tronco (Trunk Impairment Scale. Em 18 voluntários com hemiparesia secundária à AVE foram aplicados os seguintes instrumentos: ECT, Protocolo de Desempenho Físico de Fugl-Meyer, Medida de Independência Funcional, EEB - Escala de Equilíbrio de Berg e Classificação de Deambulação Funcional. As avaliações foram realizadas por três fisioterapeutas experientes e o reteste da ECT foi realizado após 48 horas. Foram encontradas moderada confiabilidade intra-examinador e excelente confiabilidade inter-examinador (pTrunk control - which is a basic motor ability to perform many functional tasks -is disrupted in most patients who have suffered a stroke. There are few foreign references and none in Portuguese dealing with the quantitative assessment of trunk control. The aim of this study was to translate, verify intra- and inter-examiner reliability, validity and internal consistency of the Brazilian version of the Trunk Impairment Scale (TIS. Eighteen hemiparetic, post-stroke volunteers were evaluated by means of the Fugl-Meyer Assessment Scale, Functional Independence Measure, Berg Balance Scale (BBS, and Functional Ambulation Classification; TIS was apllied by three experienced physical therapists; retest was carried out 48 hours later. Data analysis showed moderate intra-rater and an excellent inter-rater reliability (p<0.05, though low internal consistency (0.45. The only scale found to correlate with TIS was BBS (r=0.491, p

  6. 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

    Directory of Open Access Journals (Sweden)

    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.

  7. 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

    Directory of Open Access Journals (Sweden)

    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

  8. Andrographolide, a Novel NF-κB Inhibitor, Inhibits Vascular Smooth Muscle Cell Proliferation and Cerebral Endothelial Cell Inflammation

    Science.gov (United States)

    Chang, Chao-Chien; Duann, Yeh-Fang; Yen, Ting-Lin; Chen, Yu-Ying; Jayakumar, Thanasekaran; Ong, Eng-Thiam; Sheu, Joen-Rong

    2014-01-01

    Background Aberrant vascular smooth muscle cell (VSMC) proliferation and cerebral endothelial cell (CEC) dysfunction contribute significantly in the pathogenesis of cardiovascular diseases. Therefore, inhibition of these cellular events would be by candidate agents for treating these diseases. In the present study, the mechanism of anti-proliferative and anti-inflammatory effects of andrographolides, a novel nuclear factor-κB inhibitor, was investigated in VSMC and CEC cells. Methods VSMCs and CECs were isolated from rat artery and mouse brain, respectively, and cultured before experimentation. The effect of andro on platelet-derived growth factor-BB (PDGF-BB) induced VSMC cell proliferation was evaluated by cell number, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The expression of extracellular signal regulated kinase 1/2 (ERK1/2), proliferating cell nuclear antigen (PCNA), and the effects on lipopolysaccharide (LPS)-induced inducible nitric oxide synthase (iNOS) and, cyclooxygenase-2 (COX2) were detected by Western blotting. Results Andro significantly inhibited PDGF-BB (10 ng/ml) induced cell proliferation in a concentration (20-100 μM) dependent manner, which may be due to reducing the expression of ERK1/2, and by inhibiting the expression of PCNA. Andro also remarkably diminished LPS-induced iNOS and COX2 expression. Conclusions The results of this study suggested that the effects of andro against VSMCs proliferation and CECs dysfunction may represent a promising approach for treatment of vascular diseases. PMID:27122804

  9. Cerebral microbleeds and intravenous thrombolysis: case report Micro-hemorragias cerebrais e trombólise endovenosa: relato de caso

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    Adriana Bastos Conforto

    2006-09-01

    Full Text Available Intravenous thrombolysis is an important procedure that has significant impact on ischemic stroke prognosis. However, intracranial hemorrhage (ICH is a feared complication of this procedure. It has been suggested that cerebral microbleeds (CMBs may increase the risk of ICH after thrombolysis. We report on a 69 years-old woman with multiple CMBs submitted to intravenous thrombolysis without complications.A trombólise endovenosa é um procedimento importante que tem impacto significativo sobre o prognóstico de pacientes com acidente vascular cerebral isquêmico. Contudo, a hemorragia intracraniana (HIC é complicação temida deste procedimento. Foi sugerido que micro-hemorragias cerebrais (MHC aumentem o risco de HIC após trombólise. Relatamos o caso de mulher de 69 anos com múltiplas MHCs submetida a trombólise endovenosa sem complicações.

  10. 视网膜血管异常与脑小血管病%Retinal vascular abnormalities and cerebral small vessel disease

    Institute of Scientific and Technical Information of China (English)

    李華; 吴丹紅

    2014-01-01

    Cerebral small vessel disease is common and is gradually being understood,but it is difficult to visualize directly in the body.The retinal vessels share the similar anatomic,physiological,and embryological characteristics with the cerebral small vessels.Their changes may reflect the changes of cerebral small vessels in a certain extent.Studies in recent years have shown that retinal vascular abnormalities are associated with lacunar infarction and white matter lesions.This article summarizes the research evidence of the correlation of between retinal vascular abnormalities and cerebral small vessel disease.%脑小血管病很常见并逐渐被认识,但在体内很难直接观察.视网膜血管与脑小血管具有相似的解剖学、生理学和胚胎学特征,其改变可能在一定程度上能反映脑小血管改变.近年来的研究显示,视网膜血管异常与腔隙性梗死和脑白质病变相关.文章对视网膜血管异常与脑小血管病相关性的研究证据进行了总结.

  11. Analyzing the Correlation between the Level of Serum Markers and Ischemic Cerebral Vascular Disease by Multiple Parameters

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    Laibin Dong

    2015-01-01

    Full Text Available Objective. To explore the serum markers associated with ischemic cerebral vascular disease (ICVD and discuss their diagnostic value. Methods. Two hundred and eighty-eight patients with ICVD and one hundred and eighty healthy persons were enrolled as the case group and the control group, respectively. This paper then carried out the univariate and multivariate logistic regression analyses of their respective levels of serum markers, made combined analysis of related factors, and detected the diagnostic value. Results. Meta-analysis results showed that for ICVD patients the levels of CRP, S-100, TNF-α, HCY, NSE, and IL-6 were higher than those of the healthy persons, while the level of HDL was obviously lower than that of the healthy persons. The multivariate regression analysis indicated that the association between the level of HDL and TNF-α and the occurrence of ICVD was statistically significant (P<0.05. The area under the curves (AUC of receiver operating characteristic (ROC curve of HDL and TNF-α was 0.916, with sensitivity of 90.91% and specificity of 76.47%. Conclusion. HDL has negative correlation with the occurrence of ICVD, while TNF-α was positively correlated with it. The combination test of HDL and TNF-α could raise the accuracy of ICVD diagnosis.

  12. Crystal Structure of CCM3, a Cerebral Cavernous Malformation Protein Critical for Vascular Integrity

    Energy Technology Data Exchange (ETDEWEB)

    Li, X.; Zhang, R; Zhang, H; He, Y; Ji, W; Min, W; Boggon, T

    2010-01-01

    CCM3 mutations are associated with cerebral cavernous malformation (CCM), a disease affecting 0.1-0.5% of the human population. CCM3 (PDCD10, TFAR15) is thought to form a CCM complex with CCM1 and CCM2; however, the molecular basis for these interactions is not known. We have determined the 2.5 {angstrom} crystal structure of CCM3. This structure shows an all {alpha}-helical protein containing two domains, an N-terminal dimerization domain with a fold not previously observed, and a C-terminal focal adhesion targeting (FAT)-homology domain. We show that CCM3 binds CCM2 via this FAT-homology domain and that mutation of a highly conserved FAK-like hydrophobic pocket (HP1) abrogates CCM3-CCM2 interaction. This CCM3 FAT-homology domain also interacts with paxillin LD motifs using the same surface, and partial CCM3 co-localization with paxillin in cells is lost on HP1 mutation. Disease-related CCM3 truncations affect the FAT-homology domain suggesting a role for the FAT-homology domain in the etiology of CCM.

  13. 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

    Directory of Open Access Journals (Sweden)

    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

  14. Monitoring of cerebral haemodynamics in newborn infants

    DEFF Research Database (Denmark)

    Liem, K Djien; Greisen, Gorm

    2010-01-01

    The most important cerebrovascular injuries in newborn infants, particularly in preterm infants, are cerebral haemorrhage and ischemic injury. The typical cerebral vascular anatomy and the disturbance of cerebral haemodynamics play important roles in the pathophysiology. The term 'cerebral...

  15. ACIDENTE VASCULAR ENCEFÁLICO: PERFIL DE INDICADORES DE RISCO

    Directory of Open Access Journals (Sweden)

    Rafaella Pessoa Moreira

    2010-01-01

    Full Text Available El conocimiento de los indicadores de riesgo auxilia en la construcción de estrategias más eficaces de intervención en las personas con accidente cerebrovascular (ACE El objetivo del estudio fue identificar los indicadores de riesgo en los clientes que sobrevivieron a esta enfermedad. Estudio transversal, realizado con 121 clientes que frecuentaban unidades de rehabilitación en Fortaleza. Datos recogidos de noviembre del 2007 a marzo del 2008, a través de entrevista. El promedio de edad fue 61,6 años (± 12,4. La mayoría era del sexo masculino (52,9%. Los clientes presentaron en promedio 1,4 (±1,0 episodios de ACV. De los indicadores de riesgo, el de mayor presencia fue la hipertensión arterial (85,1%, seguido por el sedentarismo (58,7%, y dislipidemias (29,8%. Se concluye que la hipertensión arterial fue el indicador de riesgo más percibido y que las medidas de control de esa enfermedad deben ser implementadas para reducir el riesgo de nuevos ACV.

  16. Systemic Expression of Vascular Endothelial Growth Factor in Patients with Cerebral Cavernous Malformation Treated by Stereotactic Radiosurgery.

    Science.gov (United States)

    Park, Sang-Jin; Park, Seong-Hyun

    2016-09-01

    Increased expression of angiogenic factors, such as vascular endothelial growth factor (VEGF), is associated with the pathogenesis of cerebral cavernous malformations (CCMs). The purpose of this study was to investigate plasma levels of VEGF in normal subjects and in patients with CCM and to evaluate change in these levels following stereotactic radiosurgery (SRS). Peripheral venous blood was collected from 6 patients with CCM before SRS using Gamma Knife and at the 1 week, 1 month, 3month, and 6 month follow-up visits. Plasma VEGF levels were measured using commercially available enzyme-linked immunosorbent assay kits. Peripheral blood samples were obtained from 10 healthy volunteers as controls. Mean plasma VEGF level of 41.9 pg/mL (range, 11.7-114.9 pg/mL) in patients with CCM at baseline was higher than that of the healthy controls (29.3 pg/mL, range, 9.2-64.3 pg/mL), without significant differences between CCM patients and controls (p=0.828). Plasma VEGF level following SRS dropped to 24.6 pg/mL after 1 week, and decreased to 18.5 pg/mL after 1 month, then increased to 24.3 pg/mL after 3 months, and 32.6 pg/mL after 6 months. Two patients suffering from rebleeding after SRS showed a higher level of VEGF at 6 months after SRS than their pretreatment level. Plasma VEGF levels in patients with CCM were elevated over controls at baseline, and decreased from baseline to 1 month after SRS and increased further for up to 6 months. Theses results indicated that anti-angiogenic effect of SRS might play a role in the treatment of CCMs.

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

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    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.

  18. P66(Shc)-SIRT1 Regulation of Oxidative Stress Protects Against Cardio-cerebral Vascular Disease.

    Science.gov (United States)

    Kong, Xiangyi; Guan, Jian; Li, Jun; Wei, Junji; Wang, Renzhi

    2017-09-01

    Growing evidence shows that acute and chronic overproduction of reactive oxygen species (ROS) and increased oxidants under pathophysiologic circumstances are of vital importance in the development of cardio-cerebral vascular diseases (CCVDs). It has been revealed that the impact of ROS can be suppressed by sirtuin 1 (SIRT1), a member of the highly conserved nicotinamide adenine dinucleotide-dependent class III histone deacetylases through protecting endothelial cells from oxidative injury. Plenty of evidences indicate that p66Shc stimulates mitochondrial ROS generation through its oxidoreductase activity and plays a vital role in the pathophysiology of CCVDs. The link between SIRT and p66Shc, though not very clear yet, may be generally illustrated like this: SIRT1 negatively regulates the expression of p66Shc in transcriptional level. In this review, the authors aimed to discuss the link between the pathogenesis of CCVDs, the regulation of ROS, the interrelation between SIRT1 and p66Shc, and the protective effect of the proper regulation of p66Shc/SIRT1 on CCVDs. The imbalance between the elimination and production of ROS can lead to oxidative stress (OS). More and more evidence suggest that ROS pathological overproduction is closely connected to the genesis and growth of CCVDs. P66shc is a gene that controls ROS level, apoptosis induction, and lifespan. Lots of evidence also indicate a role for SIRT1 mediating OS responses through several ways including directly deacetylating some transcription factors that control anti-OS genes. SIRT1 downregulation can lead to a decreased deacetylation of p66shc gene promoter and can then result in p66shc transcription. SIRT1 binds to the promoter of p66Shc where it can deacetylate histone H3, which weakens the transcription and translation of p66shc.

  19. Acidente vascular encefálico como complicação da hipertensão arterial: quais são os fatores intervenientes? Accidente Vascular Encefálico como complicación de la hipertensión arterial: ¿cuáles son los factores que interfieren? Stroke as complication of arterial hypertension: which are the intervenient factors?

    Directory of Open Access Journals (Sweden)

    Larissa Bento de Araújo Mendonça

    2012-06-01

    Full Text Available O objetivo foi identificar os fatores intervenientes na adesão ao tratamento anti-hipertensivo que contribuíram para surgimento do acidente vascular encefálico (AVE. Estudo descritivo realizado em uma Unidade de AVE de um hospital público. A amostra constituiuse de 75 pacientes com diagnóstico de Hipertensão Arterial Sistêmica acometidos por um AVE. A coleta de dados aconteceu em março e abril de 2010. Estudo aprovado pelo Comitê de Ética e Pesquisa sob parecer nº 110302/10. Os fatores intervenientes na adesão do paciente ao tratamento anti-hipertensivo foram: sexo masculino (61,4%, idade >60 anos (48%, antecedentes familiares para HAS (68%, baixa escolaridade (72%, renda familiar até um salário mínimo (52% e presença de efeitos colaterais (22,6%. Talvez a experiência de um AVE seja um fator determinante para a maior adesão do paciente ao tratamento antihipertensivo. É necessário que os enfermeiros realizem acompanhamento ao hipertenso periodicamente, informando-o acerca da doença e do tratamento, visando evitar complicações.El objetivo fue identificar los factores que intervienen en la adherencia al tratamiento antihipertensivo que contribuyeron a la aparición del accidente vascular encefálico (ACV. Estudio descriptivo en una unidad de ACV de un hospital público. La muestra fue constituida por 75 pacientes diagnosticados con Hipertensión Arterial Sistémica afectados por el ACV. La recolección de datos ocurrió entre marzo y abril de 2010. Estudio aprobado por el Comité de Ética e Investigación bajo parecer nº 110302/10. Los factores que intervienen en la adhesión del paciente al tratamiento antihipertensivo fueron: sexo masculino (61,4%, edad > 60 años (48%, antecedentes familiares de hipertensión arterial (68%, baja escolaridad (72%, renta familiar hasta un sueldo mínimo (52% y presencia de efectos colaterales (22,6%. Tal vez la experiencia de un ACV sea un factor determinante en la mayor adherencia del

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

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    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

  1. 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

    Directory of Open Access Journals (Sweden)

    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

  2. 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

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    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

  3. Family experience and adaptation to stroke and role of an assistance project = Vivência e adaptação da família com o acidente vascular encefálico e atuação de um projeto de assistência a essas famílias

    Directory of Open Access Journals (Sweden)

    Simone Roecker

    2012-10-01

    Full Text Available The experience of a family with a chronic disease is, at first, difficult and stressful, making the family unsafe and concerned. We aimed to understand the experience and adaptation of the family to a chronic illness (stroke and describe the actions developed by a project of assistance at home. This is a qualitative study, Case Study type, conducted with a family assisted through home visits by the Project for Assistance and Support for the Family of Chronic Patients at Home, in Maringá, Paraná State. Data were gathered through consultation of the records of the family in May and June 2009, and data were submitted to content analysis. In the beginning there were many difficulties, however, over time the caregivers provided proper assistance, not considering it an obligation, but incorporating the situation to their normal routine, and they proved to be formidable in the process of care to patients, performing procedures with great skill, commitment and immeasurable love, affection and dedication. Accordingly, the responsibility of a health care professional is to intervene by providing appropriate guidance to the family, assisting in the rehabilitation of the family facing the care to this new condition.A vivência de uma família com a doença crônica é no início, difícil e estressante, podendo tornar a família insegura e preocupada. Objetivou-se compreender a vivência e o processo de adaptação da família em virtude do acidente vascular encefálico e descrever as ações desenvolvidas por um projeto de assistência no domicílio. Estudo qualitativo, do tipo Estudo de Caso, realizado com uma família assistida por meio de visitas domiciliares pelo Projeto de Assistência e Apoio à Família de Pacientes Crônicos no Domicílio, em Maringá, Estado do Paraná. A coleta de dados se deu pela consulta dirigida ao prontuário da família, durante os meses de maio e junho de 2009, sendo os dados submetidos à análise de conteúdo. No in

  4. Elaboração de um manual ilustrado de exercícios domiciliares para pacientes com hemiparesia secundária ao acidente vascular encefálico (AVE Elaboration of an illustrated home exercise manual for stroke patients with hemiparesis

    Directory of Open Access Journals (Sweden)

    Adriana Maria Barsante Santos

    2012-03-01

    Full Text Available A realização de exercícios físicos para pacientes com sequelas motoras pós-acidente vascular encefálico (AVE é essencial para a recuperação funcional. Programas educacionais podem facilitar a repetição dos exercícios em casa e contribuir para o tratamento. Este trabalho teve como objetivo elaborar e aplicar um manual de exercícios domiciliares para pacientes com AVE. O estudo consistiu em duas etapas: na primeira foi elaborado um manual de exercícios domiciliares (piloto com fotos e textos simples para facilitar a compreensão. Foi realizada uma avaliação funcional de cada paciente e selecionados os exercícios mais adequados, que deveriam ser feitos em casa. Esse manual foi aplicado a 17 pacientes, 70% crônicos e 30% agudos. Após 15 dias, o paciente retornava e era solicitado que reproduzisse os exercícios e informasse o nível de compreensão das fotos e do texto do manual e se sentia dor ao realizá-los. As fotos e os exercícios referidos como difíceis foram revistos, e criada a versão teste que foi aplicada em outros 23 pacientes, dando origem à versão final do manual. A avaliação do manual piloto foi insatisfatória, sendo que apenas 56% referiram aprovação das fotos e 87% do texto. Após a reformulação, a compreensão das fotos e do texto alcançou valores acima de 98%. Foi possível obter um manual ilustrado de exercícios domiciliares, de fácil aplicação e compreensão, específico e individualizado, para pacientes com AVE e adaptável aos diferentes quadros motores.The practice of exercises for patients with motor sequels post-stroke is essential for the functional recovery. Educational programs can facilitate the repetition of the exercises at home and contribute to the treatment. The objective of this study was to elaborate a home exercise manual for stroke patients. The study consisted of two stages: in the first one, a home exercise manual was made (pilot with pictures and simple text to facilitate

  5. 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

    Directory of Open Access Journals (Sweden)

    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

  6. Hippocampal expression of synaptic structural proteins and phosphorylated cAMP response element-binding protein in a rat model of vascular dementia induced by chronic cerebral hypoperfusion

    Institute of Scientific and Technical Information of China (English)

    Hui Zhao; Zhiyong Li; Yali Wang; Qiuxia Zhang

    2012-01-01

    The present study established a rat model of vascular dementia induced by chronic cerebral hy-poperfusion through permanent ligation of bilateral common carotid arteries. At 60 days after mod-eling, escape latency and swimming path length during hidden-platform acquisition training in Morris water maze significantly increased in the model group. In addition, the number of accurate crossings over the original platform significantly decreased, hippocampal CA1 synaptophysin and growth-associated protein 43 expression significantly decreased, cAMP response element-binding protein expression remained unchanged, and phosphorylated cAMP response element-binding protein expression significantly decreased. Results suggested that abnormal expression of hippo-campal synaptic structural protein and cAMP response element-binding protein phosphorylation played a role in cognitive impairment following chronic cerebral hypoperfusion.

  7. VASCULAR: Inhibition of myogenic tone in rat cremaster and cerebral arteries by SKA-31, an activator of endothelial KCa2.3 and KCa3.1 channels

    OpenAIRE

    Mishra, Ramesh C.; Wulff, Heike; Hill, Michael A.; Braun, Andrew P.

    2015-01-01

    Endothelial KCa2.3 and KCa3.1 channels contribute to the regulation of myogenic tone in resistance arteries by Ca2+-mobilizing, vasodilatory hormones. To define further the functional role of these channels in distinct vascular beds, we have examined the vasodilatory actions of the KCa channel activator SKA-31 in myogenically active, rat cremaster and middle cerebral arteries. Vessels pressurized to 70 mmHg constricted by 80–100 microns (i.e. 25–45% of maximal diameter). SKA-31 (10 μM) inhibi...

  8. Protein kinase C inhibition attenuates vascular ETB receptor upregulation and decreases brain damage after cerebral ischemia in rat

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    Vikman Petter

    2007-01-01

    Full Text Available Abstract Background Protein kinase C (PKC is known to be involved in the pathophysiology of experimental cerebral ischemia. We have previously shown that after transient middle cerebral artery occlusion, there is an upregulation of endothelin receptors in the ipsilateral middle cerebral artery. The present study aimed to examine the effect of the PKC inhibitor Ro-32-0432 on endothelin receptor upregulation, infarct volume and neurology outcome after middle cerebral artery occlusion in rat. Results At 24 hours after transient middle cerebral artery occlusion (MCAO, the contractile endothelin B receptor mediated response and the endothelin B receptor protein expression were upregulated in the ipsilateral but not the contralateral middle cerebral artery. In Ro-32-0432 treated rats, the upregulated endothelin receptor response was attenuated. Furthermore, Ro-32-0432 treatment decreased the ischemic brain damage significantly and improved neurological scores. Immunohistochemistry showed fainter staining of endothelin B receptor protein in the smooth muscle cells of the ipsilateral middle cerebral artery of Ro-32-0432 treated rats compared to control. Conclusion The results suggest that treatment with Ro-32-0432 in ischemic stroke decreases the ischemic infarction area, neurological symptoms and associated endothelin B receptor upregulation. This provides a new perspective on possible mechanisms of actions of PKC inhibition in cerebral ischemia.

  9. 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

    DEFF Research Database (Denmark)

    Hempel, Casper; Hoyer, Nils; Kildemoes, Anna

    2014-01-01

    increased levels of VEGF in brain and plasma and decreased plasma levels of soluble VEGF receptor 2. EPO treatment normalized VEGF receptor 2 levels and reduced brain VEGF levels. Hypoxia-inducible factor (HIF)-1α was significantly upregulated whereas cerebral HIF-2α and EPO 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 EPO-treated mice. Also...

  10. Recuperação da motricidade voluntária do membro superior de pacientes com hemiplegia após acidente vascular cerebral: avaliação prognostica

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    Abrão Anghinah

    1976-06-01

    Full Text Available O estudo tem por finalidade o registro e a análise dos principais fatos que ocorrem durante a recuperação da motricidade voluntária do membro superior em pacientes com hemiplegia após AVC, tendo por objetivo contribuir para a avaliação do prognóstico. De particular interesse foi a observação comparativa do retorno espontâneo da motricidade voluntária nos vários segmentos do membro superior em 88 pacientes com hemiplegia após AVC hospitalizados na fase aguda da afecção. Dos 88 pacientes hemiplégicos estudados, com diagnóstico suficientemente esclarecido e evolução acompanhada durante período satisfatório para permitir conclusões, 56 casos (grupo 1 atingiram melhora clínica, com remissão parcial ou completa da sintomatologia neurológica (discreto deficit de força, hiperreflexia e hipertonia e recuperação de todos os movimentos voluntários nas várias articulações do membro superior, enquanto 32 pacientes (grupo 2 com persistência da sintomatologia neurológica, particularmente a hipertonia, apresentaram melhora clínica discreta e recuperação parcial de movimentos do membro superior. A quantificação clínica de sinais neurológicos utilizada no presente estudo, tornou possível registrar as modificações mais importantes ocorridas durante a evolução dos 88 pacientes. Este critério permitiu destacar quantitativamente a regressão espontânea da sintomatologia e a determinação do nível crítico de estabilização (platô. A análise dos dados fornecidos pelos dois grupos estudados permitiu concluir que: o ponto crítico de regressão da sintomatologia e recuperação da motricidade voluntária ocorre em média, 70 dias após ter-se instalado a hemiplegia; o cômputo médio de 256 pontos, que foi obtido 70 dias após a instalação da hemiplegia, representa o nível crítico de estabilização; embora a precocidade de aparecimento de movimentos iniciais logo após a instalação da hemiplegia seja dado importante para o prognóstico, o autor acredita ser de capital importância a caracterização dos tipos de movimentos iniciais. Levando em conta os tipos de movimentos iniciais o autor observou que, quando nos pacientes com hemiplegia após AVC, os movimentos de flexo-extensão e oponência do polegar aparecem precocemente de forma isolada ou associada a movimentos da articulação proximal (ombro, ou central (cotovelo é de esperar melhor prognóstico do que nos pacientes cujo movimento inicial é representado por flexão do cotovelo e/ou flexão-adução do braço.

  11. Epidemiologia e quadro clínico do acidente por cascavel sul-americana (Crotalus durissus Epidemiology and clinical features of South American rattlesnakes (Crotalus durissus envenomation

    Directory of Open Access Journals (Sweden)

    Miguel Tanús Jorge

    1992-08-01

    Full Text Available Foram estudados 249 casos de acidentes por cascavel sul-americana (Crotalus durissus atendidos no HVB-IB, São Paulo, Brasil, de 1974 a 1990. Os acidentes foram mais comuns no período da tarde, nos meses de janeiro a abril e de outubro a dezembro. Dentre cem serpentes classificadas quanto à subespécie 99 eram C. d. terrificus. Pertenciam ao sexo masculino 80,7% dos pacientes. Os membros inferiores e superiores foram picados em, respectivamente, 66,4% e 29,2% dos casos. As manifestações clínicas mais freqüentes foram dor (61,0% e edema (55,0% no local da picada, ptose palpebral (75,9%, escurecimento da urina atribuível à mioglobinúria (38,6% e mialgia (36,1%. Nove pacientes foram submetidos a diálise devido a insuficiência renal aguda (3,6%, três apresentavam insuficiência respiratória que motivou intubação e/ou traqueostomia e um apresentou acidente vascular cerebral isquêmico. A alteração da coagulação sanguínea ocorreu em 48,1% dos pacientes. Oito amostras de sangue colhidas horas após a picada mostraram leucocitose sendo 6 com desvio a esquerda e, nos dias subseqüentes, tendência à normalização do número de leucócitos e aparecimento de eosinofilia. Atividade sérica da creatinoquinase apresentou-se aumentada em 20 dentre 21 pacientes, sendo maior no final das primeiras 24 horas após a picada, chegando a 2.377 vezes o valor de referência. A letalidade foi de 0,8%.Under study were two hundred and forty nine cases of accidents caused by South American rattlesnakes (Crotalus durissus admitted to the Vital Brasil Hospital, São Paulo, Brasil, from 1974 to 1990. The accidents were more common in the afternoon, from January to April and from October to December. Ninety nine out of 100 snakes classified as subspecies were C. d. terrificus. Most of the patients were males (80.7%. The inferior and superior limbs were bitten in 66.4% and 29.2% of the cases, respectively. The more frequent clinical manifestations were

  12. Modeling Cerebral Vascular Injury

    Science.gov (United States)

    2016-01-01

    The EXODUS II file format was developed at Sandia National Laboratories specifically to store and retrieve data for finite element analyses . To...vasospasm and pseudoaneurysm can lead to further damage to the brain over time. Intracranial hemorrhages and hematomas can be life threatening and...flow within the arteries and the corresponding internal pressure of the vessels. Also, since it uses a 1-D approximation of the vessels, any damage

  13. Glutamatergic and central cholinergic dysfunction in the CA1, CA2 and CA3 fields on spatial learning and memory in chronic cerebral ischemia-Induced vascular dementia of rats.

    Science.gov (United States)

    Cao, Yanjing; Gou, Zengmei; Du, Yifeng; Fan, Yongjun; Liang, Lizhen; Yan, Yongxing; Lin, Ping; Jin, Mudan; Du, Yifenf

    2016-05-04

    Chronic cerebral ischemia (CCI) is associated with cognitive decline in aging, vascular dementia and Alzheimer's disease. Substantial evidence has shown that chronic cerebral ischemia may cause cognitive impairment, but the underlying neurobiological mechanism is poorly understood so far. In the present study, we used a rat model of chronic cerebral ischemia by permanent bilateral common carotid artery occlusion (BCCAO) to investigate the alterations of glutamatergic and central cholinergic dysfunction, and their causal relationship with the cognitive deficits induced by chronic cerebral ischemia. We found that BCCAO rats exhibited spatial learning and memory impairments dysfunction 3 month after BCCAO. Meanwhile, vGluT levels as well as glutamatergic and central cholinergic positive neurons in the hippocampus CA1-3 field significantly decreased. The protection of glutamergic and cholinergic neurons or regulating glutamate and central cholinergic levels in hippocampal subregion may have beneficial effects on cognitive impairments associated with the possible mechanism in CCI-induced vascular dementia.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  15. Activación del área motora primaria mediante RMf posrehabilitación en pacientes con miembro torácico parético, como secuela de enfermedad vascular cerebral

    OpenAIRE

    Cerrato-Cuadra,Alfonso; Carrillo-Mezo, Roger

    2005-01-01

    La rehabilitación es una parte básica en el tratamiento de las secuelas de un accidente vascular cerebral (AVC). Un 10% se recupera en su totalidad en forma espontánea y el 10 % no se recupera, 80 % se beneficia con el tratamiento. En el trabajo se presentan los resultados obtenidos en 20 pacientes tratados en el Instituto Nacional de Neurología y Neurocirugía con miembro torácico parético como secuela de un accidente vascular cerebral, usando distintos métodos de terapia.

  16. Use of an optical technique to evaluate the cerebral vascular effects of alcohol (A): Effects on deoxyhemoglobin (DH) and levels of reduced cytochrome oxidase (rCO)

    Energy Technology Data Exchange (ETDEWEB)

    Barbour, R.L.; Gebiewold, A.; Altura, B.M. (Southern Univ. of New York, Brooklyn (United States))

    1992-02-26

    The dose-response effects of acute A infusion were studied to examine the suggestion that A can induce stroke-like events as a consequence of cerebral vasospasm. By employing a single sending and receiving fiber, an optical backscatter measurement was employed to monitor the levels in DH and rCO in a closed cranium preparation. Anesthetized rats were prepared by cannulating a branch of the internal carotid artery and subjected to either a bolus infusion (BI) or to a constant infusion (CI) of 5 or 10% A at various rates. Results showed that low BI doses of A typically produced a slight increase in the oxyhemoglobin signal indicating that vasodilation had probably occurred. Higher BI doses, however, produced a prompt and significant reduction in the hemoglobin signal with a rise in rCO suggesting a vasoconstrictor response leading to ischemia, followed by recovery within 3-5 min. CI of A produced a similar cerebral vascular response, in a dose-related manner, but of a more sustained nature. At 30-50% of the BI dose levels, a global blanching of the brain surface occurred; rCO levels increased by 50-90% with a corresponding decline in levels of oxyhemoglobin. Control experiments using identical volumes/flow rates of Ringers solution failed to produce any alterations in the optical spectrum. Overall, these data indicate that, depending on dose, (a) A can induce vasodilatory or vasoconstrictor effects in the intact brain; (b) the more pronounced effects involve vasospasm in the cortical microcirculation leading to global ischemia as determined by elevated levels of rCO and DH; (c) optical measurements permit direct noninvasive assessment of the cerebral vascular effects of substances of abuse.

  17. 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

    DEFF Research Database (Denmark)

    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...... caspase and calpain activity was reduced markedly in EPO-treated mice....

  18. vascular hemiplegia

    OpenAIRE

    Voto Bernales, Jorge; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú

    2014-01-01

    The vascular hemiplegia is the functional disorder of a lateral half of the body produced by alterations of cerebral vessels. Should review the concepts of this common condition, with the dual aim of expanding its nosographic value and considering the hemiplegic patient as worthy of the highest professional care La hemiplejia vascular, es el trastorno funcional de una mitad lateral del cuerpo producido por alteraciones de los vasos cerebrales. Conviene revisar los conceptos sobre esta frec...

  19. vascular hemiplegia

    OpenAIRE

    Voto Bernales, Jorge; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú

    2014-01-01

    The vascular hemiplegia is the functional disorder of a lateral half of the body produced by alterations of cerebral vessels. Should review the concepts of this common condition, with the dual aim of expanding its nosographic value and considering the hemiplegic patient as worthy of the highest professional care La hemiplejia vascular, es el trastorno funcional de una mitad lateral del cuerpo producido por alteraciones de los vasos cerebrales. Conviene revisar los conceptos sobre esta frec...

  20. 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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  1. Clinical value of detection on serum monocyte chemotactant protein-1 and vascular endothelial cadherin levels in patients with acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Xia Zhou; Cheng Zhang

    2016-01-01

    Objective: To study the correlation of serum monocyte chemotactant protein-1 (MCP-1) and vascular endothelia cadherin (VE-cadherin) levels in patients with acute cerebral infarction, and nerve injury molecules, interleukins and matrix metalloproteinases. Methods: A total of 86 patients with acute cerebral infarction treated in our hospital from April 2012 to October 2015 were selected as the observation group and 50 healthy subjects in the same period treated in our hospital were selected as the control group. The serums were collected and the contents of MCP-1, VE-cadherin, heart-type fatty acid binding protein (H-FABP), S100 calcium binding protein B (S100B), neuron-specific enolase (NSE), interleukin-lb (IL-1b), IL-6, IL-17, IL-18, matrix metalloproteinase-2 (MMP2), MMP3 and MMP9 were measured. Results: The serum contents of MCP-1, VE-cadherin, H-FABP, S100B, NSE, IL-1b, IL-6, IL-17, IL-18, MMP2, MMP3 and MMP9 in observation group were significantly higher than those of control group. Carotid artery plaque formation and unstable plaque properties will increase the serum contents of MCP-1, VE-cadherin, H-FABP, S100B, NSE, IL-1b, IL-6, IL-17, IL-18, MMP2, MMP3 and MMP9 in patients with cerebral infarction. The serum levels of MCP-1, VE-cadherin and the contents of H-FABP, S100B, NSE, IL-1b, IL-6, IL-17, IL-18, MMP2, MMP3 and MMP9 were positively correlated. Conclusions: The serum levels of VE-cadherin and MCP-1 were significantly increased in patients with acute cerebral infarction. MCP-1 and VE-cadherin can increase the secretion of interleukins and matrix metalloproteinases, which can result in the carotid artery plaque formation, unstable plaque properties and the injury of nerve function.

  2. Clinical value of detection on ser um monocyte chemotactant protein-1 and vascular endothelial cadher in levels in patients with acute cerebral infarction

    Directory of Open Access Journals (Sweden)

    Xia Zhou

    2016-11-01

    Full Text Available Objective: To study the correlation of serum monocyte chemotactant protein-1 (MCP-1 and vascular endothelia cadherin (VE-cadherin levels in patients with acute cerebral infarction, and nerve injury molecules, interleukins and matrix metalloproteinases. Methods: A total of 86 patients with acute cerebral infarction treated in our hospital from April 2012 to October 2015 were selected as the observation group and 50 healthy subjects in the same period treated in our hospital were selected as the control group. The serums were collected and the contents of MCP-1, VE-cadherin, heart-type fatty acid binding protein (H-FABP, S100 calcium binding protein B (S100B, neuron-specific enolase (NSE, interleukin-lb (IL-1b, IL-6, IL-17, IL-18, matrix metalloproteinase-2 (MMP2, MMP3 and MMP9 were measured. Results: The serum contents of MCP-1, VE-cadherin, H-FABP, S100B, NSE, IL-1b, IL- 6, IL-17, IL-18, MMP2, MMP3 and MMP9 in observation group were significantly higher than those of control group. Carotid artery plaque formation and unstable plaque properties will increase the serum contents of MCP-1, VE-cadherin, H-FABP, S100B, NSE, IL-1b, IL-6, IL-17, IL-18, MMP2, MMP3 and MMP9 in patients with cerebral infarction. The serum levels of MCP-1, VE-cadherin and the contents of H-FABP, S100B, NSE, IL-1b, IL-6, IL-17, IL-18, MMP2, MMP3 and MMP9 were positively correlated. Conclusions: The serum levels of VE-cadherin and MCP-1 were significantly increased in patients with acute cerebral infarction. MCP-1 and VE-cadherin can increase the secretion of interleukins and matrix metalloproteinases, which can result in the carotid artery plaque formation, unstable plaque properties and the injury of nerve function.

  3. Early expressions of hypoxia-inducible factor 1alpha and vascular endothelial growth factor increase the neuronal plasticity of activated endogenous neural stem cells after focal cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Seung Song; Jong-Tae Park; Joo Young Na; Man-Seok Park; Jeong-Kil Lee; Min-Cheol Lee; Hyung-Seok Kim

    2014-01-01

    Endogenous neural stem cells become “activated” after neuronal injury, but the activation sequence and fate of endogenous neural stem cells in focal cerebral ischemia model are little known. We evaluated the relationships between neural stem cells and hypoxia-inducible fac-tor-1α and vascular endothelial growth factor expression in a photothromobotic rat stroke model using immunohistochemistry and western blot analysis. We also evaluated the chrono-logical changes of neural stem cells by 5-bromo-2′-deoxyuridine (BrdU) incorporation. Hypoxia-inducible factor-1α expression was initially increased from 1 hour after ischemic injury, followed by vascular endothelial growth factor expression. Hypoxia-inducible factor-1αimmunoreactivity was detected in the ipsilateral cortical neurons of the infarct core and peri-in-farct area. Vascular endothelial growth factor immunoreactivity was detected in bilateral cortex, but ipsilateral cortex staining intensity and numbers were greater than the contralateral cortex. Vascular endothelial growth factor immunoreactive cells were easily found along the peri-infarct area 12 hours after focal cerebral ischemia. The expression of nestin increased throughout the microvasculature in the ischemic core and the peri-infarct area in all experimental rats after 24 hours of ischemic injury. Nestin immunoreactivity increased in the subventricular zone during 12 hours to 3 days, and prominently increased in the ipsilateral cortex between 3-7 days. Nes-tin-labeled cells showed dual differentiation with microvessels near the infarct core and reactive astrocytes in the peri-infarct area. BrdU-labeled cells were increased gradually from day 1 in the ipsilateral subventricular zone and cortex, and numerous BrdU-labeled cells were observed in the peri-infarct area and non-lesioned cortex at 3 days. BrdU-labeled cells rather than neu-rons, were mainly co-labeled with nestin and GFAP. Early expressions of hypoxia-inducible factor-1α and

  4. Age-related changes in the sympathetic innervation of cerebral vessels and in carotid vascular responses to norepinephrine in the rat: in vitro and in vivo studies.

    Science.gov (United States)

    Omar, Nisreen Mansour; Marshall, Janice M

    2010-08-01

    We hypothesized that the density of sympathetic noradrenergic innervation of cerebral arteries and vasoconstrictor responses evoked in carotid circulation by norepinephrine (NE) increase with maturation and age. In rats of 4-5, 10-12, and 42-44 wk of age (juvenile, mature, middle aged), glyoxylic acid applied to stretch preparations showed the density of noradrenergic nerves in basilar and middle cerebral arteries was greater in mature than juvenile or middle-aged rats. In anesthetized rats, infusion of NE (2.5 mug/kg iv) increased mean arterial pressure (ABP) to approximately 180 mmHg in mature and middle-aged but to only approximately 150 mmHg in juveniles rats. Concomitantly, carotid blood flow (CBF) decreased in mature and middle-aged rats but remained constant in juveniles because carotid vascular conductance (CVC) decreased more in mature and middle-aged than juvenile rats. We also hypothesized that nitric oxide (NO) blunts cerebral vasoconstrictor responses to NE. Inhibition of NO synthase with l-NAME (10 mg/kg iv) induced similar increases in baseline ABP in each group, but larger decreases in CVC and CBF in mature and middle-aged than juvenile rats. Thereafter, the NE-evoked increase in ABP was similar in juvenile and mature but accentuated in middle-aged rats. Concomitantly, NE decreased CVC in juvenile and mature, but not middle-aged rats; in them, CBF increased. Thus, in juvenile rats, sparse noradrenergic innervation of cerebral arteries is associated with weak NE-evoked pressor responses and weak carotid vasoconstriction that allows autoregulation of CBF. Cerebral artery innervation density increases with maturation but lessens by middle age. Meanwhile, NE-evoked pressor responses and carotid vasoconstriction are stronger in mature and middle-aged rats, such that CBF falls despite the evoked increase in ABP. We propose that in juvenile and mature rats, NO does not modulate NE-evoked pressor responses, cerebral vasoconstriction, or CBF autoregulation

  5. Eficácia da eletroestimulação muscular expiratória na tosse de pacientes após acidente vascular encefálico Effectiveness of electrical stimulation in expiratory muscle on cough of patients after stroke

    Directory of Open Access Journals (Sweden)

    André Luís Ferreira de Meireles

    2012-12-01

    Full Text Available Indivíduos com sequelas de acidente vascular encefálico (AVE apresentam como complicação comum a hipotonia de tronco com consequente fraqueza da sua musculatura, em especial, o reto abdominal que é o principal músculo acionado para a tosse. As correntes elétricas têm sido amplamente utilizadas para recrutamento de fibras musculares nas mais diversas patologias. O presente estudo teve como objetivo avaliar a eficácia da eletroestimulação transcutânea de média frequência (ETMF na força muscular expiratória e tosse de pacientes com sequela de AVE. Trata-se de um estudo quase-experimental (antes e depois onde foram selecionados 11 indivíduos pós-AVE entre 40 a 65 anos, ambos os sexos e estáveis hemodinamicamente. Os pacientes foram avaliados quanto a parâmetros clínicos e pneumofuncionais (ventilometria, pico de fluxo expiratório (PFE e manovacuometria e submetidos ao protocolo, que constava de ETMF no músculo reto abdominal com o aparelho de corrente Russa, frequência portadora de 2.500 Hz modulada a 40 Hz, durante 15 minutos, por 15 sessões. Na avaliação inicial observou-se diminuição da força muscular inspiratória e expiratória (Pimáx; Pemáx e do PFE quando comparados aos valores de normalidade preditos na literatura. Após a ETMF houve incremento da Pimáx e Pemáx sem significância estatística (p=0,18 e p=0,29 já o PFE teve um acréscimo de 283,73 L/minuto para 347,27 L/minuto (p=0,03. Pode-se observar que a ETMF foi eficaz no incremento dos parâmetros avaliados, com o PFE sendo o de maior impacto e significância estatística, no entanto, mais estudos com populações maiores se fazem necessários para análise dessa nova abordagem terapêutica.Individuals with sequelae of stroke present as a common complication hypotonia and weakness of trunk muscles, in special the rectus abdominal muscle which is the main muscle activated for cough. The electrical stimulation (ES is being widely used to fiber

  6. iFlow in the auxiliary diagnosis of cerebral vascular disease%iFlow成像辅助诊断脑血管性病变

    Institute of Scientific and Technical Information of China (English)

    黄远亮; 周玉明; 童绥君; 傅建新; 王向东; 姜园

    2011-01-01

    目的 评估iFlow成像在脑血管性病变中的辅助诊断价值.方法对65例脑血管病变患者进行常规全脑2DDSA检查,对所采集的图像用iFlow软件编码,由低年资和高年资医师分别观察2D DSA图像及iFlow彩色编码血流图的血管解剖、病灶形态、大小、血流动力学情况,评估iFlow对脑血管病变是否具有辅助诊断价值.结果 iFlow成像能在一幅iFlow彩色编码血流图上完整显示脑血管DSA采集的动态序列所包含的病变信息,包括病灶的解剖形态、血流动力学变化及组织灌注情况,较2D DSA更加直观.低年资医师和高年资医师对iFlow辅助诊断价值认定的差异有统计学意义(x2=6.032,P=0.014).结论iFlow较单独2D DSA图像显示病变更全面,能对临床医师、尤其是低年资医师诊断和评估脑血管病变提供帮助.%Objective To evaluate the impact of iFlow in the auxiliary diagnosis of cerebral vascular diseases.Methods Totally 65 patients with cerebral vascular diseases underwent whole brain 2D DSA.Then the data were converted to color coded images with iFlow.The vascular anatomy,the shape and size of lesions,the blood dynamics on 2D DSA and iFlow images were evaluated by junior and senior physicians,who then reported whether iFlow images had supplementary diagnosis value.Results iFlow images displayed whole information of lesions more clearly than those of 2D DSA in brain vascular dynamic sequence,including vascular anatomy,hemodynamic changes and tissues perfusions.The evaluation of 2D DSA and iFlow images with junior and senior physicians had statistical difference (x2 =6.032,P=0.014).Conclusion Compared to single DSA,iFlow can facilitate the diagnosis and evaluation of cerebral vascular diseases,especially for junior physicians.

  7. Comparison of MEK/ERK pathway inhibitors on the upregulation of vascular G-protein coupled receptors in rat cerebral arteries

    DEFF Research Database (Denmark)

    Sandhu, Hardip; Ansar, Saema; Edvinsson, Lars

    2010-01-01

    on translational level and increased respective contractions. The prostanoid TP receptor mediated contraction curve was left-wards shifted by organ culture. Organ culture was associated with elevated pERK1/2 in the vascular smooth muscle cells: the MEK1/2 inhibitor U0126 attenuated the endothelin ET(B) receptor......Organ culture is an in vitro method for investigating cellular mechanisms involved in upregulation of vasocontractile G-protein coupled receptors. We hypothesize that mitogen-activated-protein kinase (MEK) and/or extracellular-signal-regulated kinase (ERK) specific inhibitors will attenuate the G......-protein coupled receptor expression following organ culture. Rat cerebral arteries were incubated 48h in the presence of MEK/ERK specific inhibitors U0126, PD98059, SL327, or AG126 for different time periods. Contractile responses by activation of endothelin receptor type A and type B, serotonin receptor 5-HT(1B...

  8. Assessment of Cerebral Blood Flow with Micro-Doppler Vascular Reduces the Risk of Ischemic Stroke During the Clipping of Intracranial Aneurysms.

    Science.gov (United States)

    Pereira, Benedito J A; Holanda, Vanessa M; Giudicissi-Filho, Miguel; Borba, Luiz Alencar B; de Holanda, Carlos Vanderlei M; de Oliveira, Jean G

    2015-12-01

    To analyze the impact of the introduction of Micro-Doppler vascular (MDV) as a method of cerebral blood flow analysis during microsurgical clipping of intracranial aneurysms to check the partial occlusion of the aneurysm and the occurrence of stenosis by comparing these results with those provided by the postoperative digital subtraction angiography (DSA) scan as well as the occurrence of ischemic infarction on the postoperative computed tomography (CT) images. We reviewed retrospectively the last 50 patients operated on before the introduction of the MDV (group 1) compared with the first 50 patients operated on using this technique (group 2). Nine (18%) of the 50 patients evaluated in the group 1 showed a new hypodensity in the postoperative CT images, whereas only 2 (4%) patients showed infarction in the group 2 (P = 0.02). In addition, in the group 1, 10 (20%) patients presented unexpected findings on DSA images (residual aneurysms, stenosis, and arterial occlusion), whereas in the group 2, those unexpected DSA findings were observed in only 3 (6%) patients (P = 0.023). MDV is an excellent method for cerebral blood flow assessment during the microsurgical clipping of intracranial aneurysms, reducing the unexpected angiographic results (residual aneurysms, stenosis, and arterial occlusion), as well as reducing the incidence of ischemic infarction on postoperative CT images, evidence of the positive impact of this method in the microsurgical treatment of intracranial aneurysms. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Acidentes com hipoclorito de sódio

    OpenAIRE

    Trigo, Catarina Correia de Sousa Dias

    2016-01-01

    O objectivo deste trabalho consistiu em definir, com base na evidência científica mais recente sobre Acidentes com hipoclorito de sódio, diferentes protocolos para a prevenção e tratamento dos acidentes causados no âmbito da endodontia. O Hipoclorito de Sódio é o irrigante frequentemente mais utilizado durante o Tratamento Endodôntico, devido às suas excelentes propriedades, capacidade de dissolver tecidos e capacidade bactericida. Há diversos factores que podem influenciar o modo de atuação ...

  10. Dual anca positivity in a child with moyamoya-like cerebral vascular changes: an unusual presentation with sudden homonymous hemianopsia.

    Science.gov (United States)

    Sakalli, Hale; Baskin, Esra; Alehan, Füsun; Agıldere, Muhteşem; Akova, Yonca Aydin; Caner, Hakan

    2012-10-01

    A 12-year-old girl presented with a sudden decrease in her right visual acuity and homonymous hemianopsia. An angiography of the retinal arteries demonstrated recanalized occlusion of the right retinal artery. Cerebral angiography showed bilateral internal carotid artery stenosis associated with the development of collateral circulation. Laboratory evaluations revealed dual antineutrophil cytoplasmic antibodies (ANCA) positivity [anti-proteinase (anti-PR3) ANCA and anti-myeloperoxidase (anti-MPO) ANCA], anticardiolipin (aCL) antibodies, and low titers of antinuclear antibodies (ANA). There was no evidence of active systemic lupus erythematosus (SLE), ANCA-related vasculitis, or other risk factors for cerebral occlusion, such as antiphospholipid syndrome (APS). Dual positivity for both cytoplasmic (c-ANCA) and perinuclear (p-ANCA) antineutrophil antibodies has been found previously in a small number of reports, but to our knowledge, this case represents the first case of moyamoya disease associated with dual ANCA positivity.

  11. 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

    OpenAIRE

    Huana Carolina Cândido Morais; Arethusa Morais de Gouveia Soares; Ana Railka de Souza Oliveira; Carolina Maria de Lima Carvalho; Maria Josefina da Silva; Thelma Leite de Araujo

    2012-01-01

    OBJECTIVE: to analyze the impact that caring has on a member of the family caring for a patient after a cerebrovascular accident, correlating life modifications and mental suffering with the perceived burden. METHOD: a cross-sectional, quantitative study, undertaken in January-April 2010 in Fortaleza, Ceará, Brazil. RESULT: 61 individuals were investigated, monitored by three hospitals' Home Care Program. Data collection was through interviews for identifying life changes, and through the app...

  12. Exercise Training Could Improve Age-Related Changes in Cerebral Blood Flow and Capillary Vascularity through the Upregulation of VEGF and eNOS

    Directory of Open Access Journals (Sweden)

    Sheepsumon Viboolvorakul

    2014-01-01

    Full Text Available This study aimed to investigate the effect of exercise training on age-induced microvascular alterations in the brain. Additionally, the association with the protein levels of vascular endothelial growth factor (VEGF and endothelial nitric oxide synthase (eNOS was also assessed. Male Wistar rats were divided into four groups: sedentary-young (SE-Young, n=5, sedentary aged (SE-Aged, n=8, immersed-aged (IM-Aged, n=5, and exercise trained-aged (ET-Aged, 60 minutes/day and 5 days/week for 8 weeks, n=8 rats. The MAPs of all aged groups, SE-Aged, IM-Aged, and ET-Aged, were significantly higher than that of the SE-Young group. The regional cerebral blood flow (rCBF in the SE-Aged and IM-Aged was significantly decreased as compared to SE-Young groups. However, rCBF of ET-Aged group was significantly higher than that in the IM-Aged group (P<0.05. Moreover, the percentage of capillary vascularity (%CV and the levels of VEGF and eNOS in the ET-Aged group were significantly increased compared to the IM-Aged group (P<0.05. These results imply that exercise training could improve age-induced microvascular changes and hypoperfusion closely associated with the upregulation of VEGF and eNOS.

  13. 64层螺旋CT脑灌注成像联合CT血管造影评价颅内外血管搭桥术后疗效%Assessment of cerebral internal and external vascular bypass graft in patients with single middle cerebral artery stenosis or occlusion by combining 64-row CT cerebral perfusion with angiography

    Institute of Scientific and Technical Information of China (English)

    陈天金; 朱栓庄; 温有信; 王耀彬; 韩向东; 白莹; 于旋

    2012-01-01

    Objective To assess the curative effect of cerebral internal and external vascular bypass graft in patients with sin -gle middle cerebral artery (MCA) stenosis or occlusion by combining 64 -row CT cerebral perfusion (CTP) with angiography ( CTA ). Methods Patients with middle cerebral artery stenosis or occlusion were recruited and underwent superficial temporal artery and mid -die cerebral artery(STA -MCA) bypass graft between March 2009 and Mar 2011. CTP and CTA examinations were performed in all patients before and after operation. The cerebral perfusion parameters were analyzed quantitatively and qualitatively . The origin, travel and anastomotic stoma of bypass grafts were evaluated by reconstructed CTA images . Results 46 patients were found with severe MCA stenosis or occlusion. The time to peak (TTP) and relative mean transit time (rMTT) images before therapy displayed the existence of perfusion delay. The relative cerebral blood flow (rCBF) and relative cerebral blood volume (rCRV) images did not change significantly. The decrease of TTP and rMTT after therapy was of statistical significance ( P 0.05). In reconstructed CTA images , 82 bridge vessels were well displayed, including double bridges in 39 patients. The accuracy of CTA examination was 96.5%. All the bypass grafts were well shown and the anastomotic stomas were unobstructed. Conclusions It is feasible to evaluate the curative effects of cerebral internal and ex — ternal vascular bypass graft by combining CTP images of cerebral perfusion after therapy with CTA images of cerebral internal and exter -nal bypass grafts.%目的 探讨64层螺旋CT脑灌注成像(CT perfusion,CTP)联合CT血管造影(CT angiography,CTA)评价单侧大脑中动脉(middle cerebral artery,MCA)重度狭窄(闭塞)颅内外血管搭桥术后疗效的可行性.方法 46例拟行颅内外血管搭桥术患者,术前、后均行CTP及CTA检查.计算脑灌注参数图,对治疗前后脑灌注参数进行定量和定性对

  14. Vasoespasmo cerebral

    Directory of Open Access Journals (Sweden)

    Antonio A. F. de Salles

    1987-09-01

    Full Text Available Vasoespasmo cerebral ocorre em patologias como enxaqueca, hemorragia subaracnóidea, trauma de crânio, após isquemia e/ou hipoxia. A fisiopatologia do vasoespasmo cerebral nestas patologias não está completamente desvendada. Neste artigo são analisados os fatores neuroquímicos e morfológicos responsáveis pelo controle circulatório cerebral. As alterações circulatórias que seguem a hemorragia subaracnóidea são utilizadas como exemplo. Conclui-se que fatores bioquímicos, fisiológicos e morfológicos são responsáveis pelas manifestações vasculares que ocorrem após a hemorragia subaracnóidea. Alternativas de tratamento do vasoespasmo cerebral são discutidas.

  15. Homocysteinemia control by cysteine in cerebral vascular patients after methionine loading test: evidences in physiological and pathological conditions in cerebro-vascular and multiple sclerosis patients.

    Science.gov (United States)

    Ulivelli, Monica; Priora, Raffaella; Di Giuseppe, Danila; Coppo, Lucia; Summa, Domenico; Margaritis, Antonios; Frosali, Simona; Bartalini, Sabina; Martini, Giuseppe; Cerase, Alfonso; Di Simplicio, Paolo

    2016-06-01

    The toxicity risk of hyperhomocysteinemia is prevented through thiol drug administration which reduces plasma total homocysteine (tHcy) concentrations by activating thiol exchange reactions. Assuming that cysteine (Cys) is a homocysteinemia regulator, the hypothesis was verified in healthy and pathological individuals after the methionine loading test (MLT). The plasma variations of redox species of Cys, Hcy, cysteinylglycine, glutathione and albumin (reduced, HS-ALB, and at mixed disulfide, XSS-ALB) were compared in patients with cerebral small vessels disease (CSVD) (n = 11), multiple sclerosis (MS) (n = 12) and healthy controls (n = 11) at 2-4-6 h after MLT. In MLT-treated subjects, the activation of thiol exchange reactions provoked significant changes over time in redox species concentrations of Cys, Hcy, and albumin. Significant differences between controls and pathological groups were also observed. In non-methionine-treated subjects, total Cys concentrations, tHcy and thiol-protein mixed disulfides (CSS-ALB, HSS-ALB) of CSVD patients were higher than controls. After MLT, all groups displayed significant cystine (CSSC) increases and CSS-ALB decreases, that in pathological groups were significantly higher than controls. These data would confirm the Cys regulatory role on the homocysteinemia; they also explain that the Cys-Hcy mixed disulfide excretion is an important point of hyperhomocysteinemia control. Moreover, in all groups after MLT, significant increases in albumin concentrations, named total albumin (tALB) and measured as sum of HS-ALB (spectrophometric), and XSS-ALB (assayed at HPLC) were observed. tALB increases, more pronounced in healthy than in the pathological subjects, could indicate alterations of albumin equilibria between plasma and other extracellular spaces, whose toxicological consequences deserve further studies.

  16. Logistic regression analysis on risk factors for vascular dementia following cerebral infarction in 403 patients from Chongqing City Hospital and family follow-up studies

    Institute of Scientific and Technical Information of China (English)

    Hong Yang; Jingcheng Li; Huadong Zhou

    2007-01-01

    BACKGROUND: Studies have demonstrated that the risk factors of vascular dementia following stroke are greatly different in region, race and other aspects.OBJECTIVE: To analyze the conditions and incidental risk factors of vascular dementia in patients with acute cerebral infarction from Chongqing City. DESIGN: Case analysis.SETTING: Department of Neurology, Daping Hospital, Third Military Medical University of Chinese PLA. PARTICIPANTS: Altogether 546 inpatients with acute ischemic stroke admitted to Department of Neurology, Daping Hospital, Third Military Medical University of Chinese PLA between May 1999 and December 2002 were involved in this study. The involved patients, including 295 males and 251 females, aged 55 - 94 years, dwelled in Chongqing over 5 years. They were admitted to hospital within 48 hours of attack of acute ischemic stroke, and survived for over 3 months. Informed consents were obtained from all the involved subjects.METHODS: ①Following the same standard, cognitive and social function evaluations were conducted by one physician on admission and 3 months after admission. Unified questionnaire, consisting of general characteristics, vascular risk factors, stroke characteristics, neurological physical sign, and other 28 factors of involved subjects, was used in all the patients. According to the investigation results, the patients were assigned into 2 groups: dementia group and non-dementia group. ②Ischemic stroke was diagnosed according to acute ischemic brain disorder>24 hours and CT or MRI imageology.③Neurophysiological examination was conducted in all the patients at 7 to 10 days after stroke (score was two SD less than or equaled to normal level was considered as abnormal).④Diagnosis and statistics of dementia were carried out with Mini-Mental State Examination and The Diagnostic and Statistical Manual of Mental Disorders-IV (published by American Psychiatric Association) on admission and 3 months after admission. Neurologic

  17. Experimental stereotactic gamma knife radiosurgery. Vascular contractility studies of the rat middle cerebral artery after chronic survival.

    Science.gov (United States)

    Major, Otto; Szeifert, György Tamás; Radatz, Matthias W R; Walton, Lee; Kemeny, Andras Armand

    2002-03-01

    In vitro isometric small vessel myograph experiments and pathological investigations were performed on rat middle cerebral arteries. Thirty-four animals provided 68 normal vessels, six further rats had the endothelial layer mechanically removed from their 12 arteries. Eighteen animals received gamma knife irradiation to the middle cerebral arteries. Fifteen of these received 50 Gray, and three 25 Gray dose to the 50% isodose and the contralateral vessels offered 20 Gray and 15 Gray irradiated specimens. Survival times varied from 12 weeks to 18 months. In the acute stage, abolition of potassium-induced relaxation occurred as early as 24 h after irradiation whilst in one year this reaction seemed to recover and remained active to 18 months. The contraction response to prostaglandin F2 alpha was diminished at six weeks in the 50 Gray-irradiated vessels. However, from one year further reduction was seen and by 18 months this response was totally abolished. We demonstrated reduction of contractile capability of the irradiated normal vessels while the vessels remained patent. When using low irradiation dose there were no pathological changes even at 18 months, but marked physiological changes could be demonstrated. Different vessel wall functions appear to have different radiosensitivity, time course and capability for regeneration.

  18. Sleep Apnea, Sleep Duration and Brain MRI Markers of Cerebral Vascular Disease and Alzheimer's Disease: The Atherosclerosis Risk in Communities Study (ARIC.

    Directory of Open Access Journals (Sweden)

    Pamela L Lutsey

    Full Text Available A growing body of literature has suggested that obstructive sleep apnea (OSA and habitual short sleep duration are linked to poor cognitive function. Neuroimaging studies may provide insight into this relation.We tested the hypotheses that OSA and habitual short sleep duration, measured at ages 54-73 years, would be associated with adverse brain morphology at ages 67-89 years.Included in this analysis are 312 ARIC study participants who underwent in-home overnight polysomnography in 1996-1998 and brain MRI scans about 15 years later (2012-2013. Sleep apnea was quantified by the apnea-hypopnea index and categorized as moderate/severe (≥15.0 events/hour, mild (5.0-14.9 events/hour, or normal (<5.0 events/hour. Habitual sleep duration was categorized, in hours, as <7, 7 to <8, ≥8. MRI outcomes included number of infarcts (total, subcortical, and cortical and white matter hyperintensity (WMH and Alzheimer's disease signature region volumes. Multivariable adjusted logistic and linear regression models were used. All models incorporated inverse probability weighting, to adjust for potential selection bias.At the time of the sleep study participants were 61.7 (SD: 5.0 years old and 54% female; 19% had moderate/severe sleep apnea. MRI imaging took place 14.8 (SD: 1.0 years later, when participants were 76.5 (SD: 5.2 years old. In multivariable models which accounted for body mass index, neither OSA nor abnormal sleep duration were statistically significantly associated with odds of cerebral infarcts, WMH brain volumes or regional brain volumes.In this community-based sample, mid-life OSA and habitually short sleep duration were not associated with later-life cerebral markers of vascular dementia and Alzheimer's disease. However, selection bias may have influenced our results and the modest sample size led to relatively imprecise associations.

  19. Usefulness of continuous suture using short-thread double-armed micro-suture for cerebral vascular anastomosis

    Directory of Open Access Journals (Sweden)

    Sei Haga

    2014-01-01

    Full Text Available Background: When microvascular anastomosis is performed in a deep, narrow operating field, securing space to throw knots is difficult. To simplify the procedure and avoid obstruction of the anastomosis, we use a continuous suturing with short-thread double-armed micro-suture. Methods: Sixty-four patients (38 cerebral revasculazation, 16 moyamoya disease, and 10 aneurysm surgery undergoing microvaucular anastomosis were included. During anastomosis, a continuous suture was placed with short-thread double-armed micro-suture. Results: During 64 microanastomosis procedures, 64 consecutive continuous sutures were performed with 1-year follow up. All patients showed patency of anastomosis with long-term follow up. Conclusions: This technique is especially useful for anastomosis in a deep, narrow surgical field, such as in superior cerebellar artery anastomosis.

  20. Chronic supplementation of paeonol combined with danshensu for the improvement of vascular reactivity in the cerebral basilar artery of diabetic rats.

    Science.gov (United States)

    Hu, Jing; Li, Ya-Ling; Li, Zi-Lin; Li, Hua; Zhou, Xuan-Xuan; Qiu, Peng-Cheng; Yang, Qian; Wang, Si-Wang

    2012-11-08

    One of the leading causes of death in the world is cerebrovascular disease. Numerous Chinese traditional medicines, such as Cortex Moutan (root bark of Paeonia suffruticosa Andrew) and Radix Salviae miltiorrhizae (root and rhizome of Salvia miltiorrhiza Bunge), protect against cerebrovascular diseases and exhibit anti-atherosclerotic effects. Traditional medicines have been routinely used for a long time in China. In addition, these two herbs are prescribed together in clinical practice. Therefore, the pharmacodynamic interactions between the active constituents of these two herbs, which are paeonol (Pae) and danshensu (DSS), should be particularly studied. The study of Pae and DSS can provide substantial foundations in understanding their mechanisms and empirical evidence to support clinical practice. This study investigated the effects and possible mechanisms of the pharmacodynamic interaction between Pae and DSS on cerebrovascular malfunctioning in diabetes. Experimental diabetes was induced in rats, which was then treated with Pae, DSS, and Pae + DSS for eight weeks. Afterward, cerebral arteries from all groups were isolated and equilibrated in an organ bath with Krebs buffer and ring tension. Effects of Pae, DSS, and Pae + DSS were observed on vessel relaxation with or without endothelium as well as on the basal tonus of vessels from normal and diabetic rats. Indexes about oxidative stress were also determined. We report that the cerebral arteries from diabetic rats show decreased vascular reactivity to acetylcholine (ACh) which was corrected in Pae, DSS, and Pae + DSS treated groups. Furthermore, phenylephrine (PE)-induced contraction response decreased in the treated groups. Phenylephrine and CaCl(2)-induced vasoconstrictions are partially inhibited in the three treated groups under Ca2+-free medium. Pre-incubated with tetraethylammonium, a non-selective K+ channel blocker, the antagonized relaxation responses increased in DSS and Pae + DSS treated diabetic

  1. Chronic Supplementation of Paeonol Combined with Danshensu for the Improvement of Vascular Reactivity in the Cerebral Basilar Artery of Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Peng-Cheng Qiu

    2012-11-01

    Full Text Available One of the leading causes of death in the world is cerebrovascular disease. Numerous Chinese traditional medicines, such as Cortex Moutan (root bark of Paeonia suffruticosa Andrew and Radix Salviae miltiorrhizae (root and rhizome of Salvia miltiorrhiza Bunge, protect against cerebrovascular diseases and exhibit anti-atherosclerotic effects. Traditional medicines have been routinely used for a long time in China. In addition, these two herbs are prescribed together in clinical practice. Therefore, the pharmacodynamic interactions between the active constituents of these two herbs, which are paeonol (Pae and danshensu (DSS, should be particularly studied. The study of Pae and DSS can provide substantial foundations in understanding their mechanisms and empirical evidence to support clinical practice. This study investigated the effects and possible mechanisms of the pharmacodynamic interaction between Pae and DSS on cerebrovascular malfunctioning in diabetes. Experimental diabetes was induced in rats, which was then treated with Pae, DSS, and Pae + DSS for eight weeks. Afterward, cerebral arteries from all groups were isolated and equilibrated in an organ bath with Krebs buffer and ring tension. Effects of Pae, DSS, and Pae + DSS were observed on vessel relaxation with or without endothelium as well as on the basal tonus of vessels from normal and diabetic rats. Indexes about oxidative stress were also determined. We report that the cerebral arteries from diabetic rats show decreased vascular reactivity to acetylcholine (ACh which was corrected in Pae, DSS, and Pae + DSS treated groups. Furthermore, phenylephrine (PE-induced contraction response decreased in the treated groups. Phenylephrine and CaCl2-induced vasoconstrictions are partially inhibited in the three treated groups under Ca2+-free medium. Pre-incubated with tetraethylammonium, a non-selective K+ channel blocker, the antagonized relaxation responses increased in DSS and Pae + DSS

  2. 血尿酸与脑血管病关系初探%A Study of the Relation between Serum Uric Acid and Cerebral Vascular Disease

    Institute of Scientific and Technical Information of China (English)

    谭来勋; 刘志超; 龙庆红

    2001-01-01

    To study the relation between the level of serum uric acid and cerebral vascular disease.Methods:The level of serum uric acid was investigated in 120 patients with acute cerebral vascular disease. Results:Patients with high uric acid level were more obese and likely to have a history of MI stroke and hypetrension(P<0.001).Furthermore, they had higher levels of serum creation,total cholesterol and total triglycerides and lower levels of LDL cholesterol,HDL cholesterol and serum glucose (P<0.001).High uric acid level was associated with the severity and outcome prognosis (P<0.05,0.005).Conclusion:Hyperuricemia is a strong predictor of stroke events and serum uric acid level is helpful in evaluating the severity and the outcome.%目的:探讨血尿酸与脑血管病的关系。方法:分析120例脑血管病患者临床资料及血尿酸含量。结果:高尿酸血症患者肥胖、有心肌梗塞史、脑卒中史、高血压病吏者较多(P<0.001),血肌酐、总胆固醇、总甘油三脂水平较高(P<0.001);而低密度脂蛋白胆固醇和高密度脂蛋白胆固醇水平、血糖水平较低(P<0.001);尿酸水平与病情、预后有关(P<0.01,0.005)。结论:高尿酸血症是脑血管危险因素;测定血尿酸含量有利于判断病情及评估预后。

  3. Non-invasive assessment of intratumoral vascularity using arterial spin labeling: A comparison to susceptibility-weighted imaging for the differentiation of primary cerebral lymphoma and glioblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Furtner, J., E-mail: julia.furtner@meduniwien.ac.at [Department of Biomedical Imaging und Image-guided Therapy, Medical University of Vienna (Austria); Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna (Austria); Schöpf, V., E-mail: veronika.schoepf@meduniwien.ac.at [Department of Biomedical Imaging und Image-guided Therapy, Medical University of Vienna (Austria); Preusser, M., E-mail: matthias.preusser@meduniwien.ac.at [Department of Medicine I, Division of Oncology, Medical University of Vienna (Austria); Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna (Austria); Asenbaum, U., E-mail: ulrika.asenbaum@meduniwien.ac.at [Department of Biomedical Imaging und Image-guided Therapy, Medical University of Vienna (Austria); Woitek, R., E-mail: ramona.woitek@meduniwien.ac.at [Department of Biomedical Imaging und Image-guided Therapy, Medical University of Vienna (Austria); Wöhrer, A., E-mail: adelheid.woehrer@meduniwien.ac.at [Institute of Neurology, Medical University of Vienna (Austria); Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna (Austria); Hainfellner, J.A., E-mail: johannes.hainfellner@meduniwien.ac.at [Institute of Neurology, Medical University of Vienna (Austria); Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna (Austria); Wolfsberger, S., E-mail: stefan.wolfsberger@meduniwien.ac.at [Department of Neurosurgery, Medical University of Vienna (Austria); Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna (Austria); Prayer, D., E-mail: daniela.prayer@meduniwien.ac.at [Department of Biomedical Imaging und Image-guided Therapy, Medical University of Vienna (Austria); Comprehensive Cancer Center-Central Nervous System Tumors Unit (CCC-CNS), Medical University of Vienna (Austria)

    2014-05-15

    Using conventional MRI methods, the differentiation of primary cerebral lymphomas (PCNSL) and other primary brain tumors, such as glioblastomas, is difficult due to overlapping imaging characteristics. This study was designed to discriminate tumor entities using normalized vascular intratumoral signal intensity values (nVITS) obtained from pulsed arterial spin labeling (PASL), combined with intratumoral susceptibility signals (ITSS) from susceptibility-weighted imaging (SWI). Thirty consecutive patients with glioblastoma (n = 22) and PCNSL (n = 8), histologically classified according to the WHO brain tumor classification, were included. MRIs were acquired on a 3 T scanner, and included PASL and SWI sequences. nVITS was defined by the signal intensity ratio between the tumor and the contralateral normal brain tissue, as obtained by PASL images. ITSS was determined as intratumoral low signal intensity structures detected on SWI sequences and were divided into four different grades. Potential differences in the nVITS and ITSS between glioblastomas and PCNSLs were revealed using statistical testing. To determine sensitivity, specificity, and diagnostic accuracy, as well as an optimum cut-off value for the differentiation of PCNSL and glioblastoma, a receiver operating characteristic analysis was used. We found that nVITS (p = 0.011) and ITSS (p = 0.001) values were significantly higher in glioblastoma than in PCNSL. The optimal cut-off value for nVITS was 1.41 and 1.5 for ITSS, with a sensitivity, specificity, and accuracy of more than 95%. These findings indicate that nVITS values have a comparable diagnostic accuracy to ITSS values in differentiating glioblastoma and PCNSL, offering a completely non-invasive and fast assessment of tumoral vascularity in a clinical setting.

  4. Stroke in patients with sickle cell disease: clinical and neurological aspects Acidente cerebrovascular em pacientes com anemia falciforme: aspectos clínicos e neurológicos

    Directory of Open Access Journals (Sweden)

    Carolina Camargo de Oliveira

    2008-03-01

    Full Text Available The aim of this study was to characterize a group of patients (n=8 with sickle cell disease (SCD and ischemic stroke concerning the clinical, neurological, imaging and progressive aspects. Data were collected from records and completed with an interview of patients and their parents. In this study there were 8 patients with ages ranging from 10 to 23 years old; SCD diagnosis was given between one and two years of age with clinical features of fatigue and anemia. The stroke was ischemic in all individuals and the first cerebrovascular event occurred before 6 years of age; 3 patients had recurrence of stroke despite prophylactic blood transfusion therapy and both cerebral hemispheres were affected in 4 patients. Clinical and neurological current features observed were: acute pain crises, sialorrhea, mouth breathing, motor, and neuropsychological impairments resulting from cortical-subcortical structure lesions.O objetivo deste estudo foi caracterizar um grupo de sujeitos (n=8 com antecedentes de anemia falciforme (AF e acidente vascular cerebral (AVC isquêmico, dos pontos de vista clínico, neurológico, radiológico e evolutivo, reavaliados através de exame neurológico e neuropsicológico. A partir de prontuários dos sujeitos com diagnóstico comprovado de AF e AVC, coletamos dados, complementados por entrevista com pacientes e responsáveis. Foram avaliados 8 pacientes; atualmente com idades entre 10 e 23 anos; diagnóstico da AF entre um e dois anos; quadro clínico de fraqueza e anemia. Em todos, o AVC foi isquêmico e o primeiro evento na maioria ocorreu antes dos 6 anos de idade; houve recorrência do AVC em 3, apesar da profilaxia com transfusão sanguínea; ambos os hemisférios afetados em 4; no quadro clínico e neurológico atual constatamos crises dolorosas, sialorréia, respiração oral e importante comprometimento motor e neuropsicológico, resultantes de lesões estruturais cortico-subcorticais.

  5. Features of cerebral vascular reactivity in patients with different clinical course of a high degree of myopia

    Directory of Open Access Journals (Sweden)

    G. V. Shkrebets

    2014-07-01

    Full Text Available Purpose: to examine the state rate parameters of cerebral and ocular vessels in patients with glaucoma combined with myopia of high degree.Methods: the study involved 3 groups of patients aged 16-32 years: 1st — 30 patients (60 eyes — with a stationary myopia of 6.5 to 9.0 D and normal intraocular pressure (IOP; 2nd — 23 patients (46 eyes — with a high degree of progressive myopia and glaucoma with normalized intraocular pressure during instillation Azopt included 2 subgroups: subgroup A — 14 patients (28 eyes — with ischemic variant of glaucoma; subgroup B — 9 patients (18 eyes — with dyscirculatory variant of glaucoma; 3rd group (control — 10 somatically healthy individuals of similar age. Following a standard ophthalmic examination techniques, as well as color Doppler mapping of the main arteries of the brain and the eyeball on the unit Acuson 128 HR/10 (USA and hypocapnic (with O2 and hypercapnic (CO2 probe.Results: In subgroup 2A patients showed significant (p <0.05 decrease in Vs in the central retinal artery and short posterior cili- ary arteries respectively 38.0% and 32.8% and increase the resistance index (RI of vessels in 21.8% and 22.6%, increase Vs in the middle cerebral artery (MCA at 11.5% and RI by 11.8% compared to the patients the third and first groups, with а hypocapnic test Vs in the MCA decreased by 35.4%, and increased with hypercapnic test for 23.0%; of the subgroup B in central retinal vein to 33.9% and 19.6%, lower Vs and RI in the vertebral artery (VA by 20,0% and 9,1% respectively, with a hypercapnic test Vs in the MCA increased by 32.2%, and decreased during hypocapnic sample at 26.0%.Conclusion: the predominance of the ability of MCA to vasoconstriction combined with reduced blood flow in central retinal artery and short posterior ciliary arteries and cause ischemica variant of glaucoma, slowing blood flow in the vertebrobasilar basin combined with a reduction of venous outflow of the of the

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

    DEFF Research Database (Denmark)

    Vorstrup, S; Hemmingsen, Ralf; Lindewald, H;

    1982-01-01

    with a spatial resolution of 1.7 cm. Based primarily on the clinical evidence and on the angiographical findings embolism was considered the pathogenetic factor in 10 cases, whereas chronic hemodynamic insufficiency rendered symptomatic by postural factors probably accounted for the symptoms in 4 patients....... Of the 14 patients, all studied days to weeks after the most recent TIA, four showed hypoperfused areas on the CBF-tomograms and with roughly the same location hypodense areas on CT-scanning, i.e. areas of complete infarction. However, an additional five patients showed reduction of CBF in areas...... 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 often harmful...

  7. Episodes of Fall Asleep During Day Time in an Elder Woman with Vascular Dementia: Impact on Cerebral Ischeamic Tolerance and Utility of ECG Holter Monitoring

    Science.gov (United States)

    Ciulla, Michele M; Acquistapace, Giulia; Paliotti, Roberta; Benfenati, Chiara; Magrini, Fabio

    2010-01-01

    Here we report the case of an 86-year-old woman with advanced dementia addressed to our service for routinary ECG Holter Monitoring (EHM) for bradycardia in AV block type I. Several day-time episodes of fall-asleep while sitting had been previously reported by the nurse and generally attributed to the dementia itself, without taking into consideration the hypothesis of an AV block. The EHM reading reported several and often subsequent pauses (561), many of them critical, the longest lasting 15,9 s with no changes in clinical condition of the patient. The results of the EHM were reported to the physicians in charge for the patient and subsequently the woman was referred to the arrhythmology unit for pace-maker device implantation. Generalizing our experience, we suggest that advanced dementia, often associated with episodes of fall-asleep, could mask a conduction disturbance causing critical pauses with syncope; therefore we suggest screening those patients for possible arrhythmic disorders. Finally, we remark that in our patient the pauses weren’t associated with a worsening of the patient as seen in the follow-up, and this fact supports the hypothesis that vascular dementia could increase cerebral ischaemic tolerance. PMID:21160915

  8. A simplified double-injection method to quantify cerebral blood flow and vascular reserve using iodine-123 IMP-SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Toyoda, Hiroshi; Nishizawa, Sadahiko; Shiozaki, Toshiki; Ueno, Makoto; Konishi, Junji [Kyoto Univ. (Japan). Graduate School of Medicine

    2002-04-01

    We developed and evaluated a simplified double-injection method for iodine-123 N-isopropyl-p-iodoamphetamine (IMP) to quantify regional cerebral blood flow (rCBF) twice in a single SPECT session. The method enabled rapid calculations of rCBF with five 10-minute SPECT scans, a fixed distribution volume (V{sub d}), and one-point arterial blood sampling to calibrate a standard input function (SIF). Sixty neurological patients were examined to measure rCBF twice in a single session of IMP-SPECT. Patients underwent frequent arterial blood sampling with two injections of IMP and acetazolamide challenge. We generated the SIF and determined the optimal V{sub d} and calibration time (t{sub cal}) for the SIF in 30 patients. Validities of the fixed t{sub cal} and V{sub d} were assessed in the remaining 30 patients. Simulation studies were also performed to evaluate the error sensitivity of the method. The optimal t{sub cal} and V{sub d} were 34 min and 30 ml/ml, respectively. The method was robust in rCBF calculation with noisy SPECT data and yielded rCBF with negligible bias and acceptable errors compared with those obtained by the double-injection method previously reported. The method can be applied to measure rCBF twice in a single SPECT session more easily and less invasively. (author)

  9. Cerebral malaria Malaria cerebral

    Directory of Open Access Journals (Sweden)

    Silvia Blair Trujillo

    2003-03-01

    Full Text Available Is the most common complication of P. falciparum malaria; nearly 90% of people who have suffered CM can recover without neurological problems. Currently there are four hypotheses that explain pathogenesis of CM: cytoadherence and sequestering of parasitized red blood cells to cerebral capillaries; rosette formation and parasitized red blood cells agglutination; production of cytokines and activation of second messengers and opening of the blood-brain barrier. However the main question remains to be answered; how the host-parasite interaction in the vascular space interferes transiently with cerebral function? Recently, the beta amyloid precursor peptide has been employed as marker of neural injury in CM. It is expected that the beta amyloid precursor peptide will help to understand the pathogenesis of CM in complicated patients of endemic areas of Colombia. La malaria Cerebral (MC es la complicación más frecuente de la malaria por P. falciparum; aproximadamente el 90% de las personas que la han padecido se recuperan completamente sin secuelas neurológicas. Aún no se conoce con claridad su patogénesis pero se han postulado cuatro hipótesis o mecanismos posibles: 1 citoadherencia y secuestro de glóbulos rojos parasitados en la microvasculatura cerebral; 2 formación de rosetas y aglutinación de glóbulos rojos parasitados; 3 producción de citoquinas y activación de segundos mensajeros y, 4 apertura de la barrera hematoencefálica. Sin embargo, queda un interrogante sin resolver aún: ¿qué proceso se lleva a cabo para que el parásito, desde el espacio microvascular, pueda interferir transitoriamente con la función cerebral? Recientemente se ha utilizado el precursor de la proteína b-Amiloide como un marcador de daño neuronal en MC; este precursor será de gran ayuda en futuras investigaciones realizadas en nuestro medio que aporten información para comprender la patogénesis de la MC.

  10. Tres anos de acidentes do trabalho em uma metalurgica: caminhos para seu entendimento

    National Research Council Canada - National Science Library

    Giglio de Oliveira Goncalves, Claudia; Dias, Adriano

    2011-01-01

    O objetivo deste artigo e descrever, atraves de estrategias metodologicas quantitativas e qualitativas, os acidentes do trabalho ocorridos em tres anos numa industria metalurgica do interior de Sao...

  11. A New Computational Model for Neuro-Glio-Vascular Coupling: Astrocyte Activation Can Explain Cerebral Blood Flow Nonlinear Response to Interictal Events.

    Directory of Open Access Journals (Sweden)

    Solenna Blanchard

    Full Text Available Developing a clear understanding of the relationship between cerebral blood flow (CBF response and neuronal activity is of significant importance because CBF increase is essential to the health of neurons, for instance through oxygen supply. This relationship can be investigated by analyzing multimodal (fMRI, PET, laser Doppler… recordings. However, the important number of intermediate (non-observable variables involved in the underlying neurovascular coupling makes the discovery of mechanisms all the more difficult from the sole multimodal data. We present a new computational model developed at the population scale (voxel with physiologically relevant but simple equations to facilitate the interpretation of regional multimodal recordings. This model links neuronal activity to regional CBF dynamics through neuro-glio-vascular coupling. This coupling involves a population of glial cells called astrocytes via their role in neurotransmitter (glutamate and GABA recycling and their impact on neighboring vessels. In epilepsy, neuronal networks generate epileptiform discharges, leading to variations in astrocytic and CBF dynamics. In this study, we took advantage of these large variations in neuronal activity magnitude to test the capacity of our model to reproduce experimental data. We compared simulations from our model with isolated epileptiform events, which were obtained in vivo by simultaneous local field potential and laser Doppler recordings in rats after local bicuculline injection. We showed a predominant neuronal contribution for low level discharges and a significant astrocytic contribution for higher level discharges. Besides, neuronal contribution to CBF was linear while astrocytic contribution was nonlinear. Results thus indicate that the relationship between neuronal activity and CBF magnitudes can be nonlinear for isolated events and that this nonlinearity is due to astrocytic activity, highlighting the importance of astrocytes in

  12. In-hospital mortality risk factors for patients with cerebral vascular events in infectious endocarditis. A correlative study of clinical, echocardiographic, microbiologic and neuroimaging findings.

    Science.gov (United States)

    González-Melchor, Laila; Kimura-Hayama, Eric; Díaz-Zamudio, Mariana; Higuera-Calleja, Jesús; Choque, Cinthia; Soto-Nieto, Gabriel I

    2015-01-01

    Cardiac complications in infectious endocarditis (IE) are seen in nearly 50% of cases, and systemic complications may occur. The aim of the present study was to determine the characteristics of inpatients with IE who suffered acute neurologic complications and the factors associated with early mortality. From January 2004 to May 2010, we reviewed clinical and imaging charts of all of the patients diagnosed with IE who presented a deficit suggesting a neurologic complication evaluated with Computed Tomography or Magnetic Resonance within the first week. This was a descriptive and retrolective study. Among 325 cases with IE, we included 35 patients (10.7%) [19 males (54%), mean age 44-years-old]. The most common underlying cardiac disease was rheumatic valvulopathy (n=8, 22.8%). Twenty patients survived (57.2%, group A) and 15 patients died (42.8%, group B) during hospitalization. The main cause of death was septic shock (n=7, 20%). There was no statistical difference among groups concerning clinical presentation, vegetation size, infectious agent and vascular territory. The overall number of lesions was significantly higher in group B (3.1 vs. 1.6, p=0.005) and moderate to severe cerebral edema were more frequent (p=0.09). Sixteen patients (45.7%) (12 in group A and 4 in group B, p=0.05) were treated by cardiac surgery. Only two patients had a favorable outcome with conservative treatment (5.7%). In patients with IE complicated with stroke, the number of lesions observed in neuroimaging examinations and conservative treatment were associated with higher in-hospital mortality. Copyright © 2014 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  13. 脑小血管病与血管性认知功能障碍的关系%Relationship between Cerebral Small Vessel Disease and Vascular Cognitive Impairment

    Institute of Scientific and Technical Information of China (English)

    何敏; 朱晓钢

    2015-01-01

    主要简述脑小血管病(cerebral small vessel disease,SVD)与血管性认知功能障碍(vascular cognitive impair-ment,VCI)的关系。SVD 包括腔隙性脑梗死、脑微出血、脑白质病变或脑白质疏松三种类型,三者均与 VCI 密切相关,均可导致认知功能下降。因 SVD 起病隐袭,在临床工作中常被忽略,早发现、早干预 SVD 对预防 VCI 至关重要。%ABSTRACT:This paper reviews the relationship between cerebral small vessel disease (SVD)and vas-cular cognitive impairment (VCI).SVD includes lacunar infarction,cerebral microbleeds,and white mat-ter lesions or leukoaraiosis.The three types of SVD are closely correlated with VCI and can result in cog-nitive decline.Because of the insidious onset,SVD is often neglected in the clinical work.Therefore,early detection and intervention of SVD are very important for the prevention of VCI.

  14. Investigation of Sleep Quality and Correlation Factors of Acute Cerebral Vascular Disease%急性脑血管病患者睡眠质量和相关因素分析

    Institute of Scientific and Technical Information of China (English)

    梅川; 王真真; 钟伟丽; 牛富生

    2012-01-01

    目的 研究急性脑血管病患者的睡眠质量和相关因素.方法 对急性脑血管病组和健康对照组进行匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQl)量表测定,比较两组的各项分值差异;进一步对急性脑血管患者进行艾森克人格特征问卷(Eysenck personality questionaire,EPQ)和简易应对方式问卷调查,并与患者的PSQl进行相关分析.结果 急性脑血管病患者PSQl平均得分13.12±2.73分,PSQl>7分者126例(54.07%).急性脑血管病组患者睡眠质量、入睡时间、睡眠时间、睡眠障碍、睡眠药物、日间功能和睡眠质量指数得分均明显高于对照组患者,差异有显著性(P均<0.001).Logistic回归分析显示,增龄、左侧病变、前循环病变是影响急性脑血管病患者睡眠质量的独立危险因素,同时急性脑血管病患者的睡眠质量与患者个性特点和积极、消极应对分值具有相关性.结论 急性脑血管病患者睡眠障碍发生率较高,其睡眠质量受年龄、左右侧别、病变血管、个性特点和应对方式等多个因素的影响.%Objective To study the sleep quality and correlation factors in acute cerebral vascular disease. Methods Two hundred and thirty-three acute cerebral vascular disease patients were evaluated by Pittsburgh sleep quality index(PSQI), Eysenck personality questionaire(EPQ) and simplified coping style questionaire. One hundred and eighty-nine persons of normal control group were evaluated by PSQI. Results The average score of PSQI of the acute cerebral vascular disease patients was 13.12±2.73, and the incidence of sleep disorder(total PSQI score>7 points) was 54.07%. There was significant difference(P<0.001) between the acute cerebral vascular disease patients and the control group in the score of the sleep index and six factors of PSQI. The result of logistic regression analysis indicates that age, diseased region and criminal blood vessel were independently

  15. Acidentes de trabalho com mototaxistas Occupational accidents among mototaxi drivers

    Directory of Open Access Journals (Sweden)

    Camila Rego Amorim

    2012-03-01

    Full Text Available A utilização da motocicleta como meio de trabalho vem contribuindo para o aumento no número dos acidentes de trânsito e se constituindo em acidentes de trabalho para os mototaxistas. O objetivo deste estudo foi estimar a incidência anual de acidentes de trabalho entre mototaxistas cadastrados em Feira de Santana, BA. Trata-se de um estudo de caráter descritivo e censitário. Foram entrevistados 267 profissionais dos 300 cadastrados na Secretaria Municipal de Transporte e Trânsito - SMTT, através de questionário estruturado. Procedeu-se à análise descritiva e foram estimadas incidências anuais de acidentes de trabalho segundo as variáveis de interesse. Calcularam-se os riscos relativos e, como medida de significância estatística, utilizou-se o teste de qui-quadrado de Pearson e o teste exato de Fisher, adotando-se p The use of motorcycles as a means of work has contributed to the increase in traffic accidents, in particular, mototaxi accidents. The aim of this study was to estimate and characterize the incidence of occupational accidents among the mototaxis registered in Feira de Santana, BA. This is a cross-sectional study with descriptive and census data. Of the 300 professionals registered at the Municipal Transportation Service, 267 professionals were interviewed through a structured questionnaire. Then, a descriptive analysis was conducted and the incidence of accidents was estimated based on the variables studied. Relative risks were calculated and statistical significance was determined using the chi-square test and Fisher's exact test, considering p < 0.05. Logistic regression was used in order to perform simultaneous adjustment of variables. Occupational accidents were observed in 10.5% of mototaxis. There were mainly minor injuries (48.7%, 27% of them requiring leaves of absence from work. There was an association between the days of work per week, fatigue in lower limbs and musculoskeletal complaints, and accidents

  16. Acidentes múltiplos como sintoma neurótico

    Directory of Open Access Journals (Sweden)

    Cicero Christiano de Sousa

    1947-06-01

    Full Text Available Assinalando o grande desenvolvimento atual da Medicina psicossomática, o A. chama a atenção para os casos em que a ação psicopatógena é indireta: do comportamento do doente resulta um dano qualquer ao seu organismo. Após recordar alguns casos na literatura cita o trabalho de Marbe que estabeleceu claramente, por meios estatísticos, que há pessoas mais sujeitas a acidentes do que outras. Para o A., de acordo com a gênese, os acidentes podem ser: 1 puramente casuais; 2 dependentes de falta de habilidade do indivíduo, ou de defeitos neurológicos; 3 constituir verdadeiros "atos falhados", comparáveis a lapsos da memória ou da linguagem, e causados por um conflito intrapsíquico de tendências conscientes ou inconscientes. Quando muito numerosos, os atos do último tipo constituem verdadeiro sintoma neurótico e evidentemente, só poderão ser afastados pela psicoterapia. O A. refere o caso de um operário que, em pouco mais de um ano de observação, sofreu 17 acidentes, de gravidade geralmente pequena. A tendência a se ferir era notada desde a adolescência. O exame mental revelou indivíduo com traços neuróticos acentuados: irritabilidade, dúvidas, inveja, ansiedade, fobias. O psico-diagnóstico de Rorschach confirmou tratar-se de um neurótico; em particular, todas as respostas são determinadas pela forma, sendo O: O o tipo de vivência; há 91% de F+; o tipo de percepção é G: (D: Dd; a seqüência é rígida; o choque de cores evidente no cartão II. Procurando dar uma explicação psicanalítica para o caso, e diante dos dados relativos à familia do paciente e à sua vida anterior, admite o A. que os acidentes indicam: 1 no plano mais profundo, uma agressividade pré-edipiana introjetada contra a mãe; 2 mais superficialmente, autocastração para se castigar dos desejos contidos no complexo de Édipo e evitar que se realizem; 3 mais superficialmente ainda, há a considerar o lucro secundário do sintoma, relativamente

  17. 脑血管介入术后皮质盲的临床分析%Acute transient cortical blindness occurring after cerebral angiography and vascular interventional management: a clinical analysis

    Institute of Scientific and Technical Information of China (English)

    江泓; 杨文洁; 胡锦清; 顾俊伟; 张伟华; 杨燕敏; 沈建康; 林东

    2013-01-01

    Objective To discuss the diagnosis, the possible etiologic factors and the corresponding prevention measures of the cortical blindness that occurs after cerebral angiography and vascular interventional management. Methods During the period from August 2007 to August 2012, cerebral angiography and vascular interventional management were carries out in 2 547 patients. Among the 2 547 cases, postoperative cortical blindness occurred in 8 cases. The clinical data were analyzed. Results After cerebral angiography and vascular interventional management, 8 cases developed transient cortical blindness, and the mean amount of contrast medium used in the performance of cerebral angiography and intervention was 107 ml. After medication the clinical symptoms disappeared completely, and all the patients recovered well. Conclusion In order to reduce the occurrence of cortical blindness after cerebral angiography and intervention, it is necessary to reduce the operation time, to employ non-ionic contrast medium and to use the contrast medium as little as possible.(J Intervent Radiol, 2013, 22: 008-011)%目的 探讨脑血管造影和介入治疗术后一过性皮质盲的诊断、可能的病因及预防措施.方法 2007年8月至2012年8月对2547例患者行脑血管造影和介入治疗,筛选出术后出现皮质盲的患者共8例次,并对患者的临床资料进行分析.结果 行脑血管造影和介入治疗共2547例患者,其中8例次术后出现了一过性皮质盲,平均对比剂用量107 ml.所有患者经治疗后症状消失,预后良好.结论 为了减少造影术后皮质盲发生率,应尽量减少造影时间,常规使用非离子型对比剂,降低对比剂使用总量.

  18. Contribució de l'Amino Oxidasa Sensible a Semicarbazida en el dany vascular: implicació en la malaltia d'Alzheimer i l'Angiopatia Cerebral Amiloide

    OpenAIRE

    Hernández Guillamón, María del Mar

    2005-01-01

    L'objectiu principal de la present tesis doctoral ha estat l'estudi de la possible contribució de l'Amino Oxidasa Sensible a Semicarbazida (SSAO) en el dany vascular, la seva implicació en l'Angiopatia Cerebral Amiloide (CAA) i la Malaltia d'Alzheimer (AD). La SSAO és un enzim multifuncional, al qual se li han atribuït diferents papers biològics depenent del teixit on es localitzi. La seva expressió es troba amplament distribuïda en mamífers, especialment en teixits altament vascularitzats, a...

  19. ESTUDIO COMPARATIVO DEL EFECTO DE CRANEO-ACUPUNTURA VS ACUPUNTURA CORPORAL, EN PACIENTES CON SECUELAS DE ENFERMEDAD VASCULAR CEREBRAL EN EL HOSPITAL REGIONAL DEL INSTITUTO DE SEGURIDAD SOCIAL AL SERVICIO DE LOS TRABAJADORES DEL ESTADO DE PUEBLA

    OpenAIRE

    MENDEZ MENDEZ, NAZARIO CELSO

    2011-01-01

    ESTUDIO COMPARATIVO DEL EFECTO DE LA CRANEOACUPUNTURA VS ACUPUNTURA CORPORAL, EN PACIENTES CON SECUELAS DE ENFERMEDAD VASCULAR CEREBRAL EN EL HOSPITAL REGIONAL DEL INSTITUTO DE SEGURIDAD SOCIAL AL SERVICIO DE LOS TRABAJADORES DEL ESTADO DE PUEBLA. LAS SECUELAS DE EVC SON UN PROBLEMA DE SALUD PUBLICA, CON MAYOR FRECUENCIA DE LA ISQUEMIA 81.25 POR CIENTO POR CIENTO Y EN SEGUNDO LUGAR LA HEMORRÁGICA CON EL 18.75 POR CIENTO, EL SEXO FEMENINO ES LA MAS FRECUENTE Y LA EDAD MAS AFECTADA ES DE LO...

  20. ESTUDIO COMPARATIVO DEL EFECTO DE CRANEO-ACUPUNTURA VS ACUPUNTURA CORPORAL, EN PACIENTES CON SECUELAS DE ENFERMEDAD VASCULAR CEREBRAL EN EL HOSPITAL REGIONAL DEL INSTITUTO DE SEGURIDAD SOCIAL AL SERVICIO DE LOS TRABAJADORES DEL ESTADO DE PUEBLA

    OpenAIRE

    MENDEZ MENDEZ, NAZARIO CELSO

    2011-01-01

    ESTUDIO COMPARATIVO DEL EFECTO DE LA CRANEOACUPUNTURA VS ACUPUNTURA CORPORAL, EN PACIENTES CON SECUELAS DE ENFERMEDAD VASCULAR CEREBRAL EN EL HOSPITAL REGIONAL DEL INSTITUTO DE SEGURIDAD SOCIAL AL SERVICIO DE LOS TRABAJADORES DEL ESTADO DE PUEBLA. LAS SECUELAS DE EVC SON UN PROBLEMA DE SALUD PUBLICA, CON MAYOR FRECUENCIA DE LA ISQUEMIA 81.25 POR CIENTO POR CIENTO Y EN SEGUNDO LUGAR LA HEMORRÁGICA CON EL 18.75 POR CIENTO, EL SEXO FEMENINO ES LA MAS FRECUENTE Y LA EDAD MAS AFECTADA ES DE LO...

  1. 脑卒中MRA表现与血管性痴呆的相关性研究%The relationship between MRA imaging and vascular dementia of patients with cerebral stroke

    Institute of Scientific and Technical Information of China (English)

    韩培海; 李成君; 高思山

    2014-01-01

    Objective To study the relationship between MRA imaging and vascular dementia (VD) of patients with cerebral stroke (CS).Methods Patients who had CS more than 6 months were divided into vascular dementia group and no vascular dementia group according to results of Minimum Mental State Examination (MMSE) and Clinical Dementia Rating (CDR).MRA data of two groups were reviewed and analyzed retrospectively.Results The rates of MRA blocking,stricture and sclerosis of back circulation system,anterior cerebral artery,deep perforators of middle cerebral artery,brain artery terminal branch in VD group were more than those in no vascular dementia group (P < 0.05).Blocking,stricture and sclerosis of vertebral artery and basilar artery was evidence (P < 0.05).The rates of blocking,stricture and sclerosis of back circulation system,anterior cerebral artery in patients with cerebral amyloid angiopathy were significantly higher than those in no vascular dementia group (P < 0.05).Conclusions MRA blocking,stricture and sclerosis of back circulation system,anterior cerebral artery,brain artery terminal branch can be used as predictive indexes of VD,blocking,stricture and sclerosis of vertebral artery and basilar artery is important to VD.%目的 探讨脑梗死患者头颅MRA表现与血管性痴呆(VD)的相关性.方法 对卒中半年以上的患者,根据简易精神状态检查量表(MMSE)、临床痴呆评定量表(CDR)评分分为VD组及脑卒中后无痴呆(SWD)组,并回顾性分析两组在卒中的MRA资料.结果 VD组中后循环系统、大脑前动脉、大脑中动脉的深穿支及大脑动脉终未分支MRA闭塞、狭窄及硬化率明显高于SWD组(P<0.05).其中后循环中椎动脉及基底动脉闭塞、狭窄及硬化最为明显(P<0.05),脑血管淀粉样变患者后循环系统、大脑前动脉发生闭塞、狭窄及硬化的机率明显增高(P<0.05).结论 后循环系统、大脑前动脉及大脑动脉终未分支MRA闭塞、狭窄及

  2. Modified constraint-induced movement therapy and modified forced-use therapy for stroke patients are both effective to promote balance and gait improvements Terapia de constrição com indução do movimento e terapia de uso forçado modificadas em pacientes pós-acidente vascular encefálico são eficientes em promover melhora do equilíbrio e da marcha

    Directory of Open Access Journals (Sweden)

    Amanda C. Fuzaro

    2012-04-01

    Full Text Available BACKGROUND: Previous studies show that chronic hemiparetic patients after stroke, presents inabilities to perform movements in paretic hemibody. This inability is induced by positive reinforcement of unsuccessful attempts, a concept called learned non-use. Forced use therapy (FUT and constraint induced movement therapy (CIMT were developed with the goal of reversing the learned non-use. These approaches have been proposed for the rehabilitation of the paretic upper limb (PUL. It is unknown what would be the possible effects of these approaches in the rehabilitation of gait and balance. OBJECTIVES: To evaluate the effect of Modified FUT (mFUT and Modified CIMT (mCIMT on the gait and balance during four weeks of treatment and 3 months follow-up. METHODS: This study included thirty-seven hemiparetic post-stroke subjects that were randomly allocated into two groups based on the treatment protocol. The non-paretic UL was immobilized for a period of 23 hours per day, five days a week. Participants were evaluated at Baseline, 1st, 2nd, 3rd and 4th weeks, and three months after randomization. For the evaluation we used: The Stroke Impact Scale (SIS, Berg Balance Scale (BBS and Fugl-Meyer Motor Assessment (FM. Gait was analyzed by the 10-meter walk test (T10 and Timed Up & Go test (TUG. RESULTS: Both groups revealed a better health status (SIS, better balance, better use of lower limb (BBS and FM and greater speed in gait (T10 and TUG, during the weeks of treatment and months of follow-up, compared to the baseline. CONCLUSION: The results show mFUT and mCIMT are effective in the rehabilitation of balance and gait.CONTEXTUALIZAÇÃO: Pacientes hemiparéticos crônicos, após acidente vascular encefálico (AVE, apresentam incapacidade para executar movimentos no hemicorpo parético. Essa incapacidade é reforçada positivamente por tentativas fracassadas de movimento, conceito chamado desuso aprendido. A terapia de uso forçado (FUT e a terapia de constri

  3. Enfermagem: características dos profissionais que sofrem acidentes com material biológico

    OpenAIRE

    2015-01-01

    O acidente de trabalho é o que ocorre pelo exercício do trabalho a serviço da empresa ou pelo exercício do trabalho. O objetivo deste estudo é descrever as características dos profissionais da enfermagem que sofrem acidentes de trabalho com material biológico. Trata-se de uma pesquisa bibliográfica integrativa desenvolvida no banco de dados do LILACS e na Biblioteca Virtual em Saúde (BVS). O período da pesquisa foi de 2010 a 2015. Os descritores foram: Acidentes de trabalho, Material biológic...

  4. Incapacidade por traumatismo raquimedular secundário a acidentes de trânsito

    OpenAIRE

    Brito,Jon Mark Praga Xavier De

    2011-01-01

    OBJETIVO: Analisar as vítimas de acidentes de trânsito que apresentam incapacidade decorrente de lesão medular. MÉTODOS: Foram avaliados os prontuários de 719 vítimas de acidentes de trânsito que solicitaram benefício devido as lesões decorrentes e selecionadas as que sofreram traumatismo raquimedular. As variáveis idade, sexo, tipo de acidente, lesões decorrentes, e grau de incapacidade de acordo com a Classificação Internacional de Funcionalidade, Incapacidade e Saúde foram então analisadas...

  5. Effects on cerebral circulation of decimeter wave therapy and variable magnetic field in patients with hemiparesis of vascular and traumatic origin

    Energy Technology Data Exchange (ETDEWEB)

    Strelkova, N.I.; Gavrilkov, A.T.; Dyuzhilova, N.F.; Strel' tsova, Ye.N.

    1981-08-01

    Both the artherosclerotic process in the case of cerebrovascular accident and cerebral trauma lead to impairment of cerebral hemodynamics, blood and spinal fluid circulation, macroscopic and microscopic disturbances. Electromagnetic waves in the decimeter range (decimeter waves - DMW) and a variable magnetic field (VMF) were used to treat these processes. Treatment was delivered directly to the region of the cerebral lesion, on the basis of the penetrating capacity of DMW and VMF to a relatively great depth (7 to 9 and 4 to 7 cm, respectively). Results of these treatments are discussed.

  6. Brief Screening of Vascular Cognitive Impairment in Patients With Cerebral Autosomal-Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy Without Dementia

    OpenAIRE

    2016-01-01

    Background and Purpose - Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a monogenic form of cerebral small vessel disease leading to early-onset stroke and dementia, with younger patients frequently showing subclinical deficits in cognition. At present, there are no targeted cognitive screening measures for this population. However, the Brief Memory and Executive Test (BMET) and the Montreal Cognitive Assessment (MoCA) have shown utilit...

  7. Regional cerebral blood flow single-photon emission tomography with {sup 99m}Tc-HMPAO and the acetazolamide test in the evaluation of vascular and Alzheimer`s dementia

    Energy Technology Data Exchange (ETDEWEB)

    Pavics, L.; Csernay, L. [Department of Nuclear Medicine, Albert Szent-Gyoergyi Medical University, Szeged (Hungary); Gruenwald, F.; Reichmann, K.; Menzel, C.; Schomburg, A.G.; Overbeck, B.; Biersack, H.J. [Department of Nuclear Medicine, University of Bonn (Germany); Horn, R.; Kitschenberg, A.; Hartmann, A. [Department of Neurology, University of Bonn (Germany)

    1999-03-01

    The diagnostic potential of technetium-99m hexamethylpropylene amine oxime (HMPAO) following systemic administration of the cerebral vasodilator acetazolamide (acetazolamide test) was evaluated by regional cerebral blood flow (rCBF) single-photon emission tomography (SPET) in patients with Alzheimer`s disease (AD) or vascular dementia (VD). An initial, high-resolution SPET study was performed with {sup 99m}Tc-HMPAO, and after 2 days the patients were re-evaluated with {sup 99m}Tc-HMPAO following systemic administration of acetazolamide. Reconstructed SPET slices were evaluated visually and semiquantitatively by a semi-automatic rCBF map method. When {sup 99m}Tc-HMPAO alone was used, bilateral hypoperfusion was found in the temporal and/or parietal regions in 33% (6/18) of the VD patients and in 70% (23/33) of the AD patients. The corresponding data obtained by quantitative evaluation were 41% (7/17) and 71% (15/21), respectively. The vascular reserve capacity, as determined with the acetazolamide test, was preserved visually in 22% (4/18) and quantitatively in 29% (5/17) of the VD patients, but in 73% (24/33) and 76% (16/21) of the AD patients. The differences in the perfusion patterns between the VD and AD patients were statistically significant (P<0.01, Fischer`s exact test). Of the VD patients with hypoperfusion (bilateral temporal and/or parietal), 4/6 (67%, visual evaluation) and 4/7 (57%, quantitative evaluation) had a decreased vascular reserve capacity as determined with the acetazolamide test. In the AD group of patients the corresponding results were 3/23 (13%) and 4/15 (27%). It is concluded that the acetazolamide test is promising in rCBF SPET to differentiate VD from AD. (orig.) With 4 figs., 3 tabs., 29 refs.

  8. Cerebrovascular hemodynamics in patients with cerebral arteriosclerosis

    Institute of Scientific and Technical Information of China (English)

    Jianbo Yang; Changcong Cui; Chengbin Wu

    2011-01-01

    The present study observed hemodynamic changes in 26 patients with cerebral arteriosclerosis using a cerebral circulation dynamics detector and transcranial Doppler.In patients with cerebral arteriosclerosis the blood supply and flow rate in the bilateral carotid arteries and the blood flow rate in the anterior cerebral and middle cerebral arteries were similar to normal controls, but the cerebral vascular resistance, critical pressure and pulsatility index were increased, and cerebral arterial elasticity and cerebral blood flow autoregulation were decreased.Compared with the lesioned hemisphere of patients with cerebral infarction, the total blood supply and blood flow rate of patients with cerebral arteriosclerosis were higher.Compared with normal subjects, patients with cerebral arteriosclerosis exhibited cognitive disturbances, mainly in short-term memory, attention, abstract capability, and spatial and executive dysfunction.Results showed that cerebral arteriosclerosis does not directly affect the blood supply of a cerebral hemisphere, but affects cognitive function.The increased cerebral vascular resistance and reduced autoregulation of cerebral blood vessels may be important hemodynamic mechanisms of arteriosclerosis-induced cerebral infarction.

  9. Acidentes de trânsito em Belo Horizonte

    OpenAIRE

    Lucia Maria Miana Mattos Paix?o

    2014-01-01

    Os acidentes de trânsito (AT) constituem relevante problema de saúde pública global devido à elevada morbimortalidade, decorrente do número crescente de veículos, precariedade do espaço urbano, alterações de estilos de vida e vulnerabilidade de determinados grupos de usuários de via. O estudo teve como objetivo avaliar a contribuição de fontes distintas de informação na análise dos AT e suas vítimas, caracterizando o perfil e identificando grupos vulneráveis entre usuários das vias urbanas em...

  10. Estudo comparativo entre a relação do hemisfério acometido no acidente vascular encefálico e a evolução funcional em indivíduos destros Comparative study on the relationship between stroke hemisphere and functional evolution in right-handed individuals

    Directory of Open Access Journals (Sweden)

    MC Voos

    2008-04-01

    Full Text Available OBJETIVO: O hemisfério esquerdo é dominante para o controle motor e o direito para a orientação espacial. Este estudo visou testar as hipóteses de que a lesão à esquerda causa maior prejuízo da movimentação voluntária e a lesão à direita resulta em perda na atenção espacial e no controle postural. Indivíduos com lesão à esquerda foram comparados com indivíduos com lesão à direita, com relação ao comprometimento inicial e recuperação três meses pós-lesão. MATERIAIS E MÉTODOS: Vinte e dois indivíduos destros com lesão isquêmica no território da artéria cerebral média (11 à esquerda e 11 à direita foram avaliados mensalmente nos três primeiros meses pós-lesão em termos de sensibilidade, tônus, força, postura, marcha, independência funcional e atenção espacial. RESULTADOS: Com relação ao comprometimento inicial, não houve diferença na sensibilidade, tônus, força, postura e atenção dos grupos. O grupo com lesão à esquerda apresentou pior desempenho inicial nos testes de marcha e de independência funcional. Com relação à taxa de recuperação, não houve diferenças na sensibilidade, tônus, força, postura, atenção e independência funcional dos dois grupos. Porém, a taxa de recuperação da marcha do grupo com lesão à esquerda foi inferior à do outro grupo. CONCLUSÕES: Foi confirmada a hipótese de que a lesão à esquerda causa maior comprometimento da movimentação voluntária, representada pela marcha e independência funcional, que a lesão à direita. Não foi obtida, no entanto, evidência de que a lesão à direita compromete de modo mais intenso a atenção espacial e a manutenção da postura que a lesão à esquerda.OBJECTIVE: The left hemisphere is supposed to be dominant for motor control and the right hemisphere dominant for spatial orientation. This study aimed to test the hypothesis that left-side lesions cause greater impairment of voluntary movement, while right

  11. The changes of cognitive function in elderly patients with cerebral vascular stenosis%老年脑血管狭窄患者认知功能的改变及影响因素

    Institute of Scientific and Technical Information of China (English)

    王小永; 于翔; 李永强; 王军文; 任敏

    2016-01-01

    Objective To observed and analyze the changes of cognitive function in elderly patients with cere-bral vascular stenosis.Methods A total of 200 elderly patients with ischemic cerebral vascular disease were selected as research objects.The cerebral vascular stenosis,risk factors of cerebrovascular disease ,scores of mini-mentalstateexami-nation (MMSE)and incidence of cognitive dysfunction were observed and analyzed.Results The age,the rate of mer-ged diabetes,the rate of merged hypertension,the plasma homocysteine (Hcy),plasma fibrinogen,the serum total cho-lesterol of the patients with cerebral vascular stenosis were significantly higher than those ofthe patients without cerebral vascular stenosis (t =4.223,3.812,3.635,χ2 =33.734,9.814,all P <0.05 ).The MMSE score,immediate recall score,attention and calculationscore,delayed recall score of the patients with mild stenosis were significantly higher than those of patients with moderate stenosis or severe stenosis.The MMSE score and delayed recall score of the patients with moderate stenosis were significantly higher than those of patients with severe stenosis.The incidence of cognitive dys-function in the patients with severe stenosis was significantly higher than that in patients with moderate stenosis,and the incidence of cognitive dysfunction in patients with moderate stenosis was significantly higher than that in patients with mild stenosis (P <0.05).Logistic multivariate regression analysis showed that there were a statistical relation between age (OR =1.397),merged hypertension (OR =1.456),plasma Hcy level (OR =1.658)and degree of cerebral vascu-lar stenosis (OR =2.138)had a to cognitive dysfunction of patients (all P <0.05).Conclusions Cerebral vascular stenosis may be involved in the pathological processes of cognitive impairment,and can be used as an secondary indicati-or to predict the risk of cognitive dysfunction in the elderly patients.%目的:观察老年脑血管狭窄患者认知功能的改变,

  12. Heart valve papillary fibroelastoma associated with cardioembolic cerebral events Fibroelastoma papilífero de valva cardíaca associado a eventos cerebrais cardioembólicos

    Directory of Open Access Journals (Sweden)

    Luciano Cabral Albuquerque

    2011-12-01

    Full Text Available Papillary fibroelastomas of the heart valves are benign, slow-growing, rare tumors of the heart. This tumor represents a potential cause of systemic embolism, stroke, myocardial infarction and sudden death. Early diagnosis is very important, as surgical excision of these tumors can prevent cerebrovascular and cardiovascular complications. Diagnosis is usually made by transesophageal echocardiogram. We describe two cases of patients with papillary fibroelastomas causing cardioembolic cerebral events, which underwent successful surgical treatment. The authors present a brief review of the literature.Fibroelastoma papilífero é um tumor benigno, raro e de crescimento lento, que geralmente tem origem no endocárdio das valvas cardíacas. Este tumor representa uma causa potencial de embolia sistêmica, infarto agudo do miocárdio, acidente vascular cerebral e morte súbita. O diagnóstico precoce é fundamental, já que a excisão cirúrgica pode evitar complicações cerebrovasculares e cardiovasculares. O diagnóstico geralmente é feito pelo ecocardiograma transesofágico. Neste trabalho, são descritos dois casos de pacientes com fibroelastoma papilífero de valva aórtica, causando eventos cerebrais cardioembólicos, que foram submetidos com sucesso a tratamento cirúrgico. Apresenta-se, ainda, uma sucinta revisão da literatura.

  13. Clinical Neuroimaging of cerebral ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawara, Jyoji [Nakamura Memorial Hospital, Sapporo (Japan)

    1999-06-01

    Notice points in clinical imaging of cerebral ischemia are reviewed. When cerebral blood flow is determined in acute stage of cerebral embolism (cerebral blood flow SPECT), it is important to find area of ischemic core and ischemic penumbra. When large cortex area is assigned to ischemic penumbra, thrombolytic therapy is positively adapted, but cautious correspondence is necessary when ischemic core is recognized. DWI is superior in the detection of area equivalent to ischemic core of early stage, but, in imaging of area equivalent to ischemic penumbra, perfusion image or distribution image of cerebral blood volume (CBV) by MRI need to be combined. Luxury perfusion detected by cerebral blood flow SPECT in the cases of acute cerebral embolism suggests vascular recanalization, but a comparison with CT/MRI and continuous assessment of cerebral circulation dynamics were necessary in order to predict brain tissue disease (metabolic abnormality). In hemodynamic cerebral ischemia, it is important to find stage 2 equivalent to misery perfusion by quantification of cerebral blood flow SPECT. Degree of diaschisis can indicate seriousness of brain dysfunction for lacuna infarct. Because cerebral circulation reserve ability (perfusion pressure) is normal in all areas of the low cerebral blood flow by diaschisis mechanism, their areas are easily distinguished from those of hemodynamic cerebral ischemia. (K.H.)

  14. Protein kinase C inhibition prevents upregulation of vascular ET(B) and 5-HT(1B) receptors and reverses cerebral blood flow reduction after subarachnoid haemorrhage in rats

    DEFF Research Database (Denmark)

    Beg, Saema S; Hansen-Schwartz, Jacob A; Vikman, Petter J;

    2007-01-01

    type 1B (5-HT(1B)) receptor upregulation and prevent the associated cerebral blood flow (CBF) reduction. The PKC inhibitor RO-31-7549 or vehicle was injected intracisternally after the induced SAH in rats (n=3 to 10 in each groups for each method). The involvement of the PKC isoforms was investigated...... by quantitative real-time polymerase chain reaction and immunohistochemistry, respectively. Administration of RO-31-7549 prevented the upregulated contraction elicited by application of ET-1 and 5-CT in cerebral arteries and kept the ET(B) and 5-HT(1B) receptor mRNA and protein levels at pre-SAH levels. Regional...

  15. Patología cerebro-vascular hemorrágica en adultos asociada al consumo de cocaína Cerebral haemorrhage in adults associated with the use of cocaine

    Directory of Open Access Journals (Sweden)

    M. Blanco

    2005-07-01

    Full Text Available La cocaína es la segunda droga de comercio ilegal más consumida en España después del cannabis. El número de pacientes atendidos en los servicios de urgencias tras consumir cocaína y los casos de muerte secundarios al consumo de la misma han ido aumentando hasta multiplicarse por seis en los últimos años. El consumo de este alcaloide ocasiona efectos nocivos, constatados sobre diferentes órganos y sistemas corporales, e incluso la muerte. A nivel del SNC destaca, por su gravedad e incidencia, la patología cerebro-vascular hemorrágica (PCVH. Este tipo de cuadro se halla asociado al consumo de drogas ilícitas entre el 9,5% y el 34% de los accidentes vasculares en menores de 45 años, siendo la cocaína la más frecuentemente implicada en su presentación. Por otro lado, la rotura de un aneurisma o malformación arteriovenosa se ha detectado hasta en el 50% de los pacientes con PCVH secundarios al consumo de cocaína. Presentamos tres casos de muerte súbita en adultos por patología cerebro-vascular hemorrágica asociada al consumo de cocaína.Cocaine is the second most frequent illegal drug consumed in Spain after cannabis. A significant increase has occurred in the number of individuals treated in emergency departments after cocaine use just as in the number of cocaine-related deaths. These rates have been actually multiplied by six in the latest years. Cocaine causes injury in different organ systems, even death. In the CNS the use of cocaine is frequently associated with cerebral haemorrhage. Stroke in young adults below 45 years is usually related to drug use between 9,5% and 34% of cases, and cocaine is the most frequently mentioned drug. Otherwise, even 50% of cocaine-related stroke is the result of rupture of saccular aneurysms involving the arteries at the base of the brain and vascular malformation. In this paper, we present three cases of sudden death in adults due to cerebral haemorrhage associated with cocaine use.

  16. Vascular Cures

    Science.gov (United States)

    ... Contact Us Vascular Disease What is Vascular Disease? Education and Awareness Vascular Diseases Abdominal Aortic Aneurysm Aortic Dissection Arteriovenous Malformation Atherosclerosis Buerger's Disease Carotid Artery Disease ...

  17. Prevalência e fatores associados a acidentes de trânsito com mototaxistas

    Directory of Open Access Journals (Sweden)

    Gilmara Celli Maia de Almeida

    2016-04-01

    Full Text Available RESUMO Objetivo: identificar a prevalência de acidentes motociclísticos envolvendo mototaxistas e fatores associados. Método: estudo transversal e exploratório, com aplicação de questionários aos mototaxistas das 32 praças de Caicó, Rio Grande do Norte, Brasil (N=420. Resultados: os mototaxistas têm alta carga horária de trabalho diária (12 horas em média e foi verificado que 63,6% já se envolveram em pelo menos um acidente motociclístico. A ocorrência de acidentes motociclísticos foi associada significativamente apenas com escolaridade (p<0,001, não havendo associação significativa com as demais variáveis, tais como idade (p=0,132, tempo de serviço (p=0,744 e carga horária de trabalho (p=0,830. Conclusão: é necessário implementar ações preventivas e educativas com os mototaxistas e usuários do serviço acerca dos acidentes e condutas emergenciais, devido à constante exposição a acidentes durante sua rotina de trabalho.

  18. Fatores associados a acidentes de trabalho envolvendo trabalhadores informais do comércio

    Directory of Open Access Journals (Sweden)

    Marcela Andrade Rios

    2015-06-01

    Full Text Available O estudo objetivou estimar a incidência de acidentes de trabalho não fatais sobre trabalhadores informais do comércio e analisar os fatores associados a esses eventos quanto aos aspectos sociodemográficos, ocupacionais, condições laborais e de saúde. Realizou-se estudo transversal com 434 trabalhadores em área comercial do Município de Jequié, Bahia, Brasil, em 2013. A regressão logística foi utilizada para avaliar os possíveis fatores associados ao acidente. Estimou-se a incidência de acidentes de trabalho (nos últimos 12 meses em 32,3%, e a análise multivariada revelou maior chance de ocorrência de acidente entre trabalhadores do sexo masculino (OR = 1,61, jovens (OR = 4,62, comerciantes de carnes/frangos (OR = 9,55 e aqueles que apresentam alto esforço físico (OR = 1,71. Com a análise dos resultados, verifica-se a necessidade de políticas públicas voltadas para a prevenção de acidentes no setor informal comércio.

  19. Comparison of MEK/ERK pathway inhibitors on the upregulation of vascular G-protein coupled receptors in rat cerebral arteries

    DEFF Research Database (Denmark)

    Sandhu, Hardip; Ansar, Saema; Edvinsson, Lars

    2010-01-01

    on translational level and increased respective contractions. The prostanoid TP receptor mediated contraction curve was left-wards shifted by organ culture. Organ culture was associated with elevated pERK1/2 in the vascular smooth muscle cells: the MEK1/2 inhibitor U0126 attenuated the endothelin ET(B) receptor...

  20. Initial experience with a reversal-of-flow cerebral protection device in carotid angioplasty Experiência inicial com dispositivo de reversão de fluxo para proteção cerebral na angioplastia carotídea

    Directory of Open Access Journals (Sweden)

    Sidnei José Galego

    2013-03-01

    Full Text Available PURPOSE: To report initial findings with the GORE Flow Reversal System®, with a focus on major/minor adverse events in the 30 first postoperative days. METHODS: The first 24 patients submitted to carotid angioplasty using the GORE system, from June 2010 to May 2012, were retrospectively assessed with regard to indications, anatomic details, technical difficulties, and early clinical outcomes, including major (stroke, death, acute myocardial infarction and minor (hematoma adverse events. RESULTS: Systemic hypertension was present in 100% of the patients, diabetes mellitus in 58.3%, and coronary disease in 37.5%. Type II aortic arch was encountered in 62.5% of the patients and atherosclerotic lesion predominantly at the carotid bifurcation affecting the internal and common carotid arteries in 79.2%. Angiographic data revealed contralateral carotid arteries with OBJETIVO: Relatar os achados iniciais da utilização do GORE Flow Reversal System® (Sistema de Fluxo de Reversão, com foco em eventos adversos maiores/menores nos primeiros 30 dias do pós-operatório. MÉTODOS: Os primeiros 24 pacientes submetidos a angioplastia carotídea com a utilização do sistema GORE, de junho de 2010 a maio de 2012, foram avaliados retrospectivamente com relação a indicações, detalhes anatômicos, dificuldades técnicas e desfechos clínicos imediatos, incluindo eventos adversos maiores (acidente vascular cerebral, morte, infarto agudo do miocárdio e menores (hematoma. RESULTADOS: Hipertensão sistêmica estava presente em 100% dos pacientes, diabete melito em 58,3% e doença coronariana em 37,5%. Arco aórtico tipo II foi encontrado em 62,5% dos pacientes e lesão de aterosclerose predominantemente na bifurcação carotídea que afeta as artérias carótidas internas e comuns em 79,2%. Dados angiográficos revelaram artérias carótidas contralaterais com estenose <50% em 95,8% de casos e preservação de fluxo sanguíneo cerebral em 95,8%. Todos os

  1. Demographic features and neuropsychological correlates in a cohort of 200 patients with vascular cognitive decline due to cerebral small vessel disease

    Directory of Open Access Journals (Sweden)

    Thomas Gregor Issac

    2016-01-01

    Full Text Available Introduction: Vascular dementia is the second most common form of dementia and is potentially reversible. Small vessel disease (SVD closely mimics degenerative dementia in view of its sub-acute onset and progressive course. Therefore, unlike large vessel disease, Hachinski Ischemic scale score may not always reflect vascular cognitive decline resulting in diagnostic and therapeutic confusions. Therefore, there is a need for detailed neuropsychological assessment for various cognitive domains for early identification of vascular cognitive decline as it carries a very good long term prognosis for cognitive morbidity, unlike degenerative dementias. Patients and Methods: This prospective study involves thorough domain based neuropsychological assessment of patients with a radiological diagnosis of SVD involving the following parameters-digit forward and backward, category fluency, color trails, stick test, logical memory test, and bender gestalt test. Magnetic resonance imaging scans done using 3-tesla machines and SVD graded using Fazekas visual scale. Results: The mean Hachinskis score was less sensitive for differentiating vascular dementia from degenerative dementia. However, the domain based neuropsychological scores were highly sensitive showing statistically significant impairment in all 6 domains tested and compared with Fazekas 1-3 grades in imaging. Discussion and Conclusion: This study aimed at establishing an early diagnosis of vascular mild cognitive impairment using domain wise neuropsychological testing and correlating it with radiological scores. Hachinskis score is more sensitive for large vessel disease in view of acute onset and step-like progression as against steady progression in SVD. However, domain-wise testing was highly sensitive in identifying early cognitive impairment in patients with SVD, and early therapeutic interventions are highly rewarding.

  2. Ultrasound -- Vascular

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Ultrasound - Vascular Vascular ultrasound uses sound waves to evaluate ... the limitations of Vascular Ultrasound? What is Vascular Ultrasound? Ultrasound is safe and painless, and produces pictures ...

  3. Ultrasound -- Vascular

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Ultrasound - Vascular Vascular ultrasound uses sound waves to evaluate the ... are the limitations of Vascular Ultrasound? What is Vascular Ultrasound? Ultrasound is safe and painless, and produces ...

  4. 老年缺血性脑卒中后轻度血管性认知障碍的影响因素%The factors of mild vascular cognitive impairment in elderly patients with ischemic cerebral stroke

    Institute of Scientific and Technical Information of China (English)

    王和平; 黄燕秋

    2016-01-01

    目的:分析老年缺血性脑卒中后轻度血管性认知障碍(VCI)的影响因素。方法对患者一般资料、体格检查、认知评估及影像学资料进行收集与调查,并行单因素分析与Logistic回归分析。结果老年缺血性卒中后轻度VCI的发生与患者年龄、文化程度、冠心病、糖尿病、高血压、卒中次数、发病部位及卒中面积有关;与性别、BM I、吸烟、饮酒等无明显相关。Logistic回归分析显示,文化程度为老年缺血性脑卒中后轻度VCI发生的保护因素,而年龄、冠心病、糖尿病、高血压、卒中次数、发病部位及卒中面积是危险因素。结论老年缺血性脑卒中后轻度 VCI发生的危险因素众多,临床上可进行针对性的早期干预。%Objective To analyze the factors of mild vascular cognitive impairment (VCI) in elderly patients with ischemic cerebral stroke. Methods The general information ,physical examination ,cognitive evaluation and imaging data were collected and investigated;single factor analysis and Logistic regression analysis were used. Results The occurrence of mild VCI in eld-erly patients with ischemic cerebral stroke was related with age ,educational level ,coronary heart disease ,diabetes ,hyperten-sion ,stroke frequency ,disease location and area of stroke ,and had non-obvious relation with sex ,BMI ,smoking ,alcohol con-sumption. Logistic regression analysis showed that education was a protective factor for mild VIC in elderly patients with is-chemic cerebral stroke ,and age ,coronary heart disease ,diabetes ,hypertension ,stroke frequency ,disease location and area were the risk factors. Conclusion The risk factors for mild VCI in elderly patients with ischemic cerebral stroke are many ;targeted early intervention can be applied in clinic.

  5. The study on vascular reserve of large cerebral arteries in acute cerebral ischemia patients with intracranial stenosis%伴有颅内动脉狭窄的缺血性脑卒中患者脑血管储备能力研究

    Institute of Scientific and Technical Information of China (English)

    黄立安; 董晓梅; 徐安定; 宋雪文; 凌雪英; 周环

    2011-01-01

    Objective To study the vascular reserve of large cerebral arteries in patients with acute cerebral thrombosis with more than 50% stenosis of the intracranial arteries. Methods Seventeen patients with acute cerebral thrombosis with magnetic resonance artery( MRA )/ transcranial doppler ultrasonography ( TCD ) confirmed stenosis of the intracranial arteries, were recruited in the study. Patients were examined by TCD before admission and 2 hour after oral Diamox treatment two days later. The changes of the blood flow before and after Diamox were compared in 187 large arteries.Results The cerehral blood flow was increased obviously following diamox. The blood flows in the right internal carotid artery( RICA ), right middle cerebral artery ( RMCA ) , right posterior cerebral artery( RPCA ) were increased after diamox but the difference did not reach statistically significance( P = 0.086,0.258 ,0.084 )but, other arteries increased cerebral blood flow significantly( P < 0.05 ). There was more increase in blood flow in non-stenosis arteries than in stenosis arteries but the difference did not reach statistically significance ( P = 0.08 ). There were no significant differences in the blood flow changes hetween moderate stenosis arteries and severe stenosis arteries ( P = 0.65 ). Conclusions Diamox test in TCD can precisely measure the large cerebral artery vascular reserve. Stenosis arteries have a decline tendency in vascular reserve compared with non-stenosis arteries. However,there is not significant difference in vascular reserve between moderate stenosis arteries and severe stenosis.%目的 对伴有颅内动脉狭窄的缺血性脑卒中患者采用口服乙酰唑胺实验研究颅内大动脉血流储备能力.方法 对17例经磁共振血管显影(magnetic resonance angiography, MRA)/或经颅多谱勒超声(transcranial doppler ultrasonography, TCD)证实颅内动脉狭窄大于50%的缺血性脑卒中患者,按TOAST分型为动脉粥样硬

  6. Acidentes perfurocortantes entre trabalhadores de enfermagem de um hospital universitário do interior paulista

    Directory of Open Access Journals (Sweden)

    Silvia Rita Marin da Silva Canini

    Full Text Available Como mostra a literatura, o risco de trabalhadores da área da saúde adquirirem patógenos veiculados pelo sangue já está bem documentado e demonstra que a Aids e a hepatite B e C, adquiridas de maneira ocupacional, são, hoje, um fato concreto. Este estudo retrospectivo, de natureza descritiva, realizado em um Hospital Universitário, no ano de 1998, objetivou analisar os acidentes perfurocortantes que acometeram os trabalhadores de enfermagem. Os resultados evidenciaram que, dos 398 acidentes ocupacionais notificados oficialmente, 125 (30,40% foram perfurocortantes e 89 (71,20% ocorreram entre trabalhadores de enfermagem. As situações mais freqüentes de ocorrência se deram quando da administração de medicamentos (25,78%. Concluiu-se que os trabalhadores de enfermagem foram os mais atingidos pelos acidentes ocupacionais envolvendo material perfurocortante.

  7. Monitoring of cerebral haemodynamics in newborn infants

    DEFF Research Database (Denmark)

    Liem, K Djien; Greisen, Gorm

    2010-01-01

    The most important cerebrovascular injuries in newborn infants, particularly in preterm infants, are cerebral haemorrhage and ischemic injury. The typical cerebral vascular anatomy and the disturbance of cerebral haemodynamics play important roles in the pathophysiology. The term 'cerebral...... haemodynamics' includes cerebral blood flow (CBF), cerebral blood flow velocity, and cerebral blood volume (CBV). Therapy aimed at changing vascular anatomy is not available. Therefore, prevention of disturbances in CBF and CBV is pivotal. However, continuous monitoring of CBF and CBV is still unavailable...... for clinical use. Tissue oxygenation may be used as a surrogate for CBF, although precision is still questionable. General knowledge of the regulation of CBF and CBV is important. Although this knowledge is still incomplete, especially regarding autoregulation and the exact role of CBV, it is still useful...

  8. Indicadores clínico-radiológicos de valor pronóstico en la patología vascular cerebral

    OpenAIRE

    Torné Torné, Ramon

    2015-01-01

    El ictus cerebral hemorrágico es una causa frecuente de mortalidad y gran discapacidad funcional en nuestra población. Profundizar en el conocimiento de la evolución clínica de estos pacientes permite ofrecer expectativas reales a los familiares y una correcta optimización de los recursos sanitarios. Los indicadores con valor pronóstico en la fase aguda deben ser utilizados en la toma de decisiones en el tratamiento de estos pacientes. Esta tesis por compendio de artículos, pretende identific...

  9. Altered cerebral vascular volumes and solute transport at the blood-brain barriers of two transgenic mouse models of Alzheimer's disease.

    Science.gov (United States)

    Do, Tuan Minh; Alata, Wael; Dodacki, Agnès; Traversy, Marie-Thérèse; Chacun, Hélène; Pradier, Laurent; Scherrmann, Jean-Michel; Farinotti, Robert; Calon, Frédéric; Bourasset, Fanchon

    2014-06-01

    We evaluated the integrity and function of the blood-brain barrier in 3xTg-AD mice aged 3-18 months and in APP/PS1 mice aged 8-months to determine the impacts of changes in amyloid and tau proteins on the brain vascular changes. The vascular volume (Vvasc) was sub-normal in 3xTg-AD mice aged from 6 to 18 months, but not in the APP/PS1 mice. The uptakes of [(3)H]-diazepam by the brains of 3xTg-AD, APP/PS1 and their age-matched control mice were similar at all the times studied, suggesting that the simple diffusion of small solutes is unchanged in transgenic animals. The uptake of d-glucose by the brains of 18-month old 3xTg-AD mice, but not by those of 8-month old APP/PS1 mice, was reduced compared to their age-matched controls. Accordingly, the amount of Glut-1 protein was 1.4 times lower in the brain capillaries of 18 month-old 3xTg-AD mice than in those of age-matched control mice. We conclude that the brain vascular volume is reduced early in 3xTg-AD mice, 6 months before the appearance of pathological lesions, and that this reduction persists until they are at least 18 months old. The absence of alterations in the BBB of APP/PS1 mice suggests that hyperphosphorylated tau proteins contribute to the vascular changes that occur in AD.

  10. Subnotificação de acidentes com perfurocortantes na enfermagem

    OpenAIRE

    2013-01-01

    O objetivo desta pesquisa foi identificar as ocorrências de subnotificação de acidente perfurocortante entre trabalhadores de enfermagem no Hospital Geral de Vila Penteado. Trata-se de uma pesquisa de campo exploratória com abordagem quantitativa, foi utilizado questionário contendo 9 perguntas fechadas e 2 abertas, relacionadas aos dados de conhecimento sobre acidente de trabalho, notificação e subnotificação. Conclui-se que os trabalhadores de enfermagem apresentam desconhecimento sobre o f...

  11. Acidentes com motociclistas: comparacao entre os anos 1998 e 2010. Londrina, PR, Brasil

    Directory of Open Access Journals (Sweden)

    Flavia Lopes Sant'Anna

    2013-06-01

    Full Text Available OBJETIVO: Comparar características de acidentes de motocicleta e de vítimas atendidas por serviços de atenção pré-hospitalar. MÉTODOS: Pesquisa transversal com dados de registros de atendimentos pré-hospitalares de motociclistas, vítimas de acidente de trânsito em Londrina, PR, em 2010, e dos resultados comparados com estudo similar de 1998. A fonte de dados foi o Registro de Atendimento do Socorrista (RAS. As frotas de motocicletas e as populações dos respectivos anos foram usadas para estimativas do risco de ocorrência de vítimas. O teste do Qui-quadrado foi usado para comparação dos perfis de acidentes e vítimas. RESULTADOS: Foram atendidos 1.576 e 3.968 motociclistas em 1998 e 2010, respectivamente (aumento de 151,8%. A taxa de motociclistas acidentados por mil habitantes passou de 396,4 para 783,1, e a de vítimas para cada mil motos de 53,1 para 61,1. Observaram-se mudanças (p < 0,05 nos perfis dos acidentes, com maiores proporções de quedas isoladas de moto, de acidentes entre motociclistas, no período da manhã, com diminuição dos ocorridos em final de semana. Em relação às vítimas, observaram-se maiores proporções de mulheres, condutores, com 35 anos ou mais. Foi menor a frequência relativa de percepção de hálito etílico e maior a prevalência do uso do capacete. Houve menor proporção de vítimas classificadas com escalas de coma e trauma moderado/grave e de encaminhamentos hospitalares. O coeficiente de letalidade imediato reduziu-se de 1,2% para 0,6%. CONCLUSÕES: Foram observadas mudanças nos perfis de acidentes e de vítimas no período. Apesar do aumento absoluto e relativo de vítimas de acidentes de motocicleta, observou-se menor gravidade proporcional desses acidentes.

  12. 脑梗死患者血清可溶性血管细胞黏附分子1的变化%Variation of soluble vascular cell adhesion molecule-1 in serum of patients with cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    李静; 周华东; 王延江

    2006-01-01

    平明显高于无感染(P<0.01).结论:可溶性血管细胞黏附分子1参与了脑梗死的病理变化过程,可作为脑梗死时病情变化的监测指标.阻断其生成和表达为改善脑梗死的预后提供了新的思路.%BACKGROUND: In subjects with different inflammatory and autoimmune diseases, soluble vascular cell adhesion molecule-1 (sVCAM-1) in sera increases, and its change may become an important monitoring index of immunological function, but its change rule has been unclear in acute cerebral infarction.OBJECTIVE: To observe the change of sVCAM-1 in sera of subjects with cerebral infarction and its clinical significance, and compare between the subjects with cerebral hemorrhage and normal population.DESIGN: A case controlled analysis.SETTING: Second Department of Brain, Research Institute of Surgery,Daping Hospital, Third Military Medical University of Chinese PLA.PARTICIPANTS: A total of 132 inpatients were selected from Second Department of Brain, Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA between May 2002 and April 2004. Among them, 89 subjects with cerebral infarction were classified into large infarction group (n=25,> 10 cm3), medium infarction group (n=31,4-10 cm3) and small infarction group (n=33, < 4 cm3) respectively according to the size of infarct focus. There were 43 subjects in cerebral hemorrhage group, and 30 healthy persons were as normal control group.METHODS: Blood samples were isolated from subjects with cerebral infarction at hour 24, days 3, 7 and 14 after onset of the disease, while the blood samples were extracted from subjects with cerebral hemorrhage at hour24 and day 14 after the onset of the disease. 4 mL venous blood was obtained from the three groups. The serum concentration of sVCAM-1 was determined with double antibody sandwich method (DASM) in all the examinees.MAIN OUTCOME MEASURES: ①Dynamic change of the serum concentration of sVCAM-1 in the course of acute cerebral

  13. Bobath、Brunnstrom、Rood及PNF技术对脑血管病迟缓期的康复疗效观察%Efficacy Observation on Bobath, Brunnstrom, Rood and PNF Technique on Rehabilitation of Cerebral Vascular Diseases in Lag Phase

    Institute of Scientific and Technical Information of China (English)

    黄妃凤; 朱炯端; 谭明芳; 孙芳; 成晓霞

    2014-01-01

    目的:观察Bobath技术、Brunnstrom技术、Rood技术及PNF技术对脑血管病迟缓期的康复疗效。方法:85例患者随机分为Bobath技术组、Rood技术组、Brunnstrom技术组、PNF技术组和对照组,五组均接受基础治疗至迟缓期结束,四组技术组分别予以相应的康复技术,治疗前后采用FMA、MBI进行康复评定,并记录迟缓期持续的时间。结果:治疗后五组患者FMA、MBI评分均较治疗前显著升高(P<0.05),且四组技术组MBI评分均显著高于对照组(P<0.05);四组技术组迟缓期持续时间均显著少于对照组(P<0.05)。结论:脑血管病迟缓期患者早期介入Bobath技术、Brunnstrom技术、Rood技术或PNF技术均可缩短迟缓期持续时间,促进患者肢体功能恢复,提高日常生活活动能力;且四种康复技术对脑血管病迟缓期患者的康复疗效相当,可康复治疗中灵活运用。%Objective:To study the rehabilitation efficacy of Bobath, Brunnstrom, Rood and PNF technique on rehabilitation of cerebral vascular dis-eases in lag phase. Methods:85 patients were randomly divided into Bobath group, Rood group, Brunnstrom group, PNF group and control group, five groups received basic treatment until the lag phase ended, four technique groups with corresponding rehabilitation technology, rehabilitation evaluation was made before and after treatment with FMA and MBI, and the duration of lag phase was recorded. Results:The FMA、MBI scores of five groups after treatment were all significantly higher than those before treatment (P<0.05);MBI scores of four technique group were all signifi-cantly higher than that of control group (P<0.05);duration of lag phase of four technique group were all significantly lower than that of control group (P<0.05). Conclusion:Cerebral vascular disease of lag phase with early intervention of Bobath, Brunnstrom, Rood and PNF technique can shorten duration of lag phase, promote the limb

  14. Via, homem e veiculo: fatores de risco associados a gravidade dos acidentes de transito

    Directory of Open Access Journals (Sweden)

    Rosa Livia Freitas de Almeida

    2013-08-01

    Full Text Available OBJETIVO Analisar as características das vítimas, vias e veículos envolvidos em acidentes de trânsito e os fatores de risco de acidentes com ocorrência de óbito.  MÉTODOS Estudo de coorte não concorrente considerando os acidentes de trânsito em Fortaleza, CE, de janeiro de 2004 a dezembro de 2008. Foram utilizados dados do Sistema de Informação de Acidente de Trânsito de Fortaleza, do Sistema de Informações de Mortalidade, do Sistema de Informações Hospitalares e dos bancos de dados de Habilitação e Veículos do Departamento Estadual de Trânsito. Técnicas de relacionamento determinístico e probabilístico foram aplicadas para integrar as bases de dados. Efetuou-se a análise descritiva das variáveis relativas às pessoas, às vias, aos veículos e ao tempo. Foram utilizados os modelos lineares generalizados na investigação de fatores de risco para óbito por acidente de trânsito. O ajuste do modelo foi verificado pela razão de verossimilhança e análise ROC.  RESULTADOS Registraram-se 118.830 acidentes no período. Predominaram colisão/abalroamento (78,1%, atropelamentos (11,9% e choque com obstáculo fixo (3,9% e com motocicletas (18,1%. Ocorreram óbitos em 1,4% dos acidentes. Estiveram independentemente associados ao óbito por acidente de trânsito: bicicletas (OR = 21,2; IC95% 16,1;27,8, atropelamentos (OR = 5,9; IC95% 3,7;9,2, choque com obstáculo fixo (OR = 5,7; IC95% 3,1;10,5 e acidentes com motociclistas (OR = 3,5; IC95% 2,6;4,6. Os principais fatores contribuintes foram envolvimento de uma única pessoa (OR = 6,6; IC95% 4,1;10,73, presença de condutores não habilitados (OR = 4,1; IC95% 2,9;5,5 um único veículo envolvido (OR = 3,9; IC95% 2,3;6,4, sexo masculino (OR = 2,5; IC95% 1,9;3,3, tráfego em vias de jurisdição federal (OR = 2,4; IC95% 1,8;3,7, horário madrugada (OR = 2,4; IC95% 1,8;3,0 e dia de domingo (OR = 1,7; IC95% 1,3;2,2, todas ajustadas segundo modelo log-binomial.  CONCLUSÕES As a

  15. ACIDENTE OFÍDICO EM EQUINO PORTADOR DE BABESIOSE CLÍNICA RELATO DE CASO

    Directory of Open Access Journals (Sweden)

    Joel de Souza Montello Neto

    2015-12-01

    Full Text Available One horse, snakebite victim and carrier of Babesia caballi, was met with intense dermal hemorrhage in the medial region of the fore and hindlimbs, face, jugular groove and ventral thorax and abdomen, and swelling in the area between the kneecap and the pastern of the left hind limb. Was made support medicine, dressing and bandage on site identified as snake-bite site. The next day, there was a marked decrease in packed cell volume, where it was decided to blood transfusion; After 12 hours the packed cell volume level is 14%, and it increased gradually, reaching 26% in the sixth day of hospitalization. The next day, there was a marked decrease in packed cell volume, where it was decided to blood transfusion; After 12 hours the hematocrit level is 14%, and it increased gradually, reaching 26% in the sixth day of hospitalization. The animal was discharged after 27 days of hospitalization. We conclude that clinical babesiosis was an enhancer factor in anemia in patients. The Synergy hemolytic action of hemoparasite as well as vascular toxic action the venom aggravate circulatory disease of the patient. Um equino vitima de acidente ofídico e portador de Babesia caballi foi atendido apresentando hemorragia dérmica intensa na região medial dos membros torácicos e pélvicos, face, sulco jugular e região ventral do tórax e abdômen, e edema na região compreendida entre a rótula e a quartela do membro pélvico esquerdo. Foi feito medicamento de suporte, curativo e bandagem no local identificado como sítio da picada. No dia seguinte, observou-se diminuição acentuada do volume globular, onde optou-se pela realização de transfusão sanguínea; decorridas 12 horas o volume globular encontrava-se em 14%, e apresentou aumento gradativo, chegando a 26% no sexto dia de internação. O animal obteve alta após 27 dias de internação. Concluímos que a babesiose clínica foi um fator intensificador na anemia apresentada pelo paciente. A sinergia da a

  16. Malaria cerebral Cerebral malaria

    OpenAIRE

    Carlos Hugo Zapata Zapata; Silvia Blair Trujillo

    2003-01-01

    La malaria Cerebral (MC) es la complicación más frecuente de la malaria por P. falciparum; aproximadamente el 90% de las personas que la han padecido se recuperan completamente sin secuelas neurológicas. Aún no se conoce con claridad su patogénesis pero se han postulado cuatro hipótesis o mecanismos posibles: 1) citoadherencia y secuestro de glóbulos rojos parasitados en la microvasculatura cerebral; 2) formación de rosetas y aglutinación de glóbulos rojos parasitados; 3) producción de citoqu...

  17. 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

    OpenAIRE

    Suellen M. Marinho dos Santos Andrade; Mayara Dinamine França Dantas; Cristina Katya Dantas Torres; Karen Lúcia de Araújo Freitas Moreira

    2007-01-01

    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,...

  18. Recuperação da motricidade voluntária do membro superior de pacientes com hemiplegia após acidente vascular cerebral: avaliação prognostica Recovery of voluntary motion in upper extremity following hemiplegia in patients with cerebrovascular accident: contribution to the prognosis

    Directory of Open Access Journals (Sweden)

    Abrão Anghinah

    1976-06-01

    Full Text Available O estudo tem por finalidade o registro e a análise dos principais fatos que ocorrem durante a recuperação da motricidade voluntária do membro superior em pacientes com hemiplegia após AVC, tendo por objetivo contribuir para a avaliação do prognóstico. De particular interesse foi a observação comparativa do retorno espontâneo da motricidade voluntária nos vários segmentos do membro superior em 88 pacientes com hemiplegia após AVC hospitalizados na fase aguda da afecção. Dos 88 pacientes hemiplégicos estudados, com diagnóstico suficientemente esclarecido e evolução acompanhada durante período satisfatório para permitir conclusões, 56 casos (grupo 1 atingiram melhora clínica, com remissão parcial ou completa da sintomatologia neurológica (discreto deficit de força, hiperreflexia e hipertonia e recuperação de todos os movimentos voluntários nas várias articulações do membro superior, enquanto 32 pacientes (grupo 2 com persistência da sintomatologia neurológica, particularmente a hipertonia, apresentaram melhora clínica discreta e recuperação parcial de movimentos do membro superior. A quantificação clínica de sinais neurológicos utilizada no presente estudo, tornou possível registrar as modificações mais importantes ocorridas durante a evolução dos 88 pacientes. Este critério permitiu destacar quantitativamente a regressão espontânea da sintomatologia e a determinação do nível crítico de estabilização (platô. A análise dos dados fornecidos pelos dois grupos estudados permitiu concluir que: o ponto crítico de regressão da sintomatologia e recuperação da motricidade voluntária ocorre em média, 70 dias após ter-se instalado a hemiplegia; o cômputo médio de 256 pontos, que foi obtido 70 dias após a instalação da hemiplegia, representa o nível crítico de estabilização; embora a precocidade de aparecimento de movimentos iniciais logo após a instalação da hemiplegia seja dado importante para o prognóstico, o autor acredita ser de capital importância a caracterização dos tipos de movimentos iniciais. Levando em conta os tipos de movimentos iniciais o autor observou que, quando nos pacientes com hemiplegia após AVC, os movimentos de flexo-extensão e oponência do polegar aparecem precocemente de forma isolada ou associada a movimentos da articulação proximal (ombro, ou central (cotovelo é de esperar melhor prognóstico do que nos pacientes cujo movimento inicial é representado por flexão do cotovelo e/ou flexão-adução do braço.The study aims the registration and analysis of the main facts which occur during recovery of the voluntary movements in the upper extremity, in patients with hemiplegia following cerebrovascular accident, and it also intends to evaluate the prognosis. Of particular interest was the comparative recognition of the spontaneous recovery of voluntary motricity in different segments of the upper extremity in 88 patients, not previously selected, with hemiplegia after cerebrovascular accident, admitted to the hospital at the acute stage. Of the 88 hemiplegic patients studied whose further evolution has been fairly followed 56 cases (group 1 experienced clinical improvement, either with partial or total remission of neurological manifestations and complete recovery of all voluntary movements in the different upper extremity joints, while 32 patients (group 2 with persistent neurological symptoms, particularly spasticity, showed a slighter clinical improvement, as well as only partial recovery of upper extremity movements. The clinical quantification of neurological signs applied in this study, has made possible to report the main significant changes developed during the 88 patients recovery. This criteria has allowed to enphasize the degree of the spontaneous remission of symptoms and the determination of the critical level of stabilization "plateau". The analysis of the data supplied by the two groups led to the following conclusions: a the critical level of remission of symptoms and the spontaneous recovery of voluntary movements ocurred around the 70th day after the installation of hemiplegia; b the 256 average score acquired 70 days after the onset of the hemiplegia represents the critical level stabilization (plateau; c although the presence of early initial movements, immediately after the installation of hemiplegia, is a valuable data for the prognosis, the characterization of early movement patterns is of most important meaning; d patients with hemiplegia after cerebrovascular acident who present the thumb flexion-extension and opposition movements showed a better prognosis than those whose initial movements were represented by the elbow flexion and/or arm flexion-adduction.

  19. Trabalho e acidentes no meio rural do Oeste Catarinense - Santa Catarina, Brasil

    Directory of Open Access Journals (Sweden)

    Sandra Márcia Tietz Marques

    Full Text Available Este estudo objetivou verificar a ocorrência de acidentes e características do trabalhador rural do Oeste de Santa Catarina, Brasil. Foram utilizados 60 questionários padronizados, com dados sociodemográficos, de trabalho e acidente laboral. Predominam os chefes de família (60%, com idade entre 41 e 60 anos e os casados (68,3%, com escolaridade média entre 4 a 8 anos, sendo 97% de famílias proprietárias, com área rural acima de 8 hectares representando 83,3%. A jornada semanal de trabalho de 80% dos trabalhadores rurais ultrapassa 40 horas semanais, com 20% de ocorrência de acidentes. Os dados revelam a diversidade de atividades e de riscos ocupacionais e alertam para a urgência na abordagem da vigilância em saúde pública, onde os acidentes de trabalho no meio rural estão a merecer atenção nas políticas sociais brasileiras, além de não participarem das estatísticas oficiais do país.

  20. Estratégia de Investimentos Baseada em Acidentes Aéreos: Há Retornos Anormais?

    Directory of Open Access Journals (Sweden)

    Silvania Neris Nossa

    2013-06-01

    Full Text Available O presente trabalho buscou investigar se uma estratégia de investimentos baseada em acidentes aéreos geraria retornos anormais. Foi feito um estudo de eventos, considerando-se todos os acidentes aéreos ocorridos no período de 1998 a 2009 e os dados das companhias aéreas e dos fabricantes das respectivas aeronaves que possuíam ações negociadas nas bolsas de valores, quando da ocorrência do evento. Os testes realizados se basearam no modelo de Campbel, Lo e Mackinlay (1997, para definição de retornos anormais, por meio de uma regressão linear entre o retorno das ações dessas empresas e o retorno do portfólio de mercado utilizado como benchmark. Assim, foi possível projetar os retornos futuros esperados para as ações das companhias aéreas e fabricantes e compará-los aos resultados efetivamente obtidos na ocorrência do evento. O resultado obtido sugere que uma estratégica de investimentos baseada em acidentes aéreos seria viável e que retornos anormais poderiam ser obtidos no período imediatamente posterior um acidente aéreo.

  1. High-fat diet increases O-GlcNAc levels in cerebral arteries: a link to vascular dysfunction associated with hyperlipidaemia/obesity?

    Science.gov (United States)

    Lima, Victor V; Giachini, Fernanda R; Matsumoto, Takayuki; Li, Weiguo; Bressan, Alecsander F M; Chawla, Dhruv; Webb, R Clinton; Ergul, Adviye; Tostes, Rita C

    2016-06-01

    Obesity and high fat intake induce alterations in vascular function and structure. Aberrant O-GlcNAcylation (O-GlcNAc) of vascular proteins has been implicated in vascular dysfunction associated with cardiovascular and metabolic diseases. In the present study, we tested the hypothesis that high-fat diet (HFD)-mediated increases in O-GlcNAc-modified proteins contribute to cerebrovascular dysfunction. O-GlcNAc-protein content was increased in arteries from male Wistar rats treated with a HFD (45% fat) for 12 weeks compared with arteries from rats on control diet (CD). HFD augmented body weight [(g) 550±10 compared with 502±10 CD], increased plasma triacylglycerols [(mg/dl) 160±20 compared with 95±15 CD] and increased contractile responses of basilar arteries to serotonin [5-hydroxytryptamine (5-HT)] [(pD2) 7.0±0.1 compared with 6.7±0.09 CD] and the thromboxane analogue 9,11-dideoxy-9α,11α-methanoepoxy prostaglandin F2α (U-46619) [(pD2) 7.2±0.1 compared with 6.8±0.09 CD]. Of importance, increased levels of O-GlcNAc [induced by 24 h-incubation of vessels with a potent inhibitor of O-GlcNAcase (OGA), O-(2-acetamido-2-deoxy-D-glucopyranosylidene)amino-N-phenylcarbamate (PugNAc)] increased basilar artery contractions in response to U-46619 [(pD2) 7.4±0.07 compared with 6.8±0.08 CD] and 5-HT [(pD2) 7.5±0.06 compared with 7.1±0.1 CD]. Vessels from rats on the HFD for 12 weeks and vessels treated with PugNAc displayed increased phosphorylation of p38 (Thr(180/182)) and extracellular signal-regulated kinase 1/2 (Erk1/2) (Ser(180/221)). Increased 5HT-induced contractions in arteries from rats on the HFD or in arteries incubated with PugNAc were abrogated by mitogen-activated protein kinase (MAPK) inhibitors. Our data show that HFD augments cerebrovascular O-GlcNAc and this modification contributes to increased contractile responses and to the activation of the MAPK pathway in the rat basilar artery.

  2. Aspectos epidemiológicos dos acidentes por aranhas no Estado do Rio Grande do Sul, Brasil

    OpenAIRE

    Chagas, Flávia Bernardo; D´Agostini, Fernanda Maurer; Beltrame,Vilma

    2012-01-01

    O presente trabalho tem por objetivo avaliar aspectos epidemiológicos dos acidentes por aranhas no Estado do Rio Grande do Sul, por meio de dados do Sistema de Informação de Agravos de Notificação (Sinan). Foram analisadas, de maneira retrospectiva, informações sobre os acidentes causados por aranhas. Os dados foram obtidos por meio das “Fichas de Acidentes por Animais Peçonhentos”, atendidos e/ou ocorridos nas unidades de atendimento. Foram registrados, na base de dados do Sinan, 12.401 caso...

  3. Vascular Cures

    Science.gov (United States)

    ... is Possible EVERY DOLLAR SAVES LIVES. Donate Now Vascular Cures innovates patient-centered research, catalyzes breakthrough collaborations and empowers people in their vascular health journey. what is vascular disease PATIENTS see ...

  4. Vascular ring

    Science.gov (United States)

    ... subclavian and left ligamentum ateriosus; Congenital heart defect - vascular ring; Birth defect heart - vascular ring ... Vascular ring is rare. It accounts for less than 1% of all congenital heart problems. The condition ...

  5. Cerebral microbleeds in patients with mild cognitive impairment and small vessel disease: The Vascular Mild Cognitive Impairment (VMCI)-Tuscany study.

    Science.gov (United States)

    Valenti, Raffaella; Del Bene, Alessandra; Poggesi, Anna; Ginestroni, Andrea; Salvadori, Emilia; Pracucci, Giovanni; Ciolli, Laura; Marini, Sandro; Nannucci, Serena; Pasi, Marco; Pescini, Francesca; Diciotti, Stefano; Orlandi, Giovanni; Cosottini, Mirco; Chiti, Alberto; Mascalchi, Mario; Bonuccelli, Ubaldo; Inzitari, Domenico; Pantoni, Leonardo

    2016-09-15

    Cerebral microbleeds (CMBs) are a neuroimaging expression of small vessel disease (SVD). We investigated in a cohort of SVD patients with mild cognitive impairment (MCI): 1) the reliability of the Microbleed Anatomical Rating Scale (MARS); 2) the burden and location of CMBs and their association with cognitive performances, independent of other clinical and neuroimaging features. Patients underwent clinical, neuropsychological (4 cognitive domains), and MRI assessments. CMBs were assessed by three raters. Out of the 152 patients (57.2% males; mean age±SD: 75.5±6.7years) with gradient-echo (GRE) sequences, 41 (27%) had at least one CMB. Inter-rater agreement for number and location of CMBs ranged from good to very good [multi-rater Fleiss kappa (95%CI): 0.70-0.95]. Lacunar infarcts and some clinical variables (e.g., hypertension and physical activity) were associated with CMBs in specific regions. Total number of CMBs and of those in deep and lobar regions were associated with attention/executive and fluency domains. MARS is a reliable instrument to assess CMBs in SVD patients with MCI. Nearly one third of these patients had at least one CMB. Total CMBs burden was associated with attention/executive functions and fluency domains impairment, lacunar infarcts, and with some potentially modifiable risk factors. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Cerebral emboli and depressive symptoms in dementia.

    NARCIS (Netherlands)

    Purandare, N.; Oude Voshaar, R.C.; Hardicre, J.; Byrne, J.; McCollum, C.N.; Burns, A.

    2006-01-01

    BACKGROUND: The vascular depression hypothesis and our recent findings of increased frequency of spontaneous cerebral emboli in dementia suggest that such emboli may be involved in the causation of depressive symptoms in dementia. AIMS: To evaluate the association between spontaneous cerebral emboli

  7. Change of cerebral blood flow distribution and vascular reserver according to age in Koreans measured by Tc-99m HMPAO brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ho Cheon; Bom, Hee Seung; Sohn, Hye Kyung; Jeong, Hwan Jeong; Min, Jung Jun; Kim, Ji Yeol [College of Medicine, Chonnam National Univ., Kwangju (Korea, Republic of); Lee Jae Tae [College of Medicine, Kyungpook National Univ., Taegu (Korea, Republic of); Moon, Dae Hyuk; Lee, Hee Kyung [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)

    1999-02-01

    The aim of this study was to evaluate the normal values of regional cerebral blood flow (rCBF) and cerebrovascular reserve (CVR) in normal children to aged volunteers using Tc-99m HMPAO. Thirty four right-handed normal volunteers (20 males, 14 females, mean age 40.3{+-}24.9 years, range 4 to 82 years) were underwent rest/acetazolamide (ACZ) brain SPECT using Tc-99m HMPAO and the sequential injection and subtraction method. rCBF was estimated on the basis of a semiquantitative approach by means of right/left ratio, region/cerebellum and region to whole brain ratios in frontal, parietal, temporal, and occipital lobes, basal ganglia, thalami, and cerebellum. CVR was measured by means of % perfusion increase calculated as % mean count change compared to rest rCBF in each regions. Mean values of right to left ratios range from 1.004 to 1.018. rCBF was highest in cerebellum and lowest in basal ganglia and thalami. Frontal and temporal rCBF decreased while occipital and thalamic rCBF increased according to age. No sexual difference of rCBF was noted. Mean CVR was 29.9{+-}12.9%. Mean CVR significantly increased to late teens, and declined thereafter. After 6th decade, CVR in both frontal lobes, left parietal lobe and right basal ganglia decreased significantly with advancing age. There was no sexual difference of CVR. Quantitative assessment of CVR was possible by ACZ Tc-99m MHPAO brain SPECT. It revealed that rCBF and CVR changed according to age in normal Korean volunteers. There was no sexual difference.

  8. Cerebral Palsy

    Science.gov (United States)

    Cerebral palsy is a group of disorders that affect a person's ability to move and to maintain balance ... do not get worse over time. People with cerebral palsy may have difficulty walking. They may also have ...

  9. Cerebral malaria Malaria cerebral

    OpenAIRE

    Silvia Blair Trujillo; Carlos Hugo Zapata Zapata

    2003-01-01

    Is the most common complication of P. falciparum malaria; nearly 90% of people who have suffered CM can recover without neurological problems. Currently there are four hypotheses that explain pathogenesis of CM: cytoadherence and sequestering of parasitized red blood cells to cerebral capillaries; rosette formation and parasitized red blood cells agglutination; production of cytokines and activation of second messengers and opening of the blood-brain barrier. However the main question remains...

  10. Rabbit focal cerebral ischemia model established by vascular interventional method%血管内介入技术制作兔局灶性脑缺血模型

    Institute of Scientific and Technical Information of China (English)

    陈丽; 戴炯; 严国锋; 沈加林; 邱永明; 许建荣; 陈学进; 江基尧

    2012-01-01

    were stained with 2, 3, 5-Triphenyltetrazolium chloride (TTC), and the conditions of infart lesions were observed. The left rabbits were sacrificed 2 weeks after operation, HE staining was performed for brain tissues, and the occlusion of middle cerebral artery and pathological changes of brain tissues were evaluated. Results Symptoms of hemiplegia emerged in rabbits of model group, and the success rate of model establishment was 94. 12% . TTC staining of brain sections confirmed there were infart lesions 6 h after operation, and the extent of infarct lesions tended to be stable 12 h after operation. It was revealed by HE staining that there was obvious isehemic damage in the right territory of frontoparietal lobe. All the above changes were not observed in sham operation group. Conclusion The focal cerebral ischemia and reperfusion model in rabbits established by vascular interventional method is micro-invasive, well-controllable, stable and reliable, which is a favorable experimental animal model for research of focal cerebral ischemia and reperfusion.

  11. Near infrared spectroscopy for frontal lobe oxygenation during non-vascular abdominal surgery

    DEFF Research Database (Denmark)

    Sørensen, Henrik; Grocott, Hilary P; Secher, Niels H

    2016-01-01

    PURPOSE: Cerebral deoxygenation, as determined by near infrared spectroscopy (NIRS), seems to predict postoperative complications following cardiac surgery. We identify the type of non-vascular abdominal surgery associated with cerebral deoxygenation and/or hyperoxygenation, how such deviations...

  12. Expression of Interleukin-10 on Cerebral Vascular Endothelial Cells in Smoking Rats%烟草烟雾对大鼠脑血管内皮细胞白细胞介素10表达的影响

    Institute of Scientific and Technical Information of China (English)

    刘菲; 柳宗兰; 王一沙

    2011-01-01

    目的 观察不同吸烟量大鼠脑血管内皮细胞白细胞介素10的表达,探讨烟草烟雾导致脑缺血的发病机制.方法 健康Wistar大鼠60只,分为正常对照组、假暴露组、暴露卷烟烟气30天组、暴露卷烟烟气30天后停止暴露30天组(戒烟组)、暴露卷烟烟气90天高剂量组、暴露卷烟烟气90天低剂量组.通过免疫组织化学法观察大鼠脑血管内皮细胞白细胞介素10的表达.结果 正常对照组和假暴露组白细胞介素10的表达较多,暴露卷烟烟气90天高剂量组白细胞介素10的表达明显低于其他各被动吸烟组,戒烟组白细胞介素10的表达明显高于其他各被动吸烟组,各被动吸烟组白细胞介素10的表达较正常对照组和假暴露组减少(P<0.05).结论 烟草烟雾可致脑血管内皮细胞白细胞介素10的表达减少,可能在缺血性脑血管病的发病中起重要作用.%Aim To observe the expression of interleukin-10 (IL-10) on cerebral vascular endothelial cells in smoking rats, and to discuss the mechanism of ischemia in brain caused by smoking. Methods 60 health Wistar rats were divied into 6 groups: normal control group, sham exposure group, exposed cigarette smoke 30 days group, exposed cigarette smoke 30 days then stopping exposion for 30 days group, exposed cigarette smoke 90 days high dose group and exposed cigarette smoke 90 days low dose group. The expression of IL-10 were observed in smoking rats by immunohistochemistry stain. Results The expression of IL-10 in normal control group and sham exposure group were more. The expression of IL-10 in exposed cigarette smoke 90 days high dose group were significantly lower than those in the other passive smoking groups. The expression of IL-10 in exposed cigarette smoke 30 days then stopping exposure for 30 days group were significantly higher than those in the other passive smoking groups. The expression of IL-10 in the passive smoking groups were significantly lower than

  13. Desigualdades entre pacientes hospitalizados por doenças cardíacas e vasculares-cerebrais em localidade do Estado de São Paulo (Brasil, 1986 Inequalities among patients hospitalized for cardiac and cerebral-vascular diseases in the City of the State of S. Paulo, Brazil, 1986

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    Juan Stuardo Yazlle Rocha

    1989-10-01

    Full Text Available Valendo-se de um sistema de informações sobre hospitalizações no Município de Ribeirão Preto, SP (Brasil foram estudadas as características clínico-epidemiológicas referidas dos pacientes internados, em 1986, por doenças cardíacas e vasculares-cerebrais (DCVC. De 43.499 hospitalizações ocorridas naquele ano, 4.673 foram ocasionadas por doenças cardíacas e vasculares-cerebrais. Utilizando a fonte de financiamento da internação como indicador do estrato social ao qual pertence o paciente, foram compostos 4 grupos de estudo: particulares, "outros", previdenciários e "não pagantes"; estes grupos apresentaram diferenças significativas quanto a coeficiente de internações por DCVC, média e mediana de idade na hospitalização, perfil ocupacional, duração da internação, freqüência dos sub-grupos diagnósticos, coeficientes de mortalidade e a idade média e mediana nos casos de óbitos. Estas diferenças foram atribuídas às disparidades sociais no nível de vida e condições de trabalho dos grupos estudados o que determina diferenças no adoecer, ser assistido e no morrer.The clinical and epidemiological characteristics of hospitalizations due to cardiac and cerebral-vascular diseases (CCVD - ICD 390 - 438, which occurred in 1986, were studied on the basis of data from an information system relating to medical care in the City of Ribeirão Preto, State of S. Paulo, Brazil. These causes accounted for 4,673 of the annual total of 43,449 hospital admissions. Using the sources of payment of the hospitalization as an indicator of the patients' social strata, the following four study groups were defined: private, social insurance, non-paying and "others". These groups showed significant differences in relation to the following variables: hospitalization rates due to CCVD, mean and median age at admission and time of death, occupation, average length of stay in the hospital, mortality rates and relative frequencies of specific

  14. Comparative Study of the Specificities of Needling Acupoints DU20, DU26 and HT7 in Intervening Vascular Dementia in Different Areas in the Brain on the Basis of Scale Assessment and Cerebral Functional Imaging

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    HUANG Yong; LAI Xin-sheng; TANG An-wu

    2007-01-01

    Objective: Using methods of clinical scale assessment and cerebral functional imaging to compare the relative specificity of needling acupoints Baihui (DU20), Shuigou (DU26) and Shenmen (HT7) in intervening vascular dementia (VD) in different areas in the brain. Methods: Fifty patients with VD were randomized into 5 groups. Needling on conventionally used acupoints of hand and foot three Yang-meridians aiming at hemiplegia was applied to the patients in Group A, and needling on DU20 to Group B, on DU26 to Group C, on HT7 to Group D and on all the three to Group E was applied additionally. Assessments of Mini Mental State Examination (MMSE), Activities of Daily Living (ADL) and Family Attitude Questionnaire (FAQ) were made. And the positron emission computerized tomography (PET) and single photon emission computerized tomography (SPECT) examinations were conducted in 5 selected patients from each group before and after treatment. Results: Needling on conventional acupoints plus DU20 could effect the inner temporal system, thalamencephalon system and prefrontal cortical system to improve memory and executive capacity of VD patients; conventional acupoints plus DU26 could effect more to the prefrontal cortical system to obviously elevate the executive capacity;that plus HT7 would reveal an effect similar to but rather weaker than plus DU20, and effect more to memory; and that plus all the three simultaneously could effect rather roundly multiple aspects of the nervous system related to intellectual activities, to elevate the recognition and enhance the executive capacity. Conclusion: Needling on various acupoints like DU20, DU26 and HT7 have effects on different brain areas.

  15. Acidentes de trabalho em indústria gráfica

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    João de Barros Barreto

    1947-03-01

    Full Text Available Os autores analisam, dentro do campo da higiene industrial, as condições sanitárias de um grande estabelecimento de artes gráficas no Rio de Janeiro — a Imprensa Nacional, o regime de trabalho aí instituído; e revistam, um a um, os processos industriais executados, especialmente atenção às causas potenciais de acidentes, que aí existem, e também àquelas cuja responsabilidade já se positivou. Ressaltam, no ponto de vista doutrinário, os diversos fatores que podem interferir na ocorrência dêsses infortúnios de trabalho; e, mostrando como tem sido superestimada a culpabilidade das máquinas, realçam a importância dos fatores individuais — idade e experiência do operário, doenças e defeitos físicos, atitude mental, constituição fisio-psicologica. Salientam como a evidência da predisposição a acidentes, que se reconheça existir, possibilita manter os operários, já em função ou pretendentes a emprego, debaixo de supervisão rigorosa; e oportuniza mesmo colocá-los melhormente, em tarefas que, no máximo, só lhes possam acarretar aciden¬tes de natureza leve. Mostram que, no período em estudo — 1942 a 1945, houve ao todo 1.123 acidentes na I.N., com o coeficiente geral de incidência de 220.3 por 1.000 operários expostos. O coeficiente de acidentes médios ou graves foi de 32 por mil, no mesmo período. Apontando ainda a descenção, no quatriênio, das curvas relativas tanto aos acidentes totais, como aos médios ou graves e aos produzidos por máquinas, dão a ver que a taxa, que retrata essa descida, é, para os primeiros, 3.5 e cêrca de 10 vêzes maior, respectivamente, que a dos acidentes por máquinas e dos médios ou graves. Mostra-se significativa a diferença, entre a tendência observada nas curvas dos acidentes em geral e dos médios ou graves; já isso, porém, não acontece, quanto à diferença entre a primeira e a dos acidentes produzidos por máquinas. De fato, sendo os valores de t respec

  16. Diagnóstico clínico diferencial entre oclusão da artéria carótida interna e da artéria cerebral média A comparative symptomatological study of internal carotid artery occlusion and middle cerebral artery occlusion

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    Roberto Melaragno

    1971-03-01

    Full Text Available Foi feito um estudo comparativo entre o quadro clínico inicial de 61 casos de oclusão da artéria carótida interna e o de 23 casos de oclusão da artéria cerebral média, diagnosticados pela angiografia cerebral e/ou pela necropsia em pacientes submetidos ou não à cirurgia vascular. Os autores comparam a idade dos pacientes, o sexo, o modo de início da afecção, a existência ou não de convulsões e/ou cefaléias, a ocorrência do acidente cerebral durante o sono ou em vigília, a existência de ictos prévios, os níveis de pressão arterial, o grau de consciência, a força muscular, os achados eletrencefalográficos, a palpação e ausculta das carótidas em nível cervical. Os resultados são demonstrados em índices percentuais, pelos quais os autores inferem que não há significância estatística nesses elementos com três exceções: a maior ocorrência de convulsões nas oclusões da artéria cerebral média em relação às da carótida, a oftalmodinamometria e a sintomatologia carotídea cervical. A oftalmodinamometria revela valores significantemente menores nas pressões da artéria central da retina, no mesmo lado da trombose da carótida em 70,0% dos casos, enquanto que medidas normais e simétricas verificaram-se em todos os casos de oclusão da artéria cerebral média em que o exame foi realizado. No que concerne a sinais arteriais no pescoço, havia anormalidades palpatórias e auscultatórias em 52,4% dos pacientes com trombose da carótida e em 8,6% dos casos com oclusão da cerebral média. Concluem os autores, portanto, que apenas a angiografia cerebral permite um diagnóstico seguro entre ambas as sedes da oclusão.A comparative study of the early clinical picture in 61 cases of internal carotid artery occlusion and 23 cases of middle cerebral artery occlusion, diagnosed by cerebral angiography and/or necropsy in patients who were either submitted to surgery or not operated upon is reported. The authors had

  17. Prevalência e fatores associados a acidentes de trabalho em zona rural

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    Fehlberg Marta Fernanda

    2001-01-01

    Full Text Available OBJETIVO: Investigar a ocorrência de acidentes do trabalho, na zona rural, e sua associação com alguns fatores de risco. MÉTODOS: O estudo foi realizado na zona rural do município de Pelotas, RS. O delineamento do estudo foi transversal de base populacional. Uma amostra representativa dos trabalhadores rurais foi obtida por meio de amostragem, em estágios múltiplos, utilizando-se os setores censitários da Fundação IBGE. As entrevistas foram realizadas em um período de quatro meses, utilizando-se questionários padronizados e pré-codificados. Os 580 trabalhadores entrevistados pertenciam a 258 famílias da zona rural. RESULTADOS E CONCLUSÕES: A prevalência de acidentes encontrada foi de 11%. Os fatores de risco associados à maior ocorrência de acidentes, na análise multivariada, foram a classe social mais baixa (OR=1,81, a cor não-branca (OR=3,50 e a insatisfação com o trabalho realizado (OR=2,77.

  18. Análise dos acidentes de trânsito ocorridos em uma Capital do Nordeste Brasileiro, em 2006.

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    Francisco José de Paula Júnior

    2013-06-01

    Full Text Available Este trabalho teve como objetivo descrever os acidentes de trânsito ocorridos na cidade de Fortaleza, capital do Ceará, no ano de 2006. Foi realizado um estudo descritivo, transversal, a partir de dados do Sistema de Informação de Acidentes de Trânsito de Fortaleza, que agrega todas as informações pertinentes aos acidentes de trânsito ocorridos na capital cearense, além de informações do Sistema de Informações Hospitalares. Esses dados foram analisados utilizando o software EPI INFO®. Em 2006, foram registrados 23.443 acidentes de trânsito. Desses, houve uma proporção de 2:1, entre homens e mulheres e os óbitos ocorreram principalmente na faixa etária de 30 a 59 anos, liderados por pedestres 141 (41,34% e motociclistas com 76 (22,28%. Entre os tipos de acidentes 14.267 (60,85% registraram-se colisões, tendo o mês de dezembro e o intervalo de 18 às 20 horas apresentado o maior número de registros. Em relação aos ferimentos, os motociclistas foram os mais lesionados, atingindo 5.634 (40,57% pessoas. Parte significativa dos acidentes e óbitos envolveu adolescentes e adultos jovens, resultando em 341 (0,71% vitimas que evoluíram para óbito. É fundamental estimular políticas públicas para melhoria nas condições de trânsito e um maior investimento para os sistemas que coletam informações sobre os acidentes.

  19. Vascular Diseases

    Science.gov (United States)

    The vascular system is the body's network of blood vessels. It includes the arteries, veins and capillaries that carry ... to and from the heart. Problems of the vascular system are common and can be serious. Arteries ...

  20. Vascular Vertigo

    OpenAIRE

    Mazyar Hashemilar; Masoud Nikanfar; Dariush Savadi Oskoui

    2017-01-01

    Vertigo is a common complaint in neurology and medicine. The most common causes of vertigo are benign paroxysmal positional vertigo, vestibular neuritis, Meniere’s disease, and vascular disorders. Vertigo of vascular origin is usually limited to migraine, transient ischemic attacks, and ischemic or hemorrhagic stroke. Vascular causes lead to various central or peripheral vestibular syndromes with vertigo. This review provides an overview of epidemiology and clinical syndromes of vascular vert...

  1. Acidente ofídico no estado de Goiás

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    Pinho Fábia Maria Oliveira

    2004-01-01

    Full Text Available OBJETIVO: Avaliar aspectos epidemiológicos dos acidentes por serpentes peçonhentas ocorridos no Estado de Goiás. MÉTODOS: Foram analisadas ''Fichas de investigação de acidentes por animais peçonhentos'', pertencentes ao sistema de notificação da Secretaria de Saúde do Estado de Goiás, no triênio 1998-2000. RESULTADOS: Foram notificados, neste período, 3.261 acidentes por serpentes peçonhentas, com coeficiente de incidência variando entre 20 e 23/100.000 habitantes. O maior número de casos ocorreu entre os meses de outubro e abril. Dentre os 2.350 casos em que houve referência ao gênero da serpente, 78,6% foram causados por Bothrops, 20,8% por Crotalus e 6% por Micrurus. Houve predominância do sexo masculino (78,5% e com faixa etária entre 20 e 39 anos de idade. As regiões anatômicas mais freqüentemente picadas foram: pé (43,6%, pernas (23,2% e mãos (20,1%. Em relação ao tempo de atendimento, mais de 80% dos envenenamentos foram atendidos com menos de 6 horas da picada. Os envenenamentos foram classificados, de acordo com a gravidade, em leves (31,6%, moderados (47,5% ou graves (9,6%. As complicações mais comuns foram necrose tecidual no local da picada (31,8% nos envenenamentos botrópicos e insuficiência renal aguda (1,2% nos envenenamentos crotálicos. A letalidade geral foi de 0,46%, sendo a maior taxa observada entre acidentes crotálicos (1%. CONCLUSÕES: Acidentes por serpentes peçonhentas no Estado de Goiás acometem principalmente a população jovem do sexo masculino e têm sido causa de óbito.

  2. Impulsividade e acidentes de trânsito Impulsiveness and traffic accidents

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    Marcus Maximilliano Araújo

    2009-01-01

    Full Text Available CONTEXTO: As lesões por acidentes de trânsito são um problema de saúde pública e constituem uma das principais causa mortis de adultos jovens no mundo. OBJETIVO: Revisar resultados relevantes sobre a relação entre impulsividade e comportamentos de risco e acidentes de trânsito. MÉTODO: O levantamento bibliográfico foi realizado nas bases MedLine, LILACS, Desastres, Cochrane Lybrary, no banco de teses da CAPES e PsycINFO, compreendendo o período de 1966 a 2006. RESULTADOS: Dos 11 estudos originais encontrados ("n" de 3806 indivíduos, seis abordaram a associação entre impulsividade e comportamento de risco no trânsito e cinco trataram da impulsividade e acidentes de trânsito. A associação entre impulsividade e correr por aventura foi observada em dois estudos e a correlação entre impulsividade e infrações em três. No desfecho acidentes, três autores mostraram associação e dois não. CONCLUSÕES: A impulsividade está associada ao comportamento de risco no trânsito, correr por aventura e infrações. A associação entre impulsividade e mais envolvimento em acidentes é controversa.BACKGROUND: Injuries due to road traffic accidents are a major public health problem as well as one of the main causes of death among young males aged 15 to 44 years. OBJECTIVES: This paper reviews the relation between impulsiveness and risk driving behavior and between impulsiveness and traffic accidents. METHODS: Bibliographic review. Sources: MedLine (1966 to 2006, Cochrane databases, LILACS, Desastres, PsycINFO and CAPES theses archive. RESULTS: In total, 11 original studies (n=3806. Association between impulsiveness and speeding for the thrill (02 articles, impulsiveness and driver violations (03 articles and impulsiveness traffic road accidents (03 articles. CONCLUSIONS: The impulsiveness is associated to the risky driving behavior, "run for thrill" and "traffic violations". The association between impulsiveness and accident proness is

  3. Related risk factors for pulmonary infections in cerebral vascular disease patients%脑血管疾病患者合并肺部感染的相关危险因素调查

    Institute of Scientific and Technical Information of China (English)

    黄贞

    2013-01-01

    OBJECTIVE To explore the related risk factors for the pulmonary infections in the patients with cerebral vascular diseases so as to perform the targeted prevention. METHODS The medical records of 176 cases with cerebral vascular diseases were retrospectively analyzed, the related risk factors for the combined pulmonary infections were analyzed as well. RESULTS There were 36 cases with pulmonary infections, and the incidence rate was 20. 46%. The incidence rates of the pulmonary infections were as follows:the people whose age was less than 70 years 11. 98% , the people whose age was more than 70 years 4. 38% , the male 23. 91 % , the female 16. 67% , the people with disorder of consciousness 51. 72%, the people without consciousness disorder 14. 29%, the hemorrhagic patients 31. 96%, the ischemic patients 6. 33%, the people with invasive operation 37. 50%, the people without the invasive operation 10. 71%, the people complicated with diabetes mellitus 60. 00%, the people without complicated diabetes mellitus 10. 64% , the people combined with chronic bronchitis 76. 92%, the people without chronic bronchitis 10. 67%, the people with intracranial hypertension 55. 56%, the people without intracranial hypertension 16. 46% , the people with the bedridden duration less than 10 days 6. 67% ,and the people with the bedridden duration more than 10 days 25. 19%. The difference in the incidence of pulmonary infections between the patients with different age, consciousness disorders, cerebrovascular disease types, invasive operations, diabetes, chronic bronchitis, intracranial hypertension, and bedridden duration was statistically significant(P< 0. 05). Multivariate logistic analysis revealed that the age, impaired consciousness, cerebrovascular disease types, invasive operation, diabetes, chronic bronchitis, and bedridden time were the independent risk factors(P<0. 01). CONCLUSION The incidence rate of the pulmonary infections is relatively high in the patients with the

  4. Clinical application of three-dimensional DSA combined with roadmap technique in diagnosis of cerebral vascular diseases%3D-DSA联合roadmap技术在脑血管疾病介入诊治中的应用价值

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    陈建华; 贺雄军; 段传志; 刘亚杰; 张炘; 彭志康; 刘亚洪; 汪求精; 何旭英; 黎凯锋

    2015-01-01

    Objective To discuss the application value of three-dimensional digital subtraction angiography(3D-DSA) combined with roadmap technology in diagnosis and therapy for cerebral vascular disease. Methods A total of 169 patients with cerebral vascular disease were enrolled, which included 73 males and 57 females;aged 6-81 years old with mean age of 49.31 years old. All of them were performed by DSA and endovascular treatment, and divided into 2 groups accorded to treatment process. The first group(n=104) received 3D-DSA and 2D-DSA examination which combined with roadmap treatment to identify features of aneurysm, arteriovenous malformations(AVM) and artery stenosis in image exposure of 3D-DSA, and compared results with those of 2D-DSA. The second group (n=65) was received 2D-DSA examination and interventional treatment, which also combined with roadmap treatment to compare with 3D-DSA examination combined roadmap treatment in first group. Results In aneurysmal neck detection rate, the accurate rate of 3D-DSA aneurysm was higher 16.3 %(7/43) than that of 2D-DSA, the exposure of aneurysmal neck was higher 48.2%than that of 2D-DSA. There were significant statistic differences in blood flow pattern of AVM artery and vascular malformation construction(P<0.05). The exposure of intravascular plaque by 3D-DSA was higher 30.7%than that of 2D-DSA, and accurate measurement of blood vessels stenosis of 3D-DSA was higher 42.3%than that of 2D-DSA. In treatment, there was significant statistic difference(P<0.05) in operation time and X-ray exposure time between 3D-DSA combined with roadmap technology and 2D-DSA combined with roadmap technology. And there were significant statistic differences between 3D-DSA and 2D-DSA in roadmap image times, image volume dose and X-ray radiation dosage( P<0.05). Conclusion It is demonstrated that compared with traditional 2D-DSA, the 3D-DSA combined with roadmap techniquein cerebrovascular disease has more important application value in diagnosis and

  5. Evaluación costo – efectividad del hospital de día geriátrico versus el servicio de mediana estancia en la recuperación funcional de pacientes con accidente vascular cerebral, del Hospital Nacional de Geriatría durante el año 2007

    OpenAIRE

    Solis Umaña, María de los Ángeles

    2013-01-01

    El siguiente trabajo de investigación pretende realizar una evaluación económica, basada en el análisis costo / efectividad, comparando la estrategia de Hospital de Día Geriátrico con la estrategia de Mediana Estancia, enfocada solamente a pacientes con accidente vascular cerebral para demostrar el beneficio institucional por el lado de los costos y el grado de recuperación funcional por el lado del beneficio en el paciente. Se revisaron para este fin los datos del año 2007, tanto en la...

  6. Effects of Naokang II on Patients with Vascular Cognitive Impairment after Cerebral Infarction%脑康Ⅱ号对脑梗死后血管性认知障碍患者的干预研究

    Institute of Scientific and Technical Information of China (English)

    王宁群; 黄小波; 魏翠柏; 陈文强; 陈玉静

    2014-01-01

    目的:观察脑康Ⅱ号对脑梗死后无痴呆型血管性认知障碍的临床疗效。方法:将100例符合入组标准的患者随机分为治疗组(中西医结合治疗组)和对照组(西医治疗组)。观察治疗前后患者认知功能、神经功能缺损程度评分、日常生活活动能力及生存质量评分。结果:治疗组NIHSS评分的改善优于对照组(P<0.05);治疗组MoCA评分的改善优于对照组,主要表现在视空间和执行功能、注意力、计算力、延迟回忆、定向力等方面(P<0.05)。治疗组与对照组在特异性生存质量量表“卒中影响量表( SIS)”中体力、日常活动能力、行动能力、社会参与等维度的改善方面具有显著差异,治疗组优于对照组(P<0.05,P<0.01)。结论:脑康Ⅱ号能够改善脑梗死后无痴呆型血管性认知障碍患者的认知功能和生存质量。%Objective:To observe the clinical effect of Naokang II on vascular cognitive impairment without dementia after cerebral infarction.Methods:100 patients that met the inclusion criteria were randomly divided into a treatment group ( treated by combination of Chinese medicine and western medicine ) and a control group ( treated by western medi-cine) .The scores of cognitive function, the neurological function defect, the activities of daily living and life quality were observed before and after treatment.Results: The improvement of NIHSS score in the treatment group was better than that in the control group (P<0.05).The improvement of MoCA score in the treatment group was also better,espe-cially in visual spatial and executive function, attention, calculation, delayed recall and directional function ( P <0.05 ) .The treatment group and the control group showed significant differences in the improvement of physical strength, ability of daily activities, action ability, social participation and other dimensions in the specific quality of life

  7. Olanzapine vs Sulpiride in Treating Delusional Syndrome after Acute Cerebral Vascular Disease%奥氮平与舒必利治疗急性脑血管疾病后妄想综合征比较

    Institute of Scientific and Technical Information of China (English)

    唐斌

    2013-01-01

    目的观察奥氮平治疗急性脑血管疾病后妄想综合征的疗效。方法 急性脑血管疾病后妄想综合征病人100例,分为2组奥氮平组50例,男性28例,女性22例,年龄(60±S11)岁,给予奥氮平2.5mg/d逐渐加至5~10mg/d、PO×4周;舒必利组50例,男性26例,女性24例,年龄(62±S13)岁,给予舒必利0.3g/d逐渐加至0.4~0.6g/d、PO×4周。结果奥氮平组和舒必利组经过4WK的治疗后总有效率分别为88%和83%(P>0.05)、两组在2周末有效率分别为78%和26%(P<0.05)。结论 奥氮平治疗急性脑血管疾病后妄想综合征与舒必利对比显效早、药物不良反应少且轻。%Objective:To observe the effects of olanzapine for curing delusions syndrome after acute cerebral vascular disease(ACVD).Method:One hundred patients with ACVD were divided into two groups; olanzapine group (50 patients) male28, female22, age(60±12)a. were given olanzapine 2.5mg/d with gradual increase dosage of 5~10>mg/d, po× 4wk;Sulpiride group of 50 patients, M26, F24, age(62±13)a, sulpiride 0.3g/d also with gradual increase of dosage into 0.4~0.6g/d, po for 4weeks. Result: After 4weeks, the general effective rates of olanzapine group and sulpivide group were 88% and 80%, respectively(P>0.05), those of two group by the end of 2weeks were 78% and 26%, respectively(P<0.05). Conclusion: Delusional syndrome disappearing after ACVD with olanzapine is earlier than sulpiride with more effective results and less adverse reactions.

  8. Nursing Procedure for Patients with Cerebral Vascular Accident Pre-hospital Emergency%浅谈脑血管意外患者院前急救的护理程序

    Institute of Scientific and Technical Information of China (English)

    潘帅平

    2015-01-01

    目的院前急救是抢救的重要环节,探讨运用规范的护理程序后院前急救脑血管意外患者生命支持的时效显著提高,在提高脑血管意外患者院前急救成功率中有重要作用。方法在院前急救中正确规范运用护理程序,迅速了解患者的生命体征,对病情做出及时评估,并进行必要的生命支持及安全转运。结果运用正确规范的护理程序后,院前急救脑血管意外患者生命支持的时效显著提高。结论在运用正确规范的护理程序后,院前急救脑血管意外患者生命支持的时效显著提高,在提高脑血管意外患者院前急救成功率中有重要作用。%Objective Pre-hospital first aid is an important part of the rescue,discussed using the normative nursing program backyard before emergency cerebrovascular accident patients life support aging significantly increased,in improving pre-hospital emergency cerebrovascular accident patients play an important role in the success rate.Methods In pre-hospital first aid cor ect specification using the nursing process,quickly understand the patient's vital signs,to condition assessment in time,and make the necessary life support and safe transport.Results Using the right after the normative nursing program,cerebrovascular accident patients with pre-hospital emergency life support aging significantly increased.Conclusion The ef ect of life support on the life support of patients with cerebral vascular accidents in the pre hospital emergency treatment is significantly improved, and it plays an important role in improving the success rate of cerebrovascular accident patients.

  9. Hipertensão intracraniana em vítimas fatais de acidente de trânsito Increased intracranial pressure in victims of fatal road traffic accident

    Directory of Open Access Journals (Sweden)

    JOSÉ EYMARD HOMEM PITTELLA

    1999-09-01

    Full Text Available Foi realizada análise morfológica, macro e microscópica, das lesões encefálicas de 120 vítimas fatais de acidente de trânsito. A hérnia para-hipocampal, a hemorragia de Duret e o infarto médio-basal occipital, indicadores fidedignos de que o paciente apresentou hipertensão intracraniana (HIC, ocorreram em 43 pacientes (35,8%. A HIC no trauma cranioencefálico é causada pela tumefação cerebral congestiva e pelos hematomas intracranianos. Na presente casuística foram observados 3 hematomas extradurais (7,0%, 9 hematomas subdurais agudos (20,9%, 6 hematomas intracerebrais (14%, 6 explosões lobares (14% e 9 tumefações cerebrais congestivas (20,9%.A morphological study, macro and microscopical, was made of brain lesions in 120 victims of fatal road traffic accidents. Parahipoccampal hernia, Duret haemorrhage and infarction in the medio-basal occipital lobe, clear evidence of raised intracranial pressure, occurred in 43 (35.8% patients. The increased intracranial pressure from the head injury is caused by brain swelling and by intracranial haematomas. In this series 3 cases of extradural haematomas (7.0%, 9 of subdural haematomas (20.9%, 6 of intracerebral haematomas (14%, 6 of burst lobe (14% and 9 of brain swelling (20.9% were observed.

  10. Digital subtraction angiography in cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sin Young; Kim, Ji Hun; Suh, Hong Kil; Kim, Hyo Heon; Kwack, Eun Young; Lee, Il Seong [College of Medicine Hallym University, Seoul (Korea, Republic of)

    1995-01-15

    The usefulness and radiographic findings of the angiography in cerebral infarction are well known. We attempted to evaluate the angiographic causes, findings, and the usefulness of DSA in cerebral infarction. The authors reviewed retrospectively DSA images of 51 patients who were diagnosed as having cerebral infarction by brain CT and/or MRI and clinical settings. DSA was performed in all 51 patients, and in 3 patients, conventional angiogram was also done. Both carotid DSA images were obtained in AP, lateral, oblique projections, and one or both vertebral DSA images in AP and lateral. The authors reviewed the patient's charts for symptoms, operative findings and final diagnosis, and analysed DSA findings of cerebral atherosclerosis with focus on 6 major cerebral arteries. Among the 51 patients of cerebral infarction 43 patients (84.3%) had cerebral atherosclerosis, 1 dissecting aneurysm, 1 moyamoya disease and 6 negative in angiogram. DSA findings of cerebral atherosclerosis were multiple narrowing in 42 patients (97.7%), tortuosity in 22 (51.2%), dilatation in 14, occlusion in 12, avascular region in 8, collaterals in 7, ulcer in 6, and delayed washout of contrast media in 3. In cerebral atherosclerosis, internal carotid artery was involved in 37 patients (86.0%), middle cerebral artery in 29 (67.4%) posterior cerebral artery in 28, anterior cerebral artery in 26, vertebral artery in 22, and basilar artery in 15. Intracranial involvement of cerebral atherosclerosis (64.9%) was more common than extracranial involvement (16.2%). In cerebral infarction MRA may be the screening test, but for more precise evaluation of vascular abnormality and its extent, DSA should be considered.

  11. Clinical study of senile cerebral vascular disease sequelae hyponatremia in elderly%老年脑血管病后遗症患者低钠血症临床研究

    Institute of Scientific and Technical Information of China (English)

    刘莹; 张敏; 李景刚

    2014-01-01

    Objective We aimed to research on the causes of senile cerebrovascular disease sequela patients complicated with hyponatremia, to facilitate the treatment process of the intervention. Method 80 patients with cerebral vascular disease sequelae from January 2012 to December 2013 in our hospital ward neural department of internal medicine were taken as the research objects. In terms of hyponatremia, they were divided into two groups: 32 cases in low sodium group, 48 cases in normal group. The related factors were analyzed. Results The main influence factors of senile cerebrovascular disease sequela patients complicated with hyponatremia is old age, being bedridden, nasal feeding, unconsciousness, combined with tumor, with pneumonia or respiratory failure, incomplete cardiac function in coronary heart disease, poor nutrition. The above factors were representative index (P<0.05). The clinical manifestations were mainly fatigue, anorexia, increase of disturbance of consciousness which accounted for 68.75%, 65.63%, 59.38%respectively, according to the incidences of qualifying are fatigue, anorexia, exacerbation of disturbance of consciousness, weak pulse, nausea, vomiting, cold extremities, dizziness, irritability, delirium and seizures. 32 cases were found in a timely manner. With timely supplement of sodium, 30 patients with hyponatremia were corrected, 2 patients with recurrent hyponatremia finally complicated with multiple organ failure, pulmonary infection were died. Conclusion The figure of elderly patients with cerebral vascular disease sequela of hyponatremia incidence is still high, the causes and severity of sequelae, complications, survival status are closely related, and the clinical manifestations were not specific. As for intervention on high risk factors of high-risk patients, the monitoring is the main means of prevention and treatment.%目的:研究老年脑血管病后遗症患者并发低钠血症的原因,以利于治疗

  12. Epidemiologia do acidente por serpentes peçonhentas: estudo de casos atendidos em 1988

    Directory of Open Access Journals (Sweden)

    Lindioneza Adriano Ribeiro

    1995-10-01

    Full Text Available Foram avaliados aspectos epidemiológicos de acidentes por serpentes peçonhentas no Estado de São Paulo, Brasil, com base em prontuários de 322 pacientes e em entrevistas feitas com 209 deles e/ou seus acompanhantes. Os acidentes ocorreram principalmente com pessoas de 10 a 20 anos de idade, do sexo masculino, nos meses de outubro a abril e no período diurno. As regiões anatômicas mais freqüentemente picadas foram os pés, as mãos e as pernas. Bothrops, Crotalus e Micrurus foram responsáveis por, respectivamente, 95,0%, 4,4% e 0,6% dos casos. Não ocorreram óbitos, mas 2,2% dos pacientes apresentaram seqüelas. Dentre os 209 entrevistados, a ocupação de lavrador foi a mais freqüentemente relacionada ao acidente que, em aproximadamente 60% das vezes, ocorreu durante o trabalho. O total de 160 pacientes (76,6% submeteram-se a alguma forma de tratamento antes de chegarem a um serviço de saúde: foram mais comuns o uso de torniquete (50,2%, a expressão local na tentativa de retirar parte do veneno (33,5%, a colocação das mais diversas substâncias sobre o local da picada (36,8% e a ingestão de outras (12,9%; pouco mais de um quarto dos pacientes submeteram-se a alguma forma de tratamento médico antes de chegar ao HVB sendo mais comum a antissepsia (8,2%, a administração do antiveneno (6,2%, de anti-histamínicos (5,7% e de analgésicos (5,3%.

  13. Epidemiologia do acidente por serpentes peçonhentas: estudo de casos atendidos em 1988

    Directory of Open Access Journals (Sweden)

    Ribeiro Lindioneza Adriano

    1995-01-01

    Full Text Available Foram avaliados aspectos epidemiológicos de acidentes por serpentes peçonhentas no Estado de São Paulo, Brasil, com base em prontuários de 322 pacientes e em entrevistas feitas com 209 deles e/ou seus acompanhantes. Os acidentes ocorreram principalmente com pessoas de 10 a 20 anos de idade, do sexo masculino, nos meses de outubro a abril e no período diurno. As regiões anatômicas mais freqüentemente picadas foram os pés, as mãos e as pernas. Bothrops, Crotalus e Micrurus foram responsáveis por, respectivamente, 95,0%, 4,4% e 0,6% dos casos. Não ocorreram óbitos, mas 2,2% dos pacientes apresentaram seqüelas. Dentre os 209 entrevistados, a ocupação de lavrador foi a mais freqüentemente relacionada ao acidente que, em aproximadamente 60% das vezes, ocorreu durante o trabalho. O total de 160 pacientes (76,6% submeteram-se a alguma forma de tratamento antes de chegarem a um serviço de saúde: foram mais comuns o uso de torniquete (50,2%, a expressão local na tentativa de retirar parte do veneno (33,5%, a colocação das mais diversas substâncias sobre o local da picada (36,8% e a ingestão de outras (12,9%; pouco mais de um quarto dos pacientes submeteram-se a alguma forma de tratamento médico antes de chegar ao HVB sendo mais comum a antissepsia (8,2%, a administração do antiveneno (6,2%, de anti-histamínicos (5,7% e de analgésicos (5,3%.

  14. Multicausalidade nos acidentes de trabalho da Enfermagem com material biológico

    OpenAIRE

    2013-01-01

    Com o objetivo de analisar a multicausalidade dos acidentes de trabalho com exposição biológica em trabalhadores de enfermagem, foi realizada uma pesquisa descritiva e exploratória em um hospital de médio porte do Estado do Paraná, no período entre janeiro de 2008 a janeiro de 2009. A população foi de 26 trabalhadores de enfermagem da clínica médica. A coleta de dados foi realizada por entrevistas semiestruturadas com cinco dos oito acidentados no período; os conteúdos foram analisados pelo D...

  15. What Is Vascular Disease?

    Science.gov (United States)

    ... Donors Corporate Sponsors Donor Privacy Policy What Is Vascular Disease? What Is Vascular Disease? Vascular disease is any abnormal condition of ... steps to prevent vascular disease here. Understanding the Vascular System Your vascular system – the highways of the ...

  16. Detecting cerebral vascular diseases by transcranial Doppler ultrasound and dolor Doppler flow imaging in comparison with digital subtracted angiography%经颅多普勒及彩色多普勒超声与数字减影脑血管造影对脑血管病检测的比较研究

    Institute of Scientific and Technical Information of China (English)

    张小征; 吕健; 李俊; 胡军民; 龚杰; 徐国政; 马廉亭; 陈欣林

    2000-01-01

    目的 评价经颅多普勒(TCD)在脑血管病诊断、疗效评估中的应用价值.方法 应用TCD检测脑血管疾病患者306例,其中脑动静脉畸形170例,颈动脉海绵窦瘘(CCF)69例,颅内动脉瘤67例,并与数字减影脑血管造影(DSA)、彩色多普勒血流显像(CDFI)进行对比研究.结果 以DSA脑血管造影为金指标,TCD检出脑动静脉畸形93%,检出CCF 100%,判断CCF静脉回流方式96%,检出颅内动脉瘤67%.对颅内较大动脉瘤(>1.5 cm)的检测有特征性表现,提出"动脉瘤样频谱"的新概念.结论 TCD能实时、准确反映颅内血流动力学改变及侧支循环代偿情况,对脑血管病诊断、疗效评估有重要价值.%Objective To evaluate the effect of transcranial Doppler(TCD)on detecting cerebral vascular diseases.Methods One hundred and seventy patients with cerebral arterovenous malformation(AVM),69 carotid cavernous fistula (CCF)and 67 intracranial aneurysms were examined early or late by TCD, digital subtracted angiography(DSA)and color Dopplor flow imaging.The results of their examination were compared and analyzed.Results If the results of DSA examination was regarded as a golden criterion of diagnosing the cerebral vascular dNease,93%of the 170 patients with AVMs,100% of the 69 patients with CCFS and 67%of the 67 patients with the aneurysms were detected by TCD respectively.It was found that the relative larger aneurysm(diameter>1.5 crn)had a special TCD manifestation, the SO-called ”aneurysm-like spectrum”. Conclusion TCD is necessary for detecting the cerebral vascular lesions because it can reveal accurately a change in the intracranial hemodynamics and a condition of the collateral circulation.

  17. CEREBRAL VENOUS THROMBOSIS AND TURNER SYNDROME: A RARE REPORTED ASSOCIATION.

    Science.gov (United States)

    Guler, A; Alpaydin, S; Bademkiran, F; Sirin, H; Celebisoy, N

    2015-01-01

    Turner Syndrome is the only known viable chromosomal monosomy, characterised by the complete or partial absence of an X chromosome. It's the most common chromosomal abnormality in females. Apart from the well known dysmorphic features of the syndrome, it has been associated with a number of vascular pathologies; mainly involving the cardiovascular, renovascular, peripheral vascular and cerebrovascular system. It seems striking that thromboembolism is not considered as a feature of the syndrome. Most of the thromboembolism cases are related to the arterial vascular system; except for some rare reported portal venous thrombosis cases, peripheral venous thrombosis cases and to the best of our knowledge a single case of cerebral venous thrombosis with Dandy Walker malformation and polymicrogyria. We herein report a cerebral venous thrombosis case with Turner Syndrome. With no other found underlying etiology, we want to highlight that Turner Syndrome, itself, may have a relationship not only with the cerebral arterial vascular system pathologies but also with the cerebral venous thrombosis.

  18. The guiding significance of the 640 layer CT perfusion combined with the vascular imaging in thrombolysis therapy for the super acute cerebral in-farction%640层CT灌注联合血管成像在脑梗死超早期溶栓中的指导意义

    Institute of Scientific and Technical Information of China (English)

    田峰; 田学实; 梁文胜

    2014-01-01

    Objective To investigate the guiding significance of 640 layer CT perfusion combined with vascular ima-ging in thrombolytic therapy for super acute cerebral infarction .Methods 30 cases of patients with superacute cere-bral infarction were taken the examination of brain CT scan and 640 CT layer perfusion combined with the vascular im-aging.The ischemic penumbra were determined according to the change of cerebral blood flow (CBF),regional cere-bral blood volume (rCBV),mean traverse time(MTT)and time to peak(TTP)in region of interest(ROI)and the ratio of left and right sides of CBF .At the same time ,38 patients were chosen to give thrombolytic therapy without CT perfu-sion imaging (20 patients with arterial thrombolytic therapy and 18 patients with intravenous thrombolytic therapy ) . Compare their discrepancy in efficacy .Results The effect of arteriovenous thrombolytic therapy guided by CT perfu-sion is better than that of non perfusion guidance of arteriovenous thrombolytic therapy .Conclusion It has a guid-ing significance in thrombolytic therapy for super acute cerebral infarction to make 640 CT perfusion combined with vascular imaging ,which can show that the degree of head and neck vascular stenosis and determine ischemic penumbra for guiding early clinical interventional thrombolytic therapy or vascular reconstruction treatment in order to save ische -mic penumbra and restore the blood perfusion of ischemic brain tissue as soon as possible .It has crucial clinical value to improve the prognosis and reduce the incidence of mortality and morbidity .%目的:探讨640层CT灌注联合血管成像在脑梗死超早期溶栓中的指导意义。方法对30例脑梗死超早期的患者,进行脑部CT平扫及640层CT灌注联合血管成像检查,根据脑血流量( CBF )、脑血容量、平均通过时间、达峰时间的变化及左右两侧CBF的比值,判定有无缺血半暗带;同时选择未做CT灌注检查的38例溶栓患者,对比它

  19. [Vascular dementia

    NARCIS (Netherlands)

    Leeuw, H.F. de; Gijn, J. van

    2004-01-01

    Vascular dementia is one of the most frequently occurring dementia syndromes. Its prevalence is about 5% among subjects above 85 years of age. Elevated blood pressure and atherosclerosis are the most important risk factors. According to international criteria, vascular dementia usually occurs within

  20. Cerebral oxygenation and hyperthermia

    Directory of Open Access Journals (Sweden)

    Anthony Richard Bain

    2014-03-01

    Full Text Available Hyperthermia is associated with marked reductions in cerebral blood flow (CBF. Increased distribution of cardiac output to the periphery, increases in alveolar ventilation and resultant hypocapnia each contribute to the fall in CBF during passive hyperthermia; however, their relative contribution remains a point of contention, and probably depends on the experimental condition (e.g. posture and degree of hyperthermia. The hyperthermia-induced hyperventilatory response reduces arterial CO2 pressure (PaCO2 causing cerebral vasoconstriction and subsequent reductions in flow. During supine passive hyperthermia, the majority of recent data indicate that reductions in PaCO2 may be the primary, if not sole, culprit for reduced CBF. On the other hand, during more dynamic conditions (e.g. hemorrhage or orthostatic challenges, an inability to appropriately decrease peripheral vascular conductance presents a condition whereby adequate cerebral perfusion pressure may be compromised secondary to reductions in systemic blood pressure. Although studies have reported maintenance of pre-frontal cortex oxygenation (assessed by near-infrared spectroscopy during exercise and severe heat stress, the influence of cutaneous blood flow is known to contaminate this measure. This review discusses the governing mechanisms associated with changes in CBF and oxygenation during moderate to severe (i.e. 1.0°C to 2.0°C increase in body core temperature levels of hyperthermia. Future research directions are provided.

  1. Cerebral Paragonimiasis.

    Science.gov (United States)

    Miyazaki, I

    1975-01-01

    The first case of cerebral paragonimiasis was reported by Otani in Japan in 1887. This was nine years after Kerbert's discovery of the fluke in the lungs of Bengal tigers and seven years after a human pulmonary infection by the fluke was demonstrated by Baelz and Manson. The first case was a 26-year-old man who had been suffering from cough and hemosputum for one year. The patient developed convulsive seizures with subsequent coma and died. The postmortem examination showed cystic lesions in the right frontal and occipital lobes. An adult fluke was found in the occipital lesion and another was seen in a gross specimen of normal brain tissue around the affected occipital lobe. Two years after Otani's discovery, at autopsy a 29-year-old man with a history of Jacksonian seizure was reported as having cerebral paragonimiasis. Some time later, however, it was confirmed that the case was actually cerebral schistosomiasis japonica. Subsequently, cases of cerebral paragonimiasis were reported. However, the majority of these cases were not confirmed histologically. It was pointed out that some of these early cases were probably not Paragonimus infection. After World War II, reviews as well as case reports were published. Recently, investigations have been reported from Korea, with a clinicla study on 62 cases of cerebral paragonimiasis seen at the Neurology Department of the National Medical Center, Seoul, between 1958 and 1964. In 1971 Higashi described a statistical study on 105 cases of cerebral paragonimiasis that had been treated surgically in Japan.

  2. Nimodipine treatment hepertensive cerebral hemorrhage to reduce cerebral vascular resistance and improve the effect of recent this paper probes into the signiifcance%尼莫地平治疗高血压性脑出血对降低脑血管阻力及提高近期疗效的意义

    Institute of Scientific and Technical Information of China (English)

    刘洪英; 刘希华; 潘双双; 何旦旦; 李梦瑶

    2014-01-01

    目的:探讨尼莫地平治疗高血压性脑出血过程中,对降低外周脑血管阻力(R)及提高近期治疗效果的意义与价值。方法选择20011年1月至2014年1月滨州市中心医院收治的高血压性脑出血患者208例,随机将其分成试验组与对照组,各104例,对照组行常规治疗,试验组在对照组治疗的基础上加用尼莫地平,采用静脉滴注方式,缓慢静滴,尼莫地平使用剂量为10 mg/d,滴注速度为1~3 mg/h。随后对两组患者的脑循环动力学参数(CVHI)进行检测,比较两组治疗前后平均血流速度(Vmean)、平均血流量(Qmean)、水肿面积与血肿体积、外周脑血管阻力(R)、临界压力值(CP)、神经功能缺损评分(NIHSS评分)、日常生活活动能力评分(BI评分),并对比两组治疗效果。结果治疗前与治疗后相比,两组患者的Qmean值均有所提高,但试验组较对照组升高明显(P0.05);两组患者R及CP值均有所降低,但试验组较对照组降低明显(P0.05),试验组NIHSS评分降低明显(P0.05);Two groups of patients R and CP values are reduced, but the lower than the control group obvious (P0.05), and the lower NIHSS scores significantly (P<0.05), BI score increase obviously (P<0.05), and the treatment were 85.58%and significant efficiency, and the 59.03%significant efficiency increased significantly (P<0.05). Conclusion Hepertensive cerebral hemorrhage application nimodipine treatment, small side effects, and the results were reliable, and can reduce cerebral vascular resistance, increase blood flow to the brain, to improve the short-term curative effect has a very important significance and value, popularization.

  3. Acute Ischemic Stroke on Cancer Patients, a Distinct Etiology? A Case-Control Study.

    Science.gov (United States)

    Carrilho Romeiro, Ana; Valadas, Anabela; Marques, José

    2015-01-01

    Introdução: Actualmente ainda não se encontra claramente definido se a etiologia do acidente vascular cerebral isquémico agudo difere entre doentes com e sem cancro. O acidente vascular cerebral isquémico e o cancro apresentam factores de risco comuns. No entanto, a literatura sugere que os doentes com cancro apresentam condições específicas que aumentam o risco de acidente vascular cerebral. O nosso objectivo foi comparar a etiologia do acidente vascular cerebral isquémico entre doentes com cancro e sem cancro. Material e Métodos: Estudo de caso-controlo realizado em doentes internados numa Unidade de acidente vascular cerebral entre Janeiro de 2007 e Dezembro de 2012. Os casos foram definidos como doentes com o diagnóstico concomitante de acidente vascular cerebral isquémico agudo e cancro; os controlos apenas com o diagnóstico de acidente vascular cerebral. Foram comparados entre os grupos: idade, género, factores de risco vasculares e etiologia do acidente vascular cerebral. Resultados: Foram identificados 56 casos, 64,3% do género masculino, com idade média de 71 anos; 21 doentes apresentavam doença neoplásica activa. O cancro gastrointestinal (25,9%) foi o mais frequente. Foram incluídos 151 controlos, emparelhados para a idade e género. A comparação dos factores de risco vasculares entre casos e controlos não revelou diferenças estatisticamente significativas, excepto para a diabetes mellitus, mais frequente no grupo de controlo (16,1% vs 33,8%, p = 0,02). A presença de história de eventos trombóticos prévios foi mais frequente na coorte de doentes com doença neoplásica (8,9% vs 0,7%, p = 0,007). O subtipo de etiologia do acidente vascular cerebral (classificação TOAST) âoutra etiologiaâ foi mais frequente nos doentes com cancro (13,04% vs 0,83%, p etiologia do acidente vascular cerebral deve alertar o médico para a pesquisa de uma doença neoplásica oculta.

  4. Paradoxical embolisation and cerebral white matter lesions in dementia.

    NARCIS (Netherlands)

    Purandare, N.; Oude Voshaar, R.C.; McCollum, C.; Jackson, A.; Burns, A.

    2008-01-01

    The study aimed to examine the relationship between spontaneous cerebral emboli (SCE), patent foramen ovale (PFO) and white matter hyperintensities (WMH) on cerebral MRI in patients with Alzheimer's disease (AD) and vascular dementia (VaD). SCE were identified by transcranial Doppler of the middle c

  5. Cerebral autoregulation dynamics in endurance-trained individuals

    NARCIS (Netherlands)

    M. Lind-Holst; J.D. Cotter; J.W. Helge; R. Boushel; H. Augustesen; J.J. van Lieshout; F.C. Pott

    2011-01-01

    Aerobic fitness may be associated with reduced orthostatic tolerance. To investigate whether trained individuals have less effective regulation of cerebral vascular resistance, we studied the middle cerebral artery (MCA) mean blood velocity (V(mean)) response to a sudden drop in mean arterial pressu

  6. 精准医疗与脑血管病:教学实践与探索%Precise Medicine in Cerebral Vascular Disease:Education Practice and Exploration

    Institute of Scientific and Technical Information of China (English)

    郑华光; 王伊龙; 李姝雅; 张宁; 董可辉; 刘丽萍; 王春雪; 赵性泉; 王拥军

    2016-01-01

    Objective To describe the definition of precise medicine and its application status in the field of cerebral vascular disease and to evaluate the effectiveness of different education patterns in professional postgraduate teaching. Methods Observation and interview methods were used in this qualitative study during the course of clinical practice, research and education.The acquaintance on progress in thrombolysis, anticoagulation and antiplatelet therapy in acute ischemic stroke and the comprehension of the relationship between guideline and precise medicine were investigated, so as to evaluate the competence of application of precise medicine in guiding clinical practice. The optimal structure of knowledge and the efifcient teaching approach were established with the experience from the western countries. Results The precise medicine consists of the precise imaging, big data and genomics and is used widely in clinical practice, research and development of new drugs. The precise medicine can also be helpful to set up the guideline and the health policy. The knowledge structure and the accomplishment of the medical students with a Master or Doctor degree still need to be improved. Clinical Epidemiology, Biostatistics, Molecular Biology and Computer Science are the foundation for the discipline of the precise medicine. To cultivate the competencies in the creating, clearing up and analyzing the database in project-based training program might be an effective education mode. Conclusion The precise medicine is the result of standardized healthcare development and the future of medical service. Medical students should build an inter-discipline knowledge background and get to be well-trained in the management of database in precise medicine project.%目的:阐述精准医疗在脑血管病专业研究生教学中的模式和意义。方法在临床实践、研究和教学中,通过观察与访谈,了解脑血管病专业研究生对精准医疗概念的理

  7. Acidentes de trabalho autorreferidos pela população adulta brasileira, segundo dados da Pesquisa Nacional de Saúde, 2013

    Directory of Open Access Journals (Sweden)

    Deborah Carvalho Malta

    Full Text Available Resumo O objetivo deste artigo é descrever o perfil da ocorrência dos acidentes de trabalho na população adulta brasileira. Estudo descritivo com dados sobre acidentes de trabalho coletados em 2013 pela Pesquisa Nacional de Saúde. Os acidentes de trabalho ocorreram em 3,4% (IC95% 4,6-5,6 da população adulta brasileira, ou 4,9 milhões de acidentes foram referidos, sendo mais frequentes entre os homens, jovens, de 18 a 39 anos, de cor preta, na região Norte do país. O Pará foi o Estado de maior ocorrência, e o Rio de Janeiro, o menor. Cerca de um terço dos acidentes foram devidos a deslocamento para o trabalho (acidentes de trajeto. Dentre os acidentados pelo trabalho, 50,4% (IC95% 45,3-55,5 deixaram de realizar suas atividades habituais, 8,8% (IC95% 6,4-11,2 foram internados e 19% (IC95% 15,3-22,7 relataram sequelas decorrentes dos acidentes do trabalho. As ocorrências de acidente de trabalhos relatadas na Pesquisa Nacional de Saúde constituem uma fonte inédita no país, possibilitando informação inestimável sobre o cenário do trabalho no Brasil. A Pesquisa Nacional de Saúde identificou que os acidentes de trabalho são subnotificados, já que as informações oficiais cobrem apenas os trabalhadores com vínculo formal de trabalho.

  8. Vascular rings.

    Science.gov (United States)

    Backer, Carl L; Mongé, Michael C; Popescu, Andrada R; Eltayeb, Osama M; Rastatter, Jeffrey C; Rigsby, Cynthia K

    2016-06-01

    The term vascular ring refers to congenital vascular anomalies of the aortic arch system that compress the esophagus and trachea, causing symptoms related to those two structures. The most common vascular rings are double aortic arch and right aortic arch with left ligamentum. Pulmonary artery sling is rare and these patients need to be carefully evaluated for frequently associated tracheal stenosis. Another cause of tracheal compression occurring only in infants is the innominate artery compression syndrome. In the current era, the diagnosis of a vascular ring is best established by CT imaging that can accurately delineate the anatomy of the vascular ring and associated tracheal pathology. For patients with a right aortic arch there recently has been an increased recognition of a structure called a Kommerell diverticulum which may require resection and transfer of the left subclavian artery to the left carotid artery. A very rare vascular ring is the circumflex aorta that is now treated with the aortic uncrossing operation. Patients with vascular rings should all have an echocardiogram because of the incidence of associated congenital heart disease. We also recommend bronchoscopy to assess for additional tracheal pathology and provide an assessment of the degree of tracheomalacia and bronchomalacia. The outcomes of surgical intervention are excellent and most patients have complete resolution of symptoms over a period of time. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Cerebral Palsy (For Teens)

    Science.gov (United States)

    ... Right Sport for You Healthy School Lunch Planner Cerebral Palsy KidsHealth > For Teens > Cerebral Palsy Print A A ... do just what everyone else does. What Is Cerebral Palsy? Cerebral palsy (CP) is a disorder of the ...

  10. Acidentes de trabalho com material biológico ocorridos em municípios de Minas Gerais

    Directory of Open Access Journals (Sweden)

    Renata Siqueira Julio

    2014-01-01

    Full Text Available O objetivo do estudo foi identificar o perfil dos acidentes com exposição a material biológico ocorridos em Minas Gerais. Estudo descritivo, transversal realizado por meio de consulta ao Sistema de Informação de Agravos de Notificação de 50 municípios do sul do Estado de Minas Gerais, Brasil, no período de 2007-2011. Foram registrados 460 acidentes, sendo que cerca da metade ocorreram entre auxiliares e técnicos de enfermagem, seguidos por enfermeiros e médicos. Houve predomínio dos acidentes ocorridos devido ao descarte inadequado de material perfurocortante. Entre os pacientes-fonte, verificou-se uma prevalência de 8,0% de sorologia reagente para o HIV; 1,0% para HBsAg; 6,0% para anti-HBC e 3% para o anti-HCV. Entre os acidentados, 14,0% não estavam imunizados para hepatite B, contudo, a prescrição de vacina e imunoglobulina foi inferior à necessidade. Os resultados subsidiarão o planejamento de ações preventivas e de novas condutas diante da ocorrência desse tipo de acidentes.

  11. Conduta pós-acidente de trabalho no cuidado às pessoas com HIV/Aids

    Directory of Open Access Journals (Sweden)

    Mariana Vieira Villarinho

    2015-08-01

    Full Text Available RESUMOObjetivo:identificar condutas pós-acidente de trabalho pelos profissionais da saúde no cuidado às pessoas com HIV/Aids.Método:estudo descritivo qualitativo com perspectiva sócio-histórica, (1986-2006 realizado em um hospital referência em doenças infectocontagiosas do Estado de Santa Catarina. Para a coleta de dados, utilizou-se entrevista, a partir da História Oral com 23 trabalhadores da saúde e para o tratamento dos dados a análise de conteúdo de Bardin foi utilizado.Resultados:emergiram condutas pós-acidente de trabalho que incluíram avaliação, registro do acidente, quimioprofilaxia quando necessária, acompanhamento, monitoramento do profissional acidentado e, sobretudo, apoio psicológico.Conclusão:nas situações em que o acidente de trabalho não pôde ser evitado, foram importantes as condutas pós-exposição como estratégias de biossegurança mencionadas pelos trabalhadores da saúde no cuidado aos pacientes com HIV/Aids, no sentido de minimizar a possível transmissibilidade do vírus HIV.

  12. VASCULAR SURGERY

    African Journals Online (AJOL)

    Thromboses can result from venous stasis, vascular injury or hypercoagulability, and those involving the deep veins proximal to the knee are linked to an increased risk of PE.2 .... tool for DVT in hospitalised patients, where higher scores.

  13. Vascular Dementia

    Science.gov (United States)

    ... that includes enjoyable activities well within the comfort zone of the person with vascular dementia. New situations, ... your cholesterol in check. A healthy, low-fat diet and cholesterol-lowering medications if you need them ...

  14. Revisão bibliográfica sobre acidentes com crianças Bibliography review about children' accidents

    Directory of Open Access Journals (Sweden)

    Luiza Jane Eyre Xavier de Souza

    1999-06-01

    Full Text Available RESUMO O objetivo do estudo consistiu em apresentar uma revisão bibliográfica dos acidentes com crianças. Utilizaram-se as pesquisas documental e bibliográfica como metodologia. Os dados evidenciam que o acidente com criança é um dos maiores problemas de saúde pública na Inglaterra. Nos Estados Unidos aconteceram, em 1989, cerca de 2.700 mortes como resultado de acidentes em crianças abaixo de 11 anos. No Brasil, também registram-se elevados índices de atendimentos envolvendo os acidentes domésticos e, em Fortaleza, no Ceará, esses casos também são identificados. Conclui-se que os acidentes com crianças são alarmantes e merecem atenção específica com uma abordagem preventiva.ABSTRACT The study's proposal was to evidence a. bibliography review about children' accidents. The bibliography and documental researches were used as methodology. The data made clear that children accidents are the bigger public health problem in. England. In the United States, in 1989, had happened about 2.700 deaths as accident results in children under 1.1 years old. In. Brazil has been registered high index of attendance at pediatric emergencies that involves home accidents. It has been concluded that these cases have been increasing and they need special attention and preventive approach.

  15. Acidentes de trabalho com material biológico em hospital universitário de São Paulo

    Directory of Open Access Journals (Sweden)

    Tanyse Galon

    2008-09-01

    Full Text Available Pesquisa exploratória descritiva com o objetivo de identificar a ocorrência e as características dos acidentes de trabalho (AT com exposição a material biológico entre trabalhadores de um hospital do Estado de São Paulo. Os dados foram coletados por meio de levantamento documental dos registros de AT no hospital e posterior registro no protocolo eletrônico da Rede de Prevenção de Acidentes de Trabalho (REPAT. Os dados foram tratados com uso da estatística descritiva e apresentados em tabelas e figuras. No ano de 2006 foram notificados 94 acidentes envolvendo exposição do trabalhador a fluidos corpóreos no hospital. Considerando-se a proporcionalidade das categorias expostas, o instrumentador cirúrgico (18,75%, o auxiliar de enfermagem (7,78% e o biologista (4,76% foram as categorias mais vitimadas. A agulha hipodérmica foi o agente causador de lesão em 71,62% dos casos. Os AT ocorreram em maior freqüência na administração de medicamentos (32,97% e na coleta de sangue (15,95%. Constatou-se a existência de dados parciais quanto ao uso de Equipamentos de Proteção Individual e a situação vacinal dos trabalhadores. Os resultados revelaram indicadores importantes das características dos acidentes e as lacunas de registros extremamente importantes para a elaboração de um programa preventivo eficaz para minimizar a ocorrência dos acidentes.

  16. Análise dos fatores associados aos acidentes de trânsito envolvendo ciclistas atendidos nas capitais brasileiras

    Directory of Open Access Journals (Sweden)

    Carlos Augusto Moreira de Sousa

    Full Text Available Resumo O Brasil possui a sexta maior frota de bicicletas do mundo, sendo esta o veículo de transporte individual mais utilizado no país. Porém, poucos estudos abordam a temática envolvendo os acidentes com ciclistas, bem como os fatores que colaboram ou evitam essa ocorrência. Utilizou-se amostragem complexa e posterior análise de dados por regressão logística multivariada e cálculo das respectivas razões de chance para estudar o Inquérito de delineamento transversal (VIVA, o qual compõe o Sistema de Vigilância de Violências e Acidentes do Ministério da Saúde. As razões de chance apontaram maiores chances de ocorrência de acidentes envolvendo ciclistas em indivíduos do sexo masculino, de menor escolaridade e que residem em área urbana e periurbana. Pessoas que não estavam utilizando a bicicleta para ir ao trabalho apresentaram maior chance de acidente. O perfil encontrado no presente estudo corrobora os achados de outros estudos, os quais consideram que a coexistência de ciclistas com os demais meios de transporte, no mesmo espaço urbano, acarreta em maior chance de acidentes. A construção de espaços exclusivos à circulação de bicicletas e a realização de campanhas educativas são preconizadas.

  17. Lesion-symptom mapping in vascular cognitive impairment

    NARCIS (Netherlands)

    Biesbroek, J.M.

    2016-01-01

    Cerebral vascular disease (CVD) is an important cause of cognitive decline and dementia, either alone or in combination with neurodegenerative diseases, such as Alzheimer's Disease (AD). The contribution of CVD to cognitive decline and dementia is referred to as Vascular Cognitive Impairment (VCI).

  18. Vasoespasmo cerebral

    OpenAIRE

    1987-01-01

    Vasoespasmo cerebral ocorre em patologias como enxaqueca, hemorragia subaracnóidea, trauma de crânio, após isquemia e/ou hipoxia. A fisiopatologia do vasoespasmo cerebral nestas patologias não está completamente desvendada. Neste artigo são analisados os fatores neuroquímicos e morfológicos responsáveis pelo controle circulatório cerebral. As alterações circulatórias que seguem a hemorragia subaracnóidea são utilizadas como exemplo. Conclui-se que fatores bioquímicos, fisiológicos e morfológi...

  19. Cerebral malaria: insight into pathogenesis, complications and molecular biomarkers

    Science.gov (United States)

    Yusuf, Farah Hafiz; Hafiz, Muhammad Yusuf; Shoaib, Maria; Ahmed, Syed Ahsanuddin

    2017-01-01

    Cerebral malaria is a medical emergency. All patients with Plasmodium falciparum malaria with neurologic manifestations of any degree should be urgently treated as cases of cerebral malaria. Pathogenesis of cerebral malaria is due to damaged vascular endothelium by parasite sequestration, inflammatory cytokine production and vascular leakage, which result in brain hypoxia, as indicated by increased lactate and alanine concentrations. The levels of the biomarkers’ histidine-rich protein II, angiopoietin-Tie-2 system and plasma osteoprotegrin serve as diagnostic and prognostic markers. Brain imaging may show neuropathology around the caudate and putamen. Mortality is high and patients who survive sustain brain injury which manifests as long-term neurocognitive impairments. PMID:28203097

  20. Pheochromocytoma complicated by intracerebral hemorrhage - a case report; Feocromocitoma complicado com acidente vascular encefalico hemorragico - relato de um caso

    Energy Technology Data Exchange (ETDEWEB)

    Nogueira, Aline Silva; Marchiori, Edson; Almeida, Fabiola Assuncao de; Martins, Renata Romano; Sales, Anderson Ribeiro; Santos, Tereza Cristina C.R.S. dos; Reis, Simone Teixeira [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia; Silveira, Sonia Marcelino T. da

    1999-06-01

    The authors report a case of pheochromocytoma that was complicated by intracerebral hemorrhage in a 17-year-old female patient. Computed tomography showed a solid mass, heterogeneous, on the right adrenal. The patient underwent a right adrenalectomy. She is being observed by our out-patients clini