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Sample records for cerebrovascular circulation

  1. Fetal cerebrovascular circulation: a review of prenatal ultrasound assessment.

    Science.gov (United States)

    Degani, S

    2008-01-01

    Antenatal intrauterine cerebrovascular events were found to play an important role in the pathogenesis of perinatal brain damage. Changes in placental vascular resistance, cardiac contractibility, vessel compliance, and blood viscosity alter the normal dynamics of fetal cerebral circulation. The circulatory mechanisms described in animal fetuses also operate in the human fetus. The isthmus of the aorta represents a watershed area reflecting the redistribution of blood during increased peripheral resistance and hypoxia. The fetal cerebrovascular system acts locally within the skull and interacts with the other components of fetal circulation to compensate by redistribution of blood in case of shortage in resources. The introduction of various sonographic techniques and the collection of data from the arterial and venous cerebral circulation have improved our understanding of the regulatory mechanisms involved in fetal cerebral hemodynamic events. Anatomical and physiological considerations of cerebral vasculature in health and disease are relevant in the research of variations in fetal brain blood perfusion. Changes in flow characteristics in fetal cerebral vasculature can be used for clinical decisions. However, caution is advised before applying research data into practice. The clinical utility is well established in situations of fetal compromise such as growth restriction and anemia.

  2. Circulating vitamin D, calcium and risk of cerebrovascular disease: a systematic review and meta-analysis.

    Science.gov (United States)

    Chowdhury, Rajiv; Stevens, Sarah; Ward, Heather; Chowdhury, Susmita; Sajjad, Ayesha; Franco, Oscar H

    2012-08-01

    Available literature suggests that both vitamin D and calcium may be associated with a wide range of non-skeletal outcomes. However, epidemiological evidence supporting their individual associations with incident cerebrovascular disease is scarce. We conducted a systematic review and meta-analysis of prospective cohort studies, published before February 2012 and sought from MEDLINE, EMBASE, BIOSIS and the Science Citation Index databases, and reported cerebrovascular disease (defined as any fatal or non-fatal ischemic stroke, hemorrhagic stroke, cerebrovascular accident or transient ischemic attack) by circulating vitamin D (25-hydroxy vitamin D [25(OH)D] as active metabolite) and calcium levels. Two independent investigators abstracted information on 25(OH)D and calcium, cerebrovascular outcomes and other characteristics from selected studies. Relative risks (RRs) were pooled by both random and fixed effects meta-analyses and were further examined under different study-level characteristics. Publication bias was assessed with funnel plots and Egger's asymmetry test. From 5,778 initial references, nine unique prospective cohort studies met our inclusion criteria. Seven studies (involving 47,809 participants and 926 cerebrovascular events) focused on circulating 25(OH)D and 3 reported on circulating calcium (22,577 participants and 727 events). For 25(OH)D, in a comparison of individuals in the top third versus those in the bottom third at baseline, the combined RR for cerebrovascular disease, adjusted for several conventional risk factors, was 0.60 (95 % CI 0.48, 0.72). The corresponding RR in the prospective studies that reported on baseline circulating calcium levels for cerebrovascular disease was 1.40 (95 % CI 1.19, 1.64). There was no apparent evidence of heterogeneity or publication bias among included studies. Available data indicate that higher circulating level of vitamin D is associated with a decreased risk of cerebrovascular disease. Conversely

  3. The effect of low concentrations of halothane on the cerebrovascular circulation in young children.

    Science.gov (United States)

    Paut, O; Lazzell, V A; Bissonnette, B

    2000-06-01

    To determine the effect of halothane on cerebral blood flow velocity measured by transcranial Doppler, 23 healthy young children were studied during surgery. Anaesthesia was induced with thiopental, fentanyl and vecuronium, and maintained with halothane in 70% nitrous oxide in oxygen. A continuous epidural anaesthesia with 0. 25% bupivacaine was performed. End-tidal carbon dioxide pressure, temperature, heart rate and systolic blood pressure were kept constant. Three minimal alveolar concentrations (MAC; 0.5, 1.0 and 1. 5) of halothane were administered in stepwise increases. The cerebral blood flow velocity increased significantly at 1.0 (p MAC (p value at 0.5 MAC. No further change in cerebral blood flow velocity was seen between 1.0 and 1.5 MAC. These data show that maximal changes in cerebral blood flow velocity are obtained at 1.0 MAC and that further increases in halothane concentration do not modify the cerebral circulation. It is suggested that young children differ from adults in that the maximal effect of halothane occurs at lower concentrations.

  4. Computer modelling of anterior circulation stroke: Proof of concept in Cerebrovascular Occlusion

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    THANH G PHAN

    2014-09-01

    Full Text Available Background: Current literature emphasizes the role of the Circle of Willis (CoW in salvaging ischemic brain tissue but not that of leptomeningeal anastomoses (LA. We developed a computational model of the cerebral circulation to 1 evaluate the roles of the CoW and LA in restoring flow to the superficial compartment of the middle cerebral artery territory and 2 estimate the size of the LA required to maintain flow above the critical ischemic threshold (>30% of baseline under simulated occlusion. Methods: Cerebral vasculature was modelled as a network of junctions connected by cylindrical pipes. The experiments included occlusion of successive distal branches of the intracranial arteries while the diameters of LA were varied. Results: The model showed that the region of reduced flow became progressively smaller as the site of occlusion was moved from the large proximal to the smaller distal arteries. There was no improvement in flow in the MCA territory when the diameters of the inter-territorial LA were varied from 0.0625 mm to 0.5 mm while keeping the intra-territorial LA constant. By contrast, the diameter of the inter-territorial LA needed to be greater than 1.0 mm in order to provide adequate (>30% flow to selected arteries in the occluded MCA territory. Conclusions: The CoW and inter-territorial LA together play important supportive roles in intracranial artery occlusion. Computational modelling provides the ability to experimentally investigate the effect of arterial occlusion on CoW and LA function.

  5. Correlation of cerebrovascular reserve as measured by acetazolamide-challenged perfusion CT with collateral circulation in unilateral high grade carotid stenosis

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    Hong, Doran; Lee, Young Hen; Seo, Hyung Suk; Je, Bo Kyoung [Dept. of Radiology, Ansan Hospital, Korea University College of Medicine, Ansan (Korea, Republic of); Suh, Sang Il; Seol, Hae Young [Dept. of Radiology, Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Kim, Jung Hyuk; Lee, Nam Joon [Dept. of Radiology, Anam Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Yang, Kyung Sook [Dept. of Biostatistics, Korea University College of Medicine, Seoul (Korea, Republic of)

    2014-01-15

    We correlated cerebrovascular reserve in unilateral high grade carotid artery stenosis or occlusion with a type of collateral circulation using acetazolamide-challenged perfusion CT (ACZ-PCT). Among the patients who underwent ACZ-PCT in our institution, we retrospectively selected the patients with unilateral high grade internal carotid artery or middle cerebral artery stenosis (> 70%) or occlusion; we verified the types of their dominant collateral circulation by digital subtraction angiography or 3T MR-angiography; first, the primary collaterals flow through the circle of Willis; second, the secondary collaterals that flow through the opthalmic artery, the basal artery or other external carotid artery. Using ACZ-PCT, we measured the difference in percentage change of cerebral blood flow of the stenotic hemisphere against contralateral normal hemisphere and compared cerebrovascular reserves of lesional hemisphere, according to the type of collaterals. A total of 28 patients were included. The percentage changes of cerebral blood flow were significantly lower in the stenotic hemisphere than the contralateral hemisphere (14.34 ± 36.43% and 34.53 ± 47.82%, p < 0.001), and in the hemisphere predominantly supplied by secondary collaterals than primary (7.03 ± 32.71% and 24.37 ± 42.03%, p < 0.05), respectively. Cerebrovascular reserves in the ipsilateral hemisphere predominantly supplied by secondary collaterals were more impaired than primary collaterals in patients with unilateral high grade carotid stenosis or occlusion.

  6. [Effect of emoxypine on myocardial electrical instability and homeostasis parameters in patients with acute disturbance of cerebrovascular circulation].

    Science.gov (United States)

    Stoliarova, V V

    2002-01-01

    The frequency of myocardial ischemia onsets, QT interval dispersion, homeostasis characteristics, and lipid peroxidation parameters were studied in a group of 49 patients with acute disturbance of cerebral circulation (ADCC). The Holter ECG monitoring revealed myocardial ischemia episodes in 42% of patients, and myocardial instability manifested by the QT interval variance in 82% of patients. The control group (30 patients) received standard complex therapy, while the test group (19 patients) additionally received emoxypine. The administration of emoxypine reduced the incidence of myocardial ischemia and positively influenced the QT interval variance and the main parameters of homeostasis.

  7. Acetazolamide-augmented dynamic BOLD (aczBOLD imaging for assessing cerebrovascular reactivity in chronic steno-occlusive disease of the anterior circulation: An initial experience

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    Junjie Wu

    2017-01-01

    Full Text Available The purpose of this study was to measure cerebrovascular reactivity (CVR in chronic steno-occlusive disease using a novel approach that couples BOLD imaging with acetazolamide (ACZ vasoreactivity (aczBOLD, to evaluate dynamic effects of ACZ on BOLD and to establish the relationship between aczBOLD and dynamic susceptibility contrast (DSC perfusion MRI. Eighteen patients with unilateral chronic steno-occlusive disease of the anterior circulation underwent a 20-min aczBOLD imaging protocol, with ACZ infusion starting at 5 min of scan initiation. AczBOLD reactivity was calculated on a voxel-by-voxel basis to generate CVR maps for subsequent quantitative analyses. Reduced CVR was observed in the diseased vs. the normal hemisphere both by qualitative and quantitative assessment (gray matter (GM: 4.13% ± 1.16% vs. 4.90% ± 0.98%, P = 0.002; white matter (WM: 2.83% ± 1.23% vs. 3.50% ± 0.94%, P = 0.005. In all cases BOLD signal began increasing immediately following ACZ infusion, approaching a plateau at ~8.5 min after infusion, with the tissue volume of reduced augmentation increasing progressively with time, peaking at 2.60 min (time range above 95% of the maximum value: 0–4.43 min for the GM and 1.80 min (time range above 95% of the maximum value: 1.40–3.53 min for the WM. In the diseased hemisphere, aczBOLD CVR significantly correlated with baseline DSC time-to-maximum of the residue function (Tmax (P = 0.008 for the WM and normalized cerebral blood flow (P = 0.003 for the GM, and P = 0.001 for the WM. AczBOLD provides a novel, safe, easily implementable approach to CVR measurement in the routine clinical environments. Further studies can establish quantitative thresholds from aczBOLD towards identification of patients at heightened risk of recurrent ischemia and cognitive decline.

  8. Endocannabinoids in cerebrovascular regulation.

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    Benyó, Zoltán; Ruisanchez, Éva; Leszl-Ishiguro, Miriam; Sándor, Péter; Pacher, Pál

    2016-04-01

    The cerebral blood flow is tightly regulated by myogenic, endothelial, metabolic, and neural mechanisms under physiological conditions, and a large body of recent evidence indicates that inflammatory pathways have a major influence on the cerebral blood perfusion in certain central nervous system disorders, like hemorrhagic and ischemic stroke, traumatic brain injury, and vascular dementia. All major cell types involved in cerebrovascular control pathways (i.e., smooth muscle, endothelium, neurons, astrocytes, pericytes, microglia, and leukocytes) are capable of synthesizing endocannabinoids and/or express some or several of their target proteins [i.e., the cannabinoid 1 and 2 (CB1 and CB2) receptors and the transient receptor potential vanilloid type 1 ion channel]. Therefore, the endocannabinoid system may importantly modulate the regulation of cerebral circulation under physiological and pathophysiological conditions in a very complex manner. Experimental data accumulated since the late 1990s indicate that the direct effect of cannabinoids on cerebral vessels is vasodilation mediated, at least in part, by CB1 receptors. Cannabinoid-induced cerebrovascular relaxation involves both a direct inhibition of smooth muscle contractility and a release of vasodilator mediator(s) from the endothelium. However, under stress conditions (e.g., in conscious restrained animals or during hypoxia and hypercapnia), cannabinoid receptor activation was shown to induce a reduction of the cerebral blood flow, probably via inhibition of the electrical and/or metabolic activity of neurons. Finally, in certain cerebrovascular pathologies (e.g., subarachnoid hemorrhage, as well as traumatic and ischemic brain injury), activation of CB2 (and probably yet unidentified non-CB1/non-CB2) receptors appear to improve the blood perfusion of the brain via attenuating vascular inflammation.

  9. Migraine, cerebrovascular disease and the metabolic syndrome

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    Alexandra J Sinclair

    2012-01-01

    Full Text Available Evidence is emerging that migraine is not solely a headache disorder. Observations that ischemic stroke could occur in the setting of a migraine attack, and that migraine headaches could be precipitated by cerebral ischemia, initially highlighted a possibly association between migraine and cerebrovascular disease. More recently, large population-based studies that have demonstrated that migraineurs are at increased risk of stroke outside the setting of a migraine attack have prompted the concept that migraine and cerebrovascular disease are comorbid conditions. Explanations for this association are numerous and widely debated, particularly as the comorbid association does not appear to be confined to the cerebral circulation as cardiovascular and peripheral vascular disease also appear to be comorbid with migraine. A growing body of evidence has also suggested that migraineurs are more likely to be obese, hypertensive, hyperlipidemic and have impaired insulin sensitivity, all features of the metabolic syndrome. The comorbid association between migraine and cerebrovascular disease may consequently be explained by migraineurs having the metabolic syndrome and consequently being at increased risk of cerebrovascular disease. This review will summarise the salient evidence suggesting a comorbid association between migraine, cerebrovascular disease and the metabolic syndrome.

  10. Depression in cerebrovascular diseases

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    Voskresenskaya, Tatyana

    2009-01-01

    The paper discusses the topical problem of depression in cerebrovascular diseases. It shows its possible causes, mechanisms of occurrence, clinical picture and negative impact on the course of cerebrovascular disease and recovery of neurological functions. There is a bilateral association between stroke and depression: on the one hand, stroke is a risk factor for the development of depression and, on the other, depression is a both direct and indirect risk factor for the development of stroke...

  11. Nitric oxide synthase inhibition and cerebrovascular regulation

    DEFF Research Database (Denmark)

    Iadecola, C; Pelligrino, D A; Moskowitz, M A;

    1994-01-01

    tone and may play an important role in selected vasodilator responses of the cerebral circulation. Furthermore, evidence has been presented suggesting that NO participates in the mechanisms of cerebral ischemic damage. Despite the widespread attention that NO has captured in recent years and the large......There is increasing evidence that nitric oxide (NO) is an important molecular messenger involved in a wide variety of biological processes. Recent data suggest that NO is also involved in the regulation of the cerebral circulation. Thus, NO participants in the maintenance of resting cerebrovascular...

  12. Cerebrovascular Reactivity in Complex Diagnostics of Vertebrobasilar Insufficiency

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    Goydenko V. S.

    2016-12-01

    Full Text Available The article presents the results of the assessment of cerebrovascular reactivity parameters due to transcranial Doppler sonography in 104 patients (62 women and 42 men with spondilogenic vertebrobasilar insufficiency. Mean age of patients was 42.9±12.2 years. It was found that the assessment of cerebrovascular reactivity and type of response to functional loading tests allows to confirm vertebrobasilar stage insufficiency, to determine the activity of various regulatory mechanisms of compensation of cerebral circulation and adaptation reserve of the cerebral vascular system.

  13. The collaterome: A novel conceptual framework of systems biology in cerebrovascular disorders

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    David S Liebeskind

    2015-01-01

    Full Text Available The collaterome is the elaborate neurovascular architecture within the brain that regulates and determines the compensatory ability, response, and outcome of cerebrovascular pathophysiology. Based on the fundamental aspects of the cerebral collateral circulation, this model provides a conceptual framework or novel approach to cerebrovascular disorders that endorses systems biology rather than traditional reductionism. The nature of this holistic approach mirrors the innate or endogenous compensatory ability of collaterals, extending this concept to reconsider current approaches to cerebrovascular disorders. The distinction of asymptomatic and symptomatic physiology, and normal brain health versus cerebrovascular disease and the management of cerebrovascular disorders from diagnosis to therapeutic strategies may be reconsidered from this conceptual framework that builds upon established knowledge in the stroke literature.

  14. Categorization of cerebrovascular intervention methods

    Institute of Scientific and Technical Information of China (English)

    Wenxin Zhao; Gelin Xu; Xinfeng Liu

    2008-01-01

    BACKGROUND: Cerebrovascular intervention is a medical strategy to diagnose and treat cerebrovascular disease by intravascular intervention techniques. With the continual developments of computer technology, imageology, and angiography, cerebrovascular intervention techniques have developed rapidly.OBJECTIVE: To summarize and to evaluate vascular imaging diagnostic techniques, vascular intra-arterial thrombolysis, vascular intra-arterial angioplasty, and vascular embolization in clinical applications.RETRIEVAL STRATEGY: An online search was conducted in PubMed for English language reports, published from January 2002 to January 2008, containing the key words: intervention therapy, cerebral vascular disease, endovascular intervention and angioplasty. A total of 57 publications were identified. Inclusion criteria: articles about cerebrovascular intervention for cerebrovascular disease; articles published either in high impact factor journals or in recent years. Exclusion criteria: duplicated articles.LITERATURE EVALUATION: 30 articles were identified concerning intravascular intervention techniques and arterial angioplasty. Of those, 7 articles were reviews and 23 were clinical or basic studies.DATA SYNTHESIS: Carotid artery and basilar artery stenosis were important etiological factors for ischemic cerebrovascular disease. The mechanism of stenosis induction included atherosclerotic plaque exfoliation and stenosis could cause hemodynamic changes to induce cerebral infarction. Therefore, the treatment of carotid artery and basilar artery stenosis played a key role in preventing ischemic cerebral infarction. The international organization for subarachnoid hemorrhage aneurysm has conclusively shown that both relative and absolute risk factors of intravascular embolotherapy were reduced compared to those of surgical occlusion, demonstrating the important role of vascular embolization for the treatment of intracranial aneurysm. Endovascular stents were placed into the

  15. Cerebrovascular manifestations following scorpion sting

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    Nataraja P; Naveen Prasad SV; Obulareddy G; Anil Ch; Naveen T; Vengamma B

    2016-01-01

    Scorpion sting is a common clinical problem in Rayalaseema area of Andhra Pradesh State in India. Clilnical presentation of scorpion envenomation can range from mild local pain to systemic manifestations involving almost all systems. Cerebrovascular manifestations of scorpion sting have been sparsely documented. We report two cases who presented with ischaemic stroke and haemorrhagic stroke following scorpion sting.

  16. Movement disorders in cerebrovascular disease.

    Science.gov (United States)

    Mehanna, Raja; Jankovic, Joseph

    2013-06-01

    Movement disorders can occur as primary (idiopathic) or genetic disease, as a manifestation of an underlying neurodegenerative disorder, or secondary to a wide range of neurological or systemic diseases. Cerebrovascular diseases represent up to 22% of secondary movement disorders, and involuntary movements develop after 1-4% of strokes. Post-stroke movement disorders can manifest in parkinsonism or a wide range of hyperkinetic movement disorders including chorea, ballism, athetosis, dystonia, tremor, myoclonus, stereotypies, and akathisia. Some of these disorders occur immediately after acute stroke, whereas others can develop later, and yet others represent delayed-onset progressive movement disorders. These movement disorders have been encountered in patients with ischaemic and haemorrhagic strokes, subarachnoid haemorrhage, cerebrovascular malformations, and dural arteriovenous fistula affecting the basal ganglia, their connections, or both.

  17. Genetic Causes of Cerebrovascular Disorders in Childhood

    NARCIS (Netherlands)

    M.E.C. Meuwissen (Marije)

    2014-01-01

    markdownabstract__Abstract__ Cerebrovascular disorders in childhood comprise ischemic stroke and hemorrhagic stroke. This thesis comprises a escription of genetic causes of childhood cerebrovascular disorders. Two examples of genetic causes of ischemic stroke, comprising a case of ACTA2 mutation an

  18. Eagle syndrome revisited: cerebrovascular complications.

    Science.gov (United States)

    Todo, Tsuyoshi; Alexander, Michael; Stokol, Colin; Lyden, Patrick; Braunstein, Glenn; Gewertz, Bruce

    2012-07-01

    Cervical pain caused by the elongation of the styloid process (Eagle syndrome) is well known to otolaryngologists but is rarely considered by vascular surgeons. We report two patients with cerebrovascular symptoms of Eagle syndrome treated in our medical center in the past year. Case 1: an 80-year-old man with acromegaly presented with dizziness and syncope with neck rotation. The patient was noted to have bilateral elongated styloid processes impinging on the internal carotid arteries. After staged resections of the styloid processes through cervical approaches, the symptoms resolved completely. Case 2: a 57-year-old man presented with acute-onset left-sided neck pain radiating to his head immediately after a vigorous neck massage. Hospital course was complicated by a 15-minute transient ischemic attack resulting in aphasia. Angiography revealed bilateral dissections of his internal carotid arteries, with a dissecting aneurysm on the right. Both injuries were immediately adjacent to the bilateral elongated styloid processes. Despite immediate anticoagulation therapy, he experienced aphasia and right hemiparesis associated with an occlusion of his left carotid artery. He underwent emergent catheter thrombectomy and carotid stent placement, with near-complete resolution of his symptoms. Elongated styloid processes characteristic of Eagle syndrome can result in both temporary impingement and permanent injury to the extracranial carotid arteries. Although rare, Eagle syndrome should be considered in the differential diagnosis in patients with cerebrovascular symptoms, especially those induced by positional change.

  19. Cerebrovascular arteriopathy (arteriosclerosis) and ischemic childhood stroke.

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    Daniels, S R; Bates, S; Lukin, R R; Benton, C; Third, J; Glueck, C J

    1982-01-01

    The aim of this report is to describe the intracranial cerebrovascular abnormalities and clinical status of 8 children who had familial lipoprotein disorders and evidence of thromboembolic cerebrovascular disease. Six of the 8 children had low levels of plasma high density lipoprotein cholesterol, two had high triglyceride levels, and all came from kindreds characterized by familial lipoprotein abnormalities and premature cardio- and/or cerebrovascular atherosclerosis. Vascular occlusion, irregularities of the arterial lumen, beading, tortuosity, and evidence of collateralization were consistently noted. We speculate that cerebrovascular arteriosclerosis in pediatric ischemic stroke victims who have familial lipoprotein abnormalities may be related to lipoprotein-mediated endothelial damage and thrombosis formation, or to the failure to restore endothelial cells' integrity following damage. The apparent association of lipoproteins and strokes in children and their families merits further exploration, particularly when assessing cerebral angiograms in pediatric ischemic stroke victims. In children with unexplained ischemic cerebrovascular accidents, the diagnostic possibility of occlusive arteriosclerosis with thrombosis must be entertained.

  20. FastStats: Cerebrovascular Disease or Stroke

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    ... this? Submit Button NCHS Home Cerebrovascular Disease or Stroke Recommend on Facebook Tweet Share Compartir Data are ... Morbidity Number of adults who ever had a stroke: 6.5 million Percent of adults who ever ...

  1. Mortalidad intrahospitalaria por accidente cerebrovascular

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    Federico Rodríguez Lucci

    2013-08-01

    Full Text Available La mortalidad global por accidente cerebrovascular (ACV ha disminuido en las últimas tres décadas, probablemente debido a un mejor control de los factores de riesgo vascular. La mortalidad hospitalaria por ACV ha sido tradicionalmente estimada entre 6 y 14% en la mayoría de las series comunicadas. Sin embargo, los datos de ensayos clínicos recientes sugieren que esta cifra sería sustancialmente menor. Se revisaron datos de pacientes internados con diagnóstico de ACV del Banco de Datos de Stroke de FLENI y los registros institucionales de mortalidad entre los años 2000 y 2010. Los subtipos de ACV isquémicos se clasificaron según criterios TOAST y los ACV hemorrágicos en hematomas intrapanquimatosos, hemorragias subaracnoideas aneurismáticas, malformaciones arteriovenosas y otros hematomas intraparenquimatosos. Se analizaron 1514 pacientes, 1079 (71% con ACV isquémico (grandes vasos 39%, cardioembólicos 27%, lacunares 9%, etiología indeterminada 14%, otras etiologías 11% y 435 (29% con ACV hemorrágico (intraparenquimatosos 27%, hemorragia subaracnoidea 30%, malformaciones arteriovenosas 25% y otros hematomas espontáneos 18%. Se registraron 38 muertes intrahospitalarias (17 ACV isquémicos y 21 ACV hemorrágicos, representando una mortalidad global del 2.5% (1.7% en ACV isquémicos y 4.8% en ACV hemorrágicos. No se registraron muertes asociadas al uso de fibrinolíticos endovenosos. La mortalidad intrahospitalaria en pacientes con ACV isquémico y hemorrágico en nuestro centro fue baja. El manejo en un centro dedicado a las enfermedades neurológicas y el enfoque multidisciplinario por personal médico y no médico entrenado en el cuidado de la enfermedad cerebrovascular podrían explicar, al menos en parte, estos resultados.

  2. Polyclonal light chains in cerebrovascular disease

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    Patrizia Fiori

    2010-08-01

    Full Text Available Patrizia Fiori1, Maria Giannetti Luigi2, Linda Iurato1, Carminantonio Tammaro3, Gigliola Esposito3, Antonio Monaco11Central Operative Unit of Neurology (Dir. A Monaco, 2Infantile Neuropsychiatry and Social Service (Dir. LM Giannetti, 3Laboratory (Dir. CA Tammaro, ASL AV, Civil Hospital of Ariano Irpino, University of Naples, ItalyAbstract: Altered membrane permeability is a hallmark of inflammation and ischemia with systemic spreading. Renal dysfunction is a risk factor for cardiovascular, cerebrovascular, and metabolic diseases. The aim of the present study was to assess proteinuria and urinary polyclonal light chains in acute stroke and chronic cerebrovascular disease compared with other neurologic diseases. Our results showed significantly increased levels of urinary polyclonal light chains in cerebrovascular disease compared with other neurologic diseases. The highest values of urinary polyclonal κ chains were found in acute stroke compared with chronic cerebrovascular disease and other neurologic diseases, while the level of λ chains was mainly increased in chronic cerebrovascular diseases. The shift to chronic renal failure seems to be signaled by a decreased polyclonal light chain/creatinemia ratio. The absence of a significant correlation with blood pressure and other seric parameters suggests that polyclonal light chains are an early marker of reversible vascular impairment with renal dysfunction before progression to irreversible renal failure and need for dialysis and/or intensive care.Keywords: polyclonal light chains, cerebrovascular disease, renal failure

  3. [PECULIARITIES OF THE CEREBROVASCULAR EFFECTS OF GLUTAMIC ACID].

    Science.gov (United States)

    Gan'shina, T S; Kurza, E V; Kurdyumov, I N; Maslennikov, D V; Mirzoyan, R S

    2016-01-01

    Experiments on nonlinear rats subjected to global transient cerebral ischemia revealed the ability of glutamic acid to improve cerebral circulation. Consequently, the excitatory amino acid can produce adverse (neurotoxic) and positive (anti-ischemic) effects in cerebral ischemia. The cerebrovascular effect of glutamic acid in cerebral ischemia is attenuated on the background action of the MNDA receptor blocker MK-801 (0.5 mg/kg intravenously) and eliminated by bicuculline. When glutamic acid is combined with the non-competitive MNDA receptor antagonist MK-801, neither one nor another drug shows its vasodilator effect. The results are indicative of the interaction between excitatory and inhibitory systems on the level of cerebral vessels and once again confirm our previous conclusion about the decisive role of GABA(A) receptors in brain vessels in the implementation of anti-ischemic activity of endogenous compounds (melatonin) and well-known pharmacological substances (mexidol, afobazole), and new chemical compounds based on GABA-containing lipid derivatives.

  4. Cerebrovascular reactivity in migraineurs as measured by transcranial Doppler

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    Thomas, T.D.; Harpold, G.J. (Alabama Univ., Birmingham, AL (USA). School of Medicine); Troost, B.T. (Bowman Gray School of Medicine, Winston-Salem, NC (USA))

    1990-04-01

    Transcranial Doppler ultrasound is a relatively new diagnostic modality which allows the non-invasive assessment of intracranial circulation. A total of 10 migraine patients were studied and compared to healthy controls without headaches. Migraineurs during the headache-free interval demonstrated excessive cerebrovascular reactivity to CO{sub 2}, evidenced by an increase in middle cerebral artery blood flow velocity of 47% {plus minus} 15% compared to 28% {plus minus} 14% in controls. Differences between the two study groups revealed no significant decrease in middle cerebral artery blood flow velocity with hypocapnia. However, the differences between middle cerebral artery blood flow velocity during hyperventilation and CO{sub 2} inhalation were significantly different comparing migraineurs and controls. Instability of the baseline blood flow velocities was also noted in migraineurs during the interictal period. Characteristics which may allow differentiation of migraineurs from other headache populations could possibly be obtained from transcranial Doppler ultrasound flow studies. 24 refs., 2 tabs.

  5. /sup 111/In platelet scintigraphy in cerebrovascular disease

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    Powers, W.J.; Siegel, B.A.; Davis, H.H.; Mathias, C.J.; Clark, H.B.; Welch, M.J.

    1982-09-01

    We obtained scintigraphic images of the neck from 100 patients with suspected cerebrovascular disease after injecting /sup 111/In-labeled autologous platelets. One or more focuses of increased activity, implying local platelet accumulation, were seen along the course of the cervical carotid arteries in 52 patients. In 64 patients, there was a highly significant correlation between the results of scintigraphy and carotid arteriography (p . 10(6)). There was no significant correlation between the scintigraphic findings and the previous or subsequent occurrence of transient ischemic attack or cerebral infarction in the carotid circulation. These data suggest that factors other than the simple formation of platlet thrombi in the cervical carotid arteries are of primary importance in the pathogenesis of stroke.

  6. Aortoiliac occlusive disease masquerading as cerebrovascular accident

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    Nandeesh B

    2007-01-01

    Full Text Available Acute aortoiliac occlusion is an unusual but potentially catastrophic condition causing acute limb ischemia and associated with early and high rates of mortality and morbidity. It is caused by either embolic occlusion of the infra renal aorta at the bifurcation or beyond or thrombosis of the abdominal aorta and its large terminal branches. Neurological symptoms are rare manifestation of acute aortoiliac occlusion and when neurological symptoms predominate, patients are mistakenly considered to have cerebrovascular event. We present a 60-year-old man with atherosclerotic thrombotic occlusion of the left common iliac artery causing acute painful monoplegia. We mistook the acute monoplegia due to acute limb ischemia for cerebrovascular accident. Pathologic examination revealed a firm thrombus occluding the origin of left common iliac artery and extending along the length of the vessel. Acute aortic iliac occlusion can masquerade as a cerebrovascular stroke and a thorough clinical evaluation and imaging studies allow early diagnosis and instituting life-saving treatment timely.

  7. [Primary antiphospholipid syndrome and cerebrovascular disturbances].

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    Kalashnikova, L A

    2005-01-01

    Neurological, including cecbrovascular, disorders frequently emerge in primary antiphospholipid syndrome (PAS). Clinical peculiarities of PAS were studied in 113 patients with cerebrovascular disturbances. Its had mainly ischemic patogenesis. Structure of cerebrovascular disorders was as follows: stroke (33% cases), transient ischemic lesions (10%), its combination (57%), thrombosis of brain venous sinuses (3%), vascular dementia (27%). Besides it were found epileptic seizures, peripheral neuropathy, headache, chorea and some symptoms of myasthenia, parkinsonism, multiple sclerosis and psychotic disorders. In all cases antibodies to phospholipids have been detected. Secondary prophylaxis includes regular use of anticoagulants and small doses of aspiriny.

  8. Cognitive impairments in patients with cerebrovascular steno-occlusive disease

    Institute of Scientific and Technical Information of China (English)

    石丹

    2012-01-01

    Objective To explore the relationship between cerebrovascular steno-occlusive disease and neuropsychological performance by cognitive function assessment. Methods Using a case-control study,45 patients with cerebrovascular steno-occlusive lesions (patient group) and 59 control subjects without cerebrovascular

  9. Two-dimensional thick-slice MR digital subtraction angiography for assessment of cerebrovascular occlusive diseases

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    Aoki, S.; Yoshikawa, T.; Hori, M.; Ishigame, K.; Nambu, A.; Kumagai, H.; Araki, T. [Dept. of Radiology, Yamanashi Medical Univ. (Japan)

    2000-12-01

    Although spatial resolution of current MR angiography is excellent, temporal resolution has remained unsatisfactory. We evaluated clinical applicability of 2D thick-slice, contrast-enhanced subtraction MR angiography (2D-MR digital subtraction angiography) with sub-second temporal resolution in cerebrovascular occlusive diseases. Twenty-five patients with cerebrovascular occlusive diseases (8 moyamoya diseases, 10 proximal internal carotid occlusions, and 2 sinus thromboses) were studied with a 1.5-T MR unit. The MR digital subtraction angiography (MRDSA) was performed per 0.97 s continuously just after a bolus injection of 15 ml of gadolinium chelates up to 40 s in sagittal (covering hemisphere) or coronal planes. Subtraction images were generated at a workstation. We evaluated imaging quality and hemodynamic information of MRDSA in comparison with those of routine MR imaging, non-contrast MR angiography, and X-ray intra-arterial DSA. Major cerebral arteries, all of the venous sinuses, and most tributaries were clearly visualized with 2D MRDSA. Also, pure arterial phases were obtained in all cases. The MRDSA technique demonstrated prolonged circulation in sinus thromboses, distal patent lumen of proximal occlusion, and some collateral circulation. Such hemodynamic information was comparable to that of intra-arterial DSA. Two-dimensional thick-slice MRDSA with high temporal resolution has a unique ability to demonstrate cerebral hemodynamics equivalent to that of intra-arterial DSA and may play an important role for evaluation of cerebrovascular occlusive diseases. (orig.)

  10. Effect of high-intensity training on endothelial function in patients with cardiovascular and cerebrovascular disease: A systematic review

    Directory of Open Access Journals (Sweden)

    Mia Kolmos

    2016-12-01

    Full Text Available Objectives: Exercise improves endothelial dysfunction, the key manifestation of cardiovascular and cerebrovascular disease, and is recommended in both cardiovascular and cerebrovascular rehabilitation. Disagreement remains, however, on the role of intensity of exercise. The purpose of this review was to gather current knowledge on the effects of high-intensity training versus moderate-intensity continuous exercise on endothelial function in cardiovascular and cerebrovascular patients. Methods: A systematic review was performed in PubMed database, Embase and Cochrane libraries and on PEDro using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were restricted to cardiovascular and cerebrovascular patients, and healthy subjects as general reference. Interventions comprised of high-intensity training alone, high-intensity training compared to moderate-intensity continuous exercise, or no training, with endothelial function as outcome measure. Endothelial function was measured either physiologically by flow-mediated dilatation and/or by systemic biomarkers. Data were analyzed descriptively due to non-comparability for a meta-analysis to be performed. Results: A total of 20 studies were included in the review. Although there was great heterogenecity in design, population and exercise protocols, all studies found high-intensity training to be safe. High-intensity training was equal to moderate-intensity continuous exercise through improvement in endothelial function in 15 of the 20 selected studies, as measured by flow-mediated dilatation, nitric oxide bioavailability and circulating biomarkers. Only a few studies examined high-intensity training in cerebrovascular patients, none with endothelial function as outcome. Conclusion: High-intensity training is promising as a time-efficient exercise strategy in cardiovascular rehabilitation, but data on endothelial effects in cerebrovascular rehabilitation are

  11. Association of Fibrin Monomer Polymerization Function, Cerebrovascular Risk Factors and Ischemic Cerebrovascular Disease in Old People

    Institute of Scientific and Technical Information of China (English)

    洪梅; 魏文宁; 李红戈; 杨锐; 杨焰

    2003-01-01

    Summary: In order to investigate the association of fibrin monomer polymerization function (FMPF)with traditional cerebrovascular risk factors and ischemic cerebrovascular disease in old people, 1 : 1paired case-control comparative study was performed for FMPF and traditional cerebrovascular riskfactors on 110 cases of old ischemic cerebrovascular disease and 110 controls matched on age, sex andliving condition. The results showed that cerebrovascular risk factors were more prevalent in casegroup than in control group. In the case group, FMPF was significantly higher than in controlgroup. There was a significant positive correlation between hypertension and fibrin monomer poly-merization velocity (FMPV), hypertension and fibrinogen (Fbg), alcohol consumption and Fbg, butno significant correlation between diabetic mellitus, smoking and FMPF was found. Among the pa-rameters of blood lipids, there were significant positive correlations between total cholesterol (TC)and parameters of FMPF to varying degrees, triglycerides (TG) and FMPV, TG and Fbg. Our re-sults also showed there were significant linear trends between TC and FMPV (P<0. 001), TC andFbg (P=0. 0087), TG and FMPV/Amax (maximum absorbance)(P=0. 0143) respectively. Multi-ple logistic regression analysis revealed that FMPF in case group remained significantly higher thancontrol group after adjustment of all risk factors that were significant in univariate analysis. It wasconcluded that there is a possible pathophysiological link between FMPF and cerebrovascular risk fac-tors. An elevated FMPF is associated with ischemic cerebrovascular disease and an independent riskfactor of this disease. In old people, detection of FMPF might be a useful screening to identify indi-viduals at increased cerebrothrombotic risk.

  12. Role of transcranial Doppler in cerebrovascular disease

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    Amit A Kulkarni

    2016-01-01

    Full Text Available Transcranial Doppler (TCD is the only noninvasive modality for the assessment of real-time cerebral blood flow. It complements various anatomic imaging modalities by providing physiological-flow related information. It is relatively cheap, easily available, and can be performed at the bedside. It has been suggested as an essential component of a comprehensive stroke centre. In addition to its importance in acute cerebrovascular ischemia, its role is expanding in the evaluation of cerebral hemodynamics in various disorders of the brain. The “established” clinical indications for the use of TCD include cerebral ischemia, sickle cell disease, detection of right-to-left shunts, subarachnoid hemorrhage, periprocedural or surgical monitoring, and brain death. We present the role of TCD in acute cerebrovascular ischemia, sonothrombolysis, and intracranial stenosis.

  13. EMPREGO DE STENTS CEREBRAIS NAS PATOLOGIAS CEREBROVASCULARES

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    Laís Rocha Lopes

    2015-06-01

    Full Text Available Objective: To understand the applicability and characteristics of the stents for the treatment of cerebrovascular pathologies in order to understand its viability for the therapy. Methods: Scientific articles were used based on electronic search as PubMed, Scientific Electronic Library Online (SciELO, Intechopen, Medscape. An international and up to date source of articles was used. Results: Cerebrovascular diseases have emerged as the second most important cause of mortality worldwide, from this principle we observe the importance of this study. Recently, as a solution form, stents have become a major treatment option for difficult and not feasible cerebral aneurysms single winding. Intracranial stents serve as a bridge to the neo-endothelialization by providing a reduction in blood flow into the aneurysm. The use of stents for treatment should be seriously analyzed according to their feasibility, the knowledge of the professional about their brands, features and deployment techniques, and theoretical part of the professional needs to have dexterity to the application of an intracranial stent. Conclusions: This review raises an awareness of this subject, starts from the concept of cerebrovascular disease and aneurysms as well as the genesis of the stents, progressing to elucidate all product brands and specific characteristics of each, ending with its applicability, as well as making clear the purpose and mechanism of stents.

  14. Auditory Dysfunction in Patients with Cerebrovascular Disease

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    Sadaharu Tabuchi

    2014-01-01

    Full Text Available Auditory dysfunction is a common clinical symptom that can induce profound effects on the quality of life of those affected. Cerebrovascular disease (CVD is the most prevalent neurological disorder today, but it has generally been considered a rare cause of auditory dysfunction. However, a substantial proportion of patients with stroke might have auditory dysfunction that has been underestimated due to difficulties with evaluation. The present study reviews relationships between auditory dysfunction and types of CVD including cerebral infarction, intracerebral hemorrhage, subarachnoid hemorrhage, cerebrovascular malformation, moyamoya disease, and superficial siderosis. Recent advances in the etiology, anatomy, and strategies to diagnose and treat these conditions are described. The numbers of patients with CVD accompanied by auditory dysfunction will increase as the population ages. Cerebrovascular diseases often include the auditory system, resulting in various types of auditory dysfunctions, such as unilateral or bilateral deafness, cortical deafness, pure word deafness, auditory agnosia, and auditory hallucinations, some of which are subtle and can only be detected by precise psychoacoustic and electrophysiological testing. The contribution of CVD to auditory dysfunction needs to be understood because CVD can be fatal if overlooked.

  15. Factors influencing ischemic cerebrovascular disease complicated by hyperhomocysteinemia

    Institute of Scientific and Technical Information of China (English)

    Zhongping An; Yonghong Xing; Sha Jin

    2008-01-01

    BACKGROUND: Hyperhomocysteinemia, as an important risk factor for ischemic cerebrovascular disease is receiving increasing attention.OBJECTIVE: To analyze whether differences of gender, age, cerebrovascular disease typing, and disease conditions exist when ischemic cerebrovascular disease occurs together with hyperhomocysteinemia. DESIGN: A controlled observation. SETTING: Department of Neurology, Tianjin Huanhu Hospital. PARTICIPANTS: A total of 601 acute ischemic cerebrovascular disease inpatients, comprising 386 males and 215 females, aged 33-90 years old, were admitted to the Department of Stroke, Tianjin Huanhu Hospital between August 2005 and April 2007, and were recruited for this study. All included patients consisted of 342 aged patients (≥ 60 years old) and 92 middle-aged and young patients ( 0.05). No significant difference in incidence of hyperhomocysteinemia existed between mild, moderate, and severe cerebrovascular disease patients (P > 0.05). CONCLUSION: There is a greater chance of ischemic cerebrovascular disease complicated by hyperhomocysteinemia in older, male patients.

  16. Enfermedad cerebrovascular: incidencia y tratamiento actual

    OpenAIRE

    Julio César Fernández-Travieso

    2014-01-01

    La enfermedad cerebrovascular o ictus representa la tercera causa de mortalidad de la población adulta y la primera de discapacidad result ante, por lo cual constituye un importante problema de salud a nivel mundial. El tratamiento del ictus en la fase aguda depende, además de la exitosa aplicación de la terapia adecuada, de una cadena de emergencia que permita su diagnóstico y manejo adecuad o y rápido, y aú n cuando se logre la supervivencia, muchos pacientes sobreviven con importantes limi...

  17. Differential properties of Van der Pol — Duffing mathematical model of cerebrovascular haemodynamics based on clinical measurements

    Science.gov (United States)

    Parshin, D. V.; Ufimtseva, I. V.; Cherevko, A. A.; Khe, A. K.; Orlov, K. Yu; Krivoshapkin, A. L.; Chupakhin, A. P.

    2016-06-01

    The present paper discusses the method of identification (diseased/healthy) human cerebral vessels by using of mathematical model. Human cerebral circulation as a single tuned circuit, which consists of blood flow, elastic vessels and elastic brain gel tissue is under consideration. Non linear Van der Pol-Duffing equation is assumed as mathematical model of cerebrovascular circulation. Hypothesis of vascular pathology existence in some position of blood vessel, based on mathematical model properties for this position is formulated. Good reliability of hypothesis is proved statistically for 7 patients with arterial aneurysms.

  18. Fetal Circulation

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Fetal Circulation Updated:Oct 18,2016 click to enlarge The ... fetal heart. These two bypass pathways in the fetal circulation make it possible for most fetuses to survive ...

  19. Cereral Circulation in Preeclampsia

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    A. A. Ivshin

    2008-01-01

    Full Text Available Objective: to evaluate the possibilities of using transcranial Doppler study in pregnant women and pueperas with preeclamp-sia. Subjects and methods. Two hundred and thirty-two pregnant women diagnosed as having varying preeclampsia were prospectively studied. A comparison group comprised 90 apparently healthy women in the third trimester of pregnancy. All the respondents underwent transcranial duplex scanning of the medial cerebral artery with the linear velocity values being determined. A number of the values reflecting the level of perfusion and intracranial pressures, hydrodynamic resistance in the system, cerebrovascular responsiveness and the state of the vascular wall were calculated. Correlation analysis was made between the parameters of cerebral circulation and the severity of preeclampsia, proteinuria, the severity of hydrops, and the parameters of central and peripheral hemodynamics. Results. The findings suggest that there is impaired cerebral perfusion in pregnant women and puerperas with varying preeclampsia, the severity of cerebral circulatory disorders being in proportion with that of preeclampsia. There is a close correlation between cerebral circulation and the individual criteria determining the severity of preeclampsia. The linear values of the Doppler spectrum, namely linear flow characteristics, are prognos-tically most significant. Conclusion. The introduction of transcranial Doppler study into obstetric care has permitted the authors not only to study cerebral circulatory disorders in healthy and pregnant women and puerperas with preeclampia in detail, but also to establish a number of highly significant prognostic criteria for the severity of this life-threatening complication of gestation. The results of transcranial Doppler study assist practitioners in timely and accurately solving the problems in the diagnosis of preeclampsia and in evaluating its severity. Cerebral circulatory values may be successfully used to

  20. Dysphagia in patients with cerebrovascular disease. Update.

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    Amarilis Barbié Rubiera

    2009-03-01

    Full Text Available An important number of patients with cerebrovascular disease also present dysphagia as a result of damage in cerebral hemispheres or brainstem, which contributes to negative morbility and functional rehabilitation prognosis due to the complications liked with this condition. It is a significant cause of nutritional dysfunctions, including increased in-hospital undernourishment, increased per patient expenditure and longer in-hospital stay. One of the objectives of the Nutritional Support Team of the Neuroscience and Neurology Institute is to reduce undernourishment causes in patients with neurological diseases. A wide review of the subject was performed including experts´ opinions, from the above mentioned institutions, in order to gather an updated report related with the significance of early diagnosis of dysphagia in patients with ictus and the opportune and correct use of therapeutic measures to reduce complication risk.

  1. Impact of Cerebrovascular Disease Mortality on Life Expectancy in China

    Institute of Scientific and Technical Information of China (English)

    LI Guo Qi; LI Yan; ZHAO Dong; FAN Jie; LIU Jing; WANG Wei; WANG Miao; QI Yue; XIE Wu Xiang; LIU Jun; ZHAO Fan

    2014-01-01

    Objective To evaluate the impact of cerebrovascular disease mortality on life expectancy (LE) in China in 2010 compared with 2005, and to identify the high-risk population (age, sex, and region) where cerebrovascular disease mortality has had a major impact on LE. Methods LE and cause-eliminated LE were calculated by using standard life tables which used adjusted mortality data from the Death Surveillance Data Sets in 2005 and 2010 from the National Disease Surveillance System. Decomposition was used to quantitate the impact of cerebrovascular disease in different age groups. Results LE in China was 73.24 years in 2010, which was higher in women and urban residents compared with men and rural residents. The loss of LE caused by cerebrovascular disease mortality was 2.26 years, which was higher in men and rural residents compared with women and urban residents. More than 30%of the loss of LE were attributed to premature death from cerebrovascular disease in people aged Conclusion Cerebrovascular disease mortality had a major impact on LE in China, with a significant difference between urban and rural residents. LE is likely to be further increased by reducing cerebrovascular disease mortality, and special attention should be paid to reducing premature deaths in people aged<65 years.

  2. SYSTOLIC HYPERTENSION. IMPACT ON CEREBROVASCULAR DISEASE

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    Juan Eloy Cruz Quesada

    2011-08-01

    Full Text Available Fundamento: La aterosclerosis es un proceso multifactorial sobre el cual actúan varios factores de riesgo. Constituye la principal causa de muerte y de morbilidad en ingresados hospitalarios, y puede ocasionar una acentuada disminución del flujo sanguíneo hacia todos los órganos del cuerpo humano Objetivo: Determinar el impacto de la hipertensión arterial sistólica sobre la enfermedad cerebrovascular. Métodos: Se realizó un estudio transversal, observacional y analítico, en 59 fallecidos hipertensos. Se analizaron las arterias cerebrales y se cuantificó la lesión aterosclerótica y su variedad, aplicándose el sistema aterométrico, teniendo en cuenta los tipos de hipertensión arterial. Se emplearon procedimientos estadísticos (medidas de tendencia central y comparativos (prueba de comparación de media aritmética basadas en el test “t” de student. Resultados: Los infartos cerebrales recientes fueron más frecuentes en hipertensos sistodiastólicos. No hubo diferencia significativa en cuanto a la edad en el momento de aparición de las lesiones para ambos sexos, pero las mujeres con hipertensión sistólica, fueron significativamente más dañadas desde el punto de vista morfométrico. Se observó correlación significativa para ambos grupos de hipertensos entre tipo de accidente cerebrovascular y variables del sistema aterométrico. Conclusiones: La hipertensión arterial sistólica es un factor importante en la génesis de la enfermedad vasculocerebral y está asociada con la progresión de la placa de ateroma.

  3. Vinpocetine and Pyritinol: A New Model for Blood Rheological Modulation in Cerebrovascular Disorders—A Randomized Controlled Clinical Study

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    Hayder M. Alkuraishy

    2014-01-01

    Full Text Available Blood and plasma viscosity are the major factors affecting blood flow and normal circulation. Whole blood viscosity is mainly affected by plasma viscosity, red blood cell deformability/aggregation and hematocrit, and other physiological factors. Thirty patients (twenty males + ten females with age range 50–65 years, normotensive with history of cerebrovascular disorders, were selected according to the American Heart Stroke Association. Blood viscosity and other rheological parameters were measured after two-day abstinence from any medications. Dual effects of vinpocetine and pyritinol exhibit significant effects on all hemorheological parameters (P0.05. Therefore, joint effects of vinpocetine and pyritinol improve blood and plasma viscosity in patients with cerebrovascular disorders.

  4. Obesity Paradox in the Course of Cerebrovascular Diseases.

    Science.gov (United States)

    Brzecka, Anna; Ejma, Maria

    2015-01-01

    Obesity remains an important risk factor of cardiovascular and cerebrovascular diseases. However, it has been observed that increased body fat and body mass index predicted longer survival after the occurrence of a cardiovascular event. This observation has been named the obesity paradox. Initially, the term obesity paradox referred to the observation of the better outcome of cardiovascular diseases, such as heart failure and coronary heart disease, in obese patients as compared to underweight and normal-weight patients. Recently, similar, although fewer, observations confirm the occurrence of the obesity paradox in patients with acute cerebrovascular diseases. The underlying reasons for the protective effects of excessive body fat tissue against the consequences of acute cardiovascular and cerebrovascular diseases are poorly understood. The effect of preconditioning may be associated with the obesity paradox. The issue of the correlation between obesity and better survival of patients with cardiovascular and cerebrovascular diseases still remains largely unexplored. Debates for and against the obesity paradox continue.

  5. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification

    DEFF Research Database (Denmark)

    Nicolaides, Andrew N; Kakkos, Stavros K; Kyriacou, Efthyvoulos

    2010-01-01

    The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis....

  6. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification

    DEFF Research Database (Denmark)

    Nicolaides, Andrew N; Kakkos, Stavros K; Kyriacou, Efthyvoulos;

    2010-01-01

    The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis.......The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis....

  7. Nearshore circulation

    NARCIS (Netherlands)

    Battjes, J.A.; Sobey, R.J.; Stive, M.J.F.

    1990-01-01

    Shelf circulation is driven primarily by wind- and tide-induced forces. It is laterally only weakly constrained so that the geostrophic (Coriolis) acceleration is manifest in the response. Nearshore circulation on the other hand is dominated by wave-induced forces associated with shallow-water. wave

  8. Current therapy for chronic cerebrovascular attack

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    A. A. Shmonin

    2015-01-01

    Full Text Available Chronic cerebrovascular attack (CCVA is a brain lesion caused by vascular factors. CCVA appears as cognitive impairments (CIs, affective (emotional disorders and focal syndromes. Treatment for CCVA requires a comprehensive approach. Effective combination therapy for CCVA involves secondary prevention of stroke and CIs; treatment of CIs; treatment of depression and other affective disorders; and neuroprotective therapy. Basic therapy for CCVA includes modification of risk factors, antihypertensive, hypolipidemic, and antithrombotic therapies. Central acetylcholinesterase inhibitors (galantamine, rivastigmine, donepezil and a reversible NMDA receptor blocker (memantine are symptomatically used at a stage of vascular and mixed dementia. There are no unique guidelines for the therapy of mild and moderate vascular nondementia-related CIs. Drug use, based on the neurochemical mechanisms underlying the development of vascular CIs, is substantiated. When choosing psychotropic agents, it is necessary to take into account the causes and clinical manifestations of neuromediator deficiency. Antidepressants are used as essential drugs. Neuroleptics and tranquilizers are additionally administered in complex-pattern syndromes, such as depression with marked anxiety. Prescription of neuroprotectors may be effective in treating both stroke and CCVA. These medicaments are most effective when a damaging factor acts, i.e. neuroprotectors should be given in a risk situation and to reduce damage. Citicoline is one of the most test drugs in a group of neuroprotectors. 

  9. Audiological profile in cases with cerebrovascular accidents

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    Matlapudi Venkata Subbarao

    2015-01-01

    Full Text Available Background: Over the past decades there has been increase demand of audiological complaints coinciding with neurological impairments due to cerebrovascular accidents (CVAs. Most of the cases represent inconsistent responses to acoustic stimuli or total lack of response to sound, documented as auditory agnosia. Aim: The present investigation aims at understanding of potential anatomical co-relates to the involvement of the cortical structure and the processing of auditory stimuli. Materials and Methods: A case series with convenient sampling method included eight cases (six male and two female with age range 45-55 years with CVA, were taken for this study. Of them two cases were found with lesion in right middle cerebral artery, four cases with left middle cerebral artery and two cases with left posterior cerebral artery lesion confirmed from magnetic resonance imaging scan. Audiological test battery including otoscopy, tuning fork test, pure tone audiometry, speech audiometry, immittance audiometry, dichotic-diotic listening test, auditory brainstem responses, otoacoustic emissions and gap detection tests were carried out including routine ENT evaluation. Results and Conclusion: Result suggests; there is a significant difference in hearing threshold and speech perception in all the eight subjects. The findings and compromised vascular anatomy in all these cases were discussed in this article.

  10. Symptomatic Epilepsies due to Cerebrovascular Diseases

    Science.gov (United States)

    Dakaj, Nazim; Shatri, Nexhat; Isaku, Enver; Zeqiraj, Kamber

    2014-01-01

    Introduction: Cerebro-vascular diseases (CVD) are the leading cause of symptomatic epilepsies. This study aims to investigate: a) Frequency of epilepsy in patients with CVD; b) Correlation of epilepsy with the type of CVD (ischemic and hemorrhage) and with age. Methodology: It is analyzed medical documentation of 816 hospitalized patients with CVD in the clinic of Neurology in University Clinical Center (UCC) during the period January - December 2010. The study included data on patients presenting with epileptic seizures after CVD, and those with previously diagnosed epilepsy, are not included in the study. The diagnosis of CVD, are established in clinical neurological examination and the brain imaging (computer tomography and magnetic resonance imaging). The diagnosis of epilepsy is established by the criteria of ILAE (International League against Epilepsy) 1983, and epileptic seizures are classified according to the ILAE classification, of 1981. Results: Out of 816 patients with CVD, 692 were with ischemic stroke and 124 with hemorrhage. From 816 patients, epileptic seizures had 81 (10%), of which 9 patients had been diagnosed with epilepsy earlier and they are not included in the study. From 72 (99%) patients with seizures after CVD 25 (33%) have been with ischemia, whereas 47 (67%) with hemorrhage. Conclusion: CVD present fairly frequent cause of symptomatic epilepsies among patients treated in the clinic of Neurology at UCC (about 10%). The biggest number of patients with epilepsy after CVD was with intracerebral hemorrhage. PMID:25685086

  11. Clinical application of dynamic digital subtraction angiography in cerebrovascular ischemic diseases

    Energy Technology Data Exchange (ETDEWEB)

    Hirata, Yoshifumi; Nonaka, Nobuhito; Matsukado, Yasuhiko; Takahashi, Mutsumasa.

    1987-09-01

    Dynamic intravenous digital subtraction angiography (IV-DSA) was performed in 37 patients with cerebrovascular ischemic diseases. The time density curve of IV-DSA was analysed, and peak time, mean transit time and mode of transit time were obtained in each patient. On the basis of these values, cerebral perfusion was classified into low, normal and high perfusion patterns. Normal perfusion pattern was noted in 40% of patients with transient ischemic attack (TIA) and 7 % of patients with cerebral infarction. Low perfusion pattern was observed in 60 % of patients with TIA and 87 % of patients with cerebral infarction. High perfusion pattern was encountered only in 7 % of patients with cerebral infarction. In ischemic patients with moyamoya disease, extremely prolonged cerebral circulation time was evidenced by the presence of a flat or uphill type of the time density curve. This finding well correlated with decreased cerebral blood flow on single photon emission tomography. These findings suggest that the analysis of dynamic DSA is very important and useful in the clinical evaluation of patients with cerebrovascular ischemic diseases.

  12. Placental ischemia-induced increases in brain water content and cerebrovascular permeability: role of TNF-α.

    Science.gov (United States)

    Warrington, Junie P; Drummond, Heather A; Granger, Joey P; Ryan, Michael J

    2015-12-01

    Cerebrovascular complications and increased risk of encephalopathies are characteristic of preeclampsia and contribute to 40% of preeclampsia/eclampsia-related deaths. Circulating tumor necrosis factor-α (TNF-α) is elevated in preeclamptic women, and infusion of TNF-α into pregnant rats mimics characteristics of preeclampsia. While this suggests that TNF-α has a mechanistic role to promote preeclampsia, the impact of TNF-α on the cerebral vasculature during pregnancy remains unclear. We tested the hypothesis that TNF-α contributes to cerebrovascular abnormalities during placental ischemia by first infusing TNF-α in pregnant rats (200 ng/day ip, from gestational day 14 to 19) at levels to mimic those reported in preeclamptic women. TNF-α increased mean arterial pressure (MAP, P blood-brain barrier (BBB) permeability in the anterior cerebrum or posterior cerebrum. We then assessed the role of endogenous TNF-α in mediating these abnormalities in a model of placental ischemia induced by reducing uterine perfusion pressure followed by treatment with the soluble TNF-α receptor (etanercept, 0.8 mg/kg sc) on gestational day 18. Etanercept reduced placental ischemia-mediated increases in MAP, anterior brain water content (P permeability (202 ± 44% in placental ischemic rats to 101 ± 28% of normal pregnant rats). Our results indicate that TNF-α mechanistically contributes to cerebral edema by increasing BBB permeability and is an underlying factor in the development of cerebrovascular abnormalities associated with preeclampsia complicated by placental ischemia.

  13. NIRS-based noninvasive cerebrovascular regulation assessment

    Science.gov (United States)

    Miller, S.; Richmond, I.; Borgos, J.; Mitra, K.

    2016-03-01

    Alterations to cerebral blood flow (CBF) have been implicated in diverse neurological conditions, including mild traumatic brain injury, microgravity induced intracranial pressure (ICP) increases, mild cognitive impairment, and Alzheimer's disease. Near infrared spectroscopy (NIRS)-measured regional cerebral tissue oxygen saturation (rSO2) provides an estimate of oxygenation of the interrogated cerebral volume that is useful in identifying trends and changes in oxygen supply to cerebral tissue and has been used to monitor cerebrovascular function during surgery and ventilation. In this study, CO2-inhalation-based hypercapnic breathing challenges were used as a tool to simulate CBF dysregulation, and NIRS was used to monitor the CBF autoregulatory response. A breathing circuit for the selective administration of CO2-compressed air mixtures was designed and used to assess CBF regulatory responses to hypercapnia in 26 healthy young adults using non-invasive methods and real-time sensors. After a 5 or 10 minute baseline period, 1 to 3 hypercapnic challenges of 5 or 10 minutes duration were delivered to each subject while rSO2, partial pressure of end tidal CO2 (PETCO2), and vital signs were continuously monitored. Change in rSO2 measurements from pre- to intrachallenge (ΔrSO2) detected periods of hypercapnic challenges. Subjects were grouped into three exercise factor levels (hr/wk), 1: 0, 2:>0 and 10. Exercise factor level 3 subjects showed significantly greater ΔrSO2 responses to CO2 challenges than level 2 and 1 subjects. No significant difference in ΔPETCO2 existed between these factor levels. Establishing baseline values of rSO2 in clinical practice may be useful in early detection of CBF changes.

  14. Neurosonological examination: A non-invasive approach for the detection of cerebrovascular impairment in AD

    Directory of Open Access Journals (Sweden)

    Barbora eUrbanova

    2014-01-01

    Full Text Available There has been a growing interest in vascular impairment associated with Alzheimer’s disease (AD. This interest was stimulated by the findings of higher incidence of vascular risk factors in AD. Signs of vascular impairment were investigated notably in the field of imaging methods. Our aim was to explore ultrasonographic studies of extra- and intracranial vessels in patients with AD and mild cognitive impairment (MCI and define implications for diagnosis, treatment and prevention of the disease. The most frequently studied parameters with extracranial ultrasound are intima-media thickness in common carotid artery, carotid atherosclerosis, and total cerebral blood flow. The transcranial ultrasound concentrates mostly on flow velocities, pulsatility indices, cerebrovascular reserve capacity, cerebral microembolization. Studies suggest there is morphological and functional impairment of cerebral circulation in AD compared to healthy subjects. Ultrasound as a non-invasive method could be potentially useful in identifying individuals in a higher risk of progression of cognitive decline.

  15. The role of endothelial progenitor cells in transient ischemic attack patients for future cerebrovascular events

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    Rokhsareh Meamar

    2016-01-01

    Full Text Available Background: The role of endothelial progenitor cells (EPCs in the maintenance of vascularization following ischemic brain after experimental stroke has been established. Accordingly, in this study, we evaluated the role of circulating EPCs in transient ischemic attack (TIA patients for future cerebrovascular (CV events. Materials and Methods: The level of circulating EPCs (staining markers: CD34, CD309 were determined using flow cytometry at 24 h after TIA in thirty consecutive patients. The EPCs level was also evaluated once in thirty healthy volunteers. Over a period of 12 months, all patients were evaluated by an experienced neurologist for recurrent TIA, stroke or death induced by CV disorders. Results: Circulating EPCs increased in patients group following the first attack of TIA when compared with controls. By analysis of covariance, cardiovascular event history, hyperlipidemia, and statin therapy remained significant independent predictors of EPCs. The mean (standard deviation duration of follow-up was 10.5 (3.1 months (range, 2–12 months. During follow-up, a total of three patients died due to CV accident and four patients experienced again recurrent TIA. By analyzing data with Cox regression, EPC did not predict the future CV events in TIA patients. Conclusion: Increased incidence of future CV events did not occur in those patients with elevated EPCs in the first attack of TIA. The significant predicting factors of EPCs were cardiovascular event history, hyperlipidemia, and statin therapy.

  16. Risk factors of cerebrovascular diseases and their intervention and management

    Directory of Open Access Journals (Sweden)

    En XU

    2015-01-01

    Full Text Available Cerebrovascular diseases are important causes of clinical death and disability because of high prevalence and morbidity and easy to recurrence. A number of risk factors have involved in the progress of cerebrovascular diseases, which include uncontrolled and controlled risk factors. The former refers to old age, gender, low birth weight, race/ethnicity, genetic factors, etc. The latter includes hypertension, diabetes mellitus, atrial fibrillation and other cardiac diseases, dyslipidemia, asymptomatic carotid stenosis, obesity, smoking, unhealthy lifestyle, alcoholism, metabolic syndrome, hyperhomocysteinemia, etc. Meanwhile, hypertension is the most important one in the above-mentioned risk factors. It would effectively reduce or postpone the onset of cerebrovascular diseases through proper intervention and management on those risk factors. DOI: 10.3969/j.issn.1672-6731.2015.01.006

  17. 7-T MRI in Cerebrovascular Diseases : Challenges to Overcome and Initial Results

    NARCIS (Netherlands)

    Harteveld, Anita A; van der Kolk, Anja G; Zwanenburg, Jaco J M; Luijten, Peter R; Hendrikse, J

    2016-01-01

    Magnetic resonance imaging (MRI) plays a key role in the investigation of cerebrovascular diseases. Compared with computed tomography (CT) and digital subtraction angiography (DSA), its advantages in diagnosing cerebrovascular pathology include its superior tissue contrast, its ability to visualize

  18. A meta-analysis of cerebrovascular disease and hyperhomocysteinaemia

    DEFF Research Database (Denmark)

    Nielsen, G M; Tvedegaard, K C; Andersen, Niels Trolle;

    2000-01-01

    Hyperhomocysteinaemia has been identified as a risk factor for stroke and cerebrovascular disease in several studies. To evaluate the evidence we performed a meta-analysis. We found 21 studies searching Medline from 1966-July 1999 using the key words homocysteine, homocystine and cerebrovascular...... was used. The reports on 8 cross-sectional and 4 longitudinal studies gave data on the mean and standard deviations of plasma or serum homocysteine for both cases and controls, and these studies were included in the meta-analysis. The results of the 5 excluded studies all pointed to a positive relationship...

  19. Effects of Dietary Nitrates on Systemic and Cerebrovascular Hemodynamics

    Directory of Open Access Journals (Sweden)

    Vernon Bond

    2013-01-01

    Full Text Available Cerebral blood flow dysregulation is often associated with hypertension. We hypothesized that a beetroot juice (BRJ treatment could decrease blood pressure and cerebrovascular resistance (CVR. We subjected 12 healthy females to control and BRJ treatments. Cerebrovascular resistance index (CVRI, systolic blood pressure (SBP, total vascular resistance (TVR, and the heart rate-systolic pressure product (RPP measured at rest and at two exercise workloads were lower after the BRJ treatment. CVRI, SBP, and RPP were lower without a lower TVR at the highest exercise level. These findings suggest improved systemic and cerebral hemodynamics that could translate into a dietary treatment for hypertension.

  20. The Cerebrovascular Disease and Nutritional State. Enfermedad cerebrovascular y estado nutricional

    Directory of Open Access Journals (Sweden)

    Mayelin Blanco Suárez

    2007-05-01

    Full Text Available Background: It is recognized the importance of malnutrition as a cause of morbidity and mortality in medical and surgical affections. The nutritional assessment of the patient should be based on a correct evaluation of different aspects. Objective: To assess the nutritional state of patients affected by cerebrovascular diseases in its ischemic form and the incidence of complications and deaths. Methods: A randomized simple and open clinical trial which is also prospective and longitudinal, not controlled by placebos that included 80 patients with a tomographed-clinical diagnosis of cerebral infarction admitted at the Higher Institute of Military Medicine during 2005. Clinical and dietary record, weight, size, daily assessments of the immunological performance by means of peripheral count of lymphocytes were analyzed. Results: Out of the total, 90 per cent of the patients had a weight loss lesser than 10 % of the ideal weight and, the 10% made evident a discrete increasing of weight. Patients with complications presented higher per cent of loss of weight and higher figures of urinary nitrogen. The higher per cent of loss of weight and the lowest lymphocytes count were found in patients with septic complications. An abbaissement in adequate nutritional parameters was found in deceased patients. Significant differences in the report of the initial malnourished patient’s complication existed. Conclusions: It was evident the relationship between the evolution of the cerebrovascular disease and the nutritional state which is conditioned by the appearance of complications with emphasis on sepsis. That’s why it is necessary to pay special attention to the nutrition of patients with neuroictus.
    Fundamento: Se reconoce la trascendencia de la desnutrición como causa de morbilidad y mortalidad en afecciones médicas y quir

  1. Evento cerebrovascular isquémico en el adulto joven

    Directory of Open Access Journals (Sweden)

    Verónica Leandro-Sandí

    2013-09-01

    Full Text Available El evento cerebrovascular isquémico es un desorden multifactorial, en el que contribuyen factores genéticos y ambientales. A pesar de que se reconoce un aumento del riesgo de eventos cerebrovasculares cuando existe una historia familiar positiva (de hasta un 75% en ciertos estudios, no se conoce la contribución exacta que tiene la genética en el desarrollo de eventos cerebrales isquémicos en el paciente joven. El papel que desempeña la predisposición genética sobre la ocurrencia de estos eventos, difiere según la edad y el tipo de evento. Los factores genéticos se conjugan con los factores de riesgo convencionales, como hipertensión arterial, diabetes y niveles de homocisteína, que a su vez interactúan con el ambiente en el desarrollo de aterosclerosis. La homocisteína por sí sola, ha sido considerada un factor aterogénico en enfermedades cardiovasculares y cerebrovasculares. Se refiere el caso de un paciente de 49 años conocido sano, quien presenta un evento cerebrovascular isquémico de la circulación cerebral anterior, con un valor en la escala para derrame del Instituto Nacional de Salud de 7 puntos al ingreso y una mutación heterocigota del gen de la metiltetrahidrofolato reductasa (región de mutación C677T.

  2. NSAIDs and cardiovascular drugs in neurodegenerative and cerebrovascular diseases

    NARCIS (Netherlands)

    M.D.M. Haag (Mendel)

    2009-01-01

    textabstractNeurodegenerative and cerebrovascular diseases are frequent in elderly populations and comprise primarily of dementia (mainly Alzheimer disease (AD)), Parkinson disease (PD) and stroke. The prevalence of these neurological disorders rises with older age. From 55 years to 90 years and abo

  3. Myocardial stress in patients with acute cerebrovascular events

    DEFF Research Database (Denmark)

    Jespersen, Christian M; Fischer Hansen, Jørgen

    2008-01-01

    Signs of myocardial involvement are common in patients with acute cerebrovascular events. ST segment deviations, abnormal left ventricular function, increased N-terminal pro-brain natriuretic peptide (NT-proBNP), prolonged QT interval, and/or raised troponins are observed in up to one third...

  4. Depression as the cause and consequence of cerebrovascular diseases

    Directory of Open Access Journals (Sweden)

    Rabi-Žikić Tamara

    2007-01-01

    Full Text Available Inbtroduction: Recent epidemiological, clinical, neuroimaging and neuropathological studies have reported substantial evidence on the complex interactive relationships between depression and cerebrovascular diseases, especially in older populations, and plausible explanations of the etiopathogenetic mechanisms in both directions have been proposed. Poststroke depression Although there is no general consensus regarding its prevalence, it is widely accepted that major depression after stroke is common and that it should be recognized as a key factor in rehabilitation and outcome following stroke. Vascular depression The "vascular depression" hypothesis presupposes that late-onset depression may often result from vascular damage to frontal-subcortical circuits implicated in mood regulation. This concept has stimulated many researches and the obtained results support the proposed hypothesis. Depression as a stroke risk factor Recent large studies have emphasized the role of depression per se in the development of subsequent stroke. Mechanisms proposed to explain the increased risk of cerebrovascular diseases in depressed patients There are a number of plausible mechanisms that could explain why depression may increase the risk of subsequent cerebrovascular disease, the most important being sympathoadrenal hyperactivity, platelet activation, an increase in inflammatory cytokines and an increased risk of arrhythmias. Conclusion: Thorough clinical examinations determining the conventional stroke risk factors in the population with depression, as well as management of depression as part of the overall measures for the reduction of cerebrovascular risk factors are of utmost importance.

  5. Cerebrovascular angiotensin AT1 receptor regulation in cerebral ischemia

    DEFF Research Database (Denmark)

    Edvinsson, L.

    2008-01-01

    The mechanism behind the positive response to the inhibition of the angiotensin II receptor AT(1) in conjunction with stroke is elusive. Here we demonstrate that cerebrovascular AT(1) receptors show increased expression (upregulation) after cerebral ischemia via enhanced translation. This enhanced...

  6. Cerebrovascular response to acute metabolic acidosis in humans.

    NARCIS (Netherlands)

    Ven, M.T.P. van de; Colier, W.N.J.M.; Kersten, B.T.P.; Oeseburg, B.; Folgering, H.T.M.

    2003-01-01

    OBJECTIVES: Evaluation of the cerebrovascular response (delta CBV/delta PaCO2) during baseline metabolic conditions and acute metabolic acidosis. METHODS: 15 healthy subjects, 5 m, 10 f, 56 +/- 10 yrs were investigated. For acidification, NH4Cl was given orally. CBV was measured using Near Infrared

  7. Cerebrovascular contributions to aging and Alzheimer's disease in Down syndrome.

    Science.gov (United States)

    Wilcock, Donna M; Schmitt, Frederick A; Head, Elizabeth

    2016-05-01

    Down syndrome (DS) is a common cause of intellectual disability and is also associated with early age of onset of Alzheimer's disease (AD). Due to an extra copy of chromosome 21, most adults over 40years old with DS have beta-amyloid plaques as a result of overexpression of the amyloid precursor protein. Cerebrovascular pathology may also be a significant contributor to neuropathology observed in the brains of adults with DS. This review describes the features of cardiovascular dysfunction and cerebrovascular pathology in DS that may be modifiable risk factors and thus targets for interventions. We will describe cerebrovascular pathology, the role of co-morbidities, imaging studies indicating vascular pathology and the possible consequences. It is clear that our understanding of aging and AD in people with DS will benefit from further studies to determine the role that cerebrovascular dysfunction contributes to cognitive health. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock.

  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. Cerebrovascular risk factors and clinical classification of strokes.

    Science.gov (United States)

    Pinto, Antonio; Tuttolomondo, Antonino; Di Raimondo, Domenico; Fernandez, Paola; Licata, Giuseppe

    2004-08-01

    Cerebrovascular risk represents a progressive and evolving concept owing to the particular distribution of risk factors in patients with ischemic stroke and in light of the newest stroke subtype classifications that account for pathophysiological, instrumental, and clinical criteria. Age represents the strongest nonmodifiable risk factor associated with ischemic stroke, while hypertension constitutes the most important modifiable cerebrovascular risk factor, confirmed by a host of epidemiological data and by more recent intervention trials of primary (HOT, Syst-Eur, LIFE) and secondary (PROGRESS) prevention of stroke in hypertensive patients. To be sure, a curious relationship exists between stroke and diabetes. Although the Framingham Study, The Honolulu Heart Program, and a series of Finnish studies reported a linear relationship between improved glucose metabolism and cerebral ischemia, the clinical and prognostic profile of diabetic patients with ischemic stroke remains to be fully understood. Our group, on the basis of TOAST classification--a diagnostic classification of ischemic stroke developed in 1993 that distinguishes five different clinical subtypes of ischemic stroke: large-artery atherosclerosis (LAAS), cardioembolic infarct (CEI), lacunar infarct (LAC), stroke of other determined origin (ODE), and stroke of undetermined origin (UDE), and now extensively used in clinical and scientific context--analysed the prevalence of cerebrovascular risk factors and the distribution of TOAST subtypes in more 300 patients with acute ischemic stroke in two consecutives studies that reported the significant association between diabetes and the lacunar subtype and a better clinical outcome for diabetic patients, most likely related to the higher prevalence of the lacunar subtype. Well-confirmed are the roles of cigarette smoking, atrial fibrillation, and asymptomatic carotid stenosis as cerebrovascular risk factors. Particularly interesting seems to be the function of

  10. Resveratrol preserves cerebrovascular density and cognitive function in aging mice

    Directory of Open Access Journals (Sweden)

    Charlotte A Oomen

    2009-12-01

    Full Text Available Resveratrol, a natural polyphenol abundant in grapes and red wine, has been reported to exert numerous beneficial health effects. Among others, acute neuroprotective effects of resveratrol have been reported in several models of neurodegeneration, both in vitro and in vivo. In the present study we examined the neuroprotective effects of long term dietary supplementation with resveratrol in mice on behavioral, neurochemical and cerebrovascular level. We report a preserved cognitive function in resveratrol treated aging mice, as shown by an enhanced acquisition of a spatial Y-maze task. This was paralleled by a higher microvascular density and a lower number of microvascular abnormalities in comparison to aging non-treated control animals. We found no effects of resveratrol supplementation on cholinergic cell number or fiber density. The present findings support the hypothesis that resveratrol exerts beneficial effects on the brain by maintaining cerebrovascular health. Via this mechanism resveratrol can contribute to the preservation of cognitive function during aging.

  11. Gray Cerebrovascular Image Skeleton Extraction Algorithm Using Level Set Model

    Directory of Open Access Journals (Sweden)

    Jian Wu

    2010-06-01

    Full Text Available The ambiguity and complexity of medical cerebrovascular image makes the skeleton gained by conventional skeleton algorithm discontinuous, which is sensitive at the weak edges, with poor robustness and too many burrs. This paper proposes a cerebrovascular image skeleton extraction algorithm based on Level Set model, using Euclidean distance field and improved gradient vector flow to obtain two different energy functions. The first energy function controls the  obtain of topological nodes for the beginning of skeleton curve. The second energy function controls the extraction of skeleton surface. This algorithm avoids the locating and classifying of the skeleton connection points which guide the skeleton extraction. Because all its parameters are gotten by the analysis and reasoning, no artificial interference is needed.

  12. Etiological and clinical analysis on 220 children with cerebrovascular diseases

    Directory of Open Access Journals (Sweden)

    Zhi-hong TANG

    2014-03-01

    Full Text Available Etiological and clinical analyses of 220 children with cerebrovascular diseases were retrospectively analyzed. One hundred and forty-nine cases (67.73% were male, and 71 cases (32.27% were female. There were 186 cases (84.55% of patients to be found with clear causes, most of which were arteriovenous malformation (80/220, 36.36%, traumatic brain injury (38/220, 17.27%, intracranial infection (15/220, 6.82% , intracranial aneurysm (13/220, 5.91% , delayed vitamin K deficiency (12/220, 5.45% , congenital heart disease (9/220, 4.09% and cavernous malformation (7/220, 3.18%. The etiological and clinical features of children cerebrovascular diseases are distinct, and timely diagnosis and treatment will help to improve patients' prognosis. doi: 10.3969/j.issn.1672-6731.2014.03.017

  13. Diamox-enhanced brain SPECT in cerebrovascular diseases

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yun Young [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    2007-04-15

    Acute event in cerebrovascular disease is the second most common cause of death in Korea following cancer, and it can also cause serious neurologic deficits. Understanding of perfusion status is important for clinical applications in management of patients with cerebrovascular diseases, and then the attacks of ischemic neurologic symptoms and the risk of acute events can be reduced. Therefore, the normal vascular anatomy of brain, various clinical applications of acetazolamide-enhanced brain perfusion SPECT, including meaning and role of assessment of vascular reserve in carotid stenosis before procedure, in pediatric Moyamoya disease before and after operation, in prediction of development of hyperperfusion syndrome before procedure, and in prediction of vasospasm and of prognosis in subarachnoid hemorrhage were reviewed in this paper.

  14. Microbubbles as drug delivery systems in cerebrovascular diseases.

    Science.gov (United States)

    Spinelli, Mariacarmela; Demitri, Christian; Sannino, Alessandro; Peruzzotti-Jametti, Luca; Bacigaluppi, Marco; Comi, Giancarlo; Corea, Francesco

    2009-11-01

    The field of neurovascular ultrasound is growing rapidly with new applications. While ultrasound contrast agents were initially used to overcome poor transcranial bone windows for identification of cerebral arteries, newgeneration microbubbles in combination with innovative contrast-specific ultrasound techniques now enable potential therapeutic procedures. This article will provide a review of recent and emerging developments along with patents in ultrasound technology and contrast-specific therapeutic techniques for cerebrovascular patients.

  15. Cerebrovascular disturbances in children with Arnold-Kiary anomaly I

    Directory of Open Access Journals (Sweden)

    Kozlitina T.N.

    2012-03-01

    Full Text Available Data of diagnostics of cerebrovascular disorders in craniovertebral passage due to Arnold — Kiary anomaly I have been considered. Clinical picture of the disease in different age groups has been represented. Condition of extra- and intracranial part of vertebral arteries and venous plexuses of the cervical part of vertebral column and craniovertebral passage, pathological asymmetry of the blood flow have been estimated. Efficacy of conservative and surgical treatment has been compared.

  16. Digital subtraction angiography in pediatric cerebrovascular occlusive disease

    Energy Technology Data Exchange (ETDEWEB)

    Faerber, E.N.; Griska, L.A.B.; Swartz, J.D.; Capitanio, M.A.; Popky, G.L.

    1984-08-01

    While conventional angiography has been used to demonstrate cerebrovascular occlusive disease in the past, digital subtraction angiography (DSA) is capable of showing progressive vascular involvement with ease, simplicity, and extremely low morbidity, making it particularly well suited for children and outpatients either alone or coordinated with computed tomography. The authors discuss the usefulness and advantages of DSA as demonstrated in 7 infants and children with hemiplegia, 4 of whom had sickle-cell disease.

  17. EFFECT OF ACUPUNCTURE ON THE INTELLIGENCE OF CEREBROVASCULAR DEMENTIA PATIENT

    Institute of Scientific and Technical Information of China (English)

    陈邦国

    2000-01-01

    Cerebrovascular dementia is a common disese in the old and medium-aged people. Its morbidity constitutes about 10-20% of all the dementia patients and results mainly from all-round decline of the brain function due to cerebral atheroscleorsis and cerebral infarction. The author of the present paper adopted acupuncture therapy to; treat this kind of disease and observed its effect on dementia patient's intelligence. Here is the report.

  18. HIGH SENSITIVE C-REACTIVE PROTEIN IN CEREBROVASCULAR ISCHEMIA

    OpenAIRE

    Padmalatha; Neeraja

    2016-01-01

    BACKGROUND Cerebrovascular ischemia is recognized as a major health problem, which causes significant morbidity and mortality. The main pathophysiology of ischemic stroke is atherosclerosis of cerebral vessels. Hs-CRP is a sensitive marker of inflammation tissue injury in the arterial wall, which contributes to atherosclerosis. In this study, we aim to investigate the association of hs-CRP in patients with ischemic stroke and to correlate hs-CRP levels with possible risk facto...

  19. Antioxidants and Dementia Risk: Consideration through a Cerebrovascular Perspective

    Directory of Open Access Journals (Sweden)

    Virginie Lam

    2016-12-01

    Full Text Available A number of natural and chemical compounds that exert anti-oxidative properties are demonstrated to be beneficial for brain and cognitive function, and some are reported to reduce the risk of dementia. However, the detailed mechanisms by which those anti-oxidative compounds show positive effects on cognition and dementia are still unclear. An emerging body of evidence suggests that the integrity of the cerebrovascular blood-brain barrier (BBB is centrally involved in the onset and progression of cognitive impairment and dementia. While recent studies revealed that some anti-oxidative agents appear to be protective against the disruption of BBB integrity and structure, few studies considered the neuroprotective effects of antioxidants in the context of cerebrovascular integrity. Therefore, in this review, we examine the mechanistic insights of antioxidants as a pleiotropic agent for cognitive impairment and dementia through a cerebrovascular axis by primarily focusing on the current available data from physiological studies. Conclusively, there is a compelling body of evidence that suggest antioxidants may prevent cognitive decline and dementia by protecting the integrity and function of BBB and, indeed, further studies are needed to directly examine these effects in addition to underlying molecular mechanisms.

  20. Cerebral blood flow in sickle cell cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Huttenlocher, P.R.; Moohr, J.W.; Johns, L.; Brown, F.D.

    1984-05-01

    Cerebral blood flow (CBF) has been studied by the xenon-133 (/sup 133/Xe) inhalation method in 16 children with suspected sickle cell cerebrovascular disease. Abnormalities consisting of decreases in total, hemispheral, or regional CBF were found in 17 of 26 studies. Eleven studies performed immediately after stroke, transient ischemic attack, or depression of state of alertness showed abnormalities. In addition to confirming regional cerebrovascular insufficiency in children with stroke due to major cerebral artery occlusion, the method detected diffuse decrease in CBF in children with stupor, coma, and seizures who had normal angiographic findings. In contrast, six of seven studies obtained after exchange transfusion or during maintenance on hypertransfusion therapy showed normal findings. The difference between results in patients with acute neurologic disturbances and those receiving transfusion therapy was statistically significant (P less than .005). The data indicate that the /sup 133/Xe method reliably demonstrates cerebrovascular impairment in sickle cell disease. They also suggest that CBF changes in patients with sickle cell disease can be reversed by exchange transfusion and by hypertransfusion therapy. The /sup 133/Xe CBF method may be useful for following up children with sickle cell disease who are at high risk for recurrent stroke.

  1. Autumn Weather and Winter Increase in Cerebrovascular Disease Mortality

    LENUS (Irish Health Repository)

    McDonagh, R

    2016-11-01

    Mortality from cerebrovascular disease increases in winter but the cause is unclear. Ireland’s oceanic climate means that it infrequently experiences extremes of weather. We examined how weather patterns relate to stroke mortality in Ireland. Seasonal data for Sunshine (% of average), Rainfall (% of average) and Temperature (degrees Celsius above average) were collected for autumn (September-November) and winter (December-February) using official Irish Meteorological Office data. National cerebrovascular mortality data was obtained from Quarterly Vital Statistics. Excess winter deaths were calculated by subtracting (nadir) 3rd quarter mortality data from subsequent 1st quarter data. Data for 12 years were analysed, 2002-2014. Mean winter mortality excess was 24.7%. Winter mortality correlated with temperature (r=.60, p=0.04). Rise in winter mortality correlated strongly with the weather in the preceding autumn (Rainfall: r=-0.19 p=0.53, Temperature: r=-0.60, p=0.03, Sunshine, r=0.58, p=0.04). Winter cerebrovascular disease mortality appears higher following cool, sunny autum

  2. Circulation economics

    DEFF Research Database (Denmark)

    Ingebrigtsen, Stig; Jakobsen, Ove

    2006-01-01

    Purpose - This paper is an attempt to advance the critical discussion regarding environmental and societal responsibility in economics and business. Design/methodology/approach - The paper presents and discusses as a holistic, organic perspective enabling innovative solutions to challenges...... concerning the responsible and efficient use of natural resources and the constructive interplay with culture. To reach the goal of sustainable development, the paper argues that it is necessary to make changes in several dimensions in mainstream economics. This change of perspective is called a turn towards...... presupposes a perspective integrating economic, natural and cultural values. Third, to organize the interplay between all stakeholders we introduce an arena for communicative cooperation. Originality/value - The paper concludes that circulation economics presupposes a change in paradigm, from a mechanistic...

  3. Contribution of cerebrovascular disease in autopsy confirmed neurodegenerative disease cases in the National Alzheimer's Coordinating Centre.

    Science.gov (United States)

    Toledo, Jon B; Arnold, Steven E; Raible, Kevin; Brettschneider, Johannes; Xie, Sharon X; Grossman, Murray; Monsell, Sarah E; Kukull, Walter A; Trojanowski, John Q

    2013-09-01

    Cerebrovascular disease and vascular risk factors are associated with Alzheimer's disease, but the evidence for their association with other neurodegenerative disorders is limited. Therefore, we compared the prevalence of cerebrovascular disease, vascular pathology and vascular risk factors in a wide range of neurodegenerative diseases and correlate them with dementia severity. Presence of cerebrovascular disease, vascular pathology and vascular risk factors was studied in 5715 cases of the National Alzheimer's Coordinating Centre database with a single neurodegenerative disease diagnosis (Alzheimer's disease, frontotemporal lobar degeneration due to tau, and TAR DNA-binding protein 43 immunoreactive deposits, α-synucleinopathies, hippocampal sclerosis and prion disease) based on a neuropathological examination with or without cerebrovascular disease, defined neuropathologically. In addition, 210 'unremarkable brain' cases without cognitive impairment, and 280 cases with pure cerebrovascular disease were included for comparison. Cases with cerebrovascular disease were older than those without cerebrovascular disease in all the groups except for those with hippocampal sclerosis. After controlling for age and gender as fixed effects and centre as a random effect, we observed that α-synucleinopathies, frontotemporal lobar degeneration due to tau and TAR DNA-binding protein 43, and prion disease showed a lower prevalence of coincident cerebrovascular disease than patients with Alzheimer's disease, and this was more significant in younger subjects. When cerebrovascular disease was also present, patients with Alzheimer's disease and patients with α-synucleinopathy showed relatively lower burdens of their respective lesions than those without cerebrovascular disease in the context of comparable severity of dementia at time of death. Concurrent cerebrovascular disease is a common neuropathological finding in aged subjects with dementia, is more common in Alzheimer

  4. Comparison of dynamic and xenon computed tomography in the evaluation of cerebrovascular ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Terada, Tomoaki; Kikuchi, Haruhiko; Kuriyama, Yoshihiro; Nagata, Izumi; Yamagata, Sen; Naruo, Yoshito; Minamikawa, Jun; Kaneko, Takaji; Sawada, Toru.

    1989-01-01

    Dynamic computed tomographic (DCT) scans with iodine contrast enhancement were compared with simultaneously obtained xenon CT studies of cerebral blood flow (CBF) in 15 patients with subacute or chronic cerebrovascular ischemic disease. Specifically, the width and corrected first moment (cMT1), as demonstrated by DCT, were compared with the regional CBF (rCBF) data and the rCBF map obtained with xenon CT. The DCT and rCBF images were well correlated in patients without, but poorly correlated in those with, leptomeningeal anastomotic collateral circulation. The correlation of rCBF and 1/width with 1/cMT1 was significant (r=0.78, p<0.01) in the former, but not in the latter. These data were thought to reflect a difference in the tracer inflow pattern between the patients with and those without leptomeningeal anastomoses. Our series did not include patterns with acute cerebral infarction or recanalization, which are thought to be associated with marked changes in cerebral blood volume in the affected region. However, the influence of cerebral blood volume should be studied in detail in our subacute or chronic series.

  5. Evaluation of computer tomography in cerebro-vascular disease (Strokes)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Sik; Baek, Seung Yon; Rhee, Chung Sik; Kim, Hee Seup [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    1984-06-15

    Most of cerebrovascular disease are composed of vascular occulusive changes and hemorrhage. Now a day, the computed tomography is the best way for evaluation of cerebrovascular disease including detection of nature, location, and associated changes. This study includes evaluation of computed tomography of 70 patients with cerebrovascular disease during the period of 10 months from April. 1983 to Feb. 1984 in Department of Radiology, Ewha Womans University Hospital. The results were as follows: 1. Age distribution of the total 70 patients was broad ranging from 25 years to 79 years. 78.6% of patients were over the age of 50. The male and female sex ratio was 1.4:1. 2. 4 out of 70 patients were normal and 66 patients revealed abnormal on C.T. findings; those were intracranial hemorrhage (28 patients), cerebral infarction (34 patients) and brain atrophy (4 patients). 3. In cases of cerebral infarction, the cerebral hemisphere was most common site of lesion (28 cases), and next was basal ganglia (2 cases). Most of the infarcts in cerebral hemisphere were located in the parietal and temporal lobes. 4. In cases of intracranial hemorrhage, the basal ganglia was most common site of lesion (15 cases). The next common site was cerebral hemisphere (9 cases). 6 patients of all intracranial hemorrhage were combined with intraventricular hemorrhage. Ratio of right and left was 2:3. 5. In patients with motor weakness or hemiparesis, more common findings on CT scan were cerebral infarction. In case with hemiplegia, more common CT findings were intracerebral hemorrhage. 6. Of the 40 cases thought to be cerebral infarction initially by clinical findings and spinal tap. 8 cases (20.0%) were proved to be cerebral hemorrhage by the CT scan. However, of the 22 cases thought to be cerebral hemorrhage, initially, only two cases (9.0%) were cerebral infarction.

  6. Tratamiento de Terapia Ocupacional en el accidente cerebrovascular

    OpenAIRE

    Domingo García, AM

    2006-01-01

    RESUMENEntre los muchos pacientes que necesitan tratamiento rehabilitador en Terapia Ocupacional están los que en la edad adulta han sufrido un accidente cerebrovascular.Uno de los factores de riesgo asociados con más frecuencia a las alteraciones del sistema nervioso central es el progresivo envejecimiento de la población, debido a esto orientaré el siguiente artículo hacia la intervención sobre la población geriátrica.La Terapia Ocupacional ofrece un tratamiento global que abarca las áreas ...

  7. The impact of ambient particulate matter (PM10) on the population mortality for cerebrovascular diseasesa case-crossover study

    Institute of Scientific and Technical Information of China (English)

    王旭英

    2013-01-01

    Objective To analyze the association between the concentration of ambient inhalable particulate matter(PM10) and population mortality for cerebrovascular diseases and to explore the impact of PM10 on cerebrovascular

  8. Tratamiento de la hipertensión arterial en accidente cerebrovascular

    OpenAIRE

    Luna Vela, Fredy Andrés

    2013-01-01

    Revisión sistemática de la literatura en la que se discuten las controversias del manejo de la presión arterial en las emergencias neurológicas agudas cerebrovasculares como accidente cerebrovascular isquémico, hemorrágico y hemorragia subaracnoidea.

  9. Pathobiology of human cerebrovascular malformations: basic mechanisms and clinical relevance.

    Science.gov (United States)

    Gault, Judith; Sarin, Hemant; Awadallah, Nabil A; Shenkar, Robert; Awad, Issam A

    2004-07-01

    Cerebrovascular malformations affect more than 3% of the population, exposing them to a lifetime risk of hemorrhagic stroke, seizures, and focal neurological deficits. Cerebral cavernous malformations (CCMs) exhibit an immature vessel wall, a brittle hemorrhagic tendency, and epileptogenesis, whereas arteriovenous malformations (AVMs) lack capillary beds and manifest apoplectic bleeding under high-flow conditions. There are also more benign venous anomalies, capillary malformations, and lesions with mixed and transitional features. Advances have been made toward understanding the natural history, radiological and pathological correlates, and clinical management. Yet, mechanisms of lesion genesis and clinical manifestations remain largely unknown, and the clinical behavior in individual patients is highly unpredictable. Lesion pathogenesis likely involves abnormal assembly or maintenance of blood vessels, resulting in dysmorphic vessel phenotypes. Familial CCM disease is in part caused by mutations in a cytoskeletal-related protein that is likely integral to interendothelial cell connectivity and maturation of the vascular wall. Rare familial forms of AVM disease have been correlated with two different transforming growth factor-beta receptor components, possibly causing disturbance in signaling during vascular assembly. Relevance of these mechanisms to the more common and otherwise identical sporadic CCM and AVM lesions is being explored. In this report, basic mechanisms of vasculogenesis and angiogenesis and how they possibly relate to the common cerebrovascular malformation lesions are reviewed. Novel concepts are discussed related to the cellular, molecular, and genetic substrates in CCM and AVM as well as to how this knowledge can be applied to predict, explain, and possibly modify clinical disease manifestations.

  10. Correlation of cerebrovascular disorder and anxiety: The Kecskemet study

    Science.gov (United States)

    Sipos, Kornel; Bodo, Michael; Szalay, Piroska; Szucs, Attila

    2010-04-01

    In order to test the hypothesis that anxiety is a risk factor for cardiovascular disease, specifically stroke, we simultaneously measured anxiety and cerebral vascular alternation, using a computer-based system, "Cerberus." Sixty nine psychiatric patients (including an alcoholic subgroup) were selected as subjects for measurements conducted in Kecskemet, Hungary. The five-item short form of anxiety test (STAI) was administered twice during the same session. Between each test, brain pulse waves were recorded by rheoencephalogram (REG). A REG peak time above 180 milliseconds was considered a cerebrovascular alteration (modified after Jenkner). Data were sorted into two groups: low anxiety (N=10) and high anxiety (N=10). Significant differences were found between cardiovascular risk factors (panxiety group, and two in the low anxiety group. For the two anxiety groups, there were no significant differences in body mass index, cardiovascular sympathetic-parasympathetic balance, age and symptoms of transient ischemic attack. The correlation of REG and age was significantly different only for the alcoholic subgroup (Szalay et al, 2007). These data support the hypothesis that a correlation exists between cerebrovascular disorder and anxiety in the studied population.

  11. Anton's syndrome due to cerebrovascular disease: a case report

    Directory of Open Access Journals (Sweden)

    Maddula Mohana

    2009-09-01

    Full Text Available Abstract Introduction Anton's syndrome describes the condition in which patients deny their blindness despite objective evidence of visual loss, and moreover confabulate to support their stance. It is a rare extension of cortical blindness in which, in addition to the injury to the occipital cortex, other cortical centres are also affected, with patients typically behaving as if they were sighted. Case presentation We present a case report of an 83-year-old white woman with cortical blindness as a result of bilateral occipital lobe infarcts. Despite her obvious blindness, illustrated by her walking into objects, the patient expressed denial of visual loss and demonstrated confabulation in her accounts of her surroundings, consistent with a diagnosis of Anton's syndrome. Conclusions A suspicion of cortical blindness and Anton's syndrome should be considered in patients with atypical visual loss and evidence of occipital lobe injury. Cerebrovascular disease is the most common cause of Anton's syndrome, as in our patient. However, any condition that may result in cortical blindness can potentially lead to Anton's syndrome. Recovery of visual function will depend on the underlying aetiology, with cases due to occipital lobe infarction after cerebrovascular events being less likely to result in complete recovery. Management in these circumstances should accordingly focus on secondary prevention and rehabilitation.

  12. ROLE OF SMOKING AND ALCOHOLISM IN CEREBROVASCULAR ACCIDENTS

    Directory of Open Access Journals (Sweden)

    Y. Indira,

    2014-06-01

    Full Text Available Though previously stroke was considered an old man disease, it is increasing among the young and middle aged people are not likely to die of stroke as they are of heart attack, but they are likely to be disabled for rest of their lives. As the cases of stroke admitted to medical wards, formed nearly 1/10th to 1/8th of total bed strength at any time, and their prolonged stay at hospital attracted our attention. To study the etiological factors for the present study we have thoroughly evaluated 50 pts, with acute cerebrovascular disease and focused more attention in the revaluation of physiological variants of clinical importance by examining the blood for complete blood picture, which may help a long way in near future to predict the risk group in developing an acute cerebrovascular stroke and to avoid risk factors and to take measures to rectify the variations so as to minimize the mortality due to stroke.

  13. Cerebrovascular Disease in Children: Recent Advances in Diagnosis and Management

    Science.gov (United States)

    Bowers, Karen J.; deVeber, Gabrielle A.; Ferriero, Donna M.; Roach, E. Steve; Vexler, Zinaida S.; Maria, Bernard L.

    2017-01-01

    Cerebrovascular disease in children manifests in many forms, all of which have devastating and long-lasting effects. Recent advances in diagnostic imaging have revealed that this condition is much more common in the pediatric population than previously believed, affecting as many as 1 in 1500 neonates and 1 in 3000 children. The underlying mechanisms that cause stroke—ischemic stroke, sinovenous thrombosis, and hemorrhagic stroke—are only beginning to be understood; however, progress has been made toward better understanding the mechanisms of disease, particularly in the fields of genetics, inflammation, and thrombus formation. Furthermore, new imaging techniques, and better understanding of how to use imaging in managing stroke, have enabled practitioners to more quickly and accurately identify cerebrovascular disease type in children, which is key to mitigation of negative outcomes. The 2010 Neurobiology of Disease in Children symposium, held in conjunction with the 39th annual meeting of the Child Neurology Society, aimed to (1) describe clinical issues surrounding childhood stroke, including diagnosis and acute care; (2) discuss recent advances in the understanding of the pathogenesis of childhood stroke; (3) review current management of and therapies for childhood stroke, including controversial therapies; and (4) establish research directions for investigators. This article summarizes the speakers’ presentations and includes an edited transcript of question-and-answer sessions. PMID:21778188

  14. Knee Joint Dysfunctions That Influence Gait in Cerebrovascular Injury

    Science.gov (United States)

    Lucareli, Paulo Roberto Garcia; Greve, Julia Maria D’Andrea

    2008-01-01

    INTRODUCTION There is still no consensus among different specialists on the subject of kinematic variation during the hemiparetic gait, including the main changes that take place during the gait cycle and whether the gait velocity changes the patterns of joint mobility. One of the most frequently discussed joints is the knee. OBJECTIVES This study aims to evaluate the variables found in the angular kinematics of knee joint, and to describe the alterations found in the hemiparetic gait resulting from cerebrovascular injury. METHODS This study included 66 adult patients of both genders with a diagnosis of either right or left hemiparesis resulting from ischemic cerebrovascular injury. All the participants underwent three-dimensional gait evaluation, an the angular kinematics of the joint knee were selected for analysis. RESULTS The results were distributed into four groups formed based on the median of the gait speed and the side of hemiparesis. CONCLUSIONS The relevant clinical characteristics included the important mechanisms of loading response in the stance, knee hyperextension in single stance, and reduction of the peak flexion and movement amplitude of the knee in the swing phase. These mechanisms should be taken into account when choosing the best treatment. We believe that the findings presented here may aid in preventing the occurrence of the problems found, and also in identifying the origin of these problems. PMID:18719753

  15. PET in cerebrovascular disease; PET bei zerebrovaskulaeren Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Herholz, K. [Neurologische Universitaetsklinik der Univ. Koeln (Germany)]|[Max-Planck-Institut fuer Neurologische Forschung, Koeln (Germany)

    1997-03-01

    Tissue viability is of particular interest in acute cerebral ischemia because it may be preserved if reperfusion can be achieved rapidly, e.g. by acute thrombolysis. Measurements of regional cerebral blood flow (CBF) and oxygen consumption by PET can assess tissue viability, and they have substantially increased our knowledge of th pathophysiology of ischemic stroke and the associated penumbra. Widerspread clinical application in acute stroke, however, is unlikely because of the large logistic and personnel resources required. In chronic cerebrovascular disease, measurement of regional CBF and glucose metabolism, which is usually coupled, provide detailed insights in disturbance of cortical function, e.g. due to deafferentiation, and contribute to differentiation of dementia types. Chronic misery perfusion, i.e. reduced perfusion that does not match the metabolic demand of the tissue, can be demonstrated by PET. It may be found in some patients with high-grade arterial stenoses. Less severe impairment of brain perfusion can be demonstrated by measurement of the cerebrovascular reserve capacity. The most frequent clinical situations can be assessed by less demanding procedures, e.g. by SPECT. In conclusion, PET has its role in cerebrovascular disease primarily within scientific studies, where high resolution and absolute quantitation of physiological variables are essential. (orig.). 65 refs. [Deutsch] Beim akuten ischaemischen Insult ist die Vitalitaet des Gewebes von besonderem Interesse, da sie durch rasche Reperfusion, z.B. durch Thrombolyse, erhalten bleiben kann. Messungen der zerebralen Durchblutung und des Sauerstoffumsatzes mittels PET geben darueber wesentliche Aufschluesse, und sie sind wichtig fuer das Verstaendnis der Pathophysiologie ischaemischer Infarkte und der Penumbra mit kritischer Perfusion beim Menschen. Ihre breitere Anwendung in der klinischen Patientenversorgung kommt allerdings wegen des hohen Aufwandes derzeit kaum in Betracht. Bei

  16. Study comparing the use of dynamic CT and Xe-CT CBF for ischemic cerebro-vascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Terada, Tomoaki; Kikuchi, Haruhiko; Kuriyama, Yoshihiro; Nagata, Izumi; Yamagata, Sen; Naruo, Yoshito; Minamikawa, Jun; Kaneko, Takaji; Sakashita, Yoshiharu

    1987-06-01

    The simultaneous measurement of dynamic computerized tomography scanning (DCT) with an iodine-contrast enhancement material bolus injection and a simultaneous xenon CT-CBF-study was done on 15 patients (8 cases of unilateral internal carotid occlusion; 3, of unilateral middle cerebral arterial occlusion, and 4, without any major cerebral arterial occlusion or significant arterial stenosis) with ischemic cerebro-vascular diseases at the subacute and/or chronic stage. The value of the width and corrected first moment (cMT1) as well as their functional images, as acquired from DCT data, were compared to the 1-CBF value and the 1-CBF map of the xenon CT-CBF-study. A comparison of the functional images of DCT and 1-CBF showed that there was a good correlation between them in the cases without leptomeningeal anastomosis as a collateral circulation. However, a poor correlation between them was found in the cases with leptomeningeal anastomosis as a collateral circulation. The correlation of 1-CBF and 1/width with 1/cMT1 was significant (r = 0.78, p < 0.01) in the former cases, but it was not significant in the latter cases. The results of our data were thought to be due to the difference in the tracer inflow pattern between the cases without leptomeningeal anastomosis and those with it as a collateral circulation. The factor of cerebral blood volume should be considered in a more detailed study, although our cases did not include any patients with acute cerebral infarction or recanalized cases, which are thought to show various changes in the cerebral blood volume. The 1/width and 1/cMT1 values acquired from DCT well reflected the CBF in the cases without leptomeningeal anastomosis as a collateral circulation.

  17. Cerebrovascular Diseases and Risk Factors: a Strategy of Primary Prevention

    Directory of Open Access Journals (Sweden)

    Miguel Angel Buergo Zuaznábar

    2007-05-01

    Full Text Available Cerebrovascular diseases constitute a health problem worldwide and have the tendency to grow up. Chronic diseases sometimes are considered transmissible diseases at a level of risk factors. The alimentary habits and the levels of physical activity at present are risk behaviors which are spread all over the world passing from one population to another as an infectious disease with incidence in the morbidity profiles worldwide. While age and sex as well as genetic vulnerability are no modifiable elements, great part of the risks associated to age and sex can be reduced. In such risks, behavior factors (alimentary habits, physical inactivity, smoking habit and alcoholism, biological factors (dyslipidemia, hypertension, overweight, and hyperinsulinemia and finally the social factors which cover a complex combination of socio-economic, cultural parameters, and other elements of the environment that interact among them. This work covers risk factors and the behavior to be followed for its modification.

  18. Diagnosis and treatment of chronic cerebrovascular disease, use of pentoxifylline

    Directory of Open Access Journals (Sweden)

    V. A. Parfenov

    2016-01-01

    Full Text Available Chronic cerebrovascular disease (CCVD is one of the most common  iagnoses in Russian neurology, by which is meant vascular cognitive impairment (VCI in modern foreign literature. There are data available in the literature on the diagnosis and treatment of CCVD (VCI. Theresults of the author’s studies show that CCVD often masks other diseases (anxiety and depressive disorders, primary headache, peripheral vestibulopathy, and Alzheimer's disease that are unfortunately poorly diagnosed in our country, so patients do not receive effective treatment. To modify risk factors for stroke (smoking and alcohol cessation, sufficient exercise, to normalize blood pressure (the use of antihypertensivemedications, to reduce blood cholesterol levels (statins, to perform antithrombotic therapy (antiplatelet agents and anticoagulants, and to use cognitive enhancers are of key importance when treating patients with CCVD (VCI. There are data on the use of pentoxifylline in patients with CCVD, vascular dementia.

  19. Expressional changes in cerebrovascular receptors after experimental transient forebrain ischemia

    DEFF Research Database (Denmark)

    Johansson, Sara; Povlsen, Gro Klitgaard; Edvinsson, Lars

    2012-01-01

    of vasoconstrictive endothelin and 5-hydroxytryptamine receptors in cerebral arteries. Experimental transient forebrain ischemia of varying durations was induced in male wistar rats, followed by reperfusion for 48 hours. Neurological function was assessed daily by three different tests and cerebrovascular expression......Global ischemic stroke is one of the most prominent consequences of cardiac arrest, since the diminished blood flow to the brain results in cell damage and sometimes permanently impaired neurological function. The post-arrest period is often characterised by cerebral hypoperfusion due to subacute...... the insult, a phenomenon that leads to increased contraction of cerebral arteries, reduced perfusion of the affected area and worsened ischemic damage. Based on these findings, the aim of the present study was to investigate if transient global cerebral ischemia is associated with upregulation...

  20. Clinical and angiographic comparison of asymptomatic occlusive cerebrovascular disease.

    Science.gov (United States)

    Gorelick, P B; Caplan, L R; Langenberg, P; Hier, D B; Pessin, M; Patel, D; Taber, J

    1988-06-01

    We compared clinical and arteriographic features in 106 patients with symptomatic unilateral carotid territory occlusive disease to determine the frequency and distribution of occlusive arterial lesions in asymptomatic vessels. Among black patients who were predominantly from Chicago, young, and female, there were fewer transient ischemic attacks and myocardial infarcts, less claudication, and more asymptomatic lesions of the supraclinoid internal carotid artery, anterior cerebral artery stem, and the middle cerebral artery stem. Among white patients predominantly from New England, elderly, and male, there was more frequent and severe occlusive asymptomatic disease at extracranial carotid and vertebral artery sites. Knowledge of the distribution of asymptomatic lesions will help guide evaluation and treatment strategies for patients with occlusive cerebrovascular disease.

  1. Pharmacoepidemiological Study on Cerebrovascular Accident in Tertiary Care Hospital

    Directory of Open Access Journals (Sweden)

    Prathyusha GR

    2016-08-01

    Full Text Available Stroke is the third leading cause of death in the United States (US and a leading cause of serious, long-term disability. Incidence of ischemic stroke is higher than hemorrhagic stroke. The aim is to conduct pharmacoepidemiology study on cerebrovascular accident patient by evaluating the use and the effects of drugs, and quantification of adverse drug reactions, drug utilization studies to improve the quality and use of medicines. A prospective observational study was conducted in department of general medicine and ICU at Mallareddy hospital, data was collected from 130 patients and it was proposed to be conducted for 6 months. Among 130 patients 78(60% are males and 52(40% are females. Among all age groups major number of CVA patients was seen in 60-69 years (30%. Among them 92% of strokes are Ischemic majorly seen in both males and females and8% strokes are hemorrhagic. Ischemic stroke (94.87% is majorly seen in 60-69 yr age group. Among various risk factors Hypertension (36.43% is the major risk factor found in males (60% and females (40%.Antiplatelet drugs (25.75% are the highest number of drugs given in patients 71.27% in males and 28.72% in females. Highest numbers of drugs are given in 50-59yrs age group and are antiplatelets. As a clinical pharmacist 16 adverse drug reactions and 25 drug interactions are reported. Proper patient counselling is needed to reduce hypertension and to reduce the risk for cerebrovascular accident. Among all antiplatelet drugs are majorly given in males and lipid lowering drugs in females.

  2. Dopamine does not limit fetal cerebrovascular responses to hypoxia.

    Science.gov (United States)

    Mayock, Dennis E; Bennett, Rachel; Robinson, Roderick D; Gleason, Christine A

    2007-01-01

    Dopamine is used clinically to stabilize mean arterial blood pressure (MAP) in sick infants. One goal of this therapeutic intervention is to maintain adequate cerebral blood flow (CBF) and perfusion pressure. High-dose intravenous dopamine has been previously demonstrated to increase cerebrovascular resistance (CVR) in near-term fetal sheep. We hypothesized that this vascular response might limit cerebral vasodilatation during acute isocapnic hypoxia. We studied nine near-term chronically catheterized unanesthetized fetal sheep. Using radiolabeled microspheres to measure fetal CBF, we calculated CVR at baseline, during fetal hypoxia, and then with the addition of an intravenous dopamine infusion at 2.5, 7.5, and 25 microg.kg(-1).min(-1) while hypoxia continued. During acute isocapnic fetal hypoxia, CBF increased 73.0 +/- 14.1% and CVR decreased 38.9 +/- 4.9% from baseline. Dopamine infusion at 2.5 and 7.5 microg.kg(-1).min(-1), begun during hypoxia, did not alter CVR or MAP, but MAP increased when dopamine infusion was increased to 25 microg.kg(-1).min(-1). Dopamine did not alter CBF or affect the CBF response to hypoxia at any dose. However, CVR increased at a dopamine infusion rate of 25 microg.kg(-1).min(-1). This increase in CVR at the highest dopamine infusion rate is likely an autoregulatory response to the increase in MAP, similar to our previous findings. Therefore, in chronically catheterized unanesthetized near-term fetal sheep, dopamine does not alter the expected cerebrovascular responses to hypoxia.

  3. Measurement of cerebral circulation time in man

    Energy Technology Data Exchange (ETDEWEB)

    Celsis, P.; Chan, M.; Marc-Vergnes, J.P.; Leydet, P.; Viallard, G.; Charlet, J.P.; Danet, B.

    1985-05-01

    A simple, inexpensive method for measuring the cerebral circulation time (CCT) was developed. The CCT was considered to be equal to the time that an intravenously injected bolus of sodium pertechnetate Tc 99m took to go from the subclavian artery to the posterior venous confluence. The dilution curves were externally recorded at these two vessels. Particular attention was given to the curve treatment. The computer programmes were specially conceived in order to detect and, if possible, correct the experimental curve defects. Several reliability criteria were also defined in order to test the validity of each measurement. From a physiological point of view, the CCT is equal to the ratio of the global cerebral blood volume to the global cerebral blood flow. Thus, it can be widely applied in clinical research. For example, in a study of the relationship between CCT and age, sex and light cerebrovascular impairment, the technique was sensitive enough to discriminate between healthy subjects and patients suffering from-transient ischemic attack, or regressive stroke, and to show the action of a drug on the cerebral circulation in such patients.

  4. Mimicking of cerebral autoregulation by flow-dependent cerebrovascular resistance: a feasibility study.

    Science.gov (United States)

    Kaufmann, Tim A S; Wong, Kai C; Schmitz-Rode, Thomas; Steinseifer, Ulrich

    2012-04-01

    Understanding circulatory autoregulation is essential for improving physiological control of rotary blood pumps and support conditions during cardiopulmonary bypass (CPB). Cerebral autoregulation (CAR), arguably the most critical, is the body's intrinsic ability to maintain sufficient cerebral blood flow (CBF) despite changes in aortic perfusion pressure. It is therefore imperative to include this mechanism into computational fluid dynamics (CFD), particle image velocimetry (PIV), or mock circulation loop (MCL) studies. Without such inclusions, potential losses of CBF are overestimated. In this study, a mathematical model to mimic CAR is implemented in a MCL- and PIV-validated CFD model. A three-dimensional model of the human vascular system was created from magnetic resonance imaging records. Numerical flow simulations were performed for physiological conditions and CPB. The inlet flow was varied between 4.5 and 6 L/min. Arterial outlets were modeled using vessel-specific, flow-dependent cerebrovascular resistances (CVRs), resulting in a variation of the pressure drop between 0 and 80mmHg. CBF is highly dependent on the level of CAR during CPB. By varying the CVR parameters up to the beginning of plateau phase, it can be regulated between 0 and 80% of physiological CBF. So while implementing autoregulation, CBF remains unchanged during a simulated native cardiac output of 5L/min or CPB support of 6L/min. Neglecting CAR, constant backflow from the brain occurs for some cannula positions. Using flow-dependent CVR, CBF returns to its baseline at a rate of recovery of 0.25s. Results demonstrate that modeling of CAR by flow-dependent CVR delivers feasible results. The presented method can be used to optimize physiological control of assist devices dependent upon different levels of CAR representing different patients.

  5. Predisposing factors in posterior circulation infarcts: a vascular morphological assessment

    Energy Technology Data Exchange (ETDEWEB)

    Coban, Goekcen; Cifci, Egemen; Yildirim, Erkan; Agildere, Ahmet Muhtesem [Baskent University Faculty of Medicine, Department of Radiology, Konya (Turkey)

    2015-05-01

    The aim of the study is to assess the effect of shape, diameter, elongation and deviation criteria of basilar artery (BA), convergence angle and diameter variations of vertebral arteries, and concurrent chronic diseases on posterior circulation infarcts. Between January 2010 and May 2013, 186 patients who underwent brain and diffusion magnetic resonance imaging (MRI) with suspected cerebrovascular accident and were diagnosed with posterior circulation infarct and 120 infarct negative control subjects were included in this case-control retrospective study. Vertebral artery (VA) and BA diameter, right (R) and left (L) VA angles at the level of bifurcation, and BA elongation-deviation, and shape of BA were assessed in a total of 306 subjects. Ischemic lesions in the posterior circulation were classified according to their anatomical location and vascular perfusion areas. No significant difference was noted between the control and patient groups with respect to BA diameter (p = 0.676). The most effective risk factors for posterior circulation infarcts were as follows: BA elongation of 2 or 3, BA transverse location of 2 or 3, increase in left VA angle, and history of hypertension, hypercholesterolemia, and diabetes mellitus. Our results suggest that prominent elongation and deviation, C and J shape of BA, and increased L VA angle may be the predictors of at-risk patients in posterior circulation infarcts. Reporting marked morphological BA and VA variations detected at routine brain MRI will aid in selection of patients. Timely detection and treatment of at-risk patients may be life-saving. (orig.)

  6. Normal aging and cognition: the unacknowledged contribution of cerebrovascular risk factors.

    Science.gov (United States)

    Morra, L; Zade, D; McGlinchey, R E; Milberg, W P

    2013-01-01

    Despite the widespread assumption that cognitive decline is an inherent part of the normal aging process, research suggests that part of the variance in age-related cognitive decline is attributable to modifiable factors common in geriatric populations such as cerebrovascular risk factors. We completed a literature search using Science Citation Index and evaluated the most cited articles from the last 10 years to determine the extent to which investigations of normal aging and cognition account for the influence of cerebrovascular risk factors. We found that the majority of the most frequently cited literature does not adequately account for the contribution of cerebrovascular risk factors and therefore, it is possible that many conclusions about normal aging and cognition are flawed or incomplete. Further investigation of the role of cerebrovascular risk factors in age-related cognitive decline is imperative to more accurately understand the effect of aging on cognition.

  7. A cohort study on the relationship between cerebrovascular hemodynamic changing and risk of strok

    Institute of Scientific and Technical Information of China (English)

    郭吉平

    2013-01-01

    Objective To study the role of cerebrovascular hemodynamic indexes(CVHI)changing in stroke and to provide reference for stroke prevention and risk factor study.Methods From 2003 to 2004,participants aged 40 years

  8. Clinical study of model-based blood flow quantification on cerebrovascular data

    NARCIS (Netherlands)

    Groth, A.; Wächter-Stehle, I.; Brina, O.; Perren. F.; Rüfenacht, D.; Bruijns, T.; Bertram, M.; Weese, J.

    2011-01-01

    Diagnosis and treatment decisions of cerebrovascular diseases are currently based on structural information like the endovascular lumen. In future, clinical diagnosis will increasingly be based on functional information which gives direct information about the physiological parameters and, hence, is

  9. Mapping white matter diffusion and cerebrovascular reactivity in carotid occlusive disease

    NARCIS (Netherlands)

    Conklin, J.; Fierstra, J.; Crawley, A. P.; Han, J. S.; Poublanc, J.; Silver, F. L.; Tymianski, M.; Fisher, J. A.; Mandell, D. M.; Mikulis, D. J.

    2011-01-01

    Objective: To characterize the relationship between cerebrovascular reactivity (CVR) and white matter (WM) diffusion in patients with internal carotid artery (ICA) occlusive disease. Methods: In this exploratory observational study, 41 patients with severe stenosis or occlusion of the extracranial I

  10. Central and cerebrovascular effects of leg crossing in humans with sympathetic failure

    NARCIS (Netherlands)

    M.P. Harms; W. Wieling; W.N. Colier; J.W. Lenders; N.H. Secher; J.J. van Lieshout

    2010-01-01

    Leg crossing increases arterial pressure and combats symptomatic orthostatic hypotension in patients with sympathetic failure This study compared the central and cerebrovascular effects of leg crossing in patients with sympathetic failure and healthy controls. We addressed the relationship between M

  11. Clinical Practice Guidelines for Cerebrovascular Disease Treatment Guía de práctica clínica para el tratamiento de la enfermedad cerebrovascular

    Directory of Open Access Journals (Sweden)

    Tania Pérez Ramos

    2009-03-01

    Full Text Available Clinical Practice Guidelines for Cerebrovascular Disease Treatment. Even when this term makes reference to the whole process affecting part of cerebral vessel system and cerebral tissue, this document focuses on the cerebrovascular or acute neurological event abruptly affecting the cerebral tissue and the neurological condition of the patient. This condition is usually cause by an abrupt vessel occlusion, of thrombotic or embolic origin, or by subarachnoid or intraventricular intraparenchymatous hemorrhage, of aneurism origin, related with hypertension or with a tumour or arteriovenous defects. The main concepts, classification and conduct are reviewed, stressing the cerebrovascular accident. It includes assessment guidelines focused on the most important aspects to be accomplished.Guía de práctica clínica para el tratamiento del paciente con enfermedad cerebrovascular. Aunque el término se refiere a todo el proceso que afecta a parte de la vasculatura cerebral y al tejido cerebral que irriga, el documento se centraliza en el accidente cerebrovascular o evento neurológico agudo que afecta en forma súbita al tejido cerebral y compromete el estado neurológico del paciente, causado por una oclusión súbita de un vaso, de origen trombótico o embólico (isquémico o por una hemorragia intraparenquimatosa, subaracnoidea o intraventricular, de origen aneurismático, hipertensivo o secundario a un tumor o malformación arteriovenosa (hemorrágico. Se revisan los conceptos, clasificación y conducta con énfasis en el tratamiento de accidente cerebrovascular isquémico. Concluye con su guía de evaluación, enfocada en los aspectos más importantes a cumplir.

  12. Revisión actualizada sobre enfermedad cerebrovascular: estudio de un caso

    OpenAIRE

    Bardají Fandos, Teodosia

    2003-01-01

    La enfermedad cerebrovascular (ECV), también denominada accidente cerebrovascular (ACV)o ictus, representa el 90% de las enfermedades neurológicas y constituye la tercera causa de muerte en la mayoría de los países desarrollados; en España representa la primera causa de muerte en mujeres de 75 años o más de edad.

  13. Clinical Observation on Acupuncture Treatment of Cerebrovascular Dementia- A Report of 32 Cases

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Cerebrovascular dementia is a common disease in the middle-aged and old people. Its incidence makes up about 10-20% of all kinds of dementia. It is mainly caused by general degeneration of the brain function resulted from cerebral arteriosclerosis and cerebral infarction. The author has treated 32 cases of cerebrovascular dementia with acupuncture in the recent years with satisfactory therapeutic results. A report follows.

  14. Care for patients with cerebrovascular disease in a general hospital. 2 years experience

    Directory of Open Access Journals (Sweden)

    Joan Omar Rojas Fuentes

    2010-08-01

    Full Text Available Background: The care of patients with cerebrovascular disease requires an organized system from pre-hospital care until discharge of the patient, to ensure the continuity of rehabilitation. In order to provide differentiated services to patients with this condition was created in the General Hospital Universitario "Dr. Gustavo Lima Aldereguía "a specialized room for attention to these diseases and the rehabilitation of patients. Objective: To determine the benefits obtained with differentiated services to patients with cerebrovascular disease in a general hospital. Methods: Descriptive case series that included 1038 patients admitted to the specialized chamber for cerebrovascular disease. We analyzed the following variables: stay, type of cerebrovascular disease, clinical classification, the Barthel index and discharge status. Results: 972 patients suffered from cerebrovascular disease, hospital stay was reduced by two days, the attention of specialized equipment increased from 51.75% to 79.2% patients were discharged with a mild degree of functional dependence. Conclusions: The differentiated services to cerebrovascular disease in general hospitals shows benefits for patients.

  15. Uric acid levels and their relation to incapacities in acute cerebrovascular disease

    Directory of Open Access Journals (Sweden)

    Julio López Argüelles

    2010-02-01

    Full Text Available Background: cerebrovascular disease and ischemic cardiopathy can be considered as an epidemic and constitute the first cause of incapacities in developed countries. Multiple studies have shown the association between uric acid levels and cerebrovascular diseases. Objective: To correlate the levels of serum uric acid and incapacities in the acute phase of cerebrovascular disease. Methods: A correlational study was carried out with 217 patients with acute cerebrovascular disease. The patient’s incapacity level was measured by using the Barthel Index and those results were related with the serum uric acid levels and other variables. Results: Male patients have higher levels of uric acid (p=0, 04; r=0, 13. Age and Barthel index were p < 0,001; r = -0, 30 and uric acid levels and Barthel Index were p=0, 03; r=-0, 14. The principal predicting factors of incapacity in the acute phase of cerebrovascular disease were the high levels of uric acid, age and diabetes mellitus. Conclusions: It is shown that the highest is the level of uric acid at advanced age; the greatest is the risk of suffering from incapacity in acute phases of cerebrovascular diseases.

  16. Pure midbrain ischemia and hypoplastic vertebrobasilar circulation.

    Science.gov (United States)

    Gilberti, Nicola; Gamba, Massimo; Costa, Angelo; Vergani, Veronica; Spezi, Raffaella; Pezzini, Alessandro; Volonghi, Irene; Mardighian, Dikran; Gasparotti, Roberto; Padovani, Alessandro; Magoni, Mauro

    2014-02-01

    Isolated midbrain infarction is rare and little is known about etiology and patient's long-term follow up. We aimed to describe the clinical features, the causative diseases and the outcome of patients with isolated midbrain infarction who were admitted to our center, focusing on vascular abnormalities of posterior circulation. All patients with first acute ischemic stroke limited to the midbrain were included and their demographic features, neurological symptoms, neuroimaging data, and cardiovascular risk factors were recorded. Functional outcome, using modified Rankin scale, was assessed at discharge and at the 3 month follow up evaluation. We found nine patients with acute isolated midbrain infarction, representing 0.61 % of all ischemic stroke admitted to our center. The most common cause of stroke was small-vessel disease (88.8 %). At stroke onset, none of the patients had consciousness disturbances, and four patients (44.4 %) had gait impairment, five patients (55.5 %) presented with diplopia due to involvement of the third nerve or fascicular type of third-nerve palsy, seven patients (77.7 %) had vascular anomalies of vertebrobasilar circulation: the most frequent was vertebral artery hypoplasia [four patients (44.4 %)]. At follow up evaluation, seven patients (77.7 %) had a good functional outcome and no patients experienced recurrence of cerebrovascular events. As isolated midbrain infarction is uncommon, specific ocular motor signs, mainly third-nerve palsy, may help to identify and localize the mesencephalic infarct. Abnormalities in vertebrobasilar circulation, such as hypoplastic basilar or vertebral artery, are frequently associated with isolated midbrain ischemia. The hypoplastic vertebrobasilar system may predispose to posterior ischemic stroke.

  17. Calidad de vida de cuidadores de adultos con accidente cerebrovascular

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    INNA ELIDA FLÓREZ TORRES

    2010-10-01

    Full Text Available Objetivo: describir la calidad de vida de los cuidadores familiares de adultos con secuelas de accidente cerebrovascular, en Cartagena, Colombia. Método: estudio descriptivo cuantitativo realizado durante el segundo semestre de 2008. Muestra no probabilística por conveniencia de 97 cuidadores. Se empleó el instrumento propuesto por Ferrell et ál. Para valorar cada uno de los bienestares que integran la calidad de vida se utilizaron medidas de tendencia central y coeficiente de variación. Resultados: el grupo de cuidadores presentó en el bienestar físico un promedio de 11,1 con relación al máximo puntaje, lo que indica el peor estado de salud; los bienestares psicológico y social tuvieron promedios de 48,8 y 21,9, respectivamente, con menor afectación. El mejor estado se halló en el bienestar espiritual, con promedio de 22,6. Conclusiones: la experiencia de ser cuidador modifica de manera importante la calidad de vida de las personas; los cuidadores, como fuente importante de cuidado informal, requieren apoyo de los sistemas de salud y, como parte de este, de los profesionales de enfermería.

  18. Computed tomographic evaluation in 8 patient of cerebrovascular moyamoya disease

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    Ko, Young Tae; Lee, Jung Suk; Suh, Soo Jhi; Kim, Soon Yong [School of Medicine, Kyung-Hee University Hospital, Seoul (Korea, Republic of)

    1980-12-15

    CT findings in eight cerebrovascular moyamoya disease were compared with carotid angiographic findings and the results were as follows: 1. The patient's age was ranged from 2 to 49 years. Of eight patients, five were less than 17 years old and the rests were two 23 years and one 49 years of age. 2. Except one 6 years old boy, all of them were female patients. 3. In precontrast CT scan of 8 cases, 6 cases of cortical atrophy, 6 cases of ventricular dilatation and 5 cases of low density area were observed. In postcontrast study the children group shows abnormal contrast enhancement in 3 out of 5 patients but all adult reveal no contrast enhancement. 4. The isodense area in CT were thought to represent good collateral manifested by angiographic moyamoya vascular network and leptomeningeal anastomosis while the low density area in CT appears to poor colleaterals manifested by transdural anastomosis. 5. To evaluate the possibility of this disease, carotid angiography should be performed to the hemiplgic child who shows multiple low density area and abnormal enhancement in CT scan. 6. CT is not only reliable for evaluation of ventricular hemorrhage but also brain damage in patients with moyamoya disease.

  19. Change of blood rheology in newborn and its cerebrovascular damage

    Institute of Scientific and Technical Information of China (English)

    Guang-Ming Chen; Chun-Hua Lai; Jun-Feng Lv; Bing-Yan Yang; Li Xing-Xi

    2016-01-01

    Objective:To explore the blood rheology, changes in myocardial enzyme spectrum and brain damage in newborn whose hematocritg (HCT) are among 60%-65%.Methods:A total of 100 cases newborn whose HCT among 60%-65% with blood routine examination were set as observation group, 100 cases newborn whose HCT <60% were set as control group, compared the blood rheology, changes in myocardial enzyme spectrum and brain damage between two groups.Results:The HCT, whole blood viscosity (high), whole blood viscosity (low shear), erythrocyte aggregation index, erythrocyte rigidity index, aspertate aminotransferase, creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, Vs, Vs and the abnormal rate of aEEG examination in observation group were significantly higher than the control group, the difference had statistical significance, RI in observation group were significantly lower than the control group, the difference had statistical significance.Conclusions:newborn whose HCT among 60%-65% but not with polycythemia have appeared and cerebrovascular lesions, it should cause clinical positive value.

  20. Cerebrovascular accidents in sickle cell disease: rates and risk factors.

    Science.gov (United States)

    Ohene-Frempong, K; Weiner, S J; Sleeper, L A; Miller, S T; Embury, S; Moohr, J W; Wethers, D L; Pegelow, C H; Gill, F M

    1998-01-01

    Cerebrovascular accident (CVA) is a major complication of sickle cell disease. The incidence and mortality of and risk factors for CVA in sickle cell disease patients in the United States have been reported only in small patient samples. The Cooperative Study of Sickle Cell Disease collected clinical data on 4,082 sickle cell disease patients enrolled from 1978 to 1988. Patients were followed for an average of 5.2 +/- 2.0 years. Age-specific prevalence and incidence rates of CVA in patients with the common genotypes of sickle cell disease were determined, and the effects of hematologic and clinical events on the risk of CVA were analyzed. The highest rates of prevalence of CVA (4.01%) and incidence (0.61 per 100 patient-years) were in sickle cell anemia (SS) patients, but CVA occurred in all common genotypes. The incidence of infarctive CVA was lowest in SS patients 20 to 29 years of age and higher in children and older patients. Conversely, the incidence of hemorrhagic stroke in SS patients was highest among patients aged 20 to 29 years. Across all ages the mortality rate was 26% in the 2 weeks after hemorrhagic stroke. No deaths occurred after infarctive stroke. Risk factors for infarctive stroke included prior transient ischemic attack, low steady-state hemoglobin concentration and rate of and recent episode of acute chest syndrome, and elevated systolic blood pressure. Hemorrhagic stroke was associated with low steady-state hemoglobin and high leukocyte count.

  1. Cerebrovascular complications in children with sickle cell disease.

    Science.gov (United States)

    De Montalembert, M; Wang, W

    2013-01-01

    Cerebrovascular accidents were until recently responsible for much mortality and morbidity in children with sickle cell disease; the likelihood of a child with HbSS having a stroke was 11% before age 20 years, with a peak incidence of ischemic stroke between 2 and 5 years of age, and of hemorrhagic strokes between 20 and 29 years of age. Vessels occlusion is likely initiated by intimal proliferation and amplified by inflammation, excessive adhesion of cells to activated endothelium, hypercoagulable state, and vascular tone dysregulation. Silent infarcts may occur and are associated with decreased cognitive functions. Transcranial Doppler ultrasonography (TCD) was more recently demonstrated able to achieve early detection of the children at high risk for clinical strokes. A randomized study demonstrated that a first stroke may be prevented by monthly transfusion in children with abnormal TCD, leading to a recommendation for annual TCD screening of children aged between 2 and 16 years and monthly transfusion for those with abnormal results. In children who have had a first stroke, the risk of recurrence is more than 50% and is greatly reduced by chronic transfusion, although not completely abolished. Hematopoietic stem cell transplant is indicated in children with cerebral vasculopathy who have an HLA-identical sibling.

  2. Cerebrovascular diseases and depression: epidemiology, mechanisms and treatment.

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    Göthe, F; Enache, D; Wahlund, L O; Winblad, B; Crisby, M; Lökk, J; Aarsland, D

    2012-09-01

    Both cerebrovascular disease (CVD) and depression are common conditions in the elderly, and there is emerging evidence of a bi-directional relationship: 1) depression can cause CVD and stroke, transient ischemic attack; and 2) subcortical CVD are associated with increased risk for depression. The frequency of poststroke depression is highest during the first month after the stroke, but remains high even after several years. Depression is associated with poorer functional prognosis and higher mortality after stroke. There is good evidence that severity of functional impairment, high neuroticism, low social support as well as genetic factors are associated with an increased risk for post-stroke depression. Deep white matter lesions are the most consistent imaging correlate of depression. Potential mechanisms mediating the association between depression and CVD are neuroinflammation and HPA-axis activation, fronto-subcortical circuit lesions, and serotonergic dysfunction. Antidepressants have demonstrated effect on poststroke depression in meta-analyses, and such drugs as well as vitamin B can reduce the incidence of depression in stroke survivors. In addition, serotonergic drugs may strengthen poststroke motor and cognitive recovery, potentially through restorative mechanisms. Psychotherapeutic strategies such as problem-solving therapy seem to be effective. There is emerging evidence that treatment of cardiovascular disease and risk-factors can reduce the risk for late-life depression, but more studies are needed to test this hypothesis.

  3. Cerebrovascular mental stress reactivity is impaired in hypertension

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    Naqvi Tasneem Z

    2009-07-01

    Full Text Available Abstract Background Brachial artery reactivity in response to shear stress is altered in subjects with hypertension. Since endothelial dysfunction is generalized, we hypothesized that carotid artery (CA reactivity would also be altered in hypertension. Purpose To compare (CA endothelium-dependent vasodilation in response to mental stress in normal and hypertensive subjects. Methods We evaluated CA reactivity to mental stress in 10 young healthy human volunteers (aged 23 ± 4 years, 20 older healthy volunteers (aged 49 ± 11 years and in 28 patients with essential hypertension (aged 51 ± 13 years. In 10 healthy volunteers and 12 hypertensive subjects, middle cerebral artery (MCA PW transcranial Doppler was performed before and 3 minutes after mental stress. Results Mental stress by Stroop color word conflict, math or anger recall tests caused CA vasodilation in young healthy subjects (0.61 ± 0.06 to 0.65 ± 0.07 cm, p Conclusion Mental stress produces CA vasodilation and is accompanied by an increase in CA and MCA blood flow in healthy subjects. This mental stress induced CA vasodilation and flow reserve is attenuated in subjects with hypertension and may reflect cerebral vascular endothelial dysfunction. Assessment of mental stress induced CA reactivity by ultrasound is a novel method for assessing the impact of hypertension on cerebrovascular endothelial function and blood flow reserve.

  4. Magnetization transfer MR of cerebrovascular disorders using calculated images

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    Enomoto, Kyoko; Watabe, Tsuneya; Amanuma, Makoto; Heshiki, Atsuko [Saitama Medical School, Moroyama, Saitama (Japan)

    1997-06-01

    This study applied a magnetization transfer contrast method to patients with cerebrovascular disorders. A 1.5 T superconducting MR unit was used, and magnetization transfer ratio (MTR) images were calculated by evaluating two paired images before and after off-resonance gradient echo pulse sequences. The normal white matter showed the highest MTRs, CSF the lowest, and gray matter, intermediate. Cerebral ischemic patients showed two patterns according to the chronological stage of the affected area. Lesions in the acute and subacute stages revealed higher transfer rates than those in the chronic stage. Patients with cerebral hemorrhage were divided into three groups: the hyperacute group showed a low transfer pattern; the acute group presented inhomogeneous high transfer rates; and the subacute group showed remarkably low transfer rates. In the acute and subacute ischemic stages, increased macromolecules caused higher MTRs than in the chronic stage. In hemorrhagic groups, low MTRs in subacute hemorrhage reflected the transfer of methemoglobin. High MTRs in acute hemorrhage with rich deoxyhemoglobin suggested increased fibrin, plasma, and serum components of macromolecules. The MTC method provided new chronological information on cerebral hemorrhage, adding to that provided by routine MR images. (author)

  5. Relationship between retinal vascular occlusions and incident cerebrovascular diseases

    Science.gov (United States)

    Zhou, Yue; Zhu, Wengen; Wang, Changyun

    2016-01-01

    Abstract Several studies investigating the role of retinal vascular occlusions, on cerebrovascular diseases (CVD) have been reported, but the results are still inconsistent. We therefore sought to evaluate the relationship between retinal vascular occlusions and CVD. We systematically searched the Cochrane Library, PubMed, and ScienceDirect databases through January 31, 2016 for studies evaluating the effect of retinal vascular occlusions on the risk of CVD. Data were abstracted using predefined criteria, and then pooled by RevMan 5.3 software. A total of 9 retrospective studies were included in this meta-analysis. When compared with individuals without retinal vascular occlusions, both individuals with retinal artery occlusion (RAO) (odds ratio [OR] = 2.01, 95% confidence interval [CI]: 1.21–3.34; P = 0.005) and individuals with retinal vein occlusion (RVO) (OR = 1.37, 95% CI: 1.24–1.50; P < 0.00001) had higher risks of developing CVD. Additionally, both individuals with central retinal artery occlusion (CRAO) (OR = 2.00, 95% CI: 1.12–3.56; P = 0.02) and branch retinal artery occlusion (BRAO) (OR = 1.60, 95% CI: 1.03–1.48; P = 0.04) were significantly associated with increased risk of CVD. Published literatures support both RVO and RAO are associated with increased risks of CVD. Further prospective studies are needed to confirm these findings. PMID:27368050

  6. Dysphagia in patients with cerebrovascular disease. Update. Disfagia en paciente con enfermedad cerebrovascular. Actualización.

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    Yolanda Aguilera Martínez

    2009-03-01

    Full Text Available An important number of patients with cerebrovascular disease also present dysphagia as a result of damage in cerebral hemispheres or brainstem, which contributes to negative morbility and functional rehabilitation prognosis due to the complications liked with this condition. It is a significant cause of nutritional dysfunctions, including increased in-hospital undernourishment, increased per patient expenditure and longer in-hospital stay. One of the objectives of the Nutritional Support Team of the Neuroscience and Neurology Institute is to reduce undernourishment causes in patients with neurological diseases. A wide review of the subject was performed including experts´ opinions, from the above mentioned institutions, in order to gather an updated report related with the significance of early diagnosis of dysphagia in patients with ictus and the opportune and correct use of therapeutic measures to reduce complication risk.Gran número de pacientes con enfermedad cerebrovascular padecen de disfagia, por lesiones de hemisferios o del tronco cerebral, lo que, además de contribuir a un mal pronóstico en términos de morbilidad y recuperación funcional, por las complicaciones que acarrea, es causa importante de afectación del estado nutricional, con incremento de la desnutrición intrahospitalaria, de la estadía y de los costos por enfermo. Uno de los propósitos del Grupo de Apoyo Nutricional del Instituto de Neurología y Neurocirugía es minimizar las causas de desnutrición en los enfermos con trastornos neurológicos. Se realizó una amplia revisión del tema y se consultaron expertos del país, procedentes de las instituciones mencionadas antes, con el objetivo de conformar un informe actualizado relacionado con la importancia del diagnóstico precoz de la disfagia en el paciente con ictus y la aplicación oportuna y adecuada de medidas terapéuticas que disminuyan el riesgo de complicaciones.

  7. Cerebrovascular Acute Radiation Syndrome : Radiation Neurotoxins, Mechanisms of Toxicity, Neuroimmune Interactions.

    Science.gov (United States)

    Popov, Dmitri; Maliev, Slava

    Introduction: Cerebrovascular Acute Radiation Syndrome (CvARS) is an extremely severe in-jury of Central Nervous System (CNS) and Peripheral Nervous System (PNS). CvARS can be induced by the high doses of neutron, heavy ions, or gamma radiation. The Syndrome clinical picture depends on a type, timing, and the doses of radiation. Four grades of the CvARS were defined: mild, moderate, severe, and extremely severe. Also, four stages of CvARS were developed: prodromal, latent, manifest, outcome -death. Duration of stages depends on the types, doses, and time of radiation. The CvARS clinical symptoms are: respiratory distress, hypotension, cerebral edema, severe disorder of cerebral blood microcirculation, and acute motor weakness. The radiation toxins, Cerebro-Vascular Radiation Neurotoxins (SvARSn), determine development of the acute radiation syndrome. Mechanism of action of the toxins: Though pathogenesis of radiation injury of CNS remains unknown, our concept describes the Cv ARS as a result of Neurotoxicity and Excitotoxicity, cell death through apoptotic necrosis. Neurotoxicity occurs after the high doses radiation exposure, formation of radiation neuro-toxins, possible bioradicals, or group of specific enzymes. Intracerebral hemorrhage can be a consequence of the damage of endothelial cells caused by radiation and the radiation tox-ins. Disruption of blood-brain barrier (BBB)and blood-cerebrospinal fluid barrier (BCFB)is possibly the most significant effect of microcirculation disorder and metabolic insufficiency. NMDA-receptors excitotoxic injury mediated by cerebral ischemia and cerebral hypoxia. Dam-age of the pyramidal cells in layers 3 and 5 and Purkinje cell layer the cerebral cortex , damage of pyramidal cells in the hippocampus occur as a result of cerebral ischemia and intracerebral bleeding. Methods: Radiation Toxins of CV ARS are defined as glycoproteins with the molec-ular weight of RT toxins ranges from 200-250 kDa and with high enzymatic activity

  8. Clinic Practical Guides for Cerebrovascular Diseases Guías de práctica clínica para las enfermedades cerebrovasculares

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    Alejandro Pando Cabrera

    Full Text Available The clinic practical guides for cerebrovascular diseases are presented. They include different aspects as its concept, classification, and epidemiological data in Cuba as well as worldwide. They also offer its diagnosis, classification, complications and treatment. The frequency of assessment of its application including the tools to measure the quality of life in patients with cerebrovascular accident and the way to proceed with them are shown
    Se presentan las guías de práctica clínica para las enfermedades cerebrovasculares. Incluye aspectos como su concepto y clasificación, datos epidemiológicos en el mundo y en Cuba, así como su diagnóstico, clasificación, complicaciones y tratamiento. Se ofrece la forma y frecuencia de la evaluación de su aplicación e incluye instrumentos para medir calidad de vida de los enfermos con accidentes cerebrovasculares.

  9. Pioglitazone improves reversal learning and exerts mixed cerebrovascular effects in a mouse model of Alzheimer's disease with combined amyloid-β and cerebrovascular pathology.

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    Panayiota Papadopoulos

    Full Text Available Animal models of Alzheimer's disease (AD are invaluable in dissecting the pathogenic mechanisms and assessing the efficacy of potential new therapies. Here, we used the peroxisome proliferator-activated receptor gamma agonist pioglitazone in an attempt to rescue the pathogenic phenotype in adult (12 months and aged (>18 months bitransgenic A/T mice that overexpress a mutated human amyloid precursor protein (APPSwe,Ind and a constitutively active form of transforming growth factor-β1 (TGF-β1. A/T mice recapitulate the AD-related cognitive deficits, amyloid beta (Aβ and cerebrovascular pathologies, as well as the altered metabolic and vascular coupling responses to increased neuronal activity. Pioglitazone normalized neurometabolic and neurovascular coupling responses to sensory stimulation, and reduced cortical astroglial and hippocampal microglial activation in both age groups. Spatial learning and memory deficits in the Morris water maze were not rescued by pioglitazone, but reversal learning was improved in the adult cohort notwithstanding a progressing Aβ pathology. While pioglitazone preserved the constitutive nitric oxide synthesis in the vessel wall, it unexpectedly failed to restore cerebrovascular reactivity in A/T mice and even exacerbated the dilatory deficits. These data demonstrate pioglitazone's efficacy on selective AD hallmarks in a complex AD mouse model of comorbid amyloidosis and cerebrovascular pathology. They further suggest a potential benefit of pioglitazone in managing neuroinflammation, cerebral perfusion and glucose metabolism in AD patients devoid of cerebrovascular pathology.

  10. Dietary Curcumin Ameliorates Aging-Related Cerebrovascular Dysfunction through the AMPK/Uncoupling Protein 2 Pathway

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    Yunfei Pu

    2013-11-01

    Full Text Available Background/Aims: Age-related cerebrovascular dysfunction contributes to stroke, cerebral amyloid angiopathy, cognitive decline and neurodegenerative diseases. One pathogenic mechanism underlying this effect is increased oxidative stress. Up-regulation of mitochondrial uncoupling protein 2 (UCP2 plays a crucial role in regulating reactive oxygen species (ROS production. Dietary patterns are widely recognized as contributors to cardiovascular and cerebrovascular disease. In this study, we tested the hypothesis that dietary curcumin, which has an antioxidant effect, can improve aging-related cerebrovascular dysfunction via UCP2 up-regulation. Methods: The 24-month-old male rodents used in this study, including male Sprague Dawley (SD rats and UCP2 knockout (UCP2-/- and matched wild type mice, were given dietary curcumin (0.2%. The young control rodents were 6-month-old. Rodent cerebral artery vasorelaxation was detected by wire myograph. The AMPK/UCP2 pathway and p-eNOS in cerebrovascular and endothelial cells were observed by immunoblotting. Results: Dietary curcumin administration for one month remarkably restored the impaired cerebrovascular endothelium-dependent vasorelaxation in aging SD rats. In cerebral arteries from aging SD rats and cultured endothelial cells, curcumin promoted eNOS and AMPK phosphorylation, up-regulated UCP2 and reduced ROS production. These effects of curcumin were abolished by either AMPK or UCP2 inhibition. Chronic dietary curcumin significantly reduced ROS production and improved cerebrovascular endothelium-dependent relaxation in aging wild type mice but not in aging UCP2-/- mice. Conclusions: Curcumin improves aging-related cerebrovascular dysfunction via the AMPK/UCP2 pathway.

  11. Microwave circulator design

    CERN Document Server

    Linkhart, Douglas K

    2014-01-01

    Circulator design has advanced significantly since the first edition of this book was published 25 years ago. The objective of this second edition is to present theory, information, and design procedures that will enable microwave engineers and technicians to design and build circulators successfully. This resource contains a discussion of the various units used in the circulator design computations, as well as covers the theory of operation. This book presents numerous applications, giving microwave engineers new ideas about how to solve problems using circulators. Design examples are provided, which demonstrate how to apply the information to real-world design tasks.

  12. Tratamiento de Terapia Ocupacional en el accidente cerebrovascular

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    Domingo García, AM

    2006-02-01

    Full Text Available RESUMENEntre los muchos pacientes que necesitan tratamiento rehabilitador en Terapia Ocupacional están los que en la edad adulta han sufrido un accidente cerebrovascular.Uno de los factores de riesgo asociados con más frecuencia a las alteraciones del sistema nervioso central es el progresivo envejecimiento de la población, debido a esto orientaré el siguiente artículo hacia la intervención sobre la población geriátrica.La Terapia Ocupacional ofrece un tratamiento global que abarca las áreas funcional, motriz, sensorial, perceptivo y cognitiva. No debemos olvidar el asesoramiento realizado al paciente, a la familia y/ o cuidadores sobre el manejo de la persona que ha sufrido un ictus, la adaptación del entorno y la prescripción, uso y manejo de ayudas técnicas cuando sea necesario.Las propuestas terapéuticas que expondré a continuación, no son recetas únicas que se puedan emplear del mismo modo en todos las personas que hayan sufrido un ictus. Con cada paciente será necesario una evaluación individualizada de su situación y una adaptación de la terapia según sus déficit específicos.La meta final de la Terapia Ocupacional es la integración óptima del paciente dentro de su entorno familiar y social, con el mayor grado de autonomía posible.ABSTRACTAmong the patients who need Occupational Therapy’s rehabilitation treatment, there are those who have suffered a cerebrovascular damage when elderly.People’s gradual ageing is one of the risk factors in the nervous central system’s alterations and this is why I am going to write about intervention on geriatric population.The Occupational Therapy’s rehabilitation treatment works on the functional, motor, sensorial, perceptive and cognitive areas. Moreover, we should not forget to advise the patient and his/her family or caregivers about the way of treating ,the environment’s adaptation, the prescription and use of technical aids when needed.The following therapeutic

  13. HIGH SENSITIVE C-REACTIVE PROTEIN IN CEREBROVASCULAR ISCHEMIA

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    Padmalatha

    2016-02-01

    Full Text Available BACKGROUND Cerebrovascular ischemia is recognized as a major health problem, which causes significant morbidity and mortality. The main pathophysiology of ischemic stroke is atherosclerosis of cerebral vessels. Hs-CRP is a sensitive marker of inflammation tissue injury in the arterial wall, which contributes to atherosclerosis. In this study, we aim to investigate the association of hs-CRP in patients with ischemic stroke and to correlate hs-CRP levels with possible risk factors of ischemic stroke and to assess the prognostic value of hs-CRP in ischemic stroke. METHODS In the present case control study after meeting inclusion and exclusion criteria, 50 patients with acute ischemic stroke admitted in the medical ward, King George Hospital, during the period between April 2014 and October 2014 and 40 asymptomatic age and sex matched control subjects were included. RESULTS The mean hs-CRP value in cases is 3.78+5.28mg/dl and in controls is 0.425+0.305mg/dl. Mean hs-CRP value is higher (3.78mg/dl in cases when compared to controls (0.425mg/dl, which is statistically significant. P admitted with severe degree of weakness (0-1/5 power with mean hs-CRP value of 4.28+4.07 without significant improvement in the power at the time of discharge; 8(16%> with mean hs-CRP value of 10.43+7.74 were expired. CONCLUSION Acute ischemic patients had higher mean hs-CRP values when compared to healthy asymptomatic control subjects P0.05. Higher mean hs-CRP values were associated with poor outcome after acute ischemic stroke. P<0.001.

  14. Thrombin, a mediator of cerebrovascular inflammation in AD and hypoxia

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    Debjani eTripathy

    2013-05-01

    Full Text Available Considerable evidence implicates hypoxia and vascular inflammation in Alzheimer’s disease (AD. Thrombin, a multifunctional inflammatory mediator, is demonstrable in the brains of AD patients both in the vessel walls and senile plaques. Hypoxia-inducible factor 1α (HIF-1α, a key regulator of the cellular response to hypoxia, is also upregulated in the vasculature of human AD brains. The objective of this study is to investigate inflammatory protein expression in the cerebrovasculature of transgenic AD mice and to explore the role of thrombin as a mediator of cerebrovascular inflammation and oxidative stress in AD and in hypoxia-induced changes in brain endothelial cells. Immunofluorescent analysis of the cerebrovasculature in AD mice demonstrates significant (p<0.01-0.001 increases in thrombin, HIF-1α, interleukin-6 (IL-6, monocyte chemoattractant protein-1 (MCP-1, matrix metalloproteinases (MMPs, and reactive oxygen species (ROS compared to controls. Administration of the thrombin inhibitor dabigatran (100 mg/kg to AD mice for 34 wks significantly decreases expression of inflammatory proteins and ROS. Exposure of cultured brain endothelial cells to hypoxia for 6 h causes an upregulation of thrombin, HIF-1α, MCP-1, IL-6 and MMP2 and ROS. Treatment of endothelial cells with the dabigatran (1 nM reduces ROS generation and inflammatory protein expression (p<0.01-0.001. The data demonstrate that inhibition of thrombin in culture blocks the increase in inflammatory protein expression and ROS generation evoked by hypoxia. Also, administration of dabigatran to transgenic AD mice diminishes expression of inflammatory proteins and ROS in the cerebromicrovasculature. Taken together, these results suggest that inhibiting thrombin generation could have therapeutic value in AD and other disorders where hypoxia, inflammation and oxidative stress are involved.

  15. Haemodynamic and cerebrovascular responses to glycerol infusion in dogs.

    Science.gov (United States)

    Chen, J L; Wang, Y C; Wang, J Y

    1989-11-01

    1. The response of cerebral blood vessels to hyperosmolar agents in vivo remains controversial, and little is known about the effect of glycerol on cerebral vessels. In this study we investigated the cerebrovascular response to intravenous administration of glycerol (1 g/kg, infused over 25 min) in dogs under pentobarbital anaesthesia. 2. intracranial pressure, systemic arterial pressure, mean arterial blood pressure, serum osmolarity and packed cell volume were continuously monitored, and blood gases were checked frequently. Through a parietal cranial window, pial vessel diameter was measured by means of a surgical microscope and a video image-analyser. 3. Pial vessel diameter increased gradually with a maximum at 30 min after the beginning of glycerol infusion. The maximum increase in diameter in small (less than or equal to 100 microns) vessels was 14.3%, whereas that in large (greater than 100 microns) vessels was 10.3%. There was only a slight increase (less than 4%) in pial vessel diameter in vehicle-infused animals. The intracranial pressure decreased drastically after glycerol infusion, whereas the mean arterial blood pressure remained constant. There were correlations between the rise in serum osmolarity, fall in packed cell volume and vasodilatation, indicating that glycerol caused vasodilatation accompanied by plasma volume expansion. 4. Our data suggest that glycerol produces cerebral vasodilatation, which might be beneficial in cerebral ischaemia and vasospasm, in addition to its intracranial pressure-reducing effect on normal or oedematous brain. The degree of vasodilatation was not sufficient to affect the predominant intracranial pressure drop resulting from cerebral dehydration.

  16. Imaging of cerebrovascular pathology in animal models of Alzheimer's disease

    Science.gov (United States)

    Klohs, Jan; Rudin, Markus; Shimshek, Derya R.; Beckmann, Nicolau

    2014-01-01

    In Alzheimer's disease (AD), vascular pathology may interact with neurodegeneration and thus aggravate cognitive decline. As the relationship between these two processes is poorly understood, research has been increasingly focused on understanding the link between cerebrovascular alterations and AD. This has at last been spurred by the engineering of transgenic animals, which display pathological features of AD and develop cerebral amyloid angiopathy to various degrees. Transgenic models are versatile for investigating the role of amyloid deposition and vascular dysfunction, and for evaluating novel therapeutic concepts. In addition, research has benefited from the development of novel imaging techniques, which are capable of characterizing vascular pathology in vivo. They provide vascular structural read-outs and have the ability to assess the functional consequences of vascular dysfunction as well as to visualize and monitor the molecular processes underlying these pathological alterations. This article focusses on recent in vivo small animal imaging studies addressing vascular aspects related to AD. With the technical advances of imaging modalities such as magnetic resonance, nuclear and microscopic imaging, molecular, functional and structural information related to vascular pathology can now be visualized in vivo in small rodents. Imaging vascular and parenchymal amyloid-β (Aβ) deposition as well as Aβ transport pathways have been shown to be useful to characterize their dynamics and to elucidate their role in the development of cerebral amyloid angiopathy and AD. Structural and functional imaging read-outs have been employed to describe the deleterious affects of Aβ on vessel morphology, hemodynamics and vascular integrity. More recent imaging studies have also addressed how inflammatory processes partake in the pathogenesis of the disease. Moreover, imaging can be pivotal in the search for novel therapies targeting the vasculature. PMID:24659966

  17. Cerebrovascular Time Constant in Patients with Head Injury.

    Science.gov (United States)

    Trofimov, Alex; Kalentiev, George; Gribkov, Alexander; Voennov, Oleg; Grigoryeva, Vera

    2016-01-01

    The cerebrovascular time constant (τ) theoretically estimates how fast the cerebral arterial bed is filled by blood volume after a sudden change in arterial blood pressure during one cardiac cycle. The aim of this study was to assess the time constant of the cerebral arterial bed in patients with traumatic brain injury (TBI) with and without intracranial hematomas (IH). We examined 116 patients with severe TBI (mean 35 ± 15 years, 61 men, 55 women). The first group included 58 patients without IH and the second group included 58 patients with epidural (7), subdural (48), and multiple (3) hematomas. Perfusion computed tomography (PCT) was performed 1-12 days after TBI in the first group and 2-8 days after surgical evacuation of the hematoma in the second group. Arteriovenous amplitude of regional cerebral blood volume oscillation was calculated as the difference between arterial and venous blood volume in the "region of interest" of 1 cm(2). Mean arterial pressure was measured and the flow rate of the middle cerebral artery was recorded with transcranial Doppler ultrasound after PCT. The time constant was calculated by the formula modified by Kasprowicz. The τ was shorter (p = 0.05) in both groups 1 and 2 in comparison with normal data. The time constant in group 2 was shorter than in group 1, both on the side of the former hematoma (р = 0.012) and on the contralateral side (р = 0.044). The results indicate failure of autoregulation of cerebral capillary blood flow in severe TBI, which increases in patients with polytrauma and traumatic IH.

  18. Nonlinear effects of respiration on the crosstalk between cardiovascular and cerebrovascular control systems.

    Science.gov (United States)

    Bari, Vlasta; Marchi, Andrea; De Maria, Beatrice; Rossato, Gianluca; Nollo, Giandomenico; Faes, Luca; Porta, Alberto

    2016-05-13

    Cardiovascular and cerebrovascular regulatory systems are vital control mechanisms responsible for guaranteeing homeostasis and are affected by respiration. This work proposes the investigation of cardiovascular and cerebrovascular control systems and the nonlinear influences of respiration on both regulations through joint symbolic analysis (JSA), conditioned or unconditioned on respiration. Interactions between cardiovascular and cerebrovascular regulatory systems were evaluated as well by performing correlation analysis between JSA indexes describing the two control systems. Heart period, systolic and mean arterial pressure, mean cerebral blood flow velocity and respiration were acquired on a beat-to-beat basis in 13 subjects experiencing recurrent syncope episodes (SYNC) and 13 healthy individuals (non-SYNC) in supine resting condition and during head-up tilt test at 60° (TILT). Results showed that JSA distinguished conditions and groups, whereas time domain parameters detected only the effect of TILT. Respiration affected cardiovascular and cerebrovascular regulatory systems in a nonlinear way and was able to modulate the interactions between the two control systems with different outcome in non-SYNC and SYNC groups, thus suggesting that the analysis of the impact of respiration on cardiovascular and cerebrovascular regulatory systems might improve our understanding of the mechanisms underpinning the development of postural-related syncope.

  19. Brain imaging changes associated with risk factors for cardiovascular and cerebrovascular disease in asymptomatic patients.

    Science.gov (United States)

    Friedman, Joseph I; Tang, Cheuk Y; de Haas, Hans J; Changchien, Lisa; Goliasch, Georg; Dabas, Puneet; Wang, Victoria; Fayad, Zahi A; Fuster, Valentin; Narula, Jagat

    2014-10-01

    Reviews of imaging studies assessing the brain effects of vascular risk factors typically include a substantial number of studies with subjects with a history of symptomatic cardiovascular or cerebrovascular disease and/or events, limiting our ability to disentangle the primary brain effects of vascular risk factors from those of resulting brain and cardiac damage. The objective of this study was to perform a systematic review of brain changes from imaging studies in patients with vascular risk factors but without clinically manifest cardiovascular or cerebrovascular disease or events. The 77 studies included in this review demonstrate that in persons without symptomatic cardiovascular, cerebrovascular, or peripheral vascular disease, the vascular risk factors of hypertension, diabetes mellitus, obesity, hyperlipidemia, and smoking are all independently associated with brain imaging changes before the clinical manifestation of cardiovascular or cerebrovascular disease. We conclude that the identification of brain changes associated with vascular risk factors, before the manifestation of clinically significant cerebrovascular damage, presents a window of opportunity wherein adequate treatment of these modifiable vascular risk factors may prevent the development of irreversible deleterious brain changes and potentially alter patients' clinical course.

  20. Nonlinear effects of respiration on the crosstalk between cardiovascular and cerebrovascular control systems

    Science.gov (United States)

    Bari, Vlasta; Marchi, Andrea; De Maria, Beatrice; Rossato, Gianluca; Nollo, Giandomenico; Faes, Luca; Porta, Alberto

    2016-05-01

    Cardiovascular and cerebrovascular regulatory systems are vital control mechanisms responsible for guaranteeing homeostasis and are affected by respiration. This work proposes the investigation of cardiovascular and cerebrovascular control systems and the nonlinear influences of respiration on both regulations through joint symbolic analysis (JSA), conditioned or unconditioned on respiration. Interactions between cardiovascular and cerebrovascular regulatory systems were evaluated as well by performing correlation analysis between JSA indexes describing the two control systems. Heart period, systolic and mean arterial pressure, mean cerebral blood flow velocity and respiration were acquired on a beat-to-beat basis in 13 subjects experiencing recurrent syncope episodes (SYNC) and 13 healthy individuals (non-SYNC) in supine resting condition and during head-up tilt test at 60° (TILT). Results showed that JSA distinguished conditions and groups, whereas time domain parameters detected only the effect of TILT. Respiration affected cardiovascular and cerebrovascular regulatory systems in a nonlinear way and was able to modulate the interactions between the two control systems with different outcome in non-SYNC and SYNC groups, thus suggesting that the analysis of the impact of respiration on cardiovascular and cerebrovascular regulatory systems might improve our understanding of the mechanisms underpinning the development of postural-related syncope.

  1. [The importance of transcranial Doppler (TDC) in the assessment of cerebrovascular hemodynamics of the acute phase of ischemic stroke].

    Science.gov (United States)

    Wojczal, Joanna; Szerej, Anna Szczepańska; Belniak, Ewa; Blaszkowska, Anna; Stelmasiak, Zbigniew

    2003-01-01

    Most recent studies on transcranial Doppler (TCD) in the acute phase of ischemic stroke are reviewed in this paper. TCD is a highly sensitive and specific method of quick, bedside assessment of cerebrovascular circulation hemodynamics in the acute phase of ischemic stroke. The following issues are discussed in the paper: a new classification of ultrasound pathological changes associated with intracranial arteries occlusion or stenosis, the frequency of spontaneous re-canalisation by TCD, a comparison of TCD results with findings obtained by means of other vascular imaging techniques (e.g. DSA, CTA and MRA), relationship between TCD baseline assessment of primary blood flow changes and thrombolysis efficacy (the so-called TIBI classification, Thrombolysis in Brain Ischemia), and prognostic significance of TCD in the acute ischemic stroke. Moreover, first clinical reports on an additive effect of TCD on thrombolytic therapy are presented. The main limitations of TCD include the lack of sufficient bone window in 5-15% of patients and the lack of sufficiently trained staff capable of performing the examination a 24 h duty, since results of the examination to a large degree depend on the examiner's skills.

  2. Cerebrovascular disease associated with Aarskog-Scott syndrome

    Energy Technology Data Exchange (ETDEWEB)

    DiLuna, Michael L.; Amankulor, Nduka M.; Gunel, Murat [Yale University School of Medicine, Department of Neurosurgery, New Haven, CT (United States); Johnson, Michele H. [Yale University School of Medicine, Department of Diagnostic Radiology, New Haven, CT (United States)

    2007-05-15

    Faciogenital dysplasia, also known as Aarskog-Scott syndrome (AAS), is an X-linked dominant congenital disorder characterized by multiple facial, musculoskeletal, dental, neurological and urogenital abnormalities, ocular manifestations, congenital heart defects, low IQ and behavioral problems. Here we describe an unusual presentation of dysplastic carotid artery, basilar artery malformation or occlusion and posterior circulation aneurysm in a 13-year-old male with AAS. (orig.)

  3. Postprandial hyperglycemia and cerebrovascular diseases%餐后高血糖与脑血管病

    Institute of Scientific and Technical Information of China (English)

    辛家厚; 周农

    2009-01-01

    Postprandial hyperglycemia is a risk factor for atherosclerosis and cerebro-vascular diseases. This article reviews the mechanisms of cerebrovascular diseases caused by postprandial hyperglycemia from aspects of postprandial hyperglycemia participating in the pathophysiological mechanisms of atherosclerosis, and the relations between postprandial hyperglycemia and cerebrovascular diseases.%餐后血糖升高是动脉粥样硬化和脑血管病的危险因素.文章分别从餐后高血糖参与动脉粥样硬化的病理生理学机制、餐后高血糖与脑血管病的关系及其病理生理学机制等方面,综述了餐后高血糖引起脑血管病的机制.

  4. Mountains and Tropical Circulation

    Science.gov (United States)

    Naiman, Z.; Goodman, P. J.; Krasting, J. P.; Malyshev, S.; Russell, J. L.; Stouffer, R. J.

    2015-12-01

    Observed tropical convection exhibits zonal asymmetries that strongly influence spatial precipitation patterns. The drivers of changes to this zonally-asymmetric Walker circulation on decadal and longer timescales have been the focus of significant recent research. Here we use two state-of-the-art earth system models to explore the impact of earth's mountains on the Walker circulation. When all land-surface topography is removed, the Walker circulation weakens by 33-59%. There is a ~30% decrease in global, large-scale upward vertical wind velocities in the middle of the troposphere, but only minor changes in global average convective mass flux, precipitation, surface and sea-surface temperatures. The zonally symmetric Hadley circulation is also largely unchanged. Following the spatial pattern of changes to large-scale vertical wind velocities, precipitation becomes less focused over the tropics. The weakening of the Walker circulation, but not the Hadley circulation, is similar to the behavior of climate models during radiative forcing experiments: in our simulations, the weakening is associated with changes in vertical wind velocities, rather than the hydrologic cycle. These results indicate suggest that mountain heights may significantly influence the Walker circulation on geologic time scales, and observed changes in tropical precipitation over millions of years may have been forced by changes in tropical orography.

  5. Cerebral blood flow, oxidative metabolism and cerebrovascular carbon dioxide reactivity in patients with acute bacterial meningitis

    DEFF Research Database (Denmark)

    Møller, Kirsten; Strauss, Gitte Irene; Thomsen, Gerda;

    2002-01-01

    BACKGROUND: The optimal arterial carbon dioxide tension (P(a)CO(2)) in patients with acute bacterial meningitis (ABM) is unknown and controversial. The objective of this study was to measure global cerebral blood flow (CBF), cerebrovascular CO(2) reactivity (CO(2)R), and cerebral metabolic rates...... to baseline ventilation, whereas CMR(glu) increased. CONCLUSION: In patients with acute bacterial meningitis, we found variable levels of CBF and cerebrovascular CO(2) reactivity, a low a-v DO(2), low cerebral metabolic rates of oxygen and glucose, and a cerebral lactate efflux. In these patients...

  6. Different cerebrovascular effects of medroxyprogesterone acetate and norethisterone acetate in the New Zealand White rabbit

    DEFF Research Database (Denmark)

    Pedersen, S H; Pedersen, N G; Dalsgaard, T;

    2004-01-01

    of different progestins on cerebrovascular reactivity in an animal model. METHODS: Fifty-six ovariectomized New Zealand White rabbits were randomized into seven groups receiving hormone treatment for 4 weeks: medroxyprogesterone acetate (MPA) (10 mg/day); norethisterone acetate (NETA) (3 mg/day); conjugated....... No overall differences were seen between CEE and E2. CONCLUSIONS: In rabbit cerebral arteries, MPA treatment causes a higher development in arterial tension compared with NETA, indicating that different progestins may display different cerebrovascular effects. However, when accompanied by estrogens...

  7. Cerebrovascular ischemic protection by pre- and post-conditioning

    Directory of Open Access Journals (Sweden)

    Jeffrey M Gidday

    2015-01-01

    Full Text Available Stroke and cardiac arrest involve injury to all the brain′s resident cells and their respective progenitors, including neurons, all glial subtypes, vascular smooth muscle, vascular endothelium, and pericytes, resulting either in the death of the individual or in a lesion that likely manifests as long-term impairments across a number of cognitive and functional domains. Thousands of studies in experimental animals and results from a few clinical trials in humans have demonstrated that the mechanisms responsible for ischemic brain injury can be blocked or slowed by survival-enhancing epigenetic responses induced by "conditioning" the brain with a stress stimulus paradigm before or even after ictus. The resultant reduction in lesion size and functional deficits are often termed endogenous "neuroprotection," but this in fact involves cytoprotective responses on the part of all the aforementioned resident brain cells and the circulating immune cells as well. The present review will summarize findings demonstrating conditioning-induced protection of the cerebral vasculature, that in turn manifests as reductions in vascularly targeted inflammatory responses; less endothelial injury and improvements in structural integrity of the circulation across all levels of organization; enhanced perfusion with less thrombosis; reductions in vascular dysregulation and reactivity impairments; and, over the longer term, more robust angiogenesis and vascular remodeling. Advancing the mechanistic basis for these innately vasculoprotective phenotypes may provide therapeutic targets for limiting cerebral circulatory injury and dysfunction following stroke and cardiac arrest.

  8. Learning Circulant Sensing Kernels

    Science.gov (United States)

    2014-03-01

    learned dictionaries. Examples of analytic dictionaries include the discrete cosine basis, various wavelets bases , as well as tight frames. Some of them...Compressive sensing based high resolution channel estimation for OFDM system. To appear in IEEE Journal of Selected Topics in Signal Processing, Special...theoretical and computational properties to a (partial) circulant matrix of the same size, our discussions below are based exclusively on the circulant

  9. Application of infrared thermal imaging in the study of preventing cardiovascular and cerebrovascular diseases with Chinese medicine health food

    Science.gov (United States)

    Li, Ziru; Zhang, Xusheng

    2009-08-01

    To explore the assessing technique which could objectively reflect the characteristics of Chinese medicine in the prevention of cardiovascular and cerebrovascular diseases, four balance features of infrared thermal images (ITI) corresponding to the up and down, left and right, proximal and distal balance of blood circulation of human body were studied. First, the ITI features of the middle-aged and elderly people with lipid abnormality history were compared with those of the healthy youth. It was found that the balance state of the youth was significantly better than that of the middle-aged and elderly, P<=0.01 for all the balance features. For the youth, the balance state of females was better than that of the males. But this sexual difference disappeared for the middle-aged and elderly group. Second, a double-blind randomized trial was carried out to study the influences of Shengyi capsule, a Chinese medicine health food with the function of helping to decrease serum lipid, on the balance features. The subjects were middle-aged and elderly people with lipid abnormality history. Shengyi capsule was taken by the trial group while Xuezhikang capsule (with lovastatin as the main effective component) by the control group for 108 days. The balance features of ITI showed that Shengyi was significantly better than Xuezhikang in improving the whole body balance of blood circulation (including the up and down, left and right, proximal and distal balance). The relative efficacy rate was 81.0% for the trial group and 33.3% for the control group, there was significant difference between the two groups (P=0.002). Shengyi could effectively decrease the low density lipoprotein cholesterol (LDL-C) but the effect of Xuezhikang in decreasing total cholesterol (TC) and LDL-C was better than Shengyi. Though the lipid-lowering effect of Shengyi was not as good as Xuezhikang, ITI reflected the obvious advantage of Shengyi in improving the whole body balance of blood circulation which

  10. First translational 'Think Tank' on cerebrovascular disease, cognitive impairment and dementia

    NARCIS (Netherlands)

    Barone, F.C.; Gustafson, D.; Crystal, H.A.; Moreno, H.; Adamski, M.G.; Arai, K.; Baird, A.E.; Balucani, C.; Brickman, A.M.; Cechetto, D.; Gorelick, P.; Biessels, G.J.; Kiliaan, A.J.; Launer, L.; Schneider, J.; Sorond, F.A.; Whitmer, R.; Wright, C.; Zhang, Z.G.

    2016-01-01

    As the human population continues to age, an increasing number of people will exhibit significant deficits in cognitive function and dementia. It is now recognized that cerebrovascular, metabolic and neurodegenerative diseases all play major roles in the evolution of cognitive impairment and dementi

  11. Preserved metabolic coupling and cerebrovascular reactivity during mild hypothermia after cardiac arrest.

    NARCIS (Netherlands)

    Bisschops, L.L.A.; Hoedemaekers, C.W.E.; Simons, K.S.; Hoeven, J.G. van der

    2010-01-01

    OBJECTIVE: Although mild hypothermia improves outcome in patients after out-of-hospital cardiac arrest, the cardiodepressive effects of hypothermia may lead to secondary brain damage. This study was performed to assess the cerebral blood flow, cerebral oxygen extraction, and cerebrovascular reactivi

  12. A novel distinctive cerebrovascular phenotype is associated with heterozygous Arg179 ACTA2 mutations

    NARCIS (Netherlands)

    Munot, Pinki; Saunders, Dawn E.; Milewicz, Dianna M.; Regalado, Ellen S.; Ostergaard, John R.; Braun, Kees P.; Kerr, Timothy; Lichtenbelt, Klaske D.; Philip, Sunny; Rittey, Christopher; Jacques, Thomas S.; Cox, Timothy C.; Ganesan, Vijeya

    2012-01-01

    Mutations in the ACTA2 gene lead to diffuse and diverse vascular diseases; the Arg179His mutation is associated with an early onset severe phenotype due to global smooth muscle dysfunction. Cerebrovascular disease associated with ACTA2 mutations has been likened to moyamoya disease, but appears to h

  13. Cerebrovascular risk factors and subsequent depression in older general practice patients

    NARCIS (Netherlands)

    Nuyen, Jasper; Spreeuwenberg, Peter M.; Beekman, Aartjan T.F.; Groenewegen, Peter P.; Bos, Geertrudis A.M. van den; Schellevis, Francois G.

    2007-01-01

    Background: This general practice-based case-control study tested the association between cerebrovascular risk factors (CVRFs) and the development of later-life depression by focusing on the impact of exposure duration to CVRFs and the modifying influence of age at depression onset. Methods: Cases w

  14. Rare cerebrovascular anomalies in a patient with Cornelia De Lange Syndrome

    Directory of Open Access Journals (Sweden)

    Jesse Jones

    2015-01-01

    Conclusion: Advance knowledge of cerebrovascular variants associated with CDL may help interventionalists prepare to approach such cases. Additionally, further inquiry into the function of proteins encoded by genes associated with CDL could better our understanding of vascular development in the brain.

  15. Effect of breath holding on cerebrovascular hemodynamics in normal pregnancy and preeclampsia

    NARCIS (Netherlands)

    van Veen, Teelkien R.; Panerai, Ronney B.; Haeri, Sina; Zeeman, Gerda G.; Belfort, Michael A.

    2015-01-01

    Preeclampsia (PE) is associated with endothelial dysfunction and impaired autonomic function, which is hypothesized to cause cerebral hemodynamic abnormalities. Our aim was to test this hypothesis by estimating the difference in the cerebrovascular response to breath holding (BH; known to cause symp

  16. Cerebrovascular risk factors and subsequent depression in older general practice patients.

    NARCIS (Netherlands)

    Nuyen, J.; Spreeuwenberg, P.M.; Beekman, A.T.F.; Groenewegen, P.P.; Bos, G.A.M. van den; Schellevis, F.G.

    2007-01-01

    Background: This general practice-based case-control study tested the association between cerebrovascular risk factors (CVRFs) and the development of later-life depression by focusing on the impact of exposure duration to CVRFs and the modifying influence of age at depression onset. Methods: Cases w

  17. Clinical and anatomical consequences of impaired cerebrovascular reserve as detectable by quantitative functional MR imaging

    NARCIS (Netherlands)

    Fierstra, J.

    2012-01-01

    Brain areas exhibiting impaired cerebrovascular reserve are believed to be at higher risk of ischemic tissue injury under circumstances in which cerebral blood flow is insufficient to meet metabolic demand. Other than for acute ischemia, which results in apparent (irreversible) loss of brain tissue

  18. Radioiodine therapy increases the risk of cerebrovascular events in hyperthyroid and euthyroid patients

    DEFF Research Database (Denmark)

    la Cour, Jeppe Lerche; Jensen, Lars Thorbjoern; Vej-Hansen, Anders

    2015-01-01

    to radiation and is capable of inducing atherosclerosis. The objective of the study was to elucidate whether ionizing radiation from radioiodine might contribute to cerebrovascular morbidity. METHODS: In a retrospective register cohort study, 4000 hyperthyroid and 1022 euthyroid goitre patients treated...

  19. Central respiratory chemosensitivity and cerebrovascular CO2 reactivity: a rebreathing demonstration illustrating integrative human physiology.

    Science.gov (United States)

    MacKay, Christina M; Skow, Rachel J; Tymko, Michael M; Boulet, Lindsey M; Davenport, Margie H; Steinback, Craig D; Ainslie, Philip N; Lemieux, Chantelle C M; Day, Trevor A

    2016-03-01

    One of the most effective ways of engaging students of physiology and medicine is through laboratory demonstrations and case studies that combine 1) the use of equipment, 2) problem solving, 3) visual representations, and 4) manipulation and interpretation of data. Depending on the measurements made and the type of test, laboratory demonstrations have the added benefit of being able to show multiple organ system integration. Many research techniques can also serve as effective demonstrations of integrative human physiology. The "Duffin" hyperoxic rebreathing test is often used in research settings as a test of central respiratory chemosensitivity and cerebrovascular reactivity to CO2. We aimed to demonstrate the utility of the hyperoxic rebreathing test for both respiratory and cerebrovascular responses to increases in CO2 and illustrate the integration of the respiratory and cerebrovascular systems. In the present article, methods such as spirometry, respiratory gas analysis, and transcranial Doppler ultrasound are described, and raw data traces can be adopted for discussion in a tutorial setting. If educators have these instruments available, instructions on how to carry out the test are provided so students can collect their own data. In either case, data analysis and quantification are discussed, including principles of linear regression, calculation of slope, the coefficient of determination (R(2)), and differences between plotting absolute versus normalized data. Using the hyperoxic rebreathing test as a demonstration of the complex interaction and integration between the respiratory and cerebrovascular systems provides senior undergraduate, graduate, and medical students with an advanced understanding of the integrative nature of human physiology.

  20. Neckties and Cerebrovascular Reactivity in Young Healthy Males: A Pilot Randomised Crossover Trial

    Directory of Open Access Journals (Sweden)

    Mark Rafferty

    2011-01-01

    Full Text Available Background. A necktie may elevate intracranial pressure through compression of venous return. We hypothesised that a tight necktie would deleteriously alter cerebrovascular reactivity. Materials and Methods. A necktie was simulated using bespoke apparatus comprising pneumatic inner-tube with aneroid pressure-gauge. Using a randomised crossover design, cerebrovascular reactivity was measured with the “pseudo-tie” worn inflated or deflated for 5 minutes (simulating tight/loose necktie resp.. Reactivity was calculated using breath hold index (BHI and paired “t” testing used for comparative analysis. Results. We enrolled 40 healthy male volunteers. There was a reduction in cerebrovascular reactivity of 0.23 units with “tight” pseudotie (BHI loose 1.44 (SD 0.48; BHI tight 1.21 (SD 0.38 P<.001. Conclusion. Impairment in cerebrovascular reactivity was found with inflated pseudo-tie. However, mean BHI is still within a range of considered normal. The situation may differ in patients with vascular risk factors, and confirmatory work is recommended.

  1. Reduction of the cerebrovascular volume in a transgenic mouse model of Alzheimer's disease.

    Science.gov (United States)

    Bourasset, Fanchon; Ouellet, Mélissa; Tremblay, Cyntia; Julien, Carl; Do, Tuan Minh; Oddo, Salvatore; LaFerla, Frank; Calon, Frédéric

    2009-03-01

    Combined evidence from neuroimaging and neuropathological studies shows that signs of vascular pathology and brain hypoperfusion develop early in Alzheimer's disease (AD). To investigate the functional implication of these abnormalities, we have studied the cerebrovascular volume and selected markers of blood-brain barrier (BBB) integrity in 11-month-old 3 x Tg-AD mice, using the in situ brain perfusion technique. The cerebrovascular volume of distribution of two vascular space markers, [3H]-inulin and [14C]-sucrose, was significantly lower (-26% and -27%, respectively; p diazepam was similar between 3xTg-AD mice and controls, suggesting no difference in the functional integrity of the BBB. We also report a 32% increase (p < 0.001) in the thickness of basement membranes surrounding cortical microvessels along with a 20% increase (p < 0.05) of brain collagen content in 3xTg-AD mice compared to controls. The present data indicate that the cerebrovascular space is reduced in a mouse model of Abeta and tau accumulation, an observation consistent with the presence of cerebrovascular pathology in AD.

  2. Dichotic auditory-verbal memory in adults with cerebro-vascular accident

    Directory of Open Access Journals (Sweden)

    Samaneh Yekta

    2014-01-01

    Full Text Available Background and Aim: Cerebrovascular accident is a neurological disorder involves central nervous system. Studies have shown that it affects the outputs of behavioral auditory tests such as dichotic auditory verbal memory test. The purpose of this study was to compare this memory test results between patients with cerebrovascular accident and normal subjects.Methods: This cross-sectional study was conducted on 20 patients with cerebrovascular accident aged 50-70 years and 20 controls matched for age and gender in Emam Khomeini Hospital, Tehran, Iran. Dichotic auditory verbal memory test was performed on each subject.Results: The mean score in the two groups was significantly different (p<0.0001. The results indicated that the right-ear score was significantly greater than the left-ear score in normal subjects (p<0.0001 and in patients with right hemisphere lesion (p<0.0001. The right-ear and left-ear scores were not significantly different in patients with left hemisphere lesion (p=0.0860.Conclusion: Among other methods, Dichotic auditory verbal memory test is a beneficial test in assessing the central auditory nervous system of patients with cerebrovascular accident. It seems that it is sensitive to the damages occur following temporal lobe strokes.

  3. Prevalence and Incidence of Myocardial Infarction and Cerebrovascular Accident in Ageing Persons with Intellectual Disability

    Science.gov (United States)

    Jansen, J.; Rozeboom, W.; Penning, C.; Evenhuis, H. M.

    2013-01-01

    Background: Epidemiological information on age-related cardiovascular disease in people with intellectual disability (ID) is scarce and inconclusive. We compared prevalence and incidence of cerebrovascular accident and myocardial infarction over age 50 in a residential population with ID to that in a general practice population. Method: Lifetime…

  4. Recurrence of cerebrovascular events in young adults with a secundum atrial septal defect

    NARCIS (Netherlands)

    Winkens, Bjorn; Dimopoulos, Konstantinos; Fernandes, Susan M.; Gatzoulis, Michael A.; Landzberg, Michael J.; Mulder, Barbara J. M.

    2010-01-01

    Background: The recurrence rate for cerebrovascular ischemic events in patients after a first TIA or CVA with an atrial septal defect type 2 (ASD2) remains unknown. At present, there are no guidelines with respect to appropriate treatment. The aim of this study was to determine incidence rates of re

  5. Impaired dynamic cerebrovascular response to hypercapnia predicts development of white matter hyperintensities

    Directory of Open Access Journals (Sweden)

    Kevin Sam

    2016-01-01

    Conclusions: Vascular impairment in regions of NAWM that progresses to WMH consists not only of decreased magnitude of ssCVR, but also a pathological decrease in the speed of vascular response. These findings support the association between cerebrovascular dysregulation and the development of WMH.

  6. Awake craniotomy in a patient with ejection fraction of 10%: considerations of cerebrovascular and cardiovascular physiology.

    Science.gov (United States)

    Meng, Lingzhong; Weston, Stephen D; Chang, Edward F; Gelb, Adrian W

    2015-05-01

    A 37-year-old man with nonischemic 4-chamber dilated cardiomyopathy and low-output cardiac failure (estimated ejection fraction of 10%) underwent awake craniotomy for a low-grade oligodendroglioma resection under monitored anesthesia care. The cerebrovascular and cardiovascular physiologic challenges and our management of this patient are discussed.

  7. The role of inflammation and interleukin-1 in acute cerebrovascular disease

    Directory of Open Access Journals (Sweden)

    Galea J

    2013-08-01

    Full Text Available James Galea,1 David Brough21Manchester Academic Health Sciences Center, Brain Injury Research Group, Clinical Sciences Building, Salford Royal Foundation Trust, Salford, UK; 2Faculty of Life Sciences, University of Manchester, AV Hill Building, Manchester, UKAbstract: Acute cerebrovascular disease can affect people at all stages of life, from neonates to the elderly, with devastating consequences. It is responsible for up to 10% of deaths worldwide, is a major cause of disability, and represents an area of real unmet clinical need. Acute cerebrovascular disease is multifactorial with many mechanisms contributing to a complex pathophysiology. One of the major processes worsening disease severity and outcome is inflammation. Pro-inflammatory cytokines of the interleukin (IL-1 family are now known to drive damaging inflammatory processes in the brain. The aim of this review is to discuss the recent literature describing the role of IL-1 in acute cerebrovascular disease and to provide an update on our current understanding of the mechanisms of IL-1 production. We also discuss the recent literature where the effects of IL-1 have been targeted in animal models, thus reviewing potential future strategies that may limit the devastating effects of acute cerebrovascular disease.Keywords: cerebral ischemia, stroke, inflammation, microglia, interleukin-1, caspase-1

  8. Cerebrovascular disease, associated risk factors and antithrombotic therapy in a population screening cohort

    DEFF Research Database (Denmark)

    Proietti, Marco; Mairesse, Georges H; Goethals, Peter;

    2017-01-01

    (4.0%) reported a positive clinical history for cerebrovascular disease. Logistic regression analysis found that age, hypertension, diabetes mellitus, history of vascular disease, history of heart failure and history of AF (all p ...-optimal antithrombotic therapy management was evident, with a low use of oral anticoagulant drugs among patients with AF and a low use of aspirin among subjects without AF....

  9. Outcomes With Edoxaban Versus Warfarin in Patients With Previous Cerebrovascular Events

    DEFF Research Database (Denmark)

    Rost, Natalia S; Giugliano, Robert P; Ruff, Christian T

    2016-01-01

    BACKGROUND AND PURPOSE: Patients with atrial fibrillation and previous ischemic stroke (IS)/transient ischemic attack (TIA) are at high risk of recurrent cerebrovascular events despite anticoagulation. In this prespecified subgroup analysis, we compared warfarin with edoxaban in patients with ver...... IS or TIA. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00781391....

  10. Significance of ultrasound evaluation of carotid atherosclerotic plaque for diagnosing ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Carotid artery is the main source for craniocerebral blood supply. Its intimal plaque formation and arterial stenosis degree both are the risk factors for ischemic cerebrovascular disease.Therefore, the close relationship of carotid atherosclerotic plaque and ischemic cerebrovascular disease, and ultrasound evaluation of carotid atherosclerotic plaque have become the hot spot in studying ischemic cerebrovascular disease.OBJECTIVE: This study was to detect the degree of carotid atherosclerosis of ischemic cerebrovascular disease patients by ultrasonography, and to analyze the situation of carotid atherosclerosis and its relationship with clinic.DESIGN: Clinical randomized concurrent control experiment.SETTING: Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA.PARTICIPANTS: Totally 60 outpatients and inpatients with ischemic cerebrovascular disease, 42 males and 18 females, admitted to Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA between January 2006 and December 2006 were involved in the patient group. They met the diagnosis criteria of ischemic cerebrovascular disease constituted by the 4th Cerebrovascular Disease Conference in 1996, and were confirmed to suffer from ischemic cerebrovascular disease by skull CT and MRI. Another 20 subjects who received healthy examination concurrently in the same hospital, 12 males and 8 females, were involved in the control group. Informed consents of detected items were obtained from involved subjects.METHODS: The plaque thickness of mid portion, distal end and crotch of common carotid artery (CCA),internal carotid artery (ICA), external carotid artery (ECA) and vertebral artery (VA) of involved subjects,who received health examination was separately detected with color Doppler ultrasonograph (HDI-5000).Then, total integral of plaque was calculated. The intima-media thickness (IMT) was measured with two-dimensional ultrasonography. The inner diameter

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

    Directory of Open Access Journals (Sweden)

    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

  12. Gaussian Fibonacci Circulant Type Matrices

    Directory of Open Access Journals (Sweden)

    Zhaolin Jiang

    2014-01-01

    Full Text Available Circulant matrices have become important tools in solving integrable system, Hamiltonian structure, and integral equations. In this paper, we prove that Gaussian Fibonacci circulant type matrices are invertible matrices for n>2 and give the explicit determinants and the inverse matrices. Furthermore, the upper bounds for the spread on Gaussian Fibonacci circulant and left circulant matrices are presented, respectively.

  13. Diffusion tensor imaging of the brain in patients with Alzheimer's disease and cerebrovascular lesions

    Institute of Scientific and Technical Information of China (English)

    CHEN Shao-qiong; KANG Zhuang; HU Xi-quan; HU Bing; ZOU Yan

    2007-01-01

    Background: Recent autopsy study showed a high incidence ofcerebrovascular lesions in Alzheimer's disease (AD).To assess the impact of cerebrovascular pathology in AD, we used diffusion tensor imaging (DTI) to study AD patients with and without cerebrovascular lesions. Materials and Methods: Conventional and DTI scans were obtained from 10 patients with probable AD, 10 AD/V patients (probable AD with cerebrovascular lesions) and ten normal controls. Mean diffusivity (D) and fractional anisotropy (FA) values of some structures involved with AD pathology were measured. Results: D value was higher in AD patients than in controls in hippocampus and the cingulate gyrus. In AD/V patients, increased D value was found in the same structures and also in the thalamus and basal ganglia compared to controls. There was a significant difference of D value between AD and AD/V patients. FA value reduced in the white matter of left inferior temporal gyrus and in the bilateral middle cingulate gyrus in patients with AD/V compared with controls. The MMSE (mini-mental state examination) score significantly correlated with FA value in the right hippocampus (r=0.639, P<0.019), in the right anterior cingulate gyrus (r=0.587, P<0.035) and in left parahippocampal gyrus (r=0.559, P<0.047). Conclusion: Cerebrovascular pathology had stronger impact on the D value than the AD pathology alone did. Elevated D value in thalamic and basal ganglia may contribute to cognitive decline in AD/V patients.Reduced FA values in AD/V patients may indicate that cerebrovascular pathology induced more severe white matter damage than the AD pathology alone did.

  14. Care for patients with cerebrovascular disease in a general hospital. 2 years experience Atención a pacientes con enfermedad cerebrovascular en un hospital general. Experiencia de 2 años

    Directory of Open Access Journals (Sweden)

    Julio López Arguelles

    2010-08-01

    Full Text Available Background: The care of patients with cerebrovascular disease requires an organized system from pre-hospital care until discharge of the patient, to ensure the continuity of rehabilitation. In order to provide differentiated services to patients with this condition was created in the General Hospital Universitario "Dr. Gustavo Lima Aldereguía "a specialized room for attention to these diseases and the rehabilitation of patients. Objective: To determine the benefits obtained with differentiated services to patients with cerebrovascular disease in a general hospital. Methods: Descriptive case series that included 1038 patients admitted to the specialized chamber for cerebrovascular disease. We analyzed the following variables: stay, type of cerebrovascular disease, clinical classification, the Barthel index and discharge status. Results: 972 patients suffered from cerebrovascular disease, hospital stay was reduced by two days, the attention of specialized equipment increased from 51.75% to 79.2% patients were discharged with a mild degree of functional dependence. Conclusions: The differentiated services to cerebrovascular disease in general hospitals shows benefits for patients.Fundamento: la atención a pacientes con enfermedad cerebrovascular requiere un sistema organizado desde la atención prehospitalaria hasta el egreso del paciente, que asegure la continuidad de la rehabilitación. En aras de brindar una atención diferenciada a los pacientes con esta afección se creó en el Hospital General Universitario “Dr. Gustavo Aldereguía Lima” una sala especializada para la atención a estas enfermedades y la rehabilitación de los pacientes. Objetivo: determinar los beneficios que se obtienen con la atención diferenciada a pacientes con enfermedad cerebrovascular en un hospital general. Métodos: estudio

  15. Caregiver awareness of cerebrovascular risk of patients with dementia due to Alzheimer's disease in São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Fabricio Ferreira de Oliveira

    2014-07-01

    Full Text Available Background Proper control of cerebrovascular risk is essential to prevent cognitive change in dementia due to Alzheimer’s disease (AD. Objective To investigate whether caregiver awareness to control cerebrovascular risk impacts the lifestyles of patients with AD. Methods Consecutive outpatients with AD were assessed for demographic features, Clinical Dementia Rating scores, cerebrovascular risk, pharmacotherapy, dietary therapy and practice of physical activities. Patients and caregivers were inquired on awareness of the importance of measures to control cerebrovascular risk. Chi-square test was employed for statistics, significance at ρ < 0.05. Results A total of 217 patients were included; whereas 149 caregivers (68.7% were aware of the need to control cerebrovascular risk, only 11 patients (5.1% simultaneously practiced physical activities and received pharmacological treatment and dietary therapy. Patients with hypertension and diabetes mellitus were more likely to receive dietary therapy (ρ = 0.007. Male patients were more engaged in physical activities (ρ = 0.018. Patients in earlier AD stages exercised (ρ = 0.0003 and received pharmacological treatment more often (ρ = 0.0072. Caregiver awareness of the need to control cerebrovascular risk was higher when patients had hypertension (ρ = 0.024 and/or hypercholesterolemia (ρ = 0.006, and influenced adherence to dietary therapy (ρ = 0.002 and to pharmacological treatment (ρ = 0.001. Discussion Caregiver awareness of the need to control cerebrovascular risk has positive impacts for patients with AD.

  16. The analysis of the clinical characteristics of visual dysfunction as the first symptom of cerebrovascular disease%以视功能障碍为首发症状的脑血管病临床特征分析

    Institute of Scientific and Technical Information of China (English)

    徐凤鸣

    2012-01-01

      Objective To investigate the clinical features of cerebrovascular disease decreased visual acuity and visual field defect as the first symptom. Methods 48 cases of patients with cerebrovascular disease cases in 2 years in the department of Neurology of our hospital with the inpatient decreased visual acuity and visual field defect as the first symptom were analyzed retrospectively. Their clinical symptoms were taken for preliminary statistics. Results The chief complaint included monocular decreased vision, binocular vision decreased, but not depending on the material of the eyes laterality and eyes at the same time depending on the not seen material. After professional inspection, five cases were confirmed with anterior circulation infarction, 33 cases were of cerebral infarction, cerebral vascular malformations were in three cases, three cases were of moyamoya disease, and carotid artery occlusion were in four cases. The anterior circulation lesions showed the monovision dysfunction, posterior circulation lesions mainly showed the performance of single, bilateral occipital, temporal lobe infarction; basilar artery syndrome and brainstem infarction. The average age of the posterior circulation was older than the age of the average lesion of the anterior circulation. Conclusion In the cerebrovascular disease as the first see dysfunction are both with anterior circulation lesions and posterior circulation lesions. The posterior circulation ratio is significantly higher than the previous cycle. The monovision dysfunction multi is mainly anterior circulation lesions, and it is the ocular symptoms of carotid artery lesions. The binocular dysfunction posterior circulation lesions are caused by occipital temporal lobe.%  目的探讨以视力下降和视野缺损为首发症状的脑血管病的临床特征。方法回顾性分析2年内于我院神经内科住院的依视力下降和视野缺损为首发症状的48例脑血管病患者病例,对其临床症

  17. Circulant Double Coverings of a Circulant Graph of Valency Five

    Institute of Scientific and Technical Information of China (English)

    Rong Quan FENG; Jin Ho KWAK

    2007-01-01

    Enumerating the isomorphism classes of several types of graph covering projections is one of the central research topics in enumerative topological graph theory. A covering of G is called circulant if its covering graph is circulant. Recently, the authors [Discrete Math., 277, 73-85 (2004)]enumerated the isomorphism classes of circulant double coverings of a certain type, called a typicalcovering, and showed that no double covering of a circulant graph of valency three is circulant. Also, in [Graphs and Combinatorics, 21, 386-400 (2005)], the isomorphism classes of circulant double coverings of a circulant graph of valency four are enumerated. In this paper, the isomorphism classes of circulant double coverings of a circulant graph of valency five are enumerated.

  18. Kernels in circulant digraphs

    Directory of Open Access Journals (Sweden)

    R. Lakshmi

    2014-06-01

    Full Text Available A kernel $J$ of a digraph $D$ is an independent set of vertices of $D$ such that for every vertex $w,in,V(D,setminus,J$ there exists an arc from $w$ to a vertex in $J.$ In this paper, among other results, a characterization of $2$-regular circulant digraph having a kernel is obtained. This characterization is a partial solution to the following problem: Characterize circulant digraphs which have kernels; it appeared in the book {it Digraphs - theory, algorithms and applications}, Second Edition, Springer-Verlag, 2009, by J. Bang-Jensen and G. Gutin.

  19. Influence of steep Trendelenburg position and CO(2) pneumoperitoneum on cardiovascular, cerebrovascular, and respiratory homeostasis during robotic prostatectomy

    NARCIS (Netherlands)

    Kalmar, A. F.; Foubert, L.; Hendrickx, J. F. A.; Mottrie, A.; Absalom, A.; Mortier, E. P.; Struys, M. M. R. F.

    2010-01-01

    The steep (40 degrees) Trendelenburg position optimizes surgical exposure during robotic prostatectomy. The goal of the current study was to investigate the combined effect of this position and CO(2) pneumoperitoneum on cardiovascular, cerebrovascular, and respiratory homeostasis during these proced

  20. The relationship between cerebrovascular complications and previously established use of antiplatelet therapy in left-sided infective endocarditis

    DEFF Research Database (Denmark)

    Snygg-Martin, Ulrika; Rasmussen, Rasmus Vedby; Hassager, Christian;

    2011-01-01

    Cerebrovascular complications (CVC) in infective endocarditis (IE) are common. The only established treatments to reduce the incidence of CVC in IE are antibiotics and in selected cases early cardiac surgery. Potential effects of previously established antiplatelet therapy are under debate....

  1. Acute Cerebrovascular Radiation Syndrome: Radiation Neurotoxicity , mechanisms of CNS radiation injury, advanced countermeasures for Radiation Protection of Central Nervous System.

    Science.gov (United States)

    Popov, Dmitri; Jones, Jeffrey; Maliev, Slava

    Key words: Cerebrovascular Acute Radiation Syndrome (Cv ARS), Radiation Neurotoxins (RNT), Neurotransmitters, Radiation Countermeasures, Antiradiation Vaccine (ArV), Antiradiation Blocking Antibodies, Antiradiation Antidote. Psychoneuroimmunology, Neurotoxicity. ABSTRACT: To review the role of Radiation Neurotoxins in triggering, developing of radiation induced central nervous system injury. Radiation Neurotoxins - rapidly acting blood toxic lethal agent, which activated after irradiation and concentrated, circulated in interstitial fluid, lymph, blood with interactions with cell membranes, receptors and cell compartments. Radiation Neurotoxins - biological molecules with high enzymatic activity and/or specific lipids and activated or modified after irradiation. The Radiation Neurotoxins induce increased permeability of blood vessels, disruption of the blood-brain barrier, blood-cerebrospinal fluid (CSF) barrier and developing severe disorder of blood macro- and micro-circulation. Principles of Radiation Psychoneuro-immunology and Psychoneuro-allergology were applied for determination of pathological processes developed after irradiation or selective administration of Radiation Neurotoxins to radiation naïve mammals. Effects of radiation and exposure to radiation can develop severe irreversible abnormalities of Central Nervous System, brain structures and functions. Antiradiation Vaccine - most effective, advanced methods of protection, prevention, mitigation and treatment and was used for of Acute Radiation Syndromes and elaboration of new technology for immune-prophylaxis and immune-protection against ϒ, Heavy Ion, Neutron irradiation. Results of experiments suggested that blocking, antitoxic, antiradiation antibodies can significantly reduce toxicity of Radiation Toxins. New advanced technology include active immune-prophylaxis with Antiradiation Vaccine and Antiradiation therapy that included specific blocking antibodies to Radiation Neurotoxins

  2. Blood pressure, risk of ischemic cerebrovascular and ischemic heart disease, and longevity in alpha(1)-antitrypsin deficiency

    DEFF Research Database (Denmark)

    Dahl, Morten; Tybjaerg-Hansen, Anne; Sillesen, Henrik

    2003-01-01

    Because elastase in alpha(1)-antitrypsin deficiency may attack elastin in the arterial wall, we tested whether alpha(1)-antitrypsin deficiency is associated with reduced blood pressure, risk of ischemic cerebrovascular (ICVD) and ischemic heart disease (IHD), and longevity.......Because elastase in alpha(1)-antitrypsin deficiency may attack elastin in the arterial wall, we tested whether alpha(1)-antitrypsin deficiency is associated with reduced blood pressure, risk of ischemic cerebrovascular (ICVD) and ischemic heart disease (IHD), and longevity....

  3. Risk of cerebrovascular events in persons with and without HIV: a Danish nationwide population-based cohort study

    DEFF Research Database (Denmark)

    Rasmussen, Line D; Engsig, Frederik N; Christensen, Hanne;

    2011-01-01

    To assess the risk of cerebrovascular events (CVEs) in HIV-infected individuals and evaluate the impact of proven risk factors, injection drug abuse (IDU), immunodeficiency, HAART and family-related risk factors.......To assess the risk of cerebrovascular events (CVEs) in HIV-infected individuals and evaluate the impact of proven risk factors, injection drug abuse (IDU), immunodeficiency, HAART and family-related risk factors....

  4. Clinical and Paraclinical Findings of Cerebrovascular Accidents in Children Admitted to Pediatric Medical Center from 1993 till 2003

    OpenAIRE

    M. Dehghani; H Montazer Lotfe Elahi; M Ashrafi

    2011-01-01

    Introduction: Stroke is a clinical diagnosis which brings up cerebrovascular diseases. Stroke includes any cerebrovascular accident which leads to local neural defect and lasts more than 24 hours. Stroke has severe and irreversible complications and high rates of recurrence after first episode, therefore we decided to study clinical and paraclinical findings of this disease for better diagnosis and prevention of it. Methods: We prepared a case series study to review medical files of the patie...

  5. Promotor polymorphisms in leukotriene C4 synthase and risk of ischemic cerebrovascular disease

    DEFF Research Database (Denmark)

    Freiberg, J.J.; Tybjaerg-Hansen, A.; Sillesen, H.

    2008-01-01

    .8(1.4 to 5.7) for -1072 AA versus GG genotype, 0.6(0.4 to 0.9) for -444 CC versus AA genotype, 2.5(1.2 to 5.4) for combined AA-AA versus GG-AA genotype, and 0.6(0.4 to 0.9) for combined GG-CC versus GG-AA genotype. Genotype did not associate with risk of deep venous thrombosis or severe carotid...... atherosclerosis, or with levels of platelets and coagulation factors. CONCLUSIONS: Leukotriene C(4) synthase -1072 AA genotype predict increased risk, whereas -444 CC genotype predict decreased risk of ischemic cerebrovascular disease.......OBJECTIVE: Cysteinyl leukotrienes are involved in inflammation and possibly in early carotid atherosclerosis. We tested the hypothesis that the -444 A/C and -1072 G/A polymorphisms of the leukotriene C(4) synthase associate with risk of ischemic cerebrovascular disease. METHODS AND RESULTS: We...

  6. Trypanosoma cruzi-associated cerebrovascular disease: a case-control study in Eastern Colombia.

    Science.gov (United States)

    Leon-Sarmiento, Fidias E; Mendoza, Eder; Torres-Hillera, Martin; Pinto, Neyla; Prada, Janette; Silva, Clara A; Vera, Silvia J; Castillo, Erwin; Valderrama, Vladimir; Prada, Didier G; Bayona-Prieto, Jaime; Garcia, Ingrid

    2004-01-15

    Trypanosoma cruzi infection is a common cause of cardiopathy in South America leading it eventually to an established stroke; however, the association between T. cruzi infection itself and cerebrovascular disease is still unknown. We did a case-control study at Eastern Colombia and found that T. cruzi infection was more frequent and statistically significant in stroke cases (24.4%) than controls (1.9%), (Chi square: 21.72; OR: 16.13; 95% confidence interval (CI): 3.64-71.4; p<0.00001). After removing the seropositive patients with cardiological abnormalities, the significance still remained by multivariate analysis (p<0.05). This is the first case-control study that demonstrated a significant link between this infection and symptomatic cerebrovascular disease, mainly ischemic, regardless of cardiac abnormalities. Therefore, we recommend that patients with stroke must be screened for T. cruzi infection if they currently live or have lived in places where this parasite is considered endemic.

  7. Apolipoprotein E gene polymorphism in cerebrovascular diseases of the Chinese Naxi populations from Yunnan province

    Institute of Scientific and Technical Information of China (English)

    Hong Xu; Qihong Yuan; Xijun Fan; Guoqiang He

    2011-01-01

    Currently it is not well known whether apolipoprotein E (ApoE) is a genetic susceptibility factor for cerebrovascular diseases in the Chinese Naxi population. The present study detected and sequenced ApoE polymorphisms of 90 patients with cerebrovascular diseases (58 cases of cerebral infarction and 32 cases of intracerebral hemorrhage), and 50 normal people of Naxi nationality from Yunnan province, China. The populations were used to analyze the relationship of ApoE polymorphisms with cerebral infarction and intracerebral hemorrhage. Results showed an association between ApoE gene polymorphism and the onset of cerebral infarction, and a possibility that the ε4 allele is a susceptibility locus for the risk of cerebral infarction. However, there was no evidence of a relationship between the ApoE gene polymorphism and cerebral hemorrhage.

  8. Long-Term Exposure to Ambient Air Pollution and Incidence of Cerebrovascular Events

    DEFF Research Database (Denmark)

    Stafoggia, Massimo; Cesaroni, Giulia; Peters, Annette

    2014-01-01

    BACKGROUND: Few studies have investigated effects of air pollution on the incidence of cerebrovascular events. OBJECTIVES: We assessed the association between long-term exposure to multiple air pollutants and the incidence of stroke in European cohorts. METHODS: Data from 11 cohorts were collected...... and occurrence of a first stroke was evaluated. Individual air pollution exposures were predicted from land-use regression models developed within the "European Study of Cohorts for Air Pollution Effects" (ESCAPE). The exposures were: PM2.5 (particulate matter [PM] below 2.5 µm in diameter), coarse PM (PM...... found suggestive evidence of an association between fine particles and incidence of cerebrovascular events in Europe, even at lower concentrations than set by the current air quality limit value....

  9. Acetylsalicylic acid provides cerebrovascular protection from oxidant damage in salt-loaded stroke-prone rats.

    Science.gov (United States)

    Ishizuka, Toshiaki; Niwa, Atsuko; Tabuchi, Masaki; Ooshima, Kana; Higashino, Hideaki

    2008-03-26

    Inflammatory processes may play a pivotal role in the pathogenesis of cerebrovascular injury in salt-loaded stroke-prone spontaneously hypertensive rats (SHRSP). Recent reports revealed that acetylsalicylic acid (aspirin) has anti-oxidative properties and elicits nitric oxide release by a direct activation of the endothelial NO synthase. The present study was designed to determine whether low-dose aspirin might prevent cerebrovascular injury in salt-loaded SHRSP by protecting oxidative damage. Nine-week-old SHRSP were fed a 0.4% NaCl or a 4% NaCl diet with or without treatment by naproxen (20 mg/kg/day), salicylic acid (5 mg/kg/day), or aspirin (5 mg/kg/day) for 5 weeks. Blood pressure, blood brain barrier impairment, mortality, and the parameters of cerebrovascular inflammation and damage were compared among them. High salt intake in SHRSP significantly increased blood brain barrier impairment and early mortality, which were suppressed by treatment with aspirin independent of changes in blood pressure. Salt loading significantly increased superoxide production in basilar arteries of SHRSP, which were significantly suppressed by treatment with aspirin. Salt loading also significantly decreased NOS activity in the basilar arteries of SHRSP, which were significantly improved by treatment with aspirin. At 5 weeks after salt loading, macrophage accumulation and matrix metalloproteinase-9 activity at the stroke-negative area in cerebral cortex of SHRSP were significantly reduced by treatment with aspirin. These results suggest that low-dose aspirin may exert protective effects against cerebrovascular inflammation and damage by salt loading through down-regulation of superoxide production and induction of nitric oxide synthesis.

  10. Cuidado popular de familias con un adulto mayor sobreviviente del primer accidente cerebrovascular

    OpenAIRE

    Lucero López-Díaz; Fabiola Castellanos-Soriano; Esperanza Muñoz-Torres

    2016-01-01

    Introducción: el accidente cerebrovascular afecta a numerosas personas en el mundo y se constituye en la principal causa de muer- te. Los sobrevivientes pueden padecer discapacidad y sufrir modificaciones en las actividades cotidianas. La familia es el principal apoyo del sobreviviente y al ser parte de una misma cultura, construye acciones de cuidado en búsqueda del bienestar. Objetivo: describir las acciones del cuidado popular de las familias con un adulto mayor sobreviviente del prim...

  11. High prevalence of peripheral arterial disease in patients with previous cerebrovascular or coronary event

    DEFF Research Database (Denmark)

    Mehlsen, Jesper; Wiinberg, Niels; Joergensen, Bjarne S;

    2010-01-01

    The presence of peripheral arterial disease (PAD) in patients with other manifestations of cardiovascular disease identifies a population at increased risk of complications both during acute coronary events and on a long-term basis and possibly a population in whom secondary prevention...... of cardiovascular events should be addressed aggressively. The present study was aimed at providing a valid estimate on the prevalence of PAD in patients attending their general practitioner and having previously suffered a cardio- or cerebrovascular event....

  12. TYPES OF TREMOR IN PATIENTS WITH CEREBROVASCULAR DISEASES AND CARDIOVASCULAR EVENTS

    Directory of Open Access Journals (Sweden)

    Petrov Igor

    2016-03-01

    Full Text Available Introduction: Tremor can occur as a part of the clinical feature of cerebrovascular diseases. Many patients with cerebral stroke have cardiovascular diseases as a comorbidity or complication of stroke; sometimes cardiovascular events can lead to embolic stroke. Aim: To present types of tremor in patients with cerebrovascular diseases and cardiovascular events and diabetes mellitus type 2, clinical characteristics of tremor and investigations used. Material and methods: In our study we included 36 patients, 24 men and 12 women, that were examined and followed for 3 years, from 2012-2015. All patients were subjected to the following investigations: neurological examination, laboratory analysis, computerized tomography of brain, magnetic resonance imaging and electroencephalography. In cardiovascular patients we also performed Doppler sonography of carotid arteries, electrocardiography, cardiac ultrasound. The patients were examined and treated by cardiologists. Results: Of all patients 22% had cerebral infarction, 41% atherosclerosis, 36% multiple lacunar infarctions and 28% diabetes mellitus type 2. Three patients with cerebral infarction had chorea, hemiballismus, dystonia and dystonic tremor, three had postural tremor and two cerebellar intention tremor. Atherosclerotic patients had atherosclerotic action tremor, while diabetic patients predominantly presented with action-type tremor. Electroencephalography showed irritative basic brain activity with slow waves, while carotid arteries stenosis was diagnosed by Doppler sonography. Computerized tomography of the brain and magnetic resonance imaging revealed cerebrovascular diseases in certain areas. Patients with cardiomyopathy, rhythm disorders, high blood pressure, hyperlipidemia was investigated and medically treated by a cardiologist. Conclusion: In cerebrovascular diseases different types of tremor can occur as the result of the damage of the extrapyramidal system.

  13. Nuclear medicine imaging in cerebrovascular disorders; Nuklearmedizinische Bildgebung bei zerebrovaskulaeren Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Barthel, H. [Universitaetsklinikum Leipzig A.oe.R. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Leipzig Univ. (Germany). Translationszentrum fuer Regenerative Medizin; Hesse, S.; Sabri, O. [Universitaetsklinikum Leipzig A.oe.R. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2007-09-15

    For diagnosing cerebrovascular disorders, single-photon emission computed tomography (SPECT) and positron emission tomography (PET) employing blood flow and oxygen consumption markers is applied. Currently, competing imaging techniques which do not rely on radiotracers are more dominant in clinical routine. However, brain SPECT and PET substantially contribute towards diagnosis and therapy monitoring in acute and chronic cerebral ischemia. Furthermore, cerebral vasculitis, vasospasm after subarachnoid hemorrhage, brain tolerance during balloon occlusion tests and brain death can be accurately diagnosed. (orig.)

  14. Endovascular external carotid artery occlusion for brain selective targeting: a cerebrovascular swine model

    OpenAIRE

    Mangla, Sundeep; Choi, Jae H.; Barone, Frank C.; Novotney, Carol; Libien, Jenny; Lin, Erwin; Pile-Spellman, John

    2015-01-01

    Background The choice of an animal model for cerebrovascular research is often determined by the disease subtype to be studied (e.g. ischemic stroke, hemorrhage, trauma), as well as the nature of the intervention to be tested (i.e. medical device or pharmaceutical). Many initial studies are performed in smaller animals, as they are cost-effective and their encephalic vasculature closely models that of humans. Non-human primates are also utilized when confirmation or validation is required on ...

  15. [Solcoseryl--new preparation for the pathogenetic treatment of patients with paroxysmal forms of cerebrovascular pathology].

    Science.gov (United States)

    Rudenko, A Iu; Bashkirova, L M

    2003-01-01

    The central goal of the investigation was to study Solcoseryl (SolcoSwitzerland) therapeutic efficacy for patients suffering from early or chronic cerebrovascular diseases complicated with different forms of paroxysms. 29 patients were examined. (14 of them were with vegetovascular dystonia, 7 with discirculatory encephalopathy of degree of 1 and 8 with discirculatory encephalopathy of degree of II). The authors revealed Solcoseryl to be positive in decreasing incidence and duration of vegetovascular fits, complaints, pathologic symptoms.

  16. Cerebral blood flow and cerebrovascular reserve capacity: estimation by dynamic magnetic resonance imaging.

    Science.gov (United States)

    Schreiber, W G; Gückel, F; Stritzke, P; Schmiedek, P; Schwartz, A; Brix, G

    1998-10-01

    We have developed a new method for estimation of regional CBF (rCBF) and cerebrovascular reserve capacity on a pixel-by-pixel basis by means of dynamic magnetic resonance imaging (MRI). Thirteen healthy volunteers, 8 patients with occlusion and/or high grade stenosis of the internal carotid artery (ICA), and 2 patients with acute stroke underwent dynamic susceptibility-weighted contrast enhanced MRI. Using principles of indicator dilution theory and deconvolution analysis, maps of rCBF, regional cerebral blood volume, and of the mean transit time (MTT) were calculated. In patients with ICA occlusion/stenosis, cerebrovascular reserve capacity was assessed by the rCBF increase after acetazolamide stimulation. Mean gray and white matter rCBF values in normals were 67.1 and 23.7 mL x 100 g(-1) x min(-1), respectively. Before acetazolamide stimulation, six of eight patients with ICA occlusions showed decreased rCBF values; and in seven patients increased MTT values were observed in tissue ipsilateral to the occlusion. After acetazolamide stimulation, decreased cerebrovascular reserve capacity was observed in five of eight patients with ICA occlusion. In acute stroke, rCBF in the central core of ischemia was less than 8 mL x 100 g(-1) x min(-1). In peri-infarct tissue, rCBF and MTT were higher than in unaffected tissue but rCBF was normal. Dynamic MRI provides important clinical information on the hemodynamic state of brain tissue in patients with occlusive cerebrovascular disease or acute stroke.

  17. Cuidado popular de familias con un adulto mayor sobreviviente del primer accidente cerebrovascular

    Directory of Open Access Journals (Sweden)

    Lucero López-Díaz

    2016-01-01

    Full Text Available Introducción: el accidente cerebrovascular afecta a numerosas personas en el mundo y se constituye en la principal causa de muer- te. Los sobrevivientes pueden padecer discapacidad y sufrir modificaciones en las actividades cotidianas. La familia es el principal apoyo del sobreviviente y al ser parte de una misma cultura, construye acciones de cuidado en búsqueda del bienestar. Objetivo: describir las acciones del cuidado popular de las familias con un adulto mayor sobreviviente del primer accidente cerebrovascular. Método: estudio etnográfico, con observación participante y entrevistas en profundidad. Participaron siete familias bogotanas (siete adultos mayores entre los dos y diez meses posteriores al primer accidente cerebrovascular y los siete cuidadores principales respectivos. Resultados: cuidadores y adulto mayor comparten acciones de cuidado para la recuperación, relacionadas con la alimentación, el cuidado personal y la ingesta de medicamentos permeadas por la creencia religiosa, fuente de soporte y vínculo afectivo. Conclusión: conocer el cuidado popular de esta población posibilita proponer acciones culturalmente congruentes con sus valores y creencias para potencializar las ca- pacidades familiares e intermediar en los procesos de tratamiento.

  18. Crowdsourcing Precision Cerebrovascular Health: Imaging and Cloud Seeding A Million Brains Initiative™

    Directory of Open Access Journals (Sweden)

    David S Liebeskind

    2016-11-01

    Full Text Available Crowdsourcing, an unorthodox approach in medicine, creates an unusual paradigm to study precision cerebrovascular health, eliminating the relative isolation and non-standardized nature of current imaging data infrastructure, while shifting emphasis to the astounding capacity of big data in the cloud. This perspective envisions the use of imaging data of the brain and vessels to orient and seed A Million Brains Initiative™ that may leapfrog incremental advances in stroke and rapidly provide useful data to the sizable population around the globe prone to the devastating effects of stroke and vascular substrates of dementia. Despite such variability in the type of data available and other limitations, the data hierarchy logically starts with imaging and can be enriched with almost endless types and amounts of other clinical and biological data. Crowdsourcing allows an individual to contribute to aggregated data on a population, while preserving their right to specific information about their own brain health. The cloud now offers endless storage, computing prowess and neuroimaging applications for post-processing that is searchable and scalable. Collective expertise is a windfall of the crowd in the cloud and particularly valuable in an area such as cerebrovascular health. The rise of precision medicine, rapidly evolving technological capabilities of cloud computing and the global imperative to limit the public health impact of cerebrovascular disease converge in the imaging of A Million Brains Initiative™. Crowdsourcing secure data on brain health may provide ultimate generalizability, enable focused analyses, facilitate clinical practice and accelerate research efforts.

  19. Genetic polymorphisms and cerebrovascular disease in children with sickle cell anemia from Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Isaac Lima da Silva Filho

    2011-06-01

    Full Text Available The aim of the present work was to examine possible genetic risk factors related to the occurrence of cerebrovascular disease (CVD in Brazilian population, the frequency of βS-globin gene haplotypes and co-inheritance with α-thalassemia (-α3.7kb and single nucleotide polymorphism of methylenetetrahydrofolate reductase (MTHFR-C677T, Factor V Leiden (FV-G1691A and prothrombin (PT-G20210A genes in children from Rio de Janeiro. Ninety four children with sickle cell anemia (SCA were included, 24 patients with cerebrovascular involvement and 70 patients without CVD as control group. The mean age of children at the time of the cerebrovascular event was similar to the control group. The frequency of -α3.7kb thalassemia was similar in both groups (p=0.751. Children with Bantu/Atypical βS-globin gene haplotype presented 15 times more chance (OR=15.4 CI 95% 2.9-81.6 of CVD than the other βS-globin gene haplotypes. The C677T polymorphism of MTHFR gene was similar in both groups (p=0.085. No mutation in the FV Leiden or PT genes was found. A large study seems necessary to establish the role of these genetic polymorphisms in Brazilian miscegenated population.

  20. Loss-of-function mutation in ABCA1 and risk of Alzheimer's disease and cerebrovascular disease

    DEFF Research Database (Denmark)

    Nordestgaard, Liv Tybjærg; Tybjærg-Hansen, Anne; Nordestgaard, Børge G;

    2015-01-01

    -brain barrier via apoE-mediated pathways. METHODS: We tested whether a loss-of-function mutation in ABCA1, N1800H, is associated with plasma levels of apoE and with risk of Alzheimer's disease (AD) in 92,726 individuals and with risk of cerebrovascular disease in 64,181 individuals. RESULTS: N1800H AC (0.......2%) versus AA (99.8%) was associated with a 13% lower plasma level of apoE (P = 1 × 10(-11)). Multifactorially adjusted hazard ratios for N1800H AC versus AA were 4.13 (95% confidence interval, 1.32-12.9) for AD, 2.46 (1.10-5.50) for cerebrovascular disease, and 8.28 (2.03-33.7) for the hemorrhagic stroke...... subtype. DISCUSSION: A loss-of-function mutation in ABCA1, present in 1:500 individuals, was associated with low plasma levels of apoE and with high risk of AD and cerebrovascular disease in the general population....

  1. Characterization and prognosis factors of cerebro-vascular disease in Cienfuegos province.

    Directory of Open Access Journals (Sweden)

    Rubén Bembibre Taboada

    2004-08-01

    Full Text Available Fundaments: Cerebrovascular disease constitutes the third cause of death and the first cause of severe discapacity in adults in those countries that have a developed health system like ours. Objective: To characterise the patients with cerebrovascular disease and to determine the variables that influence upon their prognosis once it is established. Method: Prospective, descriptive, longitudinal study of a series of cases developed at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨. Questionnaires were applied to the patients that fitted the inclusion criteria (n 1318 Results: The mean age was 66,08 years with a predominance of white patients ( 75,26 %, mainly males ( 56,67%. The risk factor of highest frequency was hypertension ( 43,24 % The evolution for alive patients without discapacities was 14,71%, alive with discapacities ( 57,96% and death 27,31%. There was a predominance of ischemic cerebrovascular disease (46,13 % of aterothrombotic infarcts and 14,94 % cardioembolic disease. In regards to hemorrhagic disease 13,42 % were intracerebral hemorrhage and 4,55% subarachnoid hemorrhage. There was a prognostic correlation between the clinical variables: consciousness, sight, sensibility, language, tone, Babinski , osteotendious reflexes and muscular force. For the general variables cerebral edema, bacterial bronchopneumonia , displacement of the medial line, diagnosis is some values, CT scan diagnoses in some values for diabetes mellitus and convulsions.

  2. Cognitive impairments in cerebrovascular disease: What is between health and dementia?

    Directory of Open Access Journals (Sweden)

    A. Yu. Emelin

    2015-01-01

    Full Text Available The problem of cerebrovascular lesions takes on even greater significance with the higher prevalence of both acute and chronic forms of cerebrovascular diseases (CVD. Cognitive dysfunctions that have a pronounced negative impact on the quality of life in patients hold a special place among the various neurological symptoms resulting from cerebrovascular lesions. The incidence of vascular dementia increases with age. The paper considers the main issues of the etiology, pathogenesis and classification of vascular cognitive impairments (VCIs. It proposes criteria for the diagnosis of VCIs in the early stages of the disease. Potentially modifiable factors, such as hypertension, coronary heart disease, orthostatic hypotension, diabetes mellitus, hypercholesterolemia, hyperhomocysteinemia, obesity, et al., are indicated to have a special place among the main etiological causes of VCIs. The timely detection of etiological factors and the assessment of their role in the development of cognitive impairments (CI in CVD form the basis for managing these patients. The issues of treating CI no dementia in patients with CVD are considered. These included the administration of nootropic, vasoactive drugs, as well as agents that exert a modulatory effect on the cholinergic and glutamatergic systems. The use of neuroprotective and neurotrophic drugs is noted to be promising in terms of the multicomponent mechanism of their action. 

  3. The fetal circulation.

    Science.gov (United States)

    Kiserud, Torvid; Acharya, Ganesh

    2004-12-30

    Accumulating data on the human fetal circulation shows the similarity to the experimental animal physiology, but with important differences. The human fetus seems to circulate less blood through the placenta, shunt less through the ductus venosus and foramen ovale, but direct more blood through the lungs than the fetal sheep. However, there are substantial individual variations and the pattern changes with gestational age. The normalised umbilical blood flow decreases with gestational age, and, at 28 to 32 weeks, a new level of development seems to be reached. At this stage, the shunting through the ductus venosus and the foramen ovale reaches a minimum, and the flow through the lungs a maximum. The ductus venosus and foramen ovale are functionally closely related and represent an important distributional unit for the venous return. The left portal branch represents a venous watershed, and, similarly, the isthmus aorta an arterial watershed. Thus, the fetal central circulation is a very flexible and adaptive circulatory system. The responses to increased afterload, hypoxaemia and acidaemia in the human fetus are equivalent to those found in animal studies: increased ductus venosus and foramen ovale shunting, increased impedance in the lungs, reduced impedance in the brain, increasingly reversed flow in the aortic isthmus and a more prominent coronary blood flow.

  4. Doença cerebrovascular tipo "moyamoya" Cerebrovascular "moyamoya" disease: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Reynaldo A. Brandt

    1976-09-01

    ' view that the "moyamoya" disease is a congenital one, since the abnormal vascular network at the base of the brain would not be necessary, in this case, to preserve good collateral circulation to the right cerebral hemisphere. No other case with the typical findings of "moyamoya" disease on one side and hypertrophy of the carotid arteries on the other was found in the literature.

  5. Measurement of anterior and posterior circulation flow contributions to cerebral blood flow. An ultrasound-derived volumetric flow analysis.

    Science.gov (United States)

    Boyajian, R A; Schwend, R B; Wolfe, M M; Bickerton, R E; Otis, S M

    1995-01-01

    Ultrasound-derived volumetric flow analysis may be useful in answering questions of basic physiological interest in the cerebrovascular circulation. Using this technique, the authors have sought to describe quantitatively the complete concurrent flow relations among all four arteries supplying the brain. The aim of this study of normal subjects was to determine the relative flow contributions of the anterior (internal carotid arteries) and posterior (vertebral arteries) cerebral circulation. Comparisons between the observed and theoretically expected anterior and posterior flow distribution would provide an opportunity to assess traditional rheological conceptions in vivo. Pulsed color Doppler ultrasonography was used to measure mean flow rates in the internal carotid and vertebral arteries in 21 normal adults. The anterior circulation (internal carotid arteries bilaterally) carried 82% of the brain's blood supply and comprised 67% of the total vascular cross-sectional area. These values demonstrate precise concordance between observations in vivo and the theoretically derived (Hagen-Poiseuille) expected flow distribution. These cerebrovascular findings support the traditional conception of macroscopic blood flow. Further studies using ultrasound-derived volumetric analysis of the brain's arterial flow relations may illuminate the vascular pathophysiology underlying aging, cerebral ischemia, and dementias.

  6. Modelled Circulation In Storfjorden

    Science.gov (United States)

    Skogseth, R.; Asplin, L.

    The model area Storfjorden is situated between the islands Spitsbergen, Barentsöya and Edgeöya at the Svalbard Archipelago. The entrance of Storfjorden is defined by a shallow bank Storfjordbanken and some small islands Tusenöyane in southeast, and by an 115m deep sill at about 76 45' N in the south. Maximum depth in Storfjorden is 190m, which is surrounded by gradually shallower shelves in the north, the east and southeast. A steep bottom slope is present on the western side of Storfjorden. He- leysundet and Freemansundet, two sounds between respectively Spitsbergen and Bar- entsöya, and Barentsöya and Edgeöya, define two narrow and shallow entrances in the north and northeast connecting Storfjorden with the northwestern Barents Sea. Strong tidal currents exist in Heleysundet (4-5ms-1) and Freemansundet (2-3ms-1), but the general circulation in Storfjorden is not well known. The coastal current in Storfjor- den is cyclonic directed into Storfjorden south of Edgeöya from the East Spitsbergen Current and out of Storfjorden south of Spitsbergen where it is called Sørkappstrøm- men. A three-dimensional sigma layered numerical ocean model called Bergen Ocean Model (BOM) was used to simulate the circulation in Storfjorden with Freemansundet opened. Two simulations were carried out, one with heat flux (100 Wm-2) and one without heat flux from the ocean to the atmosphere. The heat flux was applied only in the proper fjord area north of the sill and not outside as a crude approximation of the effects of a polynya in the sea ice cover during winter. Both simulations had a 4km horizontal resolution and 21 sigma layers. The model is forced by winds (from the NCEP reanalyzed fields) and tides. Initial fields are from the DNMI/IMR climatol- ogy. The model simulation without heat flux gave a circulation heavily dependent on tidal forcing, showing strong tidal currents up to 2ms-1 in Freemansundet, between Tusenöyane and on Storfjordbanken southwest of Edgeöya. Earlier

  7. Resolvability in Circulant Graphs

    Institute of Scientific and Technical Information of China (English)

    Muhammad SALMAN; Imran JAVAID; Muhammad Anwar CHAUDHRY

    2012-01-01

    A set W of the vertices of a connected graph G is called a resolving set for G if for every two distinct vertices u,v ∈ V(G) there is a vertex w ∈ W such that d(u,w) ≠ d(v,w).A resolving set of minimum cardinality is called a metric basis for G and the number of vertices in a metric basis is called the metric dimension of G,denoted by dim(G).For a vertex u of G and a subset S of V(G),the distance between u and S is the number mins∈s d(u,s).A k-partition H ={S1,S2,...,Sk} of V(G) is called a resolving partition if for every two distinct vertices u,v ∈ V(G) there is a set Si in Π such that d(u,Si) ≠ d(v,Si).The minimum k for which there is a resolving k-partition of V(G) is called the partition dimension of G,denoted by pd(G).The circulant graph is a graph with vertex set Zn,an additive group ofintegers modulo n,and two vertices labeled i and j adjacent if and only if i - j (mod n) ∈ C,where C C Zn has the property that C =-C and 0(∈) C.The circulant graph is denoted by Xn,△ where A =|C|.In this paper,we study the metric dimension of a family of circulant graphs Xn,3 with connection set C ={1,-n/2,n - 1} and prove that dim(Xn,3) is independent of choice of n by showing that 3 for all n =0 (mod 4),dim(X,n,3) ={ 4 for all n =2 (mod 4).We also study the partition dimension of a family of circulant graphs Xn,4 with connection set C ={±1,±2} and prove that pd(Xn,4) is independent of choice of n and show that pd(X5,4) =5 and 3 forall odd n≥9,pd(Xn,4) ={ 4 for all even n ≥ 6 and n =7.

  8. North Atlantic Circulation

    Science.gov (United States)

    Molinari, R.; Bryan, K.; Schott, F.

    The intensity of the North Atlantic winddriven and thermohaline circulation and the close proximity of many oceanographic installations make the North Atlantic a particularly favored region of the world ocean from the standpoint of research in ocean circulation. Recent increases in available data and advances in numerical modeling techniques served as the impetus to convene a joint workshop of modelers and observers working on the North Atlantic with the Scientific Committee on Oceanic Research (SCOR) Working Group (WG) 68 (“North Atlantic Circulation”). Goals of the workshop were to provide an update on data sets and models and to discuss the poleward heat flux problem and possible monitoring strategies. The joint Workshop/SCOR WG-68 meeting was convened by F. Schott (chairman of the working group; Rosenstiel School of Marine and Atmospheric Science, Miami, Fla.), K. Bryan (National Oceanic and Atmospheric Administration/ Geophysical Fluid Dynamics Laboratory (NOAA/GFDL)), and R. Molinari (NOAA/Atlantic Oceanographic and Meteorological Laboratory (NOAA/AOML)).

  9. Circulation of Stars

    Science.gov (United States)

    Boitani, P.

    2016-01-01

    Since the dawn of man, contemplation of the stars has been a primary impulse in human beings, who proliferated their knowledge of the stars all over the world. Aristotle sees this as the product of primeval and perennial “wonder” which gives rise to what we call science, philosophy, and poetry. Astronomy, astrology, and star art (painting, architecture, literature, and music) go hand in hand through millennia in all cultures of the planet (and all use catasterisms to explain certain phenomena). Some of these developments are independent of each other, i.e., they take place in one culture independently of others. Some, on the other hand, are the product of the “circulation of stars.” There are two ways of looking at this. One seeks out forms, the other concentrates on the passing of specific lore from one area to another through time. The former relies on archetypes (for instance, with catasterism), the latter constitutes a historical process. In this paper I present some of the surprising ways in which the circulation of stars has occurred—from East to West, from East to the Far East, and from West to East, at times simultaneously.

  10. Time series analysis of the association between ambient temperature and cerebrovascular morbidity in the elderly in Shanghai, China

    Science.gov (United States)

    Zhang, Xian-Jing; Ma, Wei-Ping; Zhao, Nai-Qing; Wang, Xi-Ling

    2016-01-01

    Research on the association between ambient temperature and cerebrovascular morbidity is scarce in China. In this study, we applied mixed generalized additive model (MGAM) to daily counts of cerebrovascular disease of Shanghai residents aged 65 years or older from 2007–2011, stratified by gender. Weighted daily mean temperature up to lags of one week was smoothed by natural cubic spline, and was added into the model to assess both linear and nonlinear effects of temperature. We found that when the mean temperature increased by 1 °C, the male cases of cerebrovascular disease reduced by 0.95% (95% Confidence Interval (CI): 0.80%, 1.10%) or reduced by 0.34% (95% CI: ‑0.68, 1.36%) in conditions of temperature was below or above 27 °C. However, for every 1 °C increase in temperature, the female cases of cerebrovascular disease increased by 0.34% (95% CI: ‑0.26%, 0.94%) or decreased by 0.92% (95% CI: 0.72, 1.11%) in conditions of temperature was below or above 8 °C, respectively. Temperature and cerebrovascular morbidity is negatively associated in Shanghai. MGAM is recommended in assessing the association between environmental hazards and health outcomes in time series studies.

  11. Increased serum C-reactive protein level in Japanese patients of psoriasis with cardio- and cerebrovascular disease.

    Science.gov (United States)

    Takahashi, Hidetoshi; Iinuma, Shin; Honma, Masaru; Iizuka, Hajime

    2014-11-01

    Psoriasis is a chronic inflammatory skin disease, which may be associated with metabolic syndrome accompanied by cardio- and cerebrovascular diseases. We investigated the relation between serum C-reactive protein (CRP) and cardio- and cerebrovascular diseases in Japanese psoriasis vulgaris patients. Ninety-seven psoriasis vulgaris patients and 79 healthy controls were assessed for serum CRP levels by immunoturbidimetry. The data were analyzed in terms of Psoriasis Area and Severity Index (PASI) scores, and comorbidity of cardio- and cerebrovascular disease and metabolic syndrome. Serum CRP levels in psoriasis vulgaris patients were significantly higher than those of healthy controls. There was no significant difference between male and female CRP levels in either psoriasis or healthy controls. No correlation was detected between PASI scores and serum CRP levels, either. Psoriasis with cardio- and cerebrovascular disease showed significantly higher CRP levels compared with those without the diseases. Furthermore, psoriasis with metabolic syndrome showed significantly higher serum CRP levels than those without the metabolic syndrome. In conclusion, serum CRP level is increased in psoriasis, and may be a useful marker for the prediction of the future risk of cardio- and cerebrovascular disease.

  12. Osteoprotegerin CGA haplotype protection against cerebrovascular complications in anti-CCP negative patients with rheumatoid arthritis.

    Directory of Open Access Journals (Sweden)

    Fernanda Genre

    Full Text Available Rheumatoid arthritis is an inflammatory disease with high incidence of cardiovascular disease due to accelerated atherosclerosis. Osteoprotegerin (OPG has been associated with increased risk of atherosclerotic disease in the general population. Several polymorphisms in the OPG gene with functional effects on cardiovascular disease in non-rheumatic individuals have been described. Therefore, we aimed to analyze the effect of three of these functional OPG polymorphisms on the risk of cardiovascular disease in a large and well-characterized cohort of Spanish patients with rheumatoid arthritis.Three OPG gene variants (rs3134063, rs2073618 and rs3134069 were genotyped by TaqMan assays in 2027 Spanish patients with rheumatoid arthritis. Anti-cyclic citrullinated peptide (anti-CCP antibody testing was positive in 997 of 1714 tested. Also, 18.3% of the whole series had experienced cardiovascular events, including 5.4% with cerebrovascular accidents. The relationship between OPG variants and cardiovascular events was assessed using Cox regression.No association between OPG gene variants and cardiovascular disease was observed in the whole group of rheumatoid arthritis patients or in anti-CCP positive patients. Nevertheless, a protective effect of CGA haplotype on the risk of cardiovascular disease in general, and specifically in the risk of cerebrovascular complications after adjusting for sex, age at disease diagnosis and traditional cardiovascular risk factors was disclosed in anti-CCP negative patients (HR = 0.54; 95%CI: 0.31-0.95; p = 0.032 and HR = 0.17; 95%CI: 0.04-0.78; p = 0.022, respectively.Our results indicate a protective effect of the OPG CGA haplotype on cardiovascular risk, mainly due to a protective effect against cerebrovascular events in anti-CCP negative rheumatoid arthritis patients.

  13. Trends in Mortality from Cerebrovascular and Hypertensive Diseases in Brazil Between 1980 and 2012

    Directory of Open Access Journals (Sweden)

    Paolo Blanco Villela

    2016-01-01

    Full Text Available Abstract Background: Cerebrovascular and hypertensive diseases are among the main causes of death worldwide. However, there are limited data about the trends of these diseases over the years. Objective: To evaluate the temporal trends in mortality rates and proportional mortality from cerebrovascular and hypertensive diseases according to sex and age in Brazil between 1980 and 2012. Methods: We evaluated the underlying causes of death between 1980 and 2012 in both sexes and by age groups for circulatory diseases (CD, cerebrovascular diseases (CBVD, and hypertensive diseases (HD. We also evaluated death due to all causes (AC, external causes (EC, and ill-defined causes of death (IDCD. Data on deaths and population were obtained from the Department of Information Technology of the Unified Health System (Departamento de Informática do Sistema Único de Saúde, DATASUS/MS. We estimated crude and standardized annual mortality rates per 100,000 inhabitants and percentages of proportional mortality rates. Results: With the exception of EC, the mortality rates per 100,000 inhabitants of all other diseases increased with age. The proportional mortality of CD, CBVD, and HD increased up to the age range of 60-69 years in men and 70-79 years in women, and reached a plateau in both sexes after that. The standardized rates of CD and CBVD declined in both sexes. However, the HD rates showed the opposite trend and increased mildly during the study period. Conclusion: Despite the decline in standardized mortality rates due to CD and CBVD, there was an increase in deaths due to HD, which could be related to factors associated with the completion of the death certificates, decline in IDCD rates, and increase in the prevalence of hypertension.

  14. The balance between cognitive reserve and brain imaging biomarkers of cerebrovascular and Alzheimer's diseases.

    Science.gov (United States)

    Murray, Alison D; Staff, Roger T; McNeil, Christopher J; Salarirad, Sima; Ahearn, Trevor S; Mustafa, Nazahah; Whalley, Lawrence J

    2011-12-01

    The cognitive reserve hypothesis explains the disparity between clinical and pathological phenotypes and why, in two individuals with the same extent of neuropathology, one may be demented while the other remains cognitively intact. We examined the balance between brain magnetic resonance imaging measures of the two most common pathologies associated with brain ageing, cerebrovascular disease and Alzheimer's disease, and parameters of cerebral reserve in well-characterized participants born in 1936, for whom childhood intelligence is known. Brain magnetic resonance imaging was carried out at 1.5T using fluid attenuation inversion recovery and T(1)-weighted volumetric sequences in 249 participants. Cerebrovascular disease was quantified by measuring brain white matter hyperintensities on fluid attenuation inversion recovery images using Scheltens' scale and Alzheimer's disease was measured from volumetric data using FreeSurfer to extract whole brain volume and hippocampal volumes in turn. The effect of these measures of brain burden on life-long cognitive ageing from the age of 11 to 68 years was compared with the effect of educational attainment and occupational grade using structural equation modelling. Complete brain burden and reserve data were available in 224 participants. We found that educational attainment, but not occupation, has a measurable and positive effect, with a standardized regression weight of +0.23, on late life cognitive ability in people without cognitive impairment aged 68 years, allowing for the influence of childhood intelligence and the two most common subclinical brain pathological burdens in the ageing brain. In addition, we demonstrate that the magnitude of the contribution of education is greater than the negative impact of either neuropathological burden alone, with standardized regression weights of -0.14 for white matter hyperintensities and -0.20 for hippocampal atrophy. This study illustrates how education counteracts the

  15. Trends in Mortality from Cerebrovascular and Hypertensive Diseases in Brazil Between 1980 and 2012

    Science.gov (United States)

    Villela, Paolo Blanco; Klein, Carlos Henrique; de Oliveira, Gláucia Maria Moraes

    2016-01-01

    Background Cerebrovascular and hypertensive diseases are among the main causes of death worldwide. However, there are limited data about the trends of these diseases over the years. Objective To evaluate the temporal trends in mortality rates and proportional mortality from cerebrovascular and hypertensive diseases according to sex and age in Brazil between 1980 and 2012. Methods We evaluated the underlying causes of death between 1980 and 2012 in both sexes and by age groups for circulatory diseases (CD), cerebrovascular diseases (CBVD), and hypertensive diseases (HD). We also evaluated death due to all causes (AC), external causes (EC), and ill-defined causes of death (IDCD). Data on deaths and population were obtained from the Department of Information Technology of the Unified Health System (Departamento de Informática do Sistema Único de Saúde, DATASUS/MS). We estimated crude and standardized annual mortality rates per 100,000 inhabitants and percentages of proportional mortality rates. Results With the exception of EC, the mortality rates per 100,000 inhabitants of all other diseases increased with age. The proportional mortality of CD, CBVD, and HD increased up to the age range of 60-69 years in men and 70-79 years in women, and reached a plateau in both sexes after that. The standardized rates of CD and CBVD declined in both sexes. However, the HD rates showed the opposite trend and increased mildly during the study period. Conclusion Despite the decline in standardized mortality rates due to CD and CBVD, there was an increase in deaths due to HD, which could be related to factors associated with the completion of the death certificates, decline in IDCD rates, and increase in the prevalence of hypertension. PMID:27355586

  16. Cerebrovascular reactivity among native-raised high altitude residents: an fMRI study

    Directory of Open Access Journals (Sweden)

    Zhang Jiaxing

    2011-09-01

    Full Text Available Abstract Background The impact of long term residence on high altitude (HA on human brain has raised concern among researchers in recent years. This study investigated the cerebrovascular reactivity among native-born high altitude (HA residents as compared to native sea level (SL residents. The two groups were matched on the ancestral line, ages, gender ratios, and education levels. A visual cue guided maximum inspiration task with brief breath holding was performed by all the subjects while Blood-Oxygenation-Level-Dependent (BOLD functional Magnetic Resonance Imaging (fMRI data were acquired from them. Results Compared to SL controls, the HA group showed generally decreased cerebrovascular reactivity and longer delay in hemodynamic response. Clusters showing significant differences in the former aspect were located at the bilateral primary motor cortex, the right somatosensory association cortex, the right thalamus and the right caudate, the bilateral precuneus, the right cingulate gyrus and the right posterior cingulate cortex, as well as the left fusiform gyrus and the right lingual cortex; clusters showing significant differences in the latter aspect were located at the precuneus, the insula, the superior frontal and temporal gyrus, the somatosensory cortex (the postcentral gyrus and the cerebellar tonsil. Inspiratory reserve volume (IRV, which is an important aspect of pulmonary function, demonstrated significant correlation with the amount of BOLD signal change in multiple brain regions, particularly at the bilateral insula among the HA group. Conclusions Native-born HA residents generally showed reduced cerebrovascular reactivity as demonstrated in the hemodynamic response during a visual cue guided maximum inspiration task conducted with BOLD-fMRI. This effect was particularly manifested among brain regions that are typically involved in cerebral modulation of respiration.

  17. Avoidable 30-Day Readmissions Among Patients With Stroke and Other Cerebrovascular Disease

    Science.gov (United States)

    Nahab, Fadi; Takesaka, Jennifer; Mailyan, Eugene; Judd, Lilith; Culler, Steven; Webb, Adam; Frankel, Michael; Choi, Dennis; Helmers, Sandra

    2012-01-01

    Background: There are limited data on factors associated with 30-day readmissions and the frequency of avoidable readmissions among patients with stroke and other cerebrovascular disease. Methods: University HealthSystem Consortium (UHC) database records were used to identify patients discharged with a diagnosis of stroke or other cerebrovascular disease at a university hospital from January 1, 2007 to December 31, 2009 and readmitted within 30 days to the index hospital. Logistic regression models were used to identify patient and clinical characteristics associated with 30-day readmission. Two neurologists performed chart reviews on readmissions to identify avoidable cases. Results: Of 2706 patients discharged during the study period, 174 patients had 178 readmissions (6.4%) within 30 days. The only factor associated with 30-day readmission was the index length of stay >10 days (vs <5 days; odds ratio [OR] 2.3, 95% CI [1.4, 3.7]). Of 174 patients readmitted within 30 days (median time to readmission 10 days), 92 (53%) were considered avoidable readmissions including 38 (41%) readmitted for elective procedures within 30 days of discharge, 27 (29%) readmitted after inadequate outpatient care coordination, 15 (16%) readmitted after incomplete initial evaluations, 8 (9%) readmitted due to delayed palliative care consultation, and 4 (4%) readmitted after being discharged with inadequate discharge instructions. Only 5% of the readmitted patients had outpatient follow-up recommended within 1 week. Conclusions: More than half of the 30-day readmissions were considered avoidable. Coordinated timing of elective procedures and earlier outpatient follow-up may prevent the majority of avoidable readmissions among patients with stroke and other cerebrovascular disease. PMID:23983857

  18. Effects of yokukansan on anxiety-like behavior in a rat model of cerebrovascular dementia.

    Science.gov (United States)

    Nogami, Ai; Sakata, Yuri; Uchida, Naoki; Yamaguchi, Kazuko; Kawasaki, Chihiro; Shindo, Taro; Kubota, Kaori; Katsurabayashi, Shutaro; Takasaki, Kotaro; Mishima, Kenichi; Nishimura, Ryoji; Fujiwara, Michihiro; Iwasaki, Katsunori

    2011-04-01

    Behavioral and psychological symptoms of dementia (BPSD) are commonly seen in patients with dementia. Current pharmacological approaches to treatment are inadequate, despite the availability of serotonergic agents to ameliorate anxiety, one of the symptoms of BPSD. The herbal medicine yokukansan has been demonstrated to improve BPSD in a randomized, single-blinded, placebo-controlled study. However, the mechanisms of the anxiolytic effect of yokukansan have not been clarified. There are also no reports on the anxiolytic effect of yokukansan in cerebrovascular ischemia models. In this study, we examined whether rats subjected to repeated cerebral ischemia exhibited anxiety-like behavior in a plus-maze task, a light/dark box test and an open-field task. We then investigated the effect of yokukansan on anxiety-like behavior in ischemic rats. Repeated ischemia was induced by the four-vessel occlusion method in which a 10-min ischemic episode was repeated once after 60 min. Yokukansan was orally administered once a day for 14 days from 7 days before ischemia induction. The last administration was performed 1 h before the behavioral experiments. The ischemic rats showed anxiety-like behavior in all three tasks, suggesting that this rat may be a good model for anxiety in cerebrovascular dementia. Yokukansan exhibited anxiolytic effects on the anxiety-like behavior in rats subjected to repeated cerebral ischemia, and exerted antagonistic effects on the wet-dog shakes induced by 1-(2,5-dimethoxy-4-indophenyl)-2-amino propane, a serotonin receptor (5-HT(2A)) agonist. This study revealed that yokukansan shows anxiolytic effects not only in normal animals but also in cerebrovascular model rats.

  19. Uric acid levels and their relation to incapacities in acute cerebrovascular disease Los niveles de ácido úrico y su relación con la discapacidad en la fase aguda de la enfermedad cerebrovascular.

    Directory of Open Access Journals (Sweden)

    Ricardo Verdecia Fraga

    2010-02-01

    Full Text Available Background: cerebrovascular disease and ischemic cardiopathy can be considered as an epidemic and constitute the first cause of incapacities in developed countries. Multiple studies have shown the association between uric acid levels and cerebrovascular diseases. Objective: To correlate the levels of serum uric acid and incapacities in the acute phase of cerebrovascular disease. Methods: A correlational study was carried out with 217 patients with acute cerebrovascular disease. The patient’s incapacity level was measured by using the Barthel Index and those results were related with the serum uric acid levels and other variables. Results: Male patients have higher levels of uric acid (p=0, 04; r=0, 13. Age and Barthel index were p < 0,001; r = -0, 30 and uric acid levels and Barthel Index were p=0, 03; r=-0, 14. The principal predicting factors of incapacity in the acute phase of cerebrovascular disease were the high levels of uric acid, age and diabetes mellitus. Conclusions: It is shown that the highest is the level of uric acid at advanced age; the greatest is the risk of suffering from incapacity in acute phases of cerebrovascular diseases.Fundamento: la enfermedad cerebrovascular y la cardiopatía isquémica pueden considerarse una epidemia, y constituyen además la primera causa de discapacidad en los países desarrollados. Numerosos estudios han demostrado la asociación de los niveles de ácido úrico con la enfermedad cerebrovascular. Objetivo: determinar la relación entre los niveles de ácido úrico sérico y la discapacidad en la fase aguda de la enfermedad cerebrovascular. Métodos: se realizó un estudio correlacional a 217 pacientes con enfermedad cerebrovascular en su fase aguda, en el que se midió el grado de discapacidad mediante el índice de Barthel y se relacionó dicho valor con los

  20. Terapéuticas intervencionistas para el accidente cerebrovascular isquémico

    OpenAIRE

    Rabadán, Alejandra T.; Luciano Sposato; Claudio Mazia

    2010-01-01

    En los últimos 20 años se han desarrollado nuevas opciones para el tratamiento y para la prevención del accidente cerebrovascular (ACV) isquémico, muchas de ellas de carácter intervencionista, tales como la endarterectomía carotídea y la trombolisis intravenosa con activador tisular del plasminógeno. La evidencia científica ha llevado a su difusión y utilización en países desarrollados mientras que en naciones emergentes se observa un retraso en su adopción. Otras modalidades terapéuticas que...

  1. Cerebrovascular disease in South Asia – Part II: Risk factors and prevention

    Directory of Open Access Journals (Sweden)

    2012-11-01

    Full Text Available In South Asian countries, conventional vascular risk factors like hypertension, diabetes mellitus, cardiac disease, smoking, obesity, atrial fibrillation are the dominant ones, while other aetiologies like rheumatic heart disease, infective meningitis-related infarcts and postpartum cerebral venous thrombosis also constitute a big fraction. This review discusses the evidence of prevalence of various risk factors in South Asian countries and possible measures to combat the rising burden of cerebrovascular disease. The last part of the review discusses prevention and identification of risk factors that are unique to or especially found in patient population of South Asia.

  2. Utilidad de los biomarcadores en el diagnóstico de la enfermedad cerebrovascular silente

    OpenAIRE

    Vilar Bergua, Andrea

    2016-01-01

    Hoy en día, las enfermedades cerebrovasculares tienen un impacto muy importante en la sociedad en países desarrollados, en el nuestro, son una causa muy frecuente de hospitalización, muerte y discapacidad. Además, el envejecimiento de la población conlleva un incremento en la incidencia de estas enfermedades, así como del coste sanitario asociado. Desde hace años, sabemos que los infartos cerebrales pueden darse en ausencia de síntomas acompañantes sugestivos de ictus y en ese caso, hablamos ...

  3. Tratamiento de la heminegligencia tras un accidente cerebrovascular. Revisión sistemática.

    OpenAIRE

    Serrano Galiano, Sara

    2013-01-01

    La heminegligencia es una alteración cognitiva que se caracteriza por la falta de atención del individuo hacia el lado contralateral a la lesión cerebral y suele adquirirse como consecuencia de un trastorno cerebrovascular. Habitualmente va a ir aparejada con otras alteraciones derivadas del origen de la misma como problemas en el área motora. (1) Los síntomas de la heminegligencia se observan al menos en el 25-30% los pacientes con lesión cerebral derecha aguda (2) y aunque la mayor parte...

  4. Transferencia del aprendizaje motor en pacientes con antecedentes de accidente cerebrovascular: serie de casos

    OpenAIRE

    Karen Castro-Medina; Mayra Pérez-Páez; Fabiola Moscoso-Alvarado; Clarice Tanaka

    2015-01-01

    Antecedentes. La rehabilitación es un proceso de reaprendizaje motor, que mejora el desempeño en términos de adquisición de nuevas habilidades y adaptación o refinamiento de habilidades aprendidas previamente. A pesar de este conocimiento, existen, considerablemente, pocos estudios que describan el aprendizaje motor después de un accidente cerebrovascular (ACV) y la relevancia del mismo en los procesos de rehabilitación y recuperación. Objetivo. Describir la transferencia del aprendizaje moto...

  5. Muertes por enfermedades cardiacas y accidentes cerebrovasculares prevenibles - (Preventable Deaths from Heart Disease and Stroke)

    Centers for Disease Control (CDC) Podcasts

    2013-09-03

    Este podcast se basa en la edición de septiembre del 2013 del informe Signos Vitales de los CDC. Más de 800,000 personas en los Estados Unidos mueren cada año a causa de enfermedades cardiacas y accidentes cerebrovasculares. Aprenda cómo controlar todos los principales factores de riesgo.  Created: 9/3/2013 by Centers for Disease Control and Prevention (CDC).   Date Released: 9/3/2013.

  6. Subjective and objective knowledge and decisional role preferences in cerebrovascular patients compared to controls

    Directory of Open Access Journals (Sweden)

    Riechel C

    2016-08-01

    Full Text Available Christina Riechel,1,* Anna Christina Alegiani,1,* Sascha Köpke,2 Jürgen Kasper,3,4 Michael Rosenkranz,1,5 Götz Thomalla,1 Christoph Heesen1,4 1Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 2Nursing Research Unit, Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany; 3Department of Health and Caring Sciences, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway; 4Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 5Department of Neurology, Albertinen-Krankenhaus, Hamburg, Germany *These authors contributed equally to this work Background: Risk knowledge and active role preferences are important for patient involvement in treatment decision-making and adherence. Although knowledge about stroke warning signs and risk factors has received considerable attention, objective knowledge on secondary prevention and further self-esteem subjective knowledge have rarely been studied. The aim of our study was to investigate knowledge and treatment decisional role preferences in cerebrovascular patients compared to controls. Methods: We performed a survey on subjective and objective stroke risk knowledge and autonomy preferences in cerebrovascular patients from our stroke outpatient clinic (n=262 and from pedestrians on the street taken as controls during a “World Stroke Day” (n=274. The questionnaire includes measures for knowledge and decisional role preferences from previously published questionnaires and newly developed measures, for example, subjective knowledge, revealed on a visual analog scale. Results: The overall stroke knowledge was low to moderate, with no differences between patients and controls. Knowledge about secondary prevention was particularly low. Only 10%–15% of participants correctly estimated the stroke absolute risk reduction potential of aspirin. The medical data

  7. Congenital spine deformities: a new screening indication for blunt cerebrovascular injuries after cervical trauma?

    Science.gov (United States)

    Capone, Christine; Burjonrappa, Sathyaprasad

    2010-12-01

    Blunt cerebrovascular injuries (BCVI) carry significant morbidity if not diagnosed and treated early. A high index of clinical suspicion is needed to recognize the injury patterns associated with this condition and to order the requisite imaging studies needed to diagnose it accurately. We report of BCVI associated with a congenital cervical spine malformation after blunt trauma. We recommend inclusion of cervical spine malformations to the current Eastern Association for the Surgery of Trauma screening criteria for BCVI and explain our rationale for the same.

  8. Warfarin therapy and incidence of cerebrovascular complications in left-sided native valve endocarditis

    DEFF Research Database (Denmark)

    Snygg-Martin, U; Rasmussen, Rasmus Vedby; Hassager, C;

    2011-01-01

    Anticoagulant therapy has been anticipated to increase the risk of cerebrovascular complications (CVC) in native valve endocarditis (NVE). This study investigates the relationship between ongoing oral anticoagulant therapy and the incidence of symptomatic CVC in left-sided NVE. In a prospective...... factors for CVC, while warfarin on admission (aOR 0.26, 95% CI 0.07-0.94), history of congestive heart failure (adjusted OR 0.22, 95% CI 0.1-0.52) and previous endocarditis (aOR 0.1, 95% CI 0.01-0.79) correlated with lower CVC frequency....

  9. Lost circulation technology development status

    Energy Technology Data Exchange (ETDEWEB)

    Glowka, D.A.; Schafer, D.M.; Loeppke, G.E.; Scott, D.D.; Wernig, M.D.; Wright, E.K.

    1992-07-01

    Lost circulation is the loss of drilling fluid from the wellbore to fractures or pores in the rock formation. In geothermal drilling, lost circulation is often a serious problem that contributes greatly to the cost of the average geothermal well. The Lost Circulation Technology Development Program is sponsored at Sandia National Laboratories by the US Department of Energy. The goal of the program is to reduce lost circulation costs by 30--50% through the development of mitigation and characterization technology. This paper describes the technical progress made in this program during the period April 1991--March 1992. 8 refs.

  10. Percutaneous interventions in Fontan circulation

    Directory of Open Access Journals (Sweden)

    Eduardo Franco

    2015-09-01

    Conclusions: Interventional catheterization procedures are often necessary to reach and maintain the fragile Fontan circulation, mainly in patients with right morphology systemic ventricles and fenestrated Fontan conduits.

  11. Long-term effects of pioglitazone on first attack of ischemic cerebrovascular disease in older people with type 2 diabetes: A case-control study in Taiwan.

    Science.gov (United States)

    Lai, Shih-Wei; Lin, Hsien-Feng; Lin, Cheng-Li; Liao, Kuan-Fu

    2016-08-01

    Long-term studies demonstrating the effect of pioglitazone use on primary prevention of ischemic cerebrovascular disease in older people with type 2 diabetes mellitus are lacking. This study investigated the relationship between pioglitazone use and first attack of ischemic cerebrovascular disease in Taiwan.We conducted a case-control study using the database of the Taiwan National Health Insurance Program. There were 2359 type 2 diabetic subjects aged ≥65 years with newly diagnosed ischemic cerebrovascular disease from 2005 to 2011 as the case group and 4592 sex- and age-matched, randomly selected type 2 diabetic subjects aged ≥65 years without ischemic cerebrovascular disease as the control group. The odds ratio (OR) with 95% confidence interval (CI) of ischemic cerebrovascular disease associated with pioglitazone use was measured by the multivariable unconditional logistic regression model.After adjustment for confounding factors, the multivariable logistic regression analysis disclosed that the adjusted ORs of first attack of ischemic cerebrovascular disease associated with cumulative duration of using pioglitazone were 3.34 for pioglitazone use does not have a protective effect on primary prevention for ischemic cerebrovascular disease among older people with type 2 diabetes mellitus during the first 3 years of use. Whether using pioglitazone for >3 years would have primary prevention for ischemic cerebrovascular disease needs a long-term research to prove.

  12. Prevention of Stroke in Patients With Silent Cerebrovascular Disease : A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

    NARCIS (Netherlands)

    Smith, Eric E; Saposnik, Gustavo; Biessels, Geert Jan; Doubal, Fergus N; Fornage, Myriam; Gorelick, Philip B; Greenberg, Steven M; Higashida, Randall T; Kasner, Scott E; Seshadri, Sudha

    2017-01-01

    Two decades of epidemiological research shows that silent cerebrovascular disease is common and is associated with future risk for stroke and dementia. It is the most common incidental finding on brain scans. To summarize evidence on the diagnosis and management of silent cerebrovascular disease to

  13. Prescripción facilitada de drogas antihipertensivas y disminución de la muerte prematura por accidente cerebrovascular

    OpenAIRE

    Javier Mariani; Marina Ridao; Gabriel González; Mauricio Monsalvo; Alejandro Macchia

    2016-01-01

    Introducción: Desde 2003, el programa Remediar (+Redes) distribuye gratuitamente medicación antihipertensiva. Durante este período, la mortalidad por accidente cerebrovascular disminuyó, aunque con inequidades entre grupos socioeconómicos. Objetivos: Evaluar la asociación entre la mortalidad por accidente cerebrovascular y la provisión de fármacos antihipertensivos. Estudiar la posible interacción entre los efectos de los antihipertensivos sobre la mortalidad y el nivel socioeconómico. ...

  14. [Variants of the clinical course of cerebrovascular diseases in various biogeochemical regions of the Ukrainian Carpathian Mountains].

    Science.gov (United States)

    Buletsa, B A; Fatula, M I; Fabri, Z I

    1990-01-01

    A total of 417 patients with cerebral circulatory disorders were examined in two biogeochemical regions of the UkrainianCarpathian Mountains. The first one is a region with iodine insufficiency; the second one is a region where the people use table salt in excess. It has been established that iodine insufficiency and excessive iodine concentration in the body of man are risk factors of the development of cerebrovascular disease. Besides, in persons with abnormal iodine metabolism, cerebrovascular diseases run a graver course than in those with normal content in the body of these trace elements.

  15. Función pulmonar en sujetos con hemiparesia crónica secundaria a un accidente cerebrovascular

    OpenAIRE

    Guerrero Gómez, Alba

    2016-01-01

    Antecedentes: las Enfermedades Cerebrovasculares se sitúan como la primera causa de muerte entre las mujeres y la tercera en hombres a nivel nacional. Son numerosas las secuelas que pueden sufrir los supervivientes, entre las que se encuentran las alteraciones del control motor y del tono muscular. Estas son las que hacen plantearse el grado de afectación de la musculatura implicada en la ventilación tras un Accidente Cerebrovascular, ya sea de manera directa o mediante la alteración de las c...

  16. Muerte prematura por accidente cerebrovascular y condición socioeconómica en la Argentina

    OpenAIRE

    Mauricio Monsalvo; Anabel Fernández Prieto; Alejandro Macchia

    2016-01-01

    Introducción: La asociación entre mortalidad por accidente cerebrovascular y el nivel socioeconómico está escasamente descripta en Argentina. Objetivos: Describir la evolución temporal de la mortalidad por accidente cerebrovascular y su asociación con el nivel socioeconómico en Argentina entre 2000 y 2011. Material y métodos: Se realizó un estudio ecológico longitudinal. La mortalidad se cuantificó mediante tasas estandarizadas por edad y sexo, y el nivel socioeconómico mediante quint...

  17. [Research on distribution of patents' holders for Chinese herbal compounds in treating cardiovascular and cerebrovascular based on cluster analysis].

    Science.gov (United States)

    YANG, Xu-Jie; XIAO, Shi-Ying

    2015-09-01

    To discuss the distribution of patents' holders for Chinese herbal compounds in treating cardiovascular and cerebrovascular, the patents' holders for Chinese herbal compounds in treating cardiovascular and cerebrovascular were cluster analyzed by means of simple statistics and cluster analysis. Clustering variables were composed of patent applications, patent maintained number, related papers' quantity, etc. Chinese herbal compound patents' holders were divided into four categories according to their different scientific research and patent strength. It is the magic weapon for Chinese herbal compound patents' holders that have scientific research patents' transforming and make coordination of patent protection and scientific innovation.

  18. Estudio clínico del proceso conductual de la emergencia del coma grave por accidente cerebrovascular

    OpenAIRE

    2007-01-01

    Objetivos: Estudiar el proceso de la emergencia del coma en pacientes en coma grave por accidente cerebrovascular (ACV). Método: Se han evaluado a 32 pacientes ingresados en una unidad de cuidados intensivos por un coma de origen cerebrovascular. Se ha realizado un seguimiento diario por neuropsicólogos e intensivistas y monitorizado el despertar del coma mediante 8 escalas de evalua ... ción clínica de los niveles de coma. Se han analizado las variables: edad, género, residencia, índice prem...

  19. The complex contribution of NOS interneurons in the physiology of cerebrovascular regulation

    Directory of Open Access Journals (Sweden)

    Sonia eDuchemin

    2012-08-01

    Full Text Available Following the discovery of the vasorelaxant properties of nitric oxide (NO by Furchgott and Ignarro, the finding by Bredt and coll. of a constitutively expressed NO synthase in neurons (nNOS led to the presumption that neuronal NO may control cerebrovascular functions. Consequently, numerous studies have sought to determine whether neuraly-derived NO is involved in the regulation of cerebral blood flow. Anatomically, axons, dendrites or somata of NO neurons have been found to contact the basement membrane of blood vessels or perivascular astrocytes in all segments of the cortical microcirculation. Functionally, various experimental approaches support a role of neuronal NO in the maintenance of resting cerebral blood flow as well as in the vascular response to neuronal activity. Since decades, it has been assumed that neuronal NO simply diffuses to the local blood vessels and produce vasodilation through a cGMP-PKG dependent mechanism. However, NO is not the sole mediator of vasodilation in the cerebral microcirculation and is known to interact with a myriad of signaling pathways also involved in vascular control. In addition, cerebrovascular regulation is the result of a complex orchestration between all components of the neurovascular unit (i.e. neuronal, glial and vascular cells also known to produce NO. In this review article, the role of NO interneuron in the regulation of cortical microcirculation will be discussed in the context of the neurovascular unit.

  20. SPECT with N-isopropyl-p iodoamphetamine in occlusive cerebrovascular diseases.

    Science.gov (United States)

    Higa, T; Tanaka, T; Ikekubo, K; Komatsu, T; Torizuka, K

    1986-12-01

    The role of SPECT imaging with N-isopropyl-p iodoamphetamine (I-123 IMP) in the detection of angiographically documented occlusive cerebrovascular diseases was evaluated in 24 patients, and the results of regional cerebral blood flow (rCBF) were compared with x-ray CT. Twelve patients had internal carotid occlusion, ten had intracranial occlusion beyond the circle of Willis, one had common carotid occlusion, and one had basilar artery occlusion. SPECT images were obtained with a gamma camera, which was rotated 360 degrees around the patient's head 30 minutes after an intravenous injection of 3 mCi of I-123 IMP. CT images in the transverse plane were obtained, and the regions of reduced attenuation were identified for comparison of topographic extension of the lesion with the regions of decreased rCBF seen on SPECT. In six cases, the lesions seen on the SPECT images were distinctly more extensive than those seen on CT. In the remaining 18 cases, the extent of the lesion was identical on both CT and SPECT images. Radiochemical and radionuclide impurities, the distance of the detector from the head, and the nature of the collimator affected the SPECT results. I-123 IMP SPECT imaging complements CT findings in detecting the ischemic zones beyond the regions identified on CT images, and may have a major rule in the management of patients with occlusive cerebrovascular diseases.

  1. Principles and Clinical Application of Dual-energy Computed Tomography in the Evaluation of Cerebrovascular Disease

    Science.gov (United States)

    Hsu, Charlie Chia-Tsong; Kwan, Gigi Nga Chi; Singh, Dalveer; Pratap, Jit; Watkins, Trevor William

    2016-01-01

    Dual-energy computed tomography (DECT) simultaneously acquires images at two X-ray energy levels, at both high- and low-peak voltages (kVp). The material attenuation difference obtained from the two X-ray energies can be processed by software to analyze material decomposition and to create additional image datasets, namely, virtual noncontrast, virtual contrast also known as iodine overlay, and bone/calcium subtraction images. DECT has a vast array of clinical applications in imaging cerebrovascular diseases, which includes: (1) Identification of active extravasation of iodinated contrast in various types of intracranial hemorrhage; (2) differentiation between hemorrhagic transformation and iodine staining in acute ischemic stroke following diagnostic and/or therapeutic catheter angiography; (3) identification of culprit lesions in intra-axial hemorrhage; (4) calcium subtraction from atheromatous plaque for the assessment of plaque morphology and improved quantification of luminal stenosis; (5) bone subtraction to improve the depiction of vascular anatomy with more clarity, especially at the skull base; (6) metal artifact reduction utilizing virtual monoenergetic reconstructions for improved luminal assessment postaneurysm coiling or clipping. We discuss the physical principles of DECT and review the clinical applications of DECT for the evaluation of cerebrovascular diseases. PMID:27512615

  2. Possibilities of using naftidrofuryl in the therapy of cerebrovascular diseases: Literature review and the authors’ observations

    Directory of Open Access Journals (Sweden)

    A. N. Belova

    2015-01-01

    Full Text Available The efficacy of naftidrofuryl in treating cerebrovascular diseases is analyzed on the basis of a review of the Russian and foreign literature. Naftidrofuryl is a seroton 5-HT2 receptor antagonist and acts on brain energy metabolism mainly during hypoxia or ischemia. The results of preclinical studies proving the antispasmodic and neuroprotective properties of the drug and its capacity to normalize microcirculation in hypoxia are briefly considered. Experimental findings served as a basis for further studies of the efficacy of naftidrofuryl in patients with stroke, chronic cerebral ischemia, or vascular dementia. The use of naftidrofuryl (dusopharm was demonstrated to statistically significantly enhance the efficiency of rehabilitation in post-stroke patients and to be followed by significant psychoemotional improvement. According to a Cochrane review, the naftidrofuryl-treated patients with vascular dementia showed a tendency towards better executive and cognitive functions, behavior, and mood. The drug was noted to have a positive effect on the health of patients with chronic cerebral ischemia.The authors provide the data of their trial of naftidrofuryl used in patients with dyscirculatory encephalopathy, which have confirmed its efficacy in this category of patients. The data available in the literature suggest that oral naftidrofuryl has a good tolerability and safety profile in patients with cerebrovascular diseases.

  3. High-intensity interval exercise and cerebrovascular health: curiosity, cause, and consequence.

    Science.gov (United States)

    Lucas, Samuel J E; Cotter, James D; Brassard, Patrice; Bailey, Damian M

    2015-06-01

    Exercise is a uniquely effective and pluripotent medicine against several noncommunicable diseases of westernised lifestyles, including protection against neurodegenerative disorders. High-intensity interval exercise training (HIT) is emerging as an effective alternative to current health-related exercise guidelines. Compared with traditional moderate-intensity continuous exercise training, HIT confers equivalent if not indeed superior metabolic, cardiac, and systemic vascular adaptation. Consequently, HIT is being promoted as a more time-efficient and practical approach to optimize health thereby reducing the burden of disease associated with physical inactivity. However, no studies to date have examined the impact of HIT on the cerebrovasculature and corresponding implications for cognitive function. This review critiques the implications of HIT for cerebrovascular function, with a focus on the mechanisms and translational impact for patient health and well-being. It also introduces similarly novel interventions currently under investigation as alternative means of accelerating exercise-induced cerebrovascular adaptation. We highlight a need for studies of the mechanisms and thereby also the optimal dose-response strategies to guide exercise prescription, and for studies to explore alternative approaches to optimize exercise outcomes in brain-related health and disease prevention. From a clinical perspective, interventions that selectively target the aging brain have the potential to prevent stroke and associated neurovascular diseases.

  4. Study of nanosensor systems for hypertension associated cerebrovascular and cardiovascular disorders

    Science.gov (United States)

    Ramasamy, Mouli; Varadan, Vijay K.

    2015-04-01

    Hypertension and hypertension associated cerebrovascular and cardiovascular diseases are on a rise. At-least 970 million people in the world and Seventy percent of the American adults are affected by high blood pressure, also known as hypertension. Even though blood pressure monitoring systems are readily available, the number of people being affected has been increasing. Most of the blood pressure monitoring systems require cumbersome approaches. Even the noninvasive techniques have not lowered the number of people affected nor did at-least increase the user base of these systems. Uncontrolled or untreated hypertension may lead to various cerebrovascular disorders including stroke, hypertensive crisis, lacunar infarcts intracerebral damage, microaneurysm, and cardiovascular disorders including heart failure, myocardial infraction, and ischemic heart disease. Hypertension is rated as the one of the most important causes of premature death in spite of the technical advances in biomedical technology. This paper briefs a review of the widely adopted blood pressure monitoring methods, research techniques, and finally, proposes a concept of implementing nanosensors and wireless communication for real time non-invasive blood pressure monitoring.

  5. Cardiovascular and cerebrovascular outcomes in elderly hypertensive patients treated with either ARB or ACEI

    Institute of Scientific and Technical Information of China (English)

    Cong Ma; Jian Cao; Xue-Chun Lu; Xin-Hong Guo; Yan Gao; Xian-Feng Liu; Li Fan

    2012-01-01

    Background Although angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) are equally important in the treatment of hypertension, there is less evidence whether they have equal cardiovascular and cerebrovascular protective effects, especially in elder hypertensive patients. This study aims to clarify this unresolved issue. Methods This cross-sectional study included clinical data on 933 aged male patients with hypertension who received either an ARB or ACEI for more than two months between January 2007 and May 2011. The primary outcome was the composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. The secondary endpoints were unstable angina, new atrial fibrillation, and transient ischemic attack. Results The median follow-up time was 24 months. Age, drug types, cerebral infarction history, renal dysfunction history were the independent predictors of the primary endpoint. The risk of an occurrence of a primary endpoint event was higher in the ARB group than the ACEI group [P = 0.037, hazard ratios occurrence was higher in the ARB group than the ACEI group (P = 0.04). In regard to the secondary endpoints, there were no significant were independent predictors of the secondary endpoint. Conclusion ACEI were more effective than ARB in reducing cardiovascular and cerebrovascular morbidity and mortality in aged patients with hypertension.

  6. Use of various CT imaging methods for diagnosis of acute ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    Gang Wang; Xue Cheng; Xianglin Zhang

    2013-01-01

    Thirty-four patients with cerebral infarction and 18 patients with transient ischemic attack were examined by multi-slice spiral CT scan, CT perfusion imaging, and CT angiography within 6 hours after onset. By CT perfusion imaging, 29 cases in the cerebral infarction group and 10 cases in the transient ischemic attack group presented with abnormal blood flow perfusion, which corresponded to the clinical symptoms. By CT angiography, various degrees of vascular stenosis could be detected in 41 patients, including 33 in the cerebral infarction group and eight in the transient ischemic attack group. The incidence of intracranial artery stenosis was higher than that of extracranial artery stenosis. The intracranial artery stenosis was located predominantly in the middle cerebral artery and carotid artery siphon, while the extracranial artery stenosis occurred mainly in the bifurcation of the common carotid artery and the opening of the vertebral artery. There were 34 cases (83%) with convict vascular stenosis and perfusion abnormalities, and five cases (45%) with perfusion abnormalities but without convict vascular stenosis. The incidence of cerebral infarction in patients with National Institutes of Health Stroke Scale scores ≥ 5 points during onset was significantly higher than that in patients with National Institutes of Health Stroke Scale scores < 5 points. These experimental findings indicate that the combined application of various CT imaging methods allows early diagnosis of acute ischemic cerebrovascular disease, which can comprehensively analyze the pathogenesis and severity of acute ischemic cerebrovascular disease at the morphological and functional levels.

  7. Clinical study on magnetic resonance imaging of lacunar infarcts and cerebrovascular high-risk group

    Energy Technology Data Exchange (ETDEWEB)

    Hironaka, Masatoshi (Hiroshima Univ. (Japan). School of Medicine)

    1990-04-01

    Magnetic resonance imaging (MRI) study was performed in 32 patients with recent lacunar stroke. T2-weighted images showed ischemic lesions more clearly than T1-weighted images. Sixty-six percent of 32 patients had periventricular lesions. Eighty-four percent had subcortical white matter lesions. Sixty-nine percent had lesions in basal ganglia. Twenty-eight percent had lesions in brainstem. Periventricular lesions were revealed symmetrically. On the other hand, lesions in other areas were not detected symmetrically. Severe periventricular lesions on MRI were similar to those of Binswanger's disease. Patients with severe periventricular lesions had often hypertension. Moreover, two of them had dementia. Twenty-three patients with transient ischemic attack had less remarkable lesions than patients with lacunar stroke. Thirty-seven patients with a history of cerebrovascular risk factors (hypertension, diabetes mellitus) had severer lesions compared with normal controls. Sixty-one percent of controls, who had no cerebrovascular symptoms and signs, had MRI lesions. These results suggest that MRI is useful for detection of cerebral ischemic lesions with no associated clinical symptoms or signs. (author).

  8. Cranial MR angiography in children with cerebrovascular diseases; Evaluation of new phase contrast technique

    Energy Technology Data Exchange (ETDEWEB)

    Sumida, Masayuki; Uozumi, Tohru; Kuwabara, Satoshi; Kurisu, Kaoru; Ikawa, Fusao; Satoh, Hideki; Yukawa, Osamu; Migita, Keisuke; Hada, Hiroshi (Hiroshima Univ. (Japan). School of Medicine)

    1993-06-01

    We evaluated the phase contrast (PC) method, a new type of MR angiography (MRA), in children with cerebrovascular diseases, and compared it with the time of flight (TOF) method and conventional angiography. The patients were nine children with the following diagnoses: two with arteriovenous malformations (AVM), one with Galenic AVM, one with cavernous angioma, four with moyamoya disease, and one with cerebral infarction. A 1.5 T Signa Advantage and a 3-D PC were used. In AVM and Galenic AVM, feeder, nidus and drainer were demonstrated separately by changing velocity encoding (VENC). In the patient with cavernous angioma, the cortical veins were well demonstrated. In moyamoya disease and infarction, stenosis or obstruction of the main arteries and revascularization after surgery were clearly demonstrated. PC is useful in the diagnosis and follow up of cerebrovascular diseases in children because PC is superior in demonstrating veins and scanning in any direction is possible. However, MRA alone cannot demonstrate small vessels and direction of flow, so preoperative conventional angiography is still necessary. (author).

  9. Cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008482 Risk factors for ischemic lacunar stroke associated headache. HU Wei(胡伟), et al. Dept Neurol, Nanjing General Hosp, Nanjing Milit Command, Nanjing 210002. Chin J Nerv Ment Dis 2008;34(5):262-265. Objective To analyze risk factors of stroke-associated headache (SH) and explore its underlying mechanisms. Methods First-ever lacunar infarction patients (n=371) were extracted from Nanjing Stroke Registration Program.

  10. Cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920743 A prospective trial of hemodilutiontherapy in acute cerebral infarction. DINGMingchen(丁铭臣), et al. Dept Neurol, XuanwuHosp, Capital Instit Med, Beijing, 100053. ChinJ Neurol & Psychiat 1992; 25(3): 146-148. Ninety two patients with acute (<72hours) cerebral infarction involving middle

  11. Cerebrovascular disorder

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930179 A study on senescence of red blood cellin patients with stroke.QIAN Caiyun(钱采韵),et al.Dept Neurol,1st Affili Hosp ZhongshanMed Univ,Guangzhou,510080.Chin J NervMent Dis 1992;18(3):146-148.Measurements of malonyldialdehyde(MDA)and superoxide dismutase(SOD)were per-formed on the patients with cerebral infarction(27 cases),cerebral hemorrhage(18 cases)and42 age-matched healthy controls.The resultsshowed that MDA content increased significant-

  12. Cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950404 Operative treatment of multiple intracranialaneurvsms in one stage.GAO Yongzhong(高永中),etal.Dept Neurosurg.Tianjin Med Coll Hosp.Tianjin,300052.Chin J Nerv & Ment Dis 1994;20(6):329-331In this study,seven patients with intracranial multi-ple aneurysms are reported.Every patient sufferedfrom two aneurysms simultaneously.Totally,therewere fourteen aneurysms(thirteen saccular and onefusiform aneurysm).There was one patient with bilat-eral arterior chorioid artery aneurysms.All of the sac-cular aneurysms were clipped through a single pterion-al approach and the fusiform aneurysm was wrappedwith muscle tissue.After clipping,some of the a-neurysmal sacs were punctured or an angiographical

  13. Doença cerebrovascular: aquisição de linguagem em pré-escolares Cerebrovascular disease: language acquisition in preschool children

    Directory of Open Access Journals (Sweden)

    Karina Tamarozzi de Oliveira

    2005-09-01

    Full Text Available São descritos 10 casos de crianças com idade cronológica entre 5 anos e 1 mês e 5 anos e 11 meses, divididas em grupo de doença cerebrovascular, (G-DCV e grupo controle (Gc. As crianças do G-DCV apresentaram DCV confirmada na fase aguda através de exame neurológico clínico e de imagem na UNICAMP. Nas avaliações utilizou-se triagem audiológica, protocolo de avaliação da linguagem infantil, teste de vocabulário por imagens Peabody, com o objetivo de avaliar os diversos subsistemas lingüísticos e as noções perceptivo-cognitivas. Na análise qualitativa do G-DCV, do ponto de vista fonoaudiológico e neurológico, quando comparado ao Gc, mostrou recuperação completa do distúrbio adquirido de linguagem (DAL em 2 crianças e alterações de linguagem em 3. O estudo dos casos revelou que os diversos aspectos que constituem a linguagem em desenvolvimento na criança pré-escolar devem ser analisados de forma individual, quantitativa e qualitativamente para achados conclusivos.We describe ten children, aging 5 years and 1 month until 5 years and 11 months, when the phonoaudiological assessment was conducted. They are divided according to cerebrovascular disease, in CVD group (CVD-G and control group (cG. Children were seen and CVD was confirmed in the acute phase at UNICAMP hospital. Audiologic assessment, protocol for Infant language assessment, and Peabody picture vocabulary test were used in the evaluations. The qualitative analysis of the subjects from a phonoaudiological and neurological point of view has shown the recovery of acquired language desorder (ALD with no influence whatsoever in the development of 2 subjects and subtle language and/or learning process alterations for 3 subjects. The cases study has revealed that all aspects of language development in preschool children should be analyzed in an individual, quantitative, and qualitative basis to lead to conclusive findings.

  14. Hipertensión arterial sistólica. Impacto sobre la enfermedad cerebrovascular.

    Directory of Open Access Journals (Sweden)

    María C. Valle Campo

    2011-08-01

    Full Text Available Fundamento: La aterosclerosis es un proceso multifactorial sobre el cual actúan varios factores de riesgo. Constituye la principal causa de muerte y de morbilidad en ingresados hospitalarios, y puede ocasionar una acentuada disminución del flujo sanguíneo hacia todos los órganos del cuerpo humano
    Objetivo
    : Determinar el impacto de la hipertensión arterial sistólica sobre la enfermedad cerebrovascular.
    Métodos
    : Se realizó un estudio transversal, observacional y analítico, en 59 fallecidos hipertensos. Se analizaron las arterias cerebrales y se cuantificó la lesión aterosclerótica y su variedad, aplicándose el sistema aterométrico, teniendo en cuenta los tipos de hipertensión arterial. Se emplearon procedimientos estadísticos (medidas de tendencia central y comparativos (prueba de comparación de media aritmética basadas en el test “t” de student.
    Resultados: Los infartos cerebrales recientes fueron más frecuentes en hipertensos sistodiastólicos. No hubo diferencia significativa en cuanto a la edad en el momento de aparición de las lesiones para ambos sexos, pero las mujeres con hipertensión sistólica, fueron significativamente más dañadas desde el punto de vista morfométrico. Se observó correlación significativa para ambos grupos de hipertensos entre tipo de accidente cerebrovascular y variables del sistema aterométrico. Conclusiones: La hipertensión arterial sistólica es un factor importante en la génesis de la enfermedad vasculocerebral y está asociada con la progresión de la placa de ateroma.

    SYSTOLIC HYPERTENSION. IMPACT ON CEREBROVASCULAR DISEASE

    Background: Atherosclerosis is a multifactor process in which several risk factors are involved. It is the leading cause of death and morbidity in hospital admitted patients, and it may cause

  15. A multidisciplinary stroke clinic for outpatient care of veterans with cerebrovascular disease

    Directory of Open Access Journals (Sweden)

    Moran E

    2011-04-01

    Full Text Available Arlene A Schmid1,2,3,4, John R Kapoor5, Edward J Miech1, Deborah Kuehn6, Mary I Dallas7, Robert D Kerns8, Albert C Lo9,10, John Concato11,12, Michael S Phipps13,14,15, Cody D Couch13, Eileen Moran13, Linda S Williams1,2,3,16, Layne A Goble17,18, Dawn M Bravata1,2,3,191Department of Veteran Affairs (VA Health Services Research & Development (HSR&D Center of Excellence on Implementing Evidence-Based Practice (CIEBP, 2VA HSR&D Stroke Quality Enhancement Research Initiative (QUERI Program, Richard L Roudebush VA Medical Center, Indianapolis, IN, USA; 3Regenstrief Institute, Indianapolis, IN, USA; 4Department of Occupational Therapy, Indiana University, IN, USA; 5Department of Medicine, University of Chicago Pritzker School of Medicine, Chicago, IL, USA; 6Nursing Service, 7Physical Medicine and Rehabilitation Service, 8Psychology Service, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA; 9Departments of Neurology, Community Health, and Engineering at Brown University, Providence, RI, USA; 10Providence Veterans Administration Medical Center, Providence, RI, USA; 11Clinical Epidemiology Research Center (CERC, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA; 12Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA; 13Department of Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA; 14Robert Wood Johnson Clinical Scholars Program, 15Department of Neurology, Yale University School of Medicine, New Haven, CT, USA; 16Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA; 17Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC, USA; 18Veterans Administration Medical Center, Charleston, SC, USA; 19Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USABackground: Managing cerebrovascular risk factors is complex and difficult. The objective of this

  16. TROPICAL METEOROLOGY & Climate: Hadley Circulation

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Jian; Vecchi, Gabriel A.

    2015-01-30

    The Hadley circulation, a prominent circulation feature characterized by rising air near the Equator and sinking air in the subtropics, defines the position of dry subtropical areas and is a fundamental regulator of the earth’s energy and momentum budgets. The character of the Hadley circulation, and its related precipitation regimes, exhibits variation and change in response to both climate variability and radiative forcing changes. The strength and position of the Hadley circulation change from year to year paced by El Niño and La Niña events. Over the last few decades of the twentieth century, the Hadley cell has expanded poleward in both hemispheres, with changes in atmospheric composition (including stratospheric ozone depletion and greenhouse gas increases) thought to have contributed to its expansion. This article introduces the basic phenomenology and driving mechanism of the Hadley circulation and discusses its variations under both natural and anthropogenic climate forcings.

  17. Sino-Danish Brain Circulation

    DEFF Research Database (Denmark)

    Bertelsen, Rasmus Gjedssø; Du, Xiangyun; Søndergaard, Morten Karnøe

    2014-01-01

    China is faced with urgent needs to develop an economically and environmentally sustainable economy based on innovation and knowledge. Brain circulation and research and business investments from the outside are central for this development. Sino-American brain circulation and research...... and investment by overseas researchers and entrepreneurs are well described. In that case, the US is the center of global R&D and S&T. However, the brain circulation and research and investments between a small open Scandinavian economy, such as Denmark, and the huge developing economy of China are not well...... understood. In this case, Denmark is very highly developed, but a satellite in the global R&D and S&T system. With time and the growth of China as a R&D and S&T power house, both Denmark and China will benefit from brain circulation between them. Such brain circulation is likely to play a key role in flows...

  18. Prospective, multidisciplinary recording of perioperative errors in cerebrovascular surgery: is error in the eye of the beholder?

    Science.gov (United States)

    Michalak, Suzanne M; Rolston, John D; Lawton, Michael T

    2016-06-01

    OBJECT Surgery requires careful coordination of multiple team members, each playing a vital role in mitigating errors. Previous studies have focused on eliciting errors from only the attending surgeon, likely missing events observed by other team members. METHODS Surveys were administered to the attending surgeon, resident surgeon, anesthesiologist, and nursing staff immediately following each of 31 cerebrovascular surgeries; participants were instructed to record any deviation from optimal course (DOC). DOCs were categorized and sorted by reporter and perioperative timing, then correlated with delays and outcome measures. RESULTS Errors were recorded in 93.5% of the 31 cases surveyed. The number of errors recorded per case ranged from 0 to 8, with an average of 3.1 ± 2.1 errors (± SD). Overall, technical errors were most common (24.5%), followed by communication (22.4%), management/judgment (16.0%), and equipment (11.7%). The resident surgeon reported the most errors (52.1%), followed by the circulating nurse (31.9%), the attending surgeon (26.6%), and the anesthesiologist (14.9%). The attending and resident surgeons were most likely to report technical errors (52% and 30.6%, respectively), while anesthesiologists and circulating nurses mostly reported anesthesia errors (36%) and communication errors (50%), respectively. The overlap in reported errors was 20.3%. If this study had used only the surveys completed by the attending surgeon, as in prior studies, 72% of equipment errors, 90% of anesthesia and communication errors, and 100% of nursing errors would have been missed. In addition, it would have been concluded that errors occurred in only 45.2% of cases (rather than 93.5%) and that errors resulting in a delay occurred in 3.2% of cases instead of the 74.2% calculated using data from 4 team members. Compiled results from all team members yielded significant correlations between technical DOCs and prolonged hospital stays and reported and actual delays (p = 0

  19. Cerebrovascular illness in the province of Cienfuegos. Tendency lines. A six years study Enfermedades cerebrovasculares en la provincia de Cienfuegos. Líneas de tendencia. Estudio de seis años

    Directory of Open Access Journals (Sweden)

    Juan E. Domínguez Suárez

    2006-10-01

    Full Text Available Background: The cerebrovascular diseases constitute the third cause of death and first of handicap in Cuba. They are inside the tasks prioritized by the World Health Organization and they receive special interest in Cienfuegos province, that is one of the populations of more longevity of the country and shows high rates of mortality. Objective: To define the tendency lines, according to the type of cerebrovascular diseases in Cienfuegos province, over the last six years. Methods: There was realized a retrospective, and descriptive study, of a series of cases. The mortality was analyzed for the different types of cerebrovascular diseases. The data were obtained, of the monthly and annual reports of the Commission of cerebrovascular diseases. Results: A half rate of morbidity of 108, 89, was verified by 100 000 habitants; the mortality due to infarct and subarachnoid hemorrhages diminishes. It was not the same in presence of intracerebral hemorrhage, in which was observed an increment. Increased the number of alive patients after the discharge from the hospital, which due to infarct and other cerebrovascular diseases, were handicapped and for their condition generated a load to the society. Conclusions: The intracerebral hemorrhage constitutes the main problem for the mortality and the infarct for the morbidity.

    Fundamento: Las enfermedades cerebrovasculares constituyen la tercera causa de muerte y primera de discapacidad en Cuba. Se encuentran dentro de las tareas priorizadas por la Organización Mundial de la Salud y reciben especial interés en la provincia de Cienfuegos, por encontrarse en ella una de las poblaciones más longevas del país y mostrar tasas elevadas de mortalidad. Objetivo: Definir las líneas de tendencia según el tipo de enfermedades cerebrovasculares en la provincia de Cienfuegos

  20. Correlation between serum fructosamine and hyperglycemia in patients with acute cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    Kaiqiu Chu; Pengpeng Liu; Lijuan Tan; Shuhua Zhou; Lisheng Ren

    2006-01-01

    BACKGROUND: Diabetes mellitus is one of the risk factors in patients with acute cerebral disease, and always leads to stroke or get it worse. There is often a high level of blood glucose in those patients with diabetes mellitus and cerebral disease, but it is hard to distinguish from both kinds of hyperglycemia. Serum fructosamine is said to be correlated with blood glucose.OBJECTIVE: To explore the relationship between serum fructosamine and blood glucose in patients with acute cerebrovascular disease.DESTGN: A case-controlled study.SETTINGS: Department of Clinical Laboratory, Health Department for Cadres and Department of Neurology of Affiliated Hospital, Qingdao University Medical College.PARTICIPANTS: Forty-eight inpatients and outpatients with cerebrovascular diseases were selected from the Department of Neurology, Affiliated Hospital of Qingdao University Medical College from December 2004 to April 2005. All the patients were confirmed with CT and MRI. There were 25 patients with diabetes mellitus secondary cerebrovascular diseases, who met the diagnostic standards of diabetes mellitus set by WHO,including 12 males and 13 females with an average of (60±8) years old, the course of diabetes mellitus ranged from 1 to 21 years.. The other 23 patients had no diabetes mellitus (without diabetes mellitus group), including 14 males and 9 females with an average of (62±6) years old. Meanwhile, another 50 healthy physical examinees in the hospital were selected as control group, including 26 males and 24 females with the average age of (62±5) years old. Informed content was obtained from all the participants.METHODS: Venous blood was drawn from all the participants, and content of blood glucose was assayed by means of glucose oxidase, and the concentration of serum fructosamine was determined by nitroblue tetrazolium colorimetric method. Comparison between groups was performed by the analysis of variance and q test, and the correlation was tested by linear

  1. Transesophageal Echocardiographically-Confirmed Pulmonary Vein Thrombosis in Association with Posterior Circulation Infarction.

    LENUS (Irish Health Repository)

    Kinsella, Justin A

    2010-01-01

    Pulmonary venous thromboembolism has only been identified as a cause of stroke with pulmonary arteriovenous malformations\\/fistulae, pulmonary neoplasia, transplantation or lobectomy, and following percutaneous radiofrequency ablation of pulmonary vein ostia in patients with atrial fibrillation. A 59-year-old man presented with a posterior circulation ischemic stroke. \\'Unheralded\\' pulmonary vein thrombosis was identified on transesophageal echocardiography as the likely etiology. He had no further cerebrovascular events after intensifying antithrombotic therapy. Twenty-eight months after initial presentation, he was diagnosed with metastatic pancreatic adenocarcinoma and died 3 months later. This report illustrates the importance of doing transesophageal echocardiography in presumed \\'cardioembolic\\' stroke, and that potential \\'pulmonary venous thromboembolic\\' stroke may occur in patients without traditional risk factors for venous thromboembolism. Consideration should be given to screening such patients for occult malignancy.

  2. Clinical Characteristics of Cerebrovascular Pathology with Patients Suffering from Ph-Negative Myeloproliferative Disease

    Directory of Open Access Journals (Sweden)

    Marine M. Tanashyan

    2016-09-01

    Full Text Available Background: Disturbances of microcirculation play a significant role in the development and progression of both acute and chronic cerebrovascular diseases (CVD and may be associated with different hemogram abnormalities. One of the reasons of the prothrombogenic state of the endothelium is the increase in the number of blood corpuscles leading to (non-Ph myeloproliferative disorders (MPD including essential thrombocythemia (ET, polycythemia vera (PV, and primary myelofibrosis (PM. Materials and Methods: The study included 167 patients: 102 patients with Ph-MPD and the control group comprising 65 patients with CVD. According to MPD subtype, the patients were divided into three groups: patients with ET (37%, n = 38, male/female 7/31, age 52 ± 7 years, those with PV (40%, n = 41, male/female 20/21, age 50 ± 6 years and those with PM (23%, n = 23, male/female 5/18, age 54 ± 4 years. Results: In 79% (n = 81 of cases in the study group (with Ph-MPD, patients had chronic CVD, with the most frequently identified symptoms being asthenia (92% and headache (72%. Headache in Ph-MPD patients was more frequently (86% associated with PM, while in patients with PV and ET it was equally distributed (70%. Neurological symptoms in 53% of cases were associated with focal changes of the brain on MRI localized in the subcortical area of the frontal and parietal lobes. Twenty-one (21% patients suffered an acute cerebrovascular accident, 8 of them had thrombotic occlusion of one of the internal carotid arteries leading to hemispheric infarcts. Endothelial function (as measured by flow-dependent dilation of the brachial artery was severely impaired in all study groups (median 5% with normal cut-off at 10%, the lowest degree of vasodilator activity being specific for patients with a history of stroke (p = 0.011. Conclusion: Patients suffering from MPD had asymptomatic focal changes in the brain in the absence of concomitant vascular disease (hypertension

  3. The family – care sponsor of patients suffering from cerebrovascular accidents

    Directory of Open Access Journals (Sweden)

    Ourania Govina

    2007-07-01

    Full Text Available The purpose of this bibliographical review is to show the role of the family in the application of care of a patient suffering from a cerebrovascular accident (CVA. CVA's are, second to arthritis, one of the most impairing illnesses in terms of ability that creates the need for training the patient on a new basis and giving the family information on new roles. One of the dimensions of holistic family care is the increased support the patient receives from family care givers. Studies and clinical research both show that informing families on care giver roles is inadequate or non‐existent. Adequate training of nurses to prepare care givers via specialized programs stimulates the family to respond to the new challenge and take on roles that are multidimensional and complicated. It is important that family care givers of people with CVA's are given new information and taught new skills in order for these patients to maximize their own self‐care potential. CVA patients, following the acute phase of their illness and rehabilitation in specialized centers are nursed at home, mainly by their families with the help of healthcare services. Usually, the responsibilities the family takes on are mainly those of self‐care needs of the patient and his motivation, so that he will organize and carry out basic life activities via learning new ways to face everyday life, always within his impaired abilities. Care guidance is a most important nursing intervention so that activities of daily living problems can be addressed. The interventions are tailored according to the care givers' educational level and the patients' needs. CONCLUSIONS The most important findings of the study are: Patients with cerebrovascular accidents have impaired ability concerning mobility, communication and socialization and need special attention and education in order to improve daily life activities. The education of hemiplegic patients with informative intervention, awareness and

  4. Clinical values of intraoperative indocyanine green fluorescence video angiography with Flow 800 software in cerebrovascular surgery

    Institute of Scientific and Technical Information of China (English)

    YE Xun; LIU Xing-ju; MA Li; LIU Ling-tong; WANG Wen-lei; WANG Shuo; CAO Yong

    2013-01-01

    Background Microscope-integrated near-infrared indocyanine green video angiography (ICG-VA) has been used in neurosurgery for a decade.This study aimed to assess the value of intraoperative indocyanine green (ICG) video angiography with Flow 800 software in cerebrovascular surgery and to discover its hemodynamic features and changes of cerebrovascular diseases during surgery.Methods A total of 87 patients who received ICG-VA during various surgical procedures were enrolled in this study.Among them,45 cases were cerebral aneurysms,25 were cerebral arteriovenous malformations (AVMs),and 17 were moyamoya disease (MMD).A surgical microscope integrating an infrared fluorescence module was used to confirm the residual aneurysms and blocking of perforating arteries in aneurysms.Feeder arteries,draining veins,and normal cortical vessels were identified by the time delay color mode of Flow 800 software.Hemodynamic parameters were recorded.All data were analyzed by SPSS version 18.0 (SPSS Inc.,USA).T-test was used to analyze the hemodynamic features of AVMs and MMDs,the influence on peripheral cortex after resection in AVMs,and superficial temporal artery to middle cerebral artery (STA-MCA) bypass in MMDs.Results The visual delay map obtained by Flow 800 software had more advantages than the traditional playback mode in identifying the feeder arteries,draining veins,and their relations to normal cortex vessels.The maximum fluorescence intensity (MFI) and the slope of ICG fluorescence curve of feeder arteries and draining veins were higher than normal peripheral vessels (MFI:584.24±85.86 vs.382.94±91.50,slope:144.95±38.08 vs.69.20±13.08,P <0.05).The artefiovenous transit time in AVM was significantly shorter than in normal cortical vessels ((0.60±0.27) vs.(2.08±1.42) seconds,P <0.05).After resection of AVM,the slope of artery in the cortex increased,which reflected the increased cerebral flow.In patients with MMD,after STA-MCA bypass,cortex perfusion of

  5. Carbon dioxide induced changes in cerebral blood flow and flow velocity: Role of cerebrovascular resistance and effective cerebral perfusion pressure

    NARCIS (Netherlands)

    F. Grüne (Frank); S. Kazmaier (Stephan); R.J. Stolker (Robert J.); G.H. Visser (Gerhard Henk); A. Weyland (Andreas)

    2015-01-01

    textabstractIn addition to cerebrovascular resistance (CVR) zero flow pressure (ZFP), effective cerebral perfusion pressure (CPPe) and the resistance area product (RAP) are supplemental determinants of cerebral blood flow (CBF). Until now, the interrelationship of PaCO2 -induced changes in CBF, CVR,

  6. Influence of remote ischemic preconditioning on cerebral oxygen metabolism and cerebral blood flow indexes of patients with ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    Hui Lu; Ning-Ning Cui; Bin-Cheng Wang

    2016-01-01

    Objective:To study the influence of remote ischemic preconditioning on cerebral oxygen metabolism and cerebral blood flow indexes of patients with ischemic cerebrovascular disease. Methods:A total of 58 patients with ischemic cerebrovascular disease in our hospital from April 2015 to January 2016 were selected as the study object, and 58 patients were randomly divided into two groups, 29 patients in control group were treated with routine treatment, 29 patients in observation group were treated with remote ischemic preconditioning on the basic treatment of control group, then the cerebral oxygen metabolism and cerebral blood flow indexes of two groups before the treatment and at first, third and sixth month after the treatment were respectively detected and compared.Results:The cerebral oxygen metabolism and cerebral blood flow indexes of two groups before the treatment all showed no significant differences (allP>0.05), while the cerebral oxygen metabolism and cerebral blood flow indexes of observation group at first, third and sixth month after the treatment were all significantly better than those before the treatment, and the results were all significantly better than those of control group at the same time too (allP>0.05).Conclusions: The influence of remote ischemic preconditioning on cerebral oxygen metabolism and cerebral blood flow indexes of patients with ischemic cerebrovascular disease are better, and its application value for the patients with ischemic cerebrovascular disease is higher.

  7. Association between ALT level and the rate of cardio/cerebrovascular events in HIV-positive individuals

    DEFF Research Database (Denmark)

    Sabin, Caroline A; Ryom, Lene; Kovari, Helen;

    2013-01-01

    An inverse association between serum alanine aminotransferase (ALT) levels and the risk of myocardial infarction (MI) has been reported in the general population. We investigated associations between ALT levels and the risk of various cardiovascular and cerebrovascular outcomes in a large cohort...

  8. Inhibition of cerebrovascular raf activation attenuates cerebral blood flow and prevents upregulation of contractile receptors after subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Ansar, Saema; Maddahi, Aida; Edvinsson, Lars

    2011-01-01

    of mitogen-activated protein kinase (MAPK) of the extracellular signal-regulated kinase (ERK)1/2 signal pathway. We hypothesize that SAH initiates cerebrovascular ERK1/2 activation, resulting in receptor upregulation. The raf inhibitor will inhibit the molecular events upstream ERK1/2 and may provide...

  9. Cerebrovascular disease in newborn infants: report of three cases with clinical follow-up and brain SPECT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Moura-Ribeiro, Maria Valeriana L. de; Ciasca, Sylvia Maria; Vale-Cavalcanti, Mariza; Etchebehere, Elba C.S.C.; Camargo, Edwaldo E. [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas

    1999-07-01

    The clinical and neurological findings of three neonates with the diagnosis of cerebrovascular disease are reported. The neuropsychological evaluation disclosed impairment of fine motor function, coordination, language, perception and behavioral disturbances. Brain SPECT imaging revealed perfusional deficits in the three cases. (author)

  10. Ultra-sensitive molecular MRI of cerebrovascular cell activation enables early detection of chronic central nervous system disorders.

    Science.gov (United States)

    Montagne, Axel; Gauberti, Maxime; Macrez, Richard; Jullienne, Amandine; Briens, Aurélien; Raynaud, Jean-Sébastien; Louin, Gaelle; Buisson, Alain; Haelewyn, Benoit; Docagne, Fabian; Defer, Gilles; Vivien, Denis; Maubert, Eric

    2012-11-01

    Since endothelial cells can be targeted by large contrast-carrying particles, molecular imaging of cerebrovascular cell activation is highly promising to evaluate the underlying inflammation of the central nervous system (CNS). In this study, we aimed to demonstrate that molecular magnetic resonance imaging (MRI) of cerebrovascular cell activation can reveal CNS disorders in the absence of visible lesions and symptoms. To this aim, we optimized contrast carrying particles targeting vascular cell adhesion molecule-1 and MRI protocols through both in vitro and in vivo experiments. Although, pre-contrast MRI images failed to reveal the ongoing pathology, contrast-enhanced MRI revealed hypoperfusion-triggered CNS injury in vascular dementia, unmasked amyloid-induced cerebrovascular activation in Alzheimer's disease and allowed monitoring of disease activity during experimental autoimmune encephalomyelitis. Moreover, contrast-enhanced MRI revealed the cerebrovascular cell activation associated with known risk factors of CNS disorders such as peripheral inflammation, ethanol consumption, hyperglycemia and aging. By providing a dramatically higher sensitivity than previously reported methods and molecular contrast agents, the technology described in the present study opens new avenues of investigation in the field of neuroinflammation.

  11. The circulation physiology of agroecosystems

    Institute of Scientific and Technical Information of China (English)

    Cao Zhiping; Richard Dawson

    2007-01-01

    This paper represents an effort to enlarge the understanding of the biophysical foundation of agroecosystems by using an analogy with the circulation of the blood in the human body. The circulation function in the human body can be represented as arterial pressure. The factors affecting arterial pressure in the human body have direct counterparts in the cultivation-husbandry system. The relationship between circulation pressure and the factors affecting that pressure in the cultivation-husbandry system are similar to the relationship between the arterial pressure and factors affecting arterial pressure in the human body. Furthermore, circulation resistance in the cultivation-husbandry system can be shown to be analogous to the calculation of peripheral resistance in the human body by Poiseuille's formula.

  12. l-arginine and l-NMMA for assessing cerebral endothelial dysfunction in ischaemic cerebrovascular disease: A systematic review.

    Science.gov (United States)

    Karlsson, William K; Sørensen, Caspar G; Kruuse, Christina

    2017-01-01

    Endothelial dysfunction (ED), in particular cerebral ED, may be an essential biomarker for ischaemic cerebrovascular disease. However, there is no consensus on methods to best estimate cerebral ED. In this systematic review, we evaluate the use of l-arginine and N(G) -monomethyl-l-arginine (l-NMMA) for assessment of cerebral ED. A systematic search of PubMed, EMBASE and the Cochrane Library was done. We included studies investigating cerebrovascular response to l-arginine or l-NMMA in human subjects with vascular risk factors or ischaemic cerebrovascular disease. Seven studies (315 subjects) were eligible according to inclusion and exclusion criteria. Studies investigated the effect of age (n=2), type 2 diabetes mellitus (DM) (n=1), cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) (n=1), leukoaraiosis (n=1), and prior ischaemic stroke or transient ischaemic attack (TIA) (n=2) on cerebral ED. Most studies applied transcranial Doppler to quantify cerebral ED. Endothelium-dependent vasodilatation (EDV) induced by l-arginine was impaired in elderly and subjects with leukoaraiosis, but enhanced in CADASIL patients. Studies including subjects with prior ischaemic stroke or TIA reported both enhanced and impaired EDV to l-arginine. Responses to l-NMMA deviated between subjects with type 2 DM and the elderly. We found only few studies investigating cerebral endothelial responses to l-arginine and l-NMMA in subjects with vascular risk factors or ischaemic cerebrovascular disease. Inconsistencies in results were most likely due to variations in methods and included subject populations. In order to use cerebral ED as a prognostic marker, further studies are required to evaluate the association to cerebrovascular disease.

  13. The Sarcoglycan complex is expressed in the cerebrovascular system and is specifically regulated by astroglial Cx30 channels

    Directory of Open Access Journals (Sweden)

    Anne-Cécile eBoulay

    2015-02-01

    Full Text Available Astrocytes, the most prominent glial cell type in the brain, send specialized processes called endfeet, around blood vessels and express a large molecular repertoire regulating the cerebrovascular system physiology. One of the most striking properties of astrocyte endfeet is their enrichment in gap junction protein Connexin 43 and 30 (Cx43 and Cx30 allowing in particular for direct intercellular trafficking of ions and small signaling molecules through perivascular astroglial networks. In this study, we addressed the specific role of Cx30 at the gliovascular interface. Using an inactivation mouse model for Cx30 (Cx30Δ/Δ, we showed that absence of Cx30 does not affect blood-brain barrier (BBB organization and permeability. However, it results in the cerebrovascular fraction, in a strong upregulation of Sgcg encoding γ-Sarcoglycan (SG, a member of the Dystrophin-associated protein complex (DAPC connecting cytoskeleton and the extracellular matrix. The same molecular event occurs in Cx30T5M/T5M mutated mice, where Cx30 channels are closed, demonstrating that Sgcg regulation relied on Cx30 channel functions. We further characterized the expression of other Sarcoglycan complex (SGC molecules in the cerebrovascular system and showed the presence of α-, β-, δ-, γ-, ε- and ζ- SG, as well as Sarcospan. Their expression was however not modified in Cx30Δ/Δ. These results suggest that a full SGC might be present in the cerebrovascular system, and that expression of one of its member, γ-Sarcoglycan, depends on Cx30 channels. As described in skeletal muscles, the SGC may contribute to membrane stabilization and signal transduction in the cerebrovascular system, which may therefore be regulated by Cx30 channel-mediated functions.

  14. Neuroimaging: biochemical principles and its application in the cerebrovascular ischemic disease.

    Directory of Open Access Journals (Sweden)

    Zenaida Milagros Hernández Díaz

    2009-07-01

    Full Text Available The knowledge of neurobiochemical principles has allowed understanding the ischemic cascade that takes place after the decrease of cerebral blood flow and the findings that are visualized in neuroimaging studies in cerebrovascular ischemic disease. The need for early diagnosis of acute events to reestablish the cerebral blood flow to reduce neurological sequels, has led to the development of advanced imaging techniques, which allows following the histochemical and morphological changes that take place within the brain in vivo, in a non-invasive way, as well as its development, extent of the cerebral damage and damaged cerebral structures. The present bibliographic review has the objective of supporting the importance of neuroimaging studies in the diagnosis of acute cerebral ischemia.

  15. Acute exercise stress reveals cerebrovascular benefits associated with moderate gains in cardiorespiratory fitness.

    Science.gov (United States)

    Brugniaux, Julien V; Marley, Christopher J; Hodson, Danielle A; New, Karl J; Bailey, Damian M

    2014-12-01

    Elevated cardiorespiratory fitness improves resting cerebral perfusion, although to what extent this is further amplified during acute exposure to exercise stress and the corresponding implications for cerebral oxygenation remain unknown. To examine this, we recruited 12 moderately active and 12 sedentary healthy males. Middle cerebral artery blood velocity (MCAv) and prefrontal cortical oxyhemoglobin (cO(2)Hb) concentration were monitored continuously at rest and throughout an incremental cycling test to exhaustion. Despite a subtle elevation in the maximal oxygen uptake (active: 52±9 ml/kg per minute versus sedentary: 33±5 ml/kg per minute, Pexercise. Collectively, these findings indicate that the long-term benefits associated with moderate increase in physical activity are not observed in the resting state and only become apparent when the cerebrovasculature is challenged by acute exertional stress. This has important clinical implications when assessing the true extent of cerebrovascular adaptation.

  16. Multimodal CT techniques for cerebrovascular and hemodynamic evaluation of ischemic stroke: occlusion, collaterals, and perfusion.

    Science.gov (United States)

    Jia, Baixue; Scalzo, Fabien; Agbayani, Elijah; Woolf, Graham W; Liu, Liping; Miao, Zhongrong; Liebeskind, David S

    2016-05-01

    Neuroimaging of cerebrovascular status and hemodynamics has vastly improved our understanding of stroke mechanisms and provided information for therapeutic decision-making. CT techniques are the most commonly used techniques due to wide availability, rapid acquisition and acceptable tolerance. Numerous multimodal CT techniques have been developed in the last few years. We summarize and explain the various multimodal CT acquisition techniques within three categories based on the scanning mode, namely static mode (single-phase CTA), multiple static mode (multi-phase CTA) and continuous mode (CT perfusion and dynamic CTA). Post-processing methods based on different acquisition modes are also introduced in an easy manner by focusing on the information extracted and products generated. We also describe the applications for these techniques along with their advantages and disadvantages.

  17. Cardiovascular and cerebrovascular pharmacology%心脑血管药理学

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@心脑血管药理学 文献标识码:D Cardiovascular and cerebrovascular pharmacology 024 Effect of flavones of Mukdenia rossiikoidz on cardiac infarction in rats   LI Yan1, LUO Ji-Hua2   (1. National Institutes of Pharmaceutical Research and Development, Beijing 102206, China; 2. Medical College, Beihua University, Jilin 132001, China)   AIM: To study the effect of flavones of Mukdenia ross ii koidz on cardiac infarction caused by coronary artery ligation. M ETH ODS: Coronary artery ligation. RESULTS: Flavones of Mukd enia rossiikoidz reduced the area of infarction and attenuated the change in S-T section. CONCLUSION: Flavones of M. rossiikoidz has protective effects against myocardial ischemia.   Key words: Mukdenia rossiikoidz; coronary artery

  18. Cerebrovascular response to CO/sub 2/ inhalation in unanesthetized goats

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, M.C.; Lopez de Pablo, A.L.; Dieguez, G.; Gomez, B.; Lluch, S.

    1979-02-01

    The effects on cerebral blood flow of inhalation of 9% CO/sub 2/ in air were examined in unanesthetized goats. This procedure increased mean cerebral blood flow from 118 to 185 ml/min per 100 g and was accompanied by a rise in Pco/sub 2/ from 33 to 50 mmHg and a fall in pH from 7.41 to 7.26. Administration of phentolamine, propranolol, or atropine into the internal maxillary artery did not modify the normal cerebrovascular response to CO/sub 2/ inhalation. It is concluded that blockade of vascular adrenergic of cholinergic atropine-sensitive receptors in the goat has no effect on the cerebral vasomotor response to hypercapnia.

  19. The TCM-Combined Treatment for Aphasia Due to Cerebrovascular Disorders

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To evaluate the therapeutic effects of scalp acupuncture (with the cluster needling, a long needle-retention and an intermittent manipulation) combined with the Schuell's stimulation and psychological care for treatment of aphasia due to cerebrovascular disorders. Method: 36 eligible cases of aphasia were randomly assigned into a treatment group and a control group. The scoring system for assessment of aphasia in speaking Chinese set by CMA Neurological Branch and that of BADE were adopted for grading the severity/degree of aphasia before and after the treatment. Results: The total effective rate in the treatment group was 84.21%, and that in the control group was 70.59%, with a very statistically significant difference (P<0.01). Conclusion: The combined scheme produced a better therapeutic effect.

  20. Computerized three-dimensional reconstruction reveals cerebrovascular regulatory subregions in rat brain stem.

    Science.gov (United States)

    Underwood, M D; Arango, V; Smith, R W; Bakalian, M J; Mann, J J

    1993-09-01

    Three-dimensional wireframe reconstructions were used to examine the relationship between the anatomical localization of electrode sites and the cerebrovascular response which was elicited by electrical stimulation of the dorsal raphe nucleus (DRN). Reconstructions of the rat brain and DRN were done from atlas plates and from Nissl-stained coronal sections (100-micron increments). Data points were entered and three-dimensional reconstructions were performed using commercially available software and a personal computer. Display of the entire brain yielded views which obscured visualization of the DRN. The data file was edited to reduce the number of contours without affecting the display resolution of the DRN. Selective display of the DRN and electronic rotation from the coronal to a sagittal view revealed a functional organization of the cerebral blood flow responses which was not apparent in two-dimensional coronal sections.

  1. Treatment of migraine attacks based on the interaction with the trigemino-cerebrovascular system

    DEFF Research Database (Denmark)

    Link, A.S.; Kuris, A.; Edvinsson, L.

    2008-01-01

    Primary headaches such as migraine are among the most prevalent neurological disorders, affecting up to one-fifth of the adult population. The scientific work in the last decade has unraveled much of the pathophysiological background of migraine, which is now considered to be a neurovascular...... disorder. It has been discovered that the trigemino-cerebrovascular system plays a key role in migraine headache pathophysiology by releasing the potent vasodilator calcitonin gene-related peptide (CGRP). This neuropeptide is released in parallel with the pain and its concentration correlates well...... with the intensity of the headache. The development of drugs of the triptan class has provided relief for the acute attacks but at the cost of, mainly cardiovascular, side effects. Thus, the intention to improve treatment led to the development of small CGRP receptor antagonists such as olcegepant (BIBN4096BS...

  2. Characterization of (/sup 3/H)5-hydroxytryptamine uptake within rat cerebrovascular tree

    Energy Technology Data Exchange (ETDEWEB)

    Amenta, F.; Rossi, M. de; Mione, M.C.; Geppetti, P.

    1985-06-07

    The in vitro uptake of tritiated serotonin ((/sup 3/H)5HT) was studied in a preparation of rat extracerebral arteries. The uptake of (/sup 3/H)5HT was time- and temperature-dependent and of high affinity; linear regression analysis gave a Ksub(m) value of 6.48 X 10/sup 7/ M for the specific uptake. Histoautoradiographic studies showed the highest density of silver grains at the level of the adventitial-medial border of the basilar artery. Fluoxetine inhibited the accumulation of silver grains within the adventitial-medial border in the blood vessel studied. The present data further support the view that a neuronal serotonergic system may play a role in the control of blood flow in the cerebrovascular tree.

  3. REHABILITACIÓN DEL ACCIDENTE CEREBRO-VASCULAR EN ADULTOS MAYORES

    Directory of Open Access Journals (Sweden)

    Facchín RJ

    2015-05-01

    Full Text Available Cerebrovascular disease (CVA or stroke is one of the most important problems of public health as it is the second leading cause of death worldwide according to WHO and the first permanent disability of sudden onset in patients over 65 years. It should always be considered functional recovery after stroke reflect the reparative processes in the area adjacent to peri ischemic damage. This is thought to occur early, perhaps in the first 3-4 weeks post-stroke. Then it considered the repetitive training is a critical stimulus for new functional connections within the healthy brain tissue and remaining. The begining of rehabilitation should be started as soon as the patient is clinically stable. The functional results depend on this early onset, of course considering the patient's tolerance to stress. We conclude that neuromuscular rehabilitation undertaken in early and interdisciplinary therapeutic instance is crucial for the patient affected by stroke, especially in the elderly.

  4. Microwave Tomographic Imaging of Cerebrovascular Accidents by Using High-Performance Computing

    CERN Document Server

    Tournier, P -H; Bonazzoli, M; de Buhan, M; Darbas, M; Dolean, V; Hecht, F; Jolivet, P; Kanfoud, I El; Migliaccio, C; Nataf, F; Pichot, C; Semenov, S

    2016-01-01

    The motivation of this work is the detection of cerebrovascular accidents by microwave tomographic imaging. This requires the solution of an inverse problem relying on a minimization algorithm (for example, gradient-based), where successive iterations consist in repeated solutions of a direct problem. The reconstruction algorithm is extremely computationally intensive and makes use of efficient parallel algorithms and high-performance computing. The feasibility of this type of imaging is conditioned on one hand by an accurate reconstruction of the material properties of the propagation medium and on the other hand by a considerable reduction in simulation time. Fulfilling these two requirements will enable a very rapid and accurate diagnosis. From the mathematical and numerical point of view, this means solving Maxwell's equations in time-harmonic regime by appropriate domain decomposition methods, which are naturally adapted to parallel architectures.

  5. Clinical value of dipyridamole brain perfusion imaging in the diagnosis of ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Using dipyridamole stress test to evaluate cerebral blood flow reserve in cerebrovascular disease (CVD). Dipyridamole stress tests were performed first, the baseline SPECT images were obtained under similar conditions 2-5 days later. By visual and semiquantitative analysis, the responses of cerebral blood flow to dipyridamole were divided into the following four patterns: A: The dipyridamole SPECT showed an expanded area of hypoperfusion, Asymmetry Index(AI) and Uptake Rate(UR) were all decreased; B: Rest images was normal but new hypoperfused areas appeared on stress test with decreased Al and UR; C: Hypoperfused areas were decreased in size or disappeared after stress test with increased Al and UR; D: No changes showed in cerebral perfusion imaging patterns, and in Al and UR between stress and rest studies. Dipyridarnole brain perfusion imaging may be helpful to the diagnosis of CVD, to the decision the therapeutic plan, and to predicting the therapeutic effect.

  6. rCBF to distant areas in the acute and chronic stages of unilateral cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Onoda, Toru; Tamada, Tsutomu; Gyoten, Masayuki; Imai, Shigeki; Kajihara, Yasumasa [Kawasaki Medical School, Kurashiki, Okayama (Japan). School of Medicine; Fukuda, Atsuhiro [Kawasaki Medical School, Kurashiki, Okayama (Japan). Clinical Care Center; Miyanoki, Syo [Kobe Univ. (Japan). School of Medicine

    2002-09-01

    In 14 patients with unilateral cerebrovascular disease, regional cerebral blood flow (CBF) to distant areas in the acute and chronic stages was evaluated by SPECT with {sup 123}I-IMP. In the acute stage, rCBF in distant areas was decreased in all patients. In the chronic stage, a decrease in rCBF was observed in the contralateral cerebellar hemisphere in 50% of unilateral cerebral hemispheric lesions, in the ipsilateral thalamus in 42.9% of cerebral cortical lesions, and in the ipsilateral cortex in 57.1% of subcortical lesions. The decreased rCBF in distant areas even in the chronic stage suggested the involvement of organic changes in the pathologic condition in this stage. (author)

  7. Moyamoya Disease – a Vasculopahty and an Uncommon Cause of Recurrent Cerebrovascular Accidents

    Directory of Open Access Journals (Sweden)

    Yasmin S Hamirani

    2008-09-01

    Full Text Available

    Moyamoya disease is a very rare chronic cerebrovascular disease of unknown etiology characterized by recurrent ischemic or hemorrhagic strokes. Initially diagnosed in Japan and named after finding puff of smoke like collateral blood vessels around the occluded blood vessels of circle of Willis. With increase awareness this disease is now diagnosed more often. Medical and surgical treatment have been used to treat the disease, with surgical treatment been mostly experimental. Special attention should be given to the surgical treatment which has shown to have an edge over the medical treatment in some clinical trials especially in young patients with recurrent strokes to prevent progressive cognitive decline and to improve their quality of life. In our patient, who is a young man, the diagnosis was picked up late and when surgical evaluation was performed, it was considered to be fruitless with findings of nonviable brain tissue on MRI imaging.

  8. First translational 'Think Tank' on cerebrovascular disease, cognitive impairment and dementia.

    Science.gov (United States)

    Barone, Frank C; Gustafson, Deborah; Crystal, Howard A; Moreno, Herman; Adamski, Mateusz G; Arai, Ken; Baird, Alison E; Balucani, Clotilde; Brickman, Adam M; Cechetto, David; Gorelick, Philip; Biessels, Geert Jan; Kiliaan, Amanda; Launer, Lenore; Schneider, Julie; Sorond, Farzaneh A; Whitmer, Rachel; Wright, Clinton; Zhang, Zheng Gang

    2016-02-13

    As the human population continues to age, an increasing number of people will exhibit significant deficits in cognitive function and dementia. It is now recognized that cerebrovascular, metabolic and neurodegenerative diseases all play major roles in the evolution of cognitive impairment and dementia. Thus with our more recent recognition of these relationships and our need to understand and more positively impact on this world health problem, "The Leo and Anne Albert Charitable Trust" (Gene Pranzo, Trustee with significant support from Susan Brogan, Meeting Planner) provided generous support for this inaugural international workshop that was held from April 13-16, 2015 at the beautiful Ritz Carlton Golf Resort in North Naples, Florida. Researchers from SUNY Downstate Medical Center, Brooklyn, NY organized the event by selecting the present group of translationally inclined preclinical, clinical and population scientists focused on cerebrovascular disease (CVD) risk and its progression to vascular cognitive impairment (VCI) and dementia. Participants at the workshop addressed important issues related to aging, cognition and dementia by: (1) sharing new data, information and perspectives that intersect vascular, metabolic and neurodegenerative diseases, (2) discussing gaps in translating population risk, clinical and preclinical information to the progression of cognitive loss, and (3) debating new approaches and methods to fill these gaps that can translate into future therapeutic interventions. Participants agreed on topics for group discussion prior to the meeting and focused on specific translational goals that included promoting better understanding of dementia mechanisms, the identification of potential therapeutic targets for intervention, and discussed/debated the potential utility of diagnostic/prognostic markers. Below summarizes the new data-presentations, concepts, novel directions and specific discussion topics addressed by this international

  9. A novel distinctive cerebrovascular phenotype is associated with heterozygous Arg179 ACTA2 mutations

    Science.gov (United States)

    Munot, Pinki; Saunders, Dawn E.; Milewicz, Dianna M.; Regalado, Ellen S.; Ostergaard, John R.; Braun, Kees P.; Kerr, Timothy; Lichtenbelt, Klaske D.; Philip, Sunny; Rittey, Christopher; Jacques, Thomas S.; Cox, Timothy C.

    2012-01-01

    Mutations in the ACTA2 gene lead to diffuse and diverse vascular diseases; the Arg179His mutation is associated with an early onset severe phenotype due to global smooth muscle dysfunction. Cerebrovascular disease associated with ACTA2 mutations has been likened to moyamoya disease, but appears to have distinctive features. This study involved the analysis of neuroimaging of 13 patients with heterozygous missense mutations in ACTA2 disrupting Arg179. All patients had persistent ductus arteriosus and congenital mydriasis, and variable presentation of pulmonary hypertension, bladder and gastrointestinal problems associated with this mutation. Distinctive cerebrovascular features were dilatation of proximal internal carotid artery, occlusive disease of terminal internal carotid artery, an abnormally straight course of intracranial arteries, and absent basal ‘moyamoya’ collaterals. Patterns of brain injury supported both large and small vessel disease. Key differences from moyamoya disease were more widespread arteriopathy, the combination of arterial ectasia and stenosis and, importantly, absence of the typical basal ‘moyamoya’ collaterals. Evaluation of previously published cases suggests some of these features are also seen in the ACTA2 mutations disrupting Arg258. The observation that transition from dilated to normal/stenotic arterial calibre coincides with where the internal carotid artery changes from an elastic to muscular artery supports the hypothesis that abnormal smooth muscle cell proliferation caused by ACTA2 mutations is modulated by arterial wall components. Patients with persistent ductus arteriosus or congenital mydriasis with a label of ‘moyamoya’ should be re-evaluated to ensure the distinctive neuroimaging features of an ACTA2 mutation have not been overlooked. This diagnosis has prognostic and genetic implications, and mandates surveillance of other organ systems, in particular the aorta, to prevent life-threatening aortic dissection

  10. Cardiovascular and cerebrovascular effects in response to red bull consumption combined with mental stress.

    Science.gov (United States)

    Grasser, Erik Konrad; Dulloo, Abdul G; Montani, Jean-Pierre

    2015-01-15

    The sale of energy drinks is often accompanied by a comprehensive and intense marketing with claims of benefits during periods of mental stress. As it has been shown that Red Bull negatively impacts human hemodynamics at rest, we investigated the cardiovascular and cerebrovascular consequences when Red Bull is combined with mental stress. In a randomized cross-over study, 20 young healthy humans ingested either 355 ml of a can Red Bull or water and underwent 80 minutes after the respective drink a mental arithmetic test for 5 minutes. Continuous cardiovascular and cerebrovascular recordings were performed for 20 minutes before and up to 90 minutes after drink ingestion. Measurements included beat-to-beat blood pressure (BP), heart rate, stroke volume, and cerebral blood flow velocity. Red Bull increased systolic BP (+7 mm Hg), diastolic BP (+4 mm Hg), and heart rate (+7 beats/min), whereas water drinking had no significant effects. Cerebral blood flow velocity decreased more in response to Red Bull than to water (-9 vs -3 cm/s, p <0.005). Additional mental stress further increased both systolic BP and diastolic BP (+3 mm Hg, p <0.05) and heart rate (+13 beats/min, p <0.005) in response to Red Bull; similar increases were also observed after water ingestion. In combination, Red Bull and mental stress increased systolic BP by about 10 mm Hg, diastolic BP by 7 mm Hg, and heart rate by 20 beats/min and decreased cerebral blood flow velocity by -7 cm/s. In conclusion, the combination of Red Bull and mental stress impose a cumulative cardiovascular load and reduces cerebral blood flow even under a mental challenge.

  11. Assessment of cerebrovascular reactivity during major depression and after remission of disease

    Directory of Open Access Journals (Sweden)

    Vakilian Alireza

    2010-01-01

    Full Text Available Background: There are a growing number of studies suggesting that depression may increase the risk of stroke. Impaired autoregulation of vascular tone may contribute to a higher risk of developing cerebrovascular diseases. Cerebrovascular reactivity (CVR reflects the compensatory dilatory capacity of cerebral arterioles to a dilatory stimulus and is an important mechanism that ensures constant cerebral blood flow. There is a hypothesis that CVR is reduced in major depression, which would explain the association between depression and stroke. Objectives: The aim of this study was to investigate the effect of depression on CVR in cerebral vessels by comparing CVR during the depression phase with that during remission. Material and Methods: Using the apnea test, we assessed CVR in 16 patients with unipolar depression during disease and after remission of disease by calculating the increase in cerebral blood flow velocity after breath-holding (the apnea test. Blood flow velocities were measured by transcranial Doppler ultrasound (TCD. Results: CVR was significantly reduced in the depression phase in comparison to that in the remission phase. However, this change was not seen in all the patients. Conclusion: CVR was reduced in most of the depressed patients. The decreased CVR, as indicated by the changes in peak systolic velocity (PSV and mean flow velocity (MFV of the middle cerebral artery, in depressed patients was more marked on the right side, which could point to a vascular basis for some kinds of depression. We recommend that other studies, with larger samples, be done; future studies should assess whether the changes in the CVR varies with the severity and type of depression.

  12. Collateral blood flow in different cerebrovascular hierarchy provides endogenous protection in cerebral ischemia.

    Science.gov (United States)

    Luo, Chuanming; Liang, Fengyin; Ren, Huixia; Yao, Xiaoli; Liu, Qiang; Li, Mingyue; Qin, Dajiang; Yuan, Ti-Fei; Pei, Zhong; Su, Huanxing

    2016-11-15

    Collateral blood flow as vascular adaptions to focal cerebral ischemia is well recognized. However, few studies directly investigate the dynamics of collateral vessel recruitment in vivo and little is known about the effect of collateral blood flow in different cerebrovascular hierarchy on the neuropathology after focal ischemic stroke. Here, we report that collateral blood flow is critically involved in blood vessel compensations following regional ischemia. We occluded a pial arteriole using femtosecond laser ablating under the intact thinned skull and documented the changes of collateral flow around the surface communication network and between the surface communication network and subsurface microcirculation network using in vivo two photon microscopy imaging. Occlusion of the pial arteriole apparently increased the diameter and collateral blood flow of its leptomeningeal anastomoses, which significantly reduced the cortical infarction size. This result suggests that the collateral flow via surface communicating network connected with leptomeningeal anastomoses could greatly impact on the extent of infarction. We then further occluded the target pial arteriole and all of its leptomeningeal anastomoses. Notably, this type of occlusion led to reversals of blood flow in the penetrating arterioles mainly proximal to the occluded pial arteriole in a direction from the subsurface microcirculation network to surface arterioles. Interesting, the cell death in the area of ischemic penumbra was accelerated when we performed occlusion to cease the reversed blood flow in those penetrating arterioles, suggesting that the collateral blood flow from subsurface microcirculation network exerts protective roles in delaying cell death in the ischemic penumbra. In conclusion, we provide the first experimental evidence that collateral blood vessels at different cerebrovascular hierarchy are endogenously compensatory mechanisms in brain ischemia. This article is protected by

  13. LIPOMA CEREBRAL EN CUERPO CALLOSO: HALLAZGO INCIDENTAL EN PACIENTE CON EVENTO CEREBROVASCULAR

    Directory of Open Access Journals (Sweden)

    Gloria Cárcamo-Portillo

    2016-07-01

    Full Text Available Los lipomas intracraneales son lesiones infrecuentes y benignas que representan el 0,03 al 0,08% de todas las masas intracraneales. Estos se encuentran relacionados a un defecto de la línea media debido a un mal cierre del tubo neural; lo que conlleva a una mala diferenciación y una persistencia anormal de la meninge primitiva con posterior diferenciación al tejido adiposo. La mitad de los casos permanecen asintomáticos y son diagnosticados como un hallazgo incidental en los estudios imagenológicos. Sin embargo, otros casos se asocian a sintomatología neurológica como retraso psicomotor, cefalea, epilepsia y parálisis cerebral. Se presenta el caso de una paciente de 46 años de edad, con antecedentes de hipertensión arterial y diabetes mellitus tipo 2; que cursa con sintomatología de Evento Cerebrovascular Isquémico por lo que le realizan –una Tomografía Computarizada (TC y una Resonancia Magnética (RM. En el reporte se describen múltiples infartos a nivel del hemisferio cerebral izquierdo mientras que al nivel de la línea media se observó una imagen compatible con lipoma cerebral que afectaba el rostro, la rodilla y la porción anterior del cuerpo calloso. La identificación de este hallazgo fue incidental. Palabras claves: Lipoma Cerebral; Cuerpo Calloso; Resonancia Magnética; Accidente Cerebrovascular. (Fuente: DeCS BIREME.

  14. Evaluation of the relative risk of stroke in patients with hypertension using cerebrovascular hemodynamic accumulative score

    Institute of Scientific and Technical Information of China (English)

    HUANG Jiuyi; WANG Guiqing; GUO Jiping; CAO Yifeng; WANG Yan; YANG Yongju; YU Xuehai

    2007-01-01

    The relative risk(RR)of stroke in patients with hypertension was evaluated by using synthetic index of cerebrovascular hemodynamics.A total of 7,371 patients with hypertension with ages≥40 years were selected from a population-based cohort study of the risk factors for stroke.The data on the baseline investigation of risk factors,the determination of cerebrovascular hemodynamic parameters (CVHP),and stroke follow-up were analyzed.The RR of stroke in patients with hypertension was evaluated by CVHP scores.Univariate analysis indicated that hypertension,complicated by other risk factors,had significant statistical association with the onset of stroke.RRS for stroke when hypertension complicated with decrease of hemodynamic scores,heart disease,cigarette smoking and alcohol consumption were 4.93(95%CI,3.26-7.45),1.90(95%CI,1.36-2.66),1.99(95%CI,1.42-2.79)and 1.73(95%CI,1.19-2.53)respectively.In multivariate analysis,hemodynamic score,age,sex,cigarette smoking,family history of stroke and systolic blood pressure were selected by the Cox regression for inclusion in the final analysis.Among them,the RR of hemodynamic score was highest.The analysis of doseresponse relationships indicated that when the hemodynamic scores in patients with hypertension were lower than 75 points,the RR of stroke at 75,60,45,30 and 15 points were 2.85,4.43,4.54,5.40 and 9.88,respectively.The risk of stroke in patients with hypertension is closely associated with hemodynamic impairment and the hemodynamic score may be used for quantitative evaluation of relative risks of stroke.

  15. The Comparison of Continuous and Intermittent Enteral Nutrition In Cerebrovascular Patients

    Directory of Open Access Journals (Sweden)

    Levent Güngör

    2011-06-01

    Full Text Available OBJECTIVE: Dysphagia and malnutrition are not so rare in stroke patients, and have an unfavorable influence on recovery. Nutritional support may reduce infections, duration of hospital stay and mortality. However, there is no clear evidence about the modality of nasogastric nutrition. In this study, intermittent and continuous enteral nutrition is compared by means of pulmonary infections and gastrointestinal tolerance, among acute cerebrovascular patients. METHODS: Sixty two acute cerebrovascular patients with dysphagia were included the study. The same volume of nutrition product was infused 4 times daily to 31 patients, and continuously for 24 hours to the remaining 31. After 10 days of follow-up, the rates of pulmonary infections, diarrhea, increased gastric residual volumes, vomiting and tube occlusion were compared between two groups. RESULTS: Twenty patients developed pneumonia (32% and 8 diarrhea (13%. Mortality due to complications associated with tube feeding was 6%. Aspiration and related pneumonia was present in 11 patients in the intermittent nutrition group (35%, and in 9 patients in the continuous nutrition group (29%. The rate of pulmonary infection was not statistically different between two groups (p>0.05. Diarrhea was observed in 7 intermittently fed patients (23%, while was present only in 1 patient (3% in the continuously fed group. Diarrhea was more common in the intermittent nutrition group, just at the statistical border (p=0.05. None of the patients developed tube occlusion, vomiting and gastric retention. The rate of mortality and the interruption of feeding was not significantly different between two groups (p>0.05. CONCLUSION: Diarrhea and pulmonary infections are more prevalent with intermittent tube feeding with respect to continuous enteral nutrition, though the difference is not so conspicuous. The reason may be contamination of the equipments and the feeding solution because of frequent manipulation and

  16. Effects of hypoxia-inducible factor 1 on ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    Yongjie Luo; Xiaoping Wang; Hongbin Sun

    2008-01-01

    Hypoxia-inducible factor I, a nuclear transcription factor, is induced by hypoxia. Hypoxia-inducible factor I, a heterodimeric DNA-binding protein, is composed of hypoxia-inducible factor 1α and hypoxia-inducible factor 1 β subunits, which are family members of the basic helix-loop-helix-PER, ARNT, SIM (PAS) protein. O2 concentration regulates hypoxia-inducible factor 1 activity via this subunit. Hypoxia-inducible factor 1α plays a major role in response to hypoxia and transcriptional activation, as well as in the target gene specificity of the DNA enhancer. Hypoxia-inducible factor 1β cannot be induced by hypoxia. This effect may be due to hypoxia-inducible factor 1 stability and activated conformation due to dimerization. Previous studies have shown that hypoxia-inducible factor 1 mRNA expression increases in the penumbra following ischemia/hypoxia. Hypoxia-inducible factor 1 plays an important role in brain tissue injury alter ischemia by affecting a series of target genes, elevating tolerance to hypoxia, and ensuring survival of neural cells. This article summarizes the structure, function, expression, regulatory mechanisms, biological effects, and significance of hypoxia-inducible factor 1 in patients with ischemic cerebrovascular disease. As a transcriptional activator, hypoxia- inducible factor 1 plays a key role in hypoxic responses by stabilizing the internal environment. It also has been shown to regulate the expression of several genes. The regulatory effects of hypoxia-inducible factor 1 in patients with ischemic cerebrovascular disease have been described. The present review re-examined the concept of brain protection at the level of gene regulation.

  17. Impaired cerebrovascular function in coronary artery disease patients and recovery following cardiac rehabilitation.

    Directory of Open Access Journals (Sweden)

    Udunna C Anazodo

    2016-01-01

    Full Text Available Coronary artery disease (CAD poses a risk to the cerebrovascular function of older adults and has been linked to impaired cognitive abilities. Using magnetic resonance perfusion imaging, we investigated changes in resting cerebral blood flow (CBF and cerebrovascular reactivity (CVR to hypercapnia in 34 coronary artery disease (CAD patients and 21 age-matched controls. Gray matter volume images were acquired and used as a confounding variable to separate changes in structure from function. Compared to healthy controls, CAD patients demonstrated reduced CBF in the superior frontal, anterior cingulate, insular, pre- and post-central gyri, middle temporal and superior temporal regions. Subsequent analysis of these regions demonstrated decreased CVR in the anterior cingulate, insula, postcentral and superior frontal regions. Except in the superior frontal and precentral regions, regional reductions in CBF and CVR were identified in brain areas where no detectable reductions in gray matter volume were observed, demonstrating that these vascular changes were independent of brain atrophy. Because aerobic fitness training can improve brain function, potential changes in regional CBF were investigated in the CAD patients after completion of a 6-month exercise-based cardiac rehabilitation program. Increased CBF was observed in the bilateral anterior cingulate, as well as recovery of CBF in the dorsal aspect of the right anterior cingulate, where the magnitude of increased CBF was roughly equal to the reduction in CBF at baseline compared to controls. These exercise-related improvements in CBF in the anterior cingulate is intriguing given the role of this area in cognitive processing and regulation of cardiovascular autonomic control.

  18. 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.

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

    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.Se objetivó evaluar la sobrecarga de cuidadores de ancianos con accidente cerebrovascular (ACV, y correlacionarla con horas de cuidado, edad e independencia funcional de los ancianos. Estudio transversal con 62 ancianos con ACV y sus cuidadores. El instrumento contenía variables sociodemográficas y económicas, Mini-Examen del Estado Mental, Medida de la Independencia Funcional (MIF y la Escala de Zarit. La posible correlación entre los puntajes de la escala de Zarit y las otras variables fue evaluada por Coeficiente de Correlación de Pearson. La mayoría de los cuidadores eran adultos, hijos, casados y de sexo femenino. El promedio de puntaje de Zarit fue 34,92 (15,8. La MIF presentó correlación negativa con la sobrecarga del cuidador, sin embargo no hubo correlación con edad y horas de cuidado. La sobrecarga de la mayoría de los cuidadores varió entre moderada y severa, y parece relacionarse con el nivel de independencia funcional del anciano.The aim was to

  20. Doença cerebrovascular na infância: I. Manifestações epilépticas Cerebrovascular disease in children: I. Epileptic manifestations

    Directory of Open Access Journals (Sweden)

    M. AUGUSTA MONTENEGRO

    1999-09-01

    Full Text Available As crises epilépticas podem constituir complicação de doença cerebrovascular (DCV, e a sua prevalência, apresentação clínica, fatores de risco e evolução em crianças tem sido estudadas por poucos autores. Neste estudo, 39 crianças com diagnóstico de DCV foram avaliadas quanto à ocorrência de manifestações epilépticas. Vinte e quatro (61,5% apresentaram crises durante algum momento da doença (22 na fase aguda e 2 na tardia; 13 (54,2% apresentaram crises generalizadas, 7 (29,2% parciais, e 4 (16,6% secundariamente generalizadas. A prevalência de manifestação epiléptica em lactentes foi significativamente maior (p=0,0362 do que nas outras faixas etárias. A localização cortical da DCV mostrou determinar de modo estatisticamente significante (p=0,0101 a ocorrência de crises. Não houve relação significativa entre o tipo de insulto vascular (isquêmico ou hemorrágico e a ocorrência de crises. Quatorze pacientes evoluíram sem crise após a fase aguda; os 2 pacientes previamente epilépticos tiveram suas crises controladas com droga anti-epiléptica (DAE; 3 evoluíram com epilepsia (1 controlado com DAE e 2 de difícil controle; 3 continuaram em acompanhamento ambulatorial e não houve tempo hábil para definir se o quadro evoluirá para epilepsia e em 2 ocorreu óbito na fase aguda.Seizures may occur as a complication of cerebrovascular disease (CVD and its prevalence, clinical presentation, risk factors and evolution have been reported by few authors. We evaluated 39 children with CVD and analysed the association with seizures. Seizures occurred in 24 (61.5% patients and were classified as partial (29.2%, generalized (54.2% and secondarily generalized (16.6%. Infants had a significantly higher prevalence of seizures (p=0.0362 than children at other ages. Cortical localization was associated with a significantly higher prevalence of seizures (p=0.0101. There were no differences between ischemic and hemorrhagic strokes

  1. Evaluation of cerebrovascular reactivity by ultrasonography in type 2 diabetic patients with hypertension

    Institute of Scientific and Technical Information of China (English)

    Jinhui Zhao; Yuxiang Chen; Zhen Zhao; Qingchun Zhao; Dongmei Hao; Shanshan Tang

    2007-01-01

    BACKGROUND: Cerebrovascular reactivity (CVR) reflects cerebrovascular reserve capacity, and cerebrovascular reactivity damage prognosticates a very high risk of stroke.OBJECTIVE: To evaluate CVR by detecting the increase rate of blood flow volume of middle cerebral artery (MCA) before and after breathholding in diabetic patients with hypertension, and observe the effects of hypertension on cerebrovascular reserve capacity of diabetic patients. DESIGN: Controlled observation.SETTINGS: Department of Function, Affiliated Hospital of Hebei University; Department of Special Diagnosis, the 202 Hospital of Chinese PLA.PARTICIPANTS: Inpatients or outpatients with type 2 diabetes mellitus (DM) or primary hypertension admitted to Departments of Gastroenterology and Cardiology, Affiliated Hospital of Hebei University and the 202 Hospital of Chinese PLA from April to December 2004 were involved in this experiment. Inclusive criteria: type 2 DM met the criteria of the report on diabetes diagnosis announced in 1999 by WHO expert committee, totally 88 patients were involved. Primary hypertension met the diagnosis criteria announced in 1999 by WHO/1SH, totally 42 patients were involved. Another group of 43 concurrent subjects who received physical examination served as controls. According to the disease condition, the involved patients were assigned into 3 groups: DM group (only diabetic patients), hypertension group (only hypertension patients) and DM complicated with hypertension group (diabetic patients with hypertension). Informed consent for the examination was obtained from all the involved subjects.METHODS: Before MCA of subjects was detected, bilateral carotid artery was routinely detected by high-frequency ultrasonography. Subjects were rejected when stenosis rate of unilateral internal carotid artery or common carotid artery≥70%. Vessels were expanded with transcranial color Duplex Doppler by breath holding test for detecting vascular reactivity. Hypercapnia was

  2. Seasonal overturning circulation in the Red Sea: 2. Winter circulation

    KAUST Repository

    Yao, Fengchao

    2014-04-01

    The shallow winter overturning circulation in the Red Sea is studied using a 50 year high-resolution MITgcm (MIT general circulation model) simulation with realistic atmospheric forcing. The overturning circulation for a typical year, represented by 1980, and the climatological mean are analyzed using model output to delineate the three-dimensional structure and to investigate the underlying dynamical mechanisms. The horizontal model circulation in the winter of 1980 is dominated by energetic eddies. The climatological model mean results suggest that the surface inflow intensifies in a western boundary current in the southern Red Sea that switches to an eastern boundary current north of 24N. The overturning is accomplished through a cyclonic recirculation and a cross-basin overturning circulation in the northern Red Sea, with major sinking occurring along a narrow band of width about 20 km along the eastern boundary and weaker upwelling along the western boundary. The northward pressure gradient force, strong vertical mixing, and horizontal mixing near the boundary are the essential dynamical components in the model\\'s winter overturning circulation. The simulated water exchange is not hydraulically controlled in the Strait of Bab el Mandeb; instead, the exchange is limited by bottom and lateral boundary friction and, to a lesser extent, by interfacial friction due to the vertical viscosity at the interface between the inflow and the outflow. Key Points Sinking occurs in a narrow boundary layer along the eastern boundary Surface western boundary current switches into an eastern boundary current Water exchange in the Strait of Bab el Mandeb is not hydraulically controlled © 2014. American Geophysical Union. All Rights Reserved.

  3. The Invertibility, Explicit Determinants, and Inverses of Circulant and Left Circulant and g-Circulant Matrices Involving Any Continuous Fibonacci and Lucas Numbers

    Directory of Open Access Journals (Sweden)

    Zhaolin Jiang

    2014-01-01

    Full Text Available Circulant matrices play an important role in solving delay differential equations. In this paper, circulant type matrices including the circulant and left circulant and g-circulant matrices with any continuous Fibonacci and Lucas numbers are considered. Firstly, the invertibility of the circulant matrix is discussed and the explicit determinant and the inverse matrices by constructing the transformation matrices are presented. Furthermore, the invertibility of the left circulant and g-circulant matrices is also studied. We obtain the explicit determinants and the inverse matrices of the left circulant and g-circulant matrices by utilizing the relationship between left circulant, g-circulant matrices and circulant matrix, respectively.

  4. Circulating Fibronectin Controls Tumor Growth

    Directory of Open Access Journals (Sweden)

    Anja von Au

    2013-08-01

    Full Text Available Fibronectin is ubiquitously expressed in the extracellular matrix, and experimental evidence has shown that it modulates blood vessel formation. The relative contribution of local and circulating fibronectin to blood vessel formation in vivo remains unknown despite evidence for unexpected roles of circulating fibronectin in various diseases. Using transgenic mouse models, we established that circulating fibronectin facilitates the growth of bone metastases by enhancing blood vessel formation and maturation. This effect is more relevant than that of fibronectin produced by endothelial cells and pericytes, which only exert a small additive effect on vessel maturation. Circulating fibronectin enhances its local production in tumors through a positive feedback loop and increases the amount of vascular endothelial growth factor (VEGF retained in the matrix. Both fibronectin and VEGF then cooperate to stimulate blood vessel formation. Fibronectin content in the tumor correlates with the number of blood vessels and tumor growth in the mouse models. Consistent with these results, examination of three separate arrays from patients with breast and prostate cancers revealed that a high staining intensity for fibronectin in tumors is associated with increased mortality. These results establish that circulating fibronectin modulates blood vessel formation and tumor growth by modifying the amount of and the response to VEGF. Furthermore, determination of the fibronectin content can serve as a prognostic biomarker for breast and prostate cancers and possibly other cancers.

  5. Atmospheric Circulation of Terrestrial Exoplanets

    CERN Document Server

    Showman, Adam P; Merlis, Timothy M; Kaspi, Yohai

    2013-01-01

    The investigation of planets around other stars began with the study of gas giants, but is now extending to the discovery and characterization of super-Earths and terrestrial planets. Motivated by this observational tide, we survey the basic dynamical principles governing the atmospheric circulation of terrestrial exoplanets, and discuss the interaction of their circulation with the hydrological cycle and global-scale climate feedbacks. Terrestrial exoplanets occupy a wide range of physical and dynamical conditions, only a small fraction of which have yet been explored in detail. Our approach is to lay out the fundamental dynamical principles governing the atmospheric circulation on terrestrial planets--broadly defined--and show how they can provide a foundation for understanding the atmospheric behavior of these worlds. We first survey basic atmospheric dynamics, including the role of geostrophy, baroclinic instabilities, and jets in the strongly rotating regime (the "extratropics") and the role of the Hadle...

  6. Circulation in blast driven instabilities

    Science.gov (United States)

    Henry de Frahan, Marc; Johnsen, Eric

    2016-11-01

    Mixing in many natural phenomena (e.g. supernova collapse) and engineering applications (e.g. inertial confinement fusion) is often initiated through hydrodynamic instabilities. Explosions in these systems give rise to blast waves which can interact with perturbations at interfaces between different fluids. Blast waves are formed by a shock followed by a rarefaction. This wave profile leads to complex time histories of interface acceleration. In addition to the instabilities induced by the acceleration field, the rarefaction from the blast wave decompresses the material at the interface, further increasing the perturbation growth. After the passage of the wave, circulation circulation generated by the blast wave through baroclinic vorticity continues to act upon the interface. In this talk, we provide scaling laws for the circulation and amplitude growth induced by the blast wave. Numerical simulations of the multifluid Euler equations solved using a high-order accurate Discontinuous Galerkin method are used to validate the theoretical results.

  7. Cerebrovascular responses to hypoxia and hypocapnia in high-altitude dwellers.

    Science.gov (United States)

    Norcliffe, L J; Rivera-Ch, M; Claydon, V E; Moore, J P; Leon-Velarde, F; Appenzeller, O; Hainsworth, R

    2005-07-01

    Cerebral blood flow is known to increase in response to hypoxia and to decrease with hypocapnia. It is not known, however, whether these responses are altered in high-altitude dwellers who are not only chronically hypoxic and hypocapnic, but also polycythaemic. Here we examined cerebral blood flow responses to hypoxia and hypocapnia, separately and together, in Andean high-altitude dwellers, including some with chronic mountain sickness (CMS), which is characterized by excessive polycythaemia. Studies were carried out at high altitude (Cerro de Pasco (CP), Peru; barometric pressure (P(B)) 450 mmHg) and repeated, following relief of the hypoxia, on the day following arrival at sea level (Lima, Peru; P(B) 755 mmHg). We compared these results with those from eight sea-level residents studied at sea level. In nine high-altitude normal subjects (HA) and nine CMS patients, we recorded middle cerebral artery mean blood flow velocity (MCAVm) using transcranial Doppler ultrasonography, and expressed responses as changes from baseline. MCAVm responses to hypoxia were determined by changing end-tidal partial pressure of oxygen (P(ET,O2)) from 100 to 50 mmHg, with end-tidal partial pressure of carbon dioxide clamped. MCAVm responses to hypocapnia were studied by voluntary hyperventilation with (P(ET,O2)) clamped at 100 and 50 mmHg. There were no significant differences between the cerebrovascular responses of the two groups to any of the interventions at either location. In both groups, the MCAVm responses to hypoxia were significantly greater at Lima than at CP (HA, 12.1 +/- 1.3 and 6.1 +/- 1.0%; CMS, 12.5 +/- 0.8 and 5.6 +/- 1.2%; P < 0.01 both groups). The responses at Lima were similar to those in the sea-level subjects (13.6 +/- 2.3%). The responses to normoxic hypocapnia in the altitude subjects were also similar at both locations and greater than those in sea-level residents. During hypoxia, both high-altitude groups showed responses to hypocapnia that were

  8. Efficacy of Standard and Intensive Statin Treatment for the Secondary Prevention of Cardiovascular and Cerebrovascular Events in Diabetes Patients: A Meta-Analysis

    OpenAIRE

    de Vries, Folgerdiena M.; Johan Kolthof; Postma, Maarten J.; Petra Denig; Eelko Hak

    2014-01-01

    AIMS: To estimate the efficacy of standard and intensive statin treatment in the secondary prevention of major cardiovascular and cerebrovascular events in diabetes patients. METHODS: A systematic search was conducted in Medline over the years 1990 to September 2013. Randomized, double-blind, clinical trials comparing a standard-dose statin with placebo or a standard-dose statin with an intensive-dose statin for the secondary prevention of cardiovascular and cerebrovascular events in diabetes...

  9. Fibroelastoma valvular aórtico como causa de accidente cerebrovascular embólico: Reporte de un caso

    OpenAIRE

    Bahamondes S,Juan Carlos; MERIÑO S,GUSTAVO; SALMAN A,JUAN; SILVA V,ABELARDO; MORA M,JAVIER

    2008-01-01

    Los tumores cardíacos son una causa rara de accidente cerebrovascular embólico. Comunicamos el caso de una paciente de 65 años quien debuta su historia con un accidente cerebrovascular. El estudio de fuente embólica con ecocardiografía transesofágica demostró un fibroelastoma de la válvula aórtica en el borde libre del velo no coronariano. El tumor fue extraído mediante circulación extracorpórea. El estudio anatomopatológico confirmó el diagnóstico y la paciente se encuentra en capacidad func...

  10. Incidence of cardiovascular and cerebrovascular disease in Danish men and women with a prolonged heavy alcohol intake

    DEFF Research Database (Denmark)

    Hvidtfeldt, Ulla Arthur; Frederiksen, M.E.; Thygesen, L.C.;

    2008-01-01

    rates of cardio- and cerebrovascular diseases than the population in general. METHODS: The cohort comprised 19,185 subjects (15,368 men and 3,817 women) who attended outpatient clinics for alcohol abusers within the Copenhagen Hospital Corporation (1954 to 1992). Incidence rates were standardized (SIR......BACKGROUND: Several epidemiological studies have found U- or J-shaped relationships between alcohol intake and cardiovascular conditions. The influence of heavy drinking is, however, sparsely studied. The objective of the present study was to examine whether alcohol addicts have higher incidence.......45-2.99; women: SIR = 2.77; 95% CI 2.18-3.48). CONCLUSIONS: The study indicates increased risks of cardio- and cerebrovascular diseases in subjects with an excessive alcohol intake Udgivelsesdato: 2008/11...

  11. Prolongation of bleeding time and inhibition of platelet aggregation by low-dose acetylsalicylic acid in patients with cerebrovascular disease

    DEFF Research Database (Denmark)

    Boysen, G; Boss, A H; Ødum, Niels

    1984-01-01

    Platelet aggregation and bleeding time was measured in 43 cerebrovascular patients participating in a controlled double-blind study of low-dose acetylsalicylic acid. In 19 patients with satisfactory inhibition of the platelet aggregation obtained by 50 to 70 mg acetylsalicylic acid per day...... the bleeding time averaged 11.2 minutes in contrast to 7.0 minutes in the placebo group, p less than 0.001. This study confirms our previous findings of platelet inhibition by low-dose acetylsalicylic acid in patients with cerebrovascular disease. The prolongation of the bleeding time demonstrates that we...... are dealing not merely with an in vitro phenomenon but with a significant in vivo effect. The study provides the rationale for clinical evaluations of low-dose acetylsalicylic acid in stroke prophylaxis....

  12. Transferencia del aprendizaje motor en pacientes con antecedentes de accidente cerebrovascular: serie de casos

    Directory of Open Access Journals (Sweden)

    Karen Castro-Medina

    2015-04-01

    Full Text Available Antecedentes. La rehabilitación es un proceso de reaprendizaje motor, que mejora el desempeño en términos de adquisición de nuevas habilidades y adaptación o refinamiento de habilidades aprendidas previamente. A pesar de este conocimiento, existen, considerablemente, pocos estudios que describan el aprendizaje motor después de un accidente cerebrovascular (ACV y la relevancia del mismo en los procesos de rehabilitación y recuperación. Objetivo. Describir la transferencia del aprendizaje motor en pacientes con antecedentes de accidente cerebrovascular después de un tratamiento con procedimientos de reeducación funcional. Materiales y métodos. Se realizó un estudio descriptivo de dos casos con pacientes que recibieron tratamiento fisioterapéutico ambulatorio con los principios de reeducación funcional desarrollados en el Hospital de las Clínicas de la Universidad de São Paulo (Brasil, entre los meses de agosto y octubre de 2013. La transferencia del aprendizaje motor se determinó según los resultados obtenidos en la evaluación de balance funcional (Mini-BESTest. Se evaluó el test antes y después del tratamiento y se compararon los resultados para determinar el porcentaje de mejora. Resultados. En los dos casos se observó mejora clínica en el desempeño de la evaluación de balance funcional Mini-BESTest con un porcentaje de mejora entre el 21% y el 41%. Conclusión. Existen pocos hallazgos literarios que describen el mantenimiento de la capacidad de aprendizaje motor en pacientes con antecedentes de ACV. Este estudio reportó la capacidad para transferir el aprendizaje motor a una habilidad motora no aprendida (balance en dos casos, con base en la mejoría clínica del desempeño motor en el test aplicado.

  13. Angiotensin II type 1 receptor blocker losartan prevents and rescues cerebrovascular, neuropathological and cognitive deficits in an Alzheimer's disease model.

    Science.gov (United States)

    Ongali, Brice; Nicolakakis, Nektaria; Tong, Xin-Kang; Aboulkassim, Tahar; Papadopoulos, Panayiota; Rosa-Neto, Pedro; Lecrux, Clotilde; Imboden, Hans; Hamel, Edith

    2014-08-01

    Angiotensin II (AngII) receptor blockers that bind selectively AngII type 1 (AT1) receptors may protect from Alzheimer's disease (AD). We studied the ability of the AT1 receptor antagonist losartan to cure or prevent AD hallmarks in aged (~18months at endpoint, 3months treatment) or adult (~12months at endpoint, 10months treatment) human amyloid precursor protein (APP) transgenic mice. We tested learning and memory with the Morris water maze, and evaluated neurometabolic and neurovascular coupling using [(18)F]fluoro-2-deoxy-D-glucose-PET and laser Doppler flowmetry responses to whisker stimulation. Cerebrovascular reactivity was assessed with on-line videomicroscopy. We measured protein levels of oxidative stress enzymes (superoxide dismutases SOD1, SOD2 and NADPH oxidase subunit p67phox), and quantified soluble and deposited amyloid-β (Aβ) peptide, glial fibrillary acidic protein (GFAP), AngII receptors AT1 and AT2, angiotensin IV receptor AT4, and cortical cholinergic innervation. In aged APP mice, losartan did not improve learning but it consolidated memory acquisition and recall, and rescued neurovascular and neurometabolic coupling and cerebrovascular dilatory capacity. Losartan normalized cerebrovascular p67phox and SOD2 protein levels and up-regulated those of SOD1. Losartan attenuated astrogliosis, normalized AT1 and AT4 receptor levels, but failed to rescue the cholinergic deficit and the Aβ pathology. Given preventively, losartan protected cognitive function, cerebrovascular reactivity, and AT4 receptor levels. Like in aged APP mice, these benefits occurred without a decrease in soluble Aβ species or plaque load. We conclude that losartan exerts potent preventive and restorative effects on AD hallmarks, possibly by mitigating AT1-initiated oxidative stress and normalizing memory-related AT4 receptors.

  14. Regional partition coefficient of water in patients with cerebrovascular disease and its effect on rCBF assessment

    OpenAIRE

    Hirata, Kenji; Hattori, Naoya; Katoh, Chietsugu; Shiga, Tohru; KURODA, Satoshi; Kubo, Naoki; Usui, Reiko; Kuge, Yuji; Tamaki, Nagara

    2011-01-01

    Objective: Cerebral blood flow (CBF) estimation with C15O2 PET usually assumes a single tissue compartment model and a fixed brain-blood partition coefficient of water. However, the partition coefficient may change in pathological conditions. The purpose of this study was to investigate the changes of partition coefficient of water in pathological regions and its effect on regional CBF assessment. Methods: Study protocol included 22 patients with occlusive cerebrovascular disease to compare p...

  15. Magnetic resonance imaging of regional hemodynamic and cerebrovascular recovery after lateral fluid-percussion brain injury in rats

    OpenAIRE

    2010-01-01

    Hemodynamic and cerebrovascular factors are crucially involved in secondary damage after traumatic brain injury (TBI). With magnetic resonance imaging, this study aimed to quantify regional cerebral blood flow (CBF) by arterial spin labeling and cerebral blood volume by using an intravascular contrast agent, during 14 days after lateral fluid-percussion injury (LFPI) in rats. Immunohistochemical analysis of vessel density was used to evaluate the contribution of vascular damage. Results show ...

  16. Murine cerebrovascular cells as a cell culture model for cerebral amyloid angiopathy: isolation of smooth muscle and endothelial cells from mouse brain.

    Science.gov (United States)

    Gauthier, Sebastien A; Sahoo, Susmita; Jung, Sonia S; Levy, Efrat

    2012-01-01

    The use of murine cerebrovascular endothelial and smooth muscle cells has not been widely employed as a cell culture model for the investigation of cellular mechanisms involved in cerebral amyloid angiopathy (CAA). Difficulties in isolation and propagation of murine cerebrovascular cells and insufficient yields for molecular and cell culture studies have deterred investigators from using mice as a source for cerebrovascular cells in culture. Instead, cerebrovascular cells from larger mammals are preferred and several methods describing the isolation of endothelial and smooth muscle cells from human, canine, rat, and guinea pig have been published. In recent years, several transgenic mouse lines showing CAA pathology have been established; consequently murine cerebrovascular cells derived from these animals can serve as a key cellular model to study CAA. Here, we describe a procedure for isolating murine microvessels that yields healthy smooth muscle and endothelial cell populations and produce sufficient material for experimental purposes. Murine smooth muscle cells isolated using this protocol exhibit the classic "hill and valley" morphology and are immunoreactive for the smooth muscle cell marker α-actin. Endothelial cells display a "cobblestone" pattern phenotype and show the characteristic immunostaining for the von Willebrand factor and the factor VIII-related antigen. In addition, we describe methods designed to preserve these cells by storage in liquid nitrogen and reestablishing viable cell cultures. Finally, we compare our methods with protocols designed to isolate and maintain human cerebrovascular cell cultures.

  17. β-FIBRINOGEN PROMOTER-455 G/A (HaeⅢ) POLYMORPHISM PREDICTION OF PLASMA FIBRINOGEN BUT NOT OF ISCHEMIC CEREBROVASCULAR DISEASE

    Institute of Scientific and Technical Information of China (English)

    毕胜; 王德生; 李国忠; 温世荣; 潘尚哈

    2004-01-01

    Objective The-455 G/A (HaeⅢ) polymorphism of β-fibrinogen gene influences levels of plasma fibrinogen. We further investigated whether it influences the risk of ischemic cerebrovascular disease. Methods We accumulated 134 acute ischemic cerebrovascular disease (ICVD) cases and compared their -455 G/A status with a control group (n = 166). The β-fibrinogen gene -455 G/A polymorphism was analyzed for all subjects by PCR-RFLP with the restrictive enzyme HaeⅢ. Results Plasma fibrinogen was higher in AA homozygous participants (341 mg/dL) than in participants carrying the G allele: GA (290 mg/dL), GG (298 mg/dL) in the control group. Plasma fibrinogen was also higher in AA homozygous patients (353 mg/dL) than in cases carrying the G allele: GA (287mg/dL), GG (302 mg/dL) in the ICVD group. However, there was no significant association between β-fibrinogen gene -455 G/A polymorphism and ICVD group. Conclusions Although a small effect cannot be excluded, β-fibrinogen gene -455 G/A polymorphism is an independent predictor of plasma fibrinogen, but not of ischemic cerebrovascular disease.

  18. Cerebrovascular and ventilatory responses to acute isocapnic hypoxia in healthy aging and lung disease: effect of vitamin C.

    Science.gov (United States)

    Hartmann, Sara E; Waltz, Xavier; Kissel, Christine K; Szabo, Lian; Walker, Brandie L; Leigh, Richard; Anderson, Todd J; Poulin, Marc J

    2015-08-15

    Acute hypoxia increases cerebral blood flow (CBF) and ventilation (V̇e). It is unknown if these responses are impacted with normal aging, or in patients with enhanced oxidative stress, such as (COPD). The purpose of the study was to 1) investigate the effects of aging and COPD on the cerebrovascular and ventilatory responses to acute hypoxia, and 2) to assess the effect of vitamin C on these responses during hypoxia. In 12 Younger, 14 Older, and 12 COPD, we measured peak cerebral blood flow velocity (V̄p; index of CBF), and V̇e during two 5-min periods of acute isocapnic hypoxia, under conditions of 1) saline-sham; and 2) intravenous vitamin C. Antioxidants [vitamin C, superoxide dismutase (SOD), glutathione peroxidase, and catalase], oxidative stress [malondialdehyde (MDA) and advanced protein oxidation product], and nitric oxide metabolism end products (NOx) were measured in plasma. Following the administration of vitamin C, vitamin C, SOD, catalase, and MDA increased, while NOx decreased. V̄p and V̇e sensitivity to hypoxia was reduced in Older by ∼60% (P 0.05). Vitamin C did not have an effect on the hypoxic V̇e response but selectively decreased the V̄p sensitivity in Younger only. These findings suggest a reduced integrative reflex (i.e., cerebrovascular and ventilatory) during acute hypoxemia in healthy older adults. Vitamin C does not appear to have a large influence on the cerebrovascular or ventilatory responses during acute hypoxia.

  19. Venous Thromboembolism and Cerebrovascular Events in Patients with Giant Cell Arteritis: A Population-Based Retrospective Cohort Study.

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    Alberto Lo Gullo

    Full Text Available To investigate the incidence of venous thromboembolism (VTE and cerebrovascular events in a community-based incidence cohort of patients with giant cell arteritis (GCA compared to the general population.A population-based inception cohort of patients with incident GCA between January 1, 1950 and December 31, 2009 in Olmsted County, Minnesota and a cohort of non-GCA subjects from the same population were assembled and followed until December 31, 2013. Confirmed VTE and cerebrovascular events were identified through direct medical record review.The study population included 244 patients with GCA with a mean ± SD age at diagnosis of 76.2 ± 8.2 years (79% women and an average length of follow-up of 10.2 ± 6.8 years. Compared to non-GCA subjects of similar age and sex, patients diagnosed with GCA had a higher incidence (% of amaurosis fugax (cumulative incidence ± SE: 2.1 ± 0.9 versus 0, respectively; p = 0.014 but similar rates of stroke, transient ischemic attack (TIA, and VTE. Among patients with GCA, neither baseline characteristics nor laboratory parameters at diagnosis reliably predicted risk of VTE or cerebrovascular events.In this population-based study, the incidence of VTE, stroke and TIA was similar in patients with GCA compared to non-GCA subjects.

  20. The Vulnerability of Vessels Involved in the Role of Embolism and Hypoperfusion in the Mechanisms of Ischemic Cerebrovascular Diseases

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    Yong Peng Yu

    2016-01-01

    Full Text Available Accurate definition and better understanding of the mechanisms of stroke are crucial as this will guide the effective care and therapy. In this paper, we review the previous basic and clinical researches on the causes or mechanisms of ischemic cerebrovascular diseases (ICVD and interpret the correlation between embolism and hypoperfusion based on vascular stenosis and arterial intimal lesions. It was suggested that if there is no embolus (dynamic or in situ emboli, there might be no cerebral infarction. Three kinds of different clinical outcomes of TIA were theoretically interpreted based on its mechanisms. We suppose that there is a correlation between embolism and hypoperfusion, and which mechanisms (hypoperfusion or hypoperfusion induced microemboli playing the dominant role in each type of ICVD depends on the unique background of arterial intimal lesions (the vulnerability of vessels. That is to say, the vulnerability of vessels is involved in the role of embolism and hypoperfusion in the mechanisms of ischemic cerebrovascular diseases. This inference might enrich and provide better understandings for the underlying etiologies of ischemic cerebrovascular events.

  1. VanderLaan Circulant Type Matrices

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    Hongyan Pan

    2015-01-01

    Full Text Available Circulant matrices have become a satisfactory tools in control methods for modern complex systems. In the paper, VanderLaan circulant type matrices are presented, which include VanderLaan circulant, left circulant, and g-circulant matrices. The nonsingularity of these special matrices is discussed by the surprising properties of VanderLaan numbers. The exact determinants of VanderLaan circulant type matrices are given by structuring transformation matrices, determinants of well-known tridiagonal matrices, and tridiagonal-like matrices. The explicit inverse matrices of these special matrices are obtained by structuring transformation matrices, inverses of known tridiagonal matrices, and quasi-tridiagonal matrices. Three kinds of norms and lower bound for the spread of VanderLaan circulant and left circulant matrix are given separately. And we gain the spectral norm of VanderLaan g-circulant matrix.

  2. Conservation of Circulation in Magnetohydrodynamics

    CERN Document Server

    Bekenstein, J D; Bekenstein, Jacob D.; Oron, Asaf

    2000-01-01

    We demonstrate, both at the Newtonian and (general) relativistic levels, theexistence of a generalization of Kelvin's circulation theorem (for pure fluids)which is applicable to perfect magnetohydrodynamics. The argument is based onthe least action principle for magnetohydrodynamic flow. Examples of the newconservation law are furnished. The new theorem should be helpful inidentifying new kinds of vortex phenomena distinct from magnetic ropes or fluidvortices.

  3. Cholesteryl ester transfer protein levels and gene deficiency in Chinese patients with cardio-cerebrovascular diseases

    Institute of Scientific and Technical Information of China (English)

    庄一义; 汪俊军; 张宏娟; 李勇; 刘小传; 李露言; 陈光辉

    2002-01-01

    Objective To detect cholesteryl ester transfer protein (CETP) levels, frequencies of CETP D442G and Ⅰ14A mutations and characteristics of abnormal lipids in patients with cardio-cerebro vascular diseases. Methods Ninety-four myocardial infarction (MI) patients,110 stroke patients and 335 healthy controls were selected. The CETP concentration was determined using ELISA. The CETP activity was measured using a substrate of 14 C-radiolabeled discoidal bilayer particles. The CETP gene mutations were detected by PCR-RFLP. Results The CETP concentrations in the MI and stroke group, were higher than those in the controls. The gene mutation frequencies of D442G in the MI, stroke and control group were 3.5%, 3.6% and 5%, respectively, and the frequencies of Ⅰ14A were 1.05%, 0.91% and 1%, respectively. One case of D442G homozygote was detected in the healthy group. The frequency of two CETP gene mutations showed no significant difference among the patients and controls. The CETP concentration and activity in subjects with CETP mutations were one-third of those in the control group. The level of HDL-C, apo-A1 increased in the mutation subjects, while the TG level decreased. Conclusions The CETP level increased significantly in patients with cardio-cerebrovascular diseases. The carriers of CETP deficiency had CETP and lipid abnormalities.

  4. Pharmacogenetics of cerebrovascular metabolism modulators in dementia due to Alzheimer’s disease

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    Fabricio Ferreira de Oliveira

    2015-03-01

    Full Text Available The aims of this study were to investigate risk factors for cognitive and functional decline among 193 patients with Alzheimer’s disease dementia (AD, and to conduct pharmacogenetic analysis on cerebrovascular metabolism modulators, taking into account APOE haplotypes and the genotypes of ACE, CETP, LDLR and the LXR-β gene. For all patients, later age at AD onset was the most important risk factor for faster cognitive and functional decline, while the late-life coronary heart disease risk was inversely related to cognitive decline only for carriers of APOE4+ haplotypes. Schooling was protective against cognitive decline only for women and carriers of APOE4+ haplotypes, while higher body mass index in late life was protective against cognitive decline only for men. Carriers of the APOE-ε4/ε4 haplotype had earlier AD onset, whereas genotypes of CETP and LDLR that had traditionally been associated with higher risk of AD were associated with later onset of dementia. Angiotensin-converting enzyme inhibitors caused a 50% reduction in Mini-Mental State Examination score changes, and had better disease-modifying properties than did centrally-acting angiotensin-converting enzyme inhibitors alone. Angiotensin receptor blockers had genetically mediated effects that led to faster cognitive and functional decline, while patients with genetic tendencies towards faster cognitive and functional decline had maximum benefits when they used lipophilic statins, and vice versa.

  5. Treatment of migraine attacks based on the interaction with the trigemino-cerebrovascular system.

    Science.gov (United States)

    Link, Andrea Stephanie; Kuris, Anikó; Edvinsson, Lars

    2008-02-01

    Primary headaches such as migraine are among the most prevalent neurological disorders, affecting up to one-fifth of the adult population. The scientific work in the last decade has unraveled much of the pathophysiological background of migraine, which is now considered to be a neurovascular disorder. It has been discovered that the trigemino-cerebrovascular system plays a key role in migraine headache pathophysiology by releasing the potent vasodilator calcitonin gene-related peptide (CGRP). This neuropeptide is released in parallel with the pain and its concentration correlates well with the intensity of the headache. The development of drugs of the triptan class has provided relief for the acute attacks but at the cost of, mainly cardiovascular, side effects. Thus, the intention to improve treatment led to the development of small CGRP receptor antagonists such as olcegepant (BIBN4096BS) and MK-0974 that alleviate the acute migraine attack without acute side events. The purpose of this review is to give a short overview of the pathological background of migraine headache and to illustrate the mechanisms behind the actions of triptans and the promising CGRP receptor blockers.

  6. Hereditary and Sporadic Forms of Aβ-Cerebrovascular Amyloidosis and Relevant Transgenic Mouse Models

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    Samir Kumar-Singh

    2009-04-01

    Full Text Available Cerebral amyloid angiopathy (CAA refers to the specific deposition of amyloid fibrils in the leptomeningeal and cerebral blood vessel walls, often causing secondary vascular degenerative changes. Although many kinds of peptides are known to be deposited as vascular amyloid, amyloid-β (Aβ-CAA is the most common type associated with normal aging, sporadic CAA, Alzheimer’s disease (AD and Down’s syndrome. Moreover, Aβ-CAA is also associated with rare hereditary cerebrovascular amyloidosis due to mutations within the Aβ domain of the amyloid precursor protein (APP such as Dutch and Flemish APP mutations. Genetics and clinicopathological studies on these familial diseases as well as sporadic conditions have already shown that CAA not only causes haemorrhagic and ischemic strokes, but also leads to progressive dementia. Transgenic mouse models based on familial AD mutations have also successfully reproduced many of the features found in human disease, providing us with important insights into the pathogenesis of CAA. Importantly, such studies have pointed out that specific vastopic Aβ variants or an unaltered Aβ42/Aβ40 ratio favor vascular Aβ deposition over parenchymal plaques, but higher than critical levels of Aβ40 are also observed to be anti-amyloidogenic. These data would be important in the development of therapies targeting amyloid in vessels.

  7. [Home-based rehabilitation in the functional recovery of patients with cerebrovascular disease].

    Science.gov (United States)

    López-Liria, Remedios; Ferre-Salmerón, Rocío; Arrebola-López, Clara; Granados-Valverde, Rocío; Gobernado-Cabero, Miguel Ángel; Padilla-Góngora, David

    2013-06-16

    Introduccion. El estudio de la eficacia en los tratamientos de rehabilitacion aplicados a pacientes con secuelas tras una enfermedad cerebrovascular (ECV) resulta decisivo en la actualidad para planificar su abordaje desde la sanidad publica y mejorar las directrices de evaluacion y tratamiento existentes. Objetivo. Describir las caracteristicas que presentan los pacientes que han sufrido ECV atendidos por las unidades moviles de rehabilitacion-fisioterapia (UMRF) y como influyen estos tratamientos sobre su recuperacion funcional. Pacientes y metodos. Estudio descriptivo prospectivo en 124 pacientes derivados a las UMRF de la provincia de Almeria entre 2008 y 2011. Se analizaron variables (pre y postratamiento) como las caracteristicas y antecedentes personales, indice de Barthel, escala de espasticidad de Ashworth modificada, dolor (hombro) y escala neurologica canadiense. Resultados. La muestra final estuvo compuesta por 106 participantes (edad media: 73,72 años). El proceso discapacitante fue isquemico en un 77,4%, y la hipertension, el factor de riesgo mas prevalente (81%). La media del indice de Barthel inicial fue de 31,04, y la media del indice final, de 57,62 (t = –11,75; p mejora funcional en los pacientes tratados en las UMRF. La rehabilitacion domiciliaria se plantea como una herramienta necesaria para las personas con mayor vulnerabilidad clinica y sin acceso a los cuidados ambulatorios, que logra los beneficios de tratamientos que son efectivos.

  8. Different cerebrovascular effects of medroxyprogesterone acetate and norethisterone acetate in the New Zealand White rabbit

    DEFF Research Database (Denmark)

    Pedersen, S H; Pedersen, N G; Dalsgaard, T

    2004-01-01

    equine estrogens (CEE) (1.25 mg/day); 17beta-estradiol (E2) (4 mg/day); MPA + CEE (10 mg/day + 1.25 mg/day); NETA + E2 (3 mg/day + 4 mg/day); or placebo. Segments from the basilar and posterior cerebral arteries were mounted in myographs for tension recordings. Concentration-response curves to potassium....... No overall differences were seen between CEE and E2. CONCLUSIONS: In rabbit cerebral arteries, MPA treatment causes a higher development in arterial tension compared with NETA, indicating that different progestins may display different cerebrovascular effects. However, when accompanied by estrogens.......47 +/- 0.19) and calcium (4.00 +/- 0.22 vs. 3.34 +/- 0.14) in the posterior cerebral artery, and to endothelin-1 (6.88 +/- 0.69 vs. 5.22 +/- 0.30) in the basilar artery, when compared with NETA. This difference was neutralized in the groups receiving the combined treatment of MPA + CEE and NETA + E2...

  9. Assessment of Vitamin D level in Cerebrovascular Accident Patients in Eastern India

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    Kaushik Chatterjee

    2014-12-01

    Full Text Available Aims and objectives: Vitamin D in addition to its effect on bone- mineral homeostasis has many extra-skeletal effects. Recently its association with cardiovascular disease, diabetes, hypertension are well described. In our study we have tried to find out any of its association with cerebrovascular accident (CVA patients. Material and Methods: In a cross sectional study serum 25 OH vitamin D3, parathormone, calcium and phosphate were estimated in 38 CVA patients and 46 age and sex matched controls. Results: Vitamin D level was found to be low in CVA patients [mean 20.01(+/-7.13 ng/ml] irrespective of their sex, residence, diabetes and hypertension. However there was no significant difference with control population [mean 20.37(+/-5.74 ng/ml; P= 0.79]. Conclusion: There is no significant difference in vitamin D level between CVA patients or non-CVA population. So the role of vitamin D deficiency in the causation of CVA needs reevaluation, especially in Indian patients." [Natl J Med Res 2014; 4(4.000: 264-269

  10. Recovery of atrophic leg muscles in the hemiplegics due to cerebrovascular accidents. Computed tomographic study

    Energy Technology Data Exchange (ETDEWEB)

    Odajima, Natsu; Ishiai, Sumio; Okiyama, Ryouichi; Furukawa, Tetsuo; Tsukagoshi, Hiroshi.

    1988-02-01

    Thirty-five patients with hemiplegia due to cerebrovascular accidents were studied with regared to the muscle wastings before and after rehabilitation training. Hemiplegics were composed of 12 improved and 23 non-improved patients. The CT scan was carried out at the midportion of the thigh and largest-diameter section of the calf. Muscle size of each cross-sectional area was measured on CT image and the increase of size (..delta..S) in each muscle after training was calculated. The ..delta..S of quadriceps femoris was correlated with that of whole cross-section of the thigh. The gracilis in non-affected side was not correlated with that of whole muscles. In both legs, there was an increase in leg muscle size after training. These changes were nost marked in the non-affected side of the improved patients. After training the difference between the two limbs remained unchanged. Recovery of muscle wasting in both legs was seen first in the quadriceps in thigh and flexors in calf. Gracilis was relatively unchanged in comparison with other muscles. Remarkable increase of muscle size in non-affected side was worthwhile to note.

  11. Effects of peritumoural oedema on cerebral blood flow and cerebrovascular reactivity in patients with alert consciousness

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Chia-Cheng [Department of Neurosurgery, Yokohama Minami Kyosai Hospital, Yokohama (Japan); Department of Neurosurgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan 236-0004; Kuwana, Nobumasa; Ito, Susumu [Department of Neurosurgery, Yokohama Minami Kyosai Hospital, Yokohama (Japan); Ikegami, Tadashi [Department of Radiology, Yokohama Minami Kyosai Hospital, Yokohama (Japan); Yamamoto, Isao [Department of Neurosurgery, Yokohama City University School of Medicine, Yokohama (Japan)

    1999-11-01

    The effects of peritumoural oedema on cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) were studied in 18 patients with alert consciousness. Hemispheric mean CBF was measured by performing first-pass radionuclide angiography using technetium-99m hexamethylpropylene amine oxime. CVR was measured as the percentage change from the baseline mean CBF value after acetazolamide administration. Patients were classified into three groups according to the severity of peritumoural oedema. The mean CBF of both hemispheres in each group was not significantly different from that of age-matched controls. CVR was preserved in patients with mild peritumoural oedema (n=6), but was significantly (P<0.01) reduced in patients with moderate (n=7) and severe peritumoural oedema (n=5). No significant correlation was found between the degree of midline shift and the mean CVR of both hemispheres (P=0.09). Surgical removal of the tumour significantly (P<0.05) improved the impaired CVR, although the mean CBF did not change. Administration of glucocorticoid improved the impaired CVR, without a change in the mean CBF, in a patient with a metastatic brain tumour. We conclude that CVR is impaired by the development of peritumoural oedema prior to changes in mean CBF. (orig.)

  12. Cerebral Endothelial Function Determined by Cerebrovascular Reactivity to L-Arginine

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    Janja Pretnar-Oblak

    2014-01-01

    Full Text Available Endothelium forms the inner cellular lining of blood vessels and plays an important role in many physiological functions including the control of vasomotor tone. Cerebral endothelium is probably one of the most specific types but until recently it was impossible to determine its function. In this review, the role of cerebrovascular reactivity to L-arginine (CVR-L-Arg for assessment of cerebral endothelial function is discussed. L-Arginine induces vasodilatation through enhanced production of nitric oxide (NO in the cerebral endothelium. Transcranial Doppler sonography is used for evaluation of cerebral blood flow changes. The method is noninvasive, inexpensive, and enables reproducible measurements. CVR-L-Arg has been compared to flow-mediated dilatation as a gold standard for systemic endothelial function and intima-media thickness as a marker for morphological changes. However, it seems to show specific cerebral endothelial function. So far CVR-L-Arg has been used to study cerebral endothelial function in many pathological conditions such as stroke, migraine, etc. In addition CVR-L-Arg has also proven its usefulness in order to show potential improvement after pharmacological interventions. In conclusion CVR-L-Arg is a promising noninvasive research method that could provide means for evaluation of cerebral endothelial function in physiological and pathological conditions.

  13. Systems pharmacology for traditional Chinese medicine with application to cardio-cerebrovascular diseases

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    Yingxue Fu

    2014-10-01

    Full Text Available Identified as a treasure of natural herbal products, traditional Chinese medicine (TCM has attracted extensive attention for their moderate treatment effect and lower side effect. Cardio-cerebrovascular diseases (CCVD are a leading cause of death. TCM is used in China to prevent and treat CCVD. However, the complexity of TCM poses challenges in understanding the mechanisms of herbs at a systems-level, thus hampering the modernization and globalization of TCM. A novel model, termed traditional Chinese medicine systems pharmacology (TCMSP analysis platform, which relies on the theory of systems pharmacology and integrates absorption, distribution, metabolism, excretion and toxicity (ADME/T evaluation, target prediction and network/pathway analysis, was proposed to address these problems. Here, we review the development of systems pharmacology, the TCMSP approach and its applications in the investigations of CCVD and compare it with other methods. TCMSP assists in uncovering the mechanisms of action of herbal formulas used in treating CCVD. It can also be applied in ascertaining the different syndrome patterns of coronary artery disease, decoding the multi-scale mechanisms of herbs, and in understanding the mechanisms of herbal synergism.

  14. MR imaging of the corpus callosum in the patients of ischemic cerebrovascular disease

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    Umahara, Takahiko; Tanaka, Yuriko; Yamaguchi, Katsuhiko; Imamura, Toshiharu; Iwamoto, Toshihiko; Katsunuma, Hideyo (Tokyo Medical Coll. (Japan))

    1990-12-01

    We studied the abnormal MR morphology of the corpus callosum (CC) in 8 cases of progressive subcortical vascular encephalopathy (PSVE), 1 case of anterior cerebral artery (ACA) area hemorrhagic infarction, 5 cases of middle cerebral artery (MCA) area infarction, and 7 cases of posterior cerebral artery (PCA) area infarction (2 cases had bilateral PCA infarction). In addition, we studied the MR imaging of sagittal sulcal lesions of CC (SSLCC), and of inner callosal-subcallosal lesions (or inner callosal-subcallosal laminar hyperintensity; ICLH). PSVE usually showed diffuse attenuations of CC, and findings similar to a localized callosal infarction sometimes were observed. The ACA infarct case showed a rupture of the CC. The MCA infarct cases had focal attenuations (mainly at the body of the CC) caused by secondary degenerations. Only 1 of the 5 cases with unilateral PCA infarction showed a lesion in the splenium of the CC. These results are generally in accord with the results of our previous pathological study of the CC in ischemic cerebrovascular disease. Linear low signal intensity areas at the gneu found in 77% of our MRI cases, and we think these lesions compatible with SSLCC which we have studied previously. ICLH was found in the cases of PSVE, multi-infarct, and clinically normals. We therefore suggest that ICLH seems to have no disease specificity. (author).

  15. Blunt cerebrovascular injury in rugby and other contact sports: case report and review of the literature.

    Science.gov (United States)

    Cuellar, Trajan A; Lottenberg, Lawrence; Moore, Frederick A

    2014-01-01

    Contact sports have long been a part of human existence. The two earliest recorded organized contact games, both of which still exist, include Royal Shrovetide Football played since the 12(th) century in England and Caid played since 1308 AD in Ireland. Rugby is the premier contact sport played throughout the world with the very popular derivative American football being the premier contact sport of the North American continent. American football in the USA has on average 1,205,037 players at the high school and collegiate level per year while rugby in the USA boasts a playing enrollment of 457,983 at all levels. Recent media have highlighted injury in the context of competitive contact sports including their long-term sequelae such as chronic traumatic encephalopathy (CTE) that had previously been underappreciated. Blunt cerebrovascular injury (BCVI) has become a recognized injury pattern for trauma; however, a paucity of data regarding this injury can be found in the sports trauma literature. We present a case of an international level scrum-half playing Rugby Union at club level for a local non-professional team, in which a player sustained a fatal BCVI followed by a discussion of the literature surrounding sport related BCVI.

  16. RECOVERY ASSESSMENT OF DAILY AND LABOUR ACTIVITIES (FOOD PREPARING AND FEEDING IN PATIENTS WITH CEREBROVASCULAR DISEASE

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    Danelina Vacheva

    2013-08-01

    Full Text Available Bulgaria is in a leading position concerning morbidity and mortality rate from cerebrovascular disease (CVD. The goal of this research was to examine, follow up and assess the recovery and the ability for food preparation and feeding in patients with CVD.Materials and methods: Sixty one patients were included in the research. All of them underwent physical rehabilitation program, based on their individual status. The program included: kinesitherapy, labour-therapy [(occupational therapy (OT and activities of daily life (ADL]; electrotherapy. The patients were assessed twice: in the beginning and at the end of the rehabilitation course. They self evaluated the basic parameters nevertheless which of the limbs was particularly affected. Wilcoxon rank test was used for the statistical analysis of non parametrical data and distribution. Results and analysis: At the end of the rehabilitation course the Wilcoxon’s curves were found shifted to the right, which confirmes improvement of the main parameter (self independence in the main task set to be fulfilled, no matter which limb was paretic.Conclusion: Early initiation of the rehabilitation course including labour activities and elements of ADL, given as instructions is essential for achieving better results in the rehabilitation of patients with CVD and for enhancing the self service ability. Functional OT stimulates the independence of patients and facilitates their recovering to independent everyday life and social activities.

  17. Cerebrovascular adaptations to cocaine-induced transient ischemic attacks in the rodent brain

    Science.gov (United States)

    You, Jiang; Volkow, Nora D.; Park, Kicheon; Zhang, Qiujia; Clare, Kevin; Du, Congwu

    2017-01-01

    Occurrence of transient ischemic attacks (TIA) and cerebral strokes is a recognized risk associated with cocaine abuse. Here, we use a rodent model along with optical imaging to study cocaine-induced TIA and the associated dynamic changes in cerebral blood flow velocity (CBFv) and cerebrovasculature. We show that chronic cocaine exposure in mice resulted in marked cortical hypoperfusion, in significant arterial and venous vasoconstriction, and in a sensitized vascular response to an acute cocaine injection. Starting after 10 days of exposure, an acute cocaine challenge to these mice resulted in a TIA, which presented as hemiparalysis and was associated with an abrupt exacerbation of CBFv. The severity of the TIA correlated with the decreases in cortical CBFv such that the greater the decreases in flow, the longer the TIA duration. The severity of TIA peaked around 17–22 days of cocaine exposure and decreased thereafter in parallel to a reorganization of CBFv from superficial to deep cortical layers, along with an increase in vessel density into these layers. Here, we document for the first time to our knowledge evidence of a TIA in an animal model of chronic cocaine exposure that was associated with profound decreases in CBFv, and we revealed that while the severity of the TIA initially increased with repeated exposures, it subsequently improved in parallel to an increase in the vessel density. This suggests that strategies to accelerate cerebrovascular recovery might be therapeutically beneficial in cocaine abusers.

  18. Association between cervical spine and skull-base fractures and blunt cerebrovascular injury

    Energy Technology Data Exchange (ETDEWEB)

    Buch, Karen; Nguyen, Thanh; Norbash, Alex; Mian, Asim [Boston University School of Medicine, Department of Radiology, Boston Medical Center, Boston, MA (United States); Mahoney, Eric; Burke, Peter [Boston University School of Medicine, Department of Surgery, Boston Medical Center, Boston, MA (United States); Libby, Brandon; Calner, Paul [Boston University School of Medicine, Department of Emergency Medicine, Boston Medical Center, Boston, MA (United States)

    2016-02-15

    Blunt cerebrovascular injuries (BCVI) are associated with high morbidity and mortality and can lead to neurological deficits. The established criteria for patients undergoing CT angiography (CTA) for BCVI are broad, and can expose patients to radiation unnecessarily. This study aimed to examine the prevalence of BCVI in patients on CTA and determine presentations associated with the highest rates of BCVI. With IRB approval, patients were selected for CTA screening for BCVI according to a predefined set of criteria at our hospital between 2007 and 2010. Patients were identified from our institution's trauma database. CTAs were retrospectively reviewed for BCVI including vasospasm and dissection. Electronic medical records were reviewed for clinical presentation and hospital course. Of 432 patients, vasospasm (n = 10) and/or dissection (n = 36) were found in 46 patients (10.6 %). BCVI was associated with cervical spine and/or skull-base fracture in 40/46 patients (87 %, P < 0.0001). Significant correlations were seen between dissection and fracture in 31/36 patients (86.2 %, p < 0.0001) and between BCVI and both neurological deficits and fractures (27/44, P < 0.0001). BCVI was significantly associated with cervical and/or skullbase fractures and neurological deficits with coexistent fractures. Patients with these injuries should be prioritized for rapid CTA evaluation for BCVI. (orig.)

  19. Optimal Backward Perturbation Analysis for the Block Skew Circulant Linear Systems with Skew Circulant Blocks

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    Zhaolin Jiang

    2014-01-01

    Full Text Available We first give the block style spectral decomposition of arbitrary block skew circulant matrix with skew circulant blocks. Secondly, we obtain the singular value of block skew circulant matrix with skew circulant blocks as well. Finally, based on the block style spectral decomposition, we deal with the optimal backward perturbation analysis for the block skew circulant linear system with skew circulant blocks.

  20. Colour Doppler evaluation of extracranial carotid artery in patients presenting with features of cerebrovascular disease: A clinical and radiological correlation

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    Sanjeev Sehrawat

    2012-01-01

    Full Text Available Aim: To evaluate the morphological and hemodynamic changes that take place in carotid arteries by colour Doppler in patients presenting with features of stroke. Background and Objectives: Cerebrovascular accidents constitute a major cause of adult mortality. The principal indication for cerebrovascular Doppler examination is stroke prevention. Colour Doppler sonography is a sensitive method for detection of atherosclerotic plaque and provides considerable information about the extent and severity of plaque as well as the resulting diminution of arterial lumen. The main strengths of sonography of carotid arteries are patient comfort, lack of risk and accuracy in detecting carotid stenosis. Material and Methods: A prospective study of Colour Doppler in carotid arteries was carried out for 12 months from 1 st July 2009 to 1 st July 2010. The study was carried out on 40 individuals, suspected of cerebrovascular insufficiency and having one or the other risk factors for cerebrovascular disease. A detailed clinical history, CNS examination findings and evidence of hypertension, diabetes mellitus, hyperlipidemia and ischemic heart disease were noted. Carotid Doppler evaluation was done by using Siemens Antares Ultrasound system. The data gathered were grey scale and Doppler findings of common carotid artery, internal carotid artery and external carotid arteries. Doppler findings were correlated with clinical features and risk factors. Results: In our study of 40 patients, the commonest lesion found was the atherosclerotic plaque. Highest incidence of plaque was seen in males 41% in the age group of 60-70 years and in females 37% in age group of 70-80 years. Cigarette smoking was the most common risk factor (60% associated with stroke/ Transient Ischaemic Attacks (TIA. Hemiparesis was the most common presenting symptom (35% among the symptomatic cases. Atheromatous plaque was most commonly found in the right carotid system (60%. Most common site for

  1. Prescripción facilitada de drogas antihipertensivas y disminución de la muerte prematura por accidente cerebrovascular

    Directory of Open Access Journals (Sweden)

    Javier Mariani

    2016-04-01

    Full Text Available Introducción: Desde 2003, el programa Remediar (+Redes distribuye gratuitamente medicación antihipertensiva. Durante este período, la mortalidad por accidente cerebrovascular disminuyó, aunque con inequidades entre grupos socioeconómicos. Objetivos: Evaluar la asociación entre la mortalidad por accidente cerebrovascular y la provisión de fármacos antihipertensivos. Estudiar la posible interacción entre los efectos de los antihipertensivos sobre la mortalidad y el nivel socioeconómico. Material y métodos: Se realizó un estudio ecológico para datos de panel. La mortalidad se expresa como tasas estandarizadas.Los fármacos antihipertensivos están ajustados a la población entre la que se distribuyeron y se expresan en cuartiles dedispensación. El nivel socioeconómico se midió por las necesidades básicas insatisfechas. Resultados: Desde el inicio del programa en 2003, la distribución de antihipertensivos aumentó significativamente, sobre todo en los grupos menos afluentes (p < 0,001. No hubo una asociación estadísticamente significativa entre la tasa de dispensaciónde antihipertensivos y la mortalidad por accidente cerebrovascular globalmente. Sin embargo, en los análisis de interacción se observó que en los quintiles 3 a 5 de necesidades básicas insatisfechas (menos afluentes, los cuartiles en los que se distribuyeron más antihipertensivos tuvieron significativamente menor mortalidad por accidente cerebrovascular (p = 0,004,p = 0,015 y p = 0,017, para los quintiles 3 a 5 de nivel socioeconómico. Conclusiones: Los resultados del presente análisis sugieren la ausencia de efectos globales de la provisión de antihipertensivossobre la mortalidad por accidente cerebrovascular. Sin embargo, los datos muestran que, entre los grupos más desfavorecidos,la distribución de antihipertensivos estuvo asociada con una reducción de la mortalidad por esta causa.

  2. Lipoprotein receptor-related protein-1 mediates amyloid-beta-mediated cell death of cerebrovascular cells.

    NARCIS (Netherlands)

    Wilhelmus, M.M.; Otte-Holler, I.; Triel, J.J. van; Veerhuis, R.; Maat-Schieman, M.L.; Bu, G.; Waal, R.M.W. de; Verbeek, M.M.

    2007-01-01

    Inefficient clearance of A beta, caused by impaired blood-brain barrier crossing into the circulation, seems to be a major cause of A beta accumulation in the brain of late-onset Alzheimer's disease patients and hereditary cerebral hemorrhage with amyloidosis Dutch type. We observed association of r

  3. Clinical utility and reliability of sup(81m)Kr SPECT images applied to posterior circulation

    Energy Technology Data Exchange (ETDEWEB)

    Yoshizawa, Takashi; Kikuchi, Haruhiko; Karasawa, Jun (National Cardiovascular Center, Suita, Osaka (Japan))

    1984-08-01

    The instrument used in this study has a sensitivity of 28,000 counts/mCi/cm/sup 3/ for sup(99m)Tc and a spatial resolution of approximately 20mm full width at a half-maximum. The tomographic images were obtained by the continuous infusion of sup(81m)Kr at the base of the ascending aorta. Material was subsequently studied in 49 cases that met the conditions of: 1) obstructive vertebrobasilar system lesions (8 cases), 2) no ischemic cerebrovascular diseases (10), or 3) ischemic cerebrovascular disorders in anterior circulation (31). The reproducibility, as studied in 20 cases, was satisfactory. 6 cases were compared with a stable Xe CT CBF map that had regional depressions similar to those of the sup(81m)Kr SPECT images. In the 2nd group, 8 of the 10 cases showed a mild laterality on cerebellar perfusion images obtained by SPECT, as did 29 of the 31 in the 3rd group; among them, 2 cases with a recently completed stroke revealed a marked depression in the ipsilateral cerebellar hemisphere to the side of the hemiplegia. Cases of the lst group showed generally depressed perfusion images of the brain stem or cerebellum, and the low-density areas of X-ray CT were comparable to the lower perfusional regions on SPECT. The authors concluded that posterior perfusion images obtained by sup(81m)Kr SPECT were affected by occlusive vertebrobasilar-system lesions as well as by carotid-system lesions and cerebellar functions, and that this method for evaluating hemodynamics will be of much more clinical use in repeated studies to demonstrate the changes in posterior ciculation in course or by some loadings with subclinical characteristics, for this paper includes the first report on cerebellar functional images, though it is restricted by the low-spatial resolution from defining the architecture of the posterior fossa in detail.

  4. Physiology of the fetal circulation.

    Science.gov (United States)

    Kiserud, Torvid

    2005-12-01

    Our understanding of fetal circulatory physiology is based on experimental animal data, and this continues to be an important source of new insight into developmental mechanisms. A growing number of human studies have investigated the human physiology, with results that are similar but not identical to those from animal studies. It is time to appreciate these differences and base more of our clinical approach on human physiology. Accordingly, the present review focuses on distributional patterns and adaptational mechanisms that were mainly discovered by human studies. These include cardiac output, pulmonary and placental circulation, fetal brain and liver, venous return to the heart, and the fetal shunts (ductus venosus, foramen ovale and ductus arteriosus). Placental compromise induces a set of adaptational and compensational mechanisms reflecting the plasticity of the developing circulation, with both short- and long-term implications. Some of these aspects have become part of the clinical physiology of today with consequences for surveillance and treatment.

  5. Proper Sizing of Circulation Pumps

    DEFF Research Database (Denmark)

    Tommerup, Henrik M.; Nørgaard, Jørgen

    2007-01-01

    , but the results can be applied to Europe in general. Despite the small sample of houses involved in the test, 15 houses, some rather safe conclusions can be drawn from the results, which showed that newly developed pumps with power consumption around 5-8 W, can perform the task of circulating the water......The paper describes the preliminary results from field tests of replacing various types of old pumps used for circulating water in heating systems in single- and double-family houses with new types of pumps. The tests were carried out in Denmark for the Danish Electricity Savings Trust...... sufficiently to keep the houses satisfactorily warm during the heating season of the test. The old replaced pumps used 5-10 times more power. In Europe alone, a gradual replacement of the present vastly oversized pumps with such small but sufficient pumps can save the construction of 17 large power plants...

  6. Journalism as Cultures of Circulation

    DEFF Research Database (Denmark)

    Bødker, Henrik

    2013-01-01

    The universe of journalism has always consisted of interspersed texts, meanings and practices. Yet, much journalism research has often isolated either texts and/or contexts and as such assumed relations between professional practices, informed (rational) readers and (conceived) core texts...... of journalism. It is, however, more important than ever to shift attention away from texts to the processes through which they are circulated. This is partly because the many cultural forms of journalism (textual, institutional, technological, material, behavioural and imagined) are undergoing significant......, likes, comments, searches, journalist roles, writing and reading positions and identities etc. Such forms will be traced within the mediation of a specific event with the overall aim of beginning a theorization of the landscape of journalism as highly interrelated cultures of circulation....

  7. Ocean circulation generated magnetic signals

    DEFF Research Database (Denmark)

    Manoj, C.; Kuvshinov, A.; Maus, S.

    2006-01-01

    Conducting ocean water, as it flows through the Earth's magnetic field, generates secondary electric and magnetic fields. An assessment of the ocean-generated magnetic fields and their detectability may be of importance for geomagnetism and oceanography. Motivated by the clear identification...... of ocean tidal signatures in the CHAMP magnetic field data we estimate the ocean magnetic signals of steady flow using a global 3-D EM numerical solution. The required velocity data are from the ECCO ocean circulation experiment and alternatively from the OCCAM model for higher resolution. We assume...... of the magnetic field, as compared to the ECCO simulation. Besides the expected signatures of the global circulation patterns, we find significant seasonal variability of ocean magnetic signals in the Indian and Western Pacific Oceans. Compared to seasonal variation, interannual variations produce weaker signals....

  8. Treatment of Thyroid Dysfunctions Decreases the Risk of Cerebrovascular Events in Men but Not in Women: Results of the MONICA/KORA Cohort Study.

    Directory of Open Access Journals (Sweden)

    Julia Six-Merker

    Full Text Available Thyroid disorders are well known to be associated with cardiovascular diseases. Some studies have shown that the negative effects of thyroid disorders are partially reversible after adequate treatment. The aim of this analysis was to assess the risk of incident ischemic cerebrovascular diseases in study participants treated for thyroid dysfunctions in a population-based cohort study.For the presented analyses data from 8564 male and 8714 female individuals aged 25 to 74 years of the MONICA/KORA cohort were used (median follow-up 14.0 years. A combined binary variable "thyroid disorder" (TDC was created utilizing data on self-reported physician-treated thyroid disorders and information about medication use. To examine the association between TDC and incident ischemic cerebrovascular events, we performed multiple adjusted Cox proportional hazard regression models and calculated hazard ratios and corresponding 95% confidence intervals (HR, 95%CI.During follow-up between 1984 and 2008/2009, 514 incident fatal and non-fatal ischemic cerebrovascular events occurred in men and 323 in women. At baseline, 3.5% of men and 15.6% of women reported TDC. In the fully adjusted model, males who reported TDC had a significantly reduced risk of ischemic cerebrovascular events (HR = 0.52, 95%CI = 0.29-0.92. A similar result was obtained in men, when we utilized information on thyroid hormones use only. For the total study population and for women with TDC we found no association with ischemic cerebrovascular events.In our longitudinal analyses subjects with treated thyroid diseases had no increased risk of incident ischemic cerebrovascular events. Surprisingly in males, even a significantly reduced risk of incident ischemic cerebrovascular events was found, a result that deserves further clarification.

  9. Conservation of circulation in magnetohydrodynamics

    Science.gov (United States)

    Bekenstein; Oron

    2000-10-01

    We demonstrate at both the Newtonian and (general) relativistic levels the existence of a generalization of Kelvin's circulation theorem (for pure fluids) that is applicable to perfect magnetohydrodynamics. The argument is based on the least action principle for magnetohydrodynamic flow. Examples of the new conservation law are furnished. The new theorem should be helpful in identifying new kinds of vortex phenomena distinct from magnetic ropes or fluid vortices.

  10. Conservation of Circulation in Magnetohydrodynamics

    OpenAIRE

    Bekenstein, Jacob D.; Oron, Asaf

    2000-01-01

    We demonstrate, both at the Newtonian and (general) relativistic levels, the existence of a generalization of Kelvin's circulation theorem (for pure fluids) which is applicable to perfect magnetohydrodynamics. The argument is based on the least action principle for magnetohydrodynamic flow. Examples of the new conservation law are furnished. The new theorem should be helpful in identifying new kinds of vortex phenomena distinct from magnetic ropes or fluid vortices.

  11. Hall Effect Gyrators and Circulators

    Science.gov (United States)

    Viola, Giovanni; DiVincenzo, David P.

    2014-04-01

    The electronic circulator and its close relative the gyrator are invaluable tools for noise management and signal routing in the current generation of low-temperature microwave systems for the implementation of new quantum technologies. The current implementation of these devices using the Faraday effect is satisfactory but requires a bulky structure whose physical dimension is close to the microwave wavelength employed. The Hall effect is an alternative nonreciprocal effect that can also be used to produce desired device functionality. We review earlier efforts to use an Ohmically contacted four-terminal Hall bar, explaining why this approach leads to unacceptably high device loss. We find that capacitive coupling to such a Hall conductor has much greater promise for achieving good circulator and gyrator functionality. We formulate a classical Ohm-Hall analysis for calculating the properties of such a device, and show how this classical theory simplifies remarkably in the limiting case of the Hall angle approaching 90°. In this limit, we find that either a four-terminal or a three-terminal capacitive device can give excellent circulator behavior, with device dimensions far smaller than the ac wavelength. An experiment is proposed to achieve GHz-band gyration in millimeter (and smaller) scale structures employing either semiconductor heterostructure or graphene Hall conductors. An inductively coupled scheme for realizing a Hall gyrator is also analyzed.

  12. Characterization and prognosis factors of cerebro-vascular disease in Cienfuegos province. Caracterización y factores pronósticos de la enfermedad cerebrovascular en la Provincia de Cienfuegos.

    Directory of Open Access Journals (Sweden)

    Eduardo Concepción Morales

    2004-08-01

    Full Text Available Fundaments: Cerebrovascular disease constitutes the third cause of death and the first cause of severe discapacity in adults in those countries that have a developed health system like ours. Objective: To characterise the patients with cerebrovascular disease and to determine the variables that influence upon their prognosis once it is established. Method: Prospective, descriptive, longitudinal study of a series of cases developed at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨. Questionnaires were applied to the patients that fitted the inclusion criteria (n 1318 Results: The mean age was 66,08 years with a predominance of white patients ( 75,26 %, mainly males ( 56,67%. The risk factor of highest frequency was hypertension ( 43,24 % The evolution for alive patients without discapacities was 14,71%, alive with discapacities ( 57,96% and death 27,31%. There was a predominance of ischemic cerebrovascular disease (46,13 % of aterothrombotic infarcts and 14,94 % cardioembolic disease. In regards to hemorrhagic disease 13,42 % were intracerebral hemorrhage and 4,55% subarachnoid hemorrhage. There was a prognostic correlation between the clinical variables: consciousness, sight, sensibility, language, tone, Babinski , osteotendious reflexes and muscular force. For the general variables cerebral edema, bacterial bronchopneumonia , displacement of the medial line, diagnosis is some values, CT scan diagnoses in some values for diabetes mellitus and convulsions.

    Fundamento: Las enfermedades cerebrovasculares constituyen la tercera causa de muerte y la primera de discapacidad grave del adulto en los países con sistemas de salud desarrollados similares al nuestro. Objetivo : Caracterizar a los pacientes con enfermedades cerebrovasculares y determinar las variables que influyen en su pron

  13. Terapéuticas intervencionistas para el accidente cerebrovascular isquémico

    Directory of Open Access Journals (Sweden)

    Alejandra T. Rabadán

    2010-10-01

    Full Text Available En los últimos 20 años se han desarrollado nuevas opciones para el tratamiento y para la prevención del accidente cerebrovascular (ACV isquémico, muchas de ellas de carácter intervencionista, tales como la endarterectomía carotídea y la trombolisis intravenosa con activador tisular del plasminógeno. La evidencia científica ha llevado a su difusión y utilización en países desarrollados mientras que en naciones emergentes se observa un retraso en su adopción. Otras modalidades terapéuticas que parecen ser muy promisorias, aunque sin tanta evidencia científica que las avale, requieren la realización y conclusión de estudios randomizados. Dentro de la evolución del ACV isquémico existe una situación particular como es el infarto cerebral "maligno". Constituye un evento devastador, que se presenta en aproximadamente el 10 al 15% de los ACV carotídeos o silvianos, y está asociado con elevada morbimortalidad. Con la información disponible actualmente, es posible recomendar la craniectomía descompresiva (CD como un método efectivo y seguro para disminuir rápidamente la presión intracraneal y lograr un pronóstico favorable sobre una base racional. Aunque no hay estudios randomizados y controlados en la literatura, existe suficiente evidencia para recomendar la CD en casos especiales.

  14. Modelo basado en SIG para el estudio de la mortalidad por enfermedad cerebro-vascular

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Tangarife Villa

    2013-06-01

    Full Text Available En los últimos 15 años el estudio para una de las tres primeras causas de muerte a nivel mundial –enfermedad cerebrovascular (ECV– se caracteriza por utilizar el enfoque epidemiológico tradicional y sus técnicas de análisis estadístico bivariado y multivariado orientadas a identificar su composición según variables de persona y explorar relaciones con sus determinantes pero sin impactar significativamente su ocurrencia, sin embargo, en el presente artículo se identifica como alternativa de análisis la modelación espacio-temporal con SIG a niveles de desagregación detallados; en este sentido el análisis comparativo de los modelos utilizados en los estudios conocidos, desvela el uso de datos y técnicas de análisis espacial básicas para identificar patrones como los evidenciados en los cinturones de diabetes y ECV en USA o el clúster colombiano de enfermedades del aparato circulatorio identificado en la región andina que sugiere un comportamiento similar para la ECV. El panorama anterior demanda la combinación de enfoques con énfasis en sus técnicas de análisis avanzadas –análisis multi-criterio, kriging, interpolación, correlación y regresión espacial– soportadas con SIG y por lo tanto, como contribución final se propone un modelo integrado dirigido a impactar positivamente la mortalidad por ECV.

  15. [Secular trends in mortality for cerebrovascular diseases in Taiwan (1959-1989)].

    Science.gov (United States)

    Su, C L; Chang, S F; Hung, T P

    1992-03-01

    Cerebrovascular disease (CVD) is predominantly a disease of the elderly, and its morbidity effects increase with advancing age. In Taiwan, the increasing proportion of the elderly, as a result of medical progress and improved health care in the past 30 years, is largely responsible for the apparent increase in the number of CVD deaths. From 1963 to 1981, CVD was the leading cause of death. The crude mortality rate (CMR) and age-specific mortality rate (ASMR) of CVD by sex were derived from vital statistical data from 1959 to 1989 in Taiwan. The age-adjusted mortality rate (AAMR) using the standard world population of WHO and the cumulative mortality rate (CUMR) from birth to less than 80 years of age were calculated. Before 1983, the total number of CVD deaths had increased steadily for 30 years. In 1989, the CMR was 76.6/100,000 in men and 67.7/100,000 in women. The highest AAMR was 158.5/100,000 in 1973 for men and 130.2/100,000 in 1972 for women, and the lowest AAMR was 91.3/100,000 in 1989 for men and 81.1/100,000 in 1972 for women. The highest CUMR was 26.3% in 1968 for men and 20.8% in 1972 for women, and the lowest CUMR was 14.5% in 1989 for men and 13.6% in 1989 for women. The AAMR and CUMR for both sexes reached a maximum in 1972 and began to decline thereafter. The declines in AAMR and CUMR were averaging 2%/yr for both sexes after 1972 and were averaging 5%/yr for men and 4%/yr for women after 1983. This declining trend in CVD deaths in Taiwan began later and has been slower than similar trends in Japan and the U.S.

  16. Left atrial volume predicts adverse cardiac and cerebrovascular events in patients with hypertrophic cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Tani Tomoko

    2011-11-01

    Full Text Available Abstract Aims To prospectively evaluate the relationship between left atrial volume (LAV and the risk of clinical events in patients with hypertrophic cardiomyopathy (HCM. Methods We enrolled a total of 141 HCM patients with sinus rhythm and normal pump function, and 102 patients (73 men; mean age, 61 ± 13 years who met inclusion criteria were followed for 30.8 ± 10.0 months. The patients were divided into two groups with or without major adverse cardiac and cerebrovascular events (MACCE, a composite of stroke, sudden death, and congestive heart failure. Detailed clinical and echocardiographic data were obtained. Results MACCE occurred in 24 patients (18 strokes, 4 congestive heart failure and 2 sudden deaths. Maximum LAV, minimum LAV, and LAV index (LAVI corrected for body surface area (BSA were significantly greater in patients with MACCE than those without MACCE (maximum LAV: 64.3 ± 25.0 vs. 51.9 ± 16.0 ml, p = 0.005; minimum LAV: 33.9 ± 15.1 vs. 26.2 ± 10.9 ml, p = 0.008; LAVI: 40.1 ± 15.4 vs. 31.5 ± 8.7 ml/mm2, p = 0.0009, while there were no differences in the other echocardiographic parameters. LAV/BSA of ≥ 40.4 ml/m2 to identify patients with cardiovascular complications with a sensitivity of 73% and a specificity of 88%. Conclusion LAVI may be an effective marker for detecting the risk of MACCE in patients with HCM and normal pump function.

  17. Imaging of Cerebrovascular Pathology in Animal Models of Alzheimer`s Disease

    Directory of Open Access Journals (Sweden)

    Jan eKlohs

    2014-03-01

    Full Text Available In Alzheimer’s disease (AD, vascular pathology may interact with neurodegeneration and thus aggravate cognitive decline. As the relationship between these two processes is poorly understood, research has been increasingly focused on understanding the link between cerebrovascular alterations and AD. This has at last been spurred by the engineering of transgenic animals, which display pathological features of AD and develop cerebral amyloid angiopathy to various degrees. Transgenic models are versatile for investigating the role of amyloid deposition and vascular dysfunction, and for evaluating novel therapeutic concepts. In addition, research has benefited from the development of novel imaging techniques, which are capable of characterizing vascular pathology in vivo. They provide vascular structural read-outs and have the ability to assess the functional consequences of vascular dysfunction as well as to visualize and monitor the molecular processes underlying these pathological alterations. This article focusses on recent in vivo small animal imaging studies addressing vascular aspects related to AD. With the technical advances of imaging modalities such as magnetic resonance, nuclear and microscopic imaging, molecular, functional and structural information related to vascular pathology can now be visualized in vivo in small rodents. Imaging vascular and parenchymal amyloid-β (Aβ deposition as well as Aβ transport pathways have been shown to be useful to characterize their dynamics and to elucidate their role in the development of cerebral amyloid angiopathy and AD. Structural and functional imaging read-outs have been employed to describe the deleterious affects of Aβ on vessel morphology, hemodynamics and vascular integrity. More recent imaging studies have also addressed how inflammatory processes partake in the pathogenesis of the disease. Moreover, imaging can be pivotal in the search for novel therapies targeting the vasculature.

  18. [Lipid and glucose profile in patients with ischemic cerebrovascular accidents in Dakar].

    Science.gov (United States)

    Ousmane, Cisse; Lemine, Dadah Samy Mohamed; Fatoumata, Ba; Makhtar, Ba El Hadji; Soda, Diop Marieme; Side, Diagne Ngor; Dieynaba, Sow Adjaratou; Modji, Basse Anna; Kamadore, Touré; Moustapha, Ndiaye; Gallo, Diop Amadou; Mansour, Ndiaye Mouhamadou

    2016-01-01

    Cerebrovascular accident (CVA) is defined as the rapid development of localized or global clinical signs of neurological dysfunction with no apparent cause other than that of vascular origin. A variety of risk factors have been identified and associated with the occurrence of Ischemic CVA, including glucose and lipid metabolism disturbances. We conducted a retrospective study at the Clinic of Neurology, Fann. Our study focused on medical records of patients with ICVA confirmed by imaging, hospitalized from January 1 to December 31 2010. All patients underwent complete lipid profile (total cholesterol, triglycerides, HDL; LDL level was calculated using Friedwald formula), kidney function tests and fasting blood sugar test were performed within 48 hours of admission. Data were analysed using univariate technique and then using bivariate technique tanks to SPSS 16.0 software. We collected 235 files. We here report a case series of patients between ages 10-99 years, with an average age of 67,06 years. Males were 42,55%, sex-ratio was 0,74 in favour of women. 26% of cases had impaired fasting glucose levels during the acute phase of ICVA. The lipid profile showed an increase in total cholesterol level in 52.34% of patients. Low levels of HDL cholesterol were found in 34.47% of patients. Hypertriglyceridemia was only observed in 3% of patients. LDL levels were high in 12,76% of patients. Atherogenicity index was high in 25,53% of patients. Disturbances of blood glucose and lipid profile are often associated with ICVA and should be taken into account to ensure better secondary prevention.

  19. Revealing the association between cerebrovascular accidents and ambient temperature: a meta-analysis

    Science.gov (United States)

    Zorrilla-Vaca, Andrés; Healy, Ryan Jacob; Silva-Medina, Melissa M.

    2016-10-01

    The association between cerebrovascular accidents (CVA) and weather has been described across several studies showing multiple conflicting results. In this paper, we aim to conduct a meta-analysis to further clarify this association, as well as to find the potential sources of heterogeneity. PubMed, EMBASE, and Google Scholar were searched from inception through 2015, for articles analyzing the correlation between the incidence of CVA and temperature. A pooled effect size (ES) was estimated using random effects model and expressed as absolute values. Subgroup analyses by type of CVA were also performed. Heterogeneity and influence of covariates—including geographic latitude of the study site, male percentage, average temperature, and time interval—were assessed by meta-regression analysis. Twenty-six articles underwent full data extraction and scoring. A total of 19,736 subjects with CVA from 12 different countries were included and grouped as ischemic strokes (IS; n = 14,199), intracerebral hemorrhages (ICH; n = 3798), and subarachnoid hemorrhages (SAH; n = 1739). Lower ambient temperature was significantly associated with increase in incidence of overall CVA when using unadjusted (pooled ES = 0.23, P < 0.001) and adjusted data (pooled ES = 0.03, P = 0.003). Subgroup analyses showed that lower temperature has higher impact on the incidence of ICH (pooled ES = 0.34, P < 0.001), than that of IS (pooled ES = 0.22, P < 0.001) and SAH (pooled ES = 0.11, P = 0.012). In meta-regression analysis, the geographic latitude of the study site was the most influencing factor on this association (Z-score = 8.68). Synthesis of the existing data provides evidence supporting that a lower ambient temperature increases the incidence of CVA. Further population-based studies conducted at negative latitudes are needed to clarify the influence of this factor.

  20. Lack of CAR impacts neuronal function and cerebrovascular integrity in vivo.

    Science.gov (United States)

    Boussadia, Baddreddine; Gangarossa, Giuseppe; Mselli-Lakhal, Laila; Rousset, Marie-Claude; de Bock, Frederic; Lassere, Frederic; Ghosh, Chaitali; Pascussi, Jean-Marc; Janigro, Damir; Marchi, Nicola

    2016-09-01

    Nuclear receptors (NRs) are a group of transcription factors emerging as players in normal and pathological CNS development. Clinically, an association between the constitutive androstane NR (CAR) and cognitive impairment was proposed, however never experimentally investigated. We wished to test the hypothesis that the impact of CAR on neurophysiology and behavior is underlined by cerebrovascular-neuronal modifications. We have used CAR(-/-) C57BL/6 and wild type mice and performed a battery of behavioral tests (recognition, memory, motor coordination, learning and anxiety) as well as longitudinal video-electroencephalographic recordings (EEG). Brain cell morphology was assessed using 2-photon or electron microscopy and fluorescent immunohistochemistry. We observed recognition memory impairment and increased anxiety-like behavior in CAR(-/-) mice, while locomotor activity was not affected. Concomitantly to memory deficits, EEG monitoring revealed a decrease in 3.5-7Hz waves during the awake/exploration and sleep periods. Behavioral and EEG abnormalities in CAR(-/-) mice mirrored structural changes, including tortuous fronto-parietal penetrating vessels. At the cellular level we found reduced ZO-1, but not CLDN5, tight junction protein expression in cortical and hippocampal isolated microvessel preparations. Interestingly, the neurotoxin kainic acid, when injected peripherally, provoked a rapid onset of generalized convulsions in CAR(-/-) as compared to WT mice, supporting the hypothesis of vascular permeability. The morphological phenotype of CAR(-/-) mice also included some modifications of GFAP/IBA1 glial cells in the parenchymal or adjacent to collagen-IV(+) or FITC(+) microvessels. Neuronal defects were also observed including increased cortical NEUN(+) cell density, hippocampal granule cell dispersion and increased NPY immunoreactivity in the CA1 region in CAR(-/-) mice. The latter may contribute to the in vivo phenotype. Our results indicate that behavioral

  1. Blunt cerebrovascular trauma causing vertebral arteryd issection in combination with a laryngeal fracture: a case report

    Directory of Open Access Journals (Sweden)

    Krettek Christian

    2011-08-01

    Full Text Available Abstract Introduction The diagnosis and therapy of blunt cerebrovascular injuries has become a focus since improved imaging technology allows adequate description of the injury. Although it represents a rare injury the long-term complications can be fatal but mostly prevented by adequate treatment. Case presentation A 33-year-old Caucasian man fell down a 7-meter scarp after losing control of his quad bike in a remote area. Since endotracheal intubation was unsuccessfully attempted due to the severe cervical swelling as well as oral bleeding an emergency tracheotomy was performed on scene. He was hemodynamically unstable despite fluid resuscitation and intravenous therapy with vasopressors and was transported by a helicopter to our trauma center. He had a stable fracture of the arch of the seventh cervical vertebra and fractures of the transverse processes of C5-C7 with involvement of the lateral wall of the transverse foramen. An abort of the left vertebral artery signal at the first thoracic vertebrae with massive hemorrhage as well as a laryngeal fracture was also detected. Further imaging showed retrograde filling of the left vertebral artery at C5 distal of the described abort. After stabilization and reconfirmation of intracranial perfusion during the clinical course weaning was started. At the time of discharge, he was aware and was able to move all extremities. Conclusion We report a rare case of a patient with vertebral artery dissection in combination with a laryngeal fracture after blunt trauma. Thorough diagnostic and frequent reassessments are recommended. Most patients can be managed with conservative treatment.

  2. Factores relacionados con presentación de ataques cerebrovasculares en niños

    Directory of Open Access Journals (Sweden)

    Angélica María Uscátegui Daccarett

    2008-04-01

    Full Text Available El ataque cerebrovascular (ACV se considera una patologíainusual en la edad pediátrica, siendo diferente en sus causasy en sus factores ambientales y raciales frente a los adultos.El objetivo del estudio consiste en describir los factoresrelacionados en la población atendida. Materiales ymétodos: Se evaluó una serie de pacientes con ataquecerebro vascular atendidos por el servicio de Neuropediatríade la Universidad Nacional de Colombia Fundación Hospitalde la Misericordia, durante el periodo enero 1 de 2001 a 31de diciembre de 2003. Resultados: Se registraron 65 casos,siendo el 61% varones; el grupo etáreo más comprometidoes el de lactantes (44,7%. El síntoma de consulta predomi-nante fueron las convulsiones (60% de los casos. El 56,9%correspondió a eventos isquémicos y el territorio másafectado fue el de la arteria cerebral media (33,2%. Lacausa más común fue infecciosa (20% de los casos, conuna frecuencia similar para quienes registraron causadesconocida. La mortalidad fue de 21,9%. Conclusiones: ElACV en los niños es una alteración frecuente y con causasmuy variadas. No determinarla dificulta establecer tratamien-to, pronóstico y prevenir las recurrencias. Los factoresrelacionados difieren de los encontrados en otras series,posiblemente por variantes genéticas y ambientales.

  3. Aortic Complex Plaque Predicts the Risk of Cryptogenic Ischemic Cerebrovascular Disease Recurrence.

    Science.gov (United States)

    Dong, Jing; Ma, Xin; Qie, Jingyuan; Ji, Xunming

    2016-03-01

    To evaluate the correlations between aortic complex plaque (ACP) and the recurrence of cryptogenic ischemic cerebrovascular disease (CICVD), and to investigate the clinical significance of ACP in CICVD. Methods CICVD patients (aged 17 to 84 years) admitted into the Department of Neurology, Xuanwu Hospital, from July 2011 to December 2013, were consecutively recruited, and divided into ACP and non-ACP groups according to head and neck computerized tomographic (CT) angiography. Recurrences of cerebral ischemic events (CIEs) were compared between these groups after follow-up. Results A total of 117 patients were enrolled (ACP group: 69, non-ACP group: 48) and followed up for a mean of 9.86 months (range: 3-33). The average age of the ACP group was 62.88 years, with 59.4% older than 60 years; the average age of the non-ACP group was 50.29 years, with 37.5% older than 60 years. At the 6-month follow-up, the recurrence rate of CIEs in the ACP group was significantly higher than that of the non-ACP group (17.0% [7/47] and 0% [0/36], respectively; χ2 = 4.283, P = 0.046). The cumulative recurrence risk for CIEs of the ACP group was significantly higher than for the non-ACP group (P = 0.004). Multivariate Cox survival analysis showed that ACP presence was an independent risk factor for CIE recurrence for CICVD patients (relative risk [RR] = 7.803, 95% confidence interval [CI], 1.827~33.319, P = 0.006). Conclusions ACP increased the recurrence risk of CIE in CICVD, and elderly CICVD patients should receive greater attention regarding the significance of ACP in recurrent CICVD.

  4. Environmental Air Pollution and Acute Cerebrovascular Complications: An Ecologic Study in Tehran, Iran

    Science.gov (United States)

    Nabavi, Seyed Massood; Jafari, Batoul; Jalali, Mozhgan Sadat; Nedjat, Saharnaz; Ashrafi, Khosro; Salahesh, Alireza

    2012-01-01

    Background: In this study, we aimed to assess the association between air pollution and cerebrovascular complications in Tehran, one of the most air-polluted cities in the world, among different subgroups of patients with stroke in 2004. Methods: In this ecologic study, we calculated the daily average levels of different air pollutants including CO, NOX, SO2, O3, and PM10 and also humidity and temperature on the day of stroke and 48 hours prior to stroke in 1 491 patients admitted with the diagnosis of stroke in eight referral hospitals in different areas of Tehran. Then, we evaluated the association between the rate of stroke admissions and the level of the selected pollutants, humidity, and temperature on the day of stroke and 48 hours prior to stroke among different subgroups of patients. Results: There was no significant association between the same-day level of the pollutants and the rate of stroke admissions, but an association was seen for their level 48 hours before stroke. These associations differed among different subgroups of age, sex, history of underlying diseases, and type of stroke. Same-day temperature had a reverse association in patients with hemorrhagic stroke and in patients without a history of heart disease or previous stroke. A direct significant association was seen for humidity level 48 hours before stroke in patients with a history of heart disease. Conclusions: It is inferred that air pollution has a direct association with the incidence of stroke and these association differs among different subgroups of patients. The results of this study are not time-dependant and can be generalized to different times and regions. Moreover, these results may be useful for environmental health policy makers. PMID:23112900

  5. Risk factors for cerebrovascular disease mortality among the elderly in Beijing: a competing risk analysis.

    Directory of Open Access Journals (Sweden)

    Zhe Tang

    Full Text Available OBJECTIVE: To examine the associations of combined lifestyle factors and physical conditions with cerebrovascular diseases (CBVD mortality, after accounting for competing risk events, including death from cardiovascular diseases, cancers and other diseases. METHODS: Data on 2010 subjects aged over 55 years were finally analyzed using competing risk models. All the subjects were interviewed by the Beijing Longitudinal Study of Aging (BLSA, in China, between 1 January 1992 and 30 August 2009. RESULTS: Elderly females were at a lower risk of death from CBVD than elderly males (HR = 0.639, 95% CI = 0.457-0.895. Increasing age (HR = 1.543, 95% CI = 1.013-2.349, poor self-rated health (HR = 1.652, 95% CI = 1.198-2.277, hypertension (HR = 2.201, 95% CI = 1.524-3.178 and overweight (HR = 1.473, 95% CI = 1.013-2.142 or obesity (HR = 1.711, 95% CI = 1.1754-2.490 was associated with higher CBVD mortality risk. Normal cognition function (HR = 0.650, 95% CI = 0.434-0.973 and living in urban (HR = 0.456, 95% CI = 0.286-0.727 was associated with lower CBVD mortality risk. Gray's test also confirmed the cumulative incidence (CIF of CBVD was lower in the 'married' group than those without spouse, and the mortality was lowest in the 'nutrition sufficient' group among the 'frequent consumption of meat group' and the 'medial type group' (P value<0.001. CONCLUSIONS: CBVD mortality was associated with gender, age, blood pressure, residence, BMI, cognitive function, nutrition and the result of self-rated health assessment in the elderly in Beijing, China.

  6. Un análisis en los accidentes cerebrovasculares una nueva mirada a los factores de riesgo para la aparición de la enfermedad. Un análisis en los accidentes cerebrovasculares

    OpenAIRE

    2013-01-01

    ResumenLa presencia o no de factores psicológicos de riesgo para la aparición de distintas enfermedades continúa siendo un tema controvertido en las ciencias médicas y psicológicas, quizás por las dificultades que se presentan en el momento de su evaluación. No obstante, ya se han realizado primeras miradas en este sentido, presentando la siguiente investigación en personas con accidente cerebrovascular, como un análisis preliminar experimental; que más que brindar datos definitorios, permita...

  7. Circulating follistatin in relation to energy metabolism

    DEFF Research Database (Denmark)

    Hansen, Jakob Schiøler; Plomgaard, Peter

    2016-01-01

    Recently, substantial evidence has emerged that the liver contributes significantly to the circulating levels of follistatin and that circulating follistatin is tightly regulated by the glucagon-to-insulin ratio. Both observations are based on investigations of healthy subjects. These novel...... a relation to energy metabolism. In this narrative review, we attempt to reconcile the existing findings on circulating follistatin with the novel concept that circulating follistatin is a liver-derived molecule regulated by the glucagon-to-insulin ratio. The picture emerging is that conditions associated...... with elevated levels of circulating follistatin have a metabolic denominator with decreased insulin sensitivity and/or hyperglucagoneimia....

  8. Genetic relationship between serum pregnancy-associated plasma protein-A gene polymorphism and ischemic cerebrovascular disease in a Northern Han Chinese population

    Institute of Scientific and Technical Information of China (English)

    Haiping Wang; Yan Song; Chen Zhang; Jingjing Zhan; Rui Zhang; Haiji Wang

    2012-01-01

    The present study recruited 193 patients with ischemic cerebrovascular disease from Inpatient and Outpatient Departments at the Affiliated Hospital of Qingdao University Medical College, China from August 2008 to May 2010, as well as 120 healthy volunteers from the Medical Examination Center at the Affiliated Hospital of Qingdao University Medical College, China, who served as controls for this study.Patients and control subjects were from the Han population in northern China.Enzyme- linked immunosorbent assay analysis revealed increased levels of serum pregnancy-associated plasma protein-A (PAPP-A) in ischemic cerebrovascular disease patients compared with healthy controls.In addition, the patients exhibited greater frequency of genotype CC and C alleles in a missense A/C (Tyr/Ser) polymorphism (dbSNP: rs7020782) of exon 14 in the PAPP-A gene.Multiple-factor logistic regression analysis on correction of age, gender, history of smoking, hypertension, diabetes mellitus, hypercholesteremia, and ischemic stroke family history showed that the risk for ischemic cerebrovascular disease in the population without the A allele at the A/C genetic locus in exon 14 of the PAPP-A was 2-folds greater than the population expressing the A allele.These experimental findings suggested that ischemic cerebrovascular disease correlated with the C allele in exon 14 of PAPP-A.In addition, the A allele is likely a protective gene; individuals carrying the A allele were less prone to ischemic cerebrovascular disease compared with individuals without the A allele.

  9. Studies on cerebral hemodynamics by single photon emission computerized tomography, 2; Evaluation of the hemodynamics before and after bypass surgery in patients with cerebrovascular occlusive disease using sup 133 Xe inhalation and single photon emission computerized tomography

    Energy Technology Data Exchange (ETDEWEB)

    Imao, Yukinori (Gifu Univ. (Japan). Faculty of Medicine)

    1991-05-01

    Cerebral blood flow (CBF) was measured by using Xe-133 inhalation method before and after administration of Diamox (DM) to evaluate the hemodynamics in a total of 34 patietns with cerebrovascular occlusive disease. Hemodynamic changes after bypass surgery were also evaluated. According to CBF findings and DM reactivity, the patients were divided into 4 types: (1) normal findings in both CBF and DM reactivity, suggesting well-developed collateral circulation and normal cerebral perfusion pressure (CPP), (2) decrease in CBF, probably due to reduction in the metabolic demand, and normal DM reactivity, (3) normal CBF and decreased DM reactivity, suggesting moderate vasodilation due to reduced CPP, and (4) decreased CBF and impaired DM reactivity. One patient in the group of type 1 had transient hemiplegia after administration of DM. Retrograde ophthalmic flow or collateral flow via leptomeningeal anastomosis on angiograms was frequently associated with impairment of DM reactivity, suggesting reduction of CPP. CBF on the operation side was increased by bypass surgery. Most of the patients recovered from impaired DM reactivity after surgery. Of 13 patients having impaired DM reactivity, 9 had obviously increased cerebral blood volume (CBV) on the occluded side compared with the non-occluded side. In the remaining 4 patients, CBV did not increase on the occluded side. Impaired DM reactivity may not necessarily be caused by the compensative increase in CBV, i.e. vasodilation, due to reduced CPP. (N.K.) 57 refs.

  10. Magnetic Resonance Imaging Quantification of Regional Cerebral Blood Flow and Cerebrovascular Reactivity to Carbon Dioxide in Normotensive and Hypertensive Rats

    Science.gov (United States)

    Leoni, Renata F.; Paiva, Fernando F.; Henning, Erica C.; Nascimento, George C.; Tannús, Alberto; de Araujo, Draulio B.; Silva, Afonso C.

    2011-01-01

    Hypertension afflicts 25% of the general population and over 50% of the elderly. In the present work, arterial spin labeling MRI was used to non-invasively quantify regional cerebral blood flow (CBF), cerebrovascular resistance and CO2 reactivity in spontaneously hypertensive rats (SHR) and in normotensive Wistar Kyoto rats (WKY), at two different ages (3 months and 10 months) and under the effects of two anesthetics, α-chloralose and 2% isoflurane (1.5 MAC). Repeated CBF measurements were highly consistent, differing by less than 10% and 18% within and across animals, respectively. Under α-chloralose, whole brain CBF at normocapnia did not differ between groups (young WKY: 61±3ml/100g/min; adult WKY: 62±4ml/100g/min; young SHR: 70±9ml/100g/min; adult SHR: 69±8ml/100g/min), indicating normal cerebral autoregulation in SHR. At hypercapnia, CBF values increased significantly, and a linear relationship between CBF and PaCO2 levels was observed. In contrast, 2% isoflurane impaired cerebral autoregulation. Whole brain CBF in SHR was significantly higher than in WKY rats at normocapnia (young SHR: 139±25ml/100g/min; adult SHR: 104±23ml/100g/min; young WKY: 55±9ml/100g/min; adult WKY: 71±19ml/100g/min). CBF values increased significantly with increasing CO2; however, there was a clear saturation of CBF at PaCO2 levels greater than 70 mmHg in both young and adult rats, regardless of absolute CBF values, suggesting that isoflurane interferes with the vasodilatory mechanisms of CO2. This behavior was observed for both cortical and subcortical structures. Under either anesthetic, CO2 reactivity values in adult SHR were decreased, confirming that hypertension, when combined with age, increases cerebrovascular resistance and reduces cerebrovascular compliance. PMID:21708273

  11. 阿司匹林与心脑血管疾病%Aspirin, Cardiovascular and Cerebrovascular Diseases

    Institute of Scientific and Technical Information of China (English)

    吴皎; 周刚; 李燕辉

    2015-01-01

    Cardiovascular and cerebrovascular diseases is the most fatal diseases in the world.The prevention and treatment of cardiovascular and cerebrovascular diseases are both basic and clinical focus.Aspirin has been used as a prevention medicine in cardiovascular and cerebrovascular diseases for over a century, which is the longest one in history.Aspirin use is estimated at 100 billion tablets annually as an analgesic, antipyretic and antiplatelet drugs.However, there are still many new findings about aspirin, such as aspirin resistance and aspirin hydrolase.This paper reviews the current research advances and future directions of aspirin in cardiovascular and cerebravascwlar diseases, mainly focuses on aspirin resistance and personalized medication.%心脑血管疾病为人类死亡原因之首,其预防与治疗始终为医学关注的焦点。阿司匹林作为心脑血管疾病的防治疗药物已经有一个世纪之久,是历史最长,同时也是用量最多的药物。每年大约有1000亿片阿司匹林被用于解热镇痛和心脑血管疾病。人们对阿司匹林的研究和认识还在不断加深,如阿司匹林抵抗的出现以及阿司匹林水解酶的鉴定。本文综述了阿司匹林在心脑血管疾病预防方面的研究热点以及未来的研究方向,主要包括阿司匹林抵抗以及个体化用药。

  12. Risk of Cerebrovascular Events in Elderly Patients After Radiation Therapy Versus Surgery for Early-Stage Glottic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Julian C.; Kruser, Tim J. [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Gondi, Vinai [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Central Dupage Hospital Cancer Center, Warrenville, Illinois (United States); Mohindra, Pranshu; Cannon, Donald M.; Harari, Paul M. [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Bentzen, Søren M., E-mail: bentzen@humonc.wisc.edu [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States)

    2013-10-01

    Purpose: Comprehensive neck radiation therapy (RT) has been shown to increase cerebrovascular disease (CVD) risk in advanced-stage head-and-neck cancer. We assessed whether more limited neck RT used for early-stage (T1-T2 N0) glottic cancer is associated with increased CVD risk, using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Methods and Materials: We identified patients ≥66 years of age with early-stage glottic laryngeal cancer from SEER diagnosed from 1992 to 2007. Patients treated with combined surgery and RT were excluded. Medicare CPT codes for carotid interventions, Medicare ICD-9 codes for cerebrovascular events, and SEER data for stroke as the cause of death were collected. Similarly, Medicare CPT and ICD-9 codes for peripheral vascular disease (PVD) were assessed to serve as an internal control between treatment groups. Results: A total of 1413 assessable patients (RT, n=1055; surgery, n=358) were analyzed. The actuarial 10-year risk of CVD was 56.5% (95% confidence interval 51.5%-61.5%) for the RT cohort versus 48.7% (41.1%-56.3%) in the surgery cohort (P=.27). The actuarial 10-year risk of PVD did not differ between the RT (52.7% [48.1%-57.3%]) and surgery cohorts (52.6% [45.2%-60.0%]) (P=.89). Univariate analysis showed an increased association of CVD with more recent diagnosis (P=.001) and increasing age (P=.001). On multivariate Cox analysis, increasing age (P<.001) and recent diagnosis (P=.002) remained significantly associated with a higher CVD risk, whereas the association of RT and CVD remained not statistically significant (HR=1.11 [0.91-1.37,] P=.31). Conclusions: Elderly patients with early-stage laryngeal cancer have a high burden of cerebrovascular events after surgical management or RT. RT and surgery are associated with comparable risk for subsequent CVD development after treatment in elderly patients.

  13. Matrix-free constructions of circulant and block circulant preconditioners

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Chao; Ng, Esmond G.; Penczek, Pawel A.

    2001-12-01

    A framework for constructing circulant and block circulant preconditioners (C) for a symmetric linear system Ax=b arising from certain signal and image processing applications is presented in this paper. The proposed scheme does not make explicit use of matrix elements of A. It is ideal for applications in which A only exists in the form of a matrix vector multiplication routine, and in which the process of extracting matrix elements of A is costly. The proposed algorithm takes advantage of the fact that for many linear systems arising from signal or image processing applications, eigenvectors of A can be well represented by a small number of Fourier modes. Therefore, the construction of C can be carried out in the frequency domain by carefully choosing its eigenvalues so that the condition number of C{sup T} AC can be reduced significantly. We illustrate how to construct the spectrum of C in a way such that the smallest eigenvalues of C{sup T} AC overlaps with those of A extremely well while the largest eigenvalues of C{sup T} AC are smaller than those of A by several orders of magnitude. Numerical examples are provided to demonstrate the effectiveness of the preconditioner on accelerating the solution of linear systems arising from image reconstruction application.

  14. Relationships of Self-Esteem among Duration of Disease, Impairments and Activity Limitation in Cerebrovascular Accident and Parkinson's Disease

    OpenAIRE

    Fujiwara, Mizuho; Nishioka, Eriko; Abe, Kazuo; 藤原, 瑞穂; 西岡, 江理子; 阿部, 和夫

    1999-01-01

    The relationships of self-esteem among the duration of illness, impairments and activities limitation were studied in cerebrovascular disease (CVD) and Parkinson's disease (PD). Fifty-four CVD patients (aged 43-83) and 41 PD patients (aged 49-78) were examined. The duration of illness was 12 to 132 months for CVD patients and 1 to 211 months for PD patients. Seventy healthy old subjects (aged 48-80) also served as normal controls. Self-esteem was scored with Rosenberg's scale. Activity of dai...

  15. Muerte prematura por accidente cerebrovascular y condición socioeconómica en la Argentina

    Directory of Open Access Journals (Sweden)

    Mauricio Monsalvo

    2016-04-01

    Full Text Available Introducción: La asociación entre mortalidad por accidente cerebrovascular y el nivel socioeconómico está escasamente descripta en Argentina. Objetivos: Describir la evolución temporal de la mortalidad por accidente cerebrovascular y su asociación con el nivel socioeconómico en Argentina entre 2000 y 2011. Material y métodos: Se realizó un estudio ecológico longitudinal. La mortalidad se cuantificó mediante tasas estandarizadas por edad y sexo, y el nivel socioeconómico mediante quintilos de necesidades básicas insatisfechas. Las unidades de observación fueron los departamentos de Argentina. La asociación entre mortalidad y nivel socioeconómico se evaluó utilizando un modelo de regresión de Poisson para datos de panel. Resultados: La mortalidad por accidente cerebrovascular aumentó progresivamente entre los quintilos de nivel socioeconómico (26,2, 28,4, 30,5, 34,5 y 36,9 por 100.000 personas, para los quintilos 1 a 5, respectivamente en el año 2000. La mortalidad en todos los grupos de nivel socioeconómico disminuyó, aunque persistieron diferencias entre ellos (17,2, 18,5, 20,1, 22,1 y 25,3 por 100.000 personas, para los quintilos 1 a 5, respectivamente en el año 2011. Las razones de tasas de incidencias fueron 1,15 (IC 95% 1,09 a 1,22; p<0,001, 1,27 (IC 95% 1,21 a 1,34; p<0,001, 1,32 (IC 95% 1,26 a 1,39; p<0,001, y de 1,48 (IC 95% 1,41 a 1,56; p<0,001, para los quintilos 2 a 5. Conclusiones: Los resultados sugieren una asociación inversa entre el nivel socioeconómico y la mortalidad por accidente cerebrovascular. Además, persistió una diferencia de mortalidad entre los niveles socioeconómicos durante el período de estudio.

  16. Autonomic Regulation of Splanchnic Circulation

    Directory of Open Access Journals (Sweden)

    Kathleen A Fraser

    1991-01-01

    Full Text Available The role of the autonomic nervous system in circulatory regulation of the splanchnic organs (stomach, small intestine, colon, liver, pancreas and spleen is reviewed. In general, the sympathetic nervous system is primarily involved in vasoconstriction, while the parasympathetic contributes to vasodilation. Vasoconstriction in the splanchnic circulation appears to be mediated by alpha-2 receptors and vasodilation by activation of primary afferent nerves with subsequent release of vasodilatory peptides, or by stimulation of beta-adrenergic receptors. As well, an important function of the autonomic nervous system is to provide a mechanism by which splanchnic vascular reserve can be mobilized during stress to maintain overall cardiovascular homeostasis.

  17. Un análisis en los accidentes cerebrovasculares una nueva mirada a los factores de riesgo para la aparición de la enfermedad. Un análisis en los accidentes cerebrovasculares

    Directory of Open Access Journals (Sweden)

    Luis Felipe Herrera Jiménez

    2013-10-01

    Full Text Available ResumenLa presencia o no de factores psicológicos de riesgo para la aparición de distintas enfermedades continúa siendo un tema controvertido en las ciencias médicas y psicológicas, quizás por las dificultades que se presentan en el momento de su evaluación. No obstante, ya se han realizado primeras miradas en este sentido, presentando la siguiente investigación en personas con accidente cerebrovascular, como un análisis preliminar experimental; que más que brindar datos definitorios, permita a la vez, abrir nuevos caminos hacia la búsqueda de la multideterminación de los procesos patológicos. Con el objetivo central de determinar factores psicológicos de riesgo para la aparición de los accidentes cerebrovasculares, se establecieron dos grupos de estudio y testigo, a los cuales se le aplicaron el test de depresión Zung-Conde, el IDARE, el cuestionario de conductas de enfrentamiento y el examen neuropsicológico de Anne-Lise Crhistensen. Se pudo definir la existencia de factores más relacionados con características personológicas, factores externos fundamentalmente provenientes del medio y factores producto de esta interacción como lo constituyen el estrés y la ansiedad. (Duazary 2006; 1: 24 - 31 

  18. Advanced devices for photoacoustic imaging to improve cancer and cerebrovascular medicine

    Science.gov (United States)

    Montilla Marien, Leonardo Gabriel

    micromachined ultrasound transducer (CMUT) two-dimensional arrays compatible with standard ultrasound scanners were used to generate real-time 3D photoacoustic images. Future probes, designed incorporating CMUT arrays, would be relatively simple to fabricate and a convenient upgrade to existing clinical ultrasound equipment. Eventually, a handheld tool with the ability to visualize, in real-time 3D, the desired microvasculature, would assist surgical procedures. The potential implications of PAI devices compatible with standard ultrasound equipment would be a streamlined cost efficient solution for translating photoacoustics into clinical practice. The practitioner could then explore the benefits of the enhanced contrast adjunctive to current ultrasound applications. Clinical availability of PAI could enhance breast cancer diagnostics and cerebrovascular surgical outcomes.

  19. Effect of hypoxia on cerebrovascular and cognitive function during moderate intensity exercise.

    Science.gov (United States)

    Lefferts, Wesley K; Babcock, Matthew C; Tiss, Matthew J; Ives, Stephen J; White, Corey N; Brutsaert, Tom D; Heffernan, Kevin S

    2016-10-15

    Exercise in hypoxia places added demands on the brain and cerebrovasculature that can impact cognitive function. The purpose of this study was to investigate the effect of acute hypoxia on cerebrovascular hemodynamics, markers of neuro-steroidal modulation and brain-blood barrier (BBB) integrity, and cognition during exercise. Thirty healthy participants (21±4yrs., BMI 24.0±2.6kg∙m(-2); 15 men) were randomized to both a≈2.5h normoxic (FiO2 20.0%) and hypoxic (FiO2 12.5%) condition on two separate days. After 1.25h, participants underwent 10min of exercise-alone (cycling at 55% HRmax) and 15min of exercise+cognitive testing. Prefrontal cortex (PFC) tissue oxygenation and middle cerebral artery (MCA) mean blood velocity (MnV) were measured using near-infrared spectroscopy and transcranial Doppler respectively at rest, during exercise-alone, and during exercise+cognitive testing. Salivary levels of dehydroepiandosterone [DHEA], DHEA-sulfate [DHEAS]) and neuron specific enolase (NSE) were measured pre and post exercise. Cognition was assessed using standard metrics of accuracy and reaction time (RT), and advanced metrics from drift-diffusion modeling across memory recognition, N-Back and Flanker tasks. MCA MnV increased from rest to exercise (pcognitive testing during exercise in both normoxia and hypoxia. PFC oxygenation increased during exercise (pcognitive challenge in normoxia but decreased during exercise in hypoxia (pcognitive tasks (pcognitive tasks was similar in normoxia compared to hypoxia, while RT was slower in hypoxia vs normoxia across memory recognition (pmodeling suggested changes in memory RT were due to increases in caution (pcognitive performance is maintained during exercise in hypoxia concomitant with slower RT in select cognitive tasks and reduced oxygenation in the PFC. These changes were accompanied by slight increases in neuro-steroidal modulation but appear independent of changes in NSE, a biomarker of BBB integrity. Maintained accuracy

  20. Evaluation of the redistribution in [sup 123]I-IMP SPECT in cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Masahiro; Shibasaki, Takashi; Horikoshi, Satoru; Ohye, Chihiro; Suzuki, Hideki (Gunma Univ., Maebashi (Japan). School of Medicine)

    1994-06-01

    We evaluated the correlation between redistribution on IMP SPECT and the regional oxygen extraction fraction (rOEF) on PET. Ten lesions that had shown the redistribution phenomenon on IMP SPECT in five patients were selected. In four patient, IMP SPECT was performed within 2 months of the onset of cerebrovascular attack. In one patient, the examination was performed 3 years after the onset. The interval between IMP SPECT and PET was 45 days, except in one patient who was in the chronic phase. The ten lesions were classified into two groups according to rOEF values as follows: Group 1, rOEF[>=]50% and Group 2, rOEF<50%. In group 1, all lesions did not show low density on final X-ray CT. By contrast, in group 2, three lesions did not show low density on the X-ray CT and the other two lesions did. Redistribution rate (RD rate) was defined as follows, RD rate= [l brace](B-A) /B- (B'-A') /B'[r brace] / (B-A) /Bx100 (%) where, A, B, A' and B' are count rate in each of the regions of interest (ROIs). Region of interest (ROI) A was positioned in the lesion on the early image of SPECT that showed redistribution on the delayed image and ROI B was in the opposite side or occipital lobe (normal brain). On the delayed image, ROI A' and B' were positioned at the same place as A and B. ROIs on PET were positioned in the lesion corresponding to ROI A and B on SPECT. In group 1, all RD rates increased more than 70%. By contrast, in group 2, most RD rates were not more than 70%. In group 1, the A'/B' ratio increased more than A/B and was always greater than 90%. It is suggested that the presence of the redistribution phenomenon on IMP SPECT dose not always show the tissue viability. But quantification of the phenomenon by calculating A'/B' or RD rate is useful in evaluating tissue viability of the lesions and in predicting the final outcome of the area. (author).

  1. Epidemiology of non-fatal cerebrovascular stroke and transient ischemic attacks in Al Quseir, Egypt

    Directory of Open Access Journals (Sweden)

    El-Tallawy HN

    2013-11-01

    Full Text Available Hamdy N El-Tallawy,1 Wafaa MA Farghaly,1 Ghaydaa A Shehata,1 Nabil M Abdel-Hakeem,2 Tarek A Rageh,1 Reda Badry,1 Mahmoud R Kandil1 1Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University Hospital, 2Department of Neurology, Faculty of Medicine, Al-Azhar University, Assiut branch, Assuit, Egypt Background and purpose: Stroke is a medical emergency that can cause permanent neurological damage, complications, and disability. We aim to determine the epidemiology of non-fatal cerebrovascular stroke (CVS and transient ischemic attacks (TIAs in Al Quseir City, Red Sea, Egypt. Methods: The total population (n=33,285 was screened through a door to door study by three specialists of neurology and 15 female social workers (for demographic data collection. All suspected stroke patients were subjected to a full clinical examination, computerized tomography (CT and/or magnetic resonance imaging (MRI of their brain, blood sugar, lipogram, serum uric acid, complete blood cells, blood urea, and serum creatinine, as well as evaluated by Barthel Index and Scandinavian Stroke Scale. Carotid doppler, echocardiography, and thyroid functions were done for selected cases. Results: CVS was recorded among 130 patients out of 19,848 subjects aged 20 years and more, yielding a total prevalence of 6.55/1,000 population. From June 1, 2010 to May 31, 2011, 36 patients were recorded to have stroke within 1-year, yielding an incidence rate of 1.81/1,000. Prevalence and incidence rates were higher among males than females, and both indices increased steadily with advancing age to reach the highest prevalence (37.02/1,000 and incidence rate (9.5/1,000 among aged persons 60 years and more. Conclusion: The prevalence of non-fatal stroke in Al Quseir city (6.55/1,000 was at the lower range of that recorded in developing countries (5–10/1,000 and slightly higher than that recorded in industrialized countries (5/1,000 population. Ischemic stroke is the most

  2. Intestinal circulation during inhalation anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Tverskoy, M.; Gelman, S.; Fowler, K.C.; Bradley, E.L.

    1985-04-01

    This study was designed to evaluate the influence of inhalational agents on the intestinal circulation in an isolated loop preparation. Sixty dogs were studied, using three intestinal segments from each dog. Selected intestinal segments were pumped with aortic blood at a constant pressure of 100 mmHg. A mixture of /sub 86/Rb and 9-microns spheres labeled with /sup 141/Ce was injected into the arterial cannula supplying the intestinal loop, while mesenteric venous blood was collected for activity counting. A very strong and significant correlation was found between rubidium clearance and microsphere entrapment (r = 0.97, P less than 0.0001). Nitrous oxide anesthesia was accompanied by a higher vascular resistance (VR), lower flow (F), rubidium clearance (Cl-Rb), and microspheres entrapment (Cl-Sph) than pentobarbital anesthesia, indicating that the vascular bed in the intestinal segment was constricted and flow (total and nutritive) decreased. Halothane, enflurane, and isoflurane anesthesia were accompanied by a much lower arteriovenous oxygen content difference (AVDO/sub 2/) and oxygen uptake than pentobarbital or nitrous oxide. Compared with pentobarbital, enflurane anesthesia was not accompanied by marked differences in VR, F, Cl-Rb, and Cl-Sph; halothane at 2 MAC decreased VR and increased F and Cl-Rb while isoflurane increased VR and decreased F. alpha-Adrenoceptor blockade with phentolamine (1 mg . kg-1) abolished isoflurane-induced vasoconstriction, suggesting that the increase in VR was mediated via circulating catecholamines.

  3. Relationship of acute cerebrovascular diseases and hypothyroidism%急性脑血管病与甲状腺功能减退

    Institute of Scientific and Technical Information of China (English)

    杨华; 马召玺; 毛慧慧; 王万华; 张炎

    2013-01-01

    急性脑血管病后可引起临床甲状腺功能低下及亚临床甲状腺功能退减,甲状腺功能低下及亚临床甲状腺功能退减可能为急性脑血管病的危险因素,本文将二者关系综述如下。%Acute cerebrovascular diseases may result in overt hypothyroidism and subclinical hypothyroidism, however, overt hypothyroidism and subclinical hypothyroidism may be risk factors of acute cerebrovascular diseases. The relationship between the two aspects is reviewed as follows.

  4. Impact of age on the cerebrovascular proteomes of wild-type and Tg-SwDI mice.

    Directory of Open Access Journals (Sweden)

    James L Searcy

    Full Text Available The structural integrity of cerebral vessels is compromised during ageing. Abnormal amyloid (Aβ deposition in the vasculature can accelerate age-related pathologies. The cerebrovascular response associated with ageing and microvascular Aβ deposition was defined using quantitative label-free shotgun proteomic analysis. Over 650 proteins were quantified in vessel-enriched fractions from the brains of 3 and 9 month-old wild-type (WT and Tg-SwDI mice. Sixty-five proteins were significantly increased in older WT animals and included several basement membrane proteins (nidogen-1, basement membrane-specific heparan sulfate proteoglycan core protein, laminin subunit gamma-1 precursor and collagen alpha-2(IV chain preproprotein. Twenty-four proteins were increased and twenty-one decreased in older Tg-SwDI mice. Of these, increases in Apolipoprotein E (APOE and high temperature requirement serine protease-1 (HTRA1 and decreases in spliceosome and RNA-binding proteins were the most prominent. Only six shared proteins were altered in both 9-month old WT and Tg-SwDI animals. The age-related proteomic response in the cerebrovasculature was distinctly different in the presence of microvascular Aβ deposition. Proteins found differentially expressed within the WT and Tg-SwDI animals give greater insight to the mechanisms behind age-related cerebrovascular dysfunction and pathologies and may provide novel therapeutic targets.

  5. Creating a Computing Programs Package to Aid in the Assessment and Prognosis of Patients Suffering from Cerebrovascular Diseases

    Directory of Open Access Journals (Sweden)

    Carlos Jaime Geroy Gómez

    2007-05-01

    Full Text Available Fundament: The have an evaluation and prognosis of patients suffering from cerebrovascular diseases in its acute phase is important in order to define the medical management as well as others several aspects. Objective: To create computing programs package to aid in the assessment and prognosis of patients suffering from cerebrovascular diseases. Method: A research and development study to create a package of programs using a C chart computing language (NET language with recognized international scale compendium and the Cuban scale prognosis. Results: A Software which shows in different screens the correspondent variables to the different evaluative scales and the prognosis Cuban scale ¨Stroke¨ is created. It is applicable to every type of patient suffering from cardiovascular diseases and an immediate assessment and prognosis is obtained. It also has a data base. It is applicable in all ictus units of our country and abroad. Conclusions: A unique software was created as a valuable tool to the attention of patients suffering from cardiovascular diseases which permit to obtain a better assessment and prognosis of this kind of patient.

  6. Effects of Hyul-Bu-Chuke-Tang on Erythrocyte Deformability and Cerebrovascular CO2 Reactivity in Normal Subjects

    Directory of Open Access Journals (Sweden)

    Woo-Sang Jung

    2012-01-01

    Full Text Available Aim. Hyul-bu-chuke-tang (HCEt is a well-known traditional herbal medicine that is used for the treatment of ischemic cerebrovascular disorders. We investigated the acute effects of HCEt on erythrocyte deformability and cerebrovascular CO2 reactivity (CVR in healthy male subjects. Materials and Methods. We examined erythrocyte deformability in an HCEt group (n=14 and a control group (n=10. CVR was measured using hyperventilation-induced CO2 reactivity of the middle cerebral artery and transcranial Doppler (TCD in the HCEt group (n=11. A historical control group (n=10 of CVR measurements was also created from our previous study. All measurements were performed prior to and 1, 2, and 3 hours after HCEt administration. Results. HCEt significantly improved erythrocyte deformability 1 hour after administration compared to the control group (2.9±1.1% versus -0.6±1.0%, P=0.034. HCEt significantly improved the CVR 2 hours after administration compared to the historical control group (9.1±4.0% versus -8.1±4.1%, P=0.007. The mean blood pressure and pulse rate did not vary from baseline values in either group. Conclusions. We demonstrated that HCEt improved erythrocyte deformability and CVR. Our findings suggest that an improvement in erythrocyte deformability contributes to HCEt’s effect on cerebral microcirculation.

  7. Carbon dioxide induced changes in cerebral blood flow and flow velocity: role of cerebrovascular resistance and effective cerebral perfusion pressure.

    Science.gov (United States)

    Grüne, Frank; Kazmaier, Stephan; Stolker, Robert J; Visser, Gerhard H; Weyland, Andreas

    2015-09-01

    In addition to cerebrovascular resistance (CVR) zero flow pressure (ZFP), effective cerebral perfusion pressure (CPPe) and the resistance area product (RAP) are supplemental determinants of cerebral blood flow (CBF). Until now, the interrelationship of PaCO2-induced changes in CBF, CVR, CPPe, ZFP, and RAP is not fully understood. In a controlled crossover trial, we investigated 10 anesthetized patients aiming at PaCO2 levels of 30, 37, 43, and 50 mm Hg. Cerebral blood flow was measured with a modified Kety-Schmidt-technique. Zero flow pressure and RAP was estimated by linear regression analysis of pressure-flow velocity relationships of the middle cerebral artery. Effective cerebral perfusion pressure was calculated as the difference between mean arterial pressure and ZFP, CVR as the ratio CPPe/CBF. Statistical analysis was performed by one-way RM-ANOVA. When comparing hypocapnia with hypercapnia, CBF showed a significant exponential reduction by 55% and mean VMCA by 41%. Effective cerebral perfusion pressure linearly decreased by 17% while ZFP increased from 14 to 29 mm Hg. Cerebrovascular resistance increased by 96% and RAP by 39%; despite these concordant changes in mean CVR and Doppler-derived RAP correlation between these variables was weak (r=0.43). In conclusion, under general anesthesia hypocapnia-induced reduction in CBF is caused by both an increase in CVR and a decrease in CPPe, as a consequence of an increase in ZFP.

  8. A síndrome ombro-mão nas hemiplegias vasculares Shoulder-hand syndrome in cerebrovascular hemiplegia

    Directory of Open Access Journals (Sweden)

    Sebastião E. Melo Souza

    1968-09-01

    Full Text Available São expostos os dados obtidos em 18 casos de síndrome ombro-mão, encontrados mediante revisão de 175 pacientes acometidos de afecção cerebro-vascular aguda. Em todos os casos a síndrome se instalou no lado paralisado, evidenciando a importância da imobilização. O início se deu, na maioria das vezes, por edema de mão, aparecendo dentro de duas a três semanas após o icto. Os resultados eletromiográficos obtidos em 7 casos, são comentados. O tratamento de maior êxito se deve à cinesiterapia, podendo-se associar a griseofulvina, útil no alívio da dor.From 175 cases of cerebrovascular disease, 18 patients with shoulder-hand syndrome are studied. In all patients the syndrome involved the paralysed limb, a fact that points to immobility as a enhancing factor. Hand edema occurring two to three weeks after the stroke was the first sign of the syndrome. Eletromyographic data were evaluated in 7 patients. Griseofulvine (for pain and kinesiotherapy are the best available tratment.

  9. Compromised cerebrovascular modulation in chronic anxiety: evidence from cerebral blood flow velocity measured by transcranial Doppler sonography

    Institute of Scientific and Technical Information of China (English)

    Hong-Liang Zhang; Zhen-Ni Guo; Ge Yang; Le Yang; Ke Han; Jiang Wu; Yingqi Xing; Yi Yang

    2012-01-01

    Objective Cerebral autoregulation (CA) is the mechanism by which constant cerebral blood flow is maintained despite changes in cerebral perfusion pressure.CA can be evaluated by dynamic monitoring of cerebral blood flow velocity (CBFV) with transcranial Doppler sonography (TCD).The present study aimed to explore CA in chronic anxiety.Methods Subjects with Hamilton anxiety scale scores ≥14 were enrolled and the dynamic changes of CBFV in response to an orthostatic challenge were investigated using TCD.Results In both the anxious and the healthy subjects,the mean CBFV was significantly lower in the upright position than when supine.However,the CBFV changes from supine to upright differed between the anxious and the healthy groups.Anxious subjects showed more pronounced decreases in CBFV with abrupt standing.Conclusion Our results indicate that cerebrovascular modulation is compromised in chronic anxiety; anxious subjects have some insufficiency in maintaining cerebral perfusion after postural change.Given the fact that anxiety and impaired CA are associated with cardiovascular disease,early ascertainment of compromised cerebrovascular modulation using TCD might suggest interventional therapies in the anxious population,and improve the primary prevention of cardiovascular disease.

  10. Asymptomatic cerebrovascular lesions detected by magnetic resonance imaging in patients with systemic lupus erythematosus lacking a history of neuropsychiatric events

    Energy Technology Data Exchange (ETDEWEB)

    Nomura, Kumiko; Yamano, Shigeru; Ikeda, Yukiko [Nara Medical Univ., Kashihara (Japan)] (and others)

    1999-10-01

    To clarify the extent of asymptomatic cerebrovascular involvement in systemic lupus erythematosus (SLE). Cerebral magnetic resonance imaging (MRI) findings and ultrasonography findings of 100 patients with SLE lacking present or past clinical neurologic deficits were compared with 66 age-matched volunteers to determine the combined intima-media thickness (IMT) of the common carotid artery, and tests for anti-cardiolipin antibodies (aCL). Thirty-eight patients, but only 2 controls, showed imaging abnormalities. Among 23 SLE patients with cerebrovascular lesions by MRI who underwent single-photon emission computed tomography (SPECT), 14 showed hypoperfusion of the lesion. The IMT value and prevalence of aCL did not differ between the 55 SLE patients tested and controls. SLE disease activity index (SLEDAI) as assessed by a quantitative clinical index was significantly greater in patients with brain lesions than in those without. The prevalence of asymptomatic brain lesions in SLE patients is high, and shows a relationship to disease activity. (author)

  11. Rho激酶与缺血性脑血管病%Rho kinase and ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    刘薇薇; 崔桂云; 沈霞

    2009-01-01

    缺血性脑血管病可导致严重的神经功能缺损.甚至死亡.Rho激酶是Rho蛋白的重要下游底物,参与血管平滑肌收缩、细胞迁移、炎症细胞浸润以及血管内皮功能障碍等多种生物学效应,在缺血性脑血管病的发生、发展和梗死体积扩大等过程中起着重要作用.Rho激酶抑制剂可有效舒张痉李血管,减轻局部炎症反应,保护内皮功能,增加缺血区域血流,缩小梗死体积,改善神经功能.%Ischemic cerebrovascular disease may result in severe neurological deficits, and even death. Rho kinase is an important downstream substrate of Rho protein. It involves in multiple biological effects, including vascular smooth muscle contraction, cell migration, inflammatory cell infiltration and vascular endothelial dysfunction. It plays important roles in the processes of the occurrence, development and expansion of infarct volume in ischemic cerebrovascular disease. Rho kinase inhibitor can effectively relax vascular spasm, reduce local inflammatory response, protect endothelial function, increase blood flow in ischemic region, reduce infarct volume, and improve neurological function.

  12. The vascular steal phenomenon is an incomplete contributor to negative cerebrovascular reactivity in patients with symptomatic intracranial stenosis.

    Science.gov (United States)

    Arteaga, Daniel F; Strother, Megan K; Faraco, Carlos C; Jordan, Lori C; Ladner, Travis R; Dethrage, Lindsey M; Singer, Robert J; Mocco, J; Clemmons, Paul F; Ayad, Michael J; Donahue, Manus J

    2014-09-01

    'Vascular steal' has been proposed as a compensatory mechanism in hemodynamically compromised ischemic parenchyma. Here, independent measures of cerebral blood flow (CBF) and blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) responses to a vascular stimulus in patients with ischemic cerebrovascular disease are recorded. Symptomatic intracranial stenosis patients (n=40) underwent a multimodal 3.0T MRI protocol including structural (T1-weighted and T2-weighted fluid-attenuated inversion recovery) and hemodynamic (BOLD and CBF-weighted arterial spin labeling) functional MRI during room air and hypercarbic gas administration. CBF changes in regions demonstrating negative BOLD reactivity were recorded, as well as clinical correlates including symptomatic hemisphere by infarct and lateralizing symptoms. Fifteen out of forty participants exhibited negative BOLD reactivity. Of these, a positive relationship was found between BOLD and CBF reactivity in unaffected (stenosis degree<50%) cortex. In negative BOLD cerebrovascular reactivity regions, three patients exhibited significant (P<0.01) reductions in CBF consistent with vascular steal; six exhibited increases in CBF; and the remaining exhibited no statistical change in CBF. Secondary findings were that negative BOLD reactivity correlated with symptomatic hemisphere by lateralizing clinical symptoms and prior infarcts(s). These data support the conclusion that negative hypercarbia-induced BOLD responses, frequently assigned to vascular steal, are heterogeneous in origin with possible contributions from autoregulation and/or metabolism.

  13. Application of electroencephalography in cerebrovascular disease%脑电图在脑血管疾病中的应用

    Institute of Scientific and Technical Information of China (English)

    王乾; 苏立凯

    2014-01-01

    Cerebrovascular disease is one of diseases which threatens human’s health seriously. It is of vital significance for patients with stroke to be diagnosed timely. Efficient treatment can help to decrease the damage of stroke. Acute evaluation of prognosis of stroke is of importance for patients and their family. Electroencephalography is an approach that can be easily operated. The defection of motor or language function has little influence to electroencephalography. Electroencephalography plays a role in early diagnosing of cerebrovascular disease, focus detection, recognition of secondary epilepsy, valuing the effect of medicine and prediction the prognosis of coma patients.%脑血管疾病严重威胁人类健康,对脑卒中病人及时确诊、积极治疗、评估病情具有重要意义。脑电图检查具有方便易行,适于床旁操作;可重复性好;不受运动、语言等功能损伤的限制等优点。脑电图可以协助脑血管疾病的早期诊断,帮助病灶定侧,发现继发性癫痫,监测药物效果及预测昏迷病人预后。

  14. A blood circulation model for reference man

    Energy Technology Data Exchange (ETDEWEB)

    Leggett, R.W.; Eckerman, K.F. [Oak Ridge National Lab., TN (United States). Health Sciences Research Div.; Williams, L.R. [Indiana Univ., South Bend, IN (United States). Div. of Liberal Arts and Sciences

    1999-01-01

    This paper describes a dynamic blood circulation model that predicts the movement and gradual dispersal of a bolus of material in the circulation after its intravascular injection into an adult human. The main purpose of the model is to improve the dosimetry of internally deposited radionuclides that decay in the circulation to a significant extent. The total blood volume is partitioned into the blood contents of 24 separate organs or tissues, right heart chambers, left heart chambers, pulmonary circulation, arterial outflow to the systemic tissues (aorta and large arteries), and venous return from the systemic tissues (large veins). As a compromise between physical reality and computational simplicity, the circulation of blood is viewed as a system of first-order transfers between blood pools, with the delay time depending on the mean transit time across the pool. The model allows consideration of incomplete, tissue-dependent extraction of material during passage through the circulation and return of material from tissues to plasma.

  15. Evaluation of high-pitch dual-source CT angiography for evaluation of coronary and carotid-cerebrovascular arteries

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Kai [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Li, Kuncheng, E-mail: cjr.likuncheng@vip.163.com [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Han, Ruijuan [Department of Cardiology, Chaoyang Hospital, Capital Medical University, Beijing 100020 (China); Li, Wenhuan; Chen, Nan; Yang, Qi; Du, Xiangying; Wang, Chen [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Liu, Guorong; Li, Yuechun [Department of Neurology Baotou Central Hospital, Inner Mongolia, Baotou 014040 (China); Zhou, Maorong [Department of Radiology, Baotou Central Hospital, Inner Mongolia, Baotou 014040 (China); Li, Ligang; Heidrun, Endt [CT BM Clinic Marketing, Siemens Healthcare, Beijing 100102 (China)

    2015-03-15

    Objectives: To explore the feasibility and diagnostic accuracy of a combined one-step high-pitch dual-source computed tomography angiography (CTA) technique for evaluation of coronary and carotid-cerebrovascular arteries. Materials and methods: 85 symptomatic patients suspected of coronary artery and cerebrovascular disease referred for simultaneous coronary and carotid-cerebrovascular CTA were included. Additional invasive angiography of the coronary and cerebral arteries was performed within 30 days in 23 and 13 patients, respectively. The objective parameters of image quality, the mean CT attenuations, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were evaluated. The subjective image quality of vessels was also assessed by 2 independent radiologists blinded to the patients’ medical history and scan protocols. The diagnostic performance of CTA including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the detection or exclusion of significant artery stenosis was calculated using the chi-squared test of contingency and correlated with the results of invasive angiography representing the standard of reference. Results: Image quality was rated excellent (score 1) in 95.3% (1074/1127), good (score 2) in 3.3% (37/1127), adequate (score 3) in 1.0% (11/1127), and non-diagnostic (score 4) in 0.4% (5/1127) of coronary segments. Image quality of carotid and cerebral vessels was rated mostly excellent (score 1, 95.12% [78/82]; score 2, 3.66% [3/82]; score 3, 1.22% [1/82]). The sensitivity, specificity, PPV and NPV for the detection of coronary stenosis were 92.2% (81.1–97.7%), 95.2% (91.7–97.5%), 79.6% (67.1–89.1%) and 98.3% (95.8–99.5%), respectively. For the detection of carotid and cerebral artery stenosis, CTA demonstrated a sensitivity of 92.8% (80.5–98.4%), a specificity of 93.5% (88.3–96.8%), a PPV of 79.6% (65.6–89.7%) and a NPV of 97.9% (94.1–99.5%). The effective

  16. Linear thermal circulator based on Coriolis forces.

    Science.gov (United States)

    Li, Huanan; Kottos, Tsampikos

    2015-02-01

    We show that the presence of a Coriolis force in a rotating linear lattice imposes a nonreciprocal propagation of the phononic heat carriers. Using this effect we propose the concept of Coriolis linear thermal circulator which can control the circulation of a heat current. A simple model of three coupled harmonic masses on a rotating platform permits us to demonstrate giant circulating rectification effects for moderate values of the angular velocities of the platform.

  17. A brief etymology of the collateral circulation.

    Science.gov (United States)

    Faber, James E; Chilian, William M; Deindl, Elisabeth; van Royen, Niels; Simons, Michael

    2014-09-01

    It is well known that the protective capacity of the collateral circulation falls short in many individuals with ischemic disease of the heart, brain, and lower extremities. In the past 15 years, opportunities created by molecular and genetic tools, together with disappointing outcomes in many angiogenic trials, have led to a significant increase in the number of studies that focus on: understanding the basic biology of the collateral circulation; identifying the mechanisms that limit the collateral circulation's capacity in many individuals; devising methods to measure collateral extent, which has been found to vary widely among individuals; and developing treatments to increase collateral blood flow in obstructive disease. Unfortunately, accompanying this increase in reports has been a proliferation of vague terms used to describe the disposition and behavior of this unique circulation, as well as the increasing misuse of well-ensconced ones by new (and old) students of collateral circulation. With this in mind, we provide a brief glossary of readily understandable terms to denote the formation, adaptive growth, and maladaptive rarefaction of collateral circulation. We also propose terminology for several newly discovered processes that occur in the collateral circulation. Finally, we include terms used to describe vessels that are sometimes confused with collaterals, as well as terms describing processes active in the general arterial-venous circulation when ischemic conditions engage the collateral circulation. We hope this brief review will help unify the terminology used in collateral research.

  18. Role of Circulating Fibrocytes in Cardiac Fibrosis

    Institute of Scientific and Technical Information of China (English)

    Rong-Jie Lin; Zi-Zhuo Su; Shu-Min Liang; Yu-Yang Chen; Xiao-Rong Shu; Ru-Qiong Nie; Jing-Feng Wang

    2016-01-01

    Objective: It is revealed that circulating fibrocytes are elevated in patients/animals with cardiac fibrosis, and this review aims to provide an introduction to circulating fibrocytes and their role in cardiac fibrosis.Data Sources: This review is based on the data from 1994 to present obtained from PubMed.The search terms were "circulating fibrocytes" and "cardiac fibrosis".Study Selection: Articles and critical reviews, which are related to circulating fibrocytes and cardiac fibrosis, were selected.Results: Circulating fibrocytes, which are derived from hematopoietic stem cells, represent a subset of peripheral blood mononuclear cells exhibiting mixed morphological and molecular characteristics ofhematopoietic and mesenchymal cells (CD34+/CD45+/collagen I+).They can produce extracellular matrix and many cytokines.It is shown that circulating fibrocytes participate in many fibrotic diseases, including cardiac fibrosis.Evidence accumulated in recent years shows that aging individuals and patients with hypertension, heart failure, coronary heart disease, and atrial fibrillation have more circulating fibrocytes in peripheral blood and/or heart tissue, and this elevation of circulating fibrocytes is correlated with the degree of fibrosis in the hearts.Conclusions: Circulating fibrocytes are effector cells in cardiac fibrosis.

  19. The Rank of Integral Circulant Graphs

    Institute of Scientific and Technical Information of China (English)

    ZHOU Hou-qing

    2014-01-01

    A graph is called an integral graph if it has an integral spectrum i.e., all eigen-values are integers. A graph is called circulant graph if it is Cayley graph on the circulant group, i.e., its adjacency matrix is circulant. The rank of a graph is defined to be the rank of its adjacency matrix. This importance of the rank, due to applications in physics, chemistry and combinatorics. In this paper, using Ramanujan sums, we study the rank of integral circulant graphs and gave some simple computational formulas for the rank and provide an example which shows the formula is sharp.

  20. Role of Circulating Fibrocytes in Cardiac Fibrosis

    Science.gov (United States)

    Lin, Rong-Jie; Su, Zi-Zhuo; Liang, Shu-Min; Chen, Yu-Yang; Shu, Xiao-Rong; Nie, Ru-Qiong; Wang, Jing-Feng; Xie, Shuang-Lun

    2016-01-01

    Objective: It is revealed that circulating fibrocytes are elevated in patients/animals with cardiac fibrosis, and this review aims to provide an introduction to circulating fibrocytes and their role in cardiac fibrosis. Data Sources: This review is based on the data from 1994 to present obtained from PubMed. The search terms were “circulating fibrocytes” and “cardiac fibrosis”. Study Selection: Articles and critical reviews, which are related to circulating fibrocytes and cardiac fibrosis, were selected. Results: Circulating fibrocytes, which are derived from hematopoietic stem cells, represent a subset of peripheral blood mononuclear cells exhibiting mixed morphological and molecular characteristics of hematopoietic and mesenchymal cells (CD34+/CD45+/collagen I+). They can produce extracellular matrix and many cytokines. It is shown that circulating fibrocytes participate in many fibrotic diseases, including cardiac fibrosis. Evidence accumulated in recent years shows that aging individuals and patients with hypertension, heart failure, coronary heart disease, and atrial fibrillation have more circulating fibrocytes in peripheral blood and/or heart tissue, and this elevation of circulating fibrocytes is correlated with the degree of fibrosis in the hearts. Conclusions: Circulating fibrocytes are effector cells in cardiac fibrosis. PMID:26831236

  1. Inflammatory response and extracorporeal circulation.

    Science.gov (United States)

    Kraft, Florian; Schmidt, Christoph; Van Aken, Hugo; Zarbock, Alexander

    2015-06-01

    Patients undergoing cardiac surgery with extracorporeal circulation (EC) frequently develop a systemic inflammatory response syndrome. Surgical trauma, ischaemia-reperfusion injury, endotoxaemia and blood contact to nonendothelial circuit compounds promote the activation of coagulation pathways, complement factors and a cellular immune response. This review discusses the multiple pathways leading to endothelial cell activation, neutrophil recruitment and production of reactive oxygen species and nitric oxide. All these factors may induce cellular damage and subsequent organ injury. Multiple organ dysfunction after cardiac surgery with EC is associated with an increased morbidity and mortality. In addition to the pathogenesis of organ dysfunction after EC, this review deals with different therapeutic interventions aiming to alleviate the inflammatory response and consequently multiple organ dysfunction after cardiac surgery.

  2. PRELIMINARY STUDY ON CIRCULATION HEIGHT OF CIRCULATION FLOW WITH THE HORIZONTAL AXIS

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    In this paper, the relationship between circulation heights of circulation flow with horizontal axis and incident flow conditions as well as side slope angles of trenches was systematically analyzed on the basis of the velocity distribution data observed in a series of model tests in a flume, and the related formula for the circulation height was proposed. Moreover, the variation of circulation flow intensity was also analyzed.

  3. Registro de enfermedad cerebrovascular isquémica Ischemic stroke registry

    Directory of Open Access Journals (Sweden)

    Juan I. Rojas

    2006-12-01

    Full Text Available El conocimiento de los factores de riesgo y los aspectos epidemiológicos del accidente cerebrovascular (ACV provienen fundamentalmente de estudios de EE.UU. y Europa, con escasa información procedente de los países en desarrollo. Las características clínicas y epidemiológicas del ACV son variables en relación a factores regionales, por lo cual es necesario conocer cuál es la situación en nuestro continente. El objetivo del trabajo es describir los subtipos clínicos y los factores de riesgo de los pacientes con ACV isquémico. Se analizaron consecutivamente los pacientes ingresados desde el 01/06/2003 al 01/06/2005 con diagnostico de ACV isquémico. Sobre un total de 395 pacientes, la edad media fue de 71.36 años (± 13.82, el 55% fueron varones. Los subtipos de ACV fueron los siguientes: infarto lacunar (40%, enfermedad de gran arteria (20%, cardioembolia (10% y otras causas (5%. La hipertensión arterial (76%, la dislipidemia (50% y el antecedente de ACV previo (34% fueron los factores de riesgo más frecuentes. Los pacientes con síntomas corticales presentaron más frecuentemente estenosis carotídea > del 70% en el doppler de vasos de cuello, siendo esto estadísticamente significativo. La información sobre el ACV en los países en desarrollo es difícil de obtener. Esta puede ser la razón del escaso número de registros provenientes de Sudamérica. La hipertensión fue el factor de riesgo más prevalente en nuestra serie. El subtipo de ACV difiere de lo informado en otras regiones del mundo predominando la enfermedad de pequeña arteria.Current knowledge of stroke risk factors and epidemiology is based mostly on USA or European studies; scarce data have been published from developing countries. Because epidemiological and clinical characteristics in stroke vary according to regional factors, we need to know the peculiarities of stroke on this subcontinent. The purpose is to describe the clinical subtypes and risk factors in

  4. Studies on intracranial collateral circulation with multi-slice CT angiography in patients with symptomatic cerebral artery stenosis

    Directory of Open Access Journals (Sweden)

    Shu-qing ZHOU

    2011-06-01

    Full Text Available Objective To explore the features of intracranial collateral circulation in patients with symptomatic cerebral artery stenosis.Method Ninety-four patients with ischemic cerebrovascular disease admitted from Apr.2004 to Jun.2009 were involved in present study.All the patients were examined with cerebral multi-slice CT angiography,and the features of cerebral artery stenosis and intracranial collateral circulation were evaluated using maximum intensity projection(MIP and volume rendering(VR images of CT angiography.Result Of the 94 patients involved,48 were diagnosed as cerebral artery stenosis,including 29 cases of cerebral infarction,18 of transient ischemic attack(TIA and 1 of moyamoya disease(MMD.Among the 14 cases of severe cerebral artery stenosis or occlusion,cerebral infarction was found in 6 cases with lesser intracranial collateral vessels(including massive cerebral infarction in 4 cases and watershed infarction in 2 cases,and focal infarction of central semi-ovale in 1 case and TIA in 7 cases were found with abundant intracranial collateral vessels.Multiple lacunar infarction was found in 22 cases of mild or moderate cerebral artery stenosis,but there was no significant correlation between the stenosed arteries and infarction sites.Abundant intracranial collateral vessels were found in one patient with Moyamoya disease but no infarction was observed.Conclusions Intracranial collateral circulation plays an important role of compensation in patients with severe cerebral artery stenosis or occlusion.Cerebral angiography with multi-slice CT is of great significance in evaluation of cerebral artery stenosis and intracranial collateral circulation.

  5. Lower prevalence of carotid plaque hemorrhage in women, and its mediator effect on sex differences in recurrent cerebrovascular events.

    Directory of Open Access Journals (Sweden)

    Neghal Kandiyil

    Full Text Available Women are at lower risk of stroke, and appear to benefit less from carotid endarterectomy (CEA than men. We hypothesised that this is due to more benign carotid disease in women mediating a lower risk of recurrent cerebrovascular events. To test this, we investigated sex differences in the prevalence of MRI detectable plaque hemorrhage (MRI PH as an index of plaque instability, and secondly whether MRI PH mediates sex differences in the rate of cerebrovascular recurrence.Prevalence of PH between sexes was analysed in a single centre pooled cohort of 176 patients with recently symptomatic, significant carotid stenosis (106 severe [≥70%], 70 moderate [50-69%] who underwent prospective carotid MRI scanning for identification of MRI PH. Further, a meta-analysis of published evidence was undertaken. Recurrent events were noted during clinical follow up for survival analysis.Women with symptomatic carotid stenosis (50%≥ were less likely to have plaque hemorrhage (PH than men (46% vs. 70% with an adjusted OR of 0.23 [95% CI 0.10-0.50, P<0.0001] controlling for other known vascular risk factors. This negative association was only significant for the severe stenosis subgroup (adjusted OR 0.18, 95% CI 0.067-0.50 not the moderate degree stenosis. Female sex in this subgroup also predicted a longer time to recurrent cerebral ischemic events (HR 0.38 95% CI 0.15-0.98, P = 0.045. Further addition of MRI PH or smoking abolished the sex effects with only MRI PH exerting a direct effect. Meta-analysis confirmed a protective effect of female sex on development of PH: unadjusted OR for presence of PH = 0.54 (95% CI 0.45-0.67, p<0.00001.MRI PH is significantly less prevalent in women. Women with MRI PH and severe stenosis have a similar risk as men for recurrent cerebrovascular events. MRI PH thus allows overcoming the sex bias in selection for CEA.

  6. O escore de CHADS2 na predição de eventos cerebrovasculares: uma metanálise

    Directory of Open Access Journals (Sweden)

    Cristina Santos

    2013-03-01

    Full Text Available O escore de CHADS2 é um método de estratificação do risco de eventos cardiovasculares, sendo útil na decisão terapêutica em doentes de moderado/alto risco. Esta metanálise tem como objectivo averiguar se o escore de CHADS2 é eficaz na predição de eventos cerebrovasculares em doentes com Fibrilação Auricular (FA. Realizou-se uma pesquisa bibliográfica informatizada nos motores de busca PubMed, EMBASE e SciELO, durante o período de março de 2011 a abril de 2012. Os estudos foram seleccionados de acordo com critérios predeterminados. A metanálise incidiu em seis estudos de coorte, observacionais e prospectivos, que avaliaram a capacidade preditiva do escore de CHADS2 para eventos cerebrovasculares e morte. Os endpoints definidos (mortalidade e/ou Acidente Vascular Cerebral [AVC] não fatal foram comparados entre doentes com CHADS2 2, e também em função da presença/ausência de FA. No que diz respeito à ocorrência de eventos cardiovasculares combinados, morte e AVC, observou-se um maior risco no grupo com escore de CHADS2 > 2 e com FA crônica, com Odds Ratio (OR respectivamente de 2.92 (IC:2.08-4.10; p 2, independentemente da presença de FA: OR = 2.93 (IC:2.81-3.06; p < 0,00001 nos doentes com FA; OR = 2.94; (IC:2.87-3.01; p < 0,00001 nos doentes sem FA. Os estudos indicam claramente a capacidade discriminativa do escorede CHADS2 para o risco de eventos cerebrovasculares, independentemente da presença ou não de FA, permitindo desta forma identificar doentes de moderado/alto risco e seleccionar estratégias terapêuticas adequadas.

  7. Vascular Steal Explains Early Paradoxical Blood Oxygen Level-Dependent Cerebrovascular Response in Brain Regions with Delayed Arterial Transit Times

    Directory of Open Access Journals (Sweden)

    Julien Poublanc

    2013-04-01

    Full Text Available Introduction: Blood oxygen level-dependent (BOLD magnetic resonance imaging (MRI during manipulation of inhaled carbon dioxide (CO2 can be used to measure cerebrovascular reactivity (CVR and map regions of exhausted cerebrovascular reserve. These regions exhibit a reduced or negative BOLD response to inhaled CO2. In this study, we sought to clarify the mechanism behind the negative BOLD response by investigating its time delay (TD. Dynamic susceptibility contrast (DSC MRI with the injection of a contrast agent was used as the gold standard in order to provide measurement of the blood arrival time to which CVR TD could be compared. We hypothesize that if negative BOLD responses are the result of a steal phenomenon, they should be synchronized with positive BOLD responses from healthy brain tissue, even though the blood arrival time would be delayed. Methods: On a 3-tesla MRI system, BOLD CVR and DSC images were collected in a group of 19 patients with steno-occlusive cerebrovascular disease. For each patient, we generated a CVR magnitude map by regressing the BOLD signal with the end-tidal partial pressure of CO2 (PETCO2, and a CVR TD map by extracting the time of maximum cross-correlation between the BOLD signal and PETCO2. In addition, a blood arrival time map was generated by fitting the DSC signal with a gamma variate function. ROI masks corresponding to varying degrees of reactivity were constructed. Within these masks, the mean CVR magnitude, CVR TD and DSC blood arrival time were extracted and averaged over the 19 patients. CVR magnitude and CVR TD were then plotted against DSC blood arrival time. Results: The results show that CVR magnitude is highly correlated to DSC blood arrival time. As expected, the most compromised tissues with the longest blood arrival time have the lowest (most negative CVR magnitude. However, CVR TD shows a noncontinuous relationship with DSC blood arrival time. CVR TD is well correlated to DSC blood arrival time

  8. Dispensing with the DVD Circulation Dilemma

    Science.gov (United States)

    Ellis, Mark

    2008-01-01

    Richmond Public Library (RPL) is a four-branch suburban library with the highest per capita circulation of any comparable library in Canada. While DVDs naturally fit into RPL's emphasis on popular material, circulating them using the standard model proved problematic: Long hold queues built up, DVDs idled on the hold shelves, and the circulation…

  9. Space-Time radar waveforms: circulating codes

    NARCIS (Netherlands)

    Babur, G.; Aubry, P.; Le Chevalier, F.

    2013-01-01

    This paper describes a concept of the circulating codes covering the whole class of the space-time codes. The circulating codes do not narrow the radiated pattern of the antenna array, thus providing a wide angular coverage, possibly tunable. In turn, the beam-forming on transmit is achievable by me

  10. On So's conjecture for integral circulant graphs

    Directory of Open Access Journals (Sweden)

    J.W. Sander

    2015-04-01

    According to a conjecture of {\\sc So} two integral circulant graphs are isomorphic if and only if they are isospectral, i.e. they have the same eigenvalues (counted with multiplicities. We prove a weaker form of this conjecture, namely, that two integral circulant graphs with multiplicative divisor sets are isomorphic if and only if their spectral vectors coincide.

  11. Uso de esteronitronas para el tratamiento y prevención del ictus o accidente cerebrovascular, enfermedades de alzheimer, parkinson y esclerosis lateral amiotrófica

    OpenAIRE

    Marco-Contelles, José; Alcázar González, Alberto

    2013-01-01

    Uso y preparación de esteronitronas con alta permeabilidad a la barrera hematoencefálica, capacidad antioxidante y neuroprotectora, como potenciales fármacos para el tratamiento del ictus o accidente cerebrovascular, enfermedades de Alzheimer, Parkinson y esclerosis lateral amiotrófica.

  12. Depression, anxiety and major adverse cardiovascular and cerebrovascular events in patients following coronary artery bypass graft surgery: A five year longitudinal cohort study

    NARCIS (Netherlands)

    P.J. Tully (Phillip); H.R. Winefield (Helen); R.A. Baker (Robert); J. Denollet (Johan); S.S. Pedersen (Susanne); G.A. Wittert (Gary); D.A. Turnbull (Deborah)

    2015-01-01

    textabstractBackground: Although depression and anxiety have been implicated in risk for major adverse cardiovascular and cerebrovascular events (MACCE), a theoretical approach to identifying such putative links is lacking. The objective of this study was to examine the association between theoretic

  13. S-adenosylmethionine Administration Attenuates Low Brain-Derived Neurotrophic Factor Expression Induced by Chronic Cerebrovascular Hypoperfusion or Beta Amyloid Treatment.

    Science.gov (United States)

    Li, Qian; Cui, Jing; Fang, Chen; Zhang, Xiaowen; Li, Liang

    2016-04-01

    Chronic cerebrovascular hypoperfusion is a high-risk factor for Alzheimer's disease (AD) as it is conducive to beta amyloid (Aβ) over-production. Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family widely expressed in the central nervous system. The structure of the rat BDNF gene is complex, consisting of eight non-coding exons (I-VIII) and one coding exon (IX). The BDNF gene is transcribed from multiple promoters located upstream of different 5' non-coding exons to produce a heterogeneous population of BDNF mRNAs. S-adenosylmethionine (SAM) produced in the methionine cycle is the primary methyl donor and the precursor of glutathione. In this study, a cerebrovascular hypoperfusion rat model and an Aβ intrahippocampal injection rat model were used to explore the expression profiles of all BDNF transcripts in the hippocampus with chronic cerebrovascular hypoperfusion or Aβ injection as well as with SAM treatment. We found that the BDNF mRNAs and protein were down-regulated in the hippocampus undergoing chronic cerebrovascular hypoperfusion as well as Aβ treatment, and BDNF exons IV and VI played key roles. SAM improved the low BDNF expression following these insults mainly through exons IV and VI. These results suggest that SAM plays a neuroprotective role by increasing the expression of endogenous BDNF and could be a potential target for AD therapy.

  14. Effects of Sildenafil on Cerebrovascular Reactivity in Patients with Becker Muscular Dystrophy

    DEFF Research Database (Denmark)

    Lindberg, Ulrich; Witting, Nanna; Lundgaard, Stine J.

    2017-01-01

    Patients suffering from Becker muscular dystrophy (BMD) have dysfunctional dystrophin proteins and are deficient in neuronal nitric oxide synthase (nNOS) in muscles. This causes functional ischemia and contributes to muscle wasting. Similar functional ischemia may be present in brains of patients...... with BMD, who often have mild cognitive impairment, and nNOS may be important for the regulation of the microvascular circulation in the brain. We hypothesized that treatment with sildenafil, a phosphodiesterase type 5 inhibitor that potentiates nitric oxide responses, would augment both the blood oxygen...... assessed by 3 T magnetic resonance (MR) scanning, evoked potentials, somatosensory task-induced BOLD functional MR imaging, regional and global perfusion, and angiography before and after 4 weeks of sildenafil, 20 mg (Revatio in gelatine capsules, oral, 3 times daily), or placebo treatment. Sildenafil...

  15. Neuroimaging: biochemical principles and its application in the cerebrovascular ischemic disease. Neuroimaginología: bases bioquímicas y su aplicación en la enfermedad cerebrovascular isquémica.

    Directory of Open Access Journals (Sweden)

    Marianela Arteche-Prior

    2009-07-01

    Full Text Available The knowledge of neurobiochemical principles has allowed understanding the ischemic cascade that takes place after the decrease of cerebral blood flow and the findings that are visualized in neuroimaging studies in cerebrovascular ischemic disease. The need for early diagnosis of acute events to reestablish the cerebral blood flow to reduce neurological sequels, has led to the development of advanced imaging techniques, which allows following the histochemical and morphological changes that take place within the brain in vivo, in a non-invasive way, as well as its development, extent of the cerebral damage and damaged cerebral structures. The present bibliographic review has the objective of supporting the importance of neuroimaging studies in the diagnosis of acute cerebral ischemia.El conocimiento de las bases neurobioquímicas ha permitido comprender la cascada isquémica que se desencadena después de la caída del flujo sanguíneo cerebral y los hallazgos que se visualizan en los estudios neuroimaginológicos en la enfermedad cerebrovascular isquémica. La búsqueda de alternativas para diagnosticar cada vez más precozmente los eventos agudos y restablecer el flujo sanguíneo cerebral, para disminuir las secuelas neurológicas, ha dado lugar al desarrollo de técnicas imaginológicas más avanzadas, las cuales permiten seguir los cambios histoquímicos y morfológicos que ocurren dentro del cerebro in vivo de forma no invasiva, así como su evolución, extensión del daño cerebral y estructuras cerebrales dañadas. La presente revisión bibliográfica tiene como objetivo fundamentar la importancia de los estudios neuroimaginológicos en el diagnóstico de la isquemia cerebral aguda.

  16. Physiology of the fetal and transitional circulation.

    Science.gov (United States)

    Finnemore, Anna; Groves, Alan

    2015-08-01

    The fetal circulation is an entirely transient event, not replicated at any point in later life, and functionally distinct from the pediatric and adult circulations. Understanding of the physiology of the fetal circulation is vital for accurate interpretation of hemodynamic assessments in utero, but also for management of circulatory compromise in premature infants, who begin extrauterine life before the fetal circulation has finished its maturation. This review summarizes the key classical components of circulatory physiology, as well as some of the newer concepts of physiology that have been appreciated in recent years. The immature circulation has significantly altered function in all aspects of circulatory physiology. The mechanisms and significance of these differences are also discussed, as is the impact of these alterations on the circulatory transition of infants born prematurely.

  17. Androgenic/estrogenic balance in the male rat cerebral circulation: metabolic enzymes and sex steroid receptors.

    Science.gov (United States)

    Gonzales, Rayna J; Ansar, Saema; Duckles, Sue P; Krause, Diana N

    2007-11-01

    Tissues from males can be regulated by a balance of androgenic and estrogenic effects because of local metabolism of testosterone and expression of relevant steroid hormone receptors. As a critical first step to understanding sex hormone influences in the cerebral circulation of males, we investigated the presence of enzymes that metabolize testosterone to active products and their respective receptors. We found that cerebral blood vessels from male rats express 5alpha-reductase type 2 and aromatase, enzymes responsible for conversion of testosterone into dihydrotestosterone (DHT) and 17beta-estradiol, respectively. Protein levels of these enzymes, however, were not modulated by long-term in vivo hormone treatment. We also showed the presence of receptors for both androgens (AR) and estrogens (ER) from male cerebral vessels. Western blot analysis showed bands corresponding to the full-length AR (110 kDa) and ERalpha (66 kDa). Long-term in vivo treatment of orchiectomized rats with testosterone or DHT, but not estrogen, increased AR levels in cerebral vessels. In contrast, ERalpha protein levels were increased after in vivo treatment with estrogen but not testosterone. Fluorescent immunostaining revealed ERalpha, AR, and 5alpha-reductase type 2 in both the endothelial and smooth muscle layers of cerebral arteries, whereas aromatase staining was solely localized to the endothelium. Thus, cerebral vessels from males are target tissues for both androgens and estrogen. Furthermore, local metabolism of testosterone might balance opposing androgenic and estrogenic influences on cerebrovascular as well as brain function in males.

  18. Platelet proteomics and its advanced application for research of blood stasis syndrome and activated blood circulation herbs of Chinese medicine.

    Science.gov (United States)

    Liu, Yue; Yin, Huijun; Chen, Keji

    2013-11-01

    The development of novel and efficient antiplatelet agents that have few adverse effects and methods that improve antiplatelet resistance has long been the focus of international research on the prevention and treatment of cardiovascular and cerebrovascular diseases. Recent advances in platelet proteomics have provided a technology platform for high-quality research of platelet pathophysiology and the development of new antiplatelet drugs. The study of blood stasis syndrome (BSS) and activated blood circulation of traditional Chinese medicine (TCM) is one of the most active fields where the integration of TCM and western medicine in China has been successful. Activated blood circulation herbs (ABC herbs) of Chinese medicine are often used in the treatment of BSS. Most ABC herbs have antiplatelet and anti-atherosclerosis activity, but knowledge about their targets is lacking. Coronary heart disease (CHD), BSS, and platelet activation are closely related. By screening and identifying activated platelet proteins that are differentially expressed in BSS of CHD, platelet proteomics has helped researchers interpret the antiplatelet mechanism of action of ABC herbs and provided many potential biomarkers for BSS that could be used to evaluate the clinical curative effect of new antiplatelet drugs. In this article the progress of platelet proteomics and its advanced application for research of BSS and ABC herbs of Chinese medicine are reviewed.

  19. 自发性脑动脉夹层致脑梗死临床及影像分析%A analysis for clinical and imaging feature of spontaneous cerebral infarction caused by cerebrovascular dissections

    Institute of Scientific and Technical Information of China (English)

    胡珏; 赵志鸿; 陈海

    2012-01-01

    Objective To explore the clinical and imaging feature of cerebral infarction caused by spontaneous cerebrovascular dissections. Methods The clinical, cerebrovascular ultrasonography and imaging date from seven patients with cerebral infarction caused by spontaneous cerebrovascular dissections confirmed by digital subtraction angiography were analyzed retrospectively. Results There were three male and four female cases aged from 33 to 52 years with average of 42.9 ±6.6. Six patients had pain in homolateral head and neck as first symptom . Two patients had TIA before cerebral infarction. Four patients with anterior-circulation infarction showed hemiparalysis , among which one showed paroxysmal blurred vision of right eye. Three patients with posterior - circulation infarction. Two complained with dizziness, and speech unclealy while one showed Wallenberg syndrome. Computed tomography angiogram were finished in two cases and the severe stenosis accompanied localized extension of the right ICA or the left VA were shown respectively. One case had a cervical vertebrae MRI scanning and the right vertebral artery appeared as a linear filling defect with a double lumen. Internal cervical artery dissections occurred in cervical segment (three case) and petrous segment (one case). The sites of vertebral artery (VA) dissections were V2 segment in two cases and V4 segment in one case. DSA showed severe stenosis (string sign) with localized extension, a flame-shaped occlusion, a dissecting aneurysm, a segmental stenosis proximal to a dissecting aneurysm (string-and-pearl sign) . Anticoagulant therapy was given in 5 patients and antiplatelet treatment was given in 2. NIHSS was from 0 score to 9 scores ( average score 2.9 ± 3.3 ) on the admission and from 0 score to 6 scores (average score 1.1 ±2.3) on discharge. After follow up of 3 ~ 12 months, Modified Rankin Scale scores were 0 in five cases and 1 in one case and 2 in one case. Conclusion Cerebral infarction caused by

  20. Evaluation of cerebrovascular reserve capacity in normal individuals%TCD对正常人大脑中动脉血流储备功能的评价

    Institute of Scientific and Technical Information of China (English)

    李倩; 孔丽; 刘玲; 戴加飞; 程茅薇; 张申宁; 陈光辉; 杨昉

    2012-01-01

    Objective To investigate the capacity of cerebrovascular reserve in normal individuals. Methods Ninety cases of normal individuals were included in this study. After TCD routine examination, the mean blood flow velocity in the middle cerebral artery during the eupnea and the end of breathholding were detected with transcranial Dopple. Results the capacity of cerebrovascular reserve in right side MCA was different from left side,and sexual did not correlated to cerebrovascular reserve,but age correlated to it. Conclusion In normal individuals,the capacity of cerebrovascular reserve was change with age. The evaluation of cerebrovascular reserve capacity with breath holding lest was safe and effective.%目的 探讨经颅超声多普勒(TCD)屏气试验对健康人群脑血流储备能力的评价.方法 试验组90例健康人,TCD检测双侧大脑中动脉的血流频谱,经过屏气试验,观察试验前后血流速度的变化值.结果 18 ~ 39岁脑血流储备能力(CVR)为(41.44+12.56)%,40 ~ 59岁为(36.36±12.15)%,≥60岁为(33.80±10.12)%,组间比较差异均有统计学意义.结论 健康人群CVR随着年龄的增长而下降;超声多普勒屏气试验评价CVR安全可靠.

  1. Quality of life of caregivers for patients of cerebrovascular accidents: association of (socio-demographic characteristics and burden

    Directory of Open Access Journals (Sweden)

    Tatiana Ferreira da Costa

    2015-04-01

    Full Text Available OBJECTIVE Investigating the association between quality of life with socio-demographic characteristics and the burden of caregivers for individuals with cerebrovascular accident sequelae. METHOD A descriptive, cross-sectional study with a sample composed of 136 caregivers. For data collection, a semi-structured questionnaire, the Barthel, Burden Interview and Short-Form-36 scales were used. Correlation analysis, t-Student test and F-test were used for the analysis in order to compare averages. RESULTS Significant averages in quality of life were demonstrated in association with female caregivers and those over 60 years in the field 'functional capacity,' and in the domains of 'mental health' and 'vitality' for those with higher income. Regarding burden association, the highlighted areas were 'functional capacity,' 'physical aspects,' 'emotional aspects' and 'pain.' CONCLUSION The creation of public policies and social support to effectively reduce the burden on caregivers is a necessity.

  2. Prothrombin and risk of venous thromboembolism, ischemic heart disease and ischemic cerebrovascular disease in the general population

    DEFF Research Database (Denmark)

    Weischer, Maren; Juul, Klaus; Zacho, Jeppe

    2010-01-01

    OBJECTIVE: We tested the hypotheses that Prothrombin G20210A heterozygosity associate with increased risk of venous thromboembolism (VTE), ischemic heart disease (IHD), and ischemic cerebrovascular disease (ICVD) in the general population and re-tested risk of IHD and ICVD in two case......-control studies. METHODS: 9231 individuals from the Danish general population were followed for VTE (VTE=DVT+PE), deep venous thrombosis (DVT), pulmonary embolism (PE), IHD, myocardial infarction (MI), ICVD, and ischemic stroke (IS) for a median of 24 years. Case-control studies included 2461 IHD cases and 867.......0(1.0-3.8) for MI, 1.4(0.7-3.1) for ICVD, and 2.1(0.8-5.4) for IS. CONCLUSION: Prothrombin G20210A heterozygosity alone and in combination with Factor V Leiden R506Q heterozygosity predicts 1.5 and 6.0 fold risk of IHD compared to non-carriers....

  3. Increased cerebrovascular pCO2 reactivity in migraine with aura--a transcranial Doppler study during hyperventilation

    DEFF Research Database (Denmark)

    Thomsen, L L; Iversen, Helle Klingenberg; Olesen, J

    1995-01-01

    Cerebrovascular reactivity during hypocapnia was tested in 20 migraineurs (8 with aura, 12 without aura) and 30 sex- and age-matched healthy subjects, and during nitroglycerin-induced headache in 12 healthy subjects. Before and during hyperventilation, mean blood-flow velocity (Vmean) in the middle...... cerebral artery was measured with transcranial Doppler. In each subject a pCO2 reactivity index (RI) was calculated as (delta Vmean/baseline Vmean)/delta pCO2. Interictally, patients with migraine with aura showed higher RI (p ... aura did not differ from healthy subjects. Ictal and interictal RIs were similar in 9 patients suffering from migraine without aura. No side-to-side differences were detected in RI. During nitroglycerin-induced headache, the RIs were no different from those recorded during migraine attacks and in non...

  4. Doenças cerebrovasculares em pacientes entre 15 e 40 anos: achados neuropatológicos em 47 casos

    OpenAIRE

    2001-01-01

    As doenças cerebrovasculares em pacientes entre 15 e 40 anos são pouco estudadas na literatura latino americana, principalmente no que tange aos achados neuropatológicos. Analisamos 47 encéfalos provenientes de necrópsias completas realizadas no período de 1987 a 1997 selecionados com base na faixa etária e alteração neuropatológica básica envolvendo fenômenos vasculares. Destes 47 casos analisados, 26 eram (55,3%) do sexo feminino. Quanto à distribuição etária, 12,8% (n=06) acometeram pacien...

  5. Depression, anxiety and major adverse cardiovascular and cerebrovascular events in patients following coronary artery bypass graft surgery

    DEFF Research Database (Denmark)

    Tully, Phillip J; Winefield, Helen R; Baker, Robert A

    2015-01-01

    BACKGROUND: Although depression and anxiety have been implicated in risk for major adverse cardiovascular and cerebrovascular events (MACCE), a theoretical approach to identifying such putative links is lacking. The objective of this study was to examine the association between theoretical...... conceptualisations of depression and anxiety with MACCE at the diagnostic and symptom dimension level. METHODS: Before coronary artery bypass graft (CABG) surgery, patients (N = 158; 20.9 % female) underwent a structured clinical interview to determine caseness for depression and anxiety disorders. Depression...... and anxiety disorders were arranged into the distress cluster (major depression, dysthymia, generalized anxiety disorder, post-traumatic stress disorder) and fear cluster (panic disorder, agoraphobia, social phobia). Patients also completed the self-report Mood and Anxiety Symptom Questionnaire, measuring...

  6. Cerebrovascular reactivity by quantitative magnetic resonance angiography with a co{sub 2} challenge. Validation as a new imaging biomarker

    Energy Technology Data Exchange (ETDEWEB)

    Caputi, Luigi, E-mail: lcaputi@istituto-besta.it [Department of Cerebrovascular Diseases, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan (Italy); Ghielmetti, Francesco, E-mail: Francesco.Ghielmetti@istituto-besta.it [Department of Neuroradiology, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan (Italy); Faragò, Giuseppe, E-mail: Giuseppe.Farago@istituto-besta.it [Department of Neuroradiology, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan (Italy); Longaretti, Fabio, E-mail: fabio.longaretti@libero.it [Department of Neuroradiology, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan (Italy); Lamperti, Massimo, E-mail: docmassimomd@gmail.com [Department of Neuroanesthesia and Intensive Care, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan (Italy); Anzola, Gian Paolo, E-mail: gpanzola@speedyposta.it [Service of Neurology, S. Orsola Hospital, Fondazione Poliambulanza, Via Vittorio Emanuele II 27, 25122 Brescia (Italy); Carriero, Maria Rita, E-mail: MariaRita.Carriero@istituto-besta.it [Department of Cerebrovascular Diseases, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan (Italy); Charbel, Fady T., E-mail: fcharbel@uic.edu [Department of Neurosurgery, University of Illinois at Chicago College of Medicine, Chicago, IL 60612 (United States); Bruzzone, Maria Grazia, E-mail: Maria.Bruzzone@istituto-besta.it [Department of Neuroradiology, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan (Italy); Parati, Eugenio, E-mail: Eugenio.Parati@istituto-besta.it [Department of Cerebrovascular Diseases, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan (Italy); Ciceri, Elisa, E-mail: Elisa.Ciceri@istituto-besta.it [Department of Neuroradiology, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan (Italy)

    2014-06-15

    Assessment of cerebrovascular reactivity (CVR) is essential in cerebrovascular diseases, as exhausted CVR may enhance the risk of cerebral ischemic events. Transcranial Doppler (TCD) with a vasodilatory stimulus is currently used for CVR evaluation. Scanty data are available for Quantitative Magnetic Resonance Angiography (QMRA), which supplies higher spatial resolution and quantitative cerebral blood flow values. Aims of our pilot study were: (a) to assess safety and feasibility of CO{sub 2} administration during QMRA, (b) evaluation of CVR under QMRA compared to TCD, and (c) quantitative evaluation of blood flow from the major intracranial arterial vessels both at rest and after CO{sub 2}. CVR during 5% CO{sub 2} air breathing was measured with TCD as a reference method and compared with QMRA. Fifteen healthy subjects (age 60.47 ± 2.24; male 11/15) were evaluated at rest and during CO{sub 2} challenge. Feasibility and safety of QMRA under CO{sub 2} were ensured in all subjects. CVR from middle cerebral artery territory was not statistically different between TCD and MRI (p > 0.05). Mean arterial pressure (MAP) and heart rate (HR) increased during QMRA and TCD (MAP p = 0.007 and p = 0.001; HR p = 0.043 and p = 0.068, respectively). Blood flow values from all intracranial vessels increased after CO{sub 2} inhalation (p < 0.001). CO{sub 2} administration during QMRA sessions is safe and feasible. Good correlation in terms of CVR was obtained comparing TCD and QMRA. Blood flow values significantly increased from all intracranial arterial vessels after CO{sub 2}. Studies regarding CVR in physiopathological conditions might consider the utilization of QMRA both in routine clinical settings and in research projects.

  7. Plasminogen activator inhibitor-1 4G/5G gene polymorphism in patients with myocardial or cerebrovascular infarction in Tianjin, China

    Institute of Scientific and Technical Information of China (English)

    战梅; 周玉玲; 韩忠朝

    2003-01-01

    Objective To investigate the association between the plasminogen activator inhibitor-1 (PAI-1) 4G/5G gene polymorphism and the occurrence of myocardial and cerebrovascular infarctions in individuals from Tianjin, China.Methods The PAI-1 genotype was determined using allele-specific polymerase chain reaction (AS-PCR) in 56 myocardial infarction (MI) patients, 54 cerebrovascular infarction(CI) patients and 83 unrelated healthy controls. All subjects ' clinical features and plasma PAI-1 activity levels were determined.Results The PAI-1 genotype distribution frequency of the single guanine deletion/insertion 4G/5G polymorphism (located -675 bp upstream from the start of transcription) significantly differed between the patients and healthy controls. In the MI group, the 4G/4G-genotype frequency was increased, but the 4G/5G-genotype is decreased when compared to the control group. In the CI group, both the 4G/4G- and 4G/5G -genotypes occurred at a lower frequency than those in the control group (P<0.001). The plasma PAI-1 activity level in the MI group was lowered as the presence of the 4G allele decreases. In the CI group, the frequency of 5G/5G was much higher than that of the control group (P<0.001). The plasma PAI-1 activity level in the CI group was elevated as the presence of the 5G allele increased. Furthermore, positive correlation between triglyceride, glucose levels and PAI-1 activity were found in all three groups (P<0.001).Conclusions The PAI-1 4G/5G gene polymorphism is associated with a higher risk of MI and CI in individuals in Tianjin, China. The deletion/insertion polymorphism is probably an important hereditary risk factor for heart diseases. Moreover, triglyceride and glucose levels of plasma have functional importance in regulating PAI-1 activity.

  8. Can the detection of misery perfusion in chronic cerebrovascular disease be based on reductions in baseline CBF and vasoreactivity?

    Energy Technology Data Exchange (ETDEWEB)

    Okazawa, Hidehiko; Kobayashi, Masato; Pagani, Marco; Yonekura, Yoshiharu [University of Fukui, Biomedical Imaging Research Center, Matcuoka-cho, Fukui (Japan); Tsuchida, Tatsuro [Faculty of Medical Sciences, University of Fukui, Department of Radiology, Fukui (Japan); Arai, Yoshikazu; Isozaki, Makoto [University of Fukui, Department of Neurosurgery, Faculty of Medical Sciences, Fukui (Japan)

    2007-01-15

    The aim of this study was to clarify whether decreases in baseline regional cerebral blood flow (rCBF) and in residual cerebral vasoreactivity (CVR), assessed by the acetazolamide (ACZ) challenge, can detect misery perfusion in patients with chronic cerebrovascular disease (CVD). Oxygen extraction fraction (OEF) and other haemodynamic parameters were measured in 115 patients (64{+-}9 years old) with unilateral cerebrovascular steno-occlusive disease (>70% stenosis) using {sup 15}O-gas and water PET. A significant elevation of OEF, by greater than the mean+2SD compared with healthy controls, was defined as misery perfusion. CBF, CVR determined by percent change in CBF after ACZ administration, OEF and other haemodynamic parameters in the territories of the bilateral middle cerebral arteries were analysed. Diagnostic accuracy for the detection of misery perfusion using the criteria determined by baseline CBF and CVR was evaluated in all patients and in only those patients with occlusive lesions. Ten of 24 patients with misery perfusion showed a significant reduction in CVR. Using criteria determined by significant decreases in CVR and baseline CBF, misery perfusion was detected with a sensitivity of 42% and a specificity of 95% in all patients. In patients with occlusive lesions (n=50), sensitivity was higher but specificity was slightly lower. The diagnostic accuracy of the threshold determined by baseline CBF alone was similar in all patients and in only those patients with occlusive lesions, and was higher than that achieved using the asymmetry index of OEF. Reductions in CVR and baseline CBF in the ACZ challenge for CVD would detect misery perfusion with high specificity. Reduction in baseline rCBF is more accurate than reduction in CVR alone for the detection of misery perfusion. (orig.)

  9. Doenças cerebrovasculares em pacientes entre 15 e 40 anos: achados neuropatológicos em 47 casos

    Directory of Open Access Journals (Sweden)

    Maggio Everton M.

    2001-01-01

    Full Text Available As doenças cerebrovasculares em pacientes entre 15 e 40 anos são pouco estudadas na literatura latino americana, principalmente no que tange aos achados neuropatológicos. Analisamos 47 encéfalos provenientes de necrópsias completas realizadas no período de 1987 a 1997 selecionados com base na faixa etária e alteração neuropatológica básica envolvendo fenômenos vasculares. Destes 47 casos analisados, 26 eram (55,3% do sexo feminino. Quanto à distribuição etária, 12,8% (n=06 acometeram pacientes entre 15 e 20 anos, 51,1% (n=24 entre 21 e 30 anos, 36,2% (n=17 entre 31 e 40 anos. As doenças básicas que culminaram no óbito foram agrupadas, sendo mais frequentes as doenças cardíacas e hematológicas (19,2%, alterações decorrentes de complicações de gestação (12,8%, doenças infecciosas, doenças dos vasos sanguíneos e doenças neurológicas (10,7% entre outras. As alterações neuropatológicas incluíram hérnia cerebral e/ou cerebelar (16%, edema cerebral (13,8%, hemorragia subaracnóidea (10%, infarto cerebral recente (9%, hemorragia intraparequimatosa (8%, encefalopatia hipóxico-isquêmica (3% e eventos menos comuns como a síndrome de Sneddon e vasculite lúpica. Tais achados expressam que os fenômenos cerebrovasculares têm, nesta faixa etária, perfil próprio com estreita relação com a doença de base.

  10. Clinical and Paraclinical Findings of Cerebrovascular Accidents in Children Admitted to Pediatric Medical Center from 1993 till 2003

    Directory of Open Access Journals (Sweden)

    M Dehghani

    2011-10-01

    Full Text Available Introduction: Stroke is a clinical diagnosis which brings up cerebrovascular diseases. Stroke includes any cerebrovascular accident which leads to local neural defect and lasts more than 24 hours. Stroke has severe and irreversible complications and high rates of recurrence after first episode, therefore we decided to study clinical and paraclinical findings of this disease for better diagnosis and prevention of it. Methods: We prepared a case series study to review medical files of the patients admitted to pediatric medical center with the diagnosis of CVA between 1993 and 2003. 19 patients were assessed in this study. Results: Their mean age was 5.72 (SD=3.801. Among clinical signs hemiparesis was the most common finding (89.5%. Vital signs were normal except for two patients with low-grade fever or hypertension. Such cardiac diseases as cardiomyopathy, valvular disorder, d-TGA, and congestive heart failure were common predisposing factors. According to CT scan reports, 6 patients (31.6% suffered from deep ischemic stroke, and 5 (21.3%, and 2 patients (10.5% suffered from superficial ischemic stroke and and hemorrhagic stroke, respectively. 2 patients manifested signs of both superficial and deep ischemic stroke. One of them suffered from Moyamoys syndrome and the other was a known case of MELAS (mitochondrial encepholomyopaty lactic acidosis syndrome. CBC was the most important abnormal test. Conclusion: According to this study, congenital heart diseases are the most common cause of stroke in children. Stroke in children is not frequently associated with vital signs change, and deep ischemic stroke is the most common type of the stroke in children.

  11. Stroke atlas: a 3D interactive tool correlating cerebrovascular pathology with underlying neuroanatomy and resulting neurological deficits.

    Science.gov (United States)

    Nowinski, W L; Chua, B C

    2013-02-01

    Understanding stroke-related pathology with underlying neuroanatomy and resulting neurological deficits is critical in education and clinical practice. Moreover, communicating a stroke situation to a patient/family is difficult because of complicated neuroanatomy and pathology. For this purpose, we created a stroke atlas. The atlas correlates localized cerebrovascular pathology with both the resulting disorder and surrounding neuroanatomy. It also provides 3D display both of labeled pathology and freely composed neuroanatomy. Disorders are described in terms of resulting signs, symptoms and syndromes, and they have been compiled for ischemic stroke, hemorrhagic stroke, and cerebral aneurysms. Neuroanatomy, subdivided into 2,000 components including 1,300 vessels, contains cerebrum, cerebellum, brainstem, spinal cord, white matter, deep grey nuclei, arteries, veins, dural sinuses, cranial nerves and tracts. A computer application was developed comprising: 1) anatomy browser with the normal brain atlas (created earlier); 2) simulator of infarcts/hematomas/aneurysms/stenoses; 3) tools to label pathology; 4) cerebrovascular pathology database with lesions and disorders, and resulting signs, symptoms and/or syndromes. The pathology database is populated with 70 lesions compiled from textbooks. The initial view of each pathological site is preset in terms of lesion location, size, surrounding surface and sectional neuroanatomy, and lesion and neuroanatomy labeling. The atlas is useful for medical students, residents, nurses, general practitioners, and stroke clinicians, neuroradiologists and neurologists. It may serve as an aid in patient-doctor communication helping a stroke clinician explain the situation to a patient/family. It also enables a layman to become familiarized with normal brain anatomy and understand what happens in stroke.

  12. Interannual variability of the Adriatic Sea circulation

    Science.gov (United States)

    Beg Paklar, Gordana; Sepic, Jadranka; Grbec, Branka; Dzoic, Tomislav; Kovac, Zarko; Ivatek-Sahdan, Stjepan

    2016-04-01

    The Regional Ocean Modeling System (ROMS) was implemented in order to reproduce interannual variability of the Adriatic Sea circulation. Simulations and model result analysis were performed for a three-year period from 1st January 2011 to 31st December 2013. ROMS model run was forced with realistic atmospheric fields obtained from meteorological model Aladin, climatological river discharges, tides and Mediterranean circulation imposed at the southern open boundary. Atmospheric forcing included momentum, heat and water fluxes calculated interactively from the Aladin surface fields during ROMS model simulations. Model results were compared with available CTD and ADCP measurements and discussed in the light of the climatological circulation and thermohaline properties of the Adriatic Sea and its coastal areas. Interannual variability in the Adriatic circulation is related to the prevailing atmospheric conditions, changes in the hydrological conditions and water mass exchange at the Otranto Strait. Basic features of the Adriatic circulation - basin-wide cyclonic circulation with several embedded smaller cyclonic gyres around main pits - are well reproduced by ROMS model. Modelled temperatures and salinities are within corresponding seasonal intervals, although measured profiles generally indicate stronger stratification than modelled ones. Summer circulation in 2011 with current reversal obtained along the eastern Adriatic coast was related to the sampling results of the early fish stages as well as to ARGO drifter movements. Simulated fields from the Adriatic scale model were used to prescribe the initial and open boundary conditions for the interannual simulation in the middle Adriatic coastal domain.

  13. SpaceX Dragon Air Circulation System

    Science.gov (United States)

    Hernandez, Brenda; Piatrovich, Siarhei; Prina, Mauro

    2011-01-01

    The Dragon capsule is a reusable vehicle being developed by Space Exploration Technologies (SpaceX) that will provide commercial cargo transportation to the International Space Station (ISS). Dragon is designed to be a habitable module while it is berthed to ISS. As such, the Dragon Environmental Control System (ECS) consists of pressure control and pressure equalization, air sampling, fire detection, illumination, and an air circulation system. The air circulation system prevents pockets of stagnant air in Dragon that can be hazardous to the ISS crew. In addition, through the inter-module duct, the air circulation system provides fresh air from ISS into Dragon. To utilize the maximum volume of Dragon for cargo packaging, the Dragon ECS air circulation system is designed around cargo rack optimization. At the same time, the air circulation system is designed to meet the National Aeronautics Space Administration (NASA) inter-module and intra-module ventilation requirements and acoustic requirements. A flight like configuration of the Dragon capsule including the air circulation system was recently assembled for testing to assess the design for inter-module and intra-module ventilation and acoustics. The testing included the Dragon capsule, and flight configuration in the pressure section with cargo racks, lockers, all of the air circulation components, and acoustic treatment. The air circulation test was also used to verify the Computational Fluid Dynamics (CFD) model of the Dragon capsule. The CFD model included the same Dragon internal geometry that was assembled for the test. This paper will describe the Dragon air circulation system design which has been verified by testing the system and with CFD analysis.

  14. Circulating miRNA and cancer diagnosis

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    miRNAs are a class of small RNA molecules with regulatory function, and play an important role in tumor development and progression. It has been demonstrated that tumor-derived miRNAs exist in the circulating nucleic acids of cancer patients. This phenomenon implies that detection of the circulating miRNA may be an effective method for non-invasive diagnosis of cancer. In this review, we summarize the applications of the circulating miRNA as biomarkers in cancer diagnosis, as well as the latest research progress in this area.

  15. Studies of Japanese cases with cerebral basal rete mirabile (Moyamoya disease). Investigation of cerebrovascular hemodynamics

    Energy Technology Data Exchange (ETDEWEB)

    Ueta, Kiyotaka

    1988-04-01

    Eight children under 15 years of age and 8 adults with basal cerebral rate (so called Moyamoya disease) were examined. Regional cerebral blood flow (rCBF) was measured in 12 of these patients under normocapneic, hypercapneic, hypocapneic and hypotensive states by a /sup 133/Xe-intracarotid injection method using a gamma camera. Patients with neurological deficits due to completed stroke (CS) had angiographically poor normograde vascularization of cortical branches of the middle cerebral artery (MCA) and poorly developed collateral circulation. Hemispheric cerebral blood flow (HCBF) in the resting state tended to decrease according to the severity of neurological deficits, but was within the normal range in patients with no neurological deficits. However, focal reduction of rCBF was seen in half of the patients with transient ischemic attacks. Development of leptomeningeal anastomosis of MCA territories from the posterior cerebral artery seemed to have a more important role than basal rete in maintaining cerebral blood flow. There was a significant reduction of the HCBF under the hypocaneic state, but no significant increase under the hypercapneic state. The lack of a CBF response to increased arterial CO/sub 2/ tension seemed to be due to maximum dilatation of cerebral arterioles. (author) 61 refs.

  16. Measurement of cerebral circulation times by means of the analysis of the time-density curve using digital subtraction angiography

    Energy Technology Data Exchange (ETDEWEB)

    Tazawa, Toshiaki; Karasawa, Jun; Touho, Hajime; Kobayashi, Keisuke; Nakagawara, Jyoji; Nakauchi, Mikio; Kuriyama, Yoshihiro

    1987-04-01

    Five patients who had suffered a transient ischemic attack (TIA) with a normal angiogram were selected as a control group for the study of the internal-carotid-artery system, while 2 patients were selected as the controls in the study of the vertebral-artery system in order to evaluate the effect of cerebrovascular lesions. The cerebral circulation time of the internal carotid artery system was defined as the difference in the arrival times of the intraarterial contrast bolus between Fischer's C1 portion and the middle of the transverse sinus, while that of the vertebral artery system was defined as the difference in arraival times between Krayenbuhl's third or fourth segment and the middle of the transverse sinus. In the internal-carotid-artery system, the circulation time (as the time difference between the two points for the control) was 4.76 +- 0.28 (mean +- SD) sec. in TTP and 4.66 +- 0.11 sec. in MTT. In the vertebral-artery system, it was 3.97 sec. on the average in TTP and 4.16 sec. in MTT. Eleven patients with middle cerebral artery stenosis or occlusion and one patient with ''MoyaMoya'' disease were selected for a study of the ischemic lesions, while one patient with an arteriovenous malformation (AVM) was selected for a study of the effect of an arteriovenous shunt. In the symptomatic patients with middle-cerebral-artery occlusion or stenosis, the circulation time was slower than that of the control group both in TTP and in MTT. There was a significant correlation between the values of the circulation time in TTP and that in MTT. The circulation time of the patient with ''MoyaMoya'' disease was significantly slower than that of the control. In the patient with an AVM, the circulation time was much faster than in the control in TTP, while it was normal in MTT. (J.P.N.).

  17. EOP MIT General Circulation Model (MITgcm)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data contains a regional implementation of the Massachusetts Institute of Technology general circulation model (MITgcm) at a 1-km spatial resolution for the...

  18. Head positioning for anterior circulation aneurysms microsurgery

    Directory of Open Access Journals (Sweden)

    Feres Chaddad-Neto

    2014-11-01

    Full Text Available Objective To study the ideal patient's head positioning for the anterior circulation aneurysms microsurgery. Method We divided the study in two parts. Firstly, 10 fresh cadaveric heads were positioned and dissected in order to ideally expose the anterior circulation aneurysm sites. Afterwards, 110 patients were submitted to anterior circulation aneurysms microsurgery. During the surgery, the patient's head was positioned accordingly to the aneurysm location and the results from the cadaveric study. The effectiveness of the position was noted. Results We could determine mainly two patterns for head positioning for the anterior circulation aneurysms. Conclusion The best surgical exposure is related to specific head positions. The proper angle of microscopic view may minimize neurovascular injury and brain retraction.

  19. Calidad de vida de cuidadores de adultos con accidente cerebrovascular Qualidade de vida de cuidadores de adultos com acidente cerebrovascular Quality of Life of Caretakers of Adults who Have Suffered a Stroke

    Directory of Open Access Journals (Sweden)

    INNA ELIDA FLÓREZ TORRES

    2010-10-01

    Full Text Available Objetivo: describir la calidad de vida de los cuidadores familiares de adultos con secuelas de accidente cerebrovascular, en Cartagena, Colombia. Método: estudio descriptivo cuantitativo realizado durante el segundo semestre de 2008. Muestra no probabilística por conveniencia de 97 cuidadores. Se empleó el instrumento propuesto por Ferrell et ál. Para valorar cada uno de los bienestares que integran la calidad de vida se utilizaron medidas de tendencia central y coeficiente de variación. Resultados: el grupo de cuidadores presentó en el bienestar físico un promedio de 11,1 con relación al máximo puntaje, lo que indica el peor estado de salud; los bienestares psicológico y social tuvieron promedios de 48,8 y 21,9, respectivamente, con menor afectación. El mejor estado se halló en el bienestar espiritual, con promedio de 22,6. Conclusiones: la experiencia de ser cuidador modifica de manera importante la calidad de vida de las personas; los cuidadores, como fuente importante de cuidado informal, requieren apoyo de los sistemas de salud y, como parte de este, de los profesionales de enfermería.Objetivo: descrever a qualidade de vida dos cuidadores familiares com seqüelas de acidente cerebrovascular, em Cartagena, Colômbia. Método: estudo descritivo quantitativo realizado durante o segundo semestre de 2008. Amostra não probabilística por conveniência de 97 cuidadores. Empregou-se o instrumento proposto por Ferrel et ál. Para valorar cada uma das condições de bem-estar que integram a qualidade de vida utilizaram-se medidas de tendência central e coeficiente de variação. Resultados: o grupo de cuidadores apresentou em bem-estar físico uma média de 11,1 em relação com a pontuação máxima, o que indica o pior estado de saúde; as condições de bem-estar psicológico e social tiveram médias de 48,8 e 21,9, respectivamente, com menor afetação. O melhor estado encontrou-se no bem-estar espiritual, com média de 22

  20. Deep Circulation in the South China Sea

    Science.gov (United States)

    Zhao, Xiaolong; Zhao, Wei; Xu, Xiaobiao; Tian, Jiwei; Zhou, Chun

    2016-04-01

    The South China Sea (SCS) is the largest marginal sea of the northwest Pacific. The deep circulation in the SCS is investigated on the basis of the Hybrid Coordinate Ocean Model (HYCOM). All the experiments show reasonable agreement with observation from mooring arrays. Analysis of these results provides a detailed spatial structure and temporal variability of the deep circulation in the SCS. The major features of the SCS deep circulation are basin-scale cyclonic gyre and concentrated deep western boundary current (DWBC). The transport of the DWBC is ~2 Sv at 16.5°N with a width of ~53 km. As flowing southwestward, the DWBC becomes weaker with a wider range. Deep upwelling in the SCS is estimated of 0.19 to 1.15 m d-1 with the strongest area around the DWBC. The model results reveal the existence of 80 to 120 days oscillation in the deep northeastern circulation and the DWBC, which are also the areas with large eddy kinetic energy. This seasonal oscillation is northwestward with a velocity amplitude of ~1.0~1.5 cm s-1. The distribution of mixing parameters in the deep SCS plays a role in both spatial structure and volume transport of the deep circulation. Compared with the north shelf of the SCS with the Luzon Strait, deep circulation in the SCS is more sensitive to the large vertical mixing parameters of the Zhongsha Island Chain area.

  1. Surgical myocardial revascularization without extracorporeal circulation

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    Salomón Soriano Ordinola Rojas

    2003-05-01

    Full Text Available OBJECTIVE: To assess the immediate postoperative period of patients undergoing myocardial revascularization without extracorporeal circulation with different types of grafts. METHODS: One hundred and twelve patients, 89 (79.5% of whom were males, were revascularized without extracorporeal circulation. Their ages ranged from 39 to 85 years. The criteria for indicating myocardial revascularization without extracorporeal circulation were as follows: revascularized coronary artery caliber > 1.5 mm, lack of intramyocardial trajectory on coronary angiography, noncalcified coronary arteries, and tolerance of the heart to the different rotation maneuvers. RESULTS: Myocardial revascularization without extracorporeal circulation was performed in 112 patients. Three were converted to extracorporeal circulation, which required a longer hospital stay but did not impact mortality. During the procedure, the following events were observed: atrial fibrillation in 10 patients, ventricular fibrillation in 4, total transient atrioventricular block in 2, ventricular extrasystoles in 58, use of a device to retrieve red blood cells in 53, blood transfusion in 8, and arterial hypotension in 89 patients. Coronary angiography was performed in 20 patients on the seventh postoperative day when the grafts were patent. CONCLUSION: Myocardial revascularization without extracorporeal circulation is a reproducible technique that is an alternative for treating ischemic heart disease.

  2. Avaliação da linguagem em crianças com doença cerebrovascular bilateral: estudo de dois casos Language evaluation in children with bilateral cerebrovascular disease: study of two cases

    Directory of Open Access Journals (Sweden)

    Karina Tamarozzi de Oliveira

    2004-09-01

    Full Text Available São descritas duas crianças, uma com idade cronológica de 5 anos e 6 meses e outra com 5 anos e 10 meses. Ambas apresentaram doença cerebrovascular (DCV bilateral, confirmada na fase aguda através de exame neurológico clínico e de imagem. Os dois pacientes foram atendidos nesta fase por médico neurologista infantil da Disciplina de Neurologia Infantil da FCM/UNICAMP, ambulatório de DCV na infância. Nas avaliações utilizou-se Triagem Audiológica, Protocolo de Avaliação da Linguagem Infantil, Teste de Vocabulário por Imagens Peabody, com o objetivo de avaliar os diversos subsistemas lingüísticos e as noções perceptiva-cognitivas. Na análise qualitativa dos dois sujeitos, do ponto de vista fonoaudiológico e neurológico, houve recuperação completa do distúrbio adquirido de linguagem para o primeiro e alterações sutis no posterior processo de aprendizagem do segundo. O estudo dos casos revelou que os aspectos predominantes devem ser analisados de forma individual, quantitativa e qualitativamente para achados conclusivos.We describe two children, aging 5 years and 6 months and 5 years and 10 months respectively, when the phonoaudiological assessment was conducted. Both children presented bilateral cerebrovascular disease (CVD, confirmed in the acute phase by means of clinical and image neurological test. During this phase, the two patients were examined by a pediatric neurologist of the Pediatric Neurology Discipline of FCM/UNICAMP, pediatric CVD ambulatory. Audiologic Assessment, Protocol for Infant Language Assessment, and Peabody Picture Vocabulary Test were used in the evaluations. The qualitative analysis of the two subjects from a phonoaudiological and neurological point of view has shown the recovery of adquired languague disturbance with no influence whatsoever in the development of the first subject and subtle language and/or learning process alterations for the second subject. The cases study has revealed that the

  3. Circulation model for water circulation and purification in a water Cerenkov detector

    Institute of Scientific and Technical Information of China (English)

    LU Hao-Qi; YANG Chang-Gen; WANG Ling-Yu; XU Ji-Lei; WANG aui-Guang; WANG Zhi-Min; WANG Yi-Fang

    2009-01-01

    Owing to its low cost and good transparency, highly purified water is widely used as a medium in large water Cerenkov detector experiments. The water circulation and purification system is usually needed to keep the water in good quality. In this work, a practical circulation model is built to describe the variation of the water resistivity in the circulation process and compared with the data obtained from a prototype experiment. The successful test of the model makes it useful in the future design and optimization of the circulation/purification system.

  4. 维生素D与心脑血管疾病的研究进展%Vitamin D with Cerebrovascular and Cardiovascular Disease

    Institute of Scientific and Technical Information of China (English)

    王滟; 郭立新

    2016-01-01

    近年来,维生素D与脑血管病间的相关性也越来越得到临床重视。但是,维生素D缺乏与心脑血管疾病的研究多限于临床观察,很多机理尚不清楚。本文针对维生素D与心脑血管疾病的研究进展进行探讨。%In recent years, the correlation between vitamin D and cerebrovascular disease is becoming more and more received clinical attention. However, vitamin D deficiency and heart cerebrovascular disease research was limited to clinical observation, and the mechanism is unclear. The author discusses Vitamin D and the progress of cardiovascular diseases.

  5. Neurogenic pulmonary edema following cerebrovascular diseases%脑血管病并发的神经源性肺水肿

    Institute of Scientific and Technical Information of China (English)

    李瑾; 沙杜鹃; 张均

    2010-01-01

    神经源性肺水肿(neurogenic pulmonary edema,NPE)是中枢神经系统重度损伤后的致死性并发症,各种脑血管病是NPE的常见原因.NPE病死率高,其发生机制涉及多种因素,但确切机制尚不完全清楚.文章就近年来脑血管病并发NPE的机制和治疗进展做了综述.%Neurogenic pulmonary edema (NPE) is a fatal complication after severe injury of central nervous system. Various cerebrovascular diseases are the common causes of NPE. The mortality of NPE is high. Its pathogenesis involves a variety of factors; however, its exact mechanism remains obscure. This article reviews the advances in pathogenesis and treatment of cerebrovascular diseases complicated with NPE in recent years.

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

    Directory of Open Access Journals (Sweden)

    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%.

  7. Estudio descriptivo de la enfermedad cerebrovascular en el Hospital Regional Docente de Ica-Perú 2003 – 2006

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    J. Jhonnel Alarco

    2010-09-01

    Full Text Available Objetivo: Determinar algunas características epidemiológicas de la enfermedad cerebro vascular (ECV, describir las características de la población estudiada según sexo, edad, procedencia, raza, forma de inicio, ubicación, tipos y subtipos, síntomas, antecedentes patológicos y mortalidad intrahospitalaria. Materiales y métodos: estudio descriptivo. Lugar: Hospital Regional Docente de Ica. Criterios de inclusión: pacientes ingresados con diagnóstico de accidente cerebrovascular. Intervenciones: revisión de historias clínicas de archivo entre los años 2003 y 2006. Principales medidas de resultados: análisis estadístico: porcentajes y medidas de tendencia central, tabuladas en una base de datos con ayuda del programa Microsoft Excel 2003 para Windows®. Resultados: de 152 pacientes ingresados al servicio de Medicina 119 fueron casos de ECV isquémico, 33 casos fueron ECV hemorrágico. El principal antecedente patológico fue la hipertensión arterial con un 75.0 %. El síntoma más frecuente fue el trastorno motor con 80.3% seguido por alteraciones del lenguaje con 55.9%. El mayor número fue encontrado entre la séptima y octava décadas de la vida. La edad mínima fue de 17 y máxima de 102 años. La mortalidad global fue de 18 casos obteniéndose una tasa de letalidad específica para el ECV isquémico de 0,8% y de 51,5% para el ECV hemorrágico. Conclusiones: Se distingue a la HTA como el principal antecedente modificable, cuya prevención reduciría notablemente su mortalidad. Palabras clave:  accidente cerebrovascular, epidemiología, hospitales, Perú.

  8. Reductions in cardiovascular, cerebrovascular, and respiratory mortality following the national irish smoking ban: interrupted time-series analysis.

    Directory of Open Access Journals (Sweden)

    Sericea Stallings-Smith

    Full Text Available BACKGROUND: Previous studies have shown decreases in cardiovascular mortality following the implementation of comprehensive smoking bans. It is not known whether cerebrovascular or respiratory mortality decreases post-ban. On March 29, 2004, the Republic of Ireland became the first country in the world to implement a national workplace smoking ban. The aim of this study was to assess the effect of this policy on all-cause and cause-specific, non-trauma mortality. METHODS: A time-series epidemiologic assessment was conducted, utilizing Poisson regression to examine weekly age and gender-standardized rates for 215,878 non-trauma deaths in the Irish population, ages ≥35 years. The study period was from January 1, 2000, to December 31, 2007, with a post-ban follow-up of 3.75 years. All models were adjusted for time trend, season, influenza, and smoking prevalence. RESULTS: Following ban implementation, an immediate 13% decrease in all-cause mortality (RR: 0.87; 95% CI: 0.76-0.99, a 26% reduction in ischemic heart disease (IHD (RR: 0.74; 95% CI: 0.63-0.88, a 32% reduction in stroke (RR: 0.68; 95% CI: 0.54-0.85, and a 38% reduction in chronic obstructive pulmonary disease (COPD (RR: 0.62; 95% CI: 0.46-0.83 mortality was observed. Post-ban reductions in IHD, stroke, and COPD mortalities were seen in ages ≥65 years, but not in ages 35-64 years. COPD mortality reductions were found only in females (RR: 0.47; 95% CI: 0.32-0.70. Post-ban annual trend reductions were not detected for any smoking-related causes of death. Unadjusted estimates indicate that 3,726 (95% CI: 2,305-4,629 smoking-related deaths were likely prevented post-ban. Mortality decreases were primarily due to reductions in passive smoking. CONCLUSIONS: The national Irish smoking ban was associated with immediate reductions in early mortality. Importantly, post-ban risk differences did not change with a longer follow-up period. This study corroborates previous evidence for cardiovascular

  9. Elevated t/e2 ratio is associated with an increased risk of cerebrovascular disease in elderly men.

    Directory of Open Access Journals (Sweden)

    Yanping Gong

    Full Text Available OBJECTIVE: To investigate the relationship between sex hormones and the risk of vascular disease in elderly men and to evaluate the advantages and disadvantages of testosterone replacement. METHODS: A total of 337 men, aged 60 to 91 years, were enrolled in this single-center, cross-sectional study, and their sex hormone levels were assessed. Linear and logistic regression analyses were utilized to compare the sex hormone levels between patients with and without vascular disease. The nonparametric K-sample test was used for inter-group comparisons. RESULTS: Aging and abnormal metabolism were both significantly associated with an increased risk of vascular diseases and changes in sex hormone levels. Primary linear and logistic regression analyses showed no significant differences in sex hormone concentrations between patients with and without vascular diseases after adjusting for age. Logistic regression with abnormal metabolism as categorical variable showed that free testosterone (FT and free estradiol (FE2 had significant relationships with CEVD risk (P<0.05. In further regression with all metabolic continuous variables included, the testosterone/estradiol (T/E2 ratio replaced FT and FE2 (P<0.05. Trend line analyses showed that T/E2 actually had a binomial linear correlation with the risk of cerebrovascular disease; its best protective effect occurred at values of 0.13-0.15, with an OR value extremely close to those of FT and FE2 (0.23 vs. 0.24-0.25. CONCLUSION: T/E2 balance plays a key role in the relationship between sex hormones and the risk of cerebrovascular disease. The balance between T and E2 may be more important than their absolute quantities. Extremely low T/E2 and inappropriately high T/E2 ratio can both harm the brain blood vessels. Careful consideration should be given before beginning testosterone replacement treatment, and supplementing with estrogen seems to be a good way to protect blood vessels of the brain in elderly men.

  10. Subclinical cerebrovascular cognitive function, and mood changes in patients with systemic  lupus erythematosus

    Directory of Open Access Journals (Sweden)

    Ghaydaa A Shehata

    2010-07-01

    in the control group. There was significant negative correlation between SLEDAI and transcranial Doppler findings in the pulsatility index of medial circumflex artery and procoagulant activity.Conclusion: Neurological disorders, cognitive impairment, depression, anxiety, psychosis and cerebrovascular changes detected by transcranial Doppler ultrasound are common in SLE.Keywords: SLE, SLEDAI, cognitive function, depression, anxiety, neurological disorders, TCD, cerebrovascular changes

  11. Accidente cerebro-vascular en la enfermedad de Fabry: Algo más que una simple estenosis Stroke in Fabry disease: More than a simple stenosis

    Directory of Open Access Journals (Sweden)

    Juan Manuel Politei

    2006-10-01

    Full Text Available Se analiza la evidencia existente a la fecha sobre los mecanismos fisiopatológicos que pueden generar accidentes cerebrovasculares en la enfermedad de Fabry. Esta entidad es el resultado de la deficiencia de a-galactosidasa A, lo que resulta en depósito patológico de glicoesfingilípidos en distintas poblaciones celulares. Asociados a la insuficiencia renal y cardíaca, los accidentes cerebrovasculares pueden derivar en la muerte de los pacientes. Durante mucho tiempo el único mecanismo generador de daño vascular informado fue la oclusión vascular por depósito lipídico a nivel endotelial. En la actualidad se describen otros mecanismos. El advenimiento de la terapia de reemplazo enzimático ha generado gran expectativa en cuanto la posibilidad de reversión de estos mecanismos. Si bien la evidencia es escasa y son necesarios más estudios a largo plazo, algunos informes demuestran que luego de meses, el tratamiento ha logrado revertir algunos de los mecanismos implicados.The objective is to analyze the updated evidence on the physiopathological mechanisms that can generate cerebrovascular damage in Fabry disease. Fabry disease is the result of the deficiency of a-galactosidasa A, which causes pathological storage of glycosphingolipids, in different cells. Associated to renal and cardiac insufficiency, cerebrovascular complications can derive in the death of the patients. During a long time the only reported mechanism was the vascular occlusion by deposit of lipids at endothelial level. At the present time, other mechanisms are postulated. The arrival of enzyme replacement therapy has generated great expectation on the possibility of reversion of these alterations. Although the evidence is scarce and more long term studies are necessary, some reports demonstrate that after months, the treatment has managed to revert some of the mechanisms involved.

  12. MRI-based cerebrovascular reactivity using transfer function analysis reveals temporal group differences between patients with sickle cell disease and healthy controls

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    Jackie Leung, MASc

    2016-01-01

    Conclusions: We demonstrated that conventional CVR analysis underestimates vessel reactivity and this effect is more prominent in patients with SCD. By using TFA, the resulting Gain and Phase measures more accurately characterize the BOLD response as it accounts for the temporal dynamics responsible for the CVR underestimation. We suggest that the additional information offered through TFA can provide insight into the mechanisms underlying CVR compromise in cerebrovascular diseases.

  13. 肾移植术后并发脑血管意外%Acute cerebrovascular accident after renal transplantation: a report of 8 cases

    Institute of Scientific and Technical Information of China (English)

    李香铁; 许化溪; 李慎勤; 王卉放; 刘少鸽; 王胜军; 杨德安; 潘志超; 王洪伟; 刘恭植; 赫俊文; 韩玮; 张爱民; 刘仰东

    1997-01-01

    对肾移植术后发生脑血管意外8例患者的临床资料进行总结,认为动脉粥样硬化、手术前后高血压、代谢紊乱、血清脂质升高、排斥反应、大剂量激素的应用等是导致脑血管意外的危险因素.另外,糖尿病、血液凝固障碍及继发性红细胞增多症也可造成脑血管意外.因此,术后不论时间长短,均有发生脑血管意外的危险,应针对发生原因进行预防.%Of 275 patients undergoing renal transplantation from Aug. 1978 to March 1994, 8 cases were diagnosed having acute cerebrovascular accidents. Successful renal transplantation might be delayed it but could not reverse it. It was believed that atherosclerosis, hypertension be-fore and after operation, metabolic disorder, continuous serum dialysis accelerated, rejection, the usage of a great doses of hormone and so on were the susceptible factors for cerebrovascular acci-dent. In addition, mellitus, blood coagulation disorder and secondary erythromatosis could cause cerebrovascular accident. Whether the time was long or short after the operation, the danger for cerebrovascular accident, so the prevention on the causes should be performed.

  14. 46 CFR 56.50-45 - Circulating pumps.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Circulating pumps. 56.50-45 Section 56.50-45 Shipping... APPURTENANCES Design Requirements Pertaining to Specific Systems § 56.50-45 Circulating pumps. (a) A main circulating pump and emergency means for circulating water through the main condenser shall be provided....

  15. Implementation assessment of the national program for the prevention and control of cerebro-vascular diseases in Cienfuegos. Period 2000-2004.

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    Rubén Bembibre Taboada

    2005-04-01

    Full Text Available Fundament: The cerebrovascular deseases are the third cause of death and the leading cause of disability in Cuba. Due to the seriousness of this situation it was created the National Program for the Prevention and Control of Cerebrovascular Deseases. Objective: to evaluate the main achievements in the execution of this program, specifically in the province of Cienfuegos. Methods: the prospective and descriptive study of a series of cases that engulfed all the patients with cerebrovascular deseases in the period of January the 1st,2000, to December 31st,2004 (n=3477. Data were obtained from the monthly and annually reports of the provincial comission; for the analysis of the deceased we counted on the reports of the Provincial Government of Health and of the State Commettee of Statistics. Results: we found a morbility rate of 192,26 per 100 000 inhabitants. The mortality rates decreased in 11,26 (from 82,51 to 71,25 per 100 000 inhabitants. The global lethality decreased in 13,74 (from 26,61 to 12,87 per 100 000 inhabitants: in infarcts, from 24,27 to 6,64; and in subarachnoid hemorrhage, from 39,21 to 24. An increment of favorable evolution in patients with brain attack and subarachnoid hemorrhage was notified, it did not happened with intracerebral hemorrhage. The evident outstanding results in the diminishing of progressive mortality and lethality during this five years support the correct decision of creating such a Program.

  16. Clinical Evaluation of Effects of Chronic Resveratrol Supplementation on Cerebrovascular Function, Cognition, Mood, Physical Function and General Well-Being in Postmenopausal Women—Rationale and Study Design

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    Hamish Michael Evans

    2016-03-01

    Full Text Available Background: This methodological paper presents both a scientific rationale and a methodological approach for investigating the effects of resveratrol supplementation on mood and cognitive performance in postmenopausal women. Postmenopausal women have an increased risk of cognitive decline and dementia, which may be at least partly due to loss of beneficial effects of estrogen on the cerebrovasculature. We hypothesise that resveratrol, a phytoestrogen, may counteract this risk by enhancing cerebrovascular function and improving regional blood flow in response to cognitive demands. A clinical trial was designed to test this hypothesis. Method: Healthy postmenopausal women were recruited to participate in a randomised, double-blind, placebo-controlled (parallel comparison dietary intervention trial to evaluate the effects of resveratrol supplementation (75 mg twice daily on cognition, cerebrovascular responsiveness to cognitive tasks and overall well-being. They performed the following tests at baseline and after 14 weeks of supplementation: Rey Auditory Verbal Learning Test, Cambridge Semantic Memory Battery, the Double Span and the Trail Making Task. Cerebrovascular function was assessed simultaneously by monitoring blood flow velocity in the middle cerebral arteries using transcranial Doppler ultrasound. Conclusion: This trial provides a model approach to demonstrate that, by optimising circulatory function in the brain, resveratrol and other vasoactive nutrients may enhance mood and cognition and ameliorate the risk of developing dementia in postmenopausal women and other at-risk populations.

  17. Effects of Resveratrol on Cognitive Performance, Mood and Cerebrovascular Function in Post-Menopausal Women; A 14-Week Randomised Placebo-Controlled Intervention Trial

    Directory of Open Access Journals (Sweden)

    Hamish M. Evans

    2017-01-01

    Full Text Available We tested whether chronic supplementation with resveratrol (a phytoestrogen could improve cerebrovascular function, cognition and mood in post-menopausal women. Eighty post-menopausal women aged 45–85 years were randomised to take trans-resveratrol or placebo for 14 weeks and the effects on cognitive performance, cerebral blood flow velocity and pulsatility index (a measure of arterial stiffness in the middle cerebral artery (using transcranial Doppler ultrasound, and cerebrovascular responsiveness (CVR to both cognitive testing and hypercapnia were assessed. Mood questionnaires were also administered. Compared to placebo, resveratrol elicited 17% increases in CVR to both hypercapnic (p = 0.010 and cognitive stimuli (p = 0.002. Significant improvements were observed in the performance of cognitive tasks in the domain of verbal memory (p = 0.041 and in overall cognitive performance (p = 0.020, which correlated with the increase in CVR (r = 0.327; p = 0.048. Mood tended to improve in multiple measures, although not significantly. These results indicate that regular consumption of a modest dose of resveratrol can enhance both cerebrovascular function and cognition in post-menopausal women, potentially reducing their heightened risk of accelerated cognitive decline and offering a promising therapeutic treatment for menopause-related cognitive decline.

  18. NAO-ocean circulation interactions in a coupled general circulation model

    Energy Technology Data Exchange (ETDEWEB)

    Bellucci, A. [Centro Euro-Mediterraneo per i Cambiamenti Climatici, Bologna (Italy); Gualdi, S.; Navarra, A. [Centro Euro-Mediterraneo per i Cambiamenti Climatici, Bologna (Italy); Istituto Nazionale di Geofisica e Vulcanologia, Bologna (Italy); Scoccimarro, E. [Istituto Nazionale di Geofisica e Vulcanologia, Bologna (Italy)

    2008-12-15

    The interplay between the North Atlantic Oscillation (NAO) and the large scale ocean circulation is inspected in a twentieth century simulation conducted with a state-of-the-art coupled general circulation model. Significant lead-lag covariance between oceanic and tropospheric variables suggests that the system supports a damped oscillatory mode involving an active ocean-atmosphere coupling, with a typical NAO-like space structure and a 5 years timescale, qualitatively consistent with a mid-latitude delayed oscillator paradigm. The two essential processes governing the oscillation are (1) a negative feedback between ocean gyre circulation and the high latitude SST meridional gradient and (2) a positive feedback between SST and the NAO. The atmospheric NAO pattern appears to have a weaker projection on the ocean meridional overturning, compared to the gyre circulation, which leads to a secondary role for the thermohaline circulation in driving the meridional heat transport, and thus the oscillatory mode. (orig.)

  19. Quality of Life Related to Health on Patients Suffering from Cerebrovascular Diseases at 2 Years of Survival

    Directory of Open Access Journals (Sweden)

    Rubén Bembibre Taboada

    2007-05-01

    Full Text Available Background: Quality of life related to health is a reliable and necessary indicator for the analysis of the sanitary state in a community. It is also a data source to define strategies in health actions in a population. Objective: To describe the aspects related to quality of life in two- year survivors from cerebrovascular disease. Method: A retrospective and prospective, descriptive study of a serie of cases with quality of life assessment related to patient’s health two years after being discharged from hospital due to ictus. A simple random sampling was performed and applied to survivors. Quality of life scale for ECVI–38 ictus was used determining the most affected cerebral dominance by means of statistic techniques. Results: the quality of life assessment in ictus showed a general mean of 46.5. The spheres identified as more engaged were the feelings and the emotional one. Illness in several of the cerebral dominance was confirmed in the majority of survivors although the obtained measurements were not high. The level of recovering at two years of the beginning of the disease was little or none in 31 ill patients. Conclusions: Alterations in quality of life related to health are sequelae which in more or lesser degree suffer from the majority of the survivors to a neuroictus. These can be determined applying ECVI-38. It is necessary to take measures to minimize the deleterious effects and fulfill the objectives for survivors have a satisfactory quality of life.

  20. Ambient Air Pollution Exposure and Respiratory, Cardiovascular and Cerebrovascular Mortality in Cape Town, South Africa: 2001–2006

    Directory of Open Access Journals (Sweden)

    Kuku Voyi

    2012-11-01

    Full Text Available Little evidence is available on the strength of the association between ambient air pollution exposure and health effects in developing countries such as South Africa. The association between the 24-h average ambient PM10, SO2 and NO2 levels and daily respiratory (RD, cardiovascular (CVD and cerebrovascular (CBD mortality in Cape Town (2001–2006 was investigated with a case-crossover design. For models that included entire year data, an inter-quartile range (IQR increase in PM10 (12 mg/m3 and NO2 (12 mg/m3 significantly increased CBD mortality by 4% and 8%, respectively. A significant increase of 3% in CVD mortality was observed per IQR increase in NO2 and SO2 (8 mg/m3. In the warm period, PM10 was significantly associated with RD and CVD mortality. NO2 had significant associations with CBD, RD and CVD mortality, whilst SO2 was associated with CVD mortality. None of the pollutants were associated with any of the three outcomes in the cold period. Susceptible groups depended on the cause-specific mortality and air pollutant. There is significant RD, CVD and CBD mortality risk associated with ambient air pollution exposure in South Africa, higher than reported in developed countries.

  1. Parametric Cerebrovascular Reserve Images Using Acetazolamide {sup 99m}Tc-HMPAO SPECT: A Feasibility Study of Quantitative Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hongyoon; Yoo, Min Young; Cheon, Gi Jeong; Kang, Keon Wook; Chung, Junekey; Lee, Dong Soo [Seoul National Univ., Seoul (Korea, Republic of)

    2013-09-15

    Basal/acetazolamide stress {sup 99m}Tc-HMPAO single-photon emission computed tomography (SPECT) has been widely used for evaluation of hemodynamics; however, qualitative and subjective visual assessment of cerebrovascular reserve (CVR) has been performed in clinical settings. The aim of this study was to generate parametric CVR images and evaluate its feasibility of quantification. Basal/acetazolamide stress {sup 99m}Tc-HMPAO SPECT data from 17 patients who underwent bypass surgery or percutaneous transluminal angioplasty were used. Spatial normalization was performed and parametric CVR images were generated using relative CVR (rCVR) of each voxel proportional to CVR of the whole brain. Binary parametric maps to show area of relatively reduced CVR were generated also using threshold of rCVR < 90 %. We calculated rCVR of internal carotid artery (ICA) using the parametric CVR images and probabilistic maps for ICA territory. Pre- and postprocedural parametric CVR images were obtained and quantitative rCVRs were compared. The rCVRs were evaluated according to visual grades for regional decreased CVR. Postprocedural rCVR obtained from parametric CVR images increased significantly from preprocedural rCVR. The rCVR was significantly correlated with visual grades of reduced CVR for each side of ICA territories. We generated parametric CVR images for basal/acetazolamide stress {sup 99m}Tc-HMPAO SPECT. As a quantitative measurement, rCVR obtained from the parametric image was feasibly assessed hemodynamic abnormalities with preserved anatomical information.

  2. Investigation of cerebral iron deposition in aged patients with ischemic cerebrovascular disease using susceptibility-weighted imaging

    Science.gov (United States)

    Liu, Yin; Liu, Jun; Liu, Huanghui; Liao, Yunjie; Cao, Lu; Ye, Bin; Wang, Wei

    2016-01-01

    Objective The aim of this study was to investigate focal iron deposition level in the brain in patients with ischemic cerebrovascular disease and its correlation with cerebral small vessel disease imaging markers. Patients and methods Seventy-four patients with first-ever transient ischemic attack (median age: 69 years; 30 males and 44 females) and 77 patients with positive ischemic stroke history (median age: 72 years; 43 males and 34 females) were studied retrospectively. On phase image of susceptibility-weighted imaging and regions of interest were manually drawn at the bilateral head of the caudate nucleus, lenticular nucleus (LN), thalamus (TH), frontal white matter, and occipital white matter. The correlation between iron deposition level and the clinical and imaging variables was also investigated. Results Iron deposition level at LN was significantly higher in patients with previous stroke history. It linearly correlated with the presence and number of cerebral microbleeds (CMBs) but not with white matter hyperintensity and lacunar infarct. Multiple linear regression analysis showed that deep structure CMBs were the most relevant in terms of iron deposition at LN. Conclusion Iron deposition at LN may increase in cases of more severe ischemia in aged patients with transient ischemic attack, and it may be an imaging marker for CMB of ischemic origin. PMID:27574434

  3. Magnetic resonance imaging of regional hemodynamic and cerebrovascular recovery after lateral fluid-percussion brain injury in rats.

    Science.gov (United States)

    Hayward, Nick Mark Edward Alexander; Tuunanen, Pasi I; Immonen, Riikka; Ndode-Ekane, Xavier Ekolle; Pitkänen, Asla; Gröhn, Olli

    2011-01-01

    Hemodynamic and cerebrovascular factors are crucially involved in secondary damage after traumatic brain injury (TBI). With magnetic resonance imaging, this study aimed to quantify regional cerebral blood flow (CBF) by arterial spin labeling and cerebral blood volume by using an intravascular contrast agent, during 14 days after lateral fluid-percussion injury (LFPI) in rats. Immunohistochemical analysis of vessel density was used to evaluate the contribution of vascular damage. Results show widespread ipsilateral and contralateral hypoperfusion, including both the cortex and the hippocampus bilaterally, as well as the ipsilateral thalamus. Hemodynamic unrest may partly be explained by an increase in blood vessel density over a period of 2 weeks in the ipsilateral hippocampus and perilesional cortex. Furthermore, three phases of perilesional alterations in CBF, progressing from hypoperfusion to normal and back to hypoperfusion within 2 weeks were shown for the first time in a rat TBI model. These three phases were similar to hemodynamic fluctuations reported in TBI patients. This makes it feasible to use LFPI in rats to study mechanisms behind hemodynamic changes and to explore novel therapeutic approaches for secondary brain damage after TBI.

  4. Positron emission tomography in cerebrovascular disease: The relationship between regional cerebral blood flow, blood volume and oxygen metabolism

    Energy Technology Data Exchange (ETDEWEB)

    Herold, S.

    1985-03-01

    Positron emission tomography in cerebrovascular disease has demonstrated the importance of the relationship between regional cerebral blood flow and the cerebral metabolic activity. In acute stroke it has been found that within the first hours after the onset of symptoms cerebral blood flow in the affected area is more depressed than cerebral oxygen utilisation. This relative preservation of oxygen utilisation results from an increase in the oxygen extraction ratio far above its normal value. However, the oxygen extraction fraction subsequently falls in the following days indicating the transition from a situation of possibly reversible ischaemia to irreversible infarction. In patients with carotid occlusive disease an increase in the oxygen extraction ratio has been observed only in very few cases. It has been shown, however, that at an earlier stage the relationship between CBF and CBV (as CBF/CBV-ratio) provides a sensitive measure of diminished perfusion pressure which could be helpful for the selection of patients for EC-IC bypass surgery. In patients with sickle cell anaemia it has been found that oxygen delivery to the brain is maintained by an increase in cerebral blood flow, whereas the oxygen extraction ratio is not increased despite the presence of a low oxygen affinity haemoglobin. Preliminary observations in classical migraine suggest an ischaemic situation during the attack.

  5. Characterization of Peripheral Immune Cell Subsets in Patients with Acute and Chronic Cerebrovascular Disease: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Peter Kraft

    2015-10-01

    Full Text Available Immune cells (IC play a crucial role in murine stroke pathophysiology. However, data are limited on the role of these cells in ischemic stroke in humans. We therefore aimed to characterize and compare peripheral IC subsets in patients with acute ischemic stroke/transient ischemic attack (AIS/TIA, chronic cerebrovascular disease (CCD and healthy volunteers (HV. We conducted a case-control study of patients with AIS/TIA (n = 116 or CCD (n = 117, and HV (n = 104 who were enrolled at the University Hospital Würzburg from 2010 to 2013. We determined the expression and quantity of IC subsets in the three study groups and performed correlation analyses with demographic and clinical parameters. The quantity of several IC subsets differed between the AIS/TIA, CCD, and HV groups. Several clinical and demographic variables independently predicted the quantity of IC subsets in patients with AIS/TIA. No significant changes in the quantity of IC subsets occurred within the first three days after AIS/TIA. Overall, these findings strengthen the evidence for a pathophysiologic role of IC in human ischemic stroke and the potential use of IC-based biomarkers for the prediction of stroke risk. A comprehensive description of IC kinetics is crucial to enable the design of targeted treatment strategies.

  6. Assessment of the arteriovenous cerebrovascular system by multi-slice CT. A single-bolus, monophasic protocol

    Energy Technology Data Exchange (ETDEWEB)

    Klingebiel, R.; Zimmer, C. [Charite CM, Humboldt Univ., Berlin (Germany). Neuroradiology Section; Rogalla, P.; Kivelitz, D. [Charite CM, Humboldt Univ., Berlin (Germany). Dept. of Radiology; Bohner, G. [Charite CM, Humboldt Univ., Berlin (Germany). Neuroradiology Section; Goetze, R. [Charite CM, Humboldt Univ., Berlin (Germany). Dept. of Radiology; Lehmann, R. [Charite CM, Humboldt Univ., Berlin (Germany). Neuroradiology Section

    2001-11-01

    Purpose: We present a protocol for the non-invasive angiographic assessment of the arterial and venous cerebrovascular (CV) system by multi-slice CT. Material and Methods: Data acquisition was performed in a multi-slice CT scanner with a scan range from the carotid bifurcation to the vertex and manual scan start following i.v. administration of 120 ml iodinated contrast medium with a flow rate of 4 ml/s. This protocol was applied in 12 patients with symptoms of acute CV insufficiency. Results: In all patients, comprehensive imaging of the arteriovenous CV system was achieved including the common carotid bifurcation, the third segment of the major cerebral arteries, the dural sinus and the internal cerebral veins. Various CV pathologies, such as a territorial artery occlusion, a thrombotic obstruction of the internal carotid artery, an intracranial arteriovenous malformation and a sinus vein thrombosis, were successfully evaluated. Conclusion: Comprehensive assessment of the arteriovenous CV system is possible by the use of a single-bolus, monophasic multi-slice scan technique.

  7. Cerebral blood flow and cerebrovascular reserve capacity in patients with occlusion or severe stenosis of cerebral arterial trunk

    Energy Technology Data Exchange (ETDEWEB)

    Yoshinaga, Shinya; Tanaka, Akira; Nakayama, Yoshiya; Tomonaga, Masamichi [Fukuoka Univ., Chikushino (Japan). Chikushi Hospital

    1997-12-01

    The cerebral blood flow (CBF) and the cerebrovascular reserve capacity (CVRC) were sequentially measured using a xenon enhanced CT scan in patients with transient ischemic attack or minor stroke due to an occlusion or a severe stenosis of the cerebral arterial trunk. The patients consisted of twelve males and one female ranging from 37 to 71 years of age (53 years on average). The vascular lesion was located in the internal carotid artery (7 patients) and in the middle cerebral artery (6 patients). Eleven patients received antiplatelet drug therapy, while two other patients underwent STA-MCA anastomosis. The CBF measurements were initially done within one month after the attack and then from 6 to 24 months (12 months on average) after the first study. Only one of 13 patients demonstrated a reattack during the period of observation and the CVRC decreased to 0% from the 14% level observed prior to the reattack, although the CBF was preserved. In the other twelve patients without a reattack, the CVRC was found to improve to 29.4% from 9.9% with statistical significance, even though the CBF remained the same in the first study. This study suggests hemodynamic insult to be closely related to the decreased in the CVRC, while STA-MCA anastomosis does not for prevent hemodynamic reattack based on a decrease in the CVRC in the early stage. (author)

  8. Dynamic single photon emission computed tomography using N-isopropyl-p-(/sup 123/I)iodoamphetamine for cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Ueda, Takashi; Kinoshita, Kazuo; Watanabe, Katsushi; Hoshi, Hiroaki; Jinnouchi, Seishi

    1988-03-01

    Continuous sequential single photon emission computed tomography (dynamic SPECT) with N-isopropyl-p-(/sup 123/I)iodoamphetamine (IMP) was perfomed in 17 patients with cerebrovascular diseases (three with transient ischemic attack, four with cerebral infarction, two with ruptured aneurysms, two with arteriovenous malformations (AVM), one with an unruptured giant aneurysm, and five with moyamoya disease). Dynamic SPECT scans were obtained with a circular-detector array emission CT instrument at a fixed level parallel to the orbitomeatal plane. The scans were taken over a 20-minute period, at 2-minute intervals, immediately after intravenous injection of IMP. Time courses of activity ratio of the affectednon-affected areas were calculated. Accumulation of IMP in ischemic areas was consistently suppressed to approximately 70 to 80% that in the non-affected areas. IMP accumulation in infarcted regions was less than 40 to 50% that in non-affected areas. In the regions of AVM and giant aneurysm, accumulation of IMP was rapid and relatively high, but its removal was prompt. Dynamic IMP SPECT appears useful in the assessment of cerebral perfusion and may have numerous applications in neurosurgery.

  9. Assessment of Hypercoagulation State in Patients with Embolic Cerebrovascular or Transient Ischemic Attack and Patent Foramen Ovale

    Directory of Open Access Journals (Sweden)

    D Nikfarjam

    2010-03-01

    Full Text Available Background: Patent foramen ovale (PFO causes a right-to-left shunt in about a quarter of normal population. Hypercoagulation may be a risk factor for embolic cerebrovascular accidents (CVA in these patients by paradoxical emboli. In this study, we checked hypercoagulation states in the embolic CVA patients with PFO. Methods: In a cross- sectional study, 40 patients with CVA or transient ischemic attack ( TIA and PFO participated in the study. Serum level of Homocystein, lupus anticoagulant screening test, Factor V leiden, Anti Cardiolipin Antibody (ACLA (IgG, IgM , Anti- thrombin III, protein C, protein S,Anti B2 glycoprotein1 and platelet count were checked in all patients. The data were analyzed using the statistical package for social science series (SPSS 15.0 and descriptive statistical method.Results: The mean age was 42.4± 12.1. Seventeen (42.5% patients were females. Twenty- two (55% cases were diagnosed as having CVA and the others as TIA. Three (7.5% of the patients were diabetic and 8 (20% had a history of different stages of hypertension. Hyperlipidemia was detected in 6 (15% patients and according to the laboratory data none had any signs of hypercoagulation.Conclusion: According to the present study, hypercoagulation as a cofactor in CVA patients with PFO did not seem to be a direct risk factor for embolic CVA at least any higher than for normal population.

  10. Circulating Endothelial Microparticles in Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    A. F. Tramontano

    2010-01-01

    Full Text Available Background. Endothelial Microparticles (EMPs are small vesicles shed from activated or apoptotic endothelial cells and involved in cellular cross-talk. Whether EMP immunophenotypes vary according to stimulus in Diabetes Mellitus (DM is not known. We studied the cellular adhesion molecule (CAM profile of circulating EMPs in patients with and without Diabetes Mellitus type 2, who were undergoing elective cardiac catheterization. Methods and Results. EMPs were analyzed by flow cytometry. The absolute median number of EMPs (EMPs/L specific for CD31, CD105, and CD106 was significantly increased in the DM population. The ratio of CD62E/CD31 EMP populations reflected an apoptotic process. Conclusion. Circulating CD31+, CD105+, and CD106+ EMPs were significantly elevated in patients with DM. EMPs were the only independent predictors of DM in our study cohort. In addition, the EMP immunophenotype reflected an apoptotic process. Circulating EMPs may provide new options for risk assessment.

  11. Walker circulation in a transient climate

    Science.gov (United States)

    Plesca, Elina; Grützun, Verena; Buehler, Stefan A.

    2016-04-01

    The tropical overturning circulations modulate the heat exchange across the tropics and between the tropics and the poles. The anthropogenic influence on the climate system will affect these circulations, impacting the dynamics of the Earth system. In this work we focus on the Walker circulation. We investigate its temporal and spatial dynamical changes and their link to other climate features, such as surface and sea-surface temperature patterns, El-Niño Southern Oscillation (ENSO), and ocean heat-uptake, both at global and regional scale. In order to determine the impact of anthropogenic climate change on the tropical circulation, we analyze the outputs of 28 general circulation models (GCMs) from the CMIP5 project. We use the experiment with 1% year-1 increase in CO2 concentration from pre-industrial levels to quadrupling of the concentration. Consistent with previous studies (ex. Ma and Xie 2013), we find that for this experiment most GCMs associate a weakening Walker circulation to a warming transient climate. Due to the role of the Walker Pacific cell in the meridional heat and moisture transport across the tropical Pacific and also the connection to ENSO, we find that a weakened Walker circulation correlates with more extreme El-Niño events, although without a change in their frequency. The spatial analysis of the Pacific Walker cell suggests an eastward displacement of the ascending branch, which is consistent with positive SST anomalies over the tropical Pacific and the link of the Pacific Walker cell to ENSO. Recent studies (ex. England et al. 2014) have linked a strengthened Walker circulation to stronger ocean heat uptake, especially in the western Pacific. The inter-model comparison of the correlation between Walker circulation intensity and ocean heat uptake does not convey a robust response for the investigated experiment. However, there is some evidence that a stronger weakening of the Walker circulation is linked to a higher transient climate

  12. A 12 GHz broadband latching circulator

    Science.gov (United States)

    Katoh, Y.; Konishi, H.; Sakamoto, K.

    The two kinds of latching circulators, external return path and internal return path, are defined, noting the advantages (faster switching speed, lower switching energy, less complicated fabrication) offered by the internal configuration. It is noted, however, that this kind of circulator is difficult to make broadband because the return paths do not seem to act as part of the ferrite junction. The development of a 12-GHz broadband, internal return path circulator with impedance matching transformer and in-phase adjustment screws designed using eigenvalue measurement is described. In describing the operating characteristics, it is noted that more than 25 dB isolation over 11 GHz to 13.5 GHz and 0.25 dB insertion loss is obtained.

  13. Experimental study of natural circulation circuit

    Energy Technology Data Exchange (ETDEWEB)

    Lemos, Wanderley F.; Su, Jian, E-mail: wlemos@lasme.coppe.ufrj.br, E-mail: sujian@lasme.coppe.ufrj.br [Coordenacao dos Programas de Pos-Graduacao de Engenharia (LASME/COPPE/UFRJ), Rio de Janeiro, RJ (Brazil). Lab. de Simulacao e Metodos Numericos; Faccini, Jose L.H., E-mail: faccini@ien.gov.br [Instituto de Engenharia Nuclear (LTE/IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Lab. de Termo-Hidraulica Experimental

    2011-07-01

    This work presents an experimental study about fluid flows behavior in natural circulation, under conditions of single-phase flow. The experiment was performed through experimental thermal-hydraulic circuit built at IEN. This test equipment has performance similar to passive system of residual heat removal present in Advanced Pressurized Water Reactors (APWR). This experimental study aims to observing and analyzing the natural circulation phenomenon, using this experimental circuit that was dimensioned and built based on concepts of similarity and scale. This philosophy allows the analysis of natural circulation behavior in single-phase flow conditions proportionally to the functioning real conditions of a nuclear reactor. The experiment was performed through procedures to initialization of hydraulic feeding of primary and secondary circuits and electrical energizing of resistors installed inside heater. Power controller has availability to adjust values of electrical power to feeding resistors, in order to portray several conditions of energy decay of nuclear reactor in a steady state. Data acquisition system allows the measurement and monitoring of the evolution of the temperature in various points through thermocouples installed in strategic points along hydraulic circuit. The behavior of the natural circulation phenomenon was monitored by graphical interface on computer screen, showing the temperature evolutions of measuring points and results stored in digital spreadsheets. The results stored in digital spreadsheets allowed the getting of data to graphic construction and discussion about natural circulation phenomenon. Finally, the calculus of Reynolds number allowed the establishment for a correlation of friction in function of geometric scales of length, heights and cross section of tubing, considering a natural circulation flow throughout in the region of hot leg. (author)

  14. Problems and strategy of drug innovation for cerebrovascular diseases%脑血管病创新药物研发的问题与对策

    Institute of Scientific and Technical Information of China (English)

    王拥军

    2011-01-01

    The successful rate of new drug research and development in Chinese pharmaceutical companies is lower and lower.The reasons include the medical need of patients is rapidly growing; the term of new drug patent is short; the growth of traditional pharmaceutical market is slow; new competitors are increasing, and the health budget is cut.The annual direct in-patient medical cost of drugs for cerebrovascular diseases is 20 billion.The drug development for cerebrovascular diseases has many difficulties: ( 1 ) many known drug targets have been well developed, so new targets are needed.(2) approval standards of new drugs around the world become much stricter.(3) the time gap between drug research and clinical evaluation is very long.Therefore, the research and development of new drugs for cerebrovascular diseases will follow the following four trends: ( 1 ) new drug target discovery should base on basic research.(2) the efficacy standard for cerebrovascular diseases will be adjusted.(3) evidence based medicine demands higher level of clinical trial.(4) systems biology has much deeper influence on new cerebrovascular drug discovery and development.%随着我国患者医疗需求的快速增长,新药专利期限缩短、传统市场的增长再下降、新的竞争者越来越多以及健康预算整体压缩等原因致使我国医药企业的新药研产率日益下降.每年脑血管药物占直接住院医疗费用的200亿,其新药研发面临着巨大压力:第一,已知的药物靶点已经被开发很多.第二,各国的药审部门标准越来越严格.第三,从药物研发到临床评价周期长.因此,脑血管病创新药物研发必须顺应4个新的趋势来加快发展该领域的新药研发:第一,新的靶点的发现必须要依赖基础研究.第二,脑血管病的疗效标准在不断调整.第三,循证医学对临床试验要求越来越高.第四,系统生物学对脑血管药物研发的影响越来越大.

  15. The stripline circulator theory and practice

    CERN Document Server

    Helszajn, J

    2008-01-01

    Stripline circulator theory and applications from the world's foremost authority. The stripline junction circulator is a unique three-port non-reciprocal microwave junction used to connect a single antenna to both a transmitter and a receiver. Its operation relies on the interaction between an electron spin in a suitably magnetized insulator with an alternating radio frequency magnetic field. In its simplest form, it consists of a microwave planar gyromagnetic resonator symmetrically coupled by three transmission lines. This book explores the magnetic interaction involved in the stripline circ.

  16. Quenching phenomena in natural circulation loop

    Energy Technology Data Exchange (ETDEWEB)

    Umekawa, Hisashi; Ozawa, Mamoru [Kansai Univ., Osaka (Japan); Ishida, Naoki [Daihatsu Motor Company, Osaka (Japan)

    1995-09-01

    Quenching phenomena has been investigated experimentally using circulation loop of liquid nitrogen. During the quenching under natural circulation, the heat transfer mode changes from film boiling to nucleate boiling, and at the same time flux changes with time depending on the vapor generation rate and related two-phase flow characteristics. Moreover, density wave oscillations occur under a certain operating condition, which is closely related to the dynamic behavior of the cooling curve. The experimental results indicates that the occurrence of the density wave oscillation induces the deterioration of effective cooling of the heat surface in the film and the transition boiling regions, which results in the decrease in the quenching velocity.

  17. First circulating beam in the AA

    CERN Multimedia

    1980-01-01

    On 3 July 1980, two years after project authorization, beam circulated for the first time in the AA. It was a 3.56 GeV/c proton test beam. We see an expecting crowd, minutes before the happy event. The persons are too numerous to name them all, but the 3 most prominent ones are at the centre (left to right): Roy Billinge (Joint AA Project Leader, with his hand on the control box), Eifionydd Jones (white shirt), Simon van der Meer (spiritus rector and Joint AA Project Leader). The first antiprotons were injected, made to circulate and cooled soon after, on 14 July 1980.

  18. 脑血管置入材料的生物相容性及并发症%Biocompatibility and complications of cerebrovascular stents

    Institute of Scientific and Technical Information of China (English)

    金秀芬; 徐艳杰

    2011-01-01

    背景:虽然支架置入技术的发展为脑血管疾病提供了较为有效的治疗手段,但其安全性和有效性还有待进一步验证.目的:阐述脑血管支架与宿主间的生物相容性,分析支架置入并发症的原因,并探讨管理方法.方法:以 "脑血管病,支架,生物相容性,并发症"和"Cerebrovascular disease,stents,biocompatibility,complication" 为检索词,计算机检索中国期刊全文数据库、PubMed数据库(1993-01/2010-11) 与脑血管支架生物相容性、支架置入治疗并发症相关的文章,按纳入和排除标准对文献进行筛选,重点对18 篇文章进行分析讨论.结果与结论:脑血管支架临床应用较多的是颅内支架,由于血管的管径限制支架的直径,不同病变对支架直径的要求不同.支架置入并发症主要有腹膜后血肿,颈动脉窦反应,高灌注综合征,脑血管痉挛和血栓形成.在各种脑血管支架中,金属支架生物相容性较差,聚合物支架、涂层支架和药物支架生物相容性均好于金属支架,能有效的预防支架置入后的再狭窄.治疗过程中进行充足的置入前准备,选择合适的支架类型,严格遵循适应证,支架置入中仔细观察病情变化,置入后良好的监测和管理可预防并发症的发生.%BACKGROUND: Although stent implanting technology has provided more effective treatments for cerebrovascular diseases, itssafety and effectiveness require to be further verified.OBJECTIVE: To explain the bio compatibility between cerebrovascular stents and the hosts, to analyze the cause of s tentcomplications, and to discuss managements.MET H 0 D S: A c o mp ute r- based online retrievalofChinaAcademicJournalF ulltext Databaseand PubMeddatabasebeiAieenJanuary 1993 and November 2010. with the key words of "cerebrovascular disease, stents, biocompatibility, complications"inChinese and English. Studies regarding the biocompatibility of cerebrovascular stents and the complications of stent

  19. Quality of Life Related to Health on Patients Suffering from Cerebrovascular Diseases at 2 Years of Survival Calidad de vida relacionada con la salud en pacientes con enfermedad cerebrovascular a los dos años de supervivencia

    Directory of Open Access Journals (Sweden)

    Inti Santana Carballosa

    Full Text Available Background: Quality of life related to health is a reliable and necessary indicator for the analysis of the sanitary state in a community. It is also a data source to define strategies in health actions in a population. Objective: To describe the aspects related to quality of life in two- year survivors from cerebrovascular disease. Method: A retrospective and prospective, descriptive study of a serie of cases with quality of life assessment related to patient’s health two years after being discharged from hospital due to ictus. A simple random sampling was performed and applied to survivors. Quality of life scale for ECVI–38 ictus was used determining the most affected cerebral dominance by means of statistic techniques. Results: the quality of life assessment in ictus showed a general mean of 46.5. The spheres identified as more engaged were the feelings and the emotional one. Illness in several of the cerebral dominance was confirmed in the majority of survivors although the obtained measurements were not high. The level of recovering at two years of the beginning of the disease was little or none in 31 ill patients. Conclusions: Alterations in quality of life related to health are sequelae which in more or lesser degree suffer from the majority of the survivors to a neuroictus. These can be determined applying ECVI-38. It is necessary to take measures to minimize the deleterious effects and fulfill the objectives for survivors have a satisfactory quality of life.
    Fundamento: La calidad de vida relativa a salud es un indicador confiable y necesario para el análisis del estado sanitario de una comunidad y fuente de datos para definir estrategias en las acciones de salud sobre una población. Objetivo: Describir aspectos relacionados con la calidad de vida en pacientes supervivientes por dos años a

  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

    Directory of Open Access Journals (Sweden)

    Sueli Marques

    2006-06-01

    Full Text Available The aims of this study were: to identify aged persons who were victims of Cerebrovascular Accident and received care at the Emergency Unit of a Public Hospital in Ribeirão Preto-SP, Brazil, and their respective families, as well as to identify the changes in family relations that occurred after the event. In order to identify these changes, the adapted Critical Incident Technique was used, while the analysis was based on the idea of Current of Thought. The sample consisted of 11 families, totaling 34 participants. The analysis of the consequences displayed the changes in family relations, which made up 13 subcategories, 5 of which were positive and 8 negative, totaling 58 alterations, 30 of which were positive and 28 negative. The study revealed the need to work with the family in order to identify changes and develop an action plan to favor the family's relations and adaptation to the demands, with a view to improving the living conditions of its members, including the aged person.Las finalidades de este estudio fueron las de identificar a los ancianos con diagnóstico médico de Accidente Cerebrovascular, atendidos en la Unidad de Emergencia de un Hospital Gubernamental de Ribeirão Preto-SP, Brasil, y a sus respectivas familias y también identificar las alteraciones en el relacionamiento familiar, que ocurrieron tras el evento. Fue utilizada la Técnica de Incidentes Críticos adaptada para identificar las alteraciones en el relacionamiento familiar ocurridas tras la enfermedad. Para el análisis, fue adoptada la reflexión del Camino del Pensamiento. La muestra fue compuesta por 11 familias, totalizando 34 participantes. El análisis de las consecuencias reveló las alteraciones en el relacionamiento familiar, que constituyeron 13 subcategorías, 5 positivas y 8 negativas, con un total de 58 alteraciones, siendo 30 positivas y 28 negativas. El estudio reveló la necesidad de trabajar con la familia para identificar las alteraciones y

  1. Influence of external circulation on sludge characteristics during start-up of internal circulation reactor

    Institute of Scientific and Technical Information of China (English)

    DING Jian-nan; WANG Dian-zuo

    2005-01-01

    The start-up of external circulation-added internal circulation(IC) reactor was finished in 26 d, 32 d fewer than that of IC reactor. To evaluate the influence of the added external circulation on the development of granular sludge, the characteristics of the granular sludge taken from the two tested laboratory-scale reactors during start-up were studied. The results show that the added external circulation can enhance biomass granulation, accelerate granule development and improve sludge characteristics. At the end of start-up, the granular size of sludge in external circulation-added IC reactor greatly increases with a size distribution much better than that of sludge in IC reactor. The granular sludge originated from external circulation-added IC reactor contains more extracellular polymers and has a greater settling velocity than that from IC reactor. Methanogenic activity of the granular sludge from the external circulation-added IC reactor started 26 d ago reaches 358.23 mL·g-1·d-1, 1.66 and 1.20 times as great as that of the sludge from the IC reactor started 26 d and 58 d ago respectively.

  2. Quality of Life of Caretakers of Adults who Have Suffered a Stroke Calidad de vida de cuidadores de adultos con accidente cerebrovascular Qualidade de vida de cuidadores de adultos com acidente cerebrovascular

    Directory of Open Access Journals (Sweden)

    HERRERA LIÁN ARLETH

    2010-10-01

    Full Text Available

    Objective: To describe the quality of life of family caretakers of adults with sequelae of cerebrovascular stroke accident in Cartagena, Colombia.

    Method: quantitative descriptive study conducted during the second half of 2008. Non-probabilistic convenience sample of 97 caregivers. The instrument proposed by Ferrell et al has been used. In order to assess each of the welfare indicators which make up for the quality of life, central trend measures and variation coefficient have been used.

    Results: the caretaker group registered a fitness average of 11.1 compared to the maximum score, which indicates the worst health status; psychological and social indicators of welfare had averages of 48.8 and 21.9, respectively, showing thus less impact. The best health status was found in spiritual welfare indicators, with an average of 22.6.

    Conclusions: The experience of working as a caretaker significantly modifies the quality of life of individuals. Caretakers, as an important source of informal care, require support from health systems and so do professionals in nursing as parts of said health systems.

    Objetivo: describir la calidad de vida de los cuidadores familiares de adultos con secuelas de accidente cerebrovascular, en Cartagena, Colombia.

    Método: estudio descriptivo cuantitativo realizado durante el segundo semestre de 2008. Muestra no probabilística por conveniencia de 97 cuidadores. Se empleó el instrumento propuesto por Ferrell et ál. Para valorar cada uno de los bienestares que integran la calidad de vida se utilizaron medidas de tendencia central y coeficiente de variación.

    Resultados: el grupo de cuidadores presentó en el bienestar físico un promedio de 11,1 con relación al máximo puntaje, lo que indica el peor estado de salud; los bienestares psicológico y social tuvieron

  3. Unsteady flow about a circulation control airfoil

    Institute of Scientific and Technical Information of China (English)

    刘晶昌; 孙茂; 吴礼义

    1996-01-01

    The unsteady flow around a circulation control (CC) airfoil was investigated with Navier-Stokes method,which includes the flow around CC airfoil with pulsating jet,the flow around oscillating CC airfoil,and the flow around oscillating CC airfoil with pulsating jet.Dynamic properties of the flow and the aerodynamic forces were rewaled.

  4. IHI-FW circulating fluidized bed boiler

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, S.; Omata, K.; Ishimoto, R.; Asai, M. (Ishikawajima-Harima Heavy Industries, Co. Ltd., Tokyo (Japan))

    1993-07-01

    The technology and application of the circulating fluidized bed boiler (IHI-FW) are outlined. Circulating fluidized bed boilers have various features as compared with bubbling fluidized bed boilers as follows; a high combustion efficiency, efficient use of limestone for desulfurization, low NOx emission, adaptability to various fuels and capability to cope with load change. The IHI-FW boiler is furthermore featured by water-wall furnace of all-welded structure, water-cooled/steam cooled cyclone, and simple circulating system. The 30 t/h circulating fluidized bed boiler was introduced into the Tsu Works, Omikenshi Co., Ltd., Japan for private power generation. The boiler equipped with a backup heavy oil burner mainly uses semi-anthracite coal, and besides sulfur capture and NOx reduction functions of a bed, a bag filter with a high dust collecting efficiency is installed in an exhaust gas system. The installation period was reduced to 2.5 months, a half of conventional ones, by more assembly in a factory followed by less field works. 7 figs., 2 tabs.

  5. Redefining circulating tumor cells by image processing

    NARCIS (Netherlands)

    Ligthart, S.T.

    2012-01-01

    Circulating tumor cells (CTC) in the blood of patients with metastatic carcinomas are associated with poor survival and can be used to guide therapy. However, CTC are very heterogeneous in size and shape, and are present at very low frequencies. Missing or misjudging a few events may have great cons

  6. Frobenius circulant graphs of valency six

    CERN Document Server

    Thomson, Alison

    2012-01-01

    A Frobenius group is a permutation group which is transitive but not regular such that only the identity element can fix two points. It is well known that such a group is a semidirect product $G = K \\rtimes H$, where $K$ is a nilpotent normal subgroup. A first kind $G$-Frobenius graph is a Cayley graph on $K$ whose connection set is an $H$-orbit $a^H$ for some $a \\in K$ with $ = K$, where $H$ is of even order or $a$ is an involution. Such graphs admit 'perfect' routing and gossiping schemes in some sense. Because of this and the importance of circulant graphs in network design, it is desirable to classify first kind Frobenius circulant graphs. In this paper we classify all 6-valent first kind Frobenius circulant graphs. We give optimal gossiping, routing and broadcasting schemes for such graphs and compute their forwarding indices, Wiener indices and minimum gossip time. We also prove that the broadcasting time of any 6-valent first kind Frobenius circulant is equal to its diameter plus two or three, indicati...

  7. Detecting holocene changes in thermohaline circulation.

    Science.gov (United States)

    Keigwin, L D; Boyle, E A

    2000-02-15

    Throughout the last glacial cycle, reorganizations of deep ocean water masses were coincident with rapid millennial-scale changes in climate. Climate changes have been less severe during the present interglacial, but evidence for concurrent deep ocean circulation change is ambiguous.

  8. Detecting Holocene changes in thermohaline circulation

    OpenAIRE

    Keigwin, L. D.; Boyle, E.A.

    2000-01-01

    Throughout the last glacial cycle, reorganizations of deep ocean water masses were coincident with rapid millennial-scale changes in climate. Climate changes have been less severe during the present interglacial, but evidence for concurrent deep ocean circulation change is ambiguous.

  9. [Circulating "tumor markers" in gastrointestinal tumors].

    Science.gov (United States)

    Borlinghaus, P; Lamerz, R

    1991-09-01

    Tumor markers (TM) of the neoplastic cell can be divided into non-shedded substances and antigens shedded in blood, urine or other body fluids. For clinicians circulating TM are more important. All relevant circulating TM are not useful in screening of asymptomatic patients because of insufficient sensitivity and specificity. With caution they are useful in the observation of risk groups. Circulating TM have their main significance as additional parameters in monitoring symptomatic patients with malignancies. Several follow up determinations are more important than one single measurement. During follow up of tumor patients TM should not be checked automatically if there are no diagnostic or therapeutical consequences. The clinically most important circulating TM in non-hormone secreting tumors of the gastrointestinal tract are the oncofetal antigens CEA and AFP and antigens defined by monoclonal antibodies e. g. CA 19-9 and CA 72-4. AFP is the primary TM in hepatocellular carcinoma, often elevated in hepatoblastoma and always normal in cholangiocellular carcinoma. CEA is the TM of first choice in patients with colorectal carcinomas and liver metastasis. CA 19-9 is TM of first choice in pancreatic carcinoma and additionally of diagnostic value in cholangiocellular carcinoma and tumors of the bile ducts. In cancer of the stomach CA 19-9 and CEA are secondary TM in combination with CA 72-4 as primary TM. Care should be taken that slight and moderate elevations of TM can be observed in benign diseases of liver, pancreas and bowel.

  10. Development Strategies for Rural Key Circulation Service Network

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    The rural key circulation service network is an important channel for ensuring agricultural products’entry to market and urban industrial products’entry to rural areas.Through in-depth survey and research,we took a look at development changes and current situations of three circulation service networks,namely,circulation of nondurable consumer goods,circulation of agricultural means of production,and circulation of agricultural products.Based on several key problems in rural circulation service network,such as logistics problem,delivery problem,backward transaction mode,and the last kilometer information,we put forward corresponding development countermeasures.

  11. Estudio descriptivo de la enfermedad cerebrovascular en el Hospital Regional Docente de Ica-Perú 2003 - 2006

    Directory of Open Access Journals (Sweden)

    J. Jhonnel Alarco

    2009-01-01

    Full Text Available Objetivo, Determinar algunas características epidemiológicas de la enfermedad cerebro vascular (ECV, describir las características de la población estudiada según sexo, edad, procedencia, raza, forma de inicio, ubicación, tipos y subtipos, síntomas, antecedentes patológicos y mortalidad intrahospitalaria. Materiales y métodos, estudio descriptivo. Lugar, Hospital Regional Docente de Ica. Criterios de inclusión, pacientes ingresados con diagnóstico de accidente cerebrovascular. Intervenciones, revisión de historias clínicas de archivo entre los años 2003 y 2006 Principales medidas de resultados, análisis estadístico, porcentajes y medidas de tendencia central, tabuladas en una base de datos con ayuda del programa Microsoft Excel 2003 para Windows®. Resultados, de 152 pacientes ingresados al servicio de Medicina 119 fueron casos de ECV isquémico, 33 casos fueron ECV hemorrágico. El principal antecedente patológico fue la hipertensión arterial con un 75.0 %. El síntoma más frecuente fue el trastorno motor con 80.3% seguido por alteraciones del lenguaje con 55.9%. El mayor número fue encontrado entre la séptima y octava décadas de la vida. La edad mínima fue de 17 y máxima de 102 años. La mortalidad global fue de 18 casos obteniéndose una tasa de letalidad específica para el ECV isquémico de 0,8% y de 51,5% para el ECV hemorrágico. Conclusiones: Se distingue a la HTA como el principal antecedente modificable, cuya prevención reduciría notablemente su mortalidad.

  12. Hemispheric asymmetry in cerebrovascular reactivity of the human primary motor cortex: an in vivo study at 7 T.

    Science.gov (United States)

    Driver, Ian D; Andoh, Jamila; Blockley, Nicholas P; Francis, Susan T; Gowland, Penny A; Paus, Tomáš

    2015-05-01

    Current functional MRI (fMRI) approaches assess underlying neuronal activity through monitoring the related local variations in cerebral blood oxygenation, blood volume and blood flow. This vascular response is likely to vary across brain regions and across individuals, depending on the composition of the local vascular bed and on the vascular capacity to dilate. The most widely used technique uses the blood oxygen level dependent (BOLD) fMRI signal, which arises from a complex combination of all of these factors. The model of handedness provides a case where one brain region (dominant motor cortex) is known to have a stronger BOLD response over another (non-dominant motor cortex) during hand motor task performance. We predict that this is accompanied by a higher vascular reactivity in the dominant motor cortex, when compared with the non-dominant motor cortex. Precise measurement of end-tidal CO2 and a novel sinusoidal CO2 respiratory challenge were combined with the high sensitivity and finer spatial resolution available for fMRI at 7 T to measure BOLD cerebrovascular reactivity (CVR) in eight healthy male participants. BOLD CVR was compared between the left (dominant) and right (non-dominant) primary motor cortices of right-handed adults. Hemispheric asymmetry in vascular reactivity was predicted and observed in the primary motor cortex (left CVR = 0.60 ± 0.15%/mm Hg; right CVR = 0.47 ± 0.08%/mm Hg; left CVR > right CVR, P = 0.04), the first reported evidence of such a vascular difference. These findings demonstrate a cerebral vascular asymmetry between the left and right primary motor cortex. The origin of this asymmetry largely arises from the contribution of large draining veins. This work has implications for future motor laterality studies that use BOLD, and it is also suggestive of a vascular plasticity in the human primary motor cortex.

  13. Radiation-epidemiological Study of Cerebrovascular Diseases in the Cohort of Russian Recovery Operation Workers of the Chernobyl Accident.

    Science.gov (United States)

    Kashcheev, V V; Chekin, S Yu; Maksioutov, M A; Tumanov, K A; Menyaylo, A N; Kochergina, E V; Kashcheeva, P V; Gorsky, A I; Shchukina, N V; Karpenko, S V; Ivanov, V K

    2016-08-01

    The paper presents an analysis of the incidence of cerebrovascular diseases (CeVD) in the cohort of Russian workers involved in recovery tasks after the Chernobyl accident. The studied cohort consists of 53,772 recovery operation workers (liquidators) who arrived in the zone of the Chernobyl accident within the first year after this accident (26 April 1986-26 April 1987). The mean external whole body dose in the cohort was 0.161 Gy, while individual doses varied from 0.0001 Gy to 1.42 Gy. During the follow-up period 1986-2012, a total of 23,264 cases of CeVD were diagnosed as a result of annual health examinations. A Poisson regression model was applied for estimation of radiation risks and for an assessment of other risk factors of CeVD. The following factors were considered as risk factors for CeVD: the dose, duration of the liquidators' work in the Chernobyl zone, and the concomitant diseases (hypertension, ischemic heart disease, atherosclerosis, and diabetes). The baseline incidence of CeVD is statistically significantly (p < 0.001) associated with all studied concomitant diseases. The incidence of CeVD has revealed a statistically significant dose response with the lack of a latent period and with the average ERR/Gy = 0.45, 95% CI: (0.28, 0.62), p < 0.001. Radiation risks of CeVD statistically significantly (p = 0.03) varied with the duration of liquidators' stay in the Chernobyl zone; for those who stayed in the Chernobyl zone less than 6 wk, ERR/Gy = 0.64, 95% CI = (0.38; 0.93), p < 0.001. Among studied concomitant diseases, diabetes mellitus statistically significantly (p = 0.002) increases the radiation risk of CeVD: for liquidators with diagnosed diabetes, ERR/Gy = 1.29.

  14. La trombectomía mecánica en el tratamiento de accidentes cerebrovasculares (ACV en la fase aguda

    Directory of Open Access Journals (Sweden)

    Alain Bonafe

    2013-08-01

    Full Text Available En Francia, la incidencia anual de accidentes cerebro vasculares (ACV es de 1.6 a 2.4 por cada mil (1.000 personas, es decir entre 100.000 y 145.000 por año, con una mortalidad del 15 al 20% al cabo del primer mes y un 75% de personas sobrevivientes con secuelas. El tratamiento de preferencia es la Trombólisis IV (Intra Venosa con rt-PA (Recombinant Tissue Plasminogen Activator - Activador del Plasminógeno Tisular Recombinante, el cual tiene una ventana de eficacia de 4 horas y media después del inicio de los síntomas. Sólo 2% de los pacientes eligibles para este tratamiento se benefician de una fibrinólisis por vía venosa. Las oclusiones de arterias de calibre grueso son responsables del 46% de los accidentes cerebrovasculares Isquémicos (ACVI y predicen una sobremortalidad y discapacidad funcional severa a los 6 meses. En ausencia de revascularización, la mitad de los ACVI de circulación anterior con oclusión arterial documentada fallece y solamente el 10% de ellos, tienen un buen pronóstico funcional a los tres meses. Algunas variables que han sido identificadas como predictoras de un mal pronóstico son: un puntaje clínico en la escala NIHSS (National Institute of Health Stroke Scale - Escala del Ictus del Instituto Nacional de la Salud superior a 12 según Fischer 2005, una oclusión documentada de una arteria intracraneal, los fracasos y las contraindicaciones de la fibrinólisis intravenosa entre otros. Esta revisión busca presentar los mecanismos, la evaluación, la eficacia y las complicaciones reportadas por la literatura sobre la trombectomía mecánica.

  15. Characteristics and risk factors of cerebrovascular accidents after percutaneous coronary interventions in patients with history of stroke

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hua; FENG Li-qun; BI Qi; WANG Yu-ping

    2010-01-01

    Background Percutaneous coronary intervention (PCI) is a well-established method for managing coronary diseases.However, the increasing use of PCI has led to an increased incidence of acute cerebrovascular accidents (CVA) related to PCI. In this study, we investigated the characteristics and risk factors of CVA after PCI in patients with known stroke history.Methods Between January 1, 2005 and March 1, 2009, 621 patients with a history of stroke underwent a total of 665 PCI procedures and were included in this retrospective study. Demographic and clinical characteristics, previous medications, procedures, neurologic deficits, location of lesion and in-hospital clinical outcomes of patients who developed a CVA after the cardiac catheterization laboratory visit and before discharge were reviewed.Results Acute CVA was diagnosed in 53 (8.5%) patients during the operation or the perioperative pedod. Seventeen patients suffered from transient ischemic attack, thirty-four patients suffered from cerebral infarction and two patients suffered from cerebral hemorrhage. The risk factors for CVA after PCI in stroke patients were: admission with an acute coronary syndrome, use of an intra-aortic balloon pump, urgent or emergency procedures, diabetes mellitus, and poor left ventricular systolic function, arterial fibrillation, previous myocardial infarction, dyslipidemia, tobacco use, and no/irregular use of anti-platelet medications.Conclusions The incidence of CVA during and after PCI in patients with history of stroke is much higher than that in patients without history of stroke. Patients with atrial fibrillation, previous myocardial infarction, diabetes mellitus,dyslipidemia, tobacco use, and no or irregular use of anti-platelet medications were at higher risk for recurrent stroke.This study showed a strong association between acute coronary syndromes and in-hospital stroke after PCI.

  16. Diabetes mellitus como fator prognóstico em doença cerebrovascular isquêmica

    Directory of Open Access Journals (Sweden)

    Terezinha V. Oliveira

    1988-09-01

    Full Text Available Como parte de estudo prospectivo de 347 casos de doença cerebrovascular isquêmica (DCVI internados em um hospital geral, foram avaliados 36 pacientes diabéticos e 36 controles com sexo, idade e pressão arterial semelhantes, com o objetivo de verificar como diabetes mellitus afeta o prognóstico em DCVI. Os 72 pacientes apresentavam vários tipos de DCVI (trombose, tromboembolismo ou embolia cardiogênica. Os pacientes diabéticos tiveram estatisticamente mais dias de internamento (p<0,05, mais complicações durante o internamento (p<0,05, mais complicações infecciosas (p<0,01 e maior número de óbitos ao fim do seguimento (p<0,05. Após 377 ±429 (média ± desvio padrão dias de seguimento, em 50% dos diabéticos havia ocorrido o óbito, enquanto após 387±405 dias 25% dos não diabéticos haviam falecido. Os óbitos em ambos os grupos ocorreram em média no oitavo mês após o evento vascular que motivou a admissão inicial. Não foram notadas diferenças com respeito ao número de óbitos durante a internação inicial ou as condições neurológicas dos sobreviventes ao fim da admissão inicial e do seguimento.

  17. Effects of xenon and hypothermia on cerebrovascular pressure reactivity in newborn global hypoxic-ischemic pig model.

    Science.gov (United States)

    Chakkarapani, Elavazhagan; Dingley, John; Aquilina, Kristian; Osredkar, Damjan; Liu, Xun; Thoresen, Marianne

    2013-11-01

    Autoregulation of cerebral perfusion is impaired in hypoxic-ischemic encephalopathy. We investigated whether cerebrovascular pressure reactivity (PRx), an element of cerebral autoregulation that is calculated as a moving correlation coefficient between averages of intracranial and mean arterial blood pressure (MABP) with values between -1 and +1, is impaired during and after a hypoxic-ischemic insult (HI) in newborn pigs. Associations between end-tidal CO2, seizures, neuropathology, and PRx were investigated. The effect of hypothermia (HT) and Xenon (Xe) on PRx was studied. Pigs were randomized to Sham, and after HI to normothermia (NT), HT, Xe or xenon hypothermia (XeHT). We defined PRx >0.2 as peak and negative PRx as preserved. Neuropathology scores after 72 hours of survival was grouped as 'severe' or 'mild.' Secondary PRx peak during recovery, predictive of severe neuropathology and associated with insult severity (P=0.05), was delayed in HT (11.5 hours) than in NT (6.5 hours) groups. Seizures were associated with impaired PRx in NT pigs (P=0.0002), but not in the HT/XeHT pigs. PRx was preserved during normocapnia and impaired during hypocapnia. Xenon abolished the secondary PRx peak, increased (mean (95% confidence interval (CI)) MABP (6.5 (3.8, 9.4) mm Hg) and cerebral perfusion pressure (5.9 (2.9, 8.9) mm Hg) and preserved the PRx (regression coefficient, -0.098 (95% CI (-0.18, -0.01)), independent of the insult severity.

  18. Effect of an educational program in primary care: the case of lipid control in cardio-cerebrovascular prevention.

    Science.gov (United States)

    Arcoraci, V; Santoni, L; Ferrara, R; Furneri, G; Cannata, A; Sultana, J; Moretti, S; Di Luccio, A; Tari, D U; Pagliaro, C; Corrao, S; Tari, M

    2014-01-01

    Lowering blood cholesterol levels reduces the risk of coronary heart disease. However, the effect of interventions depends on the patients' adherence to treatment. Primary care plays an important role in the detection, treatment and monitoring of disease, therefore different educational programs (EP) have been implemented to improve disease management in general practice. The present study is aimed to assess whether a general practitioner auditing and feedback EP may improve dyslipidaemia management in a primary care setting and to evaluate patients' adherence to prescribed lipid-lowering treatment. The quality of cardiovascular and cerebrovascular disease prevention before and after the implementation of an EP offered to 25 general practitioners (GPs), was evaluated. Clinical and prescription data on patients receiving at least one lipid-lowering treatment was collected. To evaluate the quality of the healthcare service provided, clinical and biochemical outcomes, and drug-utilization, process indicators were set up. Adherence was evaluated before and after the EP as the "Medication Possession Ratio" (MPR). A correlation analysis was carried out to estimate the effect of the MPR in achieving pre-defined clinical end-points. Prescription data for lipid-lowering drugs was collected in a sample of 839 patients. While no differences in the achievement of blood lipid targets were observed, a slight but significant improvement of the MPR was registered after the EP (MPR >0.8=64.2% vs 60.6%, p=0.0426). Moreover, high levels of statin adherence were associated with the achievement of total blood cholesterol target (OR=3.3 for MPR >0.8 vs MPR goal (OR=3.3 for MPR >0.8 vs MPR <0.5, 95% CI:1.5-7.2). The EP partially improved the defined clinical targets; probably, a more patient-based approach could be more appropriate to achieve the defined target. Further studies are needed to identify how healthcare services can be improved.

  19. EXTRACORPOREAL CIRCULATION: EFFECT OF LONG-TERM (24-HOUR) CIRCULATION ON BLOOD COMPONENTS

    OpenAIRE

    Solberg, Robert Glen

    2010-01-01

    Extracorporeal circulation damages blood and causes harmful side effects such as stroke and/or systemic inflammatory response in patients. Reactions of blood components to extracorporeal circulation include complement and inflammatory reactions, coagulation and thrombogenesis, frank hemolysis, and platelet activation and adhesion to the extracorporeal circuit. Non-physiologic pressure and flow produced by blood pumps contribute to blood injury. Two pump types, roller and centrifugal, are u...

  20. Warm World Ocean Thermohaline Circulation Model

    Science.gov (United States)

    Zimov, N.; Zimov, S. A.

    2014-12-01

    Modern day ocean circulation is dominated by thermal convection with cold waters subsiding in the Northern Atlantic, filling the ocean interior with cold and heavy water. However, ocean circulation diminished during the last glaciation and consequently the downwelling of the cold. Therefore interior ocean water temperatures must have been affected by other mechanisms which are negligible in the current state. We propose that the submergence of highly saline water from warm seas with high rates of evaporation (like the Red or Mediterranean Sea) was a major factor controlling ocean circulation during the last glaciation. Even today, waters in these poorly connected seas are the heaviest waters in the World ocean (1.029 g/cm3). The second mechanism affecting ocean temperature is the geothermal heat flux. With no heat exchange between the atmosphere and the ocean, geothermal heat flux through the ocean floor is capable of increasing ocean temperature by tens of degrees C over a 100 thousand year glacial cycle. To support these hypotheses we present an ocean box model that describes thermohaline circulation in the World Ocean. According to the model parameters, all water circulation is driven by the water density gradient. Boxes include high-latitude seas, high salinity seas, surface ocean, glaciers, and rift and lateral zones of the ocean interior. External heat sources are radiative forcing, affected by Milankovich cycles, and geothermal heat flux. Additionally this model accounts for the heat produced by organic rain decay. Taking all input parameters close to currently observed values, the model manages to recreate the glacial-interglacial cycles. During the glacial periods only haline circulation takes place, the ocean is strongly stratified, and the interior ocean accumulates heat while high-latitudes accumulate ice. 112,000 years after glaciation starts, water density on the ocean bottom becomes equal to the density of water in high-latitude seas, strong thermal